Hyperemesis Care Pathway – Salisbury Hospital NHS Foundation Trust Patient attends GP Patient self refers to ED Assessed by ED team Does not meet outpatient management criteria Telephone referral to O&G Admitted to SAU for inpatient management Meets criteria for outpatient management After 3pm Patient booked to attend next day AGU hyperemesis clinic (Mon-Fri) or SAU (Sat/Sun) Referrer asked to administer IM antiemetic and fluid Before 3pm Patient attends AGU hyperemesis clinic/SAU Baseline observations and investigations – confirm suitable for outpatient management Discharge to Primary Care Oral antiemetics Discharge Assessment - SHO Normal biochemistry Urinalysis </= 1+ ketones Weight stable/increasing Vomiting <5 x day Drinking >500ml day Improved Observations Tolerating light diet Outpatient Management Anti-emetics and iv fluid therapy over 4-6 hours Pelvic USS (if none previous) Oral vitamin supplements Yes No Home overnight with oral antiemetics and return following morning