Gastric Lavage for Paint Thinner Ingestion
Gastric lavage should NOT be performed for paint thinner ingestion under any circumstances. Paint thinner is a hydrocarbon with high aspiration potential, making gastric lavage absolutely contraindicated due to the severe risk of chemical pneumonitis and respiratory compromise 1, 2.
Why Gastric Lavage is Contraindicated
Hydrocarbons like paint thinner pose extreme aspiration risk, and gastric lavage is explicitly contraindicated when hydrocarbons with high aspiration potential have been ingested 1, 2. The mechanical process of inserting a tube and lavaging the stomach significantly increases the likelihood of vomiting and subsequent aspiration, which can cause life-threatening chemical pneumonitis 1.
Even in poisonings where gastric lavage might theoretically be considered, the evidence shows it should not be employed routinely and carries significant morbidity without proven clinical benefit 1, 2. The procedure is only potentially justified in rare cases of life-threatening ingestions of non-hydrocarbon substances when performed within 60 minutes of ingestion 1, 3.
Appropriate Management for Paint Thinner Ingestion
Immediate Priorities
Prioritize airway protection and respiratory support as the primary concern, since hydrocarbon aspiration causes direct lung injury 4, 3.
Implement supportive care measures including monitoring for respiratory distress, oxygen supplementation if needed, and hemodynamic stabilization 4, 3.
Do NOT induce vomiting with ipecac syrup or any other method, as this dramatically increases aspiration risk 4, 3.
Decontamination Approach
Activated charcoal is NOT indicated for hydrocarbon ingestions, as hydrocarbons are poorly adsorbed by charcoal and the risk of aspiration during administration outweighs any theoretical benefit 4.
Contact poison control centers immediately for expert guidance on management, as they can provide substance-specific recommendations and ongoing consultation 4, 5, 6.
Key Clinical Pitfalls to Avoid
Never perform gastric lavage for any hydrocarbon ingestion, regardless of the amount ingested or time since ingestion 1, 2.
Do not delay airway protection to attempt any gastrointestinal decontamination method 4, 5.
Avoid any intervention that increases vomiting risk, including mechanical stimulation of the pharynx or administration of emetics 4, 3.
Evidence Quality Note
The contraindication to gastric lavage for hydrocarbon ingestion represents a consensus position from major toxicology societies based on well-established pathophysiology and clinical experience 1, 2. The 2013 position paper update reinforces that gastric lavage should not be performed routinely, if at all, and specifically excludes hydrocarbons due to aspiration risk 2.