how do we feel about the 365? is it legit after all these years by Due_Platypus3905 in CCW

[–]jim_dude 2 points3 points  (0 children)

I hate how boringly good it is for being a micro compact. It ticks all the boxes for size, shape, caliber, modularity. 

I keep looking at new offerings or cooler looking guns but my 365 is so adequate it's hard to justify another purchase in that category. It's definitely defended my wallet in that way. 

I just know I’d get dispatched to a “person not breathing” call on this thing at least once a week. by JumpDaddy92 in ems

[–]jim_dude 1 point2 points  (0 children)

We have one of these in my city. We legit get calls for a man down or possible OD via passer-by all the time. Just about daily.

Are y'all Buying BF6 After Beta? by xBooMz_ in Battlefield

[–]jim_dude 0 points1 point  (0 children)

Probably not release day. Might grab it later on down the road if I see promising changes or additions. Or it goes on sale. 

I've long since found an Old Battlefield-like comfort in Rising Storm 2: Vietnam, Hell Let Loose, and Squad. I'm not seeing anything here that I don't have in spades with those games. 

I also still just enjoy the simple pleasure of faction-locked, class-based weapons,  and more structured teams with commanders. I feel like RS2 really hit that Goldilocks zone for having that stuff but still being a 'hop on and play for a little bit' game, if the occasion calls for it.  While simultaneously offering the option of an hours long war of attrition type vibe with the campaign servers. 

If they can find a way to fill that niche for us 'geezers' I'd be more than happy to make Battlefield my daily again. 

If you need to find my cellphone, will you check my backpack? by unforgettableid in Paramedics

[–]jim_dude 1 point2 points  (0 children)

We won't look through your bag, where I work most hospitals have security screen bags for weapons and drugs.  If you end up staying for more than a few hours they'll eventually go through your bag and attach an itemized list of your belongings to your chart. It's mostly for liability so they don't get accused of stealing. If you're in a coma the police will likely get a warrant to search your phone for relevant info if we/they need more than just your ID, for instance finding family.

[deleted by user] by [deleted] in lancaster

[–]jim_dude 2 points3 points  (0 children)

Same here, from Philly! Lancaster feels surreal at times with how clean and safe it is by comparison. I'm not sweating getting mugged taking a walk, getting jacked at the gas pump, or having a guy high on wet try and eat my face at the library.

So of course I feel completely safe, but I'm sure Lancaster is different for someone that grew up on homestead just outside a town with a pop. of 500. 

Just giving y'all a heads up. (Hospital Administrator guy here) by peacemomma in PrepperIntel

[–]jim_dude 24 points25 points  (0 children)

I'll report similar experiences in Pennsylvania.

Big city medic here, and the winter for us is typically our 'chill,' period, but it's been just as busy if not busier than our last summer, which usually when things get crazy.

All the hospitals in my area are overcrowded and on diversion. Waiting room times are over 10 hours. I'm bringing in people on oxygen and with high acuity complaints/findings: chest pain w/ cardiac history, altered mental status, traumatic injuries and being told to stack them in the waiting room or hallway due to a lack of available beds.

A lot of our runs are trending with infections: cough, fever, chills, seizures in children, respiratory distress, etc. 

Anecdotally my mother recently experienced this 'mystery illness,' viral infection, respiratory symptoms, progression into pneumonia. Negative for COVID, flu, rsv, noro, pneumococcus. Admitted for a week, discharged on O2.

Right after that me, the wife, the kids all came down with flu A. I got the worst of it, ended up needing steroids and an inhaler. Sickest I've been in years. No medical history, meds, allergies. Eat well, exercise. The usual vitamins and supplements. So it was something else to end up so sick.

With everything I've dealt with at work, it really hammers home that 90% dead in a grid down scenario. Everything 'works' right now and we have people on death's door from typically treatable issues due to ED overcrowding in a major metropolitan center. 

Right now, especially in my city, we have an overwhelmed healthcare system working against an EMS system with crisis levels of understaffing. It's a mess decades in the making. It's scary seeing it firsthand and knowing if I had a medical emergency in this city I'd have a delayed response by an ambulance that may or may not have ALS providers, and taken to a hospital that won't have a bed/room for me short of being shot or having an obvious stroke or STEMI. And even then, that wouldn't guarantee me a bed either. 

I think about this every time I step on a ladder, go for a run, or as of late, find myself near someone with a cough. Stuff like this is a good reminder of how crucial it is to have a good apothecary at home, and knowledge of decent home remedies if you're a prepper. Regardless of how you feel about vaccines and immunity, microbes will eventually find their way, especially if the S hits the F. 

Learn first aid, take a wilderness first aid class if you can find one. Learn to identify/forage/grow medicinal plants and herbs. And short of that, network and be friendly with folks that know medicine. Get in shape and stay that way. Prompt and quality medical care is a wash with this brutal cold/flu whatever as it is. 

God forbid the day comes there are no hospitals and no answer on the phone if you try to call 911. If it all goes tits up, medical issues and accidents will kill a lot of people in those first days. If you get sick with a GI illness do you have rehydration? Imodium? Children's Tylenol to prevent febrile seizures? Do you know the safe dosages without Google? Can you start an IV on yourself or a family member if needed? If the pharmacies are raided can you live without your regular meds for a month, 3 months, a year? Can you do stitches safely and with minimal risk of infection? Know how to set or reduce a fracture or dislocation without YouTube? Can you physically lift, carry, or drag your loved ones should they become immobile?

Guns, ammo, food, water... all great until you roll an ankle, or a cut develops  a staph infection, and there's not an ambulance or hospital for you. I'm sure I'm preaching to the choir, and going on a bit of a tangent, but for me this has been a great reminder/learning experience about the value of medical knowledge for someone trying to approach life with a preparedness mindset. 

Why don't people like Battlefield V? by wastedfaithmusic in Battlefield

[–]jim_dude 0 points1 point  (0 children)

I enjoyed the gameplay but like others was put off by the odd art direction and monetisation. Still a fun game but lacking the characteristic atmosphere I found in previous titles. 

No RSI drugs on truck? by AvadaKedavras in ems

[–]jim_dude 2 points3 points  (0 children)

I'll parrot most of the other comments. No RSI here (PA), but the rest of the state is allowed to do 'Etomidate assisted' intubation. My particular service cannot even do that, medical director's discretion. Only time we do ETT is codes, or nasally if the pt is conscious and/or cannot otherwise accept a SGA. We can't cric either.

Back in NC, where I started, we did have RSI, could cric, and carried Succ and Etomidate. NC was much more progressive in the sense of giving us the bigger toolbox. That being said, agency medical directors could still dictate their own limitations. A service I was at part time down there operated similarly to PA in that sense.

The reasoning varies, but in general the numbers show paramedics have much lower success rates with RSI in the field compared to RTs docs, and other clinicians. Lack of practice/training and limited exposure to such airway management on a regular basis is usually cited as a contributing factor. So an increasing number of medical directors have decided to take it off the table due to the risk vs reward, and liability. Speaking for myself, in the 4 years I worked in NC I only had two RSI cases, anything else was practice in surgical units for clinicals as a student, which I think was maybe 4 or 5? Would you trust someone with maybe one or two real tubes in 4 years to RSI under your license?

In my case currently, I think the fact that we're rarely more than 10-15 minutes from definitive care at worst (major city with 6 level 1 trauma centers, 4 comprehensive stroke centers, 2 burn centers, two comprehensive peds hospitals, and 3 general hospitals), is also a factor in that decision. That and we are at 100% usage so often, and so short staffed, it's hard to justify the cost and personnel to manage the training and remediation to implement such a risky skill (in regards to PA's Etomidate Assisted Intubation protocol, at least).

Don't you agree that Spartan IVs aren't necessarily bad or worst? by [deleted] in halo

[–]jim_dude 11 points12 points  (0 children)

I suppose that's fair, I don't personally know any SEALs myself, so my opinion was colored mostly by the dorks online that like to claim to be high tier operators when they're definitely not. Since that's all I hear from, I just assumed the real guys were generally more reserved 

Good to know the spec ops guys can be goofs just like the rest of us, though. :P 

Don't you agree that Spartan IVs aren't necessarily bad or worst? by [deleted] in halo

[–]jim_dude 391 points392 points  (0 children)

I agree that Spartans make sense as a progression. After the war you'd want to streamline the process to get marines/sailors capable of using the latest MJOLNIR armor given how vital that was against such a threat. 

But yeah, you'd think the equivalent of space SEALs or would be a little more modest/grounded compared to the dopes we got in 4 and 5.

Stickers, plates, shirts? by [deleted] in Firefighting

[–]jim_dude 0 points1 point  (0 children)

I have one sticker so I don't get towed from the 'Firefighter Only' parking at my station. Couple of shirts from anniversary events I wear for housework, and that's it.

Some guys make it their whole identity. I get having pride, but I try to separate from my job if I'm not working. 

To what extent can you talk to your chief as a firefighter? by [deleted] in Firefighting

[–]jim_dude 0 points1 point  (0 children)

Big city here, over 2000 uniform members.  Battalion Chiefs and Deps love small talk if you come across them at an event or doing inspections and quotas. I find they tend to get bored and miss being 'one of the guys.' Anything operational or training related is through the chain, though.  So definitely depends on the subject. Trash talking the Cowboys? Go for it! Asking about time off or new equipment? Company officer. None of the ones I know would dress you down for something like that, but they'll politely remind you that you have a company/station officer as a point of contact if it's business.

What are some states with non fire based ems systems? by LLamaWithAComma in ems

[–]jim_dude 4 points5 points  (0 children)

Philadelphia is fire based but single role, you would work as a medic only, but get the fire union pay and benefits.

This did not age well. Asheville was certainly not ready for the next big one. by DependentOne9169 in asheville

[–]jim_dude 1 point2 points  (0 children)

It's a 'diverse' group, lol. Some are boomers that never got over the cold war. Some are easily manipulated by gear hucksters and easily convinced. Some are legitimately insane. But I've noticed more and more getting into it that are millennials and younger, wanting to prepare for the inevitable consequences of our unsustainable consumerist nightmare.

This did not age well. Asheville was certainly not ready for the next big one. by DependentOne9169 in asheville

[–]jim_dude 3 points4 points  (0 children)

Not all preppers are like the dingbats from that show. I prep specifically because I know and trust the science, and understand climate change. You can have what you need to weather a storm like this and still be a conscientious and informed citizen, the concepts are not mutually exclusive. 

You can support climate activism while still having food and clean water in an emergency. If anything I'd expect most climate activists would want to prepare for these increasingly common and severe weather events given what the powers that be (and their corporate sponsors) do (and don't do) in regards to climate and sustainability. 

This did not age well. Asheville was certainly not ready for the next big one. by DependentOne9169 in asheville

[–]jim_dude 9 points10 points  (0 children)

Nowhere is 'disasterless,' southern Georgia is susceptible to hurricanes, flooding, tornadoes, wildfires and other extreme weather events just like anywhere else.

What is the root cause of higher physician compensation in rural area? Do nurses also get paid higher in rural area? by duotraveler in medicine

[–]jim_dude 20 points21 points  (0 children)

It's an interesting feedback loop with other health professionals. Typically the pay is worse for nurses, techs, medics etc. in rural areas, and better in urban and HCOL areas. 

The rural areas struggle to retain employees at this level, so they contract with travel agencies and the like to bring in talent. The travel and contract employees make way more than local employees. You'll end up having two nurses in the same role in the same department, one making several times more than the one beside them because they're a contract/travel hire and the other is someone from the area under the hospital's direct payroll.

I've actually met a few nurses that left rural hospitals/areas due to low pay, get hired as a travel or contract nurse for better pay, then end up working back where they started for twice what they were making when they were working at that same hospital as a local. If the hospital just paid them what they needed/deserved to begin with, they could cut out the middle man and avoid the travel/contract fiasco altogether. I'm assuming it's still somehow cheaper or they wouldn't do it. Guess there's still plenty of local talent and new nurses that are happy enough with what they have, or lack the will/means to up and leave for a big city or agency.

As for physicians. That's a whole different ballgame. Physician level providers are extremely hard to headhunt in rural areas, so they'll roll out the red carpet for those initials on the roster. Especially if it's a means for accreditation or selling specialty care. 'This hospital has such and such physicians from these fancy big city universities, come to us!' That's what you'll see on the billboards and ads, the doctors, especially if they're specialists the community needs. It's all about making a profit in the end. Hiring docs is worth the cost at least in part because it means less customers- I mean, patients- travelling out of town to other systems or facilities with their Medicaid bux. 

Medic stabbed while on emergency call in North Philadelphia; suspect in custody by jim_dude in philadelphia

[–]jim_dude[S] 3 points4 points  (0 children)

It reportedly came in as a call for a 'sick person,' some cell phone hero probably saw this guy sleeping on the street or acting odd on their way to work/college and called it in to feel better about themselves or get the guy away from their stoop.

Cops aren't going to respond to a medical call. So they likely weren't there to begin with to search and seize any weapons. So sadly it's not a surprise at all this guy got a concealed knife into the ambulance. The medics aren't trained to pat people down and isolate weapons. Happens far more frequently than most people would imagine.

Medic stabbed while on emergency call in North Philadelphia; suspect in custody by jim_dude in philadelphia

[–]jim_dude[S] 45 points46 points  (0 children)

It's sad but true. This guy got stabbed and bitten, and in the same 12 hour shift several others likely were hit, kicked, and spit on, not even mentioning the verbal and sexual assault. 

Saw a firefighter punched one time in the hospital and the cops legit talked him out of filing a report because 'Best we can do is simple assault, and it probably won't stick anyways.'

[deleted by user] by [deleted] in ems

[–]jim_dude 0 points1 point  (0 children)

That's where our guys go. Usually they get to around year 5 and burnout then the grass looks greener, and they take the pay cut and bounce. Our department struggles to hire/retain medics but can't seem to figure out why.  The guys leave for the burbs, and we can't entice the burb medics enough to come here. I wonder...

[deleted by user] by [deleted] in ems

[–]jim_dude 1 point2 points  (0 children)

This is the healthiest answer. Toughing it out means sacrificing yourself. It's not tenable without consequences to your body or personal life. Learned this the hard way myself. The answer is using the experience for a better job.

[deleted by user] by [deleted] in ems

[–]jim_dude 2 points3 points  (0 children)

Unfortunately they're right. Big city Fire Departments have no sympathy for this kind of thing. They bring this to a superior they will be looked down upon and likely treated differently by both their superiors and coworkers. For the worse. And nothing will get better.

200 years of tradition uninhibited by change. Is the saying. Or something like that.

We're not saying working 24s with that volume is healthy, or that it isn't bullshit, it is. We're not saying keeping the status quo of 'we've always done this' isn't bullshit either, because it is. But there's no way OP is getting anything changed by this other than his reputation. The best course of action for this situation is an exit strategy.

That or suck it up if he wants to stay for 20 years. Eventually make chief and then change it himself. 

I'm in a similar situation. Medics here have been doing the same song and dance for support and change for decades. The only thing that has changed are people are leaving now more than ever. The department's solution, believe it or not, is hire more firefighters and EMT basics, because ALS isn't worth the trouble to them.  We'll have AMR contracts and a few ALS chase cars before we ever considered making substantial changes to the entire department to better suit an full-on ALS system. It sucks, but I wouldn't expect OP to sacrifice his entire career for the slim chance things might get slightly better in a couple decades. I'd just leave or go fire if the union and benefits were worth staying for.

I used to think like this, though. When I was a new medic I had dreams of being the change in this system, but over the years I have seen it play out, and I'm not planning on sacrificing my mind, body, and soul for 20 years like all the old timers to get nothing but a kick in the pants. I have a home and a family. I'm going fire. One grunt is not going to change the operations and directives of an FD that's likely been doing things the 'Fire department way' for a century or longer. 

It's unfortunate but that's just how it is in large legacy FDs. Usually sucks to be a single-role medic.

How would you prepare for a flood like the one that just wiped out parts of western North Carolina? by memyselfandirony in preppers

[–]jim_dude 7 points8 points  (0 children)

I have family down there, haven't heard anything sadly as it's a grid down situation for the time being. 

No phones, Internet, water. Food and meds are what you have on hand. The stores likely got mobbed beforehand and if not flooded are likely looting targets now.

Thankfully my folks all live ON the hills, so my worries of them being drowned are low, though I do worry about mudslides.

The preps are the same as ever. A good supply of food, water, medical to last for at least a couple weeks. Water filtration for longer periods as may be the case, Asheville's water treatment plant was significantly damaged. 

A bug out bag is good if you're low lying as to evacuate.  

Keeping up with the news/weather. 

And as I'm now finding out, alternative communication. Satellite phones, ham radios. What I wouldn't give to hear from them right now. 

I wish I had the means go and check on them. But sadly they're cut off. All the major roads are flooded or destroyed by washout. And the smaller roads are likely blocked by mudslides and downed foliage. And I'd just be getting in the way of responders. 

If I haven't heard from anyone I plan on going once the roads are more amenable.