How well do you deal with vomit

[Infofreak411]

If someone in the hospital shows symptoms of vomiting and gastrointestinal distress, how do they distinguish if its caused by something contagious such as norovirus or if its a non contagious cause such as food poisoning.

In the case it is norovirus, what measures do nurses take to prevent getting it?

[tigerlily1000]

This is an interesting topic. Emesis has always been my nemesis! I once took a slide on an un-noticed oyster on the floor of the ICU in 1980, so lugies have also been my enemy for a looong time! Gotta luv nurse stuff!

[Isis Phoenix]

RE: A patient vomiting at the hospital,or at a nursing home;not a pleasant situation,but as nurses we learn to manage it.

Nursing:

Maybe we could begin by looking at the age of the patient, medical history, current diagnosis,diet,food recently consumed, the frequency, color, and consistency of the vomitus. Measure the vital signs; determine if it is accompanied by fever, abnormal breathing, abnormal heart rate, diarrhea, pain, weakness etc. listen to the bowel sounds,examine the abdomen and rectal area, Collect samples, and report the findings to the MD. Obtain permission to establish an IV line.

Place patient in semi Fowler's position, place a basin on the bed table for the vomitus, encourage good hand washing for the patient, and nursing staff, and the use of PPE such as a gown,gloves,goggles,and mask if the cause of the organism is unknown and if there is the chance that splashes will occur.

Medical Management:Usual TX

Labs, sample of vomitus, chest X-ray and possible x-ray of the abdomen, per rectal Compazine if there is no diarrhea, injectable Tigan, or IV Zofran, fluids and electrolyte replacement, and possible antibiotic depending on the organism found…as well as enteric precautions.

“I do not know all the answers, but together we can find them.”

(M Ecallawh)

[Nurse SMS, MSN, RN]

I go into "mom" mode when one of my patients is vomiting. Bin or trashcan, stand slightly to the side, hand on the back soothingly, cool washcloth to the back of the neck, calm presence. I never worry about "catching" something. Either I will or I won't. All I can do is follow precautions and hope for the best. In the moment I honestly do not care.

[pamport]

We all have something that is our kryptonite. Despite many years of ICU practice, I have never been able to tolerate lugies.... phlegm, hawking and spitting - Honestly, there is just something about it that induces a huge case of queasy. I would go to great lengths to avoid assisting with extubations (unavoidable lugie exposure). My nightmare? The COPD 'hawker' who thinks it's OK just to spit. Heck, I'd rather deal with a full-blown lower GI Bleed.

That's funny !

[invisiblewounds]

I will gladly clean BM all day long if it meant never ever ever ever cleaning up vomit.

"I've saved some sunlight if you should ever need a place away from darkness where your mind can feed." - Rod McKuen

[brillohead, ADN, RN]

What does swabbing the nares for flu have to do with vomiting?

Are there STILL nurses who don't understand that "the flu" is influenza, which is a respiratory illness?

Yes, people call it "the stomach flu" but puking is NOT influenza and swabbing the nares for influenza is completely ineffective in diagnosing vomiting.

Most contagious cases of vomiting (and diarrhea too, for that matter) are transmitted via fecal-oral route. FOMITES, FOMITES, FOMITES, PEOPLE! (Does this mean I can get my Crusty Old Bat badge now?)

Any time my kid has the poops or the pukes, I tell him, "You ate someone's poop."

Yes, it's an oversimplification, and sometimes it's through no fault of our own (food service workers can contaminate our food, or improper storage/handling/inspection/preparation can result in contaminated food), but in the vast majority of cases that don't have another cause (like post-op / medication side effects / whatever), at some point someone else's fecal matter entered our mouth and resulted in the gastrointestinal symptoms of noro, etc.

Wash your hands, wash your hands, wash your hands. Especially before eating (or putting your hands/fingers in your mouth for any reason) -- wash your hands, people!

[Christy1019, ASN, RN]

What does swabbing the nares for flu have to do with vomiting?

Are there STILL nurses who don't understand that "the flu" is influenza, which is a respiratory illness?

Yes, people call it "the stomach flu" but puking is NOT influenza and swabbing the nares for influenza is completely ineffective in diagnosing vomiting.

Most contagious cases of vomiting (and diarrhea too, for that matter) are transmitted via fecal-oral route. FOMITES, FOMITES, FOMITES, PEOPLE! (Does this mean I can get my Crusty Old Bat badge now?)

Any time my kid has the poops or the pukes, I tell him, "You ate someone's poop."

Yes, it's an oversimplification, and sometimes it's through no fault of our own (food service workers can contaminate our food, or improper storage/handling/inspection/preparation can result in contaminated food), but in the vast majority of cases that don't have another cause (like post-op / medication side effects / whatever), at some point someone else's fecal matter entered our mouth and resulted in the gastrointestinal symptoms of noro, etc.

Wash your hands, wash your hands, wash your hands. Especially before eating (or putting your hands/fingers in your mouth for any reason) -- wash your hands, people!

Thank you!! As I was reading through the posts I kept thinking, there's gotta be at least one person besides me thinking this.

I've never seen anyone diagnosed in the ED with norovirus, therefore I have no idea what the test for it is. I frequently do see diagnosis of "viral illness" or "gastritis" however but its a diagnosis made after ruling all else out.

Also, someone earlier suggested obtaining a sample of the emesis as part of the nursing interventions, however unless you suspect a GI bleed and are sending it for occult blood, what is the purpose of this?