Sjy

joined 1 year ago
[–] [email protected] 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.

[–] [email protected] 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.

[–] [email protected] 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”.

[–] [email protected] 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.

[–] [email protected] 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.

[–] [email protected] 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.

[–] [email protected] 1 points 11 months ago

Sorry forgot about this post, but it us an important topic to me. I’m only speaking for the United States All 50 states and the District of Columbia have a good Samaritan law, in addition to Federal laws for specific circumstances.

And I agree some of this is just getting into semantics but yes get an AED if one is available, early defibrillation is without a doubt the best way to increase survival rates also activate emergency services as soon as possible there are things we carry that can help if the patient is receiving adequate CPR prior to our arrival, those steps are crucial. But ensure that you minimize any time spent not provided high quality CPR. Without blood flowing to the patients brain, it starts to die. Once the brain is dead there is nothing in modern medicine that can revive it.

I don’t have an argument if someone is concerned about consequences for helping another person. I do what I do so I can sleep at night knowing I did what I believed was best and I did it to the best of my abilities. If I have to go to court then so be it, the bonus for me going to court is at least I’ll get to meet someone I’ve helped successfully resuscitate, that alone would make going to court worth it, independent of any verdict that is rendered. But that’s just me, I’ve had to pronounce a lot of people. I’ve had one or two go into cardiac arrest in front of my and then after treating them they talked to me during the ride to the hospital and I know I’ve had a handful of people that made a full and complete neurological recovery, but I’ve never gotten to meet any of them, which is also fine, but it would be neat to get to talk to one of them and hear their side of the experience.

[–] [email protected] 1 points 11 months ago (1 children)

It’s been a while but I saw a disturbing post about Plex recently that reminded me of this - the post was an email that Plex sent someone with something along the lines of “see what * Lemmy user * has been watching recently” which shows they track what people have and are watching from their “private” library. Huge invasion of privacy and I no longer care if it’s easier for friends/family to use, I’ve deactivated my server and been offering extra help if someone struggles with jellyfin.

Anyway, I wasn’t able to get this working. Were you?

[–] [email protected] 2 points 11 months ago

I’m on mobile so the article is blocking me from reading it but really wish I could because this seems like a very interesting situation.

The main questions I have are, how many people were involved in her care? Was the surgery responsible for the surgery and anesthesia or was an anesthesiologist present? How long was she in cardiac arrest? If not and what type of resuscitation was needed? did he fail to administer adequate vasopressors or not recognize that she needed them or that she went into cardiac arrest?

Depending on the answers this could vary from any time in jail is unreasonable to life in jail is reasonable.

Anesthesia is VERY risky. It is routine for people to go into cardiac arrest during very routine and standard anesthesia for routine procedures, that’s what anesthesiologists do every day.. but without more information I can say death is a very real possibility from any anesthesia, if she went into cardiac arrest and was resuscitated then okay, that situation is something the surgeon should be able to handle and any attempt to transfer her somewhere before she is stable would violate EMTALA (in the US). If she didn’t then it is a risk of not waking up after anesthesia that needs to be explained and understood before undergoing any anesthesia. But if she went or remained hypotensive for too long that was not treated causing brain damage that’s more malpractice than manslaughter.

Additionally, EMS is generally not trained or equipped handle patients in this situation. Depending on how progressive the system is, they might be able to manage but being transferred from surgery that required resuscitation makes her a critical care patient, which leads me to understand why a doctor would be hesitant to handoff the patient. I say this as a paramedic who specializes in critical care transport that has dealt with many doctors that were hesitant to transfer care to me.

Wish I could read the article to form an opinion on this because if she stayed alive for 14 months I really would like to see how they connected that to him. I know alive can mean she has a pulse but no neurological activity but again that seems more like a malpractice situation rather than a criminal one. But oh well.

[–] [email protected] 2 points 11 months ago* (last edited 11 months ago) (1 children)

How does one host their own beeper server?

Edit: found it

[–] [email protected] 2 points 11 months ago

Clearly OP isn’t a hypocrite or lying and is justified in not having sympathy for anyone breaking the law. Which is understandable as I’m sure OP has never broken any laws by illegally entering a country, breaking into and robbing someone’s house, or worst of all picking up a bird feather. And if OP has ever broken the law I hope there isn’t any expectation of sympathy if refused emergency service when they are needed.

[–] [email protected] 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

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