Nausea

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Kenny

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Maybe this belongs into SCENARIOS but since I have the solution to this, I'll post here first.

You arrive on the scene with either a conscious or an unconscious individual.
This individual is either complaining of impending vomit or is actively vomiting.

How do you guys handle this situation and more specifically, what tools do you use?

Cheers!
Kenny
 
Well, are they conscious or unresponsive? Your proceedures will differ depending on LOC.
 
Fair enough!

How about both scenarios, if you could please. Thanks.
 
Let's call the patients coherent and impaired, I'm sorry.
 
Just happened to me the other day. Was doing an IFT and pt. was complaining of Nausea. I just had suction ready if she indeed did begin to aspirate. Clear the airway and go from there, put them on thier side, or lean them up.

Luckily, I made the driver slow way down and take corners very carefully. We got there without a hitch.
 
Ok, let’s start with a conscious pt c/o nausea, no active vomiting.

Let them be in their position of comfort. O2 @ 15 lpm via nrb (tell them O2 will help with nausea), give them a puke pan and tell them to take the mask off if they feel the need to puke (always seems to happen automatically), IV, normal medical assessment for conscious pt. If they begin vomiting, remove nrb and attempt blow-by O2, closely monitor pt for airway comp, have suction ready.

Unresponsive pt vomiting:

Secure to backboard with seatbelt/clip straps, have board propped so pts left side is down, turn head to left, blow-by O2, IV, normal assessment for unresponsive pt. Have something ready to attempt to catch vomit (or just stay out of the way), very closely monitor airway and actively suction as soon as pt finishes vomiting, be careful to not cause upper resp spasms. Be ready to invasively intervene to protect airway. Be ready to deal with respiratory arrest if vomit is aspirated. If available, defiantly consider ALS intercept for precautionary airway management.
 
Linuss said:
Zofran 2mg or Phenergan 12.5mg FTW!
Click to expand...

I would go with a red biohazard bag first :P untill more of an assessment has been completed.

Vomiting could be caused by anything from digital manipulation to Cycad nut poisoning.

We need more information to play this scenario
 
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Kenny said:
You arrive on the scene with either a conscious or an unconscious individual.
This individual is either complaining of impending vomit or is actively vomiting.
Click to expand...


Yep, belongs in scenarios, unless you're still in class, in which case it belongs behind a little padlock.

I'm going to assume that we have an unconscious individual complaining that ze (lolpronouns) is about to vomit. I'll start by figuring out how I gained telepathy.

Okay, so to improve this thread,

lightsandsirens5 said:
Ok, let’s start with a conscious pt c/o nausea, no active vomiting.

O2 @ 15 lpm via nrb (tell them O2 will help with nausea), give them a puke pan
Click to expand...
If you're going to pull it off and give it blow-by if they vomit, why not use a NC? And lol, emesis basins. Use a standard paper-cone vomit bag. For lots of vomit or a patient who can't hold the bag, cut a head-sized hole in one side of a red bag, put it on the patient like a bib. All credit for the second trick goes to some local 911 providers with years of managing vomity underaged drunks.


lightsandsirens5 said:
Unresponsive pt vomiting:

Secure to backboard with seatbelt/clip straps, have board propped so pts left side is down, turn head to left, blow-by O2, IV
Click to expand...

Why the backboard if you're going to turn them anyway? As with the above example, why blow-by?

I'd like feedback on supplemental O2 for AMS with vomiting, because this seems to happen a lot where I am, and disagreements about it are also common.
 
The big question is, WHY are they puking? (or about to be puking?)

I've found that giving Zofran 4mg IVP before the puking begins is a great thing. Keeps me from having to clean the truck, my boots, the cot and the patient.

If puking is already underway, a redbag or puke bag work wonders.

Now, give us an idea as to WHY this guy is puking? EtOH? Head Injury? Food Poisoning? Forced to listen to Black Eyed Peas 'Boom Boom Pow"?
 
MrConspiracy said:
If you're going to pull it off and give it blow-by if they vomit, why not use a NC? And lol, emesis basins. Use a standard paper-cone vomit bag. For lots of vomit or a patient who can't hold the bag, cut a head-sized hole in one side of a red bag, put it on the patient like a bib. All credit for the second trick goes to some local 911 providers with years of managing vomity underaged drunks.
Click to expand...

Good point on the O2. I guess an NC would be better.

And no, not an emisis basin (worthless things they are) I mean those tub things that hold like 2 or 2.5 gallons. Same material as the little pans (again, worthless), but lots bigger.




Why the backboard if you're going to turn them anyway? As with the above example, why blow-by?
Click to expand...

Makes it easier to keep them turned. And they are not c spined. Just on the board and strapped on with 2 or 3 straps. I guess it is not a requirement, but it will not hurt anything. And since an unresponsive vomiting pt could rapidly become very critical, I'd like having them on the backboard in case CPR is needed. (I have had several CPRs recently caused by aspiration, so this is kind of a new sore spot for me)
 
MrConspiracy said:
If you're going to pull it off and give it blow-by if they vomit, why not use a NC? And lol, emesis basins. Use a standard paper-cone vomit bag. For lots of vomit or a patient who can't hold the bag, cut a head-sized hole in one side of a red bag, put it on the patient like a bib. All credit for the second trick goes to some local 911 providers with years of managing vomity underaged drunks.
Click to expand...

Check out this site that I recently found. I have had the benefit of using these in the field recently and they have worked out better than I had ever hoped!

[Removed SPAM link]

So simple, small and convenient. Has anyone else used these before? I'd love to hear what you think.

Thanks.
 
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Kenny said:
So simple, small and convenient. Has anyone else used these before? I'd love to hear what you think.
Thanks.
Click to expand...

There are other emesis bags on the market... the ones we have are even graduated (kinda like suction jar) to estimate fluid volume.
 
Foxbat said:
There are other emesis bags on the market... the ones we have are even graduated (kinda like suction jar) to estimate fluid volume.
Click to expand...

I'd be interested in seeing those. Do you know where you got them?
 
Kenny said:
Check out this site that I recently found. I have had the benefit of using these in the field recently and they have worked out better than I had ever hoped!

[Removed SPAM link]

So simple, small and convenient. Has anyone else used these before? I'd love to hear what you think.

Thanks.
Click to expand...

Was this the purpose of your "scenario"?

Spamming?
 
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exodus said:
Seems like it, I like 4mg Zofran IVP
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If that "bib" was the tool and treatment plan he referred to in the original posting, I think the OP may of missed something important.

Judging by the lack of answers to the multitude of questions asked, i find it safe to say the OP does not know, or can not fabricate a plausible answer/
 
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Lifeguards For Life said:
If that "bib" was the tool and treatment plan he referred to in the original posting, I think the OP may of missed something important.
Click to expand...

True that. It's better than boring spam though. At least we had a little discussion.
 
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