Santa Barbara County EMS, Santa Barbara, California, USA.
Prehosp Emerg Care. 2011 Jan-Mar;15(1):34-8. doi: 10.3109/10903127.2010.519822.
OBJCTIVE: The objectives were to evaluate the safety and efficacy of ondansetron in the out-of-hospital treatment of undifferentiated nausea or vomiting.
Patients with severe nausea or intractable vomiting who were transported by paramedic-staffed ambulances in eight California counties were treated with intravenous (IV), intramuscular (IM), or oral dissolving tablet (ODT) administration of ondansetron. Data were collected prospectively for a six-month period using an online database. Prospectively defined outcome measures were 1) efficacy as measured by a quantitative visual analog nausea scale and 2) incidence of adverse effects. There were no control or placebo groups.
Data was collected for 2072 patients, but one patient did not receive the medication. Therefore, Ondansetron was administered to 2,071 patients (3.7% of transported patients). Most patients were adult, with only 66 patients less than 18 years old. Of the 2,071 patients, 1,320 (64%) received IV administration, 77 (4%) received IM administration, and 674 (33%) received ODT administration of ondansetron. Intravenous administration resulted in the largest improvements in nausea scores (mean 4.4; 95% confidence interval [CI] 4.2, 4.5), followed by IM (mean 3.6; 95% CI 3.0, 4.3) and ODT (mean 3.3; 95% CI 3.1, 3.5). Overall, the mean decrease in nausea score was 4.0 (95% CI 3.9, 4.1; p < 0.001) on a 10-point scale. After medication administration, four patients had mild hypotension, one had hypertension, two had itching or rash, and one had a brief episode of supraventricular tachycardia that resolved spontaneously.
Ondansetron is safe and effective for out-of-hospital treatment of nausea and vomiting when administered by paramedics via the IV, IM, or oral route. When available to paramedics, ondansetron is used frequently.
评估昂丹司琼在院外治疗未分化恶心或呕吐中的安全性和疗效。
在加利福尼亚州的 8 个县，由配备护理人员的救护车转运的严重恶心或难治性呕吐患者接受静脉（IV）、肌肉内（IM）或口服分散片（ODT）给予昂丹司琼。在六个月的时间里，使用在线数据库前瞻性地收集数据。前瞻性定义的结局指标为 1）通过定量视觉模拟恶心量表测量的疗效，和 2）不良反应发生率。没有对照组或安慰剂组。
共收集了 2072 例患者的数据，但有 1 例患者未接受药物治疗。因此，2071 例患者接受了昂丹司琼治疗（转运患者的 3.7%）。大多数患者为成年人，只有 66 例患者年龄小于 18 岁。在 2071 例患者中，1320 例（64%）接受 IV 给药，77 例（4%）接受 IM 给药，674 例（33%）接受 ODT 给药。IV 给药可使恶心评分的改善最大（平均 4.4；95%置信区间 [CI] 4.2，4.5），其次是 IM（平均 3.6；95% CI 3.0，4.3）和 ODT（平均 3.3；95% CI 3.1，3.5）。总体而言，10 分制的恶心评分平均下降 4.0（95% CI 3.9，4.1；p<0.001）。用药后，4 例患者出现轻度低血压，1 例出现高血压，2 例出现瘙痒或皮疹，1 例出现短暂的室上性心动过速，自发缓解。
当护理人员通过 IV、IM 或口服途径给予昂丹司琼时，昂丹司琼用于院外治疗恶心和呕吐是安全有效的。当护理人员能够获得昂丹司琼时，它被频繁使用。
