The first patient I used Penthrox for had a fractured dislocation of her ankle, and was obviously in severe pain.
I administered the drug to the patient and for my first time using Penthrox I found that it was simple to assemble, and extremely easy for the patient to understand how to use correctly.
Within seconds we were able to both manipulate her badly deformed ankle, and plaster it, without her being aware that the procedure had been carried out until about a minute later!!
Well, amazingly, I used it a further three times the same day. All the patients had comminuted fracture dislocations of their ankles, they all had time critical skin, and all needed admission and subsequent ORIF. The instances of this occurring in just one shift is almost unheard of except during times of extreme weather conditions. Only one of the patients required additional analgesia to Penthrox and I can only report how much time, effort and manpower this saved, which is especially important in a busy ED.
Normal procedure would have been to transfer the patient to resus, (once you had managed to find space for the patient) apply capnography and monitoring equipment, assess – gain consent and then administer conscious sedation.
Then one would need to assemble a team of appropriate staff – One to maintain airway and direct observation of the patient, one to reduce the fracture/dislocation and one to provide counter traction and one to apply the POP and mould. The patient would then have to recover, continue to be monitored until sufficiently awake, and then wait for the porter to transport to X-ray.
There are obviously associated risks of sedation and airway control, as well as that of nausea and vomiting. Without exception, all the patients had their serious injuries attended to efficiently and effectively within minutes of arrival.
I was very impressed with the product – I feel it will be an invaluable alternative to our current practice that will benefit our patients suffering with moderate to severe pain following trauma injuries without question.
I prescribe Penthrox most days, both pre-hospital and in the Emergency Department. It’s my hand grenade for pain, enabling rapid relief whilst I arrange definitive care.
Within seconds we were able to manipulate her badly deformed ankle and plaster it, both without her being aware that the procedure had been carried out until about a minute later!
In quite a few cases, we have saved not just time, but also valuable resource, as the injuries have been able to be dealt with in the minor injury section, whereas some of these patients would have been needed to have been moved to majors/resus.
I have now adopted a Penthrox First approach for all my relevant trauma pain patients.
Penthrox reduced my patient’s pain score from 10/10 to 2/10 within one minute.