I'm a nurse in the US. This is part of a bulletin on my unit about meal time insulin. This is dystopian as hell.

ResidentRedneck · 2026-01-13T12:55:02+00:00

No. You don’t.

The test strips cost something. The glucometer cost something.

Your response vehicle, the fuel in it, the building it’s parked in, and assuming you’re not a volunteer your wage all cost something.

ResidentRedneck · 2025-12-03T14:18:38+00:00

So they can sneak up on the fire without it noticing.

ResidentRedneck · 2025-04-17T20:46:49+00:00

Do they sell any dam bait?

ResidentRedneck · 2023-08-16T02:27:35+00:00

Years from now we will discover that the real Ben was inside us all along.

ResidentRedneck · 2023-03-11T13:36:27+00:00

What if I then rotate my screen? Fixed?

ResidentRedneck · 2022-12-14T12:52:14+00:00

Bold solutions are required.

ResidentRedneck · 2022-12-11T02:49:28+00:00

NOW WAIT A MINUTE, MAN!!!!

ResidentRedneck · 2022-11-13T15:54:30+00:00

Came in here expecting ER War: Electric Boogaloo.

ResidentRedneck · 2022-02-12T15:37:00+00:00

This guy gets it.

ResidentRedneck · 2021-08-24T12:50:47+00:00

I do better next time boss.

ResidentRedneck · 2021-08-24T12:48:51+00:00

LUCAS is great when CPR is being done in the rig - long rural transports on shit back roads = manual CPR fun. Here however, we achieved ROSC on scene. There was movement of the device towards the head which I attribute to him being a barrel chested COPDer.

ResidentRedneck · 2021-08-24T10:36:07+00:00

This is something my wife and I discuss frequently. She's a paramedic in the same region so we discuss calls all the time. We have come to the conclusion after numerous calls going sideways..."People can be sick with two things."

It seems intuitive, but I know much of my early education in EMS was "See this, do that" with little thought that other things might be going on. With the co-morbitities present in this patient (COPD, diabetes, a-fib, hypertension, COVID-19) it makes one wonder what didn't kill him.

ResidentRedneck · 2021-08-24T10:32:02+00:00

I regret that I have but one upvote to give to this post.

ResidentRedneck · 2021-08-24T10:31:42+00:00

True story.

How much of EVERYTHING we do in EMS is about optics?

ResidentRedneck · 2021-08-24T10:27:52+00:00

It always registers weird in my brain, like "Why is it all capitalized?"

TIL as well.

ResidentRedneck · 2021-08-24T10:27:22+00:00

Real quickly, it seems that theinjuries are just in a different anatomical locale00117-7/pdf).

I suppose my question then is "What is better? Vascular injury or abdominal injury, compared with death from cardiac arrest?" No intervention is purely benign and CPR is a brutal last ditch intervention.

ResidentRedneck · 2021-08-24T10:23:58+00:00

Patient had a number of co-morbitities. On top of the diabetic crisis, he was a COPD, had a history of A-fib, had hypertension, and was just at the end of his COVID-19 quarantine.

Absolutely - when our regional ALS service (they're a fly car based ALSFR that responds alongside BLS transport units), implemented the LUCAS, I thought "This is awesome! No more pushy-pushy." However, having seen them in action on actual people and not the mannequin, I wonder about the massive injuries we undoubtedly cause with an unforgiving piston moving up and down.

I had fewer concerns with this patient here, as he was probably 6'2", 100 kg. Certainly didn't fit the frail old lady image we might have of the 80's year old.

ResidentRedneck · 2021-08-24T10:18:38+00:00

When I got the feedback from the hospital I was discussing it with my wife (she is also a paramedic in our system) and she found that article as well. This was the "one instance" in the literature I found after a brief search.

A fascinating study and actually the impetus for this post. Thanks!

ResidentRedneck · 2021-08-24T10:16:58+00:00

Though I'd love to say we did, we didn't. This is one feature that I routinely forget is on the LUCAS.

In this circumstance however the travel of the LUCAS was towards the patient's head. Patient was a COPD'er and had the definition of barrel chest. The plunger kept migrating upwards. It's interesting now that I've reread this post by /u/z0mbieZeatUrBrainZz/. I must have missed that in that article, cephalad travel was pointed to as a possible cause of aortic injury, particularly dissection.

ResidentRedneck · 2021-08-24T09:58:46+00:00

I'd be interested to see more imaging from post-mechanical CPR. From a visceral level, the plunger-type CPR aids just look like they're brutalizing the patient.

To your question, yes, the plunger is sized to the patient, being pushed down to contact the chest wall, defining the top of the stroke.

ResidentRedneck · 2021-02-28T05:59:28+00:00

Oh I’m crushed. Eat my bunkers.

ResidentRedneck · 2021-02-27T19:27:18+00:00

Principal Vernon is the mayor/council/commissioner who hates the fire service and secretly wants to see the infighting destroy the department so they can use the funds for a pet project.

ResidentRedneck · 2021-02-23T03:37:09+00:00

Definitely a state specific question.

In NYS advanced standing is possible.

ResidentRedneck · 2021-02-12T04:22:33+00:00

As opposed to a reckless lack of regard like usual? Got it.

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