4/15/2024 0 Comments Random female email generatorThere is no limit to the number of times you can generate new usernames. Ready to start again? Hit the DELETE ALL button to clear your list and generate more random usernames.įeel free to use this tool as much as you like. Hit the SAVED IDEAS button to see your list, and then hit the DOWNLOAD button to grab a text file with all your saved names. You can specify the domain name or choose between the most commonly used email providers including Gmail, Yahoo, Outlook, Protonmail, and AOL. You can prioritise different birth years, backgrounds and personalities to find the perfect female name, as well as selecting by initial or ending. Generate up to 10,000 fake or unregistered email addresses in bulk using completely randomized names and user ids. This saves those names to your SAVED IDEAS list. Our female name generator is very similar to our first name generator except that it focusses on name for girls. Random female celebrities: Rerun Options. Female Names Celebrities People Recipes Cocktails Search Menu. If you see a few usernames you’d like, you can use the STAR button. Generate a group of women celebries randomly or just one celebrity at a time. Once copied, paste the username wherever you might need it. Verwende einfach irgendeinen Namen deiner Wahl. If you spot a username you like, you can hit the COPY button (the icon of two rectangles overlapping each other). Es ist nicht notwendig den E-Mail-Generator zu verwenden. Once you’ve entered your word, hit the GENERATE button to create 24 random usernames that incorporate that word. The word must only include Latin characters and be between 3 and 20 characters long. If you’d rather your username incorporate a keyword, you can feel free to enter it into the keyword text box. If you need more, just hit the GENERATE MORE button. Click on the email that you want to add to your selected favorites list. The expected number of different random fake emails will appear. Fake email is a great way to protect your primary mailbox from junk e-mail avoid spam and stay safe. Enter the number in the input field to generate the number of email addresses. You can easily register an account on any site and receive a registration confirmation to fake mail generator. As soon as the page loads, you’ll automatically see two dozen unique handles you can use. Fake Email Generator - this is an unlimited number of email accounts that you can use for your own needs. Using our online service to create random usernames couldn’t be simpler. If you need help with this, we can make you some random usernames! In other words, if your name is John Doe and you were born in 1980, your username shouldn’t be “JohnDoe1980.” That is far too easy to guess. The more random your username is, the harder it is for hackers to guess it. Our totally free online tool uses a database of thousands of random words to create unique and hard-to-guess usernames.Ĭreating a unique username is more important than you might think.
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The slave, where appropriate, holds veto power over any command given by the Goddess, at which time they may rightfully refuse to obey that command. The slave agrees to please the Goddess to the best of their ability, in that they now exist solely for the pleasure of said Goddess. All of the slave’s possessions likewise belong to the Goddess, including all assets, finances, and material goods, to do with as they see fit. The slave also agrees that, once entered into the Slavery Contract, their body belongs to their Goddess, to be used as seen fit, within the guidelines defined herein. There are no boundaries of place, time, or situation in which the slave may willfully refuse to obey the directive of the Goddess without risking punishment, except in situations where the slave’s veto (see section 1.0.1) applies. The slave agrees to submit completely to the Goddess in all ways. This agreement must be entered voluntarily, but cannot be broken except under the conditions stated herein, after which certain precautions shall be taken to protect those involved. It’s time to lace up those dancing shoes, darlings, and let the tantalizing tango of FLR commence! See also – Teaching him to heel.This contract is provided as a secure and binding agreement which defines in specific terms in a relationship and interaction between two individuals, hereafter termed the slave and the Goddess. As for our dear gentlemen, embrace the steps, feel the rhythm of submission, and let it guide you towards a more satisfying and exciting relationship. So, ladies, lead with confidence and finesse, and you’ll soon have your man performing his dance of devotion flawlessly. In our delightful dance of female dominance, it’s not just about the moves but the emotion we infuse into them. Remember, darling reader the goal isn’t just to get your man on his knees but to instil a sense of joy and fulfilment in him as he performs the act. Stay patient and consistent in your reminders and reinforcements. It takes time for a behaviour to become a habit, typically a few weeks. Something like, “If you neglect to show your respect as we’ve agreed, you’ll lose the privilege of our evening cuddle session.” Teaching Your husband rituals Step 5: The Habit Formation If he continues to forget, consider introducing a mild punishment or withholding certain privileges, always in the context of your consensual dynamic. A gentle reminder like, “Darling, aren’t you forgetting something?” should suffice. In the initial phase, he might forget at times. This positive reinforcement will encourage him to keep doing it. I would love it if you could do this every time.” Step 2: The ReinforcementĮach time he does it on his own, shower him with praise and possibly a reward, even if it’s just a smile and a thank you. Choose a relaxed, intimate moment to tell him, “Darling, you have no idea how powerful and loved I feel when you kneel and kiss my feet as I enter. Start by explaining why you find this act so appealing. Teaching your husband rituals – 5 Steps Step 1: The Introduction Training him to perform this gesture without being prompted? Well, that’s just the cherry on top, and I’m all too eager to help you add that garnish. It’s an intoxicating blend of devotion, respect, and just a dash of sexy subservience. “I find it sexy when my husband kneels and kisses my feet when I enter a room how do I train him to do it all the time without asking?”ĭear reader, I can see why you find your husband’s foot-kissing greeting so appealing. Today, we’re addressing a delightful reader query about making a certain act of obeisance a permanent feature in her divine matriarchy. Oh, the thrill of submission, darlings! Welcome back to our sizzling soiree of female supremacy, where we shape the world one knee-bent man at a time. Prices vary and will be provided at the time you place your order. When you place your order, you will need your TD Bank account number and the TD Bank routing number. We will authenticate your identity so Harland Clarke can process future orders from you. You've never ordered checks with us before.You're not a TD Bank Online Banking customer, and.SECURITY NOTE: If you changed the address on your account within the last 3 business days, then you must either place your check order at your local TD Bank or wait 3 days to place your online order.įor your security, you must call or visit us to place your first order if: Your check ordering information will be securely sent to Harland Clarke so you'll be sure to receive your order on time and without errors.Go to Account Options, then choose "Account Services" and select Order Checks. You can even order deposit slips for your savings account.įrequently Asked Questions about ordering checks What's the easiest way to order checks? Title 31 Helpline: 86 (toll-free inside the U.S.) or 31 (not toll-free, for callers outside the U.S.With TD Bank and our check provider, Harland Clarke, you'll find a wide selection of check styles – plus address labels, checkbook covers and much more – that are sure to suit your personal tastes and budget.Money Laundering Prevention An MSB Guide PDF.Reporting Suspicious Activity A Quick Reference Guide for MSBs PDF.Examination Manual for Money Services Businesses PDF.Bank Secrecy Act Requirements A Quick Reference Guide for MSBs PDF. Form 105, Report of International Transportation of Currency or Monetary Instruments.Report of Foreign Bank and Financial Accounts (FBAR).Additional Resources Other BSA Reporting Requirements FinCEN may reject any required reports filed in paper format. Financial institutions, including MSBs, must electronically file all required BSA reports using FinCEN's BSA E-Filing System. The BSA E-Filing System supports the electronic filing of BSA forms (either individually or in batches) through a FinCEN secure network. Generally, MSBs that know, suspect or have reason to suspect that the transaction or pattern of transactions is suspicious and involves $2,000 or more, must electronically file a FinCEN Form 111, Suspicious Activity Report on the activity. MSBs must electronically file FinCEN Form 112, Currency Transaction Report, when they have a cash-in or cash-out currency transaction, or multiple transactions, totaling more than $10,000 during one business day for any one person, or on behalf of any one person. Provide for an independent review to monitor and maintain an adequate program.Provide education and training to appropriate personnel and.Incorporate policies, procedures and internal controls reasonably designed to assure compliance with the BSA.Designate a person to assure day-to-day compliance with the BSA.Each program must be written and take into account the inherent risks, as well as: The program should reasonably prevent individuals from using the MSB to facilitate money laundering or to finance terrorist activities. Developing an Effective AML ProgramĪll MSBs are required to develop and implement an anti-money laundering (AML) compliance program. They are also required to renew their MSB registration each two-calendar-year period following the initial registration by filing another Form 107. The MSB’s owner or controlling person must register by the end of a 180-day period, which begins the day after the date they established the MSB. Registering with the Federal GovernmentĮvery MSB must register with FinCEN by electronically filing FinCEN Form 107, Registration of Money Services Business, unless a person or business is only an MSB because they serve as an agent of another MSB. A person who engages as a business in the transfer of funds is an MSB as a money transmitter, regardless of the amount of money transmission activity. Money Services BusinessĪn MSB is generally any person offering check cashing foreign currency exchange services or selling money orders, travelers’ checks or pre-paid access (formerly stored value) products for an amount greater than $1,000 per person, per day, in one or more transactions. Department of the Treasury’s Financial Crimes Enforcement Network (FinCEN). The Bank Secrecy Act (BSA) requires many financial institutions, including money services businesses (MSB), to keep records and file reports on certain transactions to the U.S. 4/15/2024 0 Comments Estate planning document checklistAn Advance Directive is comprised of two sections: Durable Power of Attorney for Health Care (Part 1) and a Living Will (Part 2). This familiarity will help the agent make health care decisions that would be in line with the principal’s wishes.Īdvance Health Care Directive – This legal instrument outlines a principal’s wishes regarding the health care and medical treatment they do and do not wish to receive in varying circumstances. A health care agent should be someone close to the principal, someone who knows and understands their values. The agent is obligated, by execution of an Advance Directive form, to act on behalf of the principal’s best interests. This designation only comes into effect when/if the principal is disabled or incapacitated in some way. We highly recommend hiring an attorney before beginning this process even the smallest of errors or missteps can have major consequences.Ī health care agent is an individual chosen by the principal to make medical decisions for them if they do not have the capacity to do so for themselves. The following guide can assist a person in creating a functional and effective estate plan. How to Create an Estate Plan in New Mexico (6 steps) These estate planning tools cover medical decisions and health care (Advance Directive), financial decisions (Power of Attorney), estate distribution and family matters (Will), and general estate planning (Trust). The following documents will give the principal peace of mind knowing that all bases are covered in the event of an unfortunate accident or untimely death an Advance Directive, a Durable (Financial) Power of Attorney, a Last Will and Testament, and a Revocable Living Trust. An estate owner, or principal as they shall be hereinafter referred to, creating an estate plan will be thinking about what will happen to them, their family, and their estate if they die or become incapacitated or disabled. Main Difference – A Last Will and Testament must undergo the probate process while a Living Trust does not.A New Mexico estate planning checklist is a form that lists all of the necessary steps to complete an estate plan. Although, it’s recommended the creator (the ‘Grantor’) authorize the attached Self-Proving Affidavit which acknowledges the signature in front of either two (2) witnesses and a notary public. Signing Requirements – No witnesses required by State law. Afterward, the successor trustees become the owners of the trust. Therefore, the creator benefits from the assets in the trust until their death. Living Trust (Revocable) – Creates an entity with the creator being the trustee and the beneficiaries being the successor trustees. Signing Requirements – Required to be signed in the presence of two (2) witnesses.The estate will still have to go through the probate process which usually takes 6-8 months if no one contests. Last Will and Testament (‘Will’) – The most traditional way to transfer an estate after death. Benefits from Governmental Programs or Civil or Military Service ĭepending on the preference of the individual, a document will need to be created that allows the transfer assets and property in the estate to the beneficiaries.Estates, Trusts, and other Beneficial Interests.Banks and Other Financial Institutions.Signing Requirements – Must be authorized with the principal and agent(s) in the presence of a notary public.The financial agent will have the ability to handle all assets, if requested, of the principal.ĭurable (Financial) Power of Attorney – Allows an individual (the ‘Principal’) to select someone else to handle all or a portion of their financial activity. Most often, this agent is the same person as the health care proxy. For the same reasons an individual should want a health care agent (‘health care proxy’), a financial agent should be selected as well. Palate: Fig, dark chocolate, toasted oak, nutty undertones Nose: Complex, oak, dried fruit, toffee, vanilla I usually create fruity and tart summer cocktails with this whisky. This regal apple blend Crown Royal flavor is a perfectly balanced whisky with notes of crisp apples and a mild kick on my tongue. Why We Like It: Crisp and refined, Crown Royal Regal Apple has an extraordinary mixture of Crown Royal whiskies infused with tart Regal Gala apples. Nose: Crisp apple, fresh vanilla, a hint of cinnamon Its flavor profile makes it a classic whisky-style drink.Ĭrown Royal Blender’s Mash’s 80-proof has one of the most flavorful and complex tastes in the five unique whiskies from Crown Royal’s extraordinary signature series. Why We Like It: This Crown Royal variant is aged in American oak and features subtle oaky notes and a warm vanilla flavor. Palate: Smooth, apple, pear, creamy, toasted oak Nose: Subtle grains, orchard fruit, vanilla, gentle oak, honey It’s best to savor it alone or in an Old-Fashioned way. Why We Like It: It has a silky, reserve-grade blend with a velvety mouthfeel-the best bottle for real Crown Royal connoisseurs.Ĭrown Royal Reserve offers a full-tasting profile with oak tones, vanilla, and spicy flavors of baking spices. Palate: Velvety, dark chocolate, toasted oak, nutty undertones. Nose: Rich, complex, dried fruit, oak, vanilla. Savor it neatly in a rocks glass, or use it in mixed drinks with soda, such as Cola, to make a delicious elevated Soda and Cream cocktail. This vanilla-flavored whisky has the full flavor of Madagascar Bourbon Vanilla, which has a distinct creamy taste and smokier aroma.Īside from its vanilla-forward taste, Crown Royal Vanilla is matured to perfection, resulting in a smooth, silky texture. Why We Like It: Experience a luxurious sip with Crown Royal Vanilla. Palate: Creamy vanilla, toffee, butterscotch, smooth Ĭrown Royal Honey is one of the limited edition flavors of Crown Royal, and if you’re into overly sweet cocktails, get your hands on this bottle and mix it with either lemon juice or orange juice. This Crown Royal flavor might be one of the sweetest flavors of Crown Royal whisky, but it still has the sophisticated, smooth taste of Canadian whisky. Why We Like It: Crown Royal Honey whiskies are infused with honey flavor, resulting in a vibrantly rich, velvety mouthfeel, delicious honey whisky. Palate: Smooth honey, butterscotch, toffee, creamy texture Nose: Sweet honey, vanilla, toasted oak, hints of apricot This amber-hued liquor is best served neat or straight in a rocks glass. The palate has an enticing vanilla aroma, velvety crème brule, and light oak pepper notes. Why We Like It: This variant is a must-try if you want to taste the pinnacle of luxury and the sweetest flavors of Crown Royal.Ĭrown Royal XR 18-Year is a rare blend of three of their exceptional whiskies aged no less than 18 years. Palate: Elegant fig, dark chocolate, toasted oak, nutty undertones Nose: Refined, oak, dried fruit, toffee, vanilla You can perfectly savor Crown Royal “Fine De Luxe” vanilla and fruit-forward flavors with a long finish in an Old-Fashioned drink or with a touch of lemon juice to elevate it as a cocktail. Unlike other flavored whiskies, it has a rich vanilla and sweet aroma with a delicately smooth-tasting profile. Why We Like It: This “Fine De Luxe” whisky is one of the signature whisky of Crown Royal. Nose: Clean, subtle sweetness, vanilla, fruit, oak This XR Red label has distinct smoky and spicy rye hints, perfect for another Old-fashioned drink. It has a pleasant apple aroma and flavors with subtle pepper notes. Why We Like It: The Crown Royal XR Red label is considered one of the rarest and most valuable Crown Royal flavors because of its limited supply, making it so rare and expensive. Palate: Rich, dark chocolate, fig, toasted oak, nutty notes Nose: Complex, dried fruit, oak, toffee, vanilla The unique maple-toasted oak of Crown Royal Maple makes a perfect sipping drink or a sweet and tart concoction with other citrus juices like orange and lemon juice. “Crown Royal: A sip of royalty in every glass” -Liquor Laboratory This Crown Royal Maple features the liquid gold of Canada, the maple syrup, with the distinctive character of Crown Royal whisky. We like its exceptional smooth texture and unique and authentic maple taste from its maple toasted oak. Why We Like It: You can experience the Canadian Maple-finished whisky with Crown Royal Maple. Palate: Sweet maple, butterscotch, oak influence Nose: Rich maple syrup, brown sugar, toasted oak, vanilla 4/14/2024 0 Comments 2d animation software free macPlease adress these problems, because I love to use this app. But, along with the erasing of the unwanted portion, it will erase the background portion as well. This is a problem, because when you have a background already drawn, and you run out of back button uses, you have to erase the portion you don’t want. To expand on the back button, I don’t understand why the button only offers a certain amount of times you may go back when it is pressed. This is a rare occasion, however it is still a major problem I have come across. First example, you may experience a bug that causes a section of drawing to be completely erased for no particular reason, and when the user tries to reverse the bug (with the back button) it does not work. However, there are a handful of major problems with the app that should be looked at. As a final pro for the app, it does pretty well tracking your finger and other makeshift pens, if you do not have pen device available for use and lag is rarely a problem. The app does also offer optional layering for your animations, which will also enhance your drawing’s appearance. I have been using this app for a while, and the tools available from the start (without the pro version) are enough to create some decent looking art. You may manage your subscriptions in your iTunes Your iTunes account will be charged for renewal within 24 hours before the end of the current period, for the same duration and at the current subscription price. Your subscriptions will automatically renew unless canceled at least 24 hours before the end of the current subscription period. Subscriptions will be charged through your iTunes account at the confirmation of purchase. Creativity 365 with 1 TB Kdan Cloud storage"Īny unused portion of a free trial period, if offered, will be forfeited when the user purchases a subscription to that publication, where applicable.Animation Desk Pro for students and educators.Animation Desk Pro with 500G Kdan Cloud storage.For more information, please refer to the Term of Service below. Export animation into Photoshop and make advanced editingĪnimation Desk is free to download and use, and more features are available in the subscription plans.Export animation as a video, GIF, and PDF sheet!.The basic version includes 3 sketch layers and one background layer.Duplicate or repeat a frame, set up FPS to control the speed.Easily manage frames in the frame viewer.Other editing tools: rulers, selection tools, and more.Setup color palettes for characters or scenes.Add captions or subtitles for your animation.Draw with different brushes or customize your own.Import video and photo, and add fantastic animation effects. Use the brushes or selection tool to complete their work. You can start from the first frame or a keyframe. Recommended by EdTech Impact, Edshelf,, All about apps in YOUR classroom, iPad EducatorsĪnimation Desk works like a digital flipbook. Learn how to make cartoons and animations, and share your videos on YouTube, TikTok, or Instagram.Ĭheck out the video tutorials in the app, or get animation tips on our website. Have fun exploring the world of animation. 4/14/2024 0 Comments Beamng drive free downloadWith years of meticulous design, intensive research and experience, the simulation authentically recreates the excitement of real world driving. Our soft-body physics engine simulates every component of a vehicle in real time, resulting in true-to-life behavior. drive is an incredibly realistic driving game with near-limitless possibilities. Its wide variety of vehicles and environments, combined with its realistic physics engine, make it a must-play for fans of driving games.BeamNG. 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In addition to the single-player experience, BEAMNG.DRIVE also has a multiplayer component that allows players to race or cooperate with each other online. Players can also repair their vehicle at repair points scattered throughout the game’s environments. The game also has a damage system that accurately simulates the effects of collisions and other types of damage on a vehicle. This realistic physics engine means that players must carefully consider their actions when driving, as reckless behavior can easily lead to accidents and damage to their vehicle. This includes factors such as tire traction, engine power, and weight distribution, among others. The game simulates real-world physics, meaning that vehicles behave and respond in a way that is consistent with how they would in the real world. What sets this game apart from other driving games is its realistic and immersive physics engine. These challenges include races, delivery missions, and destruction derbys, among others. Players can explore these environments at their leisure, or participate in various challenges and scenarios. The game’s environments are equally diverse, ranging from open countryside to dense cities and everything in between. Players can also adjust various settings such as tire pressure, s uspension stiffness, and engine tuning to fine-tune the performance of their vehicle. Each vehicle has its own unique handling characteristics and can be customized with different skins and parts. In BEAMNG.DRIVE, players can choose from a wide range of vehicles, including cars, trucks, buses, and even boats and planes. The game was released in 2015 and has gained a dedicated player base due to its detailed physics engine and wide variety of vehicles and environments to explore. BEAMNG.DRIVE free download is a realistic and immersive driving game developed by the independent video game studio BEAMNG. 4/14/2024 0 Comments Yamaha ecu flash toolStage 3: 9000 RPM, 100 Octane, Free Flow exhaust upgrade, modified stock impeller or Solas 12-17, Great for Lites racing class. Stage 2: 9000 RPM Rev Limiter, Free Flow exhaust upgrade, modified stock impeller or Solas 12-17, Great for Lites racing class. Stage 1 Lites: 8600 RPM, 100 Octane, Free Flow exhaust upgrade, modified stock impeller or Solas 12-17. Stage 1: 8600 RPM Rev Limiter, Free Flow exhaust upgrade, modified stock impeller or Solas 12-17. The FREE Woolich Racing Tuned software allows you to make changes to the Fuel Maps, Ignition Maps, RPM Limiters, Secondary Throttle Plate Maps as well as many other maps and settings in your ECU. Sort By: Brock's Motorcycle ECU Flash is the most comprehensive ecu flash available for your bike. Map Editing (want to create your own performance maps, we offer an editor package to allow you to build your own custom maps).ĮCU logging (allows you to record and monitor ecu parameters like TPS, RPM, and other important parameters). Our BrockFLASH is designed to work in conjunction with a Brock’s Performance full exhaust system, Dynojet PCV (sold separately,) and Brock’s custom PCV fuel mapping to provide the most complete, user-friendly fuel adjustment combination possible. Map sharing (Have a custom map you have developed you can read and share these with your customers). Reflash back to stock (not like you would ever want to) The solas 12-17 also offers great improvements if you don't want to bend your OEM impeller.Īccess to all of our performance maps at no additional cost Get the tools needed to flash and adjust your Yamaha YZF-R3s ECU at TST Industries. We highly suggest bending your impeller to achieve maximum performance from any ECU tune. Improve the performance of your bike without sending your ECU off. You can purchase licenses separately to reflash more vehicles. This kit includes 1 license, to reflash 1 Yamaha Superjet. The Silber Turbos reflash tool is simple to use, just download our software and you will unlock the potential from your 1050cc Superjet. We supply you with a reflash cable, and multiple maps to flash. Flash tool version 4.2 will now allow you to read the 512 bytes of NV Ram data directly from the ECU. EcuFlash also allows you to edit ECU data (known as 'maps' or 'tables') in a human-readable format using a XML-based definition system to translate the data. EcuFlash uses the reflash vehicles via the OBDII port. Our ecu reflash tool for the new Yamaha Superjet is the best bang for your buck. EcuFlash is a general-purpose ECU reflashing and editing tool that supports an ever-growing list of vehicles. 4/14/2024 0 Comments Auscultation lung soundsBe patient, continue your own breathing and tune out mental distractions as you attempt to differentiate between rales, wheezes or rhonchi. You are both attempting to hear the existence of something – a pulse or movement of air – while also assessing the quality or type of sound you are hearing. Auscultation requires your attention and mindfulness. As you listen, consider how what you are hearing matches the patient’s current and chronic medical conditions, age and chest wall thickness. Use every patient contact as an opportunity to hear the gentle whoosh of air during exhalation and inhalation. A critical step in identifying abnormal lung sounds is having listened to lots and lots of normal lung sounds. You may need to move the patient to the ambulance or an exam room before you are going to be able to hear well with your stethoscope. Some scenes, especially outdoors, as just too loud with ambient noise. Ask your partner to pause with an assessment or intervention or the patient to stop moving while you are listening. Use verbal direction and body language, like a focused glance or head nod, to quiet your partner, the patient and bystanders as you attempt to listen. Double-check the direction the ear tips are facing if you are having a hard time hearing. The ear tubes and ear tips are generally angled and should be inserted pointed or angled towards the user’s nose. The most common mistake I have seen EMT students make is inserting the stethoscope ear tips in the wrong direction. If you hold the diaphragm too loosely, you’ll hear the sound of the diaphragm moving on the patient’s skin and hair. Apply just enough pressure that the diaphragm doesn’t slide and stays in place as the patient’s chest wall expands and contracts with breathing. The diaphragm of the stethoscope, placed on the patient’s bare skin, needs to be held firmly in place, but not pressed deeply into the patient’s tissue. Start high and listen to lung sounds as you work your way down the patient’s back. If you are too low or below the posterior rib cage, you are more likely to hear bowel sounds than the whoosh of air moving in and out of the lungs. The lungs are underneath and protected by the ribs. You’ll hear best if you place the stethoscope diaphragm directly against the patient’s bare skin. Clothing, even light layers, can dampen the sounds you are attempting to hear. But don’t spend so much on a stethoscope that you’ll be financially and emotionally crushed if you leave it behind on scene or forget to take it out of the ambulance at shift change. The beginner stethoscope you bought at the start of EMT class might be great for the relative calm and quiet of the classroom, but you’ll probably be better served by a higher-quality stethoscope in the ambulance, on the street or in a patient’s bedroom. When buying a stethoscope, like anything, you’ll get what you pay for. In general, use hearing protection anytime you are operating light- or heavy machinery, including your lawnmower, leaf blower and chainsaw. While riding in the ambulance or fire apparatus, keep the windows up when running with the siren (and lights) and use employer-provided hearing protection. When you are not using your stethoscope, take good care of your hearing by keeping the volume down on music, videos and games, especially while using AirPods or headphones. I have also added additional tips from other EMS educators, so read all the way to the end of the article and submit your own tips to be added to the list. If you are having a hard time hearing through your stethoscope, here are a few things to try. Bystanders and partners talking, dogs barking, idling vehicle engines and more can make it difficult to hear the transmission of audio waves from the patient’s lungs, heart, bowels or arteries through the stethoscope tubing and into your ears. But hearing through a stethoscope in the chaotic prehospital environment is a constant challenge. In some situations, paramedics might auscultate a patient’s heart sounds or a long bone to assess for a fracture. At a minimum, EMTs and paramedics are expected to auscultate a patient’s blood pressure and listen to lung sounds as part of a respiratory illness physical exam. Auscultation, which is to listen, with a stethoscope is part of every patient assessment. |
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