Vomiting With Shaking: Dehydration, Infection, and Emergency Signs

More Emergency & Urgent Care Articles

Vomiting With Shaking: Dehydration, Infection, and Emergency Signs

By Your Health Magazine Health Information Team

Vomiting and shaking can occur when an infection causes chills, repeated vomiting leads to dehydration, blood sugar falls, or the body reacts to pain or stress. The combination is sometimes an emergency, particularly when shaking is severe or accompanied by confusion, breathing difficulty, fainting, intense pain, blood in the vomit, or an inability to keep fluids down.

Why Vomiting and Shaking May Happen Together

The type of shaking provides an important clue. Shivering with a fever may reflect the body’s response to infection. Fine trembling with sweating, hunger, or a racing heartbeat may indicate low blood glucose, especially in someone taking insulin or certain diabetes medicines. Trembling after forceful retching can also result from physical exertion, pain, fear, or an adrenaline response.

Possible causes include:

The MedlinePlus overview of nausea and vomiting describes additional causes, warning signs, and reasons to contact a healthcare professional.

Watch for Dehydration

Vomiting removes both fluid and electrolytes. A person may also stop drinking because each sip triggers more nausea. Dehydration can develop more quickly when vomiting occurs with diarrhea, fever, heavy sweating, or frequent urination.

Early signs may include:

• Dry or sticky mouth
• Strong thirst
• Dark yellow urine
• Urinating less often than usual
• Fatigue, headache, or dizziness
• Muscle cramps or generalized weakness

Confusion, fainting, little or no urine, a rapid heartbeat, or rapid breathing can indicate severe dehydration. The National Library of Medicine provides more detail about dehydration symptoms and treatment.

Infants, young children, older adults, pregnant people, and those with chronic illnesses or weakened immune systems may become seriously dehydrated sooner. In a baby, warning signs include no tears when crying, a dry mouth, unusual sleepiness, sunken eyes, or substantially fewer wet diapers.

When Shaking May Point to an Infection

Chills or intense shivering can occur as body temperature rises during an infection. Viral gastroenteritis commonly causes vomiting, watery diarrhea, abdominal cramps, and sometimes fever. Bacteria, parasites, contaminated food, urinary infections, respiratory infections, and other illnesses can also produce vomiting with chills.

The National Institute of Diabetes and Digestive and Kidney Diseases explains that viral gastroenteritis can cause vomiting and dehydration. “Stomach flu” is an informal name for this intestinal infection; it is not caused by influenza viruses.

Severe shaking should not automatically be dismissed as an ordinary fever. Sepsis is a life-threatening reaction to an infection. According to the CDC’s information about sepsis symptoms and risk factors, warning signs can include fever or shivering, feeling very cold, clammy skin, confusion, extreme discomfort, a high heart rate, or shortness of breath. These symptoms require immediate medical evaluation.

Other Important Causes

Low blood glucose

People who use insulin or certain other diabetes medicines may develop low blood glucose if they vomit, cannot eat, or take medication without their usual food intake. Shaking, sweating, dizziness, hunger, confusion, and behavior changes are possible signs. Someone with diabetes should follow the sick-day and low-glucose plan provided by their healthcare team. Confusion, a seizure, loss of consciousness, or inability to swallow is an emergency.

Diabetic ketoacidosis

Vomiting can also occur with dangerously high blood glucose and diabetic ketoacidosis. Warning signs include marked thirst, frequent urination, abdominal pain, dry mouth, fruity-smelling breath, unusual fatigue, and fast or deep breathing. Anyone with diabetes who is vomiting and has high ketones, breathing difficulty, or several of these symptoms needs emergency care.

Bleeding or another abdominal emergency

Bright-red blood or dark material resembling coffee grounds in vomit may indicate gastrointestinal bleeding. Black, tarry stool, faintness, a rapid pulse, or severe weakness increases the concern. As explained in this article about how severe blood loss can become life-threatening, significant bleeding requires urgent treatment.

Severe or steadily worsening abdominal pain, a swollen abdomen, persistent vomiting, or inability to pass stool or gas may signal an obstruction or another condition that cannot be managed safely at home.

When to Seek Care

Call 911 for vomiting and shaking accompanied by:

• Loss of consciousness, a seizure, severe confusion, or difficulty waking
• Trouble breathing, blue or gray lips, or severe chest pain
• Signs of shock, such as cold clammy skin, fainting, severe weakness, or a weak rapid pulse
• Sudden neurological symptoms, including weakness on one side or difficulty speaking
• Severe low blood glucose when the person cannot safely swallow or treat themselves

Go to an emergency department promptly for:

• Blood or coffee-ground-like material in vomit
• Severe abdominal pain, a rigid abdomen, or persistent swelling
• A severe headache with a stiff neck, confusion, fever, or light sensitivity
• Vomiting after a significant head injury
• Suspected poisoning or medication overdose
• Fast or deep breathing, fruity breath, or high ketones in someone with diabetes
• Possible sepsis symptoms, particularly confusion or breathing difficulty with fever and shivering

Adults should contact a healthcare professional promptly if they cannot keep liquids down for approximately 12 hours, have not urinated for eight hours, continue vomiting for more than 24 hours, or are developing signs of dehydration. Children and people at higher risk may need evaluation sooner. A primary care clinician, pediatrician, urgent care center, or emergency department can help determine the appropriate level of care.

What to Do While Monitoring Symptoms

1. Take small, frequent sips. If there are no emergency signs, try small amounts of water or an oral rehydration solution rather than drinking a large volume at once.
2. Monitor urine and alertness. Dark or infrequent urine, increasing sleepiness, confusion, or worsening dizziness may indicate dehydration.
3. Check temperature. Note whether shaking occurs with fever, sweating, or feeling unusually cold.
4. Check glucose when appropriate. A person with diabetes should use their established sick-day plan and contact their diabetes care team if vomiting interferes with eating, drinking, or glucose management.
5. Resume food gradually. Once liquids remain down, small portions of familiar, easily tolerated foods may be easier than a full meal.
6. Use medications cautiously. Over-the-counter nausea or diarrhea products are not appropriate for everyone. Ask a healthcare professional or pharmacist, especially before giving them to a child or combining them with prescription medicines.

A clinician evaluating vomiting and shaking may ask about fever, diarrhea, pain, recent food intake, pregnancy, medication use, diabetes, possible toxic exposures, and how long fluids have stayed down. Depending on the findings, blood or urine tests may be used to assess glucose, electrolytes, kidney function, infection, pregnancy, or other possible causes.