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