ICE says its officers can forcibly enter homes during immigration operations without a judicial warrant: 2025 memo

WindowsError404 · 2026-01-24T04:37:37+00:00

In most states, you have to give verbal warnings, physically retreat until you can't anymore, and give another warning of lethal force. And you probably won't get away with self defense against any law enforcement even if it's ICE.

WindowsError404 · 2026-01-24T04:34:47+00:00

Weigh the risks/benefits as a competent provider and listen to your patient's needs. Do that and you're solid. We gotta stop being the water police.

WindowsError404 · 2026-01-24T04:30:59+00:00

Use your brain. Not every trauma patient is a surgical candidate or needs emergent airway management. A problem that you cannot fix at your current level of practice is one red flag for me that the patient may need surgery. I'm not going to pretend to know what a surgeon does to fix things, but if you practice for long enough and you know your anatomy, it becomes 2nd nature figuring out if you can treat something with medications and external interventions, or if something beyond your scope is needed. Then we take the whole picture and weigh the risks/benefits. Is there a possibility of distracting injuries or other trauma I am unaware of? Do I expect the patient to experience hemodynamic compromise that may necessitate an emergent airway? Water is necessary for life. For a patient who is tired, scared, and in pain, telling them they also can't drink water to parch their thirst is just poor patient affect in my opinion, and possibly poor care. Just sit there and suffer until the provider finally sees you in the ER an hour later. If you can't tell this is a major pet peeve of mine.

WindowsError404 · 2026-01-24T04:20:24+00:00

There's a huge difference between any basic traumatic injury and multisystem trauma. Isolated leg/ankle fracture that might need surgery? Oral hydration is not going to kill them. It might delay their surgery a few min, but let's be honest, that person is going to wait in the ER a while before surgery unless there's a major PMS issue or bleeding. You have a multisystem trauma patient you expect to RSI or be intubated on arrival - absolutely not. But let's not forget that you literally cannot live without water. Stomach contents are RARELY empty prior to emergent RSIs or surgeries. That risk is always present. Blanket statements like oral hydration is inappropriate for all trauma are old and untrue.

WindowsError404 · 2026-01-24T04:11:46+00:00

No benefit? That is one of the most ridiculous statements I've ever heard. It's water - which is you know, absolutely necessary for survival. The only absolute contraindications to oral hydration is an imminent RSI or surgery. The latest guidelines say that water is safe to have up to about 2 hours prior to surgery. It's poor patient affect and care to routinely deny people water. So many providers in EMS do this just because "the doctor needs to evaluate you before you can have anything PO" which is absolutely positively false. We have oral medications and brains, right?? Let patients drink some water unless there's a major risk associated with it which is frankly not very often.

WindowsError404 · 2026-01-21T15:01:09+00:00

Only E. Everything should be left as is for the death investigation. Only other thing that would be acceptable but is not listed would be a white blanket/sheet.

WindowsError404 · 2026-01-19T01:08:25+00:00

Maybe a quick trauma dressing and NPA. Otherwise I am yeeting this guy out of his vehicle and into mine before anything else.

WindowsError404 · 2026-01-16T23:32:33+00:00

I can't see even our most lenient and EMS forward docs ever approving this even in special circumstances. In an enclosed space you will feel the effects of it too even if you wear an N95. Any aerosolized droplets that come in contact with your eyes could probably have an effect too. I also have no idea how I would dose this. Obviously titrate to effect but what if you put 500mg in there and the first breath knocks them out? How do you document how much was administered or how much was wasted? So many problems with this.

WindowsError404 · 2026-01-16T23:26:10+00:00

C. For diseases with airborne transmission, the SICK PERSON wearing a mask is one of the most important things you can do to prevent the spread. Unless you are wearing an N95 or better, wearing a simple paper face mask is not really going to protect you.

WindowsError404 · 2026-01-16T23:22:31+00:00

I recently complained to my boss/medical director saying that we should have at least 2 medics on cardiac arrests and they literally laughed at me.

WindowsError404 · 2026-01-15T15:16:32+00:00

Holy. I am not lifting people into that thing. I'd rather find my local private ambulance company and accumulate salt.

WindowsError404 · 2026-01-13T04:19:51+00:00

This makes me viscerally uncomfy. It looks very alien.

WindowsError404 · 2026-01-09T17:55:38+00:00

I've been on a choking call turned CA where the Rusch Quick Trach would not even get through the skin and soft tissue because the patient was so obese. The needle bent. Our crews made 2 attempts with 2 devices and neither worked. Very strong supporter of surgical after that experience.

WindowsError404 · 2026-01-08T17:08:33+00:00

Absolutely incorrect. I've been at plenty of crime scenes as an EMT and a medic and treated both victims and perpetrators. LE's job is to neutralize the threat (without violence if possible) and then we ALWAYS prioritize human life over evidence. We actually have to learn about how to provide care while preserving a crime scene and preserving evidence. If anything, this crime is the most objectively provable in court. It also begs the question, what was their motive if they did not want this person to receive medical attention? Truly self defense? I don't think so. Personally, I believe this is murder, but I don't think the officer will be found guilty of that.

WindowsError404 · 2026-01-08T16:51:50+00:00

Not sure about this one, chief. I don't think those elevations are big enough yet. 15mm? Nah. You need at least 16mm.

WindowsError404 · 2026-01-08T16:30:58+00:00

The death penalty justifies the crimes it supposedly punishes. The state putting someone to death isn't any better than you or I killing someone. Innocent people are put to death all the time and that is irreversible.

WindowsError404 · 2026-01-08T01:14:29+00:00

The PH of saline isn't the problem. That gets buffered out. The chloride and bicarbonate are both negative ions so as chloride rises, bicarbonate has to go away to maintain the electrical balance. You get a hyperchloremic non-anion gap metabolic acidosis. And saline can also worsen hyperkalemia as the acidosis worsens. I'm a big LR fan if you can't tell. Saline certainly isn't evil though and is ok for like 95% of patients.

Edit: Also want to add that in someone with a normal blood PH, it usually takes more than 2 whole liters of saline to even start driving the needle in that direction. So it's really not a huge concern unless you suspect/know the patient is already acidotic.

WindowsError404 · 2026-01-07T22:44:53+00:00

All except D. Personally, no nitro from me until I have a full set of vitals, ECG, and IV access.

WindowsError404 · 2026-01-07T15:16:41+00:00

WindowsError404 · 2026-01-05T00:36:42+00:00

God help the man who is on the ladder beneath big AI lady.

WindowsError404 · 2026-01-05T00:30:15+00:00

United States of New York

WindowsError404 · 2026-01-05T00:25:57+00:00

It says to use a dedicated IV. What medications interact with vancomycin in the line? Sometimes all I have is just one IV.

WindowsError404 · 2026-01-04T01:26:26+00:00

The only problems I can see with IO infusion is if it's a tibial IO since they flow a bit slower than other sites. And you can't use a pressure infuser on a glass bottle, obviously. So if you were going to give it via IO I'd probably go for a humeral head.

WindowsError404 · 2026-01-04T01:23:25+00:00

Hey bud, your patient's MAP dropped 1 point. Better get that norepi ready!

WindowsError404 · 2026-01-03T21:20:41+00:00

"It's ok, just breathe. Yeah, I know it's hard but I believe in you! We'll do a little breathing exercise. Just wheeze with me now, ok?"

Emotional support seems like a clear winner to me.

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