There have been a number of reports from UK hospitals that Endoscopy services have stopped inserting all gastrostomy (PEG) tubes as part of their emergency COVID-19 response. Nasogastric tube feeding in the community (including care homes) has been advocated by some units as a safer alternative.
PEG feeding remains an important component of nutritional care for carefully selected patients. We believe that NG tube placement (in common with all nasal procedures) can be aerosol generating and BAPEN have written to PHE to recommend a change in national guidance. There are also a number of other practical and safety issues which can make NGT feeding in the community challenging.
The BSG updated Endoscopy guidance published on 3rd April 2020 recommends that hospitals maintain all emergency and essential endoscopy procedures – this includes urgent inpatient PEGs. BAPEN and BSG therefore both advise that every effort should be made to maintain services for PEG insertion in patients where this is deemed to be an essential part of their care pathway.
Dr Trevor Smith, BAPEN President
Dr Cathryn Edwards, BSG President
Dr Ian Penman, BSG Vice-President Endoscopy
Dr Beverly Oates, NHSI Gastroenterology GIRFT Programme Clinical Lead