• Diarrhoea and Vomiting SSOU Guideline

    Definition

    Diarrhoea and /or vomiting causing dehydration 

    Admission Criteria

    • Diarrhoea and / or vomiting
    • Dehydration / lethargy 

     

    Exclusion Criteria

    • SEPSIS
    • Likely LOS > 24 hours
    • Diagnosis unclear
    • Major co-morbidities
    • Bloody diarrhoea

     

    Investigations

    • FBE
    • UEC
    • Glucose
    • LFT
    • Consider: Stool culture if prolonged (>3 days), toxic or returned traveller
    • Blood culutres if patient becomes septic (will not be indicated in most patients who are admitted to SSOU for gastroenteritis).

     

    Suggested Medications

     consider the need for potassium replacement

     
     Drug  Dose  Frequency  Route 
     Normal Saline 

      1 litre stat 1-2 more litres over next 2-4 hours 

    		 as required   
       Metaclopramide  10mg 6/24 prn  oral 
      Panadol / panadeine forte   1g (note, the consitpating side effect of codiene
     may be a welcome relief in some cases of gastroenteritis)     		 4 hourly prn  oral  
      Ondansetron  4 - 8 mg  8-12 hourly oral/IV
       
        

     

    Specific Observations

    • Report abdominal pain / changing
    • Report haematemesis / bloody stools
    • Report fever > 38 C

     

    Specific Management Issues

    • Prefer Single Room
    • Contact precautions

     

    Discharge Criteria

    • Normal hydration
    • Appropriate social supports
    • Able to tolerate fluids

     

    Hospital Admission Criteria

    • Dehydration not resolved
    • Persistent vomiting
    • Abnormal vital signs
    • Unclear diagnosis
    • Ongoing significant pain