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Indikace k provedení výplachu žaludku:

  • eliminace toxické látky do 60 minut od požití
  • eliminace látky, která zpomaluje žaludeční motilitu

Kontraindikace

  • požití kyselin/louhů
  • saponátů
  • kerosenů

Mezi relativní kontraindikaci je porucha vědomí, v takovém případě musíe pacienta zajistit k výkonu endotracheální intubací.

Jak budeme postupovat?

  • výplach provádíme u pacienta buď v poloze na boku (nebo vsedě, kdy  malé dítě drží sestra na klíně)
  • pacientovi zavedeme dostatečně silný katetr s centrálním otvorem

  • katétr zavádíme tak, že koncovou část zvlhčíme hydrosolubilním lubrikantem (v nouzi vodou), uchopíme ji mezi palec a ukazovák pravé ruky jako pero a zvolna zavedeme do žaludku (sonda by měla být zavedena přibližně do vzdálenosti shodné se vzdáleností mezi kořenem nosu a processus xiphoideus)
  • po zavedení do žaludku obvykle ze sondy vytéká žaludeční obsah, pokud   se tak nestane, aplikujeme do sondy malé množství vzduchu, přičemž   fonendoskopem přiloženým nad epigastriem při správném zavedení   sondy slyšíme jasné bublání
  • na zavádění sondy do dýchacích cest pacient reaguje prudkým kašlem →  sondu pak ihned vytáhneme
  • vlastní výplach provádíme aplikací F1/1: 200 až 300 ml u dospělého a 10 ml/kg u dětí pro dosi ohřátého na tělesnou teplotu (sterilní být nemusí), obsah následně aspirujeme   zpět

  • „čistou“ vodu nepoužíváme pro riziko hyponatrémie
  • není vhodné překračovat doporučené objemy, neboť větší množství  naráz aplikované tekutiny může kontraproduktivně akcelerovat pasáž  žaludečního obsahu do duodena
  • první dávku výplašku posíláme na toxikologii, s výplachem pokračujeme dokud neaspirujeme čirou tekutinu
  • snahou je, aby množství vypláchnuté tekutiny odpovídalo zhruba   instilovanému množství
  • na závěr do sondy aplikujeme carbo medicinalis

 

 

Částečný zdroj: wikiskripta.eu

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