Gastric lavage

The gastric lavage (also gastric lavage or gastric lifting or lifting ) is a medical procedure for emptying the stomach . Colloquially, the process is also known as "pumping out the stomach".

indication

Gastric lavage, which used to be frequently performed, is now rarely used because there is little evidence of its effectiveness in poison elimination and of its prognostic benefit.

The most common use is to remove orally ingested toxic substances such as household chemicals or drugs that have been taken accidentally or with suicidal intent. The flushing out of these substances via a hose system is intended to prevent the nasopharynx and esophagus from repeatedly coming into contact with the pollutant - as with induced vomiting .

In addition, irrigation can be performed for diagnostic reasons, for example if gastric bleeding is suspected.

Contraindications

Gastric lavage is contraindicated in unconscious patients without a secure airway and when there is a risk of bleeding or injury to the gastrointestinal tract. Relative contraindications are the ingestion of caustic substances or hydrocarbons , but also poisoning, which can be treated well with an antidote or other less risky methods.

You should i. d. Usually no longer be carried out if the poison ingestion was more than an hour ago.

Risks

The main complication risk is the one aspiration pneumonia , mainly in the absence of protection of the respiratory tract or ingestion of hydrocarbons threatens. Further risks are laryngospasm with hypoxia , bradycardia , water intoxication with hyponatremia, or injury to the esophagus or stomach.

procedure

A large diameter tube is passed through the mouth and into the stomach. Through this the stomach contents are flushed out. The rinsing liquid, usually lukewarm saline solution , is not only introduced into the stomach through the tube in individual portions of 150 to 300 ml up to a total amount of at least 20 liters, but is also removed in this way. On the one hand, this prevents the fluid from getting into the airways and the patient to be treated aspirates , and on the other hand, it avoids contact of the irrigation fluid with the esophagus , as would be the case with vomiting . In addition, this procedure allows the amount of liquid introduced and discharged to be balanced.

Usually it is very uncomfortable for the person on whom such a measure is carried out. Those affected are not always fully responsive, as the substances ingested have often already passed into the bloodstream and affect the body. As it is not always known which substances have been taken, people are reluctant to administer sedatives. The hose is usually not particularly hard. To prevent the hose from being bitten off, a teething ring is placed in the mouth through which the hose is passed. During the flushing, the affected person has a strong need to swallow, occasionally vomiting may occur past the tube. If the stomach has been rinsed until only clear liquid can be drawn off, activated charcoal and Glauber's salt are often added to neutralize toxins that have already migrated into the intestines. Then the hose is removed.

In almost all cases, the ingestion of any pollutants leads to hospitalization, as the monitoring of body functions must be ensured. If the substances ingested are known, the poison information center is consulted and an antidote is administered if possible .

Systems

In emergency rooms of hospitals special flushing systems are kept ready. Two large syringes are attached to a double-lumen tube. While the rinsing liquid is introduced via one, the other sucks off the gastric mixture again. This will make the process easier. It is also possible to use traditional systems. Here liquid is introduced through a hose and then sucked off. The flushed out liquid can be examined, whereby the foreign matter can be determined.

Veterinary medicine

In veterinary medicine , gastric elevation plays a role especially in horses . Due to anatomical features (small stomach with strong kinking of the stomach entrance , long soft palate ) horses can hardly vomit . If you consume food that swells up quickly (e.g. sugar beet pulp ), your stomach will quickly become overloaded , which can be life-threatening. Rinsing out the stomach through a nasogastric tube is one way of conservatively eliminating this acute disorder.

Individual evidence

1. ↑ Position Paper: Gastric Lavage. In: Journal of Toxicology: Clinical Toxicology. 42, 2004, p. 933, doi : 10.1081 / CLT-200045006 .

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !