PUQE-24
Nausea & vomiting severity (last 24 h)
Clinician mode
Low risk
3
Mild NVP
- Ladder: cyclizine/promethazine → prochlorperazine/metoclopramide → ondansetron (>10/40 preferred) → steroids.
- PUQE ≥13, ketonuria, weight loss ≥5% → admit for IV fluids + thiamine.
- Always give thiamine before any glucose-containing fluid (Wernicke prevention).
Reference range
Mild ≤6 · Moderate 7–12 · Severe ≥13 (validated PUQE-24)
Common pitfalls
- Only counts symptoms in the last 24 h.
- Score can miss dehydration — always check ketonuria & weight.