G/GJ tubes: What to do if your child’s feeding tube is pulled out

​​If your child’s feeding tube is accidentally pulled out, you may re-insert it if you have learned how to do so.

If your child has a G or GJ tube (anything other than a low-profile G tube​), and it is accidentally pulled out, it is important to insert an emergency tube in the tract as soon as possible to prevent it from closing.

The emergency tube you will use is called a Foley catheter. It will be one size smaller than your child’s G or GJ tube. For example, if your child has a 12 FR tube, the Foley catheter will be 10 FR.

The sooner you insert the Foley catheter, the easier it will be. You will need to carry your emergency supplies with you at all times in case the tube is accidentally pulled out.

Your emergency supplies will include:

  • a Foley catheter one size smaller than your child’s tube
  • water-based lubricating jelly
  • tape
  • a 3 mL slip-tip syringe with 3 mL of sterile or distilled water.

​​Inserting the emergency Foley catheter

The steps for inserting the Foley catheter differ if your child’s G tube is new or if they have had it for a while. If the G tube is new, the tract might not be healed (this usually takes eight weeks). If your child has a GJ tube, it will be treated like a new tube no matter how long it has been in.​​

Within eight weeks of getting the tube

The first eight weeks after your child first gets their tube is the most important time for healing.

If your child’s G tube is accidentally pulled out within eight weeks of when it was put in, do the following.

  1. Gather your Foley catheter, lubricating jelly and tape.
  2. Wash your hands and the skin around your child’s feeding tube with soap and water.
  3. Wet the tip of the Foley catheter with the lubricating jelly. If you do not have lubricating jelly, you can wet the tip of the Foley catheter with water.
  4. Measure the Foley catheter against your index finger (about 4 to 6 cm). Insert this amount into the stoma and into your child’s stomach.
  5. Tape the Foley catheter to your child’s stomach.

Do not use the Foley catheter to give your child food, liquids or medications. If your child cannot eat or drink by mouth, you may insert a nasogastric tube​ if you have been trained to do this. If not, go to the closest emergency room as soon as possible.

Eight or more weeks after getting the tube

If your child’s tube is pulled out eight or more weeks after getting the tube, do the following.

  1. Gather your Foley catheter, lubricating jelly, tape, and syringe with water.
  2. Wash your hands and the skin around your child’s feeding tube with soap and water.
  3. Wet the tip of the Foley catheter with the lubricating jelly.
  4. Measure the Foley catheter against your index finger (about 4 to 6 cm).​ Insert this amount into the stoma and into your child’s stomach.
  5. Tape the Foley catheter to the skin.
  6. Once the Foley catheter is in place, fill the balloon with 3 mL of sterile or distilled water. This will help to keep the tube in place while you are feeding your child.
  7. You will likely see stomach contents coming from the end of the Foley catheter. If you do not see stomach contents, using an adaptor or extension, connect a syringe to the end of the Foley catheter and pull back.
  8. After you see stomach contents, flush the tube with sterile or distilled water.
  9. Close the Foley catheter with either a catheter plug, the plunger of the syringe or an extension set.

Do not use the Foley catheter to feed or give liquids or medications until you know it is in the right place. If you cannot get stomach contents back from the Foley catheter, contact your G tube specialist before feeding.

When to get medical help

Stop feeding and seek medical help if your child has any of the following problems after the Foley catheter is inserted:

  • a hard bloated stomach
  • severe pain in the stomach
  • vomiting, coughing or gagging
  • sudden high fever
  • Diarrhea
  • problems with food and liquids getting into the lungs (aspiration)
  • problems breathing.

If your child has a GJ tube

Regardless of how long the GJ tube has been in, the Foley catheter will need to be inserted as described above. You may only feed through the Foley catheter if it is safe to feed your child into the stomach, which is not always the case (for example, if the GJ tube is inserted through the stomach but lies in the small intestine, where the child is fed directly). Speak to your medical team about emergency feeding options for your child.

If you cannot insert the Foley catheter, contact your G tube specialist.

Once the emergency catheter is in place, a new G tube or GJ tube will need to be inserted at the hospital. If you are not able to use the Foley catheter to feed (if your child’s G tube was inserted in the last eight weeks, or if your child uses a GJ tube), this should be done as soon as possible. During business hours, call the radiology department of your hospital. For help after hours, on the weekend, or during holidays, go to the emergency department of your hospital for help.

If your child’s G tube had been in for eight weeks or longer, you can use the Foley catheter to feed for up to one month. This means replacing the tube is not urgent situation, and you can contact your G tube specialist on the next working day.

Key points

  • If your child’s G tube or GJ tube is accidentally pulled out, you must insert a Foley catheter into the tract as soon as possible.
  • You must keep your emergency supplies with you at all times, wherever you go.
  • The Foley catheter will be one size smaller than your child’s G tube or GJ tube.
  • If your child’s tube is accidentally pulled out within 8 weeks of when it was put in, insert the Foley catheter but do not feed or inflate the Foley catheter’s balloon. Have an emergency plan.
  • If your child’s tube is accidentally pulled out after 8 weeks, insert the Foley catheter, inflate the balloon, and feed for as long as one month.
  • Stop feeding your child with the Foley catheter if he or she has a hard bloated stomach, severe stomach pain, vomiting, gagging, high fever, trouble breathing, or diarrhea.
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Holly Norgrove, RN, BScN

9/7/2015
Notes: