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Old 03-03-2013, 02:35   #51
OlliesRevenge
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Quote:
Originally Posted by Gallium View Post

Your middle school is a more likely candidate for a lawsuit, based on your awful, piss-poor display of lack of reading comprehension, and inability to connect-the-dots.
Quote:
Hopper talked to the dead woman’s daughter by phone. She said her mother had been at the facility for three years and was in good care. The woman also said that even if her mother had received CPR, she doesn’t think she would have survived.
The deceased has family. I don't have to connect too many dots to figure out that there is the potential for liability here. The facility should have done CPR... period.

If you are feeling butthurt from the "drones killing children" thread, why don't you respond to my posts over there.
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Old 03-03-2013, 02:38   #52
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Running CPR on a 86-88yr old...who here has ever done it successfully?
Me too. Multiple times. We have a good save rate here in Seattle.
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Old 03-03-2013, 02:59   #53
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I love the "She is 87 years old and ready to die posts".
My mom is 83 years old, makes clothing & jewelry and sells them at crafts fairs. She does yoga at the gym 6 days a week & is no where near ready to die.
I have no idea the condition of this lady and neither does anyone else on this forum!
The facts are the "nurse" did nothing but call 911 and then watch the lady die.
If she had a DNR (and the paper says she didn't) why call 911? Why not wait 15 minutes then just call the meat wagon?
That "nurse" didn't sound very interested in whether the lady lived or died.
The daughter apparently had no problem with her mother dieing.
If I had a parent in that place I'd pull them out so fast it would make their head spin but I don't and never will.
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Old 03-03-2013, 03:33   #54
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My great aunt is 89(will be 90 in october) and still mows and weedeats her rather large yard. She lives by herself way out in the country. Is she one of those old people not worth saving?

We need the name of the nurse so we can publicly shame the scumbag.
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Old 03-03-2013, 04:46   #55
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Wrong on all counts.

First, you aren't the only one here who has been down the road of having a dying relative, thank you very much. Many of us here have AT LEAST as much experience on that road as you.

Second, the nurses present DID have a duty to act, if not a legal one clearly a moral one, and the medical ethicist cited in the article agrees.

Third, there has been nothing presented here or in the article indicating that the deceased woman was suffering from dementia or any other mentally debilitating issues which would render her incapable of making decisions regarding a DNR, nor is there anything in the article stating that her daughter was an authorized agent for such decisions - that's your private biases masquerading as fact.

Open you eyes and READ and you might learn something as well!

BAKERSFIELD, CA
  • Bayless was a resident at Glenwood Gardens' independent living facility, an area adjacent to, but separate from, Glenwood's skilled nursing facility and assisted living facility.
  • Jeffrey Toomer, executive director at Glenwood, told Channel 17's Kelsey Thomas the actions were consistent with company policy: Staff does not attempt CPR in the independent living facility.
  • Unlike the skilled nursing facility and assisted living facility, the independent section does not offer medical help, he said, and its clients know that.




I am not certain what all the huff and hubbub is all about. Above, I have distilled the meat of the story into three easily digestible points (no possibility of choking on this, I promise).


Slathrum, you are making so many assumptions.... For starters, a EMS crew is going to transport someone UNLESS there are obvious signs of traumatic death (ie, decapitation) or unless they are "cold and dead".


You cannot in one breath argue about her mental health condition and then not acknowledge she was not in the facility of her own volition.


You are assuming she choked? How about we stick to the facts we know, not the ones we like and thus create?




To those of you who have worked a 86-88yr old - good on you. If I happen on ANYONE who I see lose consciousness, and does not have a pulse or stops breathing, absent a clear and distinct risk to my well being, and unless someone can show me proof of a DNR or HC Proxy, I am working that person until I can no longer do so, or someone with my level of training or higher steps in.


If I happen on a scene where someone is already being worked, I will form a "chain" to allow that responder to get a break/blow air.


I have an elderly parent and an even more elderly step parent. None of them have indicated they want to quit living, if they lose consciousness/have a cardiac event I would hope and wish that someone with the tools, training and skills step in to assist.


One of the things I most certainly NOT DO is stick em in a facility where it is a clear policy to not have anyone on staff go beyond making a phone call to 911.




Everything else is simply for the sake of discussion and has no bearing on the law. A nursing home facility in California (or NY, or MA, or MD or any other state in the union) cannot have policy that contravenes state law.


- G out again.
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Old 03-03-2013, 04:47   #56
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Since the majority of people in this thread believe the decedent had the right to eternal life, please tell me where in this article is the link to her medical file. I apparently missed her H&P. If she were truly independent living, she would have been at a restaurant not the dining hall of this type of facility.

I think the most telling part of this story is that the daughter was okay with the outcome. Mom probably was not able to have a second career making jewelry or mowing lawns.
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Old 03-03-2013, 05:35   #57
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With the new changes to CPR recently all you really have to do is open the airway and start compressions. If they were worried about the respiration's they could have at least just started compressions until fire arrived. Not everyone at a nursing home has been sent there to die. Some patients are there recovering from procedures. With what they charge to stay there you would think they could throw in a little care once in awhile.
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Old 03-03-2013, 05:36   #58
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Maybe Obamacare doesn't include CPR if you are past the age of 70.
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Old 03-03-2013, 05:44   #59
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Gallium, I sincerely hope you are a better physician than a debater, if you are in fact one. I made no assumptions, and if you read what I wrote in its entirety you would have *hopefully* realized that. There are those of us that obviously are more experienced on the subject of death, mortality and what happens in the real world outside of a hospital than you are. I'm not even necessarily referring to myself here. Sir, you may want to look a little further into knowing what you are talking about before dismissing others.

Also, EMS crews do not typically transport out of hospital cardiac arrests. Unless you obtain a return of spontaneous circulation or there is reason to believe a specialized higher level of care would be beneficial, then the deceased stays put. The reason, of course, is that quite frankly we are better at running codes. Period. Unless you are a trauma surgeon at a Level 1 facility, your care is either inferior or redundant, thus negating the need for transport.

Last edited by slathrum; 03-03-2013 at 05:53..
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Old 03-03-2013, 05:49   #60
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Quote:
Originally Posted by TJ Superfly View Post
With the new changes to CPR recently all you really have to do is open the airway and start compressions. If they were worried about the respiration's they could have at least just started compressions until fire arrived. Not everyone at a nursing home has been sent there to die. Some patients are there recovering from procedures. With what they charge to stay there you would think they could throw in a little care once in awhile.

Well, you're wrong.

The new guidelines call for chest compressions 1st.

Quote:
http://www.jems.com/article/patient-...elines-summary

Recognition/Assessment
• When encountering an unconscious person, briefly check for no breathing or no normal breathing (i.e., no breathing or only gasping) at the same time as checking responsiveness.
• You no longer need to “look, listen and feel for breathing.”
• Recognize unresponsiveness and absence of normal breathing (e.g., apnea, gasping) as a sign of sudden cardiac arrest (SCA).
• Treat unresponsive victims with occasional gasps as if they’re not breathing (Class I; see p. 8 for definitions).
• To minimize delays in starting compressions, start compressions if you don’t feel a pulse within 10 seconds (Class IIa).
and


My only gripe with these instructions is that it does not clearly state to check for a pulse initially.
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Old 03-03-2013, 05:54   #61
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Originally Posted by slathrum View Post
Gallium, I sincerely hope you are a better physician than a debater, if you are in fact one. I made no assumptions, and if you read what I wrote in its entirety you would have *hopefully* realized that. There are those of us that obviously are more experienced on the subject of death, mortality and what happens in the real world outside of a hospital than you are. I'm not even necessarily referring to myself here. Sir, you may want to look a little further into knowing what you are talking about before dismissing others.
...and you claim you made no assumptions?




I am not a doctor. I am posting from my hotel room (Holiday Inn) so that makes me fully qualified to speak on these matters.

Let me highlight your assumptions for you...

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Hmm...

  • ...so grandma was in an assisted living facility, and her arrest was witnessed in a dining hall.
Looks like I forgot this one the 1st time around...she was in an independent living facility.

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Originally Posted by slathrum View Post
...
  • What do you suppose the chances of her arrest being caused by an airway obstruction are? I'd say about 50/50. I don't know the transport protocols there, but


  • I would imagine that the reason she was transported instead of being pronounced on scene, was due to the crews finding a reversible cause of death and being able to return circulation, for the time being anyway.

  • We can assume that she was reasonably ambulatory, able to function independently and free of diagnosed psychiatric disorder since she was in such a facility. Grandma had an ok life still.


  • Hypothetically, let's say this nurse witnessed her choking prior to the code. Granted, we're assuming a nursing home staff member could recognize choking, but still...by their policy, all she can do is stand there and watch while waiting for EMS.


  • Meanwhile, grandma dies when chest compressions would have likely cleared the obstruction. That may or may not have been what happened, but it's entirely plausible.

It's beyond me why anyone would want to live in such a place, or how anyone could work under such policies. Kind of makes you wonder what the policy is when fellow staff members or non-residents experience medical emergencies that a bystander could reasonably assist with, let alone someone trained to help.

Last edited by Gallium; 03-03-2013 at 14:09..
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Old 03-03-2013, 05:59   #62
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Originally Posted by slathrum View Post
...

Also, EMS crews do not typically transport out of hospital cardiac arrests. Unless you obtain a return of spontaneous circulation or there is reason to believe a specialized higher level of care would be beneficial, then the deceased stays put. The reason, of course, is that quite frankly we are better at running codes. Period. Unless you are a trauma surgeon at a Level 1 facility, your care is either inferior or redundant, thus negating the need for transport.



What I have highlighted above is something that is dictated almost entirely at the state and local levels. You cannot reasonably speak for anywhere except for where you live - if indeed your state/locality has such protocols.

Would you mind sharing with us what state you are referring to, so we can independently verify what you are claiming?

Because that is not the protocol in my state, or another handful of whose protocols I am aware of.
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Old 03-03-2013, 06:04   #63
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Was "the nurse" an RN or a nursing assistant, personal care aide or med tech? It makes a difference.

My parents researched CPR for 85-year-olds when they moved to The Home in 2007. To quote my father, "Don't let them break my ribs and sternum doing chest compressions - no CPR ever." Old folks' bones don't heal very fast and breathing is a bear with busted ribs.

Compression requires movement of 5 cm or right at 2 inches. Old brittle bones will break.

The survival rate after CPR is low anyway, and lower for the elderly. It doesn't work as well as it does on tv. Read the medical school research - Hopkins, Harvard, etc.

CPR was developed during the Korean War for healthy youngsters.
(Edited to add: Forget the Korean War. The combination of artificial respiration and chest compression - CPR - was developed at Johns Hopkins and presented in a paper to the Maryland Medical Society in 1960.)

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Old 03-03-2013, 06:09   #64
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You first. What exactly is your qualification? You made a reference to being a physician; I am not just pulling that out of the air. I suppose you are right, I did make those assumptions. Anyone who knows what's what knows I'm likely right. Gallium, just because you open your mouth, doesn't necessarily mean you have something important to say. Dang it, there I go with assumptions again!
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Old 03-03-2013, 06:19   #65
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CPR guidelines change every couple years. We are having more saves every year with the defibrillators we carry. If CPR is started and we can get there in four minutes or so the chances for survival are better than they used to be. You at least have to try. I don't understand why some of you think it's not even worth the effort.
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Old 03-03-2013, 06:24   #66
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This is retarded. The nurse is a typical NH nurse who likes to sit on her rear.

If the nurse was going to stick to policy I'm sure in the minutes that passed she could have found a non-employee to help as the operator requested.
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Old 03-03-2013, 06:26   #67
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CPR guidelines change every couple years. We are having more saves every year with the defibrillators we carry. If CPR is started and we can get there in four minutes or so the chances for survival are better than they used to be. You at least have to try. I don't understand why some of you think it's not even worth the effort.

Folks have argued that from their personal perspective.

Speaking for myself: I made no such argument, except to deconstruct a few misconceptions in this thread. As I have stated earlier in this thread, and will repeat, if I see someone who has had a cardiac event that requires CPR, unless it is clearly unsafe for me to do so (and even then it depends on who the intended recipient is. My spouse/child/parent?) or unless there is a clearly discernible DNR, I am going to render aid, and keep doing so until I am no longer capable of doing so, or I am relieved (preferably by someone with my level of training and certification or higher).

What I have discussed is that we may find the nurse's actions "immoral", she has no duty to act, as her state would not allow her to continue working as a nurse, nor would they continue to allow the nursing home facility to run with their license.

Do you remember the (mentally unstable) man who died/drowned in 2-3ft of water northern CA with firefighters standing around because they did not either have the current training or gear to effect a rescue?

Much of the same thing here.
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Old 03-03-2013, 06:37   #68
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You first. What exactly is your qualification? You made a reference to being a physician; I am not just pulling that out of the air.I suppose you are right, I did make those assumptions. Anyone who knows what's what knows I'm likely right. Gallium, just because you open your mouth, doesn't necessarily mean you have something important to say. Dang it, there I go with assumptions again!

So, first you say you didn't make any assumptions, and now you concede you made them. I have no intent of being disrespectful to you or anyone else here (except maybe Ender, Angry Fist & Okie ).

I don't understand what you mean by "Anyone who knows what's what..." What specifically do you mean?

I never assume when I post on GT that anything I say is "important". There are instances when and where I am paid to speak, and to teach. Even in those instances I do not assume what I am saying is important. Besides, that is neither here, nor there, and has no bearing on the dialogue at hand.


If you infer I make a reference to being a physician by this:

Quote:
http://glocktalk.com/forums/showpost...9&postcount=39
...If I am wearing scrubs, and 'scope around my neck, and a name tag that says "Dr. Gallium", if I am not at work at a medical facility, or if I have not been dispatched while on duty, or called onto active duty, I have no obligation or requirement to render aid to anyone.
My earlier observation stands. You are fraught to making assumptions where others have not made those same leaps.

I have no desire to measure balls or dicks with you. You made an assertion that:
Quote:
Also, EMS crews do not typically transport out of hospital cardiac arrests. Unless you obtain a return of spontaneous circulation or there is reason to believe a specialized higher level of care would be beneficial, then the deceased stays put.
I have asked you very politely if you have any means of supporting your assertion. I highly doubt that if you live in the USA, your above quoted assertion is true, and I am calling you on it.

- G
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Old 03-03-2013, 06:53   #69
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Gallium, with all due respect, I think you are wrong on this. I'm pretty sure she was employed by the ILF and there fore had a duty to act unless she was not trained in CPR, not likely. If she had been a nurse visiting a relative, no duty to act. The nurse will be investigated, dimes to donuts.

Policy does not provide shelter from criminal or civil consequences. If a policy states that all shoplifters are to be summarily executed upon confirmation of finding merchandise. Granted I may have over played my hand on the example. I will also admit that withholding CPR is likely not criminal.....

I guess we will see eh?

I don't know of many nursing homes that could survive, having a policy that contravenes state law in such a egregious manner.

You (and I, and many others who posted in this thread) knows how anal our states are about licensing of medical professionals, and licensing of health care facilities that are operated by medical professionals and staffed by medical professionals. I would hanker a guess that in your state, and in CA, this type of medical facility requires medical direction in the form of an MD.

In that same breath, YES, nursing homes can be some of THE WORST PLACES to have our loved ones. The abuses are numerous and sometimes shocking.

I am interested (and intrigued) to see what the final outcome of this will be. I have no problems in saying "I was wrong".
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Old 03-03-2013, 06:54   #70
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Yes, I suppose I made assumptions. I applaud you and your ability to point that out Gallium, even though I prefaced each of those assumptions with words like "hypothetical," "chances," and even the actual word "assume." That was my intent. I simply added some food for thought, choked on or not. I never stated that that was what happened, but that it was entirely plausible, which it was. Certainly more plausible than your assumption that I do not reside or work in the USA. I mean really, that's your best "assumption?"
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Old 03-03-2013, 07:07   #71
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Yes, I suppose I made assumptions. I applaud you and your ability to point that out Gallium, even though I prefaced each of those assumptions with words like "hypothetical," "chances," and even the actual word "assume." That was my intent. I simply added some food for thought, choked on or not. I never stated that that was what happened, but that it was entirely plausible, which it was. Certainly more plausible than your assumption that I do not reside or work in the USA. I mean really, that's your best "assumption?"

goodnight slathrum. You should give it a rest. First you said you didn't make any assumptions, then you concede you did, now you are saying (paraphrased) yes, I certainly was making assumptions, because I used words that denote an assumption...

You were quite firm that you hadn't made any assumptions. I can only respond to what you have written.

Quote:
Originally Posted by slathrum The Okie Corral
...
Also, EMS crews do not typically transport out of hospital cardiac arrests. Unless you obtain a return of spontaneous circulation or there is reason to believe a specialized higher level of care would be beneficial, then the deceased stays put. The reason, of course, is that quite frankly we are better at running codes. Period.

Unless you are a trauma surgeon at a Level 1 facility, your care is either inferior or redundant, thus negating the need for transport.
Now, do you have an answer for your earlier assertion? What state/country do you live in? Not only did you make a claim, you also gave a reason, "period".

The part I have highlighted in blue is a clear indication that you do not have much of an idea of what you are talking about. To say that pre-hospital care would be equal, or superior to a Level IV center is simply wrong, much less L3, L2 or L1.

http://en.wikipedia.org/wiki/Trauma_center

Is it possible that a EMS crew with a EMT-P/CC and another EMT-P/CC/driver can offer a higher level of care than a L3 or L4 trauma center? Yes, it is REMOTELY possible, but statistically improbable, and very unlikely.


From this point forward, I will not respond to anymore of your posts, but will simply smile and nod and keep on moving.
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Old 03-03-2013, 07:15   #72
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This is not really that surprising. A friend of mine recently had an accident on his motor scooter. He lost control of it at 40 mph and hit a median. He flipped it and went tumbling on the pavement with the scooter. He had a broken arm, broken leg, and head injuries. This happened right in front of a hospital emergency room. Some of the ER staff heard the accident and came out to watch him writhing on the ground. They then called 911 and waited 15 minutes for the ambulance knowing he was seriously injured and possibly dying. They only began working on him when the ambulance carried him from the street to their entrance. I was shocked when I heard this but was told regulations and liability prevented the ER staff from taking a gurney out to the street to pick up my friend. We do indeed have serious problems in this country when medical professionals sworn to help the sick are prevented from doing their job by regulation and fear of lawsuits.
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Old 03-03-2013, 07:32   #73
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Quote:
Originally Posted by Gallium View Post
goodnight slathrum. You should give it a rest. First you said you didn't make any assumptions, then you concede you did, now you are saying (paraphrased) yes, I certainly was making assumptions, because I used words that denote an assumption...

You were quite firm that you hadn't made any assumptions. I can only respond to what you have written.



Now, do you have an answer for your earlier assertion? What state/country do you live in? Not only did you make a claim, you also gave a reason, "period".

The part I have highlighted in blue is a clear indication that you do not have much of an idea of what you are talking about. To say that pre-hospital care would be equal, or superior to a Level IV center is simply wrong, much less L3, L2 or L1.

http://en.wikipedia.org/wiki/Trauma_center

Is it possible that a EMS crew with a EMT-P/CC and another EMT-P/CC/driver can offer a higher level of care than a L3 or L4 trauma center? Yes, it is REMOTELY possible, but statistically improbable, and very unlikely.


From this point forward, I will not respond to anymore of your posts, but will simply smile and nod and keep on moving.
Well then...bye. I admitted to the assumptions because I made them, not to placate your ego or need to be right. What has been lost on you, is that there is truth in those assumptions. Oh well.
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Old 03-03-2013, 07:44   #74
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" A friend of mine recently had an accident on his motor scooter."

Was the available ER staff on duty trained to evaluate and move a person with possible spinal injuries and head injuries?

It's so easy to say they should have just run out and scraped him up and taken him inside, but he could have gone from a broken back to complete quadriplegia in a heartbeat if moved improperly.
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Old 03-03-2013, 07:50   #75
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Sounds like an assisted living facility just...

Assisted with death.

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