Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 29 Mar 1999 23:49:27 -0500 (EST) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 29 Mar 1999 23:48:51 -0500 (EST) Received: via switchmail; Mon, 29 Mar 1999 23:48:50 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 29 Mar 1999 23:47:59 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 29 Mar 1999 23:47:35 -0500 (EST) Received: from mb3.mailbank.com (mb3.mailbank.com [209.133.104.8]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 29 Mar 1999 23:47:28 -0500 (EST) Received: from localhost (user-2iveshf.dialup.mindspring.com [165.247.114.47]) by mb3.mailbank.com (8.9.1a/8.9.1) with SMTP id UAA18799 for ; Mon, 29 Mar 1999 20:47:23 -0800 Date: Mon, 29 Mar 1999 20:47:23 -0800 Message-Id: <199903300447.UAA18799@mb3.mailbank.com> X-Authentication-Warning: mb3.mailbank.com: Host user-2iveshf.dialup.mindspring.com [165.247.114.47] claimed to be localhost From: Wayne Roberts To: Subject: Re: W-EMED medical certification X-Mailer: HandMail 2.0 Mime-Version: 1.0 Content-Type: text/plain; Charset="iso-8859-1" Content-Transfer-Encoding: 8bit X-MIME-Autoconverted: from quoted-printable to 8bit by list.srv.cis.pitt.edu id XAA23934 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P69250.CNM Piedmont Search & Rescue in VA (part of the Appalachian Search & Rescue Conference in VA, MD, WV, and PA) requires CPR and Basic First Aid, or equivalent, in order to become an Active Member (in addition to 32 hours of SAR training including Call Out Qualified). Wayne Roberts, EMT-CT Richmond, VA PSAR >I am curious what other rescue groups require for medical certification >in their teams, and at what rank (rescue, support, etc) they require >certification? > >Thanks; > >Steve Kelleher >EMS Director >Alpine Rescue Team >Evergreen, CO. >slpknot@ibm.net Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 29 Mar 1999 21:42:57 -0500 (EST) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 29 Mar 1999 21:42:14 -0500 (EST) Received: via switchmail; Mon, 29 Mar 1999 21:42:14 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 29 Mar 1999 21:40:28 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 29 Mar 1999 21:39:16 -0500 (EST) Received: from out2.ibm.net (out2.ibm.net [165.87.194.229]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 29 Mar 1999 21:39:11 -0500 (EST) Received: from ibm.net (root@slip-32-101-226-91.co.us.ibm.net [32.101.226.91]) by out2.ibm.net (8.8.5/8.6.9) with ESMTP id CAA13432 for ; Tue, 30 Mar 1999 02:39:08 GMT Message-ID: <37003920.19EC3586@ibm.net> Date: Mon, 29 Mar 1999 19:38:24 -0700 From: Steve Kelleher X-Mailer: Mozilla 4.07 [en] (X11; I; Linux 2.0.36 i586) MIME-Version: 1.0 To: WEMSI Subject: W-EMED medical certification Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P6D440.CNM I am curious what other rescue groups require for medical certification in their teams, and at what rank (rescue, support, etc) they require certification? Thanks; Steve Kelleher EMS Director Alpine Rescue Team Evergreen, CO. slpknot@ibm.net Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 24 Mar 1999 16:31:51 -0500 (EST) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 24 Mar 1999 16:30:59 -0500 (EST) Received: via switchmail; Wed, 24 Mar 1999 16:30:56 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 24 Mar 1999 16:29:35 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 24 Mar 1999 16:27:06 -0500 (EST) Received: from m4.boston.juno.com (m4.boston.juno.com [205.231.101.198]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 24 Mar 1999 16:27:00 -0500 (EST) Received: (from pcrs242@juno.com) by m4.boston.juno.com (queuemail) id D6HN4Y8E; Wed, 24 Mar 1999 16:25:25 EST To: wilderness-emergency-medicine@list.pitt.edu Date: Wed, 24 Mar 1999 16:18:07 -0500 Subject: W-EMED ASRC Message-ID: <19990324.161808.12598.0.pcrs242@juno.com> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 0,2,4,6-9 From: Deborah M Gessner Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 33554560 0 1 P73F00.CNM Suzen Thank You for the invite yes I would like to go, but depends on how much and where and where do we meet,etc. I tried to send several messages to you personal email but it keeps coming back as error in you address and it didn't know why. I received yours fine, let me know something is there a registration? Deborah Long Way Home SAR 1 Dublin,Va. ___________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com/getjuno.html or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 23 Mar 1999 15:32:31 -0500 (EST) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 23 Mar 1999 14:22:39 -0500 (EST) Received: via switchmail; Tue, 23 Mar 1999 14:22:36 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 23 Mar 1999 14:21:34 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 23 Mar 1999 14:21:19 -0500 (EST) Received: from mail1.uct.ac.za (exim@mail1.uct.ac.za [137.158.128.73]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 23 Mar 1999 14:21:02 -0500 (EST) Received: from mort by mail1.uct.ac.za with local (Exim 2.01 #3) for wilderness-emergency-medicine@list.pitt.edu id 10PWjP-0004U6-00; Tue, 23 Mar 1999 21:20:55 +0200 Received: by mail1.uct.ac.za (Mort 2.23alpha) id 539 from ALEWIS@ITS; Tue Mar 23 21:20:55 1999 From: "Andrew Lewis" To: wilderness-emergency-medicine@list.pitt.edu Date: Tue, 23 Mar 1999 21:20:39 SAST-2 Subject: Re: W-EMED Lasik X-mailer: Pegasus Mail v3.40 Message-Id: Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 33554560 0 1 P58A70.CNM Hi Jay I presume by LASIK that you mean the corneal slice plus low intensity laser and then the corneal flap being replaced. This is very different (and safer) than RK, which is a bit barbaric. In RK the cornea is sliced and therefor colapses slightly changing the refractive index. In LASIK a permanent lens is 'built' into the eye. I believe RK can cause the cornea to collapse in low pressure resulting in blndness. I have just had LASIK surgery done to both eyes less than a month ago. I had both eyes done at once and basically walked out of the operating theatre and could see perfectly 48hrs later. Since then I have happily gone diving, rock climbing, surfing etc... Side effects (for me) include reduced tolerance to glare and wind (I ride a motorbike) as well as a (slightly) reduced ability to focus on fine visual detail. I may also still need glasses for night driving. It's also taken me about 3 weeks to improve my 'focusing time'. On the whole I am more than happy with the results. I feel much more happy about responding to incidents where I am expecting bad weather. Nothing like having to clean your glasses with a muddy rag while grovelling up some exposed ridge in a storm :-) Also with glasses there's always that last minute panic at night deciding where to hide the specs so my buddies won't walk on them. As for contacts on overnight trips the less said the better. While I haven't been on a helicopter mission since my op I have got hold of a pair of wide 'cycling' sunglasses to protect my eyes from the wind blast. If you want more info on the op please email me directly. regards Andrew Lewis > From: Jaymullen@aol.com > Date sent: Tue, 23 Mar 1999 11:18:33 EST > To: wilderness-emergency-medicine@list.pitt.edu > Subject: W-EMED Lasik > Send reply to: wilderness-emergency-medicine@list.pitt.edu > Anyone have any information regarding Lasik in the wildernessj/ mountaineering > setting? > > I'm considering the surgery, but am a bit worried givent he experience of Beck > Weathers with RK on Everest. > -- ______________________________________ System Software Information Technology Services University of Cape Town ph (+27 21) 650-3032 fax (+27 21) 650-3726 ______________________________________ Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 24 Mar 1999 00:38:57 -0500 (EST) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 24 Mar 1999 00:38:18 -0500 (EST) Received: via switchmail; Wed, 24 Mar 1999 00:38:17 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 24 Mar 1999 00:34:16 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 24 Mar 1999 00:33:30 -0500 (EST) Received: from mx0-smtp.goodnet.com (envy.goodnet.com [207.98.129.151]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 24 Mar 1999 00:33:23 -0500 (EST) Received: from PC_.goodnet.com (d10-17.phoenix.goodnet.com [209.141.106.82]) by mx0-smtp.goodnet.com (8.9.3/8.9.3) with SMTP id WAA29795 for ; Tue, 23 Mar 1999 22:33:20 -0700 (MST) Message-ID: In-Reply-To: References: Conversation with last message X-MSMail-Priority: Normal X-Priority: 3 To: "WEMS News" MIME-Version: 1.0 From: "Tim Kovacs" Subject: W-EMED Andrew Lewis, re LASIK and High Altitude Date: Tue, 23 Mar 99 21:03:10 PST Content-Type: text/plain; charset="ISO-8859-1"; X-MAPIextension=".TXT" Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P21860.CNM Andy, please give me your email address for a personal inquiry. Thanks, Tim Kovacs, President Mountain Rescue Association tkovacs@goodnet.com www.mra.org "You can't teach people to rescue in the mountains until they have learnt to climb... ...It is a number of small points which have little significance individually that, considered together, spell danger to the experienced rescuer." Hamish MacInnes Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 23 Mar 1999 14:17:17 -0500 (EST) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 23 Mar 1999 14:16:34 -0500 (EST) Received: via switchmail; Tue, 23 Mar 1999 14:16:34 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 23 Mar 1999 14:14:53 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 23 Mar 1999 14:14:11 -0500 (EST) Received: from selectrec.net (mail.selectrec.net [209.184.56.3]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 23 Mar 1999 14:14:05 -0500 (EST) Received: from default (209.184.56.22) by selectrec.net with SMTP (Eudora Internet Mail Server 2.1); Tue, 23 Mar 1999 13:15:05 -0500 From: "selectrec" To: Subject: Re: W-EMED Lasik Date: Tue, 23 Mar 1999 13:13:41 -0600 Message-ID: <01be7561$433cfb20$1638b8d1@default> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 4.71.1712.3 X-MimeOLE: Produced By Microsoft MimeOLE V4.71.1712.3 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P34F40.CNM Hi Jay.. I had both eyes done in '82 - still at 20/20 Granted, I haven't done Everest - I go the other direction. I have done several caving exepditions - with no problems. I had it done the ol' fashioned way - with a ruby scalpel. The laser wasn't even an option. I work with the Austin Fire Dept - in heat and smoke and do a lot with the National Cave Rescue Commission - again, quite satisfied John Green South Central Regional Coordinator - NCRC USAR Tx TF1 Technical Rescue Instructor Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 23 Mar 1999 11:21:45 -0500 (EST) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 23 Mar 1999 11:21:05 -0500 (EST) Received: via switchmail; Tue, 23 Mar 1999 11:21:04 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 23 Mar 1999 11:20:53 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 23 Mar 1999 11:19:21 -0500 (EST) Received: from imo23.mx.aol.com (imo23.mx.aol.com [198.81.17.67]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 23 Mar 1999 11:19:17 -0500 (EST) From: Jaymullen@aol.com Received: from Jaymullen@aol.com by imo23.mx.aol.com (IMOv19.3) id hKVCa13434 for ; Tue, 23 Mar 1999 11:18:33 -0500 (EST) Message-ID: Date: Tue, 23 Mar 1999 11:18:33 EST To: wilderness-emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: W-EMED Lasik Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 216 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P2C030.CNM Anyone have any information regarding Lasik in the wildernessj/ mountaineering setting? I'm considering the surgery, but am a bit worried givent he experience of Beck Weathers with RK on Everest. Jay Mullen Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: From: Self To: "Howard M. Paul" Subject: Re: [NH] Fwd: W-EMED [PSA/PIO] Unusual Emergency Request Cc: wilderness-emergency-medicine@list.pitt.edu Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Mon, 22 Mar 1999 23:28:12 -0500 Howard and responders -- as much as I appreciate the personal agony of situations such as brain cancer, it is quite off topic for this list. On behalf of hundreds of subscribers, please stay to topics relevant to wilderness emergency medicine. I would like to remind all that the policy has always been that those who repeatedly post on off-topic issues will be removed from list. Thank you, and my best wishes for Nena's father. -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 22 Mar 1999 23:33:14 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 22 Mar 1999 23:32:36 -0500 (EST) Received: via switchmail; Mon, 22 Mar 1999 23:32:36 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 22 Mar 1999 23:30:37 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 22 Mar 1999 23:28:41 -0500 (EST) Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 22 Mar 1999 23:28:28 -0500 (EST) Received: from 136.142.57.10.pitt.edu (ehdup-u-38.rmt.net.pitt.edu [136.142.23.148]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 22 Mar 1999 23:28:19 -0500 (EST) Message-Id: <199903230428.XAA27197@post-ofc05.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: "Howard M. Paul" Date: Mon, 22 Mar 1999 23:28:19 -0500 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: [NH] Fwd: W-EMED [PSA/PIO] Unusual Emergency Request CC: wilderness-emergency-medicine@list.pitt.edu References: <1fdaeab3.36f6f50c@aol.com> In-reply-to: <3.0.5.32.19990322224036.0086b4a0@mail.highland.net> X-mailer: Pegasus Mail for Win32 (v3.01d) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P2B220.CNM Howard and responders -- as much as I appreciate the personal agony of situations such as brain cancer, it is quite off topic for this list. On behalf of hundreds of subscribers, please stay to topics relevant to wilderness emergency medicine. I would like to remind all that the policy has always been that those who repeatedly post on off-topic issues will be removed from list. Thank you, and my best wishes for Nena's father. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: From: Self To: Shirley Carroll ,"Howard M. Paul" Subject: Re: [NH] Fwd: W-EMED [PSA/PIO] Unusual Emergency Request Cc: wilderness-emergency-medicine@list.pitt.edu Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Mon, 22 Mar 1999 23:26:13 -0500 Shirley and Howard -- as much as I appreciate the personal agony of situations such as brain cancer, it is quite off topic for this list. On behalf of hundreds of subscribers, please stay to topics relevant to wilderness emergency medicine. I will also take this opportunity to remind all the those who repeatedly post on off-topic issues will be removed from list by the listowners. Thank you, and my best wishes for Nena's father. -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 22 Mar 1999 22:43:05 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 22 Mar 1999 22:42:28 -0500 (EST) Received: via switchmail; Mon, 22 Mar 1999 22:42:27 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 22 Mar 1999 22:41:50 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 22 Mar 1999 22:40:02 -0500 (EST) Received: from smtp02.infoave.net (smtp02.infoave.net [165.166.0.27]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 22 Mar 1999 22:39:57 -0500 (EST) Received: from oemcomputer ("port 1817"@[204.116.59.91]) by SMTP00.InfoAve.Net (PMDF V5.1-12 #23426) with SMTP id <01J95BB2VTK68Y52CP@SMTP00.InfoAve.Net> for wilderness-emergency-medicine@list.pitt.edu; Mon, 22 Mar 1999 22:39:35 EST Date: Mon, 22 Mar 1999 22:40:36 -0500 From: Shirley Carroll Subject: Re: [NH] Fwd: W-EMED [PSA/PIO] Unusual Emergency Request In-reply-to: <1fdaeab3.36f6f50c@aol.com> X-Sender: thehavens@mail.highland.net To: wilderness-emergency-medicine@list.pitt.edu Message-id: <3.0.5.32.19990322224036.0086b4a0@mail.highland.net> MIME-version: 1.0 X-Mailer: QUALCOMM Windows Eudora Light Version 3.0.5 (32) Content-type: text/plain; charset="us-ascii" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 35127424 0 1 P49B50.CNM At 08:57 PM 3/22/99 -0500, you wrote: >Date: Mon, 22 Mar 1999 11:30:37 -0700 >To: wilderness-emergency-medicine@list.pitt.edu >From: Nena Wiley (by way of "Howard M. Paul" > ) >Subject: W-EMED [PSA/PIO] Unusual Emergency Request > >Folks - My Father just had brain surgery to remove a malignant primary, Level >4 tumor called Glioblastoma Multiforme. We are seeking alternative & >experimental treatment & case histories. >If anyone can help me - please write me personally at: coyotearz@aol.com > >Nena Wiley, Maj CAP >PA ACV/SWR Nena, Our prayers are with you and your family. This type of brain cancer is very aggressive. A neighbor we became friends with had a glioblastoma. Unfortunately we met him after surgery and radiation. There was little we could do, although he did improve for a short time. He did not change his diet though, and you cannot eat dead cooked food and expect to gain life from them. What goes in is the fuel the body has to heal with. Change of diet is imperative. Master Formula and organic juicing would be ideal. Anyone who is in a health crisis should only juice and eat raw foods that have LIFE. I would use essential oil of frankincense, diffused, rubbed on the brain stem, on the feet. I would IMMEDIATELY begin taking therapeutic doses of beta glucan and transfer factor. http://www.nautilusnutritionals.com - Products - Immune Modulators. I have been taking beta glucan since 3 weeks after breast cancer surgery (2/97). ALl tumor tests remain normal. It is an immune enhancing supplement made from the cell walls of baker's yeast and has over 30+ years of scientific study and research by such as Harvard and many more. It has been used effectively along with chemotherapy and radiation, even reducing the amounts needed. I did not do any drugs or radiation, but changed diet, use oils, take beta glucan, and for the last year have included Master Formula as part of my daily food. Insulin dependent diabetes of 31+ years has improved also. I have written testimonies, and you can also call 1-888-411-1143 to hear live recorded testimonies. Forms to order with are available on FOD at 1-888-411-1142. Diet is crucial. Truly, what we eat today determines our health tomorrow. This cannot be stressed enough! These are the things I would do to improve my health, especially facing cancer. Time is of the essence. Sherman quit taking radiation and lived 6 more weeks, suffering terribly. It didn't have to be that way. Our prayers are with you. May God bless and watch over you. Shirley ****** Kraig and Shirley Carroll ... in the hills of Kentucky ICQ #26952217 thehavens@highland.net http://www.thehavens.com/ 606-376-3363 Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 22 Mar 1999 21:40:37 -0500 (EST) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 22 Mar 1999 21:39:49 -0500 (EST) Received: via switchmail; Mon, 22 Mar 1999 21:39:49 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 22 Mar 1999 21:37:43 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 22 Mar 1999 21:35:59 -0500 (EST) Received: from raven.prod.itd.earthlink.net (raven.prod.itd.earthlink.net [209.178.63.9]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 22 Mar 1999 21:35:55 -0500 (EST) Received: from default (1Cust230.tnt1.pleasantville.nj.da.uu.net [63.10.1.230]) by raven.prod.itd.earthlink.net (8.8.7/8.8.5) with SMTP id SAA28242 for ; Mon, 22 Mar 1999 18:27:07 -0800 (PST) From: "David Israel" To: Subject: RE: W-EMED [PSA/PIO] Unusual Emergency Request Date: Mon, 22 Mar 1999 21:23:01 -0500 Message-ID: <000101be74d4$135cf320$e6010a3f@default> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 8bit X-Priority: 3 (Normal) X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook 8.5, Build 4.71.2173.0 Importance: Normal In-Reply-To: <4.1.19990322112925.009ba6f0@pop.ecentral.com> X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3110.3 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P64080.CNM Gene therapy is showing some promise. Here is an article for your review. David Israel Hematology/oncology Clinics of North America Volume 12 • Number 3 • June 1998 Copyright © 1998 W. B. Saunders Company ---------------------------------------------------------------------------- ---- ---------------------------------------------------------------------------- ---- 617 GENE THERAPY ---------------------------------------------------------------------------- ---- GENE THERAPY FOR MALIGNANT GLIOMAS Jane B. Alavi MD Stephen L. Eck MD, PhD ---------------------------------------------------------------------------- ---- This work was supported in part by grant RO1 CA 67799 from the National Institutes of Health. ---------------------------------------------------------------------------- ---- Division of Hematology and Oncology, Department of Medicine, The University of Pennsylvania Medical Center, Philadelphia, Pennsylvania ---------------------------------------------------------------------------- ---- Address reprint requests to Stephen L. Eck, MD, PhD Division of Hematology and Oncology Department of Medicine Room 409 Stellar-Chance Laboratories 422 Curie Blvd. Philadelphia, PA 19104-6100 Relative to their prevalence, malignant gliomas have received a disproportionate amount of attention as targets for gene therapy. [9] Several factors have contributed to the interest in gene therapy techniques for malignant gliomas (principally anaplastic astrocytomas and glioblastoma multiforme). Malignant gliomas are good candidates for gene therapy because their growth is relatively well localized. Although they infiltrate the surrounding brain, thereby making complete surgical excision impossible, they rarely metastasize outside the brain. This tremendously simplifies the targeting of gene vectors to the tumor. Systemic delivery of genetic vectors to widespread metastases is currently not achievable with high efficiency and low toxicity (see article by Drs. Wivel and Wilson on p 483 of this issue). The local delivery to the bulk of the tumor, however, can be achieved through either stereotactic injection of vectors into the brain tumor or infiltration of the tumor with genetic vector at the time of gross total resection. This approach bypasses the blood-brain barrier that limits the entry of many otherwise potentially useful chemotherapy agents. In addition, direct injection of genetic vectors limits systemic exposure to the therapeutic agent and, therefore, minimizes systemic toxicity. Malignant gliomas have extremely high mortality rates that have not been affected significantly by newer surgical, radiation, or drug therapies; thus, experimental, high-risk therapies are more reasonable options for patients with malignant glioma. Currently, ---------------------------------------------------------------------------- ---- 618 several of the glioma gene therapy clinical trials treat patients as part of their initial therapy. Brain tumors comprise a broad spectrum of biologic and clinical features making it unlikely for a single therapeutic approach to be applicable to all patients. Several molecular approaches to these tumors are being developed, including enzyme-prodrug therapy, targeting tumor suppressor and angiogenesis functions, immunotherapy, and the use of oncolytic viruses. This article discusses the preclinical work to develop these approaches and the early clinical trials. ENZYME-PRODRUG GENE THERAPY Malignant gliomas (especially glioblastoma multiforme) show minimal responsiveness to currently available chemotherapy. This stems, in part, from the difficulty in delivering high levels of chemotherapeutic agents across the blood-brain barrier without significant systemic toxicity. This can be potentially overcome by producing high levels of chemotherapy within the tumor itself. [41] Introduction of prodrug activating genes has been studied extensively in brain tumor experimental models and in a few ongoing human clinical trials. [9] [11] [12] [32] In this strategy, the tumor cells are modified genetically to express an enzyme capable of activating an otherwise inactive prodrug. Although the prodrug is administered systematically, only in the genetically modified tumor cells does it encounter the enzyme capable of converting it into a toxic form. [12] The intended result is high-dose, local, sustained delivery of a cytotoxic agent that is largely confined to the tumor. A variety of prodrug-activating enzymes and prodrugs (Table 1) have been tested for this so-called suicide gene therapy. The concept of intratumor delivery of chemotherapy is not new. [12] The recently approved implantation of BCNU-containing wafers (Gliadel, Rhone-Poulenc Rorer, Collegeville, PA) has proven effective (albeit minimally) in treating gliomas [43] and provides a basis for comparison. The enzyme-prodrug combinations that employ foreign (nonhuman) enzymes (e.g., HSVtk and CD, see Table 1) have the advantage of only activating the drug in the tumor. Those enzyme-prodrug combinations that employ enzymes naturally present in other TABLE 1 -- ENZYME-PRODRUG COMBINATIONS Enzyme Prodrug Herpes simplex virus thymidine kinase (HSVtk) Ganciclovir, acyclovir, famciclovir Cytosine deaminase (CD) 5-fluorocytidine (5-FC) Deoxycytidine kinase Cytosine arabinoside, fludarabine, difluorodeoxycytidine Xanthine-guanine phosphoribosyl transferase 6-thioxanthine, 6-thioguanine Nitroreductase 5-(aziridinyl-1-yl)-2,4-dinitrobenzamide Cytochrome P-450 Cyclophosphamide, methyl propylchloroethyl nitrosourea ---------------------------------------------------------------------------- ---- 619 human tissues (e.g., cytochrome P450 in the liver, see Table 1) may have higher systemic toxicity because the prodrug is not activated solely in the brain tumor. As with other forms of chemotherapy, gene-delivered enzyme-prodrug therapy can likely be combined with other conventional therapies such as radiation therapy. [22] For instance, cytosine deaminase (CD) gene therapy converts 5-fluorocytidine (5-FC) to 5-fluorouracil (5-FU), [41] a known radiation sensitizer. [25] Importantly, the therapeutic benefit of enzyme-prodrug gene therapy extends to tumor cells in the tumor mass that have not taken up the therapeutic gene. This so-called bystander effect allows a potentially inefficient gene transfer process (transduction of a small percentage of the tumor cells) to have a large therapeutic effect. [15] The bystander effect stems from several processes whose contribution to the overall effect varies with the enzyme-prodrug combination, tumor type, and experimental model being studied. Figure 1 illustrates the major components of the bystander effect. First, the activated drug is exported to adjacent cells through gap junction connections between adjacent cells. Gap junctions appear to be important in the HSVtk-ganciclovir system, in which the active metabolites are not very stable outside of the tumor cell. [13] Simple diffusion between cells is readily achieved in the cytosine deaminase-fluorocytidine Figure 1. The bystander effect. A tumor cell tranduced with the thymidine kinase gene produces the thymidine kinase enzyme (TK). Systemic administration of ganciclovir results in production of ganciclovir metabolites within the tumor cell. The active drug metabolites diffuse to neighboring cells through gap junctions or are released into the extracellular environment. Tumor cell debris can also be taken up by antigen presenting cells (APC), which in turn stimulate lymphocytes to mount an immune response to the tumor cells. ---------------------------------------------------------------------------- ---- 620 system because the activated drug (5-FU) readily diffuses through tumor cells and is stable in the extracellular environment. [41] Similarly, tumor cell death (as a result of the activated drug) may release more active drug that is taken up by neighboring tumor cells. Finally, in some animal models, it has been observed that tumor cell death results in release of tumor antigens that are taken up by antigen presenting cells (APC), which in turn activate lymphocytes to mount an immune response against the tumor cells. [2] [4] Oldfield [32] was the first to apply enzyme-prodrug gene therapy to patients with malignant gliomas. He employed the HSVtk strategy proposed Figure 2. Injection of retroviral producer cells into brain tumor. Mouse cells (large oval-shaped cells) modified to secrete retrovirus (small ovals) are injected into the tumor. They are taken up by nearby tumor cells (irregular shape) in which the therapeutic gene becomes integrated into the genome of dividing tumor cells. The therapeutic protein is expressed from the integrated gene. ---------------------------------------------------------------------------- ---- 621 by Moolten [27] by implanting modified murine cells (producer cells) that secrete a retroviral vector carrying the HSVtk gene. [32] Injection of the producer cells was used in this clinical trial to increase the effective dose of retroviral vector (see article by Drs. Wivel and Wilson on p 483 of the issue). As shown in Figure 2 , the producer cells are implanted into the tumor where they produce retroviral particles that transduce nearby cells to make thymidine kinase enzyme. Fifteen patients with progressive malignant brain tumors (gliomas, metastatic breast cancer, and melanomas) were treated in the initial clinical trial. [32] The therapy was well tolerated, although seizures (controlled by anticonvulsants) and focal hemorrhages were observed in some patients. Two patients with glioblastoma multiforme had durable responses lasting more than 4 years. [32] In some patients, tumor specimens were removed 7 days after implantation of retroviral producer cells. Analysis of these tumor specimens revealed that gene transfer was limited to a small region surrounding the site of injection. This suggests that neither the injected producer cells nor the secreted retrovirus travels very far within the tumor bed. Nonetheless, this study was the first to demonstrate a clinical benefit in patients, albeit a few highly selected patients with small tumors. This, and similar clinical studies, [21] are now in advanced-phase clinical trials to determine its effectiveness in a larger patient population. This study [32] highlights some of the limitations of retroviral gene therapy. Producer cells needed to be injected because the virus could not be made concentrated sufficiently. The handling of producer cells, which must remain viable, is cumbersome and difficult to apply in general clinical practice. Because the virus only transduces dividing tumor cells, tumor cells that are mitotically arrested (a significant proportion) do not express the therapeutic gene. The authors [11] and others [44] have sought to overcome these problems using a replication defective adenovirus vector. Recombinant adenovirus can be prepared in stable suspensions that are up to a millionfold more concentrated than the retrovirus preparations. Furthermore, the adenovirus transduces tumor cells independent of their mitotic activity; thus, direct injection of the viral particles can be used to transduce a portion of the tumor cells (Fig. 3) . It remains to be determined whether tumor penetration by adenovirus can achieve a greater tissue distribution than that achieved by retroviral particles. Both viruses are very large compared with conventional drugs and may have limited diffusion within the tumor. A potential drawback to the use of adenovirus is the pre-existing immunity to this virus that all patients have. A brisk immune response to the virus could result in severe cerebral edema. [29] Studies [37] in rodents and primates indicated that this approach was feasible despite the immune response to the virus. The authors' trial design at the University of Pennsylvania provided for the treatment of patients with a recombinant adenovirus expressing HSVtk. Four dose levels ranging from 108 to 1011 plaque-forming units were tested with three patients at each dose. Stereotactic injection of virus was carried out at five sites in the malignant glioma, followed by resection of the tumor 1 week later. The residual tumor that ---------------------------------------------------------------------------- ---- 622 Figure 3. Injection of recombinant adenovirus into brain tumor. Recombinant adenovirus is injected directly into the tumor. The adenovirus is taken up by all cells that come in contact with the virus independent of whether the cells are dividing actively. The therapeutic gene does not become integrated into the target cell genome and the adenovirus begins to produce the therapeutic protein within a few hours after injection. could not be removed was re-treated at the time of resection with additional adenovirus at the same dose. Twelve patients have been treated in this manner to date. Overall, the patients tolerated the procedure well with toxicities and complications not different from those found in patients undergoing these procedures without gene therapy. Although virus-induced inflammation may have contributed to increased intracranial pressure in a few patients, this was controlled by standard measures. This study is ongoing in an effort to define the dose-limiting toxicity and potential benefit. To overcome the physical limitations imposed by the local injection ---------------------------------------------------------------------------- ---- 623 of virus into the tumor, Neuwelt and colleagues [28] have examined the feasibility of intra-arterial injection of recombinant virus. They have shown that osmotic blood-brain barrier disruption can facilitate intra-arterial administration of virus into experimental brain tumors. This may offer a means to transduce the tumor cells that have infiltrated the normal brain. Such cells are surgically inaccessible and may not be reached by virus injected into the surgical resection site. If successful, this method would provide widespread delivery to locally infiltrating brain tumors that are not surgically accessible. An alternative approach is to infuse the genetic vector slowly into the tumor through a stereotactically placed catheter. Zhu et al [45] treated rats with experimental gliomas by continuous intracerebral infusion of a HSVtk-liposome complex. They observed a complete response in 36% of the animals following administration of ganciclovir. A variation of this approach has been tested in two patients using infusion of HSVtk vector through an Ommaya (PS Medical, Goleta, CA) reservoir connected to the tumor cavity. [20] Direct interstitial infusion has been clinically tested for its ability to distribute a large protein into malignant brain tumors. [23] This technology also could be applied to the delivery of genetic vectors. Other enzyme-prodrug combinations have shown promise in rodent brain tumor experimental models, including the cytosine deaminase/5-fluorocytosine [16] and cytochrome P450/cyclophosphamide [8] [24] combinations. TARGETING TUMOR SUPPRESSOR AND ANGIOGENESIS FUNCTIONS Tumor suppressor gene therapy is being developed for several cancers including gliomas. The overexpression of wild-type p53 can suppress tumor growth even in cells that express endogenous wild-type p53. Hsiao and colleagues [18] have examined the use of this approach in human glioblastoma cell lines. They found that gene-liposome complexes could penetrate up to 20 tumor cell layers when applied to a model of the postoperative surgical cavity. Liposome-mediated p53 gene transfer in mice bearing xenografted human gliomas suppressed tumor growth and improved overall survival. [18] Similarly, Black and colleagues [3] showed that stereotactic injection of adenovirus expressing p53 into rats with brain tumors decreased tumor volume and induced changes consistent with p53-induced apoptosis. Besides p53 itself, downstream effectors of p53 function can be introduced into glial tumor cells and induce growth arrest. [7] Multicenter clinical trials using adenovirus expressing p53 are under development to test these principles in patients with relapsed malignant gliomas. Overexpression of p53 in tumor cells has been reported to induce a bystander effect through up-regulation of thrombospondin-1, which inhibits tumor angiogenesis. Tumor angiogenesis also can be targeted directly by gene transfer-mediated expression of anti-angiogenic agents. [30] Glioblastoma multiforme ---------------------------------------------------------------------------- ---- 624 has many characteristics of an angiogenesis-dependent tumor. As low-grade glial tumors progress to high-grade glioblastomas, there is a significant increase in tumor growth rate and tumor vascularization. Despite the greater density of blood vessels, glioblastoma multiforme tumors typically outgrow their blood supply and spontaneously develop necrotic centers as the peripheral (better vascularized) cells in the tumor continue to grow. Vascular endothelial growth factor (VEGF) is produced at high levels by glioblastoma cells, at intermediate levels by low-grade glial tumors, and at low levels by normal brain. [31] The production of VEGF is a direct response to tissue hypoxia within the glial tumors. [19] [36] The dependence of malignant gliomas on angiogenesis can be exploited to achieve a therapeutic benefit. For instance, when glioma tumor cells were stably transfected with an antisense DNA construct that diminished VEGF production, the cells inexplicably grew more rapidly in vitro. However, when implanted in vivo, the tumor growth rate was decreased significantly compared with the untransduced control cells. Furthermore, the resulting tumors were more necrotic as a result of a lower blood vessel density. [34] Antisense agents delivered by gene transfer also have been studied for their ability to inhibit other angiogenic factors such as basic fibroblast growth factor. [33] Fine and colleagues [39] have shown that viral-mediated gene transfer of the anti-angiogenic peptide platelet factor 4 can inhibit endothelial proliferation and reduce the vascularity of glial tumors in vivo. These studies demonstrate that gene delivery can be used to inhibit tumor vascularization using a variety of approaches. The use of platelet factor 4 is particularly attractive because this small soluble peptide is excreted into the extracellular space where it can diffuse readily. Therefore, the effects of platelet factor 4 gene transfer may be seen in tumor cells remote from those transduced by the therapeutic gene. IMMUNOTHERAPY OF MALIGNANT GLIOMAS Therapies designed to elicit an immune response to tumors have been sought for over a century with very little success. A better understanding of the immune effector pathways and characterization of cytokines involved in the immune response have led to the development of gene-transfer-based immunotherapies of human gliomas. [10] One approach has been to overcome the endogenous immunosuppressive effects of the tumors themselves. Transforming growth factor (TGF)-beta is produced by many tumors, including human gliomas, and suppresses cell-mediated immunity. Sobol and colleagues [14] demonstrated that blocking TGF-beta secretion could enhance the immune response to an experimental glioma cell vaccine. In this work, rats received intracranial implantation of a fatal dose of glioma cells. Five days later they were immunized with irradiated glioma cells expressing either an antisense TGF-beta construct, or recombinant interleukin (IL)-2, or they received an unmodified cell vaccine. All of those receiving the antisense, TGF-beta-modified ---------------------------------------------------------------------------- ---- 625 cells as a vaccine survived. In contrast, only 30% of the animals receiving the IL-2-secreting vaccine or 20% of the animals receiving unmodified tumor cell vaccine survived. Although these findings are encouraging, the 20% survival rate of control animals indicates that this tumor model is inherently immunogenic and likely overestimates the effect that this maneuver would have in less immunogenic human gliomas. Sampson et al [35] examined the effects of a large panel of immunostimulatory molecules including IL-2, IL-3, IL-4, IL-6, TNF-alpha, INF-gamma, GM-CSF, and B7-1. Implantation of the gene-modified astrocytoma cells (which also produce TGF-beta) showed a dramatic survival benefit for animals receiving IL-2-, IL-4-, or TNF-alpha-modified tumor cells. Chiocca [8] and Tseng et al [42] have seen similar results in related cytokine therapies for experimental gliomas. Direct injection of viral vectors producing cytokines would be easier to implement in the clinical setting. This approach would eliminate the need to produce a gene-modified cell vaccine for each patient as is currently done in some centers. [38] Furthermore, Glick et al [17] have shown that intracerebral vaccination with vector-delivered cytokine (IL-2) is superior to subcutaneous vaccination. There is, however, a significant risk of delivering too much cytokine into the brain. Tjuvajev et al [40] injected retroviral producer cells secreting IL-2 or INF-gamma along with gliomas cells into the brains of rats. Although this induced an immune response to the tumor cells, it also caused very severe central nervous system toxicity as a result of blood-brain barrier disruption and vasogenic edema. Thus, the simplicity and efficacy of this approach are tempered by the need to control cytokine gene expression within the brain carefully so as to confine the effects to the tumor. REPLICATING VIRUSES FOR THE TREATMENT OF GLIOMAS As noted in the discussion of enzyme-prodrug gene therapy, the spread of virus within the tumor may be quite limited when replication-defective viruses are used. This may be potentially overcome by employing a replication conditional virus (i.e., a virus that selectively replicates only in the tumor and not in the normal brain parenchyma). In theory, this should provide better tumor penetration as the virus gradually spreads through the tumor. Several research groups are pursuing such approaches using conditionally replicating adenoviruses and herpes simplex viruses (HSV). For example, disruption of the gamma34.5 gene in HSV arrests the viral growth in the central nervous system of rodents but still permits it to grow in the tumor cells. [6] When gamma34.5 mutant HSV virus is injected into xenogeneic experimental gliomas, long-term survival can be achieved. [1] In this model, tumor cell death is primarily due to the lytic action of the virus as it selectively replicates within and then destroys the tumor cells. Martuza and colleagues [26] have combined this strategy with the previously described thymidine kinase/ganciclovir approach. In this system, tumor cells are killed both by the lytic action ---------------------------------------------------------------------------- ---- 626 of the virus and by the HSVtk-mediated activation of ganciclovir. This may have a safety advantage by allowing the lytic virus to be destroyed before it can invade normal tissues. Adenoviral vectors can be engineered similarly to replicate selectively in p53-deficient cells, [5] but this approach is limited to those patients with glioblastomas that have p53 mutations (Fig. 4) . Clinical trials based on these principles will likely begin in the United States in the near future; however, there is significant concern over the use of replicating-virus therapy in the brain. In this case, the immune response to the virus could be more toxic than the virus itself, which is especially true in patients with pre-existing immunity to the virus such as frequently occurs with adenovirus and herpes Figure 4. Oncolytic action of replication competent virus. A virus engineered to replicate selectively in tumor cells (see text) is injected into the tumor. Infection of a few cells leads to their death and release of progeny virus that infect nearby cells. The cycle of virus replication and cell lysis continues until the edge of the tumor is reached or until an immune response to viral proteins eradicates the virus. ---------------------------------------------------------------------------- ---- 627 viruses. Such a response could induce local inflammation and an increase in intracranial pressure. The authors have seen evidence of this effect when using the replication defective adenovirus at high doses in their current glioma clinical trial. [11] Many of the animal models used to demonstrate the effectiveness of this approach were immunodeficient mice. These studies underestimate immune-mediated toxicity. In patients with an intact immune response and prior exposure to these viruses, the immune response could limit the spread of the virus within the tumor and thereby diminish the efficacy as well. These issues are being addressed in ongoing, preclinical safety testing. CONCLUSION Gene therapy for brain tumors encompasses a broad range of therapeutic approaches. There are two major obstacles in treated gliomas. The delivery of the genetic vector must reach a larger portion of the tumor than has been achieved in the initial clinical trials. In addition, the immune response to current vectors poses a significant risk of inflammation-induced elevation of intracranial pressure. Newer generation viral and synthetic vectors will likely lessen this problem. Finally, additional molecular targets will certainly be identified and brought forth in new clinical trials. References 1. Andreansky SS, He B, Gillespie GY, et al: The application of genetically engineered herpes simplex viruses to the treatment of experimental brain tumors. Proc Natl Acad Sci USA 93:11313-11318, 1996 2. Asai A: Gene therapy for brain tumors: Induction of apoptosis and immunogenic modulation in glioma cells. No Shinkei Geka 23:7-15, 1995 3. Badie B, Drazan KE, Kramar MH, et al: Adenovirus-mediated p53 gene delivery inhibits 9L glioma growth in rats. Neurol Res 17:209-216, 1995 4. Banchereau J, Steinman RM: Dendritic cells and the control of immunity. Nature 392:245-252, 1998 5. Bischoff JR, Kirn DH, Williams A, et al: An adenovirus mutant that replicates selectively in p53-deficient human tumor cells. Science 274:373-376, 1996 6. Chambers R, Gillespie GY, Soroceanu L, et al: Comparison of genetically engineered herpes simplex viruses for the treatment of brain tumors in a scid mouse model of human malignant glioma. Proc Natl Acad Sci USA 92:1411-1415, 1995 7. Chen J, Willingham T, Shuford M, et al: Effects of ectopic overexpression of p21 (WAF1/CIP1) on aneuploidy and the malignant phenotype of human brain tumor cells. Oncogene 13:1395-1403, 1996 8. Chiocca EA: Brain tumor gene therapy in mice with a novel "suicide" gene: The cyclophosphamide-activating CYP2B1 gene. Clin Neurosurg 42:370-382, 1995 9. Culver KW: Gene therapy for malignant neoplasms of the CNS. Bone Marrow Transplant 18(suppl):S6-S9, 1996 10. Dietrich PY, Walker PR, Saas P, et al: Immunobiology of gliomas: New perspectives for therapy. Ann NY Acad Sci 824:124-140, 1997 11. Eck SL, Alavi JB, Alavi A, et al: Clinical protocol: Treatment of advanced CNS malignancies ---------------------------------------------------------------------------- ---- 628 with the recombinant adenovirus H5.010RSVTK: A phase I trial. Hum Gene Ther 7:1465-1482, 1996 12. Eck SL, Wilson JM: Gene-Based Therapy. In Hardman JG, Limbird LE (eds): Goodman & Gilman's: The Pharmacological Basis of Therapeutics. New York, McGraw-Hill, 1995, pp 77-102 13. Elshami AA, Saavedra A, Zhang H, et al: Gap junctions play a role in the `bystander effect' of the herpes simplex virus thymidine kinase/ganciclovir system in vitro. Gene Ther 3:85-92, 1996 14. Fakhrai H, Dorigo O, Shawler DL, et al: Eradication of established intracranial rat gliomas by transforming growth factor beta antisense gene therapy. Proc Natl Acad Sci USA 93:2909-2914, 1996 15. Freeman S, Abboud CN, Whartenby KA, et al: The "bystander effect": Tumor regression when a fraction of the tumor mass is genetically modified. Cancer Res 53:5274-5283, 1993 16. Ge K, Xu L, Zheng Z, et al: Transduction of cytosine deaminase gene makes rat glioma cells highly sensitive to 5-fluorocytosine. Int J Cancer 7:675-679, 1997 17. Glick RP, Lichtor T, Mogharbel A, et al: Intracerebral versus subcutaneous immunization with allogeneic fibroblasts genetically engineered to secrete interleukin-2 in the treatment of central nervous system glioma and melanoma. Neurosurgery 41:898-906, 1997 18. Hsiao M, Tse V, Carmel J, et al: Intracavitary liposome-mediated p53 gene transfer into glioblastoma with endogenous wild-type p53 in vivo results in tumor suppression and long-term survival. Biochem Biophysi Res Commun 233:359-364, 1997 19. Ikeda E, Achen MG, Breier G, et al: Hypoxia-induced transcriptional activation and increased mRNA stability of vascular endothelial growth factor in C6 glioma cells. J Biol Chem 270:19761-19766, 1995 20. Izquierdo M, Cortes ML, Martin V, et al: Gene therapy in brain tumours: Implications of the size of glioblastoma on its curability. Acta Neurol Scand Suppl 68:111-117, 1997 21. Izquierdo M, Martin V, de Felipe P, et al: Human malignant brain tumor response to herpes simplex thymidine kinase (HSVtk)/ganciclovir gene therapy. Gene Ther 3:491-495, 1996 22. Kim SH, Kim JH, Kolozsvary A, et al: Preferential radiosensitization of 9L glioma cells transduced with HSV-tk gene by acyclovir. J Neurooncol 33:189-194, 1997 23. Laske DW, Youle RJ, Oldfield EH: Tumor regression with regional distribution of the targeted toxin TF-CRM107 in patients with malignant brain tumors. Nat Med 3:1362-1368, 1997 24. Manome Y, Wen PY, Chen L, et al: Gene therapy for malignant gliomas using replication incompetent retroviral and adenoviral vectors encoding the cytochrome P450 2B1 gene together with cyclophosphamide. Gene Ther 3:513-520, 1996 25. Minsky BD: The role of adjuvant therapy in the treatment of colorectal cancer. Hematol Oncol Clin North Am 11:679-697, 1997 26. Miyatake S, Martuza RL, Rabkin SD: Defective herpes simplex virus vectors expressing thymidine kinase for the treatment of malignant glioma. Cancer Gene Ther 4:222-228, 1997 27. Moolten F: Tumor chemosensitivity conferred by inserted herpes thymidine kinase genes: paradigm for a prospective cancer control strategy. Cancer Res 46:5276-5281, 1986 28. Nilaver G, Muldoon LL, Kroll RA, et al: Delivery of herpesvirus and adenovirus to nude rat intracerebral tumors after osmotic blood-brain barrier disruption. Proc Natl Acad Sci USA 92:9829-9833, 1995 29. Peltekian E, Parrish E, Bouchard C, et al: Adenovirus-mediated gene transfer to the brain: Methodological assessment. J Neurosci Methods 71:77-84, 1997 30. Plate KH: Gene therapy of malignant glioma via inhibition of tumor angiogenesis. Cancer Metastasis Rev 15:237-240, 1996 31. Plate KH, Risau W: Angiogenesis in malignant gliomas. Glia 15:339-347, 1995 32. Ram Z, Culver KW, Oshiro EM, et al: Therapy of malignant brain tumors by intratumoral implantation of retroviral vector-producing cells. Nat Med 3:1354-1361, 1997 ---------------------------------------------------------------------------- ---- 629 33. Redekop GJ, Naus CC: Transfection with bFGF sense and antisense cDNA resulting in modification of malignant glioma growth. J Neurosurg 82:83-90, 1995 34. Saleh M, Stacker SA, Wilks AF: Inhibition of growth of C6 glioma cells in vivo by expression of antisense vascular endothelial growth factor sequence. Cancer Res 56:393-401, 1996 35. Sampson JH, Ashley DA, Archer GE, et al: Characterization of a spontaneous murine astrocytoma and abrogation of its tumorigenicity by cytokine secretion. Neurosurgery 41:1365-1373, 1997 36. Shweiki D, Itin A, Soffer D, et al: Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-induced angiogenesis. Nature 359:845-848, 1992 37. Smith JG, Raper SE, Wheeldon E, et al: Intracranial administration of adenovirus expressing HSVTK in combination with ganciclovir produces a self-limited, dose-dependent inflammatory response. Hum Gene Ther 8:943-954, 1997 38. Sobol RE, Fakhrai H, Shawler D, et al: Interleukin-2 gene therapy in a patient with glioblastoma. Gene Ther 2:164-167, 1995 39. Tanaka T, Manome Y, Wen P, et al: Viral vector-mediated transduction of a modified platelet factor 4 cDNA inhibits angiogenesis and tumor growth. Nat Med 3:437-442, 1997 40. Tjuvajev J, Gansbacher B, Desai R, et al: RG-2 glioma growth attenuation and severe brain edema caused by local production of interleukin-2 and interferon-gamma. Cancer Res 55:1902-1910, 1995 41. Trinh QT, Austin EA, Murray DM, et al: Enzyme/prodrug gene therapy: Comparison of cytosine deaminase/5-fluorocytosine versus thymidine kinase/ganciclovir enzyme/prodrug systems in a human colorectal carcinoma cell line. Cancer Res 55:4808-4812, 1995 42. Tseng SH, Hwang LH, Lin SM: Induction of antitumor immunity by intracerebrally implanted rat C6 glioma cells genetically engineered to secrete cytokines. J Immunother 20:334-342, 1997 43. Valtonen S, Timonen U, Toivanen P, et al: Interstitial chemotherapy with carmustine-loaded polymers for high-grade gliomas: A randomized double-blind study. Neurosurgery 41:44-48, 1997 44. Vincent AJ, Esandi MC, Avezaat CJ, et al: Preclinical testing of recombinant adenoviral herpes simplex virus-thymidine kinase gene therapy for central nervous system malignancies. Neurosurgery 41:442-451, 1997 45. Zhu J, Zhang L, Hanisch UK, et al: A continuous intracerebral gene delivery system for in vivo liposome-mediated gene therapy. Gene Ther 3:472-476, 1996 ---------------------------------------------------------------------------- ---- MD Consult L.L.C. http://www.mdconsult.com Frameset URL: /das/journal/view/N/10322723?ja=116071&PAGE=1.html&ANCHOR=top&source=CL,MI > -----Original Message----- > From: owner-wilderness-emergency-medicine@list.pitt.edu > [mailto:owner-wilderness-emergency-medicine@list.pitt.edu]On Behalf Of > Nena Wiley (by way of "Howard M. Paul" ) > Sent: Monday, March 22, 1999 1:31 PM > To: wilderness-emergency-medicine@list.pitt.edu > Subject: W-EMED [PSA/PIO] Unusual Emergency Request > > > Folks - My Father just had brain surgery to remove a malignant > primary, Level > 4 tumor called Glioblastoma Multiforme. We are seeking alternative & > experimental treatment & case histories. > If anyone can help me - please write me personally at: coyotearz@aol.com > > Nena Wiley, Maj CAP > PA ACV/SWR > > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu > Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 22 Mar 1999 21:29:41 -0500 (EST) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 22 Mar 1999 21:28:31 -0500 (EST) Received: via switchmail; Mon, 22 Mar 1999 21:28:30 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 22 Mar 1999 21:26:32 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 22 Mar 1999 21:24:21 -0500 (EST) Received: from raven.prod.itd.earthlink.net (raven.prod.itd.earthlink.net [209.178.63.9]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 22 Mar 1999 21:24:17 -0500 (EST) Received: from default (1Cust230.tnt1.pleasantville.nj.da.uu.net [63.10.1.230]) by raven.prod.itd.earthlink.net (8.8.7/8.8.5) with SMTP id SAA25515 for ; Mon, 22 Mar 1999 18:23:37 -0800 (PST) From: "David Israel" To: Subject: RE: W-EMED [PSA/PIO] Unusual Emergency Request, be careful Date: Mon, 22 Mar 1999 21:19:31 -0500 Message-ID: <000001be74d3$95e09f00$e6010a3f@default> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 8bit X-Priority: 3 (Normal) X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook 8.5, Build 4.71.2173.0 Importance: Normal In-Reply-To: <4.1.19990322112925.009ba6f0@pop.ecentral.com> X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3110.3 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P7BD10.CNM Dear Maj, Please be careful when choosing alternative therapy for your Dad. I recently came across this article in "Neurology" that might be of help. My thoughts are with you. David Israel, MD LSTC-EMS Education Atlantic City Medical Center Neurology Volume 52 • Number 3 • February 1999 Copyright © 1999 American Academy of Neurology ---------------------------------------------------------------------------- ---- ---------------------------------------------------------------------------- ---- 617 Articles ---------------------------------------------------------------------------- ---- Alternative therapy use in neurologic diseases Use in brain tumor patients Marja J. Verhoef 1 PhD Neil Hagen 2 3 MD, FRCPC Guy Pelletier 3 PhD Peter Forsyth 2 3 MD, FRCPC 1 Department of Community Health Sciences (Dr. Verhoef) 2 Departments of Clinical Neurosciences and Medicine (Drs. Hagen and Forsyth), The University of Calgary 3 Tom Baker Cancer Center (Drs. Hagen, Pelletier, and Forsyth), Calgary, Alberta, Canada. T ---------------------------------------------------------------------------- ---- Parts of this manuscript were presented at the annual meeting of the American Neurological Association; San Diego, CA; September 28 to October 1, 1997. Received June 22, 1998. Accepted in final form October 17, 1998. ---------------------------------------------------------------------------- ---- Address correspondence and reprint requests to Dr. Marja J. Verhoef, Department of Community Health Sciences, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1 Canada; mverhoef@ucalgary.ca Copyright © 1999 by the American Academy of Neurology Article abstract-- Background: The extent of alternative therapy use in brain tumor patients is unknown, but it may be frequent and seems important to those who use it. Objective: To characterize alternative therapy use in brain tumor patients. Methods: Prospective questionnaire-based survey of 167 brain tumor patients who attended a cancer center in Southern Alberta. Physicians completed forms describing clinical information such as disease status. Results: The response rate was 91% (167/184). Twenty-four percent of patients used alternative therapies and often more than one therapy at the same time. Motivation to use these therapies was influenced by the desire for patient-focused treatment and a perceived need to take charge. Alternative therapy users were younger ( p = 0.04) and more likely to be on sick or disability leave ( p = 0.02), to come in for repeat visits ( p = 0.05), and to have received conventional treatments ( p = 0.01). Users tended to have lower quality of life with respect to physical well-being, functional well-being, and a specific brain tumor subscale. Clinical variables, such as disease status, tumor type, and Karnofsky Performance Score, were not related to alternative therapy use. Major changes in number and types of alternative therapy use occurred during the study period. No major side effects or tumor responses were seen with alternative therapies. Conclusions: Alternative therapy use in brain tumor patients is common and may reflect unmet patient needs with respect to their cancer care within the current model of health care delivery. We became interested in the use of alternative therapies when we encountered several brain tumor patients whose hands had an orange hue. When questioned, they told us they were taking beta carotene and that many other brain tumor patients were also using alternative therapies. We were curious as to how commonly these were used, which ones were used, what motivated patients to consider using them, and what their costs and perceived benefits and side effects were. The use of alternative therapies is increasingly popular despite limited proof of their benefit. These therapies are easy to recognize but harder to define. On a practical level, they can be defined as practices that do not conform with the standards of the medical community and are not widely taught at North American medical schools. [1] The use of alternative therapies in cancer patients varies between 9% and 45%. [2] [3] [4] [5] [6] [7] Alternative therapy use varies with geography, historical and political setting, and acceptance of such therapies by the medical community. [8] No prior studies have assessed alternative therapy use in patients with brain tumors. A large study commissioned by the American Cancer Society found that the use of alternative therapies was lowest in patients with cancer of the bladder (2%) and highest in patients with cancer of the brain and CNS (21%). [4] However, no information was provided regarding the therapies used or reasons for use in the latter. In the field of oncology, this issue is recognized, but there are few reports of the use of these therapies in neurologic diseases. Alternative therapies are used in 9 to 56% of neurologic patients with a variety of disorders such as AD, [9] [10] multiple sclerosis, [11] epilepsy, [12] migraine, [13] and postconcussion and whiplash syndromes. [14] Although many patients use these therapies, there are few in-depth studies addressing this issue in neurologic patients. It is not clear what benefit patients derive from the use of alternative therapies. Only a handful of systematic studies addressing the benefit of alternative therapies have been published in peer-reviewed journals. [15] [16] [17] [18] [19] Furthermore, the quality of life of patients taking these therapies is usually reported to ---------------------------------------------------------------------------- ---- This project was funded by a grant from the Alberta Cancer Board. ---------------------------------------------------------------------------- ---- 618 be the same or lower than conventionally treated patients. [20] Although alternative therapies are frequently perceived as "natural" and "nontoxic," there are reports of serious toxicities associated with their use. [21] [22] Finally, the costs of these therapies can be burdensome. [1] [6] The aim of this study was to characterize the use of alternative therapies in brain tumor patients. We also compared the quality of life of patients using these therapies with those who did not and attempted to identify factors that would predict which patients would use alternative therapies. Finally, we examined whether alternative therapy use changed over the disease trajectory of patients living with brain tumors. Methods. The study design was a prospective questionnaire-based survey of primary brain tumor patients. All patients with a histologic or radiographic diagnosis of a primary brain tumor who attended the Tom Baker Cancer Center (TBCC) in Southern Alberta (Canada) between October 1995 and September 1996 were eligible and were asked to participate in the study. TBCC is the sole ambulatory tertiary cancer treatment center in Southern Alberta (referral population 1.3 million) and all brain tumor patients requiring treatment with radiation or chemotherapy are referred there. Patients were asked to complete a self-report questionnaire assessing sociodemographics, treatment information, alternative therapy use, reasons for use, cost and perceived benefits, and side effects of treatment. Clinical information assessing disease status (e.g., improved, stable, recurrent) and treatment status (e.g., first postoperative visit, first postradiotherapy visit, routine follow-up visit) was collected at the time of the visit by the attending physician on a specifically designed form. The questionnaire explained: "Alternative therapies are any treatments other than surgery, radiation, or chemotherapy for your tumor. Common types of alternative therapies are metabolic therapies, diet, vitamin supplements, mental image therapy, spiritual or faith healing, and immune therapies." A list of types of practitioners who might provide these therapies was included, as well as an extensive list of examples of various alternative therapies. Up to two follow-up questionnaires were administered about 6 months after the first visit during the patients' routine scheduled visit. Owing to variation in scheduled appointments, the length of time between these measurements varied somewhat. We developed a questionnaire specifically for brain tumor patients because of a lack of information in this field; one of us (M.J.V.) had developed questionnaires on alternative therapy use in other diseases. [23] [24] The brain tumor patient questionnaire was reviewed extensively by clinic personnel and piloted on about 20 patient volunteers. Most of the data were quantitative (continuous as well as categorical), but a series of open-ended questions were also included. We measured quality of life using the Functional Assessment of Cancer Therapy (FACT-BR) scale. [25] This scale consists of a core questionnaire (FACT-G) assessing general quality of life in cancer patients to which a specific subscale has been added to measure quality of life in patients with brain tumors. The FACT-G consists of subscales assessing physical well-being, social/family well-being, relationship with doctor, emotional well-being, and functional well-being. The validity and reliability of the FACT-BR and the FACT-G have been demonstrated. [25] [26] Data analysis was primarily descriptive, consisting of frequencies, summary measures, t-test, and chi-square analysis. Logistic regression analysis was performed to assess which factors had the strongest independent effect on alternative therapy use. Open coding [27] was used to analyze the responses to the open-ended questions. The study was approved by the Conjoint Health Research Ethics Board of The University of Calgary, and signed, informed consent was obtained from all patients. Results. Of 195 consecutive patients who were approached for the study, four could not be included due to language difficulties and seven were deemed too ill. An additional 17 patients refused to participate in the study. Therefore, 167 patients (91% response rate) form the basis of this report. Follow-up was completed for 99/167 (59%) patients; 34 had died and the remaining 34 did not come in for follow-up visits during the study, refused to fill out the questionnaire a second time, or were too ill to complete the follow-up questionnaire. Patient characteristics. Fifty-six percent of the respondents were men and the mean age was 44 years (range, 20 to 83). The most common tumor types were low-grade glioma (28%), malignant glioma (26%), meningioma (16%), glioblastoma multiforme (14%), medulloblastoma (3%), and other diagnoses (12%). The high frequency of low-grade gliomas in the clinic reflects their superior survival and the young age of our patients. The median Karnofsky Performance Score was 85 (range, 40 to 100). Eighty-five percent of these patients had clinically stable disease, 14% had recurrent disease either at the time of the clinic visit or at some time in the past, and for 1%, disease status was unknown. Interestingly, 94% of patients thought their disease status was stable. Thirty-four (21%) patients were enrolled when they attended the clinic for their first visit. The other 79% were enrolled during follow-up visits and 78% of these visits were routine; nonroutine visits occurred because of clinical or radiographic deterioration or for other reasons (e.g., issues of symptom control or increasing seizures). Seventy-four percent of all patients had received, or were receiving, chemotherapy, radiotherapy, or both. Thirty percent of patients were employed, 30% were on sick or disability leave, and the remainder were homemakers, students, unemployed, or retired. Sixty-two percent had received more than a high school education. Awareness of alternative therapies. Forty-nine percent of respondents had become aware of an average of 2.6 alternative therapies after their tumor was first diagnosed. The most common types of therapies of which patients were aware were herbal therapies (69%), mind-body therapies (40%), and animal- and vegetable-derived therapies, particularly shark cartilage (36%). Patients believed 95% of all therapies they had heard of might be effective. The most common way patients heard about these therapies was from family or friends. Alternative therapy use. Forty patients (24%) had used or were using these therapies to treat their cancer. Together, these patients used 103 different alternative therapies representing six different categories of therapies (table 1) . Twenty-two of the 28 patients who used more ---------------------------------------------------------------------------- ---- 619 TABLE 1 -- Alternative therapies used by brain tumor patients Therapy type Commonly used in therapy Patients using this therapy, % * Herbal Essiac, Echinacea, Pau D'arco 65 Mind-body Imagery/visualization, faith healing, meditation 33 Animal/vegetable-derived Shark cartilage, mushrooms 25 Vitamin Beta carotene, vitamins 20 Dietary Macrobiotic 15 Other Acupuncture, reflexology, homeopathy, chiropractic 20 * Some patients used more than one therapy of the same type. ---------------------------------------------------------------------------- ---- than one alternative therapy used therapies from more than one category (e.g., herbal therapy along with mind-body therapy). No consistent patterns of combinations of alternative therapies emerged. Most commonly, motivation seemed to be influenced by wishes for patient-focused treatment and the need to "take charge" of their care (table 2) . TABLE 2 -- Reasons for alternative therapy use by brain tumor patients (n = 40) Reason No. (%) of patients * 1. My physicians left me little, if any, hope; i.e., "Could not offer available medical options other than `see you in six months' ... " 12 (30) 2. My physicians think differently about causes and treatment of disease than I do; i.e., "[I believe] that conventional medicine has no cures--prolongs life only." 9 (23) 3. Conventional treatment did not provide a cure, does not work; i.e., "I think I made a mistake doing radiation because I feel it didn't do anything for me." 9 (23) 4. To do something, take charge of my health; i.e., "I simply think I have a role in remaining healthy." 9 (23) 5. To augment conventional treatment; i.e., "I believe that the use of all forms (within cost and `personal' perception of possibilities) of treatment should be used." 8 (20) 6. Side effects of conventional therapies; i.e., "The alternative medicine appears to help my memory, my disposition and my tiredness." 6 (15) 7. I will take anything that might help; i.e., "Do anything that might help and might boost my immune system." 4 (10) 8. Other (including wishes of family, natural treatments, curiosity, lack of personal care from physicians, other); i.e., "Keeps the wife and children happy. They are doing the best they can for me"; "I have personally been involved with holistic health for a long period of time"; and "All natural--no side effects." 18 (45) * Multiple responses were common. ---------------------------------------------------------------------------- ---- Sixty-six percent of these therapies were perceived to be helpful in general and 35% were credited with making the tumor shrink or stop growing. The latter effects were mainly perceived for dietary and animal- and vegetable-derived therapies. No patient had an objective response to these therapies that could not otherwise be attributed to radio- or chemotherapy. When asked about benefits, 73% of all therapies had positive effects; most commonly, patients mentioned improved physical or mental well-being and increased energy. Of all reported therapies, 10% were found to have side effects, the most common of which was bad breath. No major objective toxicities attributable to these therapies were found for any patients using alternative therapies. Cost of alternative therapies. A minority of alternative therapy users (15/40; 37%) responded to the question about the average cost of each alternative therapy per month. This may reflect difficulty in assessing the monthly amount or an unwillingness to answer this question. The median cost of alternative therapies per month among responders was $55 (range, $7 to $420). When asked who paid for alternative therapies, more patients responded: 65% (26/40) indicated they paid 100% of the costs themselves, 10% (4) indicated that their families covered 100% of the costs, 15% (6) indicated that they shared the cost with their family, and 10% (4) did not provide this information. Perceptions of physician attitudes toward alternative therapy use. Forty-five percent (18) of alternative therapy users indicated that their doctor was aware they were using these therapies, 33% (13) were not sure whether their doctor knew, and 23% (9) indicated that their doctor was unaware of their use. Of the 18 patients who told their doctor they were using alternative therapies, 28% (5) described a positive (supportive, encouraging) reaction, 33% (6) a negative (discouraging, condescending) reaction, and the remaining 39% (7) a neutral ("don't mind," "try anything," "can't hurt") reaction from their treating physicians. Relationship between alternative therapy use and quality of life. Total scores on the FACT-BR quality of life scale were not significantly different between users and nonusers. However, subscale scores on physical well-being, functional well-being, and the brain subscale were significantly lower in patients who were using alternative therapies, indicating a lower quality of life (table 3) . Factors related to alternative therapy use. Table 4 presents the relationships between self-reported sociodemographic and clinical characteristics and the use of alternative therapies. Users were more likely to have received prior radiotherapy or chemotherapy, to have come in for a follow-up visit, to be on sick or disability leave, to be younger, or to have a higher income than nonusers. None of the clinical characteristics recorded by the physicians (such as whether the tumor was stable or recurrent, type of tumor, or Karnofsky Performance Score) was significantly related to alternative therapy use. However, there was a trend for patients with glioblastoma multiforme and malignant glioma to be more likely to use alternative therapies than patients with other diagnoses. Logistic regression analysis showed that employment status and having received or receiving radio- and chemotherapy significantly and independently affected the use of alternative ---------------------------------------------------------------------------- ---- 620 TABLE 3 -- FACT-BR subscales and total scores for users and nonusers of alternative therapies Subscale Users, mean ± SE Nonusers, mean ± SE p Value Physical 19.5 ± 6.3 * 21.8 ± 5.8 0.035 Social 21.6 ± 4.9 21.4 ± 6.0 0.879 Relationship with doctor 6.2 ± 1.8 6.9 ± 2.0 0.082 Emotional 15.1 ± 4.2 15.1 ± 4.0 0.987 Functional 15.7 ± 6.8 18.9 ± 7.9 0.025 FACT-G 78.7 ± 17.1 83.6 ± 17.0 0.126 Brain subscale 50.6 ± 14.5 55.7 ± 13.4 0.050 FACT-BR 129.8 ± 30.1 138.4 ± 28.4 0.112 FACT = Functional Assessment of Cancer Therapy; G, core questionnaire; BR, core questionnaire with subscale specific to brain tumor patients. * Note: a lower value corresponds to a lower quality of life. ---------------------------------------------------------------------------- ---- therapies. Income was not included in the modeling process, as the response rate for this question was low (59%), which would result in deletion of 70 respondents from the analysis. Changes in alternative therapy use over time. At the time the second questionnaire was completed, 26% of patients (26/97) were using alternative therapies, compared with 24% of users (40/167) identified when the questionnaire was first completed. Although the rate of use remained the same, several changes in use took place over the disease course of brain tumor patients. Table 5 shows TABLE 4 -- Relationship among sociodemographic variables, treatment received, visit number, and alternative therapy use Characteristic Users Nonusers p Value Sex, % male 60 56 0.65 Age, mean 42 47 0.04 Education, % High school 31 41 0.26 > High school 69 59 Employment status, % Employed 22 33 0.02 Sick/disability leave 48 24 Other (homemaker, retired, etc.) 30 43 Income, % $40,000 47 69 >$40,000 53 31 0.03 Visit, % First 10 25 0.05 Follow-up 90 75 Treatment received, % Chemotherapy 31 12 <0.01 Radiotherapy 72 40 <0.001 Radio- and chemotherapy 52 11 <0.0001 TABLE 5 -- Change in alternative therapy use between the first and second time the questionnaire was completed (n = 97) * Alternative therapy use at first completion of the questionnaire Alternative therapy use at second completion of the questionnaire User (n = 29) Nonuser (n = 73) User (n = 26) 15 11 Nonuser (n = 71) 9 62 * This table only applies to patients who completed the questionnaire twice. ---------------------------------------------------------------------------- ---- how many patients started (n = 9), stopped (n = 11), continued using (n = 15), or stayed away from alternative therapy use (n = 62). Of the 15 patients who were still using alternative therapies at the time of the second questionnaire, only three used the same number and the same type of therapies. The other 12 patients changed the number or the type of therapies used, or both. Further exploratory analysis was done to determine whether any factors were related to whether patients would continue, discontinue, or begin using alternative therapies. Men were significantly more likely to be continuing users than women (12/15 versus 3/15; p = 0.03). Patients who had received both chemotherapy and radiation were significantly more likely to be continuing users (7/17) than stoppers (2/11) or new users (0/9; p = 0.05). Although not significant, the disease status of new users was more likely to have recently progressed (3/9) than was that of persistent users (1/15), stoppers (0/11), and nonusers (2/62). Whether patients continued, stopped, or started using alternative therapies was not significantly related to quality of life at the time that the second questionnaire was completed, nor was it related to the quality of life when the initial questionnaire was completed. Discussion. This study shows that alternative therapies are used by 24% of brain tumor patients, which represents half of the patients who were aware of these treatments. The frequency of use is similar to that found in the study commissioned by the American Cancer Society. [4] Our study also determined the types of therapies used and their perceived benefits, side effects, and costs. Why do brain tumor patients use these therapies? The most common reason was that conventional therapies are not very effective. Alternative therapies were often used as a "last resort" after the treatments with radio- and chemotherapy were completed and conventional treatments offered no further hope. A second important reason was patients wanting to be more proactive in their care and to "take charge." Finally, the patients wanted to be sure "everything possible was being done." Given the dismal prognosis for many brain tumor patients, it is somewhat surprising that alternative therapies are not more commonly used. As expected from studies including patients with systemic cancer, patients were likely to be users if they had previously used multiple conventional ---------------------------------------------------------------------------- ---- 621 treatments, were on sick or disability leave, were younger, or had higher incomes. Although these are rather nonspecific factors, they may be useful in identifying patients who are more likely to consider alternative treatments and may require counseling regarding risks, benefits, and costs. Were these therapies useful to patients? Two thirds of patients who used them thought so, at least in a general way, either by improving energy levels or physical and mental well-being. One third of users had high expectations and anticipated that alternative therapies would shrink or cure their tumor. However, we did not encounter any patient who experienced an objective clinical or radiographic response that could not be attributed to concurrent therapy with radiation, chemotherapy, or corticosteroids. We concluded that alternative therapies seemed to provide comfort to patients who believed that every possible treatment was being used and that they had an opportunity to take an active role in their care. Users of alternative therapies had the same or lower quality of life than nonusers, which confirms the results of previous research. [20] This could partly be due to their disease being somewhat more severe or advanced. Was any harm done by taking these treatments? Despite a number of serious side effects reported with alternative therapies, [21] [22] patients did not report any significant adverse effects in our study. No patient reported what would be considered a serious (grade 3 or 4 National Cancer Institute of Canada common toxicity criteria [28] ) toxicity. These may have been unreported, however, as one patient had moderate (grade 3 toxicity) gastrointestinal side effects following enema treatments but did not report them in the study. All the reported side effects were minor (such as bad breath or mild gastrointestinal upset). Although average costs were about $50 per month, they could be as high as $420 per month. We were unable to determine if this was a source of financial hardship for our patients. In summary, we did not find significant harm done by the alternative therapies our patients used, although some had the potential to cause serious side effects and could be expensive. In light of the above results, we would like to point out that it was not the purpose of this study to assess scientific evidence of the efficacy of these therapies. Our study has several strengths and limitations that should be considered. A major strength is the external validity of the study, as virtually everyone in Southern Alberta who required brain tumor treatment was referred to our center and the majority (85%) participated. As a second strength, its longitudinal nature provided information about changes in use over time. There were several limitations. First, we did not survey patients in our population who were not referred for treatment with radiotherapy or chemotherapy. Therefore, patients with completely resected tumors, those treated with hormonal therapy (such as pituitary adenomas), or patients who were too ill to be referred were not sampled. This represents a small proportion of patients. A second limitation is under-reporting. Data of a highly sensitive nature such as income or the costs of these therapies were often not reported. We know of two patients who under-reported the costs of their therapies; the family of one raised money to send him to a clinic in another country and a second patient spent $20,000 on aggressive "cleansing" procedures in another country. We could not determine why this information was not recorded. We may also have under-reported the number of alternative therapies patients were using, as we only included space for four therapies on the questionnaire. Finally, because the use of alternative treatments is exquisitely sensitive to factors such as culture and sociodemographics, types, costs, side effects, or other details will vary considerably from population to population. Therefore, the experience of brain tumor patients in Southern Alberta may not be generalizable to all brain tumor patients. Alternative therapies are used by a significant number of our patients and we suggest that neurologists should discuss them with their patients. Many physicians are uncomfortable dealing with topics such as this in which there are strongly held (and often contradictory) beliefs and little objective data. However, patients need advice and support on these topics, which the physician is uniquely qualified to provide. It is now our practice to raise this issue routinely with our patients and provide advice if it is obvious that the proposed treatments will be highly toxic or expensive. This also highlights the need to study alternative treatments objectively in properly conducted clinical trials in neurologic patients. Potential interaction effects between alternative and conventional therapies also need to be assessed. Because use of alternative therapies may be largely motivated by patients' wishes to be more involved in their treatment, we now directly invite patients to participate in decisions regarding their conventional treatments offered by our cancer facility. Cancer patients vary widely in how much they want to become involved in their own care, and physicians need to facilitate that involvement according to each patient's preferences. [29] References 1. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Alternative medicine in the United States. Prevalence, costs and patterns of use. N Engl J Med 1993;328:246-252. 2. Cassileth BR, Lusk EJ, Strouse TB, Bodenheimer BJ. Contemporary unorthodox treatments in cancer medicine. A study of patients, treatments and practitioners. Ann Intern Med 1984;101:105-112. 3. Sollner W, Zingg-Schir M, Rumpold G, Fritsch P. Attitude toward alternative therapy, compliance with standard treatment, and need for emotional support in patients with melanoma. Arch Dermatol 1997;133:316-321. 4. Lerner IJ, Kennedy BJ. The prevalence of questionable methods of cancer treatment in the United States. CA Cancer J Clin 1992;42:181-191. ---------------------------------------------------------------------------- ---- 622 5. Risberg T, Kaasa S, Wist E, Melsom H. Why are cancer patients using non-proven complementary therapies? A cross-sectional multicentre study in Norway. Eur J Cancer 1997;33:575-580. 6. Begbie SD, Kerestes ZL, Bell DR. Patterns of alternative medicine use by cancer patients. MJA 1996;165:545-548. 7. Munstedt K, Kirsch K, Milch W, Sachsse S, Vahrson H. Alternative cancer therapy--survey of patients with gynecological malignancy. Arch Gynecol Obstet 1996;258:81-88. 8. Murray RH, Rubel AJ. Physicians and healers--unwilling partners in health care. N Engl J Med 1992;326:61-64. 9. Hogan DB, Ebly EM. Complementary medicine use in a dementia clinic population. Alzheimer Dis Assoc Disord 1996;10:63-67. 10. Coleman LM, Fowler LL, Williams ME. Use of unproven therapies by people with Alzheimer's disease. J Am Geriatr Soc 1995;43:747-750. 11. Fawcett J, Sidney JS, Riley-Lawless K, Hanson MJ. An exploratory study of the relationship between alternative therapies, functional status, and symptom severity among people with multiple sclerosis. J Holist Nurs 1996;14:115-129. 12. Danesi MA, Adetunji JB. Use of alternative medicine by patients with epilepsy: a survey of 265 epileptic patients in a developing country. Epilepsia 1994;35:344-351. 13. MacGregor EA, Vohrah C, Wilkinson M. Analgesic use: a study of treatments used by patients for migraine prior to attending the City of London Migraine Clinic. Headache 1990;30:571-574. 14. Evans RW, Evans RI, Sharp MJ. The physician survey on the post-concussion and whiplash syndromes. Headache 1994;34:268-274. 15. Bagenal F, Easton D, Harris E, Chilvers CE, McElwain TJ. Survival of patients with breast cancer attending Bristol Cancer Help Centre. Lancet 1990;336:606-610. 16. Moertel CG, Fleming TR, Rubin J, et al. A clinical trial of amygdalin (Laetrile) in the treatment of human cancer. N Engl J Med 1982;306:201-206. 17. Spiegel D, Bloom JR, Kraemer HC, Gottheil E. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet 1989;2:888-891. 18. Chlebowski RT, Bulcavage L, Grosvenor M, et al. Hydrazine sulfate influence on nutritional status and survival in non-small-cell lung cancer. J Clin Oncol 1990;8:9-15. 19. Loprinzi CL, Kuross SA, O'Fallon JR, et al. Randomized placebo-controlled evaluation of hydrazine sulfate in patients with advanced colorectal cancer. J Clin Oncol 1994;12:1121-1125. 20. Cassileth BR, Lusk EJ, Duport G, et al. Survival and quality of life among patients receiving unproven as compared with conventional cancer therapy. N Engl J Med 1991;324:1180-1185. 21. Capobianco DJ, Brazis PW, Fox TP. Proximal muscle weakness induced by herbs. N Engl J Med 1993;329:1430. Letter. 22. Larrey D, Vial T, Pauwels A, et al. Hepatitis after germander ( Teucrium chamaedrys) administration: another instance of herbal medicine hepatoxicity. Ann Intern Med 1992;117:129-132. 23. Verhoef MJ, Sutherland LR, Brkich L. Use of alternative medicine by patients attending a gastroenterology clinic. Can Med Assoc J 1990;142:121-125. 24. Sutherland LR, Verhoef MJ. Alternative medicine consultation by patients attending a multidisciplinary HIV clinic. AIDS Patient Care 1995;9:106-111. 25. Cella DF, Tulsky DS, Gray G, et al. The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 1993;11:570-579. 26. Weitzner MA, Meyers CA, Gelke CK, Byrne KS, Cella DF, Levin VA. The Functional Assessment of Cancer Therapy (FACT) scale. Cancer 1995;75:1151-1161. 27. Creswell JW. Research design. Qualitative and quantitative approaches. Thousand Oaks, CA: Sage Publications, 1994. 28. Forsyth P, Cairncross G, Stewart D, Goodyear H, Wainman N, Eisenhauer E. Phase II trial of docetaxel in patients with recurrent malignant glioma: a study of the National Cancer Institute of Canada Clinical Trials Group. Invest New Drugs 1996;14:203-206. 29. Hagen NA, Whylie B. Putting clinical practice guidelines into the hands of cancer patients. Can Med Assoc J 1998;158:347-348. ---------------------------------------------------------------------------- ---- MD Consult L.L.C. http://www.mdconsult.com Frameset URL: /das/journal/view/N/10583204?ja=137515&PAGE=1.html&ANCHOR=top > -----Original Message----- > From: owner-wilderness-emergency-medicine@list.pitt.edu > [mailto:owner-wilderness-emergency-medicine@list.pitt.edu]On Behalf Of > Nena Wiley (by way of "Howard M. Paul" ) > Sent: Monday, March 22, 1999 1:31 PM > To: wilderness-emergency-medicine@list.pitt.edu > Subject: W-EMED [PSA/PIO] Unusual Emergency Request > > > Folks - My Father just had brain surgery to remove a malignant > primary, Level > 4 tumor called Glioblastoma Multiforme. We are seeking alternative & > experimental treatment & case histories. > If anyone can help me - please write me personally at: coyotearz@aol.com > > Nena Wiley, Maj CAP > PA ACV/SWR > > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu > Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 22 Mar 1999 18:25:33 -0500 (EST) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 22 Mar 1999 18:24:56 -0500 (EST) Received: via switchmail; Mon, 22 Mar 1999 18:24:56 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 22 Mar 1999 18:23:07 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 22 Mar 1999 18:22:38 -0500 (EST) Received: from preytor.ecentral.com (root@preytor.ecentral.com [206.64.70.3]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 22 Mar 1999 18:22:34 -0500 (EST) Received: from default (ppp2-145.ecentral.com [208.213.102.145]) by preytor.ecentral.com (8.9.1a/8.9.1) with SMTP id QAA15524 for ; Mon, 22 Mar 1999 16:22:31 -0700 Message-Id: <4.1.19990322112925.009ba6f0@pop.ecentral.com> X-Sender: hmpaul@pop.ecentral.com X-Mailer: QUALCOMM Windows Eudora Pro Version 4.1 Date: Mon, 22 Mar 1999 11:30:37 -0700 To: wilderness-emergency-medicine@list.pitt.edu From: Nena Wiley (by way of "Howard M. Paul" ) Subject: W-EMED [PSA/PIO] Unusual Emergency Request Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P26810.CNM Folks - My Father just had brain surgery to remove a malignant primary, Level 4 tumor called Glioblastoma Multiforme. We are seeking alternative & experimental treatment & case histories. If anyone can help me - please write me personally at: coyotearz@aol.com Nena Wiley, Maj CAP PA ACV/SWR Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 22 Mar 1999 01:40:09 -0500 (EST) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 22 Mar 1999 01:39:33 -0500 (EST) Received: via switchmail; Mon, 22 Mar 1999 01:39:33 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 22 Mar 1999 01:39:22 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 22 Mar 1999 01:37:50 -0500 (EST) Received: from m4.boston.juno.com (m4.boston.juno.com [205.231.101.198]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 22 Mar 1999 01:37:47 -0500 (EST) Received: (from pcrs242@juno.com) by m4.boston.juno.com (queuemail) id D6AXHH43; Mon, 22 Mar 1999 01:37:23 EST To: wilderness-emergency-medicine@list.pitt.edu Date: Mon, 22 Mar 1999 01:30:12 -0500 Subject: W-EMED Re: Significantly Ambitious Scope of SAR Objectives.... Message-ID: <19990322.013014.4878.0.pcrs242@juno.com> References: <19990319.023815.13358.0.pcrs242@juno.com> <36F4B984.F253F4E7@erols.com> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 0-1,6-8 From: Deborah M Gessner Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 33554560 0 1 P18E20.CNM Thanks Gene, You hit on everything I wanted to know and you have answered my questions. I will relay this to the people who ask me to do this. Near us is Southwestern Va. Mt. rescue in Blacksburg and we are suppose to get together this week and talk I will let him know what you said and it all makes sense to me now. Thank you again, I will send more later on our group Deborah ___________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com/getjuno.html or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 19 Mar 1999 02:49:36 -0500 (EST) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 19 Mar 1999 02:48:59 -0500 (EST) Received: via switchmail; Fri, 19 Mar 1999 02:48:58 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 19 Mar 1999 02:47:05 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 19 Mar 1999 02:45:15 -0500 (EST) Received: from m4.boston.juno.com (m4.boston.juno.com [205.231.101.198]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 19 Mar 1999 02:45:12 -0500 (EST) Received: (from pcrs242@juno.com) by m4.boston.juno.com (queuemail) id D53B7EBZ; Fri, 19 Mar 1999 02:45:08 EST To: wilderness-emergency-medicine@list.pitt.edu Date: Fri, 19 Mar 1999 02:38:15 -0500 Message-ID: <19990319.023815.13358.0.pcrs242@juno.com> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 0-1,3,9-13 From: Deborah M Gessner Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 33554560 0 1 P1C470.CNM Hi Gang I need some help here,(all input welcome) Long Way Home Search and Rescue that I started may be taking a new turn. I have been ask about making it a regional group and as a task force. To be called Long Way Home Regional Task Force, to include all special rescues like: SAR, Dive, Tactical, Rope, Cave, Confined space, Extracation including all types of it, Urban SAR, Collapsed building, and anything else that comes up. Regional would be all surrounding fire depts. and rescue squads in our Valley. Should we do this or stay a small sar group? And if we did do it how would we go about doing it? I NEED BIG HELP WITH THIS ONE Can respond here or at : longwayhome-regional-task-force@juno.com Thank You Deborah Gessner at Dublin,Va. ___________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com/getjuno.html or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 18 Mar 1999 23:11:46 -0500 (EST) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 18 Mar 1999 23:11:09 -0500 (EST) Received: via switchmail; Thu, 18 Mar 1999 23:11:07 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 18 Mar 1999 23:09:51 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 18 Mar 1999 23:08:56 -0500 (EST) Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 18 Mar 1999 23:08:34 -0500 (EST) Received: from 136.142.57.10.pitt.edu (ehdup-t-91.rmt.net.pitt.edu [136.142.23.101]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 18 Mar 1999 23:08:26 -0500 (EST) Message-Id: <199903190408.XAA18068@post-ofc05.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: Mkeowl@aol.com Date: Thu, 18 Mar 1999 23:08:02 -0500 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED Betadine allergy CC: wilderness-emergency-medicine@list.pitt.edu In-reply-to: X-mailer: Pegasus Mail for Win32 (v3.01d) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P3FEB0.CNM On 17 Mar 99, at 11:49, Mkeowl@aol.com wrote: > Anyway, for my SAR dog and I, I keep and have used diluted Calendula > Tincture or Goldenseal Tincture to clean and flush the wounds. For > punctures or deep wounds I ONLY use Ledum Tincture, diluted, then > Goldenseal. > > I have used these successfully many times. (My conventional vet who is > open- minded, said that he is amazed that some of the wounds -- severe > punctures, lacerations, >10" torn tissue wounds, healed so well without > ANY antibiotics or conventional drugs.) The recommended treatment for contaminated wounds is high- pressure irrigation with plain sterile (or at least clean) water or saline -- even betadine has tissue-toxic properties (though much less so than peroxide, alcohol, merthiolite, or tincture of iodine). So I'm not surprised that you've had good results with homeopathic tinctures -- which are to a very high approximation, distilled water -- as this essentially is the irrigant of choice! The chance of a standard homeopathic dilution actually containing even a molecule of Calendula or Goldenseal is tiny. Certainly homepathic succussed dilutions are much better for irrigating wounds than alcohol, peroxide or the like. And this sort of "superiority" is what led to Hahnemann's success compared to the quacks of his time who were giving toxic drugs. But luckily, we now have better scientific methods to evaluate drugs, including trials that use randomization and blinding and matched control groups to prevent bias. Much better than Hahnemann's provings. Take care. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 18 Mar 1999 12:39:09 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 18 Mar 1999 12:38:28 -0500 (EST) Received: via switchmail; Thu, 18 Mar 1999 12:38:27 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 18 Mar 1999 12:37:13 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 18 Mar 1999 12:36:49 -0500 (EST) Received: from mail.rwth-aachen.de (mail.RWTH-Aachen.DE [137.226.144.9]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 18 Mar 1999 12:36:39 -0500 (EST) From: ca.t@iname.com Received: from iname.com (s4m061.dialup.RWTH-Aachen.DE) by mail.rwth-aachen.de (PMDF V5.1-12 #30440) with ESMTP id <01J8ZHC8NJFI0002A9@mail.rwth-aachen.de> for wilderness-emergency-medicine@list.pitt.edu; Thu, 18 Mar 1999 18:27:25 +0100 Date: Thu, 18 Mar 1999 18:29:24 +0100 Subject: Re: W-EMED EMT-B-course To: wilderness-emergency-medicine@list.pitt.edu Message-id: <36F137F4.73967EA@iname.com> MIME-version: 1.0 X-Mailer: Mozilla 4.05 [de]C-QXW0310a (Win95; I) Content-type: text/plain; charset=us-ascii Content-transfer-encoding: 7bit References: <36F0C121.BC919B32@iname.com> <19990318.094303.13422.0.pcrs242@juno.com> Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P1FC10.CNM Thanks, I am looking forward to your answer. Christian Deborah M Gessner schrieb: > Christian > We are having several courses in our area, EMT-B and higher I will see if > anything is set for the date you need . I am in Dublin, Va. and normally > classes of some sort are being held within a one hour radius of here all > the time. > I will check and get back to you. > Deborah Gessner EMT, SAR-Coordinator > Dublin Va. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 18 Mar 1999 11:10:33 -0500 (EST) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 18 Mar 1999 11:09:46 -0500 (EST) Received: via switchmail; Thu, 18 Mar 1999 11:09:45 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 18 Mar 1999 11:06:19 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 18 Mar 1999 11:05:50 -0500 (EST) Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 18 Mar 1999 11:05:44 -0500 (EST) Received: from emed.upmc.edu (pphled03.dwing.upmc.edu [128.147.175.164]) by post-ofc05.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Thu, 18 Mar 1999 11:05:34 -0500 (EST) Received: from EMERG_MED/SpoolDir by emed.upmc.edu (Mercury 1.21); 18 Mar 99 11:21:28 -0500 Received: from SpoolDir by EMERG_MED (Mercury 1.30); 18 Mar 99 11:21:13 -0500 Received: from JTG.isd.upmc.edu by emed.upmc.edu (Mercury 1.30); 18 Mar 99 11:21:09 -0500 From: "Jack T. Grandey" To: Subject: RE: W-EMED EMT-B-course Date: Thu, 18 Mar 1999 11:05:10 -0500 Message-ID: <000001be7159$1a4f8680$7215e59d@JTG.isd.upmc.edu> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 8bit X-Priority: 3 (Normal) X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook 8.5, Build 4.71.2173.0 Importance: Normal X-MimeOLE: Produced By Microsoft MimeOLE V4.72.2106.4 In-Reply-To: <36F0C121.BC919B32@iname.com> Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P1C9B0.CNM There are a number of classes that may meet your needs through the Center for Emergency Medicine. Information on their programs can be found at: http://www.pitt.edu/~cemwp/ Information on WEMT courses is at: http://www.wemsi.org JTG Jack T. Grandey, NREMT-P Director UPMC MedCall                                                  Operations Director UPMC Health System                                     Wilderness EMS Institute http://www.upmc.edu/                                         http://www.wemsi.org/ -----Original Message----- From: owner-wilderness-emergency-medicine@list.pitt.edu [mailto:owner-wilderness-emergency-medicine@list.pitt.edu]On Behalf Of ca.t@iname.com Sent: Thursday, March 18, 1999 04:02 To: wilderness-emergency-medicine@list.pitt.edu Subject: W-EMED EMT-B-course Maybe someone of the list could help me with my problem. I am a German EMT (posted here once before and met a lot of people) looking for a possibility to attend EMT-classes. I´ve had one course already settled, the flight is booked, but I´ve been informed yesterday that the school is going to be closed. I am now looking for a full-time EMT-course ANYWHERE from 7/12 to 8/19/99. EMT-B, higher levels and WEMT would do. If you could help me, please let me know. Christian Neitzel ca.t@iname.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 18 Mar 1999 09:53:06 -0500 (EST) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 18 Mar 1999 09:52:22 -0500 (EST) Received: via switchmail; Thu, 18 Mar 1999 09:52:20 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 18 Mar 1999 09:51:11 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 18 Mar 1999 09:50:28 -0500 (EST) Received: from m4.boston.juno.com (m4.boston.juno.com [205.231.101.198]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 18 Mar 1999 09:50:20 -0500 (EST) Received: (from pcrs242@juno.com) by m4.boston.juno.com (queuemail) id D5ZH4HMX; Thu, 18 Mar 1999 09:49:55 EST To: wilderness-emergency-medicine@list.pitt.edu Cc: wilderness-emergency-medicine@list.pitt.edu Date: Thu, 18 Mar 1999 09:43:01 -0500 Subject: Re: W-EMED EMT-B-course Message-ID: <19990318.094303.13422.0.pcrs242@juno.com> References: <36F0C121.BC919B32@iname.com> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 0,4-28 From: Deborah M Gessner Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 33554560 0 1 P79710.CNM Christian We are having several courses in our area, EMT-B and higher I will see if anything is set for the date you need . I am in Dublin, Va. and normally classes of some sort are being held within a one hour radius of here all the time. I will check and get back to you. Deborah Gessner EMT, SAR-Coordinator Dublin Va. On Thu, 18 Mar 1999 10:02:25 +0100 ca.t@iname.com writes: >Maybe someone of the list could help me with my problem. I am a German >EMT (posted here once before and met a lot of people) looking for a >possibility to attend EMT-classes. I´ve had one course already >settled, >the flight is booked, but I´ve been informed yesterday that the school >is going to be closed. >I am now looking for a full-time EMT-course ANYWHERE from 7/12 to >8/19/99. EMT-B, higher levels and WEMT would do. If you could help me, >please let me know. > >Christian Neitzel >ca.t@iname.com >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe >wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu > ___________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com/getjuno.html or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 18 Mar 1999 11:59:39 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 18 Mar 1999 11:59:01 -0500 (EST) Received: via switchmail; Thu, 18 Mar 1999 11:59:01 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 18 Mar 1999 11:57:24 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 18 Mar 1999 11:56:59 -0500 (EST) Received: from imo13.mx.aol.com (imo13.mx.aol.com [198.81.17.3]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 18 Mar 1999 11:56:52 -0500 (EST) From: Mkeowl@aol.com Received: from Mkeowl@aol.com by imo13.mx.aol.com (IMOv19.3) id hLNBa17140; Thu, 18 Mar 1999 11:52:35 -0500 (EST) Message-ID: <9faea364.36f12f53@aol.com> Date: Thu, 18 Mar 1999 11:52:35 EST To: wilderness-emergency-medicine@list.pitt.edu, ben@wildmed.com Mime-Version: 1.0 Subject: Re: W-EMED EMT-B-course Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 236 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P731D0.CNM Christian, Sorry this info was lost. ben@wildmed.com This is the school where I received my WEMT... Linda R. Uihlein in VA Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 18 Mar 1999 11:52:06 -0500 (EST) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 18 Mar 1999 11:51:17 -0500 (EST) Received: via switchmail; Thu, 18 Mar 1999 11:51:16 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 18 Mar 1999 11:48:43 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 18 Mar 1999 11:48:26 -0500 (EST) Received: from imo15.mx.aol.com (imo15.mx.aol.com [198.81.17.5]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 18 Mar 1999 11:48:23 -0500 (EST) From: Mkeowl@aol.com Received: from Mkeowl@aol.com by imo15.mx.aol.com (IMOv19.3) id hNZZa20480; Thu, 18 Mar 1999 11:47:24 -0500 (EST) Message-ID: <42e7525d.36f12e1c@aol.com> Date: Thu, 18 Mar 1999 11:47:24 EST To: wilderness-emergency-medicine@list.pitt.edu, ben@wildmed.com Mime-Version: 1.0 Subject: Re: W-EMED EMT-B-course Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 236 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P5EA90.CNM Dear Christian, I've included The Wilderness Medical Associates in this post (the WEMT school where I received my WEMT). VERY good instructor for my first WEMT certification. They also offer an EMT class. You might ask for their schedule and see if they can help you. Good luck, Linda R. Uihlein in VA Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 18 Mar 1999 06:04:15 -0500 (EST) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 18 Mar 1999 06:03:39 -0500 (EST) Received: via switchmail; Thu, 18 Mar 1999 06:03:38 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 18 Mar 1999 06:01:39 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 18 Mar 1999 06:01:17 -0500 (EST) Received: from mail.rwth-aachen.de (mail.RWTH-Aachen.DE [137.226.144.9]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 18 Mar 1999 06:01:13 -0500 (EST) From: ca.t@iname.com Received: from iname.com (s4m048.dialup.RWTH-Aachen.DE) by mail.rwth-aachen.de (PMDF V5.1-12 #30440) with ESMTP id <01J8YZMP95TA0002LH@mail.rwth-aachen.de> for wilderness-emergency-medicine@list.pitt.edu; Thu, 18 Mar 1999 10:00:27 +0100 Date: Thu, 18 Mar 1999 10:02:25 +0100 Subject: W-EMED EMT-B-course To: wilderness-emergency-medicine@list.pitt.edu Message-id: <36F0C121.BC919B32@iname.com> MIME-version: 1.0 X-Mailer: Mozilla 4.05 [de]C-QXW0310a (Win95; I) Content-type: text/plain; charset=iso-8859-1 Content-transfer-encoding: 8BIT Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P71140.CNM Maybe someone of the list could help me with my problem. I am a German EMT (posted here once before and met a lot of people) looking for a possibility to attend EMT-classes. I´ve had one course already settled, the flight is booked, but I´ve been informed yesterday that the school is going to be closed. I am now looking for a full-time EMT-course ANYWHERE from 7/12 to 8/19/99. EMT-B, higher levels and WEMT would do. If you could help me, please let me know. Christian Neitzel ca.t@iname.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 17 Mar 1999 11:57:21 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 17 Mar 1999 11:56:38 -0500 (EST) Received: via switchmail; Wed, 17 Mar 1999 11:56:37 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 17 Mar 1999 11:51:28 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 17 Mar 1999 11:50:51 -0500 (EST) Received: from imo15.mx.aol.com (imo15.mx.aol.com [198.81.17.5]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 17 Mar 1999 11:50:48 -0500 (EST) From: Mkeowl@aol.com Received: from Mkeowl@aol.com by imo15.mx.aol.com (IMOv19.3) id hOTUa12463 for ; Wed, 17 Mar 1999 11:49:29 -0500 (EST) Message-ID: Date: Wed, 17 Mar 1999 11:49:29 EST To: wilderness-emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: Re: W-EMED Betadine allergy Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 236 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 35127424 0 1 P38B60.CNM I am holistic (specifically, Homeopathic). I WOULD be interested in feedback from the MDs. (I have been treating myself and my animals for >6 years and under the care of a Homeopathic, MD, several Homeopathic DVMs -- only way, IMHO, to do it right...) Anyway, for my SAR dog and I, I keep and have used diluted Calendula Tincture or Goldenseal Tincture to clean and flush the wounds. For punctures or deep wounds I ONLY use Ledum Tincture, diluted, then Goldenseal. I have used these successfully many times. (My conventional vet who is open- minded, said that he is amazed that some of the wounds -- severe punctures, lacerations, >10" torn tissue wounds, healed so well without ANY antibiotics or conventional drugs.) I do want to emphasize that I have studied and learned about Homeopathy for 7 years and taken several weeks of classes. This is not an easy subject, but I believe in our over-drugged world, a growing class of Complimentary Medicine. Respectfully submitted, Linda R. Uihlein in VA Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 17 Mar 1999 11:54:10 -0500 (EST) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 17 Mar 1999 11:53:30 -0500 (EST) Received: via switchmail; Wed, 17 Mar 1999 11:53:28 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 17 Mar 1999 11:51:48 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 17 Mar 1999 11:51:31 -0500 (EST) Received: from imo12.mx.aol.com (imo12.mx.aol.com [198.81.17.2]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 17 Mar 1999 11:51:27 -0500 (EST) From: Mkeowl@aol.com Received: from Mkeowl@aol.com by imo12.mx.aol.com (IMOv19.3) id hJOIa28756 for ; Wed, 17 Mar 1999 11:49:26 -0500 (EST) Message-ID: <119289b4.36efdd16@aol.com> Date: Wed, 17 Mar 1999 11:49:26 EST To: wilderness-emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: Re: W-EMED Betadine allergy Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 236 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P1DE10.CNM I am holistic (specifically, Homeopathic). I WOULD be interested in feedback from the MDs. (I have been treating myself and my animals for >6 years and under the care of a Homeopathic, MD, several Homeopathic DVMs -- only way, IMHO, to do it right...) Anyway, for my SAR dog and I, I keep and have used diluted Calendula Tincture or Goldenseal Tincture to clean and flush the wounds. For punctures or deep wounds I ONLY use Ledum Tincture, diluted, then Goldenseal. I have used these successfully many times. (My conventional vet who is open- minded, said that he is amazed that some of the wounds -- severe punctures, lacerations, >10" torn tissue wounds, healed so well without ANY antibiotics or conventional drugs.) I do want to emphasize that I have studied and learned about Homeopathy for 7 years and taken several weeks of classes. This is not an easy subject, but I believe in our over-drugged world, a growing class of Complimentary Medicine. Respectfully submitted, Linda R. Uihlein in VA Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 17 Mar 1999 08:42:27 -0500 (EST) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 17 Mar 1999 08:41:49 -0500 (EST) Received: via switchmail; Wed, 17 Mar 1999 08:41:47 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 17 Mar 1999 08:41:28 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 17 Mar 1999 08:40:39 -0500 (EST) Received: from imo21.mx.aol.com (imo21.mx.aol.com [198.81.17.65]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 17 Mar 1999 08:40:32 -0500 (EST) From: DonCraft@aol.com Received: from DonCraft@aol.com by imo21.mx.aol.com (IMOv19.3) id hPHBa08602 for ; Wed, 17 Mar 1999 08:39:43 -0500 (EST) Message-ID: Date: Wed, 17 Mar 1999 08:39:43 EST To: Wilderness-Emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: W-EMED Betadine allergy Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 205 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P5D660.CNM Sorry about the previous message...It was a mix up... I am wondering what would be a good substitute for betadine in my kit...I have a friend who is very alergic to it. Also, is betadine allergy a common concern? Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 8 Mar 1999 23:58:31 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 8 Mar 1999 23:57:54 -0500 (EST) Received: via switchmail; Mon, 8 Mar 1999 23:57:54 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 8 Mar 1999 23:56:52 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 8 Mar 1999 23:53:10 -0500 (EST) Received: from titan.tcn.net (root@titan.tcn.net [199.166.4.2]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 8 Mar 1999 23:52:58 -0500 (EST) Received: from one (comp35.tcn.net [209.135.79.35]) by titan.tcn.net (8.8.5/8.6.9) with SMTP id XAA10393 for ; Mon, 8 Mar 1999 23:51:42 -0500 (EST) Message-Id: <199903090451.XAA10393@titan.tcn.net> X-Sender: broche@titan.tcn.net X-Mailer: QUALCOMM Windows Eudora Pro Version 4.0 Date: Mon, 08 Mar 1999 23:52:53 +0000 To: wilderness-emergency-medicine@list.pitt.edu From: Bernie Roche Subject: W-EMED Source of Article Needed (? Rick Meyers?) Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P146F0.CNM Hi, all: I've had an inquiry about a cute little article which I added to our WEMSI web site a while back, entitled "All I Ever Needed to Know I learned From My Dog". I had added "This page is dedicated to Rick Meyers". rick, if you're listening, did you send this article to me, or to our mailing list? I need to identify the source, if possible. Thanks, and Best Wishes, Bernie Roche, RN, BScN, W-EMT, OSJ WEMSI Web Site Administrator http://www.wemsi.org/ broche@tcn.net Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 10 Mar 1999 10:56:12 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 10 Mar 1999 10:55:34 -0500 (EST) Received: via switchmail; Wed, 10 Mar 1999 10:55:32 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 10 Mar 1999 10:55:12 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 10 Mar 1999 10:54:36 -0500 (EST) Received: from relay.icon.co.za (relay.icon.co.za [196.26.208.4]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 10 Mar 1999 10:54:31 -0500 (EST) Received: (qmail 1104 invoked from network); 10 Mar 1999 15:53:57 -0000 Received: from mail450.icon.co.za (196.26.208.3) by relay.icon.co.za with SMTP; 10 Mar 1999 15:53:57 -0000 Received: from icon.co.za (m2-50-ndf.dial-up.net [196.34.156.114]) by mail450.icon.co.za (8.9.3/8.8.8) with ESMTP id RAA25301; Wed, 10 Mar 1999 17:53:52 +0200 (GMT) Message-ID: <36E3D39B.243E1F49@icon.co.za> Date: Mon, 08 Mar 1999 15:41:47 +0200 From: Arthur Morgan X-Mailer: Mozilla 4.04 [en] (Win95; U) MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu, Jay J Wiseman Subject: Re: W-EMED Shock: Does raising the legs really help? References: <199903042019.PAA29914@post-ofc04.srv.cis.pitt.edu> <19990305.082547.20582.0.JayWiseman@juno.com> X-Corel-MessageType: EMail Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P0AAC0.CNM Hello all , I don't have any literature with me , but as I understand it , there are two things to consider : If the patient is on a rigid support such as a long spine board , and the foot end is elevated there will be a *small* increase in the venous return to the heart and so an increase in cardiac output . This may be of limited help , but there will be a *large* decrease in the ability of most people to breathe , and so there will be a large decrease in the oxygenation of the blood . Taken together this means that the oxygen delivery to the body will decrease - not what is usually wanted . Note that with high paraplegia and quadriplegia where the patient is just able to breathe , there may be an INCREASE in the ventilation in the head down position because of the effect on the shape of the diaphragm . If the head and trunk are left horizontal , and just the lower limbs are elevated there will still be some increase in venous return , but very little effect on breathing . If there is a critically low blood pressure there may be some shunting of blood from the lower limbs to the central organs . All this means a possible small increase in oxygen delivery to the central organs - a good thing . There will be little danger , BUT if there are too few rescuers time and effort will be wasted , with little beneficial return . I suggest that lower limbs only be raised , and only if other treatment is not decreased . Somebody else can tell us how to do this whilst moving through rough country . I suspect that not much good research has been done in human patients . I have often moved shocked patients from a head down position to a horizontal one , with an improvement in their clinical state . During a rescue keep the patient as horizontal as possible , and don't move him roughly . An intravenous infusion of fluid will do more for the patient . Arthur Jay J Wiseman wrote: > > Hi folks, > > Jay here -- researching this issue for a friend of mine. Anybody got any > juicy info one way or the other? > > Many thanks, > > > I wonder if you might provide some elucidation, or point me in the > right > > direction to find what I'm looking for. I've been teaching wilderness > > emergency care for many years, and formerly worked in EMS training. > I've > > recently become involved with an organization that is rather vehement > that > > elevating a patient's legs is not indicated for the prevention or > treatment > > of shock. It would seem that the Red Cross also adopts this stance. > Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sun, 7 Mar 1999 12:22:04 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sun, 7 Mar 1999 12:21:28 -0500 (EST) Received: via switchmail; Sun, 7 Mar 1999 12:21:28 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sun, 7 Mar 1999 12:20:53 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sun, 7 Mar 1999 12:17:26 -0500 (EST) Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sun, 7 Mar 1999 12:17:23 -0500 (EST) Received: from emed.upmc.edu (pphled03.dwing.upmc.edu [128.147.175.164]) by post-ofc05.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Sun, 7 Mar 1999 12:17:21 -0500 (EST) Received: from EMERG_MED/SpoolDir by emed.upmc.edu (Mercury 1.21); 7 Mar 99 12:31:37 -0500 Received: from SpoolDir by EMERG_MED (Mercury 1.30); 7 Mar 99 12:31:25 -0500 Received: from JTG.isd.upmc.edu by emed.upmc.edu (Mercury 1.30); 7 Mar 99 12:31:16 -0500 From: "Jack T. Grandey" To: Subject: RE: W-EMED WEMT Classes Date: Sun, 7 Mar 1999 12:13:51 -0500 Message-ID: <002301be68bd$dfd8fd40$84c79380@JTG.isd.upmc.edu> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 8bit X-Priority: 3 (Normal) X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook 8.5, Build 4.71.2173.0 Importance: Normal In-reply-to: <19990306.160422.30054.0.pcrs242@juno.com> X-MimeOLE: Produced By Microsoft MimeOLE V4.72.2106.4 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P1C550.CNM Deborah: A complete list of scheduled WEMT classes, using the WEMSI curriculum is available on our web site, http://www.wemsi.org The one that I know of that is closest to you is scheduled for Aug 14-22, 1999, near Elkins, WV. Complete information is available at: http://svis.org/erncrc/erncrc.htm Select 1999 ER-NCRC Weeklong Information. Feel free to email me directly, if you need anything further. JTG Jack T. Grandey, NREMT-P Director UPMC MedCall                                                  Operations Director UPMC Health System                                     Wilderness EMS Institute http://www.upmc.edu/                                         http://www.wemsi.org/ -----Original Message----- From: owner-wilderness-emergency-medicine@list.pitt.edu [mailto:owner-wilderness-emergency-medicine@list.pitt.edu]On Behalf Of Deborah M Gessner Sent: Saturday, March 06, 1999 16:04 To: wilderness-emergency-medicine@list.pitt.edu Subject: W-EMED WEMT Classes Hi Deborah here, I have started a SAR group that is a branch off of our rescue squad for special rescue Long Way Home Search and Rescue, we are located in Southwest Va.in Dublin,Va.. Some are sar certified through VAVRS(Va.Assoc.of Volunteer Rescue Squads) and some are certified Va. Dept. of Emergency Services SAR,some are both and all are EMT's. Does anyone know of a WEMT class near us we can take, drive to and not cost to much for traveling expense's and any information would be appreciated. Also I am still trying to finish writhing the POP's & SOP's to turn in to the county so everyone will be working on the same sheet of music. If any one can help me on this all is welcome. Here is email address for help with POP's & SOP's on it I will send you the address, fax # , and any thing else you need for this. I hope there are some WEMT classes close, also we were given a Dog to use for SAR, Her name is Harley, she is 3/4 lab & 1/4 chow she has a perfect sniffer I just nee to get her trained. Thanks to all , I love this list it is great info. Deborah Dublin, Va. ___________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com/getjuno.html or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: From: Self To: Patton Turner Subject: Re: W-EMED Anaphylaxis and Antihistimines Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Sun, 7 Mar 1999 12:00:16 -0500 On 6 Mar 99, at 0:09, Patton Turner wrote: > > I note in the WEMS Med kit list oral Benadryl (Diphenhydramine) is > recommended as a fast acting antihistimine. However, both Anakits and > USFS Insect Sting Kits use chewable chlorpheniramine tablets. Is this > only because Benadryl isn't available in a chewable form, or is there some > other benefit. You'd have to ask whoever designed the Anakit why they chose chlorpheniramine (e.g., Chlor-Trimeton). Diphenhydramine (e.g., Benadryl) is by far the most recommended antihistamine for acute allergic reactions -- chlorpheniramine will work, though. The usual escalation by dermatologists is: 1. diphenhydramine; if that isn't working, try: 2. hydroxyzine (e.g., Atarax, Vistaril); if that isn't working, try: 3. cyproheptadine (e.g., Periactin). All are sedating antihistamines, but are also all much more effective than the new nonsedating antihistamines. I personally like chlorpheniramine for occasional chronic allergy problems, because it's not quite as sedating as diphenhydramine, but it's not quite as effective an antihistamine, either. -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 6 Mar 1999 22:23:37 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 6 Mar 1999 22:23:36 -0500 (EST) Received: via switchmail; Sat, 6 Mar 1999 22:23:35 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 6 Mar 1999 22:22:18 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 6 Mar 1999 22:20:16 -0500 (EST) Received: from gull.prod.itd.earthlink.net (gull.prod.itd.earthlink.net [207.217.120.85]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 6 Mar 1999 22:20:13 -0500 (EST) Received: from f_wu1.ColoradoCollege.edu (1Cust206.tnt2.den2.da.uu.net [208.251.249.206]) by gull.prod.itd.earthlink.net (8.8.7/8.8.5) with SMTP id TAA25452 for ; Sat, 6 Mar 1999 19:20:11 -0800 (PST) Message-Id: <199903070320.TAA25452@gull.prod.itd.earthlink.net> X-Sender: F_Wu@tikki.ColoradoCollege.edu X-Mailer: QUALCOMM Windows Eudora Pro Version 4.0 Date: Sat, 06 Mar 1999 20:23:04 -0700 To: wilderness-emergency-medicine@list.pitt.edu From: Fred Wu Subject: Re: W-EMED WEMT Classes In-Reply-To: <19990306.160422.30054.0.pcrs242@juno.com> Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P5EE60.CNM Deborah, You might want to check with these 3 organizations: Wilderness Medicine Institute, www.wildernessmed.com Wilderness Medical Associates, www.wildmed.com SOLO, www.stonehearth.com Fred At 04:04 PM 3/6/99 -0500, you wrote: >Hi Deborah here, > > I have started a SAR group that is a branch off of our rescue squad >for special rescue Long Way Home Search and Rescue, we are located in >Southwest Va.in Dublin,Va.. Some are sar certified through >VAVRS(Va.Assoc.of Volunteer Rescue Squads) and some are certified Va. >Dept. of Emergency Services SAR,some are both and all are EMT's. >Does anyone know of a WEMT class near us we can take, drive to and not >cost to much for traveling expense's and any information would be >appreciated. >Also I am still trying to finish writhing the POP's & SOP's to turn in to >the county so everyone will be working on the same sheet of music. If >any one can help me on this all is welcome. >Here is email address for help with POP's & SOP's on it I will send you >the >address, fax # , and any thing else you need for this. > I hope there are some WEMT classes close, also we were given a Dog >to use for SAR, Her name is Harley, she is 3/4 lab & 1/4 chow she has a >perfect >sniffer I just nee to get her trained. > >Thanks to all , I love this list it is great info. >Deborah >Dublin, Va. > >___________________________________________________________________ >You don't need to buy Internet access to use free Internet e-mail. >Get completely free e-mail from Juno at http://www.juno.com/getjuno.html >or call Juno at (800) 654-JUNO [654-5866] >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu > Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 6 Mar 1999 16:18:10 -0500 (EST) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 6 Mar 1999 16:18:08 -0500 (EST) Received: via switchmail; Sat, 6 Mar 1999 16:18:08 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 6 Mar 1999 16:17:05 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 6 Mar 1999 16:16:45 -0500 (EST) Received: from m1.boston.juno.com (m1.boston.juno.com [205.231.100.199]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 6 Mar 1999 16:16:42 -0500 (EST) Received: (from pcrs242@juno.com) by m1.boston.juno.com (queuemail) id D43BEX7G; Sat, 06 Mar 1999 16:16:05 EST To: wilderness-emergency-medicine@list.pitt.edu Date: Sat, 6 Mar 1999 16:09:33 -0500 Subject: W-EMED WEMT classes Message-ID: <19990306.160933.30054.1.pcrs242@juno.com> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 0-3 From: Deborah M Gessner Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 33554560 0 1 P57F30.CNM Deborah again, Sorry I forgot to include the other email address: longwayhome-sar@juno.com ___________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com/getjuno.html or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 6 Mar 1999 16:17:30 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 6 Mar 1999 16:14:11 -0500 (EST) Received: via switchmail; Sat, 6 Mar 1999 16:14:11 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 6 Mar 1999 16:12:42 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 6 Mar 1999 16:11:54 -0500 (EST) Received: from m1.boston.juno.com (m1.boston.juno.com [205.231.100.199]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 6 Mar 1999 16:11:48 -0500 (EST) Received: (from pcrs242@juno.com) by m1.boston.juno.com (queuemail) id D43A5A2C; Sat, 06 Mar 1999 16:10:48 EST To: wilderness-emergency-medicine@list.pitt.edu Date: Sat, 6 Mar 1999 16:04:21 -0500 Subject: W-EMED WEMT Classes Message-ID: <19990306.160422.30054.0.pcrs242@juno.com> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 0-1,6,9,12,14-15,18-23 From: Deborah M Gessner Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 33554560 0 1 P60B30.CNM Hi Deborah here, I have started a SAR group that is a branch off of our rescue squad for special rescue Long Way Home Search and Rescue, we are located in Southwest Va.in Dublin,Va.. Some are sar certified through VAVRS(Va.Assoc.of Volunteer Rescue Squads) and some are certified Va. Dept. of Emergency Services SAR,some are both and all are EMT's. Does anyone know of a WEMT class near us we can take, drive to and not cost to much for traveling expense's and any information would be appreciated. Also I am still trying to finish writhing the POP's & SOP's to turn in to the county so everyone will be working on the same sheet of music. If any one can help me on this all is welcome. Here is email address for help with POP's & SOP's on it I will send you the address, fax # , and any thing else you need for this. I hope there are some WEMT classes close, also we were given a Dog to use for SAR, Her name is Harley, she is 3/4 lab & 1/4 chow she has a perfect sniffer I just nee to get her trained. Thanks to all , I love this list it is great info. Deborah Dublin, Va. ___________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com/getjuno.html or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 5 Mar 1999 22:03:45 -0500 (EST) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 5 Mar 1999 22:00:24 -0500 (EST) Received: via switchmail; Fri, 5 Mar 1999 22:00:24 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Mar 1999 21:59:42 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 5 Mar 1999 21:56:18 -0500 (EST) Received: from Montu.kynd.net (mail@montu.kynd.net [208.162.108.5]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 5 Mar 1999 21:56:14 -0500 (EST) Received: from frhcg [208.167.52.214] by Montu.kynd.net with smtp (Exim 1.62 #1) id 10J7HW-0000ud-00 (Debian); Fri, 5 Mar 1999 21:57:39 -0500 Message-ID: <000a01be677d$4f4d6e00$02000003@frhcg> From: "Oldfield Family" To: Cc: , Subject: Re: W-EMED Wilderness First Aid and Wilderness First Responder Classes Date: Fri, 5 Mar 1999 21:59:08 -0500 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 4.72.3155.0 X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3155.0 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu Apples and oranges dont always cost or taste the same either- You referred to an advanced course in wilderness first aid not meeting the standards of a basic course you reviewed- does the advanced course meet the standard for the advanced first aid? Taking into consideration you are comparing a wilderness course to Red Cross first aid for city folk, What if any thought did your service give to that and what where those thoughts? -----Original Message----- From: Keith Conover, M.D., FACEP To: wilderness-emergency-medicine@list.pitt.edu Cc: asrc-bod@virginia.edu ; EMS-L@listserv.ACNS.NWU.EDU Date: Thursday, March 04, 1999 4:45 PM Subject: W-EMED Wilderness First Aid and Wilderness First Responder Classes You can make your own decision about what this means, I'm just reporting. 1. The recommended minimum Wilderness First Responder (WFR) course content, published by the Wilderness Medical Society, goes against the Wilderness First Responder standards established by ASTM F-30 Committee on EMS -- that WFR training is built on the National Standard Curriculum for First Responders, and is an extension to that training. Thus, it is possible for a WFR course to meet the minimum WMS content but to not meet the ASTM standards or to be able to be certified as First Responders by a state EMS agency. 2. I was at a meeting of the Medical Advisory Committee of the Pennsylvania Emergency Health Services Council today. One of our jobs is to determine which first aid courses should be recognized as equivalent to the American Red Cross Standard First Aid course -- for purposes of protection under the state Good Samaritan law. We reviewed several National Safety Council (NSC) first aid classes, and found them all equivalent to ARC Standard First Aid -- except for the NSC Advanced Wilderness First Aid class, which leaves out some material covered in the ARC Standard First Aid class. Thus, if you've taken the NSC Advanced Wilderness First Aid class, you don't have the same protection as someone who has taken ARC Standard First Aid or quite a number of courses that have been recognized as equivalent in our state. Again, read into this what you will -- Good Samaritan protection doesn't mean much in my opinion, and I'm in favor of WFR being based on the DOT FR training and the ASTM F-30 standards. Your actual mileage may differ. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 5 Mar 1999 19:21:43 -0500 (EST) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 5 Mar 1999 19:18:23 -0500 (EST) Received: via switchmail; Fri, 5 Mar 1999 19:18:22 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Mar 1999 19:18:00 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 5 Mar 1999 19:15:53 -0500 (EST) Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 5 Mar 1999 19:15:48 -0500 (EST) Received: from 136.142.57.10.pitt.edu (ehdup-f2-12.rmt.net.pitt.edu [136.142.21.102]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 5 Mar 1999 19:15:45 -0500 (EST) Message-Id: <199903060015.TAA16513@post-ofc04.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: TOBY58@aol.com Date: Fri, 5 Mar 1999 19:15:44 -0500 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED Wilderness First Aid and Wilderness First Responder Classes CC: wilderness-emergency-medicine@list.pitt.edu In-reply-to: X-mailer: Pegasus Mail for Win32 (v3.01d) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P70220.CNM On 5 Mar 99, at 9:24, TOBY58@aol.com wrote: > I take it that all of this also perttains to the WEMT class that I'm > currently in, or is this diferent? I doubt it. Most WEMT classes either add onto your existing EMT- Basic (or above) or include _all_ that is needed to get an EMT-Basic. There is no national standard for WEMT, however, so it's up to you to make sure that your WEMT provider, if it's an EMT and WEMT class combined, makes sure you can sit for state and National Registry EMT tests and get the certification. If it's a WEMT module, which is an add-on for people with existing EMT certificates, it's just a continuing education class and you only need to be concerned if you need con-ed credit for recertifying your EMT. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 6 Mar 1999 23:17:15 -0500 (EST) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 6 Mar 1999 23:17:13 -0500 (EST) Received: via switchmail; Sat, 6 Mar 1999 23:17:12 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 6 Mar 1999 23:15:41 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 6 Mar 1999 23:13:48 -0500 (EST) Received: from camel8.mindspring.com (camel8.mindspring.com [207.69.200.58]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 6 Mar 1999 23:13:42 -0500 (EST) Received: from LOCALNAME (user-38lcaj9.dialup.mindspring.com [209.86.42.105]) by camel8.mindspring.com (8.8.5/8.8.5) with SMTP id XAA27642 for ; Sat, 6 Mar 1999 23:13:41 -0500 (EST) Message-Id: <3.0.1.16.19990306000946.2ff7dde8@pop.mindspring.com> X-Sender: pmturner@pop.mindspring.com X-Mailer: Windows Eudora Light Version 3.0.1 (16) Date: Sat, 06 Mar 1999 00:09:46 To: wilderness-emergency-medicine@list.pitt.edu From: Patton Turner Subject: W-EMED Anaphylaxis and Antihistimines In-Reply-To: <199903070320.TAA25452@gull.prod.itd.earthlink.net> References: <19990306.160422.30054.0.pcrs242@juno.com> Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 35127424 0 1 P20600.CNM I note in the WEMS Med kit list oral Benadryl (Diphenhydramine) is recommended as a fast acting antihistimine. However, both Anakits and USFS Insect Sting Kits use chewable chlorpheniramine tablets. Is this only because Benadryl isn't available in a chewable form, or is there some other benefit. Patton Turner Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: From: Self To: TOBY58@aol.com Subject: Re: W-EMED Wilderness First Aid and Wilderness First Responder Classes Cc: wilderness-emergency-medicine@list.pitt.edu Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Fri, 5 Mar 1999 19:09:38 -0500 On 5 Mar 99, at 9:24, TOBY58@aol.com wrote: > I take it that all of this also perttains to the WEMT class that I'm > currently in, or is this diferent? I doubt it. Most WEMT classes either add onto your existing EMT- Basic (or above) or include _all_ that is needed to get an EMT-Basic. There is no national standard for WEMT, however, so it's up to you to make sure that your WEMT provider, if it's an EMT and WEMT class combined, makes sure you can sit for state and National Registry EMT tests and get the certification. If it's a WEMT module, which is an add-on for people with existing EMT certificates, it's just a continuing education class and you only need to be concerned if you need con-ed credit for recertifying your EMT. -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 5 Mar 1999 11:29:17 -0500 (EST) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 5 Mar 1999 11:29:00 -0500 (EST) Received: via switchmail; Fri, 5 Mar 1999 11:29:00 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Mar 1999 11:27:22 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 5 Mar 1999 11:25:26 -0500 (EST) Received: from x5.boston.juno.com (x5.boston.juno.com [205.231.100.23]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 5 Mar 1999 11:25:20 -0500 (EST) Received: (from jaywiseman@juno.com) by x5.boston.juno.com (queuemail) id D4X8DHVG; Fri, 05 Mar 1999 11:25:08 EST To: wilderness-emergency-medicine@list.pitt.edu Date: Fri, 5 Mar 1999 08:25:47 -0800 Subject: W-EMED Shock: Does raising the legs really help? Message-ID: <19990305.082547.20582.0.JayWiseman@juno.com> References: <199903042019.PAA29914@post-ofc04.srv.cis.pitt.edu> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 0-2,4-7,9-10,12,14,16,18,20-22,24-26,28-30 From: Jay J Wiseman Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 33554560 0 1 P39E30.CNM Hi folks, Jay here -- researching this issue for a friend of mine. Anybody got any juicy info one way or the other? Many thanks, > I wonder if you might provide some elucidation, or point me in the right > direction to find what I'm looking for. I've been teaching wilderness > emergency care for many years, and formerly worked in EMS training. I've > recently become involved with an organization that is rather vehement that > elevating a patient's legs is not indicated for the prevention or treatment > of shock. It would seem that the Red Cross also adopts this stance. I've > heard arguments ranging from lack of evidence that it's helpful to claims > that it's harmful and the effect is the reverse of what's intended. > > I find this difficult to swallow without proof. I notice that Bowman still > advocates raising legs in the 3rd ed. of Outdoor Emergency Care. > > Do you have any insight into this debate? Do you know of any studies or > data that support either side of the debate? > ___________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com/getjuno.html or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 4 Mar 1999 21:16:13 -0500 (EST) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 4 Mar 1999 21:16:02 -0500 (EST) Received: via switchmail; Thu, 4 Mar 1999 21:16:02 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 4 Mar 1999 21:14:16 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 4 Mar 1999 21:13:56 -0500 (EST) Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 4 Mar 1999 21:13:50 -0500 (EST) Received: from 136.142.57.10.pitt.edu (ehdup-c2-8.rmt.net.pitt.edu [136.142.20.158]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 4 Mar 1999 21:13:36 -0500 (EST) Message-Id: <199903050213.VAA00640@post-ofc05.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: "Langley R. Muir" Date: Thu, 4 Mar 1999 21:13:30 -0500 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED Wilderness First Aid and Wilderness First Responder Classes CC: wilderness-emergency-medicine@list.pitt.edu In-reply-to: <3.0.5.32.19990304192737.007bf180@magma.ca> References: <199903042019.PAA29914@post-ofc04.srv.cis.pitt.edu> X-mailer: Pegasus Mail for Win32 (v3.01d) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P1BEB0.CNM On 4 Mar 99, at 19:27, Langley R. Muir wrote: > > 1. ..... Thus, it is possible for a WFR course to > >meet the minimum WMS content but to not meet the ASTM > >standards or to be able to be certified as First Responders by a > >state EMS agency. > > > >2. ...Thus, if you've taken the NSC Advanced Wilderness > >First Aid class, you don't have the same protection as someone who > >has taken ARC Standard First Aid or quite a number of courses that > >have been recognized as equivalent in our state. > > > >Again, read into this what you will -- Good Samaritan protection > >doesn't mean much in my opinion, and I'm in favor of WFR being based > >on the DOT FR training and the ASTM F-30 standards. Your actual > >mileage may differ. > > > >--Keith Conover, M.D., FACEP > Keith: The import of this would be much enhanced if you told us what is > missing from the curricula - then we could make some sort of judgement. It > would also allow someone to decide to add in the missing bits. Certainly. I don't have the entire curriculum in front of me, the detail work was done by the PEHSC staff. They noted that the wilderness first aid course left out any mention of preventive measures for coronary heart disease. There may have been some other missing items as well. I'll cc: PEHSC directly and see if the staff member who did the comparison can give a more detailed answer about what was missing in the NSC Advanced Wilderness First Aid course compared to ARC standard first aid. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: From: Self To: "Langley R. Muir" Subject: Re: W-EMED Wilderness First Aid and Wilderness First Responder Classes Cc: wilderness-emergency-medicine@list.pitt.edu Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Thu, 4 Mar 1999 21:10:38 -0500 On 4 Mar 99, at 19:27, Langley R. Muir wrote: > > 1. ..... Thus, it is possible for a WFR course to > >meet the minimum WMS content but to not meet the ASTM > >standards or to be able to be certified as First Responders by a > >state EMS agency. > > > >2. ...Thus, if you've taken the NSC Advanced Wilderness > >First Aid class, you don't have the same protection as someone who > >has taken ARC Standard First Aid or quite a number of courses that > >have been recognized as equivalent in our state. > > > >Again, read into this what you will -- Good Samaritan protection > >doesn't mean much in my opinion, and I'm in favor of WFR being based > >on the DOT FR training and the ASTM F-30 standards. Your actual > >mileage may differ. > > > >--Keith Conover, M.D., FACEP > Keith: The import of this would be much enhanced if you told us what is > missing from the curricula - then we could make some sort of judgement. It > would also allow someone to decide to add in the missing bits. Certainly. I don't have the entire curriculum in front of me, the detail work was done by the PEHSC staff. They noted that the wilderness first aid course left out any mention of preventive measures for coronary heart disease. There may have been some other missing items as well. I'll cc: PEHSC directly and see if the staff member who did the comparison can give a more detailed answer about what was missing in the NSC Advanced Wilderness First Aid course compared to ARC standard first aid. -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 4 Mar 1999 20:00:45 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 4 Mar 1999 19:27:02 -0500 (EST) Received: via switchmail; Thu, 4 Mar 1999 19:27:01 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 4 Mar 1999 19:26:34 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 4 Mar 1999 19:24:41 -0500 (EST) Received: from mx1.magmacom.com (mx1.magmacom.com [206.191.0.217]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 4 Mar 1999 19:24:32 -0500 (EST) Received: from mail2.magma.ca (mail2x.magma.ca [206.191.0.220]) by mx1.magmacom.com (8.9.1a/8.9.1) with ESMTP id TAA11481 for ; Thu, 4 Mar 1999 19:24:30 -0500 (EST) Received: from default (x2port84.magma.ca [206.191.28.84]) by mail2.magma.ca (8.9.1a/8.9.1) with SMTP id TAA21848 for ; Thu, 4 Mar 1999 19:24:29 -0500 (EST) Message-Id: <3.0.5.32.19990304192737.007bf180@magma.ca> X-Sender: langley@magma.ca X-Mailer: QUALCOMM Windows Eudora Light Version 3.0.5 (32) Date: Thu, 04 Mar 1999 19:27:37 -0500 To: wilderness-emergency-medicine@list.pitt.edu From: "Langley R. Muir" Subject: Re: W-EMED Wilderness First Aid and Wilderness First Responder Classes In-Reply-To: <199903042019.PAA29914@post-ofc04.srv.cis.pitt.edu> Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 35127424 0 1 P074B0.CNM At 15:19 04/03/1999 -0500, you wrote: 1. ..... Thus, it is possible for a WFR course to >meet the minimum WMS content but to not meet the ASTM >standards or to be able to be certified as First Responders by a >state EMS agency. > >2. ...Thus, if you've taken the NSC Advanced Wilderness >First Aid class, you don't have the same protection as someone who >has taken ARC Standard First Aid or quite a number of courses that >have been recognized as equivalent in our state. > >Again, read into this what you will -- Good Samaritan protection >doesn't mean much in my opinion, and I'm in favor of WFR being >based on the DOT FR training and the ASTM F-30 standards. Your >actual mileage may differ. > >--Keith Conover, M.D., FACEP Keith: The import of this would be much enhanced if you told us what is missing from the curricula - then we could make some sort of judgement. It would also allow someone to decide to add in the missing bits. Cheers. Langley Dr. Langley R. Muir 4 Valewood Crescent 1-613-824-9391 (voice) Gloucester, Ontario 1-613-824-2875 (fax) Canada cc913@ncf.ca K1B 4E8 Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 4 Mar 1999 15:20:41 -0500 (EST) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 4 Mar 1999 15:20:32 -0500 (EST) Received: via switchmail; Thu, 4 Mar 1999 15:20:31 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 4 Mar 1999 15:20:05 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 4 Mar 1999 15:19:16 -0500 (EST) Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 4 Mar 1999 15:19:12 -0500 (EST) Received: from 136.142.57.10.pitt.edu (ehdup-a2-4.rmt.net.pitt.edu [136.142.20.34]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 4 Mar 1999 15:19:09 -0500 (EST) Message-Id: <199903042019.PAA29914@post-ofc04.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: wilderness-emergency-medicine@list.pitt.edu Date: Thu, 4 Mar 1999 15:19:08 -0500 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: W-EMED Wilderness First Aid and Wilderness First Responder Classes CC: asrc-bod@virginia.edu, EMS-L@listserv.acns.nwu.edu X-mailer: Pegasus Mail for Win32 (v3.01d) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu You can make your own decision about what this means, I'm just reporting. 1. The recommended minimum Wilderness First Responder (WFR) course content, published by the Wilderness Medical Society, goes against the Wilderness First Responder standards established by ASTM F-30 Committee on EMS -- that WFR training is built on the National Standard Curriculum for First Responders, and is an extension to that training. Thus, it is possible for a WFR course to meet the minimum WMS content but to not meet the ASTM standards or to be able to be certified as First Responders by a state EMS agency. 2. I was at a meeting of the Medical Advisory Committee of the Pennsylvania Emergency Health Services Council today. One of our jobs is to determine which first aid courses should be recognized as equivalent to the American Red Cross Standard First Aid course -- for purposes of protection under the state Good Samaritan law. We reviewed several National Safety Council (NSC) first aid classes, and found them all equivalent to ARC Standard First Aid -- except for the NSC Advanced Wilderness First Aid class, which leaves out some material covered in the ARC Standard First Aid class. Thus, if you've taken the NSC Advanced Wilderness First Aid class, you don't have the same protection as someone who has taken ARC Standard First Aid or quite a number of courses that have been recognized as equivalent in our state. Again, read into this what you will -- Good Samaritan protection doesn't mean much in my opinion, and I'm in favor of WFR being based on the DOT FR training and the ASTM F-30 standards. Your actual mileage may differ. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: From: Self To: wilderness-emergency-medicine@list.pitt.edu Subject: Wilderness First Aid and Wilderness First Responder Classes Cc: EMS-L@listserv.ACNS.NWU.EDU Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Thu, 4 Mar 1999 15:17:33 -0500 You can make your own decision about what this means, I'm just reporting. 1. The recommended minimum Wilderness First Responder (WFR) course content, published by the Wilderness Medical Society, goes against the Wilderness First Responder standards established by ASTM F-30 Committee on EMS -- that WFR training is built on the National Standard Curriculum for First Responders, and is an extension to that training. Thus, it is possible for a WFR course to meet the minimum WMS content but to not meet the ASTM standards or to be able to be certified as First Responders by a state EMS agency. 2. I was at a meeting of the Medical Advisory Committee of the Pennsylvania Emergency Health Services Council today. One of our jobs is to determine which first aid courses should be recognized as equivalent to the American Red Cross Standard First Aid course -- for purposes of protection under the state Good Samaritan law. We reviewed several National Safety Council (NSC) first aid classes, and found them all equivalent to ARC Standard First Aid -- except for the NSC Advanced Wilderness First Aid class, which leaves out some material covered in the ARC Standard First Aid class. Thus, if you've taken the NSC Advanced Wilderness First Aid class, you don't have the same protection as someone who has taken ARC Standard First Aid or quite a number of courses that have been recognized as equivalent in our state. Again, read into this what you will -- Good Samaritan protection doesn't mean much in my opinion, and I'm in favor of WFR being based on the DOT FR training and the ASTM F-30 standards. Your actual mileage may differ. -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Mar 1999 10:14:14 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Mar 1999 10:13:58 -0500 (EST) Received: via switchmail; Tue, 2 Mar 1999 10:13:58 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Mar 1999 10:12:03 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Mar 1999 10:10:15 -0500 (EST) Received: from imo29.mx.aol.com (imo29.mx.aol.com [198.81.17.73]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Mar 1999 10:10:10 -0500 (EST) From: MikeValora@aol.com Received: from MikeValora@aol.com by imo29.mx.aol.com (IMOv19.3) id fVOa022135 for ; Tue, 2 Mar 1999 10:08:54 -0500 (EST) Message-ID: <2792d494.36dbff06@aol.com> Date: Tue, 2 Mar 1999 10:08:54 EST To: wilderness-emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: Re: W-EMED Medicine Chest Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 2.5 for Windows Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P5BAF0.CNM About six years ago SOLO started a program with an Organization called Geomed, the purpose is to bring healthcare to impoverished areas of the world. They have been working in El Salvador for at least 4 or 5 years and would be a good resource to you. Their number is 603-356-6939. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Mar 1999 06:27:49 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Mar 1999 06:27:39 -0500 (EST) Received: via switchmail; Tue, 2 Mar 1999 06:27:39 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Mar 1999 06:26:01 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Mar 1999 06:25:51 -0500 (EST) Received: from imo16.mx.aol.com (imo16.mx.aol.com [198.81.17.6]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Mar 1999 06:25:46 -0500 (EST) From: Caverbru@aol.com Received: from Caverbru@aol.com by imo16.mx.aol.com (IMOv18.1) id 3QLWa04305 for ; Tue, 2 Mar 1999 06:24:25 -0500 (EST) Message-ID: Date: Tue, 2 Mar 1999 06:24:25 EST To: wilderness-emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: Re: W-EMED FW: foul language Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 4 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P26E10.CNM I agree it was not appropriate, but I laughed a lot and will forward to more appropriate places. Bru Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Mar 1999 06:26:24 -0500 (EST) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Mar 1999 06:26:16 -0500 (EST) Received: via switchmail; Tue, 2 Mar 1999 06:26:16 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Mar 1999 06:25:51 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Mar 1999 06:25:20 -0500 (EST) Received: from imo14.mx.aol.com (imo14.mx.aol.com [198.81.17.4]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Mar 1999 06:25:17 -0500 (EST) From: Caverbru@aol.com Received: from Caverbru@aol.com by imo14.mx.aol.com (IMOv18.1) id XGRBa05501 for ; Tue, 2 Mar 1999 06:24:21 -0500 (EST) Message-ID: Date: Tue, 2 Mar 1999 06:24:21 EST To: wilderness-emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: Re: W-EMED Medicine Chest Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 4 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P532A0.CNM You after going through the official channels you might also want to find out what development agencies like Peace Corps, CARE, Save the Children, OXFAM and others are doing. Bru Randall Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Mar 1999 01:01:47 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Mar 1999 01:01:34 -0500 (EST) Received: via switchmail; Tue, 2 Mar 1999 01:01:34 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Mar 1999 01:00:45 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Mar 1999 01:00:31 -0500 (EST) Received: from m1.boston.juno.com (m1.boston.juno.com [205.231.100.199]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Mar 1999 01:00:29 -0500 (EST) Received: (from pcrs242@juno.com) by m1.boston.juno.com (queuemail) id D4PDEMQ2; Tue, 02 Mar 1999 00:59:58 EST To: wilderness-emergency-medicine@list.pitt.edu Date: Tue, 2 Mar 1999 00:53:42 -0500 Subject: Re: W-EMED another one of those why do i do this stuff things Message-ID: <19990302.005343.4566.1.pcrs242@juno.com> References: <199902220345.DAA00487@out.fetchmail.com> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 13,22-26,28-74 From: Deborah M Gessner Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 33554560 0 1 P26D40.CNM On this subject, I'm not paid for what I do, I am a VOLUNTEER and proud of it. Don't get me wrong but I couldn't do it for money . See I am giving back to the county for what they have done for me and my family. Our crew has been in operation for 50 years this past July 16,1998. We have always been a volunteer organizations until a 3-4 years back. Our daylight calls we were having trouble getting them answered so we ask for a few paid people to help us out on days only. Well all *#*#* broke loose Co. paid a group $40,000.00 to do a study to tell tell them what we had already ask of them EXCEPT they said we needed them round the clock and there has been bad feelings ever since. They make us feel like we are no good like dirt, I am sure not all paid people are like that. A lot have quit but I am still there I am a life time member. I love what I do and I have learned a lot in the past 25 years from telephone to beepers and plectrons to pagers and cell phones. Rescue will always be a part of me in my heart and my head. It is a blessing to see a life saved or born, the smile or thank you, big little or small, male female child or adult , and no matter what the situation it will always be worth it to me. We get very little thanks for the job we do volunteer or paid But it is all out of love for GOD's Children and the gift of life. If you are married then they should of know the kind of person you are and what you would do and be there by you side no Matter what. THE GIFT OF LIFE- SO OTHERS MAY LIVE---- NO GREATER MAN THAN HE WHO LAY DOWN HIS LIFE FOR ANOTHER Deborah Pulaski Co Life Saving Crew pcrs242 also Coordinator Pulaski Co. Long Way Home Search and Rescue email: longwayhome-sar@juon.com On Mon, 22 Feb 1999 03:45:00 0000 David Grog an writes: >Sitting around the station, late at night, after running 10 to 12 >calls already >can cause a man/woman to think. Is it really worth it? We leave our >families >behind and fulfill our dream of being an EMT/Paramedic. What happens >when the >long hours and stressful calls take their toll. Some turn their backs >on EMS >forever. Most, however, move on to another aspect of the field of >medicine. This >requires returning to school and earning or furthering degrees. > >Is it wrong that we want to better our lives and the lives of our >family >members? I think not, but often we meet resistance from the service we >work for. >This can come in many forms. Excuses such as staffing, or "Why would >you EVER >want to leave here." Sometimes only the "favorites" recieve time off >required to >continue their education. > >EMS services all to often consider their employees as possessions and >not the >commodities that they are. We are hard working professionals that want >only to >better ourselves. We want to give our families a nice home, our kids a >good >education, and save a little of ourselves for retirement. > >So, the next time your supervisor questions your intentions, ask him >one >question. "Did you want to be a 'GRUNT' your whole career?" If he >answers "YES", >then it's apparent that he never had one ounce of ambition. > >.....and that's all I have to say about that. >___________________________________________________________________ >Sent via BigAssWeb - free email service at http://www.bigassweb.com > >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe >wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu > ___________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com/getjuno.html or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Mar 1999 08:47:17 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Mar 1999 08:47:08 -0500 (EST) Received: via switchmail; Tue, 2 Mar 1999 08:47:07 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Mar 1999 08:45:29 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Mar 1999 08:43:36 -0500 (EST) Received: from hotmail.com (f23.hotmail.com [207.82.250.233]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Mar 1999 08:43:33 -0500 (EST) Received: (qmail 13285 invoked by uid 0); 2 Mar 1999 13:43:01 -0000 Message-ID: <19990302134301.13284.qmail@hotmail.com> Received: from 198.250.223.115 by www.hotmail.com with HTTP; Tue, 02 Mar 1999 05:42:58 PST X-Originating-IP: [198.250.223.115] From: "Chris Adams DO" To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Vit-C & Snakes Date: Tue, 02 Mar 1999 05:42:58 PST Mime-Version: 1.0 Content-type: text/plain Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P03910.CNM Perhaps you are supposed to crush up the tablets and rub them on the bite...just kidding...NO use for vit c in this case. >From owner-wilderness-emergency-medicine@list.pitt.edu Mon Mar 1 10:36:09 1999 >Received: from localhost (majordom@localhost) > by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) > ID ; > Mon, 1 Mar 1999 13:02:35 -0500 (EST) >Received: from Montu.kynd.net (mail@montu.kynd.net [208.162.108.5]) > by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) > ID for ; > Mon, 1 Mar 1999 13:02:29 -0500 (EST) >Received: from frhcg [208.167.52.161] > by Montu.kynd.net with smtp (Exim 1.62 #1) > id 10HX1Q-0005hH-00 (Debian); Mon, 1 Mar 1999 13:02:28 -0500 >Message-ID: <003301be640e$13842660$02000003@frhcg> >From: "Oldfield Family" >To: >Subject: Re: W-EMED Vit-C & Snakes >Date: Mon, 1 Mar 1999 13:05:21 -0500 >MIME-Version: 1.0 >Content-Type: text/plain; > charset="iso-8859-1" >Content-Transfer-Encoding: 7bit >X-Priority: 3 >X-MSMail-Priority: Normal >X-Mailer: Microsoft Outlook Express 4.72.3155.0 >X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3155.0 >Sender: owner-wilderness-emergency-medicine@list.pitt.edu >Precedence: bulk >Reply-To: wilderness-emergency-medicine@list.pitt.edu > >Perhaps it's to remove the metallic taste in your mouth from the hem toxin? > >Ronald D. Oldfield PA-C >CPT, SP, MEARNG >Emergency Medicine >-----Original Message----- >From: allenro >To: 'wilderness-emergency-medicine@list.pitt.edu' > >Date: Monday, March 01, 1999 12:03 PM >Subject: RE: W-EMED Vit-C & Snakes > > >>I can't think of any reason why Vitamin C would be useful in treatment >>of a poisonous snakebite, and with all due modesty, I know quite a bit >>about the management of venomous snakebite. >> >>Where did you hear this? >> >>Rob Allen >> >>Robert C. Allen, DO, FACEP >>Lt Col, USAF MC FS >>Group Surgeon >>720th Special Tactics Group (AFSOC) >>Hurlburt Field FL >>e-mail: allenro@stn.hurlburt.af.mil >> >> >>> -----Original Message----- >>> From: Hound [SMTP:Bloodhnd@wvinter.net] >>> Sent: Sunday, February 28, 1999 10:43 AM >>> To: wilderness-emergency-medicine@list.pitt.edu >>> Subject: W-EMED Vit-C & Snakes >>> >>> Yes, well I was told to carry Vit-C with me in case of snake bite and >>> wondered if someone could tell me what it does to help a snakebite >>> situation >>> ??? >>> >>> Most Assuredly Hound !!! >>> Daniel and Lonesome ReubenCGC >>> http://greenday.ntu.edu/daxe/hound/hound.htm >>> http://WWW.BLOODHOUNDS.COM/guide >>> >>> Do not reproduce without author's express permission. >>> To unsubscribe, send the text "unsubscribe >>> wilderness-emergency-medicine" >>> as the body of a message (no subject) To: Majordomo@list.pitt.edu >>> Submissions To: wilderness-emergency-medicine@list.pitt.edu >>Do not reproduce without author's express permission. >>To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >>as the body of a message (no subject) To: Majordomo@list.pitt.edu >>Submissions To: wilderness-emergency-medicine@list.pitt.edu >> > >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu > ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Mar 1999 00:26:37 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Mar 1999 00:26:28 -0500 (EST) Received: via switchmail; Tue, 2 Mar 1999 00:26:27 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Mar 1999 00:25:40 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Mar 1999 00:24:31 -0500 (EST) Received: from m1.boston.juno.com (m1.boston.juno.com [205.231.100.199]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Mar 1999 00:24:25 -0500 (EST) Received: (from pcrs242@juno.com) by m1.boston.juno.com (queuemail) id D4PBCVYY; Tue, 02 Mar 1999 00:24:04 EST To: wilderness-emergency-medicine@list.pitt.edu Date: Tue, 2 Mar 1999 00:17:47 -0500 Subject: Re: W-EMED another one of those why do i do this stuff things Message-ID: <19990302.001748.4566.0.pcrs242@juno.com> References: <199902220345.DAA00487@out.fetchmail.com> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 0-6,8-54 From: Deborah M Gessner Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 33554560 0 1 P53650.CNM Dave, may I copy your letter some people in our group need to hear this Thank you for this Deb, Pulaski Co.Life saving crew 242 also I am Coordinator for our SAR group called Long Way Home Search and Rescue longwayhome-sar@juno.come On Mon, 22 Feb 1999 03:45:00 0000 David Grog an writes: >Sitting around the station, late at night, after running 10 to 12 >calls already >can cause a man/woman to think. Is it really worth it? We leave our >families >behind and fulfill our dream of being an EMT/Paramedic. What happens >when the >long hours and stressful calls take their toll. Some turn their backs >on EMS >forever. Most, however, move on to another aspect of the field of >medicine. This >requires returning to school and earning or furthering degrees. > >Is it wrong that we want to better our lives and the lives of our >family >members? I think not, but often we meet resistance from the service we >work for. >This can come in many forms. Excuses such as staffing, or "Why would >you EVER >want to leave here." Sometimes only the "favorites" recieve time off >required to >continue their education. > >EMS services all to often consider their employees as possessions and >not the >commodities that they are. We are hard working professionals that want >only to >better ourselves. We want to give our families a nice home, our kids a >good >education, and save a little of ourselves for retirement. > >So, the next time your supervisor questions your intentions, ask him >one >question. "Did you want to be a 'GRUNT' your whole career?" If he >answers "YES", >then it's apparent that he never had one ounce of ambition. > >.....and that's all I have to say about that. >___________________________________________________________________ >Sent via BigAssWeb - free email service at http://www.bigassweb.com > >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe >wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu > ___________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com/getjuno.html or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 1 Mar 1999 17:37:52 -0500 (EST) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 1 Mar 1999 17:37:32 -0500 (EST) Received: via switchmail; Mon, 1 Mar 1999 17:37:31 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 1 Mar 1999 17:36:55 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 1 Mar 1999 17:36:19 -0500 (EST) Received: from shepherd.hurlburt.af.mil (shepherd.hurlburt.af.mil [151.166.15.65]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 1 Mar 1999 17:36:16 -0500 (EST) Received: from shepherd.hurlburt.af.mil (root@localhost) by shepherd.hurlburt.af.mil with ESMTP id QAA06180 for ; Mon, 1 Mar 1999 16:28:05 -0600 (CST) Received: from emh.stn.hurlburt.af.mil (emh.stn.hurlburt.af.mil [151.166.160.105]) by shepherd.hurlburt.af.mil with ESMTP id QAA06176 for ; Mon, 1 Mar 1999 16:28:04 -0600 (CST) Received: by emh with Internet Mail Service (5.5.1960.3) id ; Mon, 1 Mar 1999 16:30:45 -0600 Message-ID: From: allenro To: "'wilderness-emergency-medicine@list.pitt.edu'" Subject: RE: W-EMED Vit-C & Snakes Date: Mon, 1 Mar 1999 16:30:44 -0600 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.1960.3) Content-Type: text/plain Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P1A0E0.CNM I've heard some pretty wild things about field treatment of snakebite, including applying electrical shock, pouring whiskey on it, put a sugar cube on it, ice water immersion, tourniquets, cut and suck... Given that anywhere between 30% and 40% of pit viper bites are dry strikes, any or all of these techniques might appear to be effective in an anecdotal report. However, there is no scientific validity to any of them, and none are currently recommended by experts in the field. This is the first I've heard of putting vitamin-C on a snakebite wound. I supposed the assumption is that the ascorbic acid will denature or otherwise deactivate the venom. I have serious doubts that this would be effective, but I have no scientific data to refute (or validate) this treatment: Don't know of anybody who might have done work on this. My recommendation for pit viper snakebite first aid is to apply an extractor pump, and beat feet to the ER (I'm +/- on constriction bands...OK is somebody with medical experience puts it on, not happy with laymen doing it. I find that layfolks usually end up putting on an tourniquet rather than a constriction band.). Regards, Rob Allen, DO, FACEP > -----Original Message----- > From: Hound [SMTP:Bloodhnd@wvinter.net] > Sent: Tuesday, March 02, 1999 5:29 AM > To: wilderness-emergency-medicine@list.pitt.edu > Subject: Re: W-EMED Vit-C & Snakes > > Hi Rob, > Well, really were'nt talken to me specifically when stated, but > the > general list > which Im not sure of the name . Have to cut down on e-mail lists I > guess". > Was told to apply tablet to wound. > Said would slow the poison's affectivness?! > > > >Where did you hear this? > > > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe > wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 1 Mar 1999 16:00:20 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 1 Mar 1999 15:27:10 -0500 (EST) Received: via switchmail; Mon, 1 Mar 1999 15:27:10 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 1 Mar 1999 15:27:01 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 1 Mar 1999 15:24:45 -0500 (EST) Received: from alma.wvinter.net (root@alma.wvinter.net [208.132.210.3]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 1 Mar 1999 15:24:40 -0500 (EST) Received: from default (usr2-032.wvinter.net [208.162.196.135]) by alma.wvinter.net (8.8.7/8.8.7) with SMTP id QAA00841 for ; Mon, 1 Mar 1999 16:29:26 -0500 Message-ID: <000d01be6422$16a48920$87c4a2d0@default> From: "Hound" To: Subject: Re: W-EMED Vit-C & Snakes Date: Mon, 1 Mar 1999 15:28:36 -0500 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 5.00.0810.800 X-MimeOLE: Produced By Microsoft MimeOLE V5.00.0810.800 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P699C0.CNM Hi Rob, Well, really were'nt talken to me specifically when stated, but the general list which Im not sure of the name . Have to cut down on e-mail lists I guess". Was told to apply tablet to wound. Said would slow the poison's affectivness?! > >Where did you hear this? Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 1 Mar 1999 13:06:45 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 1 Mar 1999 13:06:34 -0500 (EST) Received: via switchmail; Mon, 1 Mar 1999 13:06:33 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 1 Mar 1999 13:04:44 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 1 Mar 1999 13:02:35 -0500 (EST) Received: from Montu.kynd.net (mail@montu.kynd.net [208.162.108.5]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 1 Mar 1999 13:02:29 -0500 (EST) Received: from frhcg [208.167.52.161] by Montu.kynd.net with smtp (Exim 1.62 #1) id 10HX1Q-0005hH-00 (Debian); Mon, 1 Mar 1999 13:02:28 -0500 Message-ID: <003301be640e$13842660$02000003@frhcg> From: "Oldfield Family" To: Subject: Re: W-EMED Vit-C & Snakes Date: Mon, 1 Mar 1999 13:05:21 -0500 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 4.72.3155.0 X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3155.0 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P6ABC0.CNM Perhaps it's to remove the metallic taste in your mouth from the hem toxin? Ronald D. Oldfield PA-C CPT, SP, MEARNG Emergency Medicine -----Original Message----- From: allenro To: 'wilderness-emergency-medicine@list.pitt.edu' Date: Monday, March 01, 1999 12:03 PM Subject: RE: W-EMED Vit-C & Snakes >I can't think of any reason why Vitamin C would be useful in treatment >of a poisonous snakebite, and with all due modesty, I know quite a bit >about the management of venomous snakebite. > >Where did you hear this? > >Rob Allen > >Robert C. Allen, DO, FACEP >Lt Col, USAF MC FS >Group Surgeon >720th Special Tactics Group (AFSOC) >Hurlburt Field FL >e-mail: allenro@stn.hurlburt.af.mil > > >> -----Original Message----- >> From: Hound [SMTP:Bloodhnd@wvinter.net] >> Sent: Sunday, February 28, 1999 10:43 AM >> To: wilderness-emergency-medicine@list.pitt.edu >> Subject: W-EMED Vit-C & Snakes >> >> Yes, well I was told to carry Vit-C with me in case of snake bite and >> wondered if someone could tell me what it does to help a snakebite >> situation >> ??? >> >> Most Assuredly Hound !!! >> Daniel and Lonesome ReubenCGC >> http://greenday.ntu.edu/daxe/hound/hound.htm >> http://WWW.BLOODHOUNDS.COM/guide >> >> Do not reproduce without author's express permission. >> To unsubscribe, send the text "unsubscribe >> wilderness-emergency-medicine" >> as the body of a message (no subject) To: Majordomo@list.pitt.edu >> Submissions To: wilderness-emergency-medicine@list.pitt.edu >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu > Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 1 Mar 1999 10:52:51 -0500 (EST) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 1 Mar 1999 10:52:41 -0500 (EST) Received: via switchmail; Mon, 1 Mar 1999 10:52:40 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 1 Mar 1999 10:50:19 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 1 Mar 1999 10:47:10 -0500 (EST) Received: from shepherd.hurlburt.af.mil (shepherd.hurlburt.af.mil [151.166.15.65]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 1 Mar 1999 10:47:01 -0500 (EST) Received: from shepherd.hurlburt.af.mil (root@localhost) by shepherd.hurlburt.af.mil with ESMTP id JAA07064 for ; Mon, 1 Mar 1999 09:38:43 -0600 (CST) Received: from emh.stn.hurlburt.af.mil (emh.stn.hurlburt.af.mil [151.166.160.105]) by shepherd.hurlburt.af.mil with ESMTP id JAA07060 for ; Mon, 1 Mar 1999 09:38:43 -0600 (CST) Received: by emh with Internet Mail Service (5.5.1960.3) id ; Mon, 1 Mar 1999 09:41:24 -0600 Message-ID: From: allenro To: "'wilderness-emergency-medicine@list.pitt.edu'" Subject: RE: W-EMED Vit-C & Snakes Date: Mon, 1 Mar 1999 09:41:23 -0600 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.1960.3) Content-Type: text/plain Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P073C0.CNM I can't think of any reason why Vitamin C would be useful in treatment of a poisonous snakebite, and with all due modesty, I know quite a bit about the management of venomous snakebite. Where did you hear this? Rob Allen Robert C. Allen, DO, FACEP Lt Col, USAF MC FS Group Surgeon 720th Special Tactics Group (AFSOC) Hurlburt Field FL e-mail: allenro@stn.hurlburt.af.mil > -----Original Message----- > From: Hound [SMTP:Bloodhnd@wvinter.net] > Sent: Sunday, February 28, 1999 10:43 AM > To: wilderness-emergency-medicine@list.pitt.edu > Subject: W-EMED Vit-C & Snakes > > Yes, well I was told to carry Vit-C with me in case of snake bite and > wondered if someone could tell me what it does to help a snakebite > situation > ??? > > Most Assuredly Hound !!! > Daniel and Lonesome ReubenCGC > http://greenday.ntu.edu/daxe/hound/hound.htm > http://WWW.BLOODHOUNDS.COM/guide > > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe > wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sun, 28 Feb 1999 11:16:16 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sun, 28 Feb 1999 11:16:05 -0500 (EST) Received: via switchmail; Sun, 28 Feb 1999 11:16:05 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sun, 28 Feb 1999 11:14:26 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sun, 28 Feb 1999 11:11:09 -0500 (EST) Received: from imo13.mx.aol.com (imo13.mx.aol.com [198.81.17.3]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sun, 28 Feb 1999 11:11:05 -0500 (EST) From: Mkeowl@aol.com Received: from Mkeowl@aol.com by imo13.mx.aol.com (IMOv18.1) id 2YRGa05309 for ; Sun, 28 Feb 1999 11:10:11 -0500 (EST) Message-ID: Date: Sun, 28 Feb 1999 11:10:11 EST To: wilderness-emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: Re: W-EMED Vit-C & Snakes Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 236 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P1BF90.CNM Does the Vit C also work as well in the canine v snake senerio? Linda, Rugby (didn't GET ME...), Chouette (I don't play with them...), and Uiltje (Got me on the tounge but, no envenomation.. %-) .... in VA Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 27 Feb 1999 20:40:54 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 27 Feb 1999 20:40:44 -0500 (EST) Received: via switchmail; Sat, 27 Feb 1999 20:40:44 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 27 Feb 1999 20:39:40 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 27 Feb 1999 20:39:27 -0500 (EST) Received: from alma.wvinter.net (root@alma.wvinter.net [208.132.210.3]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 27 Feb 1999 20:39:24 -0500 (EST) Received: from default (usr2-018.wvinter.net [208.162.196.121]) by alma.wvinter.net (8.8.7/8.8.7) with SMTP id VAA13475 for ; Sat, 27 Feb 1999 21:44:29 -0500 Message-ID: <003301be62bb$b4ff7700$79c4a2d0@default> From: "Hound" To: Subject: W-EMED Vit-C & Snakes Date: Sat, 27 Feb 1999 20:43:13 -0500 MIME-Version: 1.0 Content-Type: text/plain; charset="Windows-1252" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 5.00.0810.800 X-MimeOLE: Produced By Microsoft MimeOLE V5.00.0810.800 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P4A330.CNM Yes, well I was told to carry Vit-C with me in case of snake bite and wondered if someone could tell me what it does to help a snakebite situation ??? Most Assuredly Hound !!! Daniel and Lonesome ReubenCGC http://greenday.ntu.edu/daxe/hound/hound.htm http://WWW.BLOODHOUNDS.COM/guide Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 27 Feb 1999 11:31:21 -0500 (EST) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 27 Feb 1999 11:31:12 -0500 (EST) Received: via switchmail; Sat, 27 Feb 1999 11:31:11 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 27 Feb 1999 11:29:16 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 27 Feb 1999 11:27:09 -0500 (EST) Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 27 Feb 1999 11:27:06 -0500 (EST) Received: from 136.142.57.10.pitt.edu (ehdup-r3-5.rmt.net.pitt.edu [136.142.22.155]) by post-ofc06.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 27 Feb 1999 11:26:52 -0500 (EST) Message-Id: <199902271626.LAA25097@post-ofc06.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: David Grogan Date: Sat, 27 Feb 1999 11:26:48 -0500 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED FW: foul language CC: wilderness-emergency-medicine@list.pitt.edu In-reply-to: <199902270605.GAA31371@out.fetchmail.com> X-mailer: Pegasus Mail for Win32 (v3.01d) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu On 27 Feb 99, at 6:05, David Grogan wrote: > > Foul Language in the Office David, this is off-topic for the wilderness-emergency-medicine list. Please don't send such mail to the list again. I will also send this to the list to ask all list members to restrict their posts to topics appropriate for the list. Thank you. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: From: Self To: David Grogan Subject: Re: W-EMED FW: foul language Cc: wilderness-emergency-medicine@list.pitt.edu Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Sat, 27 Feb 1999 11:12:22 -0500 On 27 Feb 99, at 6:05, David Grogan wrote: > > Foul Language in the Office David, this is off-topic for the wilderness-emergency-medicine list. Please don't send such mail to the list again. I will also send this to the list to ask all list members to restrict their posts to topics appropriate for the list. Thank you. -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 27 Feb 1999 01:08:20 -0500 (EST) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 27 Feb 1999 01:08:09 -0500 (EST) Received: via switchmail; Sat, 27 Feb 1999 01:08:08 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 27 Feb 1999 01:07:47 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 27 Feb 1999 01:05:40 -0500 (EST) Received: from out.fetchmail.com (pecan.coconut.co.uk [195.89.193.97]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 27 Feb 1999 01:05:35 -0500 (EST) Received: from fetchmail.com (out.fetchmail.com [195.89.193.106]) by out.fetchmail.com (8.9.1/8.9.1) with ESMTP id GAA31371; Sat, 27 Feb 1999 06:05:10 GMT Message-Id: <199902270605.GAA31371@out.fetchmail.com> Content-Type: text/plain Content-Disposition: inline Mime-Version: 1.0 X-Mailer: MIME-tools 4.102 (Entity 4.111) From: David Grogan To: Resq_Doll@webtv.com, medic101@mailcity.com, emt-ps@webtv.net, wilderness-emergency-medicine@list.pitt.edu, gjport@Juno.com, timothy.maloney@cwix.com, Dnor25@aol.com, angelface45@mailcity.com, Monypit@Juno.com, MzKymz@webtv.net, cEllis79@webtv.net, dspiker@pathway.net, flyte104@aol.com, medick@hotmail.com, fyrfyter@webtv.net, romclehs@nauticom.net, vocblack@total.net, shanm@webtv.net, vc@execnet.net, medic009@webtv.net Subject: W-EMED FW: foul language Date: Sat, 27 Feb 1999 06:05:10 0000 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 35127424 0 1 P7AB00.CNM Foul Language in the Office It has been brought to management's attention that some individuals throughout the company have been using foul language during the course of normal conversation with their co-workers. Due to complaints received from some employees who may be easily offended, this type of language will be no longer tolerated. We do however, realize the critical importance of being able to accurately express your feelings when communicating with co-workers, therefore, a list of "TRY SAYING" new phrases has been provided so that proper exchange of ideas and information can continue in an effective manner without risk of offending our more sensitive employees. SO: TRY SAYING: Perhaps I can work late. INSTEAD OF: When the fuck do you expect me to do this? TRY SAYING: I'm certain that is not feasible. INSTEAD OF: No fucking way!! TRY SAYING: Really? INSTEAD OF: You've got to be shitting me. TRY SAYING: Perhaps you should check with... INSTEAD OF: Tell someone who gives a shit. TRY SAYING: Of course I'm concerned. INSTEAD OF: Ask me if I give a shit. TRY SAYING: I wasn't involved in the project. INSTEAD OF: It's not my fucking problem. TRY SAYING: That's interesting. INSTEAD OF: What the fuck?!?! TRY SAYING: I'm not sure I can implement this. INSTEAD OF: Fuck it, it won't work. TRY SAYING: I'll try to schedule that. INSTEAD OF: Why the hell didn't you tell me sooner? TRY SAYING: Are you sure this is a problem? INSTEAD OF: Who the fuck cares? TRY SAYING: He's not familiar with the problem. INSTEAD OF: He's got his head up his ass. TRY SAYING: Excuse me sir? INSTEAD OF: Eat shit and die motherfucker. TRY SAYING: So you weren't happy with it? INSTEAD OF: Kiss my ass. TRY SAYING: I'm a bit overloaded at this moment. INSTEAD OF: Fuck it, I'm on salary. TRY SAYING: I don't think you understand. INSTEAD OF: Shove it up your ass. TRY SAYING: I love a challenge. INSTEAD OF: This job sucks. TRY SAYING: You want me to take care of that? INSTEAD OF: Who the hell died and made you boss? TRY SAYING: I see. INSTEAD OF: Blow me. TRY SAYING: Yes, we really should discuss it. INSTEAD OF: Another fucking meeting!!! TRY SAYING: I don't think this will be a problem. INSTEAD OF: I really don't give a shit. TRY SAYING: He's somewhat insensitive. INSTEAD OF: He's a fucking prick. TRY SAYING: She's an aggressive go getter. INSTEAD OF: She's a ball busting bitch. TRY SAYING: I think you could use more training. INSTEAD OF: You don't know what the fuck you're doing. Thanks RU ___________________________________________________________________ Sent via BigAssWeb - free email service at http://www.bigassweb.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 26 Feb 1999 16:59:42 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 26 Feb 1999 16:59:28 -0500 (EST) Received: via switchmail; Fri, 26 Feb 1999 16:59:27 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 26 Feb 1999 16:57:33 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 26 Feb 1999 16:55:33 -0500 (EST) Received: from jason04.u.washington.edu (root@jason04.u.washington.edu [140.142.78.5]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 26 Feb 1999 16:55:27 -0500 (EST) Received: from aagaard02.u.washington.edu (mcmullen@aagaard02.u.washington.edu [140.142.14.4]) by jason04.u.washington.edu (8.9.1+UW98.09/8.9.3+UW99.01) with ESMTP id NAA30694 for ; Fri, 26 Feb 1999 13:55:22 -0800 Received: from localhost (mcmullen@localhost) by aagaard02.u.washington.edu (8.9.1+UW98.09/8.9.2+UW99.01) with ESMTP id NAA36276 for ; Fri, 26 Feb 1999 13:55:21 -0800 Date: Fri, 26 Feb 1999 13:55:20 -0800 (PST) From: Russell McMullen To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED antibiotics in the wilderness In-Reply-To: <00e901be61c9$f3b1f740$02000003@frhcg> Message-ID: MIME-Version: 1.0 Content-Type: TEXT/PLAIN; charset=US-ASCII Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P62420.CNM I believe most would favor levofloxacin as the quinolone of choice for a wilderness medical kit as it: [1] Covers reasonably well most of the relevant infections that ciprofloxacin covers [e.g.: sinusitis, bacterial enteritis, urinary tract infections] [2] Covers Staphylococcus and [particularly] Streptococcus better than ciprofloxacin; thus it would be preferred as treatment for significant skin infections [3] Treats lower respiratory infections better than ciprofloxacin, in particular pneumococcal pneumonia, which ciprofloxacin should not be used for. [4] Is adequate treatment for some of the "atypical" infections that one might consider doxycycline for. [5] Has the convenience of once a day dosing [6] Has a more benign interaction pattern with other medications compared to ciprofloxacin. [7] Has minimal interaction with caffeine [unlike ciprofloxacin] Also, the proscription against quinolone usage in children is based largely on animal studies that demonstrated changes in fetal joint cartilage when the medications were given to pregnant animals. Studies in human children given short courses of quinolones have failed to show evidence of significant immediate joint problems or long-term joint or growth problems. No one would recommend quinolones for pregnant [or nursing] mothers as a matter of course, but many people would use them for SHORT-TERM treatment in children, IF NECESSARY. I certainly would use a quinolone if that is what is available and a child has an infection that requires antibiotics, and I have little concern at all in using them in children in their mid-teens. Also, quinolones are neuroexcitory and should be used with caution in people with a history of seizure disorder. This may neuroexcitation may be more pronounced in older/elderly patients. Quinolones appear to be responsible for tendonitis and also cases of Achille's tendon rupture, although this appears to occur more in the elderly, those with renal insufficiency, and those who already have some evidence of tendonitis. Tendon rupture has been reported more with ciprofloxacin, probably only because it has been used in this country for about 10-11 years. Russell McMullen, M.D. Associate Director, Emergency Medicine Service Co-Director, Travel and Tropical Medicine Service Box 356123 University of Washington Medical Center Seattle, WA 98195 USA 206.598.6205 Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 26 Feb 1999 15:59:27 -0500 (EST) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 26 Feb 1999 15:59:18 -0500 (EST) Received: via switchmail; Fri, 26 Feb 1999 15:59:17 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 26 Feb 1999 15:59:12 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 26 Feb 1999 15:57:19 -0500 (EST) Received: from Montu.kynd.net (mail@montu.kynd.net [208.162.108.5]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 26 Feb 1999 15:57:14 -0500 (EST) Received: from frhcg [208.167.52.212] by Montu.kynd.net with smtp (Exim 1.62 #1) id 10GULD-0002xZ-00 (Debian); Fri, 26 Feb 1999 15:58:35 -0500 Message-ID: <00f601be61ca$fc3878c0$02000003@frhcg> From: "Oldfield Family" To: Subject: Re: W-EMED Ventilators in Wilderness Medicine Date: Fri, 26 Feb 1999 16:00:03 -0500 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 4.72.3155.0 X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3155.0 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P6DCA0.CNM Steve I must Ditto DR Burton Very weight intensive system dependant on large scuba type tanks, the cavalry should definitely bring these assetts on helo , boat , or vehicle. Scrubber is great but even the newer "high Speed" version is excess weight in and out. But definitely a cool toy! -----Original Message----- From: Steve Kelleher To: wilderness-emergency-medicine@list.pitt.edu Date: Tuesday, February 23, 1999 12:54 AM Subject: W-EMED Ventilators in Wilderness Medicine >Has anyone out there used automatic ventilators or demand valves in a >wilderness setting? Pros and Cons? Are they any more efficient than a >standard NRB mask or BVM at conserving oxygen on long transports? Did you >have to obtain permission from your physician advisor on the use of these >devices? > >Steve Kelleher >Alpine Rescue Team >Evergreen, CO. > >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu > Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 26 Feb 1999 15:54:31 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 26 Feb 1999 15:54:18 -0500 (EST) Received: via switchmail; Fri, 26 Feb 1999 15:54:17 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 26 Feb 1999 15:52:15 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 26 Feb 1999 15:50:00 -0500 (EST) Received: from Montu.kynd.net (mail@montu.kynd.net [208.162.108.5]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 26 Feb 1999 15:49:50 -0500 (EST) Received: from frhcg [208.167.52.212] by Montu.kynd.net with smtp (Exim 1.62 #1) id 10GUE3-0002tb-00 (Debian); Fri, 26 Feb 1999 15:51:12 -0500 Message-ID: <00e901be61c9$f3b1f740$02000003@frhcg> From: "Oldfield Family" To: Subject: Re: W-EMED antibiotics in the wilderness Date: Fri, 26 Feb 1999 15:51:06 -0500 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 4.72.3155.0 X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3155.0 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P5A080.CNM Inorder to prpoerly prepare yourself and your party you need to consider some key points: 1. Purpose of your trip 2. Level of Medical training 3. Destination 4. Length of trip 5. Time for evac or med rescue 6. Size of party 7. Bulk weight and cost Note** IV drugs are not wilderness friendly typically temture and light prone,require special equipment and procedures. PO drugs are more stable , simple to carry ,administer, protect and store. MOST RECOMMENDED PO DRUG FOR WILDERNESS / EXPEDITION USE ***DOXCYCLINE*** treats many wilderness processes minimal dosage (BID) good tissue perfusion and plasma times covering both enteric and arthropod diseases. Minimal side effect panel- light sensitivity is minor if properly clothed and erythropoi is more prominent with long term use. CIPRO is Fluroquinoline of choice if you elect to carry one- found that for simple clean adventures flagyl works well- Remember fluro's are not safe in kids or pregnancy and should be used with extreme caution in renal failure,dehydration and at altitude **** KEY ELEMENT IF YOUR NOT UP ON IT DON"T ATTEMPT TO UTILIZE IT*** I generally carry on lite treks a small kit with only the bare essentials-epipen,tylenol,ibuprofen,assorted bandaids,two cravats and safety pins-truly all you need for 5 days or less in general national park to minimal alaskan bush seen. If you would like more specifics feel free to email me, would be glad to help and provide ref for research or study. Ronald D. Oldfield PA-C CPT,SP,MEARNG Emergency Medicine -----Original Message----- From: abrain To: wilderness-emergency-medicine@list.pitt.edu Date: Thursday, February 18, 1999 6:44 PM Subject: W-EMED antibiotics in the wilderness >here is a question to all the Drs. on the list. What would be the best type of >antibiotics to carry for an extended backpacking trip. I'm thinking about both >P.O. and IV antibiotics. >andy > >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu > Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 26 Feb 1999 15:16:19 -0500 (EST) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 26 Feb 1999 15:15:37 -0500 (EST) Received: via switchmail; Fri, 26 Feb 1999 15:15:36 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 26 Feb 1999 15:14:25 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 26 Feb 1999 15:12:35 -0500 (EST) Received: from Montu.kynd.net (mail@montu.kynd.net [208.162.108.5]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 26 Feb 1999 15:12:26 -0500 (EST) Received: from frhcg [208.167.52.129] by Montu.kynd.net with smtp (Exim 1.62 #1) id 10GTdn-0002Ws-00 (Debian); Fri, 26 Feb 1999 15:13:44 -0500 Message-ID: <00d601be61c4$b8257760$02000003@frhcg> From: "Oldfield Family" To: Subject: Re: W-EMED Medicine Chest Date: Fri, 26 Feb 1999 15:15:12 -0500 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 4.72.3155.0 X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3155.0 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P2AE30.CNM WHO is good general reference but unfortunately it is just that a generic go anywhere basic reference. Study your deployment site and environment know the endemic and the high risk elements and plan for that . In todays service there are know bottom less supply chains. Not to mention you only have so much packing space available. Choice between reusable and disposable take the reusable! Ronald D. Oldfield PA-C CPT, SP, MEARNG Emergency Medicine -----Original Message----- From: Chris Adams DO To: wilderness-emergency-medicine@list.pitt.edu Date: Thursday, February 25, 1999 3:04 PM Subject: Re: W-EMED Medicine Chest >Would suggest starting with the New Emergency Health Kit from the World >Health Organization. That at least will give you a starting point to >then add to. > >Info can be obtained by calling the World Health Organization in Geneva >at 41.22.7912111. > >Hope that this helps. > >Chris M. Adams DO CPT,MC,USA >Fort Drum NY > > >>From owner-wilderness-emergency-medicine@list.pitt.edu Wed Feb 24 >21:41:38 1999 >>Received: from [136.142.185.20] by hotmail.com (1.0) with SMTP id >MHotMail309737402731810835185958712291054868399510; Wed Feb 24 21:41:38 >1999 >>Received: from localhost (majordom@localhost) >> by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) >> ID ; >> Wed, 24 Feb 1999 16:10:43 -0500 (EST) >>Received: from enterprise.fuse.net (enterprise-qe1.fuse.net >[206.230.21.11]) >> by list.srv.cis.pitt.edu with ESMTP >(8.8.8/8.8.8/cisls-7.2.2.1) >> ID for >; >> Wed, 24 Feb 1999 16:10:28 -0500 (EST) >>Received: from fuse.net (blackbird-59.day.fuse.net [208.23.223.187]) >> by enterprise.fuse.net (8.8.5/8.8.5) with ESMTP id QAA27026 >> for ; Wed, 24 Feb 1999 >16:10:24 -0500 (EST) >>Message-ID: <36D4973C.57880F3A@fuse.net> >>Date: Wed, 24 Feb 1999 16:20:12 -0800 >>From: Danny Smith >>X-Mailer: Mozilla 4.5 [en] (Win95; I) >>X-Accept-Language: en >>MIME-Version: 1.0 >>To: wilderness-emergency-medicine >> >>Subject: W-EMED Medicine Chest >>Content-Type: text/plain; charset=us-ascii >>Content-Transfer-Encoding: 7bit >>Sender: owner-wilderness-emergency-medicine@list.pitt.edu >>Precedence: bulk >>Reply-To: wilderness-emergency-medicine@list.pitt.edu >> >>In June I will be going on a Humanitarian Medical mission to el >>Salvador. I am open for suggestions as to what to take in terms of >>medical supplies. >> >>___________________________ >>Danny E. Smith USAFR >>EMS Coordinator >>NCOIC Training & Education >>445 ASTS - WPAFB, OH >> >> >>Do not reproduce without author's express permission. >>To unsubscribe, send the text "unsubscribe >wilderness-emergency-medicine" >>as the body of a message (no subject) To: Majordomo@list.pitt.edu >>Submissions To: wilderness-emergency-medicine@list.pitt.edu > > >______________________________________________________ >Get Your Private, Free Email at http://www.hotmail.com >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu > Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 26 Feb 1999 15:16:32 -0500 (EST) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 26 Feb 1999 15:13:06 -0500 (EST) Received: via switchmail; Fri, 26 Feb 1999 15:13:05 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 26 Feb 1999 15:10:47 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 26 Feb 1999 15:06:58 -0500 (EST) Received: from Montu.kynd.net (mail@montu.kynd.net [208.162.108.5]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 26 Feb 1999 15:06:52 -0500 (EST) Received: from frhcg [208.167.52.129] by Montu.kynd.net with smtp (Exim 1.62 #1) id 10GTYS-0002TG-00 (Debian); Fri, 26 Feb 1999 15:08:12 -0500 Message-ID: <00d101be61c3$f2932880$02000003@frhcg> From: "Oldfield Family" To: Subject: Re: W-EMED Medicine Chest Date: Fri, 26 Feb 1999 15:09:41 -0500 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 4.72.3155.0 X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3155.0 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P51460.CNM Sgt Smith Begin with your alotted MTO&E that should be a start and mandated by your unit's designation. Search out the direct purpose of your mission what type of relief,construction of schools and bridges or are you involved in a MEDCAT if so the higher medical command will tell you what you are going to need or it will be waiting for you on the airfield. Prior coordination through command channels is a neccessity! don't go in blind your an NCO - find out your mission and sit down with your troops and leaders and plan your event and train for it. See if you are replacing someone else in country call them or write them and find out first hand what your getting into you that feed back to inform your command chain and yourself. Find out about the place and the area -zooology,endemic diseases,arthropods, Out of country deployments you may search the afmic site at the institute of med research for a country sitrep which will give you more than you want to know about anywhere outside the U.S. any more assistance don't hesitate to ask! Ronald D. Oldfield PA-C CPT, SP, MEARNG Emergency Medicine -----Original Message----- From: Danny Smith To: wilderness-emergency-medicine Date: Wednesday, February 24, 1999 5:30 PM Subject: W-EMED Medicine Chest >In June I will be going on a Humanitarian Medical mission to el >Salvador. I am open for suggestions as to what to take in terms of >medical supplies. > >___________________________ >Danny E. Smith USAFR >EMS Coordinator >NCOIC Training & Education >445 ASTS - WPAFB, OH > > >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu > Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 25 Feb 1999 13:59:43 -0500 (EST) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 25 Feb 1999 13:59:21 -0500 (EST) Received: via switchmail; Thu, 25 Feb 1999 13:59:19 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 25 Feb 1999 13:57:53 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 25 Feb 1999 13:56:53 -0500 (EST) Received: from hotmail.com (f273.hotmail.com [207.82.251.164]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 25 Feb 1999 13:56:50 -0500 (EST) Received: (qmail 3481 invoked by uid 0); 25 Feb 1999 18:56:19 -0000 Message-ID: <19990225185619.3480.qmail@hotmail.com> Received: from 198.250.223.115 by www.hotmail.com with HTTP; Thu, 25 Feb 1999 10:56:18 PST X-Originating-IP: [198.250.223.115] From: "Chris Adams DO" To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Medicine Chest Date: Thu, 25 Feb 1999 10:56:18 PST Mime-Version: 1.0 Content-type: text/plain Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P40A20.CNM Would suggest starting with the New Emergency Health Kit from the World Health Organization. That at least will give you a starting point to then add to. Info can be obtained by calling the World Health Organization in Geneva at 41.22.7912111. Hope that this helps. Chris M. Adams DO CPT,MC,USA Fort Drum NY >From owner-wilderness-emergency-medicine@list.pitt.edu Wed Feb 24 21:41:38 1999 >Received: from [136.142.185.20] by hotmail.com (1.0) with SMTP id MHotMail309737402731810835185958712291054868399510; Wed Feb 24 21:41:38 1999 >Received: from localhost (majordom@localhost) > by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) > ID ; > Wed, 24 Feb 1999 16:10:43 -0500 (EST) >Received: from enterprise.fuse.net (enterprise-qe1.fuse.net [206.230.21.11]) > by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) > ID for ; > Wed, 24 Feb 1999 16:10:28 -0500 (EST) >Received: from fuse.net (blackbird-59.day.fuse.net [208.23.223.187]) > by enterprise.fuse.net (8.8.5/8.8.5) with ESMTP id QAA27026 > for ; Wed, 24 Feb 1999 16:10:24 -0500 (EST) >Message-ID: <36D4973C.57880F3A@fuse.net> >Date: Wed, 24 Feb 1999 16:20:12 -0800 >From: Danny Smith >X-Mailer: Mozilla 4.5 [en] (Win95; I) >X-Accept-Language: en >MIME-Version: 1.0 >To: wilderness-emergency-medicine > >Subject: W-EMED Medicine Chest >Content-Type: text/plain; charset=us-ascii >Content-Transfer-Encoding: 7bit >Sender: owner-wilderness-emergency-medicine@list.pitt.edu >Precedence: bulk >Reply-To: wilderness-emergency-medicine@list.pitt.edu > >In June I will be going on a Humanitarian Medical mission to el >Salvador. I am open for suggestions as to what to take in terms of >medical supplies. > >___________________________ >Danny E. Smith USAFR >EMS Coordinator >NCOIC Training & Education >445 ASTS - WPAFB, OH > > >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 24 Feb 1999 16:46:54 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 24 Feb 1999 16:14:08 -0500 (EST) Received: via switchmail; Wed, 24 Feb 1999 16:14:07 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 24 Feb 1999 16:12:18 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 24 Feb 1999 16:10:43 -0500 (EST) Received: from enterprise.fuse.net (enterprise-qe1.fuse.net [206.230.21.11]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 24 Feb 1999 16:10:28 -0500 (EST) Received: from fuse.net (blackbird-59.day.fuse.net [208.23.223.187]) by enterprise.fuse.net (8.8.5/8.8.5) with ESMTP id QAA27026 for ; Wed, 24 Feb 1999 16:10:24 -0500 (EST) Message-ID: <36D4973C.57880F3A@fuse.net> Date: Wed, 24 Feb 1999 16:20:12 -0800 From: Danny Smith X-Mailer: Mozilla 4.5 [en] (Win95; I) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine Subject: W-EMED Medicine Chest Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P66A10.CNM In June I will be going on a Humanitarian Medical mission to el Salvador. I am open for suggestions as to what to take in terms of medical supplies. ___________________________ Danny E. Smith USAFR EMS Coordinator NCOIC Training & Education 445 ASTS - WPAFB, OH Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 23 Feb 1999 16:21:14 -0500 (EST) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 23 Feb 1999 16:20:41 -0500 (EST) Received: via switchmail; Tue, 23 Feb 1999 16:20:38 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 23 Feb 1999 16:19:21 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 23 Feb 1999 16:18:43 -0500 (EST) Received: from mars.wsahs.nsw.gov.au (firewall-user@westmed.wh.su.edu.au [192.195.170.5]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 23 Feb 1999 16:18:37 -0500 (EST) Received: by mars.wsahs.nsw.gov.au; id IAA21954; Wed, 24 Feb 1999 08:18:29 +1100 (EST) Received: from saturn.wsahs.nsw.gov.au(10.8.200.55) by mars.wsahs.nsw.gov.au via smap (3.2) id xma021942; Wed, 24 Feb 99 08:18:08 +1100 Received: from icu.wsahs.nsw.gov.au by saturn.wsahs.nsw.gov.au (5.65v4.0/1.1.8.2/03May97-1136AM) id AA14420; Wed, 24 Feb 1999 08:18:07 +1100 Message-Id: <199902232118.AA14420@saturn.wsahs.nsw.gov.au> Received: from WM-ICU/SpoolDir by icu.wsahs.nsw.gov.au (Mercury 1.21); 24 Feb 99 08:21:41 +1000 Received: from SpoolDir by WM-ICU (Mercury 1.30); 24 Feb 99 08:21:23 +1000 From: "Sean Warren, NE(a) ICU, 58729" Organization: Westmead Intensive Care To: wilderness-emergency-medicine@list.pitt.edu Date: Wed, 24 Feb 1999 08:21:16 +1100 Mime-Version: 1.0 Content-Type: text/plain; charset=US-ASCII Content-Transfer-Encoding: 7BIT Subject: Re: W-EMED Methoxyflurane In-Reply-To: <36D2F4DB.5D7E5419@icon.co.za> X-Mailer: Pegasus Mail for Win32 (v3.01b) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P43C90.CNM Arthur wrote >Used in a "whistle" held by the patient it will > be great - how do you intend to use it ? Thanks for your help Arthur. I'm personally not using it but our ambulance officers are using a Penthrox inhaler where the methoxyflurane is instilled on to a wick and then the inhaler is connected to O2 at 8LPM. The patients are only getting very low doses. They get about 3 to 6 mls in any one treatment episode by the ambos'. I believe that the military are using the self-contained whistle type. Sean Warren Nurse Educator (a) Intensive Care Unit Westmead Hospital (02) 9845 8729 (02) 9845 6065 page 01970 seanw@icu.wsahs.nsw.gov.au Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 23 Feb 1999 13:38:52 -0500 (EST) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 23 Feb 1999 13:38:42 -0500 (EST) Received: via switchmail; Tue, 23 Feb 1999 13:38:42 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 23 Feb 1999 13:38:05 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 23 Feb 1999 13:37:21 -0500 (EST) Received: from cgi.icon.co.za (cgi.icon.co.za [196.26.208.8]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 23 Feb 1999 13:37:16 -0500 (EST) Received: from mail450.icon.co.za (mail450.icon.co.za [196.26.208.3]) by cgi.icon.co.za (Postfix) with ESMTP id DB639467A6 for ; Tue, 23 Feb 1999 20:36:42 +0200 (SAST) Received: from icon.co.za (m8-56-ndf.dial-up.net [196.34.159.248]) by mail450.icon.co.za (8.9.3/8.8.8) with ESMTP id UAA01749 for ; Tue, 23 Feb 1999 20:36:41 +0200 (GMT) Message-ID: <36D2F4DB.5D7E5419@icon.co.za> Date: Tue, 23 Feb 1999 20:35:07 +0200 From: Arthur Morgan X-Mailer: Mozilla 4.04 [en] (Win95; U) MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Methoxyflurane References: <199902230723.AA28895@jupiter.wsahs.nsw.gov.au> X-Corel-MessageType: EMail Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P33440.CNM Hello all , I have not used methoyflurane for almost 20 years , but at low concentrations it is a very good and safe and cheap analgesic . There MAY be a problem with shocked patients - it releases fluoride radicals when metabolized . Do not use it for very prolonged times without reading the literature . Used in a "whistle" held by the patient it will be great - how do you intend to use it ? Arthur Sean Warren, NE(a) ICU, 58729 wrote: > > Hi, > I'm a long time reader of this list but a first time contributor. > > My enquiry concerns the use of methoxyflurane in the EMST and > remote area settings. Do any of your civilian services use this as a > pain relief option on a regular basis. If you have any experience > with this drug, your comments on it's pros & cons would be > appreciated. The ambulance service here in Sydney (Australia) > has began using it instead of entanox (50/50 nitrous/oxygen) and I > am currently trying to assess what, if any, implications this may > have on patients. The only real use of this drug in New South > Wales in the last 10-15 years has been for pediatric anesthetics > and limited use by the military. > > Your comments will be greatly appreciated. Thanks in advance. > > Sean Warren > Nurse Educator (a) > Intensive Care Unit > Westmead Hospital > > (02) 9845 8729 > (02) 9845 6065 > page 01970 > seanw@icu.wsahs.nsw.gov.au > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 23 Feb 1999 06:41:46 -0500 (EST) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 23 Feb 1999 06:41:36 -0500 (EST) Received: via switchmail; Tue, 23 Feb 1999 06:41:35 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 23 Feb 1999 06:40:35 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 23 Feb 1999 06:37:11 -0500 (EST) Received: from post2.fast.net (post2.fast.net [198.69.204.22]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 23 Feb 1999 06:37:08 -0500 (EST) Received: from dad (maxtnt04-abe-166.fast.net [206.245.177.166]) by post2.fast.net (8.8.8/8.8.5) with SMTP id GAA15803 for ; Tue, 23 Feb 1999 06:37:05 -0500 (EST) Message-ID: <001401be5f20$f7b9e560$a6b1f5ce@dad> From: "Barry J. Burton" To: Subject: Re: W-EMED Ventilators in Wilderness Medicine Date: Tue, 23 Feb 1999 06:36:54 -0500 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 4.72.3155.0 X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3155.0 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P62EE0.CNM I'm sorry Steve, but you got me when tired, and I feel compelled to reply, DESPITE my limited wilderness experience (gg) From: Steve Kelleher Date: Tuesday, February 23, 1999 12:16 AM Subject: W-EMED Ventilators in Wilderness Medicine >Has anyone out there used automatic ventilators or demand valves in a >wilderness setting? Pros and Cons? IMHO, in NON Wilderness setting, pros ar ethat VENTILATION is consistant, and effort (in ventilating) is preserved to maintain the Airway (if BLS, via mask seal, if ALS , via ET tube) thus freeing limited number of operators to provide other /additional functions. CONS, if BLS, requires GREAT mask seal, if ALS, requires METICULOUS SURVEILANCE of the airway and mechanical function, and it CONSUMES GAS VERY quickly (that is the usual power source if 100% O2 system) In Wilderness, I can't won't carry that much gas to a site, so you are talking about a bivouc, or significant external support....PLUS, unless intubated, you need a DEDICATED rescuer to "Become One" with the patients airway, thus losing the rescuer's self-protective self-moving asset. (AS I Humbly See it) >Are they any more efficient than a >standard NRB mask or BVM... YES > ...at conserving oxygen on long transports? NO WAY > Did you >have to obtain permission from your physician advisor on the use of these >devices? > Law in PA requires tthat "ATV's" be authorized by individual service Medical Director For completeness, DAN (Diver's Alert Network) has recently come out of prototype with a system to maintain high FiO2 for long duration dive boat rescues, using an Oxygen rebreather system. Not had my hands on it (without watchful eyes) but it is DESIGNED with the same concerns as Cave or Alpine Rescue. Uses a CO2 scrubber and "Closed" circuit breathing tube to allow the patient /rescuer to "lose" less O2 to the atmosphere. Same problems in NON-BREATHING BLS patient apply as in above comment. >Steve Kelleher >Alpine Rescue Team >Evergreen, CO. "Dr" Barry Barry J. Burton, D.O., FACOEP ER-NCRC / WEMSI Medical Command Physician Prior PA Medical Advisory Committee Chairperson..... > >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 23 Feb 1999 02:26:59 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 23 Feb 1999 02:26:51 -0500 (EST) Received: via switchmail; Tue, 23 Feb 1999 02:26:51 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 23 Feb 1999 02:26:16 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 23 Feb 1999 02:23:57 -0500 (EST) Received: from mars.wsahs.nsw.gov.au (firewall-user@westmed.wh.su.edu.au [192.195.170.5]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 23 Feb 1999 02:23:51 -0500 (EST) Received: by mars.wsahs.nsw.gov.au; id SAA12904; Tue, 23 Feb 1999 18:23:46 +1100 (EST) Received: from jupiter.wsahs.nsw.gov.au(10.8.200.50) by mars.wsahs.nsw.gov.au via smap (3.2) id xma012896; Tue, 23 Feb 99 18:23:30 +1100 Received: from icu.wsahs.nsw.gov.au by jupiter.wsahs.nsw.gov.au (5.65v4.0/1.1.10.5/15May97-1046AM) id AA28895; Tue, 23 Feb 1999 18:23:24 +1100 Message-Id: <199902230723.AA28895@jupiter.wsahs.nsw.gov.au> Received: from WM-ICU/SpoolDir by icu.wsahs.nsw.gov.au (Mercury 1.21); 23 Feb 99 18:26:56 +1000 Received: from SpoolDir by WM-ICU (Mercury 1.30); 23 Feb 99 18:26:48 +1000 From: "Sean Warren, NE(a) ICU, 58729" Organization: Westmead Intensive Care To: wilderness-emergency-medicine@list.pitt.edu Date: Tue, 23 Feb 1999 18:26:42 +1100 Mime-Version: 1.0 Content-Type: text/plain; charset=US-ASCII Content-Transfer-Encoding: 7BIT Subject: W-EMED Methoxyflurane In-Reply-To: <001f01be5ee8$d65ee740$dfdfdfdf@SKELLEHER-HOME.neonsoft.com> X-Mailer: Pegasus Mail for Win32 (v3.01b) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P65280.CNM Hi, I'm a long time reader of this list but a first time contributor. My enquiry concerns the use of methoxyflurane in the EMST and remote area settings. Do any of your civilian services use this as a pain relief option on a regular basis. If you have any experience with this drug, your comments on it's pros & cons would be appreciated. The ambulance service here in Sydney (Australia) has began using it instead of entanox (50/50 nitrous/oxygen) and I am currently trying to assess what, if any, implications this may have on patients. The only real use of this drug in New South Wales in the last 10-15 years has been for pediatric anesthetics and limited use by the military. Your comments will be greatly appreciated. Thanks in advance. Sean Warren Nurse Educator (a) Intensive Care Unit Westmead Hospital (02) 9845 8729 (02) 9845 6065 page 01970 seanw@icu.wsahs.nsw.gov.au Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 22 Feb 1999 23:59:52 -0500 (EST) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 22 Feb 1999 23:59:34 -0500 (EST) Received: via switchmail; Mon, 22 Feb 1999 23:59:34 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 22 Feb 1999 23:58:17 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 22 Feb 1999 23:56:48 -0500 (EST) Received: from out2.ibm.net (out2.ibm.net [165.87.194.229]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 22 Feb 1999 23:56:30 -0500 (EST) Received: from SKELLEHER-HOME (slip-32-100-230-6.co.us.ibm.net [32.100.230.6]) by out2.ibm.net (8.8.5/8.6.9) with SMTP id EAA97838 for ; Tue, 23 Feb 1999 04:56:27 GMT Message-ID: <001f01be5ee8$d65ee740$dfdfdfdf@SKELLEHER-HOME.neonsoft.com> From: "Steve Kelleher" To: Subject: W-EMED Ventilators in Wilderness Medicine Date: Mon, 22 Feb 1999 21:56:10 -0700 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 4.72.3155.0 X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3155.0 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P76B40.CNM Has anyone out there used automatic ventilators or demand valves in a wilderness setting? Pros and Cons? Are they any more efficient than a standard NRB mask or BVM at conserving oxygen on long transports? Did you have to obtain permission from your physician advisor on the use of these devices? Steve Kelleher Alpine Rescue Team Evergreen, CO. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sun, 21 Feb 1999 22:51:55 -0500 (EST) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sun, 21 Feb 1999 22:51:47 -0500 (EST) Received: via switchmail; Sun, 21 Feb 1999 22:51:46 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sun, 21 Feb 1999 22:50:56 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sun, 21 Feb 1999 22:48:06 -0500 (EST) Received: from out.fetchmail.com (pecan.coconut.co.uk [195.89.193.97]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sun, 21 Feb 1999 22:46:05 -0500 (EST) Received: from fetchmail.com (out.fetchmail.com [195.89.193.106]) by out.fetchmail.com (8.9.1/8.9.1) with ESMTP id DAA00487; Mon, 22 Feb 1999 03:45:01 GMT Message-Id: <199902220345.DAA00487@out.fetchmail.com> Content-Type: text/plain Content-Disposition: inline Mime-Version: 1.0 X-Mailer: MIME-tools 4.102 (Entity 4.111) From: David Grogan To: wind4flyte@aol.com, nikki170@aol.com, Resq_Doll@webtv.com, medic101@mailcity.com, emt-ps@webtv.net, wilderness-emergency-medicine@list.pitt.edu, gjport@Juno.com, timothy.maloney@cwix.com, Dnor25@aol.com, angelface45@mailcity.com, Monypit@Juno.com, MzKymz@webtv.net, flyte104@aol.com, wallacej@mail.findlay.edu, medick@hotmail.com, fyrfyter@webtv.net, romclehs@nauticom.net, vocblack@total.net, shanm@webtv.net, vc@execnet.net Subject: W-EMED another one of those why do i do this stuff things Date: Mon, 22 Feb 1999 03:45:00 0000 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P440A0.CNM Sitting around the station, late at night, after running 10 to 12 calls already can cause a man/woman to think. Is it really worth it? We leave our families behind and fulfill our dream of being an EMT/Paramedic. What happens when the long hours and stressful calls take their toll. Some turn their backs on EMS forever. Most, however, move on to another aspect of the field of medicine. This requires returning to school and earning or furthering degrees. Is it wrong that we want to better our lives and the lives of our family members? I think not, but often we meet resistance from the service we work for. This can come in many forms. Excuses such as staffing, or "Why would you EVER want to leave here." Sometimes only the "favorites" recieve time off required to continue their education. EMS services all to often consider their employees as possessions and not the commodities that they are. We are hard working professionals that want only to better ourselves. We want to give our families a nice home, our kids a good education, and save a little of ourselves for retirement. So, the next time your supervisor questions your intentions, ask him one question. "Did you want to be a 'GRUNT' your whole career?" If he answers "YES", then it's apparent that he never had one ounce of ambition. .....and that's all I have to say about that. ___________________________________________________________________ Sent via BigAssWeb - free email service at http://www.bigassweb.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 19 Feb 1999 09:28:27 -0500 (EST) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 19 Feb 1999 09:28:10 -0500 (EST) Received: via switchmail; Fri, 19 Feb 1999 09:28:07 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 19 Feb 1999 09:27:44 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 19 Feb 1999 09:26:46 -0500 (EST) Received: from smtpsrv1.isis.unc.edu (smtpsrv1.isis.unc.edu [152.2.1.138]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 19 Feb 1999 09:26:43 -0500 (EST) From: explore@sharpshin.med.unc.edu Received: from IRC1.FAMMED.UNC.EDU (irc1.fammed.unc.edu [152.19.27.30]) by smtpsrv1.isis.unc.edu (8.9.1/8.9.1) with SMTP id JAA16470 for ; Fri, 19 Feb 1999 09:26:40 -0500 (EST) Message-Id: <199902191426.JAA16470@smtpsrv1.isis.unc.edu> Date: Fri, 19 Feb 1999 09:24:46 -0500 (Eastern Standard Time) To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED antibiotics in the wilderness In-Reply-To: <36CC9211.D39ABCBC@rt66.com>; from "explore" at Fri Feb 19 09:24:46 1999 X-Mailer: Siren Mail (Windows Version 4.0.2 (Windows 95/NT)) X-Sender: explore@siren.med.unc.edu MIME-Version: 1.0 Content-Type: TEXT/PLAIN; CHARSET="US-ASCII" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P3B660.CNM Andy, Your best bet for PO antibiotics would likely be a newer fluroquinoline called levofloxacin (brand name Levaquin). It is once a day dosing and covers common organisms responsible for skin, respiratory (also covers atypical), gastrointestinal (travelers diarrhea) and urinary tract infections. Are you taking IV abx on a backpacking trip? Tom Bush, MSN,FNP Family Nurse Practitioner Department of Family Medicine University of North Carolina Chapel Hill explore@med.unc.edu -- Begin original message -- > From: abrain > Date: Thu, 18 Feb 1999 15:20:01 -0700 > Subject: W-EMED antibiotics in the wilderness > To: wilderness-emergency-medicine@list.pitt.edu > Reply-To: wilderness-emergency-medicine@list.pitt.edu > > here is a question to all the Drs. on the list. What would be the best type of > antibiotics to carry for an extended backpacking trip. I'm thinking about both > P.O. and IV antibiotics. > andy > > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu > -- End original message -- Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 18 Feb 1999 23:28:13 -0500 (EST) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 18 Feb 1999 23:28:04 -0500 (EST) Received: via switchmail; Thu, 18 Feb 1999 23:28:04 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 18 Feb 1999 23:27:09 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 18 Feb 1999 23:25:22 -0500 (EST) Received: from crius.flash.net (echo.flash.net [209.30.0.40]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 18 Feb 1999 23:25:02 -0500 (EST) Received: from umaryland.edu (p77.sas1.dialup.bwi1.flash.net [208.194.198.77]) by crius.flash.net (8.9.1/8.8.5) with ESMTP id WAA26027 for ; Thu, 18 Feb 1999 22:24:51 -0600 (CST) Message-ID: <36CCE7A1.AE259028@umaryland.edu> Date: Thu, 18 Feb 1999 23:25:05 -0500 From: Kevin Gerold Organization: University of Maryland X-Mailer: Mozilla 4.5 [en] (Win98; I) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED antibiotics in the wilderness References: <36CC9211.D39ABCBC@rt66.com> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P25540.CNM Andy: The answer depends on how far you'll be from civilization and what you might encounter. I'll place my gerneral vote for Ciprofloxacin 500 mg tablets. Dont' forget the value of bacitracin ointment for minor skin wounds and infections. abrain wrote: > > here is a question to all the Drs. on the list. What would be the best type of > antibiotics to carry for an extended backpacking trip. I'm thinking about both > P.O. and IV antibiotics. > andy Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 18 Feb 1999 17:22:52 -0500 (EST) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 18 Feb 1999 17:22:41 -0500 (EST) Received: via switchmail; Thu, 18 Feb 1999 17:22:40 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 18 Feb 1999 17:22:15 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 18 Feb 1999 17:21:17 -0500 (EST) Received: from Rt66.com (mack.rt66.com [198.59.162.1]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 18 Feb 1999 17:21:08 -0500 (EST) Received: from rt66.com (pmd06.rt66.com [198.59.176.39]) by Rt66.com (8.9.3/8.9.1) with ESMTP id PAA10549 for ; Thu, 18 Feb 1999 15:21:05 -0700 (MST) Message-ID: <36CC9211.D39ABCBC@rt66.com> Date: Thu, 18 Feb 1999 15:20:01 -0700 From: abrain X-Mailer: Mozilla 4.5 [en] (Win95; U) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: W-EMED antibiotics in the wilderness References: Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P4AFE0.CNM here is a question to all the Drs. on the list. What would be the best type of antibiotics to carry for an extended backpacking trip. I'm thinking about both P.O. and IV antibiotics. andy Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 18 Feb 1999 14:02:29 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 18 Feb 1999 14:02:18 -0500 (EST) Received: via switchmail; Thu, 18 Feb 1999 14:02:17 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 18 Feb 1999 14:01:12 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 18 Feb 1999 14:00:49 -0500 (EST) Received: from p3-real.sfasu.edu (p3-real.sfasu.edu [144.96.128.8]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 18 Feb 1999 14:00:45 -0500 (EST) Received: from [144.96.241.96] (technology.education.sfasu.edu) by SFAADM.SFASU.EDU (PMDF V5.1-12 #7232) with ESMTP id <01J7W1RINUJ69KP3D9@SFAADM.SFASU.EDU> for wilderness-emergency-medicine@list.pitt.edu; Thu, 18 Feb 1999 13:00:43 CDT Date: Thu, 18 Feb 1999 13:00:13 -0600 From: "Robert M. Judy" Subject: Re: W-EMED ALASKA SAR In-reply-to: <3.0.1.16.19990216201959.2dbf6d18@pop.mindspring.com> X-Sender: rjudy@sfaadm.sfasu.edu To: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 Content-type: text/plain; charset=us-ascii Content-transfer-encoding: 7BIT References: Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P07FE0.CNM What are the details on checking the cornea of the eye? >At 01:14 AM 2/3/99 EST, you wrote: >>All, >> Just updated: the survivor from the capsized vessel was released from Homer >>hospital at 0630 today in good condition. Not quite 100 percent, but >>extremely fortunate. Thanks for the discussion and protocol references. The >>rough sea state and hazardous conditions did prevent immediate extraction and >>extensive assessment. > >The Ship's Medicine Chest and First Aid at Sea suggests using a cool mirror > held under or near their nose or open mouth. The idea is that the >condensed water vapor will show if there is any respiration. Of course the >best policy is "Never cold and dead without first being warm and dead". >But that's easy to say typing on a PC in my house. > >Another thing to check for might be the condition of the cornea of the eye. > At least this doesn't require removing a mustang suit (as would a rectal >core temp or postmortem lividity), or any diagnostic equipiment > >Pat > > >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu Robert M. Judy Technical Support Specialist College of Education Stephen F. Austin State University P.O. Box 6103, SFA Station Nacogdoches, TX 75962 V 409-468-1424 F 409-468-1577 KD5FEE Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 18 Feb 1999 12:59:02 -0500 (EST) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 18 Feb 1999 11:50:26 -0500 (EST) Received: via switchmail; Thu, 18 Feb 1999 11:50:22 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 18 Feb 1999 11:41:31 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 18 Feb 1999 11:40:56 -0500 (EST) Received: from imo22.mx.aol.com (imo22.mx.aol.com [198.81.17.66]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 18 Feb 1999 11:40:47 -0500 (EST) From: Mkeowl@aol.com Received: from Mkeowl@aol.com by imo22.mx.aol.com (IMOv18.1) id IBIEa01428 for ; Thu, 18 Feb 1999 11:33:02 -0500 (EST) Message-ID: Date: Thu, 18 Feb 1999 11:33:02 EST To: wilderness-emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: Re: W-EMED hello Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 236 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P1CFC0.CNM David may I send this to local EMS friends...? Thanks, Linda in VA Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 18 Feb 1999 01:33:11 -0500 (EST) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 18 Feb 1999 01:33:02 -0500 (EST) Received: via switchmail; Thu, 18 Feb 1999 01:33:02 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 18 Feb 1999 01:32:37 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 18 Feb 1999 01:30:46 -0500 (EST) Received: from out.fetchmail.com (pecan.coconut.co.uk [195.89.193.97]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 18 Feb 1999 01:30:43 -0500 (EST) Received: from fetchmail.com (out.fetchmail.com [195.89.193.106]) by out.fetchmail.com (8.9.1/8.9.1) with ESMTP id GAA18589; Thu, 18 Feb 1999 06:29:34 GMT Message-Id: <199902180629.GAA18589@out.fetchmail.com> Content-Type: text/plain Content-Disposition: inline Mime-Version: 1.0 X-Mailer: MIME-tools 4.102 (Entity 4.111) From: David Grogan To: flyte104@aol.com, wind4flyte@aol.com, nikki170@aol.com, wallacej@mail.findlay.edu, medick@hotmail.com, Resq_Doll@webtv.com, medic101@mailcity.com, fyrfyter@webtv.net, Dnor25@aol.com, emt-ps@webtv.net, romclehs@nauticom.net, wilderness-emergency-medicine@list.pitt.edu, gjport@Juno.com, timothy.maloney@cwix.com, vocblack@total.net Subject: W-EMED hello Date: Thu, 18 Feb 1999 06:29:34 0000 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P17830.CNM I got this from a good friend that i thought was kinda neat and made me think.... Well, you have done it. You have survived paramedic training. I hope that it turned out to be all that you hoped that it would be. And I hope that your career as a paramedic is all that you hope that it will be. But I have a question, What exactly do you expect to get out of your new status? What rewards do you expect in EMS? If you became a paramedic for the "thank yous," prepare to be disappointed. The people that you help the most, will inevitably thank you the least. On the old Emergency! TV show the victims were always coming back to the station to thank Johnny and Roy for saving their life. To date nobody has ever thanked me for saving their life. In fact they usually cuss me out because they didn't want to be saved. Oftentimes after weeks in an ICU, they forget who you are or what you did. The worst is when they tell you through gasping, non-compliant breaths that you had better save their life because... "it's your job!" No, if you want "thank yous" or recognition as a hero then you are entering the wrong business. Maybe you became a paramedic for the technical aspects. There are a lot of neat procedures to perform, and toys to play with as a paramedic, but the trouble is you have to perform them on sick, screaming, smelly, people. And that takes all the fun out of it. Are you here because you like the autonomy? As a fire fighter you generally have to take orders from someone. As a paramedic you get to make more of your own decisions, assert your own leadership skills. The down side of this is that you are oftentimes solely responsible for another person's life. You must give that correct dosage, recognize the subtle symptoms. If a mistake happens you need to bear the brunt. Is it the money that you are after? You will soon realize that the fatigue of the fifth run after midnight makes any financial gain hardly worth the effort. Please search your own souls continually and if you ever feel that the patients don't deserve your care, or that you never need to sit through another CE class because you already know it all, get out while you can. EMS is better off without you, and you are better off without EMS. So why should you be working as a paramedic? Because hopefully you see paramedicine as the greatest job on earth. Hopefully everyday you will go home having pleased *yourself*! Just your own quiet knowledge that one persons life is somehow a little bit better because you have acted as you were trained, this should be reward enough. Take comfort in the fact that the real rewards in EMS are not external or finite but internal and infinite. Look for them there; you'll be a lot happier. ___________________________________________________________________ Sent via BigAssWeb - free email service at http://www.bigassweb.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 18 Feb 1999 20:05:41 -0500 (EST) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 18 Feb 1999 20:05:31 -0500 (EST) Received: via switchmail; Thu, 18 Feb 1999 20:05:31 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 18 Feb 1999 20:03:57 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 18 Feb 1999 20:02:33 -0500 (EST) Received: from camel7.mindspring.com (camel7.mindspring.com [207.69.200.57]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 18 Feb 1999 20:02:27 -0500 (EST) Received: from LOCALNAME (user-37ka0r5.dialup.mindspring.com [207.69.3.101]) by camel7.mindspring.com (8.8.5/8.8.5) with SMTP id UAA12218 for ; Thu, 18 Feb 1999 20:02:25 -0500 (EST) Message-Id: <3.0.1.16.19990217205856.339f074c@pop.mindspring.com> X-Sender: pmturner@pop.mindspring.com X-Mailer: Windows Eudora Light Version 3.0.1 (16) Date: Wed, 17 Feb 1999 20:58:56 To: wilderness-emergency-medicine@list.pitt.edu From: Patton Turner Subject: Re: W-EMED ALASKA SAR In-Reply-To: References: <3.0.1.16.19990216201959.2dbf6d18@pop.mindspring.com> Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P13D00.CNM At 01:00 PM 2/18/99 -0600, you wrote: >What are the details on checking the cornea of the eye? Please verify this, but IIRC, the cornea becomes translucent or opaque, and may become wrinkled. Pat Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 17 Feb 1999 19:27:15 -0500 (EST) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 17 Feb 1999 19:26:58 -0500 (EST) Received: via switchmail; Wed, 17 Feb 1999 19:26:57 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 17 Feb 1999 19:25:02 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 17 Feb 1999 19:23:50 -0500 (EST) Received: from dewdrop2.mindspring.com (dewdrop2.mindspring.com [207.69.200.82]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 17 Feb 1999 19:23:45 -0500 (EST) Received: from LOCALNAME (user-37kbsqq.dialup.mindspring.com [207.69.243.90]) by dewdrop2.mindspring.com (8.8.5/8.8.5) with SMTP id TAA22428 for ; Wed, 17 Feb 1999 19:23:39 -0500 (EST) Message-Id: <3.0.1.16.19990216201959.2dbf6d18@pop.mindspring.com> X-Sender: pmturner@pop.mindspring.com X-Mailer: Windows Eudora Light Version 3.0.1 (16) Date: Tue, 16 Feb 1999 20:19:59 To: wilderness-emergency-medicine@list.pitt.edu From: Patton Turner Subject: Re: W-EMED ALASKA SAR In-Reply-To: Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P6D080.CNM At 01:14 AM 2/3/99 EST, you wrote: >All, > Just updated: the survivor from the capsized vessel was released from Homer >hospital at 0630 today in good condition. Not quite 100 percent, but >extremely fortunate. Thanks for the discussion and protocol references. The >rough sea state and hazardous conditions did prevent immediate extraction and >extensive assessment. The Ship's Medicine Chest and First Aid at Sea suggests using a cool mirror held under or near their nose or open mouth. The idea is that the condensed water vapor will show if there is any respiration. Of course the best policy is "Never cold and dead without first being warm and dead". But that's easy to say typing on a PC in my house. Another thing to check for might be the condition of the cornea of the eye. At least this doesn't require removing a mustang suit (as would a rectal core temp or postmortem lividity), or any diagnostic equipiment Pat Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 5 Mar 1999 09:07:45 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 5 Mar 1999 09:07:35 -0500 (EST) Received: via switchmail; Fri, 5 Mar 1999 09:07:35 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Mar 1999 09:06:44 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 5 Mar 1999 09:05:45 -0500 (EST) Received: from m14.boston.juno.com (m14.boston.juno.com [205.231.101.193]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 5 Mar 1999 09:05:41 -0500 (EST) From: chew143@Juno.com Received: (from chew143@juno.com) by m14.boston.juno.com (queuemail) id D4XYDQLN; Fri, 05 Mar 1999 09:05:27 EST To: wilderness-emergency-medicine@list.pitt.edu Date: Sun, 14 Feb 1999 09:04:25 -0500 Subject: Re: W-EMED Wilderness First Aid and Wilderness First Responder Classes Message-ID: <19990214.090426.-206733.0.chew143@juno.com> X-Mailer: Juno 2.0.11 X-Juno-Line-Breaks: 0-1,5-6,11-12,18-19,22-30 X-Juno-Att: 0 MIME-Version: 1.0 Content-Type: text/plain Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P5C870.CNM Dr. Conover, The NSC Advanced Wilderness Program is the information that I gave to Dr. Burton, to help me redevelop the Field Medic Program for the PA Civil Air Patrol. My thought were to use the NSC Wilderness course as a supplement to any first aid or EMS (urban) training that the individual already has. In the preface of the NSC WFA manual it clearly states - "Much of the information in this book is different from what you might read in an urban first aid manual. Wilderness first aiders must be prepared to treat problems that they would not be asked to deal with when an ambulance is only minutes away." I think that the NSC has already established that this particular program is unlike a normal first aid course, and I do not see where they are comparing the program to a First Responder Program. At best if you taught the NSC First Responder Program and then the NSC WFA course you would meet the ASTM standards. This is what the NSC WFA program is designed as, a supplement, not a standalone program. I have the complete NSC WFA program materials if anyone has any specific questions, (Dr. Burton is currently reviewing a copy of the student manual.) Thanks you for hearing my input. ====================================================== Bruce E. Chew, Jr., FF/EMT-P, Chief, Bucks County Rescue Squad P.O. Box 211 Bristol, PA 19007 Phone: (215) 788-0444 x21 Fax: (215) 788-3772 BCRS On-Line: http://www.bcrs.org ___________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com/getjuno.html or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 13 Feb 1999 19:40:52 -0500 (EST) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 13 Feb 1999 19:40:41 -0500 (EST) Received: via switchmail; Sat, 13 Feb 1999 19:40:41 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 13 Feb 1999 19:40:37 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 13 Feb 1999 19:39:14 -0500 (EST) Received: from wasp.aa.nps.navy.mil (wasp.aa.nps.navy.mil [131.120.149.13]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 13 Feb 1999 19:39:09 -0500 (EST) Received: from howard.aa.nps.navy.mil (howard.aa.nps.navy.mil [131.120.149.244]) by wasp.aa.nps.navy.mil (8.8.3/8.8.8b1) with SMTP id QAA01212 for ; Sat, 13 Feb 1999 16:39:06 -0800 (PST) Message-Id: <3.0.6.32.19990213164456.008d29f0@aa.nps.navy.mil> X-Sender: howard@aa.nps.navy.mil X-Mailer: QUALCOMM Windows Eudora Light Version 3.0.6 (32) Date: Sat, 13 Feb 1999 16:44:56 -0800 To: wilderness-emergency-medicine@list.pitt.edu From: Rick Howard Subject: W-EMED Stethoscope Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P30760.CNM A while back there was a thread about a source for a cheap stethoscope - using them for double duty as tent anchors, etc. I notice Pacific Rescue has dual-head S-scopes (in SAR colors!) for $10.95 at: http://www.pacificrescue.com/index.html Rick Howard San Jose Search and Rescue (CA) Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sun, 7 Feb 1999 18:22:58 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sun, 7 Feb 1999 18:22:48 -0500 (EST) Received: via switchmail; Sun, 7 Feb 1999 18:22:47 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sun, 7 Feb 1999 18:22:22 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sun, 7 Feb 1999 18:21:48 -0500 (EST) Received: from Montu.kynd.net (mail@montu.kynd.net [208.162.108.5]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sun, 7 Feb 1999 18:21:44 -0500 (EST) Received: from frhcg [208.167.52.101] by Montu.kynd.net with smtp (Exim 1.62 #1) id 109dYF-000664-00 (Debian); Sun, 7 Feb 1999 18:23:43 -0500 Message-ID: <00c001be52f0$f7c71280$02000003@frhcg> From: "Oldfield Family" To: Subject: Re: W-EMED CPR Guidelines Date: Sun, 7 Feb 1999 18:24:09 -0500 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 4.72.3155.0 X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3155.0 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P35850.CNM I am in agreement with Mr. Green and his israeli Doctor friend on the survivability of CPR due to certain elements of injury. Some thoughts on wilderness resuscitation issues, If your on an expedition chances are you know these individuals some are probably very close friends. The odds are if one is in trouble the whole group to include yourself is in dire straits. This is a situation that brings even the most experienced individuals vagal tone up. Typically all the pre planning in the world goes out the window. Don't get me wrong pre planning and coordination is a must but keep it in your mind that most events tax the best prepared and only those who maintain a will and a wit survive. enough on that issue back to CPR. Local Policy and situation should dictate resuscitation criteria for wilderness rescue teams, Discuss with your medical Director criteria for active resuscitation or deferred intervention. Most issues are common sense. But the hazard to teams especially in technical rescue is altered when a mission changes to body recovery. -----Original Message----- From: selectrec To: wilderness-emergency-medicine@list.pitt.edu Date: Tuesday, February 02, 1999 10:08 PM Subject: Re: W-EMED CPR Guidelines >well, >I have seen some good data reguarding the question - do we start cpr in the >wild, at what time do we not start? Some have put a lot of thought into >this - some have put too much. >>From a Doctor in Israel, i got some good feedback when i asked this very >same question a few years ago. > >if cpr is needed due to brain trauma, they're dead. If it is due to blunt >trauma, they're dead - if the arrest occurs in the Er - they have @ 1% >chance. >If CPR is due to hypovolemia - and there are no vitals - they're dead. >Penetrating abdominal truama - if the arrest occurs in teh ER - and they are >intubated within 5 min - they have 0-3%chance. > >I believe the deciding factor on all this is the individual situation - not >trying to be callus or anything - I think about myself, the team, the >location, the big picture on using the protocol to resucitate or not. If I >was on an expedition, and I knew everyone - I think I would react >differently than if I was on a cave rescue - at the bottom of Fantastic pit >and I am with some one who cratered their face and was in arrest. > >Again - it will be each individual's decision. > >John Green >NCRC _ South Central Region >J&LGreen@selectrec.net > > >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu > Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sun, 7 Feb 1999 13:44:13 -0500 (EST) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sun, 7 Feb 1999 13:44:02 -0500 (EST) Received: via switchmail; Sun, 7 Feb 1999 13:44:02 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sun, 7 Feb 1999 13:42:56 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sun, 7 Feb 1999 13:42:29 -0500 (EST) Received: from crius.flash.net (echo.flash.net [209.30.0.40]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sun, 7 Feb 1999 13:42:25 -0500 (EST) Received: from [208.194.198.114] (p114.sas2.dialup.bwi1.flash.net [208.194.198.114]) by crius.flash.net (8.9.1/8.8.5) with ESMTP id MAA11327 for ; Sun, 7 Feb 1999 12:42:18 -0600 (CST) Message-Id: In-Reply-To: Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Date: Sun, 7 Feb 1999 13:27:06 -0500 To: wilderness-emergency-medicine@list.pitt.edu From: Kevin Gerold Subject: W-EMED Re: Comparison of Classic II and Littman Lighweight Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P1BCB0.CNM The discussions about stetheoscopes always comes back to the fundamental question in prehospital care...what do you need to know. Prehospital care interventions are limited to resuscitation and life support. The context of wilderness EMS defines a general level of fitness. People go off into the wild in o.k. shape and get acutely ill or injured. To the extent that they can go on unassisted, they are not seriously ill or injured (in the context of EMS). In that context, what do you want a stetheoscope to do? Any stetheoscope will enable the user to determine a BP (the value of which is in question), and assist with confirming a tension pneumothorax. Bowel sounds...yea, the inexpensive ones will give you that also, but so what? What else is there? My point....any stetheoscope will serve it's purpose in any prehospital setting and in nearly all hospital settings. If you're using it every day, I'd want a nice one too. They feel better and stand up to everyday use. That's why mechanics buy snap-on tools. If you're a cardiologist searching for Gr I regurgitant murmurs, I'd suggest the cardioscope. Medical students are continually reminded that the most important part of the stetheoscope is the part that fits between the earpieces! Save your money, buy what you need. ******************************************************** Dr. Kevin Gerold University of Maryland Medical Center 22 S. Greene Street Baltimore, MD Office: (410) 328-1808 Facimile: (410) 323-0820 This telecopy transmission contains privileged, confidential information belonging to the sender and is intended only for use by the individual or entity named above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this telecopied information is strictly prohibited. If you have received this telecopy in error, please notify me by the telephone number listed above. INTERCEPTION OF ELECTRONIC COMMUNICATIONS COULD BE A VIOLATION OF MARYLAND AND FEDERAL LAW ******************************************************** Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sun, 7 Feb 1999 09:45:26 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sun, 7 Feb 1999 09:45:13 -0500 (EST) Received: via switchmail; Sun, 7 Feb 1999 09:45:09 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sun, 7 Feb 1999 09:43:52 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sun, 7 Feb 1999 09:42:51 -0500 (EST) Received: from imo12.mx.aol.com (imo12.mx.aol.com [198.81.17.2]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sun, 7 Feb 1999 09:42:48 -0500 (EST) From: Rustiblade@aol.com Received: from Rustiblade@aol.com by imo12.mx.aol.com (IMOv18.1) id AFCBa24348; Sun, 7 Feb 1999 09:40:43 -0500 (EST) Message-ID: Date: Sun, 7 Feb 1999 09:40:43 EST To: tkovacs@goodnet.com, kconover+@pitt.edu, jenkinsa@cwu.EDU, wilderness-emergency-medicine@list.pitt.edu, sar-l@listserv.islandnet.com, NCRC@ontosystems.com, mra@altadena.net Mime-Version: 1.0 Subject: W-EMED Re: Comparison of Classic II and Littman Lighweight Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL for Macintosh sub 53 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu If you don't have the experience with an expensive stethacope, it is much better to get the six dollar special. The cheapies are more fogiving and still do the job. It's just an extention of your ear. In a pinch i've just used my ear directly on the posterior chest. Kind of hard to get a good seal sometimes though. Marc Beverly, BS-EMS, WEMT-P I/C Abq. Mountain Rescue Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 6 Feb 1999 16:26:36 -0500 (EST) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 6 Feb 1999 16:26:23 -0500 (EST) Received: via switchmail; Sat, 6 Feb 1999 16:26:22 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 6 Feb 1999 16:25:10 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 6 Feb 1999 16:24:25 -0500 (EST) Received: from mx0-smtp.goodnet.com (envy.goodnet.com [207.98.129.151]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 6 Feb 1999 16:24:20 -0500 (EST) Received: from PC_.goodnet.com (d7-14.phoenix.goodnet.com [209.140.135.143]) by mx0-smtp.goodnet.com with SMTP id OAA23895; Sat, 6 Feb 1999 14:23:54 -0700 (MST) Message-ID: In-Reply-To: <199902041814.NAA27920@post-ofc04.srv.cis.pitt.edu> References: Conversation <36B57959.1C33@vmspop.cwu.edu> with last message <199902041814.NAA27920@post-ofc04.srv.cis.pitt.edu> X-MSMail-Priority: Normal X-Priority: 3 To: "Keith Conover" , jenkinsa@cwu.edu, "WEMS News" , "SAR-L" , "NCRC Discussion List" , "MRA" MIME-Version: 1.0 From: "Tim Kovacs" Subject: W-EMED Comparison of Classic II and Littman Lighweight Date: Sat, 06 Feb 99 12:58:11 PST Content-Type: text/plain; charset="ISO-8859-1"; X-MAPIextension=".TXT" Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu Worked with a partner the other day who has the lightweight Littman, and compared to my Classic II that I carry currently in my MR Pack, the Classic II definitely has beetter acoustics. You may have a different experience, and I did it, not in the wilderness, but in noisy in-city environments over a 24 hour period. Tim Kovacs, President Mountain Rescue Association tkovacs@goodnet.com www.mra.org "You can't teach people to rescue in the mountains until they have learnt to climb... ...It is a number of small points which have little significance individually that, considered together, spell danger to the experienced rescuer." Hamish MacInnes Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 5 Feb 1999 00:35:59 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 5 Feb 1999 00:35:38 -0500 (EST) Received: via switchmail; Fri, 5 Feb 1999 00:35:37 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Feb 1999 00:35:23 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 5 Feb 1999 00:34:50 -0500 (EST) Received: from imo16.mx.aol.com (imo16.mx.aol.com [198.81.17.6]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 5 Feb 1999 00:34:47 -0500 (EST) From: Bighoss19@aol.com Received: from Bighoss19@aol.com by imo16.mx.aol.com (IMOv18.1) id SEOUa27784 for ; Fri, 5 Feb 1999 00:33:28 -0500 (EST) Message-ID: <44d4dd6f.36ba82a8@aol.com> Date: Fri, 5 Feb 1999 00:33:28 EST To: wilderness-emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: Fwd: W-EMED Has anybody actually used a CPR face shield Content-type: multipart/mixed; boundary="part0_918192809_boundary" X-Mailer: AOL 4.0 for Windows 95 sub 214 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 570949760 0 1 P184D0.CNM This is a multi-part message in MIME format. --part0_918192809_boundary Content-ID: <0_918192809@inet_out.mail.aol.com.1> Content-type: text/plain; charset=US-ASCII --part0_918192809_boundary Content-ID: <0_918192809@inet_out.mail.aol.com.2> Content-type: message/rfc822 Content-transfer-encoding: 7bit Content-disposition: inline From: NOMAD2517@aol.com Return-path: To: Bighoss19@aol.com Subject: Re: W-EMED Has anybody actually used a CPR face shield? Date: Wed, 3 Feb 1999 09:05:10 EST Mime-Version: 1.0 Content-type: multipart/mixed; boundary="part1_918192809_boundary" --part1_918192809_boundary Content-ID: <0_918192809@inet_out.mail.aol.com.3> Content-type: text/plain; charset=US-ASCII I got carried away and did a two page answer -- you will have to open it I used MS WORD for the 2 pages -- get back to me if this is a problem. --part1_918192809_boundary Content-ID: <0_918192809@inet_out.mail.aol.com.4> Content-type: application/octet-stream; name="POCKET~1.DOC" Content-transfer-encoding: base64 Content-disposition: inline 0M8R4KGxGuEAAAAAAAAAAAAAAAAAAAAAPgADAP7/CQAGAAAAAAAAAAAAAAABAAAALQAAAAAA AAAAEAAALwAAAAEAAAD+////AAAAACwAAAD///////////////////////////////////// //////////////////////////////////////////////////////////////////////// //////////////////////////////////////////////////////////////////////// //////////////////////////////////////////////////////////////////////// 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AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAA== --part1_918192809_boundary-- --part0_918192809_boundary-- Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: From: Self To: jenkinsa@cwu.edu,wilderness-emergency-medicine@list.pitt.edu, sar-l@listserv.islandnet.com, NCRC Discussion List , mra@altadena.net Subject: Re: lightweight stethoscopes and BP cuffs for SAR Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Thu, 4 Feb 1999 00:49:53 -0500 On 1 Feb 99, at 9:52, Andrew P. Jenkins, PhD wrote: > Thanks for the heads-up on the new Littman "ears." What about the > cost? As you know, our gear has a propensity toward falling into > crevasses and flying away with helicopters. Do have a source for > non-profit agency pricing? Haven't searched for a cheap source, I'm sure there is probably one out there somewhere. But probably you can't find too big a discount, they're a bit on the expensive side ($30-40 range or more) but probably will last for a long time. -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 3 Feb 1999 20:50:50 -0500 (EST) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 3 Feb 1999 20:50:36 -0500 (EST) Received: via switchmail; Wed, 3 Feb 1999 20:50:34 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 3 Feb 1999 20:50:25 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 3 Feb 1999 20:49:36 -0500 (EST) Received: from imo29.mx.aol.com (imo29.mx.aol.com [198.81.17.73]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 3 Feb 1999 20:49:32 -0500 (EST) From: Fishmedic@aol.com Received: from Fishmedic@aol.com by imo29.mx.aol.com (IMOv18.1) id 8FICa01222 for ; Wed, 3 Feb 1999 20:36:19 +1900 (EST) Message-ID: Date: Wed, 3 Feb 1999 20:36:19 EST To: wilderness-emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: Re: W-EMED Has anybody actually used a CPR face shield? Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 3.0 16-bit for Windows sub 38 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P55430.CNM Regarding the face shield/foil studies... check Prehospital and Disaster Medicine, Vol. 8, No. 2 of April-June 93. "Devices for Expired Air Resuscitation" Rossi, Lindner and Ahnefeld. That will be a start! No worse for blowing gunk than any of the other devices used and because you're down there maybe even better (less likely to keep ablowin' when your lips are vibrating with each breath!). Better than nothing at all and all the advantages of the increased tidal volume seen with mouth to mouth and mouth to mask. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 3 Feb 1999 10:45:04 -0500 (EST) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 3 Feb 1999 10:44:37 -0500 (EST) Received: via switchmail; Wed, 3 Feb 1999 10:44:33 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 3 Feb 1999 10:43:03 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 3 Feb 1999 10:42:30 -0500 (EST) Received: from swan.prod.itd.earthlink.net (swan.prod.itd.earthlink.net [207.217.120.123]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 3 Feb 1999 10:42:27 -0500 (EST) Received: from [153.34.12.55] (1Cust55.tnt2.hou2.da.uu.net [153.34.12.55]) by swan.prod.itd.earthlink.net (8.8.7/8.8.5) with SMTP id HAA22754 for ; Wed, 3 Feb 1999 07:42:25 -0800 (PST) Message-Id: <199902031542.HAA22754@swan.prod.itd.earthlink.net> Subject: W-EMED Am I still subscribed? Date: Wed, 3 Feb 99 09:43:37 -0000 x-sender: kayak001@mail.earthlink.net x-mailer: Claris Emailer 2.0, March 15, 1997 From: kayak001 To: Mime-Version: 1.0 Content-Type: text/plain; charset="US-ASCII" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P10D00.CNM Haven't seen anything posted to this list since November 8th...was just wondering if everyone's taking some time off, or if I'm still subscribed. I have enjoyed the discussions in the past. ------------------------------------------------------------------- Neil Harrison \\|// Houston, Texas email: nil@nol.net (@ @) web: www.nol.net/~nil/ ----------------------------ooO~(_)~Ooo---------------------------- 100% recycled electrons Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Feb 1999 21:21:05 -0500 (EST) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Feb 1999 21:20:53 -0500 (EST) Received: via switchmail; Tue, 2 Feb 1999 21:20:52 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Feb 1999 21:20:14 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Feb 1999 21:19:34 -0500 (EST) Received: from selectrec.net (mail.selectrec.net [209.184.56.3]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Feb 1999 21:19:23 -0500 (EST) Received: from default (209.184.56.43) by selectrec.net with SMTP (Eudora Internet Mail Server 2.1); Tue, 2 Feb 1999 20:28:16 -0500 From: "selectrec" To: Subject: Re: W-EMED CPR Guidelines Date: Tue, 2 Feb 1999 20:17:32 -0600 Message-ID: <01be4f1b$5b371380$2b38b8d1@default> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 4.71.1712.3 X-MimeOLE: Produced By Microsoft MimeOLE V4.71.1712.3 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P02890.CNM well, I have seen some good data reguarding the question - do we start cpr in the wild, at what time do we not start? Some have put a lot of thought into this - some have put too much. >From a Doctor in Israel, i got some good feedback when i asked this very same question a few years ago. if cpr is needed due to brain trauma, they're dead. If it is due to blunt trauma, they're dead - if the arrest occurs in the Er - they have @ 1% chance. If CPR is due to hypovolemia - and there are no vitals - they're dead. Penetrating abdominal truama - if the arrest occurs in teh ER - and they are intubated within 5 min - they have 0-3%chance. I believe the deciding factor on all this is the individual situation - not trying to be callus or anything - I think about myself, the team, the location, the big picture on using the protocol to resucitate or not. If I was on an expedition, and I knew everyone - I think I would react differently than if I was on a cave rescue - at the bottom of Fantastic pit and I am with some one who cratered their face and was in arrest. Again - it will be each individual's decision. John Green NCRC _ South Central Region J&LGreen@selectrec.net Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 3 Feb 1999 01:21:18 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 3 Feb 1999 01:21:10 -0500 (EST) Received: via switchmail; Wed, 3 Feb 1999 01:21:10 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 3 Feb 1999 01:19:42 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 3 Feb 1999 01:18:02 -0500 (EST) Received: from imo19.mx.aol.com (imo19.mx.aol.com [198.81.17.9]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 3 Feb 1999 01:17:49 -0500 (EST) From: ALASKANEWF@aol.com Received: from ALASKANEWF@aol.com by imo19.mx.aol.com (IMOv18.1) id QIRa020089 for ; Wed, 3 Feb 1999 01:14:41 -0500 (EST) Message-ID: Date: Wed, 3 Feb 1999 01:14:41 EST To: wilderness-emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: Re: W-EMED MAMMALIAN DIVE REFLEX Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0.i for Mac sub 189 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P2B970.CNM Tim, Go ahead and include it, it was meant to generate discussion and review. Regards, Bill Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 3 Feb 1999 01:18:53 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 3 Feb 1999 01:18:43 -0500 (EST) Received: via switchmail; Wed, 3 Feb 1999 01:18:43 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 3 Feb 1999 01:17:07 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 3 Feb 1999 01:15:17 -0500 (EST) Received: from imo15.mx.aol.com (imo15.mx.aol.com [198.81.17.5]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 3 Feb 1999 01:15:14 -0500 (EST) From: ALASKANEWF@aol.com Received: from ALASKANEWF@aol.com by imo15.mx.aol.com (IMOv18.1) id HGBEa03539 for ; Wed, 3 Feb 1999 01:14:31 -0500 (EST) Message-ID: Date: Wed, 3 Feb 1999 01:14:31 EST To: wilderness-emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: W-EMED ALASKA SAR Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0.i for Mac sub 189 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P4FB40.CNM All, Just updated: the survivor from the capsized vessel was released from Homer hospital at 0630 today in good condition. Not quite 100 percent, but extremely fortunate. Thanks for the discussion and protocol references. The rough sea state and hazardous conditions did prevent immediate extraction and extensive assessment. Regards, LT Bill Kupchin USCG Airsta Kodiak Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Feb 1999 17:48:22 -0500 (EST) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Feb 1999 17:48:11 -0500 (EST) Received: via switchmail; Tue, 2 Feb 1999 17:48:10 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Feb 1999 17:46:57 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Feb 1999 17:46:26 -0500 (EST) Received: from shepherd.hurlburt.af.mil (shepherd.hurlburt.af.mil [151.166.15.65]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Feb 1999 17:46:17 -0500 (EST) Received: from shepherd.hurlburt.af.mil (root@localhost) by shepherd.hurlburt.af.mil with ESMTP id QAA11422 for ; Tue, 2 Feb 1999 16:38:43 -0600 (CST) Received: from emh.stn.hurlburt.af.mil (emh.stn.hurlburt.af.mil [151.166.160.105]) by shepherd.hurlburt.af.mil with ESMTP id QAA11418 for ; Tue, 2 Feb 1999 16:38:42 -0600 (CST) Received: by emh with Internet Mail Service (5.5.1960.3) id ; Tue, 2 Feb 1999 16:40:36 -0600 Message-ID: From: allenro To: "'wilderness-emergency-medicine@list.pitt.edu'" Subject: RE: W-EMED MAMMALIAN DIVE REFLEX Date: Tue, 2 Feb 1999 16:40:35 -0600 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.1960.3) Content-Type: text/plain; charset="iso-8859-1" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P645F0.CNM Lt Kupchin: Very unfortunate case. Any idea what the eventual outcome of the survivor is/was? I would hesitate before second-guessing a rescuer in this situation. Inside an overturned hull, likely pitch dark, in the ocean, in water likely close to 32 degrees, and you have no idea when/if the hulk is going to sink, maybe with you still in it. Add to that the fun and games of trying to get into the air pocket in the first place, probably through narrow passages clogged with debris, only to find two apparently lifeless bodies. Trying to get an accurate pulse or respirations under those conditions would be damn-near impossible, much less trying to get an accurate core temperature (take your hand out of a glove in 32 degree water and see how long you can do something with it...). Now figure that you are going to have to tow two bodies out of the hull, both of whom are in buoyant suits, without getting tangled up in wires, debris or whatever. Adding to the fun and games, how are you going to supply air to the victim during the u/w swim? Even if the rescuers thought that one of the victims was still alive, how would they keep them breathing during the swim out? Unconscious people can't hold regulators in their mouths. A nightmare of a situation, any way you look at it. True, the mantra in hypothermia is not dead until warm and dead, but there ARE circumstances where people are cold and dead and are going to stay that way. One such circumstance is where there is a serious risk of life/limb to the rescuers in attempting to recover the body. I believe the Alaska State EMS protocols give another: In cases of hypothermic drowning, airway submersion of over 60 minutes is a presumption of death (although in this case it sounds as if the victims didn't have submerged airways). What about cases where there are obviously fatal injuries, but the victim is hypothermic? Do you still have to attempt to resuscitate until they're warm and dead? A lot of our rescue brothers and sisters have taken some horrible risks over the years to recover unsalvageable patients, or doing just plain body drags. More than a few have died in such attempts. Sometimes you have to make a judgement call: Is the probability of survival worth the risk to the rescue team? Is recovering a body worth losing another life? Like I said, an unfortunate situation, for everybody concerned. Rob Allen > -----Original Message----- > From: ALASKANEWF@aol.com [SMTP:ALASKANEWF@aol.com] > Sent: Tuesday, February 02, 1999 3:35 PM > To: wilderness-emergency-medicine@list.pitt.edu > Subject: W-EMED MAMMALIAN DIVE REFLEX > > All, > We just had an interesting case up here in Alaska with a fishing > vessel that > iced up and capsized. Two crewman were trapped in the overturned hull > and > were not discovered until after an exhaustive search by air and vessel > assets. > Pararescuemen dove on the overturned vessel after the weather > subsided. The > Pararescuemen were unable to get a pulse on either of the crewmen. > They were > in survival suits in a cramped bow compartment in a small air pocket. > With no > pulse they were pronounced dead and the vessel towed (inverted) to a > village. > It was decided to retrieve the bodies when the wind and seas subsided > and it > was safer. When rescuers reentered the boat, one of the victims had > weak > vitals. The rescue team accessed the hull with chainsaws carefully > extracting > the vessels skipper and deceased crewman. The survivor was taken to > the > village health clinic and we eventually transported him to Homer > hospital in > stable condition after the fog and snow cleared. > This case is being looked at. Good example of risk vrs gain and > weighing > the possibility of a survivor in a not so optimistic situation. Are > there any > medical guidelines i.e. water temp, exposure duration, secondary > assessments > to follow in these situations? > The survivor was in the hull, in a survival suit for 24 hours. The > deceased > crewman's survival suit was not zipped up completely. > Sorry so long but good knowledge out of a bad situation. > > Respectfully, > LT Bill Kupchin > USCG Airsta Kodiak > Kodiak AK 99619 > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe > wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Feb 1999 17:42:27 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Feb 1999 17:42:14 -0500 (EST) Received: via switchmail; Tue, 2 Feb 1999 17:42:13 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Feb 1999 17:40:38 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Feb 1999 17:40:01 -0500 (EST) Received: from edtnps05.telusplanet.net (edtnps05.telusplanet.net [198.161.157.105]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Feb 1999 17:39:42 -0500 (EST) Received: from clgrtnt1-port-186.agt.net ([161.184.40.186]:1033 "HELO LOCALNAME") by edtnps05.telusplanet.net with SMTP id <518639-4363>; Tue, 2 Feb 1999 15:39:16 -0700 X-Sender: dhsc@mail.agt.net Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" To: wilderness-emergency-medicine@list.pitt.edu From: dhsc@agt.net (Donovan & Sheri) Subject: W-EMED CPR Guidelines X-Mailer: Message-Id: <19990202223931Z518639-4363+93@edtnps05.telusplanet.net> Date: Tue, 2 Feb 1999 15:39:16 -0700 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P31FD0.CNM Hi all I'd like to start by saying that it's great to see the list come alive again. What guidelines do folks have for when it is pointless to start CPR in the wilderness? I teach Wilderness First Aid for St. John Ambulance and the Canadian Red Cross and keep getting this question. Can anyone offer any firm, research-based guidelines? Thanks Donovan Hoggan Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Tue, 2 Feb 1999 16:25:49 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Feb 1999 16:25:39 -0500 (EST) Received: via switchmail; Tue, 2 Feb 1999 16:25:36 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Feb 1999 16:24:06 -0500 (EST) Received: from send202.yahoomail.com (send202.mail.yahoo.com [128.11.68.126]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Feb 1999 16:24:02 -0500 (EST) Message-ID: <19990202212120.15370.rocketmail@send202.yahoomail.com> Received: from [194.230.3.135] by send202.mail.yahoo.com; Tue, 02 Feb 1999 13:21:20 PST Date: Tue, 2 Feb 1999 13:21:20 -0800 (PST) From: Daniele Maggiore Subject: Ippocrate Award To: wilderness-emergency-medicine-approval@list.pitt.edu MIME-Version: 1.0 Content-Type: text/plain; charset=us-ascii X-PMFLAGS: 34078848 0 1 P78820.CNM Translations Online KellerInsurance Interservices Trust SA Property Advice IPPOCRATE AWARD PRESS RELEASE M&P Maggiore & Partners SA of Lugano (Svizzera), in partnership with Translations Online, KellerInsurance and Interservices Trust SA, notifies an announcement of a competitive examination about the best scientific publications published on the International Journal of Medicine “Ippocrate“ in two years. The scientific asseies must be originals and never have been published before. They can relate to any medical discipline, surgery, biochemistry, and they can regard clinical, experimental, cultural, historical and medico-legal interest. Publications under considerations must appear on “Ippocrate“ from January 1999 to December 2000, and must be written in English Language. Manuscript must be prepared in strict compliance with the “Instructions of the Authors“ published on Ippocrate. Ippocrate Award consists in an First Prize of 5.000 Switzerland Francs, the Second Prize in an plate and the Third Prize in an Honourable mention. This announcement of a Competitive Examination is visible on Internet http://www.ippocrate.net. Requests of announcement and copies of Ippocrate must be adressed to : Ippocrate, M&P Maggiore & Partners SA, C.P. 728, 6902 Lugano Paradiso (Switzerland). _________________________________________________________ DO YOU YAHOO!? Get your free @yahoo.com address at http://mail.yahoo.com -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Feb 1999 21:55:52 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Feb 1999 21:55:41 -0500 (EST) Received: via switchmail; Tue, 2 Feb 1999 21:55:41 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Feb 1999 21:54:37 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Feb 1999 21:54:18 -0500 (EST) Received: from mx0-smtp.goodnet.com (envy.goodnet.com [207.98.129.151]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Feb 1999 21:54:12 -0500 (EST) Received: from PC_.goodnet.com (d3-47.phoenix.goodnet.com [207.98.135.175]) by mx0-smtp.goodnet.com with SMTP id TAA01029 for ; Tue, 2 Feb 1999 19:54:03 -0700 (MST) Message-ID: In-Reply-To: References: Conversation with last message X-MSMail-Priority: Normal X-Priority: 3 To: "WEMS News" MIME-Version: 1.0 From: "Tim Kovacs" Subject: W-EMED Thanks for info on Pararescue programs Date: Tue, 02 Feb 99 18:28:50 PST Content-Type: text/plain; charset="ISO-8859-1"; X-MAPIextension=".TXT" Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P1B410.CNM Thanks all for the info. on PJ/Pararescue units! Tim Kovacs, President Paramedic-W Mountain Rescue Association tkovacs@goodnet.com www.mra.org "You can't teach people to rescue in the mountains until they have learnt to climb... ...It is a number of small points which have little significance individually that, considered together, spell danger to the experienced rescuer." Hamish MacInnes Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Feb 1999 14:04:24 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Feb 1999 14:04:11 -0500 (EST) Received: via switchmail; Tue, 2 Feb 1999 14:04:11 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Feb 1999 14:03:52 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Feb 1999 14:03:17 -0500 (EST) Received: from relay.icon.co.za (relay.icon.co.za [196.26.208.4]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Feb 1999 14:03:04 -0500 (EST) Received: (qmail 23469 invoked from network); 2 Feb 1999 19:02:31 -0000 Received: from mail450.icon.co.za (196.26.208.3) by relay.icon.co.za with SMTP; 2 Feb 1999 19:02:31 -0000 Received: from icon.co.za (m6-27-ndf.dial-up.net [196.34.159.91]) by mail450.icon.co.za (8.9.1/8.8.8) with ESMTP id VAA09640 for ; Tue, 2 Feb 1999 21:02:29 +0200 (GMT) Message-ID: <36B72369.D98C9BD9@icon.co.za> Date: Tue, 02 Feb 1999 18:10:17 +0200 From: Arthur Morgan X-Mailer: Mozilla 4.04 [en] (Win95; U) MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED MAMMALIAN DIVE REFLEX References: <199902021102.GAA05382@titan.tcn.net> X-Corel-MessageType: EMail Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P2DC60.CNM Bernie Roche wrote: > > At 01:34 AM 2/2/99 -0500, you wrote: ( LT Bill Kupchin ) > >All, > > We just had an interesting case up here in Alaska with a fishing vessel > that > >iced up and capsized. Two crewman were trapped in the overturned hull and > >were not discovered until after an exhaustive search by air and vessel > assets. > >Pararescuemen dove on the overturned vessel after the weather subsided. The > >Pararescuemen were unable to get a pulse on either of the crewmen. They were > >in survival suits in a cramped bow compartment in a small air pocket. > With no > >pulse they were pronounced dead and the vessel towed (inverted) to a village. ... > > Hi, Bill: > > Yes, the number one rule of hypothermia treatment is: > > "Never dead until WARM and dead. > > Sadly, this case illustrates the reason for the rule. Severe hypothermia > can mimic death. > AJM: This also shows that diagnosing death whilst in difficult and dangerous conditions is not possible with any degree of certainty . If the conditions allowed the " deceased " should have been moved to a better environment . If my imagination is correct I would presume that the rescuers were in danger by just being there , and doing an extrication would have been impossible . Arthur Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Feb 1999 10:49:10 -0500 (EST) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Feb 1999 10:48:57 -0500 (EST) Received: via switchmail; Tue, 2 Feb 1999 10:48:56 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Feb 1999 10:46:54 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Feb 1999 10:44:41 -0500 (EST) Received: from cgns11.uscg.mil (cgns11.uscg.mil [152.121.49.5]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Feb 1999 10:44:33 -0500 (EST) Received: from d11ex1.esualameda.uscg.mil ([10.33.32.141]) by cgns11.uscg.mil (8.8.5/8.8.5) with ESMTP id KAA09669 for ; Tue, 2 Feb 1999 10:22:22 -0500 (EST) Received: by D11EX1 with Internet Mail Service (5.0.1460.8) id ; Tue, 2 Feb 1999 07:44:20 -0800 Message-ID: From: "Ongemach, Jeff PO" To: wilderness-emergency-medicine@list.pitt.edu Subject: RE: W-EMED MAMMALIAN DIVE REFLEX Date: Tue, 2 Feb 1999 07:45:14 -0800 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.0.1460.8) Content-Type: text/plain; charset="iso-8859-1" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P6A080.CNM Just curious-why were the bodies not removed by the pararescuemen? I concur with Bernie Roche's comments on "Warm and Dead", but I agree with the risk assessment-a CG rescue swimmer would not be able to enter the hull, but a pararescueman is dive qualed. To completely address the issue, what was the reason they could take a pulse, but didn't extricate the bodies? That would have placed them on deck for adequate assessment. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Feb 1999 17:46:46 -0500 (EST) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Feb 1999 15:52:04 -0500 (EST) Received: via switchmail; Tue, 2 Feb 1999 15:52:01 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Feb 1999 15:51:03 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Feb 1999 15:50:33 -0500 (EST) Received: from mx0-smtp.goodnet.com (envy.goodnet.com [207.98.129.151]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Feb 1999 15:50:29 -0500 (EST) Received: from PC_.goodnet.com (d2-23.phoenix.goodnet.com [207.98.135.87]) by mx0-smtp.goodnet.com with SMTP id NAA18277 for ; Tue, 2 Feb 1999 13:50:26 -0700 (MST) Message-ID: In-Reply-To: References: Conversation with last message X-MSMail-Priority: Normal X-Priority: 3 To: "WEMS News" MIME-Version: 1.0 From: "Tim Kovacs" Subject: Re: W-EMED MAMMALIAN DIVE REFLEX Date: Tue, 02 Feb 99 12:25:04 PST Content-Type: text/plain; charset="ISO-8859-1"; X-MAPIextension=".TXT" Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P09F90.CNM Lt. Kupchin. Would appreciate permission to reprint this on the Mountain Rescue Assn list server for input. Tim Kovacs, President Paramedic-W Mountain Rescue Association tkovacs@goodnet.com www.mra.org "You can't teach people to rescue in the mountains until they have learnt to climb... ...It is a number of small points which have little significance individually that, considered together, spell danger to the experienced rescuer." Hamish MacInnes Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Feb 1999 06:04:43 -0500 (EST) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Feb 1999 05:31:46 -0500 (EST) Received: via switchmail; Tue, 2 Feb 1999 05:31:46 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Feb 1999 05:30:53 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Feb 1999 05:30:14 -0500 (EST) Received: from titan.tcn.net (root@titan.tcn.net [199.166.4.2]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Feb 1999 05:30:12 -0500 (EST) Received: from one (comp2.tcn.net [209.135.79.2]) by titan.tcn.net (8.8.5/8.6.9) with SMTP id GAA05382 for ; Tue, 2 Feb 1999 06:02:05 -0500 (EST) Message-Id: <199902021102.GAA05382@titan.tcn.net> X-Sender: broche@titan.tcn.net X-Mailer: QUALCOMM Windows Eudora Pro Version 4.0 Date: Tue, 02 Feb 1999 05:31:38 +0000 To: wilderness-emergency-medicine@list.pitt.edu From: Bernie Roche Subject: Re: W-EMED MAMMALIAN DIVE REFLEX In-Reply-To: Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P328C0.CNM At 01:34 AM 2/2/99 -0500, you wrote: >All, > We just had an interesting case up here in Alaska with a fishing vessel that >iced up and capsized. Two crewman were trapped in the overturned hull and >were not discovered until after an exhaustive search by air and vessel assets. >Pararescuemen dove on the overturned vessel after the weather subsided. The >Pararescuemen were unable to get a pulse on either of the crewmen. They were >in survival suits in a cramped bow compartment in a small air pocket. With no >pulse they were pronounced dead and the vessel towed (inverted) to a village. >It was decided to retrieve the bodies when the wind and seas subsided and it >was safer. When rescuers reentered the boat, one of the victims had weak >vitals. >The rescue team accessed the hull with chainsaws carefully extracting >the vessels skipper and deceased crewman. The survivor was taken to the >village health clinic and we eventually transported him to Homer hospital in >stable condition after the fog and snow cleared. > This case is being looked at. Good example of risk vrs gain and weighing >the possibility of a survivor in a not so optimistic situation. Are there any >medical guidelines i.e. water temp, exposure duration, secondary assessments >to follow in these situations? Hi, Bill: Yes, the number one rule of hypothermia treatment is: "Never dead until WARM and dead. Sadly, this case illustrates the reason for the rule. Severe hypothermia can mimic death. > The survivor was in the hull, in a survival suit for 24 hours. The deceased >crewman's survival suit was not zipped up completely. > Sorry so long but good knowledge out of a bad situation. > >Respectfully, >LT Bill Kupchin >USCG Airsta Kodiak >Kodiak AK 99619 >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu Best Wishes, Bernie Roche, RN, BScN, W-EMT, OSJ WEMSI Web Site Administrator http://www.wemsi.org/ broche@tcn.net Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Feb 1999 00:29:05 -0500 (EST) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Feb 1999 00:28:54 -0500 (EST) Received: via switchmail; Tue, 2 Feb 1999 00:28:54 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Feb 1999 00:26:51 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Feb 1999 00:25:37 -0500 (EST) Received: from smtp.clarityconnect.com (smtp.clarityconnect.com [209.150.228.60]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Feb 1999 00:25:26 -0500 (EST) Received: from clarityconnect.com (206.64.143.5) by smtp.clarityconnect.com with ESMTP (Eudora Internet Mail Server 2.2.1a3); Tue, 2 Feb 1999 00:25:05 -0500 Received: from ndh (207.198.30.239) by clarityconnect.com with SMTP (Eudora Internet Mail Server 2.2); Mon, 1 Feb 1999 23:50:54 -0500 X-Sender: ndh@lightlink.com X-Mailer: QUALCOMM Windows Eudora Pro Version 4.0 Date: Mon, 01 Feb 1999 23:48:04 -0500 To: wilderness-emergency-medicine@list.pitt.edu From: nigel dyson-hudson Subject: BP method also taught in my NYS EMT class RE: W-EMED lightweight stethoscopes and BP cuffs for SAR In-Reply-To: Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Message-ID: <1294191449-18938348@clarityconnect.com> Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P55B50.CNM This BP estimate was also taught in the New York State EMT class I took 2 years ago. i.e. how quickly do you have to get the mast pants on or call for Advanced to get an IV and fluids in. nigel At 11:06 AM 2/1/99 -0600, you wrote: >The use of capillary refill was at one time a common 'fourth vital >sign', however it has fallen out of favor. It's not a very accurate >indicator of perfusion. In terms of estimating blood pressure, it's not >going to help much. > >What we teach to the USAF Pararescuemen is to palpate for radial, >femoral and carotid pulses. If a radial pulse is present, the systolic >pressure is above 80-90. If no radial , but femoral is present, then >the systolic pressure is 60 or above, and if only the carotid is >present, then the pressure is above 40. > >Obviously, these are ball-park figures, not terribly accurate. However, >it gives some idea of how far in the kimchee the patient is, and takes >only a few seconds to do. Much better to get a ball-park figure than >whip out a BP cuff in the middle of a firefight (or in an avalanche >chute, or on the side of a cliff). > >Regards, > >Rob Allen > >Robert C. Allen, DO, FACEP >Lt Col, USAF MC FS >Group Surgeon >720th Special Tactics Group (AFSCO) >Hurlburt Field, FL > >> -----Original Message----- >> From: Mike Lynch [SMTP:mlynch@impulse.net] >> Sent: Tuesday, February 02, 1999 1:05 AM >> To: wilderness-emergency-medicine@list.pitt.edu >> Subject: RE: W-EMED lightweight stethoscopes and BP cuffs for SAR >> >> A question on approximating blood pressure: Can capillary refill >> timed with >> a stop watch (inexpensive sport watches that many of us carry have >> 1/100th >> second stop watch timing) be used to replace blood pressure >> measurements in >> a wilderness medical situation? I am a SAR dog handler. Several >> vets, >> including the instructor of a working dog trauma course that I took, >> told me >> that they use capillary refill time (measured on a dog's gums) as a >> vital >> sign that is equivalent to blood pressure and monitor its change with >> time >> as we would monitor blood pressure changes with time for a human >> patient. >> >> Mike Lynch, mlynch@impulse.net >> >> > -----Original Message----- >> > From: owner-wilderness-emergency-medicine@list.pitt.edu >> > [mailto:owner-wilderness-emergency-medicine@list.pitt.edu]On Behalf >> Of >> > Keith Conover, M.D., FACEP >> > Sent: Monday, February 01, 1999 6:48 AM >> > To: wilderness-emergency-medicine@list.pitt.edu >> > Cc: sar-l@listserv.islandnet.com; NCRC Discussion List; >> > mra@altadena.net >> > Subject: W-EMED lightweight stethoscopes and BP cuffs for SAR >> > >> > >> > I recently replaced a couple of my old beatup Littman stethoscopes >> > that I use for SAR with new ones. I got the current "Littman >> > Lightweight" scopes. While I think the "Lightweight" is mainly a >> > marketing term for their inexpensive scopes, they are indeed a bit >> > lighter than the old "nurse scopes" that I'd been using. Weighing >> > them, the old ones are about 1.3 oz., and the new ones about 0.9 >> > oz. The new ones also appear quite sturdy. >> > >> > (If looking for conversions to metric, check out: http://www.ocean- >> > news.com/units.html) >> > >> > There are many places to get Littman scopes on the Web, the >> > particular place I chose because I was also getting a new fancy >> > scope for my work in the ED was: >> > http://www.steeles.com/index.html, specifically >> > http://www.steeles.com/3mlittlit.html >> > >> > Yes, there are lighter scopes, including the disposable kind. But >> > they break easily and you can't hear #$%$% with them. So I'm >> > happy with the lightweight Littman for SAR. >> > >> > But what about lightweight, sturdy BP cuffs? Most BP cuffs are >> > heavy. Anyone have good experiences with a light BP cuff to >> > report? >> > >> > Thanks. >> > --Keith Conover, M.D., FACEP >> > http://www.pitt.edu/~kconover >> >> Do not reproduce without author's express permission. >> To unsubscribe, send the text "unsubscribe >> wilderness-emergency-medicine" >> as the body of a message (no subject) To: Majordomo@list.pitt.edu >> Submissions To: wilderness-emergency-medicine@list.pitt.edu >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu > nigel dyson-hudson, InternetSmiths, ndh@InternetSmiths.com Internet and Notes Domino since the beginning. "mad dogs and Englishmen" and I am both! Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 2 Feb 1999 01:38:02 -0500 (EST) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 2 Feb 1999 01:37:50 -0500 (EST) Received: via switchmail; Tue, 2 Feb 1999 01:37:50 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 2 Feb 1999 01:35:56 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 2 Feb 1999 01:35:39 -0500 (EST) Received: from imo16.mx.aol.com (imo16.mx.aol.com [198.81.17.6]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 2 Feb 1999 01:35:35 -0500 (EST) From: ALASKANEWF@aol.com Received: from ALASKANEWF@aol.com by imo16.mx.aol.com (IMOv18.1) id MDDSa27801 for ; Tue, 2 Feb 1999 01:34:47 -0500 (EST) Message-ID: Date: Tue, 2 Feb 1999 01:34:47 EST To: wilderness-emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: W-EMED MAMMALIAN DIVE REFLEX Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0.i for Mac sub 189 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P4DB50.CNM All, We just had an interesting case up here in Alaska with a fishing vessel that iced up and capsized. Two crewman were trapped in the overturned hull and were not discovered until after an exhaustive search by air and vessel assets. Pararescuemen dove on the overturned vessel after the weather subsided. The Pararescuemen were unable to get a pulse on either of the crewmen. They were in survival suits in a cramped bow compartment in a small air pocket. With no pulse they were pronounced dead and the vessel towed (inverted) to a village. It was decided to retrieve the bodies when the wind and seas subsided and it was safer. When rescuers reentered the boat, one of the victims had weak vitals. The rescue team accessed the hull with chainsaws carefully extracting the vessels skipper and deceased crewman. The survivor was taken to the village health clinic and we eventually transported him to Homer hospital in stable condition after the fog and snow cleared. This case is being looked at. Good example of risk vrs gain and weighing the possibility of a survivor in a not so optimistic situation. Are there any medical guidelines i.e. water temp, exposure duration, secondary assessments to follow in these situations? The survivor was in the hull, in a survival suit for 24 hours. The deceased crewman's survival suit was not zipped up completely. Sorry so long but good knowledge out of a bad situation. Respectfully, LT Bill Kupchin USCG Airsta Kodiak Kodiak AK 99619 Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Mon, 1 Feb 1999 17:24:20 -0500 (EST) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Mon, 1 Feb 1999 17:24:14 -0500 (EST) Received: via switchmail for kconover+@pitt.edu; Mon, 1 Feb 1999 17:24:11 -0500 (EST) Received: from listserv.islandnet.com (listserv.islandnet.com [199.175.106.5]) by post-ofc03.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 1 Feb 1999 17:24:00 -0500 (EST) Received: by uucp.islandnet.com id m107Re7-0017tDC for grandey+@pitt.edu; Mon, 1 Feb 1999 14:16:43 -0800 (PST) Resent-Date: Mon, 1 Feb 1999 14:16:43 -0800 (PST) Old-Return-Path: Message-ID: Date: Mon, 1 Feb 1999 22:15:04 +0000 To: wilderness-emergency-medicine@list.pitt.edu Cc: SAR-L , MRA From: John T Eley Subject: Re: W-EMED Pararescue programs In-Reply-To: MIME-Version: 1.0 X-Mailer: Turnpike (32) Version 3.05 Resent-Message-ID: <"BCuI2.A.N_F.Afit2"@listserv.islandnet.com> Resent-From: sar-l@listserv.islandnet.com Reply-To: sar-l@listserv.islandnet.com X-Mailing-List: archive/latest/730 X-Loop: sar-l@listserv.islandnet.com Precedence: list Resent-Sender: sar-l-request@listserv.islandnet.com In the UK we have the 321st Special Tactics Sqn based at RAF Mildenhall,there are more US units throughout the world. Look at this web site it has more info. http://www.wpafb.af.mil/museum/history/rescue/rescue.htm John Eley Severn Rescue Inshore Rescue Boats & Cliff Rescue In message , Tim Kovacs writes >Does anyone have a cureent list of which military units still have >Pararescue/ PJ-type units which are involved in SAR? > >Tim Kovacs, President >Mountain Rescue Association >tkovacs@goodnet.com >www.mra.org > >"You can't teach people to rescue in the mountains until they have learnt >to climb... >...It is a number of small points which have little significance >individually that, considered together, spell danger to the experienced >rescuer." Hamish MacInnes > >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu -- John T Eley ========================================================================== SAR-L Search and Rescue discussion list. For unsubscribe information-email to sar-l-request@listserv.islandnet.com with the word 'help' in the subject field. ========================================================================== -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 1 Feb 1999 14:48:27 -0500 (EST) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 1 Feb 1999 14:48:18 -0500 (EST) Received: via switchmail; Mon, 1 Feb 1999 14:48:17 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 1 Feb 1999 14:47:23 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 1 Feb 1999 14:46:51 -0500 (EST) Received: from shepherd.hurlburt.af.mil (shepherd.hurlburt.af.mil [151.166.15.65]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 1 Feb 1999 14:46:47 -0500 (EST) Received: from shepherd.hurlburt.af.mil (root@localhost) by shepherd.hurlburt.af.mil with ESMTP id NAA19972 for ; Mon, 1 Feb 1999 13:39:07 -0600 (CST) Received: from emh.stn.hurlburt.af.mil (emh.stn.hurlburt.af.mil [151.166.160.105]) by shepherd.hurlburt.af.mil with ESMTP id NAA19968 for ; Mon, 1 Feb 1999 13:39:07 -0600 (CST) Received: by emh with Internet Mail Service (5.5.1960.3) id ; Mon, 1 Feb 1999 13:40:58 -0600 Message-ID: From: allenro To: "'wilderness-emergency-medicine@list.pitt.edu'" Subject: RE: W-EMED Pararescue programs Date: Mon, 1 Feb 1999 13:40:54 -0600 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.1960.3) Content-Type: text/plain Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P1F4E0.CNM USAF Pararescue is divided up into several different branches. Active duty units include: -'Conventional' Rescue units (part of Air Combat Command and Pacific Air Command) at Moody AFB, GA, Nellis AFB NV, and one squadron in the far east. -Special Tactics Squadrons (Pararescue and Combat Control combined, part of Air Force Special Operations Command) at Hurlburt Field FL, Pope AFB NC, and McCord AFB WA. There are two overseas ST squadrons as well. Air National Guard Rescue squadrons are in New York, Alaska, and California. Air Force Reserve Rescue squadrons are at Davis-Monthan AFB AZ, Portland OR, and Patrick AFB FL The PJ Schoolhouse is at Kirtland AFB, NM. All these units are involved with Combat SAR training and operations However, their involvement with civilian SAR varies quite a bit. The Guard units, since they answer to State authority most of the time, are more active in civilian SAR than the active duty units. Regards, Rob Allen Robert C. Allen, DO, FACEP Lt Col, USAF MC FS Group Surgeon 720th Special Tactics Group (AFSOC) Hurlburt Field, FL > -----Original Message----- > From: Tim Kovacs [SMTP:tkovacs@goodnet.com] > Sent: Tuesday, February 02, 1999 2:49 AM > To: WEMS News > Cc: SAR-L; MRA > Subject: W-EMED Pararescue programs > > Does anyone have a cureent list of which military units still have > Pararescue/ PJ-type units which are involved in SAR? > > Tim Kovacs, President > Mountain Rescue Association > tkovacs@goodnet.com > www.mra.org > > "You can't teach people to rescue in the mountains until they have > learnt > to climb... > ...It is a number of small points which have little significance > individually that, considered together, spell danger to the > experienced > rescuer." Hamish MacInnes > > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe > wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 1 Feb 1999 14:15:42 -0500 (EST) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 1 Feb 1999 14:15:28 -0500 (EST) Received: via switchmail; Mon, 1 Feb 1999 14:15:28 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 1 Feb 1999 14:15:07 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 1 Feb 1999 14:14:41 -0500 (EST) Received: from x5.boston.juno.com (x5.boston.juno.com [205.231.100.23]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 1 Feb 1999 14:14:34 -0500 (EST) Received: (from jaywiseman@juno.com) by x5.boston.juno.com (queuemail) id D2D5B9U3; Mon, 01 Feb 1999 14:14:18 EST To: wilderness-emergency-medicine@list.pitt.edu Date: Mon, 1 Feb 1999 11:18:28 -0800 Subject: W-EMED Has anybody actually used a CPR face shield? Message-ID: <19990201.111828.16054.0.JayWiseman@juno.com> References: X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 0-1,3-4,6,8-10,12-16,18,20,22,24-28,30,32,34-36,38, 40-41,43-46,48-50,52,54-56,58-68 From: Jay J Wiseman Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 33554560 0 1 P4D100.CNM Hi folks, I teach a fair number of CPR classes, to various groups -- both medical and "civilian." I notice that it's common practice during these classes to recommend the use of what are called "face shields," or to at least point out that they are available for use, during mouth-to-mouth breathing. (So I guess in this case it's now mouth-to-face-shield breathing.) I've participated in a large number of on-duty codes, and two off-duty codes, and I've used most of the other devices available for ventilation, but I personally have never used one of these face shields during an actual resuscitation. I've bought samples of the common brands (MDI, Ambu, Laerdal, LifeMask) and looked them over. Some seem like they would be easy enough to carry on an everyday basis (the Laerdal seems easier to carry than a credit card), and that's all well and good. But, in my mind, a more important question is how well would they work in an actual resuscitation? At this point I have no personal experience on this point, nor do I know anybody who does. Some of my concerns are: Can one reliably and consistently adequately ventilate the patient? Is there really significantly increased protection from infectious disease, at least for the rescuer, by using one? (Only the LifeMask brand seems to have a "biologically significant" filter.) Can you adequately spot developing cyanosis? Major question: Is the rescuer less likely to be aggressive about clearing regurgitated food out of the pharyx (and therefore more likely to blow it into the patient's lungs) because the rescuer is somewhat protected from this regurgitated food and therefore doesn't have to directly deal with it? This could be a significant issue. (It's my experience that regurgitation significantly complicates about one CPR attempt in three.) [I'm going to set aside the question of how important are ventilations at all in the case of cardiac arrest.] So, has anybody out there actually used one of these face shields in a real situation, or seen one being used? What brand was it? In your opinion, how well did it work? Any other comments? My concern is that very large numbers of people are buying and carrying these devices, but I know of no studies regarding their effectiveness, nor do I personally know anybody who has extensive actual experience in their use. Just how "reality tested" are these things? Any input? Regards, Jay Wiseman (CPR instructor, among other things) ___________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com/getjuno.html or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 1 Feb 1999 13:54:54 -0500 (EST) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 1 Feb 1999 13:54:37 -0500 (EST) Received: via switchmail; Mon, 1 Feb 1999 13:54:36 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 1 Feb 1999 13:52:50 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 1 Feb 1999 13:52:19 -0500 (EST) Received: from mcfs.whowhere.com (mcfs.whowhere.com [209.1.236.44]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 1 Feb 1999 13:52:09 -0500 (EST) Received: from Unknown/Local ([?.?.?.?]) by angelfire.com; Mon Feb 1 10:51:26 1999 To: wilderness-emergency-medicine@list.pitt.edu Date: Mon, 01 Feb 1999 18:51:26 -0000 From: "JOSH HORNE" Message-ID: Mime-Version: 1.0 X-Sent-Mail: on X-Mailer: MailCity Service Subject: Re: W-EMED Re: lightweight stethoscopes and BP cuffs for SAR X-Sender-Ip: 208.245.241.53 Organization: Angelfire (http://email.angelfire.com:80) Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P0F690.CNM I am new to this list but you should be able to get a littman light for about 45 dollars or less. Josh Horne EMTP -- On Mon, 01 Feb 1999 09:52:24 Andrew P. Jenkins, PhD wrote: >Keith Conover, M.D., FACEP wrote: >> >> I recently replaced a couple of my old beatup Littman stethoscopes >> that I use for SAR with new ones. I got the current "Littman >> Lightweight" scopes. > The new ones also appear quite sturdy. > >Keith, >Thanks for the heads-up on the new Littman "ears." What about the >cost? As you know, our gear has a propensity toward falling into >crevasses and flying away with helicopters. Do have a source for >non-profit agency pricing? > >I've been lugging around a chunky Sprague-Rappaport two tube job for >quite some time. I find the sound quality is great with the two tubes >and it's sturdy construction allows for double duty as deadman anchor to >keep the rainfly from blowing away. I don't think you could break one >if you tried and if it "flies away" on a rescue I'm only out $15. > >Andy Jenkins, PhD, EMT >CWMR >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu > Angelfire for your free web-based e-mail. http://www.angelfire.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 1 Feb 1999 12:13:57 -0500 (EST) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 1 Feb 1999 12:13:47 -0500 (EST) Received: via switchmail; Mon, 1 Feb 1999 12:13:47 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 1 Feb 1999 12:13:29 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 1 Feb 1999 12:13:01 -0500 (EST) Received: from shepherd.hurlburt.af.mil (shepherd.hurlburt.af.mil [151.166.15.65]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 1 Feb 1999 12:12:23 -0500 (EST) Received: from shepherd.hurlburt.af.mil (root@localhost) by shepherd.hurlburt.af.mil with ESMTP id LAA21760 for ; Mon, 1 Feb 1999 11:04:51 -0600 (CST) Received: from emh.stn.hurlburt.af.mil (emh.stn.hurlburt.af.mil [151.166.160.105]) by shepherd.hurlburt.af.mil with ESMTP id LAA21747 for ; Mon, 1 Feb 1999 11:04:49 -0600 (CST) Received: by emh with Internet Mail Service (5.5.1960.3) id ; Mon, 1 Feb 1999 11:06:40 -0600 Message-ID: From: allenro To: "'wilderness-emergency-medicine@list.pitt.edu'" Subject: RE: W-EMED lightweight stethoscopes and BP cuffs for SAR Date: Mon, 1 Feb 1999 11:06:38 -0600 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.1960.3) Content-Type: text/plain Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P679C0.CNM The use of capillary refill was at one time a common 'fourth vital sign', however it has fallen out of favor. It's not a very accurate indicator of perfusion. In terms of estimating blood pressure, it's not going to help much. What we teach to the USAF Pararescuemen is to palpate for radial, femoral and carotid pulses. If a radial pulse is present, the systolic pressure is above 80-90. If no radial , but femoral is present, then the systolic pressure is 60 or above, and if only the carotid is present, then the pressure is above 40. Obviously, these are ball-park figures, not terribly accurate. However, it gives some idea of how far in the kimchee the patient is, and takes only a few seconds to do. Much better to get a ball-park figure than whip out a BP cuff in the middle of a firefight (or in an avalanche chute, or on the side of a cliff). Regards, Rob Allen Robert C. Allen, DO, FACEP Lt Col, USAF MC FS Group Surgeon 720th Special Tactics Group (AFSCO) Hurlburt Field, FL > -----Original Message----- > From: Mike Lynch [SMTP:mlynch@impulse.net] > Sent: Tuesday, February 02, 1999 1:05 AM > To: wilderness-emergency-medicine@list.pitt.edu > Subject: RE: W-EMED lightweight stethoscopes and BP cuffs for SAR > > A question on approximating blood pressure: Can capillary refill > timed with > a stop watch (inexpensive sport watches that many of us carry have > 1/100th > second stop watch timing) be used to replace blood pressure > measurements in > a wilderness medical situation? I am a SAR dog handler. Several > vets, > including the instructor of a working dog trauma course that I took, > told me > that they use capillary refill time (measured on a dog's gums) as a > vital > sign that is equivalent to blood pressure and monitor its change with > time > as we would monitor blood pressure changes with time for a human > patient. > > Mike Lynch, mlynch@impulse.net > > > -----Original Message----- > > From: owner-wilderness-emergency-medicine@list.pitt.edu > > [mailto:owner-wilderness-emergency-medicine@list.pitt.edu]On Behalf > Of > > Keith Conover, M.D., FACEP > > Sent: Monday, February 01, 1999 6:48 AM > > To: wilderness-emergency-medicine@list.pitt.edu > > Cc: sar-l@listserv.islandnet.com; NCRC Discussion List; > > mra@altadena.net > > Subject: W-EMED lightweight stethoscopes and BP cuffs for SAR > > > > > > I recently replaced a couple of my old beatup Littman stethoscopes > > that I use for SAR with new ones. I got the current "Littman > > Lightweight" scopes. While I think the "Lightweight" is mainly a > > marketing term for their inexpensive scopes, they are indeed a bit > > lighter than the old "nurse scopes" that I'd been using. Weighing > > them, the old ones are about 1.3 oz., and the new ones about 0.9 > > oz. The new ones also appear quite sturdy. > > > > (If looking for conversions to metric, check out: http://www.ocean- > > news.com/units.html) > > > > There are many places to get Littman scopes on the Web, the > > particular place I chose because I was also getting a new fancy > > scope for my work in the ED was: > > http://www.steeles.com/index.html, specifically > > http://www.steeles.com/3mlittlit.html > > > > Yes, there are lighter scopes, including the disposable kind. But > > they break easily and you can't hear #$%$% with them. So I'm > > happy with the lightweight Littman for SAR. > > > > But what about lightweight, sturdy BP cuffs? Most BP cuffs are > > heavy. Anyone have good experiences with a light BP cuff to > > report? > > > > Thanks. > > --Keith Conover, M.D., FACEP > > http://www.pitt.edu/~kconover > > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe > wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 1 Feb 1999 11:10:26 -0500 (EST) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 1 Feb 1999 11:10:18 -0500 (EST) Received: via switchmail; Mon, 1 Feb 1999 11:10:18 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 1 Feb 1999 11:07:48 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 1 Feb 1999 11:07:19 -0500 (EST) Received: from impulse.net (mail.impulse.net [204.188.6.10]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 1 Feb 1999 11:07:15 -0500 (EST) Received: (qmail 22570 invoked by alias); 1 Feb 1999 16:07:12 -0000 Received: from lo1-31.impulse.net (HELO lynch) (204.182.12.31) by mail.impulse.net with SMTP; 1 Feb 1999 16:07:12 -0000 From: "Mike Lynch" To: Subject: RE: W-EMED lightweight stethoscopes and BP cuffs for SAR Date: Mon, 1 Feb 1999 08:05:17 -0800 Message-ID: <000101be4dfc$b179cf00$0d00a8c0@lynch> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 (Normal) X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook 8.5, Build 4.71.2232.26 Importance: Normal X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3110.3 Disposition-Notification-To: "Mike Lynch" In-Reply-To: <199902011448.JAA07155@post-ofc05.srv.cis.pitt.edu> Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P21D70.CNM A question on approximating blood pressure: Can capillary refill timed with a stop watch (inexpensive sport watches that many of us carry have 1/100th second stop watch timing) be used to replace blood pressure measurements in a wilderness medical situation? I am a SAR dog handler. Several vets, including the instructor of a working dog trauma course that I took, told me that they use capillary refill time (measured on a dog's gums) as a vital sign that is equivalent to blood pressure and monitor its change with time as we would monitor blood pressure changes with time for a human patient. Mike Lynch, mlynch@impulse.net > -----Original Message----- > From: owner-wilderness-emergency-medicine@list.pitt.edu > [mailto:owner-wilderness-emergency-medicine@list.pitt.edu]On Behalf Of > Keith Conover, M.D., FACEP > Sent: Monday, February 01, 1999 6:48 AM > To: wilderness-emergency-medicine@list.pitt.edu > Cc: sar-l@listserv.islandnet.com; NCRC Discussion List; > mra@altadena.net > Subject: W-EMED lightweight stethoscopes and BP cuffs for SAR > > > I recently replaced a couple of my old beatup Littman stethoscopes > that I use for SAR with new ones. I got the current "Littman > Lightweight" scopes. While I think the "Lightweight" is mainly a > marketing term for their inexpensive scopes, they are indeed a bit > lighter than the old "nurse scopes" that I'd been using. Weighing > them, the old ones are about 1.3 oz., and the new ones about 0.9 > oz. The new ones also appear quite sturdy. > > (If looking for conversions to metric, check out: http://www.ocean- > news.com/units.html) > > There are many places to get Littman scopes on the Web, the > particular place I chose because I was also getting a new fancy > scope for my work in the ED was: > http://www.steeles.com/index.html, specifically > http://www.steeles.com/3mlittlit.html > > Yes, there are lighter scopes, including the disposable kind. But > they break easily and you can't hear #$%$% with them. So I'm > happy with the lightweight Littman for SAR. > > But what about lightweight, sturdy BP cuffs? Most BP cuffs are > heavy. Anyone have good experiences with a light BP cuff to > report? > > Thanks. > --Keith Conover, M.D., FACEP > http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 1 Feb 1999 18:06:38 -0500 (EST) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 1 Feb 1999 18:06:27 -0500 (EST) Received: via switchmail; Mon, 1 Feb 1999 18:06:26 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 1 Feb 1999 18:04:48 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 1 Feb 1999 18:04:27 -0500 (EST) Received: from macs.mxim.com (macs.mxim.com [204.17.143.130]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 1 Feb 1999 18:04:17 -0500 (EST) Received: from localhost (localhost [127.0.0.1]) by macs.mxim.com (8.7/8.6.9) with SMTP id PAA24581 for ; Mon, 1 Feb 1999 15:03:39 -0800 (PST) Message-Id: <199902012303.PAA24581@macs.mxim.com> X-Mailer: exmh version 2.0.1 12/23/97 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Has anybody actually used a CPR face shield? In-reply-to: Your message of "Mon, 01 Feb 1999 11:18:28 PST." <19990201.111828.16054.0.JayWiseman@juno.com> Mime-Version: 1.0 Content-Type: text/plain; charset=us-ascii Date: Mon, 01 Feb 1999 15:03:38 PST From: Hal Lillywhite Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P54680.CNM Jay J Wiseman I've participated in a large number of on-duty codes, and two >off-duty codes, and I've used most of the other devices available >for ventilation, but I personally have never used one of these >face shields during an actual resuscitation. I'm not sure what you mean by "face shield." I carry a small one way mask (Rondek USA Isoshield) in a pouch attached to my key chain. I'm not a professional medic so have only done CPR for real once. In that case I was mighty glad to have it and it worked well. I was on the scene immediately after a drunk tried to walk across a busy freeway with predictable results. He was a bloody mess and another first responder who got to him just before I did had decided he was dead and we couldn't do anything. He did however have a pulse when I checked but that pulse soon stopped. I did provided breaths while someone else did compressions and we got a natural pulse to return. No vomit in this case and I had no particular difficulty (other than excitement from my first real case) getting air into the lungs. Unfortunately, but not unexpectedly, the patient died soon after being transported. He had obvious signs of severe head injury and considering the impact probably other serious internal injuries as well. As for the possibility of poor care of a vomiting patient when a mask is usee, I think the solution is training. I doubt a well trained rescuer will overlook that issue. The pocket masks in fact would probably be ejected by a vomiting patient making it obvious that there was a problem. I don't know of any actual studies and my experience is obviously not extensive. I can only provide the one data point described above. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 1 Feb 1999 09:51:32 -0500 (EST) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 1 Feb 1999 09:51:23 -0500 (EST) Received: via switchmail; Mon, 1 Feb 1999 09:51:23 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 1 Feb 1999 09:49:38 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 1 Feb 1999 09:48:25 -0500 (EST) Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 1 Feb 1999 09:48:16 -0500 (EST) Received: from 136.142.57.10.pitt.edu (ehdup-f3-13.rmt.net.pitt.edu [136.142.21.123]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 1 Feb 1999 09:48:06 -0500 (EST) Message-Id: <199902011448.JAA07155@post-ofc05.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: wilderness-emergency-medicine@list.pitt.edu Date: Mon, 1 Feb 1999 09:47:52 -0500 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: W-EMED lightweight stethoscopes and BP cuffs for SAR CC: sar-l@listserv.islandnet.com, NCRC@ontosystems.com (NCRC Discussion List), mra@altadena.net X-mailer: Pegasus Mail for Win32 (v3.01d) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu I recently replaced a couple of my old beatup Littman stethoscopes that I use for SAR with new ones. I got the current "Littman Lightweight" scopes. While I think the "Lightweight" is mainly a marketing term for their inexpensive scopes, they are indeed a bit lighter than the old "nurse scopes" that I'd been using. Weighing them, the old ones are about 1.3 oz., and the new ones about 0.9 oz. The new ones also appear quite sturdy. (If looking for conversions to metric, check out: http://www.ocean- news.com/units.html) There are many places to get Littman scopes on the Web, the particular place I chose because I was also getting a new fancy scope for my work in the ED was: http://www.steeles.com/index.html, specifically http://www.steeles.com/3mlittlit.html Yes, there are lighter scopes, including the disposable kind. But they break easily and you can't hear #$%$% with them. So I'm happy with the lightweight Littman for SAR. But what about lightweight, sturdy BP cuffs? Most BP cuffs are heavy. Anyone have good experiences with a light BP cuff to report? Thanks. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: From: Self To: wilderness-emergency-medicine@list.pitt.edu Subject: lightweight stethoscopes and BP cuffs for SAR Cc: sar-l@listserv.islandnet.com,NCRC@ontosystems.com (NCRC Discussion List),mra@altadena.net Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Mon, 1 Feb 1999 09:46:49 -0500 I recently replaced a couple of my old beatup Littman stethoscopes that I use for SAR with new ones. I got the current "Littman Lightweight" scopes. While I think the "Lightweight" is mainly a marketing term for their inexpensive scopes, they are indeed a bit lighter than the old "nurse scopes" that I'd been using. Weighing them, the old ones are about 1.3 oz., and the new ones about 0.9 oz. The new ones also appear quite sturdy. (If looking for conversions to metric, check out: http://www.ocean- news.com/units.html) There are many places to get Littman scopes on the Web, the particular place I chose because I was also getting a new fancy scope for my work in the ED was: http://www.steeles.com/index.html, specifically http://www.steeles.com/3mlittlit.html Yes, there are lighter scopes, including the disposable kind. But they break easily and you can't hear #$%$% with them. So I'm happy with the lightweight Littman for SAR. But what about lightweight, sturdy BP cuffs? Most BP cuffs are heavy. Anyone have good experiences with a light BP cuff to report? Thanks. -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 1 Feb 1999 13:16:38 -0500 (EST) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 1 Feb 1999 13:16:31 -0500 (EST) Received: via switchmail; Mon, 1 Feb 1999 13:16:31 -0500 (EST) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 1 Feb 1999 13:15:26 -0500 (EST) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 1 Feb 1999 13:14:47 -0500 (EST) Received: from mx0-smtp.goodnet.com (envy.goodnet.com [207.98.129.151]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 1 Feb 1999 13:14:44 -0500 (EST) Received: from PC_.goodnet.com (d14-9.phoenix.goodnet.com [209.141.96.74]) by mx0-smtp.goodnet.com with SMTP id LAA25436; Mon, 1 Feb 1999 11:14:41 -0700 (MST) Message-ID: X-MSMail-Priority: Normal X-Priority: 3 To: "WEMS News" Cc: "SAR-L" , "MRA" MIME-Version: 1.0 From: "Tim Kovacs" Subject: W-EMED Pararescue programs Date: Mon, 01 Feb 99 09:49:28 PST Content-Type: text/plain; charset="ISO-8859-1"; X-MAPIextension=".TXT" Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu Does anyone have a cureent list of which military units still have Pararescue/ PJ-type units which are involved in SAR? Tim Kovacs, President Mountain Rescue Association tkovacs@goodnet.com www.mra.org "You can't teach people to rescue in the mountains until they have learnt to climb... ...It is a number of small points which have little significance individually that, considered together, spell danger to the experienced rescuer." Hamish MacInnes Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End --