Hey man, that's my weed!

Patient: "I'm nauseated, i'm vomiting, my belly hurts, and I use cannabis a lot! I have cannabis hyperemesis syndrome."

Paramedic: "You have what now?"

Cannabis (marijuana) use for medical and recreational purposes alike is more common now than ever before. Speaking of common,  EMS providers often encounter patients who fall into the trap of cyclic vomiting, chronic nausea, and diffuse abdominal pain. But, have you ever stopped to ponder whether or not  these two topics are related? Is Cannabis Hyperemesis Syndrome (CHS) on your differential diagnosis list for the nausea, vomiting, abdominal pain patient?

Join me as we take a dive into the "need to know" pathophysiology for EMS, diagnosis, and care plan development for the patient possibly experiencing CHS!

References: 

Beadle, K., et al. “385 Isopropyl Alcohol Nasal Inhalation Intervention for Nausea in the Emergency Department: A Randomized Placebo-Controlled Human Trial.” Annals of Emergency Medicine, vol. 66, no. 4, 8 Dec. 2015, https://doi.org/10.1016/j.annemergmed.2015.07.421. 

Hernandez, Jeremy M., et al. “Cannabinoid Hyperemesis Syndrome Presentation to the Emergency Department: A Two-Year Multicentre Retrospective Chart Review in a Major Urban Area.” CJEM, vol. 20, no. 4, 2017, pp. 550–555., https://doi.org/10.1017/cem.2017.381.

Pickett, Jason  R. “Cannabis Hyperemesis Syndrome.” Episode 13: Austin-Travis County EMS System Office of the Medical Director Official Podcast. Apple Podcasts, 22 Feb. 2018. 

Winstead-Derlega, Christopher. “More than a Hot Shower – Treatment for Cannabinoid Hyperemesis Syndrome (CHS).” EmDOCs.net - Emergency Medicine Education, EmDOCS, 20 Nov. 2020, http://www.emdocs.net/more-than-a-hot-shower-treatment-for-cannabinoid-hyperemesis-syndrome-chs/.

Stay safe, and do good care!