Divemedic

Sit down and shut up

There are many people who claim that public employees should not have the right to collectively bargain. There are two examples in my own list of blogs that I regularly read.This post is about why I disagree:

For starters, what is collective bargaining? Collective bargaining is where a large group of people band together to bargain (collectively) with another group of people. Examples of this include public employees banding together to form a union. This union then sends representatives to negotiate working conditions with their employer, the taxpayer. The taxpayer himself has formed a collective unit that appoints representatives to negotiate on their behalf. The representatives of the taxpayers then negotiate with the representatives of their employees, and a deal is reached.

By using their representatives to prohibit the employees from being able to negotiate, the taxpayers seek to gain an unfair advantage over the employees by making sure that they are the only ones at the table. A “take it or leave it” approach, if you will.

Aside from the moral issue, there is the constitutional one. How can you prohibit one group of citizens from exercising their First Amendment right to associate with others and petition their government for a redress of grievances while allowing others to do the same? How is the right of groups like the TEA party, NRA, AARP, or NORML to collectively lobby for government largess for their members any more valid than the right of the IAFF, FOP, or NEA to do the same for THEIR members? Does the mere act of drawing a government paycheck negate your constitutional rights? Or does it only count when it is your own ox being gored?

I am not arguing in this post that the pay and benefits of any given public employee are appropriate for the position, all I am saying is that denying any group the right to negotiate those benefits is the equivalent of telling them to sit down and shut up. Certainly not the behavior of a free society. “I may not agree with what you have to say, but I will defend with my life your right to say it.” is a mere platitude to both the Liberal Left and the Conservative Right. To both of those camps, your right to speak is dependent on what you have to say.

By Divemedic, ago

Capnography for ROSC patients

There was a case recently where a paramedic was working a code on a patient in PEA. During the code, the EtCO2 of the patient rose from 12mm to 27. The medic correctly assumed that his patient was a ROSC patient. He stated so to the ED staff when he turned the patient over to them. The doctor ignored the medic, and stated that the increased EtCO2 meant nothing, and declared the patient dead. Some time later, when the staff went in to prepare the patient’s body for delivery to the morgue, they noticed the patient trying to breathe. The code was resumed, with the result that the patient finally expired several days later. Lawsuits are pending.

The evidence is overwhelming, capnography is a reliable predictor of ROSC in an arrest patient. Here are some studies to prove my point:

Analysis of the Efficacy of Waveform Capnography Monitoring Using Bag-Valve-Mask Ventilation. Wales, RA. Society for Technology in Anesthesia 2011.
  End Tidal Carbon Dioxide Levels Predict Cardiac Arrest. Manyam H. Society for Technology in Anesthesia 2011.
End Tidal Carbon Dioxide Predicts Cardiac Arrest. Manyam H, Thiagarajah P, Patel G, French R, Chaluvadi S, Balaan M. American Heart Association  Resuscitation Science Symposium 
Analysis of the Efficacy of Waveform Capnography Monitoring Using Bag-Valve-Mask Ventilation. Wales RA, Dyott W. Prehospital Emergency Care (NAEMSP). January 2010; Volume 14, (Suppl 1), 48-49.    
  Capnography as a Survival Predictor in Cardiopulmonary Resuscitation.Farinha LF. Resuscitation, Volume 81, Issue 2, Supplement 1, December 2010, Page S57.Sleep and Pulmonary Rehab
Partial Pressure of End-tidal Carbon Dioxide – Reliable Criteria for Termination of Non-traumatic Cardiac Arrest Resuscitative Efforts in the Field. Grmec et al. Resuscitation, Volume 81, Issue 2, Supplement 1, December 2010, Page S26.
Capnography during CPR in SUMMA 112: Preliminary Study. Diez-Picazo LD, et al. Congreso Nacional SEMES 2009. June 2009.
   

By Divemedic, ago

Preemption

There are two things I noticed today, and both of them are related:   

First

Today, I was in Saint Cloud and decided to stop by the Orlando Utilities Commission office that is there, in order to pay my bill. The office is inside City Hall. Just inside the door of the OUC office is a security guard who is armed with a Glock handgun. (I am assuming a 9mm, since that and .38Spl are the only calibers that armed guards can carry under state law.)

Just behind the security guard, there is a sign on the wall that reads “No weapons, firearms, or knives with a blade greater than 3.5 inches are permitted inside.” (or words to that effect- I will get pictures next time, if possible)

According to the OUC website:

OUC-The Reliable One is a municipal utility owned by the citizens of Orlando. It provides electricity and water services to customers in Orlando, St. Cloud, and parts of Orange and Osceola counties.

Second

This story was running on the local cable news channel:

Anyone who visits the Osceola County Administration building will now have to go through a metal detector. Osceola County Commissioner John Quinones said it’s in response to both local tensions and recent national incidents.

 I am not sure if the entire building requires entry, or just the Commission chambers, as the actual press release implies that the magnetometers will only be used for commission meetings.

Why these two stories are important:

The state legislature passed 790.33 some years ago, which states:

Except as expressly provided by general law, the Legislature hereby declares that it is occupying the whole field of regulation of firearms and ammunition, including the purchase, sale, transfer, taxation, manufacture, ownership, possession, and transportation thereof, to the exclusion of all existing and future county, city, town, or municipal ordinances or regulations relating thereto. Any such existing ordinances are hereby declared null and void. (emphasis added)

The law goes on to say:

It is the intent of this section to provide uniform firearms laws in the state; to declare all ordinances and regulations null and void which have been enacted by any jurisdictions other than state and federal, which regulate firearms, ammunition, or components thereof; to prohibit the enactment of any future ordinances or regulations relating to firearms, ammunition, or components thereof unless specifically authorized by this section or general law; and to require local jurisdictions to enforce state firearms laws. (emphasis added)

 So, a county that prohibits firearm possession in a county administration building cannot prohibit CCW holders from possession weapons, unless that building is a police station, jail, a meeting of the legislative body, or a school administrative building. The OUC office in City hall, and the general administrative offices of Osceola county do not fit any of those restrictions, therefore the sign and the magnetometers are in violation of state law.

It seems like government offices state wide are beginning to react to the school board shooting in Bay County and to the shooting in Arizona by violating the law themselves. We need to watch this, and do what we can to bring them into compliance with the law.

By Divemedic, ago

Virtual firearms training

Gander Mountain opens their new virtual training range this weekend, the first of its kind in the nation. I took the tour today, and I decided that it is great.

There is an indoor shooting range that is absolutely state of the art, with ranges out to (I think) 75 feet. Calibers up to .300 Winmag can be fired. The live fire is not the best part.

They have a virtual shooting range. Upon entering the virtual half of the training facility, everyone must pass through a magnetometer to ensure that no live weapons or ammunition enters the virtual training area. This is to prevent accidents. There are virtual shooting simulators, and the last thing anyone wants is an ND with a live weapon. The store employees will store your weapon in a locked room for the duration of your time inside the virtual facility.

All of the virtual weapons are Glocks. They are CO2 powered, and when you fire them, they recoil like the real thing. A computer records your hits and misses.

There is a shooting range that uses virtual weapons. It is set up like a conventional shooting range, with shooting lanes and video reproductions of cardboard targets at varying ranges.

There is a 180 degree and a 300 degree simulator that can place you in shooting scenarios like clearing a building, a convenience store robbery, and various other confrontations. Sometimes you are called upon to shoot, sometimes you cannot shoot. When you are in the simulator running these scenarios, there is always a certified firearms instructor with you.

The instructors are all former police firearms instructors, and the prices for the academy run from $40 to $75 per half hour session. considering that there is no time wasted loading magazines, changing targets, or money spent on ammo, this should be a pretty economical training tool. As soon as I go for an actual shooting session, I will report on how it was.

By Divemedic, ago

Drug lethality

Of the drugs that Americans routinely abuse, many of them are quite toxic. Take a look at this:

The median lethal doses for different substances in a 100kg male:

nicotine 5 g
Cocaine 9.5 g
aspirin 20 g
THC (main ingredient of marijuana) 127g
alcohol: 180 g
caffeine 192 g

acetaminophen (Tylenol): 200 g
table salt: 300 g

Sucrose (table sugar): 2900 g

The issue here is not so much the total lethal dose, but how close you must be to the lethal dose in order to get the effect you are looking for. The largest cluster of substances has a lethal dose that is 10 to 20 times the effective dose: These include cocaine, MDMA (often called “ecstasy”) and alcohol. A less toxic group of substances, requiring 20 to 80 times the effective dose to cause death, include Rohypnol (flunitrazepam or “roofies”) and mescaline (peyote cactus). The least physiologically toxic substances, those requiring 100 to 1,000 times the effective dose to cause death, include psilocybin mushrooms and marijuana, when ingested. I’ve found no published cases in the that document deaths from smoked marijuana, so the actual lethal dose is a mystery. My guess is that smoking marijuana is more risky than eating it, but still safer than alcohol.

Alcohol ranks at the dangerous end of the toxicity spectrum. So despite the fact that about 75 percent of all adults in the United States enjoy an occasional drink, it must be remembered that alcohol is toxic. This makes me wonder why we spend so much money on the drug war. Nevermind, the answer is profit.

By Divemedic, ago

We are surrounded by idiots

A young paramedic, who works for a different agency within the system, but we share a common medical director, came to me this week and wanted to confirm that he was correct in arguing with his supervisor on a certain medical issue. It seems that he ran a call on a woman who was complaining of vertigo and shortness of breath. He found a weak radial pulse, and the monitor (ECG) showed a sinus rhythm at a rate of 86, and her BP was 84/50. Our young medic started a line, and was preparing to give some fluids, and that is where the trouble began.

The supervisor that was on scene felt for a radial pulse, and got a pulse of 36. He insisted that this meant that the patient was bradycardic, and that the young medic administer atropine. The medic refused, and an argument ensued. Our young medic was instructed to “treat the patient and not the monitor” and ordered again to give the atropine. Young medic refused. After the call, our young medic friend was written up for insubordination and failure to follow orders, and sent to see the QA department. The QA department SIDED WITH THE SUPERVISOR, and now the medic faces a discipline hearing, where he is likely to get suspended. The woman from QA told him not to depend on the monitor, as she has seen a Lifepack get a BP and an O2 sat from a mannequin.

So he came to me, and asking for my take, and I gave my opinion. For those who may not know, here it is: The reason for the discrepancy between the patient’s pulse and the rhythm on the ECG was caused by blood pressure. It takes a systolic blood pressure of about 80-90 for a person to have a palpable radial pulse. Since the patient’s BP was so close to 80, it is likely that some pulses were reaching that threshold, while others were not. Since the monitor showed a heart rate of 86, giving Atropine would not have corrected the issue, as this was likely a fluid issue, or perhaps even a problem with vascular tone. In either case, the appropriate treatment would have been fluids, and if that failed, Dopamine should be considered. I told the medic that he should get the Medical Director involved, and get him to come to the discipline hearing if possible.

I am really starting to become convinced that there are very few competent people working anywhere in our health care system. That includes everyone from medics and nurses to the doctors. I am not sure where these idiots come from, or how they manage to pass the state test, but they are out there, and they actually get promoted to positions of power. Unbelievable.

By Divemedic, ago

The food police

Michelle Obama’s pet cause is childhood obesity, and spends a considerable amount of her time lecturing us on how we should be eating healthy, even to the point of advocating for regulating the restaurant industry. Except, look at the menu for the White House Superbowl party: bratwurst, kielbasa, cheeseburgers,
 and deep dish pizza. This is not the first time the first lady has been caught in her hypocrisy. In October, the first lady veggie gardener downed a cheeseburger and French fries in a Milwaukee diner. I recently blogged about how people always SAY that they want healthy foods, but when it comes down to it, people actually buy food that isn’t so healthy. The reason for this is obvious: rice cakes covered in bee spit might be good for you, but it tastes like crap.

By Divemedic, ago

Redefining the language

The Second Amendment covers ARMS. That means all of them- machine guns, grenades, artillery, jet fighters, naval warships, and yes, even nukes.

If you disagree that the 2A includes nukes, you don’t simply redefine the words of the COTUS, that is the same thing that the Brady bunch does now. The founders had a method for changing the Constitution: the Amendment process. I am sure that 3/4 of the state legislatures would have no problem passing an Amendment that exempts nuclear weapons from the Constitutional definition of arms.

By Divemedic, ago

Excellent ideas in culinary marketing

DiGiorno’s pizza recently announced that they will be packaging a frozen pizza in the same box with a batch of cookie dough. You can have pizza and freshly baked cookies for dinner. What a great idea.

Of course, the nanny media is already bitching about how companies are making us fat by producing articles that we will buy, instead of producin what we SHOULD be eating, if only we were smart enough. The typical complaints about how it is bad for your health to eat pizza and cookies, and how companies should be offering healthier alternatives are heard.

Look, the grocery store offers healthy alternatives. I was just shopping today, and there were sections of the store that contained vegetables and all sorts of healthy stuff. Don’t like pizza and cookies? Then don’t buy them.

I will tell you that my brother owns a vending machine business, and he is constantly asked to carry healthy snacks. Every time he puts healthy snacks in a machine, they do not sell. The people counter that it is his fault, because he puts junk food in there WITH the healthy snacks, and people cannot make the healthy choice when there is junk food there as well.

The problem is obvious to these people- we have too much freedom for our own good.

By Divemedic, ago

Getting things done

You have to admire the Democrats for one thing: They know how to get stuff done. When they had control of the Congress and Whitehouse, they rammed through the Health Care law without even bothering to read it. When they do not have control, they browbeat the Republicans into submission by screaming about the need to be “bipartisan” and the Republicans cave.

When that doesn’t work, they attach amendments to bills at the last minute, and those amendments sneak through laws that would not normally pass. The Executive signs orders that have the effect of law, thus bypassing Congress, on laws that would normally not see the light of day.

They lie, they cheat, they steal their way to power. This is the reason why the founders intended to limit the extent of the power of the Federal Government.

I just read a column by Walter Williams, the man that I would like to see in the Whitehouse, and I love a couple of the quotes from it:

“A Constitution of Government once changed from Freedom, can never be restored. Liberty, once lost, is lost forever.”- John Adams

“Congress has not unlimited powers to provide for the general welfare, but only those specifically enumerated.” – Thomas Jefferson

“With respect to the two words ‘general welfare,’ I have always regarded them as qualified by the detail of powers connected with them. To take them in a literal and unlimited sense would be a metamorphosis of the Constitution into a character which there is a host of proofs was not contemplated by its creators.” – James Madison

But what do those guys know, they are old white men who lived over 100 years ago, don’t you know.

By Divemedic, ago