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    t3

    Explore " t3" with insightful episodes like "#183: Why do I Have Hypothyroidism?", "#347: Thyroid Health: Why Your Doctor Might Be Looking at the Wrong Numbers With Dr. Todd Cameron", "Programas de Verão", "Crianças sem Filtros" and "Anúncios a Brinquedos nos Anos 90" from podcasts like ""The Gutsy Gynecologist™️ Show", "Vitality Radio Podcast with Jared St. Clair", "Renascença - Eish...!", "Renascença - Eish...!" and "Renascença - Eish...!"" and more!

    Episodes (28)

    #183: Why do I Have Hypothyroidism?

    #183: Why do I Have Hypothyroidism?

    Have you heard that your thyroid is just sluggish? That your thyroid is causing your health problems? If so, then this episode is for you! Today, I'm sharing why you really have hypothyroidism and what you can do about it starting TODAY!

    You'll hear more about:

    • What is reverse T3
    • The process that slows down or speeds up your thyroid
    • Things  that inhibit the production of T4
    • What TSH really is and its function in the body
    • The driving factor in reverse T3 production 
    • And more!

    Come ignite the tiny ember that is smoldering inside of you! Get out of survival mode for one day. Choose You! Bring your dreams back to life with a sisterhood of inspiring, courageous women! I want to see you there!! https://thebeevent.com/

    Struggling with balancing your hormones? Grab your copy of the The Gutsy Gynecologist's Guide to Balancing your Hormones: https://drtabatha.com/free-guide/

    Support your hormone balance- EnergyLift!

    Connect with Dr. Tabatha:
    Work with us: Schedule a call

    Dr. Tabatha's Facebook: https://www.facebook.com/DrTabatha
    Dr. Tabatha's IG: https://www.instagram.com/thegutsygynecologist/
    Dr. Tabatha's YouTube: https://www.youtube.com/channel/UCWea1x1abLERehb5yn_nfow

    #347: Thyroid Health: Why Your Doctor Might Be Looking at the Wrong Numbers With Dr. Todd Cameron

    #347: Thyroid Health: Why Your Doctor Might Be Looking at the Wrong Numbers With Dr. Todd Cameron

    On this episode, Jared discusses thyroid health with Dr. Todd Cameron, his own personal Functional Medical Physician. Dr. Cameron explains why TSH numbers on blood tests are only a small part of the bigger picture, and how levothyroxine (synthroid) isn’t likely the answer to solving your thyroid issues. You will learn about the various other thyroid hormone numbers that matter and why they matter. You will also learn about the reference or “normal range” in blood test labs and why it doesn’t mean optimal. This episode is loaded with information you probably have never heard before. It also pairs wonderfully with episode #349 on Iodine with Charles Hakala. Jared suggests that you listen to both of these episodes to get a clearer picture of how to optimize thyroid health. 


    Products:   

    LugoTab Iodine Tablets

    Terry Naturally Tri-Iodine

    Solaray Selenium


    Additional Information:

    Dr. Westin Childs - YouTube

    Cameron Wellness + Spa Phone Number: 801-486-4226

    Episode #349: All About Iodine, Your Thyroid’s Best Friend, But That’s Not All


    Visit the podcast website here: VitalityRadio.com


    You can follow @vitalityradio and @vitalitynutritionbountiful on Instagram, or Vitality Radio and Vitality Nutrition on Facebook. Join us also in the Vitality Radio Podcast Listener Community on Facebook. Shop the products that Jared mentions at vitalitynutrition.com. Let us know your thoughts about this episode using the hashtag #vitalityradio and please rate and review us on Apple Podcasts. Thank you!


    Please also join us on the Dearly Discarded Podcast with Jared St. Clair.


    Just a reminder that this podcast is for educational purposes only. The FDA has not evaluated the podcast. The information is not intended to diagnose, treat, cure, or prevent any disease. The advice given is not intended to replace the advice of your medical professional.

    Crianças sem Filtros

    Crianças sem Filtros
    Esta semana ouvimos em direto na televisão o Artur, um menino, que, coitado, estava a sofrer durante uma festa muito conhecida no nosso país, não se coibiu de fazer um pedido muito especial ao repórter que o entrevistou. A propósito de crianças sem filtro, a Filipa Galrão recordou algumas das mais conhecidas pérolas infantis que se tornaram virais.

    इंदिरा गांधी अंतर्राष्ट्रीय टर्मिनल 3: सबसे लोकप्रिय हवाई अड्डा I Delhi T3

    इंदिरा गांधी अंतर्राष्ट्रीय टर्मिनल 3: सबसे लोकप्रिय हवाई अड्डा I Delhi T3
    क्या आपको पता है कि दिल्ली के इंदिरा गांधी हवाई अड्डे पर हर साल लगभग 4 करोड़ से ज्यादा यात्री आते हैं? और आईजीआई एयरपोर्ट दुनिया में दूसरा सबसे व्यस्त एयापोर्ट में से एक है...

    Healing Graves Disease Without Medication

    Healing Graves Disease Without Medication

    On today's episode we speak with Priscilla. When diagnosed with Graves' Disease and initially hustled through the Western healthcare system, she decided to take control of her own healing.  She was able to successfully reach and sustain remission on her own, even through pregnancy and the birth of her son.  Hear her empowering story and wisdom through experience and revel in the affirmation that we have every right to take control of healing our own bodies!

    Connect more with Priscilla HERE

    Let's talk naturopathic health. Reach me to begin your journey to wellness HERE

    Support the show

    Mon parc immobilier avantages et inconvénients par type de biens - On fête les 100k écoutes !

    Mon parc immobilier  avantages et inconvénients  par type de biens - On fête les 100k écoutes !

    Lien vers le programme négocier pour faire des gros billets !

    www.grosbillets.com/nego

    Dans l'épisode du jour, trois gros sujets au programme.

    Tout d'abord on fête les 100 000 écoutes du podcast, les 100 notes sur Apple podcast et je vous raconte le programme que j'ai mis en place négocier pour faire des gros billets !

    Je vous explique comment j'ai créé ce programme. Je me suis mis à la place de l'auditeur qui se dit "oh punaise encore un". 
    Ayant suivi de nombreuses formations, les réflexions que je me dis bien souvent et que vous devez aussi vous faire sont les suivantes:

    1) encore un formateur qui n'a que deux biens et veut nous apprendre la vie
    2) les prix sont délirants
    3) je n'ai pas le temps de visionner 15h de vidéos au moment où je suis à fond dans les recherches 
    4) c'est bien beau les vidéos, mais je voudrais un échange avec le formateur. 

    Pour chacune de ces problématiques j'ai donc mis en place une solution, parce que je suis vraiment un gars trop cool :) 

     

    Pour le sujet de l'épisode en lui-même, je vous présente par type de biens que je possède du studio au T4 quels sont les avantages et inconvénients, quels biens je privilégie et quels biens j'évite.

    Je vous parle également des raisons pour lesquelles je n'ai ni immeuble ni maison.

     

    Merci 100 000 fois pour vos écoutes et nul doute que ça va continuer super fort !!

    Bonne écoute à tous et dites-moi si vous voulez un épisode en direct de Budapest ?

    La formation bourse à tarif imbattable - https://www.grosbillets.com/bourse

    www.grosbillets.com :

    • 🚀 Découvrez tous mes liens sur ce site au nom on ne peut plus évocateur !
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    Why am I so hot? Hot flashes - causes and symptoms

    Why am I so hot? Hot flashes - causes and symptoms

    Your doctor may not know this about your body! Discover how a thyroid imbalance may indicate deeper issues and why your hormones could be disrupting your sleep.  A Naturopathic Doctor's recommendations to help perimenopausal and menopausal women FEEL BETTER.

    Dr. Danielle Marchildon ND received her Bachelor of Science in Biology from the University of Waterloo and her Naturopathic Doctor degree from the Canadian College of Naturopathic Medicine. At the Collective Health Clinic in Orangeville, Ontario she treats all aspects of women’s health, mental health, fertility, digestive concerns, skin conditions, and chronic pain to name a few. She also offers food sensitivity testing, hormone testing, and can run all standard bloodwork. 


    Connect with Dr. Danielle Marchildon ND at:
    Collective Health Clinic
    drdanielle@collectivehc.ca
    519 941 3100

    RESOURCES:
    New Menopausal Years, The Wise Woman Way - by Susun Weed

    This episode of OWN THE GREY is brought to you by I AM.

    • Discover your unique talents
    • Realize your potential
    • Align to your path

    Take the first step to Uncover Your Life Purpose by visiting www.debrajones.ca/courses



    This episode is brought to you by LUNCH with a HEALER podcast. The BEST conversations happen when you're having lunch with a friend - especially when one is a healer! Pull up a chair at LunchwithaHealer.com


    Support the show

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    CONNECT with Debra Jones


    How to understand your thyroid blood tests | Dr Anna Ord | Ep 70

    How to understand your thyroid blood tests | Dr Anna Ord |  Ep 70

    How to understand your hypothyroid blood tests is so important! TSH, T4, T3, Reverse T3, TPO ... what are these? What do they mean? What blood tests should you ask for?

    When you have hypothyroidism, Hashimoto's or really any other thyroid conditions, it's helpful to understand what the 'thyroid blood tests' mean and how to interpret them for yourself.

    In this episode of the Let's Talk Thyroid podcast I talked with Dr Anna Ord who is a General Practitioner in Perth, Australia. Dr Ord was diagnosed with Hashimoto's about 4 years ago which gives her a very helpful perspective as a doctor on managing thyroid health!

    We cover:

    • Dr Ord's personal thyroid experience (diagnosis, management), how it has impacted the way she investigates thyroid conditions and helps her patients manage theirs too.
    • Which hypothyroid blood tests to request - including normal & optimal levels
    • Why doctors DON'T request all these tests
    • What to do if your doctor won't order the tests for you
    • Other important tests for the hypothyroid patient.

    ---------------------
    Meet  Dr Anna Ord

    Dr Anna Ord MD, FRACGP is a family physician, a General Practitioner with a special interest in nutritional and environmental medicine. She obtained her speciality training with the Royal College of General Practitioners in the UK over a decade ago.

    After being diagnosed with Hashimoto's Thyroiditis 4 years ago, she became determined to discover more about this common autoimmune condition in order to help herself and her patients manage daily symptoms.

    She continues to attend courses and workshops to develop her expertise in the filed of nutritional medicine. She recently because an ACNEM Certified Doctor (Australasian College of Nutritional and Environmental Medicine).

    Connect with Dr Ord

    Facebook Group

    Hashimoto's Thyroiditis Course

    --------------------------

    Let’s Talk Thyroid is a podcast where we explore different aspects of living thyroid-friendly lifestyle positively & practically to help you thrive and not just survive. I bring together my experiences as a Hashimoto's patient, interviews with real people thriving with thyroid issues and experts to give us the low down on different aspects of living a healthy thyroid lifestyle. Expect discussions on diet, energy, gut health, stress, holistic approaches, essential oils, sleep, relationships and more.

    ------------------------
    Let's talk further with Annabel...

    Book now available - Let's Talk Thyroid: Positive & Practical Thyroid Help: buy via annabelbateman.com and Amazon

    My Thyroid Box available now.

    Book your Strategy Session: annabelbateman.com/strategy

    Go to annabelbateman.com for full  show notes, download my thyroid freebie or to book a strategy session.

    Join the Let's Talk Thyroid Community on Facebook https://www.facebook.com/groups/584308325427424

    Connect

    Get your copy and get started on your thyroid journey today.

    Available via Amazon or letstalkthyroid.com

    Support the show

    ⭐️ NEW Become a monthly supporter from $3/month

    If you get value from the Let's Talk Thyroid podcast, I'd love to invite you to become a monthly supporter from US$3/month. This will help me enormously to cover the costs of producing the podcast and making the content available freely.


    Thyroid Dysfunction Demystified: Signs, Symptoms, And Remedies With Elle Russ

    Thyroid Dysfunction Demystified: Signs, Symptoms, And Remedies With Elle Russ

    Thyroid dysfunction is no longer a mystery. Tune in to this episode with Dr. Stephanie and Elle Russ where they delve into the early mental health and cognitive signs of thyroid issues. You'll discover the role of your hormones, what hormone replacement can do to help, and which supplements to integrate into your diet to begin healing. Dr. Stephanie and Elle Russ will explain what optimal lab values and rages should look like and share important diet and lifestyle considerations. Finally, they'll give you advice on how to find the right care and doctor for yourself.

     

    We’d like to thank our sponsors, 

    Athletic Greens - redeem an exclusive offer here: http://www.athleticgreens.com/stephanie

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    PRIMEADINE - get 10% Off your Order with Promo Code “DRSTEPHANIE10” - 

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    And follow me on social:

    Instagram: https://www.instagram.com/dr.stephanie.estima

    Facebook: https://www.facebook.com/groups/betterwithdrstephanie 

    Join the Hello Betty Community here - https://hellobetty.club/membership/

     

    Connect with Elle

    www.elleruss.com

    Thyroid Checklist 

    www.ellerussshow.com

     

    Episode Overview: 

    • 12:35 Welcoming Elle
    • 14:30 Elle’s Origin Story & How She Found Her Thyroid Issues
    • 27:00 Mental Health & Cognitive Signs of Thyroid Issues
    • 37:00 How Thyroid Hormones Work
    • 44:51 Optimal Lab Ranges For Thyroid
    • 52:03 Thyroid Hormone Replacement
    • 58:02 When You Need Hormone Replacement
    • 1:03:32 TSH & T4
    • 1:14:00 Thyroid Efficient People
    • 1:17:00 How To Find Your Optimal Dose Of Exogenous
    • 1:20:00 Low Ferritin & Iron
    • 1:24:07 Iron Supplementation
    • 1:25:55 Vitamin D
    • 1:29:10 Veganism
    • 1:37:57 Reverse T3
    • 1:43:38 T4 Conversion To T3
    • 1:46:47 Foods and Lifestyle Considerations For Thyroid
    • 1:53:00 Finding The Right Care & Doctor
    • 2:03:31 Conclusion

    Ep 46: ASIM Basic and Counterstrike (Part 2)

    Ep 46: ASIM Basic and Counterstrike (Part 2)

    Episode 46: ASIM Basic and Counterstrike (Part 2)

    We are picking up from last week's topic about ASIM Basic to talk about the Counterstrike training system. Bill and Adam give some tips and tricks that will enhance your training as you run scenarios.

    Bill Godfrey:

    Today, we're going to pick up where we left off. You may remember, last week we were talking about the ASIM basic class, some tips for instructors that are either new or maybe a little rusty. We're going to pick up talking about the Counterstrike exercise system and how we facilitate that, and some tips and tricks that both Adam and I use when we're running those scenarios. There may be some people listening that are not familiar with the Counterstrike system, Adam, can you describe it for the audience?

    Adam Pendley:

    The Counterstrike board itself comes as a kit and it includes a large overhead view of a typical city or environment. The one that we typically use is the 29th Street mall, which is your typical outside, open-air, count center type mall. We also have available a school-type setting, an airport-type setting. There're different environments, it's a large overhead view and it's on a big game board, but we don't like to call it a game board because it's a training tool. In the kit, also includes some chips that act as movement for those that have been impacted by the incident, movement of the first responders, they're used in a certain way to do initial response, triage, transport, and allowing those that are taking the training to get actual inputs for a scenario that is fast-moving, but it's controlled enough that we can get to the training points we need. It starts with a large overhead view of the environment, but the kit also includes the position specific vests.

    It includes the staging area board, and it also includes some tools for command to use. The point is, that like a lot of the other training we do for active shooter incident management, the kit itself is really more about setting up a training environment, so you can do a tabletop exercise that has a realism to it and has some randomness to it, that allows what is happening, what the instructor presents, starts the scenario, it has a scenario go in a certain direction, but the input from the students kind of guides where the scenario ends up. I like to say a lot that the Counter-Strike board itself is more about up a training environment that focuses back on the training itself.

    I think that's really important for people to know, is that it's not just about, hey, moving some pieces around on a game board, it has nothing to do with that. It has to do with being able to do a scenario from start to finish that hits on the training points that are important to, not only be the ASIM process, but that are important to the agency that's using it for the training.

    Bill Godfrey:

    I think that's a really great description and overview. It gives you a sandbox, that allows you to get your students or your trainees up around the table. More than just a tabletop, it actually enables some functional role play. You can have them be in the different positions, simulate their radio calls, you're standing up the different command elements and walking through the scenario. So I think that's a great description, Adam. Thank you.

    Adam, let's talk a little bit, just take it from the beginning of, how do you set up your board when you're getting ready to do a scenario in the ASIM basic class?

    Adam Pendley:

    Sure. Throughout the training, throughout the four-hour block, the students will have an opportunity to do three scenarios. The first scenario is usually a relatively low complexity, typically a single shooter in one of the environments on the board that has enough room to show the movement of the responders and the movement of the survivors and those who have been injured. Typically just start with the bad guy chip in one of those areas on the mall scenario, I use the Macy's because it's got a nice amount of space to it. One of the interesting things about the Counter-Strike board is, it allows for randomness. There is a single die that represents what the shooter may do, so you roll that one single die, and it comes up with a number of people that have been shot, and you add that randomness to it.

    Then you call out those student numbers, the law enforcement chips each have a unit number on them, so you dispatch them to the scene. They arrive and park their vehicle and then they have a personnel chip that goes along with it, and represents them, the person, getting out of the police car and moving towards the crisis site. In that first scenario, you're really controlling the movement and making sure that everyone sees how the board works. You show, as you get to the point where you established tactical in a staging area, and all the positions that follow on, on the checklist, you walk through it slowly. The board allows for the bad guy to always, get the first move, if you will, until the bad guy has been eliminated in some way, but they can move through some spaces.

    Then the responders can move through some spaces. The board has a grid on it that allows for faster movement when you're indoors, slower movement when you're outdoors, because of distance. There's a lot of ways to control that movement, and what I try to encourage the instructors to understand, is that they need to have the full scenario in mind. Obviously, the students can make some decisions, that moving in a different direction, but the instructor is essentially the exercise controller, the exercise SIM cell and the exercise evaluator, all at the same time. It's also important at this point, when we're talking about things that add to success and things that might detract from the training, is to not over coach while the scenario is going on, let it unfold, make sure you're controlling the direction of that scenario, but don't provide too much input. Let them depend on the checklist, let them work it through, and then later you'll have the opportunity to add some more complexity for scenarios two and three.

    Bill Godfrey:

    I think that's a fantastic description. I love the comment about over coaching and we'll talk about that one a little bit more. One of the common mistakes, I'm going to call it a mistake, that may be a little bit harsh, but I'm going to call it a mistake anyways. One of the common mistakes I see with new instructors or instructors that are rusty, is that very first scenario, as you said, we try to make it a low complexity scenario. They get focused on trying to keep their bad guy alive or in play or, quite frankly, just trying to win. And they start moving the bad guy and you end up leaving this, just a string of casualties behind you in multiple locations. That actually is a fairly complex scenario and it's way too difficult for the first one.

    Responders for the very first scenario, struggling to get their feet underneath them. That's too difficult a scenario to give them. One of the mistakes and the corrections that I frequently provide is look, the very first one, keep your bad guy in one location. Like you said, using the Macy's store. Okay. Maybe I move around from one grid to the grid right next to it inside the store, but I'm not going to move all over the place. I'm going to basically stay there until they come and neutralize the threat by either taking me into custody or some other action. Have you seen that as well, Adam?

    Adam Pendley:

    Absolutely. On that first scenario, I usually almost always never leave that first environment. What I do is, you can actually slow down the responder a little bit. And you're just clear about that. You say, "Look, I realize that you would probably be able to make your way through Macy's very quickly, to address the threat. However, we're going to let some other parts of the scenario unfold", and then they understand that, right? You're controlling the pace at which that first scenario moves, and it needs to move slowly enough to see all the elements of the training, but absolutely let the first contact team make contact with the suspect. And when they reach the same grid, when they're within eyesight of each other, again, that's where the Counter-Strike tools come into play, usually have a contact team, that first one almost always has a good number, four officers on it.

    And they each get diced as well, and then they roll against the suspect. So with four officers on the contact team, they almost always will win the gun battle, so that the highest number out of the guns on the contact team versus the single gun of the suspect, that's how you decide who wins the shootout, if you will. That's really important, you want that first contact team to win. You want them to enjoy the idea that they've come in and eliminated the threat to save lives, right? So-

    Bill Godfrey:

    Yeah, that's the other classic new instructor mistake is trying to win, not your job to win. It's your job to lose. You just want to make them work for it a little bit.

    Adam Pendley:

    Then, after you built all these building blocks, you get to see how the board works. People understand that. It's always funny when you first are handing out, because they look like poker chips, right? The training tools for the responders and the survivors are all, they look like poker chips. Invariably you get the, "Oh, I'm all in", and all those jokes that go along with that. But then immediately afterwards, once they start doing it, they realize. I've had people comment that like, wow, I didn't realize that would be as realistic or as stressful as I expected it to be. Because, again, the training tool just provides inputs for them to have to make a good decision. After you get all that done, you do the module two, which we talked about with response integration.

    Now you can come back in that second scenario, everyone stay seated, and you actually call them up as their dispatch. It provides more realism to responding to an actual event, listening to the radio, since folks are responding. Now when you come in as 5th man, or when you come in as medical branch, you're having to depend on those people down range. Because at this point you shouldn't let everyone stand and look at the board. They're not learning anymore, now they're doing. When they come to their position, you may let them go to the board briefly to park their vehicle, like where they would click tactical or where they would establish staging that. But after that, they have to go a little further away in the room to actually work those positions and communicate down range, get that situational awareness that they need from those eyes and ears that are actually in the crisis site.

    Then that creates some additional view of them. In that scenario, typically as my second scenario, I will move through the theater, create some casualties in the theater as the bad guy, and then leave and go out into the parking garage. For the second scenario, I allow him to be contained, a little bit of a hostage scenario. Sometimes you can just say, "Hey, he is holed up behind a car", is there somebody in the car, you do not have a clean shot at him, so you're just going to have to communicate. Then that takes that first contact team and it gives them something to do, and then they have to remember to tell tactical, Hey, there are some casualties that are in the theater that still need to be secured, right? The second contact team, and there's so many training directions this can go, you don't want all of your responders all running to the barricaded subject because, while everyone's looking at the barricaded subject, there's still people bleeding to death in the theater, right?

    Early on, they have to separate those duties. Like, "Hey, you go back and secure the category collection point", then it teaches the importance of communication between police and fire, that you can have a secured warm zone, while you still maybe have a hot zone at another location in the crisis site. It really creates a lot of great conversations. We've increased the complexity, you allow for there to be some casualties in one location, a subject contained or barricaded in a second location. And then it gives all, by that point, every student in the room is engaged because you're having to build around a scenario that has a lot of security elements, a lot of importance about communicating where the casualty collection point is. A lot of communicating where the best ambulance exchange point is going to be, a lot of intelligence that has to be established as far as what's going on and how do we resolve this situation? So that second scenario is enough complexity to keep everybody busy.

    Bill Godfrey:

    Absolutely. I think one of the key things that we begin to build on and, and teach them, is you got to be able to do more than one thing at a time, from the management of this event, means you're doing multiple things at the same time. Now, each team may have, and really should only have, one particular mission. So as you've said in your example there, contact, one's got the bad guy pinned down in the parking garage, but contact two has got to be addressing the casualties and getting the casualty collection point back in the theater. So that idea of doing more than one thing at a time, I think is critical. You talked a little earlier about, sometimes they want to move a little fast and having to artificially slow them down.

    One of my favorite ways to slow them down is, like you said, you usually have that first contact team is generally going to be three or four officers. My favorite way to slow them down is to tell them they all have to talk about what they're going to do next before they move, where are they going to move and how are they going to move? And that's usually good for a three or four minute discussion, because nobody wants to be the strong headed one that just makes the decision for everybody else. it's always kind of fun to watch those dynamics. Have you seen that occur in some of the classes you've done?

    Adam Pendley:

    Sure, absolutely, and you can make them do that and get some real world experience out of it as well. That initial contact team, they can't just shoot the bad guy and then high five and that be it. They need to also do their security, immediate action plan and medical. Right? As soon as that suspect is down, the team that is standing there at the Counter-Strike training board, need to also communicate, okay, who has security? What are we going to do? If we hear additional gunfire, who's going to begin medical on these casualties, right? So, making them talk through those other training elements that many law enforcement has ever seen over the years. And then also for the fire EMS, when they arrive as the RTF, same thing, you can make them work through, discuss like, Hey, this patient has a serious chest wound.

    This patient has been shot in the leg and have them talk about why they would prioritize these red patients versus the yellow tag patients versus the green tag patients, and work through how they would manage the room. A lot of students like to use the room boss type training and concept. So they have the first RTF is in charge of making those decisions, those sort of things. All of that's really important. And I really liked that you emphasize the fact that you can do more than one thing at a time, and there's more than one way to do that second scenario, you can actually let the suspect escape, which that creates multiple tactical decisions that have to be made while you're still trying to care for patients. That's a good way to add complexity. The second scenario, you can have more than one suspect. The only thing I don't like about more than one suspect to add complexity, is that it's just so rare. When you talk about active shooter type incidents across the country, more than one suspect is very unusual.

    Bill Godfrey:

    I completely agree, it's almost a bridge too far in the basic class for that first four-hour block. I think it takes it level to a complexity that you just doesn't have time to build to.

    Adam Pendley:

    Right. On that note, when we talk about mistakes or things that I don't do is, there is almost zero training value in ever trying to ambush the fire EMS that are responding. I don't shoot at the RTFs. That would be a big mistake.

    Bill Godfrey:

    100%. It's negative training.

    Adam Pendley:

    Now I will say that I actually did it one time, and I had a transport officer, who was standing at the tactical and triage table, but he was not communicating with his peers. And he kept calling on the radio to have [inaudible 00:18:27] send the ambulance to a particular location. And literally, he was not listening to the fact that we had the suspect vehicle in that same parking lot that he was sending the ambulance to. And we tried to coach him, we tried to say, make sure you communicate, there's security issues there. And he kept pushing forward and pushing forward.

    So, as the instructor, I did actually shoot at an ambulance and we had a medic who was a casualty, but it became a great training point, but it was only because his lack of communication was so egregious that we had to use it as a learning point. But that's the only time and out of the dozens and dozens of times I've done this, these scenarios. So that's really important, I think, to add, but one of the values of letting the suspect leave the scene, because that has happened many times across the country, is you don't want, and I use this turn of phrase with the students all the time, is known bleeding is not going to stop while you search for unknown threats. So if you have no additional stimulus and you're able to secure a warm zone, then secure it and begin the treatment of patients, while you continue to do those other law enforcement things that have to be done.

    Bill Godfrey:

    1000%. I'm so glad you brought that up because I had that on my list to mention the most common, consistent mistake that's made by law enforcement, is that failure to shift gears when we go from an active threat to an inactive threat or a question mark. It's super easy if the threat is taken into custody or the threat is neutralized or subdued or whatever, but when the threat leaves or is in the wind or a ghost or the shooting stops, maybe the threat kills himself, but you don't know that, and the shooting stops and there's no explanation why. It's just this trap that law enforcement falls into a 100% of the time, to begin working and searching for the suspect and beginning clearing operation. And even though we lay out the priorities very clearly, active threat is number one, rescue is number two.

    Clearing is the third priority, rescue is supposed to come before that. And everybody always agrees when you say it in class, but when you give them a scenario where they've got active gunfire or active threat, and then the shooting stops and they don't know why. The way I like to do it, Adam, and I'm not sure how you do it, but the way I like to do, is I just take my bad guy chip and I pick him up, put him on the bucket and they go, "What are you doing?" I go, "Well, you've lost contact with the bad guy". "Well, what do you mean?" "Well, you don't know where he is". He may be still on the scene. He may have left the scene. You don't know he's not on the board anymore. And it just generates this element of confusion and searching.

    And it provides that opportunity to say, "At what point are you going to switch gears?" "At what point are you going to stop searching for this and acknowledge you've changed phases from an active threat to a war. You've gone from a hot zone to a warm zone because you don't have an active threat anymore." And I think that's a really, really important scenario. So one of your three scenarios, you've got to kind of force that issue. The other one that I think is a really good one that generates some really great conversation. You know, Adam, you mentioned earlier about the, the dice roll off in the gun battles. And, and so if you've got a contact team of four, each one of them gets a die and then a single bad guy gets the die. And so you got four rolling against one and whoever gets the high number wins.

    Well every once in a while. Usually at least once during a class, the bad guy's going to win the roll off. And then you take one of the responder chips, one of those law enforcement contact chips, you turn them over and you say, "Okay, that is now a casualty. You've got an officer down." And then my suspect, I almost always say, "I'm breaking contact that is your turn. I'm breaking contact and moving away." And now you look at the three or four officers that are part of that, contact team and go, "What are you going to do?" "Are you going to stay with your guy that's down?" "Are you all going after the bad guy?" "Are you going to split your team?" You've got 60 seconds to make a decision, go. And I always like hearing that conversation. How does that play out for you when you do that kind of stuff?

    Adam Pendley:

    Not only is there that decision-making, of how do you continue to pursue the active threat? Because obviously you don't want the threat to continue to go off and hurt innocent people as well, and how do you begin that officer rescue? The question then becomes, do they really lose all management of the incident? A lot of times, the officer who may be injured may not be a serious injury. It may be a yellow tag or a green tag, and then you have to make the decisions. Are you still going to stick with the RTF process and allow that officer to be transported in an EMS unit where he's going to get the best prehospital care that he can get? Or are you going to default to what a lot of law enforcement agencies do and you quickly pull up a police car, and he's bouncing around in the back of the plastic seat while trying to rush to the nearest hospital?

    It's one of a hundred different training discussions that come up using the board as an input when you're doing those injects during the actual scenario. It's all a great discussion to see how they sort it out, because what many of us who are listening know, is there's not necessarily a right or wrong answer for some of these wicked problems, right? You just have to make a decision and do the best you can with what you're presented with.

    Bill Godfrey:

    I completely agree, and I think this has been a great conversation. I want to just, as we, as we wrap up here, a couple of other tips for working with the Counter-Strike. So it's when you're doing the ASIM basic class, and it's the first time people are seeing it, you've got to keep it very simple. There's some rules that we have that go with how to play this and the rules of engagement, if you will. It has to do with using time on turns and other things like that. When you're doing the basic class, you rarely need to do any of that, because you're just trying to get people to understand the roles. But when you're coming back to do retraining with people that have seen it before, sometimes you need to increase the difficulty level.

    And one of the ways that I like to do that is to put them on a clock, where they get 60 seconds to have their turn, to communicate with each other, make a decision, decide where they're going to move, how they're going to move, what they're going to do. And it's amazing how putting them on a clock and then ending their turn at that time, really changes the dynamic and puts them under a lot of pressure to communicate very quickly with each other and very effectively. And then of course, if I get some that are really squared away, I'll adjust the time down and give them 30 seconds. Or, if they're struggling a little bit, I'll move it to two minutes. I think the rules actually suggest a 60 second clock, but the instructors should adjust that number to keep the difficulty level appropriate for the group that you're working with. Would you agree?

    Adam Pendley:

    Even in the four hour block, when you get to the third scenario, you can pick something that hits on the training needs that are important in your jurisdiction. If having more than one casualty collection point has been a point of concern or friction, use that to increase the complexity, more than one suspect. One of the scenarios I really like to use is that, because by this time they usually get it, right? So I let the initial active shooter run its course. And while they're transporting patients, I'll take that second suspect ship and create kind of a suspect vehicle in one of the parking garages. But I don't tell anyone at the board what that is. I will actually go to the incident commander, do a mock telephone call and be a witness who saw the suspect get out of this vehicle, and then watch the communication process work in reverse, because everything we've done so far has been the crisis site communicating out to command.

    Well, what if they get that real-world phone call that says, "Hey, we think another suspect vehicle in another location." How does that get communicated down through tactical? And how is that response? Sometimes you can even make that call, go to the fire chief, make the fire chief get that call from a witness that he just happens to know, and how does he communicate that to law enforcement? Working the process and working the communication structure that you have in place, working it in reverse, is sometimes a very good training scenario as well.

    Bill Godfrey:

    I think it absolutely is. The one other thing that I wanted to mention is, in the Counter-Strike kit, we also have these scenario cards. Now we never use them in the basic class because as I said, we're just trying to get them through the basics. But when you've got people that are coming back and using it over and over again, you don't want it to get stale and you don't want to get boring. So what we've crafted with the cards, when you've got a group that's been through the basic training already, and you're just trying to do refreshers and roll call training, or give them a quick 10 minutes scenario, 15 minute scenario, is you can hand out the cards and you can let one of the responders play the bad guy. As the bad guy, you get a goal card.

    This is your objective. This is what you're trying to do. And it gives you some rules of engagement. And then there's also some wild cards, if you will, that give you different things. For example, you can chain, and as the bad guy, you can chain and lock the doors. You can put IEDs in, things like that. And then on the good guy side, we've got things like the SWAT team was training down the road, they're immediately available. You have an undercover detective that is among the victims, that can take the suspect into custody. These kind of wild cards that can just dramatically change the rate and the pace of the play and increase the difficulty level of the training. But it also really works to keep it fresh. Have you got any other tips or tricks that you want to throw out for the crowd before we wrap it up?

    Adam Pendley:

    One of the other tips and tricks is we have learned over the years that the ASIM process, building that response from the ground up, applying a tactical group supervisor, and then integrating fire and EMS, works well for other types of scenarios as well. You can start your scenario with a bank robbery that then turns into a pursuit in a shooting. The scenario can be, a vehicle has crashed into a building and somebody has gotten out and has used a knife to attack folks. Even though we call it the Active Shooter Incident Management process, this process works for a variety of different types of scenarios. When you've had a real world incident that you want to recreate in a training environment, that's another really good way to use this board.

    I think, especially as we close, the big emphasis here is this is not a, hey, we come and do the four-hour train the trainer course, and then you have this Counter-Strike kit that then sits in the closet at the station and is never pulled out again. The way this training is the most effective is to, use it on a regular basis. It's meant to be easy. You pull it out, you set the board up, you call in a few people on duty, run through a couple of scenarios, kind of keep that process fresh in their mind, and put it back in the box and you do it again next week. The more frequently you're able to use the training tool, the better everyone is when the real world incident occurs.

    Bill Godfrey:

    The other really key thing there, Adam is, if you do it with frequency, the length of time, it takes you to run these scenarios and refresh people decreases. You can run scenarios in as little as 10 minutes, just to remind people of the process of you coming back to them. It doesn't need to pull people off the road for an hour. Ten to 15 minutes if you're just doing quick refreshers can be enough. If it hasn't been a long time since the last time you did it.

    Well, Adam, thank you so much for taking the time to talk to us both about the ASIM basic class and some tips for instructors that are out there trying to teach this, or might be a little rusty. And then also the deep dive we did on the techniques that we use for facilitating scenarios with Counter-Strike. I really appreciate your time being here.

    Adam Pendley:

    Yes, sir.

    Bill Godfrey:

    All right. Ladies and gentlemen, thank you for tuning in. We hope you enjoyed it. If you have any suggestions or questions for us, please send them in to info@c3pathways.com. Again, that email address is info@c3pathways.com. I'd like to thank our producer, Karla Torres as always for putting together these podcasts. And, until next time, stay safe.

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