Vomiting resident survival guide

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Vomiting
Resident Survival Guide
Overview
Causes
FIRE
Diagnosis
Treatment
Do's


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rinky Agnes Botleroo, M.B.B.S.

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Overview

This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.


Causes

Life Threatening Causes

Life-threatening causes of vomiting include[1]:

Common Causes

Common causes include: [3]

Diagnosis

Shown below is an algorithm summarizing the diagnosis of Vomiting

 
 
 
 
 
 
Patient comes with vomiting
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Take complete history
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Ask the following questions about vomiting

❑How long have you had nausea and vomiting?

❑How much have you vomitted?

❑What is the colour of the vomitus?

❑Have you had previous episodes like this or this is the first time?

❑Is there any foul smell of the vomitus?

❑Is there only food particle or any other mucous/substance present with the vomitus?

❑Have you notice any blood streaks mixed with vomitus?

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Ask the related questions

❑Did your nausea and vomiting occur right after eating?

❑Do you have a fever?

❑Do you take any other medication

❑Have you recently eaten out?

❑Have you eaten any canned product?

❑Have you suffered from headache or photophobia along with this vomiting?

❑Did you have any abdominal pain?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Record the vitals:

Blood pressure

Weight

Body Mass Index

❑Temperature

❑Heart rate

❑Respiratory rate
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Do general physical examination:

Look for signs of dehydration[4][5]

*Look for sunken eyes[5]

*Dry mouth/tongue, thirst[5]

*Dry skin

*Dizziness and a lack of focus[5]

*Orthostatic blood pressure drop,tachycardia[5]

*Light-headedness

*Dark urine or decreased urine output

*Increased capillary refill time[4]

*Poor skin turgor

*Tiredness

*Appetite

Perform abdominal examination

*Look for any abdominal tenderness

*Presence of bowel sound
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
If patient gives history of
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
History of

❑ Abdominal pain

❑ Eating out or eating reheated canned food

❑ Abdominal bloating

❑Passage of loose stool

 
 
History of

❑Headache
 
 
 
 
D04
 
 
D05
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Gastroenteritis
 
❑Photophobia

❑Triggered by smell, light or loud sound

❑Unilateral headache usually,maybe bilateral which stays for 2-3 days

❑May have history of taking wine, chocolate

 
{{{D02}}}
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Migraine
 
 
 
Tumor
 
 
 
 
 
 
 
 
 
 
 
 

Treatment

Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Do's

  • Encourage patient to keep taking small sips of water frequently so that they don't become dehydrated.[6]
  • Recommend patients to take sweet drink such as fruit juice for replacing lost sugar, although they should avoid sweet drinks if those make them feel sick.
  • Recommend to have salty snacks, such as crisps, can help replace lost salt.

Don'ts

  • Patient who is vomiting continuously and also has past medical history of Diabetes corrected with Insulin should consult with their physicians before taking insulin as vomiting alters blood sugar levels.
  • Renal consultation should be acquired especially with severe hyponatremia

References

  1. Hayes B, Murtagh C, Mann GB (August 2008). "A case of life-threatening nausea and vomiting". J Pain Symptom Manage. 36 (2): 206–10. doi:10.1016/j.jpainsymman.2007.10.022. PMID 18495417.
  2. 2.0 2.1 Frese T, Klauss S, Herrmann K, Sandholzer H (February 2011). "Nausea and vomiting as the reasons for encounter in general practice". J Clin Med Res. 3 (1): 23–9. doi:10.4021/jocmr410w. PMC 3194022. PMID 22043268.
  3. Scorza K, Williams A, Phillips JD, Shaw J (July 2007). "Evaluation of nausea and vomiting". Am Fam Physician. 76 (1): 76–84. PMID 17668843.
  4. 4.0 4.1 "Adult Dehydration - StatPearls - NCBI Bookshelf".
  5. 5.0 5.1 5.2 5.3 5.4 Shaheen NA, Alqahtani AA, Assiri H, Alkhodair R, Hussein MA (December 2018). "Public knowledge of dehydration and fluid intake practices: variation by participants' characteristics". BMC Public Health. 18 (1): 1346. doi:10.1186/s12889-018-6252-5. PMC 6282244. PMID 30518346.
  6. "Vomiting in adults | NHS inform".


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References