#enfit

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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.

It is the objective of, “Global Enteral Device Supplier Association” popularly known as GEDSA to minimize the instances of patient mortality due to misconnections of tubes, syringes and connectors. The ENFit system was found to be the most effective. However, doing away with the old and routinely used medical equipment including connectors could not be done overnight. The connectors, syringes and other ENFit devices were developed in compliance with ISO 80369 with medical facilities, manufacturers and home users made aware about the efficacy of using the products.

The enteral appliances or feeding tubes promoted by GEDSA have been hailed by the medical fraternity and manufacturers alike. The transition from the conventional connectors to specialized ones that prohibit any kind of misconnection has been taking place slowly but surely. Tube feeding via ENFit is expected to be the new normal very shortly.

One would have to educated about the design as well as its utility and learn how the risks of misconnection can be avoided totally. However, it suffices to know that the ENFit connectors will help to do away with the Legacy connectors for good and ensure that no patient is inconvenienced due to faulty connection.

The situation had indeed been grave just a few years ago when ‘tubing misconnections’ had resulted in death of patients as well. This was found to be common both within the hospital as well as home settings. The Legacy connectors that had been widely used before happed to multifunctional and could  easily fit into feeding tubes, catheters, IV lines, tracheostomy tubes as well as other types of non enteral tubing. Sure, the paramedics and nurses employed by quality medical facilities are highly trained with enough experience but cannot overlook human error. This resulted in mix up of tubings and a neonate could be fed with urine or nutritive products would enter the blood stream with disastrous results.

The ENFit connector, on the other hand, consists of a female to male connection that will only be compatible with tubes meant for feeding. There has also been a transitional connector in the interim that was sourced by the users while the ENFit connectors were being manufactured and not available.

It is also important to know that switching to ENFit connectors will require female ENFit syringes for fitting into medication ports and enteral tubes. While it is common to feed the preterm babies enterally, the adults may also have to be fed in the same way especially when they are unable to chew and swallow. Changing to an ENFit connector and syringe will not hamper the speed of flow especially when blended is passed through it.

Specialist doctors attending to infants in the NICU need to be extra cautious about using ENFit connections, however. They have to take care to see that there is no major displacement while administering food or medication via the enteral route when the connections have been reversed from female to the male end.