Managing Postoperative Nausea With an Application of Ice Pack to the Posterior Upper Neck

Q: What non-pharmacological method was evaluated for postoperative nausea?

An ice pack was applied to the posterior upper neck as a first-line approach for mild to moderate postoperative nausea.

Q: Who were included and excluded from the quality improvement project?

Adults 18+ receiving general anesthesia with very mild to moderate nausea in Phase I or II PACU were included, while patients with severe nausea, active vomiting, contraindications, hypothermia, refusal, or head/neck plastic surgery were excluded.

Q: How was effectiveness assessed after the ice pack application?

Nausea levels were documented at the time of ice pack application and after five minutes, with effectiveness reported by patients and nausea ratings showing a significant reduction.

Oct 16, 2026

Uploaded by Kurz

Measures the effectiveness of a non-pharmacological approach for postoperative nausea (PON) by applying an ice pack to the posterior upper neck. This observational quality improvement project included adults (18+) receiving general anesthesia who had very mild to moderate nausea in Phase I or II PACU care. Patients with severe nausea, active vomiting, contraindications, hypothermia, refusal, or head/neck plastic surgery were excluded. Mild to moderate PON received ice as first-line; outcomes were tracked at baseline and after five minutes. Of 70 patients, 61% reported effectiveness; nausea decreased significantly (baseline 2.3±0.6 to 1.5±1.1, P<.001).

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Purpose

Design and Participants

Exclusion Criteria

Methods

Findings

Conclusions

Journal of PeriAnesthesia Nursing 37 (2022) 774−777 Contents lists available at ScienceDirect Journal of PeriAnesthesia Nursing journal [homepage:](homepage: www.jopan. org)[ www.jopan. org](homepage: www.jopan. org) Best Practice Managing Postoperative Nausea With an Application of Ice Pack to the Posterior Upper Neck Dana R. Scharfenberg, MN, RN, OCN, CPAN*, Alice Salcido, BSN, RN, CPAN, Patricia Malone, BSN, RN, Jamie Clark, BSN, RN, CCRN, Margaret A. Steele, BSN, RN University of Washington Medical Center Montlake, Seattle, WA Keywords: nausea postoperative nausea PON PONVice pack ice bag A B S T R A C T Purpose: Measure effectiveness of a non-pharmacological approach to manage postoperative nausea (PON) by applying an ice pack to the posterior upper neck. Design: This was an observational quality improvement project. The sample included adults 18 years old and older who received general anesthesia (inhalation and/or intravenous), recovering in Phase I or Phase II postoperative care unit (PACU) experiencing very mild to moderate nausea. Exclusion criteria were patients who experienced severe nausea or were actively vomiting; were admitted for head or neck plastic surgery; were hypothermic (< 36.0°C); patients who refused the ice pack, or the provider stated that placing an ice pack to the patient’s posterior upper neck was contraindicated. Methods: Patients who experienced mild to moderate PON had an ice pack applied to the posterior upper neck as ﬁrst line management. If the patient’s nausea continued to progress or did not improve within ﬁve minutes of ice pack application the patient was offered a different non-pharmacological approach or pharmacological approach to prevent vomiting as per standards of care. Demographics were collected and patient’s level of nausea was documented at the time of ice pack application and after ﬁve minutes. Findings: Of the 70 patients included in this study, 61% reported ice pack application as effective in mitigating their nausea, 14% were unsure, and 24% reported not effective. There was a signiﬁcant decrease in nausea between baseline (2.3 § 0.6; range 1-3) and ﬁve minutes post application (1.5 § 1. 1; range 0-4). The within subject baseline-post change (\#0.9 § 1. 1; P < .001) reﬂected a decrease in nausea. Conclusions: Application of an ice pack to the posterior upper neck, may effectively decrease very mild to moderate PON. © 2022 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved. Approximately one-third of surgical patients experience postoperative nausea (PON) and often report it as more disturbing than postoperative pain. 1,2 Some known PON risk factors addressed in this study include female gender, age less than 50, and inhalation anesthetic agent use.2 When PON progresses to vomiting, associated complications may include longer recovery time, unplanned hospital admission, increased hospital length of stay, and decreased patient satisfaction.1 Antiemetic medications have potential side effects, patients may have allergies or adverse reactions, and some do not effectively treat PON. 1,2 Some antiemetics can interact negatively with anesthetic agents by contributing to drowsiness, may not be available at some Conﬂict of Interest: None to report. * Address correspondence to Dana R. Scharfenberg, University of Washington Medical Center Montlake, Seattle, WA. [E-mail address:](E-mail address: danaskin@uw.edu)[ danaskin@uw.edu](E-mail address: danaskin@uw.edu) (D.R. Scharfenberg). healthcare facilities, and can be expensive.2 Not all antiemetics effectively treat PON, may cause permanent side effects (like serotonin syndrome or tardive dyskinesia), and can take up to four hours to reach full efﬁcacy. 1,2 Pharmacologic action may take too long to prevent vomiting and options may be limited. Therefore, it is essential to maximize non-pharmacological approaches. The pathophysiology of nausea and vomiti

FAQs

What non-pharmacological method was evaluated for postoperative nausea?

An ice pack was applied to the posterior upper neck as a first-line approach for mild to moderate postoperative nausea.

Who were included and excluded from the quality improvement project?

Adults 18+ receiving general anesthesia with very mild to moderate nausea in Phase I or II PACU were included, while patients with severe nausea, active vomiting, contraindications, hypothermia, refusal, or head/neck plastic surgery were excluded.

How was effectiveness assessed after the ice pack application?

Nausea levels were documented at the time of ice pack application and after five minutes, with effectiveness reported by patients and nausea ratings showing a significant reduction.

Oct 16, 2026

Uploaded by Kurz