This document discusses food poisoning and enteral nutrition. It describes two types of food contamination: biotic (by microorganisms like bacteria, molds and viruses) and abiotic (by non-biological agents like pollution and chemical residues). It outlines methods to prevent food poisoning like heat, cold, drying and chemical processes. It also discusses enteral nutrition through tubes, the types of tubes used, feeding procedures, complications, and forms of administration like bolus and continuous infusion.

1. Food system II
Dr. CARLOS GUARDADO

2. food poisoning
► Water and salt (the only ones that cannot be altered)
► Other foods can be altered (improper storage)
► Contamination: the presence of any foreign agent that produces
alteration
► They are foodborne diseases.
► There are two kinds
► Biotic Pollution
► Abiotic Pollution

3. Biotic Pollution
► It is food contamination by biological agents
► Harmless or pathogenic microorganism (Bacteria)
► Can be found in soil, water and air
► Microorganisms can be exogenous, endogenous
► Factors that produce proliferation:
► Humidity
► Temperature
► Weather
► pH
► presence of oxygen

4. Bacterias
► Very small organisms
► They are found everywhere including in food
► There are bacteria harmless to man (yogurt)
► There are pathogenic bacteria ( salmonella,
staphylococcus)

5. Molds and Viruses
► Mushrooms
► Mold (bread)
► Camembert yeast cheese
► Viruses: food uses it as a means of transport

6. Abiotic Pollution
► Food is contaminated by non-biological physical or chemical agents
► Environmental pollution
► lead, cadmium
► Substances from cleaning product residues
► Chemical additives used in the food manufacturing process

7. Prevention of Food Poisoning
► Physical Methods:
► Heat: Sterilization, Pasteurization
► Cold :Refrigeration, Freezing
► Drying: It consists of reducing the water content using environmental
conditions
► Dehydration: It consists of reducing water content with artificial heat

8. Chemical Methods
► Salting: salt
► Smoking: Subjecting food to incomplete combustion of wood
► Pickled: vinegar
► Pickled: Vinegar and salt

9. Food handling
Processes subjected to food
Elaboration
Stored
Transportation
Commercialization
Consumption
Royal Decree 202/2000 Ministry of Health and consumption that establishes
compliance with all processes

10. Hygiene standards for the handler
► Wash your hands properly (cut off the transmission mechanism)
► Wear clean clothes and shoes
► shower regularly
► The cut nails
► Clean hair and cover with hats
► Handler wounds should be covered with a bandage
► If the handler has an illness, communicate it
► don't cough
► No Smoking
► Do not wear jewelry, rings

11. Enteral nutrition
► Orally or by surgical (gastrostomy) or non-surgical
(SNG) tube
► It is the nutritional support technique by which
nutritional substances are provided directly to the
digestive system at any level sufficient for the
digestion and absorption of nutrients.
► Remove dental prosthesis
► Indicated in patients who cannot cover their
nutrient needs with daily oral intake but have a
well-functioning digestive
systemhttps://www.youtube.com/watch?v=cAnto
w3hDIg

12. Enteral nutrition
► The probes are long hollow tubes of different diameters, flexible rigid
semi-rigid
► The caliber of the probe is indicated in French units (D=N. probe X 0.33)
► Probes can be surgical and non-surgical
► The most frequent materials used are PVC for administrations of 10 to 14
days and silicone lasts 3 months.
► The tube of choice is the nasogastric tube, it is the technique of choice
since it is the simplest and allows continuous administration of bolus
feeding.
► Nasogastric measures between 75 and 125 cm in length
► Nasoduodenal between 91 to 300 cm in length

19. General enteral nutrition precautions
► Keep the patient at a 45 degree angle while administering
► Check the residue or gastric content before each feeding if the residue is
greater than 150ml, suspend feeding
► Check drip rate
► After the administration of the nutrition, it is convenient to wash the tube
with 30 ml

20. Care of the patient with a nasogastric tube
► Clean the nostrils once a day to avoid irritation
► Lips get dry because patients breathe through their mouths
► Apply Vaseline to the nostril
► Change the tape strips for the fixation of the probe
► Ensuring the patency of the probe
► https://www.youtube.com/watch?v=L2nX6zAzOVk

21. Patient care with gastroenterostomy tube
► Check daily that the skin of the stoma does not present irritation,
inflammation or secretion
► Wash the stoma every two times using soap and water and change the
hypoallergenic plaster daily
► Place a gauze around the tube and watch for possible loss of food or gastric
juice

22. Foods for enteral nutrition
► Commercial preparations contain exactly and balanced three basic nutrients:
Proteins, fats and carbohydrates
► But it depends a lot on the patient's situation.
► There are diets for kidney, liver, heart patients
► Check the formulas expiration date
► Room temperature, do not keep the formula connected for more than 24 hours
► Medications should not be mixed with formulas

23. Forms of administration of the
enteral diet
► intermittent administration
► Approaches a normal feeding schedule
► It can be done with three systems
► Syringe bolus: 200 to 400 ml is administered using 50 ml syringes once every 6
hours
► Gravity: A drip system similar to serum therapy
► infusion pump

24. ongoing administration
► The administration is made by slow drip of 40 to 150ml per hour during the
day
► An infusion pump is used
► The gastrointestinal system needs to be working

25. Complications of the administration of
enteral nutrition
► Mechanical complications
► Gastrointestinal complications
► metabolic complications
► infectious complications
► psychological complications

26. mechanical complications
► Nosebleed
► Nausea
► Probe not advancing properly
► Airway Insertion
► nasal erosions
► otitis media

27. Gastrointestinal complications
► Diarrhea
► Constipation
► vomiting
► Nausea

28. metabolic complications
► Very important of a water balance
► Avoid dehydration or hyperhydration

29. infectious complications
► aspiration pneumonia
► Peritonitis

30. Parenteral Nutrition
► It is the supply of nutrients to the body through a venous
route.
► Indications: when the digestive system is not well or needs
to be at rest
► Higher cost and a greater number of complications