From the Research
Gastric lavage should not be performed routinely in the management of poisoned patients, and when it is indicated, the optimal position is not clearly established due to limited and equivocal evidence. When considering the optimal position for gastric lavage in acute poisoning, several factors must be taken into account, including the anatomy of the stomach and esophagus, the risk of aspiration, and the effectiveness of the procedure.
- The left lateral decubitus position, with the head slightly lowered, has been suggested as a potential optimal position for gastric lavage, as it may help to minimize the risk of aspiration and allow for more effective removal of stomach contents 1.
- However, the evidence supporting the use of gastric lavage in acute poisoning is limited and equivocal, and most studies suggest that it should not be performed routinely 2, 3.
- In fact, the American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists have stated that gastric lavage should not be employed routinely in the management of poisoned patients, and that it may cause significant morbidity 3.
- More recent studies have also highlighted the potential risks and limitations of gastric lavage, and have suggested that it should only be considered in rare cases where the patient's life is at risk and the procedure can be undertaken within 60 minutes of ingestion 2, 4.
- Ultimately, the decision to perform gastric lavage and the optimal position for the procedure should be made on a case-by-case basis, taking into account the individual patient's needs and circumstances, and with careful consideration of the potential risks and benefits.
- It is also important to note that other methods of decontamination, such as activated charcoal, may be more effective and safer than gastric lavage in many cases 5, 4.