- Clean work area
- Soap and water
- Hydrogen peroxide (H2O2)
- Clean gauze pads
- Catheter tip syringe (35 ml)
- Water for flushing the tube
Cleaning and dressing the wound:
- Wash your hands with soap and water.
- Remove the old dressing. Look at the area where the tube enters the skin. Check for redness, swelling, green or yellow liquid drainage, or excess skin growing around the tube. A small amount of clear or tan liquid drainage is normal. See the problem solving list in the last section for what to do if you notice any of these things.
- Clean the skin under the plastic piece around the tube with soap and water or during bath time / shower. Then rinse the skin using clean tap water and dry thoroughly.
- To clean crusted drainage off of the skin, tube or disc, use half-strength hydrogen peroxide (1 tablespoon hydrogen peroxide mixed with 1 tablespoon water) and cotton swabs. Dry with a clean cotton swab.
- If there is any drainage at the disc, place one 2 x 2 softwick piece under the plastic disc.
- Do not rotate a jejunal tube. This can cause kinking.
Flushing the Tube
To flush the G-J port of your tube, slowly push warm clean tap water into the side opening of the G-port or J-port of the connector. The syringe may be washed in warm water, air dried and reused.
Medication or Feeding
Your doctor or nurse will give you instructions through what port medications and feedings should be given. Be sure to follow their instructions carefully. Do not mix medications unless you are instructed to do so by your doctor.
Protecting the Tube
Keep your child from pulling on his / her tube. There are several different ways of securing a G-J tub. Your child's doctor or nurse will discuss these with you. Here are some suggestions:
- Keep the tube taped or pinned to the diaper or shirt.
- Keep the child's T-shirt over the tube. One-piece, snap T-shirts work best for infants and toddlers.
- An alternate way to cover the tube is to use an ACE wrap or stretchy gauze over it.
- Most children get used to the tube after a while, but until they do, they may need to wear elbow splints if necessary.
- Be sure to keep the end of the tube closed as directed.
The following is an emergency problem that can occur with a G-J tube. For an emergency, take your child to the emergency room.
Emergency problem: G-J tube is forcefully pulled out.
Before coming to the Emergency Room: If bleeding occurs, press on the site with a clean soft cloth. The opening in the stomach may close within hours, so it is important not to wait before coming to the Emergency Room. When a G-J tube is replaced it is important to verify that the tube is in the right place, by taking an X-ray. Be sure to bring the tube with you to the Emergency Department.
The following are non-emergency problems that can occur with your child's G-J tube. Remember to notify your child's doctor if your child will miss a feeding because of a problem with his / her G-J tube.
(To be completed with the help of your healthcare team.)
My child has a _____________ (type of tube).
My child's tube size is _______fr. with a balloon volume of _____ ml.
This information is necessary if the tube needs to be replaced. If your child has a balloon catheter type tube, please check for level of tube placement every day. If the length of the tube seems much less than normal then call your nurse or doctor.
It is important to allow your infant to have pleasant sensations during feeding. This can be done by allowing him to suck on a pacifier during the feeding and by talking to and allowing him to face you during the feeding. You may even hold him at this time.
Always call your doctor or nurse if you have any questions or problems.
MD ______________ Nurse ____________ Home Health _________