Antiemetic (Central)
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
Reduction in nausea determined by Visual Analog Scale
|
Patient
|
ED-MD
|
Barrett TW., DiPersio DM., Jenkins CA., Jack M., McCoin NS., Storrow AB., et al. A randomized, placebo-controlled trial of ondansetron, metoclopramide, and promethazine in adults. Am J Emerg Med 2011; 29(3):247-55. Medline
|
|
I
|
Supportive (Green)
|
Reduction in nausea
|
Patient
|
ED-MD
|
Braude D., Crandall C. Ondansetron versus promethazine to treat acute undifferentiated nausea in the emergency department: A randomized, double-blind, noninferiority trial. Acad Emerg Med 2008; 15(3):209-15. Medline
|
|
I
|
Supportive (Green)
|
Reduction of vertigo symptoms
|
Patient
|
ED-MD
|
Ercin D, Erdur B, Turkcuer I, Seyit M, Ozen M, Yilmaz A, et al. Comparison of efficacy dimenhydrinate and metoclopramide in the treatment of nausea due to vertigo; a randomized study. Am J Emerg Med 2021; 40:77-82. Medline
|
|
I
|
Supportive (Green)
|
Hospitalization rates
|
Patient
|
ED-MD
|
Stork CM., Brown KM., Reilly TH., Secreti L., Brown LH. Emergency department treatment of viral gastritis using intravenous ondansetron or dexamethasone in children. Acad Emerg Med 2006; 13(10):1027-1033. Medline
|
|
I
|
Supportive (Green)
|
Nausea and vomiting incidence
|
Patient
|
In-Patient
|
Tramer MR., Walder B. Efficacy and adverse effects of prophylactic antiemetics during patient-controlled analgesia therapy: A quantitative systematic review. Anesth Analg 1999; 88:1354-61. Medline
|
|
I
|
Supportive (Green)
|
Functional symptoms of motion sickness
|
Patient
|
In-Patient
|
Weinstein SE., Sterns RM. Comparison of marezine and dramamine in preventing symptoms of motion sickness. Aviation, Space and Environmental Med 1997; 68:890-894. Medline
|
|
I
|
Neutral (Yellow)
|
Efficacy of reduction of nausea intensity
|
Patient
|
ED-MD
|
Meek R, Mee MJ, Egerton-Warburton D, Graudins A, Meyer A, Pouryahya P, et al. Randomized Placebo-controlled Trial of Droperidol and Ondansetron for Adult Emerg Department Patients With Nausea. Acad Emerg Med 2019; 26(8):867-77. Medline
|
|
II
|
Supportive (Green)
|
Change in VAS nausea rating
|
Patient
|
PH-Paramedic
|
Fullerton L., Weiss SJ., Froman P., Oglesbee S., Cheney P. Ondansetron oral dissolving tablets are superior to normal saline alone for prehospital nausea. Prehosp Emerg Care 2012; 16(4):463-8. Medline
|
|
II
|
Supportive (Green)
|
Hospitalization
|
Patient
|
ED-MD
|
Hervas D., Armero C., Carrion T., Utrera JF., Hervas JA. Clinical and economic impact of oral ondansetron for vomiting in a pediatric emergency department. Pediatr Emerg Care 2012; 28(11):1166-8. Medline
|
|
II
|
Supportive (Green)
|
Mean time from administration to disposition
|
Patient
|
ED-MD
|
Mayhall EA., Gray R., Lopes V., Matteson KA. Comparison of antiemetics for nausea and vomiting of pregnancy in an emergency department setting. Am J Emerg Med 2015; 33(7):882-6. Medline
|
|
III
|
Supportive (Green)
|
Reduction nausea
|
Patient
|
SIM
|
Muth ER., Jokerst M., Sterns RM, et al. Effects of dimenhydrinate on gastric tachyarrhythmia and symptoms of vection-induced motion sickness. Aviation, Space and Environmental Med 1995; 66:1041-5. Medline
|
|
III
|
Supportive (Green)
|
Nausea and vomiting severity
|
Patient
|
OR
|
Salvucci AA., Squire B., Burdick M., Luoto M., Brazzel D., Vaezazizi R. Ondansetron is safe and effective for prehospital treatment of nausea and vomiting by paramedics. Prehosp Emerg Care 2011; 15(1):34-8. Medline
|
|
III
|
Supportive (Green)
|
Nausea scales
|
Patient
|
PH-Paramedic
|
Warden CR., Moreno R., Daya M. Prospective evaluation of Ondansetron for undifferentiated nausea & vomiting in the prehospital setting. PEC 2008; 12:87-91. Medline
|
|
III
|
Supportive (Green)
|
Nausea visual analogue scale rating
|
Patient
|
SIM
|
Weichenthal L., Soliz T. The incidence and treatment of prehospital motion sickness. Prehosp Emerg Care 2003; 7(4):474-476. Medline
|
Antiemetic (GI Action)
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
Reduction in nausea determined by Visual Analog Scale
|
Patient
|
ED-MD
|
Barrett TW., DiPersio DM., Jenkins CA., Jack M., McCoin NS., Storrow AB., et al. A randomized, placebo-controlled trial of ondansetron, metoclopramide, and promethazine in adults. Am J Emerg Med 2011; 29(3):247-55. Medline
|
|
I
|
Supportive (Green)
|
Reduction in nausea
|
Patient
|
ED-MD
|
Braude D., Crandall C. Ondansetron versus promethazine to treat acute undifferentiated nausea in the emergency department: A randomized, double-blind, noninferiority trial. Acad Emerg Med 2008; 15(3):209-15. Medline
|
|
I
|
Supportive (Green)
|
Incidence of vomiting
|
Patient
|
ED-MD
|
Chae J., Taylor DM., Frauman AG. Tropisetron versus metoclopramide for the treatment of nausea and vomiting in the emergency department: A randomized, double-blinded, clinical trial. Emerg Med Australas 2011; 23(5):554-61. Medline
|
|
I
|
Supportive (Green)
|
Reduction in vomiting
|
Patient
|
ED-MD
|
Epifanio M, Portela JL, Piva JP, Ferreira CHT, Sarria EE, Mattiello R. Bromopride, metoclopramide, or ondansetron for the treatment of vomiting in the pediatric Emerg Department: A randomized controlled trial. J Pediatr 2018; 94(1):62-8. Medline
|
|
I
|
Supportive (Green)
|
Reduction in vertigo intensit
|
Patient
|
ED-MD
|
Ercin D, Erdur B, Turkcuer I, Seyit M, Ozen M, Yilmaz A, et al. Comparison of efficacy dimenhydrinate and metoclopramide in the treatment of nausea due to vertigo; a randomized study. Am J Emerg Med 2021; 40:77-82. Medline
|
|
I
|
Supportive (Green)
|
-
|
Patient
|
|
Lacroix G., Lessard MR., Trepanier CA. Treatment of post-operative nausea and vomiting: Comparison of propofol, droperidol and metoclopramide. Can J Anaesth 1996; 43:115-20 Medline
|
|
I
|
Supportive (Green)
|
Hospitalization rates
|
Patient
|
ED-MD
|
Stork CM., Brown KM., Reilly TH., Secreti L., Brown LH. Emergency department treatment of viral gastritis using intravenous ondansetron or dexamethasone in children. Acad Emerg Med 2006; 13(10):1027-1033. Medline
|
|
I
|
Supportive (Green)
|
Nausea and vomiting incidence
|
Patient
|
In-Patient
|
Tramer MR., Walder B. Efficacy and adverse effects of prophylactic antiemetics during patient-controlled analgesia therapy: A quantitative systematic review. Anesth Analg 1999; 88:1354-61. Medline
|
|
II
|
Supportive (Green)
|
Mean time from administration to disposition
|
Patient
|
ED-MD
|
Mayhall EA., Gray R., Lopes V., Matteson KA. Comparison of antiemetics for nausea and vomiting of pregnancy in an emergency department setting. Am J Emerg Med 2015; 33(7):882-6. Medline
|
|
II
|
Supportive (Green)
|
Vomiting during the primary and secondary survey
|
Patient
|
In-Patient
|
Vermeijden HD., Leenen LPH., van PM, Dijkgraaf MGW., Hietbrink F. Analysis of two treatment modalities for the prevention of vomiting after trauma Orogastric tube or anti-emetics. Injury 2017; 48(10) 2106-11. Medline
|
|
III
|
Supportive (Green)
|
Change in nausea score
|
Patient
|
ED-MD
|
Cham S., Basire M., Kelly AM. Intermediate dose metoclopramide is not more effective than standard dose metoclopramide for patients who present to the emergency department with nausea and vomiting: A pilot study. Emerg Med Australas 2004; 16(3):208-11. Medline
|
Isopropyl alcohol
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
Reduction in nausea in patients not requiring oral antiemetics
|
Patient
|
ED-MD
|
April MD, Oliver JJ, Davis WT, Ong D, Simon EM, Ng PC, Hunter CJ. Aromatherapy Versus Oral Ondansetron for Antiemetic Therapy Among Adult Emergency Department Patients: A Randomized Controlled Trial. Ann Emerg Med. 2018 Aug;72(2):184-193. doi: 10.1016/j.annemergmed.2018.01.016. Epub 2018 Feb 17. Erratum in: Ann Emerg Med. 2019 May;73(5):552. PMID: 29463461. Medline
|
|
I
|
Supportive (Green)
|
Nausea numerical rating scale
|
Patient
|
ED-MD
|
Beadle KL, Helbling AR, Love SL, April MD, Hunter CJ. Isopropyl Alcohol Nasal Inhalation for Nausea in the Emerg Department: A Randomized Controlled Trial. Ann Emerg Med 2016; 68(1):1-9.e1. Medline
|
|
I
|
Supportive (Green)
|
Nausea
|
Patient
|
ED-MD
|
Candemir H, Akoglu H, Sanri E, Onur O, Denizbasi A. Isopropyl alcohol nasal inhalation for nausea in the triage of an adult emergency department. Am J Emerg Med 2021; 41:9-13. Medline
|
|
I
|
Supportive (Green)
|
Severity of Nausea
|
Patient
|
ED-MD
|
Lee SY, Tamale JR. Isopropyl alcohol inhalation for the treatment of nausea in adult emergency department patients: a systematic review and meta-analysis. Emerg Med J Sept 2023; 40(9):660-5. Medline
|