Vomiting (Emesis): Symptoms, Complaints, Signs

The following symptoms and complaints may occur together with vomiting (emesis):

Leading symptom

Accompanying symptoms

  • Nausea
  • Headache
  • Dizziness

Chemotherapy-induced nausea and vomiting (CINE)

This is divided into three phases

  • Acute-onset CINE: onset of nausea and/or vomiting within the first 24 h after administration of a chemotherapeutic agent; often occurs after only a few minutes
  • Delayed-onset CINE: occurrence at least 24 h after cytostatic drug administration and may persist for up to 120 h after admission
  • Anticipatory CINE: This occurs before the application of the antineoplastic agent in patients who have had CINE.

Warning signs (red flags)

Infants and young children

Dehydration (lack of fluids) and shock

The following children are at increased risk:

  • Infants with low birth weight
  • Infants, with signs of malnutrition
  • Children under one year of age, especially children under 6 months.
  • Children who have had > 5 diarrheal stools within the last 24 hours
  • Children who have vomited more than twice within the past 24 hours
  • Children who have not previously received supplemental fluids or have been unable to tolerate them
  • Children in whom breastfeeding has been discontinued during the disease.

Warning signs (red flags) in children (= possible indicators of other diagnoses) [NICE recommendations; 1, 2 ]

  • Fever > 38 °C in children younger than 3 months of age.
  • Fever > 39 °C in children over 3 months of age
  • Shortness of breath or tachypnea (“rapid breathing“).
  • Changes in consciousness
  • Meningismus (painful stiffness of the neck)
  • Bulging fontanelle in infants
  • Rash that can not be pushed away
  • Blood or mucus accumulation in the stool
  • Bilious (greenish) vomiting
  • Severe or localized abdominal pain
  • Distended abdomen or pain on release