Gastric lavage in children
Gastric lavage in children is conducted with food poisoning, medicinal and chemical intoxications, as well as with intestinal infections. This manipulation belongs to the category of pre-hospital care.
The time spent cleaning the stomach in a child can save his life or prevent the development of severe consequences. Therefore, every responsible parent should know the technique of washing, and also have a set of necessary tools.
It should be remembered that gastric lavage is advisable only in the first hours of poisoning. Further, toxic substances are absorbed into the blood and detrimentally affect the vital organs and systems of the body.
Indications and contraindications
Indications for gastric lavage are as follows:
- food poisoning;
- chemical or drug intoxication;
- intestinal infections;
- intestinal obstruction;
- anomalies in the development of the gastrointestinal tract in the newborn;
- narrowing of the cardiac sphincter of the stomach;
- decreased muscle tone of the stomach.
- atresia of the esophagus;
- organic narrowing of the esophagus;
- scars after chemical or thermal burns of the esophagus;
- acute bleeding from the upper sections of the gastrointestinal tract;
- severe neurological disorders;
- impaired cerebral circulation;
- convulsions, epileptic seizure;
- absence of cough reflex;
- unconsciousness of the child, without pre-intubation of the trachea (introduction of the intubation tube into the larynx and trachea to maintain airway patency and maintain spontaneous or independent breathing).
What to consider
It should be borne in mind that children of the first year of life should be swaddled before washing the stomach. And the children in the unconscious state must first be intubated.
Gastric lavage for a child up to four months is possible only through a nasogastric tube. It can only be supplied by medical personnel in a specialized institution.
It is advisable to purify the stomach with boiled water at room temperature. It is not recommended to use a solution of potassium permanganate, since in this case a burn of the upper respiratory tract is possible.
It should also take into account the amount of fluid administered to each child. So, if a newborn baby needs to enter about 200 milliliters in a total volume, a one-year-old child - about one liter, a preschool child - 3-5 liters, a schoolchild - 6-7 liters, and a teenager already about 8 liters.
Preparing the child for gastric lavage
Young children are first given a nasogastric tube (a small tube is inserted into the stomach through the nose), this procedure is performed only in the hospital. If the probe is placed through the nose, then a roller is placed under the shoulders of the child, the head is thrown backwards. For the purpose of anesthesia, one drop of lidocaine is injected into the nasal passage. Before using this medication, you should make sure that this baby does not have allergies to it. Smooth circular movements put the probe into the nasal passage.
Older children are advisable to put the probe into the stomach through the mouth, since it has a larger diameter. The first thing done is the toilet in the mouth. The mucous membrane of the oral cavity is wiped with a moistened wool swab of furacilin solution. The probe should be lubricated with vaseline or glycerin ointment. Between the teeth of the child is inserted a rotor-expander. It is necessary to ask the baby to swallow. After that the doctor should make sure that the probe is located in the stomach. With the help of the "Janet" syringe, the doctor injects a small amount of air through the probe, while simultaneously listening to the epigastric region with a phonendoscope. With proper manipulation in the stomach, air will be heard.
Preparation of solution
Boil water should be prepared at room temperature before starting the washing. It must be remembered that too cold water can cause a spasm of the musculature of the upper respiratory tract, and hot water will promote the vasodilation, therefore, accelerate the absorption of toxins into the blood.
Washing can also be carried out with a weak saline solution (based on 1 tablespoon per 1 liter of water).
Stomach washing technique
There are several ways to wash it. Older children can use the "restaurant method", that is, without pre-setting the probe. In this case, the child drinks about half a liter of water at a time and causes vomiting, pressing a blunt object on the root of the tongue. In total, the child should drink about 5-8 liters of water.
When the stomach is washed through a catheter, the liquid is introduced into the established funnel, then it is lowered below the stomach level, achieving the outlet of the wash water. Manipulation is carried out until the washings are clear. At the end of the procedure, it is necessary to remove the probe, rinse the mouth and throat with warm water.
In order to achieve a positive result, it is necessary to follow the algorithm of gastric lavage in children.
After washing, the introduction of adsorbents is recommended, to bind toxic substances and quickly remove them from the body. These include:
- Activated carbon.
It should be remembered that with unqualified purification of the stomach may develop severe consequences . Aspiration (ingression into the respiratory tract) by washing water and blood (with a trauma to the pharynx, esophagus or stomach), the development of edema of the brain or lungs (with the introduction of more fluid) is possible.
Therefore, in severe cases or if the child is very small, you need to go to the hospital, where you will be provided with specialized care, observing the technique of gastric lavage in children, and will give recommendations on the recovery of the body after poisoning the child.