Lecture on PEG Tubes

Introduction

• Presenter: Michelle Memo
• Role: Clinical Registered Dietician at Roswell Park, Buffalo, New York
• Topic: Overview and use of PEG (Percutaneous Endoscopic Gastrostomy) tubes

What is a PEG Tube?

• Definition: Flexible tube placed through the abdominal wall into the stomach.
• Purpose:
  • Deliver nutrition, fluids, and medications directly to the stomach.
  • Assist when there are swallowing difficulties or insufficient nutrient intake due to:
    • Surgery
    • Cancer treatment side effects (e.g., poor appetite, mouth sores, throat pain)
  • Decompress stomach contents in case of bowel obstruction (referred to as a venting PEG).

Administration of PEG Tube Feeds

• Nutrition Products: Special liquid nutrition and fluids provided.
• Initial Steps:
  • Nutrition assessment by a dietician to determine liquid nutrition needs.
  • PEG tube must be used within 24 hours of placement.
  • Complete instructions will be provided by healthcare providers.
• Eating Considerations:
  • Does not always prevent oral intake, but quantity may be limited by a doctor.

Hygiene and Preparation

• Precautions: Before Handling:
  • Wash hands thoroughly with soap and water.
• Flushing the Tube:
  • Use 2 ounces (60 ml) of room-temperature water before and after each feed.
  • Types of water: bottled, tap, distilled (not wall water).
  • Use a 60 cc or 2-ounce syringe; if smaller (e.g., 30 cc), administer twice.

Administering Feeds

• Water Flush:
  • Ensure the venting part is capped if using a venting PEG.
  • Secure the syringe to the PEG, push in water slowly.
• Feeding Protocol:
  • Do not lie flat for at least one hour post-feeding.
  • Ensure formula is at room temperature and shaken well.
  • Use the same syringe for water flush and formula.
  • Refrigerate unused liquid nutrition; bring to room temperature before use.

Demonstration and Key Points

• Formula Administration
  • Use the same method as water flush.
  • Ensure no clogs or kinks during administration.
• Post-Feeding Flush:
  • Provide another full syringe of water after formula administration.

Support and Questions

• Medical Team: Contact for any PEG tube care or function concerns.
• Registered Dietitians at Roswell Park: For nutrition or hydration queries.

Thank you for attending the session. If you have further questions, feel free to reach out to the medical team or your dietitians. Have a good day.