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, 30 Jun 1998 09:25:25 -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; Tue, 30 Jun 1998 09:25:24 -0400 (EDT) Received: via switchmail for kconover+@pitt.edu; Tue, 30 Jun 1998 09:25:24 -0400 (EDT) Received: from mail.virginia.edu (mail.Virginia.EDU [128.143.2.9]) by post-ofc02.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 30 Jun 1998 09:25:18 -0400 (EDT) Received: from Virginia.EDU by mail.virginia.edu id aa21897; 30 Jun 98 9:25 EDT Received: from post-ofc05.srv.cis.pitt.edu by mail.virginia.edu id aa21890; 30 Jun 98 9:25 EDT Received: from 136.142.57.10.pitt.edu (ehdup-b1-14.rmt.net.pitt.edu [136.142.20.84]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 30 Jun 1998 09:24:52 -0400 (EDT) Message-Id: <199806301324.JAA05651@post-ofc05.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: sar-l@listserv.islandnet.com, wilderness-emergency-medicine@list.pitt.edu, PSARC.Forms.Committee@pitt.edu Date: Tue, 30 Jun 1998 09:24:52 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Open Letter about WEMS in PA Reply-to: kconover+@pitt.edu CC: EMS-L@listserv.acns.nwu.edu, asrc-bod@virginia.edu Priority: normal X-mailer: Pegasus Mail for Win32 (v3.01b) Precedence: bulk An Open Letter to the Pennsylvania SAR and EMS Communities --Keith Conover, M.D., FACEP www.pitt.edu/~kconover 412-561- 3413 (H) [member, Board of Directors, Pennsylvania Search and Rescue Council; member, Medical Advisory Committee, Pennsylvania Emergency Health Services Council; Medical Director, Wilderness EMS Institute; Medical Director for Pennsylvania, Appalachian Search and Rescue Conference; Medical Advisor, Eastern Region, National Cave Rescue Commission] Several recent events have convinced many that now is the time to rethink wilderness/ backcountry rescue in Pennsylvania. * Searches: There were several Wilderness EMTs and wilderness rescue-trained people at the search base during several recent searches in southwest Pennsylvania. But when the find was made, this rescue/medical capacity didn't make it to the patient. * SAR Forms: The Pennsylvania Search and Rescue Council is now revising the state SAR forms packet. These are the standard for search operations in Pennsylvania, and includes a medical/evacuation plan. * Pennsylvania EMS changes: Pennsylvania EMS has a new director, Margaret Trimble. Many changes are coming to the Pennsylvania EMS system; EMS has been "moved up" a level in the state bureaucracy. And after many years, there is hope of having an organized wilderness EMS capacity within the Pennsylvania EMS system. At present, Wilderness EMS has to be outside the EMS system. See below, and the postings at www.wemsi.org, for more about the legal and legislative aspects of wilderness EMS in Pennsylvania. * Rescues: At a recent meeting of the Pennsylvania Emergency Health Services Council Medical Advisory Committee, I was chatting with Dr. Doug Kupas of Geisenger Medical Center. Doug has a strong interest in wilderness as well as "street" EMS and has been the medical director for Wilderness EMT classes in north-central PA. Geisenger's helicopter service responds several times a year to rescues in Rickett's Glen state park. Doug said that the rescue management is usually fragmented between several different agencies, with varying experience levels and wilderness rescue training. Seldom are Wilderness EMTs taking care of the patients, even though the rescues often take several hours. * WEMSI: The Wilderness EMS Institute continues its attempts to improve backcountry medical care in Pennsylvania and around the globe. WEMSI WEMT and Wilderness Command Physician classes are offered in Pennsylvania on a regular basis. WEMSI also works to develop model Wilderness EMS systems in the U.S. and other countries. Well, who knows how these are all going to come together, or what the results will be? But the synchronicity is undeniable. Wilderness rescue and wilderness EMS in Pennsylvania need to improve, and the resources and determination are coming together. What can we do? What should we do? A first step (because it's easiest): improve rescue and Wilderness EMS when a search finds someone. DCNR (Department of Conservation and Natural Resources) Rangers and PSARC (Pennsylvania Search and Rescue Council) teams work together pretty closely, and do the bulk of the searches in Pennsylvania. Together, we can make some changes for the better right now. Let's first agree on what needs to happen to make rescues and backcountry medical care work out right. And then we can make it happen during every search. The easiest way to make it happen is to (1) put the protocol on the Medical/Evacuation Plan form in the new PSARC SAR Forms Packet, and then (2) tell all search managers to use the Forms Packet. Here are some specific suggestions: * Identify Personnel: Sign-in forms will have places for "WEMT" "WEMT-P" "FTM" and "FTL" -- so we can tell who has the training we need for the rescues. * More Detailed Medical/Evacuation Plan: include the following in the Medical/Evacuation Plan protocol: * Evacuation Team TAF: "Create a Task Assignment Form for the Evacuation Team with adequate personnel, including specific names, and equipment for the task and where it is. Make sure that as personnel at Base change to update the personnel on the TAF as needed. Attach the TAF, with maps ready to mark the subject's location, to the Medical/Evacuation Plan." * Minimum Rescue Personnel: "When possible, assign two FTLs and two WEMT-Basics or better to respond with the Evacuation Team." * Stripping Base for the Evacuation Team: "If the Evacuation Team includes members of Base Staff, indicate staff members to go and who is to replace their functions:" Stripping the base isn't ideal. But it's better than not having a trained evacuation team at all, which is what's been happening recently. * Medical Direction: "Establish a link to a Wilderness Command Physician (WCP) by calling the local WEMT's WCP, or if the local WEMTs don't have a certified WCP, call WEMSI at 1-800-232-5921 and have the WEMSI WCP on call to provide medical direction to WEMTs on the evacuation team." Kenneth Brody, the EMS lawyer for the Department of Health, has ruled that backcountry care is outside the scope of the existing Pennsylvania EMS system (see the Legal Issues in Pennsylvania section of www.wemsi.org for more). Though "street" providers can provide Good Samaritan-type care in backcountry situations, it cannot be considered a regular part of their EMS scope of practice. This means that going outside their "street" protocols to provide acceptable backcountry care (e.g., reducing dislocations, giving oral fluids, giving antibiotics) is questionable. Note also that, according to the EMS law, regular Command Physicians cannot provide medical direction for backcountry patients, except as an exceptional circumstance. If they end up in court, "regular" Command Physicians providing medical direction for backcountry rescues will probably be held to national standards such as those established in the Wilderness Medical Society Practice Guidelines, not to standard regional "street" protocols. >From a patient-care perspective, it is preferable to have Wilderness EMTs under the direction of Wilderness Command Physicians caring for the patient until the he or she reaches an ambulance. WCPs can provide direction to WEMTs outside the EMS system, through the Pennsylvania Medical Practice Act's generic Delegated Practice provisions. For PSARC/DCNR searches, this could be the WEMT's usual WCP or, if the on-scene WEMTs don't have a WCP, it could be the WCP on call for the Wilderness EMS Institute. I think we might be able to get approval for this policy at the highest level, i.e., a vote from the Medical Advisory Committee of the Pennsylvania Emergency Health Services Council. This would also require an agreement between WEMSI and PSARC for WEMSI to provide wilderness EMS direction for PSARC searches, if and only if no local Wilderness Command Physicians are available. Well, this may be somewhat controversial, but I think something along these lines will make rescues during searches a lot better, and improve the quality of patient care. What about rescues that aren't part of a search? Well, that's a much more difficult situation, due to the number of agencies involved. But I think if we can attack the search problem first, we can create a model that will serve us well on straight rescues as well. Thank you for your thoughts about these ideas. -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 30 Jun 1998 09:29:39 -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, 30 Jun 1998 09:26:09 -0400 (EDT) Received: via switchmail; Tue, 30 Jun 1998 09:26:09 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 30 Jun 1998 09:26:01 -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 ; Tue, 30 Jun 1998 09:25:06 -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, 30 Jun 1998 09:25:00 -0400 (EDT) Received: from 136.142.57.10.pitt.edu (ehdup-b1-14.rmt.net.pitt.edu [136.142.20.84]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Tue, 30 Jun 1998 09:24:52 -0400 (EDT) Message-Id: <199806301324.JAA05651@post-ofc05.srv.cis.pitt.edu> From: "Keith Conover, M.D., FACEP" To: sar-l@listserv.islandnet.com, wilderness-emergency-medicine@list.pitt.edu, PSARC.Forms.Committee@pitt.edu Date: Tue, 30 Jun 1998 09:24:52 -0400 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: W-EMED Open Letter about WEMS in PA CC: EMS-L@listserv.ACNS.NWU.EDU, asrc-bod@virginia.edu X-mailer: Pegasus Mail for Win32 (v3.01b) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu An Open Letter to the Pennsylvania SAR and EMS Communities --Keith Conover, M.D., FACEP www.pitt.edu/~kconover 412-561- 3413 (H) [member, Board of Directors, Pennsylvania Search and Rescue Council; member, Medical Advisory Committee, Pennsylvania Emergency Health Services Council; Medical Director, Wilderness EMS Institute; Medical Director for Pennsylvania, Appalachian Search and Rescue Conference; Medical Advisor, Eastern Region, National Cave Rescue Commission] Several recent events have convinced many that now is the time to rethink wilderness/ backcountry rescue in Pennsylvania. * Searches: There were several Wilderness EMTs and wilderness rescue-trained people at the search base during several recent searches in southwest Pennsylvania. But when the find was made, this rescue/medical capacity didn't make it to the patient. * SAR Forms: The Pennsylvania Search and Rescue Council is now revising the state SAR forms packet. These are the standard for search operations in Pennsylvania, and includes a medical/evacuation plan. * Pennsylvania EMS changes: Pennsylvania EMS has a new director, Margaret Trimble. Many changes are coming to the Pennsylvania EMS system; EMS has been "moved up" a level in the state bureaucracy. And after many years, there is hope of having an organized wilderness EMS capacity within the Pennsylvania EMS system. At present, Wilderness EMS has to be outside the EMS system. See below, and the postings at www.wemsi.org, for more about the legal and legislative aspects of wilderness EMS in Pennsylvania. * Rescues: At a recent meeting of the Pennsylvania Emergency Health Services Council Medical Advisory Committee, I was chatting with Dr. Doug Kupas of Geisenger Medical Center. Doug has a strong interest in wilderness as well as "street" EMS and has been the medical director for Wilderness EMT classes in north-central PA. Geisenger's helicopter service responds several times a year to rescues in Rickett's Glen state park. Doug said that the rescue management is usually fragmented between several different agencies, with varying experience levels and wilderness rescue training. Seldom are Wilderness EMTs taking care of the patients, even though the rescues often take several hours. * WEMSI: The Wilderness EMS Institute continues its attempts to improve backcountry medical care in Pennsylvania and around the globe. WEMSI WEMT and Wilderness Command Physician classes are offered in Pennsylvania on a regular basis. WEMSI also works to develop model Wilderness EMS systems in the U.S. and other countries. Well, who knows how these are all going to come together, or what the results will be? But the synchronicity is undeniable. Wilderness rescue and wilderness EMS in Pennsylvania need to improve, and the resources and determination are coming together. What can we do? What should we do? A first step (because it's easiest): improve rescue and Wilderness EMS when a search finds someone. DCNR (Department of Conservation and Natural Resources) Rangers and PSARC (Pennsylvania Search and Rescue Council) teams work together pretty closely, and do the bulk of the searches in Pennsylvania. Together, we can make some changes for the better right now. Let's first agree on what needs to happen to make rescues and backcountry medical care work out right. And then we can make it happen during every search. The easiest way to make it happen is to (1) put the protocol on the Medical/Evacuation Plan form in the new PSARC SAR Forms Packet, and then (2) tell all search managers to use the Forms Packet. Here are some specific suggestions: * Identify Personnel: Sign-in forms will have places for "WEMT" "WEMT-P" "FTM" and "FTL" -- so we can tell who has the training we need for the rescues. * More Detailed Medical/Evacuation Plan: include the following in the Medical/Evacuation Plan protocol: * Evacuation Team TAF: "Create a Task Assignment Form for the Evacuation Team with adequate personnel, including specific names, and equipment for the task and where it is. Make sure that as personnel at Base change to update the personnel on the TAF as needed. Attach the TAF, with maps ready to mark the subject's location, to the Medical/Evacuation Plan." * Minimum Rescue Personnel: "When possible, assign two FTLs and two WEMT-Basics or better to respond with the Evacuation Team." * Stripping Base for the Evacuation Team: "If the Evacuation Team includes members of Base Staff, indicate staff members to go and who is to replace their functions:" Stripping the base isn't ideal. But it's better than not having a trained evacuation team at all, which is what's been happening recently. * Medical Direction: "Establish a link to a Wilderness Command Physician (WCP) by calling the local WEMT's WCP, or if the local WEMTs don't have a certified WCP, call WEMSI at 1-800-232-5921 and have the WEMSI WCP on call to provide medical direction to WEMTs on the evacuation team." Kenneth Brody, the EMS lawyer for the Department of Health, has ruled that backcountry care is outside the scope of the existing Pennsylvania EMS system (see the Legal Issues in Pennsylvania section of www.wemsi.org for more). Though "street" providers can provide Good Samaritan-type care in backcountry situations, it cannot be considered a regular part of their EMS scope of practice. This means that going outside their "street" protocols to provide acceptable backcountry care (e.g., reducing dislocations, giving oral fluids, giving antibiotics) is questionable. Note also that, according to the EMS law, regular Command Physicians cannot provide medical direction for backcountry patients, except as an exceptional circumstance. If they end up in court, "regular" Command Physicians providing medical direction for backcountry rescues will probably be held to national standards such as those established in the Wilderness Medical Society Practice Guidelines, not to standard regional "street" protocols. >From a patient-care perspective, it is preferable to have Wilderness EMTs under the direction of Wilderness Command Physicians caring for the patient until the he or she reaches an ambulance. WCPs can provide direction to WEMTs outside the EMS system, through the Pennsylvania Medical Practice Act's generic Delegated Practice provisions. For PSARC/DCNR searches, this could be the WEMT's usual WCP or, if the on-scene WEMTs don't have a WCP, it could be the WCP on call for the Wilderness EMS Institute. I think we might be able to get approval for this policy at the highest level, i.e., a vote from the Medical Advisory Committee of the Pennsylvania Emergency Health Services Council. This would also require an agreement between WEMSI and PSARC for WEMSI to provide wilderness EMS direction for PSARC searches, if and only if no local Wilderness Command Physicians are available. Well, this may be somewhat controversial, but I think something along these lines will make rescues during searches a lot better, and improve the quality of patient care. What about rescues that aren't part of a search? Well, that's a much more difficult situation, due to the number of agencies involved. But I think if we can attack the search problem first, we can create a model that will serve us well on straight rescues as well. Thank you for your thoughts about these ideas. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 27 Jun 1998 16:00:03 -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 ; Sat, 27 Jun 1998 15:56:41 -0400 (EDT) Received: via switchmail; Sat, 27 Jun 1998 15:56:40 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 27 Jun 1998 15:55:09 -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, 27 Jun 1998 15:54:11 -0400 (EDT) Received: from pop.goodnet.com (pop.goodnet.com [207.98.129.100]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 27 Jun 1998 15:54:08 -0400 (EDT) Received: from PC_.goodnet.com (phx-ts17-3.goodnet.com [207.98.133.4]) by pop.goodnet.com (8.8.8/8.8.6) with SMTP id MAA18007 for ; Sat, 27 Jun 1998 12:56:00 -0700 (MST) Message-ID: X-MSMail-Priority: Normal X-Priority: 3 To: "WEMS News" MIME-Version: 1.0 From: "Tim Kovacs" Subject: W-EMED MRA announces new officers Date: Sat, 27 Jun 98 11:52:04 PDT Content-Type: text/plain; charset="ISO-8859-1"; X-MAPIextension=".TXT" Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P49DD0.CNM NEWS RELEASE The Mountain Rescue Association, based in Golden, Colorado is proud to announce its new officers for 1998-2000, elected at the 40th Annual meeting at Mt. Hood, Oregon last weekend. President: Tim Kovacs, Central Az MRA & Maricopa County Sheriff's Office MR, AZ. tkovacs@goodnet.com Vice President: Rocky Henderson, Portland Mtn Rescue, OR. rockyh9@idt.net Secretary: Tom Frazer, El Paso County SAR, CO. frazer@csc32.cxo.dec.com Member At Large/ Treasurer: Jon Inskeep, Sierra Madre SAR, CA. 71553.661@compuserve.com Member At Large: Rod Knopp, Idaho Mtn SAR Unit, ID. idsar@execu.net The MRA is also proud to announce a New Medical Advisor/ Chair: Ken Zafren, MD/ FACEP. Alaska Mtn Rescue Group & Denali National Park. Other Members: Joe Rusinko, MD, FACEP. Tacoma Mtn Rescue, WA Martin Radwin, DO. Weber County SAR, UT Highlights of the 40th Annual Meeting include; - Establishing a new MRA Research Grant. - Placing new Avalanche and Climbing Public Safety Announcements in various publications. - Piloting a new Snowboarder Safety program - Continuing to co-host the North American Technical Rescue Symposium (this year in November in North Carolina) with the National Association for Search and Rescue (NASAR). - Continuing to work with NASAR to provide delegates to the International Commission for Alpine Rescue in Europe (IKAR-CISA). - Addressing the "No Bolting, No Permanent Anchors" issue with the USFS, as it relates to potential Rescue matters. The MRA, established in 1958 and made up of over 85 operational volunteer and governmental mountain rescue organizations in the US, Canada, South America and Europe, is a volunteer organization "dedicated to saving lives through rescue and mountain safety education". Numerous MRA units are also involved in FEMA and OFDA responses. The MRA provides peer accreditation to teams, collects SAR Mission Statistics, provides a Clearinghouse for research, numerous liaisons and committees, and is committed to serving agencies to provide safe and quality mountain and wilderness Technical, Snow & Ice search and rescue. The MRA's website is at www.mra.org or mra@mra.org Please don't hesitate to contact one of us for anything we can do for you. "You can't teach people to rescue in the mountains until they have learnt to climb... ...It is a number of small points which have little significance individually that, considered together, spell danger to the experienced rescuer." Hamish MacInnes By Authority: Tim Kovacs, President. tkovacs@goodnet.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 ; Fri, 3 Jul 1998 12:34:04 -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, 3 Jul 1998 12:30:45 -0400 (EDT) Received: via switchmail; Fri, 3 Jul 1998 12:30:45 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 3 Jul 1998 12:29:49 -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 ; Fri, 3 Jul 1998 12:29:30 -0400 (EDT) Received: from emu.capnet.state.tx.us (mail.capnet.state.tx.us [204.65.39.248]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 3 Jul 1998 12:29:27 -0400 (EDT) Received: from discovery ([204.65.21.6]) by emu.capnet.state.tx.us (8.9.0/8.9.0.1998-0610-0126) with SMTP id LAA18321; Fri, 3 Jul 1998 11:31:48 -0500 (CDT) Message-Id: <199807031631.LAA18321@emu.capnet.state.tx.us> Comments: Authenticated sender is From: "Lee Deviney" Organization: Texas Public Finance Authority To: rjudy@sfasu.edu Date: Tue, 23 Jun 1998 22:15:55 -500 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: W-EMED Re: Kayak Polo Injuries, Not a Joke CC: canoetx@world.std.com, wilderness-emergency-medicine@list.pitt.edu X-mailer: Pegasus Mail for Win32 (v2.42) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-PMFLAGS: 34078848 0 1 P422C0.CNM Jeeesh! I can't argue with you w/r/t safety. Maybe I'll do something safer...like the Texas Watrer Safari. Haven't tried polo but have watched in Austin and California...I think it's a hell of a good and fun way to teach fundamentals especially to young aspiring competetive paddlers. I know there must be a kayak helmet in the garage...no face mask though.. Maybe the old high school football helmet still fits. Lee > Date: Fri, 03 Jul 1998 10:47:55 -0500 > From: Robert Michael Judy > Subject: Kayak Polo Injuries, Not a Joke > To: Glenn Hart > Cc: canoetx@world.std.com, wilderness-emergency-medicine@list.pitt.edu > Organization: SFASU College of Education, Technologist > Reply-to: Robert Michael Judy > On a more serious note I would like to advise all paddlers to: > > get a face guard and use it. > > install a face shield on your helmet and wear it. > IF WE SET > AN EXAMPLE OTHERS WILL FOLLOW!!!! > > obtain and use face saving equipment on your paddling helmet. > > I hope all the previous humor doesn't prevent people from reading, > understanding, and adopting the above advice. > > A lot has been said in the past few months about paddler > deaths/injuries and I will not quote any of it but the jist of the > advice is that paddling helmets should provide protection for the > temple and face area. Several writers have speculated that some > incidents may have been survivable if more protection was used by > the involved paddlers. > > Temple and face injuries often result in short to long term > incapacitation resulting from temporary loss of or reduction in > consciousness, short term shock states induced by sudden blunt > trauma, and/or intense pain. Disorientation resulting from trauma is > a bad state for people upside down in paddle boats. (period) > > There are no good reasons for paddlers not to wear more temple and > face protection.. > > I wish Paddlesport Instructors would make as big a issue of > temple/face protection as they do about PFDs. I know there are a > lot of seemingly good reasons popping into peoples heads about why > temple/face protection is not such a big deal, why it isn't ALWAYS > necessary, etc. and I say the same kind of reasoning is used by > people who don't want to wear PFDs all the time they are in their > boats. > > None of us would paddle with someone not wearing a PFD and helmet, > none of us should paddle with someone not wearing a face/temple > protective device. > > I hate to drag the WEMT guys (CC above) into this but I feel quite > strongly about this and some of them may have arguments/anecdotes > which will convince more of you to adopt face/temple protection for > your helmets. > > Have a safe weekend, paddle hardy. > > Glenn Hart wrote: > > > > I think that Marco guy is the one who was playing polo on Town > > Lake the other day, but he left early when someone accidentally > > hit him with a paddle, giving him a fat lip. > > > > Glenn Hart > Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-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, 15 Jun 1998 21:50:11 -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, 15 Jun 1998 21:48:40 -0400 (EDT) Received: via switchmail; Mon, 15 Jun 1998 21:48:40 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 15 Jun 1998 21:48:31 -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 ; Mon, 15 Jun 1998 21:48:04 -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 ; Mon, 15 Jun 1998 21:47:58 -0400 (EDT) Received: from 136.142.57.10.pitt.edu (ehdup-a1-16.rmt.net.pitt.edu [136.142.20.26]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Mon, 15 Jun 1998 21:47:39 -0400 (EDT) Message-Id: <199806160147.VAA28848@post-ofc05.srv.cis.pitt.edu> Comments: Authenticated sender is From: "Keith Conover, M.D., FACEP" To: "Alan Keith" , wilderness-emergency-medicine@list.pitt.edu Date: Mon, 15 Jun 1998 21:46:31 +0000 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED Message confirmation problems In-reply-to: <002f01bd9881$0792b460$71d69bce@newmicronpc> X-mailer: Pegasus Mail for Win32 (v2.54) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 8bc018b06c074a4feea9839bc801b5e3 X-PMFLAGS: 34078848 0 On 15 Jun 98 at 12:14, Alan Keith wrote: > Dear sirs, > I have tried to confirm my wish to be placed on your mailing list > and either get a undelivered mail due to the incorrect placement > of quotation marks in the return address or receive the same > message to confirm my wish to be place on the list with a > confirmation number. Please place me on the list and I hope you > can rectify the other problems. > Alan Keith > avalon@cookeville.com > auth 25b5d029 Hi, Alan. You should send "subscribe" and let the mailer take your address from the header, it refuses to take subscriptions otherwise. Detailed instructions are below in my .SIG Please let me know by direct email if this works. Sorry for the trouble. 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 -- 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, 12 Jun 1998 22:29:17 -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, 12 Jun 1998 22:29:08 -0400 (EDT) Received: via switchmail; Fri, 12 Jun 1998 22:29:08 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 12 Jun 1998 22:27:53 -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, 12 Jun 1998 22:27:06 -0400 (EDT) Received: from smtp1.goodnet.com (smtp1.goodnet.com [207.98.129.2]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 12 Jun 1998 22:27:03 -0400 (EDT) Received: from unknown (phx-ts12-20.goodnet.com [207.98.132.117]) by smtp1.goodnet.com (8.8.8/8.8.6) with SMTP id TAA15490; Fri, 12 Jun 1998 19:28:23 -0700 (MST) Message-ID: In-Reply-To: <0019111F.003144@ed.gov> References: Conversation <0019111F.003144@ed.gov> with last message <0019111F.003144@ed.gov> X-MSMail-Priority: Normal X-Priority: 3 To: "WEMS News" , "WEMS News" MIME-Version: 1.0 From: "Tim Kovacs" Subject: Re: W-EMED In search of Koester/dbS Productions Date: Fri, 12 Jun 98 19:12:17 PDT Content-Type: text/plain; charset="ISO-8859-1"; X-MAPIextension=".TXT" Content-Transfer-Encoding: 7bit Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 6e55d848f45436b00629b12444558995 X-PMFLAGS: 34078848 0 NASAR bookstore also has the Fatigue book. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Thu, 11 Jun 1998 08:56:08 -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, 11 Jun 1998 08:56:02 -0400 (EDT) Received: via switchmail; Thu, 11 Jun 1998 08:56:02 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Thu, 11 Jun 1998 08:54:12 -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 ; Thu, 11 Jun 1998 08:53:29 -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 ; Thu, 11 Jun 1998 08:53:20 -0400 (EDT) Received: from 136.142.57.10.pitt.edu (ehdup-b2-8.rmt.net.pitt.edu [136.142.20.98]) by post-ofc06.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Thu, 11 Jun 1998 08:53:16 -0400 (EDT) Message-Id: <199806111253.IAA28787@post-ofc06.srv.cis.pitt.edu> Comments: Authenticated sender is From: "Keith Conover, M.D., FACEP" To: "PA Em. Health Svcs. Council" Date: Thu, 11 Jun 1998 08:53:16 +0000 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: W-EMED PA State EMS Plan CC: wilderness-emergency-medicine@list.pitt.edu, sar-l@listserv.islandnet.com, "Allegheny Mtn. Rescue Maillist" X-mailer: Pegasus Mail for Win32 (v2.54) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 1b6c72f206c65fa858c73728d60be281 My only comment on the PA EMS Plan is that it seems to neglect a major issue that we discussed at the last MAC meeting, i.e., the question of the scope of practice of EMS providers, specifically in special settings including interhospital transfer and in settings outside "official" EMS. As the official representative of the Pennsylvania Wilderness EMS and Search and Rescue communities to the MAC, I would in particular like the wilderness/backcountry context to be included in the state EMS Plan. This is documented in the letters posted at http://www.wemsi.org/pa_ems.html I will encourage others in the WEMS/SAR communities to review the proposed new PA EMS Plan, available at www.pehsc.org by a copy of this message. Thank you very much. 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 -- 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, 10 Jun 1998 18:37:34 -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, 10 Jun 1998 18:37:27 -0400 (EDT) Received: via switchmail; Wed, 10 Jun 1998 18:37:27 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 10 Jun 1998 18:36:41 -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, 10 Jun 1998 18:36:16 -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 ; Wed, 10 Jun 1998 18:36:11 -0400 (EDT) Received: from 136.142.57.10.pitt.edu (ehdup-c3-14.rmt.net.pitt.edu [136.142.20.184]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Wed, 10 Jun 1998 18:36:01 -0400 (EDT) Message-Id: <199806102236.SAA29720@post-ofc04.srv.cis.pitt.edu> Comments: Authenticated sender is From: "Keith Conover, M.D., FACEP" To: sark9keel@Juno.com (Lara L Oehrlein), wilderness-emergency-medicine@list.pitt.edu Date: Wed, 10 Jun 1998 18:36:00 +0000 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED rjk5a@avery.med.virginia.edu CC: Robert Koester In-reply-to: <19980610.165514.24342.0.sark9keel@juno.com> X-mailer: Pegasus Mail for Win32 (v2.54) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 6809e8629dee06a181592288fdfecc6a On 10 Jun 98 at 16:55, Lara L Oehrlein wrote: > Hi! I read on wilderness-emergency-med list that you published a > book called > "Fatigue: Sleep Management During Disasters and Sustained > Operations." > > Can you please send order information? Thanks! > > Lara Oehrlein Hi, Lara. You accidentally posted to the list rather than to Bob. And here's his new address: Robert Koester Maybe he can post ordering information to the list. It's a good book. He also has a training course for SAR teams and other related agencies based on the book. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 10 Jun 1998 17:10:16 -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, 10 Jun 1998 17:10:08 -0400 (EDT) Received: via switchmail; Wed, 10 Jun 1998 17:10:08 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 10 Jun 1998 17:08:51 -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, 10 Jun 1998 17:08:23 -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 ; Wed, 10 Jun 1998 17:08:18 -0400 (EDT) Received: from ts89-22.tor.istar.ca ([204.191.137.173] helo=k9corner) by mail1.toronto.istar.net with smtp (Exim 1.92 #2) for wilderness-emergency-medicine@list.pitt.edu id 0yjs6n-0004Bq-00; Wed, 10 Jun 1998 17:08:38 -0400 From: "Steve Urszenyi" To: Subject: RE: W-EMED In search of Koester/dbS Productions Date: Wed, 10 Jun 1998 17:06:39 -0400 Message-ID: <000001bd94b3$a951a940$ad89bfcc@k9corner> 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 In-Reply-To: <0019111F.003144@ed.gov> Importance: Normal 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-UIDL: c8e76fbfcb07bae545b5bb1fabe4a6ae X-PMFLAGS: 34078848 0 Peter McCabe wrote: > Bob Koester (aka dbS Publications) lives in Charlottesville VA. > His home phone number is (804) 293-5502. He also has a > WEB page which can be linked via <>. > Hope this helps. His e-mail address is Bob Koester < mailto:rjk5a@avery.med.virginia.edu > Steve Urszenyi Paramedic & Acting Supervisor, EMS Operations Toronto EMS ( http://www.city.toronto.on.ca/ems/ ) Personal e-mail: mailto:k9corner@istar.ca Steve's Canine Corner: http://home.istar.ca/~k9corner ICQ # 6809162 The opinions expressed herein are my own, and do not necessarily reflect those of any department, agency or municipality. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-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, 10 Jun 1998 17:54:14 -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, 10 Jun 1998 17:54:09 -0400 (EDT) Received: via switchmail; Wed, 10 Jun 1998 17:54:08 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 10 Jun 1998 17:53:59 -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, 10 Jun 1998 17:53:26 -0400 (EDT) Received: from m8.boston.juno.com (m8.boston.juno.com [205.231.101.196]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 10 Jun 1998 17:53:20 -0400 (EDT) Received: (from sark9keel@juno.com) by m8.boston.juno.com (queuemail) id DFEQLK43; Wed, 10 Jun 1998 17:52:39 EDT To: wilderness-emergency-medicine@list.pitt.edu Date: Wed, 10 Jun 1998 16:55:13 +0000 Subject: W-EMED rjk5a@avery.med.virginia.edu Message-ID: <19980610.165514.24342.0.sark9keel@juno.com> References: X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 1-6 From: sark9keel@Juno.com (Lara L Oehrlein) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 39727820c2a00c338f2d71031fe3e998 X-PMFLAGS: 36700288 0 Hi! I read on wilderness-emergency-med list that you published a book called "Fatigue: Sleep Management During Disasters and Sustained Operations." Can you please send order information? Thanks! Lara Oehrlein _____________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com Or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-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, 10 Jun 1998 15:22:41 -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 ; Wed, 10 Jun 1998 15:22:33 -0400 (EDT) Received: via switchmail; Wed, 10 Jun 1998 15:22:33 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 10 Jun 1998 15:21:32 -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, 10 Jun 1998 15:21:11 -0400 (EDT) Received: from vader.ed.gov (root@vader.ed.gov [165.224.216.253]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 10 Jun 1998 15:21:06 -0400 (EDT) Received: from smtpgwy1.ed.gov (smtpgwy1.ed.gov [165.224.16.166]) by vader.ed.gov (8.8.7/8.8.4) with SMTP id PAA13622 for ; Wed, 10 Jun 1998 15:23:17 -0400 (EDT) Received: from ccMail by smtpgwy1.ed.gov (IMA Internet Exchange 2.12 Enterprise) id 0019111F; Wed, 10 Jun 1998 15:20:46 -0400 Date: Wed, 10 Jun 1998 15:24:14 -0400 Message-ID: <0019111F.003144@ed.gov> From: Peter_McCabe@ed.gov (Peter McCabe) Subject: Re: W-EMED In search of Koester/dbS Productions To: wilderness-emergency-medicine@list.pitt.edu Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 66f735559f6e4a0288ea2decdb974a7c X-PMFLAGS: 33554560 0 Bob Koester (aka dbS Publications) lives in Charlottesville VA. His home phone number is (804) 293-5502. He also has a WEB page which can be linked via <>. Hope this helps. /s/ Peter McCabe ______________________________ Reply Separator _________________________________ Subject: W-EMED In search of Koester/dbS Productions Author: wilderness-emergency-medicine@list.pitt.edu at Internet Date: 6/10/1998 3:04 PM Query: In 1997 Robert Koester published an excellent book titled, "Fatigue: Sleep Management During Disasters and Sustained Operations." I wanted to order additional copies of the book but find that the 800 numbers in the book have been discontinued. Can't find RK or dbS productions in the directory. Anyone know if the book is still available or how to contact these parties? Thanking anyone in advance, Kevin Gerold Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu ************************************************************** This email message and attachments have been scanned and found to be free of all known viruses. ************************************************************** Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 10 Jun 1998 15:08:59 -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, 10 Jun 1998 15:08:48 -0400 (EDT) Received: via switchmail; Wed, 10 Jun 1998 15:08:48 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 10 Jun 1998 15:07:06 -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, 10 Jun 1998 15:06:34 -0400 (EDT) Received: from endeavor.flash.net (endeavor.flash.net [209.30.0.40]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 10 Jun 1998 15:06:27 -0400 (EDT) Received: from [208.194.198.69] (balshiva2-117.flash.net [208.194.198.117]) by endeavor.flash.net (8.8.8/8.8.5) with ESMTP id OAA14908 for ; Wed, 10 Jun 1998 14:06:25 -0500 (CDT) Message-Id: Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii" Date: Wed, 10 Jun 1998 15:04:54 -0400 To: wilderness-emergency-medicine@list.pitt.edu From: Kevin Gerold Subject: W-EMED In search of Koester/dbS Productions Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 4174ee6422350cd631953d0e950707e4 X-PMFLAGS: 34078848 0 Query: In 1997 Robert Koester published an excellent book titled, "Fatigue: Sleep Management During Disasters and Sustained Operations." I wanted to order additional copies of the book but find that the 800 numbers in the book have been discontinued. Can't find RK or dbS productions in the directory. Anyone know if the book is still available or how to contact these parties? Thanking anyone in advance, Kevin Gerold Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-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, 10 Jun 1998 12:55:01 -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, 10 Jun 1998 12:54:49 -0400 (EDT) Received: via switchmail; Wed, 10 Jun 1998 12:54:49 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 10 Jun 1998 12:54:01 -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 ; Wed, 10 Jun 1998 12:52:48 -0400 (EDT) Received: from imo16.mx.aol.com (imo16.mx.aol.com [198.81.17.38]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 10 Jun 1998 12:52:36 -0400 (EDT) From: DoctrRick@aol.com Received: from DoctrRick@aol.com by imo16.mx.aol.com (IMOv14_b1.1) id BLROa04557 for ; Wed, 10 Jun 1998 12:51:28 -0400 (EDT) Message-ID: <3a40bc01.357eb991@aol.com> Date: Wed, 10 Jun 1998 12:51:28 EDT To: wilderness-emergency-medicine@list.pitt.edu Mime-Version: 1.0 Subject: Re: W-EMED Thermometers and Thermometer Covers, Serotonin Syndro Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 170 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 8bfc546c4819f3e3969fe41cc6886329 X-PMFLAGS: 34078848 0 We have had good luck with large animal veterinary thermometers. They are very durable and still need to be kept out of high temps and do not work for hypothemia temperatures. Yet for picking up fever they work good orally. Rick Bennett, Instructor Wilderness Medicine Institute Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Wed, 10 Jun 1998 13:43:53 -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, 10 Jun 1998 13:43:46 -0400 (EDT) Received: via switchmail; Wed, 10 Jun 1998 13:43:46 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Wed, 10 Jun 1998 13:41:56 -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 ; Wed, 10 Jun 1998 13:41:38 -0400 (EDT) Received: from llama.swcp.com (llama.swcp.com [198.59.115.19]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Wed, 10 Jun 1998 13:41:34 -0400 (EDT) Received: from localhost (tanman@localhost) by llama.swcp.com (8.8.5/8.8.0) with SMTP id LAA27946 for ; Wed, 10 Jun 1998 11:41:33 -0600 (MDT) X-Authentication-Warning: llama.swcp.com: tanman owned process doing -bs Date: Wed, 10 Jun 1998 11:41:33 -0600 (MDT) From: TANMAN To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Thermometers and Thermometer Covers, Serotonin Syndro In-Reply-To: <3a40bc01.357eb991@aol.com> Message-ID: MIME-Version: 1.0 Content-Type: TEXT/PLAIN; charset=US-ASCII Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 7db8b4ee349f2884d44f34c4de196451 X-PMFLAGS: 34078848 0 What is the price range of a good mecury thermometer? Thomas A. Naegele, DO Internet 9405 Lagrima de Oro NE 505-275-7267 Albuquerque, NM 87111 Board Certified Family Practice/Board Certified Quality Assurance MEDICAL WHITE PAPERS MAGAZINE FOR COMMUNITY PHYSICIANS http://www.swcp.com/~tanman/ __________________________________________________________________ Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Tue, 9 Jun 1998 22:31:02 -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 ; Tue, 9 Jun 1998 22:30:56 -0400 (EDT) Received: via switchmail; Tue, 9 Jun 1998 22:30:55 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Tue, 9 Jun 1998 22:30:19 -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 ; Tue, 9 Jun 1998 22:29:38 -0400 (EDT) Received: from x12.boston.juno.com (x12.boston.juno.com [205.231.101.26]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Tue, 9 Jun 1998 22:29:35 -0400 (EDT) Received: (from cvw@juno.com) by x12.boston.juno.com (queuemail) id DFCMV4YM; Tue, 09 Jun 1998 22:26:57 EDT To: wilderness-emergency-medicine@list.pitt.edu Date: Tue, 9 Jun 1998 00:47:47 -0600 Subject: Re: W-EMED Gloves Message-ID: <19980609.202606.16062.0.cvw@juno.com> References: <199806081252.IAA08576@post-ofc04.srv.cis.pitt.edu> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 1-12,17-18,20-21,23-27,29-30 From: cvw@Juno.com (chris v weddle) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: e829ea3fcfc30b929b387501b15996f8 X-PMFLAGS: 33554560 0 On Mon, 8 Jun 1998 08:52:07 +0000 "Keith Conover, M.D., FACEP" writes: >Question -- for the WEMSI standard Personal Wilderness Medical Kit, >which is designed both as a personal EMT kit for rescues, with >additional modules for searches and for medics or other advanced >providers -- how many pair of gloves should one carry? >They don't weigh much, but remember that backpackers cut the handles >off toothbrushes and the margins off maps to save weight . . . >Thanks for your thoughts. >--Keith Conover, M.D., FACEP > http://www.pitt.edu/~kconover When I went into wilderness for rescue reasons, I would take a belt pouch that held 10 pairs. Used 'em up often enough. Gloves are so easily torn in that setting, and often as not I was handing out a few pairs to others.Basically this was part of a "see much trauma, plug many leaks" sort of a kit. My small kit for personal wandering has 2 pairs. And the kit fits in a zip-loc sandwich bag no larger than the glove pouch of my rescue days. I have cut margins off maps to fit them into smaller packages, and to start fires. Never did the toothbrush handle trick 'tho... Chris Weddle Colorado Springs An invitation: Please read my small book on SAR Team Membering, and then share your candid opinion: http://www.frii.com/~cvw _____________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com Or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Mon, 8 Jun 1998 08:58:54 -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, 8 Jun 1998 08:55:30 -0400 (EDT) Received: via switchmail; Mon, 8 Jun 1998 08:55:30 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Mon, 8 Jun 1998 08:54:19 -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, 8 Jun 1998 08:52:15 -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 ; Mon, 8 Jun 1998 08:52:12 -0400 (EDT) Received: from 136.142.57.10.pitt.edu (ehdup-d1-15.rmt.net.pitt.edu [136.142.20.205]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Mon, 8 Jun 1998 08:52:11 -0400 (EDT) Message-Id: <199806081252.IAA08576@post-ofc04.srv.cis.pitt.edu> Comments: Authenticated sender is From: "Keith Conover, M.D., FACEP" To: wilderness-emergency-medicine@list.pitt.edu Date: Mon, 8 Jun 1998 08:52:07 +0000 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: W-EMED Gloves X-mailer: Pegasus Mail for Win32 (v2.54) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: c43239b4fb193192a8e417725adb05a5 Question -- for the WEMSI standard Personal Wilderness Medical Kit, which is designed both as a personal EMT kit for rescues, with additional modules for searches and for medics or other advanced providers -- how many pair of gloves should one carry? They don't weigh much, but remember that backpackers cut the handles off toothbrushes and the margins off maps to save weight . . . Thanks for your thoughts. --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 ; Sat, 6 Jun 1998 20:33:33 -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 ; Sat, 6 Jun 1998 20:33:24 -0400 (EDT) Received: via switchmail; Sat, 6 Jun 1998 20:33:24 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 6 Jun 1998 20:33:10 -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, 6 Jun 1998 20:31:32 -0400 (EDT) Received: from cig.defence.gov.au (cig.defence.gov.au [203.102.38.193]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 6 Jun 1998 20:31:22 -0400 (EDT) From: Craig.Schramm.186001@army.defence.gov.au Received: by cig.defence.gov.au; id KAA26764; Sun, 7 Jun 1998 10:23:29 +1000 (EST) Received: from unknown(203.10.138.5) by cig.defence.gov.au via smap (3.2) id xma026758; Sun, 7 Jun 98 10:23:03 +1000 Received: by inet-cbr.defence.gov.au; (5.65v3.2/1.3/10May95) id AA08259; Sun, 7 Jun 1998 00:28:43 GMT Received: from defweb1.defence.gov.au (unverified [203.10.138.10]) by dkn-ms4.defence.gov.au (Integralis SMTPRS 2.04) with SMTP id ; Sun, 07 Jun 1998 10:28:19 +1000 Received: from ns.defence.gov.au by defweb1.defence.gov.au; (8.8.7/1.1.8.2/24Oct97-0322PM) id KAA01399; Sun, 7 Jun 1998 10:30:18 +1000 (EST) Received: from test.army.defence.gov.au by ns.defence.gov.au; (8.8.7/1.1.8.2/24Oct97-0322PM) id KAA02559; Sun, 7 Jun 1998 10:00:17 +0930 (CST) Received: from dmdenotesgtwy.army.defence.gov.au by test.army.defence.gov.au (SMI-8.6/SMI-SVR4) id KAA05815; Sun, 7 Jun 1998 10:32:38 +1000 Received: by dmdenotesgtwy.army.defence.gov.au(Lotus SMTP MTA v1.06 (346.6 3-18-1997)) id 4A25661C.0002CDFC ; Sun, 7 Jun 1998 10:30:38 +1000 X-Lotus-Fromdomain: AUSTDEFENCE To: wilderness-emergency-medicine@list.pitt.edu Message-Id: <4A25661C.00026A71.00@dmdenotesgtwy.army.defence.gov.au> Date: Sun, 7 Jun 1998 10:27:34 +1000 Subject: Re: W-EMED Thermometers and Thermometer Covers, Serotonin Syndro 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-UIDL: e70a3070fd275ac610c65b17e4288fb5 X-PMFLAGS: 34078848 0 "kconover+"@pitt.edu on 06/05/98 08:08:54 PM Please respond to wilderness-emergency-medicine@list.pitt.edu To: gt2030a@prism.gatech.edu, wilderness-emergency-medicine@list.pitt.edu cc: Subject: Re: W-EMED Thermometers and Thermometer Covers, Serotonin Syndro >I was talking about the _electronic_ thermometers. The glass ones are useless -- tend to become inaccurate with exposure to temperature extremes, and broken when you need them. The electronic ones come with case. Aircrew get mighty touchy about mercury from broken thermometers in their aircraft, too. Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc06.srv.cis.pitt.edu (root@post-ofc06.srv.cis.pitt.edu [136.142.185.43]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 6 Jun 1998 09:40:59 -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 ; Sat, 6 Jun 1998 09:40:53 -0400 (EDT) Received: via switchmail; Sat, 6 Jun 1998 09:40:53 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 6 Jun 1998 09:38:52 -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 ; Sat, 6 Jun 1998 09:38:16 -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 ; Sat, 6 Jun 1998 09:38:12 -0400 (EDT) Received: from 136.142.57.10.pitt.edu (ehdup-b1-11.rmt.net.pitt.edu [136.142.20.81]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 6 Jun 1998 09:38:08 -0400 (EDT) Message-Id: <199806061338.JAA10929@post-ofc04.srv.cis.pitt.edu> Comments: Authenticated sender is From: "Keith Conover, M.D., FACEP" To: BjmPAc@aol.com, wilderness-emergency-medicine@list.pitt.edu Date: Sat, 6 Jun 1998 09:38:03 +0000 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED Serotonin Syndrome more info please? In-reply-to: <4f415a1a.3579243d@aol.com> X-mailer: Pegasus Mail for Win32 (v2.54) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 079aaf93c643436806f7a35896c14320 D-SSRI.TXT SSRI and related antidepressants ================================ _ SSRI = Selective Serotonin Reuptake Inhibitors - Prozac (fluoxetine) - Paxil (paroxetine) - Zoloft (sertraline) - Fluvox (fluvoxamine) _ Other related (partial) serotonin uptake inhibitors - Effexor (venlafexine) - Buspar (buspirone) - Meridia (sibutramine) - Wellbutrin (bupropion) --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-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 6 Jun 1998 09:39:38 -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 ; Sat, 6 Jun 1998 09:39:23 -0400 (EDT) Received: via switchmail; Sat, 6 Jun 1998 09:39:22 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 6 Jun 1998 09:38:38 -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, 6 Jun 1998 09:38:13 -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, 6 Jun 1998 09:38:08 -0400 (EDT) Received: from 136.142.57.10.pitt.edu (ehdup-b1-11.rmt.net.pitt.edu [136.142.20.81]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 6 Jun 1998 09:38:04 -0400 (EDT) Message-Id: <199806061338.JAA10918@post-ofc04.srv.cis.pitt.edu> Comments: Authenticated sender is From: "Keith Conover, M.D., FACEP" To: BjmPAc@aol.com, wilderness-emergency-medicine@list.pitt.edu Date: Sat, 6 Jun 1998 09:38:03 +0000 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED Serotonin Syndrome more info please? In-reply-to: <4f415a1a.3579243d@aol.com> X-mailer: Pegasus Mail for Win32 (v2.54) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 1a62ab925a988d28a301d4d2ca183e4e MH-NMS.TXT: Malignant Hyperthermia vs. Neuroleptic Malignant Syndrome ========================================================= see also: Serotonin Syndrome Neuroleptic malignant syndrome (NMS) and malignant hyperthermia (MH) share many clinical features the most prominant of which are hyperthermia and muscular rigdity. However extrapyramidal manifestations are not a feature of MH and the extent of temperature elevation in the latter is, in general, much greater than in NMS. The cause of the temperature elevation is believed to be related to the muscular activity in both cases but the underlying cause of this is different in each case. In MH a defect in muscle calcium tranport is believed to be responsible whereas NMS is probably of central origin and related to hypothalamic dopamine blockage or deficiency. There is *no* overlap in the drugs that cause one syndrome or the other (2). Rare case reports have identified patients who have been diagnosed with both disorders (1). In-vitro tests in patients who have been diagnosed with NMS have failed to identify this group as being at risk for development of MH and thus anesthetic management would not be altered (3). In fact the muscular rigidity and fever associated with NMS has been sucessfully treated with sux (4) although most authors prefer the use of pancuronium (when an NMB is deemed to be indicated) for this purpose. Pseudocholinesterase deficiency will prolong the duration of paralysis in patients given depolarizing NMBs. Even those with normal cholinesterase genotypes exhibit a graded response to sux based upon their baseline levels (5). There is no relation between pseudocholinesterase levels and the development of NMS. H. Louzon MD (1) Kelly D, Brull SJ Neuroleptic malignant syndrome and mivacurium: a safe alternative to succinylcholine? Can J Anaesth 1994 Sep;41(9):845-9 Neuroleptic malignant syndrome (NMS) and malignant hyperthermia (MH) may have a common pathogenic mechanism; therefore, it has been suggested that known triggering agents for MH (such as succinylcholine) should be avoided in patients with NMS. Electroconvulsive therapy (ECT) continues to play a major therapeutic role in contemporary psychiatry, and succinylcholine has been the muscle relaxant of choice in attenuating violent muscle contractions induced by ECT. Mivacurium is a non-depolarizing muscle relaxant with a relatively rapid onset and a short duration of action, and to date it has been proved safe in MH-susceptible patients. In this case report, following succinylcholine use during ECT, a patient with NMS developed an increase in temperature and serum creatine kinase (CK) level, possibly due to an MH reaction. Since the patient's mental status necessitated further ECT, mivacurium was administered during subsequent treatment and resulted in effective attenuation of muscle contractions without elevation of patient temperature or CK levels. In addition, there was no marked prolongation of the anaesthetic. Mivacurium is a suitable agent for patients with NMS undergoing ECT, as it has not been associated with precipitation of an MH response. (2) Keck PE Jr, Caroff SN, McElroy SL Neuroleptic malignant syndrome and malignant hyperthermia: end of a controversy? J Neuropsychiatry Clin Neurosci 1995 Spring;7(2):135-44 Two primary hypotheses have been proposed to explain the pathophysiology of the neuroleptic malignant syndrome (NMS): 1) that NMS is produced by abrupt and extensive central dopamine receptor blockade by neuroleptics, particularly in nigrostriatal and hypothalamic pathways; and 2) that NMS, like malignant hyperthermia (MH), results from a preexisting defect in skeletal muscle metabolism that is unmasked or provoked by neuroleptic exposure. To evaluate these models, the authors review studies published since 1980 of the clinical features, epidemiology, risk factors, laboratory assessment, and relevant animal models of NMS and MH. Data from these studies suggest that although NMS and MH are clinically similar, they are pharmacologically distinct, implying that cross-reactivity between triggering agents is unlikely to occur. (3) Bello N, Adnet P, Saulnier F, Lestavel P, Adnet-Bonte C, Reyford H, Etchrivi T, Tavernier B, Krivosic-Horber R [Lack of sensitivity to per-anesthetic malignant hyperthermia in 32 patients who developed neuroleptic malignant syndrome] Ann Fr Anesth Reanim 1994;13(5):663-8 The aim of this study was to verify whether a relationship exists between neuroleptic malignant syndrome (NMS) and anaesthetic-induced malignant hyperthermia (MH) or not. The in vitro halothane-caffeine tests were performed on muscle tissue obtained from 32 patients with documented NMS episodes. The diagnosis of NMS relied on Levenson's criteria. The results, expressed in accordance with the criteria of the European MH Group, defined 29 subjects as MH non-susceptible. Three patients were classified as MH equivocal. These findings demonstrate the lack of any link between NMS and MH. Therefore, patients with a history of NMS are not likely to be at risk of developing MH and special measures against MH are not required for anaesthesia in these patients. (4) Morris HH 3d, McCormick WF, Reinarz JA Neuroleptic malignant syndrome. Arch Neurol 1980 Jul;37(7):462-3 The neuroleptic malignant syndrome is an uncommon, severe illness that consists of fever, muscular rigidity, and stupor. Various neuroleptics have been associated with the disease. A detailed neurological, medical, and neuropathological evaluation of this case was performed. Presumably, the syndrome is secondary to biochemical dysfunction of the basal ganglia and possible of the hypothalmus. (5) Vanlinthout LE, van Egmond J, de Boo T, Lerou JG, Wevers RA, Booij LH Factors affecting magnitude and time course of neuromuscular block produced by suxamethonium. Br J Anaesth 1992 Jul;69(1):29-35 This study was designed to identify factors that significantly alter the magnitude and duration of suxamethonium-induced neuromuscular block in patients with an apparently normal genotype for pseudocholinesterase. One hundred and fifty-six adults (ages 18-65 yr) were allocated to 13 subgroups. Patients in each subgroup received suxamethonium 50-2000 micrograms kg-1. The mechanographic response of the adductor pollicis brevis muscle to ulnar nerve stimulation was recorded. The ED50 was found to be 167 micrograms kg-1, ED90 was 316 micrograms kg-1 and ED95 was 392 micrograms kg-1. The duration of action (delta t) was in agreement with earlier published results. The magnitude of block was dose-related and decreased with increasing onset time (ton) and pseudocholinesterase activity (PChA). Neither age nor gender affected the degree of suxamethonium-induced block. Delta t was dose-related, decreased with increasing PChA, and was shorter for women. Age and ton had no effect on delta t. --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-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Sat, 6 Jun 1998 09:38:50 -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, 6 Jun 1998 09:38:43 -0400 (EDT) Received: via switchmail; Sat, 6 Jun 1998 09:38:43 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 6 Jun 1998 09:38:37 -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, 6 Jun 1998 09:38:18 -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, 6 Jun 1998 09:38:10 -0400 (EDT) Received: from 136.142.57.10.pitt.edu (ehdup-b1-11.rmt.net.pitt.edu [136.142.20.81]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Sat, 6 Jun 1998 09:38:07 -0400 (EDT) Message-Id: <199806061338.JAA10923@post-ofc04.srv.cis.pitt.edu> Comments: Authenticated sender is From: "Keith Conover, M.D., FACEP" To: BjmPAc@aol.com, wilderness-emergency-medicine@list.pitt.edu Date: Sat, 6 Jun 1998 09:38:02 +0000 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED Serotonin Syndrome more info please? In-reply-to: <4f415a1a.3579243d@aol.com> X-mailer: Pegasus Mail for Win32 (v2.54) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 25d2783b917d909f11a4e61287eecd79 On 6 Jun 98 at 7:13, BjmPAc@aol.com wrote: > > Could someone comment on Serotonin Synd please?? I'm more intested > in that then what to use to cover thermometers.....thanks > > any references would be appreciated, especially regardingsun > exposure issues. Here's the text notes I have: P-Serot.TXT: Serotonin Syndrome ================== See Also: Malignant Hyperthermia vs. Neuroleptic Malignant Syndrome _ Differentiating from NMS: - +++ reflexes in SS, not in NMS _ Serotonin Syndrome may be same as neuroleptic malignant syndrome - NMS: + long term neuroleptics + withdrawal of dopamine agonists + rigidity rather than myoclonus - ? if central hyperthermic hyperexcitability syndrome found in both SS and NMS _ Symptoms of Serotonin Syndrome: - Altered Mental Status: akathisia, agitation, confusion, incoordination, mania, coma. - Autonomic instabiity: hyperthermia, tachypnea, diarrhea, mydriasis, diaphoresis, shivering, tachycardia, variable BP - Neuromuscular abnormalities: nystagmus, myoclonus, rigidity, tremor, hyperreflexia, clonus, seizures. _ Serotonin Syndrome caused by: - excess serotonin in CNS, - decreased reuptake - blocked metabolism, - upregulated receptors _ Specific initiators - SSRI (selective serotonin reuptake inhibitors) excess or OD; e.g.: - Drug Interactions: + MOA inhibitor (Selegiline (Deprenyl) is supposed to be selective MAO-B inhibitor) + SSRI + SRI (Clomipramine, imipramine, TCAs, DM, Demerol, Talwin) (Ref: Tintinalli 4th ed. p 749, Rosen 3rd ed. p 2625) + Agonists such as tryptophan, busiprone, lithium + N.B.: lithium upregulates 5-HT receptors + cocaine _ SS morbidity: - hyperthermia and rigidity may lead to rhabdomyolysis _ Differential Diagnoses: - various ODs, including PCP. _ Rx - Agressive cooling - paralytics - Dantrolene - Benzodiazepines - questionable approaches: + dopamine antagonists: + methysergide + propanolol + cyproheptadine + chlorpromazine ------------------------------ Referenced files will be in separate messages --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 ; Sat, 6 Jun 1998 07:16:07 -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, 6 Jun 1998 07:15:59 -0400 (EDT) Received: via switchmail; Sat, 6 Jun 1998 07:15:57 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Sat, 6 Jun 1998 07:14:18 -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 ; Sat, 6 Jun 1998 07:13:49 -0400 (EDT) Received: from imo20.mx.aol.com (imo20.mx.aol.com [198.81.17.42]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Sat, 6 Jun 1998 07:13:45 -0400 (EDT) From: BjmPAc@aol.com Received: from BjmPAc@aol.com by imo20.mx.aol.com (IMOv14_b1.1) id BLLDa04312; Sat, 6 Jun 1998 07:13:00 -0400 (EDT) Message-ID: <4f415a1a.3579243d@aol.com> Date: Sat, 6 Jun 1998 07:13:00 EDT To: wilderness-emergency-medicine@list.pitt.edu, broche@titan.tcn.net Mime-Version: 1.0 Subject: W-EMED Serotonin Syndrome more info please? Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 3.0 for Windows 95 sub 76 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: ca2d315e336589881bf8008097fedae4 X-PMFLAGS: 35127424 0 Could someone comment on Serotonin Synd please?? I'm more intested in that then what to use to cover thermometers.....thanks any references would be appreciated, especially regardingsun exposure issues. bjm, pa-c Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 5 Jun 1998 23:00:58 -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, 5 Jun 1998 23:00:51 -0400 (EDT) Received: via switchmail; Fri, 5 Jun 1998 23:00:50 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Jun 1998 22:59:32 -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 ; Fri, 5 Jun 1998 22:58:56 -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, 5 Jun 1998 22:58:53 -0400 (EDT) Received: from 136.142.57.10.pitt.edu (ehdup-e3-3.rmt.net.pitt.edu [136.142.21.53]) by post-ofc06.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 5 Jun 1998 22:58:46 -0400 (EDT) Message-Id: <199806060258.WAA09736@post-ofc06.srv.cis.pitt.edu> Comments: Authenticated sender is From: "Keith Conover, M.D., FACEP" To: Bernie Roche , wilderness-emergency-medicine@list.pitt.edu Date: Fri, 5 Jun 1998 22:55:41 +0000 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED Thermometers and Thermometer Covers, Serotonin Syndr In-reply-to: <199806052023.QAA29159@titan.tcn.net> References: <199806051754.NAA04360@post-ofc04.srv.cis.pitt.edu> X-mailer: Pegasus Mail for Win32 (v2.54) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 672d499fa0fbacf546b08cd4825c64ae On 5 Jun 98 at 16:01, Bernie Roche wrote: > The glove will be stronger, and the probe will have the same > sharpness, as when it is used with the flimsy junk covers made for > it.  So the glove should be less prone to tearing than the > original covers.  The key issue here is adequate lubrication, > so that the glove does not adhere to the rectal mucosa.
Ah, but think about how the glove finger is looser than the tight-fitting sleeve designed for the probe. The friction on the bunched loose glove-finger material will create a greater force tending to hold the glove finger back when you try to insert it, compared with the tight-fitting sleeve. Just think about sliding the thermometer probe in without any cover -- minimal friction. Now think about trying to force it in when the anus is covered by a sheet of plastic wrap. True, the plastic wrap will tend to get pushed in by the probe -- but the resistance is such that the probe will likely rip through the plastic rather than bringing the plastic along with it into the anus. Similarly with the glove -- it's not as bad as a flat piece of plastic wrap over the buttocks, but not as good as something that fits the probe exactly. And my suggestion about the Saran Wrap as a cover didn't envision it spread out over the buttocks, but firmly wrapped around the probe to minimize such problems. Any engineers out there to comment on this? Thanks. --Keith Conover, M.D., FACEP http://www.pitt.edu/~kconover Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: From: Self To: Bernie Roche ,wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Thermometers and Thermometer Covers, Serotonin Syndr Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Fri, 5 Jun 1998 22:00:58 On 5 Jun 98 at 16:01, Bernie Roche wrote: > The glove will be stronger, and the probe will have the same > sharpness, as when it is used with the flimsy junk covers made for > it.  So the glove should be less prone to tearing than the > original covers.  The key issue here is adequate lubrication, > so that the glove does not adhere to the rectal mucosa.
Ah, but think about how the glove finger is looser than the tight-fitting sleeve designed for the probe. The friction on the bunched loose glove-finger material will create a greater force tending to hold the glove finger back when you try to insert it, compared with the tight-fitting sleeve. Just think about sliding the thermometer probe in without any cover -- minimal friction. Now think about trying to force it in when the anus is covered by a sheet of plastic wrap. True, the plastic wrap will tend to get pushed in by the probe -- but the resistance is such that the probe will likely rip through the plastic rather than bringing the plastic along with it into the anus. Similarly with the glove -- it's not as bad as a flat piece of plastic wrap over the buttocks, but not as good as something that fits the probe exactly. And my suggestion about the Saran Wrap as a cover didn't envision it spread out over the buttocks, but firmly wrapped around the probe to minimize such problems. Any engineers out there to comment on this? Thanks. -- End -- Received: from post-ofc02.srv.cis.pitt.edu (root@post-ofc02.srv.cis.pitt.edu [136.142.185.24]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 5 Jun 1998 15:56:34 -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 ; Fri, 5 Jun 1998 15:56:22 -0400 (EDT) Received: via switchmail; Fri, 5 Jun 1998 15:56:21 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Jun 1998 15:55:17 -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 ; Fri, 5 Jun 1998 15:54:58 -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 ; Fri, 5 Jun 1998 15:54:54 -0400 (EDT) Received: from Pbroche (ppp-101.m2-10.tor.ican.net [142.154.22.101]) by titan.tcn.net (8.8.5/8.6.9) with SMTP id QAA26876 for ; Fri, 5 Jun 1998 16:17:02 -0400 (EDT) Message-Id: <199806052017.QAA26876@titan.tcn.net> X-Sender: broche@titan.tcn.net X-Mailer: QUALCOMM Windows Eudora Pro Version 4.0 Date: Fri, 05 Jun 1998 15:54:57 -0400 To: wilderness-emergency-medicine@list.pitt.edu From: Bernie Roche Subject: Re: W-EMED Thermometers and Thermometer Covers In-Reply-To: <199806051148.HAA16374@post-ofc04.srv.cis.pitt.edu> Mime-Version: 1.0 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 48e2d88fabca1687f135de83cc667f6e X-PMFLAGS: 34079360 0 At 07:48 AM 05/06/98 +0000, you wrote:

[snip]

>You can get probe covers for these BD thermometers, but I've found
>(for about the fourth time now) that, after being in your pack for a
>couple of months, you simply can't get the probe into one of these
>flimsy covers without ripping it.

[snip]

>My next solution to try:=A0 I've wrapped the thermometer in Saran Wrap,
>and plan to carefully unwrap it and use the Saran Wrap wrapped over
>the probe as a cover.

[snip]

>Anyone else have ideas?

Hi, Keith:

Yes.  Use surgical rubber gloves in the kit.  Aside from their normal uses, they make an excellent thermometer cover...just use plenty of lubricant, and leave the thermometer in situ a bit longer to allow the lubricant and glove to reach body temperature.

Since the surgical rubber gloves are powdered, they withstand storage in our packs fairly well.

Now, how do we treat a latex allergy per rectum?????

Best Wishes,

Bernie Roche, RN, BScN, W-EMT, OSJ
WEMSI Web Site Administrator
http://www.wemsi.org/
broche@titan.tcn.net Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-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, 5 Jun 1998 16:00:39 -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 ; Fri, 5 Jun 1998 16:00:23 -0400 (EDT) Received: via switchmail; Fri, 5 Jun 1998 16:00:22 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Jun 1998 15:58:49 -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 ; Fri, 5 Jun 1998 15:58:30 -0400 (EDT) Received: from x17.boston.juno.com (x17.boston.juno.com [205.231.100.29]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 5 Jun 1998 15:58:25 -0400 (EDT) From: emsmark@Juno.com Received: (from emsmark@juno.com) by x17.boston.juno.com (queuemail) id PVI16007; Fri, 05 Jun 1998 15:57:02 EDT To: kconover+@pitt.edu, wilderness-emergency-medicine@list.pitt.edu Date: Fri, 5 Jun 1998 14:04:35 -0500 Subject: Re: W-EMED Thermometers and Thermometer Covers, Serotonin Syndro Message-ID: <19980605.140438.11758.25.emsmark@juno.com> References: <199806051754.NAA04360@post-ofc04.srv.cis.pitt.edu> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 0-11,20-21,29-32 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 864e956da35c59c0dc25295c519788d6 X-PMFLAGS: 33554560 0 On Fri, 5 Jun 1998 "Keith Conover, M.D., FACEP" writes: >On 5 Jun 98 at 9:22, emsmark@Juno.com wrote: > >> Gloves -- the venerable item from our PPE -- gives you 5 options >> each, plus they come in both latex or non-latex (some people >> have latex allergies). Again, put KY on the exterior for rectal >> insertion, and your thermometer/probe stays clean and dry. > >My only worry is that, since it will fit loosely, that the tip of >the probe will be relatively "sharp" and will poke through the end >when you insert it. Good point. I forgot to preface with "I have not tried this...." I should think that unless you are dealing a very tight rectum, you ought be able to get the probe in with liberal lubrication like KY. [Do not use petroleum based lubes, they'll break down the latex, defeating your efforts -- I do not know what the effects are on other products like vinyl or nitrile gloves.] Guess I'll have to dig out a condom and a glove and see if they can withstand the simulated pressure: 'forcing' a thermometer into a tight-fisted hand should exceed the tensions involved in rectal insertion :) In another reply, s+j nolan asked about "other" emergency uses for condoms. These might include making a flutter valve for chest decompression (tension pneumothorax), a constricting band to help start an IV or for (gulp) snake bites (although that is a whole other topic here, from what I have been reading), a waterproof cover for a bandaged digit.....those are just the things we tried in class. Improvise and be creative -- they are a rather durable/versatile piece of latex* [*consider latex allergies before using in any setting!] Mark McCormick, EMT-P _____________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com Or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc01.srv.cis.pitt.edu (root@post-ofc01.srv.cis.pitt.edu [136.142.185.25]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 5 Jun 1998 13:56:07 -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, 5 Jun 1998 13:55:59 -0400 (EDT) Received: via switchmail; Fri, 5 Jun 1998 13:55:58 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Jun 1998 13:55:00 -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, 5 Jun 1998 13:54:36 -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 ; Fri, 5 Jun 1998 13:54:33 -0400 (EDT) Received: from 136.142.57.10.pitt.edu (ehdup-a3-8.rmt.net.pitt.edu [136.142.20.58]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 5 Jun 1998 13:54:26 -0400 (EDT) Message-Id: <199806051754.NAA04360@post-ofc04.srv.cis.pitt.edu> Comments: Authenticated sender is From: "Keith Conover, M.D., FACEP" To: emsmark@Juno.com, wilderness-emergency-medicine@list.pitt.edu Date: Fri, 5 Jun 1998 13:54:25 +0000 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED Thermometers and Thermometer Covers, Serotonin Syndro In-reply-to: <19980605.100027.11758.21.emsmark@juno.com> X-mailer: Pegasus Mail for Win32 (v2.54) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: a8f098a9b38bf6405d8d39ff7ef3c67e X-PMFLAGS: 34078848 0 On 5 Jun 98 at 9:22, emsmark@Juno.com wrote: > Gloves -- the venerable item from our PPE -- gives you 5 options > each, plus they come in both latex or non-latex (some people have > latex allergies). Again, put KY on the exterior for rectal > insertion, and your thermometer/probe stays clean and dry. My only worry is that, since it will fit loosely, that the tip of the probe will be relatively "sharp" and will poke through the end when you insert it. --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-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 5 Jun 1998 13:50:54 -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 ; Fri, 5 Jun 1998 13:17:46 -0400 (EDT) Received: via switchmail; Fri, 5 Jun 1998 13:17:46 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Jun 1998 13:16:25 -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 ; Fri, 5 Jun 1998 13:16:06 -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, 5 Jun 1998 13:16:03 -0400 (EDT) Received: from pobox.com (ehdup-m-3.rmt.net.pitt.edu [136.142.22.13]) by post-ofc05.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Fri, 5 Jun 1998 13:15:56 -0400 (EDT) Message-ID: <357835EB.8D9F08F4@pobox.com> Date: Fri, 05 Jun 1998 13:16:12 -0500 From: DP/EJ X-Mailer: Mozilla 4.03 [en] (Win95; I) MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Thermometers and Thermometer Covers, Serotonin Syndrome References: <199806051148.HAA16374@post-ofc04.srv.cis.pitt.edu> <19980605.100027.11758.21.emsmark@juno.com> <35781E9A.71A@cnnet.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-UIDL: 5c6a5f774835ae0e71cc1f66dc5a61a0 X-PMFLAGS: 34078848 0 Just a reminder that when gloves, condoms and other such products are selected for inclusion in field kits, that latex allergy be considered. At the least, synthetic alternatives should be included; better to eliminate all latex if possible. In any case, be aware of the potential for iatrogenic reactions to natural rubber latex containing products. Dan Peden Pittsburgh, Pa. s+j nolan wrote: > > Every kit has gloves, and some folks already include condoms in their > > kits, so an option is right at hand when your "official" cover doesn't > > work or you want to extend your protection. [My paramedic instructor > > recommended we carry a couple in our kits because they have many > > emergency uses beyond the "intended design".] > > > > Hope this input is helpful. > > Mark McCormick, EMT-P > > > Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-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, 5 Jun 1998 12:42:13 -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 ; Fri, 5 Jun 1998 12:42:06 -0400 (EDT) Received: via switchmail; Fri, 5 Jun 1998 12:42:06 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Jun 1998 12:40:58 -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 ; Fri, 5 Jun 1998 12:40:41 -0400 (EDT) Received: from ua1.cnnet.com (ua1.cnnet.com [207.229.6.10]) by list.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 5 Jun 1998 12:40:37 -0400 (EDT) Received: from [207.229.6.115] by ua1.cnnet.com (NTMail 3.03.0017/1.aikr) with ESMTP id qa359960 for ; Fri, 5 Jun 1998 10:37:54 -0600 Message-ID: <35781E9A.71A@cnnet.com> Date: Fri, 05 Jun 1998 10:36:42 -0600 From: s+j nolan X-Mailer: Mozilla 3.01 (Win95; I) MIME-Version: 1.0 To: wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Thermometers and Thermometer Covers, Serotonin Syndrome References: <199806051148.HAA16374@post-ofc04.srv.cis.pitt.edu> <19980605.100027.11758.21.emsmark@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-UIDL: f49f161ed4e286a6c4ffd233e5fa989b X-PMFLAGS: 34078848 0 > Every kit has gloves, and some folks already include condoms in their > kits, so an option is right at hand when your "official" cover doesn't > work or you want to extend your protection. [My paramedic instructor > recommended we carry a couple in our kits because they have many > emergency uses beyond the "intended design".] > > Hope this input is helpful. > Mark McCormick, EMT-P > Interested in knowing what "other" emergency uses condoms have. Julie Nolan, BA, RN Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- X-cs: From: Self To: Daniel Hoechst ,wilderness-emergency-medicine@list.pitt.edu Subject: Re: W-EMED Thermometers and Thermometer Covers, Serotonin Syndro Reply-to: kconover+@pitt.edu MIME-Version: 1.0 Content-type: text/plain; charset=ISO-8859-1 Content-transfer-encoding: 8BIT Date: Fri, 5 Jun 1998 10:08:45 On 5 Jun 98 at 8:51, Daniel Hoechst wrote: > I'm not sure about the size of the thermometers but an idea I had is > to get those travel toothbrush holders and put the hole thermometer > inside it. These holders are the length of a normal toothbrush and > some have quite a large volume inside. Maybe some other kind of hard > case would protect the thermometer as well. You can get them at any > drug store. I was talking about the _electronic_ thermometers. The glass ones are useless -- tend to become inaccurate with exposure to temperature extremes, and broken when you need them. The electronic ones come with case. -- End -- Received: from post-ofc07.srv.cis.pitt.edu (root@post-ofc07.srv.cis.pitt.edu [136.142.185.73]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 5 Jun 1998 10:10:10 -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 ; Fri, 5 Jun 1998 10:10:03 -0400 (EDT) Received: via switchmail; Fri, 5 Jun 1998 10:10:02 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Jun 1998 10:09:28 -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, 5 Jun 1998 10:09:12 -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, 5 Jun 1998 10:09:09 -0400 (EDT) Received: from 136.142.57.10.pitt.edu (ehdup-b1-6.rmt.net.pitt.edu [136.142.20.76]) by post-ofc05.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID ; Fri, 5 Jun 1998 10:09:00 -0400 (EDT) Message-Id: <199806051409.KAA16855@post-ofc05.srv.cis.pitt.edu> Comments: Authenticated sender is From: "Keith Conover, M.D., FACEP" To: Daniel Hoechst , wilderness-emergency-medicine@list.pitt.edu Date: Fri, 5 Jun 1998 10:08:54 +0000 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: Re: W-EMED Thermometers and Thermometer Covers, Serotonin Syndro In-reply-to: <199806051251.IAA17489@acmex.gatech.edu> References: <199806051148.HAA16374@post-ofc04.srv.cis.pitt.edu> from "Keith Conover, M.D., FACEP" at Jun 5, 98 07:48:02 am X-mailer: Pegasus Mail for Win32 (v2.54) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 818c07e16b7fa12e26a66fd2865b99a3 On 5 Jun 98 at 8:51, Daniel Hoechst wrote: > I'm not sure about the size of the thermometers but an idea I had is > to get those travel toothbrush holders and put the hole thermometer > inside it. These holders are the length of a normal toothbrush and > some have quite a large volume inside. Maybe some other kind of hard > case would protect the thermometer as well. You can get them at any > drug store. I was talking about the _electronic_ thermometers. The glass ones are useless -- tend to become inaccurate with exposure to temperature extremes, and broken when you need them. The electronic ones come with case. --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-ofc04.srv.cis.pitt.edu (root@post-ofc04.srv.cis.pitt.edu [136.142.185.11]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 5 Jun 1998 11:55:29 -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, 5 Jun 1998 11:55:21 -0400 (EDT) Received: via switchmail; Fri, 5 Jun 1998 11:55:21 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Jun 1998 11:54:24 -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, 5 Jun 1998 11:54:01 -0400 (EDT) Received: from x17.boston.juno.com (x17.boston.juno.com [205.231.100.29]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 5 Jun 1998 11:53:57 -0400 (EDT) From: emsmark@Juno.com Received: (from emsmark@juno.com) by x17.boston.juno.com (queuemail) id LDY16007; Fri, 05 Jun 1998 11:52:55 EDT To: wilderness-emergency-medicine@list.pitt.edu Date: Fri, 5 Jun 1998 09:22:10 -0500 Subject: Re: W-EMED Thermometers and Thermometer Covers, Serotonin Syndrome Message-ID: <19980605.100027.11758.21.emsmark@juno.com> References: <199806051148.HAA16374@post-ofc04.srv.cis.pitt.edu> X-Mailer: Juno 1.49 X-Juno-Line-Breaks: 1-28,33-34,38-39,44-47 Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: ab2a78c7d7cb62f8f9ef302f72858615 X-PMFLAGS: 33554560 0 My reply is relative to the thermometer cover portion of the original message. On Fri, 5 Jun 1998 "Keith Conover, M.D., FACEP" writes: >The WEMSI Personal Wilderness Medical Kit includes, for the >minimum kit, a BD electronic thermometer, for situations where you >don't need a continuous-reading Radio Shack type indoor-outdoor >"rectal" thermometer. >You can get probe covers for these BD thermometers, but I've found >(for about the fourth time now) that, after being in your pack for >a couple of months, you simply can't get the probe into one of >these flimsy covers without ripping it. The pressure of being in >the pack, plus maybe exposure to heat, seems to press the two >sides of the flimsy plastic together and "weld" them together. > >My next solution to try: I've wrapped the thermometer in Saran >Wrap, and plan to carefully unwrap it and use the Saran Wrap >wrapped over the probe as a cover. It can also extend protection >back over more of the thermometer than the "official" probe >covers, which is handy given how messy it often is taking a rectal >temp on an ill or injured patient in the backcountry. >Anyone else have ideas? Other options that come to mind are condoms and gloves. Condoms are available in both lubricated and non-lubed; though I imagine the lubed is messier because it is coated on both sides, while you can apply KY to the exterior of the non-lubed prn, keeping the thermometer/probe clean and dry. Gloves -- the venerable item from our PPE -- gives you 5 options each, plus they come in both latex or non-latex (some people have latex allergies). Again, put KY on the exterior for rectal insertion, and your thermometer/probe stays clean and dry. Every kit has gloves, and some folks already include condoms in their kits, so an option is right at hand when your "official" cover doesn't work or you want to extend your protection. [My paramedic instructor recommended we carry a couple in our kits because they have many emergency uses beyond the "intended design".] Hope this input is helpful. Mark McCormick, EMT-P _____________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com Or call Juno at (800) 654-JUNO [654-5866] Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-emergency-medicine" as the body of a message (no subject) To: Majordomo@list.pitt.edu Submissions To: wilderness-emergency-medicine@list.pitt.edu -- End -- Received: from post-ofc05.srv.cis.pitt.edu (root@post-ofc05.srv.cis.pitt.edu [136.142.185.10]) by pop.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cispop-7.2.2.1) ID ; Fri, 5 Jun 1998 08:52:50 -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, 5 Jun 1998 08:52:36 -0400 (EDT) Received: via switchmail; Fri, 5 Jun 1998 08:52:35 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Jun 1998 08:51:43 -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 ; Fri, 5 Jun 1998 08:51:19 -0400 (EDT) Received: from acmex.gatech.edu (gt2030a@acmex.gatech.edu [130.207.165.22]) by list.srv.cis.pitt.edu with ESMTP (8.8.8/8.8.8/cisls-7.2.2.1) ID for ; Fri, 5 Jun 1998 08:51:15 -0400 (EDT) Received: (from gt2030a@localhost) by acmex.gatech.edu (8.8.5/8.8.5) id IAA17489 for wilderness-emergency-medicine@list.pitt.edu; Fri, 5 Jun 1998 08:51:14 -0400 (EDT) From: Daniel Hoechst Message-Id: <199806051251.IAA17489@acmex.gatech.edu> Subject: Re: W-EMED Thermometers and Thermometer Covers, Serotonin Syndrome To: wilderness-emergency-medicine@list.pitt.edu Date: Fri, 5 Jun 1998 08:51:13 -0400 (EDT) In-Reply-To: <199806051148.HAA16374@post-ofc04.srv.cis.pitt.edu> from "Keith Conover, M.D., FACEP" at Jun 5, 98 07:48:02 am X-Mailer: ELM [version 2.4 PL25] MIME-Version: 1.0 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-UIDL: d6a0641c6e551257c53690f2ccdea5b1 X-PMFLAGS: 35127424 0 I'm not sure about the size of the thermometers but an idea I had is to get those travel toothbrush holders and put the hole thermometer inside it. These holders are the length of a normal toothbrush and some have quite a large volume inside. Maybe some other kind of hard case would protect the thermometer as well. You can get them at any drug store. Daniel Hoechst, WFR Do not reproduce without author's express permission. To unsubscribe, send the text "unsubscribe wilderness-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, 5 Jun 1998 07:49:27 -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, 5 Jun 1998 07:49:12 -0400 (EDT) Received: via switchmail; Fri, 5 Jun 1998 07:49:11 -0400 (EDT) Received: from list.srv.cis.pitt.edu via qmail ID ; Fri, 5 Jun 1998 07:49:01 -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 ; Fri, 5 Jun 1998 07:48:09 -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 ; Fri, 5 Jun 1998 07:48:05 -0400 (EDT) Received: from 136.142.57.10.pitt.edu (ehdup-b1-6.rmt.net.pitt.edu [136.142.20.76]) by post-ofc04.srv.cis.pitt.edu with SMTP (8.8.8/8.8.8/cispo-7.2.2.2) ID for ; Fri, 5 Jun 1998 07:48:02 -0400 (EDT) Message-Id: <199806051148.HAA16374@post-ofc04.srv.cis.pitt.edu> Comments: Authenticated sender is From: "Keith Conover, M.D., FACEP" To: wilderness-emergency-medicine@list.pitt.edu Date: Fri, 5 Jun 1998 07:48:02 +0000 MIME-Version: 1.0 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Subject: W-EMED Thermometers and Thermometer Covers, Serotonin Syndrome X-mailer: Pegasus Mail for Win32 (v2.54) Sender: owner-wilderness-emergency-medicine@list.pitt.edu Precedence: bulk Reply-To: wilderness-emergency-medicine@list.pitt.edu X-UIDL: 6eb944acc4968bb0d03a70caad0acb50 X-PMFLAGS: 34078848 0 The WEMSI Personal Wilderness Medical Kit includes, for the minimum kit, a BD electronic thermometer, for situations where you don't need a continuous-reading Radio Shack type indoor-outdoor "rectal" thermometer. (Example from last Saturday -- checking the temp on someone who's been lost or stranded but it's been quite warm. As soon as you get a single rectal temp that shows he's not hypothermic or febrile, you don't really need to continue rechecking the temperature.) These thermometers only go down to 96 degrees F (35 degrees C) but still are useful for excluding hypothermia, as long as you have a low-reading thermometer available soon for backup. And they only go up to 105 degrees F (40.8 degrees C) and just last week we had a patient in the ED who had some mild heat exposure, some diarrhea and vomiting (? if infectious), and was on a SSRI (selective serotonin reuptake inhibitor, a kind of psychiatric drug that is prescribed a lot these days, Zoloft in this particular case) as well as two phenothiazines (don't remember which, maybe Compazine and Phenergan). She showed marked motor restlessness, and had a rectal temp of 107 F! We decided that she must have at least a component of Serotonin Syndrome, a relatively newly-discovered illness related to neuroleptic malignant syndrome (NMS). I wouldn't be surprised if more of the elderly wander-away-type lost people aren't on similar drugs these days, and we may find such high temps on search subjects. In the ED, we gave the patient some midazolam (Versed) which decreased the motor tone and motor restlessness, and probably was as important as the cooling blanket and acetaminophen at getting her temperature down. You can get probe covers for these BD thermometers, but I've found (for about the fourth time now) that, after being in your pack for a couple of months, you simply can't get the probe into one of these flimsy covers without ripping it. The pressure of being in the pack, plus maybe exposure to heat, seems to press the two sides of the flimsy plastic together and "weld" them together. My next solution to try: I've wrapped the thermometer in Saran Wrap, and plan to carefully unwrap it and use the Saran Wrap wrapped over the probe as a cover. It can also extend protection back over more of the thermometer th