Rhinevault-Leadership Experience.doc - Running Head...

Running Head: CANNABINOID HYPEREMESIS
Leadership Experience
PYT1
Patricia Rhinevault

CANNABINOID HYPEREMESIS
A1. Cannabinoid hyperemesis syndrome has become a common complaint seen in our emergency
department since the legalization of marijuana in the state of Washington.
A1a. Our facility does not have a standard way of treating the symptoms or a policy in place. Our
staff is also relatively uneducated about the syndrome and the management of these patients.
A2. I used WGU’s library, talked to emergency department physicians and talked with our nurse
educator for the department.
A2a. “Cannabinoid hyperemesis (CHS) is a syndrome seen in some chronic cannabis users. It is
characterized by cyclic nausea and vomiting, as well as a pattern of compulsive hot water bathing for
symptom relief. Essential for diagnosis is long-term cannabis use, though no specific definition of “long-
term” has been established. Major features for the syndrome include severe cyclic nausea and vomiting,
resolution of symptoms with cannabis cessation, symptom relief with hot showers or baths, abdominal
pain (epigastric or periumbilical), and at least weekly marijuana use.” (Iacopetti, 2014). I work in the
emergency department and we are frequently seeing patients who present with cyclic vomiting who try
to treat their symptoms with smoking, or eating, more marijuana. Many patients I have spoken to are
unfamiliar with cannaboid hyperemesis. Being able to educate patients will go a long way towards
treating, and preventing, this syndrome.
A3a. One of the first problems is that marijuana is now legal in the state of Washington and is
accessible to so many more people. There is little known about CHS right now, as it is a fairly new
condition. A second contributing factor is that many clinicians treat the symptoms of uncontrollable
nausea and vomiting without treating the cause in the case of CHS.
A4. Quitting use of marijuana is the best treatment for CHS. Other suggested treatments include “…
intravenous (IV) hydration is indicated. The use of medications including vitamin B6, ondansetron,
promethazine, metoclopramide, dexamethasone, famotidine, and droperidol, alone or in combination,