Medication administration procedure

Paediatric guidelines (in development)
NHS Lothian

NB. The G-tube does not have a clamp so overlook the parts about unclamping or clamping the tube.

Items required for the procedure

  • Syringes with medication drawn up as prescribed
  • 60ml enteral syringe
  • Cooled boiled water for flushing
  1. Not all medications can be given down the gastrostomy tube. It is important to check with your doctor or pharmacist if your child/young person’s medications are suitable to be given this way. All medicines should be in liquid or dispersible form. If your medication doesn’t come in this form, you must check with your pharmacist for an alternative.
  2. Medication should never be mixed, as they may react with one another.
  3. The tube must be flushed before and after each drug with the recommended amount of cooled boiled water, as detailed by the dietitian.

The Procedure

  1. Ensure everything you need has been collected and is near to hand.
  2. Inform the child/young person that you are going to give them some medication.
  3. Position the child/young person in a sitting position. If this is not possible their head should be elevated by at least one pillow. For babies, place the pillow underneath the top of the mattress.
  4. Wash and dry hands thoroughly.
  5. Open feeding port cover and attach 60ml enteral syringe to it, ensure clamp is closed.
  6. Unclamp the gastrostomy tube and slowly pushing the plunger of the syringe to insert the water; only administer the recommended amount of cooled boiled water.
  7. Once the flush is complete close the clamp.
  8. Disconnect the 60ml enteral syringe containing the cooled boiled water.
  9. Connect the syringe containing the prescribed medication.
  10. Unclamp the gastrostomy tube; administer medication by slowly pushing the syringe plunger down until all medication is administered.
  11. Close the clamp, disconnect the empty medication syringe.
  12. Connect the 60ml enteral syringe containing the cooled boiled water to the feeding port.
  13. Unclamp the gastrostomy tube and flush the recommended amount of cooled boiled water into the tube.
  14. Once the flush is complete close the clamp.
  15. Disconnect the 60ml enteral syringe containing the cooled boiled water.
  16. Repeat steps 7 to 16 for each medication.
  17. Once complete, close clamp and replace feeding port cover.
  18. Wash and store reusable syringes as per manufacturer’s instructions.
  19. Wash and dry hands thoroughly.