Assisting in Gastric Lavage

ASSISTING IN GASTRIC LAVAGE
Definition: Gastric lavage is the aspiration of the stomach contents and washing out of the
stomach by means of a gastric tube.
Underlying Principles:
Ingested food has a normal route in the GIT in order to ensure adequate absorption
of nutrients and elimination of ingested portions. Failure to eliminate the ingested
portion and products of fermentation can cause discomfort due to the effect of
abdominal distention.
There are some cases wherein the ingested food or chemical are poisonous and its
absorption can lead to poisoning. Immediate decompression is necessary to
minimize absorption of these poisonous chemical. The nurse has an important
role in ensuring safety of the patient through assisting either health care personnel
in decompression.
Purposes:
1. To cleanse the stomach of undigested food, fermenting material, and toxic and
poisonous substances.
2. To relieve persistent vomiting.
3. To cleanse the stomach to prevent and to check nausea.
4. To cleanse the stomach to prepare for gastric surgeries.
5. To relieve gastric distention, pain, congestion, and inflammation.
6. To analyze gastric function.
Equipment:
Tray with the following articles:
 Sterile pack with sterile bowl
 Irrigating solution as prescribed
 Mouth wipes
 Graduate measure
 Large kidney basin or bucket
 Rubber sheet with draw sheet
 Towel
 Nasogastric tube (desired size), if needed
 Large irrigating syringe or Asepto syringe
 Sterile pair of gloves
 Clean disposable glove
STEP RATIONALE
ASSESSMENT
1. Inspect the volume, color, and character of Thick secretions and a reduced volume of
gastric aspirates (if obtainable). secretions may indicate need to irrigate tube.
Excess volume of secretions may indicate
delayed gastric emptying.
2. Note ease in infusing in tube feeding. Failure of formula to infuse as desired may
indicate developing obstruction.
3. Check the physician’s order. To be sure of the exact procedure to be done
and to identify the purpose of the procedure.
4. Refer to agency policies regarding routine Determines frequency of irrigation.
irrigations (e.g. before medication
administration).
1
STEP RATIONALE
PLANNING
1. Identify expected outcomes following the
completion of the procedure: Irrigation fluid clears inner lumen of feeding
 NG tube remains patent. tube of accumulated solids and secretions.
 Abdomen relieved of distention Feeling of comfort absence of N/V.
2. Explain procedure to patient. Minimizes anxiety during manipulation of

tube.
3. Wash hands. Reduces transmission of microorganisms.
4. Prepare equipment.
a. Gather the needed equipment. To identify what items must be obtained
separately.
b. Examine NG tube for flaws: rough or Flaws in feeding tube hamper tube intubation
sharp edges on distal end and closed or and can injure patient.
clogged outlet holes.
c. Bring equipment to bedside. Set a table To prevent delay in the performance of the
for equipment. You may need to clean procedure. Ensures ease and success of
the surface of the table. procedure. For infection control.
IMPLEMENTATION
1. Identify the patient. To be sure that you are performing the
procedure to the right patient.
2. Prepare equipment at patient’s bedside and
apply gloves.
3. Assist patient to position of comfort and This position decreases passage of gastric
ease of drainage. contents into the duodenum during lavage and
 CONSCIOUS: client on high Fowler’s minimize the possibility of aspiration into the
if tolerated or semi Fowler’s at left lungs.
lateral position
 UNCONSCIOUS: in left lateral with
the head lowered approximately 15
degrees downward neck and trunk
forming a straight line.
PHYSICIAN’S RESPONSIBILTY
1. Kink NG tube
2. Determine that NG tube is properly placed. With tip of tube correctly placed in stomach,
irrigation will not create risk of aspiration.
3. Draw up normal saline or tap water in
syringe.
4. Insert tip of catheter into end of NG tube. Prevents leakage of fluid clears tubing.
Release kink and slowly
5. If unable to instill fluid, reposition patient Changing patients’ position may move tip
on left side and try again. away from stomach wall. Notify physician if
unable to instill fluid.
STEP RATIONALE
6. Aspirate further gastric contents before
instilling lavage solution in small amounts Infusion of fluid clear tubing. Overfilling of
through an asepto syringe. stomach may cause regurgitation and
7. Elevate asepto syringe above the patient’s aspiration or force the stomach contents
head and infuse approximately 150-200 ml through the pylorus. Lavage fluid should be
of solution. left in place about one minute.
2
8. Lower the asepto sysringe and siphon The fluid should flow in freely to drain by
gastric contents into receptable. gravity.
9. Repeat lavage procedure until the return Tubing is clear and patent.
flow is relatively clear.
Nurses Responsibilities
1. Assist physician as needed.

2. Monitor amount of fluid infused and total Amount fluid brained minus the amount
amount of fluid drained. infused equals the GIT discharge. Fluid
drained less than fluid infused indicates fluid
retention.
3. Reconnect tube to suction or remove tube
if ordered.
4. Make patient comfortable.
5. Do proper aftercare of equipment.
 Dispose used supplies .
 Wash equipment with soap and water
if non-CD
 Soak with zonrox 1:9 solutions. Wash
with soap and water after
 Remove and discard gloves
 Wash hands Reduces transmission of microorganisms.
6. Send specimen to laboratory for
examination if needed.
EVALUATION
Observe ease with which tube feeding instills
through tubing A successful irrigated tube is patent, allowing
for free flow of tube-feeding solution
RECORDING AND REPORTING
1. Record time of irrigation, amount and type
of fluid instilled, and results in progress
notes or appropriate flow sheet.
2. If patient’s intake and output are being
monitored, record amount and types of fluid
instilled.
UNEXPECTED OUTCOMES AND RELATED INTERVENTIONS

 Tube remains obstructed.
Retry irrigation. If unsuccessful, notify physician. Tube may need to be removed and
then reinserted.
Revised :
VVB
1/2021
3
Student: ___________________________
Instructor: _________________________
Instructor’s Signature: _______________ Date: _________________
PERFORMANCE CHECKLIST ASSISTING IN GASTRIC LAVAGE
Below Needs Remarks

PREPARATION: Excellent Satisfactory Satisfactory Major
Remedia-
tion
( 4) (3) (2) (1)
ASSESSMENT
1. Inspected the volume, color, and character
of gastric aspirates (if obtainable).
2. Noted ease of infusing in the NG tube
feeding.
3. Checked the physician’s order.
4. Referred to agency policies regarding
routine irrigations (e.g. before medication
administration).
PLANNING
1. Identified expected outcomes following the
completion of the procedure:
- NG tube remains patent.
- Abdomen relieved of distention
2. Explained procedure to patient.
3. Washed hands.
4. Prepared equipment:
a. Gathered the needed equipment.
b. Brought equipment to bedside.
c. Set a table for equipment.
IMPLEMENTATION
1. Identified the patient.
2. Assisted patient to position of comfort and
ease of drainage.
 CONSCIOUS: client on high Fowler’s
at left lateral position
 UNCONSCIOUS: in the left lateral
with the head lowered approximately 15
degrees downward neck and trunk
forming a straight line.
3. Prepared equipment at patient’s bedside and
applied gloves.
4. Worn gloves.
5. Opened the sterile pack and poured the
ordered irrigating solution in bowl using
aseptic technique.
6. Applied towel on patient’s chest.
7. Assisted physician as needed.
8. Monitored amount of fluids infused and total
amount of fluid drain.
9. Reconnected tube to suction/ or clamped or
removed tube if ordered.
10. Made patient comfortable after procedure:
4
Needs
Excellent Satisfactory Below Major Remarks
PREPARATION: Satisfactory Remedia-
tion
( 4) (3) (2) (1)
ASSESSMENT
 Placed patient in a comfortable position.
 Gave oral care.
 Gave face wash.
11. Did after care of equipment:
 Disinfected equipment.
 Rinsed and washed all equipment with
soap and water.
 Returned equipment to its proper place
or CSR if necessary.
EVALUATION
1. In case of obstructed NGT, observed ease
with which tube feeding instills through
tubing.
2. In case of ingested poisoning abdomen was
cleared of gastric content.
RECORDING AND REPORTING
1. Recorded time of irrigation, amount and
type of fluid instilled, and results in
progress notes or appropriate flow sheet.
2. If patient’s intake and output are being
monitored, record amount and type of fluid
instilled.
3. Recorded/ reported patient’s response to
management.

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ASSISTING IN GASTRIC LAVAGE

2. Explain procedure to patient. Minimizes anxiety during manipulation of

1. Assist physician as needed.

UNEXPECTED OUTCOMES AND RELATED INTERVENTIONS

Instructor’s Signature: _ Date: ___

PERFORMANCE CHECKLIST ASSISTING IN GASTRIC LAVAGE

Below Needs Remarks

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