Gastric Lavage
From Anvita Health Wiki
Contents |
Indications
-
- rarely removes clinically significant amount of poison [2]
- increases likelihood of early endoscopy but not better patient outcomes [3]
Contraindications
- Caution:
- airway protection ( endotracheal intubation) must preceed gastric intubation in patients
- without gag reflex
- with ingestion of a CNS depressant
Procedure
- or orogastric tube is placed
- 36-40 French (adults)
- bite blocks are often necessary to prevent biting down on the tube
- lavage is performed in the left lateral decubitus position, head down if possible
- the stomach is irrigated with 1 liter of normal saline (or less depending upon capacity), 200-250 mL aliquots [2]
- the fluid is then suctioned through the nasogastric tube
- the procedure is repeated until the fluid is clear or it becomes apparent that the fluid will not clear
- generally requires a minimum of 2 L (adults) [2]
- charcoal may be administered through the gastric tube
Complications
- pulmonary aspiration
- esophageal perforation
- hypothermia
- epistaxis
- perforation of the posterior pharynx, esophagus
- installation of lavage fluid & charcoal into the lungs
- hyponatremia in small children given hypotonic lavage fluid
- gastric biopsy with the newer active pump stems
More General Terms
Additional Terms
- gastrointestinal hemorrhage
- nasogastric tube (NGT) placement (gastric intubation)
- toxicity; poisoning; overdose
References
- Dorland's Medical Dictionary, 23rd ed., WB Saunders, Philadelphia, 1990
- Daubert GP, Emergency Medicine, University of California, Davis
- Huang ES et al. Impact of nasogastric lavage on outcomes in acute GI bleeding. Gastrointest Endosc 2011 Nov; 74:971. PMID: [1]
- Pallin DJ and Saltzman JR. Is nasogastric lavage in patients with acute upper GI bleeding indicated or antiquated? Gastrointest Endosc 2011 Nov; 74:981. PMID: [2]
