Post-Op Nausea + Vomiting Flashcards
1
Q
What are the risk factors for PONV?
A
Female sex History of PONV or motion sickness Strong opioids Non-smoker Type of surgery: - gynae - emergency - middle ear - eyes
2
Q
What are the strategies for preventing PONV?
A
Considering regional anaesthesia
Reduce use of opioids
Adequate hydration
Combination of anti-emetics
3
Q
How is a patient’s PONV assessed?
A
PONV score (check regularly): 0 = no nausea or vomiting 1 = nausea only 2 = vomiting once 3 = vomiting more than once
4
Q
When should you give treatment for PONV?
A
If score of 1 or more
5
Q
Which treatment would you try first for PONV?
A
Ondansetron 4mg IV
Review in 30mins - 1 hour
6
Q
Which treatment might you try second for PONV?
A
Cyclizine 50mg IV
Review in 30mins - 1 hour
7
Q
What would you do if a patient remains nauseous after the second anti-emetic?
A
Check for other causes
Call for advice
Consider Buccastem 3mg
Consider 4 hourly ondansetron
8
Q
Which other causes might you check for in PONV?
A
Ensure patient comfort + positioning Blocked NG tube Intra-abdominal pathology Ileus Hypoxia Hypotension Pain Hypovolaemia Opioids, antibiotics
