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Have you ever wondered what nurses do during the historic times? When mechanical ventilators are not yet invented, how do nurses manage to survive? Rather, did their patients back then survive? Charles Darwin once said, “It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change.” Pondering upon this quote, we realize that the nursing profession survived because of our ability to adapt to changes. It is dynamic. Whatever innovation in nursing techniques we have not is because of how we embraced the evolution of healthcare. Nightingale said: “Unless we are making progress in our nursing every year, every month, every week, take my word for it, we are going back.” The past is important to move forward. And yes, we are entering a new era of nursing interventions. Let’s hop in a time machine and travel back in time and learn about the practices we don’t do (hopefully for good) anymore.
1. Rotating tourniquets Also known as congesting cuffs, are often used to treat patients with acute pulmonary edema secondary to heart failure during the 1960s. The idea was to pool the
blood in the veins and decrease the venous return therefore ultimately decreasing pulmonary congestion. Congesting cuffs were placed on three extremities and inflated to 20 to 80 mmHg to achieve its effect. Tourniquet invented by Morell. Image via: commons.wikimedia.org Why did it disappear? Aside from being time-consuming, potent drugs like diuretics are available today. Studies also cannot support the effectivity of this practice.
2. Use of the artificial lung: “The Iron Lung Machine.” Colloquially known as the “iron lung,” enables a person to breathe when normal muscle control has been lost. It
These were glass with a metal plunger. 10-20cc were used for blood taking and two ccs. For drug injection. Image via: https://samhs.org.au/ Back then, resterilization of syringes and urinary catheters were a trend. Syringes were made of glass and catheters were made of metal instead of the silicone we use today. Since they’re made of hardened materials, they were heat sterilized and immersed in alcohol– a practice that would be frowned upon today. Needles were not for single use and had to be sharpened manually. Yikes. Metal urinary catheters. Image via: https://samhs.org.au/ Why did it disappear? Single-use disposable syringes are the standard today ever since the occurrence of HIV and blood-borne pathogens. Different reusable equipment was produced because it’s safer and prevents cross contamination. Also, resterilizing is more costly for hospitals.
4. Notable antiseptic: Dakin’s Solution for wounds Dakin’s solution was used mostly during the Worlds War I. It is composed of sodium hypochlorite and baking soda, and invented by a chemist and a surgeon. After the war, it was widely used for bedsores and infected wounds.
Dakin’s Solution|healthykin.com Why did it disappear? It didn’t! Some institutions still use this today though others prefer proven antiseptics like povidone iodine, etc.
5. Penthrane and Trilene inhalers for labor pain An inhaler for pain relief was once introduced for pregnant women who can’t tolerate labor pain. Analgizer. Image via: anaesthesiaheritagecentre Trichloroethylene (Trilene) and methoxyflurane (Penthrane) were popular analgesics used in obstetrics during the 1900s. These were administered via a calibrated, temperature- compensated vaporizers given to a mother for PRN pain relief during labor.
It was then thought that saline acts as a lubricant in facilitating the ease of passage of the suction catheter with the same concept, it was also thought to loosen and dilute secretions and enhance a cough. Image via openbccampus.ca Why did it disappear? Instilling was often traumatic for patients, and cough reflex was not always elicited especially for people with tetraplegia with little or no diaphragm innervation. Prevalence of mucolytics to enhance mobilization of secretions is most commonly used. Studies have also proved that the practice increases the patient’s risk for pneumonia and the possibility of pushing bacterial formation deeper into the lungs.
10. Cut the Foley catheter before removal. An old-school practice that deserves to stay as it is. The practice involves snipping an inserted indwelling foley catheter to facilitate easy removal. Why did it disappear? The practice can be considered dangerous because the tension can cause the end left with the patient to retract into the bladder. 11. Milking chest tube drains This involves squeezing, twisting, or kneading the chest tube to create bursts of suction to move clots and remove any visible secretions. Why did it disappear? The reason is the risk of air leakage within the chest tube, which can cause irritation and tissue trauma around the insertion site of the tubing. 12. Coca-Cola to unclog nasogastric tubes.
Image via Gallery of Graphic Design Coca-cola (or any carbonated soda) is a notorious unclogger for feeding tubes. The acidity in cola is believed to help unclog the tube. Why did it disappear? Coke, being an acidic fluid, can damage the integrity of the NG tube. It can also contribute to clogging by denaturing proteins in some enteral formulas. Water or replacing the tube is recommended. Knowing these interventions is a revelation for present nurses. Nevertheless, these practices taught us a lesson: to continually improve and render the best and proven care we could give to our patients.
