Stomach Pumping (Gastric Lavage): Procedure, Time, Risks & Modern Role

Gastric Lavage Overview

Procedure duration: Typically 15–30 minutes.

Step-by-Step Process

1. Patient positioned (left lateral, head down) or intubated if unconscious to protect the airway.
2. Large-bore orogastric or nasogastric tube inserted.
3. Tube placement confirmed via aspirate pH or X-ray.
4. Sequential instillation and aspiration of warm water or saline (200–300 mL aliquots) until returns clear.
5. Activated charcoal may be instilled post-lavage if indicated.

Narrow Indications

• Life-threatening ingestion within 1 hour (some toxins up to 4 hours).
• Agents not adsorbed by charcoal (iron, lithium, alcohols, heavy metals).
• Large volume ingestions.

Contraindications and Risks

• Corrosive ingestion (perforation risk).
• Hydrocarbons (aspiration pneumonitis risk).
• Unprotected airway (aspiration risk).
• Complications: aspiration, esophageal/gastric perforation, electrolyte shifts, arrhythmias, hypoxia.

Current Clinical Role

Rarely used today. Activated charcoal plus whole bowel irrigation is preferred for most poisonings. The decision is made by a toxicologist or emergency physician.