Gastric lavage is a technique that allows to wash the inside of the stomach, removing the content that has not yet been absorbed by the body. Thus, this procedure is generally used in cases of ingestion of toxic or irritating substances, for which there is no antidote or no other form of treatment. Understand what to do immediately in case of poisoning.
Ideally, gastric lavage should be done within 2 hours of ingesting the substance and must be done at the hospital by a nurse or other health professional trained to avoid complications such as aspiration of fluids into the lung.
When is indicated
In most cases, gastric lavage is used to clean the stomach in case of ingestion of high doses of substances or drugs that can be toxic to the body, such as:
- Antihypertensive agents, such as propranolol or verapamil; Tricyclic antidepressants, such as Amitriptyline, Clomipramine or Nortriptyline.
However, not all cases of exaggerated ingestion of a substance need gastric lavage. The best way to find out if this procedure is really necessary, and what to do to reduce the risk of complications, is to consult the Anti-Poison Information Center, on 0800 284 4343.
Less frequently, gastric lavage can also be used to empty the stomach before diagnostic tests, such as endoscopy, for example. Find out more about endoscopy and when it is done.
Step-by-step gastric lavage
Gastric lavage needs to be done at the hospital by a nurse or other trained health professional. During the procedure, the professional must follow the following steps:
- Insert a gastric tube through the mouth or nose to the stomach; Lay the person down and turn him / her to the left side, to facilitate the emptying of the stomach; Connect a 100 mL syringe to the tube; Remove the contents of the stomach using the syringe; Place 200 to 300 mL of saline heated to 38ºC inside the stomach; Remove all the contents of the stomach again and re-insert 200 to 300 mL of serum; Repeat these steps until the contents removed from the stomach are clear.
Normally, to obtain a correct gastric lavage, it is necessary to use up to 2500 mL of saline during the entire procedure. In the case of children, the amount of serum needed can vary between 10 to 25 mL of serum for each kg of weight, up to a maximum of 250 mL.
After washing, it is also advisable to insert between 50 to 100 grams of activated charcoal in the stomach, to prevent the absorption of any remaining substance that is still left in the stomach. In the case of children, this amount should be only 0.5 to 1 gram per kg of weight.
Possible washing complications
Although gastric lavage is a life-saving technique for someone who has taken a very high dose of a toxic substance, it can also cause some complications. The most common is the aspiration of fluid into the lungs, which can end up causing pneumonia, for example.
To avoid this risk, the procedure must be done by a nurse and in a sitting position, since there is less chance of the liquid passing through the airways. Other complications that can happen include gastric bleeding, spasm of the larynx or perforation of the esophagus, which need to be treated as soon as possible in the hospital.
Who should not do
The decision to perform gastric lavage or not should always be evaluated by a medical team, however, gastric lavage is contraindicated in cases such as:
- Unconscious person without intubation; Ingestion of corrosive substances; Presence of thick esophageal varices; Excessive volume of vomiting with blood.
In addition, if surgery has been performed on the gastrointestinal tract, washing also needs to be well evaluated, as there is a greater risk of complications.
