These instructions are for Children’s Hospital of Philadelphia (CHOP) patients with a low-profile GJ tube (gastro-jejunostomy) or low-profile J tube (jejunostomy), who have been told to use Clog Zapper®.

Important information about Clog Zapper:

• Clog Zapper is a powder that breaks up formula clogs in different types of feeding tubes.
• Caution: protective eyewear is needed.  Clog Zapper can cause irritation if it comes in contact with the eyes.   
• It should be stored at room temperature until mixed.  Once mixed, Clog Zapper should be stored in the refrigerator and used within 24 hours.
• Clog Zapper contains coconut and should not be used for children with tree nut allergies.
• Clog Zapper contains maltodextrin, a type of sugar. If your child is on a ketogenic diet, they will need microlipids once the tube is unclogged. Talk to your healthcare provider about how much to give.
• You must know the length of your child’s tube before using Clog Zapper.
• Do not use the instructions that come in the kit.

Instructions using Clog Zapper:

1. Gather the supplies:
   • Clog Zapper Kit
   • Centimeter measuring tape
   • Scissors
   • Glass of water
2. Wash your hands with soap and water or clean with sanitizer.
3. Turn off the feeding pump and remove the feeding bag tubing and extension set from J tube feeding port.
4. Fill the Clog Zapper syringe to 10 ml mark with water.
   
5. Recap the syringe.
6. Shake! Shake! Shake for about 3-5 minutes to remove lumps.
   
7. Use a centimeter measuring tape and measure the Clog Zapper applicator from below the wings to the known length of your child’s tube.  
8. If the applicator length (31cm) is shorter than the known length of your child’s tube, it can be used without being cut.
   • Example:
     • The applicator is 31cm.
     • If your child’s tube is 34 cm.
     • Do not cut the applicator.
       Wings on Clog Zapper applicator Centimeter measuring tape
9. If the applicator length (31cm) is longer than the known length of your child’s tube, cut off the tip end of the applicator to equal the length of your child’s tube.
   • Example:
     • The applicator is 31cm.
     • If your child’s tube is 28 cm.
     • Cut 3 cm.
       • Do not cut the end with the applicator port.
         
10. Insert Clog Zapper applicator directly into the ‘J’ feeding port.
11. If unable to put the applicator all the way into the J tube, cut length to fit.
    • Example:
      • Measure the length of the applicator that is hanging out of the J tube. For example: 2 cm extra.
      • Cut the measured length off of the end of the applicator.
      • Cut off 2 cm.
        
12. Attach syringe to applicator.  
13. Gently fill tube with Clog Zapper until the solution starts leaking out (usually 2-5 ml).
    
14. Remove applicator from tube and close the feeding port.  
15. Keep applicator and syringe in case the procedure must be repeated.  
16. Any unused Clog Zapper can be refrigerated for up to 24 hours if needed.  
    
17. Keep solution in tubing for 60 minutes.  
18. Fill oral syringe with water.
    
19. Flush with the amount of water that you were taught to use.
20. If tube flushes, resume feeding.
    

If tubing cannot be flushed, you may repeat the steps above if you have been told to by your health care provider.

If a 2nd dose of Clog Zapper has been used and the tube is still clogged, call Interventional Radiology.

Call your CHOP team with any questions or concerns.

If you have any questions about your child’s health, please contact your child’s healthcare provider. This document is intended only to provide general educational information and is not intended as medical advice or treatment. Please consult with your healthcare provider prior to use, as some of this information may need to be adapted for your child’s specific needs. It is the responsibility of your healthcare provider to advise you on the appropriate use of this information. If you/your child are not already a CHOP patient, this document does not create a doctor-patient relationship between you/your child and CHOP. CHOP is not responsible for any outcomes you/your child might experience from your use of this document. This document is provided "AS IS", WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, express or implied. If this document refers to any drugs or medical devices, it is the responsibility of your healthcare provider to check the FDA status prior to use. If this document includes references to drug dosing, please do not rely on this document. Your healthcare provider should check the package insert for each drug before use. Hyperlinks used within this document may not be translated into other languages.

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