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Medical

VOMITING & DIARRHEA

Signs and Symptoms: Differential Diagnosis:
• Pain • CNS Injury/Mass/Infection
• Abdominal Distention • Myocardial Infarction
• Constipation • Drugs/Toxins
• Diarrhea • Bowel Obstruction
• Anorexia • Diabetic Ketoacidosis
• Pregnancy
Associated Symptoms: • Infections
Fever, Headache, Weakness, Malaise, • Gastroenteritis
Myalgia, Cough, Dysuria, Mental • Food Borne / Toxic
Status Changes, Rash • Psychologic
• Appendicitis
Universal Patient Care Guideline
Continued from: O2 (if Hypoxemic)
Tactical Evacuation Guideline IV/IO Guideline
Cardiac Monitor If no improvement after
1000mL Bolus:
Evidence of Alcohol Abuse? Hypotension/Shock
NO YES YES Blood Glucose <60? Guideline
Thiamine 100mg IV/IM
NO
50% Dextrose 25g IV Tachycardia / Hypotension? YES 1000mL IVF IV
or D10 drip
OR NO

Glucagon 1mg IV/IM
Nausea and/or Vomiting? YES Promethazine 12.5mg IV
NO Glucose 60-250? YES NO OR
YES Abdominal Pain? Ondansetron 4-8mg IV
NO
Reassess q5min

Abdominal Pain Guideline When appropriate, return to:
Tactical Evacuation Guideline
Consider
Pain Management Guideline
Consider
Chest Pain Guideline
Pearls:
• Suspicion of other underlying condition should prompt immediate referral to appropriate protocol.
• In pregnant patients with nausea/vomiting – can substitute D5 1/2NS or D5NS in place of NS.
• Fluid of choice for vomiting is NS. Fluid of choice for diarrhea is LR.
• Continually monitor for any decompensation.

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