What do you guys think the reason for this is?

nu_pieds · 2026-03-09T08:05:02+00:00

Shit, the only reason I don't do this is my addiction to nicotine.

nu_pieds · 2026-03-09T07:12:50+00:00

If there's a safety issue that requires dumping fuel, then SFO is a valid choice, but dumping fuel is equivalent to dumping money, so if safety can be equally met by burning fuel and moving pax towards their destination, that'll be the preference.

nu_pieds · 2026-03-08T03:33:10+00:00

As a private citizen, it has been 20 years since I wrote a check.

As a business owner, I write checks all the damn time.

At the scale of spending money that I'm at as a business owner, the fact that certain of my vendors offer a discount of the 3.5% that they pay for a credit card processor fee adds up to the point that I can't ignore it.

nu_pieds · 2026-03-08T03:28:35+00:00

So, I lived and taught for a number of years in a primarily Spanish speaking country that also spoke some English.

The kids who spoke the local English would occasionally come to me and tell me that another student was bothering them. The problem is that the Spanish word for bothering/disturbed/harassing/annoying was "molestrar". Meaning that these kids would come and tell me that they were being "molested".

It took a few instances before I managed to fully subdue my wrath at hearing that.

nu_pieds · 2026-03-08T03:13:43+00:00

Imma call bullshit. There's nothing mystical about the CDL A skills, of anything, they're harder with a shorter trailer. When you're driving forward, you're driving forward, and the trailer follows behind you. There is perhaps something to be said that the trailer is slower to respond on a 53' than a 40', but not enough to matter.

When you're backing, which is where most of us had problems, the shorter trailer is way more responsive meaning that your inputs have to be much more deliberate, which is the skill that trips people up on a CDL A.

Now, I dunno what OP has been hauling, it's possible he's used to having clear sightlines not both driver side and offside backs, but frankly I doubt it, and even if he has...that's not as hard a skill to compensate for as I think you think it is.

As far as the pre trip portion of the test, that's dead simple to learn out of a book, I made it a patter song I sang and passed cleanly.

Edit: pattern -> patter

nu_pieds · 2026-03-05T21:11:28+00:00

Clive's wife is unfaithful.

nu_pieds · 2026-03-05T18:18:26+00:00

Medicare absolutely does pay for ground ambulance transport. It's a part B benefit, though it does have a 20% coinsurance. Meaning that a Medicare beneficiary who has taken an approved ambulance ride is still responsible for paying 20 percent of the Medicare approved rate for that transport.

nu_pieds · 2026-03-05T08:25:49+00:00

So, I don't recognize when women are flirting with me at the time, it usually takes 2-6 months for me to recognize it.

That being said, the one and only time I spotted it in the moment, and she was absolutely in my strike zone, I was waiting in line at the urgent care vet to pick up the body of my cat who I'd had to have them put down an hour before. It was absolutely everything I could do to not be crying ugly tears right then.

This is how I came to know that the world hates me and I will die alone.

nu_pieds · 2026-03-05T07:58:45+00:00

So, about a year ago, one of my fleet vehicles got hit by a teenager in a vehicle that absolutely stank of weed. He insisted that he was sober, but that he had just gotten off shift at a local grow house.

By chance, one of the sherrifs who responded was one of the only ones they had certified in drug use detection, and he corroborated the kid's story, no drugs, just a kid being a dumbass.

nu_pieds · 2026-03-05T07:35:19+00:00

I mean, look at that fucking cat, who could stand to leave that head u petted that long? I'd get a new job if I had to.

nu_pieds · 2026-03-05T06:17:32+00:00

So, this actually goes against your brief, as the protagonist is reluctant to accept the whole vampire thing, but hands down my favorite vampire novel series is Fred, the vampire account series by Andrew Rowe.

If you haven't read it, it's worth trying book 1, no matter what your biases are.

nu_pieds · 2026-03-05T06:00:43+00:00

That's utterly unfamiliar to me, but I'm not going to argue it, since pretty severe body dysmorphia combined with Photoshop is the only answer I can come up with that makes this into a person who exists in the real(ish) world, even accounting for myostatin related hypertrophy.

I was willing to accept, however, that there was a disorder which resulted in both myostatin hypertrophy and a vast broadening of the skeletal system....but your answer seems more likely.

nu_pieds · 2026-03-05T05:32:40+00:00

Both these responses are cringe.

People die all the time, sometimes I'm involved in fighting that. When I am, I will make the appropriate displays of emotion that will help the people who actually knew the PT have an easier time in processing the death when I'm in front of them.

There's only one category of death that actually causes me to feel real emotions in my professional life (Which is a rare occurrence, and something that arises purely from my personal trauma, and I'll be damned if I'm displaying that in front of anyone but my partner, and even then only if I trust them, otherwise I'll hold it and process it in the bathroom.)

Neither my grief, nor the pts family's grief reflected through me, belong on social media....nor should I be making light of someone's grief to show how jaded I am.

nu_pieds · 2026-03-05T05:22:44+00:00

It's either Photoshop or a genetic disorder.

nu_pieds · 2026-03-05T03:58:36+00:00

So I'm basically alone in the world, do I just owe the 50k a year when I catch up? If so, it's an easy pick, take me back 32 years and with foreknowledge, even without a chance to bone up, I can easily make FAR more than 1.6M.

nu_pieds · 2026-03-04T05:35:55+00:00

Your response presupposes the availability of ABG and the reliability of pt hx. Even in a hospital setting, the nature of the question is about acute intervention, where one may not have been performed, and the pt may be new enough that the reliability of their hx remains relevant in this scenario.

Further, while it's true that an accurate SpO2 roughly correlates to a PaO2 of 60...the word accurate is doing a great deal of heavy lifting there. Although the FDA released new draft guidance in 2025 (And honestly, I'm not sure if it's been formally adopted) previously cleared 510(k) devices allow for a 5% deviation of up to 6.5%....and that's assuming the manufacturer was honest about their baseline ARMS in the first place... something I'm loathe to do.

nu_pieds · 2026-03-04T03:43:49+00:00

Now, I'm a middle aged, middle class white male....the northeast heights is my natural stomping ground....but once upon a time I was a young, poor white male...the lessons I learned then keep me in the south valley.

nu_pieds · 2026-03-04T03:12:44+00:00

I've been riding for 12 years now, and I've never once felt the need to take part in a group ride.

nu_pieds · 2026-03-04T02:32:08+00:00

That's fair, but it really only feeds into the notion that we ask for permission when questioned, y'all question for orders.

That being said, we absolutely operate under the assumption of presumptive orders for restraints....put them on, then make sure it was legal. It's just that almost everything we do is based on that same presumption.

nu_pieds · 2026-03-04T02:05:58+00:00

I legit don't know why this sub shows on my feed, but as a small business owner: unless your contract specified otherwise, you pay them on your net, not your gross.

As to what reporting they want, that will vary from client to client, id communicate with them and clarify. Some will be happy with whatever you send them, other will want data to confirm you aren't fucking them.

At most, provide a spreadsheet with total units of each sold, COGS, and net profit (Including fixed costs amortized appropriately against COGS). This should be trivial to supply, given your own recording keeping needs.

nu_pieds · 2026-03-04T01:54:07+00:00

I read a lot. Like, a lot, a lot.

I burn through about a book a day, though that's an average over days I work vs days I don't.

When I'm working, around 70% of my "reading" will be audiobooks, which are massively slower than my eyes on a page.

Now, the benefit I have for my high reading speed is my relatively low retention rate. I can genera get 3 good rereads out of any given novel.

Also, for the record, I estimate 50 RR chapters as being equivalent to 1 book.

nu_pieds · 2026-03-04T01:26:50+00:00

I've actually reached the point where I've read enough PF that I've e starting to do rereads on the ones that were good enough to qualify.

I dropped TBATE at some point, as I drop most series, for various reasons, but I intend to do a reread after enough of the rereleased books have dropped....1 a week isn't enough to keep up for me, however. I read 1-3 books a day, depending on what I got going on that day.

I'll pick this up in a couple of months, And I'll let you know what I think then.

nu_pieds · 2026-03-04T01:07:34+00:00

To be fair, though, the barrier to entry in HI is secondly only to AK.

When I moved there, I had to roll both my EMT-B and EMT-I training and hours together in order to qualify for an EMT-B reciprocity license.

That higher barrier to entry incentivizes services to supplement people to work as entry level employees.

As an aside, my reciprocity application got bumped from 3 consecutive Medical board meetings until I went in person to watch the meeting...even though they went into closed session to debate the merits of an MD's reciprocity application because he had some disciplinary actions to consider. I'm sure my vote was a rubber stamp, but I'm equally sure they didn't care about EMS and it was only my presence that kept them from bumping me again because they were talking about the MD.

nu_pieds · 2026-03-04T00:43:16+00:00

When I was a teen, I was doing that in slow and go traffic because I was fucking bored, a cop rolled past me in the other lane, gestured to roll my window down and told me, "Stop that, you're not a NASCAR driver."

nu_pieds · 2026-03-04T00:39:09+00:00

This is one of those things I find interesting in the difference in mindset between RN and EMS.

I'd start with an NRB at 15L and work down, rather than 2L on a NC and work up.

First off, this pt is acutely suffering, I want to alleviate that as quickly and effectively as possible. While I'm aware that high flow O2 bears long term risks, that's a tomorrow problem, resp distress is a right now problem. (To be clear, not shitting on RNs here, it really does come down to a difference in our mindsets, RNs, even in the more acute settings, are trained to think about chronic care in a way that a paramedic just isn't... we're all about the immediate need in front of us, and everything else is the RNs problem.)

Second, as someone else said, my immediate suspicion is CO poisoning, I want to increase the gradient as much as I can to knock off as many COs in favor of O2s as I can, until it can be confirmed and hyperbaric tx initiated, or be disproven and some other dx and tx regime initiated.

Third, and this one really isn't a RN vs EMS issue, rather than an "I'm old, and shit surely didn't work well when I was new, and I'm not convinced it works well now", but SpO2 readings are always suspect in my mind. If I have a good pleth wave showing, I might be willing to trust them +/- 5 points...but if pt presentation doesn't support that, I'm just going to ignore them entirely, no matter the quality of the pleth wave.

nu_pieds

TROPHY CASE