Gastric Aspiration and Lavage in Acute Poisoning

Abstract

Since advice regarding gastric aspiration and lavage in acute poisoning is confusing and to date has often been based on outmoded methods of quantitative analysis, 259 poisoned patients were studied to assess the value of this procedure, especially with reference to barbiturate and salicylate poisoning. More than 200 mg. of barbiturate was recovered in 24 (37%) out of 65 barbiturate cases washed out within four hours of ingestion, but in only 1 out of 65 washed out after four hours. As much as 20 g. of salicylate was recovered nine hours after ingestion. Complications of gastric aspiration and lavage were rare. We would recommend that gastric aspiration and lavage should be performed : (1) in those patients suffering from barbiturate poisoning who ingested the drug within four hours, unless it can be definitely established that fewer than 10 tablets or capsules were taken ; (2) if the patient is unconscious and the time of ingestion is not known ; and (3) in all cases of salicylate poisoning irrespective of the time of ingestion. In poisoning by other sedatives, tranquillizers, and anti-depressant drugs the advice offered for barbiturate poisoning might probably apply. This study would not have been possible without the willing help of the house-officer, Dr. R. G. Blomfield, the nursing staff of the Poisoning Treatment Centre, and the Department of Medical Photography, Edinburgh University. © 1966, British Medical Journal Publishing Group. All rights reserved.