Nausea is a common side effect of both trauma and the medications used to treat pain, anxiety, and delirium. Consider prophylactic treatment whenever possible and treat immediately upon patient report of symptoms. If the patient has recently undergone an emergency general anesthetic or any type of abdominal surgery, then ensuring that they are not at aspiration risk is important prior to medication. If there is a concern for gastric distention or any type of obstruction (functional or mechanical), then the patient should receive gastric decompression with an nasogastric tube in additional to pharmacologic management for nausea.
Ondansetron is a safe antiemetic in the adult population and is increasingly the therapy of choice for acute undifferentiated and trauma-related nausea.29 It has no effect on consciousness or the respiratory drive; additionally, at the doses recommended for these patients (4-8 mg per dose) has no clinically significant effect on QT interval.29-32