We'll Take Care of Our Own; We Will Have No Choice

Care of Our Own

I'M not sure where to begin. 

Ok I'll play the bad guy here to start:

Where does it say that the government will guarentee you any medical treatment?

Where does it say that you have priority over another patient for limited resources within a hospital. 

When a pandemic starts so does triage. Think (M.A.S.H.) They will have set procedures as to who they will see and what resources may be provided to each patient.
-------------------------------------------------------
Enough bad guy routine:

Yes we are here to learn and pass information between us because - We know that we will be on our own either by choice or by order of the Government.

So learn what you can. 
GET CPR certified ASAP. 
Start CERT training. 

By the time you finish that training you will be answering a lot of questions for others, to help them-selfs.

  No warning - no way to fight - no way to win!  
We need help in our local communities to survive. Remember that quote:    "...No man is an island..."

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by: RICHARD-FL @ Fri Apr 13, 2007 at 21:36:00 PM CDT

CERT Good Start - But Home Care Not Big Part of That

Where does it say that the government will guarentee you any medical treatment?

Basic reasons we started this tea party:

to establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty

While that does not 'guarantee medical treatment' I don't recall saying it was (or even should be) guaranteed to me or anyone else.  I just think ignoring one major segment of a problem is not an effective way of addressing it, effectively allocating resources, or doing much to promote any of those listed purposes.

When a pandemic starts so does triage. Think (M.A.S.H.) They will have set procedures as to who they will see and what resources may be provided to each patient.

First, your optimism is refreshing, but I think misguided.  The kind of triage procedures you assume are already set are barely even proposed in academic circles to say nothing of solidified on an operational basis.  The ethical issues are daunting.  The implementation, especially in the absence of serious pre-pandemic buy-in by the public, will be the devil's own nightmare.  This ain't 1950's Korea, this is small town, suburbian and downtown USA and while the rules may end up being similar, the expectations and 'troop' compliance will be a world away.

Yes we are here to learn and pass information between us because - We know that we will be on our own either by choice or by order of the Government.

In 1918 communties that worked together came out better.  It has been proven the same in disaster after disaster - communities that are knit together by common interest and common effort pull through better, more intact than those that through choice or through chance are made up of individuals or households that isolate themselves and try to rely solely on individual resources. YOYO is no more inevitable than any other approach either now as we prepare or then as we respond. 

The Federal Government is choosing to limit its role.  Many states are doing the same.  Just because they can't do everything does not mean they should not do what they can to facilitate, guide and encourage.  There's more that could be done that they are leaving undone. 

So learn what you can. 
GET CPR certified ASAP. 
Start CERT training.

Thanks.  The Community Emergency Response Teams offer important learning opportunities and are excellent ways to work together as neighbors to become more prepared for general emergencies and disasters, as are general and advanced first aid training available at many Red Cross agencies around the country. Another recommended course is for Wilderness First Aid training where the focus is on initial and prolonged care for a patient in the backcountry - as opposed to initial stabilization and transport. 

For more on CERT (including some in your area) go here:
https://www.citizenc...


ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Fri Apr 13, 2007 at 23:20:18 PM CDT

[ Parent ]

TEA PARTY?

Thanks for the great follow up.  RICH

  No warning - no way to fight - no way to win!  
We need help in our local communities to survive. Remember that quote:    "...No man is an island..."

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by: RICHARD-FL @ Sat Apr 14, 2007 at 07:00:17 AM CDT

[ Parent ]

there are some very interesting

and innovative ideas being developed using CERT as a model... stay tuned in the next few months for more.

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by: DemFromCT @ Sat Apr 14, 2007 at 07:03:01 AM CDT

[ Parent ]

if the ideas involve sending people out with no safe PPE

such bureaucratic brainstorms will be very short-lived.

And if they want to force people who signed up for earthquakes and hurricanes into plague duty having never warned the public to prepare, to reduce consequences, they should just 'fess up, and turn themselves over to the public now. They've played russian roulette with the public's families for over 18 months; they should not think they can keep stalling with impunity.

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by: crfullmoon @ Sat Apr 14, 2007 at 09:04:23 AM CDT

[ Parent ]

hi, crfullmoon

don't let the perfect be the enemy of the good.

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by: DemFromCT @ Sat Apr 14, 2007 at 10:43:59 AM CDT

[ Parent ]

don't let the losses be so high in the first month

that we lose too many of our hcw, responders, and good-hearted volunteers. Not telling them about a virus won't protect them from infection. Neither will surgical masks. People also can't eat PR messages.

TPTB may think having all these people signed up and ready to obey orders is good; why have faith in what kinds of orders they will be given? Unwarned = expendable.

Full and fair disclosure is not demanding perfection, just honesty.

Tricking unprepped people to sign up for "emergencies" when TPTB know they need them for pandemic, (as well as misrepresenting pandemic as being very likely to be 98% survivable, and real vaccine to be handed out "sooner than Leavitt said") is going to backfire. Trust is going to be lost. Be honest. Maybe they can't; our local ph holding the pandemic preparedness reins in our town was of the mind, "it's going to be so bad anyway there's nothing we can't do; so I can't tell the public".

Will the public think that was "good"?

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by: crfullmoon @ Sun Apr 15, 2007 at 08:37:23 AM CDT

[ Parent ]

...

it does tend to make one consider that perhaps TPTB are looking at a much, much darker future.  against the collapse of the civilized world, trust and public opinion really wouldn't be considerations...  jokes, perhaps..  little more.

or...  maybe i need a break...  i'll try the break..

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by: c3jmp @ Sun Apr 15, 2007 at 11:54:54 AM CDT

[ Parent ]

Definitely time for a break.

Grim possibilities make clear that today is extraordinarily precious.  Go do something spontaneous and fun :->. 

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by: InKy @ Sun Apr 15, 2007 at 12:47:39 PM CDT

[ Parent ]

CERT and Neighborhood Watch

Both excellent models to start with.  I will be interested to see what comes out (hopefully  sooner rather than later.)

While there is a long list of problems with using this type of neighborhood organization model to address pandemic planning and response, there is always such a list, always.  You do what you can to whittle it down and work around it and put up with the items that won't go away.

They will not be the only answer, but they can be one part of the answer and could fill what is now one of the most obvious gaps in the planning and response continuum.

The development of such local citizen organizations also exposes people to better information on the issue and encourages them to do personal prep.

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Sat Apr 14, 2007 at 11:26:54 AM CDT

[ Parent ]

Richard - I do not know where to start either.

Richard-FL,

  I have to play the bad guy also and agree with you. Where does it say the government or anyone else "guaruntees" medical help.

  With that fact said please add "Widerness first aide" to the CPR, AED, First aide and CERT.

  "We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America."

  Unfortunatly "Personal responsibility" is hard to teach.

  Ones person's living out of a shopping cart is anothers person's life. There are several homeless who want to be homeless. Except where they can not take care of themselves it is hard to impose my standard of living on them. This might be one of those times.

  Good question to ask SusanC.

Kobie.

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by: Kobie @ Sat Apr 14, 2007 at 15:54:37 PM CDT

[ Parent ]

Good compilation of written resources. Videos are needed

For many people, the resources you list will prove invaluable.

Unfortunately, a significant percentage of the population has problems with medical literacy (understanding written medical instructions,even if they are functionally literate), and some would not be able to read at all.

It would be tremendously helpful for videos to be developed showing how to provide care for those with influenza, stressing the most important aspects.  It's also very helpful to have visual demonstrations of what to look for and how to do things.

Since videos can be expensive to make (at least $1,000/minute for professional ones), I hope that some foundations, universities, or CDC would consider making such videos.  They could be dubbed into different languages and used by many people.

Thanks for compiling this list as a good starting point.

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by: big critter @ Fri Apr 13, 2007 at 22:41:25 PM CDT

Videos

Now there is an excellent opportunity for the public airwaves to actually be used in the public interest.  I can see it now. Oprah could do shows on home care with the casts of ER and Grey's Anatomy.  Martha Stewart could do shows on how to cook real food rather than nuking convenience foods.  The cable news channels will be wall-to-wall pandemic coverage, and they'll need something to fill all that time.  Of course, this assumes that the grid stays up.

I hear the train a comin'
It's rolling round the bend
~The Man in Black

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by: SouthernBlueNeck @ Sat Apr 14, 2007 at 06:19:40 AM CDT

[ Parent ]

videos - please include the deaf who walk silently amoungst us. n/t

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by: Kobie @ Sat Apr 14, 2007 at 15:55:38 PM CDT

[ Parent ]

Actually, with closed captioning

videos should work quite well for most.  But now you have me wondering what would happen if the grid goes down and we have to rely on radio.

I hear the train a comin'
It's rolling round the bend
~The Man in Black

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by: SouthernBlueNeck @ Sat Apr 14, 2007 at 18:17:39 PM CDT

[ Parent ]

Cloths captioning is not bad.

Southern BluNeck,

  Hi. Closed captioning is not bad for the hard of hearing, noisy bars, and some deaf.

  ASL (American Sign Lanugage) has a different sentace structure from English, Spanish or other languages.

  Please indulge me for a second and pronounce these words:

SYZYGY -  the astronomical alignment of three planets.

SYNAESTHETE - A person for whom sense impressions occur through stimulation of a different  sense to that expected. They see light, taste sound or hear smells.

CLINQUANT  -  Glittering with gold or silver; a false and showy glitter.

FLOCCINAUCINIHILIPILIFICATION -  The action or habit of judging something to be worthless. Yes this is the word from the TV commercial.

ICHTHYOPHAGOUS - Fish-eating.

LEIOTRICHOUS - Having straight hair. It comes from Greek `leios', smooth, plus `trikhos', hair.

  Everyone in my class tried to sound them out. Deaf people either can not or find it hard to do. Letters do not have sound.

  Try these "easy words"

"The pasture is used to produce produce"
"The dove dove into the bushes"
"The scout wound the bandage around the wound"
"I read what the president will read tonight"
"He didn't object to the object"
"When I saw the tear in the fabric, I shed a tear."
"Since there is no time like the present, you may present the present"
"He was too close to the door to close it"
Harder - cept' for us hunters :) Lol
"The buck does and the does do, too"

  Make the message as easy to hear as possible. Ues a spanish person for a spanish audiance - right? Ues a deaf person for a deaf audiance.

  Just my thoughts.

Kobie
"What do you call the writing on the back of team Jersy's ?"
"Cloths captionin of course" :)  LOL LOL

P.S. I can not pronouce FLOCCINAUCINIHILIPILIFICATION either.

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by: Kobie @ Sun Apr 15, 2007 at 13:51:57 PM CDT

[ Parent ]

FLOCCINAUCINIHILIPILIFICATION --Easy peasy!!!

Floxin-nossin-i-hilli-pilli-fication

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by: Bronco Bill @ Sun Apr 15, 2007 at 14:07:41 PM CDT

[ Parent ]

FLOCCIN... long titles

'break' the left column until they fade.

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by: DemFromCT @ Sun Apr 15, 2007 at 15:09:28 PM CDT

[ Parent ]

I remembered that...

about 2 seconds after I hit post! Sorry...

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by: Bronco Bill @ Sun Apr 15, 2007 at 15:41:08 PM CDT

[ Parent ]

Ha, DemFromCT and BroncoBill - to wild. Now I know how to say it. n/t

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by: Kobie @ Sun Apr 15, 2007 at 18:12:54 PM CDT

[ Parent ]

That's easy for y'all to say ;-) n/t

I hear the train a comin'
It's rolling round the bend
~The Man in Black

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by: SouthernBlueNeck @ Sun Apr 15, 2007 at 19:41:13 PM CDT

[ Parent ]

See Pandemic Preparation Message Video Brief - Great Diary by Edna Mode

http://www.newfluwik...

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Tue Apr 17, 2007 at 20:04:34 PM CDT

[ Parent ]

Another prep?

We just brought my mother home on hospice. One of the things they provide is a prescription 'comfort kit' with small amounts of atavan, compazine,morphine,etc- all in drops that don't need to be swallowed well or suppositories. The lid of the box has a chart - what each drug is for, and range of doses.

These are things we couldn't readily buy to prep, but if a hospital/ pharmacy/ center  handed these out with a set of instructions it would certainly soften the blow of being told there is no professional care available. It would reinforce the message that even though 'we' can't help, we do care- as well as give people a big dose of confidence that they can care for themselves or their loved ones at home.

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by: dogsma @ Fri Apr 13, 2007 at 23:12:01 PM CDT

Great example. n/t

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Fri Apr 13, 2007 at 23:22:53 PM CDT

[ Parent ]

...

i'd be concerned about the route of "feeding the animals"..  it is a good idea...  when bodies are stacking up, tho, crowds will demand more - and once they reach that state, it's a losing battle.  you can talk a single hysterical person down..  trying that with a group of hysterical folks frequently leads to less stable results.

the biggest thing that can be done now, is knowledge.  the govt owns the airwaves, not business; the govt could be running 24x7 programming on what to expect, how to prep, what to get - they just choose not to.  too many folks in govt whose continued employment relies upon popularity with the masses.  religious sensitivities aside, i'd tell those in govt that choose not to engage now (while there is time), to all go to hell...  no point, tho, in that..  more and more, it looks like it will come to them - they just have to be themselves.

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by: c3jmp @ Sat Apr 14, 2007 at 07:31:35 AM CDT

[ Parent ]

guidelines said to stockpile palliative care meds

http://www.ahrq.gov/...
Palliative Care: http://www.ahrq.gov/...

..."The needs of those who may not survive catastrophic mass casualty events and the 'existing' vulnerable populations affected by the event should be incorporated into the planning, preparation, response, and recovery management systems of all regions and jurisdictions."
-Joint Commission on Accreditation of Healthcare Organizations,2004

..."Without deliberate planning and direction, stocking up on appropriate supplies, and the development of realistic guidelines, supportive care services for the dying in MCEs will be erratic, inefficient, disruptive, and potentially indefensible as the basis for social reorganization after the disaster ."...

..."Recommended actions include:
Build on existing relationships.
Have State and local home health, hospice, and long-term care organizations and professional associations contact leaders in their State and regional-area disaster preparedness planning bodies to get involved in these activities/processes.

Have disaster planning leadership at a national level help to engender a network of leaders in home health, palliative and hospice care, and long-term care to be engaged in disaster planning, supported by appropriate research support and development expertise, so that promising ideas are quickly shared and tested and so that cross-region support is available in times of crisis.

As noted earlier, the barriers to implementing these recommendations involve the fact that palliative care, long-term care, and home care are already resource poor; there is a lack of understanding of the potential utility of incorporating community-based health care, mental health, and social service professionals into planning, even by the professionals themselves; and there is a dearth of literature and expertise on the subject."...

..."Include pediatric-specific palliative care issues in all plans; failure to do so will hamper the ability of health care workers to move children into palliative care and develop guidelines for treating them"...

..."In the event of a catastrophic MCE, casualties will be triaged at the site of the incident and again after transport to an ACS.
Some will be deemed "likely to die" during the extreme circumstances of the catastrophe"(months of disruptions?) "and therefore will be triaged not to receive (or not to continue to receive) life-supporting treatment.
For these casualties, death will be expected within a short period.

This reality poses substantial challenges for all involved, including the recognition that some people who might survive under other circumstances now will die. Given the usual focus of rescue in manageable disaster events, most patients, families, and emergency responders are likely to resist this designation and attempt to save all, potentially exacerbating an already overwhelmed medical care system.
Thus, ACS and providers need to be identified and used for this population during catastrophic MCEs."...(Thus, "triaged to die" will all go to the Alternate Care shelters; the ones your unwarned neighbors are being asked to volunter "to care for the sick" at, who will be their dying unwarned neighbors' children, grandparents, and other fellow citizens, and the bodies will be carried out of the schools or whatever your ACS is . Local plans still think "for central collection and storage"! )

..."Recommended actions include:
Stockpile palliative care medications in each community for disaster response, including injectible morphine and dihydromorphone, injectible haloperidol, subcutaneous butterfly needles, tegaderm, antipyretics, steroids, and diuretics. (Why they do not mention palliative pain medicines in skin patches, I don't know - too slow? Certainly easier to administer.)

Plan for the needs of"(this makes no sense; wouldn't they be "expected to die in a short time"?) "individuals chronically dependent on dialysis, ventilators, or other special supplies such as dressings, splints, syringes and oral droppers, incontinence supplies, beds or cushioned surfaces, and personal protective devices.

Barriers will include the need to stock supplies near the settings of service and preferably distant from hospitals and other sites of definitive care for survival.
  Long-term care facilities, inpatient hospice settings, or home nursing care offices are possibilities." ( since the existing patients will not make the cut for scarce resouces during pandemic year?)

Having controlled substances in strong lockboxes is probably most naturally sited at nursing homes, where systems are in place and storage of these drugs is already set up. Another option would be designated pharmacies. "...

..."Training in palliative care must occur prior to an MCE and will involve many layers of education and practice. Planners can incorporate experts now working with seriously chronically ill persons" (who won't be during pandemic?) to be mobilized to serve those who might live and who are seriously ill.
Thus, many of the physicians, nurses, and therapists who regularly serve the disabled or elderly will be needed to provide life-extending treatments.

Planners could designate in advance certain leadership to remain in place and mobilize retired professionals and layperson volunteers."...(there's the public again; hard choices are going to be made, and unprepared people are going to have to run what got those hospital workers during Katrina got prosecuted for doing, when they had no sleep, no communication, and needs overwhelmed resources. But, that's only if officials actually bought palliative meds- and bet they didn't, or certainly not enough - and the public still has no idea pandemic is possible this year and that so many will die, for many reasons. We will wish we had bought the palliative meds. And, that tptb had adequately warned the public. )
....................
dogsma, forgive me for writing on such a topic while you are going through what you are. I'm not tactful, but I do care. Glad you're getting help and she's able to be at home.

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by: crfullmoon @ Sat Apr 14, 2007 at 09:59:09 AM CDT

[ Parent ]

Dogsma good idea, CrfullMoon - the more you write the better I am. C3, There will be time and *proof* afterwards for those who did not take action n/t

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by: Kobie @ Sun Apr 15, 2007 at 18:16:06 PM CDT

[ Parent ]

minor edits made

spelling of Dr Grattan Woodson's name corrected.

Also, see Ontario planning guide: Taking Care of Yourself and Your Family: What to Do If You Get Pandemic Flu.

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by: DemFromCT @ Sat Apr 14, 2007 at 06:56:34 AM CDT

see also

National Defense University
http://www.ndu.edu/c...

Bird Flu & You: A Quick Guide to Protecting Yourself and Your Family from Bird (Pandemic) Flu

In anticipation of a possible flu pandemic, the life sciences group at CTNSP has started a number of initiatives to address both civilian and military implications.

UPDATE March 16 2007: Due to the overwhelming success of the Bird Flu and You poster and handout, CTNSP can no longer fulfill poster requests at this time. The Life Sciences office is currently working on version 2.0 of the poster and plan on releasing the updated material on or about Summer 2007. Life Sciences will be taking online requests for version 2.0 at lifesciences@ndu.edu . If you would like to request version 2.0 please include a complete mailing address and the amount you would like to receive. Please note any requests that are greater than 20 copies will require a Fed Ex account number.

In the meantime version 1.0 is available in a downloadable electronic file below in 8 different languages. Please note if you intend on publishing portions or all of the materials and your organization is outside the United States government you must obtain written permission from the authors. Please email lifesciences@ndu.edu if you would like to receive permission for reproduction.

We currently do not have hard copies of the foreign language translations

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by: DemFromCT @ Sat Apr 14, 2007 at 07:06:46 AM CDT

[ Parent ]

ITW, please add a link to Dr Woodson's book translations

Because I feel translations are, well, important in these things.  http://www.fluwikie....

Also, maybe some easy things could be done by children as part of the Resilient Kids Project http://www.fluwikie....

Regarding videos, couldn't we start off some of our own and upload them to youtube?  How hard can that be, I mean, just a procedure to measure fever?  Folks here would select the best and that would be it.  :-?

You arm yourself to the teeth just in case.  You don't leave the gun near the baby's hand.

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by: lugon @ Sat Apr 14, 2007 at 10:16:45 AM CDT

Done. nt

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Sun Apr 15, 2007 at 15:40:49 PM CDT

[ Parent ]

Looking for Follow-up on Turkey WHO Conf on Clinical Info on H5N1 Patient

Has anyone seen any publications that came out of this conference?

WHO meeting explores H5N1 treatment issues
Mar 19, 2007 (CIDRAP News) - Health experts gathered today at a World Health Organization (WHO) conference in southern Turkey to discuss findings in patients who have H5N1 infections and identify areas for future research on treatment, according to news services.

The meeting, a follow-up to one held in Hanoi in 2005, is intended to seek support from doctors for a proposed WHO system for collecting data on H5N1 cases, Canadian Press (CP) reported. Doctors would be asked to submit standardized clinical information on their patients who have H5N1 infections, which would allow the WHO to track disease patterns and treatment efficacy, the report said. ...

http://www.cidrap.um...
WHO Announcement of Meeting:
http://www.who.int/c...

Avian Influenza A (H5N1) Infection in Humans

The Writing Committee of the World Health Organization (WHO) Consultation on Human Influenza A/H5

Sept. 29, 2005

http://content.nejm....

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Sat Apr 14, 2007 at 12:21:18 PM CDT

they also gave assurances

about serology data being published...

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by: DemFromCT @ Sat Apr 14, 2007 at 12:53:50 PM CDT

[ Parent ]

ITW, and others

thank you for putting this together.  At the end of the day, if and when TSHTF, we can each only depend on ourselves...


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

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by: SusanC @ Sat Apr 14, 2007 at 15:03:51 PM CDT

Who's job to prepare the public is not the WHO but the leader who sets the vision and rally's the people.

ITW,

  I would say it is the leader, the president who stirs the people to care for themselves. Who sets the national vision and then rally's support.

  Then we can move as one co-ordinated team all ??? million of us (varies by country).

  IMO, its the people - not the art work or buildings - that make a country what it is.

Kobie
Give a man a fish and you feed him lunch.
Teach a man to fish and he can care for himself.

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by: Kobie @ Sat Apr 14, 2007 at 16:00:26 PM CDT

Who's job is it?

TPTB, of course.  Plus anyone else who is asking that question, if you don't mind me saying so!  Individuals at this day and age can muster a lot of influence if they work persistently at it over time.  Don't underestimate you ability to influence those who take policy decisions!

With all respect, Kobie, if you ssy "it's the leader.  when he does this... then we can do this" you may be selling yourself short.

Think "if I do this, he may be pressurized, encouraged, inspired, to do that...."

;-)


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

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by: SusanC @ Sat Apr 14, 2007 at 16:14:36 PM CDT

[ Parent ]

We are the one's we have been waiting for. n/t

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Sat Apr 14, 2007 at 23:55:29 PM CDT

[ Parent ]

SusnC, ITW then here is a PSA

ITW,

  Thank you for the starting this. I am glad the CERT modle was mentioned. For better or worse I do think many would answer the call. The more that are prepared, the fewer have to be saved.

  SusanC I do think ones leaders play an important part. I was rush in pointing to one leader

  After lamenting about the information age becomming the entertainment age. An age when entertainers are better known, paid more and hold more public sway than out political or social leaders. "If you can not beat them - join them"

  To give the PSA long term life look at teh success full commercials. They commercial shows average people in unreal situations where the audiance is taken to or shown a new perspective to look at an age old problem.

  The Geico commercial "So simple a cave man could do it" The Sleep aid commercial with teh Deep sea diver, Abe Lincoln and the furry badger. Even the old hardies commercial "Where's the beeef"

  Yes these are American commercials. I am ignorant of other one. How ever People are People where ever you go. The idea of Elders, Angels and the idiot plays well as long as they are respected and set apart from us.

  The scean opens on a dark room illuminated by a large round lit "pool". One figure in toaga stands looking down intensly. His  hand on his chin as his facial expression changes from concern to a grin and back again. Another toga figure approches from the darkness with clip borard or tablet in hand.

T1:"Whats up down there today"
T2:"Ohh, same stuff. Few storms, chaos, good beach weather in Spain."

T1:"What about the pandemic?"
T2:"The world powers are working but the average person hasn't a clue. Good beach wether in Spain you know."

T1:"Did'nt we tell them!" gruff voice, as he checks the tablet in his hand.
T2:"OH yea, but you know them.",with grin,"Can't deal with uncertanty. This group wants time, date and video footage. So modernized. Ahh not like our time. One or two lightning boltsout of place and we where ready for anything. Ohh, new album comming out -  have to get that one."

T1:"So why are you so chipper?"
T2:"Ha, its not my tush on the line down there. With moder stuff they will be safe. Good beach wether in Memphis."

T1:"Ah, but they are still not prepared. Um, Egypt or Tennessee??"
T2:"No Florida, Memphis Florida. Good beach weather today." 

  The picute fades to black screen with white letters saying Http//wwww.pandemicflu.gov  followed by others.

  The BSA logo with the words "Be Prepared" is one I am shying away from. Thre are restrictions and reasons for its use beyond my limited knowledge.

  Using this group of people more PSA can be done. the problem is comming up with 15,20 adn 30 second spots.

Just some ideas. Other ideas wil be needed.

  If we are the ones - who is listining? Those who want to be saved are already looking and believe.

Kobie
"Change their minds and you change the world"- Wonder Woman.

"She lets her knowledge out a bit at a time, so as not to embarrass me." Dr. Who (Ian) talking about Susan, in "An Unearthly Child"

"Save the cheerleader" from "Heros" (ok that did not apply but it sounded good. Wer' on a roll you know  :) lol

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by: Kobie @ Sun Apr 15, 2007 at 14:07:46 PM CDT

[ Parent ]

not related but i was imagining two car-safety engineers (in my imagination

they worked for Mercedes-Benz), probably talking about how to design a new airbag or something of that sort, sobbing and saying "Well, the truth is I [sob, sob] simply can't bear imagining the worst case! [hickup]".

(Yes, I know, TPTB didn't apply for their current save-the-world job.  Ah, well.)

You arm yourself to the teeth just in case.  You don't leave the gun near the baby's hand.

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by: lugon @ Sun Apr 15, 2007 at 15:14:19 PM CDT

[ Parent ]

TPTB save teh world

Lugon,

  I have to disagree. They wanted the position, asked for it and convinced others they are the right person.

  With that said, they should not do it alone. Just because someone else is in charge does not allive me of my responsibility to speak up. Once I do I submit to the wisdom of the group.

Kobie

---

by: Kobie @ Sun Apr 15, 2007 at 18:03:18 PM CDT

[ Parent ]

Kobie, responsbility, yes

but I'm thinking more of personal power.  Empowerment of the individual.  Most people do not realize how much influence they can bring, often because they are not used to it.  But the other commonest obstacle is believing that they can't.

Now, I'm not the touchy feelie ;-) libertarian type, I'm very pragmatic.  So where personal empowerment comes in, in my world view, is if individuals constantly, indeed obsessively think about what solution they can bring to the table, that will help tptb.

No, I have not been co-opted ;-), but I do know that when we think of tptb, or government, or leaders, in the abstract, we give up our power to influence.  How does one influence an entity, or a notion?  Cos that's what 'the-powers-that-be' is, just an idea.  You cannot wrap your mind around an idea and hope to make that idea do something different, cos the idea is already pre-defined in your head.

OTOH, if we stop and make them real, in our mind's eye, ie de-construct the idea and turn it into its components, then our perceptions change.  They are, at the end of the day, people.  Human beings, in flesh and blood.  Now, if this pandemic thing is so d****d difficult for you to deal with, consider how hard it is if you are an official actually having to solve this problem, but with the same problems that you and I see: namely, ignorance, denial, lack of resources, obstruction by vested interest, bureaucracy who cannot think out of boxes, etc.

Sure, there are plenty of officials who don't care, and they just literally move papers from In-tray to Out-tray (or, in the electronic age, to Outbox, or Sent).  But most of the time, it is because they do not personally see a solution that would make a difference, which is exactly the same as what you are feeling.

But what if, with all the wonderful ideas that we have here, that you have read on this and other forums, you begin the process of adapting it to fit their mod of operation?  For example, suppose you want to get everyone to prep, so that people can SIP and avoid getting infected, which is pretty hard to sell to policymakers, cos of the conflicting claims on their decision by other interests.  So you get upset, and say, ain;t gonna work.  True. 

But suppose you turn the idea around, and ask yourself what is one problem that officials face that could be solved by people prepping, then sometimes, not everytime, you begin to see some openings eg stop talking about SIP, and sell the case for prepping as community resilience against infrastructure crises, or one way to reduce the demand on severely limited resources in a pandemic, or one way to spread the cost (remember lack of funds is always a problem) to the public themselves, then you begin to have a chance to sell your case.

But that's not enough.  You can't go to tptb (in the flesh, not in the abstract) and sell an idea, no matter how good it is.  You have to package it as something that will help them, in what they are doing.  So targeting your efforts become important.  Most people think of targeting as finding the official who can give you what you want; but an alternative way is to find the official who will benefit from what you have to offer!

Your personal power exists in your ability to help, not your ability to judge or demand, IMHO.  And I'm not saying this to imply anything personal about you, Kobie, but all of us in general.  If you understand what I mean, ;-)


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

---

by: SusanC @ Sun Apr 15, 2007 at 18:58:47 PM CDT

[ Parent ]

SusanC, I just added a link to Adjustment Reactions

under "suggestions for activists": http://www.fluwikie....

You arm yourself to the teeth just in case.  You don't leave the gun near the baby's hand.

---

by: lugon @ Mon Apr 16, 2007 at 02:22:46 AM CDT

[ Parent ]

SusanC, We agree on so many things for differnent reasons.

SusanC,

  I agree with you.

  "Empowerment of the individual." - I wave my magic wand over the audiance and Poof (deep voice)"Thy are empowered - go forth and conqure?"  I have a hard time understanding why people do not think they are empowered?

  Just try and short them a half dollar/euro or say "we forgot your hotel" reservation. "Boom! straight to the moon Alice. Straight to the moon" They feel empowered.  Yet they always where and are.

  "Bring their solution to the table" - that is what I want. What I like about this group. Ohh yes Nimbus and others track down news but seeing others feelings and ideas helps most.

  Unfortunatly there are penalties for thinking or speaking out of the box. Mr. Michael Osterholm was labled "chick little" for saying "AI was coming, prep now" and even the new WHO health director from China has taken some hits. My apologies, I read her CNN interview over the weekend but can not remeber all the facts.

  SusanC - do we need to give our politicians permission to help us? "Please use the limited funds to do this - not that." or "Put a AI tax on this to raise money for Prepping."  Even the less expensive - "Please just update your websites with links so we can find the informaiton."

  As for personal politics - I hope it becomes a campaine issue. Send an email of support for those who mention, talk or support prepping. Do not let them work in a vacume without some reward for doing good.

  As for the group politics - IMO it is best to have a vision people can rally behind than to make political deals or be seen as a voting group. IMO best to stay non-political as neutral ground where any political camp can meet.

  Yes - prepping will not only save the government money now but in the future. When I asked "What if BF never happens" people seemed to agree that prepping is good for snow storms, power outages, being fired/job loss, floods, etc. That each person who can feed themselves is one less person the government needs to feed. Each person who can shelter themselves is one less person the government needs to shelter.

  However - we can not develop our own vaccines. We can not develop rewire our hospitals so they never loose power below a certin level. The governement can do this - if asked and backed by the people. 

  My only fear with mucking in some's level of self reliance is imposing my ideas on them.

  Lets say you have Homeless Harry, poverty pete, working class jane,  outdoorsman oscar, Tycoon Tommy, and rock star Mick Jagger. Which level is minimal? They all have different comfort levels. My ideas of comfort do not match theirs.

  What if they do not care?

  All I can do is warn them and try to help them. Try to relive any fear blocking their thoughts of dealing with AI.

  Loss of words now. Thanks SusanC. Personal power exsits within. How to use it wisely and let yourself be heard. Help official see a workable solution that benifits them and us.

  Well if it benefits us does it not benefit them?

Kobie
P.S. if Mick Jagger is adopting, Pick me, pick me.  :) ha ha ha

---

by: Kobie @ Mon Apr 16, 2007 at 07:37:30 AM CDT

[ Parent ]

SusanC - Sorry if there was anything wrong or offensive.

SusanC,

  I know you can respond to every message.

  I am sorry if there was anyting offensive or confrintational in the post

"SusanC, We agree on so many things for differnent reasons.  "

  Knowing what to do for my family is much easier than making broad statements. They are issues I do not have answers for nor all the training to deal with yet.

Kobie

---

by: Kobie @ Tue Apr 17, 2007 at 07:54:44 AM CDT

[ Parent ]

Offensive? How?

I don't understand.  ;-)

No, I didn't find anything offensive at all.  Sometimes if I read posts very quickly, I could miss some posts.  Or if, in this case, I thought what you were saying were rhetorical rather than actual questions!  LOL

So, for the record, no, I don't always respond to all posts.  I try, but I don't have a 100% track record, if that's what you mean.  lol

Anyhow, I do agree with you, that individuals can take responsibilities, but there are always going to be dilemmas and some problems that are more intractable than others.  We can but do out best.  I don't think we have any choice, personally.  ;-)


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

---

by: SusanC @ Tue Apr 17, 2007 at 11:34:04 AM CDT

[ Parent ]

Offensive How?

SusanC,

  Glad I was not offensive or downplaying your original post.

  Was just checking to make sure I was not offensive. Things do not always come out the right way. Some posts have already been marked as "Too American" or "There are people in the rest of the world"

  In my response to you I tried pointing to both the good and bad sides.

  Nuff said. I'd rather check and be wrong than not check.

Kobie

 

---

by: Kobie @ Tue Apr 17, 2007 at 12:07:08 PM CDT

[ Parent ]

TPTB can't

I spoke with a public health nurse today at our county's emergency prep day (we live in a volcano/earthquake region of Washington State).  She said that they had put together information sheets and gotten them to the regional Educational Service District.  There they sit as neither the county or the ESD office has the funds to copy them  -- there is also a reluctance to redirect funds because things seem "quiet" -- so there is energy toward childhood obesity, vaccinations (including new one for girls), earthquake training, mental health training and some emphasis on handwashing techniques.

It's hard for me to see pandemic flu as just one of many issues -- the nurse did talk, very sensibly, about measured responses -- that they are developing protocals for various levels of concern.  It's the same-o, same-o.  It all depends on how soon and how bad. 

I felt good that pandemic flu is clearly being taken seriously but also keenly aware that if it is "bad"  and "Soon" there just isn't a lot in the pipeline from TPTB

---

by: Olymom @ Sun Apr 15, 2007 at 00:40:36 AM CDT

"TPTB Can't" - Olymom two questions

Olymom,

  The two weeks of supplies does that run contrary to what TPTB want? Do they want people to evacuate and there for not have any supplies at home?

  Yes, funds are limited. Childhood obesity, vaccinations (including new one for girls), earthquake training, mental health training do take time. The new vaccinations for girls meet with opposition in my area which suprised me. With out additional funds nothing happens. Alot of places do not want volunteers m

  If the home supplies are an issue then can they put a link to the PandemicFlu.gov website?

  BTW - just by leaving some information out at work and church I've foud those interested in prepping. Hoping they pass the word as well.

  Best wishes to you.

Kobie

---

by: Kobie @ Sun Apr 15, 2007 at 18:27:49 PM CDT

[ Parent ]

It's 1950 all over again where is the CD ?

So where is the Civil Defense Center in your area?

They are all gone now since the mid 1970's,  maybe we need something along those lines with each street having its own appointed CD authority reporting to a regional center close to what the military uses in a chain of command.

I think the key will be communications up and down.  What you and your neighbors need and what resources will be given to you while in SIP.

Also CD was a civilian organization and had LEO powers for purposes of arrest to assist the police in security.

May need to find some old manuals and do some major reading.  It was a good model used during war and disaster for most of the 20th century.

RICH

  No warning - no way to fight - no way to win!  
We need help in our local communities to survive. Remember that quote:    "...No man is an island..."

---

by: RICHARD-FL @ Sun Apr 15, 2007 at 07:23:45 AM CDT

The 1950's CD - people will think it is music :) Will go looking. What do others think??Thanks. n/t

---

by: Kobie @ Sun Apr 15, 2007 at 18:05:15 PM CDT

[ Parent ]

Thanks so much...

...for consolidating the home care info in one place, and for such a fantastic, comprehensive list. 

Re:  CERT training.  DH & I took the training last year.  In the first session, I asked them what advice they had about pandemic flu, and whether they were planning a section on it.  They said it wasn't funded, and they seemed to want to move on as quickly as possible after my question.  There is a CERT segment on medical care, but it consisted of how to get the wounded out of a dangerous building, and basic triage.)  CERT, in it's present form does not address pandemic response!

IMHO, and I've suggested this in the past, the Certified Nurse Assistant training given by nursing homes could be easily adapted to specifically address taking care of a patient w/severe flu, diarrhea, dehydration, pneumonia, etc. 

In CA, CNA training is 20 hours (mandated by state regs).  I was a CNA long ago...training teaches you, for example, how to count respirations, take BPs, use a stethoscope to listen for abnormal heart and lung sounds, measure input/output, etc., etc.--It has everything we'd need, and would just need to be tweaked. 

Why reinvent the wheel?  Adapt CNA training and and offer it as a special CERT section. What's also great about it is that it's geared for someone without a post-secondary education.  Call up the currently CERT-trained folks and get them in first to take the training. 

---

by: SoCal @ Sun Apr 15, 2007 at 09:29:00 AM CDT

CERT, in it's present form does not address pandemic response!

that's true. There's work to change the form.

---

by: DemFromCT @ Sun Apr 15, 2007 at 10:06:20 AM CDT

[ Parent ]

You've illuded to this above as well -

Is this occuring on a national, state or local basis?

Is it a pandemic focus or a more general re-alignmend of CERT in response to Katrina or the threat of other mass casualty events?

Any general timeline on which we might either here of the effort publically or see the results?


ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

---

by: Into The Woods @ Sun Apr 15, 2007 at 15:46:19 PM CDT

[ Parent ]

I know people who are working on a training module

to address panflu prep for a CERT-style public. I can't tell you the timetable or specifics, but we will publish the complete module on the wiki for comment and review when it is available.

---

by: DemFromCT @ Sun Apr 15, 2007 at 15:52:14 PM CDT

[ Parent ]

Great to know. Thanks. N/T

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Sun Apr 15, 2007 at 16:33:42 PM CDT

[ Parent ]

Also looking forward to the module. How much can you cover? I know, just wait. :) n/t

---

by: Kobie @ Sun Apr 15, 2007 at 18:29:49 PM CDT

[ Parent ]

thanks

I repaired some of the links on the ARDS page.

---

by: DemFromCT @ Sun Apr 15, 2007 at 19:23:58 PM CDT

Starting Intravenous Lines

Not that many folks will have the resources to start an Intravenous Line, but this link looks pretty useful:

http://www.mrprotoco...

Michael Pezzulli

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by: michael pezzulli @ Mon Apr 16, 2007 at 06:04:26 AM CDT

Think it is simple? Read this. n/t

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Tue Apr 17, 2007 at 11:30:47 AM CDT

[ Parent ]

it takes longer to describe

than do, as is often the case.  ;-)

Try explaining, without diagrams, how to pare an apple!


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

---

by: SusanC @ Tue Apr 17, 2007 at 11:36:13 AM CDT

[ Parent ]

I'[m Sure. But you can't kill the apple if you do it wrong.

For instance, what's with the 'no big bubbles' thing anyway? I know it can be a problem, but how much?

It's this type of information that will be difficult to pass along to lay home care providers. 

The further up the ladder you go in intensity of care, the more knowledge is required to 'first do no harm' that we as lay people don't know and never see (unless we are unfortunate enough to have someone forget that knowledge at a critical moment.)

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Tue Apr 17, 2007 at 11:51:34 AM CDT

[ Parent ]

Other side of the coin

ITW,

  Let me play the other side of the coin

  "They are going to die anyway (or that is the feeling at the moment of the family) They need fluids and medication.

  Besides - with so many people dying who is going to do an autopsy?

  Don't worry - you could get it right"

  Now I do not advocate that desperate view. The more I think about 1918 pandemic the more stunned I am that people just watched others die in huge numbers. It may have been the norm back then but I'm not sure how it will be tolerated by developed nations.

  Technical question - pushing the needle into the vein is a easy as pushing the needle through the vein - right? You will still get fluid flow - just no benifit.

Kobie

---

by: Kobie @ Tue Apr 17, 2007 at 12:23:39 PM CDT

[ Parent ]

You go thru the vein

and you get a huge hematoma or else the fluid under the skin swells the area as the fluid infuses which may or may not cause a cellulitis. It has to be done with extreme cleanliness as you do not want to cause an infection in the bloodstream. Depending on the person the site may only be viable for a couple of days. The site itself may ecome infected. The infusion rate needs to be accurate so you don't give someone congestive heart failure. There is more to it than the technical part of starting the infusion....I am sure there are tutorials on the web and of course this is not medical advice, etc...

Life is not so short but that there is always time enough for courtesy. Ralph Waldo Emerson

---

by: mojo @ Tue Apr 17, 2007 at 12:42:12 PM CDT

[ Parent ]

Clean site

Mojo,

  Hi. Thank you.

  I actually feel comfetable cleaning the site.
  "Use one betadine soaked swab and starting from the center make a widening circle outward, discard swap. Pick up second swab and repeate. "

  I've donated blood lots of times and that part I can watch. Its the next step when the needle goes in that I can have trouble watching and would have trouble doing.

  Yes: "this is not medical advice and no warrenty is impllied or conveyed, your milage may vary, etc, etc."

Kobie

---

by: Kobie @ Tue Apr 17, 2007 at 15:16:31 PM CDT

[ Parent ]

Not as easy as it looks

Kobie,
Starting an IV on someone who is healthy and hydrated is very different than starting an IV on someone who is very ill and dehydrated.  IV's for flu patients will probably not be started until they are so ill that they cannot swallow on their own - and by this time, getting the needle into their vein will be more difficult.  Also, rate and type of solution will differ depending upon previous health problems, problems related to the flu (multiple organ failure, etc), how dehydrated the person is, and their age/body mass.  Doing any of these steps wrong could lead to the death of the person you are trying to help. 

---

by: Sniffles @ Tue Apr 17, 2007 at 15:36:33 PM CDT

[ Parent ]

Bevel up

on the needle and you will feel a slight pop when it enters the vein.  Carefully thread the cannula up the vein as you are removing the needle.Blood will drip out when the needle is removed. Hook up the tubing which you have already flushed with the iv fluid so there is no air in it.

You can check for placement by crimping the tubing for a moment and will see blood enter the tubing where it hooks to the cannula or you can lower the bag below the iv site and gravity will make blood enter the tubing. Better yet is to have a syringe with normal saline to draw back checking for blood and then flush while checking site for any swelling.. If using a butterfly, thread the needle up the vein and tape in place. Hookup as above.

If you see a big hematoma at the site you may have gone thru the vein and you will see swelling as fluid enters the tissue but in a dehydrated person you might not see the swelling at the site right away.
If you are using a tourniquet it is removed as soon as you hit the vein before the other steps.
I never liked using one.
Here are pics
http://www.mrprotoco...
Not medical advice, etc and so on.

Life is not so short but that there is always time enough for courtesy. Ralph Waldo Emerson

---

by: mojo @ Tue Apr 17, 2007 at 15:46:17 PM CDT

[ Parent ]

I really would not recommend

it except in a life or death situation if one has no training in maintaining it. Too much fluid can cause congestive heart failure or pulmonary edema.

If the person is ill enough I'd personally go the rectal route. They won't care at that point.

Truly though, if this thing progresses like the cases we are seeing now with the best care and equipment, it seems nothing will really help but if it is a loved one and no medical care is available we will all do what we can do.

Hopefully it will become less virulent.
I have started thousands of IV's and can probably do it blindfolded but when I was learning I blew a lot of veins.

Life is not so short but that there is always time enough for courtesy. Ralph Waldo Emerson

---

by: mojo @ Tue Apr 17, 2007 at 15:54:50 PM CDT

[ Parent ]

On never knows

Mojo,

  Hope I never have to. Even with 120% HCW in force and another 80%(guessing) from HC teachers and retired HCW, I belive there are more than enough people to overwhelm the system. Hence I may the onlyperson at hand.

  "Too much is never enough" (tiger den ldr motto)

  Yes - the good samaritan law would not apply as I would be working beyond what I have been shown should something go wrong. Little consiquence as I would feel bad even if was not my fault. Something else lay people are not well prepared for.

  Better than sitting around doing nothing. I would want others to at least try. Occasionaly things work the first time round.

Kobie

---

by: Kobie @ Wed Apr 18, 2007 at 07:22:49 AM CDT

[ Parent ]

rehydration through non-vein paths

there was this idea, not sure if from Dr Woodson's book, to pipe salty water through ... nay, can't find it

maybe try this?  http://rehydrate.org...

You arm yourself to the teeth just in case.  You don't leave the gun near the baby's hand.

---

by: lugon @ Tue Apr 17, 2007 at 14:21:54 PM CDT

[ Parent ]

I've Got You Under My Skin / I Hardly Even Knew'um.

There are a evidently a number of ways to hydrate and even administer medication (though this would obviously involve much more expertise) without trying to thread the proverbial needle into someone's vein.

Hypodermoclysis (subcutaneous infusion of fluids):
An Alternative Infusion Technique
http://dysphagia.com...

Hypodermoclysis, the subcutaneous infusion of fluids, is a useful and easy hydration technique suitable for mildly to moderately dehydrated adult patients, especially the elderly.

Rectal Medication Administration
http://health.enotes...

Rectal suppositories may be used for the treatment of fever, nausea, and pain; they may also be prescribed to induce sedation or bronchodilation, or to reduce the nausea and vomiting that can accompany chemotherapy. Medicated enemas may be used to cleanse the bowel, to combat bacteria, or to kill parasites.

Methods of Hydration in Palliative Care Patients

Includes discussion of various routes for hydration including both Subcutaneous Route and Proctoclysis
http://www.ircm.qc.c...

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

---

by: Into The Woods @ Tue Apr 17, 2007 at 17:21:45 PM CDT

[ Parent ]

Looks too simple

Michael,

  Hi. Thanks. I know more than I did but never having held a needle I would be timid.

  *joke*
  There is never a heroin addict around when you need one, but there must be one in the neighbor hood somewhere.
  *end of joke*

  However if TPTB think a college grad can just pick up the pices and follow the directions - which the directions you posted where good - is overly optomistic.

  Peoples arms look diffetent and getting over sticking a sharp object deep into someone else's skin..........

  IMO the average person may help hand out supplies or do minor repairs but is not a replacement for even an entry level HCW.  Yet when a family memner lies dying on the bed many will try to be.

Kobie

 

---

by: Kobie @ Tue Apr 17, 2007 at 11:44:14 AM CDT

[ Parent ]

Field Expedient Medicine

Tools, Techniques, Supplies and Remedies.

Given the general lack of preparation that can be expected, can we point folks to sources for 'macgyver' medicine. 

Don't want to recreate the wheel here, but if we can tell folks where to look - that would be helpful.

Added a couple of Flu Wiki 2 Dairy urls above re Field Expedient Medical Techniques.


ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

---

by: Into The Woods @ Tue Apr 17, 2007 at 12:26:38 PM CDT

the other end

As some one with really small veins that tend to roll when poked, I know I'm not an easy patient to help.  The tube up the nether end sounds dreadful but the directions I've read sound pretty straightforward and a lot more idiot proof. 

---

by: Olymom @ Wed Apr 18, 2007 at 14:01:28 PM CDT

...

might get some ky, then... on the off chance the patient survives, and you might ever run into them later in life after they've fully recovered..  especially if they are bigger than you, or hold grudges.

iv's...  been there, done that...  it really would be better for folks to get trained on that - it's not something that one can read a pdf on and gain a skill set.

---

by: c3jmp @ Wed Apr 18, 2007 at 15:34:59 PM CDT

[ Parent ]

Training counts - its ok not to try

C3Jmp,

  Yea have to agree. It all depends on how bad things get.

  BTW in college a nurse student told me decades ago "Liquid mediciins that can be put in one end can be put in the other when teh patient is un able to swallow safely"

  I had blotted this memory out till now.

Kobie
"One should never think too highly of them seleves and forget there is a direct uninterrupted tube connecting the mouth to one's rear end" - from a french guy at a party.

---

by: Kobie @ Thu Apr 19, 2007 at 07:34:00 AM CDT

[ Parent ]

Update of Content - Home Care

Have added these in the last couple of days:

PATIENT CARE 9.5 mins video
A practical 'how to' guide to managing patients with influenza and minimize health risks.  (Added 4.17.07)

Adjustment Reactions during an Influenza Pandemic (Added 4.17.07)

Field Expedient Medical Techniques II (Added 4.17.07)

(Mods: Flu Wiki issue: Can't access Field Expedient Medical Techniques I at Flu Wiki. Will add it later if possible.  The link is provided in Part Deux but takes you to a locked page sans substance.  http://www.fluwikie2... )

Interactive Health Tutorial on Avian Influenza Or Bird Flu - National Library of Medicine (Added 4.18.07)

Interactive Health Tutorials - General Listing National Library of Medicine(Added 4.18.07)

Drugs, Supplements, and Herbal Information
Medline Plus (A service of the National Library of Medicine and the National Institutes of Health)(Added 4.18.07)

See live links above.

Wondering whether there is any kind of guide for how formulate medications for Hinder application. (Formulas, mixtures etc.)  Guessing you can't just drop the pill in a bag full of water and enemize away.

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

---

by: Into The Woods @ Wed Apr 18, 2007 at 16:10:01 PM CDT

Community Resilience

I'll have some new community resilience URLS to add to this thread in the coming weeks.  I'm working on some projects with a friend of the wiki.

Be kind, for everyone you meet is engaged in a great struggle.--Philo of Alexandria

---

by: Melanie @ Thu Apr 19, 2007 at 22:15:59 PM CDT

Hope they're still coming. n/t

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

---

by: Into The Woods @ Thu May 03, 2007 at 13:45:57 PM CDT

[ Parent ]

Community Mask Guidance - Added May 3, 2007

Interim Public Health Guidance for the Use of Facemasks and Respirators in Non-Occupational Community Settings during an Influenza Pandemic May 2007  (Added May 3, 2007)

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

---

by: Into The Woods @ Thu May 03, 2007 at 13:46:49 PM CDT

New Resources Added 6.22.07

American Red Cross - Preparing for a Flu Pandemic Fact Sheet
Coping and Emotional Well-Being (Added 6/22/07)

A survey of human cases of H5N1 avian influenza reported by the WHO before June 2006 for infection control

(Added 6/22/07.  Currently restricted access.)

Influenza Pandemic Preparation and Response - A Citizen's Guide
Sarah Booth & Kelsey Hills-Evans with Tessa Anderman, Maya Guendelman, and Christine Chang

Conceived, supported and sponsored by
Jane and Peter Carpenter
Also sponsored by
Mid-Peninsula Citizen?s Preparedness Committee  (Added 6.22.07)

Still looking for suggested additions that I can add to the body of the diary for easy cut and paste. 

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

---

by: Into The Woods @ Fri Jun 22, 2007 at 18:21:40 PM CDT

Version 1.3 Citizens Guide Added 071307 nt

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

---

by: Into The Woods @ Fri Jul 13, 2007 at 14:18:50 PM CDT

link is here

http://www.newfluwik...

---

by: DemFromCT @ Fri Jul 13, 2007 at 14:28:25 PM CDT

[ Parent ]

Thanks. Diary revised accordingly. nt

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Fri Jul 13, 2007 at 15:40:24 PM CDT

[ Parent ]

75% of deaths may occur in non-hospital setting : JTFCS Mass Fatality Working Group

In a mass-fatality incident associated with a communicable disease, the location of the bodies will not be restricted to one geographic area. Since hospitals will be admitting only the sickest patients and using public health?s isolation and quarantining procedures for other ill individuals, as many as 75% of deaths may occur outside a hospital, additionally straining both workers in the field and the coordination of activities and information. Morgue space will be quickly overwhelmed.

In case anyone needed further confirmation of where the bulk of pandemic care will be provided, this is one of the assumptions used by the Joint Task Force Civil Support Mass Fatality Working Group. 

http://www.homelands...

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Mon Jul 23, 2007 at 13:39:54 PM CDT

remains treated with care

From link above:

The following should be considered priority strategy and policy areas in planning for pandemics and catastrophic health events:

Although mass-fatality events have remained relatively rare in the United States, the current threat environment and forecasts of pandemic influenza require revised strategy by government and industry and modified expectations by the public. Most people assume that the remains of a loved one will be treated with care and will be expeditiously returned to the next of kin for customary interment. Therefore, government leaders and public information officers must prepare now to deliver honest and timely information to the community. These leaders must be ready to deal proactively with heightened levels of frustration and anger in order to restore confidence and maintain public trust during periods of massive social and economic dislocation.

Pandemics are "Wicked Problems". - Average Concerned Mom

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by: ACM @ Mon Jul 23, 2007 at 14:51:18 PM CDT

[ Parent ]

probably more than 75% if you work the numbers

I bet more than 75% of deaths occur outside of a hospital setting.  I can't work the numbers in my head but for instance:

Hillsborough County, FL has about 3300 hospital beds total for a population that well exceeds 1,000,000.  If we take the conservative esstimate that 20% of the population will get sick that is 200,000.  If there is a 2% (again, likely conservative for H5N1) that will give you 4,000 dead.  That is already 700 more deaths than there are hospital beds for ... and that doesn't include collateral deaths from healthcare shortages.  With conservative numbers Hillsborough county only has 83% of the beds they need ... for the dead.  3300 divided by 200,000 means that we only have roughly 2% of the beds that we need for everyone who gets sick.

There is no way that everyone who gets sick ... even using conservative numbers ... will get a traditional hospital bad.  I'm not sure how many beds they could add using tent cities as I'm not sure how they would staff those facilities.

The higher the AR the worse these numbers become, even if you stick to the "mild" 2% CFR.


Never doubt that a small group of thoughtful, committed citizens can change the world, indeed it is the only thing that ever has. -- Margaret Mead

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by: KathyinFL @ Mon Jul 23, 2007 at 15:08:32 PM CDT

[ Parent ]

Caring For Yourself and Others - New Preparedness Guide Fairfax County VA

Caring for Yourself and Others - Seasonal and Pandemic Influenza 
A Preparedness Guide for the Fairfax - Falls Church Community

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Wed Jul 25, 2007 at 09:24:40 AM CDT

turning off bold

test.

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by: DemFromCT @ Sun Nov 18, 2007 at 18:33:26 PM CST

[ Parent ]

another test

here.

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by: DemFromCT @ Sun Nov 18, 2007 at 18:36:38 PM CST

[ Parent ]

WHO Aug 2007 Clinical Mgmt Guidelines and 06 Rapid Pharm Guidance

Added to Diary Text August 21 2007

From the recent international meeting (March 2007 in Turkey);

Clinical management of human infection with avian influenza A (H5N1) virus
15 August 2007  (Added August 21, 2007)

WHO H5N1 Clinical Case Summary Form (Added August 21, 2007)

Supplementary WHO H5N1 Clinical Case Data (Added August 21, 2007)

WHO Rapid Advice Guidelines on pharmacological management (Added August 21, 2007)

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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here.

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by: DemFromCT @ Sun Nov 18, 2007 at 18:38:40 PM CST

[ Parent ]

Field Expedient Medical Techniques - still wondering if they are over at Flu Wiki

(Can't access Field Expedient Medical Techniques I at Flu Wiki as referenced in the following. Will add it later if possible.)

Field Expedient Medical Techniques II (Added 4.17.07)

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Tue Aug 21, 2007 at 15:38:47 PM CDT

Central Ohio's "Health Information Translations" - Pandemic Home Care Resources

Added to Diary Text 8.21.07

From Health Information Translations, an Ohio-based collaborative initiative to improve health education for limited English proficiency patients:

12 Tranlations of "Pandemic Flu: What it is and How to Prepare" (Added 8.21.07)

12 Tranlations of "Home Care for Pandemic Flu" (Added 8.21.07)

12 Tranlations of "Power Outages"(Added 8.21.07)

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Tue Aug 21, 2007 at 18:02:29 PM CDT

Montgomery County: Stay At Home Toolkit - Influenza

Stay At Home Toolkit for Influenza
Montgomery County Department of Health and Human Services, Public Health Services - Montgomery County Maryland  (Added 9.19.07)

Nice resource.  Hat tip: Dem

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Wed Sep 19, 2007 at 20:39:40 PM CDT

Adding New Version of Citizen's Guide to Resource Listing

Influenza Pandemic Preparation and Response - A Citizen's Guide - Version 1.5 November 2007

Sarah Booth &
Kelsey Hills-Evans

Conceived, supported and sponsored by
Jane and Peter Carpenter
Also sponsored by
Mid-Peninsula Citizen's Preparedness Committee  (Added to Body of Original Diary 11.7.07)

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Wed Nov 07, 2007 at 13:46:55 PM CST

I wish they'd have fixed that map

it says North America doesn't have H5N1 in wild birds; it does (according to the HEDDS table) officials are just equivocating about which strains/subclades; the public thinks it means H5N1 isn't here at all. Wish the map could be broken down by clades or something...

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by: crfullmoon @ Wed Nov 07, 2007 at 14:26:21 PM CST

[ Parent ]

Mods - help turning off bold - thnks. ITW n/t

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Sun Nov 18, 2007 at 18:00:42 PM CST

ITW ... thanks for reminding about this diary

I need to get all of this stuff printed off and into its own binder.

So much to print, so little toner.  [sigh]

Never doubt that a small group of thoughtful, committed citizens can change the world, indeed it is the only thing that ever has. -- Margaret Mead

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by: KathyinFL @ Mon Nov 19, 2007 at 07:54:43 AM CST

Resource costs

I am trying to keep the resource list in the body of the diary up-to-date by editing it to include new additions/versions as they come along.

There are some of these documents (longer ones) that actually might be cheaper to buy than to print.

For instance the "Where There Is No Doctor" volumes are so long that ordering a copy might be a better alterative than printing.

It depends on who is doing the publishing and how much they are taking out of the purchase price.

There is also a fair degree of overlap and redundancy - which means that folks should skim through these and decide what looks like it fits their needs/situation. 

The other option is to download, especially if onto a portable drive, for access/printing later even if the internet is not available. 

The key in downloading is to organize your downloads into categories that you will remember and be able to find things in as needed.

I started sending myself emails of important documents with the topic broken into searchable categories and subcategories to make it easier to file later.  It has helped alot.

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Mon Nov 19, 2007 at 15:57:21 PM CST

[ Parent ]