Whole bowel irrigation: Difference between revisions
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==Indications<ref>Thanacoody, R, et al. Position paper update: Whole bowel irrigation for gastrointestinal decontamination of overdose patients. Clin Toxicol. 2015; 53(1):5-12. doi: 10.3109/15563650.2014.989326.</ref>== | ==Indications<ref>Thanacoody, R, et al. Position paper update: Whole bowel irrigation for gastrointestinal decontamination of overdose patients. Clin Toxicol. 2015; 53(1):5-12. doi: 10.3109/15563650.2014.989326.</ref>== | ||
*Sustained or delayed-release formulations | |||
*Agents with potential for bezoar formation | |||
*Iron and other heavy metals | |||
*Paint chips containing [[Lead]] | |||
*[[Lithium overdose]] (extended-release tablets) | |||
*Drugs carried by body packers | |||
==Contraindications== | ==Contraindications== | ||
*Preceding diarrhea | |||
*Ingestion of substances expected to result in significant diarrhea (except heavy metals) | |||
*Bowel obstruction (as evidenced by lack of bowel sounds) | |||
==Procedure== | ==Procedure== | ||
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==Complications== | ==Complications== | ||
*Bloating, cramping, rectal irritation (from frequent bowel movements) | |||
==See Also== | ==See Also== | ||
Revision as of 14:33, 25 August 2015
Indications[1]
- Sustained or delayed-release formulations
- Agents with potential for bezoar formation
- Iron and other heavy metals
- Paint chips containing Lead
- Lithium overdose (extended-release tablets)
- Drugs carried by body packers
Contraindications
- Preceding diarrhea
- Ingestion of substances expected to result in significant diarrhea (except heavy metals)
- Bowel obstruction (as evidenced by lack of bowel sounds)
Procedure
- Give polyethylene glycol via NGT or PO (if pt tolerates) until rectal effluent is clear
- Adult: 1.5-2 L/hr
- Peds 6-12yr: 1 L/hr
- Peds <6yr: 0.5 L/hr
- Give ondansetron or metoclopramide as needed for N/V
Polyethylene glycol dosing
Can be given orally or by NG tube
- 20-40 mL/kg/hr in young children
- 2L/hr in adults
Continue irrigation until the rectal effluent is clear
Complications
- Bloating, cramping, rectal irritation (from frequent bowel movements)
See Also
References
- ↑ Thanacoody, R, et al. Position paper update: Whole bowel irrigation for gastrointestinal decontamination of overdose patients. Clin Toxicol. 2015; 53(1):5-12. doi: 10.3109/15563650.2014.989326.