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Vomiting, Pediatric, Emergency Medicine

Christina M. Conrad Reviewed 06/2017
 


Basics

Description

  • Forceful, coordinated act of expelling gastric contents through the mouth; characterized by nausea, retching, and emesis; no gastric contents are expelled during retching.

  • Emesis res...

Diagnosis

Signs and Symptoms

  • General:

    • Appearance variable depending on the underlying cause

    • Signs of dehydration, including tachycardia, tachypnea, pallor, decreased perfusion, and shock

    • Altered mental st...

Treatment

Pre-Hospital

Not applicable 

Initial Stabilization/Therapy

  • Fluid resuscitation with 0.9% NS IV; caution if concern about increased intracranial pressure.

  • Determine bedside fingerstick glucose.

Ed Treatment/Procedures

Follow-Up

Disposition

Admission Criteria

  • Unstable vital signs, including persistent tachycardia or other evidence of hypovolemia

  • Serious etiologic condition or inability to exclude serious etiologic cond...

Pearls and Pitfalls

  • Determine presence or absence of bile or blood in emesis.

  • Bilious vomiting in the neonate is an important anatomic abnormality such as malrotation until proven otherwise.

  • Consider ca...

Additional Reading

  • Chandran  L, Chitkara  M. Vomiting in children: Reassurance, red flag, or referral? Pediatr Rev.  2008;29(6):183–192.

  • Claudius  I, Kou  M, Place  R, et al. An evidence based rev...

Codes

ICD9

  • 530.81 Esophageal reflux

  • 787.03 Vomiting alone

  • 787.04 Bilious emesis

  • 578.0 Hematemesis

ICD10

  • K21.9 Gastro-esophageal reflux disease without esophagitis

  • R11.10 Vomiting, unspecified

  • R11.14 Bilious v...

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