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. 2021 Feb 24;14(1):15.
doi: 10.1186/s12245-021-00334-z.

Implementation of isopropyl alcohol (IPA) inhalation as the first-line treatment for nausea in the emergency department: practical advantages and influence on the quality of care

Peter Veldhuis  1 , Maartje Melse  2 , Nieke Mullaart  3
Affiliations

Implementation of isopropyl alcohol (IPA) inhalation as the first-line treatment for nausea in the emergency department: practical advantages and influence on the quality of care

Peter Veldhuis et al. Int J Emerg Med. .

Abstract

Background: 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). However, it is not yet known what the practical consequences are related to the use of IPA in the ED.

Objectives: The 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.

Methods: We 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.

Results: Comparing 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.

Conclusion: Implementation 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 registration: NTR, NL7717 , Registered on March 23, 2018 - Retrospectively registered.

Keywords: Emergency department; Implementation outcome measures; Isopropyl alcohol inhalation; Nausea; Quality of care.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Treatment protocol for nausea during the implementation phase
See this image and copyright information in PMC

References

    1. Myer PA, Mannalithara A, Singh G, Singh G, Pasricha PJ, Ladabaum U. Clinical and economic burden of emergency department visits due to gastrointestinal diseases in the United States. Am J Gastroenterol. 2013;108(9):1496–1507. doi: 10.1038/ajg.2013.199. - DOI - PubMed
    1. Egerton-Warburton D, Meek R, Mee MJ, Braitberg G. Antiemetic use for nausea and vomiting in adult emergency department patients: randomized controlled trial comparing ondansetron, metoclopramide, and placebo. Ann Emerg Med. 2014;64(5):526–532.e1. doi: 10.1016/j.annemergmed.2014.03.017. - DOI - PubMed
    1. Singer AJ, Garra G, Thode HC. Oligoantiemesis or inadequate prescription of antiemetics in the emergency department: a local and national perspective. J Emerg Med. 2016;50(6):818–824. doi: 10.1016/j.jemermed.2016.03.019. - DOI - PubMed
    1. Furyk JS, Meek RA, Egerton-Warburton D. Drugs for the treatment of nausea and vomiting in adults in the emergency department setting. Cochrane Database Syst Rev. 2015. 10.1002/14651858.CD010106.pub2. - PMC - PubMed
    1. Singer AJ, Garra G, Thode HC. Do emergency department patients with nausea and vomiting desire, request, or receive antiemetics. Am J Emerg Med. 2017;35(5):790–791. doi: 10.1016/j.ajem.2016.12.044. - DOI - PubMed