Paediatric Nausea and Vomiting

Question 1

Undifferentiated nausea and vomiting may include but is not limited to (PAEDIATRICS)

Answer 1

secondary to opioid analgesia
secondary to cytotoxic drugs or radiotherapy
severe gastroenteritis

Question 2

The main focus in paediatric nausea and vomiting

Answer 2

oral rehydration

Question 3

What do we assess for with N/V in paediatrics

Answer 3

• Undifferentiated N/V
• Potential Spinal Injury
• Potential Eye Trauma

Question 4

Mgx for N/V Paediatrics

Answer 4

Ondansetron
Small Child 2mg
Medium Child 4mg
ODT

Question 5

Differential Diagnosis for Paediatric N/V

Answer 5

Gastroenteritis
Sepsis
Anaphylaxis
Appendicitis

Question 6

Signs of Dehydration in Paediatrics

Answer 6

Increased Thirst
Lethargy
Pallor
Sunken Eyes
Tachycardia
The output of Urine - # nappies changed
Skin Turgor
Mucosa

Question 7

Mgx for SD3 of N/V in Paediatrics

Answer 7

1. R+R
2. Position - POC
3. MICA if required
4. Oral Fluids as tolerated
5. Ondansetron 4mg ODT - 2mg for Small Child/4mg for Medium Child
6. MICA up/downgrade/cancel
7. Extrication - Walk/Wheelchair to stretcher
8. Reassess VSS 10/60
9. Load Signal ? MICA ?

Question 8

What are some causes of GI bleeds?

Answer 8

Haemorroids
Peptic ulcers
Varices
Diverticulitis
Esophageal tears

Question 9

Clinical Signs of Dehydration as per N/V Adult CPG

Answer 9

postural perfusion changes including tachycardia, hypotension or dizziness
decreased sweating and urination
poor skin turgor, dry mouth, dry tongue
fatigue and altered consciousness
evidence of poor fluid intake compared to fluid loss.

Question 10

Undifferentiated nausea and vomiting may include but is not limited to (ADULTS)

Answer 10

secondary to cardiac chest pain
secondary to opioid analgesia
secondary to cytotoxic drugs or radiotherapy
severe gastroenteritis

Question 11

Adult CPG N/V what are clinical indications for mgx of N/V

Answer 11

Undifferentiated N/V
Vestibular Nausea incl. potential for motion sickness, planned aeromedical evacuation, vertigo
Prophylaxis for potential spinal injury or eye trauma

Question 12

Administration of Normal Saline in the Dehydrated Adult Patient

Answer 12

If Less than Adequate Perfusion:
- Consider max 40mL/kg NS IV titrated to patient response, consult for further fluid. If consult unavailable further 20mL/kg (max 60mL/kg)

If Adequate Perfusion but showing clinical signs of dehydration:
- Consider NS 20mL/kg over 30/60