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In other trials, administering amphetamine with pro- 2. Priesol AJ. Motion sickness. January 2016. http://www.upto
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fexofenadine to prevent motion sickness. Ann Pharmacother.
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will likely suffer from motion sickness. The proportion 8. Spinks AB, Wasiak J. Scopolamine (hyoscine) for preventing
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The views and medical opinion herein represent those of avoid travel travail. Postgrad Med. 1999;106:177–184.
the authors. They do not reflect the operation practice 14. Estrada A, LeDuc PA, Curry IP, et al. Airsickness prevention
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The cases are provided to be educational and thought 408–413.
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Disclosures
The authors have nothing to disclose.
Sgt Banting is a physician assistant with CANSOFCOM.
References Major Meriano is a practicing emergency physician. He has
served in various capacities with the Canadian Forces and Re-
1. Benson AJ. Motion sickness. In: Pandoff KB, Burr RE, eds. serves since 2003. Comment and suggestions can be sent to
Medical aspects of harsh environments. Vol 2. 2002. http://www
.cs.amedd.army.mil/Portlet.aspx?ID=7c0ebab2-6720-4e15 sofclinicalcorner@gmail.com.
-883b-dbfaafa960f9. Accessed May 2016.
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