STARS Train the Trainer Class (TtT) - Beta-Gastric Tubes for EMS

Gastric Tubes for EMS

Pdf Summary

This document provides training guidance for managing gastric tubes in special needs children, focusing on indications, tube types, assessment, field use, and common complications.<br /><br />Children may have gastric tubes to facilitate feeding and medication administration or to provide nutritional supplementation. The main tube types covered are the MIC-KEY button, a low-profile tube commonly used in children that enters the stomach and is held in place by a balloon inflated with 3–5 mL of sterile water and requires extension tubing for use; the gastrostomy tube, typically placed surgically and often used for continuous feeds, secured by a balloon and external disc, also inflated with 3–5 mL sterile water and generally not requiring additional tubing; and the gastrojejunostomy (G-J) tube, used for poor gastric function, chronic vomiting, or severe GERD, allowing feeds to bypass the stomach into the jejunum. G-J tubes are prone to dislodgement and clogging and should not be replaced in the field.<br /><br />Assessment of placement and patency includes inspecting the stoma site for redness, rash, and drainage; attaching extension tubing and a Toomey syringe to aspirate stomach contents (do not aspirate through the jejunal port on G-J tubes); and flushing with water (5–10 mL for infants/toddlers, 10–30 mL for children/adolescents).<br /><br />In the field, gastric tubes can be used to administer medications and, in some cases, as an alternative to IV access—most commonly for glucose administration and cautious rehydration (“start low and go slow”). Avoid using the jejunal port for medications.<br /><br />Complications include dislodgement and abdominal distention. Because stomas can begin closing within an hour, dislodged gastric tubes should be replaced on scene when possible, following age-of-tract guidance; for newer tracts, place a temporary catheter as a placeholder and transport. Dislodged G-J tubes require transport. For abdominal distention, vent the tube to release air; never connect to suction, though it may be opened to gravity. Transport is required when a tube cannot be managed in the field or under listed criteria.

Keywords

pediatric gastric tube management

special needs children enteral feeding

MIC-KEY button tube

gastrostomy tube (G-tube)

gastrojejunostomy tube (G-J tube)

stoma site assessment and care

tube placement and patency check

field medication administration via G-tube

tube dislodgement replacement protocol

abdominal distention venting and complications