Assisted feeding

Question 1

When do we need to consider assisted feeding?

Answer 1

anorexia/anticipated anorexia
weight loss/malnutrition
Increased losses e.g., renal disease, chronic diarrhoea
Increased requirements e.g., extensive healing wound
Bypass areas of GIT

Question 2

What are types of assisted feeding?

Answer 2

Naso-oesophageal/naso-gastric tubes
Oesophagostomy tubes
Gastrostomy tubes (PEG)

Question 3

Describe the features of naso-oesophageal or naso-gastric tubes

Answer 3

well tolerated
3-5 days
cheap
home care possible
can lead to food in wind pipe if dislodged

Question 4

Describe the features of an oesophagostomy tube

Answer 4

tube enters oesophagus from incision on neck
Well tolerated
3-4 weeks
GA needed to place
can get infected
home care possible

Question 5

Describe the features of percutaenous endoscopic gastrostomy tubes (PEG)

Answer 5

tube placed into stomach via abdominal wall
GA needed to place
allow 2 weeks before use to allow tube to heal into stomach wall so no food leaks into body cavity
Left in place for months, possibly indefinitely
Used for swallowing disorders
Expensive

Question 6

What are common problems with feeding tubes?

Answer 6

Blockages
dislodging
trauma
infection
over-granulation

Question 7

What are causes of problems with feeding tubes?

Answer 7

not flushing
coughing/sneezing/vomiting/movement
Chewing/biting and pawing
poor care of surgical site
Infection

Question 8

Describe the feeding of the critical patient

Answer 8

Day 1 - feed 1/3 of daily requirement
Day 2 - feed 2/3 of daily requirement
Day 3 - feed entire daily requirement
Weigh patient every morning and afternoon
Warm food and water to body temp
Record quantity of food and water given
Make note of how well food was tolerated