G
GASTRIC LAVAGE
After poisoning or a drug overdose, especially in patients who have central nervous system depression or an inadequate gag reflex, gastric lavage is used to flush the stomach and remove ingested substances through a gastric lavage tube. For patients with gastric or esophageal bleeding, a lavage with normal saline solution may be used to stop bleeding. Gastric lavage is contraindicated after ingestion of a corrosive substance, such as lye, ammonia, or mineral acids, because the lavage tube may perforate the already compromised esophagus.
Typically, a doctor, gastroenterologist, or nurse performs this procedure in the emergency department or intensive care unit. Correct lavage tube placement is essential for patient safety because accidental misplacement (in the lungs, for example) followed by lavage can be fatal.
ESSENTIAL DOCUMENTATION
If possible, note the type of substance ingested, when the ingestion occurred, and how much substance was ingested. Obtain and record preprocedure vital signs and level of consciousness (LOC). Record the date and time of lavage, the size and type of nasogastric tube used, the volume and type of irrigant, and the amount of drained gastric contents, including the color and consistency of drainage. Document the amount of irrigant solution instilled and gastric contents drained on the intake and output record sheet. Note whether drainage was sent to the laboratory for analysis. Also record any drugs instilled through the tube. Assess and record vital signs every 15 minutes on a frequent vital signs assessment
sheet and LOC on a Glasgow Coma Scale sheet until the patient is stable. (See “Intake and output,” pages 216 to 218; “Level of consciousness, changes in,” page 251; and “Vital signs, frequent,” page 436.) Indicate the time that the tube was removed and how the patient tolerated the procedure.
sheet and LOC on a Glasgow Coma Scale sheet until the patient is stable. (See “Intake and output,” pages 216 to 218; “Level of consciousness, changes in,” page 251; and “Vital signs, frequent,” page 436.) Indicate the time that the tube was removed and how the patient tolerated the procedure.
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