Dr. Michael Austin, RPPEO Medical Director, has released a new Clinical Bulletin providing guidance on the use of anti‑emetic medications in adults aged 65 years and older. This bulletin supports day‑to‑day clinical decision‑making for an ageing patient population with differing risk profiles.

The guidance clarifies how ondansetron and dimenhydrinate may be selected and dosed in older adults, with emphasis on:

• using the lowest effective dose
• weighing sedation, anticholinergic burden, and cardiac risk
• reassessment and clear documentation
• applying clinical judgment rather than age‑based rules alone

Key messages include that ondansetron is generally preferred in older adults due to lower sedation and anticholinergic effects, while dimenhydrinate may still be appropriate in selected cases. Online Medical Consultation remains available at any point when risks and benefits are unclear.

All paramedics are encouraged to review RPPEO Clinical Bulletin 3.1: Guidance on Anti‑Emetic Use in People 65 Years and Older before applying this guidance in the field.

Questions, feedback, or quality‑related concerns can be directed to Quality@RPPEO.ca.