Podcasts about immobilization

In today's episode of Ditch the Lab Coat, we dive into the raw, real-world chaos of trauma that unfolds beyond the controlled environment of a hospital. Dr. Mark Bonta is joined by Dr. Andrew Petrosoniak, a trauma director and emergency medicine expert who specializes in designing effective healthcare systems, to explore the unpredictable nature of street-level emergencies.Throughout the episode, the duo unpacks the reality of responding to accidents in real-world settings, where medical tools are limited and the stakes are high. From discussing the importance of overcoming the bystander effect to the critical role of tourniquets in stopping a traumatic bleed, Dr. Petrosoniak shares actionable insights that go beyond traditional medical scenarios.Dr. Petrosoniak reflects on his experience with high-stress situations, emphasizing the power of a calm presence and strategic communication to provide reassurance until professional help arrives. The conversation highlights how anyone, not just medical professionals, can make a significant difference during emergencies through basic actions like calling for help and offering reassurance.Listeners are encouraged to rethink what being prepared means, urging them to consider keeping essential items like a tourniquet, defibrillator, and first aid kit nearby. This episode serves as a poignant reminder that life-saving efforts often start not in the ER but at the scene of an accident, where immediacy, intuition, and courage can have the most profound impact.Join Dr. Bonta and Dr. Petrosoniak as they explore the instinctual side of emergency response, sharing both practical advice and engaging anecdotes from the frontline of trauma care.Episode HighlightsApplying Tourniquets Properly Apply a tourniquet tightly enough to stop bleeding below the site. This is crucial in emergencies to prevent excessive blood loss.Understanding Trauma's Reality Trauma doesn't happen in a controlled environment. Real-life situations require quick thinking and improvisation with limited resources.Importance of the Bystander Effect Overcome the bystander effect by taking charge in emergency situations. Your presence and action can make a significant difference.Street-Level Medical Preparedness Real-life medical emergencies demand an understanding of how to act without hospital tools – a phone call and support can be vital.Interpreting Blood Loss Know signs of severe blood loss—confusion and cold extremities—rather than estimating based on visible blood alone.Role of First Responders Sometimes non-medical professionals, like St. John Ambulance volunteers, are better prepared for emergencies due to their specific training.Communication in Crisis In emergencies, communicate clearly, outlining the plan to provide comfort, rather than giving false assurances of safety.Understanding Electrical Injuries High-voltage injuries are extremely dangerous. Never approach if there's a risk of being electrocuted. Safety should be our top priority.Value of Proper Equipment Keeping simple equipment like a tourniquet and blanket in your car can be life-saving during an unforeseen emergency.Preparedness Beyond Hospitals Being prepared for emergencies means more than medical skills. It's about readiness to act and show compassion, no matter where you are.Episode Timestamps04:44 — Thrill-seeking risks and physiological reactions08:12 — Managing stress and preparedness in emergencies11:54 — Immobilization advice after falls15:55 — Survival odds after high falls18:20 — Crisis communication in prehospital care22:35 — Ski injury first-aid and bystander concerns26:09 — Tourniquet use: prioritize stopping bleeding27:01 — Emergency situational awareness tips31:29 — Assessing blood loss in hospital settings33:31 — Understanding the impact of blood loss36:38 — Electrocution safety and response challenges39:56 — “Mark's Power Room Dilemma”43:58 — Simplifying trauma response protocols45:48 — Compassion in crisis: the human side of trauma careDISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization a

The Difference in Achilles Tendon Loading within Immobilizing Boots Based on Ankle Angle, Boot Type, and Walking Speed Michener LA, McClure PW, Tate AR, et al. Orthop J Sports Med. 2024;12(10):23259671241283810. doi:10.1177/23259671241283806 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik/Jason/Chris's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight Koal Challenge – Sam Roux

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Knowing when to mobilize and when to immobilize healing tissue is essential to the optimal healing of soft tissue healing. Ansi van der Walt discusses a review of the research on mobilization and immobilization after acute soft tissue injuries. Learn more about Ansi van der Walt: https://www.fitness4pets.com/ Bookmark the Vet Rehab Summit: https://vetrehabsummit.com/ Learn more about CuraCore: https://curacore.org/vet/ To learn about Onlinepethealth, watch a free webinar, or join any of our Facebook groups, click here: https://onlinepethealth.com/podcast

Today, we discuss updates in the WMS guidelines regarding the protection of patients with suspected spinal injuries.The Wilderness Medicine Society Clinical Practice Guidelines are all open-access, and you can find links to all of these guidelines on the right sidebar of this page.The education in this episode is based on the:Wilderness Medical Society Clinical Practice Guidelines for Spinal Cord Protection: 2024 UpdateIf you've never seen a vacuum mattress before, this video (2:10) gives a good introduction. If the brief mention of the Diploma in Mountain Medicine alpine skills course got you interested, you can learn more about the DiMM here.As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. Connect with us by email at wildernessmedicineupdates@gmail.com.You can pay us a compliment and share the show with a new listener on any popular platform here.

Listen to Andrew Duckworth and Daniel C. Perry discuss the paper 'Cost-effectiveness analysis of soft bandage and immediate discharge versus rigid immobilization in children with distal radius torus fractures' published in the June 2024 issue of The Bone & Joint Journal.Click here to read the paper.Find out as soon as the next episode is live by following us on X (Twitter), Instagram, LinkedIn, Tik Tok or Facebook!

Ashleigh VanHouten gives us a deep dive into the world of muscle science and nutrition for women. Along with Dr. Stephanie, she explores the intricacies of muscle hypertrophy, shedding light on topics such as simultaneous muscle building and fat loss, bulking and cutting strategies, and the importance of progressive overload. Whether you're a seasoned weight trainer or just starting your fitness journey, this conversation promises to dismantle myths and provide invaluable insights for maximizing strength and vitality.Episode Overview:0:00 Intro/Teaser1:20 Exploring Muscle Science for Women2:12 Focus on Muscle Building and Nutrition3:43 Prioritizing Muscle Contraction and Effort6:56 The Importance of Time Under Tension13:09 Manipulating Time Under Tension16:11 The Benefits of Filming Workouts22:05 Balancing Full Range of Motion and Partial Reps24:50 Understanding Body Mechanics in Training30:59 Coaching and Foundation32:49 Consistency and Foundations34:24 Foundational Movement Patterns36:06 Initial Assessment and Movements36:39 Impact of Injury in Fitness37:39 Injury Prevention and Importance41:35 Long-Term Impact of Injury44:33 Modifying Workouts When Injured50:28 Consequences of Undernourishing55:05 Nutrition and Safety Signal58:57 Misconceptions in the Fitness IndustryResources Mentioned:Effects of Unilateral Eccentric versus Concentric Training of Nonimmobilized Arm during Immobilization - https://journals.lww.com/acsm-msse/fulltext/2023/07000/effects_of_unilateral_eccentric_versus_concentric.8.aspxBuild Muscle Faster with Kaatsu Training - https://youtu.be/r2lC6a648F8?si=gE3_0Ccnhbz92xzdAshley's books - https://ashleighvanhouten.com/collections/my-bookChicken LIver Mousse - https://ashleighvanhouten.com/blogs/news/chicken-liver-mousse-recipeMuscle Science for Women (featuring Dr. Stephanie) - https://podcasts.apple.com/podcast/ep-45-fitness-in-your-40s-and-beyond-dr-stephanie-estima/id592596408?i=1000633181161Bio:Ashleigh is a health coach, speaker, podcast host, and author of one of the only nose-to-tail, organ-meat-centric cookbooks in existence, called It Takes Guts. Her new book is called Carnivore-ish. She created and co-hosts the Muscle Science for Women podcast, downloaded more than two million times, where she interviews some of the leading minds in exercise and nutrition methodology and overall wellness and discusses topics relevant to health and muscle building.We are grateful to our sponsors:BODYBIOFish Oil Plus, alongside the balance oil, are the two oils that I use for myself and my family on a daily basis. We take it straight up with a tablespoon, but it also mixes really well into smoothies and you can also drizzle it over your salad. Head over to https://bodybio.com/better and use code better at checkout to get 15% off your first order.FATTY15Essential fatty acids create better skin, hair, nails, repair age-related damage to cells, and activate pathways that regulate sleep and mood. You can get an additional 15% off of their 90-day subscription starter kit if you go to https://fatty15.com/better and use code BETTER at checkout.BON CHARGE (face mask)I am doubling down on this year for my best skin ever. The Bon Charge Red Light Face Mask helps with glowing, younger, firmer-looking skin with minimal effort or time AND without really changing your usual day or night routine.  Head over to https://boncharge.com/better and use the discount code BETTER at checkout to get 15% off your entire cart.

Immobilization is the breeding ground of hopelessness and despair! Take a listen to hear about just how vital movement is especially in seasons of high distress.

Join Steve and Marlowe as they break down Capitalist Realism chapter 4: "Reflexive impotence, immobilization and liberal communism" and discuss how educational paradigms under neoliberalsm and the entertainment industry engender a kind of apathy in students and place educators in a double-bind. ----- Patreon: https://www.patreon.com/LostFuturesPod Rate us on Apple Podcasts: https://podcasts.apple.com/us/podcast/lost-futures-a-mark-fisher-podcast/id1685663806 Spotify: https://open.spotify.com/show/0EnwNGZijCDZVIl5JtjwGT Follow us on Twitter: @lostfuturespodTheme Song By: EvilJekyll Art/animation by: Gregory --- Support this podcast: https://podcasters.spotify.com/pod/show/lost-futures/support

Join Steve and Marlowe on Monday as they break down Capitalist Realism chapter 4: "Reflexive impotence, immobilization and liberal communism" and discuss how educational paradigms under neoliberalsm and the entertainment industry engender a kind of apathy in students and place educators in a double-bind. ----- Patreon: https://www.patreon.com/LostFuturesPod Rate us on Apple Podcasts: https://podcasts.apple.com/us/podcast/lost-futures-a-mark-fisher-podcast/id1685663806 Spotify: https://open.spotify.com/show/0EnwNGZijCDZVIl5JtjwGT Follow us on Twitter: @lostfuturespodTheme Song By: EvilJekyll Art/animation by: Gregory --- Support this podcast: https://podcasters.spotify.com/pod/show/lost-futures/support

On this month's EM Quick Hits podcast: Anand Swaminathan on update to ED management of postpartum hemorrhage, Nour Khatib on serotonin syndrome and its mimics, Katie Lin on an approach to recognition and management of severe TBI and brain herniation syndromes, Hans Rosenberg on the ED management of ulcerative colitis, Heather Cary on pediatric c-spine immobilization controversies and techniques, Navpreet Sahsi on the difference between humanitarian and development work The post EM Quick Hits 53 Postpartum Hemorrhage, Serotonin Syndrome, TBI Herniation Syndromes, Ulcerative Colitis, Pediatric C-Spine Immobilization, Global EM appeared first on Emergency Medicine Cases.

Spine specialist, Dr. Matthew Alexander shares a back pain story of a high school athlete with an elusive diagnosis. Dr. Alexander enjoys spending time with his lovely wife Katie and their four children, Annie, Ethan, Ellie and Georgie. He enjoys the outdoors, adventure sports, waterskiing, ATVs, and snowmobiling.  Dr. Alexander serves the Lord as a deacon at Bible Baptist Church and is a strong supporter of international missions. About Dr. Alexander: Undergraduate Education Bachelor's of Science in Human Anatomy 1993-1996 Cedarville University 1996-1997 SUNY Empire State Graduate Education Doctor of Chiropractic High Honors ”Magna Cum Laude” 1996-1999 New York Chiropractic College Practice Experience Apple Country Chiropractic, PC Private Practice since 1999 Post Graduate Continuing Education Certification Certified Cox-Flexion-Decompression (2005) Whiplash: Acceleration/Deceleration Syndrome (1998) Resources: Contact Dr. Alexander Radiographic Outcomes of Immobilization using Boston Brace for Pediatric Spondylolysis Elastic Lumbar Support Versus Rigid Thoracolumbar Orthosis for Acute Pediatric Spondylolysis: A Prospective Controlled Study Find a Back Doctor The Cox 8 Table by Haven Medical  

In this episode, the host Jeffrey Besecker delves into the topic of pain and suffering and how they contribute to personal growth. It challenges the belief that growth can only occur through pain and discomfort, suggesting that growth can also happen in states free of suffering. The guest, John Eli Garay, shares insights on how to navigate the complexities of the autonomic nervous system and achieve emotional self-regulation.  John offers guidance on understanding and navigating the autonomic ladder, emphasizing the importance of self-regulation and embracing security. He explains how our bodies store information from past experiences and how the autonomic nervous system helps us identify sources of safety or danger.  The episode explores the role of emotional self-regulation and finding a balance of homeostasis where our inner light can shine. Tune in to learn more about embracing growth and evolution without being overwhelmed by emotional triggers.  Timestamp: [00:03:28] Trauma and the body. [00:07:43] The role of neuroception. [00:09:00] Flavors of our stories. [00:14:19] Autonomic Nervous System Responses. [00:18:30] Immobilization in dorsal vagal state. [00:23:50] Overachievers in sympathetic state. [00:27:17] Action biases as a heuristic. [00:31:24] Conflict and social media. [00:35:25] Emotional intelligence and self-awareness. [00:41:43] The ventral vagal response. [00:45:07] Intuitive awareness of triggers. [00:50:35] Emotional regulation and cleaning. [00:52:30] Triggering past memories. [00:57:11] Cognitive behavioral theory vs polyvagal theory. [01:01:10] Somatic experiences and conscious awareness. Credits: JOIN US ON INSTAGRAM: @thelightinsidepodcast SUBSCRIBE: pod.link/thelightinside Featured Guests:  John Eli Garay Credits: Music Score by Epidemic Sound Executive Producer: Jeffrey Besecker Mixing, Engineering, Production, and Mastering: Aloft Media Studio Senior Program Director:  Anna Getz --- Support this podcast: https://podcasters.spotify.com/pod/show/thelightinside/support

Break the Anxiety Cycle in 30 Days- Online Course- https://courses.therapyinanutshell.com/anxietyskills What keeps us anxious? -Running from our feelings -Avoiding our problems and -Immobilization- not taking any action. Anxiety isn't the same as a hot fear response, it's much more of a cold, frozen dread response. On the polyvagal ladder it hovers between the FFF response and the shut down response. Looking for affordable online counseling? My sponsor, BetterHelp, connects you to a licensed professional from the comfort of your own home. Try it now for 10% off your first month: https://betterhelp.com/therapyinanutshell Learn more in one of my in-depth mental health courses: https://courses.therapyinanutshell.com Support my mission on Patreon: https://www.patreon.com/therapyinanutshell Sign up for my newsletter: https://www.therapyinanutshell.com Check out my favorite self-help books: https://kit.co/TherapyinaNutshell/best-self-help-books  Therapy in a Nutshell and the information provided by Emma McAdam are solely intended for informational and entertainment purposes and are not a substitute for advice, diagnosis, or treatment regarding medical or mental health conditions. Although Emma McAdam is a licensed marriage and family therapist, the views expressed on this site or any related content should not be taken for medical or psychiatric advice. Always consult your physician before making any decisions related to your physical or mental health. In therapy I use a combination of Acceptance and Commitment Therapy, Systems Theory, positive psychology, and a bio-psycho-social approach to treating mental illness and other challenges we all face in life. The ideas from my videos are frequently adapted from multiple sources. Many of them come from Acceptance and Commitment Therapy, especially the work of Steven Hayes, Jason Luoma, and Russ Harris. The sections on stress and the mind-body connection derive from the work of Stephen Porges (the Polyvagal theory), Peter Levine (Somatic Experiencing) Francine Shapiro (EMDR), and Bessel Van Der Kolk. I also rely heavily on the work of the Arbinger Institute for my overall understanding of our ability to choose our life's direction. And deeper than all of that, the Gospel of Jesus Christ orients my personal worldview and sense of security, peace, hope, and love https://www.churchofjesuschrist.org/comeuntochrist/believe If you are in crisis, please contact the National Suicide Prevention Hotline at https://suicidepreventionlifeline.org or 1-800-273-TALK (8255) or your local emergency services. Copyright Therapy in a Nutshell, LLC

Date: July 21, 2023 Reference: McDonald et al. Patterns of change in prehospital spinal motion restriction: a retrospective database review. AEM July 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM. Case: A 42-year-old […] The post SGEM#411: Heads Won't Roll – Prehospital Cervical Spine Immobilization first appeared on The Skeptics Guide to Emergency Medicine.

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.01.28.526043v1?rss=1 Authors: Dvinskikh, L., Sparks, H., Brito, L., MacLeod, K. T., Harding, S. E., Dunsby, C. Abstract: Improving cardiac function through stem-cell regenerative therapy requires functional and structural integration of the transplanted cells with the host tissue. Visualizing the electromechanical interaction between native and graft cells necessitates 3D imaging with high spatio-temporal resolution and low photo-toxicity. A custom light-sheet fluorescence microscope was used for volumetric imaging of calcium dynamics in co-cultures of adult rat left ventricle cardiomyocytes and human induced pluripotent stem cell-derived cardiomyocytes. Aberration-free remote refocus of the detection plane synchronously to the scanning of the light sheet along the detection axis enabled fast dual-channel 3D imaging at subcellular resolution without mechanical sample disturbance at up to 8 Hz over a {approx}300 m x 40 m x 50 m volume. The two cell types were found to undergo electrically stimulated and spontaneous synchronized calcium transients and contraction. Electromechanical coupling was found to improve with co-culture duration, with 50% of adult-CM coupled after 24 hours of co-culture, compared to 19% after 4 hours (p = 0.0305). Immobilization with para nitroblebbistatin did not prevent calcium transient synchronization, with 35% and 36% adult-CM coupled in control and treated samples respectively (p = 0.91), indicating that electrical coupling can be maintained independently of mechanotransduction. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Darting animals present significant challenges, whether moose or deer, cougars or bears. The effects of the chase could be done by helicopter on foot or in the back of a truck puts a lot of stress on the animals. The opioid that is injected into their body then decreases their respiratory rate which increases the chance of hyperthermia and elevated body temperature that can last up to 40 hrs.   Thompson, D.P. et al. (2020) “Acute thermal and stress response in Moose to chemical immobilization,” The Journal of Wildlife Management, 84(6), pp. 1051–1062. Available at: https://doi.org/10.1002/jwmg.21871.   Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/paul-yudin/your-adrenaline License code: QWS1TG5BYTFK2PCL

What Causes Frozen Shoulder?It is not known exactly what causes this condition. Immobilization of the shoulder (after an arm injury, for instance) can lead to a frozen shoulder. Inflammation of the muscles and/or tendons, as with rotator cuff tendinitis or bursitis, can also cause the shoulder joint to become frozen. The glenohumeral joint is surrounded by muscles and tendons and held together by ligaments. When the balance between the ligaments, tendons, and muscles is interrupted the tissue form what are called adhesions. Adhesions turn fascia, the covering of the muscles into raisins. Raisins? Are you crazy?What's am Adhesion?Adhesions are easy to visualize as raisins. Muscle tissue should resemble grapes. When the fascia becomes irritated the covering shrivels up and causes pain that would limit motion. The more something hurts the less likely you are to use it. Adhesions in my estimation are a big cause of adhesive capsulitis. Like any muscles that are not used they will atrophy. So now when I mention atrophy the raisin-to-grape analogy would make more sense. There are many nerves in the fascia which is another reason shoulder pain due to adhesions is so painfulMuscles That Cause Frozen ShoulderIf you have had trauma to your shoulder there can be other muscles involved. What I am going to tell you is that there are 4 primary muscles involved in adhesive capsulitis. BY addressing these muscles first we find the most success in treating shoulder pain.SubscapularisThe Subscapularis the muscle found in front of your scapula internally rotates the humerus and brings it closer to the midline of the body. It also protects the shoulder from moving out of place in a forward direction.The Latissimus DorsiThe latissimus dorsi is responsible for a lot of things. It helps to stabilize your pelvis, it goes all the way down from your shoulder to your lumbar spine. The lats play an extremely important role in stabilizing the neck, shoulder, back, and hips. Think of the latissimus as the anchor of your back. An unstable shoulder needs to be rectified when you have a frozen shoulder.The Middle DeltoidOf the three Deltoid muscles,the Middle Deltoid is the one we see most often involved with cases of frozen shoulder. There are three heads of the deltoid muscle group. They help lift the arm front, side, and backward. The anterior and posterior portions are stronger and are usually safe from strains. It is interesting to note that the deltoid muscle is the largest arm muscle there is, even larger than the pectoralis muscles. The supraspinatus is most commonly injured because there are three different positions where it can become compressed. Overuse of the shoulder can cause the muscle and tendons to become inflamed.  The supraspinatus stabilizes the shoulder joint by keeping the head of the humerus firmly pressed medially against the glenoid fossa of the scapula. The supraspinatus moves the shoulder inwards and allows you to lift the arm. When we treat frozen shoulder we typically start by working the supraspinatus.Core Health Darien treats frozen shoulders by lengthening and strengtThis podcast welcomes your feedback here are several ways to reach out to me. If you have a topic you would like to hear about send me a message. I appreciate your listening. Dr. Brian Mc Kayhttps://twitter.com/DarienChiro/https://www.facebook.com/ChiropractorBrianMckayhttps://chiropractor-darien-dr-brian-mckay.business.sitehttps://podcasts.apple.com/us/podcast/not-just-chiropractor-for-stamford-darien-norwalk-new/id1503674397?uo=4

Listen to Andrew Duckworth, Nick Johnson and Joseph Dias discuss the paper 'One-year outcome of surgery compared with immobilization in a cast for adults with an undisplaced or minimally displaced scaphoid fracture' published in the August 2022 issue of The Bone & Joint Journal.Click here to read the paper.Find out as soon as the next episode is live by following us on Twitter, Instagram, LinkedIn or Facebook!

Lexman interviews Albert Bourla, a stamp collector and fluorimeter technician. They discuss Bourla's expertise in the field, as well as the risks and benefits of using fluorometers. They also talk about pyrostat immobilizations and the puma, a wildcat cat species in danger of extinction.

A lengthy period of immobilization can really get you behind after knee surgery. Here's some ways to regain any lost mobility into flexion. The post Regaining Knee Flexion Motion After Immobilization appeared first on Mike Reinold.

We all learned it.We've all done it.And we (mostly) all know that it's wrong.Dr. Seth Collings Hawkins joins Trevor and Claire to discuss spinal immobilization. Rigid immobilization of trauma patients is entrenched dogma, but we've probably all heard that this procedure is not just without benefit, but is in fact harmful to our patients. Dr. Collings Hawkins is a leader in the wilderness EMS community, and he breaks down the reality of spinal immobilization and how we can all do better. Listen up as he talks about the history of this intervention, discusses appropriate uses for the rigid backboard and c-collar, and then shows how we can do better. This is important information for everyone to hear, from new medics to experienced flight surgeons. Have a listen and let us know what you think!

With high fertilizer prices, ongoing drought, and potential for nitrogen carryover from the 2021 season, it is important we assess nitrogen is available in the soil for the 2022 growing season. Dr. Don Flaten (Retired University of Manitoba professor) and John Heard (Soil fertility specialist with the Government of Manitoba) provide insight into how mineralization and immobilization play a role in your nitrogen fertility plan. Hint: your expected nitrogen release value may not be as reliable as you think!

Join host Dr. Sonny Konda as he discusses the Notable Paper Comparing Long-Leg and Short-Leg Cast Immobilization with author Dr. Christopher Souder. This paper was presented at the OTA 2021 Annual Meeting.   For additional educational resources visit: https://ota.org/

Its trauma-time: should we immobilize for only one week in conservative proximal humerus fracture treatment? According to the author Carlos Torrens (Spain) we can do so. In this interview we are with our SECEC expert and Co-moderator Mehmet Demirhan (Turkey). The intro and outro including some thoughts on this interesting topic was taken with Gregory Cunningham from Switzerland. Happy listening !Music under CC-license from: "Something Elated" Artist: Broke for free"Breakfast with Tiffany" Artist: Broke for free"Modestly Rude" Artist: Nobuo3000"Fond" Artist: Monplaisirwww.freemusicarchive.org

Season 3 - SecrecyThis episode focuses on the period that follows preparation and purification, which for Siddha based practices is known as immobilization. It turns out that the subtle sexual essences humans produce are also homologs of breath and mind. Breath, Mind, and Seed tend to evaporate and disperse quickly and must be caught and held in one place in order for the transformational process to proceed. The classic techniques of asana, pranayama, bandha, mudra etc are discussed as the means that drive this process. -Support our podcast on patreon: Patreon.com/circleyogashalaReceive early access to podcasts, Matt's notes: a printable study guide, Yoga in Action publication subscriptions, Ask Matt quarterly zoom calls, discounts on retreats, and more!Learn more about our trainings and programs: www.circleyogashala.comIn this episode we talk about:Immobilization - the period that follows preparation and purification for Siddha based practicesThe connection of Breath, Mind, and Seed with the transformational processThe classic techniques of asana, pranayama, bandha, mudra as the means that drive that process

Welcome to The Awareness Space and our short psycho education sound bites. Wellbeing information in under 5 minutes -- Today we share an instagram blog post from Mily Gomez of Latibule Counseling. The podcast shares about the shutdown and dorsal vagal response to trauma. Looking at how the parasympathetic nervous system takes control. Is there a way to help ourselves out of a shutdown state? -- This content was written by Counselor and Trauma Therapist Mily Gomez, NCC, LPC of Latibule Counseling. As always please read the disclaimer in the description of podcast and also put yourself first -- Mily Gomez, NCC, LPC - Counselor and Trauma Therapist Based in Yuma, Arizona, USA. Website www.latibulecounseling.com  Facebook @latibulecounseling  Instagram @latibulecounseling  info in English and @psicologiasomatica  info in Spanish -- For more on us visit www.theawarenessspace.com -- If you are in need of support regarding anything you have seen here today then please contact the support services listed below. You can also visit our directory of content providers who also offer a range health and wellness treatments, therapies and classes. Please contact a health professional if you need help -- UK The Samaritans - https://www.samaritans.org/  Mind - The Mental Health Charity - https://www.mind.org.uk/  -- USA National Suicide Prevention Hotline: 1 (800) 273-8255 National Domestic Violence Hotline: 1 (800) 799-7233 LGBT Trevor Project Lifeline: 1 (866) 488-7386 National Sexual Assault Hotline: 1 (800) 656-4673 Crisis Text Line: Text “HOME” to 741741 -- Australia Helplines and online support https://www.mhc.wa.gov.au/getting-help/helplines -- Downloadable Resources Prevent Suicide - Grassroots https://www.prevent-suicide.org.uk/ -- More afforadable Online Counseling https://www.betterhelp.com/about/ -- Our thanks to... Thank you to Storyblocks Video & Creators - https://www.videoblocks.com/  for all the video footage featured in this production -- VIDEO DISCLAIMER - PLEASE READ BEFORE LISTENING.... Welcome to The Awareness Space and today we share a instagram blog written by Counselor and Trauma Therapist Mily Gomez, NCC, LPC of Latibule Counseling. As always please read the disclaimer in the description of podcast and also put yourself first as the following content may bring things up for you that feel uncomfortable. Look after you and take a break from the podcast if you need too. The podcasts on this channel and it's content are not a substitute for the support and guidance of a qualified health professional. We are here to share information that may be useful to our viewers and we hope you enjoy. Links to organizations that can support you are in the description. The content taken from books, blogs and articles for this video are designed to showcase the information and does not mean the authors or writers are affiliates of The Awareness Space. The views, opinions and theories shared via this podcast, channel and TAS as a whole do not representative of the individual views, opinions and beliefs of the narrators, producers or creators and of this channel and movement as a whole. All visual and musical content on this video is sourced from storyblocks video and storyblock audio, we thank all the musical artists & filmmakers for their creative content. No one featured in the video is an affiliate of TAS and all part of the original creator's project.

Welcome to Sports Med Res’ this week in review podcast where we highlight the news in sports medicine research from the week ending on April 16, 2021. This week’s podcast focused on treating a first-time anterior shoulder dislocation. * Immobilization vs. Surgery – Is it Worth Going Under the Knife? * Metrics of OsteoChondral Allografts (MOCA) Group Consensus Statements on the Use of Viable Osteochondral Allograft * Consensus Definition of Sport Specialization in Youth Athletes Using a Delphi Approach * Clinical Practice Guidelines: Lateral Ankle Ligament Sprains * ACSM Expert Consensus Statement on Weight Loss in Weight-Category Sports * Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values RSS Feed, Apple Podcasts, or Google Podcast Evidence-Based CEU Courses from Sports Med Res and Human Kinetics (3-10 EBP CEUs/course) The post First Time Shoulder Dislocations: Surgery or Immobilization? appeared first on Sports Medicine Research.

Good Morning Veterans, Family, and Friends, welcome back to the FOURTEENTH EPISODE of the Veteran Doctor. On this week's podcast, we will discuss PTSD and Tough Months. We will also continue our fun facts of UBI (Useful Bits of Information) and Veteran News, so stick around for the program! Different times of the year become very busy for many people, but for many veterans this can cause tough times when many barriers develop with many different obstacles like Post Traumatic Stress Disorder. Many people have limited knowledge on this issue, except for what the media portrays it as, which is virtually untrue. Here are some facts to educate you on this disorder that challenges many veterans and can give you some knowledge to help these veterans in many ways. Understanding PTSD in veterans Many veterans have a hard time readjusting to life outside of the military. Many always feel on edge, emotionally numb and disconnected, or close to panicking or exploding. For all too many veterans, these are common experiences—lingering symptoms of post-traumatic stress disorder (PTSD). It’s hard living with untreated PTSD and, with long Veterans Affairs (VA) wait times, it’s easy to get discouraged. But many can feel better and get started today, even while waiting for professional treatment, by being proactive and educating themselves on the disorder itself and things to help relieve symptoms. What causes PTSD? Post-traumatic stress disorder (PTSD), sometimes known as shell shock or combat stress, occurs after you experience severe trauma or a life-threatening event. It’s normal for a veteran’s mind and body to be in shock after such an event, but this normal response becomes PTSD when their nervous system gets “stuck.” A Veterans nervous system has two automatic or reflexive ways of responding to stressful events: Mobilization, or fight-or-flight, occurs when you need to defend yourself or survive the danger of a combat situation. Your heart pounds faster, your blood pressure rises, and your muscles tighten, increasing your strength and reaction speed. Once the danger has passed, your nervous system calms your body, lowering your heart rate and blood pressure and winding back down to its normal balance. Immobilization occurs when you’ve experienced too much stress in a situation, and even though the danger has passed, you find yourself “stuck.” Your nervous system cannot return to its normal state of balance, and you’re unable to move on from the event. This is PTSD. Recovering from PTSD involves transitioning out of the mental and emotional war zone you’re still living in and helping your nervous system become “unstuck.” Symptoms of PTSD in veterans While veterans develop symptoms of PTSD in the hours or days following a traumatic event, sometimes symptoms don’t surface for months or even years after you return from deployment. While PTSD develops differently in each veteran, there are four symptom clusters: Recurrent, intrusive reminders of the traumatic event, including distressing thoughts, nightmares, and flashbacks, where you feel like the event is happening again. You may experience extreme emotional and physical reactions to reminders of the trauma, such as panic attacks, uncontrollable shaking, and heart palpitations. Extreme avoidance of things that remind you of the traumatic event, including people, places, thoughts, or situations you associate with the bad memories. This includes withdrawing from friends and family and losing interest in everyday activities. Adverse changes in your thoughts and mood, such as exaggerated negative beliefs about yourself or the world and persistent feelings of fear, guilt, or shame. You may notice a diminished ability to experience positive emotions. Being on guard all the time, jumpy, and emotionally reactive, as indicated by irritability, anger, reckless behavior, difficulty sleeping, trouble concentrating, and hypervigilance. Here are some resources or ideas to help veterans experiencing PTSD events or having issues. Help for Veterans Life in the military has taught you to be strong in the face of some of life's most challenging obstacles. It's also taught you to expect the unexpected. As a veteran, you know hardships can happen in every corner of life. If you or someone you know needs support, your military family is committed to helping. Assistance is at hand. Non-medical counseling for veterans When life throws you a curveball, you might need to talk to someone who gets it. Veterans have several options for confidential non-medical counseling. To receive non-medical counseling from Military OneSource as a veteran, you must be within 365 days of separation from the military. The U.S. Department of Veterans Affairs offers the Vet Center Program that provides quality readjustment counseling. If you have served in any combat zone, you and your family are eligible. Vet Centers can be found all across the U.S. Risk factors and treatment for Post-Traumatic Stress Disorder People who live through a traumatic event sometimes suffer its effects long after the danger has passed. Several factors play a role in developing Post-Traumatic Stress Disorder, so there is no way to know who will or won’t experience it. The good news is treatment is available, and early treatment may help reduce long-term symptoms. Alcohol and substance abuse programs While anyone can be at risk of alcohol and substance abuse, there are several aspects of military life that can trigger it. Understand the signs of a substance abuse problem. If you find yourself or know someone repeatedly engaging in activities that have a negative impact on your life, you might be engaging in addictive behavior. Learn more about the signs. You can also find support through Alcoholics Anonymous and other similar programs. To find a program near you, call SAHMSA's National Helpline at 800-662-4357 or find treatment centers online. The VA provides effective treatment services for all eligible veterans. Options include therapy as well as medications in some cases. To get help, speak with your existing VA healthcare provider or call 800-827-1000. Housing assistance and help for homeless veterans Delinquency and assistance for housing loans Veterans at risk of becoming homeless can always call or visit their local VA medical center or Community Resource and Referral Center for assistance. Veteran homelessness The VA, in collaboration with other government offices and partners, offers programs such as Supportive Housing, Homeless Provider Grants, Enhanced-Used Lease, and Acquired Property Sales for Homeless Providers. Help for suicide prevention If you’re having suicidal thoughts or you're concerned about a loved one, don't hesitate. Have a confidential talk with a professional who knows how to help. The Veterans Crisis Line is always open. Call: 1-800-273-8255 then Press 1. Call for help or chat online 24/7 at no cost. Speak to qualified Veteran Affairs responders who understand the challenges of military life. They know — many are veterans themselves. Since its launch in 2007, the Veterans Crisis Line has answered nearly 2.4 million callers and engaged in almost 294,000 chats. The Defense Suicide Prevention Office is committed to developing suicide prevention efforts among all military services stakeholders. From best practices to resources for family and friends, help is available. Every veteran is valuable and deserves our support. As a military family, we're committed to supporting veterans' strength and resilience. Don't hesitate to reach out and get the care you need or for someone you know. Conclusion There is no bigger gift than the gift of caring for another veteran in need. So, if you see a fellow brother/sister that is a little down on his/her luck, give him/her a helping hand, guidance, knowledge, anything that may just give him/her a boost that will get them through that tough time. I know they will appreciate it more than you know. They would do the same for you if you were in need.

Welcome back to the VTE Dublin Podcast where you’ll find all the recent talks from the VTE Dublin Conference. Be sure to subscribe to the VTE Dublin Podcast VTE Prevention following lower limb immobilization Mr Jonathan Keenan | Consultant Orthopaedic and Trauma Surgeon | Dept of Surgery | University Hospitals Plymouth NHS Trust Video: Audio: […]

Pasi overcomes a train injury while Rios prepares for the fire that Randy doesn't believe in then all 3 of them pitch in on a permanent decision about Rios's body. Alternate titles include: "The Sound of Immobilization" "Limped Right Into That One" and "Hog on a Hog"

This conversation with Palmer Kippola, a functional health coach who underwent her own battle with a debilitating autoimmune condition -- multiple sclerosis -- but came out on top of it, with no active disease present in her body today. We talk about the question that sparked her journey of experimentation, trial and error, and ultimately of learning and healing. Palmer shares her perspective on how the medical system’s approach to autoimmune conditions is changing led by patients themselves, explains in layman’s terms why autoimmune diseases occur in the body in the first place and the various aspects that contribute to development of such a condition, and highlights that now is one of the best times in history to beat an autoimmune condition. She invites and encourages the listener continuously throughout this episode, through her positive, open-dialogue approach. We hope you enjoy listening to this conversation as much as we enjoyed having it!Palmer Kippola is a #1 Amazon best-selling author, speaker, autoimmune reversal and prevention advocate, and Functional Medicine Certified Health Coach (FMCHC). Palmer developed a system called F.I.G.H.T.S.™ to help others beat autoimmune conditions based on her 26-year battle to overcome multiple sclerosis.You can check out Palmer Kippola’s website here, and read more about her “Beat Autoimmune” book here.

**WARNING: YOU MUST BE 18 YEARS OF AGE OR OLDER TO ENJOY THIS CONTENT**In this episode, we enjoyed another round of Layered Kinks. This is a game we made up where we choose 5 kinky playing cards (coming to an Etsy shop sometime soon), negotiate down to 3 cards, and then put the kinks together into one scene. The purpose of this game is to ensure we challenge ourselves and to avoid stagnation. So if you're wondering how I ended up with sushi in my ass crack, press Play and enjoy! Episode mentioned: Ep 11 - Mummification: Let's Try It! Wax used: https://etsy.com/shop/NotoriousToys· Check out our website at kinkyintroverts.com · You can also find us on Spotify, Stitcher, iTunes, Castbox, Google Podcasts, iHeartRadio, Podbay, Listen Notes, and more. · Primary podcast: Kinky Introverts - BDSM at Home · Mini podcast: Kinky Introverts - Screams, Moans, and Train Shots · Email us at kinkyintroverts@gmail.com · Or leave us a voicemail at *67-203-807-KINK (5465) · Our socials are FetLife, Twitter, Instagram, and Reddit · Creative Commons Music by Jason Shaw on Audionautix.comSupport the show (https://www.patreon.com/kinkyintroverts)

Martin KD, McBride T, Unangst A, Chisholm J. Prospective Study of Military Special Operations Medical Personnel and Lower Extremity Fracture Immobilization in an Austere Environment. Foot Ankle Ortho; 2020,5(2):1-6. https://doi.org/10.1177/2473011420916144

In this episode, we review the high-yield topic of Halo Orthosis Immobilization from the Spine section. --- Send in a voice message: https://anchor.fm/orthobullets/message

This podcast is part of the 2019 NSH Symposium/Convention Poster Podcast Series. To read the full abstract, visit the Block.   Authors: Carlos Genty, BS, HT(ASCP)QIHC, Critical X, Houston, Texas; Timothy McDonnell, MD, Ph.D., Critical X, Houston, Texas    

As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level.  We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable.  There is, however, no substitute for reviewing the new protocols you will be exercising in depth. It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves. New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.  Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation.  Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care.  Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.  

3D printing is the most significant advance in fracture immobilization in decades and Exiom has the best solution. Listen to this "live" interview with the CEO of Exiom, Erik Paul. You will get the inside scope on the origins of the technology to grass roots commercialization here in the US. Software makes a better cast or brace for your child or loved one. You will start to see these in Emergency rooms everywhere. https://www.exiom.com/ --- Support this podcast: https://anchor.fm/tigerbuford/support

The following is a short list of salient points related to the podcast and the corresponding source literature. As always, read the source literature and critically appraise it for yourself. Take none of the following as a substitution for local protocol or procedure. 2018 NAEMSP Spinal Immobilization paper https://naemsp.org/resources/position-statements/spinal-immobilization/ Securing a patient to the stretcher mattress significantly reduces lateral motion: Am J Emerg Med. 2016 Apr;34(4):717-21. doi: 10.1016/j.ajem.2015.12.078. Epub 2015 Dec 30. C-Collar limits visible external motion in the intact spine, but not internal motion in the unstable injured spine: Horodyski M, DiPaola CP, Conrad BP, Rechtine GR 2nd. Cervical collars are insufficient for immobilizing an unstable cervical spine injury. J Emerg Med. 2011 Nov;41(5):513-9. doi: 10.1016/j.jemermed.2011.02.001. Epub 2011 Mar 12. PubMed PMID: 21397431. C-Collar increases ICP: Davies G, Deakin C, Wilson A. The effect of a rigid collar on intracranial pressure. Injury. 1996 Nov;27(9):647-9. PubMed PMID: 9039362. C-Collar causes distraction of unstable C-spine: Ben-Galim P, Dreiangel N, Mattox KL, Reitman CA, Kalantar SB, Hipp JA. Extrication collars can result in abnormal separation between vertebrae in the presence of a dissociative injury. J Trauma. 2010 Aug;69(2):447-50. doi:10.1097/TA.0b013e3181be785a. PubMed PMID: 20093981. Lador R, Ben-Galim P, Hipp JA. Motion within the unstable cervical spine during patient maneuvering: the neck pivot-shift phenomenon. J Trauma. 2011 Jan;70(1):247-50; discussion 250-1. doi: 10.1097/TA.0b013e3181fd0ebf. PubMed PMID: 21217496. Spinal immobilization negatively impacts the physical exam: March J et al. Changes In Physical Examination Caused by Use of Spinal Immobilization. Prehosp Emerg Care 2002; 6(4): 421 – 4. PMID: 12385610 Chan D, Goldberg R, Tascone A, Harmon S, Chan L. The effect of spinal immobilization on healthy volunteers. Ann Emerg Med. 1994 Jan;23(1):48-51. PubMed PMID: 8273958. Chan D, Goldberg RM, Mason J, Chan L. Backboard versus mattress splint immobilization: a comparison of symptoms generated. J Emerg Med. 1996 May-Jun;14(3):293-8. PubMed PMID: 8782022. Even Manual In Line Stabilization alone increased difficulty during intubation and increases forces applied to the neck: Thiboutot F, Nicole PC, Trépanier CA, Turgeon AF, Lessard MR. Effect of manual in-line stabilization of the cervical spine in adults on the rate of difficult orotracheal intubation by direct laryngoscopy: a randomized controlled trial. Can J Anaesth. 2009 Jun;56(6):412-8. doi: 10.1007/s12630-009-9089-7. Epub 2009 Apr 24. PubMed PMID: 19396507. Santoni BG, Hindman BJ, Puttlitz CM, Weeks JB, Johnson N, Maktabi MA, Todd MM. Manual in-line stabilization increases pressures applied by the laryngoscope blade during direct laryngoscopy and orotracheal intubation. Anesthesiology. 2009 Jan;110(1):24-31. doi: 10.1097/ALN.0b013e318190b556. PubMed PMID: 19104166. Spinal immobilization makes it harder to breath and decreases forced expiratory volume: “...produce a significantly restrictive effect on pulmonary function in the healthy, nonsmoking man.” Chan, D., Goldberg, R., Tascone, A., Harmon, S., & Chan, L. (1994). The effect of spinal immobilization on healthy volunteers. Annals of Emergency Medicine, 23(1), 48–51. https://doi.org/10.1016/S0196-0644(94)70007-9 Schafermeyer RW, Ribbeck BM, Gaskins J, Thomason S, Harlan M, Attkisson A. Respiratory effects of spinal immobilization in children. Ann Emerg Med. 1991 Sep;20(9):1017-9. PubMed PMID: 1877767. Totten VY, Sugarman DB. Respiratory effects of spinal immobilization. Prehosp Emerg Care. 1999 Oct-Dec;3(4):347-52. PubMed PMID: 10534038. Prehospital providers can effectively apply selective immobilization criteria without causing harm: Domeier, R. M., Frederiksen, S. M., & Welch, K. (2005). Prospective performance assessment of an out-of-hospital protocol for selective spine immobilization using clinical spine clearance criteria. Annals of Emergency Medicine, 46(2), 123–131. https://doi.org/10.1016/j.annemergmed.2005.02.004 Out of 32,000 trauma encounters, a prehospital clearance protocol resulted in ONE patient with an unstable injury that was not immobilized. This patient injured her back one week prior, required fixation, but had no neurological injury: Burton, J.H., Dunn, M.G., Harmon, N.R., Hermanson, T.A., and Bradshaw, J.R. A statewide, prehospital emergency medical service selective patient spine immobilization protocol. J Trauma. 2006; 61: 161–167 Ambulatory patients self extricating with a cervical collar results in less cervical spine motion than with the use of a backboard: Shafer, J. S., & Naunheim, R. S. (2009). Cervical Spine Motion During Extrication: A Pilot Study. Western Journal of Emergency Medicine, 10(2), 74–78. https://doi.org/10.1016/j.jemermed.2012.02.082 Engsberg JR, Standeven JW, Shurtleff TL, Eggars JL, Shafer JS, Naunheim RS. Cervical spine motion during extrication. J Emerg Med. 2013 Jan;44(1):122-7. doi:10.1016/j.jemermed.2012.02.082. Epub 2012 Oct 15. PubMed PMID: 23079144 Lift and slide technique is superior to log roll: Boissy, P., Shrier, I., Brière, S. et al. Effectiveness of cervical spine stabilization techniques. Clin J Sport Med. 2011; 21: 80–88 Despite there not being any randomized control trials evaluating spinal immobilization, patients transferred to hospitals immobilized have more disability than those transported without immobilization: Hauswald, M., Ong, G., Tandberg, D., and Omar, Z. Out-of-hospital spinal immobilization: its effect on neurologic injury. Acad Emerg Med. 1998; 5: 214–219 “Mechanism of injury does not affect the ability of clinical criteria to predict spinal injury” Domeier, R.M., Evans, R.W., Swor, R.A. et al. The reliability of prehospital clinical evaluation for potential spinal injury is not affected by the mechanism of injury.Prehosp Emerg Care. 1999; 3: 332–337 Spinal immobilization in penetrating trauma is associated with an increased risk of death: Vanderlan, W.B., Tew, B.E., and McSwain, N.E. Jr. Increased risk of death with cervical spine immobilisation in penetrating cervical trauma. Injury. 2009; 40: 880–88 Stuke, L.E., Pons, P.T., Guy, J.S., Chapleau, W.P., Butler, F.K., and McSwain, N.E.Prehospital spine immobilization for penetrating trauma-review and recommendations from the Prehospital Trauma Life Support Executive Committee. J Trauma. 2011; 71: 763–769 “The number needed to treat with spine immobilization to potentially benefit one patient was 1,032. The number needed to harm with spine immobilization to potentially contribute to one death was 66.” Haut, E.R., Kalish, B.T., Efron, D.T. et al. Spine immobilization in penetrating trauma: more harm than good?. J Trauma. 2010; 68: 115–121 Vanderlan WB, Tew BE, Seguin CY, Mata MM, Yang JJ, Horst HM, Obeid FN, McSwain NE. Neurologic sequelae of penetrating cervical trauma. Spine (Phila Pa 1976). 2009 Nov 15;34(24):2646-53. doi: 10.1097/BRS.0b013e3181bd9df1. PubMed PMID: 19881402. Velopulos CG, Shihab HM, Lottenberg L, Feinman M, Raja A, Salomone J, Haut ER. Prehospital spine immobilization/spinal motion restriction in penetrating trauma: A practice management guideline from the Eastern Association for the Surgery of Trauma (EAST). J Trauma Acute Care Surg. 2018 May;84(5):736-744. doi:10.1097/TA.0000000000001764. PubMed PMID: 29283970. Use of LSB can cause sufficient pressure to create pressure ulcers in a short period of time: Cordell W:H, Hollingsworth JC, Olinger ML, Stroman SJ, Nelson DR. Pain and tissue-interface pressures during spine-board immobilization. Ann Emerg Med. 1995 Jul;26(1):31-6. PubMed PMID: 7793717. The natural progression of some C-spine injuries is to get worse, sometimes because we force them into immobilization devices, sometimes because of hypotension, vascular injury, or hypoxia, but surprisingly not because of EMS providers… Harrop JS, Sharan AD, Vaccaro AR, Przybylski GJ. The cause of neurologic deterioration after acute cervical spinal cord injury. Spine (Phila Pa 1976). 2001 Feb 15;26(4):340-6. PubMed PMID: 11224879. Reports of asymptomatic but clinically important spine injuries are, at best, dubious: McKee TR, Tinkoff G, Rhodes M. Asymptomatic occult cervical spine fracture: case report and review of the literature. J Trauma. 1990 May;30(5):623-6. Review. PubMed PMID: 2188001. Bresler MJ, Rich GH. Occult cervical spine fracture in an ambulatory patients. Ann Emerg Med. 1982 Aug;11(8):440-2. PubMed PMID: 7103163.

Mary is in a rollover MVC at freeway speeds. She self-extricated and insists she has no neck or back pain. Can we take Mary at face value or do we need to be concerned for a possible spinal cord injury and immobilize her?

Darren Braude and Karim Brohi battle it out in the #SMACCDub Cage Match 'It is time to throw away the hard cervical collar'.

Show me an intensivist that cares about bone! I do. Critical illness is detrimental to bone health for various reasons – profound vitamin D deficiency, extreme immobilisation, inflammation, excessive cytokine levels, malnutrition, endocrine dysfunction and medication all may lead to accelerated bone turnover and rapid bone loss. Today, many ICU patients are elderly, and therefore at substantial fracture risk even before critical illness. As an example, one year after a hip fragility fracture, 50 % of patients are either dead or independent. Bone health is therefore very important for morbidity and mortality of ICU survivors, adding up to the long-term sequelae after severe illness. Generally, osteoporosis remains underdiagnosed and therefore undertreated. On the other hand, recent evidence suggests that osteoporotic patients previously treated with a bisphosphonate may have a survival benefit compared to other patients. Furthermore, several publications in the last years showed that FGF-23, a phosphaturic, bone-derived hormone predicts outcome in the acute setting very accurately. Overall, the link between critical illness and bone is strong in both directions and will be discussed in this talk.

Welcome to the Power Plant Podcast! Know your enemy! In this episode we'll talk about Stress and ways to combat it through herbal nutrition. We discuss the physical effects of stress as well as the warning signs. We will discuss different ways to regulate the nervous system and recommend some powerful herbs and extracts to combat fatigue. In this episode we will be taking calls from John in New York, who has a high stress job and can't seem to turnoff the mental chatter after work hours. We'll also hear from Sharon in Washington DC, who also has a very demanding job and is looking for a natural way to combat stress. Last we will hear from Lucy in Portland who lost her job, has two kids and is looking for something to help with focus as well as combat stress.    This show is sponsored by Dr. Vim's Herbal Nutrition. Dr. Vim's herbal formulas are designed for men and women to  mental focus, physical energy, stress reduction and a healthy libido. They use only filler free high potency botanical extracts. ensuring that every batch delivers a full dose of the most powerful phytonutrients on the planet.    Podcast 2: Stress: 3 types of stress responses: Social Engagement Mobilization Immobilization   1. Social engagement - our most evolved strategy for keeping ourselves feeling calm and safe. Since the vagus nerve connects the brain to sensory receptors in the ear, eye, face and heart, socially interacting with another person can calm you down and deescalate a “fight-or-flight” type response. When using social engagement you can think clearly, and body functions such as digestion, the immune system, blood pressure, and heartbeat continue to work normally. 2. Mobilization -commonly referred to as "fight-or-flight" response. When social engagement is no longer an appropriate response and we need to either defend ourselves or run away from danger, the body prepares for mobilization. It releases hormones and neurotransmitters to provide the energy you need to protect yourself. When this happens, body functions such as digestive function and immune function, stop working. Under normal conditions, when the danger has passed your nervous system calms the body, the heart rate and blood pressure normalize, and the body goes back into balance. 3. Immobilization - the least evolved response to stress and used by the body only when social engagement and mobilization have failed. You may find yourself traumatized or frozen in an angry, panic-stricken or otherwise dysfunctional state. In extreme, life-threatening situations, you may even lose consciousness or find yourself enabled to survive high levels of physical pain. However, until you’re able to deescalate to a mobilization response, your nervous system may be unable to return to its pre-stress state of balance.   Inappropriate Stress Response!! While it’s not always possible to respond to stress using social engagement, many of us have become conditioned to responding to every minor stressor by immediately resorting to fight or flight. Since this response interrupts other body functions and clouds judgment and feeling, over time it can cause stress overload and have a detrimental effect on both your physical and mental health. Effects of stress overload The body’s autonomic nervous system often does a poor job of distinguishing between daily stressors and life-threatening events. For example: you have a mild, low level stress situation in life and have a stress response like you’re facing a life-or-death situation. When you repeatedly experience the fight or flight stress response in your daily life, it can raise blood pressure, suppress the immune system, increase the risk of heart attack and stroke, speed up the aging process and leave you vulnerable to a host of mental and emotional problems.   Health problems which are caused or exacerbated by stress include: Pain of any kind Heart disease Digestive problems Sleep problems Depression Weight problems Auto immune diseases Skin conditions, such as eczema   Common warning signs of chronic stress: Memory Problems Inability to concentrate Poor judgements Moodiness Sense of loneliness and isolation Depression or general unhappiness Aches and pains Digestive problems Nausea Chest pain or rapid heartbeat Loss of libido Weakened immune function Eating more or less Sleeping problems Substance abuse   Power Plants that promote a healthy stress response:   Energizing herbs for stress management 1. Ashwagandha - The flagship herb of Ayurveda supports healthy adrenal function, energy, and mental focus. Ashwagandha (KSM-66) has been clinically researched and is backed by several randomized, double-blind, placebo controlled human clinical trials to support a multitude of body function. Ashwagandha is one of the most versatile plants in existence and is a key herbal component in countless herbal stress formulas. 2. Rhodiola Rosea -A favorite among athletes and herbal practitioners, Rhodiola has a reputation as one of the world’s greatest mood and energy tonics.  It's unique array of phytochemicals have been researched for their ability to regulate critical neurotransmitters like dopamine and serotonin.  Rhodiola Rosea may help you manage stress, but it won't be sedating. 3. Ginseng (Chinese, Korean, and American) - There are 3 popular types of Ginseng used around the world; Chinese, Korean, and American.  Chinese Ginseng (Ren Shen) is considered the "king of herbs" in Traditional Chinese Medicine (TCM) and is celebrated as its' premier tonic herb.  It's active compounds, referred to as ginsenosides, are known to restore qi (pronounced "chi") or energy levels and to support a calm, alert mind. Korean Ginseng has similar properties. American Ginseng, known as the ‘Yin Ginseng’, has similar ginsenosides to its Chinese counterpart, although is traditionally viewed as a gentler tonic better suited to people with excess metabolic heat.  It can also help promote a relaxed, calm attitude among those prone to stress and overwork. 4. Holy Basil - one of the most celebrated plants in India, Holy Basil has been valued for centuries for benefiting the mind, body, and spirit.  This great tasting Ayurvedic has been researched for it's potential in the areas of stress relief and relaxation in recent times.  It's the perfect herb to help stay calm and cool in the fast-paced, modern era. 5. Eleuthero - Once thought to be a member of the Ginseng family and referred to as Siberian Ginseng, Eleuthero, is well known as one of the best adaptogenic agents ever used by man.  The epitome of an adaptogen, it supports decreased stress and fatigue while boosting energy and endurance.  Eleuthero is also used in formulas to support memory and concentration. 6. St. John's Wort- revered in Europe for it's ability to help cope with stress and support a positive outlook.  St. Johs's Wort is believed to promote serotonin, a key neurotransmitter thought to play a major role in the central nervous system and in maintaining mood balance.  7. Damiana - traditionally used as an aphrodisiac in Mexico, Damiana also has a reputation for relieving stress and anxiety. Damiana is relatively easy to find, makes a great herbal infusion, and blends well with other herbs.    Calming herbs for stress management 1. Lemon Balm - a member of the mint family, this calming herb has been used in Europe, the Mediterranean, Northern Africa, and India for thousands of years because of it's myriad benefits.  The rosemarinic acids present in Lemon Balm are believed to boost levels of GABA, a calming neurotransmitter, in the brain. Elevated GABA levels are thought to reduce the level of anxiety. 2. Lavender -one of the most common herbs or oils used for stress relief, Lavender has been used for centries for restlessness, sleep problems, nervousness, and mood balancing.  It has a fabulous aroma, tastes great, and blends well with other herbs like Lemon Balm and Chamomile. 3. Wild Milky Oats -rich in B vitamins, potassium, and magnesium Wild Milky Oats are thought to be soothing to the brain and nervous system, while at the same time being restorative to the adrenal glands and nerves.  It's the perfect herb to use to relax and calm the nerves and to tonify the endocrine system. 4. Skullcap Herb - an herb found in countless sleep and stress formulas, Skullcap Herb is believed to help combat mental chatter and relax the mind  and calm the nerves to provide a calm focus.  Some people use it before bedtime to mitigate feelings of agitation and nervous tension. 5. Chamomile - documentation of the herb for its therapeutic benefits goes back over 5000 years, and today it is still one of the most commonly consumed herbs on the planet. Chamomile tea and extracts of Chamomile are frequently used as a mild sedative to calm nerves and reduce anxiety, to help with nightmares and other sleep problems.  6. Peppermint - A common herb that you may even have in your garden, Peppermint has been steeped for hundreds of years to cool the body, calm the nerves, and help the body relax. Peppermint is the perfect herb to relax with during those hot summer evenings. 7. Magnolia -used in Chinese medicine for hundreds of years, Magnolia is believed to help manage stress by keeping the stress hormone, cortisol, in check.  It has also been shown to increase levels of GABA, a calming neurotransmitter, in mice.  It is commonly found in herbal sleep an stress formulas.  8. Passion Flower - Native to southeastern parts of the Americas, Passionflower is now grown throughout Europe and in the United States.  It has been used historically as a calming herb for anxiety, insomnia, seizures, and hysteria and is still used today to alleviate anxiety and insomnia. Scientists believe Passionflower works by increasing levels of GABA, a calming neurotransmitter, in the brain.  Although it can be used as a stand alone herb, it commonly found in herbal infusions with other herbs such as Valerian, Lemon Balm, and Chamomile to promote sleep or relaxation. 9. L - Theanine - not an herb per se, L - Theanine is an amino acid found in green and black teas. It's famous for it's ability to promote alphawave activity in the brain resulting in a feeling of relaxation and mental clarity.  L-Theanin is an excellent choice for stress support, focus, or calming down before bedtime. 10. Kava Kava -  a plant native to the western Pacific islands, Kava was consumed in ceremonies to promote relaxations.  Today, it is still commonly used to help calm anxiety, stress, and restlessness, and to treat sleeping problems. It is important to research Kava before using it, especially if you have a history of liver problems, because it has been associated with liver problems in the past.      Key Word Definitions:  Adaptogen - a nontoxic substance and usually a plant extract that is used to increase the body's ability to resist the damaging effects of stress and promote or restore homeostasis. Tonic -  A remedy believed to restore exhausted function and promote vigor and a sense of well-being. Tonics are categorized according to the organ or system on which they are presumed to act, as cardiac, kidney, adrenal, vascular etc. Neurotransmitter - a substance  that transmits nerve impulses across a synapse.  Some neurotransmitters are inhibitory (calming) such as GABA and some are exitotory (stimulating) like dopamine. Serotonin -  An important neurotransmitter that has many functions including the regulation of mood, appetite, and sleep. Serotonin also plays a role in cognitive functions, including memory and learning. The modulation of serotonin at synapses is believed to be a major factor in several classes of pharmacological antidepressants. GABA (gamma-Aminobutyric acid) - the main inhibitory or calming neurotransmitter in the brain, GABA influences our mood by reducing high levels of the hormones adrenalin, noradrenalin and dopamine. It also affects the neurotransmitter serotonin. Having sufficient GABA in our brain is linked to being relaxed and happy, while having too little GABA is associated with sleep problems, and feeling anxious, stressed, and depressed. Tryptophan - as a precursor to many neurotransmitters and neurochemicals, including serotonin and melatonin, L-tryptophan is an essential amino acid that helps improve sleep and reduce stress. Melatonin is known to help improve sleep, and serotonin is needed to improve mood and mental health. Cortisol - Cortisol is a steroid-based hormone and is synthesized from cholesterol and belongs to a group of hormones called glucocorticoids. Cortisol is made in the adrenal cortex of the adrenal gland, which is near the kidney. It is the primary stress hormone.  It's functions are to increase sugars (glucose) in the bloodstream, enhance your brain's use of glucose and to increases the availability of substances for tissue repair.  Cortisol also curbs functions that would be nonessential or detrimental in a fight-or-flight situation. It alters immune system responses and suppresses the digestive system, the reproductive system and growth processes. It alerts regions in your brain that control mood, motivation and fear. Stimulant - a substance that temporarily increases the physiologic activity of an organ, a system of organs, or that increases nervous excitability and alertness. Adrenal Gland - One of two small endocrine glands, located above each kidney. The outer part, or adrenal cortex, secretes steroid hormones (corticosteroids). The inner part, or adrenal medulla, secretes epinephrine and norepinephrine. Traditional Chinese Medicine (TCM) - The current name for an ancient system of health care from China. Traditional Chinese medicine (TCM) is based on a concept of balanced qi (pronounced "chi"), or vital energy, that is believed to flow throughout the body. Qi is proposed to regulate a person's spiritual, emotional, mental, and physical balance and to be influenced by the opposing forces of yin (negative energy) and yang (positive energy). Disease is proposed to result from the flow of qi being disrupted and yin and yang becoming imbalanced. Among the components of TCM are herbal and nutritional therapy, restorative physical exercises, meditation, acupuncture, and remedial massage. Ayurveda - The traditional Hindu system of health and medicine, based on maintaining balance among the five elements earth, air, fire, water, and  ether.  The word Ayurveda is derived from the Sanskrit words “ayur,” meaning life, and "veda,” meaning knowledge. Homeostasis - The tendency of biological systems to maintain relatively constant conditions in the internal environment while continuously interacting with and adjusting to changes originating within or outside the system.   Function Nutrition: B- vitamins (Folate, B-12, etc.) - a group of water-soluble vitamins that have varied metabolic functions and include coenzymes and growth factors. These essential nutrients allow us to convert our food into fuel, keeping us energized throughout the day. Vitamin B5 is very important for the adrenals and therefore helps with modulating stress. Folate and vitamin B12 are important for mood balance, and given the links between anxiety and depression, they may also be helpful for anxiety. B-6 - an important co-factor nutrient that may boost the production of GABA, a calming neurotransmitter.  GABA is  a key factor supporting the production of other neurotransmitters (chemical messengers) such as serotonin. When supplementing with B-6, the conenzyme or active form (pyridoxal 5'-phosphate) is superior to the isolated form (Pyridoxine), because some people can't activate pyridoxine. Folate - Folate has literally hundreds of function in the human body. It helps the body use Iron, Amino Acids, and Vitamin B-12, thus impacting energy on many levels.  It facilitates the synthesis of key neurotransmitters, such as dopamine, serotonin, and norepinephrine, that are involved in mood regulation and other important functions. Magnesium - Magnesium is needed for the production of ATP, which is the main energy-producing molecule in the body. When magnesium is deficient our cells produce less energy resulting in fatigue. Magnesium is also the fourth most abundant mineral in the human body, a necessary co-factor for hundreds of enzymes, and the most critical mineral of all for coping with stress. Lithium - Lithium is a mineral that is associated with brain function, mood, focus, and the neurotransmitters dopamine.  It has a wide range of other health benefits including immune health, bone health, and antioxidant support. Zinc - Supports the regulation of key energizing neurotransmitter, dopamine, that supports cognitive function and gives you your drive. It is also key in the metabolization of melatonin, which impacts our quality of sleep.  It's also essential for male and female reproductive health and fertility.  It also impacts strength and athletic performance by regulating the flow testosterone and inulin-like growth growth factor-1 (IGF-1). It's noteworthy that the highest concentrations of zinc found in the body is in our brain! It is a principal factor in modulating the brain and body’s response to stress and key to regulating mood.  Selenium - Support thyroid health and supports hormonal balance impacting energy on many levels. Omega 3's (Fish Oils and Algae) - Essential fatty acids that support a healthy inflammation response, combat depression and promote healthy mood and cognitive function.  Omega 3's also support adrenal function and provide hormone support.  Maintaining healthy a adrenal function is imperative for proper stress management. Lifestyle: Sleep, Diet, Personal Relationships, and Exercise all impact how we feel, how we cope with stress, and how much energy we have.  It's important to not overlook the obvious.  Sleep hygiene -  simple habits that promote quality sleep. Prioritize sleep.  Get what ever it is your body requires (7-9 hrs generally). Try to go to sleep around 10pm, when cortisol levels are at their lowest and melatonin levels are at their highest. Stop eating 2 hours before bedtime, and stop hydrating at least an hour before bedtime.  Create at dark environment to sleep in.  Avoid light before bedtime, including T.V., computers, and smart devices that emit light.  You can even dim the lights ahead of time when you're ready to unwind. Try not to hit that snooze button in the morning.  We don't want to interrupt our hormone and neurotransmitter cycles. Avoid the use stimulants, especially in the afternoon and evening.  Diet - No matter what herbs and supplements you take, you still have to support your body with healthy eating habits. Poor eating habits stress our bodies out and may even affect our mood. Eat lots of fresh fruits and especially vegetables.  Try to get the full color spectrum when selecting fruits and vegetables.  Complete nutrition is essential for stress, mood, and energy support.  We've already mentioned key vitamins, minerals, Omega 3's, etc.  Try to find foods rich in these valuable nutrients that support healthy energy levels and promote a healthy stress response.  You can reference the functional nutrition list above to narrow down your search. Exercise - Try and get a moderate amount of fresh air, sunlight, and exercise.  Don't over exercise! The goal is to promote health, and over training can deplete the adrenal and negatively impact your stress and energy levels negatively.  Do it, but don't over do it! Toxic Relationships - Social engagement is the most evolved way to cope with stress. That's why it is so important to surround yourself with people who do not normally add to your stress load.  If simply being around a particular person provokes a fight or flight response, chances are that's a Toxic Relationship!  Always look to build a strong supporting cast of good people to de-stress with.  

Ep #7 – Simulation Episode – Selective Spinal Immobilization with Dr. Joe Bart (Full HD video on YouTube) https://www.youtube.com/watch?v=Lh44vQHpQvk&feature=iv&src_vid=PkNRiJm6FRY&annotation_id=annotation_4084272705   Joseph A. Bart DO – EMS division – Operations Medical Director, Deputy Fellowship Director University of Buffalo Profile Page: https://medicine.buffalo.edu/content/medicine/faculty/profile.html?ubit=jabart National Center for Security & Preparedness: http://www.albany.edu/ncsp/   -- Eliminate the Standing Take Down -- Selective use of the C-collar -- The Backboard as an Extrication Device -- The Role of Alternate Devices -- Q&A with Dr. Bart   Follow us on Twitter: www.twitter.com/EMS_Nation Like us on Facebook: www.facebook.com/prehospitalnation   Wishing Everyone a safe tour! ~Faizan H. Arshad, MD www.emsnation.org    

Editor's Audio Summary by Edward Livingston, MD, Deputy Editor, JAMA, the Journal of the American Medical Association, for the October 6, 2015 issue

Cancer is a leading cause of death worldwide. Although several common treatment options exist, there is an urgent need for improved tumor therapeutics. Therefore, we evaluated three innovative anticancer approaches in vivo. These were newly synthesized siRNA polyplexes, novel myxobacterial anticancer compounds, and innovative polymeric melphalan formulations. We evaluated the in vivo characteristics of polymeric bound siRNA. We could demonstrate that the polymer FolA-PEG24-K(Stp4-C)2 is an efficient carrier for targeting siRNA to the folate receptor expressing tumor tissue of mice. Moreover, the siRNA was able to enter tumor cells and led to specific gene silencing. After systemic injection, the polyplexes did neither cause any toxic side effects nor accumulate in any healthy organ. With only 6 nm average diameter, polyplexes were very small, resulting in fast removal from blood circulation by renal clearance. Addition of larger PEG spacers to the initial polyplex led to an increased polyplex size. As a result, the renal clearance was decreased, and polyplex distribution in the body was optimized. These results show that the in vivo hurdles of siRNA delivery can be overcome by binding siRNA to the precise and multifunctional polymers. Natural compounds have broad therapeutic effects, and are basis for the production of various anticancer drugs. Myxobacterial products often target cell structures which are rarely targeted by other metabolites, and they exert novel modes of action. Therefore, they are of particular importance for the development of new anticancer drugs. In this thesis, we evaluated three novel myxobacterial compounds in vivo. Within our experimental settings, we could demonstrate for the first time that archazolid, pretubulysin and chondramide can impair the migration and colonization of breast cancer cells in mice. Concerning their impact on tumor growth reduction, the compounds have promising characteristics, but the experimental setups need further improvement. Cytostatic drugs, like melphalan play an important role in cancer therapy, but bear problems, such as a low therapeutic efficacy and strong toxic side effects. Immobilization of chemotherapeutics on polymers is an interesting option to reduce their toxicity and enhance their efficacy, mainly by passive tumor targeting. We evaluated three innovative polymer-melphalan formulations in cell viability and proliferation assays. The covalent conjugate of poly(oxyethylene H-phosphonate) with melphalan was additionally investigated in vivo. This polymeric immobilization of melphalan led to an improved therapeutic effect compared to the pure cytostatic drug, as the growth and regrowth of HuH7 tumors could be hampered effectively. In conclusion, this thesis deals with the in vivo evaluation of innovative cancer therapeutics, which were successfully investigated in murine tumor models. The results with the experimental agents, based on siRNA, polymers or biogenic drugs, are encouraging starting points for further anticancer research.

Thoracic & Lung Cancers

This podcast covers the JBJS issue for May 2011. Featured are articles covering: Recombinant Human Bone Morphogenetic Protein-2: A Randomized Trial in Open Tibial Fractures Treated with Reamed Nail Fixation; recorded commentary by Dr. Bhattacharyya; Clinical Comparisons of the Anatomical Reconstruction and Modified Biceps Rerouting Technique for Chronic Posterolateral Instability Combined with PCL Reconstruction; Immobilization in External Rotation After Primary Shoulder Dislocation Did Not Reduce the Risk of Recurrence - A Randomized Controlled Trial; recorded commentary by Dr. Miller; Treatment of Displaced Intra-Articular Calcaneal Fractures with Closed Reduction and Percutaneous Screw Fixation.

This podcast covers the JBJS issue for May 2011. Featured are articles covering: Recombinant Human Bone Morphogenetic Protein-2: A Randomized Trial in Open Tibial Fractures Treated with Reamed Nail Fixation; recorded commentary by Dr. Bhattacharyya; Clinical Comparisons of the Anatomical Reconstruction and Modified Biceps Rerouting Technique for Chronic Posterolateral Instability Combined with PCL Reconstruction; Immobilization in External Rotation After Primary Shoulder Dislocation Did Not Reduce the Risk of Recurrence - A Randomized Controlled Trial; recorded commentary by Dr. Miller; Treatment of Displaced Intra-Articular Calcaneal Fractures with Closed Reduction and Percutaneous Screw Fixation.

Rev. Dwayne explores the movie Brokeback Mountain and challenges us to move beyond the “brokeback” places in our lives. Scripture: Hebrew 12:1-3, Luke 13:6-9, and a reading from, "Kitchen Table Wisdom," by Rachel Naomi Remen. Movie based on novel, "Close Range: Wyoming Stories," by Annie Proulx.

Fri, 1 Jan 1993 12:00:00 +0100 http://epub.ub.uni-muenchen.de/4218/ http://epub.ub.uni-muenchen.de/4218/1/073.pdf Yan, Yongan; Bein, Thomas Yan, Yongan und Bein, Thomas (1993): Molecular recognition through intercalation chemistry: immobilization of organoclays on piezoelectric devices. In: Chemistry of Materials, Vol. 5, Nr. 7: pp. 905-907.

Fri, 1 Jan 1982 12:00:00 +0100 http://epub.ub.uni-muenchen.de/8115/ http://epub.ub.uni-muenchen.de/8115/1/wiesner_henning_8115.pdf Wiesner, Henning; Gatesman, T. Wiesner, Henning und Gatesman, T. (1982): Immobilization of Polar and Brown bears using Etorphine and Xylazine. In: The Journal of zoo animal medicine, Vol. 13: pp. 11-18. Tiermedizin