goodells

I thought I was the only one! Something in the UI cache is so horribly corrupted and it has been for years on my MacBook, I just gave up hope.

It's interesting how different standards for behavior on public transit are over there compared to the US. The €100 fine for playing music out loud introduced by Irish Rail sounds heavenly. Here in Dallas, half the trains I get on have someone openly smoking (cigarettes, weed, meth) on them and the rare transit security officers supposed to be doing something about it are the ones playing loud videos on their phones!

I would disagree for a few reasons, at least for its application to cardiac arrest. It might have some niche applications, but that's only speculative.

The main determinant of successful CPR is maintaining coronary perfusion pressure with unrelenting chest compressions so that the heart has a fighting chance at starting to beat normally again. Moving the blood so that it has enough pressure at the aorta where the coronaries branch off of is way way way more important than keeping it oxygenated, which we're already pretty good at. In fact, over-oxygenation in CPR has been shown to be detrimental to outcomes because it causes oxidative stress at the cellular level. Oxygen is nasty, it's amazing that life evolved to harness it.

I do agree that modern medicine (especially emergency medicine) is really cool, that's why I switched careers after working in software engineering. We have lots of tools at our disposal, it's already science fiction. Modern resuscitation involves drugs that manipulate the ion channels of the heart in various ways, we can shift fluids around by changing the osmolarity of IV fluids (and we can pump them into you through your bones after drilling into them if needed...), cardiac monitors and AEDs will time a shock just right depending on the dysrhythmia to increase the odds of success, we can even just repeatedly shock a heart to make it beat in some situations like an AV block. And that's just the stuff that they let paramedics do (i.e. trained monkeys, I am one).

Yes, CO2 still builds up.

In an acute situation where oxygenation isn't sufficient, the imminent threat of anoxic brain injury and end-organ dysfunction is the concern. Measures would obviously be taken to correct that, up to and including rapidly sedating and paralyzing a patient in order to mechanically ventilate them with an increased fraction of inhaled oxygen and/or additional pressure (PEEP) to increase the surface area in the alveoli available for gas exchange.

Respiratory acidosis (i.e. the accumulation of CO2 and acidification of the blood due to inadequate breathing) is generally not harmful on its own, the concern there is just adequate oxygenation. However there are metabolic causes of acidosis, usually due to lactic acid accumulation, which lead to end-organ dysfunction because lots of enzymatic reactions in the body expect a very narrow pH range to work effectively. This occurs over a period of days, though.

It would be quite distressing because of the accumulation of CO2 in the blood, even with completely adequate oxygenation delivered intrarectally. The slight change in acid-base balance is what makes a person feel the need to breathe, and CO2 is an acidic byproduct of metabolism. This is why people with metabolic acidosis (e.g. in diabetic ketoacidosis or sepsis) have an increased respiratory rate.

"Any sufficiently advanced home automation is indistinguishable from a haunting."

The fixation on comparing this to a toilet plunger is unnecessary and somewhat off-putting, but yes, this is pretty common nowadays. The LUCAS is a huge help and makes running a cardiac arrest feasible with a crew of 2-3 people, previously it required a larger team and lots of switching out who was doing chest compressions. It also makes it much easier to move a patient while CPR is in progress since you don’t need to pause compressions moving in and out of the back of an ambulance, etc.

They do tend to be… rougher… apparently they do _such good_ CPR that the risk of damaging the great vessels is much higher than with manual CPR, but I think the tradeoff of getting consistent chest compression quality works out in favor of it still.

There’s a saying in EMS: “lift with your firefighter, not with your back!”. My heart goes out to any firefighters named Lucas.

Yep, it has issues so frequently. I wonder how many companies/teams start using AWS and blindly choose us-east-1 without realizing what they're getting into.

<rant>

It's also quite annoying sometimes that some things _need_ to be in us-east-1, and if e.g. you are using Terraform and specify a different default region, AWS will happily let you create useless resources in regions that aren't us-east-1 that then mysteriously break stuff because they aren't in this one blessed region. AWS Certificate Manager (ACM) certificates are like this, I believe.

</rant>

Some unsolicited recommendations for sci-fi novels that cover this topic well:

- "The Mote in God's Eye" by Jerry Pournelle and Larry Niven (1974)

- "A Fire Upon The Deep" by Vernor Vinge (1992)

Your mentioning the pantheon gave me a flashback to how one of my old companies named their non-prod environments. The dev environment services were named after all the Greek gods, and the QA/demo environment services after the Roman gods. It was so horribly confusing…

I’m also now mildly disturbed/worried by the idea of going about my business in AI-generated VR a few years from now (maybe with some 2D-to-3D-ifying compatibility layer) and being haunted by ghosts of stock image watermarks.

Sometimes I check out /r/teachers to get an idea of what's going on in education. The general consensus is that behavior issues are completely out of control for a variety of reasons:

- Shortage of dedicated special education teachers

- Parents who won't discipline kids at home

- Top-down pushes from administration such as "restorative justice", "least restrictive environment", and a few other phrases that will make any classroom teacher's skin crawl

- Unwillingness from administration to apply suspensions or expulsion due to how this ties to school funding

- Lack of flexibility in the teaching job market due to teachers being a licensed profession and most states suspending a teacher's license if they quit mid-year, leaving apathetic teachers trapped in bad schools

- Attempts to discipline non-white students frequently resulting in accusations of racism, making it not worth the trouble

In the classroom, the end result seems to be that behavior meltdowns take up a disproportionate amount of a teacher's attention and they aren't empowered to deal with it, all at the expense of the quality of instruction for the rest of the students. The standardized test score metrics discussed here are a not too surprising consequence.