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