Vomiting Greater than 1 yo
IF A PATIENT IS VOMITING BE SURE TO ASSESS FOR HEAD INJURY BEFORE GOING ANY FURTHER
[1] MODERATE vomiting (3-7 times/day) AND [2] age > 1 year old AND [3] present < 48 hours
* Older Children Over 1 Year - Sips of Clear Fluids
- Offer clear fluids in small amounts for 8 hours.
- Water or ice chips are best for vomiting in older children (Reason: Water is directly absorbed across the stomach wall)
- Other clear fluids: Use half-strength Gatorade. Make it by mixing equal amounts of Gatorade and water. Can mix apple juice the same way. ORS (such as Pedialyte) is usually not needed in older children, but can also be used. Popsicles work great for some kids.
- The key to success is giving small amounts of fluid. Offer 2-3 teaspoons (10-15 ml) every 5 minutes. Older kids can just slowly sip a clear fluid.
- After 4 hours without vomiting, double the amount.
- After 8 hours without vomiting, return to regular fluids.
- Caution: If vomiting continues over 12 hours, switch to ORS or half-strength Gatorade (Reason: needs some electrolytes).
* Stop Solid Foods
- Avoid all solid foods in kids who are vomiting.
- After 8 hours without throwing up, gradually add them back.
- Start with starchy foods that are easy to digest. Examples are cereals, crackers and bread.
- Return to normal diet in 24-48 hours.
* Avoid Meds
- Discontinue all nonessential medicines for 8 hours. (Reason: usually makes vomiting worse.) (Avoid ibuprofen, which can cause gastritis.)
- Consider acetaminophen suppositories (same as oral dose) if the fever needs treatment (over 102 F or 39 C and causing discomfort).
- Call if child vomiting an essential medicine.
* Expected Course
- For the first 3 or 4 hours, your child may vomit everything. Then the stomach settles down.
- Vomiting from viral gastritis usually stops in 12 to 24 hours.
- Some children may develop diarrhea after the vomiting stops.
- Mild vomiting with nausea may last 3 days.
* Reasons To Call Back
- Vomiting everything for 8 hours (12 hours for age over 6 years)
- Moderate vomiting persists over 48 hours
- Vomiting becomes worse
- Any abdominal pain becomes severe or constant
- Signs of dehydration
- Your child becomes worse
