Halyard MIC-KEY User manual

MIC-KEY*
G FEEDING TUBE
YOUR GUIDE TO
PROPER CARE

CONTENTS
I INTRODUCTION TO TUBE FEEDING 1
II ABOUT THE MIC-KEY* G FEEDING TUBE 1
- The External Base 2
- The MIC-KEY*Feeding Port 2
- The Silicone Retention Balloon 2
- The Balloon Valve 3
III ACCESSORIES 3
- The MIC-KEY*Extension Set 3
- The MIC-KEY*Bolus Extension Set 3
- The Syringes 4
IV CARE AND USE 4
- Maintenance of the MIC-KEY*G Feeding Tube 5
V FEEDING THROUGH THE MIC-KEY* FEEDING TUBE 5
- Proper Placement 5
- Residual 6
- Decompression or Venting 6
- Continuous Feeding 7
- Bolus Feeding 8
- Medications 9
VI REPLACING THE MIC-KEY* FEEDING TUBE 9
VII CHILDREN’S CORNER 10
VIII PROBLEM SOLVING 11
IX SPECIAL CHILDREN’S PROBLEMS 14
X GLOSSARY OF TERMS 15

1
INTRODUCTION TO
TUBE FEEDING
Good nutrition maintains health, growth and
healing. Many dierent medical problems are
treated by gastrostomies when the person
cannot eat or eat enough to meet nutritional
requirements. A gastrostomy delivers
nourishment and liquid through a tube into the
stomach. Formula suitable for tube feeding may
be commercially prepared or may be blenderized
table food prescribed by the specialist.
Adequate nutrition depends on the right type
and amount of formula. Your specialist has
prescribed your feeding schedule, formula, and
amount of water.
ABOUT THE MIC-KEY*
G FEEDING TUBE
A MIC-KEY*Feeding Tube has been inserted
into your stomach through the abdominal wall.
There is an inflatable balloon at one end and an
external base at the other. This tube allows the
intake of food and water that your body requires.
Your specialist has measured you to ensure
that you have the right size MIC-KEY*feeding
tube. You also received care and maintenance
instructions. This pamphlet will help you
remember the instructions. You received
instructions about your diet and medication.
Follow the instructions closely and never put any
other diet or medication through your tube.
Feeding Port
Balloon Port
Silicone
Retention
Balloon
MIC-KEY*Feeding
Port Cover SECUR-LOK*
Connector
MIC-KEY*Extension
Set with SECUR-LOK*
Right Angle
Connector and 2
Port “Y” and clamp
MIC-KEY*
Feeding Tube
MIC-KEY*
Feeding and
Medication Port
Medication Port
Clamp

2
THE EXTERNAL BASE
The external base holds the tube in place yet
allows air circulation to the skin around and
underneath it. The bottom of the base should
rest just above the skin surface. A good fit is
considered one-eighth inch (3 mm) above the
skin, or approximately the thickness of a dime.
THE MIC-KEY*FEEDING PORT
Nourishment and liquids are delivered through
the gastrostomy tube and into the stomach
through the feeding and medication port.
When nourishment or liquids are not being
administered, the feeding port is capped o with
the attached feeding port cover.
An anti-reflux valve is located inside and toward
the top of the feeding port. This helps prevent
stomach contents from leaking out of the tube.
The use of the extension set will open or unlock
the valve. The extension set is used for feeding
and venting (also called decompression or
burping).
It is important to keep the feeding port and
anti-reflux valve clean. Dried formula may lodge
inside the recess and hold the valve open. The
best preventative measure is to flush thoroughly
with enough water to clear all formula and to use
cotton tipped applicators and water. Be sure that
residual formula is not left to pool and dry inside
the valve opening.
THE SILICONE
RETENTION BALLOON
Your feeding tube has a balloon inside the
stomach that has been inflated to hold the tube
in place. Your specialist filled it with water when
the tube was inserted. Check the balloon volume
once a week.

3
THE BALLOON VALVE
The balloon, which holds the tube in place,
is inflated and deflated by inserting a luer slip
syringe into the balloon valve. It should only
be used when checking the balloon volume or
replacing the MIC-KEY*. It is important to never
attempt to feed through the balloon valve. It
is also important to keep this valve clean. The
recess in the valve can trap foreign material and
it must be clean to function properly.
ACCESSORIES
THE MIC-KEY*EXTENSION SET
Your MIC-KEY*kit contains an extension set. Use
this extension set for continuous feeding with a
formula pump. To attach the extension set, align
the black line on the extension set with black
line on the feeding port. Insert the “nose” of the
SECUR-LOK*connector into the feeding port and
rotate it one quarter turn clockwise. Open the
extension set feeding port and attach the feeding
bag connector to the extension set with a firm
push and twist. The extension set “swivels” with
movement and allows you to change position
during feeding.
Wash the extension set after every feeding
with warm soapy water and rinse it thoroughly.
Prompt flushing and rinsing prevents the
formula from drying and building up. Extension
sets are disposable and should be replaced
every few weeks.
THE MIC-KEY*BOLUS
EXTENSION SET
Your MIC-KEY*feeding tube kit also contains
a MIC-KEY*bolus extension set. Some people
receive several feedings during the day. Use the
bolus extension set to feed with a catheter tip
syringe or feeding bag. It normally takes twenty
to forty minutes to bolus feed. This method
resembles a normal feeding pattern.
Feeding Port
Bolus
Feeding Port
MIC-KEY*Continuous
Feed Extension Set
with SECUR-LOK*Right
Angle Connector and
2 Port “Y” and clamp
MIC-KEY*Bolus Feed
Extension Set with
Cath Tip SECUR-LOK*
Straight Connector
and clamp
SECUR-LOK*
Connector
SECUR-LOK*
Connector
Medication Port
Clamp
Clamp

4
THE SYRINGES
A 6 ml luer slip syringe is included with your
feeding tube kit. Use it to inflate and deflate the
retention balloon when periodically checking
its volume and when you replace the MIC-KEY*
feeding tube.
Your MIC-KEY*feeding tube kit also includes
a 35 ml catheter tip syringe. It should be used
when priming and flushing the extension sets,
and when checking for proper placement of the
MIC-KEY*feeding tube.
CARE AND USE
Clean the MIC-KEY*feeding tube daily. Care is
simple and easy. Just keep the tube and the skin
around the tube (stoma) clean and dry.
The following supplies will make your
work easier:
• soap and water
• cotton-tip applicators
• tissues
• luer slip syringe
The balloon holds your feeding tube in place.
Check the volume of water in the balloon at
least once a week. To do this, attach the luer slip
syringe to the balloon port and withdraw all the
water while leaving the feeding tube in place. If
there is less fluid than the amount originally pre-
scribed, replace it with the prescribed amount.
Distilled or sterile water is a good choice for
the replacement fluid once the stoma site has
healed. (Never fill the balloon with air. Air will
rapidly migrate out of the balloon and the
MIC-KEY*feeding tube will not stay in place).
Rotate the MIC-KEY*feeding tube in a full circle
when you perform daily tube care. This will
prevent the tube or balloon from adhering to
the skin.

5
MAINTENANCE OF THE
MIC-KEY*GASTROSTOMY
FEEDING TUBE
ALWAYS WASH YOUR HANDS WITH
WARM SOAPY WATER BEFORE TOUCHING
YOUR TUBE.
Develop a habit of inspecting the skin around
the tube (stoma) after feeding. Make sure the
skin is clean and dry. Observe the stoma for a
few minutes checking for gastric leakage. If you
use a dressing, change it when it becomes wet
or soiled. Never allow a wet dressing to remain
in contact with the skin. Note: The MIC-KEY*
feeding tube does not require a dressing.
Gently clean the skin around the stoma. Rotate
the MIC-KEY*feeding tube and clean again. Use
cotton-tip applicators or a soft cloth, using soap
and warm water. If you think soap is irritating
the skin, try cleansing with water alone or try
another soap.
Clean the feeding port with a cotton tip
applicator or soft cloth to remove oil or food.
If you receive a continuous feeding, flush the
tube and the extension set tubing at least three
times daily.
AVOID PUNCTURING OR TEARING
ANY PART OF THE MIC-KEY*
GASTROSTOMY FEEDING TUBE.
FEEDING THROUGH
THE MIC-KEY* FEEDING TUBE
PROPER PLACEMENT
Before feeding, check the tube to be sure that it
is not clogged or displaced outside the stomach.
To do this, connect the extension set to the
MIC-KEY*feeding tube and attach a Monoject
catheter tip syringe with 10 ml’s of water to the
extension set feeding port. Pull back on the
plunger. When you see stomach contents in
the tube, flush the MIC-KEY*feeding tube with
water. Stomach contents are normally yellow or
clear unless there is food in the stomach. If you
feel resistance as you inject the water, pull back
stomach contents again, then try to re-inject the
water. Check for leaking around the stoma.

6
Another method is to draw 5 to 10 ml’s of air into
a syringe. Place a stethoscope on the left side
of the abdomen just above the waist. Inject the
air into the extension set feeding port and listen
for the stomach to “growl”. Try again if you do
not hear it. If you still do not hear it, do not
proceed to feed. Contact the specialist and
report the problem.
RESIDUAL
Another advantage of the MIC-KEY*feeding tube
is the ability to measure stomach residual without
a decompression tube. Residual is the amount of
gastric fluid and formula left in the stomach four
hours after feeding. The stomach may not always
empty completely. The amount of residual varies
and may depend upon your activity or position.
Check for residual if the formula backs up in
the extension tubing or if you feel nauseated.
Generally, replace the residual back into the
stomach. It contains important electrolytes and
nutrients. Check the residual again in 30 minutes
and resume the feeding if the amount is less than
you obtained at the first check.
DECOMPRESSION
OR VENTING
Your specialist may instruct you to decompress
(release air or food from the stomach) before
or after feedings. To decompress the stomach,
attach the extension set or bolus extension
set to the MIC-KEY*feeding tube. Drain into a
collecting cup or bag.

7
CONTINUOUS FEEDING
The specialist will recommend the type of
formula best for you.
1. Clean the tops of formula cans and shake
well. (If using powdered formula, it should
be prepared fresh every day. Refer to the
information section of this booklet for the
prescribed amount. Label each formula
batch with the date and time you
prepared it.)
2. Wash hands with soap and water and
dry thoroughly.
3. Fill the feeding administration bag
with formula.
4. Connect the feeding administration bag
tubing to the MIC-KEY*extension set
feeding port.
5. Purge air from the tubing by allowing
formula to run through the tubing. When
formula has reached the extension set
SECUR-LOK*Connector, clamp the tubing.
6. Remove the feeding port cover. Insert
the extension set into the feeding port by
matching the black lines on the extension
set and feeding port. Lock the extension
set into place by turning the connector
CLOCKWISE until you feel a slight resistance
(approximately three-quarters turn). DO
NOT turn the connector past the stop point.
7. Connect the feeding administration
bag tubing to the pump. Set the pump
rate according to the manufacturer’s
instructions. Unclamp the tubing and
begin feeding.
8. When the feeding is nearly finished, add
the prescribed amount of water to the
feeding bag.
9. After the formula and water have been
administered, disconnect the feeding
administration bag tubing from the
extension set. Flush the extension set
with 10–20 ml’s of warm water or until
the tubing is clear.
10. Disconnect the extension set from the
MIC-KEY*feeding tube by rotating it
COUNTER-CLOCKWISE until the black line
on the feeding port lines up with the black
line on the extension set. Gently detach the
extension set and cap the MIC-KEY*feeding
tube securely with the attached feeding
port cover.
11. Wash the extension set and feeding bag in
warm soapy water immediately after each
use. Rinse thoroughly and air dry.