Reader Feedback: December

Nitrox vs. Nitrous Oxide

I read with great interest the article regarding prehospital use of nitrous oxide [“Nitrous Oxide as a Prehospital Analgesic"]. However, the author consistently refers to nitrous oxide as nitrox. Nitrox is generally understood to be a 50/50 blend of nitrogen and oxygen, the gas used by scuba divers to breathe underwater—a completely different gas. After more than a decade in various prehospital and inpatient settings, I can tell you with confidence I have never heard anyone call nitrous oxide “nitrox.” This oversight made the article lose a lot of credibility for me.

—Ryan Sexton

Do We Really Need AEMTs?

I enjoyed your article on practices that should/may be obsolete [“Another Angle: Not Helpful, Possibly Harmful”]. After 30-plus years on and off again in EMS, I have seen many practices come and go and sometimes come back. I am old enough that when watching Johnny and Roy apply rotating tourniquets, I was the only one in the group who knew what it was for. I do not agree with intermediate-level providers (EMT-I, AEMT, etc.) being on the “obsolete” list.

I am an AEMT. I was a paramedic a long time ago; I volunteer in a rural community and simply maintain the AEMT now. The cost of becoming a paramedic has been rising. Thirty years ago it was nearly free. Now it’s $15,000 or more and requires a lot of time, which makes for a well-trained prehospital provider but is a hard hurdle to jump. At the same time the bulk of calls, at least those I see, are BLS or “light” ALS. A quick IV, some D50, Narcan (titrated to breathing), fluid, and a breathing treatment go a long way to help the majority of patients as we transport.

Because of the wide assortment of patients who can be helped with simple AEMT skills, it’s worthwhile for many communities to keep that level around. I could potentially see the argument that we should make it cheaper and easier to train paramedics, then ultimately drop the AEMT.

—Brian Mason, NRAEMT, MSCS

Expo in the Big Easy

As a resident of Louisiana and a former chief of this great city, I sincerely appreciate your openness in considering New Orleans as a host city for such a prestigious event. [EMS World Expo] provided a tremendous opportunity for not only New Orleans but the entire southeast region. The proximity of the event allows professionals who may not otherwise have the financial means a closer travel location to help advance themselves both personally and professionally. For this, I cannot say thank you enough. In speaking with Dr. [Jeffrey] Elder, we both realized this was the first conference in our city we were actually able to enjoy, as we weren’t being pulled in different directions. Thank you for the opportunity in allowing me to bring my knowledge and experience to others.

—Carl Flores