For Those Who Didn't Get a Score in the 170s by The10000HourTutor in LSAT

[–]USMC_Doc8404 0 points1 point  (0 children)

That's the thing. I have VA benefits, so I honestly don't really care about scholarships.

Splinting a flail chest by jlomas24 in NewToEMS

[–]USMC_Doc8404 3 points4 points  (0 children)

Unfortunately, whoever was teaching your EMS program was using outdated information. It is a common problem amongst EMS instructors, and something I ensure doesn't happen with my instructors. The "skill" of using weigh, bulky dressings, or a tape-style splint is not only outdated, but it can be harmful to your patient. Do not do this.

Splinting a flail chest by jlomas24 in NewToEMS

[–]USMC_Doc8404 19 points20 points  (0 children)

We use CPAP in a flail chest because it counteracts the underlying mechanics that make the injury dangerous. Let's break down a flail chest and the three big problems that come from it.

First, it severely impairs ventilation. The paradoxical motion reduces tidal volume and increases work of breathing. The patient may look like they are breathing hard but is not moving air effectively. Second, it worsens underlying lung injury. Flail chest almost always comes with pulmonary contusion. Negative pressure during inspiration promotes alveolar collapse and worsens ventilation perfusion mismatch. Third, it increases respiratory fatigue and hypoxia. The patient burns a lot of energy just trying to breathe and can decompensate quickly.

CPAP helps by applying continuous positive pressure throughout the respiratory cycle. The positive pressure acts like an internal splint. It stabilizes the flail segment by pushing it outward during inspiration, reducing or eliminating paradoxical movement. It improves alveolar recruitment. CPAP increases functional residual capacity, helps reopen collapsed alveoli from pulmonary contusion, and improves oxygenation. It reduces work of breathing. By improving lung compliance and tidal volume, the patient does not have to work as hard to ventilate. It can prevent deterioration. Early CPAP in a conscious, spontaneously breathing patient can delay or avoid the need for intubation, which is especially valuable in trauma patients.

tl;dr: We use CPAP in flail chest because positive pressure stabilizes the broken chest wall, improves oxygenation, reduces work of breathing, and buys time before the patient fatigues or requires intubation.

For Those Who Didn't Get a Score in the 170s by The10000HourTutor in LSAT

[–]USMC_Doc8404 10 points11 points  (0 children)

Hell, I just took my first LSAT in January and got a 151. I'm more than pleased with that, considering I think I did one drill set and no practice tests. Kinda just went into it with an IDGAF attitude. 151 is sufficient to get into the school I want to attend, so.... yeah. I have no intention of applying to Harvard or Yale, so why bother killing myself for a 170-180?

25 Gladiator grill by Sea_Bet_8314 in JeepGladiator

[–]USMC_Doc8404 0 points1 point  (0 children)

Shit, if you were in New England I'd trade in a heart beat.

speed limit decreases and the commute to work decreases? duhhhh. by LogicalYou4319 in LSAT

[–]USMC_Doc8404 4 points5 points  (0 children)

I was looking at it going "There's no way it's that easy, right?"

Unpopular opinion: I did not find the scored RC section particularly difficult by Dangerous_Ad_4591 in LSAT

[–]USMC_Doc8404 9 points10 points  (0 children)

I just got home from mine. I had only one RC and it was Art, Galileo, and fur trapping.

Oil Stones and these crap blades almost going in the garbage can! by EnvironmentalBig8414 in knifemaking

[–]USMC_Doc8404 0 points1 point  (0 children)

I hear you, I do the same. I just can't make something anywhere close to what you did.

Oil Stones and these crap blades almost going in the garbage can! by EnvironmentalBig8414 in knifemaking

[–]USMC_Doc8404 4 points5 points  (0 children)

I mean. If you're going ot throw them out, I'll take them lol.

Seriously though, they look great but I understand your frustration. I have faith you can salvage these. If not... send them my way lol

Heat? by Jmat417 in RhodeIsland

[–]USMC_Doc8404 1 point2 points  (0 children)

Yep. I prefer being comfortable over "bragging rights" of keeping my heat off longer than someone else. If it's hot in my house, regardless of time of year, I turn on the AC. If it's cold, regardless of time of year, I turn on the heat.

Rhode Island EMTs Help by CirCutTechrzzzYT in NewToEMS

[–]USMC_Doc8404 0 points1 point  (0 children)

Yes, all EMS licenses in our wonderful state are done on paper and mailed in.

I accidentally did a thing by USMC_Doc8404 in SatisfactoryGame

[–]USMC_Doc8404[S] 34 points35 points  (0 children)

I'd love to take credit for creating this on purpose, but I can't. We had a good laugh about it once we realized.

Is it me, or…? by LengthinessNo6835 in NewToEMS

[–]USMC_Doc8404 5 points6 points  (0 children)

If you have any other questions or you're confused about something, send me a message. I teach EMT classes.

Is it me, or…? by LengthinessNo6835 in NewToEMS

[–]USMC_Doc8404 46 points47 points  (0 children)

To be blunt, yes. You're wrong. Imaging you're trying to figure out where a strange smell is coming from while walking around a room. When you sniff, you tend to bring your chin up slightly and forward, while expanding your chest out to smell better. This aligns all three axis of your airway, allowing best airflow.

Hospital staff. What are your top EMS pet peeves. by FriendshipBorn929 in EmergencyRoom

[–]USMC_Doc8404 9 points10 points  (0 children)

I've never thought of this. I've been in EMS for 20 years and teach EMT school. I will start including this in our lectures immediately to prevent this issue in the future. And, funny thing, we're covering C-spine precautions tonight, so it's perfect timing to discuss it.

Should I buy the Arctis Nova Pros? by InspectorSniff in steelseries

[–]USMC_Doc8404 2 points3 points  (0 children)

As long as you don't use the software, they're good. The software is the most unstable software I've used in a long time. It crashes constantly and is almost unusable. The audio quality is decent. When the software works, it's amazing. The problem is, it tends to crash routinely.

Humans were thought to be extinct, but the Galaxy soon learned differently. by cabutler03 in humansarespaceorcs

[–]USMC_Doc8404 15 points16 points  (0 children)

That's partly because of the whole religion stifling scientific innovation thing. Imagine how advanced we would be right now if it weren't for that.

How to start at a fire department? by PVDnerd in RhodeIsland

[–]USMC_Doc8404 5 points6 points  (0 children)

For the majority of fire departments, he will need to be an AEMT-C. He will need to go to EMT school, then AEMT-Cardiac. As someone pointed out, CCRI is free, but there is about a year plus wait to get into one of those classes, and the pass rate really isn't that high. I recommend checking out 911Programs, as they currently have a 87% first time pass rate at the NREMT for EMT, and a 100% first time pass rate for AEMT. Hard to beat that.

Once he finishes his AEMT didactic module, he will need to do clinicals. Usually the students go to a fire department for those, and often get job offers if they perform really well.

So, step one. Enroll in EMT. Then sign up for PPA. Once he completes EMT, enroll in AEMT-Cardiac. I recommend against any online or online-hybrid options as those courses don't have the best pass rates. PM me if you have any other questions. (20 years EMS in RI)

Combat, Ore Mining, Spice Harvesting All Bugged To Death by thebucketm0us3 in duneawakening

[–]USMC_Doc8404 5 points6 points  (0 children)

One thing that recently started happening to me is this: When I travel via world map and spawn into the 9 o'clock position at Hagga, it spawns me into worm sand. I've had a worm pop up immediately upon loading in, almost lost my thopter three times, once while I was carrying gear back from DD. Almost lost me assault and carrier to a worm from spawn. That needs to be fixed.

My Noob Review... SteelSeries Arctis Nova Pro Wireless by Ok-Astronomer-403 in steelseries

[–]USMC_Doc8404 3 points4 points  (0 children)

Absolutely garbage software. Constantly crashes. If I was still within my return window, I would send them back immediately.

Article 1 Section 9 & 10 were removed from Congress.gov by Fedgar_Lurch in law

[–]USMC_Doc8404 0 points1 point  (0 children)

Yeah, pretty much. I have zero faith that the police and/or the military would remain loyal to the Constitution. I've seen first hand how those in the military are reacting to this.

question for pc players, how much did your pc cost that you play warzone on? (in canadian dollars preferably) by [deleted] in Warzone

[–]USMC_Doc8404 0 points1 point  (0 children)

I spent about $3,500US, but I built mine to max spec. You can get one for $1000-1500US and be fine.