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Nausea and Vomiting (CPG A0701)

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Stop

  • Prochlorperazine must not be given IV

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Undifferentiated Nausea and Vomiting

  • Aspirin 300 mg oral if not already administered

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Nitrates

  • Ondansetron 4 mg ODT orally (repeat 4 mg @ 5-10/60 if required, max. 8 mg)

  • If known allergy or C/I to Ondansetron and > 21 years, Prochlorperazine 12.5 mg IM

  • Adequate perfusion but significant dehydration: Consider Normal Saline 20 mL/kg IV over 30 minutes

  • Less than adequate perfusion: Consider Normal Saline IV (max. 40 mL/kg) titrated to patient response. Consult for further fluid. If consult unavailable repeat Normal Saline 20 mL/kg IV (total 60 mL/kg)

  • If patient is unable to tolerate ODT or IV is in situ, Ondansetron 8 mg IV slow push

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Vestibular Nausea

  • Pt age ≥ 21 years - Prochlorperazine 12.5mg IM

  • Pt age < 21 years - Ondansetron as per nausea and vomiting

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Prophylaxis

  • Ondansetron as per nausea and vomiting

  • If known allergy or C/I to Ondansetron and > 21 years, Prochlorperazine 12.5 mg IM

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Flow Chart

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