I. FIRST AID. THE FOLLOWING IS ONLY AN EMERGENCY GUIDE AND NOT A COURSE OF INSTRUCTION.
First aid can mean the difference between temporary or permanent injury, rapid recovery or long-term disability, and life and death. The three primary objectives are (1) maintain an open airway, (2) maintain breathing, and (3) to maintain circulation. During this process you will also control bleeding, and reduce or prevent shock. You must respond rapidly, stay calm, and think before you act. Do not waste time looking for ready-made materials, do the best you can with what is at hand. CALL 911 AS SOON AS POSSIBLE. IF SOMEONE IS AVAILABLE TO MAKE THE CALL, TELL THEM TO DO IT, MAKING EYE CONTACT, AND CONFIRMING THEY ARE CALLING.
When responding to a victim, take a few seconds to inspect the area. Remain calm as you take charge of the situation, and act quickly but efficiently. Decide as soon as possible what has to be done and which injury needs attention first.
II. INITIAL ASSESSMENT:
Safety- If you or the victim are in danger, consider this threat against the possible damage caused by early movement. If you decide to move the victim, do it quickly and gently to a safe area where proper first aid can be given. You cannot help the victim if you become one yourself.
Mechanism of injury- Determine extent and how it happened. If victim is unconscious, look for clues.
Medical information devices - Examine victim for a MEDIC ALERT necklace, bracelet, or identification card. This tag provides medical conditions, medications, and allergies.
Number of casualties - If more than one victim, limit your assessment to looking for an open airway, breathing, bleeding, and circulation, the life-threatening conditions.
Bystanders - Ask bystanders to help you find out what happened. Bystanders can help by calling 911, providing emotional support to the victim, and keeping onlookers from getting in the way.
III. GENERAL RULES
1. Stay calm. Give first aid immediately. Keep victim lying down until you determine seriousness of injury. If you suspect head or neck injuries or are unsure, keep them lying flat. Special care must be taken for a victim with a suspected neck or back injury. The following represent exceptions.
a. Vomiting or bleeding around the mouth - If the victim is vomiting or bleeding around the mouth, place them on their side, or back with head turned to the side.
b. Difficulty breathing - If the victim has a chest injury or difficulty breathing place them in a sitting or semi-sitting position.
2. Move victim no more than necessary. Loosen restrictive clothing at neck and waist. Carefully remove only enough clothes to get a clear idea of injuries. When necessary, cut clothing, along seams. Ensure the victim does not become chilled. Inform the victim what you are doing and why.
3. Reassure victim the injuries are understood and EMS will arrive soon. Do not give food or drink. If the victim thirsty, wet lips with a wet towel. Keep victim warm enough to maintain normal temperature.
4. Keep victim calm. Excitement and excessive handling will aggravate their condition. Prevent victim from seeing injuries.
5. Do not touch open wounds or burns with fingers or un-sterile objects unless absolutely necessary. Place a barrier between you and victim's blood or body fluids, using plastic wrap, gloves, or a clean, folded cloth. Wash hands with soap and warm water immediately after, even if you wore gloves.
6. Splint all suspected, broken or dislocated bones in position found. Do not attempt to straighten broken or dislocated bones because of risk of further injury. Do not move victim if you do not have to.
IV. Information on Common Injuries.
The following is only an emergency guide and not a course of instruction. Keep this pamphlet handy to be consulted for first aid guidance.
SHOCK
Shock occurs in any badly injured person. Treat victim for shock whether or not symptoms present. First call 911. Shock can cause death even though the injury itself would not be fatal.
Symptoms are:
1. Anxiety, restlessness and fainting.
2. Nausea and vomiting.
3. Excessive thirst.
4. Eyes are vacant, dull (lackluster), large (dilated) pupils.
5. Shallow, rapid, and irregular breathing.
6. Pale, cool, clammy skin
7. Weak, rapid pulse
8. General body weakness
If shock has not completely developed, the first aid you provide may prevent it.
1. Maintain open airway - Head-tilt/chin-lift or jaw-thrust.
2. Control bleeding - Direct pressure, elevation, indirect pressure, or tourniquet if indicated.
3. Place the victim on their back, with legs elevated 6 to 12 inches. If possible take advantage of a natural slope and place victim so the head is lower than the feet. If they are vomiting or bleeding around the mouth, place them on their side, or back with head turned to the side. If you suspect head or neck injuries, or are unsure of victim's condition, keep them flat.
4. Splint suspected broken and dislocated bones in the position found. Do not attempt to straighten broken or dislocated bones, because of the high risk of causing further injury. Splinting prevents further tissue damage and shock.
5. Keep victim comfortable, and warm enough to maintain normal body temperature.
6. Keep the victim calm. Excitement and excessive handling will aggravate their condition. Prevent victim from seeing injuries, reassure them their injuries are understood and EMS will arrive soon.
7. Do not give victim anything to eat or drink. If victim thirsty, wet lips with wet towel.
CPR
Whenever a person is unconscious, call 911 for help. Check for breathing. If not, start rescue breathing ASAP. Use personal protective equipment (PPE) in first aid kit. Check for life-threatening conditions.
1. Call 911
2. Tap and shout. If no response, continue to procedure below.
3. Open airway. If no injury to head, neck or back, hand on the victim's forehead, fingers of your other hand under the bony part of the chin. Avoid pressure under the chin. Tilt head and lift jaw, avoid closing victim's mouth.
4. If you suspect victim may have an injury to head, neck, or back, you must use Jaw Thrust to minimize movement of victim. Kneeling at top of victim's head, place your elbows on ground. Place your fingers behind the angle of the jaw or hook your fingers under the jaw, bring jaw forward. Separate lips with your thumbs to allow breathing through the mouth. Do not tilt head or extend neck.
5. Look, listen and feel for breathing.
6. Breathing absent â?? gently maintain airway, pinch nostrils closed, two full breaths- Each breath should take 1 second. Between each breath allow the victim's lungs to relax - place your ear near their mouth and listen for air to escape and watch the chest fall as victim exhales.
7. Breathing present â?? maintain airway.
8. If no breathing, begin CPR. Two fingers at sternum (where lowest ribs meet), and put heel of your other hand next to your fingers. Place one hand on top of other, interlace fingers.
9. Lock your elbows and compress victimâ??s chest 1½ to 2 inches. Count aloud as you compress 30 times at the rate of 3 compressions for every 2 seconds. Finish cycle by giving victim 2 breaths. This should be performed four times - 30 compressions and 2 breaths - after which check the victim's carotid artery for pulse and any signs of consciousness.
10. If no pulse, continue CPR, checking for pulse after every 4 cycles until EMS arrives. Discontinue if pulse and breathing is present, but maintain airway. If you feel a pulse but victim is still not breathing, rescue breaths, one rescue breath every five seconds (remember to pinch the nose to prevent air from escaping). After first rescue breath, count five seconds and if victim does not take a breath, another rescue breath, repeating until breathing resumes.
11. Check for and control any bleeding
12. Manage shock
13. Monitor conscious level.
14. Monitor airway, breathing, circulation; control bleeding, manage shock.
HEAD WOUNDS
Closed head wounds may not be obvious; many times you will have to treat the victim based on how the accident happened. You may see only delayed symptoms- seizure, confusion, or personality changes. Head wounds must be treated with particular care, since there is always possibility of brain damage. If you suspect head injury, call 911 immediately - Time is critical. Look for:
1. Depressions, lacerations, deformities, bruising around eyes or behind ears.
2. Never touch a wound, examine it to determine depth, separate the edges, or remove impaled objects.
3. Check the eyes: Are the pupils (constricted) small, (dilated) large, equal, or unequal?
4. Blood or clear (cerebrospinal) fluid dripping from the nose or ears. (Cover loosely with a sterile dressing to absorb but not stop the flow).
1. Keep victim flat, stabilize head and neck as you found them, your hands on both sides of head.
2. Establish and maintain open airway using jaw-thrust. Do not tilt head or extend neck. Check airway, breathing, and circulation (ABC's).
3. Finger sweep to remove any objects from mouth.
4. Maintain neutral position of head and neck, if possible, apply cervical collar or towel collar.
5. Control bleeding using gentle, continuous pressure. Never apply direct pressure if skull is depressed or bone fragments seen.
6. Apply dressing - Do not use direct pressure or tie knots over wound. Apply ice or cold packs with cloth to prevent damage to skin.
7. Treat for shock - Do not raise victim's feet. If victim is vomiting or bleeding around mouth, place them on their side keeping neck straight. Do not give anything to eat or drink.
SPINAL INJURY
Back or neck pain following an injury should be treated for a fractured spine. Twisting or bending of neck or back, whether due to original injury or careless handling, is likely to cause irreparable damage. Call 911 immediately. Time is critical.
1. Keep the victim flat, stabilize head and neck as you found them by placing your hands on both sides of head. Do not move victim unless it is absolutely necessary. Do not move the head forward, backward, or sideways. Do not allow victim to move or sit up.
2. Establish and maintain an open airway - jaw-thrust maneuver. Do not tilt head or extend neck. Check airway, breathing, and circulation (ABCs).
3. Finger sweep to remove any objects from mouth.
4. Maintain neutral position of head and neck. If possible, apply cervical collar or towel collar.
5. Keep the victim comfortable and warm enough to maintain normal body temperature.
6. Treat for shock - Do not raise victim's feet. If the victim is vomiting or bleeding from the mouth, very gently and carefully place them on their side keeping the neck straight. Do not give anything to eat or drink.
7. Do not move victim unless absolutely necessary. Do not move the head. Do not allow the victim to move or sit up.
HEAT STROKE
Heat stroke is life-threatening. The victim experiences breakdown of sweating mechanism and is unable to eliminate body heat. If the body temperature is too high, the brain, kidneys, and liver may be permanently damaged.
Signs and symptoms:
1. 105 degrees or higher temperature.
2. Hot, wet, or dry and reddish skin.
3. Small (constricted) pupils.
4. Headache, nausea, dizziness, or weakness.
5. Deep and rapid breathing at first, then shallow and almost absent.
6. Fast and weak pulse.
If you suspect heat stroke, call 911 immediately - Time is critical.
1. Move the victim immediately to a cool area and place them in a cold water bath. If this is not possible, give a sponge bath by applying wet, cold towels to the entire body. If available, place cold packs around the neck.
2. Monitor the airway, breathing, and circulation (ABCs).
3. Treat for shock.
4. Remove victim's clothing, do not allow the victim to become chilled.
5. If victim is conscious, give one-half cup of cool water every 15 minutes. If victim vomits, stop giving water. Do not give salt tablets.
CHEST INJURIES
All chest injuries must be considered serious. Any victim complaining of difficulty breathing without signs of an airway obstruction must be examined for either an open or closed chest injury.
Sucking chest wound. Penetrating injury that makes a hole in chest cavity, causing lung to collapse. This condition is a medical emergency that will result in death if not treated quickly. Signs and symptoms:
1. Difficulty breathing and sharp chest pain.
2. Bluish skin color and anxiety.
1. Immediately seal the wound with hand or any airtight material available. Drivers License or Credit Card may work. The material must be large enough so that it will not be sucked into wound when victim breaths. Call 911.
2. Firmly tape material in place leaving one corner untaped to prevent a pressure buildup. If victimâ??s condition deteriorates, remove the seal immediately.
3. Lay victim on their injured side. Do not move victim unless it is absolutely necessary.
4. If shock or breathing difficulty occurs, place victim in a semi-sitting position.
5. Do not give victim anything to eat or drink. If victim thirsty, wet lips with a wet towel.
Flail Chest. Ribs are broken. This condition can be life-threatening. The bone ends may puncture a lung and cause severe bleeding. Do not move victim unless necessary. It may be difficult to detect a flail chest in an obese or muscular victim. Signs and symptoms:
1. Difficulty breathing that causes severe pain.
2. Swelling at site of injury.
3. Victim supports chest with hands and arms.
1. Call 911; Establish and maintain the airway, breathing, and circulation (ABC's).
2. Gently feel chest to locate edges of flail area.
3. Stabilize flail area with a pad of dressings or a pillow and secure with tape or straps.
4. Position victim with flail area against an external object lying on injured side.
5. Treat for shock.
ABDOMINAL INJURIES
Abdominal injuries can cause death because of the vital organs that may be damaged and/or bleeding. Most injuries to the abdomen require surgery.
Closed abdominal injuries
Signs and symptoms of (closed) abdominal injury include:
1. Intense pain, nausea, vomiting, and spasm of the abdominal muscle.
2. Tenderness, distention, muscle rigidity, and shock.
3. Victim lies with legs pulled up, protecting the abdomen.
1. Call 911; Establish and maintain the airway, breathing, and circulation (ABC's).
2. Place victim in the most comfortable position.
3. Carefully remove enough clothing to get a clear idea of the extent of the injuries.
4. Treat for shock.
5. Give nothing by mouth.
Open abdominal injuries: Always suspect damage to internal organs.
1. Establish and maintain airway, breathing, and circulation (ABC's).
2. Carefully remove enough clothing to get a clear idea of the extent of the injuries.
3. Place victim in the most comfortable position.
4. Treat for shock.
5. Control bleeding
6. Apply a dry sterile dressing.
7. If organs are sticking out, do not touch or replace them. Apply a sterile compress, moistened with sterile water. If sterile water is not available, use drinking water.
8. Do not use material that clings, such as paper towels, cotton, or toilet paper. Apply aluminum foil or plastic wrap over the compress keeping the area moist and warm.
9. Hold compress in place with bandage, donâ??t apply more pressure than needed to hold bandage.
10. Give nothing by mouth.
FRACTURES.
It is difficult to tell joint or muscle injuries from fractures. When in doubt, always treat as a fracture. Closed fractures can be turned into open fractures by rough or careless handling. Do not move victim more than necessary. Always use extreme care when treating a suspected fracture. Call 911 immediately. Immobilize injured part with splints to prevent broken bones from moving and causing further damage.
In an emergency, almost any firm object or material will serve as a splint- Sticks, boards, cardboard, and folded newspapers. A fractured leg can be immobilized by securing it to the uninjured leg. Splints should be lightweight, padded, strong, rigid, and long enough to reach the joint above and below the fracture. If they are not properly padded, they will not adequately immobilize the injured part. Clothing, bandages, blankets, or any soft material may be used as padding. If victim is wearing heavy clothes, you may be able to apply the splint on the outside, allowing clothing to be part of the padding.
1. Control bleeding with direct pressure, indirect pressure, or tourniquet only as a last resort.
2. Treat for shock. Do not move the victim until the injury has been splinted.
3. Monitor airway, breathing, and circulation (ABCs).
4. Remove all jewelry from the injury site. Gently cut clothing away so that you don't move the injured part and cause further damage.
5. Cover all wounds with sterile dressings, including open fractures. Do not push bone ends back into skin. Avoid excess pressure on wound.
6. Do not attempt to straighten broken bones. Fasten splints in place with bandages, tape, clothing, or similar. One person should hold splints while another tapes them.
7. Leave fingers or toes exposed. If tips of the fingers or toes turn blue or cold, loosen splint.
8. Wrap from bottom of splint to top, firmly but not too tight. Donâ??t stop circulation of blood.
9. Check pulse to ensure circulation. If pulse is absent, loosen splint until circulation returns.
SNAKE BITES
Every reasonable effort should be made to kill or positively identify snake. A poisonous bite should be considered a true medical emergency until symptoms prove otherwise. The bite of the pit viper is extremely painful and causes immediate swelling around fang marks, usually in 5 to 10 minutes, spreading and possibly involving the whole extremity within an hour. If only minimal swelling occurs within 30 minutes, the bite will likely have been nonpoisonous. When venom is absorbed, there is discoloration of the skin, followed by blisters and numbness in the affected area. Other signs are weakness, rapid pulse, nausea, shortness of breath, vomiting, shock, headache, fever, chills, and blurred vision. The rattler bite is further characterized by numbness and tingling in the mouth and possibly the face and scalp. A metallic taste may be noted.
1. Move victim away from (the snake) danger.
2. Calm victim, keep them lying down, quiet, and warm. Do not give the victim anything to eat or drink.
3. Immobilize victim's affected extremity, keeping bite area below level of the heart.
4. Remove jewelry from affected area.
5. Apply a constricting band (belt, tape) 2 to 4 inches above fang marks between bite and heart. It should be tight enough to stop the flow of blood in the veins but not through the arteries. Adjust the band as swelling occurs. Never place a band around a joint, neck, or chest.
6. Suction bite over fang marks, using extractor from snakebite kit. Suction by mouth only as last resort. Suction after 30 minutes is ineffective, venom has already diffused.
7. Monitor airway, breathing, and circulation (ABCs).
8. Treat for shock.
9. Never apply ice.
10. Contact nearest medical facility so proper anti-venom can be made available.
11. Transport victim (and dead snake) as soon as possible.
INSECT, SPIDER AND SCORPION BITES/STINGS.
Can cause an acute allergic reaction that can be fatal. Individuals with known sensitivities carry medication in commercially prepared kits. Signs and symptoms:
1. Local reaction of pain, redness, itching, and swelling.
2. Allergic reaction of difficulty breathing or swallowing, itching, redness, swelling (eyelids, lips, and tongue), hives, flushing, and abdominal cramps.
3. Shock may follow quickly, and death may occur.
INSECT STINGS.
1. Calm victim, keep them lying down, quiet, and warm.
2. Immobilize affected extremity, keeping area below the level of the heart.
3. Remove jewelry from affected area.
4. Scrape out stinger from skin with a plastic card. Do not use tweezers.
5. Wash area with soap and water.
6. Place cold-pack to area to reduce swelling and pain.
7. Monitor airway, breathing, and circulation (ABCs).
8. Treat for shock.
9. Get professional medical treatment.
Black widow bites are leading cause of death from spiders. Signs and symptoms include:
1. Pain and spasms of the back, chest, shoulders, and abdominal muscles within 30 minutes.
2. Nausea, vomiting, rigid abdomen.
3. Anxiety, fever, sweating, and rash.
1. Apply cold-packs to affected area, do not apply ice.
2. Monitor airway, breathing, and circulation (ABCs).
3. Treat for shock.
4. Transport the victim (and spider) for medical treatment.
Brown recluse spider bites. This spider is yellow to dark brown. Violin-shaped marking on its back. Signs and symptoms:
1. Bluish area surrounded by white, turning red (bulls-eye pattern).
2. Nausea, vomiting, joint pain, chills and fever within 24 hours.
3. Ulcer within 10 days.
1. Monitor airway, breathing, and circulation (ABCs).
2. Treat for shock.
3. Transport victim (and the spider) for professional medical treatment.
SCORPION STINGS. Can be fatal, most occur on hands. Signs and symptoms:
1. Pain, swelling, and discoloration at sting site.
2. Nausea, vomiting, seizures, restlessness, and drooling.
1. Apply a constricting band (belt, tape) 2 inches above sting. It should be tight enough to stop flow of blood in veins but not through arteries. Adjust band as swelling occurs. Never place a band around a joint, neck, or chest.
2. Apply cold-packs to affected area, do not apply ice.
3. Transport victim for professional medical treatment.
BLEEDING
A person can bleed to death in less than one minute, but call 911 as soon as possible. Use personal protective equipment (PPE) including gloves before touching victim. Infections that can be transmitted through blood and body fluids include: HIV, Hepatitis, staph and strep infections, Syphilis, TB, malaria, herpes, and blood infections. The greatest risks are HIV and Hepatitis.
Bleeding can be controlled by:
1. Direct pressure is first and most effective method. Place a sterile dressing or clean cloth on wound, tie a knot or adhere tape directly over wound, only tight enough to control bleeding. If bleeding is not controlled, apply another dressing over first or apply direct pressure with hand or fingers on wound. Direct pressure can be applied by victim or a bystander. Under no circumstances is a dressing removed once it has been applied.
2. Elevation of the wound. Raising an injured arm or leg above heart will help control bleeding.
3. Indirect Pressure. Indirect pressure is used in addition to direct pressure and elevation when direct pressure and elevation donâ??t work. Bleeding from artery can be controlled by applying pressure to pressure point- blood flow can be controlled by pressing artery against an underlying bone. Pressure is applied with fingers, thumb, or heel of hand. Do not apply pressure to neck (carotid) pressure points, it can cause cardiac arrest.
Pressure to a pressure point should be released every 8 to 10 minutes to see if bleeding has stopped. The pressure points are:
1. For wound of temple or scalp- In front of the ear against the skull.
2. For wound of face, below eyes- In the under side of the jaw, about one-third the distance from the angle of the jaw towards the chin.
3. For wound of shoulder or upper arm- Behind the inner third of the collar bone pushing against the top rib.
4. For severe bleeding of the lower part of the upper arm and elbow- On the inside of upper arm, in the groove between the muscles, halfway between shoulder and elbow.
5. For severe bleeding of the thigh and lower leg- In the hollow of the inside thigh, on the front, center part of the crease in the groin. Position victim on back, kneel on opposite side from wounded leg, place heel of your hand directly on pressure point, and lean forward to apply pressure. If bleeding is not controlled, it may be necessary to press directly over artery with flat surface of fingertips and to apply additional pressure on fingertips with heel of your other hand.
4. Tourniquets. Tourniquets should be used only if all other methods fail to stop bleeding. Tourniquets should only be used when an arm or leg has been partially or completely severed and when bleeding is uncontrollable. It should be loosened only by trained medical help. A tourniquet should be used only on the extremities. Tourniquets cause tissue damage and loss of extremities.
The standard tourniquet is normally a piece of cloth folded until it is 3 or more inches wide and 6 or 7 layers thick. A tourniquet can be a strap, belt, tape, towel, or similar. A folded triangular bandage makes a great tourniquet. Never use wire, cord, or any material that will cut the skin. To apply a tourniquet:
1. While maintaining pressure point, place tourniquet between heart and wound, leaving 2+ inches of uninjured skin between tourniquet and wound.
2. Place a pad (roll) over artery.
3. Wrap tourniquet around extremity twice, and tie a half-knot on upper surface.
4. Place a short stick or similar object on half-knot, tie a square knot.
5. Twist stick to tighten, until bleeding is controlled.
6. Secure stick in place. Never cover a tourniquet.
7. Dress and bandage wound. Treat person for shock.
Remove PPE carefully to avoid contaminating yourself. Dispose of PPE in designated containers before leaving area. Wash hands and other exposed skin with soap and hot water immediately after contact. Use antiseptic cleaner and paper towels where sinks and soap are not available.
5. Nosebleed. If a fractured skull is suspected, do not stop the bleeding. Cover nose with a loose, dry, sterile dressing and call 911. If victim has a nosebleed due to other causes, do the following:
1. Keep victim quiet, sitting with head tilted forward.
2. Pinch nose shut (if no fracture), place ice or cold packs to bridge of nose, or put pressure on upper lip just below nose.
3. Inform victim not to rub, blow, or pick their nose.
4. If nosebleed continues, bleeding starts again, or bleeding is because of high blood pressure, call 911.
5. If victim loses consciousness, place them on their side to allow blood to drain from the nose and call 911.
HUMAN AND ANIMAL BITES
Human bites must be treated by a physician. Animal bites present the possibility of rabies. The animal should be captured and confined so it can be observed for signs of rabies. If you must take the animal's life, do not damage the head, it will be necessary to examine brain.
1. Control bleeding with direct pressure and elevation.
2. Wash the area with soap and warm water, apply a sterile dressing.
3. Transport to nearest medical treatment facility.
CHOKING.
The tongue is the most common cause of obstruction in the victim who is unconscious. A foreign body can cause a partial or complete airway obstruction.
1. Shout "Help"-Ask victim if you can help. Of of one of of on Call 911, Say "Airway is obstructed"
3. Abdominal thrusts (Heimlich Maneuver)
a. Stand behind victim.
b. Place your arms around the victimâ??s waist.
c. With your fist, place thumb side against middle of abdomen, above navel and below tip of sternum (breastbone).
d. Grasp your fist with your other hand.
e. Keeping elbows out, press fist into abdomen with a quick upward thrust.
f. Repeat until obstruction is clear ore victim becomes unconscious. If victim is or becomes unconscious do the following:
4. Finger sweep - Place victim on back, open victim's mouth and grasp tongue and lower jaw between thumb and fingers, run index finger in the mouth inside of cheek to base of tongue. Use "hooking" motion to dislodge object.
5. Open airway (Head-tilt/Chin-lift, or jaw thrust if head, neck or spinal injury).
6. Listen for Breathing. Place your ear over victim's mouth and nose. Look at chest, listen and feel for breathing, 3 to 5 seconds. If airway remains blocked, perform abdominal thrusts.
7. Perform abdominal thrusts. Straddle victim's thighs. Place heel of your hand against middle of the abdomen, above navel and below tip of breastbone. Place other hand on top of first (Fingers should point towards victim's head). Press abdomen 6 to 10 times with quick upward thrusts.
8. Continue steps 4 to 7 -Until successful in opening airway, you are exhausted, or you are relieved by another individual.
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Joe Reitman
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Joined: 11/16/2003
Posts: 10810
Location: Morgan County Georgia
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