Sjy

joined 1 year ago
[–] Sjy@lemm.ee 4 points 10 months ago* (last edited 10 months ago)

Paramedic here! They both serve different purposes. CPR keeps blood circulating to keep one’s brain and other important organs alive. An AED will detect the activity of someone’s heart and if it is a specific rhythm it will shock it. Cardiac arrest isn’t always a flat line, it can be the heart quivering or ineffectively pumping. This shock stops the heart briefly and then hopefully their heart will return to a normal rhythm.

In the simplest terms I can think of, someone in cardiac arrest needs both. Without CPR their brain will die. Without an AED they are less likely to come out of cardiac arrest and will just remain dead.

[–] Sjy@lemm.ee 8 points 11 months ago

Yes. I’ve been in a lot of operating rooms for a lot of different surgeries. It’s also common to give antibiotics before a surgery..and wear surgical masks.. which is my point, also in the context of COVID masks still work to reduce the spread of a virus. Antibiotics will not work against a virus.

[–] Sjy@lemm.ee 4 points 11 months ago (2 children)

Yes, please make sure if you have surgery you tell your surgeon “no need to wear a mask, just a helmet and some knee pads”.

[–] Sjy@lemm.ee 2 points 11 months ago (1 children)

Late reply but to specify, the crumple zones dissipating energy to protect the occupants, but in part the situation you’re describing airbags do a great job at preventing people from hitting the steering wheel / walls.

A very very advanced harness system might compensate a little for a lack of crumple zones during a very rapid deceleration collision. The issue isn’t so much as stopping someone from but being thrown around in the car, seat belts do that, but nothing can stop one’s internal organs from doing the same thing inside their body. So when a body stops during a rapid deceleration, internal organs still try to move. This movement tears everything, most notably one’s aorta and a torn aorta means death with no possible chance of survival.

A small tear in one’s aorta and one may survive long enough for emergency services to show up, a bad one and they will have bleed out before a 911 call taker has time to answer a call for help.

[–] Sjy@lemm.ee 2 points 11 months ago

Don’t have it in my program, yet. I do ground critical care so maybe not the situation you’re looking at but a lot of flight programs are adopting it. It’s great and it should be the next big thing.

Our protocols are starting with using it for placing A-lines, but our doc gives us a lot of freedom to practice. That said I’ve seen it used to confirm ET tubes, identify pneumothorax, guide needles for when performing pericardiocentesis, and assess volume status to guide fluid resuscitation. This is in addition to identifying internal bleeding/ruptured aortas and starting IVs.

Now this isn’t necessarily for your average medic, but if it is a progressive or rural system as long as no one extends their scene time to use it, it could be very useful. But it will be most beneficial in a critical care settings.

[–] Sjy@lemm.ee 9 points 11 months ago (1 children)

This is beautiful and just a perfect description. Even though this sucks day to day I will say very rarely but sometimes, this can spin to our benefit. I recently had an electrical contractor fuck up some work I needed done..well, that’s an understatement my entire home needed to be rewired, and I wanted wiring so I didn’t have to keep charging my doorbell camera.

Now my mind goes thought everything as it normally would, I pay large amounts of money and I’m told everything is done. Well my doorbell camera isn’t charging. Out of the entire house that’s all I can focus on. I have an endless list of stuff that needs to get done but I want my doorbell camera to have power. The guy adds the wire for the doorbell and I’m happy. Until I see it isn’t charging. Trace the wire and it isn’t connected to anything, talk to the guy and he gives me some excuse, it’ll be done soon. Wait when I followed the wire for the doorbell I didn’t see anything connected to my roof above my bathroom. Okay they also didn’t install the exhaust fan correctly.

Now my house still needs 80% of a total renovation but he didn’t fix the doorbell and I just don’t want to keep charging it. So I’m scared of messing with any electricity, which is why I paid someone to do my electrical work. But maybe I can just hook up a doorbell. Well a weekend of researching and I still am not sure how to do it, but I found a copy of the national electric code because I think the exhaust fan is supposed to be going up through my roof.

Long story short the guy didn’t do half the work I paid for. I now have a log of every wire that was run, every junction box that was placed, every switch, every outlet, everything, including if it is up the code of the exact code that it is violating. Along with a note about the expected electrical load, that should be on each circuit, how much is can candle and how much more I can add to still be within code for continuous load. I also have the manufacture date of every wire that was placed and found a bit of damage to an exterior and a door wall that wasn’t there and found it caused by the contractor that are both is areas I said do not touch.

So now, I have all this information and if I am successful in suing him I will have gotten a great deal on having the house rewired considering I now know how to rewire an entire house and have improved a few circuits in my house, but I’m not an electrician so I can’t actually do anything with this information. But here I am on lemmy writing about this instead of doing what I planned on doing today with no idea how to actually sue someone and an existential dread of trying to figure out how to or if I should hire an attorney.

It’s great. I mean awful.. well actually both, but also neither.

[–] Sjy@lemm.ee 2 points 11 months ago* (last edited 11 months ago) (1 children)

How does one host their own beeper server?

Edit: found it

[–] Sjy@lemm.ee 2 points 1 year ago

Yes, pain is pain. People can still feel it and suffer even if they do not remember it. Anesthesia in context of surgery is too complex of a topic for me to comment on but I do frequently manage patients that are sedated, on ventilators either going to or coming from surgery. There are different scales and tools we use to assess if someone is under sedated or in pain. Keeping explanations simple pain can reflect as changes in vital signs, rigid or tense muscles, facial expressions. Sedation in the context I’m referring to is more a scale of either how awake someone is or what type of stimulation they respond to, for example do they open their eyes if someone says their name? Or do they open their eyes if I gently tap on their shoulder or do I need to put pressure on their nail bed for them to respond, if they respond at all. If they’re sedated enough they won’t remember the pain but they would still feel pain. Again this is NOT referring to general anesthesia during surgery, that is too complex and anesthesiologist have a very difficult job ensuring people are adequately medicated for surgery while also ensuring that they treat the side effects of the anesthesia medications so they don’t just kill people.

The two do have some overlap and my previous statement assumes no chemical paralysis. There are also times where it is acceptable to just sedate someone, or do something emergent without sedation and then giving something like Versed which causes retrograde amnesia. The person may have been fully conscious and felt everything that just happened but still won’t remember it.

This is a bit of an oversimplification but I’d say firing of the nerves is pain. I don’t have literature available to support but I know giving babies anesthesia is very dangerous so I would like to believe that the reasons you listed where just an over simplified “it’s really okay to do X or Y because they won’t remember it” rather than explaining to a parent in a way that they would truly understand the risk of anesthesia for a baby AND still allow whatever procedure to be done or force a parent to knowingly elect to put their baby through pain and suffering for a procedure. But again, not a doctor and I don’t work with people/babies during surgery

[–] Sjy@lemm.ee 48 points 1 year ago* (last edited 1 year ago) (2 children)

This is very good advice, especially if someone has taken drugs. Please tell us. The medicine I give for chest pain can kill someone if they’re having that pain from doing a ton of cocaine and not a possible heart attack.

After the first time someone went into cardiac arrest after I started treating them after telling me they didn’t use any drugs or alcohol today - I followed up found out he survived but had in fact taken a ton of cocaine today, I’ve changed my wording to “Have you taken any drugs or alcohol recently? It’s okay if you have I’m not a cop but if you have it changes which medicine I can safely give you.”

[–] Sjy@lemm.ee 10 points 1 year ago

Believe it or not, it is assuming the pelvis is present, it is very easy to determine sex. Just look at the pubic arch, just inferior (below) the pubic symphysis. Narrow (less than 90 degrees) is male wide (more than 90 degrees) is female. There are a few other details like the shape of the iliac crest and the size of the pubic cavity but the pubic arch is the simplest.

[–] Sjy@lemm.ee 5 points 1 year ago

Late but USA, wanted to share a personal experience. While at work I collapsed and had to take an ambulance to the hospital. I got sent the bills for everything. Including the ambulance ride. I stayed in the hospital overnight for observation. They couldn’t figure out what happened and I didn’t have symptoms anymore so I was discharged. Whole event cost maybe $500.

Here’s the kicker, I work(ed) as a paramedic for the ambulance company that transported me. I had insurance that was not from the company so prices were reasonable relative to what one would expect in the country. Had I been insured through work, well, the insurance provided by the company doesn’t cover transport by that company’s ambulance.

[–] Sjy@lemm.ee 2 points 1 year ago

Thanks for the affirmation that it wasn’t just me thinking the names sounded like a joke to those that aren’t familiar.

But the software I’m referring to this is free and open source, if you have any smart devices, it is worth looking into for convenience and the amount of customization and integrations available, in addition to running locally and respecting user privacy.

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