Gastric lavage. Technique and algorithm of gastric lavage

The question of how to wash the stomach interested everyone. Gastric lavage in case of poisoning can be done in a hospital, but there are techniques for home use. To facilitate gastric lavage, you can use a tube and a funnel. Gastric lavage is done when food, alcohol poisoning, intoxication occurs methyl alcohol, available acute gastritis with copious secretion of mucus. Sometimes manipulation is used for necrosis and uremia.

Gastric lavage with a probe: a) washing scheme; b) washing technique.

Target

Tasks of gastric lavage and indications for use:

Medical purposes. Techniques performed by the tubeless method, gastric or nasogastric tube (through the nose) are necessary in case of severe poisoning, including poisonous substances, alcohol, spoiled food for complete cleaning GIT.
Diagnostic flush. Procedures are required in preparation for an assigned study of the gastrointestinal tract or, if differentiation is necessary inflammatory processes with the identification of an irritant from other pathologies. It is carried out in the hospital.

Contraindications and indications

Indications for flushing in the hospital or at home:

food poisoning, alcohol;
moderate or accidental use of unnecessary medication;
excessively acidic gastric juice;
intoxication with poisons, acids, alkalis, methyl alcohol;
gallbladder motility disorder;
intestinal obstruction;
release of toxins, such as urea kidney failure, into the lumen of the stomach.

Contraindications for gastric lavage:

there is bleeding of the digestive tract;
high degree stenosis of the esophagus;
dysfunction of the heart muscle;
functional disorders of the circulatory system;
involuntary muscle contractions - spasms, convulsions;
lack of consciousness.

House wash technique

When making wrong actions at food poisoning can exacerbate the situation and cause negative consequences. They make mistakes that cause complications:

Single dose a large number fluid, which provokes the opening of the gastric sphincter and the release of poisons with toxins into the intestines. The portion is calculated taking into account the patient's body weight: 5-7 ml per kg.
Uncontrolled total volume and concentration of flushing agent: excess, deficiency, high concentration, the weakness of the substance.
Inaccurate probe or siphon washing, provoking rupture of the esophagus.

Gastric lavage technique:

The procedure is performed in a sitting position.
The approximate amount of the first serving is 2 liters.
The presence of a container for vomit.
The product is drunk in a warm form for short span time.
Following the last portion drunk, the patient puts his feet together, presses his hands on his stomach. The body is tilted forward.
provoked vomiting reflex fingers or spatula.
To remove the sour taste in the mouth and acidity in the stomach, take an additional 500 ml of washing agent with dissolved soda in the amount of 10 g. After drinking the entire volume, vomiting is again caused.
After the procedure, you should take Levomycetin in the amount of 1 tablet.

Basic Methods

There are a large number of gastric lavage methods that differ in the types of washing solutions prepared on the basis of potassium permanganate, salt, and soda. The process is done without a special device - a probe. But to facilitate manipulation, it is recommended to use it. Probing can be carried out using a rubber tube, the length of which is 150 cm and the thickness is 10-12 mm. For infusion, a funnel with a capacity of 0.5-1 l is provided. Equipment of the device must be sterile and stored in sealed bags. Preparation of the probe includes its disinfection with 1-2 liters of boiling water. In case of severe poisoning, a siphon bowel lavage is additionally prescribed.

Solutions

Salt is the most commonly used. A remedy is prepared from 50-75 ml of a substance dissolved in 5-10 l warm water. The remedy provokes a spasm of the gastric sphincter, which prevents the release of toxic substances or toxins into the intestines. Potassium permanganate is popular. You need to make a pale pink solution. After cooking, it is filtered through a thick paper filter or a four-layer gauze. Due to the ingress of small undissolved crystals, a burn of the mucous membrane of the esophagus and stomach is possible. For acute disorder digestive function remedy is not recommended.

In case of poisoning with methyl alcohol or acid, a neutralizing soda solution with a concentration of 2% is effective, and alkali intoxication is eliminated citric acid. Highest Efficiency endowed with sorbents with enterosorbents, such as Polysorb, Enterosgel.

Potassium permanganate

It is necessary to drink until the gag reflex is felt.

The tool helps the patient with all poisoning, saves from intoxication with bacteria. To prepare the desired concentration, it is recommended to take several crystals of the substance and first dissolve in a small amount of water. After filtering through a dense filter, a pale pink washer is prepared. The victim is enough 2-3 liters.
Schematic not shown individual intolerance. Due to high oxidizing properties potassium permanganate is incompatible with the use of coal, sugar and similar substances.

Algorithm for taking salt and water

Salt. The tool is endowed with a stopping effect on the ingress of toxins and poisons from the stomach into the intestines. Volumes - 5 l. This amount will require 50 g of dry matter.
Soda. Soda solutions are ideal for a small victim (up to 3 years old) and for poisoning with acids, methyl alcohol. 2% substances are used. Baking soda is a powerful antacid that effectively reduces stomach acid.

Prepared from 10 g in 1 liter of boiling water. Reception algorithm: warm remedy offered to the victim in small portions, depending on age and body weight. On average, 3 liters of the drug will be needed to fill the patient's stomach. When cooking, it is important to thoroughly dissolve the crystals, which will become visible in the absence of bubbles. carbon dioxide.

sodium chloride

Pharmaceutical agent has a pronounced antimicrobial effect, promotes the removal of toxins and poisons in short time. Before use, the 2-5% liquid is heated to 36-38°C. The algorithm of use is prescribed in the instructions. Not suitable for use in case of:

renal dysfunction;
puffiness on the periphery of the diseased organ;
arterial hypertension;
heart failure;
pregnancy toxicity.

Rinse the stomach - this is the first thing to do in case of poisoning. The sooner this procedure is carried out after the ingestion of toxic substances through the mouth, the better. Sometimes life just depends on it.

Of course, it is better if this procedure is done by a physician in a hospital. But it takes time for the ambulance to arrive, and the poison begins to be absorbed into the blood after 5-10 minutes. Therefore, it is so important to be able to provide first aid on the spot and be able to quickly flush the stomach at home.

The main indications for gastric lavage

The main indication is poisoning. A person can be poisoned both accidentally and intentionally with the aim of suicide.

How to properly wash the stomach

Rinse the stomach at home in case of poisoning - it is purely mechanical to remove all its contents with a liquid. The easiest way to do this at home is to give water to drink and induce vomiting, and you need to do this several times. This is called probeless rinsing. The procedure is not very pleasant, but simple and effective.

Before gastric lavage, you can take a sorbent to reduce the absorption of toxins. It can be activated charcoal (10 tablets crushed into powder and mixed in a glass of water), enterosgel or polysorb (1-2 tablespoons).

What is the best way to wash the stomach in case of poisoning?

Can be just clean or boiled water. It should be warm, not cold and not hot.
Salt solution. Prepared at the rate of 1 full teaspoon (with top) per 1 liter of water. Salt water helps to compress the outlet of the stomach, thereby preventing the promotion of its contents into the intestines.
Soda solution. 2 teaspoons baking soda for 1 liter of water.
A solution of potassium permanganate. Gastric lavage with potassium permanganate, in addition to mechanical cleansing, also has an antiseptic (disinfecting) effect. The solution should be light pink in color, a few crystals are enough for 3 liters of water. Make sure the crystals are completely dissolved better solution filter.

How is the procedure carried out

The poisoned person is seated on a chair or laid on its side. Pour water or rinse solution into a glass and drink. At one time you need to drink 2-3 glasses, and do it for a short time(3-5 minutes). The rapid filling of the stomach with a large volume of liquid in itself will cause a reflex spasm of its walls and vomiting.
If vomiting does not occur on its own, it should be induced. To do this, press with a spatula or fingers on the root of the tongue.
It is better not to pour out the first portions of vomit, they may be needed to analyze and determine the cause of poisoning.

The procedure will need to be repeated several times. How many times to wash the stomach in case of poisoning? There is no definite answer here. Ideally, until clean water begins to come out with vomiting, without any impurities. This usually requires 3 to 5 liters of liquid.

When can't you do it?

If the person is unconscious. He cannot swallow, do not pour water on him by force, he may choke.
When there are signs of bleeding from the stomach: hematemesis or "coffee grounds" vomiting.
In the presence of a very strong "dagger" pain in the abdomen, since perforation of the ulcer is possible.
In case of poisoning with concentrated acids, alkalis, gasoline, turpentine. Only the probe method of washing is applicable here, since inducing vomiting can provoke a second burn of the esophagus. You should not try to wash the stomach with soda in case of acid poisoning and vice versa, since the resulting chemical reaction gas can cause perforation of the walls of the stomach.
Violation swallowing reflex, for example, in patients with stroke or other diseases of the nervous system.
With an attack of bronchial asthma.
With convulsive syndrome.
If there are heart rhythm disturbances, low blood pressure, suspicion of a heart attack.
It is undesirable to wash the stomach at home for young children, this is done only in last resort(for example, a child has poisoned himself with pills, it takes a long time to wait for an ambulance, and time is very expensive).

What to do after washing

Not always clean water coming out of the stomach with vomiting means that the stomach is completely washed out. Some of the toxins may remain in the folds of the mucous membrane, and something may have time to pass into the intestines.

After washing, it is desirable to give the patient a sorbent, that is, a substance that binds toxins to itself and prevents them from being absorbed into the blood. It could be crushed water activated carbon, enterosgel, polysorb, laktofiltrum.

At alcohol poisoning you can give a glass of water to drink with 5 drops of ammonia dissolved in it.

In any case, after poisoning, you need to drink more fluids, no longer for the purpose of washing, but for the purpose of detoxification - the speedy removal of the already absorbed poison. We apply for this clean water, electrolyte solutions (Regidron), or mineral water without gas.

If you feel satisfactory (for example, with mild food poisoning), you can stay at home and call a doctor. You should refrain from taking any food until the end of the day.

If symptoms persist - nausea, abdominal pain, diarrhea, fever, weakness, it is better to call an ambulance (if it has not been called before) and go to the hospital.

In the hospital, the procedure for gastric lavage will be repeated, but this will be done with the help of a probe.

How to wash the stomach in the hospital

In the hospital, the stomach will be washed professionally. This is done using a thick or thin (nasogastric) tube. The essence of the method is as follows: a thick gastric tube is inserted behind the root of the tongue, the patient makes swallowing movements and the tube moves into the stomach.

A thin probe is inserted through the nose, mainly used in young children and unconscious patients.

A funnel is attached to the end of the probe, through which water or the same washing solutions are poured. As the stomach fills, the funnel goes down and the washing water flows into it. The funnel is emptied and filled with a new portion of the washing solution. This is done many times, the total volume of liquid with the probe washing method can reach up to 10 liters.

Absolutely shown only probe washing in a hospital for poisoning with caustic substances.

In a hospital, they can also clean the intestines with an enema.

Poisoning in children

Most poisonings in children are accidental and occur early and preschool age. Most often children are poisoned medicines as well as household chemicals.

If a child is poisoned, call immediately ambulance. Such calls are always prioritized and an ambulance will be dispatched immediately.

What can be done before the arrival of the brigade?

A child older than 3 years old can try gastric lavage in the usual way- give water to drink and induce vomiting.

It is almost impossible for a small child to do such a procedure at home. The main help for poisoning in such children is to induce vomiting.

With strong excitement, older children are fixed, infants and toddlers are swaddled.

Stimulate vomiting reflex irritation language root. You can give your child 1-2 tablespoons of a concentrated saline solution to drink (2-3 teaspoons per glass of warm water). Drinking is given from a bottle with a pacifier. You can try to inject it into your mouth in small portions using a syringe without a needle, gently inner surface cheeks.

Do not forcibly pour liquid into the child, it can get into Airways.

The ambulance team will start washing the stomach through a tube to the child already at home. The amount of fluid to be administered at one time for washing the child is approximately the following: 50-100 ml in the first 6 months, 150 ml per year, the total amount for children under one year old is not more than 1 liter.

Children aged 2-5 years are injected with 200-300 ml at a time, the total amount is 2-5 liters. Usually, the calculation of the required fluid is simplified as follows: 1 liter for each year of life. For example, a 2-year-old child needs 2 liters to flush.

For children from 6 years old, a portion for washing is 400-500 ml, the total amount is 6-8 liters.

Indications for gastric lavage are the occurrence of food poisoning or the presence of problems with its digestion. Flushing is indicated in case of gallbladder dyskinesia, advanced level acidity of gastric juice.

Gastric lavage technique

In addition to the above method of gastric lavage at home, there are some more varieties. In this case, it is planned to use a special device consisting of a thick-walled rubber tube, the length of which is 1.5 m. This tube has a wide lumen and a funnel, the capacity of which is 0.5-1 l. The funnel and rubber tube must be sterilized by boiling. They should be stored in plastic bags. Before doing a gastric lavage using this device, it is necessary to rinse it using 1-2 liters of boiling water for this.

For the procedure, you need to prepare 8-10 liters of warm water, it is not necessary that it be boiled. Seat the victim on a chair, lean his back against the back of the chair and tilt his head forward several times, cover with an oilcloth apron, a sheet or a plastic cape. Put a basin at your feet. One of the caregivers inserts a probe into the stomach, the end of which should be brought to the root of the tongue and synchronously directed with light translational movements with the patient's swallowing movements towards the esophagus. Do not make sudden efforts when inserting the probe. After the probe is inserted into the stomach (at least 50 cm), a funnel is put on its free end, water is poured into it, while the funnel needs to be slightly tilted so that air does not get into it. At first, the funnel must be held below the patient's mouth. After the funnel is filled with water, it must be raised until the water reaches the neck of the funnel. At this point, the funnel must be lowered and the contents of the stomach poured into the pelvis. The amount of liquid that was introduced into it should come out of the stomach.

When carrying out a gastric lavage, it is impossible to allow the water to leave the funnel completely, since it will enter the stomach after this air gets in which complicates the procedure. After gastric lavage and removal of the probe, rinse your mouth, wipe your lips and chin with a towel.

Solutions for gastric lavage

For gastric lavage, a saline solution can be used, for the preparation of which you need to add 2-3 tablespoons to 5-10 liters of liquid. salt. They cause a spasm of the exit from the stomach and prevent the movement of toxins or poison from the stomach into the intestines.

Gastric lavage can be carried out with potassium permanganate pale pink. The solution must first be filtered using a paper filter or gauze folded in four layers, since small crystals of potassium permanganate that do not dissolve in water can cause a burn of the mucous membrane of the esophagus or stomach. The potassium permanganate solution has a significant drawback: it irritates the gastric mucosa, so it is undesirable to use it in case of acute disorders digestion.

The most effective is the use of a solution in which sorbents and enterosorbents are used: polysorb or enterosgel.

In case of acid poisoning, 2 percentage solution soda. In case of alkali poisoning - a solution of citric acid.

Gastric lavage in children

For gastric lavage in children, all of the above solutions can be used, and for children under 3 years old, in case of a violation of water and electrolyte metabolism, gastric lavage is performed using a sodium chloride solution (0.9% isotonic solution).

It is necessary to use a sufficiently warm solution (35-37 degrees), which will stop intestinal peristalsis and prevent the child from cooling, which, in turn, will prevent the movement of toxic substances through the intestines and stomach. Gastric lavage in children in the following way: the child needs to be drunk with a solution for washing and artificially induce vomiting, for which it will be enough to insert a finger into the mouth and press on the root of the tongue. It is worth continuing the procedure until the vomit is a clean wash solution.

Gastric lavage relieves the patient's body of toxic substances. Even before the arrival of an ambulance, a person needs to empty the stomach of food containing biological or chemical toxins.

This can be done at home, with minimal skills and available funds.

The simple procedure is repeated administration and excretion of fluid into the stomach. At self-conduct cleansing measures, water is administered orally and excreted, causing a gag reflex.

IN medical institutions use a probe, which is considered more effective. But even when using a probe medical workers Injuries cannot be ruled out:

soft tissue injury oral cavity and digestive tract;
perforation of the esophagus with the formation of false passages;
insertion of a probe into the trachea;
damage vocal cords;
destruction of dental crowns.

If the patient is conscious, then the procedure is not difficult. The basic rule is correct posture patient. If it is not observed, aspiration of the respiratory tract with wash water and stomach contents may occur.

For the procedure, you need to prepare:

take two containers - for the liquid, which is used to clean the stomach and for washing water. They must be kept until the arrival of an ambulance and analysis of the composition in order to facilitate the establishment of the type of toxin;
prepare warm water or a special solution for gastric lavage in a volume of 5-10 liters;
the assistant must be protected - the contents of the vomit and washings may contain virulent forms of microorganisms, toxins, aggressive means. For personal protection use a long rubberized apron and thick medical gloves;
prepare a spatula or spoon to irritate the root of the tongue;
clean napkins or a soft small towel.

The patient is seated on a chair with a back, if he is too weak and cannot sit, he is laid on the bed on his side. In both cases, the patient's head should be below the stomach during the procedure to prevent aspiration of vomit.

The patient is given to drink a liquid in a volume of 500-1000 ml in order to maximally stretch the walls of the stomach, ensure a more complete removal of toxins from the mucosal folds and cause a gag reflex. It is more convenient to do this with a sterile spatula, pressing on the base of the tongue. The assistant supports the patient and fixes his head with his hands.

The patient leans over the container so that the head is below the knees or the plane of the bed. The contents after removing the first portion of water are stored for laboratory analysis.

Gastric lavage is carried out several times until a clear excreted fluid appears.

Preparation of the main types of solutions

The simplest and accessible way is washing the gastrointestinal tract with boiled water heated to 20-24 °.

Warm water prevents spasm of the esophagus and stomach, protects against thermal injury to the mucosa and stimulates the elimination of toxins. Hot water provoke accelerated absorption of poisons and burn mucous membranes.

In case of poisoning chemicals you will need a special solution to neutralize the toxic liquid. Solutions are prepared as follows:

a solution using potassium permanganate is prepared by dissolving several crystals of the substance in warm water. The resulting solution is thoroughly stirred to completely dissolve the crystals and filtered through gauze folded several times. Then the resulting solution is diluted with warm water to a light pink color;
soda solution is prepared at the rate of 2 tbsp. drinking soda for 5 liters of warm water. This type of solution is necessary in case of poisoning with acid-containing agents;
saline solution is prepared on the basis of food or sea salt at the rate of 2 tbsp. salt in 5 liters of warm water. saline solution affects the tone of the sphincter of the stomach, causing it to contract, which prevents the promotion of toxic contents. In addition, the saline solution creates in the stomach cavity osmotic pressure that reduces the absorption of toxins;
a solution of lemon juice or vinegar is necessary to neutralize food slurry in case of alkali poisoning. To prepare it, dissolve the juice of ½ lemon or 10 ml of a 3% solution of table vinegar in 2 liters of warm water.

Gastric lavage in case of poisoning has its own contraindications.

Contraindications for gastric lavage

Some conditions are contraindications for self-lavage of the stomach:

poisoning with petroleum products (gasoline, kerosene) or caustic liquids (pipe cleaner, strong acid). Such toxic substances cause mucosal burns, and their removal can increase the damage;
suspicion of perforation of the stomach or intestines, a history of peptic ulcer;
internal bleeding;
impaired blood supply to the brain, epilepsy;
pre-infarction state, heart rhythm disturbance;
lack of laryngeal and cough reflex, risk of aspiration by vomit;
unconsciousness, convulsions;
narrowing of the esophagus, impaired function of external respiration.

IN listed cases washing should be carried out only in specialized medical institutions using a probe.

Errors during the procedure

Violations of the gastric lavage procedure at home can lead to a serious condition of the patient:

a large amount of fluid introduced at one time stretches the gastric occlusive sphincter, and toxic substances enter the intestine. To prevent this, it is necessary to calculate the volume of liquid for a single dose. For an adult, 5-7 ml of liquid per 1 kg of weight is needed;
the introduction of too concentrated solutions, which has a damaging effect on the inflamed gastrointestinal mucosa;
lack of control of the amount of liquid introduced into the stomach and the volume of wash water. The difference between these indicators should not exceed 1% of the patient's body weight. A higher indicator indicates intensive fluid absorption, which can provoke overhydration with serious consequences.

The above algorithm is designed for adult patients. The release of the stomach in children has its own characteristics.

Basically, the procedure for gastric lavage in case of poisoning in a child is similar to the above algorithm. But there are features due to anatomical and age differences:

the stomach of a child is smaller in volume than that of an adult and varies depending on age. Therefore, it is necessary to calculate the amount of liquid per dose according to the formula: 200 + 100 ml x (n- 1), where n is the age little patient. children infancy give a fixed volume of liquid - newborns ~ 30-50 ml, and babies under the age of six months - 100 ml. One-year-old children can be administered no more than 200 ml. A older than a year- calculated according to the above formula;
for washing use boiled water heated to 20-24 ° C or pharmacy solution NaCl;
the ratio of the injected and received fluid should be strictly taken into account;
if the child is restless or unconscious, then gastric lavage is carried out only by specialists using a probe.

The use of the gastric lavage procedure in case of poisoning does not exclude the examination of the patient by a doctor and, if necessary, hospitalization.

Gastric lavage- a method of cleansing the body of toxins and poisons that have entered the stomach, is more often used in acute poisoning. The procedure improves the patient's condition, promotes speedy recovery, saves lives.

At the first symptoms of poisoning, according to the standards of treatment for infectious diseases, it is recommended to take the bactericidal enterosorbent PEPIDOL (2 tablespoons every 3 hours until the condition is completely normal).

When should you gastric lavage?

Indications

Acute poisoning food, mushrooms, medicines, alcohol.
Narrowing of the stomach outlet
Decreased tone of the muscular wall of the stomach or duodenum 12
Bowel obstruction
With the release of toxic substances into the lumen of the stomach. For example: excretion of urea in chronic renal failure.

Contraindications

Organic narrowing of the esophagus
Acute bleeding from the esophagus or stomach
Severe burns of the larynx, esophagus, stomach with acids and alkalis
Violations cerebral circulation
myocardial infarction, unstable angina, severe violations heart rate
Unconscious state (without prior intubation). Intubation - the introduction of a special tube into the larynx and trachea to maintain airway patency and maintain respiratory activity.
No cough or throat reflex
Seizures, convulsions

Gastric lavage methods

Flushing without using a probe
Flushing with a thick probe
Washing with thin probe

Gastric lavage without using a probe ("restaurant method")

If the patient cannot swallow the tube, then he can drink water on his own and then induce vomiting, thus clearing the stomach.
Drink should be in portions up to 500 ml at a time. Then expect vomiting or stimulate it. In total for efficient rinsing The stomach needs about 5-10 liters of water.

Solutions for washing:

Pure boiled water (20-24°C). Water for washing should not be hot, as it can dilate blood vessels and increase the absorption of toxins, nor cold, which can cause stomach cramps.

Means for collecting wash water (basin, bucket, etc.). Wash water must be shown to emergency doctors, this will help in diagnosing the disease.
Protective equipment for persons helping the patient (waterproof apron, gloves). Vomit may contain viruses, bacteria, poisons and toxins that can enter the body and cause various diseases(For example: intestinal infection or viral hepatitis).

How to do it?

Walkthrough:

This procedure does not completely empty the stomach and therefore it is best used only if lavage with a tube is not possible!

You can't induce vomiting! In case of poisoning with strong acids, alkalis, turpentine, vinegar essence, bleach, bath and toilet cleaners, furniture polish. In these cases, gastric lavage should be used with a probe.

Gastric lavage using a thick tube

What is needed for washing?

Probe for gastric lavage;
The probe itself is a tube made of a rubber compound 80-120 cm long, a thick probe with a diameter of 10-13 mm, a thin one 5-9 mm. One end is cut, and the other is rounded and has side holes.
Washing solution (5-10 liters)

Pure boiled water ( 20-24°C). Water for washing should not be hot, as it can dilate blood vessels and increase the absorption of toxins, nor cold, which can cause stomach cramps.
Saline solution (2 tablespoons per 5 liters of water). Prevents the movement of toxins and poisons further into the intestines, causing a spasm of the output sphincter of the stomach.
Light solution of potassium permanganate (potassium permanganate). Make sure that there are no small crystals of potassium permanganate left by stirring the solution well or filtering it. Since the crystals can get on the mucous membrane of the esophagus, stomach and cause burns. Potassium permanganate binds toxins, and also has an antiseptic and antimicrobial action.
Soda solution (2 tablespoons per 5 liters of water).
Important! Correctly calculate a single dose of infusions (5-7 ml per 1 kg of the patient's body weight). The simultaneous introduction of a large volume of fluid into the stomach contributes to its entry into the intestines.

Funnel with a capacity of 500ml-1l, mug
Towel, napkins
Wash water tank
Gloves, waterproof apron
Vaseline oil or glycerin

How to do it?

Walkthrough:

Make sure that the patient is conscious and adequately understands what is happening.
give correct position sick sitting on a chair (closer to the back) or lying on your side (without a pillow under your head).
Cover the patient's chest with an apron or diaper
Determine the required length of the probe for the procedure. To do this, using a probe, the distance is measured, from the lips to the earlobe, then down the front abdominal wall, to the lower edge of the xiphoid process. The found point should be marked on the probe, which will be a good guide when inserting the probe and will allow you to bring it to right place.
Explain to the patient that when the probe is inserted, he may feel nausea and vomiting., but if you breathe deeply through your nose, these moments can be suppressed. In addition, the probe must not be squeezed with teeth and pulled out.
Wash your hands, wear gloves
Sprinkle the rounded end of the probe liberally with glycerin or vaseline oil
Stand to the right of the patient(if you are right handed). Ask the patient to open their mouth and place the rounded end of the probe on the root of the tongue.

At inappropriate behavior the patient is better to carry out the procedure with an assistant who would hold the patient and fix the head in the correct position.

Ask the patient to make several swallowing movements(if possible), during which the probe should be slowly and evenly advanced into the esophagus. Advance the probe to the required mark, if the resistance is small.

Make sure the probe is in the stomach

Options:

The beginning of the release of gastric contents when the probe is lowered below the level of the stomach
Using Janet's syringe, inject 20 ml of air into the stomach, while listening with a phonendoscope or directly leaning your ear against the abdominal wall in the stomach area characteristic sounds.
Draw contents from the stomach into a syringe

When pouring water into the funnel, make sure that it does not empty completely, otherwise air will enter the stomach, which will make it difficult to rinse.

Repeat the procedure until clean wash water(use prepared 5-10 liters of water).
After the end of the procedure, disconnect the funnel and slowly remove the probe by wrapping it in a napkin or towel.

Note:

Correctly calculate the portion of a single injection of liquid (5-7 ml per 1 kg of the patient's body weight). Too much water introduced once contributes to the opening of the outlet of the stomach and the entry of toxins and poisons into the intestines.
Monitor the amount of injected and withdrawn fluid (the difference should not exceed 1% of the patient's weight). Absorption of large amounts of fluid into the body can lead to grave consequences(“water poisoning”).

Video:

Gastric lavage with a thin gastric tube

What is needed for washing?

Pure boiled water ( 20-24°C).
Saline solution (2 tablespoons per 5 liters of water).
Light solution of potassium permanganate (potassium permanganate)
Soda solution (2 tablespoons per 5 liters of water).

A glass of water (50 ml) and a drinking straw
Syringe jane
Adhesive plaster
Towel, napkins
Gloves
Container for washing water (basin, bucket, etc.)
5-10 liters of rinse solution

How to do it?

Walkthrough:

Make sure that the patient understands the course and goals of the upcoming procedure.
Put on an apron and gloves.
Insert a thin probe through the mouth (see gastric lavage with a thick probe) or through the nose.

Insertion of a thin gastric tube through the nose

Technique for inserting a thin probe into the stomach

Gastric lavage in children

The technique and principles of gastric lavage in children are practically no different from gastric lavage in adults. However, there are some features:

Children should be better fixed, the procedure should be carried out with an assistant. The child is seated on the hands of an assistant, who grabs the child’s legs with his legs, fixes his hands with one hand, and his head with the other, placing his hand on the child’s forehead. The child can be wrapped in a diaper or sheet and laid on its side.
The diameter of the gastric tube must be selected depending on the age of the child
The volume of flushing fluid is calculated based on the age of the child. A single volume for washing for a newborn is 30-50 ml, for a child from 1-6 months 100 ml, from 6-12 months 200 ml. For children older than 1 year, the volume is calculated by the formula (200 + 100 ml x (n-1), where n is the number of years).
Be sure to take into account how much liquid was injected and how much was removed, excessive water ingestion into the intestines can lead to so-called "water poisoning" (the difference should not be more than 1% of the child's body weight).

Possible difficulties and complications when gastric lavage with a probe

Out of the funnel less water than was introduced into the stomach. Perhaps some of the water passed into the intestines. Or the probe is bent and is preventing normal outflow of fluid. This happens when the probe is inserted too deep or if it is not inserted enough. To solve the problem, you need to insert the probe a little deeper or pull it out a little.
The elimination of fluid from the stomach has stopped. Perhaps the probe holes are clogged with blood clots, mucus, food debris. In this case, the probe should be removed and cleaned.
When the probe is inserted, the mucous membrane, esophagus, stomach can be damaged, which in some cases can lead to bleeding and blood entering the respiratory tract.
Ingress of wash water into the respiratory tract with the development of acute respiratory failure.
Damage to the vocal cords when the probe enters the larynx (getting into the larynx is accompanied by coughing, shortness of breath and blue face).

Common mistakes when gastric lavage

The introduction of large volumes of liquid once, promotes the opening of the exit sphincter of the stomach and the entry of poisons and toxins into the intestines. Calculation according to the formula 5-7 ml per 1 kg of the patient's body weight.
There is no control over the amount of injected and withdrawn fluid. Excessive absorption of water into the body can lead to serious violations(“water poisoning”). The difference between the injected and withdrawn water should not exceed 1% of the patient's body weight.
The use of concentrated solutions of potassium permanganate (potassium permanganate), which causes chemical burns stomach and esophagus.