Gastric lavage: definition, procedure, risks

What is gastric rinse?

Gastric lavage is a gastric emptying procedure to remove toxic substances from the digestive system. This procedure used to be commonly used as a way to treat poisoning or drug overdose in areas with limited health facilities.

In the past, health workers also performed gastric rinses to empty the patient's digestive tract before surgery. This is so that the surgeon can open the digestive tract without being disturbed by the undigested stomach contents.

Gastric lavage was once a very popular therapy in the 19th century. However, along with the development of research in the world of medicine, this method, also known as gastric irrigation, was found to be less effective.

Procedure gastric lavage may help flush out toxins along with the patient's stomach contents. However, medical personnel cannot be sure how much poison is exiting the patient's body.

Gastric lavage therapy also carries a significant risk of complications, especially in patients with airway disorders. This is because gastric lavage therapy uses a nasogastric tube that is inserted from the nose into the stomach organ.

Therefore, gastric lavage therapy is now used less frequently. Even if it is done, gastric lavage therapy should only be carried out in health facilities with medical personnel who have experience doing this procedure.

The procedure also has to be carried out within a certain period of time while the poison is still in the stomach. Past this time, the toxic substances may have entered the patient's system so that other techniques are needed to remove the toxins from the body.

What conditions require gastric lavage ?

Therapy gastric lavage it is rarely used in modern medicine. Now, gastric lavage only performed when the patient has ingested large quantities of poison or as first aid for life threatening poisoning.

This procedure is also only performed in cases of poisoning that lasted less than 60 minutes. This is the average time it takes for the body to empty the stomach contents. Once more than 60 minutes, the poison may have absorbed and carried the blood.

Gastric rinse therapy should also not be used in cases of poisoning with corrosive substances or hydrocarbons. Corrosive substances are usually found in cleaning solutions for clothes, batteries, furniture cleaners, and others.

Meanwhile, hydrocarbons are often found in gasoline, oil lamps, kerosene, and thinner paint.

Corrosive substances and hydrocarbons can erode body tissues. Attempts to forcibly remove these materials from the body through the esophagus risk causing damage to the tissues of the stomach, esophagus, and nose.

Apart from cases of poisoning with toxic substances within 60 minutes, gastric lavage therapy is also carried out if the patient has the following conditions.

The poisoning is fatal, which leaves the patient unconscious.
Poisoning is fatal due to an overdose of anticholinergic drugs within 4 hours. Anticholinergic drugs block the function of the conscious muscles and are commonly used to treat overactive bladder and obstructive pulmonary disease.
Large amounts of salicylate poisoning within 12 hours.
Iron or lithium mineral poisoning.
Paraquat poisoning, a weed-fighting ingredient.

In addition, this procedure can be performed in patients with gastrointestinal bleeding.

What is the gastric rinse procedure?

Before starting the procedure, the medical personnel must explain the entire procedure gastric lavage to the patient to facilitate cooperation with the patient. This therapy should be performed while the patient is relaxed to get the desired results.

If the patient is very agitated, the medical personnel can provide sufficient sedation to reduce the patient's anxiety. However, medical personnel also need to monitor the patient's condition and be alert to intubate if the patient's consciousness has decreased due to sedation.

The medical personnel then lay the patient's body in a position facing to the left. The patient's head is tilted and tried to be 20 degrees lower than his body position. This position will make it easier for the nasogastric tube to enter the stomach.

The medical personnel will then apply lubricant to the nasogastric tube and insert the tube into the patient's mouth. This tube is inserted until it reaches the hull in the predetermined position.

Slowly, the medical personnel will put the saline solution (water and salt) into the mouth using a large syringe connected to a tube.

The saline solution required for adults is 200 - 250 mL, while for children as much as 10-15 mL / kg body weight (maximum 250 mL).

The medic then pulled the syringe slowly to remove the saline solution from the stomach. The discharged liquid is then disposed of in a bucket near the patient's bed. The amount of rinse fluid that comes out must be the same as that which came in.

This step is done until the rinse fluid that comes out looks clear. After that, the medical personnel will continue to add activated charcoal (activated charcoal) into the patient's stomach. Activated charcoal will absorb the remaining toxins in the stomach.

The risk of complications faced by the patient

Procedure gastric lavage has a number of complications, but complications of a serious nature are quite rare. The most common risk of complications is aspiration pneumonia due to ingress of toxic substances into the lungs.

In addition, gastric lavage therapy can also cause complications in the form of:

hypoxia (low blood oxygen levels),
spasms of the larynx (muscles in the vocal cords),
slowed heart rate,
low blood sodium levels, as well
injury to the stomach due to the use of a nasogastric tube.

Gastric lavage or gastric lavage is a therapy previously used to treat poisoning. This therapy is still being used today, but its practice is no longer as popular as it used to be because of its lack of effectiveness.

If you or someone around you swallows a poisonous substance, immediately call the emergency number or go to the nearest hospital for help. Medical personnel can provide the right help according to your condition.