Technique
Gastric lavage involves the passage of a tube (such as an Ewald tube) via the mouth or nose down into the stomach followed by sequential administration and removal of small volumes of liquid. The placement of the tube in the stomach must be confirmed either by air insufflation while listening to the stomach, by pH testing a small amount of aspirated stomach contents, or x-ray. This is to ensure the tube is not in the lungs. In adults, small amounts of warm water or saline are administered and, via a siphoning action, removed again. In children, normal saline is used, as children are more at risk of developing hyponatremia if lavaged with water. Because of the possibility of vomiting, a suction device is always on hand in case of pulmonary aspiration of stomach contents. Lavage is repeated until the returning fluid shows no further gastric contents. If the patient is unconscious or cannot protect their airway then the patient should be intubated before performing lavage. The person must be put to sleep for a period of time during the operation due to its high risk of shock and hyponatremia.
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