- Indications:-
- With patient has ingested a potentially life-threatening amount of a poison and the procedure can be undertaken within 60 minutes of ingestion.
- Cleaning the stomach before an upper endoscopy in someone who has been vomiting blood.
- Collecting stomach acid for tests.
- Relieving pressure in someone with a blockage in the intestines.
- Loss of airway protective reflexes, such as in a patient with a depressed state of consciousness.
- Ingestion of a corrosive substance such as a strong acid or alkali.
- Ingestion of a hydrocarbon with high aspiration potential.
- Patients who are at risk of hemorrhage or gastrointestinal perforation due to pathology, recent surgery, or other medical condition, that could be further compromised by the use of gastric lavage.
- Complications:-
- Aspiration pneumonia.
- Laryngospasm.
- Hypoxia and hypercapnia.
- Mechanical injury to the throat, esophagus, and stomach.
- Fluid and electrolyte imbalance.
- Struggling patients may be at greater risk of complications
- Technique:-
- Gastric lavage involves the passage of a tube via the mouth or nose down into the stomach, followed by sequential administration and removal of small volumes of liquid.
- The placement of the tube in the stomach must be confirmed either by air insufflation while listening to the stomach, by pH testing a small amount of aspirated stomach contents, or x-ray. This is to ensure the tube is not in the lungs.
- Lavage is repeated until the returning fluid shows no further gastric contents.
- If the patient is unconscious or cannot protect their airway then the patient should be intubated before performing lavage.
video: Nasogastric Intubation from New England Journal of Medicine..
Dr Ibrahim