PICU nutrition guideline (RCH only): Insertionįor longer term jejunal feeding, a surgical jejunostomy (PEJ) tube Utilised by nursing staff competent in the procedure. Patients requiring out of hours NJT insertion the following guideline will be Six French (6FR)Įnteral tubes are not recommended as they block easily.įor NJT placement for patients in PICU and ![]() (8-9) At RCH, the recommended tube to be insertedįor jejunal feeding is the yellow CORFLO* silastic enteral feeding tube with ENfit® connector. Of correct position of a newly inserted tube is mandatory before feedings or Tubes may be placed with the assistance of endoscopy or fluoroscopy. Is preferred. NJT insertion without direct vision will requireĬonfirmation 4 hours post procedure via abdominal xray. Insertion under direct vision via radiological exposure.Microbiological defenses of the stomach, therefore sterile or pasteurizedįeeds must be used and an aseptic non-touch technique adhered to whenīecome blocked requiring frequent flushingįeeding result in reduced mobility of the patient Risk of gastro-intestinal infection as the tube bypasses the natural (5, 6)Ĭan be challenging due to the following factors: (1-4) While onerous, jejunal feeding is safer and less expensive than parenteral nutrition (PN). Jejunal feeding is indicated in patients with gastric outlet obstruction, gastroparesis, pancreatitis, severe reflux with faltering growth, and known reflux with aspiration of gastric contents, where continuous gastric feeding has been trialed and unsuccessful. Jejunal feeding may be initiated for a patient of any age. Ensure adequate pain management plan is in place (if post PEG-J Freka).Advise route and preparation advice for medication administration, in conjunction with pharmacy.Please ensure dietitian is referred at least 48 hours prior to discharge. Referral to dietitian for RCH HEN program (as required).Referral to dietitian for recommended feeding plan post jejunal tube insertion.Ensure jejunal specific Home Enteral Nutrition (HEN) education has been completed, including pump training (for RCH patients not previously known to RCH nutrition department).For new insertion of PEJ or G-J tube, dietitians should refer to Jejunal tube grade up local guideline.To ensure grade up feed plan and target regime is clearly documented.A dietitian referral should be initiated on admission or when jejunal tube is placed. Patients post insertion of jejunal feeding tube should be managed by their main unit dietitian.For patients post PEG-J Freka insertion, education should also be completed on stoma care/delivery of feeds.To provide education on delivery of feeds, flushes, medication administration and ensure parents/carers are competent in flushing, delivering feeds and caring for jejunal tube.Safe administration of jejunal feeds and medications during inpatient stay.Percutaneous Endoscopic Jejunostomy (PEJ) - a feeding tube which is inserted through the abdominal wall directly into the small intestine (jejunum).The Jejunal extension is then inserted through the middle of the PEG. ![]()
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