It's time to blow the Whistle

We've all had these patients. Elderly...fell...likely hip fracture...in severe pain. Young...sports injury...shoulder dislocation...in severe pain. You feel bad watching them suffer, but as a BLS provider there's not much you can do. As a medic, you need an IV first. Your patient needs an intervention and every movement or bump in the road hurts. Rapid pain management should be one of our top priorities as EMS providers, but in some states, BLS providers can't even provide Tylenol to their patients. WTF!

Inhaled nitrous (laughing gas) is approved in rare locales, but some fear the abuse potential and logistics for storage and maintenance is considered a hassle not worth the effort. Enter "The Green Whistle" (aka Penthorax, aka methoxyflurane). It provides a "subanesthetic" dose of immediate pain relief, which hasn't shown any evidence of causing respiratory suppression. The main adverse effects, dizziness and headache! Compared to the severe pain from a fracture or dislocation, a little dizziness and headache are welcome friends.

Methoxyflurane is already used in many countries, including Canada since 2018, but is not yet approved for use in the US. At a cost of around $30 per dose, it begs the question, why?

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