Handbook of Drug Administration Via Enteral Feeding Tubes

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Whilst enteral feeding provides a lot of health benefits for those that need it, it does have a psychological impact. There is no published research on those adults born with OA/TOF who are enterally fed, but literature on adults with other reasons for enteral feeding has shown a number of common themes. These include:

Hotjar sets this cookie to identify a new user’s first session. It stores a true/false value, indicating whether it was the first time Hotjar saw this user. Enteral feeding is a method of supplying nutrients directly into the gastrointestinal tract. This guideline will use this term describe Orogastric, Nasogastric and Gastrostomy tube feeding. A wide range of children may require enteral feeding either for a short or long period of time for a variety of reasons including: Please note this guideline does not refer to the management of Jejunal tubes, for information regarding care of these please see theEffervescent tablets – Convenient and accurate dosing, but may have high salt content, need a large volume of water and take a while to disperse. In severe hypophosphatemia, less than 0.3 mmol/L, give IV sodium or potassium phosphate 0.8 mmol/kg of body weight in half normal saline over 12 to 24 hours. [47] [48] Remove the plunger from the syringe and place the tip of the syringe into the enteral tube connector at end of the enteral tube. Tubes which are being used for aspiration or drainage should not be used for the purpose of administering medicines. Resting energy expenditurecan becalculated using indirect calorimetry. This method calculates the caloric requirements in patients requiring enteral feeding. When indirect calorimetry is unavailable, approximately 25 kcal/kg per day is the approximate energy requirement. Clinicians can calculate caloric intake for patients on mechanical ventilation using the Penn State equation. [9]

The British Association for Parenteral and Enteral Nutrition (BAPEN) provide information on the advantages and disadvantages associated with particular me dicines formulations. Recommended formulations Gilbertson, H.R et al 2007,' To determine a practical pH cutoff level for safer confirmation of nasogastic tube placement', Unpublished study, Royal Children's Hospital, Melbourne Amy Long Carrera, MS, RD, CNSC, CWCMS, uses her more than 15 years of clinical nutrition experience in the areas of bariatric, oncology, acute rehab, neonatal and long-term care nutrition in both hospital and corporate settings. She served as Corporate RD and Enteral Product Manager for Shield HealthCare’s for eight years. She now serves as Marketing Manager for Kate Farms near Santa Barbara, CA, as well as Assistant Director, Dietary Services at Windsor Terrace Healthcare Center. She has served as a team leader on several ASPEN task force projects. Misplacement of PEG for enteral feeding might lead to the formation of gastrocolic, colocutaneous, and gastro colocutaneous fistulae. A gastrocolic fistula connects the wall of the stomach and the colon. Gastro colocutaneous fistula is an epithelial connection between the wall of the stomach, colon, and skin that can occur because of iatrogenic puncture or direct erosion of the PEG into the colon wall and the skin. [55] [32] [56] [57] [58] Do not administer drugs through tubes used for aspiration or on free drainage unless specifically directed by medical staff.The cliniciancoordinates and directs the care related to enteral feeding. The clinician determines the optimal feeding regimen for the patient.A nutrition nursespecialist is primarily responsible for educating the patient on using the feeding tube. The nurse also supervises the care of the tube and notifies the clinician if any complications develop.The dietician manages the evaluation of the nutritional requirements, including the calculation of the daily caloric need and the optimal fluid requirements.The pharmacist provides the enteral feed and can mix and compounds parenteral nutrition. The pharmacist advises on the compatibility of nutrients and interaction.Other ancillary staff includesthe social worker, physical, occupational and speech therapists, and a case manager to help arrange home supplies. [64] Open the roller clamp and set the flow rate by counting the drops per minute. As a guide, 20 drops of standard feed is approximately 1ml. Use the following equation or the table below to calculate the drip rate: (ml/hour) /3 = drops/minute Feeds can be administered via syringe, gravity feeding set or feeding pump. The method selected is dependent of the nature of the feed and clinical status of the child. There is limited evidence available to support one method of feeding over the other. Gilbertson, H., Rogers, E., & Ukoumunne, O., 2011. Determination of a practical pH cutoff level for reliable confirmation of nasogastric tube placement, 35(4), pg 540-544.