G, GJ, J Tube Complications Clinical Pathway – Inpatient – Check the Tube Fit: Tubes that Are Too Tight or Too Loose

G, GJ, J Tube Complications Clinical Pathway – Inpatient

Check the Tube Fit: Tubes that Are Too Tight or Too Loose

See the G Tubes, GJ Tubes, J Tubes Job Aid.

To check the tube fit:

  1. Wiggle the tube to check the fit against the skin
  2. Assess when child is sitting and lying flat
  3. Assess how the tube is secured (see guidance)

A well-fit tube should:

  • Not cause indentations or puckering of the skin
  • Be snug against the skin with ability to place 1 piece of split gauze between the tube and skin easily
  • Be able to rotate 360 degrees
Tube Fit For All Tubes Comments
Too Tight
  1. Place a dry dressing between the skin and tube to prevent skin injury until the tube can be replaced
  2. Secure the tube
  3. Tube shaft length may need to be increased – notify the appropriate service for guidance
Tube is too tight example 1 Tube is too tight example 2 Tube is too tight example 3
  • Low-profile ("button") style tubes have measured stoma lengths
  • Standard (MIC gastrostomy and MIC gastrojejunostomy) tubes can be adjusted by movable circular bumper
  • For replacement standard tubes, the retention disc may need to be adjusted; see G Tubes, GJ Tubes, J Tubes Job Aid
  • For non-balloon G tubes and GJ tube:
    • For percutaneous radiologic (PRG) tubes that have a
      cross bar. Contact IR if the cross bar is too tight and difficult to rotate.
  • Contact General Surgery for surgical low-profile balloon J tube.
Too Loose
  • For low-profile balloon tubes:
    • Ensure appropriate balloon fill volume
  • Exception: Surgically placed low-profile balloon jejunostomy tube should not be filled to volume on balloon port
  • Low-profile ("button") style tubes have measured stoma lengths.
  • Standard (MIC gastrostomy and MIC gastrojejunostomy) tubes can be adjusted by movable circular bumper.
  • For replacement standard tubes, the retention disc may need to be adjusted; see G Tubes, GJ Tubes, J Tubes Job Aid
  • For non-balloon G tubes and GJ tube:
    • For percutaneous radiologic (PRG) tubes that have a
      cross bar. Contact IR if the cross bar is too loose and
      not secure.
  • For surgical low-profile balloon J tube call General Surgery.
  • See Reinsertion of Replacement Balloon G Tube Procedure.