Some patients in Milton Keynes are fed directly into their stomach or jejunum via an enteral feeding tube. These people will be seen by a dietitian in their own home or care home. The following information is only relevant for those who have such a feeding tube in place.
We have a local contract with Abbott Nutrition who provide a home delivery service to these patients. All feeding tubes, syringes and pumps will come from the Abbott Hospital to Home service – they can also deliver any feed required. This service will contact the patients’ GP on a monthly basis and deliver feed directly to the door. If preferred, deliveries can be arranged from the local pharmacy instead (for feed only, all feeding equipment needed will still come from Abbott Hospital to Home).
As part of the contract provided by Abbott Nutrition, there is an Abbott Nurse Advisor who provides all training, troubleshooting and in some cases tube changes in the patient’s place of residence. In the unlikely event of running out of feed, please contact Abbott Hospital to Home to see when a delivery can be arranged (0800 018 3799). As Abbott Hospital to Home need a prescription from the doctor before arranging a delivery it may take a few days, therefore the doctor can be contacted to arrange a local prescription for a few days’ supply. If all of these options do not work, please contact the dietitian.
Percutaneous Endoscopic Gastrostomy (PEG) care
If the tube has been placed in the last 7-10 days and persistent abdominal or stomach pain or bleeding occurs after the procedure, the below advice should be followed.
If the tube was placed at Milton Keynes:
Contact the endoscopy unit on 01908 996 461 from 08.30-18.30 Monday – Friday. Outside of these hours, contact 01908 66 00 33 and ask to speak to the on-call medical registrar.
If the tube was placed at Northampton:
Seek advice from the nutrition nurse during office hours on 01604 634 700. Outside of these office hours urgently refer to your GP or ‘Out of Hours’ GP services.
Please see the following sheets for advice on how to care for the PEG tube.
Please note these are for PEG tubes only. If the tube is a Radiologically Inserted Gastrostomy (RIG), jejunostomy, balloon gastrostomy tube or low profile device and you have questions regarding their care, please contact the Abbott Nurse Advisor.
It can take a long time to unblock a tube. Use a pumping action on a syringe, trying to draw the blockage back into the syringe if possible. Warm water can be used in the tube to help clear the blockage. Massage of the tube may help break up the blockage. A warm flannel/cloth wrapped around the tube may also help.
Never use fizzy drinks or fruit juices as these can affect the integrity of the tube. Never poke anything down the tube to try and unblock it either.
If after trying the above the tube is still blocked, please contact the Abbott Nurse Advisor.
Tube has fallen out
PEG tubes – e.g. Freka 15 french:
Attend A&E directly. The stoma site where the tube has come out can close up extremely quickly and doctors may not be able to replace it.
Balloon gastrostomies/low profile devices e.g. mic-key buttons and Radiologically Inserted Gastrostomies (RIG):
If the tube falls out, phone the Abbot Nurse Advisor on 07824 483 335 (9am – 5pm Monday to Friday). Try and replace the fallen out tube if possible back through the stoma and tape in place – DO NOT USE THIS TUBE to administer feed, water or medications.
If the Abbott nurse advisor has not got back to you within an hour, attend A&E. Take your spare tube with you. Let the dietitians know so that a spare tube can be ordered.
Attend A&E urgently.
The local community enteral feeding policy can be found here.