Gastric lavage
Gastric lavage is a method in which the contents of the stomach are removed from the stomach through the esophagus: stagnant, fermented liquid( food), inadequate food or poisons;blood;bile.
Flushing is used with both medical and diagnostic purposes for:
• stomach diseases - atony of the wall of the stomach or duodenum;
• poisoning with food substances, various poisons;
• obstruction of the intestine: paresis, mechanical obstruction.
For gastric lavage, a simple device consisting of a 0.5-1.0 l glass funnel with 100 cm dividers, connected to a thick-walled rubber tube 1-1.5 m long and about 1 to 1.5 cm in diameter, is used.
Washing is carried out at room temperature( 18-20 ° C).In addition to water, you can use a 2% solution of sodium hydrogen carbonate, a light solution of potassium permanganate.
The patient sits on a chair, leaning against his back, leaning his head slightly forward. Next, near the feet, put a basin or a bucket. The patient's chest is covered with an oilcloth apron, a sheet and warned that the introduction of the probe can cause nausea and even the urge to vomit, which he can suppress, making swallowing movements and breathing deeply through his nose.
It is necessary to explain to the patient that this manipulation is safe and painless. He should not squeeze the lumen of the probe with his teeth and pull it out. Given the individual characteristics of patients( growth, constitution, constitution), before the introduction of the probe should measure the distance from the navel to the incisors, and then add the distance in one palm, then the probe will precisely fall into the cavity of the stomach.
The nurse is standing on the right. The patient opens his mouth wide and breathes deeply through his nose. The nurse quickly enters the probe at the root of the tongue, the patient closes her mouth and makes several swallowing movements, after which the nurse pushes the probe along the esophagus. If the probe jumped out or curled, it is removed and, after calming the patient, is injected again. If the probe gets into the larynx, the patient begins to cough, gasps, turns blue and loses his voice.
Gastric lavage consists of two stages.
The first stage of : the funnel is held at the level of the patient's knees, somewhat obliquely, so as not to introduce air into the stomach, and begin to pour the solution into it, gradually raising it above the level of the mouth. The liquid quickly enters the stomach. It should be remembered that one can not wait until all the water flows from the funnel into the stomach, since in this case air is sucked into it, which makes it difficult to remove the contents of the stomach.
The second stage of the starts from the moment when the water reaches the neck of the funnel. After this, the funnel is lowered to the level of the knee of the patient and waiting until it is filled with the contents of the stomach. Then the funnel is tipped over the pelvis or bucket, and once the liquid stops flowing out of it, again fill the funnel with a solution;repeat the procedure until the clear water comes from the stomach.
Usually, 8-10 liters of water or wash liquid is used to wash the stomach. During gastric lavage, it is necessary to monitor the patient's condition and rinsing water. When blood veins appear, the procedure should be stopped if washing is not associated with acid poisoning, in which gastric lavage is necessary;in such cases, gastric lavage should be done carefully, in small portions, trying not to cause vomiting.
A relaxed patient rinsing the stomach is done in bed. For this, the patient is laid on his side. To ensure that the rinsing liquid does not leak into the larynx, the head should be placed low and also turned to the side.
If the patient can not swallow the probe, the patient is given a drink of 1-2 liters of warm sodium bicarbonate solution, and if vomiting does not occur, it is caused by irritating the root of the tongue or throat with a spatula or swab. The procedure is repeated several times. Completely remove the contents of the stomach in this way will not succeed, so it should be used only in cases where it is impossible to wash the stomach in the usual way with a probe.
If gastric lavage for food poisoning is done several hours after it and some of the food has already entered the intestine, after completing gastric lavage, it is necessary to inject into it a solution of salt laxative( 60 ml of a 25% solution of magnesium sulphate) through the probe. At the end of the gastric lavage, the funnel is removed and the probe is removed by a rapid movement. The funnel and probe are thoroughly rinsed with a hot water jet, passing it through the tube and pressing down several times, then boiling.