Gastric Lavage - Nursing Science

What is Gastric Lavage?

Gastric lavage, also known as stomach pumping or gastric irrigation, is a medical procedure used to clear the contents of the stomach. This technique is often utilized in cases of drug overdose, poisoning, or to obtain gastric samples for diagnostic purposes. The procedure involves the insertion of a tube through the mouth or nose into the stomach, followed by the administration and removal of liquid to wash out the stomach contents.

When is Gastric Lavage Indicated?

Gastric lavage is indicated in several situations, including:

Drug Overdose: When a patient has ingested a potentially toxic amount of medication.
Poisoning: In cases where a toxic substance has been ingested and needs to be removed quickly.
Diagnostic Evaluation: To obtain gastric contents for laboratory analysis.
Preparation for Surgery: To empty the stomach before certain surgical procedures.

Contraindications

While gastric lavage can be life-saving, it is not suitable for every patient. Contraindications include:

Corrosive Substance Ingestion: Such as acids or alkalis, which can cause further damage.
Esophageal Varices: Due to the risk of bleeding.
Unprotected Airway: If the patient is unable to protect their airway, there is a risk of aspiration.
Severe Comatose State: Without airway protection, the procedure is risky.

Procedure Steps

The gastric lavage procedure involves several steps:

Patient Assessment: Assess the patient's condition and obtain informed consent.
Preparation: Gather necessary equipment including the lavage tube, lubricant, and lavage solution.
Insertion of the Tube: Introduce the tube through the nose or mouth into the stomach.
Aspiration: Initially aspirate stomach contents to evaluate the need for lavage.
Lavage: Administer the lavage solution and aspirate it back, repeating until the aspirate is clear.
Post-Procedure Care: Monitor the patient for complications and document the procedure.

Potential Complications

Gastric lavage is not without risks. Potential complications include:

Aspiration Pneumonia: If stomach contents are aspirated into the lungs.
Esophageal Perforation: Due to improper tube insertion.
Fluid and Electrolyte Imbalance: From excessive lavage.
Hypothermia: If cold lavage solutions are used.

Nursing Considerations

Nurses play a critical role in the successful execution of gastric lavage. Key nursing considerations include:

Patient Education: Explaining the procedure to the patient to alleviate anxiety.
Monitoring Vital Signs: Keeping a close watch on the patient’s vital signs throughout the procedure.
Documentation: Accurately documenting the procedure, including the amount and type of lavage solution used, and any complications.
Post-Procedure Monitoring: Observing the patient for any delayed complications and ensuring comfort.

Conclusion

Gastric lavage is a valuable procedure in emergency and diagnostic settings. However, it must be performed with caution due to the potential for serious complications. Nurses are essential in both the execution and monitoring phases, ensuring patient safety and efficacy of the procedure. Understanding the indications, contraindications, and proper technique is crucial for successful outcomes.