Pondering peg tube placement: ethical considerations in advanced dementia nursing 6033: ethical dimensions in nursing ethics paper winde r chambers texas woman’s university november 30, 2009 peg 2 introduction summary of the case study effectiveness of tube feeding with oral feeding in patients with advanced dementia the search. There are separate articles on enteral feeding, nutritional support in primary care and nutritional support in hospital a nasogastric tube is a narrow bore tube passed into the stomach via the nose it is used for short- or medium-term nutritional support, and also for aspiration of stomach. Ethics roundtable debate: withdrawal of tube feeding in a patient with persistent vegetative state where the patients wishes are unclear and there is family dissension tom buckley, 1 david crippen, 2 anthony l dewitt, 3 malcolm fisher, 4 antonios liolios, 5 christine l scheetz, 6 and leslie m whetstine 7.
Full text full text is available as a scanned copy of the original print version get a printable copy (pdf file) of the complete article (786k), or click on a page image below to browse page by page links to pubmed are also available for selected references. Ethics and feeding in stroke social and psychological issues, which all impact on quality of life, these include: swallowing problems (dysphagia) patients with acute stroke who are unable to take adequate nutrition and fluids orally should have ng feeding initiated within 24 hours of admission. The ethics of ng feeding at end of life meyers and gridiron 1991 hodges and tolls 1994) and decisions around its use at the end of life have raised significant clinical, ethical, and legal concerns (del roi et al , 2012. To tube or not to tube the hospitalist 2006 august2006(8) and experience psychosocial issues that can lead to weight loss and poor nutrition8 common causes of weight loss in older hospitalized adults include cancer, gastrointestinal disorder, and depression9 a short course of tube feeding through a nasogastric tube can be tried.
A feeding tube, also known as a gavage tube, is used to give nutrition to infants who cannot eat on their own the feeding tube is normally used in a hospital, but it can be used at home to feed. Long term feeding tubes: ethical issues in physicians’ decision making∗ north carolina medical society when a decisionally incapable patient who suffers from a chronic, progressive. Nasogastric (ng) tube feeding is used as a form of nutritional supplementation and rehabilitation in a variety of medical settings it requires the insertion of a tube through the nasal passage, down the esophagus, and into the stomach. Tube feeding — right or wrong: the medical, legal and ethical issues david e milkes, md or nasogastric feeding tube though the procedure is fairly routine medically, there are many complex issues surrounding peg use, particularly for patients near the end of life, where the decision to use or not to use a peg is frequently made.
The bapen principles of good nutritional practice has been devised to draw together existing guidelines and evidence base, ethics and clinically assisted nutrition or hydration approaching the end of life naso gastric (ng) tube insertion management of enteral feeding related diarrhoea. Therefore not be started without considering all related ethical issues guideline for the care and management of enteral feeding in adults clinical guideline: guideline for the care and management of enteral feeding in adults naso-gastric tube feeding (ng) a fine bore feeding tube (french gauge 5-8) is inserted via the nose into the. In the august issue of the journal of the american geriatrics society, the american geriatrics society (ags) ethics committee and clinical practice and models of care committee released an updated position statement on the use of feeding tubes in adults with advanced dementia the statement, which had been updated from the 2013 version. The above case report provides an opportunity to discuss some of the challenges in managing ng feeding tubes and specifically, the problems with accurately determining tube location we are told that the ng feeding tube had migrated from the patient's small bowel into the esophagus.
Association guidance, ethics, euthanasia, medicine and law, tube feeding, by nasogastric tube his parents and doctor wanted to withdraw his tube feeding but because of doubts about the lawfulness of this action the hospital applied for a judicial declaration that. Feeding: children with feeding tubes part 1: the issues children who receive all or part of their nourishment through a tube create special challenges for therapists and parents there is a tendency for others to view the tube as an enemy of progress -- as something to be gotten rid of. “nasogastric feeding tube” (ng tube) is a tube that is passed through the nose and down through the nasopharynx and esophagus into the stomach “transgastric jejunal feeding tube” (“g-j tube”) is a feeding tube that is placed through the. Abstract tube feeding is now legally regarded as medical treatment the provision of nutrition through nasogastric or gastrostomy feeding tubes is not part of basic care according to several recent court decisions. A nasogastric tube (ng tube) is a special tube that carries food and medicine to the stomach through the nose it can be used for all feedings or for giving a person extra calories.
Dysphagia is common after stroke, so feeding through a nasogastric (ng) tube may be necessary these tubes are frequently dislodged, causing interruption to feeding and hydration, and potential aspiration of feed or fluids into the lungs. Removing feeding tubes from patients in a persistent vegetative state find out more about this topic, read articles and blogs or research legal issues, cases, and codes on findlawcom. This process is known as nasogastric (ng) intubation during ng intubation, your doctor or nurse will insert a thin plastic tube through your nostril, down your esophagus, and into your stomach. Questions about the proper use of feeding tubes gained national attention in the case of terri schiavo, a florida woman who suffered severe brain damage on feb 25, 1990, that left her in a vegetative state at age 26.
For terminally ill patients, palliative care specialists can help evaluate the benefits and risks of continuing enteral feeding and help clinicians navigate ethical issues, such as whether to continue enteral feedings and other life-prolonging measures. A feeding tube is a small, soft, plastic tube placed through the nose (ng) or mouth (og) into the stomach these tubes are used to provide feedings and medicines into the stomach until the baby can take food by mouth. The ethics of force feeding in anorexia nervosa o patients become emotionally attached to and physically reliant on nasogastric feeding, and were anxious about the tube being removed.
Wouldappear,intheseterminallyillpatientsistoarresttheirrapiddeteriorationmuchofthedata,however, regarding ng feeding at the end of life is inconclusive2–4 a short. What are the pros and cons of using a feeding tube my initial thought is not to insert a feeding tube unless it's a temporary thing, while healing is going on or some kind of recuperation, i guess if it seems as if the person would like to eat, but just can't swallow anymore, it might be worth doing. Taylor, s, 2013, confirming nasogastric feeding tube position versus the need to feed, intensive and critical care nursing, 29, pg 59-69 turgay, a s, & khorshid, l 2010 effectiveness of the auscultatory and ph methods in predicting feeding tube placement, journal of clinical nursing, 19, pg 1553-1559.