35 Burst results for "Ten Minutes"
Heinen's goal ignites late surge, Penguins top Rangers 7-4
"The the the the penguins penguins penguins penguins coughed coughed coughed coughed up up up up a a a a four four four four one one one one lead lead lead lead before before before before scoring scoring scoring scoring three three three three times times times times in in in in the the the the final final final final nine nine nine nine minutes minutes minutes minutes of of of of their their their their seven seven seven seven four four four four victory victory victory victory over over over over the the the the Rangers Rangers Rangers Rangers Danton Danton Danton Danton Heinen Heinen Heinen Heinen broke broke broke broke the the the the four four four four four four four four deadlock deadlock deadlock deadlock yeah yeah yeah yeah there there there there we we we we just just just just simplified simplified simplified simplified go go go go back back back back to to to to our our our our game game game game and and and and stuck stuck stuck stuck with with with with it it it it J. J. J. J. cancel cancel cancel cancel Jeff Jeff Jeff Jeff Carter Carter Carter Carter added added added added empty empty empty empty netters netters netters netters Pittsburgh Pittsburgh Pittsburgh Pittsburgh appeared appeared appeared appeared to to to to be be be be in in in in control control control control after after after after Evan Evan Evan Evan Rodriguez Rodriguez Rodriguez Rodriguez scored scored scored scored the the the the last last last last two two two two goals goals goals goals in in in in the the the the opening opening opening opening period period period period putting putting putting putting the the the the pens pens pens pens up up up up by by by by three three three three Louis Louis Louis Louis Domingue Domingue Domingue Domingue stopped stopped stopped stopped thirty thirty thirty thirty two two two two shots shots shots shots for for for for the the the the penguins penguins penguins penguins who who who who host host host host game game game game four four four four on on on on Monday Monday Monday Monday it it it it was was was was great great great great you you you you look look look look at at at at our our our our our our our our last last last last ten ten ten ten minutes minutes minutes minutes of of of of the the the the games games games games and and and and the the the the majority majority majority majority of of of of the the the the time time time time and and and and there there there there is is is is on on on on which which which which was was was was I I I I think think think think huge huge huge huge the the the the Rangers Rangers Rangers Rangers eventually eventually eventually eventually tied tied tied tied it it it it on on on on Andrew Andrew Andrew Andrew Copp Copp Copp Copp shorthanded shorthanded shorthanded shorthanded goal goal goal goal late late late late in in in in the the the the second second second second after after after after frankly frankly frankly frankly trying trying trying trying to to to to entertain entertain entertain entertain me me me me preparing preparing preparing preparing tallied tallied tallied tallied sixty sixty sixty sixty six six six six seconds seconds seconds seconds apart apart apart apart in in in in the the the the period period period period I'm I'm I'm I'm the the the the ferry ferry ferry ferry
What Does It Mean to Be 'Woke'
"So we have Elon Musk, Tucker Carlson played Elon Musk at an interview somewhere. And he gave, we have to get it shown if you can get the first segment of last night's Tucker Carlson show. And I would say ten minutes in is Sergey Brin on video defining what woke is. What progressivism is, I have spent my life defining and explaining the left and he did it in the I think one sentence better than I ever did. Oh, the honor made sure to get boy. I said turkey Brennan, I'm sorry, Elon Musk. Big mistake. Big, big, big, big, giant mistake. No, it's Elon Musk, Sean, that we're looking for. Something to the effect of it provides a shield for the cruel to wrap themselves in moral purity.
Have Wealthy Societies Historically Embraced 'Wokeism'?
"Of history, I'm curious, you mentioned the French Revolution. There has there been times ever in history. Where a very wealthy society decides to embrace this kind of woke ideology, something similar to woken. Does that make sense? I mean, there was a legitimate reason to get rid of the bourbons. And they looked at there were a lot of moderate people and they looked at the British system and they said, you can have a monarchy compatible with a constitutional republic. And that was eminently possible in 1787. And then you had these cycles of revolution where today's revolutionary would be tomorrow's sellout. You just want more robespierre was killed by the very people who used to support him, right? And basically got liquidated him and his brother in about 1400. And they applauded for ten minutes. The legend goes. They did. And then those cycles kept going and then you always are into it. So what does that mean for us then? Well, it always ends because chaos is unsustainable. So Napoleon ended it. Very brilliant fashion. He just said, I am the revolution, I'm going to make all the total power. I'm going to create a military academy that's going to be based on Napoleon. It's just like Stalin stopped it.
Jennifer Griffin Responds to Col. Douglas Macgregor's Putin Comments
"Want to play the response that Jennifer Griffin had, and she responded to colonel McGregor and I'm going to ask him for his response of her response. As he comes on here, which is cut 9 where Jennifer Griffin responds to colonel McGregor right afterwards, play cut 9. I just heard your last guess and I feel like I need to correct some of the things that colonel Doug McGregor just said because and I'm not sure ten minutes is enough time to do so because there were so many distortions in what he just said and talking about the west and NATO vilifying Putin and sounding like an apologist for Putin. So those what he just said was so distorted that I do feel that our audience needs to know the truth. She continued, let me see the other clip here that she was on here. She continued by uncut 18. Let's play cut 18, please. And talking about how put he thinks he knows how far Putin wants to go. I don't think anyone that I've spoken to here at The Pentagon or elsewhere in western intelligence believes they know how far Putin wants to go. And I think that the world has seen what Putin is capable of and to blame NATO membership for what we've seen Putin unleashed. We've seen from Putin's own words that he is talking in czarist terms from an 18th 19th century view of empirical imperial Russia. Debate is good in situations like this. When there is a consensus that they keep on putting on television, you're not allowed to have any sort of nuance or any sort of difference of opinion, then that's usually when really bad things happen. That's usually where you get situations like when you invade Iraq. Or when you lock down your entire country.
Why Did Larry Taunton Visit Cuba?
"Hey folks, welcome back. We're talking to my friend Larry Alex Taunton, who knows a little bit about communism. In fact, ten minutes ago, or maybe it was two days ago, he was in Cuba. Larry, why? Were you in Cuba? Well, it's interesting, Eric, I've wanted the opportunity to get into Cuba for many, many years now, and it seems I was always blocked. And on this occasion, I had the opportunity to go for humanitarian reasons, but it gave me the opportunity to really look at the underbelly of communism there. And of course, what you find is that any communist state, kind of like Islamic states, they create cookie cutter a country. They all kind of look the same in terms of their poverty, the way their secret police operates. And in this kind of thing. But Cuba relates to our conversation about Ukraine. In explaining why we are where we are. John F. Kennedy decided that the west simply would not tolerate a Russian missiles 90 miles off of our coast. We were very nervous about having a Russian puppet state, rightly so, right off of the coast of the United States, bay of pigs happened all of these things. The efforts to destabilize the Castro regime. Well, this time it's reversed. The Russians see us. As putting a puppet state right up against their border
Mike Eruzione: The Longest 10 Minutes After Leading Against Soviet Union
"So you come out of the locker room after a second period You score what winds up being the winning goal the fourth goal of the game I think it was the first play Wasn't it a period You're sitting there This goes in the med I mean what's going through your head afterwards outside of I just go do you like holy Moses We could win this thing now You score the goal It's your goal Yeah I scored with ten minutes left to go and it was probably the longest ten minutes of our lives All I thought was we got the lead First of all if it wasn't for Mark Johnson scoring two goals who knows what would have happened in the game So you know the great thing about our team is it was a team Obviously I've always said what el Mark Johnson we don't win because he scored so many goals and so many big goals But our defense all four lines it wasn't it's a cliche sometimes but everybody contributed Everybody did their job Everybody did what they needed to do And played well So I gave us the lead and I was happy that I was able to help the team at some point in the game
Caller Comments on Mark Davis & Mike Gallagher's Take on Biden's 'S.O.B.' Comment
"Every morning I do a hit with Mark Davis on his morning show on 6 60 a.m. the answer in Dallas, we post every one of them on the Mike Gallagher show podcast, he and I are very like minded and we're dear Friends off the air as well as on, but once in a while we disagree, you can check out that podcast, by the way, as I guess Dale does in Detroit, Mike online dot com subscribe to our podcast. Get the M and M experiences we call it because it's a great, it's a great ten minutes or so of radio. And today was action packed. So whose side are you on on this one this morning, Dale? Well, first of all, I listen to it live and I'm on not on your side today. That's all right. Tell me, tell me why. So you don't think we look silly when we complain about Biden calling douchey an SOB after four years of mister mister Trump? In this particular case, context is key because in Trump's case, when he called Todd an SOB, it was right out in plain sight. He was doing a speech. And it was more like, oh, that's kind of a crazy SOB. SOB. He said, oh, he's a sleepy SOB. Whereas in this case, Biden said it kind of under his breath, aside. And he was actually calling him. It's a totally different thing. Yeah. I understand. But I just think we just you're not wrong. Mark wasn't wrong, it just to me appears kind of silly and sort of gives them a lot of ammunition when they say, you poor snowflake Trump supporters. You defended Trump for four years and now all of a sudden you're getting you're offended at Joe Biden calling Peter douche and SOB. It just seems silly to me. This laugh that we shot laughing off and realizes the other caller said, this is a symptom of Biden, Biden, losing complete control of this presidency.
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
"ten minutes" Discussed on News/Talk/Sports 94.9 WSJM
"And i must have Found a quarter in my piggy bank. And i have now have Mister tom austin on the phone. It's time for ten minutes with tom. Tom austin of austin tax and financial tax preparation planning retirement strategies. And planning and a whole lot more. Tom how are you this morning in their pocket there to keep that line open here this morning. Yeah we need something. I'm glad i had my piggy-bank nearby. And i've been saving my money in my spare change but speaking of that In saving money and saving money for retirement. That's what a lot of people are doing that are in the The working force right now But let's talk about some of the people that maybe retired presumably done saving now. It's time for them to Some of the money that they've saved. What might that look like for some of your clients as you work with them through this process of financial planning after retirement. Well that's a big part of what we do. At austin taxing financial. I find and i've been doing this for well over twenty years and when people come in to talk to me depends on on where they're at. Sometimes they may be a few years out. Sometimes it's right around the corner. And and what i find is that it can be a stressful time and somewhat of an emotional time for people after they've been saving all their life and now They have to start spending that and they're not gonna have that paycheck anymore. And so the biggest concern. I see is do i have enough you know and so people i find they just they wanna plan. They want to understand the plan and they wanna feel good about the plan and what that really means is that they wanna feel okay that they're not going to run out of money and they're going to be okay so my job is to give them a plan and to help them and moving forward but also giving them an honest assessment of where they might be as far as what that may look like. It's going to be different for everybody depending on on how much they've saved Where's the money coming from. Do they have a pension is it. You know four one k. Money which is going to be taxable when they draw out you know so. There's a lot of decisions that we have to look at and and helping them navigate through you know when detect social security. Do you need to take social security right away. I mean optimally. We you know we to be able to Delay social security. I think that's usually the best option. It's not it's not always what we would would recommend but for a lot of people especially if you have quite a bit of savings and retirement accounts and stuff to use some of that money. I delay your social security And then we have to look at you know what types of lifestyles you know. Do people wanna have in retirement. We know we have some people that Maybe not have not saved enough. They haven't been You know saved enough for maybe live beyond their their means and they have to work longer On the other hand we have people that have saved a lot. And but they're very frugal and they they you know don't use a lot of income initially and there's some things that we may have to look at if somebody has a you know a million dollars in a retirement account and they're not using very much of it you know when they turned seventy two they have to take a minimum distribution that can trigger a very large tack. So there's a lot of things that we look at. You know as folks move into the retirement phase of their life And we talk. We've talked a lot on this. Show donnie about conversions. And i'm a big proponent of that and again it's not for everybody. I think sometimes people hear things and they all roth. Ira's a roth conversion. That i gotta do this. If the good thing it needs to be done you know in a systematic manner in a manner that you understand what the tax ramifications are of doing that And so one of the biggest things that we look at is You know how taxes are going to affect your money and retirement. What types of income that income. That people are going to need you know how and where you're gonna invest that money. What types of risks are you taking. What kind of taxes are you going to be paying. And certainly things like the tax on social security which we talked a lot about which is derived from other sources of your income. So there's a lot of things that we can do to to reduce taxation to keep more money in the client's bahgat give them some comfort level of of Where their money's being invested how we're going to generate income and ultimately the goal is just to make people feel good about moving forward. You know as they move into those retirement years yeah. It's a lot more to think about than having a a target year that you want to retire or even Setting and saying well. I wanna make sure i have this much saved up like you said. There's a lot of different factors that go along with that planning and doing it early And working with somebody like you is probably the best way for them to To plan for this stuff instead of just doing it on their own. So how might folks get a hold of you if they want to learn more about Their financial planning and and planning for retirement..
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
"ten minutes" Discussed on News/Talk/Sports 94.9 WSJM
"It's time for ten minutes. Would tom tom austin of austin tax and financial tax pepper preparation and planning and retirement strategies. And planning and a whole lot more. Tom how are you this morning. Good thirty six. Are you kidding me. I had to walk out the door yet that. That's that's getting down there. Yeah you might as well stay inside. I it's one of those one of those days ed frost on my windshield. This morning. just But i know you keep up to date with a lot of different things And i know We've done this in the past. But i'd love to see what What kind of tidbits you have for us this morning. Yeah occasionally like mix it up a little bit and and you know bring out. Some things have maybe happened in our economy just in our world and some interesting facts. But i got a few today johnny in the first one Find interesting that nearly seven percent of employees in accommodations and food services sector left their job just in august seven percent that means that one in fourteen hotel clerks restaurants servers. Barbeques quit their job in a single month. So this is kind of a phenomenon that we've seen you know you see that There's a lot of people that are looking for people to work. And i think there was some thought that when they the federal unemployment and which ended the first of september that people would go back to work. But we see that that just hasn't been happening and certainly the the restaurant industry and service industry hotels. And and what have you have probably been affected. The most you know but we see across a lot of the different sectors and i think a lot of people are just trying to figure out you know. I think kobe chains a lot of things way. People viewed work Hurts some talk about you know. Do we really need to have two people working in the home and also a lot of things. I think people are reevaluating that trading that absolutely and some people even shifting into two totally different jobs Whether maybe the one point lost their job during the pandemic and working in those hospitality industries and thought. Okay maybe career change so it's it's surprising thing so so as of june of this year the top one percent of households. Now hold a larger share of us wealth which is about twenty seven percents than the entire middle class which is twenty six point six percent. It's the first time in history that the middle class as held a lower share of our national wealth. And so what that tells us. I'm not exactly sure. They made the rich keep getting richer. you know. There's a lot of conversation about how you lift the lower class or middle class. You know into maybe a better standard of living You know so you know. There's a lot of things going on. You know from the political side of of the direction of our country you know and some of the spending and things that you know dictate you know. Some of the things that may occur you know with distribution of wealth and so forth with all the The flaws that we have. I think our system still is probably the capitalist system is still probably the best in the world you know and and most people have opportunities here The number of jobs created i. The commercial internet was more than has more than tripled since twenty twelve shifting united states from an industrial company to an information company and. I think we see that more and more people. I think a big part of those people wanting to work from home and and You know the opportunity that we have you know through the internet Next one nearly two thirds of americans who use social media platforms. I believe that life was better before it..
"ten minutes" Discussed on Ten Minute Medic
"So as relocated this within any vehicle Asian, there are multiple sub collisions that are going to occur both within and. Of Vehicle. So first of all, we have the vehicle collision itself car versus tree impacts the tree the car then stops during this motor collision when the car strikes another Adriana Energy is transferred from the moving vehicle to the non moving object or to the of a car. Now, that's going to be really important particularly when we're talking about. Vehicle versus vehicle. Type of auto impacts. Thankfully, they cars are not the tanks that they used to be back in the late sixties and seventies, but they're now designed crumple-zones particularly in front of the vehicle. So as to absorb as much of the energies possible. Now, the important thing about this absorption of energy is that. If. It's absorbed in to the vehicle and that means as not being absorbed into the patient's body, which ultimately results in lastra trauma less potential if trauma for the patient, although the vehicle is stopped the occupants even if they are restrained are continuing to move along at the same speed at which the movie. And the Monte collision is the second aspect of collision that occurs and this happens when the body strikes the interior of the vehicle including the restraint devices, the airbag, the seat belts, or anything else that are found inside of the vehicle. As your patient makes contact energy contained in the patient's bodies now transformed energy that will damage or potentially cause damage to the patient centered or. The body stops but as we spoke earlier organs, themselves will continue to move forward until they impact the bony structure of muscular skeletal system that will help to stop the. Tissues and organs the patients body will continue to slide in a forward direction impact in either each other which can cause some or bony surfaces of four actual pelvis. This phase collision can cost compression stretch were sure injuries as Oregon's continue to move forward with about the same amount of force as was originally in the vehicle secondary collisions occur anything loose within the vehicle now strikes the passengers. On a professional mill, this is why that is so very important that loose out be secured in the back of an ambulance. Last thing you really want is a monitor sliding around in the back of the ambulance upon impact. Thanks for listening to this week's offering of ten minute medic. In next week's section will take a look at the different pathways or patient can take Doreen. Motor vehicle trauma as well as how understanding more about making of injury can raise your degree of suspicion for unseen trauma. Sure hope is join us. Thanks again..
"ten minutes" 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 minutes" 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 minutes" 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 minutes" Discussed on NewsRadio KFBK
"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 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 gig speed network call one eight hundred five oh one six thousand now for your Comcast business ten minute advantage Comcast business beyond fast friends ten twenty one nineteen restrictions apply not available to current Comcast business customers comparison based on download speeds it does not include Ethernet service internet speed in competitive built in the last sixty days required one three hundred dollars prepaid card per company call for details wondering when you should get a real ID federal ID requirements are changing may need a real like the fly access federal buildings were military base is a California real ID dot org to find out the best time for you to apply check which documents you'll need to bring with you to the DMV and even start the application online is a California real ID dot award brought to you by the California D. M. V. hi I'm Vanessa with P. Jeannie if you're in your home or business and you smell gas your first step is to get out travel a safe distance until you can't smell the gas and then call nine one one first responders will make it safe to learn more visit P. G. E. dot com slash safety okay we can live on news ninety three point one AMPK six oh five news ninety three point one K. F. B. K. rob or to go with you on this Saturday evening rob or to go dot com.
"ten minutes" 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 minutes" 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 minutes" 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 minutes" 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 minutes" 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 minutes" 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 minutes" 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,
"ten minutes" Discussed on KIRO Radio 97.3 FM
"Ten minutes. Kiro radio realtime traffic, I'm Tracy Taylor. So. Absolutely objective. No, political tinge sort of way, none of my opinion in an everlasting unquenchable desire to pack people into Seattle. So they get more congressional seats at cetera walking around money. Washington state is created an ambitious they call it the plan to let you have two eighty us are assisted dwelling units or some kind of accessories. Talk permit to meet, maybe I know all this nonsense. So that you can have two little tiny houses in your backyard now to be fair. They've actually also recognize the nature of of red tape in here. Okay, permit Queen. Yeah. I wish that glowed when the lights squad and the tunnel. And I don't wanna talk about it. I have my bike ride tunnel shirt on because I'm doing that on Sunday. But I hope the lifestyle go out down there. Eighty us. And then day dues are two different things. Attached dwelling unit accessory dwelling unit. Attached means your basement attached to the main house seven accessory dwelling unit. A completely different structure on your property. And these are not very big. But I do like the idea of having these families zone. So there's three of them on kind of one property as long as there's parking and accessibility for everybody. I don't think it's terrible. There's not parking one of the things that have eliminated is the requirement for off street parking owner occupancy minimum says, so I mean aside from the parking, which I don't consider red tape they've gone through and cut a lot of the red tape. There was never requirement for parking for a single family house. Anyway, I mean, so we're not really talking about a massive. I mean, I get your point start making me feel bad making you guys ever really was there was there was often for for how for dense housing such such as condominiums and apartments, but with with single family houses, they were never they never had the requirement to provide an actual onsite parking spot for that. So so that's not really any change from existing law. I think this is a really good idea. I think Seattle has its own idea that is advancing it even further and Seattle's idea ads on that the mayor's office pushing sort of in line with with this idea to do it state wide to allow you to get the have. I think it's three preapproved mother-in-law cottage plans that are ready permit such effectively they come pre permanent provided. Your plot is is adequate mic house. So you can absolutely well three different designs their MC houses. Anyway, if you take a look at these are not these are not elaborate structures, and I'm fine with that. But I like it because the permanent process in Seattle can be fairly difficult time, consuming and expensive and your architect is. It is time consuming and expensive as well. Getting out getting those out of the way and just doing slight modifications really does allow people to to make a little bit of rental income and open up a neighborhood for additional housing. Okay. So my last text message from one of my contractors. Hey, candy. The city of Seattle. Stop by and said, you need to hire an Arborist. We have the Arborist in line with the architect, if you would like to go through the architect, you would then be charged for the Arborist fee the architect fee and the contractor fee to have the Arborist look at your tree that that's red taste. So so what are you? What what was the issue with your tree is my tree to the widest growth point at base or will it continue to grow and grow and mature cedar tree? So right now, I think it's like three and a half and potentially could get to four things to say about this one the road on on tree houses, we should let people build three houses. Wouldn't that be cool? If we could just have tree houses, the other thing is here's my here's here's my. Here's my concern. Because this is from the sideline institute who published the four speech election law that someone called the honest election thing for Xi to pay for politico. Speech. You don't like I have a fear that one day, they require this that one day, they say if you have this much square footage open square footage required that you build this housing. What? So what would be your analog on that? What would be your comparison? What you've seen something like that happened. Just I go to the nature of one party politics and the desire to in other words, I don't know of one an analog, oh, forcing people to do things forcing somebody with their own private property to actually open it up for building for a private for. They don't want the oh all the time. I mean, if you talk about rural landowners, all the time they're told told they're they're told to build housing on their land for other people. They're told that you have to. So there are told you have to put this next to a stream, and you've got to grow, this type of crop, etc. Our sold out of us example that she said, no, I did that I said it would grow to that. So the what they're doing is actually allowing people to do something they want to do. So there is no state law requirement that you put an additional housing right there. There simply isn't. So I don't know why that would necessarily be a fear the fear could be in a legitimate one. In a neighborhood is that your neighborhood could get more densely populated. And then there are a set of conditions marking being a good example that come along with that. But I actually think this is not a bad idea. And it's a nice compromise from the townhouse. Idea where you live in a tiny house, and suddenly there are two fifty foot structures next to you block him out the sun. This may be a nice way to take some of the pressure off housing without actually entirely changing the neighborhoods character, I just feel misheard. I feel hurt. And my hope is that. You'll listen. Don't feel hurt. I do know, Mike. I'm just saying that I fear it because of the nature of the sideline and. Your every single law comes from the site institute, whose okay forcing didn't right this satellite reported this. This is Washington state legislature did zoo celebrating reported on the case they just want us to win the New York Times does a story. It's time of legislation. It's just turtle sideline celebrates it. Do you like this or not I like it? But he don't want it to become forceful for be. You have a yard. You have to use your yard in this way. If you would like to live in within city limits. That's a hallmark of of ultra controlling governance that okay, you got too much square footage minority. People telling us we got too much income. We need to redistribute that. I don't get heavy on it. I just telling us fear, and I don't feel validated. That's all I think when you live in Seattle, and you own a home in Seattle, you see the impacts that different way that different types of housing has on your neighborhood. And it makes you look at it. Just like the parking is a great example. All right. Well, I don't have sidewalks in my neighborhood is just an older neighbourhood that doesn't have sidewalks. Okay. Well, then do. Oh, worry you have street parking. Because not every house has a garage house has a driveway. All right. So now where are you street parking right in the grass on peoples yards or right up against the edge? So then you can't walk around it safely. You're automatically in the roads. Then you start thinking about that. Well, how many houses have Airbnb on our street and people are coming and going at all hours? And so you your neighborhoods change in Seattle pretty quickly. That's actually, that's actually a more immediate fear might even be more rational. It certainly marash about that, Mike. There's plenty of examples of government run amok telling people to use property, but I see to you the point that that's not a lot this since we're talking homeless. We do this real quick. This is down in South Carolina homeless man, and a young girl has down syndrome. They made they made a video together Kimberly Phillips in her daughter has down syndrome or visiting a homeless shelter and the girl took a liking to gentleman there. Sometimes..
"ten minutes" Discussed on The Adam Carolla Show
"Ten minutes. Going into the bathroom. The husband is. Do you want some X? It's it's funny twenty this is fucking by the way things have to be euro otherwise. But if it's not what what's been going on over the last thirty five years of people talking about what's new nutrition is spoken. Put look spray on butter on their popcorn, you know, much popcorn. And you want long as you spray that margarine on popcorn has almost no calories. It's like we literally did things like by wait. Hey, light popcorn it. I'll look I'll heaviest outcome on the SaaS your fist year. Whatever you believe me. Go stand on that scale. Now, I'll give you a pillow case of popcorn go. Good too. Big T-Bone steaks. I rest my signs. It's so insane. And then of course, you have to think well what's currently going on. That's what you always have to think so easy back and laugh at everyone being wrong. But what is currently going on covering this up on the no where else I'd bring it up. We talked about trope earlier we talked about food and outdated things one trope. I don't know. Why was every it was in so many sitcoms back in the day? I never signed off on it. And I just realized ridiculous of us Kristie mates. Some delicious, Meatloaf, why was Meatloaf, what's for dinner. Moms. Hey, big Christmas story. They don't want.
"ten minutes" Discussed on News 96.5 WDBO
"Ten minutes. Invest a pedia they're saying that are two thousand eighteen tax returns, which will file in the coming days aren't going to look anything like what we're used to. What are some of the changes we need to be watching out for Mike? I know you're not a CPA, but you have a CPA on the team. But you're also very in tune with taxes on retirement for sure. Huge part of what we do it needs to be part of any financial plan. I need to understand not just how much I'm making on my portfolio. But it's one of these things it's not just what you make. It's what you keep. Right. Keeping more of what you've earned is really important. And that's why you have to be really efficient with taxes. Now, we all are gonna pay. What we owe. Right. Vitor seem more than your fair share. And that's that's why it's so critical when it comes to taxes and all that now twenty eighteen all right? So here we are twenty nineteen. We're going to have to get these taxes done by tax time. Right. You're gonna be the middle of April. But what's happened is things have changed quite a bit? So no longer or tax firms going to look like they used to look like we used to have a ten forty eight or ten forty forty a was kind of a standard that people used in the ten forty easy was the really easy one. You just fill stuff in and they've done away with all the easy easy. Right. But basically anybody, you know, the new ten forty is going to be used by all filers, and it's just a short two pager tax return. Okay. So don't be alarmed that you can't find that ten forty ez anymore. It's just a short two pager. And I do think it's going to be a lot easier for most people now one of the things that is going to benefit people's we've got lower taxes. So that we still have a number of tax brackets. But the top tash bracket was reduced to thirty seven percent from thirty nine point six, I realize most people aren't in that top tax bracket. But regardless you're going to want to make sure that you understand where you fall, I think most people will benefit from that. No, one of the big things that you're going to see is the Senator deduction was the big deal was increased. And so if your married filing jointly your standard deduction now is twenty four thousand dollars. So that's going to eliminate the need for a lot of people to itemize deductions. A lot of people used to you know, I mean, I think of going over to to good-will writer Salvation Army or or what have you in saving those receipts and making sure that you were you had them just God forbid, you get audited. And you're declaring stuff a lot of these charities are very worried because. The incentive to make charitable contributions isn't as high anymore because you really don't benefit from the the tax deduction for most people because they probably won't itemize unless you can get itemized deductions over twenty four thousand now big thing on that itemized deductions is the salt limitation. That is it's you know, state and local taxes, but they limited that it used to be unlimited. So if you were paying state or local taxes, and you had some property in you had crazy taxes that you were paying you could write those off. Well, it's not that you can't write them off anymore, but they've limited to ten thousand dollars. Okay. So this is where Trump really got after the people in New York and California. Crazy crazy property taxes. And they got that in there. So by limiting at it's going to hurt all of those landowners, very wealthy, and we're using that. So that being said, just you know, we can certainly get you help when it comes to that. I'm not going to personally help you with your taxes. But you know, we've got people that can do that for you. And make sure you're not paying more than your fair share when it comes to taxes and all that as part of our financial planning process. So if you wanna come sit down have take a look at your investments, make sure your efficient and optimized there was put together a financial plan for you. And we'll we'll put that financial plan in your hands. You walk out of her office with it that will just show you the steps to being successful retirement. What you need to do. And then also we'll take a look at the tax situation for if you have any questions, but just give us a call the next ten minutes, and we'll be able to do that for you complimentary taxes a big deal any day of the week. But especially every day of the week in retirement. So that comprehensive financial plan know that it is going to address some of those issues where do you stand? What taxes where do you stand with fees? Where do you stand with your risk? Versus return. Are you an appropriate investments for being fifty and older here in Florida? Find out those things what that comprehensive financial plan. Mike was talking about. It's a fifteen hundred dollar value. But there's no charge. If you call within the next ten minutes, and it doesn't.