FLOURISH® Home Nutrition from Shield HealthCare Tube Feeding At Home Man for Us one) Cee Ve) CYAdult Enteral Nutrition Guide 99% of our customers would recommend us to friends and family.* Since 1957, Shield HealthCare has been helping people with a heed for disposable medical Products live comfortably at home. Shield HealthCare is dedicated to fulfilling the medical supply needs of consumers and the caregiving community with a focus on customer satisfaction. *2016 Annual Report on Quality, Press-Ganey Associates, Inc.BU eae Ue ORCC eB RM he Melee eee once Rees ta ee mT EAC) Peco Re CRM ener Shield HealthCare’s Enteral Nutrition Support Program Features © On-staff Registered Dietitians with specialized training in tube feeding and nutrition + Direct communication with you, your doctor, nurse and other healthcare professionals © Quarterly tube feeding monitoring program + Your customer service agent will ask you specific questions to make sure your feeding plan is still appropriate for you and refer you to one of our Registered Dietitians as needed. © Comprehensive offering of tube feeding formulas and supplies © Supplies conveniently shipped directly to your door © Direct billing to your insurance Enteral nutrition is when a special liquid food formula containing protein CeCe ce COMICS UMS ORO canon ge Ren nc) the stomach or small bowel. The word “enteral” refers to your Pee Tate aay1 you are unapte to meet your nutritional neeas by moutn, a 1eeaing tube provides a way to obtain life-sustaining nutrients. This method of “eating” bypasses the mouth and esophagus and delivers nutrition directly into your stomach or small intestine. This guide provides the basic information about tube feeding, including how to care for your tube and the skin around it, how to deliver feedings and how to prevent common complications. This information does not replace the advice of your healthcare professionals. Table of Contents Your Feeding Plan uo... 4 Life with a Feeding TUbe 0... eee eeeseeeeeeeeneee 5 Your Feeding Tube... cee ecececeeteeeetesseeetensereneees 6 DEIVETING | MEGICHOTS oc. ostaaserrancticecera mtncceartmorsns 9 Delivering FOrMula wo... ceecceceeeeteeteteeeeteeneees 10 Feeding Method - Bolus/Syringe ......:ccccceeceee 4 Feeding Method - GraVity 0... TB Feeding Method - PUMP... ccc 15 Priming Your Pump...... bc eeeeeeeteseeteeteeeeeee dT Setting Your Pump. Managing Common Complications .......0.:ccccce 19 Preventing Infection................ re) Resolving a Clogged Feeding T TUDE. ececeeeceteeeeeees 21Skin Care and Your Feeding Tube. Potential Tube Feeding-Related Skin Issues .......... 23 RESOUICES ANA SUSPON saenuncnetamenummccan When to Call Shield HealthCare.... Infinity™ Pump Troubleshooting Guide............. nen Kangaroo Joey™ Pump Troubleshooting Guide.....29 How to Use the Enteral Backpack ..........cccceceeee 30 Your Feeding Plan You and your healthcare team will come up with a feeding plan that meets your nutritional needs and works well for your medical condition. Formula: Total # of cans/cartons per day: Calories per day: Feeding method: 1 Bolus/Syringe OGravity Pump Feeding schedule: Water flushes: ___ Milliliters before and after each feeding ___ Milliliters before and after medication __Nilliliters every 4 hours on continuous feeding Dem arsrV are UKM INC ON el Ske Re SSETOM Recent Rn na car hang of it with support from family, friends and your healthcare team. Although you will need to make some life changes, the key to adjusting successfully is for you and your team to come up with the plan that best fits your current lifestyle. Sree ee Meena Res aed Oe tenure rete ie ta Ree Pie acek=y (ort Work with your healthcare team to plan a feeding schedule that fits with Pree Sonu neeu Com cu CR TR CR neuen nae Cee eee a imc a eee reat Ran nee re Nel a URCR oR noms CO ened re) CRUD eae og ea ee Cone Pac CRN Ma Cun Ranaut Cue ma OnLEN] eee aCe ue RcCEES Seep aea Mh eo om Ae Ra ae eC fee ee eC Rel mc score PT RUN RC esau tein tate cece Peete Som Mae nen eu nueeCeumec CUR acne feel during and after feedings. Write down any questions or concerns and PeVn ae ROR ane elet oau a os Cee eat nace Coan ray Cm mcm Ce ee Cae ene Co ae eta cna ce support groups or join an online forum, such as the Oley Foundation ORO cel eva There are many different types of feeding tubes. Your doctor chose the one that would work best for you at the time. If necessary, he or she may decide to change the type of tube you have if necessary. M , This tube enters the body through the nose and passes through the esophagus. The tip of the tube “ may be in the stomach (nasogastric) or further down the gastrointestinal tract in the small intestine (nasojejunal). These tubes are generally for short- term useee Gastrostomy tube (G-tube) For this tube, a hole is made through the abdominal wall. The tip of the tube sits in the stomach. The length of some gastrostomy tubes may be adjusted by sliding the external bolster up or down the tubing. Most gastrostomy tubes will last a few months to a year or longer. - Feeding Port 0 Medication Port ———____ a —e Fill Port External Bolster* Balloon** or internal bumper “External bolster holds your tube in place. “If your tube does not have a balloon it will have an internal bumper to hold the tube in place. SAS Us site el Jejunostomy tube (J-tube) Ajejunostomy tube is placed during a surgical procedure, in which a hole is made further down on the abdominal wall. The tip of the tube lies in the jejunum, bypassing the stomach. Gastrojejunostomy tube (GJ-tube) 2p, Although only one hole is made in the abdomen, ye — this type of tube has two ports: one that enters : ~~ ~| the stomach and one that enters the jejunum. The iad y gastric port is typically used to vent gases fromthe stomach or to deliver medications, while the jejunal port is used for formula. Alow-profile tube, also known as a button tube, sits close to the skin and requires extension tubing in order to use it. When not in use, it snaps shut. The tube may be in the stomach or jejunum. These tubes come in different French sizes and lengths. Many are held in place by an internal balloon that holds water. They are usually replaced every few months. Your Feeding Tube It may be helpful to note details about your tube for when it needs to be replaced. Your tube type: Brand: French size: Length (if applicable): Balloon volume (if applicable): PAC VC UE Flushing Your Tube with Water Discuss your fluid needs with your healthcare team. Although tube feeding formula contains water, it is usually not enough to meet your daily needs. You will need to put additional water in your tube to stay hydrated and toprevent wre Wave Hun Cuyginy GUE WW HeULaLiUND UF UNeU Furuta. neyuED tap water is safe for most people with a feeding tube. Flush your tube with at least 15 to 30 milliliters of water before and after giving formula and medications and every 4 hours when the tube is not in use. Supplies: © Cup of room temperature or warm water © 60-milliliter enteral syringe Instructions: © Place the tip of the syringe into the water and pull back on the plunger until the water reaches the specified amount, at least 15 to 30 milliliters. © Insert the tip of the syringe into your feeding port and slowly push the plunger until the water goes through. * You may also remove the plunger from the syringe, insert the tip into your feeding port and slowly pour water into the syringe. Es _ ere cnere reine Cra me Tenet cuales ec Rem eacus OM nereeeaRaiecd Pause al eek al o Weed Pet eacuee re RELDelivering Medications Medication is the most common cause of a clogged tube. Follow these tips to help prevent clogs: Stop the feeding and flush the tube with water before and after medication administration. © Give each medication separately unless otherwise instructed by your doctor or pharmacist. © Crush only those medications which are immediate-release. Sustained-release and enteric-coated medications don’t dissolve well and may not absorb properly when crushed ® Dissolve medications in warm water before giving them. e Use liquid medications when available. ® Dilute liquid medications with water to prevent clogging and gastrointestinal discomfort. © Ask the doctor or pharmacist if your medications are ideal for your feeding tube.Delivering Formula Feeding Tips Your healthcare team will provide instructions on the rate (how fast your formula flows) and the volume (the amount of formula used) for your feedings. Always wash your hands before handling your tube, formula and feeding supplies. You should be sitting upright or at a 30- to 40-degree angle during your feeding and for an hour afterward. This will help to prevent aspiration of formula into the airway. Use wooden blocks to keep the head of the bed at this angle if you get your feedings while you are lying down or sleeping. If you experience any symptoms of feeding intolerance during your feeding, such as nausea or vomiting, diarrhea or abdominal bloating, try slowing down the rate and contact your healthcare professional.DASCHLE AA CNVAoTO lam ar -iUo)A0 len k—i—re) aroma ere} M-NZ11 Cl] (Cm Le shieldhealthcare.com/community/videos Feeding Method - Bolus/Syringe This method uses a syringe to administer a specified amount of formula at once, much like a meal. Most people have a feeding every three hours or so. Discuss your feeding schedule with your healthcare team to find the best plan for you. ‘Supplies: © 60-milliliter enteral syringe © Room temperature water © Formulashieldhealthcare.com/community/videos CLT dite Ue SAA? Instructions: 1. If you have a low profile feeding tube, attach the extension tubing. 2. Open your feeding port and flush the tube with at least 15 to 30 milliliters of water or the amount advised by your healthcare team (see page 8). 3. Clean off the outside of your formula container with a clean towel and open it. 4, Remove the plunger from the syringe. 5. Attach the syringe to your feeding port, holding up the tube and syringe with one hand. 6. Slowly pour formula into the syringe with your other hand. Allow it to flow by gravity into your stomach. It should take around 15 minutes to deliver 8 ounces of formula. Feed more slowly or more quickly depending on your tolerance. You can make the formula flow faster or slower by raising the syringe higher or lower in relation to your stomach. You can also push the formula in with the plunger to speed it up. 7. Flush your feeding tube with the amount of water recommended by your healthcare team. 8. Close the feeding port and disconnect the extension tubing if applicable. 9. Wash and dry all equipment and your hands. 10. Refrigerate any leftover formula and use within 24 hours. —_Wash your hands Cava iim (ol0) handle the tube site or formula and feeding supplies. Feeding Method - Gravity With this method, formula flows out of a feeding bag and into your feeding tube by gravity. This method is slower than the bolus/syringe method and uses a roller clamp on the bag’s tubing to control the rate. Supplies: © 60-milliliter enteral syringe © Room temperature water * Gravity feeding bag . . IV pole FormulaAY shieldhealthcare.com/community/videos 13 www.shieldhealthcar com Instructions: 1. If you have a low profile feeding tube, attach the extension tubing. 2. Open your feeding port and flush the tube with at least 15 to 30 milliliters of water or the amount advised by your healthcare team (see page 8). 3. Hang your gravity feeding bag from the IV pole so that the bag is at least 18 inches above your stomach. 4. Clean off the outside of your formula container with a clean towel and open it. 5. If the gravity bag has a roller clamp or other type of clamp, make sure it is closed. 6. Open the bag and pour in the desired amount of formula. Close the bag. 7. Prime the tubing to release any air. This will prevent the air from going into your stomach and making you uncomfortable. Slowly open the clamp/roller clamp and allow the formula to flow until it reaches the tip of the tubing, then clamp it shut. Remove the cover on the tip of the gravity bag’s tubing. 9, Attach the tip of the tubing to your feeding port. Slowly open the clamp/ roller clamp to start feeding. Control the rate of feeding by adjusting theclamp/roller clamp. It should take between 30 to 60 minutes to deliver 8 ounces of formula, depending on your tolerance. 10. When you are done feeding, disconnect the gravity bag tubing from your feeding tube. . Flush your feeding tube with the amount of water recommended by your healthcare team. 12. Close the feeding port and disconnect the extension tubing if applicable. 13. Wash and dry all equipment and your hands. 14, Refrigerate any leftover formula and use within 24 hours. eV aier 1s Feeding Method - Pump With this method, a battery-powered pump infuses formula into your feeding tube. The pump may be set to run at a continuous rate over several hours or intermittently to run for 1 or 2 hours at a time. Refer to your pump’s Operator’s Manual for more information. See page 27 for feeding pump troubleshooting guides. ‘Supplies: 60-milliliter enteral syringe Room temperature water Feeding bag Feeding pump IV pole or Enteral backpack a Formula f \ Tip of Cassette \ oe the feeding ee tube ececeeHow to Start and Set Up Your Infinity Feeding Pump he shieldhealthcare.com/community/videos Instructions: 1. 2. 4 If you have a low profile feeding tube, attach the extension tubing. Open your feeding port and flush the tube with at least 15 to 30 milliliters of water or the amount advised by your healthcare team (see page 8). Flush the tube every time you use it for feeding or medications or every time you turn the pump on and off. Hang the feeding bag from the IV pole so that the bag is at least 18 inches above your stomach. If you are using an enteral backpack, secure the bag inside and thread the tubing through the holes and out the back of the backpack. Insert the cassette intn the feerine numn The cassette includes thelooped part of the tubing. Wrap the loop around the black wheel on the front of the pump and stretch it lightly until the clear plastic piece that houses the tubing fits and clicks into the pump. 5. Close the pump door and turn the pump on. Keep it plugged in if you are near an electrical outlet, to keep the pump charged. 6. Open the bag and pour in the desired amount of formula. Squeeze the air out of the bag and close it. 8. Prime the tubing to release any air (see page 17). This will prevent the air from going into your body and making you uncomfortable. 9. Remove the cover on the tip of the feeding bag’s tubing. 10. Attach the tip of the bag’s tubing to your feeding port. 11. Set the pump to desired settings and start the feeding (See page 18). 12. When you are done feeding, disconnect the tubing from your feeding tube. a . Flush your feeding tube with the amount of water recommended by your healthcare team. 14. Close the feeding port and disconnect the extension tubing if applicable. 15. Wash and dry all equipment and your hands. 16. Refrigerate any leftover formula and use within 24 hours. eV aier 1s Priming Your Pump Priming the Enteralite® Infinity® pump: © Toprime the pump using the automatic prime feature, push and hold the PRIME button until the formula reaches the end of the tubing. Release the PRIME button. © To prime the tubing manually, squeeze any air out of the bag and closeHon yOu ve aeauy WaueU Ue SEL FeMUvE 1 HTUnT Ue pulp. LUUR Tur a raised tear-drop on the blue part of the tubing. Gently press the tubing together with your thumb and index finger to allow the formula to free- flow through the tubing until it reaches the tip. Re-insert the cassette into the pump and close the door. Priming the Kangaroo Joey™ pump: ‘© Press PRIME PUMP in the opening menu. ¢ To prime automatically, press AUTO PRIME once. To prime manually, press and hold HOLD TO PRIME until the formula reaches the end of the tubing. 17 www.shieldhealthcare.com Setting Your Pump Setting the Enteralite® Infinity® pump: e Set the rate of the pump by pressing the RATE/DOSE button until theword RATE is displayed on the screen. Push the + button until the desired rate is reached. * Set the dose you want to deliver by pressing the RATE/DOSE button until the word DOSE is displayed on the screen. If you want to set a specific amount, push the + button until the desired amount is reached. If you want the pump to simply shut off when the formula is gone, continue to push the + button until the INF (Infinity) is displayed on the screen. e Press RUN to start the feeding. * Select ADJUST FEED, then FEED RATE. « Use the arrows on the left to set the desired rate and press ENTER. © Press RUN to start the feeding. For operator’s manuals visit: Enteral infinityfeedingpump.com Mannninn Cammnan CamalinntinneIVIANAYI IY VULLIIULE GULP NUAUUL IS Dealing with Gastrointestinal Issues You may experience gastrointestinal symptoms while on tube feeding. In some cases, reducing the rate or the amount of formula may help. Even if you are able to tolerate a slower rate or smaller amount, you may not be getting all of your nutrition. You may need to discuss trying a different formula or feeding plan with your healthcare team. Keep in mind that gastrointestinal issues may be related to other things besides the feeding, such as medications or infection. Contact your team if you experience any of these issues. Diarthea Slow down the feeding rate and contact your team Constipation Not enough water and/or | Ask your healthcare team if fiber you need additional fiber or water Nausea or Too much formula/too fast |Sit upright or keep the head vomiting of the bed at 30 degrees or greater during the feeding jand for 60 minutes after ‘Stow down the feeding rate and contact your team Cold formuta Use room-temperature formula Feeling of fullness |Too much formula/too fast _|Slow down the feeding rate or abdominal land contact your team discomforthd DAAC UT Lk rn Preventing Infection Wash your hands every time you handle the tube site or formula and feeding supplies. Use a new feeding bag daily or as instructed by your healthcare team. Between feedings, rinse the bag thoroughly with warm water. Use a new syringe each day. If you use syringes for medication only, rinse with warm water and replace every other day or as instructed by your healthcare team. For gravity and pump feeding, pour the amount of formula into the bag that will be used within 12 hours. Practice good oral hygiene. Keeping your mouth clean and moist may help prevent oral bacteria from migrating down your airway and causing pneumonia. + Floss and brush with a soft toothbrush and toothpaste at least once daily. Be careful not to swallow if instructed by your healthcare team. + Wipe the inside of your mouth with a clean, damp washcloth or mouth swab. + Avoid alcohol-containing mouthwashes, as these can be drying. Store unopened formula in a cool dry place. Refrigerate leftover formula and discard after 24 hours. Practice good oral hygiene. Brush your teeth andResolving a Clogged Feeding Tube If formula or water will not go through the tube or if you notice resistance when flushing, your tube may be clogged. First, make sure the tubing is not clamped or kinked. Then, follow these steps to clear the clog: © Attach a 60-millilter enteral syringe to the feeding tube. Pull back on the plunger to remove as much fluid as possible and discard this fluid. Avoid pulling back on the plunger if you have a J-tube. © Administer at least 10 milliliters of warm water with the syringe. Gently move the plunger back and forth to help loosen the blockage. © If the blockage does not clear, clamp the tube for at least 5 to 15 minutes, allowing the warm water to soften the clog. If you can see the clog, massage that portion of the tube gently with your fingers. © Unclamp the tube and repeat steps 2 and 3. * If you are unable to release the clog, contact your healthcare team. Prevent a clogged tube by flushing the tube with at least 15 to 30 milliliters of water before and after giving formula and medications and every 4 hours when the tube is not in use. Medication is the most common cause of clogged tubing.Watch how to unclog a feeding tube at shieldhealthcare.com/community/videos Pa ACCU ie} Skin Care and Your Feeding Tube RASkinP reservation Caring for skin through intelligent product solutions ‘Most tube-related skin issues can be prevented with routine monitoring and care of the stoma site. A healthy stoma site should look like healthy skin. Wash your hands before touching the tube or your skin. © Check the skin around your feeding tube daily. If you notice redness, pain, irritation or leaking around the site, notify your healthcare team. © Rotate the external bolster %4 turn daily. It should rotate freely. Do not rotate jejunostomy tubes. © Check the external bolster height regularly both while sitting and lying flat. There should be about the width of a dime between the bolster and your skin. If your tube has a balloon, check the volume weekly or as recommended by your healthcare team to make sure it is filled with the right amount of water. © Clean the area, including underneath the external bolster, with mild soap and water. © Keep the skin around your feeding tube clean and dry. After a few days, leave the skin open to air unless your healthcare provider tells WSyout appiy gauze. re © Secure the tube to clothing to prevent damage to the skin from excessive pulling. + Loop a piece of tape or a rubber band around the tubing and use a safety pin to secure it to clothing. + Wrap an ace bandage or abdominal binder around the waist and secure the tubing underneath. ‘Replace the tube immediately if it comes out, or secure it with tape until it can be replaced. If left open, the hole can close up within a few hours! eV aier 1s Potential Tube Feeding-Related Skin Issues Contact your healthcare team if you notice any of these signs on the skin around your feeding tube. Leakage around the tube can occur if the tube fits too loosely. ¢ Adjust the external bolster height and/or balloon volume as needed. © Apply a skin protectant or moisture barrier. © Use a short-term dressing, such as gauze to absorb drainage. BU ose Ce ee Col a ae ea MU BS Yea cou mole Rt eS Ue Ceol Lele RMA Ce of a dime. Pressure necrosis may develop if the external bolster fits too tightly. You may notice redness, irritation and pain around your tube. © If your tube has a balloon, verify that it is filled with the correct amount of water.© If your tube does not have a balloon, adjust the height of the external bolster. Hypergranulation tissue appears as discolored, irritated and raised skin tissue around the tube. ‘© Prevent it by using only mild soap and water for daily cleaning. © Stabilize the tube (see page 22) to restrict movement that may further irritate the skin. © Treatment may include foam dressings to apply pressure and absorb moisture, silver nitrate sticks, moisture barriers and/or steroid creams. 23 PS Cur re Bacterial infection may occur if moisture remains around the site. You may notice pain, inflammation, redness or drainage that may have an odor or color. Wash your hands before touching your skin or the tube itself. © Clean the site two to three times daily with warm water and keep it dry. Your doctor will determine if you need an oral or topical antibiotic. Yeast infection may occur as a result of excessive moisture from leakage or perspiration. It may present as a rash with swelling and sores around the site. © Gently cleanse and dry the skin around your tube.© If you use a dressing, change it when it I ] becomes moist. Your doctor may suggest antifungal powder or other treatments. A healthy stoma site should look like healthy an SLT ede ee oo Resources and Support Your Shield HealthCare Registered Dietitian (RD) is part of your healthcare team. Contact your local Shield HealthCare office or call 800.228.7150 to get in touch with your RD for questions about your tube feeding and nutritional needs. Shield HealthCare 24-hour pump hotline: 866.614.PUMP (7867) Call this number if you experience problems with your feeding pump after hours. Shield HealthCare Community Nutrition site: shieldhealthcare. /community/nutrition/ Articles, tips and videos to help you and your family adjust to tube feeding.Tube Feeding Videos: shieldhealthcare.com/community/videos/ Tube feeding organizations: Feeding Tube Awareness Foundation works to raise positive awareness of tube feeding. feedingtubeawareness.com facebook.com/FeedingTubeAwareness The Oley Foundation provides support to home tube-fed adults and children in the form of newsletters, a video library, an online. community forum, regional support groups, an annual consumer conference and more. oley.org The Oley Foundation also runs an equipment supply exchange, through which you may donate or request tube feeding supplies and formula. oley.org/equipexchange. html When to Call Shield HealthCare Reordering Supplies: @ Call Shield HealthCare at 800.228.7150 to reorder your tube feeding supplies monthly. + Contact us a few days before you run out of supplies. You should receive a reminder call from us around this time each month. Changes to your feeding plan: © Let us know if your doctor makes changes to your plan, such as the amount of formula you use every day.Questions or concerns about your feeding pump: © During business hours call 800.228.7150 After business hours call our 24-hour pump hotline at 866.614,PUMP (7867) Questions about the information in this booklet: Your Shield HealthCare Registered Dietitian (RD) is part of your healthcare team! + Contact your local Shield HealthCare office or call 800.228.7150 to get in touch with your RD for questions about your tube feeding and nutritional needs. Call Shield HealthCare for all of your home medical supply needs, including: « Incontinence Enteral Nutrition (OScolang Urological + Wound Carecoe seeoteie s FE retina piers andresre tig, ‘air present in las air removed from bag of pump delivery set? SSGmT |B bw aresuttont neta IENO:Manualycrimetubingby _—_-IFYES:Press and hold tumegbayiosbedoungenty the PRIVE key to move Squcingtoverhafctbaywnle thea inthetubang pest inching eal calor tubing lust pump avery set Elon ted drop symbol Essent and tesure Hold thi poston tl al iris feeaing removed Woon bag antag [Rtetormala | Let formula sit for 10-15 minutes before praparing pump delivery sat bblenderized or for feeding if foam is presentin tuna, flush by priming pump aggressively mixed?| delivery set etter manually or wth the pump and resumefeedina, trapped inside the cassette? Remove tubing from pump and manually prime tubing by turning bag Upside down, gatly squeezing lower half of bag while pinching the tea colored tubing just below the drop symbol Hold this position until allaichas passad through the taal segrnent fo the tubing alarm continues, contact 'MO0G Customer Advocacy, (800) 970-2337 for assistance. ERRA, ERRD or ERRF Alarms “Turn pump off Unload and reload delivery set cassette. Make 1.Was pump door | F7=ty) pump. very Spentwtie pump |PTRstaP” S4"e doorisclosed securely, then tum pump back on while running? If alarm continues, contact MOOG Customer Advocacy, 1800) 970-2337 for assistance. STE orclosed — |My ‘Turn pump of. Unload end reloed delivery set cassette. Moke “Seaway LINES S32? sure coor is closed securely, then turn pump back on, 2 wale emied Contact M006 Customer Advocacy, (800) 970-2337 or tab on inside tworder anew doer. a Contact MOOG Customer Advocacy, (800) 970-2387 forassistance. Moog ia registered rademarkof Moog lc andi subside ‘All Wademarks indicated herein are the property at Moog, Inc, and its subsidiaries. ” Shien ne iromscmonye son MOOG TG aie mee Infinity™ Pump Troubleshooting Guide SET ae ee eaToa Pr ele region of cassette Feceptacle clean? 4. Are their visible signs of damage to pressure sensors, erea? Check dativery set for obstructions or kinks in tubing (Correct blockage and resume feeding eB ‘Contact MOOG Customer Advocacy, (200) 970-2337 tw order anew door. ‘dampened sponge, or wash entire pump under running water: Do not use abrashe materials or harsh chernicals 3. ls pressure sensor o Clean pressure sensor rea with acotton swab, sft cloth or ‘Contact MOOG Customer Advocacy, (200) 970-2337 ‘toreturn pump fer service. Disconnect from patient and fila new delivery sot with food Prime set and stat pump. alarm continues, contact MOOS Customer Advocacy. (800) 970-2337 for assistance. Bara Tis AIC adapter charger plugged into ‘wall outlet and pump erly? 2s wall outlet functioning properly? 13 Does charger port see tebe fever nicarg ar 4. Does charger adapter appear tohave any damage? 5.8 Battery Symbol and E and Ff fuel gauge flashing? Cheek connections for both wall plug and pump adapter Re Green indicator ignt on charger wal plug should be SIM tete>luminated and pump display should have plug symbol with sorolling bars between E ard Fof fuel gauge ‘ien purnp is fully charged, bars wil stop serllina rey Plug another device into outlet to verity outlets functioning Sa erovely Contact MOOG Customer Advocacy, (800) 970-2337 Mes toorder anew charger. YES ‘Contact MOOG Customer Advocacy. (800) 970-2337 toretumn pump for service. Contact MOOG Customer Advocacy, (600) 970-2337 toretum pump for service. G& condition continues, contact MOOG Customer Advocacy, (800) 970-2327 to return pump for service.Kangaroo Joey™ Pump Troubleshooting Guide ETE Cem les ae cleat mati) Listed below are some of the probable causes of alarm conditions and their corrections. ‘Status LEDs Re Yellow-=Hold Pause Green=Normal Operation Menu Selections Programming & Menu: Selection Buttons = = Power Button SYMPTOM | PROBABLE CAUSE ‘CORRECTIONS Hold Eeror —] Pump in HOLDING mode for | press jm CONTINUE to retuin to HOLDING scieen, or press ‘more than 10 minutes, and hald the Power button totum off. Several tins are avallale from the HOLDING screen, such as RUN or ADJUST SETTINGS. Flow Error | Occlusion in pump-patient ine. | Check for and correct the occlusion in the line between pump (downstream occlusion) and patient, Replace Pump Setif enor cannot be resolved. Feed Error | Empty bag or occasion in bag- | Check for empty bag and refi or check for and correct the pump line. ‘occlusion inthe line between the pump and feed bag, Replace (upstream occasion) Pump Seti error cannot be resahved. Flush Err | Empty bag or acclusion in flush | Check for empty bag and rfl or check for and correct the line ‘occlusion inthe line between the pump and flush bag, Replace Pump Seti error cannot be resolved Flow Error | Pump Set in use beyond Informational waning message blinks on upper left of screen. Use> 24 Hs | recommended length of time. | itis recommended that the Pump Set be replaced. Pump Set | Pump Set not propery oaded | Check black ring retainer (MISTIC) and valve; reload Pump Set Dislodged J to pump. and restart pump to continue. Replace Pump Set if enor cannot be resolved, Battery low Battery charge too low. Immediately plug pump into AIC outlet to recharge battery and to prove power for pump. Rotor Err | Purp Set tubing not properly | Check that the tubing is loaded on the rotor and that it is nat loaded on rotor, or some. damaged, tom, et, Reload tubing or replace Pump Set. ‘other unusual rotor operating condition ‘System Error | General error caused by many | Poner down pump and attemat restart to clear enor. Call factors, See Manual for ero list. | customer service with screen code fer cannat be resolved ca COVIDIEN Fe ee re eicelaPARC eae eel) How to Use the Enteral Backpack Step 1 _ Inserting the Feeding Set A. For a 500-mL feeding bag: Place the bag in the first large section of the backpack. (Fig. 1) Thread the end of the tubing through the middle set of Velcro straps, and through the hole on the bottom, toward the back of the backpack. The end of the tubing should exit the back of the backpack. (Fig. 1) B. For a 1,200-mL bag: Place the bag in the largest section, to the rear of the backpack. (Fig. 3) Thread the end of the tubing through the Velcro straps on the bottom, and out the back of the backpack. (Fig. 2) Thread the cassette through the hole toward you until it sits in the pump section. Step 2 Securing the Feeding Bag Squeeze any air out of the feeding bag and pour desired amount of formula into the bag. Close it Tightly. Secure the neck of the feeding bag with the Velcro strap inside the backpack. Secure the handle of the bag with the inner metal clip. (Fig. 3) Step 3. Inserting the Pump Load the cassette into the pump and close the door. Prime the tubing per pump instructions and set the pump to the desired setting. Secure the pump in the front section of the backpack with the Velcro straps. Be sure that the pump fits snugly. Close all sections of the backpack, using the zippers. Step 4 Making the Backpack Comfortable & Secure Adjust the shoulder straps according to comfort. Use the abdomen strap to secure the backpack around the waist.SSAC UT aise ae NOTESxn eL} Have You Visited Our Online Community?Visit Shield HealthCare’s online communities for the latest health care news, product updates, helpful caregiver tips and more: www.shieldhealthcare.com/community Ostomy Wound Incontinence Ostomy Lifestlye Breastfeeding GROW Pediatric Urological Nutrition Caregivers www.shieldhealthcare.com f v in & ? & © Shield | wwwstievoHeattHcare.com Nine ann OM eee ae Caeeee Pata teem ett eer eme eu na Baan ASU ater eae eM UTSele cam ote Ree Mel erome) eT) Texas Gen Pence Dallas EER L yd ey Ee 7d Ost Reena) euaoat ELLE Ber Eee CROLL Los Angeles poral ENR) inary 800.493.7863 Chicago Recent) CERT Ue) ETE eTd CER San Diego Oar ETAL Ua San Francis 10.675.8840 Oe POR tn Mee eM Ogee Man Cereus CRN eee 090000 Celebrating \Caregiving MKT BKADULTGUIDE 2017