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Wed Jun 14 13:09:37 BST 2006

Congrats on your progress.  We have finished all House Deligates business except ref cmttee E. Which I am on the Tex Delig group.  It has 45 items.  It could be a long morning.    Our flu vaccine resolution is on E cmttee.    As is direct consumer advertising and aninal research appeal of AMA pollicy.  It will not be reversed, but CRM might want to hear themselves talk a while.   

K

Sent via BlackBerry, return via KMattox at aol.com

-----Original Message-----
From: Krin135 at aol.com
Date: Wed, 14 Jun 2006 06:45:22 
To:trauma-list at trauma.org
Subject: Re: Protocols

In a message dated 14-Jun-06 02:17:47 Central Daylight Time,  
Lorick at Lorick.org writes:

At one  point (many years ago), using nitrous for pre-hospital analgesia was 
felt to  be a great idea.
Almost immediately reversible, rapidly effective, with  minimal 
cardiovascular effect and using FiO2 of .50 via demand valve
I have  actually never been sure why it didn't catch on, except for the 
problems  controlling it...
I have never heard anyone who had the chance to use it in  the field say 
anything but positive things about it, but it never became  widespread.

Maybe our OZ folks can chime in here, as I believe that  Entenox (50-50 mix 
of O2 and NO) has been used in the field there for some  time.

The problem that I can see is that Nitrous Oxide is  considered a moderately 
hazardous gas here in the US, and some sort of  scavenging or overboard 
disposal system may be mandated by local or state codes.  I know that many dental 
offices in Louisiana had to get a suction scavenging  system set up at a fair 
additional cost about 10 years ago. Considering how much  Nitrous could 
theoretically build up in the back of a type 1 or 3 box on a long  transport, and the 
potential effect on the medic, I'd be surprised if a mobile  unit would be 
exempt from similar requirements.

ck

Charles S. Krin, DO  FAAFP

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