Received: from post-ofc03.srv.cis.pitt.edu (post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by shadow-blue.cis.pitt.edu with ESMTP (8.7.5/cispop-1.6.1.3) ID ; Tue, 2 Jul 1996 08:47:47 -0400 Received: from local (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.7.5/cispo-2.0.1.1) ID ; Mon, 1 Jul 1996 11:21:34 -0400 (EDT) Received: via switchmail; Mon, 1 Jul 1996 11:21:34 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 1 Jul 1996 10:15:38 -0400 (EDT) Received: from local (majordom@localhost) by list.srv.cis.pitt.edu (8.7.5/cisls-2.4) ID ; Mon, 1 Jul 1996 10:13:50 -0400 (EDT) X-Authentication-Warning: list.srv.cis.pitt.edu: majordom set sender to owner-wilderness-emergency-medicine using -f Received: from emout13.mail.aol.com (emout13.mx.aol.com [198.81.11.39]) by list.srv.cis.pitt.edu with SMTP (8.7.5/cisls-2.4) ID for ; Mon, 1 Jul 1996 10:13:47 -0400 (EDT) From: BMannix@aol.com Received: by emout13.mail.aol.com (8.6.12/8.6.12) id KAA23586 for wilderness-emergency-medicine@list.pitt.edu; Mon, 1 Jul 1996 10:13:08 -0400 Date: Mon, 1 Jul 1996 10:13:08 -0400 Message-ID: <960701101306_345147389@emout13.mail.aol.com> To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: thermometer/hygrometer and heat stress Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk X-PMFLAGS: 33554560 0 Side-by-side on a bookcase in my office I keep a cheap twin-dial thermometer/hygrometer and a somewhat more expensive electronic (twin-LCD) version of the same instrument. They are never within 20 degrees of each other. I think I keep them just to remind me not to trust too much in instruments. Brian Mannix -- End -- Received: from post-ofc03.srv.cis.pitt.edu (post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by shadow-blue.cis.pitt.edu with ESMTP (8.7.5/cispop-1.6.1.3) ID ; Tue, 9 Jul 1996 00:35:23 -0400 Received: from local (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.7.5/cispo-2.0.1.1) ID ; Tue, 9 Jul 1996 00:35:16 -0400 (EDT) Received: via switchmail; Tue, 9 Jul 1996 00:35:16 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 9 Jul 1996 00:34:57 -0400 (EDT) Received: from local (majordom@localhost) by list.srv.cis.pitt.edu (8.7.5/cisls-2.4) ID ; Tue, 9 Jul 1996 00:33:46 -0400 (EDT) X-Authentication-Warning: list.srv.cis.pitt.edu: majordom set sender to owner-wilderness-emergency-medicine using -f Received: from emout19.mail.aol.com (emout19.mx.aol.com [198.81.11.45]) by list.srv.cis.pitt.edu with SMTP (8.7.5/cisls-2.4) ID for ; Tue, 9 Jul 1996 00:33:43 -0400 (EDT) From: DoctrRick@aol.com Received: by emout19.mail.aol.com (8.6.12/8.6.12) id AAA23919 for wilderness-emergency-medicine@list.pitt.edu; Tue, 9 Jul 1996 00:34:45 -0400 Date: Tue, 9 Jul 1996 00:34:45 -0400 Message-ID: <960709003443_572589976@emout19.mail.aol.com> To: wilderness-emergency-medicine@list.pitt.edu Subject: Ear Barotrauma Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk X-PMFLAGS: 33554560 0 Folks, Diving for some, like me, is an exercise in ear endurance. For those is such a place, what are some sound recommendations for helping to prevent and manage the discomfort of middle ear congestion associated with multi dive excursions. Apart from going slow in desending and asending, and the use of decongestants, what advice can you offer. Thanks, Rick Bennett PhD Wilderness Medicine Institute -- End -- Received: from post-ofc02.srv.cis.pitt.edu (post-ofc02.srv.cis.pitt.edu [136.142.185.11]) by shadow-blue.cis.pitt.edu with ESMTP (8.7.5/cispop-1.6.1.3) ID ; Tue, 9 Jul 1996 17:23:46 -0400 Received: from local (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.7.5/cispo-2.0.1.1) ID ; Tue, 9 Jul 1996 17:23:40 -0400 (EDT) Received: via switchmail; Tue, 9 Jul 1996 17:23:40 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 9 Jul 1996 17:22:32 -0400 (EDT) Received: from local (majordom@localhost) by list.srv.cis.pitt.edu (8.7.5/cisls-2.4) ID ; Tue, 9 Jul 1996 17:21:36 -0400 (EDT) X-Authentication-Warning: list.srv.cis.pitt.edu: majordom set sender to owner-wilderness-emergency-medicine using -f Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.11]) by list.srv.cis.pitt.edu with ESMTP (8.7.5/cisls-2.4) ID for ; Tue, 9 Jul 1996 17:21:33 -0400 (EDT) Received: from unixs5.cis.pitt.edu (jmbst85@unixs5.cis.pitt.edu [136.142.185.37]) by post-ofc02.srv.cis.pitt.edu with SMTP (8.7.5/cispo-2.0.1.1) ID ; Tue, 9 Jul 1996 17:14:46 -0400 (EDT) Date: Tue, 9 Jul 1996 17:14:45 -0400 (EDT) From: "Jonnathan Busko, NREMT-P" Subject: Re: Ear Barotrauma To: DoctrRick@aol.com cc: wilderness-emergency-medicine@list.pitt.edu In-Reply-To: <960709003443_572589976@emout19.mail.aol.com> Message-ID: MIME-Version: 1.0 Content-Type: TEXT/PLAIN; charset=US-ASCII Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk X-PMFLAGS: 34078848 0 Rick, I instructed diving for several years. One of the things they never bothered to tell me in my IDC was just how congested and sore my head would be after two days of ups and downs in the pool and two days of ups and downs in open water (instructors, I think, make four ascents and descents for every ascent/descent that students make). Although I'm not exactly recommending this as the ultimate in sterile practice / safe hygine (sp), I found that when I _HAD_ to make a descent (i.e., the student just dumped all his air and disappeared below my fins) and my inner ear had absolutely no intention of cooperating, cracking the bottom of my mask and physically snorting a good shot of water up both nostrils, followed by vigorous nasal exhalation, always opend up my eustachian tube sufficeintly to make a comfortable descent and, later, ascent. Otherwise, the decongestants and slow rates are about all I can recommend (though you might want to try jaw wiggling and swallowing if mucho mucous doesn't appeal to you) > Folks, > > Diving for some, like me, is an exercise in ear endurance. For those is such > a place, what are some sound recommendations for helping to prevent and > manage the discomfort of middle ear congestion associated with multi dive > excursions. Apart from going slow in desending and asending, and the use of > decongestants, what advice can you offer. > > Thanks, > > Rick Bennett PhD > Wilderness Medicine Institute Jonnathan -_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_- Jonnathan Busko, NREMT-P MS II, University of Pittsburgh School Of Medicine. President, Emergency Medicine Student Association at UPMS jmbst85+@pitt.edu -_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_- -- End -- Received: from post-ofc02.srv.cis.pitt.edu (post-ofc02.srv.cis.pitt.edu [136.142.185.11]) by shadow-blue.cis.pitt.edu with ESMTP (8.7.5/cispop-1.6.1.3) ID ; Wed, 10 Jul 1996 20:30:50 -0400 Received: from local (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.7.5/cispo-2.0.1.1) ID ; Wed, 10 Jul 1996 20:30:44 -0400 (EDT) Received: via switchmail; Wed, 10 Jul 1996 20:30:44 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 10 Jul 1996 20:30:10 -0400 (EDT) Received: from local (majordom@localhost) by list.srv.cis.pitt.edu (8.7.5/cisls-2.4) ID ; Wed, 10 Jul 1996 20:28:39 -0400 (EDT) X-Authentication-Warning: list.srv.cis.pitt.edu: majordom set sender to owner-wilderness-emergency-medicine using -f Received: from llama.swcp.com (llama.swcp.com [198.59.115.19]) by list.srv.cis.pitt.edu with SMTP (8.7.5/cisls-2.4) ID for ; Wed, 10 Jul 1996 20:28:35 -0400 (EDT) Received: (from tanman@localhost) by llama.swcp.com (8.6.9/8.6.9) id SAA13466; Wed, 10 Jul 1996 18:28:33 -0600 Date: Wed, 10 Jul 1996 18:28:33 -0600 (MDT) From: TANMAN cc: wilderness-emergency-medicine@list.pitt.edu Subject: Re: Ear Barotrauma In-Reply-To: <960709003443_572589976@emout19.mail.aol.com> Message-ID: MIME-Version: 1.0 Content-Type: TEXT/PLAIN; charset=US-ASCII Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk X-PMFLAGS: 34078848 0 I worked for the military for many years and took care of a number of navy seals. They said that they washed their ear canals with peroxide (3%) and water to make 1.5% solution daily and that it helped tremendously. Thomas A. Naegele, DO Internet 9405 Lagrima de Oro NE 505-275-7267 Albuquerque, NM 87111 Board Certified Family Practice/Board Certified Quality Assurance Practice Guidelines/Clinical Paths>http://www.swcp.com/~tanman/ __________________________________________________________________ -- End -- Received: from post-ofc02.srv.cis.pitt.edu (post-ofc02.srv.cis.pitt.edu [136.142.185.11]) by shadow-blue.cis.pitt.edu with ESMTP (8.7.5/cispop-1.6.1.3) ID ; Wed, 10 Jul 1996 22:22:33 -0400 Received: from local (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.7.5/cispo-2.0.1.1) ID ; Wed, 10 Jul 1996 22:22:23 -0400 (EDT) Received: via switchmail; Wed, 10 Jul 1996 22:22:22 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 10 Jul 1996 22:21:16 -0400 (EDT) Received: from local (majordom@localhost) by list.srv.cis.pitt.edu (8.7.5/cisls-2.4) ID ; Wed, 10 Jul 1996 22:20:53 -0400 (EDT) X-Authentication-Warning: list.srv.cis.pitt.edu: majordom set sender to owner-wilderness-emergency-medicine using -f Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.11]) by list.srv.cis.pitt.edu with ESMTP (8.7.5/cisls-2.4) ID for ; Wed, 10 Jul 1996 22:20:48 -0400 (EDT) Received: from unixs4.cis.pitt.edu (jmbst85@unixs4.cis.pitt.edu [136.142.185.28]) by post-ofc02.srv.cis.pitt.edu with SMTP (8.7.5/cispo-2.0.1.1) ID for ; Wed, 10 Jul 1996 22:10:14 -0400 (EDT) Date: Wed, 10 Jul 1996 22:10:13 -0400 (EDT) From: "Jonnathan Busko, NREMT-P" Reply-To: "Jonnathan Busko, NREMT-P" Subject: Ear barotrauma To: wilderness-emergency-medicine@list.pitt.edu Message-ID: MIME-Version: 1.0 Content-Type: TEXT/PLAIN; CHARSET=US-ASCII Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk X-PMFLAGS: 34078848 0 As I was looking in my medicine cabinet last night, I realized that I had "Saline Mist" in there. It serves the same purpose as snorting water up your nose without the worries of what grows in the pools and quarries of northeastern Ohio and Western Pennsylvania Jonnathan -_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_- Jonnathan Busko, NREMT-P MS II, University of Pittsburgh School Of Medicine. President, Emergency Medicine Student Association at UPMS jmbst85+@pitt.edu -_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_- -- End -- Received: from post-ofc02.srv.cis.pitt.edu (post-ofc02.srv.cis.pitt.edu [136.142.185.11]) by shadow-blue.cis.pitt.edu with ESMTP (8.7.5/cispop-1.6.1.3) ID ; Thu, 11 Jul 1996 03:47:45 -0400 Received: from local (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.7.5/cispo-2.0.1.1) ID ; Thu, 11 Jul 1996 03:47:39 -0400 (EDT) Received: via switchmail; Thu, 11 Jul 1996 03:47:38 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 11 Jul 1996 03:45:43 -0400 (EDT) Received: from local (majordom@localhost) by list.srv.cis.pitt.edu (8.7.5/cisls-2.4) ID ; Thu, 11 Jul 1996 03:44:05 -0400 (EDT) X-Authentication-Warning: list.srv.cis.pitt.edu: majordom set sender to owner-wilderness-emergency-medicine using -f Received: from emout18.mail.aol.com (emout18.mx.aol.com [198.81.11.44]) by list.srv.cis.pitt.edu with SMTP (8.7.5/cisls-2.4) ID for ; Thu, 11 Jul 1996 03:43:59 -0400 (EDT) From: JMPARNELL@aol.com Received: by emout18.mail.aol.com (8.6.12/8.6.12) id DAA11654 for wilderness-emergency-medicine@list.pitt.edu; Thu, 11 Jul 1996 03:42:50 -0400 Date: Thu, 11 Jul 1996 03:42:50 -0400 Message-ID: <960711034250_355527721@emout18.mail.aol.com> To: wilderness-emergency-medicine@list.pitt.edu Subject: diving and ear problems Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk X-PMFLAGS: 33554560 0 I have been a listener on this list for a while now, and due to my lack of medical training have had very little to imput, but I do know a little about diving. I have certified about 1000 people to date, and can't begin to calculate the ascents/descents. Not to be insulting to the very robust gentleman that inhales water up his nose, my first advise would be to disregard his advise. Snorting a head-full of water could cause lots of safety problems. Airway management is a prime consideration underwater, and a slightly uncontrolled snort of water could easily cause some people to loose control of their breathing (laryngeal and epiglotic function impairment might be a proper medical term?). If you do actually get water in your paranasal sinuses you are inviting the worst internal otitis you can imagine. Bottom line is that some people are able to equlaize easier than others. There are no tricks that I know about other than ones already posted. Most importantly, GO SLOW! People that smoke or have allergies seem to be much more prone to having ear problems. Others problems such as frequent colds, recurrent otitis externa/media or sinusitus, any eustachian tube malady, oral surgery, or history of mid-face fracture, to name a few can cause certain individuals to have much more problem equalizing. But again, I am no physcian. The Divers Alert Network provides physicians for consults daily by phone free of charge by calling 919-684-2948. This is the non-emergency number that is manned at Duke University. They would be happy to talk to anyone in more detail than I could ever aspire to. Thanks, Jeff Parnell President, Adventure Technologies, Inc. Murfreesboro, Tn. NCRC S.E. Regional Coordinator PADI OWSI Instructor -- End -- Received: from post-ofc03.srv.cis.pitt.edu (post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by shadow-blue.cis.pitt.edu with ESMTP (8.7.5/cispop-1.6.1.3) ID ; Fri, 12 Jul 1996 19:15:20 -0400 Received: from local (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.7.5/cispo-2.0.1.1) ID ; Fri, 12 Jul 1996 19:15:09 -0400 (EDT) Received: via switchmail; Fri, 12 Jul 1996 19:15:09 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 12 Jul 1996 19:14:15 -0400 (EDT) Received: from local (majordom@localhost) by list.srv.cis.pitt.edu (8.7.5/cisls-2.4) ID ; Fri, 12 Jul 1996 19:13:23 -0400 (EDT) X-Authentication-Warning: list.srv.cis.pitt.edu: majordom set sender to owner-wilderness-emergency-medicine using -f Received: from graf.cc.emory.edu (graf.cc.emory.edu [170.140.1.44]) by list.srv.cis.pitt.edu with ESMTP (8.7.5/cisls-2.4) ID for ; Fri, 12 Jul 1996 19:13:19 -0400 (EDT) From: rbrow01@emory.edu Received: from 170.140.250.225 (anx54-225.dialup.emory.edu [170.140.250.225]) by graf.cc.emory.edu (8.7.3/8.6.9-950630.01osg-itd.null) with SMTP id TAA20994; Fri, 12 Jul 1996 19:11:06 -0400 (EDT) Message-ID: <31E6EA33.22C0@emory.edu> Date: Fri, 12 Jul 1996 19:13:40 -0500 X-Mailer: Mozilla 3.0b5 (Macintosh; I; PPC) MIME-Version: 1.0 To: JMPARNELL@aol.com CC: wilderness-emergency-medicine@list.pitt.edu Subject: Re: diving and ear problems References: <960711034250_355527721@emout18.mail.aol.com> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk X-PMFLAGS: 34078848 0 Excellent point. People don't drown from inhaling lungfuls of water. While the exact mechanism(s) aren't fully known, it is most likely that a small amount of water (as little as 10cc) causes acute laryngospam, functinally closing off the airway, and probably bronchospasm as well--remember, people die of asthma attacks, too. Snorting sea water while diving seems a foolish risk. Ronald L Brown, MD Emory University School Of Medicine Div of Emergency Medicine Atlanta, GA -- End -- Received: from post-ofc03.srv.cis.pitt.edu (post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by shadow-blue.cis.pitt.edu with ESMTP (8.7.5/cispop-1.6.1.3) ID ; Fri, 12 Jul 1996 23:29:40 -0400 Received: from local (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.7.5/cispo-2.0.1.1) ID ; Fri, 12 Jul 1996 23:29:31 -0400 (EDT) Received: via switchmail; Fri, 12 Jul 1996 23:29:31 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 12 Jul 1996 23:28:36 -0400 (EDT) Received: from local (majordom@localhost) by list.srv.cis.pitt.edu (8.7.5/cisls-2.4) ID ; Fri, 12 Jul 1996 23:27:49 -0400 (EDT) X-Authentication-Warning: list.srv.cis.pitt.edu: majordom set sender to owner-wilderness-emergency-medicine using -f Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.7.5/cisls-2.4) ID for ; Fri, 12 Jul 1996 23:27:45 -0400 (EDT) Received: from unixs4.cis.pitt.edu (jmbst85@unixs4.cis.pitt.edu [136.142.185.28]) by post-ofc01.srv.cis.pitt.edu with SMTP (8.7.5/cispo-2.0.1.1) ID ; Fri, 12 Jul 1996 23:26:27 -0400 (EDT) Date: Fri, 12 Jul 1996 23:26:27 -0400 (EDT) From: "Jonnathan Busko, NREMT-P" Reply-To: "Jonnathan Busko, NREMT-P" Subject: Re: diving and ear problems To: rbrow01@emory.edu cc: JMPARNELL@aol.com, wilderness-emergency-medicine@list.pitt.edu In-Reply-To: <31E6EA33.22C0@emory.edu> Message-ID: MIME-Version: 1.0 Content-Type: TEXT/PLAIN; CHARSET=US-ASCII Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk X-PMFLAGS: 34078848 0 On Fri, 12 Jul 1996 rbrow01@emory.edu wrote: > well--remember, people die of asthma attacks, too. Snorting sea water > while diving seems a foolish risk. Just to clarify-I snort water on the surface, not at 60 feet. Like I said, saline mist works just as well. Purely anecdotal, but I've never experienced any lyrangospasm/other respiratory problems while diving. But since there seems to be general dislike of my water snorting theory, let's stick to my second posting-if nothing else works, get a bottle of "saline mist," remove your mask, snort sterile FDA approved salt water up your nose, and you may find that you have an easier time clearing your ears. Also, test fly any meds you take _before_ you dive with them. This may seem obvious, but I know divers who thought that diving made them dopey until the first time they tried Seldane out of the water, and discovered it was the Seldane, not the diving that was having odd effects on them. Jonnathan -_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_- Jonnathan Busko, NREMT-P MS II, University of Pittsburgh School Of Medicine. President, Emergency Medicine Student Association at UPMS jmbst85+@pitt.edu -_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_- -- End -- Received: from post-ofc03.srv.cis.pitt.edu (post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by shadow-blue.cis.pitt.edu with ESMTP (8.7.5/cispop-1.6.1.3) ID for ; Sun, 14 Jul 1996 14:00:09 -0400 Received: from local (daemon@localhost) by post-ofc03.srv.cis.pitt.edu (8.7.5/cispo-2.0.1.1) ID for kconover@pop.pitt.edu; Sun, 14 Jul 1996 14:00:08 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Sun, 14 Jul 1996 14:00:07 -0400 (EDT) Received: from mail.airmail.net (server-f.iadfw.net [206.66.12.40]) by post-ofc03.srv.cis.pitt.edu with SMTP (8.7.5/cispo-2.0.1.1) ID for ; Sun, 14 Jul 1996 14:00:02 -0400 (EDT) Received: by mail.airmail.net (/\##/\ Smail3.1.30.16 #30.73) id ; Sun, 14 Jul 96 13:00:00 -0500 (CDT) Message-Id: Date: Sun, 14 Jul 96 13:00:02 -0500 (CDT) X-Sender: teamecho@mail.airmail.net X-Mailer: Windows Eudora Version 1.4.4 Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" To: kconover@pitt.edu From: teamecho@airmail.net (Dean Ross) Subject: Re: Psychrometers X-PMFLAGS: 34078848 0 You Wrote: Thanks for your very informative reply. Two questions: what exactly is Team Echo, and can I copy your reply to the whole wilderness-emergency-medicine list? TEAM ECHO, all caps, Emergency Care Hazardous Operations, is an interagency all-risk response team. Comprised of members of the Dept. of Interior (USFWS) and civilian specialists. We train and respond with our skills to a varied assortment of Wildland Operations. For more information visit us at our Web Page: http://web2.airmail.net/teamecho/echo.net You are welcome to pass along any of the information I have given you. This approach has been successful for us and shown obvious results. Any other questions, just e-mail us. Dean Ross Unit Coordinator -- End -- X-cs: From: Self To: wilderness-emergency-medicine@list.pitt.edu Subject: New National Standard Wilderness First Aid Course Cc: asrc@list.pitt.edu Reply-to: kconover@pitt.edu Date: Tue, 16 Jul 1996 19:24:18 A short announcement. I just received in the mail today my courtesy copies of the new American Red Cross textbook, "First Aid: When Help is Delayed." This very short (23-page) text, and accompanying set of 18 slides, is designed as an add-on to other first aid courses, such as the ARC Community First Aid and Safety, or the Standard First Aid course. Though short and basic, it represents the first course that has been released with the intent of providing a national standard. The text is Stock #656222 from Mosby Lifeline. I'm sure the best way to get copies will be from your local Red Cross chapter. It looks as though it would make a good minimal qualification for the general outdoorsperson. However, for SAR personnel, I'd recommend a higher level, something along the lines of Bob Koester's course, or those offered by organizations such as SOLO and WMA. -- End -- X-cs: From: Self To: wilderness-emergency-medicine@list.pitt.edu Subject: (Fwd) CSAR Digest #157 Cc: Reply-to: kconover@pitt.edu Date: Wed, 17 Jul 1996 08:55:33 ------- Forwarded Message Follows ------- Date: Tue, 16 Jul 96 19:52:45 pdt From: Computers_In_SAR Digest To: csarfwd@hpasdd.mayfield.hp.com Subject: CSAR Digest #157 Digest #157 Tue Jul 16 19:43:23 PDT 1996 The Computers in SAR (CSAR) Mailing List Digest Contents: RE- handheld hygrometers Administrivia: Send submissions to csar@hpasdd.mayfield.hp.com To subscribe or unsubscribe to the CSAR Digest, send a message to: csar-request@hpasdd.mayfield.hp.com Back Issues: Via Anonymous FTP, Address: hairball.ecst.csuchico.edu Directory: cd /pub/ems/sar/csar_digest Via World-Wide Web, URL: ftp://hairball.ecst.csuchico.edu/pub/ems/sar Via Email: CSAR-Request@hpasdd.mayfield.hp.com This message is copyrighted 1996 by the individual contributors. All rights reserved. Do not reproduce without the poster's permission, but feel free to ask. =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- -=-=-= Date: 16 Jul 1996 08:22:18 -0700 >From: "Chris Antonsen" Subject: RE- handheld hygrometers Please excuse the horrid formating on my previous message. I=D5ll = avoid default formating and fancy ascii characters this time. My = message is in response to Keith Conover=D5s inquiry in CSAR Digest = #154. Anyway, I hope this is more readable. I have quite a bit of experience with one particular model of hand = held hygrometer. I use a few of them to collect data for long term = and short term studies of humidity inside "sealed" containers. = While they are officially rated at plus/minus 2 % accuracy (both = RH and temp), they typically run at about plus/minus 0.5% = accuracy. However, the units I am using cost more than 10 times = the radio shack unit mentioned. For heat stress considerations you certainly don't need sling = psychrometer accuracy. I wouldn't for an instant consider taking = such a unit to base camp, much less into the field. Most of the = generally available (household use) electronic units seem to claim = plus/minus 5 % accuracy. I wonder, however, if the $25 unit can = attain even that. The key question is what level of accuracy do you = need? My gut feeling is that you can make the kind of general cut = on heat stress hazard which you are seeking with a unit that is = accurate to within plus/minus 5 %, but less accuracy (e.g., = plus/minus 10 %) won't do it. If the model of hygrometer doesn't = have an accuracy rating, assume it is pretty bad and not reliable = for evaluating heat stress hazard. Using hand held hygrometers is pretty much a no-brainer. It = should be obvious to any user that if you carry it in your shirt = pocket, it sees you more that your surroundings. Likewise, most = people intuitively understand that if you put any object in the sun, = thermometers included, they will get much hotter than the air = temperature. So reminding folks to use common sense is about all = the serious training required, other than where the unit=D5s on and = off button is. Also, if you abruptly change environments = (temperature or RH) it will take several minutes for the unit to = reflect the new conditions. =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- -=-=-= End of the CSAR Digest #157 ********************************************************************** * I had cross-posted this to the CSAR digest, and this was one of the replies I got there. Makes sense to me: if we can find a reasonably accurate (+/- 5%) handheld unit, it would be much more reasonable than a sling psychrometer. Again, we don't need research-style accuracy. Maybe we need to test these Radio Shack units against a sling psychrometer to get our own accuracy figures. Any volunteers? -- End -- X-cs: From: Self To: wilderness-emergency-medicine@list.pitt.edu Subject: (Fwd) Psychrometers Reply-to: kconover@pitt.edu Date: Mon, 22 Jul 1996 22:58:59 Dean gave his permission to forward this to the w-e-m list. --Keith ------- Forwarded Message Follows ------- Date: Fri, 12 Jul 96 10:48:42 -0500 (CDT) To: kconover@pitt.edu (Kenneth Conover M.D.) From: teamecho@airmail.net (Dean Ross) Subject: Psychrometers Our agency, TEAM ECHO, is based in the lower southwest an we have significant experience dealing with the HEAT STRESS related issues. Focusing primarily on all-risk wildland operations we use HTI, Heat Temperature Index, as one of our determining factors. When HTI reaches 105, we establish an alert. This means that our crews are informed at a shift briefing of signs, symptoms, and strategies for dealing with, and avoiding injury. There are several factors that come into play when determining work load and task completion. 1. Physical Condition. As you probably are aware we (USFWS, FSS, NPS and others) have a standard of physical fitness for our personnel. This is called the "Step Test". If you are unfamiliar with this test is goes like this. A candidate steps on and off an approximate 15" box, 90 times a minute, for five minutes, and their pulse is taken after 15 seconds of rest. This score is age adjusted, and we use a minimum score of 45 for any field personnel. There are some that do not place emphasis on this test but we consider it a good base line of physical endurance. 2. Fluid intake. All our personnel that are working a project at 000-2000 feet MSL, during HTI Alert, are required to drink 8 liters or quarts of water during a eight hour shift. One liter/quart is added for each 1000 feet of altitude gain. Each crew supervisor makes sure this is done. No exceptions. Our goal, their urine should be clear. No sodas. 3. We have noticed that on protracted wearing of helmets with foam inserts, ex: climbing helmets, in HTI Alerts that heat related symptoms progress more rapidly. We now take this into account. When helmets are required PPE for non-climbing, non-technical aspects, ex: getting there or just searching, a ventilated helmet, ex: bullard advent, with web support is used. Also, backpacks are removed and replaced with fanny packs, ex: Mountainsmith Tour and Day lumbar packs. Radio Chest packs are to be of ventilated construction, or minimum in size. 4. If Heat Stress Occurs. In the case of heat exhaustion or heat stroke when symptoms or signs are presented, immediate cooling is activated. Each field EMS person has 6 good quality chemical ice packs. The are applied to the lateral neck areas (R/L), under each arm pit, and on each side of the groin area (we cover these with blue surgical towels to minimize direct contact). We have and utilize an air-conditioned field operations center during all HTI Alert Ops. We do not administer iced IV's. I have briefly described some of our experiences, if you have any queries call or e-mail me. By the way, we use sling psychrometers, they do not use batts. or lose calibration. Dean Ross Unit Coordinator TEAM ECHO 1-800-399-3246 1-800-369-3246 teamecho@airmail.net -- End -- X-cs: From: Self To: wilderness-emergency-medicine@list.pitt.edu Subject: (Fwd) TEAM ECHO WEB Page Reply-to: kconover@pitt.edu Date: Tue, 23 Jul 1996 17:47:31 ------- Forwarded Message Follows ------- Date: Tue, 23 Jul 96 11:16:34 -0500 (CDT) To: kconover@pitt.edu From: teamecho@airmail.net (Dean Ross) Subject: TEAM ECHO WEB Page Correstion in previous E-mail. TEAM ECHO is located at: http://web2.airmail.net/teamecho/echo.htm Sorry for the trouble. -- End -- Received: from post-ofc01.srv.cis.pitt.edu (post-ofc01.srv.cis.pitt.edu [136.142.185.10]) by shadow-blue.cis.pitt.edu with ESMTP (8.7.5/cispop-1.6.1.3) ID for ; Wed, 24 Jul 1996 15:07:43 -0400 Received: from local (daemon@localhost) by post-ofc01.srv.cis.pitt.edu (8.7.5/cispo-2.0.1.1) ID for kconover@pop.pitt.edu; Wed, 24 Jul 1996 15:07:41 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Wed, 24 Jul 1996 15:07:41 -0400 (EDT) Received: from slug.swcp.com (slug.swcp.com [198.59.115.24]) by post-ofc01.srv.cis.pitt.edu with SMTP (8.7.5/cispo-2.0.1.1) ID for ; Wed, 24 Jul 1996 15:04:32 -0400 (EDT) Received: (from tanman@localhost) by slug.swcp.com (8.6.9/8.6.9) id NAA22902; Wed, 24 Jul 1996 13:04:13 -0600 Date: Wed, 24 Jul 1996 13:04:12 -0600 (MDT) From: TANMAN To: "Keith Conover, M.D." cc: wilderness-emergency-medicine@list.pitt.edu Subject: Edible and Medicinal Plants In-Reply-To: <199607232154.RAA24402@post-ofc01.srv.cis.pitt.edu> Message-ID: MIME-Version: 1.0 Content-Type: TEXT/PLAIN; charset=US-ASCII X-PMFLAGS: 34078848 0 For those that are interested. My fifth book just got printed, 423 pages, over 150 plants, mosses, and fungi, EDIBLE and MEDICINAL PLANTS OF THE GREAT LAKES. published by Wilderness Press, PO Box 217, Davisburg, MI 48350 800-852-8652 Thomas A. Naegele, DO Internet 9405 Lagrima de Oro NE 505-275-7267 Albuquerque, NM 87111 Board Certified Family Practice/Board Certified Quality Assurance Practice Guidelines/Clinical Paths>http://www.swcp.com/~tanman/ __________________________________________________________________ -- End -- Received: from post-ofc01.srv.cis.pitt.edu (post-ofc01.srv.cis.pitt.edu [136.142.185.10]) by shadow-blue.cis.pitt.edu with ESMTP (8.7.5/cispop-1.6.1.3) ID for ; Sat, 27 Jul 1996 07:56:45 -0400 Received: from local (daemon@localhost) by post-ofc01.srv.cis.pitt.edu (8.7.5/cispo-2.0.1.1) ID for kconover@pop.pitt.edu; Sat, 27 Jul 1996 07:56:44 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Sat, 27 Jul 1996 07:56:43 -0400 (EDT) Received: from jeflin.tju.edu (jeflin.TJU.EDU [147.140.128.114]) by post-ofc01.srv.cis.pitt.edu with SMTP (8.7.5/cispo-2.0.1.1) ID for ; Sat, 27 Jul 1996 07:56:06 -0400 (EDT) Received: by jeflin.tju.edu (AIX 3.2/UCB 5.64/4.03) id AA82216; Sat, 27 Jul 1996 07:54:52 -0500 Date: Sat, 27 Jul 1996 07:54:52 -0500 (CDT) From: "Jack T. Grandey" To: "Keith Conover, M.D." Cc: Multiple recipients of list EMED-L Subject: Re: What size ETT? In-Reply-To: <199607270249.WAA29252@post-ofc02.srv.cis.pitt.edu> Message-Id: Mime-Version: 1.0 Content-Type: TEXT/PLAIN; charset=US-ASCII On Fri, 26 Jul 1996, Keith Conover, M.D. wrote: > On a related note, if you were off to a desert island and could only > take one ET tube, what size would you take? > > Or more specifically, if you were designing a small ALS kit to be > carried by a paramedic or doctor, up and down mountainsides all day > during a mountain search, or through difficult cave passages during a > cave search, and were going to carry a single tube, what size would > you carry? (No laryngoscope as it weighs too much, just practice your > digital intubations and carry some gloves, they're light.) > > We decided on a 6.5. Takes care of most bigger children and barely > adequate for adults. This humble mud-medic opts for a 7.0. A bit big for kids, but they're less common & a bit better for the more common adult. Also - If only one, spend the $8.50 and get an Endotrol. The control-ablility increases flexibility to include nasals. Wrap a BAAM, unit dose of lubifax, and a regular stylette in and /s increasing weight or space, you can handle just about anything. BTW: a # 4 Miller on a Pedi handle is pretty compact & light. $.02 is probably a bit much for MHO. JTG Jack T. Grandey, NREMT-P Program Director, EMS Education Operations Director Albert Einstein MEdical Center Wilderness EMS Institute -- End -- X-cs: From: Self To: BZEG15A@prodigy.com (MR LARRY M JONES) Subject: Re: Burns section, Chapter 12 Cc: wilderness-emergency-medicine@list.pitt.edu Reply-to: kconover@pitt.edu Date: Sat, 27 Jul 1996 15:53:19 On 27 Jul 96 at 11:40, MR LARRY M JONES wrote: > Keith, > > I would be very careful when using snow to cool a burn. As a matter > of fact, I would not recommend it. The problem, as you know, with > using too cold an application is the reflex vasocontriction in an > area that already has a compromised blood supply. This results in a > larger ischemic raea surrounding the burn injury, which will lead to > enlarging and deepening the burn. Generally, I suggest we use cool > dressings. As the wet compress drys out, cooling of the wound is > accomplished through this dehydration, conduction and convection. > Also, while I do not recognize the one minute rule of Burton, > cooling the burn has an end point. It should not interfere with > proper application of protective dressings (protecting the burn from > air currents will do alot for pain relief) and the evacuation of the > victim. > > With regard to posting my comments, I have no objection. They might > generate some lively discussion on your mailing list. > > Larry > Thanks very much for your comments. I will indeed pass them on to the wilderness-emergency-medicine list. -- End -- X-cs: From: Self To: wilderness-emergency-medicine@list.pitt.edu Subject: burns [final answer in separate message] Reply-to: kconover@pitt.edu Date: Sat, 27 Jul 1996 16:02:57 To: kconover+@pitt.edu From: "Barry J. Burton, D.O." Subject: [burns] Cc: BEAUCHAMP.BRUCE@CONSULT.HSC.WVU.EDU Keith.. [snip] Author describes cooling of a burn with continued cool applications, without regard to extent of body surface area. THis is inconsistant with the American Burn Foundation guideliunes that permit cooling for not more than one minute, especially when multiple body regions (>9% BSA) are involved. This recommnedation stems from the concept of a "zone of Stasis" that can be converted to a zone of necrosis if blood flow is compromised by extensive cooling, and the complication of systemic hypothermia in the major burn patient. References (from memory) American Burn Life Support Program. [snip] Barry J. Burton, D.O. EMS Fellowship Director Albert Einstein Medical Center Philadelphia, PA burtonb@aehn2.einstein.edu From: BZEG15A@prodigy.com (MR LARRY M JONES) Date: Fri, 26 Jul 1996 13:30:40, -0500 To: goldgergr@USA.REDCROSS.ORG, kconover@pitt.edu, VardellD@USA.RED-CROSS.ORG Subject: [burns] Hello all, [snip] The comment made by Dr. Burton . . . cites the American Burn Foundation as recommending that cooling of burns not last for more than one minute, especially when the burn size is more than 9% body surface area. I don't recognize the American Burn Foundation and assume he is referring to the American Burn Association, of which I am an active member. More importantly, I don't recall the recommendation to which he refers. [snip] "Do not use ice or ice water to cool burns since it may result in loss of body heat and may also make the burn deeper." I recommend using only cool water. [snip] Larry M. Jones, M.D., FACS Director, Trauma Services and Burn Center Mercy Hospital of Pittsburgh 1400 Locust Street Pittsburgh, PA 15219 (412) 232-7786 or BZEG15A@prodigy.com Larry From: Barry Burton Subject: [burns] Keith I stand corrected on the ABA reference. As previously mentioned, that was off the top of my head. I have the same ABLS text that you have, went through it thouroughly, and could not find the reference. I did find Achauer, Management of the burned patient 1987 Appleton and Lange, in which it discusses the Burn Wound, zone of stasis etc. They also quote (Chap 1 Choctaw, Eisner, Wachtel) That prehospital care may "includes the application of fluids to the burned area taking care, particularly in cold climates, to avoid hypothermia. ...Its local use should be confined to burns of less than Hope this helps. Sorry for not finding the other reference. (if it really exists) Barry -- End -- From: kconover@pitt.edu To: BZEG15A@prodigy.com (MR LARRY M JONES) Subject: [burns] Reply-to: kconover@pitt.edu Date: Sat, 27 Jul 1996 10:47:12 On 27 Jul 96 at 9:52, MR LARRY M JONES wrote: > As far as Dr. Burton's comments, we discussed this before over the > telephone. I agree that cooling of the burn wound should not be a > long drawn-out process, but I don't recall seeing the one minute > rule anywhere. > Great. Thanks. One related question-- what about continued cold applications for pain relief in the wilderness setting? Often those there have no access to strong analgesics, and a long time to get out, but plenty of cold water or snow. I wonder how much additional damage such cooling will cause, and whether the analgesic effect might be worth it -- at least to the person who'd feeling the pain. It's like the (now-pretty-much-discarded) idea that Lomotil will slow down your invasive diarrhea at the cost of making you more likely to be sicker later. If I'm coming down off a peak with an incoming storm, or working my way through a crawlway in a cave -- I don't _care_ if I'll be sicker later, give me the Lomotil! I'd also like to ask your permission to post your comments on the topic of first aid for burns to the wilderness-emergency-medicine list, as I think it will be of general interest. Thanks. -- End -- -- End -- X-cs: From: Self To: EMED List ",Jack T. Grandey" Subject: Re: What size ETT? Cc: wilderness-emergency-medicine@list.pitt.edu Reply-to: kconover@pitt.edu Date: Sat, 27 Jul 1996 16:21:52 On 27 Jul 96 at 7:54, Jack T. Grandey wrote: > This humble mud-medic opts for a 7.0. A bit big for kids, but > BTW: a # 4 Miller on a Pedi handle is pretty compact & light. I feel compelled to point out that when we set up this kit's contents Mr. Grandey was one of those who agreed with the 6.5 recommendation. And the recommendation for not including a laryngoscope in the basic kit . But I guess I should also point out that there are very lightweight disposable plastic laryngoscope blades that will fit on a standard Welch-Allyn pediatric handle. I got my set of three different sized blades from: Parr Emergency Product Sales P.O. Box 76 Galloway, OH 43119 And putting two 1.6 V Eveready lithium "photographic" cells in this handle makes a very light-weight combination. As a good example, I try to keep my Personal Wilderness Medical Kit just exactly the same as listed on the Web page. But I've got a laryngoscope in a "physician addendum" bag that I carry when I'm willing to carry the extra weight. BTW, Gerber makes a nice light folding camp saw (looks a little like an oversized buck knife). When I went to our local climbing store and got one, and told them it was for the amputation kit in my medical bag, they were horrified. I'm still called "Dr. Bonesaw" whenever I go in there. Jack, too, and some of the other Wilderness Medics have their own extra goodies; guess it's in the nature of the game to never leave well enough alone. The kit list is also on our web site, URL listed in my .SIG below. BTW, the Web site is due for a significant upgrade in the next few days. And over the next 3-6 months we will be producing an updated version of our wilderness medical kit list. Comments or suggestions for improvement appreciated. "Do I contradict myself? Very well then, I contradict myself." -- End -- Received: from post-ofc01.srv.cis.pitt.edu (post-ofc01.srv.cis.pitt.edu [136.142.185.10]) by shadow-blue.cis.pitt.edu with ESMTP (8.7.5/cispop-1.6.1.3) ID for ; Sun, 28 Jul 1996 10:50:19 -0400 Received: from local (daemon@localhost) by post-ofc01.srv.cis.pitt.edu (8.7.5/cispo-2.0.1.1) ID for kconover@pop.pitt.edu; Sun, 28 Jul 1996 10:50:17 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Sun, 28 Jul 1996 10:50:16 -0400 (EDT) Received: from jeflin.tju.edu (jeflin.TJU.EDU [147.140.128.114]) by post-ofc01.srv.cis.pitt.edu with SMTP (8.7.5/cispo-2.0.1.1) ID for ; Sun, 28 Jul 1996 10:46:57 -0400 (EDT) Received: by jeflin.tju.edu (AIX 3.2/UCB 5.64/4.03) id AA20173; Sun, 28 Jul 1996 10:45:44 -0500 Date: Sun, 28 Jul 1996 10:45:43 -0500 (CDT) From: "Jack T. Grandey" To: "Keith Conover, M.D." Cc: wilderness-emergency-medicine@list.pitt.edu Subject: Re: What size ETT? In-Reply-To: <199607272033.QAA16735@post-ofc01.srv.cis.pitt.edu> Message-Id: Mime-Version: 1.0 Content-Type: TEXT/PLAIN; charset=US-ASCII X-PMFLAGS: 34078848 0 On Sat, 27 Jul 1996, Keith Conover, M.D. wrote: > On 27 Jul 96 at 7:54, Jack T. Grandey wrote: > > > This humble mud-medic opts for a 7.0. A bit big for kids, but > > > BTW: a # 4 Miller on a Pedi handle is pretty compact & light. > > I feel compelled to point out that when we set up this kit's contents > Mr. Grandey was one of those who agreed with the 6.5 recommendation. > And the recommendation for not including a laryngoscope in the basic > kit . Yup. What's your point? Given, the general applicability of intubation in the wilderness, I still believe it is of limited utility. My comment was in reference to my personal kit, where every item must have @ least one secondary utility to gain admission. This always requires trade-offs in ideal vs. good-enough for each task. I carry much more than most, but use it in a variety of venues. > > But I guess I should also point out that there are very lightweight > disposable plastic laryngoscope blades that will fit on a standard > Welch-Allyn pediatric handle. I got my set of three different sized > blades from: > > Parr Emergency Product Sales > P.O. Box 76 > Galloway, OH 43119 I still have some concern re: the sturdiness of the plastic blades. I have not checked them lately, though. > > And putting two 1.6 V Eveready lithium "photographic" cells in this > handle makes a very light-weight combination. As a good example, I > try to keep my Personal Wilderness Medical Kit just exactly the same > as listed on the Web page. But I've got a laryngoscope in a > "physician addendum" bag that I carry when I'm willing to carry the > extra weight. politically correct as always. > > BTW, Gerber makes a nice light folding camp saw (looks a little like > an oversized buck knife). When I went to our local climbing store > and got one, and told them it was for the amputation kit in my > medical bag, they were horrified. I'm still called "Dr. Bonesaw" > whenever I go in there. > > Jack, too, and some of the other Wilderness Medics have their own > extra goodies; guess it's in the nature of the game to never leave > well enough alone. The nature of the activity requires modification to best fit the sub-specialty. What is commonly used on a hillside is sledom used underground. Where do you spend your time? Or...do you need to be ready for either? > > The kit list is also on our web site, URL listed in my .SIG below. > BTW, the Web site is due for a significant upgrade in the next few > days. And over the next 3-6 months we will be producing an updated > version of our wilderness medical kit list. Comments or suggestions > for improvement appreciated. > > "Do I contradict myself? Very well then, I contradict myself." "We have met the enemy...and they are us." JTG Program DIrector, EMS Education Operations Director Albert EInstein Medical Center Wilderness EMS Institute -- End --