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"With up to 2,300 m (7,545 ft) of rock on top of it, the Gotthard Base Tunnel, which is scheduled to go into regular operation in December 2016 in the Swiss Alps, is not only the world’s longest, but also the deepest railway tunnel ever built. Accordingly, the temperatures in the tunnel are very high, with the surrounding rock expected to reach 45° C (113° F) once the tunnel is fully operational. Since unrestricted rail operations are only permitted in temperatures of 40° C (104° F) or less, the heat has to be controlled with suitable equipment. Large fans developed and built especially for this application by TLT-Turbo GmbH provide fresh air for regular operations as well as during maintenance and repair work. Separate fans ensure that the emergency exits are properly ventilated in case of fire. In addition to coming up with a technical solution that could handle the special challenges of this project, the engineers and planners had to develop detailed preliminary plans as well as a sophisticated logistics and installation concept.The Gotthard Base Tunnel consists of two 57-km (35-mile) long tubes, one in each direction. Including all connecting and access tunnels, the entire underground system measures 152 km (95 miles). At Faido and Sedrun, at approximately 16 and 36 km (9 and 23 miles) respectively, two multifunction stations were built that cut each of the two tubes into three sections of roughly equal length. Here, trains can make emergency stops and change tracks, if necessary. This is also where eight large axial fans made by TLT were installed that exchange the air, i.e. they extract a certain amount of heated air and inject the same amount of cool fresh air a few hundred meters further down the train tracks. In addition to the four exhaust and four supply fans, 24 so-called jet fans were installed along with associated components like silencers, shut-off dampers, drives and lubrication systems from TLT.In addition to exchanging the air, these fans are used to enable maintenance and repair operations in the tunnel. Current plans call for blocking each tunnel tube for one night per week in order to perform preventive maintenance work, thus enhancing the tunnel’s overall functionality and availability. During these hours, many people will be in the tunnel who require fresh air. “One of the major criteria for winning this bid was the fans’ ability to quickly switch between a wide-range of modes. TLT fans are among the best in the world in this regard,” said Andreas Kuhn, TLT’s project manager for the Gotthard Base Tunnel, about the selection of his company’s fans for this project."

Dec 1, 2016

By William Bergeson

"BACKGROUND As of December 2015, there are roughly 475 road tunnels within the United States according to the most recent national tunnel inventory data compiled by the Federal Highway Administration (FHWA); whereas, there are more than 615,000 highway bridges on public roads. The FHWA estimates that tunnels represent nearly 100 miles of Interstates, State routes, and local routes. Tunnels are part of the national transportation infrastructure and represent a significant financial investment for the owner and, hence, the tax payers. Tunnels, that are not properly maintained, usually require more extensive repairs and consume more resources. Tunnels must provide safe, reliable, and effective transportation even as these structures age and deteriorate. Furthermore, tunnels generally remain in service for extended periods of time due to their very high construction costs. For example, many tunnels were constructed decades ago during two historic periods of highway system expansion; the first period correlated with the era of public works programs linked to the Great Depression of the 1930-40s; and the second period of expansion occurred with the building of the interstate highway system in the 1950-60s. As such, these tunnels are fast approaching 60 to 80 years old. Congress enacted the Moving Ahead for Progress in the 21st Century Act (MAP-21), which was signed by the President on July 6, 2012. This legislation followed a fatal tunnel incident on July 10, 2006 and a National Transportation Safety Board (NTSB) report1 that noted the importance of conducting regular tunnel inspections. MAP-21 authorized the Federal Highway Administration (FHWA) to develop a mandatory inspection program for all tunnels on all public roadways (Bergeson and Ernst 2015): To help safeguard tunnel users and to ensure reliable levels of service, the FHWA developed the National Tunnel Inspection Program (NTIP), which is comprised of the National Tunnel Inspection Standards (NTIS), the Tunnel Operations Maintenance Inspection and Evaluation (TOMIE) Manual, the Specifications for National Tunnel Inventory (SNTI), and the Manual for Bridge Evaluation (MBE). The data collected from the program will be stored in a National Tunnel Inventory (NTI) database. A comprehensive and refresher training program was also developed to help qualify and certify key tunnel inspection personnel to include the program manager and team leader."

Jan 1, 2016

By W. J. Schitt

Section 15 covers a loose collection of topics that involve water in some way. The chapters in this section include Dredge and Placer Mining (Chapter 15.1), Solution Mining: Surface Techniques (Chapter 15.2), and Solution Mining: In Situ Techniques (Chapter 15.3). The dredge and placer systems involve water in several forms. The segment on hydraulicking or hydrosluicing discusses the use of monitors to direct high-pressure water jets to move material. As such, this represents an alternative to mechanical breakage, loading, and hauling. This chapter also covers placer mining (except dry placering) where the water provides the medium that promotes the separation of minerals based on their density and other settling characteristics. Thus placer mining is generally limited to concentration of gold, tin ore, diamonds, and other heavy minerals that are already liberated and are contained in a less dense matrix. The third topic, straight forward dredging, as in sand and gravel operations, involves water only in an incidental way. Here water simply covers the minerals of interest. Thus the dredging system need only lift a payload from the submerged location to the surface for further processing or handling

Jan 1, 2008

By Robert Burgess, Dale Gill, Jaco Steyn, Bill Kyslinger

"With mining, especially coal extraction, comes the necessity of supporting the roof. Since the 1950s, the primary method for roof support has been the use of roof bolts. Roof bolting is considered one of the most hazardous jobs in underground coal mining. In 2004, there were 3,405 injuries reported to the U.S. Mine Safety and Health Administration (MSHA). Of those injuries, 17 percent were associated with bolting machines (593 injuries). The majority of the injuries resulted from rock falling from supported roof. However, injuries involving a part of the body being struck by, or caught between, during bolting and drilling occurred with relatively high frequency (Burgess and Steiner, 2007).Roof drilling and bolt installation is labor-intensive and repetitive. These labor-intensive and repetitive requirements can lead to cumulative trauma. Operators are expected to perform a considerable amount of lifting, carrying, bending, reaching and stretching. Back and shoulders become sore from bending and twisting to install bolts or lift and position drill steels, wrenches and bolts. Confined operator spaces also contribute to difficult and awkward working positions for the operators (Cornelius and Turin, 1998).In South Africa, the majority of the roof bolting machines used are “man-in-position” style machines (Fig. 1). This puts the operator in close proximity to where the drilling and bolting process is performed. When proper operation procedures are followed, it has been proven to be a very effective, productive and safe system. The MSHA-certified automatic temporary roof support (ATRS), canopies and dust collection system of Fletcher bolters all provide the operator with unparalleled protection. However, there are some occupational hazards inherent to the zone located next to the drilling and bolting zone. This has led some customers to request relocating the operator away from this zone. The idea being that the operators will no longer be located in the face area, greatly reducing their exposure to dust, noise, machine and geological hazards."

Mar 1, 2017

By Mike Tracy

This section of the Handbook deals with general principles to be evaluated in the development of a mining operation. It addresses the major issues that must be examined to fully evaluate a mining venture. Of course, one of the main topics to be evaluated is mine planning, which is covered in more detail in other sections (13, 17) of the Handbook and should be referenced in mine development projects. The topics to be discussed in this introduction include equipment and supplies, infrastructure, utilities, and project management. In any of the aspects mentioned, the current existing conditions at or near the mine site must be evaluated. This will include assessment of current use of utilities, infrastructure, housing, equipment suppliers, etc., as well as anticipated growth, both in the supply aspect of these systems as well as projected usage on these systems. After full assessment of both these aspects, an evaluation must be made as to the requirements the project will place on these items. Assessment must be made as to any up-grades required to bring the project on line, what impact the project will have on existing or expanded systems, and anticipated future growth impacts on support systems not only of the project but of other surrounding industry and urban devel-opment

Jan 1, 2008

By Z. T. Bieniawski

Geomechanics signifies the science and engineering of soil and rock materials and of rock masses. It is a field of professional practice and research that draws heavily on the elements of soil and rock mechanics. Geomechanics contributes to a number of disciplines: mining engineering, civil engineering, geological engineering, petroleum and natural gas engineering, and engineering geology (including the elements of geohydrology and geophysics). These disciplines are involved in the design and construction of such projects as mines, tunnels, foundations for structures, excavated rock slopes, dams, shafts, boreholes, oil reservoir wells, underground storage facilities for oil and gas, and hazardous waste repositories. Geomechanics allows us to improve both our environment and our quality of life. In the context of this Handbook, the scope of geomechanics is discussed mainly from the point of view of applications to mining engineering. However, the coverage of the subject mate¬rial is so comprehensive that it is relevant to other disciplines as well. Section 10 covers the field of geomechanics in a structured fashion, beginning with the fundamental principles and leading into practical applications in mining engineering. Throughout the treatment of the subject, knowledge of geologic conditions is assumed since this is discussed in other sections of the Handbook. An important feature of this section is a series of practical examples illustrating the various aspects of geomechanics. Since geomechanics is concerned with both soil and rock mechanics, Chapter 10.1 introduces the fundamentals of soil

Jan 1, 2008

By Michael Lenz

Predictive maintenance technologies including vibration analysis, tribology, infrared thermography, ultrasonic detection, and electrical measurements have been applied to large electric mining shovels. The predictive program was initiated on the P&H Model 2300 and 4100 electric shovels. The utilization of these technologies has shown the potential for improving electric mining shovel availability and minimizing maintenance costs. Predictive technologies provide the tools to assess machinery condition. Availability is enhanced by the condition based planning of component replacement. Maintenance costs are minimized by focusing resources through condition based prioritization.

Jan 1, 1997

The mining industry is one of the three pillars of the Namibian economic development, besides tourism and the fishing industry. Generating 20 % of the GDP and more than 50 % of the export income, half of this amount derives from the diamond mining industry. In 2008, the annual production of 2.2 mio carat achieved an income higher than 1.44 billion Namibian Dollars (more than 750 mio Euro). After the global recession in early 2009, which also caused a significant downcrease in production to only 0.93 mio Carat, the diamond mining industry easily restored itself and the production figures for 2010 are expected to be even higher than those achieved in 2008. Compared to other diamond producing countries, Namibia is mainly producing diamonds of highest quality (jewellery quality), with less than 10 % of the mined diamonds not falling into this category. This high quality stands also for the worldwide highest prize achieved per carat. With 370 $US per carat it is more than four times higher than that of the average South African stone. In 1908 the finding of the first diamonds in the Namib desert close to the coastal town of Lüderitz was reported by a Mr Stauch, railway inspector for the then German colonial railway company. This event immediately triggered a Diamond Rush and subsequently the set-up of the restricted diamond mining area ?Sperrgebiet? through the German colonial administration. In 1913, only five years after the first mining operations had started, the steadily increasing production allowed for more than 20 % of the diamond production worldwide. After the First World War, the new South African government concentrated all mining activities in one organization, CDM (Consolidated Diamond Mines of South West Africa) which in following decades conducted an extensive and detailed exploration of the whole Sperrgebiet and started numerous new diamond mining operations.

Jan 1, 2011

By Corby G. Anderson

Since 1985, the Sunshine Mining Company has used a patented nitric-sulfuric acid pressure leaching system for production of silver and copper from a refractory sulfide ore body. To better understand this novel process, a program of lab scale testing was undertaken to quantify the effect of system variables on silver recovery. Some of the factors studied include temperature, agitation, acidity, vessel pressure, particle size, percent solids and oxidizer amount. In turn, this knowledge will be applied in actual plant practice to upgrade reaction time, increase concentrate throughput, raise silver recovery and lower reagent costs. A discussion of plant process changes resulting from lab scale testing is included.

Jan 1, 1991

By Russell G. Shomperlen

Grinding mills in excess of 5 meter diameter and 3500 kilowatts per mesh are putting new demands on big gears. This paper returns to the basics of ring gear design beginning with the fundamental power formulas specified by AGMA. Specific emphasis is given to those elements in the rating equations which require closer attention as gear diameters and transmitted power increase. Strict process control in the manufacture of the gear blank is also stressed. Finally, the writer offers a guide to proper installation, lubrication and maintenance.

Jan 1, 1981

By Fahimeh Dehghani, Louis Ackah, Tathagata Ghosh, Justin Godbold, Jia Liu, Meisam Peiravi, Manoj Mohanty, Azam Baharlouei

Primary economical deposits of rare-earth elements (REEs) are exhausting all over the world, and it has become necessary to find new sources and methods for their extraction. In addition, increasing the application of REEs in modern technological society has increased its demand globally. One of the important movements to compensate for the future shortages of critical metals is the recovery of REEs from recyclable materials. This paper presents a review of the classification and extraction methods, as well as general applications of REEs with emphasis on secondary sources such as coal and coal byproducts, iron ore tailings, apatite, and phosphate byproducts. An overview of the current state of knowledge on the various methods of REE beneficiation and extraction is covered. These methods include physical separation, as well as hydrometallurgical and bio-hydrometallurgical techniques. The application of these REE extraction techniques for enhanced recovery has been driven primarily by the unique industrial application of these important elements. This paper further explores the existing and potential environmental challenges associated with REE extraction. The authors have presented a wide array of literature, in-depth discussion of the subject, and a succinct summary of processes and relevant case studies.

Sep 23, 2020

By C. O. Lee

The Grand Isle Sulphur Mine is located in the Gulf of Mexico, approximately seven miles off the coast of Grand Isle, Jefferson Parish, Louisiana. The depth of water at this location is about 50 feet. The deposit is on acreage covered by oil, gas, and mineral leases which were originally issued in favor of Humble Oil & Refining Company by the State of Louisiana, and which were continued, maintained, and redesignated by the Department of the Interior of the United States, pursuant to Section 6(b) of the Outer Continental Shelf Lands Act. On September 19, 1956, Freeport Sulphur Company acquired from Humble Oil & Refining Company the sulphur rights underlying the tracts. This assignment was approved by the Secretary of the Interior on July 12, 1957. The Director, United States Geological Survey, approved Freeport Sulphur Company as Operator on July 31, 1957. Actual design began in September 1956; the first structural contract was let December 15, 1957, and offshore erection began in June 1958. The initial phase of construction will be completed and production started in early 1960. The estimated total cost of the project is $30,- 000,000, of which $8,000,000 is the extra cost for being in the Gulf of Mexico.

Jan 1, 1959

By W. Hermülheim, J. Brune

"This paper analyzes mine emergency management and rescue practices in German underground coal mines and compares them to those used in the United States. The German mining industry has developed these practices over more than 100 years, and they have successfully managed numerous fire, water inundation and ground control emergencies using these techniques. The authors interviewed German mine emergency professionals about rescue team and emergency operations. These operations were then analyzed to determine which of these German principles would be of interest to United States mine rescue teams. Implementing these programs into United States mine rescue and emergency operations was analyzed. INTRODUCTION Coal mining has become much safer industry than it has been in the past. Advances in safety and health regulations and company polices have improved working conditions for miners all over the world. Even with these advances there is still a need for continued attention to safety and health. It is also important for mine safety professionals to observe practices and procedures in other countries and cultures and learn what and how to apply this knowledge in their own systems. Coal mine rescue has been an integral part in improving coal mine safety. Mine rescue procedures have evolved with time, experience and technology development. Today, coal mine rescue teams are still needed and must be continually trained and prepared for any mine emergency. Although it is hoped that improved mine safety policies and practices will eliminate coal mine disasters in the future, accidents remind us that disasters can still happen today. In May 2014, Turkey experienced a severe coal mine disaster where 301 people were killed [G.Tuysuz, 2014]. Our industry must learn from these incidents, focusing on disaster prevention and making improvements in mine rescue operations. Mine rescue procedures differ from country to country due different regulatory environments and different historical evolution of emergency response. Sharing practices and procedures from one country to another enables learning from different experiences and cultural backgrounds. Sharing is also a way of preserving information, identifying and learning best practices."

Jan 1, 2015

By Howard Lum, Sergio Valles, John Bednarski, Gordon Enas, Jay Arabshahi

"Water drawn from the Sacramento-San Joaquin Delta provides water supply to 66 percent of California’s population and supports the state’s agriculture industry. The existing through-Delta water system is outdated and unreliable with environmental risk to some fish and wildlife species. The Bay-Delta Conservation Plan (BDCP) has been established to environmentally retrofit and modernize California’s water delivery system through the Delta by restoring habitats, constructing new diversion points in the north Delta and providing a means to transport water supplies under the Delta, rather than through sensitive natural channels.Under BDCP, the Delta Habitat Conservation and Conveyance Program (DHCCP) has developed several alternatives to convey water from the Sacramento River in the north to the existing pumping facilities in the south Delta through an isolated conveyance system. The new conveyance system would become an integral part of the State Water Project (SWP) and the federal Central Valley Project (CVP) by transporting water to the export pumping plants for each of these projects. The DHCCP is managed by the California Department of Water Resources (DWR), while state and federal water contractors provide technical support to the program.The initial conceptual study efforts on the overall program commenced in 2007 and examined various options for the proposed conveyance system. Several conveyance alternatives were analyzed at that time. The Conceptual Engineering Report published on Oct. 1, 2013 identified the modified pipeline/tunnel option (MPTO) as the preferred alternative to be included in the BDCP environmental documents. MPTO includes three river intakes and pump stations along the Sacramento River, various sizes of pipelines and tunnels, junction structures and two forebays that are capable of delivering up to 4 million gpm (9,000 cfs) from the Sacramento River to the SWP and CVP. The river intakes are located near Hood in Sacramento County approximately 64 km (40 miles) from Clifton Court Forebay (CCF) in Contra Costa County. This route would cross portions of Sacramento, San Joaquin and Contra Costa counties. Figure 1 depicts the configuration of the MPTO alternative."

Apr 1, 2016

By Scott G. Britton

Mine exploitation is a broad subject whose focus is the technical skills or efforts needed for the extraction of mineral from a known ore body. Mine exploitation can be considered the very core of the mining engineering discipline. It begins at the conclusion of the exploration and development stages of mining and ends when the ore body is exhausted and the mine (or mines)closes and is reclaimed. Section 8 on mine exploitation is comprised of seven chapters: (1) classification of mining methods, (2) mine surveying and mapping, 3) systems engineering, (4) computer methods, (5) labor relations and training, (6) management and administration, and (7) mine closure, sealing, and abandonment. Each chapter focuses its efforts towards providing detailed and useful information for the engineer on basic mine exploitation principles. The information can be applied to a broad range of mining problems without regard to mineral type or mining method.

Jan 1, 2008

The Environmental Session will consist of five papers dealing with various aspects of trace elements associated with coal. Analytical procedures to determine the amounts of trace elements will be discussed. Other papers will deal with trace elements in streams downstream from coal mines, potential pollution from wastes from coal preparation plants, potential recovery of trace elements, and potential pollution from trace elements as a result of the combustion of coal.

Jan 1, 1979

By Alan K. Burton

Massive increases in the productive capability of open pit nines after World. War II were in a large part made possible by the introduction of ever larger trucks and the supply of a seemingly bottomless ocean of inexpensive and readily accessible oil. Over a period of about 25 years, a variety of technological developments permitted a tenfold truck payload increase, from about 32 tonnes (35 tons) to 320 tonnes (350 tons). There is no, doubt that this was a remarkable achievement resulting in impressive benefits of scale as well as the ability to control what would otherwise have become an intolerable traffic congestion problem in today's large open pit mines. It became fashionable and economically possible during this time to mine large quantities of low grade material and to tolerate very high stripping ratios. As tine has gone by and as easier to get at and higher grade deposits have been depleted, ore grades have tended to decline while stripping ratios have increased. The alternative to reduced revenues has been an ever increasing demand to step up production which in turn has led to a continuing demand for ever larger and larger trucks. While a larger truck has had the effect of reducing the cost of the operator per unit of material moved and of reducing traffic congestion, it has not specifically addressed the subject of fuel cost.

Jan 1, 1981

By Donald W. Gentry

This section deals with one of the most fascinating aspects of mining the evaluation of mine investment opportunities. Be-fore proceeding further, it is important to clarify the meaning of some fundamental terms used frequently in the text. 6.0.1.1 Mine Valuation vs. Evaluation The words "valuation" and "evaluation" in a mining context are often used interchangeably. However, for the purposes of this section, a distinction is made between the two terms in accordance with commonly accepted practice. The word valuation in a mining project context has the rather narrow meaning of placing a dollar or other currency value on the worth of the project as a whole. In other words, the value of a mining project refers to a measure of the desirability of ownership of that property. As such, the major item of interest is, "what is the mine worth?," or `what is the value of the mine?" The value of a mining project may actually be determined in the marketplace at any specific point in time, or it may be estimated by one of several methods. The topic of mine valuation is discussed in more detail in Chapter 6.1. The word evaluation in a mining project context connotes the broader meaning of determining the numerical values of all

Jan 1, 2008

By J. F. Brune

"Re-occurring face ignitions in U.S. coal mines are concerning and require a closer look at air quality monitoring systems and practices employed in these mines. The explosion disaster at the Upper Big Branch mine in West Virginia in 2010 caused 29 fatal injuries and was largely caused by inadequate water sprays and inadequate ventilation monitoring. In this comparison, the author compares ventilation system monitoring in Australian, German and U.S. underground coal mines and makes recommendations for improvements and best practices. Mines in Germany and Australia are adhering to more stringent requirements for monitoring air quality and quantity and for monitoring water spray systems on cutters to prevent frictional ignitions. Air quality should to be monitored for sufficient oxygen, toxic gases, explosibility and for fire gases indicating a potential fire. Ventilation monitors must also confirm that sufficient quantities of air are available. Fully automated, continuously recording atmospheric monitoring and alarm systems are established practices in Germany and Australia and should be mandated for U.S. mines as well, in addition to the current, regular spot inspections of the ventilation system by certified mine examiners. BACKGROUND: METHANE EXPLOSIONS, FACE IGNITIONS AND NEED FOR AIR QUALITY MONITORING Accumulations of methane in face areas of underground coal mines frequently lead to ignitions that can cause burns, traumatic injuries and, in the case of the 2010 Upper Big Branch disaster, cause major explosions with multiple fatalities. Table 1 shows the number of reported face ignitions in U.S. coal mines between 2010 and 2014, based on statistical data published by MSHA (MSHA 2010 – 2014). Although there appears to be a downward trend in such ignition incidents over time, ignitions continue to occur with some regularity; and each ignition may cause a potentially catastrophic mine explosion.Per regulation, all U.S. coal mining machinery, continuous miners and longwall equipment, is outfitted with continuously monitoring methane sensors wired to cut power to the equipment as the methane level exceeds 1%. Face ignitions keep occurring because these sensors are usually not positioned in sufficiently close proximity to the coal cutting drums or to the freshly exposed coal face where the methane is most likely released. Therefore, methane may accumulate in explosive concentrations near the coal face and the cutting drums long before the gas concentration reaches the 1% level near the monitor and creates an alarm."

Jan 1, 2016

By C. S. Harman, C. A. Enright, J. F. Brune

"The mining environment presents challenging and complex situations for the application of medical care. The combination of remote locations, difficult access and longer response times may create an increase in morbidity and mortality in the event of serious accidents. The U.S Mine Safety and Health Administration (MSHA) has only minimal requirements of first aid training for mine workers. For mine rescue team members, MSHA requires medical training at the Emergency Medical Responder (EMR) level, as only prescribed by mine rescue contest rules. This paper examines, based on mine accident statistical information, whether a higher level of medical training, for example at the Emergency Medical Technician (EMT) or at the Advanced Life Support (ALS) level can better address injuries most commonly disabling or leading to the death of miners in the United States. BACKGROUND Prehospital emergency medical care for the sick and injured has evolved considerably from first inception. Ambulances used to be staffed by persons with little training and equipment and prehospital care was focused largely on the rapid transport of the injured person to a hospital and. The modern prehospital care model was initially developed in military applications, where medics were responsible for some treatment on the battlefield and rapid transport to the care of a physician. In 1965, the National Academy of Sciences and National Research Council Committees on Trauma and Shock published Accidental Death and Disability: The Neglected Disease of Modern Society (National Research Council Committees on Trauma and Shock, 1966). This white paper laid out the consequences of the insufficiency of the Emergency Medical System (EMS) in the United States at that time. According to this paper, in 1965, 107,000 people were killed from accidental injury, with another 400,000 injured with permanent disability. The authors estimated that approximately 50% of ambulance services were provided by local morticians that were not capable of rendering advanced life support. The paper states that, based on experiences in the Vietnam war, seriously wounded soldiers had a better chance of survival in the battle field compared to traffic accident victims with similar traumatic injuries because the military was capable of providing first aid and efficient transportation to emergency care facilities. The white paper states that death rates from battle injuries declined significantly from 8% in World War I to 2% in Vietnam. The publication of this white paper is credited for the broad evolution and rapid advance of the civilian EMS system after 1965. It eventually lead to the creation of the National Highway Transportation Safety Administration (NHTSA) National Standard Curricula (NSC) for emergency medical care in 1985. Training, and therefore required skill and knowledge for prehospital emergency care has continued to grow to reach the current standard."

Jan 1, 2016