avanos MIC Mode D'emploi page 5

Balloon Maintenance
Precise balloon life cannot be predicted. Silicone balloons generally last 1–8
months, but the life span of the balloon varies according to several factors. These
factors may include medications, volume of water used to inflate the balloon,
gastric pH, and tube care.
Check the water volume in the balloon once a week.
• Insert a male Luer syringe into the Balloon Inflation Port (BAL.) and
withdraw the fluid while holding the tube in place. Compare the amount of
water in the syringe to the amount recommended or the amount initially
prescribed and documented in the patient record. If the amount is less
than recommended or prescribed, refill the balloon with the water initially
removed, then draw up and add the amount needed to bring the balloon
volume up to the recommended and prescribed amount of water. Be aware
as you deflate the balloon there may be some gastric contents that can leak
from around the tube. Document the fluid volume, the amount of volume to
be replaced (if any), the date and time.
• Wait 10–20 minutes and repeat the procedure. The balloon is leaking if it has
lost fluid, and the tube should be replaced. A deflated or ruptured balloon
could cause the tube to dislodge or be displaced. If the balloon is ruptured,
it will need to be replaced. Secure the tube into position using tape, then
follow facility protocol and/or call the physician for instructions.
Caution: Refill the balloon using sterile or distilled water, not air or
saline. Saline can crystallize and clog the balloon valve or lumen, and air may
seep out and cause the balloon to collapse. Be sure to use the recommended
amount of water as over-inflation can obstruct the lumen or decrease
balloon life and under-inflation will not secure the tube properly.
Daily Care & Maintenance Check List
• Assess the patient for any signs of pain, pressure or discomfort.
• Assess the stoma site for any signs of infection, such as redness, irritation,
edema, swelling, tenderness, warmth, rashes, purulent, or gastrointestinal
drainage. Assess the patient for any signs of pressure necrosis, skin
breakdown, or hypergranulation tissue.
• Use warm water and mild soap.
• Use a circular motion moving from the tube outwards.
• Rinse thoroughly and dry well.
• Assess the tube for any abnormalities such as damage, clogging, or abnormal
discoloration.
• Use warm water and mild soap being careful not to pull or manipulate the
tube excessively.
• Rinse thoroughly and dry well.
• Clean the Jejunal, Gastric, and Balloon Inflation Ports. Use a cotton tip
applicator or soft cloth to remove all residual formula and medication.
• Verify that the external bolster rests 1–2 mm above the skin.
• Flush the feeding tube as described in the General Flushing Guidelines
section above.
Caution: Do not rotate the external retention bolster. Rotating the
bolster may cause the tube to kink and possibly lose position.
Tube Occlusion
Tube occlusion is generally caused by:
• Poor flushing techniques
• Failure to flush after measurement of gastric residuals
• Inappropriate administration of medication
• Pill fragments
• Thick formulas, such as concentrated or enriched formulas that are generally
thicker
• Formula contamination that leads to coagulation
• Reflux of gastric or intestinal contents up the tube
To Unclog a Tube
1. Make sure that the feeding tube is not kinked or clamped off.
2. If the clog is visible above the skin surface, gently massage or milk the tube
between fingers to break up the clog.
3. Connect a 30 to 60 ml ENFit® syringe filled with warm water into the
appropriate access port of the tube and gently pull back on then depress
the plunger to dislodge the clog. Do not use smaller size syringes as this can
increase pressure on the tube and potentially rupture smaller tubes.
4. If the clog remains, repeat step #3. Gentle suction alternating with syringe
pressure will relieve most obstructions.
5. If this fails, consult with the physician. Do not use cranberry juice, cola drinks,
meat tenderizer or chymotrypsin, as they can actually cause clogs or create
adverse reactions in some patients. If the clog is stubborn and cannot be
removed, the tube will have to be replaced.
Caution: Do not insert foreign objects through the tube.
MRI Safety Information
Non-clinical testing has demonstrated the MIC* GJ enteral feeding tube is MR
Conditional. A patient with this device can be safely scanned in an MR system
meeting the following conditions:
• Static magnetic field of 1.5 T and 3 T only
• Maximum spatial field gradient of 4,000 Gauss/cm (40 T/m)
• Maximum MR system reported, whole body averaged specific absorption rate
(SAR) of 4 W/kg for 15 minutes of scanning (i.e. per pulse sequence) in the
First Level Controlled Operating Mode
Using the scan conditions defined above, the MIC* GJ enteral feeding tube is
expected to produce a maximum temperature rise of 3.0 °C after 15 minutes of
continuous scanning (i.e. per pulse sequence).
In non-clinical testing, the image artifact caused by the device extends
approximately 5 mm from the MIC* GJ enteral feeding tube when imaged using a
gradient echo pulse sequence and a 3 T MRI system.
Warning. For enteral nutrition and/or enteral medication only.
For more information, please call 1-844-4AVANOS (1-844-428-2667) in the
United States, or visit our web site at www.avanos.com.
Educational Booklets. "A Guide to Proper Care" and "A Stoma Site and Enteral
Feeding Tube Troubleshooting Guide" are available upon request. Please contact
your local representative or contact Customer Care.
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