Anecdotes dominate AP’s story on EMTs using nitrous oxide for pain relief

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story touches on costs, saying:

Stowe, a largely volunteer squad, is adding a unit to a second ambulance this fall at a cost of about $3,800, plus costs for disposable supplies and some cleaning agents, as well as the nitrous cylinders, which cost about $14 to refill. Brinkman estimates the drug costs less than $10 per use once the equipment is purchased.  

It’s not exactly clear what the consumer cost would be, but readers can infer that it’s likely to be inexpensive.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story sufficiently explains the potential harms of the drug:

Not all is rosy. Nitrous oxide in and of itself has the potential to be used as a recreational drug and can be misused by providers and patients, or can be stolen for personal use or sale on the street, according to the American Ambulance Association.

And while it has its advantages, nitrous oxide also can cause nausea, vomiting and light-headedness, which could cause complications with some patients, said Dr. Edward Yaghmour, chairman of the American Society of Anesthesiologists’ Committee on Obstetric Anesthesia.

The gas cannot be used in patients with head injuries, or who have abdominal pain or pulmonary concerns.  

This is enough to be Satisfactory. But two major risks weren’t discussed adequately: Intermediate EMTs may not be able to recognize a patient with early or initial stages of shock. Giving nitrous to that patient could be disastrous and lead to death. There is also a problem with patients who have underlying lung disease and who need extra oxygen. Giving nitrous is usually a 70% nitrous to 30% oxygen, which may not be enough oxygen for some patients with heart or lung diseases.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

We would have liked to have seen more scientific expertise tapped for this piece, but we give the story credit for talking with a wide range of sources. We did not detect any potential conflicts of interest.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story makes it clear that nitrous oxide is currently available in 30 states. It would be hard to quantify, of course, just how frequently it is actually used in ambulance runs. But the story does not overstep to indicate that it is a rapidly rising trend. The story says:

Nitrous oxide equipment has been sold to ambulance crews in at least 30 states in the past three years, including Maine, New York, North Dakota, Oregon, Texas and Wisconsin, according to Henry Schein Medical, the sole distributor of the version for ambulances. Nitrous has been more commonly used in ambulances in Europe and Australia.

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story does not rely on a news release.