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Gastric lavage
Gastric lavage is the standard method of obtaining specimens for TB diagnosis in young children. It is generally carried out only in infants and children below the age of two years. In older children specimens for TB microscopy and culture are better obtained by sputum induction, or voluntary coughing.
It is best to perform the lavage first thing in the morning before the child has had food or drink.
The procedure
First explain the procedure fully to the parent or caregiver.
Complete a request form for the laboratory and place a patient identification sticker on this form.
Place the specimen in a plastic bag together with the request form, and keep in the ward refrigerator (NOT freezer) or in a cooler box containing ice packs.
What then?
What then?
Obtain two specimens per patient (on consecutive days). Specimens should not be collected over weekends unless unavoidable, in which case they will be placed in the refrigerator whilst awaiting collection
Safety issues:
Since insertion of the nasogastic tube may induce coughing, there is a possibility that M. tuberculosis aerosols may be generated. Staff present in the ward should wear N95 respirator masks throughout the procedure. All potentially contaminated devices should be discarded or sterilized before re-use.