Hypothermia: An Unusual Indication for Gastric Lavage

Thermal desorption ambient ionization mass spectrometry for emergency toxicology

“…Even after 4–6 h of ingestion, if the toxicants are ingested in large quantities, or are found to be not readily adsorbed by activated charcoal, or are able to delay absorption and gastric emptying, or require metabolic activation before they become toxic, or if the patient's bowel sounds are absent on physical examination, gastric lavage for the poisoned patients is indicated (Ellenhorn & Barceloux, 1988; Joint Formulary Committee, 1997). Moreover, there is no documented evidence to exclude the beneficial effects of gastric lavage (Adler et al, 2011; Kimura et al, 2008a, 2008b). Gastric lavage is reported to be effective in decontaminating the gastrointestinal tract by emptying the stomach within 2 h after ingestion of poisons (Joint Formulary Committee, 1997; Vale, 1997), and is therefore routinely utilized in treating most of the patients who poisoned themselves with pesticides in China (Gu et al, 2004).…”

“…Moreover, the experimental evidence demonstrating the capability of TD‐ESI‐MS platform in characterizing trace chemical compounds (regardless of their different physical properties) in liquid eye drops, viscous cold syrup, ointment, and solid tablet without any pretreatment of extraction and separation have been reported (Huang et al, 2013). It was reported that the detection limit of TD‐ESI for acetaminophen standard solution was below 25 ng/ml (Huang et al, 2013); the detection limit of DART for one kind of explosive, pentaerythritol tetranitrate (PETN), was found to be 100 pg (Cody et al, 2005); the detection limit of DESI for ethyl palmitate was 7 fmol (Takáts et al, 2004). As documented in these previous studies, even trace amount of polar or nonpolar organic compounds can be sensitively detected by well‐established ambient ionization mass spectrometric techniques.…”

Gastric lavage in children as a method of decontamination of the gastrointestinal tract – should it be used routinely?

“…Adler i wsp. opisali przypadek 50-letniej kobiety, która została przewieziona na oddział ratunkowy w stanie śpiączki oraz w hipotermii [29]. Wykonana tomografia komputerowa wykazała dużą liczbę tabletek w żołądku.…”

“…Na podstawie analizy ww. przypadku klinicznego autorzy publikacji stwierdzili, że po usunięciu połkniętej substancji przez pozostawioną rurkę Fauchera można zastosować ogrzewanie czynne wewnętrzne, wyprowadzając w ten sposób pacjenta z hipotermii [29].…”