Who should perform the first replacement of gastrostomy and PEG tubes? What about subsequent replacements?

Who should perform the first replacement of gastrostomy and PEG tubes? What about subsequent replacements?

• A. The first replacement should be performed by the physician who inserted the tube; after that, trained nurses may replace
• B. The first replacement by nurse; later by physician
• C. The first by physician assistant; later by family
• D. The first by pharmacist; later by nurse

Answer: (A)

The key idea here is safety and procedural experience. The first replacement of a gastrostomy/PEG tube is performed by the clinician who placed the tube because they are responsible for creating the tract, confirming correct tube type and size, and ensuring proper placement to avoid injury or tract disruption. After the tract has formed and with appropriate training and a clear protocol, trained nurses can perform routine subsequent replacements, which helps maintain nutrition support without needing a physician for every exchange. If any signs of trouble appear—difficult to advance, leakage, bleeding, tube dislodgement, or occlusion—physician involvement is needed.

The key idea here is safety and procedural experience. The first replacement of a gastrostomy/PEG tube is performed by the clinician who placed the tube because they are responsible for creating the tract, confirming correct tube type and size, and ensuring proper placement to avoid injury or tract disruption. After the tract has formed and with appropriate training and a clear protocol, trained nurses can perform routine subsequent replacements, which helps maintain nutrition support without needing a physician for every exchange. If any signs of trouble appear—difficult to advance, leakage, bleeding, tube dislodgement, or occlusion—physician involvement is needed.