The procedure for stomach pump for poisoning cases is slight different than normal Ryle’s tube gastric lavage‘ Though this procedure is done by doctor most of the time, but during emergency nurse may be asked to do the procedure for life saving purpose.
Details of Stomach Pump Procedure And Stomach Wash out
- No need of intimating the procedure to patient as the pr cedure is sometimes conducted by force and sometimes against the wishes of patient in poisoning case.
- Keep few witnesses or relatives to witness the procedure a medicolegal case.
- You may not put attention for sterilization of equipment to save time as the procedure is a emergency life saving.
- Prepare a bucket of potassium permanganate solution by adding a pinch of crystal of potassium permanganate to a bucket (about 10-15 litre) of plain water. In case potassium permanganate is not available, plain water may be used for stomach wash.
- Select a Levine suction stomach wash tube or plain stomach wash tube with a funnel end.
- Remove some stomach content and preserve in clean bottle with labelling for medicolegal examination of poison.
- Then introduce potassium permanganate solution through the funnel by a mug about 50-109cc at a time.
- Each time suck out the fluid from stomach either by suction bulb attached to the middle of the tube in a suction stomach tube or by lowering the funnel from the stomach level to downwards into bucket if plain tube is used.
- Continue flushing out stomach till the colour of potassium permanganate returns to its original colour. In other earlier flushed out sample the colour of potassium permanganate solution is changed due to oxidation by the poison. When all poison from stomach is flushed out then pot. permanganate returns back with same colour.
- Leave about 200 ml of Pot. Permanganate solution in stomach to neutralize any left over poison or poison which has passed beyond stomach to intestine.
- Remove the tube gently. Clean the mouth of patient. If conscious give him hot drink.
Available stomach tubes
Levine stomach tube : Size 12*18 inches are available, It has a suction bulb provided with inside valve arrangement to suck out fluid when pressed. At the lower end it has four holes towards tip. It is commonly used for removal of gastric contents postoperatively or in poisoning cases.
Ryle’s tube :
This is commonly used for gastric aspiration or feeding purpose in hospitals. It has thin bore. It has three markings at various places to indicate the tip of the tube in stomach when introduced. One is to indicate tip at oesophageal end of stomach, next to indicate tip at body of stomach and third one to indicate tip at pylorus of stomach. This tube cannot be used to empty gastric contents in food poisoning due to the thin lumen to be blocked by food particles—the tip is weighted by a small metal covered by rubber.
Rehfuss tube : It is available in duodenal and stomach types. It has large metallic lower end which has perforation to allow gastric content to pass through. It is used for draining out gastric, duodenal and gall-bladder.
Large stomach tube with Funnel: This is a plain thick bore stomach wash tube having a funnel at the mouth end. There is one big opening at the lower stomach end of the tube. This is only used for emptying stomach contents in food poisoning or drug poisoning cases. The cleansing fluid is poured through the funnel end by a jug holding it upright and well above the level of stomach. The contents are drained out when the funnel is lowered below the level of stomach.
Miller-Abbott tube : This is a thin bore tube mainly used for duodenal and gall bladder drainage. It has a inflatable balloon at the tip or mouth end of the tube