Using the right connector for tube feeding and administration of medication had been a challenge for many years. One could not always fault the harried nurses and caregivers as they were often bogged down by the sheer workload. The introduction of ENFit has come as a boon that cut short the work of medical facilities and other areas dealing with patient care to a great degree.

It has reduced the possibility of misconnection to a high degree with the FDA giving the nod to manufacturers and users to go ahead with the design. ENFit happens to be a brand name that has ushered in a global chance for all kinds of enteral feeding products. A long time user of such products can find the difference in feeding tubes, syringes, and extension sets designed to eliminate the possibility of misconnections. The use of ENFit connectors has been mandated by the law across California at present with manufacturers and facilities in other states expected to migrate to this new and almost foolproof system.

The incidents of misconnections had been prevalent in the neonatal unit, especially the NICU, where almost every newborn baby had to be fitted with many tubes. It was easy to become confused between the feeding tube and IV connection, with the attendant often misconnecting the ends. This seriously jeopardized the health of the frail baby with many succumbing because of a single mistake.

The kinds of tubes and connectors used by different facilities varied greatly too. This prompted GEDSA (Global Enteral Device Supplier Association) to come into existence with the sole intention of developing the usable and safe design of enteral connectors that would benefit the patients and minimize liability for the facilities.

Changing to the new system is not easy, though with many manufacturers failing to meet the deadline. GEDSA has addressed the issue with a temporary adapter being added to the feeding sets until transitioning to the approved ENFit products. It is advisable to ensure use if ENFit product ASAP, however. This can also reduce choking in babies, in addition to misconnection.

Extensions / Tubing – GEDSA formulated adaptors come with a cap to secure the bag but have no valves to prevent leakage. It is essential to make the transition within the specified period to decrease mishaps in the NICU and other sections of the facility.

Feeding – All connectors recommended by GEDSA are available in identical diameters as the existing connectors. This enables the infants to feed on fortified breast milk and thicker blends made out of different formulas, including homemade ones.

Syringes - The ENFit design is available in a wholly new line of needles available in a variety of sizes. Facilities in the process of transition may continue to use the oral, catheter, Luer tips. The ENFit syringes meant for non-enteral use will remain specific to their purpose.

Feeding a new born child in the NICU poses an extraordinary challenge. The specialists and care givers at the NICU do their best to provide adequate nutrition to the neonate, no doubt but the best efforts may go waste for a variety of reasons. Utilizing a specialized equipment known as neonatal enteral feeding pump is recommended by the authorities with the, “The Joint Commission, Academy of Nutrition and Dietetics,”  and the, “American Society for Parenteral and Enteral Nutrition (ASPEN).”

The results have been outstanding with almost all hospitals and medical facilities making the switch. Simply using a pump does not make the feeding process accurate though. One would also have to be concerned about safety norms and ensure that there is no fatal mix up during feeding.

Tips to Enforce accuracy of Pump Feeding

The feeding pumps deliver preset volumes of nutrition to a helpless and frail neonate who is in dire need of nutrition. The accuracy of the feed gets hampered when the pumps do not deliver the exact quantity of nutrition or its rate becomes too fast or slow. Even a tiny difference can significantly alter the baby’s health as almost all under nourished new borns need to be fed the right amount of food in order to ensure the right nutrition. The care providers need to take note of the following points in order to provide the right nutrition to the patient.

· It is most important to set the amount of volume delivery to 0 in order to gauge the exact amount post the feed. This method makes one doubly sure of the accuracy.

· Comparing the times between the beginning of the feed to the completion of the infusion. This enables one to understand whether the actual time taken is the same as the programmed period.

· It is advisable to opt for a volume based system of ordering instead of a rate based one.

· It is best to note the recommendations provided by the manufacturer and follow the instructions to a T

· Regular testing needs to be done as well

· The accuracy of the pump might be affected with age, kind of service, condition as well as the wear & tear

How to purchase an Enteral Pump

· There are a number of features that one must consider before finalizing the decision of going for a particular enteral pump for neonatal use. The best way to make a quality buy would be to check the following:-

· The ease of setting the volume to 0 before each feeding cycle begins.

· The capacity of being able to track the volume of nutrition provided for a specific duration i.e. 12 or 24 hours.

· Presence of alarms for detecting interruption and period of inactivity

· Display of the delivered volume, time and rate of infusion

Not many individuals can go through life without the assistance of a medical professional. Unfortunately, the trauma happens to get magnified when the patient is a helpless infant who remain in the NICU. While there are a number of equipment and procedures adopted to make the underweight and re term infant capable of dealing with life, the neonate may also need the able services of a nephrologist for attending to the urinary problems that besiege the child. A catheterization tray is almost always employed during the process of catheterization though wherein a small and pliant soft tube is introduced into the bladder. The tube can be removed after minutes or retained there permanently in accordance with the complaint.

The kit usually contains all items required for insertion of the catheter including an option for selecting the tube. A tray along with examination gloves, an underpad, fenestrated drapes, a selection of syringes, swabs and a drainage bag is found within the kit that proves to be of extreme importance while trying to insert a catheter into the bladder a young child.

Many individuals especially the parents fail to understand why such a young child must be subjected to an invasive procedure. However, the medical professionals have no other options when the new born child does not produce urine or has an abysmally low amount of urine production. This is likely to happen when the baby:-

· Is diagnosed with low blood pressure

· Does not have a properly developed urinary system

· Is on medication that paralyzes certain muscles temporarily

The urine output is usually measured by the care givers once the catheter is in place. This enables the professionals to assess the amount of fluid required by the neonate. However, catheterization can also be done for diagnosing infections and ailments affecting the kidney or bladder. The catheter used for diagnosis is not retained inside though. It is removed immediately with the contents being tested for pathogens.

The entire process needs to be done by a trained nurse or a care giver with years of experience in insertion of all types of catheters including umbilical vein catheters which are usually employed for new born babies. Precision and ensuring that the device is inserted securely without hurting the tiny and frail individual is of paramount importance though! The best way to make sure that the baby suffers no ill effects would be to use a quality tray including a multiple procedure one. The special trays labeled for neonatal use are most preferred during the procedure as it is sure to contain intensely tiny micro forceps that can hold and dilate the umbilical vein most carefully.

Every individual tends to develop a number of medical conditions at some point or other in their lives. Finding the right doctor and being treated for the ailment is the standardized way of becoming fit presently. Unfortunately, the neonates or newborn babies may be too weak and unable to perform many of the bodily function necessitating an external aid for various purposes.

A tiny and frail baby who is unable to produce the required urine output is certain to need assistance. While a premature baby needs to be kept within an ‘intensive care unit,’ when it is unable to cope on its own, infants that attain the required weight with healthy vital signs usually get discharged and are taken home by their parents. However, the babies are sure to need a catheterization tray containing a number of equipment including a catheter, a collection bag along with a set of gloves, and several antiseptic baby wipes for the insertion of the urinary aid.

New born kids may need catheterization when they have an abnormally low weight at birth or have been born without the urinary system fully developed. The neonates placed on a ventilator may also have trouble with urination on account of taking multiple medicines that curb the normal movement of muscles. It is seldom the task of the parent though. Children who are severely ill need to be supervised 24X7 by a professional medical care giver who also insert the catheter into the tiny bladder perfectly! The need for an experienced care giver happens to be all important here as a novice nurse can end up injuring the kid’s bladder or urethra inadvertently by trying to insert the catheter incorrectly by force.

That is certainly not the only problem that a new mother has to face though. Even a healthy baby often has trouble suckling and feeding from the breast of the mother due to a number of reasons. While putting the infant on bottle had been the norm just a few years ago, it is advisable to utilize a ‘lactation aid’ at present. Using a supplemental system of feeding has proved to be most effective as it allows the mother to touch her child thence bonding with the baby as desired. The formula feeding bottle may be able to provide the right amount of milk but it discourages personal contact that is deemed to be unfavorable for proper development of the baby.

Advantages Of Using a Milk Tube

· The infant learns how to breast feed albeit by means of a breast milk tube but in close contact with the mother.

· The slow moving milk encourages the baby to closely bond with the parent instead of developing a fondness of the feeding bottle where the flow of milk is much faster.

· The amount of milk is sufficient for nutrition of the baby with the mother not being worried about imperfect latching thereby failing to get adequately fed.

Fast progress in the field of medical science has helped people to get modern devices and equipments that suit different medical needs.Catheterization tray is helpful for reducing risk factors that are common with catheterization of blood vessels. These trays become more effective when they are coupled with Silicone Umbilical Catheters. These catheters are available in single lumen and double lumen designs. These products are helpful in taking care of the neonatal patients. They help to get the best possible clinical result at an affordable cost. These products come with some specific features that make them unique and safe for medical use. Some of these features are mentioned below: They are made with silicone that medical science accepts as a safe material for medical kits. The material minimizes the risk of 'miss-tracking' during inserting them into blood vessels.   They come with a 3-way stopcock that makes the kits safer for use.     Usage of single lumen catheter and catheterization tray is very technical. Every user must be aware of various precautions and maintenance guidelines while using them. Some of these tips are mentioned below: Precautions:

Users must read the warnings and usage guidelines, instruction, and precautions carefully before using. Otherwise, they may face terrible consequences that may even lead to death.

Only consider using seal pack products. Do not buy a kit, if it is available damaged or previously opened.  

These products, especially single lumen catheter, are fragile. Users must take extra care to protect them as long as possible.

Avoid using them with clamps, sharp instruments, or forceps as they can damage them.  

Users, especially the clinicians, must not detach the hub from the umbilical catheter.

These kits should not be used above a pressure of 40 pound per square inch (psi).

The catheter placement should be verified radiographically for accurate measurements. 

These kits must be preceded by an established institute protocol.

It should be used only by trained people who know how they work. They also have a good knowledge of the risks patients can face.

Special precautions must be taken to minimize exposure to blood-borne pathogens. 

Maintenance: 

The users must check the correct position of the umbilical catheter before using it.

Patients must be kept under strict observation to notice and record the circulatory compromise that they show while using these kits.

In case, the catheter is used intermittently, then the users need to flush the lumen before and after every use. Flushing can be done with saline.

While locking the catheter lumen with heparin solution, the user must use positive pressure technique for assured safety.

To avoid any security threats with these catheters when not in use, they must be closed with stopcock. This can prevent it getting exposed to the conditions outside.It will be safe for further use.