philpo

@philpo@feddit.org

• ⁨Comment⁩ on ⁨2022 vs. 2026 FIFA World Cup ticket prices⁩ ⁨⁨1⁩ ⁨day⁩ ago⁩:

  For the cheapest ticket you could have flown to the (excellent) womans European championship, got a CAT1 ticket,see Geneva and fly back.

• ⁨Comment⁩ on ⁨[deleted]⁩ ⁨⁨4⁩ ⁨days⁩ ago⁩:

  Another Healthcare Professional here: I second this healthcare professionals advice.

  Don’t get strangers opinions through the internet who’s credentials you can’t verify. See a healthcare professional.

• ⁨Comment⁩ on ⁨Has anyone else experienced these psychological changes after eating meat?⁩ ⁨⁨1⁩ ⁨week⁩ ago⁩:

  Please see my edit in case you haven’t before.

  And your ancestors were omnivores unless you have a lot of sudden body hair growth on a full moon.

  Seriously dude. I know mania feels great. But it isn’t.

• ⁨Comment⁩ on ⁨Has anyone else experienced these psychological changes after eating meat?⁩ ⁨⁨1⁩ ⁨week⁩ ago⁩:

  Okay, okay. I know it’s a cliche right now, but can we please please please get this guy a brain scan? This sounds like a really good case for a few parasites.

  Seriously. You either had a massive massive anemia (red meat can temporarily (!) help then), you are a top shitposter or you have a major issue.

  Source: Healthcare professional. Not your HCP.

• ⁨Comment⁩ on ⁨What do ambulances do with patients cars?⁩ ⁨⁨1⁩ ⁨week⁩ ago⁩:

  Yeah. Here cops are generally the “end of the food chain” legally. Whenever none else is responsible for something or the responsible department is not available they are the ones who sort it out.

  Health department outside of office hours? Call the cops.

  Building is in a possibly insecure state out of office hours? Call the cops.

  They can of course get other departments like ambos,firies,etc. to help,but in the end, it’s their job.

  Public safety officer is very much part of their job description here.

• ⁨Comment⁩ on ⁨What do ambulances do with patients cars?⁩ ⁨⁨1⁩ ⁨week⁩ ago⁩:

  Paramedic and former ambulance service director here: In my jurisdiction the car is the sole responsibility of the police - in theory. So basically we call the police and let them handle it. They will decide if it’s safe to leave it where it is (e.g. if it’s on a highway, post accident or otherwise a traffic hazard). They will usually ask the patient if they should call a specific company or,if the car is still roadworthy, if they should call someone like a relative to get it - within certain limits of course, they won’t do that on a highway and if the relative is two hours away the patient is also SOL.

  If the car is stationary as in a safe and legal parking spot it’s a bit different, then in theory we could still call the cops,but they would hate us for it when the patient is conscious. In these cases most crews simply lock down the car and give the key to the patient - the same way we lock down an apartment when we leave with a patient.

  The only case when we might leave a car unlocked and unattended is an unresponsive patient that has a transport priority,aka we need to go NOW. We will still call the cops (and they will either find a way to secure the car or tow it),but we sure as hell won’t wait. While I might have a minute to spare waiting for the cops for an average unconscious patient e.g. post seizure there are a lot of reasons where I don’t have that - and might not have the time in some awake cases as well. In these cases a car might be left unlocked - especially in times when the key rarely is still required in the ignition anymore where I can easily find it. But in these cases the life of the patient takes priority over any material assets.

  (To give you a more practical example: The last guy I left the car unlocked was a gentleman with sudden onset of massive pain between the shoulder blades and a large difference in blood pressure values between the arms - a good sign of a thoracic aortic aneurysm, a very deadly condition. That’s a “fuckfuckfuck we need to go now” condition. I looked for the car key once for around 5 seconds,the car was a mess, I couldn’t find it. Dispatch sends the cops,but they often take a long time here once they know we are no longer on scene. Sadly he didn’t even make it to the hospital alive. But we tried).

• ⁨Comment⁩ on ⁨Why can't countries with vast deserts make solar farms to power the world?⁩ ⁨⁨2⁩ ⁨weeks⁩ ago⁩:

  Yeah, but by now the much lower cost and higher efficiency of panels vs. the drawbacks of the location has shifted the cost/benefit ratio quite a bit.

  It’s far cheaper to build the panels where the energy is needed and compensate for bad weather by building more panels (and other sources) instead of having the drawbacks of the north african location. Solar panels in the desert are an issue - as noted here multiple times, sand does not mix well with panels, neither does too much heat. Solar reflector plants have never really taken off due to various issues as well. And transport remains an issue by itself and so does political stability in these countries.

• ⁨Comment⁩ on ⁨Shh⁩ ⁨⁨2⁩ ⁨weeks⁩ ago⁩:

  Tbf, I remember the times we reused everything, even tubes.

  And it was a mess and there is so much evidence that the whole process of reusing is even worse for the environment.

• ⁨Comment⁩ on ⁨Between Codeberg, Forgejo, Gitea, etc., which do you prefer and why?⁩ ⁨⁨2⁩ ⁨weeks⁩ ago⁩:

  Gitea once now Forgejo.

• ⁨Comment⁩ on ⁨Why is the human body so incredibly bad at responding to colds?⁩ ⁨⁨2⁩ ⁨weeks⁩ ago⁩:

  Not really. While COVID does indeed go through the roof atm in the northern hemisphere, bacterial supra infections are fairly common for flu patients.

• ⁨Comment⁩ on ⁨Awooga⁩ ⁨⁨3⁩ ⁨weeks⁩ ago⁩:

  Well,patients do get asked for consent before these pictures are taken (and usually are again asked for approval again when the whole thing is layouted).

  But,tbh, most patient I got to know with similar, rare, cases are often more than happy to help science and help other patients who experience the same right now or in the future.

  I personally had a case I worked with peripherally where a breast implant basically exploded after a road traffic accident and the poor, rather young, patient suffered from a catastrophic infection and bodily reaction before that. As in: “She nearly died,was on ecmo, needed her sternum replaced”-catastrophic. (And no, not a cosmetic breast implant, just making sizes equal)

  Tbh, despite extensive plastic surgery the final result was…really grim. I have seen third degree burns with a better cosmetic result… Especially for such a young woman. Further correction would need to be done much later, at least 5 years from then. She was nevertheless very keen on appearing in the case report and did willingly take part in photos(and even provided pre incident photos), appeared in front of medical students and interns, etc. It was part of her way of dealing with it,of making sense out of this freak occurrence.

• ⁨Comment⁩ on ⁨Awooga⁩ ⁨⁨3⁩ ⁨weeks⁩ ago⁩:

  Shit. That’s a terrifying case in so many aspects.

• ⁨Comment⁩ on ⁨Awooga⁩ ⁨⁨3⁩ ⁨weeks⁩ ago⁩:

  My condolences to your spine.

• ⁨Comment⁩ on ⁨Not trying to disparage first responders on 911. Why aren't nurses included with fire and police departments? Did we not take care of people on the backend of the rescuing?⁩ ⁨⁨3⁩ ⁨weeks⁩ ago⁩:

  I don’t know where you live,but as you are mentioning 911 I guess it’s the US - there are a shitton of ambulance services that use nurses as BLS or ALS providers around the world. (The netherlands, sweden, Italy, Spain, just to name a few. I intentionally do not name the US here,see below)

  For the US, UK and to a lesser extent Germany there is a simple reason: You guys did fight tooth and nail not to do so.

  But let’s go back a bit further: If you look into the history of EMS it’s not like that the fire departments were that happy to do so (and to this day I am a staunch opponent to them doing so. It’s an all around bad idea) and in many parts of these countries police, cab services and funeral homes did provide the first ambulances, other than charity organisations.

  When it became clear that prehospital care was needed in these countries the fire departments or independent “transport only” ambulance services had become the norm in most areas and there indeed were some people that pushed for nurse staffed ambulances - as nurses during the war had shown to be beneficial in that role.

  But they were basically scolded, often even publicly insulted, by nursing associations:

  • Nursing back then was far from an independent profession like it is today. Back then actual medical skills were largely dependent on doctors orders with very little leeway for interpretation. (From a nursing book in 1958 “if the blood pressure of a patient is too high or too low must,under all circumstances,be decided by the doctor and it’s not upon the nurse to decide this.”) Asking someone who is fully dependent on another profession for decision making to now make independent decisions without that profession and in the worst possible environment and use skills that the same person wouldn’t be allowed to use in their regular workplace understandably was a major cause for concern, dissent and resentment back then. And to some extent this is understandable.

  • The second factor was based on the issue of gender and “morals”. Nursing back then was a mostly female profession. Putting them to the scenes ambulances need to respond to (brothels, crime scenes, etc.) would, according to a female nursing director in a UK hospital “corrupt my girls”. Additionally, due to the fact that heavy lifting would be required(see below) and the ambulances would need to be driven by someone, the “poor nurses” would need to work alongside male ambulance drivers and that would also lead to immorality. (Their words, not mine. In case of the UK somewhat insulting to their Queen,imho)

  • Another factor was surely the fact that “transport only” ambulances already existed and that (also due to the lack of proper equipment) it was (rightfully so) considered backbreaking work - patients did need to be lifted far more than today, lifting equipment was primitive and medical equipment was far heavier. (I remember defibrillators that had 40kg…and I am not that old). So adding a third person would mean extra cost while you still need men (according to their reasoning back then). And as the first paramedic provides little more than BLS+ it was not that resource intensive to teach the people already doing the job.

  Nowadays nursing has developed a lot. But so has paramedicine and it is an independent health care profession in the more professional systems (CAN,UK,IR,AU,NZ,GER,POL,etc.). Because skills,mindset and approaches towards patient care are different. The US with it’s abhorrent EMS system uses nurses in some roles,but tbh, the main reason is a lack of proper paramedic training standards, standardisation and oversight and the results are, well, underwhelming.

  And why are nurses not named in line with other first responders in the US and similarly in a lot of other countries?

  Because they aren’t first responders. The issue with being a first responder is not the level of care, it’s the “unknown”. Hospitals are, to a certain extent a controlled environment. Even in the ED you most of the time know what’s happening next, even if the next patient is a multi system trauma and comes in without prior notification it’s still your playing field. You have light, it’s warm/cold, you are rarely alone, you have your equipment where it was the day before and the day before. On scene it’s different. The next call might be a mansion. Or in a ditch. Or a methlab. It’s the same people you see in the ED, but now it’s their home turf. I have resuscitated an almost naked 12 year old in -20° C alone (as a in “single responder”) in a park known for it’s shady people. That’s different.

  Don’t get me wrong: Nursing has it’s own challenges - I worked both sides long enough to know that I sure as hell won’t ever work another hour in nursing. As a para you have 1 patient most of the time. Not 25. Once you know your call,you can be almost sure that you won’t have another patient until you complete the call there won’t be another patient suddenly taking away your attention. You can leave the patient after like an hour max. And you rarely see them again.

  All these things are different in nursing. Multiple patients, changes in priorities, seeing patients day after day - it is its own beast. But it’s different.

  I am happy for everyone who does nursing. So am I for every midwife. Or every guy and gal that takes up paramedicine. We all have our place in this hellish trade.

• ⁨Comment⁩ on ⁨How to Decide what an Appropriate Medical Response is for Loved Ones⁩ ⁨⁨4⁩ ⁨weeks⁩ ago⁩:

  Good, that makes it a bit better. Sorry if I am a bit salty about this topic, but I literally had to attend a 13 year old girl who got hit by a car due to someone “racing to hospital” once - was not a pleasant call and ended with life altering injuries. (And the reason for the “emergency” absolute bullshit).

  The “drive safely” is relative,btw - even for professionals, believe me. There is a small study that compared the driving skills of regular first responders (lights&siren drivers) in a simulated family/partner/work-partner emergency under regular driving conditions (no lights and sirens) to their normal driving skills. It’s between 4 and 7 times more likely to commit a potentially accident producing traffic infringement.

  Anyway: Just because we can send these resources doesn’t mean we always do - emergency medical call takers generally know what they are doing and will ask you the right questions. It won’t be “I need an ambulance, by kid got stuck by a bee in the neck” “okay,we send one,bye!”.

  And even if they decide to make it an “all out” call there are plenty of people along the way who can stand resources down once they reach you and assess you. But we would rather send resources 10 times and be not needed 9 times than have the one call that actually needs that response not getting it. So… Don’t be mortified. In doubt,call us.

• ⁨Comment⁩ on ⁨How to Decide what an Appropriate Medical Response is for Loved Ones⁩ ⁨⁨4⁩ ⁨weeks⁩ ago⁩:

  First of all: Stay calm. It’s extremely rare for people to go to the doctor to late just due to “not caring enough” unless it’s old (mostly rural)folks. (One of the first things I learned: When a farmer calls an ambulance, always take full ALS gear with you) Or caused by mental health issues or financial constraints. People are far more resilient than we generally think.

  Then: Most industrial nations have “medical helplines”. In Australia it’s 1800 022 222, in Canada 811, in Germany 116 117, etc. Resesarch your local number and if unsure: Call them.

  Then: Look at the so called ABCDE Scheme.(Extended version of blood goes round and round and air goes in and out and any deviation from that is bad)

  Airway: Anything that fucks up an profoundly airway for more than 30 seconds is an issue - call an ambulance. Aspiration, foreign body obstruction, anaphylaxis reaction with airway issues. Extremly runny noses (as in RSV) and associated breathing problems warrant an ED visit. (But seriously people, get your kids vaccinated)

  B: Breathing: Anything that continuously makes breathing problems is a “go to the ED” or “call an ambulance” thing. Continuously (!) is the point. It’s normal for someone to have a coughing fit or breath a bit heavy when having a flu. But there is a difference between “my lungs are gonna kill me, i need to stay on the sofa and watch netflix” to “breathing has become so bad I actually have to focus on it and one flight of stairs slowly would make me feel woozy” to "okay,now I really really need to fight to breath enough ".The second one is a reason for an urgent care visit, the later one for an ambulance call. Also: Look for the lips and the area around it. Does it look blueish? If yes: Seek help. There are countless examples online. With children it’s a bit more difficult, to be fair. But as a parent you often will know when - when you manage to stay calm. Signs of acute need to seek help: Children whose chest kind of “cave in” between the ribs need an ambulance. Children who can normally focus on you or other things and don’t due to being focused on breathing? Call an ambulance. Children who are having audible breathing problems (as in: you hear them in a quiet room and it’s not their nose) will need an ED visit. And again: If they become blueish/whiteish. But again: There is scientific proof that parents who manage to remain calm and get a calm observant look on their kid identify urgent and critical cases better than healthcare professionals. The staying calm part is hard,though.

  Circulation: In adults: For fuck sake people: If you have chest pain that is not triggered by a certain action (e.g. a pain to the wall of the chest when breathing in deeply, a slight pain when coughing, etc.) call an ambulance. And especially for women: Strange abdominal pain, neck, arm or jaw pain counts. Especially when paired with shortness of breath, when it gets worse when you exert yourself. Or when it stays more than a few hours. Or is paired with very low or high blood pressure relative to your normal blood pressure. If you feel something pulsating in spots where normally nothing should be pulsating maybe see urgent care. Previously unknown dizziness when standing up? ED.

  With children again it’s a bit more difficult. The good news is: They very very rarely are compromised circulation wise,they hold themselves together for a long time (and then crash). But: It takes a lot for the latter to happen. Generally: Massive and sustained vomiting or diarrhoea are an indication to go to the ED, sooner than you would do as an adult and the smaller the earlier. A very good indicator is the recap test, look it up online.

  D is “disability” in this scheme and meant in the sense of “neurological issues”. They are actually easier than most people think. It’s obvious that an unconscious person should get an ambulance, as well as a seizure (please also call for febrile seizures). If someone is showing neurological deficits by either being disoriented, absent or having sensory or paralysis-like issues don’t wait,call an ambulance. If someone is suddenly vomiting uncontrollably and having a headache or any other neurological issues: Get to the ED. Likely a migraine,but there is a slight chance for a very very bad other reason. (And migraines aren’t fun either).

  In children look up meningism signs - can happen due to fever as well, but that’s a good reason to go to the Urgent care clinic.

  E is meant here as exposure,but covers bleeding,trauma, abdominal issues and infection as well. Seek help for scaldings/burns and any bleeding that you can’t stop within minutes or that requires more than a large bandaid. Seek help for anything that does belong in the body. Sustained abdominal pain that makes a child unable to be calmed down for more than 1 hour is a very good reason to go to the ED. A bladder infection in a child is a good reason to go to urgent care. An abdomen that gets hard as a brick when a little bit of pressure is applied is a reason to call an ambulance.

  Fever is a bit of a hit and miss situation, especially in children: First: Fever and sepsis are NOT the same. You can have a bad sepsis and have zero fever. (The last guy I nearly lost to fever had 34.5°C and never went beyond 36.5° before). Second: Fever sadly has the issue of causing febrile seizures and putting a lot of strain on the circulatory system. Which is bad. Third: But a bit of fever is nothing bad per se and there is more and more scientific evidence that an too aggressive approach to reducing fever is a bad idea as well in children. So…in the end it’s a bit of a question of moderation. Give something when the child is actively “sick” and unable to do most things due to that. Give something when the fever goes beyond 39.5° C. Fever itself is not a reason to go to ED or call an ambulance - the symptoms that go along with it might. (And please get a proper thermometer and not one of these “forehead” or touchless ones. And don’t try the house remedies of lowering fever like putting cold wet towels on the patient…they have all been proven to make it worse)

  This is just a little bit of advice. And you don’t know if I really know what I am talking about. So please read up yourself. Get a first aid course and a children’s first aid course. Check local resources and where urgent care options are. The ED and ambulances are the worst options - both in treatment quality, resources and often comfort.

• ⁨Comment⁩ on ⁨How to Decide what an Appropriate Medical Response is for Loved Ones⁩ ⁨⁨4⁩ ⁨weeks⁩ ago⁩:

  Critical care Paramedic here: The reaction above is the worst one basically. Worse than doing nothing. Don’t do that.

  Yes, anaphylaxis is bad and kills people. If it is that bad ,you will know that something is wrong within 60-120seconds. (That’s why epipen exist)

  But: There is a shit load of things that can be done in between “getting stung” and “cardiac arrest” in terms of first aid - and emergency medical dispatchers can and will tell you what to do. None of them can be done properly in a moving private vehicle.

  But what happens - more often than it should is people doing these stunts risking the lives of others, having an accident themselves or simply delivering a dead patient to a hospital that could have easily been saved by basic first aid and an ambulance.

  And to make matters worse: You will very likely be in a even worse spot. EDs in a lot of countries(it is surely the case in Germany)are not necessarily staffed by people who are experienced with paediatric anaphylaxis patients and only a minority of hospitals deal with any paediatric patients at all. If you’re unlucky an intern with 1.5 years of post graduation experience who didn’t even see an adult anaphylactic reaction so far will staff the ED, has no equipment to deal with paediatric patients and one can only hope the intensivist/anaesthesiologist on duty is not currently dealing with other stuff. While ambulance staff get trained in this shit regularly, it has more than enough equipment available, and can bring in specialist staff (critcare, physician response units, helicopters) - and believe me,most ambulance systems will make that a “send everyone” call. (For my neck of the woods: Neighbourhood app alarm to send off duty personnel, volunteer first responders from a charity or closest BLS ambulance, ALS resource, physicians response car, potentially helicopter with paediatric intensivist)

  So…for fucks sake people,call an ambulance. In most industrial nations they will be faster, they will know what to do, where to transport and you won’t risk crashing into other people or having a dead patient in the backseat by the time you arrive.

  (BTW: It’s extremely rare for an sting into the skin of the neck to actually impede the airway due to it’s location - there are very few tissues where this can become an issue. Totally different for stings within the airway and mouth, but most stings outside that lead to airway obstruction would have led to the same result for a sting into the arm. The location does not have direct causation for the location of the systemic reaction)

• ⁨Comment⁩ on ⁨Water Boil Advisory⁩ ⁨⁨5⁩ ⁨weeks⁩ ago⁩:

  I literally told you the actual scientific approach that is currently used by disaster response management professionals. The methods used in OPs case are utterly insufficient and potentially dangerous. I also gave you an example why.

  So…

• ⁨Comment⁩ on ⁨Water Boil Advisory⁩ ⁨⁨5⁩ ⁨weeks⁩ ago⁩:

  That can easily be done by cell broadcasts (which can absolutely have different stages of priority nowadays), mass-SMS (every cellphone that first registers in an affected area gets a SMS, via designated disaster management apps, by placing handouts on peoples doors (you usually do that by identify people at risks e.g. homecare patients, then you go by high to low risk areas - depending on the search of the contamination) and last but not least a few trucks with loudspeakers (even regular cop cars do) do wonders.

  What happens here if someone is not at home when called, is not an actual customer of the water company, etc.?

  There are dozens of better ways than how this was handled in OPs case.

  Source: I consult community and disaster response organisations on this stuff.

• ⁨Comment⁩ on ⁨Who is the enemy?⁩ ⁨⁨5⁩ ⁨weeks⁩ ago⁩:

  Nah, you’re good. True methheads are… something else… That stuff really fries brains.

• ⁨Comment⁩ on ⁨Who is the enemy?⁩ ⁨⁨5⁩ ⁨weeks⁩ ago⁩:

  Paramedics hate methamphetamine. And alcohol. And high voltage electrical current.

  But we love people who injure themselves creatively.

• ⁨Comment⁩ on ⁨Guess I'll just die⁩ ⁨⁨1⁩ ⁨month⁩ ago⁩:

  I just leave that here:

  youtu.be/8EmRCJET5T4

• ⁨Comment⁩ on ⁨Um... I'm not even using a VPN... Fuck you reddit.⁩ ⁨⁨1⁩ ⁨month⁩ ago⁩:

  Fair enough!

• ⁨Comment⁩ on ⁨Um... I'm not even using a VPN... Fuck you reddit.⁩ ⁨⁨1⁩ ⁨month⁩ ago⁩:

  For the Mozilla users: There is a shitton of Tampermonkey (an extension) scripts that automatically redirect you to old.reddit.com.

• ⁨Comment⁩ on ⁨Do gangs that collect protection money actually do any protecting?⁩ ⁨⁨1⁩ ⁨month⁩ ago⁩:

  From what I understand,yes, but she said “they showed us a guy they beat to pulp, he said he is sorry. But the guy wore a ski mask when he robbed my aunt. How should we know if it was him or if that was just some homeless person?”

• ⁨Comment⁩ on ⁨Do gangs that collect protection money actually do any protecting?⁩ ⁨⁨1⁩ ⁨month⁩ ago⁩:

  I know someone whose family founded a small retail chain (with like 5 shops or something, each operated by another relative) in an east European country shortly after the fall of the iron wall that is, well, pretty much associated with mafia-like structures.

  According to her after the initial mayhem they did have a group establish themselves that was more “mafia” like. Think black suits,old Mercedes Benz cars,etc. They actually had a “emergency number” they were supposed to call and where someone picked up 24/7. And according to her someone actually came - unlike the police back then (who also wanted money). They responded fairly fast - and to them it seemed like they actually at least tried to find perpetrators. But they were never quite sure if some of the people who robbed them were actually sent by these groups themselves to prove how much the shops needed protection. Over the times things got more extreme and the “group” only wanted money to protect people from themselves - possibly because drugs got involved and the “thugs” got younger. But at least then the police stepped up their game and did more.

• ⁨Comment⁩ on ⁨Why are there so many german communities on Lemmy?⁩ ⁨⁨1⁩ ⁨month⁩ ago⁩:

  Yeah. For an “eingetragener Verein”. For a Vereinsgründung of a non registered association two members are enough. So if you want to be a Klugscheißerle, read your BGB first. Micdrop

• ⁨Comment⁩ on ⁨Why are there so many german communities on Lemmy?⁩ ⁨⁨2⁩ ⁨months⁩ ago⁩:

  Verdammte Autokorrektur!

  Verdammte Grammatischeafdler!

  Verdammt!

• ⁨Comment⁩ on ⁨Why are there so many german communities on Lemmy?⁩ ⁨⁨2⁩ ⁨months⁩ ago⁩:

  I know. But an Austrian one.

  One could say they are more German than the Germans, but… well…that didn’t work out well before…so we don’t say that anymore I think.

• ⁨Comment⁩ on ⁨Why are there so many german communities on Lemmy?⁩ ⁨⁨2⁩ ⁨months⁩ ago⁩:

  Yeah. Personally I try to visit non-American subs for that quite often here. Australia, Canada,etc. provide different views and influences as well and are English speaking.