A 16 year old boy presents to the clinic with vomiting a moderate amount for 5 hours.  He has vomited 3 times, it is clear in colour and not forceful. He does not have any reported abdominal pain. He has voided 4 times today and has had one normal bowel movement. Earlier this morning he was playing lacrosse and was struck by another player. There was no witnessed loss of consciousness. He sustained no obvious injuries.

Physical Examination: He looks tired.  Abdomen is soft. 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