carry-out-gastric-lavage

Carry Out Gastric Lavage

Gastric lavage 

This is the process of cleaning out stomach contents.

OR   This is a gastro intestinal decontamination technique that aims to empty the stomach of toxic substance
by the sequential administration and aspiration of small volumes of fluid via a nasal gastric tube.

   Gastric lavage is the process of washing out of the stomach via a nasogastric tube or stomach tube.
Lavage is ordered to wash out the stomach (after ingestion of poison or an overdose of medication, for
example) or to control gastrointestinal bleeding. If the patient does not have a nasogastric tube in place
already, the physician will order the insertion of the appropriate tube.

INDICATIONS OF GASTRIC LAVAGE.
  •  Ingestion of a potentially life threatening substances e.g. chloroquine, cyclic antidepressants e.g.
    amitriptyline, imipramine.
  •  Ingestion of large amounts of a substance not absorbed to charcoal e.g. iron, lithium.
  •  To confirm levels of bleeding from the gastric intestinal tract.
  •  Ingestion of substance which have propensity to form bezoars (a mass found trapped in the GIT)
    e.g. iron salicylates such as aspirin, acetylsalicylic acid
  •  It can also be used as a cooling technique for hyper thermic patients.
CONTRAINDICATIONS
  •  Comatose and convulsing patients.
  •  Ingestion of a corrosive substance such as strong acids &strong alkaline.
  •  Pills too large for lavage tube.
  •  Patients at risk of hemorrhage or gastro intestinal perforation due to pathology.
  •  Unintentional ingestion in young children.
  •  Ingestion of hydrocarbons (e.g ethanol) & detergent.
Complications of gastric Lavage
  •  Incomplete decontamination leading to severe intoxication despite the procedure
  •  Pulmonary aspiration
  •  Hypoxia
  •  Laryngospasm
  •  Mechanical injury to the gastrointestinal tract
  •  Water intoxication (especially in children)
  •  Hypothermia
REQUIREMENTS FOR GASTRIC LAVAGE

Gastric lavage is a clean procedure

Top shelf

  • Rubber tubing, stomach
    tube, funnel connection
    towel patient is unconscious
    and clip in a bowel
  • 2 Gallipots
  • Bowl of swabs
  • Vomitus bowel
  • 20 ml syringe
  • Litmus paper stomach
    contents
  • Jar of water

Bottom Shelf

  •  Mackintosh cape
  •  Receiver
  •  Jar for stomach contents
  •  Lubricant
  •  Adhesive strapping
  •  Bucket for collecting
    stomach contents
  •  3 receivers

Bed-side

  • Suction machine if the ,
    towel patient is
    unconscious
  • Hand washing facilities
    Screens
PROCEDURE FOR GASTRIC LAVAGE.
  1.  Collect the equipment needed and prepare the trolley
  2.  Explain the procedure to the patient to enable cooperativeness.
  3.  Screen the bed & close the adjacent windows to ensure privacy.
  4.  Bring the trolley to the bedside to prevent unnecessary movement.
  5.  Place a bucket on the floor at the bedside to collect wastes.
  6.  Request the patient to sit up if conscious or prone position and place a mackintosh cape & towel around the patient’s neck & bed clothes to protect the bed and the patient.
  7. Connect up the funnel to the tubing using a connector but keep the stomach tube separate until it has been passed to prevent aspiration of the fluid by the patient.
  8.  Lubricate the tube & pass it over the tongue into the pharynx & oesophagus to ease passage of the tube.
  9.  Keep on asking and encourage the patient to swallow to gain patient’s cooperation.
  10.  Connect the syringe on the tube & withdraw some stomach contents to ensure that the tube is in the stomach.
  11. Test the stomach contents with a litmus paper to confirm that you are in the stomach. acidic stomach content will turn blue litmus paper red.
  12.  Clip the stomach tube with an artery forceps & ;place it in the receiver to prevent back flow to stomach content.
  13. Apply the stomach tube with an artery forceps and place it in the receiver to prevent the flow of fluids before starting the procedure.
  14.  Open the clip and allow approximately 300mlsof fluids to run into the lower funnel until the level begins to rise to empty the stomach of the unwanted or harmful contents.
  15. Invert the funnel into the bucket to siphon out the stomach contents. Repeat the procedure until the fluid which is returning is clear. note the nature of the stomach content.
  16. Clip the stomach tube, withdraw it from the stomach evenly and quickly disconnect the tube from the funnel & tubing and place it in the receiver to prevent trauma to the patient.
  17.  Give the patient a mouth wash thanks the patient and clear away the requirements to encourage patient’s comfortability
  18.  Wash your hands and document the findings ((a). Type and amount of lavage solution used.
    (b).Appearance, odor, color, and amount of gastric return.
    (c). Patient’s tolerance to procedure.
    (d).Disposition of specimens.
  19.  Clear away all the requirements.
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