Securing the PEG or Extension Set
Other than the daily spinning of the G-tube, movement and pulling on the site should be minimized to prevent trauma and leakage.
Many parents use medical tape, such as Micropore (paper tape) or Hypafix, or a securement device, such as a Grip-Lok, to secure tubes and extension sets, especially for continuous feeders. You can secure the tube to the stomach with tape. Or you can form a tab to pin to the child’s clothing or diaper by wrapping tape around the tubing and folding it back onto itself.
Little hands can be persistent, so many families have had to come up with unique ways to secure the tube. The image on the right is just one creative example.
Checking the Balloon
If your child has a button or tube held in with a balloon, you may need to periodically check the water level in the balloon. Some doctors like you to check the balloon on a regular basis, such as once a week, while others only suggest you check the balloon if the tube seems to be loosening up or tightening.
To check the balloon, insert a slip tip syringe into the balloon port. While holding the tube in place, withdraw back the water from the balloon into the syringe. Sometimes you will also withdraw some air. It can be difficult to get all of the water and air in one try, so you may need to pull back a few times.
Once you have emptied the balloon, note how much water is in the syringe. If there is more or less water in the syringe than there should be, add or remove water until the right amount remains in the syringe. If the water from the balloon is very discolored or looks contaminated, you may want to replace it entirely. Note that the stomach is not sterile, so regular tap water is fine unless your child has an immune system disorder.
Children with MicKey buttons tend to keep 5ml in the balloon, but your doctor may advise putting more or less water into the balloon, depending on your child’s size and needs. AMT MiniONE balloons should be filled according to the manufacturer’s guidelines (p. 11). Insert the correct amount of water back into the balloon and remove the syringe.
If the balloon seems to be losing water continuously, or if more fluid is in the balloon than was initially inserted, the balloon may have a small hole. Replace the tube or button as soon as possible. Even if the balloon has burst, the tube or button can be taped in place until it can be replaced.