PEG Feeding Training (Percutaneous Endoscopic Gastrostomy) is for care professionals to learn how to correctly use a PEG Feeding Tube.
A PEG feeding tube is used to improve a person's nutritional intake and contribute to a greater quality of life where there are severe swallowing difficulties, which can lead to:
- chest infections caused by food and water entering the lungs
- inadequate nutrition via eating less
PEG feeding is often required when an individual's muscles used for chewing and swallowing becoming weak, slow and or uncoordinated.
A PEG tube provides nutrition directly without chewing or swallowing directly into the abdominal wall. A suitable liquid formula containing protein, fat, carbohydrate, fluid, vitamins and minerals will be provided as determined for each individauls requirements.
The three main ways that the liquid feed is provided:
- liquid is poured down a syringe into the tube
- a bag of liquid food is hung from a stand and drips through the tube
- an electric pump.
How PEG tubes are inserted
A minor surgical procedure of around 30 minutes is completed under a sedative or general anaesthetic
An endoscope is used to examine the inside of the stomach. After the area has been anesthetized, a small incision is made through the abdominal wall. A guide wire is inserted into the incision and brought up through the endoscope into the stomach with the feeding tube attached. The tube is prevented from moving by a small plastic disc internally and a flange externally. A cap is placed over the end of the tube when feeding is not taking place.
Is accidental removal of the tube dangerous?
Generally, no - this is a common misconception. It is not usually life-threatening when an accidental or deliberate removal of the tube has taken place, although the re-insertion of the PEG Feeding Tube needs to be undertaken by a trained person
Common problems & solutions
Exit site infection, blocked feeding tubes, incorrect feeding formula, deteriorated tubes or gastrostomy tubes that have been inadvertently removed are the most common problems.
Infection of the tube exit site can be avoided by washing the site with warm water and soap and cleaning around the external bumper with a cotton bud, ensuring that the area is also dried thoroughly. After each feed, the tube should be flushed with cooled, boiled water to avoid tube blockages.
The tube should be checked each day and any changes in the appearance of the exit site e.g. redness, itchiness or presence of discharge or the tube itself. Cracking or leakages should be reported to the referring doctor immediately. A feeding tube will generally last between one to two years and can be easily replaced without hospital admission.
Best feeding position & formula
A person should never be positioned laying down flat. They should lie with their head at a 30° angle or sitting upright in a chair, remaining in this position for approximately 30 to 60 minutes afterwards.
http://mnd.asn.au/cms/images/pdfs/Factsheets/factsheet_peg_2007.pdf . MND Victoria, Updated 2007.
http://www.health.qld.gov.au/nutrition/resources/etf_tfah.pdf . Queensland Health. Updated 2007.
K Dollard,G Young, PEG Care and Support Service. 1999, Adelaide: Flinders Medical Centre.
Hong Kong Geriatrics Society, Clinical Guidelines on Enteral Tube Feeding. Amended ed. 2003, Hong Kong: Hong Kong Geriatrics Society.