How to Care for Tubes and Drains at Home

Most people don’t expect to become medical experts on equipment used to treat health concerns, but if you’ve been sent home after a procedure with a feeding tube or drain, it can feel more than a little intimidating.

Even after you’ve been shown how to use them, knowing how to care for tubes and drains at home isn’t always second nature. When you start the process you might suddenly feel stuck, or run into a problem you don’t remember discussing with your doctor or nurse at the hospital.

Let’s take a look at the common tubes and drains that can be seen in the home, and then at basic use and how to troubleshoot problems. With this guide as a handy reference, you can feel like a pro in no time.

What are some common tubes and drains?

Older adults who are experiencing complications of a health condition or surgery may require tubes and drains for various reasons. These can be temporary until a wound or surgical site heals or a condition improves or they may be a more permanent device.

Common tubes and drains include:

Feeding tubes- these are used to help someone who can’t eat or drink get nutrition and hydration. They can be temporary, like nasogastric (NG) tubes, or permanent, like gastric (G) tubes (also sometimes called PEG tubes) that connect directly to the stomach, or jejunostomy (J) tubes that connect directly to the small intestine.

Surgical drains- these are placed under the skin during surgical procedures to allow excess fluid or infection to drain from a wound or surgical repair. They can be connected to a collection bag, bulb (such as with a Jackson-Pratt, or JP drain), or small pump called a wound vacuum (wound vac). They are removed by your doctor as the area heals and they are no longer needed.

Urinary catheters- when the bladder can’t drain well on its own, a urinary catheter may be used to help. There are three common types that can be inserted into the body:

- A straight catheter, which is single-use

- A foley (or indwelling) catheter, which enters the bladder through the urethra

- A suprapubic catheter, which is inserted through the skin on the abdomen just above the pubic area and directly into the bladder.

Nephrostomy tubes- inserted through the skin and into one or both kidneys, these drain urine in cases where there is damage to the bladder, the bladder has been removed, or urine cannot travel from the kidneys to the bladder. They can be temporary or permanent depending on the situation.

Biliary drains- the bile duct empties bile produced by the liver into the small intestine. If it becomes blocked, bile will build up in the liver. To help with this, a biliary drain that connects to a drainage bag outside of the body is sometimes placed in the bile duct.

How do I care for tubes and drains at home?

There are some basics to keep in mind when caring for tubes and drains. Anytime a device enters the body through the skin or another opening, there is a risk for infection, so it’s important to keep these devices clean and dry and to report signs of infection such as redness, heat, swelling, pain, abnormal drainage, or fever to your doctor right away.

Along with knowing the signs and symptoms of infection, here are some tips for each device:

Caring for feeding tubes at home

Things to know include: 1

Follow your doctor’s instructions for skin care around the tube
Wash your hands before handling the tube or feeding solution
Keep formula refrigerated and never use formula that has been at room temperature longer than your doctor’s recommendation
Don’t put anything in the tube that your doctor hasn’t instructed you to use
Flush the tube with plain water between feedings and medications to keep it from getting clogged
For feedings that go into the stomach, keep the person sitting up or their head up during the feedings and for 30-60 minutes afterward
If the feeding is causing nausea, cramps, or diarrhea, slow the rate. You can work with your doctor on the best rate to avoid problems.
If the tube comes out or is blocked, call your doctor right away. Don’t try to reinsert it yourself.

Caring for surgical drains at home

Things to know include: 2

Empty and measure the collection bag or bulb for your drain as instructed by your doctor
Report any changes in drainage (amount, color, or smell) to your doctor right away
Fever, redness, swelling, pain, heat, or drainage at the insertion site of the drain need immediate attention
If you’ve been given instructions on milking the tubing, be sure you follow them- skipping this step can cause the drain to clog
Always wash your hands before handling the drain, tubing, or changing any dressings
Change dressings as directed and keep the site clean
If the tube falls out, stitches become loose, or the drainage bulb loses suction, notify your doctor

Caring for urinary catheters at home

By caring for a urinary catheter correctly, you can help reduce your risk of developing a urinary tract infection. Here are some things to know about urinary catheters: 3

Always wash your hands before touching the catheter or the skin around the insertion site
Keep the drainage bag below the level of your bladder, so urine does not flow backwards into the bladder
Empty the drainage bag regularly, before it becomes overly full
Avoid touching the spout of the drainage bag to anything
Report the following to your doctor right away:

- Changes in the color, amount, or smell of your urine
- Pain in your abdomen, back, or in your urethra
- Redness, swelling, pain, or drainage at the insertion site
- Fever
- You notice the drainage bag is no longer filling with urine
- The catheter falling out- with suprapubic catheters, the opening can close if the catheter is not replaced quickly

Caring for nephrostomy tubes at home

Follow these basics when caring for your nephrostomy tube(s): 4

Always wash your hands before handling the site, tube(s), or a drainage bag
Change the dressing and clean around the insertion site as directed by your doctor. This includes when it is soiled. Missing this step can lead to infection!
Follow your doctor’s instructions for flushing the tube regularly
Report the following to your doctor right away:

- Fever
- Urine or drainage leaking from the insertion site
- Red, irritated, or painful skin at the insertion site
- Nausea or vomiting
- Back or flank pain
- Foul-smelling urine
- A tube that falls out
- Difficulty flushing the tube
- A drainage bag that stops filling with urine

Caring for biliary drains at home

To care for a biliary drain, there are some basic things to know: 5

Always wash your hands before handling the drain, bag, or touching the insertion site or dressing
Change the dressing as directed by your doctor, and when it is soiled
Flush the drain as directed by your doctor
Record any output from the drain as directed by your doctor
Report the following to your doctor right away:

- Fever
- Redness, swelling, pain, or discharge at the insertion site
- Your skin or the whites or your eyes have a new or worsening yellow tint
- The color or smell of the drainage from the biliary drain changes
- The tube starts to come loose or falls out from the insertion site
- New or worsening belly pain
- New or worse nausea or vomiting
- Inability to pass stools or gas

Caring for tubes and drains at home is a team effort

With all of the above devices, it’s important to remember that you are part of a team when it comes to caring for them at home. If you’re not sure if something is a problem, it’s best to contact your doctor as soon as possible.

Avoiding infection is critical to caring for any tube or drain. Washing your hands, keeping the site and the tube or drain clean, and reporting signs of infection to your doctor immediately can help you avoid complications of infection.

It is equally important to follow up with your doctor as directed. Be sure to keep a record of any drain output if they have asked you to, and bring it to your appointments. If the drain is temporary, this can help them decide when it is safe to remove it.

Involving family and caregivers in the care of your tube or drain at home can help make the process easier. They can watch for signs and symptoms of a problem and sometimes see the site more clearly than you can. Always be sure that anyone else touching your skin near the insertion site while helping you with personal care and hygiene has washed their hands.

By following these simple rules, you can more easily manage the care of a tube or drain at home and continue your regular activities as much as possible.

Professional caregivers through Caresify can help you with personal hygiene and transportation to follow-up appointments if you require assistance with these activities. To learn more, you can read about care services here, or call 888-799-5007.

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