GASTRIC LAVAGE

PRESENTED BY:
SNEHA P
ROLL NO: 116
 DEFINITION
 Also known as “stomach pumping” or “gastric irrigation”

 The process of administration and evacuation of

small volumes of liquid through orogastric tube to
remove unabsorbed ingested toxic substances within
the stomach.
INDICATIONS
 Removal of unabsorbed poison from the body

 Cleaning the stomach before endoscopy

 Collecting stomach acid for tests

 Relieving pressure in intestinal obstruction

REQUIREMENTS:
1.Tubes:
EDWALD TUBE (Most commonly used)
-
 EDLICH TUBE
 LAVACUATOR

2.Irrigation solutions
 POSITION FOR LAVAGE
 The patient should be on his left side
or prone with head hanging over the
edge of the bed and face facing down .
supported by assistant.

 TRENDELENBURG POSITION:
- Head higher than feet by
15-30 degree.
- To prevent regurgitation of fluid
 PROCEDURE
1. BEFORE INTRODUCTION OF TUBE:
 Remove dentures if present
 Place wooden mouth gag to avoid bite of tube
 Distal end is lubricated by glycerine or paraffin
 Tongue is depressed with depressor
 Left lateral position to prevent aspiration
2. INTRODUCTION OF TUBE:
Lubricated tube is slowly passed downwards
through the pharynx and esophagus into stomach
till mark is reached (50cm from
distal end)
3.CONFIRMATION OF TUBE:
Once the tube is passed, confirm that it is in the
stomach via auscultation and aspirate the stomach
contents .
Note: If coughing and breath sounds heard, suspicion of
tube in trachea.
4.LAVAGING THE STOMACH:
Three steps:
1. Pass about 250ml of plain warm
water through funnel, held above
. the head level.
2.When funnel is empty, pinch and
tube between thumb and finger.
3. Lower the tube below head level
. contents will be emptied by
siphon action.
5.PRESERVATION OF FIRST SAMPLE:
This sample is preserved in all poisoning cases as it must be
handed over to police for chemical analysis.

6.INDICATION FOR STOPPAGE:

-when returning fluid is clear, odourless and same nature as that
of fluid introduced.
-Exception: when KMNO4 is used should be stopped when

fluid is pink in colour.

7.LATE LAVAGE IS USEFUL IN:

a. when poison decrease gastric motility eg : morphine, TCA,etc
b. when poison is sticky in nature eg salicylates
CONTRAINDICATIONS
 ABSOLUTE:
1.Corrosive: risk of gastric perforation
2. Non- toxic ingestion
3.Sharp and pointed object ingestion

 RELATIVE:
1.Cardiac arrhythmia
2.Coma
3.Esophageal varices
4.Kerosene poisoning
COMPLICATIONS
1. Aspiration pneumonia
2. Water intoxication
3. Cardiac arrhythmia
4. Bleeding
5. Hyponatremia
6. Laryngospasm
7. Perforation
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