The decision to insert a PEG tube will always be made on an individual basis after discussions with the patient and the multi-disciplinary team. When someone only needs temporary enteral tube feeding it's sometimes possible to pass a thin tube through the nose to the stomach. However, if the individual requires longer-term enteral feeding, PEG feeding could be considered. Generally speaking, PEG tubes are better tolerated than NG tubes. They have fewer interruptions and are easier to use and they also have fewer risk/complications than NG tubes. The PEG tube is often more comfortable and is relatively straightforward to care for and handle at home. Lots of people choose a PEG tube as they are a discreet alternative, which can be easily hidden under clothes. On the day of the procedure, patients should not eat for six hours and will need to stop drinking clear fluids two hours before the procedure. In most hospitals, when the patient arrives on the ward a cannula or small needle will be placed in the arm or hand, before being transferred into a dedicated Endoscopy Unit. The procedure doesn't require a general anesthetic, although some patients may be given a sedative.
A mouth guide will be positioned in the patient's mouth, and the endoscope then passes through the mouth into the stomach. During the procedure, suction equipment is used to remove saliva and other secretions in the throat. An antiseptic solution and local anesthetic will be applied to the individual's stomach. The tube is then placed into the stomach with an exit made through the abdominal wall. A little plastic disk on both the inside and outside stops the tube from becoming dislodged, with the entire procedure usually taking between 20-30 minutes. If you are caring for a patient with a PEG tube you must pay meticulous attention to hand hygiene and other facets of infection control. Wash your hands carefully and always wear gloves and an apron, when administering the food or carrying out a task which involves touching the tube. The tube and the surrounding area must be cleaned each day with soap and water and thoroughly dried. The tube should also be flushed before and after every enteral tube feeding, to reduce the risk of infections or blockages developing.
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