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Fully agreed with all the above - it is early days to make any statements with certainty. The most we can say at this point is that Omicron *may* be less likely to cause severe illness but it is early days to be emphatic. And vaccination is still the smart choice.

Seems like it’s plausibly less likely to cause hospitalization under some control conditions(see, for e.g.: https://www.medrxiv.org/content/10.1101/2021.12.21.21268116v1) “When compared to non-SGTF infections, we found that SGTF infections had an 80% lower odds being admitted to hospital, but...

Municipal retirement?

Other use cases — reactive airway disease, croup, bronchiolitis, adrenal crisis/adrenal insufficiency

The answer to most of those is - we do not but we ought to. My normative view is that people should bear financial consequences for behavior that you reference. Smoking is actually a great example, cigarettes are heavily taxed and that tax revenue helps pay for, among other things, care for the...

Agree with the two caveats: (1) they need to bear the full financial burden (2) they can’t impose any externalities on others (spreading) #2 is where infectious disease necessarily differs from other conditions.

Seems like it can’t hurt? I had always been told that steroids are beneficial but outside of the prehospital timeline - so maybe they’d help by the time the patient is hanging out in the ED or up on the floor.

AAAI seems to be lukewarm at best on corticosteroid admin, they’re adjunctive but not great evidence supporting use. See, for example: https://www.aaaai.org/allergist-resources/ask-the-expert/answers/old-ask-the-experts/corticosteroids-anaphylaxis and...

Known or possible exposure? BP normal? Any GI symptoms? Assuming that the patient is having no other issues than urticaria and hives, I would say no. But if there’s GI upset, low BP, and/or respiratory symptoms, then yes. This does not appear to meet AAAI’s criteria for anaphylaxis. (See...

We definitely will have PowerLoad - it's a nonstarter in our agency to not have it. One problem we do have is overstocking - I am also interested in pushing for soft storage but we shall see if that is viable.

It’s usually mentioned (in the protocols I have read and textbook references). A lot of the use cases cite isolated extremity and soft tissue trauma. For example, see VT protocols

Fair point on that. VT has some recommendations: https://www.healthvermont.gov/sites/default/files/Nitrous%20Start%20Up%20Guide%2017-05-30%20rev.pdf Or maybe Penthrox? I think they have approved it recently in the US?

I will say I have read a lot of state and regional protocols and I see nitrous offered less often than I would like. It really ought to be an EMT-level skill as it is.

Solving for better drivers is definitely a challenge. I was looking to push for 4x4 drivetrain for getting unstuck and shorter boxes for ease of maneuver.

Beyond the standard KKK-1822F requirements, are there any specific safety features you'd expect to see in a vehicle? I'm thinking about things like 360-degree external cameras, internal cameras, external rub rail lighting, four-point restraints. Anything critical you'd like to see?

While I agree with the general point, I do question whether we are fully accounting for the other capabilities that paramedics bring. Obviously, there is opportunity to extend more capabilities further down the "clinical ladder" (Nitronox, anybody?), but pain control, sedation, etc. have...

Doing something more is better, all else equal. There's ample research out there showing that procedural success and outcomes are associated with volume per provider - and more medics means fewer procedures (all else equal) per ALS provider. (For example, a study in Australia found that "OHCA...

Not saying I disagree with the conclusions but I do have methodological questions, which really just means we need to be doing research at a better level of evidence (RCTs?). Some of the feedback - seems like mainly physicians? - was what I was referencing...

This study was panned but I think it picks up on a broad truth that there is a paucity of evidence in favor of widespread ALS for survival & morbidity outcomes. OPALS is still the best we’ve got (I am inclined to believe, anyway). If you include other metrics like pain control, etc. which do...

All good points above. I am pushing for Type IIs and fighting a losing battle. I also would be amenable to shorter 140”, 150” type IIIs