Annals of emergency medicine
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Review
Does gastric lavage really push poisons beyond the pylorus? A systematic review of the evidence.
Classically, treatment of acute self-poisoning involves resuscitation and supportive care, followed by gastric emptying, administration of activated charcoal, and use of specific antidotes. Recently, however, the practice of gastric emptying has fallen out of favor in the West because physicians have recognized its complications and the lack of evidence for clinical benefit from its practice. Authoritative position statements have stated that forced emesis should not be used and that gastric lavage should be used in restricted settings. ⋯ However, analysis of the data presented in this article shows no significant difference in the number of radio-opaque marker pellets present in the small bowel after gastric lavage, ipecac-induced forced emesis, or no intervention. The second, an observational study using human volunteers, showed significantly less poison in the small bowel after gastric lavage than after no intervention. In conclusion, it seems that no published data support the statement that gastric lavage forces poison into the small bowel.
-
Review
Does gastric lavage really push poisons beyond the pylorus? A systematic review of the evidence.
Classically, treatment of acute self-poisoning involves resuscitation and supportive care, followed by gastric emptying, administration of activated charcoal, and use of specific antidotes. Recently, however, the practice of gastric emptying has fallen out of favor in the West because physicians have recognized its complications and the lack of evidence for clinical benefit from its practice. Authoritative position statements have stated that forced emesis should not be used and that gastric lavage should be used in restricted settings. ⋯ However, analysis of the data presented in this article shows no significant difference in the number of radio-opaque marker pellets present in the small bowel after gastric lavage, ipecac-induced forced emesis, or no intervention. The second, an observational study using human volunteers, showed significantly less poison in the small bowel after gastric lavage than after no intervention. In conclusion, it seems that no published data support the statement that gastric lavage forces poison into the small bowel.