Topic: Tests & Procedures
This handout was written to answer some of the questions most often asked about caring for a gastrostomy button. Feel free to ask your doctor or nurse to go over any information you do not understand. Your child has been fitted with a G-button to replace the G-tube.
HOW DO I GIVE A BOLUS FEED?
1. Make sure formula is warmed or at least room temperature before giving through the tube. Give _____ oz. of ________________ over ______minutes.
2. Open the safety plug and attach feeding tube.
3. Child should be in a sitting or reclined position.
4. Open the clamp on tube and allow the feed to flow in.
5. When feeding is done, rinse inside of the tube using _____oz. of water to clear formula from tubing. Remove the tube and replace safety plug.
6. Rinse tubing well.
HOW DO I DO A CONTINUOUS FEED?
1. Clamp the feeding bag tubing.
2. Fill feeding bag with approximately four hours worth of cold or room temperature formula.
3. Attach feeding bag tubing to G-button tubing.
4. Unclamp feeding bag tubing, let formula run through the tubing, and reclamp.
5. Place tubing in pump.
6. Set pump at ___cc/hr.
7. Open the button safety plug and attach tube.
8. Unclamp tubing and turn pump on.
9. When feeding bag is almost empty, add another four hours worth of formula.
10. Feeding bag and tubing should be changed every day.
HOW DO I LET EXCESS AIR OUT OF THE STOMACH?
1. Attach bolus feeding tube to button.
2. Place a syringe on the tubing; for Bard, must use a decompression tube.
3. Open the button safety plug and attach the tube.
4. Sit your child up until the gas or stomach bloating is relieved.
5. Remove the tube and replace the safety plug.
HOW DO I GIVE MEDICINES THROUGH THE G-BUTTON?
1. Check to see what pills or tablets could be in liquid form.
2. Crush tablets and mix with warm water.
3. Flush with 10cc H20.
4. Open safety plug and attach tube and syringe.
5. Give medicine through tube and rinse the tube with ____cc of lukewarm water.
6. Remove the tube and replace the safety plug.
HOW DO I CLEAN THE SKIN AROUND THE G-BUTTON?
1. Use mild soap and warm water or half strength hydrogen peroxide (equal parts of water and hydrogen peroxide mixed together).
2. Clean skin in a circular motion with a cotton swab or gauze.
3. Turn the button every day.
4. Allow area to air dry.
5. Check for signs of redness, soreness, swelling or unusual drainage.
WHAT ARE SOME PROBLEMS?
1. Button is clogged. If the button is pulled out, don’t panic. Call your child’s doctor right away.
2. Button is pulled out or breaks
a. Attempt to replace button and tape in place
b. If unable to replace:
1. FOR GI PATIENTS – During office hours (8:00 am – 4:00 pm) call the GI office at (937) 641-3090 for replacement in the clinic.
FOR SURGERY PATIENTS – during office hours call the office at (937) 641-3090
c. After hours, weekends or holidays, come into the Almost Home Unit (AHU) on the fourth floor at The Children’s Medical Center for replacement. (Bring old button with you to the clinic or AHU.)
d. Call AHU (937) 641-3060 before coming to let them know you are on your way and what the button size and length is so that they can be sure to have supplies available.
3. Stoma (gastrostomy site) looks irritated (redness, swelling or drainage) Redness or soreness of the skin around the tube may be the result of gastric leakage (see #4).
Clean and dry the area 3-4 times daily. Be sure to rotate the button in full circle with cleaning.
Call the doctor if:
• The skin around stoma remains red and sore
• The red area is larger than a quarter
• There is an odor from the stoma
• Drainage of pus from around the tube
Granulation tissue – this is the excessive growth of scar tissue, an attempt by the body to repair the site. The tissue may grow, bleed and/or produce drainage and may require treatment. Contact the doctor for treatment.
4. Leaking around the tube
a. Vent the stomach. The stomach may be too full of formula or gas.
b. Check the fluid level in the balloon by attaching a syringe to the side inflation valve and withdraw the fluid from the balloon.
c. If amount is less than prescribed, re-inflate the balloon with the appropriate amount.
d. If the volume of fluid is appropriate, try increasing the volume by 1cc (up to a total of 10cc) until the leak stops.
e. If leaking continues, call the doctor.
5. Tube gets disconnected during a feeding
Try to figure out how much formula was lost. Put the feeding tube back in the G-button and continue the feeding. Add more formula to replace the formula that was lost.
6. If your child is admitted to the hospital
Bring your child’s feeding tubing to the hospital. The hospital may not have the right size or type of tubing readily available.
Derechos de autor(c) de The Children's Medical Center, ano 1999. Este material unicamente tiene fines educativos. No puede ser reproducido, distribuido ni modificado sin previa autorizacion de The Children's Medical Center of Dayton, One Children's Plaza, Dayton, Ohio, 45404-1815. Llame al 937-641-3666 para solicitar autorizacion o para obtener un juego maestro para copias. Para obtener mas informacion puede visitar www.childrensdayton.org (consulte la seccion de informacion legal).
La informacion contenida en este material es unicamente informacion de tipo general. No debe considerarse como completa. Para obtener mas informacion acerca de los complementos para leche materna, por favor pidala a su doctor.
The information contained in this handout is for general information only and should not be considered complete. For specific information about bathing your baby, please ask your doctor or nurse practitioner.
Additional information may be located in the Family Resource Center, 2nd floor, near the Outpatient Surgery Center. Hours of the center vary; please contact the Family Resource Center at 937-641-3700.
Copyright(c) The Children's Medical Center of Dayton. This material is for educational purposes only. It cannot be reproduced or distributed without permission from Dayton Children's.
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