hi my name is Michelle memo I'm a clinical registered dietician here at Roswell in Buffalo New York today I'm gonna talk about what a peg tube is a PEG tube stands for a percutaneous endoscopic gastrostomy tube it is a flexible tube that is placed through the abdominal wall into the stomach a PEG tube also allows for nutrition fluids and medications to be delivered directly into the stomach a PEG tube can be helpful or necessary if you are having trouble swallowing or are not taking in enough nutrients through your mouth either due to surgery or side effects from your cancer treatment such as poor appetite mouth sores or throat pain a PEG tube can also be placed to decompress the stomach contents if there is a bowel obstruction this is deferred as a venting peg and is placed to prevent and manage nausea or even vomiting so how are PEG tube feeds given special liquid nutrition products as well as fluids can be given through the PEG tube here at Roswell Park a registered dietitian will complete a full nutrition assessment to determine the appropriate amount of liquid nutrition required to appropriately meet nutritional and hydration needs once a PEG tube is placed it has to be used within 24 hours a healthcare provider will give complete instructions and demonstrate using the PEG tube so a PEG tube does not necessarily prevent or mean that you're going to not be eating by mouth but a doctor may limit the amount that is able to be taken in through your mouth completely so the caregiver and the patient should make sure they're thoroughly washing their hands with soap and water before preparing liquid nutrition or having any contact with the PEG system the first thing I'm going to show is how to administer the flush with 2 ounces or 60 ml of room-temperature water before and after each feed you can use bottled water you can use tap water you can use distilled water or any bottled water as mentioned you cannot use wall water you want to make sure the water is at room temperature or lukewarm you do not want to make sure it's hot or both boiling you can pour it into any container that you have available and you want to make sure that you are using a 60 cc or 2 ounce syringe if you have a smaller syringe provided by the homecare you're gonna have to administer it twice the smaller syringes maybe 30 CC if your PEG tube looks something like this which would be the venting peg you are going to have to make sure that the park that's venting is capped if it's on cap then you're gonna see water coming out so I cap it I'm gonna pull up some water for my flush before the feed all the way to the top which will be my two ounces this is a full syringe of water I attach it to the peg and I push it down all the way in so this way it's very secure and then I slowly push it in and as you can see it's going a nicely no water is coming out and it's going into the container / stomach you do not want to lie flat for at least one hour after your feeding you want to use room-temperature liquids even for your formula always make sure that the formula has been shaken to make sure that the contents have all been mixed together I have shaken my formula prior to you can use the same syringe for administering your formula as you did for the flush refrigerate any unused liquid nutrition and bring to room temperature before putting through the PEG tube so now I'm gonna demonstrate administering the formula I'm just using a different tube just to show how the formula goes in but it's the same method so you want to pull back the formula after you have poured it into your container attach the syringe to the to feed push it in to make sure it's secured and push the syringe down as you can see my formula is going in there's no clogs or kinks in the tube and it's all administered after I have administered the formula you want to give another full syringe of water if you have any questions about the care or functioning of your PEG tube talk to your medical team if you have any questions or concerns about your nutrition or hydration talk to your registered dietitians at Roswell Park they'll make suggestions for changing your regimen thank you and have a good day