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@geneutau-blog
Here’s my line up for #mtac2018 lineup! Friday: Aizawa Shota from BNHA Early Saturday: Eliza Hamilton from Hamilton Late Saturday: Mabel Pines from Gravity Falls Sunday: Kazuma from Noragami #lineup #cosplay #bnha #hamiltonmusical #gravityfalls #noragami
I’m finally starting to work on my Chise Hatori (ep 5 outfit) cosplay! I made the “gorse” wand first because I love working with faux flowers. I think it turned out great! #cosplay #cosplaywip #cosplayprop #ancientmagusbride #chisehatori #fauxflowers #wip
I saw someone do a #cosplayextremes tag, And I thought it would be cool to do it but with two characters from the same series! #gravityfalls #stanfordpines #mabelpines #comparison #sidebyside #cosplay #splitview
Here’s the other design from the Photoshoot with @fayetheotaku! #prom #photography #dress #corset #appareldesign #brickwall
Just recently did a Photoshoot with @fayetheotaku for some of my dress designs! #fashion #prom #photoshoot #nature #gown #chiton #goldenhour
“Yesterday Upon the Stair” AMV
Made an AMV based on @pitviperofdoom‘s amazing fanfic “Yesterday Upon the Stair”! If you haven’t read it yet, you definitely should!
Song: “The Wolf” by SIAMES
Click here to watch on YouTube in HD!
I want to hire literally everyone who has contributed even slightly to the Space Orcs and Space Australians tags to make a video game in which you literally just Dick around in a colonized Galaxy and terrorize the locals as a human in first person. Also community made ships. I want high intelligence AI for the aliens and for there to be role playing element to it. This is literally just an idea in the wind so wink wink indie/Triple A developers FUCKING PICK THIS IDEA UP.
No, no, no, this is amazing!! Let’s go deeper!
YOUR AVATAR: Based on things you choose for your avatar, everything from physical to emotional to personality, the game responds accordingly.
Example, you’re 5′0″ tall - you get to freak aliens out when the engines fail and no one can get into the engine room, except you through the vents because you’re only five freaking feet tall and barely weigh 115 lbs. Problem: you’re not an engineer but you have to find a way in there and get the doors clear so the engineers CAN get in there, otherwise everyone’s gonna die!
The game CREATES situations based on who you are/have chosen to be, so an avatar who’s a forty-year-old, black man and CMO on his ship is going to have a very different gaming experience from an avatar who’s a sixteen-year-old girl from India who’s instigating trade agreements/negotiations with other planets - and that’s only IF they clicked ‘yes’ to a specific field or position. We could literally have a whole bunch of avatars running all over kingdom-come just for the giggles!
I HAVE ABSOLUTELY NO SKILL IN DEVELOPING ANY KIND OF SOFTWARE FOR THIS KIND OF STUFF. SOMEONE GET ON THIS!! Please?
I LIKE THIS KEEPS THE IDEAS COMING
Okay. Ideas. Here we go:
You’ve identified your avatar as an extrovert and social butterfly - congratulations, you’re on the list for special invitees to elite parties where everything from hostage situations to lasting friendships with emperors take place.
You’ve identified your avatar as curious and a quick learner - you get to explore different worlds and learn new languages. This can be done either on cargo or exploratory vessels or both!
You’re courageous and reckless - you help save your crewmates after a crash (which you caused).
You’re conscientious and shy - your crewmates adore you because you go out of your way to put their needs and wants before yours. This also creates general confusion because they don’t understand that their happiness makes you happy. That being said, when pirates take the ship, your crewmates go absolutely nuts when that one pirate punches you because NO ONE TOUCHES OUR PRECIOUS HUMAN!! WE WILL RIP YOUR ARMS OFF!!
Positive and negative personality traits will also either create or nullify situations, especially when used in specific combinations. You can create as many avatars as you want to unlock certain situations/levels.
Also your avatar shouldn’t just consist your height and haircolor. You can say how good your eyesight is, and if you need glasses (which you could lose at some point in the game) you can add them. And hairdye and coloured contacts to freak your alien friend out. Further, what about that post from ‘walking through memory’. At some point in the game you are in a familiar place, but the light goes off and you have to find the way relying on your memories.
The Beginning of the game should reflect your character, like starting in a prison cell for being too violent, or waking up on a normal morning only for shit to get serious real fast. For the prison escape you cause a riot and get to the landing platform with your prison buddies and have to choose a ship. Each ship decides the fates of your friends and how you start the game. Steal the Wardens yacht and one of your friends gets arrested by local authorities but you get an economic head start after selling it. Choosing the pod-dropship lands you on a mostly wild and uncolonized planet with one of your friends sacrificing themselves as bait while you escape to the planet. Choosing the fighter means that you abandon your friends but you now have a battle ready ship which can’t be fracked since fighters are easy to steal. Choose the Corvette and you will have to fight through a blockade and depending on how well you do, the more of your friends survive.
In addition: Human factions. For instance a part of the galaxy is under the control of all of Humanity, this section is split into several varying sub categories of humans who each interact with the Galaxy differently. Depending on what faction you belong to changes how aliens and other humans perceive you. If you belong to a faction largely controlled by companies you aren’t completely respected. If you don’t belong to a faction you are considered a wanderer by the galaxy and you do not benefit from any perks but you also do not lose any perks either. Being a high ranking official in a faction lets you play a more political style compared to that of a factionless adventurer/wanderer who can leave any solar system whenever they please to go fight asteroid worms for a quick buck.
@theterrorsofspacehumans
Imagine mmorpg.
A stabby roomba walks you through character creation, not to mention when you earn a rare skill.
Inevitably, no matter what choices are made, you find an alien who thinks humans are the cutest thing. There are three choices- Stock up on wierd merch to sell off later School said alien on the topic of respect Or gift the alien with 5 minutes of your presence/tolerance/autograph, which will lead to the discovery of an earthling pet shop. This is the only way to get a dog, cat, or bird.
You can adopt species from other planets. Adopt a fierce enough creature and it will defend you (as much as its stats allow) from any hostiles
All aliens believe dragons and dinosaurs are real. Players cannot change this.
Crewmates level up a bit by bonding with each other. Humans get a bonus.
Adrenaline boosts stats temporarily
Political players get negotiation bonuses, and are more capable than aliens at deceiving others (Theres a post out there about hiding emotion. Its the one ending with “10 yrs costomer service.”)
Memes are misunderstood. Constantly. They become a comunication technique and you can rickroll listeners on any coms device at any time. (Pls dont)
You can choose a few habbits. They are commented on and admired/feared
Stabby roomba bumping around is the loading screen
Idk these ideas work both mmorpg and rpg
Let’s dive into combat.
You have the choice of picking one weapon at the start of the game and as you progress you gain more efficient guns, spears, and other weapons.
Your characters fighting style depends on their traits. If there thin and short they tend to do dodge attacks and are the most proficient at light weaponry (pistols and knifes) excluding when they are on adrenaline, then they can handle big guns for a short time. Big muscled characters fight witch giant guns and are good at fighting with their fists, adrenaline makes them quite terrifying.
You are able to take lessons for combat and shooting at certain points in the game.
There are cases were some aliens just run away from you in fear of their lives, you can choose to attack them or not.
If you have an alien or other living being that you have a good bond with by your side when you are fighting your abilities go up by 25%
When you have pets by your side they will defend you against attacks.
That’s all I have right now
Special quests:
The more you complete certain tasks (that differ per job and skill set) you can gain reputatikn points. The more reputation points you have, the higher chance of activating a special quest.
Each quest would vary from species, to the description, some are traps as well. Better to take someone with you tgan go alone
If you successfully complete the task, you become better friends with the species and they will help you out. Can range from giving you items, information, advice etc.
As a pilot or engineer, you can choose to name and/or talk to the machines you work with, which boosts their performance over time
This is incredible and I want to offer my coding and project organizing hours to this if people want to make it happen
ok we have a discord with everything we need to get started. Artists and coders are especially important but everyone’s welcome to join in and help out :)
https://discord.gg/t2ZfvHj
come say hi :)
Anyone interested?
Hey friends. We already have a few people but we could always have more. Particularly those who are willing to lend their talents in 3d modeling and animation, especially for people and creature designs. This game is going to be a free open sourced community based project, so the more the merrier.
We could also use more people who know how to program (specifically in C# but any programming experience is good) and/or know how to work with Unity.
the link to the discord is https://discord.gg/t2ZfvHj.
UPDATE
the link above has expired. If you want to join send me a dm. Please include your skills so we can get a good idea of who is joining.
(Boosting and have deleted the older post)
My mom has always told me that she wasn’t surprised I got into cosplay and apparel design, because I used to dress up in my own unique style as soon as I was allowed to dress myself. The #cosplayersaskids tag is so adorable I couldn’t help myself XD (thanks to @aboveaveragepictures for the photo!) #celebi #gijinka #pokemoncosplay #grateful #loveumom
MysticMessenger buddies lolol #mysticmessenger #rayroute #nospoiler #hype #thisRouteIsSlowlyKillingUs
HERE’S THE THING THOUGH
I used to work for a call center and I was doing a political survey and I called this number that was randomly generated for me and the way our system worked was voice-activated so when the other person said hello you’d get connected to them, so I just launch right into my “Harvard University and NPR blah blah blah” thing and then there’s this long pause and I think the person’s hung up even though I didn’t hear a click
And then I hear “you shouldn’t be able to call this number.”
So I apologize and go into the preset spiel about because we aren’t selling anything, etc. etc. and the answer I get is
“No, I know that. What I mean is that it should be impossible for you to call this number, and I need to know how you got it.”
I explain that it’s randomly generated and I’m very sorry for bothering him, and go to hang up. And before I can click terminate, I hear:
“Ma’am, this is a matter of national security.”
I accidentally called the director of the FBI.
My job got investigated because a computer randomly spit out a number to the Pentagon.
This is my new favourite story.
When I was in college I got a job working for a company that manages major air-travel data. It was a temp gig working their out of date system while they moved over to a new one, since my knowing MS Dos apparently made me qualified.
There was no MS Dos involved. Instead, there was a proprietary type-based OS and an actually-uses-transistors refrigerator-sized computer with switches I had to trip at certain times during the night as I watched the data flow from six pm to six AM on Fridays and weekends. If things got stuck, I reset the server.
The company handled everything from low-end data (hotel and car reservations) to flight plans and tower information. I was weighed every time I came in to make sure it was me. Areas of the building had retina scanners on doors.
During training. they took us through all the procedures. Including the procedures for the red phone. There was, literally, a red phone on the shelf above my desk. “This is a holdover from the cold war.” They said. “It isn’t going to come up, but here’s the deal. In case of nuclear war or other nation-wide disaster, the phone will ring. Pick up the phone, state your name and station, and await instructions. Do whatever you are told.”
So my third night there, it’s around 2am and there’s a ringing sound.
I look up, slowly. The Red phone is ringing.
So I reach out, I pick up the phone. I give my name and station number. And I hear every station head in the building do the exact same. One after another, voices giving names and numbers. Then silence for the space of two breaths. Silence broken by…
“Uh… Is Shantavia there?”
It turns out that every toll free, 1-900 or priority number has a corresponding local number that it routs to at its actual destination. Some poor teenage girl was trying to dial a friend of hers, mixed up the numbers, and got the atomic attack alert line for a major air-travel corporation’s command center in the mid-west United States.
There’s another pause, and the guys over in the main data room are cracking up. The overnight site head is saying “I think you have the wrong number, ma’am.” and I’m standing there having faced the specter of nuclear annihilation before I was old enough to legally drink.
The red phone never rang again while I was there, so the people doing my training were only slightly wrong in their estimation of how often the doomsday phone would ring.
Every time I try to find this story, I end up having to search google with a variety of terms that I’m sure have gotten me flagged by some watchlist, so I’m reblogging it again where I swear I’ve reblogged it before.
But none of these stories even come close to the best one of them all; a wrong number is how the NORAD Santa Tracker got started.
Seriously, this is legit.
In December 1955, Sears decided to run a Santa hotline. Here’s the ad they posted.
Only problem is, they misprinted the number. And the number they printed? It went straight through to fucking NORAD. This was in the middle of the Cold War, when early warning radar was the only thing keeping nuclear annihilation at bay. NORAD was the front line.
And it wasn’t just any number at NORAD. Oh no no no.
Terri remembers her dad had two phones on his desk, including a red one. “Only a four-star general at the Pentagon and my dad had the number,” she says.
“This was the ‘50s, this was the Cold War, and he would have been the first one to know if there was an attack on the United States,” Rick says.
The red phone rang one day in December 1955, and Shoup answered it, Pam says. “And then there was a small voice that just asked, ‘Is this Santa Claus?’ ”
His children remember Shoup as straight-laced and disciplined, and he was annoyed and upset by the call and thought it was a joke — but then, Terri says, the little voice started crying.
“And Dad realized that it wasn’t a joke,” her sister says. “So he talked to him, ho-ho-ho’d and asked if he had been a good boy and, ‘May I talk to your mother?’ And the mother got on and said, ‘You haven’t seen the paper yet? There’s a phone number to call Santa. It’s in the Sears ad.’ Dad looked it up, and there it was, his red phone number. And they had children calling one after another, so he put a couple of airmen on the phones to act like Santa Claus.”
“It got to be a big joke at the command center. You know, ‘The old man’s really flipped his lid this time. We’re answering Santa calls,’ ” Terri says.
And then, it got better.
“The airmen had this big glass board with the United States on it and Canada, and when airplanes would come in they would track them,” Pam says.
“And Christmas Eve of 1955, when Dad walked in, there was a drawing of a sleigh with eight reindeer coming over the North Pole,” Rick says.
“Dad said, ‘What is that?’ They say, ‘Colonel, we’re sorry. We were just making a joke. Do you want us to take that down?’ Dad looked at it for a while, and next thing you know, Dad had called the radio station and had said, ‘This is the commander at the Combat Alert Center, and we have an unidentified flying object. Why, it looks like a sleigh.’ Well, the radio stations would call him like every hour and say, ‘Where’s Santa now?’ ” Terri says.
For real.
“And later in life he got letters from all over the world, people saying, ‘Thank you, Colonel,’ for having, you know, this sense of humor. And in his 90s, he would carry those letters around with him in a briefcase that had a lock on it like it was top-secret information,” she says. “You know, he was an important guy, but this is the thing he’s known for.”
“Yeah,” Rick [his son] says, “it’s probably the thing he was proudest of, too.”
So yeah. I think that might be the best wrong number of all time.
Source: http://www.npr.org/2014/12/19/371647099/norads-santa-tracker-began-with-a-typo-and-a-good-sport
I LOVE THE NORAD STORY!!!!
So that’s how the Santa tracker began and I don’t think I’ve ever heard a better story.
Merry Christmas everyone!
Cheer for the new year! We’re here to Save the Day!
Included in the digital file are
12 spreads + 1 month, 1920 pixels wide
A PDF explaining the options needed to turn them into wallpapers
A PDF of the calendar pages
There are unobtrusive watermarks of the artists’ names for safety!
(the above image is an example ^^)
OTHER NEWS Our postcards just came in, and they are fabulous! These + extra calendars from our bulk order are available on our SHOP.
They’ll be shipped along with the calendars in late December! The calendars will be here next week.
One last reminder our GIVEAWAY ends in 3 days! Reblog the post to enter! Thanks for the support everyone!
I had an awesome photoshoot with @checkpoint_photography for my John Laurens cosplay! #hamilton #hamiltoncosplay #johnlaurens #johnlaurenscosplay #hanahaki #hanahakidisease #cosplay #cosplayphotoshoot
Too bad Herc isn’t here! #hamiltoncosplay #johnlaurens #hamilton #txmdsmtsu #txmd #halloween (at Middle Tennessee State University (MTSU))
GOOD BOYS
I’m a little behind because i forgot to start #inktober yesterday :P But here are my #swift and #divided days! #wings #hamilton #alexanderhamilton #aaronburr #inktober2017
"Raise a Glass to Freedom!" Sorry for not posting recently I just started sophomore year and I was getting back in to the grove of things. Here's a John Laurens Costest to kick things off again! #johnlaurens #hamiltoncosplay #costest #hamilton #hamiltonmusical #raiseaglasstofreedom
Injury angst for writing dummies.
Hospitals and injury are always such a staple of angst fics, but 9 times out of 10 the author has clearly never been in an emergency situation and the scenes always come off as over-dramatized and completely unbelievable. So here’s a crash course on hospital life and emergencies for people who want authenticity. By someone who spends 85% of her time in a hospital.
Emergency Departments/Ambulances.
Lights and sirens are usually reserved for the actively dying. Unless the person is receiving CPR, having a prolonged seizure or has an obstructed airway, the ambulance is not going to have lights and sirens blaring. I have, however, seen an ambulance throw their lights on just so they can get back to the station faster once. Fuckers made me late for work.
Defibrillators don’t do that. You know, that. People don’t go flying off the bed when they get shocked. But we do scream “CLEAR!!” before we shock the patient. Makes it fun.
A broken limb, surprisingly, is not a high priority for emergency personnel. Not unless said break is open and displaced enough that blood isn’t reaching a limb. And usually when it’s that bad, the person will have other injuries to go with it.
Visitors are not generally allowed to visit a patient who is unstable. Not even family. It’s far more likely that the family will be stuck outside settling in for a good long wait until they get the bad news or the marginally better news. Unless it’s a child. But if you’re writing dying children in your fics for the angst factor, I question you sir.
Unstable means ‘not quite actively dying, but getting there’. A broken limb, again, is not unstable. Someone who came off their motorbike at 40mph and threw themselves across the bitumen is.
CPR is rarely successful if someone needs it outside of hospital. And it is hard fucking work. Unless someone nearby is certified in advanced life support, someone who needs CPR is probably halfway down the golden tunnel moving towards the light.
Emergency personnel ask questions. A lot of questions. So many fucking questions. They don’t just take their next victim and rush off behind the big white doors into the unknown with just a vague ‘WHAT HAPPENED? SHE HIT HER HEAD?? DON’T WORRY SIR!!!’ They’re going to get the sir and ask him so many questions about what happened that he’s going to go cross eyed. And then he’s going to have to repeat it to the doctor. And then the ICU consultant. And the police probably.
In a trauma situation (aka multiple injuries (aka car accident, motorbike accident, falling off a cliff, falling off a horse, having a piano land on their head idfk you get the idea)) there are a lot of people involved. A lot. I can’t be fucked to go through them all, but there’s at least four doctors, the paramedics, five or six nurses, radiographers, surgeons, ICU consultants, students, and any other specialities that might be needed (midwives, neonatal transport, critical retrieval teams etc etc etc). There ain’t gonna be room to breathe almost when it comes to keeping someone alive.
Emergency departments are a life of their own so you should probably do a bit of research into what might happen to your character if they present there with some kind of illness or injury before you go ahead and scribble it down.
Wards
Nurses run them. No seriously. The patient will see the doctor for five minutes in their day. The nurse will do the rest. Unless the patient codes.
There is never a defibrillator just sitting nearby if a patient codes.
And we don’t defibrillate every single code.
If the code does need a defibrillator, they need CPR.
And ICU.
They shouldn’t be on a ward.
There are other people who work there too. Physiotherapists will always see patients who need rehab after breaking a limb. Usually legs, because they need to be shown how to use crutches properly.
Wards are separated depending on what the patient’s needs are. Hospitals aren’t separated into ICU, ER and Ward. It’s usually orthopaedic, cardiac, neuro, paediatric, maternity, neonatal ICU, gen surg, short stay surg, geriatric, palliative…figure out where your patient is gonna be. The care they get is different depending on where they are.
ICU.
A patient is only in ICU if they’re at risk of active dying. I swear to god if I see one more broken limb going into ICU in a fic to rank up the angst factor I’m gonna shit. It doesn’t happen. Stop being lazy.
Tubed patients can be awake. True story. They can communicate too. Usually by writing, since having a dirty great tube down the windpipe tends to impede ones ability to talk.
The nursing care is 1:1 on an intubated patient. Awake or not, the nurse is not gonna leave that room. No, not even to give your stricken lover a chance to say goodbye in private. There is no privacy. Honestly, that nurse has probably seen it all before anyway.
ICU isn’t just reserved for intubated patients either. Major surgeries sometimes go here post-op to get intensive care before they’re stepped down. And by major I mean like, grandpa joe is getting his bladder removed because it’s full of cancer.
Palliative patients and patients who are terminal will not go to ICU. Not unless they became terminally ill after hitting ICU. Usually those ones are unexpected deaths. Someone suffering from a long, slow, gradually life draining illness will probably go to a general ward for end of life care. They don’t need the kind of intensive care an ICU provides because…well..they’re not going to get it??
Operations.
No one gets rushed to theatre for a broken limb. Please stop. They can wait for several days before they get surgery on it.
Honestly? No one gets ‘rushed’ to theatre at all. Not unless they are, again, actively dying, and surgery is needed to stop them from actively dying.
Except emergency caesarians. Them babies will always get priority over old mate with the broken hip. A kid stuck in a birth canal and at risk of death by pelvis is a tad more urgent than a gall stone. And the midwives will run. I’ve never seen anyone run as fast as a midwife with a labouring woman on the bed heading to theatres for an emergency caesar.
Surgery doesn’t take as long as you think it does. Repairing a broken limb? Two hours, maybe three tops. Including time spent in recovery. Burst appendix? Half an hour on the table max, maybe an hour in recovery. Caesarian? Forty minutes or so. Major surgeries (organs like kidneys, liver and heart transplants, and major bowel surgeries) take longer.
You’re never going to see the theatre nurses. Ever. They’re like their own little community of fabled myth who get to come to work in their sweatpants and only deal with unconscious people. It’s the ward nurse who does the pick up and drop offs.
Anyway there’s probably way, way more that I’m forgetting to add but this is getting too long to keep writing shit. The moral of the story is do some research so you don’t look like an idiot when you’re writing your characters getting injured or having to be in hospital. It’s not Greys Anatomy in the real world and the angst isn’t going to be any more intense just because you’re writing shit like it is.
Peace up.
Ya hear that, Buckley? Loss.jpeg ain’t realistic.
of all the additions and replies on this post so far this is by far my fave.
Thumbs up for this from your friendly neighbourhood physician. (Also, I did mostly emergency care for a few years before switching to radiology. I got the adrenaline junking out of my body before settling down.)
One correction from someone who spent almost a decade working in an ambulance across two states: it is required by law to have your lights on if there is a patient in your rig. Now, this might be a state-by-state law IDK, but in both states I worked in, it was the case. You reserve sirens for Serious Shit because, guess what, they stress out the patient, so unless your patient is crashing in the back of your rig, you don’t run a continuous siren. You are, however, once again required by law to turn on the siren briefly while approaching and driving through stop signs or red lights. (You will also use your siren briefly to get idiots in front of you to move over when you’re stuck in traffic and have a patient whose condition can escalate.)
Also, unrelated to the lights and sirens issue, lemme add a detail about us asking a lot of questions. If you want verisimilitude in your story, remember SAMPLE:
Signs and symptoms
Allergies
Medications
Past illness/injury/disease
Last food, drink, and medication taken
Events leading up to the injury or illness
These are the questions EMTs are trained to ask every patient, though they rarely end up coming out in that order. Also, you can totally add a W to that, which is inevitably “Why did you wait so long to call us?” *sighs forever*
And for some more basic on-scene emergency care, remember CABC: C-spine, Airway, Breathing, Circulation. This time, actually in that order (except for cardiac arrest, in which case remember CAB: Compressions, Airway, Breathing).
The long and short of CABC is: if the patient fell or was in a car accident or had any other potentially traumatic injury, start with stabilizing the C-spine (typically via cervical collar and head blocks and backboard), because if there is a fracture in the neck and you don’t manage it and end up severing the spinal cord that high up, your patient’s probably going to die, and if not, will probably be paralyzed from the neck down.
Once C-spine is stable, make sure the patient’s airway is clear (this includes both foreign obstruction and the patient’s own tongue). Yes sometimes this actually involves sticking your finger in their throat to clear shit out, and yes it’s gross. It also means positioning an unconscious patient’s head in a certain way (assuming there is no chance of C-spine damage) to keep the airway open. EMTs also carry little plastic hook things called oropharyngeal airways in a bunch of sizes that keep the patient’s tongue from blocking their airway. And of course if needs be you can intubate, although this is not a skill EMTs have (paramedics do, though, and in some states there’s a certification called EMT-I [the I for intermediate] that also teaches that skill). If someone’s just come across an unconscious person and doesn’t have an airway to use, and you’re sure their C-spine is fine, you can roll them onto their left side and gently curl them; that’ll help keep the airway clear and also helps the heart pump blood a little more efficiently than if you’d rolled them onto their right side.
Anyway, once the airway’s secure, you move on to making sure the patient is actually breathing. If they’re not, you do it for them with an ambu bag. If they are but are struggling, or aren’t struggling but may for any reason potentially go into shock or have compromised circulation (broken leg, high fever, etc.), you give them supplemental oxygen, typically through a nonrebreather mask, though the flow rate depends on their symptoms.
Okay so once we’ve secured the patient’s C-spine, airway, and breathing, only then do we worry about circulation (unless the patient’s in cardiac arrest, remember, in which case we secure circulation first). Which in the case of trauma is generally first aid for serious open wounds and preventing or treating shock, and in the case of medical issues may be getting an ECG reading or administering medication or, if the patient does go into cardiac arrest, chest compressions and defibrillation.
Okay, that’s the end of the CABCs, but you’ll note that in the last para I said treating serious open wounds. Because a minor open wound is going to wait until after the next step after the CABCs, which is a full-body assessment wherein we meticulously assess a trauma patient using palpation from, basically, head to toe, looking for broken bones, soft tissue damage, internal bleeding, etc. Some of those things can be pretty serious, so before we treat a shallow cut, we check for, like, broken ribs that might puncture a lung.
So obviously not all of these things happen all the time. A patient presenting with an asthma attack needs neither a full-body assessment nor C-spine and circulation management. So we just jump straight to airway and breathing and forego the rest. (And then ask anyone with them our SAMPLE questions if the patient is too distressed to speak, because we still need those answers, but also if the patient is too distressed to speak you can bet we’re asking their companion in the back of a moving ambulance.)
Sometimes you spend a Long Fucking Time at a scene, either because the patient is resisting transport (this happens a lot, especially with the uninsured; we stick around and do everything we can to help them while simultaneously trying to encourage them to go to the ER anyway), or because the patient’s trapped in a smashed car and we’ve got to cut the door off and peel the roof back and get a cervical collar and a backboard on the patient while they’re still in the damn driver’s seat and lemme tell you that is a goddamn game of Jenga and can take half an hour, or because the patient isn’t critical but you want to minimize discomfort and damage so you take the time to meticulously package them while also getting all your questions answered on scene to make sure you haven’t missed anything, or because … well, you get the point. Sometimes shit just takes forever.
Other times, we do what’s called a scoop-and-go, typically with patients in critical conditions that can’t really be managed without surgery or medications we don’t carry. Like, patient bleeding out while giving birth? Not a whole lot we can do about that, so we get them in the rig as fast as fucking possible and race to the hospital while trying to get the most critical questions answered. These kinds of situations are very rare, though; it’s much more common to be on scene for 15 or 30 minutes than 5 minutes.
OH AND, another thing. Listen. EMTs do not approach a scene that is not secured. If there’s an active shooter, or a hostage situation, or a raging fire, or a potential for something to explode (or for something that’s already exploded to collapse), or a flash flood, or a hazardous materials spill, or whatever else, we do not go in until the unstable situation has been resolved. It sucks waiting 100 yards away while a critical patient is maybe dying and you can’t get to them yet, but listen, the first thing they teach you is don’t make new patients. IOW, don’t become a victim yourself; you can’t help anyone if you get wounded in the crisis too, and in fact then you’ve just become an additional burden on the personnel remaining.
Okay, so, any questions?
ALL OF THIS. With one exception to what @rachelhaimowitz added, which is:
I’ve never heard of the lights-must-be-on rule. It’s gotta be one or a few specific states. Generally speaking, lights and sirens increase accident rates, and most states are actively trying to REDUCE their use, not increase them, but I don’t know where she lives, so that’s accurate in her part of the country (I’m assuming the US). But it’s inaccurate in most of the country.
xoxo, Aunt Scripty
So I love everything about this post and had to throw in my two cents!
So I work in a real crowded city and, luckily, I don’t need to go lights and sirens since I’m primarily non-emergency. But in the few times I’ve had to make that decision, I tend towards not using lights/sirens or at least not sirens.
Because once you turn those suckers on, drivers become unpredictable as fuck. They freeze, they slow, they swerve, at least one car is guaranteed to move to the left instead of the right.
I drive safer and get to a hospital faster when I go with the flow as much as possible and am able to predict what the cars around me will do.
Secondly, i used a scale called OPQRST which I use to quantify pain.
Onset (were you hit? Why pain?) Provocation (does it fade? Heighten?) Quality (dull or sharp?) Radiation (Where?Does it move?) Severity (pain scale) Time (how long has it been going on?)
If you ever want to heighten the drama and imply something is seriously wrong in your fic, try something like this:
EMT: so what happened? Where does it hurt? Bystander: X and X happened and got hit in the stomach really hard! Patient: ow! My right shoulder hurts! EMT: Fuck.
Referred pain is usually a sign of internal damage to an organ. In this case I’d be thinking there’s something bad with the liver, but I don’t really go further than the “fuck” before loading up and heading out.
This^
