The LSUHSC New Orleans
Emergency Medicine Interest Group

Presents

The Student Procedure Manual


Gastric Lavage

by Rodd Daigle with
Patrick Hymel

Indications
Complications
Equipment
Procedure
Complications
Interpretation of Results
Follow-Up
Related Procedures

Indications

Complications

Equipment

Procedure

  1. Gown, mask (with eye protection) and gloves should ALWAYS be worn.
  2. Detennine level of consciousness (LOC), if the patient has a decreased LOC then his airway-protective reflexes will be decreased, and aspiration of gastric contents into lungs is likely. If there is doubt, check for a gag reflex. If gag reflex is absent, or the Glasgow Coma Scale(GCS) is < 9- INTUBATE.
  3. If the patient doesn't blink reflexively after touching the eyelashes, probably there is an impaired neuro exam and an unprotected airway, requiring a cuffed ET tube.
  4. Place patient in the left lateral decubitus position with the head lowered about 10' (this decreases the passage of gastric contents into the duodenum during lavage, and reduces the possibility of pulmonary aspiration of gastric contents.
  5. Restrain the uncooperative patient's hands.
  6. Estimate tube length; it should stretch from the nose, around the ear and to the midepigastrum.
  7. Tubes of 36 French or larger should be passed orally.
  8. If performing nasogastric incubation, lubricate tubing with jelly.
  9. Have patient put his chin on his chest to facilitate entrance of tubing into the esophagus.
  10. Gently push tubing through nose or mouth.
  11. Confirm tube's entrance into the stomach by auscultation over the gastric region while injecting air with the 50-ml catheter tipped syringe.
  12. Carefully aspirate gastric contents, repositioning the lavage tube often.
  13. Tape the lavage tube in place.
  14. Administer tap water using the Y connector and clamping the drainage arm of the lavage tube.
  15. Administer several aliquots of about 200 ml for adults and 10 ml/kg for children, draining after each infusion.
  16. Continue lavage for 3 L after gastric returns are clear.
  17. Activated charcoal (I gm/kg) is then introduced through the ravage tube.
  18. Clamp the lavage tube, to avoid drippina fluid into the trachea, and gently pull out.
  19. If repetitive doses of activated charcoal are to be administered, the lavage tube should be removed and a standard nasogastric tube should be inserted.

Complications

Interpretation of Results

Follow-Up

Related Procedures

 


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