Vomitting And Diarrhea : Medical Triage : Online Medical Help

Medical Triage : Online Medical Help

Vomitting And Diarrhea

Severe in elderly, the mentally handicapped, infants and children

Consider volvulus in infants

Gastroenteritis is the most common cause of diarrhea. Most causes are not immediately life-threatening except by severe dehydration.

Vomitting And Diarrhea

Causes of vomitting

sepsis (eg urinary tract infection)

central nervous system disorders

electrolyte disturbances (may be due to drugs

renal failure, or other metabolic conditions

gastrointestinal tract disorders eg intestinal obstruction, hepatitis, pyloric stenosis, appendicitis, peritonitis and pancreatitis.

Vomitting And Diarrhea

Subjective

Screen for blood loss in vomit and stools.

Ask for signs of severe disease :       

prolonged duration          

very frequent episodes.      

associated with fever and abdominal pain

Vomitting And Diarrhea

Objective           

Look out for signs of shock. In botulism, neurotoxicity may cause respiratory paralysis. 

Look for dehydration:           

decreased skin turgor

sunken eyeballs

In infants, sunken fontanelles

In severe disease, signs of shock.

Look out for pallor, jaundice, distended abdomen and coffee grounds in the vomitus.

Vomitting And Diarrhea

Assessment

Critical   

Patients with blood in vomit or stools

Patients with hypotension

Patients who are severely dehydrated

Semi-critical       

Patients who are dehydrated

Vomitting And Diarrhea

Non-critical

mild vomitting and diarrhea

Isolated diarrhea without dehydration 

Generally, infants and the elderly are more likely to be dehydrated, so be more liberal in uptriaging them.  

Plan      

If critical, prepare for intravenous access.    

Poisoning

Poisoning may be accidental or intentional.

Children and the elderly

consider the possibility of child or elder abuse.

In adults and teenagers

usually indicates an underlying psychosocial problem. Poisons may be ingested, inhaled, or absorbed through the skin or eye.

Poisoning

Subjective

Type of poison

Time of poisoning & duration

Amount

Objective

ABCD

Vital signs

Confused,comatose

Classical smell

Pupils

Mouth inspection

Associated injuries

Poisoning

Assessment

Critical

Abnormal VS except fever

Comatose,confused

Possible insecticide, antidep, antipsychotic

PCM >14 tablets within 6 hours

Semi-critical

PCM, aspirin, bleach, petroleum distillates

Non-critical

Antibiotics,OCP(unless contain iron), vitamins