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www.halyardhealth.com
Distributed in the USA by Halyard Sales, LLC, Alpharetta, GA 30004
In USA, please call 1-844-425-9273 • halyardhealth.com
Halyard Health, Inc., 5405 Windward Parkway, Alpharetta, GA 30004 USA
Halyard Belgium BVBA, Leonardo Da Vincilaan 1, 1930 Zaventem, Belgium
Sponsored in Australia by Halyard Australia Pty Limited; 52 Alfred Street, Milsons Point, NSW 2061
製造販売元 ハリヤード・ヘルスケア・インク 横浜市西区みなとみらい二丁目2番1号
*
Registered Trademark or Trademark of Halyard Health, Inc., or its affiliates. © 2015 HYH. All rights reserved. 2015-07-29
15-H1-459-0-00 / 70170019
Single Use Only
Do not use
if package is damaged
Product is NOT made with DEHP
as a plasticizer
Caution
Rx Only
Sterilized Using
Ethylene Oxide
Do not resterilize
Diameter
Length
Consult instructions
for use
General Flushing Guidelines
• Use a 30 to 60 cc catheter tip syringe. Do not use smaller size syringes as this can increase pressure on the tube and
potentially rupture smaller tubes.
• Use room temperature tap water for tube flushing. Sterile water may be appropriate where the quality of municipal water
supplies is of concern. The amount of water will depend on the patient’s needs, clinical condition, and type of tube, but
the average volume ranges from 10 to 50 mls for adults, and 3 to 10 mls for infants. Hydration status also influences the
volume used for flushing feeding tubes. In many cases, increasing the flushing volume can avoid the need for supplemental
intravenous fluid. However, individuals with renal failure and other fluid restrictions should receive the minimum flushing
volume necessary to maintain patency.
• Do not use excessive force to flush the tube. Excessive force can perforate the tube and can cause injury to the
gastrointestinal tract.
• Document the time and amount of water used in the patient’s record. This will enable all caregivers to monitor the patient’s
needs more accurately.
Daily Care & Maintenance Check List
Assess the patient
Assess the patient for any signs of pain, pressure or
discomfort.
Assess the stoma site
Assess the patient for any signs of infection, such as
redness, irritation, edema, swelling, tenderness, warmth,
rashes, purulent or gastrointestinal drainage.
Assess the patient for any signs of pressure necrosis, skin
breakdown or hypergranulation tissue.
Clean the stoma site
Use warm water and mild soap.
Use a circular motion moving from the tube outwards.
Clean sutures, external bolsters and any stabilizing
devices using a cotton-tipped applicator.
Rinse thoroughly and dry well.
Assess the tube
Assess the tube for any abnormalities such as damage,
clogging or abnormal discoloration.
Clean the feeding tube
Use warm water and mild soap being careful not to pull
or manipulate the tube excessively.
Rinse thoroughly, dry well.
Clean the jejunal, gastric and balloon ports
Use a cotton tip applicator or soft cloth to remove all
residual formula and medication.
Do not rotate the external bolster
This will cause the tube to kink and possibly lose position.
Verify placement of the external bolster
Verify that the external bolster rests 2–3mm above
the skin.
Flush the feeding tube
Flush the feeding tube with water every 4–6 hours
during continuous feeding. Anytime the feeding is
interrupted, or at least every 8 hours if the tube is not
being used.
Flush the feeding tube after checking gastric residuals.
Flush the feeding tube before and after medication
administration.
Avoid using acidic irrigants such as cranberry juice and
cola beverages to flush feeding tubes.
Balloon Maintenance
Check the water volume in the balloon once a week.
• Insert a Luer slip syringe into the balloon inflation port and withdraw the fluid while holding the tube in place. Compare
the amount of water in the syringe to the amount recommended or the amount initially prescribed and documented in the
patient record. If the amount is less than recommended or prescribed, refill the balloon with the water initially removed,
then draw up and add the amount needed to bring the balloon volume up to the recommended and prescribed amount
of water. Be aware as you deflate the balloon there may be some gastric contents that can leak from around the tube.
Document the fluid volume, the amount of volume to be replaced (if any), the date and time.
• Wait 10–20 minutes and repeat the procedure. The balloon is leaking if it has lost fluid, and the tube should be replaced. A
deflated or ruptured balloon could cause the tube to dislodge or be displaced. If the balloon is ruptured, it will need to be
replaced. Secure the tube into position using tape, then follow facility protocol and/or call the physician for instructions.
Note:
Refill the balloon using sterile or distilled water, not air or saline. Saline can crystallize and clog the balloon valve or
lumen, and air may seep out and cause the balloon to collapse. Be sure to use the recommended amount of water as over-
inflation can obstruct the lumen or decrease balloon life and under-inflation will not secure the tube properly.
Tube Occlusion
Tube occlusion is generally caused by:
• Poor flushing techniques
• Failure to flush after measurement of gastric residuals
• Inappropriate administration of medication
• Pill fragments
• Viscous medications
• Thick formulas, such as concentrated or enriched formulas that are generally thicker and more likely to obstruct tubes
• Formula contamination that leads to coagulation
• Reflux of gastric or intestinal contents up the tube
To Unclog A Tube
1. Make sure that the feeding tube is not kinked or clamped off.
2. If the clog is visible above the skin surface, gently massage or milk the tube between fingers to break up the clog.
3. Next, place a catheter tip syringe filled with warm water into the appropriate adaptor or lumen of the tube and gently pull
back on then depress the plunger to dislodge the clog.
4. If the clog remains, repeat step #3. Gentle suction alternating with syringe pressure will relieve most obstructions.
5. If this fails, consult with the physician. Do not use cranberry juice, cola drinks, meat tenderizer or chymotrypsin, as they can
actually cause clogs or create adverse reactions in some patients. If the clog is stubborn and cannot be removed, the tube
will have to be replaced.
Balloon Longevity
Precise balloon life cannot be predicted. Silicone balloons generally last 1-8 months, but the life span of the balloon varies
according to several factors. These factors may include medications, volume of water used to inflate the balloon, gastric pH and
tube care.
Warning: For enteral nutrition and/or medication only.
For more information, please call 1-844-425-9273 in the United States, or visit our web site at www.halyardhealth.com.
Educational Booklets: “A Guide to Proper Care” and a Stoma Site and Enteral Feeding Tube Troubleshooting Guide is available
upon request. Please contact your local representative or contact Customer Care.
