Corflo Nasogastric/nasointestinal feeding tube with stylet and ANTI-IV connector should be used with the halyard CORTRAK 2 enteral access system (EAS) and CORTRAK 2 nasogastric/nasointestinal (NG/NI) feeding tubes, allowing clinicians to place NG/NI tubes at the bedside without the need for X-ray confirmation.

Features

• With stylet
• Non-Weighted
• Without ENFit Connector
• With ANTI-IV Connector

Indications for Use

The Avanos Corflo Feeding Tube is designed for patients who require intermittent or continuous tube feedings through the nasogastric or nasoenteric route.

Device Lifetime

The device has been validated for use up to 30 days.

Tube Insertion

This feeding tube is to be inserted by trained and competent individuals or clinicians, in accordance with institution/facility/hospital protocols.

• Explain the procedure to the patient if applicable.
• Position the patient in sitting or Fowler’s position as tolerated. Warning: The patient should not lean forward, nor should the head and neck be extended. Caution: Do not use a stylet if the tube is not packaged with one, as the stylet may exit the distal tip.
• Remove the tube from the package and close the access ports.
• Measure the length of the tube to be inserted to ensure that the tip/bolus enters the gastric region. Place the exit port of the tube at the tip of the nose. Extend the tube to the earlobe, then to the xiphoid process. Use the printed centimeter marks on the tube to aid intubation and check for tube migration—warning: Pre-measurement of tubing length is essential. Do not insert excess. Occlusion may result from the kinking of the tube.
• Determine preferred nostril for insertion. Provide a cooperative patient with a glass of water and a straw.
• Before insertion, activate the lubricant on the tip by dipping it in water.
• Direct tube posteriorly, aiming the tip parallel to the nasal septum and the superior surface of the hard palate. Advance the tube to the nasopharynx, allowing the tip to seek its own passage. As the patient swallows sips of water, advance the tube through the esophagus into the stomach with a gentle motion.
• Utilize printed centimeter marks on the tubes to aid insertion. Warning: Coughing may indicate passage of tube into trachea. If tracheal passage is suspected, remove the tube. Absence of coughing does not confirm tube placement in the stomach. If resistance is encountered, immediately remove the tube. Notify clinician. Care should be taken if any type of endotracheal device is in place, as it may guide the feeding tube into the trachea. Misplacement of the feeding tube into the trachea or lungs may result in serious injury.
• Confirm tube position and integrity per institution/facility/hospital protocol (e.g., pH measurement, X-ray, etc.). Warning: Tube position in the stomach must be confirmed before flushing and use.
• For tubes packaged with a stylet: After the tube position in the stomach is confirmed, remove the stylet by flushing the tube through the side port with up to 10 ml of water to activate the internal lubricant immediately before stylet removal. Warning: Never reinsert the stylet when the tube is in the patient.
• Secure tube per institution protocol.

Tube Maintenance

• Follow your institution/facility/hospital protocol or clinician’s order.
• It is recommended that the tube be irrigated every 4 hours with up to 20 ml of water (up to 10 ml for infants or children) before and after medication administration or when feeding formula is interrupted. Warning: Vigorous syringe force should not be used to irrigate, administer liquids, or unblock the tube.
• The feeding tube should be monitored, regularly assessed, and replaced when clinically indicated based on functionality and patient condition.

To Unclog a Tube

• Do not use excessive force to flush the tube. Excessive force can perforate the tube and cause injury to the gastrointestinal tract or risk of aspiration.
• If the tube becomes clogged, it is best to first attempt clearance immediately by using aspiration with a sterile syringe. Use a 30 to 60 ml syringe. Do not use smaller size syringes as this can increase pressure inside the tube and potentially rupture the tube.
• If aspiration fails, you may attempt gentle flushing. Use a 30 to 60 ml syringe with sterile fluid. Do not use air, as it is compressible.
• If gentle flushing is not sufficient to clear the clog, consider the use of an enzymatic-based declogging solution (e.g., CLOGZAPPER).
• If the tube cannot be unclogged easily (without force), replace the tube with a new one.

Note: When administering crushed medicine, be sure to crush it finely and dilute it as appropriate (until there are no visible particles) to ensure the solution is of a low enough viscosity to avoid clogging.

Ability to Connect to Non-Enteral Medical Devices

The ENFit connectors were designed to prevent misconnections between enteral devices and other devices used in various medical applications. However, the design of the ENFit® connector cannot overcome all chances of misconnection. The following connector types are potential misconnections for the ENFit connector (feeding/medication access port) of this enteral feeding tube:

• Suction Ports on Endotracheal Suction Systems
• Respiratory circuit filtration connectors
• Oxygen Inlet Connectors for Resuscitation Devices
• Baxter IV Solution Bag ports (such as NaCl, Ringer's Solution, etc.)
• Sample ports on drainage bags
• Peritoneal Dialysis Connectors
• Cones & sockets of ISO 5356-1:2004 & ISO 5356-2:2004
• Temperature sensor connectors & mating ports of ISO 8185:2007
• Oxygen nipples as defined in EN 13544-2:2002

Corflo NG/NI feeding tubes have satisfied biocompatibility testing as a device for long-term use per ISO 10993-1.

Note: Placement and use of any feeding tube may result in patient discomfort.

Complications

Infrequently occurring factors as a result of use or misuse of any feeding tube may include:

• Pneumothorax, GI perforation, Aspiration, Airway obstruction, Tissue irritation or necrosis, Allergic reaction, Contamination, Delay in diagnosis, Delay or misdose of medication or nutrition, and related complications or the need for additional medical procedures.

MRI Safety Information

Non-clinical testing demonstrated that the weighted CORFLO Enteral Feeding Tubes are MR Conditional. A patient with this device can be scanned safely immediately after placement under the following conditions:

• Static magnetic field of 3-Tesla or less
• Spatial gradient magnetic field of 720-Gauss/cm or less
• The MR system reported a whole body averaged SAR of 3.0-W/kg (i.e., associated with a calorimetry measured value of 2.8- W/kg)

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Warnings

• The patient should not lean forward, nor should the head and neck be extended.
• Pre-measurement of tubing length is essential. Do not insert excess. Occlusion may result from kinking of the tube.
• Coughing may indicate passage of the tube into the trachea. If tracheal passage is suspected, remove the tube. Absence of coughing does not confirm tube placement in the stomach. If resistance is encountered, immediately remove the tube. Notify clinician. Care should be taken if any type of endotracheal device is in place, as it may guide the feeding tube into the trachea. Misplacement of the feeding tube into the trachea or lungs may result in serious injury.
• Tube position in the stomach must be confirmed before flushing and use.
• Never reinsert the stylet when the tube is in the patient.
• Vigorous syringe force should not be used to irrigate, administer liquids, or unblock the tube.