Aromatherapy

Overview: 
  • Aromatherapy is part of a complementary or integrative approach used to promote comfort or enhance well-being
  • Essential oils used for aromatherapy are made from the distillate from an aromatic plant or oil expressed from the peel of a citrus fruit
  • UCSF encourages use of hospital-endorsed aromatherapy products only 
Clinical Use: 
  • Clinician provision of UCSF-endorsed aromatherapy products may only be used to promote “well-being,” in alignment with regulatory standards. 
  • Essential oils are not used to treat specific symptoms such as pain, anxiety, or nausea.

Indications:

  • Clinicians select essential oils based on patient's preference or the patient's past experience with aromatherapy

Contraindications: 

  • History of adverse reactions or events associated with essential oils 
  • Patients with a history of migraine or seizures who do not have a history of essential oil use 

  • Population-specific:
    • Pregnancy
    • History of bronchial hyper-reactivity (e.g., asthma) 

Dosing: 

  • Remember: A little goes a long way! 
  • For multi-dose bottles, place one to three drops on an absorbent material, e.g. cotton ball, and place in a small, covered container for self-dosing (and aroma containment) 
  • For single-use aromatherapy products, review package instructions for desired effect

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 essential oils and diffusers are 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 products on hand 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 multi-use 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