Methoxyflurane Use and Pregnancy
Question# 868
With the current Methoxyflurane trial in some jurisdictions, there seems to be a lack of information regarding safety of paramedics with regarding to inhaling patient's exhaled medication. Particularly with regards to pregnant paramedics, as pregnancy is a contraindication for the patient themselves. Is there any information available about the risk to pregnant paramedics who are attending to patient's using Methoxyflurane? Since patients don't seem to understand they are meant to breathe back into the tube so the carbon filter can collect their expired medication... Note: this med was delivered with paramedic using N95 mask but is awaiting a new fit test.
Answer:
The key message is that the risk to pregnant paramedics from exposure to Methoxyflurane, even in cases of patient noncompliance, is extremely low and should not cause undue concern. The overall likelihood of harmful exposure is minimal, particularly in well-ventilated environments like ambulances.
Given the current Methoxyflurane trial in certain jurisdictions, there is understandably some concern regarding the safety of paramedics, particularly those who are pregnant, when exposed to inhaled exhaled medication from patients. While pregnancy is a contraindication for Methoxyflurane use in patients themselves, there is limited data regarding the potential risks to pregnant paramedics in these situations.
At present, pregnant paramedics are advised not to participate in the Methoxyflurane trial due to the absence of specific safety data regarding exposure during pregnancy, even though the levels of exposure under ideal conditions with proper ventilation are considered extremely low. N95 masks, while effective in filtering particles like viruses and bacteria, do not offer protection against Methoxyflurane inhalation and should not be relied upon as a safeguard in this context.
It is important that patients are educated on the correct use of the inhaler, specifically the importance of breathing in and out through the device so that the carbon filter can effectively capture their exhaled medication. However, in the event that a patient does not consistently breathe in and out through the inhaler as instructed, it is important to note that the risk of exposure to paramedics remains very low, particularly when ambulance ventilation systems are on.
Further guidance on the safety of Methoxyflurane use for pregnant paramedics will ultimately be determined by provincial occupational health authorities, who will assess the available evidence to ensure that paramedic safety is not compromised. It is also worth noting that paramedics have access to other highly effective pain management options, ensuring that patient care remains uninterrupted and safe.
Given the current Methoxyflurane trial in certain jurisdictions, there is understandably some concern regarding the safety of paramedics, particularly those who are pregnant, when exposed to inhaled exhaled medication from patients. While pregnancy is a contraindication for Methoxyflurane use in patients themselves, there is limited data regarding the potential risks to pregnant paramedics in these situations.
At present, pregnant paramedics are advised not to participate in the Methoxyflurane trial due to the absence of specific safety data regarding exposure during pregnancy, even though the levels of exposure under ideal conditions with proper ventilation are considered extremely low. N95 masks, while effective in filtering particles like viruses and bacteria, do not offer protection against Methoxyflurane inhalation and should not be relied upon as a safeguard in this context.
It is important that patients are educated on the correct use of the inhaler, specifically the importance of breathing in and out through the device so that the carbon filter can effectively capture their exhaled medication. However, in the event that a patient does not consistently breathe in and out through the inhaler as instructed, it is important to note that the risk of exposure to paramedics remains very low, particularly when ambulance ventilation systems are on.
Further guidance on the safety of Methoxyflurane use for pregnant paramedics will ultimately be determined by provincial occupational health authorities, who will assess the available evidence to ensure that paramedic safety is not compromised. It is also worth noting that paramedics have access to other highly effective pain management options, ensuring that patient care remains uninterrupted and safe.
References
Austin M.A., Mao, S., Marchand, J., MacLeod, J., & Cantor, Z. (2025). Prehospital Inhaled Methoxyflurane Non-Clinical Occupational Exposure Study. (Presented by Dr. Michael Austin as an oral presentation at the National Association of EMS Physicians 2025 Annual Meeting).