AMT G-JET Button User manual

Patient Education Guide
®
G-JET Button
800 869 7382
[email protected]
Made In USA
© 2017 Applied Medical Technology, Inc. C-4418-C
Patents: http://www.AppliedMedical.net/Patents/
Trademarks: http://www.AppliedMedical.net/Trademarks/
Applied Medical Technology, Inc.
8006 Katherine Boulevard
Brecksville, OH 44141
www.AppliedMedical.net
ISO 13485 Registered Company
Support is available. In addition to your healthcare provider, there are many
resources available to help you with enteral feeding.
www.Oley.org
www.P2pusa.org
www.FeedingTubeAwareness.com
www.FoodForTubies.com
Guidence & support to help you manage your gastrostomy tube (G-Tube)
®
Patient Education Guide
Low Prole Gastric-Jejunal Enteral Feeding Tube
G-JET Button
Innovating. Educating. Changing Lives.™
Guidance and support to help you manage your Gastric-Jejunal tube (G-J tube)
Connect with AMT
Cleared for
Initial Placement

Applied Medical Technology, Inc.
Patient Education Guide Contents
G-JET® Button Low Prole Gastric-Jejunal Enteral Feeding Tube
Enteral Nutrition
Introduction to Tube Feeding
G-JET® Button Components
Reduces Skin Irritation & Discomfort
Reduces Risk of Misconnections
Optimal Flow
AMT Clamp™
Jejunal (Glow Green™) Feed Set
Gastric (White) Feed Set
Feeding into the Jejunum
Decompressing the Stomach
Dual Extension/Feed Set Hook-Up
Stoma Site Care
Device Maintenance
Device Related Concerns
Re-Ordering Information – Available G-JET®Button Sizes
Connector & Adapter Options
Information Card
Share Your Story
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Proper nutrition is essential to maintaining our bodies’ health, growth and ability to heal.
Various medical conditions may make it dicult or impossible for a person to eat, and
thus deny the body of essential nutrients. In such cases, a gastrostomy tube (G-tube) is
inserted to provide direct access to the stomach for feeding. A G-tube is a convenient,
comfortable and eective means for delivering nutritional formulas to the body. These
nutritional formulas are either commercially available or homemade using a food processor.
A healthcare provider will prescribe the proper feeding procedure, formula and amount of
water to most eectively feed each patient.
Comfort and Condence are Important, Too
As a caregiver or patient, we believe you have a right to the most comfortable and
reliable gastro-jejunal tubes...that’s why we developed the G-JET®Button. Reading and
understanding this guide, along with using our products, will help provide the comfort and
condence you deserve.
Introduction to Tube Feeding
George J. Picha M.D.,PhD., F.A.C.S.
Founder of AMT and Co-Inventor of the low profile button feeding device. AMT specializes in
enteral devices, our core business.

Enteral Nutrition (EN) is the delivery of nutrients to the body
using the gastrointestinal tract or digestive system. Your
digestive system is made up of several hollow organs
joined as a long tube or pathway through your body.
Digestion begins in your mouth, through chewing the food
you intake into smaller pieces which are then swallowed
and passed down your esophagus. The esophagus carries
the food from your mouth to your stomach. Once in the
stomach, the food gets broken down into its main nutrients.
These nutrients then pass into your small intestine where
they are absorbed into the blood stream. Once through
your small intestine, the remaining material passes into
your large intestine where excess liquid is absorbed leaving
solid waste product behind to be passed out of your body.
Enteral Nutrition
2Applied Medical Technology, Inc.
Various medical conditions may make it difficult or
impossible for you to eat orally, denying your body of
essential nutrients. In such cases, your healthcare provider
will select the best type of alternative feeding for your
situation.
A Gastrostomy Tube, also known as a G-tube, may be
inserted through the abdominal wall to provide direct
access to the stomach for feeding.
A Gastric-Jejunal Tube, also know as a G-J tube, may be
inserted through the abdominal wall into and through the
stomach to provide direct access to the jejunum, which is
the second part of the small intestine.
A G-tube or a G-J tube is a convenient and effective
means for delivering nutritional formulas to the body. These
nutritional formulas are either commercially available or
homemade using a food processor. A healthcare provider
will prescribe the proper feeding procedure, formula, and
amount of water to most effectively feed you.
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Esophagus Body Exterior
Stomach*
Liver
Large
Intestine
Small Intestine
Gastric Medication
*Color Representational only
Jejunum
Jejunal Nutrition
Gastric
Medication
Body Exterior
G-JET®Button
Stomach*

4
Introduction to Tube Feeding
A feeding tube, like the G-JET®Button, is used when
you cannot ingest food through your mouth, or are
unable to get the proper amount of nutrients to meet
your needs. The G-JET® Button delivers a liquid food
(called formula) directly into the small intestine by
bypassing your mouth, esophagus, and stomach.
Once the formula enters your body through the
G-JET®Button, digestion works the same as when
food begins in your mouth. You get the same nutrients
delivered to your body through a G-JET®Button as
you would get by mouth.
Tube feeding with the G-JET®Button provides you
with a complete and healthy diet so growth and
development can continue. It will take time to adjust
to tube feeding at home, but with the help of your
healthcare provider, some practice, and this patient
education guide, you will gain confidence to take care
of your G-JET®Button.
Additional Support:
In addition to your healthcare provider, there are many resources available to help you
with Enteral Tube Feeding:
www.oley.org - The Oley Foundation is for people who feed by tube or IV at home
www.p2pusa.org - A unique support system for parents of children with developmental disabilities
www.feedingtubeawareness.com - A group of parents of children with feeding tubes
www.foodfortubies.com - An organization that helps people with feeding tubes use “real” food
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5
Connect with AMT.
www.AppliedMedical.net
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G-JET®Button Components
6
External Bolster
The external bolster keeps the tube in place. A properly fitted device should not
fit tightly against the skin. Instead, a 1/8 inch (3mm) gap between the external
bolster and the skin surface is recommended to provide room for air circulation
and cleaning of the stoma site. The recommended amount of water to place into
the balloon is printed on top of the balloon fill valve.
1
Balloon Valve
The balloon is inflated and deflated by inserting a slip tip
syringe into the balloon valve. Do NOT attempt to feed
through the balloon valve. The recess in the valve can trap
foreign material, such as lint or spilled formula. The balloon
valve must be kept clean to function properly.
2
Anti-Reux Valve / One Way Valve
A valve is located in the bottom of the feeding port (jejunal port) and the
decompression/medication port (gastric port) to prevent stomach contents from
leaking out of the tube. The valve is opened when the feeding set adapter is
locked into place.
3
Internal Retention Balloon
A balloon is inflated inside the stomach to hold the tube in place. Once the tube
is inserted, the balloon is filled with the prescribed amount of water.
Gastric Holes
Gastric holes are located immediately after the balloon to provide gastric-only
access through the gastric port.
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5
Device meets biocompatibility standard ISO 10993 and is
approved for permanent contact (greater than 30 days).
MR Conditional
It is recommended to check the balloon volume as directed by your healthcare provider.
See page 20 for complete instructions on how to check ll volume.
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Lot Number & Device Size
The lot number and device size are etched (laser engraved)
on the top of the device for complete traceability.
Anti-Kink Technology
Co-extruded radiopaque stripes and anti-kink tubing
provide clear radiographic identification.
Feeding Port (Glow Green™)
Used to administer formula into the jejunum. The
feeding port should remain sealed with the safety plug
when the port is not being used.
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10
6
Decompression/Medication Port (White)
Used to decompress the stomach and administer
medication as prescribed by your healthcare
provider. The decompression/medication port should
remain sealed with the safety plug when the port is
not being used.
7
NOTE: Anti-kink spring
available in the 16F &18F
Individual Port Cover with Safety Plugs
Individual safety plugs for each port should be closed
when not in use.
8
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Reduces Skin Irritation & Discomfort
8
Four Point Comfort:
A Durable Balloon:
• G-JET®Button’s internal retention balloon is
made from the highest grade medical silicone
• More compliant and better able to withstand
stomach contractions
• G-JET®Button device meets the
biocompatibility standard ISO 10993
(Cleared for permanent contact, greater than 30 days)
Gauze or pads are not necessary.
For additional stoma site concerns, see page 18.
4 point stabilized external bolster creates more comfort and less risk of irritation
No hard or bulky external bolster means more patient comfort
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b
c
d
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Reduces Risk of Misconnections
Right Angle
Feed Set
Jejunal length printed
on “J” strap and
laser engraved on the
external bolster.
G and J safety plugs have
distinctive shapes for
tactile differentiation.
Clearly Labeled:
Right Angle
Extension Set
White Gastric
Glow Green™Jejunal
Accidentally feeding the stomach instead of the jejunum can be dangerous! The
G-JET®Button addresses this potential risk in multiple ways.
Mutually-Exclusive Ports:
Gastric feed set will ONLY properly lock into the gastric (white) port.
Jejunal feed set will ONLY properly lock into the jejunal (Glow Green™) port.
Device ports, extension and feed sets are color-coded.
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Optimal Flow
10
The G-JET® Button transforms internally from a tri-lumen design in its proximal (Gastric) segment to a
single large lumen in its distal (Jejunal) segment.
Optimal Flow for Reduced Clogging: Internal Lumen Diameter Comparison
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The AMT Clamp™
Reduce Pullouts with the AMT Clamp
™
for Continuous Feeding
Our new Y-Port is made from a special elastomer that helps secure the stepped
connector with a “sticky” friction t. The new purple color signies “enteral feeding”
to avoid misconnections, and the translucent material aids visualization so you can
see the ow through the Y-Port walls. If pullouts persist, ask for an AMT Clamp™
to reduce disconnects.
The AMT Clamp Device part number is 4-3000
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∆Gastric lumen cross-sectional area
xContains tungsten [Competitor ]
ª Jejunal lumen cross-sectional area
*Comparison calculations of the competitor are based on corresponding device size.
No Competitor
Equivalent
No Competitor
Equivalent
*
*
*
Jejunal Lumen Portion
0%
100%
200%
25%
125%
50%
150%
75%
175%
Competitor device Jejunal Portion
AMT G-JET®Gastric Portion
Internal Lumen Cross-Size Comparison
18 F
56%Larger 81%Larger 57%Larger
18F16F16 F14 F22F
41% Larger∆131% Largerª
G-JET®Button G-JET®Button

Jejunal (Glow Green™) Feed Set
12
*Attaching the Feed Set to the Jejunal Port:
1. Remove jejunal feeding port safety plug (see page 7, #6) from the top of the
G-JET®Button, revealing the Glow Green™color interlock.
2. Holding the button, as shown in Figure A, line up the black mark on the jejunal
(Glow Green™) feeding set adapter with the black mark on the G-JET®Button.
3. Make sure the feeding set adapter is pushed in completely and gently turn
no more than 3/4 clockwise to lock the adapter in place. When fully locked, the
adapter will stop rotating.
Do NOT attempt to rotate the adapter past 3/4 turn. If the adapter does not rotate
freely when first inserted into the feeding port, make sure the adapter is pushed in
all the way and that there is nothing blocking the jejunal port.
Remove the feed set by rotating the connector COUNTER-CLOCKWISE until the
black line of the feeding set aligns with the black line on the jejunal port. Remove the
feeding set and cap the jejunal port with the attached feeding port safety plug.
Starting PositionFig. A. Locked
Position
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Gastric (White) Extension Set
13
*Attaching Extension Set to the Gastric Port
1. Remove the gastric decompression/medication port safety plug (see page 7, #7)
from the top of the G-JET®Button, revealing the white color interlock.
2. Holding the button, as shown in Figure B, line up the black mark on the gastric
Decompression/Medication Extension Set with the black mark on the G-JET®.
3. Make sure the extension set adapter is pushed in completely and gently turn the
adapter no more than 3/4 turn clockwise to lock the adapter in place. When fully
locked, the adapter will stop rotating.
Do NOT attempt to rotate the adapter past 3/4 turn. If the adapter does not rotate
freely when first inserted into the feeding port, make sure the adapter is pushed in
all the way and that there is nothing blocking the gastric port.
Remove the extension set by rotating the connector COUNTER-CLOCKWISE until
the black line of the extension set aligns with the black line on the gastric port.
Remove the set and cap the gastric port with the attached port safety plug.
Starting Position
Fig. B.
Locked Position
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*Dual Extension/Feed Set Hook-Up on page 17*Dual Extension/Feed Set Hook-Up on page 17

14
Gather the needed materials: formula, feed set, irrigating syringe, enteral feeding pump
and water for flushing the tube.
ALWAYS wash your hands BEFORE preparing the formula and touching the G-JET®
Button. Wash with soap and warm water, rinse thoroughly and dry with a clean towel.
Shake ready-to-use formula and wipe the container tops before opening with a clean
cloth OR mix powdered or concentrated formula with water according to the nutritional
label directions.
(ALWAYS follow the manufacturer’s instructions. DO NOT mix new formula with old formula.)
Prime the tubing: Attach the feeding bag tubing to the right angle feed set and clamp one
or both tubes. Pour the prescribed amount of formula into the feeding bag and allow
the liquid to flow through to the end of the tubing where it is clamped off. This pushes
the air out of the tubing and prevents it from being pumped into the stomach.
Connect the Jejunal (Glow Green™) Feed Set to the Glow Green™ port labeled “J” for
jejunal. (For detailed directions see page 12)
Connect the feeding bag tubing to the pump. Set the flow rate. Unclamp the tubes and
begin feeding. (Follow the manufacturer’s directions to set the pump.)
When feeding is complete, clamp both the feed set tubing and the feed bag tubing.
Then disconnect the feeding bag.
Flush the feed set with the prescribed amount of water.
Disconnect the feed set and wash it with warm soapy water.
Never attempt to bolus feed through the jejunal lumen.
Jejunal Feeding:
For all feeding methods, it is recommended that you feed with your head elevated
above your heart. You should stay in an upright position for at least 30 minutes after
feeding. Please consult your healthcare provider to create a feeding plan that meets
your needs.
Feeding into the Jejunum
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Jejunal Feeding Continued:
Flush the jejunal port EVERY SIX HOURS WITH AT LEAST 30 ml WATER. DO NOT
USE FORCE. Note: If you are simultaneously decompressing the stomach while
feeding and you see formula in the gastric drainage, stop the feeding and notify your
healthcare provider.
WARNING: NEVER CONNECT THE JEJUNAL PORT TO SUCTION. DO NOT
MEASURE RESIDUALS FROM THE JEJUNAL PORT.
CAUTION: DO NOT ADMINISTER MEDICATIONS THROUGH THE JEJUNAL
FEEDING PORT. THIS WILL CLOG THE TUBE. TO HELP AVOID CLOGGING, USE
A FEEDING PUMP TO DELIVER FORMULA THROUGH THE JEJUNAL LUMEN.
NEVER ALLOW FORMULA TO REMAIN IN THE TUBE.

Decompressing the Stomach
16
Administering Medication:
Use liquid medications when possible.
Speak with your pharmacist to determine if it is safe to crush solid medication and
mix with water. If safe, crush the solid or tablet medication into a fine powder using
a pill crusher or the back of a spoon.
Mix the powder with warm water until it is completely dissolved before administering
through the Gastric (White) port of the G-JET®Button.
DO NOT crush enteric-coated tablets, timed-release tablets or capsules.
DO NOT mix medications.
DO NOT add medications to food formulas or containers.
Flush the gastric port EVERY SIX HOURS with at least 30 ml of water.
CAUTION: DO NOT administer medications through the jejunal feeding port.
ALWAYS FOLLOW YOUR CLINICIAN’S INSTRUCTIONS:
Your healthcare provider may recommend decompressing or “venting” the stomach
(letting the air or liquid out) before or after feeding to help relieve pressure.
Stomach/Gastric Decompression:
Connect the Gastric (White) Extension Set to the
white port labeled “G” for gastric (For detailed
directions see page 13). The end of the Extension Set
may be left open for gravity drainage, or connected
to low intermittent suction.
Raise the Extension Set approximately 6" above the
stomach so gas and stomach contents can pass
freely up and down the tube. Do this as directed by
your healthcare provider.
DO NOT use continuous or high intermittent suction.
High pressure could collapse the G-JET®Button or
injure the stomach tissue and cause bleeding.
Flush the gastric port EVERY SIX HOURS with at
least 30 ml of water.
This guide is not intended as a substitute for professional medical care and advice.
Your first source of information should be your healthcare provider.
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Dual Extension/Feed Set Hook-Up
17
Gastric (White) Extension Set:
Turn a 3/4 Turn Clockwise
Jejunal (Glow Green™) Feed
Set: Turn a 1/4 Turn Clockwise
To Attach an Extension Set to the Gastric Port of the G-JET®Button:
To Attach a Feed Set to the Jejunal Port of the G-JET®Button:
Do NOT attempt to rotate the adapter past 3/4 turn. If the adapter does not rotate
freely when first inserted into the gastric or jejunal port, ensure the adapter is pushed
in all the way and that there is nothing blocking the gastric or jejunal port.
Remove the extension set by rotating the connector COUNTER-CLOCKWISE until
the black line of the extension or feed set aligns with the black line on the gastric or
jejunal port. Remove the set and cap the AMT gastric or jejunal port with the attached
port safety plug.
Feed Set & Extension Set Hook-Up:
Follow the directions on page 13, steps 1 through 3.
Follow the directions on page 12, steps 1 through 3. However,
on step 3 only turn the feed set a 1/4 turn.
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