Gastric lavage in poisoning: not to be neglected

Abstract

Poisoning is a common cause of admission and mortality, especially of the young people in hospitals in Nepal. Limiting ongoing absorption of toxic compounds is one of the core principles of care for poisoned patients, and gastrointestinal decontamination is the most important aspect. Common gastric decontamination techniques and their indications, problems, contraindications and selective roles in the management of poisoning are reviewed in the article. Each of the gastrointestinal decontamination techniques has its own role, problems and contraindications. The use of each of them is selective.

Gastric lavage, in particular, is indicated after any potentially life-threatening poisoning. The benefit from gastric lavage in such circumstances with overdose with any potentially lethal ingestion is quite significant. This becomes more important in view of young age of the patients involved. Further, in our set-up, poisons consumed are commonly toxic and antidotes and intensive care of poisoning may not be available. That is why the mortality rate from poisoning is high as compared with that in the developed countries. Thus, the gastric lavage appears to be more important in our set up than in the developed countries. The Management and the Departments of Medicine and Emergency of Hospitals and Poison Centres should ensure that the use of gastric lavage is not neglected in indicated cases. It would be quite effective to include the procedure of gastric lavage in the log book of postgraduate students of Internal Medicine and General Practice.