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Penthrox between Paramedic Services
Question# 966
Hi,
It has already been clarified that an ACP (regardless of service) who provided narcotics for pain management can hand off that patient to a PCP crew regardless of service.
With deployment plans changing, and the opportunity to hand-over patient care to a different service (ie: Renfrew in West Ottawa hands care over to the Ottawa crew), if the patient has been treated with a study drug (penthrox), can they hand-over the patient to the Ottawa Crew?
Has everyone in the region been educated on the medication?
It has already been clarified that an ACP (regardless of service) who provided narcotics for pain management can hand off that patient to a PCP crew regardless of service.
With deployment plans changing, and the opportunity to hand-over patient care to a different service (ie: Renfrew in West Ottawa hands care over to the Ottawa crew), if the patient has been treated with a study drug (penthrox), can they hand-over the patient to the Ottawa Crew?
Has everyone in the region been educated on the medication?
Answer:
For clarity, not everyone in the RPPEO catchment area is trained in the use of Penthrox (methoxyflurane). Because of this, there are important considerations when transferring care in situations where a study drug has been administered.
If the patient is continuing to use Penthrox, even though the medication is self‑administered, the patient must remain in the care of the service trained and authorized to use it. This means that once you enter another service area, you would retain care until handover at the receiving hospital.
However, another safe and appropriate option is to discontinue Penthrox prior to transfer, provided the patient no longer requires it. In this case, you may transfer care to the other paramedic service crew with a thorough and complete handover, including:
All paramedics within the RPPEO are trained and authorized in other pain‑management options and can transition the patient to alternate analgesia if necessary. It is a shared professional responsibility to consult with the other paramedic service crew and determine if they are trained and comfortable to continue/assume patient care. It is also crucial to document this handover for quality purposes in the patient care journey.
The key distinction is this:
Continuing administration of a medication requires training and authorization, whereas monitoring a patient after the medication has worn off or been discontinued does not. This is similar to PCPs assuming care of a patient who has previously received narcotics from an ACP—monitoring is permitted, continued administration is not.
If the patient is continuing to use Penthrox, even though the medication is self‑administered, the patient must remain in the care of the service trained and authorized to use it. This means that once you enter another service area, you would retain care until handover at the receiving hospital.
However, another safe and appropriate option is to discontinue Penthrox prior to transfer, provided the patient no longer requires it. In this case, you may transfer care to the other paramedic service crew with a thorough and complete handover, including:
- Total dosing given
- Vital signs and pain scores pre‑ and post‑administration
- Patient response to the medication
- Any adverse effects observed
All paramedics within the RPPEO are trained and authorized in other pain‑management options and can transition the patient to alternate analgesia if necessary. It is a shared professional responsibility to consult with the other paramedic service crew and determine if they are trained and comfortable to continue/assume patient care. It is also crucial to document this handover for quality purposes in the patient care journey.
The key distinction is this:
Continuing administration of a medication requires training and authorization, whereas monitoring a patient after the medication has worn off or been discontinued does not. This is similar to PCPs assuming care of a patient who has previously received narcotics from an ACP—monitoring is permitted, continued administration is not.