Gastric lavage should be questioned if which lab value is elevated?

• A. Increased serum bicarbonate level
• B. Decreased serum bicarbonate level
• C. Elevated ALT
• D. Low calcium

Answer: (A)

When deciding whether to perform gastric lavage, the type of substance ingested guides the risk–benefit assessment. An elevated serum bicarbonate level points to ingestion of an alkaline agent (alkali), which can cause caustic injury to the GI tract. In such cases, gastric lavage can spread the caustic material and worsen injury or perforation, so the procedure is generally questioned or avoided.

The other values don’t point to this same risk. Elevated ALT signals liver injury, not a concern that directly dictates lavage safety. Low calcium or a decreased bicarbonate level indicate different metabolic processes that aren’t specifically about caustic ingestion or the risks of lavage.