Gastric lavage

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

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

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

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

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

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

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

• Activated charcoal
• Poisoning
• Drug overdose
• Nasogastric intubation