Gastric Lavage - PowerPoint PPT Presentation

1 / 15
About This Presentation
Title:

Gastric Lavage

Description:

Gastric Lavage In The diagnosis of tuberculosis in young children Gastric lavage Gastric lavage is the standard method of obtaining specimens for TB diagnosis in ... – PowerPoint PPT presentation

Number of Views:2684
Avg rating:3.0/5.0
Slides: 16
Provided by: UCTA5
Category:

less

Transcript and Presenter's Notes

Title: Gastric Lavage


1
  • Gastric Lavage
  • In
  • The diagnosis of tuberculosis in young children

2
Gastric lavage
  • Gastric lavage is the standard method of
    obtaining specimens for TB diagnosis in young
    children.
  • It is generally carried out only in infants and
    children below the age of two years.
  • In older children specimens for TB microscopy and
    culture are better obtained by sputum induction,
    or voluntary coughing.

3
It is best to perform the lavage first thing in
the morning before the child has had food or
drink.
4
The procedure
  • First explain the procedure fully to the parent
    or caregiver.

5
The procedure (continued)
  • Place the infant or young child in the supine
    position, and have an assistant restrain the
    child and flex the head slightly.

6
The procedure (continued)
  • Select the appropriate tube. Determine the
    length to be passed by measuring the distance for
    the manubrium sterni to the xiphisternum. Double
    this and add 5cm. Mark the appropriate length on
    the tube.

7
The procedure (continued)
  • Lubricate the lower 3-4cm with KY jelly, and pass
    it through a nostril toward the occiput (not
    vertex). If resistance is encountered, withdraw
    the tube and try the other nostril. Continue
    even if gagging occurs but withdraw immediately
    if there is severe coughing, choking or cyanosis.

8
The procedure (continued)
  • Introduce the selected length and fix the tube
    lightly to the cheek. Aspirate the tube and test
    the contents with litmus (blue to red indicates
    acid). If no fluid is obtained advance the tube
    3cm and try again. If still unsuccessful, inject
    3m of normal saline. Withdraw the tube if this
    causes coughing.

9
The procedure (continued)
  • Using a syringe, draw sterile 0.9 NaCl for
    lavage from a 20ml ampoule 5 10 mls for babies
    less than 1 year and 10-20 mls for babies older
    than 1 year. Inject NaCl into the stomach through
    the tube and leave for 2-3mins.

10
The procedure (continued)
  • Withdraw a volume equal to that of the normal
    saline injected and collect into a 50 ml tube
    containing 100mg of sodium bicarbonate.

11
What to do with the specimen
  • Screw the cap tightly closed.
  • Invert the tube 5 times to mix contents.
  • Label the jar with the aspirate as follows 
  • Child's name
  • Name of hospital
  • Place a patient identification sticker on the
    jar, with the number (1 or 2) and type of
    specimen(i.e. gastric lavage)
  • Date and time of collection.
  • Complete a request form for the laboratory and
    place a patient identification sticker on this
    form.
  • Place the specimen in a plastic bag together with
    the request form, and keep in the ward
    refrigerator (NOT freezer) or in a cooler box
    containing ice packs.

12
What to do with the specimen
  • Transport specimens to the laboratory as soon as
    possible after collection, but in any case within
    a maximum of 4 hours
  • Specimens should be placed in a closed 3kPa screw
    cap transport container containing sufficient
    absorbent material to absorb any potential
    spillage. 
  • The 3kPa container should then be placed in a
    secondary transport box containing an ice pack.
    This box must be clearly labeled as biohazardous
    and containing potentially infectious material.

13
What then?
  • Then give the usual milk feed

14
What then?
  • Obtain two specimens per patient (on consecutive
    days).
  • Specimens should not be collected over weekends
    unless unavoidable, in which case they will be
    placed in the refrigerator whilst awaiting
    collection

15
Safety issues
  • Since insertion of the nasogastic tube may induce
    coughing, there is a possibility that M.
    tuberculosis aerosols may be generated.
  • Staff present in the ward should wear N95
    respirator masks throughout the procedure.
  • All potentially contaminated devices should be
    discarded or sterilized before re-use.
Write a Comment
User Comments (0)
About PowerShow.com