35 Burst results for "Ten Minute"
Was the Government in on Creating the Illusion of January 6?
"Talking to Julie Kelly Julie, your book is January 6th. And you're laying out some facts here. And what is your conclusion based? I mean, you've looked into this a lot. But as your conclusion, roughly what mine is, as I listen to you, that the fix was in, that people like Nancy Pelosi. I mean, this is chilling that the Speaker of the House of Representatives was in on wanting to create an incident that would give them political leverage against their enemies. Can this be happening in America? Is this possible? It is a hard reality to confront that the people in power are that evil. Are that a moral? Are that desperate for revenge against their political opponents, including millions of Americans, that they're capable of doing such a thing? And it's been a tough reality to confront through my reporting over the past year, but Eric, when I listen to these line prosecutors, what they say in charging documents, the accusations that they make against American citizens. When I listen to federal judges, berate Americans for parading in the capitol, accusing them of trying to overthrow the government, sentencing them to 30, 60, 90 days in prison, people with no criminal record just for walking in and out of the capitol for ten minutes where they thought they had been permitted. When I take in what I hear and what I read, I do believe that that is exactly what this government did on January 6th. It was months in advance. You only have to go back to some of the lockdown rallies for instance in Lansing Michigan in April of 2020 that created a lot of the same optics a lot of the same news coverage. I considered a dress rehearsal for January 6th. So this is not far fetched conspiracy theorist thinking. This
Dear Father, Dear Son: Two Lives... Eight Hours
"And in any case, my dad and I finally had a long discussion when I was 25 years old after not talking to him for almost ten years. A discussion that I assume would last maybe ten minutes. It ended up lasting 8 hours, thus the subtitle of the book, dear father, dear son, two lives, 8 hours. So after we got out of the way all the antagonism I had towards my dad and every plane his life is very difficult life to me. We didn't start talking about our lives. And one of the things he asked me or told me was that I was not a troublemaker, the way my younger brother was. And since my dad and I were so candid during this very long conversation, I told him, no, I actually I was quite a troublemaker. Unlike my little brother, I was just more clever at not getting caught. And he didn't believe me. So I told him some of the things that I had pulled off, and the last stunt I told him was a time. My friend and I threw a brick through the window of some kid in the neighborhood because the kid in the neighborhood had offended. I turned out it was a white kid in the neighborhood. Now the neighborhood where I lived in
Larry Describes His Evolving Relationship With His Father
"Walked out of the cafe with just two of us working there with a cafe full of customers. My dad came home, and threw the $10 a day that he paid me for tips at me as I was laying on my bedroom, and he and I did not have a meaningful conversation for ten years. And then when I'm 25 years old, we finally sit down for a conversation I thought would last for ten minutes, it lasted for 8 hours, and my dad morphed in my before my very eyes from this mean over to this kind carrying sensitive man who had been completely misunderstood by my brothers and me for most of most of our lives at that point. Anyway, I want to pick it up from there. My dad was born and raised in Athens, Georgia, although he did travel around the country with some man who was in his mom and his life for a while. He told me that he worked on a bridge in Tampa, Florida for a while. He also said he worked in Memphis, Tennessee for a while. In any case, he was raised in Athens, Georgia, and one of the things my dad told me, is that he left school when he was 13 years old because he came home, and he was making too much noise for his mother's then boyfriend. My dad also said he was about ready to leave school anyway. And because he was about ready to leave school anyway, that probably played a huge role in him leaving the house when he came home at the age of 13, and was making too much noise for his mother's van boyfriend. My dad said that, yeah, that was the
Rep. Kevin McCarthy: From Bakersfield to Washington
"Know what makes Kevin Kevin. Where did you come from? Where did you get to to where you're at now? Well, you know, I'm from California, but it's not the part of California most people envision. It's a place called Bakersfield, California. And this is, if you ever read the grapes of wrath, this is the shantytown in that book. This is agriculture. It's energy, it's oil. It's we have a couple of military bases. And a couple people who are from Bakersfield, you might think of Merle Haggard, buck Owens. It's a little more Texas of California. And I grew up with a family. I was the youngest of three. My father and mother, my father worked two jobs. He was a fireman and he moved furniture on his days off. And when I got a high school, we didn't have great wealth. So I went to community college. And they instilled in me a work ethic. And I always had a job, but I remember I met this guy that owned a car dealers. He had a car dealer's license, but he ran a little convenience stores. And I'd pay him a $100 to take me to the car auctions in LA LA is like two hours away. And you had to be a dealer to go down there. And this is where it had a big fairgrounds where all the dealers would bring their trade ins. But you have to be a dealer to go. And I would go and I would buy and sell cars and I'd flip them to pay my way through college. Now, I know your attorney, I found out later it was illegal, but I didn't know why I was doing it. Thanks, statue, LeBron James probably run along. And, you know, when you're a community college on the weekends, what you do, you go get your friends who are away at college, right? So I had somebody my best friend was up at Stanford and some people have seen and had some good friends down San Diego state. So there's one Friday now I'm gonna go down to the weekend to San Diego state. So I go to the grocery store to cash a check, so I have some money for the weekend. An interesting thing happened. The day I'm there to catch a check the day before, the lottery started in California, not lotto but lottery. And so I'm cashing the check. I buy a lottery ticket and I won the lottery. The most you can win at the time is 1985, it's $5000. So you know he put yourself in my place. You're 20 years old. It's a Friday night. You just won $5000 and 85 money before the Biden inflation. And you end up like ten minutes from Tijuana, right? So I come back, I take my folks to dinner and I get my brother and sister each a hundred bucks and I take the majority rest of money and one thing you know about me I like to take risk. I put the majority rest in to one stock. And I did pretty well. I made 30% of my money in 6 weeks. And at the end of the next semester, I decided to take a break from school. I went out to try to buy a franchise, but no one would sell me one, but that didn't deter me. Another thing you learned is I never give up. So I opened up a deli. And there's three lessons I learned in all of my small businesses. You're the first to work, your last to leave in your last to be paid. And we were pretty successful. So at the end of almost two years, I now have enough money. I could pay my whole way through college and I wouldn't have to work. And as long as I went to Cal state, and nobody in my family at that moment had finished a four year degree so I sell my business, I'm going to college and I opened the newspaper and it said be a summer intern in Washington D.C. with my local congressman. Now I do not know this man, but I thought he'd be lucky to have me so I applied. And you know what he did? He turned me down. But you know at the end of the story is, I'm now elected to the seat. I could not get an internship for. Only in America
Brady picked off twice in 1st; Bucs lose to Washington 29-19
"Taylor Heinicke threw for two hundred fifty six yards on a twenty yard touchdown pass to the Andre Carter as the Washington football team upset the Buccaneers twenty nine nineteen Washington intercepted Tom Brady twice in the first quarter but he did manage to throw two touchdown passes his second one to Mike Evans brought the books to within twenty three nineteen early in the fourth quarter Heinecke then led Washington on the nineteen play eighty yard drive in ten minutes and twenty six seconds for the final touchdown for offense to have the ball there ten minutes left up by four and to go nineteen plays and go down there and and and and it's like that's huge for us especially with how it's been going last for weeks Antonio Gibson scored on a pair of one yard touchdown runs Craig heist Landover Maryland
Man who traveled to space on Blue Origin flight dies in plane crash
"Hi Mike Rossi a reporting a man who went to space with William Shatner dies in a plane crash Glenn M. to breeze to travel to space with William Shatner in October was killed in a small plane crashed Thursday in northern New Jersey state police say the forty nine year old to freeze and fifty four year old Thomas P. Fisher were aboard a single engine Cessna one seventy two that went down Thursday afternoon the breeze was an instrument rated private pilot ed Fisher owned a flight school authorities did not say who was piloting the aircraft the breeze Shatner and two others took a ten minute flight to the edge of space on October thirteenth aboard blue origin's new Shepard spacecraft hi
Kyle Rittenhouse Takes the Stand at His Trial
"Cal rittenhouse is testifying. He was called by his defense team to testify about the triple shooting. It killed Joseph rosenbaum and Anthony huber and wounded gauge grass roots here is Kyle rittenhouse on the stand in Kenosha Wisconsin. I knew Nick was Smith and Dominic black. You did not know the owner of car surfs previously. I did not. Was he being nice to you guys? Was he happy you were there? Was he mad at you for being there? Describe it. He was happy we were there. And you heard testimony that you owners, I believe that was Friday afternoon. I did. And did they give you permission to be there? They did. And the other individuals in this photograph, some of whom have testified in this trial. Ten minutes before this photograph was taken. Did you know any of them? I did not. Did you ever spoke into any of them? No. And when you were there, what was the idea? Was there a plan? What was going to happen? Yes, the plan was to I went down there to provide first aid. I also, I brought my orange first aid kit, the fanny pack, and I also brought my pelican box which was filled with first stage stuff. By my feet to provide first aid. The orange box by your feet you referred to as a pelican body? Yes. Did you have that before the 25th? Yes. Was it stock? Yes. With things that you would bought and brought? Yes. Nope. All right, we lost the feed there. We'll pick it up where we left off. It's got your reaction to this testimony. It's powerful, it's riveting, compelling, and again, it contradicts the narrative that this was a cold blooded killer, the way Joe Scarborough and the MSNBC clowns characterized
The Similarities Between Terry McAuliffe and Horace Mann
"I don't know about you, but I like talking to John's mirror. And I was talking to him was a yesterday about John Dewey, Horace Mann, about education about what mcauliffe said before he went down in flames and John, I thought, let's keep talking about that because we had ten minutes here. And I said, this is actually so important. And that's why when he said what he said that parents shouldn't have the right to interfere in what the teachers teach I just thought that is one of the wildest statements I've ever heard. The idea that an adult running for office could say such a thing or even things such a thing, again, call me naive, but I was absolutely astonished. Well, it was a great moment of candor. Terry mcauliffe said in a debate, parents should not be telling teachers what to teach in schools. We have experts for that. That was very candid. And as I said last time, Horace Mann, the founder of mass compulsory public education in America, Horace Mann, school for teachers is associated with Columbia University. I remember seeing it when it would get off to Trevor bridge. He was a Unitarian. He kept that kind of quiet. He was a social gospel reformer, and he thought it was the job of public schools to save children from their parents. You had all these fundamentalist Christians who believed in the Bible. You had all these Catholic immigrants getting off the boat like my ancestors. And they had all these reactionary views. They were not on board with modern science with progressive ideas with eugenics with all the things that the progressive movement had in mind. A massive federal government managing the country from the top down as experts basically peeling away the old constitution. Woodrow Wilson, before he ran for president, wrote a book about how the constitution was this archaic obsolete rickety 18th century mechanism we needed clear it out of the way so that we could run the government according to the dictates of modern science. And by modern science, they meant Charles
Editor Joel Berry Describes His Comedy Influences
"Folks I am talking to Joel berry not to be confused with crunch berry or really any berry, Joel berry you're your own man, and you grew that beard of your own volition. Did you grunt it out in hopes of landing a gig with the Babylon bee? Because I know that if they see an unbearded youth walk in, they just think like he's probably not reforms enough for us, right? Yeah. Well, I was hired and I started reading spurgeon and like the next morning, it just was incredible. I'm going a beard virtually all the time. But I just shave it off before anybody notices. But I want you to know that it's there. You know, it's happening, basically. It's happening as much as your beard is happening. It's growing about the same rate. See that sometimes. I think you should the next few years. If you take certain vitamins, you could like grunt it out in four days. It's unbelievable. Okay, so here's my question for you. When you were growing up, like ten minutes ago, who were your heroes? Who were your comedy heroes? Is there anything that influenced you or what's your comedy thing? Well, you know it came a little bit later in life. I'll be honest. I was homeschooled very sheltered. You know, I grew up in the world where you know you don't watch The Simpsons, you know, you stay away from The Simpsons. So I had to kind of play catch up later on. But I want to know what level are we talking? It's one thing to avoid The Simpsons. It's another thing to turn your own butter. Like where were you on that spectrum? You were maybe a step above churning our own butter. We were pretty long Jean skirts on the ladies. Oh yes. And like a whole Holly hobby kind of aesthetic? Yeah. So those early Apple on B jokes where we would talk about the Sports Illustrated swimsuit edition, introducing its first baptist supermodel in the long Jean skirt. Those jokes were also too good. It's too good. So yeah, so what did so when did you I mean, was it reading the onion? What was it? What were you reading that made you think I want to do this? Unless it was the B itself. Yeah, it was the B itself, you know? I think the bee was originally inspired by what the onion did. Our founder Adam Ford, he read an onion headline shortly after the Alberta fell decision when they redefine the meaning of marriage at the Supreme Court. And it was something to the effect of forced Supreme Court Justices suddenly realized that they will be the villains in an upcoming Oscar winning movie. You know? And that's a pretty good headline, right? Yeah, it's very good. And I think Adam at that point, he read that. And even though he vehemently disagreed with the point of view of the onion, he had to respect the joke. Why aren't we doing
Leadership Lessons from a US Army General Maj Gen John Gronski (retd) - burst 11
"A gunnery. Sergeant michael burkhart was the who was the explosive ordinance disposal team leader went down to that site with two young marines and they were going to conduct a post blast analysis to determine a tactics techniques procedures insurgents. Were using so we could try to prevent these attacks from happening again in the future and when gunny burkhardt got down there with two young rains was chaotic. The soldiers were cisterna. Seen the ad that a chaos there were two reporters from the omaha world herald newspaper there there were embedded reporter so anyway going burkhard gets down. There sees the destroyed up. Armored humvee sees a crater near that up armored humvee bow four feet in diameter a couple of feet deep makes an assumption that that's for that roadside bomb that destroyed that humvee was placed jumps down into crater. Take a closer look as soon as he did that. He realized he made a mistake because he could see in the dirt in front of him to artillery shells. Red detonation cord running in the nose was a roadside bomb. That an insurgent have placed their so. He took his k bar knife. Cut the red debt. Detonation cord to neutralize that roadside bomb. He didn't see a third artillery shell into dirt behind him in that crater. An insurgent was off in the distance. Hit a button. On a that nation device that artillery shell exploded not going burkhardt about fifteen feet into the air lands on the dirt road unconscious pants soaked with blood. Our soldiers call a medevac helicopter. Ride away go up tomb start. Cut his pants off. Start tending to his boons after few minutes burkhart regains consciousness. The soldiers couldn't believe that and and he's laying there and he asked the soldiers if he has both of his legs because they had no no sensation from the waist down. They sure to me had both of his legs. They continue to work on 'em couple minutes later. He gets a tingling sensation in his legs. He tells the soldiers he wants to stand up. Soldiers couldn't believe that this guy had just gotten blown up and so we struggles to his feet. He standing there to soldiers around him. The medevac helicopter comes in lands on the ground behind them. The soldiers point to the stretcher On the ground in front of the misogony. We've got you know. Gotta put you on a stretcher and carry you to that helicopter. He looks at the soldiers and he says i'm not going to have you carry me that helicopter on a stretcher. I'm going to walk there under my own power. Because i don't want the insurgents of the pleasure of seeing me being carried that helicopter and easy. He says that he raises his hand into the air and gives the insurgents which i will call a one finger salute reporter reported from the omaha world heritage takes a picture of him standing there Groin protector. you know. In in front of his private area there. No pants on finger thrown up into the air soldiers around him. You'd say the helicopter the background. That picture became an iconic picture of the iraq war but what is deleted Point of the story. And the reason i tell this story and the reason. I think it's important. The leadership point of this story is member told you. He had two young marines with them that day. He knew he was going to have to recover from his wounds. He knew what all the roadside bomb attacks were getting that those two young marines were going to have to be out there probably later on that day routes realizing roadside bombs. The reason he wanted to walk to that helicopter instead of being carried there had nothing at all to do with what he thought and surgeons for thinking. He wanted to walk to that helicopter so we would not shatter the confidence of those too young marines. Pseudo leadership point is even after getting blown up ten minutes earlier. His main concern was not with his own wounds. His bank concern was with those two young marines. Who he was leading an isn't that what leadership is all about. And we talked about that looking out for the welfare of those you lead rather than your own welfare and that's exactly what gandhi burkhardt exemplified that day. And that's why. I like to tell that story that i read read that story. I had to read it again. Because i was laughing because i could just see i. I have friends who are marines right by the way. There's no such thing as an ex marine okay. the just doesn't exist. I've been told that countless times by my friend there's just no such thing they they may be quote unquote have retired at the end of their name. But they're still all. And and and i just thinking about them go. That's exactly what jimmy would. That's exactly what he would have done. That's what bob would have done. He would have done the same thing. I i can. Just see it. I just great story but it was truly the surprise in that lesson was not. I thought it was going to be resiliency. It is but the point is that he cared so much about making sure that those other two young marines were their that their mental emotional state was not shaken. Yeah and you know jay that think about this as leaders we face adversity almost every day in whatever organization were leading the some degree and and sometimes things get tough honest and the point is as a leader. You can't be thinking. I'm an figuratively. I'll use this. You know you can't be thinking. I'm cold i i'm hungry. You know i. I'm shivering right. No you you've got to show those you're leading that you know what i've got the resiliency to overcome this. And because i do you have the resiliency to overcome. They might be called. I might be hungry. I might be weak. But i'm going to take care of you before i take care of myself. And that's the essence of leadership. We underestimate the modeling of behavior. Don't we when it comes to leadership absolutely. Yeah and you know what the other thing i learned in my forty years of leading soldiers also leading teams in the business sector. Is the people you lead are always watching you practice. You know you could. You could put down in writing. What your leadership philosophy is or you could verbally give some guidance about behaviors. You're looking for but those you lead are going to be watching to see you. Know how do you adhere your own guidance. Behaviors that you're looking for you. Exemplify those behaviors and your followers are always watching and your actions speak so much larger than larger louder than your words. Do
Pollster Richard Baris Answers Our Virginia Questions Ahead of the Razor Tight Tuesday Election
"So Richard, you are your smart, much smarter than Nate silver. I say that every time you come on and you get things right, you do a terrific job and you're the best with polling and political predictions that I've seen, and so let's talk about what's happening in Virginia. Let's just kind of let's take this piece by piece. We got about ten minutes to go through this. Where was this race 6 months ago and how and why did it develop into the tight race it is today? Yeah, I mean, even a month ago, Charlie, you know, McCall, he was former democratic governor who left supposedly with an approval rating around 54%. This should really not have been a race of Virginia is even with the current climate, Virginia is, you know, had Joe Biden one at ten points, 54 44. What really is going on in the last 8 months or so 6 months, Democrats began to erode support in Virginia and it's coming from independence. The democratic base is a little leakage there, but it really is coming from independence in third party voters who supported Democrats last November. And at the end of the day, Glenn young turned the page almost at the perfect time. And it wasn't only him he had help, but the public education issues soared to the forefront and Democrats, the whole time throughout these last few months, wanted this to be about Medicare, expansion, Medicaid expansion. Trump, amazingly. And of course, about the pandemic response. And instead, Charlie, three out of the four top issues are Republican environment issues. So jobs in the economy is number one. Taxes inflation, cost of living is number two, and now three is public education. And four is coronavirus. So it just turned up a call of all the perfect storm. You know, I turned all the political stars aligned for junk and we see he's got to lead now. He
Capitals' Sprong has goal, assist in 4-1 win over Devils
"The Washington Capitals continued their strong start to the season by defeating the New Jersey Devils four to one the devils had won their first two games the camp sort out three oh and one took control early on goals by Anthony map and Dimitri all up in the first ten minutes four to nothing lead Daniel Sprong sentences the goal midway through the second period up to to three nothing strong had assisted on the first goal we got all four lines one sixty mingling goalies McLean greater things are playing a team game and we're disappointed washers ending and we want to come over to get started now that season going again because that's off also contributed a goal and assist caps goalie Vitek Bennett check you'll to just let go beyond the coconut of the devils who played without injured star Jack Hughes I'm John Merriam
William Shatner sets record in space with Blue Origin spaceflight
"In a flight that lasted about ten minutes ninety year old actor William Shatner has become the oldest person to go into space marches are a letter with the latest amenities start Q. one William Shatner and three fellow passengers blasted off from West Texas to more than sixty six miles into space as part of the blue origin flight Jenner's claim to fame is playing captain Kirk on Star Trek upon returning Shatner was overcome as he thanked blue origin founder Jeff Bezos what you have given well is the most profound experience
John Solomon: January 6 Commission Chairman Once Sympathized With Black Secessionist Group
"Back with john. Solomon you've got to listen. It's going up in ten minutes. The latest podcast from john solomon reports with president trump. follow him at j solomon reports and bookmark. justin used dot com. You sent me earlier today. An unbelievable i don't know how many man-hours this took you to research. But we tell us about this story. Hubris adjust the news dot com about the chairman of the quote unquote insurrection investigative committee. Yeah absolutely while for months weeks now. We've seen bennie thompson. The democratic congressman from mississippi on television sympathizing with the police officers were injured on january six during the capitol right and denouncing an event that he has repeatedly called and insurrection. Fifty years ago. He was on the opposite side of an insurrection. This movement back in nineteen seventy one. When a group known as the republic of new afrika was making waves throughout mississippi. Why because the fbi was closely watching as it was trying to put together a movement to take if necessary by force land from people in mississippi louisiana georgia south carolina and alabama and create a separate nation on us l. called the republic of new afrika. So you know just to be explicit here. Ethnic separatists in america. That's yes they actually wrote their own declaration of independence. They renounced their citizenship in a meeting monitored by the fbi they engaged in multiple conflicts with police. Officers usually doing something Waffle like stopping car for traffic incident or executing a search warrant three times members of the are group killed a police officer in the early seventies and bennie thompson. Then a young alderman from a tiny town called bolton mississippi then known as bg times. Not even known as benny. He spoke out in favor of this
September Jobs Report Disappointing Under Liberal Economy
"Ready to do my podcast this morning And one of the things I do because I'm always behind closed curtains in the dark all day And I get sad not sad like sand the acronym seasonal affective disorder Like I need some sun 'cause you do get sad on sand right So for like ten minutes before producer D tells me he's ready to start taping the podcast I sit outside in the sun to get some sun in my eyeballs to not turn into one of those weird looking things like the oracles from the 300 movie you know with the white nasty looking skin and stuff That's what'll happen to me So I'm outside and I'm reading a couple stories right before the podcast gets started And if these two stories are improved positive about the cancer eating this country alive that the modern liberal is I don't know what is A story number one the jobs numbers come out Now explain to me how now that the economy is reopened you have money everywhere The federal government has printed a boatload of money with no value to back it You have a bunch of people clamoring to get out to go out and eat to go back to shows You have packed college football stadiums You have Christmas coming up explain to me in what damn universe An economy should be struggling right now to hire people I will wait liberal idiots I will wait a minute because you're too stupid to figure out the question Jim's like you better say something We're gonna go to a best of it You can't take time out on radio Like after 5 or 6 seconds it kicks to a best of I can't leave you that much time even though you're very dumb and can't figure it out In what world should the jobs numbers we were expecting 500,000 new jobs And we only got a 194 for liberals listening That's less than half In what world does that make sense to you
Ep4: Unboxing The Mystery Box Film Challenge
"I can't really stressing enough. Anyone can participate in the mystery. Box film challenge you. Don't have to be in scranton wilkes-barre you don't have to be in northeast. Pennsylvania you can be anywhere in participate. We've made it so we've made it really streamlined. Like keeping announcing the items online. And that's because of the pandemic it's like okay if you wanna do a challenge during a pandemic how we're gonna do this like we don't want to give out physical boxes and it's really not that conducive if you want to grow it so announcing the items was the best way to do it and it's it's really easy to it's just like people just have to go find the items if they have them in their house or they had the borrow him or if you wanna buy 'em yourself that's that's a really good we do. We're on facebook on instagram. We'll have a facebook group so you could talk to people this where we usually put the list of the requirements items prompts on. There's usually a document i to facebook page on the facebook group in the video is always there when we announced but this is the first year that the mystery box film challenge is on film freeway. That was a decision that i made that phone. Freeways really the premier place to find film festivals film challenges and i wanted just to get more is on the challenge because last year had lake. We had i think twenty one sign ups and we got twelve films back so usually are ratio is lake. We get a lot of sign ups in usually we get about half of them to submit a film which was amazing during a pandemic all types of films different genres like first time filmmakers season professionals to it's it's everybody you can do it. You can totally participate in this challenge. It's so much fun. And it's just a great way to connect with people in network with filmmakers in your area and asking for help and we're always here he always email us if you need help or have any questions but yeah all our items in prompts and requirements and specifications are on our film freeway page. If you searched the mystery box challenge on film freeway and like i said before you have two months to make film they need to be wanna ten minutes in laying that includes your credit entitles. They can't go beyond ten minutes Ill should align with the pg thirteen rating. We don't allow our crm teen films. These are short films are not gonna be feature films. So it's pretty good for that. And then you have your technical specifications as well and we do the emission on phil freeway as well. We used to have people email us. They're finish phones but we're not doing that. Everything is going to be through film freeway We do have a submission fee this year all past years. The film challenge has been free but with Just doing the challenge. It's a lot of it's like. We want to do a lot. More marketing in the marketing costs money. And we want to give her filmmaker swag like shirts and stickers and It better prizes in that costs money so like we have a regular deadlines mission is five dollars and then we have a late deadline for this year. So regular deadline for this year's film challenges november tenth. You still have time You can do a filming day you can edit and day and do whatever and are late. Deadline is november thirtieth and that will be a ten dollar fee early We kind of Wanted to do the challenge between like late summer and fall on we try to pretty close to one the northeast. Pennsylvania film festival has a festival. The festival usually is in march But it's just a pain the butt film in the winter. that can't be done. It's just a pain in the butt to film in the winter so we had the challenge earlier this year so it was. We kicked it off on september first skinner complete in the end of november to give people that end of summer fall timeframe which is still pretty nice to film. It's actually unseasonably warm now. Still which is awesome northeast pennsylvania. So i hope everyone can participate in the film challenge. It's a really great challenge to be creative and to just get yourself out there and start making films it's a real catalyst for people on lake like this is like if you wanna skies the limit if you want to do any type of film you want and have all the requirements inc for the challenge. I wanted to participate in the challenge. One year i actually wrote my script. And i just couldn't get anyone to get enough pete. I couldn't get a crew and actors together to do it. But i was like i'm going to keep the script and i'm gonna keep working on it and i'm gonna eventually produce it so i wrote a script. Siro my script for the mystery box challenge. This call fallout. And so i kept working on it and working on the script editing. I had my colleagues rita the detailer with me at lunch. They gave me feedback. So i just kept the script that i wrote for the mystery box kept working working working at and i gave it to my friend bridget. She edited it for me. Give me feedback. I kept ending it in editing. It got to a point where i thought it was good. And i just didn't then the pandemic again the pandemic hits and i just haven't i have not produced the film yet but i do want to. It's not really conducive to film during the pandemic. Because it's all takes place in a basement so really. The premise of fallout is. There's a group of friends who are hunkering down for an impending nuclear attack. While one of their friends is outside could be dead could not be dead Who knows and they're really freaked out in steph happens in. I don't want to give too much away. But i decided to submit that script to a couple screenplay competitions recently on film freeway in. It's gotten right now. It's gotten six official selections for six different vessels which is pretty awesome Just to get it out there in get it recognized which is pretty cool and it's like all right. This is really something. So i really want to film this. But it's like don't have. It's a catalyst. The mystery box film challenges are really creative. way to really get into filmmaking. Answer really start making something i i mean. I find a lot of people even myself included you. Stop yourself sometimes. If you wanna make film you stop yourself. It's like even. I wanna participate this year. Even though i'm the organizer. I still want to participate in writing my scripts and like i know what i to ride. And it's like okay. Who am i gonna get. Who is like the crew and stuff like that and making it simple so we can get it done in a day and i can edit it on time and get it in. So it's it's in own if you don't end up if you write something you end up not making it to the deadline to keep your script and keep reworking it. I mean you know. They asked for help. Get your parents involved. If the if you need to be can't find anyone you know you don't need to have a professional camera you can. Have someone help you edit or you can try editing yourself. I mean it's just anyone can participate. So i hope you guys Take some time to go to our website. The mystery box film challenge go to our film freeway page. Take a look at the list of items and problems in specifications and requirements and see if he can get a film. We would love to see your film. And you'll get them will be the premier's gonna be at the northeast pennsylvania film festival. We don't know what they yet. Um that'll come close when it gets to march but I'm so glad you guys can join me to for the une boxing. The mystery box film challenge. And i hope you guys participate. If you have any questions you can email the mystery box. Film challenge mystery box any p. Mail dot com. The mystery box challenge is on facebook. Instagram follow us. And we're also on youtube where you can find pass emissions to get some inspiration They're really talented. People who cemented in any type of person. Like if you're just new to filmmaking you for professional like everyone's got some great stuff and it's on youtube for everyone to look at so thank you guys so much for joining us for our scranton talks podcasts. About the mystery box film challenge. To go and participate. There is still time. We're on the halfway point so so go on our phone. Freeway patients admit to our film challenge. It's gonna be awesome. I can't wait to see you guys. And i hope if you do submit You get to join us at the film festival for the premiere of the films in copa. Get to meet you. That'd be great and get to network with other filmmakers as well in scranton So the the film festival usually happens downtown. Scranton in pennsylvania so i hope you guys can participate. Thank you so much for joining us for grand talks podcast. Be sure to subscribe to our podcast to get all the latest episodes. We upload episodes once a month Be sure to check out our facebook instagram. like i said again and we do our scranton. Talks live on facebook and on electric city television. If your local once a month our next Interview is gonna be on october. Nineteenth live on our facebook page on the independent film creative hub. Electric television will be talking with bridget. Lamonica she's a local filmmaker from northeast pennsylvania. Who actually is living and working in atlanta now. So we'll be talking to her about her projects what she's been doing Like working in the film industry. She's fully in the film industry a freelance basis working atlanta. So we'll be talking with her on october nineteenth at seven fifteen pm so i hope you can join us for that and thank you once again for joining us on this episode of scranton talks Be sure to check out the independent film creative. A website at www dot com are creative dot com where you can check a directory of pete filmmakers. Who are on there if you need any help finding actors and crew. That's the place to go for the with. You're looking for your crew for your mystery. Buxom challenge in. It's free to sign up so you can make your own directory on there so go there and check it out. Thank you guys so much again. Be sure to tell all your friends about scranton talks. Podcasts can't wait to hear from you on the next episode.
Star Trek's Captain Kirk rocketing into space next week
"Says he's thrilled anxious and nervous about going into space next week our margins are a letter with the latest William Shatner says even though he will become the oldest person to go into space at the age of ninety it's nothing that he will go over around bragging about gender will be part of the blue origin space launch next Tuesday for a ten minute trip that sixty six miles up and be seed today show host Chanel Jones asked Shatner if there's a connection to playing captain Kirk on Star Trek in this trip I'm sure sorry to disappoint you no connection but all that was fiction
3 Reasons Why Democrats Can't Leftist Legeslation
"So i just had a conversation with your colleague. I believe. democrats fall into two categories liberals and leftists. there are no moderates. there isn't a pro-life democrat out. There left there are no modern liberals old school democrats and then there are leftist progressives leftist as their word they can't agree and so everything is stopped. They can't agree on what to do. Who's going to win that battle. Well here's what i think is going to happen First of all This one point. One trillion dollar bipartisan infrastructure. Thing passed the senate weeks ago. The house could always just pass it in ten minutes if they wanted. It was just sitting there one trillion dollars just sitting on the table. All you gotta do is pick. Put it in your pocket. They're going to do it and the news. This morning is nancy. Pelosi his decoupled that from this demand to pass three point five trillion dollars in social and climate spending and remember president biden caused kind of a ruckus when he came out and said that they were absolutely they had to be passed together Even though the senate had just passed this bill The house would not pass it until they also passed three point five trillion. They've given up on that. Okay so they're gonna take the money because they'd be insane not too then The the three point five trillion dollars appears to be just murky at the moment We don't know what the to mentioned in cinema and other democrats think wha- what their final position is the democrats are running into the problem. they've always had. Which is they do not control a majority of seats in the senate and it's you can't get new deal size legislation done without even bear senate. Majority last thing is they. Congress operates really only in a crisis. Remember back when the economy collapsed. They passed Tarp in about ten minutes. I mean they can think they could pass a trillion dollar bill. You know before the end of your show if they wanted to. They wait until things become a crisis so they are going to have to pass something to keep the government funded for some period of time and then something to Raise the debt ceiling.
"ten minute" Discussed on Ten Minute Medic
"The amount of kinetic energy increases to almost one hundred, twenty, thousand K. You. And when they say speed kills the really do minute. American energy increases were the white as a person goes from one hundred and fifty, two, hundred, eighty pounds. But really not quite that much. Understanding the anatomy of the human body coupled with basic grasp of Connecticut Energy You can begin to develop type six cents about the things that are going on with your trauma patient. Keep in mind outside out of mind, can often caused some real issues as far as having an effective assessment towards a patient of trauma particularly, any type of internal injuries we are looking at her patient and we begin to compare what has happened with the mechanism injury with injuries that we're seeing as well as the potential for injuries that are unseen we call busy index suspicion. Is Index of suspicion or your gut feeling will become much more accurate as you get more experience understand that early on your basic mistakes as far as what your gut is telling you. But that's okay. That's all in how you get your experience in your education as far as you're moving along and as you see more patients and USS more patients, the better off, you will get it this to understand the Bob Mechanics of trauma. We need to settle upon just a few definitions as we're moving through here. Now, for some of these definitions are going to be a no brainer. There may be others that you may or may not be familiar with it. That's that's okay. So, say penetrating trump penetrating trauma happens when objects such as a knife or a bullet or any other objects for that matter Pearson Protective Barrier of the skin and enters into the body. Any subsequent injury may be caused either directly or indirectly by the spin attraction will. Particularly Take A stronger deeper look at this type of injury causation. Particularly, we take a look at gunshot wounds a little bit later on. Compression happy injuries happened when a body stops abruptly while the internal structures are still moving forward. Now. The most common type of injury that we would see this in is a head injury with a coup contract injury to where the brain sloshes forward. You have an injury about the interior and sloshes backward and you have an injury on the post here. Stretching injuries are just opposite of compression these occur when part of the body is pulled away from from another in particular, you can see these types of injuries when you have sprains. In particular the ankle and the knee win differently, ovens and tendons begin to get stretched a porn. Now, a very medieval example of this occurred people were stretched on the rack is a type of punishment or torture or to exact a confession. In a share type of injury, the internal organs continue to move forward at varying rates Speedo. We talked about this while ago. When we were speaking about the car that stops the body shop's internal order themselves are still continuing to to pass on forward as the as the body of stopped. Win The body itself stops any type of limit or tendon that crosses the Oregon will cause it to be lacerated this quite frequently with liver lash rushes do the foul. Some four ligament crosses the interior surface of liver, as well as with injuries too theoretically or particularly within the lever. This fast inform legemaate acts much like a cheese cutter and that is very tough. It's very. Fibrous and it literally, the liver will continue to go around it on both sides until Liberte south could can become lashing right in the patient of lead to death. There are three phases of a traumatic event that we're GONNA take a look at in depth here..
"ten minute" Discussed on Ten Minute Medic
"Do not live a low blood. Sugar sneak up on you. As the child is compensated shock respiratory rate is going to naturally go up this may result in a transient period of respiratory alice. Carbon dioxide is blown blown off as a child against tire from the SANTITA. The rapid breathing in breathing begins to slow. She made transition over into a state of metabolic. Pollick acidosis now. It might seem logical to administer sodium bicarbonate offset versus but this is not indicated. The key here is to use fluid lewd resuscitation restore perfusion body is designed to tolerate metabolic acidosis for a short period of time and the administration of by car would be harmful for your patient strays Asian over discussion of distributive shock. And what it does to the body distributive shock. You may hear a call. Visiting shot comes. `Bout Win The dilation and constriction of the vascular has been impaired. The big issue isn't so much that the arteries dilate because they do they're simply unable to constrict as a result. You have a much larger container with less lewd pressure inside the pathophysiology of this is something like this I I because of the massive Basal dilation peripheral vascular resistances decreased often drastically. This results had Poli- within the veins. Import tissue perfusion because of this pooling Venus return to the heart is reduced as well is the cardiac output the three primary causes of distributive shock include. NFL Alexis an injury. The central nervous system or sepsis sizes simpleton distributive shock can be misleading in that in the case of a nervous system. Injury your patient maybe in compensated shock yet had a normal or Bradley carded heart rate heart. Association's Pals Course Discusses Three types of distributive shock. Septic Genyk the single brief look at all three of these now. semper shock occurs because of a reaction to it infection that at least an instability in the perfumery status of your pediatric patient. It is the most common type of distributor shock senior children earlier that you diagnose sipped shocked the easier. It is to deal with and leads to minimize of organ damage. Septic shock tends to occur in a two phase process beginning any with peripheral Basal dilation. The first phase is often referred to as warshaw this comes about toxins. Caused by the infection. Prevent the catecholamines immune system from inducing vase on construction the heart rate increases in order to maintain cardiac output. The capillaries will also begin to become permeable allowing in fluid. Move into the interstitial tissues. Essentially shock continues unabated. The patient enters the second phase known as coach on the heart and respiratory Tori right will still be elevated but cardiac output continues to decrease at some point bodily systems began to fail affecting the kidneys and liver early on the goal of treating. Septic shock has identified the columns and eliminate. Obviously that's not going to be possible. Pre Hospital perspective. Our primary focus this will be the support perfusion for the body by giving them..
"ten minute" Discussed on Ten Minute Medic
"You're listening to two minute mic Lee podcast for busy paramedic students. I'm your host Dr Bill Young in my role job. I'm associate professor. The Department of Para Medicine at Eastern Kentucky University students will be taking their pediatric advanced life support course when they return in the spring so the next few podcast focus on topics from that course. This week's topic will focus on basic life support for the pediatric cardiac arrest patient. The initial assessment of the pediatric Edrich patient is very similar to that of adult. What you've determined that the patient's level of consciousness move quickly to assess in Pulse N.? Risk rations the save time assists both of these simultaneously. Keep in mind that you shouldn't take any longer than ten seconds to evaluate both of them to Jay for breathing. Look for Reisen. Follow the patient's chest. Your patient is breathing and doing so adequately with good title simply monitor the patient and transport to the nearest appropriate facility. If your patience number. We're if breathing is inadequate such gasping report TATO volume your patients considered to be in respiratory failure or respiratory arrest. Made sure that you addresses this. Is Life threatening problem before you move on. In your patient assessment. It depends on the age of the child has to where we will assess their pulse for patient as an infant. Somehow faith the break you'll artery at either one of the arms if your child is older such a school age or older you may for karate kid or ephemeral false. Sometimes it can be difficult to determine whether the patient has a pulse or not. This is even more so in children especially if they're overweight. If you don't feel a pulse within ten seconds can she must begin. CPR immediately even if the patient has a pulse. But if it's less than sixty beats per minute or if the patient shows an inadequate cardiac output you should begin in Cpr away pulse checks should be limited to duration of ten seconds every two minutes. It is imperative that you do not interrupt CPR. We are unless it is absolutely necessary. In an effort to make it easier to remember the American Heart Association has mandated a goal of one hundred to one hundred hundred twenty compressions per minute for all patients. Just a little hint here. If you're taking the pediatric advanced life support. Course most likely be a survey questions regarding this right if you do by yourself ratios thirty compressions to relations in all patient populations adults children and infants. You have a second rescue prison. Your compression ventilation. Right is fifteen corporations to to violations for most children cardiac arrest. You'll either US one or two hands to compress the chest in the event of cardiac arrest Anthony Use of the thumbs on the sternum with the rest of the fingers and circling the backs. Preferred the primary reasons for this are one. It provides a better blood supply to the cardiac muscle. Say Only it also helps to maintain a consistent depth as well as S. force of chest compressions and lastly some research studies show that it may indeed bring about an increase in blood pressure which improves perfusion to the brain and the heart he sent you compress the tissue compress about a third of the diameter of the chance to in order to provide an adequate ojection fraction of blood from the left ventricle. Then allow the chest fully recoil so that the heart and refill the blood for the knicks compression allowing the chest to fully recoil is just about as important a part Harda. CPR is compressing the chest and having the right compression rate if you happen to be alone during the cardiac arrest and the child is small enough to carry with you to the phone. Do just that child with you as you call for help. The child is too large security. Performed two minutes high-quality CPR and then activate now one above all else made sure to maintain consistent compressions although compression gets the top billing in any type of resuscitation effort. It's important to remember that. You must provide adequate ventilation for your patient as well. In order for ventilation be -ffective you must have an open patent airway. Part of the challenge with children especially very young children is that they have very large posterior Oxford. If you allow the child supine on the floor or a bed. This part of the hill pushed Chen four were causing the airway to become included. Make sure that you put the child in a neutral position padding underneath shelters one way to measure. This would be to make sure that the external ear canal is aligned. With the superior part of the child's shoulder when a child goes into cardiac arrest in most often is preceded by an occurrence of respiratory figure. Vic this is unlike many adults who have some type of cardiovascular event or disease that precipitates their cardiac arrest when the adult heart stops the oxygen content of the blood is still sufficient to fulfil the auction workload demands of the heart for a few moments after cessation pulse. Most of the time children do not have this oxygen reserve. It's very important that you provide high-quality compressions and Malaysians during cardiac arrest especially for infants and children. Because how's this very reason during a cardiac arrest and you may be called upon to use an e. It's preferable to actually use pediatric size pads. If they're available they're not inviolable. Viable use the adult pads. Come with the favorite later in this situation would be probably best to use the anterior poster position the patches on the chest I and the patients back. You do not want the pads touch but you should not trimmed past. Try to make them fit the patient apply. AD as soon as possible possible is studies. Show that the early fibrillation is most effective especially in children in a situation where you must provide defibrillation for an infant. If you have a Emmanuel Monitor defibrillator violence preferrable to use that rather than a the primary reason here is demanding differ blazer can provide a much lower energy energy content for defibrillation in an infant in Canada. You date however should a day be all that you have than make sure that you use it most situations of pediatric cardiac arrest come about as a result of airway involvement breathing abnormalities or both be aggressive in dealing with these that your patient. We'll have the best.
"ten minute" Discussed on KOA 850 AM
"In ten minutes like make a big failed to surprise and delight a customer or come up with the winning idea and right now ten minutes is all it takes to help your business cut down on costs interruptions and download times introducing the Comcast business ten minute advantage ten minutes if we can't offer you faster speed or better savings on your current internet service will give you three hundred dollars for your time call one eight hundred five oh one six thousand now Comcast business goes beyond fast with high speed internet that means downloads in seconds not minutes get bandwidth for all apps and devices it all starts with our give speed network call one eight hundred five oh one six thousand now for your Comcast business ten minute vantage Comcast business beyond fast friends nine twenty two nineteen restrictions apply not available to current Comcast business customers comparison based on download speeds it does not include Ethernet service record internet speed in competitive built in the last sixty days required one three hundred dollar prepaid card per company call for details when it comes to save big on new windows it doesn't get any bigger than this champions best sale of the year is back right now the champion comfort three sixty five windows direct from the factory to your home for fifty percent off your that right fifty percent off there's no middle man no mark ups no hidden costs and no bigger savings on better window sites Dave Logan champions the only when a company that I personally endorsed him right now he checked the windows fifty percent off and sun rooms inciting thirty five percent off plus sixty months low interest financing millions of windows install since nineteen fifty three and recommended by more than nine out of ten customers champion is the right choice for your home book your appointment online a champion save now dot com the champion save now dot com subject to qualifying credit approval all discounts apply to regular prices select styles apply minimum purchase required cannot be combined with other advertised offers see store or website for details..
"ten minute" Discussed on KOA 850 AM
"In ten minutes like make a big sale surprise and delight a customer or come up with the winning idea and right now ten minutes is all it takes to help your business cut down on costs interruptions and download times introducing the Comcast business ten minute advantage ten minutes if we can't offer you faster speed or better savings on your current internet service we'll give you three hundred dollars for your time call one eight hundred five oh one six thousand now Comcast business goes beyond fast with high speed internet that means downloads in seconds not minutes. bandwidth for all apps and devices it all starts with our gig speed network call one eight hundred five a one six thousand now for your Comcast business ten minute vantage Comcast business beyond fast friends nine twenty two nineteen restrictions apply not available to current Comcast business customers comparison based on download speeds it does not include Ethernet service record internet speed in competitive built in the last sixty days required one three hundred dollars prepaid card per company called her to tell Mary guys kept safe because the Army National Guard responds protects and support's our nation when it needs the most from fighting wildfires with air support helping civilians and flooded neighborhoods to delivering food and supplies to those who have lost everything the Army National Guard always responds when disaster strikes the Army National Guard also trains to be ever vigilant against threats foreign and domestic they protect our skies with missile defense weaponry they secure our information communications and infrastructure with cyber security and they protect us against chemical biological and radiological hazards with the civilian support team the Army National Guard also stands ready to deploy and provide support for conflicts forty military missions abroad join the Army National Guard and be there to respond protect and support your community and your country visit National Guard dot com to learn more about part time service sponsored by the Colorado Army National Guard here by the Colorado broadcasters.
"ten minute" Discussed on KGO 810
"I hope I'm not the night yes it's getting interesting so me tell me ask you so the **** monologues came out when but nineteen ninety four it seems longer than that doesn't like it seems ever on for ever yeah it was an immediate hit it was because it was really for the first time I started doing it it was just it was the wildest thing people just connected with it yeah and then it just grew and grew and grew it's like a snowball did anybody ever try to get you to change the title everybody tried to tide I always joke about it because people used to say well if you just change the title and I be like well what would I call it the pocketbook no it wasn't like I was kind of like getting people in the theater it was like yeah we're doing month we're doing **** I I wanted people to make a conscious choice to come to a place called the **** monologues and I'll tell you a funny thing when you know all these different countries started to do it and it's really surprising the ones who did it first not the ones you'd expect Paris was one of the laugh really and yeah and and you would think you know with the but they were vehement about changing the tile and I was so I've never have allowed that anywhere and so they were one of the last people to do it and once it started the powers it lasted there twenty years it ran for twenty a long long time but but you were talking before about not being able to save the China on on the network the first time CNN did a story on the **** monologues could you could say **** on the networks that you can save a China need I say more yeah right and they did a ten minute piece on the play and never mention no it was really an act of incredible issued a genius right to avoid it but I think it's amazing to see in the twenty some odd years since it people were all the time now it's part of the culture is not this very dark scary horrible shameful thing we actually have them and we're proud of them we we talk about them and they exist in and I think when things exist it's much harder to do bad things to them in the dark for you know how I mean I I know we're talking about your book and talking about a part of your life but it seems to me on the on the overall whole known you for half an hour now no seriously like that you you're very hopeful are you yeah of course well full watch I I'm I'm the back at school you know I can go on I must go on I will go on I mean what what what I think is that we are we are on the brink of of either going to make the biggest leap in human consciousness or we're going to perish we really are we're on we're really at the turning point in in in human consciousness and I'm often that we're going to make the leap Intel told differently you know but I think it's going to require all of us coming into a period where we've you know the predator in chief is currently a top of the of this country he is the outcome of many years of us not making apologies I'm I'm not making reparations of us not acknowledging our history beginning with the indigenous we committed genocide against followed by African four hundred years of slavery the African Americans in Jim crow and mass incarceration we are we and then if we look at our families where we have massive denial and we things are happening and we're forgetting we have diabolical amnesia in this country and so really what an apology does is the antidote to amnesia it basically says what occurred did occur and operations yeah right we need to give everybody dollars but we can try to level the playing fast and only what's happened here and say this happened we are sorry for this happening with just the way the NYPD came out this week and apologize for stock raising mazing it was a huge relief and everybody's consciousness because they said it's real in the New York times finally printed the obituary for the the you know who Alan Turing right that's right he he was went to jail for about being gay that's right but when those things happen something gets released to the culture something gets freed we can go on so we're up this reckoning now and and and first is the manifestation of that he's the he's the it's like the toilets overflowing and he's sitting on top of it you know the thing I love about who was talking about this book seems to me the apology is is you're turning around its you're saying instead of being sought a sign of weakness is a sign of great strength and hope and possibility and if the brave men if you know cast we used to say it only takes ten percent of the people to have a revolution that ten percent of the men began to come forward to make authentic real deep apologies like I outlined earlier that would begin the tide turning so that they could begin to be this reckoning this this accountability that would allow people to get free in every direction we're not gonna move for less man make ending violence against all women their central issue it's not going to change I always said judge man by the women they choose to be around and bite lint men men shoes strong women with strong opinions and I always think better of them right and and I think that you know that it's the way I look at strength in people and the way it you know you never stop growing you never stop opening your eyes and stuff can't switch so six thirty tonight the Commonwealth class all right everybody get on a thank you email somebody again talked will call the apology as she is the author John monologues her name is eve ends are coming up Rick Riley join us he's written commander in chief about trump cheating in golf.
"ten minute" Discussed on Ten Minute Medic
"Today's podcast will do with the issue of chest trauma in general. Enuma thorax in particular, as you should always. Let's start with a review of the anatomy physiology of the respiratory system. The twelve pairs of ribs, connect posterior Lee with the spine and interior Lee with the sternum the ever part of the sternum is called the angle of Louis in his will be helpful when we're judging whether there's been any movement of the trachea. The space between each Ray was known as an intercostal space, and we'll be wear should we need to will insert needles or other devices to decompress the chest, the muscles that lie along, these intercostal spices are important towards increasing the rate, and touto volume when the work of the diaphragm is overwhelmed, the diaphragm is a translucent muscular organ, that forms, an airtight, seal between the thrash, cavity and the abdomen. It contracts dour with inspiration and relaxes upward during actually is one of the most important organs, braving, the action or physiology of breathing. All depend upon a change in the atmosphere pressure, both inside and outside of the thrash, e cavity. First thing that you as a payer may Stu must remember is that nature will try to equalize vacuum. That is one location that has a lower pressure than the other gas flow into the lower atmosphere. Ick area in an attempt equalize the pressures, the pressure fan within the alveoli I will change depending on whether your patient is inhaling or exhaling, the wire connected to the outside atmosphere, by way of the Broncos the Bronco and the trachea as such the pressure within the vehicle. I will equalize with that of the pressure found outside the body. The pressure fan within the Interflora space that is the space between the visceral, and proud of pleura varies. Normally it's about four to six millimeters of mercury lower than that found in the Alviela and by association that of the atmosphere, ick pressure, when the diaphragm contracts downward, the space within the threats that cavity increases according to Boyle's law, when we make container larger without change in the amount of substance with. Within the container the pressure within that container. Lowers think of this way, we blow up a balloon to diameter of six inches measure, that pressure then transfer all the contents of that very balloon into another one with a diameter of twelve inches what'll happen to the pressure fan within the second Bologne. That's right. The pressure will be less going back to our statement that mother nature does not like it. When there's a Bank, you, she'll try to fill that bake Huma something. So as depressure equalize air will rush into the lungs. The body contains barrel receptors that will measure the pressure within the lung. So as to prevent over inflation, and almost always eliminate the danger of too, much air going into them, keep in mind, that in the Stupar process of inspiration and expiration, the inspiration processes, the active of the two an exhibition is a passive process, the passive process of excellence, does not need any energy. Spill air from the lungs as the chest wall muscles begin to relax the. Diaphragm does the same returning to dome like shape. The pressure within the thrash cavity increases to about four to six millimeters of mercury greater than that of the outside atmosphere. This is the opposite process of her balloon example earlier, instead this time, we're taking air from a twelve inch balloon and return it to the six inch diameter balloon again, because a Boyle's law, we have decreased the volume of the container and increase the pressure, this inequality of pressure as related to the inside of the alvie lion. The outside atmosphere, cause air to flow our until the pressures are equalized blunt force trauma, is any injury this, 'cause Connecticut energy is transferred through the tissues of the chest wall, generally without leaving an opening penetrating trauma happens when an object such as a knife, or a bullet, enters the chest either these making can lead to simple or tension with authorities. Let's take a closer look at each of these. A Numa thorax occurs. When there's a tear in the lung tissue that causes air leak out of the lung and into the pleural space, depending on how much air scape, this may cause a partial or total collapse along. It's not the same thing as tension with Orage, one of the most common causes of simple, new with or ashes of fractured rib the ends of the river sharp and the movement of the lung pleura beneath the fracture can cause it to be punctured. Patients also have non with or acts, as a result of blabs or weakened areas on the surface alongs. There are several factors that go into patient's presentation with a simple with Orix these include how severe the patients. How Pasha is as well, the amount of lung that has collapsed treatment for a simple, Numa thorax is primarily supportive. Get your v started apply oxygen and watch for the possibility of at progressing to attention, Numa thorax, which you will discuss in just a few moments. The use of pulse. Ox, symmetry white form cap Naga is essential transport your patient in a semi Fowler's position and constantly monitored them for progression to a more severe tinged with orange the second happened Numa for actions that of an openness with orange most of the time the mechanism of injury for this type of wound is penetrating trauma, that allows a direct passageway from the outside atmosphere into the thorax air will tend to follow the path of least resistance when the patient tries to breathe, and a considerable amount of air from the outside atmosphere will enter directly under the thorax because of this many times, the wound will have type of flutter valve made up of tissue from inside the body. This prevents air from being expelled. When the patient tries to tell the mechanics of inlays should begin to be hampered as the long on the injured side begins to be collapsed. This least of the collapse of alveoli, I'd known as at Alexis not only is the physical aspect of innovation compromise because of. This at Alexis the exchange of carbon dioxide and oxygen at the elbow, or level has hampered the initial treatment of an open Numa or actions to silly by placing your gloved hand over the opening. You can then apply. One of the commercially available chess seals or in the absence of those improvise one by using foil or plastic and sealing it with tape watch for the progression of the new authorities patients commonly have a secondary injury to the lung. If the patient begins to complain of in Chris dismissal. Technip Neil or tack cardia opened the dressing allow in the air that may build up in the thorax to escape. Once again, be sure to observe your patient for signs and symptoms. That might indicate that they have progressed attention in thorax. Attention new methotrexate is a true life and death emergency that occurs as air continues to be trapped within the thorax with no method of escape this increased pressure lease to shift in the organs and vascular. Within the media Steinem the spices, greater pressure on the lung on the injured side, leading to an even greater area of collapse. In addition, the shifting of the heart will place pressure on the Vena Cava causing reduction in the blood flow to the heart this reduction in the prelude causes an overall reduction of the cardiac output during your assessment or these patients, they will, obviously complain of chest pain and difficulty breathing, as cardiac output in preloaded decreases, there will be a decrease in overall oxygenation in general, and to the brain in particular, this will lead to increased agitation as well as. Zayed these early signs of your patient being in compensated. Shock don't overlook them, although the classic sign of diminish breath. Sounds on the effect aside are accurate is often very difficult to determine whether they're prisoner. Absent in the noisy pre hospital environment. Accompany this tracheal deviation away from the side of injury. We tend to make a big deal of this time. But keep in mind if it is present it is. A late San in addition when you're a for the signed be sure to look for just above the angle of Louis the sternum any higher up. You may be led to a false negative as trachea as anchor, by strong muscles in the Nick watch for your patient, progress in a d compensated shock your goal in the treatment of these patients is to make an attempt to equalize the internal and external air pressures, this may be accomplished by the use of needle decompression. The research shows that this is I safe procedure for paramedics to do. Newly compression is done by the introduction of large. Ten to fourteen gauge needle with a catheter over the needle into the pleural space of the chest, the minimum length of your NATO should be eight centimeters longer. If available, there are two insertion points that are used one would be the second intercostal space in the anterior part of the chest. And the second would be the fifth intercostal space of the mid actually, part of the chist, once a needle has been inserted is should be removed leaving only the Teflon catheter. You may hear Russia air escaping from the thorax if the pressure found, there's excessive there's some positive negatives to both locations. Some studies show that if there is a greater failure of decompression when used in the mid clavicle area because of a greater amount of fatty tissue in this area, the issue of the use of the mid actually line, is that when a patient has been packaged for transport to the trauma center, their arms, may either ACLU the catheter, or hot is so that you may not know if it's become dislodged some agencies advocate for.
"ten minute" Discussed on Ten Minute Medic
"Decisions. Fetal viability are made on the basis of the best stationl age available. When estimating the fetal age of the resuscitation area. Rough guide might be that when the Fundus of the uterus extends beyond the Emba likes. The feta's is potentially viable. Let's take a look as treatment modalities the prime directive of the paramedic. Can dealing with a traumatic OB patient is to ensure the oxygenation of both a mother and the baby using pulse. Ox administrartion to maintain an Oto saturation of greater than ninety five percent. It's important to remember that signs and symptoms. The shock maybe hidden from you until massive loss takes place. The mother could have a blow Lhasa thirty percent and without it showing the traditional and symptoms of shock. Always work out the assumption that your patient is either in shock or will shortly go into shock while carrying four biologically. The body is designed to shunt blood from the fetus to maintain the life of the mother, you'll hear me repeat this over and over the best hope for the baby survival is aggressive treatment of the mother the protocol for the treatment of pregnant trauma patient remains similar to those for a non-pregnant one assess the abdomen determine if it is rigid or board like if either they symptoms are present, you might they might indicate an abroad. Tailless enter a rupture uterus. Both are life threatening to the mother and the baby. If your patient is bleeding vastly do not place any bandages dressings in the Janet south. But across the opening the administration of bolles twenty-six per kilogram will stimulate the production of anti-air etiquette. Hormone also known as as a present for the Postino pituitary land. This is also the same area from which oxidised greeted therefore in addition to provide a fluid Belus which will increase circulation volume as well as a pre load. The spouse will also stimulate the production of oxytocin, which will cost some degree of as a construction thus reducing the amount of bleeding dealing with trauma. The pregnant patient will be one of those stress because it you'll ever run my advice, providing the best care both mom and baby is to focus on what's best for the bomb in doing. So you'll sit of the best possibilities for survival of fitness. Thanks again for listing with this episode. We launched. A new feature fan in her show notes tunnel the ten minute medic review with HFS owed will include three to five national registry type questions. In addition to the answers will give a rationale for join. I hope you enjoy it next week's podcast will review the threefold pathophysiology of asthma, and how you should respond to patients suffering from an exacerbate tion of you see you next week.
"ten minute" Discussed on Ten Minute Medic
"Magin that you're you're running a scenario. You've got a twenty two year old male patient that law enforcement is college you on they're not entirely sure what's going on. When you get there. You've identified. Guide. The patient is has history of autism. Give us some ideas in your patient assessment and your interaction with the with with this patient. How would you speak with them? How would you minimize not having multiple steps in what you're asking the patient of do or what you're telling the patient that you're going to do as as part of your assessment? I always like say it's kind of like going low and slow guy Asian you wanna get down yacht. First of all you want to reduce all the the sensory. Stop may be at light speed people. Did you know noise, everything you wanna limit that next all the things that we have on on emergency saying absolutely good and not to get off topic. But if he can teach the family, what we need to know after your first contact saying, look, you know, if we knew the child was on Tissot. We'd learned how to adjust our response. Okay. If I that's a great way. 'cause 'cause I tell my students said families are secondary patients that can be your your best friends or your worst enemies, and there are a lot easier. And you get a lot more information from them when they're your best friend. So I think what you're saying. There is is outstanding information. Well, yeah. And if you think about it that way to that with a an autistic person, it's it's that in space in oh, not gonna react. Well to an adversarial and of approach or or you know, coming in guns blazing. You know, we got our kits. We got our firefighters with us. We're just, you know, go from zero to sixty in two seconds on. It's not going to do anybody. Even neuro typical person any good you're gonna you're gonna grant them up with an autism person. You're really going to Jack up and then you're working on a meltdown. You're not getting anything done. So you know, sitting beside. Them talking softly. Finding out if they light-touch don't like touch. That's key giving them time to respond to your questions. Not all very often, especially new medics, as you know, we're often thinking of the next question before we heard the answer to the question. We just yeah. Yeah. Don't do that. Because then you're you're not going to get anywhere with any patient. But certainly not person you just got to ask the question watch their reaction give him time to respond if they can respond NFL nonverbal. There are other ways to do it. Do they have a night at do? They have you know, a tablet of some sort that helps them communicate or or you're going to have to use some other other things, you know, the county they point to things, you know, it's it's you know, how he amasses man, you just gotta adjust. So the question has to be as then I mean, we we beat into the students head what I called the BS seen safety dance. What is the likelihood of danger for someone to get hurt? Either the patient or one of the responders if you're doing everything that you're supposed to be doing your shutting down lied. You're you're clearing the room out. You have minimal number of people. What's the likelihood of a patient that has autistic of becoming violent? Well, you know, it's always there. I mean, there's a lot of aggressive autism. But I think a large majority of assistant, April are more huggers. Okay. Than an aggressive. But you know, you have to use your Spidey senses. You know, you have to get that history. From your your your family good in a bait. They mentioned that a child can be aggressive. Well, maybe you don't want to be in there alone. You know? And maybe that's a good reason have law enforcement on scene. But the last thing you wanna do is is restrain an autism person. Right as oh. From bad. Do a whole lot worse really quick drying restraint. And obviously sometimes we have to restrain bit hemicycle restraints with I said, or did, you know, a physical restraints, but onto stick people aren't developed the same way. Neuro typical people are in. There have been more fragile on the have less upper body strength. So you know, you really opening up a can of worms by trying to restrain or being aggressive in your approach. And you know, you can very easily without intending to do everything wrong. You're make us get may make that one outcome really bad. So all future outcomes for whoever response to this person in the future are going to turn out the same bat.
"ten minute" Discussed on Ten Minute Medic
"Welcome to the ten minute. They podcast for busy paramedic students. This is a podcast where we take one subject discussing for a maximum of ten minutes. I'm your host Dr Bill young. One of the areas. It's commonly failed while taking the national registry. Makings Ayman's out of IMAS operations, the problem with this is that we tend to cover evils operations at the beginning of class. Never to be mentioned again until you're sitting in front of the computer screen taking your exam. It literally becomes out sight outta mind. One of the things that I was suggested you do a good paramedic student this to periodically review. The miss opperations sanction in particular, dealing with incident response and the level of ethicality of how you treat a patient's as we podcast. We'll take a look at one of those issues focusing on. What is the right time for us to not transport a patient to the hospital, I gave a little ham. If you'll always do what's in best interest of your patient. Honestly, doing what's in the best interest of your patient? You're rarely around as podcast was recorded in April two thousand nineteen not long ago. They must roll the surprised dismayed by the report of a man who was berated treated poorly by EMS agency in South Carolina. According to news reports a patient had a history of schizophrenia. However, they invest crew responded to a report him running up and down interstate ninety five while naked ultimately released him four hours later, he was struck by vehicle and killed. On the highway the instant with paramedics show in the lack of compassion was cut a body. Cam video of the responding deputy podcast will not address lack compassion or professionalism shown on the video by the mess group. Instead, we'll take a look some of the legal aspects of releasing patients at the same than how to minimize your legal liability. Keeping my I am not an attorney nor to play one on television. Racially exciting announcement was made by Medicare under a new project. EMS is now going to be reimbursed for treatment without transport in certain situations. This Saturday at the same time causes me. Great fear, one of the areas that EMS has the Duggal sacred in as have no transport of patients who led her own show to need between transport. Let's take a look and review the criteria. Which legal ability is minimize in doing. What is best for the patient is maximized when faced with weather to transport ship patient of hospital or not after we use the word, competency when dealing. With a patient's ability to make health care decisions for themselves. More accurate term would be capacity to make decisions however, because competency is generally will be using that word Kamla within the United States hopes that patients have the right of self-determination in regard to whether or not Duceppe medical treatment, one of the greatest most basic rights humans have and must be protected as that of Tommy Tommy can be defined as the right to make decisions that are once best interest. All patients are considered to have competence to make legal decisions about their care until preventable is now in order to make those decisions the patient has to have the right to either give or withhold consent for treatment any adult that has been determined of been found competent is able to tell you whether or not they want treatment even further if a patient desires to be treated, they are right to tell you to what degree they want the treatment to continue or stop. This would include withholding particular medicines. Or trey. Tement while civility accepting transport of the hospital. Challenge rises when the pre hospital care is needed patients that may or may not be have the ability to understand their condition, and we're not sure if they're capable of making the best decisions about their care key in this. Doctor Automic is that the patient must be competent a wish that there was a tried and true method, but which you could determine competency at all times, unfortunately detail, you that would be a lie. So how do we determine whether patients comment to refuse treatment and or transport well begin with the very basics is your patient awaken alert. Now, it's important to remember that being awake is not the same thing as being alert some factors that you must take into consideration when dealing with patient carbons the to refuse treatment should often include involving the patient's family when available to determine the agree to which the patient is acting normal. Keep in mind that your patients family can become your greatest ally. Where you're worse. To enemy the treatment of the patient. Now, we sometime on the legal aspects of patient competency. Let's turn to the clinical side of it stated earlier than determination of competences, not a science, but more of an art it's important to take into consideration vase and culture the patient when trying to determine this comments can be influenced native white by the presence of dementia delirium alcohol into drugs. However, it's important to remember that simple because a patient smells of alcohol. Does not mean that they're incompetent to make their own decisions in the paramedics action of determining confidence. The history is often. The most important tool that we have must be the place where we first him as discussed earlier determinative patients normal based on this critical. The second step is to explore whether or not any change in the patient's Covent of ability is related to her versatile 'cause all patients, and I mean, all patients who exhibited change on a level. Cognition should get a finger. Stick glucose to check for Hubble glassy Mia fill raid. Listen to an earlier ten minute medic podcast, entitled you're so sweet on the approach into paramedics should take the diabetic patient determined that the impairment is not going to improve your next step should be to find out. If it's getting worse as well. As to what degree the impairment has on your patients decision making ability. Make sure that you're able to differentiate between a patient with dysphasia or difficulty in speaking from the one who is speaking gibberish, stroke patient will often have some problems speaking, clearly, but will retain the ability to make cognitive medical decisions. A the Monica can be helpful and do the detailed assessment on the middle. Competent patient is asset A S S E T A for appearance s is for speech esus for censorial is for emotional state and tears for thought process. Take a deeper dive at each of the. These look at the appearance of your patient. Although each patient will have a different socio economic status and don't let this by sheer assessment look at how they're dressed as well as the personal hygiene. If the patient is to shoveled explore the reasons why based should be assessed for proper pronunciation as well as normal patterns s. Also sounds for since Oreo does your patient know where they are the time of the day things like that one word of caution here beware of asking any patient regardless of their chief complaint. What time of day it is if you respond to them after midnight, even the best of us will have a challenge. Intranet question we've been awake in the middle of the night is their emotional state appropriate for the moment. Does the patient seem depressed or in a state of mania? Lastly, look the thought process SM them simple questions that they should be able to answer such as who is the president in. What is to listen to the like is it possible that a patient with dementia? Could still be able to make some or all of their medical decisions. While a short insures. Yes. Patient with diagnosis of dementia may require the prayer made to take a much closer look and evaluation at the mental status of him. But each situation is different take an individual approach each of these situations as you deal fairly and compassionately with each patient and their family if you have any Dallas to the patient's capacity for decision-making default in the conservative broach. This however must be done in conjunction with patients family as well. From the point of wellbeing for the patient in an article from the stat pearls website, leeann Goldstein suggested the following regarding the decision making criteria for patients. The patient must have sufficient information from the provider regarding the medical condition in the associated risks to health in person. The patient must understand that a decision has to be made. The patient must understand the rich burden. And benefits of all options, including that of doing nothing. The patient must be able to use the information to make a decision in the setting of his values and belief systems. The patient must be able to communicate his choice to the provider, and they must be acting without coercion or undue influence, including from family, friends, or even you as the provider in his responsibility of the emergency responder to identify loss of capacity for medical decision. Make it is not the patience responsibility to prove that they retain such capacity. You can find the full citation the full article in the show notes in conclusion taking the approach that you will do the very best for your patience is the best route of care for them as well. As the best source of legal predation for yourself, you're gonna wind up on video on the internet. Why not make for some form of compassion state? Need care for your patient. Thanks again for joining the ten minute medic. I'm. Excited about our next topic as it was chosen by their request from the paramedics students at Arkansas state university are Dixie stations will address IMAS interactions with autistic patients the first long will deal with what autism is. And the second will provide some ethics of dealing with these patient interactions. The best way to ensure that you hear these off your episodes follower podcast on your favorite player. Thanks again for listing.
"ten minute" Discussed on Ten Minute Medic
"Processes. Wells protecting the airway. Should he vomit? The first line drug should be considered for your inflected patient is epinephrine. Apias classified as a sympathetic agonise? Which means it will increase the heart rate result in peripheral Vice Construction and improve the cardiac output as it works to constrict the blood vessels. It'll also help to stem the plasma that his Laking from a basket jer leading to an increase in a patient's blood pressure. It's also a faked it for the reversal of the broncho constriction so common in these patients. You're dosing regimen for epinephrine zero point one zero point three of a one to ten thousand concentration solution of epi. This should be given IV this translates into three to five milliliters of this one to ten thousand concentration. Deafened hydra mean more commonly called Benadryl is more frequently administered in the allergic reaction or an flight to patient than any other drug. It is an h one and h two blocker that is effective at neutralizing the effects of history, the standard adult doses to give twenty five to fifty milligrams IV, or I am keep in mind that when administering hydrated is very painful, the paint can be lessened by ministering, slowly, the primary Sada faith from its administration will be sleeping on the part of your patient. Having a severe ineffective reaction is very frightening experience for anyone remember to remain common, compassionate with your patient the side effects from the administration of epi. And deafen Bing can add to that fear as you should with all your patience, be sure to tell them about the side effects. So that when they do begin to exhibit them their anxiety is lessened support in the emotional status of these patients is portent as. Oh pouring their physical needs. Thanks for taking time to listen to this week's ten minute medic in next week's episode will transition over to look at some of the issues behind patient consent. And why this could be a particularly thorny issue for the paramedic. Thanks again. For listening.
"ten minute" Discussed on Newsradio 700 WLW
"He said. Music you take your little fees and the rabbi vacation, man. Doc lamp tank Sam. You're you're right on the money or do. I know. I know do I know I know that crowd. I got Austin be while thanks for checking out the show appreciate but he did dudes Twenty-three. You gotta be really good at that stuff. I guess I guess you're not no matter what age you are. Yeah. I just times I reached a phone. I got stuff going on. You got stuff going on? And I'm trying to find out some information on sitting there and my ten minute drive. And it's just it's stupid is what it is. It literally can wait. I'm a I'm a PSA waiting to happen here. Man. Sitting there looking at my phone. Okay. I'll check that. I could look for whatever part. It is as soon as I get in the store, whatever it is. I'm gonna go shopping for the you name the home improvement place. I can it's ten minutes. Relax, and believe me. I'm the guy. I think I'm really really busy all the time. I am. But it's also self made business it really that important to be looking at your phone while you're driving a car. No. But if driving weren't so damn boring, and this is where I'm holding out. I asked my son this yesterday, he's got a car. It's a couple of years old. And they me about new what are you getting a trucker seventy his dad, I'm gonna keep this car alive because I'm holding out for the self driving vehicle. Well, you baby weight awhile. And it may cost a little bit more than you have with your used car used Kia. I'm holding out for the self driving car. And then we'll have it made. I think that's something else too. Is that we just keep building in more creature comforts, right? If you have I was gonna say luxury cars, but I don't even I think they're on just regular shows. The last time I was shopping for a car by the way because I'm too cheap. A regular is the like the lane keeping your lane. The automated breaking if you get too close to someone the adaptive cruise control that's pretty damn close to autonomous vehicle right there. You know what I'm saying? Is you have a vehicle that is gonna keep itself in the lane? And it's going to break if it senses traffic in front of you like the previous caller said Emma's rear ended a bunch of people that the car do itself. Negative, courage. More people to go there. Nothing to do here. It's not a totally autonomous car because you still have to have your hands on the wheel. But it's the same. Tommy, you're going to be looking at your Email more. If you have that I don't know if I'm not gonna rear end anybody. And if I got out of my lane, it's gonna pull me back. I can catch up on all sorts of work here. So have you think distracted driving's bad? Now. These numbers are only going to go up. So willy is on the way in just a few minutes. Of course, we have reds round up with the cowboy happening in just a few minutes. They were rained out on Saturday. No surprise, they got shut out yesterday. So they're nice even one and one at this point. And now, I believe Milwaukee's in town will be talking about that with the cowboy as he reds twenty nine thousand.
"ten minute" Discussed on Ten Minute Medic
"Uh-huh. Welcome to the ten minute. Medic the podcast for busy paramedic students. I'm your host. Dr Bill young is that time of the year. Again, when students begin to be paid for the national registry of EMT certifying exam. You spend many hours studying about the body, and how to treat it when it malfunctions why not spend a little time studying the exam that will lead to your licenses in the professional in today's podcast. We'll take a look at the exam and how you can best prepare for it. National history. Test questions are multiple choice with four potential answers. There's a popular urban legend that all the answers are correct. And the candidate must choose which one with registry believes as the most correct? This is false. The question you'll see are developed and reviewed by panel of experts from around the world who are not employed by the national registry. They must come to a consensus to question agrees with the practice analysis study determining the activities of EMS responders. They made sure that there's only one correct answer. Now, the other choices may have some great truth in them. But they are indeed incorrect now while this might seem like a process of trickery it actually serves to evaluate your level of critical thinking ability each answer must be referenced by the most common to Mt textbooks that are used in the nation today. The computer based exam that a national registry is now utilizing this call cat or meter deftest testing and sees Amos tailored specifically to the individual student candidate. This means that the exam that you take will be personalized for you, and you alone. This testing method uses a process called IOT or I don't response theory. I don't response theory testing is used in almost all other health professionals testing for licensor IOT is raking is scientific method to help you measure, your degree of competency that is based on the fact that the likelihood of testing candidate answering a question correctly is directly related to their. The ability and the difficulty level of question, computer. Adaptive national registry exams will deliver questions one at a time to the candidate. And are not randomly generated. They are rated along the same ability scale as the candidate exhibiting proficiency. In other words, the exam will measure your proficiency and give you questions at straight. You almost everyone that comes out of the exam feels that they've done poorly. The first questions on the exam are generally just below the passing standard. If a question is asked that is below the candidates level of ability. The probability is high that the candidate will answer the question, right? Additionally, there are some questions that'll be asked that are considered pilot questions for future exams. They are absolutely no bearing whatsoever on whether you're on a pass or fail. If a question that's asked is missed by the candidate, they'll received a slightly less difficult questions. Their next one the students fistful answering the question correctly, then somewhat more difficult question will pop up as a questions get more difficult. The student will be in a missile at that point the question's gonna bit easier until your successfully injuring them again at this point in the exam. The application software determines the ability estimate for the student and begins delivering questions that are slightly harder or slightly easier than the candidate's ability. Question. Difficult is determined by whether you answer them correctly or not as the CAT exam progress is this estimates more and more precise as the pattern of right or wrong answers, really begins to show, whether you have entry level competence. The example end at the point where there is a high degree of certainty that to candidates true ability is above or below the passing standard CAT matches. The question difficulty of the candidates perceived level of ability, and this limits the number of questions delivered as well. As increases accuracy. No more of the days of sitting is taking one hundred eighty multiple choice question by paper, you cannot skip a question and come back to lighter the stress some people crazy the nature of the cat exam. Requires that you answer each question. Individually before any individual questions are delivered. So what should you studied to prepare for the national registry exam? When I was completed my doctoral studies, I was required to take a comprehensive exam at the end of the course, I asked my adviser as to how this study, and what I should know his reply was that I needed to know everything about everything that wasn't much help. But also pretends to the registry exam, technically, you should know everything that was covered in the EMS course materials, there's no secret methods or inside can replace proper test preparation. But there are some things that are common. The tests are heavy and the basics. Let's take a look at some of these areas of study, no CPR in shock as well. As all the same categories of the test itself. It's broken down into multiple categories that include airway breathing cardiac medical trauma, OBM pediatrics in operations. We'll talk more about operations in a minute. Now, the major components of the airway and the normal rate. Inches of respiration for adult in pediatric patients. Keep in mind that registry will not ask you what a normal respiratory rate is, but you must be able to determine what is abnormal in how to develop a treatment plan to address. It be familiar with diabetic emergencies in the various causes of syncope. There is a large portion of the exam that's related to operations in many students overlook this since September eleven great effort has been made to incorporate more education about in them's and ICS with regards. The MS understand how these systems work and how they might applied to a mass casualty incident, and you'll be a step ahead of the other candidates. This is a commonly failed section as EMS operations are typically covered at the beginning of the class never to be referred to again when you're getting close to the end of the class. Make sure you go back and refer to it. The national registry exam is not based upon the textbook that you used in your class and. Is not based on. How you provide cap preoccupied care and your state the exam is based upon the national registry. Practice analysis done every five years the exam questions are written to fall within the department of transportation education guidelines, and as such cover the national scope of practice EMT books on the other hand give you their interpretation of the standards. So what are some strategies for you and taking the exam? Well, I read the whole question all the way through at least a couple of times and formulate the answer in your head prior to look at your answer choices. National register test questions are typically only two lines or lists and length each word is important. If you look at the answer choice prior to understand the question completely. You may be led to choose an incorrect answer also be sure that you know, where you are in the scenario there's four potential answers two of them can be eliminated. Right away after reading the question a couple of times. Now, you just have to decide the best choice between the remaining two. Now, knowing where you are in the process of assessment might make you select airway when you are actually plot down in a section that is beyond where you assess the airway. It's time to be honest here. Most of the questions that you're going to get in some of the training programs are in the knowledge category. Eighty to ninety percent of the time. These are the questions that you're going to see in your class. Respectfully, ask your instructor how they construct the questions if they're getting all of them from the publishers test Bank. You may have some challenges when you get the registries exam. These knowledge questions are not bad. But if that's all that you see then you're going to struggle when you get into the higher level critical thinking questions don't complicate the scenario of the situation when you're looking at it in other words, don't play the well, what if don't ring elements into the questions that aren't there this because you overlook basics, which is probably what the question is testing for relax. Relax. Relax and don't forget to breathe. Finally, don't rush. You have got more than enough time to answer all the questions that you're going to get and it's more important view that answer each question accurately, rather than quickly nother legis is that you can tell whether. You've passed by the number of questions, you get this is also false. Remember from earlier in our podcast, we discussed how software determines what question you'll receive. As was how difficult it'll be this is what determines whether you pass or not whether you get the minimum or the maximum number of questions only says that he took the minimum or maximum number of questions do determine whether you passed determined that you're competent or failed determining that. You are not competent. We here at the ten minute medic one wish you good luck. As you get closer to taking your certifying exam. We have a whole host of pot cash that will help you to prepare for those. So we encourage you to go back into our library. And listen to those today. Thanks again for listening.
"ten minute" Discussed on Ten Minute Medic
"Now, you're listening to the ten minute medic the podcast for busy paramedic students. I'm your host, Dr Bill young as of this podcast. Trouble continues to be one of the leading causes of death in the United States having a mortality rate of us highest forty percent. This doesn't even begin to address the mobility issues. The caution of off to the patient during the recovery process. These cops can easily run into the hundreds of thousands of dollars depending on the severity of the trauma and the degree in length of care required. The activation of the lethal trauma. Try that includes the patient developing doses the onset of hypothermia as well as excessive non Arshi carrying fluid resuscitation can accelerate quarry allopathy maybe prison as soon as the patient arrives at the emergency department, or in many cases, while there were the amiss according to an article by Winston in military medical research journal, uncontrolled hammers from coagulation dysfunction is one of the main potentially preventable causes of the mortality in both civilian and the military settings. This condition can be made worse with the administration of large amounts of blood products as such it's important. We explore the utilization of all options both inside and outside the hospital tale the patient survive until they can arrive at a facility that has surgical capabilities is the administration of TSA in the pre hospital setting a potential game changer for trauma patients current research. Seems to indicate the terrorists and definitive benefits win given early trans Amy gas. It is one of the drugs that EMS should take a very close look at and consider implementing within the protocols when dealing with patients is severe and life threatening trauma. The quiet relation of blood is one of the most important body functions that humans possess, the physiological development of clouds with fiber is offset by the anti coagulation process. One of the largest concerns of the patient who is hemorrhaging during trauma is the breakdown of blood clots specifically, the breakdown of fiber strands this process begins when an enzyme by the name of plasminogen, that's produced by the liver and attached to the fiber stands that hold the clot in place. The substance is now known as tissue plasminogen activator TB. Yes, very similar to the TV that is used to dissolve a clot during my car. He'll infarctions is released by the end of the'll. Sales of the vascular converse plasminogen into plasma n- that accelerates. A breakdown of the clot these into filial sales are found in the lining of the vascular throughout the body. This breakdown of the clock sales is known as fiber analyzes anytime that there's any trauma to the body of fiber clock begins to form as a result of its response to the bleeding the clock starts out as a Lakewood the begins to transform into a gel like substance, eventually forming a clot. When the body is working correctly, or the bleeding is not massively severe this results in a plug being formed at the site of the blading causing it to stop. Cooperation, which is simply another name for Claudia begins almost the instant the body suffers an insult resulting in David. So the empathy lining of blood vessels. As a result of blood being exposed to the space underneath epithelial. There are to making his to begin to take place I structural and chemical changes in platelets, causing them to become very sticky. And they begin to adhere to each other. The second change that occurs is the exposure of tissue beneath epithelial cells to plasma this. Intern results in the development of a substance called fiber, simply put the platelets four of the plug and fiber and wraps around this platelet plug to help ensure stabilization and decreases movement studying on his crash to was a research trial that evaluated the healthfulness of TSA over twenty thousand adult trauma patients were treated either with a placebo or given ta say result. It showed that the death rate after four ways was significantly lower in the patients who received the TSA. The researchers found that when TSA was given within an hour of injury. The risk of death was reduced by thirty three percent. When the initial dose of TX was given three hours or greater after the trauma. The effect was not nearly as dramatic. The researchers found that there was not an increased risk of an inclusion of an artery that would lead to native outcome. The Kurd treatment guideline for trauma centers for patients that present to their facility include the administration of blood in order to maintain perfusion, including the delivery of oxygen and the removal of waste products. The administration to TSA has also been shown to reduce death rates by inhibiting Fabri, analyzes one of the major major criticisms of the crash to trial was that. There was no inclusion criteria developed from a definitive research perspective, basically, it was based upon the decision of the trading physician who decided whether the patient would receive TSA or not for some this was a research design flaw. There's some. Undefinitive benefits to the administration of TSA in the pre hospital setting. So these include the cost depending upon where it's purchased the cost of essay in America ranges from twenty five to fifty dollars per one gram dose in addition since current recommendations are the TSA be given within three hours and preferably within one hour, then administration by paramedics at the scene or while in route to the hospital is the ideal opportunity for the administration of stroke. It remains to be seen if the survival rates referenced earlier would be even higher. Hopefully, this'll be researched soon the protocol for TSA administration varies as most protocols do but should be similar to the volleying. I your patient must present with profound hemorrhagic shock vital sign parameters should include a blood pressure of less than ninety millimetres. Mercury. Stolac a heart rate of great greater than one hundred ten or a combination of both you should administer one gram of TSA over ten. Minutes for your initial dose mixed the TSA and fifty milliliters normal sailing and infuse if you have access to it or using fusion pop your pop dosing rate should be set at three hundred sixty milliliters per hour. Although it's highly unlikely that you will minister a second dose. If your patient is being transferred from a lower level of care to a trauma center, you may need to observe a maintain the second dose. This is one gram of TSA in one hundred milliliters normal sailing to be infused over eight hours. This may require direct order from your physician ticks is not recommended for use in pediatric patients younger than twelve years of age adverse reactions or side effects that may company say ministration include habitation. If the medication is infused too fast affiliate of euphoria on the part of the patient, diarrhea, nausea vomiting and blurred. Vision is contraindicated in patients who are allergic to the medication. Though suffering from a mile Cario, infarction, CVA or pulmonary embolism. In conclusion TSA should be administered to trauma patients who are suffering from severe hemorrhages soon as safely possible. This is bordered by a large amount of American international research says that include the Israeli defence force. The megani Debbie MSI, also in Israel and in various countries in Europe continue say make a difference if given the pre hospital arena, the research says yes, the benefits clearly outweigh the risk. Thanks again. For taking time to listen to the ten minute medic.
"ten minute" Discussed on Ten Minute Medic
"Infiltrates while you're giving it it can cause blood sugar levels to rapidly spike, which can bring around problems of its own therefore, most physicians recommend the administration of ten percent dextrose in water. If you're not able to get an Ivy started Glueck Agung can be given either intramuscularly or via international keep him on the glue gun raises the bug sugar about stimulating the break down and release of glycogen stores found in the liver. These patients must be transported to the hospital as they have. No reserve follow back on should the blood sugar level drop after you've left book gone may not be effective in patients who suffer from liver disease who are Mounir nourished or elite athletes diabetic dough acidosis also known as decay is most frequently seen in patients who suffer from type one diabetes. If you were. Call type one diabetes comes about it because of a resistance to or inadequate production of the levels of insulin. Because of this the blood glucose levels begin to rise as glucose is not able to enter the sale the sales now becomes starved. Even though there's plenty glucose circulating within the body. The insulin receptors will not allow to enter into the sales this which over to fat metabolism. Some products that are produced by this fat metabolism include fatty acids and lesser all the glycerin inadequate form of glucose, and thus provides a little bit of energy to the sales. As a fat continues to be metabolized waste products known as Kito acids begin to form and your patient begins to come every. Because of this acidosis pedestrian moved from the intracellular space into the intervention killer space as a patient suffers from an increase of urination. This potassium has passed out of the body causing a deficit. Sodium has also moved out and replaced by hydrogen this increase in hydrogen ions, only serves to make the acidosis worse. Vomiting is very common. This massive urination accompanied by the vomiting least, dehydration and hypoglycemic shock your patient has a net loss of potassium. But he or she may remain hyperlink. Look for EKG changes that include a longer than normal PR, interval, a wide cure s and tall. Peak t ways your patient may progress to having seizures generally these patients are in a deep coma. Your treatment for them is limited to fluid replacement to try to offset had hydration we don't administer insulin pre hospital doing so. Could lead to a rebound hypoglycemic spacious will be admitted to the intensive care unit and insulin will be administered over hours if not days in order to try to normalize their blood sugar levels and hacker molar hyperglycemia state as we said known as I s glucose passes into the urine causing severe diarrhea sus. This results in the patient becoming dehydrated in this disease. You'll often see blood sugar levels of thousand milligrams per deciliter or higher quite often. When you do a stick on your glucose, monitor it will simply read high the difference. Here is still enough insulin. That's active to prevent your patient from tab in fat and producing heat dome. Bodies your area of treatment for these patients is fluid replacement. These patients are truly an emergency state have in a death rate as high as seventy percent, this may be because symptoms are very subtle in the early part of the condition and may only become a. To the patient or family as your patient prepares to crash is normally seen in geriatric patients early signs. Simpson's include include urination as well as thirst the mucous membranes become dry and sunken patients present attack cardio. We will generally not see the couse smiles respiration because your patients not as toxic treatment for says fluid replacement and rapid transport to an appropriate facility. Thanks again for joining the ten minute medic next week's podcast. We'll take a look at the X rated medication that we give in trauma more commonly known as transatlantic acid again. Thanks for joining.
"ten minute" Discussed on Ten Minute Medic
"This is the ten minute. Medic the podcast for busy pair may students. I'm your host Dr Bill young today. We're going to take it look at diabetes. Type one diabetes comes about one. Beta cells are destroyed resulting little to no production of insulin by the patriots. Now, this type of diabetes may be known. Also as insulin dependent diabetes mellitus or ID him. The good thing about this is it is less common than type two. But the bad thing is is much more serious. Heredity does play a role in whether a person is at risk for the development of type one diabetes. The causes a type one diabetes are not clear, but it does appear the antibodies are produced that attack the cells and destroy them. Keep in mind that these beta sales are found within the islands of Langer hawn's that we discussed in the last lecture because there's no insulin or inadequate amount of insulin. Blood sugar levels will continue to rise. It's not unusual for a patient to have a butcher level of four hundred or higher because portion of this glucose spills over into the year in your patient will begin to diaries, large amounts of fluid leading to hydration. In addition when the body is not able to utilize glucose circulating in the blood because there's little to no way insulin to allow to you into the cell metabolism of fat becomes the method. Which the body attempts to provide energy this catabolism fat Mesa? Dehydration worse as at least to constant thirst also known as Polly Zia massive urination known as Polly urea in white loss, regardless of how much the patient eats. If left untreated to patient can progress to diabetic Kito acidosis a life threatening condition that will talk about in just a few moments as we stated earlier heredity may also play a role in whether a patient develops type two diabetes or not. Is well known patients who are Abass and inactive are much more likely to develop type two diabetes at one point type two diabetes used to be known as adult onset diabetes. This is no longer at anchor description as it can be manifested impatience as young as twelve years old. The onset of type two diabetes is not nearly as dramatic as what we see with type one for the most part blood sugar levels are not as high as seen in type one. A second reason is there still enough insulin is being produced and as effective enough to for stall the metabolism of fat as a primary source of energy. We don't see diabetic Kito acidosis in these patients, very often either. However, there is a condition known as hyper ause bowler, hyperglycemia state shorten to h h s will discuss in this podcast as well. The initial treatment for type two diabetes is lifestyle management with reduction of carbohydrate intake as well. As an increase in exercise. The patient is strongly encouraged to try to bring white down to a more normalized state. This doesn't work independent maybe placed on oral hyperglycemia medications. That's important to remember that this is not an oral form of insulin. As inside would be an activated by the acid in the stomach. Instead these medications have a two fold process. Yes. I the attempt to improve insulin secretion and second that tamped increase the number of insulin receptor sites found on the cell wall. If this fails or if your patient is non compliant with lifestyle change, which is not unusual the last line of defense or treatment is the administration of insulin regardless of whether it's type one or type two diabetes. There are a number of native outcomes. If the condition is not managed these include the depletion of protein in the body that leads to the whiting muscles, the increase use the fat for energy sources which can result in diabetic to acidosis. And lastly because serum glucose narrow -duced the amount of glucose circulating the vascular remains high this results in a denigration of the lining of the vascular system in general and the arteries specifically if left unchecked your patient could suffer blindness Schroeck, heart disease and renal Taylor. Let's take a look at some of the diabetic emergencies. It can come about hypoglycemia is. Edition results when there's dot enough serum glucose circulating within the body. Generally, we see symptoms that begin to manifest themselves. When the levels dropped to below sixty milligrams per deciliter, keeping by the some type one diabetes can have much lower blood sugars and still remain conscious several years ago when I worked in Georgia. We had a patient who has a type one diabetic. She would regular college on the nonemergency line. Simply asked us to come over checker blood Scher us, she just in Phil, right? Having become very familiar with this Beijing, we'd always run emergency her house, even though she had called on the nonemergency line. And the dispatcher said that she sounded awake alert and coherent. It was not unusual for us to get there to find that she had a blood sugar level of twenty and still be functioning normal cognitive level there. Several reasons why patient may become hypoglycemic. These include patients who take a higher than normal dose of insulin. Those who don't eat because they're sick patients who engage. Unusually vigorous exercise without eating afterwards as well as some antibodies the most common antibodies that can bring this on include Levin, arith- romance and inseparable signs and symptoms of hypoglycemia include anxiety or nervousness, combative behavior. Confusion, a rapid weak pulse. Accompanied by cold, clammy skin. If not treated rapidly your patient Cam progressed, having seizures and subsequently cardiac arrest, hypoglycemia should be suspected in any patient with an offer middle status. Therefore, all of these patients who present with an Alder mental status. She get blood glucose level check, regardless of their history. Patients with diabetes, usually become very good at recognizing the signs and symptoms of hypoglycemia because of this they will generally carry some type of snacks such as candy or cracker. So that they can offset the drop of blood sugar when they sent him and on until they're able to eat some protein and complex carbohydrates. In the past all patients, hypoglycemia received an amp of fifty percent, dextrose keeping my dismay -cations various CITIC and can cause necrosis if it infiltrates
"ten minute" Discussed on Ten Minute Medic
"You're listening to the ten minute medic the podcast for busy paramedic students. I'm your host Dr Bill young in last week's podcast. We took a look at the airway and the trauma patient and how you should go about approaching it from a basic perspective. This week's podcast will take a little bit more in depth. Look at things such as sectioning position to your patient as well as win to and just as importantly when not to use or consider drug assisted or rapid sequence innovation. Luckily for both you and your patients most of the time the airway can be managed with simple skills. It's important for your way, the benefits versus the risk of when you're moving to more advanced skills in equipment and maintenance of airway the use of simplest tools that are of the most effective the situation will generally be the best for your patient. The trauma patient that is coupled with an Alder mill status and being us upon position that has copious amounts of facial blading can be one of the most difficult challenges in airway maintenance that you'll face the ability to you suction ineffective mannequin determine whether your patient survives or not the biggest challenge that you'll need to keep a man win such thing is causing your patient to become hypoxia because of extended time of sectioning. I wish there was some way. I can tell you fixed amount of time to suction but much of that will depend upon the amount of blood or vomit us that your patients producing these preoccupation win suction. He will help offset any of the hypoxia that may develop if you're able even if your patients backboard roll the patient over their side, gravity, your friend. This'll help much of whatever fluid is in the patient's airway to exit the mouth and not wind up in the lung. If your patient has massive amounts of blading vomiting, don't waste your time using a soft suction catheter. Get the largest heart catheter that you can find that will move the most fluid from your patients airway when section of your patient. Remember the steps first pre-accident your patient by ministering hundred percent oxygen next insert your catheter without the suction being applied the seltzer adduced amount of hypoxia that patient may spirits as well as if you use a soft catheter the catheter may adhere to soft tissue on the way in of suction applied. Lastly as soon as you're finished sectioning, reaction nature patient, beware of hyperventilation for the reasons that stated earlier in this lecture in addition to bleeding vomiting. There are number of other issues that may come of that made it difficult for you to major the airwaves trauma patients. Some of these include patients who have short action large tongues. One way of minimizing in the native of face of the large sunk sizes using the Indo tracheal Laurien scope blade this wider, the normal this house to lift and move the tongue up and out of the way. Day. One method of identifying whether a patient may be difficult to innovate is by the use of the Mallam Patty score to do this. It works best. If you're patient sitting upright with the head intro position gave him this'll rarely been the case with your trauma. Patients have your patient opener mouth stick their out. Look the structures of the back of the throat to see how clearly they are able to be saying in a class. One Malam potty the best of all of them. It exists when you're able to see all the structures of the soft palate, including the villa. Clash is present when you're able to see the Euboea, but no soft palate a class three. And you're able to only say the base of the villa from where it 'attaches. A class four exist. When no extractors are violent, and is the most difficult indicator of all unreal. Cajun's you may be called medically induce your patients so that they are sedated paralyzed innovated in a person who is proficient in this practice is the safe tool to use. However, and I must stress this. This should be practiced on a regular basis, you should review the drugs and the ministration protocols in order not to make a better way situation. Even worse. These pharmacological agents to assist in the innovation process falls into two categories. One is called drug assisted innovation or DA the cygnus called rapid sequence interbay tion or are sl. Let's take a look at each of these these medications such has been dazzling him fennel or diazepam used with the goal of relaxing, your patient enough to allow you to introduce the entertain to into the trachea the purposes relax the patient, but not to cause the protective mechanisms of the airway been negated in rapid sequence innovation or. Sl. The patience for sedated, the paralytic agent Zena minister to the patient that causes muscle paralysis and removes the patient's ability to protect his own airway. Some studies have shown that patients tend to be revealing more this procedure lead into a poor outcome. Other studies show little or no difference between this and other methods of airway maintenance more study is needed indications for other drug tested innovation or rapid sequence interbay shin, including those patients who are need of secure airway and are combative because of a hey Andry or severe how boxy Mia you must be confident as well as realistic in your assessment of your ability to innovate the patient. If you're going to go this route failure to be able to manage the airway can lead to how Pasha as a result of aspirin or death from hypothalamus of crisis the drugs that you will a minister to do. This are almost all universal in the Saudi fate of causing a drop in the patient's blood pressure. The follow is the protocol approved by the Kentucky board of emergency medical services for the use of drug assisted innovation or rapid sequencing innovation. Please refer to the board. The miss website for more details on this protocol, keep in mind that it is a restricted protocol and providers must be pre approved by the board prior to doing this procedure. I may Shas you have all the equipment that you're going to need to accomplish a procedure, including suction, establishing IV of at least assize of an eighteen gauge all patients should be on entitled. CO two monitoring pre-auction night your patient in a tap to raise a pulse ox up to ninety four percent or higher administer Lada. Cain one and a half milligrams per kilogram. Every push to independent who is suffering from a hit injury stroke or hypertensive crisis. Your patient is going to be given a drunk and ministered zero point zero one milligrams per kilogram of recounting to help with decreasing the muscle facilitations that come about as a result of some of the drugs facilitations are slight tremors in our sl. Sedate the awake patient with Tommy date with zero point one to zero point three milligram per kilogram. IV push at a maximum of twenty milligrams or Maderas lamb zero point one milligram per kilogram. IV push with a maximum of five milligrams. Us lower doses. In the hypertensive patient or the overly patient sedation. Drugs can be omitted in the unconscious by shot. But please make sure that your patient is truly unconscious. Paralyze will sucks coaling the doses. One point five milligrams per kilogram IB, pushing adults and two milligrams per kilogram IV push in children flush the IV with Tennessee. Tennessee's of IV fluids fallen any Drug administration. If you using drug assisted innovation sedate, the patient with Tommy date at zero point one zero point three milligrams Ivy push at a maximum of twenty milligrams or Mme zero point one milligram per kilogram. IV push again, follow the Drug administration by flushing the line with a bowl of fluid to make sure that the drug is into the central circulation in the past silica maneuver was a favourite appear. Mish to either clued the softness or reduce the potential for vomiting to bring the trachea interview research shows that is really not very effective even make it more difficult for the person doing innovation to see the trachea one of the big challenges of paramedics and industry unabated as verification that the tube is indeed in the right place. One study showed that one out four to were in this office, especially with the availability of Intel seal to monitoring this is inexcusable but the methods of tape placement. Advocation include direct visualization of the tube as it passed. The cords seeing the chest rise and fall with each village in prisons, bilateral breast sounds in four areas. Over the chest Fargo,