Gastric lavage

Description:

The gastric lavage is the method of treatment based on the principle of communicating vessels. It is made for removal from a stomach of substandard food, poisons. This procedure is especially important at a pre-hospital stage.
Necessary equipment for a gastric lavage
Wide (diameter of 10-12 mm, 28-36F) gastric tube 1-1,5 m long. The gastric tube has to correspond to physical data of the patient. The most convenient reference point — diameter of the nasal course. Everything that enters a nose, quietly will pass in a gullet.
Funnel with a capacity about 1 l and a gleam of a tubular part not less than 8 mm for putting on on a gastric tube;
Ladle (mug) for a water nalivaniye in a funnel.
Bucket with tap water of room temperature.
Basin for plum of washing waters.
Oil-cloth apron (2 pieces), towel, gloves.

All accessories to a gastric lavage (tube, funnel, tip) are stored in the soldered cellophane package of date about sterilization terms.
Equipment of a gastric lavage

The gastric lavage is technically easy, but, as well as any medical manipulation, requires attention and skill. The gastric lavage belongs to sisterly manipulations, however during execution of the procedure participation of the doctor or constant control from its party is necessary. Besides, it is more convenient to do a gastric lavage together.
The patient sits down on a chair, having placed legs that between legs it was possible to put a basin. Dentures delete. The breast of the patient is closed an oil-cloth apron. The patient should not squeeze a probe gleam teeth.

The end of a gastric tube before the procedure should be oiled liquid (at its absence — to moisten with water), and to put on a funnel the opposite end. At the raised gag reflex administration of atropine is useful.

The sister, having also put on an apron, costs on the right and several behind from the patient who has to open a mouth widely. The Bystry movement to enter the probe for a language root. Further the patient is asked to breathe a nose and to do the deglutitory movements during which the probe is carefully advanced on a gullet. The probe is entered at length equal to distance from a navel to cutters of the patient plus 5–10 cm.

At introduction of the probe to the first tag on it (45-46 cm from the end) lower a funnel. The funnel should be held the wide party up, but not from top to bottom. If the probe in a stomach, then comes to a funnel gastric contents. Otherwise the probe is advanced further. The first portion needs to be collected for the analysis in a separate small bottle. After that begin actually a gastric lavage.

When the funnel becomes empty, it is again smoothly lowered over a basin up to the height of knees of the patient, holding a funnel the wide party up (and not from top to bottom as it is often represented in drawings) where stomach contents pour out.

As soon as liquid ceases to follow from a funnel, it is filled with solution again. The procedure is repeated to pure washing water. On average spend 10-20 l of water for a gastric lavage.

After a gastric lavage it is recommended for sorption of the poison which remained in a stomach via the probe to enter an enterosorbent (absorbent carbon, 1 g/kg) and laxative (preference should be given to a liquid paraffin). Efficiency often offered as laxative salts of magnesium (for example, magnesium sulfate of 25-30 g) raises doubts since they act insufficiently quickly (in 5-6 hours), besides salts of magnesium are contraindicated at a renal failure. The liquid paraffin (100-150 ml) is not soaked up in intestines and actively connects fat-soluble toxic substances (for example, a dichloroethane). Administration of laxatives is contraindicated at poisoning with the cauterizing liquids.

Upon termination of a gastric lavage disconnect a funnel, the bystry, but smooth movement take the probe through the towel brought to the patient's mouth. Everything (including washing waters) is disinfected. The gastric tube after disinfection will be sterilized (if the probe is reused) or utilized (if the probe of single use is used).