Whole bowel irrigation: Difference between revisions

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**Peds <6yr: 0.5 L/hr
**Peds <6yr: 0.5 L/hr
*Give ondansetron or metoclopramide as needed for N/V
*Give ondansetron or metoclopramide as needed for N/V
====Polyethylene glycol dosing====
'''Can be given orally or by NG tube'''
*20-40 mL/kg/hr in young children
*2L/hr in adults
Continue irrigation until the rectal effluent is clear


==Complications==
==Complications==

Revision as of 14:33, 25 August 2015

Indications[1]

  1. Sustained or delayed-release formulations
  2. Agents with potential for bezoar formation
  3. Iron and other heavy metals
  4. Paint chips containing Lead
  5. Lithium overdose (extended-release tablets)
  6. Drugs carried by body packers

Contraindications

  1. Preceding diarrhea
  2. Ingestion of substances expected to result in significant diarrhea (except heavy metals)
  3. Bowel obstruction (as evidenced by lack of bowel sounds)

Procedure

  • Give polyethylene glycol via NGT or PO (if pt tolerates) until rectal effluent is clear
    • Adult: 1.5-2 L/hr
    • Peds 6-12yr: 1 L/hr
    • Peds <6yr: 0.5 L/hr
  • Give ondansetron or metoclopramide as needed for N/V

Polyethylene glycol dosing

Can be given orally or by NG tube

  • 20-40 mL/kg/hr in young children
  • 2L/hr in adults

Continue irrigation until the rectal effluent is clear

Complications

  1. Bloating, cramping, rectal irritation (from frequent bowel movements)

See Also

References

  1. 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.