MedicYeti

Cedar Creek Sporting Clays in the Millville area. They have auto throwers that can be set with a delay for the single shooter.

I keep a list in 2 places. I tripe it out and print it and it stays in a filing cabinet. I also email myself the list and keep it in a file of things I don't delete. My personal fear is some scum bag steals them and now they are distributed to multiple scum bags. They are locked but a determined enough person can eventually get in. My list is simple. Manufacturer. Make. Serial. Cal.

John Torelli, Jersey Small Arms Gunsmithing in Millville. [email protected] Range 609 in Rio Grande has a gunsmith.

Who is this dude?

I'll start saving now. I'm down for a road trip. Does participating in the NRA Winchester Marksmanship Program meet the criteria for target shooting?

Range 609 in Rio Grande, Cape May County had a couple Glock Mag models.

Rabbits are cool. Get a Flemish Giant for a bunny that can be up to 2.5 feet long and 40 lbs.

Cape May Court House (GSP 13) is just rain and a lot of wind.

Just off exit 4 of the GSP is the lovely town of Rio Grande, Middle Township. "Rio" as its know by the locals is home to a number of motels (6 off the top of my head) that cater to unemployed, underemployed and recently released criminals. There have been a couple tent city's in the area over the years, housing society's best and brightest. I've only treated a few overdoses in Rio this year (ok we are only 12 days into the year but who cares). United Uniforms in Rio has opened a gun shop then built a range, Range 609. The range is a decent facility with around 20 lanes, all 15 yards deep. It's clean, well lit and the staff is friendly. For my visit I didn't know what to expect so I kept things simple with a 10/22 and a USFA Zip 22. There weren't others there so the SO was keeping watch over me (they don't know me so I don't care). The cost was around $20/hour for just the range. They have a decent selection of rentals but I didn't partake or ask about rental fees. It was a pleasant experience and I would go back, even though that means going through Rio.

Agreed

Are you sure it's not phishing for information? Contact Walmart and Twitter directly, not through the emailed links to check. Change your password. You should always keep an eye on your bank and credit card charges. Good luck

Interesting read. A few parts are misleading like the statement that "the system has changed little in the past 40 years". I have started working in EMS dispatch part-time. Being in EMS for over 22 years; being on the radio is different. All call centers use an ANI/ALI screen. (Automatic Number Identification/Automatic Location Identification). This ANI/ALI system is antequated. It tells the number of the caller and the location. When someone calls from a large business which has multiple extensions the main business address comes up and the identified number is the main business number. Example: someone calls from a casino/hotel. I get the name of the casino but not a room number or extension. The locator for cell phones has 2 phases; first is a general area then more precise GPS coordinates come up. The case with the old guy who got shot started with a 9-1-1 hang up which gave a broad area. Some confusion followed and the police were sent to the wrong house. The home owner saw 2 people with flash lights in his yard and did not know they were police.

The others said what I was going to say. Have her volunteer with a local squad. The squad will send her to EMT school. This is also a good way to learn if she has a stomach for this line of work. I've seen a lot of kids become EMT's, get on one really bad call then never step into an ambulance again. That said, keep her focused on getting her BSN, there are tons of possibilities with a BSN that don't exist elsewhere. My wife is an RN, BSN who does clinical research. She makes her own hours, travels all over the country and gets involved in cool stuff. Millville Rescue had a program, I believe it's still offered. Gloucester used to have a program. At one time Cumberland's EMT class was associated with the fire academy (IIRC).

Each time your heart pumps, about half of the blood goes up into your head, brain and arms. The brain has a lot of blood vessels from fairly large to 1 cell wall thick and everything in between. The other half of your blood takes care of the rest of the body. Your brain requires a lot of blood, oxygen and nutrients in order to function. In the assessment portion I discussed the importance of finding out if your pt can answer questions, inability to answer questions, follow commands or even stay awake hint that the brain isn’t getting the blood, oxygen and nutrients that it needs to function. Some issues can be easily fixed, some can’t be fixed. I’ll go over a few. Stroke. A strove occurs when a portion of the brain isn’t getting the blood it needs. This can be caused by 2 different issues. A blood clot has moved through the arteries and become stuck somewhere in the brain. Like a dam blocking a river, this blood clot isn’t letting the blood get past and everything down river will suffer. Without blood and it’s goodies the brain will start to die. The other possibility is a bleed. One of the blood vessels in the pt’s brain has burst and blood is leaking out into the skull. This can happen spontaneously or as a result of a head injury. Again, everything down river of the burst will suffer because it’s not getting blood or it’s getting less blood, think about a cut in a garden hose – some water may come out the nozzle but there’s also plenty squirting out the cut. When a person has a stroke one of the first things the hospital does it to take the pt to a CAT scan to look at the brain. Most of the hospitals I take people to actually have us keep the person on the stretcher and go straight to CAT scan so there is as little delay as possible. CAT scan is the only way to diagnose a clot vs. a bleed. If a person has a clot then medication to dissolve the clot can be given. Bleeds may require immediate surgery. Giving a clot busting medication to someone who has a bleed will kill them. Aspirin to a stroke victim is a very bad idea. To assess for a stroke remember F.A.S.T.. F-Face, is one side of the face not moving, do they have asymmetrical movement of the mouth? Think Sylvester Stallone, he suffers a facial nerve injury when he was born which limits the lip movement on one side of his mouth. A-Arms and hands, can the person grip your fingers and squeeze with near equal strength? Can they simply hold their arms straight in front of them for a few seconds? S-Speech. Can they speak clearly or do they slur their words like a drunk frat boy? T-Time. This is one of the most important things EMS and the hospital need to know. TIME! When did this start? When was the pt last seen normal? When did someone speak to the pt, when were they seen, were they normal then? Treatment is dictated by the time the symptoms started, if the pt gets to the hospital within 4 hours of the onset time then the hospital will try to fix the issue, if it’s been more than 4 hours the goal is to prevent it from becoming worse. (This is grossly over-simplified and the 4 hours can be extended for some pt’s). Low blood sugar. Is the person a diabetic? Did they take insulin but not eat enough now their blood sugar is too low for their brain to function? These people will present like a stroke but will usually be sweating a lot. It takes days for a person’s blood sugar to climb dangerously high, it takes less than an hour for it to drop dangerously low. If you meet someone who isn’t acting correctly, is sweaty and may have a medic alert tag or tattoo that says “Diabetic” give them sugar. Make sure they are awake enough to swallow and given them soda, OJ with sugar, icing, a doughnut, anything with real sugar (diet soda is not going to help). They will improve fairly quickly. They will need to eat something with protein and complex carbs to prevent the sugar from dropping again. Infection, especially in the elderly population, can mimic a stroke. Breathing problems, especially when they become severe, will rob the brain of oxygen. These people will become anxious and combative while they fight for air. They are not trying to be a jerk, they are dying. Drugs. People like drugs; prescription, synthetic, street and any combination of the above. I may do a separate thing on drugs at a later date. So… You’re having dinner with your parents and while clearing off the table you dad falls. You check him out, he is speaking but not making much sense: “Dad, are you ok?” Dad says “purple” He reaches out to you with his left hand but can’t move his right. With assistance you get him off the floor and onto a chair but you notice he can’t put weight on his right leg. What do you do? Take note of the time. If this happened at 5:47 then write down 5:47 onset. Use a sharpee and write it on dad’s forearm, big – it’ll come off. Take a breath and call 9-1-1. The first question they will ask is “What is your location?” or “where is your emergency?” don’t launch into a full report, answer the questions they ask. They will get to a point where they ask specific questions but then need a location first. Once 9-1-1 gets a location and a little bit of info the ambulance and paramedics will be sent. The units often get sent by someone who is sitting near the person you are talking to, so you won’t generally hear the dispatch. EMS will arrive and check vital signs, move dad to the ambulance and get going to a stroke center. The stroke center may NOT be the hospital right down the road. EMS may sit on scene for a few minutes to get a few things done that will save time once dad gets to the hospital. If the stroke is bad enough and dad can’t control his airway EMS may put him to sleep and take control of his breathing, this is better done with all hands and in a still truck then doing it at 60mph. Keep dad comfortable, don’t let him fall again, don’t give him food or drink. Try to stay calm. Lock the dogs in a bedroom. If dad is a hoarder then clear a path. Send someone to the street to flag down the first arriving unit. If dad gets worse call 9-1-1 again and give them an update, they may give you instructions. What if help is delayed? The ambulance crashes into the medic truck, it’s a crazy busy day for EMS, maybe conditions are slowing everything down like in a blizzard. You can consider taking dad to the hospital yourself. In this case the closest hospital should be your destination. Any hospital can do a CAT scan and give clot busters. The hospital can also arrange transferring dad to a specialty hospital if needed. What if society has collapsed and help isn’t coming? You can move dad to a recliner and sit him back, don’t lay him flat but put him back so he won’t fall over. Keep an eye on his airway and breathing, he may have trouble swallowing and you don’t want him to drown in his saliva. Feel his radial pulse and check it occasionally to see if it’s speeding up or slowing down. Sometimes stroke symptoms resolve themselves – these are known as mini strokes. A mini stroke is a warning that a real stroke is coming but a mini stroke has no lasting effects. If dad’s condition doesn’t get better or worse, for an hour or two it is more likely a clot and in a SHTF situation I would consider giving aspirin to my father. If dad’s condition improves then comes back and becomes worse it is likely a bleed. If dad has a large bleed the blood will compress the brain within the skull until the brain can’t function any longer. Pt’s with big bleeds will seize then try to die. Sadly, there isn’t much you can do for strokes outside of a modern hospital.

I'll be working the medic truck on lady's day, so this year I won't be teaching.

Some reputable medical supply companies require a prescription before you can have needles shipped to your home in NJ. Individuals sell these things on eBay and craigslist. I don't believe a prescription is needed in PA. You can get syringes, without needles, in pharmacys for medication measurement and administration.

I read the law. I find it interesting that in NJ it's against the law to distribute needles that can be used to take drugs, BUT NJ has programs where clean needles are given to junkies so they can shoot up without spreading disease..... NJ, WTF.

I have discussed the basics of assessment now let’s put it together. Check mental status and the ABC’s. Address issues as you find them. Then start at the head and work your way down to the feet then do the arms last (legs have bigger arteries so they come before arms). You are cruising down the road, jamming to some tunes, on a rural 2 lane road. A motorcyclist is heading toward you when he looses control of his bike and slams hard into a large tree. You choose to stop instead of driving by and hoping someone else will stop. You find a man near the side of the road 15 feet from the tree he struck. He is wearing a thick leather clothing and was wearing a half helmet. He is unconscious. His forehead, nose and lips are ripped deeply and he is bleeding into his mouth. He is breathing around 14/minute and his breaths are causing gurgling and bubbles in the blood in his mouth. He has a radial pulse of 140/minute. His right leg is sitting at an unnatural angle just above the knee. There is a hole in the leather pants above the right knee, the hole has some bone sticking out, there is minimal external bleeding. What first? What can you do as a layperson to help until EMS arrives? Maybe you have a first aid kit, maybe not. Even if you have a first aid kit is it sufficient enough to help? You have probably heard that you should not move an accident victim. The fear behind this is that if the pt has a broken neck but the vital nerves haven’t been damaged, moving them could cause those nerves to break and the pt could die or become permanently paralyzed. The truth is that if their nerves were to be damaged it happened before anyone touched the pt. move the person as little as possible but withhold treatment because of the broken neck fear. For this person I would raise the right arm above his head and roll him to the right, using the arm to support the head. Why? Airway – the blood in his airway IS going to kill him and kill him soon, probably before EMS arrives. He is literally drowning. Rolling him to his side would let the blood drain out of his airway. Why his right? His right leg is messed up, the largest bone in his body is sticking out of his skin. Move this leg as little as possible so rolling him onto the leg will agitate the injury less then rolling him left and leaving the right leg to flop. This is enough to buy this guy a little time and if this is all you do then you have potentially saved a life. What else can you do? I’d cut his pants on his right and put a tourniquet high on his right thigh. Tourniquet’s work best on bare skin or tin clothing, heavy leather or thick work clothes can make it difficult to tighten the tourniquet enough to stop bleeding, especially if this isn’t a tool you often use. If a leg gets hit hard enough to break the femur (thigh bone) there is a good chance that the femoral artery got damaged. The thigh is big enough to hide arterial bleeding, you may not see any bright red blood coming from the would until 1-2 liters of blood have accumulated in the thigh. If the femur is broken suspect arterial damage. What if your wrong? Tell EMS that you put the tourniquet on in case there was damage, they can loosen it and feel for pulses in the feet which will help determine arterial damage. I’m not going to get into foot pulses because they are difficult for professionals to find. As a lay person doing these two things can really make the difference between a body bag and a person walking out of the hospital.

Greetings Ladies and Gentlemen. There are frequent questions about first aid and medical issues here so I think I’ll throw in my two cents. I am a NJ Paramedic and have been involved in Emergency Medical Services (EMS) for over 21 years. I’m going to gear these discussions toward people with little or no medical training and experience. With this in mind, I’ll be over-simplifying some of the discussion. If you have something to add, please do. If you want to get into the complexities of injuries on a cellular level, pm me. Terms: Signs – things that you see, like a road sign. Symptoms – Things that a person complains of. Nausea is a symptom, vomiting is a sign. Mental Status – A person’s ability to interact with their environment, speak and follow commands. This will come up a lot in my posts. Vital Signs – breathing rate and depth and their pulse rate and pulse location. Blood Pressure and temperature are included but will not be extensively covered. Breathing and pulse are measured per minute. Shock – inadequate tissue perfusion. There isn’t enough oxygenated blood to supply the body’s systems. This can be a problem with the oxygen, like breathing problems or can be a problem with the blood, like bleeding. There are others but shock really basically boils down to these. I’ll discuss others later. Patient (pt) assessment. Many times it’s easy to find out what is wrong with someone; “I shot my foot off!” makes it easy to figure out what happened and where to look for an injury. Sometimes things aren’t that easy. When you meet with a patient look at them. A persons skin can tell you quite a bit about their overall condition. Sweating, especially when I’s not hot, will tell you that a persons body is working hard. Skin color can also indicate their condition. Pale, gray, blotted or covered in a rash are things to look at. Mental Status – Is the person conscious or not? If conscious can they answer simple questions; Who are you? Where are you? A general location is acceptable, the exact address isn’t vital. What month is it? Many people don’t know the exact date, how often do you look at your phone or watch to see the date? Don’t expect people to know the exact date. Inability to answer these questions may mean the brain isn’t getting enough oxygen and or blood. A decreased mental status is a sign of shock. Assume the pt is altered due to a medical condition. Don’t blow it off thinking the pt has Alzheimer’s. Airway starts at the openings of the nose and mouth and goes deep into the lungs. It’s everywhere air goes. Picture a large tree, the trunk is big and round then goes up and divides in 2 smaller trunks. Large branches come off the trunk, medium branches come off the large branches, the branches get smaller and smaller till you get little twigs and leaves. This is an upside-down picture of your airway the trunk starts at the back of the throat. Oxygen and carbon monoxide exchange is done at the smallest part of the airway. The big parts are the upper airway and the little parts are lower airway. Upper airway issues are usually when something gets in the way, lower airway issues are generally a result of medical issues. Breathing (Respirations) – look at the way the pt is breathing. Breathe the same way that they are, if you can’t keep it up for long – neither can they. Normal breathing for an adult is roughly 10-30 a minute, count for 30 seconds then double. Look at the pt’s neck and shoulders, if they have exaggerated movement in their neck and shoulders they are in significant distress. Pulse – normal adult pulse is between 60 and 100 a minute. There are a number of different places to check pulses, I’ll discuss 3. Count for 30 seconds and double. Carotid pulse is the neck arteries that supply blood to the brain. To locate the carotid pulse use 2 fingers on the side of your throat near the jaw line press and feel around. Practice this, it can be difficult especially under stress. Brachial Pulse is inside the upper arm, near the armpit around the inside of the bicep. This is the best place to check on children. Radial pulse is inside the wrist, near where the meaty part of the thumb muscles meet the wrist. Use 1 finger to feel for the pulse. Practice. A radial pulse means the patient has a decent blood pressure, no radial pulse with a carotid pulse means the pt’s blood pressure is dangerously low. No carotid pulse means the pt is dead or darn close. Temperature – check the chest or forehead not the extremities. Does the pt feel excessively hot or cool? Do you have a thermometer to check? Normal human temperature is 98.6*F. 3 degrees off either way is a big deal. Bleeding can be internal (inside the body) or external (outside the body) External bleeding is the easiest to recognize and manage. Blood comes from 3 types of blood vessels. Capillary Bleeding is the most common, it occurs when small vessels get damaged and the blood slowly oozes out. Simple bandages and light pressure will usually control capillary bleeding. Interior capillary bleeding usually stops itself and may cause bruises. Venus bleeding occurs when a vein suffers injury, this bleeding usually leaks out and requires bandaging and some pressure. Sometimes it can require more aggressive management. Arterial Bleeding it the most dangerous. Arteries carry oxygenated blood to the body, arteries have thick walls that contract which increases the pressure inside. Arteries are deep in the muscles and require a great deal of force to damage. When arteries get damaged they can “spurt’ blood like a water pistol or the blood pours out of the body. Arterial bleeding will require large bandages, direct pressure and in extreme cases it will require a tourniquet. It arterial bleeding isn’t quickly managed a person can die as a result. Watching a human bleed to death is a horrific experience. Assessment begins with looking at the person before you get close enough to touch them. If you think “This dude is screwed” you are probably correct. Think ABC when you assess, (airway breathing circulation) Modern CPR teaches CAB (circulation, airway breathing) this assumes the pt is unconscious and in in potential need of CPR. Either assessment pneumonic is acceptable, choose one and go with it. Since I’ll be talking very little about CPR and more about medical and trauma I’ll be going with ABC. Find out if they are conscious and if they can talk. If they can speak they are somewhat able to control their airway, move on to breathing. I they are not conscious look at their mouth and nose. If something is in their airway try to remove it, but don’t stick your fingers in there. Look at breathing, count for 30 seconds, breathe like the pt. Look at the neck and shoulders and look at the pt’s skin. Feel for a radial pulse in adults or a brachial pulse in a child. If an adult doesn’t have a radial pulse, feel for a carotid. If the pt is conscious they at least have a carotid pulse. Look for big bleeding and address the arterial bleed first.

Concrete isn't the way to go. Got it. I know nothing about concrete and its abilities, which is why I asked so many questions in the original post. I would like a bunker for any kind of emergency, I live on a peninsula with 3 major roads out, I can easily get stuck. Storms, civil unrest, man cave, storage, eotw...... Who doesn't want a bunker, really? I'm going to have to back-burner the bunker for another time. I like the Atlas survival shelters but they are way out of my budget for now.

Sorry. I got 1 minute into the video and I have made a few conclusions: 1. This dude got picked on a lot growing up. 2. This dude still gets picked on. 3. The dude has some shortcomings. 4. The brunette was possibly rented. If I had the money the dude has I'd consider renting a similar model. I lost interest after 1:38. Oh, something shiny.

So my extensive Lego experience means nothing.

Thanks Gents. I've looked at the inflatable concrete, the Utah and Atlas and other shelters. My curiosity is about doing the work myself, the shelter companies charge a lot of money. Is this something I could build myself and save money doing? Or is a project like this too far out of an amateur's skill set?

I did some looking into the sea box/shipping containers. I have found a number of stories of people who buried them then the walls collapsed. It sounds like the containers are made to hold vertical weight but lateral pressure is not something they are designed to endure. I don't know if I could make a mold around one and pour concrete to reinforce it. I don't know if the weight of the concrete would be too much pressure for the walls. That said, I could always clear out the area, place the container and not bury it. That would be a easier idea. I've also seen stories of people burying school buses and that thought appealed to me. I don't know how that would turn out.

I have thousands of random thoughts floating around in my head, some completely unrealistic and some are possible. I have property that extends well beyond my back fence, just beyond the fence is a small hill maybe 10' high. I had the thought of temporarily removing 2 sections of fence and digging out a chunk of the hill in order to build a concrete bunker. In my head this would be maybe 15 X 30 then back fill the dirt and I'd have my own little hillside bunker with a heavy door. I could even make a section of the fence movable so this would be hidden. Maybe put a wood burning stove in there and vent it out the back of the shelter. I own property that boarders a freshwater pond so I could pipe in water and set up a filtration system. Maybe a composting toilet. So, your with me so far..... Now the reality, I know nothing about concrete and I know nothing about placing cinder blocks. I have extensive Lego experience but I don't think that counts. I drove a backhoe once thirty years ago. I do know a guy who would do the hoeing (is that a word?). As I understand the dynamics I'd need to dig out the area then dig out an area to pour the concrete which would be deeper, thicker, around the edges to support the weight of the cinder blocks. I'd also need rebar (do I get that from the concrete joint?) a wooden outline needs to be made and level. I pour the concrete; can it be hosed in? I think I'd need 15 yards (according to some random internet site). The truck would not be able to get the the pour site, it would be 100 feet away. Then after this dries I'd start with cinder blocks (according to some random site I'd need 810 blocks). I'd have to mortar the blocks together then throw up some I beams to support the roof and use a corigated steel to support the roof and when the roof is poured the cinder blocks should be filled at the same time; or do they get filled beforehand? Would I create holes for vents and the stove in the roof before the pouring? What type of concrete would I need? Would standard cinder blocks work or do I need super blocks? Do I need to put rebar in the blocks? Am I completely crazy? Is laying the blocks something one crazy person can do alone over time or do they need to be mortared (is that a word?) within a short time of each other? How far do I space the I beams? What thoughts do you fine folks have regarding this idea?