Potential for Change in Practice: Treatment of Nausea in the Emergency Department

This is a brief summary of the study from Michael D. April et al published in Annals of Emergency Medicine in 2018 called "Aromatherapy Versus Oral Ondansetron for Antiemetic Therapy Among Adult Emergency Department Patients: A Randomized Controlled Trial."

http://www.annemergmed.com/article/S0196-06441501361-X/fulltext

Significance: Inhaling isopropyl alcohol for a short interval may improve mild nausea in patients better than ondansetron and without risk of QT-prolongation. Although this study was small, its intervention is easy, cheap and with relatively rapid onset (<1hr) making its potential to change practice large.

Intervention: Inhale from commercially prepared medical pad saturated with isopropyl alcohol. Inhale as frequently as required to achieve nausea relief, with the pad 1-2cm from the nares.

Study Setup: 122 individuals were enrolled to study the effect on nausea of inhaled isopropyl alcohol and oral ondansetron versus inhaled isopropyl alcohol and oral placebo versus inhaled saline solution placebo and oral ondansetron. Nausea was measured by a visual analog scale.

Results: Groups which received isopropyl alcohol improved by an average of 30+ points on the nausea scale, whereas the ondansetron plus placebo group only improved by 9 points. Additionally, fewer subjects in the isopropyl alcohol group required rescue antiemetic therapy (27.5% vs 25% vs 45%)

Limitation: Study included relatively healthy subjects with relatively mild nausea.

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I am sharing my interest and passion for medicine with the Steem community by posting brief summarizes of interesting and impactful studies.