The provision of a percutaneously placed enteral tube feeding service

David Westaby, Alison Young, Paul O'Toole, Geoff Smith, David S Sanders

This guideline, relating to the provision of a percutaneously placed enteral tube feeding service, is focused upon a specific area of nutrition provision that has not been previously targeted. It should be read in the context of other recent guidelines, which have covered the wider field of nutrition provision. The present guideline includes a summary of the ethical issues associated with enteral tube feeding, but these issues are dealt with in detail by the Royal College of Physicians working party report on oral feeding. Furthermore there is no reference to the provision and make-up of the enteral feeds themselves (an area well covered in the reports referred to). The aim of the guideline is to identify the role of percutaneously placed enteral feeding tubes within the wider context of nutrition provision. Guidance is provided for patient selection, the technical aspects of tube placement as well as the prevention and management of associated complications, with an emphasis on endoscopic tube placement (rather than radiological or surgical techniques). The target audience is wide, and includes consultants and specialist registrars in gastroenterology, surgery and radiology, nurse endoscopists and endoscopy nurses, dietitians and nutrition nurse specialists (both hospital and community based). This guideline also provides a basis upon which a primary care trust can purchase enteral nutrition services.