Question 1: Gastric lavage is contraindicated in the following:
- A. Barbiturate poisoning
- B. Paracetamol poisoning
- C. Kerosene poisoning (Correct Answer)
- D. Carbolic acid poisoning
Explanation: ***Kerosene poisoning***
- Gastric lavage is contraindicated in **hydrocarbon poisoning** like kerosene due to the high risk of **aspiration pneumonitis**. [1]
- Aspiration of hydrocarbons can lead to severe **chemical pneumonitis**, acute respiratory distress syndrome (ARDS), and even death.
*Barbiturate poisoning*
- Gastric lavage can be useful in **barbiturate poisoning**, especially if presenting within 1-2 hours of ingestion, to remove unabsorbed drug.
- It's part of the management strategy to reduce drug absorption and potentially speed up recovery.
*Paracetamol poisoning*
- **Gastric lavage** may be considered in paracetamol overdose, particularly if performed within 1-2 hours of ingestion, to remove unabsorbed drug.
- However, **activated charcoal** is usually the preferred method for gastric decontamination in paracetamol overdose, followed by **N-acetylcysteine**.
*Carbolic acid poisoning*
- While typically considered a corrosive, gastric lavage might be cautiously used in **carbolic acid (phenol) poisoning** in specific circumstances, such as very early presentation or large ingestions, but it carries risks of esophageal injury. [2]
- Dilution with milk or water is often preferred, but lavage should be avoided if there's evidence of significant caustic injury or perforation risk.