Armored Personnel Carriers

Sometimes APC’s can disappoint (see below)

Chechen rebels on the move after ambushing a Russian BTR-80 during the First Chechen War, August 1996

 

Fun with Maps

In some parts of the world it can take up to 24 hours to drive to the nearest health center. In populated areas, the time usually ranges from 10 minutes to an hour, but there are many contrasts. Where I live, it’s about an hour and twenty minutes, driving like a bat out of hell, but we usually CASEVAC by helicopter if it’s serious, here in the Arizona highlands.

 

Tobacco Household Expenditure by US regions.

 

All cities/towns in the US that end in -burg or -burgh.

 

Irish Ancestry in the US by county.

 

Map of colonies of the Order of St. John, 1651-1665.

 

Historical and present distribution of the Sumatran Rhinoceros

 

Skin pigmentation in modern African population. It may be racist to point this out. I’m not sure how that works anymore, since race is simply a construct and how you personally identify.

 

32 out of 40 most polluted cities in the world are in India, 2020. This might be construed as racist too since the American VP (Ho) is Indian. However the finding shouldn’t surprise anyone who has been to India.

 

Italian unification in the 1860s.

 

The Asian American and immigrant community in the Atlanta area has quickly grown over the past two decades. The democrats fear them because they usually don’t buy into the bullshit. They displace Afro-Americans in many areas.

 

Best performing Republican candidate by county, 1976-2020.

Reagan and Trump dominate most of the country, with Romney strong in Utah and Bush II in the northwest and parts of Texas. Ford is #1 in Grand Rapids and some other random counties. Note how well Trump 2020 scored, and yet he lost to a walking corpse and a whore…strange doings.

Best performing Democrat by margin of victory in each county from 1976-2020.

Carter and Bill Clinton dominate this map, Obama in the Midwest and Black Belt, and Dukakis in Iowa. Arizona is recounting the Biden vote from the machines and is taking a forensic view. It will be interesting to see how that plays out.

 

There is no break out for ice tea…

 

Death from liver cirrhosis in the world. According to WHO data, the region most affected by liver cirrhosis is Africa, with Egypt and Nigeria in the lead (161 and 87 deaths per 100,000 inhabitants over 15 years of age).

 

 

42 COMMENTS

  1. An ambulance ride to the closest trauma hospital is 30 min from our response area, less time than it takes to get a helicopter launched, a suitable landing zone secured, and the patient loaded. Multiple patients are a different story, but when the wind blows 55 mph like it did yesterday you just have to be a bit more creative with your transport decisions.

    • In bad weather, heavy snow or wind, etc. it’s all ground transport from here as well. In Arizona there are a lot of areas where it gets hot in the summer and the helicopters can’t get off the ground because the air is thinned out. They fly when they can.

      The C-130’s that fly fire suppression can’t take off in temps over 122 degrees.

      • The reason they can’t take off is that they are required by federal regulation to know that they have enough power to successfully take off. 122 degrees F = 50 degrees C. The C-130 power chart (like just about every chart for every airplane) only goes up to 50 degrees C. So they can’t take off because they can’t prove they have enough power. If the chart went to higher temperatures they might be able to legally take off.

        • I don’t know whether or not the charts reflect the power curve accurately or not at C50, but you wouldn’t want a fully loaded C-130 not to be able to gain altitude and drop to the ground.

  2. I visited Nepal. In some Villages it takes many days to walk to the nearest medical service facility. Not a hospital or anything similar to what we expect. Maybe a nurse with some basic equipment but no electrisity.

    • John, so much of that situation is due to graft and corruption. How much of the medical relief supplies are siphoned off before they reach the people in need? I know you’re aware, but many readers may not be. Norway is a MAJOR donor at these crisis points. Getting relief through to where it’s needed is a challenge.

  3. Not mentioned is there are still gaps in cell phone coverage, not in ever case but mostly due to terrain. To a lesser extent, there are gaps in radio reception. Both of these became significant factors in the case of two fatalities.

    A nurse of 30+ years experience working in rural New Mexico told me of when she was called out to a single car roll over with multiple injuries. They had stabilized both patients but required faster transport to the hospital. The helicopter enroute observed an ambulance and mistook that for the accident ambulance. They landed on the road (terrain restricted) which blocked traffic on the road.

    The accident ambulance with patients became mired in the traffic jam which happened to be a location without cell coverage and their radio transmissions were too garbled to be understood. By the time the heli-crew resolved their mistake and were airborne and arrived to the correct ambulance, both patients succumbed to their injuries. The AAR indicated that both would had likely survived save for the error and gaps in cell and radio coverage.

    Such gaps may be expected in rural areas or places with steep terrain. Surprisingly, I have found gaps in cell coverage just short miles outside of metropolitan areas. Upper Michigan (not the Yooper), as example. However, much of the upper MI peninsula has gaps. But NE of Los Angeles can be problematic. Even in and around Payson, AZ there were gaps.

    I know the infrastructure (mostly repeaters) is not able to provide complete coverage which is something the cell companies are still working to rectify. Third party contractors are hired by the cell companies to field survey, select the sites, and install tower and equipment. Even a two man crew can win those contracts (not required to be a ‘big’ company).

    The take-away is don’t relax even when within short distance of populated areas.

    • There are HUGE gaps in and around Payson, AZ. Drive down State Route 87 and you don’t get cell reception until you’re about five miles from the Blue Ridge (AZ) Fire Dept.

    • Thus the reason serious people have sat-phones, which work really well except underground.

      Seriously, though. The powers-that-be don’t care about rural people. Rural people and loners can all FOAD as far as the powers-that-be feel. Remember, “The Hunger Games” was a warning, and all of us ‘District’ losers are just peons for the ‘Capital’ elite to play with.

      • Beans, my Irridium satphone doesn’t work that well inside of my home (steel roof may be to blame). It wants to see the bird.

  4. For a reasonable yearly cost we have a MediVac emergency helo service in the Northern Rockies, otherwise it’s $2500 – $5000 just to call an ambulance from town, almost an hour away. Laramie is closer by half, better in an emergency and easier to drive oneself.

    Cell boosters are required at home, but with Hwy 287 as a major route service has been improved over the past 10 years with new towers. Otherwise I just ask MrsM to stitch me up, faster and no waiting around with every sick person on the planet in close proximity. Altho sometimes the smallest suture may be 2-0, but hey, better than a town trip bleeding all over the pick up.

    Went to South Carolina to help a friend, took me to his favorite breakfast spot, something like The Moose Restaurant. Ham came out on it’s own plate (the big oval one’s), same with hash browns, the omelet had to be 6 eggs…and a must, sweet tea for the beverage. Everyone at every table at 7 am had sweet tea. If I lived in the south I’d weigh 300 pounds.

    • The ambulance (Advanced Critical Cardiac Care) with paramedics is no-cost because of the fire district here, and paying taxes into that district. Subscriptions outside of the district can be purchased. Having said that, I am one of those guys who prefers to deal with, and am usually prepared to deal with minor emergencies, or to help others. For the big things, it’s nice to have the availability of care, especially as one ages.

      Yeah…if I lived in South Carolina and ate Southern cooking every day, I wouldn’t fit in my truck…the bed, not just behind the wheel.

      • The next morning was a proper platter of biscuits and red-eye gravy (never knew “red-eye” was an added cup of coffee), a monster sized ham slice and plate of hash browns, and black coffee. I was good until dinner..after a sluggish re-start. Might have needed that MediVac had I pushed it too soon. They’re certainly happy eaters down south with some seriously good fare.

  5. I’m shocked that England isn’t the highest tea drinker but then again Turkey doesn’t count because it’s made from pieces of apple. I’m also rather shocked that we aren’t higher on the dying from cirrhosis of the liver since everybody lives in the pub! I think once we are released at the end of June that might go creeping up substantially!

  6. Chronic hepatitis B and C are at least as likely as alcohol abuse in terms of etiology of liver cirrhosis in most of the countries on that infographic. But that doesn’t mean we can’t fun suspecting them of closet drinking.

    @Rick: that is a very sad story about the ambulance confusion. On the cheerful side, I once met a woman who nearly exsanguinated after a car crash in very very rural southern Utah. She was driving late at night, fell asleep and crossed the median into the path of an 18-wheeler. Her car was destroyed and she suffered multiple injuries including a femur snapped clean. There was no cell coverage in the area and traffic was incredibly sparse there, and especially that time of night. However less than a minute after the accident a car pulled up. The driver happened to be a trauma surgeon and the passenger his trauma-nurse girlfriend. They were hardcore outdoors types and also did Medicins Sans Frontieres stuff, so they were used to providing critical care in essentially grid-down situations, and as a matter of habit had a mini trauma kit in the trunk of their car. The surgeon also had a satellite phone. With that they were able to summon a helicopter. In the meantime they got the woman stabilized as much as possible, with two large-bore IVs running normal saline (which was what they had) wide open, desperately trying to give her heart something to pump with since she was nearly bled dry. Anyway, the woman apparently coded twice on the helicopter, but ultimately survived. When I met her a couple of years after the accident she was racing (mountain bike) in the Pro class at NORBA Nationals/Hunter Mountain, NY.

    Minnesota has an excellent air system for emergency STEMI (major heart attack) care, centered on the cardiac catheterization laboratory of the University of Minnesota. Local transport is ambulance, regional helicopter, remote areas fixed wing. One of the key factors that makes this work is allowing any physician (i.e. some schmoe in Podunk BFE) to activate the cath lab at UMN, so that the interventionalists are fully ready to go as soon as the patient arrives. We’ve adopted letting the ER docs activate our lab, which saves valuable time. When I was a trainee we required a cardiologist to see the patient in the ER to determine if it really was a STEMI before activating the lab. So the first month we rolled out the new policy there were 9 ER-initiated STEMI activations. Eight were false alarms. There was much gnashing of teeth and bitching about “those idiots”. But they got better at it, and I am convinced the new policy improves outcomes for patients. Oh yeah, “activation” refers to after normal working hours of course. From 7a to 5p or so they’re in there working anyway so if you got a STEMI in the ER, you call as you’re bringing up the patient. But after 6 pm pretty much everyone has gone home, so you need to call in the interventional cardiologist, a nurse or two, a tech, and so forth. Hence “activating the lab”.

    • You certainly paint an amazing picture of world few of us witness on our day to day. A western hat tip to you and your team.

      • Thanks, Paul, but I feel compelled to reveal that I don’t see patients any more (research and consulting these days), and most importantly in this context, I was never trained as an interventional cardiologist (the guys who put in coronary stents, certain prosthetic valves, etc). Basically, I can (could?) do diagnostic catheterizations, but am not trained to do interventions.

        As to the girl who lost the head-on with a truck and survived (barely), that was the hand of God or something that brought the surgeon and trauma nurse, WITH IVs and fluids, within a minute of the accident. She should have been dead, end of story. But she survived, and probably because she was a fit endurance athlete at baseline, recovered well enough to return to professional mountain biking. (Bear in mind that “pro” for >>50% of them, especially in those days, meant a $10k per annum stipend and free equipment. Those people lived hand-to-mouth. But then again at that time I was a grad student being paid $995/month so I was in the same boat, only with much lower VO2max. I was all wiry and ridiculously low body fat (7%) back then, so I sort of fit in visually, but even the gurrrls could kick my skinny butt on the tarmac or the trail.)

  7. Didn’t the BTR go up in smoke pretty easily? Seem to remember reading the rear door was also a fuel tank??

    Healthcare was one of SLW’s prime concerns when we moved here. So far it’s been excellent. The hospital is a teaching hospital and their neonatal facility is very highly rated. We see a lot of life flight choppers here to bring people in from the outlying areas. The in-laws homestead isn’t “far” mileage-wise, but it takes an hour to get there.

    • Most Soviet/Russkie stuff has the fuel in the rear doors. So did later versions of the venerable M113. It’s a good place for fuel. If the enemy is behind you, you’re forked, really forked. And if the fuel gets splashed and burns, but the penetration doesn’t penetrate into the vehicle, people can go out top or front hatches, maybe. And you can escape a sunken sub, too, supposedly…

      As to healthcare and teaching hospitals, it is a good thing/bad thing. They love weird and special cases, as long as the weird or special case is interesting to them. And normal cases where the patient varies from their parameters? Not so much… DAMHIK, too much anger and betrayal there.

    • You’re thinking BMP. BTR has center-side doors.

      BTR is fine against rifle fire and shell fragments, which is all it was ever intended to resist. It’s a second-line vehicle.

      -Kle.

  8. Interesting. I nearly became a Chaplain for the SMOM, curiously. If I had, I would’ve been privileged to celebrate Mass on the shield of a knight on the field of battle.

    Too bad they don’t fight anymore. Hmmmm.

    • It’s past time for the Militant Orders to rise. Way past time.

      FYI – the Knights of St. Lazarus, once truly badass fighters, now are an order made up of mostly rich men who sacrifice their later lives and their fortunes in rebuilding churches, monasteries and convents.

      Militant orders really need to be resurrected. Having a few armed knights and squires would help keep ‘random youths’ (who always seem to be mohammedens) from torching churches in Europe.

      • Militant Orders means “militias” and just whispering that word sends the timid hearts in Congress into shock.

  9. Interestingly, deaths due to the effects of alcohol used to be much higher in the USA pre-Prohibition than post-Prohibition. We as a nation did have a major alcohol problem. But… well… Prohibition did kind of work (and the introduction of safe water helped a lot, too.)

    • Also, there wasn’t anything much to do for recreation that was non-reproductive except drink before Prohibition, but afterwards, creation of those activities really started ramping up.

      For both the good and the bad.

      -Kle.

  10. I don’t think I really believe the map of India regarding time to EMS.

    I strongly doubt that they can be that fast over that large an area w/o counting extremely basic first aid as EMS.

    Either that or my bad color vision is screwing with me again.
    -Kle.

LEAVE A REPLY

Please enter your comment!
Please enter your name here