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Whole bowel irrigation
From WikEM
(Redirected from Whole-bowel irrigation)
Indications[1]
- Sustained or delayed-release formulations
- Agents with potential for bezoar formation
- Iron and other heavy metals
- Paint chips containing Lead
- Lithium overdose (extended-release tablets)
- Drugs carried by body packers
- LIMPS = Lithium, Iron, Metals, Packers/stuffer, Sustained release drugs (BB, CCB)
Contraindications
- Preceding diarrhea
- Ingestion of substances expected to result in significant diarrhea (except heavy metals)
- Bowel obstruction (as evidenced by lack of bowel sounds)
Procedure
- Give polyethylene glycol via NGT or PO (if tolerates) until rectal effluent is clear
- Adult: 1.5-2 L/hr
- Peds 6-12yr: 1 L/hr
- Peds <6yr: 0.5 L/hr
- Peds alt: 20-40 mL/kg/hr in young children
Give ondansteron or metoclopramide as needed for nausea/vomiting
Complications
- Bloating
- Cramping
- Rectal irritation (from frequent bowel movements)
See Also
References
- ↑ Thanacoody, R, et al. Position paper update: Whole bowel irrigation for gastrointestinal decontamination of overdose patients. Clin Toxicol. 2015; 53(1):5-12. doi: 10.3109/15563650.2014.989326.
