Last reviewed
2026-02-07
Workflow pack
Nausea/vomiting outpatient workflow
Workflow for dehydration-risk assessment, supportive management, and escalation when oral-intake failure persists.
Trust and governance
Use only within this workflow's defined scope and exclusions.
Clinical owner
Family Medicine Editorial Team
Risk tier
Medium
Review cadence
Every 6 months
Next due 2026-08-07
Review status
Current
Scope limits
Initial outpatient management of nausea/vomiting in clinically stable adults and adolescents.
Exclusions (escalate/redirect)
- Persistent hemodynamic instability or severe dehydration requiring urgent IV pathway.
- GI bleeding or severe focal abdominal pathology requiring emergency care.
References
Escalate-now emphasis (medium-risk workflow)
Treat red-flag findings as urgent. Escalate the care pathway early if concern persists or follow-up reliability is uncertain.
At a glance
Rapid decision framing for in-visit use. Educational only; always apply clinical judgment.
Immediate actions
- Evaluate fluid tolerance, orthostatic symptoms, and dehydration risk quickly.
- Screen for high-risk causes including bleeding, severe pain, and pregnancy context.
- Determine whether safe oral rehydration pathway is feasible.
Red flags / escalate now
- Inability to maintain oral intake with progressive dehydration signs.
- GI bleeding, severe abdominal pain, confusion, or hemodynamic compromise.
- Worsening systemic illness in high-risk comorbidity settings.
First-line plan
- Start hydration-first management with symptom-guided outpatient treatment.
- Use targeted investigations only when results will change immediate decisions.
- Set explicit escalation triggers if expected recovery does not occur.
Follow-up and monitoring
- Reassess early if oral intake remains poor or symptoms persist.
- Escalate for worsening dehydration, pain, or systemic instability.
- Reinforce clear return precautions and hydration goals.
Next useful actions
Keep moving without restarting the search.
These are the most likely next clicks after opening this workflow.
Condition guidance
Referral checklists
Tools and calculators
Return precautions (patient script)
Suggested plain-language wording for safety-net counseling:
If symptoms get worse, new warning signs appear, or you cannot follow the plan from this visit, seek urgent care now.
- Use with the specific red flags listed on this page.
- Confirm follow-up timing and where to go after-hours.
- Document that return precautions were reviewed and understood.
Visit-close checklist
- Document disposition, rationale, and unresolved diagnostic uncertainty.
- Give explicit return precautions and follow-up timeline before ending visit.
- Attach a relevant handout when available to reinforce adherence and safety-netting.