For vomiting I base the child's NPO period on their age and size. I don't
like the idea of an infant going long >30 minutes with out attempts to
rehydrate if they are losing fluid.
For breastfed babies I tell mom to use short frequent feeds. How short and
freq is based on how efficiently baby feeds and mom's let down. Think how
long would it take for a baby to get 5 to 10cc of milk.
Fortunately I don't run into this much with breastfeeders and the few I have
ALL been managed as out patients.
Phenergan (promethazine) is a phenothiazine class med, as is Compazine,
needing a prescription in the US. It is mostly used for sedation, nausea ,
and motion sickness. It is not risk free and can cause dystonic reactions.
The main problem is it will cause sedation and is basically turning off an
alarm and ignoring a fire. Therefore one most be very careful and sure of
the diagnosis before using it so as not to cover up S/S of illnesses that
can present like gastroenteritis such as Strep pharyngitis, acute
appendicitis, pneumonia etc.
As I resident I had several attendings who would not allow us to use it. We
could be shot. (Anyone like that in Hershey, Gail? :-) )
-Rob


Rob Cordes, DO, FAAP, FACOP
Wilkes Barre, PA
mailto:[log in to unmask]