Antiemetics: unrelated to our current directives but I was just wondering what the rationale was for specifically using dimenhydrinate as our prehospital antiemetic option? As I understand it, and I've had a number of conversations with physicians of different disciplines regarding the same, dimenhydrinate is most effective for motion sickness, and other antiemetics exist that are typically more effective for the types of emesis that we typically deal with in the field.
The incorporation of ondansetron within the updated Nausea and Vomiting Medical Directive has occurred and will be available once the Ministry has released the updated directive and training has occurred. When the Nausea and Vomiting medical directive was developed, the cost of the drug was extremely high, but now is much more affordable in its generic form. You are correct that dimenhydrinate is best suited for nausea and vomiting associated with motion sickness, in addition to nausea and vomiting from peripheral vertigo. As such, paramedics will be able to tailor treatment based on the most likely cause of the nausea and vomiting in the updated directive.