The Fall of Hospitals

[erqueen75]

I had some experience with catheters a long time ago in a galaxy far far away, LOL. I was a hospital orderly before going back to college.
Hospital got bought out and the new administration (Humana, if I recall correctly) only allowed me one cheap plastic glove (kind of like the ones used in food service) to use for catheterization.

I fought it and won.

CHEAP *******S

 

[erqueen75]

Medic. Also worked as a Tech in the ER.

Thank you for your service Radiogoon.
Erqueen75

 

[DrJenner]

The normal saline lactated ringers debate-
I think if you are an ICU person you tend to go LR while ER peeps like NS.
Cautious with dumping in large amounts of NS - would say more than 3L as you can cause hyperchloremic metabolic acidosis- would switch to LR after about 3L of NS

 

[Kevin L]

The normal saline lactated ringers debate-
I think if you are an ICU person you tend to go LR while ER peeps like NS.
Cautious with dumping in large amounts of NS - would say more than 3L as you can cause hyperchloremic metabolic acidosis- would switch to LR after about 3L of NS

Got it. Thank you.

There can be too much of a good thing.

As a medic, I often encountered hypovolemic shock, and our policy (at the time, many years ago) was to go ahead and dump crystalloid fluids into the patient very quickly. We even had this thing called a RIC catheter, which had a larger diameter lumen than even a 14 guage over-the-needle catheter.

As I said, it was many years ago.

 

[DrJenner]

Got it. Thank you.

There can be too much of a good thing.

As a medic, I often encountered hypovolemic shock, and our policy (at the time, many years ago) was to go ahead and dump crystalloid fluids into the patient very quickly. We even had this thing called a RIC catheter, which had a larger diameter lumen than even a 14 guage over-the-needle catheter.

As I said, it was many years ago.

Oh yeah, I mean if it’s all you have- that’s what you have to do.
Just think it would be beneficial to have both on hand. Also caution in using LR in acute kidney failure due to hyperkalemia (too much potassium)- can make that worse.
Although if you’re that on the brink in a SHTF situation and you need dialysis you’re probably screwed anyway

 

[Kevin L]

Oh yeah, I mean if it’s all you have- that’s what you have to do.
Just think it would be beneficial to have both on hand. Also caution in using LR in acute kidney failure due to hyperkalemia (too much potassium)- can make that worse.
Although if you’re that on the brink in a SHTF situation and you need dialysis you’re probably screwed anyway

Scewed with a pinecone.

I sometimes have to bite my tounge when I read about people using and stockpiling things like antibiotics, IV fluids, and so forth . . . with the idea of using them without any experience or formal training.

I intend to store such things, but I plan on having regular contact with a physician and an advance-practice nurse practitioner, so I'll have real-time direction and guidance on how to properly administer these things.

I understand that--in a true crisis--doing something is better than nothing . . . yet a lot of people want to learn about antibiotics, but not proper aseptic technique . . . or how to administer IV fluids, but not how to properly use an Ambu bag or airway adjuncts like a nasopharyngeal airway, or how to use a laryngiscope to visualize the chords and put in an endotracheal tube. How many laypeople have obtained a suction unit with Yankauer tips to clear an airway of emesis . . . and know how to use it? Or that once someone develops aspiration pneumonia under austere conditions, that all of the IV fluids and antibiotics in world won't--in all probability--do any good?

Partial measures without imaging and/or diagnostic lab results may--on many occasions--be worse than doing nothing at all.

I'm not trying to be a troll, but can you guys see my concerns even if you disagree with me?

 

[DrJenner]

Scewed with a pinecone.

I sometimes have to bite my tounge when I read about people using and stockpiling things like antibiotics, IV fluids, and so forth . . . with the idea of using them without any experience or formal training.

I intend to store such things, but I plan on having regular contact with a physician and an advance-practice nurse practitioner, so I'll have real-time direction and guidance on how to properly administer these things.

I understand that--in a true crisis--doing something is better than nothing . . . yet a lot of people want to learn about antibiotics, but not proper aseptic technique . . . or how to administer IV fluids, but not how to properly use an Ambu bag or airway adjuncts like a nasopharyngeal airway, or how to use a laryngiscope to visualize the chords and put in an endotracheal tube. How many laypeople have obtained a suction unit with Yankauer tips to clear an airway of emesis . . . and know how to use it? Or that once someone develops aspiration pneumonia under austere conditions, that all of the IV fluids and antibiotics in world won't--in all probability--do any good?

Partial measures without imaging and/or diagnostic lab results may--on many occasions--be worse than doing nothing at all.

I'm not trying to be a troll, but can you guys see my concerns even if you disagree with me?

Absolutely
the stockpiles should be used carefully- and in partnership with someone who has some medical knowledge - be it a paramedic, RN, nurse practitioner, PA, physician whatever.
You can definitely do more harm than good- such as med reactions and even crystallization of the meds (ceftriaxone and LR can cause reaction).

 

[Kevin L]

Absolutely
the stockpiles should be used carefully- and in partnership with someone who has some medical knowledge - be it a paramedic, RN, nurse practitioner, PA, physician whatever.
You can definitely do more harm than good- such as med reactions and even crystallization of the meds (ceftriaxone and LR can cause reaction).

Thank you.

I sometimes encounter a lot of hostility when I tell people that certain meds are by prescription and managed by a doctor for very good reasons.

 

[erqueen75]

Absolutely
the stockpiles should be used carefully- and in partnership with someone who has some medical knowledge - be it a paramedic, RN, nurse practitioner, PA, physician whatever.
You can definitely do more harm than good- such as med reactions and even crystallization of the meds (ceftriaxone and LR can cause reaction).

Thank you, Doctor.
Gotta remember those IV Fluid/I.V. Medication incapabilities...
Need to get a copy of one of those HUGE charts in the MED Room that shows the compatible/non-compatible combinations...

Erqueen75

 

[erqueen75]

Got it. Thank you.

There can be too much of a good thing.

As a medic, I often encountered hypovolemic shock, and our policy (at the time, many years ago) was to go ahead and dump crystalloid fluids into the patient very quickly. We even had this thing called a RIC catheter, which had a larger diameter lumen than even a 14 guage over-the-needle catheter.

As I said, it was many years ago.

Kevin, you made my mouth water when you mentioned 14-gauge!!!
We used to say just shove a pencil in his arm!!!

God we're sick, but in a "I want to help you," good way.
Erqueen75

 

[lonewolf]

Although if you’re that on the brink in a SHTF situation and you need dialysis you’re probably screwed anyway

Dialysis, Cancer treatment, any kind of life saving treatment and the person wont be around for long post SHTF.
mind you neither will the doctors and nurses in a full blown SHTF event.

 

[MOS0231]

https://www.zerohedge.com/covid-19/...re-staffing-crisis-vaccination-mandate-forces
I think this could be a bigger disaster than COVID itself.
And it is all man-made.

 

[jontte]

https://www.zerohedge.com/covid-19/...re-staffing-crisis-vaccination-mandate-forces
I think this could be a bigger disaster than COVID itself.
And it is all man-made.

we have the same crap here, even without a covid mandate, so many RN's,PN's are so utterly fedup about the pay, treatment from the upper management, short staffing etc...the new ones we get, are....
below any standard, some didn't even grasp the meaning of the ABCDE protocol,don't have a clue about CPR, but as immigrants they get the job, despit that I like my boss,I hate that she likes to play the game of kumbayaa...

 

[DrJenner]

@erqueen75 I hope most of those meds in the chart aren't administered by people who aren't trained. Yikes.

 

[DrJenner]

we have the same crap here, even without a covid mandate, so many RN's,PN's are so utterly fedup about the pay, treatment from the upper management, short staffing etc...the new ones we get, are....
below any standard, some didn't even grasp the meaning of the ABCDE protocol,don't have a clue about CPR, but as immigrants they get the job, despit that I like my boss,I hate that she likes to play the game of kumbayaa...

Yep its sad and everywhere. People are leaving in droves, has nothing to do with mandate yet.
Everyone burned out and over it.

 

[Kevin L]

Kevin, you made my mouth water when you mentioned 14-gauge!!!
We used to say just shove a pencil in his arm!!!

God we're sick, but in a "I want to help you," good way.
Erqueen75

I agree.

I could always tell who the new nurses were . . . because during lunch, the veterans were eating lunch while talking about secretions, pus, maggot-infested decubitis from low-end SNF facilities, and colostomy bags.

The new nurses were the ones whom weren't eating and looking pale and/or green around the gills.

I had few issues with this, as I could run on a 4 car pile-up with multiple fatalities, and have spaghetti when I got back to the station.

 

[user 7000]

Scewed with a pinecone.

I sometimes have to bite my tounge when I read about people using and stockpiling things like antibiotics, IV fluids, and so forth . . . with the idea of using them without any experience or formal training.

I intend to store such things, but I plan on having regular contact with a physician and an advance-practice nurse practitioner, so I'll have real-time direction and guidance on how to properly administer these things.

I understand that--in a true crisis--doing something is better than nothing . . . yet a lot of people want to learn about antibiotics, but not proper aseptic technique . . . or how to administer IV fluids, but not how to properly use an Ambu bag or airway adjuncts like a nasopharyngeal airway, or how to use a laryngiscope to visualize the chords and put in an endotracheal tube. How many laypeople have obtained a suction unit with Yankauer tips to clear an airway of emesis . . . and know how to use it? Or that once someone develops aspiration pneumonia under austere conditions, that all of the IV fluids and antibiotics in world won't--in all probability--do any good?

Partial measures without imaging and/or diagnostic lab results may--on many occasions--be worse than doing nothing at all.

I'm not trying to be a troll, but can you guys see my concerns even if you disagree with me?

He's not wrong guys....a little internet knowledge is a dangerous thing.

 

[DrHenley]

https://www.zerohedge.com/covid-19/...re-staffing-crisis-vaccination-mandate-forces
I think this could be a bigger disaster than COVID itself.
And it is all man-made.

I was just listening to them talking about this a few minutes ago on the Buck Sexton show.

 

[Kevin L]

He's not wrong guys....a little internet knowledge is a dangerous thing.

Thank you very much for validating my concerns.

 

[user 7000]

But bartering medical supplies for medical skills is good barter.

 

[Kevin L]

But bartering medical supplies for medical skills is good barter.

I agree . . . although I predict that--post SHTF--there will be unethical dirtbags peddling fake medications, IV bags refilled with water, and so forth.

 

[Proud Prepper]

These doctors and scientists want to stop the nonsense going on in hospitals.

https://doctorsandscientistsdeclaration.org/

 

[DrJenner]

I hope it’s successful
No one should be dictating medical treatment. Not attorneys, not insurance companies, not large corporations- it should be up to the doc after conversation with the patient.

 

[EastenerWesterner]

I agree.

I could always tell who the new nurses were . . . because during lunch, the veterans were eating lunch while talking about secretions, pus, maggot-infested decubitis from low-end SNF facilities, and colostomy bags.

The new nurses were the ones whom weren't eating and looking pale and/or green around the gills.

I had few issues with this, as I could run on a 4 car pile-up with multiple fatalities, and have spaghetti when I got back to the station.

i have eaten dinner with 2 Vet specialists with A GP sitting behind us. The double boarded college professor and my wife.
I heard a lot of gross stuff and told my wife afterwards, I didn’t understand half of it. She said, don’t worry neither did the GP sitting behind you.

 

[Kevin L]

i have eaten dinner with 2 Vet specialists with A GP sitting behind us. The double boarded college professor and my wife.
I heard a lot of gross stuff and told my wife afterwards, I didn’t understand half of it. She said, don’t worry neither did the GP sitting behind you.

LOL

 

[Kevin L]

LOL

I don't claim to have never gotten sick, however.

I'm sure you all know how hot Florida can get in August.

We had a welfare check in a trailer park on a guy that no one had heard from in a while, and the mail was accumulating into a large mountain.

Well . . . it was a metal Airstream trailer, which was sitting in the hot August sun in South Miami.

The resident had died on the toilet (we guessed that he had "vagaled out" while straining from constipation, which means that he possibly died because his heart slowed down from too much stimulation of the vagus nerve.

He had died approximately 11 or 12 days before.

I was OK until the M.E. guys pulled him off the toilet . . . and his ass tore off and was left behind because it was sticking to the toilet seat . . . which--of course--caused me to heave my guts up in the shower stall.

As we were leaving, one M.E. guy said "How awful. I can't stand the smell of vomit . . ."

It was a difficult call.

(Added later, after getting approval on prior post from forum members)

P.S. I think this was when I began to drink heavily . . . not that it's an excuse.

 

[Kevin L]

I don't claim to have never gotten sick, however.

I'm sure you all know how hot Florida can get in August.

We had a welfare check in a trailer park on a guy that no one had heard from in a while, and the mail was accumulating into a large mountain.

Well . . . it was a metal Airstream trailer, which was sitting in the hot August sun in South Miami.

The resident had died on the toilet (we guessed that he had "vagaled out" while straining from constipation, which means that he possibly died because his heart slowed down from too much stimulation of the vagus nerve.

He had died approximately 11 or 12 days before.

I was OK until the M.E. guys pulled him off the toilet . . . and his ### tore off and was left behind because it was sticking to the toilet seat . . . which--of course--caused me to heave my guts up in the shower stall.

As we were leaving, one M.E. guy said "How awful. I can't stand the smell of vomit . . ."

It was a difficult call.

If anyone here is so hardcore bads--- that they wouldn't have--at least--contemplated being violently ill after experiencing that under similar circumstances . . . then all I have to say is that your stones and/or ego is much bigger than mine . . . and that's saying a lot.

 

[EastenerWesterner]

LOL

I have literally gotten sick. Accident call when I was at a Halloween Party. Walked 3 doors down to get there.
El Camino broadsided, kids were in the back. Trick or treat bags next to the over turned vehicle.
No amount of alcohol helped me that night.

 

[lonewolf]

The British National Health Service is short of 44,000 nurses and 9,000 doctors, thats without people leaving because they are burnt out with the pressure of dealing with Covid.

 

[Kevin L]

The British National Health Service is short of 44,000 nurses and 9,000 doctors, thats without people leaving because they are burnt out with the pressure of dealing with Covid.

I understand why they are burned out.