Ondansetron Versus Dexamethasone/Ondansetron to Treat Acute Nausea in the Emergency Department

Nausea is a common complaint in patients who present to the emergency department (ED).
Although the number of conditions that can present with nausea are numerous, the mainstay of
treatment has become intravenous ondansetron (Zofran), not only due to its rapid onset but
also its availability. One of the major drawbacks to using this form is that it often needs
to be redosed. This study aims to compare intravenous (IV) ondansetron alone versus IV
ondansetron given with IV dexamethasone (Decadron) as another viable option when treating
patients with nausea in the emergency department.

Previous studies in patients undergoing surgical procedures have shown that when IV
dexamethasone is given with IV ondansetron to post-operative patients they have less nausea
and vomiting than ondansetron alone, and were even found to show decreased post-operative
pain associated with nausea. It has also been shown to decrease the need to re-dose
antiemetic medication. Although this combination has not been tested in the emergency
department it is believed by these investigators that the additional use of dexamethasone may
decrease the need to use repeated doses of ondansetron.

The investigators believe this may change the way physicians currently approach the nauseated
patient in regards to treatment. That rather than possibly giving multiple doses of one
medication over and over to reduce a patient's nausea, physicians can give two medications
together at one time. The investigators hope to demonstrate that by giving intravenous
dexamethasone and ondansetron together, it may be possible to reduce the number of patients
who need additional doses of nausea medication.