Nausea/Vomiting Medical Directive

Question 1

Nausea/Vomiting MD

What are the indications for the N/V MD?

Answer 1

Nausea OR vomiting

Question 2

Nausea/Vomiting MD

What are the conditions for ondansetron administration?

Answer 2

Weight: ≥25 kg
LOA: Unaltered

Question 3

Nausea/Vomiting MD

What are the conditions for dimenhydrinate administration?

Answer 3

Age: <65 years
Weight: ≥25 kg
LOA: Unaltered

Question 4

Nausea/Vomiting MD

What are the contraindications to ondansetron administration?

Answer 4

Allergy to ondansetron
Prolonged QT syndrome (known to patient)
Apomorphine use

Question 5

Nausea/Vomiting MD

What are the contraindications to dimenhydrinate administration?

Answer 5

Allergy or sensitivity to dimenhydrinate or other antihistamines
Overdose on antihistamines or anticholinergics or tricyclic antidepressants
Co-administration of diphenhydramine

Question 6

Nausea/Vomiting MD

What is the dose for ondansetron?

Answer 6

Weight: ≥25 kg
Route: PO
Dose: 4 mg
Max # of doses: 1

Question 7

Nausea/Vomiting MD

What is the dose for dimenhydrinate for patients ≥25 kg to <50 kg?

Answer 7

Route: IV/IM
Dose: 25 mg
Max # of doses: 1

Question 8

Nausea/Vomiting MD

What is the dose of dimenhydrinate for patients ≥50 kg?

Answer 8

Route: IV/IM
Dose: 50 mg
Max # of doses: 1

Question 9

Nausea/Vomiting MD

How should dimenhydrinate be diluted prior to IV administration?

Answer 9

Dimenhydrinate (50 mg/1 ml) should be diluted 1:9 with normal saline or D5W prior to IV administration.

Question 10

Nausea/Vomiting MD

How long after ondansetron administration do we need to wait to give dimenhydrinate?

Answer 10

If a patient has received ondansetron and has no relief of their nausea & vomiting symptoms after 30 minutes, dimenhydrinate may be considered.