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HWN Suggests

Myths of Toxicology: Gastric Lavage

Unfortunately — or fortunately, depending on your point of view — decades of research have not been able to demonstrate any clinical benefit from lavage. Multiple volunteer studies have shown that when lavage is done at 30 or 60 minutes after ingestion of a marker, 50 percent at most is recovered. After one hour, as the marker passes through the pylorus into the small intestine, the amount that can be recovered becomes even smaller. Because most toxicology patients do not present to the emergency department within an hour of ingestion, the majority would not be expected to derive even theoretic benefit from lavage.

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Articles of Interest

Gastric lavage

Previously widely favoured method that has now been all but abandoned due to lack of evidence of efficacy and risk of complications.

Gastric Lavage and Activated Charcoal Application

Gastric Lavage (GL) should not be undertaken routinely. Whether gastric lavage positively alters the morbidity or mortality of the poisoned patient, even applied shortly after the intake, is controversial.

Gastric Lavage What Is It and How It Is Done

The safety and efficacy of gastric lavage for gastrointestinal decontamination are under debate for all individuals, but especially in children. Drawbacks of this procedure include the potential for incomplete content removal; the invasive, painful, and time-consuming nature of the procedure; and the risk of complications, such as bradycardia, esophageal or gastric perforation, aspiration pneumonia, hypoxia, electrolyte imbalances, and other iatrogenic damage.

Gastric Lavage: Position Paper Update

Gastric lavage should not be performed routinely, if at all, for the treatment of poisoned patients.

NG Lavage: Indicated or Outdated?

NG lavage DOES NOT help patients in the emergency department with acute upper GI bleed and is an outdated practice.

Orogastric Lavage

Orgastric lavage is a controversial topic. In the past, it was used liberally in patients with a variety of reported toxic exposures. In recent times, it is performed rarely in the developed world, as the benefits are not clear and supportive care has significantly advanced. In spite of this change, there may still be a role for orogastric lavage in a small subset of patients presenting early after a life threatening toxic ingestion.

The Hazards of Gastric Lavage for Intentional Self-Poisoning in a Resource Poor Location

Gastric lavage as performed for highly toxic poisons in a resource-poor location is hazardous. In the absence of evidence for patient benefit from lavage, (and in agreement with some local guidelines), we believe that lavage should be considered for few patients – in those who have recently taken a potentially fatal dose of a poison, and who either give their verbal consent for the procedure or are sedated and intubated.

Resources

Obgyn Key

Gastric lavage has been performed for almost two centuries, and it yet remains a controversial procedure. In 1812, Physick used a hollow tube to lavage twin infants with laudanum (tincture of opium) overdose