The Hot Shower
The ER card

The card for the worst night.

When you're too sick to explain, this speaks for you. It tells the ER what's going on, asks them to check for other causes, and gives the doctor the facts, without picking a fight.

See the evidence behind it
01
Print it
Print this page. The two card faces come out wallet-sized. Cut them out, put them back to back.
02
Or save it
On your phone, screenshot both cards below and keep them in a favorites album. No printer needed.
03
Hand it over
At triage, give it to the nurse. Fill in your name and a contact so they know who you are.
Front
I may have Cannabinoid
Hyperemesis Syndrome
ICD-10 R11.16

I'm a heavy, long-term cannabis user with severe cyclic vomiting. My symptoms are relieved by hot showers, which is a known sign of CHS.

Please still evaluate me for other causes of vomiting. I'm not asking you to assume CHS. I know it can hide something else.
Name
DOB
Emergency contact
Back · for the clinician
Reference, not a request
R11.16
  • Standard antiemetics (e.g. ondansetron) often underperform. Haloperidol, droperidol, or olanzapine plus topical capsaicin are the supported options.
  • Please check electrolytes and consider an ECG first. Prolonged vomiting depletes potassium, low potassium prolongs QT, and the drugs above prolong it too.
  • Not first-line: opioids and benzodiazepines. They may worsen it.
  • Diagnosis of exclusion. Please rule out other causes.
Ruberto 2021 (HaVOC) · GRACE-4, 2024 · Kwag 2022 (QTc in CHS) · Johns Hopkins CHS pathway, 2025. Full sources at the QR.
the evidence

Why it's written this way

A card that ordered specific drugs could make a busy team anchor on CHS and miss something dangerous, or read as drug-seeking and get ignored. This one does the opposite: it gives your history, names the one tell that helps them recognize CHS, and explicitly asks them to keep looking. It helps the doctor do their job, it doesn't try to do it for them.

On a phone? Take a screenshot of each card above and keep them where you can find them fast. The QR on the back opens the evidence page, so a curious clinician can check the sources themselves.