Nutrition Initiation and Advancement Clinical Pathway — PICU/PCU
Nutrition Initiation and Advancement Clinical Pathway — PICU/PCU
Scheduled & Unscheduled Interruptions: Recommendations for Resuming Feeds
Elective and/or emergent procedures: radiological studies/interventions, OR, bedside procedure…etc.
Stopping & Resuming Feeds
- Follow appropriate NPO guideline & place on maintenance IVF prior to procedure
- Discontinue feedings
- For emergent procedure (if possible), aspirate gastric contents via feeding tube to empty the stomach; consider sump placement to drain stomach contents.
- Aspirating gastric contents may not fully empty the stomach. Follow all precautions for prevention of aspiration.
- Following completion of procedure/transport, return patient to pre-procedure/transport status
- Resume feeds when deemed appropriate by clinical team:
- Within 24 hours of procedure – restart at the last tolerated rate & resume pathway advance.
- ≥ 24 hours after procedure – restart at ½ the last tolerated rate & resume pathway advance.
- For surgical procedures, defer to surgery team for resuming feeds.
- If not tolerated, determine etiology of intolerance & follow feeding guideline.
- Continue to advance feedings according to the feeding guideline.