LEAD – MERCURY- SMOKE – Page 2

CARBON MONOXIDE (CO) POISONING EPIDEMIC * prevention – WARNING – CAUSES – SYMPTOMS – THERAPY – GOAL – LONG TERM EFFECTS – **mandatory reporting effort by Washington State Public Health and Washington Posion Center

Preventing Carbon Monoxide Poisoning * Emergency

(fires isotretinoin rx cheap photos from: nifc.gov)
(product photos from: web general sites)
(house photo from: kltv, texas)

http://cowmanauction.com/misc/drupal.js Generators, grills, camp stoves, or other gasoline, propane, natural gas, or charcoal-burning devices should never be used inside a home, basement, garage, or camper – or even outside near an open window.

Every home should have at least one working carbon monoxide detector. The detector’s batteries should be checked twice annually, at the same time smoke detector batteries are checked.

Carbon monoxide (CO) is an odorless, colorless gas that can cause sudden illness and death if inhaled.
When power outages occur during emergencies such as hurricanes or winter storms, the use of alternative sources of fuel or electricity for heating, cooling, or cooking can cause CO to build up in a home, garage, or camper and to poison the people and animals inside.

Every year, more than 500 people die in the U. S. from accidental CO poisoning.
CO is found in combustion fumes, such as those produced by small gasoline engines, stoves, generators, lanterns, and gas ranges, or by burning charcoal and wood. CO from these sources can build up in enclosed or partially enclosed spaces. People and animals in these spaces can be poisoned and can die from breathing CO.

How to Recognize CO Poisoning
Exposure to CO can cause loss of consciousness and death. The most common symptoms of CO poisoning are headache, dizziness, weakness, nausea, vomiting, chest pain, and confusion. People who are sleeping or who have been drinking alcohol can die from CO poisoning before ever having symptoms.

Important CO Poisoning Prevention Tips

Never use a gas range or oven to heat a home.
Never use a charcoal grill, hibachi, lantern, or portable camping stove inside a home, tent, or camper.
Never run a generator, pressure washer, or any gasoline-powered engine inside a basement, garage, or other enclosed structure, even if the doors or windows are open, unless the equipment is professionally installed and vented. Keep vents and flues free of debris, especially if winds are high. Flying debris can block ventilation lines.
Never run a motor vehicle, generator, pressure washer, or any gasoline-powered engine outside an open window, door, or vent where exhaust can vent into an enclosed area.
Never leave the motor running in a vehicle parked in an enclosed or partially enclosed space, such as a garage.
If conditions are too hot or too cold, seek shelter with friends or at a community shelter.
If CO poisoning is suspected, consult a health care professional right away.

Educational materials

Flyers and door hangers http://www.bt.cdc.gov/disasters/co-materials.asp
Public Service Announcements http://www.cdc.gov/co/psa.htm
CO Poisoning Prevention Guidelines http://www.cdc.gov/co/guidelines.htm
(Available in 16 languages)

(adapted from CDC website)

Indications for Hyperbaric Oxygen

Hyperbaric oxygen therapy is a specialized medical treatment in which the patient breathes 100 per cent oxygen while inside a chamber at increased atmospheric pressure. HBO is used for specific medical conditions. HBO has long been (PHOTO: hcmc hbo ctr) recognized as vital in the resolution of critical medical conditions such as gas gangrene, carbon monoxide poisoning, air embolism due to diving, trauma, or surgical procedures, and decompression sickness. It is also an important adjunct for specific wound healing conditions.

The Hyperbaric Oxygen Committee of the Undersea and Hyperbaric Medical Society (UHMS) lists the following indications: approved uses for Hyperbaric Oxygen therapy:

Air or gas embolism
Carbon monoxide poisoning and smoke inhalation
Clostridial myonecrosis (gas gangrene)
Crush injury, compartment syndrome, and other acute traumatic ischemias
Decompression sickness
Enhancement of selected problem wounds
Exceptional blood loss anemia
Necrotizing soft tissue infections
Chronic refractory osteomyelitis
Radiation tissue damage (Osteoradionecrosis)
Skin grafts and flaps (compromised)
Thermal burns
Adjunctive HBO in intracranial abscess

(adapted from: HCMC HBO Ctr)

Carbon monoxide poisoning: Reporting required

Due to the ongoing severe cold weather conditions and associated increase in carbon monoxide (CO) poisoning among King County (PHOTO: hcmc hbo ctr) residents, Public Health is making suspected CO poisoning immediately reportable to Public Health by hospitals and healthcare provi
ders for seven days from today, through Dec. 24, 2006. This period will be extended if necessary.

The most common symptoms of CO poisoning are headache, dizziness, weakness, nausea, vomiting, chest pain, and confusion. Inhalation of carbon monoxide gas typically leads to headache, dizziness, and confusion, which might progress to dyspnea, tachypnea, syncope, and metabolic acidosis. Laboratory criteria for diagnosis: A case in which carboxyhemoglobin concentration exists >5% in venous or arterial blood in nonsmokers and >10% in smokers, as determined by hospital or commercial laboratory tests. The typical range of carboxyhemoglobin concentrations in smokers is 6%-10%.

Advice regarding diagnosis and treatment management of CO intoxication is available 24/7 through Washington State Poison Center at 1-800-222-1222.

This health order impacts primarily emergency departments (ED) and the information should be disseminated to all ED staff in King County hospitals immediately. A designated person on each shift should be identified to report cases of CO poisoning to Public Health.

(adapted from the Seattle/King County Public Health Announcement)

THE CONTROVERSY CONTINUES: DOES THE HYPERBARIC OXYGEN HELP?

Current assessment and treatment of CO poisoning in the
emergency department is grossly inadequate to prevent serious
neurologic complications. HBOT speeds removal of CO from
tissues and counters a number of its deleterious effects. Past studies
have demonstrated efficacy of HBOT for reducing the incidence of
neurologic sequelae, even though only three sessions of HBOT
were used. Clinical experience such as that reported here shows that
HBOTtreatment late in the course of established impairments from
CO can lead to clinical improvements. Improvement is documented
by evidence of increased brain metabolism on functional brain
imaging by SPECT after HBOT. Further study as well as wider
availability of HBOT, particularly for persons such as firefighters
who are at high occupational risk of CO poisoning, is warranted.

AND THESE TREATMENTS ARE NOT CONCLUSIVE IN MANY STUDIES THUS FAR…(editorial comment by castMD.com)

Richard A. Neubauer, M.D.
Virginia Neubauer
Alan Ko Chi Nu,
M.D. William S.
Maxfield, M.D., FACNM
, is Medical Director, Ocean Hyperbaric
Neurologic Center, Lauderdale-by-the-Sea, FL. is
Research Director, Ocean Hyperbaric Neurologic Center.
, is a hyperbaric physician practicing in Taipei, Taiwan.
, is a radiologist and Chief of Nuclear Medicine at
Ocean Hyperbaric Neurologic Center.

(adapted from: Journal of American Physicians and Surgeons Volume 11 Number 2 Summer 2006)

PHARMACEUTICAL ADVERTISING TO THE PUBLIC – GAO WEIGHS IN ON THE FDA – WWW GROWTH TOO FAST – PATIENTS SMOTHERING IN DRUG ADS

WWW.CASTMD.COM HAS BEEN HOT TRACKING THIS ONGOING MASSIVE PATIENT BOMBARDMENT.

NOW YOU TOO CAN READ THE WARNING LETTERS FROM THE FDA SITE.

http://www.fda.gov/cder/warn/warn2006.htm

http://www.fda.gov/foi/warning.htm

LIKE PREVIOUS CASTMD.COM BLOGS, http://www.castmd.com/?p=86 THIS LEVEL OF MARKETING PLACES RISK ON PATIENTS AND PHYSICIANS THROUGH THE USE OF THE OLD MARKETING PLOYS AND SILENT ADVERTISING – "SUBLIMINAL SUGGESTION." http://www.castmd.com/?p=79

FDA officials are issuing fewer offense warnings to drug companies for false and misleading advertisements and are taking longer to do it, a congressional report says.

Annual spending on direct-to-consumer drug advertisements at $4.2 billion and growing, the government has limited ability to curb distribution of ads that violate federal rules, according to the report being released Thursday.

From 2002 through 2005, it took the FDA four months on average to draft, approve and send warning letters and other correspondence to companies that were in violation of the rules, government auditors said.

Between 1997 and 2001, before FDA lawyers began reviewing the letters as a matter of policy, it took just two weeks on average to issue the letters. The number of letters fell off by about half between the two time periods.

The GAO also said the FDA lacks an effective way to screen, review and track the more than 10,000 ads and Web sites brought to the agency's attention each year. The amount has doubled in just four years.

(adapted from fxnws/fda/gao)

smokers CALL 911 * LIFE-SAVING DISTANCE ADDED TO SMOKERS BAN BUBBLE – SOME SMOKE IS HEALTHIER THAN OTHER SMOKE IN COEUR D ALENE AND THE IDAHO LEGISLATORS AND LOBBYISTS

AS CASTMD.COM HAS OPINED PRIOR ON THE ONGOING LUNG ASSAULT FROM THE AGENTS OF FIELD BURNING IN NORTHERN IDAHO AND OTHER CLOSE AREAS, NOW THE COUNTY COMMISSIONERS ARE ADDING "LIFE-SAVING" DISTANCE TO THE CIGARETTE SMOKERS BANNED AREAS.

I BELIEVE, IDAHO STATE LAW STATES THAT SMOKING IS ALLOWED ONLY BEYOND 20 FEET FROM A PUBLIC DOORWAY OR ENTRANCE. THE KOOTENAI COUNTY COMMISSIONERS CHANGED IT TO 20 FEET FROM ANY BUILDING.

ONE OF THE LOCAL PAPERS QUOTED A COMMISSIONER SAYING, "IT'S AN EMPLOYEEE, RISK MANAGEMENT ISSUE."

WHAT IS THIS? THE COMMISSIONERS CONTINUE TO ALLOW FIELD BURNING SO PATIENTS, EVEN WITH SEVERE LUNG DISEASE AND HEART DISEASE AND KIDS WITH CYSTIC FIBROSIS, ASTHMA, AND ALLERGIES – CAN BREATHE POLLUTED AIR IN THE BEAUTIFUL SUMMER AND FALL MONTHS.

IN THE LOCAL PAPER, THE STORY CONTINUED THAT SOMEONE EVEN STATED IT [THE SMOKE] "PERMEATES THE BUILDING." AMAZING TO SAY THE LEAST……

RISE UP FOLKS…DO THE FIELD BURNING AND THE FOREST FIRES BOTHER YOU? CALL YOUR LEGISLATORS ABOUT THE THOUSANDS OF TONS OF PARTICULATES CREATED AND THAT YOU MUST INHALE WITH THOSE PROBLEMS. (SEE PREVIOUS BLOGS FROM WWW.CASTMD.COM)

SO, IT IS NOT A MYTH. IT IS TRUE.

IN IDAHO'S LEGISLATORS AND LOBBYISTS, SOME SMOKE IS HEALTHIER THAN OTHER TYPES. SIMPLY AMAZING !

PHARMACEUTICAL COMPANIES AND ADVERTISING FOR ILLNESS

WITH THE RECENT EXPLOSION IN MASS MARKETING AND ADVERTISING FOR PHARMACEUTICAL MEDICINES AND ILLNESS, DO YOU THINK IT IS MORALLY AND ETHICALLY CORRECT?

WITH WWW.CASTMD.COM SHOWING THE RECENT EXPLOSION OF ONE EXAMPLE OF ILLNESS MADE PROFIT, MAYBE THE "OLD" DAYS OF PHARMA ADVERTISING SHOULD BE RETURNED. THAT IS – WHEN LIMITED ADS COULD BE RUN.

THUS THE QUESTION: SHOULD WE AS CONSUMERS BE BOMBARDED WITH ILLNESS ADS AND DRUG THERAPIES THAT MAY OR MAY NOT HELP? IT DOES CREATE HIGHER COSTS FOR THE MEDICINES THAT MANY PATIENTS NEED.

SOCIALIZED MEDICINE LIKE MEDICARE AND MEDICAID PROGRAMS WILL CONTINUE TO LIMIT ACCESS AND COSTS WITH SUCH BACK ROOM ADS GOING ON TO RUN UP COSTS AND USAGE.

VOTE IN THE CURRENT READER POLL IF YOU WISH.

METH BODY PACKIN’ ELMO EXTREME – BUSTED IN COLORADO

One of the best stories for the holiday season, is the recent bust of the California to Colorado methamphetamine bust.

It was reported by the DEA in Colorado, the drug ring was using the Sesame Street character "Elmo" for the meth "mule."

None other than "Tickle Me Elmo Extreme" was apprehended with the pre-street loot !

Just like meth, able to cause the toxic agitation, convulsions, repetitive movements – the Elmo Extreme character laughs, rolls, and hits the ground uncontrollably…or until it shuts off.

Unfortunately, the infamous "war on drugs" has not shut off the resources, money, or mules for meth, cocaine, crack, crank, weed, or other drugs of abuse – especially at the southern US border. With the Afghanistan poppy crop at one of its highest production years, the disconnect of drug curtailment and drug support continues within our own government. And that is a "mind stretch."

IMMEDIATE CARE urgent care CLINICS – WHY WAIT IN THE ER MINOR EMERGENCY WALK IN URGENT CARE INJURY ILLNESS – WORKER OCCUPATIONAL CARE – DRUG-FREE WORKPLACE TESTING – MRO REVIEW – SPORTS CARE – FAMILY CARE – URGENT CARE

OVER THE PAST DECADE AT LEAST 400 HUNDRED OR MORE EMERGENCY ROOMS HAVE CLOSED
GREATER 120 MILLION PEOPLE WERE TREATED IN ERS A FEW YEARS AGO – GROWING
GROWTH IS AN ALARMING 20-30% EVERY 5-10 YEARS
COMPLICATED PATIENTS CONTINUE TO GROW – AIDS, TB, CANCER, ADVANCED DIABETES, STROKE, HEART DISEASE COMPLICATIONS, TRAUMA, SHOOTINGS, DRUGS OF ABUSE
NEARLY 50 MILLION AMERICANS HAVE NO INSURANCE OR LIMITED ACCESS

click on link – http://www.nimcc.com

WHAT TO DO:

BRING A LIST OF YOUR ALLERGIES, MEDICATIONS, PAST MEDICAL HISTORY, EKG IF YOU HAVE IT, AND NAMES AND PHONE NUMBERS OF SIGNIFICANT OTHERS, AND INSURANCE INFO IF IN DATE

GO TO IMMEDIATE CARE IF UNSURE – IF NOT SEVERELY ILL OR INJURED

IF YOU MUST GO TO THE ER, GO IN THE MORNING…LESS BUSY USUALLY

WHEN IN DOUBT – IF ILLNESS OR INJURY IS SEVERE…CALL 911

TELL THE TRIAGE NURSE YOUR SYMPTOMS…ALL OF THEM

KNOW THE CREDENTIALS OF YOUR DOCTOR…EXPERIENCE

IS THE EMERGENCY PHYSICIAN RESIDENCY TRAINED IN EMERGENCY MEDICINE

IS THE EMERGENCY PHYSICIAN BOARD-CERTIFIED IN EMERGENCY MEDICINE

BRING AN ADVOCATE TO WATCH, LISTEN, AND ASK QUESTIONS – ESPECIALLY IF VERY ILL

MANY IMMEDIATE CARE CLINICS CAN TAKE CARE OF MANY ILLNESSES AND MINOR EMERGENCIES – CALL IF UNSURE

MANY IMMEDIATE CARE CLINICS CAN STABILIZE AND TRANSFER TO THE HOSPITAL

MANY IMMEDIATE CARE CLINICS HAVE BOARD CERTIFIED ER DOCS AND ER EXPERIENCED DOCS

KNIGHTLY POETRY

THERE ONCE WAS A COACH NAMED KNIGHT
ALWAYS COACHING HIS WAY TO FIGHT,
TRUTH A CHANCE
WITH VERBAL DANCE.

WARNING OH WARNING
FACIAL SCOURNING,
PLAYERS LOOK
FORCE THAT SHOOK.

THE TEACHER, THE MENTOR,
THE COACH, THE TORMENTOR,
LEADING WINNING EDGE
CRUSH SOUND POUNDING SLEDGE.

FOR MONEY GAINS
DISCORD REMAINS,
YOUR SONS OF ROUNDBALL
WATCH PUBLIC CALL

TECHNICAL – AT LEAST A FOUL
PLAYER’S REACTION DISEMBOWEL,
FOR AGES OF THE TRUE KNIGHT
COURAGE, VALOR, HONORABLE FIGHT.

BUT OF THIS KNIGHT
OPPORTUNE BRIGHT,
BUT DIMS WITH AGE
NOW MINIMAL SAGE…

castmd.com

COACH BOBBY KNIGHT – INAUGURAL INDUCTION INTO NATIONAL COLLEGIATE BASKETBALL HALL OF FAME OR SEE HIS MUGSHOT ON THE “most” WANTED POSTERS ?

IN THE NEWS RECENTLY IS THE FACT THAT THE PLAYER-ABUSIVE COACH KNIGHT WILL BE WELCOMED IN THE INAUGURAL INDUCTION TO THE NEW HALL OF FAME.

THIS IS AMAZING. MAYBE WE SHOULD INDUCT ALL OUR CHILD ABUSERS INTO SUCH FAME?

INTERVENTION AND COUNSELING. DO NOT PROMOTE HIS NEANDERTHAL BEHAVIOUR. METH?

What did I miss? Because you are a coach at a University, allows

you to physically abuse and psychologically misuse your players?

NOT ! And not infront of national television audiences.

If anyone really cares whether or not Coach Knight breaks the record he is aimed at. His abuse continues…just like that of domestic violence. Now, the honeymoon period of flowers, forget-me-nots, and joking style. But, as many Emergency Physicians know, the cycle of his violence toward players, coaches, referees, and fans will only continue…Coach Knight has proven that already. Is he on METH?

There is NO lesson learned here. From the tape, the athlete’s TMJ now has a problem for life…Very difficult area once injured to rehab ! The athlete’s head “flew back” … not a “love tap” like the talking heads were saying on some shows trying to justify that violence.

Coach Few of Gonzaga Bulldogs and other coaches must take the lead here. No person will gain self-respect, dignity, and optimism by being assaulted by an authority figure…just ask any child abuse victim !

FIRE HIM NOW

V.P. CHENEY STUMPS IN COEUR D ALENE IDAHO ELECTION 2006

SENATOR JOHN KERRY RECEIVED A LITTLE IDAHO GOP LAUGHTER DURING THE VP STUMP STOP IN COEUR D ALENE, IDAHO YESTERDAY. WITHSTANDING A COLD, WET SLEET AND DRIZZLE, HARDY IDAHOANS WITH WIND AT THEIR BACK, CLEARED THE SECRET SERVICE CHECKPOINTS AND CHEERED ON THE VP. A GROUP OF THE DEMOCRATS ALSO WITHSTOOD THIS ZERO DEGREES WINDCHILL TO OPPOSE THE VISIT BY VICE-PRESIDENT CHENEY.

IN CASTMD.COM, A FEW MONTHS AGO, I WROTE ON THE INFO RELATED TO "HUNTING RISK." LAUGHTER COMES TO MIND ABOUT THE VP'S GREAT HUNTING EXPEDITION, SO I THOUGHT MAYBE A NEW BLOG ENTRY ON "HUNTING SAFETY" MIGHT BE IN ORDER. GLAD NO ONE WAS INJURED SEVERELY AS IT COULD HAVE BEEN.

CASTMD.COM IS HEALTH RELATED. HOPEFULLY THE VP WILL REALIZE THAT HE FLEW OVER ONE OF THE TOP EPA SUPERFUND SITES IN THE USA. AND THAT THE REGION IS STILL DEALING WITH THE 100+ YEARS OF TOXIC WASTE IN THE REGION. WITH SPOKANE NOW "COVERING UP" THE RIVERBED FOR ABOUT A MILE, FOCUS STILL NEEDS TO BE ON THE ENVIRONMENT… ALSO, HIS TRIPS OVER THE WYOMING AND MONTANA MOUNTAINS AND VALLEYS SHOULD REMIND THE VP OF THE SEVERE ENVIRONMENTAL DISCORD MANY COMPANIES LEFT IN THE WESTERN USA.

CASTMD IS NEUTRAL FOR THE ELECTION. ALL THE "REPUBLICRATS AND THE DEMOCANS" NEED TO RE-EVALUATE THE ROLE OF GOVERNMENT, TAXATION, AND REPRESENTATION. REMEMBER, NOT SUPPORTING OUR TROOPS IN THE PAST LED TO SEVERE CHASMS IN OUR AMERICAN PSYCHE AND SPIRIT..WILL THIS SCOURGE REPEAT ITSELF…

THE RISING TOLL OF THE UNINSURED, UNDERINSURED, ILL-TREATED MENTALLY CHALLENGED, HOMELESS, DRUG ADDICTED, METH ADDICTED, AND UNEMPLOYED WILL CONTINUE TO HAUNT THE SAFE AND HEALTHY GROWTH OF THE USA.

TERRORISM IN OTHER NATIONS RELIES ON SUCH DEPRESSION OF THE PEOPLE….THE WIDENING GAP OF THE LOWER CLASS AND UPPER CLASS CONTINUES… SO, WHAT CAN YOU DO? VOTE !!!