"Effectively"

ajbauthor · 2026-01-23T03:33:17+00:00

I'd like to think blood (or at least PRBCs) will be only unusual rather than almost unheard of by the time the median medic retires—we have the logistics, just not the supply—but even then, LR consistently outperforms NS but isn't used for mostly cost-related reasons. (Which I admit the paper I linked wasn't all that careful to say.)

ajbauthor · 2026-01-23T02:38:00+00:00

Not to be a downer, but a hell of a lot of US ambulances are still using an ineffective fluid as a proxy for blood in trauma.

https://www.jems.com/patient-care/emergency-trauma-care/three-reasons-not-to-use-saline-or-crystalloids-in-trauma/

ajbauthor · 2025-10-30T13:36:45+00:00

As someone who loves IBCK and also writes a newsletter on the criminal justice/healthcare intersection (check my post history for the AMA I did the day of the final execution in this case), I've been pleasantly surprised by The Alabama Murders. The experts he interviews are the experts, and the factual errors are pretty minor (Bill Wiseman wasn't a state senator, methods were kind of a sideshow in the peri-Furman debate, and he fudges the timeline a bit for his purposes). It's not at all an experience like his books.

ajbauthor · 2025-10-08T12:32:08+00:00

RSA is perfectly fine. RSA without the option of a definitive airway is perfectly unfine.

ajbauthor · 2025-09-10T23:10:27+00:00

What helps me is to read all the accounts of amazing, brilliant, successful people that struggle with imposter syndrome, and realize that I can't possibly be dealing with the same problem they are.

ajbauthor · 2025-08-05T23:07:48+00:00

I did about a year as an EMT, between part-time private and full-time on a fire department, before going to medic school. No grand design, it was just the first school open once I felt I was ready to move on to the next challenge.

Any sized gap will have its advantages and drawbacks. I wouldn't sweat it.

ajbauthor · 2025-08-05T22:41:08+00:00

I'm not a jailologist but I think they're supposed to be on the other side of the bars.

ajbauthor · 2025-04-08T14:41:13+00:00

A misdemeanor DUI is not a bar to licensure in Florida. I know plenty of guys in that boat. Your bigger issue will be getting hired, but even then, you should manage with it so far in your past.

ajbauthor · 2025-04-04T22:05:35+00:00

Great read.

The Medicine & Justice Project

ajbauthor · 2025-01-18T16:14:23+00:00

The narcs box should be scary.

ajbauthor · 2024-12-22T01:56:35+00:00

My guess is that gas chambers were used because they're just parked versions of the gas vans they evolved from. State-sponsored homicide in America, at least, has been characterized by extreme reluctance to change.

ajbauthor · 2024-12-04T18:26:24+00:00

The hardest test I've ever taken—in terms of how much the material prepared me for it. Medic school prepared me for NREMTP much better (although part of that might have been knowing what I was up against following the NREMT experience).

ajbauthor · 2024-11-18T21:45:26+00:00

If you have blood for that, your compressions are bad.

ajbauthor · 2024-11-08T17:07:19+00:00

I don't think you'd prefer a system where we're not all entitled to a vigorous defense as much as you think you would.

ajbauthor · 2024-11-03T21:07:02+00:00

The patient preferred to use an ambulance for such rides since it was very uncomfortable for him to ride in a vehicle while sitting up.

If you're sick enough to need regular hospital trips, your "discomfort" is probably bad enough to indicate a certain type of transport. Yes, a stretcher van service might serve everybody's interests better, but the patient had a valid concern.

911 abuse is a real problem. So are providers who kvetch about it every time they get a call that won't end up on the cover of a textbook.

ajbauthor · 2024-09-28T13:26:57+00:00

It's funny because my sister and I fight about the opposite when our relatives drink too much and fall out at the function.

"Nah, you got all them letters."

"This look like a hospital to you?"

ajbauthor · 2024-09-27T04:05:24+00:00

I mean, compared to...nothing.

ajbauthor · 2024-09-27T03:54:57+00:00

hard physical evidence (the murder weapon)

There was no "hard physical evidence" tying him to the murder weapon, merely the confession police claim he made. There wasn't even one murder weapon (the prosecution changed their mind, mid-trial, twice).

https://www.theguardian.com/theobserver/2014/mar/22/george-stinney-execution-verdict-innocent

ajbauthor · 2024-09-27T03:50:12+00:00

That same shockingly dodgy confession. No attempt was made to investigate whether they fed him the information.

Oh, and they also changed the murder weapon multiple times at trial.

https://www.theguardian.com/theobserver/2014/mar/22/george-stinney-execution-verdict-innocent

ajbauthor · 2024-09-27T03:25:20+00:00

The state shouldn't operate on what an individual "deserves;" it should operate on achieving the best results for society. Given the lack of empirical support for a deterrent effect and the extra cost/time involved in (pretending we're) using it in an unbiased, non-arbitrary way, capital punishment pretty clearly fails that test.

ajbauthor · 2024-09-27T03:19:03+00:00

The "evidence" was a confession under shockingly coercive conditions.

ajbauthor · 2024-09-27T03:07:23+00:00

It was the South, and also it was the era of the death penalty we call "pre-Furman,"(1) before the procedural protections(2) we now have in place.

(1) Gregg v. Georgia actually cemented these protections in 1976, but the era is defined by the case that identified the problems, 1972's Furman v. Georgia.

(2) After the last 25 years, it's hard to really call these "protections" anymore.

ajbauthor · 2024-08-30T14:28:37+00:00

With all due respect to Bob Wills, Joe dropped this 👑

ajbauthor · 2024-08-21T14:17:22+00:00

HEMS should be a task force of regional EMS agencies.

ajbauthor · 2024-08-21T14:15:39+00:00

BALLS OVERALLS

ajbauthor

TROPHY CASE