Tube Size, Lavage, and Emesis

Conventional wisdom holds that lavage and emesis are equally effective in gastric emptying and ingestant removal.1 An observation made at this institution during an epidemic of Jimson week ingestion may be of some consequence. Emergency room personnel and pediatric house officers noted that if lavage were performed following ipecac-induced emesis, significant amounts of recognizable material (seeds, stems, leaves, roots, etc) could be removed.2 The effectiveness of the emesis may have been diminished by the atropine-like activity of Jimson weed; however, productive lavage after emesis has been observed with such frequency in other ingestions, that delayed gastric emptying due to an anticholengergic effect seems not to be reason for the productive results.