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Hi, My Daughter Is Having Vomiting Since Yesterday. One Whole

Posted on Thu, 28 Nov 2019

Question: Hi, my daughter is having vomiting since yesterday. One whole day she had vomiting and loose motion. Consulted local paediatrician and started ORS and ondem and also gave IM injection emeset. She was good whole day today but got another 2 vomit and 4 loose motion few hour back. High fever of 103F gave meftal P but the fever is not coming down. Should I get her admitted. Immediate response is appreciated

Follow up: Dr. Pradeep Kumar Jain (16 minutes later)

It’s an emergency situation please... quick response is appreciated.

Answered by Dr. Pradeep Kumar Jain (5 hours later)

Brief Answer:
I am sorry for the delayed reply, hope the child is doing well

Detailed Answer:
Hi,

I am really very sorry for the delayed reply. I hope she is doing well now.
I have seen the prescription and the medicines written are appropriate for her age and clinical status.

Please let me know about her current status.

High-grade fever which is not responding to mefenamic acid and paracetamol along with vomiting should be better managed in an emergency. Whole-body tepid sponging helps in decreasing the temperature and should be done in case of high fever.

In case of persistent vomiting, the efficacy of the oral medication is not good and there is a risk of dehydration.

Fever, vomiting and loose motion in this age is most likely due to some viral infection and can be managed well with fluids, antipyretics, and anti-emetic. But if fever persists longer than 3-4 days blood tests should be done as this can be due to bacterial infection and antibiotics may be needed.

Please get back to me with her current status. Let me know if you have any more doubts.
Thanks and regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Pradeep Kumar Jain (2 hours later)

I took her to the emergency in XXXXXXX Asia hospital as the fever was still 104 but by the time we reached there, fever was down to 100. Duty doctor advised to do sponging in case of high fever to reduce it.

Current status: Fever has increased a bit. Loose motion is still there and baby complains of stomach ache.

Can cyclofom be given on empty stomach?

Answered by Dr. Pradeep Kumar Jain (1 minute later)

Brief Answer:
Cyclopam should be avoided in vomiting

Detailed Answer:
Hi

It's good to know that fever has decreased. Medicines for fever take time in controlling temperature and continuous sponging helps in such case.
Cyclopam contains dicyclomine and Simethicon. Dicyclomine should be avoided if tgere is vomiting and loose stool as it worsens the condition.
Spasmodic pain abdomen is common in loose stool and vomiting due to increased motility of intestine. Better to use Colicaid as it does not contain cyclomine. The dose is same as cyclopam.
Vomiting may also cause acidity or acidity may worsen vomiting.
I would like to add lansoprazole (Junior lanzol) once a day for two to three days. For this weight half tablet once a day is the usual dose.
In prescription ondensetron injection has been mentioned but there is no maintainance dose to control it.
Give ondensetron drop for vomiting.
Continue giving zinc, ORS, anti-emetic. Monitor temperature and give early dose of paracetamol if temperature is more than 99.
Meftal p contains mefenemic acid and it should be better avoided because of increased risk of acidity. Also meftal p should be given if fever is of high grade and not responding to paracetamol/sponging.
If fever persists longer, blood test should be done for dengue, bacterial infection etc.
I hope this helps.
Please let me know if you have any more questions.
Wishing for your baby's good health.
Regards

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Above answer was peer-reviewed by : Dr. Vaishalee Punj