ABSTRACT
Indications for Gastric Emptying 2 ◾ Agents that cause pylorospasm and gastric outlet obstruction: ASA, meprobamate,
iron ◾ Agents that form concretions or masses: ASA, enteric-coated and sustained release
tabs, iron, meprobamate, phenobarbital
Contraindications to Gastric Emptying ◾ Caustic acid-alkali ingestions ◾ Hydrocarbon ingestions ◾ Sharp and pointed material ingestions ◾ Drug packet ingestions ◾ Bleeding diathesis, coagulopathies ◾ Esophageal varices and Mallory-Weiss tears ◾ Signicant vomiting ◾ Nontoxic ingestions (Table 2.1)
Ipecac Emesis 1 Indications
Contraindications ◾ Potential for compromised AW protective reexes ◾ Imminent seizure or coma: INH, camphor ◾ Imminent deterioration: TCAs, propoxyphene, propranolol ◾ Caustic acid-alkali ingestions ◾ Hydrocarbon ingestions ◾ Sharp material ingestions ◾ Increased risks of bleeding ◾ Signicant vomiting ◾ Nontoxic ingestions
Table 2.1 Nontoxic Home Products 1
Ipecac Emesis 2 Dose
Complications ◾ Intractable vomiting (rare), delayed emesis while unconscious ◾ Mallory-Weiss tears ◾ Pneumomediastinum ◾ Aspiration pneumonitis ◾ Delayed activated charcoal administration ◾ Electrolyte abnormalities ◾ Substance abuse = bulimia (Princess Diana, Karen Carpenter)
adsorbed to activated charcoal. ◾ Reserve ipecac-induced emesis for witnessed ingestions at home, unless ipecac is con-
traindicated or activated charcoal administration is anticipated shortly.
