NJ Study Session: Guided tube placement in action

Hosted by BDA Critical Care Specialist Group

The BDA CCSG ‘NJ team’ are organising an exciting virtual study session, aimed at dietitians and other healthcare professionals interested in guided post-pyloric tube placements.

Speakers

  • Dr Shameer Mehta, Consultant Gastroenterologist & Nutrition Lead, The Royal London Hospital,Honorary Associate Professor, University College London, Consultant Gastroenterologist & Nutrition Lead, Cleveland Clinic London  – Gastrointestinal anatomy and anatomical considerations during NJ placement *

Shameer Mehta is a Consultant Gastroenterologist and Nutrition Lead at both The Royal London Hospital (Barts Health NHS Trust) and Cleveland Clinic London where he leads large multidisciplinary Nutrition teams. He was a consultant in Intestinal Failure at University College London Hospital for six years before moving across London in 2021. He is an active researcher and educator and remains Honorary Associate Professor at University College London.

Summary of what Dr Mehta will cover: This talk will cover normal and abnormal upper gastrointestinal anatomy, patient selection for nasojejunal tube placement, techniques for endoscopic placement and troubleshooting common tube problems,

  • Dr Lee-anne Chapple, Senior Critical Care Dietitian and Research Fellow, Royal Adelaide Hospital and University of Adelaide – Delayed gastric emptying: causes, consequences, measurement techniques and management strategies.

Dr Lee-anne Chapple is the Senior Critical Care Dietitian at the Royal Adelaide Hospital, and a research fellow at the University of Adelaide in Adelaide, Australia. She leads the intensive care nutrition research program at the Royal Adelaide Hospital conducting research focusing on nutrition physiology during critical illness and early recovery. In particular, Dr Chapple has an interest in improving nutrient digestion, absorption and utilisation to prevent muscle wasting and improve recovery for critically ill patients.

Summary of what Lee-anne will cover: This presentation will introduce attendees to the causes of delayed gastric emptying (GE), techniques to identify and measure GE both clinically and from a research perspective, and address the consequences associated with delayed GE and strategies that may help alleviate delayed GE.

  • Dr Stephen Taylor, Research Dietitian, Southmead Hospital, North Bristol NHS Trust – Bedside nasojejunal tube placement: Techniques to increase success **

Qualified '85 (circa Cretaceous period), 5y in Bolton re-learning how to pronounce the last vowel correctly (a la 'Northerner') and getting interested in ICU/ nutrition support. Realised I needed some projects to 'keep me off the streets'. Bristol '91, Frenchay Hospital doing ICU, PhD on early feeding in TBI patients (RCT) and burns '99, endoscopic NJ placement '03, Energy & Nitrogen req books in '07' & '12. NJ versus prokinetics RCT 2016 and attaining adequate protein without overfeeding 2016-18 (Southmead Hospital), advantages of bridle securement 2018-19, safe vs unsafe ways of interpreting Cortrak traces 2017-2020, development of an IRIS tube operator guide 2020-present and more on the safety of guided tube placement. I admit I still get excited when getting over the superior duodenal flexure.......... and spreadsheets !!!

Summary of what Stephen will cover: He will cover the rationale for NJ and expertise including techniques: Analysis; Techniques by anatomy and Training

  • Terpsi Karpasiti, Clinical Lead Critical Care Dietitian, Royal Brompton & Harefield Hospitals, part of Guy’s and St Thomas’ NHS Foundation Trust BDA CCSG ‘Novel tech’ assessments and recommendations

Terpsi currently works as the Clinical Lead Critical Care Dietitian at Royal Brompton & Harefield Hospitals. She previously worked as a dietitian in four further UK intensive care units, after moving to the UK from the warm island of Cyprus. Terpsi specialises in cardiorespiratory critical care and extracorporeal membrane oxygenation (ECMO); she has worked in two world-renowned specialist cardiorespiratory ICUs, and currently as part of one of the country's largest ECMO retrieval centres. She completed her MSc in Critical Care at Barts and the London School of Medicine, QMUL in 2020.  

Terpsi's main clinical and research interests involve the nutritional, metabolic and gastrointestinal complication management of complex critically ill patients requiring ECMO and other forms of advanced mechanical cardiorespiratory support. Terpsi has an extended role within the critical care team, to include nasogastric and bedside post-pyloric tube placements and co-chair the BDA Critical Care Specialist Group (CCSG) NJ team. Currently, she is also joint research officer for the BDA CCSG.

Summary of what Terpsi will cover: This presentation will provide attendees with an overview of the newly published CCSG NJ team novel tech assessments, to include a review of currently available guided tube placement methods (Cortrak/IRIS) as well as training recommendations for new operators.

  • Mary Phillips, ACP Dietitian (HPB Surgery), Royal Surrey County Hospital, Royal Surrey NHS Foundation Trust – Guided tube placement methods & examples using video-guidance devices

Mary is an experienced HPB Dietitian, who graduated from the University of Surrey in 2000. She has been placing NJ tubes for the last 7 years. She is currently undertaking her PhD exploring the long-term effects of pancreatic surgery. 

Summary of what Mary will cover: A review of the practical technique used to interpret IRIS images and the benefits and limitations of its use in different clinical settings. 

  • Dani Milne, Intensive Care Dietitian, Southmead Hospital, North Bristol NHS Trust - Guided tube placement methods & examples using electromagnetic devices

Dani is an intensive care dietitian that also specialises in feeding tube placement, particularly bedside post-pyloric placement. She has been working in NBT ICU for 4 years and placing post-pyloric tubes for 2 years.

Summary of what Dani will cover: An overview of Cortrak equipment along with an in-depth look at Cortrak NJ traces, highlighting the importance of receiver placement and the GI flexure system.

  • Rowan Clemente & Frances Greer-Rogers, Dietitan, Southmead Hospital, North Bristol NHS Trust – Novice operator training and experiences

Frances has 10 years’ experience as clinical dietitian, 7 years in ICU. Currently working in ICU and Neurosurgery and for last 2 years working in extended practice inserting NJs, NGs and bridles.

Summary of what Rowan and Frances will cover: The process of developing NJ service in NBT, what’s included in the job description and how to achieve competency

* Please note that this session will be pre-recorded, followed by a live Q&A

** As this will be an interactive session, to make the most of it we would encourage attendees to have access to a feeding tube, two guidewire and 60ml syringe for practice purposes. If you are watching as a group, there will also be the opportunity for some joint practice tasks.

Detailed agenda to follow. All speakers/sessions are subject to change due to circumstances beyond our control.

The study session will be recorded and circulated to those who register.

Cost

  • Critical Care Specialist Group Member £30
  • BDA Member £50
  • Non Member £75

Due to the low cost for this study session the online system is open for card payments only, if you are unable to pay via card please email [email protected]

Invoices will be sent out in due course, these might not be received until January 2023.

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