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Posted: 8/15/2007 4:47:20 PM EDT
Does anyone have any knowledge of whether having some tanks of medical Oxygen on hand would
be helpful in someone who is suffering from a life-threatining (avian?) flu. What I'm wondering is, say
the hospitals are not available, what would most increase the odds of survival for the patient at home?

I am thinking that

1) Anti viral medication like Tamiflu (maybe or maybe not)

2) Antibiotics to treat secondary respiratory infection (pneumonia)

3) Oxygen?

Link Posted: 8/15/2007 5:50:17 PM EDT
[#1]
No practical/economical way to keep enough O2.


Get your regular flu vaccine.

There is a avian flu vaccine coming down the pike.


Link Posted: 8/15/2007 6:15:51 PM EDT
[#2]

Quoted:
Snip

I am thinking that

1) Anti viral medication like Tamiflu (maybe or maybe not) Not worth the money in most folks opinion- it may help you get over a virus a day or two quicker.  It also has a fairly short shelf life.  I'd spend the money on more important things.

2) Antibiotics to treat secondary respiratory infection (pneumonia) not a bad idea of course

3) Oxygen? Oxygen is never a bad idea for illnesses, but can you reasonably keep enough on hand?  I can't see it being worth the costs and effort unless you already have a family member on home O2  
Link Posted: 8/15/2007 6:35:06 PM EDT
[#3]
O2 as an emergency management tool is excellent.  But it can't really go beyond that.

At home I have a small EMT bottle, with BVM's in a few sizes, as well as intubation equipment and supplies.  But unless the EMS system gets involved, I'm out in a short time.  So in true SHTF, O2 at home or bug out is not do-able.
Link Posted: 8/15/2007 6:36:20 PM EDT
[#4]
Wouldn't a ventilator delivering room-air be more practical?
Link Posted: 8/15/2007 6:39:42 PM EDT
[#5]

Quoted:
Wouldn't a ventilator delivering room-air be more practical?


You gotta be a real serious prepper to buy a vent for a what-if like that.  Not a cheap item.  Not to mention it is not exactly an easy thing to manage.
Link Posted: 8/15/2007 6:42:20 PM EDT
[#6]

Quoted:

Quoted:
Wouldn't a ventilator delivering room-air be more practical?


You gotta be a real serious prepper to buy a vent for a what-if like that.  Not a cheap item.  Not to mention it is not exactly an easy thing to manage.


WTF kind of prepper do you have to be to keep enough bottled O2 to keep someone alive during a bout of H5N1?



ETA:

Here
Less money than one of my ARs plus accesories and about the same as the other AR.
Link Posted: 8/15/2007 6:44:33 PM EDT
[#7]

Quoted:

No practical/economical way to keep enough O2.




Yes there is, get a used oxygen concentrator for a couple hundred bucks. EBay has them from tik=me to time w/ accessories at less than the med supply rip-off prices.

One might save your or a loved one's life in the event of a BFP.

You don't have to be a rocket scientist to use one but I'm sure someone will disagree.
Link Posted: 8/15/2007 6:47:22 PM EDT
[#8]

Quoted:
Wouldn't a ventilator delivering room-air be more practical?


There are some saying a CPAP could be very useful especially if augmented with O2 from bottles, or more practical for preppers, an O2 concentrator.

Get both.
Link Posted: 8/15/2007 7:02:37 PM EDT
[#9]
I think I would rather have an EMT bottle in a bag with Airway kit, Masks and Canula
Along with a second larger bottle for sustainment in the event I cannot transport immediately. Just never gave it much thought. a Bag and mask as a secondary ventilation kit as well.
Link Posted: 8/15/2007 7:07:13 PM EDT
[#10]

Quoted:
I think I would rather have an EMT bottle in a bag with Airway kit, Masks and Canula
Along with a second larger bottle for sustainment in the event I cannot transport immediately. Just never gave it much thought. a Bag and mask as a secondary ventilation kit as well.


For the present H5N1 infections you would need a large tag team to suppliment breathing with a bag. They would probably become infected as well if it's H2H.

Check out how many liters a large bottle contains and its weight.

Then compare the size, weight, energy consumption and capability of an O2 concentrator.

Then look around for a cheap one.
Link Posted: 8/15/2007 7:10:16 PM EDT
[#11]
Quoted:
Does anyone have any knowledge of whether having some tanks of medical Oxygen on hand would
be helpful in someone who is suffering from a life-threatining (avian?) flu. What I'm wondering is, say
the hospitals are not available, what would most increase the odds of survival for the patient at home?

I am thinking that

1) Anti viral medication like Tamiflu (maybe or maybe not)
*********ABSOLUTELY it's what's kept most of the H5N1 survivors alive.

2) Antibiotics to treat secondary respiratory infection (pneumonia)
*********ABSOLUTELY it's critical to fight the secondary infections as well as is getting you pneumovax shot.

3) Oxygen?
**********ABSOLUTELY if you expect your investment in the former to pay off.

Link Posted: 8/15/2007 8:41:02 PM EDT
[#12]

Quoted:

Quoted:

No practical/economical way to keep enough O2.




Yes there is, get a used oxygen concentrator for a couple hundred bucks. EBay has them from tik=me to time w/ accessories at less than the med supply rip-off prices.

One might save your or a loved one's life in the event of a BFP.

You don't have to be a rocket scientist to use one but I'm sure someone will disagree.


First off, just to let you know, you're arguing airway mamagement with a physician. (Bubba, not me. I'm a simple unfrozen caveman paramedic.)

O2 concentrators put out enough oxygen for low flow applications, but don't supply enough for use with anything other then a cannula. You talk about not having to be a rocket scientist to use one, but I've seen RNs put patients on non-rebreather masks with a O2 concentrator, markedly reducing the O2 concentration the patient was getting. Any acute crisis that requires oxygen as the 'make or break' in patient care is going to require a hell of a lot more then the 4-6 lpm a concentrator puts out.

Any acute medical crisis requiring O2 requires far more advanced resources as well. Think intubation, ventelation, bipap / cpap,  meds.... having a used oxygen concentrator sitting in the corner isn't of much use itself. It's like having a lower receiver around for home defense, one piece of the puzzle that's not much use without the others.

I manage airways and respiratory function for a living. There's a reason I hustle my ass to definitive care when a patient crumps on me, and that's with ~$40 grand worth of gear on hand, as well as another medic.

In my wilderness medic course, we talked fairly extensively about the coorelation between the level of care needed in an austere setting and survivability. If you have to drop a tube on a partient and you're a couple of days away from definitive care, your patient ain't gonna make it.




Link Posted: 8/15/2007 9:11:42 PM EDT
[#13]

Quoted:
Quoted:
Does anyone have any knowledge of whether having some tanks of medical Oxygen on hand would
be helpful in someone who is suffering from a life-threatining (avian?) flu. What I'm wondering is, say
the hospitals are not available, what would most increase the odds of survival for the patient at home?

I am thinking that

1) Anti viral medication like Tamiflu (maybe or maybe not)
*********ABSOLUTELY it's what's kept most of the H5N1 survivors alive.

2) Antibiotics to treat secondary respiratory infection (pneumonia)
*********ABSOLUTELY it's critical to fight the secondary infections as well as is getting you pneumovax shot.

3) Oxygen?
**********ABSOLUTELY if you expect your investment in the former to pay off.



I think you need to do some research on medical websites- Tamiflu is not a miracle drug contrary to what so many survival sites (and those selling it) report.  While it helped initially, reports starting in 2005 show that the virus has become increasingly resistant.  Buy all you want, but I'm not sold on the bird flu being that great a threat (neither were either of my microbiology professors or any of the docs I work with).  I'm certainly no expert though nor do I claim to be.

For those advocating getting a vent- it's not rocket science, but yes, it does require some knowledge; it's not a plug and play device.  Do you know when to use it?  Do you know what lung sounds you are listening for?  Do you know how the machine works and what to do when the alarms start going off.  Do you know what to looks for as far as potential problems.  Are you going to intubate someone and if so how do you propose to keep them sedated and feed them?  Do you have enough fluids on hand to keep them hydrated.  Do you have urinary catheters and know how to use them?  What happens when one more than one family member gets sick?  These are just some of the many questions you need to be asking.  

For those interested, here's a site where the guy is sorta advocating getting one avian flu blog

 
Link Posted: 8/15/2007 9:27:23 PM EDT
[#14]

Quoted:

Quoted:

Quoted:

No practical/economical way to keep enough O2.




Yes there is, get a used oxygen concentrator for a couple hundred bucks. EBay has them from tik=me to time w/ accessories at less than the med supply rip-off prices.

One might save your or a loved one's life in the event of a BFP.

You don't have to be a rocket scientist to use one but I'm sure someone will disagree.


First off, just to let you know, you're arguing airway mamagement with a physician. (Bubba, not me. I'm a simple unfrozen caveman paramedic.)

O2 concentrators put out enough oxygen for low flow applications, but don't supply enough for use with anything other then a cannula. You talk about not having to be a rocket scientist to use one, but I've seen RNs put patients on non-rebreather masks with a O2 concentrator, markedly reducing the O2 concentration the patient was getting. Any acute crisis that requires oxygen as the 'make or break' in patient care is going to require a hell of a lot more then the 4-6 lpm a concentrator puts out.

Any acute medical crisis requiring O2 requires far more advanced resources as well. Think intubation, ventelation, bipap / cpap,  meds.... having a used oxygen concentrator sitting in the corner isn't of much use itself. It's like having a lower receiver around for home defense, one piece of the puzzle that's not much use without the others.

I manage airways and respiratory function for a living. There's a reason I hustle my ass to definitive care when a patient crumps on me, and that's with ~$40 grand worth of gear on hand, as well as another medic.

In my wilderness medic course, we talked fairly extensively about the coorelation between the level of care needed in an austere setting and survivability. If you have to drop a tube on a partient and you're a couple of days away from definitive care, your patient ain't gonna make it.


You're no doubt correct.

However if a loved one is dying and there is the slightest chance they could be saved by one litre of O2, I'd just prefer to have it, stepping on turf notwithstanding.
Link Posted: 8/15/2007 9:44:18 PM EDT
[#15]

Quoted:

Quoted:

Quoted:

Quoted:

No practical/economical way to keep enough O2.




Yes there is, get a used oxygen concentrator for a couple hundred bucks. EBay has them from tik=me to time w/ accessories at less than the med supply rip-off prices.

One might save your or a loved one's life in the event of a BFP.

You don't have to be a rocket scientist to use one but I'm sure someone will disagree.


First off, just to let you know, you're arguing airway mamagement with a physician. (Bubba, not me. I'm a simple unfrozen caveman paramedic.)

O2 concentrators put out enough oxygen for low flow applications, but don't supply enough for use with anything other then a cannula. You talk about not having to be a rocket scientist to use one, but I've seen RNs put patients on non-rebreather masks with a O2 concentrator, markedly reducing the O2 concentration the patient was getting. Any acute crisis that requires oxygen as the 'make or break' in patient care is going to require a hell of a lot more then the 4-6 lpm a concentrator puts out.

Any acute medical crisis requiring O2 requires far more advanced resources as well. Think intubation, ventelation, bipap / cpap,  meds.... having a used oxygen concentrator sitting in the corner isn't of much use itself. It's like having a lower receiver around for home defense, one piece of the puzzle that's not much use without the others.

I manage airways and respiratory function for a living. There's a reason I hustle my ass to definitive care when a patient crumps on me, and that's with ~$40 grand worth of gear on hand, as well as another medic.

In my wilderness medic course, we talked fairly extensively about the coorelation between the level of care needed in an austere setting and survivability. If you have to drop a tube on a partient and you're a couple of days away from definitive care, your patient ain't gonna make it.


You're no doubt correct.

However if a loved one is dying and there is the slightest chance they could be saved by one litre of O2, I'd just prefer to have it, stepping on turf notwithstanding.


Ask any of the WI Defensive Edge crew, and they'll tell you I don't give a shit about turf. I cheerfully teach what I know to anyone, and suck up knowledge from anyone who will teach me. I'm just offering realism. If you want to give your loved one that slightest chance, don't stop at buying a used O2 concentrator off of ebay, as it won't offer them that. Learn how to intubate, and buy a lyringoscope, a set of tubes and a BVM. Then learn how to place a nasogastric tube, educate yourself about tube feedings and nutrition, and buy the necessary supplies. Study up on deep suctioning and bronchial toileting and buy suction caths, sterile saline, suction, etc. Then learn how to place a foley cath and buy a handful. Learn about capnography, acid base balance and pulse oxymetry, and buy monitors for both. Learn IV skills and buy IV caths, drip sets and saline. I'm sure I'm leaving stuff out, but I'm describing the bare bones minimum you'll need to support someone in respiratory collapse for any length of time.

I understand wanting to keep loved ones safe. However, buying a used O2 concentrator does nothing towards this, and takes resources away from things that might actually make a difference. That's not turf, that's realism. Leave decision making based on feelings instead of thoughts to the liberals. base your planning and decisions on cognition, not emotion. That's how you're going to keep your family safe.

Link Posted: 8/15/2007 9:54:46 PM EDT
[#16]

Quoted:

Quoted:

Quoted:

Quoted:

Quoted:

No practical/economical way to keep enough O2.




Yes there is, get a used oxygen concentrator for a couple hundred bucks. EBay has them from tik=me to time w/ accessories at less than the med supply rip-off prices.

One might save your or a loved one's life in the event of a BFP.

You don't have to be a rocket scientist to use one but I'm sure someone will disagree.


First off, just to let you know, you're arguing airway mamagement with a physician. (Bubba, not me. I'm a simple unfrozen caveman paramedic.)

O2 concentrators put out enough oxygen for low flow applications, but don't supply enough for use with anything other then a cannula. You talk about not having to be a rocket scientist to use one, but I've seen RNs put patients on non-rebreather masks with a O2 concentrator, markedly reducing the O2 concentration the patient was getting. Any acute crisis that requires oxygen as the 'make or break' in patient care is going to require a hell of a lot more then the 4-6 lpm a concentrator puts out.

Any acute medical crisis requiring O2 requires far more advanced resources as well. Think intubation, ventelation, bipap / cpap,  meds.... having a used oxygen concentrator sitting in the corner isn't of much use itself. It's like having a lower receiver around for home defense, one piece of the puzzle that's not much use without the others.

I manage airways and respiratory function for a living. There's a reason I hustle my ass to definitive care when a patient crumps on me, and that's with ~$40 grand worth of gear on hand, as well as another medic.

In my wilderness medic course, we talked fairly extensively about the coorelation between the level of care needed in an austere setting and survivability. If you have to drop a tube on a partient and you're a couple of days away from definitive care, your patient ain't gonna make it.


You're no doubt correct.

However if a loved one is dying and there is the slightest chance they could be saved by one litre of O2, I'd just prefer to have it, stepping on turf notwithstanding.


Ask any of the WI Defensive Edge crew, and they'll tell you I don't give a shit about turf. I cheerfully teach what I know to anyone, and suck up knowledge from anyone who will teach me. I'm just offering realism. If you want to give your loved one that slightest chance, don't stop at buying a used O2 concentrator off of ebay, as it won't offer them that. Learn how to intubate, and buy a lyringoscope, a set of tubes and a BVM. Then learn how to place a nasogastric tube, educate yourself about tube feedings and nutrition, and buy the necessary supplies. Study up on deep suctioning and bronchial toileting and buy suction caths, sterile saline, suction, etc. Then learn how to place a foley cath and buy a handful. Learn about capnography, acid base balance and pulse oxymetry, and buy monitors for both. Learn IV skills and buy IV caths, drip sets and saline. I'm sure I'm leaving stuff out, but I'm describing the bare bones minimum you'll need to support someone in respiratory collapse for any length of time.

I understand wanting to keep loved ones safe. However, buying a used O2 concentrator does nothing towards this, and takes resources away from things that might actually make a difference. That's not turf, that's realism. Leave decision making based on feelings instead of thoughts to the liberals. base your planning and decisions on cognition, not emotion. That's how you're going to keep your family safe.



WOW, you sure know A LOT about respiratory issues.

Us regular guys obviously won't stand a chance if our families get infected with BF and can't get professional help.
Link Posted: 8/15/2007 10:03:51 PM EDT
[#17]

Quoted:

Quoted:

Quoted:

Quoted:

Quoted:

Quoted:

No practical/economical way to keep enough O2.




Yes there is, get a used oxygen concentrator for a couple hundred bucks. EBay has them from tik=me to time w/ accessories at less than the med supply rip-off prices.

One might save your or a loved one's life in the event of a BFP.

You don't have to be a rocket scientist to use one but I'm sure someone will disagree.


First off, just to let you know, you're arguing airway mamagement with a physician. (Bubba, not me. I'm a simple unfrozen caveman paramedic.)

O2 concentrators put out enough oxygen for low flow applications, but don't supply enough for use with anything other then a cannula. You talk about not having to be a rocket scientist to use one, but I've seen RNs put patients on non-rebreather masks with a O2 concentrator, markedly reducing the O2 concentration the patient was getting. Any acute crisis that requires oxygen as the 'make or break' in patient care is going to require a hell of a lot more then the 4-6 lpm a concentrator puts out.

Any acute medical crisis requiring O2 requires far more advanced resources as well. Think intubation, ventelation, bipap / cpap,  meds.... having a used oxygen concentrator sitting in the corner isn't of much use itself. It's like having a lower receiver around for home defense, one piece of the puzzle that's not much use without the others.

I manage airways and respiratory function for a living. There's a reason I hustle my ass to definitive care when a patient crumps on me, and that's with ~$40 grand worth of gear on hand, as well as another medic.

In my wilderness medic course, we talked fairly extensively about the coorelation between the level of care needed in an austere setting and survivability. If you have to drop a tube on a partient and you're a couple of days away from definitive care, your patient ain't gonna make it.


You're no doubt correct.

However if a loved one is dying and there is the slightest chance they could be saved by one litre of O2, I'd just prefer to have it, stepping on turf notwithstanding.


Ask any of the WI Defensive Edge crew, and they'll tell you I don't give a shit about turf. I cheerfully teach what I know to anyone, and suck up knowledge from anyone who will teach me. I'm just offering realism. If you want to give your loved one that slightest chance, don't stop at buying a used O2 concentrator off of ebay, as it won't offer them that. Learn how to intubate, and buy a lyringoscope, a set of tubes and a BVM. Then learn how to place a nasogastric tube, educate yourself about tube feedings and nutrition, and buy the necessary supplies. Study up on deep suctioning and bronchial toileting and buy suction caths, sterile saline, suction, etc. Then learn how to place a foley cath and buy a handful. Learn about capnography, acid base balance and pulse oxymetry, and buy monitors for both. Learn IV skills and buy IV caths, drip sets and saline. I'm sure I'm leaving stuff out, but I'm describing the bare bones minimum you'll need to support someone in respiratory collapse for any length of time.

I understand wanting to keep loved ones safe. However, buying a used O2 concentrator does nothing towards this, and takes resources away from things that might actually make a difference. That's not turf, that's realism. Leave decision making based on feelings instead of thoughts to the liberals. base your planning and decisions on cognition, not emotion. That's how you're going to keep your family safe.



WOW, you sure know A LOT about respiratory issues.

Us regular guys obviously won't stand a chance if our families get infected with BF and can't get professional help.


I guess I don't understand your attitude, but I'm not looking for a fight here, and I'm not trying to chest thump. This forum exists as a medium to exchange information, and I was offering up what I know. If I'm missing something here, please clue me in.

What I know about respiratory care is barely just enough to show me how much I don't know. I guess that's my point. There's a reason why respiratory therapy is a disipline all by itself, and I'm not a pimple on a good doctor's ass. If my wife goes into respiratory collapse in a SHTF situation without definitive care available, I'm going to do everything in my power to save her. And I'm going to fail.

You obviously have strong feelings about this issue. I'm sorry you're not open to any real exchange on the subject. God willing, we'll never have to actually face it. If we do, I'll remember this exchange, and I'll pray for you and yours. Hope you'll do the same for me.
Link Posted: 8/15/2007 10:28:50 PM EDT
[#18]

Quoted:

Quoted:

Quoted:

Quoted:

Quoted:

Quoted:

Quoted:

No practical/economical way to keep enough O2.




Yes there is, get a used oxygen concentrator for a couple hundred bucks. EBay has them from tik=me to time w/ accessories at less than the med supply rip-off prices.

One might save your or a loved one's life in the event of a BFP.

You don't have to be a rocket scientist to use one but I'm sure someone will disagree.


First off, just to let you know, you're arguing airway mamagement with a physician. (Bubba, not me. I'm a simple unfrozen caveman paramedic.)

O2 concentrators put out enough oxygen for low flow applications, but don't supply enough for use with anything other then a cannula. You talk about not having to be a rocket scientist to use one, but I've seen RNs put patients on non-rebreather masks with a O2 concentrator, markedly reducing the O2 concentration the patient was getting. Any acute crisis that requires oxygen as the 'make or break' in patient care is going to require a hell of a lot more then the 4-6 lpm a concentrator puts out.

Any acute medical crisis requiring O2 requires far more advanced resources as well. Think intubation, ventelation, bipap / cpap,  meds.... having a used oxygen concentrator sitting in the corner isn't of much use itself. It's like having a lower receiver around for home defense, one piece of the puzzle that's not much use without the others.

I manage airways and respiratory function for a living. There's a reason I hustle my ass to definitive care when a patient crumps on me, and that's with ~$40 grand worth of gear on hand, as well as another medic.

In my wilderness medic course, we talked fairly extensively about the coorelation between the level of care needed in an austere setting and survivability. If you have to drop a tube on a partient and you're a couple of days away from definitive care, your patient ain't gonna make it.


You're no doubt correct.

However if a loved one is dying and there is the slightest chance they could be saved by one litre of O2, I'd just prefer to have it, stepping on turf notwithstanding.


Ask any of the WI Defensive Edge crew, and they'll tell you I don't give a shit about turf. I cheerfully teach what I know to anyone, and suck up knowledge from anyone who will teach me. I'm just offering realism. If you want to give your loved one that slightest chance, don't stop at buying a used O2 concentrator off of ebay, as it won't offer them that. Learn how to intubate, and buy a lyringoscope, a set of tubes and a BVM. Then learn how to place a nasogastric tube, educate yourself about tube feedings and nutrition, and buy the necessary supplies. Study up on deep suctioning and bronchial toileting and buy suction caths, sterile saline, suction, etc. Then learn how to place a foley cath and buy a handful. Learn about capnography, acid base balance and pulse oxymetry, and buy monitors for both. Learn IV skills and buy IV caths, drip sets and saline. I'm sure I'm leaving stuff out, but I'm describing the bare bones minimum you'll need to support someone in respiratory collapse for any length of time.

I understand wanting to keep loved ones safe. However, buying a used O2 concentrator does nothing towards this, and takes resources away from things that might actually make a difference. That's not turf, that's realism. Leave decision making based on feelings instead of thoughts to the liberals. base your planning and decisions on cognition, not emotion. That's how you're going to keep your family safe.



WOW, you sure know A LOT about respiratory issues.

Us regular guys obviously won't stand a chance if our families get infected with BF and can't get professional help.


I guess I don't understand your attitude, but I'm not looking for a fight here, and I'm not trying to chest thump. This forum exists as a medium to exchange information, and I was offering up what I know.

What I know about respiratory care is barely just enough to show me how much I don't know. There's a reason why respiratory therapy is a disipline all by itself, and I'm not a pimple on a good doctor's ass. If my wife goes into respiratory collapse in a SHTF situation without definitive care available, I'm going to do everything in my power to save her. And I'm going to fail.

You obviously have strong feelings about this issue. I'm sorry you're not open to any real exchange on the subject. God willing, we'll never have to actually face it. If we do, I'll remember this exchange, and I'll pray for you and yours. Hope you'll do the same for me.


Please don't misunderstand. I'm acknowledging your expertise on this subject.

And you, very likely correctly, are expressing an extremely negative outcome for someone who becomes infected with BF without being able to be treated in a professional setting.

We both know that if there is a BF pandemic, by def large numbers will need treatment and it's likely there aren't sufficient medical resources for even a small fraction of those falling ill. People will have to be treated at home or at a BO location and it won't be much different than when technology was primitive.

Most will survive, some will not based on historic viral pandemics.

My personal psychology is very entrepreunal and it is difficult for me to give up on challenges if there is even the slightest chance of prevailing. My life has been blessed, partly as a result of this characteristic. Like you I learn all I can and share knowledge and ideas as much as I can.

So you can understand, if on the margin, someone is sick and making just one more effort might make the difference between a positive rather than a negative outcome, it seems to me at least to give the effort a shot. Maybe I'm too much of an optimist but that's how I think.

In the pandemic of 1918 roughly 5% IIRC of infected patentients died. Many more suffered debilitating consequenses. But I'm just not convinced that everyone infected is going to die w/o all the fancy equipment and techniques you have outlined. There are marginal cases and if someone can improve the odds even slightly, then I say go for it.

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