If your child's GJ tube or combination tube has been
accidentally pulled out or you can't replace the balloon-type tube,
you will need to insert a temporary foley type tube.
If your child has a balloon-type tube, such as a Mic-Key, AMT mini one,
kangaroo or Mic-G and the balloon is not broken,
wash the tube and reinsert it back into the stoma.
To learn how to do this, see the video on AboutKidsHealth.ca.
Here are the steps for inserting a foley type tube:
Gather your emergency kit. It will include a temporary foley type tube.
Carry your emergency kit with you at all times, wherever you go.
If you do not have all the necessary supplies to insert the foley type tube,
contact your G tube specialist or go to the emergency department.
Prepare the following supplies on a clean surface:
a foley type tube,
a washcloth, soap and water,
water-soluble lubricant or water to lubricate the tube,
tape,
three 5 mL syringes—one with water to fill up the balloon,
one that is empty to check the pH
and one with water to flush the tube—
pH strips,
pH colour reference guide,
an adaptor or extension set.
Now that you have your supplies ready,
wash your hands with soap and water.
Next, lay your child flat on their back on a bed or couch.
Your child may be upset during the insertion.
While the insertion can be done on your own,
it may be helpful to have a second person to comfort,
distract or hold your child's hands to prevent them from interfering.
Clean your child's stoma with a soapy washcloth and rinse with water.
Remove the foley type tube from the package
and insert the tip into the lubricant.
You will need to measure the tube from its tip before
inserting it into your child's stoma.
If your child weighs less than 3 kg, the tube should be about 3 to 4 cm in length.
This is about half the length of your index finger.
If your child away is more than 3 kg, the tube should measure 4 to 6 cm.
This is the full length of your index finger.
With your dominant hand, hold the tube at the length
you just measured for your child's weight.
At a slight angle, insert the tube into the stoma to the length you measured.
You may have to use some light force to insert the tube,
but it should not be too difficult.
If your child is upset and crying, their abdominal muscles will be more rigid.
This may tighten the stoma, making it more difficult to insert the tube.
Try to insert the tube when your child is taking a breath in.
The abdominal muscles may be more relaxed,
and it may be easier to insert the tube.
Once the foley type tube is successfully inserted,
tape the tube onto the abdomen.
Congratulations: You have now prevented your child's stoma from closing!
What you do now depends on the type of tube your child
had and how long they had it.
You should not use the temporary foley type tube for feeds, medications or fluids
if your child had a GJ or combination tube,
if you do not know which type of tube your child had
or if your child had a G tube that was originally inserted less than eight weeks ago.
Contact your G tube specialist or go to the emergency department
of the hospital that manages your child's tube.
If your child's G tube was originally inserted more than eight weeks ago,
you may now use the foley type tube for feeds, liquids and medications
once you have confirmed that it is in your child's stomach.
Confirm that the foley type tube is in the stomach by
checking the acidity of the stomach contents.
This is called checking the pH.
If you do not have pH strips, do not use the tube until the placement
has been checked by your G tube specialist or an interventional radiology department.
To check the pH of your child's stomach fluid,
insert an extension set into the large end of the Foley catheter.
Next, pull back a small amount of stomach contents.
Your child's stomach contents may look like this.
If you cannot get any stomach contents,
move your child side-to- side or sit them upright.
Sometimes, you get air before stomach contents will flow.
Empty the stomach contents from the syringe onto the pH strip
and compare the colours on the pH strip to the colours on the reference guide.
If the pH is less than 6.0, the tube is in the stomach.
Flush the tube with 5 mL of water.
Inflate the balloon of the foley type tube by inserting the syringe
into the port marked VAL and slowly pushing in the
amount of water indicated on the side of the foley.
Remove the tape and gently pull the tube until you feel resistance.
This tells you that the balloon has reached
the inside of the stomach wall and the tube is now secure.
When you're done, re-tape the tube to the abdomen.
If your child recently had their medications or feed, the pH may be higher.
If your child stomach contents look like any of these pictures,
you may continue to use the tube.
If the pH is 6.0 or higher and the tube was very difficult to
get in or the stomach contents do not look like the examples,
it may not be safe to use the foley type tube.
Recheck the pH in one hour.
If it is still 6.0 or higher, do not use the foley type tube.
Contact your G tube specialist to arrange a tube change or,
after hours, go to the emergency department
of the hospital that manages your child's tube.
Well done! You can now use the temporary foley
type tube for feeds, medications and fluid.
You can use the foley type tube for up to one month;
however, you should contact your G tube specialist within
the next few days to discuss replacing the tube.