Abstract
BackgroundNasal inhalation of isopropyl alcohol (IPA) seems an effective anti-emetic for the symptomatic treatment of nausea in the emergency department (ED) compared to conventional anti-emetics (Ondansetron and Metoclopramide). However, it is not yet known what the practical consequences are related to the use of IPA in the ED.ObjectivesThe purpose of this study was to assess the practical implications for patient care associated with IPA use and to evaluate the viability of permanent implementation of IPA inhalation as a first-line therapy for nausea in the ED.MethodsWe conducted a prospective, single-center implementation study comparing ED-based care for nauseated patients before (n=106) and after (n=104) the introduction of IPA. We evaluated the treatment process and cost and assessed implementation using a survey based on recommended implementation outcome measures.ResultsComparing baseline phase to implementation phase, we found a significant increase in the percentage of patients receiving nausea treatment (66.0% versus 97.1%; p<0.001) and a reduction in time to treatment initiation (7 versus 1 min, p<0.001). Additionally, IPA introduction was associated with a decrease in the administration of conventional anti-emetics (0.52 versus 0.23 administrations per patient, p<0.001) and a notable drop in treatment cost (€1.33 versus €0.67 per patient). Nurses were content with IPA implementation and regarded definitive implementation as feasible and sustainable.ConclusionImplementation of IPA as the first-line nausea treatment in the ED can increase the quality of care and improve care efficiency. Definitive implementation of IPA as a first-line treatment in the ED is both viable and practically feasible.Trial registrationNTR, NL7717, Registered on March 23, 2018 - Retrospectively registered
Highlights
Nausea is one of the most common complaints in the emergency department (ED) and has a great variety of possible causes [1]
Implementation of isopropyl alcohol (IPA) as the first-line nausea treatment in the ED can increase the quality of care and improve care efficiency
Main results The percentage of nauseous patients that received nausea treatment was 66.0% in the baseline phase and 97.1% during the implementation phase (p
Summary
Is nausea an uncomfortable complaint, it can cause complications like aspiration and dehydration [2]. It is relieved by treating the underlying cause. Nasal inhalation of isopropyl alcohol (IPA) seems an effective anti-emetic for the symptomatic treatment of nausea in the emergency department (ED) compared to conventional anti-emetics (Ondansetron and Metoclopramide).
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