6-48 hours post-insertion
Patients are usually kept nil-by-mouth and nil-byPEG
for 4 hours after insertion to allow sedation to
wear off (Haywood, 2012). Flushing should be done
6-8 hours post-placement (NHS Lothian, 2011).
Practice is to flush the tube with 50 ml of sterile waterfor 6 hours unless contraindicated. If a patient
experiences any discomfort or pain during fiushing,
urgent medical attention is needed. It is safe to start
using the tube if flushing does not cause any pain.
The NPSA (2010) developed 'red-flag' alerts {Box 4)
to initiate immediate reaction to serious complications
post-insertion. These red-flag alerts have been incorporated
into the NCP to guide nurses in identifying
early signs of complications. If the patient develops
any of the symptoms in Box 4 the medical team must
be informed immediately; these symptoms could be
signs of complications (Haywood, 2012). Referral to
dietitian to commence an appropriate feeding regimen
should be part of the care plan.
NHS Lothian (2011) recommends removing the
dressing around the PEG after 24 hours and leaving it
exposed. It is vital to clean around the PEG stoma
aseptically using sterile gauze and normal saline. To
ensure that the PEG is not too tight against the gastric
wall, it is also important that there is very slight
(about 2-3 mm) in and out movement of the PEG
prior to feeding (NHS Lothian, 2011)