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If i have ruled out surgical belly and other causes like increased icp  for vomiting,and  follow up is available- I will send them home with several days of zofran-  as well as good instructions when to return to ED

Stuart Bradin DO, FAAP , FACEP 
Associate Professor of Pediatrics and Emergency Medicine
The University of Michigan

Sent from my iPhone

> On Dec 20, 2015, at 11:21 AM, Brian Sanders <[log in to unmask]> wrote:
> 
> I routinely send home with zofran. Never have seen missed serious diagnosis with zofran rx. There are a couple of studies to this point. Here is one..
> Ondansetron use in the pediatric emergency department and effects on hospitalization and return rates: are we masking alternative diagnoses?
> Sturm JJ, et al. Ann Emerg Med. 2010.
> Show full citation
> 
> Brian Sanders, MD
> Medical Director
> Pediatric Emergency Medicine
> Lowell General Hospital
> 
>> On Dec 20, 2015, at 2:40 AM, Eugene Izsak <[log in to unmask]> wrote:
>> 
>> I will send the home on with a max of 2-4 doses if it works in the ED.
>> 
>> 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)
>>>>> 
>>>>> 
>>>>> Sent from my Verizon Wireless 4G LTE smartphone
>>>>> 
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>>> 
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>> 
>> 
>> 
>> -- 
>> *"I would rather be the kind of person who makes molehills out of
>> mountains, then mountains out of molehills." *
>> *"I dream of a better world, where chickens can cross the road and not have
>> their motives questioned." Anon.*
>> *"The art of medicine consists in amusing the patient while nature cures
>> the disease." Voltaire*
>> *"I may not have gone where I intended to go, but I think I have ended up
>> where I needed to be."  Douglas Adams*
>> 
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