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Thanks ..



has been a tough year for work, guards, change of address, family ... in a few months my mother died and some calcifications that appeared in my left breast, which were apparently to be benign, were cancer with aggressive infiltration and markers. Being

physician, and seeing the number of inaccuracies in medicine, from the beginning I trusted the surgery, I think the "sister list" of medical art.
Everything else is likely, experimental drugs, statistics, coldness in the treatment of multiple queries in Oncology and dose of hope that the sick are concerned.

's love, I feel for each and every one of you, do not know if you can imagine what can represent moments.
I think I see more hopeful, and stronger than I am deep, but I suspect also that if you see me that's because basically it will be, but even I realize it me.
is why that mirror of friendship is so necessary sometimes, when you feel so lost.

Thanks:
Juke, Moli and parents, Foruno, Iñaki, Kanif, Txolarte, Mike, and Mike, Frabetti, Galileo, my dear Gang, and many others foreros and Forero, who from a distance I have supported.
Thanks to:
Javiviz and his wonderful mother, Isa, Jabier, José, Antonio, Pinky, Iñaki, Jose, Itziar, Eli, JoseRamón, Light, Conchita, Justi, Marta, Bethlehem, Bego, Marian, Mariví, Maribel, Celia , Goñi, Mary, Ross, Rachel, Eneko, Arrate, Guti, and all my brothers: Charles, Elizabeth, Bingen, and Carlos, Bego, Bingentxu, Jordi, Claude, Marisa, Chefi.
Kauldi Thanks to my son, a true master of this little engine and boat at sea.

Thanks to all you gave me kicks kicks this year and the previous one (do not deserve their names appear) by the slights, disappointments, hard feelings, arguments and say enough dose to damage, because then you have made me appreciate the value of friends, of love, affection in a word of friendship.
Thanks to my sleepless nights, the chosen, and defended my loneliness, my tears and laughter. Thanks.

A good year 2011, which I hope and I wish, because we deserve each and every one! Mil
Ezker!
Thanks!

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TRAUMA JOURNAL

Historically, many of the lessons learned in assisting wounded in the military field have found application in the civilian trauma (ATLS protocols, PHTLS, etc.). The experiences of combat medics in World War II, Korea and Vietnam, along with their growing understanding of the on-site assistance, rapid evacuation, transport and final treatment of those injured in combat, are the basis on care which is based tactical combat casualties. While SWAT teams began to appear in the 1960's, it was recognized that the medical support of some kind would be necessary for units in high-risk missions. The model proposed model was based on medical military combat, suggesting it was part of the tactical unit. More specifically, these technicians were a medical team of special operations. Some of the policemen and paramedics who were tactical units often were veterans of Vietnam. It is important to mention that for best performance of a tactical medical team in a public security force, it is necessary to integrate the staff who are trained in three areas: as a provider of medical services, be a police officer, and be official of techniques special intervention (SWAT type techniques). Recently, medi-cal services civil emergency has been called to assist in numerous school shootings, mall shootings and other acts of terrorism that have tactical factors similar to those found in combat. The threat of receiving hostile fire, having to attend multiple injuries has covered, and prolonged evacuation times have come into play. Fighting in the border cities, and some other places in our country are examples that illustrate that even in urban settings, starting treatment, and transport of injured may require tactics and training outside the parameters of the proto-cols standard of medical services emergencies. The adoption of the guidelines apply-able tactical care of combat casualties in tactical programs for Emergency Medical Services and the application of these principles to the tactical operations-tion of the Corps and State Security Forces can be a better continuity-ing tactics and additional lives saved when the wounded are produced during the course of these operations.
Unfortunately this is the situation faced by prehospital services, the paramedics will have to manage both tactical medical protocols for medical care (use of tourniquet combat pneumothorax management, use of gauze combat) and techniques for the extraction of casualties under fire, injured etc transport. "NAR will have to ply the use of rigid stretchers canvas military style stretchers use of tactics, we must train them in skills now Tactica Medicine. In hospitals, emergency physicians will have to know how to handle war wounds such as traumatic amputations, treatment of patients with burns and shrapnel wounds (explosions explosive devices), gunshot wounds of high-speed fire, replacement of liquids, and not to standard ATLS, but Tactica Medicine protocols (especially in hospitals where no bank blood count) will have to think about putting into practice triage of combat, it is urgent to prepare to cope.
Each day more victims for gunshot wounds, are becoming increasingly common among patients admitted to hospitals with wounds of war, every day patients admitted with injuries exsanguinating multiple gunshot to the emergency room, shootings occur more everyday, it is urgent that we be able to handle such situations, this is the reality that we are facing. Lt.
. Cor. Retired Hernandez Luis Alfredo Perez Bold Tactics Instructor of Medicine
43 2009, 12 (2): 43

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It is my honor to inform you that for the first time in Mexico, we have a Chapter
Tactical Medicine in the College, and myself are pleased to inform you that I have
distinguished with the appointment of Director of Tactical Medicine
Chapter of the Mexican Association of Emergency Medicine, we
hac iend Tactical Medicine electronic publications on the website of the college, in the same way they came out and commented that the article published in Trauma Magazine (Broadcasting Authority of the Mexican Association of Medicine and Surgery of Trauma) on TACTICAL MEDICINE, and commentary
editorial also addresses the same subject, then I add the greetings links:

http://www.imbiomed.com.mx/1/1/articulos . php? method = showIndex & id_revista = 213

http://www.cmme.org.mx/mesa.htm

We have courses scheduled for San Luis Potosi, and Queretaro

and we're in:

http://twitter.com/TCCC_MEXICO

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First Tactical Medicine Course (Combat Trauma Care) Tactical Medicine Course

Under the endorsement of the Mexican Association of Emergency Medicine, was conducted the first course of Tactical Medicine, which was made on the premises of the Municipal Civil Protection unit Zacatecas Capital, with participation of 25 students from various corporations the country, the course starting on 13 August, on this day were addressed issues and practices with regard to Care Under Fire, 14 were treated on issues and practices as it pertains to the Tactical Field Care, to complete the August 15 corresponds with the Care Equation Tactics, the course was developed under the standards of "Committed on Tactical Combat Casualty Care USA, the students thoracic puncture practices, application of intraosseous route and FASTX FAST1 devices, placement of MAT (Military Application Tourniquet) Cricotomía with Cric device, placement of T-POD, track application intravenous campaign, nasopharyngeal airway placement, and practices under fire paint ball equipment (gotcha), on the link below you can see the video of course.

http://www. facebook.com / group.php? gid = 121725931198175 & v = app_2392950137

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CARE TRAUMA IN COMBAT (ATC)

Tactical Medicine Course COMBAT TRAUMA CARE (ATC) in Aguascalientes, on 10, 11 and 12 September 2010, separate registration on 16 August this year, reports to email greetings medtacmex@gmail.com

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Tomorrow will be exported the first batch of 40 tons of Hass avocados to the U.S.

opens a market of 310 million consumers for that product

export Hass avocados. Photo: ANDINA / Archive

Lima, July. 22 (ANDINA). Tomorrow will be the first export Peruvian Hass avocados to the United States, which corresponds to a batch of 40 metric tons (MT), after that in January this year was obtained proper authorization from the health authority that country, today announced the Agriculture Minister, Adolfo de Cordova.
said the Ministry of Agriculture (Minag) and the Animal and Plant Health Inspection Service (APHIS), Department of Agriculture (USDA), led to legal proceedings and facilitate plant protection, from the date the Peruvian avocado access to a market of 310 million consumers.
said the first batch of avocado belongs to company Camposol, with avocado crops in Trujillo (La Libertad), that after fulfilling the requirements given permission to send to America the first 40 tons (in two containers of 20 MT each a), which will be the beginning of the first shipments will continue in the coming weeks.
"Today is a historic day, the Government and Minag have complied with the policy of opening new markets for agricultural products that benefit all avocado growers (small and medium), who will improve their incomes with access to a market of over 310 million consumers. "
U.S. market is the Hass avocado world's largest, because only in 2008 were sold over 500 thousand metric tons of this avocado. This authorization
access the avocado was obtained on 13 July, when APHIS received the Work Plan of the National Service of Agrarian Health (SENASA), signed and approved, which includes procedures for monitoring and action plan for Stenoma catenifer, in accordance with the standard published by the United States.
Peru only last year exported more than 37.800 tons of Hass avocados to other markets and the projection of the sector in 2010 is set to 50,000 MT a year later, exporting about 60,000 MT.
"Undoubtedly, the entry of Hass avocados Peruvian U.S. market will strengthen significantly the volume of Peruvian exports, and by the end of the year would exceed U.S. $ 3.000 billion in agricultural exports," said the minister.
Hass Avocado has a captive market in the world, as credited $ 53 million of exports recorded last year, 68 million reported in 2008 and 44 million in 2007.
2012, exports are projected Peruvian Hass avocado over 120 million dollars.
producing regions Hass avocados in the country, with a total of 7.000 hectares of crops are: Cajamarca, La Libertad, Ancash, Junín, Lima, Cusco, Arequipa, Ica, Moquegua and Tacna, whose fields areas have become agro-export thanks to the efforts of entrepreneurs and agricultural producers who have been benefiting 15,000 families.
De Cordova also said that meetings are held with U.S. officials to finalize the next export to this market, peppers, fresh peppers, papayas, custard apples, pears, among other Peruvian products.
Peru and exported to the U.S. products such as asparagus, artichokes, mangoes, grapes, onions and paprika.
United States takes 60 to 75 percent of Hass avocados that are exported around the world, and we followed by Japan and Canada in second and third place respectively, the overall import between 18 and 20 percent of the total.

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price of vegetables would rise 50% by frost

For fruits, industry representatives dismiss an effect on the values, since most of the harvest season products such as oranges and lemons already occurred.

Freezing temperatures recorded during the past few weeks take the vegetable prices rise and they commented on the tenants of La Vega Central.

The frost that affected in recent days to the south central region, which accounts for 92% of the domestic cultivation of vegetables, has impacted the production of vegetables that according to estimates by traders will result in price increases averaging 50% .
Froilan Flores, vice president of the Association Chilean Free Trade Organizations (ASOF) said that crops have had a major impact on their production are vegetables that grow along the ground like lettuce , the cabbage, the cauliflower the broccoli, the garlic the parsley and chard .
"In the case of lettuce in recent days Costina have increased between 70% and 80% in value, although the greatest impact should be noted in two weeks with average increases of 50%, "explained Flores.
As an example traders in the Central Vega commented that the lettuce Milan has gone from $ 200 to $ 300 a unit and planned in the coming days will reach $ 400. While the garlic is now costing $ 200 could rise to $ 300 each .
Another product which is estimated to have an impact are the avocados as 85% of its production takes place in Valparaiso and Metropolitan regions.
this regard, the chairman of the Hass Avocado , Adolfo Ochagavía , explained that "even not have a diagnosis of the situation because to measure the effects it takes about 10 days of frost occur and therefore the end of this week we take a tour of the plantations to make an assessment on the ground ".
however, said that given the low temperatures have been recorded in some areas it is possible to foresee any impact on production will be transferred to prices.
So, in the Vega Central warn that Palta Hass whose value is between $ 1,200 and $ 1,400 a kilo could reach between $ 2,000 and $ 2,500, while the black variety of La Cruz is now sold $ 1,000 may up to $ 1,500.
For tomatoes, Italian squashes and peppers should not be registered increases for this reason, because in winter come from the Region of Tarapacá . However, they may experience increases in the coming weeks due to the cost of transportation from the north of the country. FRUIT

In the fruit sector the situation is different because most of the harvest season products and was therefore not projected price increases . Juan Carlos Sepúlveda
, general manager Fruit Producers Federation (Fedefruta) , said that " the case of deciduous fruit such as grapes and peaches at this time are in recess, while evergreen such as oranges, clementines and lemons, most of them was harvested so should not have problems of supply. " Indeed
stressed that increases in the production of oranges and lemons in recent years should compensate for any shortfall which may affect some areas .
Source: The Nation

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TACTICAL MEDICINE COURSE . TCCC attention to trauma in combat tactics

Hello courses will be run from the month of September, next gave Aguascalientes, dates to be confirmed by this means we will be reporting dates and give in and do the same Remember that the course is endorsed by the Mexican College of Emergency Medicine

AC greetings

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medicine course manual. TACTICAL MEDICINE COURSE

Here is the cover of the manual of tactical medicine course, which will take place on 13, 14 and 15 August this year zacatecas, and we give in seven proposals for the following courses hopefully decide what will and dates.

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. JOURNAL ARTICLE PUBLICATION

The next 13, 14 and 15 August this year, will race in the city of Zacatecas Guadalupe, the ATC Tactical Medicine Course (Combat Trauma Care), were made during workshops thoracic puncture, Fast implementation of 1 (intrabony) tourniquet use and management, use of DAM (Drag Devices Manual) to drag patients, among others, the course is designed under the protocols of the Committee on Tactical Combat Casualty Care, 2010.

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Arequipa exported 700 tons of Hass avocados

MARKET IN NORTH AMERICA, EUROPE AND ASIA

AREQUIPA planting and export Hass avocados to the United States, Europe and Asia, won a grant fund Agroemprende nonrefundable. With this incentive, 35 farmers will be launched on 35 hectares, the first pilot partnership and export. FUND. Agroemprende launched a national competition in which 921 registered farm business plans, winning 99 in the country, 10 of them Arequipa. Mario Tapia Valdivia, president of the Association of Agroexporters The Majeño said its export project received a grant of 338 non-refundable thousand suns. "Farmers we must place a compensation of 176 thousand suns to start the project. The seedlings will be planted in June and in 3 years, exported 170 tons. From the fifth year, will export 700 tonnes annually, "he said.

Tapia said the fund will be channeled by Agrobanco to pay creditors of the project. The 2011 will double the number of hectares planted with avocado

and 2015 175 tons will be planted.

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Hello, I am pleased to tell that in the next issue of the journal Trauma, will be published an article that I wrote specifically on tactical medicine, it would be helpful to my comments on this article hoping to continue this blog as well as future collaborations with the magazine. Thanks and appreciate your comments.
atte.
Tte.Cor. BOLD PEREZ

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Hass avocados are able to export to the United States

From next month, Peru may be placed 19.000 tons annually in the U.S. market.

Since February near the Hass avocado

Peruvian

may enter the U.S. market, reported the Agriculture Minister, Adolfo de Cordova. "We have intensified our work with the U.S. government for the Peruvian Hass avocado

can enter one of the largest markets in the world," he said in a press release. indicated that this is one of the most anticipated of the Free Trade Agreement (FTA) since it came into force in February 2009. "With the entry of Hass avocados

the U.S. market will expand So our major export market for the benefit of thousands of domestic producers of Hass avocados "he said. In Peru there are a 7.000 hectares planted with Hass avocado

. United States is the market

Hass avocado consumption

world's largest. Only in 2008 were sold and consumed over 500 million kilos from the state of California, Mexico and Chile. Peru could export 19,000 tonnes per annum to the United States. President Alan García Pérez, Minister of Agriculture, the Secretary of Affairs Regulatory and Marketing Department of Agriculture of the United States, Edward M. Avalos, and the president of Prohass, Enrique Camet, will be present Monday at the Government Palace to present the official entry of Hass avocados

that nation's market.

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PHASES TRAUMA CARE IN COMBAT TACTICAL LOW.

differences civilian prehospital care and medical tactics are very marked, although the two disciplines oversee the recovery of those injured in tactical medicine, deprives the lack of material and equipment, causes of trauma are different, the environment (conditions of darkness, crossfire, areas with gas, etc.) extreme environments (mountains, desert), the mission of the unit, the evacuation time can be much longer in the tactical environment.

fundamental goals of medicine tactics are: 1 .- Treat
low
2 .- To prevent more casualties.
3 .- Complete the mission.

Tactical Phases of Care combat casualties (CTBC)
care tactical combat casualties, focuses on the prevailing situation, depending on the tactical situation, tactical paramedic staff, will find: Under fire. In the field
tactical
in the evacuation of casualties.
These are the three phases of care tactical combat casualties.


medical care under fire:
This phase is characterized by paramedical personnel are combatants. Among the most important actions to be deprived in this stage is that the medical or paramedical personnel, firepower support to the efforts of other staff, care will focus primarily on eliminating the threat, as this decreases, the actions are focused on providing the best possible care to casualties, provided medical care for the wounded is the first level of response, being implemented by the same low or one of the companions near the injured, the medical equipment available is limited to the medical personnel who carry all the elements and preferably should bring:
1 pad of combat.
1 elastic bandage 10 cm. 1
combat tourniquet (CAT). 1 gauze
combat.
1 pair of gloves. Nasopharyngeal
1.
1 roll of adhesive tape 2 inches. 1 package of drugs
combat (antibiotics and analgesics)

This equipment should be placed in one location in the uniform of all personnel (combatants and noncombatants), so that this form may be accessed on quickly and expeditiously.
During this phase and if necessary the approach to the victims, asked if that is in a position to respond to enemy fire, to hide or even to pretend to be dead in this way decrease the chance of injury Additionally, after being covered with the victim, proceed to the placement of the tourniquet, if necessary. Note that in this phase of medical care under fire, not made Initial assessments of "ABC" The important thing is to respond to hostile fire, remove the victim if possible and exsanguinating wound management, the most convenient way to manage limb injuries is the use of tourniquet combat, not recommended the use of pressure dressings, hemostatic substance use, or other measures to control bleeding. A patient with head and neck injuries by gunshot fire, rarely have spinal cord damage from handling is made in the field, for that reason it is not necessary to stabilize the cervical spine Patients are unanswered (unconscious, not breathing, pulse) will not be resuscitated. At this stage of Tactical Casualty Care in Combat. NOT RECOMMENDED FOR THE IMPLEMENTATION OF cardiopulmonary resuscitation, these maneuvers may help rather than endanger the lives of the rescuers, may even endanger the mission.

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Some Background.


The experiences of combat medics in World War II, Korea and Vietnam, along with his growing understanding of field support, rapid evacuation, transportation and final treatment of those injured in combat are the basis on which care is based tactical combat casualties. While SWAT teams began to appear in the decade 1960, as a result of incidents like the Sniper Tower of Texas, the shooting in Los Angeles with the Symbionese Liberation Army, and many other acts, it was recognized that some form of medical support units would be needed for missions high risk. The proposed model was based on the military model of combat medic, suggesting it was part of the tactical unit. More specifically, these technicians (basic at first and then the paramedic level) was a medical team of special operations. Some of the policemen and paramedics who were these tactical units were often veterans of Vietnam, for many years United States, there were very few units nationwide. A department SWAT team and began the medical program at that time in the 1970's was the Sheriff of Pima County, Tucson, Arizona. Which has been in continuous operation as a SWAT team with the support of clinicians for more than 30 years. It is important to mention that for best performance of a tactical medical team in a public security force, it is necessary to integrate the staff who are trained in three areas: being a police officer, being a provider of medical services and be official special intervention techniques (SWAT techniques). For this reason, and because the high cost of training staff member of these bodies, most SWAT teams, even today, use the external medical support for their team.
Since the 1960's to the 1980's there was a mosaic isolated from the teams that developed their own versions of tactical medical support. The need to revisit the trauma in the tactical environment has been widely recognized. The Tactical Combat Casualty Care Project (CARE tactical combat casualties) was initiated by the Naval Special Warfare Command (Naval Special Warfare Command) in 1993, and continued later by the Special Operations Command (U.S. Special Operations Command (USSOCOM)). This effort developed a set of protocols for trauma in combat Tactics that were published as a supplement in the journal Military Medicine in 1996. CARE guidelines tactical combat casualties provide physicians combat trauma management strategies in combat. CARE The first course in tactical combat casualties took place in 1996 at the Submarine Medical Office sponsored by the Office of Naval Medicine and Surgery (BUMED). Shortly after this training was mandatory for all paramedics of SEAL (special operations in the United States Navy. His name is an acronym Sea, Air and Land (Sea, Air and Earth)). Since then, it has gradually gained acceptance in the military. He has also found wide acceptance in the medical community civilian security forces. Incorporating CARE guidelines tactical combat casualties in the operating Prehospital Trauma Life Support (PHTLS) was an important step in the process of transition from CARE tactical combat casualties. The fourth edition of this manual, published in 1999 contains for the first time a chapter in military medicine. The recommendations contained in the PHTLS Manual carry the endorsement of the Committee on Trauma of the American College of Surgeons and the Association National Emergency Technicians.
The need for regular updating of the guidelines of CARE tactical combat casualties was recognized. The original document recommended that the guidelines were updated as necessary by a committee of the Department of Defense created for this purpose. This concept was approved by the Special Operations Command United States, and the Committee on Tactical Combat Casualty Care of (CoTCCC), which was subsequently founded in 2002 as part of USSOCOM's biomedical research. In 2007, was increased prominence of CARE tactical combat casualties in the Global War on Terrorism. In March of 2008. the CoTCCC was relocated to function as a Board of Health Undersecretary of the Department of Defense of the United States.
The Committee, updating the guidelines based on:
1) in the ongoing review of the literature of civilian and military prehospital medicine;
2) in continuous interaction with the military research labs care for the wounded in combat;
3) first-hand data from combat health, medical,
4) views of both military and civilian experts.
Historically, many of the lessons learned in assisting wounded in the military field have found application in civilian trauma care. Recently, the civilian emergency medical services have been called to assist in numerous school shootings, mall shootings and other acts of terrorism that have tactical factors similar to those found in combat. The threat of receiving hostile fire, having to attend multiple injuries to shed, and prolonged evacuation times have come into play. The massacres at Columbine and Virginia Tech are examples that illustrate that even in urban settings, starting treatment, and transport of injured may require training and tactics outside the parameters of standard protocols SEM. The adoption of the guidelines of the CARE tactical combat casualties in tactical EMS programs and the application of these principles to the tactical operations of Security Forces and the State can result in better continuity tactics and additional lives saved when the wounded are produced during the course of these operations.

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continue ... Medicine


Up to 90% of wounded in combat died before receiving medical care in a medical setting, the fate and survival rate of these patients are in the hands of who provides the first attention.
differences civilian prehospital care and medicine tactics are very marked, although the two disciplines oversee the recovery of those injured in tactical medicine, deprives the lack of material and equipment, causes of trauma are different, the environment (conditions of darkness, crossfire, areas gases, etc..) extreme environments (mountains, desert), the mission of the unit, the evacuation time can be much longer in the tactical environment.
fundamental objectives are tactical medicine: to treat casualties, prevent further casualties and complete the mission. Phases

Casualty Care in Combat Tactical (CTBC)
care tactical combat casualties, focuses on the situation prevails, depending on the tactical situation, tactical paramedic staff, they were: under fire, tactical field or in the evacuation of casualties. These are the three phases of care tactical combat casualties.

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Tactica, which is it??

Due to the current insecurity in the world in the fight against terrorism and organized crime, care techniques Prehospital have had to be changed, then the term emerging in English Tactical Combat Casualty Care TCCC (Tactical care combat casualties), the relatively recent term emergence takes into account the integrated management of victims in tactical situations, providing medical care according to the situation without risking life and operation, for this reason it is vitally important that the bodies of either pre-hospital care security forces or civilians are aware of these new techniques, which may be necessary in any situation.