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I do the same, Rick.  2 doses in an Rx.  The illness is not over.   I would like to know if they usually need to use it or not.  

Kathy Kelly 

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> On Dec 20, 2015, at 4:06 PM, Rick Place <[log in to unmask]> wrote:
> 
> I actually do not see a big deal on this, one way or the other, and at
> times prescribe a couple of doses for the few hours after discharge. It is
> not a routine practice, but a select practice.
> 
> While the "literature" does not "support" this, I would argue that the
> literature provides direct guidance for about 10% of what we do. The rest
> is extrapolated.
> 
> The literature suggests zofran is safe and effect. I do not believe that it
> masks serious disease, such as intussusception or surgical pathology, and
> this should have been addressed on the primary visit. Certainly not in the
> limited doses prescribed.
> 
> I personally don't think it sends ANY message other than the one I intend:
> here are a couple of doses of the next few hours. Again, I am select in who
> I provide this (and every) medication for and specific in my purpose.
> 
> Why do I do this?
> 
> Once resistant, a colleague reminded me that nausea can be construed as a
> source of pain. We prescribe NSAIDS for comfort in the context of fever and
> we prescribe NSAIDS for MSK trauma. Why not zofran for nausea (which many
> of our very young children experience, but do not articulate well.)
> 
> In my personal life, I generally eschew most of what I do clinically (as I
> can choose the risk benefit and do not need to offer/choose the most
> conservative choice for myself and my family). However, I have found that
> ibuprofen and ondansetron are the most useful agents available and I find
> each of them to be "miracle" drugs from time to time.
> 
> Rick Place
> Inova Fairfax
> 
> On Sat, Dec 19, 2015 at 10:00 PM, Gill Winnik <[log in to unmask]>
> wrote:
> 
>> While I routinely use Zofran for my nausea/vomiting patients, I do not
>> discharge pediatric patients with a prescription for Zofran. I'm not sure
>> what the rationale for that is perhaps the idea is that if there is a
>> serious cause for the nausea/vomiting the patient should come back and it
>> should not be masked by Zofran but the same can be said for Tylenol or
>> Motrin.
>> So my question to the group is does anyone routinely prescribe Zofran to
>> discharged children who presented with nausea forward/vomiting?
>> Did anyone have a bad experience doing this?
>> Thank you
>> 
>> Gill (Giora) Winnik
>> 
>>>> On Dec 17, 2015, at 6:59 PM, Aaron Wiener <[log in to unmask]>
>>> wrote:
>>> 
>>> We use zosyn for all appy's.
>>> None perf and pre-operatively, ancef/mefoxitin.  If perforated or chance,
>>> Zosyn.
>>> Mike Falk.
>>> 
>>> On Thu, Dec 17, 2015 at 1:42 PM, Todd Zimmerman <
>>> [log in to unmask]> wrote:
>>> 
>>>> For appe, what abx are you using.
>>>> For those using Rocephin and Flagyl, what dose of Flagyl are you using
>> in
>>>> the er, 10 per kg or 30 per kg?
>>>> And Rocpehin?
>>>> 
>>>> This is a bit more generalized, as there are obviously many different
>>>> practice styles that remain within safety...For your DKA, what volume of
>>>> fluids and over how long are you giving the first amount.I give between
>> 10
>>>> and 20 ml per kg over 60 minutes.
>>>> And finally, who thinks Michigan State will win CFB? Hoops?
>>>> Thanks,Todd Z(Please don't quote up to date, I read it)
>>>> 
>>>> 
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>> 
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