Gastric lavage is a therapeutic procedure used to wash out the stomach with sterile liquids mainly to remove ingested poisons, prepare for endoscopy, or diagnose and manage gastric hemorrhage. The procedure involves inserting a lavage tube, administering a rinsing solution, and aspirating stomach contents, while monitoring the patient's vital signs and respiratory status for potential complications like aspiration pneumonia or mechanical injuries. Precautions and specific antidote usage depend on the type of poisoning and must be followed to ensure patient safety.

1. Gastric Lavage
(Stomach Wash)

2. Definition
Therapeutic procedure for washing out of the stomach with sterile water or normal saline or
using antidote

3. Purpose
For urgent removal of ingested substance to decrease systemic absorption.
To empty the stomach before endoscopic procedure
To diagnose gastric hemorrhage and to arrest hemorrhage.

4. INDICATIONS
Ingested poison
Cleaning of stomach before upper GI endoscopy
To collect samples from stomach for analysis
To relieve pressure in blocked intestines
Evacuate clots
CONTRAINDICATIONS
Depressed state of consciousness
Seizure
Corrosive poisoning
Acid and alkali poisoning
Ingestion of hydrocarbon or petroleum distillates
Patient at risk of gastric perforation or bleeding

5. Principle
Siphon
The siphon is a simple apparatus consisting of a
bent tube having a short arm and a long arm.
The short arm of the siphon is placed in the liquid to be emptied and
the long arm is carried down to the lower level. The air must be first
removed from the siphon tube before it operates. When air is
removed, fluid flows because of the different pressure in the two
arms.

6. Equipment

7. Lavage tube

8. Solutions used
Plain water (Plain water is particularly useful when the poison is unidentified)
Normal saline
Weak solution of sodium bicarbonate or boric acid in corrosive poisoning
Specific antidotes: if the person is identified. There are three types of antidotes.
a. Physical antidotes: it is the one that mixes with the poison and dilutes the poison or prevents its
absorption or soothes and protects the mucus membrane.
b. Chemical antidotes: These react with the poison and neutralize it.
c. Physiologic antidotes: these have a systemic effect opposite to that of the poison. If the poison has
depressive action, the antidote has stimulating effect on the body.

9. Procedure
Preparatory phase
Protect the patient airway
Keep the suction equipment ready
Cardiac monitor and pulse oximetry
IV line(20 Gauge)
Consent
Patient position (Semi Fowler’s position or left lateral with slightly elevated head)
Check baseline vitals with abdominal girth
Check gag reflex

10. Implement phase
Hand hygiene
Insert lavage tube (same principle of NG tube insertion)
Pour normal saline or tap water or antidote mixture into the irrigation container through or
funnel
Introduce 200 to 300 ml of irrigating solution via lavage tube
Aspirate the content with syringe or by gravity
If needed send the sample to lab for gastric analysis
Repeat the procedure until the goal is achieved
Measure the amount, color and consistency

11. After care
Do not leave the patient alone during gastric lavage.
Monitor vital signs, respiratory status, and the patient’s level of consciousness
continuously and report acute changes immediately to the provider.
Perform hand washing
Record all the things you’ve done, the time of procedure started until the time it
ended, assessment before and after the procedure, amount of fluid color odor of
gastric contents, and the collected specimen in the nurses’ notes.

12. Important nursing aspects
Monitor vitals
Watch for hypotension
Check airway and breathing
Watch for aspiration
Strict hand hygiene
Avoid introducing air into the stomach
Use clamp if needed

13. Complications
Aspiration pneumonia
Laryngospasm
Hypoxia and hypercapnia
Bradycardia
SOB
Mechanical injury to the throat, esophagus, and stomach.

14. Thank you