Endoscope/Gastroscope
Skin preparation: Alcohol swabs/povidone iodine swabs
No. 11 blade
Lidocaine for local sedation
Sterile gown and gloves
PEG tube kit including 14-to18 gauge needle, a guide wire, sheath, feeding tube, skin disc
Dressing: 2 x 2 or 4 x 4 gauze, adhesive tape
Personnel
PEG tube placement is performed with 2 operators, usually an experienced endoscopist and surgeon, at the bedside, operating room, or endoscopy suite. An anesthetist and endoscopy nurse are also required to provide sedation and aid with endoscopy equipment and oral suction as needed.
Preparation
Prior to PEG placement, it is important to visualize the patient's abdomen, past medical and surgical history, and any relevant imaging to optimize the location of the tract for feeding tube insertion. The patient is positioned supine with the head of the bed raised to 30 degrees to prevent aspiration. A bite block is usually used to allow for more open access to the scope, and suction is also made available for secretions and prevent the risk of aspiration. If the patient is not comatose, the patient usually undergoes mild sedation with only 1 to 2 mg of benzodiazepine and a small dose of narcotic to relax the patient. The patient also receives location anesthetic, generally lidocaine, at the tube insertion site. The site is then made sterile with alcohol, povidone-iodine swabs, or sterile soaps and the field is prepped with sterile drapes
