These instructions are part of a teaching program for families of patients at The Hospital for Sick Children. They are provided in addition to detailed hands-on training. We urge you not to follow these instructions without training and advice from a health-care professional who understands your child’s unique needs. Please also review these instructions with your doctor or nurse to check if they are suitable for your situation.
IMPORTANT: Only vent from the stomach. Some GJ tubes (often called combination tubes) have access to the stomach and can be used to vent from the gastric port.
Never vent from the jejunum (jejunal or J-port).
Please visit https://www.aboutkidshealth.ca/Article?contentid=3827&language=English to learn more about how to vent a feeding tube and https://www.aboutkidshealth.ca/tubefeeding for more information on G and GJ tubes.
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How to vent a feeding tube.
Each technique described can be used for any style of G-tube. If your tube requires an extension set, this must be attached when trying to vent. Only vent from the stomach. Some GJ tubes, often called Combination Tubes, have access to the stomach and can be used to vent from the gastric port.
Do not vent from the jejunum or J-port.
Technique number one: Leaving the end of the tube open to vent. You will need a washcloth, syringe with water for flushing. Step one: Open the end of the G-tube, resting the tube on a washcloth. Step two: If needed unclamp the tube. Step three: After venting, flush the G-tube with water to clear the tube and then clamp the tube. You may gently massage the stomach to push the air out of the tube.
Technique number two: Using a syringe to vent. You will need a large catheter tip syringe, a syringe with water for flushing. Step one: Pull the plunger out of the syringe. Step two: Open the end of the G-tube. For low profile balloon G-tubes, you will need to attach the bolus or venting extension set. Step three: Attach the syringe, without the plunger, to the end of the G-tube. Step four: Position the tube and syringe above the child’s stomach allowing the air to rise. Step five: Unclamp the tube if needed. Step six: After venting, remove the syringe and flush the G-tube with water to clear the tube and clamp the tube. You may gently massage the stomach to help push the air out of the tube.
Technique number three: Manually venting. You will need a large catheter tip syringe and a syringe with water for flushing. Step one: Open the end of the G tube. Step two: Attach the syringe to the end of the G-tube. Step three: Unclamp the tube if needed. Step four: Slowly pull back on the syringe to remove air from the stomach. Step five: After venting, remove the syringe and flush the G-tube with water to clear the tube. Step six: Clamp the tube if needed.
Technique number four: Using the Farrell valve system to vent. You will need a Farrell valve system. Step one: Hang the Farrell bag on the pole at the same height as the feeding pump. Step two: Close the white roller clamp and blue clamp on the Farrell bag. Step three: Attach the primed feeding bag to the Y port on the Farrell bag. Step four: Open the white roller clamp on the Farrell bag and prime the feeding bag allowing some of the feed to go up the Farrell bag. Step five: Close the white roller clamp on the Farrell bag. Step six: Open the blue clamp on the Farrell bag and prime the feeding tube all the way to the end. Step seven: Flush the tube. Step eight: Attach the Farrell bag, with the feeding bag connected to it, to the feeding tube. Step nine: Position the y port on the feeding bag at or below the stomach. Step ten: Open all the clamps and rollers and start feeds. Feed will move up and down in the Farrell bag.
The Farrell bag will not fill up with air as there is a vent to allow it to escape. if the bag fills with formula the tube may be blocked. Manage this accordingly. To give medications, close the blue clamp on the Farrell bag and give medications directly into the feeding tube.
Wait at least 30 minutes after giving medications to start venting again.
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