CHS Emergency Room Guide: What to Expect and How to Prepare

Experiencing a Cannabinoid Hyperemesis Syndrome (CHS) episode can be frightening, especially when emergency care is necessary. This detailed guide outlines exactly what to expect during your ER visit and how to prepare effectively to reduce anxiety and ensure optimal care.

When Should You Visit the Emergency Room?

Immediate Signs to Seek Emergency Care

Head to the ER immediately if you experience:

• Severe dehydration (dizziness, confusion, rapid heartbeat)
• Continuous vomiting lasting over 24 hours
• Blood or coffee-ground appearance in vomit
• Severe, worsening abdominal pain
• Electrolyte imbalance symptoms (muscle cramps, irregular heartbeat, weakness)
• Loss of consciousness or fainting
• Chest pain or difficulty breathing

ER vs. Urgent Care: Know the Difference

Emergency Room: Severe symptoms, dehydration, intense pain, or life-threatening concerns.

Urgent Care: Mild to moderate symptoms, stable conditions needing IV fluids, and follow-up coordination.

Preparation Checklist: Before Heading to the ER

Essential Items to Bring

Medical Documentation:

• Insurance card and photo ID
• List of current medications
• Previous CHS diagnosis and recent lab results
• Primary care doctor’s contact details

CHS-Specific Details:

• Symptom diary and cannabis use history
• Previous CHS episode details
• Effective and ineffective past treatments
• Current symptom severity and duration

Comfort Essentials:

• Phone charger
• Comfortable clothing
• Support companion
• Small towel (for heat application)
• Tolerable clear fluids

Summarize Your Medical History

Prepare a concise, one-page summary including:

• Cannabis usage (frequency, duration, products)
• Past CHS episodes (dates, treatments, outcomes)
• Medications, allergies, medical conditions
• Recent symptom or usage changes

What to Expect During Your ER Visit

Initial Triage Assessment

Expect a quick evaluation of:

• Vital signs (blood pressure, heart rate, temperature)
• Pain level (scale of 1–10)
• Symptom description and onset
• Urgency determination

Typical questions asked include:

• “When did symptoms begin?”
• “Rate nausea/pain severity.”
• “Any recent substance use?”
• “Previous similar episodes?”

Medical Evaluation and Tests

Physical Examination:

• Abdominal check
• Hydration status
• Neurological, heart, and lung assessments

Common Tests:

• Blood tests (electrolytes, kidney function, complete blood count)
• Urinalysis (hydration, drug screening)
• Imaging tests (possible abdominal CT scans)

Treatments Offered

Immediate Treatments:

• IV hydration
• Anti-nausea medication (ondansetron, promethazine)
• Non-opioid pain relief
• Electrolyte replenishment

Comfort Measures:

• Hot packs for abdominal relief
• Calm, quiet environment
• Slow reintroduction of clear fluids

Effective Communication with Medical Staff

Explaining CHS Clearly

Use a simple, direct explanation:

“I have Cannabinoid Hyperemesis Syndrome (CHS), a condition triggered by chronic cannabis use causing severe vomiting, nausea, and abdominal pain. Hot showers help temporarily, but stopping cannabis is the only effective long-term treatment.”

Addressing Common Challenges

• Staff unfamiliar with CHS: Provide printed literature, reference medical studies, or request a gastroenterologist consultation.
• Skepticism about cannabis link: Highlight your symptom diary, correlation timing, and hot shower relief.
• Unsuitable medication suggestions: Clearly communicate past treatment effectiveness and sensitivities.

Managing Your Hospital Stay

Advocate for Yourself

• Request hot packs for comfort.
• Ask about room temperature adjustments.
• Clearly report symptom changes.
• Seek updates regularly.

ER Timeline Expectations

• 1–2 Hours: Initial assessment, IV fluids, and medication administration.
• 2–4 Hours: Review of test results, assessment of symptom relief.
• 4+ Hours: Planning discharge, coordinating follow-up care.

Before Discharge

Discharge Essentials

Ensure you have:

• Clear instructions and emergency return criteria
• Prescriptions and medication details
• Scheduled follow-up appointments
• Contact information for future questions

Ask specifically about:

• Symptoms requiring immediate return
• Follow-up scheduling
• Home management strategies
• Medication interactions

Financial and Insurance Considerations

Before Arrival

• Confirm ER insurance coverage.
• Clarify copays and deductibles.
• Have your insurance information ready.

Cost-Management Tips

• Choose in-network hospitals.
• Inquire about financial assistance.
• Request detailed billing.
• Appeal insurance rejections if necessary.

Follow-Up Care After the ER

Immediate Follow-Up Steps

• Contact your primary physician within 48 hours.
• Schedule gastroenterologist consultation.
• Initiate a cannabis cessation plan.

Ongoing Management

• Regular medical follow-ups
• Symptom tracking
• Nutrition and hydration management
• Mental health support as needed

Special Circumstances

Frequent ER Visits

• Document previous visits and treatments.
• Clearly explain your management strategies.
• Explore case management services.

Pregnancy

• Immediately inform medical staff.
• Discuss medication safety and specialized care.
• Seek OB/GYN consultation.

Mental Health

• Request emotional support resources.
• Consider professional counseling and support groups.
• Address anxiety or depression proactively.

Advocacy and Awareness

Sharing Your Experience

• Offer feedback to medical teams.
• Support CHS awareness initiatives.
• Participate in advocacy and educational efforts.

Emergency Resources and Contacts

• Poison Control: 1-800-222-1222

• Crisis Text Line: Text HOME to 741741

• SAMHSA National Helpline: 1-800-662-4357

Final Thoughts

Seeking emergency care for severe CHS symptoms is justified and critical. Proper preparation, clear communication, and proactive self-advocacy can significantly improve your ER experience and health outcomes.