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SAN ANTONIO –Nausea and vomiting are common conditions in emergency departments, and failure to control them is not only unpleasant for patients and everyone around them but also can led to adverse effects such as dehydration, metabolic alkalosis, gastroesophageal tears and aspiration.
That’s why a recent article in Annals of Emergency Medicine has been so embraced by emergency physicians looking for a safe and inexpensive remedy. It reports that patients suffering from nausea in the ED got significant relief by sniffing pads saturated with isopropyl alcohol compared to a control group sniffing pads saturated with a saline solution.
"We love it when we find a cheap, easy and fast way to bring relief to our patients," said lead author Kenneth Beadle, EMPA-C, of the San Antonio Uniformed Services Health Education Consortium in San Antonio. "Nausea and vomiting are the chief complaint for nearly 5 million emergency patients every year, so this remedy has the potential to help a lot of people."
For the randomized, double-blind, placebo-controlled trial conducted in an urban tertiary care ED, patient nausea and pain were measured with previously published 11-point verbal numeric response scale scores, while patient satisfaction was measured by a five-point Likert scale. The primary outcome was reduction in nausea 10 minutes from initiation of the treatment, with secondary outcomes including patient satisfaction and pain reduction.
Of the 80 patients completing the study, 37 (46.3%) received nasally inhaled isopropyl alcohol and 43 (53.8%) received nasally inhaled normal saline solution. Patients were instructed to inhale deeply through their noses from the pads every two minutes for four minutes, for a maximum of three inhalations. At 10 minutes post-intervention, median nausea verbal numeric response scale score was 3 in the isopropyl alcohol arm vs. 6 in the placebo arm, for an effect size of 3.
At the same time, the median satisfaction score was 4 among patients sniffing isopropyl alcohol, compared to the control group. The two arms didn’t differ significantly in median pain verbal numeric response scale scores or of subsequently receiving rescue anti-emetics.
"Alcohol wipes are safe and there were no adverse effects," Beadle added. "Further research is warranted to test the duration of the effect and performance in comparison to traditional, pharmaceutical anti-emetics. That said, the available evidence suggests these alcohol wipes may be a potent tool for relieving nausea and improving satisfaction among our emergency patients."