Save time when performing gastric lavage

When performing gastric lavage, spike a bag of normal saline (NS) with standard IV tubing, recommends Ben Laughton, RN, BSN, CEN, an emergency nurse at Johns Hopkins Bayview Medical Center in Baltimore, MD. "Push the end of the tubing into the end of the nasogastric (NG) tube," he explains. "Sometimes, the tip of the tubing must be removed or the end must be `adapted' using various connecting pieces." The NS can then be opened up "wide," bolusing 200-500 cc NS into the stomach.

"As the patient begins to feel "full," or about 250 cc have gone into the comatose adult patient, the flow can be stopped with the rollerclamp and the NG tube can be attached to intermediate suction," says Laughton. An advanced technique involves suctioning through the "blue" port on salem sumps or even continuous lavage with intermediate suction: the NS through the blue port and the suction via the main line or vice versa.

"This technique is time-saving and is actually more comfortable for the patients as the tube is jostled less by the nurse," says Laughton. Pitfalls include bolusing the stomach with too much NS or suctioning with too high a pressure, potentially ulcerating the stomach wall, he notes.