Vomiting

Here’s a breakdown of the provided text, focusing on the key information about the study and its findings:

Problem:

children wiht frequent vomiting due to acute intestinal infections often experience a recurrence of vomiting after being discharged from the Emergency Department (ED).
This recurrence can led to continued discomfort and potentially further medical interventions.
There’s been an ongoing debate about the best treatment approach for these children after ED discharge.

To evaluate if providing children with an anti-vomiting medication (ondansetron) to take at home, as needed, improves their recovery after ED discharge for frequent vomiting from an acute intestinal infection.

Study Design:

Type: Double-blind randomized clinical trial.
Participants: Over 1,000 children aged six months to 18 years.
Location: Six pediatric hospitals in Canada.
Intervention: Children were given either ondansetron or a placebo.
Medication: Ondansetron, described as a well-tolerated and safe anti-nausea drug.

Children who received ondansetron at home were less likely to have moderate-to-severe symptoms after ED discharge.
The study provides evidence that giving two doses of ondansetron at the time of ED discharge is beneficial for children with frequent and recent vomiting from an intestinal infection.

An earlier study by Dr. Freedman found that ondansetron was effective in stopping vomiting and reducing the need for intravenous fluids when given as a single dose in the ED. Though, some children still experienced vomiting recurrence at home.

Implications and Recommendations:

The study’s results shoudl resolve the debate on the best treatment approach for these children after ED discharge.
Healthcare teams should provide two doses of ondansetron to children with frequent and recent vomiting from an intestinal infection at the time of ED discharge.
The findings have been incorporated into national recommendations for ED healthcare providers.

The next step is to identify a specific sub-group of children who are most likely to benefit from ondansetron to ensure appropriate and effective medication use.

Key People Involved:

Dr. Stephen Freedman: Pediatric ED physician, lead investigator of the study, professor at the Cumming school of Medicine.
Dr.Terry P. Klassen: Pediatric emergency physician, professor at the University of Saskatchewan, network co-founder and study co-author.

Collaboration:

* The study was conducted within the Pediatric Emergency Research Canada (PERC) network, highlighting the effectiveness of national collaboration among Canadian researchers.

Overall Message:

The study demonstrates that providing children with a short course of ondansetron to take at home after an ED visit for acute gastroenteritis can significantly reduce the recurrence of vomiting and improve their recovery. This research provides strong evidence to guide clinical practice in pediatric emergency medicine.