How is the risk of tube dislodgement minimized following gastrostomy tube replacement?

Updated: May 26, 2020
  • Author: Erik D Schraga, MD; Chief Editor: Vikram Kate, MBBS, MS, PhD, FRCS, FACS, FACG, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS, FFST(Ed)  more...
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Answer

The most frequent cause of G-tube dislodgment is pulling exerted on the tube by the patient. A dislodged tube is an adverse event that can result in serious harm to the patient. To prevent, recognize, and manage dislodged tubes, the following best practices and risk reduction strategies are suggested [17] :

  • Follow ASPEN guidelines for G-tube care [18]
  • Document the tube type, location, and external markings (cm) in the medical record at the time of insertion and follow-up assessment
  • Institute daily self-assessment of the G-tube, confirm the position of the tube and external bumper, and ensure daily skin care
  • Apply an external securing device to G-tubes without external bumpers
  • In patients with cognitive impairment, restrain the hands
  • Consider T-fasteners in children and patients at high risk for dislodgment
  • Perform a radiologic contrast study to confirm tube placement
  • Avoid using tubes such as urinary or gastrointestinal drainage tubes as replacements for G-tubes
  • Educate nurses and other clinicians about the design, care, and maintenance of commonly used tubes
  • Educate family members about tube care
  • In tubes with retention balloons, check the volume of water weekly

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