Oligoantiemesis or Inadequate Prescription of Antiemetics in the Emergency Department: A Local and National Perspective

Abstract

Background: Nausea and vomiting are common, but prevalence of antiemetic use in ED patients is unknown.

Objectives: We determined the use of antiemetics in emergency department (ED) patients presenting with nausea and vomiting (NV).

Methods: We conducted a retrospective chart review of ED patients presenting to a local ED with NV and analyzed data from the National Hospital Ambulatory Care Survey for similar patients to determine the frequency of administration of antiemetics in the ED.

Results: Of 3876 patients presenting to a local ED with NV in 2014, 2637 (68% [95% confidence interval (CI) 67-69%]) received an antiemetic. Of an estimated 11.3 million U.S. ED visits for NV in 2011 (the latest year available), antiemetics were prescribed in 56% (95% CI 53-59%). Females, older patients, and those with vomiting were more likely to receive antiemetics. Use of antiemetics was associated with reduced admissions in the single institution (odds ratio [OR] 0.62, 95% CI 0.52-0.74), but not in the national database (OR 1.08, 95% CI 0.74-1.60).

Conclusions: Many patients presenting with NV do not receive antiemetics while in the ED. Effort should be made to further study and reduce the phenomenon of undertreatment of nausea or vomiting, coined "oligoantiemesis."

Keywords: antiemetics; emergency department; nausea; vomiting.