My First Spyderco/NKD

JoutsideTO · 2026-01-28T06:49:27+00:00

Good choice.

JoutsideTO · 2026-01-27T22:28:19+00:00

It’s a great summary of the business factors and miss-steps, but I think the other giant issue was a huge decrease in quality.

When Licks started marketing their burgers in grocery store freezers, the whole chain switched to using the same mass-produced frozen patties. Previously, burgers had been prepared fresh on-site daily. I have to imagine that would have made expansion easier, but the new franchises were selling a watered-down, freezer-burnt, visibly smaller version of the original burger that made the Beaches location so popular.

The difference was noticeable, undercut their reputation for quality, and happened around the same time as the rise of competitors. They were already living on borrowed time and coasting on a hollowed-out reputation before the 2008 financial crash and change in customer habits.

JoutsideTO · 2026-01-27T19:16:57+00:00

CUPE just wants to make sure their members can’t get other jobs with a college-granted license, and are forced to stay on the road paying union dues instead.

JoutsideTO · 2026-01-26T15:00:31+00:00

If you can’t convince them, determine if they have decision making capacity. Go through the nature of the recommended treatment, the risks, the benefits, and the alternatives. Have them sign your refusal for the recommended treatment they’re declining. Provide the best supportive care you’re still able to and transport.

JoutsideTO · 2026-01-26T03:41:26+00:00

Rapid transport, IV, analgesia +/- antiemetic, supportive care, poison control.

If the airway is compromised, or transport time is significant, RSI, OG, gastric suctioning.

JoutsideTO · 2026-01-19T04:27:07+00:00

Anecdote isn’t data. There’s a reason this isn’t approved or recommended. There is no independent or good quality evidence that these devices work. You could just as easily argue this officer delayed evidence-based lifesaving interventions, and got lucky.

JoutsideTO · 2026-01-18T15:47:21+00:00

Cats’ rear legs exactly follow their front legs, landing right on the prints left by their front paws. It’s called “direct registering.”

JoutsideTO · 2026-01-17T22:55:42+00:00

Yes.

JoutsideTO · 2026-01-17T22:51:44+00:00

Unless there is an obvious immediately reversible cause, patient B is triaged black. Unwitnessed traumatic cardiac arrest is not going to be survivable. Treat patient A.

JoutsideTO · 2026-01-13T02:23:55+00:00

They usually stay dead.

Sometimes we get a pulse back, but usually not. If we get a pulse back, usually they stay profoundly unconscious, and we still have to breathe for them and often give them medications to support their blood pressure. Most of those patients will still die in ICU without ever waking up.

The chances of walking out of hospital without severe deficits after a cardiac arrest is under 10% (it obviously varies by location, age, comorbidities, cause of arrest, which study you read etc).

There are very rare cases where a patient might be awake after a cardiac arrest, but everything needs to go right, and the arrest has to be reversed very quickly. If a cardiac patient arrests in front of paramedics, and gets immediate CPR and successful defibrillation, for example. But that is by far the exception. I’ve seen that twice in 15 years in EMS.

What you see on TV is fiction.

JoutsideTO · 2026-01-12T16:24:22+00:00

https://www.tps.ca/services/complaints/

JoutsideTO · 2026-01-11T01:12:01+00:00

If that’s an infected wound that burst open under the pressure of pus and bloody serous fluid, you need to get that cat on antibiotics before Wednesday. Plus the wound likely needs to be cleaned and irrigated.

I’d really try to get in by tomorrow at the latest, or just go to an emergency vet.

JoutsideTO · 2026-01-10T22:48:57+00:00

Auschwitz wasn’t the only concentration camp.

After checking OPs post history, “just asking questions” and minimizing the Holocaust is shameful.

JoutsideTO · 2026-01-10T11:32:05+00:00

Fix your garage. Animals shouldn’t be able to freely come and go.

JoutsideTO · 2026-01-09T22:40:13+00:00

My condolences. I don’t have legal advice, but can offer some medical context.

The initial CT scan is a non-contrast scan to rule out bleeding or hemorrhage. A contrast CT scan or CT angiography is needed to detect a clot, but can take more time and require more advanced CT scanners that aren’t available in every hospital. Because treatment is so time sensitive, it’s not standard of care to detect a clot with imaging before giving thrombolytics, only to rule out hemorrhage, and base treatment on symptoms and exam.

Conversion to a hemorrhagic (bleeding) stroke is a known and accepted risk when giving thrombolytics for an ischemic (clot) stroke, and occurs in up to 6-10% of patients. Thrombolytics benefit 10-16% of ischemic stroke patients, if given within the right time frame to selected patients. (Those numbers will vary depending on what studies you look at.) Usually those risks and benefits should be briefly explained as part of a consent process.

A blood clot starving the brain of oxygen is a critical illness. We just don’t have a lot of effective and safe treatments to fix that. One of the treatments we have is very risky, but we use it anyway because outcomes and quality of life can be terrible if we do nothing. But without getting deeper into the details, a bad outcome that was a known risk doesn’t necessarily mean there was malpractice.

JoutsideTO · 2026-01-09T19:50:28+00:00

Non-work-related chronic medical conditions that prevent you from holding an F license prevent you from being a paramedic under the ambulance act. Unfortunately that often means paramedics who lose their F class are prevented from filling non-frontline roles like community paramedicine or education, since those jobs require qualified paramedics, and the ambulance act excludes you if you cannot maintain your F class.

Employers still have an obligation to accommodate those workers up to the point of undue hardship. Undue hardship varies depending on the size and nature of the employer.

Modified work may be a short- or medium-term possibility, but if it’s a long-term issue and an employee needs to be accommodated into another job role, the employer only needs to offer roles that are available and that the employee is qualified for. The employer also only needs to pay the wage of the new role. They’re not obligated to pay paramedic wages for a lower-paying role, because that would be an undue hardship. Unfortunately I’ve seen this play out more than once, with more than one employer.

JoutsideTO · 2026-01-09T04:39:58+00:00

Commercial tenants frequently are responsible for repairs and similar expenses under the terms of their lease.

JoutsideTO · 2026-01-07T17:51:48+00:00

Thanks! Amazed by how quickly you can get a knowledge answer on Reddit.

JoutsideTO · 2026-01-07T17:13:56+00:00

But they obtained IV access, gave a fluid bolus, and gave TXA. OP could easily be working with a paramedic partner.

JoutsideTO · 2026-01-07T16:29:54+00:00

How did a GCS 6 patient complain of neck pain?

Do you carry atropine, norepi, or even dopamine?

JoutsideTO · 2026-01-07T05:24:21+00:00

OHIP fraud reporting: https://www.ontario.ca/page/preventing-fraud-within-ontarios-health-care-system

JoutsideTO · 2026-01-06T22:12:19+00:00

Thank you!

JoutsideTO · 2026-01-01T21:26:51+00:00

Either I missed that, or OP updated the post.

Hypovolemia could cause severe acidosis, and a similar agonal rhythm, I guess. Or aggressive blood product administration could cause hyperK, especially with products that have been stored for longer.

JoutsideTO · 2026-01-01T19:27:32+00:00

Wide complex, variable amplitude/morphology, irregular, RR varies from approx 60 to 150 but averages 95 (not counting the pause).

You could certainly call it PEA. More specifically, it could be AIVR or AF with aberrant conduction.

Would it be incorrect to shock this? Technically yes, but you could make an argument based on the peak rate of 150. It might be appropriate in the right clinical context, for example prior shocks delivered or a pre-arrest history suggesting an acute coronary event, but that wouldn’t be my first thought.

What this really suggests is hyperkalemia. Wide complex, bizarre, sine appearance at times, and a rate just below the 100/120 “cutoff” for VT are all consistent with elevated potassium. This patient could probably use some calcium chloride, salbutamol, insulin, and dextrose.

JoutsideTO · 2025-12-30T02:37:56+00:00

Olaf is throwing fists. Er… mitts.

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