China
Africa
Explore chapters and articles related to this topic
Technics of Touch
Published in Michael van Manen, The Birth of Ethics, 2020
The feeding tube is one of neonatal medicine’s simplest of technologies. It is a flexible, silastic hollow tube usually inserted at the bedside by feeding it into the child’s mouth or nostril until its end reaches its destination, the stomach. Secured in place by taping the exterior end to the angle of the mouth, the feeding tube becomes an extra body orifice, mechanically connecting stomach to world, offering a new way to touch the child. Bypassing the voluntary swallowing, the tube orifice is existentially different from the mouth orifice as food and medicines can be pushed slowly or quickly into the stomach by means of hand syringe or infusion pump. In neonatal care, this technology is used extensively as many infants are unable to effectively coordinate suck and swallow due to prematurity, illness, or some other issue.
Enteral nutrition
Published in David Westaby, Martin Lombard, Therapeutic Gastrointestinal Endoscopy A problem-oriented approach, 2019
The feeding tube must now be re-routed from mouth to nose. This is achieved using an oronasal transfer technique: a short, soft, Ryles-type tube is passed through the nose to the back of the mouth (suitable tubes are provided in some commercial kits) (Fig. 8.4). Using a gloved finger, the tube is swept forward and delivered out of the mouth. Alternatively, dental forceps can be used to retrieve the Ryles tube from the nasopharynx. The feeding tube, still with its reinforcing guidewire, is inserted into the oral end of the Ryles tube and pushed through until it emerges from the nose end. Plenty of lubrication is required. The feeding tube is pulled through the Ryles tube until the loop of tube coming out of the mouth is reduced to a few centimetres.
The Role of Biomedical Technology
Published in Kant Patel, Mark Rushefsky, Healthcare Politics and Policy in America, 2019
The feeding tube was removed on March 18, 2005. The parents of Terri Schiavo appealed to Governor Bush to intervene further in the case (Lyman 2005). Responding to political pressure from the conservatives, Governor Bush asked the Florida Department of Children and Families (FDCF) to obtain custody of Terri Schiavo in light of allegations of spousal abuse brought against Michael Schiavo. After holding a hearing, Judge Greer, on March 24, 2005, issued a restraining order prohibiting the FDCF from removing Terri Schiavo from the hospice or reinstating the feeding tube. The Schindlers decided to end their federal appeals (Associated Press 2005). Terri Schiavo died on March 31, 2005. President Bush called upon the nation to build a culture of life. The Vatican issued a statement calling Ms. Schiavo’s death a violation of the sacred nature of life that shocked the conscience (Goodnough 2005c).
Combined endovascular and surgical treatment of a giant celiac artery aneurysm with consequent gastric outlet obstruction: a case report and literature review
Published in Acta Chirurgica Belgica, 2023
Nick Smet, Thijs Buimer, Tim Van Meel
After the patient’s intake returned to normal, the feeding tube was removed. Regression of biochemical cholestasis was seen. The patient made an uneventful recovery and was discharged after one week. After three months, he returned to the outpatient clinic with recurrent gastric outlet obstruction, and blood test showed no cholestasis. Control CT demonstrated no regression of the aneurysm and compression of the duodenum. It was decided to perform a gastroenterostomy in order to deviate the compressed duodenum. Due to persistent gastroparesis and thus ineffectiveness of the gastroenterostomy alone, a complemental Roux-en-Y anastomosis was made. The further postoperative course was uneventful. The last visit in the outpatient clinic was in October 2021, the patient had no residual digestive complaints and has gained weight. A CT abdomen was conducted which showed decrease of the aneurysm from 14 to 6 cm.
Percutaneous gastrostomy in amyotrophic lateral sclerosis: a review
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2022
AndrÉ Castanheira, Michael Swash, Mamede De Carvalho
The standard procedure for enteral nutrition in ALS patients is percutaneous endoscopic gastrostomy (PEG), percutaneous radiologic gastrostomy (PRG), or radiologically inserted gastrostomy (RIG) (7,15). Nonetheless, per-oral image-guided gastrostomy (PIG) and percutaneous gastrojejunostomy (PEG-J) are also currently used in patients with ALS (6,9,16,17). The PEG procedure is the most common approach. This consists of placing a feeding tube directly into the stomach through an incision in the abdominal wall (18). First, an endoscope is inserted through the mouth and advanced to the stomach (1). Then, the endoscope position is identified through the abdominal wall using a light source within the endoscope, and insufflation (18). After that, a catheter is placed into the stomach and a guidewire is inserted and pulled out of the mouth (1,18). Finally, the short PEG tube is attached to the guidewire, pulled through the stomach, and fixed with an external and internal bumper (1,18). Despite being the recommended procedure, current guidelines warn that there is no convincing evidence that PEG increases survival or quality of life (7) and a Cochrane review has concluded that there was insufficient evidence for comment regarding timing and safety of PEG insertion in ALS (19).
In vitro evaluation of enteral tube administration of lansoprazole orally disintegrating tablets
Published in Pharmaceutical Development and Technology, 2021
Alicia Hoover, Priyanka Chitranshi, Magdalene Momot, Katherine Tyner, Anna Wokovich
Some PPIs, including lansoprazole, are formulated as ODTs that can be administered orally or, for patients who are unable to swallow, through an enteral feeding tube (Gremse et al. 2004). In accordance with the product label, these formulations can be administered through an oral syringe and ≥8 French NG tube for patients, who have difficulty swallowing, such as the elderly and children. A tablet is placed in a syringe, water is added to disintegrate the tablet, and the syringe is shaken for dispersal. The drug suspension is then administered through a NG tube, and the syringe and the tube are flushed with additional water. The administration of lansoprazole through a NG tube is equivalent to the oral dosage form (Gremse et al. 2004; Howden 2005). However, the administration of proton pump inhibitors through enteral feeding tubes creates the potential risk for the drug product to clog the tube or to adhere to the sides of the tube (Williams 2008; Wensel 2009). If a feeding tube becomes obstructed, the patient may need to seek medical assistance and have the tube removed and replaced.