How does the MIC-KEY* G Tube feeding port work?
Food and liquids are delivered through the tube and into the stomach through the feeding and medication ports. When not in use, the port should be capped off with the attached cover. An anti-reflux valve located inside and toward the top of the feeding port helps prevent stomach contents from leaking out of the tube. The valve is opened with the extension set.
What maintenance is required for the silicone balloon? (all tubes)
The balloon should be filled with distilled or sterile water. Saline and tap water are not recommended as they may damage the balloon. Air is also not recommended for inflation. The balloon volume should be checked weekly and additional water added if the amount in the balloon is less than the amount prescribed by the physician. An underfilled balloon could cause the tube to fall out or become dislodged. Check the IFU for recommended fill volumes as they vary by tube size.
CAUTION: USE CARE WHILE FILLING OR REMOVING WATER FROM THE BALLOON. BE SURE TO STABILIZE TTHE FEEDING TUBE IN THE STOMA AS IT MAY BE EASILY PULLED OR FALL OUT WHEN THE BALLOON IS DEFLATED.
What is the purpose of the syringes in the MIC-KEY* G kit?
A 6 ml syringe is included with the MIC-KEY* G Tube and is intended to fill or empty the balloon when recurring volume checks are made and when the feeding tube is replaced. A 20 ml or larger catheter syringe should be used when priming and flushing the extension sets and when checking for proper placement of the feeding tube.
What are the steps for daily maintenance of the MIC-KEY* G Tube?
- Wash hands with soap and water then dry hands thoroughly before touching the tube.
- Inspect the skin around the stoma before and after feeding. Make sure the skin is clean and dry, free of infection, and check for any gastric leakage.
- Dressings are not recommended for long-term use and should be avoided unless necessary. If one has been used, change it as soon as it becomes wet or dirty.
- Gently clean the skin around the stoma using soap and warm water and cotton-tip applicators or a soft cloth, followed by a thorough rinsing and drying well.
- Inspect the tube and rotate the bolster 360◦ plus a quarter turn to prevent tissue from adhering to the tube, to relieve pressure on the skin and to allow for air circulation. Do not rotate jejunal tubes as they extend into the jejunum and rotating may cause them to torque and retract into the stomach.
- Gently clean the feed head or bolster with a cotton-tip applicator or soft cloth.
- Ensure the balloon and feeding ports are clean and clear of any residual formula or fluid and free of debris. Caution: Do not push cotton-tipped applicators or other foreign objects through the feeding port valve as this may cause the valve to tear and leak.
- Flush the feeding tube with water every 4-6 hours during continuous feeding, before and after every intermittent or bolus feeding, or at least every 8 hours if the tube is not being used.
How is a MIC-KEY* G Tube placement checked?
Before feeding, check the G tube to be sure it is not clogged or displaced outside the stomach. You may do this by drawing 5-10 ml of air into a syringe. Place a stethoscope on the left side of the abdomen just above the waist. Inject the air into the extension set feeding port and listen for the stomach to “growl.” Try again if you do not hear the sound. If you still do not hear it, do not proceed to feed. Contact your care team and report the problem.
Another method is to connect the extension set to the feeding tube and attach a catheter tip syringe with 10 ml of water to the extension set feeding port. Pull back on the plunger. When stomach contents appear in the tube, flush the tube with water.
Check for leaking around the stoma. If at any time you suspect the feeding tube has become dislodged, discontinue feeding and contact your care team to report the problem.
What is the proper procedure for decompression or ‘venting’ with a FARRELL* bag? (MIC-KEY & MIC G and GJ tubes)
The FARRELL* Valve System is a closed enteral decompression system intended to allow excess gas to be removed from your stomach (gastric distention/bloating) and to prevent the loss of formula/nutrition, medication, and stomach contents. While venting, any formula/nutrition that goes into the FARRELL* bag and tubing must be gravity fed back into the patient. The white roller clamp helps control the speed at which the formula/nutrition is fed into the patient. The FARRELL* Valve System is for use with neonates, pediatric, and adult patients. A syringe can be attached to your extension set or standard-length tube prior to using the FARRELL* bag to reduce pressure. For details on how to use the FARRELL bag, check out the patient care guide or video.
How should medications be given? (all tubes)
Medications should be given in liquid form. Thick medication can plug the feeding port. If a medication is only available in tablets or capsules, make sure it can be crushed and mixed with water. Medication should not be mixed with formula as they may harden together and cause the tube to become occluded. Never crush enteric-coated medication. Before and between each medication the port or tubing should be flushed with water.
What do I do if there is gastric leakage from the stoma site? (all tubes)
Leakage may occur for a variety of reasons.
- You may be feeding too rapidly or feeding too large a volume. Always consult with your care team before making any adjustments to your feeding regime.
- Improper positioning during feeds. Keep the head elevated at least 30 degrees during and 1 hour after feeding. This can also help prevent aspiration.
- Your balloon may not have the adequate amount of fluid. Weekly balloon volume checks can help ensure you have the correct amount. Your balloon may be leaking if you notice the fluid volume is continuously below the prescribed amount. If the balloon does have a leak, it will need to be replaced.
- The device may be poorly sized or inadequately stabilized and you should have your clinician re-evaluate the tube using a stoma measuring device.
CAUTION: USE CARE WHILE FILLING OR REMOVING WATER FROM THE BALLOON. THE FEEDING TUBE MAY Fall out or BE EASILY PULLED OUT.
If you suspect gastric leakage:
- Gently clean and dry the site, then check the site after 30 minutes to see if there is any fresh leakage. This will indicate whether there is actual gastric leakage and not just spillage from a previous feeding or tube check. If there is actual gastric leakage and the skin is intact, you may ask your physician whether you should apply a skin protectant or moisture barrier such as zinc oxide ointment. Notify the physician if skin redness extends more than 1 cm from the stoma or is accompanied by pain, swelling or removed skin.
How does the standard-length gastrostomy feeding tube work? (MIC G)
The MIC* (Bolus) Gastrostomy Feeding Tube is used to provide a means of accessing the stomach to provide nourishment, liquids and medication. It may also be used as a means to release excess air or contents from the stomach.
The MIC* (Bolus) Gastrostomy Feeding Tube is made of silicone and is kept in place by an internal balloon that keeps the tube from falling out of the stomach and a SECUR-LOK* external retention ring or disc that keeps the tube from migrating into the stomach. The tube should be capped when not in use.
How does the GJ feeding tube work? (MIC-KEY & MIC GJ)
The GJ or gastric-jejunal feeding tube is used to provide a means of accessing the stomach and jejunum to provide nourishment, liquids, medication and decompression. This type of tube extends through the stomach and into the jejunum for feeding into the small intestine. The jejunal feeding port will be used to administer feeds and medication. The gastric port can be used for decompression or medication (only if advised by your care team). Low-profile GJ tubes require an extension set to open the valves to administer nutrition, liquids, and medications.
How does the J feeding tube work? (MIC-KEY and MIC J)
The J or jejunal feeding tube is used to provide a means of accessing the jejunum to provide nourishment, liquids, and medication directly to the small intestine. The jejunal feeding tube is made of silicone and is kept in place by an internal balloon that keeps the tube from falling out of the stomach and a fixed external retention disc that keeps the tube from migrating into the stomach. Low-profile J tubes require an extension set to open the valves to administer nutrition, liquids, and medications.