Evaluating outcomes associated with a discharge action plan employing single-dose home use of ondansetron in patients with acute gastroenteritis

Abstract

Elizabeth Haines1, Robert van Amerongen2, Robert Birkhahn1, Wendy Wen1, Theodore Gaeta11Department of Emergency Medicine, 2Pediatric Emergency Services, New York Methodist Hospital, Brooklyn, NY, USAAbstract: Acute gastroenteritis accounts for 1–2 million annual pediatric emergency department visits in the US. The current literature supports the use of antiemetics, such as ondansetron, in the emergency department, reporting improved oral rehydration, cessation of vomiting, and reduction in the need for intravenous rehydration. However, there remains concern that using these agents may “mask alternative diagnoses” and negatively impact patient care. We present a case series of 29 patients who received a pediatric emergency department discharge action plan which allowed for a dose of ondansetron to be dispensed by the clinician at the time of discharge. Patients were instructed to administer the ondansetron at home for treatment of ongoing nausea and vomiting any time after 6 hours from the time of emergency department discharge. These patients were followed up at 3–5 days following discharge to assess for outcomes. Implications of this discharge action plan and future directions are discussed.Keywords: gastroenteritis, ondansetron, discharge action plan