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Nursing Field Notes / GI

Emetics 🤮

NG-035 GI ADHD-friendly visual edition

Drugs that make a person vomit on purpose. The one to know is ipecac syrup — used to empty the stomach rapidly when someone has ingested poison or for drug overdose. The exam lives in the contraindications.

📄 Simple Nursing original — opens in Drive →

💧 15 mL + 1–2 glasses waterIpecac syrup dose after suspected poisoning.
☎️ Call poison control FIRSTBefore using ipecac syrup, call the hotline for advice.
🚫 Caustic · corrosive · petroleumKerosene & friends — high risk of pulmonary aspiration.
⚫ Charcoal cancels ipecacActivated charcoal decreases the effects of ipecac.
💊

WHAT

STEP 1 · THE DRUG & THE DOSE

One drug, one job: bring the poison back up — fast, and only when it is safe to.

🤮 Ipecac syrup — the only name on the card

Generic / Trade: n/a

Use: Induction of vomiting post poison ingestion or drug overdose

Indication: used to empty the stomach rapidly when someone has ingested poison or for drug overdose.

Ipecac syrup is available both as a nonprescription product and as an FDA-approved prescription product.

🧠 “E-metic = Empty.” Emetics empty the stomach; anti-emetics stop the emptying. Same root, opposite jobs.

⏱️ The dose clock — 15 · water · 20 · once

To cause vomiting after suspected poisoning 1 15 mL ipecac syrup the whole dose — measured, not guessed 2 1–2 glasses of water chase the syrup down right after 3 Wait 20 minutes ⏳ watching for vomiting 4 No vomiting? Repeat ONCE may be repeated once in 20 minutes — once only
🧠 “15 · water · 20 · once.” Say it like a phone number. Four numbers, whole dose card.

☎️ Before the bottle is opened HIGH YIELD

Before using ipecac syrup to treat poisoning, call a poison control hotline for advice.

Only use under the supervision of a licensed healthcare provider.

The phone call comes before the syrup — every single time.

🧠 “Dial before you spill.” Poison control 📞 → provider supervision 🩺 → then the 15 mL.

📄 Source note — the “Action” paragraph

Retained exactly as written on the source card: “They neutralize or reduce the acidity of stomach and duodenal contents by combining with HCl and increasing the pH of the stomach acid. They may increase the sphincter tone of the lower esophagus. Examples of antacids include aluminum (Amphojel), magaldrate (Riopan), and magnesium (Milk of Magnesia).”

⚠️ Read this as an antacid fact, not an emetic fact. The paragraph names antacids and describes neutralizing acid — the opposite of inducing vomiting. Learn it with the acid-neutralizer card; the emetic action you are tested on is induction of vomiting to empty the stomach.
🚫

WATCH

STEP 2 · WHEN NOT TO GIVE

Every gate must be clear. One red gate = no ipecac, no exceptions.

🚦 The gate ladder — clear all six

☎️ CALL POISON CONTROL FIRST before using ipecac syrup to treat poisoning 🚫 Comatose · altered mental status or at risk for aspiration of stomach contents 🚫 Seizures — now or coming substance can cause AMS or seizures = no 🚫 Caustic · corrosive · petroleum kerosene → high risk of pulmonary aspiration 🚫 Condition worsened by vomiting bradycardia · severe HTN · hemorrhagic diathesis 🚫 Pregnancy or lactation 🤰 🚫 Crohn's disease ✅ ALL SIX CLEAR + provider supervision 15 mL ipecac syrup + 1–2 glasses water repeat once in 20 min if no vomiting

⚠️ Adverse effects — the vomit tax

💧 Dehydration
🧪 Electrolyte imbalance
📈 Tachycardia
🤢 Nausea, vomitingthe effect and the side effect
🧠 “Fluid out = D.E.T. bill.” Dehydration → Electrolyte imbalance → Tachycardia. Vomiting always sends a bill.

⚫ Interaction: activated charcoal

Activated charcoal decreases the effects of ipecac.

The charcoal binds in the gut — the syrup loses its punch.

🧠 “Charcoal kills the encore.” Black powder in = no big performance out.

🛑 Do not use — the full contraindication list

🚫 Do not give if…Why / detail
Patient is fully conscious (as written on the source card)Source wording retained — see the note below.
Not under a licensed provider's supervisionOnly use under the supervision of a licensed healthcare provider.
Turpentine, corrosives, alkalies (lye for soap), strong acids, petroleum distillates, kerosene, cleaning fluid, paint thinner, furniture polishCaustic or corrosive agents such as kerosene bring a high risk of pulmonary aspiration.
Comatose, altered mental status, or at risk for aspiration of stomach contentsCannot protect the airway from what comes back up.
Patient is having seizuresActive seizing = no emetic.
The substance ingested can cause altered mental status or seizuresThe poison itself will take the airway later.
Medical condition that can be exacerbated by vomitingBradycardia · severe hypertension · hemorrhagic diathesis.
Pregnancy or lactationDo not give.
Crohn's diseaseDo not give.
🧠 “If it makes you CRAMP, don't make them vomit.”
Caustics & petroleum · Reduced consciousness (comatose/AMS/aspiration risk) · Agent that causes AMS or seizures · Maternity (pregnancy or lactation) · Physical conditions vomiting worsens (bradycardia · severe HTN · hemorrhagic diathesis) · Seizures now + Sick bowel (Crohn's).
📄 Source note: the first bullet reads “Do not use on patients who are fully conscious” on the source card, while the rest of the list blocks the unresponsive patient (comatose, altered mental status, aspiration risk). Kept verbatim; flag it if an exam item hinges on it.

WIN

STEP 3 · NURSING MANAGEMENT

What you must know — and who you must call — before anything goes down the hatch.

🩺 Before giving the emetic you must know…

1
🧪 The chemical ingested
what exactly went in — this decides caustic vs not
2
The time ingested
how long it has already been in the stomach
3
👀 What symptoms occur before being brought in
seizures or altered mental status here = stop
4
☎️ The primary healthcare provider should also call the poison control center to obtain information on proper treatment HIGH YIELD
🧠 The 3 W's + 1 call: What chemical · When ingested · What symptoms — then the provider calls poison control. No W's, no ipecac.

✅ Do

  • Call the poison control hotline for advice before using ipecac syrup.
  • Give only under the supervision of a licensed healthcare provider.
  • Give 15 mL syrup, then 1–2 glasses of water.
  • May repeat once in 20 minutes if vomiting does not occur.
  • Watch for dehydration, electrolyte imbalance, tachycardia.

❌ Don't

  • Never with caustics, corrosives, petroleum distillates — turpentine, lye, strong acids, kerosene, cleaning fluid, paint thinner, furniture polish.
  • Never if comatose, altered mental status, or aspiration risk.
  • Never during seizures — or if the substance can cause seizures or AMS.
  • Never in pregnancy or lactation, or with Crohn's disease.
  • Never when vomiting would worsen the condition — bradycardia, severe hypertension, hemorrhagic diathesis.

QUICK RECALL

SAY IT OUT LOUD
🤮 Emetic = EmptyEmpty the stomach fast after poison or overdose.
😴 Not alert = no ipecacComatose · AMS · aspiration risk · seizures.
🧠 3 W's before you giveWhat chemical · When ingested · What symptoms.
💧 D.E.T. billDehydration · Electrolytes · Tachycardia.
🎯 Cover & check — 4 rapid-fire questions
Q1: What is the ipecac syrup dose, and what follows it?
15 mL ipecac syrup followed by 1–2 glasses of water — may be repeated ONCE in 20 minutes if vomiting does not occur.
Q2: A child drank kerosene. Give ipecac?
NO — caustic/corrosive agents such as kerosene bring a high risk of pulmonary aspiration. Same for turpentine, lye, strong acids, petroleum distillates, cleaning fluid, paint thinner, furniture polish.
Q3: Three things you must know BEFORE giving the emetic?
The chemical ingested, the time ingested, and what symptoms occurred before being brought in — and the provider should call poison control for proper treatment.
Q4: Which drug decreases the effects of ipecac?
Activated charcoal.