Gastric lavage

Definition
• Irrigation or washing out of stomach
• It is a rare procedure
 Purpose
• Babies born by cesarean section
• Severely asphyxiated baby
• Meconium stained liquor
• Polyhydraminos, single umbilical artery,
Hypoplastic small for dates babies, Infants of
diabetic mother (to rule out or confirm the
patency of esophagus to rule out esophageal
atresia and to assess the volume of gastric
contents as n aid t the diagnosis of upper GI tract
obstruction)
 Articles
• A clean tray containing
• Towel
• NG tube with Y connector
• Syringes for aspiration(2,5,10ml) and
instillation(20,50ml) of infusates
• NS 0.9%-20ml
• Xylocaine gel
• Stethescope
• Kidney tray
 Procedure
• Measure length of tube insertion by
positioning the tube from the nares or mouth
to the ear, and to the umbilicus.
• If the tube is obstructed, flush first with water
• Left lateral head-down position with a 20-
degree table tilt (Trendelenburg).
• Measure the length of insertion from the
mouth to the ear to the epigastrium; mark it
on the tube with an indelible pen.
• Lubricate tube with gel.
• Insert the tube through the mouth midline after
lubrication.
• Advance the tube to the length mark.
• To check position, aspirate tube with 10-mL
catheter tip syringe; gastric aspirate confirms
positioning in stomach.
• Insert small amount of air ( mL) via orogastric
tube while listening to the epigastric area with
stethoscope.
• If unsure about tube position, obtain a chest
film to confirm tube position.
• Secure tube to the face with tape.
• After insertion of the nasogastric/oro-gastric
tube tube, attach the lavage tubings to the
patient’s gastric tube, then begin to irrigate
stomach with saline.
• Use 10–15-mL/kg aliquots of warm (38 °C)
isotonic saline.
• After specified amount of infusates , aspirate
gastric contents by clamping the irrigant
solution’s tubing and aspirate or turning on
suction source.
Or
• Inject NaCl into the stomach through the tube
and leave for 2-3mins.
• Lavage should continue until the effluent is
clear. Warm fluids avoid hypothermia.
Respiratory status, and patient level of
consciousness.
• Monitor vital signs,
• The volume of lavage fluid returned should be
approximate the amount of fluids given.
• Monitor and document the nature of aspirate
contents.
 Complications
• aspiration pneumonia(most dangerous)
• Laryngospasm
• Hypoxia
• Bradycardia
Notes