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Dec 1. 2003 -Treatment Recommendations for Vomiting

The main point - Avoid dehydration.

We must replace the fluids that are lost.

Vomiting two - three times a day will not cause dehydration. Our body loses fluids with "salts" - not water; so it is important to try to use an "isotonic" solution. ( and not Tea; Coke; or juices ).

The "isotonic" drinks available in Israel are "ISOSTAR" sports drink . This is the correctly proportioned solution for returning bodily fluids. It tastes good, and can be purchased at pharmacies and the supermarket (without a prescription ).

There are also prescription Isotonic drinks, (Oral Rehydration) that come as powders or effervescent tablets. HYDRAN (powder for preparation of 1 Liter); REHYDRAT (powder for 250 cc) and ORSET (tablets for 60 cc per tablet). THESE MUST BE PREPARED EXACTLY - NO MORE OR LESS WATER; AND NO ADDITIONAL SUGAR OR JUICE CONCENTRATE ("squash").

These are available with a prescription at all pharmacies. They are very useful to have at home and for trips "for emergencies".

How much do we give ? As much as possible!

How often? This is a CRITICAL point!!!

During the first hour after vomiting give nothing.

During the second hour - give 5 cc ( a sip ) every 5 minutes. This is a very small amount, but it will probably stay inů

From two hours and more after vomiting - give as much as they want; (but try to give about 250 cc (a cup) per hour for adults and children over age 10). (60 cc/hour per 10 kg body weight)

Chicken broth is a good "food" to start with. It can be the "instant" also.
Milk products should be avoided if diarrhea begins. (It frequently does)

We can give medicine against vomiting ("anti-emetic"). Not all doctors agree to give children antiemetics, The pediatric ER at Kaplan Hospital doesn't give antiemetics; and will hospitalize to return fluids IV if vomiting doesn't stop.

PRAMIN (Metoclopramide) is a very effective antiemetic. It does have a rare but unpleasant side effect of involuntary motions, that can be reversed with an injection at the ER. This is the reason some doctors avoid using Pramin.

You can always turn to the emergency clinics ( Moked ) to evaluate the degree of dehydration.

If this is not possible - turn to the hospital ER. If you have questions - call me.
Good Luck, Dr Robert Hoffman

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