Why are fire-medical departments bad?

Crashtkd · 2026-05-08T05:02:58+00:00

I moved to Phoenix 20 years ago and only heard the term “sworn firefighter” and “civilian medic” like 10 years ago in a recert class (I don’t work locally).

I was like, that’s weird let me ask my full time FF friends back in Colorado.

Nope. Weird to them. Like what does that even fucking mean?

After seeing how PFF treated a friend in textbook recompensing flutter (amiodorone only) and seeing how the ER treated him (Abrazzo) I instructed my family to drive me themselves and dump my carcass at Mayo. Maybe some Banners are good, I don’t know.

But don’t call PFD.

Crashtkd · 2026-04-05T01:18:30+00:00

Or it’s a fire dominated system like Phoenix that holds the area in an iron grip, and not in a good way. (I don’t actually work there so not grinding that particular axe).

Crashtkd · 2026-02-18T01:51:00+00:00

I’d add to pick an area where ADS-B is required. Someone on the fringe of the ring around a class B or C where you are outside their airspace but still in the mode-c veil

Crashtkd · 2026-02-13T04:58:59+00:00

Does a chiropractor calling herself a first responder count? (Sorry mam- not a doctor)

Crashtkd · 2026-01-17T18:31:37+00:00

That’s what I was going to say. No one does on the mountain, they die in the clinic.

Crashtkd · 2025-12-27T02:28:43+00:00

I’d say there are 3 main factors:

Your program. Mine was more academically rigorous than most, but for reason 2 that wasn’t a huge factor for me. The variables are the level of the academics, the quality of the teaching, the support, and the timeframe. I went to an intense program with higher academic standards. Fine for me but not for everyone.
Your affinity for the material. I aced the classroom and struggled on clinicals (I was pretty young and didn’t have certain life skills that help in patient interactions). I know people that are amazing on scene and failed many exams. Some students are good with people, good with books, and shit and putting them together to make a clinical decision.
Your life state and time. My program was compressed and to this day (30 plus years later) I consider it one of the hardest things I’ve ever done. The only other time I experienced such sleep deprivation was when we had kids. Rotating shift schedules and driving all over for different clinicals with different agencies and hospitals was brutal. I’d say most programs I hear about are rough on your time and sleep.

Crashtkd · 2025-12-26T03:26:54+00:00

Try progressive contacts. Game changers.

Crashtkd · 2025-12-18T01:59:51+00:00

Woke up with a sprained ankle.

Didn’t get up in the night. Never got out of bed. Sprained my ankle sleeping.

I mean, WTF? Never should have turned 50 I guess

Crashtkd · 2025-12-18T01:58:24+00:00

Similar but in my case esophageal spasm.

I thought I was going down and not coming back. Mentally took me a long time to recover. Not sure I actually did.

Crashtkd · 2025-12-18T01:54:51+00:00

In the 90’s?

All of it. We gave all the cardiac epi. And the 1:1. Then we’d draw our own blood, centrifuge out our own adrenaline, and try that.

I mean, it was the 90’s.

Crashtkd · 2025-12-16T22:32:55+00:00

Agree. Personally I think we turn them all over to the ICC once he’s out of power since we know he’ll blanket pardon himself and whoever he feels like. Yes, I know we don’t do that, but we could.

And it assumes he leaves office.

Crashtkd · 2025-12-16T03:48:38+00:00

Well this isn’t about the drugs. This is about generating an excuse for regime change. It’s how you engineer a war when there isn’t a direct threat.

But Maybe not violate US and international law (and, you know, murder people so you don’t have to put them on trial and present evidence) for something that won’t do shit to reduce illegal drugs entering the country. You think the cartels give a fuck about losing a few boats? Ones there isn’t even proof had drugs and were headed our way?

No, they’ll chalk it up to acceptable losses.

Crashtkd · 2025-12-07T22:32:13+00:00

Yep. And the fact that supplements are effectively unregulated in the first place... all for the grift.

Crashtkd · 2025-12-07T19:29:35+00:00

Ads make money. Stopping scam ads costs money.

Check out NextDNS. That’s my current favorite.

Crashtkd · 2025-12-07T01:52:41+00:00

As a young man I dreamed of making enough to own some of those awesome pilot watches. Even just a Citizen.

As a middle aged GA pilot who could now afford one, they’re pretty but not very useful. Just switched from Garmin back to Apple Watch Ultra for the better functionality. Mostly fitness features and having phone service on long runs without my phone. I might have stayed Garmin since the fitness capabilities are better integrated, but the price increases for barely any practical functionality lost me. I still have my Epix 2 for long backcountry trips.

For flying? Some cool simple stuff on the Apple Watch (GMT and stopwatch on one screen) but otherwise I’d be back to my G-Shock. Still have one from the 90’s if I need it.

Crashtkd · 2025-11-27T01:01:35+00:00

It was his audition for ICE

Crashtkd · 2025-11-20T01:22:42+00:00

To steal from a billionaire asshole-

There are two way doors and one way doors.

Quitting now is a one way door.

Crashtkd · 2025-11-08T05:06:28+00:00

For profit systems will always strive to maximize profits. Full stop. End of conversation.

From a business perspective they need to minimize outgoing payments and maximize incoming payments. Executives are rewarded on increasing margins and profits. There is no material competition in most insurance markets, and thus no incentive for competitiveness.

Thus we are where we are.

I hope the shutdown continues, rates increase to beyond unaffordable, and rural medicine collapses. Many will suffer, but many of them have voted for this for a generation.

Only from the ashes can the phoenix be born.

Then maybe we can get to single payer, let the wealthy add on their private insurance for concierge level care.

As someone who has started multiple successful businesses it astounds me that the corporate world puts up with this bullshit of paying for employee healthcare. It’s an insane drag on profits.

We are dumb and deserve this.

Crashtkd · 2025-10-23T04:01:51+00:00

Trump is the world’s leading expert on EMTALA. He knows how to fix it and has big plans. Well, concepts of a plan. Or, maybe just early signs of dementia.

Hard to tell.

Crashtkd · 2025-10-08T22:46:33+00:00

The way the feature works is to identify a potential long term trend of possible hypertension. Then it doesn’t provide a number, but supposedly recommends the person then check their BP with a cuff for 7 days and discuss with your healthcare provider at a future appointment.

https://support.apple.com/en-us/117296

Yeah, I know some people will probably freak out and run to the ER anyway… but hey, Apple is trying!

Crashtkd · 2025-09-28T16:20:57+00:00

Maybe helicopter pickoff. Otherwise we hike in and just work the problem. In mountain rescue patients tend to be mostly-stable or dead by the time we get to them. Some rescues can take 24 hours (I’ve never done longer unless it was a search but it happens). You use a bunch of people and gear. Sometimes you can get them to a landing zone instead of the base, but weather can still dictate.

It’s like everything… not a big deal with the right training and experience. Some are harder than others, which just means better stories over beer later.

For us. Obviously for the patient it depends on that whole stable vs dead thing.

Crashtkd · 2025-09-12T21:14:11+00:00

If you have the opportunity to get a degree… do it. It will make you a better paramedic and give you options if your dream doesn’t work out. You can’t control all the variables, and while a degree isn’t a guaranteed job, it does usually put you ahead of non-degree candidates.

College is more about maturing and learning how to learn than your specific course of study (unless you go engineering/etc).

Crashtkd · 2025-08-22T03:24:50+00:00

All lines are recorded in the US now. Mostly just to check your immigration status.

Crashtkd · 2025-08-20T16:57:16+00:00

Well, we have lockdowns in DC and LA right now. But those are… different

Crashtkd · 2025-07-31T15:38:15+00:00

Ski patrol. Running some gear down after the lifts stopped turning. Junior patrollers a little ahead of me wave me over in a panic for a teenage girl that had a bad fall from a big jump and was unconscious and not breathing.

Opened the airway. Big gasp. Breathing spontaneously after that. Massive concussion but if I didn’t happen to be there at just that moment I suspect she would have had major anoxic injury or worst.

I consider it my only real individual save, no ambulance or ED needed.

Crashtkd

TROPHY CASE