Category Archives: ___c) General Clinic

Friday, October 5, 2012 · 12:10 AM

First Aid Supply List

(Survival Manual/ 6. Medical/ c) General Clinic/ First Aid supply list)

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The three top killers of mankind  are:
1) Upper Respiratory Infection,
2) Diarrhea and
3) Skin Infections.
Your household medical kit should be weighted heavily to cover against  these diseases

Your personal or group’s specific needs obviously determine the type and amount of stored medicinal items. Most of the items everyone should have, others are related to personal health issues. Where as one family might need to store more antacids, another may need a larger supply ion antihistamines, etc.

 I developed the following personal list, to track purchase locations, expiration date, item cost and a lilttle information about the product. The width of the list has been reduced to fit in the columnar confines of the WordPress blog page. To keep track of the supplier, I used a code like G= Walgreen’s, W=Walmart. A=Amazon.com, where  most of the itmes were purchased. Items with expiration date were simply entered below the suppliers code name, ie W/7-15-2014, meaning  “Bought at Walmart, expires July 15, 2014.” If a situation arose that looked extremely serious, the one area of supply that I would want to seriosly increase would be the antibiotics, also several extra gallons of regular, unscented household clorox (not listed).

WHERETO BUY/EXP DATE COST IN STOCK ITEM
PAIN RELIEF-FEVER

W

08/2013

  $7.98  x Tylenol, extra strength 100 tablets: Temporarily relieves minor aches and pains due to: headache, muscular aches, backache, arthritis, the common cold, toothache, menstrual cramps, temporarily reduces fever.
Equate Ibuprofen, 200 mg x 24 tablets
Benedryl
EverCool Cooling bandana’s (3 pack), $10.01: Included 2 in F.A. kit. Have special polymer beads that are sewn in. When soaked in water, they expand to 100x their original size. The coolness comes from the polymer beads retaining the water and evaporation the process can last several days.
HAIR-EYE-NOSE-LIP
2- Head & Shoulders shampoos, 1.7 fl oz ea.
Hartz Flea & Tick Powder (for dogs), 4 oz. or Hunter’s Brand Flea and Tick Quick Kill 16 oz/ or another brand in powder/shampoo/drops
Bausch & Lomb Eye relief Eye Wash with eye cup, 4 fl. Oz.
Equate Sterile Gentle Lubricant Eye Drops, 1 fl oz.
Bacitracin, mupirocin, or other antibacterial Eye ointment
Blistex Silk and Shine lip balm.
DENTAL
Dental floss picks. Plankers Micro mint. Dental flosser, 90 ct.
2- pack Oral B Medium toothbrushes.
Dentemp O.S. One Step, Caps and Fillings Repair, 8+ Repairs, 2g Blister (Pack of 6)
Clove oil, 2 oz., Now Essential Oils
Dental pick, 4 pc. carver and probe set, stainless steel, $6.33.Stainless 6:” dental mirror, $5.52.Tartar remover/scraper 6.5” handle, $3.95
Sensodyne Cool Gel with fluoride: toothpaste and topical tooth pain reliever for sensitive teeth, 4 oz.
Cool Mint Listerine antiseptic mouth wash, 8.5 fl oz.
RESPIRATORY SYSTEM
Thermometer, oral, mercury
Vics Vaporub ointment, 1.76 oz., topical cough medicine with medicated vapors that works quickly for adults as well to relieve cough symptoms
box Kleenix
N95 NIOSH approved respirators, 3M, 20/pack, to reduce exposure to airborne disease particles.
Surgical Procedure masks, earloop, 50 ct.; ‘isolation masks’, for infected person to wear, protects others from large respiratory droplets.
Halls Mentho-lypts cough drops. Relieves cough and sore throat. 30 ct.
Equate Cold Multi-Symptom or Wal-Flu: (Acetaminophen) pain reliever/ fever reducer/ antihistamine/ cough suppressant/ nasal decongestant infused with chamomile and white tea flavors. 2 pkg of 24 gel caps ea.
Walgreens Wal-Four Nasal Decongestant Spray, 1 oz., Temporarily relieves nasal & sinus congestion, swollen nasal membranes; for common cold, hay fever.
Saline Nasal Spray, 1.5 oz-For dry nasal membranes
Mucus relief: (Guaifenesin – 600 mg x 40 tablets) Expectorant. Helps loosen phlegm (mucus) and thin bronchial secretions to rid the bronchial passageways of bothersome mucus and make coughs more productive.
STOMACH
Prilosec, 42 tablets
Equate anti-diarrheal, (loperamide hydrochloride) 48 caplets
Natrol Acidophilus Probiotic Capsules, Dietary Supplement. Guaranteed 3 billion live cultures – at time of manufacture. Helps ease occasional stomach discomfort. By taking Natrol Acidophilus each day, you can: Help maintain a healthy balance of friendly bacteria in your digestive system. Promote digestive health. Help improve lactose intolerance.
Emergen-C: Super orange, 1000 mg Vit C+24 nutrients with antioxidents, ELECTROLYTES & 7 B vitamins. 30 packets
Humco Castor Oil, For relief of occasional constipation, stimulant laxative produces bowel movement in 6 to 12 hours.
Equate gas relief, (simethicone) 60 soft gels
1-Magnesium Citrate, 10 oz, powerful system cleaning laxative used in hospitals, 3 bottle/doses.
Dulcolax laxative Suppository, 4 suppositories
Bragg organic apple cider vinegar 2 ea 16 oz bottles.
Equate Motion Sickness 50 mg x 100 tablets: Helps treat symptoms associated with motion sickness; nausea, vomiting and dizziness, $8.68
TOPICAL-SKIN CARE
hydrogen peroxide, 3%, 16 oz.- Topical Use against infection by decreasing germs In minor cuts, burns, and abrasions
70% Isopropyl alcohol, 16 oz
Tea Tree oil- natural antiseptic, bactericide, fungicide, rashes
Petroleum jelly-relieves dry skin and chaffing, for minor burns
Caladryl or Calamine lotion- poison oak, etc.
Backwoods Cutter Insect repellant, 6 oz spray can, 23%DEET. Or Repel 100 –insect repellent, 100% DEET
Equate Sport Sunscreen spf 50, 8 oz.
Johnson’s Baby Powder, 1.5 oz.
Dermoplast antibacterial spray- for burns, relieves pain, Benzethonium Chloride
Cortizone10 or Aveeno 1% Hydrocortisone cream/gel- Hydrocortizone 1%: Relief of itching due to inflammation and from: Eczema, Psoriasis, Seborrheic Dermatitis, Poison Ivy/Oak/Sumac, insect bites, rashes from soaps, detergents, cosmetics and jewelry.
Equate Triple Antibiotic Ointment 1 oz.- Contains Bacitracin Zinc, Neomycin Sulfate, Polymyxin B Sulfate- used to prevent minor skin injuries such as cuts, scrapes, and burns from becoming infected.
Vagisil, 1 oz.- Pain/itch relieving creamsoothes and relieves external feminine itching, burning and irritation, soothes with benzocaine & resorcinol
Equate Antibacterial liquid handsoap, 7.5 oz.
WOUNDS
Trim, 2 – Mini slant & Point tweezers
Splinter Out splinter remover 20/box,
2- elastic bandages, 2”x 2 yards, Ace wrap Type,
Coach elastic bandages, 3”x 2 yards, Ace wrap Type
3 ea. Rolled gauze bandage, 2×2.5 yds
Johnson & Johnson First Aid Covers Gauze Pads Large 4″ x 4″, 10 ct
Johnson & Johnson Medium gauze pads, 2”X2”, 10ct.
CuradBand-Aid Adhesive Bandages, Assorted Sizes 100 ea
Johnson & Johnson Red Cross Mirasorb Gauze Sponges. 50 ct 4”x4”cleaning and prepping light-to-moderately draining wounds and applying medication. Or 100% cotton facial cleansing pads, 60ct (costmetic area)
Bandage scissors
Johnson & Johnson first aid tape, roll ½”x 6yds
Gold Bond Medicated Foot Powder, 4 oz.
Mole skin, 3 sheets, 4-5/8”x3-3/8”
Finger splints, plastic, 3 ea.
TENDON & SKELETAL
Mueller Adjust to fit Ankle brace, one size, fits L or R ankle.
Mueller Self adjusting Knee stabilizer, $14.28
Arm sling/triangular bandage/bandana
Epsom Salts, 4 lbs (magnesium sulfate) soaking aid for minor sprains and bruises, saline solution for short term relief of constipation.
Instant Cold Pack, 2 pack
ANTIBIOTICS
1- Fish Mox (Amoxicillin) 250mg, 100 Capsules
1- Fish Cillin (Ampicillin) 250 mg – 100 Caps
3 ea. Aqua-Doxy (Doxycycline) 100mg Tablets – 30 Count
1- Fish Cycline (Tetracycline) 250 mg – 100 Caps
SUPPLEMENTS
Finest Natural B-12 Vitamin 1000 mcg. 2x 150 tablet bottles. Dietary Supplement Tablets. Contribute to normal brain function and for nervous system health. 1000 micrograms every day. A low level of vitamin B12 has also been associated with memory loss and other cognitive deficits, asthma, depression, AIDS, multiple sclerosis, tinnitus, diabetic neuropathy and low sperm counts. Eggs, cheese and some species of fish also supply small amounts, but vegetables and fruits are very poor sources. Several surveys have shown that most strict, long-term vegetarians are vitamin B12 deficient. Many elderly people are also deficient because their production of the intrinsic factor needed to absorb the vitamin from the small intestine decline rapidly with age.
Calcium tablets (Tums): consume enough calcium every day to maintain adequate blood and bone calcium levels. Recommended calcium intake for adults is 1,000 to 1,300 milligrams daily. Multi-vitamins typically do not contain more than 200 to 250 mg of calcium . Tums are 1000 mg /tablet with 40% elemental Ca.. Not to take with tetracycline or doxycycline antibiotics.
Vitamin C, 500 mg x 250 caplets
Spring Valley Vitamin D-3 Protect bone, joint, and immune health. vitamin D3 is extremely useful in absorbing calcium and phosphorus from the intestines so the two key minerals can be used by the body. Vitamin D3 is the vitamin that is used by humans. Receiving approximately 15 minutes of sunlight per day, if you are able, will provide you with all the Vitamin D you need. The FDA suggests that you consume 200 to 400 IU per day of Vitamin D if you are less than 50 years old. If you are over 50, it is suggested that you consume 600 IU. If you do not have adequate vitamin D in your diet, your bones can become brittle and more prone to breaks or fractures. According to the Vitamin D Council, research has implicated vitamin D deficiencies in the pathologies of 17 cancers, and implicated it in major diseases including depression, diabetes and heart disease.
Spring Valley Echincea 760 mg, 100 capsules. One of the most popular herbs in America today. Contains substances that enhance the activity of the immune system, relieve pain, reduce inflammation, and have hormonal, antiviral, and antioxidant effects. For general immune system stimulation, during colds, flu, upper respiratory tract infections, or bladder infections.
Finest Natural Magnesium 250 mgx 300 tablets. Dietary Supplement Tablets. Magnesium is an essential mineral and plays an important role in energy metabolism, protein synthesis, neuromuscular transmission and bone structure, energy support.
Equate Mature Men’s Multivitamin. Memory and concentration: Ginkgo, Heart health: With vitamins B6, B12, C, E and folic acid; Healthy blood pressure: With vitamins D, C, calcium and magnesium: Eye health: With vitamins E, A, C and zinc: Immunity: With vitamins C, A, E and selenium: Physical energy: With vitamins B6, B12, pantothenic acid, chromium and folic acid: More vitamin D.
Finest Natural One-Per-Day Omega-3 Fish Oil Softgels Softgels.Omega 3s are necessary for many vital functions in the body and have been shown to: Support heart health, Support mental performance and proper brain function, Support a healthy mood, Support healthy skin, nerve and joint function.
MISC
IOSAT potassium Iodide (anti radiation pills)
Water bulb for rinsing wounds and dental work.
scotch whisky, 2 pt, 4 ea. 50 ml.
Nolvasan Scented Disinfectant. Bactericide, virucide, 1 pt
Flashlight, aa batteries
Nitrile exam gloves, Ansell, about 100 store in a zip lock bag.
Kleenix Hand Towels, 60 each
Sterile towelettes, Wet Ones, 2 containers, 20+60 wipes
Tongue blades, (jumbo craft sticks) 75 ct.
Cotton balls, jumbo, pkg 70
Cotton swabs, purse pack, 30 ct.
(Sphygmomanometer) Omron HEM-780 Automatic Blood Pressure Monitor with ComFit Cuff, $69.73, or Omron Healthcare HEM-629N Portable Wrist Blood Pressure Monitor, $72.49
Medicine dropper (2)
Safety pins, assorted sizes, size 3- 2”, 30 ct
Condom, non lubricated
Book: ‘Nurses Drug Guide, 2009’
Book: ‘Where There Is No Dentist ‘

First Aid Kit Supply List
17 January 2011, The Survival Podcast Forum, by Dr. Kyle Christensen,
Pasted from <http://thesurvivalpodcast.com/forum/index.php?topic=23991.0&gt;

 First Aid Kit List
It is important that each of us has access to a good first aid kit and that you know how to use it. Assemble your kit now, before you need it.  Get a box or plastic tote and begin throwing things in.  You will be surprised how much you can find around the house before you need to make a run to the drug store. Tailor the contents to fit your family’s particular needs and lifestyle. Assemble them in a backpack or tool chest. Any bottle or container that is not labeled should be discarded.  “If in doubt, throw it out.” Check your kit periodically to update and restock.  Start using it now for any of your health needs.

A.  Tools
1. Tweezers and splinter removers– for removal of splinters or debris from skin or tissues.
2. Scissors – to cut bandages, cloth, etc.
3. Thermometer – for taking temperatures.
4. Tongue Depressors – for finger splints and for sad or depressed tongues.
5. Snake Bite Kit – in addition to snake bites, use for spider or insect bites.  A portable suction extractor devise is good to have on hand.
6. Cotton Applicator (Q-tips) – to apply herbs in small areas or to scrub and clean tissue.
7. Cotton balls
8. Instant Ice Pack – for sprains, strains, contusions when a freezer and ice is not available.  The “I” in R.I.C.E. (Rest, Ice, Compress, Elevate)
9. Chemical hot packs
10. Epi-Pen – epinephrine injection, if there is a history of severe allergic reactions.
11. Otoscope – this tool can be purchased inexpensively to view the ear canal.
12. Stethoscope & Blood Pressure Cuff – to monitor blood pressure and to listen to the heart/lungs.
13. Nail Clippers – specialized tool for nails (ingrown toenails)
14. Bulb Syringe – to forcefully rinse wounds, for small enemas, to extract mucus. Sterilize after every use.
15. Hot Water Bottle/Enema/Douche.
16. Dental Emergency Kit (includes mirror, probe – to view and examine mouth and teeth.)
17. Paper & pencil
18. Needles and thread
19. Burn Gel
20. Safety pins
21. Paper drinking cups
22. Dust masks/mirco filter masks (95N) – also to be used for protection from H1N1 or other viruses.
23. Knee Brace
24. Wrist Brace
25. Ankle Brace
26. Cool-Down Bandana – absorbs water and used to wrap around head or neck to cool fever
27. Surgical tool kit
28. String
29. Eye cup (to rinse eye)

B.  Bandages
1. 16-36 each Band-Aids – 1/2” x 3”, 3/4” x 4”, knuckles
2. Ace Bandages – 2”, 3” and 6”
3. Flannel – 11” x 14” – an old nightgown or shirt
4. Gauze – many sizes of both pads and rolls
5. Waterproof tape and Hypoallergenic tape
6. Vinyl examination gloves – one box to 1,000 gloves – multiple sizes if necessary for your family.
7. Feminine Napkins – Maxi-pads– for gun shot wounds & severe bleeding (not just female issues)
8. Moleskin AND Molefoam– for blisters or to protect skin from wear.
9. SAM Splint or some other splinting material– use for arms, legs, ankle or neck immobilization.
10. Aluminum finger splints
11. Butterfly bandages, Steri-Strips and Super Glue for wound closure.
12. Triangular bandages to make a sling or wrap.
13. Bandaging strips – cut or tear an old clean sheet into 4” strips that can be used for gauze, to wrap or bind injuries.
14. Non-adhering dressings [Telfa]
15.  Duct tape – great to remove warts – better than OTC treatments
16. Stick-It – (helps bandages to adhere to the skin)
17. Adhesive remover (like Goof-off)

 C.  Miscellaneous
1. Sea Salt – for mineral replacement in dehydration (Celtic Sea Salt, Redmond Real Salt)
2. Epsom Salt or Dead Sea Salt  – used to draw out toxins and radiation.          Used 1 –2 cups per bath.
3. Soap – liquid anti-bacterial or castile soap – to clean wounds and skin. I like Dr. Bronner’s Castile Soaps.
4. Apple Cider Vinegar – for arthritis (internally) and to wash the skin.
5. Baking Soda – used to neutralize acids burns, for re-hydration, and insect bites.
6. Hard Candy or Taffy to bring blood sugar up.  Its got to have real sugar in it.  No diabetic sugar-free candy.
7. Miso Soup – used nutritionally to ward off the effects of radiation.  Made into a soup/broth.
8. Rubbing Alcohol or alcohol preps – used to clean around wounds.
9. Potassium Iodide or Potassium Iodate – for thyroid protection against radiation – use as directed for dosage amounts.

D.  Non-Herbal Supplements to consider
1. Calcium
2. Magnesium – for electrolyte imbalances
3. Omega 3 oil
4. Vitamin C
5. Vitamin D3
6. Melatonin – for sleep
7. Air Borne – for immune system boost

E.  OTC (Over-the-Counter) from the Drug Store to consider for those not yet secure with herbal medicine.  In an emergency, you need to have what you are accustomed to using.
1. Triple Antibiotic ointment
2. Anti-fungal cream
3. Nystatin
4. Butt Paste – this stuff is great and not just for Butts – highest amount of zinc oxide
5. Lotion and sunscreen– for dry skin, sun protection (don’t forget your hat)
6. Petroleum jelly – to help seal exit wounds
7. Insect repellant – to ward of disease carrying mosquitos
8. Baby powder or corn starch (avoid talc as it can cause other problems)
9. Gold Bond Foot Powder
10. Dermoplast
11. Aloe Gel
12. Pregnancy tests
13. Condoms (not just for their intended use – they’re sterile)
14. Tummy relief – peptobismal tablets
15. Cough Drops – Halls or Ricola – get lots
16. Vics Vapor Rub
17. Benedryl cream
18. Generic Benedryl – DiPhenhydramine hydrochloride – for general sedating –esp. for children
19. Mucinex or Mucus relief – to clear lungs of congestion to prevent pneumonia
20. Electrolyte replacement (powdered Gatorade or similar product, or Sea Salt)
21. Saline solution – for eye rinse or wound cleansing
22. Carmax lip balm or chapstick
23. Mouthwash rinse
24. Dental Wax – for anyone with braces
25. Dental Floss
26. Floss threader for those with braces, bridges or hardware in their mouth
27. Iodine – for cleaning and prepping the skin
28. Antacid (Tums, Rolaids, etc.)
29. Baking soda
30. Calamine lotion
31. Decongestant tablets & spray
32. Diarrhea medication (to stop it, not give it to you)
33. Household ammonia
34. Hydrocortisone cream .5% to 1%
35. Hydrogen Peroxide – to cleanse wounds and disinfect
36. Alcohol – spirits – whiskey (use as a disinfectant wash)
37. Insect sting swabs or Meat Tenderizer (for insect bites) (Tea Tree oil works very good)
38. Oil of Cloves – for dental pain (aka Clove Essential Oil)
39. Aspirin – NSAID
40. Aleve/Naprosyn (naproxen) NSAID
41. Advil – Ibuprofen NSAID
42. Tylenol/Acetaminophen – Very hard on the liver – be cautious with use alternate with NSAIDs
43. Antibiotics and Prescription medications (hang on to what you’ve got “just in case”)  Observe expiration dates.
44. Sugar or glucose solution (or sugar candy)
45. Syrup of Ipecac – to induce vomiting (purge the stomach)
46. Tiger Balm or use Western Botanicals Deep Heat Oil or Ointment
47. Book: Nurses Drug Guide

F.  Emergency and Other Items to Consider
1. Cell phone and charger that utilizes the accessory plug in your car dash
2. Emergency phone numbers of all family, friends and contact information for your family doctor and pediatrician, local emergency services, emergency road service providers and the regional poison control center
3. Small, waterproof flashlight and extra batteries
4. Candles and matches for cold climates – when making a fire ignite it from a candle not a match.
5. Flint and Steel fire-starter.  Always have a backup method to start a fire.
6. Mylar emergency blanket
7. First-aid instruction manual – such as Herbal First Aid and Health Care, by Christensen – personally I have several that cover many different aspects of health and first aid.
8. Plastic bags and large garbage bags for the disposal of contaminated materials
9. Safety pins in assorted sizes
10. Paracord – 50 to 300 feet. Or other strong cord or rope.
11. Water purifying – chlorine bleach and/or hand water filter
12. Copies of important family documents
13. Whistle
14. Ear plugs
15. A good hat for everyone
16. Maps of the area and a compass
17. Clear Plastic sheeting to cover windows (if they break in an earthquake) and extra Duct tape
18. Tarps/stakes/twine/nails/rope/spikes
19. Good multipurpose knife and Scissors
20. Siphon & hand pumps
21. Boy Scout Handbook – use an old one that you don’t need to use –it’s a good reference book with lots of information
22. Work Gloves
23. Glue – Gorilla glue, wood glue and Super Glue
24. Extra Contacts, Glasses and Reading Glasses
25. Repair tools – screwdrivers, wrenches, vice grips, etc.
26. Wrenches/pliers to turn of water and gas to home
27. Sewing Awl
28. Bug Out Bag – 72 Hour Kit for each member of your household.  Don’t forget to keep on in your car so that emergency essentials are always on hand wherever you are.
29. Etc. – the list can go on forever.

For those  who have discovered the effectiveness and safety of Natural Healthcare and Herbal Products.
.
Herbal Formulas to consider
1. Immune Boost – used for infectious illness, feverish illness or a general immune system boost.
2. Colon Cleanse – an excellent herbal laxative that assists with elimination while building tone and strengthening the colon.
3. Colon Detox – used to deeply cleanse the colon, for diarrhea, used as a drawing poultice, for stings and bites.  Use internally for food poisoning.
4. Digestion Aid Formula – for indigestion, upset stomach or gastritis.
5. CTR Ointment (Complete Tissue Repair Ointment) – use to speed the healing of cuts, wounds, abrasions, bruises.  Any type of wound healing.
6. Lungs Plus formula – for asthma, pneumonia, bronchitis, any respiratory problem.
7. Deep Heat oil or ointment – for sprains, strains and muscular pain.  Also relieves earache (only use if eardrum is NOT ruptured).
8. CTR Syrup – used internally to speed the healing of any injury where tissue has been disrupted or damaged.
9. Earth Nutrition and/or Bountiful Blend – for concentrated whole food nutrition.  Improves health, energy and vitality.  Use daily to avoid illness while improving health.
10. Kidney-Bladder Formula – for urinary tract infection, incontinence, general edema (swelling) or kidney and bladder concerns.
11. Liver-Gallbladder Formula – for any liver condition (infectious or toxic), for digestive complaints.
12. Nerve Calm Formula – for nervous tension, irritation, insomnia or panic attacks.
13. Herbal Anti-Septic Formula – to cleanse and disinfect wounds.
14. Herbal Tooth Powder – for any teeth or gum infection or weakness.  Tightens loose teeth.
15. Herbal Ear Drops – used for earaches inside the ears as well massaged down the neck to milk congestion from the lymphatics.  Used also for external glandular swelling or cysts.
16. Herbal Mouthwash – for gingivitis, pyorrhea, and mouth sores.
17. Female Balance Formula – for any hormonally related female condition.
18. Anti-Plague Syrup – for any infectious condition that can result in death (the plague).  Use to boost and stimulate the immune system.
19. Herbal Snuff – for sinus congestion
20. Herbal Eyewash – cleans and disinfects (use a few drops in eyecup of pure water)

Single Herbs to consider
1. Cayenne tincture – used to stop bleeding, for shock and to increase circulation
2. Cayenne powder – for bleeding, shock and circulation
3. Milk Thistle powder – for liver protection against poisoning (Tylenol, mushrooms, etc.)
4. Lobelia tincture – relaxant, anti-spasmodic, for asthma (bronchial dilator), an emetic.
5. Peppermint essential oil – for digestion, opens the lungs and sinuses.
6. Tea Tree essential oil – topical anti-fungal, anti-bacterial
7. Oregano infused oil – sublingually used for anti-fungal, anti-bacterial, anti-viral, immune builder.
8. Clove essential oil – topical pain reliever for teeth or mouth sores.
9. Lavender essential oil – topical anti-bacterial, for insect bites.
10. Garlic infused oil – for ear infections, topical anti-bacterial, anti-fungal.
11. Slippery Elm bark powder – soothes digestive upsets, for colitis and irritable bowel.
12. Castor oil – used topically as a fomentation to relieve and reduce pain, inflammation, growths and swellings.
13. Shepherd’s Purse tincture – stops excessive bleeding, especially menstrual or related to childbirth.
14. Crystalized Ginger or Ginger capsules – used for motion sickness, dizziness, nausea, indigestion or taken for cold hands and feet.
15. Yarrow tincture – for fevers
16. Plantain tincture – for bites, stings, or skin irritations
17. Mullein tincture – calms and soothes digestion
18. Fennel tincture – for gas or bloating.
What did I miss?  Of course, we could list the whole hospital, but suggest any obvious item we can add.
This information is not intended to diagnose, treat, cure or prevent any diseases, or replaces the services of a competent health care provider.  This program has not been evaluate or approved by the FDA.  By all means listen to your body and use common sense.
Compiled and Revised by Dr. Kyle Christensen, January 2011

———————————————————–

 Updated First Aid Kit List
1. Monistat (or other feminine yeast infection cream)
2. Witch Hazel or Prep H
3. Visine Regular Eye Drops
4. Visine Allergy Eye Drops
5. OraJel
6. Aamens Itch Powder
7. Flexible Drinking Straws
8. Eye Dropper
9. Sunglasses
10. Safety Glasses
11. Extra Rx Eye Glasses
12. Eye Glass Repair Kit
13. List of Medicine Allergies/Reactions
14. Medical History (blood type, current maintenance medication(s), immunizations, etc)

And for the little ones:
1. Children’s Tylenol/Motrin
2. Diaper Rash Cream or Corn Starch
3. Children’s Decongestant
4. Children’s Cough Meds
5. Pedialite

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Monday, August 27, 2012 · 12:10 AM

Survival and physical fitness

(Survival Manual/ 6. Medical/ c) General Clinic/ Survival & physical fitness

“No man who is not willing to help himself has any right to apply to his friends, or to the gods.”
……………………………Demosthenes (384–322 BC, Greek statesman and orator of ancient Athens)

1.  Survival & Physical Fitness
2011, No More Dependence, posted in Health/Hygiene
Pasted from:

Being physically fit is important for numerous reasons. Besides the most valuable benefit of increasing one’s own health (and thereby decreasing the risk for infections, diseases, common illness, etc.), being physically fit increases energy levels, boosts self-confidence, improves mental clarity, and generally improves quality of life.

Striving towards physical fitness may not be as fun as getting new gear or as tangible as buying 100 lbs of beans, but No More Dependence sincerely believes that regular exercise, combined with a sensible diet, is one of the most fundamental and practical survival skills to possess.

Ultimately, when weighing likely risks and potential real world survival scenarios, an individual who is generally regarded as physically fit, will have a greater likelihood of survival than his or her out of shape, or weaker, counterpart.

That being said, we’re not advocating everyone should spend every day in a gym exercising, we’re merely observing that as individuals who strive to be prepared and rely less on others, being in shape is a solid tactical advantage.

[Photo: 1968, teenage boys out for a hike.]

.

[Photo: fast forward to 2012, teenage girls out for a hike.]

2.  First and foremost to being a Prepper is a mental attitude: That of “I am responsible for me”. If you are relying on the government or others to take care of you then you are a dependent of them, not an independent citizen capable of supporting themselves. And that is exactly what a Prepper is or strives to be – an Independent Citizen capable of supporting themselves. Throw out the attitudes and beliefs that if something happens you’ll let others take care of you. In fact, throw out the notion that nothing bad will ever happen to you – chances are extremely high that it will! Whether it’s a personal, family, neighborhood, city, state, national or world event – bad things happen every single day – dodging them all is pretty near impossible.
Becoming a Prepper requires independence and self-reliance in all areas of our lives including finances, utilities, food, clothing, health, devices and furniture, to name a few key areas.

————–  a major health issue ————-

3.  Being lazy can kill you: Physical inactivity responsible for 5 millions deaths every year
Wednesday, July 18, 2012, NYDaily News, by AFP RELAX NEWS
Pasted from: http://www.nydailynews.com/life-style/health/lazy-kill-physical-inactivity-responsible-5-millions-deaths-year-article-1.1116883

Having a couch potato lifestyle is a risk factor comparable to smoking or obesity, say experts in the medical journal The Lancet, which described physical inactivity as failing to do 30 minutes of moderate physical activity five times a week, 20 minutes of vigorous activity three times a week, or a combination of the two.

Here’s some extra motivation to get off the couch and get in shape: A report in the medical journal The Lancet claims that physical inactivity kills about five million people every year.

“Roughly three of every 10 individuals aged 15 years or older — about 1.5 billion people — do not reach present physical activity recommendations,” experts said in a report that described the problem as a “pandemic.”

The picture for adolescents is even more worrying, with four out of five 13- to 15-year-olds not moving enough, it said.

Physical inactivity was described for the study as failing to do:

1) 30 minutes of moderate physical activity five times a week, or
2) 20 minutes of vigorous activity three times a week, or
3) or a combination of the two.

Inactivity increases with age, is higher in women than in men, and more prevalent in high-income countries, the researchers found.

A second study, comparing physical activity levels with population statistics on diseases like diabetes, heart problems and cancer, said lack of exercise claimed more than 5.3 million of the 57 million deaths worldwide in 2008.
It said inactivity was a risk factor comparable to smoking or obesity.

Lack of exercise causes an estimated six percent of coronary heart disease cases, seven percent of type 2 diabetes (the most common form) and 10 percent of breast and colon cancers, it said.
Reducing inactivity by 10 percent could eliminate more than half a million deaths every year, the report said, adding that the estimates were conservative.
The human body needs exercise to help the bones, muscles, heart and other organs function optimally, but populations are walking, running and cycling less and less as they spend more time in cars and in front of computers, the investigators said.

The Lancet series called for global efforts to promote physical exercise by improving pedestrian and cyclist safety on city roads, for example, more physical education at school or promoting access to free public exercise spaces.
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4.  Physical inactivity causes 1 in 10 deaths worldwide, study says
July 18, 2012, CNN, By Matt Sloane
Pasted from: <http://www.cnn.com/2012/07/18/health/physical-inactivity-deaths/index.html>
Researchers say physical inactivity has become a global pandemic.

 Story Highlights
•  Physical inactivity causes 1 in 10 deaths worldwide, series of studies in Lancet say
• Researchers suggest public health officials treat inactivity as a pandemic
• Inactivity often rises with age and is higher in women as well as in high-income countries
• Studies: Exercise events and better public transportation help improve physical activity

(CNN) — Physical inactivity causes 1 in 10 deaths worldwide, according to a series of studies released in British medical journal The Lancet, putting it on par with the dangers of smoking and obesity. The results also suggest that public health officials treat this situation as a pandemic.
Specifically, Harvard researchers say, inactivity caused an increase in deaths from coronary heart disease, type 2 diabetes, breast and colon cancers and caused more than 5.3 million deaths in 2008 worldwide.
If physical inactivity rates were to go down by even 10% to 20% worldwide, they say, it could save between a half-million and 1.3 million lives each year. This could also raise global life expectancy by almost a year.

“This summer, we will admire the breathtaking feats of athletes competing in the 2012 Olympic Games,” wrote Dr. I-Min Lee, a Harvard researcher and the lead author of an article accompanying the series of studies. “Although only the smallest fraction of the population will attain these heights, the overwhelming majority of us are able to be physically active at very modest levels, which bring substantial health benefits.”
This series of five studies was specifically timed to be released just days before the start of the 2012 Olympics in London next week, and each of the studies focused on one specific issue related to physical inactivity and its effect on global health.

Adults and children at increased risk
The first in the group of five studies suggested that one-third of adults, and close to 80% of adolescents worldwide, are at increased risk of disease as a result of physical inactivity.
According to the report, some 1.5 billion adults worldwide face a 20% to 30% increased risk of heart disease, diabetes and certain cancers.
Researchers also found that inactivity levels varied widely across the globe, with the lowest levels in Bangladesh (5%) and the highest levels in Malta (71%).
“In most countries, inactivity rises with age and is higher in women than in men [34% vs 28%],” wrote Dr. Pedro C. Hallal, a professor at the Universidade Federal de Pelotas in Brazil. “Inactivity is also increased in high-income countries.”

Why are some people more active?
The second study looked at why certain people and groups of people exercise while others do not.
The study authors found that previous research focused on individual-level factors such as age, sex and socioeconomic status, and they were conducted primarily in high-income countries. But they suggest future research focus on middle and lower-income countries.

“Research has been heavily concentrated in a few developed countries, most of which have stable or falling rates of noncommunicable diseases, rather than in low-income countries where understanding of evidence-based strategies for increasing physical activity is poor,” wrote Adrian Bauman, a researcher from the University of Sydney in Australia. “Targeting factors known to cause inactivity is key to improving and designing effective interventions to increase activity levels.”
Bauman and his colleagues found that health status, being male, young or wealthy tend to make people more physically active, as does family and societal support for physical activity.

What works to promote physical activity
The third article in The Lancet series looked at what specific programs and types of programs work to promote physical activity.
“Because even moderate physical activity such as walking and cycling can have substantial health benefits, understanding strategies that can increase these behaviors in different regions and cultures has become a public health priority,” wrote Gregory Heath, a researcher from the University of Tennessee and the lead author of this study.

Heath and his team found that the use of mass-media campaigns to promote exercise, as well as signs to remind people to be active — taking the stairs, for example — had some effect on getting people more active.
The team also found that free, public exercise events, creating an environment that was conducive to exercise (bike lanes and walking trails), and improving public transportation were more likely to improve physical activity.

“Overall, our findings showed the interventions to have consistent and significant effects on physical activity and behaviors,” Heath wrote. “Even though in some instances the effect sizes of these interventions were rather modest, they were large enough to translate into real population-level benefits if rolled out on a larger scale.”

Using mobile phones to get people active
The fourth study found that technology, and specifically cell phone technology, could be significant in helping people get fit.
“With the high prevalence of both physical inactivity and the rapid growth of the mobile phone sector in low-income and middle-income countries, there is a potential for population-level effects that could truly affect global health,” wrote Dr. Michael Pratt, a researcher from the Centers for Disease Control and Prevention.

Researchers believe that with more than 4 billion text messaging users worldwide, this could be an effective way to deliver health-conscious messages, particularly in low-income countries.
According to this report, Pratt and his team estimated that using Internet-based technologies could be twice as effective in middle-income countries as in high-income countries, given that 71% of the world’s population lives in these countries and many have access to cell phones.
“This is a big challenge, but marked progress in countries such as Colombia and Brazil suggests that it is also an achievable challenge,” he wrote.

Obesity should be considered a pandemic
The final report suggests that physical inactivity should be recognized as a global pandemic and should be treated like any other infectious-disease pandemic would be.
“The role of physical inactivity continues to be undervalued despite robust evidence of its protective effects,” wrote Harold Kohl, a researcher at the University of Texas School of Public Health and lead author of this study. “The response … has been incomplete, unfocused and most certainly understaffed. … The effect of this tardiness has been to put physical activity in reverse gear compared with population trends and advances in tobacco and alcohol control and diet.”

Kohl called on countries — low, middle and high-income — to work across disciplines to fix this problem.
“Physical inactivity is an issue that crosses many sectors and will require collaboration, coordination and communication with multiple partners,” he wrote, citing specifically city and community planners, transportation engineers, schools, parks and recreation officials and the media.

He says that almost 75% of World Health Organization member countries have some sort of plan to improve physical activity, but only 55% of the plans have been put into effect and only 42% of the plans in effect are well-funded.
“Substantial improvements in the infrastructure of planning and policy, leadership and advocacy, workforce training and surveillance must be realized,” he said.
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5.  Two out of Three Very Obese Kids Already Have Heart Disease Risk Factors: High Blood Pressure, Cholesterol, Blood Glucose Evident Even in Under-12s
23 July 2012, ScienceDaily,
http://www.sciencedaily.com/releases/2012/07/120723193205.htm

Two out of three severely obese kids already have at least one risk factor for heart disease, suggests research published online in “Archives of Disease in Childhood”.
The prevalence and severity of childhood obesity has been rising worldwide, but little research has been carried out on the underlying health problems that children with severe weight problems have, say the authors.
They base their findings on data supplied by pediatricians to the Dutch Paediatric Surveillance Unit between 2005 and 2007.

During this period, doctors treating all new cases of severe obesity in children from the ages of 2 to 18 across The Netherlands were asked to supply information on their patients’ cardiovascular risk factors, including high blood pressure, fasting blood glucose levels, and blood fats (lipids).
The definition of severe obesity started at a body mass index (BMI) of 20.5 for a 2 year old, at 31 for a 12 year old, and at 35 for an 18 year old.
Over the three years, most (87% to 94%) of pediatricians submitted their monthly findings on every severely obese child they treated to the surveillance unit, providing information on 500 children in all.

When pediatricians were contacted again, with a request for further data, 363 responded and 307 of their children were correctly classified as severely obese.
Just over half (52%) of these 307 children were boys. They tended to be more severely obese at the younger end of the age spectrum; the reverse was true of girls. Full information on cardiovascular risk factors was available for 255 (83%).
Two out of three (67%) had at least one cardiovascular risk factor. Over half (56%) had high blood pressure; a similar proportion (54%) had high levels of low density ‘bad’ cholesterol; one in seven (14%) had high fasting blood glucose; and just under 1 per cent already had type 2 diabetes.

And “remarkably” say the authors, almost two thirds (62%) of those aged 12 and under had one or more cardiovascular risk factors. Only one child’s obesity was attributable to medical rather than lifestyle factors.
Nearly one in three severely obese children came from one parent families.
“The prevalence of impaired fasting glucose in [these children] is worrying, considering the increasing prevalence worldwide of type 2 diabetes in children and adolescents,” write the authors.
“Likewise, the high prevalence of hypertension and abnormal lipids may lead to cardiovascular disease in young adulthood,” they add.
And they conclude: “Internationally accepted criteria for defining severe obesity and guidelines for early detection and treatment of severe obesity and [underlying ill health] are urgently needed.”
The above story is reprinted from materials provided by BMJ-British Medical Journal, via EurekAlert!, a service of AAAS.
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6.  We’re getting sicker: More Americans have a chronic health condition
Vitals on NBCNEWS.com
http://vitals.nbcnews.com/_news/2012/07/31/13053268-were-getting-sicker-more-americans-have-a-chronic-health-condition?lite

MyHealthNewsDaily
More than one in five middle-aged U.S. adults, and nearly half of adults over age 65, have more than one chronic health condition, such as hypertension and diabetes, according to a new government report.
The report said that in 2010, 21.3 percent of women and 20.1 percent of men between ages 45 and 64 had at least two chronic health conditions. In 2000, the rate among men was 15.2 percent, and among women it was 16.9 percent.
Increases were also seen in adults older than 65, with 49 percent of men and 42.5 percent of women reporting in 2010 that they had at least two chronic health conditions. In 2000, the rates were 39.2 percent of men and 35.8 percent of women.

Treatment for people with multiple chronic conditions is complex, the researchers said. By looking at trends in the rates of people with more than one condition, researchers are better able to make decisions about managing and preventing these diseases, and they can make better predictions about future health-care needs, they said.
The increases were due mainly to rises in three conditions: hypertension, diabetes and cancer, according to the report. These increases may be due to more new cases, or due to people living longer with the conditions because of advances in medical treatments.

The report also said that middle-aged adults with at least two chronic conditions had increasing difficulty, between 2000 and 2010, in getting the care and prescription drugs they needed because of cost. In 2010, 23 percent reported not receiving or delaying the medical care they needed, and 22 percent said they didn’t get the prescriptions they needed. In 2000, these rates were 17 percent and 14 percent, respectively.

The CDC does not consider obesity itself to be a health condition; rather, it is a risk factor for other conditions, such as heart disease, cancer and diabetes. The obesity rate in the U.S. increased in the United States over the past 30 years, but has leveled off in recent years, the report said.
The report is based on data gathered during the National Health Interview Survey, in which participants complete a detailed questionnaire about their health status and health-related behaviors. Participants reported whether a physician has diagnosed them with any of nine chronic health conditions: hypertension, heart disease, diabetes, cancer, stroke, chronic bronchitis, emphysema, current asthma and kidney disease.

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Wednesday, July 4, 2012 · 12:10 AM

Amoxicillin

(Survival Manual/ b. Medical/ c) General Clinic/ Amoxicillin)

Disclaimer
The information, ideas, and suggestions in the 4dtraveler.net blog are not intended as a substitute for professional advice. Before following any suggestions contained in this post, you should consult your personal physician. Neither the author or Word Press shall be liable or responsible for any loss or damage allegedly arising as a consequence of your use or application of any information or suggestions in this blog.

Pasted from <http://www.drugs.com/amoxicillin.html>
Pasted from <http://www.medicinenet.com/amoxicillin/article.htm>
Pasted from <http://en.wikipedia.org/wiki/Amoxicillin>

Amoxicillin brand names: Amoxil, Dispermox, Moxatag, Trimox, Wymox

A.   Amoxicillin and its use
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 Below, pasted from <http://www.drugs.com/amoxicillin.html>
What is amoxicillin?
Amoxicillin is a penicillin antibiotic. It fights bacteria in your body.
Amoxicillin is used to treat many different types of infections caused by bacteria, such as ear infections, bladder infections, pneumonia, gonorrhea, and E. coli or salmonella infection. Amoxicillin is also sometimes used together with another antibiotic called clarithromycin (Biaxin) to treat stomach ulcers caused by Helicobacter pylori infection. This combination is sometimes used with a stomach acid reducer called lansoprazole (Prevacid).
Amoxicillin may also be used for purposes not listed in this medication guide.

Important information about amoxicillin
Do not use this medication if you are allergic to amoxicillin or to any other penicillin antibiotic, such as ampicillin (Omnipen, Principen), dicloxacillin (Dycill, Dynapen), oxacillin (Bactocill), penicillin (Beepen-VK, Ledercillin VK, Pen-V, Pen-Vee K, Pfizerpen, V-Cillin K, Veetids), and others.

Before using amoxicillin, tell your doctor if you are allergic to cephalosporins such as Omnicef, Cefzil, Ceftin, Keflex, and others. Also tell your doctor if you have asthma, liver or kidney disease, a bleeding or blood clotting disorder, mononucleosis (also called “mono”), or any type of allergy.

Amoxicillin can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking amoxicillin. Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Amoxicillin will not treat a viral infection such as the common cold or flu. Do not share this medication with another person, even if they have the same symptoms you have.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking amoxicillin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Preparions: Capsules: 250 and 500 mg. Tablets: 500 and 875 mg. Chewable tablets: 125, 200, 250, and 400 mg. Powder for suspension: 50 mg/ml ; 125, 200, 250, and 400 mg/5 ml. Tablets for suspension: 200 and 400 mg
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Below, pasted from <http://www.medicinenet.com/amoxicillin/article.htm>
Storage: Store Amoxil capsules as well as 125 and 250 mg dry powder at or below 20°C (68°F); tablets, chewable tablets, as well as 200 and 400 mg dry powder should be stored at or below 25°C(77°F). Store Trimox capsules and unreconstituted powder at or below 20°C (68°F) and chewable tablets at room temperature 15°-30°C (59°-86°F). Powder that has been mixed with water should be discarded after 14 days. Refrigeration is preferred but not required for powder mixed with water.

Prescribed for: Amoxicillin is used to treat infections due to organisms that are susceptible to the effects of amoxicillin. Common infections that amoxicillin is used for include infections of the middle ear, tonsils, throat, larynx (laryngitis), bronchi (bronchitis), lungs (pneumonia), urinary tract, and skin. It also is used to treat gonorrhea.

Dosing: For most infections in adults the dosing regimens for amoxicillin are 250 mg every 8 hours, 500 mg every 8 hours, 500 mg every 12 hours or 875 mg every 12 hours, depending on the type and severity of infection.

For the treatment of adults with gonorrhea, the dose is 3 g given as one dose.

For most infections, children older than 3 months but less than 40 kg are treated with 25 mg/kg/day in divided doses every 12 hours, 20 mg/kg/day in divided doses every 8 hours, 40 mg/kg/day in divided doses every 8 hours or 45 mg/kg/day in divided doses every 12 hours depending on type and severity of the infection.
Amoxicillin can be taken with or without food.

 Drug interactions: Amoxicillin is rarely associated with important drug interactions.

Side effects: Side effects due to amoxicillin include diarrhea, dizziness, heartburn, insomnia, nausea, itching, vomiting, confusion, abdominal pain, easy bruising, bleeding, rash, and allergic reactions. Individuals who are allergic to antibiotics in the class of cephalosporins may also be sensitive to amoxicillin.

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Below, pasted from <http://www.drugs.com/amoxicillin.html>
Before taking amoxicillin
Do not use this medication if you are allergic to amoxicillin or to any other penicillin antibiotic, such as:

  • ampicillin (Omnipen, Principen);
  • dicloxacillin (Dycill, Dynapen);
  • oxacillin (Bactocill); or
  • penicillin (Bicillin C-R, PC Pen VK, Pen-V, Pfizerpen, and others).

To make sure you can safely take amoxicillin, tell your doctor if you are allergic to any drugs (especially cephalosporins such as Omnicef, Cefzil, Ceftin, Keflex, and others), or if you have any of these other conditions:

  • asthma;
  • liver disease;
  • kidney disease;
  • mononucleosis (also called “mono”);
  • a history of diarrhea caused by taking antibiotics; or
  • a history of any type of allergy.

FDA pregnancy category B. Amoxicillin is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Amoxicillin can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking amoxicillin. Amoxicillin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

 How should I take amoxicillin?

  • Take amoxicillin exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
  • You may take amoxicillin with or without food.
  • Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
  • You may place the liquid directly on the tongue, or you may mix it with water, milk, baby formula, fruit juice, or ginger ale. Drink all of the mixture right away. Do not save any for later use.
  • The chewable tablet should be chewed before you swallow it.
  • Do not crush, chew, or break an extended-release tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time.
  • To be sure this medicine is helping your condition and is not causing harmful effects, your blood will need to be tested often. Your liver and kidney function may also need to be tested. Visit your doctor regularly.
    • If you are being treated for gonorrhea, your doctor may also have you tested for syphilis, another sexually transmitted disease.
    • If you are taking amoxicillin with clarithromycin and/or lansoprazole to treat stomach ulcer, use all of your medications as directed. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor’s advice.
  • Take amoxicillin for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Amoxicillin will not treat a viral infection such as the common cold or flu. Do not share this medication with another person, even if they have the same symptoms you have.
  • Amoxicillin can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using this medication.
  • Store this medication at room temperature away from moisture, heat, and light. You may store liquid amoxicillin in a refrigerator but do not allow it to freeze. Throw away any liquid amoxicillin that is not used within 14 days after it was mixed at the pharmacy.


What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. 

What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include confusion, behavior changes, a severen skin rash, urinating less than usual, or seizure (black-out or convulsions).

 What should I avoid while taking amoxicillin?
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking amoxicillin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to. 

Amoxicillin side effects
Get emergency medical help if you have any of these signs of an allergic reaction to amoxicillin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

  • white patches or sores inside your mouth or on your lips;
  • fever, swollen glands, rash or itching, joint pain, or general ill feeling;
  • severe blistering, peeling, and red skin rash;
  • pale or yellowed skin, yellowing of the eyes, dark colored urine, fever, confusion or weakness;
  • severe tingling, numbness, pain, muscle weakness; or
  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin.

Less serious amoxicillin side effects may include:

  • stomach pain, nausea, vomiting;
  • vaginal itching or discharge;
  • headache; or
  • swollen, black, or “hairy” tongue.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

 What other drugs will affect amoxicillin?
Tell your doctor about all other medicines you use, especially:

  • An antibiotic such as azithromycin (Zithromax), clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), or telithromycin (Ketek);
  • Sulfa drugs (Bactrim, Gantanol, Gantrisin, Septra, SMX-TMP, and others); or
  • A tetracycline antibiotic such as demeclocycline (Declomycin), doxycycline (Adoxa, Doryx, Oracea, Vibramycin), minocycline (Dynacin, Minocin, Solodyn, Vectrin), or tetracycline (Brodspec, Panmycin, Sumycin, Tetracap).

This list is not complete and other drugs may interact with amoxicillin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
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Below, pasted from <http://en.wikipedia.org/wiki/Amoxicillin>
Modes of Delivery
Amoxicillin is usually taken orally, commonly as a tablet or a suspension, but can also be injected. There is recent research with mice that indicates successful delivery using intraperitoneally injected amoxicillin-bearing microparticles.

Side-effects
Side-effects include nausea, vomiting, rashes, and antibiotic-associated colitis. Loose bowel movements (diarrhea) also may occur. Rarer, but patient-reported, side-effects include mental changes, lightheadedness, insomnia, confusion, anxiety, sensitivity to lights and sounds, and unclear thinking. Immediate medical care is required upon the first signs of these side-effects.

The onset of an allergic reaction to amoxicillin can be very sudden and intense – emergency medical attention must be sought as quickly as possible. The initial onset of such a reaction often starts with a change in mental state, skin rash with intense itching (often beginning in fingertips and around groin area and rapidly spreading), and sensations of fever, nausea, and vomiting. Any other symptoms that seem even remotely suspicious must be taken very seriously. However, more mild allergy symptoms, such as a rash, can occur at any time during treatment, even up to a week after treatment has ceased. For some people who are allergic to amoxicillin the side effects can be deadly.

Use of the amoxicillin/clavulanic acid combination for more than one week has caused mild hepatis in some patients. Young children having ingested acute overdoses of amoxicillin manifested lethargy, vomiting and renal dysfunction.

 Nonallergic amoxicillin rash
Somewhere between 3% and 10% of children taking amoxicillin (or ampicillin) show a late-developing (>72 hours after beginning medication and having never taken penicillin-like medication previously), often itchy rash, which is sometimes referred to as the “amoxicillin rash.” The rash can also occur in adults.

The rash is described as maculopapular or morbilliform (measles-like; therefore, in medical literature, it is called “amoxicillin-induced morbilliform rash”). It starts on the trunk and can spread from there. This rash is unlikely to be a true allergic reaction, and is not a contraindication for future amoxicillin usage, nor should the current regimen necessarily be stopped. However, this common amoxicillin rash and a dangerous allergic reaction cannot easily be distinguished by inexperienced persons, and therefore a healthcare professional should be consulted if a rash develops.

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B.    Fish Mox (Amoxicillin)
AMAZON.COM: Fish Mox (Amoxicillin), 250mg, 100 Capsules, $16.28 + free shipping.
•  Standard pharmacy quality Amoxicillin antibiotic
•  Labeled for use in fish tanks, in pull apart capsules for easy use – 250 mg. strength

Product Description
Fish-Mox exerts a bactericidal action on gram positive and some gram negative bacteria. Useful for control of some common bacterial diseases of fish including aeromonas and pseudomonas genera and mysobacterial group (gill diseases, chondrococcus).

Add contents of one capsule (250 mg) into aquarium for each 10 gallons  of water to be treated. It is recommended that extended medication baths continue for a minimum of 5 days & for not more than 10 days. Discontinue treatment if no improvement is noted within 5 days.
[10 gallons water per 250mg Amoxicillin * 8.3 pounds water per gallon water =83 pounds of water per 250mg Amoxicillin
or 500mg Amoxicillin per 166 lbs body weight.]

 Customer reviews:
‘For most infections, the dosage weight of this drug is 500mg for an average 160-200 lbs adult, taken 2 to 3 times a day. Take a total of 1 Gram (1000  mg) per day, using 500mg Fish Mox that would be two pills a day. Water mass is considered in determining dosage, since this is a Penicillin class of drug. You can double the dosage for short term, serious infections. A bottle should cost $25 for 100 Pills. It’s a human grade pharmaceutical medication, the same pills humans take.’ Pasted from <http://www.godlikeproductions.com/forum1/message813524/pg1>

1)  Review of product “Fish Mox“, February 11, 2007 By Cathy F. Elkiss (Gettysburg, PA USA This review is from: Fish Mox (Amoxicillin) 250mg, 100 Capsules (Misc.) “I run a sanctuary for abandoned and homeless cats in my community, and I like to keep a supply of amoxicillin and ampicillin on hand for treating the occassional upper respiratory infections to which these animals are prone. They are both excellent products – safe, inexpensive, easy to use and most important, effective. Thank you! Cathy Elkiss”
2)  It’s The Real Stuff!!, April 17, 2009 By A.A.Roxx (PA) This review is from: Fish Mox (Amoxicillin) 250mg, 100 Capsules (Misc.) “I had a bad sinus infection, tried to get a doctors appointment and was told I had to wait 2 weeks. I ordered the Fishmox received it fast from Amazon, took it 4 times a day and within 5 days the sinus infection was gone! Stayed on it for 10 days total. I saved $100 doctors visit and $90 Amoxicillin purchase (I have no medical insurance). It is real Amoxicillin. It worked for me.’
3)   Pharmaceutical Grade Amoxicillin, February 25, 2011 By J. Ellison (Silverton, oregon) – This review is from: Fish Mox (Amoxicillin) 250mg, 100 Capsules (Misc.) “Fish-Mox is pharmaceutical grade Amoxicillin made in Tolleson AZ, & is same as Human Antibiotic. Capsule has FDA lot & Registration number printed on each Cap. Is non-suspended yellow powder in a pull-apart gelatin capsule. It’s the Real-McCoy; Excellent value. JE Oregon”
4)  Fish Mox (Amoxicillin) 250mg, 100 Capsules, February 2, 2011 By nubbles. This review is from: Fish Mox (Amoxicillin) 250mg, 100 Capsules (Misc.) ‘This is the real deal pharmacy grade Amoxicillin, 250mg, 100 caps. Of course it’s for aquarium use only, but if you accidentally take some yourself, for let’s say calming your abscessed tooth down, you will be very OK. and if your dog accidentally eats a couple a day it might accidentally calm down his ear yeast infection. Order with confidence! and upon arrival you can inspect the pills, enter the ID on them ‘westward 938’ into google and you will see info from FDA and others telling you these are the real deal.”
5)  100% Amoxicillan, See Below……, December 10, 2010 By Westfin. This review is from: Fish Mox (Amoxicillin) 250mg, 100 Capsules (Misc.) “I just received my order of Fish Mox, which will be used for my fish, but I was curious so I looked up the name and number from one of the capsules and here are the results: <http://www.drugs.com/imprints/west-ward-938-15375.html>&#8221; [“West-ward 938”, Pill imprint West-ward 938 has been identified as Amoxicillin 250 mg. Amoxicillin is used in the treatment of urinary tract infection; bacterial infection; bladder infection; bronchitis; upper respiratory tract infection (and more), and belongs to the drug class aminopenicillins. There is no proven risk in humans during pregnancy”….]

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See also the informative YouTube videos with, “Patriot Nurse”. The following link takes you to her discussion of the  “Top 5 Antibiotics for SHTF”:

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http://www.youtube.com/watch?v=DOfthwm_v3E&feature=relmfu

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See also the book, “The Doom and Bloom(tm) Survival Medicine Handbook” (Keep your loved ones healthy in every disaster, from wildfires to a complete societal collapse),  by  Joseph Alton, M.D. and AMY ALTON, A.R.N.P., sold through Amazon.com

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Monday, April 16, 2012 · 12:10 AM

Eye injuries

(Survival Manual/6. Medical/c) General Clinic/Eye injuries)

 A.  First Aid
Take prompt action and follow the steps below if you or someone else has an eye-related injury.
Pasted from <http://www.nlm.nih.gov/medlineplus/ency/article/000054.htm>

Small object on the eye or eyelid
The eye will often clear itself of tiny objects, like eyelashes and sand, through blinking and tearing. If not, take these steps:
1.  Tell the person not to rub the eye. Wash your hands before examining it.
2.  Examine the eye in a well-lighted area. To find the object, have the person look up and down, then side to side.
3.  If you can’t find the object, grasp the lower eyelid and gently pull down on it to look under the lower eyelid. To look under the upper lid, you can place a cotton-tipped swab on the outside of the upper lid and gently flip the lid over the cotton swab.
4.  If the object is on an eyelid, try to gently flush it out with water. If that does not work, try touching a second cotton-tipped swab to the object to remove it.
5.  If the object is on the eye, try gently rinsing the eye with water. It may help to use an eye dropper positioned above the outer corner of the eye. DO NOT touch the eye itself with the cotton swab.
A scratchy feeling or other minor discomfort may continue after removing eyelashes and other tiny objects. This will go away within a day or two. If the person continues to have discomfort or blurred vision, get medical help.

Object stuck or embedded in the eye
1.  Leave the object in place. DO NOT try to remove the object. DO NOT touch it or apply any pressure to it.
2.  Calm and reassure the person.
3.  Wash your hands.
4.  Bandage both eyes. If the object is large, place a paper cup or cone over the injured eye and tape it in place. Cover the uninjured eye with gauze or a clean cloth. If the object is small, cover both eyes with a clean cloth or sterile dressing. Even if only one eye is affected, covering both eyes will help prevent eye movement.
5.  Get medical help immediately.

Chemicals in the eye
1.  Flush with cool tap water immediately. Turn the person’s head so the injured eye is down and to the side. Holding the eyelid open, allow running water from the faucet to flush the eye for 15 minutes.
2.  If both eyes are affected, or if the chemicals are also on other parts of the body, have the victim take a shower.
3.  If the person is wearing contact lenses and the lenses did not flush out from the running water, have the person try to remove the contacts AFTER the flushing procedure.
4.  Continue to flush the eye with clean water or saline while seeking urgent medical attention.
5.  After following the above instructions, seek medical help immediately.

Eye cuts, scratches, or blows
1.  If the eyeball has been injured, get medical help immediately.
2.  Gently apply cold compresses to reduce swelling and help stop any bleeding. DO NOT apply pressure to control bleeding.
3.  If blood is pooling in the eye, cover both of the person’s eyes with a clean cloth or sterile dressing, and get medical help.

Eye lid cuts
1.  Carefully wash the eye. Apply a thick layer of bacitracin, mupirocin, or other antibacterial ointment on the eyelid. Place a patch over the eye. Seek medical help immediately.
2.  If the cut is bleeding, apply gentle pressure with a clean, dry cloth until the bleeding subsides.
3.  Rinse with water, cover with a clean dressing, and place a cold compress on the dressing to reduce pain and swelling.

DO NOT
•  DO NOT press or rub an injured eye.
•  DO NOT remove contact lenses unless rapid swelling is occurring, there is a chemical injury and the contacts did not come out with the water flush, or you cannot get prompt medical help.
•  DO NOT attempt to remove a foreign body that appears to be embedded in any part of the eye. Get medical help immediately.
•  DO NOT use cotton swabs, tweezers, or anything else on the eye itself. Cotton swabs should only be used on the eyelid.
•  DO NOT attempt to remove an embedded object
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B.  Foreign Body, Eye Treatment
<http://www.emedicinehealth.com/foreign_body_eye/page7_em.htm>

Self-Care at Home
You should be able to care for minor debris in your eye at home. If you have trouble removing something in your eye or if a larger or sharper object is involved, you should seek medical attention. If you are wearing a contact lens, it should be removed prior to trying to remove the foreign body. Do not put the contact lens back into your eye until your eye is completely healed.
For minor foreign bodies, such as an eyelash, home care should be adequate.
1.  Begin by rinsing your eye with a saline solution (the same solution used to rinse contact lenses). Tap water or distilled water may be used if no saline solution is available. Water will effectively flush out your eye, but the chlorine in most tap water can cause varying levels of irritation. How you wash out your eye is less important than getting it washed out with great amounts of water.
…..•  A water fountain makes a great eye wash. Just lean over the fountain, turn on the water, and keep your eye open.
…..•  At a sink, stand over the sink, cup your hands, and put your face into the running water.
…..•  Hold a glass of water to your eye and tip your head back. Do this many times.
…..•  If you are near a shower, get in and put your eye under the running water.
…..•  If you are working outside, a garden hose running at a very modest flow will work.
…..•  If washing out your eye is not successful, the object can usually be removed with the tip of a tissue or a cotton swab.
2.  Pull back the eyelid by pulling down on the bottom edge of the lower lid or by pulling up on the upper edge of the upper lid.
3.  Look up when evaluating for a foreign body under the lower lid.
4..  Look down when evaluating for a foreign body under the upper lid. You will often need someone to help you in this case.
5.  Be very careful not to scrape the tissue or the cotton swab across your cornea, the clear dome over the iris.
6.  For larger foreign bodies or metal pieces, you should seek medical care, even if you are able to safely remove them at home.
…..•  If the foreign body is easily accessible and has not penetrated your eyeball, you may be able to remove it carefully with a cotton swab or a tissue.
…..•  If you have any question about penetration of the eye, do not remove the object without medical assistance.
…..•  If you cannot remove the object or if you continue to have the sensation that something is in your eye even after the debris is removed, you should seek medical care.
7.  After the foreign body is removed, your eye may be red and tearing.
8.  You may protect your eye by cutting the top part off of a Styrofoam or paper cup and placing the cup over your eye. If you place a cup over your eye, do not put any pressure on the injured eye, because it could cause additional injury to your eye.
…..•  This cup can be taped in place and will form a cover over your eye.
…..•  It is very important not to rub your eye or to apply any pressure to your eye. If you have punched a hole in your eye (called a ruptured globe or eyeball), you can do significant damage by pressing or rubbing your eye. This is especially true with small children who will rub their eyes to try to remove the debris.

Medical Treatment
•  For scratches on your cornea (called corneal abrasions), the usual treatment is an antibiotic ointment and/or antibiotic eye drops and pain medicine. If the abrasion is large (greater than 50% of the corneal surface), then it may also be treated with a patch.
•  Any noted damage to the iris, the lens, or the retina requires immediate evaluation by an ophthalmologist and may or may not require surgery.
•  A ruptured eyeball requires surgery by an ophthalmologist.
•  If no other injury is noted, hyphema (blood in between the cornea and the iris) requires close follow-up care with an ophthalmologist.
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C.  Corneal Abrasion
<http://www.utahmountainbiking.com/firstaid/eyes.htm>
Scenario: A branch brushes your face and there’s sharp pain in your eye. It hurts to blink.
[Image at right: Description: A corneal abrasion is a scratch over the clear part of the eye. It causes an irritable   or sharp “foreign body” sensation in the eye. Often it feels like   something scratchy is stuck under the upper eyelid, because the eyelid rubs over the scratch as it blinks. With a very minor corneal abrasion, the eye may simply feel “dry.” The abrasion usually heals quickly, often overnight.
Except for a   little redness, the eye with a corneal abrasion often looks normal. Painful eyes should be checked, regardless of how “normal” they look.]

Concerns:
A large abrasion may take a long time to heal, and can cause an inflammatory reaction within the eyeball. Sometimes a sharp object cuts into the deep tissue of the cornea. This can permanently change your vision. Debris in the scratch, such as shreds of tree bark, can lead to infection and ulceration of the cornea. There may still be a scratchy particle stuck under your upper eyelid, and it will continue to damage your cornea. So don’t take chances with your eyeballs. If the scratchy sensation hasn’t gone away after you get back to your car (around an hour), head for the ER.

See the doctor if:
– the scratchy sensation doesn’t go away promptly
– vision is blurry
– the eye is sensitive to light
– there is deep pain
– you develop mucous in the eye

Immediate care:
Don’t rub the eye. It’s best to rest a minute, letting the eye water, with the eyelids as relaxed as possible. If the symptoms don’t go away, turn around and head back.

Foreign Body
You get a chunk of something in your eye. The eye begins to sting and water.
[Image at left: Description: Foreign material in the eye can scratch the cornea. There may be an irritable, stinging, or sharp “foreign body” sensation in the eye.  Sharp bits of sand or wood can rapidly dig themselves into the tissue of the   cornea or underside of the upper lid.
Foreign body under the lower eyelid margin. Particles are   easier to remove here, but are actually more common under the upper eyelid.]

Concerns:
The foreign matter can damage the cornea — the part of the eye you see through. Debris in the eye can lead to infection and ulceration of the cornea. A scratchy particle under your upper eyelid will continue to scratch up your cornea. So don’t take chances with your eyeballs. If the scratchy sensation hasn’t gone away after you get back to your car (around an hour), head for the ER.

See the doctor if:
– the scratchy sensation doesn’t go away quickly
– vision is blurry
– the eye is sensitive to light
– there is deep pain
– you develop mucous in the eye

Immediate care:
Don’t rub the eye. (Rubbing the eye can grind loose sharp particles into the cornea!) It’s best to rest a minute, letting the eye water, with the eyelids as relaxed as possible. If the symptoms don’t go away, turn around and head back.

If you’re far out in the woods and the eye is extremely watery and painful, you can try to dislodge the particle. Usually it will be under the upper eyelid. Assuming your squirt bottle has clean water in it, flush the eye. Turn your head sideways, so the squirt bottle can aim slightly downward as it faces the eye. With the eyelids gently closed, put your index finger and thumb together and press against the eye, as though you were going to take hold of your eyelids.

[ Image at left: While holding gentle pressure, spread the thumb and finger to pull the lids aside. Now squirt for several seconds. If the scratching continues, grasp the upper eyelashes and pull the eyelid straight forward away from the eye. Squirt up into the slit between the eyelid and eyeball. Then rest a minute to see if   the symptoms subside.     Position of  the squirt bottle to flush debris from the eye. The victim is lying down, and   the bottle is aiming towards the gap between the retracted upper eyelid and   eyeball. The rescuer is pulling up on the brow and upper eyelid, while the   victim looks towards the feet.]

If you can feel exactly where the particle is, you could try to rub it off. Wash your hands thoroughly. Now pull the eyelid forward, with your thumb on the underside. As the eyelid comes forward, put a free finger (middle finger) against the cleft between the eyelid and eyebrow, then rotate the pad of the thumb so slips under the edge of the eyelid. Run it sideways along the underside of the eyelid where you feel the particle. Be careful about this — not every doctor would think it’s a good idea — because you’re getting germs from your finger into the eye. And (unless you succeed in removing a particle) the more you mess with your eye, the worse it will feel.

If the foreign body sensation persists, leave the eye alone. There may be an abrasion of the cornea, which feels exactly like something scratchy is still in the eye. Go have the eye

D.  UV Eye damage
<http://vision.about.com/od/eyeexaminations/a/sun_protection.htm>
<http://en.wikipedia.org/wiki/Photokeratitis>
Ultraviolet radiation harms more than just your skin. Too much unfiltered sunlight can harm your eyes by damaging the lens and even the retina.
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1.  Cataracts
•  Overexposure to the sun’s UV rays can damage the lens of the eye and increase your risk of developing cataracts.
•  Cataracts occur when the lens of the eye becomes cloudy, rendering all images blurry and out of focus.
•  Cataracts are the leading cause of blindness.
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** See also the 4dtraveler post: (Survival Manual/6. Medical/c) General Clinic/Eyeglass repair & emergency glasses) which discusses how to make emergency glasses for several survival scenerios.

2.  Retinal damage – Macular Degeneration
•  Prolonged exposure to UV radiation can damage the retina (the sensitive lining of the eye used for sight).
•  Macular degeneration occurs when the macula (an area in the retina) is damaged, thus causing loss of central vision.
•  While studies have yet to prove what causes macular degeneration, it is possible that overexposure to the sun’s UV light may be a contributing factor.
•  Most forms of retinal damage are irreversible.

3. Snow Blindness
Exposure  to  reflected sunlight from  snow, ice, or water, even on grey overcast days, can result in  sunburn of the tissues comprising the  surface  of  the   eye, as well as  the retina, producing snow blindness. Symptoms. Symptoms  may not be apparent until  up  to 12 hours after exposure. The   eyes initially  feel  irritated and  dry; then, as  time passes, eyes feel as though they are full of  sand. Blinking and moving the eyes may be extremely painful.  The eyelids are usuallyred, swollen, and difficult  to open.

Remedial Action: A  mild case will heal spontaneously in a few days, but you can  obtain some relief by applying cold compresses and a lightproof  bandage.  An ophthalmic  ointment can be  applied hourly to relieve pain and lessen the inflammatory reaction.

Prevention: Snow blindness can be prevented by constant  use  of   sunglasses or a  tinted helmet  visor.  If  the  glasses or helmet are lost, an emergency  set of goggles can be made from a  thin piece of leather, cardboard, or other lightproof material. Cut the material the width of the face with  horizontal  slits over the eyes. These  improvised  goggles can be held in place with string or cord from the parachute shroud lines  attached to the  sides and tied  at  the back of the head.

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Thursday, March 22, 2012 · 12:10 AM

Personal Protective Equipment

(Survival Manual / 6. Medical / c) General Clinic / Personal Protective Equipment)

Personal Protection Equipment (PPE) by hazard
<http://en.wikipedia.org/wiki/Personal_protective_equipment#Biological_hazard_protection>
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Biological hazard protection
Protective equipment for biological hazards includes masks worn by medical personnel (especially in surgery to avoid infecting the patient but also to avoid exposing the personnel to infection from the patient.) Gloves, frequently changed, are used to prevent infection but also transfer between patients.

*** PPE should always be regarded as a ‘last resort’ to protect against risks to safety and health.

Ballistic
Ballistic personal protective equipment (or armor) is used in combat by soldiers and in lesser conflicts by law enforcement.

Blunt Trauma
Law enforcement and Corrections officers wear Blunt Trauma PPE for crowd management, civil disturbances, cell extractions, riot control, violent disturbances, and other emergency response operations.

Fire
Fire proximity suit

Sports
Protective clothing is also worn for contact sports, such as ice hockey and American football. Baseball players wear sliding shorts and a cup under their pants. See baseball clothing and equipment, cuirass, goalie mask, jockstrap. Law in many countries requires protective headgear and eyewear for riding a motorcycle.

Air-Purifying Respirator
Respirators such as “gas masks” and particle respirators filter chemicals and gases or airborne particles. A second type of respirator protects users by providing clean, respirable air from another source. This type includes airline respirators and self-contained breathing apparatus (SCBA). In work environments, respirators are used when adequate ventilation is not available or other engineering control systems are not feasible.
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Biological & Chemical Hazard

1.  Principles for using biological (and chemical ) Personal Protective Equipment (PPE)
In all cases, the following principles apply:
•  PPE reduces but does not completely eliminate the possibility of  infection (contamination).
•  PPE is only effective if used correctly and at all times where contact may occur.
•  Any contact between contaminated (used) PPE and surfaces / clothing / people outside the isolation area must be avoided.
•  Used PPE must be sealed in appropriate disposal bags and sterilized or decontaminated. If staff temporarily leave the isolation area, a complete change of PPE and hand washing required.
•  The use of PPE does not replace basic hygiene measures such as hand-washing, washing is still essential to prevent transmission.
•  Exposure to the infected patientt should be kept to an absolute minimum necessary for the level of care required.

Who should use Personal Protective Equipment?
•  All those who are handling infected or suspected to be infected poultry and poultry products. These include cullers and animal husbandry/veterinary staff.
•  All doctors, nurses and health care workers who provide direct patient care to avian influenza cases (keep to minimum necessary for patients’ condition);
•  All support staff including medical aides, X-ray technicians, cleaners, transport staff, laundry staff (keep staff to the minimum necessary, designate avian influenza laundry staff, etc.);
•  All laboratory staff who handle patient specimens from suspect cases (keep to the minimum the staff necessary for laboratory procedures);
•  Family members who care for avian influenza patients (visits should be avoided where possible); The patient(s) should wear a mask (N95 preferable) when other people are in the isolation area. Contacts and international travelers during home isolation/quarantine must wear a mask (N95 preferable).

Personal Protective Equipment (lowest level threats)
The items included are:
•  Masks (N-95; N/P/R-100, If not available N80 or surgical masks as last resort)
•  Gloves
•  Gloves and aprons
•  Hair Covers
•  Eye protective ware (goggle)
•  Boots or shoe covers
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2.  Basic Sanitation techniques (If you need to wear PPE then you should be following the steps listed below):
Hand washing
•  It is the single most important and effective component for preventing the transmission of infection and removal of contamination.
•  Running water and soap with friction should be ideally used for 15 to 20 seconds.
•  It is important to dry hands after washing.
•  A 70% alcohol-based hand rub solution after hand washing can be used.

Hand washing  should be done:
•  After removing gloves
•  Before and after patient contact or contact with potentially infected material
•  After contact with blood and body fluids
•  After taking samples
•  After taking blood-pressure or vital signs from patient
•  After using bath room
•  After blowing/wiping nose
•  Before eating and preparing food.
•  When leaving the isolation unit.

Waste disposal
The practices as approved by the Hospital Infection Control Committee or hospital authorities must be followed. Some of these are:
•  Waste should be collected in designated color coded plastic bags for sterilization and disposal.
•  Double bag system for transport should be used.

Cleaning and disinfection of hospital environment and equipment
The practices as approved by the Hospital Infection Control Committee or hospital authorities must be followed. Some of these are:
•  Cleaning staff should wear full PPE
•  Cleaning should be done thoroughly to be followed by disinfection
•  Items and areas requiring cleaning and disinfection are:
•  Bedside table, bed stand, accessible areas of bed and floors (Use 0.1% sodium hypochlorite as disinfectant)
•  If any surface is grossly contaminated, pour 1% sodium hypochlorite first and leave it for 10-15 minutes to be followed by cleaning and usual disinfection (0.1% sod. hypochlorite).
•  Basins and bedpans should be cleaned and disinfected before being used for another patient.
•  Spray disinfectant is prohibited.

PPE reduces but does not completely eliminate the possibility of infection or contamination.
•  PPE is only effective if used correctly and at all times where contact may occur.
•  Any contact between contaminated (used) PPE and surfaces / clothing / people outside the isolation area must be avoided.
•  Used PPE must be sealed in appropriate disposal bags and sterilized or decontaminated. If staff temporarily leave the isolation area, a complete change of PPE and hand washing required.
•  The use of PPE does not replace basic hygiene measures such as hand-washing, washing is still essential to prevent transmission.
•  Exposure to the infected patient should be kept to an absolute minimum necessary for the level of care required.
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3.  Discussion of general protective clothing
•  Surgical mask: Surgical masks are designed to protect the sterile field of the patient from contaminants generated by the wearer. Although surgical masks filter out large-size particulates, they offer no respiratory protection against chemical vapors. These masks are effective against respiratory droplets and are used when treating infected patients who require “droplet precautions” such as pneumonic plague.
•  Protective Clothing: Most protective clothing is aimed at protection against chemicals and CWAs because intact skin provides an effective barrier against all BWAs except the trichothecene mycotoxins.
• Chemical-protective clothing: Chemical-protective clothing (CPC) consists of multilayered garments made out of various materials that protect against various hazards. Because no single material can protect against all chemicals, multiple layers of various materials are usually used to increase the degree of protection. Aluminum-lined, vapor-impermeable garments increase the level of protection. Protection is maximized by total encapsulation. An assortment of types of chemical-protective hats, hoods, gloves, and boot covers complements the garments.
•  Barrier gown and latex gloves: Barrier gowns are waterproof and protect against exposure to biological materials, including body fluids, but do not provide adequate skin or mucous membrane protection against chemicals. Latex gloves also protect wearers from biological materials but are inadequate against most chemicals.
Barrier gowns, latex gloves, and leg and/or shoe covers together comprise “contact precautions” and are useful for agents such as viral hemorrhagic fevers.
•  Chemical-protective gloves: Chemical-protective glove sets consist of a protective outer glove made out of butyl rubber and an inner glove for absorption of perspiration. Glove sets are available in 4 sizes and 3 thicknesses (7, 14, and 25 mL) with varying tactile sensitivities. Gloves may be worn for 12 hours in the contaminated environment. After visual inspection, gloves may be reused for another 12 hours. After use, gloves may be decontaminated and reused.
•  Chemical-protective footwear covers: Chemical-protective footwear covers (CPFC) are single-sized butyl rubber footwear covers that protect combat boots against all agents. Vinyl over boots are also available.
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4.  Biohazard Levels
<http://en.wikipedia.org/wiki/Biological_hazard>
The United States’ Centers for Disease Control and Prevention (CDC) categorizes various diseases in levels of biohazard, Level 1 being minimum risk and Level 4 being extreme risk. Laboratories and other facilities are categorized as BSL (BioSafety Level) 1-4 (Pathogen or Protection Level) as follow:

Biohazard Level 1:
•  Bacteria and viruses including Bacillus subtilis, canine hepatitis, Escherichia coli, varicella (chicken pox), as well as some cell cultures and non-infectious bacteria.
•  At this level precautions against the biohazardous materials in question are minimal, most likely involving gloves and some sort of facial protection.
•  Usually, contaminated materials are left in open (but separately indicated) waste receptacles. Decontamination procedures for this level are similar in most respects to modern precautions against everyday viruses (i.e.: washing one’s hands with anti-bacterial soap, washing all exposed surfaces of the lab with disinfectants, etc.). In a lab environment, all materials used for cell and/or bacteria cultures are decontaminated via autoclave.

Biohazard Level 2:
•  Bacteria and viruses that cause only mild disease to humans, or are difficult to contract via aerosol in a lab setting, such as hepatitis A, B, and C, influenza A, Lyme disease, salmonella, mumps, measles, scrapie, dengue fever, and HIV.
•   “Routine diagnostic work with clinical specimens can be done safely at Biosafety Level 2, using Biosafety Level 2 practices and procedures. Research work (including co-cultivation, virus replication studies, or manipulations involving concentrated virus) can be done in a BSL-2 (P2) facility, using BSL-3 practices and procedures.

Biohazard Level 3:
•  Bacteria and viruses that can cause severe to fatal disease in humans, but for which vaccines or other treatments exist, such as anthrax, West Nile virus, Venezuelan equine encephalitis, SARS virus, variola virus (smallpox), tuberculosis, typhus, Rift Valley fever, Rocky Mountain spotted fever, yellow fever, and malaria. Among parasites Plasmodium falciparum, which causes Malaria, and Trypanosoma cruzi, which causes trypanosomiasis, also come under this level.

Biohazard Level 4:
•  Viruses and bacteria that cause severe to fatal disease in humans, and for which vaccines or other treatments are not available, such as Bolivian and Argentine hemorrhagic fevers, Dengue hemorrhagic fever, Marburg virus, Ebola virus, hantaviruses, Lassa fever, Crimean-Congo hemorrhagic fever, and other hemorrhagic diseases.
•  When dealing with biological hazards at this level the use of a Hazmat suit and a self-contained oxygen supply is mandatory.
•  The entrance and exit of a Level Four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, autonomous detection system, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors opening at the same time. All air and water service going to and coming from a Biosafety Level 4 lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release.
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5. Employer Guidelines for appropriate PPE (Personal Protective Equipment)
<http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9767>Personal protective equipment is divided into four categories based on the degree of protection afforded.
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PPE Level A  (To be selected when the greatest level of skin, respiratory, and eye protection is required.  )
Definition: The hazardous substance has been   identified or is an unknown, and requires the highest level of protection for   skin, eyes, and the respiratory system based on either the measured (or   potential for) high concentration of atmospheric vapors, gases, or   particulates; or the site operations and work functions involve a high   potential for splash, immersion, or exposure to unexpected vapors, gases, or   particulates of materials that are harmful to skin or capable of being   absorbed through the skin.
—Substances with a high degree of hazard to   the skin are known or suspected to be present, and skin contact is possible;   or
—Operations must be conducted in confined,   poorly ventilated areas, and the absence of conditions requiring Level A have   not yet been determined.
—When an event is uncontrolled or   information is unknown about: the type of airborne agent, the dissemination   method, if dissemination is still occurring or it has stopped.
Components: A fully encapsulated, liquid and vapor   protective ensemble selected when the highest level of skin, reparatory and   eye protection is required.
—Positive pressure, full face-piece   self-contained breathing apparatus (SCBA), or positive pressure supplied air   respirator with escape SCBA, approved by the National Institute for Occupational Safety and Health (NIOSH).  Closed-circuit Rebreather/ open   circuit SCBA.
—Totally-encapsulating chemical-protective suit.
—Gloves, outer, chemical-resistant.
—Gloves, inner, chemical-resistant.
—Boots, chemical-resistant, steel toe and   shank, outer booties.
—Disposable protective suit, gloves and   boots (depending on suit construction, may be worn over totally-encapsulating   suit).
—Coveralls.
*—Long underwear.
*—Hard hat (under suit), personal cooling   system, chemical resistant tape.
**Optional/as needed.
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PPE Level B  (The highest level of respiratory protection is necessary but a lesser level of skin protection is needed.) 
Definition: The type and atmospheric concentration of   substances have been identified and require a high level of respiratory   protection, but less skin protection.
—The atmosphere contains less than 19.5   percent oxygen; or
—The presence of incompletely identified   vapors or gases is indicated by a direct-reading organic vapor detection   instrument, but vapors and gases are not suspected of containing high levels   of chemicals harmful to skin or capable of being absorbed through the skin.
—A liquid-splash-resistant ensemble used   with the highest level of reparatory protection.
—The suspected aerosol is not longer being   generated, but other conditions may present a splash hazard.
Components: A liquid-splash-resistant ensemble used   with the highest level of reparatory protection.
—Positive pressure, full-face piece   self-contained breathing apparatus (SCBA), or positive pressure supplied air   respirator with escape SCBA (NIOSH approved).
—Hooded chemical-resistant clothing   (overalls and long-sleeved jacket; coveralls; one or two-piece   chemical-splash suit; disposable chemical-resistant overalls).
—Gloves, outer, chemical-resistant.
—Gloves, inner, chemical-resistant.
—Boots, outer, chemical-resistant steel toe   and shank.
—Boot-covers, outer, chemical-resistant.
—Hard hat, personal cooling system,   chemical resistant tape.
*—Coveralls.
*—Face shield.
**Optional/as needed.
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PPE Level C  (The concentration and type of airborne substance is known and the criteria for using air purifying respirators are met)
Definition: The atmospheric contaminants, liquid   splashes, or other direct contact may adversely affect or be absorbed through   any exposed skin.
—The types of air contaminants have been   identified, concentrations measured, and an air-purifying respirator is   available that can remove the contaminants; and
—All criteria for the use of air-purifying   respirators are met.
Components: A liquid-splash-resistant ensemble, with   the same level of skin protection as Level B, used when the concentration(s)   and type(s) of airborne substances(s) are known and the criteria for using   air-purifying respirators are met.
—Full-face or half-mask, air purifying respirators (NIOSH   approved).
—Hooded chemical-resistant clothing   (overalls; two-piece chemical-splash suit; disposable chemical-resistant   overalls).
—Gloves, outer, chemical-resistant.
—Gloves, inner, chemical-resistant.
—Boots (outer), chemical-resistant steel   toe and shank.
—Boot-covers, outer, chemical-resistant.
—Coveralls.
*—Hard hat, face shield, personal cooling   system.
*—Escape mask.
*—Face shield.
**Optional/as needed.
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PPE Level D
Definition: Selected when the atmosphere contains no   known hazards.   Work   functions preclude splashes, immersion, or the potential for unexpected   inhalation of or contact with hazardous levels of any chemicals.   This level has no respiratory protection   and minimal skin protection. Level D protection is the normal work clothes   and non- respiratory PPE. Work shirt, safety boots and safety glasses are all   examples of PPE used at this level. Dust masks used on a voluntary basis   would still fall under Level D protection. In   hospitals, Level D consists of surgical gown, mask, and latex gloves   (universal precautions). Level D PPE provides no respiratory protection and   only minimal skin protection.
.
Level   D Modified
– This Level is the same as Level D for respiratory protection,   but the skin protection is increased to that of Level C. Components: A work uniform affording minimal   protection: used for nuisance contamination only.
—Coveralls.
—Boots/shoes, chemical-resistant steel toe   and shank.
—Boots, outer, chemical-resistant   (disposable).
*—Gloves.
*—Safety glasses or chemical splash   goggles.
*—Hard hat.
*—Escape mask.
*—Face shield.
**Optional/as needed.
.
6.  Types of Respirators
Surgical masks
Surgical masks are not respirators and are not certified as such; they do not protect the user adequately from exposure. The primary purpose of a surgical facemask is to help prevent biological particles from being expelled by the wearer into the environment. Persons suspected of having avian influenza should be separated from others and asked to wear a surgical mask. If a surgical mask is not available, tissues should be provided and patients should be asked to cover their mouth and nose when coughing.
The benefit of wearing surgical masks by well persons in public settings has not been established and is not recommended as a public health control measure at this time. Surgical masks are not adequate PPE for airborne infections. Even though influenza is primarily spread via droplet, there may also be airborne spread. An N95 respirator or PAPR should be recommended, at least in the initial stages of a pandemic and while supplies last.
In contrast to healthcare workers who necessarily have close contact with ill patients, the general public should try to avoid close contact with ill individuals. Nevertheless, persons may choose to wear a mask as part of individual protection strategies that include cough etiquette, hand hygiene, and avoiding public gatherings. Mask use may be most important for persons who are at high risk for complications of influenza and those who are unable to avoid close contact with others or must travel for essential reasons such as seeking medical care.
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Respirators
Respirators are designed to help reduce the wearer’s exposure to airborne particles. Respirators protect the user in two basic ways.
•  a) The first is by the removal of contaminants from the air. Respirators of this type include particulate respirators, which filter out airborne particles [ie., volcanic ash, dust storms]; and, b )  “gas masks” which filter out chemicals and gases [‘tear gas’, smoke, many hazardous chemical and dangerous biological agents].
•  Other respirators protect by supplying clean respirable air from another source. Respirators that fall into this category include airline respirators, which use compressed air from a remote source; and self-contained breathing apparatus (SCBA), which include their own air supply.

Respirators are designed to reduce exposures of the wearer to airborne hazards. Biological agents, such as viruses, are particles and can be filtered by particulate filters with the same efficiency as non-biological particles having the same physical characteristics (size, shape, etc.). However, unlike most industrial particles there are no exposure limits established for biological agents. Therefore, while respirators will help reduce exposure to avian influenza viruses, there is no guarantee that the user will not contract avian flu. Respirators may help reduce exposures to airborne biological contaminants, but they don’t eliminate the risk of exposure, infection, illness, or death.

Beards, long mustaches, and stubble may interfere with a good seal and cause leaks into the respirator.

Recent CDC infection control guidance documents provide recommendations that health care workers protect themselves from diseases potentially spread through the air (such as SARS or Tuberculosis) by wearing a fit-tested respirator at least as protective as a NIOSH-approved N-95 respirator. The N95 only offers protection down to .3 microns, and viruses are smaller than this — human SARS coronaviruses measure between 0.1 and 0.2 microns. But viruses often travel on larger particles, such as globs of mucus, which can be filtered. Available data suggest that infectious droplet nuclei may range in size from 1 mm to 5 mm; therefore, respirators used in health care settings should be able to efficiently filter the smallest particles in this range.

[Photo at right: NIOSH approved N95 Particle/ Dust filter mask]

An N-95 respirator is one of nine types of disposable particulate respirators.
Particulate respirators are also known as “air-purifying respirators” because they protect by filtering particles out of the air you breathe. Workers can wear any one of the particulate respirators for protection against diseases spread through the air — if they are NIOSH approved and if they have been properly fit-tested and maintained. NIOSH-approved disposable respirators are marked with the manufacturer’s name, the part number (P/N), the protection provided by the filter (e.g. N-95), and “NIOSH.”
A N-95 filters at least 95% of airborne particles.
Higher level particulate respirators [i.e., N-100 filter at least 99.97% airborne] may also be used.

[Image below: The North® 7600 Full Face Mask Respirator: designed to provide eye, face and N100 respiratory protection, while ensuring optimal comfort and performance. Dual flange silicone seal with superior fitting characteristics, a hard-coated polycarbonate lens w/ over 200° field of vision & protects against irritating gases, vapors and flying particles. Includes 5-strap harness, oral nasal cup, chin cup and speaking diaphragm. NIOSH/MSHA approved.]

An N100 mask is well suited for those who want NIOSH’s highest rated filtration efficiency in a maintenance free respirator. It provides a minimum filter efficiency of 99.97% against non-oil based particles. It is nearly 200 times more effective than the N95 filter (typical style seen above), and is also about ten times more expensive.

Protective Respiratory Devices
Two basic types of respirators are available: atmosphere supplying (self-contained breathing apparatus [SCBA], supplied-air respirator [SAR]) and air purifying respirator (APR).

•  Self-contained breathing apparatus: SCBA consists of a full facepiece connected by a hose to a portable source of compressed air.
•  Supplied-air respirator: SAR consists of a full face piece connected to an air source away from the contaminated area via an airline.
•  Air-purifying respirator: An APR consists of a face piece worn over the mouth and nose with a filter element that filters ambient air before inhalation. Three basic types of APRs are available: powered, disposable, and chemical cartridge or canister.
_a)  Nonpowered APRs operate under negative pressure, depending on the inspiratory effort of the wearer to draw air through a filter. Because PAPRs function under positive pressure, they provide the greatest degree of respiratory protection. Various chemical cartridges or canisters, which eliminate various chemicals including organic vapors and acid gases, are available.
_b)  Disposable APRs are usually half masks, which do not provide adequate eye protection. This type of APR depends on a filter, which traps particulates. The use of a high-efficiency particulate air (HEPA) filter or use in combination with a chemical cartridge enhances disposable APRs.

One measure of respiratory filtration efficiency relevant to BWA exposures is the percent penetration of droplet nuclei into the face piece. For exposures to biological aerosols, a) PAPRs with HEPA filters are most efficient, b) followed by elastomeric half-mask HEPA filter respirators and, c) non-HEPA disposable APRs.
All APRs are limited by the adequacy of their face seals. Accordingly, APRs do not provide adequate respiratory protection in environments immediately dangerous to life or health.
•  High-efficiency particulate air filter (HEPA)
HEPA filters remove particles of 0.3-15 µm diameter with an efficiency of 98-100%, efficiently excluding aerosolized BWA particles in the highly infectious 1- to 5-µm range. HEPA filters are incorporated into various protective respiratory devices including PAPRs and elastomeric half-mask respirators. This type of filtration is required when caring for a patient infected with a disease requiring “airborne precautions” such as smallpox and viral hemorrhagic fevers. Use of an N-100 filter should provide the same protection as the HEPA filter.

7.   Masks
A.  North 760008A Full Face M/L Facepiece (by Honeywell Corporation)
<http://www.amazon.com/North-Products-Facepiece-Respirators-760008A/dp/B002KFAHGU/ref=sr_1_1?s=hi&ie=UTF8&qid=1330858157&sr=1-1>
AMAZON Price (2011): $148.94 +$6.58 = $155.52
Technical Details
•  Type: Full Face
•  Size: Medium/Large
•  Material: Silicone
•  Harness Type: 5 Point
•  For Use With: North Cartridges and Filters
Product Description
Half Full Facepieces – Respiratory Protection Type: Full Face Size: Medium/Large Material: Silicone Harness Type: 5 Point For Use With: North Cartridges and Filters Connection Type: Threaded
Technical Details
Designed to provide eye, face and respiratory protection while ensuring optimal comfort and performance. Dual flange silicone seal give this facepiece superior fitting characteristics. Hard-coated polycarbonate lens provides over 200° field-of-vision and protects the wearer’s eyes and face against irritating gases, vapors and flying particles. Lens meets ANSI standards for high impact and penetration resistance. Compatible with North cartridges, filters and accessories. NIOSH approved.

 B.  North 770030 Medium Silicone Half Mask Respirator 7700 Series, Mask Only
http://www.amazon.com/North-Safety-7700-half-Small/dp/B001429P1S
AMAZON Price: $19.99 +$5.90=$$25.89
The 7700’s soft non-allergenic silicone seal provides excellent protection, comfort and fit. The half masks cradle suspension system allows the facepiece to seal evenly on the face without creating pressure points. It’s low profile gives workers a wide field to vision and does not interfere with protective eyewear. The low inhalation and exhalation resistance of the 7700 Series makes breathing easier to reduce worker fatigue. NIOSH approved when used with North cartridges and/or filters. Dual Cartridge Silicone Half Mask: Silicone facepiece material conforms to facial features and doesn’t harden with age. Silicone is easy to clean, durable and resists distortion. Contoured sealing flange and cradle suspension system eliminates discomfort caused by pressure points on facial nerves. Nose area design is comfortable and well-fitting. Minimal dead air space limits re-breathing of exhaled air. Direct cartridge-to-facepiece seal minimizes replacement parts and simplifies maintenance. The most comfortable and durable half mask available. Does not interfere with protective eyewear.  Size: 770030S – Small 770030M – Medium 770030L – Large.
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8.  Biohazard protection
•  North 7700 N100 filter; Recommended half mask for H1N1-type flu virus (Swine flu).
•  Hantavirus: Use of an N-100 filter should provide the same protection as the HEPA filter. Available evidence suggests that Hantavirus is transmitted by inspiring small (less than 5 micron) viral particles in aerosols which the N-100 is the most effective in removing.

A.  Mask particle filter protection efficiency
USA Filter Standards     Efficiency *
NIOSH N95                      94%
NIOSH N99                      99%
NIOSH N100                    99.97%

Assigned Protection Factors

Type of respirator Dust respirator Quarter mask Half mask Full
facepiece		 Helmet/
hood
1. Air-Purifying Respirator max 4 5 10 50 …………..
2. Powered Air-Purifying Respirator (PAPR) ………….. 50 1,000 1,000
4. Self-Contained Breathing Apparatus (SCBA)  Pressure-demand or other positive-pressure mode circuit) ………….. ………….. 10,000 10,000

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Two of North’s many filters (these are my choices for an emergency kit): One for dust, blowing sand and ash, the other for many chemical and biological hazards.
See at <http://www.amazon.com/North-Safety-Defender-Multi-purpose-cartridge/dp/B002D94BZQ/ref=pd_cp_hi_0>

List of North filter cartriges/pictures/prices:
<http://www.respiratormaskprotection.com/Respirator-Cartridge-Filter-Reference-Chart.html>
Most can be bought at Amazon at better prices than found elsewhere.

  

9.  DuPont TY127S Disposable White Tyvek Coverall Suit 1428
Amazon Price $5.49 + $4.57 S&H (same price as local Home Depot and Lowes paint department, less (my 8.25%) your state sales tax. Choose one size larger than your normal, to ensure al fit over your clothing and allow flexibility.
Technical Details
•  Serged seams, attached hood, front zipper closure, elastic wrists, and elastic ankles.
•  Inherent barrier protection against dry particulate hazards.
•  Applications range from agriculture to spray painting to lead remediation.
•  Even after abrasions, stops microporous particles better than other reusable garments.
•  The best balance of protection, durability and comfort.
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What are the features of  Tyvek disposable coveralls?
•  It is made from a tough material that helps prevent skin contact with wet/dry, harmful objects, or chemicals in the environment.
•  Microscopic particles as small as 0.5 microns are retarded in access through a Tyvek coverall.
•  It can’t be easily scratched or torn
•  The coverall is made from one material in one layer
•  The Tyvek disposable coverall has the ability to let air and moisture pass through which can reduce possible heat stress.
•  Tyvek suits create a barrier to water from mild splash occurrences.
•  It is proved to be six times more breathable than microporous materials
•  It can be used in various low hazard applications. As Personal Protective Equipment it fulfills body/skin protection necessary for many Level D and C threats and partial protection for Level B threats.
•  Tyvek disposable coveralls are perfect for disaster clean-up work in order to protect the wearer with maximum comfort and protection. It comes in hooded coveralls for overall protection.

 

Sports Body Armor
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Types of sports body armor
Padded pants are full-length protective armor for use when protection of hips, quads, shins, and calves is needed.
Upper body armor provides excellent soft-padded protection for the back, sides, shoulders, and arms.

Titan Sport Jacket, by Fox Racing, Amazon $139.95
<http://www.amazon.com/gp/product/B005VBFZQ2/ref=pd_lpo_k2_dp_sr_2?pf_rd_p=486539851&pf_rd_s=lpo-top-stripe-1&pf_rd_t=201&pf_rd_i=B0033PRRCS&pf_rd_m=ATVPDKIKX0DER&pf_rd_r=1P8A4A6CC24CMTQCET0Y>

Full body under jersey coverage has a new standard with the Titan Sport Jacket. Its complete plastic plating of key contact areas is unmatched. Its full mesh main body offers a precise, bunch-free fit. Add in the intelligently engineered ventilation zones and the Titan Sport Jacket truly becomes the ultimate battle suit.

Fox Racing’s new Titan Sport Jacket is probably the first hard-shell under-jersey body armor for down hill (DH) and free ride that doesn’t make you look like a linebacker. Despite protecting all critical upper-body contact areas, including shoulders and elbows, with lightweight, high-impact plastic the Titan is surprisingly svelte. The main body is made of a comfortable stretchy mesh fabric that prevents the jacket from bunching up under your jersey. Smartly designed vents in the chest and back plates also work with the mesh to help keep you cool. A major improvement is the addition of a hard-plastic chest-plate. The articulated spine protector is designed to move fluidly with a rider but can also be zipped off easily. Adjustment straps at the shoulders and ribs allow for a precise fit and better protection. The Velcro on the kidney belt has the mildly annoying habit of attaching itself to the jacket’s soft meshy parts, but that’s probably an unavoidable feature of good Velcro. While the Titan jacket is designed to be worn under your jersey, the anatomically shaped Batman aesthetic almost makes it cool enough to wear on its own.

Design & Function
•  Anatomic high impact two piece plastic chest plate
•  Removable articulated plastic back coverage
•  High impact plastic shoulder and elbow coverage
•  Soft vented mesh main body fabric for enhanced fit,
•  Comfort and ventilation
•  Center zipper for easy on and off

An Upper Body Bike padded top is often used with the following extreme sports and activities:
Skate: Derby, Mountain Board
Bike: Down Hill, Single Track, Street, Mountain
Motor bike: ATV, Dirt, Street, Street Bike, Motocross, Super Moto, Track
Field sports: Polo
Other sports: Clown Work, Equestrian, Martial Arts, Street Louge.
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 Ballistic Body Armor

How to choose body armor: < http://bulletproofme.com/How_to_Select_Body_Armor.shtml>
Pictures/prices/sales: <http://www.qmuniforms.com/Body-Armor/?src=SHIPFREE&gclid=CKmDrub_zK4CFQFeTAod0lHK_Q>

Body Armor Threat Levels
Deciding which body armor to purchase is as important as any purchase you will make.
Before deciding on brands, you need a little knowledge about body armor to help with your decision.
All body armor products are categorized into one of six levels.

The levels begin with Level I which offers the least amount of protection and go up to Level IV which offers the most amount of protection. This level system is the most important factor in making a purchase. You don’t need a Level IV – which will stop rifle rounds – if the purpose of the vest is to give you protection from sharp edged weapons while walking a tier a Garden State Prison. However, if you are on a tactical entry team used for high risk assaults or handling prison riots, you will need armored protection that will stop more than just knives.

An old but still very valuable street cop rule-of-thumb is to have a level of ballistic performance that stops, at a minimum, the round you carry in your service weapon. This rule is as relevant and true today as it was when body armor was first available.
Be advised, though, there are many variables.
The ballistic threat of a round depends on more than just the round. Variables include its composition, shape, caliber, mass, angle of impact, and impact velocity. Because of the wide variety of rounds and cartridges available in a given caliber and because of the existence of hand loaded ammunition, body armor that will defeat a standard test round may not defeat other loadings in the same caliber.
The National Institute of Justice (NIJ) is the research, development, and evaluation agency of the United States Department of Justice. It is from the NIJ where we get the levels of body armor. It is called the National Institute of Justice (NIJ) Ballistic Resistance of Police Body Armor.

Below is a list describing the available levels of ballistic performance of body armor:

Level I  (22 LR; 38 Special)
Level I vests offer the most basic level of protection.  This level of protection is virtually obsolete due to the common use of higher velocity ammunition. During testing the ammunition used is a .38 caliber traveling at 850 feet per second and a .22 caliber fired from a long rifle with a traveling speed of 1,050 feet per second.  Level I vests only stop fragmentation and low-velocity pistol ammunition. They are not recommended for pistol ballistic protection but can be used for riot gear or for playing paintball.

Level II-A  (Lower Velocity 357 Magnum; 9 mm)
Level II-A vests are typically 4mm thick and tested using a 9mm full metal jacket at 1,090 feet per second and a .357 Magnum jacketed soft point ammunition at 1,250 feet per second.  These bulletproof jackets offer the minimum level of protection required to protect against most threats faced on the streets.  Since this vest is thinner than a level II or III-A it offers greater comfort and concealability at the cost of offering less protection against blunt trauma.

Level II  (Higher Velocity 357 Magnum; 9 mm)
Level II vests are typically 5mm thick and tested using 9mm full metal jacket ammunition at 1,175 feet per second and .357 jacketed soft point ammunition at 1,395 feet per second.  Since they are thicker they offer more protection against blunt trauma while remaining comfortable to wear and easy to conceal.  These bulletproof vests are ideal when vests need to be concealed, worn for a long time, or when the ability to move a lot is necessary.  Theses vests are often worn by police officers.  Since Level II vests are thicker they offer great levels of protection against blunt trauma caused by higher-velocity rounds.

Level III-A  (44 Magnum; Submachine Gun 9 mm)
Level III-A vests are between 8 to 10 millimeters thick and are tested for 9 mm full metal jacket ammunition at 1,400 feet per second (the velocity of a submachine gun) and .44 Magnum Lead Semi-Wadcutter ammunition at 1,400 feet per second.  These vests offer the highest level of blunt trauma protection while remaining concealable.  Level III-A vests are suited to protect against most handguns as well as all the weapons tested on the lower-level vests.  Among all the concealable bulletproof vests they are the most expensive, thick, stiff, and heavy.  They are ideal for high-risk situations including protection against explosions and grenade attacks.

Type IV  (Armor-Piercing Rifle)
This armor protects against 30 caliber armor-piercing bullets (U.S. military designation APM2), with nominal masses of 10.8 g (166 gr) impacting at a velocity of 868 m (2850 ft) per second or less. It also provides at least single hit protection against the threats mentioned in lower levels.

• Some professionals are more concerned they will be attacked with a knife or a blunt object, so when looking at armor select for penetration protection as well.
 

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List  of ammunition shown in the photograph above:

1. .22 Magnum 40 gr. JHP (1209 FPS   / 369 MPS)
2. .32 ACP 60 gr. Silvertip JHP (936 FPS / 285 MPS)
3. .380 ACP 95 gr. FMC (902 FPS / 275 MPS)
4. .38 Special 125 gr. Nyclad SWHP (1009 FPS / 308 MPS)
5. .38 Special +P 110 gr. JHP (1049 FPS / 320 MPS)
6. .38 Special +P 140 gr. JHP (869 FPS / 265 MPS)
7. 9mm 124 gr. FMC (1173 FPS / 358 MPS)*
8. 9mm 125 gr. JSP (1121 FPS / 342 MPS)
9. 9mm 147 gr. Black Talon (1010 FPS / 308 MPS)
10. 9mm 147 gr. Golden Saber (1083 FPS / 330 MPS)
11. 9mm 147 gr. Hydra Shok (1011 FPS / 308 MPS)
12. .357 Magnum 158 gr. JSP (1308 FPS / 399 MPS)
13. .357 Magnum 110 gr. JHP (1292 FPS / 394 MPS)
14. .357 Magnum 125 gr. JHP (1335 FPS / 407 MPS)
15. .40 Caliber 180 gr. FMJTC (992 FPS / 302 MPS)
16. .40 Caliber 170 gr. FMJTC (1095 FPS / 334 MPS)
17. 10mm 155 gr. FMJTC (1024 FPS / 312 MPS)
18. 10mm 170 gr. JHP (1137 FPS / 347 MPS)
19. .41 Magnum 210 gr. LSWC (1141 FPS / 348 MPS)
20. .44 Magnum 240 gr. LFP (1017 FPS / 310 MPS)		 21. .45 Long Colt 250 gr. LRN (778   FPS / 237 MPS)
22. .45 ACP 230 gr. FMJ (826 FPS / 252 MPS)
23. 12 Ga. 00 Buck (9 pellet) (1063 FPS / 324 MPS)
24. 9mm 124 gr. FMJ (1215 FPS / 370 MPS)*
25. 9mm 115 gr. Silvertip JHP (1252 FPS / 382 MPS)
26. 9mm 124 gr. Starfire JHP (1174 FPS / 358 MPS)*
27. .357 Magnum 158 gr. JSP (1453 FPS / 443 MPS)*
28. .357 Magnum 145 gr. Silvertip JHP (1371 FPS / 418 MPS)
29. .357 Magnum 125 gr. JHP (1428 FPS / 435 MPS)
30. 10mm 175 gr. Silvertip JHP (1246 FPS / 380 MPS)
31. .41 Magnum 210 gr. JSP (1322 FPS / 403 MPS)
32. .44 Magnum 240 gr. SJHP (1270 FPS / 387 MPS)
33. 9mm 124 gr. FMJ (1440 FPS / 439 MPS)*
34. 9mm 115 gr. FMJ Israeli (1499 FPS / 457 MPS)
35. 9mm 123 gr. FMJ Geco (1372 FPS / 418 MPS)
36. 9mm 124 gr. FMJ Cavin (1259 FPS / 384 MPS)
37. .44 Magnum 240 gr. LSWC (1448 FPS / 441 MPS)*
38. .44 Magnum 240 gr. HSP (1320 FPS / 402 MPS)
39. 12 ga. 1 oz. Rifled Slug (1290 FPS / 393 MPS)
40. 12 ga. 1 oz. Rifled Slug (1254 FPS / 382 MPS)

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Monday, March 19, 2012 · 12:10 AM

Vaccination notes

(Survival Manual/6. Medical/c) General Clinic/Vaccination notes)

The romantic 1800s
14 December 2009, Health Sentinal, by Roman Bystrianyk
<http://healthsentinel.com/joomla/index.php?option=com_content&view=article&id=2662:historic-data-shows-vaccines-not-key-in-declines-in-death-from-disease&catid=5:original&Itemid=24>
Many of us have a picture of the 1800s that has been colored by a myriad of filters that have led us to a nostalgic and romantic view of that era. We picture a time where gentleman callers came to call upon a well-dressed lady in a finely furnished parlor. We imagine a time where people leisurely drifted down a river on a paddle wheel riverboat while sipping mint juleps and a time of more elegant travel aboard a steam train traveling through the countryside. We picture an elegant woman dressed in a long flowing gown leaving a sleek horse drawn carriage with the aid of a well-dressed man in a top hat. We think of those times where life was simple, ordered, in a near utopian world free of the many woes that plague modern society.

But if we remove those filters and cast a more objective light upon that time a different view emerges. Now imagine a world where workplaces had no health, safety, or minimum wage laws. It was a time where people put in 12 to 16 hours a day at the most tedious menial labor. Imagine bands of children roaming the streets out of control because their parents are laboring long days. Picture the city of New York surrounded not by suburbs, but by rings of smoldering garbage dumps and shantytowns. Imagine cities where hogs, horses, and dogs and their refuse were commonplace in the streets. Many infectious diseases were rampant throughout the world and in particular in the larger cities. This is not a description of the Third World, but was a large portion of America and other western cities only a century or so ago.

Our perceptions of history encompass a lot of willful rejection of knowledge. It is easier and more convenient to wax nostalgically rather than acknowledge an uncomfortable reality. We insist on creating a more pleasant historical illusion, but by doing so we cloud a historical issue in a way that promotes a bad misunderstanding of the past, and has every potential to result in bad misunderstandings of the future.
•  1807-1812: Glasgow, England – Measles accounts for 11% of all deaths.
•  1830s: United States – Eastern seaboard cities have a mortality rate from tuberculosis of 400 per 100,000.
•  1845-1850: Ireland – Great Famine claims approximately 2 million lives, some from starvation, but far more from typhus and other epidemics consequent upon malnutrition and social collapse.
•  1854: New York City – Nearly 2,500 people are killed by cholera.
•  1847-1861: 2,589,843 Russians contract Cholera and over 1,000,000 die.
•  1861-1865: American Civil War – The Union Army loses 186,216 men to disease, twice the number killed in action; nearly half were claimed by typhoid and dysentery.
•  1855: Yellow fever rages in Norfolk and Portsmouth Virginia, Louisiana, and Mississippi. In the Virginia plague area one out of five die of the fever, its victims buried wholesale in trenches without coffins.
•  1865: New York City – Fifteen thousand tenement houses have been built, many of which are hardly more than “fever nests”.
•  1867-1872: Hospice des Enfants Assists reports 1,256 cases of measles and 612 deaths with a mortality of 49%. Malnutrition was known to be rife in orphanages at the time.
•  1871: A terrible smallpox epidemic which threw both New York and Philadelphia into morning. It killed over eight hundred people in the former city, more than ever before in its history, while the latter the deaths nearly reached two thousand.
•  1871-1872: England – Smallpox epidemic 42,200 deaths suggesting 200,000 or more cases.
•  1870-1875 Europe – One of the worst epidemics in European smallpox history is estimated to have killed at least 500,000 people.
•  Prussia – Great smallpox epidemic. Despite strict vaccination laws 69,839 die from smallpox more than in any other northern state.
•  Chicago – Despite a high vaccination rate, over 2000 people contract smallpox and more than a fourth of these die. The fatality among children under five is the highest ever recorded.
•  1873: Memphis – Suffers attacks of yellow fever, smallpox, and cholera simultaneously. People flee the city leaving half of the houses vacant.
•  1874: Bloomington, Illinois – All kinds of garbage and human and animal waste had been thrown into small streams running into Sugar Creek and became known as the “North and South Sloughs”. Over the years the Sloughs “became a … sodden pool of stench that was the breeding places for disease … because it drained sewage into the community’s primary water source, Sugar Creek.”

These historic points show that infectious diseases were a constant and deadly threat during these times. England was the country that early in 1838 began to keep statistics on causes of death and is the best source to find out the devastating impact of these infectious diseases.
.

What would happen if we stopped vaccinations?
<http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm>
In the U.S., vaccination programs have eliminated or significantly reduced many vaccine-preventable diseases. However, these diseases still exist and can once again become common—and deadly—if vaccination coverage does not continue at high levels.

Polio
Stopping vaccination against polio will leave people susceptible to infection with the polio virus. Polio virus causes acute paralysis that can lead to permanent physical disability and even death. Before polio vaccine was available, 13,000 to 20,000 cases of paralytic polio were reported each year in the United States. These annual epidemics of polio often left thousands of victims–mostly children–in braces, crutches, wheelchairs, and iron lungs. The effects were life-long.
In 1988 the World Health Assembly unanimously agreed to eradicate polio worldwide. As a result of global polio eradication efforts, the number of cases reported globally has decreased from more than 350,000 cases in 125 countries in 1988 to 2,000 cases of polio in 17 countries in 2006, and only four countries remain endemic (Afghanistan, India, Nigeria, Pakistan). To date polio has been eliminated from the Western hemisphere, and the European and Western Pacific regions. Stopping vaccination before eradication is achieved would result in a resurgence of the disease in the United States and worldwide.

Measles
Before measles immunization was available, nearly everyone in the U.S. got measles. An average of 450 measles-associated deaths were reported each year between 1953 and 1963.

In the U.S., up to 20 percent of persons with measles are hospitalized. Seventeen percent of measles cases have had one or more complications, such as ear infections, pneumonia, or diarrhea. Pneumonia is present in about six percent of cases and accounts for most of the measles deaths. Although less common, some persons with measles develop encephalitis (swelling of the lining of the brain), resulting in brain damage.

As many as three of every 1,000 persons with measles will die in the U.S. In the developing world, the rate is much higher, with death occurring in about one of every 100 persons with measles.

Measles is one of the most infectious diseases in the world and is frequently imported into the U.S. In the period 1997-2000, most cases were associated with international visitors or U.S. residents who were exposed to the measles virus while traveling abroad. More than 90 percent of people who are not immune will get measles if they are exposed to the virus.

According to the World Health Organization (WHO), nearly 900,000 measles-related deaths occurred among persons in developing countries in 1999. In populations that are not immune to measles, measles spreads rapidly. If vaccinations were stopped, each year about 2.7 million measles deaths worldwide could be expected.
In the U.S., widespread use of measles vaccine has led to a greater than 99 percent reduction in measles compared with the pre-vaccine era. If we stopped immunization, measles would increase to pre-vaccine levels.

Haemophilus Influenzae Type b (Hib) Meningitis
Before Hib vaccine became available, Hib was the most common cause of bacterial meningitis in U.S. infants and children. Before the vaccine was developed, there were approximately 20,000 invasive Hib cases annually. Approximately two-thirds of the 20,000 cases were meningitis, and one-third were other life-threatening invasive Hib diseases such as bacteria in the blood, pneumonia, or inflammation of the epiglottis. About one of every 200 U.S. children under 5 years of age got an invasive Hib disease. Hib meningitis once killed 600 children each year and left many survivors with deafness, seizures, or mental retardation.

Since introduction of conjugate Hib vaccine in December 1987, the incidence of Hib has declined by 98 percent. From 1994-1998, fewer than 10 fatal cases of invasive Hib disease were reported each year.

This preventable disease was a common, devastating illness as recently as 1990; now, most pediatricians just finishing training have never seen a case. If we were to stop immunization, we would likely soon return to the pre-vaccine numbers of invasive Hib disease cases and deaths.

Pertussis (Whooping Cough)
Since the early 1980s, reported pertussis cases have been increasing, with peaks every 3-5 years; however, the number of reported cases remains much lower than levels seen in the pre-vaccine era. Compared with pertussis cases in other age groups, infants who are 6 months old or younger with pertussis experience the highest rate of hospitalization, pneumonia, seizures, encephalopathy (a degenerative disease of the brain) and death. From 2000 through 2008, 181 persons died from pertussis; 166 of these were less than six months old.

Before pertussis immunizations were available, nearly all children developed whooping cough. In the U.S., prior to pertussis immunization, between 150,000 and 260,000 cases of pertussis were reported each year, with up to 9,000 pertussis-related deaths.

Pertussis can be a severe illness, resulting in prolonged coughing spells that can last for many weeks. These spells can make it difficult for a person to eat, drink, and breathe. Because vomiting often occurs after a coughing spell, persons may lose weight and become dehydrated. In infants, it can also cause pneumonia and lead to brain damage, seizures, and mental retardation.

The newer pertussis vaccine (acellular or DTaP) has been available for use in the United States since 1991 and has been recommended for exclusive use since 1998. These vaccines are effective and associated with fewer mild and moderate adverse reactions when compared with the older (whole-cell DTP) vaccines.

During the 1970s, widespread concerns about the safety of the older pertussis vaccine led to a rapid fall in immunization levels in the United Kingdom. More than 100,000 cases and 36 deaths due to pertussis were reported during an epidemic in the mid 1970s. In Japan, pertussis vaccination coverage fell from 80 percent in 1974 to 20 percent in 1979. An epidemic occurred in 1979, resulted in more than 13,000 cases and 41 deaths.

Pertussis cases occur throughout the world. If we stopped pertussis immunizations in the U.S., we would experience a massive resurgence of pertussis disease. A study found that, in eight countries where immunization coverage was reduced, incidence rates of pertussis surged to 10 to 100 times the rates in countries where vaccination rates were sustained.

Pneumococcal
Before pneumococcal conjugate vaccine became available for children, pneumococcus caused 63,000 cases of invasive pneumococcal disease and 6,100 deaths in the U.S. each year. Many children who developed pneumococcal meningitis also developed long-term complications such as deafness or seizures. Since the vaccine was introduced, the incidence of invasive pneumococcal disease in children has been reduced by 75%. Pneumococcal conjugate vaccine also reduces spread of pneumococcus from children to adults. In 2003 alone, there were 30,000 fewer cases of invasive pneumococcal disease caused by strains included in the vaccine, including 20,000 fewer cases in children and adults too old to receive the vaccine. If we were to stop immunization, we would likely soon return to the pre-vaccine numbers of invasive pneumococcal disease cases and deaths.

Rubella (German Measles)
While rubella is usually mild in children and adults, up to 90 percent of infants born to mothers infected with rubella during the first trimester of pregnancy will develop congenital rubella syndrome (CRS), resulting in heart defects, cataracts, mental retardation, and deafness.

In 1964-1965, before rubella immunization was used routinely in the U.S., there was an epidemic of rubella that resulted in an estimated 20,000 infants born with CRS, with 2,100 neonatal deaths and 11,250 miscarriages. Of the 20,000 infants born with CRS, 11,600 were deaf, 3,580 were blind, and 1,800 were mentally retarded.

Due to the widespread use of rubella vaccine, only six CRS cases were provisionally reported in the U.S. in 2000. Because many developing countries do not include rubella in the childhood immunization schedule, many of these cases occurred in foreign-born adults. Since 1996, greater than 50 percent of the reported rubella cases have been among adults. Since 1999, there have been 40 pregnant women infected with rubella.

If we stopped rubella immunization, immunity to rubella would decline and rubella would once again return, resulting in pregnant women becoming infected with rubella and then giving birth to infants with CRS.

Varicella (Chickenpox)
Prior to the licensing of the chickenpox vaccine in 1995, almost all persons in the United States had suffered from chickenpox by adulthood. Each year, the virus caused an estimated 4 million cases of chickenpox, 11,000 hospitalizations, and 100-150 deaths.

A highly contagious disease, chickenpox is usually mild but can be severe in some persons. Infants, adolescents and adults, pregnant women, and immunocompromised persons are at particular risk for serious complications including secondary bacterial infections, loss of fluids (dehydration), pneumonia, and central nervous system involvement. The availability of the chickenpox vaccine and its subsequent widespread use has had a major impact on reducing cases of chickenpox and related morbidity, hospitalizations, and deaths. In some areas, cases have decreased as much as 90% over prevaccination numbers.

In 2006, routine two-dose vaccination against chickenpox was recommended for all children, adolescents, and adults who do not have evidence of immunity to the disease. In addition to further reducing cases, this strategy will also decrease the risk for exposure to the virus for persons who are unable to be vaccinated because of illness or other conditions and who may develop severe disease. If vaccination against chickenpox were to stop, the disease would eventually return to prevaccination rates, with virtually all susceptible persons becoming infected with the virus at some point in their lives.

Hepatitis B
More than 2 billion persons worldwide have been infected with the hepatitis B virus at some time in their lives. Of these, 350 million are life-long carriers of the disease and can transmit the virus to others. One million of these people die each year from liver disease and liver cancer.

National studies have shown that about 12.5 million Americans have been infected with hepatitis B virus at some point in their lifetime. One and one quarter million Americans are estimated to have chronic (long-lasting) infection, of whom 20 percent to 30 percent acquired their infection in childhood. Chronic hepatitis B virus infection increases a person’s risk for chronic liver disease, cirrhosis, and liver cancer. About 5,000 persons will die each year from hepatitis B-related liver disease resulting in over $700 million in medical and work loss costs.

The number of new infections per year has declined from an average of 450,000 in the 1980s to about 80,000 in 1999. The greatest decline has occurred among children and adolescents due to routine hepatitis B vaccination. Infants and children who become infected with hepatitis B virus are at highest risk of developing lifelong infection, which often leads to death from liver disease (cirrhosis) and liver cancer. Approximately 25 percent of children who become infected with life-long hepatitis B virus would be expected to die of related liver disease as adults.

CDC estimates that one-third of the life-long hepatitis B virus infections in the United States resulted from infections occurring in infants and young children. About 16,000 – 20,000 hepatitis B antigen infected women give birth each year in the United States. It is estimated that 12,000 children born to hepatitis B virus infected mothers were infected each year before implementation of infant immunization programs. In addition, approximately 33,000 children (10 years of age and younger) of mothers who are not infected with hepatitis B virus were infected each year before routine recommendation of childhood hepatitis B vaccination.

Diphtheria
Diphtheria is a serious disease caused by a bacterium. This germ produces a poisonous substance or toxin which frequently causes heart and nerve problems. The case fatality rate is 5 percent to 10 percent, with higher case-fatality rates (up to 20 percent) in the very young and the elderly.

In the 1920’s, diphtheria was a major cause of illness and death for children in the U.S. In 1921, a total of 206,000 cases and 15,520 deaths were reported. With vaccine development in 1923, new cases of diphtheria began to fall in the U.S., until in 2001 only two cases were reported.

Although diphtheria is rare in the U.S., it appears that the bacteria continue to get passed among people. In 1996, 10 isolates of the bacteria were obtained from persons in an American Indian community in South Dakota, none of whom had classic diphtheria disease. There was one death reported in 2003 from clinical diphtheria in a 63 year old male who had never been vaccinated.

There are high rates of susceptibility among adults. Screening tests conducted since 1977 have shown that 41 percent to 84 percent of adults 60 and over lack protective levels of circulating antitoxin against diphtheria.

Although diphtheria is rare in the U.S., it is still a threat. Diphtheria is common in other parts of the world and with the increase in international travel, diphtheria and other infectious diseases are only a plane ride away. If we stopped immunization, the U.S. might experience a situation similar to the Newly Independent States of the former Soviet Union. With the breakdown of the public health services in this area, diphtheria epidemics began in 1990, fueled primarily by persons who were not properly vaccinated. From 1990-1999, more than 150,000 cases and 5,000 deaths were reported.

Tetanus (Lockjaw)
Tetanus is a severe, often fatal disease. The bacteria that cause tetanus are widely distributed in soil and street dust, are found in the waste of many animals, and are very resistant to heat and germ-killing cleaners. From 1922-1926, there were an estimated 1,314 cases of tetanus per year in the U.S. In the late 1940’s, the tetanus vaccine was introduced, and tetanus became a disease that was officially counted and tracked by public health officials. In 2000, only 41 cases of tetanus were reported in the U.S.

People who get tetanus suffer from stiffness and spasms of the muscles. The larynx (throat) can close causing breathing and eating difficulties, muscles spasms can cause fractures (breaks) of the spine and long bones, and some people go into a coma, and die. Approximately 20 percent of reported cases end in death.

Tetanus in the U.S. is primarily a disease of adults, but unvaccinated children and infants of unvaccinated mothers are also at risk for tetanus and neonatal tetanus, respectively. From 1995-1997, 33 percent of reported cases of tetanus occurred among persons 60 years of age or older and 60 percent occurred in patients greater than 40 years of age. The National Health Interview Survey found that in 1995, only 36 percent of adults 65 or older had received a tetanus vaccination during the preceding 10 years.

Worldwide, tetanus in newborn infants continues to be a huge problem. Every year tetanus kills 300,000 newborns and 30,000 birth mothers who were not properly vaccinated. Even though the number of reported cases is low, an increased number of tetanus cases in younger persons has been observed recently in the U.S. among intravenous drug users, particularly heroin users.

Tetanus is infectious, but not contagious, so unlike other vaccine-preventable diseases, immunization by members of the community will not protect others from the disease. Because tetanus bacteria are widespread in the environment, tetanus can only be prevented by immunization. If vaccination against tetanus were stopped, persons of all ages in the U.S. would be susceptible to this serious disease.

Mumps
Before the mumps vaccine was introduced, mumps was a major cause of deafness in children, occurring in approximately 1 in 20,000 reported cases. Mumps is usually a mild viral disease. However, serious complications, such as inflammation of the brain (encephalitis) can occur rarely. Prior to mumps vaccine, mumps encephalitis was the leading cause of viral encephalitis in the United States, but is now rarely seen.

Serious side effects of mumps are more common among adults than children. Swelling of the testes is the most common side effect in males past the age of puberty, occurring in up to 37 percent of post-pubertal males who contract mumps. An increase in miscarriages has been found among women who develop mumps during the first trimester of pregnancy.

Before there was a vaccine against mumps, mumps was a very common disease in U.S. children, with as many as 300,000 cases reported every year.  After vaccine licensure in 1967, reports of mumps decreased rapidly. In 1986 and 1987, there was a resurgence of mumps with 12,848 cases reported in 1987. Since 1989, the incidence of mumps has declined, with 266 reported cases in 2001. This recent decrease is probably due to the fact that children have received a second dose of mumps vaccine (part of the two-dose schedule for measles, mumps, rubella or MMR).  Studies have shown that the effectiveness of mumps vaccine ranges from 73% to 91% after 1 dose and from 79% to 95% after 2 doses and that 2 doses are more effective than 1 dose.

We can not let our guard down against mumps. A 2006 outbreak among college students led to over 6500 cases and a 2009-10 outbreak in the tradition-observant Jewish community in 2 states led to over 3400 cases. Mumps is a communicable disease and while prolonged close contact among persons my facilitate transmission, maintenance of high 2-dose MMR vaccine coverage remains the most effective way to prevent and limit the size of mumps outbreaks.

Other Notes:
•  Some counter culture types talk naively about living with nature in a society stripped of modern trappings and benefits. What they fail to recall is that, down through history, Mother Nature has been a real bitch.
•  Modern survival must entail using as many modern means and techniques as possible.
•  Nearly 100% of US deaths from disease now are chronic diseases of old age, such as heart disease, stroke and cancer.

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Friday, November 25, 2011 · 1:50 AM

List of abbreviations used in medical prescriptions

(Survival manual/6. Medical/c) General clinic/Abbreviations used in medical prescriptions)

This is a list of abbreviations used in medical prescriptions (sometimes referred to as sig codes). This listing does not include abbreviations for actual pharmaceuticals (which is a separate article in itself). Capitalization and the use of periods is a matter of style. In the attached list, Latin is not capitalized whereas English acronyms are. The period is used wherever there are letters omitted in the abbreviation.

Abbreviations which are officially not to be used in the United States (as required by the Joint Commission) are marked in blue letters. Those abbreviations which are discouraged from use by other organizations are lettered in orange.

List of abbreviations used in medical prescriptions
http://en.wikipedia.org/wiki/List_of_abbreviations_used_in_medical_prescriptions

Abbreviation Latin Meaning Possible confusion
aa ana of each
ad ad up to
a.c. ante cibum before meals
a.d. auris dextra right ear “a” can be mistaken as an “o”   which could read “o.d.”, meaning right eye
ad lib. ad libitum use as much as one desires; freely
admov. admove apply
agit agita stir/shake
alt. h. alternis horis every other hour
a.m. ante meridiem morning, before noon
amp ampule
amt amount
aq aqua water
a.l., a.s. auris laeva, auris sinistra left ear “a” can be mistaken as an “o”   which could read “o.s.” or “o.l”, meaning left eye
A.T.C. around the clock
a.u. auris utraque both ears “a” can be mistaken as an “o”   which could read “o.u.”, meaning both eyes
bis bis twice
b.d./b.i.d. bis in die twice daily
B.M. bowel movement
BNF &nbsp British National Formulary
bol. bolus as a large single dose (usually intravenously)
B.S. blood sugar
B.S.A body surface areas
b.t. bedtime mistaken for “b.i.d”, meaning twice daily
BUCC bucca inside cheek
cap., caps. capsula capsule
c, c. cum with (usually written with a bar on top of the   “c”)
cib. cibus food
cc cum cibo with food, (but also cubic centimetre) mistaken for “U”, meaning units; also has   an ambiguous meaning; use “mL” or “milliliters”
cf with food
comp. compound
cr., crm cream
CST Continue same treatment
D5W dextrose 5% solution (sometimes written as D5W)
D5NS dextrose 5% in normal saline (0.9%)
D.A.W. dispense as written (i.e., no generic substitution)
dc, D/C, disc discontinue or discharge ambiguous meaning
dieb. alt. diebus alternis every other day
dil. dilute
disp. dispersible or dispense
div. divide
d.t.d. dentur tales doses give of such doses
D.W. distilled water
elix. elixir
e.m.p. ex modo prescripto as directed
emuls. emulsum emulsion
et et and
eod every other day
ex aq ex aqua in water
fl., fld. fluid
ft. fiat make; let it be made
g gram
gr grain
gtt(s) gutta(e) drop(s)
H hypodermic
h, hr hora hour
h.s. hora somni at bedtime
h.s hour sleep or half-strength ambiguous meaning
ID intradermal
IJ, inj injectio injection mistaken for “IV”, meaning intravenously
IM intramuscular (with respect to injections)
IN intranasal mistaken for “IM”, meaning intramuscular,   or “IV”, meaning intravenously
IP intraperitoneal
IU international unit mistaken for “IV” or “10”, spell   out “international unit”
IV intravenous
IVP intravenous push
IVPB intravenous   piggyback
L.A.S. label as such
LCD coal tar solution
lin linimentum liniment
liq liquor solution
lot. lotion
mane mane in the morning
M. misce mix
m, min minimum a minimum
mcg microgram
m.d.u. more dicto utendus to be used as directed
mEq milliequivalent
mg milligram
MgSO4 magnesium sulfate may be confused with “MSO4”, spell out   “magnesium sulfate”
mist. mistura mix
mitte mitte send
mL millilitre
MS morphine sulfate or magnesium sulfate can mean either morphine sulfate or magnesium   sulfate, spell out either
MSO4 morphine sulfate may be confused with “MgSO4”, spell out   “morphine sulfate”
nebul nebula a spray
N.M.T. not more than
noct. nocte at night
non rep. non repetatur no repeats
NS normal saline (0.9%)
1/2NS half normal saline (0.45%)
N.T.E. not to exceed
o_2 both eyes, sometimes written as o2
od omne in die every day/once daily (preferred to qd in the UK[3])
od oculus dexter right eye “o” can be mistaken as an “a”   which could read “a.d.”, meaning right ear, confusion with omne in   die
om omne mane every morning
on omne nocte every night
o.p.d. once per day
o.s. oculus sinister left eye “o” can be mistaken as an “a”   which could read “a.s.”, meaning left ear
o.u. oculus uterque both eyes “o” can be mistaken as an “a”   which could read “a.u.”, meaning both ears
oz ounce
per per by or through
p.c. post cibum after meals
pig./pigm. pigmentum paint
p.m. post meridiem evening or afternoon
p.o. per os by mouth or orally
p.r. by rectum
PRN, prn pro re nata as needed
pulv. pulvis powder
PV per vaginam via the vagina
q quaque every
q.a.d. quoque alternis die every other day
q.a.m. quaque die ante meridiem every day before noon
q.d.s. quater die sumendus four times a day can be mistaken for “qd” (every day)
q.p.m. quaque die post meridiem every day after noon
q.h. quaque hora every hour
q.h.s. quaque hora somni every night at bedtime
q.1h, q.1° quaque 1 hora every 1 hour; (can replace “1” with other   numbers)
q.d., q1d quaque die every day mistaken for “QOD” or “qds”,   spell out “every day” or “daily”
q.i.d. quater in die four times a day
q4PM at 4pm mistaken to mean every four hours
q.o.d. every other day mistaken for “QD”, spell out “every   other day”
qqh quater quaque hora every four hours
q.s. quantum sufficiat a sufficient quantity
QWK every week
R rectal
rep., rept. repetatur repeats
RL, R/L Ringer’s lactate
s sine without (usually written with a bar on top of the   “s”)
s.a. secundum artum use your judgement
SC, subc, subcut, subq, SQ subcutaneous “SC” can be mistaken for “SL”,   meaning sublingual; “SQ” can be mistaken for “5Q” meaning   five every dose
sig write on label
SL sublingually, under the tongue
sol solutio solution
s.o.s., si op. sit si opus sit if there is a need
ss semis one half or sliding scale ambiguous meaning; mistaken for “55” or   “1/2”
SSI, SSRI sliding scale insulin or sliding scale regular insulin mistaken to mean “strong solution of iodine”   or “selective serotonin reuptake inhibitor”
stat statim immediately
supp suppositorium suppository
susp suspension
syr syrupus syrup
tab tabella tablet
tal., t talus such
tbsp tablespoon
troche trochiscus lozenge
t.d.s. ter die sumendum three times a day
t.i.d. ter in die three times a day
t.i.w. three times a week mistaken for twice a week
top. topical
T.P.N. total parenteral nutrition
tr, tinc., tinct. tincture
tsp teaspoon
U unit mistaken for a “4”, “0” or   “cc”, spell out “unit”
μg microgram mistaken for “mg”, meaning milligram
u.d., ut. dict. ut dictum as directed
ung. unguentum ointment
U.S.P. United States Pharmacopoeia
vag vaginally
w with
wf with food (with meals)
w/o without
X times
Y.O. years old
List of symbols used   in prescriptions
Symbols Latin Meaning Possible confusion
@ at mistaken for “2”; spell out “at”
>  greater than mistaken for a “7”
<  less than mistaken for an “L”
℞ take, take this, or take thus prescription drug

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Friday, November 11, 2011 · 12:07 AM

Home medicine cabinet & medication expiry notes

Survival Manual/6. Medical/ c) General clinic/Medical & expiry notes

The home medicine chest (for when times are good)

What you need
•  A tube of antibiotic ointment for cuts and scrapes. If the tube touches an infected cut (especially one that’s full of pus), toss it and buy a new one.
•  A box of alcohol wipes. They’re much safer to have around than a bottle of rubbing alcohol, which is poisonous if swallowed. Use them to clean thermometers and the skin around wounds (stick to soap and water on open cuts,
since alcohol hurts).
•  Anti-diarrheal to relieve stomach upsets.
•  Antiseptic cream or liquid for cleaning cuts and  grazes.
•  Adhesive tape to secure bandages and dressings.
•  Aspirin/paracetamol/ibuprofen to relieve pain.
•  Cough formulas – chesty/dry/tickly.
•  Decongestants for stuffed, blocked nose.
•  Disposable gloves to protect against infection.
•  Hydrocortisone cream for bites & stings.
•  Mild laxatives to counter constipation.
•  Sharp scissors (with rounded ends).
•  Sun protection lotion (SPF 20 or higher).
•  Thermometer to monitor temperature (with sanitary sleeves).
•  Topical treatment for muscular pain.
•  Tweezers for removing foreign bodies
•  Anti-diarrhea medication. Your doctor may suggest this for mild cases of diarrhea.
[Photo above:  One of my two home medical cabinets, ca 2009.]

What to throw out:
By law, an over-the-counter medication must have an expiration date based on when it may have only 90 percent of its original potency. Check your medicine cabinet periodically, and discard pills in the toilet (not the bathroom trash can); pour liquids down the drain.
•  Any expired prescription drug (especially antibiotics  — some may be ineffective or even unsafe)
•  Any medicine that has changed color or developed a “funny” smell
•  Other products that may simply not work as well after their expiration dates: Painkillers, decongestants, cough suppressants, and other OTC medicines won’t be dangerous, but they may be slightly less potent.
•  Sunscreen should not be kept longer than three years (it can lose its effectiveness even earlier if regularly exposed to extreme heat).

Medication Expiration Dates
For further information on expiry dates read: <http://www.health.harvard.edu/fhg/updates/update1103a.shtml>
1.  A report of the American Medical Association (AMA) notes that the US Food and Drug Administration (FDA) and Pharmaceutical Research and Manufacturers of America (PhRMA) “were unaware of any comprehensive studies that addressed the clinical impact of pharmaceutical dates and no such studies were found in the peer-reviewed scientific literature” (AMA, 2008).
2.  In everyday terms, a medication expiration date is the point at which a batch of drugs has reached the end of the longest period of time the manufacturer has tested the continued potency and safety of
a medication. This process is known as stability testing.
3.  There are a couple of things to note here. First, the manufacturer is only required to provide testing results to the FDA for the duration at which it tested a drug; it is not required to test a drug until it is no longer viable. Say the company tests a drug’s stability at two years on the shelf and determines that the drug has no changes at this point. Then the FDA will require the company to stamp the packaging with an expiration date two years from the date of manufacture. Is the drug still good after that date? Well, it wasn’t tested — so no one can say for sure.
4.  What little I did find in the research journals all essentially referenced one long-term study conducted by the FDA at the request of the military. In 2000, Laurie P. Cohen in an article for the Wall Street Journal reported that between 1993 and 1998, the military had the FDA test more than 100 drugs –- both prescription and over-the-counter –- finding that 90% of these medications were safe and effective far past their original expiration date. In some cases, eight to fifteen years beyond their expiration dates. By 2008, the number of tested medications was up to 312.
5.  As per Joel Davis, a former FDA expiration-date compliance chief, “most drugs are probably as durable as those the agency has tested for the military” (Altschuler in Kramer, 2003). Noted exceptions to this include nitroglycerin, insulin and some liquid antibiotics.
6.  “Wisdom dictates that if your life does depend on an expired drug, and you must have 100% or so of its original strength, you should probably toss it and get a refill, in accordance with the cliché, “better safe than sorry.” If your life does not depend on an expired drug –- such as that for headaches, hay fever, or menstrual cramps –- take it and see what happens” (Altschuler in Kramer, 2003). Pasted from <http://bipolar.about.com/od/medications/a/expir_when.htm>
7.  “In a study conducted by the FDA on a large stockpile of medications purchased by the military, 90% of more than 100 medications were safe and effective to use years after the expiration date. More recently, the FDA approved two-year extensions on expiration dates for a number of drugs, including the antibiotics Cipro (ciprofloxacin), penicillin, and tetracycline; the Tagamet (antiulcer/antireflux drug
 cimetidine); and Valium (diazepam), a tranquilizer. The drugs in the FDA study, however, were stored under ideal conditions — not in a bathroom medication cabinet, where heat and humidity can cause drugs to degrade”.

Note: You spend 90% of your health care dollars in the last year of your life. Insurance is something you buy that covers unlikely, but catastrophically expensive events.  End-of-life costs are not unlikely, they are inevitable. Tell your homeowners insurance company that you will have a fire that consumes your home within the next 10 years and then try to price that insurance.

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Tuesday, November 8, 2011 · 1:25 AM

Pandemic fears good for the pharmaceutical industry?

(Survival Manual/6. Medical/c) General Clinic/Pandemic fears good for the pharmaceutical industry?)

1.  Data the drug industry would prefer you didn’t see
Child Health Safety,  Vaccines Did Not Save Us – 2 Centuries of Official Statistics.   <http://childhealthsafety.wordpress.com/graphs/&gt;

This is the data the drug industry do not want you to see. Here are two centuries of UK, USA and Australian official death statistics which show conclusively and scientifically, that modern medicine is not responsible for and played little part in substantially improved life expectancy and survival from disease in western economies.

The main advances in combating disease over 200 years have been [1]  better food and [2] clean drinking water.  [3] Improved sanitation, [4] less overcrowded and [5] better living conditions also contribute. This is also borne out in published peer-reviewed research:

•  Measles was one of the very potent infectious killers. As the graph clearly shows deaths were rampant throughout the 1800s and then began a rapid decline and virtually became a relatively benign disease by the mid 1900s causing very few deaths. By the time the measles vaccine was introduced approximately in 1968 the death rate for measles had fallen by over 99%. [Graph below]

•  Whooping cough, also known as pertussis, was an infectious killer on par with measles killing many people throughout the 1800s. Similar to measles a slow and steady decline began in the late 1800s
becoming much less of a deadly threat by the mid 1900s. By the time the whooping-cough vaccine was introduced the 1950s the death rate had also fallen by over 99%. [Graph below]

•  Scarlet fever was twice the killer that measles and whooping-cough were during the 1800s. Similar to measles and whooping-cough, scarlet fever also made a rapid fall in death rate starting in the late 1800s and becoming virtually benign by the mid 1900s. Although a scarlet fever vaccine was patented in 1924 it was never in widespread use.
•  Smallpox was a lesser killer than measles, whooping-cough, or scarlet fever, but was still an important agent of mortality.
Smallpox, like scarlet fever, became exceptionally deadly periodically interestingly in somewhat synchronized with scarlet fever. In the late 1700s a man by the name of Edward Jenner created a vaccine he believed would protect against smallpox. Jenner believed that if he could inject someone with cowpox, the germs from the cowpox would make the body able to defend itself against the dangerous smallpox. However for the next 80 years despite strong vaccination laws in England smallpox continued to take many lives culminating with a massive smallpox pandemic in 1872. Again, similar to the other infectious diseases already discussed the death rate from smallpox finally began to decline by the late 1800s and became less of a killer by the early 1900s.

This historic research shown in the form of these graphs clearly demonstrates that vaccines were not the key factors in the reduction in deaths from these deadly diseases. Both whooping-cough and measles death rates had fallen by 99% before the introduction of vaccines. A much bigger killer, scarlet fever, had its death rate also decline into virtual obscurity without the use of any vaccine. Smallpox remained a significant killer despite having a vaccine in use for approximately 80 years and then that disease’s death rate declined along at the same time as the other infectious diseases.

Can “vaccinatable” diseases “return” despite vaccination?  Yes.  If you are too poorly nourished your body is likely to lack essential nutrients needed to maintain its immune system sufficiently to withstand disease.  This will happen regardless of how many vaccinations you have had.  This was experienced in Eastern Europe following the collapse of the old Soviet Bloc and the economic chaos which ensued, leaving many in great poverty.
For the same reason vaccines do not “work” and “save” lives in impoverished African and other third world economies.  The majority of third world child deaths still occur despite vaccination.  These children need proper food, clean water to drink and wash in, and sanitation.  We give them vaccines instead. [Think about what this means to your community’s health if the electric grid infrastructure is down for an appreciable amount of time, say, for several months. Mr Larry]

2.  The Great 1918 Flu Pandemic Was Not Due to Flu … or A Virus
Apr-14-2011, J Holcombe, D Jacobson for Salem-News.com
http://www.salem-news.com/articles/april142011/1918-flu.php
“A Press Release, issued by NIAID contains a striking finding and conclusion: The 20 to 40 million deaths worldwide from the great 1918 Influenza (”Flu”) Pandemic were NOT due to “flu” or a virus, but to pneumonia caused by massive bacterial infection.” William Engdahl

(LONDON) – From Engdahl’s work:
“One of the most terrifying images that has been used by spokesmen for WHO, by the pharma industry and various beneficiaries of the current “swine flu” panic is that of the 1918 “Spanish Flu” which is said to have resulted in more deaths than all World War I. Was it really a flu? Broxmeyer is convinced as others that it wasn’t.

“Lawrence Broxmeyer believes that the 1918 pandemic was due to bacteria, particularly  mutant forms of flu-like fowl, swine, bovine, and human tuberculosis (TB) bacteria. “These forms of tuberculosis are often viral-like, mutate frequently and can “skip” from one species to another. Moreover the antibodies from such viral TB forms react in the compliment fixation and later “viral” assays. They also grow on cultures which are supposed to grow only viruses,” he notes.

The NIAID press release dovetails with firsthand accounts –  of many kinds of leftover (potentially spoiled) vaccines the pharmaceutical industry wanted to offload after WWI, being forced on soldiers, as well as of aspirin use suppressing immunity and leading to pneumonias, as detailed in Saying Goodbye to Fear of the 1918 Flu.

[Photo at right 1918 flu pandemic. Could  the massive flu deaths of WWI have a direct relationship to Gulf War Disease?]

“I heard that seven men dropped dead in a doctor’s office after being vaccinated. This was in an army camp, so I wrote to the Government for verification. They sent me the report of U.S. Secretary of War, Henry L. Stimson. The report not only verified the report of the seven who dropped dead from the vaccines, but it stated that there had been 63 deaths and 28,585 cases of hepatitis as a direct result of  the yellow fever vaccine during only 6 months of the war. That was only one of the 14 to 25 shots given the soldiers. We can imagine the damage that all these shots did to the men.
[Imagine 14-25 different ‘dead virus’s’ injected into your body in a short period of time. Global diseases experts point out that the modern flu can go around from pig to bird to man (Avain flu and Pig flu), becoming more dangerous and more contagious. What kind of pathogenesis might occur within  your body from its dealing with, and the interaction of 14-25 ‘dead viruses? Such vaccinations were deemed ‘safe;’ by the government and medical profession ca 1918. Today, similar, and other practices, may be seen as safe, yet the future may prove them wrongful as well. Are you interested in being part of the grand experiment? Think, before doing. A single vaccination now and again is one thing, ‘efficient, multiple vaccinations’ may be quite another. Just as we look back at the primitive medical profession of the early 1900s, in 100 years from now, future people will likewise look back at our practices and shake their heads with an incredulous smirk.]

“All the doctors and people who were living at the time of the 1918 Spanish Influenza epidemic say it was the most terrible disease the world has ever had [seen]. Strong men, hale and hearty, one day would be dead the next. The disease had the characteristics of the black death added to typhoid, diphtheria, pneumonia, smallpox, paralysis and all the diseases the people had been vaccinated with immediately following World War 1. Practically the entire population had been injected “seeded” with a dozen or more diseases — or toxic serums. When all those doctor-made diseases started breaking out all at once it was tragic.”

Could such a conglomeration of 14-25 vaccines trigger what Broxmeyer suspects – “particularly mutant forms of flu-like fowl, swine, bovine, and human tuberculosis (TB) bacteria”?

And if there were no virus that caused the 1918 “flu,” then how could another pandemic – avian, swine or otherwise – occur that is linked to the 1918 virus?

From an interview with German physician, Dr. Stephan Lanka, virologist:
“Dr Jeffery Taubenberger, from whom the allegation of a reconstruction of the 1918 pandemic virus originates, works for the US-American army and has worked for more than 10 years on producing, on the basis of samples from different human corpses, short pieces of gene substance by means of the biochemical multiplication technique PCR. Out of the multitude of produced pieces he has selected those which came closest to the model of the genetic substance of  the idea of an influenza virus, and has published these.

“In no corpse however was a virus seen or isolated or was a piece of gene substance from a such isolated. By means of the PCR technique there were produced out of nothing pieces of gene substance whose earlier existence in the corpse could not be demonstrated.

“If viruses had been present, then these could have been isolated, and out of them their gene substance could have been isolated too; there would have been no necessity for anyone to produce laboriously, by means of PCR technique – with clearly a swindle intention – a patchwork quilt of a model of the genetic
substance of the idea of an influenza virus. ….

“In order to see through this swindle one only has to be able to add up the published length pieces, in order to ascertain that the sum of the lengths of the individual pieces, which supposedly makes up the entire viral gene substance of the purported influenza virus, does not make up the length of the idea of the genome of the influenza virus model.

“Even simpler it is to ask in what publication you can find the electron microscope photo of this supposedly reconstructed virus. There is no such publication.”

Is WHO covering up a tuberculosis epidemic with fake H1N1 panic?, William Engdahl wrote,

“Dr. Robert Donaldson, of the Pathological Society of Great Britain has concluded that there wasn’t “the slightest shred of evidence” that the 1918 disease was due to a “virus” or influenza.
“When questioned regarding the electron pictograph of H1N1 that the CDC recently came up with on their website, … German virologist Dr Stefan Lanka, an expert on the documentation of viruses, attest[ed] to the fact that the H1N1 picture was bogus.
“The virologist wrote that he had “written the CDC many times as to who made the H1N1 photo’s and whether they where scientifically documented as to chemical characteristics and other properties.” There was never any reply.

“He concluded “If CDC refuses to cite the source of the photos,  they are fake.”  … In conclusion, without the isolation of the H1N1, there is no H1N1 infecting virus” …

“Even more bizarre is the admission by the US Government’s Food and Drug Administration … that the ‘test’ approved for premature release to test for H1N1 is not even a proven test. “More to the point … there is no forensic evidence in any of the deaths reported to date that has been presented that proves scientifically that any single death being attributed to H1N1 Swine Flu virus was indeed caused by such
a virus.”

The projection of a swine flu virus potentially killing millions worldwide, rested on the 1918 flu which was not caused by a flu (or virus).  That was the terrorizing basis on which the WHO urged new, untested H1N1 vaccines on the world. The WHO and media suggested that the avian flu was a new deadly virus that, like the 1918 flu, threatened a worldwide pandemic with millions of deaths.  Professor Albert Osterhaus at the WHO, nicknamed “Dr. Flu,” the central figure internationally in promoting the idea of pandemics that would kill millions, was exposed by Dutch media as having financial interests in vaccine development.

From WHO, ‘Mr Flu’ under investigation for gross conflict of interest  by William Engdahl
“More careful investigation into the Osterhaus Affair suggests that the world-renowned Dutch Virologist may be at the very center of a multi-billion Euro pandemic fraud which has used human beings in effect as human guinea pigs with untested vaccines and in cases now emerging resulting in deaths or severe
bodily paralysis or injury.”  ….”

In the following two sentences, Osterhaus builds to the idea of a deadly pandemic using one non-fact after another  and goes on from there to project its spread to Europe.  In suggesting a deadly threat to the entire world, he uses no facts.  He does, though, include the words “indeed” and “real.

“… if the virus manages indeed to, to mutate itself  [Indeed:”in fact; in reality; in truth; truly (used for emphasis, to confirm and amplify a previous  statement, to indicate aconcession or admission, or, interrogatively, to obtain confirmation.]

in such a way that it can transmit from human to human, then we have a completely different situation, we might be at the start of the pandemic.”

” … there is a real chance that this virus could be trafficked by the birds all the way to Europe. 

There is a real risk, but nobody can estimate the risk at this moment, because we haven’t done the experiments.”  …. 

Engdahl again:
“Osterhaus claimed that bird feces were the source, via air bombardment or droppings, onto populations and birds below, of the spread of the deadly new Asian strain of H5N1. There was only one problem with the now voluminous frozen samples of diverse bird excrement he and his associated had collected and frozen at his institute. There was not one single confirmed example of H5N1 virus found in any of his samples.

“Not only was Osterhaus in a key position to advocate the panic-inducing WHO “Pandemic emergency” declaration. He was also chairman of the leading private European Scientific Working group on Influenza, which describes itself as a “multidisciplinary group of key opinion leaders in influenza [that] aims to combat the impact of epidemic and pandemic influenza.” Osterhaus’ ESWI is the vital link as they themselves describe it “between the World Health Organization (WHO) in Geneva, the Robert Koch Institute in Berlin and the University of Connecticut, USA.”

“What is more significant about the ESWI is that its work is entirely financed by the same pharma mafia companies that make billions on the pandemic emergency as governments around the world are compelled to buy and stockpile vaccines on declaration of a WHO Pandemic. The funders of ESWI include H1N1 vaccine maker Novartis, Tamiflu distributor, Hofmann-La Roche, Baxter Vaccines, MedImmune, GlaxoSmithKline, Sanofi Pasteur and others.

“There were no mass deaths from Avian flu, but Roche and GSK made fortunes from sale of anti-viral drugs.

Continuing from the interview  with Dr. Lanka:
[1] “The politicians and the media are taking it upon themselves to delude us into believing everything, for instance, delude us into believing that migratory birds in Asia have been infected with an extremely dangerous, deadly virus.
[2] “These mortally diseased birds then keep flying for weeks on end.
[3] They fly thousands of kilometres, and then in Rumania, in Turkey, Greece
[4] and elsewhere infect hens, geese or other poultry, with which they have had no contact,
[5] and which within a very short time get diseased and die.

“….Anyone who believes this will believe too that babies are brought by the stork. In fact the larger part of people in Germany do believe in a danger from bird flu, don’t they[?].

“Is there, then, no bird flu at all?

“Since the late 19th century, diseases of poultry in mass animal farming have been observed: Blue coloring of the crest, decrease in egg laying performance, sagging of the feathers, and sometimes these animals die too. These diseases were called bird pest.

“In present-day mass poultry farming, in particular when hens are being raised in cages, many animals die each day as a result of species-alien animal farming. Later, these consequences of the mass animal farming were no longer called bird pest, but bird flu. Since decades back, we are experiencing that a transferable virus is being maintained as the cause of this, in order to deflect from the actual causes.

“Then those 100 million hens which appear to have died from bird flu in reality have died from stress or and/or from nourishment deficiency and poisoning?

“No! If one hen lies fewer eggs or gets a blue crest and that hen is tested H5N1-positive too, then all the other hens are gassed. That is how there got to be those 100 million apparently H5N1-killed hens.

The “bird flu” generated billions in profit to the pharmaceutical industry, while on the animal side, it made and makes huge profits for agribusiness.  (A true distinction between these industries doesn’t really exist since the pharmaceutical industry supplies animal vaccines and drugs, GE-hormones, and
 antibiotics added to animal feed derived from GMOs and pesticides they are involved in producing.

“If you look at this more closely, then you see behind it a several-decades-long strategy: In the West,
the big enterprises are cleaning … up with this, because those animals which have died “from the contagious disease” are being compensated for at the expense of the general public, at the highest market price, while in Asia and everywhere where poultry are being farmed successfully, the poultry market there is being destroyed maliciously and on purpose under the leadership of the UN organization FAO.

“All big Western poultry farming enterprises, … if the market price for poultry sinks, they get an infectious disease diagnosed, so that they can get their animals sold at a higher price than would be possible with normal farming, “taken care of” at the governmentally guaranteed maximum price,  and all the animals in one single batch too.

“To bring it to the common denominator: It’s modern subvention (“grant of financial aid as from a government …”) scamming combined with paralyzing scaremongering, which as a secondary effect guarantees that nobody asks for proof.

“Of what did those 61 persons die who were demonstrated to have H5N1?

“There is only very little in the way of publicly available reports, describing what were the symptoms and how these persons were then treated. These cases clearly point in one direction: Persons with symptoms of a cold, who then had the bad luck to fall into the hands of H5N1 hunters, were killed with enormous amounts of chemotherapy supposed to restrain the phantom virus. Isolated in plastic tents, surrounded by madmen in space suits, they died, in panicky fear, from multiple organ failures.

“In the media, photos of bird flu viruses and influenza viruses constantly are being shown. Some of these photos show round formations. Are those not viruses?
“No! ….
“If you ask the picture agencies or a news agency such as the dpa from where they are getting these
 photos of theirs, then they will refer you to the American contagious-disease authority the CDC of the Pentagon. From this CDC it is that the only photo of the purported H5N1 originates too.”

The WHO and CDC are still urging H1N1 vaccines and flu vaccines (which contain the H1N1 vaccine), based on fear it could kill as the 1918 virus did, and on the avian flu as proof of deadly viruses leaping from animals to humans, able to strike at any moment, potentially killing many millions – as the 1918 virus was supposed to have done.

But there is no evidence for a virus in any of those cases: no evidence for a 1918 virus, no evidence of a H5N1 virus bolstered by spurious photos from the CDC, and no evidence of an H1N1 virus but fake photos and wildly false data from the CDC.

Based on almost a century of falsely believing the 1918 catastrophe was caused by a virus when it was not, the world has been terrorized into believing it could come back.

The bird and mammalian species took hold on the earth approximately 65 million years ago, i.e. the same time as the dinosaurs went extinct. So did the flu and other viruses of all the surviving species. Since then, all those viruses have been mating and mutating among themselves without the sky caving in due to any infection. Therefore, any talk of a bird or swine flu pandemic with the probability to kill millions of people is either a purposeful or hallucinogenic nonsense to make profit on the backs of the innocent following.
Shiv Chopra (microbiologist, veterinarian, Health Canada food safety and vaccine expert)

.
Truth Comes Out: 2009 H1N1 Flu Pandemic ‘deaths’ of Children Were Actually Caused by MRSA
November 8, 2011, International Business Times, By Natural News
http://au.ibtimes.com/articles/245026/20111108/truth-comes-2009-h1n1-flu-pandemic-deaths.htm

(NaturalNews) Remember two years ago when every news show featured hysterical reports about the so-called H1N1 pandemic and how the supposed killer flu was striking down healthy kids? True, many previously healthy children became critically ill, developing severe pneumonia and respiratory failure. And some tragically died after being diagnosed with H1N1. But was that really the accurate explanation of what caused their death?
According to the largest nationwide investigation to date of the flu in children who became critically ill, scientists from Children’s Hospital Boston have found another reason to explain the severity of the youngsters illness. It turns out that it most likely wasn’t H1N1 alone that caused healthy children to become so ill many died.
Instead, these kids were unknowingly infected with something else. That additional infection, the superbug known as methicillin-resistant Staphylococcus aureus (MRSA), spiked the risk for flu-related deaths 8-fold in children who were otherwise believed to be totally healthy before they became ill.
Almost all of these children who were found to be infected with the superbug were immediately treated with vancomycin, considered to be best treatment for MRSA. Yet they died despite being administered this powerful antibiotic and their deaths were blamed on the flu. But the new research suggests it was the MRSA that played a huge role in killing these children.

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Saturday, October 22, 2011 · 3:14 AM

Eyeglass repair & emergency glasses

(Survival manual/6.Medical/c) General clinic/ Eyeglass repair & emergency glasses)

How to Repair Broken Eyeglasses at Home
eHow Health
<http://www.ehow.com/how_6525813_repair-broken-eyeglasses-home.html#ixzz1HPUn5suA> Some eyeglass frame repairs are done easily at home.
You can repair your broken eyeglass frames at home if necessary. Most repairs are considered temporary and are done to help you get by until your eye care practitioner replaces your frame or glasses with new ones. Several do-it-yourself repairs are done easily with just a few tools and items you probably already own. Fix your own eyeglasses at home in just a few steps.

Things you’ll need:
•  Small screwdriver
•  Tape
•  Pliers
•  Eyeglass repair kit (Amazon.com ~$4.10)
•  Towel
•  Nail polish remover
•  Fast bonding glue

1.   Spread a towel over your work area surface. In case any small parts fall, you will find them easier. Replace any missing screws. Tighten all screws by placing the frame so it is resting on your work surface with the head of the screw pointing up. Some frames have screws on the bottom side of the frame, slightly hidden. Check all sides of the frame for hidden screws. Inexpensive eyeglass repair kits are sold in most major department stores and optical retail shops and contain different sizes and types of screws commonly used in most eyeglass frames, and small screwdrivers.
2.   Reattach broken temples, the part of the frame that rests on your ear, or hinges with glue. Be sure to clean off any old glue from previous repairs with nail polish remover. Frame parts are either metal or plastic. Use the proper type of glue designed for the material you are repairing.
The hinge holds the front of the frame to the temples. The broken hinge may be attached to the front of the frame or to the temple. Use a toothpick and dab a little glue in the hole where the hinge fits. Insert the hinge and hold for 60 seconds. Depending on the repair, you may not be able to open and close the temple once the hinge is adhered. Use caution when taking your glasses on and off.
3.   Fix bent metal frames by reshaping the end piece, located at the outer edge of the top of the frame front. This holds the temples to the front of the frame and can become bent. Cover the pliers’ tips with tape to prevent scratching the metal frame. Grasp the front of the frame with one hand and cover the end piece with the pliers’ tips and compress gently. Bend slightly to widen or tighten the end piece.
4.   Repair a broken bridge, the part of a metal or plastic frame that sits on the nose, with tape or glue. Tape is a temporary fix and is bulky and unsightly, but does work in emergencies. Wrap tape tightly around the two pieces of broken frame until the frame feels stable. Have someone else hold the frame while you wrap the tape. Glue is also used to hold broken plastic frames at the bridge but does not hold long. Be careful not to get glue on your lenses.

A.  How to Repair Eyeglass Temples
eHow Health
<http://www.ehow.com/how_8045585_repair-eyeglass-temples.html>
Repair eyeglasses at home for a temporary fix.
Broken eyeglasses can ruin your day, but when immediate repair by an optician is not possible, some eyeglass problems can be mended at home, including damaged temples. Always bring them to an optician, as poorly repaired eyeglasses can result in additional vision problems or discomfort. Use these repair tips for temporary fixes.
Things you’ll need:
•  Eyeglass screws
•  Eyeglass repair kit, including tiny flat-head screwdriver
•  Lighter
•  Hot glue gun
Procedure
1. Replace Screws
__a) Examine the screws that join the temples and front of your eyeglasses. Different-sized screws are used in different glasses, but eyeglass repair kits available at drug or grocery stores contain screws of various sizes.
__b) Compare the size of the screws you have purchased to the loose or broken screw in your glasses. If the screw was lost, base the size of the replacement on the size of the joint.
__c) Align the frame with the edge of the temple. The joint holes should match. Insert the screw into the joint. Tighten with the tiny screwdriver included in the
eyeglass repair kit.

2.  Steam the plastic
__a) Use heat to fix temples of plastic glasses that have been bent out of shape. While wearing gloves to protect your hands, hold the frame over boiling water. Allow steam to heat the temple.
__b) Gently touch the plastic with your thumb and forefinger to test malleability.
__c) Shape the temple as it was before it was damaged. Continue to check heat and malleability levels as you do. The temple also can be replaced with an identical or similar piece from another pair of glasses.

3.  Use hot glue
__a) Use a hot glue gun to repair metal frames when the temple is broken in two. Allow the glue gun to heat according to directions.
__b) Squeeze the handle, placing heated glue on one piece of the temple.

• Tips & Warnings: If you have non-metal frames and are not sure that your frames are plastic, do not attempt to heat them. Some frames may appear to be plastic, but are made from less malleable materials.

B.  How to Repair a Broken Eyeglass Frame
Repair a Broken Eyeglass Frame
With the help of an inexpensive eyeglass repair kit, you can perform minor repairs on eyeglass frames. The kits are sold at drugstores and hardware stores.
Things you’ll need:
•  Fast-bonding Glue
•  Orthodontic Rubber Bands
•  Magnifying Glass
•  Clear Nail Polish
•  Eyeglass Repair Kit And/or Miniature Safety Pin
•  Toothpick
•  Pliers With Tape On Tips
Procedure
1. Examine the cause of the problem with a magnifying glass. Is the hinge stretched out? Is the screw loose or missing? Did the hinge break off?
2. If the hinge is stretched out, cover the tips of a pair of pliers with masking or duct tape to avoid scratching the frames and then use the pliers to bend the hinge gently back into place. Or slide an orthodontic rubber band (available from dentists) or a small rubber ring (an eyeglass repair kit may include this) over the loose hinge to hold it in place.
3. If the screw is loose, tighten it with a tiny screwdriver from the eyeglass repair kit. The tip of a paring knife will serve as a screwdriver in a pinch.
4. If the screw is lost, replace it with one of the screws from the kit, or slip a miniature safety-pin into the screw hole and close it. If the repair kit’s screw does not fit into the hole, do not force it, as that might strip the threads inside the frame.
5. Dab a tiny bit of clear nail polish on the hinge screw once you’ve tightened it to hold the screw in place. Let dry.
6. If the metal hinge has broken off the frame, wash both surfaces and scrape away any paint or old glue. Then use a toothpick to dab fast-bonding glue to the break. Hold the pieces in place for 60 seconds to allow the glue to dry.
7. If the earpiece keeps slipping off the frame or has broken off, re-adhere it with fast-bonding glue. If you get the glue on your skin, wipe it off with acetone-based nail-polish remover.

C.   How to Repair Eyeglasses With a Broken Bridge
Repair the broken bridge on your eyeglasses.
The bridge of your eyeglasses provides nearly 90 percent of the weight of your eyeglasses. So when the bridge breaks, your eyeglasses will be useless. The bridge is vulnerable to breakage, and permanent repairs are difficult to make on your own. A professional should make permanent repairs to eyeglasses; otherwise your vision can be impaired. You can make temporary repairs however, until you can take your glasses to an optician or replace them with a new pair of eyeglasses.
Things you’ll need:
•  Adhesive tape
•   Glue gun and glue stick
•  Super Glue or Gorilla Glue
•  Scissors
•  Aluminum foil
Procedure
1.  Wrap the bridge of your eyeglasses in adhesive tape or a hypo-allergenic tape that won’t irritate sensitive skin. Cut a one-inch section of tape with scissors. Hold the bridge together with one hand while your wrap the tape carefully with the other around the broken bridge. Overlap the tape tightly as you wrap it.
2.  Glue the bridge of your eyeglasses together with a hot glue gun and glue stick so that the break won’t be so visible. Put a glue stick in the glue gun and plug it in. Set the glasses on a heat-proof surface, like a piece of aluminum foil. Wait until the glue stick has begun to melt in the glue gun. You can tell by pressing the trigger; you should see some glue coming from the nozzle. Hold the bridge together with one hand while pressing the trigger on the glue gun and applying hot glue to the broken ends of the bridge. Hold the bridge in place with both hands, and press together for one minute or until the glue dries.
3.  Glue the bridge of your eyeglasses together with Superglue, Gorilla Glue or other semi-permanent glue that works on plastic. Hold the glasses together with one hand over a piece of aluminum foil while squeezing glue on the broken bridge. Hold the bridge together with both hands for about one minute until the glue dries.

.
Emergency Glasses
Paddling Net, by Tom Watson
http://www.paddling.net/guidelines/showArticle.html?269
Without glasses, my entire mid to long-distance view is fuzzier than green bologna in the back of the ‘frig. If I were to lose or damage my glasses on a kayaking trip, I would be dead in the water as far as being able to do many activities. I am therefore diligent in bringing an extra pair – even if the prescription is a bit old – on a trip, just in case!
But what can you do should you lose or destroy the only spectacles you have? A classic Twilight Zone episode features a lone survivor of a nuclear attack. He is an avid reader who finds years worth of books undamaged in the city library. Soon after stockpiling a decade’s supply of volumes he accidentally drops and breaks his thick reading glasses. Should you ever find yourself in a similar predicament (broken glasses, that is) don’t worry; if you have duct tape, some wire or a big needle (or a sharp hawthorn or locust thorn handy) you can create a usable pair of glasses.
These glasses will be similar to Eskimo “snow goggles” made of slats of bone or other materials. The wearer would look through a narrow, horizontal slit in the eye slat. This minimized the amount of sunlight and reflective glare entering the eye from the white snowy surface below.

These emergency glasses are designed to restore a bit of your sight by working on the principle of the pinhole camera. The pinhole captures only certain straight rays of light that focus on the retina of the eye (or on the film plane of a pinhole camera). Align several of these pin holes onto an opaque surface and look through it, and voila! – each hole becomes a tiny lens offering a clearer image.
•  The first step is to take a 12″ – 14″ piece of 2″ duct tape, fold it in half lengthwise and press the adhesive backs together.
•  Step two starts by finding the center of the strip and cutting out a nose notch, then measure equally out from the notch to the center of each eye. Mark each center for the field of holes you’ll be punching through the tape.
•  Next, get a piece of wire the size of a large paper clip. In an emergency consider a large thorn from a locust or hawthorn tree. The more perfectly round each hole is, and the cleaner the edges, the better it acts like the lens on a pinhole camera.
•  You want to make a field of holes at least as wide and high as your eye is round. My pair has eight rows with about 10 holes in each row. The rows are about 1/8″ across and the holes are about 1/8″ apart. I staggered each row of hole just like the stars on the American flag are staggered. I used the heated tip of a large needle to make the holes quickly and cleanly.
There are many materials out of which this eye strip can be made. As long as you can create rows of uniform, clean-edged holes, you can use anything stiff enough, yet pliable to be worn as a mask over the eyes. Doubling a strip of duct tape back on itself gives you a perfect thickness to create these glasses.
•  You then tie on a piece of string or shoelace to each outside corner of the “glasses” and then tie the mask in place across your eyes. Finally, adjust the ban so each eye can look directly out through the field of small holes. Once in place you should see things clearly although you might have little halos around images and other visual “ghosts” but they are clear enough that you can read what would otherwise be quite blurry.
Also of interest is that the farther away the viewed object is, the less the pinholes are noticed. The honeycomb effect of the holes is more noticeable when viewing a book held close to the eyes, because the eyes are focused just a short distance in front of the glasses. When looking at a distant TV, however, the holes are hardly visible at all since the eyes are focused much farther away. Also, because of the distance, you can view the entire TV screen through one hole, an obvious benefit.
Getting back to the snow blindness goggles, the duct tape technique can also be used to make a similar pair of lenses to be worn against glare off the water. It’s not the fanciest piece of eye wear, but it is crudely functional. Besides, when you’ve got nothing else, these “glasses” can save your day.

Some advantages that pinholes have over prescription glasses
http://www.myopia.org/ebook/17chapter12.htm
As we get into our 40’s and 50’s and inability to focus close develops, pinholes provide a simple and inexpensive solution for reading or other close work.
Bifocals or trifocals are designed to provide a clear image only at fixed distances. Pinholes provide an improved image at ALL distances. In many applications, such as alternating between watching TV and reading, they can easily take the place of those very expensive prescription lenses that are so lucrative for the anti-consumer eye doctor/optical industry alliance.
Multi-focal lenses provide a continuously variable curve that is supposed to give good vision at all distances. In reality, the distortion on either side of the center line is considerable and often too great for comfortable use. Pinholes eliminate this problem.
There is no need to continually throw away old glasses and buy new, stronger ones. Unless the pinholes break, they can be used an entire lifetime.
While pinholes are not as cheap as off-the-rack reading glasses, they are considerably cheaper than individual prescription glasses. For example, a person who is a little nearsighted but only needs clear distant vision for occasional TV viewing would find pinholes a cheaper solution than prescription glasses.
Off-the-rack reading glasses have the same lens power in each lens. Some people find these cheap glasses unsuitable because the refractive error in each eye is not the same. Pinholes are ideal for such people because these glasses do not require a similar refractive error in each eye.
There is a pincushion effect when looking through the edges of prescription glasses. That is, straight lines appear curved. This disturbing effect does not occur with pinholes.
When you lay prescription glasses down improperly, they can easily get scratched at the center of the lens, the very area you have to look through. Scratching pinholes has no effect on their performance.
Pinholes do not have to be cleaned of fingerprints and other marks that affect vision.
Using pinholes as sunglasses. Who could imagine that pinhole glasses could be better sunglasses than conventional sunglasses? Well, it’s true! This is such an intriguing and revolutionary concept that it deserves its own page. Don’t fail to read, Pinholes As Sunglasses.

Using pinholes as computer glasses. If you are looking for a way to reduce the visual stress of prolonged work at a computer, read Pinholes As Computer Glasses.
Pinholes cannot replace prescription glasses in every situation. People with over 6 diopters of myopia will probably not find pinholes useful, because pinholes cannot eliminate all of the blur. And just as it would be risky to wear ordinary glasses in situations where they could be broken and damage the eyes, there are situations where using pinholes instead of prescription glasses is not advisable. Use common sense and only wear the pinholes when the limited view does not pose a risk.

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