Antiemetic article

[Just Plain Ruff]

This is a really good article on antiemetics.

http://www.emsresponder.com/features/artic...n=0&id=6550

[spenac]

Good article. We need to give patients relief. The sooner they receive an antiemetic the more comfortable they are. Patients comfort and well being should be our main concern as healthcare professionals.

[JakeEMTP]

Good article. We've had Zofran for about 5 months now. Phenergan is still on the ambulance but is hardly used.

As Spenac astutely noted, patient comfort is the goal. Since the only true contraindication is hypersensitivity, if the pt. has N/V, they can have Zofran.

[Ridryder 911]

I agree antiemetics should be given as soon as possible, why not?

Personally, I much prefer phenergan IV for most nausea cases. Even though, it has had "bad" reports; I believe it is because of poor administration. I always dilute it before administering it as well as the amount given. In regard of Zofran, it is a good medication if they are not currently nauseated. It has very little antiemetic action if the patient is currently vomiting. Again, great if one suspects that they will become nauseated. I have heard the costs has been reduced since a generic version has been introduced. I know the costs of Zofran ready tabs are $1200 per 15. Compazine, is another one of my favorites but fell into poor favor when the manufacture site decreased the availability due to storm damages (which they so happened to also make Zofran...a coincidence?)

R/r 911

[spenac]

Doing my Paramedic ambulance ride outs the service had just put Zofran on board that day. I had a patient activly vomitting. Slow IV push of Zofran 4mg and in mid vomit patient stopped. Patient remained free of nausea and vomitting for over an hour. Patient stayed alert and was able to talk to us entire transport.

I like phenergan but sometimes makes patients sleep when you need them alert.

[mobey]

Anyone use Maxeran? or Benadryl? for nausia/vomiting

[itku2er]

Anyone use Maxeran? or Benadryl? for nausia/vomiting

We dont but do give Maxeran (reglan) on a regular basis at the SNF. It works better long term to control nausea. We actually have a few on Zofran before dialysis. But it is an expensive drug. The most I have ever seen Zofran used for was in long term treatment for CA patients it really helps with the N/V from treatments. I have never seen Benadryl used for N/V.

[akroeze]

Unfortunately the only anti-emetic I have experience with is Gravol (Dimenhydrinate.... you 'mericans call it Dramamine) IV/IM. Is there an "official" statement out there as to the strengths and weaknesses of each? Sorta like you can find for narcs.

[wrmedic82]

Im all about making the patient as comfortable as possible. On our trucks we carry Phenergan and Zofran.

The one thing we started doing last year is moving towards Zofran ODT. We still carry the Zofran IV, but thats what we are pushing towards.

My personal experience with Zofran ODT is that is works great if the patient has nausea, but not actively vomiting. It dissolves under the tongue in about 30-45 seconds and tastes like cotton candy. The only problem I have seen is with patients actively vomiting. Its kinda pointless at that point. Most medics in our system as well as myself prefer IV Zofran.

Whats everyone elses take on it??

[ERDoc]

I use IV Zofran quite a bit (much to the chagrin of admin as it is the most expensive despite now being the most expensive). It works great, even for those who are actively vomiting. I don't use it very often for migraines. I also use reglan, phenergan and compazine quite a bit. They all seem to be equally effective. I'm a big proponent of EMS anti-emetics. I would much rather have them vomiting on the floor of your ambulance than on the floor of my ER