Clinical Pathway for Management of Gastrostomy Tube Complications
Identify the type and maturity of G/GJ/J tube in LDA
- G Tubes, GJ Tubes, J Tubes
- Initial vs. replacement tube*
- * Please contact General Surgery if unable to determine who placed the G/GJ/J tube or if the G/GJ/J tube was placed by an outside hospital.
Basics of tube/stoma care:
- Devices for securing a tube and dressings
- Keep site dry
- Treat skin around stoma like other healthy skin – soap + water daily with minimal lotion
- Bedside clinician (RN, MD, APP) comprehensive site assessment:
- Clean the stoma and site
- Check the tube fit (tight vs. loose)
- Contact unit-based resource (e.g., CNS, Skin Champion, APP)
- Document the site with images in Epic Media tab by CNS, APP, FLOC
![Erythema around Stoma](/sites/default/files/1-erythema-around-stoma.jpg)
![Granulation Tissue](/sites/default/files/2-granulation-tissue.jpg)
![Leaking](/sites/default/files/3-leaking.jpg)
![Irritant Dermatitis](/sites/default/files/4-irritant-dermatitis.jpg)
![Enlarged stoma/keyhole](/sites/default/files/5-enlarged-stoma-keyhole.jpg)
![Prolapse](/sites/default/files/6-prolapse.jpg)
Notify the Appropriate Service
Information about the inserting/managing service is located in the LDA in Epic.
See a sample LDA.
To notify the appropriate service, see contact information below and Sample ISBARQ.
Initial G tubes/J tubes placed by General Surgery |
|
---|---|
Replacement G tubes/J tubes initially placed by General Surgery | |
Initial G tubes placed by IR and all GJ tubes |
|
Replacement G tubes that were initially placed by IR |
|
All Tubes at KOPH | Call KOPH Gen Surg Cnslt 1st Contact via Epic Chat |
Reviewed by Children's Hospital of Philadelphia Clinical Care Committee: May 2019
Posted: May 2019
Revised: July 2023
Editors: Clinical Pathways Team
Posted: May 2019
Revised: July 2023
Editors: Clinical Pathways Team