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

Indications
Control acute upper GI hemorrhage
Remove irritating gastric secretion
Help evacuate clots
Obtain information on the site and rate of
bleeding

Contraindications and cautions

1.Knock the clot
Shock

Bleeding

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 equipment
Gastric tube
Irrigation tray

Adhesive tape
Lubricating jelly
Cetacaine spry or xilocin spry

The Procedure Cont

The equipment cont

60 ml catheter tip syringe
Tincture of benzoin
Normal saline or tap water

Bite block
Suction equipment

Irrigation try
Gastric tube

Lubricating jelly
Cetacaine spry

Adhesive
tape

60 ml syringe with
catheter tip

Bite block
Normal saline

Suction
equipment

The Procedure Cont

Preparatory Phase
1 Protect the patient airway
2 Suction equipment available

3 Cardiac monitor and pulse oximetry

4 Insert large broe intravenous line
5 Insert gastric tube
6 Patient position

The Procedure Cont

Implementation Phase
1. Pour normal saline or tap water into an irrigation
container
2. Draw up the solution 200to300 ml and installed to
the stomach through gastric tube

3. Aspirate the solution

The Procedure Cont

Implementation Phase Cont

4. Repeat until Active bleeding stop .

5. Measuring and documenting .

1.Perforation
of esophageal
varices

2.MalloryWeiss tear

Complications

3.Aspirating
of gastric
content

4.Systemic
hypothermia

Mallory-Weiss
tear

esophageal
varices

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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 .

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

Pulse oximetry

Cardiac monitor

Activated
charcoale

Preparation Phase:
1.
2.
3.
4.

Restrain the patient.

Obtain intravenous equipment .
Assess the patient level of consciousness.
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.
2.
3.
4.
5.
6.
7.

Tracheal placement of lavage tube .

Aspiration
Pneumonia .
Hypoxia .
Laryngospasm .
Fluid and electrolyte imbalance .
Vagal stimulation leading to bradycardia

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