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Emergency Medical TechnicianNew for 2017-2018Non-latex gloves must be provided by competitor.PurposeTo provide HOSA members with an opportunity to develop and demonstrate knowledge andskills as a team in emergency medical care.DescriptionThis event will consist of two rounds of competition for a 2-person team. Round One is awritten, multiple choice test. Written test will measure knowledge and understanding at therecall, application or analysis levels. Higher-order thinking skills will be incorporated asappropriate.The top scoring teams will advance to Round Two for the performance of selected skill(s)identified in a written scenario. The scenario will require the use of critical thinking skills. Theperformance will be timed and evaluated according to the event guidelines.Dress CodeCompetitors shall wear proper business attire or official HOSA uniform, or attire appropriate tothe occupational area, during the orientation, written test and skill(s) jeans and shorts are notacceptable. Bonus points will be awarded for proper dress.Rules andProcedures1. Competitors in this event must be active members of HOSA-Future HealthProfessionals and in good standing in the division in which they are registered tocompete (Secondary or Postsecondary/Collegiate). Competitors should compete in skillsevents at the highest level of training. An example would be students enrolled in anEmergency Medical Technician course should compete in the Emergency MedicalTechnician event and not in the CPR/First Aid event.2.Competitors must be familiar with and adhere to the “General Rules and Regulations ofthe National HOSA Competitive Events Program (GRR)."3.The written test will consist of fifty (50) multiple choice items. Competitors will be given60 minutes to complete the test. The scores of the two team members will be averagedfor one composite score and will be used as a part of the final score for the event.Round One:Written Test PlanPatient Assessment . 20%Basic Life Support . 20%Trauma . 15%Medical Emergencies . 15%Pediatrics and Childbirth . 15%Environmental Emergencies . 10%Special Situations . 5%4.All competitors shall report to the site of the event orientation at the time designated.The Round One test will immediately follow the orientation. No proxies will beallowed for the orientation.Emergency Medical Technician Guidelines (August 2017)1

5.Test Instructions: There will be a maximum of 60 minutes to complete the test. Therewill be a verbal announcement when there are 15 minutes remaining for the test period.NOTE: States/regions may use a different process for testing, to include but not limitedto pre-conference testing, online testing, and testing at a computer. Check with yourArea/Region/State for the process you will be using.6.7.All official references are used in the development of the written test. The specificreferences selected for each skill are the National Registry EMT skill sheets. Emergency Care and Transportation of the Sick and Injured. Series Editor: AndrewN. Pollak, MD, FAAOS. Published by Jones & Bartlett Learning. Latest edition. American Heart Association, Basic Life Support, Latest edition. Distributed byChanning L. Bete Co., Inc. – 1-800-611-6083. Limmer, Daniel. Emergency Care. Published by Prentice Hall, a “Brady” book,Latest edition. NREMT Basic Level Skill Sheetshttp://www.nremt.org/nremt/about/psychomotor exam emt.aspThe test score from Round One will be used to qualify the team for Round Two. Theskills approved for this event are:Skill I:Skill II:Skill III:Skill IV:Skill V:Skill VI:Patient Assessment - TraumaPatient Assessment - MedicalBVM Ventilation: Apneic Adult PatientImmobilization/SplintingA. Spinal Immobilization: Seated PatientB. Spinal Immobilization: Supine PatientC. Joint InjuryD. Long Bone InjuryBleeding Control/Shock ManagementCardiac Arrest Management/AED8.The selected skill(s) for Round Two, in the form of a written scenario, will be presentedto the competitors at the start of the skill to be performed. The timing for the skill willbegin when the scenario is presented. The scenario will be the same for each team andwill include a challenging component that will require the competitors to apply criticalthinking skills. Each scenario will include patient assessment and additional skill(s).9.The scenario is a secret topic. Professional ethics demand that competitors DO NOT discussor reveal the secret topic until after the event has concluded. Violation of the ethics rules willbe severely penalized.10.Competitors must complete all steps of the skill listed in the guidelines even if the stepsmust be simulated/verbalized. (If the equipment is available, the competitors wouldcomplete all steps of the skill as the scenario warrants. If the equipment is NOTavailable, the competitors would simulate/verbalize the steps.)11.In performance of a skill scenario, competitors are required to follow the higheststandard of care when treating victims. Competitors should follow the steps on therating sheet unless the highest standard of care required differs from the steps on theEmergency Medical Technician Guidelines (August 2017)2

rating sheet. Judges will know when the treatment of victims/patients differs slightlyfrom the rating sheet and when the competitors provide medically acceptable care, andwill award points accordingly.12.Oxygen Administration: Oxygen tank assembly is not included in the HOSA EMTevent. HOWEVER, an oxygen tank that is ready to use may be available. If theapplication of oxygen is indicated by the scenario and condition of the victim(s) thecompetitors should follow proper EMS protocol in initiating and maintaining oxygentherapy.If a tank is NOT available and oxygen is indicated, the competitors should verbalize thenecessary steps that involve the application of oxygen.Points will be awarded as indicated on the rating sheet used to evaluate all aspects ofteam’s performance, including the use of oxygen therapy.13.A twelve (12) minute maximum time limit has been set for the team demonstration.Timing will begin when the scenario is presented to the team. Competitors will bestopped at the end of the time allowed.14.Judges will provide information to competitors as directed by the rating sheets.Competitors may ask questions of the judges while performing skills if thequestions relate to victim physiology. For example: What are the vital signs? Do I hear breath sounds? Do I have a distal pulse? Is the patient breathing? Are the patient’s lips blue?15.The teams must earn a score of 70% or higher on the combined skill(s) of the event(excluding the test) in order to be recognized as an award winner at the ILC.16.In case of a tie, the highest averaged test score will be used to determine the rank.Required Personnel: One Event Manager One QA to provide quality assurance for the event by ensuring that the guidelines are followed and all event documents are complete.One Section Leader per section1 judge per section per skillProctors for Testing - Approximately one proctor for 20 competitorsEvent assistants per section as neededOne-two patients as required by the scenario (per section)Holding room attendants(s)Timekeepers (if necessary)Emergency Medical Technician Guidelines (August 2017)3

Competitor Must Provide: Event guidelines – one per team (orientation) Two #2 lead pencils with eraser Watch with second hand* Teams have the option of bringing one kit per person or one kit per team. Barrier supplies for each competitor:o 10 pairs of non-latex gloves AND 2 masks AND 2 gownso 1 set of goggles or safety glasses per person 10 "4x4" (packaged any way) 10 any size self-adhering roller bandages (i.e. Kling) 6 cravats (Defined as strips of cloth, triangular bandages folded into strips, roller gauze, or other similarmaterial to tie or anchor splints in place.) Adhesive tape Scissors Penlight 3 occlusive dressing supplies 3 abdominal dressings Stethoscope/B/P cuff Trauma dressing (ABD) Oral airway kit (sizes 0-6) BVM Pocket mask and/or other appropriate barrier (face shield, mouth-to-mask device) Tourniquet Cell phone for simulating call for EMS assistanceFacilities, Equipment and Materials (Per Section): Clinical and/or laboratory stations for selected skills Holding rooms or areas for competitors (if off-site) Written scenario Patient and judge scripts as needed Calculators, note pads, pencils for judges Stopwatch Assorted props, which may include pillows and/or blankets Rating sheets – one per judge per team Evaluation Forms – competitor, judge, and personnel #2 lead pencils with eraser to complete evaluationsRound One: Written Test (Reference: all resources) One pre-numbered test copy per competitor Scantron / answer forms for each competitor.Round Two Skills Equipment:Skill IPatient Assessment – Trauma (National Registry EMT Skill Sheets) PatientSkill IIPatient Assessment – Medical (National Registry EMT Skill Sheets) PatientEmergency Medical Technician Guidelines (August 2017)4

Skill IIIBVM Ventilation: Apneic Adult Patient (National Registry EMT Skill Sheets) Skill IV-AOxygen cylinder (tank)O2 regulator and attachmentsAirway management manikin without electronic connectionsSuction deviceSuction catheterSpinal Immobilization: Seated Patient (National Registry EMT Skill Sheets) Patient KED 1 set - Extrication collarsSkill IV-B Spinal Immobilization: Supine Patient (National Registry EMT Skill Sheets)PatientLong spinal immobilization board1 set - Extrication collarsHead immobilizerStrapsSkills IV - C & D Joint and Long Bone Immobilization (National Registry EMT Skill Sheets) Patient Board splints (2 each size)Skill VBleeding Control/Shock Management (National Registry EMT Skill Sheets) PatientSkill VICardiac Arrest Management/AED (National Registry EMT Skill Sheets) AED (with appropriate size batteries) CPR manikinEmergency Medical Technician Guidelines (August 2017)5

Event Flow ChartOrientation and 50 item test in60 minutesScan TestAverage scores of team membersTop teams advance to Round 2Competitors perform skills70% of skills pointsYESAdd team test score to teamskill score for final tally.Rank top 10 competitorsaccording to their final score70% of skills pointsNOCompetitor not recognized atAward SessionSample Round One Test Questions1.Pupils that are nonreactive to light may indicate any of the following conditions EXCEPT:A.dehydration.B.eye injury.C.drug influence.D.head injury.2.If an adult patient is not breathing but has a pulse, the patient should be ventilated at a rate of:A.6-8 breaths per minute.B.10-12 breaths per minute.C.14-16 breaths per minute.D.18-20 breaths per minute.3.All of the following are indications a patient is in shock EXCEPT:A.restlessness and anxiety.B.bounding pulse.C.cool, pale skin.D.shallow, rapid breathing.Emergency Medical Technician Guidelines (August 2017)6

EMERGENCY MEDICAL TECHNICIANTeam #: Section #:Judge's Signature:Skill I: Patient Assessment – Trauma1.Practiced body substance isolation precautions throughout skill2.Scene Size-up10b.Determines the mechanism of injury/nature of illness10c.Determines the number of patients10d.Requests additional EMS assistance of necessary10104.Primary Survey/Resuscitation7.0Determines the scene/situation is safeIf trauma suspected, competitor verbalizes/simulates, "SpinalImmobilization performed at this time"6.1a.3.5.Possiblea.Verbalizes general impression of patient10b.Determines responsiveness/level of consciousness10c.Determines chief complaint/apparent life threats10AwardedAirwaya.Opens and assess airway10b.Inserts adjunct as indicated10Breathinga.Assesses breathing10b.Assures adequate ventilation10c.Initiates appropriate oxygen therapy10d.Manages any injury which may compromise breathing/ventilation10Circulationa.Checks pulse10b,Assesses skin (either color, temperature or condition)10c.Assesses for and controls major bleeding (if present)10d.Initiates shock management (positions patient properly, conservesbody heat)108.Identifies patient priority and makes treatment/transport decision109.History taking – attempts to obtain sample history.10SECONDARY ASSESSMENT10.Heada.Assesses mouth*, nose*, and assesses facial area10b.Inspects and palpates the scalp and ears10c.Assesses eyes*10Emergency Medical Technician Guidelines (August 2017)7

Items Evaluated11.a.Checks position of trachea10b.Checks jugular veins1010Chest*a.Inspects chest10b.Palpates chest1010c. Auscultates chest13.Abdomen/pelvis*a.Inspects and palpates abdomen10b.Assesses pelvis10102020c. Verbalizes assessment of genitalia/perineum as needed14.AwardedNeck*c. Palpates cervical spine12.PossibleLower Extremities*One (1) point per leg includes inspection, palpation, and assessment ofmotor, sensory and distal circulatory function15.Upper ExtremitiesOne (1) point per arm includes inspection, palpation, and assessment ofmotor, sensory and distal circulatory function16.Posterior thorax, lumbar and buttocks*a.Inspects and palpates posterior thorax10b.Inspects and palpates lumbar and buttocks (verbalizes) area1017.Obtains baseline vital signs (must include BP, P and R)1018.Manages secondary injuries and wounds appropriately.1019.Demonstrates how and when to reassess the patient1020.Interventions (verbalizes proper intervention/treatment.)101021.Exhibits acceptable affect with patient and other personnel22.a.b.c.d.e.f.g.Provides report to Emergency DepartmentUnit identificationPatient’s age and sexChief complaintMental statusVital signsTreatment in progressEstimated time of arrivalTOTAL POINTS -- SKILL I111111100000005170% Mastery for Skill I 35.7* Award points in areas denoted by * if done, OR if integrated within sequence of Primary Survey/Resuscitation.**If a student jeopardizes the patient’s or his/her own safety and does not take immediate action to correct the error, thetotal points for the skill or specific subpart(s) of the skill will be deducted.Emergency Medical Technician Guidelines (August 2017)8

EMERGENCY MEDICAL TECHNICIANTeam #: Section #:Judge's Signature:Skill II: Patient Assessment - MedicalPossible1.Practiced body substance isolation precautions throughout skill102.Scene Size-upa. Determines the scene/situation is safeb. Determines the mechanism of injury/nature of illnessc. Determines the number of patientsd. Requests additional help if necessary1111000010Awarded3.If trauma suspected, competitor verbalizes/simulates, "Spinalimmobilization performed at this time"4.Primary Survey/Resuscitationa. Verbalizes general impression of patientb. Determines responsiveness/level of consciousness (AVPU)c. Determines chief complaint/apparent life threats111000Assesses airway and breathinga. Assessmentb. Assures adequate ventilationc. Initiates appropriate oxygen therapy111000Assesses Circulationa. Assesses for and controls major bleedingb. Checks pulsec. Assesses skin (either color, temperature, or condition)111000Identifies patient priority/makes transport decision101111110000002011111000005.6.7.History Taking8.History of the present illness ing questions of associated signs and symptoms related toOPQRSTPast medical history AllergiesPast pertinent historyEvents leading to present illnessMedicationsLast oral intakeEmergency Medical Technician Guidelines (August 2017)9

Items Evaluated10.Secondary Assessment(Assesses affected bodypart/system)Possible ePulmonaryMusculoskeletalGI/GUPsychological/Social Pulse Blood pressure Respiratory rate and quality50000011.Vital Signs12.States field impression of patient112113.Interventions (verbalizes proper intervention/treatment)1014.Exhibits acceptable affect with patient and other personnel1015.Reassessmenta.Determines how and when to reassess the patient to determinechanges in condition1016.AwardedProvides report to Emergency Departmenta. Unit identification10b. Patient’s age and sex10c. Chief complaint10d. Mental status10e. Vital signs10f. Treatment in progress10g. Estimated time of arrival10TOTAL POINTS -- SKILL II4970% Mastery for Skill II 34.3**If a student jeopardizes the patient’s or his/her own safety and does not take immediate action to correct the error, thetotal points for the skill or specific subpart(s) of the skill will be deducted.Emergency Medical Technician Guidelines (August 2017)10

EMERGENCY MEDICAL TECHNICIANTeam #: Section #:Skill III:Judge's Signature:BVM Ventilation: Apneic Adult PatientPossible1.Practiced body substance isolation precautions throughout skill102.Checks responsiveness and breathing for at least 5 but no more than 10 seconds20AwardedJudge states “The patient is unresponsive and apneic.3.Requests additional EMS assistance104.Checks pulse for at least 5 but no more than 10 seconds1010Judge states “You palpate a weak carotid pulse at a rate of 60.”5.Opens airway properlyJudge states “The mouth is full of secretions and vomitus.”6.Prepares rigid suction catheter107.Turns on power to suction device or retrieves manual suction device.108.Inserts rigid suction catheter without applying suction109.Suctions the mouth and oropharynx (quickly and adequately)10Judge states “The mouth and oropharynx are clear.”10.Opens the airway manually1011.Inserts oropharyngeal airway1010Judge states “No gag reflex is present and the patient accepts the airway adjunct.”12.Ventilates the patient immediately using a BVM device unattached to oxygen*Judge states “Ventilation is being properly performed without difficulty.”13.Rechecks pulse for at least 5 but no more than 10 seconds1014.Attaches the BVM assembly to oxygen @ 15L/min1015.Ventilates the patient adequatelya. Proper volume to make chest rise10b. Rate of 10-12/min, but not to exceed 12/min10Initiates ventilation within 30 seconds after taking body substance isolationprecautions and does not interrupt ventilations for greater than 30 seconds at anytime1016.17. Exhibits acceptable affect with patient and other personnel.TOTAL POINTS – SKILL III70% Mastery for Skill III 13.31019*Award this point if competitor elects to ventilate initially with BVM attached to reservoir and oxygen, as long as firstventilation is delivered within 30 seconds. **If a student jeopardizes the patient’s or his/her own safety and does not take immediateaction to correct the error, the total points for the skill or specific subpart(s) of the skill will be deductedEmergency Medical Technician Guidelines (August 2017)11

EMERGENCY MEDICAL TECHNICIANTeam #: Section #:Judge's Signature:Skill IV-A: Spinal Immobilization: Seated PatientPossible1.Practiced body substance isolation precautions throughout skill102.Directs assistant to place/maintain head in neutral in-line position103.a.Directs assistant to maintain manual immobilization of the head10b.Assures manual stabilization until it is maintained mechanically104.Reassesses motor, sensory and circulatory function in each extremity105.Applies appropriately sized extrication collar106.Positions the immobilization device behind the patient107.Secures the device to the patient’s torso108.Evaluates torso fixation and adjusts as necessary109.Evaluates and pads behind the patient’s head as necessary1010.a.Secures the patient’s head to the device10b.Completes immobilization with the head in a neutral, inline position.1011.Verbalizes moving the patient to a long backboard1012.Reassesses motor, sensory and circulatory function in each extremity1013.Minimally manipulates or moves patient throughout skill, avoiding potentialspinal compromise101014.Exhibits acceptable affect with patient and other personnelTOTAL POINTS -- SKILL IV-AAwarded1670% Mastery for Skill IV-A 11.2Note: The assistant in this skill is the other competitor.**If a student jeopardizes the patient’s or his/her own safety and does not take immediate action to correct the error, thetotal points for the skill or specific subpart(s) of the skill will be deducted.Emergency Medical Technician Guidelines (August 2017)12

EMERGENCY MEDICAL TECHNICIANTeam #: Section #:Judge's Signature:Skill IV-B: Spinal Immobilization: Supine PatientPossible Awarded1.Practiced body substance isolation precautions throughout skill102.Directs assistant to place/maintain head in neutral in-line position103.a.Directs assistant to maintain manual immobilization of the head10b.Assures manual stabilization until it is maintained mechanically104.Reassesses motor, sensory and circulatory function in each extremity105.Applies appropriately sized extrication collar106.Positions the immobilization device appropriately107.Directs movement of the patient onto the device without compromising theintegrity of the spine108.Applies padding to voids between the torso and the board as necessary109.Immobilizes the patient’s torso to the device1010.Evaluates and pads behind the patient’s head as necessary1011.Immobilizes the patient’s head to the device1012.Secures the patient’s legs to the device1013.Secures the patient’s arms to the device1014.Reassesses motor, sensory and circulatory function in each extremity1015.Completes immobilization with the head in a neutral, inline position.1016.Minimally manipulates or moves patient throughout skill, avoiding potentialspinal compromise101017.Exhibits acceptable affect with patient and other personnelTOTAL POINTS -- SKILL IV-B1870% Mastery for Skill IV-B 12.6**If a student jeopardizes the patient’s or his/her own safety and does not take immediate action to correct the error, thetotal points for the skill or specific subpart(s) of the skill will be deducted.Emergency Medical Technician Guidelines (August 2017)13

EMERGENCY MEDICAL TECHNICIANTeam #: Section #:Judge's Signature:Skill IV-C: Joint Immobilization1.Practiced body substance isolation precautions throughout skill2.a.Directs immediate application of manual stabilization of theinjury.b.Minimizes movement of the injured extremity3.Assesses distal motor, sensory and circulatory function in the injuredextremityPossible10101010AwardedJudge states “Motor, sensory and circulatory functions are present and normal.”4.Selects proper splinting material105.Immobilizes the site of the injury106.Immobilizes the bone above the injured joint107.Immobilizes the bone below the injured joint108.Secures the entire injured extremity109.Reassesses distal motor, sensory and circulatory functions to the injuredextremity10Judge states “Motor, sensory and circulatory functions are present and normal.”10.Exhibits acceptable affect with patient and other personnelTOTAL POINTS - SKILL IV-C101170% Mastery for Skill IV-C 7.7**If a student jeopardizes the patient’s or his/her own safety and does not take immediate action to correct the error, thetotal points for the skill or specific subpart(s) of the skill will be deducted.Emergency Medical Technician Guidelines (August 2017)14

EMERGENCY MEDICAL TECHNICIANTeam #: Section #:Judge's Signature:Skill IV-D: Long Bone ImmobilizationPossible1.Practiced body substance isolation precautions throughout skill102.a.Directs immediate application of manual stabilization of theinjury.10b.Minimizes movement of the injured extremity10103.Assesses distal motor, sensory and circulatory function to the injuredextremityAwardedJudge states “Motor, sensory and circulatory functions are present and normal.”4.Measures the splint105.Applies the splint106.Immobilizes the joint above the injury site107.Immobilizes the joint below the injury site108.Secures the entire injured extremity109.Immobilizes hand/foot in the position of function.1010.Reassesses distal motor, sensory and circulatory functions to theinjured extremity10Judge states “Motor, sensory and circulatory functions are present and normal.”11.Exhibits acceptable affect with patient and other personnelTOTAL POINTS - SKILL IV-D101270% Mastery for Skill IV-D 8.4**If a student jeopardizes the patient’s or his/her own safety and does not take immediate action to correct the error, thetotal points for the skill or specific subpart(s) of the skill will be deducted.Emergency Medical Technician Guidelines (August 2017)15

EMERGENCY MEDICAL TECHNICIANTeam #: Section #:Judge's Signature:Skill V: Bleeding Control/Shock ManagementPossible1.Practiced body substance isolation precautions throughout skill102.Applies direct pressure to the wound10AwardedJudge states “The wound continues to bleed.”3.Applies tourniquet.104.Controlled bleeding using correct skills in a timely manner.10Judge states “The patient is exhibiting signs and symptoms of hypoperfusion.”5.Properly positions the patient106.Applies high concentration oxygen107.Initiates steps to prevent heat loss from the patient108.Indicates need for immediate transportation109.Exhibits acceptable affect with patient and other personnel10TOTAL POINTS - SKILL V9Mastery for Skill V – 6.3**If a student jeopardizes the patient’s or his/her own safety and does not take immediate action to correct the error, thetotal points for the skill or specific subpart(s) of the skill will be deducted.Emergency Medical Technician Guidelines (August 2017)16

EMERGENCY MEDICAL TECHNICIANTeam #: Section #:Judge's Signature:Skill VI Cardiac Arrest Management/AEDPossible1.Practiced body substance isolation precautions throughout skill102.Determines the scene/situation is safe103.Attempts to question bystanders (judge) about arrest events104.Checks patient responsiveness10a. Observes the patient and determines the absence of breathing orabnormal breathing (agonal gasps)10b. Checks carotid pulse (no more than 10 seconds).10AwardedJudge states “The patient is unresponsive.”5.Assesses breathing and pulse simultaneously.Judge states “The patient is pulseless.” AND “The patient is apneic.” OR “The patient has gasping, agonalrespirations.”6.Immediately begins chest compressions of adequate depth and rate,allowing the chest to recoil completely107.Requests additional EMS response108.Performs approx. 2 minutes of high quality, 1 rescuer adult CPRa.Adequate depth and rateb.Correct compression-ventilation ratioc.Allows the chest to recoil completelyd.Adequate volumes for each breath11110000Note: After approx. 2 minutes or 5 cycles, the 2nd rescuer enters and resumes compressions while first rescueroperates the AED.9.Turns on AED power1010.Follows prompts and correctly attaches AED to patient1011.Directs rescuer to stop CPR and ensures all individuals are clear of thepatient1012.Initiates analysis of the rhythm1013.a.111000b.c.Ensures that all individuals are clear of the patient and verbalizes“All clear.”Delivers shock from AEDDelivers shock in a timely mannerEmergency Medical Technician Guidelines (August 2017)17

Items EvaluatedPossible14.Immediately directs rescuer to resume chest compressions1015.Does not interrupt CPR for more than 10 seconds at any point1016.Exhibits acceptable affect with patient and other personnel1017.Verbalizes transportation of patient when one of the following are met:10Awarded3 shocks administered, 3 consecutive NSI or regains pulseTOTAL POINTS -- SKILL VI2370% Mastery for Skill VI – 16.1**If a student jeopardizes the patient’s or his/her own safety and does not take immediate action to correct the error, thetotal points for the skill or specific subpart(s) of the skill will be deducted.Emergency Medical Technician Guidelines (August 2017)18

Emergency Medical Technician Guidelines (August 2017) 1 Emergency Medical Technician Purpose To provide HOSA members with an opportunity to develop and demonstrate knowledge and skills as a team in emergency medical care. Description This event will consist of two

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