Have you used code blue lavage/gavage?

Specialties Emergency

Published

We have been inserviced on the code blue system and everyone seems apprehensive to use it. Our ER docs let the RN choose the NG or code blue at this time...they just want it done.

Any pros/cons or tips from those that have used it??

Thanks, Karen

seastir,

I like your way better! We still have to use nasal or gastric lavage first. Why did you get to change?

thanks,

Karen

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I think the use of routine gastric lavage for overdose will come to an end soon. Unless you can get the pt within 60min, the lavage really doesn't do anything.

It won't be to long until just the administration of charcoal will become the treatment of choice.

http://www.clintox.org/Pos_Statements/Gastric_Lavage.html

bob

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Bob,

Thanks for the web site info. I printed info to take to work to share. We rarely get patients within 60 minutes of the overdose. It's amazing how many we get in for their repeat performance and they beg to "Just drink the black stuff"

Karen

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Here in Ja. we don't use codes. Once a client arrest/need some immediate attention we just call a Dr. On the wards/ER dept. it is the same.Just call if we need help. :o :nurse:

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nurseeverycare,

The code blue is a brand name of a lavage oral gastric tube to use for patients that have over dosed.

When our patient arrest/need immediate attention we also have our ER doctor's to assist us immediately or the hospital units/ward call for "code team" to respond and assist. When a patient "arrests", we call this a "code".

What do you use for clients that have over dosed on pills? Do you lavage/gavage or just give activated charcoal?

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Thanks for the clarification. I guess "code blue" is simular to what we call gastric lavarging for OD pt. We pass a normal NG tube put activated charcoal down, spigot or we give them to drink

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This code blue tube system is passed orally and comes with a special tube that has 2 syringes attached. One is for input,the other for output directly in it's own attached drainage bag. It is easier to pass than a NG tube and faster to lavage/gavage by use of the syringe system(once you learn how to use it!). I wish I had a packet insert from this to send you. It has pictures and troubleshooting techniques.

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Specializes in Nephrology, Cardiology, ER, ICU.

We use the Code Blue also and love it. Again, we don't lavage if more than 60 minutes have passed sinced ingestion.

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traumaRUs,

That makes sense not to lavage if over 60 minutes has passed. I

will try to make that part of our protocol! We still haven't had another chance to use code blue on nights yet.

Thanks,

Karen

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I have used the code blue and have preferred it because you can induce lots of fld and the tube doesn't clog. In all the literature I've read, it really should not be passed nasally (too large and will sometimes cause major trauma):bluecry1: A point in fact: Several years ago, at another hosp, we had a physician who became a little miffed at a patient and decided to teach her a lesson and pass the tube nasally. Well, almost immediately, the patient stopped fighting and became non responsive. She ended having a huge cerebral bleed( I think probably 2nd to the stress of having that large a tube passed nasally). :nono: Also most literature today does not recommend that lavage be done period unless you can be assured that the ingestion occurred no more than one hour PTA in the ED. It is felt that lavage in all other cases causes you to push the ingested product further along thereby causing more damage.:scrying:

Right now where I work and in my last facility, we opted for charcoal unless we were certain of the ingestion time.

But back to the code blue, they are very easy to use once you get used to them but I agree that you usually need two people. One other thing, if you get a garbage bag and cut or poke a hole in one side and slip it over the patients head, if they should vomit it goes into the bag and not everywhere else.

Hope this helped

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gmx4dh,

Thanks for your response. Our code blue tube is for oral use only.

I like the garbage bag idea...we could just use a red hazmat bag and just tie it up and toss it in the haz mat box!

Thanks,

Karen

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Specializes in Trauma, Teaching.

We've used the Code Blue lavage for a long time. It really does work well. We often use soft restraints on their hands just as a precaution, sometimes our OD's have no desire to lose their pills! One night I lavaged a guy whose beer was still so fresh it foamed in the tubing. I'd say we got to that one in under 60 minutes:roll :D

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