Enteral feeding tubes and home enteral nutrition — structured clinical encounter

Station brief (candidate)

You are the paediatric registrar in a general paediatric clinic. A four-year-old with severe cerebral palsy is referred because of an unsafe swallow on a videofluoroscopic study and faltering growth despite maximised oral feeding and fortification. Her weight has fallen from the twenty-fifth to below the third centile. The multidisciplinary team agrees that long-term enteral feeding is needed. The team asks you to choose the device and justify it, to outline the pre-gastrostomy assessment, to explain the device options and the likely conversion, to build the home enteral nutrition programme, and to describe how you would recognise the common and serious complications. You have twelve minutes with the team and five minutes for examiner discussion. [8]