MARCO Grand Rounds for May 18, 2008

From Warren, KD4GUA:

Most of our active members will be in Dayton this Sunday. It will be "Open Sunday." "Vox Pox," communication program. Let's have 30 new net controllers on board...it should work out okay.

If possible, we will transmit from Dayton but it is doubtful as most of the visitors will be homeward bound by 10 a.m. eastern.

The program for the following week is pending...any suggestions?

MARCO Grand Rounds for May 11, 2008

From Warren, KD4GUA:

One woman woke up with a paintbrush in her hand, having painted her front door in her sleep--she was taking Ambien (or Lunesta) sedative hypnotics. How safe are these non benzodiazaepines? Remember Halcion? I had a patient fall asleep while walking up the gangway to an airliner!

Tune in Sunday, 10 a.m. Eastern time 14.307 and give us your experiences with these drugs. Should be fun.

MARCO Grand Rounds for May 4, 2008

From Warren, KD4GUA:

This Sunday we will discuss a problem that is becoming more and more prevelant--clostridium difficile infections. Which drug is best Flagyl or Vancomycin--or is there something else? Tune in, should be fun.

Sri Lanka Update

Hemantha Gamage notified MARCO today that the Sri Lankan government has been so impressed by the MediShare-funded VHF radio project, that they will pay to generalize it throughout the western part of the country. Read on:

Dear Sirs/Madams,
Our provincial council decided to have the VHF system to all the health units and ambulances in the western province , Sri Lanka. They have realised the value of VHF radios esp in disasters. MARCO/Medishare should get the credit for introducing the system and funding for it. Provincial health minister assured that the government would bear the cost for such a system.

They requested me to do a study and a plan for the whole province as soon as posible. Anyway I am supposed to start my MD at the post graduate institue of medicine,University of Colombo. But I promised to stay with them as a volunteer for the system. I enjoy the work.

Thank you.

Hemantha 4S7HG

MARCO Grand Rounds for April 27, 2008

From Warren, KD4GUA:

You are on an airplane and a passenger is having chest pain. They call for a doctor...should you respond? Will you respond? Do Good Samaritan laws go into effect when you are passing over different states in rapid succession? What state law would ensue if something went wrong?

This Sunday we will discuss the "Good Samaritan" laws and how they effect you. Should be fun...10 a.m. eastern time...CW on at 9:30 a.m. Eastern.

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This grand rounds generated some interesting commentary:

From Bob, K4RLC

I missed the net on Good Samaritan laws, and wonder if you will write it up for the newsletter?

I'm interested not because of air travel, but because both our kids play several high school sports. Fortunately, they haven't been hurt yet, but some of the parents in the stands are pretty out of shape, and I've had to work on one who collapsed during a basketball game. We all tailgate at the football games, and food is copious and tasty, and that situation is ripe for a coronary or diabetic event.

A rare event happened here a few weeks ago at a high school Lacrosse game. A player was hit in the chest by the lacrosse ball, and collapsed from Commotio Cordis. He was fortunate in that a teammate's Dad is Director of Rehab Medicine here, and had read up on this rare condition beforehand. There were a total of 3 physicians and 6 nurses among the spectators, and all helped. But what saved this young man's life was the AED, as he went into V Fib. He had to be shocked three times.

He survived but suffered a hypoxic event, so I'll probably see him. I'm the neuropsychologist for our professional hockey team (Carolina Hurricanes) and see them all after concussions, as well as high school and some college kids with concussive type injuries.

Thanks for your input about out of shape parents in the stands, hi.

From Mary Kaye, AE4BX:

had something to add about being a pseudo-team doctor. When my son was in 8th grade he played football for a small private school, It was his first year playing (over many of Mom's objections). I was the unofficial team doctor by default. My husband who was a first-aid trained pharmacist, sat down on the bench with the players. I had every possible piece of equipment in my station wagon, head board etc etc etc.

The routine was that when anyone was down, my son should step aside and show me his numbers (so I could walk). Well the feared incident happened, and one of our team members went down on the ground after a tackle, held his neck saying "my neck, my neck, my neck!!!!!!" After inspecting my son's number of course, I rushed down on the field, saw that the boy could move his legs, stopped the game and called EMS. Expected chaos. Well as the sirens were heard from afar, the boy's father came down on the field, a rough an tumble redneck also smelling of spirits if I were to render an opinion. He looked at the kid, shouted. (EXPLETIVE DELETED) SCOTT, GET YOUR RED LAZY A-- UP OFFA THE GROUND AND GO PLAY BALL!!!!!!!!!!!"

Well as the EMS guys were running the stretcher on the field, the kid got a red face and said "Uh, OK Dad", and jumped up and ran to the bench". Leaving me there red-faced and about to punch out that redneck myself.

I inquired from an orthopedist later how I could tell - and he said always ask the player to raise his head up himself, and of course don't help him or yank the helmet off etc. If he had either a bad whiplash or a structural damage of any kind to the neck he can't raise his head. I saw this done many times on the field in later football games when I became an armchair expert.

My son's football career was over that year by the way. I said he could grow tall and play basketball or find himself a foster home. He took the advice, grew to 6'3" and played basketball nicely according to plan. That was also the end of my team doctor career.

And Warren KD4GUA's reply

Bob RLC in Raleigh asked about the specifics concerning the Good Samaritan Laws as he missed the lecture. Basically you are covered if you act in good faith, do not perform gross neglect, do not accept money for your deeds and do not leave the patient until someone else can take over with equal or more experience. You do not have to perform a good samaritan act unless you live in Vermont, Minnesota or Louisiana, France or Germany and then it is mandatory to help. Benign neglect is acceptable, i.e., if you do 15 instead of 30 chest thrusts for each mouth to mouth (which is now not required) that is benign neglect because you simply missed the last Red Cross course in CPR. The individual or next of kin must give consent unless the patient is unconscious or not able to give good judgment. In most jurisdictions Good Samaritan laws only protect those that have had basic first aid training and are certified by the AHA, Red Cross, or other heal th organizations. In other jurisdictions, any rescuer is protected from liability, granted he acted rationally. Congress passed a bill about 1994 enabling good samaritan laws in flight regardless of which state the plane is flying over. In international flight the rules go by the carrier's home country.

PS: The requirements as you walk through the hospital and there is a cry for help from someone else's patient--that is another story and perhaps another Sunday lecture.

MARCO Grand Rounds for April 20, 2008

From Warren, KD4GUA:

This Sunday we are planning on having Phil Wildman the pilot who has flown both the Atlantic and Pacific over 250 times in single engine Piper aircraft (and Cessnas). He will tell us what it is like flying for 17 hours over endless ocean and how he got to know himself better. This is today's Lindbergh. He will discuss the use of radio for navigation and communication. Today, GPS has largely taken the place of radio navigation but we will let him tell his story.

It should be a good one. Let' s hope propagation doesn't let us down this weekend. He assures me he will be on board and is not mike shy.

Sunday, 10 a.m. Eastern 14.307--CW net at 9:30.

Further update from Sri Lanka

Additional news from Hemantha Gamage, 4S7HG:

Dear Sirs,

I wish to foward an outline of our VHF project in Sri Lanka.

The system operates from the District General Hospital Gampaha, which is the largest hospital in the area. There are small peripheral hospitals transfer difficult patents to above hospital. The system operates with a base station installed at the District General Hospital Gampaha and the mobile units are fixed to the ambulances. There are 3 ambulances at above hospital and one ambulances each in the peripheral small hospitals, Biyagama, Dompe, Divulapitiya and Minuwangoda. Therefore 7 mobile units are fixed are given for those ambulances.

The provincial health authority appreciated the contribution of the MARCO in establishing this system. The Ministry and the provincial director will address MARCO in order to thank you all for the good work done.

I presented the radios officially to the secretary of the provincial health ministry on behalf of the MARCO. I will attach few photographs for the time being but the provincial health ministry will contact MARCO with better pictures and hopefully video of the opening day.

I am grateful to all friends at MARCO for extending all the support and courage for me to drive this project towards success.

This morning our hospital system experienced a disaster just one day after launching the system. This was a suicide terrorist attack killing one eminent cabinet minister of the government and around 14 civilians. The incidence took place close to Gampaha draining most of the patient s to District General Hospital Gampaha. Hospital authority informed me that our system played a big role in coordinating ambulances very quickly.

Please give me some time to send the pictures and whole story in sometime as I was very busy with installing the system and other arrangements with the opening ceremony.

Thank you all once again.

Hemantha (4S7HG)

MARCO Grand Rounds for April 13, 2008

From Warren, KD4GUA:

We had 30 checkins for April 6's discussion on "Lipitor and Statin Drugs" with a 5/3 propagation rating (pp). This coming Sunday we will investigate medical arbitration...

"By signing this agreement you are waiving your right to a jury trial and you are agreeing to arbitrate all clams arising out of or related to your medical care and treatment." Will your patients sign this?

Those of you who are utilizing arbitration agreements be sure to be on board to narrate your experience in this new and challenging field. Should be fun.

PS: Linda KE5BQK is baking a cake for the Marco Banquet May 17th in Dayton, Ohio. All 16 reserved rooms at the Holiday Day North have been taken according to Danny W4DAN. However, there are still rooms available by phoning 937 278 4871. If you would like to share a room, notify Danny by email Danny@W4DAN.us

Let's have a party.

MARCO Grand Rounds for April 6, 2008

From Warren, KD4GUA:

This Sunday we will again attempt to talk about Lipitor and the statins. Tune in 14.307 10 a.m. eastern, hope there is no "contest time" so soon.

Blog-meister's note: Contests are planned at least a year ahead of time, and their dates/times are not kept a secret. We should never be surprised to find a full-blown contest raging. It makes sense to take off four weekends a year during the running of the SSB CQWW, ARRL Sweepstakes, ARRL DX, and CQWPX contests.

Christine Haycock, WB2YBA, Silent Key

Today's MARCO-list brought the sad news from Fred Simowitz, K0FS, that Chris Haycock, WB2YBA had passed away in January. She was a woman of extraordinary accomplishments and a long-time MARCO dignitary. The following excerpt from the Newark Star-Ledger but scratches the surface of her life story:

Haycock, Dr. Christine HAYCOCK Dr. Christine Haycock, surgeon, professor, 84 Christine E. Haycock, M.D., 84, of Newark, died on Wednesday, Jan. 23, 2008, at the Center for Hospice Care at St. Josephs Hospital in Wayne. The funeral service will be on Friday at 7:30 p.m. at the S.W. Brown & Son Funeral Home, 267 Centre St., Nutley, swbrownandson.com. Friends will be received at the funeral home from 4 to 8 p.m. The interment of her remains will take place at Arlington National Cemetery in Virginia. Born in Mount Vernon, N.Y., and raised in Richmond, Va., before moving to Nutley, Dr. Haycock went from Nutley High School to the Presbyterian Hospital School of Nursing. She earned her B.S. degree from the University of Chicago, her medical degree from the State University of New York, Downstate Medical Center (1952), and held a masters degree in political science from Rutgers University. She first served in the Army during World War II in the U.S. Cadet Nurse Corps. She extended her military career when she obtained her M.D. and became the first woman intern at Walter Reed Army Medical Center, at which time she became the first woman to transfer directly from the U.S. Army Nurse Corps to the U.S. Army Medical Corps. After serving in the United States and Japan, she reverted to active reserve status, ultimately retiring in 1984 at the rank of colonel. She was also a graduate of the U.S. Army Command and General Staff College and the U.S. Army War College (1977). Dr. Haycock resumed her residency in surgery following her active military service at St. Barnabas Medical Center and a year as a senior resident at St. Johns Episcopal Hospital in Brooklyn, N.Y. She then returned to Newark and opened a private practice in general surgery. She was a diplomat of the American Board of Surgery and a fellow of the American College of Surgeons. She was a leading expert in sports medicine and was a member of the American College of Sports Medicine. She had published widely in this field, particularly concerning women in sport. In 1982, she served as president of the American Medical Womens Association and was a past president of the New Jersey Medical Womens Association. She was long affiliated with the University of Medicine and Dentistry of New Jersey. In 1968, she joined the faculty of the New Jersey Medical School as associate professor of surgery and director of emergency services at University Hospital. She retired in 1992 as professor emeritus of surgery. Dr. Haycocks wide interests included amateur radio, photography, videography, and breeding and showing miniature schnauzers, Manchester terriers and Italian greyhounds. The Foundation for the History of Women in Medicine and The College of Physicians of Philadelphia recently presented the fifth annual Alma Dea Morani Renaissance Woman award to Dr. Haycock on Oct. 28, 2004. In their citation it was noted that, Dr. Haycock excelled as a physician, teacher and mentor to other women who sought to become physicians. She was best known for her influence on sports medicine for women, her work on the eradication of uterine cancer and her leadership in the establishment of the trauma center at University Hospital in Newark, as well as her post as commander of a trauma unit during her service in the Army Medical Corps. In 2006, she was inducted into the Nutley Hall of Fame.

RIP and 73.

Sri Lanka Radio Project

MediShare International has supported MARCO Member Hemantha Gamage, 4S7HG in his efforts to equip his hospital with a VHF mobile communications system to facilitate communication with its ambulances. In an email sent today, Hemantha announced the near-completion of this project. Congratulations!

Dear Sirs,
I am pleased to inform you that we have started installing radio equipments of our VHF system in Sri Lanka. This week we installed the base station at the District General Hospital Gampaha.
The base station was fixed in the room reserved for the Telephone operators in the hospital. The antenna was fixed on the roof top of the 7 story building. The cable is 100m long approximately. This happened because we planned for a repeater but we had to give up that idea due to licensing problems. The radio is transmitting 25w but we checked the effective power reaching the antenna was only 2.5w. However we could contact Colombo without much problem yesterday.

We have to do more fine tuning in order to get more effective radiation.

We have also started installing mobile units and would complete them by next Tuesday.
At the same time we happened to pay approximately Rs. 15000/= per radio as the annual frequency charge. But we are negotiating with the central government and telecom authorities with the help of local government health minister to exempt the charges. I wish it would work. I am very happy that most of our senior officers and the (Local Government) health minister are enthusiastic about this new development. Also they are very happy to see ambulances of 4 small peripheral hospitals getting reliable mode of communication with our project.

We have fixed a date for a small opening ceremony for the new development, tentatively fixed 5th of april 2008. I would appreciate if you could send a message (or any suggestion) for the opening ceremony. I apologize that I could not send you some pictures of the work done because

I was busy with my family commitments and my job.
Anyway I will send all the photos and details of the project as soon as I completed the work (opening ceremony).

However I feel I have driven our work to towards the "goal" successfully. Also I feel the time, money and effort that I spent with your lavish contribution has become a fruitful effort.
My director and the minister would contact you after completion of the project for thanking the friends at MARCO.


Thank you.
Hemantha Gamage 4S7HG.

MARCO Grand Rounds for March 30, 2008

From Warren, KD4GUA:

This Sunday we will decide truth from fantasy--research states "Except among high-risk patients, the benefits of statins such as Lipitor are overstated." The false advertising states that Lipitor reduces the risk of heart attack by 30%. Where did they get this 30%? The study found for each 100 patients taking Lipitor for 3.5 years they averaged two heart attacks per hundred whereas those not on Lipitor had three heart attacks per hundred--a reduction of 30%!!! A bunch of baloney--by the way to they still sell baloney? I'm a stockholder in Pfizer so I promise to take it easy.

Warren KD4gua PS: Our pilot last week was a no-show--I think he is mike shy.
Blog-meister's note: This weekend is the CQ WPX phone contest, so it may be tough sledding. Give it a try regardless.

MARCO Grand Rounds for March 23, 2008

From Warren, KD4GUA:

Propagation--good propagation seems to have staggered through the Daylight Time change as we had 34 check-ins last Sunday during our discussion of "Hospitalists."

This Sunday we hope to have on board Phil Waldman, the ferry pilot who has flown the Atlantic and Pacific in small planes over 250 times...he will discuss the fun involved in being over the vast oceans all alone with yourself and how you get to know yourself better.

Tune in should be fun. If you have any questions for Phil ASK, he is easy to talk to--especially using radio location finding prior to GPS.

MARCO Grand Rounds for March 16, 2008

From Warren, KD4GUA:

Last Sunday with the advent of Daylight Savings Time and the delay in transition of the Gray Line, propagation was impossible. We had a long skip but no short skips. Fortunately, Phil Waldman, Ferry Pilot who was to be our guest was unable to show because of a weather hold up in the Pacific on a small plane flying to Japan. I will have breakfast with him Saturday morning and will suggest we further postpone his talk because of the bad change in propagation. Instead, we will talk about "Hospitalists." Do you love em or envy them, or cuss 'em? Now, everyone say "Bananas." (You're a fine bunch!)

MARCO Grand Rounds for March 9, 2008

From Warren, KD4GUA:

Sunday, MARCO's host will be Phil Weldman, President and owner of "Globe Aero", a ferrying service for small airplanes. Phil has made over 250 ocean crossings to Europe and Australia in single engine Cessnas and Piper aircraft. He will tell you how he utilizes his radios and the changes that GPS has brought. If you didn't have the opportunity to meet Charles Lindbergh, here is your chance to meet the 21st century version.

Three weeks ago, I drove to Lakeland, Florida to tour Phil's hangar which is geared to take in a brand new airplane on one end, fit it with auxiliary tanks, and have it exit refitted on the other side. On the tarmac was a brand new Piper two place single engine landplane with conventional landing gear destined to be flown to Berlin, Germany. A car drove up and out popped a retired TWA captain who was to fly the little plane over. We chatted and parted. One week later I learned the little plane took on ice 400 miles out of Iceland, became a flying ice brick, lost its lift and the pilot informed Iceland center--"I'm going down." Icing levels were at sea level. The pilot and plane were not recovered. This Sunday's Grand Rounds will be dedicated to that pilot, his name? Captain Greg Frey, TWA retired.

Tune in should be educational...write down your questions and Phil will try to answer them.

MARCO Grand Rounds for March 2, 2008

From Warren, KD4GUA:

This Sunday we will discuss the "Hospitalist." One of the fastest growing medical specialties is a field that barely existed a decade ago: Hospital Medicine. Today, about half of all hospitals now use hospitalists in some capacity.

We will discuss your experience dealing with this touchy subject and what your feelings are. Why not drop the office practice and do this work? Am I qualified? Tune in, should be educational.

MARCO Grand Rounds for February 10, 2008

From Warren, KD4GUA:

This Sunday we will discuss: 'WHAT WILL YOUR PATIENTS THINK About Computers in the Exam Room?"

This will be a discussion rather than a lecture so be willing to participate and express your opinion. Many patients feel the computer is interfering with the doctor-patient relationship....instead of eye to eye it is eye to computer...how do you feel about this, are you spending more time talking to the computer than to the patient?

OPEN FORUM, Join in, Sunday, 10 a.m. Eastern 14.307....should be fun...

MARCO Grand Rounds for January 27, 2008

This Sunday on the Bob Currier Marco Grand Rounds we will discuss "THE SCIENCE OF ROMANCE." Your textbook and homework assignment is to read the Jan. 28, 2008 edition of TIME magazine.

For example, "women who live communally tend to synchronize their menstrual cycles. In nature this is a good idea; it is not in the community's interest for one ovulating female to monopolize the reproductive attention of too many males. Better to have all the females become fertile at once and allow the fittest potential mates to compete with one another for them." Males can sense by smell when a female is ovulating! (if he doesn't have a cold!).

Tune in, should be fun--BUT DO YOUR HOMEWORK!

"Aether" will be in the mail tomorrow (Jan 23) with the CME certificates if you qualify. Unfortunately four of our usual gang haven't paid their dues and your mailing labels did not arrive in Tampa Bay. If your dues are behind (and mine are also!) get on the ball, not behind it..as soon as the membership is updated you will receive CME certificate. Only fair.

Do your homework--good topic, good resource and enticing, enticing. Warren kd4gua.

MARCO Grand Rounds for January 20, 2008

This Sunday we will continue the discussion on "When can I go home after a radionuclide test?" Tune in 14.307 Sunday at 10 a.m. Eastern....get your reservations into Dayton...details coming up in next Aether.

-Warren KD4gua.

MARCO Grand Rounds for January 13, 2008

From Warren, KD4GUA:

This Sunday we will have a double feature.

Feature #1. Is it safe to send patients home after radiation therapy? (Will they irradiate their loved ones?)

Feature #2. A new study in patients over 80 with hi bp who had their bp lowered to the conventional target range had lower survival rates than those with blood pressures at higher levels. What is your input? Should be fun....tune in 14.307 10 a.m. Eastern time.

CW net at 9:30 Eastern time.