Gastric lavage: Difference between revisions

Latest revision as of 21:50, 11 December 2024

Gastric Lavage

Gastric lavage, also known as stomach pumping or gastric irrigation, is a medical procedure that involves the removal of the contents of the stomach. It is typically performed in emergency situations, such as in cases of poisoning or drug overdose, to prevent the absorption of toxic substances into the bloodstream.

Indications[edit]

Gastric lavage is primarily indicated in the following situations:

Acute poisoning: When a patient has ingested a potentially life-threatening amount of a toxic substance, gastric lavage may be used to remove the substance from the stomach before it can be absorbed.
Drug overdose: In cases of overdose with certain medications, gastric lavage can help reduce the amount of drug absorbed into the body.
Preparation for surgery: Occasionally, gastric lavage is used to clear the stomach contents before surgery to reduce the risk of aspiration.

Contraindications[edit]

Gastric lavage is not suitable for all patients and situations. Contraindications include:

Corrosive substance ingestion: If the ingested substance is corrosive, such as strong acids or alkalis, gastric lavage may cause further damage to the esophagus and stomach.
Airway compromise: If the patient has an unprotected airway or is at risk of aspiration, gastric lavage may not be safe.
Late presentation: If a significant amount of time has passed since ingestion, the substance may have already moved beyond the stomach.

Procedure[edit]

The procedure for gastric lavage involves several steps:

1.Patient preparation: The patient is positioned appropriately, usually lying on their side with the head slightly elevated to reduce the risk of aspiration. 2.Insertion of the tube: A lubricated orogastric or nasogastric tube is gently inserted through the mouth or nose into the stomach. 3.Aspiration of stomach contents: Initial aspiration is performed to remove any liquid contents from the stomach. 4.Irrigation: Small amounts of saline or water are introduced into the stomach through the tube, followed by aspiration to remove the fluid along with any stomach contents. 5.Repetition: The irrigation and aspiration process is repeated several times until the aspirated fluid is clear. 6.Removal of the tube: Once the procedure is complete, the tube is carefully removed.

Complications[edit]

While gastric lavage can be life-saving, it is not without risks. Potential complications include:

Aspiration pneumonia: If stomach contents are aspirated into the lungs, it can lead to pneumonia.
Esophageal or gastric perforation: The insertion of the tube or the lavage process can cause tears in the esophagus or stomach.
Electrolyte imbalance: Repeated lavage can lead to disturbances in electrolyte balance.

History[edit]

Gastric lavage has been used for centuries, with early references dating back to ancient times. The procedure became more standardized in the 19th and 20th centuries with the development of better medical equipment and understanding of toxicology.

Current Use[edit]

Today, gastric lavage is less commonly used than in the past, largely due to the development of more effective and safer treatments for poisoning, such as activated charcoal and specific antidotes. However, it remains a valuable tool in certain emergency situations.

Also see[edit]

@@ Line 1: / Line 1: @@
-= 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.
+Gastric lavage, also known as stomach pumping or gastric irrigation, is a medical procedure that involves the removal of the contents of the stomach. It is typically performed in emergency situations, such as in cases of poisoning or drug overdose, to prevent the absorption of toxic substances into the bloodstream.
-[[File:Doctor Jukes pumping the stomach of Curtis, several other al Wellcome V0011337.jpg|thumb|Illustration of a gastric lavage procedure.]]
+==Indications==
+Gastric lavage is primarily indicated in the following situations:
-== Indications ==
+* '''[[Acute poisoning]]''': When a patient has ingested a potentially life-threatening amount of a toxic substance, gastric lavage may be used to remove the substance from the stomach before it can be absorbed.
-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.
+* '''[[Drug overdose]]''': In cases of overdose with certain medications, gastric lavage can help reduce the amount of drug absorbed into the body.
+* '''[[Preparation for surgery]]''': Occasionally, gastric lavage is used to clear the stomach contents before surgery to reduce the risk of aspiration.
-<youtube>
+==Contraindications==
-title='''{{PAGENAME}}'''
+Gastric lavage is not suitable for all patients and situations. Contraindications include:
-movie_url=http://www.youtube.com/v/X6W4SIdT978
-&rel=1
-embed_source_url=http://www.youtube.com/v/X6W4SIdT978
-&rel=1
-wrap = yes
-width=750
-height=600
-</youtube>
-== Procedure ==
+* '''[[Corrosive substance ingestion]]''': If the ingested substance is corrosive, such as strong acids or alkalis, gastric lavage may cause further damage to the esophagus and stomach.
-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.
+* '''[[Airway compromise]]''': If the patient has an unprotected airway or is at risk of aspiration, gastric lavage may not be safe.
+* '''[[Late presentation]]''': If a significant amount of time has passed since ingestion, the substance may have already moved beyond the stomach.
-* Preparation
+==Procedure==
-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.
+The procedure for gastric lavage involves several steps:
-== Risks and Considerations ==
+.'''[[Patient preparation]]''': The patient is positioned appropriately, usually lying on their side with the head slightly elevated to reduce the risk of aspiration.
+.'''[[Insertion of the tube]]''': A lubricated orogastric or nasogastric tube is gently inserted through the mouth or nose into the stomach.
+.'''[[Aspiration of stomach contents]]''': Initial aspiration is performed to remove any liquid contents from the stomach.
+.'''[[Irrigation]]''': Small amounts of saline or water are introduced into the stomach through the tube, followed by aspiration to remove the fluid along with any stomach contents.
+.'''[[Repetition]]''': The irrigation and aspiration process is repeated several times until the aspirated fluid is clear.
+.'''[[Removal of the tube]]''': Once the procedure is complete, the tube is carefully removed.
-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.
+==Complications==
+While gastric lavage can be life-saving, it is not without risks. Potential complications include:
-== Alternatives ==
+* '''[[Aspiration pneumonia]]''': If stomach contents are aspirated into the lungs, it can lead to pneumonia.
+* '''[[Esophageal or gastric perforation]]''': The insertion of the tube or the lavage process can cause tears in the esophagus or stomach.
+* '''[[Electrolyte imbalance]]''': Repeated lavage can lead to disturbances in electrolyte balance.
-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.
+==History==
+Gastric lavage has been used for centuries, with early references dating back to ancient times. The procedure became more standardized in the 19th and 20th centuries with the development of better medical equipment and understanding of toxicology.
-== External Links ==
+==Current Use==
+Today, gastric lavage is less commonly used than in the past, largely due to the development of more effective and safer treatments for poisoning, such as activated charcoal and specific antidotes. However, it remains a valuable tool in certain emergency situations.
-* [https://www.poison.org/articles/gastric-lavage Poison Control - Gastric Lavage]
+==Also see==
-* [https://emedicine.medscape.com/article/814774-overview Medscape - Gastric Lavage]
+* [[Activated charcoal]]
+* [[Poisoning]]
+* [[Drug overdose]]
+* [[Nasogastric intubation]]
-== References ==
+{{Medical procedures}}
-<references />
 [[Category:Medical procedures]]
-[[Category:Toxicology]]
 [[Category:Emergency medicine]]
+[[Category:Gastroenterology]]
-{{stub}}