Diarrhoea and vomiting

For Children

The most common complication from diarrhoea and vomiting illnesses is dehydration. This is because you are losing my fluid that you can take down. Dehydration in children is harder to establish that in adults. By asking a few different questions, you can determine if there is any evidence of dehydration.

• Fewer wet nappies - e.g., producing less urine
• Drinking less than 50% of their normal amount
• Blue, grey or pale or blotchy skin.
• Blue lips or tongue
• Child stops feeding completely

Diarrhoea and vomiting illness are particular common in children, as they often are very contagious and pick them up from other children at daycares and school. Often they are self-limiting - i.e. they will get better on their own - as long as a child stays hydrated.

Children with diabetes may experience complications if they develop diarrhoea or vomiting, as these conditions can significantly disrupt their blood sugar levels.

Green projectile vomiting in babies is concerning, as it may indicate a blockage in their stomach or intestines.

For Adults

Older adults can often deteriorate faster than younger adults. If in doubt and you are concerned about a patient calling, please speak with your line manager.

Dehydration in adults can be easier to spot as adults often will feel thirsty and have a dry mouth. Other symptoms may include:

• Dark yellow urine or infrequent urination
• Fatigue or dizziness
• Rapid heartbeat or breathing
• Confusion or irritability

Vomiting and diarrhoea can be more concerning in adults if:

• There is blood in the vomit or stools
• Vomiting persists for more than 48 hours
• The individual has a pre-existing condition that could be exacerbated by dehydration, such as kidney disease or heart disease
• Patient is immunocompromised - e.g, they have recently had chemotherapy or regular take medications that alter their immune system.

Immuncompromised patients

Here are some examples of medications that can suppress the immune system:

• Corticosteroids (e.g., prednisone, dexamethasone)
• Immunosuppressants used in organ transplantation (e.g., tacrolimus, cyclosporine)
• Disease-modifying antirheumatic drugs (DMARDs) used for autoimmune conditions (e.g., methotrexate, azathioprine)
• Biologics used for various conditions (e.g., adalimumab, infliximab)
• Certain cancer treatments (e.g., rituximab, cyclophosphamide)

These medications can make patients more susceptible to infections, including severe cases of diarrhoea and vomiting.