Hooking Up

A feeding tube comes with a lot of new equipment and supplies.

Feeding Pump and Bags:

There is two main pumps available in the United States: the Covidien Kangaroo Joey and the Moog EnteraLite Infinity.

The Covidien Kangaroo Joey allows a patient to feed and flush while hooked up. There are feed and flush bags available. A patient can fill one bag (with the purple cap) with the formula, and place sterile water in the second bag (with the blue cap). After the bags are primed, which is important to get all the excess air out of the bag to prevent painful air bubbles from entering the small bowel, a patient can then input their feed and flush requirements into the Joey. Total formula volume would be entered, followed by feeding rate, and then total flush volume would be entered, along with how often it should occur. This is very handy for overnight use, or when patients are not ambulatory. Instead of having to get up in the middle of the night, disconnect, fill a syringe, flush, and then re-connect, a patient can stay sound asleep and have the pump stop the formula, run the water flush, and then re-start formula feeding.

The Joey pump has many more electronic options than the EnteraLite. One popular feature is its ability to Auto Prime. With a touch of a button, the air will be forced out of the bag and the formula advanced down the line automatically. The machine stops priming when there are about 6" of tubing left. This is to prevent formula from spilling out the connector. All a patient has to do is manually hold the Auto Prime button for a few seconds to complete purge out the air and bring the formula to the end of the connector.

The Moog EnteraLite Infinity does not have the feed and flush option that the Joey does. It also doesn't auto prime. Once formula is poured into the bag, a patient must snap on the cap, turn the bag upside down to force the air to the top, and then manually pinch the longer end of the cartridge, slowly advancing the formula down the line.

Although it is more time consuming and requires hand strength, the Infinity drives out air much more effectively than the Joey. This allows the Infinity to be used in any position, even upside down. For active adults, this is very important. It is also extremely important for toddlers, children, and teens that roll around, hang from jungle gyms, and toss their feeding backpacks into various positions and configurations. The lighter weight and smaller size of the Infinity makes it easier to transport and camouflage. It can be placed in waist packs, purses, and cross body bags.

The pump that is right for you will depend on your feeding requirements. Some suppliers also only carry one brand of pumps, and some insurers only cover one brand.

Syringes:

There are many different types and sizes of syringes.  Catheter (large, long tip) or slip tip (short, thin tip) syringes are good choices to start.  Syringes come in a variety of sizes ranging from 1 ml to 60 ml.

Syringes may or may not be covered by insurance.  Some pharmacies will give them out for free with medications. Syringes can be reused at home.  They can be washed with soap and hot water and rinsed well.  Do not put syringes in the dishwasher.

Tape:

There are many types of tape with varied uses.  Some common ones are:

Hypafix: This is a thin, flexible, breathable cloth tape that must be cut with scissors.  It has a strong hold (does not rip apart) even when wet but is gentle on skin.  It works well for securing NJ-tubes.

Micropore: Micropore (also known as paper tape) is a gentle adhesive that comes off easily when wet.  It is extremely versatile and works well for securing J-tube or G/J-tube extension sets to the skin.

Medipore: Medipore is a light, thin, flexible, breathable cloth tape that is similar to Hypafix except that it is pre-perforated so no scissors are necessary.  This adhesive is not quite as strong as Hypafix, but does work well and is gentle on skin.

Duoderm:  This dressing can be used as base on the face for those who use NJ tubes.  It works well to protect the skin from the daily irritation of the NJ tube.  Patients can place it on the cheek where the tube needs to be, place the NJ tube, and then use a layer of another type of adhesive over the top to secure the tube.  It protects the cheek from getting a groove in it from the tube, and is very gentle on the tender skin of the cheeks. It is a soft and pliable gel adhesive that sticks well to clean, dry skin and when removed, is very gentle on the skin.

Tegaderm: Tegaderm is a very thin, clear dressing commonly used to cover things like IVs and accessed ports. It is fabulous as an NJ tube adhesive.

Durapore: This is a silky cloth tape with a very strong adhesive.  It tends to be irritating on sensitive skin but has a strong hold until it gets wet.  It can be used for taping NJ tubes and extension sets to clothing.

There are also a multiple of securement devices that can be used to stabilize and hold your tube in place.  Some options are: Bard Stat-Lock Device, Hollister Tube Attachment Device, and Grip-Lock.