Percutaneous Endoscopic Gastrostomy – Post Insertion Care
When your patient returns to the ward:
- Intravenous sedation and analgesia is used during the PEG insertion therefore close monitoring is required particularly in the elderly patient.
- The PEG may be used after 6 to 8 hours. Flush first with sterile water and commence the feed at a slow rate. A feeding regime should be obtained from the dietitian.
- Observe the stoma (insertion site) for bleeding. Apply a dressing if required.
- Give pain relief if needed.
- Do not bath the patient for 2 weeks post insertion, a shower is ok.
- Do not disturb the PEG for at least 24 hours
24 to 48 hours Post PEG insertion
- Gradually increase the feed according to the dietetic regime
- Remove the dressing around the PEG after 24 hours and leave exposed. Clean around the PEG stoma aseptically.
- Turn the PEG through 360° every day to aid the formation of the stoma and to reduce pressure on the gastric mucosa.
- Ensure that there is very slight (about 2-3 mm) in and out movement of the PEG prior to feeding. This ensures the PEG is not too tight against the gastric wall.
After 48 hours
The stoma may be gently cleaned with soap and water. Observe for signs of infection. Do not disturb the external retainer.
Tricks and Tips
Flushing the tube:
Use at least 30 to 50 mls of sterile water in a 50 ml syringe.
Depress the syringe plunger slowly but firmly.
Ensure that the tube is flushed after all feed and each medication.
Ensure the stopper on the ‘Y’ connector is correctly replaced.
If the tube is flushed properly it should not block. Blockages are usually caused by medicines that cause sedimentation in the tube.
To unblock a tube try flushing vigorously but without excessive force with warm water. Soda water may also be used.
Never try to unblock the tube by using force or by introducing instruments into the tube. This may damage the tube or injure the patient.
Royal Infirmary of Edinburgh. 2007. Percutaneous Endoscopic Gastrostomy – Post Insertion Care Guidelines. Retrived August 11, 2010 from http://www.mph.ed.ac.uk/endo/guidepeg2.htm