Gastrostomy (G, GJ, J) Complications — Check the Tube Fit: Tubes that Are Too Tight or Too Loose — Clinical Pathway: Inpatient

G, GJ, J Tube Complications Clinical Pathway — Inpatient

Check the Tube Fit: Tubes that Are Too Tight or Too Loose

See the G Tubes, GJ Tubes, J Tubes Job Aid.

To check the tube fit:

  1. Wiggle the tube to check the fit against the skin.
  2. Assess when patient is sitting and lying flat.
  3. Assess how the tube is secured (see guidance).

A well fit tube should:

  • Not cause indentations or puckering of the skin.
  • Be snug against the skin with ability to place 1 piece of split gauze between the tube and skin easily.
  • Be able to rotate 360 degrees.
Check the Tube Fit: Tubes that Are Too Tight or Too Loose
Tube Fit For all Tubes Comments
Too Tight
  1. Place a dry dressing between the skin & tube to prevent skin injury.
  2. Secure the tube.
  3. Tube may need to be upsized – notify the appropriate service
Tube is too tight example 1 Tube is too tight example 2 Tube is too tight example 3
  • For initial MIC Balloon G-Tubes: Hollister® Dressing may need to be changed/replaced.
  • For replacement MIC Balloon G-Tube the retention disc may need to be adjusted. See Job Aid: G Tubes, GJ Tubes, J Tubes.
  • For non-balloon G-Tubes & GJ tube:
    1. For percutaneous radiologic (PRG) tubes that have a cross bar – adjust the cross bar and loosen so that 1 piece of split gauze can be placed. Notify appropriate service for guidance.
    2. For capsule non-balloon tubes and tubes with no cross-bar – notify the appropriate service
  • For surgical low-profile balloon J-tube: call General Surgery.
Too Loose
  • For balloon tubes:
    1. Check the listed balloon volume in the LDA.
    2. Check the actual balloon volume.
    3. If needed, fill the balloon with water to the recommended volume located on the balloon port of the tube.

  • Exception: Do Not fill balloon of surgically placed low profile balloon jejunostomy tube to the volume printed on the balloon port. Fill volume for Surgically Placed Low Profile Balloon Jejunostomy Tube is noted in the LDA.

    If balloon is filled to the volume listed in LDA and tube continues to leak, call General Surgery. Notify the appropriate service.