Emergency situations are rare, however, you should be aware of what to do if you cannot feed normally. This information gives guidance for certain situation; you should contact the Home Enteral Nutrition (HEN) Service or seek medical advice if a situation occurs that prevents you from feeding.

If you have diabetes you should seek medical advice if you are unable to have your feed as this may affect your blood sugars.

If your tube falls out

Please see our information about what do to if your gastrostomy feeding tube comes out.

Power failure

It is recommended that whenever possible, your pump is plugged into the mains electricity. This will make sure that if there is a power failure there is optimum battery power left. The battery life of enteral feeding pumps when fully charged is:

• Nutricia Flocare Infinity pump: 24 hours
• Abbott Freego pump: 24 hours

In the event of a power failure, you should continue with your feeding regimen as advised by the dietitian until your pump runs out of battery. Try to make sure that the back light on the pump is off to help preserve power. When your pump no longer has any battery life or is flat, you should follow the advice below depending on the type of feeding tube you have.

If you are tube feeding into your stomach:

• When you are no longer able to use your pump you may need to commence bolus syringe feeding instead to make sure you get the feed and fluids you require.
• If you know the power failure is only affecting your place of care and those in close proximity, and it is within normal working hours, please call the HEN Service for an individualised interim plan.
• Some people will not be able to tolerate their full feed volume given as boluses as it may cause symptoms, such as bloating, nausea, regurgitation, diarrhoea or vomiting. It is recommended that you have as much feed as you can tolerate and replace the remaining volume with water. If possible, call the HEN Service for an individualised plan.
• If possible, go to a suitable place with a power supply.
• If you cannot go somewhere where there is a power supply, and you are unable to tolerate bolus feeding, we recommend you go to hospital.

If you are tube feeding into your jejunum:

• It is not advisable to give large bolus feeds via a jejunal feeding tube. Due to the bowel being very narrow, it is often unable to tolerate large rapid volumes given in a bolus. This may lead to diarrhoea and feeling unwell. You may be able to tolerate small regular boluses of feed and/or water that may keep you hydrated for a short while. If you are able to, contact the HEN Service for advice on bolus volumes.
• If you are unable to tolerate small boluses of feed and water in adequate amounts to prevent dehydration, we recommend you go to hospital.

Water failure

If there is a failure in the water supply, we recommend using bottled water which has been boiled and cooled.

If water has to be used that is not from a mains source, for example from a household water tank, it should be boiled and cooled.

How to prepare cooled boiled water:

• Empty kettle and fill using drinking water available.
• Bring to the boil and allow to cool for 30 minutes.
• Pour into a clean suitable container, such as plastic jugs and bottles with lids.
• Store in the fridge at eight degrees celsius or below. Store on the top shelf away from raw food.
• Discard any unused water 24 hours after boiling.
• If you are unable to put the water in the fridge due to a power cut, the water must not be kept for longer than four hours.

If it is not possible to boil the water due to a power failure, use bottled water.

If water is not available and you cannot go to another area where water is available, other fluids such as UHT milk, fruit juice or soda water can be administered to keep you hydrated.

If you do move to another area for the short-term, please inform the HEN Service to make sure you have all the stock and equipment you need to feed safely.

If you cannot move to obtain a safe and secure water supply, it is important to seek advice. Your GP or HEN Service may be able to advise you.

Poor weather conditions

Extreme weather may lead to deliveries of feed and equipment being delayed or cancelled. If you are running out of equipment for feeding, please contact your feed company directly who will be able to help you.

If, in extreme circumstances, you have used your stock and there are delays expected in deliveries, your GP or the HEN Service may be able to arrange a prescription for feed to be dispensed from a local pharmacy or be able to suggest an alternative. Please contact your GP or HEN Service as soon as possible to discuss this further.

If you are unable to obtain your feed, you should replace it with UHT milk – except if you have a milk/lactose intolerance – where possible to provide nutrition and maintain hydration. These are not long-term solutions so please contact the HEN Service as soon as possible to discuss what next steps to take.

Feed stock

We recommend you have a seven day stock/supply of feed available at all times. When you have 10 days of feed left, contact your home enteral feed company to arrange a delivery of a months supply of feed.

Holiday periods

Your enteral feed company will contact you leading up to holiday periods, such as Easter and Christmas, to undertake early or additional stock checks and to make sure you have enough feed and equipment.

Please make sure you participate in planning for holidays so you have enough feed and equipment.

The enteral feed companies and HEN Service do not work on bank holidays, however, the out-of-hours services for the enteral feed nurses are available via phone.