This website is intended for healthcare professionals only.

Hospital Healthcare Europe
Hospital Pharmacy Europe     Newsletter          

Transforming the management of emergency pain relief in the UK

Galen Ltd has announced that the Joint Royal Colleges Ambulance Liaison Committee (JRCALC) has issued its new pain management clinical practice guidelines for UK ambulance services teams.

Under the ‘management of adults in chronic pain’, the JRCALC guidelines now recommend the use of inhaled pain relief medication, Penthrox® (methoxyflurane) for adults with injuries causing moderate to severe pain.1 The JRCALC guidelines provide a comprehensive and co-ordinated approach to how patients receive optimal care in the pre-hospital setting.

The JRCALC guidelines have been updated to reflect the progression in clinical practice, providing UK ambulance services with the most up-to-date clinical advice and treatment options for patients. The inclusion of Penthrox for moderate to severe pain management provides a useful treatment option for improved patient care in an emergency setting” explained the author of this section, Dr Bob Winter, Medical Director at East Midlands Ambulance Service and Member of JRCALC Main Committee.
Commenting on his personal experience using Penthrox® in the North West of England, Tim Byrom, Advanced Paramedic with the North West Hazardous Area Response Team explained “Our trust is currently evaluating the use of Penthrox for the management of acute moderate to severe traumatic pain. Whilst this evaluation is still ongoing the results so far are positive, with good analgesic effects demonstrated. It has been shown to be particularly beneficial in difficult to access incidents such as incidents at height.”
The East of England Ambulance Service, is currently in the process of adopting Penthrox®. “We are interested in adopting Penthrox for our trust as it provides another pain relief option for our paramedics and could potentially reduce the use of opioids and cannulation when manging a patient in moderate to severe pain. We are pleased to see the inclusion of Penthrox on the JRCALC guidelines as this provides a greenlight for other ambulance services in the UK to move forward with adoption of Penthrox”, explained Tom Davies, Medical Director, East of England Ambulance Service.
Earlier in 2017, Penthrox® was included on the PHECC guidelines2-4 in the Republic of Ireland. Following the update, the use of Penthrox® has been adopted by both their national ambulance service and most of the major private ambulance providers in the Republic of Ireland.
Galen’s Managing Director, David Bennett, commented “We welcome the inclusion of Penthrox on the JRCALC guidelines and are delighted that it is now confirmed as an option for effective pain management. This is a timely inclusion, as it follows the addition of Penthrox to the pre-hospital emergency care council (PHECC) guidelines in Ireland earlier this year. We are hopeful that the updated JRCALC guidelines will provide a confidence boost to the remaining UK ambulance services and pre-hospital teams yet to adopt Penthrox to do so and we look forward to continuing to work with emergency response teams across the UK to provide optimal patient care.”


  1. Joint Royal Colleges Ambulance Liaison Committee (JRCALC), Clinical Practice Supplementary Guidelines 2017,… (accessed September 2017)
  2. Pre-Hospital Emergency Care Council, Clinical Practice Guidelines, Advanced Paramedics, 2017, 6th edition. (accessed September 2017)
  3. Pre-Hospital Emergency Care Council, Clinical Practice Guidelines, Paramedics, 2017, 6th edition. (accessed September 2017)
  4. Pre-Hospital Emergency Care Council, Clinical Practice Guidelines, Emergency Medical Technician, 2017, 6th edition: (accessed September 2017) Summary of Product Characteristics, Penthrox®:� (accessed September 2017)