Emergency Medicine Book

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Gastric Lavage

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  1. Indications
    1. Overdose or Ingestion within 1 hour
    2. Specific overdose after 1 hour
      1. Ingested drug slows peristalsis
        1. Anticholinergics
        2. Opioids (Narcotics)
      2. Ingested drug forms Bezoar
        1. Salicylates
        2. Iron
  2. Contraindications
    1. Insignificant overdose
    2. Corrosive Ingestion
    3. Hydrocarbon Ingestion
    4. Minimally effective if given >1 hour post-ingestion
  3. Complications
    1. Aspiration
    2. Esophageal Perforation
    3. Epistaxis
    4. Electrolyte imbalance
    5. Hypothermia
  4. Preparations
    1. Activated Charcoal in aqueous solution (preferred due to lower Emesis, aspiration risk)
    2. Activated Charcoal in Sorbitol
  5. Technique
    1. Consider Endotracheal Intubation in advance
      1. Indicated for neurologic Impairment
    2. Use a large bore tube (28 French Ewald tube)
      1. Larger tubes cause considerable nasal trauma
    3. Position patient
      1. Head down
      2. Left lateral decubitus
    4. Technique
      1. Aspirate first prior to fluid lavage
      2. Instill lavage fluid into stomach
        1. Adult 100-300 cc water or normal saline per wash
        2. Child 10 cc/kg normal saline per wash
      3. Aspirate fluid back and dispose of fluid
    5. Repeat lavage
      1. Single dose is sufficient in many cases
      2. If repeated, alternate aqueous and Sorbitol charcoal preparations every 2 hours

Gastric Lavage (C0017134)

ConceptsTherapeutic or Preventive Procedure (T061)
ICD996.33
MSHD005751
EnglishGastric drainage -stomach pump, Gastric drainage by stomach pump, Gastric irrigation, Gastric Irrigations, Gastric Lavage, Gastric Lavages, Gastric washout, Irrigation of stomach, Nasogastric irrigation, Pumping stomach out, stomach lavage, Stomach pump, Stomach pumped out, stomach pumping, Stomach washout, Washing out stomach contents
Spanishdrenaje gastrico con bomba, irrigacion del estomago, irrigacion gastrica, irrigacion nasogastrica, lavado de estomago, lavado gastrico
Parent Conceptsphysically based treatment method (C0237934), Nonoperative alimentary tract irrigation, cleaning, and local instillation (C0178108), Irrigation (C0022100), Drainage procedure (C0013103), Gastric Lavage (C0017134), Procedures on the stomach (C0872393), Ambiguous concept (C1274012), Gastric drainage procedure (C0588453), Duplicate concept (C1274013), Procedure by device (C1285536)
SourcesAOD, CSP, ICD9CM, LCH, MSH, MTH, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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