Upyogi Baatein – Ayurvedic Health Tips in Hindi

• Ingested poisoning

Contra-indications:-

• Corrosive poisoning (except carbolic acid)
• Convulsions
• Comatose patient
• Upper alimentary tract illness/ pathology etc.

Method:-

• It is done using a stomach tube.
• It is life saving measure if performed within 1 hour of ingestion of poison.After this the poison is absorbed in the system and the procedure will prove ineffective.
• Even if the patient has been vomiting out the contents still gastric lavage should be performed to wash out the traces of poison that may be present in the gastric cavity.
• Therefore , gastric lavage or stomach wash proves to be a mandatory measure in treating ingested poison except when contra-indicated.

Procedure:-

• Patient should be lying on his left side or prone with his head hanging over the edge of the bed and face down supported by a subordinate , this is done so that the mouth is at a lower level than larynx. By this positioning the secretions of respiratory tract can come out easily and it prevents aspiration of any contents into the respiratory pathway.
• The end of the rubber tube is lubricated with the liquid parrafin, glycerine, milk or any other slimy material and inserted into the oral cavity.
• If required a tongue depressor can be used to lower the tongue so as to facilitate insertion of the tube.
• The tube should be inserted till the mark on the tube.Once reached the mark, it is assumed that the tip of the tube is inside the stomach.
• To confirm the position of the tip of tube , a small amount of air is pushed through the tube , a stethoscope is placed over the stomach area to hear the bubble sounds.
• Absence of any cough reflex also confirm the position of the tube in the abdominal cavity.
• The tube should be inserted with utmost care and without applying any considerable force ; if force is applied chances are high that the esophageal , respiratory or stomach wall might get injured.
• About half litre of warm water should be passed through the funnel held high up above the patients head. Due to gravitational force the warm water will immediately pass through the tube.
• After this the funnel should be lowered below the gastric level and whatever is in the stomach will come out itself.
• The contents of the first wash should be preserved and sent for biochemical analysis.
• Large amount of warm water during the first wash should be avoided as this might push the stomach contents into the duodenal cavity.
• This procedure should be repeated many times and continued till the color of solution (inserted through the funnel ) and the content (aspirated out through the tube) are same.
• Nearly ten litres of water might be required for gastric lavage.
• Some amount of the solution should be allowed to remain in the stomach cavity. By this trace of poisons ;if ant left behind , will be neutralized.

Solutions used for gastric lavage include:-

1. Potassium permanganate
2. Magnesium Sulphate
3. Sodium sulphate
4. Activated charcoal
5. Fuller's earth etc.

• These are selected on the basis of nature and dosage of poisons.
• After appropriate gastric lavage , the tube should be removed carefully.

Gastric lavage in infants and children:-

• For infants and children , Ryle's tube or a number 8  to 12 French catheter can be used for gastric lavage.
• About 25 cm. length is sufficient to reach the stomach cavity and this length should be marked before-hand by using an adhesive tape.
• The tip of the tube should be lubricated and inserted through nostrils or oral cavity.
• If the child coughs , it suggests that the tube is entering the respiratory passage , in such condition the tube should be slightly retracted and again pushed in the esophageal tube.
• The outer end of the tube should be connected to a syringe (20-50 ml) and the gastric contents be aspirated out.
• Later solutions (mixed with antidotes etc.) should be pushed through the tube and aspirated out.
• One has to be very careful when performing gastric lavage in children.