Uncomplicated Nausea and Vomiting in the Emergency Department
Uncomplicated Nausea and Vomiting in the Emergency Department
Nausea and vomiting is a common complaint in the emergency department. Treatment is important
 for many reasons. In addition to patient comfort, there are adverse effects secondary to
 vomiting such as dehydration, metabolic alkalosis, Mallory-Weiss tears, and aspiration. Two
 mediations common used for nausea in ED patients include Ondanesetron and Metoclopramide.
This study will compare Ondansetron 4 mg vs 2 mg vs Metoclopramide 10 mg to look for efficacy
 in nausea and vomiting treatment for patients in the ED with many different causes. We will
 also look for cost effectiveness as well, since Metoclopramide is much less expensive than
 Ondansetron, which is less expensive at lower doses. There is little research about nausea
 medication in the ED literature even though these medications are used frequently in the ED
 for many causes of nausea.
Inclusion Criteria:

 -  18 years or older with nausea and at least 1 episode vomiting in the last 12 hours
 presenting to the York Hospital Emergency Department

 Exclusion Criteria:

 -  Patients known to have hypersensitivity to the drugs ondansetron or metoclopramide

 -  gastrointestinal hemorrhage, mechanical obstruction or perforation

 -  patients with pheochromocytoma

 -  seizure disorder

 -  patients receiving other drugs which are likely to cause extrapyramidal reactions such
 as butapherones and phenothiazines

 -  patients experiencing hyperemesis gravidum

 -  patients unable to understand the informed consent (intoxicated, Spanish speaking)

 -  prior antiemetics within 12 hours

 -  inability to perform visual analog scale

 -  renal dialysis