NAUSEA / VOMITING
ALL LEVELS
DESIGNATION OF CONDITION
Any patient who is complaining of nausea and/or actively vomiting
EMPHASIS ON PATIENT CARE
Airway management, adequate oxygenation, evaluation of underlying causes
1. Primary Management – ABC’s and have suction available. If patient is in spinal protocol, turn patient to one side, maintain spinal restriction manually.
2. Secondary Management - History, physical exam, and vital signs:
a. Check orthostatic vital signs
b. CHECK BLOOD GLUCOSE.
c. SAMPLE history
d. Assess skin turgor and evaluate for dehydration
AEMT
1. Initiate an IV/IO of isotonic crystalloid
2. Consider fluid bolus (250-500mL) as dictated by patient condition
3. Consider an Antiemetic
a. ONDANSETRON (Zofran): 4 mg slow IV/IO/IM or PO (ODT) may repeat x1
b. PO Zofran may be followed by an IV dose of 4 mg. if not responding. Max 8 mg
• Pediatric 0.1mg/kg IV/IO/IM or 2 mg PO if > 2 y/o 4 mg if >4 y/o
c. PROMETHAZINE (Phenergan) 12.5-25 mg IV/IO to be diluted in 100 ml of NS administered as a piggy back on a patent IV, or 25-50 mgs Deep IM (NOTE: This medication has been discontinued for the Dona Ana County Fire Rescue service effective April 2025).
PARAMEDIC
1. ECG monitor
2. Monitor patients' vital signs and continue to reassess
3. Transport to appropriate facility
ALL LEVELS
DESIGNATION OF CONDITION
Any patient who is complaining of nausea and/or actively vomiting
EMPHASIS ON PATIENT CARE
Airway management, adequate oxygenation, evaluation of underlying causes
1. Primary Management – ABC’s and have suction available. If patient is in spinal protocol, turn patient to one side, maintain spinal restriction manually.
2. Secondary Management - History, physical exam, and vital signs:
a. Check orthostatic vital signs
b. CHECK BLOOD GLUCOSE.
c. SAMPLE history
d. Assess skin turgor and evaluate for dehydration
AEMT
1. Initiate an IV/IO of isotonic crystalloid
2. Consider fluid bolus (250-500mL) as dictated by patient condition
3. Consider an Antiemetic
a. ONDANSETRON (Zofran): 4 mg slow IV/IO/IM or PO (ODT) may repeat x1
b. PO Zofran may be followed by an IV dose of 4 mg. if not responding. Max 8 mg
• Pediatric 0.1mg/kg IV/IO/IM or 2 mg PO if > 2 y/o 4 mg if >4 y/o
c. PROMETHAZINE (Phenergan) 12.5-25 mg IV/IO to be diluted in 100 ml of NS administered as a piggy back on a patent IV, or 25-50 mgs Deep IM (NOTE: This medication has been discontinued for the Dona Ana County Fire Rescue service effective April 2025).
PARAMEDIC
1. ECG monitor
2. Monitor patients' vital signs and continue to reassess
3. Transport to appropriate facility