Gastric lavage

Gastric Lavage

Gastric lavage, also known as stomach pumping, is a medical procedure that involves the washing out of the stomach's contents using water or a saline solution. This procedure is often employed in cases of acute poisoning or drug overdose, with the aim of removing the toxic substance from the stomach before it can be absorbed into the bloodstream.

Illustration of a gastric lavage procedure.

Indications

Gastric lavage is primarily indicated in cases of acute poisoning or ingestion of a toxic substance, where the procedure can be performed within a certain time frame after ingestion (usually within 1 hour) to be effective. It may also be considered in some cases of drug overdose, especially if the ingested substance is known to delay gastric emptying or form concretions.

Procedure

The gastric lavage procedure involves the insertion of a large-bore orogastric tube through the patient's mouth and into the stomach. The position of the tube is verified, and then the stomach is repeatedly flushed with small volumes of a saline solution or water. The fluid is then removed, along with any stomach contents, through the tube. The procedure may be repeated several times until the washout fluid is clear.

• Preparation

Before gastric lavage, patients typically undergo a risk assessment to determine if the procedure is appropriate based on the ingested substance, the amount ingested, and the time elapsed since ingestion. Precautions are taken to protect the airway in unconscious or semi-conscious patients to prevent aspiration.

Risks and Considerations

While gastric lavage can be a life-saving procedure in cases of poisoning, it is not without risks. Potential complications include aspiration pneumonia, esophageal or gastric perforation, and electrolyte imbalances. Therefore, the decision to perform gastric lavage involves careful consideration of the risks and benefits for each individual patient.

Alternatives

In many cases, alternative treatments such as activated charcoal administration are preferred due to fewer complications and a broader window of effectiveness. Gastric lavage is considered when these alternatives are not suitable or effective.

External Links

• Poison Control - Gastric Lavage
• Medscape - Gastric Lavage

References

Gastric lavage Resources
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