Triaging down to BLS

[NPO]

Perhaps the sarcasm wasn't well transmitted lol.

I only brought it up because people love to cite it, but there's like evidence. The only time is ever been problematic is in dosrs of 32mg.

 

[EpiEMS]

I'd be happy if EMTs could give IM zofran...... This way you don't even need to tie up a medic to make the patient feel better..... based solely on my own personal experience, I still think it's a miracle drug

Or ODT, even easier. (If they're not profusely vomiting, anyway.)

 

[DrParasite]

Or ODT, even easier. (If they're not profusely vomiting, anyway.)

I was given that when I had my kidney stone..... didn't help, although after it dissolved it may have been swallowed, which caused the resulting vomiting.

My opinion is if EMTs can give epi IM, they can give zofran IM

 

[Tigger]

I was given that when I had my kidney stone..... didn't help, although after it dissolved it may have been swallowed, which caused the resulting vomiting.

My opinion is if EMTs can give epi IM, they can give zofran IM

Yea, we are lucky that Colorado went along with that line of thinking. Our EMTs (with an additional class) can give both Zofran IV or IM (and Narcan for that matter). Great for the medics who now don't have to attend every patient that we can't collectively gain IV access on. Regular, straight out of class Colorado EMTs give ODT.

 

[NPO]

That sounds great. But it doesn't matter because we can't get IV Zofran anyway. Reglan is all we've got right now.

 

[Carlos Danger]

But but but...

QT PROLONGATION!

It actually is a thing. I've seen it many times personally, and it has been show to prolong the QT more than droperidol, which it effectively replaced for the same reason.

The problem isn't so much the zofran itself, but that fact that lots of drugs we give effect the QT. So if someone is on Celexa (for instance), and you give zofran, and that doesn't work so you give benadryl, you could definitely see some effects. It rarely causes problems, but they do happen.

 

[NPO]

It actually is a thing. I've seen it many times personally, and it has been show to prolong the QT more than droperidol, which it effectively replaced for the same reason.

The problem isn't so much the zofran itself, but that fact that lots of drugs we give effect the QT. So if someone is on Celexa (for instance), and you give zofran, and that doesn't work so you give benadryl, you could definitely see some effects. It rarely causes problems, but they do happen.

Yeah. It's something to be aware of, but not freakout over.

Now, if the patient has multiple causes for concern for prolonged QT, like hypokalemia as well as multiple medications, then perhaps an EKG is warranted.

 

[ParamagicFF]

In my system there is about a 5% chance a patient with no categorically ALS conditions receives zofran for their nausea/vomiting. We have the drug and a protocol for it of course, but those patients always end up triaged to BLS.