How to Perform Gastric Lavage: A Step-by-Step Guide for Medical Professionals

Gastric lavage (stomach pumping) is a critical medical procedure used to remove toxic substances, undigested pills, or harmful chemicals from the stomach. While its application has declined with advancements in alternative treatments like activated charcoal, it remains essential in acute poisoning cases. This guide outlines the standardized protocol for safe and effective gastric lavage.

Gastric Lavage Kit | GCMEDICA

Pre-Procedure Preparation

1. Indications & Contraindications

Indications: Acute ingestion of life-threatening toxins (e.g., iron tablets, pesticides) within 1–2 hours.

Contraindications:

Corrosive substance ingestion (risk of esophageal perforation).

Unprotected airway in unconscious patients.

Known gastrointestinal perforation.

2. Equipment Setup

Large-bore orogastric tube (36–40 French for adults; pediatric sizes vary).

Irrigation solution: Warm saline (0.9% NaCl) or water (15–20°C).

Suction device, lubricant, and protective gear (gloves, face shield).

Step-by-Step Procedure

Step 1: Position the Patient

Place the patient in left lateral decubitus position to delay gastric emptying and reduce aspiration risk. Elevate the head by 20° if conscious.

Step 2: Insert the Orogastric Tube

Measure the tube length from the mouth to the epigastrium.

Lubricate the tube and insert through the mouth, guiding it into the stomach.

Confirm placement via auscultation (air insufflation) or radiography.

Step 3: Aspirate Gastric Contents

Attach a syringe to aspirate initial gastric contents for toxicology analysis.

Step 4: Lavage Cycle

Instill 200–300 mL of irrigation fluid (adults) or 10–15 mL/kg (pediatrics).

Allow the fluid to drain via gravity or gentle suction.

Repeat until the effluent is clear (typically 2–5 cycles).

Step 5: Post-Lavage Care

Administer activated charcoal (if indicated) after lavage.

Monitor vital signs and watch for complications (e.g., aspiration, electrolyte imbalance).

Key Safety Considerations

Airway Protection: Intubate unconscious patients before lavage.

Fluid Balance: Avoid overhydration; track input/output volumes.

Complication Management:

Aspiration pneumonia: Elevate the head and suction secretions promptly.

Tube misplacement: Verify positioning before irrigation.

When to Avoid Gastric Lavage

Time elapsed > 2 hours (reduced efficacy).

Hydrocarbon or acid/base ingestion (risk of chemical burns).

Gastric lavage demands precision and adherence to clinical guidelines to mitigate risks. For medical facilities seeking high-quality lavage equipment, explore our certified, single-use orogastric tubes and irrigation systems designed for emergency care.

Keywords: gastric lavage procedure steps, emergency stomach pumping technique, medical gastric lavage protocol, orogastric tube placement guide.