Record of Methoxyflurane Use

Methoxyflurane Use

Introduction
Methoxyflurane is a prescription-only pain-relieving medication, used by approved individuals under a standing order of the SLSNZ medical director.

AUTHORISED MEMBERS DO NOT HAVE TO CONSULT BEFORE ADMINISTERING METHOXYFLURANE.

IF THERE ARE ANY QUESTIONS PLEASE CONTACT SURFCOM VIA 0800 SAVE LIFE.

It is a legal requirement that appropriate records be kept. Please complete this form for every patient that receives methoxyflurane.

This form (or the paper equivalent) must be completed to order replacement vials orders@surflifesaving.org.nz.

A ‘SLSNZ Incident Report Form’ must be completed via the Patrol App and Methoxyflurane must be ticket in the First Aid section.

Any non-urgent questions please contact:

Sam Blackmore - SLSNZ National Lifesaving Development Officer

sam.blackmore@surflifesaving.org.nz

Question Title

* 1. By filling out the information below, I confirm that I hold a current authorisation to use methoxyflurane under the SLSNZ Medical Director.

First Name *

Surname

Email Address *