Chetzemoka

You are correct, and we actually also use them on people who are not actively dead, but are having a bad heart rhythm that is causing intolerable symptoms.

The shocking dead people to resuscitate them thing, the part that everyone is familiar with, is when the ventricles of someone's heart have started quivering in a chaotic rhythm called ventricular fibrillation or vfib. If someone is experiencing vfib, they're actually dead because vfib invariably degrades into full stop flatline very quickly. Shocking someone in vfib briefly stops their heart in hopes that it will reboot itself into a rhythm that is compatible with life.

But the right atrium can also fall into fibrillation. You've heard about this on TV (if you're in the US); we call that afib. Afib is compatible with life, because the ventricles are the main part of the pump and can continue to beat even if the right atrium goes a little haywire. But often that beating isn't very effective and people will experience low blood pressure and shortness of breath. And the right atrium isn't clearing blood out of itself effectively in afib, which can cause the blood to clot in the heart and lead to a stroke if a piece of clot breaks off.

So, you may be thinking to yourself, wait, ventricular fibrillation we use a defibrillator, so what about atrial fibrillation, and that is correct, we can use a defibrillator to shock someone in afib, reboot their heart, and hope they go back into a normal, more effective rhythm. (We do mildly sedate people before doing that lol.) Sometimes that works, sometimes we have to just control afib with meds and we have to keep them on blood thinners to prevent a clot in the heart.

And lastly, there's a more complicated heart rhythm called Supraventricular Tachycardia or SVT that sometimes also responds to being shocked. We try a couple of other treatments first for SVT, but shocking can work. And again, people are mildly sedated for that.

We still have the same infection control protocols to prevent spreading an illness from an infectious patient to other patients that we've had since before the pandemic. That includes wearing a mask (and usually gown, gloves, face shield) when in a room with an infectious patient. We're just not wearing masks in the hallways and break rooms anymore, and it's caused some outbreaks among staff.

One significant contributing factor to this is the ridiculous American expectation that people should work unless they can't stand up anymore, and if you take a day off, it comes out of your vacation time or it's possible that it could be unpaid. We incentivize people to ignore mild symptoms of illness that result in them arriving to work in the early infectious stages of illnesses. We need to change that, to encourage people to stay home even if they mostly feel well, but suspect they're coming down with something without it eating into their already scarce PTO.

It's difficult to communicate with an elderly person whose hearing aid battery has failed (or who refuses to wear them). Communicating with them while wearing a mask is nearly impossible. It honestly complicates their care, and we did it through the entire pandemic.

When my hospital lifted its mask mandate, I thought I would wear a mask forever. It wasn't discouraged, left totally up to us. But then one time I pulled it down because I couldn't communicate with a patient. Then I did it again. Eventually I was routinely pulling it down to talk to people, and I thought why even bother?

Naturally I continue to wear one if someone is diagnosed with an actual respiratory illness. But the ease of communicating with the people who compromise the majority of the patient population in a hospital is my primary barrier to going back to wearing one all the time.

One thing we need that would really help is better protections for sick workers so people don't try to skirt the rules and talk themselves into coming to work in the early stages of an illness.

The character's name is Boromir.

What do you think would be the mechanism of death when he gets hit by an arrow? Even bullets rarely kill instantly. Bullets stop people because they hurt and people go into shock. A properly trained soldier absolutely is capable of continuing to fight through this. Short of a head shot, the most likely mechanism of death is blood loss, which takes a little time. When. Boromir dies, he is ashen pale the way a person with catastrophic blood loss would be. I think that death scene is more realistic than you realize.

This headline is some absolute bullshit.

California already had health insurance for undocumented immigrants, as does Massachusetts. It's just limited to emergency care and pregnancy care.

California is expanding their existing coverage to comprehensive health care including primary care, which is cheaper than letting medical conditions get so completely out of control that they require expensive and disabling emergency hospitalizations.

I love the rhythm of this language. "Honga Tonga Honga Ha'apai" is so much fun to say.

Yes, a stopped heart shows up as a flat line with no activity on an EKG. We don't shock people when their hearts have completely stopped because it doesn't do anything and can actually damage the heart. Defibrillators are named that because they're intended to shock a heart that is in a chaotic electric rhythm called fibrillation where the heart is just kind of shivering instead of beating fully.

If a person has flatlined, you can do CPR and administer epinephrine, and if you're extremely lucky get their heart to start fibrillating so a shock might have a chance of being effective at restoring a normal heart beat. This is why someone whose heart has stopped completely is 2-3 times less likely to survive CPR than a person experiencing fibrillation.

Additional context about these "training" fees. The people coming over from the Philippines are TRAINED NURSES. They're properly educated, often already working, and in my experience generally excellent nurses. These "training fees" are literally wage slavery. These nurses require very little training, mostly about US healthcare laws and facility policies. These facilities are not teaching them how to be nurses.

As long as they don't let it be run by private equity firms like the US. In theory our combination long term care/short term rehab facilities provide this care model. They contain a doctor, nurses, aides, social workers, and physical therapists. Who are all paid rock bottom wages and criminally understaffed while the owners rake in millions by literally bankrupting vulnerable elderly people.

I'm assuming the UK facilities will be public like NHS unless the Tories get their way and kill that too.

From a volcano, per the source you linked:

"The Hunga Tonga-Hunga Ha’apai volcano — which violently erupted in January 2022 and blasted an enormous plume of water vapor into the stratosphere – likely contributed to this year’s ozone depletion. That water vapor likely enhanced ozone-depletion reactions over the Antarctic early in the season.

“If Hunga Tonga hadn’t gone off, the ozone hole would likely be smaller this year,” Newman said. “We know the eruption got into the Antarctic stratosphere, but we cannot yet quantify its ozone hole impact.”

As a critical care nurse, the miraculous CPR recoveries are such a horrible disservice to our patients and their families. CPR is not two minutes of some light exercise and then the person wakes up and is ok forever.

It's 20-30 mins of intense, brutal, scary, undignified activity followed by best case scenario, we put you in the ICU, deliberately make you hypothermic for a day or two, and hope you wake up. That increases your chances of surviving the incident to a whopping 64%.

Surviving to discharge and having a meaningful recovery is a whole other ballgame, and depends a lot on the condition you were in when you had cardiac arrest in the first place. Your elderly grandpa with cancer, sepsis, bad kidneys, etc. is probably not going to go home. Your middle-aged wife who came in because she was having a heart attack actually stands a good chance.

Movies like to show people shocking a flatlined patient who just pops up and walks away when in reality presenting fully flatlined means you're 2-3 times less likely to be resuscitated at all.

I'm happy to leave some leeway in fictionalized depictions of medical care for the sake of story progression. But the complete ignorance currently common in fictional resuscitation scenarios feeds a really malignant sort of magical thinking that keeps us torturing elderly people. I'd really appreciate less of that in my job.