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G, GJ, J Tube Complications Clinical Pathway — Inpatient

Clinical Pathway for Management of Gastrostomy Tube Complications

 
 
Identify the tube type and maturity of stomal tract in LDA
Verify that the info in LDA is up to date and accurate
  • Local resources for support include:
    • CNS
    • Skin Champion
    • APP
 
 
Bedside Team Completes the Following Steps
 
 
 
 
 
 
 
 
 
 
 
 
Erythema around Stoma
Irritant Dermatitis
Leaking
Enlarged stoma/keyhole
Granulation Tissue
Prolapse
If no improvement following bedside treatments, contact the appropriate service
PHL
Type of Tube Contact via Epic Secure Chat
Initial and Replacement G Tubes/
J Tubes Placed by General Surgery
  • Contact General Surgery for problems with these tubes:
    • Weekdays between 9 a.m. – 4:30 p.m.: PHL Gen Surg Gtube in Epic On-Call Finder
      • If NP in General Surgery is not available: Gen Surg Cnslt ED/IP in On-Call Finder
    • For PHL NICU: Contact PHL NICU Green FLOCs via Epic Chat
Initial G Tubes Placed by IR and
All GJ Tubes
  • Contact IR for problems with these tubes
    • Weekdays 7 a.m. – 5 p.m. PHL IR FLOC
Replacement G Tubes That Were Initially Placed by IR
  • Contact PHL Wound Ostomy Gtube Consult
    • Monday – Friday: 8 a.m – 4:30 p.m.
Replacement G Tubes That Are Currently Followed by GI
All Tubes Placed Outside of CHOP and Not an Established Patient with General Surgery or GI
  • Contact PHL Wound Ostomy Gtube Consult
  • Contact General Surgery on Nights/Weekends/Holidays
KOPH
Type of Tube Contact via Epic Secure Chat
Initial G Tubes Placed by IR and
All GJ Tubes
  • Contact IR for problems with these tubes:
    • Weekdays 7 a.m. – 5 p.m. PHL IR FLOC
Replacement G Tubes Placed by IR Consult KOPH Gen Surg Cnslt 1st Contact via Epic Chat
All Tubes Placed by General Surgery
All Tubes Placed Outside of CHOP

 

Posted: May 2019
Last Revised: May 2025
Editors: Clinical Pathways Team

 

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