Gastric lavage. Performing and learning.pptx

Gastric lavage. Performing and learning

1. GASTRIC LAVAGE

2. INTRODUCTION Gastric lavage also commonly called stomach wash or gastric suction, is the process of cleaning out the contents of the stomach. It has been for eliminating poisons from the stomach.

3. PURPOSE For purpose removal of ingested subtance to decrease systemic absorption. To empty the stomach before endoscopic procedure. To diagnose gastric hemorrhage and to arrest hemorrhage.

4. INDICATIONS With patient has ingested poison. Cleaning the stomach before and upper endoscopy in someone who has been vomiting blood. Collecting stomach acid for tests. Relieving pressure in someone with a blockage in the intestines.

5. CONTRAINDICATIONS Loss of airway protective reflexes, such as in patients with a depressed state of consiousness. Ingestions 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.

6. COMPLICATION Aspiration Pneumonia While taking the unwanted poison and drugs out of the stomach (lavage), the subtance might accidentally enter the respiratory canal, into the lungs and cause aspiration pneumonia. 2. Laryngospasm Uncontrolled and involuntary muscle contraction (spasm) of the larynx cord. 3. Hypoxia and hypercapnia Lack of oxygen in the body tissues.

7. COMPLICATION 4. Bradycardia Pulse is slow and lower than normal. 5. Shorterness of breathing Patient might exprience dyspnea due to a tube inserted through the oropharynx that can obstruct the patient airway, which cause low oxygen supply. 6. Mechanical injury to the throat, esophagus and stomach.

8. PERFORM GASTRIC LAVAGE No Steps 1 Check physician’s order and indication for gastric lavage. 2 Identify the patient 3 Assess patient Level of consiousness Type of poisoning 4 Greet and explain the procedure to the patient 5 Provide privacy 6 Assist the patient into the position as ordered: Conscious patient: sitting up position Unconsious patient: left lateral position with head, neck and truck forming a straigh line. Comatose patient will be intubated with a cuffed naso-tracheal or endotracheal tube. 7 Wash hand and wear gloves 8 Place protective covering under patient to protect beg linen. 9 Observe and record vital signs of pulse, blood pressure and temperature.

9. No Steps 10 Remove dentures and inspect the oral cavity for loose teeth and remove any secretions that may prevent the patient’s tongue from falling back. 11 Measure the length of the tubing Measure from the bridge of the nose or mouth to pinnae of the ear and down 4cm beyond the xiphoid process. Mark the length with plaster. 12 Lubricate the tube with water-soluble lubricant or water 13 Insert tube Instruct patient to open mouth (Unconscious patient use a mouth gag) Insert tube up fill faring Instruct patient to swallow simultaneously push the tube gently in until the marked level Unconscious patients push tube gently in until level marked Never force the catheter. Lower the head of the bed after lavage tube has been inserted to facilitate drainage. Stand by suction apparatus. 14 Observe the patient throughout the procedure.

10. No Steps 15 Test that tube in the stomach by either; Aspirating some of the stomach contents and performing the litmus test. Blue litmus paper will turn red. Auscultate with sthethoscope over the epigastrium and inject 2-3ml of air into the tube to hear a swooshing sound over the stomach area. Placing some water in a receiver and submerge the free end of the tube below water level as the patient exhales to observe presence of bubbles. 16 The stomach contents witha syringe attached to the tube before instilling water or antidote. Sve the specimen for analysis. 17 Perform lavage Attach the funnel or a 50ml syringe to the tube Use small volume of fluid Elevate funnel or syringe and instill 150-300ml of solution per instillation Lower the funnel and allow the gastric content to flow into receiver. Save samples of first washing. Repeat until clear. At completion of the lavage, the stomach may be left empty or a prescribed solution may be installed according to the doctor’s instruction.

11. No Steps 18 Observe the return fluid Amount Smell Color Contents 19 Removing tube keeping the head lower than the body pinch and remove tube gently and quickly while instruction patient to breathe in and hold breath 20 Provide mouth gargle 21 Record fluid input and output througout the procedure

12. THANK YOU