Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Tue, 31 Oct 2000 19:44:46 -0500 (EST) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JVZYTYSY0600FDSO@mb2i0.ns.pitt.edu>; Tue, 31 Oct 2000 19:43:59 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Tue, 31 Oct 2000 19:42:48 -0500 (EST) Received: from imo-r16.mail.aol.com (imo-r16.mx.aol.com [152.163.225.70]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Tue, 31 Oct 2000 19:42:40 -0500 (EST) Received: from Mkeowl@aol.com by imo-r16.mx.aol.com (mail_out_v28.32.) id h.2f.c631d26 (3858) for ; Tue, 31 Oct 2000 19:41:48 -0500 (EST) Date: Tue, 31 Oct 2000 19:41:47 -0500 (EST) From: Mkeowl@aol.com Subject: W-EMED Need a SOP for MD used in SAR... Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <2f.c631d26.2730c0cb@aol.com> MIME-version: 1.0 X-Mailer: Windows AOL sub 123 Content-type: text/plain; charset="US-ASCII" Content-transfer-encoding: 7bit Precedence: bulk Where would I find SOPs or other related info to write a 'job description' for a Family Physician who is interested in working with a SAR unit? He has taken CE in Wilderness Medicine and is now interested in working in SAR. Thanks for your help. Linda R. Uihlein Blue and Gray SAR Dogs, VA EMT, WEMT 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Wed, 25 Oct 2000 20:48:22 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JVRNBQG76M004QB1@mb1i0.ns.pitt.edu>; Wed, 25 Oct 2000 20:48:22 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Wed, 25 Oct 2000 20:46:48 -0400 (EDT) Received: from gtei2.bellatlantic.net (gtei2.bellatlantic.net [199.45.39.161]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Wed, 25 Oct 2000 20:46:41 -0400 (EDT) Received: from klaptop (client-141-151-77-152.bellatlantic.net [141.151.77.152]) by gtei2.bellatlantic.net (8.9.1/8.9.1) with ESMTP id UAA09542; Wed, 25 Oct 2000 20:46:09 -0400 (EDT) Date: Wed, 25 Oct 2000 20:45:15 -0400 From: "Keith Conover, M.D., FACEP" Subject: Re: W-EMED Fwd: PDA/Handheld Computer Use for Pt Reporting In-reply-to: <47.20cc6a5.2719b49b@aol.com> Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: Kcub1@aol.com, wilderness-emergency-medicine@list.pitt.edu Cc: mra@altadena.net Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <39F7465B.22086.1121E089@localhost> MIME-version: 1.0 X-Mailer: Pegasus Mail for Win32 (v3.12c) Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Precedence: bulk On 14 Oct 2000, at 9:07, Kcub1@aol.com wrote: > Keith, et al...Do you or any organization use a PDA for Pt reporting, > med info, etc? Does this device have any application in a "wilderness" > setting? Just a thought...Keith Cubbedge Keith, I've been a big fan of computer technology for charting. I've been using a PC-based speech recognition system for charting in the ED for years. And there are zillions (well, at least a dozen or so) companies who will take your money in exchange for a PDA with a charting application on it, some for inhospital, some for prehospital. Come to the annual ACEP/PaACEP ED Information Systems Symposium in New Orleans January 13-15 (www.paacep.org) to see many of them. (You can also hear my lecture on human interfaces for software design.) Nonetheless, I have never and would likely never consider a PDA for wilderenss use. Not reliable or robust enough. Rite-in-the-Rain paper, or Tyvek, and a Sharpie waterproof marker with a wooden pencil backup is my preferred wilderness charting system! BTW, WEMSI Patient Record Forms are available at: http://www.pitt.edu/~kconover/ftp/ WEMSI Patient Record Form 11.pdf Any critique is welcomed, as we plan to update these and then print them up on Rite-in-the-Rain paper. We'll see if we can get someone who has a Web storefront to carry them for people who want them, it'll be cheaper for individuals to get them that way. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover sent with Pegasus high-security email download free from www.pmail.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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sat, 14 Oct 2000 16:29:27 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JVC12WP9B2003HE2@mb1i0.ns.pitt.edu>; Sat, 14 Oct 2000 16:29:26 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sat, 14 Oct 2000 16:27:29 -0400 (EDT) Received: from hotmail.com (oe11.law7.hotmail.com [216.33.236.115]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sat, 14 Oct 2000 16:27:26 -0400 (EDT) Received: from mail pickup service by hotmail.com with Microsoft SMTPSVC; Sat, 14 Oct 2000 13:26:51 -0700 Date: Sat, 14 Oct 2000 16:29:07 -0400 From: Craig Button Subject: Re: W-EMED Fwd: PDA/Handheld Computer Use for Pt Reporting Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V5.50.4133.2400 X-Mailer: Microsoft Outlook Express 5.50.4133.2400 Content-type: text/plain; charset="iso-8859-1" Content-transfer-encoding: 7bit X-Priority: 3 X-MSMail-priority: Normal Precedence: bulk X-Originating-IP: [24.4.253.16] X-OriginalArrivalTime: 14 Oct 2000 20:26:51.0830 (UTC) FILETIME=[160D5D60:01C0361D] References: <47.20cc6a5.2719b49b@aol.com> There are lots of applications that can be used with a PDA. Everything from simple database/pt documentation to references and even as a terminal to packet radio/ham radio. It's one of those area's that uses are limited by imagination and programing ability. 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sat, 14 Oct 2000 09:10:07 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JVBLQ8O32Y003EQ0@mb1i0.ns.pitt.edu>; Sat, 14 Oct 2000 09:10:07 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sat, 14 Oct 2000 09:09:28 -0400 (EDT) Received: from imo-r19.mail.aol.com (imo-r19.mx.aol.com [152.163.225.73]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sat, 14 Oct 2000 09:09:26 -0400 (EDT) Received: from Kcub1@aol.com by imo-r19.mx.aol.com (mail_out_v28.31.) id h.47.20cc6a5 (4322); Sat, 14 Oct 2000 09:07:39 -0400 (EDT) Date: Sat, 14 Oct 2000 09:07:39 -0400 (EDT) From: Kcub1@aol.com Subject: W-EMED Fwd: PDA/Handheld Computer Use for Pt Reporting Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: kconover@pitt.edu (Keith Conover,M.D.,FACEP) Cc: fdvenom1@hotmail.com, ADickison@aol.com, rgoodman@dps.state.nm.us, jisaac@bwn.net (Jeff Isaac), tkovacs@goodnet.com, conterra@pacificrim.net (conterra), Sarpuma@aol.com, wilderness-emergency-medicine@list.pitt.edu, zafren@alaska.com, jstankie@weir.net (John Stankiewicz), bob.norris@leland.stanford.edu (Robert Norris), mra@altadena.net, tschimel@wyoming.com (Tod Schimelpfenig) Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <47.20cc6a5.2719b49b@aol.com> MIME-version: 1.0 X-Mailer: Windows AOL sub 118 Content-type: multipart/mixed; boundary="part1_47.20cc6a5.2719b49b_boundary" Precedence: bulk --part1_47.20cc6a5.2719b49b_boundary Content-Type: text/plain; charset="US-ASCII" Content-Transfer-Encoding: 7bit Keith, et al...Do you or any organization use a PDA for Pt reporting, med info, etc? Does this device have any application in a "wilderness" setting? Just a thought...Keith Cubbedge --part1_47.20cc6a5.2719b49b_boundary Content-Type: message/rfc822 Content-Disposition: inline Return-Path: Received: from rly-za02.mx.aol.com (rly-za02.mail.aol.com [172.31.36.98]) by air-za04.mail.aol.com (v76_r1.8) with ESMTP; Thu, 12 Oct 2000 02:51:58 -0400 Received: from lists.sni.net (lists.sni.net [199.117.27.5]) by rly-za02.mx.aol.com (v75_b3.9) with ESMTP; Thu, 12 Oct 2000 02:51:45 -0400 Received: (from majordomo@localhost) by lists.sni.net (8.9.3/8.9.3) id XAA05058 for colorado-ems-include; Wed, 11 Oct 2000 23:19:37 -0600 X-Authentication-Warning: lists.sni.net: majordomo set sender to owner-colorado-ems@lists.csn.net using -f Received: from mailman2.sni.net (IDENT:root@mailman2.sni.net [199.117.27.34]) by lists.sni.net (8.9.3/8.9.3) with ESMTP id XAA05055 for ; Wed, 11 Oct 2000 23:19:31 -0600 Received: from mail.littleton.org (mail.littleton.org [206.83.103.3]) by mailman2.sni.net (8.9.3/8.9.3) with SMTP id AAA15181 for ; Thu, 12 Oct 2000 00:44:05 -0600 Received: from COL-Message_Server by mail.littleton.org with Novell_GroupWise; Thu, 12 Oct 2000 00:43:56 -0600 Message-Id: X-Mailer: Novell GroupWise 5.5.2 Date: Thu, 12 Oct 2000 00:43:19 -0600 From: "Eric Sondeen" To: Cc: Subject: PDA/Handheld Computer Use for Pt Reporting Mime-Version: 1.0 Content-Type: text/plain; charset=US-ASCII Content-Disposition: inline Content-Transfer-Encoding: 8bit X-MIME-Autoconverted: from quoted-printable to 8bit by lists.sni.net id XAA05055 Sender: owner-colorado-ems@lists.csn.net Precedence: bulk PDA/Handheld Computer Use for Pt Reporting Several of us are investigating ways to use wireless internet applications for PDA's/Palm/WindowsCE to make the going a bit easier on the EMS front. We are already using the Epocrates.Com for pharmacology updates infield and "Docs to Go" for the Denver Metro Protocols, but.... It's not enough. Is anyone using, or aware of, some good PDA patient reporting software that can be linked with hospital records and/or EMS agency patient software? We would need something with a flexible interface to translate for several receiving hospitals' software. The wireless internet solutions look best--why not beam the info rather than waiting for arrival and upload? Thanks for your help. Eric Eric Sondeen Littleton Fire The October 2000 issue of "RadioResource" magazine has some ideas for those wishing an update on the technology. --part1_47.20cc6a5.2719b49b_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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Fri, 13 Oct 2000 13:13:56 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JVAFY6DA2W00C9JC@mb2i0.ns.pitt.edu>; Fri, 13 Oct 2000 13:13:56 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Fri, 13 Oct 2000 13:12:37 -0400 (EDT) Received: from montu.kynd.net (mail@montu.kynd.net [208.162.108.5]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Fri, 13 Oct 2000 13:12:33 -0400 (EDT) Received: from rosalind.ts5-dvrf.att.kynd.net (master) [12.27.186.52] by montu.kynd.net with smtp (Exim 3.12 #1 (Debian)) id 13k8NR-0008Ig-00; Fri, 13 Oct 2000 13:12:14 -0400 Date: Fri, 13 Oct 2000 13:13:12 -0400 From: Oldfield Family Subject: Re: W-EMED Re: Emergency medical portable non pressurized oxygen Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu, Darrell Stevens Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <019f01c03538$f16458e0$0a01a8c0@master> MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V4.72.3155.0 X-Mailer: Microsoft Outlook Express 4.72.3155.0 Content-type: text/plain; charset="iso-8859-1" Content-transfer-encoding: 7bit X-Priority: 3 X-MSMail-priority: Normal Precedence: bulk DITTO, no kudos here,spill and temp variable Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Fri, 13 Oct 2000 12:08:27 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JVADNZ9S2800C19B@mb2i0.ns.pitt.edu>; Fri, 13 Oct 2000 12:08:26 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Fri, 13 Oct 2000 12:04:42 -0400 (EDT) Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Fri, 13 Oct 2000 12:04:39 -0400 (EDT) Received: from micron ("port 1119"@[136.142.22.173]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JVADITKH3000C93W@mb2i0.ns.pitt.edu> for wilderness-emergency-medicine@list.pitt.edu; Fri, 13 Oct 2000 12:04:38 -0500 (EST) Date: Fri, 13 Oct 2000 12:04:15 -0400 From: "Keith Conover, M.D., FACEP" Subject: W-EMED Re: Emergency medical portable non pressurized oxygen In-reply-to: <014701c032da$aa855ce0$d2d9aec7@dstevens> Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: Darrell Stevens Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <39E6FA3F.25902.D2F6904@localhost> MIME-version: 1.0 X-Mailer: Pegasus Mail for Win32 (v3.12c) Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Precedence: bulk Thanks for the information. I will pass it on to appropriate lists. One problem we noted with a similar device (EMox, from South Africa) is that the device has to be held upgright -- difficult in the litter. And if it tips over, the patient gets a facefull of warm chemical slurry. Ask Steve Meyer, WEMT coordinator for Maryland, it happened to him on one WEMT exercise! Also, your caveat not to shake the mixture may make it difficult to use for wilderness rescue. If you might consider designing something that can go in a rescue litter, without sticking up, and will work for a longer period or can be continuously refilled -- I think a lot more people will be interested. Thanks again. On 10 Oct 2000, at 9:53, Darrell Stevens wrote: > Attached is our new product, System 02, that allows you to store until > needed oxygen. The process needed to produce over 1 hour of oxygen is > simply to add water and two chemicals. This will give you 99.5% pure > oxygen at a flow rate of 6 LPM. > > I think if you read more about our product it may fit nicely into > WEMSI. > > If you can't open the attachment, visit our web site at > www.system02.com > > Thanks for your time > Darrell Stevens > VP of Sales > 916 802-6789 > --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover sent with Pegasus high-security email download free from www.pmail.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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Tue, 3 Oct 2000 12:22:23 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JUWF8T4AQG009R2W@mb2i0.ns.pitt.edu>; Tue, 3 Oct 2000 12:22:23 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Tue, 03 Oct 2000 12:21:01 -0400 (EDT) Received: from imo-r03.mail.aol.com (imo-r03.mx.aol.com [152.163.225.3]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Tue, 03 Oct 2000 12:20:51 -0400 (EDT) Received: from Ralphwolf@aol.com by imo-r03.mx.aol.com (mail_out_v28.24.) id h.20.c33421b (1883) for ; Tue, 03 Oct 2000 12:20:12 -0400 (EDT) Date: Tue, 03 Oct 2000 12:20:11 -0400 (EDT) From: Ralphwolf@aol.com Subject: Re: W-EMED Patient treatment shelters/tents Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <20.c33421b.270b613b@aol.com> MIME-version: 1.0 X-Mailer: AOL 5.0 for Windows sub 119 Content-type: text/plain; charset="US-ASCII" Content-transfer-encoding: 7bit Precedence: bulk A big 'X' slashed into the floor of any decent mountain tent should allow for top flight emerg. shelter to drop over the immobilized patient... Mark Rogacki Director Education & Training LK Painter Center 2355 Main St. PO Box 575 Collins, NY 14034 716.532.2006 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Tue, 3 Oct 2000 08:40:52 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JUW7I51L480024EF@mb1i0.ns.pitt.edu>; Tue, 3 Oct 2000 08:40:51 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Tue, 03 Oct 2000 08:39:00 -0400 (EDT) Received: from redtail.med.unc.edu (redtail.med.unc.edu [152.19.4.7]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Tue, 03 Oct 2000 08:38:57 -0400 (EDT) Received: from med.unc.edu (apex.med.unc.edu [152.19.4.80]) by redtail.med.unc.edu (8.9.3/8.9.3) with ESMTP id IAA26802 for ; Tue, 03 Oct 2000 08:38:56 -0400 (EDT) Date: Tue, 03 Oct 2000 08:38:56 -0400 (EDT) From: Tom Bush Subject: Re: W-EMED Patient treatment shelters/tents Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <22f7823d6c.23d6c22f78@med.unc.edu> MIME-version: 1.0 X-Mailer: Netscape Webmail Content-type: multipart/mixed; boundary="--3adc490056f272df" Content-language: en Precedence: bulk X-Accept-Language: en This is a multi-part message in MIME format. ----3adc490056f272df Content-Type: text/plain; charset=us-ascii Content-Disposition: inline Content-Transfer-Encoding: 7bit Joel, Have you considered a tarp? A properly rigged 10X10 tarp provides ample space and head room for several people. Two can be rigged in an A frame fashion for even more space. You can create a sturdy, wind resistant shelter anywhere there are trees. The set up can be modified for any terrain and weather condition. Here in the southeast, I only carry a tent on camping trips during the summer when insects are an issue. Skill in setting up a tarp requires some practice and will provide a lightweight, versatile and low tech (ie less to go wrong)shelter that is limited only by your imagination. You can find a thorough discussion of the virtues of the properly rigged tarp in a book published by ICS called "The Basic Essentials of Camping" by Cliff Jacobson. You may find such a tarp in a Campmor catalog or make one to fit you specific needs. If you would like more info on how to do this please contact me direcly. Regards, Tom Bush, NP Clinical Assistant Professor Department of Orthopaedics University of North Carolina School of Medicine Chapel Hill, NC 27599-7055 Tom_Bush@med.unc.edu ----- Original Message ----- From: Joel McNamara Date: Monday, October 2, 2000 6:30 pm Subject: W-EMED Patient treatment shelters/tents > Does anyone have any suggestions/experience with tents suitable for > patient treatment during a disaster situation? > > The Western Shelter models widely used by Federal DMATs seem both > heavyand cumbersome. I can't help thinking that a more > lightweight/hi-tech > alternative could be used. At least for the first 72 hours before > fully equipped Federal resources arrive. > > Perhaps something along the lines of a Megamid(s) for first in > respondingteams, and then an Eureka! Equinox (or similar) for > second in teams. > > Obviously, weather and wind resistance and durability are key issues. > > Any thoughts appreciated. > > Joel McNamara > > 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.eduSubmissions To: wilderness-emergency- > medicine@list.pitt.edu ----3adc490056f272df Content-Type: text/x-vcard; name="explore.vcf"; charset=us-ascii Content-Disposition: attachment; filename="explore.vcf Content-Description: Card for Tom Bush Content-Transfer-Encoding: 7bit begin:vcard n:Bush;Tom fn:Tom Bush NP tel;fax:919.966.7956 tel;work:919.966.9242 org:University of North Carolina at Chapel Hill;Orthopaedics adr:;;CB #7055;Chapel Hill;NC;27599-7055; version:2.1 email;internet:Tom_Bush@med.unc.edu title:Clinical Assistant Professor end:vcard ----3adc490056f272df-- 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Mon, 2 Oct 2000 19:56:55 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JUVGU05I28009MC5@mb2i0.ns.pitt.edu>; Mon, 2 Oct 2000 19:56:55 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Mon, 02 Oct 2000 19:56:14 -0400 (EDT) Received: from irvexch.rainbow.com (user24.rainbow.com [209.78.195.24]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Mon, 02 Oct 2000 19:56:11 -0400 (EDT) Received: by mail.rainbow.com with Internet Mail Service (5.5.2650.21) id ; Mon, 02 Oct 2000 16:55:45 -0700 Date: Mon, 02 Oct 2000 16:55:44 -0700 From: MKern Subject: RE: W-EMED Patient treatment shelters/tents Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: "'wilderness-emergency-medicine@list.pitt.edu'" Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <954CBFE62E42D41197A500508BA54BAAD78663@mail.rainbow.com> MIME-version: 1.0 X-Mailer: Internet Mail Service (5.5.2650.21) Content-type: text/plain; charset="iso-8859-1" Precedence: bulk What size of a shelter are you looking for? Something similar to the Western Shelter size, but less heavy? -----Original Message----- From: Joel McNamara [mailto:joelm@eskimo.com] Sent: Monday, October 02, 2000 3:31 PM To: wilderness-emergency-medicine@list.pitt.edu Subject: W-EMED Patient treatment shelters/tents Does anyone have any suggestions/experience with tents suitable for patient treatment during a disaster situation? The Western Shelter models widely used by Federal DMATs seem both heavy and cumbersome. I can't help thinking that a more lightweight/hi-tech alternative could be used. At least for the first 72 hours before fully equipped Federal resources arrive. Perhaps something along the lines of a Megamid(s) for first in responding teams, and then an Eureka! Equinox (or similar) for second in teams. Obviously, weather and wind resistance and durability are key issues. Any thoughts appreciated. Joel McNamara 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Mon, 2 Oct 2000 18:31:50 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JUVDUIIHTE0020XV@mb1i0.ns.pitt.edu>; Mon, 2 Oct 2000 18:31:49 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Mon, 02 Oct 2000 18:30:58 -0400 (EDT) Received: from mx2.eskimo.com (root@mx2.eskimo.com [204.122.16.49]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Mon, 02 Oct 2000 18:30:51 -0400 (EDT) Received: from eskimo.com (joelm@eskimo.com [204.122.16.13]) by mx2.eskimo.com (8.9.1a/8.8.8) with ESMTP id PAA06786 for ; Mon, 02 Oct 2000 15:30:42 -0700 (PDT) Received: from localhost (joelm@localhost) by eskimo.com (8.9.1a/8.9.1) with SMTP id PAA20745 for ; Mon, 02 Oct 2000 15:30:35 -0700 (PDT) Date: Mon, 02 Oct 2000 15:30:33 -0700 (PDT) From: Joel McNamara Subject: W-EMED Patient treatment shelters/tents Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 Content-type: TEXT/PLAIN; charset=US-ASCII Precedence: bulk X-Authentication-warning: eskimo.com: joelm owned process doing -bs Does anyone have any suggestions/experience with tents suitable for patient treatment during a disaster situation? The Western Shelter models widely used by Federal DMATs seem both heavy and cumbersome. I can't help thinking that a more lightweight/hi-tech alternative could be used. At least for the first 72 hours before fully equipped Federal resources arrive. Perhaps something along the lines of a Megamid(s) for first in responding teams, and then an Eureka! Equinox (or similar) for second in teams. Obviously, weather and wind resistance and durability are key issues. Any thoughts appreciated. Joel McNamara 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Mon, 2 Oct 2000 10:26:31 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JUUWWTBJ8U009MNH@mb2i0.ns.pitt.edu>; Mon, 2 Oct 2000 10:26:32 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Mon, 02 Oct 2000 10:25:03 -0400 (EDT) Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Mon, 02 Oct 2000 10:25:01 -0400 (EDT) Received: from klaptop ("port 1054"@[136.142.20.44]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JUUWUTZMS0001VIN@mb1i0.ns.pitt.edu> for wilderness-emergency-medicine@list.pitt.edu; Mon, 02 Oct 2000 10:25:00 -0500 (EST) Date: Mon, 02 Oct 2000 10:24:54 -0400 From: "Keith Conover, M.D., FACEP" Subject: W-EMED spam Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <39D86276.28061.33E3763@localhost> MIME-version: 1.0 X-Mailer: Pegasus Mail for Win32 (v3.12c) Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Precedence: bulk Sorry for the recent spam. Please exercise your delete key. Thus far, spam on this list is relatively rare. Majordomo, unlike eGroups, doesn't allow "alternate" addresses, so closing the list would mean some people wouldn't be able to post from their alternate addresses. But at least Majordomo doesn't include advertising with each message! For now, I'll ask you to just ignore the occasional spam. If it gets severe, I'll close the list. Take care. --Keith Conover, M.D., FACEP listowner 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID for ; Sun, 1 Oct 2000 12:13:58 -0400 (EDT) Received: from listserv.islandnet.com ("port 16938"@[199.175.106.5]) by pitt.edu (PMDF V5.2-32 #41462) with SMTP id <01JUTMDO3JHM00200A@mb1i0.ns.pitt.edu> for kconover@imap.pitt.edu (ORCPT rfc822;kconover+2B@pitt.edu); Sun, 1 Oct 2000 12:13:58 EST Received: by uucp.islandnet.com id m13flju-0017GqC for kconover+@pitt.edu; Sun, 01 Oct 2000 09:13:22 -0700 (PDT) Resent-date: Sun, 01 Oct 2000 09:13:22 -0700 (PDT) Date: Sun, 01 Oct 2000 09:04:55 -0600 Resent-from: sar-l@listserv.islandnet.com From: Donovan Hoggan Subject: Fw: Safety Officer Resent-sender: sar-l-request@listserv.islandnet.com To: sar-l@listserv.islandnet.com Reply-to: sar-l@listserv.islandnet.com Resent-message-id: <"pk5tQC.A.mCH.RK215"@listserv.islandnet.com> Message-id: <003001c02bb8$f7582620$aae1b9c7@seasar> MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V5.50.4133.2400 X-Mailer: Microsoft Outlook Express 5.50.4133.2400 Content-type: multipart/alternative; boundary="----=_NextPart_000_002D_01C02B86.AB1A1840" X-Priority: 3 X-MSMail-priority: Normal Precedence: list X-Loop: sar-l@listserv.islandnet.com Old-Return-Path: X-Mailing-List: archive/latest/3733 This is a multi-part message in MIME format. ------=_NextPart_000_002D_01C02B86.AB1A1840 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable Hello all I'm posting this to WEMS list as well so I apologize in advance for = duplicate messages. I am the First-Aid Coordinator for a small SAR team in Alberta. I'm = looking for information the role, duties, training, etc. of the person = who is responsible for the safety of the searchers. Does anyone else = have this role separate from the Search Manager? Is anyone aware of = training materials, books, etc. that I can use to develop a Safety = Officer course? =20 As well, what issues do we need to look at for this? So far, we have = identified issues like ensuring access to hygiene around the command = post (eg. hand washing station outside the toilet), problems with = sending exhausted searchers driving home, consulting with Search = Manager, etc. What else should be included in training someone for this = position? Any help anyone can offer on-list or off would be great. I look forward = to hearing from you. Donovan Hoggan First-Aid Coordinator SEASAR Association ------=_NextPart_000_002D_01C02B86.AB1A1840 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable
Hello all
 
I'm posting this to WEMS list as = well so I=20 apologize in advance for duplicate messages.
 
I am the First-Aid Coordinator for a = small SAR team=20 in Alberta.  I'm looking for information the role, duties, = training, etc.=20 of the person who is responsible for the safety of the searchers.  = Does=20 anyone else have this role separate from the Search Manager?  Is = anyone=20 aware of training materials, books, etc. that I can use to develop = a Safety=20 Officer course? 
 
As well, what issues do we need to look = at for=20 this?  So far, we have identified issues like ensuring access = to=20 hygiene around the command post (eg. hand washing station outside the = toilet),=20 problems with sending exhausted searchers driving home, consulting with = Search=20 Manager, etc.  What else should be included in training someone for = this=20 position?
 
Any help anyone can offer on-list or = off would be=20 great.  I look forward to hearing from you.
 
Donovan Hoggan
First-Aid Coordinator
SEASAR = Association
------=_NextPart_000_002D_01C02B86.AB1A1840-- ========================================================================== To unsubscribe (List) send email to sar-l-request@listserv.islandnet.com To unsubscribe (Digest) send email to sar-l-d-request@listserv.islandnet.com with the word 'unsubscribe' in the subject field, for either one. ========================================================================== -- End -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sat, 30 Sep 2000 07:36:51 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JURYEQKVYU001XVL@mb1i0.ns.pitt.edu>; Sat, 30 Sep 2000 07:36:51 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sat, 30 Sep 2000 07:36:06 -0400 (EDT) Received: from www.daemyung.co.kr (daemyung.co.kr [210.92.79.2]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sat, 30 Sep 2000 07:35:58 -0400 (EDT) Received: from monorailpc (host-216-77-221-227.fll.bellsouth.net [216.77.221.227]) by www.daemyung.co.kr (8.6.9H1/8.6.9) with SMTP id UAA10553; Sat, 30 Sep 2000 20:16:43 +0900 Date: Sat, 30 Sep 2000 20:16:43 +0900 From: donald453@bbc.co.uk Subject: W-EMED Porche Boxter or Luxury Cruise Earn $$$ In Days This Works!!! Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: donald453@bbc.co.uk Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <200009301116.UAA10553@www.daemyung.co.kr> MIME-version: 1.0 Content-type: text/plain; charset=unknown-8bit Precedence: bulk Dear Friend, Thank you for your time and interest. This email contains the ENTIRE PLAN of how YOU can make $50,000 or more in the next 90 days simply sending email! Seem impossible? Just read on and see how easy this is... Due to the popularity of this letter on the Internet a major nightly news program recently devoted an entire show to the investigation of the program described below to see if it really can make people money. The show also investigated whether or not the program was legal. Their findings proved that there are absolutely no laws prohib- iting the participation in the program. This has helped to show people that this is a simple, harmless and fun way to make some extra money at home. The results have been truly remarkable. So many people are participating that those involved are doing much better than ever before. Since everyone makes more as more people try it out, it's been very exciting. You will understand once you try it yourself! ***********THE ENTIRE PLAN IS HERE BELOW**************** ***Print This Now For Future Reference*** $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ If you would like to make at least $50,000 in less than 90 days Please read this program...THEN READ IT AGAIN!!! $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ THIS IS A LEGITIMATE, LEGAL, MONEY MAKING OPPORTUNITY!!! It does NOT require you to come into contact with people or make or take any phone calls. Just follow the instruc- tions, and you will make money. This simplified e-mail marketing program works perfectly, 100% EVERY TIME! Email is the sales tool of the future. Take advantage of this virtually free method of advertising NOW!!! The longer you wait, the more people will be doing business using email. Get your piece of this action!!! ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Before you delete this program from your in-box, as I almost did, take a little time to read it and REALLY THINK ABOUT IT. Get a pencil and figure out what could happen when YOU participate. Figure out the worst possi- ble response and no matter how you calculate it, you will still make a lot of money! You will definitely get back what you invested. Any doubts you have will vanish when your first orders come in. $$$ IT WORKS $$$ Jody Jacobs Richmond, VA ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ HERE'S HOW THIS AMAZING PROGRAM WILL MAKE YOU THOUSANDS OF DOLLARS $$$$!!!! This method of raising capital REALLY WORKS 100% EVERYTIME. I am sure that you could use up to $50,000 or more in the next 90 days. Before you say, "BULL..." please read this program carefully. This is not a chain letter, but a perfectly legal money making business. As with all multi-level businesses, we build our business by recruiting new partners and selling our products. Every state in the USA allows you to recruit new multi- level business partners, and we sell and deliver a prod- uct for EVERY dollar received. YOUR ORDERS COME BY MAIL AND ARE FILLED BY E-MAIL, so you are not involved in personal selling. You do it privately in your own home, store or office. This is the EASIEST marketing plan any- where! It is simply order filling by email! ******************************************************** The product is informational and instructional material containing the secrets on how to open the doors to the magic world of E-COMMERCE, the information highway, the wave of the future! PLAN SUMMARY: (1) You order the 4 reports listed below ($5 each) which come to you by e-mail. (2) Save a copy of this entire letter and put your name after Report #1 and move the other names down. (3) Access Yahoo.com or any of the other major search engines to locate hundreds of bulk email service comp- anies (search for "bulk email") and have them send 25,000 - 50,000 emails for you (amount $49+) (4) Orders will come to you by postal mail -simply email them the report they ordered. Let me ask you - isn't this about as easy as it gets? ******************************************************** YOU CAN START TODAY-JUST DO THESE EASY STEPS: STEP #1: ORDER THE FOUR REPORTS Order the 4 reports shown on the list below (you can't sell them if you don't order them) For each report, send $5.00 CASH, the NAME & NUMBER OF THE REPORT YOU ARE ORDERING, YOUR E-MAIL ADDRESS, and YOUR NAME AND RETURN ADDRESS (in case of a problem) to the person whose name appears on the list next to the report. MAKE SURE YOUR RETURN ADDRESS IS ON YOUR ENVELOPE IN CASE OF ANY MAIL PROBLEMS! 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Report #1 will tell you how to download bulk email software and email addresses so you can send it out to thousands of people while you sleep! Remember that 50,000+ new people are joining the Internet every month. Your cost to participate in this is practically nothing surely you can afford $20 and initial bulk mailing cost. You obviously already have a computer and an Internet connection and email is FREE! There are two primary methods of building your down-line: METHOD #1: SENDING BULK EMAIL. Let's say that you decide to start small, just to see how it goes, and we'll assume you and all those involved email out only 2,000 each. Let's also assume that the mailing receives a 0.5 response. The response could be much better. Also, many people will email out hundreds of thousands of programs instead of 2,000(Why stop at 2,000?) But continuing with this example you send out only 2,000 programs. With a 0.5% response, that is only 10 orders for REPORT #1. Those 10 people respond by sending out 2,000 programs each for a total of 20,000. Out of those 0.5% 100 people respond and order REPORT #2. Those 100 mail out 2,000 programs each for a total of 200,000. The 0.5% response to that is 1,000 orders for REPORT #3. Those 1,000 send out 2,000 programs each for a 2,000,000 total. The 0.5% response to that is 10,000 orders for REPORT #4. That's 10,000 $5 bills for you CASH!!! Your total income in this example is $50 + $500 + $50,000 for a total of $55,550!!! REMEMBER FRIEND, THIS IS ASSUMING 1,990 out of 2,000 PEOPLE YOU MAIL TO WILL DO ABSOLUTELY NOTHING AND TRASH THIS PROGRAM! DARE TO THINK FOR A MOMENT WHAT WOULD HAPPEN IF EVERYONE, OR HALF SENT OUT 100,000 PROGRAMS INSTEAD OF 2,000. Believe me, many people will do just that, and more! METHOD #2 - PLACING FREE ADS ON THE INTERNET Advertising on the Internet is very, very inexpensive, and there are HUNDREDS of FREE places to advertise. Let's say you decide to start small just to see how well it works. Assume your goal is to get ONLY 10 people to participate on your first level. (Placing a lot of FREE ads on the Internet will EASILY get a larger response) Also assume that everyone else in YOUR ORGANIZATION gets only 10 down-line members. Look how this small number accumulates to achieve the STAGGERING results below: 1st level--your first 10 send you $5.......$50 2nd level-10 members from those($5x100)....$500 3rd level-10 members from those($5x1000)...$5,000 4th level-10 members from those($5x10000)..$50,000 $$$$$$$$$$THIS TOTALS--------------$55,550 $$$$$$$$$$$$$ AMAZING ISN'T IT? Remember friends, this assumes that the people who participate only recruit 10 people each. Think for a moment what would happen if they got 20 people to participate! Most people get 100's of participants and many will continue to work this program, sending out programs WITH YOUR NAME ON THEM for years! ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ People are going to get emails about this plan from you or somebody else and many will work this plan-the question is-Don't you want your name to be on the emails they will send out? ***DON'T MISS OUT!!!***JUST TRY IT ONCE!!!*** ***SEE WHAT HAPPENS!!!***YOU'LL BE AMAZED!!!*** ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ALWAYS PROVIDE SAME-DAY SERVICE ON ALL ORDERS! This will guarantee that the email THEY send out with YOUR name and address on it will be prompt because they can't advertise until they receive the report! ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ GET STARTED TODAY: PLACE YOU ORDER FOR THE FOUR REPORTS! Notes: ALWAYS SEND $5 CASH(US CURRENCY) FOR EACH REPORT. CHECK NOT ACCEPTED. Make sure the cash is concealed by wrapping it in two sheets of paper. On one of those sheets write: (a)the number & name of the report you are ordering, (b)your email address, and (c)your name & postal address. REPORT #1 "The Insider's Guide to Advertising for Free on the Internet! ORDER REPORT #1 FROM: GARRY DEAN 309 A HUTTO KENAI, AK 99611-7829 REPORT #2: "The Insider's Guide to Sending Bulk E-mail on the Internet" ORDER REPORT #2 FROM: DAVID WEBBER 6307 CALIFORNIA AVE. SW APT # 1B SEATTLE, WA 98136 REPORT #3: "The Secrets to Multilevel Marketing on the Internet" ORDER REPORT #3 FROM: KATHY BARROW 410 SYCAMORE ST.. CONWAY, SC 29527 REPORT #4 "How to become a Millionaire utilizing the Power of Multilevel Marketing and the Internet" ORDER REPORT #4 FROM: PAM BARESSI 3321 WILLIAM JOHNSTON LANE #11 DUMFRIES, VA 22026 *********TIPS FOR SUCCESS************* TREAT THIS AS YOUR BUSINESS! Be prompt, professional, and follow directions accurately. Send for the four reports IMMEDIATELY so you will have them when the orders start coming in because: When you receive a $5 order, you MUST send out the requested product/report. It is required for this to be a legal business and they need the reports to send out their letters(with your name on them!) - ALWAYS PROVIDE SAME-DAY SERVICE ON THE ORDERS YOU RECEIVE. Be patient and persistent with this program - If you follow the instructions exactly-results will follow$$$. *********YOUR SUCCESS GUIDELINES*************** Follow these guidelines to guarantee your success: If you don't receive 20 orders for REPORT #1 within 2 weeks continue advertising or sending out emails until you do. Then, a couple of weeks later you should receive at least 100 orders for REPORT #2. If you don't, continue advertising or sending out emails until you do. Once you have received 100 or more orders for REPORT #2, YOU CAN RELAX, because the system is already working for you, and the cash will continue to roll in! THIS IS IMPORTANT TO REMEMBER: Every time your name is moved down on the list, you are placed in front of a DIFFERENT report. You can KEEP TRACK of your PROGRESS by watching which report people are ordering from you. To generate more income, simply send another batch of emails or continue placing ads and start the whole process again! There is no limit to the income you will generate from this business! ======================================================== Under Bill S. 1618TITLE III passed by the 105th US Congress this letter cannot be considered spam as long as the sender includes contact information and a method of removal. This is one time e-mail transmission. No request for removal is necessary. _________________________________________________________________________ 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sat, 30 Sep 2000 07:36:51 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JURYEQKVYU001XVL@mb1i0.ns.pitt.edu>; Sat, 30 Sep 2000 07:36:51 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sat, 30 Sep 2000 07:36:06 -0400 (EDT) Received: from www.daemyung.co.kr (daemyung.co.kr [210.92.79.2]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sat, 30 Sep 2000 07:35:58 -0400 (EDT) Received: from monorailpc (host-216-77-221-227.fll.bellsouth.net [216.77.221.227]) by www.daemyung.co.kr (8.6.9H1/8.6.9) with SMTP id UAA10553; Sat, 30 Sep 2000 20:16:43 +0900 Date: Sat, 30 Sep 2000 20:16:43 +0900 From: donald453@bbc.co.uk Subject: W-EMED Porche Boxter or Luxury Cruise Earn $$$ In Days This Works!!! Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: donald453@bbc.co.uk Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <200009301116.UAA10553@www.daemyung.co.kr> MIME-version: 1.0 Content-type: text/plain; charset=unknown-8bit Precedence: bulk Dear Friend, Thank you for your time and interest. This email contains the ENTIRE PLAN of how YOU can make $50,000 or more in the next 90 days simply sending email! Seem impossible? Just read on and see how easy this is... Due to the popularity of this letter on the Internet a major nightly news program recently devoted an entire show to the investigation of the program described below to see if it really can make people money. The show also investigated whether or not the program was legal. Their findings proved that there are absolutely no laws prohib- iting the participation in the program. This has helped to show people that this is a simple, harmless and fun way to make some extra money at home. The results have been truly remarkable. So many people are participating that those involved are doing much better than ever before. Since everyone makes more as more people try it out, it's been very exciting. You will understand once you try it yourself! ***********THE ENTIRE PLAN IS HERE BELOW**************** ***Print This Now For Future Reference*** $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ If you would like to make at least $50,000 in less than 90 days Please read this program...THEN READ IT AGAIN!!! $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ THIS IS A LEGITIMATE, LEGAL, MONEY MAKING OPPORTUNITY!!! It does NOT require you to come into contact with people or make or take any phone calls. Just follow the instruc- tions, and you will make money. This simplified e-mail marketing program works perfectly, 100% EVERY TIME! Email is the sales tool of the future. Take advantage of this virtually free method of advertising NOW!!! The longer you wait, the more people will be doing business using email. Get your piece of this action!!! ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Before you delete this program from your in-box, as I almost did, take a little time to read it and REALLY THINK ABOUT IT. Get a pencil and figure out what could happen when YOU participate. Figure out the worst possi- ble response and no matter how you calculate it, you will still make a lot of money! You will definitely get back what you invested. Any doubts you have will vanish when your first orders come in. $$$ IT WORKS $$$ Jody Jacobs Richmond, VA ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ HERE'S HOW THIS AMAZING PROGRAM WILL MAKE YOU THOUSANDS OF DOLLARS $$$$!!!! This method of raising capital REALLY WORKS 100% EVERYTIME. I am sure that you could use up to $50,000 or more in the next 90 days. Before you say, "BULL..." please read this program carefully. This is not a chain letter, but a perfectly legal money making business. As with all multi-level businesses, we build our business by recruiting new partners and selling our products. Every state in the USA allows you to recruit new multi- level business partners, and we sell and deliver a prod- uct for EVERY dollar received. YOUR ORDERS COME BY MAIL AND ARE FILLED BY E-MAIL, so you are not involved in personal selling. You do it privately in your own home, store or office. This is the EASIEST marketing plan any- where! It is simply order filling by email! ******************************************************** The product is informational and instructional material containing the secrets on how to open the doors to the magic world of E-COMMERCE, the information highway, the wave of the future! PLAN SUMMARY: (1) You order the 4 reports listed below ($5 each) which come to you by e-mail. (2) Save a copy of this entire letter and put your name after Report #1 and move the other names down. (3) Access Yahoo.com or any of the other major search engines to locate hundreds of bulk email service comp- anies (search for "bulk email") and have them send 25,000 - 50,000 emails for you (amount $49+) (4) Orders will come to you by postal mail -simply email them the report they ordered. Let me ask you - isn't this about as easy as it gets? ******************************************************** YOU CAN START TODAY-JUST DO THESE EASY STEPS: STEP #1: ORDER THE FOUR REPORTS Order the 4 reports shown on the list below (you can't sell them if you don't order them) For each report, send $5.00 CASH, the NAME & NUMBER OF THE REPORT YOU ARE ORDERING, YOUR E-MAIL ADDRESS, and YOUR NAME AND RETURN ADDRESS (in case of a problem) to the person whose name appears on the list next to the report. MAKE SURE YOUR RETURN ADDRESS IS ON YOUR ENVELOPE IN CASE OF ANY MAIL PROBLEMS! Within a few days you will receive, by email, each of the 4 reports. Save them on your computer so you can send them to the 1,000's of people who will order them from you. STEP #2: ADD YOUR MAILING ADDRESS TO THIS LETTER a. Look below for the listing of the four reports. b. After you've ordered the 4 reports, delete the name and address under Report #4. This person has made it through the cycle. c. Move the name and address under REPORT #3 down to REPORT #4. d. Move the name and address under REPORT #2 down to REPORT #3. e. Move the name and address under REPORT #1 down to REPORT #2. f. Insert your name/address in the REPORT #1 position. STEP #3: Take this entire letter, including the modified list of names, and save it to your computer. Make NO changes to these instructions. Now you are ready to use this entire email to send by email to prospects. Report #1 will tell you how to download bulk email software and email addresses so you can send it out to thousands of people while you sleep! Remember that 50,000+ new people are joining the Internet every month. Your cost to participate in this is practically nothing surely you can afford $20 and initial bulk mailing cost. You obviously already have a computer and an Internet connection and email is FREE! There are two primary methods of building your down-line: METHOD #1: SENDING BULK EMAIL. Let's say that you decide to start small, just to see how it goes, and we'll assume you and all those involved email out only 2,000 each. Let's also assume that the mailing receives a 0.5 response. The response could be much better. Also, many people will email out hundreds of thousands of programs instead of 2,000(Why stop at 2,000?) But continuing with this example you send out only 2,000 programs. With a 0.5% response, that is only 10 orders for REPORT #1. Those 10 people respond by sending out 2,000 programs each for a total of 20,000. Out of those 0.5% 100 people respond and order REPORT #2. Those 100 mail out 2,000 programs each for a total of 200,000. The 0.5% response to that is 1,000 orders for REPORT #3. Those 1,000 send out 2,000 programs each for a 2,000,000 total. The 0.5% response to that is 10,000 orders for REPORT #4. That's 10,000 $5 bills for you CASH!!! Your total income in this example is $50 + $500 + $50,000 for a total of $55,550!!! REMEMBER FRIEND, THIS IS ASSUMING 1,990 out of 2,000 PEOPLE YOU MAIL TO WILL DO ABSOLUTELY NOTHING AND TRASH THIS PROGRAM! DARE TO THINK FOR A MOMENT WHAT WOULD HAPPEN IF EVERYONE, OR HALF SENT OUT 100,000 PROGRAMS INSTEAD OF 2,000. Believe me, many people will do just that, and more! METHOD #2 - PLACING FREE ADS ON THE INTERNET Advertising on the Internet is very, very inexpensive, and there are HUNDREDS of FREE places to advertise. Let's say you decide to start small just to see how well it works. Assume your goal is to get ONLY 10 people to participate on your first level. (Placing a lot of FREE ads on the Internet will EASILY get a larger response) Also assume that everyone else in YOUR ORGANIZATION gets only 10 down-line members. Look how this small number accumulates to achieve the STAGGERING results below: 1st level--your first 10 send you $5.......$50 2nd level-10 members from those($5x100)....$500 3rd level-10 members from those($5x1000)...$5,000 4th level-10 members from those($5x10000)..$50,000 $$$$$$$$$$THIS TOTALS--------------$55,550 $$$$$$$$$$$$$ AMAZING ISN'T IT? Remember friends, this assumes that the people who participate only recruit 10 people each. Think for a moment what would happen if they got 20 people to participate! Most people get 100's of participants and many will continue to work this program, sending out programs WITH YOUR NAME ON THEM for years! ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ People are going to get emails about this plan from you or somebody else and many will work this plan-the question is-Don't you want your name to be on the emails they will send out? ***DON'T MISS OUT!!!***JUST TRY IT ONCE!!!*** ***SEE WHAT HAPPENS!!!***YOU'LL BE AMAZED!!!*** ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ALWAYS PROVIDE SAME-DAY SERVICE ON ALL ORDERS! This will guarantee that the email THEY send out with YOUR name and address on it will be prompt because they can't advertise until they receive the report! ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ GET STARTED TODAY: PLACE YOU ORDER FOR THE FOUR REPORTS! Notes: ALWAYS SEND $5 CASH(US CURRENCY) FOR EACH REPORT. CHECK NOT ACCEPTED. Make sure the cash is concealed by wrapping it in two sheets of paper. On one of those sheets write: (a)the number & name of the report you are ordering, (b)your email address, and (c)your name & postal address. REPORT #1 "The Insider's Guide to Advertising for Free on the Internet! ORDER REPORT #1 FROM: GARRY DEAN 309 A HUTTO KENAI, AK 99611-7829 REPORT #2: "The Insider's Guide to Sending Bulk E-mail on the Internet" ORDER REPORT #2 FROM: DAVID WEBBER 6307 CALIFORNIA AVE. SW APT # 1B SEATTLE, WA 98136 REPORT #3: "The Secrets to Multilevel Marketing on the Internet" ORDER REPORT #3 FROM: KATHY BARROW 410 SYCAMORE ST.. CONWAY, SC 29527 REPORT #4 "How to become a Millionaire utilizing the Power of Multilevel Marketing and the Internet" ORDER REPORT #4 FROM: PAM BARESSI 3321 WILLIAM JOHNSTON LANE #11 DUMFRIES, VA 22026 *********TIPS FOR SUCCESS************* TREAT THIS AS YOUR BUSINESS! Be prompt, professional, and follow directions accurately. Send for the four reports IMMEDIATELY so you will have them when the orders start coming in because: When you receive a $5 order, you MUST send out the requested product/report. It is required for this to be a legal business and they need the reports to send out their letters(with your name on them!) - ALWAYS PROVIDE SAME-DAY SERVICE ON THE ORDERS YOU RECEIVE. Be patient and persistent with this program - If you follow the instructions exactly-results will follow$$$. *********YOUR SUCCESS GUIDELINES*************** Follow these guidelines to guarantee your success: If you don't receive 20 orders for REPORT #1 within 2 weeks continue advertising or sending out emails until you do. Then, a couple of weeks later you should receive at least 100 orders for REPORT #2. If you don't, continue advertising or sending out emails until you do. Once you have received 100 or more orders for REPORT #2, YOU CAN RELAX, because the system is already working for you, and the cash will continue to roll in! THIS IS IMPORTANT TO REMEMBER: Every time your name is moved down on the list, you are placed in front of a DIFFERENT report. You can KEEP TRACK of your PROGRESS by watching which report people are ordering from you. To generate more income, simply send another batch of emails or continue placing ads and start the whole process again! There is no limit to the income you will generate from this business! ======================================================== Under Bill S. 1618TITLE III passed by the 105th US Congress this letter cannot be considered spam as long as the sender includes contact information and a method of removal. This is one time e-mail transmission. No request for removal is necessary. _________________________________________________________________________ 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Thu, 28 Sep 2000 17:34:55 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JUPQPJOP9W0019WH@mb1i0.ns.pitt.edu>; Thu, 28 Sep 2000 17:34:55 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Thu, 28 Sep 2000 17:31:55 -0400 (EDT) Received: from mail.memlane.com (mail.memlane.com [199.185.225.3]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Thu, 28 Sep 2000 17:31:52 -0400 (EDT) Received: from seasar ([199.185.225.195]) by mail.memlane.com (Post.Office MTA v3.5.3 release 223 ID# 0-55152U3000L300S0V35) with SMTP id com for ; Thu, 28 Sep 2000 15:16:13 -0600 Date: Thu, 28 Sep 2000 14:23:43 -0600 From: Donovan Hoggan Subject: W-EMED Safety Officer Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <002701c0298a$0047b920$c3e1b9c7@seasar> MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V5.50.4133.2400 X-Mailer: Microsoft Outlook Express 5.50.4133.2400 Content-type: multipart/alternative; boundary="----=_NextPart_000_0024_01C02957.B4D315C0" X-Priority: 3 X-MSMail-priority: Normal Precedence: bulk This is a multi-part message in MIME format. ------=_NextPart_000_0024_01C02957.B4D315C0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable Hello all I'm posting this to SAR list as well so I apologize in advance for = duplicate messages. I am the First-Aid Coordinator for a small SAR team in Alberta. I'm = looking for information the role, duties, training, etc. of the person = who is responsible for the safety of the searchers. Does anyone else = have this role separate from the Search Manager? Is anyone aware of = training materials, books, etc. that I can use to develop a Safety = Officer course? =20 As well, what issues do we need to look at for this? So far, we have = identified issues like ensuring access to hygiene around the command = post (eg. hand washing station outside the toilet), problems with = sending exhausted searchers driving home, consulting with Search = Manager, etc. What else should be included in training someone for this = position? Any help anyone can offer on-list or off would be great. I look forward = to hearing from you. Donovan Hoggan First-Aid Coordinator SEASAR Association ------=_NextPart_000_0024_01C02957.B4D315C0 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable
Hello all
 
I'm posting this to SAR list as well so = I apologize=20 in advance for duplicate messages.
 
I am the First-Aid Coordinator for a = small SAR team=20 in Alberta.  I'm looking for information the role, duties, = training, etc.=20 of the person who is responsible for the safety of the searchers.  = Does=20 anyone else have this role separate from the Search Manager?  Is = anyone=20 aware of training materials, books, etc. that I can use to develop = a Safety=20 Officer course? 
 
As well, what issues do we need to look = at for=20 this?  So far, we have identified issues like ensuring access = to=20 hygiene around the command post (eg. hand washing station outside the = toilet),=20 problems with sending exhausted searchers driving home, consulting with = Search=20 Manager, etc.  What else should be included in training someone for = this=20 position?
 
Any help anyone can offer on-list or = off would be=20 great.  I look forward to hearing from you.
 
Donovan Hoggan
First-Aid Coordinator
SEASAR = Association
------=_NextPart_000_0024_01C02957.B4D315C0-- 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Thu, 28 Sep 2000 17:34:55 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JUPQPJOP9W0019WH@mb1i0.ns.pitt.edu>; Thu, 28 Sep 2000 17:34:55 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Thu, 28 Sep 2000 17:31:55 -0400 (EDT) Received: from mail.memlane.com (mail.memlane.com [199.185.225.3]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Thu, 28 Sep 2000 17:31:52 -0400 (EDT) Received: from seasar ([199.185.225.195]) by mail.memlane.com (Post.Office MTA v3.5.3 release 223 ID# 0-55152U3000L300S0V35) with SMTP id com for ; Thu, 28 Sep 2000 15:16:13 -0600 Date: Thu, 28 Sep 2000 14:23:43 -0600 From: Donovan Hoggan Subject: W-EMED Safety Officer Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <002701c0298a$0047b920$c3e1b9c7@seasar> MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V5.50.4133.2400 X-Mailer: Microsoft Outlook Express 5.50.4133.2400 Content-type: multipart/alternative; boundary="----=_NextPart_000_0024_01C02957.B4D315C0" X-Priority: 3 X-MSMail-priority: Normal Precedence: bulk This is a multi-part message in MIME format. ------=_NextPart_000_0024_01C02957.B4D315C0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable Hello all I'm posting this to SAR list as well so I apologize in advance for = duplicate messages. I am the First-Aid Coordinator for a small SAR team in Alberta. I'm = looking for information the role, duties, training, etc. of the person = who is responsible for the safety of the searchers. Does anyone else = have this role separate from the Search Manager? Is anyone aware of = training materials, books, etc. that I can use to develop a Safety = Officer course? =20 As well, what issues do we need to look at for this? So far, we have = identified issues like ensuring access to hygiene around the command = post (eg. hand washing station outside the toilet), problems with = sending exhausted searchers driving home, consulting with Search = Manager, etc. What else should be included in training someone for this = position? Any help anyone can offer on-list or off would be great. I look forward = to hearing from you. Donovan Hoggan First-Aid Coordinator SEASAR Association ------=_NextPart_000_0024_01C02957.B4D315C0 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable
Hello all
 
I'm posting this to SAR list as well so = I apologize=20 in advance for duplicate messages.
 
I am the First-Aid Coordinator for a = small SAR team=20 in Alberta.  I'm looking for information the role, duties, = training, etc.=20 of the person who is responsible for the safety of the searchers.  = Does=20 anyone else have this role separate from the Search Manager?  Is = anyone=20 aware of training materials, books, etc. that I can use to develop = a Safety=20 Officer course? 
 
As well, what issues do we need to look = at for=20 this?  So far, we have identified issues like ensuring access = to=20 hygiene around the command post (eg. hand washing station outside the = toilet),=20 problems with sending exhausted searchers driving home, consulting with = Search=20 Manager, etc.  What else should be included in training someone for = this=20 position?
 
Any help anyone can offer on-list or = off would be=20 great.  I look forward to hearing from you.
 
Donovan Hoggan
First-Aid Coordinator
SEASAR = Association
------=_NextPart_000_0024_01C02957.B4D315C0-- 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID for ; Thu, 21 Sep 2000 13:04:34 -0400 (EDT) Received: from elbert.interrural.net ("port 3639"@[216.169.69.2]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JUFP7VIJQ4000X5S@mb1i0.ns.pitt.edu> for kconover@imap.pitt.edu (ORCPT rfc822;kconover@pitt.edu); Thu, 21 Sep 2000 13:04:32 EST Received: from mail.ruralhealth.org ([216.169.78.227]) by elbert.interrural.net (Post.Office MTA v3.5.3 release 223 ID# 0-57009U5100L500S0V35) with ESMTP id net; Thu, 21 Sep 2000 11:07:25 -0600 Received: from peter1 [216.169.79.18] by mail.ruralhealth.org (SMTPD32-5.01) id AD3C294D0090; Thu, 21 Sep 2000 10:54:20 -0700 (MST) Date: Thu, 21 Sep 2000 11:08:17 -0600 From: Peter Hackett Subject: Re: W-EMED AMS In-reply-to: <39C33790.21169.1D9D56B5@localhost> X-Sender: phack/ruralhealth.org@127.0.0.1 To: kconover@pitt.edu, Jodie Katz , wilderness-emergency-medicine@list.pitt.edu Message-id: <3.0.1.32.20000921110817.00779a60@127.0.0.1> MIME-version: 1.0 X-Mailer: Windows Eudora Pro Version 3.0.1 (32) Content-type: text/plain; charset="us-ascii" References: Possible mechanisms of action of ginkgo for AMS (all are established as actions of the extract, these are the ones I think most likely involved in AMS protection): inhibition of iNOS inhibition of platelet activating factor oxygen radical scavenger If you do a lit search under ginkgo, you'll find hundreds of articles discussing its pharmocologic action. All the best, Peter At 09:04 AM 09/16/2000 -0400, Keith Conover, M.D., FACEP wrote: >I'm really not sure. I'll cc: Peter Hackett, who's doing some of the >work, and see if I can provide some thoughts. Ginkgo Biloba >extract is a mixture of many different types of pharmacologic >agents, so I think we're at the early stages of investigation -- not >much more advanced than traditional shamans who note cause >and effect for botanicals. Here is one of the references: > >1. Roncin JP, Schwartz F, P DA. EGb 761 in control of acute >mountain sickness and vascular reactivity to cold exposure. Aviat >Space Environ Med 1996; 67:445-52. > >METHOD: We recruited 44 subjects to participate in a study >of the preventive effect of Ginko biloba extract (EGb 761) on >acute mountain sickness (AMS) and vasomotor changes of >the extremities during a Himalayan expedition. After giving >their written informed consent, the subjects were >randomized to two groups. One group received 160 mg of >EGb 761 per day in two divided doses and the other group >received placebo. Assessment was based on the course of >the Environmental Symptom Questionnaire (ESQ) score and >the cold gradient measured by photoplethysmography. >RESULTS: The prophylactic efficacy of treatment with EGb >761 was clearly demonstrated in this study. In terms of >factor 1 (AMS-Cerebral), no subject in the EGb 761 group >developed acute mountain sickness versus 40.9% of >subjects in the placebo group; this difference was very >significant (p < or = 1.4 x 10(-3)). In terms of factor 2 (AMS- >Respiratory) , 3 subjects (13.6%) in the EGb 761 group >developed acute mountain sickness versus 18 (81.8%) in the >placebo group; this difference was very significant (p = 1.2 x >10(-5)) . CONCLUSION: Due to its multiple pharmacological >actions, EGb 761 provides an interesting response to the >prevention of mountain sickness for moderate altitude (5400 >m) with gradual exposure. It also decreased vasomotor >disorders of the extremities, as demonstrated by >plethysmography (p < 10(-8)) and a specific questionnaire (p >< 10(-9)). > >I haven't looked at this study, just the abstract, but doesn't >say anything about blinding, so somewhat suspicious of the >results. > >On 3 Sep 2000, at 0:18, Jodie Katz wrote: > >> Keith, >> >> Is there any thought as to the mechanism of action of gingko in the >> prevention of AMS? >> >> >> Jodie Katz, M.D., WEMT >> >> 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 > > >--Keith Conover, M.D., FACEP > http://www.pitt.edu/~kconover > sent with Pegasus high-security email > download free from www.pmail.com > > Peter Hackett, M.D. 610 Sabeta Drive Ridgway, CO 81432-9335 Phone: 970-626-2477 Fax: 970-626-2467 email: phack@ruralhealth.org -- End -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Thu, 21 Sep 2000 13:06:25 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JUFPA8X4WY000W1V@mb1i0.ns.pitt.edu>; Thu, 21 Sep 2000 13:06:25 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Thu, 21 Sep 2000 13:04:37 -0400 (EDT) Received: from elbert.interrural.net (elbert.gj.net [216.169.69.2]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Thu, 21 Sep 2000 13:04:33 -0400 (EDT) Received: from mail.ruralhealth.org ([216.169.78.227]) by elbert.interrural.net (Post.Office MTA v3.5.3 release 223 ID# 0-57009U5100L500S0V35) with ESMTP id net; Thu, 21 Sep 2000 11:07:25 -0600 Received: from peter1 [216.169.79.18] by mail.ruralhealth.org (SMTPD32-5.01) id AD3C294D0090; Thu, 21 Sep 2000 10:54:20 -0700 (MST) Date: Thu, 21 Sep 2000 11:08:17 -0600 From: Peter Hackett Subject: Re: W-EMED AMS In-reply-to: <39C33790.21169.1D9D56B5@localhost> Sender: owner-wilderness-emergency-medicine@list.pitt.edu X-Sender: phack/ruralhealth.org@127.0.0.1 To: kconover@pitt.edu, Jodie Katz , wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <3.0.1.32.20000921110817.00779a60@127.0.0.1> MIME-version: 1.0 X-Mailer: Windows Eudora Pro Version 3.0.1 (32) Content-type: text/plain; charset="us-ascii" Precedence: bulk References: Possible mechanisms of action of ginkgo for AMS (all are established as actions of the extract, these are the ones I think most likely involved in AMS protection): inhibition of iNOS inhibition of platelet activating factor oxygen radical scavenger If you do a lit search under ginkgo, you'll find hundreds of articles discussing its pharmocologic action. All the best, Peter At 09:04 AM 09/16/2000 -0400, Keith Conover, M.D., FACEP wrote: >I'm really not sure. I'll cc: Peter Hackett, who's doing some of the >work, and see if I can provide some thoughts. Ginkgo Biloba >extract is a mixture of many different types of pharmacologic >agents, so I think we're at the early stages of investigation -- not >much more advanced than traditional shamans who note cause >and effect for botanicals. Here is one of the references: > >1. Roncin JP, Schwartz F, P DA. EGb 761 in control of acute >mountain sickness and vascular reactivity to cold exposure. Aviat >Space Environ Med 1996; 67:445-52. > >METHOD: We recruited 44 subjects to participate in a study >of the preventive effect of Ginko biloba extract (EGb 761) on >acute mountain sickness (AMS) and vasomotor changes of >the extremities during a Himalayan expedition. After giving >their written informed consent, the subjects were >randomized to two groups. One group received 160 mg of >EGb 761 per day in two divided doses and the other group >received placebo. Assessment was based on the course of >the Environmental Symptom Questionnaire (ESQ) score and >the cold gradient measured by photoplethysmography. >RESULTS: The prophylactic efficacy of treatment with EGb >761 was clearly demonstrated in this study. In terms of >factor 1 (AMS-Cerebral), no subject in the EGb 761 group >developed acute mountain sickness versus 40.9% of >subjects in the placebo group; this difference was very >significant (p < or = 1.4 x 10(-3)). In terms of factor 2 (AMS- >Respiratory) , 3 subjects (13.6%) in the EGb 761 group >developed acute mountain sickness versus 18 (81.8%) in the >placebo group; this difference was very significant (p = 1.2 x >10(-5)) . CONCLUSION: Due to its multiple pharmacological >actions, EGb 761 provides an interesting response to the >prevention of mountain sickness for moderate altitude (5400 >m) with gradual exposure. It also decreased vasomotor >disorders of the extremities, as demonstrated by >plethysmography (p < 10(-8)) and a specific questionnaire (p >< 10(-9)). > >I haven't looked at this study, just the abstract, but doesn't >say anything about blinding, so somewhat suspicious of the >results. > >On 3 Sep 2000, at 0:18, Jodie Katz wrote: > >> Keith, >> >> Is there any thought as to the mechanism of action of gingko in the >> prevention of AMS? >> >> >> Jodie Katz, M.D., WEMT >> >> 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 > > >--Keith Conover, M.D., FACEP > http://www.pitt.edu/~kconover > sent with Pegasus high-security email > download free from www.pmail.com > > Peter Hackett, M.D. 610 Sabeta Drive Ridgway, CO 81432-9335 Phone: 970-626-2477 Fax: 970-626-2467 email: phack@ruralhealth.org 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Mon, 18 Sep 2000 12:39:09 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JUBHGF6U3C000EP5@mb1i0.ns.pitt.edu>; Mon, 18 Sep 2000 12:39:09 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Mon, 18 Sep 2000 12:31:58 -0400 (EDT) Received: from mail.trailnet.com (mail.trailnet.com [63.71.68.3]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Mon, 18 Sep 2000 12:31:54 -0400 (EDT) Received: from lookingglass.net ([207.18.213.68]) by mail.trailnet.com (Post.Office MTA v3.5.3 release 223 ID# 0-60892U4000L400S0V35) with ESMTP id com for ; Mon, 18 Sep 2000 10:39:08 -0600 Date: Mon, 18 Sep 2000 10:43:05 -0600 From: Andy Subject: W-EMED ICS, WMET training, & Forest Fires Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <39C64619.CEB0D34C@lookingglass.net> MIME-version: 1.0 X-Mailer: Mozilla 4.72 [en] (Win98; I) Content-type: text/plain; charset=us-ascii Content-transfer-encoding: 7bit Precedence: bulk X-Accept-Language: en At our local forest fire back in May (~8,000 acres) I took the opportunity to talk with the Medical Unit Leader and study her 'emergency room' and the medicines she had available. Several interesting items came out of that conversation that I have discussed locally but now I would like to extend the conversation to this list (of which I am a recent enrollee). First: While she is formally, per ICS protocol, under the Logistics Section Support Branch Manager she actually reported directly to the Safety Officer who is part of the Command Staff. Has anyone else run into this situation or a situation where the Medical Unit Leader reported to a position other than the standard Chain of Command? How did it work? What were the problems? Second: She said that her people were assigned to Strike Teams (fire-fighting teams) as individual resources and they were responsible for their team operating under the protocols of their parent organization. This means that EMT-B's, -I's, and -P's would follow whatever medical protocols to which they were accustomed (which makes a whole bunch of sense when you think about it). Question: Has anyone been in this situation? Did you have the equipment (splints, IV's, and etc) readily available to the level of your training, what did you miss the most? What medical condition are you really, really, glad that DIDN'T come-up, would there have been a way to treat that problem, realistically, given the situation? Third: What training has your local group (EMS, Fire Fighting, Police, SAR, National Forest Service, & etc) given for such situations that you consider the greatest thing since sliced bread? What do you consider was pointless and a waste of time? Have you taken the American Burn Association's training & is it worth- while or worthless for WEMT training? Thank you in advance for your response, Andy Thornton 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID for ; Mon, 18 Sep 2000 10:56:00 -0400 (EDT) From: Lfrizzsolo@aol.com Received: from imo-r13.mx.aol.com ("port 58299"@[152.163.225.67]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JUBDUJDHAM006YGM@mb2i0.ns.pitt.edu> for kconover@imap.pitt.edu (ORCPT rfc822;kconover@pitt.edu); Mon, 18 Sep 2000 10:56:00 EST Received: from Lfrizzsolo@aol.com by imo-r13.mx.aol.com (mail_out_v28.15.) id h.db.9be8b0f (3860); Mon, 18 Sep 2000 10:55:16 -0400 (EDT) Date: Mon, 18 Sep 2000 10:54:52 -0400 (EDT) Subject: Re: W-EMED Re: Field Rewarming To: jsilveramc@hotmail.com Cc: kconover@pitt.edu Message-id: MIME-version: 1.0 X-Mailer: AOL 4.0 for Windows 95 sub 110 Content-type: text/plain; charset="US-ASCII" Content-transfer-encoding: 7bit Hey Jonathan, Thanks for re-sending that e-mail with your questions about hypothermia. Believe it or not, the information that Dr. Conover has given you IS consistent with what SOLO teaches; HOWEVER, these efforts in the backcountry are not meant to REWARM, but rather to STABILIZE and PREVENT FURTHER COOLING. SOLO has (at least as long as I have been around) always taught that providing warm, humidified oxygen in the form of rescue breaths would help these patients (albeit not a whole lot). We also tell students that the use of external heat sources (heat packs, hot water bottles, etc.) can be placed in the groin, armpits, hands, and feet areas. Again, we're trying to stabilize the patients. Of course, most important is to remove the patient from the cold environment, remove wet clothes, and replace with new layers of dry insulating materials (while handling the patient gently). The total sum of all these efforts are not going to rewarm the patient, but they will help to stabilize and prevent further cooling. In this case the semantics are truly significant. Hope that helps. --Holly -- End -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID for ; Sat, 16 Sep 2000 17:47:16 -0400 (EDT) Received: from blount.mail.mindspring.net ("port 7703"@[207.69.200.226]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU8ZMQOYL40008D3@mb1i0.ns.pitt.edu> for kconover@imap.pitt.edu (ORCPT rfc822;kconover@pitt.edu); Sat, 16 Sep 2000 17:47:16 EST Received: from dfs-office (user-2initsa.dialup.mindspring.com [165.121.119.138]) by blount.mail.mindspring.net (8.9.3/8.8.5) with SMTP id RAA04382 for ; Sat, 16 Sep 2000 17:47:14 -0400 (EDT) Date: Sat, 16 Sep 2000 14:46:42 -0700 From: Douglass Sisk Subject: RE: W-EMED Wilderness EMS Course Offierings In-reply-to: <39C37F81.17195.1EB6122A@localhost> To: kconover@pitt.edu Reply-to: 76556.1550@compuserve.com Message-id: <000001c02027$99bd3060$8a7779a5@dfs-office> MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V4.72.3110.3 X-Mailer: Microsoft Outlook 8.5, Build 4.71.2173.0 Content-type: text/plain; charset="iso-8859-1" Content-transfer-encoding: 7bit Importance: Normal X-Priority: 3 (Normal) X-MSMail-priority: Normal Dear Keith, You know, I had that thought as soon as I posted that message. (that shortest of all possible time periods is that moment you click the "send" key...) My post was not meant as a commercial at all.. I totally support the non-commercial nature of the list and like you hope that my post doesn't precipitate a rash of "commercials". I know there are plenty of other quality programs out there teaching wilderness medicine... I merely offered WMI as an additon to SOLO, etc. I'm not, btw, affiliated with WMI except that I'm a graduate of the WEMT program and had a good experience there. Thanks for your time moderating the list... Have a great time in Scotland. I wish I could go... Best, Douglass Sisk, BS, MS, WEMT, NREMT You may post this to the list if you feel it appropriate. -- End -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sat, 16 Sep 2000 14:49:25 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU8TF85KMA000E01@mb1i0.ns.pitt.edu>; Sat, 16 Sep 2000 14:49:25 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sat, 16 Sep 2000 14:48:53 -0400 (EDT) Received: from tomts7-srv.bellnexxia.net (tomts7.bellnexxia.net [209.226.175.40]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sat, 16 Sep 2000 14:48:50 -0400 (EDT) Received: from Two ([64.229.113.129]) by tomts7-srv.bellnexxia.net (InterMail vM.4.01.03.00 201-229-121) with SMTP id <20000916184849.GJSX23574.tomts7-srv.bellnexxia.net@Two> for ; Sat, 16 Sep 2000 14:48:49 -0400 Date: Sat, 16 Sep 2000 15:51:53 -0500 From: Bernie Roche Subject: RE: W-EMED Wilderness EMS Course Offierings In-reply-to: <39C37F81.17195.1EB6122A@localhost> Sender: owner-wilderness-emergency-medicine@list.pitt.edu X-Sender: broche@titan.tcn.net To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <20000916184849.GJSX23574.tomts7-srv.bellnexxia.net@Two> MIME-version: 1.0 X-Mailer: QUALCOMM Windows Eudora Pro Version 4.0 Content-type: text/html; charset="iso-8859-1" Content-transfer-encoding: quoted-printable Precedence: bulk References: <000201c01ff7$ccf89440$ee7079a5@dfs-office> <39C33B68.16171.1DAC5C5B@localhost> At 02:11 PM 9/16/00 -0400, you wrote:

>So let's not see a rash of commercial advertisements here, please.=A0
>Not that any paid WEMT instructors or staff I know have ever
>made themselves rich, but this list is supposed to be commercial-
>free.=A0 I do think that at some point the Wilderness Medical Society
>may have a listing of commercial WEMT providers on their Web
>page, and if and when, I'll announce it here.
>
>--Keith Conover, M.D., FACEP

Hi:

If someone would provide a listing of commercial and non-commercial WEMT providers, I'll put it up in the WEMSI web site.

Best Wishes,

Bernie Roche, RN, BScN, W-EMT, OSJ

WEMSI Web Site Administrator

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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sat, 16 Sep 2000 14:12:00 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU8S4T1ZJA000E04@mb1i0.ns.pitt.edu>; Sat, 16 Sep 2000 14:11:59 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sat, 16 Sep 2000 14:11:21 -0400 (EDT) Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sat, 16 Sep 2000 14:11:18 -0400 (EDT) Received: from micron ("port 2234"@[136.142.21.33]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU8S3WLTFI006IHG@mb2i0.ns.pitt.edu> for wilderness-emergency-medicine@list.pitt.edu; Sat, 16 Sep 2000 14:11:17 -0500 (EST) Date: Sat, 16 Sep 2000 14:11:13 -0400 From: "Keith Conover, M.D., FACEP" Subject: RE: W-EMED Wilderness EMS Course Offierings In-reply-to: <000201c01ff7$ccf89440$ee7079a5@dfs-office> Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: Douglass Sisk , wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <39C37F81.17195.1EB6122A@localhost> MIME-version: 1.0 X-Mailer: Pegasus Mail for Win32 (v3.12c) Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Precedence: bulk References: <39C33B68.16171.1DAC5C5B@localhost> On 16 Sep 2000, at 9:04, Douglass Sisk wrote: > If you're not independently wealthy enough to go to Scotland... and > you happen to live or hang out in the western half of the US, another > option for W-EMT and First Responder classes is the Wilderness > Medicine Institute (now part of NOLS) @ http://wmi.nols.edu. Quality > instruction in a variety of outdoor settings, with courses offered all > over the western US. Hmm. My announcement was primarily related to a change in plans for an accredited academic offering specifically for emergency medicine residents, with a couple of notes about alternatives for those who aren't EM residents who keep emailing about the rotation in Pittsburgh. But I guess it was close to advertising. WEMSI is a volunteer operation, as are some organizations who offer classes based on the WEMSI Curriculum (examples include the Irish Mountain Rescue Association and U.S. National Cave Rescue Commission). However, there are some commercial organizations who, if not profit-motivated, at least have some of their staff and instructors partially supported by course fees, who offer courses based on the WEMSI Curriculum. The WEMSI curriculum has always been slanted particularly at SAR team members, and WEMSI courses are really not suited for trip leaders, and the like. That's why SAR organizations sometimes offer WEMSI courses -- WEMSI doesn't charge for the WEMSI curriculum, just has some QI (quality improvement) requirements for those who offer the courses. There are many other organizations who offer WEMT courses, based on their own curricula. Many of these are much better suited to trip leaders than the WEMSI curriculum. WMI, SOLO, and WMA seem to be the biggest providers. If someone wants a WEMT course in their area, they can usually arrange with WMI, SOLO, WMA, or other similar organizations to come to their area and offer a course. WEMSI doesn't do this, except occasionally to send some experienced staff to a new area (e.g., Scotland) to help the SAR/EMS people there get started in using the curriculum themselves. WEMSI staff who go usually have their airfare and food/lodging covered by the sponsoring organization, but receive no other compensation. So let's not see a rash of commercial advertisements here, please. Not that any paid WEMT instructors or staff I know have ever made themselves rich, but this list is supposed to be commercial- free. I do think that at some point the Wilderness Medical Society may have a listing of commercial WEMT providers on their Web page, and if and when, I'll announce it here. --Keith Conover, M.D., FACEP W-EMED list owner WEMSI Medical Director WMS Web Committee member 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sat, 16 Sep 2000 12:05:39 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU8NP7D1DW000DSW@mb1i0.ns.pitt.edu>; Sat, 16 Sep 2000 12:05:39 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sat, 16 Sep 2000 12:05:09 -0400 (EDT) Received: from smtp6.mindspring.com (smtp6.mindspring.com [207.69.200.110]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sat, 16 Sep 2000 12:05:06 -0400 (EDT) Received: from dfs-office (user-2inis7e.dialup.mindspring.com [165.121.112.238]) by smtp6.mindspring.com (8.9.3/8.8.5) with SMTP id MAA15414 for ; Sat, 16 Sep 2000 12:05:04 -0400 (EDT) Date: Sat, 16 Sep 2000 09:04:32 -0700 From: Douglass Sisk Subject: RE: W-EMED Wilderness EMS Course Offierings In-reply-to: <39C33B68.16171.1DAC5C5B@localhost> Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <000201c01ff7$ccf89440$ee7079a5@dfs-office> MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V4.72.3110.3 X-Mailer: Microsoft Outlook 8.5, Build 4.71.2173.0 Content-type: text/plain; charset="iso-8859-1" Content-transfer-encoding: 7bit Importance: Normal X-Priority: 3 (Normal) X-MSMail-priority: Normal Precedence: bulk If you're not independently wealthy enough to go to Scotland... and you happen to live or hang out in the western half of the US, another option for W-EMT and First Responder classes is the Wilderness Medicine Institute (now part of NOLS) @ http://wmi.nols.edu. Quality instruction in a variety of outdoor settings, with courses offered all over the western US. Best, Douglass Sisk, BS, MS, WEMT, NREMT 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID for ; Sat, 16 Sep 2000 10:10:40 -0400 (EDT) Received: from smtp2.gateway.net ("port 3867"@[208.230.117.246]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU8JOMZKCY0007FI@mb1i0.ns.pitt.edu> for kconover@imap.pitt.edu (ORCPT rfc822;kconover+2B@pitt.edu); Sat, 16 Sep 2000 10:10:40 EST Received: from default (1Cust59.tnt3.pittsburgh.pa.da.uu.net [63.10.67.59]) by smtp2.gateway.net (8.9.3/8.9.3) with SMTP id KAA28411 for ; Sat, 16 Sep 2000 10:10:38 -0400 (EDT) Date: Sat, 16 Sep 2000 10:08:44 -0400 From: "Matthew F. Russell, M.D." Subject: RE: W-EMED AMS In-reply-to: <39C33790.21169.1D9D56B5@localhost> To: Keith Conover Message-id: MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V5.00.2919.6600 X-Mailer: Microsoft Outlook IMO, Build 9.0.2416 (9.0.2911.0) Content-type: text/plain; charset="iso-8859-1" Content-transfer-encoding: 7bit Importance: Normal X-Priority: 3 (Normal) X-MSMail-priority: Normal Keith, At the recent WMS conference, Hackett proposed that the mechanism may have to do with inhibition of Nitrous Oxide Synthetase...but that was just a theory and that one Australian researcher was doing further work to try and better elucidate the mechanism of action. -----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: Saturday, September 16, 2000 9:04 AM To: Jodie Katz; wilderness-emergency-medicine@list.pitt.edu Cc: Peter Hackett Subject: Re: W-EMED AMS I'm really not sure. I'll cc: Peter Hackett, who's doing some of the work, and see if I can provide some thoughts. Ginkgo Biloba extract is a mixture of many different types of pharmacologic agents, so I think we're at the early stages of investigation -- not much more advanced than traditional shamans who note cause and effect for botanicals. Here is one of the references: 1. Roncin JP, Schwartz F, P DA. EGb 761 in control of acute mountain sickness and vascular reactivity to cold exposure. Aviat Space Environ Med 1996; 67:445-52. METHOD: We recruited 44 subjects to participate in a study of the preventive effect of Ginko biloba extract (EGb 761) on acute mountain sickness (AMS) and vasomotor changes of the extremities during a Himalayan expedition. After giving their written informed consent, the subjects were randomized to two groups. One group received 160 mg of EGb 761 per day in two divided doses and the other group received placebo. Assessment was based on the course of the Environmental Symptom Questionnaire (ESQ) score and the cold gradient measured by photoplethysmography. RESULTS: The prophylactic efficacy of treatment with EGb 761 was clearly demonstrated in this study. In terms of factor 1 (AMS-Cerebral), no subject in the EGb 761 group developed acute mountain sickness versus 40.9% of subjects in the placebo group; this difference was very significant (p < or = 1.4 x 10(-3)). In terms of factor 2 (AMS- Respiratory) , 3 subjects (13.6%) in the EGb 761 group developed acute mountain sickness versus 18 (81.8%) in the placebo group; this difference was very significant (p = 1.2 x 10(-5)) . CONCLUSION: Due to its multiple pharmacological actions, EGb 761 provides an interesting response to the prevention of mountain sickness for moderate altitude (5400 m) with gradual exposure. It also decreased vasomotor disorders of the extremities, as demonstrated by plethysmography (p < 10(-8)) and a specific questionnaire (p < 10(-9)). I haven't looked at this study, just the abstract, but doesn't say anything about blinding, so somewhat suspicious of the results. On 3 Sep 2000, at 0:18, Jodie Katz wrote: > Keith, > > Is there any thought as to the mechanism of action of gingko in the > prevention of AMS? > > > Jodie Katz, M.D., WEMT > > 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 --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover sent with Pegasus high-security email download free from www.pmail.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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sat, 16 Sep 2000 09:21:07 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU8HY7CLJE000DSW@mb1i0.ns.pitt.edu>; Sat, 16 Sep 2000 09:21:07 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sat, 16 Sep 2000 09:20:51 -0400 (EDT) Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sat, 16 Sep 2000 09:20:48 -0400 (EDT) Received: from micron ("port 1659"@[136.142.23.135]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU8HXQZOD2000E01@mb1i0.ns.pitt.edu> for wilderness-emergency-medicine@list.pitt.edu; Sat, 16 Sep 2000 09:20:47 -0500 (EST) Date: Sat, 16 Sep 2000 09:20:40 -0400 From: "Keith Conover, M.D., FACEP" Subject: W-EMED Wilderness EMS Course Offierings Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Cc: "Todd L. Slesinger M.D." , David Dreitlein , "Imran m. bajwa" Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <39C33B68.16171.1DAC5C5B@localhost> MIME-version: 1.0 X-Mailer: Pegasus Mail for Win32 (v3.12c) Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Precedence: bulk Sorry for the delay in getting back to everone who is interested. Although I generally offer a month-long rotation in Wilderness EMS for R-2/-3 emergency medicine residents in August or November of each year, I will not be able to offer one this November except under some exceptional circumnstances. I will be going to Scotland in the middle of the month to help some Scottish mountain rescue people put on the first Scottish WEMSI Wilderness EMT and Wilderness Command Physician courses. So I'll be gone about half the month, and the only way I can handle residents on this rotation (the centerpiece of which is always helping with a WEMT/WCP class) is if the residents are independently wealthy and can afford the airfare to Scotland and back! The course will be at Glenmore Lodge in the Cairngorms from 5-11 November -- haven't quite figured out departure and return dates, as we will want to have a couple of days for climbing or hillwalking in the Cairngorms before returning. And, as a reminder, this course is solely wilderness EMS (designed to train you to be a medical director for a SAR team) and solely for EM residents in the U.S. or Canada, and solely at the R- 2 level or above. If you're looking for other kinds of wilderness medicine training opportunities, I suggest you contact the Wilderness Medical Society: http://www.wms.org Also, if you are interested in a Wilderness Command Physician course, designed to take a physician who already knows how to provide medical direction for paramedics to the level of providing online medical direction for SAR team EMTs and paramedics, there definitely will be such a course at the Scotland course http://www.wildmedic.org Any other WCP courses that will be offered will be posted on the WEMSI pages http://www.wemsi.org Physicians, RNs, PAs, etc. who wish to serve as _members_ of a SAR team may find it worthwhile to take the entire WEMSI WEMT class. The prerequisite is U.S. EMT-Basic or equivalent. A physician or RN who has read through the EMT book and spent a bit of time in an ambulance as an observer would be in good standing to take the course. A First Responder who learns well by reading, and who has read through the EMT book and spent some time in an ambulance would also be in good standing to take the WEMT course without being left behind in class and practical sessions. Physicians who are interested in wilderness medicine in general, but not as part of a SAR team, might look to the training for physicians occasionally offered by SOLO: http://www.stonehearth.com/ Those who are interested in learning more of the SAR end of things should work with a local SAR team -- check my Web page, URL below, for links to SAR organizations. Again, sorry for the delay in getting this information out to everyone. Take care. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover sent with Pegasus high-security email download free from www.pmail.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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sat, 16 Sep 2000 09:06:24 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU8HFY0R7K000E04@mb1i0.ns.pitt.edu>; Sat, 16 Sep 2000 09:06:24 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sat, 16 Sep 2000 09:05:03 -0400 (EDT) Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sat, 16 Sep 2000 09:05:00 -0400 (EDT) Received: from micron ("port 1657"@[136.142.23.135]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU8HE2OA6G000DZY@mb1i0.ns.pitt.edu> for wilderness-emergency-medicine@list.pitt.edu; Sat, 16 Sep 2000 09:04:59 -0500 (EST) Date: Sat, 16 Sep 2000 09:04:16 -0400 From: "Keith Conover, M.D., FACEP" Subject: Re: W-EMED AMS In-reply-to: Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: Jodie Katz , wilderness-emergency-medicine@list.pitt.edu Cc: Peter Hackett Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <39C33790.21169.1D9D56B5@localhost> MIME-version: 1.0 X-Mailer: Pegasus Mail for Win32 (v3.12c) Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Precedence: bulk I'm really not sure. I'll cc: Peter Hackett, who's doing some of the work, and see if I can provide some thoughts. Ginkgo Biloba extract is a mixture of many different types of pharmacologic agents, so I think we're at the early stages of investigation -- not much more advanced than traditional shamans who note cause and effect for botanicals. Here is one of the references: 1. Roncin JP, Schwartz F, P DA. EGb 761 in control of acute mountain sickness and vascular reactivity to cold exposure. Aviat Space Environ Med 1996; 67:445-52. METHOD: We recruited 44 subjects to participate in a study of the preventive effect of Ginko biloba extract (EGb 761) on acute mountain sickness (AMS) and vasomotor changes of the extremities during a Himalayan expedition. After giving their written informed consent, the subjects were randomized to two groups. One group received 160 mg of EGb 761 per day in two divided doses and the other group received placebo. Assessment was based on the course of the Environmental Symptom Questionnaire (ESQ) score and the cold gradient measured by photoplethysmography. RESULTS: The prophylactic efficacy of treatment with EGb 761 was clearly demonstrated in this study. In terms of factor 1 (AMS-Cerebral), no subject in the EGb 761 group developed acute mountain sickness versus 40.9% of subjects in the placebo group; this difference was very significant (p < or = 1.4 x 10(-3)). In terms of factor 2 (AMS- Respiratory) , 3 subjects (13.6%) in the EGb 761 group developed acute mountain sickness versus 18 (81.8%) in the placebo group; this difference was very significant (p = 1.2 x 10(-5)) . CONCLUSION: Due to its multiple pharmacological actions, EGb 761 provides an interesting response to the prevention of mountain sickness for moderate altitude (5400 m) with gradual exposure. It also decreased vasomotor disorders of the extremities, as demonstrated by plethysmography (p < 10(-8)) and a specific questionnaire (p < 10(-9)). I haven't looked at this study, just the abstract, but doesn't say anything about blinding, so somewhat suspicious of the results. On 3 Sep 2000, at 0:18, Jodie Katz wrote: > Keith, > > Is there any thought as to the mechanism of action of gingko in the > prevention of AMS? > > > Jodie Katz, M.D., WEMT > > 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 --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover sent with Pegasus high-security email download free from www.pmail.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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Wed, 13 Sep 2000 20:03:20 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU4XIF6STC000207@mb1i0.ns.pitt.edu>; Wed, 13 Sep 2000 20:03:21 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Wed, 13 Sep 2000 20:02:04 -0400 (EDT) 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-7.2.2.2) ID for ; Wed, 13 Sep 2000 20:02:01 -0400 (EDT) Received: from localhost (localhost [127.0.0.1]) by macs.mxim.com (8.7/8.6.9) with SMTP id RAA05293 for ; Wed, 13 Sep 2000 17:01:19 -0700 (PDT) Date: Wed, 13 Sep 2000 17:01:18 -0700 (PDT) From: Hal Lillywhite Subject: Re: W-EMED Backboard questions. In-reply-to: "Your message of Sun, 10 Sep 2000 13:54:41 EDT." <39BB92A1.15863.576EDA@localhost> Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <200009140001.RAA05293@macs.mxim.com> MIME-version: 1.0 X-Mailer: exmh version 2.0.1 12/23/97 Content-type: text/plain; charset=us-ascii Precedence: bulk Keith Conover, MD writes: >The short answer as far as this list is concerned is that you >shouldn't use backboards for wilderness EMS, you should use >vacuum mattresses! Well this is getting into sort of another topic but backboards do have a place in wilderness medicine, they just shouldn't be used as in the wilderness the same way they are used in urban medicine. You should not fasten a wilderness patient directly to the backboard. However a backboard used in conjunction with a vacuum mattress and possibly a Sked can make for a very comfortable ride out in even the roughest terrain. I suggest a folding aluminum backboard, cut down width wise so it fits easily in a Sked. Put the patient in the vacuum mattress and fasten the mattress to the backboard. Put the whole thing in a sked and you have a packaging system which is both easier to handle and more comfortable than a basket litter. I was a doubter so they put me in this system and drug me around a bit, including over some sharp edges. (That's right, they didn't carry me, they drug me over all the obstacles they could find.) I never felt the edges, the rocks on the ground etc. If there is a system easier on the patient and rescuers I don't know what it is. If the patient can stand to be vertical for a short time it is also a great packaging system for vertical rescue, you can drag the patient over the edge of a cliff very easily compared to the traditional horizontal litter. Put the tie-in to the Sked about a third of the way down from the head and add a couple of tag lines to prevent spinning. The system usually comes over the edge without the need for edge men to fight it away from the obstacles. One edge person can handle it easily. 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 10 Sep 2000 14:02:20 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU0E1Q3UIO007QH8@mb1i0.ns.pitt.edu>; Sun, 10 Sep 2000 14:02:18 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 10 Sep 2000 14:02:09 -0400 (EDT) Received: from mail.austin.rr.com (sm1.texas.rr.com [24.93.35.54]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 10 Sep 2000 14:02:06 -0400 (EDT) Received: from connolly ([24.93.38.106]) by mail.austin.rr.com with Microsoft SMTPSVC(5.5.1877.537.53); Sun, 10 Sep 2000 13:03:47 -0500 Date: Mon, 11 Sep 2000 18:06:19 -0500 (CDT) From: Micheal Mc Evoy Subject: Re: W-EMED Backboard questions. In-reply-to: <001901c01b25$1aad9fa0$60f35a8f@cao03330> Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Cc: cao03330@pop02.odn.ne.jp Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 Content-type: TEXT/PLAIN; charset=US-ASCII Precedence: bulk On Sun, 10 Sep 2000, Mark Wallace wrote: >Scenario: > >The pt is a 21 year old male who was hit by a car from the left side while >riding his motorcycle(vehicle vs. motorcycle). > >Initial assessment: > Mental(AVPU): Pt response to painful stimulation > Airway: Jaw thrust maneuver is performed to keep the airway open > Breathing: Normal, but O2 is given at 12L/m(nonrebreather mask) > Circulation: Pulse is present, No major bleeding > Skin: Normal > > >Rapid Trauma Assessment(DCAP-BLS): > Neck and Head: Normal (Cervical Collar is Applied) >Chest, abdomen, pelvis: No signs of trauma > Leg: Left lower leg, 20 cm distal the knee, is swollen > and deformed. > >The next phase of the rapid trauma assessment would to inspect and palpate >the back as the pt is being log-rolled onto a backboard. > >Question 1: Should the leg be splinted before log-rolling the Pt? I think >you should splint to prevent further damage to the leg and because the >nature of the accident. But I also read (Warning: Reading can be dangerous) >that if the pt is a priority, then you should forgo splinting and just >immobilize. Is the pt currently supine ? If so there is no immediate need to move the pt, so splint the lower leg. This could also be the case if the pt was prone. If the pt is in a latreral recumbant, the way I undersstand it, you would palpate the spine, backboard the pt, then deal with the lower leg. >The rapid trauma assessment(DCAP-BLS) is kind of new to me. The order I >remember was initial assessment, gather SAMPLE history, physical exam, >baseline vitals, treatment, transport, and ongoing assessment. > >Question 2: Should a splinted leg be strap separately to the backboard? There isn't a need for this in this particulate senario. >Question 3: If the pt starts to regurgitate and suction is not near by, what >should be done? Once the pt is boarded, tip the board sideways and let the pt vomit. Someone will need to clear the airway once the pt is done. If the pt has not been boarded, some needs to hold the head, other support the spine, while the pt is turned on their side. >Thank you for your time and patience. > >Mark > > >cao03330@pop02.odn.ne.jp -- Micheal Mc Evoy voyageur@whitepine.com WFR/Ground Tracker/Swiftwater Rescue Travis County Search and 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 10 Sep 2000 13:55:48 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU0DSPGF5I0056N1@mb2i0.ns.pitt.edu>; Sun, 10 Sep 2000 13:55:49 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 10 Sep 2000 13:54:57 -0400 (EDT) Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 10 Sep 2000 13:54:50 -0400 (EDT) Received: from klaptop ("port 1047"@[136.142.21.162]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU0DRDFXPU0056N1@mb2i0.ns.pitt.edu> for wilderness-emergency-medicine@list.pitt.edu; Sun, 10 Sep 2000 13:54:49 -0500 (EST) Date: Sun, 10 Sep 2000 13:54:41 -0400 From: "Keith Conover, M.D., FACEP" Subject: Re: W-EMED Backboard questions. In-reply-to: <001901c01b25$1aad9fa0$60f35a8f@cao03330> Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: Mark Wallace , wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <39BB92A1.15863.576EDA@localhost> MIME-version: 1.0 X-Mailer: Pegasus Mail for Win32 (v3.12c) Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Precedence: bulk On 10 Sep 2000, at 21:45, Mark Wallace wrote: > I have been asked to make a training video on how to properly use a > backboard. I use to be an EMT about 6 years ago and I have forgotten a > few things(add the fact that techniques also change). Any way my > questions are: Hmmm. Your question is mostly off-topic for a _wilderness_ list. The short answer as far as this list is concerned is that you shouldn't use backboards for wilderness EMS, you should use vacuum mattresses! There was an extensive discussion of this on the ems-l list. The ems-l list or other EMS non-wilderness lists would be a better place for your question, anyway. Suggest you check www.naemsp.org and check the ems-l archives and subscribe to that list. Take care. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover sent with Pegasus high-security email download free from www.pmail.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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 10 Sep 2000 08:44:36 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU02XUASSO006W90@mb1i0.ns.pitt.edu>; Sun, 10 Sep 2000 08:44:36 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 10 Sep 2000 08:44:01 -0400 (EDT) Received: from t-mta4.odn.ne.jp (mfep4.odn.ne.jp [143.90.131.182]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 10 Sep 2000 08:43:57 -0400 (EDT) Received: from cao03330 ([143.90.243.96]) by t-mta4.odn.ne.jp (InterMail vM.4.01.02.27 201-229-119-110) with SMTP id <20000910124353305.RONT.882.t-mta4.odn.ne.jp@mta4.odn.ne.jp> for ; Sun, 10 Sep 2000 21:43:53 +0900 Date: Sun, 10 Sep 2000 21:45:43 +0900 From: Mark Wallace Subject: W-EMED Backboard questions. Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <001901c01b25$1aad9fa0$60f35a8f@cao03330> Organization: MSE Rescue and Safety MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V5.00.2615.200 X-Mailer: Microsoft Outlook Express 5.00.2615.200 Content-type: multipart/alternative; boundary="----=_NextPart_000_0010_01C01B70.78599DC0" X-Priority: 3 X-MSMail-priority: Normal Precedence: bulk This is a multi-part message in MIME format. ------=_NextPart_000_0010_01C01B70.78599DC0 Content-Type: text/plain; charset="iso-2022-jp" Content-Transfer-Encoding: 7bit I have been asked to make a training video on how to properly use a backboard. I use to be an EMT about 6 years ago and I have forgotten a few things(add the fact that techniques also change). Any way my questions are: Scenario: The pt is a 21 year old male who was hit by a car from the left side while riding his motorcycle(vehicle vs. motorcycle). Initial assessment: Mental(AVPU): Pt response to painful stimulation Airway: Jaw thrust maneuver is performed to keep the airway open Breathing: Normal, but O2 is given at 12L/m(nonrebreather mask) Circulation: Pulse is present, No major bleeding Skin: Normal Rapid Trauma Assessment(DCAP-BLS): Neck and Head: Normal (Cervical Collar is Applied) Chest, abdomen, pelvis: No signs of trauma Leg: Left lower leg, 20 cm distal the knee, is swollen and deformed. The next phase of the rapid trauma assessment would to inspect and palpate the back as the pt is being log-rolled onto a backboard. Question 1: Should the leg be splinted before log-rolling the Pt? I think you should splint to prevent further damage to the leg and because the nature of the accident. But I also read (Warning: Reading can be dangerous) that if the pt is a priority, then you should forgo splinting and just immobilize. The rapid trauma assessment(DCAP-BLS) is kind of new to me. The order I remember was initial assessment, gather SAMPLE history, physical exam, baseline vitals, treatment, transport, and ongoing assessment. Question 2: Should a splinted leg be strap separately to the backboard? Question 3: If the pt starts to regurgitate and suction is not near by, what should be done? Thank you for your time and patience. Mark cao03330@pop02.odn.ne.jp ------=_NextPart_000_0010_01C01B70.78599DC0 Content-Type: text/html; charset="iso-2022-jp" Content-Transfer-Encoding: quoted-printable
I have been asked to make a = training video=20 on how to properly use a backboard. I use to be an EMT about 6 years ago = and I=20 have forgotten a few things(add the fact that techniques also change). = Any way=20 my questions are:
 
Scenario:
 
The pt is a 21 year old male who = was hit by=20 a car from the left side while riding his motorcycle(vehicle vs. = motorcycle).=20
 
Initial assessment:
      =20 Mental(AVPU): Pt response to painful stimulation
           =       =20 Airway: Jaw thrust maneuver is performed to keep the airway=20 open
           =   Breathing:=20 Normal, but O2 is given at 12L/m(nonrebreather mask)
           = Circulation:=20 Pulse is present, No major bleeding
    =    =20              = Skin:=20 Normal
 
    =    =20
Rapid Trauma = Assessment(DCAP-BLS):
    =    =20             &= nbsp;   =20 Neck and Head: Normal (Cervical = Collar is=20 Applied)
    =    =20     Chest, abdomen, pelvis: No signs of = trauma
    =    =20             &= nbsp;           &n= bsp;         =20 Leg: Left lower leg, 20 cm distal the knee, is swollen and=20 deformed.
 
The next phase of = the rapid=20 trauma assessment would to inspect and palpate the back as the pt is = being=20 log-rolled onto a backboard.
 
Question 1: Should the leg be splinted before log-rolling the = Pt?  I=20 think you should splint to prevent further damage to the leg and because = the=20 nature of the accident. But I also read (Warning: = Reading=20 can be dangerous) that if the pt is a priority, then you should = forgo=20 splinting and just immobilize.
 
 
The rapid=20 trauma assessment(DCAP-BLS) is kind of new to me. The order I remember = was=20 initial assessment, gather SAMPLE history, physical exam, baseline = vitals,=20 treatment, transport, and ongoing assessment.
 
Question 2: Should a splinted leg be strap separately to the=20 backboard?
 
Question 3: If the pt starts to regurgitate and suction is not near = by, what=20 should be done?
 
 
Thank you for your time and=20 patience.
 
Mark
 
 
cao03330@pop02.odn.ne.jp
 
 
 
 
 
 
------=_NextPart_000_0010_01C01B70.78599DC0-- 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 10 Sep 2000 08:44:36 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JU02XUASSO006W90@mb1i0.ns.pitt.edu>; Sun, 10 Sep 2000 08:44:36 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 10 Sep 2000 08:44:01 -0400 (EDT) Received: from t-mta4.odn.ne.jp (mfep4.odn.ne.jp [143.90.131.182]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 10 Sep 2000 08:43:57 -0400 (EDT) Received: from cao03330 ([143.90.243.96]) by t-mta4.odn.ne.jp (InterMail vM.4.01.02.27 201-229-119-110) with SMTP id <20000910124353305.RONT.882.t-mta4.odn.ne.jp@mta4.odn.ne.jp> for ; Sun, 10 Sep 2000 21:43:53 +0900 Date: Sun, 10 Sep 2000 21:45:43 +0900 From: Mark Wallace Subject: W-EMED Backboard questions. Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <001901c01b25$1aad9fa0$60f35a8f@cao03330> Organization: MSE Rescue and Safety MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V5.00.2615.200 X-Mailer: Microsoft Outlook Express 5.00.2615.200 Content-type: multipart/alternative; boundary="----=_NextPart_000_0010_01C01B70.78599DC0" X-Priority: 3 X-MSMail-priority: Normal Precedence: bulk This is a multi-part message in MIME format. ------=_NextPart_000_0010_01C01B70.78599DC0 Content-Type: text/plain; charset="iso-2022-jp" Content-Transfer-Encoding: 7bit I have been asked to make a training video on how to properly use a backboard. I use to be an EMT about 6 years ago and I have forgotten a few things(add the fact that techniques also change). Any way my questions are: Scenario: The pt is a 21 year old male who was hit by a car from the left side while riding his motorcycle(vehicle vs. motorcycle). Initial assessment: Mental(AVPU): Pt response to painful stimulation Airway: Jaw thrust maneuver is performed to keep the airway open Breathing: Normal, but O2 is given at 12L/m(nonrebreather mask) Circulation: Pulse is present, No major bleeding Skin: Normal Rapid Trauma Assessment(DCAP-BLS): Neck and Head: Normal (Cervical Collar is Applied) Chest, abdomen, pelvis: No signs of trauma Leg: Left lower leg, 20 cm distal the knee, is swollen and deformed. The next phase of the rapid trauma assessment would to inspect and palpate the back as the pt is being log-rolled onto a backboard. Question 1: Should the leg be splinted before log-rolling the Pt? I think you should splint to prevent further damage to the leg and because the nature of the accident. But I also read (Warning: Reading can be dangerous) that if the pt is a priority, then you should forgo splinting and just immobilize. The rapid trauma assessment(DCAP-BLS) is kind of new to me. The order I remember was initial assessment, gather SAMPLE history, physical exam, baseline vitals, treatment, transport, and ongoing assessment. Question 2: Should a splinted leg be strap separately to the backboard? Question 3: If the pt starts to regurgitate and suction is not near by, what should be done? Thank you for your time and patience. Mark cao03330@pop02.odn.ne.jp ------=_NextPart_000_0010_01C01B70.78599DC0 Content-Type: text/html; charset="iso-2022-jp" Content-Transfer-Encoding: quoted-printable
I have been asked to make a = training video=20 on how to properly use a backboard. I use to be an EMT about 6 years ago = and I=20 have forgotten a few things(add the fact that techniques also change). = Any way=20 my questions are:
 
Scenario:
 
The pt is a 21 year old male who = was hit by=20 a car from the left side while riding his motorcycle(vehicle vs. = motorcycle).=20
 
Initial assessment:
      =20 Mental(AVPU): Pt response to painful stimulation
           =       =20 Airway: Jaw thrust maneuver is performed to keep the airway=20 open
           =   Breathing:=20 Normal, but O2 is given at 12L/m(nonrebreather mask)
           = Circulation:=20 Pulse is present, No major bleeding
    =    =20              = Skin:=20 Normal
 
    =    =20
Rapid Trauma = Assessment(DCAP-BLS):
    =    =20             &= nbsp;   =20 Neck and Head: Normal (Cervical = Collar is=20 Applied)
    =    =20     Chest, abdomen, pelvis: No signs of = trauma
    =    =20             &= nbsp;           &n= bsp;         =20 Leg: Left lower leg, 20 cm distal the knee, is swollen and=20 deformed.
 
The next phase of = the rapid=20 trauma assessment would to inspect and palpate the back as the pt is = being=20 log-rolled onto a backboard.
 
Question 1: Should the leg be splinted before log-rolling the = Pt?  I=20 think you should splint to prevent further damage to the leg and because = the=20 nature of the accident. But I also read (Warning: = Reading=20 can be dangerous) that if the pt is a priority, then you should = forgo=20 splinting and just immobilize.
 
 
The rapid=20 trauma assessment(DCAP-BLS) is kind of new to me. The order I remember = was=20 initial assessment, gather SAMPLE history, physical exam, baseline = vitals,=20 treatment, transport, and ongoing assessment.
 
Question 2: Should a splinted leg be strap separately to the=20 backboard?
 
Question 3: If the pt starts to regurgitate and suction is not near = by, what=20 should be done?
 
 
Thank you for your time and=20 patience.
 
Mark
 
 
cao03330@pop02.odn.ne.jp
 
 
 
 
 
 
------=_NextPart_000_0010_01C01B70.78599DC0-- 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sat, 9 Sep 2000 01:45:10 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTYA0G7NAC007GZY@mb1i0.ns.pitt.edu>; Sat, 9 Sep 2000 01:45:09 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sat, 09 Sep 2000 01:44:40 -0400 (EDT) Received: from Mail.austin.rr.com (sm2.texas.rr.com [24.93.35.55]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sat, 09 Sep 2000 01:44:35 -0400 (EDT) Received: from connolly ([24.93.38.106]) by Mail.austin.rr.com with Microsoft SMTPSVC(5.5.1877.537.53); Sat, 09 Sep 2000 00:42:09 -0500 Date: Sun, 10 Sep 2000 05:48:46 -0500 (CDT) From: Micheal Mc Evoy Subject: Re: W-EMED petroleum burns??? In-reply-to: Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 Content-type: TEXT/PLAIN; charset=US-ASCII Precedence: bulk It really depends on the current conditions. In arctic or subarctic conditions, several seconds is too long for exposure. Although this would cause frostbite more so than petroleuim burns. In an arctic senario, and I believe this will apply weel to any other, it is best to use a specified set of gloves to pour fuel. This keeps the contamination to one set of gloves, not everyones and limits the contact exposure to the fuel. Micheal -- Micheal Mc Evoy voyageur@whitepine.com WFR/Ground Tracker/Swiftwater Rescue Travis County Search and Rescue On Sat, 9 Sep 2000, Gurkan Ozel wrote: >Date: Sat, 09 Sep 2000 04:00:42 GMT >From: Gurkan Ozel >Reply-To: wilderness-emergency-medicine@list.pitt.edu >To: wilderness-emergency-medicine@list.pitt.edu >Subject: Re: W-EMED petroleum burns??? > > >Thanks for all the input. In order to be little specific, for how long you >folks think, one's skin should stay in contact for serious (even moderate) >complications to start? (10 mins? 2 hours at min?) You can consider this >question in 2 parts, at normal temperatures and under freezing point (a cold >camping day). I know contact with petroleum products speeds up the freezing >of a tissue, which happens first, burn or freezing at 20 F and moderate >wind? >Thanks in advance. >Gurkan > > >_________________________________________________________________________ >Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com. > >Share information about yourself, create your own public profile at >http://profiles.msn.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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sat, 9 Sep 2000 21:25:05 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTZF7D7E2E0056N0@mb2i0.ns.pitt.edu>; Sat, 9 Sep 2000 21:25:05 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sat, 09 Sep 2000 21:23:57 -0400 (EDT) Received: from mtiwmhc24.worldnet.att.net (mtiwmhc24.worldnet.att.net [204.127.131.49]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sat, 09 Sep 2000 21:23:54 -0400 (EDT) Received: from pavillion ([12.77.75.87]) by mtiwmhc24.worldnet.att.net (InterMail vM.4.01.02.39 201-229-119-122) with SMTP id <20000910012322.QVGX4085.mtiwmhc24.worldnet.att.net@pavillion> for ; Sun, 10 Sep 2000 01:23:22 +0000 Date: Sat, 09 Sep 2000 21:28:00 -0400 From: "Roy Alson, MD" Subject: Re: W-EMED petroleum burns??? Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <001d01c01ac6$5c80b700$f216fea9@pavillion> MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V5.00.2919.6700 X-Mailer: Microsoft Outlook Express 5.00.2919.6700 Content-type: multipart/mixed; boundary="----=_NextPart_000_001A_01C01AA4.D48CF460" X-Priority: 3 X-MSMail-priority: Normal Precedence: bulk References: This is a multi-part message in MIME format. ------=_NextPart_000_001A_01C01AA4.D48CF460 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit It can be as short as 30 minutes. In the bad old days when I smoked a pipe, I would sometimes overfill my lighter. The napthalene would seep out and soak through my pocket, giving me a chemical burn in the shape of the lighter. I would notice the stinging about 1/2 hour after I filled the lighter. Roy Alson, MD ----- Original Message ----- From: "Micheal Mc Evoy" To: Sent: Sunday, September 10, 2000 6:48 AM Subject: Re: W-EMED petroleum burns??? > It really depends on the current conditions. In arctic or subarctic > conditions, several seconds is too long for exposure. Although this would > cause frostbite more so than petroleuim burns. > > In an arctic senario, and I believe this will apply weel to any other, it > is best to use a specified set of gloves to pour fuel. This keeps the > contamination to one set of gloves, not everyones and limits the contact > exposure to the fuel. > > Micheal > > -- > Micheal Mc Evoy voyageur@whitepine.com > WFR/Ground Tracker/Swiftwater Rescue > Travis County Search and Rescue > > On Sat, 9 Sep 2000, Gurkan Ozel wrote: > > >Date: Sat, 09 Sep 2000 04:00:42 GMT > >From: Gurkan Ozel > >Reply-To: wilderness-emergency-medicine@list.pitt.edu > >To: wilderness-emergency-medicine@list.pitt.edu > >Subject: Re: W-EMED petroleum burns??? > > > > > >Thanks for all the input. In order to be little specific, for how long you > >folks think, one's skin should stay in contact for serious (even moderate) > >complications to start? (10 mins? 2 hours at min?) You can consider this > >question in 2 parts, at normal temperatures and under freezing point (a cold > >camping day). I know contact with petroleum products speeds up the freezing > >of a tissue, which happens first, burn or freezing at 20 F and moderate > >wind? > >Thanks in advance. > >Gurkan > > > > > >_________________________________________________________________________ > >Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com. > > > >Share information about yourself, create your own public profile at > >http://profiles.msn.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 > ------=_NextPart_000_001A_01C01AA4.D48CF460 Content-Type: text/x-vcard; name="Roy L Alson, MD, PhD.vcf" Content-Transfer-Encoding: quoted-printable Content-Disposition: attachment; filename="Roy L Alson, MD, PhD.vcf" BEGIN:VCARD VERSION:2.1 N:Alson;Roy;L FN:Roy L Alson, MD, PhD ORG:Wake Forest University School of Medicine;Emergency Medicine TITLE:Assistant Professor TEL;WORK;VOICE:336-716-2193 TEL;WORK;FAX:336-716-5438 ADR;WORK;ENCODING=3DQUOTED-PRINTABLE:;;Department of Emergency = Medicine=3D0D=3D0A301 Medical Center Blvd;Winston-Sale=3D m;NC;27157-1089;USA LABEL;WORK;ENCODING=3DQUOTED-PRINTABLE:Department of Emergency = Medicine=3D0D=3D0A301 Medical Center Blvd=3D0D=3D0AWinston-S=3D alem, NC 27157-1089=3D0D=3D0AUSA X-WAB-GENDER:1 URL:http://www.sortteam.org URL:http://www.wfubmc.edu\em EMAIL;PREF;INTERNET:ralson@wfubmc.edu REV:20000910T012800Z END:VCARD ------=_NextPart_000_001A_01C01AA4.D48CF460-- 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sat, 9 Sep 2000 00:02:05 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTY6ELZUFS007GZY@mb1i0.ns.pitt.edu>; Sat, 9 Sep 2000 00:02:02 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sat, 09 Sep 2000 00:01:21 -0400 (EDT) Received: from hotmail.com (f256.law9.hotmail.com [64.4.8.131]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sat, 09 Sep 2000 00:01:14 -0400 (EDT) Received: from mail pickup service by hotmail.com with Microsoft SMTPSVC; Fri, 08 Sep 2000 21:00:42 -0700 Received: from 213.243.0.9 by lw9fd.law9.hotmail.msn.com with HTTP; Sat, 09 Sep 2000 04:00:42 +0000 (GMT) Date: Sat, 09 Sep 2000 04:00:42 +0000 (GMT) From: Gurkan Ozel Subject: Re: W-EMED petroleum burns??? Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 Content-type: text/plain; format=flowed Precedence: bulk X-Originating-IP: [213.243.0.9] X-OriginalArrivalTime: 09 Sep 2000 04:00:42.0804 (UTC) FILETIME=[861B3F40:01C01A12] Thanks for all the input. In order to be little specific, for how long you folks think, one's skin should stay in contact for serious (even moderate) complications to start? (10 mins? 2 hours at min?) You can consider this question in 2 parts, at normal temperatures and under freezing point (a cold camping day). I know contact with petroleum products speeds up the freezing of a tissue, which happens first, burn or freezing at 20 F and moderate wind? Thanks in advance. Gurkan _________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com. Share information about yourself, create your own public profile at http://profiles.msn.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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Fri, 8 Sep 2000 22:51:47 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTY3XIAO6S007GZY@mb1i0.ns.pitt.edu>; Fri, 8 Sep 2000 22:51:46 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Fri, 08 Sep 2000 22:50:54 -0400 (EDT) Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Fri, 08 Sep 2000 22:50:51 -0400 (EDT) Received: from micron ("port 1635"@[136.142.20.237]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTY3WA6SOK004K4W@mb1i0.ns.pitt.edu> for wilderness-emergency-medicine@list.pitt.edu; Fri, 08 Sep 2000 22:50:50 -0500 (EST) Date: Fri, 08 Sep 2000 22:50:46 -0400 From: "Keith Conover, M.D., FACEP" Subject: W-EMED confused spam from Atlanticare.org Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <39B96D46.15957.2AFDA1D@localhost> MIME-version: 1.0 X-Mailer: Pegasus Mail for Win32 (v3.12c) Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Precedence: bulk Sorry for all the garbled messages to the list from Atlanticare.org. Their mailer obviously is ill. I found a su*bscriber from this domain and uns*ubscribed him, so ideally the spam will cease soon. If not, I will have to restrict posting to su*bscribed addresses -- but that means that you won't be able to post if there is even a slight difference in your current email from the one under which you su*bscribed. So we'll wait for a day or two and see if this dies down. P.S. "su*bscribed" [sic] is necessary. I have the list set to bounce all messages with requests about "unsu*bscribe me please" (and variants) to me -- so you don't have to view them, sigh at people's stupidity (unsu*bscribe information is at the bottom of each message), and delete the messages. Thanks for your patience and apologies again for having to exercise your delete-key finger. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover sent with Pegasus high-security email download free from www.pmail.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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Fri, 8 Sep 2000 13:59:59 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTXLD6GVK8004ME3@mb2i0.ns.pitt.edu>; Fri, 8 Sep 2000 13:59:59 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Fri, 08 Sep 2000 13:58:47 -0400 (EDT) Received: from neptunium.dowco.com (root@neptunium.dowco.com [209.87.128.98]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Fri, 08 Sep 2000 13:58:44 -0400 (EDT) Received: from iname.com (tch1c129.chw.dowco.com [204.244.173.129]) by neptunium.dowco.com (8.9.3/8.8.7) with ESMTP id KAA60073 for ; Fri, 08 Sep 2000 10:58:31 -0700 (PDT) Date: Fri, 08 Sep 2000 10:58:27 -0700 From: Glen Subject: Re: W-EMED petroleum burns??? Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <39B928C2.26211D4F@iname.com> Organization: Always! MIME-version: 1.0 X-Mailer: Mozilla 4.75 [en] (Win98; U) Content-type: text/plain; charset=us-ascii Content-transfer-encoding: 7bit Precedence: bulk X-Accept-Language: en References: G'day, Short term No Long term exposure yes it will cause the skin to blister ect IE Chemical burn.. Cheers, Glen (Esso Refinery Tech) Gurkan Ozel wrote: > Recently I got a question about "petroleum burns". A guy claims that one can > cause burn on someone if one spills significant amount of petroleum product > (this was limited to gasoline or kerosene, camping stove fuel in particular) > on another's body! Remember, there is no fire involving in the action. Could > that be true? Is it called "petroleum burn"? > Thanks, > > Gurkan > _________________________________________________________________________ > Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com. > > Share information about yourself, create your own public profile at > http://profiles.msn.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 -- Cheers, Glen ozdream@iname.com ICQ #17239752 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Fri, 8 Sep 2000 12:43:49 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTXIPQLDT60074CJ@mb1i0.ns.pitt.edu>; Fri, 8 Sep 2000 12:43:49 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Fri, 08 Sep 2000 12:39:46 -0400 (EDT) Received: from imo-d06.mx.aol.com (imo-d06.mx.aol.com [205.188.157.38]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Fri, 08 Sep 2000 12:39:43 -0400 (EDT) Received: from Yankeemedc@aol.com by imo-d06.mx.aol.com (mail_out_v28.15.) id h.5d.6410bc (7703) for ; Fri, 08 Sep 2000 12:39:05 -0400 (EDT) Date: Fri, 08 Sep 2000 12:39:05 -0400 (EDT) From: Yankeemedc@aol.com Subject: Re: W-EMED petroleum burns??? Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <5d.6410bc.26ea7029@aol.com> MIME-version: 1.0 X-Mailer: AOL 5.0 for Windows sub 120 Content-type: text/plain; charset="US-ASCII" Content-transfer-encoding: 7bit Precedence: bulk Dr. Burton is absolutely right regarding chemical burns. Petroleum products may or may not be irrotating to the skin, sepends on sensitivity, for short duration (hand washing, etc) but over long duration can cause sever damage. One example that sticks in my mind is the patient who was trapped in an overturned tractor trailer for several hours, with diesel fuel dripping on his pants. Initial thoughts were that legs were crushed (he had no sensation due to compression), but upon extrication, his most significant problem was severe chemical burns which produced swelling to the extent that he required fasciotomy to relieve the internal pressure on his legs. Did fine and was discharged a few days later. Interesting note is that at one point the medical teams called a trauma surgeon to the scene to consider amputation of what were thought to be crushed legs. Luckily, that didn't happen. Charles F. Dusha Asst. Chief, Logan Rogersville Fire District Springfield, MO Operations Supervisor, Clark Airport Branson, MO 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: R From: Keith Conover, M.D., FACEP X-RS-ID: X-RS-Flags: 0,0,1,1,0,0,0 X-RS-Sigset: 2 To: wilderness-emergency-medicine@list.pitt.edu Subject: confused spam from Atlanticare.org Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Fri, 8 Sep 2000 09:58:24 -0400 Sorry for all the garbled messages to the list from Atlanticare.org. Their mailer obviously is ill. I found a su*bscriber from this domain and uns*ubscribed him, so ideally the spam will cease soon. If not, I will have to restrict posting to su*bscribed addresses -- but that means that you won't be able to post if there is even a slight difference in your current email from the one under which you su*bscribed. So we'll wait for a day or two and see if this dies down. P.S. "su*bscribed" [sic] is necessary. I have the list set to bounce all messages with requests about "unsu*bscribe me please" (and variants) to me -- so you don't have to view them, sigh at people's stupidity (unsu*bscribe information is at the bottom of each message), and delete the messages. Thanks for your patience and apologies again for having to exercise your delete-key finger. -- End -- X-cs: R From: Keith Conover, M.D., FACEP X-RS-ID: X-RS-Flags: 0,0,1,1,0,0,0 X-RS-Header: In-reply-to: <200009081300.JAA03490@list.srv.cis.pitt.edu> X-RS-Sigset: 2 To: owner-wilderness-emergency-medicine@list.pitt.edu Subject: confused spam from Atlanticare.org Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Fri, 8 Sep 2000 09:55:27 -0400 Sorry for all the garbled messages to the list from Atlanticare.org. Their mailer obviously is ill. I found a su*bscriber from this domain and uns*ubscribed him, so ideally the spam will cease soon. If not, I will have to restrict posting to su*bscribed addresses -- but that means that you won't be able to post if there is even a slight difference in your current email from the one under which you su*bscribed. So we'll wait for a day or two and see if this dies down. P.S. "su*bscribed" [sic] is necessary. I have the list set to bounce all messages with requests about "unsu*bscribe me please" (and variants) to me -- so you don't have to view them, sigh at people's stupidity (unsu*bscribe information is at the bottom of each message), and delete the messages. Thanks for your patience and apologies again for having to exercise your delete-key finger. -- End -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Fri, 8 Sep 2000 09:40:55 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTXCBYMHBW004SPL@mb2i0.ns.pitt.edu>; Fri, 8 Sep 2000 09:40:55 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Fri, 08 Sep 2000 09:40:34 -0400 (EDT) Received: from post3.fast.net (post3.fast.net [198.69.204.24]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Fri, 08 Sep 2000 09:40:31 -0400 (EDT) Received: from r01c02adm03 (maxtnt10-abe-264.fast.net [209.92.18.10]) by post3.fast.net (8.9.3/8.8.5) with SMTP id JAA25842 for ; Fri, 08 Sep 2000 09:40:28 -0400 (EDT) Date: Fri, 08 Sep 2000 09:48:13 -0400 From: Barry Burton Subject: Re: W-EMED petroleum burns??? In-reply-to: Sender: owner-wilderness-emergency-medicine@list.pitt.edu X-Sender: n3vow@pop.fast.net To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <3.0.6.32.20000908094813.008eed20@pop.fast.net> MIME-version: 1.0 X-Mailer: QUALCOMM Windows Eudora Light Version 3.0.6 (32) Content-type: text/plain; charset="us-ascii" Precedence: bulk I'll take a stab at it. It is a chemical burn, based on the property of the "solvent" which will defat the skin if left n contact for a period of time. Well documented in the burn literature, and a specific part of the American Burn Associations Advanced Burn Life Support Program. In occupational medicine we see Gasoline station attendants with skin problems of their hands from this phenomenon. In EMS the parrellel is to assure a "wash down" of a patient who has gasoline on them, not only for oder, but like all other chemical burns, to dilute the concentration and reduce the contact time. Take a close looka t your hands after washing with gasoline or turpentine. Same process... The substances you list are all petroleum distillates, so probably the reason he is using that term. Barry Burton, DO. NovaCare Occupational and Sports Medicine Langhorne PA At 11:24 AM 09/08/2000 GMT, you wrote: >Recently I got a question about "petroleum burns". A guy claims that one can >cause burn on someone if one spills significant amount of petroleum product >(this was limited to gasoline or kerosene, camping stove fuel in particular) >on another's body! Remember, there is no fire involving in the action. Could >that be true? Is it called "petroleum burn"? >Thanks, > >Gurkan >_________________________________________________________________________ >Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com. > >Share information about yourself, create your own public profile at >http://profiles.msn.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 -- X-cs: R From: Keith Conover, M.D., FACEP X-RS-ID: X-RS-Flags: 0,0,1,1,0,0,0 X-RS-Sigset: 2 To: wilderness-emergency-medicine@list.pitt.edu Subject: spam from Atlanticare.org Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Fri, 8 Sep 2000 09:00:15 -0400 Sorry for all the garbled messages to the list from Atlanticare.org. Their mailer obviously is ill. I found a subsc*iber from this domain and unsubsc*ibed him, so ideally the spam will cease soon. If not, I will have to restrict posting to subsc*ibed addresses -- but that means that you won't be able to post if there is even a slight difference in your current email from the one under which you subsc*ibed. So we'll wait for a day or two and see if this dies down. P.S. "subsc*ibed" [sic] is necessary as I have the list set to bounce all messages with requests about "unsubs*ribe me please" and variants to me so you don't have to view them, sigh at people's stupidity (unsubsc*ibe information is at the bottom of each message), and delete the messages. Thanks for your patience and apologies again for having to exercise your delete- key finger. -- End -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Fri, 8 Sep 2000 07:25:42 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTX7LC52U40073FA@mb1i0.ns.pitt.edu>; Fri, 8 Sep 2000 07:25:42 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Fri, 08 Sep 2000 07:24:45 -0400 (EDT) Received: from hotmail.com (f6.law9.hotmail.com [64.4.9.6]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Fri, 08 Sep 2000 07:24:42 -0400 (EDT) Received: from mail pickup service by hotmail.com with Microsoft SMTPSVC; Fri, 08 Sep 2000 04:24:41 -0700 Received: from 144.122.7.45 by lw9fd.law9.hotmail.msn.com with HTTP; Fri, 08 Sep 2000 11:24:41 +0000 (GMT) Date: Fri, 08 Sep 2000 11:24:41 +0000 (GMT) From: Gurkan Ozel Subject: W-EMED petroleum burns??? Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 Content-type: text/plain; format=flowed Precedence: bulk X-Originating-IP: [144.122.7.45] X-OriginalArrivalTime: 08 Sep 2000 11:24:41.0633 (UTC) FILETIME=[61AC3910:01C01987] Recently I got a question about "petroleum burns". A guy claims that one can cause burn on someone if one spills significant amount of petroleum product (this was limited to gasoline or kerosene, camping stove fuel in particular) on another's body! Remember, there is no fire involving in the action. Could that be true? Is it called "petroleum burn"? Thanks, Gurkan _________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com. Share information about yourself, create your own public profile at http://profiles.msn.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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 3 Sep 2000 23:34:53 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTR607ISJ0003YFQ@mb2i0.ns.pitt.edu>; Sun, 3 Sep 2000 23:34:53 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 03 Sep 2000 23:34:23 -0400 (EDT) Received: from Mail.austin.rr.com (sm2.texas.rr.com [24.93.35.55]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 03 Sep 2000 23:34:15 -0400 (EDT) Received: from connolly ([24.28.75.63]) by Mail.austin.rr.com with Microsoft SMTPSVC(5.5.1877.537.53); Sun, 03 Sep 2000 22:31:59 -0500 Date: Mon, 04 Sep 2000 22:38:57 -0500 (CDT) From: Micheal Mc Evoy Subject: Re: W-EMED AMS In-reply-to: <4.2.0.58.20000903174524.00955ed0@mail.force9.net> Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 Content-type: TEXT/PLAIN; charset=US-ASCII Precedence: bulk SAR Teams need acclimization as much as the people that they need to help. The ability to use drugs, herbal or pharmecutical, to enable the SAR personnel to be on site sooner has an advantage for both the team members and the "victim". While I may use something to get me ready for altitude in a rescue senario, I would rather use the slower process in preparation for vacation. As for the mechanism, I believe that Ginko Biloba is a vasal dialator. -- Micheal Mc Evoy voyageur@whitepine.com SAR Medic/Ground Tracker Travis County Search & Rescue I'm proud of the sam blood in my vein, I'm a son of de Nort' Win' wance again -- So we'll fill her up til de bottle's drain An' drink to de Voyageur. --Henry Drummond, "The Voyageur" On Sun, 3 Sep 2000, Nigel Smee wrote: >Date: Sun, 03 Sep 2000 22:44:28 +0100 >From: Nigel Smee >Reply-To: wilderness-emergency-medicine@list.pitt.edu >To: wilderness-emergency-medicine@list.pitt.edu >Subject: W-EMED AMS > >Its interesting to read about natural remedies as replacements for >manufactured chemicals in any branch of medicine. St Johns Wort is also >being studied for its medicinal properties in various ailments. >Re use of drugs for AMS, I'm not an expert, but lets not forget that a main >cause of mountain sickness is rushing the acclimatization process, starting >too high, going too fast, bad planning. >People who use drugs to get high just die higher! >I know there are lots of reasons why we do it, but there are problems >associated with using remedies as preventatives. > >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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Mon, 4 Sep 2000 13:48:46 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTRZSWV87M00436F@mb2i0.ns.pitt.edu>; Mon, 4 Sep 2000 13:48:47 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Mon, 04 Sep 2000 13:46:58 -0400 (EDT) Received: from gigi.excite.com (gigi.excite.com [199.172.152.110]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Mon, 04 Sep 2000 13:46:55 -0400 (EDT) Received: from slippery ([199.172.153.106]) by gigi.excite.com (InterMail vM.4.01.02.39 201-229-119-122) with ESMTP id <20000904174621.JKU21483.gigi.excite.com@slippery> for ; Mon, 04 Sep 2000 10:46:21 -0700 Date: Mon, 04 Sep 2000 10:46:21 -0700 (PDT) From: James Martinez Subject: Re: W-EMED Uphill Extrication Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <14515364.968089581598.JavaMail.imail@slippery> MIME-version: 1.0 X-Mailer: Excite Inbox Content-type: text/plain; charset=us-ascii Content-transfer-encoding: 7bit Precedence: bulk X-Sender-Ip: 32.101.25.60 Fritz- Thank you for the feedback! I like it!! Hey--I'm an MFA instructor as well. I own a company here in Washington State and have 10 instructors. Have a nice weekend! James It's not so much what we do, but how we do it that makes the difference. _______________________________________________________ Say Bye to Slow Internet! http://www.home.com/xinbox/signup.html 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Mon, 4 Sep 2000 10:53:35 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTRTOPC37W003YFQ@mb2i0.ns.pitt.edu>; Mon, 4 Sep 2000 10:53:35 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Mon, 04 Sep 2000 10:53:01 -0400 (EDT) Received: from imo-r13.mx.aol.com (imo-r13.mx.aol.com [152.163.225.67]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Mon, 04 Sep 2000 10:52:58 -0400 (EDT) Received: from MYScher@aol.com by imo-r13.mx.aol.com (mail_out_v28.15.) id h.71.64ed79b (7065) for ; Mon, 04 Sep 2000 10:52:20 -0400 (EDT) Date: Mon, 04 Sep 2000 10:52:20 -0400 (EDT) From: MYScher@aol.com Subject: Re: W-EMED AMS, Gingko Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <71.64ed79b.26e51124@aol.com> MIME-version: 1.0 X-Mailer: AOL 5.0 for Windows sub 114 Content-type: text/plain; charset="US-ASCII" Content-transfer-encoding: 7bit Precedence: bulk Another route for info on this might be a traditional Chinese physician...there's a Dr. Wong in Brookline, MA that my wife has referred to...he's an MD who first trained and practiced in China in traditional medicine. Mordechai Y. Scher Worcester, MA for now... 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Mon, 4 Sep 2000 08:25:00 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTROIFD864006V80@mb1i0.ns.pitt.edu>; Mon, 4 Sep 2000 08:24:58 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Mon, 04 Sep 2000 08:24:32 -0400 (EDT) Received: from mail4.uts.ohio-state.edu (mail4.uts.ohio-state.edu [128.146.214.33]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Mon, 04 Sep 2000 08:24:29 -0400 (EDT) Received: from page (ts3-4.homenet.ohio-state.edu [140.254.112.59]) by mail4.uts.ohio-state.edu (8.9.3/8.9.3) with SMTP id IAA19313 for ; Mon, 04 Sep 2000 08:24:28 -0400 (EDT) Date: Mon, 04 Sep 2000 08:24:28 -0400 (EDT) From: John Page Subject: W-EMED AMS, Gingko Sender: owner-wilderness-emergency-medicine@list.pitt.edu X-Sender: page.95@pop.service.ohio-state.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <200009041224.IAA19313@mail4.uts.ohio-state.edu> MIME-version: 1.0 X-Mailer: Windows Eudora Pro Version 2.1.2 Content-type: text/plain; charset="us-ascii" Precedence: bulk Jodie - Noticed your question regarding gingko and AMS - Sorry - have no wonderful answer - yet I should provide a tip - suggest you contact either: 1. Some of the international mountain climbing groups. 2. Esp. those that have a Chinese EMT type around them. One partial connection would be to contact Richard Burns (world class high mountain & ice climber) at: climbsafe@hotmail.com He may be better able to direct you. Besides that: Might you be familiar with how one can get detailed herbal and supplemental approval standards out of Germany? (like FDA - but on herbs ect.) As Germany has fully approved Gingko - but I do not know the specifics. Best of luck - and please: I would be happy to be made aware as you get closer to an answer... John 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Mon, 4 Sep 2000 04:31:10 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTRGCKG9TG00436F@mb2i0.ns.pitt.edu>; Mon, 4 Sep 2000 04:31:11 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Mon, 04 Sep 2000 04:30:32 -0400 (EDT) Received: from smtp-server.nlr.nl (spider.nlr.nl [137.17.80.200]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Mon, 04 Sep 2000 04:30:29 -0400 (EDT) Received: from fripcy.nlr.nl (fripcy.nlr.nl [137.17.228.92]) by smtp-server.nlr.nl (8.10.1/8.10.1/NLR 29/03/2000) with ESMTP id e848TvH3804605; Mon, 04 Sep 2000 10:29:58 +0200 (CDT) Date: Mon, 04 Sep 2000 10:29:56 +0200 From: Frits van Doorn Subject: Re: W-EMED Uphill Extrication Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <200009040829.e848TvH3804605@smtp-server.nlr.nl> MIME-version: 1.0 X-Mailer: Microsoft Internet Mail 4.70.1154 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 7bit X-Priority: 3 X-MSMail-priority: Normal Precedence: bulk Disclaimer: "The National Aerospace Laboratory NLR DOES NOT ACCEPT ANY FINANCIAL COMMITMENT derived from this message." Reading some of the comments I would contribute the following. - Ask the victem how he felt and if he has some complications got from his head down extraction. If there are no problems then the right method is used: just for this incident. - As morphine has been given I get the impression that there was some kind of person who knows more about medic treatment and this person should monitor the victem all the time: that is what we learn when learning first aid: always keep on monitoring the ABC's. So if something went wrong going uphill you probably would have used the STA line: Stop Think Act and tried an other way to extract. My motto is: - Stick to the things you know best. - Do the things you've been taught. "You can only find real love insight yourself." Frits van Doorn MFA-instructor IAHD-instructor the Netherlands ---------- > From: James Martinez > To: wilderness-emergency-medicine@list.pitt.edu > Subject: W-EMED Uphill Extrication > Date: Sunday, September 03, 2000 5:06 PM > > Had a rescue the other day and opposite our team's expectations the patient > was appox. 75 ft down an embankment and weighed 260 pounds. > > He had rolled off of a quadrunner and was rather lucky to be alive. The > first responders had found him and splinted his broken ankle (his only > injury) with two pine branches....crude, but stable. > > By the time our mountain rescue team arrived in order to handle the > high-angle extrication, we had the patient already in the stokes and > wrappped and ready to go. > > The only thing that we as a collective were unsure of, was the proper way to > extricate this patient...broken ankle uphill, or downhill. We made a > command decision and took him up with his ankle uphill. (medic had already > given him morphine) > > After all was said and done, we conducted an AAR (after action review) Some > thought we were incorrect in taking the patient with his ankle uphill, and > some thought we should have in order to minimize swelling to his > ankle...even with morphine onboard. > > Can you shead some light on which may have been the proper extrication > method, with your experiences??? > > James > WEMT-B > > > It's not so much what we do, but how we do it that makes the difference. > > > > > > _______________________________________________________ > Say Bye to Slow Internet! > http://www.home.com/xinbox/signup.html > > 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 3 Sep 2000 21:55:20 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTR2IRRPAA00436F@mb2i0.ns.pitt.edu>; Sun, 3 Sep 2000 21:55:19 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 03 Sep 2000 21:54:44 -0400 (EDT) Received: from imo-r12.mx.aol.com (imo-r12.mx.aol.com [152.163.225.66]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 03 Sep 2000 21:54:42 -0400 (EDT) Received: from Jwg1987@aol.com by imo-r12.mx.aol.com (mail_out_v28.15.) id h.5f.a083536 (3944) for ; Sun, 03 Sep 2000 21:54:06 -0400 (EDT) Date: Sun, 03 Sep 2000 21:54:05 -0400 (EDT) From: Jwg1987@aol.com Subject: Re: W-EMED Uphill Extrication Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <5f.a083536.26e45abd@aol.com> MIME-version: 1.0 X-Mailer: AOL 5.0 for Windows sub 120 Content-type: text/plain; charset="US-ASCII" Content-transfer-encoding: 7bit Precedence: bulk Just curious, concerning the position of the subject, When you say head down, was that with the litter completely vertically heads down or horizontally with the head end lowered? If it was completely vertical, was it required because of terrain? John Goldfuss 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 3 Sep 2000 18:05:56 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTQUIDZOBK00436J@mb2i0.ns.pitt.edu>; Sun, 3 Sep 2000 18:05:57 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 03 Sep 2000 18:05:43 -0400 (EDT) Received: from murphys-outbound.servers.plus.net ([212.159.14.225]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 03 Sep 2000 18:05:40 -0400 (EDT) Received: (qmail 21763 invoked from network); Sun, 03 Sep 2000 22:04:52 +0000 Received: from unknown (HELO nbs) (212.159.17.190) by 212.159.14.225 with SMTP; Sun, 03 Sep 2000 22:04:52 +0000 Date: Sun, 03 Sep 2000 22:44:28 +0100 From: Nigel Smee Subject: W-EMED AMS Sender: owner-wilderness-emergency-medicine@list.pitt.edu X-Sender: mediact@mail.force9.net To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <4.2.0.58.20000903174524.00955ed0@mail.force9.net> MIME-version: 1.0 X-Mailer: QUALCOMM Windows Eudora Pro Version 4.2.0.58 Content-type: text/plain; charset="us-ascii"; format=flowed Precedence: bulk Its interesting to read about natural remedies as replacements for manufactured chemicals in any branch of medicine. St Johns Wort is also being studied for its medicinal properties in various ailments. Re use of drugs for AMS, I'm not an expert, but lets not forget that a main cause of mountain sickness is rushing the acclimatization process, starting too high, going too fast, bad planning. People who use drugs to get high just die higher! I know there are lots of reasons why we do it, but there are problems associated with using remedies as preventatives. 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 3 Sep 2000 17:09:45 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTQSJOJBRC00436J@mb2i0.ns.pitt.edu>; Sun, 3 Sep 2000 17:09:43 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 03 Sep 2000 17:09:10 -0400 (EDT) Received: from imo-d10.mx.aol.com (imo-d10.mx.aol.com [205.188.157.42]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 03 Sep 2000 17:09:08 -0400 (EDT) Received: from MYScher@aol.com by imo-d10.mx.aol.com (mail_out_v28.15.) id h.f7.26ea025 (4360) for ; Sun, 03 Sep 2000 17:08:33 -0400 (EDT) Date: Sun, 03 Sep 2000 17:08:33 -0400 (EDT) From: MYScher@aol.com Subject: W-EMED EMS work in NM ? Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 X-Mailer: AOL 5.0 for Windows sub 114 Content-type: text/plain; charset="US-ASCII" Content-transfer-encoding: 7bit Precedence: bulk If anyone has any leads or advice for me re: EMS (hopefully paramedic) work in central or northern NM (Santa Fe might be nice...), please drop me a line. I'll also be looking to volunteer for backcountry rescue. We'll be relocating there come spring or summer, so that my wife can fulfill her loan for service obligations after residency. (BTW, she's looking for appropriate work in FP medicine, maybe some emergency work, if anyone has any ideas). I will be finishing paramedic school this spring. Thanks and many blessings!! Mordechai Y. Scher EMT Spencer Rescue paramedic student combat medic (09), IDF 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 3 Sep 2000 14:07:04 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTQM67RS1S003QIA@mb2i0.ns.pitt.edu>; Sun, 3 Sep 2000 14:07:04 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 03 Sep 2000 14:06:40 -0400 (EDT) Received: from smtp.nwlink.com (smtp.nwlink.com [209.20.130.57]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 03 Sep 2000 14:06:37 -0400 (EDT) Received: from [207.202.172.145] (ip145.r3.d.bel.nwlink.com [207.202.172.145]) by smtp.nwlink.com (8.9.3/8.9.1) with ESMTP id LAA00761 for ; Sun, 03 Sep 2000 11:06:35 -0700 (PDT) Date: Sun, 03 Sep 2000 11:06:36 -0700 From: Douglas Burchard Subject: Re: W-EMED Uphill Extrication In-reply-to: <12415182.968001018725.JavaMail.imail@slippery> Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 Content-type: text/plain; charset="US-ASCII" Content-transfer-encoding: 7bit Precedence: bulk User-Agent: Microsoft-Outlook-Express-Macintosh-Edition/5.02.2022 > From: James Martinez > > Thanks for your response...I'll pass it on to the rest of our team. I do > believe you're right. If it would have been a prolonged rescue we most > likely would have placed him head up...who knows....we'll cross that bridge > next time. > > Thanks again! > > James > It's not so much what we do, but how we do it that makes the difference. James, I just wanted to second Mr. Tate's opinion. From a short term extrication off of a ski hill (ski patrol) to a long term extrication from the back country (search and rescue) if not otherwise indicated I'll always suggest comfort as a consideration. It's doubtful swelling of the ankle would have been a big problem and you could always change your treatment during the extrication based of patient monitoring. BTW, I like the nic-line! ;) -- Douglas Burchard, OEC, WEMT-B email: burchard@nwlink.com King County Search and Rescue (KCSARA) phone: 425/562-1968 Training Coordinator fax: 208/293-8639 Course Signups: http://209.80.56.222/kcsara/ 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 3 Sep 2000 13:24:16 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTQKO5WH8C004LWX@mb1i0.ns.pitt.edu>; Sun, 3 Sep 2000 13:24:16 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 03 Sep 2000 13:24:07 -0400 (EDT) Received: from mtiwmhc25.worldnet.att.net (mtiwmhc25.worldnet.att.net [204.127.131.50]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 03 Sep 2000 13:24:05 -0400 (EDT) Received: from pavillion ([12.77.74.147]) by mtiwmhc25.worldnet.att.net (InterMail vM.4.01.02.39 201-229-119-122) with SMTP id <20000903172334.ZIFM6375.mtiwmhc25.worldnet.att.net@pavillion> for ; Sun, 03 Sep 2000 17:23:34 +0000 Date: Sun, 03 Sep 2000 13:28:04 -0400 From: "Roy Alson, MD" Subject: Re: W-EMED Uphill Extrication Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <004d01c015cc$51a196f0$f216fea9@pavillion> MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V5.00.2919.6700 X-Mailer: Microsoft Outlook Express 5.00.2919.6700 Content-type: text/plain; charset="iso-8859-1" Content-transfer-encoding: 7bit X-Priority: 3 X-MSMail-priority: Normal Precedence: bulk References: <16881320.967993573487.JavaMail.imail@slippery> People do not die from bronken ankles. They die from airway compromise, shock or massive injury. His mechanism was a high risk one for any of these. While keeping his head lower, would help reduce swelling of the ankle (a minor concern) and could help with shock (Trendelenburg's position), it can also compromise the airway and breathing, as the abdominal contents are now pushed against the diaphragm. In my opinion, that is the biggest reason not to transport someone in a head down attitude. Roy Alson, MD ----- Original Message ----- From: "James Martinez" To: Sent: Sunday, September 03, 2000 11:06 AM Subject: W-EMED Uphill Extrication > Had a rescue the other day and opposite our team's expectations the patient > was appox. 75 ft down an embankment and weighed 260 pounds. > > He had rolled off of a quadrunner and was rather lucky to be alive. The > first responders had found him and splinted his broken ankle (his only > injury) with two pine branches....crude, but stable. > > By the time our mountain rescue team arrived in order to handle the > high-angle extrication, we had the patient already in the stokes and > wrappped and ready to go. > > The only thing that we as a collective were unsure of, was the proper way to > extricate this patient...broken ankle uphill, or downhill. We made a > command decision and took him up with his ankle uphill. (medic had already > given him morphine) > > After all was said and done, we conducted an AAR (after action review) Some > thought we were incorrect in taking the patient with his ankle uphill, and > some thought we should have in order to minimize swelling to his > ankle...even with morphine onboard. > > Can you shead some light on which may have been the proper extrication > method, with your experiences??? > > James > WEMT-B > > > It's not so much what we do, but how we do it that makes the difference. > > > > > > _______________________________________________________ > Say Bye to Slow Internet! > http://www.home.com/xinbox/signup.html > > 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 3 Sep 2000 13:11:35 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTQK8FMDAK003YEL@mb2i0.ns.pitt.edu>; Sun, 3 Sep 2000 13:11:35 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 03 Sep 2000 13:10:53 -0400 (EDT) Received: from fortune.excite.com (fortune-rwcmta.excite.com [198.3.99.203]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 03 Sep 2000 13:10:49 -0400 (EDT) Received: from slippery ([199.172.153.106]) by fortune.excite.com (InterMail vM.4.01.02.39 201-229-119-122) with ESMTP id <20000903171018.GRM9589.fortune.excite.com@slippery> for ; Sun, 03 Sep 2000 10:10:18 -0700 Date: Sun, 03 Sep 2000 10:10:18 -0700 (PDT) From: James Martinez Subject: RE: W-EMED Uphill Extrication Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <12415182.968001018725.JavaMail.imail@slippery> MIME-version: 1.0 X-Mailer: Excite Inbox Content-type: text/plain; charset=us-ascii Content-transfer-encoding: 7bit Precedence: bulk X-Sender-Ip: 32.101.25.140 Dear Mr. Tate- Thanks for your response...I'll pass it on to the rest of our team. I do believe you're right. If it would have been a prolonged rescue we most likely would have placed him head up...who knows....we'll cross that bridge next time. Thanks again! James It's not so much what we do, but how we do it that makes the difference. _______________________________________________________ Say Bye to Slow Internet! http://www.home.com/xinbox/signup.html 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 3 Sep 2000 12:08:39 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTQI1DR8QO006A5K@mb1i0.ns.pitt.edu>; Sun, 3 Sep 2000 12:08:38 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 03 Sep 2000 12:08:23 -0400 (EDT) Received: from tenforward.com (tenforward.com [206.213.105.2]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 03 Sep 2000 12:08:20 -0400 (EDT) Received: from david [209.43.157.158] by tenforward.com (SMTPD32-6.04) id A76839430252; Sun, 03 Sep 2000 09:08:08 -0700 Date: Sun, 03 Sep 2000 09:00:34 -0700 From: "The Tate's" Subject: RE: W-EMED Uphill Extrication In-reply-to: <16881320.967993573487.JavaMail.imail@slippery> Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V5.00.2615.200 X-Mailer: Microsoft Outlook IMO, Build 9.0.2416 (9.0.2910.0) Content-type: text/plain; charset="iso-8859-1" Content-transfer-encoding: 7bit Importance: Normal X-Priority: 3 (Normal) X-MSMail-priority: Normal Precedence: bulk Swelling from the ankle injury wouldn't have killed the subject. Assuming that shock wasn't a consideration I would have brought him up head first. In the long run it would have been more comfortable for him, of course with the morphine he probably wasn't that uncomfortable anyhow. Bottom line though in this case it wouldn't have mattered. David Tate -----Original Message----- From: owner-wilderness-emergency-medicine@list.pitt.edu [mailto:owner-wilderness-emergency-medicine@list.pitt.edu]On Behalf Of James Martinez Sent: Sunday, September 03, 2000 8:06 AM To: wilderness-emergency-medicine@list.pitt.edu Subject: W-EMED Uphill Extrication 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 3 Sep 2000 11:08:54 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTQFXCEJG8003YEK@mb2i0.ns.pitt.edu>; Sun, 3 Sep 2000 11:08:54 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 03 Sep 2000 11:06:51 -0400 (EDT) Received: from fortune.excite.com (fortune-rwcmta.excite.com [198.3.99.203]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 03 Sep 2000 11:06:44 -0400 (EDT) Received: from slippery ([199.172.153.106]) by fortune.excite.com (InterMail vM.4.01.02.39 201-229-119-122) with ESMTP id <20000903150613.BONW4359.fortune.excite.com@slippery> for ; Sun, 03 Sep 2000 08:06:13 -0700 Date: Sun, 03 Sep 2000 08:06:13 -0700 (PDT) From: James Martinez Subject: W-EMED Uphill Extrication Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <16881320.967993573487.JavaMail.imail@slippery> MIME-version: 1.0 X-Mailer: Excite Inbox Content-type: text/plain; charset=us-ascii Content-transfer-encoding: 7bit Precedence: bulk X-Sender-Ip: 32.101.25.151 Had a rescue the other day and opposite our team's expectations the patient was appox. 75 ft down an embankment and weighed 260 pounds. He had rolled off of a quadrunner and was rather lucky to be alive. The first responders had found him and splinted his broken ankle (his only injury) with two pine branches....crude, but stable. By the time our mountain rescue team arrived in order to handle the high-angle extrication, we had the patient already in the stokes and wrappped and ready to go. The only thing that we as a collective were unsure of, was the proper way to extricate this patient...broken ankle uphill, or downhill. We made a command decision and took him up with his ankle uphill. (medic had already given him morphine) After all was said and done, we conducted an AAR (after action review) Some thought we were incorrect in taking the patient with his ankle uphill, and some thought we should have in order to minimize swelling to his ankle...even with morphine onboard. Can you shead some light on which may have been the proper extrication method, with your experiences??? James WEMT-B It's not so much what we do, but how we do it that makes the difference. _______________________________________________________ Say Bye to Slow Internet! http://www.home.com/xinbox/signup.html 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 3 Sep 2000 00:19:28 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTPT94SJZQ003YG2@mb2i0.ns.pitt.edu>; Sun, 3 Sep 2000 00:19:27 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 03 Sep 2000 00:17:09 -0400 (EDT) Received: from maynard.mail.mindspring.net (maynard.mail.mindspring.net [207.69.200.243]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 03 Sep 2000 00:17:03 -0400 (EDT) Received: from natasha ([209.138.168.228]) by maynard.mail.mindspring.net (8.9.3/8.8.5) with SMTP id AAA01382 for ; Sun, 03 Sep 2000 00:17:02 -0400 (EDT) Date: Sun, 03 Sep 2000 00:18:02 -0400 From: Jodie Katz Subject: W-EMED AMS Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V5.50.4133.2400 X-Mailer: Microsoft Outlook IMO, Build 9.0.2416 (9.0.2910.0) Content-type: text/plain; charset="iso-8859-1" Content-transfer-encoding: 7bit Importance: Normal X-Priority: 3 (Normal) X-MSMail-priority: Normal Precedence: bulk Keith, Is there any thought as to the mechanism of action of gingko in the prevention of AMS? Jodie Katz, M.D., WEMT 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Wed, 30 Aug 2000 15:15:01 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTL3D2H3U0006HVB@mb1i0.ns.pitt.edu>; Wed, 30 Aug 2000 15:15:00 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Wed, 30 Aug 2000 15:13:22 -0400 (EDT) Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Wed, 30 Aug 2000 15:13:08 -0400 (EDT) Received: from micron ("port 1091"@[136.142.20.124]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTL3ACDTL6002X27@mb2i0.ns.pitt.edu> for wilderness-emergency-medicine@list.pitt.edu; Wed, 30 Aug 2000 15:12:50 -0500 (EST) Date: Wed, 30 Aug 2000 15:12:46 -0400 From: "Keith Conover, M.D., FACEP" Subject: RE: W-EMED Acute Mountain Sickness In-reply-to: Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: princessa@1srg.org, wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <39AD246E.28055.3E14C60@localhost> MIME-version: 1.0 X-Mailer: Pegasus Mail for Win32 (v3.12c) Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Precedence: bulk References: <39AC2D51.19558.1BD97B@localhost> On 29 Aug 2000, at 22:14, Jodie Katz wrote: > Also, since there is no FDA oversight per se on herbal remedies, I was > wondering if you recommend any particular brand, or if you feel that > anything advertised as being produced according to German E Commission > standard is sufficient. I simply do not have enough experience to > make a judgment call and certainly would not want to make a mistake on > this one. Oh, dear. I'm afraid I don't know much about herbals. But, I do know from some lectures I've attended that the German standards for herbals are as good as our FDA standards for non-herbals. So a standardized preparation that meets the E commission standards would be fine. I was at the drugstore yesterday and a bottle of 100 40 mg pills was about $5 or a bit more -- very cheap for an effective medicine. You know, if this really plays out, this will be the first time I'm aware of when a herbal will essentially replace a "regular" medicine as the drug of choice for a particular condition -- with good science behind it. Interesting times! --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover sent with Pegasus high-security email download free from www.pmail.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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID for ; Wed, 30 Aug 2000 03:31:10 -0400 (EDT) Received: from smtp-server.nlr.nl ("port 23557"@[137.17.80.200]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTKERXZA2U002WPP@mb2i0.ns.pitt.edu> for kconover@imap.pitt.edu (ORCPT rfc822;kconover+2B@pitt.edu); Wed, 30 Aug 2000 03:30:46 EST Received: from fripcy.nlr.nl (fripcy.nlr.nl [137.17.228.92]) by smtp-server.nlr.nl (8.10.1/8.10.1/NLR 29/03/2000) with ESMTP id e7U7UFG3910926; Wed, 30 Aug 2000 09:30:15 +0200 (CDT) Date: Wed, 30 Aug 2000 09:30:12 +0200 From: Frits van Doorn Subject: Re: W-EMED Acute Mountain Sickness To: kconover@pitt.edu Message-id: <200008300730.e7U7UFG3910926@smtp-server.nlr.nl> MIME-version: 1.0 X-Mailer: Microsoft Internet Mail 4.70.1154 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 7bit X-Priority: 3 X-MSMail-priority: Normal Disclaimer: "The National Aerospace Laboratory NLR DOES NOT ACCEPT ANY FINANCIAL COMMITMENT derived from this message." Excuse me, but what means BID ? Thanks in advance. Frits van Doorn the Netherlands fvdoorn@nlr.nl ---------- > From: Keith Conover, M.D., FACEP > To: Jodie Katz > Cc: wilderness-emergency-medicine@list.pitt.edu > Subject: Re: W-EMED Acute Mountain Sickness > Date: Wednesday, August 30, 2000 3:38 AM > > On 29 Aug 2000, at 20:56, Jodie Katz wrote: > > > We all know about the use of Diamox in the prevention of AMS, however > > I have recently come across some controversy in the timing of the > > initial dose. I have seen anything from 24 hours to 30 minutes prior > > to ascent. Also dosing regimens vary considerably, from 125mg daily > > to 250mg twice daily. > > Well, Peter Hackett says 67.5 mg BID is fine. But, it has side > effects, and he's going to be publishing some data showing that, > believe it or not, Gingkoa Biloba extract is as effective and with > fewer side effects (cheaper, too). Dosage is 100-120 mg BID. > > He and some others presented some prelimiminary data to this > effect at the Wilderness Medical Society annual meeting a couple > of weeks ago. > > Most people recommend starting 24 hours prior to ascent. As far > as I know, the exact timing hasn't been studied, but the 24 hour > figure is what was used in most of the studies as I remember. > > > Also, does anyone have any experience in the use of either Decadron > > alone or in combination with Diamox for the same purpose? I know that > > the side effect profile is much longer than that of Diamox, but there > > are those who cannot take the drug. Also, for individual who need to > > ascend and work fairly quickly with less-than-ideal time to > > acclimatize, I wondered if a Decadron/ Diamox combo has any value over > > that of a single agent. Thanks for the input and any references would > > be greatly appreciated. > > Hasn't been studied. Decadron is recommended for prohpylaxis > only if sulfa-allergic and unable to take Diamox (but with Gingkoa, > this may go out the door). This is due to the side effect profile of > Decadron which is considerable, even compared to Diamox. > > BTW, I've found that when I take the reduced dose of Diamox > recommended above, I only have to get up TWICE in the middle of > the night to pee (Diamox is a diuretic) and I only get tingling in my > extremities for about 12 hours instead of 24. > > --Keith Conover, M.D., FACEP > http://www.pitt.edu/~kconover > sent with Pegasus high-security email > download free from www.pmail.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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID for ; Tue, 29 Aug 2000 22:13:26 -0400 (EDT) Received: from blount.mail.mindspring.net ("port 14975"@[207.69.200.226]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTK3NZHR080061MX@mb1i0.ns.pitt.edu> for kconover@imap.pitt.edu (ORCPT rfc822;kconover@pitt.edu); Tue, 29 Aug 2000 22:13:03 EST Received: from natasha (pool-209-138-175-158-nwrk.grid.net [209.138.175.158]) by blount.mail.mindspring.net (8.9.3/8.8.5) with SMTP id WAA12501; Tue, 29 Aug 2000 22:12:58 -0400 (EDT) Date: Tue, 29 Aug 2000 22:14:01 -0400 From: Jodie Katz Subject: RE: W-EMED Acute Mountain Sickness In-reply-to: <39AC2D51.19558.1BD97B@localhost> To: kconover@pitt.edu Cc: wilderness-emergency-medicine@list.pitt.edu Reply-to: princessa@1srg.org Message-id: MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V5.50.4133.2400 X-Mailer: Microsoft Outlook IMO, Build 9.0.2416 (9.0.2910.0) Content-type: text/plain; charset="iso-8859-1" Content-transfer-encoding: 7bit Importance: Normal X-Priority: 3 (Normal) X-MSMail-priority: Normal I recently heard about the use of gingko, but was unaware of the source of the information. Thanks for that info. Also, since there is no FDA oversight per se on herbal remedies, I was wondering if you recommend any particular brand, or if you feel that anything advertised as being produced according to German E Commission standard is sufficient. I simply do not have enough experience to make a judgment call and certainly would not want to make a mistake on this one. Jodie Katz, M.D., WEMT -----Original Message----- From: Keith Conover, M.D., FACEP [mailto:kconover+@pitt.edu] Sent: Tuesday, 29 August, 2000 21:38 To: Jodie Katz Cc: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Acute Mountain Sickness On 29 Aug 2000, at 20:56, Jodie Katz wrote: > We all know about the use of Diamox in the prevention of AMS, however > I have recently come across some controversy in the timing of the > initial dose. I have seen anything from 24 hours to 30 minutes prior > to ascent. Also dosing regimens vary considerably, from 125mg daily > to 250mg twice daily. Well, Peter Hackett says 67.5 mg BID is fine. But, it has side effects, and he's going to be publishing some data showing that, believe it or not, Gingkoa Biloba extract is as effective and with fewer side effects (cheaper, too). Dosage is 100-120 mg BID. He and some others presented some prelimiminary data to this effect at the Wilderness Medical Society annual meeting a couple of weeks ago. Most people recommend starting 24 hours prior to ascent. As far as I know, the exact timing hasn't been studied, but the 24 hour figure is what was used in most of the studies as I remember. > Also, does anyone have any experience in the use of either Decadron > alone or in combination with Diamox for the same purpose? I know that > the side effect profile is much longer than that of Diamox, but there > are those who cannot take the drug. Also, for individual who need to > ascend and work fairly quickly with less-than-ideal time to > acclimatize, I wondered if a Decadron/ Diamox combo has any value over > that of a single agent. Thanks for the input and any references would > be greatly appreciated. Hasn't been studied. Decadron is recommended for prohpylaxis only if sulfa-allergic and unable to take Diamox (but with Gingkoa, this may go out the door). This is due to the side effect profile of Decadron which is considerable, even compared to Diamox. BTW, I've found that when I take the reduced dose of Diamox recommended above, I only have to get up TWICE in the middle of the night to pee (Diamox is a diuretic) and I only get tingling in my extremities for about 12 hours instead of 24. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover sent with Pegasus high-security email download free from www.pmail.com -- End -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Tue, 29 Aug 2000 22:14:09 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTK3OYEU6G005ZWI@mb1i0.ns.pitt.edu>; Tue, 29 Aug 2000 22:13:47 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Tue, 29 Aug 2000 22:13:34 -0400 (EDT) Received: from blount.mail.mindspring.net (blount.mail.mindspring.net [207.69.200.226]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Tue, 29 Aug 2000 22:13:27 -0400 (EDT) Received: from natasha (pool-209-138-175-158-nwrk.grid.net [209.138.175.158]) by blount.mail.mindspring.net (8.9.3/8.8.5) with SMTP id WAA12501; Tue, 29 Aug 2000 22:12:58 -0400 (EDT) Date: Tue, 29 Aug 2000 22:14:01 -0400 From: Jodie Katz Subject: RE: W-EMED Acute Mountain Sickness In-reply-to: <39AC2D51.19558.1BD97B@localhost> Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: kconover@pitt.edu Cc: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V5.50.4133.2400 X-Mailer: Microsoft Outlook IMO, Build 9.0.2416 (9.0.2910.0) Content-type: text/plain; charset="iso-8859-1" Content-transfer-encoding: 7bit Importance: Normal X-Priority: 3 (Normal) X-MSMail-priority: Normal Precedence: bulk I recently heard about the use of gingko, but was unaware of the source of the information. Thanks for that info. Also, since there is no FDA oversight per se on herbal remedies, I was wondering if you recommend any particular brand, or if you feel that anything advertised as being produced according to German E Commission standard is sufficient. I simply do not have enough experience to make a judgment call and certainly would not want to make a mistake on this one. Jodie Katz, M.D., WEMT -----Original Message----- From: Keith Conover, M.D., FACEP [mailto:kconover+@pitt.edu] Sent: Tuesday, 29 August, 2000 21:38 To: Jodie Katz Cc: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Acute Mountain Sickness On 29 Aug 2000, at 20:56, Jodie Katz wrote: > We all know about the use of Diamox in the prevention of AMS, however > I have recently come across some controversy in the timing of the > initial dose. I have seen anything from 24 hours to 30 minutes prior > to ascent. Also dosing regimens vary considerably, from 125mg daily > to 250mg twice daily. Well, Peter Hackett says 67.5 mg BID is fine. But, it has side effects, and he's going to be publishing some data showing that, believe it or not, Gingkoa Biloba extract is as effective and with fewer side effects (cheaper, too). Dosage is 100-120 mg BID. He and some others presented some prelimiminary data to this effect at the Wilderness Medical Society annual meeting a couple of weeks ago. Most people recommend starting 24 hours prior to ascent. As far as I know, the exact timing hasn't been studied, but the 24 hour figure is what was used in most of the studies as I remember. > Also, does anyone have any experience in the use of either Decadron > alone or in combination with Diamox for the same purpose? I know that > the side effect profile is much longer than that of Diamox, but there > are those who cannot take the drug. Also, for individual who need to > ascend and work fairly quickly with less-than-ideal time to > acclimatize, I wondered if a Decadron/ Diamox combo has any value over > that of a single agent. Thanks for the input and any references would > be greatly appreciated. Hasn't been studied. Decadron is recommended for prohpylaxis only if sulfa-allergic and unable to take Diamox (but with Gingkoa, this may go out the door). This is due to the side effect profile of Decadron which is considerable, even compared to Diamox. BTW, I've found that when I take the reduced dose of Diamox recommended above, I only have to get up TWICE in the middle of the night to pee (Diamox is a diuretic) and I only get tingling in my extremities for about 12 hours instead of 24. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover sent with Pegasus high-security email download free from www.pmail.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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Tue, 29 Aug 2000 21:40:05 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTK2IOHI9200651T@mb1i0.ns.pitt.edu>; Tue, 29 Aug 2000 21:39:42 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Tue, 29 Aug 2000 21:39:28 -0400 (EDT) Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Tue, 29 Aug 2000 21:39:23 -0400 (EDT) Received: from micron ("port 1042"@[136.142.23.160]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTK2H44PX000651T@mb1i0.ns.pitt.edu> for wilderness-emergency-medicine@list.pitt.edu; Tue, 29 Aug 2000 21:38:27 -0500 (EST) Date: Tue, 29 Aug 2000 21:38:25 -0400 From: "Keith Conover, M.D., FACEP" Subject: Re: W-EMED Acute Mountain Sickness In-reply-to: Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: Jodie Katz Cc: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <39AC2D51.19558.1BD97B@localhost> MIME-version: 1.0 X-Mailer: Pegasus Mail for Win32 (v3.12c) Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Precedence: bulk On 29 Aug 2000, at 20:56, Jodie Katz wrote: > We all know about the use of Diamox in the prevention of AMS, however > I have recently come across some controversy in the timing of the > initial dose. I have seen anything from 24 hours to 30 minutes prior > to ascent. Also dosing regimens vary considerably, from 125mg daily > to 250mg twice daily. Well, Peter Hackett says 67.5 mg BID is fine. But, it has side effects, and he's going to be publishing some data showing that, believe it or not, Gingkoa Biloba extract is as effective and with fewer side effects (cheaper, too). Dosage is 100-120 mg BID. He and some others presented some prelimiminary data to this effect at the Wilderness Medical Society annual meeting a couple of weeks ago. Most people recommend starting 24 hours prior to ascent. As far as I know, the exact timing hasn't been studied, but the 24 hour figure is what was used in most of the studies as I remember. > Also, does anyone have any experience in the use of either Decadron > alone or in combination with Diamox for the same purpose? I know that > the side effect profile is much longer than that of Diamox, but there > are those who cannot take the drug. Also, for individual who need to > ascend and work fairly quickly with less-than-ideal time to > acclimatize, I wondered if a Decadron/ Diamox combo has any value over > that of a single agent. Thanks for the input and any references would > be greatly appreciated. Hasn't been studied. Decadron is recommended for prohpylaxis only if sulfa-allergic and unable to take Diamox (but with Gingkoa, this may go out the door). This is due to the side effect profile of Decadron which is considerable, even compared to Diamox. BTW, I've found that when I take the reduced dose of Diamox recommended above, I only have to get up TWICE in the middle of the night to pee (Diamox is a diuretic) and I only get tingling in my extremities for about 12 hours instead of 24. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover sent with Pegasus high-security email download free from www.pmail.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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Tue, 29 Aug 2000 20:58:48 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTK12IPU5U0031SZ@mb2i0.ns.pitt.edu>; Tue, 29 Aug 2000 20:58:26 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Tue, 29 Aug 2000 20:56:06 -0400 (EDT) Received: from smtp6.mindspring.com (smtp6.mindspring.com [207.69.200.110]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Tue, 29 Aug 2000 20:55:59 -0400 (EDT) Received: from natasha ([209.138.247.172]) by smtp6.mindspring.com (8.9.3/8.8.5) with SMTP id UAA06204 for ; Tue, 29 Aug 2000 20:55:34 -0400 (EDT) Date: Tue, 29 Aug 2000 20:56:38 -0400 From: Jodie Katz Subject: W-EMED Acute Mountain Sickness Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 X-MIMEOLE: Produced By Microsoft MimeOLE V5.50.4133.2400 X-Mailer: Microsoft Outlook IMO, Build 9.0.2416 (9.0.2910.0) Content-type: text/plain; charset="iso-8859-1" Content-transfer-encoding: 7bit Importance: Normal X-Priority: 3 (Normal) X-MSMail-priority: Normal Precedence: bulk We all know about the use of Diamox in the prevention of AMS, however I have recently come across some controversy in the timing of the initial dose. I have seen anything from 24 hours to 30 minutes prior to ascent. Also dosing regimens vary considerably, from 125mg daily to 250mg twice daily. Also, does anyone have any experience in the use of either Decadron alone or in combination with Diamox for the same purpose? I know that the side effect profile is much longer than that of Diamox, but there are those who cannot take the drug. Also, for individual who need to ascend and work fairly quickly with less-than-ideal time to acclimatize, I wondered if a Decadron/ Diamox combo has any value over that of a single agent. Thanks for the input and any references would be greatly appreciated. Jodie Katz, MD, WEMT CMO 1 SRG 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sat, 26 Aug 2000 00:07:54 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTEMIOGTTS005HFX@mb1i0.ns.pitt.edu>; Sat, 26 Aug 2000 00:07:37 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sat, 26 Aug 2000 00:07:01 -0400 (EDT) Received: from imo-r01.mx.aol.com (imo-r01.mx.aol.com [152.163.225.1]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sat, 26 Aug 2000 00:06:56 -0400 (EDT) Received: from Omikid@aol.com by imo-r01.mx.aol.com (mail_out_v28.15.) id h.9c.6da4e1b (4189) for ; Sat, 26 Aug 2000 00:06:03 -0400 (EDT) Date: Sat, 26 Aug 2000 00:06:03 -0400 (EDT) From: Omikid@aol.com Subject: Re: W-EMED Adverse reaction to Halcion Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <9c.6da4e1b.26d89c2b@aol.com> MIME-version: 1.0 X-Mailer: AOL 5.0 for Windows sub 118 Content-type: text/plain; charset="US-ASCII" Content-transfer-encoding: 7bit Precedence: bulk NOt sure what the laws, etc. in China (or in the air for that matter) are, but keep in mind that many drugs in other countries are NOT prescription. (for instance, in Thailand, most anything but narcotics can be bought otc from a pharmacy. The pharmacist may even suggest something if you are not sure what you want) The fact that it is prescription in the US or another country makes little difference in such situations, legally anyway. I am not saying that it is a good idea, jsut a thought on the legality of the issue. Of course if you are going to give somebody a drug, it is a good idea to know the indications, contra-indications, side effects, and all that. Take care, Naomi 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Fri, 25 Aug 2000 22:50:02 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JTEJS61EZK002BW6@mb2i0.ns.pitt.edu>; Fri, 25 Aug 2000 22:49:45 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Fri, 25 Aug 2000 22:48:22 -0400 (EDT) Received: from imo-r09.mx.aol.com (imo-r09.mx.aol.com [152.163.225.9]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Fri, 25 Aug 2000 22:48:19 -0400 (EDT) Received: from Caverbru@aol.com by imo-r09.mx.aol.com (mail_out_v28.15.) id h.9e.8e4b17e (4407) for ; Fri, 25 Aug 2000 22:47:25 -0400 (EDT) Date: Fri, 25 Aug 2000 22:47:25 -0400 (EDT) From: Caverbru@aol.com Subject: W-EMED Adverse reaction to Halcion Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <9e.8e4b17e.26d889bd@aol.com> MIME-version: 1.0 X-Mailer: AOL 5.0 for Windows sub 114 Content-type: text/plain; charset="US-ASCII" Content-transfer-encoding: 7bit Precedence: bulk We've been told a million times not to take someone else's prescription drugs. But that's just what this person sitting near me on the plane back from China did. The results were not pleasant and I wanted to get some idea if this was common or not. Shortly after our first in flight meal a person near me made some gagging sounds. Not seeing anyone else offering to assist this person I got an airsick bag and handed it to him. At that point he had what appeared to be a momentary seizure. Eyes open, but unresponsive. After maybe a minute he started to vomit. By this time a flight attendant had arrived and took charge of the airsick bags that were accumulating. A couple of MD's came over and I faded back. I did stick close enough to hear this person had taken another person's dosage of Halcion to help him sleep on the flight. This brings up two points: 1. Is this a common reaction to this particular drug? 2. When you think about giving meds from your wilderness med kit to someone else you better be up to speed on what the contraindications and possible adverse side effects are. Your comments are welcome. 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Tue, 22 Aug 2000 12:19:28 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JT9QWE98V2005M71@mb1i0.ns.pitt.edu>; Tue, 22 Aug 2000 12:19:14 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Tue, 22 Aug 2000 12:19:04 -0400 (EDT) Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Tue, 22 Aug 2000 12:19:02 -0400 (EDT) Received: from micron ("port 1254"@[136.142.20.232]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JT9QVTMO98005EBI@mb1i0.ns.pitt.edu> for wilderness-emergency-medicine@list.pitt.edu; Tue, 22 Aug 2000 12:18:49 -0500 (EST) Date: Tue, 22 Aug 2000 12:18:45 -0400 From: "Keith Conover, M.D., FACEP" Subject: W-EMED Re: Field Rewarming Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: NCRC@ontosystems.com (NCRC Discussion List) Cc: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <39A26FA5.17680.2B83FA1@localhost> MIME-version: 1.0 X-Mailer: Pegasus Mail for Win32 (v3.12c) Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Precedence: bulk (cross post) On 18 Aug 2000, at 8:44, Larish, Michael wrote: > What is the current concensus on the field rewarming of seriously > hypothermic patients? At what point in time does the usual "Do not > rewarm, let the hospital rewarm under very controlled conditions..." > change to "We have an extended ETA, we need to do it as best we can..."? > > > Our usual protocol for someone seriously/profoundly hypothermic > is: Hi, Mike. > 1. Treat with kid gloves (i.e. very gently) so as not to induce > ventricular tachycardia or other related issues. Absolutely right! Also keep level or slightly head-down. > 2. Remove wet > clothing, place in dry clothing or blankets, protect from elements. Right. Cut off clothing, don't remove in other ways to avoid additional afterdrop from patient helping and increasing muscle bloodflow -- also don't let patient help with rescue. Remove wet clothes only if you've got good dry insulation at hand. > 3. Do NOT rewarm in the field - transport immediately following > standard BLS procedures Nope, sorry. This is an old myth that should be expunged whenever it crops up. Speaking as the Subject Matter Expert on this topic for the recent DOT revision of the U.S. paramedic program (www.pitt.edu/~paramedi/) and as someone who just came back from the annual meeting of the Wilderness Medical Society last week, where Gordon Giesbrecht of the University of Manitoba, currently the most productive researcher on the topic, presented his latest findings (soon to be published): When in the field with any hypothermic patient, add as much heat as you can. Given the danger of spontaneous v. fib, the sooner you can rewarm, the better. Adding heat to the core rather than the periphery is good. Warm humidified air or oxygen are good, but these methods only add a little heat. Hot-tub rewarming can cause rewarming shock if IV fluid is not provided, but if you carry a hot tub in your pack, please email me directly so we can recruit you for our jmountain rescue group! The ONLY time to not supply heat is in the case of cold-water SUBmersion (*not immersion hypothermia, but near- drowning*). The best method, per Gordon's recent data, for use in the field, is the HeatPac charcoal vest, information on my web page, URL below. There is also a detailed lesson plan on hypothermia, with hundreds of citations to the literature, at http://www.wemsi.org. Hope this helps. > 1. Treat with kid gloves (i.e. very gently) so as not to induce > ventricular tachycardia or other related issues. 2. Remove wet > clothing, place in dry clothing or blankets, protect from elements. 3. > Do NOT rewarm in the field - transport immediately following standard > BLS procedures > > In the winter time, we often have several mountain, 4x4 or snowmobile > rescues each year. Most of the time, the conditions for these rescues > are of course extreme (you never have rescues in good weather and nice > conditions). Hypothermia is a very real issue and often transport can > be hours away to get them down to the point of being able to put them in > an ambulance or, if possibly, medical flight transport. > > > -- > Lt. Mike Larish | Butte County Sheriff's Office > bcsar@saber.net (home) | Search & Rescue (Training) Officer > mlarish@buttecounty.net | Communications Reserve Officer > Keith Conover, M.D., FACEP (NSS 12893, WD4PSY) http://www.pitt.edu/~kconover - Information Systems Coordinator, Dept. of EM, Mercy Hospital - Clinical Assistant Professor, Dept. of Emergency Medicine, Univ. of Pittsburgh (EM Residency and Center for Emergency Medicine) - Medical Director, Wilderness EMS Institute (http://www.wemsi.org; for a WEMSI-sponsored list, send "subscribe wilderness-emergency-medicine" to Majordomo@list.pitt.edu) - Eastern Region, Natl. Cave Rescue Comm./Appalachian SAR Conf. 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Tue, 22 Aug 2000 11:32:33 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JT9P9A7MI40064DT@mb1i0.ns.pitt.edu>; Tue, 22 Aug 2000 11:32:22 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Tue, 22 Aug 2000 11:31:28 -0400 (EDT) Received: from smtp-server.nlr.nl (spider.nlr.nl [137.17.80.200]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Tue, 22 Aug 2000 11:31:25 -0400 (EDT) Received: from fripcy.nlr.nl (fripcy.nlr.nl [137.17.228.92]) by smtp-server.nlr.nl (8.10.1/8.10.1/NLR 29/03/2000) with ESMTP id e7MFUbk3735559; Tue, 22 Aug 2000 17:30:37 +0200 (CDT) Date: Tue, 22 Aug 2000 17:30:37 +0200 From: Frits van Doorn Subject: Re: W-EMED is there a test for cold water "asthma"/bronchial spasms? Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <200008221530.e7MFUbk3735559@smtp-server.nlr.nl> MIME-version: 1.0 X-Mailer: Microsoft Internet Mail 4.70.1154 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 7bit X-Priority: 3 X-MSMail-priority: Normal Precedence: bulk Disclaimer: "The National Aerospace Laboratory NLR DOES NOT ACCEPT ANY FINANCIAL COMMITMENT derived from this message." Hello Nigel, I don't think you expected an answer like this but you never know. I am not a doctor but I know of a Dutch man of the age 39 with asthmatic bronchitis who likes to take a swim in very cold water like glacier water. He is even an active dive instructor and can make lonely hikes in the wilderness all alone. How he is coping with it is as follows. He knows that the water is very cold so he says to himself before entering the water: 'It is cold and I can handle it!' and visualises the cold and the reaction his body will make. The experience he has from other cold water actions. Then he wets his face and enters the water. 'THIS IS COLD!' he shouts and monitors the reaction of his body. Then he thinks 'When a Navy Seal can do I can do it too!' which gives him an impuls to stay just a second longer. On his way out of the water he thinks 'Luckily I'm not a Navy Seal.' (Believe me I know he regreds that! Because the spirit of those people made him to the things he is doing now!) He always listens to what his body is telling him and when he has a bad time he will leave the water earlier than is needed because his body is telling so. Because he listens to his body and takes sometimes (as other people might think) stupid measures he was only 4 or 5 times seriously ill the last 10 years. He always drinks a lot of water and eats always something else which has a lot of natural vitamines like fresh vegetables and every day some fruit. When he has to cough or the mucus in his mouth is getting thick he starts to drink even more water (or something like fanta or cola light, thee and never coffee!). Alcoholic drinks, sparingly and never on a hike. I hope to go on a nice fall/winter hike in Scotland or Norway this year and keep on dreaming of going back one day to Alaska. Frits van Doorn the Netherlands fvdoorn@nlr.nl ---------- > From: nigel dyson-hudson > To: wilderness-emergency-medicine@list.pitt.edu > Subject: W-EMED is there a test for cold water "asthma"/bronchial spasms? > Date: Tuesday, August 22, 2000 1:54 PM > > Is there a test for cold water "asthma"/bronchial spasms? > Is there a test for exercise or cold weather asthma? > > Now that I am the other side of 40, I have noticed that even 60s/70s degree > water in the local state park swimming area takes my breath away. My > cousins, on my mother's side, have a history of asthma and my mother gets a > hacking bronchial cough during the winter. > > I also recently saw somewhere in the popular press that heart > irregularities during swimming were actually a bigger problem then most > people suspected. > > thanks, nigel > > nigel dyson-hudson, InternetSmiths, ndh@InternetSmiths.com > "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 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Tue, 22 Aug 2000 07:59:22 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JT9HSY9K14005YNH@mb1i0.ns.pitt.edu>; Tue, 22 Aug 2000 07:59:09 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Tue, 22 Aug 2000 07:55:47 -0400 (EDT) Received: from mx.lightlink.com (root@mx.lightlink.com [205.232.34.15]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Tue, 22 Aug 2000 07:55:44 -0400 (EDT) Received: from officeweb.lightlink.com (cci-ndhudson.clarityconnect.net [209.150.235.205]) by mx.lightlink.com (8.8.8/8.8.8) with ESMTP id HAA32655 for ; Tue, 22 Aug 2000 07:55:30 -0400 Date: Tue, 22 Aug 2000 07:54:47 -0400 From: nigel dyson-hudson Subject: W-EMED is there a test for cold water "asthma"/bronchial spasms? Sender: owner-wilderness-emergency-medicine@list.pitt.edu X-Sender: ndh@pop3.lightlink.com To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <4.3.1.0.20000822073931.00dc7ac0@mail.notesdomino.com> MIME-version: 1.0 X-Mailer: QUALCOMM Windows Eudora Version 4.3.1 Content-type: text/plain; charset="us-ascii"; format=flowed Precedence: bulk Is there a test for cold water "asthma"/bronchial spasms? Is there a test for exercise or cold weather asthma? Now that I am the other side of 40, I have noticed that even 60s/70s degree water in the local state park swimming area takes my breath away. My cousins, on my mother's side, have a history of asthma and my mother gets a hacking bronchial cough during the winter. I also recently saw somewhere in the popular press that heart irregularities during swimming were actually a bigger problem then most people suspected. thanks, nigel nigel dyson-hudson, InternetSmiths, ndh@InternetSmiths.com "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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Sun, 20 Aug 2000 10:44:51 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JT6V0I3CE0001GCF@mb2i0.ns.pitt.edu>; Sun, 20 Aug 2000 10:44:42 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 20 Aug 2000 10:43:52 -0400 (EDT) Received: from imo-r07.mx.aol.com (imo-r07.mx.aol.com [152.163.225.7]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 20 Aug 2000 10:43:50 -0400 (EDT) Received: from Trackingwolf@cs.com by imo-r07.mx.aol.com (mail_out_v27.12.) id h.db.896e58b (4204) for ; Sun, 20 Aug 2000 10:43:02 -0400 (EDT) Date: Sun, 20 Aug 2000 10:43:01 -0400 (EDT) From: Trackingwolf@cs.com Subject: W-EMED Benadryl use in hot weather Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 X-Mailer: CompuServe 2000 32-bit sub 109 Content-type: text/plain; charset="US-ASCII" Content-transfer-encoding: 7bit Precedence: bulk Here in the southeast we have recently had tempertures over 100, with high humidity levels of around 50%. Is Benadryl safe to use in these conditions? or will it increase the risk of heat illness? Any ideas as to what antihistimine to use if a replacement is needed? Dean trackingwolf@cs.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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Fri, 18 Aug 2000 21:14:00 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JT4OEV5HV0001A63@mb2i0.ns.pitt.edu>; Fri, 18 Aug 2000 21:13:53 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Fri, 18 Aug 2000 21:13:14 -0400 (EDT) Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Fri, 18 Aug 2000 21:13:10 -0400 (EDT) Received: from micron ("port 1028"@[136.142.23.143]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JT4ODAAFJM001BTC@mb2i0.ns.pitt.edu> for wilderness-emergency-medicine@list.pitt.edu; Fri, 18 Aug 2000 21:13:04 -0500 (EST) Date: Fri, 18 Aug 2000 21:12:02 -0400 From: "Keith Conover, M.D., FACEP" Subject: Re: W-EMED Club evening talk: help needed In-reply-to: <35748737873@medinfo.sita.co.za> Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: Rob Thomas , wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <399DA6A2.7271.22A7E9@localhost> MIME-version: 1.0 X-Mailer: Pegasus Mail for Win32 (v3.12c) Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Precedence: bulk On 18 Aug 2000, at 8:48, Rob Thomas wrote: > Hi all > > I've offered to give a talk in a month or so to a section of the > Mountain Club of South Africa. The topic is that of improvised first > aid. You've already gotten some good ideas from the list. Here is an outline for a presentation on the topic I did several years ago: Emergency Medicine -- Tools and Talent Conference "Improvising Emergency Care -- What to do when you ain't got much to work with" Keith Conover, M.D. Attending Staff, Department of Emergency Medicine, Mercy Hospital of Pittsburgh Clinical Assistant Professor, Division of Emergency Medicine, University of Pittsburgh Medical Director, Wilderness EMS Institute, Pittsburgh, Pennsylvania This session will be interactive. We will explore concepts for improvising in the following situations: - ambulance equipment failure (e.g., ambulance on fire) - catastrophic disasters (e.g., a major earthquake) - wilderness search and rescue (e.g., a half-hour hike into the patient) - when confronted with a medical emergency without equipment (e.g., snowed in at Seven Springs resort) The specifics will depend on the participant's interests and expertise. However, we will definitely discuss: - improvising splinting, including traction splinting and spinal immobilization - improvising bandaging - improvising airway management - improvising litters - improvising medications and rehydration fluids Those planning to participate should prepare by mentally reviewing any first aid training they might have had long ago. Unfortunately, modern EMS training assumes you've always got everything you need. The only take-home message that participants might want to be write down is related to emergency water disinfection - if dirty, flocculate (alum or white campfire ash) - 8 drops Betadine/liter for 30 minutes; use more or leave longer if dirty or very cold water - 4 cc of Clorox 5% bleach for 40 liters (10 gallons) over- night; double if have to use in an hour As for the rest-- well, just improvise! And, here are my notes on how to prepare for the lecture: Tools Conference ================ Flail Chest Thermometer: rectal Thermometer: frostbite rewarming Sun Protection: snowblindness Snakebite Suction Cold Packs Stick splints Hypothermia protection Splinting sticks Cravats Foam Pads Sam splint Duct tape strapping tape piggyback sling Sheet bandages Litter staves blanket 2 parkas climbing rope 2 leaf bags Stokes Litter and straps for traction splinting mud and gravel for cervical spine immobilization plastic bags for mud water and towel for washing off after mud salt shaker can of pop (soda to those outside Pittsburgh) newspaper magazines paramedic shears Diagrams: rope stretcher, piggyback carry --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover sent with Pegasus high-security email download free from www.pmail.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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Fri, 18 Aug 2000 12:50:48 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JT46U0UT3G0016VQ@mb2i0.ns.pitt.edu>; Fri, 18 Aug 2000 12:50:42 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Fri, 18 Aug 2000 12:50:18 -0400 (EDT) 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-7.2.2.2) ID for ; Fri, 18 Aug 2000 12:50:15 -0400 (EDT) Received: from localhost (localhost [127.0.0.1]) by macs.mxim.com (8.7/8.6.9) with SMTP id JAA01622 for ; Fri, 18 Aug 2000 09:49:35 -0700 (PDT) Date: Fri, 18 Aug 2000 09:49:35 -0700 (PDT) From: Hal Lillywhite Subject: Re: W-EMED Club evening talk: help needed In-reply-to: "Your message of Fri, 18 Aug 2000 10:47:52 EDT." Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <200008181649.JAA01622@macs.mxim.com> MIME-version: 1.0 X-Mailer: exmh version 2.0.1 12/23/97 Content-type: text/plain; charset=us-ascii Precedence: bulk cheazlit@ix.netcom.com writes: >... >To improvise, you must look at both your problem and your solution >in a physical vs. functional manner. Don't say "I need a splint". >Say "I need something that is reasonably rigid, about X in size. I >need something that will bind that thing to the injured body part". >At that point, you can start looking around for the items that >fulfill those needs. Good comments. What people need to do in such situations is what's often called "thinking outside the box." That is, they need to get away from their normal mindsets. If we think of duct tape, for example, as a repair item for things we may forget that it can also be used to repair people. I'm reminded of an experiment I read about years age (Rob might even be able to work something like this into his presentation.) Two groups of people were given the same problem, namely to take a nail, a string and a weight and make a pendulum in a building where there was a rafter to suspend it. No hammer was provided. One group was simply handed the items and told to make the pendulum. Most succeeded, they used the weight as a hammer. The other group was told, "Make a pendulum by driving the nail into the rafter, tying the string to it and tying the weight to the string." Few succeeded. Having been told that the weight was a weight they failed to think of it as a potential hammer. 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Fri, 18 Aug 2000 10:48:45 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JT42KO4D6K001A63@mb2i0.ns.pitt.edu>; Fri, 18 Aug 2000 10:48:38 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Fri, 18 Aug 2000 10:48:01 -0400 (EDT) Received: from smtp10.atl.mindspring.net (smtp10.atl.mindspring.net [207.69.200.246]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Fri, 18 Aug 2000 10:47:58 -0400 (EDT) Received: from smui3.eng00.mindspring.net (smui3.eng00.mindspring.net [207.69.200.50]) by smtp10.atl.mindspring.net (8.9.3/8.8.5) with ESMTP id KAA01811 for ; Fri, 18 Aug 2000 10:47:53 -0400 (EDT) Received: by smui3.eng00.mindspring.net id KAA0000008287; Fri, 18 Aug 2000 10:47:52 -0400 (EDT) Date: Fri, 18 Aug 2000 10:47:52 -0400 From: cheazlit@ix.netcom.com Subject: Re: W-EMED Club evening talk: help needed Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: Precedence: bulk X-Originating-IP: 165.236.189.201 Hi Rob, I just did a paper at the National Speleological Society Rescue Session on the "Pocket Medical Kit" Much of the focus of the paper has to do with the mindset needed to improvise equipment from what you have on hand. The basic premise is that people think of things by functional characteristics rather than by physical ones. By functional, I mean that folks look at something and see it for what it DOES. "That is a writing instrument". If I were to look at it for what it IS (physical characteristics) I would say "That is a straight, rigid thing with a relatively smooth outside. It also leaves marks on clean dry surfaces". To improvise, you must look at both your problem and your solution in a physical vs. functional manner. Don't say "I need a splint". Say "I need something that is reasonably rigid, about X in size. I need something that will bind that thing to the injured body part". At that point, you can start looking around for the items that fulfill those needs. The Self Rescue Group (of which I am chair) has compiled a list of favorite texts on self rescue and improvisation. This is at: http://home.netcom.com/~cheazlit/self_rescue/rec.html I will also send you my paper on improvisation next week, when I get back from travel. Regards, Cindy Heazlit 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Fri, 18 Aug 2000 03:27:18 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JT3N5DYZHI0059W4@mb1i0.ns.pitt.edu>; Fri, 18 Aug 2000 03:27:12 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Fri, 18 Aug 2000 03:26:33 -0400 (EDT) Received: from smtp02.iafrica.com (smtp02.iafrica.com [196.7.0.140]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Fri, 18 Aug 2000 03:26:22 -0400 (EDT) Received: from [196.7.216.15] (helo=clyde.sita.co.za) by smtp02.iafrica.com with esmtp (Exim 1.92 #1) for wilderness-emergency-medicine@list.pitt.edu id 13PgXb-000ATQ-00; Fri, 18 Aug 2000 09:26:11 +0200 Received: (from uucp@localhost) by clyde.sita.co.za (8.9.3/8.9.3) with UUCP id JAA16417 for wilderness-emergency-medicine@list.pitt.edu; Fri, 18 Aug 2000 09:25:13 +0200 Received: from medinfo.sita.co.za (medinfo.iplan.co.za [196.16.129.16]) by bonnie.sita.co.za (8.11.0/8.11.0) with ESMTP id e7I6oFn06222 for ; Fri, 18 Aug 2000 08:50:15 +0200 Received: from MEDINFO/SpoolDir by medinfo.sita.co.za (Mercury 1.44); Fri, 18 Aug 2000 08:48:51 +0200 Received: from SpoolDir by MEDINFO (Mercury 1.44); Fri, 18 Aug 2000 08:48:28 +0200 Date: Fri, 18 Aug 2000 08:48:26 +0200 From: Rob Thomas Subject: W-EMED Club evening talk: help needed Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <35748737873@medinfo.sita.co.za> Organization: State I.T. Agency, S.A. X-Mailer: Pegasus Mail v3.31 Precedence: bulk X-Real-Sender: ROBT Hi all I've offered to give a talk in a month or so to a section of the Mountain Club of South Africa. The topic is that of improvised first aid. This desire to do this was prompted by a rescue call I received from a backpacking party with a suspected ankle fracture above the treeline in the mountains. While advising the party I realised that they didn't have any idea how to improvise a splint for the ankle despite having all the tools necessary. That was easy to solve but it started me thinking. What I'd like to do is to instill a mindset (or at least awaken people to its potential) of being able to improvise the tools necessary for the management of most problems likely to be encountered in a recreational mountaineering. The talk is going to be aimed at people who do not have any depth of emergency care knowledge and who are likely to encounter a major problem only once in their lives if they're unlucky. Most of them will, however, probably have to deal with minor problems from time to time. Things I'm considering covering are: * Improvised splints (traction, other long bone, spinal) * Improvised hot- and cold-packs * Improvised airway management (basic) * Improvised carries (techniques, applications & limitations): * The improvisation mindset * Commonly carried outdoors items and their uses in improvisation * Compiling an improvisation-friendly first-aid kit * Medication adaptation (eg: crush anti-emetics & mix with paste to form suppository) This last is where I need help. I'm aware, for example, that sugar has a role to play in haemostasis (clotting), but I'm not sure exactly how. Anyone care to enlighten me? Any other suggestions as to what I should include? Thanks in advance Regards Rob -- Rob Thomas +27-12-450-2957 07h30-16h30 GMT+0200 +27-82-652-1490 all hours (try to be reasonable) 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 -- Return-Path: Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Thu, 17 Aug 2000 16:27:12 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JT303XJI2Y003T46@mb1i0.ns.pitt.edu>; Thu, 17 Aug 2000 16:27:05 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Thu, 17 Aug 2000 16:26:39 -0400 (EDT) Received: from mb1i0.ns.pitt.edu (mb1i1.ns.pitt.edu [136.142.185.161]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Thu, 17 Aug 2000 16:26:37 -0400 (EDT) Received: from micron ("port 1284"@[136.142.23.95]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JT302IAWLY0055II@mb1i0.ns.pitt.edu> for wilderness-emergency-medicine@list.pitt.edu; Thu, 17 Aug 2000 16:26:04 -0500 (EST) Date: Thu, 17 Aug 2000 16:25:54 -0400 From: "Keith Conover, M.D., FACEP" Subject: Re: W-EMED WMS Conference In-reply-to: Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: Douglas Burchard , wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <399C1212.8610.93F02C@localhost> MIME-version: 1.0 X-Mailer: Pegasus Mail for Win32 (v3.12c) Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Precedence: bulk References: <01bd01c007fb$14e1c520$3b5c059a@cr804385a> On 14 Aug 2000, at 9:09, Douglas Burchard wrote: > I just returned from the WMS Summer Conference. I'm glad I went and > they had some really great info I'm sure I'll be using in our program. > > I was a little surprised that while they covered acute care in a > wilderness environment they noticeably lacked anything on what to do > after the patient is stable. "Transport" is great but no more helpful > than the standard urban EMT texts. > > I'm not asking what to do. I'm just wondering if I'm alone in a desire > to see more of this type of information in the WMS Conferences. Maybe > I'm missing something and MDs already know the information. But > talking with nurses I somehow doubt that. ;) Our transport times can > range from 2 to 24 hours (while slogging down a trail with a litter) > so this is something we stress. Since our response time is between 1 > and 3 hours, acute care isn't frequently an issue. > > I would have also like to seen a discussion on WEMT protocols and > delegation of the Wilderness Command Physician. This is primarily a > doctor's conference so this would seem to be the venue for that > discussion. Good comments. But the majority of people at the conference are docs who are involved in outdoor recreation, not SAR. They are there for personal development. A minority are researchers, and another minority are SAR people, docs or otherwise. Some fall into all of the categories. A couple of years ago, the WMS conference in Lake Placid featured SAR. Turnout was not that good, and SAR medical politics caused some problems. However, I, too, would like to see the WMS focus more on SAR medical care issues, and I discussed this at length with Bill Forgey. Look for more of a focus on these issues from the WMS in the future. Take care. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover sent with Pegasus high-security email download free from www.pmail.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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.3) ID ; Sun, 16 Jul 2000 23:26:03 -0400 (EDT) Disposition-notification-to: mwhitehd@istar.ca Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JRUPE9ZU3A003XE0@mb2i0.ns.pitt.edu>; Sun, 16 Jul 2000 23:25:59 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Sun, 16 Jul 2000 23:25:32 -0400 (EDT) Received: from smtp1.interramp.com (smtp1.interramp.com [38.8.45.2]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Sun, 16 Jul 2000 23:25:27 -0400 (EDT) Received: from [154.5.91.129] (helo=cr804385a) by smtp1.interramp.com with smtp (Exim 1.90 #1) for wilderness-emergency-medicine@list.pitt.edu id 13E1Wv-0004JO-00; Sun, 16 Jul 2000 23:25:17 -0400 Date: Wed, 16 Aug 2000 23:27:30 -0400 From: Michael Whitehead Subject: Re: W-EMED use of tourniquets! Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: <01bd01c007fb$14e1c520$3b5c059a@cr804385a> X-MIMEOLE: Produced By Microsoft MimeOLE V5.00.2919.6600 X-Mailer: Microsoft Outlook Express 5.00.2919.6600 X-Priority: 3 X-MSMail-priority: Normal Precedence: bulk References: <20000716164412.82702.qmail@hotmail.com> Dear Gurkan, You've certainly done your homework. I agree with everything Charles Dusha had to say. I 've been teaching the St. John Ambulance Wilderness First Aid program in Toronto and Southern Ontario for five years. A reference you didn't mention consulting is Wayne Merry's St John Ambulance Official Wilderness First Aid Guide. It recommends that when a tourniquet is applied, if medical help is more than an hour away, the tourniquet should be loosened very slowly once every 45 minutes for 5 minutes to allow reoxygenation of tissue. While the tourniquet is loosened, maintain direct pressure. If bleeding remains severe, retighten the tourniquet. If bleeding has stopped or is manageable with direct pressure, leave the tourniquet loosely in place. Any casualty with a tourniquet must be marked with TK and the time the tourniquet is applied, so that medical help knows a tourniquet was applied and for how long. A casualty with a tourniquet is certainly in shock, and more susceptible to hypothermia (when it's cold) or dehydration and heat exhaustion/heat stroke (when it's hot). Air medevac is preferable to moving the casualty by land or water. I hope this information is helpful. Best regards, Michael Whitehead FA/CPR/ Wilderness First Aid Instructor-Trainer St. John Ambulance, Canadian Red Cross, Heart and Stroke Foundation Toronto, Canada mwhitehd@istar.ca ----- Original Message ----- From: "Gurkan Ozel" To: Sent: July 16, 2000 12:44 PM Subject: W-EMED use of tourniquets! Hi all, Was wondering what you guys think of use of tourniquets. Two main questions (maybe everything can be asked about TNTs), where to be applied and how long should be left in place once applied.Although this is a wilderness medicine list I want to find out about its use at urban situations as well. Almost all of my sources regarding urban patient care, suggest not to release the tourniquet until the patient arrives ER or a physician is consulted. This may be true when, the majority of time, the arrival time from the scene (scene to ER) is somewhere between 30-45 minutes or shorter. What if your ETA (to ER) is longer than 45 minutes? (this runs around 50 minutes in Turkey - excluding the major cities where there is a good response system had been set up-, and even more especially for the highway accidents where there is a limited aeromedical services available and you are, say, 60-70 miles away from the nearest medical facility) What would your suggestion be during a long urban transports and the patient needs a tourniquet to be applied since everything else failed? What is the safe time limit before the tissue necrosis occurs as a result of ischemia? As long as the wilderness recovery is indicated, the sources I have suggests several different applications. Regarding the time limits: No time limit is indicated (Isaac, J., Outward Bound WFA Handbook), totally discouraged (Wilkerson, J.A.; Medicine for Mountaineering), advised not to be released until a physician consulted (NSC and WMS - WFA Emergency Care for Remote Locations, Schimelphenig, T. and Lindsey, L..; NOLS WFA), advised to be released briefly every 10-15 mins (Auerbach, P.S.; Medicine for the Outdoors, Tilton, B. ; Medicine for the Backcountry) and released every 5 minutes according to the WMS Practice Guidelines (Forgey, W. - editor). Another point is where to be applied, and the options are: "Just above the wound (2-4 inches above)" or "as close to the wound as possible and above elbow or knee". Imagine a casualty with a hand torn apart 4 inches above his wrist, and no other option left to try but a tourniquet to stop bleeding. If you consider losing a limb, ain't that better to apply just above the wound and loose as little part of the limb as possible? Then the effectiveness is of question, the anatomy of the forearm will not allow a complete shut off of a blood supply... Would like to hear what the list members think! Many thanks for the invaluable input in advance. Gurkan Ozel, EMT-B Ankara, Turkey ________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail 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 -- Return-Path: Received: from mb2i0.ns.pitt.edu (mb2i1.ns.pitt.edu [136.142.185.162]) by imap.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisimap-7.2.2.4) ID ; Mon, 14 Aug 2000 12:11:47 -0400 (EDT) Received: from list.srv.cis.pitt.edu (majordom@[136.142.185.20]) by pitt.edu (PMDF V5.2-32 #41462) with ESMTP id <01JSYKBE5CSU000MQQ@mb2i0.ns.pitt.edu>; Mon, 14 Aug 2000 12:11:48 EST Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.2) ID ; Mon, 14 Aug 2000 12:10:45 -0400 (EDT) Received: from smtp.nwlink.com (smtp.nwlink.com [209.20.130.57]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.2) ID for ; Mon, 14 Aug 2000 12:10:42 -0400 (EDT) Received: from [207.202.172.90] (ip90.r2.d.bel.nwlink.com [207.202.172.90]) by smtp.nwlink.com (8.9.3/8.9.1) with ESMTP id JAA17796 for ; Mon, 14 Aug 2000 09:10:40 -0700 (PDT) Date: Mon, 14 Aug 2000 09:09:55 -0700 From: Douglas Burchard Subject: W-EMED WMS Conference In-reply-to: <01bd01c007fb$14e1c520$3b5c059a@cr804385a> Sender: owner-wilderness-emergency-medicine@list.pitt.edu To: wilderness-emergency-medicine@list.pitt.edu Reply-to: wilderness-emergency-medicine@list.pitt.edu Message-id: MIME-version: 1.0 Content-type: text/plain; charset="US-ASCII" Content-transfer-encoding: 7bit Precedence: bulk User-Agent: Microsoft-Outlook-Express-Macintosh-Edition/5.02.2022 I just returned from the WMS Summer Conference. I'm glad I went and they had some really great info I'm sure I'll be using in our program. I was a little surprised that while they covered acute care in a wilderness environment they noticeably lacked anything on what to do after the patient is stable. "Transport" is great but no more helpful than the standard urban EMT texts. I'm not asking what to do. I'm just wondering if I'm alone in a desire to see more of this type of information in the WMS Conferences. Maybe I'm missing something and MDs already know the information. But talking with nurses I somehow doubt that. ;) Our transport times can range from 2 to 24 hours (while slogging down a trail with a litter) so this is something we stress. Since our response time is between 1 and 3 hours, acute care isn't frequently an issue. I would have also like to seen a discussion on WEMT protocols and delegation of the Wilderness Command Physician. This is primarily a doctor's conference so this would seem to be the venue for that discussion. As I said before, there was some great information and presentations. The research on the Avalung was immediately useful. Improvised airway management was good. Infectious Diseases and many others will play well into keeping up the knowledge base of our instructors. Just thought I'd make a comment to our community on what I'd seen and would like to see. -- Douglas Burchard, OEC, WEMT-B email: burchard@nwlink.com King County Search and Rescue (KCSARA) phone: 425/562-1968 Training Coordinator fax: 208/293-8639 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 --