101. Off-Season Boating, Cold Shock And Hypothermia The ACA National Canoe Sailing Committee, with details on sailing rigs, history and all aspects of sailing canoes. http://www.enter.net/~skimmer/coldwater.html

CONTENTS Off-Season Boating, Cold Shock and Hypothermia Recent Accidents in Cold Water Hypothermia References On-Line General Boating Safety ... "Off-Season Boating, Cold Shock, Hypothermia" (2 page Acrobat PDF file, 583K) Main Page OFF-SEASON BOATING, COLD SHOCK and HYPOTHERMIA The risk of falling overboard or capsizing may be small, but the threat-to-life of such accidents is most serious. There are no crowds of boaters on lakes and rivers in the colder months of the year. Fishermen work their favorite coves nearly undisturbed. On inland waters, migrating waterfowl appear in the fall and return again in the spring as soon as the ice goes out. The fine, breezy days of spring and fall are the best of days for many open boaters. There are trade-offs for these blessings. The water is cold (less than 60 degrees F) in the off-season. More than half of the fatal boating accidents in Pennsylvania occur when the water is cold. Most such accidents occur in calm weather, relatively close to shore. Because fewer boaters are on the water, the likelihood of a prompt rescue is greatly reduced. Off-season boaters must be as self-sufficient as possible. Immersion in cold water rapidly incapacitates and may kill boaters who are not wearing protective clothing. Surfers, sailboarders, and river paddlers wear wet suits or dry suits when the water is cold. Off-season sailors, fishermen, hunters, and other folks out in open boats can use these same precautions to greatly improve their safety on the water.

102. Therapeutic Hypothermia After Cardiac Arrest: An Advisory Statement By The Advan Induction of moderate hypothermia (28°C to 32°C) before cardiac arrest has been Recovery from outof-hospital cardiac arrest after mild hypothermia http://circ.ahajournals.org/cgi/content/full/108/1/118

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted ... Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal ... Request Permissions PubMed PubMed Citation Articles by Nolan, J.P. Articles by Atkins, D. Related Collections Other Stroke CPR and emergency cardiac care Brain Circulation and Metabolism Primary and Secondary Stroke Prevention Circulation. ILCOR Advisory Statement Therapeutic Hypothermia After Cardiac Arrest An Advisory Statement by the Advanced Life Support Task Force of the International Liaison Committee on Resuscitation J.P. Nolan, FRCA P.T. Morley, MD T.L. Vanden Hoek, MD R.W. Hickey, MD W.G.J. Kloeck, MB BCh, DipPEC(SA), Chair J. Billi, MD P.T. Morley, MD J.P. Nolan, MD K. Okada, MD C. Reyes, MD M. Shuster, MD, FRCPC P.A. Steen, MD M.H. Weil, MD, PhD V. Wenzel, MD R.W. Hickey, MD P. Carli, MD T.L. Vanden Hoek, MD D. Atkins, MD From the *Resuscitation Council of Southern Africa (RCSA)

103. KYW: Health: Cold Weather Dangers Certain people are more susceptible to hypothermia including infants, The best defense against both frostbite and hypothermia is dressing in layers. http://kyw.com/health/local_story_009155317.html

var oassitepage='kyw.com/health'; content_headline='KYW%3A%20Health%3A%20%20Cold%20Weather%20Dangers';content_section='health'; @import url("http://static.viacomlocalnetworks.com/css/story.css"); accID='DM5307031CNM78EN3'; content_group='/health;/kyw.com/health;/kyw.com/health';content_title='PUT+PAGE+NAME+HERE'; KYW: Health: Cold Weather Dangers Search News Video The Web Dining A A+ A++ Save It ... Water Cooler Seen on CBS 3 Special Reports I-Team Investigations 3 On Your Side Woman's View ... TV Schedule Services Careers Real Estate Autos Travel ... Coupons Lifestyle Family New Baby Collections Video Slideshows In Our Area Community Calendar Contests Other Ways to Get News XML Feeds Track It! About Us Station Info Contact Us Press Releases Jobs Our Partners CBSnews.com CBS.com Health Health Main Men Women Kids Aging Health Library Jan 9, 2004 4:00 pm US/Eastern Health: Cold Weather Dangers var title=charStrip("Health: Cold Weather Dangers"); writeClipImg(title, "http://kyw.com/health/local_story_009155317.html", "saveit"); Save It Email It Print It (KYW) PHILADELPHIA The bitter cold temperatures are more than uncomfortable; they can be downright dangerous. Medical Reporter Stephanie Stahl has the story.

104. Search And Rescue - Hypothermia Ice Mountain hypothermia is a condition where your body core temperature is too hypothermia is a process of body heat loss, and sometimes a rapid one, http://www.dcnr.state.pa.us/forestry/searchandrescue/hypthm.aspx

Forestry Recreation Forest Health Private Forest Landowners ... Contacts Hypothermia Dressing properly for the outdoors is the single, most important prevention measure to avoid hypothermia. Being properly dressed for the outdoors can easily be accomplished if you think of it in three levels. First, you must dress appropriately for the main activity that you expect to be doing. Second, you must allow for varying degrees of exertion. And third, you must allow reasonable flexibility for unexpected changes. While many new "miracle" fabrics are advertised as being able to "do it all", the simplest and best solution is to dress in layers. This allows you to make adjustments in activity level or weather conditions to keep yourself comfortable and safe. Our bodies can withstand a relatively broad temperature range (35 degrees F to 105 degrees F), but we are most comfortable when we are at homeostasis. Homeostasis is when your body produces and loses heat at the same level. If you are participating in a low energy producing activity such as sitting quietly, you will produce less heat and will require more insulation (clothes). Conversely, if you are enjoying a high energy activity such as cross-country skiing you will produce excess heat and moisture and will need to shed some of that insulating clothing to allow them to escape.

105. Cold Wet Killer - Hypothermia Advice for hillgoers encountering someone with cold related health problems. http://www.scotclimb.org.uk/article.php?id=96

106. Public - Hypothermia hypothermia. Select a section to view guidance statement information on hypothermia. Prevention Screening Diagnosis Consultation for Diagnosis http://pier.acponline.org/physicians/public/d598/d598.html

Author: Dmitri Guvakov, MD, PhD; Stuart Weiss, MD, PhD; Albert Cheung, MD Module updated - 2005-08-04 Author information and module status Hypothermia Select a section to view guidance statement information on Hypothermia. Prevention Screening Diagnosis Consultation for Diagnosis ... Additional Resources What's New ACP Members can access the full PIER website. Newly Cited Reference Risk factors influencing inadvertent hypothermia in infants and neonates during anesthesia. Newly Cited Reference Thoracic lavage in accidental hypothermia with cardiac arrest - report of a case and review of the literature. Newly Cited Reference Ethanol versus lipopolysaccharide-induced hypothermia: involvement of urocortin. FAQs The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP. Because all PIER modules are updated regularly, printed web pages or PDFs may rapidly become obsolete. Therefore, PIER users should compare the date of the last update on the website with any printout to ensure that the information being referred to is the most current available. 190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.

107. Hypothermaia Cold Weather Senior Health IS IT hypothermia? LOOK FOR THE UMBLES STUMBLES, MUMBLES, hypothermia is a particular problem for older people who lack proper http://seniorhealth.about.com/library/news/bl_PR_cold.htm

zJs=10 zJs=11 zJs=12 zJs=13 zc(5,'jsc',zJs,9999999,'') zfs=0;zCMt='a08' About Senior Health Home Safety hypothermaia cold weather Senior Health Essentials Senior Health Dictionary Senior Health FAQ ... Help zau(256,140,140,'el','http://z.about.com/0/ip/417/C.htm','');w(xb+xb+' ');zau(256,140,140,'von','http://z.about.com/0/ip/496/6.htm','');w(xb+xb); FREE Newsletter Sign Up Now for the Senior Health newsletter! See Online Courses Search Senior Health IS IT HYPOTHERMIA? LOOK FOR THE "UMBLES" STUMBLES, MUMBLES, FUMBLES, AND GRUMBLES NATIONAL INSTITUTES OF HEALTH NIH News Release National Institute on Aging FOR IMMEDIATE RELEASE Thursday, January 23, 2003 Contact: Jeannine Mjoseth Older people who lower the thermostat to cut heating bills raise their risk of hypothermia, a potentially fatal condition in which the body's temperature drops for a prolonged period. Hypothermia is a particular problem for older people who lack proper nutrition, take certain medications, drink alcohol, and who have conditions such as arthritis, Alzheimer's disease, stroke, and Parkinson's disease. If you suspect someone may have hypothermia (hi-po-ther- mee-uh), look for the "umbles" stumbles, mumbles, fumbles, and grumbles - these show that the cold is affecting how well a person's muscles and nerves work. Take their temperature with a thermometer that has been shaken to its lowest point. If their temperature doesn't rise above 96°, call for emergency help. While you are waiting, keep the person warm and dry. Wrap the person in blankets, towels, coats whatever is handy. An older person's skin may be easily damaged so be gentle if you rub their arms and legs to generate warmth.

108. Hypothermia Archive http://ww3.telerama.com/~eeyore/hypothermia/

109. AllRefer Health - Hypothermia (Cold Exposure, Low Body Temperature) hypothermia (Cold Exposure, Low Body Temperature) information center covers common causes, symptoms, first aid measures, prevention tips, getting medical http://health.allrefer.com/health/hypothermia-info.html

AllRefer Channels :: Yellow Pages Reference Health Home ... Contact Us Quick Jump Allergic Reactions Animal Bites Anterior Knee Pain ACL Injury Bleeding Broken Nose Burns Choking/Heimlich Maneuver CPR Dental Injuries Drug Abuse First Aid Ear Emergency Eye Emergency Fracture Frostbite Genital Injury Head Injury Heart Attack First Aid Heat Emergencies Insect bites or Stings Meniscus Tear Poisoning First Aid Sprains Sunburn First Aid Tick Bite Wounds 60+ More Injury Topics Alternative Medicine Health News Symptoms Guide Special Topics ... Medical Encyclopedia Web health.allrefer.com You are here : AllRefer.com Health Hypothermia Hypothermia Definition Causes Prevention First Aid ... Go To Main Page Alternate Names : Cold Exposure, Low Body Temperature Definition Hypothermia is dangerously low body temperature, below 95 degrees Fahrenheit (35 degrees Centigrade). Exercise - Dress Appropriately Skin Layers People who are most likely to experience hypothermia include those who are: Very old or very young Chronically ill, especially with heart or circulation problems Malnourished Overly tired Under the influence of alcohol or other drugs Previous Top Next Jump to another section Definition Hypothermia: Causes Hypothermia: Prevention Hypothermia: First Aid ... Call Immediately for Emergency Medical Assistance if Topics that might be of interest to you Diabetes Other Topics CPR Frostbite Shock Unconsciousness - First Aid Review Date : 8/22/2003 Main Page of Hypothermia From Our Sponsors: A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's

110. Hypothermia - VeterinaryPartner.com - A VIN Company! hypothermia is when the body temperature goes below 100.5 degrees. hypothermia may be a sign of serious illness (ie, diabetes, Addison s disease, http://www.veterinarypartner.com/Content.plx?P=A&A=367&S=1&SourceID=20

111. Accidental Hypothermia Accidental hypothermia in the MontBlanc massif, pathophysiology and treatment. http://perso.wanadoo.fr/dmtmcham/hypothermia.htm

ACCIDENTAL HYPOTHERMIA DEFINITIONS PHYSIOLOGY CLINICAL AND BIOLOGICAL ASPECTS CLASSIFICATION The pathophysiological mechanisms lead to distinguish three kinds of hypothermia, very different in their treatment. This emphasizes the importance of a precise knowledge of the circumstances. Acute hypothermia The cold is so severe, that thermogenesis doesn't succeed in maintaining the equilibrium; the organism cools before the energy reserves are used and the blood volume modifications are set up. This kind of hypothermia occurs in injured alpinist or skiers, immobilized in snow, a crevasse or a torrent. Sub-acute hypothermia This is hypothermia of an unharmed alpinist stuck in the mountain. It only appears when the energy reserves are used, so its onset is more or less rapid according to the patient's condition. Thermogenesis is very reduced, spontaneous rewarming is more uncertain and cooling can continue even with a minimal heat loss. Moreover, the liquid movements have time to appear and there is a big risk of hypovolemia during rewarming. Sub-chronic hypothermia This is found in poor urban environments, in winter. Onset is very slow, the inter-compartment liquid transferts are important, spontaneously compensated by the patient, with a big risk of edema during rewarming.

112. Street Medic's Guide To Hypothermia To prevent hypothermia it is better to be slightly cold and generating heat than Don t let things progress to hypothermia. Stay out of the coldest, http://www.bostoncoop.net/balm/hypothermia.html

Boston Area Liberation Medic (BALM) Squad Providing Medical Coverage for Progressive Actions in Boston and Beyond BALM Squad Home What Do Street Medics Do? Training The BALM Library ... Contact Us For a printer-friendly version of this handout, click here . This handout is formatted for double-sided printing, with two copies of the handout on each sheet. You will need the free Adobe Acrobat Reader to access the printer-friendly version of the handout. To download the latest version of Acrobat Reader for your computer, click here Street Medic's Guide to Hypothermia HYPOTHERMIA = when core body temperature drops Risk factors for hypothermia: Cool, cold, wet, or windy weather. Improper clothing and equipment. Clothes that are tight and impair circulation. Fatigue. Dehydration. Extremes of age. Immobility. Not eating enough. Alcohol, cigarettes, caffeine. Not taking hypothermia seriously. Highest risk = days when the weather changes a lot, when its cool but not cold, or when people don't anticipate the cold, wet, and/or wind. Medical conditions that increase risk of hypothermia.

113. The Powerboat Training Website You may wonder why an article on hypothermia but its all too easy when boating hypothermia is a serious threat to Northwest boaters, and it takes the http://www.powerboat-training.co.uk/articles/articles-hypothermia.htm

home email Navigation The PowerboatTraining Website info@powerboat- training.co.uk Articles To return to the list of articles please select 'Back' This article is supplied by Washington State Parks and Recreation Commission Hypothermia You may wonder why an article on hypothermia but its all too easy when boating later in the year to get your crew very cold and possibly hypothermic. Read the article then hope never to need to deal with the issue. H ypothermia is a serious threat to Northwest boaters, and it takes the lives of several Washingtonians each years. Our marine waters and most of the state's lakes and streams remain cold throughout the year, so hypothermia is a danger that knows no season. A boater who ends up in the water may begin falling victim to hypothermia in a matter of only a few minutes, so quick action is often the key to survival. Understanding and avoiding hypothermia can mean the difference between being alive or dead when help arrives. What is Hypothermia?

114. Accidental Hypothermia hypothermia is marked by unusually low body temperatures, Severe hypothermia can cause an irregular heartbeat leading to heart failure and death. http://www.wramc.amedd.army.mil/education/hypother.htm

Accidental Hypothermia The Cold Can Be Trouble for Older People Introduction What is hypothermia? What to look for Treatment and recovery from hypothermia ... Remember these important facts Introduction Cold weather can be risky for anyone, but especially for older people. Almost everyone is familiar with winter hazards such as broken bones from falls on ice or breathing difficulties triggered by cold air. But the winter chill can also lead to a temperature drop inside the body that can be deadly if not found quickly and treated properly. This lowered body temperature, usually brought on by staying in a cool place for a long time, is called hypothermia (hi-po-ther-mee-uh). It is a special problem for older people, who often have other illnesses or take medications that can interfere with the body’s ability to regulate its temperature. What is hypothermia? Hypothermia is marked by unusually low body temperatures, below 96° F (35.5° C) - well below the body’s normal temperature of 98.6° F (37° C). What may seem like a mere couple of degrees can have a devastating effect. Severe hypothermia can cause an irregular heartbeat leading to heart failure and death. Body temperature is a balance between how much heat is produced and how much is lost. The brain acts as a thermostat, sending and receiving signals to and from parts of the body that affect temperature: the spinal cord, muscles, blood vessels, endocrine system, and skin. The body has many different reactions to cold. Shivering by the muscles, for instance, is one way the body produces heat. Muscles shiver in response to messages sent by the nerves; shivering increases muscle cell activity, which in turn produces heat.

115. Asanguineous Ultraprofound Hypothermia Cryonics at Alcor Life Extension Foundation, the world s leading cryonics organization since 1972. Information on cryonics, cryobiology, nanomedicine, http://www.alcor.org/Library/html/tbwcanine.html

Home About Cryonics Cryonics Myths Notable Quotes ... Library A MANNITOL-BASED PERFUSATE FOR REVERSIBLE 5-HOUR ASANGUINEOUS ULTRAPROFOUND HYPOTHERMIA IN CANINES by Jerry D. Leaf, Michael G. Darwin, and Hugh Hixon Cryovita Laboratories, Inc. 10743 Civic Center Drive Rancho Cucamonga, CA 91730 Unpublished paper [accompanying figures not available] This work was carried on from 1984 thru 1987 ABSTRACT Introduction Materials and Methods asanguineous perfusate The composition of the perfusate used for total body washout is given in Table 1 [PDF file] . Six liters of perfusate were prepared the night before each experiment and stored on ice. Preoperative All animals received humane care in compliance with the Principles of Laboratory Animal Care formulated by the National Society for Medical Research and the Guide for the Care and use of Laboratory Animals prepared by the National Institutes of Health (NIH Publication No. 80-23, revised 1978). Hypothermia was initiated by surface cooling. The dogs were placed on a cooling blanket connected to a Blanketrol heater/cooler set to 0°C and covered with Ziploc bags of crushed ice. Both esophageal and rectal temperatures were measured to the nearest 0.1°C with a YSI Model 46TUC temperature meter. Heart rate and ECG were monitored using three limb leads on an Electrodyne Model CB121B recording system. Sodium bicarbonate was infused as needed in combination with induced respiratory alkalosis to control pH according to the alpha-stat pH strategy (38). Respiratory alkalosis was induced by increasing the oxygen flow to the oxygenator to produce an average perfusate arterial pCO2 of 24 ± 7.9 (SD) mm Hg during deep hypothermic TBW.

116. Adult Health Advisor 2004.2: Hypothermia hypothermia is more likely to occur if something, such as an accident, keeps you from moving or hypothermia may happen after a heart attack or stroke. http://www.med.umich.edu/1libr/aha/aha_hptherm_crs.htm

Adult Health Topics All Health Topics Find a UMHS Doctor Search Adult Topics Search All Topics This information is approved and/or reviewed by U-M Health System providers but it is not a tool for self-diagnosis or a substitute for medical treatment. You should speak to your physician or make an appointment to be seen if you have questions or concerns about this information or your medical condition. Index Hypothermia What is hypothermia? Hypothermia is a dangerously low body temperature. Normal body temperature ranges between 97.2°F (36.2°C) and 99.5°F (37.5°C). If your body temperature is just a few degrees lower than this, your bodily functions slow down. If your temperature drops too low and stays low for more than a few hours, the body's organs can be damaged and there is a risk of death. How does it occur? Your temperature can drop gradually as your body is exposed to cold temperatures. This could happen if: You spend a lot of time in a cold, unheated indoor environment. You are outside in cold weather without proper protection against the cold, wind, rain, or snow.

117. Home hypothermia/Hyperthermia Surveillance. hypothermia. hypothermia is defined as a cold injury associated with a fall of body temperature to less than 94.1° F, http://www.dhss.mo.gov/HypoHyperthermia/

DHSS Home State Home Ask Us Home ... Contact Us breadCrumbs("main",">>","index.htm","crumb","crumb","crumb","0"); Hypothermia/Hyperthermia Surveillance Hypothermia The elderly are more likely to be victims of cold-related illness resulting in death. Too often handicapped or elderly individuals fall outside their homes and are unable to reach shelter or help. During the cold weather seasons 1989-2004 (preliminary data), 110 (51%) hypothermia deaths were of people age 65 years and older. Deaths of individuals between the ages of 25-64 often have a contributing cause of substance abuse or a debilitating medical condition. Since 1989, there have been 97 (45%) hypothermia deaths in this population. Fortunately, deaths in people age <25 years are rare, accounting for only 7 (3%) of the total 214 Missouri hypothermia deaths for the 1989-2004 (preliminary data). From cold weather winter seasons 2000 through 2004 (preliminary data), the largest number of deaths were among white males comprising 48% (n=39) of the 81 total cold related deaths. The majority, 46 (57%), of deaths occurred in the non-metropolitan areas of Missouri. Jackson County had 18 (22%) deaths, St Louis County had 9 (11%), and St Louis City had 8 (10%) of the total 81 hypothermia deaths since 2000. Missouri is the only state that conducts on-going statewide surveillance for cold weather related illnesses and deaths.

118. Hypothermia Tips hypothermia is a condition in which your body temperature drops causing your Significant hypothermia occurs when your body temperature is around 95 http://transportation.ky.gov/person/hypothermia tips.htm

(Next Tip) Hypothermia is a condition in which your body temperature drops causing your bodily functions to shut down. Significant hypothermia occurs when your body temperature is around 95 degrees Fahrenheit. Severe hypothermia will begin at 90 degrees Fahrenheit. This will occur during cold temperatures. Hypothermia will most often happen when the temperature is between 30 and 50 degrees Fahrenheit. This is because people can become careless in these temperatures. The weather may seem warm after a long winter and people may go out unprotected. In the summer, 50 degree water, like Lake Superior, can cause hypothermia if a person is in the water too long. Just a few minutes in cold water are enough to kill someone. Wind, wetness, and cold contribute to hypothermia the most. When the body temperature reaches 97 degrees, the victim will begin to shiver. More violent shivering, speech difficulty, and sluggish thinking will occur from 95 to 91 degrees Fahrenheit. At this point, they will require assistance to reverse hypothermia. The victim’s muscles will become rigid and their skin puffy as their body temperature falls to 86 degrees. From 85 to 81 their pulse drops, and the victim will think irrationally. When the victim is between 80 and 78 degrees Fahrenheit, they become unconscious. Below 78, few have survived. HOW WOULD YOU TREAT A HYPOTHERMIA VICTIM?

119. Therapeutic Hypothermia For Head Injury (Cochrane Review) Abstract of a systematic review of the effects of health care prepared by the Cochrane Collaboration. http://www.update-software.com/Abstracts/AB001048.htm

From The Cochrane Library, Issue 3, 2005 Therapeutic hypothermia for head injury (Cochrane Review) Alderson P, Gadkary C, Signorini DF ABSTRACT What's new in this issue Search abstracts Browse alphabetical list of titles Browse by Review Group A substantive amendment to this systematic review was last made on 28 July 2004. Cochrane reviews are regularly checked and updated if necessary. Background: Induced hypothermia has been used in the treatment of head injury for many years. Encouraging results from small trials and laboratory studies led to renewed interest in the area and some larger trials. Objectives: To estimate the effects of mild induced hypothermia in moderate and severe head injury on mortality, long-term functional outcome, complications, and short-term control of intracranial pressure (ICP). Search strategy: We searched the Injuries Group Specialised register (last searched in 2001), MEDLINE, EMBASE and the Cochrane Controlled Trials Register. We handsearched conference proceedings and checked reference lists of relevant articles, including a systematic review published in 2003. Selection criteria: Randomised controlled trials of mild hypothermia to 34-35º Celsius for at least 12 hours versus control (open or normothermia) in patients with any closed head injury requiring hospitalisation. Two reviewers independently assessed all trials.

120. Hypothermia hypothermia. THINK FIRST! When the wind blows, we generally feel cooler. If you take a thermometer out in the wind, what will happen to the temperature it http://www.galaxy.net/~k12/water/hypo.shtml

HYPOTHERMIA THINK FIRST! When the wind blows, we generally feel cooler. If you take a thermometer out in the wind, what will happen to the temperature it is reading? MATERIALS 1 thermometer 1 book 1 paper towel 1 rubber band room temperature water PROCEDURE 1. It is very important that the water you use is room temperature. To make room temperature water, put some tap water in a bottle and let it sit in the room overnight. 2. When handling the thermometer, be careful not to hold it by the bulb or you will be measuring your body's temperature. 3. Record the starting temperature of the thermometer. 4. Hold the thermometer in your hand while your partner makes wind on it by waving the book near it. Do not blow on it with your mouth. 5. After a minute of wind, record the temperature. What do you observe? 6. Now wrap one layer of paper towel around the bulb of the thermometer and hold it there with the rubber band. Make sure you can see the scale. 7. Dip the thermometer wrapped in the paper towel in room temperature water. Record the temperature. 8. Once again, hold the thermometer (still wrapped in the towel) and have your partner make wind using the book.

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