Call it a quick fix, a workaround, a “MacGyverism”—or the current internet term for it—a hack.
“We love it when we find a cheap, easy, and fast way to bring relief to our patients,” said Kenneth Beadle, DSc, MPAS, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX, who describes his own hack below.
Whatever you call it, here are a few you can use to quickly and handily bring relief to patients.
An alcohol wipe makes a handy antiemetic
It’s not uncommon for a child or adult patient to feel nauseous and have the urge to vomit in the doctor’s office. But is there a “cheap, easy, and fast way to bring relief” to patients who look like they’re about to throw up?
Yes: Have the patient sniff an alcohol prep pad.
Dr. Beadle and colleagues showed that an alcohol prep pad is an economical and easy way to lower symptoms of nausea. In their study, they instructed patients who presented with a chief complaint of nausea or vomiting to inhale deeply (through the nose) from an isopropyl alcohol pad every 2 to 4 minutes for a maximum of three inhalations.
Within 10 minutes, patients who sniffed the alcohol pad had nausea scores that were half that of similar patients who sniffed a saline wipe (placebo group). Also, the satisfaction score for the patients in the alcohol group was double the satisfaction score for the patients in the placebo group.
Capsaicin cream for cannabinoid hyperemesis syndrome
Speaking of nausea and vomiting, have you heard of cannabinoid hyperemesis syndrome (CHS)? It’s a relatively newly recognized syndrome associated with chronic cannabis use. Symptoms include significant nausea, vomiting, and abdominal pain in people who are heavy users. The big clue to the diagnosis: taking very hot showers or baths to relieve symptoms.
With more states legalizing marijuana, the prevalence of CHS is increasing significantly. But because marijuana is usually associated with relieving nausea rather than causing it, clinicians don’t think to suspect nausea as a symptom of cannabis use.
Sniffing an alcohol pad probably won’t work for these patients. Cannabis consumption has thrown their thermoregulatory system out of whack and apparently turned off a receptor in the peripheral nervous system. This receptor is activated only by scalding heat (greater than 109° F) or capsaicin.
So, if you have a suffering patient sitting in front of you, apply 0.025% to 0.075% topical capsaicin cream to the abdomen for a quick “Band-Aid” fix to help relieve the patient’s nausea and vomiting. (Or, use it as a diagnostic tool to identify CHS.) Of course, the only real remedy is to quit cannabis altogether.
Take eye tests with your smartphone
Have you ever wanted to give a patient a quick vision test but didn’t have an eye chart or other equipment available? There’s an app for that. Actually, there are a few.
• Peek Acuity Pro is a CE registered class 1 medical device that measures visual acuity “accurately, rapidly, and reliably,” according to its developer Peek Vision. The app also includes equivalents of “count fingers,” “hand movement,” and “light perception” tests. It’s a free download—but it’s only available for Android devices.
• Smart Optometry is a free app for both Android and iPhone devices. Its basic version includes tests for visual acuity, contrast sensitivity, and color vision. Additional vision tests (for accommodation, amblyopia, macular degeneration, optic nerve function, etc) are available, as well as a cobalt blue light for use with fluorescein dye. (Speaking of which, here’s a bonus hack: Use fluorescein dye in a patient’s eye to find a “missing” contact lens.)
These and similar apps provide only approximate visual acuity measurements, but are nonetheless sufficient for clinical use or screening for a referral to an eye care provider.
Use a tea bag for uncontrolled bleeding
This bit of folk medicine is well known among oral surgeons: If a wisdom tooth extraction won’t stop bleeding, have the patient clench down on a moistened tea bag for up to 30 minutes. It must be black tea, which contains tannic acid.Tannic acid can be an effective vasoconstrictor, especially in mucous membrane tissues. Tannic acid also has antibacterial, antioxidant, and astringent properties, which help to reduce the risk of infection when placed over a cut or wound.
A moistened tea bag slows bleeding in other mucous membranes, too—such as after a hemorrhoidectomy.
Just be sure to throw out the tea bag after use, so you don’t mistakenly make tea with it!