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G/GJ tubes: What to do if your child’s feeding tube is blockedGG/GJ tubes: What to do if your child’s feeding tube is blockedG/GJ tubes: What to do if your child’s feeding tube is blockedEnglishGastrointestinalChild (0-12 years);Teen (13-18 years)Abdomen;Small Intestine;StomachDigestive systemNon-drug treatmentAdult (19+) CaregiversNA2018-04-11T04:00:00ZTharini Paramananthan, RN, BScN, MScN;Silvana Oppedisano, MN, RN(EC)Health (A-Z) - ProcedureHealth A-Z<p>Learn what to do if your child's feeding tube becomes blocked.</p><p>If your child has a G or GJ tube, and it becomes blocked by formula or medications, it is important to try to unblock the tube as soon as possible. Leaving the tube blocked will delay or prevent food (i.e., formula), liquid, and medications from entering the stomach or jejunum (small intestine). The longer the tube remains blocked, the harder it may be to unblock.<br></p><h2>Key points</h2><ul><li>If your child’s tube becomes blocked, it is important to try to unblock the tube right away.</li><li>If your child’s tube has an adaptor, remove it first to check if it is the cause of the blockage.</li><li>Use a pulsing push-and-pull motion with warm water to try to unblock your child’s feeding tube. If this does not work, contact your G tube specialist.</li><li>If you have a prescription for pancreatic enzymes and sodium bicarbonate, try this method if warm water does not work.</li><li>If your child has a low-profile G tube, first try to flush the tube via the feeding port before removing the tube and unblocking it manually. If this does not work, change the low-profile tube or insert a Foley catheter.</li><li>Prevent tube blockage by flushing with 5 to 10 mL water before and after you give food or medication, and every four hours during continuous feeds.<br></li></ul><h2>How to unblock a feeding tube</h2><p>There are two different ways to unblock a feeding tube at home. Try using warm water first. If that doesn’t work, you can use activated pancreatic enzymes.<br></p><h3>Using warm water</h3><p>To unblock your child’s G tube or GJ tube, you will need a 1 mL and 5 mL slip-tip syringe and warm water.</p><ol><li>Fill the 1 mL and 5 mL slip-tip syringes with warm water.</li><li>If your child’s tube has an adaptor attached to the end of the tube, remove it.</li><li>Connect the 1 mL syringe directly to the feeding tube.</li><li>Using a pulsing push-and-pull motion, insert as much water into the tube as possible. This thrusting motion will help clear out any formula or medication that has built up inside the tube. You may have to try this a few times to unblock the tube.</li><li>When the tube is no longer blocked, flush with at least 5 mL of warm water.</li><li>If you removed the adaptor to attach the 1ml syringe directly to the tube, re-attach it to the tube to resume feeds and medication administrations.</li></ol><h3>Using activated pancreatic enzymes</h3><p>If you cannot unblock the feeding tube with warm water, you can try using pancrelipase (a combination of pancreatic enzymes) and sodium bicarbonate. This mixture works very well when the tube becomes blocked with formula. You will need a prescription from your physician or nurse practitioner to get the pancreatic enzymes from pharmacy. Your G tube specialist (at SickKids, this is the G Tube Resource Nurse) may provide you a prescription as well.</p><p>When using the pancreatic enzymes, please consider the following:</p><ol><li>Pancrelipase is made from pork products. Cultural and dietary considerations must be considered.</li><li>If your child has an allergy to pork products, do not attempt this.</li><li>There is a possibility of skin irritation and redness if the pancreatic enzymes are left on the skin. When opening the capsule, be careful not to spill the contents on the skin. If you do, simply wash the area with soap and water right away.</li></ol><p>To use the pancreatic enzymes, you will need one pancrelipase capsule, one sodium bicarbonate 325 mg tablet, sterile or distilled water, and two 5 mL syringes (one to mix the medications and one to flush).</p><p>This is what you can do:</p><ol><li>Wash your hands.</li><li>Open the pancreatic enzyme capsule.</li><li>Crush the sodium bicarbonate tablet.</li><li>Mix the two drugs together with 5 to 10 mL of warm sterile or distilled water.</li><li>Push as much of the mixture into the tube as possible; then let it sit in the tube for 30 minutes.</li><li>Attempt to flush the tube with at least 5 mL of sterile or distilled water.</li><ul><li>If your child is younger than 1 year, only try this procedure once.</li><li>If your child is older than 1 year, you can repeat the procedure twice. If you are unsuccessful in unblocking the tube, you may repeat this procedure immediately after the first attempt. Ensure you aspirate all the remaining pancreatic enzyme mixture in the tube prior pushing the new mixture.</li></ul><li>If the tube has become unblocked, flush with at least 5 mL of sterile or distilled water and continue with your feeds and medications.</li></ol><p>If warm water or activated pancreatic enzymes do not unblock the feeding tube, and if your child has a G tube or GJ tube that cannot be replaced by you at home, contact your child’s G tube specialist to have your child’s tube replaced in hospital.</p><h2>If your child’s low-profile tube is blocked</h2><p>Low-profile balloon type G tubes, such as the Mic-Key button or AMT MiniONE, rarely block because they are much shorter than other types of G tubes. Ensure the extension tubing is not blocked by flushing it with 5 to 10 mL of warm sterile water. If the extension tubing is blocked, replace it with new extension tubing. If you have been trained to change your child’s low-profile balloon type G tube, you may replace the feeding tube with a new one.</p><ol><li>Wash your hands with soap and water.</li><li>Use a slip tip syringe to deflate the balloon of the tube. Throw this water away.</li><li>Remove the tube from the stoma.</li><li>You may see a physical blockage in the tube. Use your index finger and thumb to squeeze the tube at the site of the blockage. Flush the tube with at least 5 mL of water to attempt to remove the blockage.</li><li>If you are successful at unblocking the low-profile G tube, and the tube is not broken, wash the low-profile G tube with soap and water, lubricate the tip of the low-profile G tube and re-insert it into the stoma. Once inserted, inflate the balloon with the amount of sterile or distilled water you normally use.</li><li>You will then need to check that the tube is in the stomach. Do this by attaching the extension tubing to the tube and pull back with a syringe until you see stomach contents flow from the tube. Once you see stomach contents, flush the tube with 5 mL of water.</li><li>If you are unsuccessful at unblocking the low-profile tube, or the tube is broken, insert a new low-profile G tube or a Foley catheter. If you have inserted the Foley catheter, contact your G tube specialist to arrange for the low-profile tube to be replaced.</li></ol><h2>How do you know if a feeding tube is blocked?</h2><ul><li>If your child receives a feed continuously via the feeding pump, the feeding pump may beep, saying there is an occlusion or flow error. This may be a problem with the pump, the feeding bag, or the tube itself.</li><li>If your child receives feed via gravity using a feeding bag, you may notice the feed stops dripping in the dripping chamber of feeding bag system.</li><li>When you are flushing your child’s tube, it may feel hard to push and only a small amount of fluid will go into the tube. This is a called a “partial blockage.”</li><li>When you are flushing your child’s tube, you may not be able to get any fluid at all into the tube. This usually means the tube is completely blocked.</li></ul><p>If your child’s G or GJ tube has any adaptors at the end of their tube, remove them and flush with water to ensure patency of adaptor. If you remove the adaptor and stomach contents flow back from the tube, your tube is not truly blocked. Rather, the adaptor was blocked and it can be washed or replaced. However, if the G tube or GJ tube does not flow back after removing the adaptor, this means the tube is blocked.</p><h2>At SickKids</h2><p>If your child is a SickKids patient, contact the G Tube Resource Nurse with any concerns.</p><h3>G Tube Resource Nurse contact info:</h3><p>Monday – Friday: 8 am – 4 pm</p><p>Phone 416-813-7177</p><p>Pager 416-377-1271</p><p>g.tubenurse@sickkids.ca</p><p>On weekends/afterhours, you may need to come to the Emergency Department for an alternate method of feed/fluids/medication administration.</p>

 

 

G/GJ tubes: What to do if your child’s feeding tube is blocked3039.00000000000G/GJ tubes: What to do if your child’s feeding tube is blockedG/GJ tubes: What to do if your child’s feeding tube is blockedGEnglishGastrointestinalChild (0-12 years);Teen (13-18 years)Abdomen;Small Intestine;StomachDigestive systemNon-drug treatmentAdult (19+) CaregiversNA2018-04-11T04:00:00ZTharini Paramananthan, RN, BScN, MScN;Silvana Oppedisano, MN, RN(EC)Health (A-Z) - ProcedureHealth A-Z<p>Learn what to do if your child's feeding tube becomes blocked.</p><p>If your child has a G or GJ tube, and it becomes blocked by formula or medications, it is important to try to unblock the tube as soon as possible. Leaving the tube blocked will delay or prevent food (i.e., formula), liquid, and medications from entering the stomach or jejunum (small intestine). The longer the tube remains blocked, the harder it may be to unblock.<br></p><h2>Key points</h2><ul><li>If your child’s tube becomes blocked, it is important to try to unblock the tube right away.</li><li>If your child’s tube has an adaptor, remove it first to check if it is the cause of the blockage.</li><li>Use a pulsing push-and-pull motion with warm water to try to unblock your child’s feeding tube. If this does not work, contact your G tube specialist.</li><li>If you have a prescription for pancreatic enzymes and sodium bicarbonate, try this method if warm water does not work.</li><li>If your child has a low-profile G tube, first try to flush the tube via the feeding port before removing the tube and unblocking it manually. If this does not work, change the low-profile tube or insert a Foley catheter.</li><li>Prevent tube blockage by flushing with 5 to 10 mL water before and after you give food or medication, and every four hours during continuous feeds.<br></li></ul><h2>Preventing a blockage</h2><p>The best way to prevent a feeding tube from getting blocked with formula or medication is by keeping the inside of the feeding equipment and feeding tube as clean as possible.</p><ul><li>Flush the G tube or GJ tube with 5 to 10 mL of water before and after every feeding.</li><li>Flush the G tube or GJ tube before and after every dose of medication.</li><li>Flush the G tube or GJ tube every four hours during continuous feeds.</li><li>Clean the feeding bag and all extension tubing after each feeding and each dose of medication. You may use hot water and soap or a water and vinegar mixture to clean the tubing.</li><li>Dissolve all medications completely before administering them through the G tube or GJ tube.</li><li>Work with your pharmacy team to choose the best form of medications for use with a G tube or GJ tube.</li></ul><h2>How to unblock a feeding tube</h2><p>There are two different ways to unblock a feeding tube at home. Try using warm water first. If that doesn’t work, you can use activated pancreatic enzymes.<br></p><h3>Using warm water</h3><p>To unblock your child’s G tube or GJ tube, you will need a 1 mL and 5 mL slip-tip syringe and warm water.</p><ol><li>Fill the 1 mL and 5 mL slip-tip syringes with warm water.</li><li>If your child’s tube has an adaptor attached to the end of the tube, remove it.</li><li>Connect the 1 mL syringe directly to the feeding tube.</li><li>Using a pulsing push-and-pull motion, insert as much water into the tube as possible. This thrusting motion will help clear out any formula or medication that has built up inside the tube. You may have to try this a few times to unblock the tube.</li><li>When the tube is no longer blocked, flush with at least 5 mL of warm water.</li><li>If you removed the adaptor to attach the 1ml syringe directly to the tube, re-attach it to the tube to resume feeds and medication administrations.</li></ol><h3>Using activated pancreatic enzymes</h3><p>If you cannot unblock the feeding tube with warm water, you can try using pancrelipase (a combination of pancreatic enzymes) and sodium bicarbonate. This mixture works very well when the tube becomes blocked with formula. You will need a prescription from your physician or nurse practitioner to get the pancreatic enzymes from pharmacy. Your G tube specialist (at SickKids, this is the G Tube Resource Nurse) may provide you a prescription as well.</p><p>When using the pancreatic enzymes, please consider the following:</p><ol><li>Pancrelipase is made from pork products. Cultural and dietary considerations must be considered.</li><li>If your child has an allergy to pork products, do not attempt this.</li><li>There is a possibility of skin irritation and redness if the pancreatic enzymes are left on the skin. When opening the capsule, be careful not to spill the contents on the skin. If you do, simply wash the area with soap and water right away.</li></ol><p>To use the pancreatic enzymes, you will need one pancrelipase capsule, one sodium bicarbonate 325 mg tablet, sterile or distilled water, and two 5 mL syringes (one to mix the medications and one to flush).</p><p>This is what you can do:</p><ol><li>Wash your hands.</li><li>Open the pancreatic enzyme capsule.</li><li>Crush the sodium bicarbonate tablet.</li><li>Mix the two drugs together with 5 to 10 mL of warm sterile or distilled water.</li><li>Push as much of the mixture into the tube as possible; then let it sit in the tube for 30 minutes.</li><li>Attempt to flush the tube with at least 5 mL of sterile or distilled water.</li><ul><li>If your child is younger than 1 year, only try this procedure once.</li><li>If your child is older than 1 year, you can repeat the procedure twice. If you are unsuccessful in unblocking the tube, you may repeat this procedure immediately after the first attempt. Ensure you aspirate all the remaining pancreatic enzyme mixture in the tube prior pushing the new mixture.</li></ul><li>If the tube has become unblocked, flush with at least 5 mL of sterile or distilled water and continue with your feeds and medications.</li></ol><p>If warm water or activated pancreatic enzymes do not unblock the feeding tube, and if your child has a G tube or GJ tube that cannot be replaced by you at home, contact your child’s G tube specialist to have your child’s tube replaced in hospital.</p><h2>If your child’s low-profile tube is blocked</h2><p>Low-profile balloon type G tubes, such as the Mic-Key button or AMT MiniONE, rarely block because they are much shorter than other types of G tubes. Ensure the extension tubing is not blocked by flushing it with 5 to 10 mL of warm sterile water. If the extension tubing is blocked, replace it with new extension tubing. If you have been trained to change your child’s low-profile balloon type G tube, you may replace the feeding tube with a new one.</p><ol><li>Wash your hands with soap and water.</li><li>Use a slip tip syringe to deflate the balloon of the tube. Throw this water away.</li><li>Remove the tube from the stoma.</li><li>You may see a physical blockage in the tube. Use your index finger and thumb to squeeze the tube at the site of the blockage. Flush the tube with at least 5 mL of water to attempt to remove the blockage.</li><li>If you are successful at unblocking the low-profile G tube, and the tube is not broken, wash the low-profile G tube with soap and water, lubricate the tip of the low-profile G tube and re-insert it into the stoma. Once inserted, inflate the balloon with the amount of sterile or distilled water you normally use.</li><li>You will then need to check that the tube is in the stomach. Do this by attaching the extension tubing to the tube and pull back with a syringe until you see stomach contents flow from the tube. Once you see stomach contents, flush the tube with 5 mL of water.</li><li>If you are unsuccessful at unblocking the low-profile tube, or the tube is broken, insert a new low-profile G tube or a Foley catheter. If you have inserted the Foley catheter, contact your G tube specialist to arrange for the low-profile tube to be replaced.</li></ol><h2>How do you know if a feeding tube is blocked?</h2><ul><li>If your child receives a feed continuously via the feeding pump, the feeding pump may beep, saying there is an occlusion or flow error. This may be a problem with the pump, the feeding bag, or the tube itself.</li><li>If your child receives feed via gravity using a feeding bag, you may notice the feed stops dripping in the dripping chamber of feeding bag system.</li><li>When you are flushing your child’s tube, it may feel hard to push and only a small amount of fluid will go into the tube. This is a called a “partial blockage.”</li><li>When you are flushing your child’s tube, you may not be able to get any fluid at all into the tube. This usually means the tube is completely blocked.</li></ul><p>If your child’s G or GJ tube has any adaptors at the end of their tube, remove them and flush with water to ensure patency of adaptor. If you remove the adaptor and stomach contents flow back from the tube, your tube is not truly blocked. Rather, the adaptor was blocked and it can be washed or replaced. However, if the G tube or GJ tube does not flow back after removing the adaptor, this means the tube is blocked.</p><h2>At SickKids</h2><p>If your child is a SickKids patient, contact the G Tube Resource Nurse with any concerns.</p><h3>G Tube Resource Nurse contact info:</h3><p>Monday – Friday: 8 am – 4 pm</p><p>Phone 416-813-7177</p><p>Pager 416-377-1271</p><p>g.tubenurse@sickkids.ca</p><p>On weekends/afterhours, you may need to come to the Emergency Department for an alternate method of feed/fluids/medication administration.</p>G/GJ tubes: What to do if your child’s feeding tube is blockedFalse

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