Goodbye, Annie

Just when I thought we were able to get away from the “cops abusing authority” trope. A cop was assisting the sheriff’s department with a call about an unpaid child support complaint, when he noticed a deer that local residents had been feeding. When the deer approached the officer and allowed him to pat its head, he took it upon himself to declare that it was a domesticated wild animal, declared that it was illegal, and then proceeded to pin the deer to the ground, pulled out his service weapon, and shot the deer in the head. In full view of horrified children that had considered the deer to be their friend.

Pokagon Band Tribal Police released a statement saying it was arresting a suspect at the same property when the deer was “euthanized”. That is copspeak for “he was following our nonexistent procedures, and we are whitewashing the entire thing.”

In summary, a “bad” cop does something illegal that he would gladly arrest anyone else for. Other cops witness this, standing there with their hands in their pockets. The “good cops” whitewash the entire thing and expect us to “back the blue.”

I Have Questions

Internet rando Eddie, claiming to be an “Alpha male” says that he is tired of waiting for Congress to act, so he going door to door and confiscating guns. Anyone who resists will be placed under citizens arrest.

  • Under what legal theory or authority will this be carried out?
  • Will Eddie and his fellow gun grabbers be armed?
  • If not, how many houses will they enter before finding out?
  • If they are, will they place themselves under arrest?

Oh, wait. He is Canadian.

A Few Errors Here

Kudos to the 14 year old girl that had the presence of mind to collect her 4 year old sister, her dog, and then escaped the house when a man broke in to their home while holding a stolen shotgun. There are some lessons to be learned here:

  • The man got the shotgun after earlier breaking into a different house, hitting the woman who lives there, and taking it from her. If you don’t have the guts to USE a firearm when it is clearly indicated, you shouldn’t own a firearm.
  • No one in this case pressed charges because they want him to “get the help that he needs.” There is no help that will fix this guy’s problem- dementia. This guy will get out of the hospital in a few days and be free to do this again. Maybe he kills someone next time.

A dude breaks into your house. You have a gun. Shoot him. If you don’t, then both of you have a gun, then eventually, HE has a gun. How would you feel, knowing that the guy hit you, stole your gun, then killed two little girls with it?

Ventilation

The lungs are the organ that allows oxygen to enter the body and carbon dioxide to leave the body. They accomplish this by permitting gas to enter small sacs called alveoli. These sacs allow the exchange of gas across their membrane. The alveoli stay open through the use of a surfactant. In an infection, it can travel to the lungs and cause a potentially fatal condition called acute respiratory distress syndrome (ARDS). In ARDS, the alveoli fill with a fluid that is essentially pus, which diminishes the lungs’ ability to provide vital organs with enough oxygen. There are ways that we can fight that.

If the patient is conscious and able to keep their own airway open, we can put them on CPAP or BiPAP, which is a mask that pressurizes the air that the person is breathing. This extra pressure forces the fluid out of the alveoli and back into the bloodstream. If a person can’t maintain their own airway, they will be intubated and placed on a ventilator. That ventilator will provide pressurized oxygen, and this is called PEEP. You can see it at work here, where a mechanical ventilator is working on a set of pig lungs as a demonstration:

As doctors have gained more experience treating patients with COVID-19, they’ve found that many can avoid ventilation—or do better while on ventilators—when they are turned over to lie on their stomachs. This is called prone positioning, or proning. Because of how the lungs are positioned, this lets you use parts of your lungs that aren’t being used when you are on your back, because it reduces pressure from the heart and diaphragm on the lungs, which allows them to inflate more easily.

If we are talking about emergency intubations (IOW not for procedural reasons), the only people who get intubated and placed on a vent are really sick. People colloquially refer to this as “being on life support.” Anyone can tell you that a person who isn’t adequately breathing on their own is pretty sick. So, for starters, anyone who is being intubated is a pretty sick puppy.

The most common complications in COVID-19 infections are bilateral pneumonia which may progressed to ARDS, sepsis and septic shock, acute kidney injury and others such as acute cardiac injury, coagulopathy, hyponatremia (low sodium levels in the blood) and acidosis (blood Ph too low). Complications are more likely in serious sickness versus non-extreme illness.

On top of that, there are risks for mechanical ventilation: overinflating the lungs, oxygen toxicity, and other issues are possible complications. These complications are more likely in people with ARDS, diabetes, high blood pressure, chronic heart or lung disease, and obesity all are at higher risk of complications from mechanical ventilation. You will recall that these same risk factors also make a patient more susceptible to COVID.

If your COVID infection is bad enough that it is collapsing your alveoli, you likely have problems with other organs as well- specifically the liver, heart, and kidneys. Remember- the same cytokine storm that is damaging the lungs is also damaging other organs as well. This can cause the development of something called MODS (multiple organ dysfunction syndrome). What causes about 20% of COVID deaths is MODS, and is not due to the use of a ventilator. Three quarters of the people who developed MODS already had underlying problems like kidney or heart disease, diabetes, or were morbidly obese.

The simple fact is that we in health care are using other methods for treating low blood oxygen caused by COVID, such as high flow devices (up to 60 liters of oxygen per minute) to try and delay or put off the need to mechanically ventilate a patient, but once you are sick enough from COVID to need a ventilator, you are really sick and your likelihood for surviving is low.

Antifa Organization

The reason for all of the medical posts is that I have been under the weather for a few days, and I had those on deck in the event I couldn’t post anything. I have some kind of respiratory infection that has knocked me for a loop. I was working last night and had to leave work early because I just couldn’t do it. I’ve been sleeping for the past 14 hours, and now I am going to try to go to work again tonight, fortified with more drugs than Motley Crue.

For the moment, take a look at this post from Matt Bracken which is a photo breakdown of this video. You can also read Peter’s comments on these events here. Now ask yourself (and be honest- there is no point of lying to yourself out of bravado)

Do you and your prepper friends have this kind of command and control? Drones for recon, fast reaction ATVs, radio coordination? These guys are effective because they are willing to do whatever it takes to win, and they are obviously getting training and equipment from somewhere. Look at the ambush tactics here. Even two years ago, they were well trained, funded, and equipped. They have a nationwide organization that is operating like a CIA led operation. Think about the implications.

Tons of people responding on both threads, complete with chest thumping about how “If that had been my car…” derp, derp. Watch the video. There is a woman in the crowd yelling “shoot him.” You can say that we have guns all you want, but most people are not willing to take the actions that will be required of them. Most don’t even understand just how savage they will have to be in such a conflict. Don’t underestimate these people. They’re not fucking around and they’re zealots. It’s time to stop with the chest thumping and bravado. They are preparing, while we are sitting around talking about how the war will be short.

Election season is underway. There will be more and more violence leading up to that. Know where the cells in your area are.

Get ready for what is coming.

Intubation

Intubation is a process where a healthcare provider inserts a tube through a person’s mouth or nose, then down into their trachea (windpipe). The tube keeps the trachea open so that gases can get through. The tube is then connected to a device that delivers oxygen and other materials to the lungs (mechanical ventilation). The device to deliver oxygen can be a bag valve, or a mechanical ventilator. Certain liquid medicines (Narcan, Atropine, Valium, Epinephrine, and Lidocaine) can be delivered this way, although that procedure isn’t as common as it used to be. Gaseous anesthetics can also be delivered this way.

Intubation is a procedure that is done under one of two conditions: Procedural or emergent. It’s done for patients who for whatever reason can’t control their own airway, to permit the healthcare team to protect and control that airway. If, due to drugs, illness, or injury, you can’t keep your own airway open, you will likely be intubated.

The main indications for intubation are:

  • general anaesthesia
  • congenital malformations
  • diseases or trauma to the upper airway
  • the need for mechanical ventilation
  • perinatal resuscitation
  • acute respiratory distress

It’s a procedure carried out in any given hospital dozens of times each day, mostly under procedural conditions. A procedural intubation is carried out for the purposes of surgery. A patient that is to be placed under general anaesthesia can’t keep their own airway open or breathe very well on their own, so they are sedated and then intubated before being placed on a mechanical ventilator of some sort. An emergent intubation is done for a sudden, unplanned reason like trauma to the airways, cardiac arrest, or acute respiratory failure.

How is it done? There are a number of methods, but here are the basics:

Once that tube is in place, we now have a secure airway that enables us to use some form of mechanical ventilation to breathe for the patient.

There are risks to intubation that include trauma and damage to the airway, and unrecognized esophageal intubation, which is where the provider inserts the tube into the esophagus instead of the trachea and doesn’t recognize the error. There are ways to mitigate these errors, but the risks can only be minimized. That is why in medicine we always weigh the risks against the benefits of any procedure.

When people complain that intubation is bad for COVID patients, they aren’t really talking about intubation. They are talking about mechanical ventilation, which is a different, but related proedure. We will talk about that in a future post.

What If Police Can’t or Won’t?

The purpose of the police is not supposed to be enforcing the law. The people themselves are pretty good, some would say too good, at protecting themselves and stopping crime, if left to their own devices. In fact, they are so good at stopping crime, that many people have been accused of crimes and punished, only for it to later be proven that the person punished wasn’t the culprit.

No, police are actually there to protect people who have been accused of crimes and protect those people to ensure that their rights to a fair and impartial trial are protected.

A convicted pedophile has set up camp directly next to a children’s school. He has signs out, offering free drugs. The police say that their hands are tied, and either can’t or won’t do anything about it. What happens when the police can’t or won’t do anything to protect children? Sooner or later, someone is going to take care of it themselves. It may be a parent of a molested child, or even a molested child or someone who feels like they themselves are a victim. At that point, the cops will fall all over themselves to find the culprit.

On the other hand, you see police and the legal system setting their sights on people who haven’t committed a crime. They are being used as political tools to destroy the opponents of those who would seek power.

This is a deadly combination. Once people feel like there is no justice to be had, they lose respect for the law. Anarchy can be the only result of this.