This guideline is intended to guide and facilitate the care of patients under the care of the clinical teams at Great Ormond Street Hospital for Children NHS Trust (GOSH). It has been approved by the Guideline Approval Group and is for use by staff of all disciplines and levels in these health care teams. The guidance contained here in is not intended to replace individual assessment and personalised treatment of the patient.
Clinical outcomes are broadly agreed, measurable changes in health or quality of life that result from our care. Constant review of our clinical outcomes establishes standards against which to continuously improve all aspects of our practice.
A gastrostomy is a feeding tube that is inserted directly into the stomach either surgically under direct vision (open or laproscopic), endoscopically (with a camera), or radiologically (x-ray guidance). A gastrostomy tube allows the delivery of supplemental nutrition and medications directly into the stomach. It also provides a mechanism to drain gastric contents if required. In order for gastrostomy feeding to be successful the child or young person must have a functioning gastrointestinal tract.
The skin is complex with an array of functions. It is the body’s largest organ, protecting the deeper tissues and organs from mechanical damage, chemical damage, bacterial damage, ultraviolet radiation and thermal damage. The skin aids in regulating body temperature, in excretion of urea and uric acid and also synthesis of vitamin D (Marieb 2012).
This guideline is intended to supplement the resources found in the 'When a Child Dies' (WACD) purple box located in every ward, which gives detailed information on the care of a child after death and, additionally, the ongoing care and attention that the child's family will require (Rationale 1).