• 0 Posts
  • 25 Comments
Joined 1 year ago
cake
Cake day: July 6th, 2023

help-circle
  • Yeah I think it’s hard to tell where people’s vices start and stop. Probably some of those people were just doing drugs, just having sex with prostitutes. To me neither of those things is inherently bad or of concern at face value. But there’s no question there’s also people who were specifically associating with those two for the kid rape.

    We will likely never know the truth but Im personally ok with all the names being dropped because even if you weren’t raping kids, your judgment was so compromised that you were associating with one of the worst sex traffickers on the planet. We should not be associating with you or doing business with you. But I think everyone’s going to assume any name on the list was diddling kids, and I just don’t think that’s true.



  • So it depends on the setting and patient. Kids tend to have respiratory causes of cardiac arrest so the focus is more on airway management and positive pressure ventilation. Kids don’t generally code just out of nowhere like say a 90 year old might keel over. There’s usually a specific cause and if you can correct that cause they will rebound.

    As for adults it’s about the setting. Outside of the hospital we should be teaching cpr only. Especially for lay people. It gets too complicated and they’re too stressed out to remember 30 and 2, 15 and 2. Plus most people have a reserve of air in their airway and lungs that gets circulated with compressions so focusing too much on trying to get breaths in causes too many delays and confusion.

    Now for ems you can debate whether they should do cpr only with a non rebreather, a bls airway and bagging, a biad, or a definitive airway. It hugely depends on your protocols, provider availability, and who the patient is.

    In hospital we are almost always going to secure the airway during a code to remove that from the equation. We have the resources and it can be done relatively quickly without the need to delay cpr for more than a pulse check in many cases.


  • So I’ve done lots of cpr. First off it’s kind of a misconception that you’ll break ribs from cpr. You are more likely to break cartilage than actually break bones and appropriate cpr isn’t going to break bones unless they’re the smallest most frail person and the individual doing cpr is going crazy doing compressions.

    Even if you break ribs you’re probably not going to have a displaced rib fracture as there’s muscles and tissue holding those bones in place, it’s pretty rare to have ribs break so bad they risk puncturing organs and it usually involves catastrophic trauma, not what you get from cpr.


  • Also for hospital systems it’s wildly unprofitable. You make your money in two places in medicine, elective surgeries and in the emergency department. Mental healthcare is slow, in the extreme cases you’re dealing with unpleasant patients that are hostile to the care you’re trying to provide, and you often have to house them and feed them for extended periods of time knowing they don’t have any money to reimburse you.

    That’s why the hospital I’m working at has built a multimillion dollar cardiac surgery tower (not a unit, not a few floors, an entire tower), but scrapped the plans to rebuild the aging and woefully inadequate inpatient psych facility.

    If we can’t squeeze every cent from you we will only do the bare minimum that the CMC requires from us.



  • It’s probably not the best approach. We are struggggggling to get primary care providers, at least in the US, and I suspect in Canada as well.

    Family medicine is not the same as say a neurosurgery residency. It’s a lot of understanding vaccination schedules and identifying and treating things like high blood pressure or high blood sugar before they become chronic issues.

    But there’s limits to what a pcp is going to manage and the complex issues are going to get punted to specialists. The problem is we don’t have enough pcps to go around and so you have this huge barrier to care because people don’t have doctors they can go see to then get referred to specialists with 3 4 and 5 year residencies that allow them to handle the complex stuff.

    Honestly for the doctor that’s gone through 4 years of medical school, while it would be great if we extended their training and made them even better educated, we also need to balance that with removing barriers that might prevent docs from choosing family medicine as their speciality.

    I’d rather someone have access to a doctor with 2 years of training than having access to no doctor because they can’t convince the new grad MDs to take an extended family medicine residency because it pays a fraction of what an orthopedic surgery specialty will pay.



  • I just want to point out of all the things here this is the least alarming, although context is key. Trust me when I say your medical professionals are googling and YouTubing all kinds of shit. I’ve watched doctors google procedures before attempting them, especially if it’s a rare procedure. YouTube actually has hundreds of hours of manufacturer hosted content designed specifically for this. Now again context is key. They say someone died after they attempted the thing they were searching. That’s def a problem especially if it were some procedure they should be fully competent to perform.

    If your mechanic is googling how to change some obscure part on a car he rarely works on, mmmm that’s reasonable. If your mechanic is googling ‘how to turn on windshield wiper Toyota Camry’ we got problems.

    I remember sitting at the nurses station one day and someone asked the ER doc if she was familiar with this extremely rare genetic disorder. She goes ‘how dare you ask me that question I am a MEDICAL DOCTOR.’ There was a bit of a pause and she goes ‘ haha just kidding I have no idea but I’m gonna look it up’ .


  • In the game heavy rain you enter a building and this pleasant old man is there. He’s very nice, talks to you casually about what brought you there. Offers you a drink. You get to click through all these options and it’s rather boring. Only as you wander the room and talk to him it just starts to not add up. He’s saying odd things. Keeps insisting you have some more tea.

    From the second you enter the room a timer gets set. The player has to be smart enough to realize the guy is sketch and leave on their own. If you drink the tea you will eventually get knocked out or if you don’t drink the tea but stay he eventually surprises you and knocks you out . Either way you wake up in his torture chamber and have to fight for your life to escape.

    Always loved that part.





  • He likes to pretend that he’s some Roman emperor god amongst mortals and we are all his playthings. If he were alive in Roman times who knows, he might have been a solid Nero but this is modern times. I suspect if we could see the tweets that historical figures would write we would have a hugely different perspective on them. Many people we hold in high regard were equal levels of dickhead. Unfortunately for him we got to see who he really is and you can’t rehab that image. All he had to do was shut the fuck up and play with his rockets. Instead he will only be remembered as a snowflake right wing troll. Nothing more.




  • The veneer cracked the day he got into it with the Thailand diver. He just assumed that since he was the smartest richest man in the world that he would naturally be tapped to solve the problem and save those kids. But he found out that no, there are actual professionals with actual experience that were needed for that job and it wasn’t a point where there was time to jerk him off and let him off easy. He had to be told to get fucked from the outset because he would just complicate things and his plan was stupid as shit. Turns out you can’t just money your way out of every problem.

    Once he started calling the diver a pedo and losing it everyone sat up and took notice that something wasn’t right. But I’d say it hasn’t been until all the twitter shit that everyone else caught on fully.




  • Maybe if the cross post could be identified and the comments merged into tabs where you can jump between them for the same post. So instead of 5 copies of the same link showing up with 5 sets of comments all of them are merged to one and when you click on the comment section it allows you to cycle through all of the different instances discussing it. It would clean up the feed but still allow you to see what each group is saying and where they are saying it.

    I’d love to have a link for a news article wheee I can jump between what all the various instances are saying so I don’t miss anything.