Question
The child vomits several times a day, has diarrhea twice, and the highest fever is 38.4°C. After the doctor checked the blood, the diagnosis was upper respiratory tract infection. After going home, there were two more episodes of diarrhea, one with a large amount and one with very little, almost no smell. The abdomen is bloated, and there is a drumming sound when tapped. The child does not want to breastfeed and vomits when forced to. The duration of the current illness and its progression: It has been three days now. Previous diagnoses and treatment experiences and outcomes: Medication prescribed yesterday: Xiliao, Jinguoyin, Tylenol. Auxiliary examination: Finger blood test.
Answer
Mild vomiting has little impact on health and does not require treatment. Severe vomiting not only loses a large amount of water but also electrolytes, leading to symptoms of dehydration and acid-base imbalance, which must be handled urgently. (1) Refrain from eating for 6 to 8 hours. Mild or moderate dehydration can be treated with oral rehydration salts, taken in small amounts multiple times. Most children can correct dehydration and acidosis. If correction is not possible or the child cannot tolerate oral rehydration, the best approach is to administer intravenous fluid correction based on blood biochemical tests. (2) Treat the primary disease. For surgical obstructive diseases, surgery should be performed to relieve the obstructed segment. For internal medicine-related vomiting, treatment of the primary disease is necessary. If the baby is fed improperly, swallows a large amount of gas, the child should be placed on the mother’s shoulder after breastfeeding and patted on the back to burp and expel gas. (3) Antivomiting medication should be taken. The safest and most effective drug is Metoclopramide, 0.3 mg per kilogram of body weight, taken three times a day, 15 to 30 minutes before meals. (4) During the fasting period for recurrent vomiting, drink small amounts of cool boiled water or ice water multiple times; drinking warm water may cause vomiting.