Since the episodes happened, did you fail to react to or recognise the face or voice of someone close to you?
YesNo
Did you feel any pain or discomfort in your abdomen (tummy/stomach)?
YesNo
Does the pain go anywhere else?
NoFlankChestShoulder tipBackOther sites
Did you vomit continuously in the past 24 hours?
NauseousIntermittentFood/fluidBright red bloodDark red bloodDark green bileOtherNo
Did you pass any blood in your stool?
Bright redTar-like/coffee groundMixed bright & dark redRedcurrant/jelly-likeNo
Do you suffer from any symptoms of dehydration (dry tongue, sunken eyes, reduced skin turgor- takes time to return to its normal position upon snapping)?
YesNo
Did you suffer from any physical injury recently?
YesNo
Did you or anyone notice that your skin/eyes turned yellow?