Skip Navigation
InitialsDiceBearhttps://github.com/dicebear/dicebearhttps://creativecommons.org/publicdomain/zero/1.0/„Initials” (https://github.com/dicebear/dicebear) by „DiceBear”, licensed under „CC0 1.0” (https://creativecommons.org/publicdomain/zero/1.0/)CO
conditional_soup @lemm.ee
Posts 30
Comments 1K
Donald Trump's "foamy saliva" in campaign video raises questions
  • Hi, I'm a paramedic x14 yrs. Didn't watch the video, but I don't think this is likely to be the case. In almost every case I've seen pink-tinged foamy sputum from CHF, the patient is in critical condition, and is in absolutely no state to be delivering a deranged rant. Even in the cases where they work on it with hacking and coughing for a bit, they're still pretty much out of gas and not going to be carrying on like dumbass here. At least, that's my experience.

  • Yuntai: Hiker finds pipe feeding China's tallest waterfall
  • This doesn't seem all that awful to me. The waterfall isn't fake, it's just something they do in the dry season so visitors don't feel like they wasted a trip. It's not the choice I would make if I were running the park, but it doesn't seem that bad to me.

  • Sure, Biden’s climate policy could be better, but consider what a second Trump term would be like
  • Thanks for sharing that. Biden's done a lot of things I agree with, I was actually pretty impressed with him until the Palestinian genocide. I wish that this is what the Biden camp was talking about. Instead, all of the messaging seems to be "the economy is fine, actually, you're complaining about nothing" or "well, at least he's not Trump", and I don't think that kind of messaging will carry the day.

  • Sure, Biden’s climate policy could be better, but consider what a second Trump term would be like
  • I'm not both siding. I'm in disbelief that in an election as important is this one, the democrats have decided that the best strategy they can use is "you don't really have a choice, you have to vote for me because I'm not Trump." Which, at best, has a track record of a 50% success rate, and arguably has a 0% success rate. I say 0% because, the way I remember it, that wasn't the strategy the Biden camp ran with in '20; they hadn't forgot that people actually did vote for Trump before. This was basically HRC's messaging in 16, "suck it up, vote blue no matter who, because, I mean, are you really going to vote for that Bozo?" And they found out the answer to that question the hard way. I don't want the democrats to learn already learned lessons at the expense of the entire country. It just feels like they're playing stupid games for themselves to win stupid prizes for everyone.

  • Sure, Biden’s climate policy could be better, but consider what a second Trump term would be like
  • So this is really where we're at. Team Biden is really going to take the HRC 16 strat of just fucking giving up on promising anything meaningful and going "what are you going to do, vote for that Bozo?"

    That's a bold strategy, Cotton.

  • "Fascism is when I don't like something, and the more I don't like it, the more fascist it is"
  • This makes more sense in the context that they believe that they're in the in group that the law should protect yet not bind, and everyone else that the cops are for are in the out-group that the law should bind and not protect. That's why there's this breathless disbelief that the J6ers and Trump have been prosecuted, and further disbelief that it's in any way legitimate.

  • A lot of ins, a lot of outs, a lot of what-have-yous
  • We already do make threats (of varying kinds, usually financial) to control our allies, as well as our enemies. We've caused whole ass revolutions because fruit companies stood to lose money. The US plays dirty whenever we want and lose zero sleep about it, and I see no reason why stopping genocide should suddenly be a case for doing everything above board. I mean, really, I'm not buying it that the same country that said "fuck ur laws lol" and teabagged Osama Bin Ladin in the middle of the night and has declared itself beyond the reach of the ICC is suddenly tied up by international laws and relationships and is just simply helpless to do anything but build a dock that can't even float.

  • A lot of ins, a lot of outs, a lot of what-have-yous
  • Let me break it down. If, tomorrow, Uncle Sam grabbed Nettanyahu by the balls and said "stop it or I'm going to fucking give you the Saddam treatment", they'd listen. Honest to goodness, Benny knows as well as anyone that we could hand deliver a drone strike to his testicles with millimeter precision within three minutes of deciding to do so. And while I recognize any of those would be political suicide, I also thing that, realistically, I think it would take far, far less than that to bring this operation to a standstill.

  • Everything must be a subscription service
  • But with all the money they're saving, they'll be able to renovate the admin building for the first time in two years, or have a nice dinner for the big donors, or give even more money to the football team.

    Edit: assuming this is a uni. If not: won't someone please think of the investors?

  • Claudia Sheinbaum, the first female president of Mexico
  • So is that last line meant to drive rage engagement, or are we just not allowed to be happy for Mexico?

    The more I've been paying attention to Mexico, the more impressed I've become with them. Yeah, they do have really serious problems, but it's 2023, who doesn't? On the bright side, they're starting to shift left (at least enough to make the investors throw a hissy fit, which we could stand a little more of), they actually have the most sane transit infrastructure in North America on average (emphasizing the average here), and I kinda get the vibe that they're starting to give a lot less of a shit about what the US might think about x thing and starting to do what they think is right.

  • 74-year-old woman pronounced dead in hospice care found breathing at funeral home
  • It's called Lazarus Syndrome. I was exposed to a case once at a large ER while waiting for a bed for my own patient (hello, am paramedic). Not too much to say about it, the ED staff were working a code, like they do, and called it. About twenty minutes later, some staff was in the room cleaning up when they noticed the patient breathing and told the nurses. Staff came running like hell and worked them for another 15-20 minutes before calling it again. Weird shit, and pretty unusual in my experience, AFAIK we still don't understand the mechanism behind it.

  • Elijah McClain

    So, I wanted to have a level-headed discussion about this case. I've been loosely following it since it happened, and I'm curious to see what others think of it, perhaps hear from folks who followed it more closely.

    For those out of the loop, here's the JEMS article on it: https://www.jems.com/patient-care/two-co-paramedics-found-guilty-in-death-of-elijah-mcclain/

    The tl;Dr is this: Aurora fire medics are dispatched to assist Aurora PD with a combative patient they believe is in an altered mental state. Aurora FD EMS crews identify this patient as qualifying for their excited delirium protocol based on PD and patient presentation, and administer the maximum dose of ketamine allowed under their weight-based dosing (which was well over what Elijah weighed). Now, there's other details (this IS a tldr), but after the ketamine, the patient goes into respiratory and cardiac arrest and is eventually declared. The paramedics involved were found guilty of negligent homicide. The FD has stood by their paramedics, saying that they followed their policies appropriately.

    Let me lead with this: it seems to me that McClain's case was a foreseeable (albeit low likelihood) and unfortunate outcome that was the cumulative result of many lesser individual poor choices on the part of both law enforcement and EMS. We lack the personal context to really appreciate those choices, I think, and we're left to armchair quarterback those decisions with only the information available to us. I do believe that Mr. McClain should still be alive, and likely would be under different systems-level conditions, such as training and clearly defined interdepartmental operations protocols. Personally, I disagree with the conviction based off of my current understanding of the situation. My current understanding of the facts does not persuade me of the presence of gross, nevermind criminal, negligence on the part of the EMS crew. There absolutely is a conversation to be had here about PD leveraging field sedation and integrating field emergency care as a compliance and law enforcement tool as opposed to a healthcare response to a medical emergency. There's another conversation to be had about systems-level choices that likely influenced this outcome. I think that just throwing these guys in jail fails to accomplish anything on those fronts, and, as such, is a false justice.

    So, I'd like to ask you guys for your thoughts. Was it preventable? Was the conviction helpful? What can be done to prevent this in future, if anything, and what's your take-away?

    0

    Field Ultrasound?

    I was wondering how many of you have experience using pre-hospital ultrasound. I've heard for a long time that it's the "next big thing", and I can see it for rural systems or maybe even community paramedicine, but I've not seen much in the way of it actually getting adopted. Do you find it to be a meaningfully useful addition to your skillset and protocols? If you were around when it was introduced, how do you feel about the introduction? What were some lessons learned by you or the system along the way?

    1
    USpolitics @lemmy.world conditional_soup @lemm.ee

    Biden's Messaging

    Hey, so, I was hoping someone could break down the strategy or rationale behind team Biden's current messaging? Cards on the table, I plan on voting for him in the general election and primary, but the Biden camp's messaging seems insane to me. I know a single person irl who's doing well financially right now, everyone else is feeling the pain. The messaging so far seems to be (and please correct me if I'm wrong): everything is fine actually, and we should all be praising him, and it doesn't matter if you disagree because the other guy is Hitler. It just comes across as super disconnected, I don't know any IRL left/Dem voters that resonate with it, and it honestly reminds me of the general vibe of the HRC campaign from 16. This election is too important to fuck up, so this messaging has got me concerned. Can someone explain how this is supposed to win Biden the election?

    22
    CA Native Plants @lemm.ee conditional_soup @lemm.ee

    Yerba Santa

    Yerba Santa is actually several closely related annual plant species native to California and Oregon. In my personal experience, Yerba Santa can frequently be found along roadsides and in disturbed soils in the Sierra Nevadas, but CalScape suggests that they're mainly found in the mountains around SoCal and along the Pacific side of the Diablo range. The leaves are tough and leathery with a rich, dark green coloration on top and a fuzzy underside that looks much paler. The plant can be a little unpleasant to handle due to the sticky resin it secretes. The leaves are long and toothed, and grow off of stems that don't branch. I've never seen a single yerba Santa plant by itself, it almost always grows in small, dense clusters like you see in the picture. Yerba Santa also puts off clusters of trumpet-like purple-white flowers from the top that are used by native butterflies, but I haven't seen this in person.

    Multiple sources report the medicinal use of Yerba Santa by both First Nations peoples (Miwuks and Yokuts to name a few) as well as Spanish settlers to treat a variety of remedies. As bitter as the plant is (also, tar is another foraging red flag for me; where there's tar, I usually expect that there's some pretty bioactive compounds like Nicotine, and that's a recipe for a bad time), I can't help but imagine that there's probably some compounds in it that might not be great to put in your body all the time, so I highly recommend doing your own research here. Also, a lot of the information about the supposed medicinal qualities seems really apocryphal and like it's just something that people repeat but never verify; I'd want to follow up with some people who have real experience with this plant before just going and chewing on it. For animals, Yerba Santa provides food for butterflies, native bees, and birds in the form of nectar and seeds, and has been documented as a forage of last resort by native blacktail deer when most other plants have already died or gone dormant. Additionally, Yerba Santa has been documented as being useful for stabilizing disturbed or scorched soils. There's a few weeds that could conceivably appear similar to Yerba Santa due to their habit of growing as a cluster of dense, non-branching stalks, but the tell I would suggest is the leaves. Most weeds that have similar growth habits won't have the same thick, robust, tar-covered leaves that Yerba Santa has, and won't have the trumpet-like flowers. The most serious lookalike, imo, is Oleander. Oleander is a woody shrub that gets much larger than Yerba Santa, but has similar-looking, rich dark-green, tarry leaves with trumpet-like flowers. OLEANDER IS VERY POISONOUS AND WILL KILL YOU IF CONSUMED. Oleander is not native, and is widely used as an ornamental throughout California. As a rule of thumb, if it's woody OR big OR looks like it's supposed to be there, it's Oleander.

    Yerba Santa varies in hardiness. Like many California natives, it is wholly unafraid of summer sun; though most natives do fine with at least a little shade in the day, Yerba Santa is beyond such weakness. Some species of Yerba Santa can grow quite aggressively in disturbed soils, while others in the Santa Barbara region are seriously endangered. If you want to get your hands on this plant, I'd advise against harvesting Yerba Santa from the wilderness for several reasons:

    • you could be harvesting an abandoned Oleander plant, and Oleander will kill you if consumed.

    • you might accidentally be harvesting one of the endangered members of the species, which is not only unethical but likely illegal.

    • Yerba Santa ain't no slouch, that plant is doing work where it is, holding the disturbed soil together and providing forage for wild animals through parts of the year when forage is scarce. You're hurting a lot of things that depend on that plant by taking it out of the ecology.

    Instead, I'd strongly recommend getting some seeds from a reputable source and trying to grow some from seed.

    0

    reading is hard

    social.photo ceanothus shared a post

    I aspire to do better some day.

    ceanothus shared a post

    Headlines have never made me watch ads or accept cookies

    14
    CA Native Plants @lemm.ee conditional_soup @lemm.ee

    [Invasive Species] Lambsquarters

    social.photo ceanothus shared a post

    Lambsquarters, also known as Goosefoot. The inflorescences are a sure indicator of late summer/early fall.

    ceanothus shared a post

    Chenopodium Album, also known as Goosefoot, Pigweed, or Lambsquarters, is a member of the amaranth family that has become endemic to much of California up to 5900 ft in elevation. It's originally native to Europe and Asia, where it has been known to be grown as a food crop for people and livestock.

    Lambsquarters' distinguishing features include soft, arrowhead-shaped, gently toothed, dark green foliage that appears silvery-gray on the underside of the leaf; the leaves also can have a fine, white powdery substance dusting their surfaces; the plant is an annual that has a large, shrub-like growth habit that I've seen grow to roughly seven feet high under good conditions, though most top out around four of five feet; it has strong stems that, as the plant ages, get streaked with purple and dry to a woody texture when the plant has died; in the late summer and early fall, the plant manifests inflorescences from which very small, black seeds will eventually fall.* The plant prefers disturbed soil, and is a common sight in agricultural and untended urban settings.

    *Some sources indicate that Lambsquarters can start flowering in May. I have spent a lot of time around these plants and I can't remember ever having seen that, but it's possibly down to regional variance.

    Like many other invasive species endemic to California, Lambsquarters is extremely drought tolerant. This is probably one of the more aesthetically pleasing endemic invaders come August or July, as it's one of the few remaining wild plants that appears healthy, happy, and green. I have some experience foraging Lambsquarters; its flavor is just sort of an unimpressive green flavor, though the leaf has a nice bite. Apparently, the leaves are very high in protein, and I think it'd probably do swell in a soup (though, again, I'd recommend boiling the leaves in a change of water first, as some sources suggest that Lambsquarters has oxalates that'll mess you up over the long run). I have no experience using the seeds as a food source, but it seems fairly straightforward, winnowing aside. The seeds are extraordinarily small and likely won't lend themselves to milling, but would probably make for a good supplementary grain to a porridge or something like that.

    So, how bad is Lambsquarters?

    Well, the California Invasive Plant Council doesn't have a page dedicated to Lambsquarters. That said, it has been known to be a reservoir of viruses for crop species also in the Amaranth family. It's likely that Lambsquarters, like the other invaders from the Amaranth family, are both practically impossible to be rid of while also being generally self-limiting, in particular given the plant's preference for disturbed soils.

    0
    CA Native Plants @lemm.ee conditional_soup @lemm.ee

    [Invasive Species] A tumble with Tumbleweed

    social.photo ceanothus shared a post

    Tumbleweed, also known as the Salsola sp.

    ceanothus shared a post

    Hello, everyone!

    I'm going to start profile common invasive species to the central valley to help people recognize them, know which are good, bad, and ugly, and distinguish them from true natives. I'm starting with a special guest the central valley drivers will soon be getting re-acquainted with: the Tumbleweed (Salsola sp.). The tumbleweed, also known as Russian Thistle, was first introduced by Russian immigrants to the Dakotas in the late 1800s. The plant spread aggressively, and was in California before the turn of the century.

    In terms of physical characteristics, Salsolas tend to have a darker, olive green appearance, with the larger stalks taking on purple-hued streaks later in the season. The leaves are sort of clusters of feathery spines (with some not so feathery spines mixed in for good measure). Later in their growth season, they have small, purple-hued flower like structures (though I don't think they're true flowers) at the nodes. They have an erect habit that forms a small, oblong sphere of a bush, about two to three foot high (there's a lot of variety there, but I'd say that about two foot is average) and a little wider than it is tall by the end of the growing season.

    Salsolas are hardy plants that thrive in disturbed souls and hot, dry conditions. In fact, they have a root structure that's designed to release the stalk of the plant and let it tumble once it comes into contact with water, which is why you generally start seeing them jump out in front of traffic around the time of the first rains. Salsolas are safe to eat in small quantities, and I have some personal experience with this. You really only want the new growth from very young plants, anything else is going to be tough as boots and half as appetizing (nevermind the spines). Young plants have smaller, softer spines and the new growth tastes of spinach when boiled (which is how I prepare it, I never eat it raw. As I recall, it has some quantity of oxalic acid in it that will wreck your kidneys with enough exposure, boiling removes the oxalic acid). I'm not personally fond of foraging Salsolas because their preference for disturbed soils generally means a high likelihood that they've been exposed to some pretty nasty stuff, and they're really only acceptable for cooking while the plants are less than a month old.

    So, how bad are tumbleweeds?

    Well, as far as I can tell, in the way of invasive plants, you can do a whole lot worse than tumbleweeds. According to the California Invasive Plant Council, Salsolas actually seem to help native grasses by stabilizing disturbed soil and introducing phosphorus. They're not very competitive, and rarely dominate anywhere long term. In fact, they note that Salsolas tend to be the first thing that will grow in disturbed soil, and are usually followed and eventually squeezed out by other plants and grasses that benefit off the shelter, phosphorus, and stabilized soil that the Salsola provides. Additionally, native animal species (in particular small lizards and reptiles) have been observed to use the Salsola for both shelter and hunting grounds. Salsolas don't have a significant impact on ecology in terms of fire risk or water patterns, either. Probably the worst thing about them is that they can be kind of a pain in the butt for humans when they swarm streets or highways or pile up on fences.

    I'm considering planting some Salsolas in my back yard to try and stabilize the loose soil this winter, and I'll cut them back once other plants start to take over.

    0

    [meme] Sad Supercommuter Noises

    social.photo ceanothus shared a post

    Kanye getting steadily less excited about the timetable for ACE coming to Merced

    ceanothus shared a post

    Kanye is getting less and less excited as the ACE rail extension to Merced gets more and more delayed. I reckon they're doing it like this to tie in to the HSR station, but come on, man.

    6
    CA Native Plants @lemm.ee conditional_soup @lemm.ee

    Recommended Plant Sources

    This is a list of reputable brands, seed dealers, and nurseries for acquiring native plants, both online and offline. If you'd like to add one to the list, just post it below, and I'd appreciate a little blurb about your experience with them or why you find them reputable.

    The list is currently pretty sparse, but with everybody's help, we can make a great list!

    Nurseries

    Online

    Offline

    SoCal

    NorCal

    Bay Area

    Central Valley

    Sierra Nevada

    Mariposa

    Creekside Nursery

    Address: 5047 Stroming Rd, Mariposa, CA 95338

    Phone: (209) 742-5107

    Web: https://www.creeksidemariposa.com/

    Blurb: Small nursery, literally by Mariposa creek. Known to carry several native shrubs including Ceanothus sp. and California Rose, as well as seeds for California Poppies.

    Brands

    Online

    Offline

    SoCal

    NorCal

    Bay Area

    Central Valley

    Sierra Nevada

    Seed Dealers

    Online

    Offline

    SoCal

    NorCal

    Bay Area

    Central Valley

    Sierra Nevada

    0
    CA Native Plants @lemm.ee conditional_soup @lemm.ee

    Thinking about planting Milkweed?

    Make sure you're planting a native species for your area first! Milkweeds have a very wide range, and there's been issues with tropical milkweeds being planted here in California, since they don't go dormant during the fall and winter. That means that:

    • Along the coast, they're more likely to be exposed to high levels of moisture that will promote disease growth that can be spread to Monarchs

    • Monarchs might lay their eggs on the non-dormant plants instead of migrating, which will likely cause the caterpillars to die, being out of season.

    California has some 15 species of milkweed that are native, with one of the more common being the narrowleaf milkweed. You can buy seeds for narrowleaf milkweed online, and now's the time to do it if you plan on directly sowing the seeds, since they need to get cold in order to germinate reliably.

    Some fast facts about milkweed:

    -It's a perennial, and once established will continue to spread through tubers.

    -It's very drought tolerant once established

    -The flowers are said to be highly fragrant and are known to draw in a lot of pollinator species besides monarchs.

    0
    CA Native Plants @lemm.ee conditional_soup @lemm.ee

    If you're thinking about planting, now's the time.

    If you've ever thought about planting some native plants, early fall is usually the ideal time to start planting for California natives. I'm considering picking up some more California Poppy seeds, as well as some milkweed. I have other ambitions for some larger shrubs, like Manzanita or Flannel Bush, but I don't know how well that's going to go. The biggest battle I'm currently fighting is that I'm lobbying to replace our crepe myrtle with a Toyon shrub.

    Do you guys have any natives that you're considering planting?

    0
    CA Native Plants @lemm.ee conditional_soup @lemm.ee

    California Native Plant Society

    www.cnps.org California Native Plant Society Chapters

    Joining your local chapter of the California Native Plant Society is a great way to connect and learn more about native plants.

    In case you're interested in learning more about or advocating for native flora, it's definitely worth checking out the CNPS. They've got chapters all over California, and many of them regularly do relatively easy hikes for educational purposes. Also, October is the month that most chapters participate in a native plant sale, so your local chapter may have some native plants available for you right now!

    0
    CA Native Plants @lemm.ee conditional_soup @lemm.ee

    California Plants for an irrigation-free Garden

    Hello, everyone! I thought I'd share this really neat in-depth presentation on how to make a garden with native trees and shrubs that requires very little to no irrigation and doesn't look deep fried by July.

    0

    California Native Plants- A community about plants native to CA

    c/ca_native_plants https://lemm.ee/c/ca_native_plants

    !ca_native_plants[email protected]

    This community is for identifying, promoting, and discussing plants native to California, as well as encouraging their use in landscapes and gardens. Questions about identification are welcomed, but the community should be only ever considered a second opinion for foraging purposes.

    3
    CA Native Plants @lemm.ee conditional_soup @lemm.ee

    Welcome and Rules

    Welcome to California Native Plants! I hope you enjoy your visit to this community and learn something new. While you're here, here are some guidelines to keep in mind:

    -Don't be a jerk, keep discussions civil.

    -Don't promote illegal activity. (AFAIK, Guerilla gardening isn't illegal per se, and tends to fall more in the realm of civil dispute, so it isn't covered by this rule. If you're going to do it, please try to proceed respectfully and don't vandalize people's property)

    -Forage with caution! You're welcome to seek plant identification advice here, including for the purpose of foraging, but we make absolutely no guarantees about the quality of the identification, as none of the participants here are vetted for their knowledge. I highly recommend doing your own homework and seeking out the opinion of local experts and guidebooks over relying solely on the opinion of internet strangers. However, communities like this one can be a useful resource for a second opinion, and that's how I recommend you use it for identification purposes. Foraging is a serious matter, and eating the wrong plant can leave you or others dead or disabled. You consume any plants on the advice given here fully at your own risk, as we should not be considered a primary source of knowledge on the matter of foraging.

    -Mistakes are welcome, malice is not. Users suspected of intentionally giving malicious or willfully bad advice or promoting blatantly ecologically destructive practices will be warned exactly once before being permanently banned.

    -This community is focused primarily on plants native to California. For better or worse, a lot of non-native plants can be found in our state as well. It's not against the rules to discuss or identify non-native plants, but the primary focus here is on promoting plants that are native to the state.

    1

    [video] confirmed: Bigfoot is a Foamer

    https://www.youtube.com/watch?v=gkQUE8Xr-cc

    Bigfoot came out just to watch the train. A true Renaissance Man.

    0

    Medical Spoops

    My personal favorite genre of ghost story is the healthcare ghost story. Nurses have told me some stories that have made my eyes water, though that's not the tale I came to tell, because for all of my later attempts, I've never been able to do it justice. Let's share our medical spooks

    I have 13 years of experience working on an ambulance as a paramedic. I've seen a lot of things, some horrible, some funny, some downright bizarre, but nothing I'd really classify as paranormal. This story was told to me by a co-worker on another ambulance shortly after it happened to her, while she was wrapping up documentation at the hospital.

    They'd been dispatched to a sick person, which is sort of the catch-all complaint when dispatch doesn't have a more applicable complaint. When they arrive at the house, they find that the patient is a man in his late fifties who's gone unresponsive. Thankfully, the man's parents are able to let them inside the home and provide them with the information they need. Suspecting Sepsis, they try to hustle and get the guy out and down to the hospital. He dies shortly before arriving at the ER. Despite the efforts of both the crew and the emergency room, they can't get him back and the man is declared dead. Law enforcement comes by to start writing up their report and starts asking for information that the crew didn't obtain. It's no problem, though, the crew tells law enforcement to just do a 911 callback to the house and ask the guy's parents. So, the officer tries it, but gets no response. Having exhausted the easy stuff, the officer goes out and decides to visit the guy's parents. When he arrives, however, the doors are locked up tight, and there's no sign of anyone else. As the officer's poking around, a neighbor notices and goes to ask if he can help. The officer tells the neighbor what's happened and asks if he can help him contact the man's parents. The neighbor looks very surprised and says that the guy's parents have both been dead for years. And that's the story of how a co-worker got medical history from a dying patient's dead parents.

    1
    Find a Community @lemmy.ml conditional_soup @lemm.ee

    a community for discussing bugs and features for lemmy

    I feel like this is a really obvious one, but I can't find it. Is there a community for requesting features and reporting bugs in Lemmy?

    1

    24 hour shifts and non-urgent transfers

    One thing I've recently seen be a point of contention is whether it's appropriate to disrupt sleep hours of 24 hour units for non-urgent transfers. That is, should 24 hour units have a time in which they're protected from being sent on non-urgent transfers? When this came up in the past, the consensus of "no" seemed to be coming from people whose systems weren't mixed 911/transfer systems and didn't do 24s. On the other hand, most of my 13 years in EMS has been with mixed-service 24 hour systems, one system of which was also a system-status deployment model (yes, I know that system status and 24 hour shifts are supposed to be mutually exclusive, but that fact never bothered company leadership). So, suffice it to say, I've had my fair share of riding 2 hours at 0300 on 30 hours without sleep for what could be an outpatient consult or because the local ED doc really wanted some other doc to take the liability for the discharge. A small company that I work for (mixed service, consecutive 24 hour shifts) recently started turning down overnight transfers for non-urgent reasons. The local (rural) ED was pissed and threatened to call other ambulance companies, but all the other companies got a good laugh when they heard where the hospital is. And in all fairness, they've laid some real stinkers of transfers in their time, including transferring due to CT glitch and transferring an 17 year old to the children's hospital two hours away for uncomplicated strep throat.

    To me, it seems clear that 24 hour shifts are still well-suited to rural EMS, and I don't think it's at all unreasonable to not gamble with the lives of your crew, patients, and fellow drivers for what essentially amounts to the convenience of the ED staff. I don't think you can even argue that it's about patient convenience, because if it's ed-to-floor, then the patient realistically isn't going to see the specialist until business hours anyway (and there's a decent enough chance that the transfer is urgent at that), and if it's ed-to-ed, then there's a good chance (in my experience) that they're just travelling 2 hours away for a discharge, and where's the convenience in that? Stranded two hours away with an extra hospital bill and an ambulance bill so that they could get an outpatient appointment; now that's what I call service. The industry has had a nasty habit of pretending that people can just choose not to be affected by lack of sleep for too long, and there's been a lot of unfortunate consequences because of that. I don't have a problem with formalizing it and making sure that it doesn't get abused, but I just don't see the benefit in rawdogging your crews on non-urgent transfers.

    What do you guys think?

    0