Gastrostomy tube (GTUBE) obstruction


  • Scene – history from Mom, assessment
  • En route – vitals, TT


  • Transport to local hospital fa


  • Mark Shelton Paramedic Woodburn Ambulance


  • David M. Spiro, MD, MPH Professor of Pediatrics University of Arkansas Medical Center

• G-tube obstruction

Differential Diagnosis

• Equipment failure

• Cerebral palsy

• Epilepsy

• Scoliosis

• Cohen syndrome

• Osteoporosis

• Kidney failure

• Developmental delay

Patient Workup History

• Caregiver states – that the G-J tube started leaking while they were giving pt his meds and it needs to be replaced promptly so that meds and nutrition can be given to the pt.

• Pt was acting normal per mom.

• Oxygen typically fluctuates, per mom; today is a bit lower than usual.

Physical Exam

• Found a clamp on tube to stop leaking

• B/P – did not check because it does not feel good to the pt

• GCS – 4-1-5 this is normal for pt

• CBG – N/A

• EKG – N/A

Editor’s Notes

The paramedics asked about the patient’s baseline vitals while obtaining the history. With children with special healthcare needs, it is essential to engage the parent for a detailed and accurate history. Key points are to evaluate for dehydration and any alteration of vital signs.

-Dr. David Spiro

Suggested References

Prehospital Assessment of Patients with Physical Disabilities

Cerebral palsy


• Gender: Male

• Age: 17 years

• Height: Not Available

• Weight: Not Available


• Temperature: 98.8 F/37.1 C

• Blood Pressure: Not Available

• Heart Rate: 107

• Respiratory Rate: 16

• Pulse Oximetry: 94% RA

Signs and Symptoms

Caregiver not able to give meds or feedings

History Medical

• PMH: Epilepsy, scoliosis, cerebral palsy, Cohen syndrome, kidney failure, osteoporosis; unable to walk or talk; developmental age of 2-3. • Allergies: Many, but mom did not have the list.

• Dispatch info: G-J tube not operational.


• Patient lives at home where mom and a caregiver take care of him; has a bed in the living room; home is very well kept. Medications • Kepra, Klonipin, magnesium, citra 3, potassium, Lamictal, iron, Carafate

Related videos