Articles: gastric-lavage.
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Acute poisoning remains a common cause of morbidity and even mortality in children and adults. The goal of gastrointestinal decontamination is to eliminate or to reduce the potentially life-threatening effects of the ingested poison. Methods of gastrointestinal detoxication in case of acute poisoning, such as induced emesis, gastric lavage, administration of activated charcoal and intestinal cleansing are discussed. ⋯ Single doses of activated charcoal can be insufficient. In certain kinds of poisoning, repeated doses of activated charcoal are advisable because of the interruption of the entero-hepatic and entero-enteric circulation. The benefit and the indications for intestinal cleansing in case of acute poisoning seem to be very limited.
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Comparative Study
Ipecac-induced emesis and gastric lavage are equally unpleasant.
It has been widely held that gastric lavage is more unpleasant than ipecac-induced emesis. In fact, patients are occasionally threatened with large rubber tubes in order to persuade them to drink ipecac. To confirm that this assumption exists, we asked 41 emergency physicians and nurses who had never personally undergone either procedure to estimate the discomfort of each using a 10 cm unsegmented visual analog scale. ⋯ Among these who had actually experienced both, there was no significant difference between the mean scores for lavage (4.09) and emesis (4.62) (P greater than 0.5, paired t-test). The mean score difference (lavage minus emesis) for the "naive" group was significantly greater than for the experimental group (1.52 vs -.53, P less than .001, unpaired t-test). Among normal volunteers, ipecac-induced emesis and gastric lavage are equally unpleasant gastric emptying procedures.
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Comparative Study Clinical Trial Controlled Clinical Trial
Efficacy of ipecac-induced emesis, orogastric lavage, and activated charcoal for acute drug overdose.
The efficacy of ipecac-induced emesis, large-bore orogastric lavage, and activated charcoal as gastrointestinal decontamination procedures after acute drug overdose is unknown. Using an ampicillin overdose model, these three procedures were compared with one another and to a control ingestion in ten human volunteers. ⋯ This model examines each intervention in a mutually exclusive fashion. It supports activated charcoal administration as the primary gastrointestinal decontamination procedure after acute drug overdose.
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Critical care medicine · Aug 1987
Comparative StudyEvaporation versus iced gastric lavage treatment of heatstroke: comparative efficacy in a canine model.
We compared the speed of cooling and treatment efficacy for evaporative cooling vs. iced gastric lavage in a canine heatstroke model. Nine random-source, mongrel dogs were anesthetized, shaved, and internally heated until the core temperature reached 43.0 degrees C. The animals were then randomly assigned to be cooled to 37 degrees C either by iced (1 degree C) tap water gastric lavage (n = 5200 ml/min) through a large (32-Fr) orogastric tube, or by spraying with tap water (n = 4, 15 degrees C, 12 L/min) before a large fan blowing room temperature air (23 degrees C) across the dog at 0.5 m/sec from a height of 50 cm. ⋯ Moreover, all animals treated with evaporation survived and were neurologically intact 48 h later, while only one lavage-treated dog was neurologically intact over the same period. The others in the lavage group died one hour after cooling (n = 1), were grossly ataxic (n = 1), or were persistently comatose (n = 2). A simple evaporative cooling technique, readily available in the emergency department, appears to be the most rapid and effective means for cooling and treating heatstroke in the dog.
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Comparative Study Clinical Trial Controlled Clinical Trial
Ipecac-induced emesis versus gastric lavage: a controlled study in normal adults.
Ipecac-induced emesis and gastric lavage are the two procedures most widely used to evacuate the stomachs of patients who have ingested poisons. To resolve a long-standing controversy over the relative efficacy of these two methods, the authors carried out a controlled study in which they administered 25 100-micrograms tablets of cyanocobalamin (vitamin B12) to 18 fasting normal adult volunteers on two separate days. On one day, each subject had emesis induced with 30 ml of ipecac syrup followed by 1,000 ml of tap water; on another day, each underwent gastric aspiration and lavage with a 1.1-cm orogastric tube using 3 l of fluid. ⋯ The recovered vomitus or gastric washings from each procedure were then analyzed for elemental cobalt using atomic absorption spectrophotometry. The mean rate of recovery of the ingested tracer with ipecac-induced emesis was only 28%, whereas gastric lavage resulted in retrieval of 45% (paired t-test, P less than 0.005). In this study, carefully performed gastric lavage was the more effective method of gastric evacuation of tablets in the adult subject.