VSSC Nursing Officer…: Gastric lavage is contraindicated after ingestion of which of the following?

VSSC Nursing Officer - 2021

Medical & Surgical Nursing

Easy

Appeared in: VSSC Nursing Officer - 2021

Explanation

Gastric lavage is absolutely contraindicated following the ingestion of corrosive substances like alkali.
Corrosive alkalis cause liquefaction necrosis, a process that deeply penetrates and dissolves tissues, making the esophagus and stomach extremely fragile.
Inserting a lavage tube or instilling fluid can easily cause a perforation, leading to mediastinitis or peritonitis, which are life-threatening complications.
The procedure can also re-expose the upper airway and esophagus to the corrosive agent, worsening the injury.

Option A: Gastric lavage is not absolutely contraindicated for aspirin (salicylate) poisoning. Its use is controversial and limited to specific situations.
Option B: Gastric lavage is not contraindicated in organophosphorous (OP) poisoning. In fact, early gastric decontamination may be considered to reduce poison absorption.
Option D: Gastric lavage is not an absolute contraindication for Odollam poisoning, although it is rarely the preferred method of decontamination.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Contraindications for Gastric Lavage in the correct sequence, documenting the action clearly, and monitoring for the expected response.
A nurse's first action in a poisoning case is to ensure patient stability (Airway, Breathing, Circulation) and then quickly identify the ingested substance, as this dictates all subsequent management.
Incorrectly performing gastric lavage on a patient with corrosive ingestion is a critical patient safety error that can cause fatal complications. This knowledge is non-negotiable for emergency care.
What if? If the patient had ingested a hydrocarbon like kerosene instead of a corrosive? Gastric lavage would still be contraindicated. The primary risk with hydrocarbons is not perforation, but aspiration, which can lead to severe chemical pneumonitis.

How to Approach the Question

First, identify the key terms in the question: 'Gastric lavage' and 'contraindicated'. This tells you the question is asking when you should NOT perform this procedure.
Next, evaluate each option based on its chemical properties and effect on the body.
Recall or deduce the primary danger of each substance. Aspirin, organophosphates, and Odollam are primarily systemic poisons. Corrosive alkali is a direct tissue-destroying agent.
Consider the mechanics of gastric lavage: inserting a tube and flushing fluid. How would this procedure interact with the substance's effects?
For systemic poisons, the goal is to remove them before absorption. For a direct tissue-destroying agent, the primary goal is to avoid further physical trauma to already damaged tissue.
This logic leads to the conclusion that lavage is most dangerous with the substance that physically damages the GI tract, which is the corrosive alkali.

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