Gastric lavage - Revision history

Blsimpso at 13:33, 29 June 2021

2021-06-29T13:33:41Z

← Older revision		Revision as of 13:33, 29 June 2021
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	*[[Activated Charcoal]]		*[[Activated Charcoal]]
	*[[Whole Bowel Irrigation]]		*[[Whole Bowel Irrigation]]

			==External Links==

			===Videos===
			{{#widget:YouTube\|id=7VVCmCkqd9Y}}


	==References==		==References==

Kearny89: /* Indications */

2019-06-11T00:18:43Z

Indications

← Older revision		Revision as of 00:18, 11 June 2019
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	*Large [[salicylate]] poisonings presenting within 12 hours		*Large [[salicylate]] poisonings presenting within 12 hours
	*[[Iron toxicity\|Iron]] or [[lithium toxicity]]		*[[Iron toxicity\|Iron]] or [[lithium toxicity]]
			*Paraquat ingestion (common in developing world)

	==Contraindications==		==Contraindications==

ClaireLewis at 21:07, 27 May 2019

2019-05-27T21:07:32Z

← Older revision		Revision as of 21:07, 27 May 2019
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	*Life-threatening poisoning (or history is not available) and unconscious presentation (eg [[Colchicine]])		*Life-threatening poisoning (or history is not available) and unconscious presentation (eg [[Colchicine]])
	*Life-threatening poisoning and presentation within 1 hour		*Life-threatening poisoning and presentation within 1 hour
	*Life-threatening poisoning with drug with anticholinergic effects and presentation within 4 hours		*Life-threatening poisoning with drug with [[anticholinergic]] effects and presentation within 4 hours
	*Ingestion of sustained release preparation of significantly toxic drug		*Ingestion of sustained release preparation of significantly toxic drug
	*Large salicylate poisonings presenting within 12 hours		*Large [[salicylate]] poisonings presenting within 12 hours
	*Iron or lithium ~~poisoning~~		*[[Iron toxicity\|Iron]] or [[lithium toxicity]]

	==Contraindications==		==Contraindications==
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	==Technique<ref>https://litfl.com/gastric-lavage/</ref>==		==Technique<ref>https://litfl.com/gastric-lavage/</ref>==
	#Intubate patient		#[[Intubate]] patient
	#Place patient in left lateral decubitus position with head 20 degrees downward		#Place patient in left lateral decubitus position with head 20 degrees downward
	#Externally measure length of lavage tube needed to reach stomach		#Externally measure length of lavage tube needed to reach stomach
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	*Aspiration of gastric contents (3% of patients)		*Aspiration of gastric contents (3% of patients)
	*[[Esophageal Rupture]] (rare)		*[[Esophageal Rupture]] (rare)
	*Profound bradycardia, cardiac arrest, and asystole may be precipitated by lavage in poisonings with propranolol, calcium channel blockers and other drugs affecting cardiac conduction		*Profound [[bradycardia]], cardiac arrest, and asystole may be precipitated by lavage in poisonings with [[propranolol]], [[calcium channel blockers]] and other drugs affecting cardiac conduction
	**Atropine should be used to block the increased vagal tone associated with the procedure in these situations		**[[Atropine]] should be used to block the increased vagal tone associated with the procedure in these situations

	==See Also==		==See Also==

SLuckettG: /* Technique */

2019-05-15T23:33:51Z

Technique

← Older revision		Revision as of 23:33, 15 May 2019
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	*A highly efficient antidote such as [[NAC]] is available		*A highly efficient antidote such as [[NAC]] is available

	==Technique==		==Technique<ref>https://litfl.com/gastric-lavage/</ref>==
	#~~Protect airway (endotracheal intubation) if~~ patient ~~is stuporous or comatose~~		#Intubate patient
	#~~Select the correct~~ tube ~~size~~		#Place patient in left lateral decubitus position with head 20 degrees downward
			#Externally measure length of lavage tube needed to reach stomach
			#Lubricate appropriately sized lavage tube and gently pass through esophagus to stomach
	#*Adults and adolescents: 36–40 French		#*Adults and adolescents: 36–40 French
	#*Children: 22–28 French		#*Children: 22–28 French
	#~~Lie patient in the left lateral decubitus position.~~		#Confirm placement of tube
	#*~~The pylorus points upward in this orientation and it helps prevent the poison from passing through the pylorus during the procedure.~~		#*Aspiration of gastric contents
	~~#Measure the length~~ of ~~the tubing. The length should allow the most proximal tube opening to be passed beyond the lower esophageal sphincter.~~		#*Auscultation of air over the epigastrium
	#~~Insert the tubing and confirm that the distal end~~ of the ~~tube is in the stomach.~~		#*XR
	#~~Withdrawal any material present in the stomach and immediately install activated charcoal if the poison is possibly adsorbed by charcoal.~~		#Using funnel or lavage syringe, aspirate any stomach contents
	#~~In adults, 250mL of a room temperature saline lavage solution is instilled via a~~ funnel or lavage syringe.		#Gently instil 200 - 250 mL warned saline into the stomach for adults, or 10 - 15 mL/kg for children (to maximum 250 mL)
	#~~In children~~, 10 to 15 mL/kg ~~is instilled~~ to a maximum of 250 mL.		#Allow instilled saline to flow out of tube and into bucket near bed
	#~~Orogastric lavage should continue for at least several liters in an adult~~ and ~~for at least 0.5 to 1.0 L in a child or~~ until ~~no particulate matter returns and the~~ effluent ~~lavage solution~~ is clear.		#Repeat instillation and drainage until effluent is clear
	#~~After orogastric lavage~~, ~~the same tube can instill another dose of~~ activated charcoal if indicated		#Once effluent is clear, may instil activated charcoal if indicated

	==Complications==		==Complications==

SLuckettG: /* Background */

2019-05-15T23:00:10Z

Background

← Older revision		Revision as of 23:00, 15 May 2019
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	==Background==		==Background==
	*~~Of limited~~/~~infrequent utility~~		*Gastrointestinal decontamination technique meant to empty stomach of toxic substances<ref>https://litfl.com/gastric-lavage/</ref>
			*Once widely used, now rarely applied
			**Little evidence for efficacy
			**High risk of complications
	*Almost never used in conscious and cooperative patients		*Almost never used in conscious and cooperative patients
	*~~Restricted to poisonings where benefits over~~ oral [[~~Activated Charcoal~~]] ~~are~~ likely		**Especially lacks utility when oral [[activated charcoal]] is likely to be successful

	==Indications==		==Indications==

Neil.m.young: Reverted edits by Neil.m.young (talk) to last revision by Alvarez13

2017-03-01T16:17:56Z

Reverted edits by Neil.m.young (talk) to last revision by Alvarez13

← Older revision		Revision as of 16:17, 1 March 2017
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	#In adults, 250mL of a room temperature saline lavage solution is instilled via a funnel or lavage syringe.		#In adults, 250mL of a room temperature saline lavage solution is instilled via a funnel or lavage syringe.
	#In children, 10 to 15 mL/kg is instilled to a maximum of 250 mL.		#In children, 10 to 15 mL/kg is instilled to a maximum of 250 mL.
	#Orogastric lavage should continue for at least several liters in an adult and for at least 0.5 to 1.0 ~~left~~ in a child or until no particulate matter returns and the effluent lavage solution is clear.		#Orogastric lavage should continue for at least several liters in an adult and for at least 0.5 to 1.0 L in a child or until no particulate matter returns and the effluent lavage solution is clear.
	#After orogastric lavage, the same tube can instill another dose of activated charcoal if indicated		#After orogastric lavage, the same tube can instill another dose of activated charcoal if indicated

Neil.m.young: Text replacement - " L " to " left "

2017-02-28T00:49:12Z

Text replacement - " L " to " left "

← Older revision		Revision as of 00:49, 28 February 2017
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	#In adults, 250mL of a room temperature saline lavage solution is instilled via a funnel or lavage syringe.		#In adults, 250mL of a room temperature saline lavage solution is instilled via a funnel or lavage syringe.
	#In children, 10 to 15 mL/kg is instilled to a maximum of 250 mL.		#In children, 10 to 15 mL/kg is instilled to a maximum of 250 mL.
	#Orogastric lavage should continue for at least several liters in an adult and for at least 0.5 to 1.0 L in a child or until no particulate matter returns and the effluent lavage solution is clear.		#Orogastric lavage should continue for at least several liters in an adult and for at least 0.5 to 1.0 left in a child or until no particulate matter returns and the effluent lavage solution is clear.
	#After orogastric lavage, the same tube can instill another dose of activated charcoal if indicated		#After orogastric lavage, the same tube can instill another dose of activated charcoal if indicated

Alvarez13 at 05:14, 8 November 2016

2016-11-08T05:14:23Z

← Older revision		Revision as of 05:14, 8 November 2016
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	==Indications==		==Indications==
	*Life-threatening poisoning (or history is not available) and unconscious presentation		*Life-threatening poisoning (or history is not available) and unconscious presentation (eg [[Colchicine]])
	*Life-threatening poisoning and presentation within 1 hour		*Life-threatening poisoning and presentation within 1 hour
	*Life-threatening poisoning with drug with anticholinergic effects and presentation within 4 hours		*Life-threatening poisoning with drug with anticholinergic effects and presentation within 4 hours

Ostermayer: Text replacement - " pts" to " patients"

2016-06-21T16:49:44Z

Text replacement - " pts" to " patients"

← Older revision		Revision as of 16:49, 21 June 2016
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	==Complications==		==Complications==
	*Increase gastric delivery of tablets into the small bowel		*Increase gastric delivery of tablets into the small bowel
	*Aspiration of gastric contents (3% of ~~pts~~)		*Aspiration of gastric contents (3% of patients)
	*[[Esophageal Rupture]] (rare)		*[[Esophageal Rupture]] (rare)
	*Profound bradycardia, cardiac arrest, and asystole may be precipitated by lavage in poisonings with propranolol, calcium channel blockers and other drugs affecting cardiac conduction		*Profound bradycardia, cardiac arrest, and asystole may be precipitated by lavage in poisonings with propranolol, calcium channel blockers and other drugs affecting cardiac conduction

Ostermayer: Text replacement - "Category:Tox" to "Category:Toxicology"

2016-03-22T16:22:40Z

Text replacement - "Category:Tox" to "Category:Toxicology"

← Older revision		Revision as of 16:22, 22 March 2016
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	[[Category:Procedures]]		[[Category:Procedures]]
	[[Category:~~Tox~~]]		[[Category:Toxicology]]