Value of Ondansetron Medication vs Inhaled Isopropyl Therapy in the Emergency Department (VOMIITED)

Emergency physicians commonly use medications to alleviate nausea and vomiting. The medication Ondansetron is used in the emergency department and after surgery for this purpose. Inhaled isopropyl alcohol has been successfully used to decrease nausea and vomiting after surgery. No trial has compared inhaled isopropyl alcohol to Ondansetron in a clinical trial.

The author proposes to prospectively investigate extension of the established antiemetic efficacy of inhaled isopropyl alcohol for undifferentiated nausea in Emergency Department patients to the 30-minute post-intervention point that has been reported to be the frequent juncture of symptom relief. By introducing prolonged intervention, and re-dosing of established benefit, into this research, the author aims to reproduce the sustained antiemetic efficacy of inhaled isopropyl alcohol for undifferentiated nausea as demonstrated for post-operative nausea and vomiting.

Inclusion criteria

• Patients aged 18-65 years presenting to the emergency department complaining of current nausea with or without episodes of emesis beginning within the previous 24hrs

Exclusion criteria

• Patients with known allergy to isopropyl alcohol
• Patients outside of the defined age range
• Patients with an inability to inhale through the nares (including recent upper respiratory infection)
• Patients greater than 20 weeks estimated gestation
• Patients with past medical history of gastroparesis, or hemoptysis
• Patients who have taken an antiemetic medication in the past 48 hours
• Patients demonstrating hemodynamic instability with systolic blood pressure <90 or tachycardia >120 bpm