Gastric lavage in acute organophosphate poison
Date First Published:
December 30, 2005
Last Updated:
December 30, 2005
Report by:
YI LI, Attending doctor (Peking Union Medical College Hospital)
Three-Part Question:
In [a patient with acute organophosphate poisoning] are [gastric lavages better than no lavage] in [decreasing mortality]?
Clinical Scenario:
A 40 year old man presents to the emergency department 30 minutes after drinking 500ml fenthion. He has a Glasgow Coma Scale score of 13/15, and has pinpoint pupils and excessive sweat. A rapid sequence induction and intubation is done. Given the recent onset and the undefinite efficacy of activated charcoal in organophosphate you wonder whether he is a candidate for gastric lavage.
Search Strategy:
Medline 1966-01/02 using the Ovid interface.
Search Details:
[exp irrigation OR lavage.mp OR exp gastric lavage OR gastric lavage.mp OR exp gastric emptying OR gastric emptying.mp OR washout.mp] AND [(exp organophosphate OR organophosphate.ar)] AND [exp poisoning OR poisons.ar OR exp suicide OR exp] limit to human.
Outcome:
Altogether 34 papers were found, none of which were relevant
to the three part question.
to the three part question.
Author Commentary:
More research is needed.
Bottom Line:
There is no currently available evidence to support the use of
gastric lavage in organophosphate poisoning. As outlined in the position statement paper, gastric lavage can be done within 1 hour of organophosphate ingestion. Local advice should be followed.
American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists.Position statement: gastric lavage. J Toxicol Clin Toxicol 2004; 42:933-943.
gastric lavage in organophosphate poisoning. As outlined in the position statement paper, gastric lavage can be done within 1 hour of organophosphate ingestion. Local advice should be followed.
American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists.Position statement: gastric lavage. J Toxicol Clin Toxicol 2004; 42:933-943.