[kmoonshine]

Does anyone have standing orders/protocols for nausea and vomiting that includes giving zofran ODT? Our ED has been swamped with nausea/vomiting patients; and I didn't know if there was anyone out there with standing orders which include giving zofran ODT prior to the patient seeing the doc. I feel so bad for the patients that are actively vomiting when our ED is completely backed up, because they have to wait longer. This would be for healthy 15-40 year olds, with main c/o nausea/vomiting (for those patients that most likely have gastroenteritis).

[bill4745]

We don't. Partly because it is apparently quite expensive. The only standing orders in our ER are for tylenol or motrin.

[jmgrn65]

Originally Posted by bill4745

We don't. Partly because it is apparently quite expensive. The only standing orders in our ER are for tylenol or motrin.

Zofran prices have come down, because it was a drug we could only give once and then go to phenegran.

[KckStrt]

We do give it prior to MD visit. Especially if they are waiting longer after triage, we don't need them vomiting all over the lobby and spreading whatever nasty they have, plus it helps with our over all scores when they get their survey .

[rjflyn]

No we dont have anything to give as far as that goes. On that note there are times I dont feel to sorry for them as more often than not you tell them to not eat or drink anything else. What happens when you reassess them later their sitting there still vomiting but they have a bag of chips, a soda or McDonalds; well of course your going to still be vomiting dummy.

Rj

[rjflyn]

Originally Posted by jmgrn65

Zofran prices have come down, because it was a drug we could only give once and then go to phenegran.

Not that much when we get calls from pharmacy's almost daily that a pt cannot afford the RX for 8 tabs at $125+.

Rj

[kmoonshine]

Depending on how your facility charges, ondansetron ODT (generic) breaks down to roughly $20 $25 bucks a pill. I'm sure that is cheaper than the charge for placing an IV and getting reglan or phenergan, since some facilities charge for not just the IV med, but charge for the nurse pushing the med. Just thought it would speed things up - having the patient feeling better before they are even seen and sent home with a script for reglan (or zofran if their insurance covers it), rather than waiting for fluids to go in, dealing with reglan reactions, etc. Plus, not needing an IV means no infection at the IV catheter site.

We've had a really nasty bug plaguing all area hospitals, and even staff are getting ill. I was persistently vomiting at home, so I called my doc and she phoned in zofran for me. Snce its generic, I paid $10 for 12 pills (wow, would've cost $200). My hubby went to pick it up at the pharmacy, and let me tell you - waiting that 30 minutes for him to come home was absolute hell. So I sympahize with patients who are waiting for quite some time to be seen. And let me tell you, zofran works BEAUTIFULLY, and it totally kicked my nausea/vomiting. They should put this stuff in the water!

[kmoonshine]

Oh yeah, one dose of zofran 4mg ODT is safe for men, women, patients with liver disease, and patients with renal failure. Same dose for all, no adjusting needed (peds dosing is different obviously).

[Larry77]

I have gone into the back for a verbal order for it before but we do not have a standing order...would be nice though.

[rgroyer1RNBSN]

We dont either, the only thing we have an order for is Phenergan or Compazine-PR or IM.