Quite often, situations arise when gastric lavage in children becomes necessary. The problem is that not all parents can imagine how to do this in practice. The question is important when it comes to the smallest. They are very inquisitive and try to drag everything in their field of vision into their mouths and taste. This applies to medicines, products, household chemicals, soaps, cosmetics and so on.
Even elemental food poisoning can cause a flush. The baby’s stomach is very sensitive to everything foreign and pathogenic, and the temptation to take everything that is bad is great. Poisoning can be caused by bowel obstruction, narrowing of the esophagus and many other situations.
Thus, properly performed gastric lavage in children will not only allow it to be cleaned of toxins, but also prevent pathogens from being absorbed into the esophagus. The condition of the child improves significantly with the end of the procedure. Anomalies of development in newborns are possible, which also require flushing, however, this is possible only in stationary conditions.
When can the procedure be carried out?
Gastric lavage may be required even at the first, even not quite obvious signs of poisoning - headache, nausea. First, you must make sure that the procedure is possible, that is, there are no contraindications:
- the child does not have internal bleeding, as indicated by an admixture of blood or its veins in the vomit or feces;
- consciousness must be fully preserved;
- no fainting;
- no cramps;
- there are no neurological pathologies;
- there are no scars on the digestive tract.
If the question rests on anomalies of development, then home washing is strictly prohibited. This is only possible in a hospital setting. Washing is absolutely excluded if acid or alkali is swallowed and burns occur in the larynx, esophagus or the stomach itself. Washing is also contraindicated in case of pulse instability, cardiac arrhythmias. In such cases, it is better to call an ambulance and wait for specialists.
Homemade method for children after 3 years
If necessary, you can also rinse the stomach at home in older children. This method is called "restaurant". Its essence is that the child needs to be drunk abundantly with ordinary boiled water or special solutions until he vomits.
The algorithm of the gastric lavage technique in children:
- Before starting the procedure, seat the child on a chair, tilting it slightly forward and supporting it.
- Cover your baby’s chest with a diaper or oilcloth apron.
- The volume of the solution should be prepared full, for the entire procedure.
- Give the child to drink the entire solution at once. It should be warm, but not hot.
- If vomiting does not occur, you can call up the gag reflex manually - carefully insert the index finger into the baby’s mouth and gently press on the root of the tongue.
- If a process occurs, slightly tilt the child's head forward, above the pelvis.
It is necessary to induce vomiting several times in a row until the water of the masses erupted from the stomach becomes clean and transparent. It is advisable to collect the first portion of the mass in a glass and show it to the doctor for the diagnosis of poisoning.
The procedure is complicated if the child is small. He will not drink water at your direction. We need a second assistant: one will hold the baby, and the second adult will pour liquid into the mouth with a large syringe without a needle.
The liquid must be poured carefully along the inner surface of the cheek so that the child cannot spit it out.
Both cases are applicable only as first aid. They do not give a full cleansing of the stomach.
Structural features of the stomach of infants
In a newborn, the size of the stomach in the first 3 days of life is only 20 ml, after a week - already 50, and per month - 80-100 ml. Therefore, it is very important to enter the desired volume of fluid.
For a child up to 4 months, gastric lavage is carried out only through a probe through the nose. Personnel should have relevant experience.
The level of introduction of the probe must be able to calculate too. Prepared for washing, the solution is poured in small doses, very carefully, without pressure. For babies, only clean boiled water is acceptable as a washing liquid.
Features of washing in children up to a year
How to do gastric lavage for a child up to a year? The procedure is carried out only in the hospital, and in case of urgent need - only ambulance workers who have this skill.
To carry out the manipulation, the child must first be swaddled. The procedure is performed with a nasogastric tube, which the doctor inserts into one of the nasal passages. A child older than 4 months old can be inserted into the mouth. The length of the introduction is determined by the value from the nose to the navel + the width of the baby’s palm.
The liquid is introduced without excessive pressure, not quickly. Max Volume:
- up to a month - 50 ml;
- up to six months - 100 ml;
- up to a year - 200 ml.
The solution is only pure boiled water.
After the introduction of the solution, you should press on the abdomen, and then on the root of the tongue - this causes vomiting.
The procedure is repeated 2-3 times until clean water goes.
Rinse preparation
Before starting the procedure, the procedure for special preparation must be observed, i.e., the algorithm for gastric lavage in children:
- Wash liquid is prepared - boiled clean water. Oilcloth and towels should be available.
- Hands are treated with an antiseptic - chlorhexidine or another antiseptic, put on rubber gloves.
- Measure the distance from the nose to the navel, put these values on the tube. This is an indicator of administration. You cannot enter below its level.
Before using the probe, the baby's oral cavity is sanitized, the end of the probe is lubricated with an anesthetic.
In case of chemical poisoning, flushing is always carried out only through a probe.
How is probe washing
The algorithm for gastric lavage with a probe in children consists in observing the following actions:
- The child lies on his back, at this time through the nasal passage, a probe is smoothly and gently introduced - up to the marked value.
- Then turn the child on his left side and bend his head down to the vomit container.
- When the probe is inserted to the mark, a funnel is attached to its second end. A wash solution is poured through it.
Wash water can be removed from the stomach using the same probe. To do this, lower the tube down. Gastric lavage in children is done until clean water - 8-10 servings of water. At the end, a probe with a gauze napkin to intercept the child at the mouth and quickly remove it - sharply, but very carefully.
Flushing after a year
The gastric lavage algorithm in children in this case is the same as with the nasal probe. The differences are only in some features: the child can sit, but he must be locked in position. Parents will help in this - one of them can pick him up and hold him.
To remove the wash water, the child needs to lie on his left side and hang his head down. Open the baby’s mouth with a rotary expander and slowly insert the probe.
If the expander is not at hand and the child is not going to open his mouth, press on his cheeks on both sides at the level of the teeth with the thumb and middle finger. If pieces of food get into the probe, it is purged with a syringe.
The last portion of the wash water should be collected in a second beaker for analysis.
Infection control
Control consists of the following activities:
- Disconnect the funnel and put it in the tray.
- Rinse the probe and immerse in 3% chloramine for an hour. After rinse again and put also in the tray.
- Place all tools and gloves for an hour in a 3% solution of chloramine.
- Wipe the apron twice with 1% r-m of chloramine.
- To wash hands with soap.
Calculation of fluid and actions after flushing
For gastric lavage for children, the volume of auxiliary fluid is:
- newborns - 200 ml;
- children 1.5-6 months - 300-500 ml;
- children from 6 to 12 months - 500-700 ml;
- from a year - 1 liter + 100 ml x number of years.
During the first half hour, the child rests, and then orally try to restore the lost volume of fluid and electrolytes: give them drink "Regidron", "Human Electrolyte", "Smecta", "Glucosolan", "Orasan", "Hydrovit". They are given warm, in small portions, every 10-15 minutes.
What to rinse
For home washing, you can prepare a saline solution - 1 tbsp. l salt in 2 liters of water. Same proportion with soda. Solutions can be mixed and watered. Better for older children.
Rinse with potassium permanganate very carefully. The proportion is only 2 crystals per 1 liter of water. The solution should be filtered through a 4-layer gauze so that there is no burn of the mucosa. If chemical poisoning, potassium permanganate is excluded. Children under 3 years old can use an aqueous solution of activated carbon or another sorbent. Calculation: up to 8 tablets of crushed coal per glass of water.
When a child is poisoned with household chemicals, it is necessary to neutralize the acid. This will help gastric lavage with soda solution - 1 tsp. into a glass of water.
In case of poisoning the child with alkalis, acidified water, for example lemon juice, is used for these purposes - 1 tsp. on 1 liter of water. It is important to observe the exact amount of gastric lavage fluid for the baby.
Frequent flushing errors
The optimal temperature of the washing liquid is from 27-29 to 33-34 degrees. A colder solution will cause stomach spasm and pain, a hotter solution will increase the rate of absorption of toxins in the stomach and worsen the condition. It is also wrong to try to place the child in front of the toilet. This position on the knees or legs increases the risk of vomiting in the trachea.
Medicines
Washing the stomach at home should not be done by herbal decoctions and infusions, because it is not known how the substances from the decoction will combine with what poisoned the stomach. Such actions can aggravate the situation.
How to understand if the procedure was successful?
The main criterion is the well-being of the child after the procedure: it should become much better. If this does not happen, then the flushing was incomplete or incorrect. Or this indicates a strong intoxication when infusion therapy in a hospital is required. Proof of success will be dry vomiting after clean water. An important indicator is approximately equal volume of injected and excreted fluid.
Hospital flushing
In a hospital, gastric lavage of a child is performed through a probe, and the algorithm for conducting it does not differ from that carried out by ambulance specialists.
The oral cavity is cleaned with a soft gauze swab. The nasopharynx can be treated with a lidocaine spray for painless insertion of the probe. After determining the desired length of introduction of the probe for young children, a thin probe A is used, after 5-6 years, a thicker gastric tube. In this case, washing is much faster.
After introducing the probe for additional control, the doctor introduces a little air into the probe and a phonendoscope identifies its location through the abdominal wall.
How to avoid mistakes
To prevent damage to the respiratory tract or esophagus, do not use the probe yourself.
It is necessary to observe the concentration of the solution or use boiled water without impurities. The volume of injected fluid should not be less than the volume of vomiting - if there are less, the stomach is not completely washed out.
During vomiting, the child's head should be supported so that it does not choke. You should not count on a cure by even a high-quality washing. This is only the first measure. A doctor's examination and treatment appointment are required.