By Mark Wegman
The interval from the Nineties to the mid-1950s is mostly thought of the “golden period” of passenger rail trip in America. It used to be a time of celebrated locomotives and plush passenger provider, a time whilst rail expertise observed its maximum advances and railroads turned the nation’s preferred mode of transportation. those glory years come alive in American Passenger Trains and Locomotives Illustrated, 1889–1971. For this quantity, writer and illustrator Mark Wegman has researched unique railroad drawings and often times even paint chips to render greater than one hundred sixty profiles, entrance and most sensible perspectives, and inside layouts depicting the steam, diesel, and electrical locomotives, besides passenger vehicles, of 3 dozen of the nation’s so much celebrated trains of the golden age. Accompanying the author’s drawings are histories of every teach, interval images, postcards, menus, baggage stickers, classic print advertisements, and distinct captions. The booklet is a lavishly appointed trip again in time to the bygone heyday of passenger-train travel.
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G. weather, time of day, and availability of helicopter landing sites at the scene and at the receiving unit. In addition special modifications to the method of transport may be necessary: • Spinal injury may require a slow police escort for a smooth journey. • Low-flying requirements may be necessary in certain clinical circumstances, such as when gaseous expansion at altitude can exacerbate a pneumothorax (especially if no chest drain has been inserted on-scene), and also for patients with decompression sickness.
Normal function of the ventilator (inspiratory/expiratory cycling) may not be heard. Helicopter transportation is particularly noisy and hearing protection should be worn by both the medical crew and patient. Simple ear plugs or ear defenders will usually suffice, but headsets offer better noise attenuation and will improve communications between crew members or between the patient and the medical team. The space between the noise attenuator, whatever is used, and the patient’s tympanic membrane will become an external ‘cavity’ and will be subject to the problems of changes in gas volume with altitude.
However, expansion of pleural gas in an inadequately vented pneumothorax will cause further collapse of pulmonary tissue. Patients can be safely transported once a chest tube is in place but careful monitoring for evidence of hypoxia or occlusion of the chest tube throughout the journey is essential. Artificially ventilated patients must be closely monitored for the development of a tension pneumothorax. qxd 38 10/9/01 10:56 AM Page 38 HANDBOOK OF PATIENT TRANSPORTATION the cabin and pressurization equipment, the power requirements, and the risks of large pressure differentials across the cabin wall) would be insurmountable.
American Passenger Trains and Locomotives Illustrated by Mark Wegman