Vomiting, though unpleasant, serves as the body’s protective mechanism to expel harmful substances or irritants. In the prehospital setting, identifying the type of vomit can offer valuable insights into a patient’s condition and aid in prompt and appropriate medical interventions. Understanding the characteristics and causes of different types of vomit can significantly improve prehospital care providers’ ability to diagnose and manage patients effectively. In this blog post, we delve into the various types of vomit and what they signify, equipping prehospital care professionals with the knowledge to deliver optimal care.

Clear or Watery Vomit

Clear or watery vomit often suggests the presence of gastric secretions without any significant food content. It may appear as a slightly frothy liquid, usually indicating an early stage of vomiting or the stomach’s evacuation of excess mucus. Clear vomit can occur due to various reasons, including:

Overconsumption of water or fluids

Gastric hyperacidity or reflux

Early stages of some viral infections

While clear vomit may not always indicate a severe condition, dehydration can be a concern in cases of prolonged vomiting. Prehospital care providers should prioritize rehydration when necessary and monitor the patient’s fluid balance closely.

Yellow or Green Vomit

Yellow or green vomit typically indicates the presence of bile. Bile is a digestive fluid produced by the liver and stored in the gallbladder. When vomiting is persistent or bile refluxes back into the stomach, the vomit may acquire a greenish-yellow colour. Causes of yellow or green vomit include:

Bile reflux due to gastrointestinal issues

Gallbladder disorders

Intestinal obstruction

Identifying yellow or green vomit can help prehospital care providers direct their attention to potential gastrointestinal issues and initiate appropriate treatment accordingly.

Brown or Coffee Ground-Like Vomit

Brown or coffee ground-like vomit can be indicative of gastrointestinal bleeding. When blood mixes with stomach acids, it can take on a darker, coffee ground-like appearance. This type of vomit suggests that there might be bleeding higher up in the digestive tract, such as the oesophagus, stomach, or duodenum. Potential causes of gastrointestinal bleeding include:

Peptic ulcers

Oesophageal varices

Mallory-Weiss tear

Gastrointestinal bleeding is a serious medical emergency that requires immediate attention and intervention in the prehospital setting. Prehospital care providers should take this type of vomit seriously and prioritise rapid transport to a hospital equipped to manage such cases.

Red or Blood-Stained Vomit

The presence of fresh, red blood in vomit is known as hematemesis and is an alarming sign of significant gastrointestinal bleeding. Blood in the vomit can indicate bleeding from the oesophagus, stomach, or upper small intestine. Hematemesis may be caused by:

Peptic ulcers

Gastritis

Oesophageal varices

Mallory-Weiss tear

Tumours in the gastrointestinal tract

Hematemesis is a critical medical emergency requiring immediate medical attention and intervention. Prehospital care providers must prioritize airway management, supportive care, and rapid transportation to a facility capable of managing severe gastrointestinal bleeding.

Undigested Food Particles 

When vomit contains undigested food particles, it may offer insights into recent dietary habits or the efficacy of digestive processes. Causes of undigested food include:

Food poisoning

Gastroparesis 

If undigested food in vomit is persistent or accompanied by other symptoms like abdominal pain or fever, further assessment is crucial to identify the underlying cause.

Recognising the different types of vomit is essential in the prehospital setting, as it can provide critical clues about the patient’s condition and aid in timely and appropriate medical interventions. From clear vomit indicating early-stage vomiting to the more concerning presence of blood-stained vomit, understanding the variations in emesis empowers prehospital care providers to respond effectively and improve patient outcomes. Always remember that any significant or persistent vomiting warrants prompt evaluation and treatment, ensuring the best possible care for patients in their time of need.