References
Efficacy and safety of methoxyflurane: managing trauma associated pain in UK SAR helicopter paramedic practice
Abstract
This article reviews the efficacy and safety of Penthrox (methoxyflurane) when administered in analgesic dosages. The review included one randomised, double blinded control trial and the remaining evidence consisted of reviews or observational and data-linkage studies. This paucity in a significant number of high quality pieces of evidence is mitigated to some extent by the collaborative unanimity of all the papers reviewed. All papers concluded that Penthrox was an efficacious analgesic. There was no evidence of Penthrox having long-term deleterious effects under an analgesic dosing regimen. The addition of an activated charcoal filter to the Penthrox inhaler renders the risk of occupational side effects negligible. Penthrox appears to be a safe and efficacious analgesic.
Search and Rescue (SAR) paramedic practice involves the provision of clinical care and the rescuing of patients from austere locations via helicopter winch. Approximately 80% of SAR Helicopter (SARH) paramedics’ patients are adults who have suffered traumatic injury, many of whom are in pain (Burgess and Dykes, 2011; Meadley et al, 2015; Sherren et al, 2013).
Pre-hospital pain management is widely reported as being universally inadequate (Buntine et al, 2007; Gausche-Hill et al, 2013; Parker and Rodgers, 2015; Coffey et al, 2016). But efficacious analgesia is imperative, not only to facilitate accurate patient assessment, but also for humanitarian reasons (Gausche-Hill et al, 2013). Provided it does not compromise a SARH mission's clinical, rescue and aviation equipoise, pain management should be initiated as soon as possible. To achieve this, the majority of the UK SARH paramedic profession has adopted intravenous (IV) morphine sulphate and Entonox as their analgesics of choice.
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