Gastric intubation and aspiration(s) therapeutic, necessitating physician's skill (eg, for gastrointestinal hemorrhage), including lavage if performed
CPT4 code
Name of the Procedure:
Gastric Intubation and Aspiration (Therapeutic), Including Lavage
Common Names: Gastric Lavage, Stomach Pumping
Summary
Gastric intubation and aspiration is a medical procedure where a tube is inserted through the nose or mouth into the stomach. The procedure can involve aspirating (suctioning out) stomach contents or performing a lavage (washing out the stomach). This is often done to address conditions like gastrointestinal hemorrhage.
Purpose
Gastric intubation and aspiration is used to:
- Remove harmful substances from the stomach.
- Control acute gastrointestinal hemorrhage.
- Obtain stomach contents for diagnostic analysis. The expected outcome is to stabilize the patient and prevent complications from bleeding or ingestion of toxic substances.
Indications
- Symptoms of gastrointestinal bleeding (e.g., vomiting blood, passing black or bloody stool).
- Overdose or poisoning.
- Need for diagnostic evaluation of stomach contents.
- Severe acute gastritis.
Preparation
- Fasting for a set period (usually 6-8 hours) before the procedure.
- Adjusting certain medications as advised by the physician.
- Blood tests and imaging studies to assess the condition.
Procedure Description
- Preparation: The patient is positioned appropriately, typically semi-upright.
- Insertion: A lubricated tube is gently inserted through the nose or mouth, then passed down into the stomach.
- Aspiration: The contents of the stomach are suctioned out.
- Lavage (if performed): Sterile saline or water is introduced via the tube and then suctioned out repeatedly to wash the stomach.
- Tools: Nasogastric tube, suction device, sterile saline.
- Anesthesia: Local anesthetic to numb the throat area, sedation may be used in some cases.
Duration
The procedure typically takes about 30 minutes to an hour, depending on the complexity and purpose.
Setting
Usually performed in a hospital setting, emergency department, or intensive care unit.
Personnel
- Physician
- Nurse
- Anesthesiologist (if sedation is required)
Risks and Complications
- Minor: Sore throat, gagging, nasal irritation.
- Major: Aspiration pneumonia, esophageal perforation, electrolyte imbalances. These complications are managed with appropriate medical interventions as needed.
Benefits
- Rapid stabilization of the patient.
- Prevention of further complications from hemorrhage or toxic ingestion.
- Helps diagnose underlying gastrointestinal issues. Benefits are usually realized immediately following the procedure.
Recovery
- Monitoring for a few hours post-procedure.
- Instructions to avoid eating or drinking for a short period post-procedure.
- Follow-up appointments if necessary.
- Recovery time is usually short, but varies depending on the patient's overall condition.
Alternatives
- Activated charcoal administration for certain poisonings.
- Endoscopic interventions for gastrointestinal bleeding.
- Proton pump inhibitors or other medications for less severe gastric conditions. Each alternative has its pros and cons, and the best option depends on the patient's specific condition and overall health.
Patient Experience
- During the procedure: Likely discomfort and gagging during tube insertion; possible sedation to ease discomfort.
- Post-procedure: Sore throat and mild abdominal discomfort.
- Pain management: Local anesthetics, sedation, and post-procedure pain relief as needed. Overall, the healthcare team aims to ensure the patient's comfort and safety throughout the procedure.