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December 01 2014


Ambulance Risk

In most cases, a 911 dispatcher will have sent an advanced life support, or ALS, ambulance to the scene, equipped with sophisticated gear and staffed with a crew of highly trained paramedics who can deliver specialized care in the field, including intubations and IV interventions. Unfortunately, according to a new study by health policy researchers at Harvard, those advanced techniques actually increase the patient's risk of death. People with out-of-hospital cardiac arrest who were treated by an ALS ambulance are more likely to die and to have poor neurological outcomes than those treated by basic life support, or BLS, ambulances, which use less-sophisticated treatment techniques, the study finds. The results are published today in JAMA Internal Medicine. "Our study suggests BLS saves more lives than ALS, and therefore, the principles of BLS should be a priority for treating and transporting out-of-hospital cardiac arrest patients," said Prachi Sanghavi, a PhD student in the Evaluative Science and Statistics concentration of the Harvard Program in Health Policy, and lead author of the study. BLS ambulances provide a more limited set of treatments in the field and instead focus on rapidly transporting patients to the nearest emergency department. For example, instead of waiting to intubate a patient, they might provide air using a simple, hand-pumped ventilation bag. "We know that community training, rapid and appropriate delivery of pre-hospital care, and high-quality hospital cardiac care may substantially improve these survival rates," said study author Alan Zaslavsky, professor of health care policy at Harvard Medical School. "This study provides important insight about the choice between providing more care in the field and bringing patients as quickly as possible to hospital treatment." Since the 1970s, ALS has grown to become the predominant form of care for cardiac arrest and other medical emergencies in the US, but there is little evidence that ALS saves lives compared with BLS, and some research has suggested that the treatments and additional time associated with ALS may harm patients. In the current study, the researchers found that patients who received BLS instead of ALS were more likely to survive to hospital discharge, to 30 days, and to 90 days. Of an estimated 380,000 cases of out-of-hospital cardiac arrest annually, 90 percent do not survive to hospital discharge, the researchers said. But at 90 days, BLS patients were nearly 50 percent more likely to survive than ALS patients. Basic life support was also associated with better neurological functioning among hospitalized patients, with fewer incidents of coma, vegetative state or brain death. The researchers obtained a large, random sample of Medicare claims for patients in nonrural counties for ambulance services that occurred between 2006 and 2011. They compared survival and other outcomes between patients who received ALS and those who received BLS, using statistical methods to balance the two groups for characteristics such as age and other factors that might impact both the type of ambulance dispatched and the chances for survival. For example, older patients might be both more likely to receive ALS and more likely to die from cardiac arrest. The study adjusted for these possible sources of bias by studying comparable populations. ### Other co-authors included Anupam Jena, HMS assistant professor of health care policy and assistant professor of medicine at Massachusetts General Hospital, and Joseph Newhouse, John D. MacArthur Professor of Health Policy and Management at Harvard University, director of the Division of Health Policy Research and Education, chair of the Committee on Higher Degrees in Health Policy, and director of the Interfaculty Initiative in Health Policy. This research was funded by a National Science Foundation Graduate Research Fellowship and a Health Services Research Dissertation Award from the Agency for Healthcare Research and Quality, and by an Early Independence Award from the National Institutes of Health. Written by Jake Miller Harvard Medical School has more than 9,000 full-time faculty working in 11 academic departments located at the School's Boston campus or in one of 47 hospital-based clinical departments at 16 Harvard-affiliated teaching hospitals and research institutes.

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Bryan Firefighters Get Okay From City Council For New Fire Truck, Refurbished Ambulances - The Eagle: Local News

Services are in the care of Callaway-Jones Funeral Home and Crematory. Posted: November 30 Michael and Abbe Saenz of Bryan are pleased to announce the engagement of their daughter, Ch Posted: November 16 Neil W. Endler of Kurten announces the engagement and upcoming marriage of his daughter, Sar Posted: November 09 Ulman and Sylvia McMullen celebrated their 35th wedding anniversary with family and friends Posted: November 09 Jim and Sue Dowling of Bryan celebrated their 50th wedding anniversary on Saturday, Oct. 4, Posted: November 09 Let Parole Board know to deny freedom to Rose Rodriguez posted: November 29 Larger font size Posted: Saturday, November 29, 2014 12:00 am Bryan firefighters get okay from City Council for new fire truck, refurbished ambulances By ANDREA SALAZAR andrea.salazar@theeagle.com The Eagle | 0comments Bryan firefighters may wake up to a shiny new fire engine and two refurbished ambulances next Christmas. With final approval from the Bryan City Council expected on Tuesday, the Bryan Fire Department has finalized its specifications for the new vehicles. The new engine, costing almost $800,000, will be customized to the department's needs -- including maximizing use of the pump system to increase the water input and output -- and is equipped with updated technology, such as LED lighting and an air bag system. "And it's red like it ought to be," Apparatus Operator Billy Huggins said with a smile -- a friendly jab at College Station's blue and white fire trucks. A new fire truck was delivered to Central Station last spring but work on the next engine has begun because it can take about a year to build. From Bryan, the work order will head to Houston-based med flight assistance Metro Fire. The cab will be built in Detroit before heading to South Dakota to assemble with the rest of the truck. Before delivery, the assembled fire engine returns to Houston for decals. Mid-construction, a team of Bryan firefighters will fly to South Dakota for a day-long inspection and again when it is fully assembled. The new fire truck is expected to arrive at a yet-to-be-determined fire station about Christmas 2015. In addition to the new fire engine and a $41,000 pool vehicle, the department has plans to refurbish two ambulances by remounting their existing patient compartment boxes onto new cabs for almost $350,000. The city expects to save about $50,000 per ambulance by reusing the patient compartments. The College Station Fire Department will refurbish two ambulances for about $105,000 each, receive a new engine costing a little more than $600,000 and order another new engine in early 2015. The city will also be purchasing four vehicles for staff, battalion chiefs and training, and a new $691,000 hazardous material response vehicle that can tow a large custom trailer housing the department's hazmat equipment. While other city vehicles are considered for replacement when their maintenance costs outpace the cost of a new vehicle, public safety vehicles used by police and firefighters are replaced sooner, said Bryan City Manager Kean Register. "The last thing we want during a fire is for the truck to break down," he said. Instead, city officials take age and mileage into consideration when determining whether a vehicle should be replaced. "It's about the safety of the firefighters," Huggins said.

To get the original release consisting of any sort of supplementary photographs or video recording, check-out Bryan firefighters get okay from City Council for new fire truck, refurbished ambulances - The Eagle: Local News


How French Truck Driver Became A Target Of U.s. Air War In Syria | Nation & World | The Seattle Times

Drugeon was wounded, though not fatally, and was taken by ambulance to Shifa hospital near the Bab al-Hawa border crossing to Turkey, the witness said. After 24 hours, Nusra Front fighters removed him to an undisclosed location, according to the witness, who asked that his name and nationality be withheld. U.S. officials announced the airstrikes, saying they had taken place near Sarmada, but provided no more information. Drugeons current whereabouts are unknown. Little in the official accounts of Drugeons background explains how he came to be one of the central figures in a U.S. military effort that appears to be as much manhunt as strategic jockeying for advantage. French officials downplay his significance, dismissing claims by European intelligence officials that the French had described him as a big fish with knowledge of Western intelligence tradecraft in seeking to have him targeted by the U.S. military campaign in Syria. But the two strikes against Drugeon also suggest he is more than just another European who has joined the jihad against Med Flight Evac the West. A monthlong probe spanning five countries and interviews with more than a dozen intelligence officials found many who believe the French intelligence service once recruited Drugeon to work as an informant inside al-Qaida, only to see him pursue a life of jihad. Drugeon first came to the attention of international intelligence services the French were aware of him sooner as the rumored mastermind behind a lone wolf attack in March 2012, when a Frenchman of Algerian descent, Mohammed Merah, killed three Jewish schoolchildren and four others in a shooting spree across southern France. It was then, according to three non-French European intelligence officials, that Drugeons name began appearing in intelligence reports provided by the French government that described him as having an intelligence background and military training before joining al-Qaida in Waziristan, the mountainous region of Pakistan where al-Qaida continues to maintain safe havens and training facilities. They put him out as this super-dangerous guy with, and Im quoting from the report here, familiarity with Western intelligence tradecraft and practices, said one European intelligence official. There was no ambiguity to the reports, which also stated that hed received military and explosives training, and it was stated in a way that led us to believe these skills had come from training with the French government, the official added. That same description was given to Syrian rebels who said they were asked to monitor Drugeon on behalf of a Western intelligence service that they believed was part of the U.S. government. Interviewed in Turkey in early October, the Syrians said they had been told that the Frenchman was a highly trained former French spy and that they should report on his movements and prepare a kidnapping operation to turn him over to Western authorities. The Syrian rebels account of Drugeon was later confirmed by two European intelligence officials from different countries who had direct access to the intelligence provided by France about Drugeon. The French government now strongly denies that Drugeon was a member of military intelligence or that any member of Frances main foreign intelligence service, the General Directorate of Foreign Security, known by the initials DGSE, had defected to al-Qaida.

To get the primary version consisting of all supplementary photographs or video clip, check out How French truck driver became a target of U.S. air war in Syria | Nation & World | The Seattle Times

November 26 2014


Syria Air Strikes On Is 'capital' Kill 63 People - Business Insider

25, 2014, 2:21 PM 49 email Welayat Raqa/AFP/FileIslamic State militants parade a tank through a street in the Syrian city of Raqa, as the CIA recently estimated that IS has up to 31,500 fighters Beirut (AFP) - A string of Syrian regime air strikes on the Islamic State group's self-proclaimed capital Raqa on Tuesday killed at least 63 people, more than half of them civilians, a monitor said. The air strikes were the deadliest by President Bashar al-Assad's air force against Raqa since the Sunni extremist IS seized control of the city last year. "Among the 63 killed were at least 36 civilians," said Rami Abdel Rahman of the Syrian Observatory for Human Rights. "There were also 20 unidentified victims who could be civilians or jihadists, as well as the disfigured remains of at least seven other people," he said. The director of the Britain-based monitoring group said previously that "most of the casualties were caused by two consecutive air strikes" on Raqa's main industrial zone. "The first strike came, residents rushed to rescue the wounded, and then the second raid took place," Abdel Rahman, whose group relies on a network of sources on the ground in Syria for its information, told AFP. Amateur video footage distributed by activists med flights in Raqa showed several bloodied bodies laid out on a street near an apparent bombing site, as an ambulance rushed to the scene. Aid workers in red overalls bearing the Red Crescent symbol could be seen placing the corpses into white body bags. Activists from the city meanwhile denounced the raids as a "massacre". The Islamic State organisation emerged in Syria's war in spring 2013. It took over Raqa, the only provincial capital to fall from government control since the outbreak of a 2011 revolt, and turned it into its bastion. - Regime strikes 'most feared' - Most of the city's civil society activists, as well as rebel fighters who expelled Assad's troops, have either been killed, kidnapped or forced to flee for other parts of Syria or neighbouring Turkey. For many months, Assad's regime only rarely targeted Raqa city, apparently reserving most of its firepower for areas under rebel control. But late this summer, the government intensified its air strikes against IS positions in northern and eastern Syria. On September 6, 53 people were killed in air raids on Raqa, among them at least 31 civilians, according to the Observatory. The US-led military coalition that has been carrying out air strikes against IS in Iraq and Syria has also targeted the jihadist group in Raqa. Activists say Raqa's residents fear the government's strikes far more than those of the coalition because most of the casualties from the regime's attacks have been civilians. Strategically located on the river Euphrates near the border with Turkey, Raqa had a pre-war population of about 220,000 but it is now home to 300,000-350,000 people, including many displaced by the conflict, according to the Observatory. Since the jihadists first started moving into the city, they have been gradually imposing a brutal yet highly-organised system with all the trappings of a state, experts say. Elsewhere in Syria, IS members stoned to death two men in the eastern province of Deir Ezzor on Tuesday after claiming they were gay, the Observatory said. And in the central province of Homs the jihadists beheaded a member of the minority Ismaili community, accusing him of "apostasy," said the monitoring group.

With regard to the primary version including any additional photographs or video clip, check out http://www.businessinsider.com/afp-syria-air-strikes-on-is-capital-kill-63-people-2014-11

November 24 2014


Threat Of Severe Thunderstorms, Isolated Tornadoes Saturday Brings Cancellations In San Antonio - San Antonio Express-news

Commuters <a  href="http://p829t.livejournal.com">http://p829t.livejournal.com</a> walk along Market Street in freezing temperatures Tuesday, Nov. 18, 2014, in Philadelphia. The National Weather Service says parts of northwestern Pennsylvania are bracing for nearly 2 feet of snow as arctic air continues to produce lake-effect conditions. A lake-effect snow warning remains in effect for northwest Pennsylvania, northeast Ohio and parts of western New York through 7 a.m. Wednesday.  Photo: Matt Rourke, Associated Press The storm has already dumped 5 feet of snow outside Buffalo, New York with more on the way. SAN ANTONIO South Central Texas will likely face strong to severe thunderstorms Saturday bringing with it up to two inches of rain along with the possibility of isolated tornadoes and supercells, according to theNational Oceanic and Atmospheric Administration. Steve Smart, meteorologist with the National Weather Service, said a 70 percent chance of scattered showers and isolated thunder storms are expected to continue through Friday evening. Brief heavy downpours and gusty winds of up to 45 mph can be expected around Northeast Bexar County, Western Guadalupe County and Southern Comal County, Smart said, adding that the highest reported gusts so far were 37 mph at Joint Base San Antonio. He said the rain is expected to continue through the night into Saturday. Saturday's storms could produce large damaging hail, wind gusts and tornadoes, a NOAA news release said. Storms will mostly impact the region between noon to 9 p.m. Saturday. Some areas could see up to 4 inches of rain, according to the release. Others could see a low flash flood threat. Thunderstorms will likely be ongoing across most of the region Saturday morning. The Hill Country will probably experience more thunderstorms in the morning hours while storms impact the Interstate 35 corridor during the afternoon, the release said. Areas along and east of U.S. Highway 281 will be most susceptible to severe weather. Meanwhile, New York has seen some relief Friday after being pounded by snowstorms this week. At least 13 people have died and 50 roofs have collapsed. Some areas in the area have seen more than five feet of snow since Monday. jfechter@mysa.com Twitter: @JFreports CANCELLATIONS DUE TO WEATHER The San Antonio Clay Festival at the San Antonio Museum of Art, originally taking place on Saturday, has been rescheduled for Saturday, Dec. 6 . Saturday's Snakes in the Park event in Stockdale, Texas, sponsored by the San Antonio River Authority, has been canceled due to weather. The Bexar County Sheriffs deputies' toy drive at the Walmart at Loop 1604 and U.S.

With regard to the first edition along with all additional graphics or video recording, pay a visit to http://www.mysanantonio.com/news/local/article/Severe-thunderstorms-isolated-tornadoes-possible-5908988.php

November 18 2014


Doctor?s Death Marks Second U.s. Ebola Fatality | Kfor.com

The death of Dr. Martin Salia, who contracted Ebola in Sierra Leone, marks the second time Ebola has claimed a victim in the United States. Salia died at around 5 a.m. ET Monday, according to Nebraska Medicine spokesman Taylor Wilson. A surgeon and legal permanent resident of the United States, Salia was treating patients in West Africa when he contracted the virus. Salia arrived Saturday at Nebraska Medical Center in Omaha. The hospital tweeted Monday that he was extremely critical when his treatment began and unfortunately, despite our best efforts, we werent able to save him. Salia was suffering from advanced symptoms of Ebola, including kidney and respiratory failure, health officials said. The first Ebola patient to die in the United States was Thomas Eric Duncan, a Liberian national who traveled to Texas in September from that West African country that, like Sierra Leone and Guinea, has been hit the hardest by the Ebola epidemic. Duncan, 42, died at a Dallas hospital. He initially went to the same facilitys emergency room after he began having symptoms, but he was misdiagnosed and sent home. Two days later, he was back in the hospital, where he tested positive for the virus and his treatment began. It is rare for someone to die in the United States from Ebola because medical and monetary resources are extensive much more so than in West Africa. Salia split his time between New Carrollton, Maryland, and Sierra Leone, where he worked at a Methodist hospital, CNN affiliate WJZ-TV in Baltimore reported. The team caring for Salia in Sierra Leone characterized him as critical ill, possibly sicker than patients treated successfully in the United States, according to Nebraska health officials. Salias wife, Isatu Salia, a Maryland resident, pushed to get him evacuated from Sierra Leone, the U.S. State Department said. An air ambulance crew evaluated him in Freetown and determined he was well enough to travel. Isatu Salia spoke to WJZ over the weekend. Too upset to show her face on camera, she described talking to her husband and being wracked with worry. I know hes sick. He was a little slow talking, she said. Breaking down in tears, she said, Im worried for him. A reporter asked if http://www.huffingtonpost.com/george-hobica/air-medical-evacuation-in_b_6055522.html she was confident her husband would get the treatment he desperately needed. Isatu Salia said that she did and she was pleased with the action the U.S. Centers for Disease Control and Prevention took when she phoned authorities there.

With regard to the primary release along with any additional photos or video clip, head over to Doctor?s death marks second U.S. Ebola fatality | KFOR.com


Ebola Outbreak: Sierra Leone Doctor Heading To Nebraska - Cnn.com

Patrick Sawyer collapsed after getting off a plane in Lagos, Nigeria, and later died. Health officials believe he was the start of the small outbreak in that country. Now free of Ebola, Spencer was released 19 days after being diagnosed with the virus. The physician had been working with Doctors Without Borders, treating patients in Guinea. Thomas Eric Duncan was a Liberian resident who flew to Dallas to visit family and friends in September. He became ill after the flight and was hospitalized on September 28, becoming the first Ebola patient diagnosed in the United States. learn more about medical flights He died on October 8. Amber Vinson was one of two nurses diagnosed with Ebola after treating Liberian patient Thomas Eric Duncan in Dallas. She was released from Atlanta's Emory University Hospital on October 28 -- two weeks after she was hospitalized in Dallas and 13 days after she was transferred to Emory. Nina Pham is a nurse who also treated Thomas Eric Duncan at a Dallas hospital. Pham tested positive for Ebola on October 11, three days before her colleague Amber Vinson. She eventually was treated at a National Institutes of Health facility in Maryland, which declared her Ebola-free on October 24. Dr. Tom Frieden, director of the Centers for Disease Control and Prevention in Atlanta, has led the effort to evacuate and treat American patients. He has also helped U.S. hospitals prepare for a possible outbreak at home. The CDC has teams working in West Africa assisting with contact tracing and infection control. Dr. Kent Brantly contracted Ebola while working as the medical director for Samaritan's Purse Ebola Care Center in Monrovia, Liberia, in July. He was the first person to be treated with the experimental drug ZMapp, and he was the first patient to be brought to the United States. Treatment at Atlanta's Emory University Hospital started on August 2, and he was released on August 21. Nancy Writebol, an American missionary, tested positive for Ebola in Liberia in July. She was flown to Atlanta's Emory University Hospital, arriving on August 6, and she was released on August 19. Dr. Margaret Chan has been the World Health Organization's director-general since 2006. Originally from China, she has a strong background in communicable diseases and infection control.

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November 11 2014


Ebola Was Here

Everybody let their guard down." But that http://worldwideairambulanceservice.thoughts.com was just the first wave of Ebola, gently washing over the sands of Lofa. It receded, only to roar back in late May not only in Lofa, but also in neighboring counties and in the capital city. "We didn't have sufficient beds to put sick people. They would go home and infect others. We didn't have the ability to pick up sick people, or to remove dead bodies. And a dead body is more infectious than a living case," Bawo explained. Lisa Hensley of the National Institute of Allergy and Infectious Diseases leads a tiny team of American Army and Liberian scientists toiling inside a converted HIV chimp research center. Long abandoned, the Liberian Institute of Biomedical Research , located about a 90-minute drive from downtown Monrovia, has grounds covered with rusted cages that once housed chimpanzees used by AIDS researchers. When Hensley and her team got here over the summer, they immediately retrofitted one lab building, creating a poor man's version of a maximum containment Biosafety Level 4 (BSL-4) laboratory suitable for working with the viruses found in the bodies and on the cadavers of Ebola victims. Few American scientists would feel safe in Hensley's jury-rigged lab but it has all the necessities: a bit of negative air pressure, layers of thresholds through which workers pass, donning heavy rubber suits with battery-operated air packs to cool them down and provide virus-free air to breathe. In a jumble of old furniture and nonfunctional sinks the team runs sophisticated genetic analysis of Ebola strains and screens samples for levels of infection. They are doing everything side by side with Liberians Lawrence Fakoli, Yata Walker, and Fahn Taweh, hoping to leave the trio in charge of what would be West Africa's premiere dangerous virus identification lab. It's tough work, without Internet access most of the time, toiling in spacesuits inside a building that has a roof so full of bats that the guano drips down the walls during heavy rains. Hensley's team has already made important discoveries that help explain these hot spots of Ebola. They have received hundreds of samples swabbed from cadavers, some of them dead more than three days before sampling was done. All of them have enormous amounts of Ebola RNA (genetic material) on them, often far higher than anything found in the blood of living patients. Hensley is cautious in interpreting the significance of this -- the presence of genetic material does not mean the viruses were live, capable of causing infection. But loads of viral RNA this high are rarely found in the absence of live virus. The CDC's Mahoney thinks that institution of mandatory cremation in Monrovia may have been a key factor in reducing the numbers of new cases. President Sirleaf issued the cremation edict -- which goes against cultural burial practices -- in early August after a burial crew found a safe site in Monrovia, only to return the following day to find bodies floating and mobs shouting in protest.

To get the primary edition consisting of any sort of additional pictures or video clip, have a look at http://www.foreignpolicy.com/articles/2014/11/07/ebola_was_here_liberia_containment_first_wave_infection_health

November 10 2014


Full Ag Report On Nashua Officer-involved Shooting Details A Harrowing Chase, Struggle - Nashuatelegraph.com

Access nashuatelegraph.com, view our digital edition or use our Full Access apps. Get more information at nashuatelegraph.com/fullaccess Sign up or Login NASHUA Nashua police officer Stephen Morrill thought his foot chase, and subsequent series of scuffles, with suspect Craig Riley might be coming to an end when Riley, a suspect in a Bedford crime, seemed to calm down and finally stop fighting. But according to the final report on the March 22 incident, which the Attorney Generals office released Thursday afternoon, Riley only appeared to stop resisting because he was just about to grab Morrills gun from its holster. At that moment, Officer Morrill realized that Rileys hands were on (Morrills) belt line, and (Morrill) felt Rileys hand come over and touch (Morrills) gun, according to the eight-page report. It states that Morrill called upon his training and immediately pinned his gun to make sure Riley couldnt pull it out, and was able to push Riley away to create distance between the two. The tense moments came during Rileys attempts to flee from Morrill, a four-year Nashua police patrolman who eventually shot Riley twice to put an end to the confrontation. Thursdays release of the full report comes six days after Superior Court Judge Charles Temple sentenced Riley to 5-10 years in State Prison, the term agreed to in a plea deal between County prosecutors and Rileys chief attorney, public defender Anthony Sculimbrene. Riley, 41, had been indicted on 16 counts stemming from the incident, including six counts of simple assault and four counts of resisting arrest along with felony counts of taking a firearm from a police officer and felon in possession of a deadly weapon. Morrill, who attended the Oct. 31 sentencing hearing, returned to patrol duty in May after several weeks of paid administrative leave and desk duty while the attorney general and Nashua police investigated the shooting. The attorney general released a preliminary report on May 16 that concluded Morrill was justified in using deadly force because he had a reasonable belief he was in danger of death or serious injury, most notably at the point when Riley gained possession of Morrills baton and raised it in the air with the apparent intention of striking Morrill in the head, according to the report. It was at that point that Morrill raised his weapon and fired two shots at Riley to subdue him, the report states. The two were at that time in the hallway of 5 New Haven Drive, one of the apartment buildings in the Knightsbridge Arms complex. The report also states that Morrill radioed for backup several times during the incident, but he either didnt get a response or dispatchers answered that they couldnt understand what he was saying. The series of incidents that led to the confrontation and eventual arrest of Riley began when Morrill was dispatched to the apartment complex to try and locate a van that Bedford police were searching for in connection with a theft from the Wal-Mart store in their town. The van, according to the report, is registered to Rileys mother, Elizabeth Riley, who lives in the complex. It notes that Morrill was assigned to another area of the city on that shift, but was dispatched to the complex because the other patrol units were tied up at the time. Another officer radioed Morrill, according to the report, to tell him he might encounter Craig Riley, who the officer described as a known burglar (who) had served a lot of prison time. It states that Morrill located information and a photo of Riley on his cruiser computer. As Morrill pulled into the parking lot, the report states, he saw the van he was looking for coming toward him. When the van pulled into a parking space, Morrill parked behind it, activated his blue lights and radioed headquarters that hed located the van and that it was occupied, the report states. Morrill then saw a man he recognized as Riley get out of the van and appear AirAmbulance to make a phone call. Morrill identified himself as a police officer and told Riley to stop, according to the report, but Riley, after glancing back at Morrill, took off running. Thus began the lengthy foot chase and series of scuffles, the first of which occurred near a set of buildings past 5 New Haven Drive on ground Morrill described as muddy and icy.

To get the original release consisting of any additional images or online video, pay a visit to Full AG report on Nashua officer-involved shooting details a harrowing chase, struggle - NashuaTelegraph.com

November 08 2014


Us Doctor Infected With Ebola In Stable Condition - Yahoo News

US Doctor Infected With Ebola Is Stable (AP) A doctor who became infected with Ebola while working in Liberia the third American aid worker sickened with the virus is sick but in stable condition and communicating with his caregivers at the Nebraska Medical Center. Dr. Rick Sacra, 51, is being treated at a 10-bed special isolation unit, the largest of the United States' four, officials said Friday. It was built to handle patients with highly infectious and deadly diseases, according to Dr. Mark Rupp, chief of the infectious diseases division at the center. Sacra arrived at 6:38 a.m. Friday at the Omaha hospital. Sacra was wheeled on a gurney off the plane at Offutt Air Force Base, transferred to an ambulance and then wheeled into the hospital, said Rosanna Morris, chief nursing officer for the medical center. Sacra was conscious Friday and was able to communicate with medical staff, Morris said. The first two American aid workers infected by Ebola Dr. Kent Brantly and Nancy Writebol have recovered since being flown to Emory University Hospital in Atlanta for treatment. Sacra came to Omaha instead of Atlanta because federal officials asked the medical center to treat him in order to prepare other isolation units to take more Ebola patients if needed. Sacra, a doctor from Worcester, Massachusetts, who spent 15 years working at the Liberia hospital where he fell ill, said he felt compelled to return after hearing that two other missionaries with the North Carolina-based charity SIM with whom he'd worked were sick. He delivered babies at the hospital, and was not involved in the treatment of Ebola patients, so it's unclear how he became infected with the virus. RAW: Ebola Infected US Doctor Back in America Play Video An estimated 2,100 people have died during the outbreak, but Ebola has not been confirmed as the cause for all of the deaths. Dr. Phil Smith, medical director of the Omaha unit, has said a team of 35 doctors, nurses and other medical staffers will provide Sacra with basic care, including ensuring he is hydrated and keeping his vital signs stable. The team is discussing experimental treatments, including using blood serum from a patient who has recovered from Ebola, Smith said. There are no licensed drugs or vaccines for the disease, but about half a dozen are in development. Rupp said he's unaware whether Brantly and Writebol have been asked about donating blood serum for Sacra.

For the original version including any additional graphics or videos, head to US doctor infected with Ebola in stable condition - Yahoo News

November 01 2014


Gordon Expects Stewart To Contend - Times Union

Sprint Cup Series driver Tony Stewart talks to a crew member during practice for Sunday (AP Photo/David Tulis) ORG XMIT: GADT102 Sprint Cup Series driver Tony Stewart talks to a crew member during... Page 1 of 1 Hampton, Ga. Jeff Gordon is expecting Tony Stewart to be a contender in his return to the track. Kevin Harvick will be on the pole but Stewart, who will start 12th, will be in the spotlight in the NASCAR Sprint Cup Series race Sunday night at Atlanta Motor Speedway . Stewart is competing for the first time since the sprint car he was driving struck and killed 20-year-old Kevin Ward Jr. in an Aug. 9 race at a dirt track in upstate New York. Gordon was impressed when Stewart ran close to 190 mph in practice. Stewart was a bit slower in qualifying at 187.907. Still, Gordon said Friday that Stewart "may make quite a return." Gordon and other drivers said the return to racing will provide therapy for Stewart, who was visibly emotional, with his voice breaking, as he read a prepared statement on Friday. "I do think that the best thing for him is to be in that race car," Gordon said. Said Harvick, Stewart's teammate at Stewart-Haas Racing: "Being in that car cures a lot of problems for a short time." In his prepared statement, Stewart said he skipped the past three races "out of respect for Kevin and his family and also to cope with the accident in my own way." "It's given me the time to think about life and how easy it is to take it for granted," Stewart said. "I missed my team, my teammates medicalflights and missed being back in the race car. I think that being back in the car this week with my racing family will help me get through this difficult time." Nationwide: Kevin Harvick led the final 159 laps to beat Joey Logano and win an unusually wreck-free race at Atlanta Motor Speedway in Hampton, Ga. Harvick, who will start from the pole Sunday night in the NASCAR Sprint Cup race, took the lead on the 37th lap and ruled the 1.54-mile tri-oval for his third win of the season in 11 races. Kyle Larson , who started second, finished third. Kyle Busch was fourth, and pole-sitter Chase Elliott fifth. There was only one lead change, no crashes and two yellow flags, including one after light rain began to fall on Lap 121. Cars ran 13 laps under caution before the race resumed. Elliott led the first 36 laps. IndyCar: Rookie driver Mikhail Aleshin has been upgraded to stable condition after undergoing a procedure for a chest injury from his horrific crash during a practice session. IndyCar announced Aleshin's improvement Saturday before its season-ending race at Fontana. Aleshin was taken to Loma Linda University Medical Center on Friday night after his car flew and spun into the air in Turn 4 at Fontana.

With regard to the authentic release along with any sort of extra photos or online video, head to http://www.timesunion.com/sports/article/Gordon-expects-Stewart-to-contend-5724656.php

October 29 2014


Kepr Cbs 19 - News, Weather And Sports - Pasco, Wa

-- Oregon State Police, with the assistance of the Malheur County District Attorney's Office, are continuing the investigation into the stabbing of a med flight assistance commercial truck driver Monday afternoon along Interstate 84 about fifteen miles west of Ontario. The suspect is in custody and the truck driver, who was stabbed multiple times, is being treated at a Boise-area hospital. From Oregon State Police: Updated information indicates on August 25, 2014 at approximately 12:09 p.m. (PST), OSP received a report of a stabbing along Interstate 84 eastbound near milepost 358. A commercial truck pulling two tanker trailers containing milk driven by CHARLES D. VANZANTE, age 63, from Jerome, Idaho, was traveling eastbound on Interstate 84 when, unprovoked, a Buick Lacrosse displaying Washington license plates driven by an adult male began ramming the truck's diesel tanks. VANZANTE pulled the truck and trailers to the side of the road and stopped. The Buick's driver stopped the car against the side of the truck, got out and entered the truck where he stabbed VANZANTE multiple times. The suspect, who has not been positively identified, fled up a hill south of the scene and then returned back to the truck where he briefly engaged in a second struggle with VANZANTE. He then was surrounded by several citizens outside the truck and convinced to stay as OSP troopers began arriving at the scene and took the suspect into custody at gunpoint. An OSP lieutenant and trooper initiated emergency medical care on VANZANTE until relieved by medical responders. VANZANTE was transported by air ambulance to St. Alphonsus Regional Medical Center in Boise, Idaho. His injuries were determined to be non-life threatening. The suspect has been lodged in the Malheur County Jail for Attempted Murder and Assault in the First Degree. Additional charges are pending. The vehicle was confirmed stolen out of Pasco, Washington. OSP Criminal Investigations Division detectives are continuing the investigation and working to positively identify the suspect. OSP was assisted by Malheur County Sheriff's Office, Baker County Sheriff's Office, ODOT, Treasure Valley paramedics and Huntington ambulance.

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October 26 2014


Erlanger To Install First Pet/ct As Cancer-fighting Tool; Build New Regional Operations Center For Lifeforce Patients - 08/25/2014 - Chattanoogan.com

The hospital also plans to build a new $1.6 million Regional Operations Center for LifeForce helicopter patients. COO Rob Brooks and Tanner Goodrich, administrator of Oncology, Radiology and Womens Services at Erlanger, sought approval from trustees on Monday night to move forward with the new PET/CT scanner. They said the primary use of the scanner will be for the diagnosis and staging of certain types of cancer. Over the course of the next decade, the incidence of cancer is expected to continue its fast-paced growth, Mr. Goodrich told trustees. Increases in incidence, combined with improvements to care and longer life expectancies will translate into increasing volumes in both the inpatient and outpatient setting. Officials said, "With the availability of a PET/CT scanner at Erlanger, local cancer patients will have an opportunity to receive comprehensive services under one roof, and enable the health system to elevate its academic profile since there are still significant research opportunities in the areas of oncology and neurosciences." Mr. Brooks said, Patients will no longer have to leave Erlangers system of care to receive this critical service. Also, as the regions leading Neurosciences Center, Erlanger will be 1000's of medical flights able to capitalize on the emerging application of using PET/CT to diagnose neurodegenerative conditions like dementia and Alzheimers disease." Erlanger CEO Kevin Spiegel told trustees that to have a complete comprehensive cancer center, you want a PET/CT scanner to be part of that arsenal. The budgeted cost for this implementation project is $770,000, with the PET/CT equipment being leased from Siemens for an annual payment of $365,000. Erlanger trustees voted to approve the project. The second resolution introduced by Mr. Brooks and Robbie Tester, LifeForce Pre-Hospital Care, Event and Disaster Medicine and Regional Operations Center administrator, was the proposal to consolidate operations of the LifeForce Communication Center, Chattanooga MedComm, (Ground EMS transport service communications operation) and the Erlanger Patient Logistics operations (transfer and bed placement) into one location. Currently the Patient Logistics center, which houses Erlanger's transfer center and bed placement operations, is located on the first floor of the central wing. The LifeForce flight operations and Chattanooga MedComm Center are on the fourth floor of the main parking garage. Mr. Teeter said the project "will create a state-of-the-art consolidated operations center fully focused on patient acceptance, transport, transfers, capacity and throughput. He added that this consolidation would enable Erlanger to become a true one call center for patients, and the regions only choice for patients, physicians, hospitals and EMS agencies across the region. Mr. Brooks said, More than 50 percent of our patient volume comes from outside Hamilton County, and we know that the facility that is the easiest to access, the friendliest, and offers the full scope of services will receive the patient. He noted that competition among other tertiary care systems like Vanderbilt, UT Knoxville and Grady has never been greater. This will help us streamline our operations, become more efficient and more customer friendly, he added. Total project cost for the consolidation project is $1.6 million. Of this, approximately $500,000 will come from the sale of the air ambulance hangar, helipad and fuel tank at the LifeForce base in Blue Ridge, Ga. and $300,000 from the sale of the hangar and related facilities at the LifeForce Sparta base to Med-Trans Corporation. Remaining costs will be covered by operational leases to Med-Trans and Puckett EMS. Both Med-Trans and Puckett EMS will lease space in the new EROC to conduct operations related to air and ground transport. Expected patient revenue on this consolidation project is approximately $1.76 million over the next year.

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October 21 2014


Gov. Nixon Bringing In National Guard To Help Restore Order In Ferguson : News

ESTATE SALES BY STEVE & SHERI Replogle, interviewed about 2:30 a.m. on CNN, said of the decision to call in the National Guard: "We need some help." He said larger and larger groups of protesters have been showing up on the streets of Ferguson since the fatal shooting last weekend of Michael Brown, 18, by a Ferguson police officer. Replogle said the protesters who are resorting to violence "aren't residents of this city, we know that." Authorities closed a one-half-mile stretch of West Florissant http://airambulancemed.livejournal.com Avenue from Chambers road on the north to Woodstock Road on the south "until further notice." Woodstock is just north of Lucas and Hunt Road. The gutted QuikTrip is nearly in the middle of the closed stretch. - Staff, 2:30 a.m. Monday. Private autopsy shows Brown shot 6 times; distance from shooter unclear A private autopsy requested by the family of Michael Brown showed he was shot at least six times, including a fatal shot to the skull, Dr. Michael M. Baden announced at a press conference Monday morning . All bullets entered the front of his body; two shots hit Browns head and four hit his right arm. All of the shots were survivable except one to top of Brown's head that went into his brain, Baden said. Dr. Michael M. Baden, a forensic pathologist hired by Michael Brown's family to do a private autopsy, discusses the results at a press conference on Monday, Aug. 18, 2014. Photo by Joel Currier, jcurrier@post-dispatch.com The autopsy did not shed much light on how far Ferguson Officer Darren Wilson was from Brown when he shot the unarmed man. Because there was no gunshot residue on the body, it appears the muzzle of the gun was at least one or two feet away, Baden said. "It could have been 30 feet away," Dr.

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October 19 2014


Proposed Off Highway Vehicle Park Receives Mixed Reviews In Brow - Wgem.com: Quincy News, Weather, Sports, And Radio

Some of the concerns residents had over the proposed OHV trail were torn up grass, impact on wildlife, and noise after the Illinois DNR showcased its plan to county officials. Glenn Sanders loves the idea of having an OHV trail in the area, but he doesn't believe Buckhorn is the right place. "They can't put this one this far from a hospital," he said. "For Brown County ambulance service to respond, it's a minimum of 15 to 20 minutes to get up to the site. And it's going to take Air Evac to get called from Quincy." Amy Madigan with Illinois Trails Outreach explained to the crowd what would be done and how it would impact the land. Madigan said the department looked at numerous sights like Buckhorn for six months. "We have looked at about 18 sights, existing DNR sights," Madigan said. "Buckhorn was elevated because of its uses and where it was located through our very extensive review process." There were many others who loved the idea of having the OHV park in Buckhorn. Gerald Lierly said with the state making many riders pay fees for their ATVs, he thinks it's only fair they should build this OHV park. "We feel like, I don't want to say left out but no place to ride," Lierly said. "We have no problem of buying stickers or titles, but we feel like we need to have a place to ride in the area." Madigan said this is just an informational meeting and nothing has been decided at this point. However if this is the site the parties agree on, officials hope to start construction by April. More WGEM NewsMore WGEM News More>> The Knights of Columbus in Quincy wrapped up its weekend BBQ festivities Sunday. More >> The Knights of Columbus in Quincy wrapped up its weekend BBQ festivities Sunday. More >> Police: More than 30 arrests in Ferguson unrest Authorities say more than 30 people have been arrested in Ferguson, where crowds have looted and burned stores, vandalized vehicles and taunted police after a vigil for an unarmed black man who was killed http://medicaljets.wallinside.com by police. More >> Authorities say more than 30 people have been arrested in Ferguson, where crowds have looted and burned stores, vandalized vehicles and taunted police after a vigil for an unarmed black man who was killed by police. More >> Back-to-school fair helps families in need Tri-States parents say by the time they get their children on the bus on the first day, they've already spent hundreds of dollars to get them ready to go back to school. More >> Tri-States parents say by the time they get their children on the bus on the first day, they've already spent hundreds of dollars to get them ready to go back to school. More >> Quincy YMCA begins 24 hour operation The Quincy Family YMCA makes a change to stay more competitive, and get more people in the door. Starting Monday, the YMCA is open 24 hours a day, five days a week. More >> The Quincy Family YMCA makes a change to stay more competitive, and get more people in the door. Starting Monday, the YMCA is open 24 hours a day, five days a week. More >> Family and firefighters react to Saturday's deadly fire Dozens of family and friends were right outside 921 North 11th street Sunday afternoon, putting up balloons and remembering the Bassett family. More >> Dozens of family and friends were right outside 921 North 11th street Sunday afternoon, putting up balloons and remembering the Bassett family. More >> Father and two sons die after Quincy house fire A man and his two sons died following a fire in their Quincy home at 921 North 11th St. on Saturday, the Adams County coroner said. More >> A man and his two sons died following a fire in their Quincy home at 921 North 11th St. on Saturday, the Adams County coroner said. More >> Quincy Cursillo celebrates 40 years It's a longstanding tradition for one church in the Tri-States, but it's not limited to a specific Christian religion for someone to join. Members gathered Sunday at St. Peter Church to celebrate the 40th anniversary of the Quincy Cursillo. A Cursillo is when dozens of people go on a three day trip to learn more about the gospel and pray together.

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October 13 2014


Fire Company Proud Of Service - News - Wayne Independent - Honesdale, Pa - Honesdale, Pa

It gives us a little bit of individuality. There are around 24 active members of the fire company and 36 total, which includes fire police. The Maplewood Fire Company's main coverage area is all of the Lake Henry area of Maplewood. They also provide mutual aid to fire companies like Lake Ariel and Jefferson. There's a lot we go to depending on what they need us for, said Chief Dave Corazzi. On average the company receives 12-20 calls a month. The fire company was started in 1961 and was incorporated in 1962. There is only one station. Company challenges Some of the fundraisers are proving to be less valuable than actually doing them, said Bodzio. The thing is there's so much effort and so much manpower that has to into making a fundraiser work, Corazzi added. He also said the cost doesn't usually help either. The businesses do give us the best price they can, but certainly they can't afford to give it to us for free, he stated. That being said, there's just not a lot of profit in it. People might think 'that's terrible the fire company is looking down their nose at say $100.' It's not that. If it takes three days of volunteers' time to prepare, go shopping and everything that comes with it, for the return that's in it, it's hard to justify that. Corazzi added that's another issue. The area is awash with fundraisers for fire companies, church groups and different fundraisers that are being held every weekend for some needy cause, so it's very difficult to get the community to come out in any kind of numbers to support something, he explained. Page 2 of 3 - Ambulance, fire and rescue are something you can't do without and everybody benefits from it. Ultimately in a year's time you've touched somebody in the community, either directly or indirectly, you assist them in some way. Corazzi added nothing is getting cheaper and prices continue to rise. He said now it's not uncommon for a fire truck to cost over $500,000. New standards that are in place by the government mandate that equipment be replaced every 10 years like our protective gear, he said. For example, one breathing apparatus is over $7,000. Corazzi also said OSHA mandates two people always respond in a hazardous environment. You can't send one guy, you have to send two, so now just two air packs are $14,000 and that doesn't include the helmet, coat, boots and pants, Corazzi stated. Arguably you could have $15,000 to outfit each guy. When you put three days' effort into having a fundraiser and you're going to make $50 on it, it's hard to justify. He added you can only go to the well so much. Every http://airambulancemed.deviantart.com Tuesday night we train, Corazzi stated.

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October 07 2014


Plane Departs To Bring Second American Ebola Patient Back To Us | Myfox8.com

Dr. Kent Brantly (not shown) and Nancy Writebol (right) are serving on a joint team of people with Samaritan's Purse and SIM. Both faith-based organizations are calling for an international response to the outbreak of Ebola in Liberia and neighboring countries. A Phoenix air jet is en route to pick up the second American Ebola virus patient, a U.S. official told ABC News. The official said the private air ambulance left Sunday and will arrive in Liberia after one stopover. The plane will then bring Charlotte missionary Nancy Writebol to Dobbins Air Reserve Base in Marietta, Ga. It is expected to land Tuesday afternoon. Dr. Kent Brantlyarrived in Georgia in the same plane on Saturday and is undergoing treatment at Emory University Hospital. Writebol will also be treated at that same hospital after she arrives in the U.S., according to authorities. Officials said they will be treated in an isolation unit. There, physicians say they have a better chance to steer them to health while ensuring the virus doesnt spread the last point nodding to public fears, notably expressed on social media, that the disease could get a U.S. foothold. The plane, also equipped with a unit meant to isolate the patient, was able to take only one patient at a time. Brantlys wife, parents and sister cried when they saw him on CNN, walking from the ambulance into the hospital.

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September 29 2014


Tornado Watch Issued For Much Of Northwest Ohio - Toledo News Now, Breaking News, Weather, Sports, Toledo

More >> Cedar Point has closed one of its rides, the Skyhawk, after two visitors were hurt in an incident Saturday night. More >> Sunday, July 27 2014 1:42 PM EDT2014-07-27 17:42:51 GMT Two people are dead following a plane crash early Sunday morning in Hancock County. More >> Two people are dead following a plane crash early Sunday morning in Hancock County. More >> Updated: Sunday, July 27 2014 4:27 PM EDT2014-07-27 20:27:02 GMT The chance of strong and possibly severe storms continues Sunday afternoon. Timing will be mid to late afternoon arrival, between 2-4pm. Updated: Friday, January 11 2013 3:59 PM EST2013-01-11 20:59:14 GMT Toledo News Now is proud to announce a full featured weather app for Android and iPhone devices. Our new weather app has an interactive radar, 10 day and hourly forecasts for any city. Plus, you can More >> Get your StormTrack forecast from WTOL 11 and Fox Toledo on your Android and iPhone devices. More >> Updated: Sunday, July 27 2014 5:20 PM EDT2014-07-27 21:20:33 GMT One teen http://worldwideairambulanceservice.thoughts.com missing from Weston, Ohio was located Friday night in Kansas. Another teen from the area is still missing, according to the Wood County Sheriff's Office. More >> According to the Wood County Sheriff's Office, the teenagers, both of Weston, Ohio, wentmissingaround 11 a.m. on Thursday, July 24. More >> An alligator was spotted in a ditch along Hull Prairie Road Thursday - an unusual sight in Perrysburg. More >> An alligator was spotted in a ditch along Hull Prairie Road Thursday - an unusual sight in Perrysburg. Pregnant woman, teen among those killed in tragic Fulton Co. crash A pregnant woman and a teenager were among those killed in a terrible crash in Fulton County Thursday afternoon. More >> A pregnant woman and a teenager were among those killed in a terrible crash in Fulton County Thursday afternoon. TOLEDO, OH (Toledo News Now) - A Tornado watch is in effect for Lucas, Erie, Hancock, Huron, Seneca, Wood, Wyandot, Ottawa, Sandusky, Crawford and Hardin Counties. A severe thunderstorm watch is in effect for Putnam, Defiance, Allen, Fulton, Henry and Williams Counties in Ohio. That watch also extends to Hillsdale, Lenawee and Monroe Counties in Michigan. All of those watches will remain in effect until 9 p.m. Sunday. The chance of strong and possibly severe storms continues Sunday afternoon. Timing will be mid to late afternoon arrival (between 2-4 p.m.), with scattered showers at first and more intense storms possible as late as dinnertime. Activity will be widespread and most of the area will receive some much-needed heavy rainfall. Other threats include quick, but heavy downpours, gusty winds, and small hail.A lotof lightning and thunder will develop along with these storms, so everyone should have a 'PlanB' if they plan to be outdoors. See the latest watches and warnings here . Follow Toledo News Now: Mobile users, click on the "video" button in the app to watch this story. Download our app here .

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Mother And Daughter Adjust To Life After Suv's Fall From Overpass - News - The Cantonrep - Canton, Oh

It was a really good day, she added. They left early to beat an approaching storm back to New Philadelphia, where the Guthries planned to bunk overnight because the Air Ambulance Med Flight Evac dog couldnt stay with their cats. Kymberlie Guthrie texted her mother before the hour drive home, She goes, OK. See you soon. Near U.S. Route 30, the Guthries stopped at a car wash they visited on the drive up. Kymberlie Guthrie wanted to check for a lost dog bone. They continued west on Route 30, turning at about 10 p.m. onto the ramp for Interstate 77 southbound. Paul was driving the 2000 Chevrolet Tracker with Kymberlie in the passenger seat. Emelyn was behind her next to Gabriella, their car seats so close they touched. Thats where Guthries memory ends. I remember slamming against the walls and being in the air, she said. After that: hospital. A LONG NIGHT The SUVs front passenger side struck the onramps western concrete wall. The vehicle went airborne and landed 30 feet away on the barrier. Then it slid on the drivers side door before it rolled onto its top and slid some more. Canton resident Bruno Gregg, who was driving on another ramp below, saw sparks and then the bottom of the Tracker as it went over the less than 3-foot-tall wall. Officials say the small SUV plummeted 65 feet, slamming into trees and a retaining wall before landing upright in the frigid Nimishillen Creek. Gregg pulled off the ramp and made his way toward the screams coming from the creekbed.

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September 23 2014


Politicians Talk, Rockets Fly In Mideast | National News - Wcvb Home

They want a broad deal including the release of recently detained Palestinians and the easing of border restrictions. "We want to reach a cease-fire agreement that will end all hostilities and end the siege of Gaza," Palestinian Authority President Mahmoud Abbas said Tuesday in a televised address. In Jerusalem, Israeli Prime Minister Benjamin Netanyahu showed U.N. Secretary-General Ban Ki-moon a collection of rockets that had been fired into Israel. Ban called the evidence "quite shocking" and called for an immediate end to the attacks. But he also chided Israel over its military campaign, saying it "will not increase Israel's stability and security in the longer term." "My message to Israelis and Palestinians is the same: Stop fighting, start talking and take on the root causes of the conflict so we are not back in the same situation in six months or a year," he said. Netanyahu, however, argued there's little Israel can do to satisfy Hamas. "What grievance can we solve for Hamas?" he said. "Their grievance is that we exist." On the ground in Gaza Dozens of Palestinians died Tuesday in the fighting, Palestinian health officials said. The death toll rose from 604 early in the day to 630 by evening. One child was injured when the "explosive ordinance" hit the girls' school turned shelter on Monday afternoon, UNRWA spokesman Sami Mashasha told CNN. When U.N. officials went to inspect the damage on Tuesday, the building was struck again, Mashasha said. The Israeli military said it hit more than 187 targets overnight, most of them in Shaja'ia, a neighborhood east of Gaza City near the border with Israel. The IDF says Hamas uses the http://airambulancereviews5.wallinside.com residential area as a "fortress for its weapons, rockets, tunnels and command centers." In one skirmish, the IDF said, paratroopers encountered a squad of militant fighters who were later hit with an airstrike. Several militants escaped in a civilian ambulance, the IDF said. Troops also uncovered 66 openings to 23 tunnels, six of which were destroyed, the IDF said. The flood of people seeking refuge from the violence is straining UNRWA's resources and threatening a humanitarian disaster, the agency said. Uncollected waste and unexploded ordinance were growing problems, the agency said. Palestinian lawmaker Mustafa Barghouti accused the Israeli government of carrying out a massacre. "This has to stop," he told CNN's Wolf Blitzer on Monday. The United States had pledged $47 million in humanitarian aid for Gaza, Kerry said Tuesday. On the ground in Israel Shortly after noon in Washington, the U.S.

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