X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 28 Sep 1999 10:54:03 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 28 Sep 1999 10:53:24 -0400 (EDT) Received: via switchmail; Tue, 28 Sep 1999 10:53:24 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 28 Sep 1999 10:51:46 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 28 Sep 1999 10:50:47 -0400 (EDT) Received: from mx0-smtp.goodnet.com (envy.goodnet.com [207.98.129.151]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 28 Sep 1999 10:50:31 -0400 (EDT) Received: from Ptkovacs (d10-25.phoenix.goodnet.com [209.141.106.90]) by mx0-smtp.goodnet.com (8.9.3/8.9.3) with ESMTP id HAA09258; Tue, 28 Sep 1999 07:52:30 -0700 (MST) Message-Id: <199909281452.HAA09258@mx0-smtp.goodnet.com> From: "Tim Kovacs" To: "SAR-L" Cc: "WEMS News" , "MRA" Subject: W-EMED Spanish Rescuer Accident Date: Tue, 28 Sep 1999 08:06:25 -0700 X-MSMail-Priority: Normal X-Priority: 3 X-Mailer: Microsoft Internet Mail 4.70.1155 MIME-Version: 1.0 Content-Type: text/plain; charset=ISO-8859-1 Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu For those of you who asked; The Chair of the Air Rescue Commission of the IKAR (International Commistion for Alpine Rescue), currently meeting in Germany, said that they are checking into the details of this unfortunate accident now, and will email back soon. Tim Kovacs, President Mountain Rescue Association Operations Leader/ Paramedic, C.A.M.R.A./ MCSO MR tkovacs@goodnet.com www.mra.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 -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 28 Sep 1999 01:21:40 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 27 Sep 1999 12:55:45 -0400 (EDT) Received: via switchmail; Mon, 27 Sep 1999 12:55:42 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 27 Sep 1999 12:53:30 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 27 Sep 1999 12:52:06 -0400 (EDT) Received: from shepherd.hurlburt.af.mil (shepherd.hurlburt.af.mil [151.166.15.65]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 27 Sep 1999 12:51:53 -0400 (EDT) Received: from shepherd.hurlburt.af.mil (root@localhost) by shepherd.hurlburt.af.mil with ESMTP id LAA11499 for ; Mon, 27 Sep 1999 11:51:28 -0500 (CDT) Received: from SMTP (virout.hurlburt.af.mil [151.166.209.70]) by shepherd.hurlburt.af.mil with SMTP id LAA11493 for ; Mon, 27 Sep 1999 11:51:27 -0500 (CDT) Received: from emh.stn.hurlburt.af.mil ([151.166.160.105]) by 151.166.209.70 (Norton AntiVirus for Internet Email Gateways 1.0) ; Mon, 27 Sep 1999 16:43:33 0000 (GMT) Received: by emh with Internet Mail Service (5.5.2448.0) id ; Mon, 27 Sep 1999 11:53:14 -0500 Message-ID: From: Allen Robert LtCol To: "'wilderness-emergency-medicine@list.pitt.edu'" Subject: RE: W-EMED osteopathic medicine Date: Mon, 27 Sep 1999 11:53:08 -0500 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.2448.0) Content-Type: text/plain Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P6B3E0.CNM I'm an Osteopathic Physician and emergency medicine specialist. I did my EM residency at a DoD facility, since I am active duty Air Force. I'm residency trained, board certified, and a Fellow of the American College of Emergency Physicians. Osteopathic physicians have done residencies in every medical and surgical specialty. Most prefer to go into primary care, since that is the main focus of most DO schools. However, I have friends who are neurosurgeons, neurologists, cardiologists, radiologists, etc. I've haven't found that being a DO has had any effect on my ability to obtain training, or on my practice after training (other than everybody in the hospital wants me to manipulate their backs/necks). Have a look at the med schools you 'd like to attend, see what their educational program and the philosophy of practice is. If Osteopathic Medicine is in line with your personal philosophy, then go for it! It's not easy (nothing in medicine or medical education is) but it's worth it. Good Luck, Rob Allen Robert C. Allen, DO, FACEP Lt Col, USAF MC FS Group Surgeon 720th Special Tactics Group Hurlburt Field, FL > -----Original Message----- > From: EdwardsPaulK@exchange.uams.edu [SMTP:EdwardsPaulK@exchange.uams.edu] > Sent: Thursday, September 23, 1999 2:04 AM > To: wilderness-emergency-medicine@list.pitt.edu > Subject: W-EMED osteopathic medicine > > Just curious if anyone has any thoughts on Osteopathic medicine? I know > it > probably has no relevance to the subject of wilderness medicine but > perhaps > I could get some outside advice on continuing my education to pursue a > professional degree as an ER physician. I am a pre-med student currently > working on a MS in physiology at our state medical school. I will be > applying for osteopathic and allopathic medical schools in less than a > year. > Does anybody know the % of students that pursue a residency in the > emergency > department from an Osteopathic school? Or any relevant information > regarding > osteopathic schools? (I understand their philosophy and feel that they > are > right on track with my philosophy; but am curious how different the > education system really promotes this philosophy?) Thanks for all > comments, > Paul > 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sun, 26 Sep 1999 00:59:09 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sun, 26 Sep 1999 00:58:34 -0400 (EDT) Received: via switchmail; Sun, 26 Sep 1999 00:58:33 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sun, 26 Sep 1999 00:57:58 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sun, 26 Sep 1999 00:56:47 -0400 (EDT) Received: from out5.prserv.net (out5.prserv.net [165.87.194.243]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sun, 26 Sep 1999 00:56:39 -0400 (EDT) Received: from SKELLEHER-HOME (slip-32-100-230-233.co.us.ibm.net [32.100.230.233]) by out5.prserv.net (/) with SMTP id EAA37710 for ; Sun, 26 Sep 1999 04:58:48 GMT Message-ID: <00fd01bf07db$cdc0f370$dfdfdfdf@SKELLEHER-HOME.neonsoft.com> From: "Steve Kelleher" To: Subject: Re: W-EMED Full body Vacume splints Date: Sat, 25 Sep 1999 22:58:39 -0600 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 4.72.3155.0 X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3155.0 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P29720.CNM We have been using the MDI brand full body and extremity splints for years and highly recommend them for quality of immobilization, patient comfort and for warmth. Obviously, vac. splints require more upkeep than a backboard; you need to regularly check the operation of the pumps, valves and bean bags to make sure they are in working order. We rarely have problems, however. You also need make sure folks receive ongoing training to use them properly. You should protect against punctures by using the splint with a litter, and keeping the splint off the ground when possible (the litter also adds more support). We have replaced the chicken wire in our stokes litters with lightweight plastic sheeting as a preventative against punctures. I also recommend using a c-collar with a vac. splint, even though they aren't required. More info. on this is available in the emails Dr. Conover sent to this list. Steve Kelleher EMS Director Alpine Rescue Team Evergreen, CO. -----Original Message----- From: Ed To: wilderness-emergency-medicine@list.pitt.edu Date: Saturday, September 25, 1999 11:14 AM Subject: W-EMED Full body Vacume splints >Greetings from North Alabama. Have a question for the list about the full >body vacume splints for use in rough country SAR work and Cave Rescue. > >What is available that people are actually using in the field (other than >sleeping, I mean conserving your energy at the cache, Keith :) ) and are >they a worthwhile addition vs the cost and durability ? > >What units would the list advise using or not using and why. I am trying to >work up some justification for adding one to our gear cache. > >Thanks for the help. > > >Ed Nicholas, EMT-D >Chief of Operations, >Huntsville Cave Rescue Unit, Inc >Operations Officer, >Huntsville Emergency Medical Services, Inc >High Angle - Rough Terrain (HART) Team >Huntsville, Alabama >KD4WNJ >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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 25 Sep 1999 14:33:29 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 25 Sep 1999 14:32:55 -0400 (EDT) Received: via switchmail; Sat, 25 Sep 1999 14:32:55 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 25 Sep 1999 14:32:02 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 25 Sep 1999 14:31:29 -0400 (EDT) Received: from quint.somtel.com (Quint.somtel.com [206.139.114.2]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 25 Sep 1999 14:31:25 -0400 (EDT) Received: from general (ddialup-na-14.somtel.com [216.227.178.34]) by quint.somtel.com (8.8.5/8.8.5) with SMTP id OAA24976 for ; Sat, 25 Sep 1999 14:33:43 -0400 Message-ID: <001d01bf0783$8b7564e0$22b2e3d8@general> From: "James Bender" To: References: <199909251640.MAA27423@post-ofc05.srv.cis.pitt.edu> Subject: Re: W-EMED Full body Vacume splints Date: Sat, 25 Sep 1999 14:26:14 -0400 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 5.00.2014.211 X-MimeOLE: Produced By Microsoft MimeOLE V5.00.2014.211 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P48F50.CNM The full body vacuum splint is what we place in our stokes on every rescue, and we use it as our primary c-spine support while during EMS calls. As far as durability we have used MDI's in the woods, and "drug them", and they did not perforate; and we have hitched them to the back of snowmobiles as a quick improvised rescue sled, without the vacuum mat being damaged. Today a Ferno rep called me and stated Ferno has now designed a vacuum splint also. This splint is compartmentalized( this is so if it gets a hole, just that compartment inflates and not the whole splint. MDI is not compartmentalized) So I should have more comments on this splint after our WEMT class in January. I like MDI, but whatever you do, do not get a Heartwell, they do not hold up very well. James from Maine ----- Original Message ----- From: Keith Conover, M.D., FACEP To: Ed ; Sent: Saturday, September 25, 1999 12:42 PM Subject: Re: W-EMED Full body Vacume splints > Allegheny Mountain Rescue Group has a MDI mattress and is > generally happy with it. I'll post some MIME digests of some relevant > messages from various lists under separate cover. > > You can also search the list archives at > > www.wemsi.org > > for older messages on the topic. > > On 25 Sep 99, at 11:28, Ed wrote: > > > Greetings from North Alabama. Have a question for the list about the full > > body vacume splints for use in rough country SAR work and Cave Rescue. > > > > What is available that people are actually using in the field (other than > > sleeping, I mean conserving your energy at the cache, Keith :) ) and are > > they a worthwhile addition vs the cost and durability ? > > > > What units would the list advise using or not using and why. I am trying > > to work up some justification for adding one to our gear cache. > > > > Thanks for the help. > > > > > > Ed Nicholas, EMT-D > > Chief of Operations, > > Huntsville Cave Rescue Unit, Inc > > Operations Officer, > > Huntsville Emergency Medical Services, Inc > > High Angle - Rough Terrain (HART) Team > > Huntsville, Alabama > > KD4WNJ > > 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 > 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 25 Sep 1999 13:26:08 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 25 Sep 1999 13:25:35 -0400 (EDT) Received: via switchmail; Sat, 25 Sep 1999 13:25:35 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 25 Sep 1999 13:24:09 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 25 Sep 1999 13:23:54 -0400 (EDT) Received: from argohouston.com (mail.argolink.net [209.144.1.128]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 25 Sep 1999 13:23:51 -0400 (EDT) Received: from h1z2r9 [209.176.43.33] by argohouston.com (SMTPD32-5.05) id A5A06AF80246; Sat, 25 Sep 1999 12:25:52 -0500 From: "SouthWest PaddleSports" To: Subject: RE: W-EMED FW: spinal injury Date: Sat, 25 Sep 1999 12:33:57 -0500 Message-ID: <000201bf077c$254e70a0$212bb0d1@h1z2r9> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 (Normal) X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook 8.5, Build 4.71.2173.0 Importance: Normal In-Reply-To: <003601bf063d$be59ef80$17148e88@suzanne> X-MimeOLE: Produced By Microsoft MimeOLE V5.00.2314.1300 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P44B30.CNM I did it running a few years back.....not fun, thought I had somehow gotten a hairline fx in my hip, but the recovery is much worse for a piriformis injury. Patti Carothers, RN SouthWest PaddleSports 26322 I-45 North The Woodlands, TX 77386-1022 281-292-5600 or 1-800-We Paddle http://www.paddlesports.com > -----Original Message----- > From: owner-wilderness-emergency-medicine@list.pitt.edu > [mailto:owner-wilderness-emergency-medicine@list.pitt.edu]On Behalf Of > Suzanne M. Atkinson > Sent: Thursday, September 23, 1999 10:35 PM > To: wilderness-emergency-medicine@list.pitt.edu > Subject: Re: W-EMED FW: spinal injury > > > >or excessive use of the piriformis, > > which is an external rotator of the hip > > How do you do this exactly??? Skating? X-C skiing? Dancing the > charleston? > > Suzanne > > 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 25 Sep 1999 13:13:37 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 25 Sep 1999 13:13:05 -0400 (EDT) Received: via switchmail; Sat, 25 Sep 1999 13:13:04 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 25 Sep 1999 13:11:08 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 25 Sep 1999 13:10:50 -0400 (EDT) Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 25 Sep 1999 13:10:45 -0400 (EDT) Received: from micron (ehdup-g-15.rmt.net.pitt.edu [136.142.21.145]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Sat, 25 Sep 1999 13:10:40 -0400 (EDT) Message-Id: <199909251710.NAA01323@post-ofc04.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: wilderness-emergency-medicine@list.pitt.edu Date: Sat, 25 Sep 1999 13:12:40 -0400 MIME-Version: 1.0 Content-type: Multipart/Digest; boundary=Digest-6A8ABF32 Subject: W-EMED even more about vacuum mattresses X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 537395328 0 1 P38610.CNM --Digest-6A8ABF32 X-cs: From: Self To: EMS-L@listserv.ACNS.NWU.EDU,"Craig B. Key, MD, EMT-P" Subject: Re: Spinal Immobilization Cc: "Sam Chewning, M.D." Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Sun, 11 Apr 1999 17:45:46 -0400 On 9 Apr 99, at 15:59, Craig B. Key, MD, EMT-P wrote: > > This is > > because of the large bills and longterm disability (sorry Jeff) > > caused by having massive sacral pressure necrosis requiring flaps > > for coverage. > > How often does this actually occur? I have never heard of it in my > institution, I suspect it is a rare occurrence. It seems mostly to be a problem with people who actually have spine fractures -- they spend hours and hours on unpadded boards. As far how often this occurs, let me cc: a friend who's a spine surgeon (as well as a cave rescue doctor) and see if he can give some specifics on how often the spine-injured patient gets a sacral decubitus from being on a backboard. > I think Elliot was talking about the extrication process of removing the > patient from a car for example. Often the backboard is placed on the car > seat and the patient is then extricated directly onto the board. This > prevents any unnecessary movement of the patient without spinal > immobilization. > > With a vacuum splint the patient would have to be removed completely from > the car before they could be placed in immobilization unless a KED or > similar device was used. If you use a KED, you have now blown any > advantage in time gained from using a vacuum splint as the KED is > relatively hard to apply and will at least double the time required for > extrication. True, it's easier and faster to slide someone out of a car onto an unpadded board. On the other hand, it's also easier and faster to fasten your patient to the board with a staple gun or nail gun than with straps. Do you want to do something that's easy and fast or something that doesn't hurt your patient? Though in my specialty of mountain and cave rescue EMS, it's just as easy to use a vacuum mattress as an unpadded spine board, I think that with practice the extra time and effort to use a vacuum mattress is worth the benefits in auto extrication, too. Besides, the seriously-injured patients are those who are likely to spend hours and hours immobized. --Digest-6A8ABF32 Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Sun, 11 Apr 1999 19:27:08 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Sun, 11 Apr 1999 18:55:26 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Sun, 11 Apr 1999 18:55:26 -0400 (EDT) Received: from listserv.acns.nwu.edu (iris.itcs.nwu.edu [129.105.213.30]) by post-ofc02.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sun, 11 Apr 1999 18:55:24 -0400 (EDT) Received: (from mailnull@localhost) by listserv.acns.nwu.edu (8.8.7/8.8.7) id RAA13572; Sun, 11 Apr 1999 17:55:15 -0500 (CDT) Received: from localhost(127.0.0.1) by iris.itcs.nwu.edu via smap (V2.0) id xma013513; Sun, 11 Apr 99 17:54:49 -0500 Received: (from mailnull@localhost) by listserv.acns.nwu.edu (8.8.7/8.8.7) id RAA11033 for ; Sun, 11 Apr 1999 17:07:11 -0500 (CDT) Received: from post-ofc06.srv.cis.pitt.edu(136.142.185.43) by iris.itcs.nwu.edu via smap (V2.0) id xma010990; Sun, 11 Apr 99 17:06:55 -0500 Received: from default (ehdup-u-55.rmt.net.pitt.edu [136.142.23.165]) by post-ofc06.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sun, 11 Apr 1999 18:06:47 -0400 (EDT) Message-Id: <199904112206.SAA06479@post-ofc06.srv.cis.pitt.edu> Date: Sun, 11 Apr 1999 18:06:45 -0400 Reply-To: kconover+@pitt.edu Sender: owner-EMS-L@listserv.ACNS.NWU.EDU From: "Keith Conover, M.D., FACEP" To: EMS-L@listserv.ACNS.NWU.EDU, "Craig B. Key, MD, EMT-P" Cc: "Sam Chewning, M.D." Subject: Re: Spinal Immobilization In-Reply-To: <370E7827.FD888FE8@hfd.ci.houston.tx.us> MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT X-mailer: Pegasus Mail for Win32 (v3.01d) X-Listprocessor-Version: 8.0 -- ListProcessor(tm) by CREN On 9 Apr 99, at 15:59, Craig B. Key, MD, EMT-P wrote: > > This is > > because of the large bills and longterm disability (sorry Jeff) > > caused by having massive sacral pressure necrosis requiring flaps > > for coverage. > > How often does this actually occur? I have never heard of it in my > institution, I suspect it is a rare occurrence. It seems mostly to be a problem with people who actually have spine fractures -- they spend hours and hours on unpadded boards. As far how often this occurs, let me cc: a friend who's a spine surgeon (as well as a cave rescue doctor) and see if he can give some specifics on how often the spine-injured patient gets a sacral decubitus from being on a backboard. > I think Elliot was talking about the extrication process of removing the > patient from a car for example. Often the backboard is placed on the car > seat and the patient is then extricated directly onto the board. This > prevents any unnecessary movement of the patient without spinal > immobilization. > > With a vacuum splint the patient would have to be removed completely from > the car before they could be placed in immobilization unless a KED or > similar device was used. If you use a KED, you have now blown any > advantage in time gained from using a vacuum splint as the KED is > relatively hard to apply and will at least double the time required for > extrication. True, it's easier and faster to slide someone out of a car onto an unpadded board. On the other hand, it's also easier and faster to fasten your patient to the board with a staple gun or nail gun than with straps. Do you want to do something that's easy and fast or something that doesn't hurt your patient? Though in my specialty of mountain and cave rescue EMS, it's just as easy to use a vacuum mattress as an unpadded spine board, I think that with practice the extra time and effort to use a vacuum mattress is worth the benefits in auto extrication, too. Besides, the seriously-injured patients are those who are likely to spend hours and hours immobized. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover --Digest-6A8ABF32 X-cs: From: Self To: "Craig B. Key, MD, EMT-P" Subject: Re: Spinal Immobilization Cc: EMS-L@listserv.ACNS.NWU.EDU Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Sun, 18 Apr 1999 11:32:27 -0400 On 12 Apr 99, at 12:30, Craig B. Key, MD, EMT-P wrote: > > True, it's easier and faster to slide someone out of a car onto an > > unpadded board. On the other hand, it's also easier and faster to > > fasten your patient to the board with a staple gun or nail gun than with > > straps. Do you want to do something that's easy and fast or something > > that doesn't hurt your patient? > > As I understand it, the vacuum splint is not rigid until the patient is > placed on it and a vacuum is established. Correct. > That being the case, how could > you extricate someone onto a non-rigid board and not compromise the spine? See below. > > Though in my specialty of mountain and cave rescue EMS, it's just > > as easy to use a vacuum mattress as an unpadded spine board, I > > think that with practice the extra time and effort to use a vacuum > > mattress is worth the benefits in auto extrication, too. > > Wait, I thought one of the advantages of the vacuum board was that it > could be applied quicker and easier. Seems like those advantages are > becoming fewer on closer investigation. No, I'm not aware of anyone who's used one saying it's easier or quicker. For someone who's already on the ground or standing, it's probably about the same or slightly easier than a plain backboard. Certainly for boarding someone out of a car, a plain board is a lot easier. But a reasonable alternative is to slide the person out of the car using hands alone and then to do a "log-roll" type carry a couple of feet, gently put them down on the vacuum mattress, and then pump it out and apply the straps. You could also use a long board to get the person out, lay the long board down, and then do a "log-roll" many-hands lift just long enough to lift the person up and slip the vacuum mattress under. Again, do you want good or quick and easy? (I know, you want both, but . . . ) The ultimate result of shielding men from the effects of folly is to fill the world with fools. --Herbert Spencer --Digest-6A8ABF32 Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Mon, 19 Apr 1999 00:46:39 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Mon, 19 Apr 1999 00:44:00 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Mon, 19 Apr 1999 00:44:00 -0400 (EDT) Received: from listserv.acns.nwu.edu (iris.itcs.nwu.edu [129.105.213.30]) by post-ofc02.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 19 Apr 1999 00:43:58 -0400 (EDT) Received: (from mailnull@localhost) by listserv.acns.nwu.edu (8.8.7/8.8.7) id XAA28594; Sun, 18 Apr 1999 23:43:18 -0500 (CDT) Received: from localhost(127.0.0.1) by iris.itcs.nwu.edu via smap (V2.0) id xma028550; Sun, 18 Apr 99 23:42:41 -0500 Received: (from mailnull@localhost) by listserv.acns.nwu.edu (8.8.7/8.8.7) id RAA04868 for ; Sun, 18 Apr 1999 17:44:24 -0500 (CDT) Received: from post-ofc04.srv.cis.pitt.edu(136.142.185.11) by iris.itcs.nwu.edu via smap (V2.0) id xma004866; Sun, 18 Apr 99 17:44:07 -0500 Received: from 136.142.57.10.pitt.edu (ehdup-v-35.rmt.net.pitt.edu [136.142.24.45]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sun, 18 Apr 1999 18:43:57 -0400 (EDT) Message-Id: <199904182243.SAA00596@post-ofc04.srv.cis.pitt.edu> Date: Sun, 18 Apr 1999 18:43:28 -0400 Reply-To: kconover+@pitt.edu Sender: owner-EMS-L@listserv.ACNS.NWU.EDU From: "Keith Conover, M.D., FACEP" To: "Craig B. Key, MD, EMT-P" Cc: EMS-L@listserv.ACNS.NWU.EDU Subject: Re: Spinal Immobilization In-Reply-To: <37123BB7.FE63A1B@hfd.ci.houston.tx.us> MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT X-mailer: Pegasus Mail for Win32 (v3.01d) X-Listprocessor-Version: 8.0 -- ListProcessor(tm) by CREN On 12 Apr 99, at 12:30, Craig B. Key, MD, EMT-P wrote: > > True, it's easier and faster to slide someone out of a car onto an > > unpadded board. On the other hand, it's also easier and faster to > > fasten your patient to the board with a staple gun or nail gun than with > > straps. Do you want to do something that's easy and fast or something > > that doesn't hurt your patient? > > As I understand it, the vacuum splint is not rigid until the patient is > placed on it and a vacuum is established. Correct. > That being the case, how could > you extricate someone onto a non-rigid board and not compromise the spine? See below. > > Though in my specialty of mountain and cave rescue EMS, it's just > > as easy to use a vacuum mattress as an unpadded spine board, I > > think that with practice the extra time and effort to use a vacuum > > mattress is worth the benefits in auto extrication, too. > > Wait, I thought one of the advantages of the vacuum board was that it > could be applied quicker and easier. Seems like those advantages are > becoming fewer on closer investigation. No, I'm not aware of anyone who's used one saying it's easier or quicker. For someone who's already on the ground or standing, it's probably about the same or slightly easier than a plain backboard. Certainly for boarding someone out of a car, a plain board is a lot easier. But a reasonable alternative is to slide the person out of the car using hands alone and then to do a "log-roll" type carry a couple of feet, gently put them down on the vacuum mattress, and then pump it out and apply the straps. You could also use a long board to get the person out, lay the long board down, and then do a "log-roll" many-hands lift just long enough to lift the person up and slip the vacuum mattress under. Again, do you want good or quick and easy? (I know, you want both, but . . . ) The ultimate result of shielding men from the effects of folly is to fill the world with fools. --Herbert Spencer --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover --Digest-6A8ABF32 Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Tue, 13 Apr 1999 14:42:24 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Tue, 13 Apr 1999 14:38:58 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Tue, 13 Apr 1999 14:38:56 -0400 (EDT) Received: from listserv.acns.nwu.edu (iris.itcs.nwu.edu [129.105.213.30]) by post-ofc02.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 13 Apr 1999 14:38:49 -0400 (EDT) Received: (from mailnull@localhost) by listserv.acns.nwu.edu (8.8.7/8.8.7) id NAA20171; Tue, 13 Apr 1999 13:38:41 -0500 (CDT) Received: from localhost(127.0.0.1) by iris.itcs.nwu.edu via smap (V2.0) id xma020055; Tue, 13 Apr 99 13:38:14 -0500 Received: (from mailnull@localhost) by listserv.acns.nwu.edu (8.8.7/8.8.7) id NAA18999 for ; Tue, 13 Apr 1999 13:32:12 -0500 (CDT) Received: from merle.acns.nwu.edu(129.105.16.57) by iris.itcs.nwu.edu via smap (V2.0) id xma018902; Tue, 13 Apr 99 13:31:48 -0500 Received: (from mailnull@localhost) by merle.acns.nwu.edu (8.8.7/8.8.7) id NAA12071 for ; Tue, 13 Apr 1999 13:31:47 -0500 (CDT) Received: from mixed009074.nuts.nwu.edu(129.105.9.74) by merle.acns.nwu.edu via smap (V2.0) id xma011936; Tue, 13 Apr 99 13:31:36 -0500 Message-Id: <2.2.32.19990413183521.006e6ee4@merle.acns.nwu.edu> Date: Tue, 13 Apr 1999 13:35:21 -0500 Reply-To: EMS-L@listserv.ACNS.NWU.EDU Sender: owner-EMS-L@listserv.ACNS.NWU.EDU From: "Ed Michelson, MD" To: ems-l@listserv.ACNS.NWU.EDU Subject: Re: Spinal Immobilization: R Vomacka replies Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" X-Sender: edatnu@merle.acns.nwu.edu X-Mailer: Windows Eudora Pro Version 2.2 (32) X-Listprocessor-Version: 8.0 -- ListProcessor(tm) by CREN Date: Wed, 07 Apr 1999 18:11:11 -0400 From: Rick Vomacka Reply-To: rvomacka@usa.net X-Mailer: Mozilla 4.51 [en] (Win98; U) X-Accept-Language: en MIME-Version: 1.0 To: EMS-L@listserv.ACNS.NWU.EDU Subject: Re: Spinal Immobilization References: <001c01be812d$8d8ea5c0$0100a8c0@cx526920-a.pwy1.sdca.home.com> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Unless things have changed in the past year or so, I seem to recall that vacuum mattresses are also not strong enough to support an adult patient when lifted from the head and foot ends ... they must be lifted from the sides -- yes? -- Rick Vomacka, Brimfield, OH "Everyone has talent. What is rare is the courage to follow the talent to the dark place where it leads." Emergency Products & Research, Inc. Kent, OH http://www.epandr.com Ed Michelson, MD Northwestern Universwity --Digest-6A8ABF32-- 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 -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 25 Sep 1999 13:12:35 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 25 Sep 1999 13:12:03 -0400 (EDT) Received: via switchmail; Sat, 25 Sep 1999 13:12:02 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 25 Sep 1999 13:11:01 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 25 Sep 1999 13:10:44 -0400 (EDT) Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 25 Sep 1999 13:10:41 -0400 (EDT) Received: from micron (ehdup-g-15.rmt.net.pitt.edu [136.142.21.145]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Sat, 25 Sep 1999 13:10:32 -0400 (EDT) Message-Id: <199909251710.NAA01292@post-ofc04.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: wilderness-emergency-medicine@list.pitt.edu Date: Sat, 25 Sep 1999 13:12:06 -0400 MIME-Version: 1.0 Content-type: Multipart/Digest; boundary=Digest-58F03895 Subject: W-EMED more about vacuum mattresses X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 537395328 0 1 P5DA50.CNM --Digest-58F03895 Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Tue, 6 Apr 1999 17:28:22 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Tue, 6 Apr 1999 17:26:47 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Tue, 6 Apr 1999 17:26:46 -0400 (EDT) Received: from listserv.acns.nwu.edu (iris.itcs.nwu.edu [129.105.213.30]) by post-ofc01.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 6 Apr 1999 17:26:45 -0400 (EDT) Received: (from mailnull@localhost) by listserv.acns.nwu.edu (8.8.7/8.8.7) id QAA16618; Tue, 6 Apr 1999 16:26:20 -0500 (CDT) Received: from localhost(127.0.0.1) by iris.itcs.nwu.edu via smap (V2.0) id xma016536; Tue, 6 Apr 99 16:26:06 -0500 Received: (from mailnull@localhost) by listserv.acns.nwu.edu (8.8.7/8.8.7) id QAA14637 for ; Tue, 6 Apr 1999 16:06:01 -0500 (CDT) Received: from ha1.rdc1.sdca.home.com(24.0.3.66) by iris.itcs.nwu.edu via smap (V2.0) id xma014576; Tue, 6 Apr 99 16:05:42 -0500 Received: from cx526920-a ([24.0.171.14]) by mail.rdc1.sdca.home.com (InterMail v4.00.03 201-229-104) with SMTP id <19990406210536.PLQN11049.mail.rdc1.sdca.home.com@cx526920-a> for ; Tue, 6 Apr 1999 14:05:36 -0700 Message-Id: <001b01be8071$3d3b2a60$0100a8c0@cx526920-a.pwy1.sdca.home.com> Date: Tue, 6 Apr 1999 14:05:45 -0700 Reply-To: EMS-L@listserv.ACNS.NWU.EDU Sender: owner-EMS-L@listserv.ACNS.NWU.EDU From: "Tom Scott" To: "EMS-L" Subject: RE: Spinal Immobilization In-Reply-To: <370A5CC9.A5753FF7@emory.edu> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 (Normal) X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook 8.5, Build 4.71.2377.0 X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3155.0 X-Listprocessor-Version: 8.0 -- ListProcessor(tm) by CREN For the last several years I've been promising myself a tattoo on my chest that said "NO BACKBOARD." The research seems to be pretty evident that the vacuum mattress is the best way to go. I guess that's why it is the standard of care in Europe. The following is a list of references I compiled 3 years ago: ------------------------------------ Chan D, Godlberg R, Tascone A, Harmon S and Chan L, "The Effect of Spinal Immobilization on Healthy Volunteers" Annals of Emergency Medicine, Vol. 23, No. 1 pp 48-51, January 1994. Study Objective: To determine the effects of standard spinal immobilization on a group of health volunteers with respect to induced pain and discomfort. Interventions: 21 healthy volunteers were placed in a standard backboard immobilization for a 30 minute period. Number and severity of immediate and delayed symptoms were determined. Measurements and Main Results: 100% of subjects developed pain within the immediate observation period. Occipital headache and sacral, lumbar, and mandibular pain were the most frequent symptoms. 55% of subjects graded their symptoms as moderate to severe. 29% of subjects developed additional symptoms over the next 48 hours. Conclusion: Standard spinal immobilization may be a cause of pain in an otherwise healthy subject. --------------------------------------------- Godlberg R, Chan D, Mason J, and Chan L, "Standard Spinal Immobilization Versus a Vacuum Mattress Splint: A Comparison of Symptoms Generated" From the Dept. of Emergency Medicine, Los Angeles County+USC Medical Center, Los Angeles, CA. Unpublished. Study Objective: To compare standard spinal immobilization techniques to a vacuum mattress splint with respect to the incidence of symptoms generated by the immobilization process. Participants: 37 healthy volunteers without history of back pain or spinal disease. Interventions: In Phase I, subjects were randomly assigned to be immobilized on either a wooden backboard or a mattress-splint for 30 minutes. The incidence and severity of any symptoms generated by the immobilization process were recorded. In Phase II, the two groups were again tested after a two week washout period, with the method of immobilization being reversed. Symptoms and severity were again recorded. Main Results: Pain symptoms were confined to four anatomic sites: occipital prominence, lumbosacral spine, scapulae and cervical spine. After adjusting for the effect of order of exposure, subjects were 3.08 times more likely to have symptoms when immobilized on a backboard than when immobilized on the VMS (p < 0.0001). They were similarly 7.88 times more likely to complain of occipital pain (p < 0.0001) and 4.27 times more likely to complain of lumbosacral pain (p < 0.0086). Severity occipital and lumbosacral pain was significantly higher during backboard immobilization (p<0.0001, p<0.0088 respectively). Conclusion: When compared to VMS, standard backboard immobilization appears to be associated with an increased incidence of symptoms in general and an increased incidence and severity of occipital and lumbosacral pain in particular. --------------------------------------------- Lovell ME and Evans JH, "A comparison of the spinal board and the vacuum stretcher, spinal stability and interface pressure" Injury, Vol. 25, No. 3 1994, pp 179-180. Abstract: The interface pressures were measured between the sacrum, mid-lumbar spine and various support surfaces. Thirty health male volunteers were recruited. The spinal board, padded spinal board and vacuum stretcher were the support surfaces evaluated. We found high and potentially ischaemic pressures between the sacrum and the spinal board interface (mean 147.3 mmHg). This was reduced in the padded board (115.5 mmHg) but dramatically reduced with the vacuum stretcher (36.7 mmHg). It was also noted that no support was given to the normal lumbar lordosis by the spinal board (padded and unpadded), but support was given the vacuum stretcher. This raises the question of how stable is an unstable spinal injury on a flat supporting surface. Hauswald M, Johnson DR, and Stockhoff C. "Superiority of a Vacuum Splint Device Over a Traditional Spine Board for Immobilization." From the Dept. Of Emergency Medicine, University of New Mexico School of Medicine. Unpublished. Thirty EMT students were immobilized on both a wooden backboard and a vacuum mattress splint for 30 minutes. 30 other students working in teams of 4 with one acting as a patient were timed as they immobilized the "patient" on each device as quickly as possible. The board was slowly lifted up to 90 degrees laterally, until the subject first felt any body part slip. The angle of tilt was recorded. Results: The vacuum splint was more comfortable than the wooden spine board: 6.6 +/- 1.5 vs. 3.3+/-1.8 (p<0.001). It was also slightly faster to apply: 132 +/- 24 seconds vs. 155 +/- 22 seconds (p<0.001). The angle at which slippage was first noted was greater for the vacuum splint than the spine board: 29.2 +/- 7.0 degrees vs. 19.8+/-4.3 degrees (p<0.05). Conclusion: Wooden spine boards have few advantages except that they are cheaper and easier to clean than vacuum splints. Vacuum splints are much more comfortable, quicker to apply and allow less slippage on lateral tilting. ----------------------------------------------------- Delbridge TR, Auble TE, Garrison HG and Menengazzi JJ, "Discomfort in Health Volunteers Immobilized on Wooden Backboards and Vacuum Mattress Splints" Prehospital and Disaster Medicine, Volume 8 Suppl 2 (Abstracts of Scientific Papers 9th Annual Conference and Scientific Assembly of NASEMSP). Jul-Sep 1993. Conclusion: The results suggest that vacuum mattress splints cause less discomfort than do wooden backboards; the effect is more pronounced as the duration of spinal immobilization increases. Prospective studies are necessary to evaluate the clinical significance of this effect and the cost-effectiveness of similar alternative immobilization devices. -------------------------------------- This is the research that I believe supports a transition from backboards to the vacuum mattress for spinal immobilization. They may cost more, but would you want you mother, father or spouse strapped to a backboard for an hour or more? Tom Scott mailto:Tom.Scott@pobox.com EMS and Managed Care Consultant Scott Consulting Poway, San Diego County, California +1 (619) 748-9064 http://members.home.net/tomscott/ > -----Original Message----- > From: owner-EMS-L@listserv.ACNS.NWU.EDU > [mailto:owner-EMS-L@listserv.ACNS.NWU.EDU]On Behalf Of Jeffrey P. > Salomone, MD > Sent: Tuesday, April 06, 1999 12:13 PM > To: EMS-L@listserv.ACNS.NWU.EDU > Subject: Re: Spinal Immobilization > > > How do you define "best"? And, furthermore, what DATA do you > have to back up > your claim of superiority? > > Jeff Salomone, MD, NREMT-P > Emory University > > Allen Sims wrote: > > > Best method of Spinal Immobilization - Vacuum Mattresses. > Nothing else even > > comes close. They are expensive, but if you want the best... > > > > Method we have adopted: > > Nylon webbing. You can buy it in bulk, and the end result is > about $5.00 a > > set. A 1000 ft roll makes 25 40 foot sections. One section > works for one > > patient. It's usually a two person job to apply, as it's > symmetrical from > > head to toe, but can be done by just one. To apply, mark the > center of the > > webbing. Place this over the patients neck (not too tight - for obvious > > reasons). Then loop to the first handhold just above the patients > > shoulders. Loop under the patients arm and through the initial > run that was > > over the patients neck, and then back to the next hole in the backboard. > > This creates a type of harness that keeps the patients shoulders very > > steady. Keeping this critical area stable is the biggest failure of all > > other types of immobilization I've tried. Then proceed loop > through your > > partners webbing at the patients center all the way down to the > feet, then > > tie securely at the end. At each handhold, you create a type > of half-hitch > > (at least that's what I call it - I'm not any type of boy scout knot > > expert). This keeps some tension, and a failsafe if the bottom > tie comes > > loose. If you want to be extra cautious, you can use some > blankets to pad > > void area, and the patient just doesn't move. If you need to lift the > > patient vertically, you can go from just above the patients > hips, between > > his legs (be careful - for obvious reasons) and then back above > the hips. > > It takes less than one minute for an experienced crew to apply. > It can be > > removed in the same amount of time in the ER. If it gets cut off by > > hospital staff, it's only a few dollars lost. It can be > washed, it's easy > > to label, it works with any backboard that has handholds, and it's very > > effective. > > > > Allen Sims > > Cypress Creek EMS > > http://www.ccems.com > > > > -----Original Message----- > > From: Stephen Reid > > To: EMS-L@Listserv.acns.nwu.edu > > Date: Friday, April 02, 1999 10:53 AM > > Subject: Spinal Immobilization > > > > >Hey folks: > > > > > >I know this is an old and drawn out topic, but unfortunately I > have been > > >tasked with the impossible mission. I need to know if there are any > > >documented studies on the use of straps (whether spider or single) > > >versus the use of tape when immobilizing a spinal patient. > > > > > >I appreciate that this topic has been beat to death, but I have as of > > >yet been able to find anything on paper....HELP! > > > > > >Thanks > > > > > > > > >-- > > >STEPHEN B REID > > >Paramedic II, EMD, Crewchief > > > > > >PO Box 1422 > > >Middleton, Nova Scotia > > >B0S 1P0 > > > > > >'EMS is an artform only few recognize but everyone appreciates' > > > > > > > > > > > > --Digest-58F03895 Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Wed, 7 Apr 1999 17:22:43 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Wed, 7 Apr 1999 17:19:22 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Wed, 7 Apr 1999 17:19:22 -0400 (EDT) Received: from listserv.acns.nwu.edu (iris.itcs.nwu.edu [129.105.213.30]) by post-ofc02.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 7 Apr 1999 17:19:20 -0400 (EDT) Received: (from mailnull@localhost) by listserv.acns.nwu.edu (8.8.7/8.8.7) id QAA18477; Wed, 7 Apr 1999 16:18:55 -0500 (CDT) Received: from localhost(127.0.0.1) by iris.itcs.nwu.edu via smap (V2.0) id xma018373; Wed, 7 Apr 99 16:18:39 -0500 Received: (from mailnull@localhost) by listserv.acns.nwu.edu (8.8.7/8.8.7) id OAA07172 for ; Wed, 7 Apr 1999 14:34:09 -0500 (CDT) Received: from ha1.rdc1.sdca.home.com(24.0.3.66) by iris.itcs.nwu.edu via smap (V2.0) id xma007153; Wed, 7 Apr 99 14:33:53 -0500 Received: from cx526920-a ([24.0.171.14]) by mail.rdc1.sdca.home.com (InterMail v4.00.03 201-229-104) with SMTP id <19990407193348.CBXP11049.mail.rdc1.sdca.home.com@cx526920-a> for ; Wed, 7 Apr 1999 12:33:48 -0700 Message-Id: <001c01be812d$8d8ea5c0$0100a8c0@cx526920-a.pwy1.sdca.home.com> Date: Wed, 7 Apr 1999 12:33:45 -0700 Reply-To: EMS-L@listserv.ACNS.NWU.EDU Sender: owner-EMS-L@listserv.ACNS.NWU.EDU From: "Tom Scott" To: Subject: RE: Spinal Immobilization In-Reply-To: <370BA206.6FAF42C9@hfd.ci.houston.tx.us> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 (Normal) X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook 8.5, Build 4.71.2377.0 X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3155.0 X-Listprocessor-Version: 8.0 -- ListProcessor(tm) by CREN Craig Key wrote > Unfortunately, the literature you posted and most of the literature out > there about vacuum splints does not demonstrate that it is any better > than a backboard at immobilization of the spinal column. All it > demonstrates is that it is more comfortable. I agree that intuitively > the vacuum splint makes more sense and probably is "best" but there is > no real evidence to support this. Here are some more references. They seem to demonstrate that the vacuum mattress is at least as efficacious as the spine board in terms of immobilization. But more importantly, vacuum mattresses don't violate the first rule of medicine: Do No Harm (which I believe is one of your mantras Craig, at least when it comes to RSI in the field). Not only are spine boards "uncomfortable" they actually result in tissue damage. EMS patients come to us with a lot of pain to begin with. Why should we add to that pain when there is an alternative that achieves the same clinical objectives: immobilization, in a pain free manner? Vacuum mattresses cost more, are harder to clean, are more easily damaged. But they should still be implemented because it is the Right Thing To Do for the patient. Tom Scott mailto:Tom.Scott@pobox.com EMS and Managed Care Consultant Scott Consulting Poway, San Diego County, California +1 (619) 748-9064 http://members.home.net/tomscott/ ----------------------------------------------- J Emerg Med 1996 Sep-Oct;14(5):553-9 The efficacy and comfort of full-body vacuum splints for cervical-spine immobilization. Hamilton RS, Pons PT University of California San Diego Medical Center/Mercy Hospital, CA 92103, USA. r_hamilton@ucsd.edu We performed a prospective crossover study to determine the cervical spine immobilization and comfort level of healthy subjects on a full-body vacuum splint in comparison with a standard backboard, with and without cervical spine collars. Twenty-six healthy volunteers were immobilized on a backboard (BB) and a full-body vacuum splint (VS), both with and without a cervical collar (CC). Pre- and post-immobilization cervical spine range-of-motion measurements were made using an electronic digital inclinometer and a standard handheld goniometer. Subjects were also asked to subjectively grade their immobilization and discomfort both overall and in seven specific body regions. No statistically significant difference was found between the VS+CC and the BB+CC for flexion and rotation, although the VS+CC combination provided significantly superior immobilization to the BB+CC for extension and lateral bending. The VS alone, in all cases except extension, provided superior immobilization to the BB alone. A statistically significant difference in subjective perception of immobilization was noted, with the BB being less effective than the other three alternatives and the VS+CC providing the best immobilization. A significant difference in overall comfort and occipital region comfort, favoring the vacuum splint, was found. In conclusion, the vacuum splint is an effective and more comfortable alternative to the background for cervical spine immobilization. ----------------------------------------------- Am J Emerg Med 1996 Jul;14(4):369-72 Comparison of a vacuum splint device to a rigid backboard for spinal immobilization. Johnson DR, Hauswald M, Stockhoff C New Mexico EMS Academy, University of New Mexico School of Medicine, Albuquerque 87106, USA. In this study, comparison of a vacuum splint device to a rigid backboard was made with respect to comfort, speed of application, and degree of immobilization. The study was a prospective, nonblinded comparative study conducted at a statewide emergency medical services (EMS) training facility and included a convenience sample of emergency medical technician (EMT) and paramedic students. The vacuum splint was judged to be significantly more comfortable on a 10-point scale than the rigid backboard after subjects had been lying on each device for 30 minutes (P < .001). It was also faster to apply: 131.6 +/- 24.3 seconds versus 154.6 +/- 22.2 seconds (P < .001). Various measures of immobilization were similar for the two devices. The vacuum splint provided better Immobilization of the torso and less slippage on a gradual lateral tilt. The rigid backboard with head blocks was slightly better at immobilizing the head. Vacuum splints offer a significant improvement in comfort over a traditional backboard for the patient with possible spinal injury. They can be applied in reasonable time frames and provide a similar degree of immobilization when compared to a standard rigid backboard. ------------------------------ Cordell WH, Hollingsworth JC, Olinger ML, Stroman SJ, Nelson DR: Pain and tissue-interface pressures during spine-board immobilization. Ann Emerg Med July 1995;26:31-36. Study objectives: Although spine boards are one of the main EMS means of immobilization and transportation, few studies have addressed the discomfort and potential harmful consequences of using this common EMS tool. We compared the levels of pain and tissue-interface (contact) pressures in volunteers immobilized on spine boards with and without interposed air mattresses. Design: Prospective crossover study. Setting: Emergency department of Methodist Hospital of Indiana, Indianapolis, Indiana. Participants: Twenty healthy volunteers who had not taken any analgesic drugs in the preceding 24 hours, were not experiencing any pain at the time of the study, and did not have history of chronic back pain. Interventions: To simulate prehospital transport conditions, we immobilized volunteers with hard cervical collars and single-buckle chest straps on wooden spine boards with or without commercially available medical air mattresses. The crossover order was randomized. After 80 minutes, immobilization measures were discontinued and the subjects were allowed to get off the boards for a recovery period of 60 minutes. Subjects were then studied for a second 80-minute period with the opposite intervention. At baseline and at 20-minute intervals, the level of pain was rated with a 100-mm visual analog scale. Tissue-interface pressures were measured at the occiput, sacrum, and left heel. Results: Mean pain on the visual analog scale was 9.7 mm at the end of the mattress period and 37.5 mm at the end of the no-mattress period (P =.0001). Although there were no significant differences in pain between the two groups at time 0, volunteers reported significantly more pain during the no-mattress period at 20 (P =.003), 40 (P =.0001), and 60 minutes (P =.0001). All 20 subjects reported that immobilization on the spine board with the mattress was "much better" (five-point scale) than that without the mattress. Interface pressure levels were significantly less in the mattress period than in the no-mattress period measured at occiput (P =.0001), sacrum (P =.0001), and heel (P =.0001). Conclusion: In a simulated immobilization experiment, healthy volunteers reported significantly less pain during immobilization on a spine board with an interposed air mattress than during that on a spine board without a mattress. Tissue-interface pressures were significantly higher on spine boards without air mattresses. This and previous studies suggest that immobilization on rigid spine boards is painful and may produce tissue-interface pressure high enough to result in the development of pressure necrosis ("bedsores"). Emergency care providers should consider the use of interposed air mattresses to reduce the pain and potential tissue injury associated with immobilization on rigid spine boards. --Digest-58F03895 X-cs: From: Self To: "Jeffrey P. Salomone, MD" How do you define "best"? And, furthermore, what DATA do you have to back > up your claim of superiority? There are excellent studies that show that after 45' on a backboard, people get severe pain, and after 90 minutes, start to get skin breakdown. [references posted on this list in the past and available again if you want them] However, there are many of us who have _slept_comfortably_ in a vacuum mattress for up to 4-5 hours during SAR exercises (after that it gets a bit uncomfortable). This by itself is enough to make me agree. And test it yourself -- there are no controlled studies of the degree of immobilization in a vacuum mattress, but properly applied and with a bit of duct tape (used preferentially in SAR) or a strap across the top of the head, you can actually feel that you move _less_ in a vacuum mattress than in a CID and collar on a hard board. Yes, I'm an unrepentant fan of vacuum mattresses! --Digest-58F03895 X-cs: From: Self To: "Jeffrey P. Salomone, MD" How do you define "best"? And, furthermore, what DATA do you have to back > up your claim of superiority? There are excellent studies that show that after 45' on a backboard, people get severe pain, and after 90 minutes, start to get skin breakdown. [references posted on this list in the past and available again if you want them] However, there are many of us who have _slept_comfortably_ in a vacuum mattress for up to 4-5 hours during SAR exercises (after that it gets a bit uncomfortable). This by itself is enough to make me agree. And test it yourself -- there are no controlled studies of the degree of immobilization in a vacuum mattress, but properly applied and with a bit of duct tape (used preferentially in SAR) or a strap across the top of the head, you can actually feel that you move _less_ in a vacuum mattress than in a CID and collar on a hard board. And yes, Craig, there are no studies -- but then there is no evidence that holding someone "tighter" is better, either -- the degree of immobilization needed for potential spine injuries is really pretty undefined, except for that one study that Vince Mosesso did with cadavers. Yes, I'm an unrepentant fan of vacuum mattresses! --Digest-58F03895 X-cs: From: Self To: "Jeffrey P. Salomone, MD" How do you define "best"? And, furthermore, what DATA do you have to back > up your claim of superiority? There are excellent studies that show that after 45' on a backboard, people get severe pain, and after 90 minutes, start to get skin breakdown. [references posted on this list in the past and available again if you want them] However, there are many of us who have _slept_comfortably_ in a vacuum mattress for up to 4-5 hours during SAR exercises (after that it gets a bit uncomfortable). This by itself is enough to make me agree. And test it yourself -- there are no controlled studies of the degree of immobilization in a vacuum mattress, but properly applied and with a bit of duct tape (used preferentially in SAR) or a strap across the top of the head, you can actually feel that you move _less_ in a vacuum mattress than in a CID and collar on a hard board. And yes, Craig, there are no studies -- but then there is no evidence that holding someone "tighter" is better, either -- the degree of immobilization needed for potential spine injuries is really pretty undefined, except for that one study that Vince Mosesso did with cadavers. This is a situation where we have to use a mixture of controlled studies and anecdotal evidence to make a decision, as in many other areas of EMS. Yes, I'm an unrepentant fan of vacuum mattresses! --Digest-58F03895 X-cs: From: Self To: EMS-L@listserv.ACNS.NWU.EDU Subject: Re: Spinal Immobilization Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Fri, 9 Apr 1999 13:19:26 -0400 Interesting discussion. Tom did indeed post a quantity of evidence, and despite Jeff's criticisms, I've read through the articles themselves and found them at least moderately persuasive, with fairly good methodology. For what it's worth, here's the detailed logical chain I've used to decide that vacuum mattresses are superior to backboards. (I'll note that my interest in wilderness EMS and the problems of very long- term evacuations prompted me to look at this quite closely.) 1. Backboards cause severe pain if you're on them more than an hour (the references Tom posted establish this without a doubt). 2. Backboards cause tissue damage if you're on them for more than a few hours. Again, fairly good evidence from Tom - but also, the American Society for Surgery of the Spine (hope I got the name right) has in the past few years been trying to persuade emergency physicians and trauma surgeons to get people, especially those with even unstable spinal injuries, off backboards ASAP. This is because of the large bills and longterm disability (sorry Jeff) caused by having massive sacral pressure necrosis requiring flaps for coverage. 3. The degree of spinal immobilization that's required for adequate protection is unknown, therefore a reasonable approach is to see if a vacuum splint is as good or better than our current baseline -- backboard, c-collar, CID. Tom quoted some data on this, and in making my own decision, I performed some not only unpublished but even unrecorded studies -- put a bunch of people (about 5) on a backboard with c-collar and CID, and had them try to wiggle. Put the same people in a vacuum mattress and had them try to wiggle. Wiggled a lot on the board, almost not at all in the vacuum mattress. Not documented, but easy to perform yourself at home! As a standard part of testing SAR immobilization, we also tilt the litter up on its foot end and bounce the litter up and down to see if the patient moves. Answer -- a lot less with the vacuum mattress. We also do this head-down and the answer is the same. Anecdotal, but quite persuasive to me. and Elliot said: > What also is missing in these studies is a critical look at how > the patient gets from wherever on to the various devices used for > immobilization. I have not had any good experience getting > patients on to the "vacuum mattress". If there is a technique > that moves the patient less than a well exec Well, I dunno about you, but the technique for slipping a vacuum mattress under someone is the same as slipping a backboard under someone. Yes, it's a bit bigger and you have to lift someone a few inches higher, but the principle's exactly the same. Yes, I'm an unrepentant fan of vacuum mattresses! (P.S. having been able to catch a nap for a couple of hours in one while being the patient in a SAR exercise is quite persuasive if you've ever been on a backboard before!) --Digest-58F03895 Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Fri, 9 Apr 1999 13:41:52 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Fri, 9 Apr 1999 13:39:34 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Fri, 9 Apr 1999 13:39:31 -0400 (EDT) Received: from listserv.acns.nwu.edu (iris.itcs.nwu.edu [129.105.213.30]) by post-ofc02.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 9 Apr 1999 13:39:24 -0400 (EDT) Received: (from mailnull@localhost) by listserv.acns.nwu.edu (8.8.7/8.8.7) id MAA11977; Fri, 9 Apr 1999 12:38:44 -0500 (CDT) Received: from localhost(127.0.0.1) by iris.itcs.nwu.edu via smap (V2.0) id xma011786; Fri, 9 Apr 99 12:38:04 -0500 Received: (from mailnull@localhost) by listserv.acns.nwu.edu (8.8.7/8.8.7) id MAA09732 for ; Fri, 9 Apr 1999 12:20:20 -0500 (CDT) Received: from post-ofc06.srv.cis.pitt.edu(136.142.185.43) by iris.itcs.nwu.edu via smap (V2.0) id xma009718; Fri, 9 Apr 99 12:20:14 -0500 Received: from 136.142.57.10.pitt.edu (ehdup-t-5.rmt.net.pitt.edu [136.142.23.15]) by post-ofc06.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Fri, 9 Apr 1999 13:20:03 -0400 (EDT) Message-Id: <199904091720.NAA02238@post-ofc06.srv.cis.pitt.edu> Date: Fri, 9 Apr 1999 13:20:02 -0400 Reply-To: kconover+@pitt.edu Sender: owner-EMS-L@listserv.ACNS.NWU.EDU From: "Keith Conover, M.D., FACEP" To: EMS-L@listserv.ACNS.NWU.EDU Subject: Re: Spinal Immobilization In-Reply-To: <370A5CC9.A5753FF7@emory.edu> MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT X-mailer: Pegasus Mail for Win32 (v3.01d) X-Listprocessor-Version: 8.0 -- ListProcessor(tm) by CREN Interesting discussion. Tom did indeed post a quantity of evidence, and despite Jeff's criticisms, I've read through the articles themselves and found them at least moderately persuasive, with fairly good methodology. For what it's worth, here's the detailed logical chain I've used to decide that vacuum mattresses are superior to backboards. (I'll note that my interest in wilderness EMS and the problems of very long- term evacuations prompted me to look at this quite closely.) 1. Backboards cause severe pain if you're on them more than an hour (the references Tom posted establish this without a doubt). 2. Backboards cause tissue damage if you're on them for more than a few hours. Again, fairly good evidence from Tom - but also, the American Society for Surgery of the Spine (hope I got the name right) has in the past few years been trying to persuade emergency physicians and trauma surgeons to get people, especially those with even unstable spinal injuries, off backboards ASAP. This is because of the large bills and longterm disability (sorry Jeff) caused by having massive sacral pressure necrosis requiring flaps for coverage. 3. The degree of spinal immobilization that's required for adequate protection is unknown, therefore a reasonable approach is to see if a vacuum splint is as good or better than our current baseline -- backboard, c-collar, CID. Tom quoted some data on this, and in making my own decision, I performed some not only unpublished but even unrecorded studies -- put a bunch of people (about 5) on a backboard with c-collar and CID, and had them try to wiggle. Put the same people in a vacuum mattress and had them try to wiggle. Wiggled a lot on the board, almost not at all in the vacuum mattress. Not documented, but easy to perform yourself at home! As a standard part of testing SAR immobilization, we also tilt the litter up on its foot end and bounce the litter up and down to see if the patient moves. Answer -- a lot less with the vacuum mattress. We also do this head-down and the answer is the same. Anecdotal, but quite persuasive to me. and Elliot said: > What also is missing in these studies is a critical look at how > the patient gets from wherever on to the various devices used for > immobilization. I have not had any good experience getting > patients on to the "vacuum mattress". If there is a technique > that moves the patient less than a well exec Well, I dunno about you, but the technique for slipping a vacuum mattress under someone is the same as slipping a backboard under someone. Yes, it's a bit bigger and you have to lift someone a few inches higher, but the principle's exactly the same. Yes, I'm an unrepentant fan of vacuum mattresses! (P.S. having been able to catch a nap for a couple of hours in one while being the patient in a SAR exercise is quite persuasive if you've ever been on a backboard before!) 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. --Digest-58F03895-- 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 -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 25 Sep 1999 12:44:48 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 25 Sep 1999 12:44:15 -0400 (EDT) Received: via switchmail; Sat, 25 Sep 1999 12:44:14 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 25 Sep 1999 12:42:30 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 25 Sep 1999 12:42:21 -0400 (EDT) Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 25 Sep 1999 12:42:18 -0400 (EDT) Received: from micron (ehdup-v-3.rmt.net.pitt.edu [136.142.24.13]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Sat, 25 Sep 1999 12:41:55 -0400 (EDT) Message-Id: <199909251641.MAA27673@post-ofc05.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: wilderness-emergency-medicine@list.pitt.edu Date: Sat, 25 Sep 1999 12:43:58 -0400 MIME-Version: 1.0 Content-type: Multipart/Digest; boundary=Digest-5CB185F3 Subject: W-EMED even more vacuum mattress messages X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 537395328 0 1 P166F0.CNM --Digest-5CB185F3 X-cs: From: Self To: "joe ivy" Subject: Re: vacuum mattresses.. Cc: NCRC@ontosystems.com (NCRC Discussion List) Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/enriched; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Wed, 15 Jul 1998 10:27:34 -0400 Times New RomanOn 14 Jul 98, at 21:17, joe ivy wrote: Keith,Saw your post on the NCRC Dlist and had some quick questions. Where does one find one of these vacuum mattresses and how much does one cost? About $400-500 > Are they reusable or one time only? Reusable. Plus easily fixed with duct tape. > How do these things work? bunch of bean-bag-chair-type styronoodles in a big heavy plastic bag. When you suck out all the air, they get hard. > How durable are they? pretty solid, at least the models I've seen. > Will they work in a SKED? Yes, but they fill it up a bit more than with just a patient. Thought others might want to know too so I'm forwarding this to the NCRC list, too. --Digest-5CB185F3 X-cs: From: Self To: "joe ivy" Subject: Re: vacuum mattresses.. Cc: NCRC@ontosystems.com (NCRC Discussion List) Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Wed, 15 Jul 1998 17:54:44 -0400 On 15 Jul 98, at 13:53, joe ivy wrote: > Keith, > > Thanks for the quick reply+ACE- Just a couple more questions occurred to > me upon reading your reply. Where does one buy these mattresses? There are several suppliers, both moutain rescue outfitters like CMC and Weinel, and EMS suppliers. I'd recommend checking your local EMS supplier first. These are used by many ambulance companies. For that matter, check your local EMS agency and ask to borrow their catalogs. > Was the > price you quoted retail or wholesale? Just a rough guide. > How compact are they when packed > i.e will it fit inside a SKED pack? They're light but big, they usually come in their own stuffsack -- but the ideal I think is a Ferno with a vacuum mattress prepacked in it, ideal for most cave rescue. > Does the mattress completely surround > the patient and if so, does it also work as padding/insulation/vapor > barrier for in-cave transport? It is under and around but not over. It indeed is padding, insulation, and lower vapor barrier, as well as flotation. Adding a small warm cover and a tarp is all you need to add. ? One more quick question+ACE- How do you suck the air out of the mattress? They come with a lightweight hand- or foot- operated pump. And to be truthful, I haven't played around with the different models to know which is best. Maybe someone else on the list has experience with the various brands? --Digest-5CB185F3 Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Tue, 21 Jul 1998 09:27:27 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Tue, 21 Jul 1998 09:27:20 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Tue, 21 Jul 1998 09:27:18 -0400 (EDT) Received: from ontosystems.com (mail.ontosystems.com [166.82.129.17]) by post-ofc03.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Tue, 21 Jul 1998 09:27:14 -0400 (EDT) Message-ID: <5C00B82D01880100@ontosystems.com> X-SMF-Message-ID: 5C00B82D01880100 X-SMF-Hop-Count: 1 Date: Tue, 21 Jul 1998 09:27:34 -0400 Sender: NCRC Discussion List From: NCRC Discussion List To: NCRC Discussion List Subject: RE: Vacuum mattresses Mime-Version: 1.0 Content-Type: text/plain; charset="ISO-8859-1" Content-Transfer-Encoding: 7BIT Precedence: Bulk X-Mailer: InterChange (Hydra) SMTP v3.12 RC6 ******************************************************************** * NOTICE! * * The following information cannot be published without the * * expressed consent of the author. * ******************************************************************** On 21 Jul 1998 at 09:27, Peter Ludwig (peter.ludwig@bfi-bbrz.or.at) wrote: Tim and others wrote: > The MRA did some field testing of the Hartwell and MDI at the annual > conference in Provo in June 1997. Vacuum matreeses are pretty popular here in central Europe almost for decades (I know them for 20 years IMHO). Every single ambulance car has one or more in it. So we can get them easily at any time. BUT: The usual mattress is much to thick and too bulky for cave rescue, we may get only very small patients into it AND a normal stretcher. So we bought a thinner one for our cave rescue cache. As patients are always also put into a stretcher this is no drawback. But I like more the Swiss system with 2 component foam in a plastic foil bag. Advantages: Only two plastic bottels to carry (one about a liter, the other half of it). The compound produces mild heat when reacting. The 'mattress' is not affected by puncturing the foil. When necessary you may bend the patient at his/her hips without moving other body parts (you have to damage the foam there). If the patient is larger/smaller you can adapt foam volume. Drawbacks: One way road: When the compound has reacted you cannot change anything (they key is, as usual, experience). Training cost is higher (but you get plenty of foam for the price of one vacuum mattress). greetings from Austria, Peter --Digest-5CB185F3 Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Tue, 28 Jul 1998 02:26:09 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Tue, 28 Jul 1998 02:26:07 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Tue, 28 Jul 1998 02:26:07 -0400 (EDT) Received: from ontosystems.com (mail.ontosystems.com [166.82.129.17]) by post-ofc03.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Tue, 28 Jul 1998 02:26:04 -0400 (EDT) Message-ID: <0FBBB82D01880100@ontosystems.com> X-SMF-Message-ID: 0FBBB82D01880100 X-SMF-Hop-Count: 1 Date: Tue, 28 Jul 1998 02:08:36 -0400 Sender: NCRC Discussion List From: NCRC Discussion List To: NCRC Discussion List Subject: two component foam mattress Mime-Version: 1.0 Content-Type: text/plain; charset="ISO-8859-1" Content-Transfer-Encoding: 7BIT Precedence: Bulk X-Mailer: InterChange (Hydra) SMTP v3.12 RC6 ******************************************************************** * NOTICE! * * The following information cannot be published without the * * expressed consent of the author. * ******************************************************************** On 28 Jul 1998 at 02:08, Peter Ludwig (peter.ludwig@bfi-bbrz.or.at) wrote: Keith Konover wrote: > Hi, Peter. Who sells this two-component foam system? Nobody. It is so easy to do it by yourself. The Swiss cave rescue uses almost exclusively the so called 'Schwarzer Trage' (Schwarzer stretcher), this is a two piece, mummy shaped, pretty 'deep' stretcher. It is also adjustable for the victim's size. And the Swiss make a plastic bag of about the same shape out of relatively sturdy plastic (lets say at least twice the thickness than a heavy duty garbage bag). If you have some experience doing so, you may easily weld your own bag with a soldering iron (and a special tip for it) in a few minutes. These two component foams where very popular about twenty years ago for insolating many things in your house, nowadays tubes are more common, but the two component type is still available. I will look for recommended brands. I think you need an accelarator to get the thing working in 10 minutes at alpine cave temperature. The Swiss carry the componets in two Nalgene bottles, the larger one has enough space left to mix the two components in it (shake it). The you fill it into the plastic bag and distribute it (experience helps, as always). You put the bag into the stretcher and then the victim. You have some minutes time to 'adjust' the foam distribution, this is the time when the foam has its final volume but is still soft, so there is no danger that the victim gets jammed in. While reacting the foam produces a mild warmth, wich is usually comfortable. In the Schwarzer stretcher the victim is covered around the sides the whole 'thickness' of the body. As the stretcher is adjustable in the length, but not in the other dimensions, the actual foam volume may vary (not possible with a vacuum mattress), pieces of hardened foam may be cut or broken away. There were several US cavers at the cave rescue day in La Chaux de Fonds last year, maybe some of them have videoed it. Also Dr. Noel Sloan has a good slide show about the Schwarzer stretcher and the foam mattress (has he disappeared completly from cave rescue?). I'm looking for a website about these things, maybe the Swiss have one greetings from Austria, Peter --Digest-5CB185F3 Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Tue, 28 Jul 1998 03:13:45 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Tue, 28 Jul 1998 03:13:44 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Tue, 28 Jul 1998 03:13:44 -0400 (EDT) Received: from ontosystems.com (mail.ontosystems.com [166.82.129.17]) by post-ofc03.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Tue, 28 Jul 1998 03:13:42 -0400 (EDT) Message-ID: X-SMF-Message-ID: A9BCB82D01880100 X-SMF-Hop-Count: 1 Date: Tue, 28 Jul 1998 03:03:42 -0400 Sender: NCRC Discussion List From: NCRC Discussion List To: NCRC Discussion List Subject: RE: Vacuum mattresses Mime-Version: 1.0 Content-Type: text/plain; charset="ISO-8859-1" Content-Transfer-Encoding: 7BIT Precedence: Bulk X-Mailer: InterChange (Hydra) SMTP v3.12 RC6 ******************************************************************** * NOTICE! * * The following information cannot be published without the * * expressed consent of the author. * ******************************************************************** On 28 Jul 1998 at 03:03, Bill Frantz (frantz@netcom.com) wrote: On 27 Jul 1998 at 18:59, Keith Conover, M.D., FACEP (kconover+@pitt.edu) wrote: > >Hi, Peter. Who sells this two-component foam system? I'd like to >see if they have a distributor in the U.S., or would be willing to sell >some for evaluation here. Two component foam plastic is available retail from TAP Plastics, with several stores in the San Francisco Bay area. It is used for filling 55 gallon drums to turn them into buoys for boating and harbor use. You may be able to find it locally in a boating supply store. ------------------------------------------------------------------------- Bill Frantz | If hate must be my prison | Periwinkle -- Consulting (408)356-8506 | lock, then love must be | 16345 Englewood Ave. frantz@netcom.com | the key. - Phil Ochs | Los Gatos, CA 95032, USA --Digest-5CB185F3 X-cs: From: Self To: Art Fortini Subject: Re: Vacuum body splints Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Wed, 23 Sep 1998 14:33:13 -0400 Hi, Art. Your concenrs seem reasonable. To me, a log roll _onto_ a vacuum splint makes no sense for the reasons you point out. Solution is simple: place the mattress in the litter. Log roll the patient, LIFT the patient to a standing position, put the litter under, and then gently lower the patient onto the middle of the stretcher/vacuum mattress combination. An even nicer solution is to to a clothing/webbing lift with people straddling the patient (often the best you can do in a cave), and then slide the litter/vacuum mattress under people's legs, gently lowering the patient onto the mattress. May I use your email message for teaching purposes with our group? It's an excellent summary of how not to use a vacuum splint! And you might want to post this reply wherever it might do the most good. Thanks. Take care. On 22 Sep 98, at 20:24, Art Fortini wrote: > Keith, > > I posted a question to thelister a month or so ago regarding full body > vacuum splints and never quite got an answer to my question.  Since I see > your name on the Cavers' Digest every now and then (i.e., you're a caver > like me), you have a little more credibility than most.  The MD after your > name helps too. > > Anyway, the question is how well is the spine protected while getting a > person INTO a vacuum splint?  I was the simulated victim once, and the > amount of motion required to get me in was pathetic.  Logrolling someone > onto a limp noodle just doesn't work very well. > > Specifically, the main problems were these: > > 1. The device is very thick.  While trying to logroll me onto it, at one > point during the "downward" part of the roll, all of my weight was > supported on the edge of the device.  It was similar to lying on a (well > paded) log which was parallel to, but offset from, my spine.  This can't > be good if someone has a real injury. > > 2. Because of the thickness, it was impossible to get it centered > relative to me while I was > lying on my side.  After they got me supine again (with the > aforementioned lump next to my spine), they had to slide me sideways to > get me centered.  They tried sliding me up & down like what you would do > for a person on a longboard, but that didn't work.  So then they tried > dragging me sideways relative to the device, and that didn't work much > better. (But they did manage to put a nice "S" curve in my back.)  > Eventually, they just manhandled me (I only weight 130 lbs) into > position.  Not very good for the spine, but they did get me centered! > > 3. Because the device had poor rigidity, the downstroke of the logroll > resulted in a significant amount of twisting of my spine.  I think the > fact that I was offset from the centerline exacerbated the problem. > > 4. After the logroll debacle, they tried just lifting me with 4 guys and > having a 5th person slide the device under me.  This was probably the > smoother of the two options, but the amount of motion my back experienced > was, IMHO, completely unacceptable. > > While I agree that it was by far the most comfortable, and possibly most > effective, spinal immobilization device I had ever been affixed to, the > amount of manhandling required to get me in offset any possible benefit. > Quite honestly, if I got injured and saw someone coming up to me with one > of those things, I would run away from them with my last dying breath.  > (Yes, I have a pretty strong opinion after having been a simulated > victim.) > > >From what I've seen on the lister, most people seem to like them.  > Myself included if I ignore the above concerns.  Since you seem to be a > supporter, please help me out.  How do YOU get people into one of these > things without bending them over a log or pushing/pulling them sideways?  > Has anyone ever done a retrospective study on the efficacy of these > devices? > > FYI, I've been an (ambulance based) EMT for almost 15 years and with SAR > for the last 7.  I am well aware that nothing currently in use is > perfect.  Wooden backboards, scoops, miller boards, KEDs, etc, all have > limitations.  In the wilderness, things get even more out of control > because the ground is NEVER flat.  At least in the urban setting, they > land on flat ground once in a while.  But if people had such a hard time > making the vacuuim splint work under ideal conditions, I have to be > skeptical. > > I've seen studies about the amount of motion caused by the logroll > maneuver.  Ditto for the use of a scoop stretcher.  Ditto for logrolling > them once they are secured and vomit.  Nothing currently in use solves all > the world's problems, and I don't expect the vacuum device to so either.  > As I see it, the key is CAUSE as little motion as possible during > application of the device, and ALLOW as little motion as possible once > they are secured.  While I believe the vacuum splint excells on the latter > point, I feel it is exceedingly poor one the former. > > So those are my ramblings.  Please try to make a convert out of  me.  > Thanks a bunch! > > - Art Fortini >   >   >   >   >   > > --Digest-5CB185F3-- 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 -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 25 Sep 1999 12:42:46 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 25 Sep 1999 12:42:12 -0400 (EDT) Received: via switchmail; Sat, 25 Sep 1999 12:42:11 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 25 Sep 1999 12:41:09 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 25 Sep 1999 12:40:51 -0400 (EDT) Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 25 Sep 1999 12:40:45 -0400 (EDT) Received: from micron (ehdup-v-3.rmt.net.pitt.edu [136.142.24.13]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 25 Sep 1999 12:40:39 -0400 (EDT) Message-Id: <199909251640.MAA27423@post-ofc05.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: Ed , wilderness-emergency-medicine@list.pitt.edu Date: Sat, 25 Sep 1999 12:42:11 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED Full body Vacume splints In-reply-to: <71CC974D48FCD111825300A0C990B705047D10@host-208-170-96-33.tlsinc.com> X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P79660.CNM Allegheny Mountain Rescue Group has a MDI mattress and is generally happy with it. I'll post some MIME digests of some relevant messages from various lists under separate cover. You can also search the list archives at www.wemsi.org for older messages on the topic. On 25 Sep 99, at 11:28, Ed wrote: > Greetings from North Alabama. Have a question for the list about the full > body vacume splints for use in rough country SAR work and Cave Rescue. > > What is available that people are actually using in the field (other than > sleeping, I mean conserving your energy at the cache, Keith :) ) and are > they a worthwhile addition vs the cost and durability ? > > What units would the list advise using or not using and why. I am trying > to work up some justification for adding one to our gear cache. > > Thanks for the help. > > > Ed Nicholas, EMT-D > Chief of Operations, > Huntsville Cave Rescue Unit, Inc > Operations Officer, > Huntsville Emergency Medical Services, Inc > High Angle - Rough Terrain (HART) Team > Huntsville, Alabama > KD4WNJ > 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 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 25 Sep 1999 12:42:21 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 25 Sep 1999 12:41:48 -0400 (EDT) Received: via switchmail; Sat, 25 Sep 1999 12:41:48 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 25 Sep 1999 12:41:01 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 25 Sep 1999 12:40:43 -0400 (EDT) Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 25 Sep 1999 12:40:39 -0400 (EDT) Received: from micron (ehdup-v-3.rmt.net.pitt.edu [136.142.24.13]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Sat, 25 Sep 1999 12:40:37 -0400 (EDT) Message-Id: <199909251640.MAA27414@post-ofc05.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: wilderness-emergency-medicine@list.pitt.edu Date: Sat, 25 Sep 1999 12:40:13 -0400 MIME-Version: 1.0 Content-type: Multipart/Digest; boundary=Digest-2AE61646 Subject: W-EMED more vacuum mattress messages X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 537395328 0 1 P09510.CNM --Digest-2AE61646 X-cs: From: Self To: sar-l@listserv.islandnet.com,asrc-field@virginia.edu Subject: MDI vacuum mattress and V-Vac suction device Cc: mra@altadena.net,NCRC@ontosystems.com (NCRC Discussion List),Allegheny Mtn. Rescue Maillist Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/enriched; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Mon, 21 Sep 1998 20:25:18 -0400 Just got a MDI vacuum mattress for Allegheny Mountain Rescue Group from Moore Medical (1-800-234-1464 x5431, Manufacturer's PN 81-A5000, Moore Medical PN 53719, Full Mattress Set: mattress, pump, adapter, case, $360.) Didn't like the light but BIG pump that comes with it. Got a lightweight V-Vac handheld hand-powered suction device (from Kim Rosser at Parr Emergency Product Sales, P.O. Box 7, Galloway, OH 43119, 412-926-3644, as I remember it was about $40). Turns out that if you cut the little adapter off the end of the MDI pump's hose, it fits perfectly into the suction end of the V-Vac (almost as if maybe it was designed that way -- maybe it was). There is a little hole in the rim of the adapter, and I put a piece of small accessory cord through this, tied a stopper knot, and attached the other end to the frame of the V-vac so it can't (well, less likely to) get lost. Takes about 90-100 "pumps" with the V-vac to evacuate the splint. Not bad. So it's lighter, smaller, and also gives you airway suction. What a deal! I'll be ordering some extras of these tips from MDI if I can - those of you who have MDI mattresses (e.g., Blue Ridge Mountain Rescue Group -- saw three of them in your locker a couple of weeks ago) might want to look into this. Medical Devices International is reachable at (800) 323-9035 Take care, all. --Digest-2AE61646 X-cs: From: Self To: sar-l@listserv.islandnet.com,NCRC Discussion List Subject: Re: MDI vacuum mattress and V-Vac suction device Cc: mra@altadena.net,Allegheny Mtn. Rescue Maillist Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Tue, 22 Sep 1998 21:55:08 -0400 On 21 Sep 98, at 20:53, Buddy Lane wrote: > Also note that MDI sells a smaller metal pump, which we use at CHCRS. > > Please be advised that the plastic pump that Keith writes about, will > NOT work in cold conditions!! We found this out the hard way; several > years ago. > > I would advise all, to check your pump for cold weather use, no matter > what the type. In addition keep the O-ring coated with silicone > grease. > > Buddy Lane, Captain > Chattanooga Hamilton County Rescue Service > Cave / Cliff Unit Hi, Buddy. What's the problem in cold? It may be that redesign of the V-Vac over the years has fixed this. Airway suction that doesn't work in the cold can be a problem, too. I've seen a small, handheld suction pump device similar to the V-vac in size and design but much heavier -- not usable for airway suction, it looks as though it's designed for vacuum splints. Blue Ridge Mountain Rescue Group in Charlottesville, VA, has one. Is that the small MDI pump you're talking about? Thanks. --Digest-2AE61646-- 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 -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 25 Sep 1999 12:42:15 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 25 Sep 1999 12:41:42 -0400 (EDT) Received: via switchmail; Sat, 25 Sep 1999 12:41:42 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 25 Sep 1999 12:40:55 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 25 Sep 1999 12:40:37 -0400 (EDT) Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 25 Sep 1999 12:40:33 -0400 (EDT) Received: from micron (ehdup-v-3.rmt.net.pitt.edu [136.142.24.13]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Sat, 25 Sep 1999 12:39:57 -0400 (EDT) Message-Id: <199909251639.MAA27263@post-ofc05.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: wilderness-emergency-medicine@list.pitt.edu Date: Sat, 25 Sep 1999 12:38:35 -0400 MIME-Version: 1.0 Content-type: Multipart/Digest; boundary=Digest-750E9A4E Subject: W-EMED vacuum mattress messages X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 537395328 0 1 P7AD50.CNM --Digest-750E9A4E Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Thu, 27 Aug 1998 18:34:37 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Thu, 27 Aug 1998 18:34:35 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Thu, 27 Aug 1998 18:34:35 -0400 (EDT) Received: from ns.altadena.net (ns.altadena.net [206.126.144.2]) by post-ofc01.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Thu, 27 Aug 1998 18:34:33 -0400 (EDT) Received: (from majordom@localhost) by ns.altadena.net (8.9.1/8.8.6) id PAA01950 for mra-outgoing; Thu, 27 Aug 1998 15:28:20 -0700 (PDT) X-Authentication-Warning: ns.altadena.net: majordom set sender to owner-mra@altadena.net using -f Received: from merlin.sedona.net (root@merlin.sedona.net [204.245.58.252]) by ns.altadena.net (8.9.1/8.8.6) with ESMTP id PAA01924 for ; Thu, 27 Aug 1998 15:28:16 -0700 (PDT) Received: from [204.245.58.60] (client51.sedona.net [204.245.58.60]) by merlin.sedona.net (8.9.1/8.8.5) with SMTP id PAA28556; Thu, 27 Aug 1998 15:27:55 -0700 (MST) Message-Id: <199808272227.PAA28556@merlin.sedona.net> Subject: Re: vacuum splints Date: Thu, 27 Aug 98 14:47:23 -0000 x-mailer: Claris Emailer 1.1 From: Ropes That Rescue To: , "MRA" , "Jim Koile" Mime-Version: 1.0 Content-Type: text/plain; charset="US-ASCII" Sender: owner-mra@altadena.net Precedence: bulk We use the Hartwell Medical full bdy air splint from Bound Tree EMS. It is very rugged and I like the air orifice at ether end. Sincerely yours---in safety, Reed Thorne Ropes That Rescue Ltd. eMail: ropes@sedona.net Web Site: http://www.sedona.net/ropes " T h e A R T o f C l e a n R i g g i n g " --Digest-750E9A4E Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Fri, 28 Aug 1998 01:05:01 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Fri, 28 Aug 1998 01:05:00 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Fri, 28 Aug 1998 01:04:59 -0400 (EDT) Received: from ns.altadena.net (ns.altadena.net [206.126.144.2]) by post-ofc02.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Fri, 28 Aug 1998 01:04:56 -0400 (EDT) Received: (from majordom@localhost) by ns.altadena.net (8.9.1/8.8.6) id VAA13346 for mra-outgoing; Thu, 27 Aug 1998 21:58:57 -0700 (PDT) X-Authentication-Warning: ns.altadena.net: majordom set sender to owner-mra@altadena.net using -f Received: from rkymtnhi.com (rkymtnhi.com [204.131.46.200]) by ns.altadena.net (8.9.1/8.8.6) with ESMTP id VAA13342 for ; Thu, 27 Aug 1998 21:58:53 -0700 (PDT) Received: from Frank.rkymtnhi.com (204.131.46.122) by rkymtnhi.com with SMTP (Eudora Internet Mail Server 1.1.2); Thu, 27 Aug 1998 22:58:15 -0600 Message-ID: <35E63774.1A07@rkymtnhi.com> Date: Thu, 27 Aug 1998 22:52:04 -0600 From: "Frank J. Nieto" X-Mailer: Mozilla 3.01C-KIT (Win95; I) MIME-Version: 1.0 To: mra lister Subject: Vacuum Mattress Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-mra@altadena.net Precedence: bulk Re:Vacuum mattress. We have been using the Vac Mattress (Bean Bag as we call it) for approximately 3 years,, we have found it to be very effective for back country evacuation of trauma patients. It provides a rigid support for the patients spine and allows for the hollows of the body that a typical backboard doesnt. It is much more comfortable for the patient for extended extrications. We used it for our MRA certification in 1995 and the patient said afterwards that it was the most comfortable that she had ever been for a certification. Some Drawbacks: 1. you need a backup. 2. When it springs a leak it is useless as a spinal immobilization device. 3. it can be repaired, but hartwell guards the kits like gold.. it took several weeks to get a kit and then it would only cover 2 holes. 4. It does have some flex to it,, so i reccomend using it in conjunction with a backboard under it for rigidity. 5. We have had our splint in repair with Hartwell for about 5 weeks , not a good turnaround time, hence the need for a spare. 6. They cost about $500.00 as opposed to $150.00 for a bb. Conclusion: The Hartwell Vacuum Splint is a very useful tool, but you must make some changes in your regular SOP's and training. as well as make sure you protect it both in the field and in storage on your truck so as not to rub holes into the splint. Frank Nieto, NREMT-P Grand County SAR, Field Director --Digest-750E9A4E Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Fri, 28 Aug 1998 08:56:24 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Fri, 28 Aug 1998 08:56:22 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Fri, 28 Aug 1998 08:56:22 -0400 (EDT) Received: from ns.altadena.net (ns.altadena.net [206.126.144.2]) by post-ofc01.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Fri, 28 Aug 1998 08:56:20 -0400 (EDT) Received: (from majordom@localhost) by ns.altadena.net (8.9.1/8.8.6) id FAA26422 for mra-outgoing; Fri, 28 Aug 1998 05:47:03 -0700 (PDT) X-Authentication-Warning: ns.altadena.net: majordom set sender to owner-mra@altadena.net using -f Received: from shadow.dimensional.com (root@shadow.pagan.net [206.124.26.20]) by ns.altadena.net (8.9.1/8.8.6) with ESMTP id FAA26418 for ; Fri, 28 Aug 1998 05:46:59 -0700 (PDT) Received: from oemcomputer (p08.pm3c04.pm.dimcom.net [206.124.5.201]) by shadow.dimensional.com (8.9.1/8.9.1) with SMTP id GAA04399 for ; Fri, 28 Aug 1998 06:46:57 -0600 (MDT) From: "Jeff Sparhawk" To: "mra lister" Subject: RE: Vacuum Mattress Date: Fri, 28 Aug 1998 06:46:04 -0600 Message-ID: <000101bdd281$d2099760$a5057cce@oemcomputer> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 (Normal) X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook 8.5, Build 4.71.2173.0 Importance: Normal X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3155.0 In-Reply-To: <35E63774.1A07@rkymtnhi.com> Sender: owner-mra@altadena.net Precedence: bulk My foggy memory seems to be telling me that a good old bike tube patch kit works well on punctured bean bags. Also, from fairly extensive testing over the last 10ish years RMRG has chosen to go with the Germa bags. I think you have to go to Sweden to get them, but they are far superior to any of the other bags around. Significant factors are outside dimensions of bag, number of beans, size of beans, reliability of valve and reliability / ease of use of the pump. --Jeff Sparhawk Some Drawbacks: 1. you need a backup. 2. When it springs a leak it is useless as a spinal immobilization device. 3. it can be repaired, but hartwell guards the kits like gold.. it took several weeks to get a kit and then it would only cover 2 holes. 4. It does have some flex to it,, so i reccomend using it in conjunction with a backboard under it for rigidity. 5. We have had our splint in repair with Hartwell for about 5 weeks , not a good turnaround time, hence the need for a spare. 6. They cost about $500.00 as opposed to $150.00 for a bb. --Digest-750E9A4E Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Fri, 28 Aug 1998 11:31:12 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Fri, 28 Aug 1998 11:31:09 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Fri, 28 Aug 1998 11:31:09 -0400 (EDT) Received: from ns.altadena.net (ns.altadena.net [206.126.144.2]) by post-ofc01.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Fri, 28 Aug 1998 11:31:07 -0400 (EDT) Received: (from majordom@localhost) by ns.altadena.net (8.9.1/8.8.6) id IAA00572 for mra-outgoing; Fri, 28 Aug 1998 08:22:36 -0700 (PDT) X-Authentication-Warning: ns.altadena.net: majordom set sender to owner-mra@altadena.net using -f Received: from preytor.ecentral.COM (root@preytor.ecentral.com [206.64.70.3]) by ns.altadena.net (8.9.1/8.8.6) with ESMTP id IAA00568 for ; Fri, 28 Aug 1998 08:22:32 -0700 (PDT) Received: from Default (ppp64.ecentral.com [206.64.70.64]) by preytor.ecentral.COM (8.8.7/8.6.9) with SMTP id JAA14840 for ; Fri, 28 Aug 1998 09:19:59 -0600 Date: Fri, 28 Aug 1998 09:19:59 -0600 Message-Id: <199808281519.JAA14840@preytor.ecentral.COM> X-Sender: hmpaul@pop.ecentral.com X-Mailer: Windows Eudora Pro Version 2.1.2 Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" To: mra@altadena.net From: "Howard M. Paul" Subject: Re: Vacuum Mattress Sender: owner-mra@altadena.net Precedence: bulk At 10:52 PM 8/27/98 -0600, you wrote: >We used it for our MRA certification in 1995 and the patient said >afterwards that it was the most comfortable that she had ever been for a >certification. > >Some Drawbacks: > >1. you need a backup. >2. When it springs a leak it is useless as a spinal immobilization >device. >3. it can be repaired, but hartwell guards the kits like gold.. it took >several weeks to get a kit and then it would only cover 2 holes. >4. It does have some flex to it,, so i reccomend using it in >conjunction with a backboard under it for rigidity. >5. We have had our splint in repair with Hartwell for about 5 weeks , >not a good turnaround time, hence the need for a spare. >6. They cost about $500.00 as opposed to $150.00 for a bb. > >Conclusion: > >The Hartwell Vacuum Splint is a very useful tool, but you must make some >changes in your regular SOP's and training. as well as make sure you >protect it both in the field and in storage on your truck so as not to >rub holes into the splint. > >My foggy memory seems to be telling me that a good old bike tube patch kit >works well on punctured bean bags. Also, from fairly extensive testing over >the last 10ish years RMRG has chosen to go with the Germa bags. I think you >have to go to Sweden to get them, but they are far superior to any of the >other bags around. Significant factors are outside dimensions of bag, >number of beans, size of beans, reliability of valve and reliability / ease >of use of the pump. Jeff and Frank: Having evaluated both the Hartwell brand and MDI/Germa brand bean bags before buying, I agree with Jeff that the MDI/Germa are superior to the Hartwell. Hartwell copied the Germa brand bag using lower quality material -- I assume to come up with a less expensive product. I was unimpressed with the projected durability of the material *for SAR & mountain rescue.* It ought to be perfectly adequate for ambulance-based EMS. It is my opinion as well Jeff, that the red bags -- the MDI/Germa -- have a much tougher fabric. I know of only one air leak in all our bags in three years. Jeff, you're right about patches. The Germa patch kit is very much like a vulcanized rubber patch kit for bike tubes. Now for brand history. The Germa bag was not manufactured here in the states when it was first introduced her. The company president was a Swede who lived in Loveland, Colo. He could not find a US fabricator that could meet his quality control standards. The import duty drove the price skyward. Hence, he sold the US manufacturing and sales rights to MDI -- so the MDI bag *is* the Germa brand bag (I've seen both). Howard _______________________________ Howard M. Paul Photography for Communication and Commerce and E m e r g e n c y ! S t o c k Denver, Colorado USA http://www.photofolio.com/paul Phone: (303) 829-5678 Fax: (303) 871-8356 --Digest-750E9A4E Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Fri, 28 Aug 1998 13:03:08 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Fri, 28 Aug 1998 13:03:06 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Fri, 28 Aug 1998 13:03:05 -0400 (EDT) Received: from ns.altadena.net (ns.altadena.net [206.126.144.2]) by post-ofc02.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Fri, 28 Aug 1998 13:03:01 -0400 (EDT) Received: (from majordom@localhost) by ns.altadena.net (8.9.1/8.8.6) id JAA04061 for mra-outgoing; Fri, 28 Aug 1998 09:56:56 -0700 (PDT) X-Authentication-Warning: ns.altadena.net: majordom set sender to owner-mra@altadena.net using -f Received: from wali.com (spectralogic.com [205.184.208.2]) by ns.altadena.net (8.9.1/8.8.6) with SMTP id JAA04057 for ; Fri, 28 Aug 1998 09:56:52 -0700 (PDT) Received: from reactor.spectralogic.com (reactor [205.184.208.138]) by wali.com (8.6.12/8.6.12) with ESMTP id KAA15170 for ; Fri, 28 Aug 1998 10:49:50 -0600 Received: by reactor with Internet Mail Service (5.5.1960.3) id <3D1DZGJK>; Fri, 28 Aug 1998 10:53:44 -0600 Message-ID: From: Steve Kelleher To: "'mra@altadena.net'" Subject: RE: vacuum splints Date: Fri, 28 Aug 1998 10:53:36 -0600 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.1960.3) Content-Type: text/plain Sender: owner-mra@altadena.net Precedence: bulk >> Also, you do not need to use a c-collar if you have applied the mattress properly. >> ... >> Ken Zafren, MD >> MRA Medical Committee Ken; I agree that this is theoretically possible; however, in practice we've not been able to get as close a fit between the head and shoulders using the bean bag as we have with a c-collar. Our protocol is to apply a c-collar, form the vac. spint as well as possible around the head/neck/shoulders, then to fold the corners of the bag down at the head (e.g. make "dog ears") so we can apply tape at the forehead/chin as a redundant backup (even though it doesn't always adhere well, but I digress...). We then evacuate the splint. On tests with this approach, we've found that using a c-collar in tandem with the vacuum splint provides better immobilization than with the splint alone and reduces the need to get a "perfect" fit with the bean bag. Given the light weight of a c-collar and the cool new "one size fits all" models, we have opted to continue using c-collars within the vacuum splint. Regards; Steve Kelleher Alpine Rescue Team Evergreen, CO. --Digest-750E9A4E Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Fri, 28 Aug 1998 13:17:20 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Fri, 28 Aug 1998 13:17:19 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Fri, 28 Aug 1998 13:17:18 -0400 (EDT) Received: from ns.altadena.net (ns.altadena.net [206.126.144.2]) by post-ofc01.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Fri, 28 Aug 1998 13:17:15 -0400 (EDT) Received: (from majordom@localhost) by ns.altadena.net (8.9.1/8.8.6) id KAA04466 for mra-outgoing; Fri, 28 Aug 1998 10:10:17 -0700 (PDT) X-Authentication-Warning: ns.altadena.net: majordom set sender to owner-mra@altadena.net using -f Received: from spot.Colorado.EDU (spot.Colorado.EDU [128.138.129.2]) by ns.altadena.net (8.9.1/8.8.6) with ESMTP id KAA04443 for ; Fri, 28 Aug 1998 10:09:41 -0700 (PDT) Received: from ecch41.colorado.edu (ecch41.Colorado.EDU [128.138.120.41]) by spot.Colorado.EDU (8.9.0/8.9.0/ITS-5.0/bigseven) with SMTP id LAA14905; Fri, 28 Aug 1998 11:09:02 -0600 (MDT) Message-Id: <3.0.5.32.19980828110951.007a3100@spot.colorado.edu> X-Sender: whitehes@spot.colorado.edu X-Mailer: QUALCOMM Windows Eudora Light Version 3.0.5 (32) Date: Fri, 28 Aug 1998 11:09:51 -0600 To: "Jeff Sparhawk" , "mra lister" From: Scott Whitehead Subject: RE: Vacuum Mattress In-Reply-To: <000101bdd281$d2099760$a5057cce@oemcomputer> References: <35E63774.1A07@rkymtnhi.com> Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Sender: owner-mra@altadena.net Precedence: bulk Hi all, I am going to repost something that I sent out a few months ago about the RMRG method for using the vacuum mattress (aka - bean bag.) As Jeff Sparhawk mentioned, RMRG uses the "Germa" bag. We looked a several different models over the past 10 or so years and have found these to be superior. The first 3 or 4 we bought were made by "Bo" in Loveland, CO when he moved over here from Sweeden. Specifically, the new "Germa" bags that we have purchased recently (may be a different name now since Germa was bought out by MDI) are made in Sweeden (not the same as the MDI bag, Howard). Jeff or I will try to update all of you with the current manufacturer. The reason that we chose this bag is that the center of gravity of the packaged pt. is lower in the litter (ie the bag is not as thick as the other US models.) _____________________________________________ Here is the RMRG method: Assemble litter and beanbag as one unit. Spread out beans so that there is a nice uniform surface. Using 7 rescuers (one at head, set at shoulders, set at waist, set at feet/legs) lift pt. up gently. Note that motion is only UP, not sideways, etc. When pt. up about 20", move litter/bean-bag combo under pt. and lower pt. into litter. Form bean-bag around head and feet, apply foot straps (to legs and pelvis w/o injury only) place helmet in position, and suck out air. Tape head to bean-bag (never tape to litter, too much motion). Place dark safety glasses on pt. to protect eyes from sun and debris. With many rescuers doing the lift, the patient has little movement to body if done correctly. It is important to lift up only and not try to move the pt. sideways otherwise you do risk a rough loading. RMRG has been using the bean-bag with our litter for 10 years now. I am not sure how long other teams have been using them, but I think that we have been pioneering their use in mountain rescue in Colorado. A retired member of RMRG who is now an emergency physician has written several papers about bean-bag use in wilderness settings. RMRG has accumulated a lot of experience in the bean-bag/litter combo. There are some fine points that must be considered that I am not sure many other users look at: 1. Do not use a bean-bag that is very thick. Pt. must be kept "low" in litter to provide better side protection and lower center of gravity. Thick bean bags act just a slight step above a back-board. There is still too much sideways motion because the bag can-not form around to the side of the pt. 2. Avoid using a chicken-wire stokes litter. A litter of this sort does not provide enough protection to the bean-bag against punctures. And a punctured bean-bag takes the pt. out of spinals (against most EMS protocols). 3. Load as a system described above - less steps makes a happier pt. and a faster rescue. 4. Secure bean-bag to litter sides. This prevents bean-bag from sliding down the litter on scree evac. 5. Always keep pump with bean-bag in case slow leak develops. 6. If possible, send a trained rescuer to hospital to make sure ED staff does not destroy bean bag with trama shears, etc. This last part can be avoided by doing inservices with your local ED staff (be sure to include x-ray staff). The bean-bag is still new enough in US EMS that many ED staff really don't know what to do with a bean-bag once it is in their care. Scott Whitehead Emissary to the Outside World Rocky Mountain Rescue Group - Boulder, CO --Digest-750E9A4E Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Fri, 28 Aug 1998 13:19:46 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Fri, 28 Aug 1998 13:19:40 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Fri, 28 Aug 1998 13:19:39 -0400 (EDT) Received: from ns.altadena.net (ns.altadena.net [206.126.144.2]) by post-ofc02.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Fri, 28 Aug 1998 13:19:35 -0400 (EDT) Received: (from majordom@localhost) by ns.altadena.net (8.9.1/8.8.6) id KAA04518 for mra-outgoing; Fri, 28 Aug 1998 10:13:34 -0700 (PDT) X-Authentication-Warning: ns.altadena.net: majordom set sender to owner-mra@altadena.net using -f Received: from spot.Colorado.EDU (spot.Colorado.EDU [128.138.129.2]) by ns.altadena.net (8.9.1/8.8.6) with ESMTP id KAA04511 for ; Fri, 28 Aug 1998 10:12:58 -0700 (PDT) Received: from ecch41.colorado.edu (ecch41.Colorado.EDU [128.138.120.41]) by spot.Colorado.EDU (8.9.0/8.9.0/ITS-5.0/bigseven) with SMTP id LAA16568; Fri, 28 Aug 1998 11:11:59 -0600 (MDT) Message-Id: <3.0.5.32.19980828111248.007b55b0@spot.colorado.edu> X-Sender: whitehes@spot.colorado.edu X-Mailer: QUALCOMM Windows Eudora Light Version 3.0.5 (32) Date: Fri, 28 Aug 1998 11:12:48 -0600 To: zafren@corecom.net (Ken Zafren, MD), mra@altadena.net From: Scott Whitehead Subject: Re: vacuum splints In-Reply-To: Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Sender: owner-mra@altadena.net Precedence: bulk >Bill Clem has developed a "soft-evac" system which incorporates a vacuum >splint inside a durable fabric cover and has a sleeping bag top which zips >to the vacuum splint. This system incorporates stays for the necessar >extra rigidity and does not require a litter. But this would not provide as much patient and bean bag protection (and enough lateral stability) for rough scree evacs thru brush, trees, etc. would it? Scott Whitehead Emissary to the Outside World Rocky Mountain Rescue Group - Boulder, CO --Digest-750E9A4E Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Fri, 28 Aug 1998 12:58:14 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Fri, 28 Aug 1998 12:58:09 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Fri, 28 Aug 1998 12:58:09 -0400 (EDT) Received: from ns.altadena.net (ns.altadena.net [206.126.144.2]) by post-ofc03.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Fri, 28 Aug 1998 12:58:04 -0400 (EDT) Received: (from majordom@localhost) by ns.altadena.net (8.9.1/8.8.6) id JAA03838 for mra-outgoing; Fri, 28 Aug 1998 09:51:49 -0700 (PDT) X-Authentication-Warning: ns.altadena.net: majordom set sender to owner-mra@altadena.net using -f Received: from home.corecom.net (root@[199.237.128.11]) by ns.altadena.net (8.9.1/8.8.6) with ESMTP id JAA03833 for ; Fri, 28 Aug 1998 09:51:43 -0700 (PDT) Received: from [10.4.1.122] (anc8163-135.corecom.net [208.161.163.135]) by home.corecom.net (8.8.7/8.8.7) with SMTP id IAA11203 for ; Fri, 28 Aug 1998 08:21:06 -0800 (AKDT) X-Sender: zafrenpp@pop.corecom.net Message-Id: Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Date: Fri, 28 Aug 1998 08:59:31 -0900 To: mra@altadena.net From: zafren@corecom.net (Ken Zafren, MD) Subject: Re: vacuum splints Sender: owner-mra@altadena.net Precedence: bulk There is clearly a lot of interest in and fairly widespread use of vacuum splints. Howard Paul has asked me to explain my remark about not needing a c-collar. There may be situations in which a c-collar and backboard may help with extrications (from a vehicle or aircraft), but once the patient is positioned on the vacuum splint, the c-collar may be removed and the splint molded to the patient's back, head and neck. Tape is useful across the forehead, just as with c-collar and backboard. The splint can also be used with a c-collar, but I think this might make it harder to fit. Bill Clem has developed a "soft-evac" system which incorporates a vacuum splint inside a durable fabric cover and has a sleeping bag top which zips to the vacuum splint. This system incorporates stays for the necessar extra rigidity and does not require a litter. Thanks to those who compared the different brands and for the suggestion about a bicycyle tire patch kit. Ken Zafren Ken Zafren, MD, FAAEM, FACEP 10181 Curvi St. Anchorage, AK 99516 USA phone: +1 907 346 2333 fax: +1 907 346-4445 e-mail: zafren@corecom.net --Digest-750E9A4E Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Sun, 30 Aug 1998 13:19:28 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Sun, 30 Aug 1998 13:19:24 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Sun, 30 Aug 1998 13:19:23 -0400 (EDT) Received: from ns.altadena.net (ns.altadena.net [206.126.144.2]) by post-ofc02.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Sun, 30 Aug 1998 13:19:19 -0400 (EDT) Received: (from majordom@localhost) by ns.altadena.net (8.9.1/8.8.6) id KAA29740 for mra-outgoing; Sun, 30 Aug 1998 10:11:57 -0700 (PDT) X-Authentication-Warning: ns.altadena.net: majordom set sender to owner-mra@altadena.net using -f Received: from imo28.mx.aol.com (imo28.mx.aol.com [198.81.17.72]) by ns.altadena.net (8.9.1/8.8.6) with ESMTP id KAA29736 for ; Sun, 30 Aug 1998 10:11:53 -0700 (PDT) From: Swp123@aol.com Received: from Swp123@aol.com by imo28.mx.aol.com (IMOv16.3) id XESJa27566; Sun, 30 Aug 1998 13:10:34 -0400 (EDT) Message-ID: <85cbb0eb.35e9878a@aol.com>> Date: Sun, 30 Aug 1998 13:10:34 EDT To: sprhwk@dim.com, mra@altadena.net Mime-Version: 1.0 Subject: Re: Vacuum Mattress Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 3.0 16-bit for Windows sub 86 Sender: owner-mra@altadena.net Precedence: bulk I've also had good luck with a tube patch kit, but I think the problem is identifying the location of the hole. As the mattress is a vaacuum system the practice of using a soap solution (or saliva) and watching for bubbles does not work. I've been able to pressurize the mattress with a raft pump and do this, but that is not a quick or suitable field method (raft pumps not being part of our standard field gear). Does anyone have any ideas for me? So far we have not had any punctures in our Hartwell mattress, but have had a problem at the seam. The manufacturer replaced the mattress at no cost, saying it had been a problem on some of the units of that age ( 4 or 5 years old). The problem of course was that we were without it for a few weeks. Yes, it's a good idea to have more than one unit. We're very happy with the unit otherwise. We use it on all evacs. The subject is very comfortable and is likely to fall asleep on the way out. Steve Patchett Albuquerque Mtn. Rescue --Digest-750E9A4E Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Mon, 8 Feb 1999 13:41:52 -0500 (EST) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Mon, 8 Feb 1999 13:41:48 -0500 (EST) Received: via switchmail for kconover+@pitt.edu; Mon, 8 Feb 1999 13:41:47 -0500 (EST) Received: from cascade.pacificrim.net (root@cascade.pacificrim.net [199.236.224.2]) by post-ofc03.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Mon, 8 Feb 1999 13:41:42 -0500 (EST) Received: from [199.236.227.132] (ppp132.whatcom.pacificrim.net [199.236.227.132] (may be forged)) by cascade.pacificrim.net (8.8.7/8.8.3) with ESMTP id KAA31837 for ; Mon, 8 Feb 1999 10:41:37 -0800 Date: Mon, 8 Feb 1999 10:41:37 -0800 Message-Id: In-Reply-To: <199902061428.JAA10125@post-ofc04.srv.cis.pitt.edu> References: <01BE50E2.83D8B140@cody.wtp.net.wtp.net> Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" To: kconover+@pitt.edu From: conterra Subject: Re: Vacuum Splint Keith, Below is a copy of the message that I wrote Kirk Wagoner Regarding Vacu mattresses. I have used many different brands over the last 12 years. Some have been good, others not. I definitely do not recommend the Ferno. We have had several failures associated with it. Rick Lipke ----------- Kirk, We have used many different brands over the years on both our ski patrol and Mtn rescue team. The Vacu-splint that gives us the least amount of trouble is the Hartwell Medical. The pump is quite large and heavy, but it dosen't freeze up like many brands. I would stay away from the Fernos, we had several in field failures with them, mostly involving the valves. I did train with an excellent Vacu mattress a few years ago in Switzerland, with Air Zermatt Rescue. It was very light, and had rubber dimples all over the bottom to keep it from sliding in the snow. Unfortunatley, I can't remember the brand. You might try getting in touch with them at 028.673487. Rick Lipke, Skagit Mountain Rescue Unit --Digest-750E9A4E-- 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 -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 25 Sep 1999 12:31:30 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 25 Sep 1999 12:30:58 -0400 (EDT) Received: via switchmail; Sat, 25 Sep 1999 12:30:58 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 25 Sep 1999 12:23:01 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 25 Sep 1999 12:22:29 -0400 (EDT) Received: from fs1.tlsinc.com (host-208-170-96-33.tlsinc.com [208.170.96.33] (may be forged)) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 25 Sep 1999 12:22:24 -0400 (EDT) Received: by host-208-170-96-33.tlsinc.com with Internet Mail Service (5.5.2448.0) id ; Sat, 25 Sep 1999 11:28:53 -0500 Message-ID: <71CC974D48FCD111825300A0C990B705047D10@host-208-170-96-33.tlsinc.com> From: Ed To: wilderness-emergency-medicine@list.pitt.edu Subject: W-EMED Full body Vacume splints Date: Sat, 25 Sep 1999 11:28:51 -0500 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.2448.0) Content-Type: text/plain; charset="iso-8859-1" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 1572992 0 1 P454F0.CNM Greetings from North Alabama. Have a question for the list about the full body vacume splints for use in rough country SAR work and Cave Rescue. What is available that people are actually using in the field (other than sleeping, I mean conserving your energy at the cache, Keith :) ) and are they a worthwhile addition vs the cost and durability ? What units would the list advise using or not using and why. I am trying to work up some justification for adding one to our gear cache. Thanks for the help. Ed Nicholas, EMT-D Chief of Operations, Huntsville Cave Rescue Unit, Inc Operations Officer, Huntsville Emergency Medical Services, Inc High Angle - Rough Terrain (HART) Team Huntsville, Alabama KD4WNJ 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 24 Sep 1999 20:58:29 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 24 Sep 1999 20:57:56 -0400 (EDT) Received: via switchmail; Fri, 24 Sep 1999 20:57:56 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 24 Sep 1999 20:55:52 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 24 Sep 1999 20:55:32 -0400 (EDT) Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 24 Sep 1999 20:55:29 -0400 (EDT) Received: from micron (ehdup-a3-12.rmt.net.pitt.edu [136.142.20.62]) by post-ofc06.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 24 Sep 1999 20:55:24 -0400 (EDT) Message-Id: <199909250055.UAA25315@post-ofc06.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: Jay J Wiseman , wilderness-emergency-medicine@list.pitt.edu Date: Fri, 24 Sep 1999 20:57:36 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED How much is too much?!? In-reply-to: <19990923.094510.29550.1.JayWiseman@juno.com> X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P31A30.CNM On 23 Sep 99, at 9:45, Jay J Wiseman wrote: > Hmmmm, interesting. I'm certainly familiar with the idea that if you > receive any "thing of value" in exchange for your services, including > "things" like a discount, then you may lose your Good Sam protection. > However, the "holding yourself out as an expert and fullfilling that role" > (even if you, presumably, are not being paid in any way) may cause you to > lose your Good Sam protection is a new one on me. Remember, if you end up in court, sued for negligence, the majority of the arguments will be based on common law (previous appellate decisions) -- and whether the court will believe you were a Good Samaritan depends a lot on how a reasonable person would view your role on a trip. What if a paid guide service (or an all-volunteer outdoor club, it matters only a little) notes in the blurb about the trip, or trips in general, that "members/guides trained in wilderness first aid/wilderness first responder/wilderness EMT accompany all trips"? Then a reasonable person going on such a trip would _expect_, and reasonably so, that any emergency that he or she has will be treated by someone competent at that level of training. That's a lot different than your just happening on someone in trouble along the trail -- people who are afraid to go out by themselves might go on a guided trip because you are there in case of emergency. Therefore, with a duty and responsibility toward members of the group, there is much less of "Good Samaritan-ness" about the relationship, and it would be that much harder for your attorney to successfully argue that the Good Samaritan law should apply. I picked a very obvious example to make the case, but the general principle applies: the more your rendering aid is as a pure bystander volunteer, the more likely your Good Samaritan defense will stick; on the other hand, the more you have a duty toward the patient, the less your Good Samaritan defense will stick. Sure, there are many other variables, but I think you can see the point -- a Good Samaritan defense can be strong or weak, depending on the facts of the case. On the other hand, good faith and doing a reasonable job given your level of training is a lot better defense than citing any Good Samaritan law. Take care. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 24 Sep 1999 19:37:34 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 24 Sep 1999 19:37:02 -0400 (EDT) Received: via switchmail; Fri, 24 Sep 1999 19:37:02 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 24 Sep 1999 19:36:48 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 24 Sep 1999 19:36:30 -0400 (EDT) Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 24 Sep 1999 19:36:26 -0400 (EDT) Received: from micron (ehdup-a3-12.rmt.net.pitt.edu [136.142.20.62]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 24 Sep 1999 19:36:20 -0400 (EDT) Message-Id: <199909242336.TAA24236@post-ofc05.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: "Suzanne M. Atkinson" , wilderness-emergency-medicine@list.pitt.edu Date: Fri, 24 Sep 1999 19:38:32 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED FW: spinal injury CC: sar-l@listserv.islandnet.com In-reply-to: <003601bf063d$be59ef80$17148e88@suzanne> X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu On 23 Sep 99, at 23:34, Suzanne M. Atkinson wrote: > How do you do this exactly??? Skating? X-C skiing? Dancing the > charleston? Hi, Suzanne. I'm sure all of those are possible. Rather than fantasizing, let me see if I can remember all the people I've seen with it in the past couple of years. 1. 92 year old guy using a comealong to pull out stumps in his yard. 2. young skinny guy sitting in a hard pew for a long time with a bit wallet in his back pocket. 3. middle-aged guy who works with one of those big floor buffers. 4. 14 year old backpacker who took a 75-foot tumbling fall and landed on a hard rock on her butt. 5. young woman who was moving furniture. 6. young woman with no good reason. 7. retired pathologist with known lumbar disk disease who was in Pittsburgh to see his neurosurgeon in the morning to arrange for a lumbar laminectomy, was basically fine when he started out in Johnstown but after the long drive had bad sciatica, had felt fine so he didn't bring his pain meds; seemed more like piriformis syndrome to me even though he had known disk-based disease and I manipulated his piriformis and he felt nearly 100% better. Did give him a couple of Percocets to take back to the hotel just in case, but he said he didn't think he'd need them. I'm sure there were others, but I can't remember them right now. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 24 Sep 1999 16:03:36 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 24 Sep 1999 16:02:43 -0400 (EDT) Received: via switchmail; Fri, 24 Sep 1999 16:02:41 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 24 Sep 1999 16:01:21 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 24 Sep 1999 15:59:39 -0400 (EDT) Received: from ns3.ge.com (ns3.ge.com [192.35.39.22]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 24 Sep 1999 15:59:32 -0400 (EDT) Received: from thomas.ge.com (thomas-o.ge.com [10.47.28.21]) by ns3.ge.com (8.9.3/8.9.3) with ESMTP id QAA24483 for ; Fri, 24 Sep 1999 16:01:15 -0400 (EDT) Received: from dnc04xntcvfsge.vfs.capital.ge.com ([3.61.128.77]) by thomas.ge.com (8.9.3/8.9.3) with ESMTP id QAA24799 for ; Fri, 24 Sep 1999 16:01:13 -0400 (EDT) Received: by DNC04XNTCVFSGE with Internet Mail Service (5.5.2448.0) id ; Fri, 24 Sep 1999 16:00:54 -0400 Message-ID: <1D1B9E1EF605D211B03B00805FA7AFDC0107057C@DNC01XNTCVFSGE> From: "Reinhart, Gregg (CAP, VFS)" To: "'wilderness-emergency-medicine@list.pitt.edu'" Subject: RE: W-EMED How much is too much?!? Date: Fri, 24 Sep 1999 16:00:50 -0400 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.2448.0) Content-Type: text/plain; charset="iso-8859-1" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P6A8F0.CNM The attached Webpage sheds some light on this confusing topic of Good Samaritans, legal duties and ethical duties. My quick synopsis: 1) Good Samaritan laws (Vermont, Minn, Wisconsin) REQUIRE a bystander to render aid and/or seek aid for a victim. 2) Immunity from Liability laws (Many states have these) provide immunity from civil action for those who offer aid. According to the sample laws quoted on the site, some states (Tenn, N. Carolina) offer immunity regardless of whether compensation is received, others (Wisconsin) withhold the immunity if compensation is received. Generally speaking, the immunity is granted unless you do something really stupid, or intentionally harmful. As a newbie EMT, in our class we were told that the typical guideline (in CT) was that as long as we provided the same level of care that "100 other EMTs with your training" would provide we would not legally be considered really stupid. However, the level of care expected was a function of level of training. The concepts of Duty and Negligence are more strict legal issues. Negligence requires proof of: Duty, Breech of Duty, and Causation of injury directly associated to that breech. I'm not a lawyer, but I don't think the 'expectations' of the people you are hiking with would constitute a LEGAL definition of 'Duty'. Compensation of one form or another very well might. Thus, it seems there are two ways you could be considered as having a legal duty to act -- if you are in a state that requires it (VT, Minn, WI), or if you are being compensated and/or have agreed to provide care. If you do not have a duty to act, most states provide you civil immunity. If you do have a duty, some states do provide immunity, and others don't. Check out the following link for more: http://www.lawstreet.com/lawguide/sigsint.html -----Original Message----- From: Jonathan Silver [mailto:kingsknight1@hotmail.com] Sent: Thursday, September 23, 1999 7:56 PM To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED How much is too much?!? >From: Jay J Wiseman >Reply-To: wilderness-emergency-medicine@list.pitt.edu >To: wilderness-emergency-medicine@list.pitt.edu >Subject: Re: W-EMED How much is too much?!? >Date: Thu, 23 Sep 1999 09:45:09 -0700 > >On Wed, 22 Sep 1999 11:47:01 -0400 "Keith Conover, M.D., FACEP" > writes: > >On 22 Sep 99, at 1:32, Jaymullen@aol.com wrote: > > >If you are paid for something, you're not a Good Samaritan. If you > >get to go on a trip for free, or for a discount, in exchange for being > > > >the trip doc or medic, you're getting paid for it. On the other hand, > > > >Good Samaritan statutes are a really quite minor protection in > >negligence cases -- just another tiny bump in the plaintiff's lawyer's > > > >road. Also, if you hold yourself out as an expert trip leader, or > >expert wilderness medic, and are fulfilling that role on a trip, and > >trip > >members know that, it may eliminate Good Samaritan protection. > >Hi folks, > >Hmmmm, interesting. I'm certainly familiar with the idea that if you >receive any "thing of value" in exchange for your services, including >"things" like a discount, then you may lose your Good Sam protection. >However, the "holding yourself out as an expert and fullfilling that >role" (even if you, presumably, are not being paid in any way) may cause >you to lose your Good Sam protection is a new one on me. > >Can you tell us a bit more about that? > >Regards, > >Jay > >___________________________________________________________________ I believe it goes to expectation on the part of those present. I hike with an outdoors club regularly. Most of the people in my club know I'm a WEMT and a WFA insructor. If something bad happens on a hike I'm on, those people may have a resonable expectation that I will act. A plausable argument cound be made that I even had a duty to act. If that is the case my Good Sam protection goes down the tubes since most states Good Sam laws do not provide protection to those with a duty to act. In any case that is my understanding. -Jonathan Silver ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 23 Sep 1999 23:56:36 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 23 Sep 1999 23:56:03 -0400 (EDT) Received: via switchmail; Thu, 23 Sep 1999 23:56:03 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 23 Sep 1999 23:54:31 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 23 Sep 1999 23:53:59 -0400 (EDT) Received: from smtp7.atl.mindspring.net (smtp7.atl.mindspring.net [207.69.128.51]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 23 Sep 1999 23:53:51 -0400 (EDT) Received: from sprynet.com (pool-207-205-182-211.phnx.grid.net [207.205.182.211]) by smtp7.atl.mindspring.net (8.8.5/8.8.5) with ESMTP id XAA13254; Thu, 23 Sep 1999 23:56:00 -0400 (EDT) Message-ID: <37EAF7A7.708E8D22@sprynet.com> Date: Thu, 23 Sep 1999 22:01:43 -0600 From: "Ron Brace, M.D. FACEP" X-Mailer: Mozilla 4.6 [en] (Win98; U) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu, EdwardsPaulK@exchange.uams.edu Subject: Re: W-EMED osteopathic medicine References: Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P28A80.CNM Paul. I am an EM physician, an MD. I did my training in the military and half of the residents in my program, and about a third in the other two army programs in Emergency Medicine where DOs. There was no difference in our practice and no difference in our success rates (that is MD vs DO). I have noticed that a higher number of 'change in career' or atypical type of applicants seem to prefer the DO route. In any case I believe Osteopathic docs do just as well in the EM selection as MDs. Just my 2 cents! Ron 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 23 Sep 1999 23:31:35 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 23 Sep 1999 23:31:04 -0400 (EDT) Received: via switchmail; Thu, 23 Sep 1999 23:31:04 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 23 Sep 1999 23:29:40 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 23 Sep 1999 23:29:16 -0400 (EDT) Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 23 Sep 1999 23:29:11 -0400 (EDT) Received: from suzanne (ehdup-a1-13.rmt.net.pitt.edu [136.142.20.23]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Thu, 23 Sep 1999 23:29:06 -0400 (EDT) Message-ID: <003601bf063d$be59ef80$17148e88@suzanne> From: "Suzanne M. Atkinson" To: References: <199909240231.WAA19509@post-ofc05.srv.cis.pitt.edu> Subject: Re: W-EMED FW: spinal injury Date: Thu, 23 Sep 1999 23:34:42 -0400 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 5.00.2615.200 X-MimeOLE: Produced By Microsoft MimeOLE V5.00.2615.200 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 1572992 0 1 P0CA00.CNM >or excessive use of the piriformis, > which is an external rotator of the hip How do you do this exactly??? Skating? X-C skiing? Dancing the charleston? Suzanne 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 23 Sep 1999 22:35:47 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 23 Sep 1999 22:32:24 -0400 (EDT) Received: via switchmail; Thu, 23 Sep 1999 22:32:22 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 23 Sep 1999 22:32:04 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 23 Sep 1999 22:31:45 -0400 (EDT) Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 23 Sep 1999 22:31:41 -0400 (EDT) Received: from micron (ehdup-u-65.rmt.net.pitt.edu [136.142.23.175]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 23 Sep 1999 22:31:25 -0400 (EDT) Message-Id: <199909240231.WAA19509@post-ofc05.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: "Mike Lynch" , wilderness-emergency-medicine@list.pitt.edu Date: Thu, 23 Sep 1999 22:33:10 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED FW: spinal injury CC: sar-l@listserv.islandnet.com In-reply-to: <000001bf060e$fb179a00$0d00a8c0@lynch> X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu Well, diagnosing a herniated disk in the field isn't easy, even for someone like me who deals with people with bad back pain, and often with herniated disks, on a daily basis. There are many things that will cause sciatica. Sciatic is "radicular" (so-called because it comes from irritation of one of the nerver roots, or radicles, coming out of the spinal cord) neuropathic (nerve-like, as opposed to broken-bone-like, or muscle-strain-like, or bruise-like, or skin-burn- like) pain radiating down the leg. Examples include a contusion of the sciatic nerve, or spasm of the piriformis muscle in the sciatic notch area from local trauma or excessive use of the piriformis, which is an external rotator of the hip -- in 30% of buttocks, the sciatic nerve goes right through the piriformis, and spasm of the piriformis causes severe pain down the leg. However, unlike with sciatica from a herniated disk with compression of one of the sciatic nerve's nerve roots, piriformis syndrome is easy to treat with stretching. If you're good at visualizing, try this next time you've been climbing or caving or paddling or whatever and your butt hurts from using your legs a lot. Assume it's your left butt that is sore. Lie on your back. Bend your left knee, and place your left foot outside your right knee. Reach across with your right hand, and pull your left knee to the right gently but firmly. (Experience with "Twister" may help.) Back to the subject. If I see someone with a likely NHP (herniated nucleus pulposis, the "in" way to talk about a herniated disk), my questions are: Do you have trouble with bowel or bladder (hesitancy or incontinence)? Do you have numbness of your perineum? If the answer is yes or maybe, I check perirectal sensation with a sharp broken Q-tip (a twig will do) and rectal tone with a rectal exam -- as a big central disk herniation can compress all the nerves coming down off the bottom of the spinal cord (which is about L1 bony level), called the cauda equina ("horse's tail" because that's what it looks like during surgery or cadaver dissection). If I think the person really has cauda equina syndrome, I admit to the hospital on bedrest and get an immediate MRI scan or CT myelogram. In the backcountry, I'd carry out (no need for immobilization) provided it doesn't endanger anyone. If no cauda equina syndrome, I check with the broken Q-tip for numbess, check reflexes, and check for weakness in the legs. Not just weakness because it hurts, true weakness from nerve damage -- I tell people it will hurt, and get them to hold their foot rigid, for example, while I suddenly pull down hard. It hurts, but then I can get a good idea, from the momentary resistance, of whether the patient is really weak or not -- not true if the patient hurts a lot and I ask the patient to pull up against resistance. I also check a "straight-leg raising" (SLR) test. Actually, raising the leg while straight at the knee hurts anyone with back spasm, so I gently bend the knee, and bend the hip; I then straighten the knee without wiggling the back. A suddent increase in pain down the leg indicates entrapment of one of the roots of the sciatic nerve. If the patient has true motor weakness, I usually admit or arrange for an expedited outpatient workup -- home to bedrest with strict instructions to come back if worse, and an MRI within a day or so. In the backcountry, I would probably carry out if it wasn't too hard. If the patient doesn't have suspected cauda equina syndrome, or true motor weakness, just some radicular pain, I send them home with pain meds and maybe a muscle relaxant to take it easy, with a followup with a back surgeon in a few days. In the backcountry, I'd give pain meds, split the patient's pack contents among the others in the party, and have the patient walk out. I see no role for immobilization, but as James suggested, an unpumped vacuum splint makes a dandy mattress to sleep on -- I've done it often enough in years past myself! (Shouldn't have said that, now everyone knows why I volunteer to keep an eye on the rescue cache at a search base.) This is probably more than you wanted to know about penguins, but hope it helps. > -----Original Message----- > From: Akadsk@aol.com [mailto:Akadsk@aol.com] > Sent: Thursday, September 23, 1999 1:29 PM > To: sar-l@islandnet.com > Subject: spinal injury > > I just responded with our local rescue squad to a YMCA camp where we found > a young girl with a suspected herniated lumbar disk (W/ a history of > similar problems). She was found on her stomach with feeling and motion in > her lower extremities, oriented x4 etc.but in exruciating pain whenever > she tried to move. So as not to bias responses I'll leave out details of > what followed but how would the MDs and medics on the list immoblize and > or transport. this didn't involve any lengthy evac. just waiting for the > ambulance. > > Dave Kruse --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: 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: <000001bf060e$fb179a00$0d00a8c0@lynch> X-RS-Sigset: 2 To: "Mike Lynch" ,wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED FW: spinal injury Cc: sar-l@listserv.islandnet.com Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Thu, 23 Sep 1999 22:28:44 -0400 Well, diagnosing a herniated disk in the field isn't easy, even for someone like me who deals with people with bad back pain, and often with herniated disks, on a daily basis. There are many things that will cause sciatica. Sciatic is "radicular" (so-called because it comes from irritation of one of the nerver roots, or radicles, coming out of the spinal cord) neuropathic (nerve-like, as opposed to broken-bone-like, or muscle-strain-like, or bruise-like, or skin-burn- like) pain radiating down the leg. Examples include a contusion of the sciatic nerve, or spasm of the piriformis muscle in the sciatic notch area from local trauma or excessive use of the piriformis, which is an external rotator of the hip -- in 30% of buttocks, the sciatic nerve goes right through the piriformis, and spasm of the piriformis causes severe pain down the leg. However, unlike with sciatica from a herniated disk with compression of one of the sciatic nerve's nerve roots, piriformis syndrome is easy to treat with stretching. If you're good at visualizing, try this next time you've been climbing or caving or paddling or whatever and your butt hurts from using your legs a lot. Assume it's your left butt that is sore. Lie on your back. Bend your left knee, and place your left foot outside your right knee. Reach across with your right hand, and pull your left knee to the right gently but firmly. (Experience with "Twister" may help.) Back to the subject. If I see someone with a likely NHP (herniated nucleus pulposis, the "in" way to talk about a herniated disk), my questions are: Do you have trouble with bowel or bladder (hesitancy or incontinence)? Do you have numbness of your perineum? If the answer is yes or maybe, I check perirectal sensation with a sharp broken Q-tip (a twig will do) and rectal tone with a rectal exam -- as a big central disk herniation can compress all the nerves coming down off the bottom of the spinal cord (which is about L1 bony level), called the cauda equina ("horse's tail" because that's what it looks like during surgery or cadaver dissection). If I think the person really has cauda equina syndrome, I admit to the hospital on bedrest and get an immediate MRI scan or CT myelogram. In the backcountry, I'd carry out (no need for immobilization) provided it doesn't endanger anyone. If no cauda equina syndrome, I check with the broken Q-tip for numbess, check reflexes, and check for weakness in the legs. Not just weakness because it hurts, true weakness from nerve damage -- I tell people it will hurt, and get them to hold their foot rigid, for example, while I suddenly pull down hard. It hurts, but then I can get a good idea, from the momentary resistance, of whether the patient is really weak or not -- not true if the patient hurts a lot and I ask the patient to pull up against resistance. I also check a "straight-leg raising" (SLR) test. Actually, raising the leg while straight at the knee hurts anyone with back spasm, so I gently bend the knee, and bend the hip; I then straighten the knee without wiggling the back. A suddent increase in pain down the leg indicates entrapment of one of the roots of the sciatic nerve. If the patient has true motor weakness, I usually admit or arrange for an expedited outpatient workup -- home to bedrest with strict instructions to come back if worse, and an MRI within a day or so. In the backcountry, I would probably carry out if it wasn't too hard. If the patient doesn't have suspected cauda equina syndrome, or true motor weakness, just some radicular pain, I send them home with pain meds and maybe a muscle relaxant to take it easy, with a followup with a back surgeon in a few days. In the backcountry, I'd give pain meds, split the patient's pack contents among the others in the party, and have the patient walk out. I see no role for immobilization, but as James suggested, an unpumped vacuum splint makes a dandy mattress to sleep on -- I've done it often enough in years past myself! (Shouldn't have said that, now everyone knows why I volunteer to keep an eye on the rescue cache at a search base.) This is probably more than you wanted to know about penguins, but hope it helps. > -----Original Message----- > From: Akadsk@aol.com [mailto:Akadsk@aol.com] > Sent: Thursday, September 23, 1999 1:29 PM > To: sar-l@islandnet.com > Subject: spinal injury > > I just responded with our local rescue squad to a YMCA camp where we found > a young girl with a suspected herniated lumbar disk (W/ a history of > similar problems). She was found on her stomach with feeling and motion in > her lower extremities, oriented x4 etc.but in exruciating pain whenever > she tried to move. So as not to bias responses I'll leave out details of > what followed but how would the MDs and medics on the list immoblize and > or transport. this didn't involve any lengthy evac. just waiting for the > ambulance. > > Dave Kruse -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 23 Sep 1999 19:51:14 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 23 Sep 1999 19:50:41 -0400 (EDT) Received: via switchmail; Thu, 23 Sep 1999 19:50:40 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 23 Sep 1999 19:48:47 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 23 Sep 1999 19:48:29 -0400 (EDT) Received: from quint.somtel.com (Quint.somtel.com [206.139.114.2]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 23 Sep 1999 19:48:25 -0400 (EDT) Received: from general (ddialup-na-25.somtel.com [216.227.178.45]) by quint.somtel.com (8.8.5/8.8.5) with SMTP id TAA04812 for ; Thu, 23 Sep 1999 19:50:36 -0400 Message-ID: <000d01bf061d$7817b0e0$2db2e3d8@general> From: "James Bender" To: References: <000001bf060e$fb179a00$0d00a8c0@lynch> Subject: Re: W-EMED FW: spinal injury Date: Thu, 23 Sep 1999 19:43:41 -0400 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 5.00.2014.211 X-MimeOLE: Produced By Microsoft MimeOLE V5.00.2014.211 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P54A40.CNM In our neck of the woods (That's Maine) we would probably use the Vac Splint (Body) and Pain Meds. James ----- Original Message ----- From: Mike Lynch To: ; Sent: Thursday, September 23, 1999 5:59 PM Subject: W-EMED FW: spinal injury > The e-mail message below, inquiring about field protocols for a suspected > herniated lumbar disk injury, was posted to the SAR-L e-mail list and is > being forwarded to the W-EMED list with permission of the author. Please > respond to Dave Kruse, Akadsk@aol.com > Thank you, > Mike Lynch > > -----Original Message----- > From: Akadsk@aol.com [mailto:Akadsk@aol.com] > Sent: Thursday, September 23, 1999 1:29 PM > To: sar-l@islandnet.com > Subject: spinal injury > > > I just responded with our local rescue squad to a YMCA camp where we found a > young girl with a suspected herniated lumbar disk (W/ a history of similar > problems). > She was found on her stomach with feeling and motion in her lower > extremities, oriented x4 etc.but in exruciating pain whenever she tried to > move. So as not to bias responses I'll leave out details of what followed > but > how would the MDs and medics on the list immoblize and or transport. this > didn't involve any lengthy evac. just waiting for the ambulance. > > Dave Kruse > > > > 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 23 Sep 1999 18:03:31 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 23 Sep 1999 18:02:56 -0400 (EDT) Received: via switchmail; Thu, 23 Sep 1999 18:02:55 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 23 Sep 1999 18:01:27 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 23 Sep 1999 18:01:05 -0400 (EDT) Received: from impulse.net (mail.impulse.net [204.188.6.10]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 23 Sep 1999 18:01:02 -0400 (EDT) Received: (qmail 96648 invoked by alias); 23 Sep 1999 22:03:12 -0000 Received: from hr1-cf9a42dc.dia.impulse.net (HELO lynch) (207.154.66.220) by mail.impulse.net with SMTP; 23 Sep 1999 22:03:12 -0000 From: "Mike Lynch" To: , Subject: W-EMED FW: spinal injury Date: Thu, 23 Sep 1999 14:59:47 -0700 Message-ID: <000001bf060e$fb179a00$0d00a8c0@lynch> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 (Normal) X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook 8.5, Build 4.71.2232.26 Importance: Normal Disposition-Notification-To: "Mike Lynch" X-MimeOLE: Produced By Microsoft MimeOLE V5.00.2014.211 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P0BCF0.CNM The e-mail message below, inquiring about field protocols for a suspected herniated lumbar disk injury, was posted to the SAR-L e-mail list and is being forwarded to the W-EMED list with permission of the author. Please respond to Dave Kruse, Akadsk@aol.com Thank you, Mike Lynch -----Original Message----- From: Akadsk@aol.com [mailto:Akadsk@aol.com] Sent: Thursday, September 23, 1999 1:29 PM To: sar-l@islandnet.com Subject: spinal injury I just responded with our local rescue squad to a YMCA camp where we found a young girl with a suspected herniated lumbar disk (W/ a history of similar problems). She was found on her stomach with feeling and motion in her lower extremities, oriented x4 etc.but in exruciating pain whenever she tried to move. So as not to bias responses I'll leave out details of what followed but how would the MDs and medics on the list immoblize and or transport. this didn't involve any lengthy evac. just waiting for the ambulance. Dave Kruse 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 23 Sep 1999 19:55:42 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 23 Sep 1999 19:55:09 -0400 (EDT) Received: via switchmail; Thu, 23 Sep 1999 19:55:09 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 23 Sep 1999 19:54:10 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 23 Sep 1999 19:54:00 -0400 (EDT) Received: from hotmail.com (f175.law4.hotmail.com [216.33.149.175]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 23 Sep 1999 19:53:56 -0400 (EDT) Received: (qmail 76269 invoked by uid 0); 23 Sep 1999 23:55:37 -0000 Message-ID: <19990923235537.76268.qmail@hotmail.com> Received: from 208.250.151.18 by www.hotmail.com with HTTP; Thu, 23 Sep 1999 16:55:36 PDT X-Originating-IP: [208.250.151.18] From: "Jonathan Silver" To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED How much is too much?!? Date: Thu, 23 Sep 1999 19:55:36 EDT Mime-Version: 1.0 Content-Type: text/plain; format=flowed Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P6E3B0.CNM >From: Jay J Wiseman >Reply-To: wilderness-emergency-medicine@list.pitt.edu >To: wilderness-emergency-medicine@list.pitt.edu >Subject: Re: W-EMED How much is too much?!? >Date: Thu, 23 Sep 1999 09:45:09 -0700 > >On Wed, 22 Sep 1999 11:47:01 -0400 "Keith Conover, M.D., FACEP" > writes: > >On 22 Sep 99, at 1:32, Jaymullen@aol.com wrote: > > >If you are paid for something, you're not a Good Samaritan. If you > >get to go on a trip for free, or for a discount, in exchange for being > > > >the trip doc or medic, you're getting paid for it. On the other hand, > > > >Good Samaritan statutes are a really quite minor protection in > >negligence cases -- just another tiny bump in the plaintiff's lawyer's > > > >road. Also, if you hold yourself out as an expert trip leader, or > >expert wilderness medic, and are fulfilling that role on a trip, and > >trip > >members know that, it may eliminate Good Samaritan protection. > >Hi folks, > >Hmmmm, interesting. I'm certainly familiar with the idea that if you >receive any "thing of value" in exchange for your services, including >"things" like a discount, then you may lose your Good Sam protection. >However, the "holding yourself out as an expert and fullfilling that >role" (even if you, presumably, are not being paid in any way) may cause >you to lose your Good Sam protection is a new one on me. > >Can you tell us a bit more about that? > >Regards, > >Jay > >___________________________________________________________________ I believe it goes to expectation on the part of those present. I hike with an outdoors club regularly. Most of the people in my club know I'm a WEMT and a WFA insructor. If something bad happens on a hike I'm on, those people may have a resonable expectation that I will act. A plausable argument cound be made that I even had a duty to act. If that is the case my Good Sam protection goes down the tubes since most states Good Sam laws do not provide protection to those with a duty to act. In any case that is my understanding. -Jonathan Silver ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 24 Sep 1999 00:47:36 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 23 Sep 1999 12:47:54 -0400 (EDT) Received: via switchmail; Thu, 23 Sep 1999 12:47:51 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 23 Sep 1999 12:46:06 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 23 Sep 1999 12:44:09 -0400 (EDT) Received: from m9.boston.juno.com (m9.boston.juno.com [205.231.100.195]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 23 Sep 1999 12:44:06 -0400 (EDT) Received: (from jaywiseman@juno.com) by m9.boston.juno.com (queuemail) id EL8DNT7Y; Thu, 23 Sep 1999 12:42:41 EDT To: wilderness-emergency-medicine@list.pitt.edu Date: Thu, 23 Sep 1999 09:45:09 -0700 Subject: Re: W-EMED How much is too much?!? Message-ID: <19990923.094510.29550.1.JayWiseman@juno.com> References: <199909221544.LAA02591@post-ofc04.srv.cis.pitt.edu> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 0,2-19,25-31 From: Jay J Wiseman Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 1048704 0 1 P41A30.CNM On Wed, 22 Sep 1999 11:47:01 -0400 "Keith Conover, M.D., FACEP" writes: >On 22 Sep 99, at 1:32, Jaymullen@aol.com wrote: >If you are paid for something, you're not a Good Samaritan. If you >get to go on a trip for free, or for a discount, in exchange for being > >the trip doc or medic, you're getting paid for it. On the other hand, > >Good Samaritan statutes are a really quite minor protection in >negligence cases -- just another tiny bump in the plaintiff's lawyer's > >road. Also, if you hold yourself out as an expert trip leader, or >expert wilderness medic, and are fulfilling that role on a trip, and >trip >members know that, it may eliminate Good Samaritan protection. Hi folks, Hmmmm, interesting. I'm certainly familiar with the idea that if you receive any "thing of value" in exchange for your services, including "things" like a discount, then you may lose your Good Sam protection. However, the "holding yourself out as an expert and fullfilling that role" (even if you, presumably, are not being paid in any way) may cause you to lose your Good Sam protection is a new one on me. Can you tell us a bit more about that? Regards, Jay ___________________________________________________________________ Get the Internet just the way you want it. Free software, free e-mail, and free Internet access for a month! Try Juno Web: http://dl.www.juno.com/dynoget/tagj. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 23 Sep 1999 03:03:46 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 23 Sep 1999 03:03:10 -0400 (EDT) Received: via switchmail; Thu, 23 Sep 1999 03:03:09 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 23 Sep 1999 03:02:54 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 23 Sep 1999 03:02:22 -0400 (EDT) Received: from exchange1.uams.edu (exchange1.uams.edu [144.30.1.148]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 23 Sep 1999 03:02:18 -0400 (EDT) Received: by exchange1.uams.edu with Internet Mail Service (5.5.2650.21) id ; Thu, 23 Sep 1999 02:04:29 -0500 Message-ID: From: EdwardsPaulK@exchange.uams.edu To: wilderness-emergency-medicine@list.pitt.edu Subject: W-EMED osteopathic medicine Date: Thu, 23 Sep 1999 02:04:28 -0500 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.2650.21) Content-Type: text/plain; charset="iso-8859-1" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P32E50.CNM Just curious if anyone has any thoughts on Osteopathic medicine? I know it probably has no relevance to the subject of wilderness medicine but perhaps I could get some outside advice on continuing my education to pursue a professional degree as an ER physician. I am a pre-med student currently working on a MS in physiology at our state medical school. I will be applying for osteopathic and allopathic medical schools in less than a year. Does anybody know the % of students that pursue a residency in the emergency department from an Osteopathic school? Or any relevant information regarding osteopathic schools? (I understand their philosophy and feel that they are right on track with my philosophy; but am curious how different the education system really promotes this philosophy?) Thanks for all comments, Paul 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 22 Sep 1999 21:04:00 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 22 Sep 1999 21:03:22 -0400 (EDT) Received: via switchmail; Wed, 22 Sep 1999 21:03:19 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 22 Sep 1999 21:01:27 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 22 Sep 1999 21:00:56 -0400 (EDT) Received: from imo15.mx.aol.com (imo15.mx.aol.com [198.81.17.5]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 22 Sep 1999 21:00:52 -0400 (EDT) From: MYScher@aol.com Received: from MYScher@aol.com by imo15.mx.aol.com (mail_out_v22.4.) id hCANa04716 (3945) for ; Wed, 22 Sep 1999 19:28:29 -0400 (EDT) Message-ID: <529be703.251ac01e@aol.com> Date: Wed, 22 Sep 1999 19:28:30 EDT Subject: Re: W-EMED cpr masks To: wilderness-emergency-medicine@list.pitt.edu MIME-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Content-Transfer-Encoding: 7bit X-Mailer: AOL 4.0.i for Windows 95 sub 69 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P7CA30.CNM Peace to you all! Concerning the question about rescue masks with a tube between the Pt's teeth...I've not actually used one, but I don't like the idea because it doesn't allow me to use a more effective OPA. If injuries prevent the use of the OPA and I need a bite block, I can always cut the OPA down to size leaving just the tooth/lip guard and a little bit of tube. OTOH, the little bit of tube attached to the masks is too short to help control the tongue, etc. just my opinion... Mordechai Y. Scher combat medic 09, IDF-r EMT crew member, Spencer Rescue Squad, Spencer, Mass. and paramedic student Worcester, Mass. 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 -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 22 Sep 1999 11:48:17 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 22 Sep 1999 11:47:42 -0400 (EDT) Received: via switchmail; Wed, 22 Sep 1999 11:47:42 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 22 Sep 1999 11:45:40 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 22 Sep 1999 11:45:17 -0400 (EDT) Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 22 Sep 1999 11:45:03 -0400 (EDT) Received: from micron (ehdup-d3-10.rmt.net.pitt.edu [136.142.20.240]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 22 Sep 1999 11:44:59 -0400 (EDT) Message-Id: <199909221544.LAA02591@post-ofc04.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: Jaymullen@aol.com, wilderness-emergency-medicine@list.pitt.edu Date: Wed, 22 Sep 1999 11:47:01 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED How much is too much?!? In-reply-to: <37a89e58.2519c3d3@aol.com> X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P1EBF0.CNM On 22 Sep 99, at 1:32, Jaymullen@aol.com wrote: > Does it really matter if you are a paid trip leader or not. What about > the doc, nurse or paramedic that joins a trip or expedition, but doesn't > get paid for it? Do any states offer good sam coverage for them? That's a good question. If you are paid for something, you're not a Good Samaritan. If you get to go on a trip for free, or for a discount, in exchange for being the trip doc or medic, you're getting paid for it. On the other hand, Good Samaritan statutes are a really quite minor protection in negligence cases -- just another tiny bump in the plaintiff's lawyer's road. Also, if you hold yourself out as an expert trip leader, or expert wilderness medic, and are fulfilling that role on a trip, and trip members know that, it may eliminate Good Samaritan protection. On the other hand, Good Samaritan protection aint' much. Here's a reference: 1. Morgan DL, Trompler VA, Trail WR Liability Immunity as a Legal Defense for Recent Emergency Medical Service System Litigation Prehospital and Disaster Medicine 1994; 9 S61 Purpose: To review all recent EMS system civil litigation appellate cases to determine their common characteristics and the number that used liability immunity (sovereign immunity, emergency medical care immunity, or Good Samaritan immunity) as a legal defense. Methods: The WESTLAW (R) computerized database of legal cases from all state and federal appellate courts was used to obtain all legal cases that named a member of the EMS system as a defendant, involved either a patient care incident or ambulance e collision, and received an appellate court opinion from 1987 to 1992. Results: Eighty-six cases were found and analyzed. Most cases (85%) were related to a patient-care incident and 71% of the cases involved a death or significant physical injury. More than 49% of the patient cases alleged inadequate assessment or treatment and 27% a11eged delay in ambulance arrival or no ambulance arrival. There were 11 cases (15%) alleging no transport of the patient to the hospital. Liability immunity was used as a defense in 53 of the cases. The appellate courts ruled in favor of 68% of the defendants that did not use an immunity defense, and in favor of 72% of those that did use liability immunity. Conclusion: Then have been a 1arge number of recent appellate cases involving EMS systems. The common characteristics of many of these cases demonstrates the need for providing rapid ambulance arrival proper assessment and treatment' and rapid patient transportation to a hospital. Although liability immunity was used as a legal defense by most EMS system defendants, the appellate court outcome was similar regardless of its use. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 22 Sep 1999 10:09:02 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 22 Sep 1999 10:08:30 -0400 (EDT) Received: via switchmail; Wed, 22 Sep 1999 10:08:30 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 22 Sep 1999 10:07:12 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 22 Sep 1999 10:05:42 -0400 (EDT) Received: from Mailhost.wyoming.com (CALAMITY.WYOMING.COM [199.190.151.2]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 22 Sep 1999 10:05:38 -0400 (EDT) Received: from Horn.wyoming.com ([199.190.151.5]) by Mailhost.wyoming.com (Post.Office MTA v3.1.2 release (PO205-101c) ID# 601-42080U15000L1500S0) with ESMTP id AAA801 for ; Wed, 22 Sep 1999 08:07:47 -0600 Received: from default (LND-CAP-41.WYOMING.COM [204.227.198.57]) by Horn.wyoming.com (8.8.7/8.8.7) with SMTP id IAA13148 for ; Wed, 22 Sep 1999 08:07:45 -0600 Message-ID: <37E8E261.4CD1@wyoming.com> Date: Wed, 22 Sep 1999 08:06:25 -0600 From: Tod Schimelpfenig X-Mailer: Mozilla 3.01 (Win95; U) MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Efficacy of Handwashing References: <3.0.5.32.19990921104218.007c1780@mail.magma.ca> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P6D1F0.CNM Langley R. Muir wrote: > > I have seen a number of unsupported statements in outdoor articles and > courses to the effect that ... XX% of people leaving outdoor courses do so > because of gastrointestinal problems that could have been prevented by > handwashing ... The value of XX varies somewhat, depending upon the source > of the anecdote. > > I have already seen the long set of abstracts on hygiene and handwashing > which is available at: http://users.aol.com/comcontrol/. I have also done > my own primary literature searches on the subject of handwashing and > related gastro-intestinal problems or infection in the outdoors. In no > case have I found any reference to a study which would provide any credible > value for XX in the above assertion or anything related to it. > > Clearly, handwashing is extremely important in reducing bacteria on the > hands and all of the references cited support this. However, everything > that I have seen has been related to food-handlers or urban health care or > day care facilities. From first principles, it is obvious that handwashing > in the outdoors is important and I don't need anyone to tell me this. > > Does anyone know of any actual statistical evidence or scientific studies > related to handwashing, gastro-intestinal problems, infection, and outdoor > activities? I would have thought that NOLS, Outward Boound, the Boy > Scouts, or the military should have some, but I haven't been able to find > anything other than bald statements that handwashing is important. > > Thanks in advance for any help that anone is able to give me. > > Cheers. Langley > > Dr. Langley R. Muir > 4 Valewood Crescent 1-613-824-9391 (voice) > Gloucester, Ontario 1-613-824-2875 (fax) > Canada cc913@ncf.ca > K1B 4E8 > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu Dr. Muir I believe the source of the data on GI illness in wilderness is Wilderness Injuries and Illness in Annals of Emergency Med 21:7 1992. This data has been subsequently misquoted in at least two popular outdoor magazines. I've heard the misquoted data repeated by wilderness medical people. The original study says 60% of reported illness on NOLS courses included GI and flu-like symptoms. Only a subset of these people were ill enough to leave the field. Hygiene was suspected as a cause but no science was applied in this study to directly connecting handwashing with the GI and flu-like symptoms. I don't know of any study specifically on handwashing in the outdoors. In the big picture of medicine handwashing on wilderness trips is really a minor concern and probably would not attract research dollars. Common sense, personal experience, application of what we do know about infection control outside wilderness (and my mother's advice) makes all the argument for handwashing I need. Tod Schimelpfenig Rocky Mountain School Director NOLS 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 22 Sep 1999 01:33:06 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 22 Sep 1999 01:32:32 -0400 (EDT) Received: via switchmail; Wed, 22 Sep 1999 01:32:30 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 22 Sep 1999 01:30:52 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 22 Sep 1999 01:30:32 -0400 (EDT) Received: from imo26.mx.aol.com (imo26.mx.aol.com [198.81.17.70]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 22 Sep 1999 01:30:28 -0400 (EDT) From: Jaymullen@aol.com Received: from Jaymullen@aol.com by imo26.mx.aol.com (mail_out_v22.4.) id hUTPa06118 (3858) for ; Wed, 22 Sep 1999 01:32:04 -0400 (EDT) Message-ID: <37a89e58.2519c3d3@aol.com> Date: Wed, 22 Sep 1999 01:32:03 EDT Subject: Re: W-EMED How much is too much?!? To: wilderness-emergency-medicine@list.pitt.edu MIME-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Content-Transfer-Encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 216 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 1572992 0 1 P504A0.CNM In a message dated 9/21/99 1:30:09 PM US Mountain Standard Time, kconover+@pitt.edu writes: << But if you happened to go out on a day hike without tat five liters of LR, you wouldn't be held responsible for not preplanning for a major trauma -- at least if you're not a paid trip leader. >> Does it really matter if you are a paid trip leader or not. What about the doc, nurse or paramedic that joins a trip or expedition, but doesn't get paid for it? Do any states offer good sam coverage for them? --Jay Jay Mullen MD 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 21 Sep 1999 23:52:44 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 21 Sep 1999 23:52:12 -0400 (EDT) Received: via switchmail; Tue, 21 Sep 1999 23:52:12 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 21 Sep 1999 23:51:00 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 21 Sep 1999 23:50:10 -0400 (EDT) Received: from imo29.mx.aol.com (imo29.mx.aol.com [198.81.17.73]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 21 Sep 1999 23:50:03 -0400 (EDT) From: DoctrRick@aol.com Received: from DoctrRick@aol.com by imo29.mx.aol.com (mail_out_v22.4.) id hYHSa29021 (4416) for ; Tue, 21 Sep 1999 23:51:37 -0400 (EDT) Message-ID: Date: Tue, 21 Sep 1999 23:51:36 EDT Subject: Re: W-EMED Efficacy of Handwashing To: wilderness-emergency-medicine@list.pitt.edu MIME-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Content-Transfer-Encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 14 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P33B70.CNM Good questions about hand washing. Yet I know of no studies that link hand washing or lack thereof with disease in the wild. NOLs review publised by several including Tod Schimelpfenig. of NOLS reports that of the medical reasons for illness the wild, about 60% were do to GI problems.( annals of emergency med 21:7 1992) There was no prospective component hence nothing about hand washing can be concluded. Yet common sense prevail. In my experience auditing trip hygiene and leading trips good hand washing is fundementally left at home and it is not good there either. Hope this helps. Rick Bennett PHD Applied Life Sciences and Instructor, Wilderness Medicine Inst. of NOLS 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 21 Sep 1999 16:13:56 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 21 Sep 1999 16:13:00 -0400 (EDT) Received: via switchmail; Tue, 21 Sep 1999 16:12:57 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 21 Sep 1999 16:11:00 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 21 Sep 1999 15:55:58 -0400 (EDT) Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 21 Sep 1999 15:55:54 -0400 (EDT) Received: from micron (ehdup-g-4.rmt.net.pitt.edu [136.142.21.134]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 21 Sep 1999 15:51:07 -0400 (EDT) Message-Id: <199909211951.PAA18495@post-ofc04.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: Michael Williams , wilderness-emergency-medicine@list.pitt.edu Date: Tue, 21 Sep 1999 15:53:07 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED How much is too much?!? In-reply-to: <37E76D72.D0A0A600@hpd.nova.edu> X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P20520.CNM On 21 Sep 99, at 7:35, Michael Williams wrote: > However, its was clear that unless > you have agreed to take on a patient (i.e., You are working in an ER, or > have merely discussed a patient's issue over the telephone), it is neither > abandonment nor is it neglect if you do absolutely nothing for someone > bleeding to death on a trail. As unconscionable as that seems, there is > no LEGAL obligation to act toward an injured party. Of course, you have > an ethical obligation, but that's the angle in which you would garner > legal protection (i.e.., failing to use the IV in your pack). This means > even if didn't feel like schlepping all the gear you would like, you are > under no legal obligation to do so. Hi, Michael, you raise some interesting points that I'd like to expand on just a bit. Vermont, Minnesota, and Alaska have statutes requiring a bystander to render aid to someone in distress -- otherwise, in the U.S. or Canada, you have no obligation to aid someone in distress. This is not true in Mexico, France, or any other Civil Code countries where instead of common law, a descendant of the Code Napoleon is followed, where, like in VT, MN, AK you must aid someone in distress. But common law requires that, if you aid someone, you don't abandon them, and further that you do everything within your power to help them. But if you happened to go out on a day hike without tat five liters of LR, you wouldn't be held responsible for not preplanning for a major trauma -- at least if you're not a paid trip leader. You'd only be held to do the best with what you had, and to do it in good faith and without gross negligence (the requirements of most states' Good Samaritan Laws, and pretty solid common law principles for where the state Good Sam law wouldn't apply, as for states where it only applies to doctors.) Have a good day. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 21 Sep 1999 14:34:23 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 21 Sep 1999 14:33:51 -0400 (EDT) Received: via switchmail; Tue, 21 Sep 1999 14:33:51 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 21 Sep 1999 14:31:47 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 21 Sep 1999 14:31:18 -0400 (EDT) Received: from swainson.med.unc.edu (swainson.med.unc.edu [152.2.119.115]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 21 Sep 1999 14:31:15 -0400 (EDT) Received: from webmail ([152.19.4.30]) by swainson.med.unc.edu (Netscape Messaging Server 3.01) with SMTP id AAA13356 for ; Tue, 21 Sep 1999 14:33:22 -0400 From: "Seth Hawkins" To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED How much is too much?!? X-Mailer: Netscape Messenger Express 3.5 [Mozilla/4.01 [en] (Win95; I)] Date: Tue, 21 Sep 1999 14:33:22 -0400 Message-ID: <19990921183322.AAA13356@webmail> Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 128 0 1 P2D3B0.CNM Michael B. Williams wrote: > it >is neither abandonment nor is it neglect if you do absolutely nothing >for someone bleeding to death on a trail. As unconscionable as that >seems, there is no LEGAL obligation to act toward an injured party. OK, I'm going out on a limb here, but I thought I heard that 2-3 states had mandatory assistance laws on the books -- ie, if you are trained to a certain level and pass someone in need, you must assist. I thought one of them was Vermont, and the other was somewhere in the southwest (?). Of course, it's unlikely the law would be utilized. Sorry if this info is incorrect, it's just out of the dusty corners of my brain (which is generally one big dusty corner). Anybody know anything about this technicality? seth ---------------------------------- Seth Collings Hawkins Carolina Wilderness Medicine UNC-Chapel Hill School of Medicine 207A Purefoy Rd, CH, NC 27514-4857 ---------------------------------- 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 21 Sep 1999 17:02:04 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 21 Sep 1999 16:40:13 -0400 (EDT) Received: via switchmail; Tue, 21 Sep 1999 16:40:10 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 21 Sep 1999 16:39:31 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 21 Sep 1999 16:37:42 -0400 (EDT) Received: from imo-d01.mx.aol.com (imo-d01.mx.aol.com [205.188.157.33]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 21 Sep 1999 16:37:37 -0400 (EDT) From: KE4WKR@aol.com Received: from KE4WKR@aol.com by imo-d01.mx.aol.com (mail_out_v22.4.) id hEKN0yTTih (4204) for ; Tue, 21 Sep 1999 16:17:22 -0400 (EDT) Message-ID: <16d9381f.251941d1@aol.com> Date: Tue, 21 Sep 1999 16:17:21 EDT Subject: Re: W-EMED How much is too much?!? To: wilderness-emergency-medicine@list.pitt.edu MIME-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Content-Transfer-Encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 214 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P6DB60.CNM The discussion is very interesting, and something I have thought over before...I have come to the conclusion myself that I carry the knowledge around with me all the time, and cannot lay that aside, and I would rather be able to use proper equipment if necessary in an emergency than have to make do unless I absolutely have to. (the instance comes to mind of the two physicians who did an emergency trach. during a transatlantic flight using what they could find in the flight pantry) Therefore I carry what I feel is an appropriate amount of equipment in my car/pack to allow me to assist someone, within my scope of practice, if need should arise. 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 21 Sep 1999 12:11:26 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 21 Sep 1999 12:10:45 -0400 (EDT) Received: via switchmail; Tue, 21 Sep 1999 12:10:45 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 21 Sep 1999 12:10:22 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 21 Sep 1999 12:10:11 -0400 (EDT) Received: from m9.boston.juno.com (m9.boston.juno.com [205.231.100.195]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 21 Sep 1999 12:10:03 -0400 (EDT) Received: (from jaywiseman@juno.com) by m9.boston.juno.com (queuemail) id EL262F6K; Tue, 21 Sep 1999 12:10:30 EDT To: wilderness-emergency-medicine@list.pitt.edu Date: Tue, 21 Sep 1999 09:12:32 -0700 Subject: W-EMED A source on the two-compass trick Message-ID: <19990921.091233.18766.1.JayWiseman@juno.com> References: <199909201745.KAA29343@macs.mxim.com> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 0-2,7-8,14-15,18-19,21-25 From: Jay J Wiseman Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 128 0 1 P1C2D0.CNM Hi folks, Jay here. I've been looking over various "wilderness survival" web sites (the ones associated with www.equipped.org seem very good) and I found a source for the "two compass" trick. That piece of advice, and what appears to be a very great deal of other very useful advice, can be found at http://www.backcountryinc.com/peterk.html on the web. The material is written by a man named Peter Kummerfeldt. According to a bio posted at the site: "Peter Kummerfeldt is a noted survival expert and chief instructor for the Survival Consultant Group. His interest in survival began with a 1953 National Geographic article on the U.S. Air Force survival-training program. Peter served 30 years in the U.S. Air Force as a survival instructor." I've noted several other interesting wilderness survival websites, and some good SAR sites as well. I'll post them if anybody's interested. Anybody else know of any good ones? Note: I have no commercial/professional/etc. relationship with any of these web sites. Regards, Jay ___________________________________________________________________ Get the Internet just the way you want it. Free software, free e-mail, and free Internet access for a month! Try Juno Web: http://dl.www.juno.com/dynoget/tagj. 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 21 Sep 1999 23:53:49 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 21 Sep 1999 12:08:10 -0400 (EDT) Received: via switchmail; Tue, 21 Sep 1999 12:08:06 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 21 Sep 1999 12:05:18 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 21 Sep 1999 12:04:41 -0400 (EDT) Received: from smtp2.supernet.com (qmailr@smtp2.desupernet.net [204.249.184.45]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 21 Sep 1999 12:04:37 -0400 (EDT) Received: (qmail 27684 invoked from network); 21 Sep 1999 16:07:52 -0000 Received: from port1-1.allentown.desupernet.net (HELO redrose.net) (208.157.103.112) by smtp2.supernet.com with SMTP; 21 Sep 1999 16:07:52 -0000 Message-ID: <37E7AC1D.3755BBDE@redrose.net> Date: Tue, 21 Sep 1999 12:02:37 -0400 From: Chris Porter X-Mailer: Mozilla 4.5 [en] (Win98; U) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu, "Langley R. Muir" Subject: Re: W-EMED Efficacy of Handwashing References: <3.0.5.32.19990921104218.007c1780@mail.magma.ca> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P584E0.CNM Try the following: http://155.217.58.58/cgi-bin/atdl.dll/fm/21-10/toc.htm This is the Army's Preventative Med manual and it may contain what you are looking for. Chris Porter "Langley R. Muir" wrote: > I have seen a number of unsupported statements in outdoor articles and > courses to the effect that ... XX% of people leaving outdoor courses do so > because of gastrointestinal problems that could have been prevented by > handwashing ... The value of XX varies somewhat, depending upon the source > of the anecdote. > > I have already seen the long set of abstracts on hygiene and handwashing > which is available at: http://users.aol.com/comcontrol/. I have also done > my own primary literature searches on the subject of handwashing and > related gastro-intestinal problems or infection in the outdoors. In no > case have I found any reference to a study which would provide any credible > value for XX in the above assertion or anything related to it. > > Clearly, handwashing is extremely important in reducing bacteria on the > hands and all of the references cited support this. However, everything > that I have seen has been related to food-handlers or urban health care or > day care facilities. From first principles, it is obvious that handwashing > in the outdoors is important and I don't need anyone to tell me this. > > Does anyone know of any actual statistical evidence or scientific studies > related to handwashing, gastro-intestinal problems, infection, and outdoor > activities? I would have thought that NOLS, Outward Boound, the Boy > Scouts, or the military should have some, but I haven't been able to find > anything other than bald statements that handwashing is important. > > Thanks in advance for any help that anone is able to give me. > > Cheers. Langley > > Dr. Langley R. Muir > 4 Valewood Crescent 1-613-824-9391 (voice) > Gloucester, Ontario 1-613-824-2875 (fax) > Canada cc913@ncf.ca > K1B 4E8 > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 21 Sep 1999 10:43:41 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 21 Sep 1999 10:43:02 -0400 (EDT) Received: via switchmail; Tue, 21 Sep 1999 10:43:00 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 21 Sep 1999 10:40:55 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 21 Sep 1999 10:40:27 -0400 (EDT) Received: from mx1.magmacom.com (mx1.magmacom.com [206.191.0.217]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 21 Sep 1999 10:40:17 -0400 (EDT) Received: from mail2.magma.ca (mail2.magma.ca [206.191.0.218]) by mx1.magmacom.com (8.9.1a/8.9.1) with ESMTP id KAA23989 for ; Tue, 21 Sep 1999 10:42:22 -0400 (EDT) Received: from default (x2port98.magma.ca [206.191.28.98]) by mail2.magma.ca (8.9.3/8.9.3) with SMTP id KAA12585 for ; Tue, 21 Sep 1999 10:42:20 -0400 (EDT) Message-Id: <3.0.5.32.19990921104218.007c1780@mail.magma.ca> X-Sender: langley@mail.magma.ca X-Mailer: QUALCOMM Windows Eudora Light Version 3.0.5 (32) Date: Tue, 21 Sep 1999 10:42:18 -0400 To: wilderness-emergency-medicine@list.pitt.edu From: "Langley R. Muir" Subject: W-EMED Efficacy of Handwashing Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P52480.CNM I have seen a number of unsupported statements in outdoor articles and courses to the effect that ... XX% of people leaving outdoor courses do so because of gastrointestinal problems that could have been prevented by handwashing ... The value of XX varies somewhat, depending upon the source of the anecdote. I have already seen the long set of abstracts on hygiene and handwashing which is available at: http://users.aol.com/comcontrol/. I have also done my own primary literature searches on the subject of handwashing and related gastro-intestinal problems or infection in the outdoors. In no case have I found any reference to a study which would provide any credible value for XX in the above assertion or anything related to it. Clearly, handwashing is extremely important in reducing bacteria on the hands and all of the references cited support this. However, everything that I have seen has been related to food-handlers or urban health care or day care facilities. From first principles, it is obvious that handwashing in the outdoors is important and I don't need anyone to tell me this. Does anyone know of any actual statistical evidence or scientific studies related to handwashing, gastro-intestinal problems, infection, and outdoor activities? I would have thought that NOLS, Outward Boound, the Boy Scouts, or the military should have some, but I haven't been able to find anything other than bald statements that handwashing is important. Thanks in advance for any help that anone is able to give me. Cheers. Langley Dr. Langley R. Muir 4 Valewood Crescent 1-613-824-9391 (voice) Gloucester, Ontario 1-613-824-2875 (fax) Canada cc913@ncf.ca K1B 4E8 Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 21 Sep 1999 09:51:47 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 21 Sep 1999 09:29:04 -0400 (EDT) Received: via switchmail; Tue, 21 Sep 1999 09:29:01 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 21 Sep 1999 09:27:22 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 21 Sep 1999 09:26:48 -0400 (EDT) Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 21 Sep 1999 09:26:44 -0400 (EDT) Received: from unixs5.cis.pitt.edu (smast27@unixs5.cis.pitt.edu [136.142.185.57]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 21 Sep 1999 09:26:31 -0400 (EDT) Date: Tue, 21 Sep 1999 09:27:18 -0400 (EDT) From: Suzanne M Atkinson X-Sender: smast27@unixs5.cis.pitt.edu To: Michael Williams cc: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED How much is too much?!? In-Reply-To: <37E76D72.D0A0A600@hpd.nova.edu> Message-ID: MIME-Version: 1.0 Content-Type: TEXT/PLAIN; charset=US-ASCII Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P58AA0.CNM I'll have to throw in my two cents as agreeing with the "kill them with kindness" point of view. I am also a med student, and we have had several discussions about malpractice in our ethics classes. The overriding theme is that if you have a decent bedside manner, you are unlikely (or much less likely) to be sued, even if something does go wrong. If you are a jerk about the matter, there is much less resistance to the famililes hesitency to press charges. ******************************************************************************* Suzanne M. Atkinson U. of Pittsburgh, MS-II E-mail: smast27+@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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 21 Sep 1999 12:24:34 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 21 Sep 1999 12:24:24 -0400 (EDT) Received: via switchmail; Tue, 21 Sep 1999 12:24:22 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 21 Sep 1999 12:22:35 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 21 Sep 1999 12:22:16 -0400 (EDT) Received: from imo22.mx.aol.com (imo22.mx.aol.com [198.81.17.66]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 21 Sep 1999 12:22:11 -0400 (EDT) From: RSSHANDLER@aol.com Received: from RSSHANDLER@aol.com by imo22.mx.aol.com (mail_out_v22.4.) id hYNEa22821 (4402) for ; Tue, 21 Sep 1999 12:23:40 -0400 (EDT) Message-ID: Date: Tue, 21 Sep 1999 12:23:40 EDT Subject: W-EMED cpr masks To: wilderness-emergency-medicine@list.pitt.edu MIME-Version: 1.0 Content-Type: text/plain; charset="ISO-8859-1" X-Mailer: AOL for Macintosh sub 54 Content-Transfer-Encoding: 8bit X-MIME-Autoconverted: from quoted-printable to 8bit by list.srv.cis.pitt.edu id MAA13924 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P4E5D0.CNM To deposit my 2¢'s worth on the cpr mask thread, I actually carry both the MDI mask/ glove pouch and the larger Laerdal in it's plastic case when ski patrolling. The MDI rides on the outside of my pack giving me immediate access to a CPR mask as well as a spare pair of gloves. The Laerdal is not too much harder to access inside my patrol pack, but my main reason for having 2 is so that in the event of the mask becoming clogged (i.e. frozen secretions) I can switch to the other mask quickly instead of dealing with the clog. Although I've never had to exercise this option I like having it. Additionally, I wonder if the masks that have a "bite block" type tube that goes between the pt's teeth might potentially help to maintain an airway, especially with facial injuries, better than the "seal around the nose and mouth" variety. Does anybody have any experience with this or thoughts about it? Thanks for your time. Rick Shandler 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 21 Sep 1999 07:34:28 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 21 Sep 1999 07:33:56 -0400 (EDT) Received: via switchmail; Tue, 21 Sep 1999 07:33:56 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 21 Sep 1999 07:32:23 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 21 Sep 1999 07:31:26 -0400 (EDT) Received: from solar.acast.nova.edu (solar.acast.nova.edu [137.52.224.11]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 21 Sep 1999 07:31:23 -0400 (EDT) Received: from hpd.nova.edu (ppp198-142.acast.nova.edu [137.52.198.142]) by solar.acast.nova.edu (8.9.1/8.9.1) with ESMTP id HAA23006 for ; Tue, 21 Sep 1999 07:33:29 -0400 (EDT) Message-ID: <37E76D72.D0A0A600@hpd.nova.edu> Date: Tue, 21 Sep 1999 07:35:14 -0400 From: Michael Williams X-Mailer: Mozilla 4.61 [en] (Win98; U) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED How much is too much?!? References: <199909201508.LAA17160@post-ofc06.srv.cis.pitt.edu> <004301bf03d4$912da120$505396ce@oemcomputer> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 1572992 0 1 P122D0.CNM Here's my $.02: I took a Medical Jurisprudence course in my 2nd year in med. school, and that hardly qualifies me as an expert. However, its was clear that unless you have agreed to take on a patient (i.e., You are working in an ER, or have merely discussed a patient's issue over the telephone), it is neither abandonment nor is it neglect if you do absolutely nothing for someone bleeding to death on a trail. As unconscionable as that seems, there is no LEGAL obligation to act toward an injured party. Of course, you have an ethical obligation, but that's the angle in which you would garner legal protection (i.e.., failing to use the IV in your pack). This means even if didn't feel like schlepping all the gear you would like, you are under no legal obligation to do so. This statute would avoid a civil suit, or get it quickly dismissed. Of course, what would mainly avoid any trouble, even if there were some negligence or abandonment, is Dr. Conover's advice from yesterday. Perhaps I'm naive, but it would seem a little kindness and manners would protect you a great deal more than a staff of attorneys! I apologize if this answer was long winded, I am a med. student, not a lawyer, and perhaps a lawyer should be consulted for the most accurate answer. Peace, Michael B. Williams Nova Southeastern College of Osteopathic Medicine Class of 2000 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 21 Sep 1999 09:28:45 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 21 Sep 1999 09:28:09 -0400 (EDT) Received: via switchmail; Tue, 21 Sep 1999 09:28:08 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 21 Sep 1999 09:27:31 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 21 Sep 1999 09:27:20 -0400 (EDT) Received: from imo25.mx.aol.com (imo25.mx.aol.com [198.81.17.69]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 21 Sep 1999 09:27:15 -0400 (EDT) From: Yankeemedc@aol.com Received: from Yankeemedc@aol.com by imo25.mx.aol.com (mail_out_v22.4.) id hOGFa20770 (4068) for ; Tue, 21 Sep 1999 09:28:49 -0400 (EDT) Message-ID: <473148ad.2518e211@aol.com> Date: Tue, 21 Sep 1999 09:28:49 EDT Subject: Re: W-EMED How much is too much?!? To: wilderness-emergency-medicine@list.pitt.edu MIME-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Content-Transfer-Encoding: 7bit X-Mailer: AOL 3.0 16-bit for Windows sub 41 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P78040.CNM Michele, and list: The point here is not, I believe, to necessarily smile, but to act with genuine concern for the welfare of the patient, without letting the egos of the caregivers get inthe way creating an uncomfortable situation. Believe it or not, my experience has been (over about 25+ years in emergency services) that when the primary goals (notice plural) of the responders involved are to (#1) give the patient the best care possible while (#2) keeping everyone else safe from harm. The problems generally occur when one of these goals is not understood to be a priority. The best solution for this, in my experience, is to communicate - with the patient, with the family, and with the other rescuers. Communication with the patient and family are very high priorities, they must be made to understand the risks involved for everyone, patient and rescuers alike. The same goes for rescuers. This goes for everything from treatment modalities and refusal of care, to complex technical rescue evolutions. Sometimes, the explanation is deferred, the rescuee relies on the "good judgement" of the "experts" (the rescuers) to get the job done. And when evrything works out per the plan, that is great. It is when something goes awry that problems occur. The standards you have decided to adopt, for your self, and for your organization, along with your SOPs and operational guidelines are designed to minimize these risks. So is a functional Incident Management System, designed to minimize risks by creating accountability. Being prepared is one thing, but one must also understand their own limitations, the limitations of those they are working with, and the limitations of the equipment they are carrying. I won't say - "Don't carry any equipment, it will get you in trouble" I travel considerably in my state, teaching EMS, Rescue, and Hazmat. I carry an extensive array of various types of equipment, including some technical rope gear, and an ALS level medical kit. I try to use my best judgement whenever I stop to assist at a scene. I long ago decided that I will provide the same level of care to a patient no matter whose jurisdiction I am in, and will deal with the consequences later. I know paramedics who have had their licenses suspended, and reinstated for doing just that. However, I feel it necessary to act consistently, safely, and within the scope of my expertise. I have also assisted departments with technical expertise and equipment that they did not possess. But in each and every case, the driving force was to ASSIST in a safe end effective manner. More of a case of - "I can do this if you want me to, and I feel that WE can safely effect this rescue". More of a matter of not stepping on toes in some cases. This probably doesn't answer your questions, but maybe can give you some insight into the thought processes necessary to make informed, rationale decisions in emergency situations. It sounds like you already play the "What if....." game. All emergency personnel I know who are worth their salt play it. Sometimes we do formal what if's. Sometimes just driving down the road, we do it informally. It's a great exercise for the mind, and a great way to develop new ideas. but most important, it is a way to preplan for those things you might run across, and better prepare yourself. The truth is, I am impressed. You are dealing with issues at the age of 17, that many people can't even foresee at a much more advanced age. you have a great deal of foresight, and i wish you well in this field. Keep up the good work. Charlie Dusha Assistant Chief/Paramedic Logan-Rogersville Fire District Springfield, MO "They say that memory is one of the first things to go in Alzheimers, but I can't remember whether or not that is true." (Before anyone takes offense - not a dig at alzheimers - just at my own memory lapses) 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 20 Sep 1999 21:53:07 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 20 Sep 1999 21:52:33 -0400 (EDT) Received: via switchmail; Mon, 20 Sep 1999 21:52:33 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 20 Sep 1999 21:51:20 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 20 Sep 1999 21:50:55 -0400 (EDT) Received: from buzz.slic.com (buzz.slic.com [206.25.233.41]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 20 Sep 1999 21:50:51 -0400 (EDT) Received: (qmail 21524 invoked by uid 0); 21 Sep 1999 01:52:56 -0000 Received: from chazy-tty16.slic.com (HELO oemcomputer) (206.150.83.80) by buzz.slic.com with SMTP; 21 Sep 1999 01:52:56 -0000 Message-ID: <004301bf03d4$912da120$505396ce@oemcomputer> From: "Michelle Schonzeit" To: References: <199909201508.LAA17160@post-ofc06.srv.cis.pitt.edu> Subject: Re: W-EMED How much is too much?!? Date: Mon, 20 Sep 1999 21:54:09 -0400 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 5.00.2014.211 X-MimeOLE: Produced By Microsoft MimeOLE V5.00.2014.211 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P2B8C0.CNM ----- Original Message ----- From: Keith Conover, M.D., FACEP > There are two main things that create a likelihood that you will get > sued for negligence. > > #1 reason someone may sue you: You act like an asshole. This is > more important than anything else. If you are a nice person and > whoever you're trying to help, or their family if the person you're > helping dies, thinks you're a nice person, they won't likely sue you. That's actually a very good point! So, lets see, that would now change the first steps to be ... Smile, Airway, Breathing, Circulation, Paperwork (try *really* hard to hold the smile through the paper work!!!) Also a quick clarification after rereading what I had typed last night while half asleep.... I would never just decide that "I didn't feel like" using equipment on hand to help someone as a bystander because I was lazy. I meant that statement more as "I wouldn't be prepared" because most of the time I don't bother schlepping all of the supplies I would use/want/need in a situation and in the rope rescue scenario I really don't know I would simply feel safe running it alone. And, no, no one paid me to post this message as a "prelude to the revision of the medical kit list" as Dr. Conover suggests, but if any would like to pay me they are more than welcome... I've got a nice long "wish list" starting with a car!! 73s and Think SNOW!!! Michelle Schonzeit http://www.angelfire.com/mt/schonzeit 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 20 Sep 1999 17:36:02 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 20 Sep 1999 17:21:43 -0400 (EDT) Received: via switchmail; Mon, 20 Sep 1999 17:21:42 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 20 Sep 1999 17:21:00 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 20 Sep 1999 17:20:27 -0400 (EDT) Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 20 Sep 1999 17:20:24 -0400 (EDT) Received: from micron (ehdup-b3-8.rmt.net.pitt.edu [136.142.20.118]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Mon, 20 Sep 1999 17:20:21 -0400 (EDT) Message-Id: <199909202120.RAA25583@post-ofc04.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: wilderness-emergency-medicine@list.pitt.edu Date: Mon, 20 Sep 1999 17:22:26 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: W-EMED Alcatel HPU 33400 Heatpac Personal Heater availability? X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu If you look at my home page (URL below), you'll find an article on the SAR/Outdoor page about what I learned as the "charcoal vest", Alcatel HPU 33400 Heatpac Personal Heater is the official name. This device is the best hypothermia rewarming device I've ever seen. I've got one myself, and for the past year or two I've been trying to get some more for the local mountain rescue team and for the local cave rescue equipment caches. However, Hawills, who is the sole US distributor I've found (contact information on my Web site, URL below), hasn't been able to get them because apparently the military is soaking up all of the production. Does anyone have another source for these devices? Or know anyone we can pressure to get a few freed up for civilian SAR teams? Hawill's has about 30 outstanding backorders and hasn't been able to get anyone to even really talk with them about getting more. Thanks for any help. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 20 Sep 1999 11:11:48 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 20 Sep 1999 11:11:05 -0400 (EDT) Received: via switchmail; Mon, 20 Sep 1999 11:11:05 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 20 Sep 1999 11:09:34 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 20 Sep 1999 11:08:36 -0400 (EDT) Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 20 Sep 1999 11:08:33 -0400 (EDT) Received: from micron (ehdup-i-14.rmt.net.pitt.edu [136.142.21.184]) by post-ofc06.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 20 Sep 1999 11:08:19 -0400 (EDT) Message-Id: <199909201508.LAA17160@post-ofc06.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: "Michelle Schonzeit" , wilderness-emergency-medicine@list.pitt.edu Date: Mon, 20 Sep 1999 11:10:23 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED How much is too much?!? and ASA for medical kits In-reply-to: <001701bf030e$afd72040$215396ce@oemcomputer> X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu On 19 Sep 99, at 22:19, Michelle Schonzeit wrote: > The most interesting part to me came up while he was discussing > legal responsibility while acting under that well know "Good Sam. > Law" Basically his arguement was that if yoiu're one of those > people who are driving around with half an emergency room in your > car you are far more likely to have trouble in a law suit, because > you'd most likely be providing care at a more advanced level, and > could leave a good lawyer a lot to play with. Disclaimer: I'm not a lawyer, nor do I play one on TV. However, as a doctor, I have a certain amount of training and experience with legal matters, including expert-witness work in malpractice situations regarding emergencies and SAR incidents. There are two main things that create a likelihood that you will get sued for negligence. #1 reason someone may sue you: You act like an asshole. This is more important than anything else. If you are a nice person and whoever you're trying to help, or their family if the person you're helping dies, thinks you're a nice person, they won't likely sue you. If, on the other hand, during the rescue, you get in fights with people, argue with the patient, and kick the SAR dogs -- then even if you did everything right, the patient will want to sue you. (If you did everything right and documented it, then the lawyer won't take the case, but the people will still _want_ to sue you.) #2 reason someone may sue you: something bad happens during the rescue. I probably don't need to belabor this. If something bad happens to someone, and you come along as a volunteer and help, and nothing bad happens during the rescue, you're probably in good shape. And, I would submit, if you have all of that heavy stuff in your pack makes it less likely that something bad will happen during the rescue. I will also note that WEMSI is working over our Personal Wilderness Medical Kit list, and expect to post a draft at www.wemsi.org within the week, and it will actually be somewhat lighter than before! And, sometime in the next couple of months we'll post a draft of a suggested daypack medical kit list for WEMTs, too. The Personal Wilderness Medical Kit list is designed for a WEMT with a SAR team -- however the daypack medical kit is just that, for WEMTs who are going out with friends or family for the day. Remember, the contents of a medical kit depends a lot on your training -- and thus I think a WEMT ought to have a different daypack first aid kit than someone with just first aid training. So I expect this list to liven up with long and esoteric discusions of, for example, whether naproxen (e.g., Aleve) or Trilisate is a better NSAID to carry in a WEMT's kit -- which will no doubt make more people carry more stuff around with them, which I think is good, what that lawyer said notwithstanding. (P.S. did one of the WEMSI staff members pay you to post this message as a prelude to the revision of the medical kit list?) WEMSI staffers -- last call -- please review the last internal draft of the wilderness medical kit list so I can get it posted for list members by the end of this month. Especially comment on whether we should change the ASA dose from 325 mg tablets to 81 mg ASA tablets. As we have ASA in there solely for chest pain, and I don't think I'd start anyone on ASA for a CVA or TIA without a CT scan to rule out a small bleed first, I'm in favor of switching to 81 mg chewable baby ASA tablets. It saves a tiny bit of weight and bulk, and as I'm in the pack-enough-for-any-emergency but-cut-the-handle-off-the- toothbrush and cut-the-margins-off-the-map school, it makes sense to me. And from an old argument, if someone says "do you have some aspirin, I don't want Tylenol because I like aspirin better for my headache" the answer is "no." Take care. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 20 Sep 1999 13:46:21 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 20 Sep 1999 13:45:49 -0400 (EDT) Received: via switchmail; Mon, 20 Sep 1999 13:45:49 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 20 Sep 1999 13:44:25 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 20 Sep 1999 13:43:55 -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-7.2.2.1) ID for ; Mon, 20 Sep 1999 13:43:49 -0400 (EDT) Received: from localhost (localhost [127.0.0.1]) by macs.mxim.com (8.7/8.6.9) with SMTP id KAA29343 for ; Mon, 20 Sep 1999 10:45:23 -0700 (PDT) Message-Id: <199909201745.KAA29343@macs.mxim.com> X-Mailer: exmh version 2.0.1 12/23/97 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED How much is too much?!? In-reply-to: Your message of "Sun, 19 Sep 1999 22:19:28 EDT." <001701bf030e$afd72040$215396ce@oemcomputer> Mime-Version: 1.0 Content-Type: text/plain; charset=us-ascii Date: Mon, 20 Sep 1999 10:45:22 PDT From: Hal Lillywhite Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P19130.CNM "Michelle Schonzeit" writes: >The most interesting part to me came up while he was discussing >legal responsibility while acting under that well know "Good Sam. >Law" Basically his arguement was that if yoiu're one of those >people who are driving around with half an emergency room in >your car you are far more likely to have trouble in a law suit... >I often carry rope and some biners, but while it often comes in >handy for odd jobs, if I did run into a rope rescue scenario, I >would not be prepared. While I never thought of it, it would seem >that say if I was named in a law suit a lawyer could say that being >a rescue person if I assisted and had rope that I decided I didn't >feel like using it could make me more liable, or hoping that kind >of thing wouldn't really stand up, lets say on the other hand I did >use it and some thing broke or got fouwled up, Like Dr. Conover, I am neither a lawyer nor do I play one on TV, I have enough sins without that. :-) I do believe Dr. Conover gives good advice when he says that you are less likely to be sued if you are nice and the subject/family like you. However I doubt this is 100% effective protection. No amount of niceness will protect you if you make a serious mistake and injure or kill a patient. Even without that, the patient or family may not be as nice as you are. If they see a chance for some easy money, I wouldn't count on being nice to counteract their greed. Sadly, there are some folks in this world who will take advantage of a Good Samaritan if they think they can profit thereby. Throw in an ambulance chasing lawyer and even some nice folks may sue you if they think they can get some money. Will carrying equipment you don't use cause you to loose a lawsuit? I don't know but the answer probably varies with jurisdiction. In general, Good Samaritan Laws require that you provide care to your level of training. As far as I know they do not require you to use any particilar equipment. However I suspect that you would be in legal jeopardy if: 1. You had equipment on hand, and 2. Arbitrarily (important word) decided not to use it, and 3. That non-use adversely affected the outcome Back to your example of not using the rope you carry. I suspect that in a legal action the issue would be one of why you did not use it. If you can give good reason for non-use you are probably OK. For example, there was no appropriate anchor available, or you were the only trained rescuer on scene and it was dangerous to allow untrained people to run a raising then you should have a good defense. Avoiding risk of dropping a patient meets the "do no harm" standard of all SAR. However if you were simply too lazy to climb 30 ft. up to a good anchor you might be in trouble. Summary: Use good practices whether on an official mission or as a bystander. If equipment cannot be safely used, then do not use it. If safety is not an issue, provide the most appropriate treatment you can under the circumstances. You have no legal obligation as a bystander to help a subject. However, once you begin to help you do usually assume an obligation to assist to the best of your ability. If you can document that your decisions were appropriate to the circumstances you should be OK. Any lawyers on this list who can confirm or negate my opinions or provide other information? 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 18 Sep 1999 21:21:57 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 18 Sep 1999 21:21:25 -0400 (EDT) Received: via switchmail; Sat, 18 Sep 1999 21:21:25 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 18 Sep 1999 21:20:10 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Sat, 18 Sep 1999 21:19:07 -0400 (EDT) Received: from imo17.mx.aol.com (imo17.mx.aol.com [198.81.17.7]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 18 Sep 1999 21:19:04 -0400 (EDT) From: Srchyn@aol.com Received: from Srchyn@aol.com by imo17.mx.aol.com (mail_out_v22.4.) id hRZTa12359 (3937) for ; Sat, 18 Sep 1999 21:20:36 -0400 (EDT) Message-ID: <4e7bd03a.25159464@aol.com> Date: Sat, 18 Sep 1999 21:20:36 EDT Subject: Re: W-EMED Homeworkers Needed! To: wilderness-emergency-medicine@list.pitt.edu MIME-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Content-Transfer-Encoding: 7bit X-Mailer: AOL for Macintosh sub 54 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P0B680.CNM It's truly amazing how bent out of shape and flustered, so many emergency med types got over a bunch of stupid emails. Get a little perspective people. You weren't victimized, it didn't do anything but waste a couple of minutes of your time. Remember that rule from the "House of God"- "at a cardiac arrest, the first thing you do is take your own pulse." Dennis 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Thu, 16 Sep 1999 08:37:41 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Thu, 16 Sep 1999 08:37:34 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Thu, 16 Sep 1999 08:37:32 -0400 (EDT) Received: from mcc15.monroecc.edu (exchange.monroecc.edu [150.160.16.35]) by post-ofc01.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Thu, 16 Sep 1999 08:37:27 -0400 (EDT) Received: by exchange.monroecc.edu with Internet Mail Service (5.5.2448.0) id ; Thu, 16 Sep 1999 08:40:12 -0400 Message-ID: <535A64F56835D211AE6100A0C9612D16174A1D@mcc25.monroecc.edu> From: "Connolly, Marc (on Outlook)" To: "'kconover+@pitt.edu'" Cc: "Slattery, Michael (on Outlook)" Subject: RE: regarding the spam mess Date: Thu, 16 Sep 1999 08:37:32 -0400 Return-Receipt-To: "Connolly, Marc (on Outlook)" MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.2448.0) Content-Type: text/plain; charset="iso-8859-1" X-PMFLAGS: 524416 0 1 P6AFE0.CNM Thank you-- Marc -----Original Message----- From: Keith Conover, M.D., FACEP [mailto:kconover+@pitt.edu] Sent: Thursday, September 16, 1999 12:09 AM To: Connolly, Marc (on Outlook); Slattery, Michael (on Outlook) Cc: wilderness-emergency-medicine@list.pitt.edu Subject: Re: regarding the spam mess Hi, Marc. I figured it was something of the sort. I've unsubscribed your address. Please let me know when you and the email administrator track down the culprit, and let me know if and when I should resubscribe your address. If you'll let us know what happened, I'll be happy to forward any messages you miss. Take care. On 15 Sep 99, at 15:51, Connolly, Marc (on Outlook) wrote: > Dr. Conover, > I became aware of the problem when I received a phone call from a member > of the list and then I saw your note. Since then, three more of the spam > messages were posted in my name on the wemd list while I was driving > between campuses at MCC! I have spoken with our email administrator (Mike > Slattery). > > Please remove me from your list as I do not want further messages going > out under my name. > > I did receive the spam message this morning, and as I quite often do, sent > a message to the sender. In a very small percentage of the cases where I > receive unsolicited mail, I do get removed from the list--so I give it a > try. Unless something went very wrong, I did not send it to the list, and > I did not send the volume I am also receiving on the list! > > However, I am still seeing these messages being sent. > > Marc Connolly > > --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 16 Sep 1999 07:22:28 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 16 Sep 1999 07:21:56 -0400 (EDT) Received: via switchmail; Thu, 16 Sep 1999 07:21:55 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 16 Sep 1999 07:20:23 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 16 Sep 1999 07:20:15 -0400 (EDT) Received: from aldus.northnet.org (qmailr@aldus.northnet.org [198.175.11.2]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 16 Sep 1999 07:20:12 -0400 (EDT) Received: (qmail 12202 invoked by uid 0); 16 Sep 1999 11:22:32 -0000 Received: from ppp-44.saranac.northnet.org (HELO northnet.org) (204.255.184.47) by aldus.northnet.org with SMTP; 16 Sep 1999 11:22:32 -0000 Message-ID: <37E0D4C8.1C441C3A@northnet.org> Date: Thu, 16 Sep 1999 07:30:17 -0400 From: karen smith X-Mailer: Mozilla 4.61 [en] (Win98; I) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Homeworkers Needed! References: <0006F043.4215@atlanticare.org> <4.2.0.58.19990916002320.0096ef00@popserver.panix.com> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P02360.CNM Stacey & Larry wrote: > Whoa! I think most people are way off base here! > > >Whatever the reason, and I'm suspicious of some sort of virus or > >malicious person on his computer, I've terminated his subscription to > >this list, and have requested the postmaster at Monroe Community > >College to terminate his email account. My apologies to the list > >members. > > Actually, the villain here is: mowhco@att.net > > I doubt Marc Connelly intended to spam the list -- I think he was trying to > strike back at the original spammer, and got tricked into doing something > dumb. This doesn't sound like any of the Melissa flavor of viruses, nor > does it look like a setup to me. > > I think Marc saw the spam, got pissed off, and tried to sent 10 copies back > to the spammer -- but he didn't see the Reply-To header, and sent his > "retribution" back to the list by accident. (I do not know him - this is > just my conclusion based on my analysis.) > > Here's my header analysis: (all times EST -0400 unless otherwise noted) > > ============================================================ > At 11:37:41 Spam #1 was sent, with these (trimmed) headers: > > >Received: from <...> p221.amax5.dialup.lax1.flash.net <...> > >From: mowhco@att.net > >Subject: W-EMED Homeworkers Needed! > >To: undisclosed-recipients:; > >Sender: owner-wilderness-emergency-medicine@list.pitt.edu > >Reply-To: wilderness-emergency-medicine@list.pitt.edu > > [This means someone on a flash.net dialup claiming to be "mowhco@att.net" > BCC'ed the WEMED list with his spam (hence the "undisclosed > recipients). Many people probably didn't realize this first spam came via > the WEMED list, since the To: field was munged. (my filter didn't pick it > up for that reason). The headers that I trimmed show a number of attempts > at indirection, to throw off those who are inexperienced in tracking spam.] > > ================================================================== > > At 11:54:58, 11:55:00, 11:55:01, 11:55:02, 11:55:03, 11:55:04, 11:55:05, > 11:55:07, 11:55:08, and 11:55:11 Spams #2-11 were sent with roughly these > (trimmed) headers: > > >Received: by exchange.monroecc.edu <...> > >Message-ID: <535A64F56835D211AE6100A0C9612D16174A10@mcc25.monroecc.edu> > >From: "Connolly, Marc (on Outlook)" > >To: "'wilderness-emergency-medicine@list.pitt.edu'" > > > >Subject: RE: W-EMED Homeworkers Needed! > > >Sender: owner-wilderness-emergency-medicine@list.pitt.edu > >Reply-To: wilderness-emergency-medicine@list.pitt.edu > ... > > [The full headers show a very clear path back to Monroe College & right > back to Marc's mailbox. There is no attempt at indirection, nor other > signs of a professional spammer. At the bottom of Marc's spam, is TWO > copies of the WEMED disclaimer. This would suggest that the original text > of Marc's message came FROM the WEMED list itself (ie- the first > spam.) The fact that this was a rapid fire succession of verbatim replies > about 20 minutes after the first spam, makes me think he was just "hitting > back" at the spammer -- instead, he missed and hit us.] > > ========================================================================== > > What to do: > > 1) Marc needs to wear the WEMED dunce cap and sit in the corner for a > little while. My guess is that when he's asked, he'll give a story > analogous to the above - there should be no problem letting him back on the > list, if he promises to be more careful, and learn a little more about spam > before taking action in the future. > > 2) The proper address for complaints is abuse@flash.net -- I've alerted > them, though I'm sure more feedback would impress on them the scope of the > problem. (Note if you complain to them, send the FULL headers of the FIRST > spam.) They seem to take spam seriously, and have a web page > (http://support.flash.net/nospam/) so you can see if they took action. > > 3) The WEMED list should be closed to submissions from people who are not > currently subscribed to the list. (This may or may not already be done.) > > 4) The moderators may wish to consider looking into some tools that filter > suspicious messages for manual handling (ie- BCC'd submissions, nonmember > submissions, multiple identical submissions, large submissions from new > subscribers, contain the words "earn more money", "check cash or money > order", etc...) > > --Larry Nathanson > > 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 16 Sep 1999 07:20:30 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 16 Sep 1999 07:19:57 -0400 (EDT) Received: via switchmail; Thu, 16 Sep 1999 07:19:56 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 16 Sep 1999 07:19:09 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 16 Sep 1999 07:19:02 -0400 (EDT) Received: from aldus.northnet.org (qmailr@aldus.northnet.org [198.175.11.2]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 16 Sep 1999 07:19:00 -0400 (EDT) Received: (qmail 11622 invoked by uid 0); 16 Sep 1999 11:21:20 -0000 Received: from ppp-44.saranac.northnet.org (HELO northnet.org) (204.255.184.47) by aldus.northnet.org with SMTP; 16 Sep 1999 11:21:20 -0000 Message-ID: <37E0D480.8A50DBAF@northnet.org> Date: Thu, 16 Sep 1999 07:29:05 -0400 From: karen smith X-Mailer: Mozilla 4.61 [en] (Win98; I) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Homeworkers Needed! References: <0006F043.4215@atlanticare.org> <199909160147.VAA09144@titan.tcn.net> <199909160352.XAA21244@titan.tcn.net> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P28D70.CNM Bernie Roche wrote: > At 11:28 PM 9/15/99 -0400, you wrote: > > > > > >Bernie Roche wrote: > > > >> At 02:10 PM 9/15/99 -0400, you wrote: > >> >On 15 Sep 99, at 13:52, Charles.Kleschick@atlanticare.org wrote: > >> > > >> >> This is message #7 so far that I've received. Are these errors or > >> >> are you seriously recruiting for this program? > >> > > >> >Whatever the reason, and I'm suspicious of some sort of virus or > >> >malicious person on his computer, I've terminated his subscription to > >> >this list, and have requested the postmaster at Monroe Community > >> >College to terminate his email account. My apologies to the list > >> >members. > >> > > >> > > >> >--Keith Conover, M.D., FACEP > >> > >> A few seconds before burning the supposed author at the stake, let's take a > >> moment to note that there have been similar mailings lately on other > >> mailing lists, which appear to have been done by an unknown person trying > >> to get the supposed (named) sender in trouble. This MAY be the case here. > >> There is, after all, no reasonable explanation for the supposed author to > >> send so many copies...even a complete idiot would know this would alienate > >> people and defeat the purpose of the advertisement. > >> > >> 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 > > Hmmmmm.....Karen, I have read and reread your comments, but I just can't > quite figure out what you were trying to say... > > > > 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 16 Sep 1999 07:20:24 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 16 Sep 1999 07:19:51 -0400 (EDT) Received: via switchmail; Thu, 16 Sep 1999 07:19:50 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 16 Sep 1999 07:18:49 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 16 Sep 1999 07:18:39 -0400 (EDT) Received: from aldus.northnet.org (qmailr@aldus.northnet.org [198.175.11.2]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 16 Sep 1999 07:18:37 -0400 (EDT) Received: (qmail 11435 invoked by uid 0); 16 Sep 1999 11:20:57 -0000 Received: from ppp-44.saranac.northnet.org (HELO northnet.org) (204.255.184.47) by aldus.northnet.org with SMTP; 16 Sep 1999 11:20:57 -0000 Message-ID: <37E0D469.A1E8D72A@northnet.org> Date: Thu, 16 Sep 1999 07:28:41 -0400 From: karen smith X-Mailer: Mozilla 4.61 [en] (Win98; I) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Homeworkers Needed! References: <0006F043.4215@atlanticare.org> <199909160147.VAA09144@titan.tcn.net> <37E063DA.77FE2713@northnet.org> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P1B900.CNM > Bernie Roche wrote: > > > At 02:10 PM 9/15/99 -0400, you wrote: > > >On 15 Sep 99, at 13:52, Charles.Kleschick@atlanticare.org wrote: > > > > > >> This is message #7 so far that I've received. Are these errors or > > >> are you seriously recruiting for this program? > > > > > >Whatever the reason, and I'm suspicious of some sort of virus or > > >malicious person on his computer, I've terminated his subscription to > > >this list, and have requested the postmaster at Monroe Community > > >College to terminate his email account. My apologies to the list > > >members. > > > > > > > > >--Keith Conover, M.D., FACEP > > > > A few seconds before burning the supposed author at the stake, let's take a > > moment to note that there have been similar mailings lately on other > > mailing lists, which appear to have been done by an unknown person trying > > to get the supposed (named) sender in trouble. This MAY be the case here. > > There is, after all, no reasonable explanation for the supposed author to > > send so many copies...even a complete idiot would know this would alienate > > people and defeat the purpose of the advertisement. > > > > Do not reproduce without author's express permission. > > To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" > > as the body of a message (no subject) To: Majordomo@list.pitt.edu > > Submissions To: wilderness-emergency-medicine@list.pitt.edu > > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 16 Sep 1999 07:20:10 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 16 Sep 1999 07:19:37 -0400 (EDT) Received: via switchmail; Thu, 16 Sep 1999 07:19:37 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 16 Sep 1999 07:18:04 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 16 Sep 1999 07:17:38 -0400 (EDT) Received: from aldus.northnet.org (qmailr@aldus.northnet.org [198.175.11.2]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 16 Sep 1999 07:17:35 -0400 (EDT) Received: (qmail 11011 invoked by uid 0); 16 Sep 1999 11:19:55 -0000 Received: from ppp-44.saranac.northnet.org (HELO northnet.org) (204.255.184.47) by aldus.northnet.org with SMTP; 16 Sep 1999 11:19:55 -0000 Message-ID: <37E0D42B.7194685D@northnet.org> Date: Thu, 16 Sep 1999 07:27:39 -0400 From: karen smith X-Mailer: Mozilla 4.61 [en] (Win98; I) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Homeworkers Needed! References: <0006F043.4215@atlanticare.org> <4.2.0.58.19990916002320.0096ef00@popserver.panix.com> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P6D9F0.CNM Stacey & Larry wrote: > Whoa! I think most people are way off base here! > > >Whatever the reason, and I'm suspicious of some sort of virus or > >malicious person on his computer, I've terminated his subscription to > >this list, and have requested the postmaster at Monroe Community > >College to terminate his email account. My apologies to the list > >members. > > Actually, the villain here is: mowhco@att.net > > I doubt Marc Connelly intended to spam the list -- I think he was trying to > strike back at the original spammer, and got tricked into doing something > dumb. This doesn't sound like any of the Melissa flavor of viruses, nor > does it look like a setup to me. > > I think Marc saw the spam, got pissed off, and tried to sent 10 copies back > to the spammer -- but he didn't see the Reply-To header, and sent his > "retribution" back to the list by accident. (I do not know him - this is > just my conclusion based on my analysis.) > > Here's my header analysis: (all times EST -0400 unless otherwise noted) > > ============================================================ > At 11:37:41 Spam #1 was sent, with these (trimmed) headers: > > >Received: from <...> p221.amax5.dialup.lax1.flash.net <...> > >From: mowhco@att.net > >Subject: W-EMED Homeworkers Needed! > >To: undisclosed-recipients:; > >Sender: owner-wilderness-emergency-medicine@list.pitt.edu > >Reply-To: wilderness-emergency-medicine@list.pitt.edu > > [This means someone on a flash.net dialup claiming to be "mowhco@att.net" > BCC'ed the WEMED list with his spam (hence the "undisclosed > recipients). Many people probably didn't realize this first spam came via > the WEMED list, since the To: field was munged. (my filter didn't pick it > up for that reason). The headers that I trimmed show a number of attempts > at indirection, to throw off those who are inexperienced in tracking spam.] > > ================================================================== > > At 11:54:58, 11:55:00, 11:55:01, 11:55:02, 11:55:03, 11:55:04, 11:55:05, > 11:55:07, 11:55:08, and 11:55:11 Spams #2-11 were sent with roughly these > (trimmed) headers: > > >Received: by exchange.monroecc.edu <...> > >Message-ID: <535A64F56835D211AE6100A0C9612D16174A10@mcc25.monroecc.edu> > >From: "Connolly, Marc (on Outlook)" > >To: "'wilderness-emergency-medicine@list.pitt.edu'" > > > >Subject: RE: W-EMED Homeworkers Needed! > > >Sender: owner-wilderness-emergency-medicine@list.pitt.edu > >Reply-To: wilderness-emergency-medicine@list.pitt.edu > ... > > [The full headers show a very clear path back to Monroe College & right > back to Marc's mailbox. There is no attempt at indirection, nor other > signs of a professional spammer. At the bottom of Marc's spam, is TWO > copies of the WEMED disclaimer. This would suggest that the original text > of Marc's message came FROM the WEMED list itself (ie- the first > spam.) The fact that this was a rapid fire succession of verbatim replies > about 20 minutes after the first spam, makes me think he was just "hitting > back" at the spammer -- instead, he missed and hit us.] > > ========================================================================== > > What to do: > > 1) Marc needs to wear the WEMED dunce cap and sit in the corner for a > little while. My guess is that when he's asked, he'll give a story > analogous to the above - there should be no problem letting him back on the > list, if he promises to be more careful, and learn a little more about spam > before taking action in the future. > > 2) The proper address for complaints is abuse@flash.net -- I've alerted > them, though I'm sure more feedback would impress on them the scope of the > problem. (Note if you complain to them, send the FULL headers of the FIRST > spam.) They seem to take spam seriously, and have a web page > (http://support.flash.net/nospam/) so you can see if they took action. > > 3) The WEMED list should be closed to submissions from people who are not > currently subscribed to the list. (This may or may not already be done.) > > 4) The moderators may wish to consider looking into some tools that filter > suspicious messages for manual handling (ie- BCC'd submissions, nonmember > submissions, multiple identical submissions, large submissions from new > subscribers, contain the words "earn more money", "check cash or money > order", etc...) > > --Larry Nathanson > > 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 16 Sep 1999 10:37:24 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 16 Sep 1999 10:36:52 -0400 (EDT) Received: via switchmail; Thu, 16 Sep 1999 10:36:52 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 16 Sep 1999 10:35:19 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 16 Sep 1999 10:34:50 -0400 (EDT) Received: from imo-d03.mx.aol.com (imo-d03.mx.aol.com [205.188.157.35]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 16 Sep 1999 10:34:47 -0400 (EDT) From: Yankeemedc@aol.com Received: from Yankeemedc@aol.com by imo-d03.mx.aol.com (mail_out_v22.4.) id hCVX0O0Lz7 (3876) for ; Thu, 16 Sep 1999 10:36:10 -0400 (EDT) Message-ID: Date: Thu, 16 Sep 1999 10:36:10 EDT Subject: Re: W-EMED Homeworkers Needed! To: wilderness-emergency-medicine@list.pitt.edu MIME-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Content-Transfer-Encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 26 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P65F80.CNM I think Karen has caught some kind of a bug now. Charlie Dusha 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 16 Sep 1999 01:42:35 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 16 Sep 1999 01:42:02 -0400 (EDT) Received: via switchmail; Thu, 16 Sep 1999 01:42:02 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 16 Sep 1999 01:40:22 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 16 Sep 1999 01:40:00 -0400 (EDT) Received: from smtp2.erols.com (smtp2.erols.com [207.172.3.235]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 16 Sep 1999 01:39:58 -0400 (EDT) Received: from foo (r95aag007784.sbo.ma.cable.rcn.com [209.6.197.43]) by smtp2.erols.com (8.8.8/8.8.5) with ESMTP id BAA08374 for ; Thu, 16 Sep 1999 01:42:10 -0400 (EDT) Message-Id: <4.2.0.58.19990916002320.0096ef00@popserver.panix.com> X-Sender: lanteej@pop.rcn.com X-Mailer: QUALCOMM Windows Eudora Pro Version 4.2.0.58 Date: Thu, 16 Sep 1999 01:28:56 -0400 To: wilderness-emergency-medicine@list.pitt.edu From: Stacey & Larry Subject: Re: Re[2]: W-EMED Homeworkers Needed! In-Reply-To: <199909151808.OAA17360@post-ofc05.srv.cis.pitt.edu> References: <0006F043.4215@atlanticare.org> Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii"; format=flowed Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P44090.CNM Whoa! I think most people are way off base here! >Whatever the reason, and I'm suspicious of some sort of virus or >malicious person on his computer, I've terminated his subscription to >this list, and have requested the postmaster at Monroe Community >College to terminate his email account. My apologies to the list >members. Actually, the villain here is: mowhco@att.net I doubt Marc Connelly intended to spam the list -- I think he was trying to strike back at the original spammer, and got tricked into doing something dumb. This doesn't sound like any of the Melissa flavor of viruses, nor does it look like a setup to me. I think Marc saw the spam, got pissed off, and tried to sent 10 copies back to the spammer -- but he didn't see the Reply-To header, and sent his "retribution" back to the list by accident. (I do not know him - this is just my conclusion based on my analysis.) Here's my header analysis: (all times EST -0400 unless otherwise noted) ============================================================ At 11:37:41 Spam #1 was sent, with these (trimmed) headers: >Received: from <...> p221.amax5.dialup.lax1.flash.net <...> >From: mowhco@att.net >Subject: W-EMED Homeworkers Needed! >To: undisclosed-recipients:; >Sender: owner-wilderness-emergency-medicine@list.pitt.edu >Reply-To: wilderness-emergency-medicine@list.pitt.edu [This means someone on a flash.net dialup claiming to be "mowhco@att.net" BCC'ed the WEMED list with his spam (hence the "undisclosed recipients). Many people probably didn't realize this first spam came via the WEMED list, since the To: field was munged. (my filter didn't pick it up for that reason). The headers that I trimmed show a number of attempts at indirection, to throw off those who are inexperienced in tracking spam.] ================================================================== At 11:54:58, 11:55:00, 11:55:01, 11:55:02, 11:55:03, 11:55:04, 11:55:05, 11:55:07, 11:55:08, and 11:55:11 Spams #2-11 were sent with roughly these (trimmed) headers: >Received: by exchange.monroecc.edu <...> >Message-ID: <535A64F56835D211AE6100A0C9612D16174A10@mcc25.monroecc.edu> >From: "Connolly, Marc (on Outlook)" >To: "'wilderness-emergency-medicine@list.pitt.edu'" > >Subject: RE: W-EMED Homeworkers Needed! >Sender: owner-wilderness-emergency-medicine@list.pitt.edu >Reply-To: wilderness-emergency-medicine@list.pitt.edu ... [The full headers show a very clear path back to Monroe College & right back to Marc's mailbox. There is no attempt at indirection, nor other signs of a professional spammer. At the bottom of Marc's spam, is TWO copies of the WEMED disclaimer. This would suggest that the original text of Marc's message came FROM the WEMED list itself (ie- the first spam.) The fact that this was a rapid fire succession of verbatim replies about 20 minutes after the first spam, makes me think he was just "hitting back" at the spammer -- instead, he missed and hit us.] ========================================================================== What to do: 1) Marc needs to wear the WEMED dunce cap and sit in the corner for a little while. My guess is that when he's asked, he'll give a story analogous to the above - there should be no problem letting him back on the list, if he promises to be more careful, and learn a little more about spam before taking action in the future. 2) The proper address for complaints is abuse@flash.net -- I've alerted them, though I'm sure more feedback would impress on them the scope of the problem. (Note if you complain to them, send the FULL headers of the FIRST spam.) They seem to take spam seriously, and have a web page (http://support.flash.net/nospam/) so you can see if they took action. 3) The WEMED list should be closed to submissions from people who are not currently subscribed to the list. (This may or may not already be done.) 4) The moderators may wish to consider looking into some tools that filter suspicious messages for manual handling (ie- BCC'd submissions, nonmember submissions, multiple identical submissions, large submissions from new subscribers, contain the words "earn more money", "check cash or money order", etc...) --Larry Nathanson 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 16 Sep 1999 00:09:37 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 16 Sep 1999 00:08:44 -0400 (EDT) Received: via switchmail; Thu, 16 Sep 1999 00:08:40 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 16 Sep 1999 00:07:35 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 16 Sep 1999 00:07:16 -0400 (EDT) Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 16 Sep 1999 00:07:12 -0400 (EDT) Received: from micron (ehdup-u-90.rmt.net.pitt.edu [136.142.23.200]) by post-ofc06.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 16 Sep 1999 00:07:04 -0400 (EDT) Message-Id: <199909160407.AAA12245@post-ofc06.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: "Slattery, Michael (on Outlook)" Date: Thu, 16 Sep 1999 00:08:54 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: FW: W-EMED Spam from your domain CC: wilderness-emergency-medicine@list.pitt.edu In-reply-to: <8D3F58D73235D211B7AD00A0C98282A8AFE56D@exchange.monroecc.edu> X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P5A650.CNM I'll forward them all to you for analysis. Thanks very much. On 15 Sep 99, at 15:33, Slattery, Michael (on Outlook) wrote: > Keith Conover: > > This is the postmaster for Monroe Community College in Rochester, > NY. I have received this message from one of my VAILD users here at the > college. It would seem that some email may be being sent in his name. If > you can provide me with the original messages so that I may use the SMTP > tracking information on each one to try and resolve this problem I would > appreciate it. > > Mike Slattery > Postmaster > Monroe Community College > > -----Original Message----- > From: Slattery, Michael (on Outlook) > Sent: Wednesday, September 15, 1999 3:29 PM > To: Slattery, Michael (on Outlook) > Subject: FW: W-EMED Spam from your domain > > > > -----Original Message----- > From: Keith Conover, M.D., FACEP [mailto:kconover+@pitt.edu] > Sent: Wednesday, September 15, 1999 2:01 PM > To: postmaster@monroecc.edu > Cc: wilderness-emergency-medicine@list.pitt.edu > Subject: W-EMED Spam from your domain > > I am forwarding, under separate cover, four spam messages that were sent > from a user in your domain to the international > wilderness-emergency-medicine list. Please investigate, and if possible, > terminate this email account. Thank you very much. * Keith Conover, M.D., > FACEP http://www.pitt.edu/~kconover Do not reproduce without author's > express permission. To unsubscribe, send the text "unsubscribe > wilderness-emergency-medicine" as the body of a message (no subject) To: > Majordomo@list.pitt.edu Submissions To: > wilderness-emergency-medicine@list.pitt.edu > --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: 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: <535A64F56835D211AE6100A0C9612D16174A1B@mcc25.monroecc.edu> X-RS-Sigset: 2 To: "Connolly, Marc (on Outlook)" ,"Slattery, Michael (on Outlook)" Subject: Re: regarding the spam mess Cc: wilderness-emergency-medicine@list.pitt.edu Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Thu, 16 Sep 1999 00:07:49 -0400 Hi, Marc. I figured it was something of the sort. I've unsubscribed your address. Please let me know when you and the email administrator track down the culprit, and let me know if and when I should resubscribe your address. If you'll let us know what happened, I'll be happy to forward any messages you miss. Take care. On 15 Sep 99, at 15:51, Connolly, Marc (on Outlook) wrote: > Dr. Conover, > I became aware of the problem when I received a phone call from a member > of the list and then I saw your note. Since then, three more of the spam > messages were posted in my name on the wemd list while I was driving > between campuses at MCC! I have spoken with our email administrator (Mike > Slattery). > > Please remove me from your list as I do not want further messages going > out under my name. > > I did receive the spam message this morning, and as I quite often do, sent > a message to the sender. In a very small percentage of the cases where I > receive unsolicited mail, I do get removed from the list--so I give it a > try. Unless something went very wrong, I did not send it to the list, and > I did not send the volume I am also receiving on the list! > > However, I am still seeing these messages being sent. > > Marc Connolly > > -- 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: <8D3F58D73235D211B7AD00A0C98282A8AFE56D@exchange.monroecc.edu> X-RS-Sigset: 2 To: "Slattery, Michael (on Outlook)" Subject: Re: FW: W-EMED Spam from your domain Cc: wilderness-emergency-medicine@list.pitt.edu Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Thu, 16 Sep 1999 00:06:05 -0400 I'll forward them all to you for analysis. Thanks very much. On 15 Sep 99, at 15:33, Slattery, Michael (on Outlook) wrote: > Keith Conover: > > This is the postmaster for Monroe Community College in Rochester, > NY. I have received this message from one of my VAILD users here at the > college. It would seem that some email may be being sent in his name. If > you can provide me with the original messages so that I may use the SMTP > tracking information on each one to try and resolve this problem I would > appreciate it. > > Mike Slattery > Postmaster > Monroe Community College > > -----Original Message----- > From: Slattery, Michael (on Outlook) > Sent: Wednesday, September 15, 1999 3:29 PM > To: Slattery, Michael (on Outlook) > Subject: FW: W-EMED Spam from your domain > > > > -----Original Message----- > From: Keith Conover, M.D., FACEP [mailto:kconover+@pitt.edu] > Sent: Wednesday, September 15, 1999 2:01 PM > To: postmaster@monroecc.edu > Cc: wilderness-emergency-medicine@list.pitt.edu > Subject: W-EMED Spam from your domain > > I am forwarding, under separate cover, four spam messages that were sent > from a user in your domain to the international > wilderness-emergency-medicine list. Please investigate, and if possible, > terminate this email account. Thank you very much. * Keith Conover, M.D., > FACEP http://www.pitt.edu/~kconover Do not reproduce without author's > express permission. To unsubscribe, send the text "unsubscribe > wilderness-emergency-medicine" as the body of a message (no subject) To: > Majordomo@list.pitt.edu Submissions To: > wilderness-emergency-medicine@list.pitt.edu > -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 15 Sep 1999 23:22:47 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 15 Sep 1999 23:19:17 -0400 (EDT) Received: via switchmail; Wed, 15 Sep 1999 23:19:15 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 15 Sep 1999 23:18:57 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 15 Sep 1999 23:18:33 -0400 (EDT) Received: from aldus.northnet.org (qmailr@aldus.northnet.org [198.175.11.2]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 15 Sep 1999 23:18:27 -0400 (EDT) Received: (qmail 19798 invoked by uid 0); 16 Sep 1999 03:20:46 -0000 Received: from ppp-51.saranac.northnet.org (HELO northnet.org) (209.4.94.4) by aldus.northnet.org with SMTP; 16 Sep 1999 03:20:46 -0000 Message-ID: <37E063DA.77FE2713@northnet.org> Date: Wed, 15 Sep 1999 23:28:26 -0400 From: karen smith X-Mailer: Mozilla 4.61 [en] (Win98; I) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Homeworkers Needed! References: <0006F043.4215@atlanticare.org> <199909160147.VAA09144@titan.tcn.net> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P06BD0.CNM Bernie Roche wrote: > At 02:10 PM 9/15/99 -0400, you wrote: > >On 15 Sep 99, at 13:52, Charles.Kleschick@atlanticare.org wrote: > > > >> This is message #7 so far that I've received. Are these errors or > >> are you seriously recruiting for this program? > > > >Whatever the reason, and I'm suspicious of some sort of virus or > >malicious person on his computer, I've terminated his subscription to > >this list, and have requested the postmaster at Monroe Community > >College to terminate his email account. My apologies to the list > >members. > > > > > >--Keith Conover, M.D., FACEP > > A few seconds before burning the supposed author at the stake, let's take a > moment to note that there have been similar mailings lately on other > mailing lists, which appear to have been done by an unknown person trying > to get the supposed (named) sender in trouble. This MAY be the case here. > There is, after all, no reasonable explanation for the supposed author to > send so many copies...even a complete idiot would know this would alienate > people and defeat the purpose of the advertisement. > > 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 15 Sep 1999 23:13:20 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 15 Sep 1999 21:52:19 -0400 (EDT) Received: via switchmail; Wed, 15 Sep 1999 21:52:17 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 15 Sep 1999 21:51:13 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 15 Sep 1999 21:50:58 -0400 (EDT) Received: from titan.tcn.net (root@titan.tcn.net [199.166.4.2]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 15 Sep 1999 21:50:54 -0400 (EDT) Received: from one (comp45.tcn.net [209.135.79.45]) by titan.tcn.net (8.8.5/8.6.9) with SMTP id VAA09144 for ; Wed, 15 Sep 1999 21:47:48 -0400 (EDT) Message-Id: <199909160147.VAA09144@titan.tcn.net> X-Sender: broche@titan.tcn.net X-Mailer: QUALCOMM Windows Eudora Pro Version 4.0 Date: Wed, 15 Sep 1999 21:54:44 -0400 To: wilderness-emergency-medicine@list.pitt.edu From: Bernie Roche Subject: Re: Re[2]: W-EMED Homeworkers Needed! In-Reply-To: <199909151808.OAA17360@post-ofc05.srv.cis.pitt.edu> References: <0006F043.4215@atlanticare.org> Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P1B4B0.CNM At 02:10 PM 9/15/99 -0400, you wrote: >On 15 Sep 99, at 13:52, Charles.Kleschick@atlanticare.org wrote: > >> This is message #7 so far that I've received. Are these errors or >> are you seriously recruiting for this program? > >Whatever the reason, and I'm suspicious of some sort of virus or >malicious person on his computer, I've terminated his subscription to >this list, and have requested the postmaster at Monroe Community >College to terminate his email account. My apologies to the list >members. > > >--Keith Conover, M.D., FACEP A few seconds before burning the supposed author at the stake, let's take a moment to note that there have been similar mailings lately on other mailing lists, which appear to have been done by an unknown person trying to get the supposed (named) sender in trouble. This MAY be the case here. There is, after all, no reasonable explanation for the supposed author to send so many copies...even a complete idiot would know this would alienate people and defeat the purpose of the advertisement. 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 15 Sep 1999 20:49:47 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 15 Sep 1999 20:49:15 -0400 (EDT) Received: via switchmail; Wed, 15 Sep 1999 20:49:15 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 15 Sep 1999 20:48:59 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 15 Sep 1999 20:48:30 -0400 (EDT) Received: from m4.boston.juno.com (m4.boston.juno.com [205.231.101.198]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 15 Sep 1999 20:48:27 -0400 (EDT) Received: (from pcrs242@juno.com) by m4.boston.juno.com (queuemail) id ELLNCN94; Wed, 15 Sep 1999 20:49:37 EDT To: wilderness-emergency-medicine@list.pitt.edu Cc: wilderness-emergency-medicine@list.pitt.edu Date: Wed, 15 Sep 1999 20:40:16 -0400 Subject: Re: W-EMED Homeworkers Needed! Message-ID: <19990915.204017.13550.0.pcrs242@juno.com> References: <535A64F56835D211AE6100A0C9612D16174A0C@mcc25.monroecc.edu> <37DFEB0B.490611CF@hpd.nova.edu> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 1-3 From: Deborah M Gessner Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 128 0 1 P088C0.CNM I have received about 15 so far and it is a pain to get it off my computer. The person that's doing it is worse than a yutz. pcrs242 ___________________________________________________________________ Get the Internet just the way you want it. Free software, free e-mail, and free Internet access for a month! Try Juno Web: http://dl.www.juno.com/dynoget/tagj. 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID for ; Wed, 15 Sep 1999 15:52:25 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID for kconover@pop.pitt.edu; Wed, 15 Sep 1999 15:52:08 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Wed, 15 Sep 1999 15:52:03 -0400 (EDT) Received: from mcc15.monroecc.edu (exchange.monroecc.edu [150.160.16.35]) by post-ofc02.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Wed, 15 Sep 1999 15:51:51 -0400 (EDT) Received: by exchange.monroecc.edu with Internet Mail Service (5.5.2448.0) id ; Wed, 15 Sep 1999 15:54:35 -0400 Message-ID: <535A64F56835D211AE6100A0C9612D16174A1B@mcc25.monroecc.edu> From: "Connolly, Marc (on Outlook)" To: "'kconover+@pitt.edu'" Cc: "Slattery, Michael (on Outlook)" Subject: regarding the spam mess Date: Wed, 15 Sep 1999 15:51:55 -0400 Return-Receipt-To: "Connolly, Marc (on Outlook)" MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.2448.0) Content-Type: text/plain; charset="iso-8859-1" X-PMFLAGS: 1572992 0 1 P79730.CNM Dr. Conover, I became aware of the problem when I received a phone call from a member of the list and then I saw your note. Since then, three more of the spam messages were posted in my name on the wemd list while I was driving between campuses at MCC! I have spoken with our email administrator (Mike Slattery). Please remove me from your list as I do not want further messages going out under my name. I did receive the spam message this morning, and as I quite often do, sent a message to the sender. In a very small percentage of the cases where I receive unsolicited mail, I do get removed from the list--so I give it a try. Unless something went very wrong, I did not send it to the list, and I did not send the volume I am also receiving on the list! However, I am still seeing these messages being sent. Marc Connolly -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 15 Sep 1999 23:09:26 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 15 Sep 1999 14:52:25 -0400 (EDT) Received: via switchmail; Wed, 15 Sep 1999 14:52:21 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 15 Sep 1999 14:49:42 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 15 Sep 1999 14:49:04 -0400 (EDT) Received: from solar.acast.nova.edu (solar.acast.nova.edu [137.52.224.11]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 15 Sep 1999 14:49:00 -0400 (EDT) Received: from hpd.nova.edu (ppp198-65.acast.nova.edu [137.52.198.65]) by solar.acast.nova.edu (8.9.1/8.9.1) with ESMTP id OAA20044 for ; Wed, 15 Sep 1999 14:50:56 -0400 (EDT) Message-ID: <37DFEB0B.490611CF@hpd.nova.edu> Date: Wed, 15 Sep 1999 14:53:00 -0400 From: Michael Williams X-Mailer: Mozilla 4.61 [en]C-compaq (Win98; U) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Homeworkers Needed! References: <535A64F56835D211AE6100A0C9612D16174A0C@mcc25.monroecc.edu> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P78980.CNM Is anyone else getting spammed by this yutz? I've received about 9 of his "solicitations!" Michael Williams michaelb@hpd.nova.edu Nova Southeastern College of Osteopathic Medicine Class of 2000 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 15 Sep 1999 23:10:28 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 15 Sep 1999 14:15:35 -0400 (EDT) Received: via switchmail; Wed, 15 Sep 1999 14:15:33 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 15 Sep 1999 14:09:26 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 15 Sep 1999 14:09:04 -0400 (EDT) Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 15 Sep 1999 14:08:55 -0400 (EDT) Received: from micron (ehdup-d2-14.rmt.net.pitt.edu [136.142.20.224]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 15 Sep 1999 14:08:41 -0400 (EDT) Message-Id: <199909151808.OAA17360@post-ofc05.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: Charles.Kleschick@atlanticare.org, wilderness-emergency-medicine@list.pitt.edu Date: Wed, 15 Sep 1999 14:10:34 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: Re[2]: W-EMED Homeworkers Needed! CC: Stacey & Larry In-reply-to: <0006F043.4215@atlanticare.org> X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P72160.CNM On 15 Sep 99, at 13:52, Charles.Kleschick@atlanticare.org wrote: > This is message #7 so far that I've received. Are these errors or > are you seriously recruiting for this program? Whatever the reason, and I'm suspicious of some sort of virus or malicious person on his computer, I've terminated his subscription to this list, and have requested the postmaster at Monroe Community College to terminate his email account. My apologies to the list members. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: 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: <0006F043.4215@atlanticare.org> X-RS-Sigset: 2 To: Charles.Kleschick@atlanticare.org,wilderness-emergency-medicine@list.pitt.edu Subject: Re: Re[2]: W-EMED Homeworkers Needed! Cc: Stacey & Larry Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Wed, 15 Sep 1999 14:09:37 -0400 On 15 Sep 99, at 13:52, Charles.Kleschick@atlanticare.org wrote: > This is message #7 so far that I've received. Are these errors or > are you seriously recruiting for this program? Whatever the reason, and I'm suspicious of some sort of virus or malicious person on his computer, I've terminated his subscription to this list, and have requested the postmaster at Monroe Community College to terminate his email account. My apologies to the list members. -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 15 Sep 1999 17:53:59 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 15 Sep 1999 14:01:57 -0400 (EDT) Received: via switchmail; Wed, 15 Sep 1999 14:01:55 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 15 Sep 1999 14:00:06 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 15 Sep 1999 13:59:48 -0400 (EDT) Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 15 Sep 1999 13:59:38 -0400 (EDT) Received: from micron (ehdup-d2-14.rmt.net.pitt.edu [136.142.20.224]) by post-ofc06.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 15 Sep 1999 13:59:27 -0400 (EDT) Message-Id: <199909151759.NAA18982@post-ofc06.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: postmaster@monroecc.edu Date: Wed, 15 Sep 1999 14:01:20 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: W-EMED Spam from your domain CC: wilderness-emergency-medicine@list.pitt.edu X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P62030.CNM I am forwarding, under separate cover, four spam messages that were sent from a user in your domain to the international wilderness- emergency-medicine list. Please investigate, and if possible, terminate this email account. Thank you very much. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: R From: Keith Conover, M.D., FACEP X-RS-Flags: 0,0,1,1,0,0,0 X-RS-Sigset: 2 To: postmaster@monroecc.edu Subject: Spam from your domain Cc: wilderness-emergency-medicine@list.pitt.edu Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Wed, 15 Sep 1999 14:00:46 -0400 I am forwarding, under separate cover, four spam messages that were sent from a user in your domain to the international wilderness- emergency-medicine list. Please investigate, and if possible, terminate this email account. Thank you very much. -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 15 Sep 1999 13:59:08 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 15 Sep 1999 13:58:33 -0400 (EDT) Received: via switchmail; Wed, 15 Sep 1999 13:58:32 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 15 Sep 1999 13:57:36 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 15 Sep 1999 13:57:07 -0400 (EDT) Received: from MailDepot.atlanticare.org (maildepot.atlanticare.org [209.3.116.3]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 15 Sep 1999 13:56:59 -0400 (EDT) From: Charles.Kleschick@atlanticare.org Received: from ccMail by MailDepot.atlanticare.org (IMA Internet Exchange 2.12 Enterprise) id 0006F043; Wed, 15 Sep 1999 13:53:01 -0400 Mime-Version: 1.0 Date: Wed, 15 Sep 1999 13:52:06 -0400 Message-ID: <0006F043.4215@atlanticare.org> Subject: Re[2]: W-EMED Homeworkers Needed! To: "'wilderness-emergency-medicine@list.pitt.edu'" , "Connolly; Marc (on Outlook)" Content-Type: text/plain; charset=US-ASCII Content-Transfer-Encoding: 7bit Content-Description: cc:Mail note part Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 1572992 0 1 P01220.CNM Marc, This is message #7 so far that I've received. Are these errors or are you seriously recruiting for this program? Chuck ______________________________ Reply Separator _________________________________ Subject: RE: W-EMED Homeworkers Needed! Author: "Connolly; Marc (on Outlook)" at -Internet Date: 09/15/1999 11:55 AM -----Original Message----- From: mowhco@att.net [mailto:mowhco@att.net] Sent: Wednesday, September 15, 1999 1:17 AM Subject: W-EMED Homeworkers Needed! Dear Future Associate, You Can Work At Home & Set Your Own Hours. Start earning Big Money in a short time NO Newspaper Advertising! Your job will be to stuff and mail envelopes for our company. You will receive $.25 for each and every envelope you stuff and mail out. Just follow our simple instructions and you will be making money as easy as 1... 2... 3 For example stuff and mail 200 envelopes and you will receive $50.00. Stuff and mail 1000 and you will receive $250.00. Stuff and mail 2000 and you will receive $500.00 and more Never before has there been an easier way to make money from home! Our Company's Home Mailing Program is designed for people with little or no experience and provides simple, step by step instructions. There is no prior experience or special skills necessary on your part, Just stuffing envelopes. We need the help of honest and reliable home workers like you. Because we are overloaded with work and have more than our staff can handle. We have now expanded our mailing program and are expecting to reach millions more with our offers throughout the US and Canada. Our system of stuffing and mailing envelopes is very simple and easy to do! You will not be required to buy envelopes or postage stamps. We will gladly furnish all circulars at no cost to you. We assure you that as a participant in our program you will never have to mail anything objective or offensive. There are no quotas to meet, and there no contracts to sign. You can work as much, or as little as you want. Payment for each envelope you send out is Guaranteed! Here is what you will receive when you get your first Package. Inside you will find 100 envelopes, 100 labels and 100 sales letters ready to stuff and mail As soon as you are done with stuffing and mailing these first letters, your payment will arrive shortly, thereafter. All you have to do is to order more free supplies and stuff and mail more envelopes to make more money. Our sales literature which you will be stuffing and mailing will contain information outlining our highly informative manuals that we are advertising nationwide. As a free gift you will receive a special manual valued at $24.95, absolutely free, just for joining our Home Mailers Program. Plus you will get your own special code number, so that we will know how much you are to get paid. And to make re-ordering of more envelopes, that our company supplies very simple for you. We are giving you this free bonus because we want you to be confident in our company and to ensure that we will be doing business with you for a long time. Benefits Of This Job: 1. You do not have to quit your present job, to earn more money at home 2. You can make between $2,500 to $4,500 a month depending on the amount of time you are willing to spend stuffing and mailing envelopes 3. This is a great opportunity for the students, mothers, disabled persons or those who are home bodies. To secure your position and to show us that you are serious about earning extra income at home we require a one-time registration fee of $35.00. This fee covers the cost of your initial start up package, which includes 100 envelopes, 100 labels and 100 sales letters and a manual, your registration fee will be refunded back to you shortly thereafter. Money Back Guarantee! We guarantee that as soon as you stuff and mail your first 300 envelopes You will be paid $75.00 and your registration fee will be refunded. Many of you wonder why it is necessary to pay a deposit to get a job. It is because we are looking for people that seriously want to work from home. * If 3.000 people told us they wanted to start working from home and we sent out 3.000 packages free to every one. And then half of the people decided not to work, this would be a potential loss of more than $60,000 in supply's and shipping that we have sent out to people that don't want to work We have instituted this policy to make sure that you really want to work and at least finish your first package. To Get Started Today Please Enclose Your Registration Fee of $35 Check,Cash Or Money Order and fill out the application below and mail to: MOHW Co PMB 11054 Ventura Blvd #126 Studio City, CA 91604 Name_____________________________________________________ Address___________________________________________________ City____________________________________ State______________ Zip Code________________ Telephone Number(s)_________________________________________ E-mail Address______________________________________________ For all orders, please allow seven (7) days for delivery and up to 10 days. Cash and Money Orders will result in faster shipping of your package. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 15 Sep 1999 11:58:08 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 15 Sep 1999 11:57:35 -0400 (EDT) Received: via switchmail; Wed, 15 Sep 1999 11:57:35 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 15 Sep 1999 11:56:31 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 15 Sep 1999 11:55:11 -0400 (EDT) Received: from mcc15.monroecc.edu (exchange.monroecc.edu [150.160.16.35]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 15 Sep 1999 11:54:54 -0400 (EDT) Received: by exchange.monroecc.edu with Internet Mail Service (5.5.2448.0) id ; Wed, 15 Sep 1999 11:57:39 -0400 Message-ID: <535A64F56835D211AE6100A0C9612D16174A0A@mcc25.monroecc.edu> From: "Connolly, Marc (on Outlook)" To: "'wilderness-emergency-medicine@list.pitt.edu'" Subject: RE: W-EMED Homeworkers Needed! Date: Wed, 15 Sep 1999 11:54:58 -0400 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.2448.0) Content-Type: text/plain; charset="iso-8859-1" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P2C9D0.CNM -----Original Message----- From: mowhco@att.net [mailto:mowhco@att.net] Sent: Wednesday, September 15, 1999 1:17 AM Subject: W-EMED Homeworkers Needed! Dear Future Associate, You Can Work At Home & Set Your Own Hours. Start earning Big Money in a short time NO Newspaper Advertising! Your job will be to stuff and mail envelopes for our company. You will receive $.25 for each and every envelope you stuff and mail out. Just follow our simple instructions and you will be making money as easy as 1... 2... 3 For example stuff and mail 200 envelopes and you will receive $50.00. Stuff and mail 1000 and you will receive $250.00. Stuff and mail 2000 and you will receive $500.00 and more Never before has there been an easier way to make money from home! Our Company's Home Mailing Program is designed for people with little or no experience and provides simple, step by step instructions. There is no prior experience or special skills necessary on your part, Just stuffing envelopes. We need the help of honest and reliable home workers like you. Because we are overloaded with work and have more than our staff can handle. We have now expanded our mailing program and are expecting to reach millions more with our offers throughout the US and Canada. Our system of stuffing and mailing envelopes is very simple and easy to do! You will not be required to buy envelopes or postage stamps. We will gladly furnish all circulars at no cost to you. We assure you that as a participant in our program you will never have to mail anything objective or offensive. There are no quotas to meet, and there no contracts to sign. You can work as much, or as little as you want. Payment for each envelope you send out is Guaranteed! Here is what you will receive when you get your first Package. Inside you will find 100 envelopes, 100 labels and 100 sales letters ready to stuff and mail As soon as you are done with stuffing and mailing these first letters, your payment will arrive shortly, thereafter. All you have to do is to order more free supplies and stuff and mail more envelopes to make more money. Our sales literature which you will be stuffing and mailing will contain information outlining our highly informative manuals that we are advertising nationwide. As a free gift you will receive a special manual valued at $24.95, absolutely free, just for joining our Home Mailers Program. Plus you will get your own special code number, so that we will know how much you are to get paid. And to make re-ordering of more envelopes, that our company supplies very simple for you. We are giving you this free bonus because we want you to be confident in our company and to ensure that we will be doing business with you for a long time. Benefits Of This Job: 1. You do not have to quit your present job, to earn more money at home 2. You can make between $2,500 to $4,500 a month depending on the amount of time you are willing to spend stuffing and mailing envelopes 3. This is a great opportunity for the students, mothers, disabled persons or those who are home bodies. To secure your position and to show us that you are serious about earning extra income at home we require a one-time registration fee of $35.00. This fee covers the cost of your initial start up package, which includes 100 envelopes, 100 labels and 100 sales letters and a manual, your registration fee will be refunded back to you shortly thereafter. Money Back Guarantee! We guarantee that as soon as you stuff and mail your first 300 envelopes You will be paid $75.00 and your registration fee will be refunded. Many of you wonder why it is necessary to pay a deposit to get a job. It is because we are looking for people that seriously want to work from home. * If 3.000 people told us they wanted to start working from home and we sent out 3.000 packages free to every one. And then half of the people decided not to work, this would be a potential loss of more than $60,000 in supply's and shipping that we have sent out to people that don't want to work We have instituted this policy to make sure that you really want to work and at least finish your first package. To Get Started Today Please Enclose Your Registration Fee of $35 Check,Cash Or Money Order and fill out the application below and mail to: MOHW Co PMB 11054 Ventura Blvd #126 Studio City, CA 91604 Name_____________________________________________________ Address___________________________________________________ City____________________________________ State______________ Zip Code________________ Telephone Number(s)_________________________________________ E-mail Address______________________________________________ For all orders, please allow seven (7) days for delivery and up to 10 days. Cash and Money Orders will result in faster shipping of your package. 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 16 Sep 1999 02:15:44 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 15 Sep 1999 11:40:46 -0400 (EDT) Received: via switchmail; Wed, 15 Sep 1999 11:40:42 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 15 Sep 1999 11:39:42 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 15 Sep 1999 11:38:04 -0400 (EDT) Received: from ns.bigbear.net (p221.amax5.dialup.lax1.flash.net [209.30.74.221]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 15 Sep 1999 11:37:41 -0400 (EDT) From: mowhco@att.net Subject: W-EMED Homeworkers Needed! Date: Wed, 15 Sep 1999 05:17:03 Message-Id: <840.688737.573663@ns.bigbear.net> To: undisclosed-recipients:; Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 128 0 1 P697C0.CNM Dear Future Associate, You Can Work At Home & Set Your Own Hours. Start earning Big Money in a short time NO Newspaper Advertising! Your job will be to stuff and mail envelopes for our company. You will receive $.25 for each and every envelope you stuff and mail out. Just follow our simple instructions and you will be making money as easy as 1… 2… 3 For example stuff and mail 200 envelopes and you will receive $50.00. Stuff and mail 1000 and you will receive $250.00. Stuff and mail 2000 and you will receive $500.00 and more Never before has there been an easier way to make money from home! Our Company's Home Mailing Program is designed for people with little or no experience and provides simple, step by step instructions. There is no prior experience or special skills necessary on your part, Just stuffing envelopes. We need the help of honest and reliable home workers like you. Because we are overloaded with work and have more than our staff can handle. We have now expanded our mailing program and are expecting to reach millions more with our offers throughout the US and Canada. Our system of stuffing and mailing envelopes is very simple and easy to do! You will not be required to buy envelopes or postage stamps. We will gladly furnish all circulars at no cost to you. We assure you that as a participant in our program you will never have to mail anything objective or offensive. There are no quotas to meet, and there no contracts to sign. You can work as much, or as little as you want. Payment for each envelope you send out is Guaranteed! Here is what you will receive when you get your first Package. Inside you will find 100 envelopes, 100 labels and 100 sales letters ready to stuff and mail As soon as you are done with stuffing and mailing these first letters, your payment will arrive shortly, thereafter. All you have to do is to order more free supplies and stuff and mail more envelopes to make more money. Our sales literature which you will be stuffing and mailing will contain information outlining our highly informative manuals that we are advertising nationwide. As a free gift you will receive a special manual valued at $24.95, absolutely free, just for joining our Home Mailers Program. Plus you will get your own special code number, so that we will know how much you are to get paid. And to make re-ordering of more envelopes, that our company supplies very simple for you. We are giving you this free bonus because we want you to be confident in our company and to ensure that we will be doing business with you for a long time. Benefits Of This Job: 1. You do not have to quit your present job, to earn more money at home 2. You can make between $2,500 to $4,500 a month depending on the amount of time you are willing to spend stuffing and mailing envelopes 3. This is a great opportunity for the students, mothers, disabled persons or those who are home bodies. To secure your position and to show us that you are serious about earning extra income at home we require a one-time registration fee of $35.00. This fee covers the cost of your initial start up package, which includes 100 envelopes, 100 labels and 100 sales letters and a manual, your registration fee will be refunded back to you shortly thereafter. Money Back Guarantee! We guarantee that as soon as you stuff and mail your first 300 envelopes You will be paid $75.00 and your registration fee will be refunded. Many of you wonder why it is necessary to pay a deposit to get a job. It is because we are looking for people that seriously want to work from home. * If 3.000 people told us they wanted to start working from home and we sent out 3.000 packages free to every one. And then half of the people decided not to work, this would be a potential loss of more than $60,000 in supply's and shipping that we have sent out to people that don't want to work We have instituted this policy to make sure that you really want to work and at least finish your first package. To Get Started Today Please Enclose Your Registration Fee of $35 Check,Cash Or Money Order and fill out the application below and mail to: MOHW Co PMB 11054 Ventura Blvd #126 Studio City, CA 91604 Name_____________________________________________________ Address___________________________________________________ City____________________________________ State______________ Zip Code________________ Telephone Number(s)_________________________________________ E-mail Address______________________________________________ For all orders, please allow seven (7) days for delivery and up to 10 days. Cash and Money Orders will result in faster shipping of your package. 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 10 Sep 1999 08:15:12 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 10 Sep 1999 08:14:38 -0400 (EDT) Received: via switchmail; Fri, 10 Sep 1999 08:14:38 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 10 Sep 1999 08:13:21 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 10 Sep 1999 08:12:50 -0400 (EDT) Received: from mail1.toronto.istar.net (mail1.toronto.istar.net [209.89.75.17]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 10 Sep 1999 08:12:47 -0400 (EDT) Received: from ms01-62.ott.istar.ca ([137.186.208.62]) by mail1.toronto.istar.net with smtp (Exim 2.02 #1) id 11PPZZ-0001uo-00 for wilderness-emergency-medicine@list.pitt.edu; Fri, 10 Sep 1999 08:14:34 -0400 Message-Id: Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Date: Fri, 10 Sep 1999 08:17:04 -0500 To: wilderness-emergency-medicine@list.pitt.edu From: pirie@istar.ca (Steven D. Pirie) Subject: W-EMED Pocket masks Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P737E0.CNM Mr. Antonsen and crew, >i have in my lap right now a belt pouch mask from MDI that seems at least >as >good as the laedral masks >so out of the box it sure seems as good, maybe better. comes in a soft >pouch >with a belt loop, >it took the place of my blucky, crushable, crunchable laedral clamshell in >my >fanny pack as soon as i got it. After having gone through two pocket face masks in my jump bag that were in soft plastic bags, I finally opted for the "clamshell" case that Laerdal sent with my pocket mask... lo' and behold the mask is intact and has survived the rigors of military man-pack travel. The problem with the masks not in the hard case occured about 4-6 months after getting them. For some reason the seal would loose it's air pressure (due to crush trauma? or friction against other things in the bag? or just a abuse of being thrown off the back of a truck?) As I take my hard shell mask out now for a little look see, I notice on the white case there is obvious marks from it rubbing up against other stuff in the med kit (as well as some yellow stuff on it that looks like chlorhexidine... humm, hope that bottle did not explode in there). As I open it, I am surprised that the paper directions are even intact (often my bag get quite wet) and I do not have the mask in a ziplock bag, only the case (maybe I should opt for the ziplock bag, now that I mention it). So that is for what it's worth. 3rd mask, 2 donated to the med kit god, as they were unable to stand the rigors of field work, 1 lives, due to the hard plastic case. Then again maybe Laedral just makes a better mask... and it was the cold and heat that killed the other two masks... something else to think about. For the record I don't own shares or work for Laedral. Take care, Steven ---------------------------------------------------------- Lt. Steven D. Pirie, RN, BScN, UE General Duty Ward Officer - Military In-Patient Unit Canadian Forces Support Unit Ottawa - Civic Hospital Site 2 Health Support Operational Training Unit ---------------------------------------------------------- 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 10 Sep 1999 05:17:00 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 10 Sep 1999 04:38:20 -0400 (EDT) Received: via switchmail; Fri, 10 Sep 1999 04:38:19 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 10 Sep 1999 04:37:56 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 10 Sep 1999 04:37:38 -0400 (EDT) Received: from mx0-smtp.goodnet.com (envy.goodnet.com [207.98.129.151]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 10 Sep 1999 04:37:35 -0400 (EDT) Received: from Ptkovacs (d11-38.phoenix.goodnet.com [209.141.106.167]) by mx0-smtp.goodnet.com (8.9.3/8.9.3) with ESMTP id BAA06198 for ; Fri, 10 Sep 1999 01:39:22 -0700 (MST) Message-Id: <199909100839.BAA06198@mx0-smtp.goodnet.com> From: "Tim Kovacs" To: Subject: Re: Fwd: W-EMED helping the rescue efforts in Turkey... Date: Fri, 10 Sep 1999 01:51:51 -0700 X-MSMail-Priority: Normal X-Priority: 3 X-Mailer: Microsoft Internet Mail 4.70.1155 MIME-Version: 1.0 Content-Type: text/plain; charset=ISO-8859-1 Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P13990.CNM I believe an MRA contact has been present for recent years in Turkey working with the goverment to do this. I'll check the name and details. NASAR is an excellent source of info for the liaison work they do as an outsource for FEMA for Urban SAR. For Mountain and Technical SAR, the MRA, made of operational teams, can offer it's help. 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-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 10 Sep 1999 11:50:47 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 10 Sep 1999 11:50:10 -0400 (EDT) Received: via switchmail; Fri, 10 Sep 1999 11:50:09 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 10 Sep 1999 11:50:00 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 10 Sep 1999 11:49:10 -0400 (EDT) Received: from hotmail.com (f206.law3.hotmail.com [209.185.241.206]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 10 Sep 1999 11:49:05 -0400 (EDT) Received: (qmail 32089 invoked by uid 0); 10 Sep 1999 15:50:23 -0000 Message-ID: <19990910155023.32088.qmail@hotmail.com> Received: from 205.169.197.108 by www.hotmail.com with HTTP; Fri, 10 Sep 1999 08:50:22 PDT X-Originating-IP: [205.169.197.108] From: "Gurkan Ozel" To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: Fwd: W-EMED helping the rescue efforts in Turkey... Date: Fri, 10 Sep 1999 08:50:22 PDT Mime-Version: 1.0 Content-Type: text/plain; format=flowed Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P47AD0.CNM Hi Tim, I already contacted NASAR & am waiting for their answer. I'd be glad to hear about the details of MAR contact with Turkey. Hoping to hear from you. Thanks, Gurkan >From: "Tim Kovacs" >Reply-To: wilderness-emergency-medicine@list.pitt.edu >To: >Subject: Re: Fwd: W-EMED helping the rescue efforts in Turkey... >Date: Fri, 10 Sep 1999 01:51:51 -0700 >MIME-Version: 1.0 >From owner-wilderness-emergency-medicine@list.pitt.edu Fri Sep 10 02:01:18 >1999 >Received: from [136.142.185.20] by hotmail.com (2.1) with ESMTP id >MHotMailB9A213DB015BD820F3BD888EB914E76A0; Fri Sep 10 02:01:18 1999 >Received: from localhost (majordom@localhost) by >list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID >; Fri, 10 Sep 1999 04:37:38 -0400 >(EDT) >Received: from mx0-smtp.goodnet.com (envy.goodnet.com [207.98.129.151]) > by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) > ID for >; Fri, 10 Sep 1999 >04:37:35 -0400 (EDT) >Received: from Ptkovacs (d11-38.phoenix.goodnet.com [209.141.106.167])by >mx0-smtp.goodnet.com (8.9.3/8.9.3) with ESMTP id BAA06198for >; Fri, 10 Sep 1999 01:39:22 >-0700 (MST) >Message-Id: <199909100839.BAA06198@mx0-smtp.goodnet.com> >X-MSMail-Priority: Normal >X-Priority: 3 >X-Mailer: Microsoft Internet Mail 4.70.1155 >Sender: owner-wilderness-emergency-medicine@list.pitt.edu >Precedence: bulk > >I believe an MRA contact has been present for recent years in Turkey >working with the goverment to do this. I'll check the name and details. > >NASAR is an excellent source of info for the liaison work they do as an >outsource for FEMA for Urban SAR. >For Mountain and Technical SAR, the MRA, made of operational teams, can >offer it's help. > >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 10 Sep 1999 03:09:21 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 10 Sep 1999 03:08:44 -0400 (EDT) Received: via switchmail; Fri, 10 Sep 1999 03:08:44 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 10 Sep 1999 03:07:40 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 10 Sep 1999 03:05:02 -0400 (EDT) Received: from mail.iwvisp.com (mail.iwvisp.com [207.141.203.5]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 10 Sep 1999 03:04:59 -0400 (EDT) Received: from iwvisp.com ([12.13.22.203]) by mail.iwvisp.com with ESMTP (IPAD 2.5/64) id 1847200 ; Fri, 10 Sep 1999 00:06:20 -0800 Message-ID: <37D8B007.388705E6@iwvisp.com> Date: Fri, 10 Sep 1999 00:15:42 -0700 From: chris antonsen Organization: none X-Mailer: Mozilla 4.61 (Macintosh; U; PPC) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED one-way valves for wilderness and pocket use References: <199908232140.RAA11784@post-ofc05.srv.cis.pitt.edu> Content-Type: text/plain; charset=us-ascii; x-mac-type="54455854"; x-mac-creator="4D4F5353" Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P132D0.CNM just back from several weeks on a 9K mountain top doing some relay stuff for the air force - nice view. i have in my lap right now a belt pouch mask from MDI (medical devices international) that seems at least as good as the laedral masks - well, i haven't had to actually use it . . . so out of the box it sure seems as good, maybe better. comes in a soft pouch with a belt loop, is essentially the same face seal as a laedral (but you can vary seal pressure), has a one way valve, and includes a pair of latex? gloves. it took the place of my blucky, crushable, crunchable laedral clamshell in my fanny pack as soon as i got it. plus it comes in a clean, sealed plastic bag inside the pouch ('course i ripped mine open as soon as i got it just to see what i had and how i should/could use it :-) medical devices international 3849 Swanson Court Gurnee, Illinios 60031 1-800-GETS MDI "Keith Conover, M.D., FACEP" wrote: > On 23 Aug 99, at 17:20, McCabe, Peter wrote: > > > Keith > > > > Does the Laerdal one-way mask come with a Cordova type pouch for carrying > > on a pack strap or similar. > > I got only the one-way valve, not the mask. The corresponding > Laerdal pocket mask comes only with a plastic folding case -- but > I'm sure it would fit into any standard belt pouch. > > --Keith Conover, M.D., FACEP > http://www.pitt.edu/~kconover > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-NAV-TimeoutProtection0: X X-NAV-TimeoutProtection1: X X-NAV-TimeoutProtection2: X X-NAV-TimeoutProtection3: X X-NAV-TimeoutProtection4: X X-NAV-TimeoutProtection5: X X-NAV-TimeoutProtection6: X Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 10 Sep 1999 02:36:16 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 10 Sep 1999 02:35:43 -0400 (EDT) Received: via switchmail; Fri, 10 Sep 1999 02:35:43 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 10 Sep 1999 02:34:12 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 10 Sep 1999 02:33:50 -0400 (EDT) Received: from mail.iwvisp.com (mail.iwvisp.com [207.141.203.5]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 10 Sep 1999 02:33:44 -0400 (EDT) Received: from iwvisp.com ([207.141.203.172]) by mail.iwvisp.com with ESMTP (IPAD 2.5/64) id 1835600 ; Thu, 09 Sep 1999 23:36:41 -0800 Message-ID: <37D8A914.126269B0@iwvisp.com> Date: Thu, 09 Sep 1999 23:46:01 -0700 From: chris antonsen Organization: none X-Mailer: Mozilla 4.61 (Macintosh; U; PPC) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED one-way valves for wilderness and pocket use References: <199908250357.XAA16514@post-ofc06.srv.cis.pitt.edu> Content-Type: text/plain; charset=us-ascii; x-mac-type="54455854"; x-mac-creator="4D4F5353" Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P0F950.CNM After a good chuckle, I realize that for most of us non_MDs, this pretty well describes how we approach most of our tough wilderness subjects. on 23 Aug, "Keith Conover, M.D., FACEP" wrote: I'd guess that a little TB is better than a lot of dead . . . Do you think the filter really adds that much? Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 9 Sep 1999 21:52:19 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 9 Sep 1999 21:51:37 -0400 (EDT) Received: via switchmail; Thu, 9 Sep 1999 21:51:37 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 9 Sep 1999 21:51:10 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 9 Sep 1999 21:49:53 -0400 (EDT) Received: from smtp2.vnet.net (smtp2.vnet.net [166.82.1.32]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 9 Sep 1999 21:49:46 -0400 (EDT) Received: from vnet.net (pool-209-138-128-2.atln.grid.net [209.138.128.2]) by smtp2.vnet.net (8.9.1a/8.9.1) with ESMTP id VAA21925 for ; Thu, 9 Sep 1999 21:51:30 -0400 (EDT) Message-ID: <37D86064.23571118@vnet.net> Date: Thu, 09 Sep 1999 21:35:32 -0400 From: Sam Chewning X-Mailer: Mozilla 4.03 [en]C-DIAL (Win95; U) MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED The two compass trick References: <199908270158.SAA15527@mx0-smtp.goodnet.com> <19990827.082659.20374.0.JayWiseman@juno.com> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P4E740.CNM Jay J Wiseman wrote: > Hi folks, > > A friend of mine who is pretty heavily involved in SAR recently shared > with me a technique (read "trick") I had never heard of before that > supposedly can help someone from becoming (more) lost in the wilderness: > carry two compasses. > > Apparently, the idea behind this is that if you get yourself really > disoriented in the woods, you can convince yourself that your single > compass is malfunctioning (which it probably ain't) and get yourself even > more disoriented. However, if your _two_ compasses are both pointing in > a direction they say is north when you are ready to swear that the > direction they are pointing is, say, west, it becomes much harder to > attribute their readings to malfunction. > > This sounds reasonable to me, but I haven't had a chance to field test > it. > > What think? > > Regards, > > Jay > > ___________________________________________________________________ > Get the Internet just the way you want it. > Free software, free e-mail, and free Internet access for a month! > Try Juno Web: http://dl.www.juno.com/dynoget/tagj. > 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 May be we should carry three, that way if two of the compasses do not agree we will have a third as a tie breaker Sam Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 8 Sep 1999 17:40:22 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 8 Sep 1999 17:39:48 -0400 (EDT) Received: via switchmail; Wed, 8 Sep 1999 17:39:48 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 8 Sep 1999 17:39:03 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 8 Sep 1999 17:38:46 -0400 (EDT) Received: from swainson.med.unc.edu (swainson.med.unc.edu [152.2.119.115]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 8 Sep 1999 17:38:37 -0400 (EDT) Received: from webmail ([152.19.4.30]) by swainson.med.unc.edu (Netscape Messaging Server 3.01) with SMTP id AAA29498 for ; Wed, 8 Sep 1999 17:40:22 -0400 From: "Seth Hawkins" To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: Fwd: W-EMED helping the rescue efforts in Turkey... X-Mailer: Netscape Messenger Express 3.5 [Mozilla/4.61 [en] (WinNT; I)] Date: Wed, 8 Sep 1999 17:40:22 -0400 Message-ID: <19990908214022.AAA29498@webmail> Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 128 0 1 P0E910.CNM Hey Gurkan. It sounds like what you want to set up there is the equivalent of NASAR (National Association for Search & Rescue) here. I would recommend getting in touch with them first -- their website is www.nasar.org. They would be the experts on how to set up a national volunteer SAR system. Otherwise you will get three dozen different US teams with different training and background offering to help, which could be pretty chaotic without a pre-existing body in Turkey to coordinate it. Otherwise, I will keep my ears open for used materials & books. Would they be sent to you in Gunnison or where? seth ---------------------------------- Seth Collings Hawkins, MSIV Carolina Wilderness Medicine UNC-Chapel Hill School of Medicine 207A Purefoy Rd, CH, NC 27514-4857 ---------------------------------- >> >>Hi there, >>This is Gurkan again, the Turkish guy. I'm writing on behalf of >my fellow >>SAR team members (ORDOS Mountain SAR Team, Ankara / Turkey). >After the >>devastating earthquake hit northwestern Turkey on Aug. 17, it >was understood >>by the government that we din't have an organized rescue groups >in Turkey & >>the present ones were needed to be re-organized. Now, the big >guys >>(politicians) are talking about introducing new systems and >improving the >>current national rescue groups. The reality is that such >efforts bring >>results in years (especially in a country like Turkey it may >even be decades >>in some cases). ORDOS SAR Team is initiating volunteer rescue >groups >>organized at city scales, working colaborately and acting much >faster than >>the existing ones, with an expanded mission, not only mountain >(or >>wilderness) SAR, but also responding natural disasters (like >>earthquakes...). This is known that the major responsibility >for the >>formation of national level rescue groups is the government's >(law makers') >>& this initiation is not a substitute, but instead completely >voluntarily, >>non-government, non-profit movement aiming to improve/provide >education & >>training for the general public. The first priority will be >given to the >>young population (45% of 65 million people is under 18), mainly >university >>students (5 government universities in Ankara host about 90,000 >students) >>who seem really willing to participate. It is obvious that >there won't be >>any problem with human resources. The other two things, >training & material, >>on the other hand require money & is beyond this volunteer >initiation's >>limits (for the scale planned). Coming to the point, is there >anybody you >>know who can: >> >> * donate new/used technical or medical material to be used on >education or >>real case purposes (backboards, manikins, ropes, >harnesses,etc..) >> * provide new/used emergency medicine textbooks (any level >FA, FR,EMT) for >>education purposes (any edition after '94) >> * be interested in going to Turkey to spend at least a couple >of weeks & >>give technical/medical training to the fellows (prefarably in >summer time >>during the school break June 1 - September 30, or in winter >January 15 - >>February 15)...I can guarantee to provide accomodation,food and >anything >>else in Turkey but there might not be any pay to the insructor >nor the >>reimbursement for the flights to/from Turkey. >> * any other means of help, money, advice,... >> >>Everything will be highly appreciated. Many thanks in advance. >> >>Gurkan Ozel >> >>********************* >>615 W. San Juan Ave. >>Gunnison, CO 81230 >> >>(970) 641-2082 >>********************** >> >> >>______________________________________________________ >>Get Your Private, Free Email at http://www.hotmail.com >>Do not reproduce without author's express permission. >>To unsubscribe, send the text "unsubscribe >wilderness-emergency-medicine" >>as the body of a message (no subject) To: >Majordomo@list.pitt.edu >>Submissions To: wilderness-emergency-medicine@list.pitt.edu >> > > > Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 8 Sep 1999 17:24:04 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 8 Sep 1999 17:23:28 -0400 (EDT) Received: via switchmail; Wed, 8 Sep 1999 17:23:27 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 8 Sep 1999 17:21:32 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 8 Sep 1999 17:20:51 -0400 (EDT) Received: from impulse.net (mail.impulse.net [204.188.6.10]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 8 Sep 1999 17:20:44 -0400 (EDT) Received: (qmail 86592 invoked by alias); 8 Sep 1999 21:22:24 -0000 Received: from hr1-cf9a4228.dia.impulse.net (HELO lynch) (207.154.66.40) by mail.impulse.net with SMTP; 8 Sep 1999 21:22:24 -0000 From: "Mike Lynch" To: , Subject: RE: W-EMED helping the rescue efforts in Turkey... Date: Wed, 8 Sep 1999 14:19:18 -0700 Message-ID: <000201befa3f$d5bd7700$0d00a8c0@lynch> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 (Normal) X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook 8.5, Build 4.71.2232.26 X-MimeOLE: Produced By Microsoft MimeOLE V5.00.2014.211 Importance: Normal In-Reply-To: <19990908193805.64686.qmail@hotmail.com> Disposition-Notification-To: "Mike Lynch" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P55F20.CNM In the United States, a major resource in a response to a disaster, like an earthquake, are groups of local volunteers called Community Emergency Response Teams (CERT). They are students, shop keepers, mechanics, teachers, engineers, and other community volunteers who train together and prepare their local neighborhoods and communities to survive and respond to disasters. Information on the Community Emergency Response Team program, including student and instructor training material and PowerPoint slide presentations, is available from the FEMA web site at http://www.fema.gov/emi/cert/ Good luck with your recovery efforts and disaster preparedness programs, Mike Lynch, mlynch@impulse.net Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 8 Sep 1999 18:50:34 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 8 Sep 1999 18:49:57 -0400 (EDT) Received: via switchmail; Wed, 8 Sep 1999 18:49:57 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 8 Sep 1999 18:49:25 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 8 Sep 1999 18:48:39 -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-7.2.2.1) ID for ; Wed, 8 Sep 1999 18:48:22 -0400 (EDT) Received: from localhost (localhost [127.0.0.1]) by macs.mxim.com (8.7/8.6.9) with SMTP id PAA06719 for ; Wed, 8 Sep 1999 15:49:23 -0700 (PDT) Message-Id: <199909082249.PAA06719@macs.mxim.com> X-Mailer: exmh version 2.0.1 12/23/97 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED helping the rescue efforts in Turkey... In-reply-to: Your message of "Wed, 08 Sep 1999 14:19:18 PDT." <000201befa3f$d5bd7700$0d00a8c0@lynch> Mime-Version: 1.0 Content-Type: text/plain; charset=us-ascii Date: Wed, 08 Sep 1999 15:49:22 PDT From: Hal Lillywhite Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P4A090.CNM Mike Lynch writes: >In the United States, a major resource in a response to a disaster, >like an earthquake, are groups of local volunteers called Community >Emergency Response Teams (CERT). They are students, shop keepers, >mechanics, teachers, engineers, and other community volunteers who >train together and prepare their local neighborhoods and communities >to survive and respond to disasters. Information on the Community >Emergency Response Team program, including student and instructor >training material and PowerPoint slide presentations, is available >from the FEMA web site at http://www.fema.gov/emi/cert/ A couple of years ago I taught a version of this to a group from our church. I called FEMA and they sent me about 30 student manuals and some instructor manuals just for the asking. I think this is a great program, probably about as good as can be deviced under the constraints they work with: 1. Cover the most important things but at the same time, 2. Keep the course short enough that ordinary citizens can spare the time. Obviously there is a lot more to learn than can be covered under constraint #2 and if Gurkan can get people trained to the EMT level (especially the wilderness EMT level) that will be a huge advantage. If not, the more emergency medical skills he can get developed the better, from basic first aid up through first responder and EMT. The class assumes no previous medical training and really covers only the basics. Of course disaster medicine is very different from standard first aid since you usually have multiple victims and no ambulance available. Each class session is about 3 hours long with a bit of study between classes suggested. As I recall the sessions are: 1. Introduction and disaster preparation, including suggested supplies to have on hand and how to make your home a bit more resistant to damage. 2. Fire suppression and hazardous materials. 3. Medical, this session deals primarly with triage and immediate care. 4. Medical, this session covers longer term care, setting up treatment areas, sanitation etc. This is the area where wilderness medical training is very useful. 5. Light search and rescue and building safety. Covers how to determine if it is safe to enter a building and how to search in buildings as well as different collapse mechanisms. 6. Teamwork, disaster psychology and a final drill. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 8 Sep 1999 15:41:52 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 8 Sep 1999 15:40:42 -0400 (EDT) Received: via switchmail; Wed, 8 Sep 1999 15:40:41 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 8 Sep 1999 15:39:14 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 8 Sep 1999 15:37:25 -0400 (EDT) Received: from hotmail.com (f41.law3.hotmail.com [209.185.241.41]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 8 Sep 1999 15:37:08 -0400 (EDT) Received: (qmail 64687 invoked by uid 0); 8 Sep 1999 19:38:05 -0000 Message-ID: <19990908193805.64686.qmail@hotmail.com> Received: from 205.169.197.108 by www.hotmail.com with HTTP; Wed, 08 Sep 1999 12:38:05 PDT X-Originating-IP: [205.169.197.108] From: "Gurkan Ozel" To: wilderness-emergency-medicine@list.pitt.edu Subject: W-EMED helping the rescue efforts in Turkey... Date: Wed, 08 Sep 1999 12:38:05 PDT Mime-Version: 1.0 Content-Type: text/plain; format=flowed Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P43C20.CNM Hi there, This is Gurkan again, the Turkish guy. I'm writing on behalf of my fellow SAR team members (ORDOS Mountain SAR Team, Ankara / Turkey). After the devastating earthquake hit northwestern Turkey on Aug. 17, it was understood by the government that we din't have an organized rescue groups in Turkey & the present ones were needed to be re-organized. Now, the big guys (politicians) are talking about introducing new systems and improving the current national rescue groups. The reality is that such efforts bring results in years (especially in a country like Turkey it may even be decades in some cases). ORDOS SAR Team is initiating volunteer rescue groups organized at city scales, working colaborately and acting much faster than the existing ones, with an expanded mission, not only mountain (or wilderness) SAR, but also responding natural disasters (like earthquakes...). This is known that the major responsibility for the formation of national level rescue groups is the government's (law makers') & this initiation is not a substitute, but instead completely voluntarily, non-government, non-profit movement aiming to improve/provide education & training for the general public. The first priority will be given to the young population (45% of 65 million people is under 18), mainly university students (5 government universities in Ankara host about 90,000 students) who seem really willing to participate. It is obvious that there won't be any problem with human resources. The other two things, training & material, on the other hand require money & is beyond this volunteer initiation's limits (for the scale planned). Coming to the point, is there anybody you know who can: * donate new/used technical or medical material to be used on education or real case purposes (backboards, manikins, ropes, harnesses,etc..) * provide new/used emergency medicine textbooks (any level FA, FR,EMT) for education purposes (any edition after '94) * be interested in going to Turkey to spend at least a couple of weeks & give technical/medical training to the fellows (prefarably in summer time during the school break June 1 - September 30, or in winter January 15 - February 15)...I can guarantee to provide accomodation,food and anything else in Turkey but there might not be any pay to the insructor nor the reimbursement for the flights to/from Turkey. * any other means of help, money, advice,... Everything will be highly appreciated. Many thanks in advance. Gurkan Ozel ********************* 615 W. San Juan Ave. Gunnison, CO 81230 (970) 641-2082 ********************** ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 7 Sep 1999 15:29:44 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 7 Sep 1999 15:29:12 -0400 (EDT) Received: via switchmail; Tue, 7 Sep 1999 15:29:11 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 7 Sep 1999 15:27:12 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 7 Sep 1999 15:24:34 -0400 (EDT) Received: from imo20.mx.aol.com (imo20.mx.aol.com [198.81.17.10]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 7 Sep 1999 15:24:29 -0400 (EDT) From: Pmclmc@aol.com Received: from Pmclmc@aol.com by imo20.mx.aol.com (mail_out_v22.4.) id hVHHa28691 (4318) for ; Tue, 7 Sep 1999 15:25:13 -0400 (EDT) Message-ID: <11ec6417.2506c098@aol.com> Date: Tue, 7 Sep 1999 15:25:12 EDT Subject: Re: W-EMED Input wanted regarding whistles To: wilderness-emergency-medicine@list.pitt.edu MIME-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Content-Transfer-Encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 21 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P061A0.CNM Regarding then late input on whistles. Based on our experience whistles are appropriate for both searchers and lost folks. Wouldn't let a kid go out without one Paul Mc Santa Fe SAR Santa Fe, NM Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 2 Sep 1999 22:01:47 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 2 Sep 1999 22:01:14 -0400 (EDT) Received: via switchmail; Thu, 2 Sep 1999 22:01:14 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 2 Sep 1999 21:59:35 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 2 Sep 1999 21:58:32 -0400 (EDT) Received: from swan.prod.itd.earthlink.net (swan.prod.itd.earthlink.net [207.217.120.123]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 2 Sep 1999 21:58:29 -0400 (EDT) Received: from [38.26.192.93] (ip240.troy6.ny.pub-ip.psi.net [38.26.192.240]) by swan.prod.itd.earthlink.net (8.9.3/8.9.3) with ESMTP id SAA26297; Thu, 2 Sep 1999 18:48:50 -0700 (PDT) X-Sender: progersk@mail.earthlink.net Message-Id: Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Date: Thu, 2 Sep 1999 21:44:36 -0400 To: Francesca Kule From: Paul Subject: W-EMED self thought..... Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P18060.CNM Stop! Think for a moment. Isn't it interesting to note that whatever it is you CAN NOT do is predicated not on what you think you can do, but on what you think you can't? best, Paul Please forgive me, I am just finishing my first week of law school and I seem to have these late night epiphanies... Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 1 Sep 1999 18:38:23 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 1 Sep 1999 18:37:50 -0400 (EDT) Received: via switchmail; Wed, 1 Sep 1999 18:37:50 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 1 Sep 1999 18:35:46 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 1 Sep 1999 18:35:01 -0400 (EDT) Received: from vop.nucleus.com (vop.nucleus.com [207.34.93.23]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 1 Sep 1999 18:34:56 -0400 (EDT) Received: from compaq (unverified [207.34.94.61]) by vop.nucleus.com (Vircom SMTPRS 4.1.180) with SMTP id for ; Wed, 1 Sep 1999 16:36:28 -0600 Message-ID: <003401bef4ca$5e0af4a0$3d5e22cf@compaq> From: "Lana Berrington" To: Subject: Re: W-EMED FYI - Ana-Kit recall Date: Wed, 1 Sep 1999 16:35:59 -0600 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 4.72.3110.1 X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3110.3 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P10420.CNM >500,000 allergic reaction kits are recalled > Thanks for the info! We were lucky here. we had 8 kits that were going to expire in January anyway, and all 8 were on the recall list. Hopefully there won't be a manufactrers shortage following this recall Lana Berrington, EMT-A Health Services Director Rocky Mountain YMCA Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 31 Aug 1999 03:10:31 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 31 Aug 1999 03:09:58 -0400 (EDT) Received: via switchmail; Tue, 31 Aug 1999 03:09:57 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 31 Aug 1999 03:09:45 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 31 Aug 1999 03:09:03 -0400 (EDT) Received: from relay05.netaddress.usa.net (relay05.netaddress.usa.net [204.68.24.185]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 31 Aug 1999 03:09:00 -0400 (EDT) Received: (qmail 4835 invoked from network); 31 Aug 1999 07:09:39 -0000 Received: from nwcst267.netaddress.usa.net (204.68.23.12) by outbound.netaddress.usa.net with SMTP; 31 Aug 1999 07:09:39 -0000 Received: (qmail 14418 invoked by uid 60001); 31 Aug 1999 07:10:09 -0000 Message-ID: <19990831071009.14417.qmail@nwcst267.netaddress.usa.net> Received: from 204.68.23.12 by nwcst267 via web-mailer(M3.2) on Tue Aug 31 07:10:09 GMT 1999 Date: 31 Aug 99 00:10:09 PDT From: Laura Norris To: wilderness-emergency-medicine@list.pitt.edu Subject: W-EMED Leadership Books X-Mailer: USANET web-mailer (M3.2) Mime-Version: 1.0 Content-Type: text/plain; charset=US-ASCII Content-Transfer-Encoding: 8bit X-MIME-Autoconverted: from quoted-printable to 8bit by list.srv.cis.pitt.edu id DAA27366 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P47400.CNM Cindy, Thanks. I also give it two thumbs up. I took your advice and ordered a copy last week. My copy of the Outdoor Leadership : Technique, Common Sense & Self-Confidence http://www.amazon.com/exec/obidos/ASIN/0898865026/foothill arrived today and you were right, it had many useful techniques. At same time I also ordered a Comprehensive Guide to Wilderness & Travel Medicine by Eric A. Weiss, http://www.amazon.com/exec/obidos/ASIN/0965976807/foothill and found that it was small enough to keep in my first aid kit or travel kit, yet packed with lots of useful information. At $5.56 I was not sure what to expect and found that it was more useful than some of my larger books. A lot more valuable since I might actually have it with me when needed. Best Regards, Laura ____________________________________________________________________ Get your own FREE, personal Netscape WebMail account today at http://webmail.netscape.com. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 30 Aug 1999 16:36:22 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 30 Aug 1999 16:35:49 -0400 (EDT) Received: via switchmail; Mon, 30 Aug 1999 16:35:49 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 30 Aug 1999 16:34:08 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 30 Aug 1999 16:33:45 -0400 (EDT) Received: from impulse.net (mail.impulse.net [204.188.6.10]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 30 Aug 1999 16:33:40 -0400 (EDT) Received: (qmail 61809 invoked by alias); 30 Aug 1999 20:35:08 -0000 Received: from lo2-cf9a473e.dia.impulse.net (HELO lynch) (207.154.71.62) by mail.impulse.net with SMTP; 30 Aug 1999 20:35:08 -0000 From: "Mike Lynch" To: Subject: RE: W-EMED Input wanted regarding whistles Date: Mon, 30 Aug 1999 13:32:06 -0700 Message-ID: <000601bef326$c2fe38e0$0d00a8c0@lynch> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 (Normal) X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook 8.5, Build 4.71.2232.26 In-Reply-To: <19990830.085753.17238.0.JayWiseman@juno.com> X-MimeOLE: Produced By Microsoft MimeOLE V5.00.2014.211 Importance: Normal Disposition-Notification-To: "Mike Lynch" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P3A7E0.CNM > -----Original Message----- > From: owner-wilderness-emergency-medicine@list.pitt.edu > [mailto:owner-wilderness-emergency-medicine@list.pitt.edu]On Behalf Of > Jay J Wiseman > Sent: Monday, August 30, 1999 8:58 AM > To: wilderness-emergency-medicine@list.pitt.edu > Subject: W-EMED Input wanted regarding whistles > > Hi folks, > > One of the almost universal recommendations I encounter regarding > wilderness survival issues is "carry a whistle." This is usually > associated with a recommendation for one of the super-whistles such as > the Fox 40 or the Storm Whistle. (The NATO whistle also has > its fans.) > > OK, so even the most expensive whistles don't cost all that much and > aren't all that bulky -- except perhaps the Storm whistle. Fine, but > I've been wondering: are whistles really likely to be all > that useful to > someone is "lost in the woods." (I'll concede their value > for rescuers > who are searching for someone.) > > I was wondering what your experiences have been regarding > these devices. > In particular, how useful do you think it really is for "civilians" to > carry a whistle while out in the wilderness? Any particular > recommendations? In your experience, is one brand or type really > significantly better than others? Any particularly > interesting successes or failures regarding them? > > Also, I've noticed that in North America the "universal > distress signal" is three whistle blasts (or three shots, or three of almost > anything else) while in Europe the universal distress signal seems to > be six such whistle blasts. What's up with that? > > Anyway, regarding the "civilians and whistles" issue, what think? > > Regards, > > Jay -------------------------------------------------- Hi Jay, Part of our standard search procedure is to call out to the search subject and blow on whistles. Our initial contact with responsive search subjects is usually by voice rather than visual. A whistle would extend the range that the subject could be heard. Standard equipment for any hiker should include a whistle, flashlight, compass, and topo map of the area. I will let someone else address the three versus six blasts on a whistle. If we here any whistle or voice on a search, we respond to it and identify the source. Mike Lynch, mlynch@impulse.net Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 30 Aug 1999 15:08:55 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 30 Aug 1999 15:08:18 -0400 (EDT) Received: via switchmail; Mon, 30 Aug 1999 15:08:18 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 30 Aug 1999 15:07:43 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 30 Aug 1999 15:07:20 -0400 (EDT) Received: from Simba.tc.gc.ca (aladdin.tc.gc.ca [198.103.96.10]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 30 Aug 1999 15:07:13 -0400 (EDT) Received: id PAA22819; Mon, 30 Aug 1999 15:00:16 -0400 Received: by gateway id ; Mon, 30 Aug 1999 15:00:18 -0400 Message-ID: <5F3979800DF7D111A6CF00805FFEE16202440184@TC1S04.tc.gc.ca> From: "Norup, Shane" To: "'wilderness-emergency-medicine@list.pitt.edu'" Subject: RE: W-EMED Input wanted regarding whistles Date: Mon, 30 Aug 1999 15:00:01 -0400 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.2448.0) Content-Type: text/plain Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P00040.CNM I believe the standard number of blasts on the whistle when in distress is nine: three short, three long, and three short (I may have the longs and shorts reversed). This is the Morse code for S-O-S. As a member of the Canadian Ski Patrol, we use whistles to communicate while on the hill. Our budget doesn't permit the luxury of issuing all patrollers with a radio. I have a Fox40 attached to my jacket. For cold weather use, plastic whistles are the only ones to use. The metal ones could result in.... well, you know what happens! My $.02 with regards to civilians and whistles is that everyone should carry one. Even in large groups. With the quick blast of the whistle, a momentary separation can easily be stopped from turning into situation where a full blown search and rescue is required. Take care! Shane Norup > -----Original Message----- > From: Jay J Wiseman [SMTP:jaywiseman@Juno.com] > Sent: Monday, August 30, 1999 11:58 AM > To: wilderness-emergency-medicine@list.pitt.edu > Subject: W-EMED Input wanted regarding whistles > > > Hi folks, > > One of the almost universal recommendations I encounter regarding > wilderness survival issues is "carry a whistle." This is usually > associated with a recommendation for one of the super-whistles such as > the Fox 40 or the Storm Whistle. (The NATO whistle also has its fans.) > > OK, so even the most expensive whistles don't cost all that much and > aren't all that bulky -- except perhaps the Storm whistle. Fine, but > I've been wondering: are whistles really likely to be all that useful to > someone is "lost in the woods." (I'll concede their value for rescuers > who are searching for someone.) > > I was wondering what your experiences have been regarding these devices. > In particular, how useful do you think it really is for "civilians" to > carry a whistle while out in the wilderness? Any particular > recommendations? In your experience, is one brand or type really > significantly better than others? Any particularly interesting successes > or failures regarding them? > > Also, I've noticed that in North America the "universal distress signal" > is three whistle blasts (or three shots, or three of almost anything > else) while in Europe the universal distress signal seems to be six such > whistle blasts. What's up with that? > > Anyway, regarding the "civilians and whistles" issue, what think? > > Regards, > > Jay > > > > > ___________________________________________________________________ > Get the Internet just the way you want it. > Free software, free e-mail, and free Internet access for a month! > Try Juno Web: http://dl.www.juno.com/dynoget/tagj. > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 30 Aug 1999 18:35:47 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 30 Aug 1999 18:35:12 -0400 (EDT) Received: via switchmail; Mon, 30 Aug 1999 18:35:12 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 30 Aug 1999 18:34:05 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 30 Aug 1999 18:33:33 -0400 (EDT) Received: from imo-d01.mx.aol.com (imo-d01.mx.aol.com [205.188.157.33]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 30 Aug 1999 18:33:28 -0400 (EDT) From: DoctrRick@aol.com Received: from DoctrRick@aol.com by imo-d01.mx.aol.com (mail_out_v22.4.) id hCVC0v2vft (3868) for ; Mon, 30 Aug 1999 18:34:23 -0400 (EDT) Message-ID: <1d113ea3.24fc60ee@aol.com> Date: Mon, 30 Aug 1999 18:34:22 EDT Subject: W-EMED DE Gloving To: wilderness-emergency-medicine@list.pitt.edu MIME-Version: 1.0 Content-Type: text/plain; charset="ISO-8859-1" X-Mailer: AOL 4.0 for Windows 95 sub 14 Content-Transfer-Encoding: 8bit X-MIME-Autoconverted: from quoted-printable to 8bit by list.srv.cis.pitt.edu id SAA13848 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P5BD50.CNM De-gloving, Easier Said than Done Rick Bennett Ph.D. Recently while teaching infectious disease control to a paramedic class, we had a discussion on gloves and Universal Precautions. Students were asked, "how do you remove gloves, especially ones that are heavily contaminated with blood or other body fluids. A student volunteered to demonstrate the technique in front of the class. The gloved hands were covered with moulage blood and the student began the process just as EMS personnel are taught. As the last glove came off, it "snapped" as gloves often do and the simulated blood splattered the student's lower and upper arms. The technique used was correct, however the glove "snap" made the correct procedure a potential infectious disease exposure! Two approaches I have developed demonstrate, vividly, how improper glove removal can possibly contaminate the EMT and nearby colleagues. Moulage Blood Technique: Have student glove up and pour moulage blood over both sides of the gloved hands. (Have some type of protective sheet under the demonstration to contain spills) The student then removes the gloves and places them in a large plastic (biohazard) bag. Examine the hands, arms and face for tiny droplets of blood. Fluorescent Dye Method: Prepare a less viscous solution of Glitterbug ™ (Brevis Corporation Salt Lake City Utah, http://www.brevis.com/index.html) by adding warm soapy water or corn oil to the stock solution of Glitterbug. Pour the thinner solution over the gloved hands. Have the student remove the gloves in the proper fashion. Turn off the lights and examine the hands, arms and face of the student with a black light. Students and instructors alike will be amazed by the amount of glowing orange dots on the student. This simple yet powerful demonstration provides an insight on the importance of proper technique in removing gloves and other garments that have been contaminated with patient's body fluids. Even the smallest amount of moulage blood or Glitterbug™ on the face presents the real possibility that even smaller droplets may have been aerosolized and may constitute ocular or respiratory exposure, thus warranting consideration for mask and eye protection as well. Yes glove up at all times and be even more careful removing them. It is easier said than done. That all to famous glove "snap" is to be avoided when removing gloves. Critically, this exercise underscores the importance of hand and arm washing after removing heavily contaminated gloves. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 30 Aug 1999 12:00:48 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 30 Aug 1999 12:00:14 -0400 (EDT) Received: via switchmail; Mon, 30 Aug 1999 12:00:14 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 30 Aug 1999 11:58:14 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 30 Aug 1999 11:57:53 -0400 (EDT) Received: from m9.boston.juno.com (m9.boston.juno.com [205.231.100.195]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 30 Aug 1999 11:57:49 -0400 (EDT) Received: (from jaywiseman@juno.com) by m9.boston.juno.com (queuemail) id EKAHGHPY; Mon, 30 Aug 1999 11:56:14 EDT To: wilderness-emergency-medicine@list.pitt.edu Date: Mon, 30 Aug 1999 08:57:49 -0700 Subject: W-EMED Input wanted regarding whistles Message-ID: <19990830.085753.17238.0.JayWiseman@juno.com> References: <1D1B9E1EF605D211B03B00805FA7AFDC0107052C@dnc01xntcvfsge> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 0-2,6-7,12-13,19-20,24-33 From: Jay J Wiseman Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 128 0 1 P42410.CNM Hi folks, One of the almost universal recommendations I encounter regarding wilderness survival issues is "carry a whistle." This is usually associated with a recommendation for one of the super-whistles such as the Fox 40 or the Storm Whistle. (The NATO whistle also has its fans.) OK, so even the most expensive whistles don't cost all that much and aren't all that bulky -- except perhaps the Storm whistle. Fine, but I've been wondering: are whistles really likely to be all that useful to someone is "lost in the woods." (I'll concede their value for rescuers who are searching for someone.) I was wondering what your experiences have been regarding these devices. In particular, how useful do you think it really is for "civilians" to carry a whistle while out in the wilderness? Any particular recommendations? In your experience, is one brand or type really significantly better than others? Any particularly interesting successes or failures regarding them? Also, I've noticed that in North America the "universal distress signal" is three whistle blasts (or three shots, or three of almost anything else) while in Europe the universal distress signal seems to be six such whistle blasts. What's up with that? Anyway, regarding the "civilians and whistles" issue, what think? Regards, Jay ___________________________________________________________________ Get the Internet just the way you want it. Free software, free e-mail, and free Internet access for a month! Try Juno Web: http://dl.www.juno.com/dynoget/tagj. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 30 Aug 1999 13:28:54 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 30 Aug 1999 13:28:16 -0400 (EDT) Received: via switchmail; Mon, 30 Aug 1999 13:28:15 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 30 Aug 1999 13:27:22 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 30 Aug 1999 13:26:51 -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-7.2.2.1) ID for ; Mon, 30 Aug 1999 13:26:45 -0400 (EDT) Received: from localhost (localhost [127.0.0.1]) by macs.mxim.com (8.7/8.6.9) with SMTP id KAA08911 for ; Mon, 30 Aug 1999 10:27:43 -0700 (PDT) Message-Id: <199908301727.KAA08911@macs.mxim.com> X-Mailer: exmh version 2.0.1 12/23/97 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Input wanted regarding whistles In-reply-to: Your message of "Mon, 30 Aug 1999 08:57:49 PDT." <19990830.085753.17238.0.JayWiseman@juno.com> Mime-Version: 1.0 Content-Type: text/plain; charset=us-ascii Date: Mon, 30 Aug 1999 10:27:43 PDT From: Hal Lillywhite Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P2C380.CNM Jay writes: >OK, so even the most expensive whistles don't cost all that much >and aren't all that bulky -- except perhaps the Storm whistle. >Fine, but I've been wondering: are whistles really likely to be >all that useful to someone is "lost in the woods." Try the following experiment: Get a good whistle and find a place where you won't disturb people too much or cause confusion. Pretend you are lost in the woods. Yell loudly as though yelling for help. Keep this up intermittently for several hours, maybe even a couple of days. To make it more realistic pretend you are low on water so you can't drink as much as you would like. How effective do you think your voice is after this? Now pull out the whistle and see how effective you think it is. The point of course it that a lost person is likely to want to attract attention and so will want to make noise frequently, even when there are no searchers visible. That tends to cause hoarseness and weaken the voice after a while. The whistle suffers much less from that problem. ... >Also, I've noticed that in North America the "universal distress >signal" is three whistle blasts (or three shots, or three of almost >anything else) while in Europe the universal distress signal seems >to be six such whistle blasts. What's up with that? I've also heard that in some places it is *nine*. It would be very useful to make this consistent world wide but I don't know of any standards body capable of doing it. I would prefer three, that is enough to avoid confusion with other signals. However each whistle blast requires precious energy from the lost person or ammunition if using a firearm or often something else which may be in short supply. I think distress signals should be chosen to reduce drain on the resources of the lost person. If that person is tired, hungry, thirsty etc. blowing six whistle blasts may be a bit demanding. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 30 Aug 1999 10:12:43 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 30 Aug 1999 10:12:04 -0400 (EDT) Received: via switchmail; Mon, 30 Aug 1999 10:12:02 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 30 Aug 1999 10:09:19 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Mon, 30 Aug 1999 10:08:00 -0400 (EDT) Received: from hotmail.com (f88.law3.hotmail.com [209.185.241.88]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Mon, 30 Aug 1999 10:07:56 -0400 (EDT) Received: (qmail 90431 invoked by uid 0); 30 Aug 1999 14:08:55 -0000 Message-ID: <19990830140855.90430.qmail@hotmail.com> Received: from 205.169.197.108 by www.hotmail.com with HTTP; Mon, 30 Aug 1999 07:08:54 PDT X-Originating-IP: [205.169.197.108] From: "Gurkan Ozel" To: wilderness-emergency-medicine@list.pitt.edu Subject: W-EMED Thanks from the Turkish guy. Date: Mon, 30 Aug 1999 07:08:54 PDT Mime-Version: 1.0 Content-Type: text/plain; format=flowed Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P624B0.CNM Hey there, Many thanks to everybody who has given me information & help me to shape my future. I appreciate that. Cheers, Gurkan Ozel ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 27 Aug 1999 14:46:20 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 27 Aug 1999 14:45:46 -0400 (EDT) Received: via switchmail; Fri, 27 Aug 1999 14:45:46 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 27 Aug 1999 14:45:20 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 27 Aug 1999 14:44:56 -0400 (EDT) Received: from ns3.ge.com (ns3.ge.com [192.35.39.22]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 27 Aug 1999 14:44:52 -0400 (EDT) Received: from thomas.ge.com (thomas-o.ge.com [10.47.28.21]) by ns3.ge.com (8.9.3/8.9.3) with ESMTP id OAA21575 for ; Fri, 27 Aug 1999 14:45:47 -0400 (EDT) Received: from dnc04xntcvfsge.vfs.capital.ge.com ([3.61.128.77]) by thomas.ge.com (8.9.3/8.9.3) with ESMTP id OAA03310 for ; Fri, 27 Aug 1999 14:45:46 -0400 (EDT) Received: by DNC04XNTCVFSGE with Internet Mail Service (5.5.2448.0) id ; Fri, 27 Aug 1999 14:45:43 -0400 Message-ID: <1D1B9E1EF605D211B03B00805FA7AFDC0107052C@DNC01XNTCVFSGE> From: "Reinhart, Gregg (CAP, VFS)" To: "'wilderness-emergency-medicine@list.pitt.edu'" Subject: RE: W-EMED The two compass trick Date: Fri, 27 Aug 1999 14:45:37 -0400 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.2448.0) Content-Type: text/plain; charset="iso-8859-1" Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P65C00.CNM It seems to me it would be much simpler to follow the tried and true woodsman's adage "Never, EVER, second guess your compass". If someone's brain is so addled as to doubt their compass, it's probably addled enough to doubt both compasses. Further, if something is disturbing the reading, it is probably external to the compass and would be better checked by moving a few yards to rule out external disturbance, since whatever is disturbing the first compass is likely to disturb the second compass... not to mention the likelihood of the compasses disturbing each other.... Just move a few yards and try again, and always trust the compass. -----Original Message----- From: Jay J Wiseman [mailto:jaywiseman@Juno.com] Sent: Friday, August 27, 1999 11:27 AM To: wilderness-emergency-medicine@list.pitt.edu Subject: W-EMED The two compass trick Hi folks, A friend of mine who is pretty heavily involved in SAR recently shared with me a technique (read "trick") I had never heard of before that supposedly can help someone from becoming (more) lost in the wilderness: carry two compasses. Apparently, the idea behind this is that if you get yourself really disoriented in the woods, you can convince yourself that your single compass is malfunctioning (which it probably ain't) and get yourself even more disoriented. However, if your _two_ compasses are both pointing in a direction they say is north when you are ready to swear that the direction they are pointing is, say, west, it becomes much harder to attribute their readings to malfunction. This sounds reasonable to me, but I haven't had a chance to field test it. What think? Regards, Jay ___________________________________________________________________ Get the Internet just the way you want it. Free software, free e-mail, and free Internet access for a month! Try Juno Web: http://dl.www.juno.com/dynoget/tagj. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 27 Aug 1999 13:51:43 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc05.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 27 Aug 1999 13:51:09 -0400 (EDT) Received: via switchmail; Fri, 27 Aug 1999 13:51:07 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 27 Aug 1999 13:50:24 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 27 Aug 1999 13:50:06 -0400 (EDT) Received: from relay1.rcp.net.pe (relay1.rcp.net.pe [200.1.178.247]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 27 Aug 1999 13:49:58 -0400 (EDT) Received: from amauta.rcp.net.pe ([161.132.5.5]:40980 "HELO amauta.rcp.net.pe" ident: "NO-IDENT-SERVICE[2]") by relay1.rcp.net.pe with SMTP id <93-222>; Fri, 27 Aug 1999 12:50:10 -0500 Received: from [200.1.182.161](asy161.rcp.net.pe[200.1.182.161]) (804 bytes) by amauta.rcp.net.pe via sendmail with P:smtp/R:smart_host/T:smtp (sender: ) id for ; Fri, 27 Aug 1999 12:51:03 -0500 (GMT) (Smail-3.2.0.105 1999-Mar-3 #33 built 1999-Mar-8) Message-Id: Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Date: Fri, 27 Aug 1999 12:54:59 -0500 To: wilderness-emergency-medicine@list.pitt.edu From: tsmith@amauta.rcp.net.pe (Tom) Subject: Re: W-EMED The two compass trick Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P0C910.CNM If held together, the two compasses will point to each other, indicating the direction is toward the spot in which you are standing. This means you are where you should be and should stay there. Which, of course, solves the problem. Everyone knows the third law of motion says if you aren't going anywhere you can't be lost. Simple. Tom Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 27 Aug 1999 13:25:18 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 27 Aug 1999 12:53:28 -0400 (EDT) Received: via switchmail; Fri, 27 Aug 1999 12:53:28 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 27 Aug 1999 12:53:03 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 27 Aug 1999 12:52:23 -0400 (EDT) Received: from Mail.lakes.com (Mail.lakes.com [209.181.160.3]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 27 Aug 1999 12:52:17 -0400 (EDT) From: emsmark@prairie.lakes.com Received: from Prairie.lakes.com (root@Prairie.Lakes.com [209.181.160.1]) by Mail.lakes.com (8.8.7/8.8.7) with ESMTP id LAA22806 for ; Fri, 27 Aug 1999 11:57:52 -0500 Received: from Modem033-Rochester.lakes.com (Modem033-Rochester.lakes.com [209.181.169.225]) by Prairie.lakes.com (8.8.7/8.8.7) with SMTP id LAA32131 for ; Fri, 27 Aug 1999 11:57:50 -0500 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED The two compass trick Date: Fri, 27 Aug 1999 16:53:37 GMT Message-ID: <37d0beff.152904919@prairie.lakes.com> References: <199908270158.SAA15527@mx0-smtp.goodnet.com> <19990827.082659.20374.0.JayWiseman@juno.com> In-Reply-To: <19990827.082659.20374.0.JayWiseman@juno.com> X-Mailer: Forte Agent 1.5/32.452 MIME-Version: 1.0 Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 8bit X-MIME-Autoconverted: from quoted-printable to 8bit by list.srv.cis.pitt.edu id MAA24985 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P67800.CNM Couldn't help adding something to this thought....if one compass is pointing (for instance) away from you (towards north,) and you doubt its reading, you grab a second compass to compare with. Placing the second compass next to the first.... Remember, opposites attract, and north will now be to your right (or left, depending on initial deflections of the two) now matter how much you turn to the right (or left) :-) My point? Hold the two several inches apart to minimize the interaction of the needles' magnetic fields. Mark On Fri, 27 Aug 1999 08:26:55 -0700, you wrote: >Apparently, the idea behind this is that if you get yourself really >disoriented in the woods, you can convince yourself that your single >compass is malfunctioning (which it probably ain't) and get yourself even >more disoriented. However, if your _two_ compasses are both pointing in >a direction they say is north when you are ready to swear that the >direction they are pointing is, say, west, it becomes much harder to >attribute their readings to malfunction. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 27 Aug 1999 11:29:22 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc04.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 27 Aug 1999 11:28:47 -0400 (EDT) Received: via switchmail; Fri, 27 Aug 1999 11:28:47 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 27 Aug 1999 11:26:54 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 27 Aug 1999 11:26:03 -0400 (EDT) Received: from m9.boston.juno.com (m9.boston.juno.com [205.231.100.195]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 27 Aug 1999 11:25:59 -0400 (EDT) Received: (from jaywiseman@juno.com) by m9.boston.juno.com (queuemail) id EJ2QHC5X; Fri, 27 Aug 1999 11:25:06 EDT To: wilderness-emergency-medicine@list.pitt.edu Date: Fri, 27 Aug 1999 08:26:55 -0700 Subject: W-EMED The two compass trick Message-ID: <19990827.082659.20374.0.JayWiseman@juno.com> References: <199908270158.SAA15527@mx0-smtp.goodnet.com> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 0-2,6-7,14-15,17-24 From: Jay J Wiseman Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 128 0 1 P664D0.CNM Hi folks, A friend of mine who is pretty heavily involved in SAR recently shared with me a technique (read "trick") I had never heard of before that supposedly can help someone from becoming (more) lost in the wilderness: carry two compasses. Apparently, the idea behind this is that if you get yourself really disoriented in the woods, you can convince yourself that your single compass is malfunctioning (which it probably ain't) and get yourself even more disoriented. However, if your _two_ compasses are both pointing in a direction they say is north when you are ready to swear that the direction they are pointing is, say, west, it becomes much harder to attribute their readings to malfunction. This sounds reasonable to me, but I haven't had a chance to field test it. What think? Regards, Jay ___________________________________________________________________ Get the Internet just the way you want it. Free software, free e-mail, and free Internet access for a month! Try Juno Web: http://dl.www.juno.com/dynoget/tagj. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 27 Aug 1999 11:00:19 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 27 Aug 1999 10:59:46 -0400 (EDT) Received: via switchmail; Fri, 27 Aug 1999 10:59:45 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 27 Aug 1999 10:58:05 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Fri, 27 Aug 1999 10:56:36 -0400 (EDT) Received: from hotmail.com (f196.law3.hotmail.com [209.185.241.196]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 27 Aug 1999 10:56:32 -0400 (EDT) Received: (qmail 18967 invoked by uid 0); 27 Aug 1999 14:57:26 -0000 Message-ID: <19990827145726.18966.qmail@hotmail.com> Received: from 205.169.197.108 by www.hotmail.com with HTTP; Fri, 27 Aug 1999 07:57:26 PDT X-Originating-IP: [205.169.197.108] From: "Gurkan Ozel" To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED EMT training for a Turkish guy. Date: Fri, 27 Aug 1999 07:57:26 PDT Mime-Version: 1.0 Content-Type: text/plain; format=flowed Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P5C3B0.CNM Hi Tacker, In order to be a student at a local comm. coll. i have to prove that I have enough financial sources (which in this case varies between $10,000-16,000+/year) as an international applicant. I'm not an American & the fees like you mentioned is for in state residents, most of the time. I'm looking for the options best fit my situation & I'd definitely consider your suggestion. Many thank for your answer, I appreciate that. Cheers, Gurkan >From: "John Vordemberge" >Reply-To: wilderness-emergency-medicine@list.pitt.edu >To: >Subject: Re: W-EMED EMT training for a Turkish guy. >Date: Thu, 26 Aug 1999 08:23:21 -0400 >MIME-Version: 1.0 >From owner-wilderness-emergency-medicine@list.pitt.edu Thu Aug 26 05:50:46 >1999 >Received: from localhost (majordom@localhost) by >list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID >; Thu, 26 Aug 1999 08:20:11 -0400 >(EDT) >Received: from mercury.janrix.com (mercury.janrix.com [207.22.155.12]) > by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) > ID for >; Thu, 26 Aug 1999 >08:20:06 -0400 (EDT) >Received: from tacker ([207.22.155.128] (may be forged)) by >mercury.janrix.com (2.5 Build 2640 (Berkeley 8.8.6)/8.8.4) with SMTP id >IAA03653 for ; Thu, 26 Aug >1999 08:21:14 -0400 >Message-ID: <000f01beefbd$cad88f00$809b16cf@tacker> >References: <19990825145454.50965.qmail@hotmail.com> >X-Priority: 3 >X-MSMail-Priority: Normal >X-Mailer: Microsoft Outlook Express 5.00.2014.211 >X-MimeOLE: Produced By Microsoft MimeOLE V5.00.2014.211 >Sender: owner-wilderness-emergency-medicine@list.pitt.edu >Precedence: bulk > >hi here in Fayetteville, NC the N.R.E.M.T.-BASIC course is $35.00 And they >also have a N.R.E.M.T.- I to N.R.E.M.T.-P (in 6 months) for about the same >price (i think) (this does not include books) at the local comm. coll. >Tacker > >Do not reproduce without author's express permission. >To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" >as the body of a message (no subject) To: Majordomo@list.pitt.edu >Submissions To: wilderness-emergency-medicine@list.pitt.edu > ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 27 Aug 1999 00:11:06 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 26 Aug 1999 21:59:45 -0400 (EDT) Received: via switchmail; Thu, 26 Aug 1999 21:59:43 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 26 Aug 1999 21:59:06 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 26 Aug 1999 21:57:31 -0400 (EDT) Received: from mx0-smtp.goodnet.com (envy.goodnet.com [207.98.129.151]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 26 Aug 1999 21:57:26 -0400 (EDT) Received: from Ptkovacs (d16-14.phoenix.goodnet.com [209.141.96.207]) by mx0-smtp.goodnet.com (8.9.3/8.9.3) with ESMTP id SAA15527 for ; Thu, 26 Aug 1999 18:58:48 -0700 (MST) Message-Id: <199908270158.SAA15527@mx0-smtp.goodnet.com> From: "Tim Kovacs" To: Subject: W-EMED EMT training for a Turkish guy. Date: Thu, 26 Aug 1999 19:10:12 -0700 X-MSMail-Priority: Normal X-Priority: 3 X-Mailer: Microsoft Internet Mail 4.70.1155 MIME-Version: 1.0 Content-Type: text/plain; charset=ISO-8859-1 Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P0F110.CNM Your local SAR or Mountain Rescue Team can also help you get through some of this training. SAR and MRA teams have internal standards and training, and can sponsor you through an EMT or Paramedic class, if you need a sponsor. Consider visiting www.mra.org for details on Mountain Rescue Teams in the US and Canada. Cheers! Tim Kovacs, President Mountain Rescue Association Operations Chief/ Paramedic-W tkovacs@goodnet.com www.mra.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 -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 26 Aug 1999 09:37:22 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 26 Aug 1999 08:24:09 -0400 (EDT) Received: via switchmail; Thu, 26 Aug 1999 08:24:06 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 26 Aug 1999 08:21:20 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Thu, 26 Aug 1999 08:20:11 -0400 (EDT) Received: from mercury.janrix.com (mercury.janrix.com [207.22.155.12]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Thu, 26 Aug 1999 08:20:06 -0400 (EDT) Received: from tacker ([207.22.155.128] (may be forged)) by mercury.janrix.com (2.5 Build 2640 (Berkeley 8.8.6)/8.8.4) with SMTP id IAA03653 for ; Thu, 26 Aug 1999 08:21:14 -0400 Message-ID: <000f01beefbd$cad88f00$809b16cf@tacker> From: "John Vordemberge" To: References: <19990825145454.50965.qmail@hotmail.com> Subject: Re: W-EMED EMT training for a Turkish guy. Date: Thu, 26 Aug 1999 08:23:21 -0400 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 5.00.2014.211 X-MimeOLE: Produced By Microsoft MimeOLE V5.00.2014.211 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P65C40.CNM hi here in Fayetteville, NC the N.R.E.M.T.-BASIC course is $35.00 And they also have a N.R.E.M.T.- I to N.R.E.M.T.-P (in 6 months) for about the same price (i think) (this does not include books) at the local comm. coll. Tacker Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 25 Aug 1999 20:13:00 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 25 Aug 1999 20:12:26 -0400 (EDT) Received: via switchmail; Wed, 25 Aug 1999 20:12:26 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 25 Aug 1999 20:10:24 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 25 Aug 1999 20:08:37 -0400 (EDT) Received: from solar.acast.nova.edu (solar.acast.nova.edu [137.52.224.11]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 25 Aug 1999 20:08:34 -0400 (EDT) Received: from hpd.nova.edu (ppp198-34.acast.nova.edu [137.52.198.34]) by solar.acast.nova.edu (8.9.1/8.9.1) with ESMTP id UAA09939 for ; Wed, 25 Aug 1999 20:09:54 -0400 (EDT) Message-ID: <37C48620.605E563C@hpd.nova.edu> Date: Wed, 25 Aug 1999 20:11:13 -0400 From: Michael Williams X-Mailer: Mozilla 4.61 [en] (Win98; I) X-Accept-Language: en MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED EMT training for a Turkish guy. References: <19990825.152530.-328735.7.Fieldmedic1@juno.com> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P0D9E0.CNM You can train for free by becoming a volunteer fire-fighter. In Maryland (I don't know about CO), I had to take a 32 hr basic training class then I took the 110 hour EMT-A class. I don't know about further certification, but volunteering is a great way to train for free, and also to do some good. The departments are usually heavy with people who just want to fight fire, and welcome an ambulance rider! Good Luck, Michael Williams NSU-COM Class of 2000 Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 25 Aug 1999 19:03:42 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc02.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 25 Aug 1999 18:21:26 -0400 (EDT) Received: via switchmail; Wed, 25 Aug 1999 18:21:26 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 25 Aug 1999 18:14:48 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 25 Aug 1999 18:12:35 -0400 (EDT) Received: from m7.jersey.juno.com (m7.jersey.juno.com [209.67.33.63]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 25 Aug 1999 18:12:30 -0400 (EDT) Received: (from fieldmedic1@juno.com) by m7.jersey.juno.com (queuemail) id EJWA2RDZ; Wed, 25 Aug 1999 18:12:58 EDT To: wilderness-emergency-medicine@list.pitt.edu Date: Wed, 25 Aug 1999 15:21:32 -0500 Subject: Re: W-EMED EMT training for a Turkish guy. Message-ID: <19990825.152530.-328735.7.Fieldmedic1@juno.com> X-Mailer: Juno 3.0.11 MIME-Version: 1.0 Content-Type: text/plain Content-Transfer-Encoding: 7bit X-Juno-Line-Breaks: 0-1,9-15,17-86 X-Juno-Att: 0 X-Juno-RefParts: 0 From: Erik W Gunnerson Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P15200.CNM Dear Gurkan, A resource you should check should be your local community college. Here in California, the tuition is cheap ( $ 11 / unit - EMT is typically a 5 unit course ) and the training is top notch. EMT training in the Sacramento Area is available at 4 colleges in a 20 mile radius. I received my training to assist myself while I was a law enforcement park ranger. I now work as an EMT and in a local hospital in the Trauma ICU and am now preparing for a career as a mobile intensive care nurse / paramedic. Good Luck ! Erik Gunnerson EMT-B EMAIL: Fieldmedic1@juno.com On Wed, 25 Aug 1999 07:54:53 PDT "Gurkan Ozel" writes: > > Hi there folks, > My name is Gurkan Ozel, from Turkey. It's been about a year that > I've been > reading (and learning) emails from the list. I'm 25, had my BS > deggree in > statistics in Turkey & I've been mountaineering & climbing (and > whole bunch > of other wilderness sports) for 8 years. I'm a co-founder and was an > > ex-director/active member of an Mountain SAR team established in > 1994 in > Ankara, Turkey. I decided to have a career in EMS 2 years ago but I > had no > chance to do that in Turkey because there is no paramedic schools. > (There > are actually no paramedics in Turkey since doctors & nurses work in > the > ambulances, but ministry of Healht is thinking about establishing a > new > system & employ paramedics within 5 years). As you might seen the > recent > earthquake disaster & tragi-comic rescue efforts performed by > Turkish > authorities with no organization at all, all these make me sad but > also > motivate me to be trained as a paramedic/rescuer & serve my country > & people > in the near future. > It's been 3 1/2 motnhs that I'm in US & I am looking for a paramedic > school. > Although I have an experience in SAR, I don't have any formal > training in > emergency medicine (except my wilderness first aid certificate which > I got > here in US). Coming from a country in which the GNP per capita > (avarage > annual salary) is $3,500, it is almost impossible for me to afford > $10,000 > or something paramedic schools. I'm currently looking for an EMT > Basic > training (maybe WEMT, in Colorado or anywhere in the states), which > is a > prerequisity for paramedic training, in a full time format (4 > weeks), > starting in September or in October & which can provide me some sort > of > financial aid. Are you aware of any source that can financially > support me > through my further training & help me to serve the people on the > other side > of the world. > Many thanks in advance for your time & effort & many thanks to the > rescuers > from all around the world who are helping my people. > > Regards, > > Gurkan Ozel > Gunnison, CO > > > ______________________________________________________ > Get Your Private, Free Email at http://www.hotmail.com > Do not reproduce without author's express permission. > To unsubscribe, send the text "unsubscribe > wilderness-emergency-medicine" > as the body of a message (no subject) To: Majordomo@list.pitt.edu > Submissions To: wilderness-emergency-medicine@list.pitt.edu ___________________________________________________________________ Get the Internet just the way you want it. Free software, free e-mail, and free Internet access for a month! Try Juno Web: http://dl.www.juno.com/dynoget/tagj. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 25 Aug 1999 10:09:50 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 25 Aug 1999 10:09:07 -0400 (EDT) Received: via switchmail; Wed, 25 Aug 1999 10:09:07 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 25 Aug 1999 10:08:17 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 25 Aug 1999 10:07:15 -0400 (EDT) Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 25 Aug 1999 10:07:12 -0400 (EDT) Received: from micron (ehdup-t-22.rmt.net.pitt.edu [136.142.23.32]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Wed, 25 Aug 1999 10:07:08 -0400 (EDT) Message-Id: <199908251407.KAA17320@post-ofc04.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: wilderness-emergency-medicine@list.pitt.edu Date: Wed, 25 Aug 1999 10:08:24 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED one-way valves for wilderness and pocket use X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P23D10.CNM On 25 Aug 99, at 14:19, Arthur Morgan wrote: > Remember to do digital intubation ONLY if the patient is awake ( he > will not need to be intubated ) What you say logically doesn't make any sense. If the patient is awake and needs intubation -- as after smoke inhalation from a forest fire -- blind nasotracheal intubation would be the means of choice in the field. Don't need a laryngoscope for this. > or if he is so deeply unconscious or > paralysed that he cannot bite your fingers off. An acquaintance of mine > had the end of his right forefinger bitten off during an attempted > intubation. I think that the extra mass of a laryngoscope is worth the > effort. A laryngoscope is a heavy bite block. A solid piece of hardwood is often available in the woods -- or there are other things in one's pack that can be improvised into a bite block when doing digital intubation. WEMSI staff people and other practicing WEMTs have discussed this in great detail in the past and decided that a laryngoscope just isn't worth the weight to carry all the time. For a team kit, or to take with you when you know the patient may need intubation, especially if not far from the road, yes, but for carrying in your SAR pack all the time? Even lightweight disposable plastic laryngoscopes take up a lot of room, and weigh a lot, and even the best plastic laryngoscopes don't work all that well compared to a "real" one. I do keep a plastic laryngoscope with lithium AA cells in my truck, to carry in when needed -- but it's not part of the standard WEMSI Personal Wilderness Medical kit that I carry in my pack, nor even in the small "physician addendum pack" that I sometimes carry. Check http://www.wemsi.org for the WEMSI Personal Wilderness Medical Kit list -- although a proposed revision will also be posted within the next few weeks. Take care. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc03.srv.cis.pitt.edu (root@post-ofc03.srv.cis.pitt.edu [136.142.185.39]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 25 Aug 1999 08:41:35 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc03.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 25 Aug 1999 08:40:38 -0400 (EDT) Received: via switchmail; Wed, 25 Aug 1999 08:40:37 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 25 Aug 1999 08:38:09 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 25 Aug 1999 08:35:56 -0400 (EDT) Received: from cgi.icon.co.za (cgi.icon.co.za [196.26.208.8]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 25 Aug 1999 08:35:49 -0400 (EDT) Received: from mail450.icon.co.za (smtp.icon.co.za [196.26.208.3]) by cgi.icon.co.za (Postfix) with ESMTP id 0C2CB4664E for ; Wed, 25 Aug 1999 14:36:30 +0200 (SAST) Received: from icon.co.za (m5-19-ndf.dial-up.net [196.34.159.19]) by mail450.icon.co.za (8.9.3/8.9.3) with ESMTP id OAA21495 for ; Wed, 25 Aug 1999 14:36:28 +0200 (GMT) Message-ID: <37C3DF4C.E334CDBD@icon.co.za> Date: Wed, 25 Aug 1999 14:19:24 +0200 From: Arthur Morgan X-Mailer: Mozilla 4.04 [en] (Win95; U) MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED one-way valves for wilderness and pocket use References: <199908232053.QAA29724@post-ofc06.srv.cis.pitt.edu> X-Corel-MessageType: EMail Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 1572992 0 1 P18930.CNM Hi, Remember to do digital intubation ONLY if the patient is awake ( he will not need to be intubated ) or if he is so deeply unconscious or paralysed that he cannot bite your fingers off. An acquaintance of mine had the end of his right forefinger bitten off during an attempted intubation. I think that the extra mass of a laryngoscope is worth the effort. Arthur Keith Conover, M.D., FACEP wrote: > > One of the things on the WEMSI Personal Wilderness Medical Kit, > advanced module, is an endotracheal tube. Instead of a (heavy) > laryngoscope, we simply have a couple of pairs of exam gloves > listed, and assume that the paramedic/physician/nurse whatever > who's using the kit can do a blind nasotracheal intubation, or a > digital oral intubation. > ... Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 25 Aug 1999 10:55:19 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 25 Aug 1999 10:54:40 -0400 (EDT) Received: via switchmail; Wed, 25 Aug 1999 10:54:39 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 25 Aug 1999 10:54:27 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 25 Aug 1999 10:54:08 -0400 (EDT) Received: from hotmail.com (f101.law3.hotmail.com [209.185.241.101]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 25 Aug 1999 10:54:02 -0400 (EDT) Received: (qmail 50966 invoked by uid 0); 25 Aug 1999 14:54:54 -0000 Message-ID: <19990825145454.50965.qmail@hotmail.com> Received: from 205.169.197.108 by www.hotmail.com with HTTP; Wed, 25 Aug 1999 07:54:53 PDT X-Originating-IP: [205.169.197.108] From: "Gurkan Ozel" To: wilderness-emergency-medicine@list.pitt.edu Subject: W-EMED EMT training for a Turkish guy. Date: Wed, 25 Aug 1999 07:54:53 PDT Mime-Version: 1.0 Content-Type: text/plain; format=flowed Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P57090.CNM Hi there folks, My name is Gurkan Ozel, from Turkey. It's been about a year that I've been reading (and learning) emails from the list. I'm 25, had my BS deggree in statistics in Turkey & I've been mountaineering & climbing (and whole bunch of other wilderness sports) for 8 years. I'm a co-founder and was an ex-director/active member of an Mountain SAR team established in 1994 in Ankara, Turkey. I decided to have a career in EMS 2 years ago but I had no chance to do that in Turkey because there is no paramedic schools. (There are actually no paramedics in Turkey since doctors & nurses work in the ambulances, but ministry of Healht is thinking about establishing a new system & employ paramedics within 5 years). As you might seen the recent earthquake disaster & tragi-comic rescue efforts performed by Turkish authorities with no organization at all, all these make me sad but also motivate me to be trained as a paramedic/rescuer & serve my country & people in the near future. It's been 3 1/2 motnhs that I'm in US & I am looking for a paramedic school. Although I have an experience in SAR, I don't have any formal training in emergency medicine (except my wilderness first aid certificate which I got here in US). Coming from a country in which the GNP per capita (avarage annual salary) is $3,500, it is almost impossible for me to afford $10,000 or something paramedic schools. I'm currently looking for an EMT Basic training (maybe WEMT, in Colorado or anywhere in the states), which is a prerequisity for paramedic training, in a full time format (4 weeks), starting in September or in October & which can provide me some sort of financial aid. Are you aware of any source that can financially support me through my further training & help me to serve the people on the other side of the world. Many thanks in advance for your time & effort & many thanks to the rescuers from all around the world who are helping my people. Regards, Gurkan Ozel Gunnison, CO ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 25 Aug 1999 03:05:07 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc07.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 25 Aug 1999 03:04:35 -0400 (EDT) Received: via switchmail; Wed, 25 Aug 1999 03:04:35 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 25 Aug 1999 03:04:11 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Wed, 25 Aug 1999 03:02:07 -0400 (EDT) Received: from mc-qout2.whowhere.com (nytoday.whowhere.com [209.1.236.38]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 25 Aug 1999 03:02:04 -0400 (EDT) Received: from Unknown/Local ([?.?.?.?]) by ivillage.com; Wed Aug 25 00:02:44 1999 To: wilderness-emergency-medicine@list.pitt.edu Date: Wed, 25 Aug 1999 00:02:44 -0700 From: "Jenny Viner" Message-ID: Mime-Version: 1.0 X-Sent-Mail: on X-Mailer: MailCity Service Subject: W-EMED Wilderness Medicine Web X-Sender-Ip: 204.179.131.203 Organization: iVillage Free Email (http://fe-mail.ivillage.com:80) Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P5CB40.CNM I am helping a friend with a medical web project. She works for a company that is one of the largest online information sites for medical articles and journals. I agreed to give her my suggestions on how they could improve the interface to the section on Emergency Medicine and Wilderness Medicine. There is one area that I could use some comments from others in the WMED group. They are also changing the way the web site is accessed. In addition to the existing web address, they are registering 100 new MD address for the medical section. For example, instead of going through a lot of screens to get to the Wilderness Medicine section, I could type www.WildernessMedicine.MD and go directly to that section with the page already customized with Wilderness Medicine information. They have already registered the name I suggested for the Emergency Medicine section and one for the Wilderness Medicine section. She told me that they have some additional budget for some more names and asked if I had any additional suggestions. I was thinking that since a lot of people in this group are probably already using the existing service, I would see what you thought of some of some of the additional names before I send her my second choice. If anyone has any comments on which are easy to use and remember please send me an email. Here are some I was thinking about. www.WildernessMedicine.MD www.Outdoormedicine.MD www.WildernessEmergency.MD www.EnvironmentalMedicine.MD www.Search-Rescue.MD www.WMED.MD www.HighAltitude.MD www.Adventure.MD www.Backpacking.MD www.Mountaineering.MD www.WEMT.MD www.BackCountry.MD I liked Wilderness.MD, but it was already taken. There are probably some good ones that I have not thought of. If you think of any better names, and they are still available please also let me know. The place to check if an MD name is still available is http://w.md in the registration section. Thanks, Jenny -- Visit http://www.ivillage.com for your FREE iVillage.com email account. iVillage.com: The #1 Women's Network -- Real Solutions for Real Women. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 25 Aug 1999 01:12:15 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc01.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 25 Aug 1999 00:01:27 -0400 (EDT) Received: via switchmail; Wed, 25 Aug 1999 00:01:26 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 25 Aug 1999 00:00:34 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 24 Aug 1999 23:58:07 -0400 (EDT) Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 24 Aug 1999 23:57:58 -0400 (EDT) Received: from micron (ehdup-e1-10.rmt.net.pitt.edu [136.142.21.20]) by post-ofc06.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 24 Aug 1999 23:57:49 -0400 (EDT) Message-Id: <199908250357.XAA16514@post-ofc06.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: "Douglas F. Kupas" , wilderness-emergency-medicine@list.pitt.edu Date: Tue, 24 Aug 1999 23:59:04 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED one-way valves for wilderness and pocket use In-reply-to: <199908241817.OAA20207@list.srv.cis.pitt.edu> X-mailer: Pegasus Mail for Win32 (v3.11) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P6F290.CNM On 23 Aug 99, at 22:59, Douglas F. Kupas wrote: > RespAide also makes a very nice filter. It may be a bit bigger than the > one you describe, but it has a filter (made to military specs) which > filters out micron sizes smalller than all viruses. They come in a nice > pocket mask "kit" which we se for our police AEDs, but they also sell the > filters alone for about $4. Doug You know, I looked at some that that had filters -- they were all a lot bigger. And the design of the one-way valves are such that it is very unlikely that anything will get from the patient to you -- I'm satisfied that the Laerdal one will prevent contamination enough. I suspect one's more likely to get contaminated from other secretions rather than through the one-way valve. The "exhaust" from most one-way valves, including the Laerdal, is back toward the patient, which helps. Now, _we_ might contaminate the patient with our TB or something . . . but if someone stops breathing on the street and someone's right there with an ET tube, I'd guess that a little TB is better than a lot of dead . . . Do you think the filter really adds that much? Please also post about any more definite plans for a WEMT in northern PA -- we had several of the Wellsboro medics at the ER- NCRC weeklong WEMT in WV this past week, and I know others are interested. Take care. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 24 Aug 1999 09:24:22 -0400 (EDT) Received: from localhost (root@localhost) by post-ofc06.srv.cis.pitt.edu (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 24 Aug 1999 09:23:46 -0400 (EDT) Received: via switchmail; Tue, 24 Aug 1999 09:23:45 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 24 Aug 1999 09:21:48 -0400 (EDT) Received: from localhost (majordom@localhost) by list.srv.cis.pitt.edu (8.8.8/8.8.8/cisls-7.2.2.1) ID ; Tue, 24 Aug 1999 09:19:02 -0400 (EDT) Received: from dfw-ix11.ix.netcom.com (dfw-ix11.ix.netcom.com [206.214.98.11]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 24 Aug 1999 09:18:41 -0400 (EDT) From: cheazlit@ix.netcom.com Received: (from smap@localhost) by dfw-ix11.ix.netcom.com (8.8.4/8.8.4) id IAA28260 for wilderness-emergency-medicine@list.pitt.edu; Tue, 24 Aug 1999 08:19:28 -0500 (CDT) Date: Tue, 24 Aug 1999 08:19:28 -0500 (CDT) Received: from sji-ca3-233.ix.netcom.com(209.109.233.233) by dfw-ix11.ix.netcom.com via smap (V1.3) id rma028212; Tue Aug 24 08:19:09 1999 To: wilderness-emergency-medicine@list.pitt.edu Message-Id: <199882561249341@ix.netcom.com> Subject: Re: W-EMED Leadership References X-Mailer: Netcomplete v4.0, from NETCOM On-Line Communications, Inc. MIME-Version: 1.0 Content-Type: text/plain; charset=us-ascii Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 524416 0 1 P39B80.CNM On 08/23/99 07:32:27 Dr. Langley R. Muir wrote: > >An excellent reference that I use for teaching leadership is: > >John Graham, Outdoor Leadership: Techniques, Common Sense, and >Self-Confidence, The Mountaineers, 1997, ISBN 0-89886-502-6. > >My copy cost $16.95 (US). > I'll also add my vote for this fine book. The Self Rescue Group gave it a "recommended" rating in its list of reading materials. Mr Graham interviewed several successful outdoor leaders, and came up with a list of characteristics that a good leader must have. The book has separate chapters that are devoted to implementing each of these characteristics. The nice part is that the author recognises personality differences, and differing leadership styles. He acknowledges them, and allows each individual to "be themself" while leading. I'll give it 2 thumbs up. Cindy Heazlit Do not reproduce without author's express permission. 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