Prophylactic Anti-Emetics in Trauma – aka “Prevention of Post-Traumatic Mopping Episodes”

Check out: Prophylactic antiemetics in trauma.
A review by Dr Jason Bendall MStJ – Medical Director for the Ambulance Service of NSW in Australia.

I’ve had the privelage of once working under Dr. Bendall (who began as a paramedic, then became a doctor and has now also completed a masters and PhD in clinical epidemiology) in a voluntary first aid capacity and have witnessed that his presence and knowledge as well as relaxed manner inspires respect and warmth in patients and colleagues alike.

This review looks at the use of anti-emetics in trauma patients.
Ondansetron and Metoclopramide were administered prophylactically to  patients. The study enrolled 196 adult trauma patients.

With an endpoint of decreasing nausea, there was a 56% decrease in nausea with the use of anti emetics and a number needed to treat of 2!

With the endpoint of preventing emesis, the use of anti-emetics prevented 9% of patients from vomiting, a NNT of 12.

The study conclusions were as follows:
Prehospital nausea and vomiting are more common in our cohort of trauma patients than the reported rates in the literature for nontrauma patients transported to hospital by ambulance. These symptoms were associated with female gender, older age, weight, and greater ISS. Our results suggest that antiemetics may be underused in trauma patients, both for prophylaxis and the treatment of active symptoms”. 

Check out Dr. Bendall’s Blog at http://drjasonbendall.wordpress.com for some insightful articles and studies by a giant in the field of advancing EMS, pre-hospital care, EBM and the role and scope of paramedics in Australia and also worldwide.

Cheers 🙂

 

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