A gastrostomy tube, often called a G-tube, is a medical device providing a pathway for nutrition and medication directly into the stomach. It is surgically placed through the abdominal wall, offering a means of feeding for individuals unable to consume adequate nutrients orally. This article provides step-by-step instructions on checking G-tube residual, an important aspect of G-tube care. Understanding this process can help ensure safe and effective use of the feeding tube.
What is G-Tube Residual and Why Check It?
G-tube residual refers to the volume of formula or other liquid that remains in the stomach from a previous feeding. This liquid is considered undigested or partially digested contents that have not yet moved into the small intestine. Checking this residual volume helps healthcare providers and caregivers monitor the digestive process and stomach emptying.
Checking G-tube residual is important for several reasons. It helps prevent complications like aspiration, where stomach contents enter the lungs, leading to respiratory issues. It also indicates how well the stomach tolerates feedings, suggesting adjustments if needed.
Gathering Your Supplies and Preparing
Gather all necessary supplies before beginning the procedure. You will need a 60 mL syringe and clean gloves. Have a clean container or basin for the aspirated residual, and a paper towel or chucks for spills.
Once supplies are ready, prepare the individual. Position the person comfortably, often in a semi-Fowler’s position (head of bed elevated to at least 30 degrees). This upright position helps reduce the risk of aspiration during the procedure. Perform hand hygiene (wash hands or use sanitizer) before touching supplies or the G-tube.
Step-by-Step Guide to Checking G-Tube Residual
Gently clamp or kink the G-tube to prevent leakage before disconnecting the feeding set. Carefully disconnect the feeding bag or administration set from the G-tube port. Maintain a clean field around the G-tube site.
Attach the 60 mL syringe to the G-tube port, ensuring a secure connection. Slowly and gently pull back on the syringe plunger to aspirate stomach contents. Continue drawing back until no more fluid can be easily withdrawn, avoiding excessive force that could irritate the stomach lining. The aspirated fluid represents the gastric residual volume.
Once aspirated, carefully remove the syringe from the G-tube port. Measure the collected fluid volume by reading the syringe markings. If the volume exceeds the syringe’s capacity, empty it into a clean container and repeat aspiration until all residual is collected and measured. After measuring, either return the residual to the stomach or discard it per medical instructions.
Interpreting Residual Volumes and Taking Action
After measuring the G-tube residual, it is important to interpret the volume and take appropriate action. General guidelines suggest that a residual volume less than 200-250 mL for adults is often considered acceptable, though specific thresholds can vary based on individual patient factors and healthcare provider orders. For pediatric patients, a common guideline for holding feeds is when the residual volume is 50% or more of the previous hour’s feed, or 25% of the total daily volume. It is important to note that specific instructions regarding what constitutes a concerning amount will always come from a healthcare professional.
If the residual volume is within the acceptable range, it is generally recommended to return the aspirated contents to the stomach. This practice helps to prevent fluid and electrolyte imbalances that could occur if the residual is consistently discarded. After returning the residual, resume the feeding or administer medications as planned.
Conversely, if the measured residual volume is higher than the prescribed limit or typical amount, certain actions may be necessary. In such cases, the healthcare provider might advise holding or delaying the next feeding to allow the stomach more time to empty. It is always important to contact a healthcare professional, such as a nurse or doctor, to report significant residual volumes and receive specific guidance on how to proceed.