Question

A 42 year old male patient in ICU, 3 days s/p MVI with head injury, currently with respiratory failure, on vent support and induced coma. Patient has active bowel sounds, and the following order is in the patient's chart:

Initiate Tube feeding: Jevity, start at 20 cc/hr, advance by 20 cc Q4h, as tolerated, until goal rate of 80cc/hr.

It's your shift. It's currently 9 AM.

Describe step by step, how you would initiate the tube feeding, what you will be looking out for, how you would be advancing the TF, etc.

Answer 1

ICU induced coma:it is also known as medically induced coma or a barb coma is a temporary coma brought on by a controlled dose of a barbiturate drug, it is used in patient to protect the brain during major neurosurggery, steps by step tube feeding : before initiating a feeding tube tube placement is verified ideally by radiography and bowel sounds are confirmed to be present, and regardless of the access route tube feeding formulas are initiated at full strength and intermittent feedings 60- 120 ml at the initial feeding, increase by 60 to 120ml at each feeding until reach the goal goal volume and continous feeding start at rates of 40 to 60 ml/hour raise by 20 ml/hour every 8 to 12 hours until reaching the goal rate.