PROTOCOLS FOR GASTROSTOMT TUBE PATIENT

Preoperative preparation
1- Patient assessment ( full history and complete physical examination ) documented in
patient file
2- Baseline Investigations ( CBC , BG , RFT and electrolyte , Bleeding profile … others
Accordingly )
3- Upper GI Endoscopy report
4- Patient counselling about the feeding tube
5- NPO /fasting the night before surgery at least 6hours
6- Iv fluids
7- Consent
8- Single dose IV antibiotic 1h prior to procedure.

Postoperative care of feeding tube

1- The feeding starts in sequential manner beginning with small dilute volume in the 1st
day postop.
2- Clean the tube site with NS
3- Asses the Tube site for possible complications
4- Dress the incision wound according Hospital guidelines
Daily Routine care of the Feeding Tube (D+A+R)
1- Dressings can be removed 24 hours after initial insertion.
2- Clean with Normal saline daily while in the hospital
3- advance tube 2-3cm ventrally
4- rotate 270 - 360⁰
Feeding on the Ward
1- Feeding commence after 6-8hours in adult and 4-6h in children after confirming the
presence of bowel sound start with fluids.
2- Pt’s should be positioned 30-45⁰ from horizontal during feeding and for 30-60min
post feeding.
3- Medications can be administered
Feeding Guide
Post-Op Day Amount given Via Tube Amount Given Note
IV
Day1 60ml/h fluids 2.5l/24h Iv fluids. Flush with 30ml
 warm water RL:NS:D5% water after each feed
 dry tea + sugar 1: 1:0.5l via the tube
Day 2 150ml/2hs 2l/24hs Iv fluids
 warm water RL :NS
 dry tea + sugar 1:1L

Day 3 200ml/2hs 1.5l/24hs Iv fluids

 warm and Cold RL: NS
water 1: 0.5L
 dry tea + sugar
 diluted milk

Day 4 400ml/3hours Stop iv fluids For discharge if the

 Porridge patients’ condition is
 milk stable
 Juice
 Sugar Tea
 any fluids

Discharge Education
1- Daily checking of stoma site - including position at skin level, leakage, excoriation.
2- Cleaning of stoma site
3- Water flushing to prevent blockages
4- Daily advancing and rotating
5- Feeding plan: - feed type, amount , method and water flushes
6- Potential complications and how to manage
7- Contact details, including after hours
8- Follow up arrangements