From the Guidelines
For a PEG procedure, your mayo stand should include the PEG kit components, a scalpel (#11 blade), hemostats, needle drivers, scissors, gauze, a marking pen, suture material, local anesthetic supplies, and sterile drapes, as outlined in the ESPEN guidelines on artificial enteral nutrition--percutaneous endoscopic gastrostomy (PEG) 1. When setting up the mayo stand for a PEG procedure, it's essential to consider the steps involved in the procedure, as described in the ESPEN guidelines 1. The procedure typically involves making a small incision in the abdominal wall, passing the tube, and securing it in place. To facilitate this, the following instruments should be included on the mayo stand:
- PEG kit components, including the gastrostomy tube, guidewire, snare, and introducer needle
- A scalpel (#11 blade) for making the incision
- Hemostats and needle drivers for controlling bleeding and handling the guidewire
- Scissors for cutting the suture material
- Gauze for cleaning and dressing the wound
- A marking pen for marking the puncture site
- Suture material (typically 3-0 or 4-0 silk) for securing the tube in place
- Local anesthetic supplies, including a 10cc syringe, 25g and 22g needles, and lidocaine, to numb the incision site before the procedure begins
- Sterile drapes to maintain a sterile field It's also important to have electrocautery available if needed for hemostasis. The ESPEN guidelines emphasize the importance of taking measures to avoid complications, such as wound infection, and provide recommendations for post-procedure care, including dressing changes and tube maintenance 1. By having these instruments organized on the mayo stand, you can ensure efficient access during the procedure and help minimize the risk of complications.
From the Research
Equipment for PEG Procedure
The following equipment should be available on the mayo stand for a PEG procedure:
- Endoscope
- PEG tube
- Guide wire
- Needle
- Scalpel
- Suture material
- Local anesthetic
Medications and Supplies
Additional medications and supplies that may be needed include:
- Sedation medication
- Antibiotics (as indicated)
- Pain medication
- Anti-nausea medication
- Gauze and dressing supplies
- Tube feeding equipment (as needed)
Preparation and Aftercare
It is essential to have a thorough understanding of the procedure, potential complications, and aftercare requirements, as outlined in studies 2, 3, 4, 5, 6. This knowledge will help ensure a successful procedure and minimize the risk of complications.
Potential Complications
Common complications associated with PEG tube placement include:
- Wound infection
- Tube blockage
- Bronchoaspiratory pneumonia
- Peritonitis
- Perforation of the colon
- Extraction of the tube
It is crucial to be aware of these potential complications and take steps to prevent them, as discussed in studies 2, 3, 4, 5, 6.