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diving or boating accidents and should be assumed if the submersion episode has not been witnessed Immobilization of the cervical and thoracic spine is important if injury to the cervical spine is suspected Use should be preferentially made of the jaw-thrust maneuver without head tilt or chin lift to open the patient s airway in these cases Postural drainage maneuvers are of unproven bene t and not recommended (Rosen et al 1995) Prompt initiation of rescue breathing has a positive association with survival Even in the spontaneously breathing patient, 100% oxygen should be started at the scene of the submersion as soon as possible Apneic patients or those with minimal respirations require bag mask ventilation or endotracheal intubation regardless of body temperature Vomiting is likely to occur when chest compressions or rescue breathing is performed, and will often complicate efforts to maintain a patent airway.

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He may, however, accept a promissory note for all or part of the redemption proceeds and thereby become a creditor of the corporation Worse yet, if Lisa obtained her shares from Morris within the 10 years preceding his retirement, even this plan will not work unless the IRS can be persuaded that her acquisition of the shares was for reasons other than tax avoidance It may be advisable to ensure that she acquires her shares from the corporation rather than from Morris, although one can expect, given the extent of Morris s control over the corporation, that the IRS would fail to appreciate the difference..

Dr Interest receivable Cr Interest income Dr Cash Cr Interest income Cr Interest receivable 40,000 40,000 240,000 200,000 40,000

In a 10-year study in Australia, vomiting occurred in half of submersion patients who required no interventions after removal from the water Vomiting occurred in two-thirds of patients who received rescue breathing and 86% of patients who required compression and ventilation (Manolios & Mackie 1988) Log roll the vomiting patient to the side and if available remove the vomitus with manual suction Ninety-three percent of submersion patients who arrive at hospital with a spontaneous pulse survive without further medical problems, emphasizing the importance of instituting early, effective CPR Approximately 10% of submersion survivors suffer permanent neurologic sequelae and about onequarter admitted to hospital subsequently die Patients who present awake and alert to hospital have good neurologic outcomes and the majority who present with altered mental status (obtunded, stuporous but arousable) ultimately do well neurologically.

Speaking of Enhancing Performance The social impact of telematics hasn t been much discussed, Juliussen told me. It s very important stuff. For example, take health care. It s staggering how many people are killed in transportation accidents: forty thousand every year in the United States, over a million worldwide. It s a major public health problem. Telematics can have a big impact everywhere. It might help the international market more than the United States. Simply knowing how to allocate resources makes a big difference, Juliussen continued. Medical personnel can improve their performance and efficiency and the number of lives they save dramatically. The medical personnel had control at this point all along; this merely makes them more effective. Telematics won t necessarily reduce the number of accidents immediately, but it may do so over time. Reducing the number of accidents as opposed to reducing the impact of accidents means that the cars, the roads, or the drivers, or all three, get better as a result of telematics. It s taking the long way around to bet that drivers will improve as a result of telematics. It s also not a sure thing. Take our previous example of a car s providing feedback to the driver about the distance to the car ahead. What if the driver won t listen What if the driver wants to tailgate What if the driver keeps pushing that gas pedal down, no matter how much back pressure he encounters Don t most people who tailgate want to We ve all got the right to tailgate sorry, I mean the ability to do so, of course as long as it s our car and a cop s not watching. Part of the