G/GJ tubes: Mic-Key low-profile GJ tubeGG/GJ tubes: Mic-Key low-profile GJ tubeG/GJ tubes: Mic-Key low-profile GJ tubeEnglishGastrointestinal;OtherChild (0-12 years);Teen (13-18 years)Stomach;Small IntestineDigestive systemProceduresAdult (19+) CaregiversNA2019-05-22T04:00:00Z7.8000000000000066.40000000000001161.00000000000Health (A-Z) - ProcedureHealth A-Z<p>A low-profile GJ tube is a type of feeding tube. Learn how to care for your child's GJ tube and how to give feeds and medication.</p><figure><span class="asset-image-title">Low-profile GJ tube</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/GTubes_LowProfile_JTube.jpg" alt="low-profile GJ tube showing balloon, balloon port, and feeding port" /> </figure> <p>A low-profile GJ tube is a type of feeding tube that provides fluids, nutrition and medications directly to the small intestine (jejunum). It is called "low-profile" because it sits close to the skin and is very discreet. Low-profile GJ tubes are placed by an interventional radiologist using image guidance.<br></p><p>A Mic-Key low-profile GJ tube is not used for primary tube insertion, instead it is a transition tube. This means that your child will have had a different type of feeding tube before transitioning to the low-profile GJ tube.</p><p>The low-profile GJ tube is placed through an opening in your child's abdomen called a stoma. The tunnel from the outside through the stoma is called the tract.<br></p><h2>Key points</h2><ul><li>A low-profile GJ tube is a type of feeding tube that provides fluids, nutrition, and medication directly to the small intestine (jejunum). It is different than a surgical J tube, which is also inserted into the small intestine.</li><li>The feeding extension set should be cleaned between each use. It should be replaced as needed.</li><li>Check the volume of water in the balloon at least once per week.</li><li>Keep the stoma and surrounding skin clean and dry, and check for signs of infection, irritation, hypergranulation tissue or leakage.</li><li>Contact the G tube team if the stoma site is infected or leaking, your child has abdominal pain or signs of respiratory distress, or if the tube is damaged.</li></ul><h2>When to seek medical attention</h2><p>Contact the G tube specialist if you notice any of the following signs and symptoms:</p><ul><li>Your child's stoma site appears infected with redness, edema (swelling) and odorous discharge.</li><li>There is hypergranulation tissue, which is pink to bright red, bloody, raw, moist, oozing yellow sticky discharge and/or painful.</li><li>The stoma site is leaking intestinal or stomach contents and /or formula.</li><li>Your child experiences abdominal pain, distension, discomfort, vomiting and/or other signs of feeding intolerance.</li><li>Your child has signs of respiratory distress (i.e. higher breathing rate or difficulty breathing).</li><li>The tube appears to be damaged, broken, or dislodged.</li></ul><h2>If the tube has moved into the stomach</h2><p>If the Mic-Key low-profile GJ tube has moved out of the small intestine and into the stomach, your child may experience:</p><ul><li>increased vomiting</li><li>vomiting formula</li><li>gagging and retching</li><li>abdominal discomfort or pain</li><li>bloated stomach</li><li>diarrhea</li><li>leaking of formula from the stoma</li></ul><p>The position of the tip of GJ tube will need to be confirmed by an interventional radiologist using image guidance. Do not use the tube for feeding until the tube position is confirmed.</p><h3>Intussusception </h3><p> <a href="/Article?contentid=958&language=English">Intussusception</a> may occur around the tube. Intussusception refers to when one part of the small bowel slides into the next part. This may lead to a bowel obstruction at the tip of the GJ tube. Large GJ tubes and/or normal movements of the bowels may cause intussusception. </p><p>A child with intussusception will experience:</p><ul><li>discomfort and feeding intolerance (vomiting when fed)</li><li>vomiting bile (green fluid)</li><li>diarrhea or blood in the stool</li></ul><p>If your child’s tube has intussuscepted, contact your G tube specialist during business hours. After hours, on weekends or on holidays, take your child to the Emergency Department.</p><h2>Giving feeds, liquids and medication through the low-profile GJ tube</h2><p>Your child's tube feeds are to remain the same as with previous GJ tube exchanges.</p><p>A Mic-Key low-profile GJ tube extension set needs to be attached to the feeding port to administer feeds and medications. A slip-tip syringe can be attached directly to the feeding port; however, this is not recommended as the one-way valve can break with frequent access. The one-way valve is built inside the GJ tube and prevents the stomach contents from flowing back out through the tube.</p><h3>Connecting the extension set to the tube</h3> <figure><span class="asset-image-title">Low-profile GJ tube with feeding extension set</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/PMD_j_tube_mic_key_01_EN.jpg" alt="" /> </figure> <ol><li>Open the plastic cover on the feeding tube.</li><li>Make sure the clamp on the extension set is closed.</li><li>Match the line on the extension to the line on the tube and push the extension into the valve.</li><li>Holding the button tube in place, turn the extension clockwise until you feel the extension lock into place. There is an arrow on the extension to show you which direction to turn it.</li><li>Attach your feeds, fluids and medications to the appropriate port at the end and open the clamp.</li><li>When you have finished using the extension, flush it with water and remove it from the tube.</li></ol><h3>Removing the extension from the tube</h3><ol><li>Clamp the extension.</li><li>Holding the tube in place, turn the extension counter-clockwise (opposite to the arrow on the extension).</li><li>Match the line on the extension to the line on the tube and remove the extension.</li><li>Close the plastic cover on the feeding tube.</li></ol><p>It is important to clean the extension set between each use and remove it from the low-profile GJ tube when it is not in use. The low-profile GJ tube's extension set should be replaced as needed (i.e. broken, rigid, stained).</p><p>Flush the low-profile GJ tube with at least 5 to 10 mL of water before and after each feed and medication dose, and every four hours during continuous feeds. This helps to prevent the low-profile GJ tube from becoming blo​cked. You may use <a href="/Article?contentid=3039&language=English">pancreatic enzymes</a> to unblock a low-profile GJ tube. This can be done at home.</p><p>For more information on what to do if your child's low-profile GJ tube is blocked, please see "<a href="/Article?contentid=3039&language=English">What to do if your child's feeding tube is blocked</a>".</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>Phone 416-813-7177</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>
Sondes gastriques et gastrojéjunales : sonde gastrojéjunale discrète Mic KeySSondes gastriques et gastrojéjunales : sonde gastrojéjunale discrète Mic KeyG/GJ tubes: Mic-Key low-profile J tubeFrenchGastrointestinal;OtherChild (0-12 years);Teen (13-18 years)Abdomen;Stomach;Small IntestineDigestive systemProceduresAdult (19+) CaregiversNA2018-02-02T05:00:00ZHealth (A-Z) - ProcedureHealth A-Z<p>Une sonde gastrojéjunale discrète est un genre de sonde d’alimentation. Apprenez à entretenir la sonde gastrojéjunale de votre enfant, et à le nourrir et à administrer ses médicaments au moyen de cette sonde.</p><figure> <img src="https://assets.aboutkidshealth.ca/AKHAssets/PMD_j_tube_mic_key_01_EN.jpg" alt="" /> </figure> <p>Une sonde gastrojéjunale discrète est un genre de sonde d’alimentation qui permet l’injection des liquides, des aliments et des médicaments directement dans l’intestin grêle (le jéjunum). On l’appelle « discrète » parce qu’elle repose tout contre la peau. Elle est insérée par un radiologiste interventionnel au moyen du guidage par imagerie.</p><p>La sonde gastrojéjunale discrète Mic-Key™ n’est pas une sonde permanente, mais bien une sonde provisoire. Autrement dit, votre enfant aura eu une autre sonde d’alimentation avant de se faire poser une sonde gastrojéjunale discrète.</p><p>On insère la sonde gastrojéjunale discrète dans une incision chirurgicale pratiquée dans l’abdomen de votre enfant au moyen d’une opération appelée stomie. Le tunnel allant de la surface de la peau à l’intérieur de l’estomac se nomme le tube.</p><h2>À retenir</h2><ul><li>Une sonde gastrojéjunale discrète est un genre de sonde d’alimentation qui injecte les liquides, les aliments et les médicaments directement dans l’intestin grêle (le jéjunum). Elle diffère de la sonde jéjunale insérée par chirurgie.</li><li>Il faut nettoyer les dispositifs à extension après chaque usage. Il faut aussi les remplacer au besoin.</li><li>Vérifiez le volume d’eau dans le ballon au moins une fois par semaine.</li><li>Tenez propres et au sec l’incision et la zone qui l’entoure; et soyez à l’affût de tout symptôme d’infection, d’irritation, d’écoulement ou de la formation de tissu de granulation.</li><li>Adressez-vous à l’infirmier-ressource si la zone de l’incision suinte ou est infectée, si votre enfant a mal au ventre ou présente des signes de détresse respiratoire, ou encore si la sonde est endommagée.</li></ul><h2>Quand faire appel aux services du personnel médical</h2><p>Communiquez avec l’infirmier-ressource si vous constatez l’un des symptômes suivants :</p><ul><li>La zone d’incision semble infectée : elle est rouge et gonflée, et elle émet un liquide malodorant.</li><li>Vous constatez la formation d’un tissu de granulation, dont la couleur va de rose à rouge vif et qui est sanguinolent, à vif, humide ou douloureux, ou qui émet un liquide jaune et visqueux.</li><li>De la préparation lactée pour nourrisson ou encore le contenu des intestins ou de l’estomac de votre enfant suintent de la zone d’incision.</li><li>Votre enfant a mal au ventre, souffre de distension ou d’inconfort, vomit ou manifeste d’autres symptômes d’intolérance alimentaire.</li><li>Il présente des symptômes de détresse respiratoire. Par exemple, il respire plus vite ou éprouve des difficultés à respirer.</li><li>La sonde semble être endommagée ou brisée, ou elle s’est détachée.</li></ul><h2>Alimentation et administration de liquides et de médicaments par la sonde gastrojéjunale discrète</h2><p>Les sondes d’alimentation de votre enfant demeureront les mêmes que lors des remplacements antérieurs de sondes gastrojéjunales.</p><p>Afin d’administrer les aliments et les médicaments, il faut fixer des dispositifs à extension au point d’alimentation de la sonde discrète Mic Key™. On peut fixer une seringue à pointe Slip directement au point d’alimentation. Il n’est toutefois pas recommandé de le faire, car la valve antireflux intégrée à la sonde risque de se briser après de multiples accès. C’est cette valve qui empêche le contenu de l’estomac de refluer dans la sonde.</p><p>Il est important de nettoyer les dispositifs à extension entre chaque utilisation et de les retirer de la sonde gastrojéjunale discrète lorsque vous ne vous en servez pas. Il faut les remplacer dès qu’ils sont brisés, qu’ils deviennent rigides ou qu’ils sont tachés.<br></p><p>Afin de prévenir l’obstruction de la sonde gastrojéjunale discrète, rincez la dans au moins 5 à 10 mL d’eau avant et après chaque dose d’aliments ou de médicaments, et toutes les quatre heures en cas d’alimentation continue. Vous pouvez déboucher la sonde aux <a href="/Article?contentid=3039&language=french">enzymes pancréatiques</a> et vous pouvez le faire à la maison. </p><p>Pour en savoir plus sur ce qu’il faut faire lorsque la sonde gastrojéjunale discrète de votre enfant est bloquée, veuillez consulter la section: <a href="/Article?contentid=3039&language=french">Quoi faire si la sonde d’alimentation est bouchée</a>.<br></p><h2>À l’hôpital SickKids</h2><p>Pour remplacer la sonde gastrique Corflo™, les patients de l’hôpital SickKids doivent demander à l’infirmier-ressource de prendre pour eux un rendez-vous avec la clinique de thérapie guidée par l’image.</p><h3>Coordonnées de l’infirmier-ressource :</h3><p>Du lundi au vendredi, de 8 h à 16 h</p><p>Téléphone : 416 813-7177</p><p>Téléavertisseur : 416 377-1271</p><p>g.tubenurse@sickkids.ca</p><p>La fin de semaine et après les heures d’ouverture, il est possible que l’enfant doive se rendre à l’urgence pour recevoir les aliments, les liquides et les médicaments dont il a besoin.</p>

 

 

 

 

G/GJ tubes: Mic-Key low-profile GJ tube2535.00000000000G/GJ tubes: Mic-Key low-profile GJ tubeG/GJ tubes: Mic-Key low-profile GJ tubeGEnglishGastrointestinal;OtherChild (0-12 years);Teen (13-18 years)Stomach;Small IntestineDigestive systemProceduresAdult (19+) CaregiversNA2019-05-22T04:00:00Z7.8000000000000066.40000000000001161.00000000000Health (A-Z) - ProcedureHealth A-Z<p>A low-profile GJ tube is a type of feeding tube. Learn how to care for your child's GJ tube and how to give feeds and medication.</p><figure><span class="asset-image-title">Low-profile GJ tube</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/GTubes_LowProfile_JTube.jpg" alt="low-profile GJ tube showing balloon, balloon port, and feeding port" /> </figure> <p>A low-profile GJ tube is a type of feeding tube that provides fluids, nutrition and medications directly to the small intestine (jejunum). It is called "low-profile" because it sits close to the skin and is very discreet. Low-profile GJ tubes are placed by an interventional radiologist using image guidance.<br></p><p>A Mic-Key low-profile GJ tube is not used for primary tube insertion, instead it is a transition tube. This means that your child will have had a different type of feeding tube before transitioning to the low-profile GJ tube.</p><p>The low-profile GJ tube is placed through an opening in your child's abdomen called a stoma. The tunnel from the outside through the stoma is called the tract.<br></p><p>Low-profile GJ tubes are different than surgically inserted J tubes. While both are inserted into the small intestine, the low-profile GJ tube enters through your child's stomach, passes through into the first part of the small intestine and ends in the jejunum. Surgical J tubes are inserted directly into the jejunum by a surgeon in an operating room.<br></p> <p>The G tube team provides support related to both low-profile GJ tubes and surgical J tubes after insertion.<br></p><h2>Key points</h2><ul><li>A low-profile GJ tube is a type of feeding tube that provides fluids, nutrition, and medication directly to the small intestine (jejunum). It is different than a surgical J tube, which is also inserted into the small intestine.</li><li>The feeding extension set should be cleaned between each use. It should be replaced as needed.</li><li>Check the volume of water in the balloon at least once per week.</li><li>Keep the stoma and surrounding skin clean and dry, and check for signs of infection, irritation, hypergranulation tissue or leakage.</li><li>Contact the G tube team if the stoma site is infected or leaking, your child has abdominal pain or signs of respiratory distress, or if the tube is damaged.</li></ul><h2>Caring for your child's low-profile GJ tube</h2> <figure><span class="asset-image-title">Low-profile GJ tube button</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/PMD_j_tube_mic_key_02_EN.jpg" alt="" /></figure> <p>The balloon port of your child's low-profile GJ tube helps to keep the tube from accidentally being pulled out. The balloon of a 14 French (FR)-size low-profile GJ tube can safely hold 5-10 mL of sterile or distilled water.</p><p>Here are some things to remember when caring for your child's low-profile GJ tube:</p><ul><li>Do not feed your child through the balloon port.</li><li>Do not fill the balloon with saline or air.</li><li>Filling the balloon with more or less water can affect the position of the tube.</li><li>Less water makes the tube stick out and more water brings the tube closer to the skin.</li></ul><p>Filling the balloon with more or less water can affect the fit of the tube to the skin. Less water in the balloon makes the tube sit looser and stick out from the skin. More water in the balloon makes the tube sit tighter and closer to the skin. If the tube is so tight you can see an indent in your child’s skin, you can decrease the amount of water in the balloon. If the tube sticks out too much and is dangling from the stoma, you can increase the amount of water in the balloon. If adjusting the balloon volume does not help with the fit of your child’s tube, you may need to have the tract re-measured by your G tube specialist.</p><h3>Checking the volume of water in the balloon</h3><p>It is important to check the amount of water in the balloon at least once a week. Use a 5 mL slip-tip syringe to do this.</p><ol><li>Insert a 5 mL syringe into the low-profile GJ tube's balloon port (marked "BAL" on a Mic-Key GJ tube).</li><li>Remove all the water from the balloon. Throw the removed water away - do not reuse it. It is normal for the removed water to be discoloured. You may re-use the syringe as long as you wash it well with hot water and soap.</li><li>Re-inflate the amount of new sterile or distilled water you usually use to inflate the balloon.</li></ol><p>It is normal to remove 0.5 mL less water from the balloon than you originally put in. This is because some of the water has evaporated.</p><p>If there is no water after attempting to withdraw, re-inflate the balloon with 5mL of water. After three to four hours, attempt to withdraw this water:</p><ul><li>If you get all the water back, the balloon may simply have been empty before. You can then re-inflate the balloon with the amount of water you normally put in. Check the balloon volume every two to three days to make sure there are no further problems.</li><li>If you do not get any water back when you withdraw after three to four hours, the balloon is likely damaged and the tube will need to be replaced. </li></ul><p>If you are concerned that the balloon is broken, there is a risk that the tube may be accidentally pulled out. Tape the tube in place until you can change the tube yourself or book an appointment with your G tube specialist to help you change the tube. Meanwhile, the tube is still in the stomach so you can continue to use the tube for feeding and medications. There is no need to go the emergency department if the balloon is broken.</p><h2>Skin care</h2><p>Keep the stoma and surrounding skin as dry and clean as possible. Dressings and tape are not needed with a low-profile GJ tube.</p><p>Despite your best effort to keep your child's skin around the stoma healthy, some common skin problems may occur including:</p><ul><li> <a href="/Article?contentid=2906&language=English">infection</a></li><li> <a href="/Article?contentid=3018&language=English">sensitivity and irritation</a></li><li> <a href="/Article?contentid=3019&language=English">hypergranulation tissue</a></li><li> <a href="/Article?contentid=3020&language=English">leaking stoma</a></li></ul><h2>When to seek medical attention</h2><p>Contact the G tube specialist if you notice any of the following signs and symptoms:</p><ul><li>Your child's stoma site appears infected with redness, edema (swelling) and odorous discharge.</li><li>There is hypergranulation tissue, which is pink to bright red, bloody, raw, moist, oozing yellow sticky discharge and/or painful.</li><li>The stoma site is leaking intestinal or stomach contents and /or formula.</li><li>Your child experiences abdominal pain, distension, discomfort, vomiting and/or other signs of feeding intolerance.</li><li>Your child has signs of respiratory distress (i.e. higher breathing rate or difficulty breathing).</li><li>The tube appears to be damaged, broken, or dislodged.</li></ul><h2>If the tube has moved into the stomach</h2><p>If the Mic-Key low-profile GJ tube has moved out of the small intestine and into the stomach, your child may experience:</p><ul><li>increased vomiting</li><li>vomiting formula</li><li>gagging and retching</li><li>abdominal discomfort or pain</li><li>bloated stomach</li><li>diarrhea</li><li>leaking of formula from the stoma</li></ul><p>The position of the tip of GJ tube will need to be confirmed by an interventional radiologist using image guidance. Do not use the tube for feeding until the tube position is confirmed.</p><h3>Intussusception </h3><p> <a href="/Article?contentid=958&language=English">Intussusception</a> may occur around the tube. Intussusception refers to when one part of the small bowel slides into the next part. This may lead to a bowel obstruction at the tip of the GJ tube. Large GJ tubes and/or normal movements of the bowels may cause intussusception. </p><p>A child with intussusception will experience:</p><ul><li>discomfort and feeding intolerance (vomiting when fed)</li><li>vomiting bile (green fluid)</li><li>diarrhea or blood in the stool</li></ul><p>If your child’s tube has intussuscepted, contact your G tube specialist during business hours. After hours, on weekends or on holidays, take your child to the Emergency Department.</p><h2>Giving feeds, liquids and medication through the low-profile GJ tube</h2><p>Your child's tube feeds are to remain the same as with previous GJ tube exchanges.</p><p>A Mic-Key low-profile GJ tube extension set needs to be attached to the feeding port to administer feeds and medications. A slip-tip syringe can be attached directly to the feeding port; however, this is not recommended as the one-way valve can break with frequent access. The one-way valve is built inside the GJ tube and prevents the stomach contents from flowing back out through the tube.</p><h3>Connecting the extension set to the tube</h3> <figure><span class="asset-image-title">Low-profile GJ tube with feeding extension set</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/PMD_j_tube_mic_key_01_EN.jpg" alt="" /> </figure> <ol><li>Open the plastic cover on the feeding tube.</li><li>Make sure the clamp on the extension set is closed.</li><li>Match the line on the extension to the line on the tube and push the extension into the valve.</li><li>Holding the button tube in place, turn the extension clockwise until you feel the extension lock into place. There is an arrow on the extension to show you which direction to turn it.</li><li>Attach your feeds, fluids and medications to the appropriate port at the end and open the clamp.</li><li>When you have finished using the extension, flush it with water and remove it from the tube.</li></ol><h3>Removing the extension from the tube</h3><ol><li>Clamp the extension.</li><li>Holding the tube in place, turn the extension counter-clockwise (opposite to the arrow on the extension).</li><li>Match the line on the extension to the line on the tube and remove the extension.</li><li>Close the plastic cover on the feeding tube.</li></ol><p>It is important to clean the extension set between each use and remove it from the low-profile GJ tube when it is not in use. The low-profile GJ tube's extension set should be replaced as needed (i.e. broken, rigid, stained).</p><p>Flush the low-profile GJ tube with at least 5 to 10 mL of water before and after each feed and medication dose, and every four hours during continuous feeds. This helps to prevent the low-profile GJ tube from becoming blo​cked. You may use <a href="/Article?contentid=3039&language=English">pancreatic enzymes</a> to unblock a low-profile GJ tube. This can be done at home.</p><p>For more information on what to do if your child's low-profile GJ tube is blocked, please see "<a href="/Article?contentid=3039&language=English">What to do if your child's feeding tube is blocked</a>".</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>Phone 416-813-7177</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>https://assets.aboutkidshealth.ca/AKHAssets/PMD_j_tube_mic_key_01_EN.jpgG/GJ tubes: Mic-Key low-profile GJ tubeFalse