3.4 Describe how to recognise and deal with adverse reactions which may occur: • during procedures • following procedures

This guide will help you answer 3.4 Describe how to recognise and deal with adverse reactions which may occur: • during procedures • following procedures.

Supporting someone through extended feeding means learning to spot and respond to adverse reactions, both while the procedure is happening and afterwards. Adverse reactions are unwanted or unexpected effects that may harm the individual’s health or wellbeing. These can range from mild discomfort to serious medical emergencies.

To give safe and effective support, you need to know what to look for and how to act quickly. Every response should protect the person’s safety, dignity, and comfort. Always follow your own organisations policies and procedures.

What are Adverse Reactions?

An adverse reaction is any negative effect that a person experiences as a result of a procedure or intervention. During or after extended feeding, these could include:

• Pain or discomfort
• Nausea or vomiting
• Breathing difficulties
• Swelling, redness, or infection near the tube site
• Diarrhoea or constipation
• Coughing or choking
• Tube blockage, leakage, or movement
• Allergic reactions, such as rash, swelling, or itching
• Anxiety or distress

Some reactions are mild and can be dealt with by making adjustments. Others are serious and need immediate medical attention.

Recognising Adverse Reactions During Procedures

While helping with extended feeding, be watchful for any signs of trouble as the feed starts and continues. Signs to look out for include:

• The person says they feel sick, dizzy, or unwell
• Coughing, choking, or sudden difficulty breathing
• Colour changes (for example, pale or bluish skin)
• Sweating, trembling, or shivering
• Sudden pain in the stomach, throat, or chest
• Restlessness, agitation, or crying
• Vomiting or gagging
• Feed coming back up the tube or out of their mouth
• Leakage from the feeding tube site
• Swelling, warmth, redness, or tenderness at or near the tube site
• Rapid heartbeat

Remember: People who find it hard to speak may show distress by changes in facial expression, body movements, or becoming unusually quiet.

Dealing with Adverse Reactions During Procedures

If you notice a mild problem, act at once:

• Pause the feeding immediately and stay calm.
• Reassure the person and explain what you are doing.
• Check the tube for blockages, leakage, or dislodgement.
• Help the person to sit upright, if possible, to reduce the risk of choking.
• If safe, use suction if trained and necessary.
• Call for help from a trained colleague, nurse, or medical professional.
• Monitor the person’s breathing, colour, and state of alertness.
• Document what happened, including what you saw, did, and the time.

If you see any signs of a severe reaction, such as difficulty breathing, blue lips, severe pain, heavy bleeding, unconsciousness, or rapid swelling, call emergency services immediately (in the UK, 999). Do not leave the person alone. Stay with them until help arrives.

Recognising Adverse Reactions Following Procedures

Problems may develop minutes, hours, or even days after extended feeding. Be alert for:

• Persistent vomiting or diarrhoea
• Feeding refusal
• Abdominal discomfort, bloating, or swelling
• Oozing, redness, or warmth at the tube site
• Unusual smell, colour, or discharge from site
• Fever or raised temperature
• General tiredness, weakness, or confusion
• Unexplained weight loss or signs of dehydration (dry lips, sunken eyes)
• Allergic symptoms (such as rash, itching, swelling)

Keep in mind: Illness or infection can develop slowly and may be missed if monitoring is not regular.

Dealing with Adverse Reactions Following Procedures

After feeding, if you notice a minor concern:

• Record your observations clearly in the care notes.
• Inform your supervisor or the person in charge.
• Continue to check on the person.
• Offer water, comfort, and reassurance within their care plan.
• Take advice before attempting another feed.

If you suspect an infection at the tube site, such as swelling, heat, pus, or severe pain:

• Do not touch or clean the site without guidance unless your role allows.
• Inform the medical or nursing team quickly.
• Do not use the tube for further feeds unless told it is safe.

For any ongoing vomiting, diarrhoea, or signs of dehydration:

• Stop all feeds until checked by a health professional.
• Offer sips of water if allowed and safe.
• Monitor urine output, alertness, and fluid intake.
• Report to the healthcare team for review.

If you spot any signs of a severe reaction, such as spreading rash, difficulty breathing, swelling of face or throat, or collapse, seek emergency medical help right away.

Reporting and Documentation

Always record:

• What you observed (symptoms, how sudden or severe, duration)
• Actions you took (stopping feed, first aid, notifications)
• Who you reported the reaction to
• The advice or actions taken by health professionals
• Any outcomes or changes to care plan

Clear, detailed records help keep the person safe and support shared learning for the team.

Preventing Adverse Reactions

By being diligent and prepared, you can reduce the risk of harm:

• Always use the correct equipment and follow up-to-date procedures.
• Check the care plan for allergies and previous reactions.
• Make sure the person is positioned well (usually upright).
• Never force feed or rush the procedure.
• Use clean, sterile supplies and wash hands thoroughly.
• Keep an eye on fluid type, temperature, and speed of feed.
• Communicate clearly with the person, asking about comfort throughout.

Communication and Emotional Support

If someone experiences an adverse reaction, reassure them and explain what is happening. Stay calm and supportive; anxiety from carers can make the situation worse for the individual. Encourage the person to share how they feel and report any further discomfort.

Involve family or advocates if the person wishes. After an event, give the person time to talk through their experience.

When to Escalate

Never hesitate to ask for help. If you are unsure or see a reaction you cannot manage, contact a nurse or healthcare professional straight away. Know your organisation’s procedure for emergencies, including who to contact and how to record the event.

Working as a Team

Adverse reactions are a shared concern. Teamwork is key to prevention and response:

• Share key information during handovers about any recent reactions.
• Learn from incidents together, adjusting care plans where needed.
• Attend regular training on recognising and managing adverse reactions.

Final Thoughts

Spotting adverse reactions, acting promptly, and seeking the right help saves lives. Always put the individual first. Watch for changes, listen to concerns, act quickly, and report fully. With the right support, people can stay safe, recover quickly, and feel secure during extended feeding.