Use of a polyethylene body jacket to prevent feeding tube removal in an agitated patient with anoxic encephalopathy.

Abstract

Maintaining a feeding tube in place in the agitated patient following a traumatic brain injury or anoxic encephalopathy is a familiar problem. However, a survey of the literature employing the MEDLINE system provided no solutions. This case study of a 36-yr-old patient with anoxic encephalopathy illustrates a new method of preventing feeding tube removal using a modified polyethylene body jacket. The patient had repeatedly pulled out his gastrostomy tube despite the use of four-way restraints, a posey, behavior modification and anti-psychotic medications at levels near sedation. A polyethylene jacket with an S-shaped tunnel for feeding tube exit was constructed to cover the abdomen. 1) The patient was unable to disturb the feeding tube. 2) The recessed design of the jacket's tunnel did not traumatize the feeding tube or obstruct fluid flow. 3) Nursing staff encountered no problems in placing or removing the orthosis. 4) Skin integrity was maintained. 5) The orthosis did not interfere with therapies.