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Updates

So I haven't been around much, much less with time to post anything. Brief rundown of life as of late:

- Work

- Work

- Work

- Got sick for 2 weeks (my annual once a year get sick episode) because sick lady accompanying patient insisted on sitting up front, which I normally don't allow to begin with, and proceeded to hack her guts out all over the truck while making no effort to cover her mouth as she sprayed biohazardous flu mucous all over the place during prolonged transport. I was too nice and at the time lacked the hindsight to make her wear an N95. Crappyness of situation reinforced as she repeatedly referred to me as "Ambulance Driver".

- If a Firefighter is not called a Fire Truck Driver, and a Police Officer is not called a Police Car driver, a Paramedic shall not be referred to as an Ambulance Driver.

- Got t-boned in intersection 30 seconds after leaving cockroach infested apartment, by driver running red light at excessive speed, "not paying attention". Truck destroyed, luckily no patient on-board.

- Swooped in and saved day on weird parking lot off-shift psych call, coincidentally while hanging out with partner. We are black clouds.

- Trauma course, which was cool.

- Set new personal record for amount of times having to pull over/stop truck to tilt spinal board for immobilized, vomiting patient. Fortunately did not break personal record for amount of body substance on uniform following incident. Partner not so lucky.

- Accidentally sliced thumb open, down to bone - lots of blood. Used expired sutures from hospital to stitch it closed. Healed well. Felt manly.

- Trying to start (and actually stick to) new exercise routine. Background fear of rhabdomyolysis ever present. Bought running shoes for the first time in my entire life.

- Made a nice kydex holster for flashlight. Figures, I end up on fixed day rotation at work, negating most of its usefulness outside of the odd powerless/lacking light bulbs apartment at work. Addicts break the light bulbs for use to vaporize cocaine/methamphetamine. Many elderly simply can't afford light. And of course there will always be power outages...

- Grossed out trainee with Lucas II Pneumatic CPR video. Check it out: http://www.youtube.com/watch?v=RP-Q_Auip-Q

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Hospital Pants

You might be wondering what the heck the above picture is all about. I can assure you though, that everything in the above photo is interrelated.

Trauma shears. They are one of my favorite things. They can pretty much cut through anything. When bored at work, it can sometimes be fun to bet newbies that I can indeed cut a penny in half, only to pull out a pair of shears and proceed to actually cut a penny in half. They cut everything from the aforementioned pennies, to thick motorcycle leathers, seatbelts, hockey equipment...anything you can throw at them. Though sometimes I've felt bad about having to use them. My partner and I were driving from one region to another, when the lights of the car ahead, far off in the distance disappeared suddenly, and as we got closer the reason became clear. The driver decided to pit his car in an epic 70km/h battle versus a lamppost, and lost (as is usually the case when it comes to lampposts). As it turned out, he was lucky to be alive, and can likely credit his relative lack of injuries to the fact that he was pretty sloshe..-intoxicated. You see, intoxicated people don't just survive horrific car accidents because they were "lucky", or because the innocent families they usually kill were just scheduled to die that day instead... It's because the alcohol in their system causes CNS depression and basically makes them into ragdolls. Their muscles just don't tense up the same way a sober person's do when the brain says "Oh crap (my pants)!" and releases mass amounts of epinephrine into the system. Their "oh crap" is more of a "huh. lamppost eh? pfft. suuuuure."

Therefore, they just sort of flop around and avoid otherwise potentially critical injuries. Now, I say relative because although he escaped spinal injury and that nasty death thing, he had a nice distal radius/ulna fracture that was manifesting itself as a really grotesque 45+ degree angulation... ie: Arm Really Not Supposed to Bend That Way Syndrome.

Or simply this:

Once again the trauma shears came through. He not only lost his car that night, but his expensive jacket as well. So. Moral of the story is this - act like an idiot = get expensive jacket cut off by guy with cool scissors. It just isn't worth it.

****

Crazy people. They come in many varieties. Some are nice-crazy, or merely "eccentric". Some are what I like to refer to as "pleasantly confused". Some are bad-crazy, dangerous-crazy, or just scary-crazy... like the guy in the hospital pants (nowhere near the hospital, I might add) who ran out into the street at full speed and started cussing, waving arms, grabbing at his clothing and hitting the front of the truck at 3am, forcing the brakes to be slammed lest he be squashed into oblivion. I don't even know what he was saying. It seemed he either REALLY hated ambulances for some unknown reason, or he REALLY wanted a ride to the hospital so he could bail out at the last second and run across the street to the liquor store or one of the nearby crackhouses. Because that doesn't actually happen in real life or anything.

Like this, but younger. And with hospital pants.

I stared at him. He stared back at me. He had the cold, disconnected look of a homicidal madman in his eyes. Our patient, hearing the commotion up front, was probably ready to have a second heart attack. I locked the doors and prepared to be flying in reverse any second... dragging the crazed hospital pants wearing psycho down the street like Arney versus the T-1000. I hoped his crazed, frantically waving arms didn't turn out to be two big spikes composed of advanced mimetic poly-alloy. He screamed something completely unintelligeable... something I can only assume was about the complete and utter failure of Ontario's mental health system, before running back into the darkness from whence he came, presumably to go ingest some more bath salts.

****

Don't eat hospital lemon meringue pie. No matter how good it looks. It isn't worth the risk. That is all.

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Patient Education

Okay. As soon as it snows enough I'm going to try and get out for some winter camping or something. In the meantime, more stuff you probably find insanely boring (but that I think everyone should know).

“Medic 2100, Priority two for you in the south end...switch to South for details. 2100 respond on a Ten-Delta-One… to 987 Hamilton Street for a 62… That’s six-two year old female, complaint of chest pain times 30, that’s three-zero minutes. Fire tiered”

On arrival, you find a 62 year old female, slightly pale, alert but sluggish, sitting on the tiled kitchen floor, her back against a wall. Your partner applies high concentration oxygen via nonrebreather, followed by the cardiac monitor. “What happened?” you ask. The patient, Mrs. Fairweather, states that she tripped on her cat, Mr. Snoogles, causing her to lose her balance and fall – her chest hitting the kitchen counter on the way down. Heart rate 86, normal sinus… BP 90 over 62, your partner says.

Upon further questioning while performing your routine assessment, Mrs. Fairweather states that she took 3 of her nitroglycerin sprays – two, which did not improve her discomfort, before calling 911 as her doctor instructed, and another before your arrival. She asks if she should take another dose, explaining she “almost had a heart attack two years ago”, and suffers angina. “Are you having chest pain?” You ask. “Yes, where I hit the counter. My doctor told me to take my nitro for chest pain…”

She reports her pain as 4/10, nonradiating and localized to the sternal area, worsening upon inspiration and palpation. There is no visible deformity or discoloration, and no associated shortness of breath. When asked if the current discomfort is similar to that of her previous episodes of angina, she says it is not, and that her angina usually feels more like a burning sort of pressure, but goes away after she rests a bit. She feels very lightheaded and dizzy. “I have a very bad headache”, she states, closing her eyes as Mr. Snoogles looks on.

That was a real call. No, none of the addresses or names are accurate, and I honestly don't remember if the cat's name was Mr. Snoogles (It was a long time ago!)

 Nitroglycerin is one of the most frequently encountered medications in the pre-hospital setting, along with antihypertensives/cardiac medications, and those for treating diabetes related disorders.

Nitroglycerine (NTG) is a vasodilator – that is, it dilates veins and arteries (arteries to a slightly lesser extent than veins). It is used for treating pain/discomfort related to angina, and for treating cardiogenic pulmonary edema. Patients suffering from angina exhibit narrowed arteries in the heart due to the build up of plaque caused by poor diet, age, or other pathologies. Because of these blockages, less oxygenated blood is able to travel through the arteries to supply cardiac muscle tissue at any given time. During periods of stress and/or activity, when cardiac muscle requires additional oxygen for adequate functioning, the needed oxygen cannot reach tissues and the affected cardiac muscle becomes ischemic. Ischemia is medical terminology for any state of inadequate oxygenation in body tissues, usually caused by poor perfusion (lack of flow of nutrient containing blood). This ischemia typically results in pain. If ischemia is prolonged, irreversible damage may occur and tissue death (infarction) ensues. A myocardial infarction (or heart attack) occurs when arteries are so blocked that oxygenated blood fails to flow to the cardiac muscle tissue, resulting in tissue death.

Nitroglycerine treats angina effectively for two reasons. Firstly, its vasodilatory effect “opens up” the pathway for blood, allowing more oxygenated blood to pass through narrowed areas. Secondly, because nitroglycerine dilates veins and arteries, it has a systemic decrease in blood pressure. Basically, your body contains about 5 liters of blood. To maintain a normal blood pressure of 120/80, that 5 liters of blood fits in a proportionately sized “container” – your vascular system. If you dilate the veins and arteries of the vascular system, a drop in blood pressure will occur because you have effectively enlarged the container that holds that blood.

This effect can be beneficial, in that less blood returning to the heart (what is referred to as preload) requires less work by its muscle to push that blood out against the resistance (or afterload) presented by the vascular system. Cardiac muscle is unique in that the more blood enters the left ventricle, the more forcefully it will contract to pump that blood. If Blood pressure is 120/80, the heart must effectively produce at least 80mmhg (the resistance pressure of the arterial system during diastole) of equivalent force to send blood to the entire body. If blood pressure is dropped, that is less force the heart must produce to do the same work. Ischemic cardiac muscle has decreased ability to generate contractile force, so lowering the amount of energy required by that muscle to push blood has a beneficial effect when treating ischemia secondary to angina.  Think about it this way… water is easier to push through a large garden hose than a narrow one.

Problems arise, however, when people are not properly educated. Too often physicians don’t have the time within their 15 minute appointment to educate patients on the correct use of their prescribed medications. This is compounded when many patients are elderly and may require more concise, easy to understand directions.

It is common practice for physicians to instruct angina patients to take 2 doses of nitro, five minutes apart, and to call 911 if those two doses provide no relief. When NTG provides no relief, this is a sign that the patient could be experiencing a heart attack. Mrs. Fairweather took her 2 doses of nitro and called 911 before taking a third. The problem is, her chest pain was not cardiac in origin, but traumatic as the result of her falling. By taking the NTG, she effectively lowered her blood pressure to the point of making herself dizzy and lightheaded. (NTG also tends to produce very unpleasant headaches due to its vasodilation of cerebral circulatory pathways) Had she attempted to stand up on her own before EMS arrival, she likely would have lost consciousness and fallen down, resulting in further injury.

Cases like this are unfortunately not uncommon, and the healthcare community at every level should be doing more to educate patients.

 The same is true regarding those people that experience typical cardiac symptoms (usually stubborn males with telltale signs/symptoms) who then go into denial and stay home in front of the TV for three hours, sweating and waiting for the pain to go away by itself. When it doesn’t and they finally call 911, irreparable damage has often already occurred. Females are a bit more difficult, as their presentations are often atypical and may involve nothing more than an unusual gastric discomfort or burning sensation.

If you know anybody who takes any medication on a regular basis, or is within the age demographic to be considered at risk for cardiac related disorders, insist that they understand how to take their medications properly, and that they know what to do (ie...don't wait) in a situation where they should be calling 911. You could be helping to save a life!

It’s also really awesome when people have current medication lists printed and stuck to the fridge ready to go… just saying.

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Entombed by Deftones on Grooveshark

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Words of Wisdom, or "How to Avoid Opiate Toxicity, Hepatic and/or Renal Failure, and the Ubiquitous Form 1"

Okay kids, here are some words of wisdom.

When your knee hurts so bad and the Tylenol 3 your quack doc prescribed just doesn't have the desired kick that only a massive loading dose of morphine derivative can provide, the solution isn't just to take, say, fifteen times the recommended amount. Four times. Over the course of two hours. And then blame your wife. After calling Telehealth, of course.

I hope we're all clear on this, yes?

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What's That Squiggly Line Mean, Anyway?

Given the subject matter of my last entry, combined with the fact that I haven't actually been going anywhere and doing anything except for work lately (meaning I have nothing really worthwhile to post), I figured I could post about ECG interpretation.

I'm not going to get into real specifics, but hope I'll be writing something which I can show to students and such (or even the curious layperson) in the future and offer a slightly simpler explanation than that which is offered by the textbooks.

Anyway, I'll be illustrating the basics behind the actual workings of the cardiac monitor, and relating things to an actual ambulance call. Here goes...

Everyone has seen those dramatic TV shows during which an ER team or ambulance crew are working a patient, and he/she suddenly becomes VSA (vital signs absent, that is). This is evidenced by the lack of waveform on the cardiac monitor - or, flatline as it has come to be known by the general public. The correct term is asystole, pronounced eh-sis-tul-ee, for reference. This is usually followed by someone quickly grabbing the pads and yelling (without a pulse check first - doh!) "CLEAR!" and shocking the patient back to life. It's worth noting that this really doesn't happen - both the shocking of asystole, and the person coming back to life, pulling the airway out, and whispering a grateful "thank you"... but that's beside the point (And so is the fact that out of hospital cardiac arrest has a less than 5% survival rate). What does that squiggly line (or lack thereof!) on the monitor actually represent?

Everyone should know that the heart beats because of an electrical "charge" - the correct term being "cardiac action potential". This system can be fairly simplified by realizing there are 3 main parts of the cardiac conduction system.

Sinoatrial node: This is the area responsible for initiating the cardiac action potential. Here, sodium ions rush into cells in exchange for potassium and an electrical charge is created (depolarization - SA nodal depolarization represented by a P wave on an ECG tracing). This charge quickly spreads throughout the atria resulting in muscular contraction before reaching the AV node. The SA node is responsible for maintaining heart rate between 60-100 beats per minute in adults. It is the heart's primary pacemaker.

Atrioventricular node: This area basically sits between the atria and the ventricles. After moving through and depolarizing the atria, the action potential is briefly slowed by this bundle of conductive tissue. This brief slowing (represented on an ECG tracing by the P-R interval) allows the atria to completely finish muscular contraction and allows atrial blood to be fully kicked into the ventricles below. If the SA node fails to initiate an action potential, the AV node can take over cardiac pacing at a speed of 40-60 beats per minute.

Perkinje Fibers: The Perkinje Fibers are bundles of conductive tissue along the ventricular walls. After passing through the AV node, the action potential quickly moves along the ventricular walls, depolarizing (represented as the QRS complex/interval on an ECG tracing) these fibers and causing ventricular muscle contraction. If pacing in the SA and AV node fail, this area can take over pacing at a very slowwww (inevitably resulting in death) 20-40 beats per minute.

As you can see from the above heart diagram, the electrical "charge", or action potential, moves from the SA node down through the heart. This is where the cardiac monitor comes in.

The most basic method of cardiac monitoring is the three lead ECG. (Many students become confused by this name, as there are actually 4 wires or "leads", instead of 3 - the fourth, green wire being a ground wire. This being said, the term 3-lead does not come from the amount of wires present, but from the number of angles the heart is viewed by the monitor)

Each wire has one electrode at the end. These are the little stickers we stick to peoples' chests/extremities. If you refer to my diagram for reference to their placement, you'll see that I have labeled each lead with a + and - symbol. Basically, the machine monitors electrical energy moving between a negative and positive point. It uses software to change whether a given electrode is used as a negative or positive point of reference depending on the lead being analyzed, or image it is generating. If a charge moves toward a positive electrode, the machine displays a positive deflection on the ECG paper, whereas a negative deflection denotes electrical movement away from a positive electrode. when electrodes are placed in a 3 lead configuration, the monitor generates just that - 3 leads or "views".

Let's look at a tracing for a better explanation.

The following tracings are those of a 59 year old male patient complaining of typical ischemic chest pain: 8/10 severity crushing/pressure-like pain substernally with radiation to the left arm and accompanied burning sensation to the jaw. He also presented with the typical diaphoresis (sweating) and shortness of breath.

When I connect the monitor, I can choose to display one of my 3 leads on screen. Generally we use lead II as our initial "primary" lead, as the monitor is applied during the first couple minutes of a call. This, lead II, is an obvious choice when you consider exactly how lead II is looking at the heart. The positive electrode looks up toward the negative, right along the heart's conduction pathway as the action potential moves from the SA node down and leftwards toward the Purkinje fibers (and the positive electrode). When I begin monitoring a patient, this is the first lead I observe because it will generally provide the best representation of any potential abnormalities.

If you compare this tracing to the example diagram pictured above, just before the cardiac conduction diagram with the SA, AV, and Purkinje areas, you will see that something here is abnormal! The ST segment is elevated significantly. ST segment elevation is a very strong indication of myocardial infarction, or heart attack. The elevation is caused by the cardiac action potential taking a different route than normal through the conduction pathway, having to travel around injured/ischemic cardiac tissue. At this point, we decide to obtain a 12 lead ECG to get a better view of what's going on in our patient's heart.

A 12 lead ECG consists of the standard 3 leads already mentioned (LA, LF, RA, and G), plus 6 additional leads - V1 through V6. These additional 6 leads look at the front (septal) and left (lateral) side of the heart, providing a good view of both the septal region and of the left ventricular wall.

And here is the 12 lead printout. This shows the original 3 leads I, II and III, as well as AVR, AVL, AVF, and our new leads V1 to V6. AVR, AVL, and AVF are views interpolated by the machine via software which attempt to provide a "wider" view of the heart using the initial 3 leads as referances.

The easiest way to explain how to read the different leads is to use cameras as an analogy. Think of each positive electrode as a camera, pointed back at its corresponding negative electrode. Every time the charge moves toward the camera, an upward stroke is translated to the paper.

We can see right away from the 12 lead that there are significant abnormalities (ST elevation) in leads II, III, and AVF. These are all known as inferior leads, as they all look UP at the heart from below. This would of course indicate that the current abnormality/injury originates in the inferior wall of the ventricle(s). There is also ST depression visible in I, AVL, V1 and moreso in V2 (known as reciprocal changes), with some elevation in V4. From this, and because there is marked ST elevation in 2 contiguous leads, I can soundly determine that this patient is indeed experiencing an inferior wall MI.

At this point, 0.4 milligrams of sub lingual nitroglycerin was administered (as this call occurred before new protocols were released that now require the determination between left and right sided ventricular infarct before administering or contraindicating NTG), and an IV established.

Following this, the patient was rapidly transported to the local emergency department where a nitro drip and further narcotic pain management was ordered and physicians arranged for rapid transport to a neighboring city's hospital equipped for emergency catheterization.

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Acute Myocardial Infarction in the Prehospital Tim Hortons Environment

If I had a nickel for every time somebody figured it'd be a funny and original idea to make a ridiculous face and clutch at their chest (because ALL real cardiac patients exhibit characteristic chest clutching and silly faces) while pretending to experience chest pain while sometimes verbally requesting CPR when we hit a restaurant for food at work... I'd probably have a million nickels. Generally, chest pain is caused by the insufficient perfusion of cardiac tissue, as opposed to insufficient IQ.

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Workspace

Everyone needs a comfy and relaxing workspace - Especially after fending off violent night shift meth heads at work. This is mine:

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Bridges and Rope and Apples and Such

Today I went out with Lachlan and Adrian and rappelled from a bridge.

Shortly after, we checked out an abandoned mansion and ended up hiking through a really nice park with some tasty apples (except for the worms...)

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Night Photography

Tonight I went out with Wade to take some photos. I've been meaning to start doing (and getting some of my skill back) more night photography, so even though I was tired, I decided to go out anyway.

You can clearly see there isn't much interesting going on in this big parking lot. But being able to use different artificial light casts from nearby buildings, etc, while pulling in ambient light from the night sky via long exposure can still produce some neat results. The photo of the building above is made more interesting not only by the geometry of the structure itself within the frame, but by the different light sources. Every light source produces a different color - relatively invisible and inconsequential to the naked eye, but very important when using a camera. The camera sees different types of light differently than we do. For example, a camera perceives the light produced by a standard household incandescent bulb as very orange/yellow. A fluorescent light, on the other hand, may produce either a bright pink/magenta, or even a green tint. Sodium vapor lighting used in many streetlights produces a pukey yellow-green color, and most LEDs produce a cool blue or near-white.

Taking into account the different light sources within a scene and trying to imagine how they will interplay with each other and look as a captured image is valuable - both for problem solving and creating (mostly subtle) degrees of added interest within an image.

Anyway, the parking lot/building location got pretty boring pretty fast, so Wade called up a friend to help out and play dead...errr... model. Wade had asked me to bring along my uniform as he wanted to get some photos to build his portfolio, and brag... err... show his friends what he's doing in paramedic college.

I ended up shooting a bunch myself, and wanted to go for a real edgy stock image/movie/TV ad sort of look. I didn't bring a bunch of gear so all I had was a 60 inch umbrella, a bare Nikon SB800, some wizards, and a light stand.

I've always loved shooting portraits in dark environments, as it gives you full control over how your subjects and backgrounds look. One might say "Dark? But that's no good for portraits! Its too..... dark!" The thing about shooting in the dark though, is that you are the sole supplier of light. You have the ability to control exactly what stays lit. Anything not lit by your light stays pitch black. You have the ability to part the blackness of night like Moses parting that big ocean or whatever that was.

When I used to teach photography and photographic lighting, I always found that what people have the toughest time understanding is the relationship between "relative" light size, and distance.

The larger the light source, relative to the subject, the softer the quality of light and the more it will "wrap around" the subject. For example, a subject lit by a 60" umbrella 5ft away will appear to be lit by a softer light than if that subject were lit by a bare 4" diameter flash head 5ft away. But move that 60" umbrella 20ft away, and the difference becomes almost nonexistent. That's because the size of that light source (the 60" umbrella) is now comparatively MUCH smaller relative to the subject.

Try this. Envision yourself as the subject of a photo. Directly 5ft in front on you stands that 60" diameter umbrella. Right beside it is that bare, 4" diameter square flash head. From here, the umbrella is MUCH larger compared to the flash head. Now leave that flash head where it is, and with your imagination, move that umbrella 50ft away from you. The size of that umbrella RELATIVE to where it started and to the flash head, from your perspective, is now much smaller than it was. This will equate to a harsher quality of light. I don't know if that makes any sense at all, but I'm rambling.

Anyway...

This is our scene. The camera is assumed to be at the bottom center of this image. What will this image look like if taken in a pitch black outdoor environment?

You can clearly see the effects of both light sources themselves. The large umbrella, at camera left produces a soft, smooth natural quality of light that illuminates a larger area without any hot spots. The bare flash to rear camera right on the other hand, produces a very harsh effect. This is one of my favorite setups for this type of shot. One large soft light, and one harsh point light source.

What if we move the bare flash up a little bit?

The result is almost a half and half effect. For a portrait, this equates to a soft light on one side of the face, and a more harsh defining effect on the opposite.

The same effect can be used very effectively (pun intended) for more traditional portrait angles as well.

Notice how the umbrella and bare flash are ALWAYS opposite each other. This is a key factor in producing that edgy look. The soft light on one side provides nice soft illumination and an attractive catchlight for portraits, and the harsh opposing light separates the subject from the background and adds that extra "pop". I added a red theatrical gel to the bare flash for effect. Pay attention to how far back the bare flash is positioned, and how far forward the umbrella is positioned. Their angle in relation to the subject and to each other will determine the overall contrast of your image.

This is an almost identical setup to what I used to use 80% of the time, even for big shoots. The equipment might change, but the underlying principles remain the same. It also goes to show that one doesn't need a studio full of gear to create good quality images, and it can be done just as readily, just as easily and just as quickly out of the studio on a random sidewalk or parking lot somewhere.

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Review: MSR Hubba Solo Tent

Having recently acquired this MSR tent, I figured I'd post a quick review.

So far, my first impressions are generally very positive. The tent is just tall enough to accommodate my height (plus US MSS cold weather and temperate bags combined) perfectly with a bit of room at either end. MSR has also opted to change the color from an obnoxiously bright orange/yellow, to a limey green color (almost identical to the bright green found in CADPAT), and it tends to blend quite well into the surrounding environment.

The interior tent itself features mostly mesh, which isn't a bad thing. The mesh seems to be of durable enough quality (very similar to that which I use in my hammocks) and the seams affixing it to the fabric body appear well stitched. The mesh allows for a good deal of ventilation, which would be perfect for hot days when using the tent without the exterior fly.

The "bathtub" floor of the tent is made of silnylon. This is the first drawback I could see with this tent, in that silnylon will be less durable as a floor material over long-term use than most other tents using polypro woven floors. MSR's solution to this is to purchase their tent "footprint" - basically a second sheet of silnylon that is placed on the ground beneath the tent, which would offer additional protection from water penetration and abrasion. At $30-40 though, I personally thought it would be a better idea to make my own out of more durable polypro weave. That and I could make my own silnylon footprint for a fraction of their retail cost, using materials I already have available to me.

Above is my DIY tent footprint made from two layers of polypro, which is much more durable than silnylon and while a bit heavier, serves a wider range of alternate uses in my pack.It attaches to the tent frame via small paracord loops that simply fit around the tent's frame.

The frame itself is constructed with aluminum tubing. The sides feature a neat weight-saving system (utilizing one single pole and a crossbar instead of two separate poles) centered around an aluminum hub.

The poles terminate with aluminum posts that fit snugly into grommets attached to the fabric tent body. While well stitched (as is the rest of the tent), the webbing used for this purpose for the sake of remaining lightweight, is a bit on the thin side and I might worry about breakage with extended use in bad weather (rot, exposure to mud and dirt weakening the fibers). I would like to have seen some slightly beefier webbing used.

Plastic or aluminum D-rings at the end of the webbing loops versus the existing yellow cord would have also been a nice addition, as this type of fabric-fabric point creates an inherently weak spot (as in rope access, rock climbing) as the fabric rubs together under stress and degrades.

The mesh body is secured to the frame via thick plastic hooks. These hooks appear to be pretty heavy duty and I wouldn't worry about them breaking. Again though, some heavier duty webbing may have been nice in securing them to the tent. The fabric used is equivalent to generic grosgrain ribbon.

The fly is secured to the frame the same way the base of the inner mesh tent is secured - by inserting the frame poles through grommets.

MSR has employed a rather ingenious tensioning system here, allowing one to place the fly and then tension the corners to ensure a taught fit and even stress distribution. I'm hoping the plastic hardware used for this purpose will last.

The fly fits well over the tent and provides good coverage. In a very heavy rain, water may hit the surrounding ground and could potentially spray back under the fly and either hit (or enter) the tent through the mesh, but I don't see that as a likely occurrence. In that event I would just use my bivy bag and sleep through it as I've done several times in the rainwithout the luxury of a tent.

One of my favorite features of this tent is the small vestibule in front of the door, seen above.

With a zipper opening and loops (on both sides) for fastening in the open position, the vestibule is just large enough to accommodate my 99 Liter pack with a bedroll atop, saving me from having to apply its rain cover and leave it outside in the elements. I can also see the small space being nice for cooking with an alcohol stove or similar, or for placing my small DIY candle powered space heater.

The fly has, in addition to the four main corner anchor points, 4 others (pictured above). Two at either end close to the ground, one in the center of the backside at ground level, and one above that at the top center. While cord/guyline for using these points is not supplied with the tent (I just used paracord), and the tent only comes with 6 pegs (strange), using the extra points greatly increases stability, and I feel like the tent would have no problem withstanding a decent winter storm if properly positioned with reference to wind direction, available windbreaks, etc. The stitching at the aforementioned tie-out points is all well done, also. While advertised as being a 3-season tent, I don't believe I'm going to have any issue using it throughout winter in any condition when paired with the US MSS and ranger blanket. I may still opt to add a few additional tie-down points along the edge of the fly for even more stability in high wind conditions.

The tent comes supplied with a water resistant loose-fitting bag that holds all of its contents. These include a long, thin bag for the poles, a small bag for the 6 pegs and an aluminum tube used to repair a damaged pole intersection.

I chose to forego packing everything into a single bag and can comfortably fit the whole thing into three separate compartments on the bottom side of my pack, with the poles and pegs being placed in their skinny bag and rolled with my foam pad.

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Tobermory, V2.0

I woke up Monday morning (actually, it was 4PM) to my friend Wade calling me, asking if I wanted to go up north at 7PM that same day. I said "Sure, lemme pack quick", and with that I was on my way.

5 hours pf driving later, and after leaving about a million dead frogs in our wake (It was pouring rain as we left, and stayed that way all night. Frogs tend to come out by the hundreds of thousands and instinctively want to hop across rural roads when it rains at night) we arrived.

I put up my hammock in the pouring rain while Wade decided to forego setting up his tent and just slept in his truck. At first it was great, until I realized a small area of my canopy's fabric had been worn or something and small drops of condensation were becoming big drops before dripping onto the bug netting to splash all over me. Rather than wuss out, I threw the bivy bag over my sleeping bag and stayed put. I remained dry and relatively cozy, though I should have thought to hang a ranger blanket outside the hammock as an insulator. It probably would have been soaked, but synthetics still retain some insulating properties when wet anyway. I've modified a ranger blanket with paracord draws at opposing ends and button edges so that it can be used as a hammock insulator in cold conditions. You lose heat from your backside quick in a hammock, as no matter how thick and lofty your sleeping bag, your weight compressing it flat against the side of the hammock, and that side being open to air, causes rapid heat loss. Placing a closed-cell foam pad underneath helps, but you wake up with a wet backside as the condensation has nowhere to go except into the pad. Surrounding the hammock itself with insulating material solves the problem. Unfortunately I didn't get a chance to test out the ranger blanket due to our not yet mentioned early departure.

I'm currently debating with myself whether or not I should simply switch back to using a tent for shelter. A tent offers a naturally warmer indoor environment in cold temperatures, full weather protection without having to use an overhead canopy as is used with a hammock, and offers an enclosed and protected space for gear storage and working in bad weather. Not having to use an external insulator in the winter could also be a big advantage to using a tent, if not only for simplicity's sake (as I would have the ranger blanket in my pack regardless).

Potential and/or absolute disadvantages to using a tent are of course a heavier pack weight, mostly consisting of poles which not only increase weight but also the size of the tent's packed size - a big disadvantage. There are also many more potential problem areas with a tent - torn seams, pulled out zippers, thinner fabric, etc... where a hammock has only a few major stress points and I know the zipper or seams aren't going to fail because I sew them myself!

And then there's the financial issue. Tents are expensive (but so are hammocks). Right now I'm at the point where I need to decide whether to buy a single person tent, or a commercially manufactured canopy for my current DIY hammock. I figure for something like a canopy, a commercially made one is just a wiser choice, and would save me from making a new one out of different, more durable materials and seam sealing it (which is a pain). Decisions, decisions, frustration.

Anyway, I woke up early in the morning with roughly 3 hours of sleep and had to get a fire going. I grabbed the BK2 and began scouring the soaking wet woods for anything that might be of use. Wooded areas up North are different than they are here in the South, as the variety of flora is unlike we have here. Where here we have a lot of Maple, Pine and similar types of trees, up North there are areas solely dominated by Birch and Spruce. Live Birch is great for fire as the bark is rich in flammable resin, but dead birch can be finicky. Many people will tell you that dead birch is just as good, as the resin remains intact in the bark. Those people either don't get out much, or have some kind of super flammable birch trees that I've never seen before, as dead birch bark can be next to useless when it gets wet and soaks up water like a sponge.

Anyway, after finding some thin, living birch bark, some upright branches and twigs from dead (but still standing) spruce, and some big chunks of the only (dead and very, very old) pine tree seemingly existent within a kilometer of my position, I got a fire started.

Always remember that even if it has just rained, dead, upright trees will very often have wet outer bark hiding dry inner layers. It might take a little more work to get their wood to catch flame, as there will always be an inherent small bit of moisture present after a big rain.

After breakfast Wade drove his new truck around our beach before we left to go kayaking.

Kayaking was uneventful as far as us not ever getting to any particular intended destination (I really wanted to go see what was on one of the small Islands I saw last time that looked like it had some funky cliffs or rock formations around its perimeter. And no, not flowerpot Island) but it was eventful in that Wade flipped his kayak, which effectively ended our kayaking day and refreshed me on water rescue.

Shortly after figuring out how to get his kayak from where we were on the shore below a small limestone cliff, to the road, and back to the truck, we headed to a new campsite and made some pasta for dinner. I put tons of parmesan on mine, as I don't eat tomato sauce. Yuck.

These are the materials we used to get the dinner fire going. Remember that you can't throw a small flame beneath a bunch of larger chunks of wood (like those on the right, by the hatchet), and expect it to start up. You have to start small. What I do is take the small flame (started via tinder mushroom, tinder bundle, or vaseline saturated natural cotton), and then apply 3 or 4 big bundles of very small twigs. Not only do the twigs generate a ton of heat and flame as they burn, but they are easy to use to keep an existing fire going if you get stuck with wet larger pieces. only after adding the third or fourth bundle of twigs should you add the larger stuff like that beside the hatchet. Wait for that stuff to catch and start burning up, and then add some larger stuff (which you've hopefully kept beside the growing fire the whole time to start drying it out a bit!)

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Equipment Upgrade

Since I no longer live where I did a month ago, with the person I lived with a month ago, whose sewing machine I was using a month ago to manufacture hammocks and other outdoorsy items, a replacement was necessary. Modern machines tend to be finicky, mostly plastic, and don't handle tough materials or heavyweight nylon threads very well, so I decided I must find an older machine to serve my purposes. While hammocks consist primarily of very lightweight materials like silnylon and mesh, many of my other projects in developing outdoor gear calls for the use of heavyweight cordura and webbing.

I ended up finding a real gem. Made of solid Italian steel back in the late 1950s when people cared about having things last a while, this thing weighs a ton and puts perfect stitches through things as tough as leather, and works just as well on the thinnest and most difficult to work with water resistant nylons. I find it amazing that somebody, perhaps a single owner, has taken such great care of it over the decades, as it presents with barely a scratch. Now I can actually fix my backpack, which wasn't possible on the other machine.

The ridiculous setup I have attached to the right side is a Manfrotto magic arm. Because I don't like using machines while mounted inside their bases, I'm using the arm and clamps to stabilize it and keep it from tipping, rather than drill holes in my desk for bolts. And yeah, that's a cutting board underneath.

Hopefully I will have another "Going Places" type of post shortly, as my work schedule permits. I haven't been out much lately due to the move and getting situated again. I'm hoping to get out very soon, and maybe do some posts about putting together some cold weather gear (which will of course be followed by obligatory posts of me actually camping in the middle of nowhere up North in the snow, putting said gear to use in a real world setting!)

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At Work

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How to Cook a Sandwich (or reheat) at Work

Step 1 - Take food from backpack/work bag. Be sure to have included an ice pack to keep fresh.

Step 2 - Wrap food in tin foil. Be sure to keep heaviest/most dense parts of food lower.

Step 3 - Locate appropriate field expedient heating equipment. An ambulance works great.

Step 4 - Place food in hot place and turn on heating equipment.

Step 5 - Enjoy.

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Review: Eberlestock V90 Battleship Pack

As promised before, I have finally found the time to do a review of the Eberlestock V90 Battleship pack. This review comes after a few months of use including about 10 days of very hard use in wooded areas. There isn't a lot of info regarding this pack floating around the web, so hopefully this may be helpful to someone.

Firstly, it is a fairly big pack. The base weight is just over 8 pounds, and the capacity is 99 Liters. The pack is divided into either one or two main compartments. One can choose to separate the single large compartment by using an internal drawstring closure halfway down the pack, effectively isolating the bottom sleep system compartment from the top "everything else" compartment.

My pack is Eberlestock's "Military green" color. The color is sort of in-between foliage green and OD. It works nicely in a variety of environments, including woodland and more arid/rocky areas, and does very well in a bit of shade - even in urban environments if one is after super ninja camo-ness.  The straps are a slightly browner hue, and can look the same color as the pack itself under certain lighting conditions. The fabric used is a nylon construction with ripstop stitching and what seems to be a water resistant backing. It seems fairly durable. The storm collars and divider are made of water resistant, lighter weight (compared to the body/exterior material) nylon.

There are plenty of exterior straps to compress the pack contents and attach just about anything to the exterior, including a sleep pad (Pictured), which can also be secured underneath the pack's lid, between in and the main compartment. I would have liked to see more MOLLE attachment points, but what's there seems adequate enough.

The pack also features 3 lateral external pockets (3 on each side). The uppermost pockets are capable of accommodating 3 liter hydration bladders, directly behind the mesh pockets (great for air-drying wet clothing, socks!) Lastly, there are also the pockets located on either side of the bottom/sleep system compartment.

The internal frame system is fairly effective at minimizing the effects of weight on one's back, and at providing a comfortable, custom fit. The frame consists of two aluminum bars that pass between multiple anchor points mounted to the rear of the pack, along with the shoulder harness. The bottoms of these bars rest in such a place when fully inserted that they create a slight stress point at the bottom of the pack near the zipper for the compartment housing the weather cover - This could eventually create tears, especially if the pack is moved along a rough surface at those points. I will not show the weather cover, as it is pretty self explanatory. It's a nylon cover with an elastic edge that covers the entire bag (even when pack is expanded) in the event of inclement weather. It is not the same color as the pack itself, and is more of a brownish tone. The internal frame rods/stays, pictured below. These can be bent to suit one's own posterior curvature:

The pack is fairly well padded. The shoulder harness connects to the pack via an adjustable ladder system (basically a MOLLE system, in essence) so that it can be moved up or down the pack. It is further secured to the pack via loops that run around the frame's aluminum stays. While not as thickly padded as the waist belt, the shoulder harness is fairly comfortable in that there are load lifters above that are used to transfer to the chest/clavicles, whatever weight is not being supported by the hips. Like the shoulder harness, the waist belt is removable as well, and features a good deal of padding making for a comfortable fit. The exterior of the waist belt is also adorned with MOLLE attachment points, making for easy attachment of quick access items.

The V90 is also expandable. The lid (which also features 2 interior and exterior pockets - the exterior being large enough to hold a softshell jacket) height is adjustable via 2 straps on the backside of the pack. Once lengthened, additional gear can be placed inside the main compartment and the storm collar pulled up (it is plenty large enough) overtop and secured via drawstring.This makes adding extra supplies quick and easy.

The main compartment consists of one large internal space, plus 4 smaller pockets at the back. The two center pockets (stacked atop eachother) are largest, the interior featuring a top strap closure and the exterior featuring a horizontal compression strap. The two side pockets are slightly narrower and feature elastic closures. The drawstring closure separating the top compartment from the bottom sleep system compartment is visible in the second photo.

The bottom/sleep system compartment is large enough to accommodate a US modular sleeping system black cold weather bag, and its GoreTex bivy - and this is a fairly tight fit. The addition of the US green patrol bag is possible... but is an extreme pain as it makes packing very tight and it WILL NOT fit unless all components are rolled and compressed perfectly every time. Using the US MSS in its black compression sack is not advisable (though possible, with much effort), as it all fits much better if you just stuff everything in freehand. A single down sleeping bag with a ranger sheet/poncho liner or similar, with the GoreTex bivy is a much better option than the full US MSS. The exterior of the compartment also features additional MOLLE attachment points, so I suppose one could always attach the MSS or similar that way, too. The zipper for the compartment opening has a bungee folded within it that, while keeping everything in place when closed, can be a pain in terms of actually zipping closed. It tends to create folds of fabric that like to get caught in and otherwise hinder attempts to zip the compartment closed.

Now for the bad. While most of the bag seems to be quite well designed and thought out, there are a few glaring issues that I wish would have been addressed during Eberlestock's design process.

The first is the fact that when I received the pack, it had only ONE of the load lifters. The other was nonexistent, and while the associated friction buckle was present above the harness, there were no marks on the harness itself to even suggest it was ever even sewn in place there. I had to sew my own on. Not acceptable for a product in its range of $ MSRP - re. expensive.

Next is a huge issue. The handles. The pack features three handles for lifting - one at the top above the shoulder harness, and two at either side. I managed to completely separate the top handle, and tear the stitching on one of the side handles, with only 30-40lbs in the pack at the time. Again... NOT acceptable for a pack designed to be used for heavy outdoor/military applications.

Even I can see that in order to be lifted from the top - the handle's only obvious intended purpose - it should have been positioned slightly different.

Instead of exiting its stitching point in a downward direction, it should have been brought up and over and an additional stitch (come on Eberlestock, use bar tacks...) made there, directing it upwards - the actual direction of lift, as such:

The side handles, while attached with the correct orientation, feature only a single line of stitching where there should really be strong bar tacks instead. I plan to add them myself to eliminate the problem.

I have no other real gripes with the pack, aside from the aforementioned slightly silly way of placing the bottoms of the aluminum stays (I will end up reinforcing this internally with heavy duty nylon webbing), the elastic bungee and zipper on the bottom compartment, and of course the ridiculous situation and quality of mounting of the exterior handles. MOLLE points along the sides of the pack would have been cool, too.

Some nice changes, however, could have been made by adding a bit of space to the side external pockets - notably the hydration pockets - as they are a bit small. When the pack is fully loaded, the inner load is compressed against the side of the pack, making it nearly impossible to insert a full (or even empty) hydration bladder into its pocket, which is not only frustrating, but a really foolish design oversight. Adding additional area to the pockets would have easily remedied the problem and avoided the necessity to place full bladders into the pack BEFORE loading it.

That's about it. Once I address the aforementioned issues I think my V90 will prove to be pretty bombproof.

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I Left My Soulmate in Tobermory

I returned tonight with my friend Dave, a past coworker, from a much-needed getaway to Tobermory for a few days. If you've never been, you should go at least once. It is one of the most beautiful places I've ever visited. While only a five hour drive from the Niagara Region, it is geographically completely different - home to crystal clear water reminiscent of that found in photos of much more exotic places, various types of caves, and high rock ledges towering atop the water.

As it was the long weekend, there were fewer places to camp. We later found (while off-roading in Dave's Toyota) a great spot, far off the beaten path, that would have been perfect (and free with a private beach!) Regardless, we started a fire as soon as we got to camp. I used the ferrocerium rod and fire mushrooms as always.

After setting up my hammock and feeling extremely hungry after the long trip, I decided it would be a great idea to eat something. I threw a can of beans into the coals and waited for them to cook. A momentary lapse of judgement and possibly a bit of stupidity however, had caused me to neglect actually opening the can first. It promptly exploded with an extremely loud bang and launched its contents skyward, most of which ended up landing on Dave's tent.

After a few quick jokes about potential second degree burns to 25% total body surface area secondary to canned bean explosion and how funny that hospital report would end up sounding, then about bears and their keen sense of smell for food and camper flesh, the tent was cleaned and I proceeded to toss in another can of dinner, this time opening it first. D'oh!

This was the view out past the other side of my hammock:

I found this little guy hanging out inside one of my boots:

After dinner we went for a walk around the big pond/lake behind our campsite and I took a bunch of photos. I haven't taken night exposures for a while, so I've been wanting to start getting back into it. The night sky in Tobermory is pretty amazing - totally clear unlike back home. It was cool and breezy (about 15 degrees with 40 kilometer/hour winds) which pushed the clouds along at a good pace, making for a nice effect. Also much nicer than being 20 degrees warmer and horribly humid back in the city.

After sleeping very comfortably in my warm hammock while Dave probably had nightmares of bears coming to eat him and his tent, I woke up and had some delicious pancakes over the fire and got things ready to go kayaking. We didn't have a set plan as far as where we would kayak to, but it would be Dave's first time so I figured we'd sort of wing it and see how things went.

After a bit of difficulty getting out of the harbor and out onto the open water, we decided to just stick to the left and head off for a small island in the far off distance, barely visible on the horizon.

The water in Tobermory is the clearest I've ever seen. It's blue and clean and in some spots you can see clear down to the bottom, even in relatively deep areas. It was so clean I decided to just drink it the whole way through our trip as I couldn't easily reach the water I had packed. It tasted better than bottled water and I still haven't had any ill effects, so it's got my thumbs up.

After 2 hours of paddling against the current, which at times consisted of some pretty big waves that came straight up over my kayak, we arrived at the little island we had set out to reach.

There were even REAL ladybugs there! Not those horrible orange Asian ones that bite.

I ended up swimming across to the adjacent island to see what was over there, when I noticed a blue object attached to some yellow rope in the water. Naturally I swam to it and cut it free, bringing it back to use for our wet clothes later.

Whoever put that milk crate in there ought to know that its illegal to use for anything other than what Beatrice says it can be used for. Geesh.

After securing our awesome new milk crate to Dave's kayak, we headed back to the harbor. Being able to coast with a waves made it a quick and easy trip back taking less than a third of the time it took to get there in the first place.

The next day, our goal was to make it to the cliffs for some swimming/sightseeing/exploring. The only legitimate access is via Parks Canada, through one of their camping areas. We found out during our first attempt that there was no parking available, and that we'd have to try again in an hour. Not wanting to wait around for an hour given that we had limited time, it was decided by Dave that we would try finding an alternate route. Basically, this consisted of taking his old Toyota up any road possible, getting us as close as possible to the shore, and then hiking in the rest of the way.

We found an unmarked dirt road/path and started to follow it. It was quickly evident that this "road" was not ever maintained, as it had enormous holes across its entire width, and a fair share of large, sharp boulders and rocks sticking up out of it just waiting to rip the transmission from beneath an unsuspecting vehicle.

This being said, the Toyota handled it surprisingly well and only bottomed out a few times. There was the odd crunching/grinding noise from beneath, but it held up alright.

After finally making it to where we originally intended, I went swimming in the freezing cold waters of Georgian Bay (and inside a cave), and climbed all over a ton of cliffs for photos.

After drying off we packed up our gear and headed back to Hamilton. I ate two bacon cheeseburgers on the way and got a headache shortly thereafter. As far as the title of this entry is concerned, upon getting soaked trying to get out of my kayak, I removed my waterlogged wallet and realized I had forgotten about the photo and steel "soulmate" charm given to me by my very recent ex. I left them among the limestone and quartz boulders at the highest point on one of the small islands in the middle of Georgian Bay where they will likely both remain until the end of the Earth.