Professional paper
USE OF METHOXYFLURANE IN PRE-HOSPITAL SETTING – EXPERIENCE OF EMS LJUBLJANA AND EMS KRŠKO
TIMOTEJ ŠUC
; Community Healthcare Centre Ljubljana, Emergency Medical Service Ljubljana, Slovenia
JAN KURINČIĆ
; Community Healthcare Centre Krško, Emergency Medical Service, Krško, Slovenia
MARIO BJELČEVIĆ
; Community Healthcare Centre Krško, Emergency Medical Service, Krško, Slovenia
Abstract
According to the international guidelines, pain treatment of the injured patient is high on the list of priorities of outpatient emergency medical services (EMS). Methoxyfl urane is an inhaled anesthetic. Its usage started in 1948, and since 1968 it has been used as a short acting inhaled analgesic. Since September 2018, EMS Krško and since June 2019 EMS Ljubljana in Slovenia are equipped with methoxyfl urane registered for injured adult patients with moderate to severe pain. Objective: We performed retrospective analysis of all patients that needed EMS in Ljubljana and Krško since the start of methoxyfl urane usage until December 1, 2019. Methods: We analyzed demographic data (gender, age), type of injury, change in 11-point verbal Numerical Rating Scale (vNRS-11), potential side effects such as drop in blood pressure or reduced Glasgow Coma Score (GCS) and need for additional analgesic therapy, as well as the presence of emergency medical doctor on the fi eld. Results: We examined 53 patients that received methoxyfl urane as analgesic treatment; the youngest patient was aged 6 years and the oldest 85 years, mean age 58 years. There were 28 (53%) male and 25 (47%) female patients. Thirty-nine (74%) patients had isolated limb injury, 11 (21%) patients were not injured, most of them had lumbago or abdominal pain, and one patient had chest pain. At the start of treatment, 26 (49%) patients had vNRS 10, mean vNRS was 8.6 and average reduction was 4. A drop in systolic blood pressure of 20 mm Hg or below 90 mm Hg was observed in four patients (17% of those who had blood pressure measured after methoxyfl urane administration). Three (6%) patients had drop in consciousness level from GCS 15 to 14. Nine (17%) patients required additional analgesic therapy. Medical doctor was present on the fi eld in 15 (28%) cases. Conclusion: As described in international studies, methoxyfl urane is safe and well-tolerated analgesic therapy even without the presence of a medical doctor on the fi eld.
Keywords
methoxyfl urane; analgesia; emergency medical service
Hrčak ID:
236572
URI
Publication date:
16.3.2020.
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