Decision-Making for the Implementation of Specialized Nutrition Support (SNS) - Flowchart
Decision-Making for the Implementation of Specialized Nutrition Support (SNS) - Flowchart
«Flowchart»

ALGORITHM FOR IMPLEMENTATION OF SNS
Is disease process likely to cause nutritional impairment?

ALGORITHM FOR IMPLEMENTATION OF SNS
Is disease process likely to cause nutritional impairment?

ALGORITHM FOR IMPLEMENTATION OF SNS
Is disease process likely to cause nutritional impairment?

ALGORITHM FOR IMPLEMENTATION OF SNS

Yes

Yes

Yes

Does the patient have PCM or is at risk for PCM?

Does the patient have PCM or is at risk for PCM?

Does the patient have PCM or is at risk for PCM?

Yes

Yes

Yes

Would preventing or treating the malnutrition with SNS improve the prognosis and quality of life?

Would preventing or treating the malnutrition with SNS improve the prognosis and quality of life?

Would preventing or treating the malnutrition with SNS improve the prognosis and quality of life?

What are the fluid, energy, mineral, and vitamin requirements and can these be provided enterally?

What are the fluid, energy, mineral, and vitamin requirements and can these be provided enterally?

What are the fluid, energy, mineral, and vitamin requirements and can these be provided enterally?

Risks and discomfort of SNS outweigh potential benefits. Explain issue to paitent or legal surrogate. Support patient with general comfort measures including oral food and liquid supplements if desired.

Risks and discomfort of SNS outweigh potential benefits. Explain issue to paitent or legal surrogate. Support patient with general comfort measures including oral food and liquid supplements if desired.

Risks and discomfort of SNS outweigh potential benefits. Explain issue to paitent or legal surrogate. Support patient with general comfort measures including oral food and liquid supplements if desired.

Keep under surveillance with frequent calorie counts and clinical assessment

Keep under surveillance with frequent calorie counts and clinical assessment

Keep under surveillance with frequent calorie counts and clinical assessment

Request CVC, PICC, or peripheral line plus enteral nutrition

Request CVC, PICC, or peripheral line plus enteral nutrition

Request CVC, PICC, or peripheral line plus enteral nutrition

Nasally inserted tube

Nasally inserted tube

Nasally inserted tube

Percutaneously inserted tube

Percutaneously inserted tube

Percutaneously inserted tube

Subclavian catheter or PICC

Subclavian catheter or PICC

Subclavian catheter or PICC

Tunneled external line or subcutaneous infusion port

Tunneled external line or subcutaneous infusion port

Tunneled external line or subcutaneous infusion port

End

End

End

Yes

Yes

Yes

No

No

No

Yes

Yes

Yes

No

No

No

Can requirements be met through oral foods and liquid supplements?

Can requirements be met through oral foods and liquid supplements?

Can requirements be met through oral foods and liquid supplements?

Yes

Yes

Yes

No

No

No

Does the patient require total parenteral nutrition?

Does the patient require total parenteral nutrition?

Does the patient require total parenteral nutrition?

Yes

Yes

Yes

No

No

No

Request feeding tube

Request feeding tube

Request feeding tube

Needed for several weeks

Needed for several weeks

Several weeks

Needed for months or years

Needed for months or years

Months or years

Request CVC or PICC

Request CVC or PICC

Request CVC or PICC

Needed for several weeks

Needed for several weeks

Several weeks

Needed for months or years

Needed for months or years

Months or years