Zofran

Prehospital Antiemetics | EMSWorld.com

I am curious was the patient fully treated for possible blood loss/shock prior to the use of the anti-emetic as per protocol?

Yes I had an 18g in right hand and 16g in left AC with fluids going in each. He ended up getting total of 1000cc by the time I got to hospital

Yes I had an 18g in right hand and 16g in left AC with fluids going in each. He ended up getting total of 1000cc by the time I got to hospital

Just be careful that you don't end up infusing so much fluid that the patient starts popping clots...

Just be careful that you don't end up infusing so much fluid that the patient starts popping clots...

His blood pressure needed 1000cc and I gave him what he needed

His blood pressure needed 1000cc and I gave him what he needed

I didn't say that you were wrong or incorrect in providing fluids... just to be careful about it as it's not good to pop established clots.

I wonder if he was referring to the black box warning that zofran carries in higher doses to cause SADS (Sudden Arrhythmic Death Syndrome) by prolonging the QT internal.

I imagine someone with a GSW has bigger problems than nausea...

It's not part of our standard order set but I generally get a Zofran order for most serious trauma patients.

I wonder if he was referring to the black box warning that zofran carries in higher doses to cause SADS (Sudden Arrhythmic Death Syndrome) by prolonging the QT internal.

*interval*

A GSW pt would often get Zofran. We give it to offset possible nausea from narcotics. We also don't like them barfing all over the CT machine.

And neither does my husband. Environmental won't clean the machine, only the floor. HE gets stuck cleaning the mess!!

Might I ask why his BP needed 1L of NS so quickly if he was awake and vomiting?

If you transport many GSW/shocky patients you might want to do some research into permissive hypotension, and present this info to your medical director for protocol review.

To answer your original question, Zofran is an anti-emetic, not an NSAID. NSAID's include medications such as Toradol, Ibuprofen, Naproxen, etc. They are, and do exactly as the name implies. In fact, many times these medications can treat the cause of a patients pain better than opioids, which primarily blunt your response to pain but are usually used when we can't easily fix the cause. I'm oversimplifying this a bit, but that's the gist.

Might I ask why his BP needed 1L of NS so quickly if he was awake and vomiting?

If you transport many GSW/shocky patients you might want to do some research into permissive hypotension, and present this info to your medical director for protocol review.

To answer your original question, Zofran is an anti-emetic, not an NSAID. NSAID's include medications such as Toradol, Ibuprofen, Naproxen, etc. They are, and do exactly as the name implies. In fact, many times these medications can treat the cause of a patients pain better than opioids, which primarily blunt your response to pain but are usually used when we can't easily fix the cause. I'm oversimplifying this a bit, but that's the gist.

BP 80/42 vomiting copious amounts

BP 80/42 vomiting copious amounts

That BP looks suspiciously like septic shock vs. trauma, although if the patient is bleeding out then of course no matter how much norepinephrine the adrenals pump out the diastolic won't be compensated enough. I don't know what meds you guys carry with you on the rig, but I assume it's not a ton of meds. I would memorize all of the meds you carry, their MOA, contraindications, administration guidelines, etc... That way when the poop hits the fan you don't have to second guess yourself. :)