GJ or G-Tube Displacement Clinical Pathway — Emergency Department
GJ or G-Tube Displacement Clinical Pathway — Emergency Department
MD/CRNP/RN Assessment
Tube Information
New vs. Established Tract
- When was the tract created (time of first tube placement)
- Who placed the tube initially (Surgery vs. IR)
- Was the initial tube placed at CHOP (who created the hole)
- Has the tube ever been changed
- Treat all first tube replacements as new tract
IR and General Surgery
| New | < 6 weeks |
|---|---|
| Established | ≥ 6 weeks |
History of Dislodgement
Was the tube pulled out with the balloon inflated
Tube Size
- Check size (diameter and length) of dislodged tube, if available
- Ask family for type and size if the tube is not available
- Review in EPIC under LDA (Lines, Drains, Airway)
- Review IR or Surgery note in EPIC
Health Issues
- Brief H&P to evaluate other acute problems
- Review chronic health problems
Medications
Determine need for administration of routine medications
Hydration
Assess need for IV fluids
Nutrition
- Consider need for glucose check
- Assess IV needs for glucose
Sedation
- IR Considerations
- Assure NPO 2 hours
- This is a non-sedated procedure
- Anxiolytics to be ordered by ED team
- ED staff must accompany patient to IR
- RN to accompany all tele monitored patients