My dad could still be alive, but he's not • Hacker News Board

Re: My dad could still be alive, but he's not

#181

Post by xyzzy_plugh » Thu, Nov 13, 2025, 4:58 AM UTC

vondur wrote: post #7

This is horrible. What is going on in Toronto that ambulances take 30 minutes to respond?

Healthcare funding is managed provincially and the Ontario government has been poorly managing the system, pretty consistently, for over a decade. Some would argue decades, but things do seem to be steadily declining post Covid, as they were pre-Covid. Over the last few years, several ERs have been experiencing intermittent closures, and at least one was closed permanently, due to staff shortage.

What's worse is that the closures are poorly communicated. I know of at least two people who, within the last couple of years, went to an ER only to find it closed.

With respect to Toronto, and more specifically ambulance services, they are jointly funded by the province and the city, but I understand that provincial funding is more significant.

All parties recognize things are not functioning well, and various attempts at increasing spending have been made, but any effort will take significant time before results are visible. I'm not particularly optimistic, and the current provincial government's track record here is dismal. Their policy is to be tight-fisted.

Re: My dad could still be alive, but he's not

#182

Post by captainkrtek » Thu, Nov 13, 2025, 5:01 AM UTC

laszlojamf wrote: post #161

captainkrtek wrote: post #122

Earlier quoted context omitted.

Depends on protocols, but hence why EMS’ job is recognition of the right issue (the best we can do), there are things we can evaluate to determine if we think its an aortic aneurysm even at the emt level to rule that out before making the determination to give aspirin (eg: comparing bilateral blood pressures, checking for pulsating masses) a heart attack is far more common than an aortic aneurysm.

would comparing bilateral blood pressure (which I assume the patient could do themselves) be enough? I'm not asking for medical advice, just like... what would _you_ do if it was you who had sudden chest pain?

Id encourage you (generally, outside of hn) to lookup the symptoms of a heart attack and aortic aneurysm.

A aortic aneurysm can present with a pulsating mass in the abdomen, and is more common in older people and smokers. The inner lumen of the aorta starts to separate and blood can flow differently or be restricted, eg: right arm bp may be different than left arm. But absence of that doesn’t rule it out entirely.

Whereas a heart attack is going to feel pain in the chest, perhaps radiating to the jaw, shoulder, back, maybe nausea, sweating, and an impending sense of doom.

Automated bp cuffs are pretty inaccurate imo, we use them at the tail end of transport to the hospital and they usually spit out wild numbers. An auscultated bp with a stethoscope and sphygmomanometer is the gold standard.

Bottom line, If you are having chest pain, call 911.

Re: My dad could still be alive, but he's not

#183

Post by scorpioxy » Thu, Nov 13, 2025, 5:04 AM UTC

tecoholic wrote: post #146

scorpioxy wrote: post #114

Earlier quoted context omitted.

Oh yes. Quite bad and I don't know if things are getting slightly better than "bad" or the media is tired of reporting about it. Up until a year or so ago, an appointment at a GP would take weeks of waiting. Specialist appointments were 1+ years waiting time. This is somewhat better now with the establishment of critical-care clinics operating after hours. This is from personal experience. The emergency rooms often h…

Wow. I didn’t know that things are this way. I am a recent immigrant living close to the city and always seem to be able to see a GP on the same day. Is that because I have private insurance and I pay out of pocket anyways? If I were a citizen, I wouldn’t be able to go to those places (at least for “free healthcare”), and will have the same wait times? Or is it geography dependent with rural Victoria having issues an…

It depends on the location and it depends on what services you're after. If you have private healthcare insurance, you get to skip the wait times at hospitals and get a choice of public or private hospitals. For clinics, it's a different story and can get quite detailed. The private insurance can help you with the payment there but not wait times.

For some regional and rural locations, the wait times can be better or can be worse than metro depending on the service.

By the way, I also pay out of pocket on top of the medicare rebate so my experience is not with bulk billing clinics. When you get access to medicare, you'd probably still need to pay out of pocket on top of the rebate as bulk billing clinics have all but disappeared. Recent government incentives aim to bring them back but with cost of living increases I doubt that'll work.

Re: My dad could still be alive, but he's not

#184

Post by verelo » Thu, Nov 13, 2025, 5:05 AM UTC

rich_sasha wrote: post #132

pugio wrote: post #48

I can speak to this. I recently joined a community first responder association (I've always wanted to know what to do in case of a medical emergency) and was shocked to hear the members' horror stories of how long it can take an ambulance to arrive. Like the author, I grew up with the narrative "in trouble, call the ambulance, they'll scream through the streets to get to you in moments". That might still be true wher…

My cousin's 3yo daughter stopped breathing one night, woke up struggling for breath, turning blue. They called the ambulance. Dispatcher said, 3 hr wait, and pretty please get off the phone, as there's a queue of callers. She started breathing again after a few minutes and seems fine, but they left the UK not long after that.

That’s wild. I fell off my garage roof almost 2 weeks back. My wife called the ambulance, they arrived within 20 minutes. We are in rural Ontario, 30 minutes from the nearest hospital, on a dirt road that is privately owned and maintained. I expected over an hour.

I plan to make a trip in to the ambulance hall and fire hall this week and say thanks. I am ok, fractured vertebrae, but honestly i just am so grateful for the public service they provide.

Re: My dad could still be alive, but he's not

#185

Post by evanelias » Thu, Nov 13, 2025, 5:06 AM UTC

pugio wrote: post #48

I can speak to this. I recently joined a community first responder association (I've always wanted to know what to do in case of a medical emergency) and was shocked to hear the members' horror stories of how long it can take an ambulance to arrive. Like the author, I grew up with the narrative "in trouble, call the ambulance, they'll scream through the streets to get to you in moments". That might still be true wher…

Even in the US, response times can really vary. As an extreme example, in Jersey City (population ~300k) there were a bunch of incidents a couple years ago where residents called 911 in an emergency and no one answered.

Re: My dad could still be alive, but he's not

#186

Post by svnt » Thu, Nov 13, 2025, 5:07 AM UTC

bonsai_spool wrote: post #143

heylook wrote: post #120

Earlier quoted context omitted.

This is the laziest, most egregious "WeLl AkShUaLlY!!!" comment I've seen in a little while. Like, really embarrassing. > According to the regulator for Ontario doctors, Jamal initially tried to place all the blame on her innocent research associate, almost ruining her career. She then tried to discredit her colleagues, claiming they had ulterior motives for questioning her results. > When that didn’t work, they foun…

> This is the laziest, most egregious "WeLl AkShUaLlY!!!" comment I've seen in a little while. Like, really embarrassing. And yet I haven't heard how this affects this person's ability to be an endocrinologist. Most of any job is routine busywork—and if ethical purity is the requirement to hold a job that impacts the lives of the public, we may never have a politician (or hospital chief) for the rest of humanity. I a…

People holding your current naive viewpoint is why we have professional societies with the power to remove licenses/disbar.

Someone who takes the hippocratic oath and then behaves in this manner is not fit to be a caregiver. Medical care is about more than technical competence.

I’d hate to see the state of the flattened world you seem to be arguing for. Please go read about the origins of professional standards.

Re: My dad could still be alive, but he's not

#187

Post by softgrow » Thu, Nov 13, 2025, 5:08 AM UTC

tharkun__ wrote: post #136

softgrow wrote: post #84

Earlier quoted context omitted.

Sounds like Hatzolah Melbourne, https://hatzolah.org.au since 1994 Since 1998, in Melbourne for anything that might need a defibrillator a fire engine is sent at the same time as the ambulance (EMR Emergency Medical Response Program). https://www.mja.com.au/journal/2002/177/6/cardiac-arrests-tr... Medical Journal of Australia article. There is also GoodSAM https://www.ambulance.vic.gov.au/goodsam/ for individual help…

What about helicopters? Does Melbourne not have/use theirs in those cases or is the system just overwhelmed? Asking because (different country) when we had a person present with stroke symptoms and called 911, they sent both an ambulance and the helicopter. The heli came first but it had to land a ways off on a field and they had to walk over and basically arrived around the same time as the ambulance. A couple minut…

I don't think my taxes/insurance costs/donations to charity are high enough. London (donation funded) has a helicopter service that attends 6 serious trauma cases a day. Denmark, Germany and others has a Helicopter Emergency Medical Service which delivers a senior doctor and paramedic. It probably doesn't scale well.

Basic issues like overhead powerlines make life difficult for helicopters. They are used in rural Australia as an alternative to road, but only due to time saving. In a city, well you get a road ambulance/paramedic/medical team.

The (Melbourne) Victorian Ambulance Cardiac Arrest Registry claims third best in the world in out of hospital cardiac arrest.

Re: My dad could still be alive, but he's not

#188

Post by canucker2016 » Thu, Nov 13, 2025, 5:09 AM UTC

starkparker wrote: post #12

vondur wrote: post #7

This is horrible. What is going on in Toronto that ambulances take 30 minutes to respond?

https://www.cbc.ca/news/canada/toronto/toronto-paramedic-sta... > Last year, Toronto paramedics reported that in 2023 there were 1,200 occasions where no ambulances were available to respond to an emergency call. That was up from only 29 occasions in 2019. > CUPE Local 416, the union representing 1,400 paramedics working in Toronto, has also reported high instances of burnout in recent years.

There were several reports during the pandemic about lack of ambulance service in Toronto:

- 2022 - https://www.blogto.com/city/2022/01/toronto-ran-out-ambulanc...

- 2023 - https://www.blogto.com/city/2023/10/paramedics-raise-alarm-c...

from the 2025 Program Summary for Toronto Paramedic Services, https://www.toronto.ca/wp-content/uploads/2025/04/8d5d-2025-...:

- Page 3

- Avg 90th Percentile response times have gone from 12 minutes in 2019 & 2020 to 14.5 mins in 2024 and almost 15 minutes as a 2025 target: (12.1, 12.1, 13.0, 14.2, 14.0, 14.5, 14.8)

- staffing is up more than 50% in that time, while number of patient transports is up just 10% during that same timeframe

- Page 4

- scary graphic - graph concerning Daily Hours with - 2019-2020 - Daily Average - 0 hours, 43 minutes

- 2021 - Daily Average - 2 hours, 29 minutes

- 2022 - Daily Average - 5 hours, 57 minutes

- 2023 - Daily Average - 4 hours, 33 minutes

- 2024 - Daily Average - 4 hours, 9 minutes

Re: My dad could still be alive, but he's not

#189

Post by grogenaut » Thu, Nov 13, 2025, 5:10 AM UTC

manyturtles wrote: post #95

markus_zhang wrote: post #73

I’m so sad to see this. For anyone who reads this, get a day, learn CPR, and buy that machine if your parents or whoever has history of heart issues. The machine doesn’t fix every kind of heart diseases but the trainer told me it decreases the possibility of death from a heart attack greatly. I recall that the possibility is lowered by 50% if you do CPR and 80% with the machine. It is not hard to use the machine as i…

Alas the data doesn't agree: "Bystander-initiated CPR may increase [survival] odds to 10%" From: https://www.npr.org/sections/health-shots/2023/05/29/1177914... Referenced underlying study: https://pubmed.ncbi.nlm.nih.gov/20123673/ Absolutely worth training for and administering, but far from 100% success.

yet it can help. no direct counter stats to your stats but different data: https://www.mediconefoundation.org/whyandhowtohelp/ https://newsroom.uw.edu/news-releases/study-spotlights-cardi...

getting compressions going and getting an AED onboard is the focus of this program. that means getting people and responders trained on CPR + AED.

Re: My dad could still be alive, but he's not

#190

Post by svnt » Thu, Nov 13, 2025, 5:11 AM UTC

bonsai_spool wrote: post #171

switchbak wrote: post #165

Earlier quoted context omitted.

"all of this is a non sequitur" ... I'm just speechless here. You're so completely off base there's not even any point arguing with you.

> "all of this is a non sequitur" ... I'm just speechless here. You're so completely off base there's not even any point arguing with you. I am very specifically responding to the post I saw when I made my post. Here is an example for the HN crowd. "I really dislike my pointy-haired-boss project manager. He is unreasonable and terrible at management. I learned that he was investigated at a previous job in computer sc…

I also replied above, so at risk of overextending myself in this thread: you are either too lacking in discernment to effectively have this conversation, or you are willfully arguing in bad faith. You are describing completely different scenarios.