Category Archives: Nausea / Vomiting

How should I proceed if the patient I’m treating tells me that they have already self-administered Gravol, within the past hour, but has since vomited multiple times. Do I proceed with IV Gravol as she has likely thrown up her self-administered dose?

When considering Gravol, if the pt has taken any antihistamines, anticholinergics, or tricyclic anti depressants should we withhold Gravol or only if they already appear to have overdosed? For example, would it be o.k. to give the patient Gravol if they take a daily antihistamine for allergies?

If the modified valsalva works & then they revert back into an SVT, can I perform the modified valsalva again? Is it only 2 attempts or 2 per episode if safe and feasible to do so; being sure not to perform more than 2 on scene delaying transport?

Question: In reference to LOA and gravol administration: a patient who has had a fall and struck their head, has a GCS of 14 (4,4,6) and is alert to person but not place and time, confused about previous events, but can follow commands and is answering some questions appropriately (ie... Birthday, wifes name). Does this rule them out for gravol? My concern is if they are nauseated and we dont treat it early, vomiting and being supine on a spinal board can be very difficult to manage by yourself. I appreciate the definition of LOA is a GCS less than normal for the patient. Can you explain the reasoning for this condition?

Question: I had a scenario where my patient stated he had a few drinks and was slightly drowsy, he answered all my questions fine and was alert to person place and time, once in the ambulance he became nauseous and began vomiting two emesis bags full, I gave gravol in this situation after listing off the contraindications and patient confirming there were none. My question is, would this have been acceptable?

Question: In regards to gravol. Pregnancy is not a contradiction but after doing research most medical journals state the following: because the studies in humans cannot rule out the possibility of harm, Dimenhydrinate should be used during pregnancy only if clearly needed. What are your thoughts?

Question: According to the PCP Dimenhydrinate Learner's Certification Package on the SWORBHP website under training materials, it says "It is also very important to note that Dimenhydrinate should not be administered to anyone with a recent history of closed head injury or medical history of a seizure disorder" (due to the decrease of seizure threshold)

However, history of seizure disorders is not a contraindication in our medical directives. Does this mean we are able to treat patients presenting under the nausea and vomiting protocol with a history of seizure disorders with Dimenhydrinate?

Question: Regarding Benadryl, in the auxiliary protocol it states that you cannot give Benadryl if the patient has taken a sedative or antihistamine in past 4 hours. This is not, however, indicated in the normal standing order protocol for Benadryl.

I am wondering if this is applicable as well if you arrive on scene with a patient who has taken Benadryl oral prior to your arrival. Do they still meet the protocol to give Benadryl even if they have already taken it? Should I still give it or withhold since they might have an overdose of Benadryl or have both the doses reacting at the same time? Would this also apply to a patient who has taken Gravol prior to EMS arrival as well?

Hope this can be clarified. I feel it's a grey area that most of us don't think about until put in the situation. Thanks.

Question: In a patient with an allergic reaction or anaphylaxis, who is experiencing nausea or vomiting, is it okay to treat them with Gravol after I have administered Benadryl?

1 2