Figures don't lie

When we want to measure auto accident fatalities, the metric of fatalities per 100 million miles driven is the one that statisticians use. This formula eliminates the chance that short-term anomalies -- such as a rash of multi-vehicle or multi-passenger accidents in a certain state -- will cause fluctuations in the rate that are not related to the true cause of the accident or accidents. The fatality rate for the last 90 years in the US looks like this:

Year	Fatality Rate (Per 100 MVM)	Fatal Accident Rate (Per 100 MVM)
1921 -	24.1	NA
1930 -	15.1	NA
1940 -	10.9	NA
1950 -	7.2	NA
1960 -	5.1	NA
1970 -	4.7	NA
1980 -	3.3	3.0
1985 -	2.5	2.2
1990 -	2.1	1.9
1995 -	1.7	1.5

Source: National Highway Traffic Safety Administration

Converting these numbers into a graph, gives you the following:

Looking at these facts, I can draw a few conclusions: The creation of drunk driving laws and the lowering of the intoxication level to .08% did nothing to reduce the fatality rate. Even more remarkable is that lowering the national speed limit to 55 miles per hour in 1973, and the subsequent raising of the speed limit to 70 miles per hour also had no effect on the fatality rate.

Now we are being duped by calls for saving lives again, when the true goal is control of our lives.

Canada's gun laws

There are many on the more control side of the gun debate that like to point out that Canada has a lower murder rate, and claim that the difference is due to the strict gun laws of our northern neighbors. Comparing the US crime rates to Canada is an apples and oranges comparison.

The entire nation of Canada has a population that is smaller than the state of California, yet Canada's population is spread over an area that is roughly the same as that of the entire United States. That results in a population density that is much lower than the United States. (Canada has a population density of 9.7 people per square mile, the US 79 people per square mile.) This is evidenced by the fact that Canada only has 3 cities with a population over 2 million people.

Even so, violent crime rates (per 100,000 population) between Canada  and the US will surprise you. The violent crime rate in Canada is 1282  per 100,000. The violent crime rate in the US is 386 per 100,000.
The murder rate in Canada is lower overall, until you exclude the large urban areas from the US statistics, and compare the areas of the US with similar population density areas of Canada. Exclude US cities with a population of over 3 million, and in this apples to apples comparison, the US actually has a lower murder rate than does Canada.

I believe that this indicates that we have a problem with culture in  our large cities more than it indicates a gun problem, being that our suburban and rural communities have a higher rate of firearms ownership than do the cities. At any rate, the scientific method dictates that in examining and comparing different data sets, one must eliminate all variables, except the one that is being compared. For that reason, a straight comparison of the US murder rate and the murder rate of any other country is not a valid comparison.

Sources:
FBI Uniform crime report:
Canada Crime report:

Status Asthmaticus

A 7 year old girl is brought into the emergency room, having an asthma attack. The staff of the emergency department gives her three updraft treatments of albuterol and atrovent, and 125mg of Solumedrol. Since she is still complaining that she cannot breathe, the staff calls for a Critical Care ambulance to transport her to the children's hospital for further treatment.
Upon arrival, the critical care paramedic sees a child who is obviously tiring of her respiratory effort, and her vitals show it: Her SaO2 is 86% on 2 liters by cannula, Heart Rate is 152, BP is 102/64. Her EtCO2 (which the hospital emergency department does not have the equipment to measure) shows a waveform that is too flat to determine is the classic "sharkfin" is present or not, and has a level of 16mmHg.
The hospital is busy debating on whether to give her another albuterol and atrovent treatment, epiniephrine, or intubating her. The paramedic asks why they have not given her a smooth muscle relaxer like magnesium sulfate, and the nurse replies that the doctor was worried that it might lower the patient's blood pressure. Of course, he was perfectly willing to give a beta agonist like albuterol to a patient who wasn't exchanging enough air for it to work, and risk sending the already tachycardic patient's heart rate even higher. Epinephrine would also increase the tachycardia.

The scenario illustrates some big flaws in how hospitals treat respiratory problems:

- Hospital emergency rooms, for the most part, do not monitor capnography, even though it is the most effective way of measuring pulmonary gas exchange on a realtime basis.
- Doctors not being the all knowing, perfect beings that the medical profession would have us treat them like
- The doctor not realizing that intubation is NOT therapeutic to asthmatics. This is a small airway problem, and will not be resolved by putting a tube in the trachea. 

In this scenario, the paramedic called medical control and requested and received orders for 25mg of magnesium sulfate over ten minutes. By the end of that ten minute period, her blood pressure was still 100/58, her heart rate was down to 122, SaO2 100%, and her capnograph showed a square wave at 38mmHg. Her lung sounds were clear, and she was breathing normally.

To everyone: We should be the masters of basic medical problems. Epi and albuterol are not magic fixes for everything respiratory.
To doctors: Medics occasionally know what they are doing

Dead cop writes 2,000 posthumous traffic tickets

In a followup to last week's post about the traffic camera ticket that was written to the stationary automobile, I found another article: Over 2,000 traffic tickets were sent out from a traffic camera, even though the officer who "reviewed" and signed the citations had been dead for months.

So much for the review system. Reminds me of the Robosigning scandal.

Pointless

The recent shooting in CT has brought them out of the woodwork. The anti-gunners. They smell blood, and they think that this is their moment. As one of my anti-gun friends put it, the shooting in CT is the best thing that could have happened for the gun control movement. They are reveling in the deaths of those children.

I made the statement that gun owners are as responsible for the CT shooting as gays are for what happened at Penn State, and I was informed by a former coworker that no one at Penn State died, and that guns kill people, and if they were illegal, we would save many lives. No matter what I said, the talking points kept coming, and no amount of discussion would allow a point to be conceded. I walked away. There is no changing the mind of the zealot. The ironic part is that this guy has such an anger problem that he was once suspended at work and not allowed to return until he completed an anger management course.

Not all of the people who are currently calling for gun restrictions are beyond reason. I asked one woman who was demanding gun laws:

Suppose it was shown that the reporting of violent crime has a causal effect on copycat murders. Would you support a law that would make it illegal for the press to report violent crime? If not, why not?

She conceded that it is a bad idea to restrict rights, but then said that 

Of course not. But I see your point and I'm not saying that taking away your 2nd amendment right is the solution. You have a right to bear arms as do I. I just don't believe that adding additional guns to an already violent and self-absorbed society is the solution. I don't know if anything can be done at this point to change things. The lack of self-control, misguided anger, obsession with violence whether in music or film is destroying this country.

 I asked how a gun law would change a nationwide obsession with violence. She did not reply.

For that reason, I have decided to only speak to people who are willing to have an actual discussion, and not simply an argument where they scream about how inanimate objects are evil, how I am a wannabe killer, or any other such nonsense. I will simply accept that those people wish to deprive me of my rights, and remove them from my life. I will no longer be friends with anyone that wants to restrict my rights based upon the actions of another person.

Mass murder

The worst mass murders in United States history:

The World Trade Center Attacks: 2,996 killed by men wielding box cutters in 2001
Oklahoma City bombing: 168 killed, over 650 injured by a man with a bomb made from fertilizer in 1995
The Happy Land Fire: 87 people killed by a man using a gasoline can
The Bath School bombing: 45 killed (38 of them children) and 58 injured by a man with a bomb in 1927

Killers using guns didn't even make the top four...

YOUR rights aren't important

Although not a hard core anti-gunner, I have a friend who is a hard core Democrat. This is what she had to tell me on Facebook about new gun laws in the wake of the Connecticut shooting:

you know they have to do something, public outcry and all. and restricting guns is the easiest thing to address. i'm sure you'll get to keep most if not all of your arsenal. and soon there will be another shooting/bombing/mass casualty event and they'll realize (hopefully) they were going at it the wrong way. i'm not sure what the answer is. things like this are just always going to happen. you can't control all the factors in events like that.

This is the mental disconnect: They are aware that gun laws will not work, but will vote to remove your rights any way. Since gun ownership isn't important to them, they will gladly throw your rights under the bus.

Blood dancing

Shieffer at CBS news says that this shooting may be what gets an assault weapons ban passed.

A hostette at MSNBC, Alex Wagner, said, "Hopefully, this shooting will result in political capital to reform gun laws. It is hopefully -- and we say this every single time we cover one of these things. There's gotta be some kind of measurable change, some kind of reaction. One would hope there would be some political capital to reform the way in which we handle gun and gun violence in this country."

The Obama White House lost no time in releasing a statement calling for an assault weapons ban.

Dancing in the blood of the victims.

1984 is here, and we paid for it

So a post over at Tam's place got me thinking. Specifically, the link to the cameras and microphones on buses, and the link that Tam placed in the comments about what the Feds can get without a warrant. There is even scarier technology than that. For example, there is this software that allows a person to listen in on calls, and even activate "environmental listening" where the phone is used as a "bug" that allows a person to remotely activate your cell phone's microphone in order to listen in on whatever is happening in the room- all without the knowledge of the cell phone's owner.

You would be foolish indeed if you believed that the police have not been exploiting this capability. The government doesn't need to bug your house, you are doing it for them.

Money, it's a gas

A speed camera issues a ticket to a stationary car. The real story here isn't that one car was erroneously ticketed. No, the real story is the fact that Baltimore's 164 cameras have issued $48 million in tickets over the last three years. If the amount of the ticket, $40, is typical, this means that 400,000 tickets a year are issued by those 164 cameras: roughly 2400 tickets for each camera.

The officers that review the pictures before they are issued review and issue 1200 tickets per day. On an 8 hour workday, that leaves just 24 seconds for each picture to be reviewed and a citation issued. In other words, this is nothing but a revenue generator with few safeguards or oversight.

Volunteerism is not the answer

There are a couple of reasons why volunteer fire departments don't work in many cases. In rural communities, they are an excellent resource, but after a response area reaches a certain size, they generally (with a few exceptions) don't work.
1. Insurance companies: The real mission of the fire department is not to put out fires. It is to save the members of a community money through reducing insurance costs. Fire departments are rated by the insurance services organization on a scale of 10 (no fire department) to 1 (very few departments achieve this). Rankings range from 1 to 10, with 1 being the best and 10 being the worst. An ISO Class 3 rating is a very good rating especially for a department that has both paid and volunteer staff. Class 1 is very difficult to achieve as it means total fire protection. Departments that are outside city limits tend to receive Class 8 or 9 because of extended response times and lack of water supply, and this is true whether or not the department is paid or volunteer.

This is where volunteers shine. In rural areas, the cost/benefit of maintaining a paid department is out shone by volunteers.

2 Liability: In general, it is difficult to discipline volunteers. After all, it isn't as if you can suspend them without pay or terminate them. In addition, many younger volunteers tend to drive way, way too fast when responding to calls, and they tend to freelance more. This causes liability issues, especially in urban areas where there are more chances of hitting someone.

3 Activity levels: The training and response levels demanded of firefighters increases every year. In urban and busy suburban departments, a fire station may easily run 3,000 or more calls per year. It is difficult to find volunteers who will dedicate themselves like this. I know there are departments who have volunteers at this level, but they are the exception, and not the rule.

There are other reasons, but these are the big ones. I say this after spending 8 years as a volunteer and having to face all of the above issues. Volunteerism used to be fairly strong in central Florida, but it has all but disappeared within the last 5 years. That is also the case in many other areas of the country.

Medicare fraud

There are many paramedics out there who work for private ambulance companies and claim that paramedics in the public sector (like firemedics) are incompetent and lazy. While I admit that this is true in many cases, I also have to say that the state of the for profit medical world today is committing fraud for profit.

When I worked for the fire department, there were many paramedics that did everything that they could to get out of doing work: this often meant that patients were shortchanged and care suffered in the name of laziness. I fought the battle against lazy medics for years.

The flip side of that is what happens in for profit systems: systematic Medicare and insurance fraud.You see, insurance and Medicare will not pay for a patient to travel anywhere by ambulance, unless there is no cheaper way for the patient to safely get to his destination. Here is how and why it becomes a systematic fraud on the taxpayer:

When a person is in a nursing home, the nursing home gets paid a fee for the housing and basic care of the person. This includes food, medicine, and transportation to medical appointments. For a patient who is on dialysis, this means three trips a week to and from the dialysis center. The only way that a nursing home can get out of paying for the transportation is if an ambulance is required because of the person's inability to take another means of transportation. This creates a situation where the ambulance company lies to get the business, and the nursing home lies to get out of paying for the person's transportation.

It is so bad, that some nursing homes tell the physical therapists that they should stop rehabilitating a person's ability to walk once they can walk 30 feet. Anything more than that, and the person is considered no longer eligible to ride in an ambulance. The ambulance company then instructs the transport crews to avoid using the word "ambulatory" in reports, and even threatens termination for any crew that allows a patient to walk to the truck and/or stretcher.

I have been on calls before where we are supposed to take a person from home to dialysis, and the person pulls up next to us in traffic while driving their own car, and told us she will be home in 5 minutes so we can take her to her appointment. Does that sound like an ambulance is the only way for her to go?

Private ambulances doing transfers, 911 calls, nursing homes, hospitals. The health system of this nation is broken, and riddled with fraud. Making everyone have insurance is not going to make it any better.