Congress Abstracts 2005

44

AN INNOVATIVE AND CREATIVE SOLUTION FOR GASTRIC OUTLET OBSTRUCTION—EXTRACORPOREAL GASTRIC ASSIST DEVICE (EGAD): IMPLICATIONS FOR NURSING. Teresita Lopez, RN, Natasha Ramrup, RN, MSN, Mary Eagan, RN, MSN, OCN^®, Moshe Shike, MD, and Saul Midownik, MEE, CEE, Memorial Sloan-Kettering Cancer Center, New York, NY.

Cancer patients with involvement of the GI tract face many challenges. One such challenge is the complex and debilitating condition known as Gastric Outlet Obstruction (GOO). GOO may result from both benign and malignant diseases. Some of the problems experienced by GOO patients are nausea, vomiting, early satiety, epigastric fullness, abdominal pain, dehydration, electrolyte imbalance and eating deprivation. The use of an EGAD may be an effective solution in maintaining adequate hydration, electrolyte balance, overall nutrition, and restore the ability to eat and drink. Nurses knowledge of EGAD, its effectiveness and complications is essential to manage, educate, and care for the patient population.

This presentation will (1) provide an overview of EGAD (2) describes the inpatient nurse’s role in educating patients about EGAD and its complication (3) describe an effective/caregiver educational plan for EGAD management and (4) highlight the impact on quality of life.

At our NCI designated comprehensive cancer center, the EGAD was created for patients who have inoperable GOO. The device allows digestive fluids, enzymes and electrolytes to be processed by the gastric intestinal tract. The EGAD includes a 28 fr. gastrostomy tube, and 28fr. jejunostomy tube joined by a small pneumatic pump which pumps gastric contents across the obstructed outlet and into the jejunum. The goals of nursing care post placement of the EGAD are astute patient assessment, educating the patient on the system operation and early detection of potential complications.

Some of the advantages of the EGAD include elimination of dependence on intravenous fluid hydration, improvement of electrolyte imbalance, and decrease expense. This device allows the patient to eat, drink and reduce the need for enteral feeding. The EGAD also improves the overall nutritional status of the patient.

Oncology nurses are in a pivotal position to provide support, reassurance and feedback regarding the device to prevent complications at home. An understanding of this debilitating condition can lead to improved patient treatment, outcome, education and overall quality of life. A multidisciplinary team is of utmost importance in managing this patient and prolonging survival.