Reenacting Galileo’s Experiments: Rediscovering the Techniques of Seventeenth-Century Science : Explores the different methodology – experimental philosophy of Galileo. Reenacting Galileo’s Experiments: Rediscovering the Techniques of Seventeenth-Century Science

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Manassas Oval Bumper Sticker : Adhesive-backed oval vinyl sticker printed in weather resistant black ink. Based on European format. Sticker size is approximately 3 ½ x 5 and kiss cut on a rectangular carrier. While originally intended for automobile bumpers they can be applied to windows, notebooks, backpacks, or other surfaces. Manassas Oval Bumper Sticker

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Introduction by Nur Amalina Che Bakri and Han Ern Yap

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Great for bento lunch – M. Brannigan – Orlando, FL USA
This container is great for packing a bento style lunch. I initially bought it for my kids but the capacity is a little larger than they need so I think I’ll keep it for myself. I like that I can pack a variety of foods and that nothing shifts around inside the container.
Emsa E503392 Clip and Close Rectangular Food-Storage Container with Lid and 3 Removable Inserts: FRIH9: E503392 Clip and Close contain it all. At home and everywhere; fridge, freezer, microwave, pantry, craft closed, lunch bag, picnic basket….to store or take along. Clip & Close is 100% leak-proof with an all around silicone seal and temperature resistant from -40-degrees F to +230-degrees F. 4 easy open/close clasps seal in aroma and moisture and keep food market-day fresh. – read more.

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What it is: All forms of triage are systems for identifying and sorting/classifying levels of severity of injury or illness. Every hospital Emergency Room has a limited number of beds and medical staffing so there is always a Triage Nurse to greet you at the door, so that those at risk for worsening or death can be prioritized and be treated first, while those whose condition is assessed to be minor, moderate, or non-life-threatening, can be sent to the waiting room to wait for their turn.

Disaster triage, though based on the same principles, is different in a number of ways. Most importantly, it must be faster (because there are so many injured at once, and because seconds or minutes may make the critical difference) and it must be simpler, so that it can be done by almost anyone, without medical knowledge or professional training.

S.T.A.R.T. multi-casualty triage is the system used by medical, rescue, and emergency personnel, both professional and volunteer, to make the best use of limited medical resources when the number of injured needing care exceeds the resources available. The goal is to “Do the most good for the most people.” When performed in line with recognized standards of practice, in most countries triage is recognized and sanctioned by law.

“Our goal is to maximize the number (of people) who will survive the incident. Some patients will live no matter what medical care they receive, and some will die regardless of the care they receive. Others will die UNLESS they receive medical care immediately (but have a good chance of survival if they do). We Don’t want to utilize valuable resources on people who are certain to die, nor on people who will survive without medical care. Our goal is to identify those who will survive the event with immediate care, and get it for them as soon as possible.”
- from “Prehospital Triage” by Matthew R. Streger, BA, NREMT-P from EMS Magazine, The Journal of Emergency Care, Rescue, and Transportation.

The basic goals of S.T.A.R.T. (which stands for simple triage and rapid treatment/or transport) are to sort injured persons based on probable needs for immediate care, to give brief essential life saving interventions, and also, to recognize futility. In this way, a small number of emergency workers and helpers can determine and act upon those persons and conditions which will benefit most from the expenditure of the limited resources available.

The origin of triage in general goes back to the time of Napoleon, but the type of triage we will discuss here -S.T.A.R.T. triage, was developed by Newport Beach Fire Department and Hoag Memorial Hospital in Orange County California in the mid 1980’s. Considered the Gold Standard of field and multi-casualty triage, S.T.A.R.T. is now practiced all over the world.

Why it is: Some injuries require immediate medical care. Serious trauma may require surgery within one hour of the injury, which has been called “the Golden Hour.” Since surgeons can only treat one person at a time, when there are many more, they must be sent to a more distant hospital, because hospitals in the disaster area will be overrun or may be shut down by damage. So it becomes critical to identify these injured early. Also very important about S.T.A.R.T. triage – each injured person, while being triaged, is also minimally treated with life-saving procedures (such as opening blocked airways, controlling bleeding, positioning for airway safety, and treating for incipient shock).

“A system is needed to determine the severity of each patient quickly and accurately. It should be easy to learn, simple to remember (especially under stress) not require any diagnostic skills, and should allow the triage (caregiver) to immediately stabilize any basic life-threats encountered. The system most widely recognized and used is the S.T.A.R.T. System”
- from “Prehospital Triage” by Matthew R. Streger, BA, NREMT-P from EMS Magazine, The Journal of Emergency Care, Rescue, and Transportation.

How it is: S.T.A.R.T. triage is a fast, compact, simple, and very specific system for identifying and marking (or “tagging” because a color-coded tag is often used) the injured into four groups or levels of priority. As each one is triaged they are given brief, essential treatments as needed, and the Triager moves from person to person until all are looked at quickly and given the first-action treatments as needed. More care is given later, after rapid triage is done and help has been requested.

Disaster triage could be described as “choosing the best of the worst” because we are giving first priority to those who will actually benefit from it most – those who have a good chance to survive and recover IF they get help soon. We don’t give first priority to the ones with minor injuries, because waiting will not change their outcome. We do not give it to the moderate injuries, because waiting will not change their outcome. We do not give it to the deceased, because waiting will not change their outcome. We give first priority to those where it makes the critical difference, and S.T.A.R.T. triage identifies those for us. We do not have to decide ourselves.

“Between 75% to 85% of fatalities occur within the first 20 minutes of the event, usually before EMS (911 emergency response) can arrive.”

In the chaos and confusion of a disaster, a simple plan like this works, and has been proven in actual practice to save about 40% more lives since its inception more than 25 years ago. That’s why it’s used by Medical Rescue and Public Safety agencies in the U.S. and many countries worldwide. The S.T.A.R.T. triage you learn and use in Disaster First Aid is the same system they use, condensed and simplified for civilians and non-professionals. The average person may not have the same equipment professional rescuers carry, but s/he does have everything that’s needed to do S.T.A.R.T. triage and save lives in those critical first minutes and hours while waiting for help to come.

S.T.A.R.T. Triage and Disaster First Aid are designed and intended for large, multi-casualty events where it’s obvious that there will not be enough ambulances and paramedics for each and every one who is injured, and many must wait. So help must be rationed and applied where it will be the most effective and make the most difference. (Please note that Neither S.T.A.R.T. nor Disaster First Aid should be used as substitute for medical care at any time when that is available.)

Using the S.T.A.R.T. formula may be stressful, especially for civilians and volunteers, who though trained will not be very experienced in triage. It’s important to remind everyone that they are not deciding the fate or outcome of any injured person, they are simply applying the time-tested and proven formula which makes the decisions for them. Knowing this gives direction, courage, and moral support not only to the citizen rescuer/helpers, but also to the hundreds of thousands of police, fire, ambulance and rescue crews throughout the world who use this formula every day in all multi-casualty emergencies. S.T.A.R.T. works. It does save the most lives that can be saved.

—————————–

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Nice material, but not the right size – DB Helle – New Brusnwick
The container is very good construction, but I was getting them to store my fruitcakes that were baked in a standard 9 inch loaf pan. The container was described as 9×6x6, but it is more like 7.5×6x4.5 and my fruitcakes won’t fit. Otherwise it’s a good storage container.
Emsa E503394 Clip and Close 3-3/4-Quart Deep Rectangle Storage Container: FRIH9: E503394 Clip and Close contain it all. At home and everywhere; fridge, freezer, microwave, pantry, craft closed, lunch bag, picnic basket….to store or take along. Clip & Close is 100% leak-proof with an all around silicone seal and temperature resistant from -40-degrees F to +230-degrees F. 4 easy open/close clasps seal in aroma and moisture and keep food market-day fresh. – read more.

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www.informatedigital.com – Video: Copyright de Canal 12 // Más de 100 operarios de la empresa eléctrica provincial, trabajan en la zona afectada por el temporal en San Pedro, para reestablecer el servicio eléctrico

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A number of years back I decided to become a Firefighter. First off, I thought that it would be a good idea to consult with my friends that were already in the field. A good friend of mine told me that in order to make yourself a better candidate for hire, I needed to become a Paramedic, but even before that, I must first become an EMT. I thought it was going to be a breeze, but after my first day of class, I realized that maybe I bit off more than I can chew, and that Firefighters knew a lot more than I originally thought. You see, I was just like you, a member of the general public that thought that the people inside the ambulance were in fact just the “drivers,” it turns out that this could not be further than the truth.

First Responders, EMTs, Paramedics and other EMS personel are highly trained professionals that take great pride in being the first line of defense in the treatment of your loved ones. This specialized group of people can be found anywhere in the field or the hospital. One thing for sure, is that if you have ever had chest pain, shortness of breath, or have found yourself trapped in a burning car you will quickly see that these people are not just licensed to drive, but are quick on their feet, highly trained, specialized personal.

So, what do EMS personal know? There are many levels to the knowledge base of the workers that represent those in EMS and each have their own personal expertise. It is often difficult to determine who is who when 911 is called, but “typically” the Paramedic is the highest level of “pre-hospital” medical care you can receive in the field. Paramedics have the ability to administer a multitude of drugs that can help even the most desperate of victims. Paramedics have specialized skills and treatments that they are authorized to administer to patients that include, but are not limited to the following:

Various Advanced life support medications that vary per region

PROCEDURES AND SKILLS

RSI (RAPID SEQUENCE INTUBATION)

External Jugular Vein Access

Transcutaneous Cardiac Pacing

Oral Endotracheal Intubation

Oral Endotracheal Intubation

Synchronized Cardioversion

Insertion of Nasogastric/Orogastric Tube

Needle Thoracostomy

Intraosseous Infusion

Nasotracheal Intubation

Needle Cricothyrotomy

Vagal Maneuvers

Axial Spinal Stabilization

Pulse Oximetry

Esophageal Tracheal Airway Device (ETAD)

MEDICAL EMERGENCIES

Adult Respiratory Emergencies

Shock (Non-Traumatic)

Altered Level of Consciousness/Seizures

Poisonings (ALS)

Adult Airway Obstruction

Heat Related Emergencies

Cold Related Emergencies

Poisonings (BLS)

CARDIAC EMERGENCIES – ADULT

Suspected Acute

Adult Tachycardias

Non-Traumatic Hypertensive Crisis

Adult Bradycardia

Adult Cardiac Arrest

12 Lead Electrocardiography

Automatic External Defibrillation AED

PEDIATRIC EMERGENCIES

Pediatric Cardiac Arrest (1 Day to 14 years of Age)

Pediatric Altered Level of Consciousness

Pediatric Respiratory Emergencies

Pediatric Seizure

Pediatric Allergic Reaction

Pediatric Airway Obstruction

TRAUMA

Trauma Triage Criteria & Destination

Adult Trauma

Pediatric Trauma

Glasgow Coma Scale Operational Definition

Fractures and Dislocations

BURN

Burn Criteria & Destination

Adult Burns

Pediatric Burns

OBSTETRICAL/NEONATAL EMERGENCIES

Newborn Care

Obstetrical Emergencies

MCI/HAZMAT

Medical Response to a Multi-Casualty Incident

Medical Response to a Haz-Mat Incident

TRANSFER OF PATIENTS

EMT-P Inter-facility Transport Guidelines

Inter-facility Transport – Nurse Staffed Units

Transport of Patients

Cardiovascular “Stemi” Receiving Centers

POLICIES AND PROCEDURES

Physician on Scene

Suspected Sudden Infant Death Syndrome Incident

Responsibility for Patient Management

Reporting Incidents of Suspected Abuse/Neglect

Patient Refusal of Care or Other Patient Request

Guidelines for Adult Refusal of Care

Determination of Death on Scene

Withholding Resuscitative Measures

POLST Form

EMSA DNR Form

Do Not Resuscitate (DNR)

A Paramedic operates under the license of the Medical Director. The Medical Director is a licensed doctor in that Paramedic state, city, or county. Paramedics have a limited scope of practice that is referenced in their Protocols. Protocols are basically the foundation to the treatment the Paramedic operates within. Paramedics operate under the strict guidelines of these rules set forth by medical direction. Protocols can vary across the United States. Some Paramedics have more protocols than others, and have the ability to operate autonomously within these protocols. Typically Paramedics that are in rural areas have more ability to perform more skills and give more medications than their counterparts in the “big city”, because medical care is so far away and time in a true medical emergency is of the essence.

So do you still think that EMS personal are just drivers? Let’s review just ONE drug that almost all Paramedics are familiar with and use in the field. Keep in mind that this is just one of about 30 drugs Paramedics are able to use in an area located in San Bernardino California’s (ICEMA Region). Paramedics are required to recognize when this drug is indicated and not indicated. The drug used below has the capability to save or kill someone under it’s use, and is measured by micro grams, per kilogram, per minute, coupled with the desired effects on the a given patient.

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Advanced Life Support Medication

DOPAMINE – Sympathetic agonist – A naturally occurring catecholamine and a chemical precursor of

norepinephrine. It acts on alpha-receptors, is dose dependent, and causes peripheral vasoconstriction. The effect on beta 1 receptors causes a positive inotropic effect on the heart, without increasing myocardial oxygen demand as much as Epinephrine. Dopamine maintains renal and mesenteric blood flow, when used in lower therapeutic doses. Used in patients with significant hypertension, when fluid replacement is unsuccessful.

Side Effects: Increased heart rate. Can worsen or induce both narrow complex and wide complex arrhythmias.

Deactivated by alkaline solutions such as Sodium Bicarbonate. May cause hypotension in patients taking Dilantin.

Infiltration of IV will cause localized tissue necrosis. Notify receiving facility if IV infiltrates. Do not give via IO.

Typical Preparations: 200mg/5ml: Ampule or Vial and premixed IV solution.

Dose:

Adult: 5-20mcg/kg/min. For the average adult 400mg of Dopamine in 250ml D5W at a rate of 30-

60 microdrops/minute provides this dose range. Titrate to blood pressure and other signs of

perfusion.

Pediatric: Contraindicated in children under 8 years of age within the ICEMA region.

This concludes our review of the ALS (Advanced Life Support) medication Dopamine.

——-

Sounds easy enough right? Most cab drivers, truck drivers, and airport shuttle drivers know about these things, so why not just call them the “ambulance driver” too? So as you can see, there is just a tad bit more to the ambulance driver than you originally thought. Am I right?

Most people respect and are somewhat familiar with the vast knowledge and extraordinary services nurses provide, but on the other hand have limited knowledge of what the capabilities of EMS are. Many times, I have been asked by nurses in the field if Paramedics are allowed to perform even the simplest of skills such as start an IV. Sometimes, these remarks are said with “tongue in cheek” because of the sometimes “ugly” workplace rivalry between Paramedics and Nurses. Did you know that most Paramedics have the ability to perform more advanced skills than that of their counterparts the nurses? In many states, counties, and cities Paramedics do not require the doctors advanced orders before performing life saving measures or to administer advanced life support medications. Paramedics are allowed to make split second decisions based on their patient’s signs and symptoms. The ability to work within their protocols allows the medics to change procedures and medications as the patient’s condition improves or worsens. Nurses are required to follow the orders of their doctor before most medications are administered. Another distinctive difference between Paramedics and Nurses is that there are certain skills that may only be performed by Paramedics and Doctors trained to do so. So, Are Paramedics better than Nurses? No, of course not! They are two completely different medical service providers. Paramedics and Nurses both have their limitations. Paramedics, EMTs, and EMS personal are again, specialized personal that are trained to perform specialized work.

So how does one become a Paramedic you ask? The requirements to become a Paramedic vary between states. In most states you must first become an EMT and acquire at least one year of field experience prior to applying to Paramedic school. The next step into getting into Paramedic school is to pass a college proficiency exam, a Paramedic academy entrance exam, oral exam, background check, medical examination, and have the necessary prerequisites to enter the Paramedic academy that can include anatomy, physiology, or medical terminology. The entire academic process can take approximately two years or more. (Depending on the program, prerequisites ETC) Many Paramedic Academy’s take one year to complete. Paramedic training is some of the toughest academic training around. Students must maintain a score of at least 80 percent to pass throughout their entire class time or are subjected to dismissal from the academy. Many will have to attempted to pass the Paramedic Academy several times before graduating. Once the academy is completed, students will have to pass a national registry examination, state examination, and finally a local examination. The fees, regulations, and form filling are endless (Especially in “anti-business friendly” California). EMS personal are required to keep their certifications, licenses updated and current by attending skills and continuous education classes. After the completion of mandated training hours, EMS personal must submit completed training certificates noting the minimum skills training hours, academic review have been met, and of course..pay the necessary fees in order to maintain their accreditation or license requirements.

I hope that this article has given you a greater understanding of capabilities of the “ambulance driver” and to know that this term is considered to be little insulting by some in the EMS field. So, the next time your loved one finds themselves at the mercy of the 911 system, you can feel a sense of relief knowing that a “cab driver” is not on the way, but an “ambulance driver” is.

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