Motion Sickness

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Motion Sickness
Prevention and treatment of Motion Sickness

• Dr Edi Albert
• GPTT Expedition Medicine Course

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Motion Sickness

• Generic term for
• Travel Sickness
• Sea-sickness
• Air sickness
• (Space sickness)

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Motion sickness

• Caused by a mismatch / misinterpretation of
  sensory information particularly from the
  labyrinthine apparatus
• 1 on commercial air craft up to gt80 in rough
  seas
• Prevention is easier than cure

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Sea sickness

• Thresholds vary from person to person and
  temporally
• Very difficult to predict who will get it
• Recurrent
• 95 adapt after approx. 3 days at sea

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Symptoms of sea-sickness

• Apathy Yawning
• Cold sweats Headache
• Anorexia Nausea
• Vomiting

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Prevention

• Offer prophylactic medication to everyone in the
  party
• Non-pharmaceutical options exist ginger
  C-bands
• Education

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Education

• Lie low if feeling sick
• Restrict visual stimuli either fix on
  non-moving object or close eyes
• Decrease magnitude of stimulus (low down on a
  boat)

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Education cont.

• Mental distraction incl.control of vehicle
• Drink plenty (water!)
• Remove any noxious stimuli
• Go to sleep

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Medication

• Oral
• Promethazine (Avomine Phenergan)
• Hyoscine (Kwells)
• Prochlorperazine (Stemetil)
• If unable to take oral meds
• Prochlorperazine suppositories
• Phenergan im

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Medication cont.

• Pseudoephedrine Ephedrine work but not licensed
  
• Scopolomine patches not available in Australia
• Maxolon does not work!
• Some evidence for phenytoin but not used in
  Australia

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Promethazine

• Prevention 25mg nocte
• Treatment 25mg tds orally
• Treatment 100mg im

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In prolonged vomiting

• Dehydration
• Metabolic alkalosis
• Hypokalaemia

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Sopite syndrome

• A symptom complex of drowsiness, decreased mental
  functioning decreased performance that is part
  of motion sickness
• May occur at threshold for motion sickness
• May continue after adaptation has abolished other
  symptoms
• Anti-emetic medication doesnt work