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Gastrostomy Tubes In Pediatric Patients: Research Paper

In some cases, only a few patients are unable to go through this procedure and will therefore need a surgically placed gastrostomy tube. The most appropriate procedure for this tube placement is usually determined by the radiologist. Unlike the surgically placed gastrostomy tubes, the PEG tubes are usually appropriate for long-term use and can stay in the appropriate position for a number of months. Currently, due to their design, they necessitate an endoscopic removal for a patient under general anaesthetic for the initial replacement or removal.

Skin Tubes:

The final category of gastrostomy tubes are the skin tubes that are usually shorter than any other category of the tubes and sit flush with the skin. The skin gastrostomy tubes consist of a mushroom-shaped or balloon end which rests inside the belly and prevents them from falling out. The skin gastrostomy tube are widely considered as the low profile category of gastrostomy tubes with the advantage that there are minimal chances of them being pulled out and are easily covered under clothing. Given the appropriate care, skin gastrostomy tubes have a high chance of staying in place for several months and are sometimes used instead of surgical or PEG gastrostomy tubes.

Maintaining Gastrostomy Tubes:

In order to maintain the effective use of gastrostomy tubes, the feeds that are put through the tubes have special formulations that are originally provided and prescribed by a dietician and doctor respectively. The dietician usually begins feeding the patient with tiny and frequent amounts of feeds with the volume of the feed increasing as the patient familiarizes him/herself with the technique. In most cases, if the patient's stomach is too full, feed may start leaking around the child's stoma site. Maintenance of the gastrostomy tube is also enhanced when one learns about the most appropriate way of feeding the child by the time they leave the hospital. While some feeds are given overnight using an exceptional pump, other feeds are usually administered by bolus. Further measures that help in maintaining the tubes include giving feeds when the patient is in a comfortable position with...

Notifying the nurses, doctors and dietician of any problems that one encounter, supervising the patient's feeding and other measures of daily care are important steps in maintaining the effectiveness and efficiency of gastrostomy tubes.
Dysphagia Patients:

For patients with severe dysphagia, the percutaneous endoscopic gastrostomy tube is considered to be the most efficient method of providing long-term nutritional support (Squires, 2006). The nurses caring for these kinds of patients with swallowing problems are required to supervise and record the nutritional and hydration status of the patient. Furthermore, these nurses are also required to interact closely with the dietician, speech and language therapist as well as the family in order to supervise the oral intake of the patient. The dietician may provide high energy supplements that may be added to the current meals or consumed between meals. It's important to often encourage these kinds of patients to eat since some of them usually find the typical sized food portions to be too daunting.

Conclusion:

Dysphagia may sometimes result in certain significant health complications such as chest infections because of recurrent aspiration, starvation, pneumonias and even death. The PEG tube is the most effective method of helping dysphagia patients to avoid these health complications.

Sources used in this document:
References:

Division of Pediatric General, Thoracic and Fetal Surgery. (2008, November). Gastrostomy

Tubes. Retrieved from The Children's Hospital of Philadelphia website: http://www.chop.edu/service/surgery-general-thoracic-and-fetal/conditions-we-treat/pediatric-surgery-gastrostomy-tubes.html

Squires, N. (2006, February 6). Dysphagia Management for Progressive Neurological

Conditions. Nursing Standard, 20(29), 53-57. Retrieved from http://nursingolderpeople.rcnpublishing.co.uk/shared/media/pdfs/dysphagia/dysphagia5.pdf
Support website: http://www.tofs.org.uk/leaflets/gastrostomytubes.pdf
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