Joint Hospital Planning Council	Approved June 7, 2006
Treatment Guidelines	Page 1 of 1

INTRACTABLE VOMITING AND/OR VERTIGO

I. Intractable Vomiting

A. Routine Paramedic care

B. Consider IV access and fluid resuscitation for dehydration and/or shock

C. For patients who have a patent airway and retractable vomiting:
ADMINISTER ONE OF THE FOLLOWING:

1. Zofran, 4 mg ODT (Oral Dissolved Tablet),

a) Do not attempt to push ZOFRAN ODT Tablets through the foil backing.

b) With dry hands, PEEL BACK the foil backing of 1 blister and GENTLY remove the tablet.

c) IMMEDIATELY place the ZOFRAN ODT Tablet on top of the tongue where it will dissolve in seconds, then swallowed with saliva.

d) Administration with liquid is not necessary.

OR

2. Zofran, IV, 4 mg undiluted over at least 30 seconds, preferably

No repeat of Zofran is indicated

Be alert for symptoms:

Blocked bowel ( Ileus)

Listen to bowel sounds before and after administration

Dystonic reaction, a possible side effect of Zofran

OR

3. Reglan, 10 mg in 50 cc normal saline over 10 min

No repeat of reglan is indicated.

Be alert for symptoms:

Sedation, diarrhea; anxiety, agitation with rapid IV administration

Dystonic reaction