Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2026
Inhaled methoxyflurane for fracture reduction in prehospital extremity trauma: an observational review of HEMS clinical practice.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrehospital manipulation and reduction (M&R) of traumatic limb injuries may be required before transfer to restore alignment, reduce pain and bleeding, and limit secondary neurovascular compromise. In many systems this requires intravenous procedural sedation, which is resource-intensive and not universally available. Inhaled methoxyflurane (IMF) is a portable, self-administered analgesic used within UK HEMS, but its utility as the primary agent for prehospital M&R is not well described.
methodsWe performed a retrospective observational review of trauma patients attended by East Anglian Air Ambulance (1 January 2019 to 31 May 2023) who received IMF to facilitate prehospital M&R of an acute limb injury. The primary outcome was successful M&R using IMF without escalation to intravenous procedural sedation; failure was inability to reduce and/or subsequent intravenous procedural sedation. Multivariable logistic regression explored associations between success and age, sex, year, pre-reduction analgesia, and anatomical site. Data are reported as n (%), median [interquartile range], and adjusted odds ratios (aOR) with 95% confidence intervals (95% CI); analyses were performed in R.
resultsOf 7765 patients attended, 788 received IMF and 309 met inclusion criteria. Median age was 48 [27-67] years and 160/309 (51.8%) were male. Successful M&R was achieved with IMF in 168/309 cases (54.4%); 127/141 (90.1%) failures required intravenous sedation. Increasing age (aOR 1.03 per year; 95% CI 1.02-1.05), prior opioid alone (aOR 2.50; 1.25-5.11) or opioid with paracetamol (aOR 2.19; 1.16-4.18), and patella injuries (aOR 30.12; 5.51-564.57) were independently associated with success, while femoral and tibia/fibula injuries had lower odds of success. No clinically important adverse events were recorded.
conclusionsIn this observational HEMS cohort selected for a trial of IMF, just over half of patients with acute traumatic limb injuries underwent prehospital manipulation and reduction without escalation to intravenous procedural sedation. Older age, pre-reduction analgesia, and patella injury were associated with success, but these findings are non-causal and should be interpreted cautiously.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.