Any kind of feeding tube usually works well – some may be a little more troublesome than others. Most of the time things go well – tubes remain patent, deliveries of supplies are made, pumps work well etc. – BUT what if things do not go to plan? Being prepared for any eventuality is the key to being successful with tube feeding. Forward thinking is a must. Make sure that discussions are held with your dietitian and/or health care professional so you are fully prepared and that all family and care givers are aware of any plans in place for emergencies.
As winter is on the way, there are additional things to think about such as power outages. Most of the feeding pumps have battery backup – but what if the pump was used all day and the pump has no charge left? Or if the hydro is out for more than a day? Do you have a plan for fluids/formula to be given? Discuss with your dietitian/doctor to check if it is okay to give formula by syringe in an emergency (especially if your tube is a Jejunostomy tube). It may be worth keeping a gravity bag available so that you can control the rate of the formula over a period of time rather than giving a bolus of formula.
What if the feeding tube blocks and your usual methods to unblock do not work? If your tube blocks frequently, discuss with your health care professional for advice on how to reduce blockages and possibly having a pancreatic enzyme eg Cotazym available to use to try and break down the blockage. Do you have a spare tube – is it easy to replace – and have you been trained on how to do this? If you have a GJ tube you would need to have the tube replaced at your local hospital.
If your GTube gets pulled out or falls out the main priority is to keep the tract from closing. It is important to replace the tube (either with a spare GTube or foley catheter) as soon as possible as the tract can close very quickly. You should always have a spare GTube or foley catheter available to insert into the tract (your Health Care Professional should train you on how to do this).
If the GTube comes out and it is a newly sited GTube, and the tract is less than 4 weeks old you would need to go directly to hospital for the tube to be reinserted, as the tract may not yet have fully formed. You should have been given information on who to contact in an emergency when the GTube was put in place.
For a GJ tube you would need to go to hospital for the tube to be replaced, however you could always insert a foley catheter to keep the tract open until you can be seen. This would only go into your stomach and not your jejunum – discuss with your health care professional before an emergency situation arises, to check if you may use this for feeding over the short term until it can be replaced – especially if there may be a delay in treatment .
What if your regular delivery of supplies is late getting to you because of weather conditions? Do you have spare supplies?
As a general rule it is always a good idea to have emergency supplies available:
- Spare G tube or foley catheter which should be the same FR size as your G Tube. Some people prefer to have a smaller FR size available as well in case the hole has shrunk and they are unable to insert the regular size
- Lubricant sachets – always use lubricant before attempting to insert a G Tube or catheter – some g tube kits come with this
- 5 or 10ml slip tip syringe for the balloon – G tube kit may have this
- 60ml syringe for flushing the tube
- Gauze and tape to secure if using a foley catheter
- Bottle of water