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Intractable vomiting
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Note: controversies are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also regarding your thought processes and the evidence behind your decisions. We can learn from each other!
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Kelly September 16, 2020 - 2:03 am
A thorough review of antiemetic agents can be found at https://emcrit.org/ibcc/antiemetic/. Single doses of ondansetron in the ED have not been shown to result in significant adverse events due to prolonged QTc. However, multiple IV doses or adding on other QT-prolonging drugs could be risky. Although the article lists prochlorperazine (compazine) as having no risk of prolonging QT, most reference cites state it may. Olanzapine has antiemetic efficacy and does not seem to prolong QT. Another option is using alcohol pads: http://pemsource.org/2016/09/13/isopropyl-alcohol-pad-for-nausea/