Question
Detailed medical condition and consultation purpose: Multiple vomits in a day, defecated twice, fever up to 38.4°C, diagnosed as upper respiratory infection after blood test. At home, defecated twice more, one with a large amount and one very little, almost no odor, abdomen bloated, knocking sound like a drum, not eating milk, vomiting after forced feeding, likes to cry. Duration of current illness and ongoing symptoms: Now for three days. Past diagnosis and treatment process and effectiveness: 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 to moderate dehydration can be treated with oral rehydration salts, taken multiple times in small doses. Most children can correct dehydration and acidosis this way. If correction is not possible or the child cannot tolerate oral rehydration, the best approach is to correct it through intravenous fluid therapy based on blood biochemistry 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 feeding, pat the back to make the baby hiccup and expel gas. (3) Antivomiting medication should be taken. The safest and most effective medication is Metoclopramide, 0.3 mg per kilogram of body weight per dose, taken three times a day, 15 to 30 minutes before meals. (4)