1. 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