What is Gastric lavage ?

Gastric lavage, also commonly called stomach pumping or gastric irrigation, is the process of cleaning out the contents of the stomach. It has been used for over 200 years as a means of eliminating poisons from the stomach. Gastric lavage involves the passage of a tube (such as an Ewald tube) via the mouth or nose down into the stomach followed by sequential administration and removal of small volumes of liquid.

- Useful within three hours after ingestion of the poison

PROCEDURE FOR GASTRIC LAVAGE

  • A stomach tube (Ewald's tube or Boa's tube) or ordinary, soft, noncollapsible  rubber tube of length 1.5 meter and diameter 1 cm with a glass funnel attached on one end and a mark at 50 cm from the other end (which should be rounded with lateral openings) is used
  • Denture must be removed and mouth gag should be placed
  • Patient should be in left lateral position or head hanging over the edge of the bed and face supported by assistant.
  • The end is lubricated with olive oil or glycerine and is slowly passed into mouth and through the pharynx and oesophagus into the stomach till the 50 cm marking.
  • About 1/4th liter of lukewarm water should be passed through the funnel held high above the patient's head
  • When funnel is empty, compress the tube below the funnel between finger and thumb and lower it below the level of stomach. the contents will be emptied by siphoning action when the pressure is released.
  • This first stomach contents should be preserved for chemical analysis.


Gastric lavage can be done with:
- water
- 1:5000 Potassium Permanganate (KMnO4)
- 5 % Sodium Bicarbonate (NaHCO3)
- 4 % Tannic acid
- 1 % Sodium or potassium iodide
- 0.9 % saline

Repeat the wash with 1/2 liter suitable solution till clear and odorless fluid comes out.

CONTRAINDICATIONS OF GASTRIC LAVAGE: 
Absolute Contraindication:
Corrosive poisoning except for carbolic acid

Relative Contraindication:
i. Convulsant poisoning
ii. Comatose patient
iii. Volatile poison
iv. upper GIT disease
v. Patient with marked hypothermia and hemorrhagic diathesis



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