Aromatherapy

Overview: 
  • Aromatherapy is the use of essential oils for therapeutic purposes
  • Essential oils are the distillate from an aromatic plant or the oil expressed from the peel of a citrus fruit
  • UCSF has approved the use of the following 6 essential oils: mandarin orange, lemon, eucalyptus, ginger, lavender, and peppermint. 
Clinical Use: 

Indications:

  • Clinicians should select essential oils based on patients’ preference

Contraindications: 

  • Pregnancy 
  • History of adverse reactions or events associated with essential oils 
  • History of bronchial hyper-reactivity (e.g., asthma) 
  • Patients with a history of migraine and who do not have a history of essential oil use 
  • Patients with a history of seizure and who do not have a history of essential oil use 
  • Best uses:
    • Clinicians consider aromatherapy as an adjuvant therapy to decrease patients’ pain or treat other symptoms 
    • At UCSF, aromatherapy may only be used to promote “well-being,” to align with regulatory standards 

Dosing: 

  • A little goes a long way: One to three drops on a cotton ball, placed in a small, covered container for self-dosing (and aroma containment) 

Applications: 

  • For brief periods of inhalation only 
  • Not to be applied to skin or taken internally 

Mechanism of Action

  • Aromatherapy is based on learned memory and the ability of the mind to condition the response to an aroma based on previous experiences. When oils enter the body through inhalation, molecules stimulate olfactory pathways that are closely connected to portions of the brain’s limbic system and may influence heart rate, BP, respiratory rate, memory, and hormone levels (1, 3).

Special Safety Considerations

  • Use of home oil diffusers is discouraged 
  • Avoid direct contact of essential oils near or in the eyes
    • If oils get into the eyes, irrigate with whole or 2% milk to dilute the oil, and then rinse with water
  • If oils are accidentally ingested, contact a poison unit. Keep bottle for identification. Encourage patient to drink whole or 2% milk. Do not induce nausea/vomiting.
  • If a skin reaction occurs, dilute essential oil with hospital approved lotion, then then wash the affected area with non-perfumed soap.
  • Be cautious with unintended use of essential oils (especially peppermint) on fingers/hands and potential eye rubbing; Oils can linger on hands even after being washed with soap and water.
  • Do not take bottles into patient rooms for infection control purposes
References: 

Allard, M. E., & Katseres, J. (2018). Using essential oils to enhance nursing practice and for self-care. The Nurse Practitioner, 43(5), 39-46. doi:10.1097/01.NPR.0000531915.69268.8f

Boyce, V. J., & Natschke, M. (2019). Establishing a comprehensive aromatherapy program in patient care settings. Pain Management Nursing, 20(6), 532-540. doi:10.1016/j.pmn.2019.06.017

Cho, E. H., Lee, M., & Hur, M. (2017). The effects of aromatherapy on intensive care unit patients’ stress and sleep quality: A non-randomized controlled trial. Evidence-Based Complementary and Alternative Medicine, 2017, 2856592-10. doi:10.1155/2017/2856592

Conlon, P. M., Haack, K. M., Rodgers, N. J., Dion, L. J., Cambern, K. L., Rohlik, G. M., . . . Cutshall, S. M. (2017). Introducing essential oils into pediatric and other practices at an academic medical center. Journal of Holistic Nursing, 35(4), 389-396. doi:10.1177/0898010116677400

Johnson, J. R., Rivard, R. L., Griffin, K. H., Kolste, A. K., Joswiak, D., Kinney, M. E., & Dusek, J. A. (2016). The effectiveness of nurse-delivered aromatherapy in an acute care setting. Complementary Therapies in Medicine, 25, 164-169. doi:10.1016/j.ctim.2016.03.00

Author: 
Marilyn A Bazinski