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Immediate stabilization
Immediate stabilization priorities
Airway protection for refractory vomiting with aspiration risk
Escalate to resuscitation bay for altered mental status
Escalate to resuscitation bay for severe tachycardia with hypotension
Circulation targets
Heart rate trend toward baseline after fluids
Systolic blood pressure adequate for perfusion
Point-of-care glucose
If hypoglycemia, IV dextrose after thiamine
IV access
Two large bore peripheral IV for severe dehydration
Consider ultrasound-guided IV for difficult access
Antiemetic pathway early
If persistent vomiting, stepwise antiemetic escalation
If refractory, combination therapy with different mechanisms
Key decision points
Key decision points
Pregnancy confirmation and gestational age
Positive pregnancy test with dating by last menstrual period
If uncertain dating or concern for complication, ultrasound
Severity stratification
Weight loss greater than 5 percent of prepregnancy weight
Ketonuria or ketosis with dehydration
Complication screening triggers
If abdominal pain or fever, alternate diagnosis workup
If jaundice or right upper quadrant pain, hepatobiliary workup
If headache or focal neurologic findings, neurologic workup
Monitoring and reassessment
Monitoring and reassessment
Vital sign trend after fluids and antiemetics
Orthostatic symptoms resolution
Urine output improvement
Electrolyte recheck timing
Repeat potassium and sodium after significant replacement
Repeat magnesium if low or prolonged vomiting
Fetal considerations
If viable gestation and concerning maternal status, obstetric input
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.