Gastric lavage

Indication

 * elimination of the toxic substance within 60 minutes of ingestion
 * elimination of a substance that slows down gastric motillity

Contraindication

 * ingestion of acids/alkalis
 * detergent
 * kerosene
 * a relative contraindication is a disturbance of the patient's consciousness; in such a case, the patient must be secured for lavage by endotrachial intubation

Method

 * we perform irrigation with the patient either in a stabilized position on his side (or sitting, when a small child is held on the nurse's lap)
 * we introduce a sufficiently strong cutheter with a central opening to the patient
 * we introduce the catheter by moistening the end part with a water-soluble lubricant (in an emergency with water), grasping it between the thumb and forefinger of the right hand like a pen and slowly introducing it into the stomach (the probe should be inserted approximately to the distance equal to the distance between the root of the nose and the xiphoideus process)
 * after insertion into the stomach, the stomach contents usually flow out of the probe, if this does not happen, we inject a small amount of air into the probe, and with the stethoscope placed above the epigastrium, when the probe is inserted correctly, we hear clear bubbling
 * the patient reacts to the introduction of the probe into the airways with a violent cough → the probe is then pulled out immediately
 * we perform our own irrigation by applying a physiological solution: 200 to 300 ml for adults and 10 ml/kg for children for a dose warmed to body temperature (it does not have to be sterile), the contents are then aspirated back
 * We do not use "pure" water because of the risk of hyponatremia
 * it is not advisable to exceed the recommended volumes, as a larger amount of liquid applied at once can counterproductively accelerate the passage of stomach contents into the duodenum
 * we send the first dose of lavage to toxicology, we continue with lavage until we aspirate a clear liquid
 * the effort is to make the amount of flushed fluid roughly equal to the instilled amount
 * at the end, we apply carbo animalis into the tube

Source

 * HAVRÁNEK, Jiří: Výplach žaludku. (upraveno)

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