School Nurses on the Front Lines of Healthcare: Children With Medical Devices-A "BOLUS" of Information About Gastrostomy Tube Malfunctions and Infections.

An important subgroup of children with special healthcare needs are children with medical complexities that require long-term, intensive healthcare interventions and treatments. As medical technology continues to advance and children with complex medical needs survive the neonatal period and progress into school-age, it is essential for school nurses to be able to recognize and acutely manage complications and malfunctions of devices in children requiring assistance from medical devices. An example of a common medical device includes gastrostomy tubes (aka G-tubes or GJ-tubes), ensuring nutrition in children with failure to thrive, significant developmental delay, swallowing dysfunction, or severe gastroesophageal reflux. These devices put children at serious medical or surgical risk when they malfunction, so it is important for healthcare providers, especially school nurses who are the first responders in schools, to recognize malfunctions and initiate appropriate care management.