Patient's question:
Detailed medical condition and consultation purpose: Vomiting several times a day, having two bowel movements, fever highest at 38.4°C. The doctor diagnosed upper respiratory infection after checking blood. After returning home, there were two more bowel movements, one large and one very small with almost no odor. Abdominal distension, with a drum-like sound when tapped. Not eating milk, vomiting after forced feeding. Prone to crying.Duration and course of the current illness: Already three days.
Previous diagnoses, treatments, and outcomes: Medications prescribed yesterday: Xiliao, Jinguo Yin, Tylenol.
Ancillary tests: Finger blood test.
Doctor's answer:
Hello: Mild vomiting has little impact on health and does not require treatment. Severe vomiting not only ejects a large amount of fluid but also loses electrolytes, leading to symptoms of dehydration and acid-base imbalance, which must be treated urgently.(1) Fast for 6 to 8 hours. For mild or moderate dehydration, oral rehydration salts (ORS) can be taken in small, frequent doses. Most children can correct dehydration and acidosis. If it cannot be corrected or the child cannot tolerate ORS, the best approach is intravenous fluid therapy based on blood biochemistry tests.
(2) Treat the underlying cause. For surgical obstructions, surgery should be performed to relieve the obstruction. For medical vomiting, the underlying condition should be treated. If the infant is improperly fed and swallows a large amount of air, the child should be placed on the mother’s shoulder after feeding, patted on the back, and encouraged to burp to expel the air.
(3) Antiemetic medication should be taken. The safest and most effective drug is metoclopramide, with a dose of 0.3 mg per kg of body weight, taken three times daily, 15 to 30 minutes before meals.
(4) For recurrent vomiting, small, frequent sips of cool or iced water can be consumed during the fasting period. Drinking warm water may trigger vomiting.