Penthrox: Raising the Standard of Pain Relief at Events

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Pain is one of the most common reasons people visit an event medical centre, and one of the hardest things to manage well outside hospital.

Penthrox® is an inhaled pain relief used for moderate to severe acute pain, particularly following injury. It works quickly, doesn’t require injections or IV access, and allows patients to control their own pain relief by breathing it in as needed.

As an Victoria Department of Health Licensed Intermediate First Aid Service provider, Emergency Medical Response  carry Penthrox out across our entire frontline team, with full training, competency assessment, and clinical governance in place.

It is stocked in:
• All response bags
• All vehicles
• All on-site medical centres

Because at events, injuries such as fractures, dislocations and significant soft-tissue injuries don’t always happen neatly next to a treatment room. Effective pain relief early on scene can reduce distress, improve cooperation, and make treatment and movement safer for everyone involved.

In Victoria, options for managing acute pain in pre-hospital and event settings are often very limited when using your own volunteer First Aiders. Penthrox fills an important gap, providing fast, effective analgesia with a Licensed First Aid Service Provider while avoiding unnecessary escalation or hospital conveyance for pain alone.

This is what good event medicine looks like: 

• Treating pain, not just injuries
• Supporting dignity and comfort
• Investing in training and governance, not shortcuts
• Giving our team the confidence to act appropriately

It’s not about over-medicalising events.
It’s about really caring properly for people when they’re hurt.

This is another quiet example of how we continue to raise the standard of care at every event we cover.

In Australia, Penthrox® is inhaled via an inhalation device (green whistle as shown above). Each inhaler device comes with a 3 mL bottle of methoxyflurane, which is poured into the base of the inhaler, as well as an activated carbon (AC) chamber that is attached to the top of the inhaler at the dilutor hole.

Once the device is assembled, the patient can then inhale methoxyflurane from the mouthpiece. To minimize exposure of individuals in the surrounding environment to methoxyflurane, patients are instructed to exhale into the inhaler. The exhaled vapor passes through the AC chamber, allowing for adsorption of exhaled methoxyflurane. To provide a stronger dose of methoxyflurane with each inhalation, patients can cover the dilutor hole on the top of the AC chamber with their fingers.

The estimated concentration of methoxyflurane provided with each inhalation is 0.2-0.4% with the dilutor hole uncovered and 0.5-0.7% when the dilutor hole is covered. Approximately 6-10 initial breaths are needed to initiate adequate analgesia. 

The Penthrox® inhaler can be used continuously for up to 25-30 minutes and, if needed, a second 3 mL inhaler can be utilized to provide ongoing analgesia for up to 54 minutes.  If used intermittently, a single inhaler may provide up to 1 hour of analgesia. The maximum recommended daily and weekly doses of methoxyflurane are 6 mL and 15 mL, respectively.