Live 365. So, now, but it should be remembered again that if they have cyanosis and it's a generally reliable clinical sign of inadequate oxygenation, it may be absent if the blood loss is reduced to circulating hemoglobin concentration below about a 5 grams per 100 milliliters. Again, so if you've got, you know, you're looking for the signs and symptoms of cyanosis, but you're looking at a person that's suffered from a large volume loss of blood, the cyanosis is not a a good rule of thumb to say, well, you know, I don't see any cyanosis, so how do I know that they're suffering from hypoxia? So your ventilatory support is indicated whenever voluntary respiratory volume are inadequate for specific conditions, things such as cardiopulmonary arrest, mechanical chest wall dysfunction, adilectasis, or pulmonary edema. We'll cover some of these things further up, and we've covered those here in the previous year too. Now, repeated examination for a hemothorax or a pneumothorax during your oxygen, your ventilatory support are especially important. Previously undetected injury may be responsible for the development of attention pneumothorax, if you're starting to use positive pressure ventilation is employed. And another thing too of somebody again, it's important to know somebody's medical background, somebody that's suffering from to COPD or something like that, sometimes it works just in the opposite. So if they're showing signs of hypoxia or cyanosis, it doesn't always work to just crank the O2 up. It actually works in an opposite fashion there. Now, if you have a high inspiratory pressure, continuous positive pressure, and the use of expiration retarding devices, they may all contribute to increased resistance in pulmonary blood flow. and the positive pressure is transmitted to the alveoli space and then the pulmonary capillaries are compressed and the blood flow through the pulmonary circulation is diminished. So if you've got a mask that's really tight on somebody's face with a strap and you've got the oxygen flow really cranked up, you're pushing that in. What you're actually doing is those little sacs where the oxygen the semipermeable membrane through the wall into the capillary. Putting pressure on the capillary, you're actually putting pressure and restricting the blood flow through the lungs, and so you're fighting against yourself. So you've got to be very careful of that. Now decreased returns to the left side of the heart causes a fall cardiac output, and they prolong or increase the chiscially in hypovolemic patients. through the music and then when we come back we're going to continue this little side jaunt onto cardiac function and then we're going to go into thermal support and touch on antibiotics and some diuretics and some other things and we should be able to finish up this chapter about resuscitation from shock and trauma. Thanks for sticking with us today on The Intelligence Report. you know tom uh... i'm gonna ask you again you would you put glasses on going to take a second just for the class they're they're they're not expensive sunglasses just well you know i think that they like polarized what do you care they're free and given to you just put the glasses on were sitting here relaxing having a cup of coffee or in a coffee shop everything school going to just put the glasses on i don't know mark a i i'm maybe i don't want to know you know This is pretty freaky stuff you're talking about. Alright, you're my friend and I trust you. I'm gonna put these glasses on. I'm gonna put the Kim Hammy-do's glasses on. Here, okay. Okay, not a problem. Put them on. I know Tom, in fact, look it, there's one on that woman's shoulder too. It looks like kind of a giant slug with like an octopussy kind of mouth. He's just crazy! He looks like he's got false teeth! And the way it's born in, it's kind of scary, isn't it? Well, it looks like a ball worm! Not at all. Does anybody else know about that? Tom a lot of us do we've all been paying attention for a long time. You'll notice look on the one. How did you find out about this? Well Tom Tom it okay relax Tom remember We're all thinking we all know what's going on I've been watching this all the while you and I've been sitting here as they've been coming and going but you know the way to find out how I found out and got the glasses I went to live 365 And then I tuned into Liberty Tree Radio. In fact, I found there are other places like PBN.4mg.com. I'm really worried about this. I'm really worried about this because I... Oh, I know Tom. Tom, look at that one over there. The one tentacle says Neocon and the other tentacle says Liberal and they're wrapped around that wall. Isn't it? It's hideous, I know, Tom. But after a while you get used to it. I've been wearing these glasses for a long time and you can see everything now. You notice, look at these other people. It's almost like they're in soup. It's definitely not as thin glasses at them. Oh, but Tom, Tom, once you put the glasses on and now that you know, you can never go back to sleep. I know. Okay, Tom. I'll tell you what. When we go home... I want you to get on the computer. I want you to go to live 365 punch in Liberty Tree radio then you can go or you can go to Liberty Tree radio dot 4 mg dot com or you can go to PB and that 4 mg dot com but you know what Tom Like I said, calm down, start to get focused. Oh, the closet monster lives! Oh yes, in fact, look at that one over there. Oh man, that guy looks like death warmed over, doesn't he? His eyes are starting to roll back. If you take the glasses off for a second, Tom, you notice something? They look perfectly normal. Put the glasses on and keep them on because you never know what's coming up behind you. Let me check. Oh my God! Oh! Oh, okay! Doc, there's one! He's trying to get hold of your throat! Tom! Okay, wait a minute. I got him, I got him, I got him, it's okay, I got him. I invented the internet. I invented the internet. I'll get him, it's one of those door things. Okay, you're safe now, Tom. We got to get out of here. Let's go. Oh, right. We are back. And yes, remember, just put the glasses on. Mike, you can never go back to sleep once you've worn them, right? Yeah, that's absolutely right. And then you have an obligation. Well here again, hopefully we're helping a little bit now. This is Friday just real quick benchmark here and this program is in the archives in a number of different ways if You want to get hold of the archives for LTR and support the programming here remember? It's a $15 donation for one month you pick the month that you want that includes shipping and we shoot it to you on CD Ed reproduces the whole of the month on the one CD and for October, November, December, whatever month you choose and whatever year and then we'll crank them out accordingly so you can pick this up in solid form there. Or if you go into our chat room, you'll find that we have a number of different ways that we will either reorganize and resend or the way that the material is also well, being archived in other locations, backups to backups to backups. Anyway, real quick on this one too, you know, we're talking about oxygen. Again, improvising is eventually going to be the case, but there are oxygens available over the counter. You can actually access oxygen kits, small, medium, and large, correct? Yes. So there's a number of systems out there that can be actually picked up and put into more sophisticated crash kits. Purely a matter of what it is that we may need to do. And again, most important is we can access this technology, so we need to pay attention to ensure that we use it properly once we access it. This is a critical issue with regard to some of the many tools of the trade that actually can be applied by support personnel in a situation like this. There's other ways you can access them. Let me give you a point. A friend of ours, his mother, she passed away, and she actually was using an air tank for almost 23 years, an oxygen tank. Because of this, Mike, she built up quite an inventory of equipment, okay? And she always took advantage, we're near a couple of big hospitals. Stuff that was being given away or personnel that had like we're medical supply personnel, they provided her with stuff. And when she did pass away, her son, knowing what our interests were, passed on all of that equipment to us. So many of our crash packs and kits are outfitted as well as any, shall we say, field EMT van or any emergency military ambulance that you'd probably run into. One of the other things just as a sidebar to watch for at disposal points with universities is that many of them have university hospitals. Because of this, they have university ambulances. Well, every so often they upgrade or they change equipment. Guess what happens to the old equipment which in many cases is sitting parked in a van that is never used. Why? How about EKG equipment? How about, oh, how about those electric start machines, you know, where you take the old battery and hook it up and, you know, get the guy going again, a thumper? Well, one of those I picked up, Mike, completely mobile, not the newest model, about two generations back, for a whopping price of $10 to include the infant paddles, all the readers, everything that I needed in the way of the support goodies, the battery chargers, and the batteries even had pretty low hours because they just rotated new batteries in when they decided to rotate the equipment out. So this is the kind of stuff you can find laying around out there when people say well I don't know if I'll have this when you hear Mike talking about a lot of the technology or about certain applications remember It's a lot closer than you think and in fact More and more one of the next things I'm looking at right now with a glut of vehicles guys ambulances as in the more recent you know designs that are you know like dually rear end box configuration pickup truck or van front end Mike, they're up here for about $400 to $600. And we're talking not all falling apart. We're talking because the latest Fed money's come in. We're talking stuff that's only, say, six, seven, eight years old, not run down, pretty much squared away. Everything's still plugged in. I just passed by one two days ago that we're going to go back and look at tomorrow. So we can set up the equipment we need, guys. It's just a matter of, again, Scratching the resources together because well even four or six hundred or eight hundred dollars is a big price nowadays considering what the economy is But an effective tool for a unit to put together many hands make for light work work together find the vehicles and then Decade them out accordingly. Anyway, Mike jump in there and go right ahead We were just touching a little bit the sideline here about the cardiac function. As the blood comes in on the right side, goes into the right atrium and then right to the right ventricle. Then it goes to the lungs where the CO2 is passed off and the hemoglobin is reoxygenated. Then it comes back to the heart. the left atrium and then to the right ventricle and it kind of has to equal. You can't have too much pressure or too much blood on one side and not enough on the other. So what is happening here, again if we put a mask on there and it's held on real tightly and we have a real high oxygen flow, it's going to expand out the alveoli. So as the blood is coming in on the right side, and then it's going to the lungs, then the flow is being restricted because the alveoli are putting pressure on the capillaries and then so you have more blood trying to come in on the right side but it's not equaled by the blood that's being returned from the lungs back to the heart to be the body. So just bear that in mind. The next thing that we're going to have to consider is thermal support. It can contribute to the deleterious cellular metabolic effects. shocked and appears frequently and review the endotoxic speculative. You've got to be real careful. You want to keep them to be kept at a normal temperature by means of a fermia blanket or maybe a fedfan.com. You can help keep her or regulate. And you can also, you might want to consider the administration of a Cetaminophen, Kyle, but again, we want to make sure that the person is not kept. The next duration is going to be Antibiotics are going to be associated with some malfunctions going on here. Now during the early post-traumatic period, the ability of the body to clear the bacteria from the circulation is depressed. Antibiotics are indicated in certain circumstances. The choice of the antibiotic therapy depends on the type of injury involved. Usually a cephalosporine is usually recommended for the initial edition of the gentamicin in selected areas. And we're going to cover the antibiotic therapy. Bear in mind, things that you might want to acquire, some gentamicin. Next to just again, we're going to give you the knowledge, and you're going to understand how to utilize these things later on. Next condition is going to be diuretics. That's something that you're going to give somebody. Forgive, you're going to make them their... going to increase their urine production. How is a good reflection tissue perfuse going to be a good urine production? How generally speaking, an inadequate urine output, inadequate volume replacement, adequate urine output of usually between 30 and 50 milliliters per hour can usually be accomplished providing an adequate volume of intravenous fluid. There is reliable clinical evidence that the volume expansion is inadequate, diuretics should be avoided. Pressure of urinary output and also then if you're going to have a rising syndrome, then the normal pulse, normal blood pressure might want to consider giving them diuretics. That might be an indication of that. So just bear in mind that you're going to watch the urine output. Again, you're going to have to have a good history of the patient. They're not diuretics and stuff. Vasoactive, the vasoconjure, the sympathetic response, primary So, let's get into English. So, sympathetic response. In other words, as the patient is starting to lose volume, the brain pressure is dropping, sends out signals and the arteries to happen is found vasoconstitutin to the sympathetic response in the shock, the primary problems of your hypo. So, it's actually working against it. We aggravate this response and generally have no role in the therapy or sympathetic response. vasoconstriction, increased perfusion, oxia and acidosis causes the sympathetic effects, some of these medications and these volume B. We send that aggressive fluid therapy to be continued during their administration. So, don't want to just give any vasoactive drugs. cause the, uh, the data constriction cause the peripheral arteries and the veins to constrict because they're already doing that on themselves and all you do is patent fuel for the fire. Hear the music, we'll be back in a couple free. Thanks for sticking with us on the Intelligence Report. 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 $2.00 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 Max 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 877-608-0. 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. And, ladies and gentlemen, we are back. This is the Intel Report LIVE! It is the last 15 minutes of the program. Mike, how much more do we have to go here on this subject? We should be able to finish this up today. We always have our cardiac drugs, steroids, and military anti-shock trousers. Now, real quick, I... Real quick on that point the last one military shock tars most people are not familiar with the fact that there are Compression systems that have been put in place and these things have actually saved a lot of lives recently haven't they? Yes If they're properly used and they have their indications and contraindications, but they're very effective Especially if soft tissue injuries and immobilization of fractures things like that. Yeah, okay. Go ahead jump in there, please We got about 10 minutes Okay, very good. Just a word about cardiac drugs. Now, in most cases of traumatic shock, the patient has an otherwise normal myocardium that has become hypoxic. Now, digitalis is generally unnecessary since your cardiac function is going to improve with your successful treatment of your volume replacement. And then, however, older patients who may have an underlying primary myocardial disease, patients who develop a very rapid tachycardia that persists after the volume replacement, and certainly patients who develop a cardiac failure exhibit a rising central venous pressure with a persistent hypotension or candidates for the digitalization. Hypokalemia, a low potassium, should be corrected or any digoxin is administered. I'm not going to go too deep into cardiac drugs. One thing that you might isoproturinol, it's sometimes the trade name is isoprel. Now that's going to help increase the cardiac contractility in your heart rate. There's certain things that you have to consider with that. Again, I'm not going to go too heavy into that. But the combination of hypoxia and acidosis frequently leads to a cardiac arrhythmias that require the therapy. DIG is a drug of choice for the treatment of the atrial arrhythmias, the ventricular arrhythmias. They can usually be treated with lidocaine. Steroids, pharmacological doses of The corticosteroids frequently are helpful in low flow states refractory to the ordinary resuscitative measures like volume replacement and pH buffering. So, just these are some of the things that you might want to be interested in or things to go on to that without going into too heavy on all the indications, contraindications, the dosages and the routes and everything like that. And just to wrap it up is the military anti-shock trousers. The circumferential compression, the lower extremities and the abdomen. has been advocated in the early management of shock. Now theoretical advantages include mobilization of the blood from the compressed areas. It's going to give you an increased effective circulatory volume to your vital organs. It's going to give control of soft tissue bleeding in the compressed areas and it's going to help stabilize the fractures. when used properly in the proper circumstances, the technique of using your mass trousers is definitely a life-saving measure to have on hand in things. Some of the things now, that wraps up that block of instruction, resuscitation from shock and trauma, and some of the things that we've covered as you might want to consider having on hand of a list of some of your needs. Obviously, you're going to need some IV solutions, preferably lactated ringers and normal saline. You're going to have to have the tubing, the needles to administer it, whether it's butterflies or the gelcos, or you can just use a regular ordinary hypodermic needle. You're going to need some gloves, two by twos and four by fours to stop the bleeding of the soft tissue injuries. some cling to help secure that, some oxygen. Obviously you're going to need an oxygen regulator. You need a good assortment of masks depending on whether it's smaller people, children, adults and things. So you need a good assortment of that. Some J-Tubes, some oral pharyngeal airways, usually they're referred to as J-Tubes. Some nasal cannulas, a way to transport the patient. stretcher or improvised stretcher. We talked earlier about Puppedium, somebody if you don't have a stretcher on hand, you can put the patient on. Quite a few things to think about. I know we've covered quite a few things about the vasoactive drug, the diuretics, the stereocardiic drugs, the oxygen, the mass trial. It's a lot of stuff to try to soak up, but I thank you for listening to the intelligence report. We're going to continue on with this. walk of instruction we're going to start talking about some facial injuries and things about observations, palpitations, examinations, categories of actual fractures. Now one of the things here too real quick guys as I pointed out to our friends in the chat room We are going to have to expand our medical support program dramatically. There are two avenues where this is going to be an issue. Number one, combat casualties. Number two, the next false flag that everybody's talking about has got to be more horrific. Whatever they pull is going to be more horrific than 9-11. Now, if you're in the area of operation, remember you're going to go through medical supplies like there's no tomorrow. Dealing with even local friendly casualties is going to be an issue. So one of the things you want to do you can go to the dollar store and pick sometimes if you're lucky they got these inexpensive black brown OD green gray Savannah tan whatever color it is Diddy bags they're about the size of a butt pack, okay? They're perfect for loading up with medical gear. Here's the thing you designate medics or at least designate field corpsman plus support personnel Everybody can throw one of these over their shoulder and carry it forward into an emergency area. Now the reason I say everyone is because we tactically carry them in between many different people so that if we get separated we all have something on hand that can be used. The other advantage is when you move into an area just like if you're an airborne unit, a ranger unit, Marines when they hit the beach think the same way. Everybody's carrying extra gear that's not for the weapon or the equipment that they're using. It's for the guy that's going to keep him alive that's either the mortar crew when you carry extra mortar rounds, the squad gunner because you carry extra belts of ammo, or the medic because he is the one who treats you when nobody else can handle it guys. So we need volume. Now here's the thing. Women's feminine devices, okay? Cotexes. Now it's just the reverse of what everybody thinks. I know we're going to go to break here. We're going to go to top of the arrow. We're almost done. Real quick, the compresses came first and the whole idea of cotexes came from the compresses. Now that's why again if all else fails guys, you go to the dollar store, you buy a box of these things, you throw them into the bulk bags along with conventional dressings, extra rolls of tape, forceps, clamps, sewing kits. Even if all it is is a sewing kit, better that than nothing. If you can get sutures, if you can get other gear, that's great. But remember that we're going to need volume in equipment. And mostly it's the idea, you've also got to trade out. When you have an individual that's been dressed, you know, been taken care of, well Mike, in about another, as soon as possible, you may have to rotate that dressing out and reapply, right? Absolutely. Usually they're going to have dressing change in 24 hours. Got it. Got to have more to replace what you used guys. So we're going to need a quantity. Let's get ready for this. Squared away. It's part of the overall program. And yes, as Ed pointed out, it's part of the 510 program too. We're at the top and Ed's going to take over for us here with his program. 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 mark, both day and night. We're going to keep our people alive. To do that, you all have to do your part. You don't have to be a combat soldier to be a medic and keep people going. Everyone out there can participate. All of you can help. Thank you, Mike. And no sweat, Mark. Actors, 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 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. and 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. the wolf bag and as usual we doing real radio and we gonna start right here to begin because if we start at the end it's gonna be too short oh