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HEMS – The Helicopter Rescue Program Near You

HEMS means helicopter emergency medical services. If you live anywhere near a town of more than 100,000 people or so, or have seen a helicopter landing at an accident scene, or the local hospital, you’re seeing HEMS in action. This is an overview of those operations, details on who the operators, pilots, medical staff and assorted other personnel who make those HEMS aircraft fly, and what makes them a vital part of the health care system.

With all the discussion these days about the health care delivery system in this country, it’s likely that at some point various individual systems and operations will come under scrutiny. What’s even more likely, given the expense and highly visible nature of helicopters in the emergency 올인구조대 business, is that those aircraft and the various hospitals which have them will be studied in depth. Fortunately, and I use that term advisedly, helicopters and their utilization in industries of all types have been scrutinized for years, dismissed as ‘royal yachts’, relegated to the peripheral and luxurious category by those who misunderstand their utility. This article attempts to address some of the issues surrounding HEMS aircraft and the various operational considerations that seem to impact the national health care debate.

First, let me advance a disclaimer of sorts. I flew a HEMS operation in Iowa for twenty years. During that time I carried over 3,200 patients aboard my helicopter, in all manner of weather, in sunniest day, and darkest night. I saw every kind of patient known to modern medicine from cardiacs, trauma, medical emergency, electric shock, drowning, neonatal, cancer complications, stabbings, shootings, farm accidents, suicide attempts you name it I flew it. Unless someone has invented a different way to maim themselves since I stopped flying, it’s likely I’ve seen it all. So I can speak with some authority.

That said, I offer this criticism of the industry, just so you know I’m trying to be objective. I’ll be the first ex-HEMS pilot to tell you that there are too many helicopter rescue operations in this country. Nationwide there are over 200 such programs, serving 180 different hospitals, some with fewer than 200 beds. Given the million dollar price tag for a standard single engine aircraft operation, with peripheral personnel and logistics to serve it, it’s no small matter for a hospital to acquire a helicopter. Plus, given the fact that in many cases the helicopter is used to fly patients away from the primary base, effectively subsidizing a larger hospital by serving patients to it, the aircraft can be a money losing proposition. Still, much of modern medicine itself is based on unknown outcomes, and patchwork intervention, so continued use of helicopters certainly isn’t an aberration in that sense. They don’t call it practicing medicine for nothing.

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Games

The History Of Online Gambling

Online gambling is a fairly recent practice, yet a very controversial one. Its history began in the 90’s, as the internet began increasing in popularity. One of the first events to take place was when the government of an island in the Caribbean, Antigua and Barbuda, passed a law in 1994 which allowed online casinos to base there. This was called the Free Trade and Processing Act. Realizing the almost endless possibilities of making money through online gambling, several entrepreneurs jumped at the now legal chance to start this new venture.

Different companies were formed that same year and more continued to be formed in the years that followed. Some of these companies were creating online casinos, and others were designing the software needed to run the financial transactions of online gambling and developing new Satta king online . As online casinos started to increase in number and become an extremely lucrative business, with reported revenues of nearly 835 million dollars in 1998 alone, different layers of the U.S government began to take notice. One in particular, Senator Jon Kyl, a Republican from Arizona, decided he would be the leader against online casinos and introduced the Internet Gambling Prohibition Act in an attempt to restrict gambling activity in the United States. The bill failed to pass in Congress, and online gambling continued to flourish, possibly even better thanks to the media attention it had received courtesy of the senator.

As online gambling continued, a few companies created software packages that could be leased by online gaming sites for a percentage of their earnings. This helps many new online gaming sites appear. Around this time, Canada also began to curb online gaming activities, raiding offices and eventually fining one of the largest online gambling servers.

In 1999, Senator Kyl presents a revised version of his Prohibition Act bill, and once again, it fails to gain the support needed in order to pass. Meanwhile, Australia allows the creation of an online casino, which in the end became the only one allowed and is currently still in operation. Although many more would-be casinos attempted to obtain licenses in Australia, the Australian government quickly formed a law preventing any new online gambling operations.

In 2000, Republican Senator Bob Goodlatte of Virginia introduces a further revised Prohibition Act to congress, and it is once more turned down. The following year, two bills that would help cut online gambling are passed in Congress. One was an updated version of the Wire Act, which makes it unlawful for individuals to be involved in the business of betting or gambling. The other bill attempts to prevent online payment to online casinos by prohibiting institutions based in the U.S. from handling such payments, making it more difficult for U.S. residents to engage in online gambling.

A few lawsuits occurred in the years that followed, and in 2006, several arrests of online gambling CEOs were made. At the same time, the U.S imposed sanctions on offshore gambling companies, resulting in Antigua and Barbuda filing a case with the World Trade Organization, which rules that U.S. actions are discriminatory and unlawful.

 

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TOTO MS934304SF-01 Lloyd Elongated One Piece Toilet Review – Maximum Flushing Power

If you’re looking for a top of the line toilet with maximum flushing power there’s no other than the TOTO Lloyd Elongated One Piece Toilet. You can have peace of mind for years with a clog free toilet and say goodbye to your plumber.

Maximum Flushing Power

The TOTO Lloyd toilet features the G-Max flushing system, a very powerful siphon jet action that removes maximum bulk of waste in a single flush hence, the terms was born “what goes down stays down”. The 토토사이트 먹튀 G-Max became an industry’s benchmark, with its excellent engineering design it is almost impossible to clog even for years of heavy usage.

It draws water into the bowl more quickly with its extra wide 3-inch flush valve compare to other 2-inch conventional toilet, this results in a more forceful flushing action. A 2-1/8 inch large glazed trapway offers an unmatched power for one-flush superiority that prevents it clogging. With this kind of power this toilet is surprisingly quiet.

Good Looks And Very Comfortable

The TOTO Lloyd looks very attractive in white colour, by adding a unique sculpted design it makes more elegant. This is an ADA compliant toilet with high-profile seat that gives you the ultimate comfort while sitting in there. This is highly beneficial for elder member of the family and for disabled as well.

Easy To Clean

This one-piece toilet is easier to clean than the conventional two-piece. Made of high quality porcelain making it non sticky to dirt and stays clean for longer period of time, if you truly value your time, this toilet saves the day.

Includes Toto’s SoftClose Seat

No need to buy a separate seat for this amazing toilet because, the Toto SoftClose seat is included. It is made from highly durable polypropylene plastic materials; this is highly resistant to chemicals and cleaning agents that ensure its toughness and long life. The seat is specially molded that perfectly shape your body contour for maximum comfort. It also comes in an anti-slid design that prevents it from slipping while you’re sitting there.

 

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all those people who feel intimidated

Nowadays, things have changed a lot with the coming of the Internet. There are many online gambling sites present on the web today since 1996, where amateur gamblers can try their luck in online casinos. This is quite advantageous for all those people who feel intimidated to play in real casinos. Also, sometimes in real casinos veteran players and dealers get annoyed with these amateurs when they ask irrelevant questions. So, it is preferable for the novice players to go for these virtual casinos.

Virtual casinos have easy access

Now, in land casinos there is also the presence of roulette machines on which players have very slim chances of winning money. It is also quite easy to go to online casinos because it just requires making use of your computer. But, in a land casino it would require spending money and often going to another country. Online casinos save you from the hassles of spending money on travel expenses. You can also play games in these casinos whenever you desire rather than waiting for your holidays in the case of land casinos.

But, there is a risk of not getting the winning amount in case of online casinos which can be quite      메이저사이트      devastating. On the other hand, you can easily collect your money in a land casino. No such fraud can occur in a land casino where you are physically present.

More games and fun at an online casino

It can also be more fun to be at a real casino because it might have live concerts, musical shows and tempting waitresses. Virtual casinos can accommodate almost 30 different types of games, rather than a land casino which does not have much space. You can also see on your computer whether your favorite game is hosted by the online casino, instead of visiting a land casino to check the availability of the desired game.

Quick availability of cash in online casinos

Online casinos also offer free bonuses to the customers in the range of 10 to 2400 dollars and they can easily spend the casino’s money. Unlike a real casino, online casinos deal in multiple currencies. This is quite beneficial for the players because they get chances to play with other players in their currencies. For example, a person who is residing in Italy can easily play with an American player by purchasing credit in US dollars. It is quite convenient because there are no annoyances of converting currency before placing a bet.

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Games

Understanding How Online Casino Tax Works

One common question comes from online casino players is that whether they are going to pay their taxes or not in playing casino games. “What if we lose?”, “How the taxes deducted from our winnings?”, “Do they always deduct taxes every time we play online casino games?” These are the common confusion many gamblers are dealing with.

So, to start it depends on the gambling law that a particular country has specifically in managing an taxes from online casinos. But not all winnings are automatically taxed by the government. But it is always a player’s responsibility to understand everything about laws that are related to 에볼루션카지노 so that they will be aware of how their country deduct money from their winnings. Here are the common processes that occur when getting a tax from online casinos and players (this is very important specially if you are a player from the United States).

Winning Taxes:

In many countries around the globe, especially the USA, it is mandatory for a player to submit or share something from her/his winnings. Sometimes, it reaches to the highest rate which is 50%, the lowest is 30%. How do they know if you win? You are obliged to declare your money or else you will be questioned if they track your money in their audit. Every player is required to declare their money if they win from playing online casino games to the IRS (Internal Revenue Services) whether it is offset by loses or not.

Though the fact still remains that online casinos specifically from U.S. do not declare the amount of your winnings, and of course the federal law do not know if you win or lose, you still have the obligation to follow the law and declare it in your own because at the end, you will still end up explaining to the IRS where your money comes from because they will track your money through their audit.

If you are a big time or the what they call “high roller” player and choose to declare and pay your online casino tax, it will be reported as other income on U.S. tax returns. The process goes by submitting only the net of your winnings. Meaning, if you play blackjack and win $3000 from a $300 bet, that means you have to declare all $2,700.

The only exemption is that you are only required to declare and pay online casino tax if and only if you win big. It considers big if you win 600$ above, and that’s the only time that you are going to declare how much money you have won from playing casino games in the internet.

Tax when a player lose:

About tax when you lose, they indicate it as itemized deductions and will be deducted to your winnings. So it would be much better if you will take care of your taxes and keep them on track. Listed under “other miscellaneous deductions”, you are able to deduct up to the amount you have declared in your total winnings. Please be reminded that you are not allowed or you can’t show a gambling tax loss. For example, if you have declared $5,000 in your winnings, you can also declare $5,000 in your itemized deductions under losses. Just make it sure that you will not exceed to the amount that you have recently declared.

It is imperative that you must prove your winnings and losses. That’s why keeping every receipt, tickets, etc. you receive from playing online casino games is a good option because the IRS strongly suggests that every online gambler must keep everything that will prove if they win or lose. All details must be included such as, the type of bet, how much you win or lose, name of the casino site, the I.P address of that casino, etc. Keeping a detailed book of your payment methods like eWallet, credit cards, debit cards etc. is very essential in paying your online casino tax.

So to conclude, keeping records in playing online casino games and making sure that they are well-organized will keep you away from being questioned by the IRS and also to avoid them sending you to jail for not paying taxes. And of course, you will be able to pay your online casino taxes hassle-free.

 

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Poker

Finding Your Knack For Online Gambling

When you are looking into gambling online, you want to make sure you find out which site would be the best one to gamble with. You should make sure they have the gambling games that you feel the most comfortable playing. This allows you to get the most from your gaming experience.

This is because everyone is more comfortable playing certain games when they are gambling. With casino gambling, it can be very confusing if you are a first time player, and not sure what exactly to look for. This allows you to find out all the information on the casino, and if you’re a new comer then you are also able to ask all the questions that you need answered to get the most from the casino that you are visiting for the first time.

If you feel like you are in need of some practice, or it is your first time then you can play for points, bk8  or other non monetary benefits then you can practice as much as you would like without worrying about losing money if you are learning how to play the game in general. This is mind easing since you want to make sure you have the games down.

If you feel like you need a break, and would like to come back later then you can. It does not matter what time of the day it is, you are able to go online into the casino, and you are able to play the games without fear of the casino being closed or having to close making you leave the casino.

This allows any busy person, or someone who loves playing the games the option of playing as long as they would like, or whenever they would like. What could be a better casino then this?

 

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Poker

Online Gambling – How to Protect Your Kids

Kids can coincidentally find betting locales as they attempt to look for internet games. While this sort of game is lawful, it’s anything but for minors. Computer game locales contrast a ton from internet betting destinations since betting ordinarily includes cash winning or losing it. It is then your duty to guarantee that your youngster won’t ever access this sort of sites. It tends to be precarious however here are a few hints on how you can assist your youngster with appreciating a protected and fun web gaming experience:

1. Before you even permit your youngster to play on the web, you need to set clear principles on which destinations are permitted and which are not. This will altogether restrict where you youngster will play just as the games that they will play. Force hard endorses for any infringement so your youngster will realize that you mean business.

Your standards can likewise incorporate play time limits, visit limitations and sharing of individual data. You need to guarantee that your youngster comprehends that they can’t share an excess of data online in case they need to be survivors of fraud. Causing them to comprehend the possible perils of fraud will tremendously diminish the odds that they will take part in acts or conduct that is outside of the standards on account of the assents that will be forced.

2. You need to remind your children that it is unlawful for minors, for example, them to take part in betting on the web. You can likewise teach your children on the idea of internet betting and how it functions.  bk8 indonesia  Disclose to them that these are organizations that are worked on the web and that these locales take in more cash than they really pay out so there’s no reason for betting as you will have less shots at winning the prize pot.

3. Screen your Mastercard and consistently guarantee that your kid never utilizes your Mastercard without your insight or consent. To take an interest in betting locales, Mastercards are frequently required and whenever left unmonitored, your children can cause enormous obligations on the web and ruin your FICO score. It’s actually similar to being a survivor of data fraud just this time, your kid was the person who utilized your Visa without your approval.

4. Your kid ought to have the option to comprehend the way that web based betting can prompt habit and can fundamentally affect their examinations and social conduct.

5. You need to effectively take part in your kid’s gaming experience. This isn’t something that your youngster would clearly need you to do, particularly when they are more seasoned and they have companions over your place to play togel online . Nonetheless, playing with your children can help you bond with your kid as you hang out, accomplishing something that your youngster truly appreciates. While having some good times, you can screen your youngster’s action on the web so you won’t ever stress that they will be sneaking into betting locales when you are not looking

 

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Games

The Upside To No Download Slot Machines

The field of online club is a huge one, and as large as it could be you will discover just two different ways to play. The most ordinary and realized technique is that where the gambling club expects you to download their product to have the option to play the games. There are sure advantages for this, as conceivable basically turn on the pc and open up this program to start playing quickly – in any case in case you’re, for example, the parcels who don’t utilize a PC that this product is viable with, or are simply suspicious about downloading structure the Internet, there is another alternative. Turning out to be an ever increasing number of famous these days is the way to deal with no download openings gambling club Judi Online Pulsa, protected, secure, and without the difficulty of establishment.

Concerning the sort of PC you own, there are various kinds of no download club programming accessible. Both generally well known among crucial basics streak assortment, and html – that is by and large leisurely overwhelmed by streak programming since it is more intuitive. Most online gambling club organizations understood that not every person needs to use valuable hard circle space, trust that a program will download, and hazard getting an infection to play – so they stepped up to the plate in making no download openings. These sorts of openings have the advantages of the downloaded forms without the drawbacks.

An issue with downloaded club programming is that you can just experience that machine. Having a program based no download gaming machine anyway empowers you to play any place you’re, on whatever PC you’re utilizing. Because of this you can play where before you choose to wouldn’t turn out to be in a situation to, maybe grinding away? (while taking a break obviously) and never must be stressed over downloading programming on organization PCs.

Numerous online no download gaming machines will likewise be allowed to utilize, which means playing for that pleasure rather than cash. That is not the slightest bit to say that they’re restricted by being free, there are loads of accessible which do expect cash to play – and do dish out very much like you would discover in a genuine live gambling club.

A couple of the no download gambling machines need you to have programming for instance java or blaze introduced on your PC. Albeit certain individuals would be tentative about downloading this – the advantage is that it’s anything but a one time download in addition to they are very legitimate organizations so it’s anything but important to stress over an infection. The more astute organizations available additionally give their own personal glimmer or java installed into the site making it so you don’t have to download that.

No download spaces would be the ideal answer for anyone, be it the individuals who might want to just play nonchalantly they can get on a webpage from anyplace and have a game title. Or on the other hand in any event, for the more regular player, realizing that they don’t need to download any product to see the whole impact from the game they love. Regardless of what your explanation, on the off chance that you plan on playing on the web gambling clubs your best arrangement will for the present be no download openings.

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Games

Playing Some Slot Machines Online

On-line slots machines are the latest obsession to reach online gamblers, with easy to use machines, massive jackpots, and high payouts. So with the design of online slot joker gaming players no longer need to depart the comfort of their living room or lounge and can bet in a virtual slot world.

Whenever a Slot machine is made they are determined to possess unique payout rates. A casino will purchase a set of slot machines and have the payback percent vary a little, although when you situate them all together they will average to a pre decided amount. Online casinos are different; they will set one payback ratio which is much higher than a pub, or casino slot machine.

On-line Slot Machines are very easy to play and you never need to spend too much time understanding how they work. Simply deposit and have fun spinning the reels. Almost all of the modern slots possess multiple pay line. Playing on maximum lines gives you the highest prospect of winning.

Nearly all online casinos include promotions when you sign up, which can range from 100%-400% match of your deposit or FREE money. To give you an example of a 100% deposit bonus. If you deposit £50 the casino will match your deposit with another £50 and that will give you £100 to play on the slots. Every online casino has slightly different terms if it comes to withdrawing these bonuses, but land based casinos in no way give you free money.

So now there is no reason to even frequent a casino, as you can play from the comfort of your own house, and get a much higher pay back rate.

I know playing from your favoured arm chair doesn’t have the same social feel, but you are able to play in tournament at almost every casino where you can play versus other players, and win large jackpots.

 

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Games

online slot Manufacture

The production of slots has become an increasingly competitive market in recent years. Not long ago, in the 1970’s, approximately 90 percent of the market was owned by one company, Bally Gaming Systems. Therefore, during that time, if you were to play a slot machine it is most likely that you were playing one made by Bally. Now there are well over a dozen slot machine manufacturers in the market, including software designers that create slot machines for online casinos. Following, though not a comprehensive list, is a sample of some of the biggest names in the field of traditional slot machine manufacturing.

AC Coin & Slot was founded in 1978 in Pleasantville, New Jersey. I don’t know about you, but when I watched Reese Witherspoon and Tobey Maguire in Pleasantville, I had no idea the town was real. I certainly didn’t think it was in New Jersey, though parts of the Garden State seem pleasant enough. Any way, AC Coin & Slot started building slot machines around the same time gambling was legalized in New Jersey and currently, in addition to selling their own slots, are the exclusive distributor of slots made by International Game Technology in Atlantic City.

Aruze Corporation, based in Japan, produces slot machines and other products. They are licensed to manufacture and distribute slot machines in Nevada, New Jersey and Mississippi. Aruze Gaming America, their U.S. branch, is based in Vegas and is a 100%-owned subsidiary.

Atronic Americas is not, like you might expect, a company based in North, South or Central America. It’s actually a German company. For some reason, they didn’t think Atronic Deutchland sounded good. It has a nice ring if you ask me. Anyway, the company began in 1994 and has become the third-largest slot machine manufacturer in the world.

Bally Gaming Systems is the original big boy on the scene. Started in 1968, it has operated under a variety of names, including Bally Technologies, and manufactured the first multi-coin slot and the first video multi-coin slot. Though they don’t have a stranglehold on the market like they used to, Bally is still a dominant name in the industry. They are not related to Bally Total Fitness.

International Game Technology (IGT) is a manufacturer based on Reno, Nevada, home of Lieutenant Jim Dangle and his fine deputies. IGT is a multinational corporation, with branch offices located across the globe and is the largest slot machine manufacturer in the world. They were an innovator in popularizing wide-area progressive slots and created a ticketed system called EZ-Pay.

Konami Gaming is the gambling division of the Japanese company best known for creating popular video joker played in arcades and on Nintendos across the world. How awesome is Konami? They created Castlevania. Enough said. They have been manufacturing slots since 1973, but have only distributed slots in the United States since 2003. They are now licensed in Nevada and several tribal territories in America.

Mikohn Gaming is a relative newcomer to slot machine manufacturing. They are based in Las Vegas and began in 1996. The majority of the games they develop and market belong to IGT.

In addition to slot machines for land-based casinos, there are some companies that specialize in designing software for online slots. Though there are many companies in this field, there are a handful of big names that are dominating the market.

Microgaming is a software development company based in the Isle of Man. They claim to have released the first online casino in 1994 and manufacture online slots for almost 100 casinos. In addition to slots, they also design games for poker, blackjack, roulette and more.

Playtech identifies themselves as the world’s largest publicly traded online gaming software developer, and I could find nothing to refute that claim. They design a wide array of games, including slots and various table games.

Real Time Gaming (RTG) was founded in 1998 in Curacao. They are best known for their progressive slots and are one of the leaders in their manufacturing. RTG is one of the few online game designers not to develop their own policy regarding American customers subsequent to the United States Congress passing of the Unlawful Internet Gambling Enforcement Act in 2006. Instead, they let each of their clients decide whether they will accept American players.

Vegas Technology is not, as you might guess, based in Las Vegas. Nope. They are located in Antigua and were founded in 1997. Vegas Technology is best known for their video slots and for the fact that you do not need to download any software to play their games.