Pediatric Enteral Access Device Management

Abstract

Enteral nutrition (EN) support has proven to be a nutrition intervention that can provide full or partial calories to promote growth and development in infants and children. To supply these nutrients, an enteral access device is required, and the use of these devices is growing. Placement of the proper device for the patient need, along with appropriate care and monitoring, is required for individualized patient management. When complications arise, early identification and management can prevent more serious morbidity. Complication management requires a tiered approach starting with staff nurses and ending with a physician expert. In addition to this, each institution needs to have an approach that is coordinated among disciplines and departments to promote consistency of practice. The formation of an enteral access team is a conduit for clinical experts to provide education to families, patients, and healthcare professionals while serving as a platform to address product and practice issues.

Dispelling Myths and Unfounded Practices About Enteral Nutrition

“…Leakage may be caused by tube movement, granulation tissue, a cracked tube, infection, and conditions that increase pressure in the stomach. It is not always due to the size of the tube …”

Paediatric gastrostomy stoma complications and treatments: A rapid scoping review

“…Children with G-and GJ-tubes are often medically complex (Goldin et al, 2016) and have fragile skin (Abdelhadi, Rahe, & Lyman, 2016) which may place them at higher risk of skin-related gastrostomy complications. Despite the wide variety of treatment options for skin-related complications identified in paediatric practice, recommendations regarding the initial treatment approach have yet to be well-defined.…”

“…The area of complication management of gastrostomy stomas would benefit from the same focus. Skin-related gastrostomy complications represent a specialised area of wound care (Abdelhadi et al, 2016). Although the overall evidence base for wound care is growing with systematic reviews published on adult burns and pressure ulcers (e.g., Jull et al, 2015)…”

Child Care Educational Manual With Gastrostomy: Construction and Validation

“…13,16 Em pesquisa, autores identificaram que a escolaridade dos participantes pode ter relação com esse resultado, relatando que apenas participantes de nível superior registraram suges- ção do dispositivo em casa, trabalhando os principais conceitos de alimentação e administração de medicamentos encontrados após leitura de levantamento bibliográfico. [19][20][21][22][23] As complicações cutâneas com gastrostomia têm espaço no capítulo cinco, onde foram trabalhados os cuidados com a pele, com foco na prevenção dessas complicações de acordo com as principais recomendações encontradas na literatura. [20][21][22][23] A saída acidental do dispositivo ganha um capítulo único, de número seis, devido à observação da literatura de ser uma complicação com bastante impacto no cuidado domiciliar.…”

“…[19][20][21][22][23] As complicações cutâneas com gastrostomia têm espaço no capítulo cinco, onde foram trabalhados os cuidados com a pele, com foco na prevenção dessas complicações de acordo com as principais recomendações encontradas na literatura. [20][21][22][23] A saída acidental do dispositivo ganha um capítulo único, de número seis, devido à observação da literatura de ser uma complicação com bastante impacto no cuidado domiciliar. 19,22 No capítulo sete objetivou-se reduzir os mitos que envolvem o cuidado com a gastrostomia, esclarecer dúvidas e fortalecer conceitos verdadeiros com linguagem bastante popular para uma leitura acessível, como orienta a literatura.…”