Paramedics are commonly called to attend patients complaining of nausea and vomiting, with the treatment of these conditions being either antiemetics or palliative measures. There are currently four antiemetics available to paramedics across Australia and New Zealand. Historically, the use of these medications, or previous medications not available in current practice, has varied dependent on each region of practice. Objective We aimed to create a snapshot in time and determine which antiemetics have been used by paramedics across their careers, their preferences of use, and their beliefs regarding each antiemetic. Methods Using an online survey, a cross-sectional and historical analysis of current and post-antiemetic use was conducted using a 5-point Likert scale and free text qualitative answers. Paramedics were invited to answer questions regarding their demographic, previous and current antiemetic medications used, and preferences regarding these antiemetics. Results A total of 476 paramedics participated in the study. Ondansetron was found to be the preferred antiemetic for most cases with nausea and vomiting (n=378, 82%) with the second line choice being metoclopramide (n=62, 13.4%). Exceptions to this were for prochlorperazine, which showed a high preference for nausea related to migraine (n=179, 56.2%) or vertigo or motion sickness (n=243, 42%). Conclusion Preferences and decision making for choosing ondansetron over other antiemetics were primarily its efficacy, minimal side effects and availability. Historically, metoclopramide has been the most common antiemetic in paramedic practice but is not generally preferred due to its contraindications, perceived lower efficacy over other antiemetics and risk of side effects.