Collectors, outdoor enthusiasts, survivalists. The Army-Navy Store from your memory as a child is just that, a memory. But there is still one place to find everything from gas masks to ammo cans and find it cheap. MainMilitary.com. Get hard to find objects like real wool blankets for under 20 bucks. Canteen for just $2. Or Trioxane fuel for just $1 a box. MAINE Military.com with free shipping on items over $150. Not including heavy items. Find surplus items for cheap now. like 30 caliber cleaning kit for just $2.99 a piece or a dozen for $30. Flair pistols are only $25. Want to add a brand new Israeli gas mask to your collection? Kids in adult sizes are just $20. Get G3 mags for just $2 or a military fuel cap for only $16. Add this iPhone holes for another $7.99. Find it all online at mainmilitary.com. With shipping throughout the world, check out mainmilitary.com or call 877-608-0179. That's 877-608-0179. 0179. Call today. Wolverine Military Outfitters folks, this is WolverineM.O.com. We specialize in ACUs, BDUs and SDUs. MOLLE gear, tactical vest, armored vest and kevlar helmets. Custom camo fabrics and camo netting. All your flare gun and ammo needs. Parachute players, red rain flares, 50 cal ammo cans, ghillie suits, snow camo, Russian gear, German gear, Swedish gear, American gear. If there's something we don't have, just ask and we'll find it for you. So check us out, wolverinemo.com, wolverinemo.com. Check out our site, it's updating daily folks. Mention Liberty Tree Radio for your listeners discount or just call us at 734-340-7285-734-340-7285. I had a dream the other night that, well I didn't understand. A figure walking through the mist with a flintlock in his hand. His clothes were torn and dirty as he stood there by my bed. He took off his three-cornered hat, and speaking low to me, he said, We've fought a revolution to secure our liberty. We wrote the Constitution as a shield from tyranny. For future generations, this legacy we gave. In this, the land of the free and home of the brave. The freedoms we secured for you, we hoped you'd always keep. But tyrants labored endlessly while your parents were asleep. Your freedom's gone, your courage lost, you're no more than a slave. In this, the land of the free and home of the brave. You buy permits to travel and permits to own a gun. Permits to start a business or to build a place for one. On land that you believe you own, you pay a yearly rent. Although you have no voice in saying how the money's spent. Your children must attend a school that doesn't educate and your Christian values can't be taught according to the state You read about the current news in a regulated press and you pay a tax you do not owe to please the IRS Your money is no longer made of silver nor of gold you trade your wealth for paper so your life can be controlled You pay for crimes that make our nation turn from God and shame You've taken Satan's number. You've traded in your name. You've given government control to those who do you harm so they could burn down churches and seize the family farm and keep our country deep in debt. Put men of God in jail. Harash your fellow countrymen while corrupted courts prevail. Your public servants don't uphold the solemn oaths they've sworn. And your daughters visit doctors so their children won't be born. Your leaders send artillery and guns to foreign shores and send your sons to slaughter fighting other people's wars. Can you regain the freedoms for which we fought and died? Or don't you have the courage or the faith to stand with pride? And are there no more values for which you will fight to save? Or do you wish your children to live in fear and be a slave? O sons of the Republic, arise, take a stand, defend the Constitution, the Supreme Law of the land, preserve our great Republic and each God given right, and pray to God to keep the torch of freedom burning bright. As I awoke, he vanished in the mist from whence he came. His words were true, we are not free, but we have ourselves to blame. For even now as tyrants trampled each God given right we only watch in tremble too afraid to stand and fight If he stood by your bedside to dream while you were asleep and wondered what remains of the freedoms He fought to keep what would be your answer if he called out from the grave? Is this still the land of the free? God bless you and God bless you, public. Well, good afternoon ladies and gentlemen, this is the second hour of the Afternoon Intelligence Report. I'm Mark Krunke. And I'm Michael Nasser. One day closer to victory for all of our brothers and sisters both on and behind the lines at occupied territories north, south, east, and west. Well, ladies and gentlemen, you are listening to us on libertytreeradio.4mg.com, pbn.4mg.com, and we're on live 365, then go to Liberty Tree Radio. You'll find us on AM and FM microstations, CB base stations, and ultra net technologies both east and west of the Mississippi, southern and central Alaska, and other systems too numerous to mention but of course the Hallmark system on the East Coast is new coming up and online and is another new sub web system that is superior to well just regular internet the guys and girls that are doing that are doing something very unique so today's date Mike is? 24 November 2008 Monday. Now As you know, we're going to be constantly touching on arms ammunition, equipment, and gear. We always do. Today is, of course, going to be a follow-up on medical issues when we get to Mike's subject today. But real quick, one of the things that we're seeing is they do not want to talk about what's really going on with the weapons purchases across the country. Okay? Well, here's the thing from the other direction a lot of you are asking what can I do to help in the overall cause? well, if any of you are great grandmas and great grandpas or if you are grandmas and grandpas and You're long in the tooth as they say if you know there was you've been here for a while and you figure That well, maybe you won't be here as long as other people. That's not that's just the way life works all of us We know we're gonna work. We're working our clock, you know down even as we speak One of the best gifts that you can give to the Patriot Movement if you're an older person is to buy weapons on paper if you feel comfortable with that and to make them Liberty Arms. In other words, every weapon that you bring out of the system puts a name on the arm that isn't going to do the enemy any good. See how that works? Every one of you out there listening that's a grandpa or a grandma of somebody who's deathly ill. but still able to walk around. If you would like to help in a different way that is very unique that's going to be sending a message to our enemy for many, many years to come, well, you can do us all a favor by going out there and papering as many weapons as you can and getting them out of the warehouse and out of the system and out to our friends and allies where they need to be. Just a suggestion some of you are listening going hmm. What could we do now? I would ask to make sure that they don't fall in the hands of somebody who's gonna be goofy enough to walk them back to a gun shop Okay, so you need to be selective on this We had a couple of our friends have done something like this in the past some of them aren't with us anymore But it has nothing to do with anything restricted so much as one of our allies Flat out decided he wanted to sponsor as many micro FM stations as he could So he bought as many of the Ramsey kits as possible under different names and he bought more and he bought more and he bought more and he bought more until Some at some point there wasn't any worrying about buying anything because he's not with us anymore, but you know what? There's no way to tell where they went and there's nobody to point a finger at because that gentleman is now with our maker Okay, but what's cool is because of him Many of you that are listening, even as I am speaking now, are listening because that man, several years ago, committed what he could to our cause. So in reality, after death, he is having how much more of an effect on an enemy that thought that he could be outlasted. In other words, that they were going to wear past him and that eventually overrun us all. So don't say you can't have an effect from the grave, okay, or that you can't have an effect after you're gone because the 100 plus micro FM's that were overtly bought and the others that were quietly bought are now just like the tens of thousands of others that are out there Informing how many other people every day? I'd say that's a gift that keeps giving Well, the same is true with regard to weapons. I don't care what class or category you pick at people, that's your choice. You decide, depending upon the totalitarian steps that are already plugged into your state and how close they are to being the Soviet ideal that they want. Okay? But you can help us. And you can help us in a unique way that puts more and more and more firearms into the hands of the people that are going to need them to fight and win the war against the oppressor. Okay, so that's pitching in in a unique way. Go ahead Mike. I'm sorry It's kind of like the gift that keeps on giving in a part in 30 caliber in 8 millimeter in 762 by 54 you name it it's out there Now another thing that I see happening because of availability And again, this is the holiday season. Hey, if they're going to give you a little special loans and other, you know, like especially unsecured loans and you can get them from different locations. Guys, take the money, turn it around, invest it in picking up your arms and ammunition now. You notice I haven't said that before and we've told you before about holding the credit cards back. Don't use them unless it's for that last step, that next wave. Well, we're there. That that, shall we say, diversion you've been trying to ignore is the attack you've been expecting. That diversion you have been trying to ignore is that attack that you have been expecting. That's where we are right now. So again, what I want you to do is keep in mind that we are going to have to be squared away top to bottom. If you've got a little space on the credit card, when the time comes, as the system collapses the rest of the way, who's going to be coming to collect on it? First of all, it's an unsecured loan, and you're the one who made the money. And the company that's probably going to go under, are you going to care? No, I don't think so. So which is going to be more valuable that piece of plastic? Well you could sharpen the edges of it guys Hook it up to a stick and use it as kind of a short-term one time strike blade. Oh, you might do that anyway, but in the meantime you could swipe it a couple more times and Again, vote with your wallet vote with your wallet and vote with your wallet In fact, the polling places across the country are Joe's Gun Shop, Fred's Gun Shop, Classic Arms, Schmidlap Arms, Bruisenberg Arms. Those are the new polling places right now, Mike, and people are voting en masse. They can't keep the ballots on the shelves and people are turning their ballots into, they're fixing to air mail their ballots in this time. They're going to air deliver them back in very precise ways. Yeah, I really feel bad guys. You know, they were hoping we would be asleep and I have to keep repeating this. They really really thought that they were gonna be able to put everybody to sleep Not one person is fooled by any of this BS even the rats on the other side are so chomping at the bit because they want to be able to puff up and tell everybody how they're gonna take your weapons and Confiscate the guns that they're shrill right now people, but it's not doing any them any good. I'm sorry finished kids done We're all cock-lock ready rock and roll and everybody's headed for the everybody's headed for the battle line Now to what degree varies but I would ask you to do something and I've asked a couple of the companies this Do not forget if you got everything else topped off But you didn't get gas masks if you don't have chem suits if you don't have water purification You need to take care of it ASAP. Okay, I tell you what we're gonna do. I know we got a caller just popped up Hold on for just a second because I think we're gonna go to break here in a minute Maybe and if we're gonna go to break call or you hold right where you are This is the Intel report. We'll be back in about three minutes, Mike and Mark and caller. On Liberty Tree Radio LTO for cheap now like 30 caliber cleaning kit for just $2.99 a piece or a dozen for $30. Flair pistols are only $25. Want to add a brand new Israeli gas mask to your collection? Kids in adult sizes are just $20. Get G3 mags for just $2 or a military fuel cap for only $16. Add this hyphen hose for another $7.99. Find it all online at mainmilitary.com. With shipping throughout the world, check out mainmilitary.com or call 877-608-0179. That's 877-608-0. 0179, call today. For more information, send us self-addressed stamp envelope to... Wolverine Military Outfitters folks, this is wolverinemo.com. We specialize in ACUs, BDUs, and SDUs. MOLLE gear, tactical vest, armored vest, and kevlar helmets. Custom camo fabrics and camo netting. All your flare gun and ammo needs. Parachute players, red rain flares, 50 cal ammo cans, ghillie suits, snow camo, Russian gear, German gear, Swedish gear, American gear. If there's something we don't have, just ask and we'll find it for you. So check us out wolverinemo.com, wolverinemo.com. Check out our site, it's updating daily folks. Mention Liberty Tree Radio for your listeners discount or just call us at 734-340-7285-734-340-7285. Go ahead Mike. Yes, good afternoon ladies and gentlemen, you're listening to second hour of the intelligence report with Mike Mark 24 November 2008. It's a Monday and I understand we got a caller. Come on up caller. Hey guys, this is Marcus and George on the road in Alabama. Hoorah! Hey, you're in alien territory Alabama? Yeah. Hey, I want to give you all a heads up. I bought two of the brand new Made by International, two and a half. that are for CBRNE, the new NBC nomenclature army's unit CBRNE. Yep. Looks like they were heading over to Fort Stewart and two brandy new units that can go into an area after there's been an attack and do sampling and then survive coming through Birmingham heading over toward Georgia and it's got to be going over to the first brigade combat team of the third ID that's been attached to Homeland Security. Very good again, that's most likely they're being prioritized with first best equipment for whatever they're going to deploy against the American people So that's exactly right mark because why would you want to give first line brand new stuff? Our unit signed here to the state to the what the battlefield is Roger exactly fact We've got you've got combat units deployed in two high-risk areas right now especially Roger min over confirm the We're still here, we got you. No, uh, uh, we were talking about filter, filter, although were you talking about people getting like catatons and the burkeys are learning how to do using a charcoal filter from an aquarium, a clean fan. Actually, to use both. Right now the burkeys are a good choice because we know their, their high reliability. If you can get any model from anybody right now because availability varies I would shop around and call around people aren't thinking about water for the moment again But it is the highest of priorities with regard to all of our people and I would recommend anybody listening take care of that Again, the other idea as far as coming up with your own filter systems. That's absolutely true Everything that you need is off the shelf if need be in fact between the aquarium supply, a pool supply, or now the latest thing is not just swimming pools, but everybody's been doing these indoor waterfalls and indoor fountains. All of the cleaning systems and processors are sitting there and they can be, they can be, shall we say, husband over into water purification for consumption. It's just a matter of knowing how the system works and supplementing its filtering system. But yeah, doing this stuff, we actually used to do the charcoal, sand, and coffee filter systems. We used to make those- Exactly. Yeah, we used to make those up for two things. Number one, for water, because it's a cheapy quicky way to go. But we did this for other projects when we were working on building our own powder, like making our own smokeless powder. We produce all of our own components. The other thing is, when I was reprocessing crankcase oil, you know, through an osmosis system, You drop the old crankcase oil in the top. You have your multi-stage sandwich filters. and basically the same thing and at the other end you're gonna get a basically clean oil all the heavy elements and material have been filtered out with the charcoal, the paper filters, the sand, the charcoal, the paper filters and the sand in layers. And a magnet. Yes, yeah, to take out the the metallic. Mark you the magnet when you're doing your oil. Yeah, because what's in the oil, the contaminant, the majority of it are the... No, I'm a punk. Yeah, the wear parts. Don't forget a copy of the I'll lose me. No, we got you, you're copied over. We got you go ahead. Oh, I think it's one-sided. I think we have him, but he may not be hearing us We got you go right ahead Marcus Yeah, he's a lot we've lost you Marcus you probably don't know but we can hear you okay We've probably lost this is live radio in this pond and none of that But we're doing it from think of how many different systems are tied in to get this done We're talking from a truck that's moving from a cell phone system, I assume, which is then hooking up to a ground line, which is being transferred into a computer, which is being mixed and matched for radio broadcasts and then going out all over the planet to people who are going, what the hell happened to the intel report? Mark, you still having me? We got you, Marcus. I'm a drunk dog. Okay, I'll tell you what, go ahead and we'll mute him so that's okay. I'll tell you what we're going to do real quick. We're almost at the bottom now. We're headed that way. When you see equipment and material moving around on the road, remember guys, certain pieces of equipment are assigned for certain tasks. One of the reasons this becomes an item of interest is that we have combat units that are in the field right now in what is perceived to be a and in fact they've used the propaganda that we're gonna be either nuked or gonna be bioed or chem'd you know by the Iranians with our troops in the field not here but over there okay keep that in how many times have you heard this well you know they can attack our troops and this and that and the other well if that rhetoric is true then wouldn't you prioritize Mike sending your best equipment forward to the troops greatest at risk That would be logical. That would be the norm if you were worried about protecting American troops. And of course the population itself, well at this end, the thing about this technology is remember it works both ways. After they have deployed against the American people, after the global ring knockers have deployed bad stuff against us, Then they're going to turn around and want to try and work their way through the area. They're not there to help us or fix anything or protect us. I will state again, and this is perfect because what he just reported, what Marcus is talking about, is why I'm going to tell you people, you need a gas mask, chem suits, and the basics. Why? Because we don't want you. You don't need to sit in that environment. Mike, we want to get them out of it, don't we? Big time. Avoid that stuff. That's right. And begin, we're in a situation like that. You've got to have the basic protection so you can waddle out of that and into an area that's fairly secure or is outside of the area of contact, the area of contamination. That's really what we're setting everything up for. And again, the Department of Defense, the U.S. government has not made any significant effort to protect you. There is no significant effort being made to protect you. If you are listening right now, you are not on the list of people to be protected. The Senate and the House, remember after 9-11 and after all the anthrax BS, it was all done by the Mossad. Remember when the Mossad attacked all the people who were anti-war, attacked their offices when the Mossad sent anthrax to the people, those people? Well, when they did that, the next thing was, they need gas masks. They need this, they need that. They didn't say the American people. Did you notice that? Mike, did you ever hear them say, oh my goodness, I just realized the American people are at risk to nuclear, biological, and chemical threat. We need to take $700 billion and buy gas masks for every American in this country. No, no, we need to give that money to the bankers. That's right. Wait a minute. If we'd built the gas masks, we'd have Americans employed and we'd improve our national defense rating, wouldn't we? Yeah, or a multiplier. Yeah, so instead what you heard was, oh, Congress needs theirs, but you don't need any. Isn't that exactly how they responded? They just hurried off to their shelters and airplanes and left us swinging. If you need rubber boots, two options. Go to main military, go into their closeout section, take a look at the rain gear boots. Those are the standard chem boots for the US military right now. That's all it is, is the rain boot. Otherwise, go to your farm and fleet or any of your farm supplies and they got all the rubber boots of any style and type you could possibly want. There's your decon kit in a bag right there. Chem suit $12 from Maine Military. Gas mask, three for $20. Spare filters for the M9 finisher are about $5 apiece. Hell, it's cheaper just to keep buying more masks than just to buy filters by themselves. And on top of that, a dollar store set a go out. A couple pairs of the black rubber gloves. And guess what? For another $5 to $7 to $10 China Sport rubber boots. Hey, I'm just as well equipped as the average combat soldier in the field right now for NBC by doing that Think about that guys now otherwise there is going to be no Yeah, yeah, the average person can't get it anyway oops because they're not making the effort and again if everybody well We just saw this happen with what just happened with the ammunition. It's what I've been then again That's an I told you so Consider this, there are not enough gas masks right now to go around and the system will not provide what is needed. So, those who get there first, get something. While people aren't thinking about this yet, I'm going to tell you right now, while people are not thinking about this for the moment, you're still talking about getting a gas mask for about $7 a unit. That same gas mask is going to go to 25 50 55 70 75 100 100 125 going once going twice $300 apiece Why can we say this? Because when desert dust one came up guys that is exactly what happened to all of the gas mask inventories When desert dust two came along it was the same thing revisited Because here's the other part of the bad math formula nobody wants to talk about. I guess I have to keep reminding everybody. The gas masks will also be bought up by governments. Huh? Well, all these companies you're dealing with that you think are like regular, they're surplus, but you've got to remember guys, they're connected to Other government companies, companies that sell to government agencies in other countries, most countries do not produce their own chemical defense technologies, ever. They count on a handful of countries to produce basically over a period of time what they need. Now if they go into another incident of any kind or as suspected let's say they want to start beating the drum when they start beating the drum all of a sudden a mic and we saw this before ABC or CNN with the news reporters with gas masks hanging around their necks didn't we? Yes, especially back during desert storm and all that you bet and remember good old wolf Blitzer and all of a sudden wolf there with his you know wolf sitting there with his gas man I'm over here in Iraq remember that one? So guys it's not a matter if it is simply a matter of when when Now basic NBC defense guys and Mike will have to start priming on this again to just remind people about the basics We're gonna go to we're gonna go to the break. We still have the things to cover medical today But I'm gonna remind everyone cover your basics read as much as you can do the research that's necessary focus This is the intel report. We got Mike and Mark. It is the second hour. It's Monday back in three on Liberty Tree Radio. Hey Tommy, you got anything? Yeah, I got plenty of them. You know, when you guys were out buying your B.M. something to uh, to be a B.M. That burning wreckage down the road, man. My beamer's gone. I'll tell you what though. Whoever you were listening to, they had their act together. This guy said a box ammo would be enough. Hell, I used that 15 minutes ago. Uh, throw me a mag, Tommy. Now, yeah, I can- And ladies and gentlemen we are back this is the Intel report live and we have a whole lot of work ahead of us here I want you to get your notepads out because Mike is going to be going over medical But real quick Mike we're gonna. This is a schedule warning. This is a schedule warning This is a schedule warning for all of you listening Tuesday and on Thursday we are going to make sure and Mike's going to be covering going to touch on basic NBC on Tuesday and on Thursday when he's up. Okay, that's not going to be the whole of the program, but I want to remind everybody if you got people you're trying to teach, this is a chance for you to sit them down at the radio or sit them down at the computer and have them listen a little bit, okay? Now the other thing tied into this and I would ask you all to do this anyway. Go to Liberty Tree Radio on YouTube or go to LibertyTreeRadio.4mg.com to our website and then go to the video link for YouTube. Now without Mark having to repeat a million times because Mark doesn't have to, if you click on the video you can use it to teach people about what they need. There are a series of militia videos on basic chemical, basic web gear, basic rations, basic medical supplies, okay, basic NBC in three different forms so you can pick whichever one you like, it's your favorite, okay. The point is it gives you a chance to just sit somebody down and say hey watch this thing real quick, it's really, this will save me a lot of time. They watch that and then let them write down and ask questions when they're done. In fact, ideally, have them ask questions, write it down, or just make a quick note. But otherwise, stay focused on the video. Stay focused on the video. We need to pair things down and save time. Okay? It is critical. Mike can do that because this is his job. This is what he's doing. He is a trainer. It is his mission. Okay? We have done this in other ways and we have tools that are already in place. Now, equipping one and two, but also again, basic NBC, nuclear biological and chemical defense, basic medical as far as compresses and bandages that are out there, stuff that's available right now. basic rations which is another thing that everybody's like oh I didn't think about that which is true a lot of people don't but and I will say this again even on the air because it needs to be said guys when you go to Arby's or if you go to McDonald's don't they have sugar packs, pepper packs, don't they have ketchup, don't they have taco sauce, don't they have chopped onions in little packets that are all set to go that are individual servings? Do you know how much of a plus that is when you are in the field changing the dimension of your meals? I mean, think about it guys. A little package of hot sauce or a little package of Tabasco sauce or a little package of taco sauce or a little package of steak sauce changes the flavor and mixes up the menu. That is a big difference. It eliminates some of the food fatigue issues that people are so worried about. Well guess what? You don't have to pay anything. You just got to keep collecting it. That's how I do it. Mark isn't made of money. Mark, every time I go somewhere, oh look, there's taco sauce. There's, oh, Arby's horsey sauce. There's, oh yeah, I like that. Oh, and I need some, I need some pepper packs. Pepper's something you won't find in any rations, because pepper's expensive and pepper, you know, varies as far as how it's stored, as far as how well it will store. So pick it up fresh, pick it up in individual packs, that way you don't have to compromise the whole thing. Put them in Ziploc bags or whatever container you want to use and then throw them in your gear and you're all set when the time comes. What's the cost if they go bad? You pick them up, you throw them in the trash. Why? Because it costs you nothing while you were going and getting your little drink at McDonald's or you got your one hamburger and you got all your other goodies. Utilize the system. By the way, a little hint here. Honey is expensive, isn't it, Mike? Big time. You ever go to Kentucky Fried Chicken? Yep, don't they give out honey packs when you order the meals if you ask for them Yes, sir. Hey, that's a nice way to be picking up individual servings of honey for well the cost you already paid for the meal But they're free. They're a gimme on topic opioid dependence is a medical condition many people struggle to overcome That too many try to handle on their own alone, but they don't have to and neither do you Treatment is available in the privacy of a physician's office click on the banner and visit turn to help calm Live 365. So, maybe one year with your family and friends, maybe you can gather around and maybe help introduce some other people to our program. That leads me to another thing I recall listening to William Cooper years ago. It was revealed to him that there's good possibility that they could also plan an attack to come and pick you up on Thanksgiving. You know you're over here at your relative's house, you're getting a little bit of sleepy, and you're at turkey. had a glass of wine, now you're snoozing in front of the TV, watching the football game, all of a sudden there's a knock at the door and game over. Bob's your uncle. It's like, come with us. So just be careful of your intake. Be aware of your surroundings all the time here and what's coming up here in these next few days. Also, I'd like any feedback. I saw it on the Today Show on Sunday. I didn't have any heads up about it, but I guess they, Al Roper, the underground, the weather underground, did a uh... subject to it from b a p f agent about firearms and everything i tried to get that out but pretty sure i'd contact somebody they said that they were going to film it But I could kind of see where it was going. They were sitting there comparing 50 calibers to 22 saying basically they had no legitimate sporting purposes. So if anybody had happened to have catch that, I'd like a little bit of input on what they saw. Okay, now you've had plenty of time to get your paper and pencil ready. This next block of instruction we are going to continue. With our resuscitation from shock and trauma, we're about knee deep into the chest injury. And just as a quick review, we talked about the initial evaluation and the therapy about clearing the airway obstructions, correction of the hemonumothorax, talked a little bit about acute cardiac tamponade. And then we went in to start getting into the definitive evaluation of the management of the patient. So about your physical examination, this is slightly a review. We backed up just a little bit to kind of get this running again. Now, it's going to, obviously, it's going to include a thorough determination of the extent of the chest injury as your resuscitative efforts result in the stabilization of the patient. So, as you're resuscitating the patient, you are starting to evaluate what's going on there. You're going to start inspecting for your chest cage symmetry, the paradoxical movement of the section of a chest wall that can be revealing. Any subcutaneous emphysema of the neck may be indicative of a centrally located major airway disruption or of an esophageal tear. But usually any of your subcutaneous emphysema on the lateral chest wall, that's going to suggest a rib fracture. And so these are some of the things if you notice as you're going down the patient doing a head toe examination, you start to discover there's weak femoral artery and they've got low blood pressure in their lower extremities. There's a very good possibility that they've got some damage. in their thoracic aorta. It's real hairy there, so basically off the top of the heart you have the aorta that comes off, it arches around, and then starts downward towards the abdomen. Part of the branches off into your hepatic circulation, give the circulation to your kidneys and your liver area, then it goes down into your groin and then splits off and goes down into the femoral arteries. But a lot of times in chest injuries and things, they could cause a tear in the aorta. So some of those signs of weak femoral artery pulses and hypotension, low blood pressure in your lower extremities. They can be a very good clinical sign that you've got a traumatic injury to the thoracic aorta. The next thing is, we ended on this the other day, we were talking about mechanical ventilation assistance. Now, this doesn't mean that we're putting a person on a ventilator. When I talk about ventilatory assistance, it could just be with a bag, valve mask, resuscitator, an ambu bag, or something like that, an oral pharyngeal airway, an endotracheal tube, a tracheostomy, any type of things like that. We're going to guarantee that we've got an open airway. This is also with or without any oxygen that we're given the person. It'll be for a variable time. The tracheostomy is not advisable initially unless there's some real upper airway obstruction. that you might encounter with a fracture of the larynx or the upper trachea. Now the proper insertion of a soft cuff, nasal, or endotracheal tube that will usually get you by and help assist in your ventilation. And you might also want to consider maybe somebody in the group pool your money and get a pulse oximeter where you can monitor the blood without having to draw blood gases on the person or find somebody that's You know, had a doctor's order and they had an order of this type of equipment, somebody that's on oxygen and they might also have a pulse oximeter at home that got left there or something like that. So that's something that you can definitely utilize with somebody and then that's going to prevent you from having to draw arterial blood gases and check out how effective your oxygenation of your mechanical ventilatory assistance is there on that field. Now, I just kind of want to touch here lightly about the indications for a thoracotomy. In other words, what we're trying to say is I'm not expecting you to be able to do open chest thoracic, cardio, pulmonary thoracic surgery type of thing. But just to understand that some of these things that are going on and it's over your head and you need to get to the person evacuated as soon as possible because these are some of the things that are really starting to cook in there. Now they're usually reappearing. Mike, we're going to go to the music here. Mike, we're going to go to break. We're going to go to break. We'll be back here. Stay right there where you are. I'm going to pull it back just one sentence. And we're going to pick right up where we left off here. Liberty Tree Radio, Mike and Mark. It is Monday. Stay awake. Collectors, outdoor enthusiasts, survivalists. The Army-Navy Store from your memory as a child is just that, on memory. But there is still one place to find everything from gas masks to ammo cans and find it cheap. MainMilitary.com. Get hard to find objects like real wool blankets for under 20 bucks. Canteen for just $2.00. Or Trioxane fuel for just $1.00 a box. MAINE. 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Get your Bedfan by going to bedfan.com or calling area code 210-632-8280. Spas 12 shotgun Phase plasma rifle. Wait a minute, wait a minute. Forget all that. Go to thegunpartsguy.com to build your own FNFL. That's right. Go to gunpartsguy.com. 360-906-8369 is the number to call. That's 360-906-8369. You want to stop the terminators? You want to stop the new world order? You need to call thegunpartsguy.com right now. that's 360-906-8369 Remember, this is the man who's got the weapon that will stop the Terminator in his tracks. The mission? The FNFL is the leading cause of big holes in bad guys. It's what you need to stop them. Call 360-906-8369 or go to gunpartsguy.com Remember, if you don't, you won't stop me. Go ahead, Mike. All right, we are back, ladies and gentlemen. We were talking about the indications for thoracotomy. They're obviously usually apparent from any observations made during the period of resuscitation, and then how stable the patient is, some of the things that you're going to take into consideration, that they're the indications that some further definitive care is going to be. It's an open sucking chest wound. You're going to usually pick that up on visual inspection, uncontrollable, hemorrhage. We're going to record the volume of blood loss and the replacement. If there is a massive air leak, you're going to start to see a progressive subcutaneous emphysema. There's esophageal injury or suspected thoracic abdominal injury with a ruptured diaphragm. Obviously, if there's a foreign body, a gunshot, or a stab wound, you're going to see the entrance wound and possibly a tract. of where that went. The thoracic aortic aneurysm, again, you're going to see a decrease. The patient is not going to respond to your resuscitative measures. You're going to see a weakened femoral pulse, and you're also going to see a drop in the blood pressure and the lower extremities. And also about cardiac tamponade, you're going to have your physical findings especially when your blood pressure numbers start getting closer together. So those are some of the indications of the possible need of an operation of thorothoracotomy. Now the operation, it's most necessary in patients with massive uncontrollable hemorrhage or air leaks or those with a cardiac tamponade. Now some of the things that you might, we'll kind of cover over some of the types of injuries. a chest wall defect. Usually your typical sources are going to be a shearing trauma like a shotgun blast, explosion, flying objects, or automobile hood ornaments or something. What you're going to see is a circulation and ventilatory deficits. And usually what you're going to do is put an occlusive dressing, maybe one or two chest tubes. If they have some major blunt trauma, automobile accident or a fall from a height, there's going to be a ventilation deficit, a possible circulation deficit, an esophageal or a diaphragmic injury, a rupture in the diaphragm, the muscle that's the bottom of the, underneath your thoracic cavity, it separates your intestines from your lungs. So there's always a possibility of that. usually what you're going to encounter are multiple injuries. Your major resuscitative efforts are going to be needed and then the need for thoracotomy is indicated by the failure of your resuscitation. So you're working your heart out and you don't seem to be getting anywhere. Now if it's a perforation type of wound, a bullet, good possibility that you're going to have a circulation deficit, definitely a life-threatening injury. and there's a good possibility that you could have a ventilation deficit. Also, we're going to always look frequently. They're going to be associated with abdominal injuries requiring some maybe abdominal surgery and a need for a thoracotomy indicated by again the failure in your resuscitative measures a penetrating wound like a knife. You're going to have a circulation deficit. Again, it depends on the location, but it can be life-threatening. But usually on this one, your resuscitative measures are usually also ficed, depending on the extent of the damage. But a lot of times, they're frequently not evident until after 8 to 12 hours of observation. If it's a minor blunt trauma, a simple fall, You're going to have a decreased ventilation and impaired removal of tracheobronchial secretions because of the pain. The person is not going to be able to cough properly to bring any of those secretions up. There's good possibility that you're going to have morbidity if they're not vigorously treated. These are especially in your age type patients. Now just a little bit we can talk here I know we're closing in on the end of the hour or we'll talk a little bit about the management of some specific type of injuries. Your chest wall trauma is frequent and it may vary from a simple rib flat fracture to multiple fractures or an injury to the bony thorax. They may be associated with soft tissue disruption resulting in a communication with the plural space. You can have the ribble fracture, it will puncture the lung or into the pleural space, and then the air as it comes in your mouth and goes into your lung, instead of being exhaled back up the trachea, it will actually be going and escaping into the pleural space. The rib fracture, the next one is going to be, it's very painful. It's going to result in chest walls with reduced tidal volume. It's real painful for the person to take good deep breaths. It's going to inhibit the satisfactory coughing by the patient. Diagnosis of rib fractures may be made in the absence of an X-ray. That will be demonstrated at the fracture site if the patient has an appropriate local tenderness. Also, again, your symmetry of it, you'll feel where it's maybe vied in there on one of the ribs. The treatment is going to be symptomatic and it's directed towards the relief of pain. And under no circumstances should any chest wall motion be restricted by putting any encircling dressings or any tape all the way around them. You might want to, depending on the extent of the injury, you might want to consider that, but usually there's not a whole lot to do with minor rip cracks. The next one is going to be a flail chest. We talked about this the other day, but just as a quick review, now it usually results from multiple ribs or a sternal frack. The sternum is the breast bone or both. and that's going to produce a detachment of the segment of the bony chest wall. Usually a sequential series of four to seven ribs will have anterior and posterior fractures resulting in a free movement of the segment of the lateral. Occasionally the sternum may be fractured and disrupted from the ribs onto the sternum itself. It enables your chest to free, paradoxical the ventilatory effort and then what will happen is it will get sucked in on the inspiration and then it will be pushed out on the expiration. So it will be moving in the opposite direction the rest of the chest. Now the tidal volume, that's the whole volume of the air is going to be diminished in the lungs and that's going to be in proportion to the volume displaced by the moving chest. Now the ventilation is going to be compromised. in the ineffectual ability of the patient to cough. Now the treatment is directed towards the immobilization of the flake of the chest wall. This was accomplished by external medication or by sandbags, but now present time it's an internal stabilization of the chest wall using a positive pressure assisted ventilation. But if you don't happen to have that, then you can immobilize the net. of the chest wall with a sandbag or something or put some tape on there to help hold that into place to keep it from grinding back and forth each time the person moves. Now this, the method about the positive pressure assisted ventilation, the manage, that method provides an adequate tidal volume and in addition it'll counteracting the adverse mechanical effects of the flailed chest wall segment. So basically what we've got to do is immobilize that section of that chest wall. And again, either you can put some wide tape on just that section to help hold that, or to put a small sandbag. Don't be throwing those 60-pound sandbags on somebody's chest to hold that in there. You might just a little 5-pound sandbag or a 10-pound, just enough to help immobilize that. The next section of what we're going to cover here is about the sucking chest wound. Now they may accompany a foreign body penetration or a perforation of the chest wall. Now, if the chest wall disruption is large and the plural space freely communicates with the exterior, an open wound with a new mold thorax is going to result. If the communication is intermittent, a flat valve effect may permit entry of the air under the atmospheric pressure during the inspiration. And then the exit is going to be obstructed during expiration. And then the condition that results is the increasing interplural pressure. And then you're going to get a tension pneumothorax. Now in either event, your immediate correction by the placement of an occlusive dressing and the evacuation of the pneumothorax will restore the integrity of the chest wall. Now, modal debridement of the chest wall will should be done urgently in a rear area or in an operating room, have been resuscitated. So we've covered the sucking chest wound about 9,000 times. I hope everybody's got that down. Quick review, there are new listeners. What you want to do is you want to find something like if you have a combat dressing with the plastic cover on it, you want to split it open so you've got about a Oh, about a 4x4 or a 5x5 piece of plastic. You want to wipe as much blood away from the wound site itself and then you want to tape three sides of that right onto the chest wall. So it's going to create a one-way valve. You don't want to tape four sides because we want the blood in the air to be able to exit out. from that wound itself. So you only want to take three sides and you want to store the patient and evacuate the patient on their injured side because if it fills up that chest cavity... Mike, we're at the top! ...with air and blood. Yeah, I hear the music. He's just trying to finish this up. I guess that's something we'll have to kick off tomorrow after we do the NBC stuff. Alright, go back about a paragraph, because we're right at the top here. Ladies and gentlemen, as always, God bless the Republic. Death to the new world order. We shall prevail ladies and gentlemen the Empire is on the run. And we are on the march of day and night. U-ROD medical support makes it. Collectors, outdoor enthusiasts, survivalists. The Army Navy Store from your memory as a child is just that, a memory. But there is still one place to find everything from gas masks to ammo cans and find it cheap. MainMilitary.com. Get hard to find objects like real wool blankets for under 20 bucks, canteens for just $2, or trioxane fuel for just a dollar a box. MAINE. Military.com with free shipping on items over $150, not including heavy items. Find surplus items for cheap now. like 30 caliber cleaning kit for just $2.99 a piece or a dozen for $30. Flair pistols are only $25. Want to add a brand new Israeli gas mask to your collection? Kids in adult sizes are just $20. Get G3 mags for just $2 or a military fuel cap for only $16. Add this iPhone holes for another $7.99. Find it all online at mainmilitary.com. With shipping throughout the world, check out mainmilitary.com or call 877-608-0179. That's 877-608-0179. 0179 call today. The Bedfan's revolutionary design directs cool air between the sheets where it's really needed. No more tossing and turning to keep you up all night. The Bedfan's thin streamline design is simple to install and fits between your bed and foot board. And did I mention how much money you're going to save by turning down your air conditioner overnight? Please don't let another sleepless night go by. Get your Bedfan by going to bedfan.com or calling area code 210-632-8280. Wolverine Military Outfitters folks, this is wolverinemo.com. We specialize in ACUs, BDUs, and SDUs. MOLLE gear, tactical vest, armored vest, and kevlar helmets. Custom camo fabrics and camo netting. All your flare gun and ammo needs. Parachute players, red rain players. 50 cal ammo cans, ghillie suits, snow camo. Russian gear, German gear, Swedish gear, American gear. If there's something we don't have, just ask and we'll find it for you. So check us out wolverinemo.com, wolverinemo.com. Check out our site. It's updating daily, folks. Mention Liberty Tree Radio for your listeners discount or just call us at 734-340-7285-734-340-7285. Are you losing precious