onMarch 23, 2024

Performing a Gastric Lavage or stomach wash

Medical Nursing

3 min read

Table of Contents

Definition

Performing gastric lavage also known as a stomach wash is a critical emergency procedure used to remove toxic substances, blood, or irritants from the stomach. It’s typically reserved for life threatening ingestions and must be done with precision and caution.

Purpose for gastric lavage

To obtain samples of gastric contents for laboratory studies.
To relieve nausea and vomiting in case of acute dilatation of stomach, pyloric stenosis and intestinal obstruction.
To reduce gastric bleeding.
To cleanse the stomach as a preparation for surgery.
To remove poisonous or irritating substances from stomach.

Articles for gastric lavage

Ryle’s tube of appropriate size (12-14 Fr)
Bowl of water/normal saline/or specific solution ordered.
Pint measure.
Water soluble lubricant/Vaseline.
A funnel to attach to the NG tube.
Stethoscope.
Kidney tray.
Towel.
Small Mackintosh.
Clean gloves.
Apron.
Mask.
Adhesive plaster and scissors.
Bucket/container for return flow.
Syringe.
Mouth gag.

Solutions Used for gastric lavage

Plain water (plain water is particularly useful when the poison is unidentified)
Normal saline.
Weak solution of sodium bicarbonate or boric acid in corrosive poisoning.
Specific antidotes: If ingested poison is identified.

Procedure for gastric lavage

	Nursing Actions	Rationale
1.	Before procedure Identify patient and check the chart for physician’s order and any specific instruction.	Ensures performance of correct procedure for the right patient.
2.	Explain procedure to the patient.	Helps in gaining cooperation of the patient.
3.	During procedure Wash hands and don gloves.	Reduces risk of contamination.
4.	Remove dentures if present and insert a mouth gag.	Dentures may cause obstruction, and mouth gag is inserted to prevent biting of the tube.
5.	Place patient in left lateral position.	Prevents aspiration of fluid into the lungs.
6.	Pass lubricated nasogastric tube slowly and gently to prevent trauma to the tissues.	Lubricating the tube makes insertion easy and prevents friction.
7.	Ensure proper placement of tube.
8.	Secure the tube with adhesive tape.	Prevents displacement of the tube.
9.	Attach the syringe to the tube and aspirate the gastric contents completely and save it for laboratory analysis.
10.	Remove the syringe and attach a funnel to the tube and fill the funnel with irrigating fluid. Raise the funnel to allow fluid to run into the stomach. Allow 2-3 funnels of fluid (150-200 mL) to flow into the stomach.	Ice cold water is used for irrigation when bleeding is present.
11.	When 2-3 funnels of fluid have run into the stomach and before the funnel is completely empty, pinch the tube, wait for one minute and invert the funnel over a receptacle and allow the fluid to siphon back/aspirate using 50 cc syringe.	200mL of fluid is to be introduced at a time to reach all parts of the stomach and inversion of funnel helps in return flow of fluid from stomach.
12.	In case of Gl bleeding, if blood increases in the outflow, stop the procedure and inform the physician.	Prevents further complications.
13.	During the procedure observe the patient’s vital signs and degree of consciousness every 15 minutes.	Monitors any deterioration in the condition of patient.
14.	Lavaging usually requires a total volume of at least 2 L.	Some clinicians advocate use of 5-10 L of solution.
15.	Discontinue the treatment by pinching the tube.	Prevents entry of air into the stomach.
16.	Leave the stomach empty at the completion of lavage.
17.	After procedure Remove gloves and wash hands.
18.	Give a mouthwash and dry the face.	Patient feels comfortable.
19.	Replace articles; record the treatment with date, time, amount of solution used, character of return flow, and condition of the patient before, during, and after the procedure.	These give detailed information about the procedure and patient’s response to the procedure.
20.	Continue to monitor the patient every 25-30 minutes as dictated by his/her condition.Check vital signs, breathing pattern, nausea, and abdominal distention.	Identifies complication at an early stage.

REFERENCES

Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884

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