avanos MIC Mode D'emploi page 5

Nutrition Administration
1. Open the cap to the access port of the MIC* J Feeding Tube.
2. Use an ENFit® syringe to flush the tube with the prescribed amount of water as described in
the General Flushing Guidelines.
3. Remove the flushing syringe from the access port.
4. Securely connect an ENFit® feed set to the access port.
Caution: Do not over-tighten the feed set connector or the syringe to the access port.
5. Complete feeding per the clinician's instructions.
6. Remove the feed set or syringe from the access port.
7. Use an ENFit® syringe to flush the tube with the prescribed amount of water as described in
the General Flushing Guidelines.
8. Remove the flushing syringe from the access port.
9. Close the cap to the access port.
Medication Administration
Use liquid medication when possible and consult the pharmacist to determine if it is safe to crush
solid medication and mix with water. If safe, pulverize the solid medication into a fine powder
form and dissolve the powder in warm water before administering through the feeding tube.
Never crush enteric coated medication or mix medication with formula.
1. Open the cap to the access port of the MIC* J tube.
2. Use an ENFit® syringe to flush the tube with the prescribed amount of water as described in
the General Flushing Guidelines.
3. Remove the flushing syringe from the access port.
4. Securely connect an ENFit® syringe containing the medication to the access port.
Caution: Do not over-tighten the syringe to the access port.
5. Deliver the medication by depressing the ENFit® syringe plunger.
6. Remove the syringe from the access port.
7. Use an ENFit® syringe to flush the tube with the prescribed amount of water as described in
the General Flushing Guidelines.
8. Remove the flushing syringe from the access port.
9. Close the cap to the access port.
Balloon Maintenance
Precise balloon life cannot be predicted. Silicone balloons generally last 1–8 months, but the life
span of the balloon varies according to several factors. These factors may include medications,
volume of water used to inflate the balloon, gastric pH, and tube care.
Check the water volume in the balloon once a week.
• Insert a male Luer syringe into the Balloon Inflation Port (BAL.) and withdraw the fluid
while holding the tube in place. Compare the amount of water in the syringe to the amount
recommended or the amount initially prescribed and documented in the patient record. If
the amount is less than recommended or prescribed, refill the balloon with the water initially
removed, then draw up and add the amount needed to bring the balloon volume up to the
recommended and prescribed amount of water. Be aware as you deflate the balloon there
may be some gastric contents that can leak from around the tube. Document the fluid volume,
the amount of volume to be replaced (if any), the date and time.
• Wait 10–20 minutes and repeat the procedure. The balloon is leaking if it has lost fluid, and
the tube should be replaced. A deflated or ruptured balloon could cause the tube to dislodge
or be displaced. If the balloon is ruptured, it will need to be replaced. Secure the tube into
position using tape, then follow facility protocol and/or call the physician for instructions.
Caution: Refill the balloon using sterile or distilled water, not air or saline. Saline can
crystallize and clog the balloon valve or lumen, and air may seep out and cause the balloon to
collapse. Be sure to use the recommended amount of water as over-inflation can obstruct the
lumen or decrease balloon life and under-inflation will not secure the tube properly.
Daily Care & Maintenance Check List
• Assess the patient for any signs of pain, pressure or discomfort.
• Assess the stoma site for any signs of infection, such as redness, irritation, edema, swelling,
tenderness, warmth, rashes, purulent, or gastrointestinal drainage. Assess the patient for any
signs of pressure necrosis, skin breakdown, or hypergranulation tissue.
• Use warm water and mild soap.
• Use a circular motion moving from the tube outwards.
• Rinse thoroughly and dry well.
• Assess the tube for any abnormalities such as damage, clogging, or abnormal discoloration.
• Use warm water and mild soap being careful not to pull or manipulate the tube excessively.
• Rinse thoroughly and dry well.
• Clean the Jejunal and Balloon Inflation Ports. Use a cotton tip applicator or soft cloth to
remove all residual formula and medication. Use a cotton tip applicator or soft cloth to
remove all residual formula and medication.
• Verify that the external bolster rests 1–2 mm above the skin.
• Flush the feeding tube as described in the General Flushing Guidelines section above.
Caution: Do not rotate the external retention bolster. Rotating the bolster may cause the
tube to kink and possibly lose position.
Tube Occlusion
Tube occlusion is generally caused by:
• Poor flushing techniques
• Inappropriate administration of medication
• Pill fragments
• Thick formulas, such as concentrated or enriched formulas that are generally thicker
• Formula contamination that leads to coagulation
• Reflux of gastric or intestinal contents up the tube
To Unclog a Tube
1. Make sure that the feeding tube is not kinked or clamped off.
2. If the clog is visible above the skin surface, gently massage or milk the tube between fingers
to break up the clog.
3. Connect a 30 to 60 ml ENFit® syringe filled with warm water into the Jejunal access port of the
tube and gently pull back on then depress the plunger to dislodge the clog. Do not use smaller
size syringes as this can increase pressure on the tube and potentially rupture smaller tubes.
4. If the clog remains, repeat step #3. Gentle suction alternating with syringe pressure will
relieve most obstructions.
5. If this fails, consult with the physician. Do not use cranberry juice, cola drinks, meat tenderizer
or chymotrypsin, as they can actually cause clogs or create adverse reactions in some patients.
If the clog is stubborn and cannot be removed, the tube will have to be replaced.
Caution: Do not insert foreign objects through the tube.
MRI Safety Information
The MIC* Jejunal Feeding Tube is MR Safe.
Warning: For enteral nutrition and/or enteral medication only.
For more information, please call 1-844-4AVANOS (1-844-428-2667) in the United States, or visit
our web site at www.avanos.com.
Educational Booklets: "A Guide to Proper Care" and "A Stoma Site and Enteral Feeding Tube
Troubleshooting Guide" are available upon request. Please contact your local representative or
contact Customer Care.
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