CHAPTER 4 Complementary/Alternative Therapies

Vicki Sweet, RN, MS, CEN, CCRN, FAEN

MAJOR TOPICS

Introduction

Types of Complementary/Alternative Therapies

Acupuncture

Aromatherapy

Herbology/Nutritional Supplements

Homeopathy

Hypnotherapy/Guided Imagery

Naturopathy

General Strategy

Assessment

Planning and Implementation/Interventions

Evaluation and Ongoing Monitoring

Documentation of Interventions and Patient Response

I. INTRODUCTION

Although not necessarily new, the use of complementary and alternative medicine (CAM) therapies is increasing throughout the United States. Some patients fully ascribe to “alternative” therapies and turn away from conventional Western medicine, and other patients use alternative remedies to complement the medical regimens prescribed by their health care practitioners. This approach is sometimes referred to as “integrative” or “holistic” medicine. The term holistic, familiar to nursing, is often incorrectly used by patients in describing the complementary therapies they may be using. Unfortunately, information on alternative therapy used is not always shared with health care providers. In some cases, certain remedies may potentiate the effects of prescription medications; in others, the effects may be contradictory. It is essential, then, for the emergency nurse to be knowledgeable about therapies and to address the use of CAM in all emergency patients. Some therapies are quite safe; others, if used improperly, may have dangerous interactions with prescribed treatments, and patients may present to the emergency department because of these reactions.

II. TYPES OF COMPLEMENTARY/ALTERNATIVE THERAPIES

A. Acupuncture

1. An ancient therapy of using needles to correct imbalances in the flow of the body’s energy, or “chi”

2. The World Health Organization considers acupuncture to be appropriate treatment for such disorders as anxiety, back pain, migraines, infertility, blood pressure regulation, and smoking cessation, among others

3. Considered relatively safe when performed by a trained practitioner. Licensure for use of acupuncture is required in some states in order to provide for adherence to infection control and safety guidelines

4. Complications

a. Minor

1) Bruising

2) Local bleeding

b. Serious

1) Nerve damage

2) Pneumothorax

B. Aromatherapy

1. Use of essential oils for healing

2. Therapy based on belief that sense of smell is connected with memory and emotion and that this connection affects health

3. Proponents believe it reduces stress and alleviates minor conditions

4. Complications

a. Accidental ingestion or inhalation of potentially toxic essential oils

b. Topical reaction including contact dermatitis, rash, pruritus

C. Herbology/Nutritional Supplements

1. Often recognized as safe

2. Complications

a. Frequently taken without appropriate guidance from health care providers

b. Labeling vague and nonspecific

c. No U. S. government regulation of quality or standardization of preparations

d. Unexpected outcomes such as stroke and liver failure have occurred

e. Multiple herb-drug interactions (Table 4-1)

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