Handbook of Drug Administration Via Enteral Feeding Tubes by Rebecca White, Vicky Bradnam

By Rebecca White, Vicky Bradnam

The guide of Drug management through Enteral Feeding Tubes furnishes you with the heritage wisdom to notify medical selection making in addition to offering over four hundred drug monographs.It offers an authoritative and useful advisor to the secure management of medications through enteral feeding tubes.

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Example text

Occlusion occurred even though the tubes had been flushed with 10 mL water before and after each aspiration. 5. Interestingly, the same was not found when elemental or semi-elemental feeds were used. The authors conclude that it is the presence of casein in the whole-protein feeds (which is absent from elemental and semi-elemental feeds) that causes the problem. Tubes with tips in the jejunum occluded far less frequently in both the Hofstetter and Allen study4 and that of Marcuard and Stegall,5 and this was assumed to be due to the higher pH of jejunal secretions.

8 Cyclical feeding The increased use of cyclical rather than continuous feeding may also be a contributory factor to feeding tube occlusion in the acute care setting. ,9 many centres choose to give patients an enteral feeding break of 4–6 hours rather than feeding continuously over 24 hours, supposedly to reduce the risk of aspiration pneumonia. Enteral feeds cause a rise in gastric pH, allowing proliferation of ­Gram-negative bacteria, which may lead to pneumonia if aspirated. The break is thought to allow Restoring and maintaining patency of enteral feeding tubes 17 gastric pH to decrease, thus reducing this risk.

A 15– 30 mL water flush is recommended,14,15 but care should be taken with fluid-restricted patients (see notes below). Water type depends on local policy. Wide-bore enteral tubes may require a higher volume owing to the large diameter of the inner lumen. Prepare a flush of water (according to local guidelines) in a 50 mL enteral syringe and label if necessary. Place it in a clean tray. Stop or suspend enteral feeding. Ensure that any other enteral feeding ports are closed and airtight. Attach the syringe to a port of the patient’s enteral feeding tube.

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