Any patient unable to maintain adequate hydration at home should be admitted to the hospital and investigated.
Discontinue any medications that may aggravate symptoms like iron supplements and antibiotics.
Discontinue oral intake.
Maintain input/output chart
IV fluids – N Saline /Hartmans
Fluid and electrolyte regimes should be adapted daily and titrated against the U&E results.
KCL may be added on according to the U & E results
DO NOT USE Double strength saline
Avoid solutions containing dextrose esp if hyponatremia exists.
Antiemetics – Cyclizine 50 mg tds PO/IV/IM
Prochlorperazine – 5-12.5 tds PO/PR/IM
Metoclopramide – 10mg tds PO/IM
Oculogyric crisis may occur – Manage with PROCYCLIIDINE 5 mg IM/IV
Thiamine – Routine supplementation
25 – 50 mg TDS PO if she can tolerate orally
– 100mg in 100ml N Saline infusion over 1 hr weekly.
H2 receptor antagonists – Ranitindine and omeprazole are useful in some patients particularly with associated hematemesis
Thromboprophylaxis – Low Molecular wt Heparin
Corticosteroids – Discuss with Consultant first (3)