Clinical Pathway for Management of Gastrostomy Tube Complications
Identify the type and maturity of G/G-J/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/G-J/J tube or if the G/G-J/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
| Resource | Expertise |
|---|---|
| General Surgery | Any G-tube or J-tube placed by General Surgery |
| Interventional Radiology (IR) | Problems with any initially placed tube by IR and all G-J tubes |
| GI G-Tube Nurse | Problems with replacement G-tubes that were initially placed by IR Replacement tubes followed by GI |
Reviewed by Children's Hospital of Philadelphia Clinical Care Committee: May 2019
Posted: May 2019
Revised: October 2020
Authors: Acord, M. MD; Stetzer, M. CWOCN; Crawford, J. ACCNS-P; Thompson, L. PA-C; Hillman, J. CRNP; Jang, L. CRNP; Boroughs, A. CWOCN; Rhodes, K. CRNP; Ehritz, C. ACCNS-P; Ryan, M. MD; Laje, P. MD
Posted: May 2019
Revised: October 2020
Authors: Acord, M. MD; Stetzer, M. CWOCN; Crawford, J. ACCNS-P; Thompson, L. PA-C; Hillman, J. CRNP; Jang, L. CRNP; Boroughs, A. CWOCN; Rhodes, K. CRNP; Ehritz, C. ACCNS-P; Ryan, M. MD; Laje, P. MD