Replacing Gastrostomy Button and Tube

<< DIGESTIVE


  • G-tubes may only be placed in the school setting if the primary tube has been changed. School personnel should verify this by the patient’s care plan or parent/guardian report
  • The primary tube/button is the initial tube placed by General Surgery, Gastroenterology or Interventional radiology.  The primary tube/button change date is dependent on the type of tube/button.  The first change date can be 6 weeks to 3 months
  • If G-tube cannot be replaced, cover the opening with a clean dressing and tape and then call parents/guardian

Considerations:

  • G-tubes may only be placed in the school setting if the primary tube has been changed. School personnel should verify this by the patient’s care plan or parent/guardian report
  • The primary tube/button is the initial tube placed by General Surgery, Gastroenterology or Interventional radiology.  The primary tube/button change date is dependent on the type of tube/button.  The first change date can be 6 weeks to 3 months
  • If G-tube cannot be replaced, cover the opening with a clean dressing and tape and then call parents/guardian
  • Provide the student with as much privacy as possible

Supplies:

  • Extra gastrostomy tube
  • Clamp or plug, if used
  • Lubricant, if desired
  • Stabilizing device, if used
  • 5-ml syringe
  • Tape
  • 2 clean cloths
  • Distilled water
  • Tap water
  • Gloves

procedure download skill competency

  1. Explain the procedure to child at his/her level of understanding
  2. Gather supplies and place on clean surface
  3. Wash hands
  4. Put on clean gloves
  5. Put a mark at the same level with a permanent marking pen
    • This step is not needed with a skin-level device
  6. Make sure replacement gastrostomy tube is the same size (French and centimeters) as previous tube
    • Look at sizing information located on device
  7. Check the new gastrostomy tube by filling the balloon with manufacture recommended ml of distilled water
    • Be sure it does not leak
  8. Remove the water from the balloon
  9. Wet the tip of the tube in tap water or lubricant
  10. Put the tip into the stoma
  11. Gently push into the stomach until the button is at skin level
  12. Fill the balloon with the indicated amount of distilled water
  13. Gently pull tube to position the balloon against the wall of stomach
    • Pulling the tube too tightly will cause the opening to enlarge and formula may leak out around the tube
  14. Clamp or plug the tube
  15. Apply stabilizing device
  16. Check the tube for correct placement
    • For a skin level device, insert an extension set and aspirate stomach contents
  17. Remove gloves
  18. Wash hands
  19. Document assessment, interventions, and outcomes in student’s healthcare record
  20. Follow up with parents/guardian and healthcare provider

Resources:

MIC—KEY LOW–PROFIILE GASTROSTOMY FEEDIING TUBE: YOUR GUIDE TO PROPER CARE
http://www.mic-key.com/media/40679/r8201b_mic-key_care_guide_english.pdf

MIC-KEY Button Reference card
http://www.mic-key.com/media/78579/ref_card.pdf

MIC Enteral Feeding Tubes and Accessories

http://www.kchealthcare.com/media/2886710/u4850_mic_enteral_tubes.pdf

Guidance and support to help you manage your gastrostomy tube (g-tube) Capsule Non-Balloon Mini ONE® Buttons
http://www.amtinnovation.com/pdf/AMT_NonBalloonPatientCare.pdf

Guidance and support to help you manage your gastrostomy tube (g-tube) Balloon Mini ONE® Buttons
http://www.amtinnovation.com/pdf/AMT_BalloonPatientCare.pdf


References:

Children’s Hospitals and Clinics of Minnesota.  (2011).  A Guide for Parents G-J tube Care at Home.  Available at: http://www.childrensmn.org/Manuals/PFS/HomeCare/196857.pdf

Children’s Hospitals and Clinics of Minnesota.  (2011).  A Guide for Parents G tube Care at Home.  Available at http://www.childrensmn.org/manuals/pfs/homecare/196854.pdf

Exit Care.  (2012).  Mosby’s Nursing Consult.  Gastrostomy Tube, Child.


Acknowledgment of Reviewers:

Lori A. Duesing, MSN, RN, CPNP-AC
Advanced Practice Nurse
Department of Gastroenterology
Children’s Hospital of Wisconsin

Kathy Leack, MS, RN, CNS
Advanced Practice Nurse
Children’s Hospital of Wisconsin


Page last updated: April 8, 2015