WORLD EMERGENCY MEDICINE SOCIETIES & RELATED

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Monday, January 31, 2022

All that Pukes

TAMING THE SRU
TAMING THE SRU - By Olivia Gobble - January 31, 2022
FEELING SICK? LET’S MAKE IT QUICK!
  • Nausea and vomiting is one of the most frequently encountered complaints in the emergency department. Regardless of etiology, management should include addressing complications, such as dehydration and electrolyte imbalances, and ruling out life-threatening diagnoses.
  • Gastroparesis is delayed gastric emptying in the absence of mechanical obstruction. Management is centered around prokinetic agents to improve GI motility, as well as antiemetics and IV fluid administration to treat the nonspecific symptoms of nausea and vomiting
  • Haloperidol is increasingly used in the ED to treat the symptoms of gastroparesis and has been found to decrease rates of hospitalization and analgesic administration
  • Cyclic vomiting syndrome is characterized by stereotypical episodes of nausea, vomiting and abdominal pain with intervening periods of normal or baseline health in between. Management focuses on 1.) Trigger avoidance and prophylaxis 2.) Abortive therapies 3.) Supportive treatment
  • Differentiating between cyclic vomiting syndrome and cannabinoid hyperemesis syndrome involves stopping marijuana usage for at least one week. If symptoms improve or resolve, cannabis hyperemesis is likely
  • Capsaicin cream has been shown to decrease abdominal pain and nausea and vomiting at 60 minutes when compared to the placebo group in patients with cannabinoid hyperemesis syndrome
  • Droperidol reduced ED LOS and additional emetic administration in patients with Cannabinoid Hyperemesis Syndrome.