Nausea/vomiting referral checklist

Urgency tier

• Immediate ED assessment for severe dehydration, GI bleeding, severe abdominal pain, altered mental status or a suspected cardiac, neurologic, toxic or metabolic emergency.
• Expedited referral for persistent vomiting with nutritional compromise or unresolved etiology.
• Routine referral for stable but prolonged symptoms after initial workup.

Minimum pre-referral workup

• Emergency transfer must not wait for completion of this checklist.
• Symptom chronology, oral-intake tolerance, and dehydration assessment.
• Focused abdominal exam and high-risk comorbidity review.
• Baseline tests completed and response to initial outpatient management.

Referral packet checklist

• Duration/frequency pattern and triggering factors.
• Objective findings, investigations performed, and treatment response.
• Current medication list and relevant comorbid context.

Pre-referral optimization tasks

• Confirm fluid tolerance and an individualized hydration plan; give immediate return precautions for deterioration.
• Review medication contributors and stop non-essential triggers where safe.
• Arrange interim follow-up pending specialist assessment.

References

• BC Emergency Health Services Nausea and vomiting (opens in a new tab)
• Emergency Care BC Oral rehydration for adults (2020) (opens in a new tab)
• Emergency Care BC Antiemetic safety (2022) (opens in a new tab)

Something out of date or unclear? Suggest an update. Leave out any patient details.