Poisoning gastric lavage

Answer D. Deferoxamine chelates iron and is the antidote in iron poisoning. Gastric lavage should be attempted with care regarding aspiration, but changes in urine pH have no effect on the elimination of iron. laboratory results will reveal an increased anion gap indicative of acidosis. The systemic absorption of many drugs taken orally can be reduced by activated charcoal unfortunately, iron is not one of them. 

Metabolic Effects. Severe metabolic acidosis with high anion gap and hyperglycemia was reported in humans after acute poisoning with endosulfan (Blanco-Coronado et al. 1992 Lo et al. 1995). In five of the six cases reported by Blanco-Coronado et al. (1992), the metabolic acidosis was corrected with gastric lavage with activated charcoal and intravenous sodium bicarbonate and diazepam. No further information regarding metabolic effects in humans after exposure to endosulfan was located. 

Subcommittee on Accidental Poisoning. 1962. Co-operative kerosene poisoning study Evaluation of gastric lavage and other factors in the treatment of accidental ingestion of petroleum distillate products. Pediatrics 648-674. 

Current evidence demonstrated no benefit for the use of gastric lavage in the management of acute poisoning patients and may increase the risk for iatrogenic complications. 

Perform gastric lavage if victim is unconscious or in some instances when conscious Administer activated charcoal to bind poison Administer milk or water if alkali, acid, hydrocarbon, or petroleum distillates have been ingested Administer antidote, if one exists, that is specific for the poison... 

Gastric lavage (with hypertonic saline solution, apomorphine injection for ingested poison). 

Acute belladonna poisoning can be treated by administering universal antidote before gastric lavage, physostigmine in the dose of 1-A mg SC can be administered after a interval... 

The emetics are used mainly in poisoning when gastric lavage facilities are not available. But in certain poisoning e.g. kerosene poisoning, corrosive acid or alkali poisoning, emetics are contraindicated. They are also not advisable in unconscious patients as they may aspirate vomitus. 

Gastric lavage may be useful for six hours after ingestion of poison. The lavage should be done as early as possible but only if vital functions are adequate. 

The specific treatment for salicylate poisoning, apart from gastric lavage and aspiration to remove the drug from the stomach, is based on a knowledge of the biochemical mechanisms underlying the toxicity. There is no antidote, but treatment may be successful. Thus, treatment involves the following ... 

The supportive treatment of aspirin poisoning may include gastric lavage (to prevent the further absorption of salicylate), fluid replenishment (to offset the dehydration and oliguria), alcohol and water sponging (to combat the hyperthermia), the administration of vitamin K (to prevent possible hemorrhage), sodium bicarbonate administration (to combat acidosis) and, in extreme cases, peritoneal dialysis and exchange transfusion. 

The first treatment for methanol poisoning, as in all critical poisoning situations, is support of respiration. For hospitalized patients, gastric lavage should be carried out after the airway has been protected by endotracheal intubation. Activated charcoal is not useful. 

When overdosing occurs, gastric lavage is advised and an alkaline, high urine output state should be maintained (see Chapter 59 Management of the Poisoned Patient). Hyperthermia and electrolyte abnormalities should be treated. In severe toxic reactions, ventilatory assistance may be required. Sodium bicarbonate infusions may be employed to alkalinize the urine, which will increase the amount of salicylate excreted. 

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