Penthrox

[gotbeerz001]

 

[akflightmedic]

Well technically I come no where near violating HIPAA....seeing as how I did not bill for the patient, I did not transmit any of his personal information electronically, in fact I only have his ONE name which is very common and an assigned birthday. Just sayin...

Almost every Afghan "in the system" has a birthday of January 1 and an estimated year based on their recollection of how many seasons have passed or any major events which occurred during their birth year and shared with them by their parents or elders.

 

[gotbeerz001]

HIPAA Hippo was kidding. [emoji14]
He just thinks he's cute.

 

[EpiEMS]

Almost every Afghan "in the system" has a birthday of January 1 and an estimated year based on their recollection of how many seasons have passed or any major events which occurred during their birth year and shared with them by their parents or elders.

That's fascinating! Must make for some interesting discussions!

 

[SandpitMedic]

They don't typically speak English... I'm not too sure about AK's experience in Afg, but my experience with non English speakers and local Arabic translators...is almost just as bad. Lol, at least my patients have birthdays though.

 

[DPM]

I typically had Taliban, who got a prisoner tag, or ANSF who had some kind of ID usually.

 

[jwk]

I don't believe MOF is commercially available in the US - as I recall, Australia is the only developed country in the world where it's commonly used. It is in fact nephrotoxic, which in the US means it's dead from a medicolegal standpoint (meaning plaintiffs lawyers would be all over it). It had very limited use in anesthesia even when it was available, and I haven't seen it in the OR in about 25 years.

 

[auseventmedic]

We use it all the time in australia, really good drug for pain relife works well with trauma and musculoskeletal injuries we give it in 3mls max of 6ml is grate for kiddies as you do not need to use a needle or cannular and we also use it with opiates

 

[DPM]

I don't believe MOF is commercially available in the US - as I recall, Australia is the only developed country in the world where it's commonly used. It is in fact nephrotoxic, which in the US means it's dead from a medicolegal standpoint (meaning plaintiffs lawyers would be all over it)...

There are a few studies that disagree about the side effects.

http://onlinelibrary.wiley.com/doi/...ionid=9543629926D846CA6C5E76AD9B42E1FD.f03t01

http://onlinelibrary.wiley.com/doi/10.1111/j.1742-6723.2006.00874.x/abstract

Unfortunately, they're "non-US" studies, so we'd probably have to wait for a US trial.

 

[jwk]

You'll never

There are a few studies that disagree about the side effects.

http://onlinelibrary.wiley.com/doi/...ionid=9543629926D846CA6C5E76AD9B42E1FD.f03t01

http://onlinelibrary.wiley.com/doi/10.1111/j.1742-6723.2006.00874.x/abstract

Unfortunately, they're "non-US" studies, so we'd probably have to wait for a US trial.

Doubt you'll ever see it in the US again. There's absolutely zero commercial interest in it and it's no longer FDA approved. Nobody is or will be interested in attempting to bring it back to market due to the potential side effects, so it would never be a commercially viable product. Far better agents have come to market in the ensuing years, and no new agents have been developed in more than 40 years.

 

[DPM]

I'm not necessarily pushing for penthrox, but I think we should have entonox. Non opiate pain relief should be a priority, considering that the US has more opiate addicts than the rest of the world combined.

 

[triemal04]

I'm not necessarily pushing for penthrox, but I think we should have entonox. Non opiate pain relief should be a priority, considering that the US has more opiate addicts than the rest of the world combined.

........we DO have entonox. All entonox is, is a premixed bottle of nitrous and oxygen; the FDA prohibits that and requires a blender to be used. But, just like in a dentists office or OR there is a portable version that can easily be used, the nitronox setup. And no, I'm not a shill for the company.

The problem is that nitronox and any other system is kind of unwieldly, and more importantly, in the US we often have a bad case of rectocranial inversion and can't recognize a different but good thing.

 

[Nova1300]

Unfortunately I think jwk is right. Getting methoxyflurane back, in any formulation, into the states is probably going to be very difficult.

I would argue one point he made, though: That far better agents have come to market in recent years. This is true. The newer anesthetic agents are better suited for providing surgical anesthesia for a myriad of reasons.

But methoxyflurane is unique in its analgesic properties, something the other agents lack. And if it can be shown to do that safely at sub-anesthetic doses in a patient-controlled device, that would be effective in all patients regardless of chronic opiate use or medical history, that was short acting, relatively inexpensive, and had very little nausea, it seems to me it might be a rather ideal agent for use in the prehospital environment.

I can't really think of any pain control mechanism currently in use in ems for which I can say all of those things are true.