Green tube med?

[Timmy]

Oppss the reference my bad…. It was EMSVillage.com which had the only research article on methoxyflurane I could find, not sure who wrote it.

Phill: I too see/use the drug on a regular bases. The article was written by Americans, I can only assume that EMS workers have written it, so when it states that Oz is more advanced than the U.S it’s coming from U.S people, not me. The article is generally referring to Australian health care as a whole, not by state.

I was only trying to be helpful and give some more info for people who don't know about the drug....

[Just Plain Ruff]

I agree, there was nothing inappropriate about cutting and pasting as many many here do the same.

Citing the source would have been nice but jeesh, I learned something.

As a standard, I don't ever think it's the poster's original work if they put a huge amount of information in a post. Unless the poster says it's their own work.

I have cut and pasted stuff here too and have never been chastised like Timmy was.

And Phil, no offense intended but maybe you didn't need all that information but I for one found it very informative and I am glad he posted it. The fact that you knew this information doesn't negate the fact that many others probably learned from his post.

First cast no stones

[aussiephil]

The article was written by Americans, I can only assume that EMS workers have written it, so when it states that Oz is more advanced than the U.S it’s coming from U.S people, not me. The article is generally referring to Australian health care as a whole, not by state.

Timmy, this is where the problem lies. The way i read this is that it was written by you & there was nothing to indicate otherwise.

Ruffems, it is important to reference, that way, should someone decide to challenge, it ensures you have not made a fool of yourself & people do not mistake the work & quotes as your own. That is a basic of any report writing. I would also prefer to see that the information provided is more accurate that a cut & paste like this was. I respect the american system,but, when a report is posted (unreferenced) & bases its findings on severely limited information, i think there is some degree of irresponsibility on the person posting. To me it also says the person posting has not read properly, or does not fully understand what was written as there are no comments added by timmy, in this case.

My concern with this is that they have based their opinions of the word of 4 people, one is a student whom i presume has very limited experience. While I have extensive use with this drug, it is NOT the primary drug of choice & has limited applications not listed here.

For example, unlike entonox, Pentrane/Penthrox/Methoxyflurane requires the patient to hold the application device. This is great with patients over approx 9 through to middle ae, however it can be a problem with the elderly.

Due to the rapid washout, history taking becomes a very drawn out affair as the pt must keep breathing the drug to ensure maximum effect.

In NSW (yes Timmy, I will only speak for the service I work for) we are prohibited from attaching O2 to the inhaler due to the concern of droplet inhalation & also, as we have areas of extreme heat, he concern for flash fires in the cars as the flash point is greatly lowered with the addition od O2. This severely limits its usage for patients with cardiac chest pain. (What is more important the delivery of high flow O2, or the administration of inhalation pain relief?)

The nephrotoxic effects are not fully addressed & there have been studies on these effects, not on patients, but on the officers administering the drug & we, in NSW are limited to administering a maximum of 6ml per day.

What Timmy also failed to advise is that many services across Australia are now embracing the use of Fentanyl as it is accepted that IV Morphine is the Gold Standard, there are other Opiate options, administered in other ways that can be more effective & less reliant on patient complicity. Fentanyl intra nasal is that method. It is non invasive -requiring no IV access, does not require the patient to hold something & is fast acting. It also has the advantage, like Penthrox of being short acting, but dose not have Dosage restrictions, like Penthrox.

While Penthrox is a good drug to have in the kit & works very well in conjunction with IV Morphine, & Itra Nasal Fentanyl, I no longer consider it as a first choice drug, but a back up.

The opinion that is expressed by the author (not Timmy)

After corresponding with an Australian first responder, a ER nurse, a physician medical director and a paramedic, we were pleasantly surprised to learn that the Australian emergency medical / prehospital care systems accepted standard of care for emergencies includes a humane and aggressive approach to the relief of pain. In fact, Australia is way ahead of the U.S. in their philosophy about prehospital pain control. Among the agents available to "ambos" (a term used to describe EMS workers), on standing orders, are the Penthrox Inhaler, Entonox and intravenous morphine. Even basic level providers in most systems can use the Penthrox Inhaler to help suffering patients.

is not necessarily correct. The criticism here is only on pain management, not the overall systems, which I have discussed elsewhere.

I hope this explains why i was not happy with the post Timmy originally left. I will accept criticism, however I will not when the information provided is lacking & not credited appropriately. I also am offended when a person appears to be speaking with authority about when it is not necessarily the case.

[DwayneEMTP]

aussiephil. fair enough...I believed your issue was with cutting and pasting in general. You make very valid points, thanks.

Dwayne

[zippyRN]

as we are on a bit of an inhaled analgesia tip

nitrous oxide is available pre mixed with O2 50/50 in the Uk under the brand names entonox (boc) and equanox (linde medical gas), the BOC offering includes CD ( carbon wrap ) cylinders which are increasingly usedinstead of D size in portable applications for both Entonox and oxygen

ought really to add that both Oxygen and entonox adminstration are add on roles for first aiders, so entonox is in use by all sectors of the UK ambulance business

[Timmy]

Well I guess I sort of thought that this sentence might have given it away After the "Survivor" show EMSvillage.com staff was inundated with questions about this mystery drug. So we decided to get the scoop on pain control "down under."

I found out (just for you guys) that the article was written by Colleen M Hayes, MBA, RN, EMT-P. So I congratulate Colleen on taking the time on a job well researched.

[aussiephil]

Timmy,

while u make that assumption, u still need to reference properly.

This also does not answer the lack of relevant information that was supplied. That is more pertinent & relevant.

If u want to quote it, it is up to you to make sure it is right.

check the facts, ask others, don't assume because Colleen M Hayes, MBA, RN, EMT-P has researched it, it is complete, look at the info i provided, & u will see it was lacking in a number of areas.

The reason i wanted to know the author is to challenge her findings & ask why it is an incomplete report?

If u have so much admiration for her

I congratulate Colleen on taking the time on a job well researched.

maybe you could ask for me.

Remember Timmy, the tobacco companies, asbestos companies & others had 'eminent experts' telling us their products were safe & in the case of tobacco, even healthy for us.

This is one report. Look at it properly, then make the same judgement.

[akflightmedic]

Phil,

Why do you have such a hard on for Timmy?

First of all, he cut and pasted an article that provided a lot of information many of us here in the US were unaware of. I learned a lot from the article.

I already encouraged him to be sure to cite sources next time, he fixed that with no complaints.

The article provided plenty of iinformation that was both relevant and informative. It is up to us, the readers to learn more and delve deeper if we so choose and if the subject so interests us.

Timmy was not submitting a term paper so there was no need to provide any more info than what he did. He found something of interest and shared it with us. If you are so inclined, go read more about it yourself(you meaning those unfamiliar with it).

Timmy did what I myself have done many times as well as several other respected members here. We see an article of interest, we cut and paste to share the knowledge just in case you do not travel the same sites as we do.

I have pasted many a topic here with no input of my own, simply the article and thats it. That is how you get a discussion going sometimes, it does not always require input froom the person sharing.

Then you bust his chops for telling her job well done. What is wrong with that?

I would have done the same. The information there and the way it is written and presented shows she put time and effort into it. Again she was writing a brief overview to explain the drug for those of us unfamiliar with it. For a more detailed educational experience, again I say it is up to US the reader to take that intiative and go seek the info ourselves by consulting those more familiar and experienced with the drug..someone such as ...yourself Aussiephil.

Geez, give the kid a break, he did nothing wrong here and I certainly do not wish to discourage him from posting in the future.

[DwayneEMTP]

Well I guess I sort of thought that this sentence might have given it away After the "Survivor" show EMSvillage.com staff was inundated with questions about this mystery drug. So we decided to get the scoop on pain control "down under."

I found out (just for you guys) that the article was written by Colleen M Hayes, MBA, RN, EMT-P. So I congratulate Colleen on taking the time on a job well researched.

Timmy,

It's important that you understand that this is not just an 'ooops' in general terms. It's an issue that can define your character.

Claiming someone else's work as your own (which I absolutely do not believe you did) show a complete lack of character. I would never again associate with someone that did this, there is just no point, as they have proven to be a thief and a liar all in one fell swoop. Not only do you not want to do it, you don't want to allow the appearance of having done it...be careful.

Using someone elses work, though not claiming it as yours, without giving them credit is hugely disrespectful. Take the time to find out who's work it is...every time! If I couldn't site the source I wouldn't use their work, with few exceptions. (There are times I have used a funny quote found floating around the internet without an authors reference. If I couldn't find them through a search I would put "author unknown" to make it clear I am not claiming it as my own thought)

You show promise for creating many bright new thoughts of your own, don't allow the waters to become cloudy with doubt as to their origin.

Timmy, your contribution with this article is great!! I'm not trying to bust your chops...I just thought this info might help you in the future.

aussiephil, what's up with chastising Timmy with a post that looks like a text message?

Dwayne

[Doctor Death]

Phil, lets keep in mind that Timmy is 17, he is in year 11, he’s doing English, he hasn’t even completed his last year of school, what makes you think that he would even know how to reference? Things have changed a lot since you and I left school.

While I do agree that this report may be a little on the ill informed/not enough information side, I think Timmy has done a great job digging up this information for your reading pleasure and information.

Instead of criticizing the poor kid, why not help him; tell him what a reference is and when to use one. Don’t say that the information is not relevant, put forward your ideas and experiences on top of what Timmy cut and pasted. Please also tell us what part of the information is not to your satisfaction, this can be miss leading to some readers when you just say that some information is not relevant or incomplete.

While it is true that you should always reference other peoples work, I think Timmy will learn from this mistake as I have read over some of his posts and have found that he has taken every single bit of advice that someone offered and has used it to benefit his next post.

My opinion of Methoxy is it should be the choice of drug to be used in Pre Hospital care. Morphine is a very strong drug and carries much complication which I’m sure you’re fully aware of. To many times I’ve seen paramedics wake in morphine when it was totally unnecessary. If you can use basic analgesics all the better, I don’t like putting patients though invasive procedures when they don’t need it.