Page 54 - 2026 SMOG

VOMITING AND DIARRHEA
Signs and Symptoms Differential Diagnosis
• Pain • CNS injury/infection
• Abdominal distention • Myocardial infection
• Constipation • Drugs/toxins
• Diarrhea • Pregnancy
• Anorexia • Gastroenteritis
• Fever • Appendicitis
• Rash • Bowel obstruction
ADULT PEDIATRIC
• IV—O —Monitor • IV—O —Monitor
2
2
• Blood Glucose <70mg/dL with evidence of • Blood Glucose <70mg/dL w/ evidence of
alcohol abuse malnourishment?
˚ Thiamine 100mg IV/IM ˚ Infant Thiamine 0.35–0.5mg/kg IV/IM
˚ 50% Dextrose 25g IV ˚ per day (max dose 1.2mg)
OR
Children Thiamine 1.2mg IV/IM per day
˚ Glucagon 1mg IM ˚ 25% Dextrose 2mL/kg IV
• If Glucose is outside <70mg/dL, start over OR
• Nausea/vomiting ˚ <20kg: Glucagon 0.5mg IV/IM
˚
>20kg: Glucagon 1mg IV/IM
˚ Promethazine 12.5mg IV • Nausea/Vomiting:
OR
˚ Ondansetron 4–8mg IV ˚ Promethazine (if >2yr old)
0.25–0.5mg/kg IV (max dose
12.5mg/dose)
˚ Ondansetron (1mo–12y/o) 0.150.3mg/kg
IV (max dose 8mg)
˚ Ondansetron (>12y/o): 4–8mg IV
Notes, Cautions, Warnings
• Suspicions of underlying conditions should prompt immediate referral to the appropriate
protocol.
• In pregnant patients with Nausea/Vomiting, substitute D5 1/2NS or D5NS in place of NS.
• The fluid of choice for vomiting is NS. The fluid of choice for diarrhea is LR.
• Continually monitor for any decompensation.

46 • MEDICAL