PEG dressing change and tube care

Dressing change at the PEG insertion site, mobilising the tube according to the hospital standard and safely giving tube feeding and medication — with the warning signs of dislocation.

Content created with AI assistance from public clinical sources (RKI, AWMF) – may contain mistakes; if in doubt, your textbook is right

Translated from the German original, which is authoritative. The exam itself is in German.

Material

• Hand disinfectant, disposable gloves, sterile gloves or sterile forceps for a fresh PEG
• Sterile swabs and pre-slit sterile slit swabs, fixation tape
• Skin or mucosal antiseptic according to the hygiene plan; for a healed insertion site, water and pH-neutral washing lotion
• Cotton buds for cleaning under the retention plate
• For administration: tube feed according to the nutrition plan, enteral syringes or giving set (ENFit), flushing fluid according to the hospital standard
• Waste bin, documentation sheet, manufacturer’s information on the PEG system used

Typical mistakes in the exam

• Cutting swabs yourself
• Mobilising the tube in the first days after placement without the hospital standard providing for it
• Fixing the retention plate too tightly or far too loosely
• Not comparing the centimetre mark with the documentation
• Crushing sustained-release tablets or mixing medications with the tube feed
• Letting feed continue to run in when the person has pain during administration

What examiners ask afterwards

• Why do you mobilise the PEG, and from when may this be done?
• What is buried bumper syndrome?
• The tube has been pulled out accidentally. What do you do, and why is speed essential?
• How do you recognise an infection of the insertion site?
• What do you do if the tube is blocked?

Sources

• DGEM: S3-Leitlinie Klinische Ernährung und Hydrierung im Alter, AWMF 073-019
• KRINKO: Basishygiene — Empfehlungen der Kommission für Krankenhaushygiene und Infektionsprävention (RKI)
• Herstellerinformation zum verwendeten PEG-System (Pflege, Verbandswechsel und Mobilisation)