Patient's question:
Detailed medical condition and consultation purpose: Vomiting several times a day, having bowel movements twice, fever up to 38.4°C. The doctor diagnosed upper respiratory infection after blood tests. After returning home, there were two bowel movements again, 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, and crying a lot.Duration and course of the current illness: Already for three days.
Previous diagnoses, treatments, and outcomes: Medications prescribed yesterday: Xiliao, Jinguo Yin, Tylenol.
Additional 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. If the vomiting is due to medical causes, the underlying disease should be treated. For infants with improper feeding and excessive swallowed air, the child should be laid 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, at a dose of 0.3 mg per kilogram of body weight, taken three times daily, 15 to 30 minutes before meals.
(4) For recurrent vomiting, during the fasting period, the child can drink small, frequent sips of cool or ice water. Drinking warm water may trigger vomiting.