Nutricia Flocare BENGMARK PEG/J Manual Del Usuario página 68

12. Unscrew the turquoise ring (L) of the spare connector from the transparent part (K). Slide the turquoise ring over
the blue jejunal tube. Fix the jejunal tube over the metallic pin inside the transparent part of the spare connector.
Make sure the tube is completely moved over the metallic pin. Connect the turquoise and transparent parts of
the spare connector by screwing in the turquoise part. Afterwards, connect the complete assembled connector
to the Y-connector, by screwing the turquoise ring of the Y-connector (J). (fig. 10 and fig. 11).
13. Fix the PEG CH 18 tubing in the external fixation disc. Ensure the correct positioning of the external fixation
disc is maintained by placing the blue safety clamp immediately behind the disc.
e 14. Check that the jejunal tube works by flushing with approx. 20 ml water.
15. Check if the jejunal tube is in the correct position with an X-ray. Note the length of the remaining part of the
intestinal tube.
B. Fluoroscopic placement:
Follow point 1-3 of the instructions mentioned under A.
4. Check that the tube tip is in the stomach with fluoroscopy and direct the tip towards the pylorus.
Withdraw the guide wire approximately 2-3 cm which will cause the tube to bend. This can facilitate finding the
pylorus and help inserting the tube-tip through it. The safety tip design of the Bengmark
manipulation with the guide wire in situ without the risk of lateral guide wire penetration, which could cause
tissue damage. After pylorus penetration the guide wire should be brought back in the original position.
5. Insert the Bengmark
beyond the Treitz ligament.
6. Once the tube is in place, withdraw the guide wire.
7. Follow point 8-15 of the instructions mentioned under A.
Verify status of the tube by checking the position and state of the external fixation disc and the tube itself, each time you
change the tube feed, if in doubt whether the tube is in the right positon, and at least three times a day.
Flush the tube before and after feed and/or medication administration, and at least every 8 hours with 20-50 ml of water
n push to prevent tube blockage (see figure 13). The Flocare
ENFit PEG CH 18, which in turn implies similar maintenance practices. Ensure you follow the maintenance instructions for the
PEG carefully, also when used in combination with the Bengmark
h. Be aware that maintenance with the PEG/J - PEG combination differs in one area (see below). Within the PEG instructions
for use the following is mentioned: Release the tube out of the external fixation disc, turn the tube daily 180º on its axis,
e tube and move tube up and down in the fully healed stoma (min 15 mm). When the PEG is combined with a Bengmark
erably the tube should NOT be turned on it's axis, but only moved up and down in the fully healed stoma (min 15 mm). Turning
the tube is NOT carried out so as to avoid twisting of the Bengmark
scope the PEG/J Bengmark
external retention disk. (see figure 12).
spiral
-
small
ve the
of the
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ck the
00546_AW.indd 68
PEG/J tube with the guide wire as far as possible in the small intestine, preferably
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coil. Always return the tube to its original position with the PEG's blue safety clamp behind the
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Disinfectants such as Povidone-Iodine (PVP-I; e.g.: Iso-Betadine
hydrochlorid-Phenoxyethanol (e.g.: Octenisept
exposure to this disinfectant might negatively effect the physical/mechanical properties of the
tube. It is recommended to use disinfectants based on Polyhexanid (e.g. Prontosan
AFTER CARE
Bengmark PEG/J is used solely in combination with the Flocare
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PEG/J.
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PEG/J CH 9 tube, leading to possible dislocation of
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) should not be used because repeated
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PEG/J tube enables
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PEG/J,
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, Braunol ) and Octenidindi-
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)
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13/05/15