Forgot your password?
Please enter your username or email address. Instructions for resetting the password will be immediately emailed to you.
Please note: While some information will still be current in a year, other information may already be out of date in three months time. If you are in any doubt, please feel free to ask.
Pseudomonas (2nd question)
- Question
- I just asked several questions about Pseudomonas, now I got some more: To probe a patient (CF, 30 years old, under artificial respiration, pseudomonas positive, in poor condition) we use 50 ml bladder syringes [in German: Blasenspritze]. Most team members afterwards rinse them with tab water and put them on some piece of cloth to let them dry. Isn’t there a risk in this procedure? Should they rather always use a new syring? (Currently it is being changed twice a day). Can you give me some advice how to pass Kreon through the stomach tube? We tried several ways. At the moment we grind it because the tube got stuck every third day.
- Answer
- Hello,
Here are the answers to your questions. In this answer as co-ordinators Judy Bradley and Stuart elborn have combined answers from two different experts (Tom Hirche and Dee McCann) which I hope you find useful.
Concerning the use of tab water / hygiene with patients under artificial respiration please consider the answer to your previous question.
Regarding use of 50ml syringe- the CREST guidelines for management of
Nutrition Support In hospital and Community and some local Belfast Trust guidelines for
enteral feeding recommend that a new oral/enteral syringe should always be used each time the feeding tube is flushed or if patient receives medications via tube.
Concerning the administration of pancreatic enzymes via tube: Unfortunately there is no panacea to administer Kreon via tube. It would be advisable to use wide tubes (12-20 CH). According to the German Society for Nutritional Medicine micro pellets may be administered with tube feeding formulas or acidic liquids (e.g. fruit juices). The grinding of pellets is contra-indicated because an early activation and thus loss of effect must be avoided. To rinse applied tubes the use of multi-vitamin solutions, e.g. Multibionta, ascorbic acid, pepsi-wine or strongly carbonated mineral waters are recommended.
For patients who are unable to take pancreatic enzymes orally elemental formula feed may also be an option.
With kind regards,
Judy Bradley/Stuart Elborn
Tom Hirche and Dee McCann
- 24.11.2008
