INDICATIONS FOR GASTRIC LAVAGE:

Acute presentation (within 12 hours) and:

1. Evident or high risk of morbidity or mortality:
Beta-blockers
Calcium channel blockers
Chloroquine
Colchicine
Cyanide
Heavy metals
Heterocyclic antidepressants
Iron
Paraquat
Salicylates
Selenious acid
2. Poor absorption by activated charcoal
Heavy metals
Iron
Lithium
Toxic alcohols
3. Evidence of formed concretion
Enteric-coated preparations
Iron
Phenothiazines
Salicylates
4. Ineffective or no antidotal therapy available
Calcium channel blockers
Colchicine

Paraquat
Selenious acid
Contraindications to Performing a Gastric Lavage:
Abnormal or absent pharyngeal/upper gastrointestinal anatomy
Active or substantial antecedent vomiting
Caustic ingestion
Coagulopathy
Decreased mental status
Inactive or diminished airway reflexes
Large pills
Large or sharp foreign body
Nontoxic or minimally toxic ingestion
Significant aspiration risk (e.g., hydrocarbon ingestion)

COMPLICATIONS :
Cardiac dysrhythmias
Electrolyte abnormalities
Empyema
Esophageal tear or perforation
Gastric perforation
Hypothermia
Laryngospasm
Nasal, oral, or pharyngeal injury
Pneumothorax
Pulmonary aspiration