GASTRIC LAVAGE

Prepared by: Salwa Maghrabi Teacher Assistant Nursing Department

OUTLINES Definition of gastric lavage . Gastric lavage for gastrointestinal

bleeding: Indications .Contraindications .The procedure .Complications.

CONT’ OUTLINES Gastric lavage for removal of

toxic substance :Indications Contraindications .Procedure .Complications .

OBJECTIVES Define gastric lavage .Enumerate the indications of

gastric lavage .Mansion the contraindications

and cautions of gastric lavage .Apply the procedure .

Definition of gastric lavage

Therapeutic procedure for washing out of the stomach with sterile water or normal saline .

Gastric lavage 1 -Gastrointestinal Bleeding

Contraindications and cautions

1.Knock the clot Bleeding Shock

2.Absent gag reflex.

3.Perforated viscus

Contraindications and Cautions Cont’

4 .Use of ice.

5. Confused , obtunded , sedated or resisting the procedure patient

The Procedure

The Procedure Cont ’

Gastric tubeIrrigation try Adhesive

tape

Lubricating jelly Cetacaine spry

60 ml syringe with catheter tip

Normal saline Bite block

Suction equipment

The Procedure Cont ’Preparatory Phase

The Procedure Cont ’

The Procedure Cont ’

2.Mallory-Weiss tear

3.Aspirating of gastric content

4.Systemic hypothermia

1.Perforation of esophageal

varices

Complications

esophageal varices

Mallory-Weiss tear

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Gastric Lavage2 -Removal of Toxic Substance

Used for removal of toxic substance or poisons from the stomach .

Most effective if the procedure is completed within 60 min. of ingestion .

1- Ingest corrosive material or sharp objects.3- Ingest substance that may cause seizures or

abrupt central venous system depression.4- Patient at risk for gastrointestinal bleeding or

perforating secondary to pathology , recent surgery.

5- Not confirm the benefits of gastric lavage.

6- Increase the chance of drug absorption.8- there is no end clear point for the procedure .9- the traditional method of installing air while

auscultating over the epigastrum to confirm the placement is not reliable.

The Equipment :1- Cardiac and pulse oximetry monitoring .2- Orogastric tube :

• 36 to 40 Fr for adult .• 24 to 32 Fr for children .

3- Lavage tubing setup.4- Tubing clamp.5- Activated charcoal

Cardiac monitor Pulse oximetry

Activated charcoale

Preparation Phase: 1.Restrain the patient.2.Obtain intravenous equipment .3.Assess the patient level of

consciousness.4.Assemble the lavage tubing and

prime it with fluid.5.Insert a large orogastric tube .

Procedural steps 1- Aspirate the stomach content .2- Unclamp the tubing between the fluid and the

patient ,and instill 200- 300 ml of warmed fluid.

3- Unclamp the tubing between the patient and the drainage source and allow the fluid to drain into the bucket by use of gravity .

Cont’ Procedural steps 4- Repeat steps 1 and 2 until the fluid return is

clear of stomach content.5- if prescribed , instill activated charcoal .

1. Tracheal placement of lavage tube .2. Aspiration 3. Pneumonia .4. Hypoxia .5. Laryngospasm .6. Fluid and electrolyte imbalance .7. Vagal stimulation leading to bradycardia

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