I've got to review again as well but a couple things pop up aside from the high vs low resource:
-Admitted CAP patients sicker than what I see in US setting
-HIV + TB rates
-Entry criteria likely included lots of viral stuff

Interesting discussion. I would probably defer at this point for most CAP

Is there enough different between resource scarce + resource rich populations to not adopt this for all admitted pts w/ CAP?

TB rates clearly higher in Kenya but not crazy. Same w/ HIV though unclear how well controlled HIV was in the specific pt

An important thing to consider: did patients w/o a-lines get more frequent bedside reassessment (just naturally)
It's easy to look at the a-line numbers and if they're w/in norm range, no need to reassess
w/o advanced monitoring, likely get more doc/RN at bedside assessing pt

Absolutely. I like ketamine as an alternate here

I’m not impressed by the lidocaine lit but topicslization may reduce the reflex response to laryngoscopy