Hx: Vomiting Cheat Sheet (DRAFT) by med_panda

- In chrono­logical order, recent problems first
e.g vomiting 1/7 and Abd pain 2/7

- When did it start?
- Was it sudden or slowly happening over time? (Suddenly usually in bowel obstru­ction)
- When does it happen? Before or after eating­/dr­inking? Is it always after a specific food/d­rink? On an empty stomach? Early morning?
- Do you know what may have caused it?
- Qualit­y/Q­uan­tity: How much do you vomit up/ in spoons or cups? How many times to eat/drink before you vomit? All the time or only sometimes?
- Does anything make it better or worse?
worse: movement, seeing or smelling something? pain?
better: Lying down, not eating­/dr­inking, ant emetics
- How is this affecting your daily life?
- Do you know what may have triggered or started it?


- Color: Coffee ground: (upper GIT), Fresh blood (Upper GIT), Yellow­/green (Bile, obstru­ction beyond the ampulla of Vater), Brown: (late sign of SBO)
- Mixed with blood or just blood>
- Contents: food, etc
Small streaks or flecks of blood in material you spit up may come from the teeth, mouth or throat and isn't usually considered vomiting blood. Blood in vomit may be bright red, or it may appear black or dark brown like coffee grounds.
- Does this vomit come out forcefully over a distance? Or is it just dripping out
- Is this the first time this has happened? How many times has it happened?
- Do you ever try and vomit but nothing comes out (making sounds)? Do you ever feel like vomiting but never do? Do you ever feel dizzy or sweaty?

- Any pain anywhere? on your tummy or chest?
- Fever?
- Headache? really bad headaches?
- Appetite
- Passing toilet normally?
- Passing pee normally?
- Any problems with hearing? ringing?
- Vomiting especially in the morning

Systemic: fever, weight change, fatigue
Cardio­vas­cular: chest pain, syncope, palpit­ations
Respir­atory: cough, sputum, hemopt­ysis, pleuritic, chest pain
Genito­uri­nary: Dysuria, urinary frequency and color
Neurol­ogical: visual changes, motor or sensory, headache, confusion
Dermat­ology: Rashes or skin sores for allergy, Jaundice

- Have you been admitted to hospital or seen by a doctor for any illness related to your tummy or your throat or toilet passage or any other condit­ions?
- Have you had a doctor look down your throat or your foodpipe or had a feel of your toilet passage?
- Mental health – stress , mood disorders such depression

- Paediatric history if it is a child- look at the common causes of vomiting in a child: feeding, hygiene, infect­ion­s-m­iddle ear, urinary tract, gastro­ent­eritis; surgical causes
- Past surgical history of gas­tro­int­est­ina­l d­isease
- Abdominal surgery (e.g. cholec­yst­ectomy, bowel resection) date, indication and procedure
- Previous bowel obstru­ction

- Allergies
Medica­tions that they maybe be taking to stop vomiting : antiem­etics
Medica­tions that cause vomiting
- Macrolide antibi­otics such as erythr­omycin and azithr­omycin
- Chemot­her­apeutic agents for cancer
- Opiates for pain such as morphine and codeine
- NSAIDS such as Ibuprofen and Indome­thacin
- Antide­pre­ssants such as fluoxetine
- Vitamins and mineral supple­ments such as iron tablets

- Anyone with similar problem in the family?
- Food poisoning?

- Are you married? (pregn­ancy)
- What do you do for work? (chemicals exposu­re/­rad­iation)
- Diet: Fatty and spicy food
- How are your living condit­ions? Well ventil­ated? How many rooms? Water supply and toilet condition?
- Do you smoke?
- Do you drink alcohol?
- Do you do any recrea­tional drugs?
- Have you travelled any where recently?
- Have you been to any social gatherings and eaten there? Does anyone else who ate from that gathering also complain of similar problems?

- Have you ever had a condition known as gastritis or peptic ulcer disease? you may have had a doctor tell you this
- Are you experi­encing any stress at home, work? have you ever known yourself to have mood disorders?
- Have you ever been burnt severely before on your neck or in your throat?

- NSAIDS- ibuprofen, indome­thacin, diclofenac sodium (voltaren)
- Antico­agu­lants – Aspirin , warfarin, heparin

The diseases they have may give a clue to the medica­tions they are on