8.2 Nausea & Vomiting: Management

Underlying cause of nausea/vomiting

Determines which medication will be most effective.

First-line treatment for undifferentiated nausea and vomiting

Ondansetron 4-8 mg ODT or IV (rarely IM).

Conditions causing vestibular nausea

Motion sickness, vertigo, aeromedical evacuation.

Ineffectiveness of ondansetron in vestibular nausea

Different neurotransmitter pathways are involved.

Preferred drug for vestibular nausea

Prochlorperazine 12.5 mg IM.

Examples of prophylactic antiemetics usage

Spinal immobilisation, penetrating eye trauma.

Prophylactic drug and dose for nausea/vomiting

Ondansetron 4-8 mg ODT or IV.

Routes for ondansetron administration

Oral wafer (ODT), IV, rarely IM.

Main role of prochlorperazine in prehospital care

Treatment of vestibular nausea or when ondansetron is contraindicated.