What is Feeding Tube Awareness Week?
This year, Feeding Tube Awareness Week will be observed from February 6th to 10th. This is a time each year for families, nurses, dietitians, and doctors to learn the best practices surrounding the standard hospital procedure of small bowel tube placement. Feeding Tube Awareness Week emphasizes the safety, emotional well-being, and nutritional needs of patients.
As of today, enteral nutrition (EN) feeding tube placement is one of the most frequent procedures performed in American hospitals.
This article will explain the importance of small bowel feeding tube placement and state-of-the-art technology that can help with safer procedures.
EN feeding tubes are flexible devices used for adults and children in medical settings. Tube feeding can save many lives by helping people receive nutrition when they are unable to eat via the regular oral route.
When the right technology in the market is used for feeding tube insertion and placement, such as ENvizion Medical’s ENvue feeding tube navigation system, care units can provide safer patient procedures, avoiding the risks associated with blind insertion.
About 6.7 million enteral feeding tubes are placed via blind insertion annually in the United States. To reduce the chance of complications associated with blind insertion, it is important to use navigation systems to confirm the direction and final placement of feeding tubes.
Blind insertion can result in the malposition of a feeding tube that causes complications such as lung collapse (pneumothorax) or aspiration pneumonia when food or liquid is breathed into the airways or lungs. Unfortunately, tubes inserted blindly through the nose have a malposition rate into the lungs of 0.5%-16%.
To prevent the complication of aspiration pneumonia, placing a feeding tube in the small bowel is recommended. Using blind insertion to achieve a position into the small bowel can be quite challenging with low success rates and requires increased time to migrate into the small bowel. It may also require prokinetic medications to facilitate migration into the small bowel.
The only possible solution to ensure accurate placement in the small bowel is using advanced feeding tube navigation technologies. As written in a report from the American Society of Parenteral and Enteral Nutrition (ASPEN), “for those patients requiring small-bowel feeding, NE tube placement with assistive technology has become the preferred method for many to achieve enteral access while attempting to minimize patient risk” (Powers et al., 2021).
Why would patients need a small bowel feeding tube procedure?
One recommended enteral feeding procedure is the insertion of a small bowel feeding tube. Post-pyloric feeding refers to a type of nutritional access where an enteral feeding tube goes directly into the small bowel, which comprises the duodenum and jejunum.
This procedure is helpful for critically ill patients who cannot digest enough nutrients due to insufficient fluids in the stomach (gastric residual volume) or risk gastric reflux and aspiration.
Switching from gastric to post-pyloric feeding may benefit patients. For one, it may reduce the risk of ventilator-associated pneumonia. The use of a small bowel feeding tube may also help provide nutritional sufficiency to patients who cannot tolerate stomach feedings.
Small bowel feeding tubes can also shorten the stay in an intensive care unit (ICU).
Because EN feeding needs to happen as soon as possible to ensure proper nutritional intake, fluid amounts, and medication dosage, one additional possible complication of inserting a small bowel feeding tube is a delay in feeding.
Initiating EN feeding sooner may assist healing, decrease the length of hospital stay, reduce mortality rates, and lead to significant financial savings.
When hospital care units adopt the relevant technology, delays in feeding due to placing a small bowel feeding tube may decrease. One of the most advanced feeding tube devices today specializing in these procedures is ENvizion Medical’s ENvue System, as featured in the section below.
What are the best device options for a small bowel feeding tube?
There are four expert-recommended devices to ensure safe tube placement and nutritional stability for patients, especially in cases where a small bowel feeding tube is deemed necessary.
These devices also work for other types of enteral feeding and extend beyond small bowel feeding tube procedures.
ENvizion Medical’s ENvue System
Every year, lung collapse (pneumothorax) affects up to 5% of the 35 million feeding tube placements conducted in hospitals worldwide. This statistic is a large part of the reason ENvizion Medical developed a feeding tube positioning system called ENvue®.
ENvue ensures that patients who are unable to eat or swallow on their own receive nutrition more quickly and safely.
This device utilizes electromagnetic body mapping technology to assist clinical staff in navigating a feeding tube as it passes through the nose of the patient to its destination in the stomach or small intestine.
While most feeding tube positioning is confirmed using repeated X-rays after placement, ENvue generates real-time, personalized results during the procedure to ensure timely and GPS-like guidance with limited radiation.
ENvizion Medical is a publicly traded global MedTech company with its product cleared by the FDA 501(k) in February 2019. ENvue is commercially available in the United States and is used in hospital scores nationwide, providing easy adaptation to the market.
Cardinal Health’s Kangaroo ePump
Enteral feeding pumps ensure patients receive sufficient caloric and nutrient intake throughout their stay in an ICU or at home. Devices like Cardinal Health’s Kangaroo ePump assist with consistent nutrient flow rates and dosing for patients. Feeding pumps are created to ease and semi-automate the feeding process.
The Kangaroo ePump has an easily adaptable interface and step-by-step guiding checkpoints for staff operations. It can be programmed to deliver continuous or intermittent feeding and provide periodic water boluses to automate flushing for tube patency and delivery of hydration when used with Kangaroo™ ePump Enteral Feeding Pump feed and flush set.
This device is super light (1.0 kg) and easy to use. It has multiple independent features, including auto-priming, anti-free flow, and an “attitude-independent” design that excludes the need for a drip chamber on the pump set. It features an LED array that notifies staff of its status in both bright and dark rooms.
ICU Medical’s Lopez Valve
Other important issues in the feeding tube community include effective and safe management of the many open lines attached to the patient and prevention of gastric and infectious body fluids exposure. ICU Medical produced a specialized connecting device, the Lopez Valve, to combat these common hospital issues.
The Lopez Valve is designed to keep patients and medical staff safe from hazardous fluid exposure, and it saves valuable time because of its reliable, closed system for fluids. It helps with feeding tube plugs, drug administration, and suctioning procedures.
This connecting device features different nutritional insertion points, such as an enteral-specific (ENFit) medication port with an easy on/off stopcock and an enteral-specific (ENFit) adapter to different types of feeding sources to prevent tubing misconnections to non-enteral systems.
Nutricia’s Flocare Infinity pump
One additional pump option is the Flocare Infinity pump by Nutricia. This pump is built to conduct safer and more timely enteral feeding necessities. The device is compatible with all Flocare Infinity feeding sets.
The Flocare Infinity’s flexible design provides for more accessible care. In addition, the fully washable pump can deliver nutrients in any position, delivering high accuracy and meeting optimal patient safety standards.
One of the most unique features is its holistic alarm option which includes settings like air and occlusion, end of dose, and battery capacity updates. This device also features a 24-hour battery. As a reliable enteral feeding pump, the Flocare Infinity automatically primes and protects from free flow.