Gastric lavage

STOMACH WasH/GAStric lavage
definition
indicaition
contraindication
procedure
solutionS used
complications
nurses role

1. Gastric Lavage (Stomach Wash)

2. Definition Therapeutic procedure for washing out of the stomach with sterile water or normal saline or using antidote

3. Purpose For urgent removal of ingested substance to decrease systemic absorption. To empty the stomach before endoscopic procedure To diagnose gastric hemorrhage and to arrest hemorrhage.

4. Indications Ingested poison Cleaning of stomach before upper GI endoscopy To collect samples from stomach for analysis To relieve pressure in blocked intestines Evacuate clots Contraindications Depressed state of consciousness Seizure Corrosive poisoning Acid and alkali poisoning Ingestion of hydrocarbon or petroleum distillates Patient at risk of gastric perforation or bleeding

5. Principle Siphon The siphon is a simple apparatus consisting of a bent tube having a short arm and a long arm. The short arm of the siphon is placed in the liquid to be emptied and the long arm is carried down to the lower level. The air must be first removed from the siphon tube before it operates. When air is removed, fluid flows because of the different pressure in the two arms. 

6. Equipment

7. Lavage tube

8. Solutions used Plain water (Plain water is particularly useful when the poison is unidentified) Normal saline Weak solution of sodium bicarbonate or boric acid in corrosive poisoning Specific antidotes: if the person is identified. There are three types of antidotes. a. Physical antidotes: it is the one that mixes with the poison and dilutes the poison or prevents its absorption or soothes and protects the mucus membrane. b . Chemical antidotes: These react with the poison and neutralize it. c . Physiologic antidotes: these have a systemic effect opposite to that of the poison. If the poison has depressive action, the antidote has stimulating effect on the body.

9. Procedure Preparatory phase Protect the patient airway Keep the suction equipment ready Cardiac monitor and pulse oximetry IV line(20 Gauge) Consent Patient position (Semi Fowler’s position or left lateral with slightly elevated head) Check baseline vitals with abdominal girth Check gag reflex

10. Implement phase Hand hygiene Insert lavage tube (same principle of NG tube insertion) Pour normal saline or tap water or antidote mixture into the irrigation container through or funnel Introduce 200 to 300 ml of irrigating solution via lavage tube Aspirate the content with syringe or by gravity If needed send the sample to lab for gastric analysis Repeat the procedure until the goal is achieved Measure the amount, color and consistency

11. After care Do not leave the patient alone during gastric lavage. Monitor vital signs, respiratory status, and the patient’s level of consciousness continuously and report acute changes immediately to the provider. Perform hand washing Record all the things you’ve done, the time of procedure started until the time it ended, assessment before and after the procedure, amount of fluid color odor of gastric contents, and the collected specimen in the nurses’ notes.

12. Important nursing aspects Monitor vitals Watch for hypotension Check airway and breathing Watch for aspiration Strict hand hygiene Avoid introducing air into the stomach Use clamp if needed

13. Complications Aspiration pneumonia Laryngospasm Hypoxia and hypercapnia Bradycardia SOB Mechanical injury to the throat, esophagus, and stomach.

14. Thank you