# Red Bag Delivery Video



## AndyPandy (27 January 2010)

An interesting video of a red bag/premature placental separation delivery that appeared on the Equine Repro mailing list today...

http://www.blip.tv/file/3135415

Thought it might be useful viewing for those who haven't experienced a red bag before!


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## maestro (27 January 2010)

Brills thanks, Im off to lecture some Stage 4 breeding so I will show them tonight.


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## AndyPandy (27 January 2010)

Oh, and before anyone says anything, this is purely for reference as to what a red-bag might look like.

There are plenty of other elements and actions in this video which I would not recommend! Perhaps we could have an entire other thread on that!


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## linali (27 January 2010)

so what is the correct course of action in a red bag birth?(apart from panic  
	
	
		
		
	


	




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## maestro (27 January 2010)

I agree with you Andypandy that also give me something to discuss, but you cant beat a visual what can go wrong. (But luckely not too often!)


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## cruiseline (27 January 2010)

Yes can you point out what you would recommend AP, please.


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## Adina (27 January 2010)

If I've got it right, it was what they were doing AFTER cutting the red bag that was wrong. ie all the messing about with the foal. AP please clarify.


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## AndyPandy (27 January 2010)

Apologies for not making it clear what I mean:

1) In the case of a red bag delivery, it is imperative that the placenta/chorion must be cut/torn and the foal removed as quickly as possible - so in that respect they appear to do the right thing.

2) Squealing, shouting, and panicking is generally not recommended. Also praying while the mare is trying to foal does not guarantee as smooth foaling! 
	
	
		
		
	


	





3) In general, interference should be kept to a minimum, and clearly there is a good deal of interference shown in the video. Allow the mare to bond with the foal - don't hog it or try to carry it away like these folks seem to do.

4) Tie the mare's placenta to itself to avoid it being stepped on, and torn.

5) See all that blood that comes out of the umblicus when they cut it? I would tend to leave it longer and allow blood to transfer from the placenta to the foal... I'm sure foalie would have been grateful for it. The cord will normally begin to close on its own and break when the mare gets up. There is no hurry.

6) Treat the stump asap - didn't see this in the video. Discussions come up all the time about the best thing to use.

7) Wash the mare's udder with warm watter and pat dry if possible as it has been shown to reduce incidence of infection in neonates.

8) Leave them alone! Excessive interference can lead to higher incidence of foal rejection.


If anyone has anything to add, or anything they do that is different, then please tack it on to this thread.

Cheers


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## JanetGeorge (27 January 2010)

[ QUOTE ]
If I've got it right, it was what they were doing AFTER cutting the red bag that was wrong. ie all the messing about with the foal. AP please clarify. 

[/ QUOTE ]

IMHO, these are the bad points:

1.  The bloody racket!  Must have stressed the mare no end!  The golden rule is DON'T PANIC (and shut up!)

2.  I would have preferred someone to keep the mare down during delivery (easy enough with something that small!)  A hanging foal with back legs still inside the mare will kick back and can damage the mare.

3.  Tying off the cord merely ties IN any infection.  Better to let it bleed a little - pinch it with fingers for a few minutes if it's bleeding too much, and then treat it for infection.

4.  Clutching the foal like that made it harder for the foal to breathe.  Ideally, with a foal that small, I'd have had a hay bale and laid the foal on it with head off the edge, to encourage drainage of any fluid left in the windpipe.

I've only had two red bags - both MUCH bigger mares - and I was on my own for both.  I though the cutting of the red bag looked a little careless - but it worked.  They were lucky the foal breathed so easily (and kept breathing despite their best efforts to crush its rib cage! 
	
	
		
		
	


	




)  Mine were FAR quieter affairs!  The risk with that palaver would be the mare saying:  "You know so much, YOU look after it!"

I'm sure AP will have spotted somethin I missed!


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## Touchwood (27 January 2010)

Agree with AP, their actual 'delivery' (other than the screaming...poor mare) was fairly textbook.

Cutting of the cord, particularly at this stage a real no no IMO - we never have to cut them, they will break of their own accord and then you have minimal bleeding.


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## AndyPandy (27 January 2010)

[ QUOTE ]
...

I'm sure AP will have spotted somethin I missed! 

[/ QUOTE ]

I think we're pretty much in agreement on this one JG


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## Clodagh (27 January 2010)

Well thank you all, I found that very interesting although I think I won't be in there panicking, I'll be outside being sick!
A lot of the foaling vids on youtube are edited so its hard to tell how long each bit takes. Also everyone seems to pull the foal out - how ever do they manage in the wild - some mares must push them out!
Not including the above vid in that, obviously that was different.


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## volatis (27 January 2010)

I couldnt watch more than a minute of that, I wanted to throtle the praying woman!


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## AndyPandy (27 January 2010)




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## TheresaW (27 January 2010)

[ QUOTE ]
Well thank you all, I found that very interesting although I think I won't be in there panicking, I'll be outside being sick!
A lot of the foaling vids on youtube are edited so its hard to tell how long each bit takes. Also everyone seems to pull the foal out - how ever do they manage in the wild - some mares must push them out!
Not including the above vid in that, obviously that was different. 

[/ QUOTE ]

I have noticed that they all seemed to get pulled out as well.  Had me a little worried actually as my books tell you not to unless necessary.  I did find one yesterday that did it all by herself though.


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## Touchwood (27 January 2010)

[ QUOTE ]
[ QUOTE ]
Well thank you all, I found that very interesting although I think I won't be in there panicking, I'll be outside being sick!
A lot of the foaling vids on youtube are edited so its hard to tell how long each bit takes. Also everyone seems to pull the foal out - how ever do they manage in the wild - some mares must push them out!
Not including the above vid in that, obviously that was different. 

[/ QUOTE ]

I have noticed that they all seemed to get pulled out as well.  Had me a little worried actually as my books tell you not to unless necessary.  I did find one yesterday that did it all by herself though. 

[/ QUOTE ]

The books will tell you that, as an 'amateur' attempting to 'help' is likely to do more damage than good.  
However, done correctly and at the right time, most mares appreciate a little help.  It is something that needs to be left to the professionals though, my husband has now foaled about 500 foals over the years, so has become fairly good at telling when a helping hand is welcome  
	
	
		
		
	


	





The other thing to remember is that horses foaling in the wild are a. often hardy native types which are generally better at this kind of thing (last time I checked TBs and warmbloods are totally domesticated animals!), and b. haven't been fed up all through their pregnancy so the foals are normally smaller!

I do agree though, there is a lot of strange stuff on the internet, and best not to take too much of it as examples!


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## JanetGeorge (27 January 2010)

[ QUOTE ]

A lot of the foaling vids on youtube are edited so its hard to tell how long each bit takes. Also everyone seems to pull the foal out - how ever do they manage in the wild - some mares must push them out!


[/ QUOTE ]

A normal, 'easy' delivery when everything goes right won't take much longer than 10 minutes from the appearance of 2 front feet and the nose, particularly if the mare has a helping hand.  An amateur 'helping' can do more harm than good, but if you know what you're doing and do it gently and quietly, you make delivery easier for mare and foal - and the mare isn't left too tired to tend the foal and get 'mothered up'.  Mares who have a long and protracted delivery are - IME - more likely to be reluctant to accept the foal.

If there is dystocia - through an overly big foal or a mispresentation - you have a much longer job and - in general - the longer it takes, the less likely you are to have a live foal and a healthy mare at the end.

The BIG difference in the wild is that the mares are leaner and fitter, and the foals not as big - no stud mix/stud balancer in the wild.  The other big difference in the wild is that only the mare cares if foal dies - or she dies!


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## TheresaW (27 January 2010)

Thankyou Touchwood and Janet George.


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## Toast (27 January 2010)

Thankyou, that was interesting to have seen a red bag delivery. But that level of interferance surely wasnt necessary ie. Hanging onto the poor foal for longer than necessary, the screaming, shouting &amp; praying.. poor mare!
x


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## Clodagh (27 January 2010)

[ QUOTE ]
Thankyou Touchwood and Janet George. 

[/ QUOTE ]

Yes, thank you for clearing that up.


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## JanetGeorge (27 January 2010)

[ QUOTE ]

I think we're pretty much in agreement on this one JG 
	
	
		
		
	


	





[/ QUOTE ]






  I see!  You must have posted while I was typing - could have saved myself some time there!  I confess I DID once tie a naval, but it was a HUGE colt with a cord thicker than my thumb.  The mare leapt to her feet and broke it rather fast - so it poured blood at a horrendous rate (of course in that case the placenta hadn't already separated!)  And I plastered it with Terramycin spray immediately!


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## S_N (27 January 2010)

Dear GOD!!!!  That was APPALLING!!!  

1) STFU!!!  They would ALL get kicked out of any stable/barn where I was foaling!!

2) you NEVER EVER *CUT* the actual red bag!  In fact you shouldn't use anything sharper than a sterile hoof pick.  The risk of cutting through the amnion and potentially the foot behind is too great - seen it happen, done by a so called 'professional' who preferred not to listen to my advice.  Yes the placenta is tough, of course it is, as you aren't presented with the placental star, which is where the foals foot would normally break the placenta, breaking the waters.

3) If you HAVE to foal a mare standing up, then yes have someone hold her head during foaling, whilst you try to support if - IF you can!  (Most TB foals weigh approx 55kgs at birth.....)  But only do so for a few minutes and allow the mare to turn to greet her foal, breaking the umbilical cord naturally, which is SAFER for the foal and possible infection.  The stump would probably need pinching for a wee bit and then treating immediately!!

An old job title of mine on a large TB stud in the UK was Foaling Manager, previous to that I had been Assistant Foaling Manager on one of the World's largest nurseries in the USA.  I was in Kentucky, foaling, during MRLS (Mare Reproductive Loss Syndrome) in 2001/2002.  One of the main problems associated with MRLS, apart from dystocia, is red bag deliveries.  I have seen more than my fair share of them and I am simply horrified by that video!  That foal was damned lucky - or maybe that woman's prayers were answered?


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## devilwoman (27 January 2010)

That was very interesting - if not very manic ! - now I have a very numpty question, what does a Red Bag Delivery mean please in thicko language ............................ thankyou.


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## JanetGeorge (27 January 2010)

[ QUOTE ]
That was very interesting - if not very manic ! - now I have a very numpty question, what does a Red Bag Delivery mean please in thicko language ............................ thankyou. 

[/ QUOTE ]

The placenta - 'red bag' is the outer 'container' that houses the foal - and nourishes it - throughout the pregnancy.  There is an inner sac (white bag) in which the foal is normally delivered, with the placenta staying IN the mare (continuing to supply oxygenated blood via the umbilical cord.)  In normal deliveries, the placenta only comes out AFTER the foal is born then called 'the afterbirth'! 
	
	
		
		
	


	




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IF - for some reason - the placenta separates prematurely during the pre-labour - the placenta comes out with the foal still in it.  It has become detached from the uterus and the foal MUST be delivered VERY quickly or it suffers lack of oxygen and dies.  (Unattended red baag deliveries usually result in a dead foal - even if the foal is still alive when it hits the ground, the bag doesn't break and the foal smothers.)

A red bag delivery is easy to spot because it IS red - as opposed to the normal 'white bag'.


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## S_N (27 January 2010)

[ QUOTE ]
That was very interesting - if not very manic ! - now I have a very numpty question, what does a Red Bag Delivery mean please in thicko language ............................ thankyou. 

[/ QUOTE ]

Placenta previa, as it's properly known, has many causes and not all proven.  Basically, the main reason for a red bag is that the foal's leading foot does not rupture the placental star, which is the area of placenta in front of the cervix and as such is the weakest point of the placenta.  IME, dealing with MRLS, placentitis is was the leading cause.  Placentitis being an infection in the womb, that in many cases causes the placenta to thicken - though not always.

There was a theory thrown around in KY about fescues in the grazing being a cause too, but I know of no research to back this up.


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## devilwoman (27 January 2010)

Thankyou JG that is a great explanation - I understand it now, and S_N thankyou.


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## Vickijay (27 January 2010)

Wow thats really interesting. Thanks.


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## Faberge (27 January 2010)

God I would throw all of them out of any foaling - epecially the praying one! 

Also (silly I know, but) how can it possibly be a surprise that the foal is some sort of palomino given the colours of the parents???!


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## henryhorn (27 January 2010)

Haven't watched the vid yet but did experience a red bag delivery a few years bag without knowing at the time what was happening.
Had rung vet but realised something was really going wrong and I could see foals movement so used the only sterile implement I had to hand, some nail scissors to cut open the bag. The young male groom stood behind me promptly passed out and fell into the bushes (I ignored him!) and I gently helped the mare get the foal out. By the time the cord had broken (didn't interfere other than rub foal dry with towels and dress stump) the vet had arrived and congratulated me on my actions, saying quite a few foals die unless help arrives.
So glad there is a vid to watch as I genuinely didn't have a clue, and I wouldn't wish the experience on anyone else. 
My vet got a bottle of Jameson's for arriving post haste and the foal grew up to be perfect..


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## Tharg (28 January 2010)

Does the placental star look any different from rest of the placenta?

  Thank you for posting the vid!


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## S_N (28 January 2010)

[ QUOTE ]
  Does the placental star look any different from rest of the placenta? 

[/ QUOTE ]

Yes, it looks like a star of stretch marks and is usually visible on a placenta that is from a red bag delivery.  Unsurprisingly it shouldn't be visible on a foaling that was not a red bag, as the placental star will have ruptured as the water broke.


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## lindsayH (28 January 2010)

[ QUOTE ]


2) you NEVER EVER *CUT* the actual red bag!  In fact you shouldn't use anything sharper than a sterile hoof pick.  

[/ QUOTE ]

Can someone please tell me exactly what should be done in these circumstances then? Assuming you don't have a sterile hoofpick to hand! Should you wait until the whole thing is on the ground and look for the star and break it there? Were the folks in the vid wrong to cut the bag before the foal was delivered? Many thanks, helpful thread.


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## elizabeth1 (28 January 2010)

As the above poster says,please could someone give a short idiots guide on how to deal with a red bag delivery?Expecting a foal in April and would really appreciate this!


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## S_N (28 January 2010)

OK, I have copied and pasted what I wrote elsewhere late last night.

The very first thing to remember is don't panic.  Much easier said than done, I know, but it doesn't help you, the mare or the foal!  Take a deep breath and think "I can do this, I HAVE to" - and you really do!  That foals life depends on you and quite possibly the mares, esp if a dystocia as well.  I know that sounds dramatic, but it is essentially true.

Ideally you will have been observing the mare in some shape or form - I foaled both of my own sleeping in a caravan on the yard, using a baby monitor and M was a red bag, but then I thought it would be...  We all know that mares can and will foal will little warning, however, the ones that come along that fast rarely have a problem.  

If a mare who has been restless, goes down and comes back up more than once, without breaking water, I'm onto her like a hawk tbth.  At the first sign that she is getting close to foaling, I always plait the mares tail from the base of the dock down to the tip - it can stay like this for a few days sometimes 
	
	
		
		
	


	








 It just makes life easier when you are quickly whacking on a vet wrap/tail wrap.  Once this is done depending on the situation I may stand quietly in the corner and let her do her thing and just monitor her.  If I think it's going to be a red bag, I will put my arm in to see if I can feel anything - when I did this with B (and I've done plenty of times before) I could feel the placenta in the birth canal.  It feels very different to the amnion only, as there is no foot/nose.  Some (as in B's case) I have ruptured the placenta in the birth canal, before it's been a big visible red bag.  This is actually easier - whether that's because of the increased pressure of the vaginal walls or because it would have broken anyway, who knows.  You have to be prepared to get SOAKED when you do this - more so if the mare is standing.

If you discover that the foaling is a red bag and you haven't had chance to wrap the tail up out of the way, then sorry, but sod that!  Tails can get washed!  

TBF most red bag deliveries are not noticed until the red bag is seen - I think I have a slightly un-natural radar for them, as of the 137 I foaled between Jan 11th 2002 and March 28th 2002, 104 were red bags.  Yes, I am sad, I have records of these things.  

Anyway, once you see it is a red bag, do NOT use a knife/scissors to rupture it!  It is all to easy to also cut the amnion, which is right behind that and possibly the foot too and if a dystocia, then it could be the nose!  The placenta at this stage is taught like an almost fully inflated football, but damn slippery and leathery, so it's very tempting to use a sharp tool.  If using your fingers doesn't work, then perhaps a sterile hoof pick would be an idea to have in your foaling kit.  I've never had to use more than my fingers or thumbs though.  

As soon as you are through the placenta (and soaked :icongbiggrin, immediately check the presentation.  If there is any dystocia, it needs correcting even more quickly than one that's not a red bag.  If the presentation is correct (hopefully the mare will have lain down by now - if not, let her, as she will be able to help you more when down) PULL!!  And I really do mean it!!  ESPECIALLY if you are on your own!  Yes it goes against almost everything you will ever read about foaling, but that foal will have been partly in the birth canal for some time and may already be starting to suffer from oxygen deprivation!  It is also likely that the mare will be tired by now.  I have had to pull till I have had to remember to breathe.  Invariably red bag foals are big sods, that get stuck at the hips and you may need to wiggle them a bit - instead of the text book arc down to the hocks, you may need to straighten up the delivery.  If you are having real problems, then put foaling ropes over the foals fore feet, to aid purchase and pull on those.  You can also (though I don't really like to, as there is little room and you can tear the mare) put lube (KY Jelly) around the vagina, between the foal and the mare.

Normally you are advised not to break the amnion until the foal is out past the shoulders and there is no danger of it slipping back in (it can happen), however, in order to get purchase on this foal, that will have happened ages ago!  It is imperative to clear the air ways ASAP!!  Run you hand firmly down the front of the face, squeezing down the nostrils, to relieve of fluid - it may take more than one go - obviously pressure is relative here!  It's also a good idea to quickly check the mouth and pallet with your finger.

Once the foal is out, hopefully the mare won't leap up, but will stay down for a while, which should allow them to remain connected via the umbilical.  Prop the foal up on to his/her sternum, so breathing is easier - kneeling behind them is often the quickest way to do this.  

Check the sex - it's amazing how many people forget to do this or get it wrong - myself included 
	
	
		
		
	


	








 Easiest way is to check under the tail - 1 or 2 barrels 
	
	
		
		
	


	





The rest of the placenta may cleanse whilst the mare is still down, in case it doesn't, you can make a start at tying it up, but NOT tying anything over the umbilical cord!  If the mare is still down (and the longer she is down, the less likely she is to cramp), but starts to talk to her baby and you are happy that the pulse through the umbilical has stopped, or at least decreased (even with red bags, where the umbilical cord may have been squashed for a period of time, the blood flow can still be quite strong after birth), pull the foal round to the mares head.  This breaks the umbilical cord naturally.  You MUST be prepared before you do this to treat the stump ASAP, to prevent infection.

Some mare's quite like to have a hot mash at this point, in a kangaroo skip next to them - B does!  She alternates between one mouthful of mash and 20 nuzzles and licks of her foal.  If the mare can get her mash whilst lying down, then it's also far easier to take a bit of her milk to test the quality of her colostrum.  I didn't even bother when B produced M, as she'd been waxed up for 4 days, then ran milk for a further 17 before foaling.  I had 500mls of frozen donor colostrum from work at the ready to defrost though.  M still had to have a plasma transfusion!

Once the foal is at the mares head and they are happy, give an enema to the foal.

As soon as the mare has cleansed, check the placenta - trust me, SO much nicer to do when they are still warm!!  If you are unsure of what to do, inspect it anyway and then put it in a bucket with a lid or in tough bin liner and inspect it with your vet in the morning.

The main thing to be aware of with foals that have been delivered through a red bag, is oxygen deprivation, which can lead to brain damage.  I've seen a fair number of dummy foals (the worst was actually over here and nowt to do with MRLS, just a MASSIVE foal out of a TINY mare, that also happened to red bag, but who's head was down when the presentation was checked!  That took way too long to come out and was very ill for a fortnight.  She'd be a 3yo now, she's yet to race, but then I think she'd be more of a sticks horse anyway) and they've all come good, some quicker than others.  

Signs of a dummy foal:
* head held at a slightly odd angle
* generally a bit slow on the uptake.  Slow to stand, slow to gain balance, slow to find the milk bar, finds latching on difficult, may even have a reduced suck reflex, in which case you need to call your vet to tube the foal!  Even when they've found the milk bar once and have successfully latched on and had a good drink, they may forget where they found that yummy stuff and next time they're hungry suck the walls!

By and large though, once the foal is safely out, apart from a barely perceptible slowness for maybe the first 24/36hrs, they are normal foals. 

Further to the above, it's always an idea to some sterile scalpels in a foaling kit, as the scalpel can be used to open the mare up, if caslicked and she's decided to foal with little warning, before the vet has done this, or indeed to nick the red bag, to make enough of a hole to get your thumb in.  It will then tear pretty easily.  But as I said above, be prepared to get soaked!!


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## Clodagh (28 January 2010)

SN That was fantastic. I will print that and put it with my bucket when we get closer.
Thank you


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## lindsayH (28 January 2010)

Ditto, many thanks.


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## Damien (6 February 2010)

http://www.youtube.com/watch?v=o8HuzwGTG8Q

came across this video v. informative 

some other good videos from the same channel


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## Tharg (28 March 2011)

Damien said:



http://www.youtube.com/watch?v=o8HuzwGTG8Q

came across this video v. informative 

some other good videos from the same channel 
	
	
		
		
	


	




Click to expand...

Anyone know where else this video is?


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