u/Slut_for_Bacon

I want to get into that game more but I just need something more realistic like DEI.

I am an EMT-B who does additional EMS for Wildnerness and sporting events as a side job.

I had a patient (60s M) yesterday during a long distance biking event who apparently had an aortic aneurysm.

20 miles into the 80 mile ride of the day (day 5 of the 7 day event), patient described a sudden headache and the feeling of a sudden increase in blood pressure, followed by dizziness.

Patient stated the headache and feeling of higher blood pressure dissipated quickly, but the dizziness remained.

Patient flagged down a staff member who gets the patient and his bike into the van, and starts driving towards me. Staff member calls me to let me know, and asks to give him aspirin. I say no.

At this point, patient begins experiencing numbness and weakness in his left leg, along with the continued dizziness.

Patient arives at my location within maybe 5 minutes.

I start doing my thing. His vitals are fairly stable with the only standouts being a slightly high BP with a systolic in the 150s (patient has a hx of hypertension and took his meds at his normal daily time), and a slightly low O2 satting at 93.

He is alert and oriented the entire time. He has the above-mentioned Hx of hypertension, and also had a stent placed a year earlier.

Mild dizziness, and increasing leg numbness and weakness remain the only symptoms. Absolutely no pain, either in the leg, or anywhere else.

Second set of vitals show a drop in O2, now at 85. I give him 4lpm and he goes back up.

Patient shows no signs of a stroke, and has a pedal pulse in the affected leg.

At this point, ALS arrives on scene and he gets transported to a local hospital.

I was kind of guessing maybe DVT or something.

I find out later he was air transferred to a much larger facility a few hours away. Initially I was told for a clot in the leg.

Next day I am told he ended up getting open heart surgery for an aortic aneurysm overnight, and is now awake and speaking.

I understand at the EMT-B level there isnt much I can do for something like that besides get him to a higher level of care.

My questions are;

1. Should I have suspected an aortic aneurysm based on the symptoms? It was nowhere near the top of my list. Patient had no pain whatsoever. This is not what I would expect an aortic aneurysm to look like. I have seen several with very different, more classic symptoms.

2. I am glad I told the driver not to give him aspirin, but if the driver had done it without asking, is there a high likelihood his bleeding would have increased to an unsustainable level before he reached a hospital?

3. I was initially told he had a clot in the leg and that was why he was being airlifted to a larger facility. Is it possible somehow the aneurysm/dissection was secondary to a clot in the leg? Could a clot contribute to an aneurysm?

Or is it more likely I was misinformed and there was no clot at all and that was just a misunderstanding by the event staff who told me?

This is a generao frustration with TW.

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I am hoping with M3TW it will get fixed.

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I dont understand why TW hasnt made it a thing to where you can attack raiding armies without declaring all out war.

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To me, attacking raiders should be a diplomatic penalty, not war.

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A faction should not be able to send an army onto your territory to steal and kill and not have it start a war, but have you start a war if you stop the raiders.

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Its fucking stupid and ridiculous.

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You should also be able to ask a faction to stop raiding your territory in the diplomacy screen.

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Not only would this make gameplay more dynamic, its more fucking realistic.

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Raids did happen historically, but killing raiders did not inherently start wars.

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It would be an easy QOL change that could add depth and dimension to the game.

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I am shocked it hasnt been implemented yet.

My partner recently had a big miscommunication regarding some inheritance issues with her aunt.

Both of them overreacted and caused the miscommunication to spiral into something way bigger than it needs to be.

I can see both of their positions. I understand why they are frustrated, but instead of just hashing out the miscommunication itself, both of them are doubling down on being mad and defensive. Instead of talking in person, they just keep messaging back and forth, and frankly, both of them are getting riled up and not sending the most thought out messages.

My partner has very little close family. This was a formative thing for her growing up. I understand that she is hurt, but I am watching her reactions to this miscommunication and can see she is digging herself into a bigger hole, and the chance of the relationship being fixed are quickly disappearing.

I dont want her to lose the little family she has left. Especially over a stupid miscommunication about money.

I want to be clear, I think my partner and her aunt both have legit reasons to be upset. But I think my partner is making a mistake in the way she is handling the situation. The messages she is sending to her aunt are inflammatory and only going to cause more issues. I dont think that is her intention, but it comes off that way.

I am not sure what my role is here. I could try to mediate, or stay out of it, or blindly support my partner.

I have not shared my personal opinions with her because she hasnt asked and because its her family business. But I honestly think if I could get her to slow down, back up, and look at the whole situation from an outside perspective, both her and her aunt would benefit.

I am a big walker and hiker.

I recently tried using Samsung Health from my phone to track steps and distance and was very surprised to see how massively innacurate it was. It was telling me I hiked 12 miles when I only hiked about 8. Similar misinfo with steps.

I understand these apps aren't 100% accurate, but is there one a little better than Samsung Health?

Personally it looked like a sea lion to me but it was hard to tell cause it kept diving.