Do emergency department patients with nausea and vomiting desire, request, or receive antiemetics

Singer, Adam J.; Garra, Greg; Thode, Henry C.

doi:10.1016/j.ajem.2016.12.044

Cited by 9 publications

(8 citation statements)

References 9 publications

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“…Droperidol 1.25 mg intravenous (IV) is the only antiemetic drug to have shown a statistically significant greater reduction in mean VAS rating in comparison with placebo . Ondansetron is the most commonly used antiemetic in the ED setting; the 8 mg IV dose was chosen as studies have reported 4 mg IV ondansetron to be equivalent with placebo …”

Section: Methodsmentioning

confidence: 99%

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Randomized Placebo‐controlled Trial of Droperidol and Ondansetron for Adult Emergency Department Patients With Nausea

Meek

Mee

Egerton‐Warburton

et al. 2018

Academic Emergency Medicine

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Objective: The objective was to separately compare effectiveness of 1.25 mg of intravenous (IV) droperidol and 8 mg of IV ondansetron with 0.9% saline placebo for adult emergency department (ED) patients with nausea. A novel primary outcome measure, expected to aid clinical interpretation of reported results, was employed.Methods: A randomized controlled trial was conducted at the three EDs of Monash Health, Melbourne, Australia. The design was to demonstrate superiority of the active drugs over placebo. The primary outcome measure of symptom improvement was defined as a visual analog scale (VAS) rating change of -8 mm or more from baseline at 30 minutes posttreatment. Mean VAS changes per group and percentages experiencing the desired treatment effect were also compared. The study was concluded after recruitment of 215 of the planned 378 patients, as interim analysis confirmed that continuation could not result in a finding of superiority.Results: Of 215 patients, 73 (34%), 71 (33%), and 71 (33%) received droperidol, ondansetron, and placebo.Symptom improvement occurred in 75% (95% confidence interval [CI] = 64% to 85%), 80% (95% CI = 69% to 89%), and 76% (95% CI = 64% to 85%), respectively. Mean VAS changes were -29 mm (95% CI = -36 to -23 mm), -34 mm (95% CI = -41 to -28 mm), and -24 mm (95% CI = -29 to -19 mm), respectively. Desired treatment effects were experienced by 77% (95% CI = 65% to 86%), 73% (95% CI = 61% to 83%), and 59% (95% CI = 47% to 71%), respectively. Conclusion:For adult ED patients with nausea, superiority was not demonstrated for droperidol or ondansetron over placebo.

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Section: Methodsmentioning

confidence: 99%

“…Effective treatment is desirable to alleviate patient distress and to reduce the potential for complications. Surveys report that ED patients with nausea expect to receive antiemetic drugs, and that ED doctors are willing to prescribe them . ED‐based trials, however, have failed to demonstrate superiority for commonly used antiemetic drugs over placebo .…”

mentioning

confidence: 99%

Randomized Placebo‐controlled Trial of Droperidol and Ondansetron for Adult Emergency Department Patients With Nausea

Meek

Mee

Egerton‐Warburton

et al. 2018

Academic Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…This is supported by the results of an Australasian survey, in which the majority of ED doctors said they did not routinely prescribe antiemetics for mild nausea . We did not specifically examine for influence of age or sex on antiemetic drug provision, but the US survey found no association with these variables …”

Section: Discussionmentioning

confidence: 74%

“…These findings are similar to those of a US ED survey of patients, which asked patients with nausea if they expected and/or wanted to receive antiemetic drug treatment. In that study, 51% of patients who wanted an antiemetic drug, and 53% of those who received one, were also from the more severe subgroups . Although we cannot be certain, we suspect that those who did not have drugs were not offered them, since 90% of patients said they would accept any offered treatment.…”

Section: Discussionmentioning

confidence: 88%

“…1 We did not specifically examine for influence of age or sex on antiemetic drug provision, but the US survey found no association with these variables. 14 Patient satisfaction has been used as a secondary outcome measure in some ED-based antiemetic drug trials, 5,9 but its utility has been questioned. 13 We found the overall responses regarding satisfaction, and expectations being met, to be similar.…”

Section: Discussionmentioning

confidence: 99%

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