Position Paper: Gastric Lavage

@article{Vale2004PositionPG,
  title={Position Paper: Gastric Lavage},
  author={J Allister Vale and Kenneth W. Kulig},
  journal={Journal of Toxicology: Clinical Toxicology},
  year={2004},
  volume={42},
  pages={933 - 943}
}
  • J. Vale, K. Kulig
  • Published 1 January 2004
  • Medicine
  • Journal of Toxicology: Clinical Toxicology
Gastric lavage should not be employed routinely, if ever, in the management of poisoned patients. In experimental studies, the amount of marker removed by gastric lavage was highly variable and diminished with time. The results of clinical outcome studies in overdose patients are weighed heavily on the side of showing a lack of beneficial effect. Serious risks of the procedure include hypoxia, dysrhythmias, laryngospasm, perforation of the GI tract or pharynx, fluid and electrolyte… 
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94 Citations
Highly Influential Citations
2
Background Citations
18
Methods Citations
2

94 Citations

Position paper update: gastric lavage for gastrointestinal decontamination
TLDR
There is no evidence showing that gastric Lavage should be used routinely in the management of poisonings, and the evidence supporting gastric lavage as a beneficial treatment in special situations is weak, as is the evidence to exclude benefit in all cases.
Utility of Upper Gastrointestinal Endoscopy for Management of Patients with Roundup® Poisoning
TLDR
Endoscopy may be useful in cases of liquid poisoning including, Roundup, both to determine the amount of residual toxin and to remove it from the stomach.
Orogastric lavage: a lifesaving procedure now forgotten.
TLDR
A teenage girl presented to Emergency Department with history of ingestion of a bottle of pesticide within the time frame before gastric emptying, and was resuscitated, intubated and orogastric lavage was performed.
Medico-legal consideration of gastric lavage in acutely intoxicated patients
TLDR
Gastric lavage is now known to be ineffective, unnecessary or hazardous in some circumstances where it used to be performed as a routine and in South Korea, there was the case of a patient who ingested cocaine.
Retained pill fragments at autopsy: Time to rethink gastric decontamination?
TLDR
The role of gastric decontamination and emptying in the care of poisoned patients is the subject of signifi cant debate in clinical toxicology and reports suggest that good supportive critical care measures may be associated with better outcomes.
Decontamination and elimination of drugs
TLDR
Epuration techniques include emetics, gastric lavage, single or multiple dose of activated charcoal, cathartics and whole bowel irrigation, while elimination techniques are not validated and blood exchange transfusions or plasma exchanges or are never indicated.
Evaluation and management of common childhood poisonings.
TLDR
Family physicians often manage substance ingestions in children, most of which are nontoxic in nature, but some long-acting medications have delayed toxin effects and require additional surveillance.
Lavage or not to lavage – hazards due to deviation from National Guidelines
TLDR
Reducing deaths from pesticide self-poisoning would require a coordinated effort involving new antidote development and optimizing medical care given to these patients at both primary and tertiary care units.
Massive levothyroxine ingestion in a pediatric patient: case report and discussion.
TLDR
The course of a toddler who ingested a massive amount of levothyroxine and review treatment options for such overdoses is described and a case illustrates, massive ingestion of lev Timothyroxine in children typically follows a benign course.
Drugs and pharmaceuticals: management of intoxication and antidotes
TLDR
Patients generally benefit from aggressive support of vital functions, careful history and physical examination, specific laboratory analyses, a thoughtful consideration of the risks and benefits of decontamination and enhanced elimination, and the use of specific antidotes where warranted.
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References

SHOWING 1-10 OF 50 REFERENCES
Does gastric lavage really push poisons beyond the pylorus? A systematic review of the evidence.
Gastric Emptying Procedures in the Self-Poisoned Patient: Are we Forcing Gastric Content beyond the Pylorus?
TLDR
The data show a significant difference in the number of residual pellets in the small bowel of the treated group (n=40), when compared with the control group (P < 0.0001), and the inefficiency of gastric-emptying procedures is highlighted.
Management of acutely poisoned patients without gastric emptying.
Esophageal laceration and charcoal mediastinum complicating gastric lavage.
Ipecac-induced emesis versus gastric lavage: a controlled study in normal adults.
Efficacy of gastric emptying: gastric lavage versus emesis induced with ipecac.
Studies on the efficacy of gastric lavage as practiced in a large metropolitan hospital.
TLDR
In a population consisting of patients with detectable quantities of drugs in the lavage sample, diazepam and amitriptyline are more adequately recovered than the sedative-hypnotic drugs.
A comparison of three gastric lavage methods using the radionuclide gastric emptying study.
Drug overdoses: Is one stomach washing enough?
TLDR
It was concluded that routine aspiration of gastric contents at hourly intervals after admission was of considerable value in removing any residual drugs.
Gastrointestinal tract perforation with charcoal peritoneum complicating orogastric intubation and lavage.
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