Which antiemetic do you use? Which one would you like to use?

[the_negro_puppy]

Currently use Metoclopramide 10-20mg IV/IM however contraindicated for under 16,

Zofran/Ondansetron is being introduced here shortly.

[mobey]

Currently use Metoclopramide 10-20mg IV/IM however contraindicated for under 16,

Rationale?

[ERDoc]

Rationale?

I'm gonna say that it is because that is what the protocols say. I don't think some people understand that just because your protocols say it is contraindicated, it does not mean that it is a true contraindication, it's just the person/people that make your protocols don't want you doing it (this is not directed at the OP, but just a general observation).

[lcfiremedic31]

We are currently using Zofran, but with the current shortage we are looking for other antiemetics, any suggestions?

[ERDoc]

We are currently using Zofran, but with the current shortage we are looking for other antiemetics, any suggestions?

Read this thread, there are quite a few.

[runswithneedles]

Ive been hearing inside the hospitals they want phenegran ran as a controlled drip. Any of you guys heard that?

[rock_shoes]

Current Alberta protocols are excellent with regard to anti-emetic administration. You have dimenhydrinate, metoclopramide, and ondansetron at your disposal with medic's discretion as to which one you use for any given patient. All three have different mechanisms of action allowing you to tailor your first choice based on patient presentation.

I seem to recall seeing a post mentioning that their allowable ondansetron dosage was 4mg. Is that for an adult or a pediatric patient? The most common adult dosage I've seen used on ambulance is 8mg IM or IV. I've also heard of single doses as high as 32mg used for oncology patients. In my own experience ondansetron is like a god-send from the land of "drugs with almost no side effects or interactions that do exactly what they're intended to do."

When I'm in BC options are much more restricted (unless you happen to work the Critical Care Transport side of things). You have dimenhydrinate, dimenhydrinate, or dimenhydrinate, regardless of how a patient became nauseated. I do expect that to change in the near future to something more in line with what Alberta is doing.

[ParamedicTZ]

I prefer to use Versed for my anti emetic. Drool is much easier to handle than vomit.

And on a serious note my service uses Zofran (IV and PO). I have never had any issues with it. Very rarely do I have to give 8mg of it, most always the 4 works great.

[Bieber]

We were carrying metoclopramide, but with the drug shortages a lot of trucks have run out--including my own. Our new protocols include ondansetron, but those aren't coming out till August (supposedly).

[Kiwiology]

The hospital here is all to happy to load you up on ondansetron while you are in hospital but if you need a script for some antiemetics post discharge they religiously use metaclopramide because (and I quote a Consultant Physician) "its cheap!"

It's also crap (but hey look who is talking)