Anti-emetics in Peds

Discussion in 'Emergency Medicine' started by waterski232002, Jun 4, 2008.

  1. waterski232002

    waterski232002 Senior Member

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    When do most of you guys write for a dose of anti-emetic medication for peds gastro patients. I find that most of the people I work with at the university hospital don't use them very often; however, it seems to be much more liberally written for in the community.

    What's your anti-emetic of choice? Do you ever send younger children out with a prescription for an anti-emetic?
     
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  3. GeneralVeers

    GeneralVeers Globus Hystericus
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    This is something that's changed in recent years. There is now evidence that Phenergan is linked to death in children under 2 years, and is not recommended for children under 16.
    In hospital we give Zofran ODT to children, and it usually works like magic. If necessary I'll send them home with a prescription for 4-5 Zofran.
     
  4. Homunculus

    Homunculus SDN Caveman Administrator
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    i love zofran. even benadryl can so some good. most often though (especially in the pukers) just giveing fluids and letting them clear some ketones will make them feel better.

    please PLEASE don't use phenergan. i can't emphasize this enough. mental status changes are hard enough to appreciate in toddlers without having that crap on board to comlplicate things. i've run into this a few times, and it's not fun. not to mention the wide variety of clinical response you may get-- including sudden death :scared: there's better stuff out there to use, so i never touch the stuff :)


    --your friendly neighborhood PO challenge loving caveman
     
  5. southerndoc

    southerndoc life is good
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    If they're vomiting enough to need fluids, I usually give them Zofran when they get fluids. It helps them to tolerate the PO challenge after fluids and speeds disposition.

    My institution seems to be a big fan of PO Zofran followed by a PO challenge. In my anecdotal experience, this seems to work about 50% of the time. About half the patients get an IV with this plan. Next month I doubt I'll follow this plan for patients that are borderline needing fluids. It really hinders patient flow when you have a kid sit around for 2 hours, not drink fluids, and then start the IV on him/her. Nothing like wasting 2 hours of everyone's time and tying up a bed.
     
  6. Jeff698

    Jeff698 EM/EMS nerd

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    I'm a big Zofran fan. If I don't think I'm going to start a line, I give 4 ODT and a trial of small sips (emphasis on small) of fluids or popsicle.

    I'm I think they may need a line, they the line (+/- EMLA cream), 4 Zofran and D5NS for ketone elimination.

    Homunculus, I'm with you on phenegran as the anti-christ drug. It's not just evil for kids, either. On many occasions, I've ended up going through the "tube or not to tube" game because of the phenegran-snowed elderly patient.

    Plus, being from East Texas, I can never remember if its phenegRan or pheneRgan. Yes, I realize there is no "U" in nuclear but I still say it that way anyway. :)

    Take care,
    Jeff
     
  7. Dr.McNinja

    Dr.McNinja Nobel War Prize Winner
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    I didn't catch it while there, but do they pronounce it amNiodarone or amiodarone, and also metoPROlol or meTOprolol.

    *Looks around, sees is in EM forum*
    There is a U in nuclear. There just aren't two.

    Bikes.
     
  8. Jeff698

    Jeff698 EM/EMS nerd

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    amIodarone
    meTOprolol

    Fair point on the U. :)

    Take care,
    Jeff
     
  9. kungfufishing

    kungfufishing Senior Member

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    uh, no, actually there would be TWO U's in nucular.
     
  10. Jeff698

    Jeff698 EM/EMS nerd

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    Speaking of this, what do y'all call the road that runs parallel to a freeway from which you enter and exit the major road? Not the on/off ramp itself, but the parallel road?

    I took a survey years ago that used your answer to tell you what part of the country you were from.

    Take care,
    Jeff
     
  11. kungfufishing

    kungfufishing Senior Member

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    the access road?
     
  12. bulgethetwine

    bulgethetwine Banned
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    The service road?

    Isn't this the same as asking someone if they want a "pop" or a "soda"?

    I'm getting pop at the 7-eleven on the service road.
     
  13. kungfufishing

    kungfufishing Senior Member

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  14. emedpa

    emedpa GlobalDoc

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    frontage road
     
  15. Dr.McNinja

    Dr.McNinja Nobel War Prize Winner
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    frontage road.

    This works because they aren't common in many places, but some are full of them. And if you aren't used to them, they suck.
    I had difficulties with them from El Paso to Corpus Christi.
     
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  17. Apollyon

    Apollyon Screw the GST
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    Platinum Plus here in Greenville is on "Frontage Road" (that's the official name). The person who does LASIK here in town has a billboard outside of it - I don't know which was there first.
     
  18. Dr.McNinja

    Dr.McNinja Nobel War Prize Winner
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    So on my first day of grad school, there was someone from West Virginia/Ohio that was in our group. We went to Subway. She ordered first (Seafood Delite, ick), then he asked what she wanted to drink. She said "a pop". He said, "we don't sell that here, we only have Coke products."
     
  19. Jeff698

    Jeff698 EM/EMS nerd

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    Yes, and that's the point. The difference is, at least according to the story I heard, is that this question can be pretty specific.

    I grew up calling these things "feeder roads". According to the story, people who use this term grew up within 100 miles of Houston.

    I grew up in a small town about 45 miles north of Houston.

    Take care,
    Jeff
     
  20. Jeff698

    Jeff698 EM/EMS nerd

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    BTW, like KungFu and Dr. McN, they're all "cokes" to me. :)

    Take care,
    Jeff
     
  21. BKN

    BKN Senior Member

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    ninja,

    Thoroughly hijacked thread, :D.

    Anyway if you dis them, you are not a good Texan. Probably from the left coast. Access roads are the best because you can get up to speed before entering the freeway and nobody suddenly brakes from the freeway cause they always have time to slow down on that nice long exit ramp. Only problem is remembering they are generally one way in the city and two way in the country.
     
  22. ccfccp

    ccfccp Stays crunchy in milk!

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    I grew up with them all being cokes, then I moved to pop country... then subsequently to soda city. I think now it just leaves me pretty confused.:laugh:
     
  23. Dr.McNinja

    Dr.McNinja Nobel War Prize Winner
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    Of course not. I'm an Aggie fan. More than 80% of the state will tell you I'm not a good Texan.
    Nah, I'm from the Southeast. I can tell you that frontage roads throw most GPS units for a loop, so I had to take a couple U-turns to find my LaQuinta inn in your hometown.
    I will throw out there that in no other city could I finish my interview, then walk to another country and buy some authentic tequila before I flew home. It does throw a wrench into the "only carry-on" plan though.
     
  24. Jeff698

    Jeff698 EM/EMS nerd

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    80%?!

    Hrumph. Gig 'em!

    And it's FEEDER roads, people!

    Geez, where'd y'all learn to talk? Some place called notHouston?

    Take care,
    Jeff
     

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