Author: Michael Connelly, Celestine Weegenaar, Aled Donaldson, Stephanie Milne / Editor: Rajesh Chatha, Robert Hirst / Codes: PC1, SLO10 / Published: 24/08/2021

At TERN Education we are keen to help you all learn how to critically evaluate the evidence behind your practice. In order to do this, we have been producing monthly Virtual Journal Club (VJC) modules on RCEMLearning since March 2021.

From August 2021, a different deanery will create and contribute to the virtual journal club each month. The Severn deanery in the South-West of England have had the honour of creating the first regional edition. Our team was made up of emergency medicine trainees from all training grades.

The VJC gives you the opportunity to critically consider your practice and earn a certificate which demonstrates the new curriculum requirement to engage in critical appraisal activity. When you finish, click the link to the forum to discuss this month’s paper with colleagues around the country.

Interested in writing a module? We are looking to recruit regional teams to write future modules. Email us at tern.education@rcem.ac.uk.

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References

  1. Mazze RI, Shue GL, Jackson SH. Renal Dysfunction Associated With Methoxyflurane Anesthesia: A Randomized, Prospective Clinical Evaluation. JAMA. 1971;216(2):278–288.
  2. Dayan AD. Analgesic use of inhaled methoxyflurane: Evaluation of its potential nephrotoxicity. Hum Exp Toxicol. 2016;35(1):91-100. doi:10.1177/0960327115578743
  3. Grindlay J, Babl FE. Review article: Efficacy and safety of methoxyflurane analgesia in the emergency department and prehospital setting. Emerg Med Australas. 2009;21(1):4-11. doi:10.1111/j.1742-6723.2009.01153
  4. Coffey F, Dissmann P, Mirza K, Lomax M. Methoxyflurane Analgesia in Adult Patients in the Emergency Department: A Subgroup Analysis of a Randomized, Double-blind, Placebo-controlled Study (STOP!). Adv Ther. 2016;33(11):2012-2031.
  5. Serra S, Voza A, Ruggiano G, et al. Efficacy, Practicality, and Safety of Inhaled Methoxyflurane in Elderly Patients with Acute Trauma Pain: Subgroup Analysis of a Randomized, Controlled, Multicenter, Open-Label Trial (MEDITA). J Pain Res. 2020;13:1777-1784. Published 2020 Jul 16.
  6. Fabbri A, Borobia AM, Ricard-Hibon A, et al. Low-Dose Methoxyflurane versus Standard of Care Analgesics for Emergency Trauma Pain: A Systematic Review and Meta-Analysis of Pooled Data. J Pain Res. 2021;14:93-105. Published 2021 Jan 20. doi:10.2147/JPR.S292521
  7. Marinangeli F, Reggiardo G, Sblendido A, et al. Prospective, Multicentre Trial of Methoxyflurane for Acute Trauma-Related Pain in Helicopter Emergency Medical Systems and Hostile Environments: METEORA Protocol. Advances in Therapy. 2018 Nov;35(11):2081-2092.
  8. Hartshorn, S., Barrett, M.J., Lyttle, M.D. et al. Inhaled methoxyflurane (Penthrox®) versus placebo for injury-associated analgesia in children—the MAGPIE trial (MEOF-002): study protocol for a randomised controlled trial. Trials 20, 393 (2019).
  9. Kubica A, Kosobucka A, Niezgoda P, et al. ANalgesic Efficacy and safety of MOrphiNe versus methoxyflurane in patients with acute myocardial infarction: the rationale and design of the ANEMON-SIRIO 3 study: a multicentre, open-label, phase II, randomised clinical trial. BMJ Open. 2021;11(3):e043330. Published 2021 Mar 1. doi:10.1136/bmjopen-2020-043330
  10. Allison SJ, Docherty PD, Pons D, Chase JG. Methoxyflurane toxicity: historical determination and lessons for modern patient and occupational exposure. N Z Med J. 2021;134(1534):76-90. Published 2021 Apr 30.
  11. Frangos J, Mikkonen A, Down C. Derivation of an occupational exposure limit for an inhalation analgesic methoxyflurane (Penthrox(®)). Regul Toxicol Pharmacol. 2016 Oct;80:210-25.
  12. Frangos, John et al. Non-interventional study evaluating exposure to inhaled, low-dose methoxyflurane experienced by hospital emergency department personnel in France. BMJ open vol. 10,2 e034647. 10 Feb. 2020.
  13. Allison, Serah Joan et al. Serum fluoride levels in ambulance staff after commencement of methoxyflurane administration compared to meta-analysis results for the general public. International journal of occupational medicine and environmental health, 134196. 1 Jun. 2021.
  14. Borobia, Alberto M et al. Inhaled Methoxyflurane Provides Greater Analgesia and Faster Onset of Action Versus Standard Analgesia in Patients With Trauma Pain: InMEDIATE: A Randomized Controlled Trial in Emergency Departments. Annals of emergency medicine vol. 75,3 (2020): 315-328. doi:10.1016/j.annemergmed.2019.07.028
  15. Data Science Blog, Testing independence: Chi Squared vs Fisher’s exact Test. [Accessed 30th July 2021]
  16. Public Health Columbia Time to Event Data analysis. [Accessed 30th July 2021]
  17. Twisk JWR, Smidt N, de Vente W. Applied analysis of recurrent events: a practical overview. Journal of Epidemiology & Community Health 2005;59:706-710.

Module Content