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Triage and stabilization
Initial priorities
Hemodynamic instability triggers
Hypotension
Persistent tachycardia
Syncope
Respiratory compromise triggers
Aspiration concern
Altered mental status
Immediate actions
If shock physiology, resuscitation bay
If active hematemesis, hemorrhage protocol
If severe agitation, initiate safety measures and sedation pathway
Monitoring
Cardiac monitor
Pulse oximetry
Noninvasive blood pressure cycling
Temperature
Access and fluids
Peripheral IV access times 1 to 2
Isotonic crystalloid bolus for dehydration
Reassessment after each bolus
High-risk complications
Acute kidney injury
Electrolyte derangements
QT prolongation
Rhabdomyolysis after prolonged vomiting or hot water exposure
Key concepts
Syndrome recognition
Cannabis hyperemesis pattern
Recurrent episodic vomiting
Chronic cannabis exposure
Supportive feature
Symptom relief with hot showers or baths
Definitive therapy
Sustained cannabis cessation
Typical ED issue
Standard antiemetics often ineffective
Red flags and escalation
Alternate diagnosis triggers
Peritoneal signs
Rebound tenderness
Guarding
Focal neurologic deficit
New weakness
New aphasia
Severe metabolic derangement
K below 3.0 mmol/L
Na below 130 mmol/L
GI bleeding concern
Hematemesis
Melena
Pregnancy
Positive pregnancy test
Severe dehydration
Sepsis concern
Fever
Rigors
Surgical abdomen concern
Distention
Obstipation
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.