What is New in the EMS Drug Bag? || Isopropyl Alcohol as an Antiemetic
Isopropyl alcohol pads are a common staple on almost every EMS call. EMS providers typically use them to disinfect an area prior to drawing up medication, establishing an IV, giving an injection, etc. 💉 💊
But wait……is that all it is good for?
Some would say, “No way!”
It is actually being referenced as an antiemetic option in some of the current EMS textbooks! 📚 There have been a few studies on it in the last decade and some of the prehospital community is now beginning to incorporate it as an actual treatment possibility on the ambulance. 🚑
Why? What does it do?
The mechanism of action isn’t super clear, however, it is speculated in some of the literature that it may be due to “olfactory distraction.” The olfactory system is primarily responsible for our sense of smell.
There are also theories circulating that it has little to do with the isopropyl alcohol and more to do with the effects of slow deep breaths on the nervous system.
Although the evidence supporting the antiemetic properties is not extensive, the research does indicate some positive results.
The patient may be advised to inhale the vapor from the isopropyl alcohol pad up to three times in a 15-minute period (obviously, follow your protocol please).
No major adverse reactions have been recorded when administered properly.
No contraindications are noted, but cal control is advised before attempting this with the pediatric population.
Does this mean to not consider other antiemetics for our patients who are nauseous or vomiting? 🤮
Absolutely not! ⛔️ Follow your protocol and treat your patient! We still have other proven options like Zofran, Phenergan, Benadryl, etc.
So now I want to know, are there any EMS providers out there using these little tools as antiseptics and antiemetics? Have you seen it yield positive results? Let me know!
References and studies. ⬇️⬇️
➡️ Veldhuis, P., Melse, M. & Mullaart, N. 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. Int J Emerg Med 14, 15 (2021). https://doi.org/10.1186/s12245-021-00334-z
➡️ Beadle KL, Helbling AR, Love SL, April MD, Hunter CJ. Isopropyl Alcohol Nasal Inhalation for Nausea in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med. 2016 Jul;68(1):1-9.e1. doi: 10.1016/j.annemergmed.2015.09.031. Epub 2015 Dec 8. PMID: 26679977.
➡️ Haelle, T., & Barclay, L. (2016, January 13). Can inhaled isopropyl alcohol alleviate nausea? Medscape. https://www.medscape.org/viewarticle/856505
➡️ SURGEONS, A. A. O. O. (2022). Nancy Caroline’s emergency care in the streets bundle. 9th edition. JONES & BARTLETT LEARNING.