# Some misconceptions about the role of an EMT off duty



## redbull (Sep 8, 2010)

Since I've become an EMT (not working yet but hopefully soon), my family and friends are always asking me for advice on what to do in case of emergency. The misconception is that I'll be able to manage the emergency and save a life. Well, the best thing I told them to do was call 911! My girlfriend said, "What if someone gets hurt in public and you're there?" 911, I said. Unless I'm carrying a med bag with me but I doubt I'm allowed to carry a mini O2 tank  with a nonrebreather / bag valve mask. 

Without the proper tools (O2, bandages), short of CPR there isn't much I can do. Another thing they did'nt know was BSI / Scene safety. They always thought that EMTs run towards the problem with blatant disregard for his or herself.


It's interesting the stuff I picked up on in the EMT class. These were all my misunderstandings as well. Anyone feel the same?


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## emt seeking first job (Sep 8, 2010)

Hey Redbull, as I have posted before, I make a point of carrying my facemask. That way, if I am some where where people know me, I can rescue breathe.

If I were among strangers, I would conisder helping beyond calling 911, under certain circumstances.

If I were in the wilderness or under some circumstances where no response of any kind was available, then I would consider improvising....

Explain to your family and gf that:

1) under NYS Law you are under no obligation to render any aid. Even call 911.

2) EMTs work under medical direction and control, outside of that, we are only qualified to do CPR. 

3) EMTs don't really (directly) save lives, per my instructor, they apply certain interventions which sustain life, or keep people in the condition they were found in, and package them to get to the hospital where their lives are saved. Of course if an EMT does not respond, the person may die, but they do not 'save' them meaning put them in a condiotn they can get up and go home.....



Redbull, dude, check your pm's, I sent you names and addresses of three places in Queens.........one of which you said you could'nt find......


IMHO, carry your face mask, always have your mobile phone, and deal with it as it comes.


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## mgr22 (Sep 9, 2010)

EMS professionals at any level should be able to improve the outcome of some emergencies just because of our experience dealing with emergencies. We're supposed to be able to size-up a scene, do a preliminary assessment, position and protect the patient, follow the ABCs, get at least some of the history, and present the case to responding units -- even without equipment. 'Course we'd also have to be willing to do those things when we're off duty. To me, that's a no-brainer.


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## LonghornMedic (Sep 9, 2010)

Call 911. Plain and simple.


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## dave3189 (Sep 9, 2010)

This issue has plagued many EMS/Fire and Law Enforcement professionals for many years.  We are all proud of what we do and our skill sets as to how we can help people, even when off duty.  That being said, especially for new EMS people, you have to be careful of the "John Wayne" syndrome.  Bottom line, at an MVC for example, we all know how dangerous it is to be out in traffic without the advantage of L.E. on scene and not wearing reflective vests.  At a medical emergency, we all have a tendency to want to start an assessment because that is what we are trained to do.  What I try to remind myself is in these situations where I can be the most help is in facilitating the "recognition and early access" component that is so vital in any EMS or rescue scenario.  For example, if I witnessed or was on scene (off-duty) at an MVC with significant MOI (IE: Roll Over) I would call 911 even if someone else had already called.  I would make sure the location was correct and would advise the 911 Operator that I was an off duty FF/EMT and that based on the mechanism, that a Medic unit would be required.  These are the ways that we can make a difference without climbing in a crumped up vehicle without PPE.  The one scenario I will always get involved with of course is SCA/CPR.  Not sure we all need jump kits in our POVs but a pocket mask is always a good bet!


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## Saytuck99 (Sep 9, 2010)

*Interesting...*

This is an interesting topic...one the I am sure has been beat to death but here is an interesting spin...For those of us in an all volunteer system... we are never "off duty". While most of the time we do have one designated crew at the building for calls it is routine that a page comes out for backup. We respond from home...in fact providers are encouraged to respond to the scene (drivers will respond and pick up a rig)...so everyone has a "jump bag".

Often times the people responding from home in their personal vehielces beat the ambulance and begin to treat which can and has made the difference.

That being said...in our area of "all volunteer" should we not respond if we are on our way to work and out of district and happen upon a scene where we can be of assistance??...does the boundry of a town line dictate whether you get out of your car or not? I am not sure...I do not take a position on this as I am too new to the field...but it is an interesting question...


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## citizensoldierny (Sep 9, 2010)

Saytuck,
Long Islander here too. I've stopped at accidents in other towns and have never had a problem. Especially since the last time I did it I was in a marked FD vehicle. Everyone looked at me as I passed the scene so I figured I'd better turn around and do something so my dept. didn't look like a bunch of dirtbags. If your ALS though per Suffolk County protocols the dept. who's district call is in has to request your assistance through medical control , otherwise you can only work as BLS.


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## Saytuck99 (Sep 9, 2010)

citizensoldierny said:


> Saytuck,
> Long Islander here too. I've stopped at accidents in other towns and have never had a problem. Especially since the last time I did it I was in a marked FD vehicle. Everyone looked at me as I passed the scene so I figured I'd better turn around and do something so my dept. didn't look like a bunch of dirtbags. If your ALS though per Suffolk County protocols the dept. who's district call is in has to request your assistance through medical control , otherwise you can only work as BLS.



Yep...I am aware of the ALS protocols...sounds ridiculous to me...but I am taking a CC class in the fall so I am sure I will find out why they do this..Yea never figured it would be a problem...I suppose since we do not do it as a profession and volunteers are the only option here it is a bit different then the rest of the country...


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## firetender (Sep 9, 2010)

mgr22 said:


> EMS professionals at any level should be able to improve the outcome of some emergencies just because of our experience dealing with emergencies. We're supposed to be able to size-up a scene, do a preliminary assessment, position and protect the patient, follow the ABCs, get at least some of the history, and present the case to responding units -- even without equipment. 'Course we'd also have to be willing to do those things when we're off duty. To me, that's a no-brainer.



Beyond this, it's simply a case-by-case judgment as to the level you choose to perform. Another thing that doesn't get addressed is #1 I think that we, as trained professionals should START by coming upon a scene and quietly (without the "Nobody move I'm a Medic!!!") assess the severity of the situation and the need for immediate intervention or not. And just having use of a cell phone does not let you off the hook for taking any other action


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## dave3189 (Sep 9, 2010)

All good points that you make!  I work in a combo Dept of Career/Part Paid so I understand what you're saying.  If you're responding in a POV, hopefully you at least have a green light, flares and a reflective vest in addition to your jump bag.


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## dave3189 (Sep 9, 2010)

FireTender, I agree with you to a point.  Within the boudries of operating safely, I don't care about duty to act laws, I'm going to be part of the solution and help where I can.


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## citizensoldierny (Sep 9, 2010)

Saytuck,
You doing CC through county or community college? If so which county? I just finished mine through Suffolk EMS. Feel free to PM me or ask here anything you might be wondering about. No matter where you take it, you should have some fun.


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## Saytuck99 (Sep 9, 2010)

Haha yep...all department issued...


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## mgr22 (Sep 9, 2010)

citizensoldierny said:


> If your ALS though per Suffolk County protocols the dept. who's district call is in has to request your assistance through medical control , otherwise you can only work as BLS.



Actually, the "home" agency can request your participation directly, without going through medical control, assuming you are already authorized to operate as an ALS provider elsewhere within SCEMS.


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## Saytuck99 (Sep 9, 2010)

citizensoldierny said:


> Saytuck,
> You doing CC through county or community college? If so which county? I just finished mine through Suffolk EMS. Feel free to PM me or ask here anything you might be wondering about. No matter where you take it, you should have some fun.



At the Dennison building...Start Sunday


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## sirkhctiw (Sep 9, 2010)

my vote is for calling 911.


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## mgr22 (Sep 9, 2010)

sirkhctiw said:


> my vote is for calling 911.



No argument about starting with that.


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## Scott33 (Sep 10, 2010)

Saytuck99 said:


> At the Dennison building...Start Sunday



Say hello to Mike M. for me


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## Phlipper (Sep 10, 2010)

firetender said:


> just having use of a cell phone does not let you off the hook for taking any other action



+1

I don't quite get the "I'll call 911 and wait" attitude many take, even when it's a bad situation.  In an MVA with significant trauma I can't see me standing around with my thumbs up my butt when I could at least ensure occupants/ejectants are breathing, that severe bleeding is controlled, and at least a rudimentary triage has been completed and ready to pass on to the responders.  And this doesn't require a jump kit or flashing lights.  Just the knowledge we already have, some improvisation, and a willingness to help folks in need.  And I figured we all had that or we wouldn't be here.  It ain't like we chose this field for the money or the glory.


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## EMS/LEO505 (Sep 10, 2010)

In New Mexico, get outta there quick. If an ambulance chaser found out that an off duty EMT was there and the person died or didn't recover fully because the off duty couldn't treat them properly (since we don't carry a whole bus of stuff with us) they will try suing you lol and knowing the state judicial system here, it would probably work.....


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## Phlipper (Sep 10, 2010)

EMS/LEO505 said:


> In New Mexico, get outta there quick. If an ambulance chaser found out that an off duty EMT was there and the person died or didn't recover fully because the off duty couldn't treat them properly (since we don't carry a whole bus of stuff with us) they will try suing you lol and knowing the state judicial system here, it would probably work.....



As soon as the civil war starts, all the lawyers are going up against the wall. h34r:


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## Saytuck99 (Sep 10, 2010)

Scott33 said:


> Say hello to Mike M. for me




I will pass it along...I have heard the class is really good...


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## mcdonl (Sep 10, 2010)

Phlipper said:


> I don't quite get the "I'll call 911 and wait" attitude many take, even when it's a bad situation.  In an MVA with significant trauma I can't see me standing around with my thumbs up my butt when I could at least ensure occupants/ejectants are breathing......



Flipper, I bet most of this is "by the book" talk. I do not think many would get on here and say that they HAVE let people who are seriously injured sit, alone with no aid while they waited for the on-duty crew to show up.

Sure, we should call 911 first, we are all in agreement of that... and we COULD be found liable for damages if we mess up but when the :censored::censored::censored::censored: hits the fan just about everyone would step up and help if help were required.


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## citizensoldierny (Sep 10, 2010)

Scott33 said:


> Say hello to Mike M. for me



Hmmm... I know of a William Micheal M.

Nice to see a few more Long Islanders here.


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## citizensoldierny (Sep 10, 2010)

Saytuck99 said:


> I will pass it along...I have heard the class is really good...



+1 class is good and it gets even better  when you start to do ride time. I rode out of  agency, made no special requests and got awesome preceptors in the 6 or so dept.'s I rode with.


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## Scott33 (Sep 10, 2010)

Saytuck99 said:


> I will pass it along...I have heard the class is really good...



It's a good intro to ALS, but one of the most important things to remember is make sure you are on top of all your clinicals, or you *will* be dropped from class if they are not completed on time. There is very little room for lateral movement of CC clinical rotations these days, and if you work / ride for an agency which only gets a few calls per day, you are going to have to make some phone calls to other departments. 



			
				citizensoldierny said:
			
		

> ... I know of a William Micheal M.



Same guy. He knows his stuff and is a good laugh...teaches at a fast pace.


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## Scott33 (Sep 10, 2010)

Phlipper said:


> I don't quite get the "I'll call 911 and wait" attitude many take, even when it's a bad situation.  In an MVA with significant trauma I can't see me standing around with my thumbs up my butt when I could at least ensure occupants/ejectants are breathing, that severe bleeding is controlled, and at least a rudimentary triage has been completed and ready to pass on to the responders.



That's all very well providing the scene is safe. Big difference between stopping on a highway at night in poor weather, and doing the same on a slow country road during daylight hours.

In those MVAs with significant trauma you mention, how do you control bleeding while you are holding c-spine, assuming you are the only one there?


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## Phlipper (Sep 10, 2010)

Scott33 said:


> That's all very well providing the scene is safe. Big difference between stopping on a highway at night in poor weather, and doing the same on a slow country road during daylight hours.
> 
> In those MVAs with significant trauma you mention, how do you control bleeding while you are holding c-spine, assuming you are the only one there?



There will almost always be other folks milling around who can be directed to do this or that.  In a combat situation non medical folks (even dumb grunts  ) can be instructed to "Put this towel over that wound and apply direct pressure and elevate it." or "Hold his head just like this and try not to move." etc.  I can see an MVA working similarly in all but extreme cases such as being the only person on scene in the middle of nowhere at 2:00AM.  MVAs usually draw a crowd.


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## LonghornMedic (Sep 12, 2010)

I say call 911. Period. But I say that in an area where the farthest ALS unit is minutes away. I don't carry anything other than my phone. In the urban/suburban area I live in, if a patient is so critical that they will die without my immediate intervention, they probably aren't going to make it anyway. If it were a rural area, where help was a long way off, I could maybe see carrying a jump bag and pitching in. Considering that a BLS FD is at most 5 minutes out, a dual Paramedic ambulance is at most 6-7 minutes out and a choice of 4 helicopters is at worst 10-15 minutes out, and I am not going to get involved(other than assisting with compressions for CPR). It's also somewhat frowned upon around here. I'm also not willing to risk my license on an off-duty call. Good Samaritan applies, but my agency is not going to pay to defend me against a lawsuit, frivolous or not.


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## hocomedic (Sep 13, 2010)

i always say K.I.S.S: Keep it simple stupid, all i have is a small trauma bag in case i cut my self or something and a CPR mask, if its anything serious i say call 911


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## bstone (Sep 13, 2010)

In the rare occasion that I get involved, my first step is to call 911. My second step is to reach onto my keychain and pull out the latex gloves I keep in a pouch. My third step starts with scene safety, etc....


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## LondonMedic (Sep 14, 2010)

Phlipper said:


> There will almost always be other folks milling around who can be directed to do this or that.  In a combat situation non medical folks (even dumb grunts  ) can be instructed to "Put this towel over that wound and apply direct pressure and elevate it." or "Hold his head just like this and try not to move." etc.  I can see an MVA working similarly in all but extreme cases such as being the only person on scene in the middle of nowhere at 2:00AM.  MVAs usually draw a crowd.


Are you accepting responsibility for the safety of the person you're just asked to climb into an MVA scene?


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## Saytuck99 (Sep 14, 2010)

*Started CC class!*

Sorry I did not respond sooner..my wife just gave birth to our second daughter...that being said I started CC class Sunday...Very interesting...Masterson is funny as hell, but Hank will be teaching most of the class. I am excited about it...

I understand getting on top of clinicals..our department is not bad...about 2900 calls a year..but we also have medics paid in other departments etc..so i am going to ride as diversly as possible and take in as much as I can..

I will keep everyone apprised...I am thus far...optomisitc... haha


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## lightsandsirens5 (Sep 14, 2010)

bstone said:


> In the rare occasion that I get involved, my first step is to call 911. My second step is to reach onto my keychain and pull out the latex gloves I keep in a pouch. My third step starts with scene safety, etc....



Wait a minute. Your *third* step is scene safety?!? That is my first! Then, and only then, call 911. What good does it do to call 911 if people are shooting at you or if after the call you are wiped away by a logging truck? Always always always always always always always make sure that your location is secure before you do anything. And I would also add, constantly reevaluate that security. Stuff can go south in a big frickin hurry, and, oh buddy do you feel stupid and scared when all of a sudden the wacked out dude on speed, who was supposed to be somewhere else, is now between you and your partner with the pt, and somehow the idiot cops are in the other end of the house. And all you are holding is the clipboard. Or (and I did not experience it personally though) the transmissin line abouve you attached to the pole the vehicle hit has been arcing for the past 5 minutes, starts dripping insulation about 30 feet aylway, and then explodes. Constant reevaluation of safety and security can prevent you from being there in those situations. Nothing is more importaint than scene safety and security. Nothing. At the worst, you remove yourself from the sene and then call 911.  

Sorry bout the thread jacking. End of rant. :-/


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## bstone (Sep 14, 2010)

lightsandsirens5 said:


> Wait a minute. Your *third* step is scene safety?!? That is my first! Then, and only then, call 911. What good does it do to call 911 if people are shooting at you or if after the call you are wiped away by a logging truck? Always always always always always always always make sure that your location is secure before you do anything. And I would also add, constantly reevaluate that security. Stuff can go south in a big frickin hurry, and, oh buddy do you feel stupid and scared when all of a sudden the wacked out dude on speed, who was supposed to be somewhere else, is now between you and your partner with the pt, and somehow the idiot cops are in the other end of the house. And all you are holding is the clipboard. Or (and I did not experience it personally though) the transmissin line abouve you attached to the pole the vehicle hit has been arcing for the past 5 minutes, starts dripping insulation about 30 feet aylway, and then explodes. Constant reevaluation of safety and security can prevent you from being there in those situations. Nothing is more importaint than scene safety and security. Nothing. At the worst, you remove yourself from the sene and then call 911.
> 
> Sorry bout the thread jacking. End of rant. :-/




Dude- I am not an active EMT when an accident/emergency happens in front of me when I am a civilian. Before running up to it and going into EMT mode, my very first step is to call 911. Then glove up and assess scene safety when/if I volunteer to be in EMT mode.


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## mgr22 (Sep 14, 2010)

Saytuck99 said:


> Sorry I did not respond sooner..my wife just gave birth to our second daughter...that being said I started CC class Sunday...Very interesting...Masterson is funny as hell, but Hank will be teaching most of the class. I am excited about it...
> 
> I understand getting on top of clinicals..our department is not bad...about 2900 calls a year..but we also have medics paid in other departments etc..so i am going to ride as diversly as possible and take in as much as I can..
> 
> I will keep everyone apprised...I am thus far...optomisitc... haha



Congrats on the new baby! Hope everyone is doing well.

FYI Mike was a student of mine. If Hank is Hank M, he was, too.


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## Scott33 (Sep 14, 2010)

Hi "M"

If you are who I think you are, we were in the same EMS dept together.

Hope all is well down there, keep the brilliant articles coming...


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## mgr22 (Sep 14, 2010)

Scott33 said:


> Hi "M"
> 
> If you are who I think you are, we were in the same EMS dept together.
> 
> Hope all is well down there, keep the brilliant articles coming...



Thanks very much. I'm grateful to have worked with so many terrific people up there.


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## Saytuck99 (Sep 28, 2010)

mgr22 said:


> Congrats on the new baby! Hope everyone is doing well.
> 
> FYI Mike was a student of mine. If Hank is Hank M, he was, too.



Really?? interesting, very small world...


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## TransportJockey (Sep 28, 2010)

This is an older thread... but let me get this straight. Do some of you really think that others of us are less of EMTs because we leave the job when we clock out? That you think less of someone because all we are willing to do is phone in an accident? I'm just not willing to risk my safety to help someone I don't know when I'm not on the clock. EMS is just a job, not a lifestyle

Yes. I will help someone if they fall out and have no ROSC. But I'm not giving breaths. Compression only CPR is just fine, and in fact it's getting taught more and more to laypeople. 

I do carry a small kit, but like I've said in the past, there are no gloves and it's only for my use on myself when i'm offroad and out in the wilderness. 

EMS/LEO505, toss me a PM if you would about your experience with lawyers and NM EMS helping off duty. I'm kinda curious about this from your perspective.


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## LonghornMedic (Sep 28, 2010)

jtpaintball70 said:


> This is an older thread... but let me get this straight. Do some of you really think that others of us are less of EMTs because we leave the job when we clock out? That you think less of someone because all we are willing to do is phone in an accident? I'm just not willing to risk my safety to help someone I don't know when I'm not on the clock. EMS is just a job, not a lifestyle
> 
> Yes. I will help someone if they fall out and have no ROSC. But I'm not giving breaths. Compression only CPR is just fine, and in fact it's getting taught more and more to laypeople.
> 
> ...



I for one agree with your position. The risks far outweigh the rewards when getting involved in off duty treatment. While we are covered under Samaritan laws, that doesn't stop a lawyer from suing you anyways. You would still have to hire an attorney to attempt to get a lawsuit dismissed. You also risk losing your medic license should you do something wrong while providing care. Then there are the issues of scene safety considerations(i.e. traffic at MVA). My philosophy in regards to off duty involvement is much the same as when I carry my CCW- Make a good witness and not a dead hero. There are known cases of off duty firefighters and medics who were killed or severely injured trying to help out on MVA's. *Our jobs are dangerous enough on duty*, let alone off duty.


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## TransportJockey (Sep 28, 2010)

LonghornMedic said:


> I for one agree with your position. The risks far outweigh the rewards when getting involved in off duty treatment. While we are covered under Samaritan laws, that doesn't stop a lawyer from suing you anyways. You would still have to hire an attorney to attempt to get a lawsuit dismissed. You also risk losing your medic license should you do something wrong while providing care. Then there are the issues of scene safety considerations(i.e. traffic at MVA). My philosophy in regards to off duty involvement is much the same as when I carry my CCW- Make a good witness and not a dead hero. There are known cases of off duty firefighters and medics who were killed or severely injured trying to help out on MVA's. *Our jobs are dangerous enough on duty*, let alone off duty.


You put it much better than I did  And another CCW holder who has that idea. I got reamed on GlockTalk for stating that type of opinion.


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