Utilised by nursing staff competent in the procedure. Patients requiring out of hours NJT insertion the following guideline will be Six French (6FR)Įnteral tubes are not recommended as they block easily.įor NJT placement for patients in PICU and (8-9) At RCH, the recommended tube to be insertedįor jejunal feeding is the yellow CORFLO* silastic enteral feeding tube with ENfit® connector. Of correct position of a newly inserted tube is mandatory before feedings or Tubes may be placed with the assistance of endoscopy or fluoroscopy. Is preferred. NJT insertion without direct vision will requireĬonfirmation 4 hours post procedure via abdominal xray. Insertion under direct vision via radiological exposure.Microbiological defenses of the stomach, therefore sterile or pasteurizedįeeds must be used and an aseptic non-touch technique adhered to whenīecome blocked requiring frequent flushingįeeding result in reduced mobility of the patient Risk of gastro-intestinal infection as the tube bypasses the natural (5, 6)Ĭan be challenging due to the following factors:

(1-4) While onerous, jejunal feeding is safer and less expensive than parenteral nutrition (PN). Jejunal feeding is indicated in patients with gastric outlet obstruction, gastroparesis, pancreatitis, severe reflux with faltering growth, and known reflux with aspiration of gastric contents, where continuous gastric feeding has been trialed and unsuccessful. Jejunal feeding may be initiated for a patient of any age. Ensure adequate pain management plan is in place (if post PEG-J Freka).Advise route and preparation advice for medication administration, in conjunction with pharmacy.Please ensure dietitian is referred at least 48 hours prior to discharge. Referral to dietitian for RCH HEN program (as required).Referral to dietitian for recommended feeding plan post jejunal tube insertion.Ensure jejunal specific Home Enteral Nutrition (HEN) education has been completed, including pump training (for RCH patients not previously known to RCH nutrition department).For new insertion of PEJ or G-J tube, dietitians should refer to Jejunal tube grade up local guideline.To ensure grade up feed plan and target regime is clearly documented.A dietitian referral should be initiated on admission or when jejunal tube is placed. Patients post insertion of jejunal feeding tube should be managed by their main unit dietitian.For patients post PEG-J Freka insertion, education should also be completed on stoma care/delivery of feeds.

To provide education on delivery of feeds, flushes, medication administration and ensure parents/carers are competent in flushing, delivering feeds and caring for jejunal tube.

Safe administration of jejunal feeds and medications during inpatient stay.

Percutaneous Endoscopic Jejunostomy (PEJ) - a feeding tube which is inserted through the abdominal wall directly into the small intestine (jejunum).

The Jejunal extension is then inserted through the middle of the PEG.

Percutaneous Endoscopic Gastrostomy-Jejunostomy Freka (PEG-J Freka) – PEG device inserted as a primary device when no previous gastrostomy exists.Percutaneous Endoscopic Gastrostomy (PEG) - a feeding tube that is placed through the abdominal wall and into the stomach.Nasojejunal Tube (NJT) - Thin soft tube passed through a patient’s nose, down the back of the throat, through the oesophagus, stomach and pyloric sphincter into the jejunum.Home Enteral Nutrition (HEN) – enteral tube feeding that occurs outside of the hospital, administered by parents/carers or patients themselves.It contains two entry points (ports) - a gastric port which opens into the stomach, and jejunal port which opens into the jejunum Gastrojejunal Tube (G-J) - a low profile balloon device inserted through an existing gastrostomy by interventional radiology which extends to the jejunum.Dumping Syndrome – rapid gastric emptying where food moves through the small bowel too quickly, resulting in a number of symptoms such as nausea, diarrhoea and abdominal cramps.Closed Feeding System – a feeding system whereby a sterile feeding container is spiked with a feeding set, to prevent contamination of the feed during administration.To provide a framework for clinical consistency in the management of jejunal feeding at the Royal Children’s Hospital. This type of feeding is also known as post-pyloric or trans-pyloric feeding. The feeding tube is passed into the stomach, through the pylorus and into the jejunum. Jejunal feeding is the method of feeding directly into the small bowel.

Qfeed for tube feeding nares