Station 12 — Gastric Lavage / Stomach Wash on Manikin
🎯 Task
You are provided with a manikin and the equipment required for gastric lavage. Demonstrate the preparation, safe positioning and correct sequence of gastric lavage, and state the important situations in which the procedure should not be performed.
⚡ Model Station Answer
- I would first assess airway, breathing and circulation, confirm that lavage is specifically indicated, and check for contraindications.
- I would prepare PPE, suction, a large-bore orogastric tube, lubricant, lavage fluid, collection containers and monitoring equipment.
- I would position the patient left lateral with the head lower than the torso when clinically safe, insert the lubricated tube to the measured length and confirm gastric placement.
- I would aspirate the initial gastric contents, then instill and recover small aliquots of warm lavage fluid while continuously monitoring the patient.
- I would stop if complications occur, complete the procedure safely and document the fluid used, return obtained and patient’s condition.
🔎 Stepwise Procedure / Approach
- Confirm indication and assess safety.
Review the poisoning history or clinical order, perform an ABC assessment and ensure appropriate monitoring and resuscitation facilities are available. - Check contraindications before starting.
Do not proceed in a patient with an unprotected airway and impaired protective reflexes, corrosive ingestion, a hydrocarbon with high aspiration risk, or suspected gastrointestinal perforation or major bleeding risk. - Prepare the equipment.
Arrange gloves and protective equipment, large-bore orogastric tube, water-soluble lubricant, suction or aspiration system, syringe/funnel as appropriate, warm isotonic lavage fluid, receiver, specimen container and monitoring equipment. - Explain, obtain consent and position correctly.
In a responsive patient explain the procedure and obtain consent. Position the patient in the left lateral position with head-down tilt when clinically appropriate to reduce aspiration risk. - Measure and insert the tube.
Estimate the required insertion length externally, lubricate the distal end and gently advance the large-bore tube through the mouth toward the stomach. Never force the tube against resistance. - Confirm gastric placement.
Confirm that the tube is in the stomach according to the approved local protocol before introducing lavage fluid. Aspirate initial gastric contents and preserve a specimen if toxicological analysis has been requested. - Perform lavage.
Introduce approximately 200–300 mL of warm isotonic fluid in an adult, then allow it to drain or aspirate it back. Repeat sequentially while monitoring the volume instilled and recovered. - Monitor throughout.
Observe airway, breathing, oxygen saturation, pulse and clinical condition. Stop immediately if respiratory distress, aspiration, significant bleeding or other deterioration occurs. - Complete safely.
Once the intended endpoint is reached, recover the lavage fluid, clamp or occlude the tube during removal when appropriate, remove it gently and provide basic aftercare. - Dispose and document.
Dispose of contaminated material safely and document the indication, procedure, fluid instilled and recovered, specimens collected and patient’s response.
🖼️ Visual Learning
Gastric Lavage — Equipment, Positioning, Tube Placement and Lavage Cycle
🎥 Practical Video
🎥 Gastric Lavage Procedure | Stomach Wash | Gastric Suction
Practical demonstration covering the equipment, patient preparation, gastric-tube technique, lavage sequence and post-procedure care.
📝 Important Viva Questions
It is the removal of gastric contents by repeated introduction and recovery of fluid through a gastric tube.
No. It is reserved for selected potentially serious ingestions after careful assessment because the procedure itself can cause significant complications.
A large-bore orogastric lavage tube is generally preferred because it permits removal of gastric material more effectively than a narrow feeding tube.
It helps keep gastric contents dependent within the stomach and assists in reducing aspiration and movement of material toward the pylorus during the procedure.
Important contraindications include an unprotected airway with impaired protective reflexes, corrosive ingestion, hydrocarbons with high aspiration potential and situations with significant gastrointestinal perforation or bleeding risk.
The initial gastric contents should be aspirated before lavage fluid is introduced and preserved in an appropriate labelled container when toxicological examination is required.
Aspiration, hypoxia, laryngospasm, tube misplacement, gastrointestinal trauma or perforation, bleeding and fluid or electrolyte disturbances may occur.