• Always try to identify and treat any underlying causes of nausea and vomiting.
  • Check that the most appropriate anti-emetic has been prescribed for the probable cause and is given by the most appropriate route. If nausea and vomiting persists, reassess and reconsider the possible causes and treat appropriately. If no improvement is seen, seek specialist advice.
  • For persistent vomiting, management of hydration and nutritional status is essential (refer to Subcutaneous fluids guideline).
  • Despite logical and appropriate treatment, the patient may continue to vomit especially if there is a duodenal/gastric outflow obstruction or bowel obstruction. Remember to consider the possibility of bowel obstruction (refer to Bowel obstruction guideline).
  • Colicky abdominal pain after taking a prokinetic drug may suggest bowel obstruction.