Roberta, the SCHIP, and Kelo

Seeing RobertaX’s Blog and her comments about “the village” paying for “free” healthcare are in keeping with my earlier comments on the subject. The feeling that Uncle Sugar should be paying for whatever it is you want this week, be it healthcare, welfare, your retirement, food stamps, whatever, has been going on for years.

Hearing people complain that the Kelo decision and how wrong it is that the court allowed the government to take private property and give it to others makes me laugh. Whether it is New London using eminent domain to take my house and give it to a business, or it is the IRS taking my money to hand out healthcare, welfare, or whatever the cause is this week, my property has been getting taken for the profit of others for my entire adult life.

I’s a Gansta, yo!

Last night, I ran a call on a woman who was, to use the medical term, “coo coo for Cocoa Puffs.” She, along with her 19 year old son, came in third in a physical altercation involving themselves, some random citizens, and the police.

During the altercation, a gun was produced by one of the actors, which caused the police to show the others all of the cool guns they possess, and some bumps and bruises were administered. That is where I come in. We arrived to find mom and son lying on the ground, with police everywhere.

The son yells things like “I’s a gangsta, yo!”
“I’m cool, like 69 degrees, yo!”

Complete with baggy pants, blue gang bandanna, underwear hanging out, and his toy gun.

I pointed out to him that flashing toy guns at people with REAL guns is not a very smart thing to do, unless one WANTS to be like, 69 degrees, yo. As in assuming room temperature.

Reporter arrested in Miami

A Miami reporter was arrested this week, for carrying a weapon on school grounds. He had a concealed weapons permit. There are a couple of problems with this arrest.

1 The law he was undoubtedly arrested for violating was 790.06(12), which states (in relevant part):

No license issued pursuant to this section shall authorize any person to carry a concealed weapon or firearm into…any elementary or secondary school facility…

Which would seem to make this a valid arrest, until you look at the statute like an attorney, At that point, you see that the legislature treats school facilities and school grounds as two different animals. See 790.115(1) (relevant parts):

(1) A person who exhibits any sword, sword cane, firearm, electric weapon or device, destructive device, or other weapon… at a school-sponsored event or on the grounds or facilities of any school…

The legislature could easily have said grounds, had it meant grounds. Instead, it chose to use the word facility. In fact, looking at the definition of “Educational facility” in 159.29(22), we see that facility DOES mean buildings:

(22) “Educational facility” means:

(a) Property, limited to a structure suitable for use as a dormitory or other housing facility or a dining facility, that is operated in the public sector and used for or useful in connection with the operation of an institution for higher education…(snip irrelevant language)

(b) Property that comprises the buildings and equipment, structures, and special education use areas that are built, installed, or established to serve primarily the educational purposes of operating any nonprofit private preschool, kindergarten, elementary school, middle school, or high school…


Even if the court decides that this reading is incorrect, it is only a Class 2 Misdemeanor. I don’t even think it will get that far, however. Because he was arrested on the sidewalk in front of the school, this would not in any way constitute the “facility.”

The second problem I have, is that since the weapon was concealed, and the reporter safely on the sidewalk, the police officer in this case had absolutely no probable cause to search him to FIND the weapon in the first place. This entire arrest smells. Perhaps this reporter was reporting on things the local gendarmes found offensive.

Cheapness

I teach classes. I teach CPR, ACLS, PALS, PHTLS, EMT, and Paramedic. I also teach the instructor courses. I had a woman call me today (from a daycare center) who wanted an adult and child CPR, AED, and first aid class for 10 of her staff. This class takes all day, and requires 2 instructors, as well as books and training materials. I quoted her a price of $400. That works out to $40 per student.

The books and materials cost me $20 per student. That leaves me with $200 to pay myself and another instructor, as well as all of my other overhead. She was angry over that, and says I am too expensive. She says my competition is less than half of what I charge. I pointed out that they charge extra for books and materials, so the end price is the same.

She wanted to pay $15 per student. I told her that I can’t do that, so she hung up in a huff.

Whatever, I can’t afford to GIVE my time away.

Sex with Robots

A major news outlet, and they are reporting National Enquirer style news.

“My forecast is that around 2050, the state of Massachusetts will be the first jurisdiction to legalize marriages with robots,”

Wow, think about it- I can get all of the tax breaks of marriage, the robot won’t cheat on you, and will never steal the remote. the article goes on to say this:

“If you have pedophiles and you let them use a robotic child, will that reduce the incidence of them abusing real children, or will it increase it?” Arkin asked. “I don’t think anyone has the answers for that yet — that’s where future research needs to be done.”

Keeping a robot for sex could reduce human prostitution and the problems that come with it.

However, “in a marriage or other relationship, one partner could be jealous or consider it infidelity if the other used a robot,” Levy said. “But who knows, maybe some other relationships could welcome a robot. Instead of a woman saying, ‘Darling, not tonight, I have a headache,’ you could get ‘Darling, I have a headache, why not use your robot?'”

Then the article goes on to talk about how the scientist is writing a paper on the ethical treatment of robots. You have got to be kidding me- the robot equal rights movement is born.

Early resolution for the new year

Since it has become apparent that we are about to get us a shiny new president, and all of the front runners for both parties seem to be anti-gun, I am going to see if I can buy one gun a month from now until inauguration of the president.

So, that is 15 guns to buy between now and January of 2009. Anyone else wanna try this with me?

A lesson in cardiology

This post arises from a call I ran yesterday with a relatively new medic. Those of you in EMS know that new medics are pretty timid, and tend to have problems with calls that require them to think outside of the box we call protocol. This was one of those times that it is obvious that we need to do so. I hope any new medics that read this will learn an important lesson.

Our patient was a 58 year old man who was working at some light gardening when he began having pain between his shoulder blades, and began loudly burping, which relieved the pain. He went inside and took some gas medicine. His obviously intelligent wife called 911 and got him to take 2 baby aspirin.

When we arrived, we found him seated on his couch, he was cool and covered in sweat. He states he has a history of hypertension, for which he takes no medicine. He states that his doctor feels like his blood sugar is too high, and wanted him tested for diabetes, but that was 6 months ago, and he hasn’t been back since. When we stand him up to plpace him on the stretcher, his pulse becomes irregular. His vitals are: P- 88, BP 138/86, RR 20. In the truck, we start an IV, and find him to be in a normal sinus rhythm, his SaO2 is 99% on room air, blood sugar is 170. His 12 lead EKG is as follows:

(Click for a larger picture)

There are a few things that jump out at you here.

  1. The 12mm height of the QRS in lead aVL indicates “voltage criteria” for left ventricular hypertrophy. This is likely caused by his history of uncontrolled high blood pressure.
  2. The length of his QRS (0.122 sec) could be considered a left bundle branch block, but I think this is probably due to the QRS widening caused by the LVH, since the EKG doesn’t have that “LBBB look” to it.
  3. The poor R wave progression in leads V1 through V6
  4. The ST segment depression in Leads V3 and V4

I pointed out to New Medic Partner (NMP) that nitroglycerin was probably a good idea here. NMP didn’t want to give it because the patient “didn’t have chest pain.”

Sigh. This is one of my pet peeves. This man has risk factors- possible untreated diabetes AND high blood pressure. He is complaining of anginal equivalents- indigestion, and back pain. His irregular pulse on standing MAY be PVC’s, and his 12 lead confirms a cardiac event.

I finally prevailed, and we alerted the hospital. The doctor sent him to the cath lab, and it turns out that he had a complete blockage of the distal end of the left anterior descending coronary artery. He was having a hearta ttack, but we caught it early, and he is now recovering.

Please, medics. Learn how to read the signs your patient is giving you, and learn to read and interpret the 12 lead EKG. Cardiology, diabetes, and drug overdoses are the three areas where medics save the most lives. Be the best you can be at this, lives depend on it.