Patients with acute vomiting, typically for hours to a few days, most often present to an emergency department, whereas patients with chronic symptoms are more often initially evaluated in outpatient office settings. Emergency department clinicians should expeditiously exclude life-threatening disorders such as bowel obstruction, diabetic ketoacidosis, adrenal crisis, toxic ingestion, or increased intracranial pressure (ICP). In both urgent care and routine outpatient settings, the following three steps should generally be undertaken in patients with nausea and vomiting: