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PostPosted: Fri Oct 30, 2015 3:03 pm 
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Almost put this in the First Aid forum, but thinking it might be better answered here. If the mods think otherwise no complaints here if you move it.

Found this Prolonged Field Care site a couple months ago though a link at Hogwarts, and both sites are really worth a long look if you haven't discovered them already. Many courses, books, and websites discuss how to apply a TQ, but not many deal with how and when to remove them for example. Not to suggest that I consider myself as having mastered first-responder medical care and ready to start earning my internet doctorin' degree, just trying to get a better understanding of what might be needed (tools and training-wise) to provide longer term care for the sick or injured at my home or BOL, such as in a PAW or a devastating regional disaster scenario, so I've been lurking around those sites trying to get some free education.

Anyway, the first thing any patient of mine needs is a better doctor, so I'd given some minor thought about different ways I might be able to contact someone more skilled in medicine than me for advice if needed. All I really came up with was calling on the local EMS vhf freqs (repeater 'in' if they're up, or on the repeater 'out' if they're down) and hope some EMT/Paramedic still had his radio on and was listening. Even if they couldn't/wouldn't be able to dispatch help, maybe they'd be willing to provide some advice. Other than that, maybe try the AMMRON 'channel 3' freqs and see if some better-prepped group than ours had a Dr or Nurse that might help remotely. Then I read this Phone a Friend – Telemedical Consult article and attachments, and listened to the podcast at the PFC site and started thinking maybe there are better ways, either by different methods of communication or on different frequencies, or maybe just a better way to phrase the initial request for medical assistance that might have a better chance of eliciting a response.

So anyone have any thoughts on how someone might increase the odds of reaching a medical professional and getting a response in a "full-blown, griddown, the SHTF 3 weeks ago and it's TEOTWAWKI now" scenario if you didn't already have a pre-arranged plan for doing so?


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PostPosted: Fri Oct 30, 2015 3:55 pm 
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The whole point of a tourniquet is to get the pt to a higher level of medical care to get it removed. To remove it is more involved than this thread will allow and involves and evaluation of what to do next, normally done by a surgeon or experienced ED doc.

If I needed someone more skilled in medicine than me I would just roll over in bed. Not everyone has that option of course.


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So anyone have any thoughts on how someone might increase the odds of reaching a medical professional and getting a response in a "full-blown, griddown, the SHTF 3 weeks ago and it's TEOTWAWKI now" scenario if you didn't already have a pre-arranged plan for doing so?


I believe the entire point of this website is to have such a plan in place.

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PostPosted: Fri Oct 30, 2015 6:17 pm 
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Stercutus wrote:
The whole point of a tourniquet is to get the pt to a higher level of medical care to get it removed. To remove it is more involved than this thread will allow and involves and evaluation of what to do next, normally done by a surgeon or experienced ED doc.

If I needed someone more skilled in medicine than me I would just roll over in bed. Not everyone has that option of course.


Decided to post this in comms because I didn't really want to discuss any specific medical procedures, but if you or your bed partner have any better suggestions on how to convert/remove a TQ than the one I linked to, please explain. My only point in mentioning it was that it can be a life saving intervention that shouldn't be withheld if needed, but in the absence of higher medical care it can't be left on indefinitely.

Stercutus wrote:
I believe the entire point of this website is to have such a plan in place.


I've had 5 PCP's in about as many years (rural, clinics close, people move, healthplans change), no chance to develop a relationship. But yeah, I'm looking for a better plan - your better half and colleagues have a HF radio plan to stay in touch? Maybe we would be interested in paying a retainer fee now for their SHTF medical advice later if needed, if they'd provide their bona fides openly and we could stay anonymous.

But really was hoping for something more like a discussion on Red Cross/Military/FEMA/Doctors without Borders MEDTAC communications info, and maybe some suggestions on how the 'Telemed Script Cheat Sheet' at the PFC site might be modified for civilians requesting medical assistance in a ZPAW type disaster.

“THIS IS _________________, In(LOCATION)__________________. I HAVE A PATIENT WITH _________________________ WHO I THINK HAS ___________________________, AND I REQUIRE CONSULTATION WITH A PHYSICIAN, CAN ANYONE ASSIST OVER?"

as an example.


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PostPosted: Fri Oct 30, 2015 7:15 pm 
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I am not sure this is what you are looking for but...

The first time I retired and spent two years sailing the Caribbean, a medical emergency while at sea was very high on my list of risks.

I contracted with these folks for their martime coverage available via the marine operator over ssb. They have been doing this a while and still provide the service.

http://www.gwdocs.com/emergency-medicine/telemedicine

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For over 20 years, the Department of Emergency Medicine has specialized in delivering comprehensive telemedicine solutions and services to patients and providers around the world. The Worldwide Emergency Communications Center (WECC) acts as the operational hub to clinical and cognitive telemedicine consults at the GW MFA. As an academic leader in telemedicine, we continuously connect shipping vessels, yachts, aircrafts, correctional facilities, research teams and organizations around the globe to leading GW MFA providers in the following specialty areas: Cardiology, Emergency Medicine, Endocrinology, ENT, Infectious Disease and Orthopedics.


They are part of The George Washington University
http://smhs.gwu.edu/emed/

I never had to use the service so I am not sure how well they work. At the time the price for telemed was quite reasonable for an annual subscription.

YMMV.

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PostPosted: Fri Oct 30, 2015 8:18 pm 
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CrossCut wrote:

So anyone have any thoughts on how someone might increase the odds of reaching a medical professional and getting a response in a "full-blown, griddown, the SHTF 3 weeks ago and it's TEOTWAWKI now" scenario if you didn't already have a pre-arranged plan for doing so?


in 'TEOTWAWKI now' scenario the best bet i believe is have a competent doctor as a close friend/prepper partner.

however your comment on tele-medicine brings up options (providing the disaster is localised) in Australia we have the Royal Flying Doctor Service (RFDS) which provides medical services to remote communities and isolated properties as well as emergency retrievals. you can call up a base either on phone/satphone or on a HF radio and you will be talking to a doctor who not only will tell you what treatment to administer but also will arrange the relevant rescue effort, be it aircraft retrieval or road retrieval. I assume America has a similar system for remote communities

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PostPosted: Sat Oct 31, 2015 2:20 pm 
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raptor: Thanks, I may email them just to get a quote for the cost out of curiosity.
taipan821: I believe Alaska does have something similar, other side of the country from me however.

Built a personal list of likely frequencies using these resources:

http://wiki.radioreference.com/index.ph ... ices_Radio
http://www.radioreference.com/apps/db/?aid=7757 (EMS Med Channels)
https://casmnextgen.com/pslib/index.php ... ?docid=108 (NIFOG)

And some local public safety ones from a state/county search:
http://www.radioreference.com/apps/db/

Didn't find much for US Armed Forces/National Guard.

Not real happy with the printed format yet, and would like to get it down to index card size, but printed copies for the house, BOL, and BOB anyway. Think I'll hit Kinko's next time I'm in town to get a couple oversized and laminated copies of the "SFMS Prolonged Field Care Card" too.


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PostPosted: Sat Oct 31, 2015 4:58 pm 
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CrossCut wrote:
raptor: Thanks, I may email them just to get a quote for the cost out of curiosity.
taipan821: I believe Alaska does have something similar, other side of the country from me however.

Built a personal list of likely frequencies using these resources:

http://wiki.radioreference.com/index.ph ... ices_Radio
http://www.radioreference.com/apps/db/?aid=7757 (EMS Med Channels)
https://casmnextgen.com/pslib/index.php ... ?docid=108 (NIFOG)

And some local public safety ones from a state/county search:
http://www.radioreference.com/apps/db/

Didn't find much for US Armed Forces/National Guard.

Not real happy with the printed format yet, and would like to get it down to index card size, but printed copies for the house, BOL, and BOB anyway. Think I'll hit Kinko's next time I'm in town to get a couple oversized and laminated copies of the "SFMS Prolonged Field Care Card" too.



Alaska Telmed is based on local clinics using fixed comms to contact a listed specialist. All part of a 'system'- not what you are looking for in this case.

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PostPosted: Sat Oct 31, 2015 7:11 pm 
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Crosecut , your list if med channels probably won't be of much use to you. Those frequencies are dedicated for paramedic and doctor communication to include telemetry of EKGs. They haven't been used much in my area thanks
to cellphones for the most part.


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PostPosted: Sun Nov 01, 2015 6:20 am 
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CrossCut wrote:
raptor: Thanks, I may email them just to get a quote for the cost out of curiosity.
taipan821: I believe Alaska does have something similar, other side of the country from me however.



Isn't that the advantage of telemedicine?

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PostPosted: Sun Nov 01, 2015 7:26 am 
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medic photog wrote:
Crosecut , your list if med channels probably won't be of much use to you. Those frequencies are dedicated for paramedic and doctor communication to include telemetry of EKGs. They haven't been used much in my area thanks
to cellphones for the most part.


Maybe, maybe not. Already have our local EMS dispatch frequencies programmed in for scanning purposes. Only have a list of about 20 others, some in use now (dispatch/tactical ones, LifeFlight/Survival Flight, HEARN), and some others that seemed likely if the Fed agencies deploy in a disaster. Not any of the data/telemetry/hospital ones obviously. Since we're only talking PAW (or ZPAW), maybe the group at Grady Memorial Hospital still has their radios on. :lol:

But seriously, in the PAW and needing an emergency medical consultation, I'd probably try my list of 20 then switch to the NOAA weather frequencies - after broadcasting a 30 sec 1050 Hz tone first.

taipan821 wrote:
Isn't that the advantage of telemedicine?


Yes, and true. I was referring to 5167.5 kHz USB (Alaska Emergency Frequency), I'm not familiar with the Alaska Telemed one TacAir referred to.


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PostPosted: Sun Nov 01, 2015 12:52 pm 
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FYI
As I recall the telemed service had a sign up fee for record transfer of the covered group and the annual subscription was around $ 1,200 in today's dollars. However you still paid by the consultation much like an ER visit normally. That consultation cost is likely very expensive just like an ER visit today.

That said as I recall my health insurance subject to co-pay and deductibles covered it as an out of network ER visit. Obviously YMMV and in an EOTWAWKI event who knows.

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PostPosted: Sun Nov 01, 2015 4:41 pm 
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http://www.comsoc.org/files/About%20Com ... tation.pdf
more than you ever wanted to know about rural medical delivery.


https://www.alaska.edu/health/downloads ... AFHCAN.pdf a 299 page report (somewhat dated as this was released in 2004)

Alaska has some unique issues related to medical delivery. I was a licensed EMT for a number of years, working within the system. How it will fare going forward with huge deficits (multibillion) in the SoA budgets and cut backs on the FedGov side is an open question.

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PostPosted: Sun Nov 15, 2015 4:55 am 
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CrossCut! Good info. I like it. For the record, I teach reduction of the TQ to Advanced Life Support providers all over the world and have for seven years now. They are advocating correctly at your link. There is some good info there....the geeky radio shit, I definitely have to learn more about. I know that in remote medicine, you are already given protocols which basically guide your actions for most emergencies so no radio contact is needed until extraction is called for. To format your call to give patient information, the MIST report is pretty universally accepted. Mechanism, injuries, signs-symptoms, treatment. The MIST is what I use here in Luhansk Oblast, Ukraine on the "contact line". Extraction is another story. The most important things with that are the freq, who you are, and where you are.....


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PostPosted: Wed Apr 26, 2017 3:06 pm 
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Update: Wildfire season here and had the scanner on over the weekend listening to local fire dispatches. Rural area, and our fire stations and EMS are still using analog and two-tone selective calling radio system. Heard a multi-alarm call begin with the long series of two tone codes meaning many stations getting activated and thought "oh shit, it's a big one" - but the message was only to inform all the county fire stations of a mandatory meeting on Monday. That did give me an idea however.

Over the last few days, with the help of a digital voice recorder and a little audio editing afterwards, I captured audio .wav files of most of the two tone codes for the EMS and fire stations in the three county area around us. Still working on ID'ing the exact fire station for a couple of them, and still a few more to capture, but I have the majority of them now saved on the recorder and DVD backup.

'nuff said, maybe too much, but just mention it in the context of a radio operator using "any means at its disposal to attract attention" for a station in distress in the zpaw.


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