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About brehon

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    where the wild things are...
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  1. Well, in principle I agree with this. My experience with both assisted living and, especially, nursing homes from well over 2 decades of the EMS perspective is...different. In my area, and my area is geographically quite large with tons of nursing homes open and more opening every day, nurses in nursing homes do not know their patients that well. Or if they do, it’s invariably some other nurse (or more likely aid from a different hall) who is in the room with the patient. Every paramedic with an ounce of experience can recite the litany of excuses, I mean reasons, why no one knows anything about the patient or why the paperwork isn’t available: not my patient, not my hall/wing, not my shift, just got back from vacation, just saw this (unconscious) patient two minutes ago and they were perfectly fine. Pro tip on the last - EMS will almost never have a 2 minute response time to a nursing home unless we just happen to drive past it as the call drops. Recognizing UTIs?! That is probably the number one reason patients are sent to the ER in my area. Rarely will the nursing home doctor prescribe antibiotics even if the nurse does a clean-catch & UA strip. Nope. Straight to the ER even when not septic. Sounds like the nursing homes in the areas you’ve worked are much better than in my area.
  2. I think you have to be careful with this. Aspirin has been thought to have increased deaths in that pandemic; however, it is not a one-to-one relationship with today because the dosing regimens were quite different 100 years ago. Doctors basically overdosed patients with aspirin which, if I recall correctly, is believed to have caused both an increase in pulmonary edema and salicylate toxicity. And, of course, doctors didn’t know anything about Reye’s syndrome. They knew next to nothing about the pharmacokinetics and pharmacodynamics of what was at the time a fairly new drug. ETA: Tylenol wasn’t introduced and marketed until the late 1950’s. People need to be very careful about not accidentally overdosing on cold & flu type medicines which contain acetaminophen, of course. But I would have no qualms about taking appropriate doses of an NSAID for symptomatic relief. There wasn’t even much thought of homeopathic v. allopathic medicine in 1918, at least among the most of the public.
  3. It depends on what you want to do with your EMT and what’s available in your area for EMTs. In my area, EMTs can work as techs in a few ERs; work for private ambulance transfer companies; volunteer as medical first responders in some of the outlying first responder organizations; and maybe one or two other things. EMTs cannot work on a 911 service ambulance (all EMS services in my area are either governmental third service {like mine - I work for a county government} or fire based {only 2 local FDs and 1 ESD have fire-paramedics} and have dual paramedic crews); work in most ERs as they tend to hire paramedics as techs; or work in various clinics as they also want paramedics. The EMTs in all of the above scenarios do not make a lot of money at all.
  4. Well, *I’m* the one who curses and all my kids - from 18 to under 10 - are the ones who scold me. They’re quite funny when they say, “MOoooooMmmm!!!! Laaannguaaagggeee!!!!” with the accompanying heavy sighs. I don’t curse all the time and try to limit it to more, ah, situationally appropriate times, but I have been known to drop a curse word or ten. I will say that i’ve noticed that judiciously using curse words makes them much more effective when they are used, especially if one uses them around others who themselves curse all the time.
  5. Whatever else might be going on, she’s well within the timeframe for eclampsia. Hopefully, they’re also monitoring that. How scary.
  6. Oh, my! That does look good! Thank you!
  7. On this lovely Sunday, I have a somewhat important question. It’s my turn to buy coffee for my station. After a lot of discussion amongst the coffee drinkers, the consensus is for a rich, strong, medium roast without flavorings. Definitely not bitter or burnt — I’m looking at you, Starbucks. We prefer to buy 2.5 or 5 lb bags of beans and grind them at the time of brewing (well, the night before). This coffee would ideally be available nationally or online and not break the bank of this poor government worker. Suggestions?
  8. I agree with everything you’ve written, especially your second paragraph. I was trying to write something similar and gave up. It’s something I’ve noticed in my football-mad area, too.
  9. Sub football for hockey in all respects except for the skates and you have the exact culture in many towns, cities, and states in the US. Especially at the high school level.
  10. I think the Marshall Plan, while not perfect, was one of the shining moments of humanity in that dark time. I had hoped that we would take a lesson from that plan in more modern times.
  11. Or how a bill becomes a law? ETA: Anyone hankering for a hunk of cheese? P.S. How do you do the quote within a quote thing? I’ve never figured it out.
  12. I’ll third Colin Woodward’s book. (I’ve only read “American Nations” so can’t speak about his other books.) Absolutely fascinating and should definitely be required reading in US, if not North American, schools.
  13. Yes, family history is very important for cardiac issues, especially since his dad died in his 30s. It’s important even though he had cocaine use as a variable that your dh doesn’t have. And the calcium channel CT scan is turning out to be *incredibly* predictive of future cardiac issues and they can usually narrow the prediction to within months. One cardiologist I’ve worked with, who has done one of the definitive studies on this, says this test will probably turn out to be one of the first non-invasive tests routinely ordered for cardiac workups in the near future. Unfortunately, many insurance companies don’t cover it right now. I’m so glad your dh is taking this seriously. I don’t know how old he is (40s?), but 40s is the age range when previously undiagnosed cardiac issues start being diagnosed. For men AND women.
  14. As an American who has waded through this entire thread, I was utterly dumbfounded at the thin-skinned, defensive responses from many of my fellow countrymen. Many of those posts were the epitome of a stereotypical American response when anything approaching criticism is leveled at us. I knew exactly what Rosie and others meant by “talking using American manners”. And I could predict how this thread would go. I’m still saddened that a question *by an American* elicited such defensiveness at the honest answers delivered by non-Americans in our community. (And not all of the non-American responders were from the English speaking, western European sphere.) And, it must be said, some of the same posters who responded defensively have themselves used over generalizations and broad-brush paintings when posting about different groups in varying contexts. Of course stereotypes don’t describe everyone in a group. No one said they did. And all descriptions of a group don’t apply to all members in the group at all times and in all places. But stereotypes exist for a reason; general descriptions based on broad experiences exist for a reason. I don’t think you, Stella, or anyone else need apologize for your thoughts, perspectives, opinions, etc. I’m just one American; however, you don’t need to reintegrate into the community because in my humble view you (a) have nothing to apologize for and (b) weren’t ever outside the community. That’s probably my American arrogance showing, no? <— last directed at me with my tongue firmly in my cheek 😉 Personally, I don’t tolerate you; I very much appreciate your varied perspectives. Frankly, they’re desperately needed as we Americans can be, and many times are, incredibly myopic.
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