GASTRIC LAVAGE

From Big Medical Encyclopedia

GASTRIC LAVAGE — the procedure of removal from a stomach of its contents applied with the medical purpose or to diagnostic testing of the received rinsing waters.

Indication to the medical Item. poisonings with various poisons accepted inside, food poisonings, gastritises with a plentiful myxopoiesis are, is more rare — uraemia (at considerable allocation of nitrogen-containing connections through a mucous membrane of a stomach), an acute necrosis of a stomach, etc. Diagnostic Item. apply at diseases of a stomach (hl. obr. for a cytologic research of rinsing waters), and also for identification of poison at poisonings and for allocation of the activator at bronchopulmonary inflammations (in case of swallowing a phlegm by the patient) and inf. damages of a stomach.

Contraindications to the Item. (probe method): large diverticulums and considerable esophageal stenoses, the remote terms (more than 6 — 8 hours) after a serious poisoning strong to-tami and alkalis (perforation of a wall of a gullet is possible). Relative contraindications: an acute myocardial infarction, an acute phase of a stroke, epilepsy with frequent convulsive attacks (a possibility of a perekusyvaniye of the probe).

A technique and technology of performance

For the Item. usually use a thick gastric tube and a funnel. Washing is carried out by the principle of a siphon when on the tube filled with liquid connecting two vessels there is fluid movement in the vessel located below. One vessel — a funnel with water, another — a stomach. During the raising of a funnel liquid comes to a stomach, during the lowering — from a stomach in a funnel.

Scheme of a gastric lavage: and — the first stage (a funnel raise higher than the level of a mouth of the patient, gradually filling it with wash liquid); — the second stage (the funnel is lowered to the level of knees of the sitting patient and incline it for draining of wash liquid with contents of a stomach).

The patient sits down on a chair, having densely leaned against its back, having slightly inclined the head forward and having moved apart knees that between legs it was possible to put a bucket or a basin. Before the Item. put on an oil-cloth apron the patient; if it has removable dentures, they are taken out. At poisoning with the cauterizing poisons (except phosphorus) to the patient before a gastric lavage suggest to drink 50 ml of vegetable oil.

The doctor (sister) becomes on the right side from the patient and the right hand enters the thick gastric tube moistened with water to a root of language after this several deglutitory movements therefore the probe easily gets through a gullet into a stomach ask to make the patient. Advance of the probe can cause an emetic reflex in some patients; in these cases to the patient suggest to breathe deeply and often, and the doctor quickly enters the probe to a tag of 50 cm

of the Item. consists of two stages. At the first stage the funnel located at the level of knees of the patient a little obliquely (not to enter air into a stomach), begin to raise higher than the level of a mouth of the patient (fig., a), gradually filling it with wash liquid (e.g., 2% solution of hydrosodium carbonate or 0,02 — 0,1% solution of potassium permanganate of room temperature). Liquid quickly passes in a stomach. It is impossible to allow full transition of all liquid from a funnel in a stomach since after liquid air nasasyvatsya that complicates removal of gastric contents. At the second stage a funnel, the water line in a cut reaches a narrow part, lower down to the level of knees of the patient and wait until it is filled with contents of a stomach (fig., b) then it is overturned over a basin. As soon as liquid ceases to follow from a funnel, it is filled with solution again and repeat the procedure until water is not pure. Usually for the medical Item. use from 10 to 20 l of water or wash liquid. At some types of acute poisonings (e.g., organophosphorous connections) about 30 — 60 l can be spent. The first and last portions of rinsing waters are brought to laboratory for a research.

The patient who is in coma, the Item. make in a ventral decubitus. At mass poisonings or when the patient cannot swallow the probe, the Item. carry out on the simplified way: the patient drinks 5 — 6 glasses of warm water or weak solution of hydrosodium carbonate then, irritating with a finger a root of language, he causes vomiting; such procedure is repeated several times with the subsequent reception of salt laxative. In some cases for the Item. use the thin polyvinyl chloride probe, entering it through a nose.

See also Sounding of a stomach .

A.S. Belousov.

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