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Old 04-23-2013
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ER Gastric Lavage when to do it

I am reading MTB 3 page 492: "Intubation and lavage can rarely be performed if the patient has ingested the substance within the last 1-2hrs and there is no response to naloxone, dextrose, and thiamine"

In MTB 3 states that any person coming in with unknown cause of coma or alter mental status you give naloxone, dextrose, and thiamine (at the start of EM chapter). In MTB 2 states if they digest something go for gastric lavage if within 2 hrs.

My confusion - so giving the state at the start why are they stating do Intubation and lavage after you give naloxone, dextrose, and thiamine and if that fails then do the lavage and intubation (where MTB 2 state you do lavage 1st known they took something)?
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Old 04-23-2013
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Sorry everyone I thing I got it.

Person take pills (unknown med) + coma or altered mental status = naloxone,.... then do intubation with gastric lavage if no signs of improvement.

Person takes pills (known meds or unknown meds) + NO signs of coma or altered mental status = do gastric lavage
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Old 04-23-2013
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Quote:
Originally Posted by gear2d View Post
I am reading MTB 3 page 492: "Intubation and lavage can rarely be performed if the patient has ingested the substance within the last 1-2hrs and there is no response to naloxone, dextrose, and thiamine"

In MTB 3 states that any person coming in with unknown cause of coma or alter mental status you give naloxone, dextrose, and thiamine (at the start of EM chapter). In MTB 2 states if they digest something go for gastric lavage if within 2 hrs.

My confusion - so giving the state at the start why are they stating do Intubation and lavage after you give naloxone, dextrose, and thiamine and if that fails then do the lavage and intubation (where MTB 2 state you do lavage 1st known they took something)?
i am not clear with your question but.......i'm tellin what i know

1st a person comes with unknown poisoning and the time of poisoning is less than 2 hrs(clear time mention)----gastric lavage would be useful(but it's rarely done though in my opinion).....and also not indicated in altered mental status changes

if a person comes with unknown poisoning and not knowing the time of poisoning and with signs (like pupil changes,tachycardia or resp.depression,altered mental status)--then naloxone,dextrose and thiamine are given.......as they work instantaneously..

if a person comes with poisoning and white out tongue and oral mucosa-----avoid lavage-----caustic poison

hope it helps..
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