By Samantha Hilker

Gundersen Tri-State Ambulance, a longstanding member of PAAW, is doing some great things in their corner of the world, so we’re shining the spotlight on them!

This past December, conversations about the use of essential oils to support patients experiencing pain, nausea and anxiety started shaping a new program for the La Crosse-based service.  The national opioid crisis is causing many healthcare organizations, and individual providers, to look at the way some conditions, like pain, are addressed.  When Dr. Chris Eberlein, Medical Director for Tri-State Ambulance and ER Physician for Gundersen Health System, started seeing the way essential oils were used to support patients within Gundersen, he wondered if there might be an application for EMS.  “I noticed that many of the patients given small doses of Fentanyl or other narcotic pain medications in the field were not leaving the ER with a prescription for painkillers – they didn’t need it.  I thought there must be something different we can do to support them without administering opiates.  The field providers (and their patients) didn’t have any other options, until now” recalls Dr. Eberlein. 

Essential oils work on the limbic system, the same system that controls our fight or flight response.  When someone breathes in the oil our olfactory nerve cells carry the essential oil into our brain. They bypass the thalamus and enter the limbic system through the cerebral cortex which lies just above it.  Scent is a powerful thing that, for many of us, triggers an immediate and intense response such as memories or nausea; it only makes sense they can have a calming effect on the senses as well.  Dr. Eberlein, Nick Eastman, Operations Supervisor – Clinical Services, connected with Denise Nicholson, Registered and Certified Clinical Aromatherapist, who leads the essential oil program at Gundersen Health System.  Denise is also an RN, BSN, Advanced Care Plan Facilitator and Nursing System Specialist with Gundersen and has studied essential oils extensively; she believes in their benefits and application for use because she has seen the patient response.  Both Gundersen and Tri-State follow the British and German models of use (inhalation and absorption), not the French model (ingestion).  “The oils are delivered by putting a few drops on a cotton ball, then taping that to the patient’s chest or by rubbing a small amount of diluted oil on the pads of a patient’s feet.  Inhalation is the fastest and safest way to deliver essential oils to a patient, but absorption can be beneficial in certain circumstances as well,” Denise explains. 

Tri-State is now carrying six (6) different essential oils on their paramedic units and has a specific procedure for their use.  “I want to make it clear that the oils are an adjunct, not a replacement for standard treatments or medical protocols.  Although we didn’t implement these oils to manage the current narcotic shortages EMS services everywhere are experiencing, we are hoping the use of the oils allows us to support patients without using as many narcotics.  We have also added non-narcotic pain medications to our pain management protocol,” Dr. Eberlein clarifies. 

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Company-wide use at Tri-State has just started and although Gundersen has been using them for some time, they have not done any formal clinical trials.  Anecdotally, however, the results are changing skeptics into believers. 

“We have one long-time paramedic who was part of our pilot group who is a bit of a skeptic.  During his introduction and education on essential oils, he decided to try some for his plantar fasciitis.  He purchased some from Gundersen (available in the hospital gift shops) and applied it to the soles of his feet…within 30 minutes his feet were pain free for the first time in years.  I think it’s safe to say he’s now one of the programs biggest supporters,” Nick Eastman shared. 

It is important to note that any service looking to implement a similar program must do their due diligence and research the use, benefits and safety of essential oils before including them in their supportive measures.  Essential oils are not regulated by the FDA and are not an alternative to standard medical treatments; some can interact with prescription medications.  Any service looking to implement essential oils as a supportive measure should also spend time researching the supplier of any oils they might incorporate into their system.  There are a lot of direct-sales companies selling essential oils these days, and you can even purchase them on Amazon.  Gundersen works with a supplier who only works with healthcare providers and is a certified and registered clinical aromatherapist; the oils go through extensive testing, so the providers and patients can be confident in what they are getting. 

PAAW is proud of the work Gundersen Tri-State Ambulance is doing and their willingness to share their experience with other services across the state – a shining example of how we are stronger together. 

Resources:

• Price, S., & Price, L. (2012). Aromatherapy for health professionals. Edinburgh: Churchill Livingstone.
  
• Buckle, J. (1997). Clinical aromatherapy in nursing. London: Arnold.
  
• Tisserand, R.,& Balacs, T. (1995). Essential oil safety, a guide for health care professionals. Edinburgh: Churchill Livingstone.
  
• Kevelle, K. (1999).  Aromatherapy for dummies. Wiley.
  
• Johnson, S. (2015) Evidence based essential oil therapy: The ultimate guide to the therapeutic and clinical application of essential oils. Johnson