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 clotBleeding 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
Irrigation try Adhesive tape Gastric tube Lubricating jelly 60 ml syringe with catheter tip Cetacaine spry
Bite block Normal saline Suction equipment
The Procedure Cont’ Preparatory Phase
1.Perforation of esophageal varices 2.Mallory-Weiss tear Complications 3.Aspirating of gastric content 4.Systemic hypothermia
esophageal varices Mallory-Weiss tear
Gastric Lavage 2- 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 .
Contraindications and Cautions 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.
Contraindications and Cautions Cont’ 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 Procedure 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
The Procedure Preparation Phase: • Restrain the patient. • Obtain intravenous equipment . • Assess the patient level of consciousness. • Assemble the lavage tubing and prime it with fluid. • Insert a large orogastric tube .
The Procedure • 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 .
The Procedure • Cont’ Procedural steps 4- Repeat steps 1 and 2 until the fluid return is clear of stomach content. 5- if prescribed , instill activated charcoal .
Complications • Tracheal placement of lavage tube . • Aspiration • Pneumonia . • Hypoxia . • Laryngospasm . • Fluid and electrolyte imbalance . • Vagal stimulation leading to bradycardia