When gastric decontamination is considered, the airway must be stabilized to minimize the risk of aspiration secondary to vomiting. Gastric emptying includes induction of emesis by syrup of ipecac and gastric lavage. Since the major toxicity of hydrocarbon ingestion is aspiration, these procedures should be reserved only for significant ingestions with a greater risk of systemic toxicity and for large intentional ingestions. Induction of emesis by syrup of ipecac is rarely indicated except in situations where the patient's mental status is intact and a large volume of a known toxic substance has been ingested. Children usually do not ingest a large volume, therefore, emesis is rarely indicated.
Similar rules apply to the utilization of gastric lavage.
In most cases, the risk and complications of aspiration outweighs the benefits of lavage. If lavage is attempted, it is advisable to perform a nasogastric lavage since the ingested substance is a liquid. Using a large-caliber orogastric tube will greatly increase the risk of vomiting and aspiration. Lavage is useful in cases where the hydrocarbon has an inherent systemic toxicity or contains additives with known toxicity. Activated charcoal has a limited role in the management of hydrocarbon ingestion.