A 20-year-old lad had to have both of his legs amputated a couple of days before his 21st birthday. After becoming incredibly ill with flu-like symptoms, the young man experienced multiple organ failure and was branded the 'sickest patient in the country'.

Levi Dewey, now aged 21, suffered from severe sepsis and is now recovering in hospital following the operation which involved the removal of his legs.

Levi Dewey had to have both legs amputated due to severe sepsis. Credit: GoFundMe/Lara Dewey
Levi Dewey had to have both legs amputated due to severe sepsis. Credit: GoFundMe/Lara Dewey

Levi's devastated family were informed by doctors that he had less than a 30% chance of survival after being assessed when he was rushed into intensive care.

However, the young man is thankfully making a remarkable recovery which his family are overjoyed with. Though the surgery has been life-changing for Levi, his family are currently fundraising to hopefully help him learn to walk again.

On 7 December 2022, Levi was rushed into Royal Derby Hospital with severe flu-like symptoms and difficult breathing before his condition rapidly deteriorated and he went into septic shock, causing his body to shut down and suffer multiple organ failure.

Following tests, doctors found that Levi was suffering from both Influenza B and Pneumococcal Pneumonia. He was then transferred from Royal Derby Hospital to Glenfield hospital, Leicester, for specialist care.

Levi, who was a JCB welder at the time, was declared to be 'the sickest patient in the country' by doctors - and his devastated family were told the difficult news that he only had a slim chance of survival.

Levi Dewey was a fit and healthy lad before his illness. Credit: GoFundMe/Lara Dewey
Levi Dewey was a fit and healthy lad before his illness. Credit: GoFundMe/Lara Dewey

But thanks to ECMO (extracorporeal membrane oxygenation) and full organ support, Levi managed to turn a corner and began to recover slowly, spending a total of 20 days on ECMO and 14 days in an induced coma. After 31 days, Levi was able to come off the ventilation system and returned closer to home to the Royal Derby Hospital for further treatment.

Unfortunately, Levi learned the difficult news that his legs would need to be amputated due to the severity of the sepsis he had suffered. The lower half of his legs had turned completely black with sepsis, posing an incredibly dangerous and life-threatening risk.

Just two days before his 21st birthday, Levi underwent the life-changing surgery. His family have since shared an update, revealing that the operation had gone well, saying: "I just wanted to give everyone an update that Levi's surgery went well yesterday and as planned."

"He has had bilateral below knee amputations of both legs and he was over the moon with this as there was the risk that it could have been above knee."

"He is currently in recovery but remaining positive about the challenges he faces ahead."

Levi Dewey is feeling optimistic for the future. Credit: GoFundMe/Lara Dewey
Levi Dewey is feeling optimistic for the future. Credit: GoFundMe/Lara Dewey

Levi is said to be 'grateful to be alive' and is remaining 'optimistic' for the future.

Levi's family have been blown away by the support they have received on the GoFundMe page they had set up for his continued treatment, raising more than £77,000 so far; which his family plan to use to make necessary home renovations and adaptations to help with Levi's mobility at home. The money will also go towards a wheelchair and high-quality prosthetics when he is able to walk again.

Levi's mother, Lara Dewey told StokeonTrent Live: "Initially we were looking to raise £10,000 but as you can see this has been exceeded and the response has been extremely overwhelming."

"It's amazing how supportive friends, family, colleagues, communities and also strangers have been towards this cause and also their generosity."

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Happy senior woman doing exercise at home with physiotherapist. Young gym trainer helping elderly smiling woman exercising at home. Old retired lady doing stretching arms at home with the help of a personal trainer during a rehabilitation session.Being physically active is the most important thing you can do to remain mobile and independent, regardless of your age or health status.

This cannot be emphasized enough – if you want to move better, you’ve got to move more.

Movement can help keep you mobile in several ways. It can help control weight, keep your muscles and bones strong, your joints working properly, your heart healthy, and your metabolism fired up.

Strength and balance get better with more movement, too, so falls become less likely, and your ability to perform basic daily functions can remain intact.

In addition to doing targeted exercises for muscle strength and flexibility, joint health, and balance, you should strive to increase routine daily physical activities that aren’t formal exercise. Climbing stairs and household chores are great examples.

Of course, if you’re in pain, the idea of doing exercise or moving around may seem impossible. But in most cases, moving will actually help reduce pain. For example, if you have osteoarthritis, regular exercise can help maintain joint function and relieve stiffness while reducing pain and fatigue.
Stronger muscles resulting from movement can also help reduce stress on joints.

How much exercise should you get? For healthy adults, 150-300 minutes of moderate exercise per week, with some happening every day, is recommended. Two sessions of strength training and balance exercise per week are recommended for adults at risk of falling.

If you’re disabled, it doesn’t mean you should completely avoid activity. If you can’t complete 150 minutes of moderate-intensity activity because of chronic conditions, just try and be as physically active as possible. Basically, try to sit less and move more.

Try to find activities that you enjoy. That way, you’ll be more motivated to get up and do them. Also, be aware of your capabilities: if your joints hurt, then don’t try and pace them. Instead, let them pace you. For example, don’t jog if you have sore knees. Cycling, swimming, or water aerobics, which are all low-impact, are much better.

If you’ve had hip or knee surgery, are experiencing joint pain, or have a chronic or unstable health condition, talk to your doctor before beginning an exercise routine.

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A 20-year-old had to have both his legs amputated just two days before his 21st birthday after becoming so ill with flu symptoms he went into multiple organ failure and was the sickest person in the country.

Levi Dewey, now 21, is recovering in hospital after the operation, having suffered from severe sepsis and multiple organ failure.

His devastated family were warned by doctors Levi had less than a 30 percent chance of survival when he was rushed into intensive care.

But the young man is on his way to a remarkable recovery after the life-changing surgery, leaving his family overjoyed as they fundraise to help him eventually walk again.

Levi Dewey, 21, had both his legs amputated below the knee just two days before his 21st birthday

Levi Dewey, 21, had both his legs amputated below the knee just two days before his 21st birthday

The 20-year-old was rushed to hospital on December 7 with flu-like symptoms and breathing difficulties

The 20-year-old was rushed to hospital on December 7 with flu-like symptoms and breathing difficulties

Levi was rushed to hospital in Derby on December 7 with serious flu-like symptoms and difficulty breathing.

The 20-year-old rapidly deteriorated and went into septic shock, suffering multiple organ failure and was sent to intensive care.

He was later found to be suffering from both Influenza B and Pneumococcal Pneumonia and was transferred from Royal Derby hospital to Glenfield hospital in Leicester for specialist treatment.

A statement from Levi's family said doctors informed them the JCB welder was 'the sickest patient in the country' at the time of his transfer, and told his heartbroken parents there was less than a 30 percent chance he would survive.

But with the help of ECMO (Extracorporeal membrane oxygenation) and full organ support, Levi slowly began to recover.

His condition rapidly deteriorated as his body went into sepsis shock and multiple organ failure

His condition rapidly deteriorated as his body went into sepsis shock and multiple organ failure

When he was moved to a hospital in Leicester, Levi's family was told there was a more than 70 percent chance he would die

When he was moved to a hospital in Leicester, Levi's family was told there was a more than 70 percent chance he would die

Levi spent 14 days in an induced coma and 31 days on ventilation as he slowly recovered

Levi spent 14 days in an induced coma and 31 days on ventilation as he slowly recovered

Before his illness Levi was a fit young man who regularly played football

Before his illness Levi was a fit young man who regularly played football

He spent 20 days on ECMO and was in an induced coma for 14 days, but after 31 days, he was able to be taken off ventilation and returned to the Royal Derby hospital for further treatment on January 9.

Despite his remarkable recovery, Levi was dealt another blow on January 11 when he was told he would need both his legs amputated due to the severity of his sepsis.

Photos of Levi in hospital show the lower half of his legs were left completely blackened by sepsis, which is an extremely serious and often life-threatening condition.

He underwent surgery on Tuesday, just two days before his 21st birthday.

An update from his family and friends after the surgery revealed it had gone well: 'I just wanted to give everyone an update that Levi's surgery went well yesterday and as planned. 

'He has had bilateral below knee amputations of both legs and he was over the moon with this as there was the risk that it could have been above knee. 

'He is currently in recovery but remaining positive about the challenges he faces ahead.'

His family have so far raised more than £70,000 to help him adapt to life as a double amputee

His family have so far raised more than £70,000 to help him adapt to life as a double amputee

He is said to be 'grateful to be alive' and 'optimistic' for the future. 

His family added on Levi's GoFundMe page they had been left 'gobsmacked' at people's generosity, having so far raised more than £77,000. 

His family are planning on using the money to help Levi's transfer home, including necessary home adaptations and renovations for the double amputee.

They will also purchase a wheelchair and, when he is able to walk again, high-quality prosthetic legs for him to use. 

His mother Lara Dewey, a child practitioner, told StokeonTrent Live: 'Initially we were looking to raise £10,000 but as you can see this has been exceeded and the response has been extremely overwhelming. 

'It's overwhelming and emotional and we are all speechless. 

'It's amazing how supportive friends, family, colleagues, communities and also strangers have been towards this cause and also their generosity.'


Sepsis is a life-threatening condition caused when the body releases chemicals to fight an infection.

These chemicals damage the body's own tissues and organs and can lead to shock, organ failure and death. 

Organ failure and death are more likely if sepsis is not recognized early and treated immediately.

Sepsis infects an estimated 55,000 Australians each year, killing between 5,000 and 9,000 making it more than four times deadlier than the road toll.

The symptoms can look like gastro or flu and can become deadly, rapidly.

The six major signs of something potentially deadly can be identified by the acronym 'SEPSIS':

  • Slurred speech or confusion, lethargy, disorientation
  • Extreme shivering or muscle pain, fever or low temperature
  • Pressing a rash doesn't make it fade
  • Severe breathlessness, rapid breathing
  • Inability to pass urine for several hours 
  • Skin that's mottled or discoloured  

Children may also show convulsions or fits, and a rash that doesn't fade when you press it - and more than 40 per cent of cases occur in children under five. 

Anyone who develops these symptoms should seek medical help urgently — and ask doctors: 'Could this be sepsis?' 

Sepsis is a leading cause of avoidable death killing about 10,000 Australians each year

Sepsis is a leading cause of avoidable death killing about 10,000 Australians each year

The early symptoms of sepsis can be easily confused with more mild conditions, making it difficult to diagnose. 

A high temperature (fever), chills and shivering, a fast heartbeat and rapid breathing are also indicators. 

A patient can rapidly deteriorate if sepsis is missed early on, so quick diagnosis and treatment is vital – yet this rarely happens. 

In the early stages, sepsis can be mistaken for a chest infection, flu or upset stomach. 

It is most common and dangerous in older adults, pregnant women, children younger than one, people with chronic conditions or those who have weakened immune systems.  

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TLC’s 1000-Lb. Sisters Season 4 shows fans how Amy and Tammy Slaton’s lives have progressed. While Amy is pregnant with her second baby, Tammy is back in rehab after feeling unwell. In episode 2 of the season, Tammy spoke to her therapist about setting “boundaries” with some of her friends in the facility. Here’s why.

‘1000-Lb. Sisters’ Season 4 shows Tammy Slaton back in a rehabilitation facility

Tammy Slaton from '1000-Lb. Sisters' Season 4 star smiling in a wheelchair
Tammy Slaton in ‘1000-Lb. Sisters’ Season 4 | TLC via YouTube

1000-Lb. Sisters Season 4 began with Tammy Slaton wanting to head back to a rehabilitation facility. Tammy mentioned how she didn’t feel well, prompting her to get help. However, once she arrived, she needed immediate medical attention. She was quickly transferred to the hospital after she had trouble breathing.

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Las Vegas, Nevada: For the last 3 months, Zachary Lopez from the original local independent news service ZachNews has been dealing with a range of health problems from COVID-19 to breathing problems.

In late December 2022, doctors discovered Zachary had blood clots in his head and lung areas, and after a short hospital stay was put on medication to help ease the blood clots but vision problems and dizziness begin to affect Zachary.

On Tuesday, January 17th, 2023, Graff Bruce V OD checked on my vision, and told Zachary to go to the emergency room immediately.

A few hours later, Zachary went inside the emergency room inside Colorado River Medical Center in Needles, California where hours later was transported by Careflight 6 to Sunrise Hospital and Medical Center in Las Vegas, Nevada where he remains hospitalized, and diagnosis with papilledema; pressure behind eyes, caused from the blood clots which continued to cause severe pains in the head.

After a spinal test on Monday, doctors and surgeons agreed that a lumbar peritoneal shunt surgery would be best for Zachary, and was scheduled the surgery to occur after 1:00 p.m. PT on Friday.

The lumbar peritoneal shunt surgery will drains small amnt fluid from back to abdomen to decrease the pressure.

The roof of the lumbar peritoneal shunt surgery includes bleeding, infection, possible neurologic deficits.

As of Sunday, January 29th, 2023, Zachary is slowly recovering from the surgery, undergoing physical therapy and being checked on over his condition following the surgery.

Despite the surgery the blood clogs remain still there and unclear if further actions are going to be taken or if medicine will be provided to yet again help in dissolving the blood clots; the pains of the blood clots are at a level that is a migraine headache with a pointy back being hit on the front and back of your head repeatedly, sometimes swelling up and wanting to explode.

Doctors have not stated officially what caused the blood clogs.

Zachary continues to get treatment inside Sunrise Hospital and Medical Center, and there is no official details on when Zachary will be discharge to come back home to Needles, California.

ZachNews operations remained stopped until Zachary is fully recovered and is healthy enough to get back to providing news and events to the great people of the community he cares about.

Zachary hopes you continue to support him as he continues to heal through the pains and struggles of the blood clots and surgery.

I miss you all and I love my ZachNews Family.


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Respiratory distress, also called acute respiratory distress syndrome (ARDS), is respiratory failure caused by rapid onset of widespread inflammation in the lungs

It can occur in patients who are critically ill or significantly injured.

Symptoms can include shortness of breath, rapid breathing, and bluish skin coloration.

Respiratory distress can be a serious, even fatal, condition.

Anyone who experiences these symptoms should seek emergency medical care immediately.

Diagnosing the cause of respiratory distress is not easy and requires clinical knowledge, a careful physical examination, and attention to detail.


What is Respiratory Distress?

Respiratory distress, also called acute respiratory distress syndrome (ARDS), is respiratory failure caused by rapid onset of widespread inflammation in the lungs.

Patients with ARDS have severe shortness of breath and often are unable to breath without the support of a ventilator.

Symptoms can include shortness of breath (dyspnea), rapid breathing (tachypnea), and bluish skin coloration (cyanosis). Respiratory distress is a critical, often fatal condition, especially among the elderly and severely ill. If not properly treated, some extreme cases of respiratory distress can lead to a decreased quality of life.


Respiratory distress can be primary or secondary:

  • Primary respiratory distress means the problem is in the lungs.
  • Secondary respiratory distress means the problem is somewhere else in the body and the lungs are compensating.

Possible primary respiratory distress problems include:

  • Anaphylaxis
  • Asthma
  • COPD
  • Pleural effusion
  • Pneumonia
  • Pneumothorax
  • Pulmonary edema

Possible secondary respiratory distress problems can include:

  • Diabetic ketoacidosis
  • Head trauma
  • Metabolic acidosis
  • Stroke
  • Sepsis
  • Toxicological overdose

Causes of Respiratory Distress and Treatment

Respiratory distress has a range of causes that can affect treatment, so EMTs must start by carefully considering the source of the condition.

For respiratory distress, the focus is usually on the lungs and auscultation (listening for sounds from the lungs, heart, and other organs).

An EMS provider’s assessment may include a physical exam, incident history, and vital signs before deciding the next step in treatment and transport of their patient.

The following are some of the most common types of respiratory distress and a brief overview of the appropriate treatment for each one.


Airway Obstruction

There are many ways that a foreign object can lodge in an airway causing an obstruction.

For example, a stroke can damage swallowing reflexes, making the person more prone to choking.

Consumption of alcohol and some drugs can also suppress the gag reflex, which could also lead to choking.

Treatment: If the airway obstruction is mild and the patient is coughing forcefully, EMS providers may not interfere with the patient’s efforts to clear the obstruction.

If the patient has signs of severe airway obstruction, as indicated by a silent cough, cyanosis, or the inability to speak or breathe, you should intervene.

If in some cases a patient becomes unresponsive, you can perform a finger sweep to clear the airway obstruction, but only if you can see solid material blocking their airway.


Asthma is a chronic, inflammatory disease of the airways.

Asthma attacks can be induced by many different causes including allergens, infections, exercise, and smoke.

Patients with asthma are very sensitive to things such as dust, pollen, drugs, air pollutants, and physical stimuli.

During an asthma attack, the muscles around the bronchioles tighten, the lining of the inside the bronchioles swells, and the inside of the bronchioles fills with thick mucus.

This severely restricts expiration of air from the lungs. Patients will often describe a history of asthma and have a prescription for a metered-dose inhaler.

TreatmentBasic Life Support treatment considerations include:

  • Calming the patient
  • Airway management
  • Oxygen therapy
  • Assisting with a prescribed inhaler


Chronic obstructive pulmonary disease (COPD) is a group of diseases that includes asthma, emphysema, and chronic bronchitis.

COPD causes a slow process of dilation and disruption of the airways and alveoli, and it includes several related irreversible conditions that limit the ability to exhale.

Symptoms of COPD include shortness of breath, fever, and increased sputum production.

The patient’s medical history can include conditions such as upper-respiratory infection, chronic bronchitis, emphysema, smoking, or working with hazardous substances such as chemicals, smoke, dust, or other substances.

Treatment. Common medications for COPD include:

  • Prednisone
  • Proventil
  • Ventolin
  • Atrovent
  • Azmacort

EMS treatment for a COPD patient with respiratory distress should include high flow oxygen.

Congestive Heart Failure

Congestive heart failure (CHF) results from too much fluid in the lungs, making it difficult to get air in.

This is in contrast to COPD patients, who typically experience difficulty getting the air out.

CHF occurs when the ventricles are weakened by a heart attack, underlying coronary artery disease, hypertension, or valve disease.

This impairs the heart’s ability to contract and empty during systole and blood backs up in the lungs and tissues of the body.

CHF is usually chronic with acute exacerbations.

During an acute episode, the patient will typically present sitting up, short of breath, diaphoretic, and pale, or cyanotic in color.

Breathing sounds can include rales or wheezes.

The medical history can include increased salt ingestion, respiratory infection, non-compliance with medications, angina, or symptoms of acute coronary syndrome.

Treatment. Common medications include:

  • ACE inhibitors
  • Furosemide (Lasix)
  • HCTZ (hydrochlorthiazide)
  • Beta-blockers
  • Angiotensin II receptor blockers
  • Digoxin (Lanoxin)

When treating patients who are suffering from congestive heart failure, seat the patient upright and administer high flow oxygen.

You may also consider positive pressure ventilation with a bag-valve-mask (BVM) if the patient is experiencing severe respiratory difficulty.

Inhalation Injuries

Inhalation injuries are caused by inhaling chemicals, smoke, or other substances.

Common symptoms include shortness of breath, coughing, hoarseness, chest pain due to bronchial irritation, and nausea.

Individuals with decreased respiratory reserve, including a history of COPD or CHF, are likely to experience an exacerbation of the disease.

Treatment: If a patient is in respiratory distress, treat immediately with high flow oxygen.

Assist breathing with a bag-valve-mask (BVM) if the respiratory effort is insufficient as indicated by a slow rate and poor air exchange.


Symptoms of pneumonia include fever, chills, cough (often with yellowish sputum), shortness of breath, general discomfort, fatigue, loss of appetite and headache.

There can be chest pain associated with breathing (usually sharp and stabbing in nature) and worsened by coughing or deep inspirations.

Other signs that sometimes present are rales, clammy skin, upper abdominal pain, and blood-tinged sputum.

Treatment: Emergency care for pneumonia depends on the severity of the patient’s breathing difficulty but may include oxygen therapy.


A pneumothorax is the presence of air between the two layers of the pleura—which are the membranes lining the thorax and enveloping the lungs.

It is caused when an internal or external wound allows air to enter the space between these pleural tissues, which can cause the lungs to collapse.

A pneumothorax can occur spontaneously (e.g., a rupture caused by disease or localized weakness of the lung lining) or as a result of trauma (e.g., gunshot or stab wound).

People who have a prior history of pneumothorax or COPD may be more at higher risk of experience this medical condition.

In some rare instances, even forceful coughing can cause a pneumothorax.

A pneumothorax can cause sharp chest pain and shortness of breath.

The patient’s breathing will sound diminished and you may be able to feel air coming from under the patient’s skin.

Treatment:  EMS treatment of a pneumothorax includes high-flow oxygen. Be judicious with your use of positive-pressure ventilation. It can turn a spontaneous pneumothorax into a life-threatening tension pneumothorax.

Tension Pneumothorax

A tension pneumothorax is a progressively worsening pneumothorax that begins to impinge on the function of the lungs and the circulatory system.

It is caused when a lung injury acts like a one-way valve that allows free air to move into the pleural space but prevents the free exit of that air.

Pressure builds inside the pleural space and compresses the lungs and other organs.

Early signs of a tension pneumothorax include:

  • Increased dyspnea
  • Cyanosis
  • Signs of shock
  • Distended neck veins
  • Shift in PMI (Point of maximum intensity, where the heart is the loudest through auscultation)
  • Tracheal displacement
  • Tracheal deviation

Treatment: If the patient is hypotensive or showing signs of hypoperfusion, then EMS providers should initiate temporizing treatment for tension pneumothorax.

Open chest wounds should have a sealable dressing placed over them with a one-way air valve to prevent air build up.

This one-way valve can be created by applying an occlusive dressing and taping on three sides.

The EMS provider should perform needle decompression on the chest wall to release encased air.

Pulmonary Embolism

A pulmonary embolism (PE) can occur when a particle (such as a blood clot, fat embolus, amniotic fluid embolus, or air bubble) gets loose in the blood stream and travels to the lungs.

If the particle lodges in a major branch of the pulmonary artery, this can interrupt blood circulation to the lungs.

If blood cannot reach the alveoli, then it cannot be oxygenated.

This condition can be caused by immobility of the lower extremities, prolonged bed rest, or recent surgery.

Signs of PE are a sudden onset of shortness of breath, rapid breathing, chest pain worsened by breathing, and coughing up blood.

Treatment: Pulmonary embolism is a life-threatening condition and should be treated with high flow oxygen and rapid transport. Move the patient gently to avoid dislodging additional emboli (particles).

When to Call Emergency Number for Respiratory Distress

Breathing is something most of us do instinctively, day and night. We don’t even think about it.

So, if you experience shortness of breath or difficulty breathing it can be quite alarming.

If you experience shortness of breath that interferes with your daily routine or body functions, you should call Emergency Number or have someone drive you to the nearest Emergency Room immediately.

You should call Emergency Number immediately if you experience shortness of breath together with any of the following  symptoms:

  • Chest pain
  • Dizziness
  • Pain that spreads to your arms, neck, jaw or back
  • Sweating
  • Trouble breathing
  • How to Treat Respiratory Distress

If you experience shortness of breath, or shortness of breath together with any of the symptoms listed above, you need to call Emergency Number or get to an ER immediately.

Treatment of respiratory distress requires a doctor.

The first goal in treating respiratory distress will be to improve the oxygen levels in your blood.

Without sufficient oxygen, your organs can fail. Increasing your blood oxygen levels can be achieved through supplemental oxygen or a mechanical ventilator that pushes air into your lungs.

Careful management of any intravenous fluids will also be critical.


People with respiratory distress are usually given medication to:

  • Prevent and treat infections
  • Relieve pain and discomfort
  • Prevent blood clots in the legs and lungs
  • Minimize gastric reflux
  • Sedate

USA: How Do EMTs & Paramedics Treat Respiratory Distress

For all clinical emergencies, the first step is rapid and systematic assessment of the patient.

For this assessment, in the USA most EMS providers will use the ABCDE approach.

The ABCDE (Airway, Breathing, Circulation, Disability, Exposure) approach is applicable in all clinical emergencies for immediate assessment and treatment.

It can be used in the street with or without any equipment.

It can also be used in a more advanced form where emergency medical services are available, including emergency rooms, hospitals or intensive care units.

Treatment Guidelines & Resources for Medical First Responders

Treatment guidelines for respiratory distress can be found on page 163 of the National Model EMS Clinical Guidelines by the National Association of State EMT Officials (NASEMSO).

These guidelines are maintained by NASEMSO to facilitate the creation of state and local EMS system clinical guidelines, protocols, and operating procedures.

These guidelines are either evidence-based or consensus-based and have been formatted for use by EMS professionals.


The guidelines include a rapid assessment of the patient for symptoms of respiratory distress, which may include:

  • Shortness of breath
  • Abnormal respiratory rate or effort
  • Use of accessory muscles
  • Quality of air exchange, including depth and equality of breath sounds
  • Wheezing, rhonchi, rales, or stridor
  • Cough
  • Abnormal color (cyanosis or pallor)
  • Abnormal mental status
  • Evidence of hypoxemia
  • Signs of a difficult airway

Pre-hospital treatments and interventions might include:

  • Non-invasive ventilation techniques
  • Oropharyngeal airways (OPA) and nasopharyngeal airways (NPA)
  • Supraglottic airways (SGA) ort extraglottic devices (EGD)
  • Endotracheal intubation
  • Post-intubation management
  • Gastric decompression
  • Cricothyroidotomy
  • Transport to closest hospital for airway stabilization

EMS providers should reference the CDC Field Triage Guidelines for decisions regarding transport destination for injured patients.

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Most children with Crouzon's Syndrome can have a normal life expectancy if diagnosed early and treated timely.

Crouzon's Syndrome is a rare genetically inherited disorder with an incidence rate of 1 in 60,000 newborns worldwide. Cranial sutures or anatomical lines are the fibrous tissue bands that join the bony plates of the skull together. In Crouzon Syndrome, the sutures, in an infant, merge prematurely affecting the normal growth of the skull and head leading to an alteration in the shape and therefore the development of the skull. The seriousness of craniosynostosis does vary from one child to another. The symptoms primarily include abnormalities of the face and head.

Dr Nitin Mokal, Paediatric Plastic Surgeon at SRCC-NH Children's Hospital said, "The syndrome is characterized by Craniosynostosis and many other features. This can cause an abnormal shape of the head and face with babies having a short and wide or long and narrow head, enlarged foreheads, shallow orbits (eye sockets) leading to bulging eyeballs, flattened cheeks, poorly developed upper jaw, protruding lower jaw, and curved, beak-like nose."

The other features associated with this syndrome include inflammation of the cornea (exposure keratitis) due to bulging eyeballs (proptosis), squint, vision loss, hearing loss, dentition problems, cleft in the lip/palate, narrow airways leading to respiratory problems and sleep apnoea. According to experts, there can be increased pressure in the brain and accumulation of excessive fluid in the brain (hydrocephalus).

Most patients can have normal life if diagnosed and treated early

Dr Uday Andar, Paediatric Neurosurgeon at SRCC-NH Children's Hospital, called for increasing awareness about Crouzon's Syndrome.

An expert in Congenital scoliosis - Spinal dysraphism - Craniofacial anomalies, Dr Andar said that most of these children can have a normal life expectancy if diagnosed early and treated timely by an experienced team.

He added, "The social stigma around abnormal facial appearance and lack of awareness about the condition leads to many children being devoid of appropriate and timely diagnosis and treatment. The treatment of this syndrome requires a multidisciplinary team approach consisting of specialists like Neurosurgeons, Plastic Surgeons, ENT Surgeons, Ophthalmologists, Dental Surgeons, Paediatric Anaesthetists, Speech and Language Therapists etc. Such children may require more than one surgical procedure during their lifetime."

Such children if referred to and treated by a team experienced in the management of craniofacial disorders can have a normal life and future, the experts at the SRCC-NH Children's Hospital noted.

Treatment of Crouzon Syndrome: A case study

Yusuf Ali, a 17-year-old teen with Crouzon Syndrome (abnormal brain structure) was having serious issues with breathing, including sleep apnoea. Besides, his bulging eyeballs were at risk of exposure to keratitis. On Yusuf's birth, his parents were told that the baby would never make it past his childhood and that if he did, he would grow up with severe mental retardation and disability. He had undergone two surgeries as a baby, but as he grew up, the problem continued, and his brain potential was at stake.

He was recently admitted and treated by a highly experienced craniofacial team at Narayana Health's SRCC Children's Hospital. He successfully underwent Monobloc Advance Surgery, which helped moved abnormal brain structure which was hampering his brain potential and gave him back his love for history, literature and the future.

The complex procedure was performed by a team of craniofacial surgeons comprising plastic surgeons: Dr Nitin Mokal, Dr Amita Hiremath, and Neurosurgeons Dr Uday Andar & Dr Saurav Samantray.

As explained by the experts, the surgery was performed to bring Yusuf's forehead and mid-face forwards so as to make space for his eyeballs and increase the diameter of his airways through the nose and mouth. The surgery is called Monobloc Advancement using a RED (Rigid External Distractor) frame.

Dr Saurav Samantray, Paediatric Neurosurgeon at SRCC-NH Children's Hospital, said, "This frame was attached to the sides of his skull, forehead, cheek and jaw bones with wires. The frame was then used to advance the forehead and face by 1 mm/day, starting one week after surgery. The frame stayed on the patient's head for 2-3 months after that it was removed, confirming adequate advancement on imaging. This process of slow advancement leads to new bone formation in the gap generated by pulling the forehead and face forwards."

Yusuf's mother noticed a discernible change in his smile and eyes immediately after the surgery. The teen was able to eat, drink, sleep, read, walk and do every other routine activity within a week of the surgery.

Dr Amita Hiremath, Craniofacial Surgeon, SRCC-NH Children's Hospital, highlighted that Yusuf's story proves the need for awareness and sensitivity towards a condition like Crouzon's Syndrome.

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Nicole White plays an exhausting "what if" game before her family ventures into public, running through scenarios that could be risky for her daughter, who is immunocompromised. 

Addison, who has underlying health issues stemming from a brain injury she experienced in utero, is at a higher risk for severe illness from COVID-19 and other viruses. Since Addison also uses a ventilator to help her breathe, she can't wear a mask for added protection, White said.

Even in the absence of a pandemic, an infection could take a serious toll on Addison, but this winter's uptick in the number of COVID, flu and respiratory syncytial viruses, or the "tripledemic," has put families of children with chronic health conditions or compromised immunity on higher alert. Parents remain vigilant, constantly assessing the risk of exposure when even the sniffles could potentially land their children in the hospital, while also struggling to provide a sense of "normalcy"  when vaccines are readily available and mask mandates are removed, families told Newsday.

“It’s so hard to always make those decisions,” said White, 38, of West Islip. “We’re always assessing. It’s like risk management. … It’s always that checklist in your brain.” 


  • The "tripledemic" has created an additional layer of fear for parents whose children have chronic conditions that make them vulnerable to respiratory illnesses. 
  • Parents said they are constantly struggling to keep their children safe while also attempting to provide a sense of normalcy. 
  • Even pre-pandemic, an infection could take a serious toll on immunocompromised children but the triple threat of RSV, flu and coronavirus poses a heightened risk.

Nicole White and husband Ryan with their 18-month-old daughter, Addison, whose underlying...

Nicole White and husband Ryan with their 18-month-old daughter, Addison, whose underlying health issues put her at an increased risk for getting very sick from COVID or other viruses.
Credit: Newsday/Steve Pfost

'Medically complex' kids most at risk

Even the common cold poses a risk for 22-month-old Addison. 

A cold she caught in October led to pneumonia and fluid around her lungs. She was hospitalized three times. When her brothers caught the flu, White sent her sons to a grandparent’s house to keep Addison safe. When White's husband and sons became ill with COVID, she and Addison temporarily moved out of their home. 

Such are the extreme measures the Whites take to protect Addison, who has cerebral palsy, which makes her vulnerable to respiratory complications.

“Any sort of virus hits her very hard on her respiratory system,” said White, adding that Addison lives on a separate floor of their home to reduce exposure to germs. “You do fear that if she gets something like that, it means an extended hospital stay. It means scary moments. It means her stopping breathing.”

The children most at risk from the “tripledemic” are those who are “medically complex," said Dr. Joan DeCelie-Germana, medical director of the Pediatric Cystic Fibrosis Center at Cohen Children’s Medical Center. The coronavirus is inflammatory and can produce mucus, and can worsen lung function. She said staff has reviewed safety protocols with families in an effort to minimize the likelihood of getting sick this winter.

“Keeping them well and trying to help them avoid getting sick because of no longer [having a] mask mandate is very challenging,” the doctor said. “We have to sometimes pull kids out of school so that they don’t keep getting sick."

RSV, flu and coronavirus cases have been trending downward in New York over the past few weeks, but state health officials continue to emphasize the importance of taking precautions against the illnesses, including getting vaccinated and wearing a mask, especially those with underlying health conditions. Doctors also recommend that immunocompromised children wear masks to school and use hand sanitizer, among other measures. 

Typically, RSV peaks first and is followed by the flu, but the illnesses overlapped this winter, said Dr. Sharon Nachman, the pediatric infectious disease division chief at Stony Brook University Hospital. She said her patients' parents run the gamut in terms of taking precautions, from opting to "cocoon" their children to encouraging their inner circle to get vaccinated. 

Any respiratory illness poses a major risk to Alfonso, known as Allie,...

Any respiratory illness poses a major risk to Alfonso, known as Allie, said his mother Erin Fiero. Next to Allie is his sister, Genevieve, or Gennie, at their Garden City home.
Credit: Howard Schnapp

'I’m trying to be calm'

Safeguarding their son's health is the primary concern for the Fieros of Garden City. 

Alfonso, known as Allie, had two surgeries and multiple ICU stays to treat and repair his trachea, said his mother, Erin Fiero. Even pre-pandemic, any respiratory virus posed a major risk to Allie, now 10. 

“Every normal respiratory illness that he got had the potential to send him to the ICU, and the majority of them did,” Fiero said. “It could’ve been anything, it could’ve been the sniffles.” 

The family was under lockdown during the initial waves of the pandemic. The perpetual need to stay on guard is exhausting, Fiero said. The isolation affected the family's mental health, but the family slowly began reintroducing in-person activities to their routine after they were vaccinated. The family is somewhat back to "normal," Fiero said, but she remains cautious.

“I can’t lose that vigilance,” Fiero said. “When I hear a cough or I see a runny nose, I’m trying to be calm, but a lot of times what I see is a potential two-week hospital stay praying by the bedside of my child.” 

Finding that balance

For parents trying to strike a balance between keeping their kids safe and providing a sense of normalcy, there is no one-size-fits-all approach, doctors told Newsday. 

"I think there are some parents who are very overly protective, but I think the pandemic has also taught them ... to find that balance of allowing their children to socialize and yet not throwing caution into the wind," said Dr. Maria T. Santiago, the chief of pediatric pulmonary at Cohen. 

Verlin Obilet Ramos said her family still isolates to protect her daughter Samantha,...

Verlin Obilet Ramos said her family still isolates to protect her daughter Samantha, 2.
Credit: Debbie Egan-Chin

Verlin Obilet Ramos, 37, said her family still sometimes wears masks and isolates to protect her daughter Samantha, 2, who required open heart surgery as an infant. In November, Samantha caught RSV, an easily transmissible upper respiratory infection, and was very sick, her mother said. 

“Every time she has a cold or some type of illness, we get scared,” said Obilet Ramos, of Inwood. “The risk is always there.” 

Despite that, Obilet Ramos said she has tried to give her daughter a normal life fearing that isolation could affect her. Samantha recently started going to a babysitter while her mother works. 

The pandemic, and now the triple threat of viruses, also has disrupted the lives of older children.

Agranil Das, 17, has Duchenne muscular dystrophy, which poses a risk to his heart and lungs. After remote learning for two years, he now attends school in person, but still wears a mask. 

The Selden teen's family tries to mitigate any potential threats. His father quit his job during the early waves of the pandemic to keep him safe, said Agranil's sister, Mrinaleni Das.

The family still takes precautions, she said, including changing their clothes and showering after coming home. “It’s just part of our daily life. It’s what we do and what we’ve been doing for three years.” 

Kimberly Booker's daughter, Zandra, who has a compromised immune system,...

Kimberly Booker's daughter, Zandra, who has a compromised immune system, has barely gone to school in person since the pandemic and learns virtually, Booker said.
Credit: Newsday/Steve Pfost

Kimberly Booker's daughter, Zandra, 14, has barely gone to school in person since the pandemic and learns virtually. She is cleared by her medical team to return to school in the spring, her mother said.

Zandra had a heart transplant as an infant, and her condition left her with a compromised immune system, including asthma, Booker, 34, of Coram, said. 

Respiratory illnesses make it difficult for the teen to breathe when sick. Booker, a nurse, sent her daughter to live with her grandmother during the first five weeks of the pandemic to avoid potential exposures. The separation was "devastating," she said.

The isolation also has worsened the teen's anxiety, Booker said, adding that the hyper-awareness of the virus has been "extremely overwhelming" for her, too. 

“It’s absolutely exhausting. It really is, truly,” Booker said of her constant vigilance. 

With Darwin Yanes 

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Recovering from Plastic Surgery: Tips for Staying Active and Healthy
Recovering from Plastic Surgery: Tips for Staying Active and Healthy

Recovering from Plastic Surgery: Tips for Staying Active and Healthy : Recovering from plastic surgery can be a complicated process. But following the proper steps can help you recover quickly and safely. Staying active and healthy ensures a speedy recovery and avoids potential complications.

This blog provides tips to help you stay active and healthy during your plastic surgery recovery. By following these tips, you can return to your routine as soon as possible.

Postoperative Guidelines

After your plastic surgery in Dallas, it is important to follow your surgeon’s instructions for recovery. This includes specific instructions on how to take care of your incisions and physical activity limits. Be sure to follow their advice to ensure the best possible outcome.

In general, a surgeon can recommend the following:

  • Avoid aggressive exercise
  • Adequate rest
  • Wash incisions properly
  • Avoid strenuous physical activity
  • Do not smoke
  • Avoid alcohol and caffeine

Stay active during recovery

You must maintain a healthy activity level during the healing process. Gentle exercise can help speed healing and improve muscle strength and flexibility. Also, staying active and moving enough prevents blood clotting and reduces inflammation. But, it is crucial to listen to your body and avoid any type of exercise that causes pain or discomfort. Here are some ways to stay active during the healing process:

  • Walking- Walking can help strengthen muscles and improve mobility in the operated area. It improves blood circulation and increases oxygenation to the body.
  • Stretching- Stretching can help you recover from plastic surgery, especially if muscles or joints have been affected. Help improve flexibility and relieve stress.
  • Breathing exercises- Simple daily breathing exercises can reduce stress and anxiety.
  • Strengthening exercises- They can help you recover from plastic surgery, particularly if muscles in the operated area have been affected.
  • Yoga- Yoga is a great way to stimulate the body and promote healing.

Rushing through exercise can prolong the recovery process. Give the body time to heal correctly and avoid overdoing it as much as possible. Follow your surgeon’s instructions and consult your surgeon if you have any questions.

Maintaining a healthy lifestyle

Maintaining a healthy lifestyle during recovery reduces the risk of complications and speeds up the healing process. Here are some suggestions for staying healthy:

  • Eat a healthy diet- Incorporate foods rich in vitamins and minerals into your diet. These compounds help reduce swelling and bruising, which are common after surgery. Consuming a healthy amount of protein can help speed up the healing process.
  • Start an exercise routine Exercising can help improve circulation and control weight, which can affect healing. Consult your surgeon to find out what types of exercises are appropriate. Avoid strenuous activity until your surgeon gives you the go-ahead.
  • Manage stress- Stress can slow down the healing process, so it is essential to find ways to manage stress. You can practice meditation, yoga, or other relaxation techniques.
  • Stay hydrated- Drinking enough water can help improve circulation and skin health and promote healing.
  • Incorporate supplements into your diet- Several supplements can boost the immune system after surgery. Nutrients such as vitamin C and fish oil help reduce the risk of infections and speed up recovery.
  • Protein shake- It can help increase protein intake and speed up the healing process after surgery.


Remember that staying positive and avoiding stress are essential during your healing process. Try to maintain a positive attitude by relaxing and eating healthily. Although you may be tempted to return to your routine as soon as possible, taking it easy during recovery is crucial. This will help ensure that your body has the time and energy to heal properly. With the right approach, you can have a smooth and successful recovery and enjoy the results of your procedure for years to come.




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ROOTSTOWN, Ohio—The Physicians Committee for Responsible Medicine, a nonprofit of more than 17,000 doctor members, is calling on Northeastern Ohio Medical University to stop using animals in a surgery training program. The medical ethics group has installed eye-catching billboards in Rootstown, Akron, and Youngstown, targeting the NEOMED-affiliated hospitals that are invited to participate in the program, which takes place at the university’s main campus in Rootstown. They read: “Ohio: Does Your Doctor Think You’re a Pig? ModernizeMedicalTraining.org.” In addition, the Physicians Committee has filed a complaint with the United States Department of Agriculture (USDA), requesting that the agency investigate NEOMED for violations of the Animal Welfare Act. 

At NEOMED, surgery residents cut into live pigs and perform invasive procedures as part of their training, even though 79% of surveyed U.S. residencies (206 of 262) do not use animals. Trainees perform dozens of procedures on the animals, including chest tube placement (to drain air, blood, or other fluids); inserting a breathing tube into the windpipe; inserting surgical tools and a camera; removal of the gallbladder and kidneys; and spreading the ribs to access the heart. The animals are then killed following the training sessions. 

The Physicians Committee’s complaint to the USDA points out that, under the Animal Welfare Act, researchers and course instructors must consider alternatives to procedures that may cause more than momentary or slight pain or distress to an animal. More than 10 other surgery residency programs in Ohio—including Cleveland Clinic, Wright State University, the University of Toledo, and Kettering Health Network in Dayton—use only human-relevant, nonanimal methods for training. Simulators mimic human anatomy, including lifelike skin, muscle, fat, and blood vessels. The devices can also bleed and provide lifelike physiological responses. Scientific studies show that simulators prepare surgeons as well or better than animals to perform life-saving procedures.

“It’s obvious to medical professionals everywhere that there’s no reason to use animals to teach surgery,” says Angie Eakin, MD, of Columbus. “NEOMED appears to be stuck in the past.”

For a copy of the federal complaint or to see the billboard artwork or locations, please contact Reina Pohl at 202-527-7326 or rpohl [at] pcrm.org.

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What Is Demerol - Injection?

Demerol (meperidine) is in a class of medications called opioid analgesics. It is most commonly used in a hospital setting with anesthesia before surgery to help relieve severe, short-lasting pain.

Demerol works by blocking opioid receptors in the brain. As a result, the brain replaces the feeling of pain with the “feel good” effects of the medication.

Although effective, this medication is not used as a first option to help with severe pain due to the high risks of adverse effects and dependency or misuse. It is generally used when alternative options are inadequate.

This medication is available as an intramuscular (into the muscle), subcutaneous (under the skin), and intravenous (into the vein) injection. A trained healthcare provider will give you meperidine in a hospital or clinic.

Drug Facts

Generic Name: Meperidine

Brand Name(s): Demerol

Drug Availability: Prescription

Administration Route: Intramuscular, subcutaneous, intravenous

Therapeutic Classification: Opioid analgesic 

Available Generically: Yes

Controlled Substance: Yes, Schedule II

Active Ingredient: Meperidine hydrochloride

Dosage Form(s): Solution for injection

What Is Demerol Used For?

The Food and Drug Administration (FDA) approved Demerol for use with anesthesia before surgery to help relieve severe, short-term pain. It is not used for chronic (long-lasting) pain.

Meperidine is considered a controlled substance due to the risks of drug misuse and dependency, even at recommended doses. Healthcare providers generally reserve controlled substance use when other treatment options are inadequate at providing pain relief or not tolerated well.

How to Take Demerol

A trained healthcare provider will typically give you the injection. You will be lying down while they give you the injection. 

If you need to continue therapy at home, your healthcare provider will teach you how to prepare and inject the medication.

When self-injecting your medication, remember to:

  • Inspect the syringe before injecting. Do not inject if you see broken seals, cracked glass, leaking, or particulate matter in the solution or if it is past the expiration date.
  • Clean the injection area with alcohol before injecting.
  • Discard the needle in a sharps container after use. Never reuse or share the needle or syringe.

Contact your healthcare provider or pharmacist if you have questions or concerns about taking your medication.


Since you will most likely receive a Demerol injection at a hospital or clinic, you may not need to worry about proper storage. However, if you are required to take this medication at home, keep it stored at room temperature (between 68 F and 77 F). You must keep Demerol out of reach of children and pets.

Off-Label Uses

Healthcare providers may prescribe meperidine for off-label uses, meaning for conditions not specifically indicated by the FDA.

Based on clinical studies, Demerol can be used to prevent shivering after surgery, a common complication of anesthesia. Typically, meperidine is given along with anesthesia during surgery. This combination prevents shivering after an operation.

How Long Does Demerol Take to Work?

The rate at which Demerol can help relieve your pain may vary from person to person. Demerol has a fast onset, so you can feel the medication begin working quickly. It can last about, on average, three hours or so.

What Are the Side Effects of Demerol?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

The following side effects commonly reported while taking Demerol include:

  • Constipation
  • Upset stomach 
  • Excessive sweating
  • Feeling weak
  • Lightheadedness or dizziness
  • Sedation

Severe Side Effects

Do not hesitate to contact your healthcare provider right away if you are experiencing any severe side effects. Call 911 immediately if you suspect your symptoms are life-threatening or need medical assistance.

Severe side effects associated with Demerol include:

  • Breathing problems (e.g., respiratory depression) are most likely to happen within the first 24 to 72 hours after the initial dose and dose increases.
  • Increased risk of seizures, especially in people with seizure disorders
  • Chest pain or pressure
  • Abnormal heartbeat
  • Trouble passing urine
  • Severely low blood pressure (hypotension)
  • Serotonin syndrome, which can cause changes in mental status (e.g., hallucinations, mood swings), vital sign abnormalities (e.g., fast heartbeat, hypertension), muscular effects (e.g., rigidity), and gastrointestinal issues (e.g., nausea, vomiting)
  • Misuse or dependence

Long-Term Side Effects

Demerol is only used for short-term pain relief because continued use of meperidine may lead to potential addiction and increase the risk of severe side effects, such as chest pain, abnormal heartbeat, or difficulty breathing. 

Report Side Effects

Demerol may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Demerol Should I Take?

Drug Content Provided and Reviewed by

IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For injection dosage form:

    • For moderate to severe pain:

      • Adults—At first, 50 to 150 milligrams (mg) injected into a muscle or under your skin every 3 or 4 hours as needed.
      • Children—Dose is based on body weight and must be determined by your doctor. The dose is usually 0.5 to 0.8 milligram (mg) per pound (lb) injected into a muscle or under your skin every 3 or 4 hours as needed.


Before starting meperidine, talk to your healthcare provider about any concerns you have about your dosage. Common dose modifications for Demerol are listed below:

  • Advanced age (65 years and older): Avoid taking Demerol.
  • Kidney problems: Avoid taking Demerol.
  • Liver problems: Your healthcare provider will monitor your response to the medication to see if you are a good fit for continued therapy.
  • Pregnancy: You should prolonged use of meperidine during pregnancy since the newborn can become dependent on the drug after birth, resulting in life-threatening withdrawal symptoms. This is known as neonatal opioid withdrawal syndrome.
  • Breastfeeding: Demerol does pass through the milk of nursing people, so the benefits of breastfeeding should be discussed with the healthcare provider.
  • Use of Demerol in children has not been established. Therefore, you should avoid meperidine for your child. You can talk to your child’s healthcare provider for a medication that is proven to be safe to help with their pain. 

Missed Dose

Demerol is most often given to you by your healthcare provider or used on an as-needed basis. Therefore, you will likely not need to keep track of scheduled doses.

If you are using Demerol as needed, only take it if you have active pain that needs to be treated. Talk to your healthcare provider if you have additional questions on how you should take your medication. 

Overdose: What Happens If I Take Too Much Demerol?

Demerol is a strong narcotic used to relieve pain. As a result, you can become dependent on the medication. This can increase the risks of taking more meperidine than your body can handle, resulting in an overdose.

The signs of a meperidine overdose include:

  • Respiratory depression (slowed heart rate and difficulty breathing)
  • Cold and clammy skin
  • Muscle flaccidity (weakness or paralysis)
  • Constricted pupils
  • Vomiting 
  • Somnolence that can lead to a coma

If prescribed Demerol, you can request an antidote called naloxone, also known by its brand name Narcan. Naloxone is a life-saving medication. It works by competing for the same opioid receptor binding sites in your body and displacing opioid binding. By blocking these receptors, Narcan helps to reverse symptoms of opioid overdose.

Whether taking excess Demerol was intentional or accidental, an overdose of meperidine can lead to severe complications or death. It is important to call 911 or medical help immediately following an overdose.

What Happens If I Overdose on Demerol?

If you think you or someone else may have overdosed on Demerol, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Demerol, call 911 immediately.


Drug Content Provided and Reviewed by

IBM Micromedex®

It is very important that your doctor check your progress while you are receiving this medicine. This is to make sure that the medicine is working properly, and to allow your doctor to check for any unwanted effects.

Do not use this medicine if you are using or have used a monoamine oxidase (MAO) inhibitor (eg, Eldepryl®, Marplan®, Nardil®, Parnate®) in the past 2 weeks. Using these medicines together may cause unwanted effects, such as confusion, agitation, restlessness, stomach or intestinal symptoms, a sudden high temperature, an extremely high blood pressure, or convulsions.

Symptoms of an overdose include extreme dizziness or weakness, slow heartbeat or breathing, seizures, trouble breathing, and cold, clammy skin. Call your doctor right away if you notice these symptoms.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that can make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicine, other prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the medicines listed above while you are using this medicine.

This medicine may cause sleep-related breathing problems (eg, sleep apnea, sleep-related hypoxemia). Your doctor may decrease your dose if you have sleep apnea (stop breathing for short periods during sleep) while using this medicine.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

Using narcotics for a long time can cause severe constipation. To prevent this, your doctor may direct you to take laxatives, drink a lot of fluids, or increase the amount of fiber in the diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.

Dizziness, lightheadedness, or fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Also, lying down for a while may relieve the dizziness or lightheadedness.

This medicine may make you dizzy, drowsy, confused, or disoriented. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert.

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are using this medicine. Serious unwanted effects can occur if certain medicines are given together with meperidine injection.

Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there. These may be symptoms of a serious condition called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.

If you have been using this medicine regularly for several weeks or longer, do not suddenly stop using it without checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent worsening of your condition and reduce the possibility of withdrawal symptoms, such as abdominal or stomach cramps, anxiety, fever, nausea, runny nose, sweating, tremors, or trouble with sleeping.

Using this medicine while you are pregnant may cause neonatal withdrawal syndrome in your newborn babies. Tell your doctor right away if your baby has an abnormal sleep pattern, diarrhea, a high-pitched cry, irritability, shakiness or tremors, weight loss, vomiting, or fails to gain weight.

Using too much of this medicine may cause infertility (unable to have children). Talk with your doctor before using this medicine if you plan to have children.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Demerol?

You should not take Demerol if any of these conditions apply to you:

  • Known allergies to meperidine  
  • If you have short-term or severe asthma 
  • If you are currently undergoing monoamine oxidase inhibitor (MAOI) therapy (anti-anxiety treatment) or have taken MAOIs within the last 14 days
  • If you have gastrointestinal obstruction, including paralytic ileus

What Other Medications Interact With Demerol?

When taking Demerol, you must be aware that other medications or supplements can worsen your side effects or can increase the amount of meperidine in the body.

Do not take the following medications with Demerol:

Taking MAOIs or benzodiazepines with meperidine can cause life-threatening side effects such as difficulty breathing, unresponsiveness, and poor blood circulation. If you are taking an MAOI, you must wait at least 14 days after stopping it to start Demerol therapy. Conversely, you must wait 14 days after stopping Demerol to start an MAOI.

CYP3A4 is a protein that breaks down medications in the body. When this protein is blocked, the medication is not broken down and remains in the body. Therefore, combining a CYP3A4 inhibitor with meperidine will increase levels of Demerol in your body, potentially leading to more side effects.

Additionally, taking other drugs that affect serotonin can heighten the risk of serotonin syndrome, which can be potentially life-threatening. These include:

Other interactions may occur with Demerol. Before starting treatment, tell your healthcare provider about any other medicines you take or plan to take, including over-the-counter (OTC) nonprescription products, vitamins, herbs, supplements, and plant-based medicines.

What Medications Are Similar?

While Demerol is approved by the FDA to treat pain, it is not recommended to be used to treat short-term pain due to its high occurrence of adverse effects. Instead, other safer opioid medications are available that provide the same relief as Demerol.

Other medications similar to Demerol used to treat short-term pain include:

  • Morphine
  • Hydromorphone
  • Hydrocodone and acetaminophen 

This is a list of drugs also prescribed for short-term pain. It is NOT a list of drugs recommended to take with Demerol. You should not take these drugs together. Talk to your pharmacist or a healthcare provider about any questions

Frequently Asked Questions

  • Can I drink alcohol with Demerol?

    No, you should not drink alcohol while taking meperidine. Alcohol is a central nervous system depressant. Combining the two can cause life-threatening side effects, such as unconsciousness, difficulty breathing, and poor blood flow.

  • If I use meperidine, will I become addicted?

    Demerol is a controlled substance. This means it is possible to become dependent on it and misuse it, which can lead to overdose and death. You should take Demerol as directed by your healthcare provider. Contact your healthcare provider if you have any questions or concerns about the risk of addiction.

  • How long after taking Demerol will my pain go away?

    Demerol is a fast-acting medication, so you may start to feel its effects soon after the dose is given. However, its effects usually last about three hours or so.

How Can I Stay Healthy While Taking Demerol?

While OTC pain medications are available, sometimes you may need stronger medications like opioids to feel adequate relief. Despite the stigma opioids carry, they are sometimes appropriate and necessary. However, it's important to follow your healthcare provider's instructions carefully to ensure that you take them safely.

While OTC pain medications are available, sometimes you may need stronger medications like opioids to feel adequate relief. Despite the stigma opioids carry, they are sometimes appropriate and necessary. However, it's important to follow your healthcare provider's instructions carefully to ensure that you take them safely.

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Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

The author would like to recognize and thank Alexya Rosas for contributing to this article.

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It’s a little after 9 a.m. on a January morning and Joe Musgrove is floating face down, motionless in the deepest part of a giant swimming pool.

Five feet away, Fernando Tatis Jr. slowly sinks to the pool’s floor, arms outstretched. His long dreadlocks drift behind his swim cap.

The unquestioned leader and the alleged cheater, holding their breath together.

Tatis breaks the surface of the pool first, quickly drawing in air.

The process is one he’s familiar with: One second you’re floating, the next you’re fighting to breathe.

In the water, if you allow the past to weigh you down, you will drown. So the pitcher for whom accountability is a core tenet and who has shown up in some of the biggest moments of the last two seasons and the kid with immeasurable talent who has fallen from grace are equally buoyant.

The two teammates are pushing themselves physically and mentally in a weekly underwater training class taught by former Marine Raiders. As they compete against and work with the unforgiving foes of water and doubt, there is common ground in striving for growth.

Yes, the metaphors are thicker than the smell of chlorine at the Coggan Family Aquatic Center.

“He’s having to face something that he never has or never wanted to face,” Musgrove said of Tatis, who is attempting to turn the page on the darkest year of his young life. “But he’s handling it really well. He’s been around Petco [Park] every day and the work ethic he’s putting in, he’s going to be ready.”

Musgrove was arguably the most vocal player in calling out Tatis after he was suspended for a failed PED test last summer. Musgrove said at the time that Tatis had work to do to show how much he wanted to be part of the team; later, the pitcher said he was ready to move forward with his teammate.

“How you act and the actions that he takes moving forward,” Musgrove said in August, “is what’s going to dictate how long this thing stays around.”

The two had private conversations detailing not only the disappointment, but the comeback.

So, the significance of Musgrove’s words now — and of Tatis working alongside him this winter — runs deeper than the 13 feet to the bottom of the pool where the two Padres players spend a couple hours each Wednesday in a class designed to help participants deal with stressful and uncertain situations.

In this pool, last offseason, Musgrove learned to embrace and redirect fear. In October, facing playoff elimination, Musgrove controlled his emotions when an umpire rubbed his ears in front of 40,000 people with millions more watching on television.

This could also be where Tatis draws strength to endure the challenge that lies ahead in 2023.

“To slow down everything,” Tatis said, when asked what he believes underwater training will do for him. “Not even in the game. I feel like this year is gonna be a little bit wild — what is waiting for me out there. Just learn how to breathe and how to come back to the [peace] that water brings me.”

Padres stars working out together underwater as they prepare for highly anticipated 2023 baseball season.

Working back

The face of baseball was absent in 2022.

Tatis missed the first four-plus months of the season because of a wrist injury sustained in a motorcycle accident. He missed the final two months because of a suspension after testing positive for a performance enhancing drug.

In October, while his teammates rapturously sprayed one another with champagne, Tatis sat home soaked in regret.

He did not dance with Juan Soto nor smoke cigars with Manny Machado. He didn’t feel the euphoria that comes from contributing to such accomplishments.

Instead, Tatis experienced the loneliness of being on the outside.

“The fact that I wasn’t there in the playoffs, I feel like that was my depression,” Tatis said. “It was a hard moment. I’m not gonna say it wasn’t hard. [There were times] I didn’t want to [watch]. It’s really hard seeing your team go so deep in the playoffs and you can’t do nothing. It makes you feel like you aren’t part of it. It stabbed me straight to the heart. But you gotta remember that feeling and just put it into your work so you’re not going to get there again.”

Tatis faced his teammates Aug. 23, 11 days after his suspension was announced. He called it the most difficult moment he has experienced in the process.

“Seeing their faces, just how heartbroken they were,” Tatis said. “I feel like a different story could have been if I was on the field. I feel like that was a stab to the team. I was apart from them. It was the first time I ever felt that. I was really heartbroken. I’ve always been successful in this area and now for the first time, I really [messed] up. And I really felt that.”

Fernando Tatis Jr. walks across the bottom of a La Jolla pool while carrying weights, part of his offseason training program.

Fernando Tatis Jr. walks across the bottom of a La Jolla pool while carrying weights, part of his offseason training program alongside pitcher Joe Musgrove.

(Groundwork Promotions)

Remorse into redemption

In September, Tatis underwent shoulder surgery, something the Padres had encouraged a year earlier. Wrist surgery in October revised the initial procedure done seven months earlier. Much of Tatis’ winter was spent healing and rehabbing in the Dominican Republic while he remained in daily contact with at least one member of the Padres’ medical staff and/or front office. He returned to San Diego to train in early January, much earlier than usual.

Tatis, who turned 24 on Jan. 2, said his shoulder is fully healed.

“I’m glad I got it,” he said of the surgery, which he agreed to after the Padres strongly suggested it following his suspension. “It feels way better. [I am] way confident. I feel like I’m gonna have my swing 100% back this year.”

His wrist, he said, is close to fully healed. He began hitting this week.

“It feels good,” he said. “I feel way more confident [compared] to last time. I feel like this time they got it right. ... It didn’t get healed right the other time. It was like 25%. This time, the last time we checked it was 90% healed. So it’s way better.”

Tatis said he will be full-go for spring training. He can participate in workouts and games through camp and then will serve the remaining 20 games of his 80-game suspension. He is scheduled to be reinstated April 20, when the Padres open a series in Arizona.

“I’m really excited,” Tatis said. “I feel like this is one of the years there’s gonna be more emotion and I’m definitely looking forward to it. I’m definitely looking forward to just being back on the field.”

He was asked whether he thinks, considering the period in which he has had to sit, that it might take time to get back to being the same player who has batted .292 and hit a home run every 12.8 at-bats in his career.

“I don’t think so,” he said, shaking his head at the suggestion. “To me it’s just baseball. This is the thing that I’ve been doing since I had memory. The same time I learned how to walk, I was swinging a bat. On the baseball side, I’m definitely not scared of what’s going to happen or how my body is going to react. I mean, I had one arm the last year I was healthy and I still found a way to play baseball in the best way possible.”

Tatis appears healthy, strong. He maintains a quiet focus in the pool but every so often allows for a moment of laughter, his head bobbing backward, his eyes mischievous. That’s when it shows — the assuredness that has been so much a part of his ability from the start.

In many ways, he appears the same fun-loving kid Padres fans adored even before they got to see him up close. The one with the big smile and the bat flips. The one who hits missiles to the seats and does a stutter-step just before the final 90 feet of his home run jog.

On a recent morning, Tatis’ voice was most alive as he described being on the field again.

“I definitely miss that,” he said. “Hitting a home run, jogging around third base, I definitely miss it.”

It’s also clear he is readying himself mentally, preparing for the boos and the derisive talk and whatever else will come.

“I’ve seen baseball all my life,” Tatis said. “From the inside of the field, from the outside of the field. I know what people are gonna talk about out there and what people are gonna be talking about on the field. It depends on me — how I’m gonna approach it, how I’m gonna take it. And it’s gonna be up to me if I’m going to answer back. ... The answer is gonna go out by itself. It’s going to be just me playing and being back on the field.

“You can’t be loved everywhere. I’m definitely going to look forward to those boos and to the applause.”

It’s most important to him, he said, to stay healthy the entire season. Tatis has played just 273 big league games in his four-year career. In February 2021, he agreed to a $340-million extension through 2034.

“When I signed the contract, I assigned myself to being on that field for 14 years,” Tatis said. “So I feel like that’s what we need to do — be on the field for the years we [set out] for.”

Padres pitcher Joe Musrgove, center, has been joined underwater by teammate Fernando Tatis Jr., far left.

Padres pitcher Joe Musrgove, center, has been joined underwater by teammate Fernando Tatis Jr., far left.

(Groundwork Promotions)

Facing the challenge

The pool workout is more than 30 minutes in when one of the instructors announces the final “warmup” exercise. The morning has already seen the participants hold their breaths for intervals of 15, 30 and 50 seconds before a fourth time in which they remained submerged for as long as they could.

Musgrove, who at his peak last winter held his breath for 4 minutes 2 seconds, reached 3:20 on a recent Wednesday. Tatis, who could hardly go 50 seconds when he first showed up, reached 1:45.

The class, run by Deep End Fitness, opens with a “circle of trust” where participants perform breath work before outlining accountability goals and individual intentions for that day’s effort. Once in the pool, the emphasis turns to relaxation techniques and mentally resetting under duress. (Translated to baseball-speak: Learning to truly flush the last play or the last pitch.)

The final warmup is called “drown-proofing.” Swimmers hold their hands behind their back and keep their feet together, as if tied. They perform 10 repetitions, dropping to the bottom of the pool and bobbing back up.

The key is to exhale before descending in order to sink faster.

“Work with the voice trying to limit you,” instructor Prime Hall tells his class, which on this Wednesday consists of a pair of professional baseball players, two mixed martial arts fighters and a professional rugby player. “Don’t block it out.”

The bulk of the workout consists of a series of swims and underwater walks while carrying dumbbells, including one impromptu race between Tatis and Musgrove.

“All that speed on land means nothing in here,” Musgrove called to Tatis.

Tatis grinned. “All right, let’s go,” he said before dipping underwater, grabbing his weights and taking strong, quick strides on his way to victory.

Hall and fellow instructor Rick Briere served together in Afghanistan. They push their students to places once perceived as impossible. The physical pressure is inherent; the emphasis is on mental fortitude.

“Every rep that you go underwater, you’re training yourself to intentionally go against what your mind is telling you to do from a survival perspective,” Hall said. “You’re focusing beyond that. You’re training your mind, every time it’s in limbic friction or mental friction, or whatever it is where you don’t want to do something, to say, ‘No, this is what we’re doing. This is a nonnegotiable. I’m in control.’”

Briere explained Tatis’ improvement underwater this way: “It’s the pressure of performance — thinking, ‘I have to get to 2 minutes.’ Now, you’re increasing your body’s demand for air supply. And you’re out of breath, so you don’t breathe freely. It makes it a lot harder. The more they learn to relax, the longer they can go.”

Tatis first worked with Deep End Fitness last season as he underwent rehabilitation from his initial wrist surgery. Lately, he’s been a regular with Musgrove.

As someone who grew up swimming in the warm, clear Caribbean Sea off the Dominican Republic, Tatis finds peace in water. It’s a sanctuary, a part of his identity.

“I’m from the island,” Tatis said as he sat on a bench after class, squeezing droplets from his hair. “I just need to be in the water. I feel part of it. I love the silence it brings me.”

As he seeks the calm and consistency necessary to maintain excellence over the course of a baseball season, Tatis will return to the things he’s learning in the pool. He will try to draw strength from the scars.

“He’s been leaning in, being in those uncomfortable situations and working through them,” Hall said. “He’s been working hard.”

Musgrove has been impressed.

Tatis has, according to some in the organization, held himself apart in some ways in the past. To some extent, it was a natural reaction to a meteoric ascension as not only his team’s biggest star but one of the most popular players in Major League Baseball. The team essentially demanded after the suspension that, going forward, Tatis be more communicative and amenable.

“Being the superstar and the face of baseball is a lot to take on,” Musgrove said. “So he hasn’t put himself out there a ton in the past. And I feel like now you’re starting to see a little bit more of him open up.”

Tatis is moving forward, focused on next steps and appreciative of those walking with him.

“You want to flip that page,” he said, “But you also want to remember what took you to those down [places] so you don’t do that again. … We gotta face whatever comes. It’s life. It’s part of it. We can never be afraid. If we’re afraid we’ll be stuck in the same part, so just look to the challenge and just stab it right in the throat.”

Tatis has little doubt this season is going to be a kind of challenge he has not yet experienced.

He was asked whether what he lost — in terms of respect in the game and love in the stands — is recoverable. He paused before answering.

“Yes,” he says. “All of it. All of it.”

He will attempt that the only way possible: One breath at a time.

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Contrive Datum Insights Pvt Ltd

Contrive Datum Insights Pvt Ltd

According to a market research study published by Contrive Datum Insights, North America held a 38.5% market share worldwide, the Asia-Pacific region is anticipated to expand at a rapid rate.

Farmington, Jan. 27, 2023 (GLOBE NEWSWIRE) -- The global Physiotherapy Equipment market size was valued at USD 19.1 Billion in 2022. It is expected to expand at a CAGR of around 6.69% from 2023 to 2030. The frequency of automobile accidents and injuries, along with the expansion of rehabilitation clinics, are projected to raise the demand for physiotherapy devices. Inappropriate dietary practises and a hectic lifestyle can cause discomfort in the ligaments, nerves, muscles, back, and neck. Stroke and Parkinson's disease are also on the rise, which is anticipated to fuel market growth.

Request Sample Copy of Report “Physiotherapy Equipments Market - Global Industry Analysis, Size, Share, Growth Opportunities, Future Trends, Covid-19 Impact, SWOT Analysis, Competition and Forecasts 2022 to 2030”, published by Contrive Datum Insights.

Due to the growing benefits of physical therapy, physicians have begun recommending it to patients. This has led to an increase in demand for physical therapy equipment. Physiotherapy, commonly known as "physical therapy," is a treatment that tries to improve and restore the body's normal function. It employs a number of technologies and techniques to help people maintain excellent health and recover rapidly from medical difficulties.

Physiotherapy Equipments Market Recent Developments:

  • In February 2022, Colfax Corporation (US) announced the renewal of its partnership with the Professional Football Athletic Trainer Society (PFATS, US), allowing the firm to continue endorsing and recommending its products to certified athletic trainers.

  • BTL Industries (UK) bought Schepp MedTech in January 2022. (US). This acquisition was made to add robots to BTL's already-extensive line of physiotherapy products.

  • Zynex, Inc. (US) announced the release of Post-operative and OA (Osteoarthritis) knee braces in January 2022. Knee braces can prevent wear and tear on the problematic joint, allowing inflammation to subside and reducing pain/degeneration of the damaged knee joint, therefore delaying or reducing the need for surgery.

Physiotherapy Equipments Market Segmentation Analysis:

In 2021, thermoelectric stimulation was the second largest market. Electrical stimulation therapy is typically used to aid in the recovery of patients suffering from a stroke, cerebral palsy, multiple sclerosis, or Parkinson's disease. Companies such as Ottobock, Bioness, and WalkAide produce functional electrical stimulators. Pain and neurological disorders are getting more prevalent, which should aid the segment's growth.

As developing nations such as China, India, Brazil, etc. become more receptive to physical therapy services, it is anticipated that the cardiovascular and pulmonary segment will expand significantly in the coming years. In 4% of high-income nations and 42% of low-income nations, heart disease is the leading cause of early death. People with pulmonary fibrosis, heart valve replacement, post-coronary bypass surgery, and coronary stent implantation can benefit from physical therapy.

The largest market share was held by hospitals and clinics since they saw the most patients and participated in the most programmes. In addition, because physiotherapy equipment is so costly, the majority of patients choose to receive care in hospitals or clinics that treat a variety of illnesses.

Regional Outlook:

North America held a 38.5% market share worldwide. This was the result of an increase in accidents and mishaps, osteoporosis, and the ageing of the population. Additionally, the market is expanding since there are more hospitals and people who give care at home for recovering patients. In addition, the number of persons with chronic conditions such as Parkinson's, strokes, paralysis, and spinal injuries is predicted to climb, resulting in an increase in the demand for physiotherapy.
During the predicted time period, the Asia-Pacific region is anticipated to expand at a rapid rate. The Asia-Pacific market is anticipated to expand because insurance coverage for physical therapy is improving, the population is ageing, and the number of individuals with degenerative neurological, cardiovascular, respiratory, and musculoskeletal problems is rising.

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Scope of Report:

Report Attributes


Growth Rate

6.69% from 2023 to 2030

Market Size in 2022

USD 19.1 Billion

By Type

Cryotherapy, Hydrotherapy, Electrotherapy, Continuous Passive Motion Units, Multi-exercise Therapy Unit, Heat Therapy, Ultrasound Physiotherapy, Other Therapy Types

By Applications

Neurological, Musculoskeletal, Cardiovascular and Pulmonary, Others

By End User

Hospitals, Rehabilitation Centers/Clinics, Homecare Settings

By Companies

BTL, EMS Physio Ltd., Dynatronics Corporation, RICHMAR, Performance Health, Storz Medical AG, Zimmer MedizinSysteme GmbH, ITO Co., Ltd., Enraf-Nonius B.V., Whitehall Manufacturing, and Others

Base Year


Historical Year

2017 to 2021

Forecast Year

2023 to 2030

Market Drivers:

Biomarkers, also called genomic markers, are unique molecules like nucleic acids (such as DNA and microRNA or mRNA) that can be found in body fluids and tissues and measured. Through molecular profiling at the epigenetic, genetic, and protein levels, biomarkers can be a reliable, specific way to learn about the properties of a disease and how it reacts to a drug. Biomarker analysis is currently used in diagnostic testing, tracking the effects of treatments, and making new drugs (especially for cancer or cardiovascular diseases). qPCR and dPCR are used in biomarker analysis to find and measure the amount of genetic material in isolated samples.

Market Restraints:

Typical qPCR/dPCR methods have a number of technical problems, such as measuring the signal during the exponential phase of the PCR reaction, having to optimise and validate assay procedures, having reaction inhibitors make it hard to find the target, and failing because the nucleotide templates aren't good enough. Unable to detect target molecule. Also, qPCR and dPCR reagents have a few problems that make it hard to use them in genomic research. For example, they chemically bind to dsDNA (SYBR green dye), they can't measure DNA quality (AluQuant), and they use chemicals that can cause cancer (Yield gel).

Market Opportunity:

Drug candidates made from plants that are used to treat diseases often come from chemically similar natural product classes that have almost the same biological effects and often have the same side effects, contraindications, dosage limits, and sites of action. Also, the biological sites of action of these natural products may not be known. This means that their biological effects and side effects may be hard to predict. Gene-based drug candidates with known sites of action can make up for the problems with plant-based drugs (specific genes or proteins).

Physiotherapy Equipments Market Key Segments Covered:

Top Market Players:
BTL, EMS Physio Ltd., Dynatronics Corporation, RICHMAR, Performance Health, Storz Medical AG, Zimmer Medizin Systeme GmbH, ITO Co., Ltd., Enraf-Nonius B.V., Whitehall Manufacturing, and Others.

By Type:

By Application:

By End-User:

Regions and Countries Covered

  • North America: (US, Canada, Mexico, Rest of North America)

  • Europe: (Germany, France, Italy, Spain, UK, Nordic Countries, Benelux Union, Rest of Europe)

  • Asia-Pacific: (Japan, China, India, Australia, South Korea, Southeast Asia, Rest of Asia-Pacific)

  • The Middle East & Africa: (Saudi Arabia, UAE, Egypt, South Africa, Rest of the Middle East & Africa)

  • Latin America: (Brazil, Argentina, Rest of Latin America)

  • Rest Of the World

Check out more related studies published by Contrive Datum Insights:

  • Hybrid-Electric Passenger Jet Market – The global Hybrid-Electric Passenger Jet Market is projected to grow at a CAGR of 9.5% during the forecast period from 2022 to 2030. Asia Pacific market accounted for the largest revenue share of over 40% in 2019 and is expected to continue to dominate during the forecast period. Commercial aviation activity in the region has been growing rapidly owing to rising passenger traffic, which in turn is expected to increase the demand for hybrid-electric passenger jets. China and Japan rank in the top five for both domestic and international travel.

  • Self-Balancing Electric Vehicles Market – The Global Self-Balancing Electric Vehicles Market Is Estimated To Be USD 41.5 Billion In 2022, At A CAGR Of 36.9% During The Forecast Period From 2022 To 2030. North America is expected to grow at the highest CAGR during the forecast period due to the well-developed transportation infrastructure in the region with advanced technology compared to developing countries such as APAC or MEA.

  • Electric Low Speed Vehicles (LSV) Market – The Electric Low-Speed Vehicles (LSV) Market size reached US$ 3.94 Billion in 2022, at a CAGR of 15.01% during the forecast period. North America had the highest share of the global low speed electric vehicle market. The North American (NA) market trend and outlook is forecast in an optimistic, balanced and conservative view while considering COVID-19. Europe is the second largest market for low-speed electric vehicles in the world.

  • Electric Drone MarketThe Electric Drone Market size was valued at USD 18.15 Billion in 2022 and is projected to reach USD 28.87 Billion by 2030, growing at a CAGR of 5.3% from 2022 to 2030. North America is a key market for electric drones, as extensive investments by the US government and regional defense authorities have led to the development of small, lightweight, and efficient electric drones. The North American market is primarily driven by the growing use of electric drones in military operations and increasing surveillance applications.

Customization of the Report: The report can be customized as per client needs or requirements. For any queries, you can contact us at [email protected] or +1 215-297-4078. Our sales executives will be happy to understand your needs and provide you with the most suitable reports.

About Us:
Contrive Datum Insights (CDI) is a global delivery partner of market intelligence and consulting services to officials in various sectors such as investment, information technology, telecommunication, consumer technology, and manufacturing. CDI assists investment communities, business executives, and IT professionals to undertake statistics-based accurate decisions on technology purchases and advance strong growth tactics to sustain market competitiveness. Comprising of a team size of more than 100 analysts and cumulative market experience of more than 200 years, Contrive Datum Insights guarantees the delivery of industry knowledge combined with global and country-level expertise.

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The organization filed a complaint with the United State Department of Agriculture's (USDA) Animal and Plant Health Inspection Service (APHIS) claiming that NEOMED subjects pigs to over 29 open and laparoscopic procedures to train surgeons.


A non-profit organization based in Rootstown Ohio is criticizing Northeastern Ohio Medical University (NEOMED) for using live animals in what they consider to be "deadly" training exercises.

According to a news release from the non-profit known as the Physicians Committee for Responsible Medicine, billboards have been installed in multiple northeast Ohio communities including Youngstown on I-680 near Glenwood Avenue reading "Ohio: Does your doctor think you're a pig?" 

The organization filed a complaint with the United State Department of Agriculture's (USDA) Animal and Plant Health Inspection Service (APHIS) claiming that NEOMED subjects pigs to over 29 open and laparoscopic procedures to train surgeons.

According to the complaint, these exercises include incisions to remove the gallbladder, drain air, blood or other fluids, remove the kidney, allow for access to the heart and for the insertion of a breathing tube into the wind pipe.

The organization went on to state that under the Animal Welfare Act, researchers and course instructors must consider alternatives to procedures that may cause more than momentary or slight pain or distress to an animal.

21 News reached out to NEOMED for comment and the university's Vice President for Communications and Chief Marketing Officer, Roderick Ingram Sr. said NEOMED is very limited in its uses of the animals and that when they do use animals, anesthesia is used to minimize pain and distress.

The full statement reads as follows:

"Northeast Ohio Medical University develops programs to help create transformational health professionals and improve health through education, discovery and service. Our students receive basic and clinical science education that combines with leadership training and field experience (clinical rotations) to prepare them as future health professionals who bring positive change to people's lives."

"Such experiences and observances are complemented by their work with cadavers and stimulated patients. NEOMED does not use live animal laboratories in our medicine and pharmacy curriculum."

"NEOMED is a regional health care training facility accredited by the Association for Assessment and Accreditation of Laboratory Animal Care International (AAALAC)."

"NEOMED operations are consistent with the National Research Council Guide for the Care and Use of Laboratory Animals, the Animal Welfare Regulations (AWR) promulgated by the United States Department of Agriculture (USDA) and the Public Health Service (PHS) policy on humane care and use of laboratory animals."

"NEOMED facilitates a very limited number of surgical training training laboratories for a regional hospital's fully accredited residency program that includes this training with their surgeons who will conduct advanced surgical techniques on patients."

"Every animal used in the training receives humane, high-quality care, including the use of anesthesia with ongoing monitoring to prevent pain and distress in surgery."

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The results of an international study showed that visual quality decreased postoperatively in all patients.

An international team of researchers reported that atropine instillation should be discouraged as a standard therapy after trabeculectomy because of the resultant greater and longer lasting reduction in visual quality.1

Panagiotis Laspas, MD, from the Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany, was the lead study author.

The investigators explained that atropine has cycloplegic and mydriatic properties, the latter of which that can cause multiple visual side effects,2 including disrupted accommodation, blurred vision, haloes, and light sensitivity. The potential systemic absorption of the drug ca affect the cardiovascular system,3 causing dysrhythmias, and affect patients’ mental state, causing confusion, restlessness, and emotional lability.4

They conducted a prospective randomized study of 40 patients who underwent standard trabeculectomy with mitomycin C at the Department of Ophthalmology Department, University Medical Center of Mainz. Postoperatively, all patients received ofloxacin and dexamethasone eye drops.

The patients then were randomly assigned into 2 groups of 20 patients each; 1 group (the intervention group) also received atropine eye drops postoperatively and were instructed to instill the drops 3 times daily for 2 days to stabilize the anterior chamber. All patients completed a visual quality questionnaire preoperatively and 2 and 6 weeks postoperatively.

The results showed that visual quality decreased postoperatively in all patients.

“Patients who received atropine eye drops described a greater and longer-lasting reduction in visual quality than those who did not receive atropine eye drops,” the authors wrote. “Trabeculectomy often leads to a transient reduction in visual quality. This reduction was greater in severity and duration in patients who received postoperative atropine eye drops.”

Based on the results, the investigators suggested that “unless there is an underlying medical necessity, we would discourage the application of atropine as a standard therapy for trabeculectomy surgery.”


1 Laspas P, Maier E, Schuster A, et al. Effects of postoperative atropine eye drops on visual quality in patients undergoing trabeculectomy. J Clin Med. 2023;12:763; https://doi.org/10.3390/jcm12030763

2 Joachimsen L, Farassat N, Bleul T, et al. Side effects of topical atropine 0.05% compared to 0.01% for myopia control in German school children: A pilot study. Int Ophthalmol. 2021;41:2001–8.

3 Merli GJ, Weitz H, Martin JH, et al. Cardiac dysrhythmias associated with ophthalmic atropine. Arch Intern Med. 1986;146:45–7.

4 Jimenez-Jimenez FJ, Alonso-Navarro H, Fernandez-Diaz A, et al. Neurotoxic effects induced by the topical administration of cycloplegics. A case report and review of the literature. Rev Neurol. 2006;43:603–9.

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Source: Christian Álvarez/Pexels

When dogs have flat, squashed faces (known as brachycephaly), many of them will have health issues and can even struggle to breathe. Now veterinarians at the World Small Animal Veterinary Association are alerting people to what they say is a “canine welfare crisis” because of how popular these breeds are.

Common brachycephalic breeds include the French Bulldog, Pug, and English Bulldog. French Bulldogs and Bulldogs are amongst the most popular dog breeds in the US, according to the American Kennel Club. In the UK, the French Bulldog, Bulldog, and Pug all featured in the top 10 dog breeds in 2021, while the French Bulldog is in Canada’s top 10. That means there are a lot of dogs with these features, and WSAVA has released a video to tell people about the risks.

Flat-Faced Dogs Struggle to Breathe

Some of these dogs have very tiny nostrils or narrow windpipes; the eyes and teeth are also often affected. Although dogs with extremely flat faces can have many health issues as a result of their breeding, perhaps the biggest concern is BOAS (Brachycephalic Obstructive Airway Syndrome). This disorder means they cannot breathe properly, and as a result, many may need surgery or have a shortened lifespan.

Unfortunately, although many people notice that their brachycephalic dog makes a lot of snuffling, snorting, and snoring sounds or has to breathe through their mouth, they think it is “normal for the breed.” This means they don’t realize that their pet has a serious medical issue—and they may even find it “cute.”

In the video, Peter Sandøe, Director of the Centre for Companion Animal Welfare at the University of Copenhagen, says:

With French Bulldogs now the most popular breed in many countries and with English Bulldogs and Pugs also very popular, the number of affected dogs is increasing dramatically. Selective breeding for an exaggerated short nose has created dogs whose health, in many cases, is compromised for the sake of perceived ‘cuteness’. It is simply unethical to breed dogs which struggle to breathe.

Flat-Faced Dogs: A Problem for Many

The obvious solution is for breeders to stop breeding dogs with such extreme features. The WSAVA says that these dogs are so popular that in many countries, only a minority of puppies of these breeds are bred through a breeder who registers puppies with the relevant kennel club. This means the kennel clubs alone can’t make a difference (although, obviously, they can help). So the WSAVA is asking breeders, vets, journalists, and dog guardians to work together to solve the crisis.

Although BOAS is related to the dog’s conformation, it’s not possible to tell just from looking, exactly which dogs will have difficulty breathing and which ones won’t. Breeders can get a test of respiratory function for any dog they plan to breed from and should only breed from those who pass. WSAVA says that an alternative if such a test isn’t available, is to only breed from dogs if they are able to take a brisk walk for three minutes without having any issues with their breathing.

It’s a complex problem because of the many factors involved. Due to their popularity, brachycephalic breeds are often used in advertising, likely encouraging more people to get these breeds. In the UK, the British Veterinary Association has a campaign to get advertisers to stop using brachycephalic breeds. Another issue is that because selling puppies is a big business, in some cases, there are also criminal gangs involved, according to a recent BBC investigation in the UK. So sadly, some people breeding puppies don't have the pups' best interests at heart.

Tips for Choosing a Brachycephalic Breed

What about people who want a French Bulldog or other brachycephalic breed? One thing to look for is a breeder whose dogs have less extreme features. There is some variability in the snout length, and it’s best to avoid the flattest faces.

People should also ask about the health tests that have been done prior to breeding and find out which tests are recommended for that specific breed. In particular, when picking a brachycephalic puppy, make sure the parent dogs can both take that fast walk without issues. If the parents struggle to breathe, their puppies will likely too.

There are plenty of alternatives to the French Bulldog (and you can find some other tips on getting a puppy here). It’s also possible to find French Bulldogs and other brachycephalic breeds in shelter and rescue, though you will probably have to be quick when they become available.

I am sure dog guardians would agree with veterinarian Jane Ladlow of the BOAS Research Group at Cambridge Veterinary School, UK, when she says in the video,

"Dogs should be able to run outside without laboured breathing, eat without gasping for breath and sleep without obstructing."

Hopefully, increased awareness will lead people to pick dogs with less extreme features.

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Martin Roberts, a 59-year-old home renovation expert, recently took to Twitter to express his gratitude for the support he received during a health scare last spring. He had been rushed into surgery due to a serious condition known as pericardial effusion, which is a build-up of fluid in the structure around the heart. Martin was back on screens this week for new episodes of Homes Under The Hammer and wore a bright shirt as a way of saying thank you for all the support he received. He thanked those who stood by him during this difficult time, expressing how much it meant to him. He also told viewers that the episode which went out yesterday was the first one he filmed after his health scare. Symptoms of pericardial effusion include shortness of breath, chest pains, discomfort when breathing, feeling light-headed or swelling in the abdomen or legs. In severe cases, surgery may be required to drain the excess fluid. Martin had to undergo surgery as the fluid build-up had placed too much strain on his heart and caused organ failure. He now wants to take better care of himself and adjust his busy work schedule.
Martin Roberts, a 59-year-old home renovation expert, recently shared an emotional display of support on Twitter after returning to screens for new episodes of Homes Under The Hammer. He had been rushed into surgery last spring due to a serious health scare caused by pericardial effusion, a condition in which excess fluid builds up in the sac around the heart. To show his appreciation for the support he received during this difficult time, Martin wore a bright shirt on the show as a way of saying thank you. He expressed his gratitude to those who stood by him and reminded viewers that the episode which aired yesterday was the first one he filmed after his health scare. Symptoms of pericardial effusion include shortness of breath, chest pains, discomfort when breathing, feeling light-headed, and swelling in the abdomen or legs. In severe cases, surgery may be required to drain the excess fluid. Martin had to undergo surgery as the fluid build-up had placed too much strain on his heart and caused organ failure. To ensure his health and wellbeing, Martin now wants to take better care of himself and adjust his busy work schedule.

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This air travels to the alveoli, the small cavities located at the end of the bronchioles that are responsible for allowing gas exchange between air and blood.

In the case of atelectasis, these small air sacs deflate and cannot inflate properly and/or absorb enough air and oxygen.

If the disease affects a large enough area, the blood may not receive enough oxygen, which can trigger various health problems.

Generally, it is not life-threatening, but in some cases it must be treated quickly.


Atelectasis: what it is

Atelectasis is one of the most common respiratory complications after surgery.

It is also a possible complication of other respiratory problems, including cystic fibrosis, lung tumours, chest lesions, fluid in the lungs and respiratory weakness.

Atelectasis can make breathing difficult, particularly if one already suffers from lung disease.

Treatment depends on the cause and severity of the collapse.

Pulmonary atelectasis, symptoms

What are the signs and symptoms? If atelectasis only affects a small area of the lungs, the person may not even have any symptoms.

But if it affects larger areas, the lungs cannot fill with enough air and the oxygen level in the blood may decrease.

When this happens, annoying and unpleasant symptoms may occur, including:

  • difficulty breathing (shortness of breath; rapid, shallow breathing; wheezing);
  • increased heart rate;
  • coughing;
  • chest pain;
  • bluish discolouration of the skin and lips.

If you experience these symptoms and have difficulty breathing, you should consult your doctor for diagnosis and treatment.

Keep in mind that other conditions, including asthma and emphysema, can also cause chest pain and breathing problems.

Why a lung can collapse

Atelectasis can be triggered by many factors: potentially, any condition that makes it difficult to take deep breaths or cough can lead to a collapsed lung.

Atelectasis can result from airway obstruction (called obstructive atelectasis) or from pressure from outside the lung (non-obstructive atelectasis).

The most common reason for people to develop this disease is surgery.

It must be known that anaesthesia can affect the patient’s ability to breathe normally or cough as it changes the normal breathing pattern and affects lung gas exchange.

All this can cause the air sacs (alveoli) to deflate.

In addition, the pain that is often experienced following surgery may make deep breathing painful: as a result, one may be inclined to adopt continuous shallow breathing, which may favour the development of the disease.

This explains why almost everyone who has undergone major surgery develops a more or less severe form of atelectasis.

Other possible causes of this pathology are:

  • thoracic trauma, e.g. a fall or a car accident, which prevent one from taking deep breaths (due to pain), which can cause compression of the lungs;
  • pressure at the level of the chest: pressure exerted on the lungs, which may depend on a tumour mass outside the bronchus, on a tumour inside the bronchus, which causes airway obstruction. In fact, if air cannot get past the blockage present, the affected part of the lung may collapse;
  • accumulation of mucus in the airways, which may cause a blockage in the airflow. This event commonly occurs during and after surgery because coughing is not possible in such cases. In addition, drugs administered during surgery cause people to breathe less deeply, so normal secretions collect in the airways. Suctioning the lungs during surgery helps to clear them, but sometimes it is not enough. Mucus plugs are also common in children, people with cystic fibrosis and during severe asthma attacks;
  • inhalation of small objects, such as a peanut, the cap of a biro, a small toy, which prevent air from flowing freely;
  • other lung diseases, such as pneumonia, pleural effusions (fluid around the lungs) and respiratory distress syndrome (RDS).

Atelectasis is not to be confused with pneumothorax, another condition that commonly causes a collapsed lung.

It is the presence of air between the lung and chest wall.


Atelectasis, the risk factors

Factors that increase the likelihood of developing this disease include:

  • advanced age
  • any condition that makes swallowing difficult;
  • bed confinement with rare changes of position;
  • lung disease, such as asthma, COPD, bronchiectasis or cystic fibrosis;
  • recent abdominal or thoracic surgery;
  • recent general anaesthesia;
  • weak respiratory muscles due to muscular dystrophy, spinal cord injury or another neuromuscular condition;
  • use of drugs that may cause shallow breathing;
  • pain or injuries that may make it painful to cough or cause shallow breathing, including stomach pain or rib fracture;
  • cigarette smoking.

What is involved in atelectasis

A small area of atelectasis, especially in an adult, is usually curable.

However, one should be aware that this disease can give rise to the following complications

  • a low level of oxygen in the blood (hypoxemia). Atelectasis makes it more difficult for the lungs to carry oxygen to the air sacs (alveoli) and thus to the rest of the body;
  • pneumonia: the risk of pneumonia continues until the atelectasis disappears. This is because the presence of mucus in a collapsed lung can lead to infection;
  • respiratory failure: the loss of a lobe or an entire lung, particularly in an infant or in people with lung disease, can be life-threatening.

Prevention of post-surgery atelectasis

Some research suggests that performing deep breathing exercises and muscle training may reduce the risk of developing atelectasis after surgery.

In addition, many patients in hospital are given a device called an incentive spirometer that can encourage them to take deep breaths, thus preventing and treating atelectasis.

If you smoke, you can reduce your risk of developing the condition by stopping smoking before any operation.

Atelectasis in children is often caused by an airway blockage.

In such cases, to reduce the risk of atelectasis, keep small objects out of reach of children.


Read Also

Emergency Live Even More…Live: Download The New Free App Of Your Newspaper For IOS And Android

Benefits And Risks Of Prehospital Drug Assisted Airway Management (DAAM)

Blind Insertion Airway Devices (BIAD’s)

Pulmonological Examination, What Is It And What Is It For? What Does The Pulmonologist Do?

Oxygen-Ozone Therapy: For Which Pathologies Is It Indicated?

Hyperbaric Oxygen In The Wound Healing Process

Venous Thrombosis: From Symptoms To New Drugs

Prehospital Intravenous Access And Fluid Resuscitation In Severe Sepsis: An Observational Cohort Study

What Is Intravenous Cannulation (IV)? The 15 Steps Of The Procedure

Nasal Cannula For Oxygen Therapy: What It Is, How It Is Made, When To Use It

Pulmonary Emphysema: What It Is And How To Treat It. The Role Of Smoking And The Importance Of Quitting

Pulmonary Emphysema: Causes, Symptoms, Diagnosis, Tests, Treatment

Extrinsic, Intrinsic, Occupational, Stable Bronchial Asthma: Causes, Symptoms, Treatment

A Guide To Chronic Obstructive Pulmonary Disease COPD

Bronchiectasis: What Are They And What Are The Symptoms

Bronchiectasis: How To Recognise And Treat It

Pulmonary Vasculitis: What It Is, Causes And Symptoms

Bronchiolitis: Symptoms, Diagnosis, Treatment

Chest Pain In Children: How To Assess It, What Causes It

Bronchoscopy: Ambu Set New Standards For Single-Use Endoscope

What Is Chronic Obstructive Pulmonary Disease (COPD)?


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The latest published research the “Mechanical Ventilators Market” report provides the overall growth and business outlook of the global industry. The assessment presented in the Coherent Market Insights research report gives thorough data and analysis of major important facets such as growth drivers, challenges, restraints, present and historical trends, and growth opportunities in the market. The report research covers valuable information on the business with insights, applications, and the industrial chain structure. And this adding report provides market sizing and forecast across the globe. It helps organization leaders make better decisions when currency exchange data is readily available. Additionally, it contains knowledge of the worldwide market competition landscape, development status, segments, and sub-segments of an industry that influence the growth scenario of the present market.

Mechanical ventilators are machines that assist patients in breathing during surgery or critical illness. Mechanical ventilators are mostly found in hospitals and transportation systems like medical evacuation air transport and ambulances. Being on a ventilator for an extended period of time can increase the risk of pneumonia as well as other risks such as vocal cord damage. Ventilators are used when there is respiratory failure or difficulty breathing. When a person is unable to breathe properly, his or her body organs do not receive enough oxygen to function properly, and too much carbon dioxide can accumulate in the blood, which must be expelled. Acute respiratory distress syndrome, asthma, a head injury, cardiac arrest, and other conditions.

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  • General Electric Company
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  • ZOLL Medical Corporation
  • Koninklijke Philips N.V.
  • Fisher & Paykel Healthcare Limited
  • ResMed
  • Max Ventilator (A.B.Industries)
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  • Inovytec
  • InnAccel Technologies Pvt Ltd.
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☑ North America (United States, Canada, and Mexico)
☑ Europe (Germany, France, UK, Russia, and Italy)
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☑ South America (Brazil, Argentina, Colombia, etc.)
☑ The Middle East and Africa (Saudi Arabia, UAE, Egypt, Nigeria, and South Africa)

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