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Inhalation of Isopropyl Alcohol Alleviates Nausea in ED Patients

Breathing with an alcohol wipe in front of the nose was more effective than breathing with a saline wipe.

Prior research has found antiemetics to be no more effective than placebo in emergency department (ED) patients with nausea (NEJM JW Emerg Med Aug 2014 and Ann Emerg Med 2014 May 9; [e-pub] [Free full-text Ann Emerg Med PDF | PubMed® abstract]). In the current study, investigators at a single academic ED randomized a convenience sample of 80 adult patients with nausea or vomiting to hold either a standard isopropyl alcohol wipe or a saline wipe 2.5 cm from the nose and breathe deeply for up to 1 minute. The intervention was repeated three times at 2-minute intervals. Patients rated nausea on an 11-point scale (with a score of 0 indicating no nausea) at baseline and 2, 4, 6, and 10 minutes after the start of the intervention.

Even though nausea was a little worse in the intervention group at baseline (median nausea score, 7 vs. 6), at 10 minutes the intervention group had less nausea than the placebo group (median score, 3 vs. 6).

COMMENT

These are promising initial data. Breathing with an alcohol pad in front of the nose seems to be a safe and effective short-term treatment for nausea. Interestingly, the investigators note that other forms of “aromatherapy,” such as peppermint oil, might be as effective. More data are needed to evaluate the longer-term effects of such interventions, and it’s a shame that the investigators only collected outcome data at 10 minutes. However, the intervention would be easy to repeat periodically. It just might be worth a try.

Daniel J. Pallin, MD, MPH reviewing Beadle KL et al. Ann Emerg Med 2015 Dec 8.

CITATION(S):

Beadle KL et al. Isopropyl alcohol nasal inhalation for nausea in the emergency department: A randomized controlled trial. Ann Emerg Med 2015 Dec 8; [e-pub].
[PubMed® abstract]

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