A 11 year old girl presents to the clinic with vomiting a moderate amount for 5 hours.  She has vomited 3 times, it is clear in colour and not forceful. She does not have any reported abdominal pain. She has voided 4 times today and has had one normal bowel movement. Earlier this morning she was playing football and was struck by another player. There was no reported loss of consciousness. She sustained no obvious injuries.

Physical Examination: She looks pale.  Abdomen is flat. On auscultation, bowel sounds are normal. On palpation it is non-tender and there are no masses or organomegaly. The remainder of the physical examination is normal.

What is/are the most appropriate initial step(s) in management? Check all that apply.

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Authors

Dr. Karen Forbes

Dr. Karen Grewal

grewalk@kgh.kari.net

Queen's University

Reviewers

Dr. Susan Bannister

Susan.Bannister@ahs.ca

Dr. Marc Zucker

Zucker@cheo.on.ca