Gastric lavage algorithm for children

Stomach pumping, or gastric lavage, is a medical procedure that may be required in specific circumstances, particularly for children. It is frequently applied in cases where a child has consumed something toxic, poisonous, or prescribed. It can be very important to know when and how this procedure is carried out in order to safeguard a child’s health.

Gastric lavage is a gentle flushing procedure used to remove undesirable or hazardous contents from the stomach. Although it may seem difficult, done properly, it can help avoid more serious health issues. For this reason, it’s critical that parents know the fundamental procedures and when to seek medical attention.

We’ll go over the main steps of the gastric lavage algorithm for kids in this post, along with when it’s required and what to anticipate from the process. If your child ever needs this kind of care, this can help you be ready for anything and give you the assurance to act quickly.

Why gastric lavage is needed?

In the event that a child has been poisoned, has swallowed something toxic or poisonous, has overdosed on drugs, or has experienced drug poisoning, gastric lavage may be necessary.

Childhood food poisoning is the most common type.

Drug overdose comes in second. No matter how hard adults try to keep prescription drugs that are illegal for them hidden from kids, curious researchers may still come across enticing bottles and pills and will undoubtedly taste them. The same is true for soap, cosmetics, and household chemicals.

Gastric lavage can aid in the removal of harmful materials from the stomach and prevent the body from absorbing more of them. The child typically experiences a great deal of relief following this procedure, and their recuperation process is greatly expedited.

When can the procedure be performed

At the earliest indications of poisoning, such as nausea and headaches, you can wash out the child’s stomach if vomiting is absent or does not relieve the child’s symptoms. Ensuring the child does not have internal bleeding is crucial (the vomit and feces should be clear of any impurities or blood streaks).

The child must be cognizant and awake during the procedure; you cannot wash out the stomach on your own if the child passes out. In addition to cases of poisoning, intestinal blockage, esophageal narrowing, and other gastrointestinal tract disorders can occasionally necessitate washing out the stomach.

Contraindications

A kid must be awake in order to wash their stomach at home. Both fainting and the existence of a convulsive syndrome are contraindications.

Avoiding any indication of stomach bleeding is advised. If a child has swallowed a liquid with an acidic or alkaline composition and sustained severe burns to their stomach, esophagus, or larynx, you should not even attempt to wash their stomach. You cannot wash the child’s stomach yourself if they have acquired or congenital pathologies linked to impaired cerebral circulation. It is preferable to decline the manipulation if the infant has an irregular heartbeat, an unstable pulse, or an aberrant cardiac rhythm.

If you’re unsure about the current list of potential contraindications, call an ambulance and wait for an expert to arrive.

Home method

If required, you can use the "restaurant method," a manual technique, to wash the stomach at home. The child in this instance is given an ample amount of special solutions or ordinary water to drink until they throw up. In case the baby does not feel the urge, one can manually trigger the gag reflex by gently pressing on the uvula root with the index finger while gently inserting it into their mouth.

For a small child, this kind of rinsing can be very challenging because it is nearly impossible to get them to drink the necessary amount of liquid. In this instance, you will require assistance from a second adult to hold the infant while the first adult uses a large, needle-free twenty-millimeter syringe to inject the solution into the child’s mouth. In order to prevent the infant from spitting it out, the liquid is poured along the inside of the cheek. It is best to have the water or drinking solution warm but not hot.

1. The child is placed in the correct position. A baby – in your arms, lying on his side, an older child – sitting or lying on his side. Such positions will prevent the child from choking on vomit if it gushes out "like a fountain".
2. A basin or other container for collecting vomit is placed on the floor at face level.
3. After drinking, induce vomiting by holding the child"s head over the container.
4. If necessary, repeat the rinsing until clean water begins to come out.

It should be mentioned that while this method does not allow you to completely clean the stomach, it is still quite acceptable for first aid. The most important thing is to measure the liquid that the child is given precisely when performing the manipulation:

• newborns – 200 ml;
• children from one and a half months to six months – 300-500 ml;
• children from 6 to 12 months – 500-700 ml;
• children from one year old – 1 liter + 100 x the number of years.

As an illustration, a two-year-old was poisoned. A volume of liquid equal to 1000 ml plus 100 x 2 = 1200 ml is his entitlement. Therefore, a five-year-old needs at least 1500 ml to empty their stomach.

Following washing, the child is given oral rehydration products to drink and is given a half-hour to rest. This will help prevent dehydration and restore the water-salt balance, which is inevitably affected by vomiting. Among them are "Smecta," "Humana Electrolyte," and "Redigron."

They are given warm; it is best for the liquid’s temperature to match the infant’s body temperature. You can drink in tiny amounts and take quick breaks.

What to rinse with

A simple saline solution can be made for at-home rinsing. You’ll need table salt that is most commonly used for this. It is sufficient to add two tablespoons of salt to five liters of water; the concentration shouldn’t be overly strong.

When making a soda solution, the same ratios must be used. You can combine these solutions and serve the child with the resulting beverage.

Use extreme caution when rinsing with potassium permanganate. Severe internal burns can result from even a small crystal overdose or uneven mixing.

If you’re not very experienced with these kinds of things, it’s best to decline a potassium permanganate solution.

The preparation instructions for this specific antiseptic are as follows: a small amount of crystals is diluted in water until light pink, and the solution needs to be run through a household carbon filter if you still wish to use it.

After washing, you can begin taking enterosorbents a few hours later. The following medications should always be kept in your home medicine cabinet: "Lactofiltrum," "Enterosgel," and activated and white carbon.

In cases of poisoning or overdose, a medical procedure called gastric lavage is performed to remove dangerous substances from a child’s stomach. A tiny tube must be carefully inserted into the child’s stomach through their mouth or nose, flushed with saline solution, and then the contents must be removed. Parents and other caregivers should be aware of the proper algorithm because acting quickly can avert major health issues. The main steps, when to seek medical attention, and safety advice are described in this article to help ensure that the procedure is carried out correctly and efficiently in an emergency.

Probe method

The stomach can be cleaned more completely with this method, but you cannot wash it at home with a tube. Not only is there not a tube in every apartment, but you also need to be able to insert the tube correctly so as not to hurt the baby.

When emergency physicians arrive, they can use the tube; hospitals also employ this method.

It’s likely that one of the parents will need to help the nurse with the manipulation.

Either seated or lying down is the patient. Pre-wrapping the baby in a sheet or a big, thick diaper helps prevent abrupt movements, which can harm the larynx and esophagus.

A baby that is unconscious is washed on its side. The parent’s job is to hold the infant; one adult hand should be placed over the child’s arms, the other on the child’s forehead, and the young patient’s legs should be fixed between the adult helping out at the knees. Everything else is handled by the nurse.

To ensure that the probe reaches the necessary depth, the medical professional first measures the distance to the stomach. This is accomplished by measuring the distances between the earlobe and the xiphoid process, which is the narrowest part of the sternum at the bottom, and the tip of the nose.

A spatula is used to open the child’s mouth; if that doesn’t work, a mouth gag and a special tongue depressor are used. The midline of the tongue is where the probe is inserted.

The process is stopped and the attempt is only made again once the baby’s breathing has been restored if the baby starts to choke while passing the probe.

Jean receives the solution via a syringe or funnel that does not have a piston. The funnel is gradually raised higher before being swiftly and cautiously lowered below the stomach’s level. Thisorgan’scontentsarepouredintoabasinthathasbeenreadybeforehand.

Until the liquid exiting the stomach is clear and pure, the procedure is repeated.

The formula "1 liter per 1 year of life" is used to determine the volume of liquid needed for such a lavage. Following the manipulation, the vomit is sent to a lab for analysis.

Rinsing has unique qualities when done on babies and young children under three years old. The healthcare professional needs to measure his movements very carefully; to make inserting the probe easier, specialized pain-relieving sprays can be used.

Common mistakes – how not to harm

Liquid temperature

The liquid’s temperature when used for rinsing is crucial. If the solution is between 27 and 29 degrees, that is ideal.

Anything hotter dilates blood vessels, making them more permeable and causing toxins to be absorbed twice as quickly; anything colder can cause an abrupt spasm of the digestive tract.

Positioning the child

Forcing a child to empty their stomach over the toilet is a mistake. Vomit can enter the respiratory system when you stand up or kneel in front of the toilet.

When washing at home, it is crucial to gather the contents of the stomach in a basin so that the attending physicians can evaluate the vomit. This is required if the parents are unsure of the child’s specific diet or beverage and the poisoning’s cause is not immediately apparent.

Medicines

Some experts in alternative medicine recommend washing children out of their stomachs with herbal decoctions and infusions, but this is not recommended. It is unknown how components in a medicinal plant decoction will interact with the stomach’s contents.

Step	Description
1. Assess the situation	Check the child"s condition and symptoms, such as nausea or poisoning signs.
2. Call for help	Contact a healthcare provider or emergency service before starting gastric lavage.
3. Prepare the materials	Gather warm water, a soft tube (if available), and a bowl for the liquid.
4. Position the child	Have the child sit upright or lie on their side to avoid choking.
5. Administer water	Give small sips of warm water to the child to help wash out the stomach.
6. Induce vomiting	If advised by a healthcare provider, gently stimulate the throat to cause vomiting.
7. Monitor the child	Observe the child for any worsening symptoms and follow the emergency team"s instructions.
8. Wait for medical help	Stay calm and continue to monitor the child"s condition until professional help arrives.

When a child consumes dangerous materials, gastric lavage may be a necessary treatment. It assists in clearing harmful substances from the stomach before they have a chance to do more damage. Even though it could seem overwhelming, being prepared for emergencies can really help.

It’s critical to remain composed and move fast. Always heed the advice of medical professionals, and don’t hesitate to seek medical attention when necessary. Only when absolutely necessary and under appropriate supervision should the procedure be carried out.

Understanding the gastric lavage procedure can help parents and other caregivers feel more confident and capable of handling the situation should it come up. They are able to take more precise action to safeguard the child’s health because they comprehend the algorithm.

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