EMS Protocol of the Week - Abdominal Pain / Severe Nausea / Vomiting (Adult and Pediatric)

The big take-home of the EMS protocol for abdominal pain/nausea/vomiting is a reiteration to be mindful of prehospital therapies administered before you receive the patient in the ED. After appropriately addressing any trauma, sepsis, or other potential emergent issues masquerading as abdominal pain, paramedics operating under this protocol can give up to two doses of (weight-based) ondansetron by Standing Order, up to 8mg total. For patients receiving ondansetron, paramedics are reminded to consider the QT-prolonging effects of the med and act accordingly. If you have the chance to chat with the medics  when they arrive to the ED, remember to check for this before you add additional meds and throw the patient into Torsades! 

Be aware that you may also receive an OLMC call requesting pain medications for these patients. Note that analgesics are not currently described in this protocol as either Standing Order or Medical Control Option, so any med requested (likely either morphine or fentanyl) would have you be approved as a Discretionary Order. Use your judgment for these requests, don’t forget to check the vitals, and remember that controlled substances require a tracking number (MMC-####).

That’s all for now! www.nycremsco.org or the protocols binder to keep you going until next week!

Dave