Zofran (ondansetron)

[82-Alpha599]

We just received our new protocols for 2010 and we now have Zofran 4mg IV or IM for nausea/vomiting. I did my homework on the drug but im just curious what you all think of it, and how to best use it.

Do you use it on the drunk 17 y/o girl who just found out what a yager bomb is all about, is it better IV or IM, push it fast/slow, ...????

any tips are appreciated
Thanks

 

[Shishkabob]

I've seen Zofran used a few times and I LOVE it, though I've only seen the PO form of it, and it was administered to anyone complaining of nausea/vomiting.



My view on the 17yo girl, if you're giving fluids or other drugs, go IV route. If you're not going to start an IV, than give IM.

 

[Fox800]

We've had it for about a year...we can give it IV or IM (pedi is IV only). It's good stuff. And yes I will give it to drunks (being transported) that are vomiting, no problem.

 

[Onceamedic]

I like to administer it to nauseous patients on the scene. It saves a lot of time when they don't puke in the rig.

PS.. its a very good drug.

 

[8jimi8]

i don't see how a po medication is going to help someone who is vomiting!

 

[Fox800]

i don't see how a po medication is going to help someone who is vomiting!

You can get it in a quick-dissolving tab B)

 

[rescue99]

We just received our new protocols for 2010 and we now have Zofran 4mg IV or IM for nausea/vomiting. I did my homework on the drug but im just curious what you all think of it, and how to best use it.

Do you use it on the drunk 17 y/o girl who just found out what a yager bomb is all about, is it better IV or IM, push it fast/slow, ...????

any tips are appreciated
Thanks

Sure beats the side effects of compazine!

No, I would NOT give Zofran to a kid who was drunk. Not a chance! My kid gets stinkin drunk, let him live the whole experience!

It works well as a slow push for people with N/V due many legitimate causes.

 

[Fox800]

Sure beats the side effects of compazine!

No, I would NOT give Zofran to a kid who was drunk. Not a chance! My kid gets stinkin drunk, let him live the whole experience!

It works well as a slow push for people with N/V due many legitimate causes.

I think this is a matter of "style points". I prefer to save my partner from having to clean up vomit off the stretcher/floor of the patient compartment. And I don't have to smell it on the way. Or get puke on my uniform. But to each their own!

 

[82-Alpha599]

cool... sounds like some good stuff cant wait to try it out.

 

[rescue99]

cool... sounds like some good stuff cant wait to try it out.

Hey ya 599..how's down river these days?

If one person who would otherwise have become an alcoholic doesn't because I refused to make it easy, I believe I've done a humane service. Besides, the drownsiness factor implies an increased airway risk.

 

[rescuepoppy]

Hey ya 599..how's down river these days?

If one person who would otherwise have become an alcoholic doesn't because I refused to make it easy, I believe I've done a humane service. Besides, the drownsiness factor implies an increased airway risk.

Aspiration poses an airway risk as well.

 

[rescue99]

Aspiration poses an airway risk as well.

My intended point..

 

[Fox800]

My intended point..

Errr...methinks that increased risk of vomiting would be more of an aspiration risk versus whatever sedative effects (very minimal to nonexistent) you'd see by administering ondansetron. We switched from promethazine to ondansetron for precisely that reason...it doesn't have the sedative effects that other antiemetic medications produce.

Lower risk of vomiting + less airway woes + less mess to clean up beats teaching a would-be alcoholic a lesson. That would seem to go along with slamming naloxone to piss off an addict.

 

[Onceamedic]

If one person who would otherwise have become an alcoholic doesn't because I refused to make it easy, I believe I've done a humane service.

I think it is just as valid to assume the patient dives even deeper into the bottle due to the indifference, ignorance and cruelty of those paid to take care of him/her.

 

[DV_EMT]

zofran is a GREAT drug. It allows a rapid relief of nausea.

it comes in as as ODT (orally disintegrating tablet) and a MDV (multi dose vial). I've seen it given primarily via 500/1000 mL drip. It can be given IVP but if your gonna go that route... just go PO

 

[Fox800]

I think it is just as valid to assume the patient dives even deeper into the bottle due to the indifference, ignorance and cruelty of those paid to take care of him/her.

:beerchug:

Treat your patient. Don't "teach them a lesson" by refusing to address their signs/symptoms, i.e. vomiting.

 

[82-Alpha599]

Hey ya 599..how's down river these days?

Oh some ol' same ol'

 

[rescue99]

Errr...methinks that increased risk of vomiting would be more of an aspiration risk versus whatever sedative effects (very minimal to nonexistent) you'd see by administering ondansetron. We switched from promethazine to ondansetron for precisely that reason...it doesn't have the sedative effects that other antiemetic medications produce.

Lower risk of vomiting + less airway woes + less mess to clean up beats teaching a would-be alcoholic a lesson. That would seem to go along with slamming naloxone to piss off an addict.

Don't agree. The ETOH effect is enough of an LOC/airway risk. I see no reason to exacerbate an existing risk. I know what recovery position, suction and a mop are for. Comes down to choice I suppose.

 

[s4l]

<3 Zofran in the ER. Shuts those damn whiny pts up.

 

[82-Alpha599]

what is the IV and IM onset of action time?