• Gastointestinal
    • Complications of enteral feeding
      • Mechanical
        • Lumen obstructed
          Discomfort
          Ulceration
          Incorrect placement
      • GI complications
        • Gastric stasis
          Nausea
          Vomiting
          Diarrhoea
          Bloating
          GORD
          Aspiration
      • Metabolic
        • Dehydration
          Overhydration
          Hyperglycaemia
          Hypercapnoea
          Electrolyte imbalance
          Refeeding syndrome
    • PONV
      • Patient factors
        • Female
          Menstruation/luteal phase
          Obesity
          Young patients
          Early mobilisation
          Non-smoking
          Hx of motion sickness or PONV
      • Surgical factors
        • Middle ear, intra-abdominal, gynae, intra-cranial & squint surgery
          Prolonged surgery & painful surgery
      • Anaesthetic factors
        • Nitrous, opioids, sympathomimetics & inhalational agents
          Prolonged GA
          Spinal with hypotension
          Dehydration
          Gastric dilatation
      • Disease factors
        • Intestinal obstruction
          Hypoglycaemia
          Hypoxia
          Uraemia
      • Apfel scoring - based on 4 factors
        • Female
        • Non-smoker
        • Hx of PONV/motion sickness
        • Post-op opiates
        • 2 factors = 1 antiemetic, 3 factors = 2 antiemetics, 4 factors = consider TIVA/regional
    • Antiemetics
      • Pharmacological
        Anti-histamines
        Anti-muscarinics
        Anti-dopaminergics
        Anti-seratoninergics
        Cannabinoids
        Corticosteroids
      • Non-pharmacological
        Ginger
        Acupuncture
        Hypnosis
        TENS
    • Delayed Gastric Emptying
      • Physiological
        • Pain
          Anxiety
          Pregnancy
          Obesity
          Advanced age
      • Pathological
        • GI obstruction
          Electrolyte abnormalities
          Diabetes
          Gastritis
          Raised ICP
          Migraine
      • Pharmacological
        • Opioids
          Anti-cholinergics
          Sympathomimetics
          Dopaminergics
          Alcohol
    • Glasgow Score
      • PANCREAS
        pO₂
        Age
        Neutrophils (WCC)
        Calcium
        Renal (urea)
        Enzymes (LDH/ALT)
        Albumin
        Sugar (glucose)