A percutaneous endoscopic gastrostomy (PEG) tube is a flexible feeding tube placed through the abdominal wall directly into the stomach. This medical device provides nutrition, fluids, and medications to individuals who are unable to consume enough by mouth. Routine monitoring of PEG tube function is important to help ensure proper care and support overall health.
Understanding PEG Tube Residuals
Gastric residual volume (GRV) refers to the amount of fluid remaining in the stomach from previous feedings or secretions. Checking GRV helps assess stomach emptying, preventing overfilling and discomfort.
Measuring GRV also reduces the risk of aspiration, where stomach contents enter the lungs. Consistent gastric emptying supports proper absorption of nutrients and medications delivered through the tube.
Steps for Checking Residuals
Gather supplies: a 60 mL syringe, clean gloves, and a measuring cup. Perform thorough hand hygiene before touching the tube or patient. Position the individual comfortably, with their head elevated to at least a 30-degree angle.
Unclamp the PEG tube and remove the cap. Attach the 60 mL syringe to the tube opening, ensuring a secure connection. Gently pull back on the syringe plunger to aspirate stomach contents slowly until no more fluid can be easily withdrawn.
Note the volume of fluid collected. If the syringe fills, empty it into the measuring cup and reattach to continue aspirating. After measuring, gently return the aspirated residual volume to the stomach unless instructed otherwise by a healthcare professional, as this prevents fluid and electrolyte imbalances.
After returning the residual, flush the PEG tube with 15-30 mL of water to clear the tube and prevent clogging. Reclamp the PEG tube, replace the cap securely, and document the residual volume and any observations according to medical guidelines.
Interpreting and Responding to Residual Volumes
Gastric residual volume indicates an individual’s digestive process. A smaller volume suggests effective stomach emptying. While specific thresholds vary, a residual volume of less than 200-250 mL is typically acceptable before a feeding.
If the measured residual volume is small and acceptable, continue the planned tube feeding. If the volume is larger than the guideline, it may indicate delayed gastric emptying. Healthcare providers may recommend holding the feeding temporarily to allow the stomach more time to empty.
Always consult with a healthcare professional for specific instructions regarding residual volume thresholds and appropriate actions. They will provide individualized guidance on whether to return a larger residual, hold the feeding, or adjust the feeding rate. Following these personalized medical instructions is important for safe and effective care.
Important Considerations for Residual Checks
The frequency of checking residuals depends on the feeding schedule and individual condition. For intermittent feedings, residuals are checked before each feeding. For continuous feedings, checks are performed every four to eight hours to monitor gastric emptying.
Accurate documentation of residual volumes is important for tracking trends and communicating with healthcare providers. Pay attention to symptoms like nausea, abdominal distension, or vomiting, as these can signal potential complications regardless of the residual volume. Report these symptoms to a healthcare professional.
Maintaining consistent technique during each residual check helps ensure accurate measurements and reduce the risk of complications. Always prioritize proper hand hygiene and maintain a clean environment around the PEG tube site. If there are any concerns about the PEG tube’s function or the individual’s well-being, seek immediate medical attention.