AP Photo/Greg Baker Hospital staff wearing protective clothing clean and disinfect a room in an isolation ward where a bird flu patient was treated in Abbotabad, Pakistan, earlier this month.

So much for the theory that migratory birds spread Avian flu; we likely owe a debt of gratitude to the agriculture police at our borders for protecting North America from sick poultry. Is the danger past us? Certainly not, and if your department didn't invest significant energy and resources in pandemic planning, you'd better make it a New Year's resolution for 2008.

"Less is more" was an EMS theme for 2007. Prehospital intubation was sharply curtailed in several states partly as a risk management concern and because CPAP finally began catching on at all levels of care. Another hospital tool took some shelf space in EMS units: hemostatic bandages, while tourniquets managed a comeback thanks to recent military experience.

Meanwhile, the FDNY piloted intranasal naloxone (Narcan®) at the EMT-Basic level; logical given that major cities have been handing it out to IV drug user families and friends for years. Also this year, Cyanokit® hit the streets of North America — an incredibly safe cyanide antidote that boasts an amazing resuscitation record in France. If the American fire service grabs onto this rescue drug, smoke inhalation deaths are likely to plummet.

CO-oximetry helped prevent dozens of carbon monoxide deaths. As this oximeter, which measures both oxygen and carbon monoxide becomes more available, fire and EMS will probably dent those mortality statistics as well. On the other end of the scale, powdered forms of diltiazem went bye bye in 2007, leaving EMS scurrying to find a replacement with a reasonable shelf life.

Specialty care grew this year, moving onward from trauma and stroke to STEMI centers. Specialization will be the buzz word into the next decade. Even the CDC jumped into the ring during 2007, issuing a trauma triage scheme that aids in selecting specialty trauma center destinations.

Speaking of the future, the National Educational Standards for EMS continue to be a work in progress. Draft 2.0 is awaiting your comments until February. A final version will go to the feds in the fall.

The National EMS Information System  train departed the station during 2007, apparently leaving behind New York, American Samoa and the Virgin Islands, all of whom failed to sign participation agreements.The project to collect and standardize EMS data on a national level will help move prehospital care into the future. 

Finally, although not in the category of Christmas gifts, your station, ambulance and equipment are probably harboring MRSA. Methicillin-resistant staphylococcus aureus, a hospital and community acquired infection that made news headlines in 2007, will again be of significant concern in 2008. EMS will need to actively work to break the chain that makes MRSA a gift that keeps on giving. Awareness, prevention and safety will carry us into 2008 and beyond.