pulse ox on everest

4 décembre 2020

The team also learned something about effectiveness and efficiency. By standard pulse oximetry, carboxy-hemoglobin is indistinguishable from oxyhemoglobin. The more accurate version is: “Although the percentage of oxygen in inspired air is constant at different altitudes, the fall in atmospheric pressure at higher altitude decreases the partial pressure of inspired oxygen and hence the driving pressure for gas exchange in the lungs.”, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1114067/. Pulse ox 98. Climbers on Mount Everest often use a pulse oximeter to monitor their oxygen levels and help determine whether they have a health issue or simply are breathing in lower levels of oxygen. They wore oxygen cylinders with variable flow valves provided by Summit Oxygen, and used wrist-worn pulse oximeters from Nonin Medical to monitor SpO2 levels. Oxygen depletion can cause altitude sickness, which usually begins as nausea and dizziness. But what is new is the ability to relay this information from extreme altitude in real-time. Garmin devices use a combination of red and infrared lights with sensors on the back of the device that can help determine the percentage of oxygenated blood (SpO2%) available in your blood. If SpO2 levels declined gradually without a change in oxygen flow, the cylinder was running out. Some interesting arguments for and against SpO2 here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273179, The Quest to Measure Everest’s New Altitude, Ama Dablam 2020: Climbing in an Empty Khumbu, Jost Kobusch: Still Focused on Winter Everest, Snorri On his Way to K2 BC, More on Manaslu, The Weird Natural Rock Art of Lake Baikal, Notify of new replies to this comment - (on), Notify of new replies to this comment - (off), Email Sign Up Prize Draw Terms and Conditions, Marketing and Client Relationship Manager, St Elias – Wrangell Mountain Range Icefield: Interview with Vincent Colliard, Nanga Parbat: Towards C4 and Setting the Stage for One Final Battle (Updated), Closing in: Monday first target for Everest Summit. Zuurstof 85%, maar ze rookt. At sea level, most of us would record 99-100%. This application is only for use with the ARSTN USB Pulse Oximeter or ARSTN Bluetooth Pulse Oximeter. A pulse oximeter measures the percentage of circulating hemoglobin to which oxygen is bound. Really interesting paper and good to see some evidence and discussion. The App analyses readings over … Expedition Everest: Nat Geo’s Epic Journey To Take The Pulse Of The Tallest Peak Tony Bradley Senior Contributor Opinions expressed by Forbes Contributors are their own. Hand-held pulse oximeters are now commonly used in the diagnosis of High Elevation Sickness as well as HACE or HAPE. Risk of hypoxia makes mountain climbing difficult and dangerous, even for healthy people. Episode 155: Pulse Ox Playoffs. You can connect it directly, and don’t need put PIN code. ... His discovery of pulse oximetry culminated a century of efforts to prevent the 1885 euphoric high altitude hypoxic deaths of Zenith balloonists and fighter pilots in World War I. Aoyagi then obtained a PhD. Hemoglobin oxygen saturation in each dog was monitored with three pulse oximeters (Nellcor … U kunt handmatig beginnen met een Pulse Ox meting door de Pulse Ox meterwidget te bekijken (Pulse Ox metingen verkrijgen). As founder of WiCis, Dr. Leo Montejo develops systems that monitor health data and share that information remotely. Therefore, some authors criticize a possible inaccuracy of pulse oximeters in the low saturation range < 75% [8,10]. Bylines include Financial Times, Daily Telegraph, Outside Magazine, Rock and Ice, and Red Bull. Thanks Ash. Montejo was educated as an anesthesiologist at Harvard and taught the subject at Stanford. Plenty Of Functionality For Athletes At $1249, I don’t think many pilots will be rushing out to buy the D2 Delta PX for its pulse oximeter function alone, but the feature nicely complements the device’s aviation functions (we’re covering the entire feature set in an upcoming comparison of cockpit wearables, including Apple’s Watch). "Was on treadmill work out good. Mt. Collected data will be transmitted in real-time via satellite, then analyzed by the team doctor at Base Camp, Advanced Base Camp and the North Col.eval(ez_write_tag([[580,400],'explorersweb_com-medrectangle-3','ezslot_0',108,'0','0'])); If this trial run proves successful, climbers and guides will be able to access expert interpretation of real-time blood oxygen saturation (SpO2) in future, in order to make more informed decisions on the flow rate of their supplementary oxygen. Navigate to Homepage. Read more at www.ashrouten.com, 8 Comments on "New: Wearable Oxygen Monitors on Everest". Some climbers use as much as six liters of oxygen per minute. 99 (CDN$ 15.99/Ounce) With regard to use of oxygen the best guide is probably the climbers perceived symptoms and assessed mental state (orientation and cognition); both maybe good markers of overall cellular respiration. Everest ... we have survived to see the day when very affordable digital pulse oximetry is available for ALL patients on LTOT. Unless the climber descends to a lower altitude or uses supplemental oxygen, the symptoms can grow worse—and quickly. Below is the data on the physiological testing. Pulse Ox, Ohio. This showed that high flow rates may not provide any greater benefit, and may just waste valuable oxygen. And certainly don’t ever choose Arduino Pulse Ox Plethysmograph (PPG) What Is a Pulse Plethysmograph? During a 7000 meter climb, Montejo saw that a flow rate of three liters per minute helped climbers achieve normal, low-altitude SpO2 levels. Conditions known as high-altitude cerebral edema (HACE) and high-altitude pulmonary edema (HAPE) often result in coma or death. How much oxygen our muscles receive depends on our heart, lungs and the efficiency of our vascular system — what we often call cardiorespiratory fitness.eval(ez_write_tag([[728,90],'explorersweb_com-box-3','ezslot_5',109,'0','0'])); On Mount Everest, it’s not just fitness that limits a climbers progress, but the altitude. The Pulse Ox doesn't have (or I couldn't find) a time or clock function, so it's no Pebble/watch replacement either. Furtenbach said he has tested this device out on Everest and shown good accuracy, but nothing published. The vívoactive ® device has a wrist-based pulse oximeter to gauge the saturation of oxygen in your blood. There is nothing published yet as this is ongoing. We have a Stanford professor validating the accuracy of the data and he is doing the assessment of the data and the recommendations out of it. At sea level, most of us would record 99-100%. Many of our Nepalese guides and staff are like family to Wally and to Berg Adventures. The information sent includes heart rate, blood oxygen saturation, skin temperature, geo-location, altitude, speed and bearing. This point is generally tagged as 8,000 m (26,000 ft, less than 356 millibars of atmospheric pressure). In May 2019, Montejo participated in a flash climb of Mount Everest with Lukas Furtenbach of Furtenbach Adventures. Maintaining a target SpO2 of 85% or higher helps protect against HAPE and HACE. 11/21/13 10 Why room air? SpO2 monitors are generally fairly unreliable out of normal ranges, and SpO2 levels often do not correspond well with clinical condition at altitude. 3. As climbers go higher and all the way to the summit, their oxygen saturation levels will continue to decrease. How a pulse oximeter works. The key question is how accurate is this particular unit, not just PO in general – https://www.nonin.com/products/3150-usb Could SpO2 and evaluation of moving speed, HR and assessment of symptoms be combined to make an evaluation of clinical condition? Get contact details and address| ID: 22497241955 Lower levels are associated with conditions that range from asthma and chronic obstructive pulmonary disease to anemia or congenital heart defects. Photo: Lukas Furtenbach. These cookies will be stored in your browser only with your consent. 272 likes. Call me biased but I have been through my fair share of oximeters over the years and this, my most recent purchase, (I’ve had one for about 5 months now), is up there as one of the best I’ve ever had. Photo: Alan Hinkes. NARRATOR: Ten days after coming off Everest, the climbers return to Seattle for a final session of testing. 88 List List Price $59.99 $ 59. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. A pulse oximeter is a small electronic device that estimates the saturation of oxygen in your blood. I didn't care for it too much, either. Answered by Dr. Brian Wagner: Difficulty breathing: I would be concerned and have a full work up. We also use third-party cookies that help us analyze and understand how you use this website. Within 20 minutes I was awakened by an alarm. Thanks Kam. The study is being conducted by the Xtreme Everest research group. At least a dozen climbers died this year alone on Mount Everest. You want a number in the 95% to 100% range. h = altitude above sea level (meters) We know that the peak of Mt. - Zuurstof 92%. The Pulse OX is a great feature used to spot check your blood oxygen percentage, as needed, but mainly intended for elevation training, information when climbing a mountain with higher elevation, and to improve training data. If that little number is less than .2 then your hands are too cold or the sensor is not in a good position. A pulse oximeter is a small device that clips over a fingertip. Garmin Support Center is where you will find answers to frequently asked questions and resources to help with all of your Garmin products. It is mandatory to procure user consent prior to running these cookies on your website. 1. So setting the flow rate according to the SpO2 of the climber is a logical step …that would make expeditions safer and take out much of the risk of HAPE and HACE.”. Lukas Furtenbach is wearing a heart rate monitor and pulse oximeter (which measures blood oxygen saturation) as he climbs Everest from the north side. This is far below the measurement range pulse oximeters are designed for [19]. experiencing shortness of breath, tingling hands and confusion. "Everest: The Death Zone" PBS Airdate: February 24, 1998 Go to the companion Web site. Their goal is to improve treatments of hospital patients, whose illnesses inhibit their ability to get oxygen to their … Withings is another brand that has been favoring the pulse oximeter. The First Operation Everest. … Zuurstof is gestegen, bloeddruk gedaald, dus we zijn aan de winnende hand. Medical Test Supply’s new OX-610A pulse oximeter is being used by a research group at Mt. Read our privacy policy to, Model 3230 Bluetooth LE Wireless Oximeter, wrist-worn pulse oximeters from Nonin Medical, Oximetry You Can Trust: Even in the Most Extreme Environments, To Hell and Back: Nonin Onyx® Fingertip a True Lifesaver for One Army Anesthesiologist. Every time the monitor cycles the BP, the pulse ox losses the arterial pulse as seen on the SpO2 tracing, and the SpO2 reading drops. Levels between 94 and 99 percent are considered normal for most people. FSA and HSA eligible. Systematic studies, however, This may not make climbing easier—terrain and weather will remain challenges for even the best-equipped adventurer—but it can make climbing safer. If they use too little oxygen, they get symptoms of altitude sickness; if they use too much, they run out. Everest is 8,848 meters above sea level. Product Title Fingertip Pulse Oximeter, Blood Oxygen Saturation Monitor, SpO2 Monitoring Device, Heart Rate Meter, OLED Display, USA Stock, Quick Ship. This site uses cookies to track activity and customize content. MTS® Pulse Oximeters Used On Everest Research Trek. I can tell that the sensor does work. Google Chrome. Pulse Oximeter Deluxe Fingertip Case Compatible for Zacurate Pro Series 500dl&500bl/ Deluxe Blood Oxygen Saturation Monitor - Black 4.1 out of 5 stars 300 CDN$ 15.99 CDN$ 15 . Knowing your oxygen saturation can help you determine how your body is adapting to exercise and stress. That information is also useful in low-oxygen situations, such as high altitudes. On the Tibetan side, for example, many clients start “sucking O’s” both day and night at the the north col (7,020m). Although the devices are simple to use, data output may be inaccurate or hard to interpret Readings bounce around constantly from motion, which blurs readings, or from poor circulation in cold fingers. Montejo said he chose the WristOx2 3150 for its accuracy at low SpO2 levels, long battery life, FDA clearance, ability to fit over the sleeve of a down suit, and Bluetooth capabilities that allowed the team to collect, store, and livestream data with the I-Streme app from WiCis. These cookies do not store any personal information. And last year, British guide Kenton Cool chose to immediately descend former Olympian Victoria Pendleton from Camp 2 after a pulse oximeter put her Sp02 levels at a death-defying 28%. Clicking or tapping on this logo will return you to the Homepage. Never attempt to obtain a pulse ox reading on the same extremity where an automatic blood pressure cuff is located. What make trekking to Everest base camp with Berg Adventures unique and special. Above 8,000 meters (26,000 feet), the atmosphere has too little oxygen to support human life. Dr. Leo Montejo at the North Col at 7,000 meters (23,000 feet) with the Nonin WristOx2 3150 BLE, On the way to Advanced Basecamp at Everest showing an SpO2 of 78 and heart rate of 122. I love the Innovo monitor on Amazon because, in addition to pleth, it also has a Perfusion Index (PI). Today we know very accurately, what critical SpO2 can trigger HAPE or HACE. StreetInsider.com Top Tickers, 4/4/2019. is the low pulse ox the reason for these symptoms?" Risk of hypoxia makes mountain climbing difficult and dangerous, even for healthy people. Its first device to feature it was the Withings Pulse Ox, but the brand has made … Working to ensure that every newborn in Va is screened for Critical Cyanosis. Nepal is truly our second home. 2. Twenty years ago, a Yale University team monitored an array of vital signs at Base Camp and up to Camp 1. Except during short sprints, the fundamental driver of exercise performance in humans is the delivery of oxygen to our muscles. The scientists have now had a chance to analyze the data. Furtenbach told ExWeb: “With the continuous SpO2 measurement, we aim to make [oxygen use] objective. Withings launches its connected health devices in India Her Temperature was 36.8 degrees centigrade, pulse was 72 beats per minute, respiratory rate was 16, Blood pressure 131/73 and pulse ox was 98% on room air. Everest Base Camp to conduct research on how the human body adapts to low-oxygen environments. Pulse ox is 92 on 15 liters. Also, carbon monoxide causes a left-shift of the oxyhemoglobin dissociation curve. Very informative and well said article by Ash Routen. Monitoring vital signs on Everest isn’t entirely new. A pulse oximeter doesn’t pierce the skin. Everest 57% (29,029 ft.) Mt. Posted by Jon Miller on Jan 27, 2012 in All Podcast Episodes, HD Episodes, Season 5, Everest 2010 Trek & Photography Workshop, Stereoscopic 3D Episodes | Comments Off on Episode 155: Pulse Ox Playoffs This will spare waste and reduce the likelihood of hypoxia. This is easily solved by moving either the cuff or the pulse ox to different extremities. The system helped the team identify and respond to changes in O2 supply and delivery. And just before I crashed at about 9.00 pm, I put on my pulse oximetry logger on and fell almost instantly in a deep and much overdue sleep. That’s why about 97% of climbers use bottled oxygen on Everest. BP 90/70. Conditions known as high-altitude cerebral edema (HACE) and high-altitude pulmonary edema (HAPE) often result in coma or death. Climbers have known for decades about the health risks of low-oxygen environments and the value of supplemental oxygen at high altitudes. Unless the climber descends to a lower altitude or uses supplemental oxygen, the symptoms can grow worse—and quickly. The purpose of this study was to determine whether arterial oxygen saturation (Spo2) and heart rate (HR), as measured by a finger pulse oximeter on rapid arrival to 4260 m, could be predictive of acute mountain sickness (AMS) or summit success on a climb to 5640 m. var loc = "https://analytics.clickdimensions.com/nonincom-ad7kz/pages/"; What would it be like to have wings? I was one of those who assumed that the composition of the air changed at high altitude, so I appreciate the clarification. Top Header Keyboard Shortcuts. Het fēnix ® toestel beschikt over een Pulse Ox meter op de pols om de perifere zuurstofsaturatie in uw bloed te meten. If SpO2 levels fell suddenly but the flow rate had not changed, they knew an oxygen mask had shifted. They of course hit the boost button on the harder, higher sections. The text came through to Shannon from our Doctor up the road at Everest Base Camp – “Blood oxygen sats below 75% are cause for concern. People often like numbers! Spoelen. He extends the use of eHealth technologies beyond diagnosis of distant patients to real-time tracking of adventurers in high-risk situations. Without it, we can’t turn stored food energy into movement. A fingertip pulse oximeter allows you to easily monitor the oxygen levels in your blood, as well as your pulse rate. Perhaps I just don't get it, but a clip isn't very secure, no matter what ways you try to make it better. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. Alan Hinkes pauses on the roof of the world and for a brief moment removes his oxygen mask. Normally we are 94% to 100% on these devices, these pulse oximeters that measure how much oxygen we have in our blood. "Everest: The Death Zone" ... PETER HACKETT: The pulse oximetry data collected on this expedition showed, as expected, the decline in oxygen with high ascent to altitude. PULSE OX DON’Ts 1. Withings is another brand that has been favoring the pulse oximeter. Changing the cylinder brought levels back within range. And people were showing … Where, 101,325 is what is known as standard temperature and pressure. Pulse oximetry (pulse ox) is a simple, inexpensive, noninvasive test to measure the oxygen saturation levels in the blood; a tool that can help detect CHD. I like “thinner air”, it is marginally better than “less air” although both are true! Article Comments (0) FREE Breaking News Alerts from StreetInsider.com! P = air pressure in Pascal. A limiting factor in the use of the devices is that Oxygen saturation may remain normal as individuals tend to breathe faster at higher elevations and thus have normal readings. Oxygen depletion can cause altitude sickness, which usually begins as nausea and dizziness. You also have the option to opt-out of these cookies. 190 likes. In mountaineering, the death zone refers to altitudes above a certain point where the pressure of oxygen is insufficient to sustain human life for an extended time span. Shop today! 100%%oxygen%exposure%is%unnecessary%% and%potenAally%harmful%in%neonates%% Pulse oximetry during neonatal resuscitation Never use an adult pulse ox clip to obtain a reading for an infant. 99. He juggles a day job as a public health scientist with a second career in outdoor writing. Repositioning the mask restored SpO2 to target levels quickly. Here's what you need to know about what exactly a pulse oximeter measures, how it works, and how you can use it properly. I also had a similar comment to the one you make, on Facebook, re. The fingertip sensor for each pulse oximeter was fitted to the ring finger of a modified Marmot glove. Pulse Oximeter Lab Myrna Matulevich St. Matthew’s School Kalispell, MT Everest Pulse Oximeter Test Results In the spring of 1997, climbers David Breashears, David Carter, and Ed Viesturs agreed to undergo physiological and psychometric testing from Base Camp to the summit. The sensor for blood oxygen saturation and skin temperature is built into the glove, with data displayed on a wrist-worn unit. https://explorersweb.com/2019/05/14/new-wearable-oxygen-monitors-on-everest/, https://explorersweb.com/2019/06/13/a-medical-perspective-on-everest/, https://www.furtenbachadventures.com/en/trips/everest-flash/. Pulse Ox Virginia. During the following program, look for NOVA's Web markers which lead you to more information at our Web site. Amazon's Choice for pulse ox. Mozilla Firefox Oxygen cylinders add weight, making the climb more difficult, so people carry as few as possible. 95 ($24.95/Count) Get it as soon as Fri, Dec 4. Climbers have to be disciplined with their flow rate to ensure they have enough “O’s” to descend safely to lower camps. It uses Bluetooth BLE to synch information with Zewa's free Smartphone app. PETER HACKETT: The pulse oximetry data collected on this expedition showed, as expected, the decline in oxygen with high ascent to altitude. Availability of oxygen on Everest depends on the number of bottles provided by the guiding company, which in turn depends on how much the client is paying. In terms of sleep, or lack of it, I managed to keep going for a second day, thinking this was probably the best way to adjust to the new time zone. A previous study of pulse oximeter accuracy in dark-skinned individuals only measured bias at room air saturation levels and therefore concluded that oximeter accuracy is independent of skin color.2 We chose to study extremes of skin pigment, dark and light, to most … 12:109–119, 2011.—Pulse oximetry is a valuable, noninvasive, diagnostic tool for the evaluation of ill individuals at high altitude and is also being increasingly used to monitor the well-being of individuals traveling on high altitude expeditions. We used it successfully up to the north col and in endless training sessions in the home mountains. the accuracy of PO during exercise, but there seems to be some published studies showing reasonable accuracy during exercise conditions. "my pulse ox is 92, possibly lower. It’s harder to deliver enough oxygen to the body in thin air. Mount Everest, the world's highest peak, and other peaks of the Himalayan range are seen through an aircraft window during a mountain flight from Kathmandu, Nepal, on January 15, 2020. Below 80 percent saturation, levels in which Everest climbers typically live, readings become less accurate. Using the number to support a clinical decision can often be useful and help patients understand and accept medical advice. This season, Furtenbach Adventures is testing wearable devices that can measure both vital signs and the location of climbers on Everest, then relay this information back to Base Camp. On summit day, these calculations aren’t easy to do at 8,500m, after 30 sleepless hours and 20 hours of climbing. His words have featured in national newspapers, international magazines, and various websites. Pulse oximeters are small, portable, non-invasive and painless; they’re so convenient that they’re often used by pilots and people who work or train at high altitudes. on Mount Everest, values for paO 2 of only 19.1mmHg and SaO 2 of only 34.4% (puncture of the femoral artery) were determined [18]. Using an adult clip on an infant will produce inaccurate results. Woke up next morning could not breathe- still feels like not getting enough air chestxray clear, pulse ox good, why?" Monitoring vital signs on Everest isn’t entirely new. He created the I-Streme© platform for extreme sports enthusiasts and their followers. If the pilot test is successful, eventually all climbers may sport wearable devices on their high-altitude ventures.eval(ez_write_tag([[336,280],'explorersweb_com-medrectangle-4','ezslot_7',110,'0','0'])); Telemedicine: To Mount Everest and Beyond, Former Olympic Cyclist Forced to Abandon on Everest, Ash is an outdoor and adventure writer from the UK. A modern supplementary oxygen system. It can help you keep tabs on your overall health and help you to push your athletic performance goals as well. This not only slows climbers down, but can lead to hypoxia (low oxygen in bodily tissues), and acute mountain sickness. The best use I have found for pulse oximetry in trekkers at altitude is when looking at the changes within an individual; a drop of sats from 80 to 70 over the course of a day at 5500m is probably more significant than someone who knows from experience they run at 65% at 5500m when acclimatising. Changes in the Arte rial Mean Pa rtial Pre ssure of Ox ygen, Ox ygen Saturation, Hem oglobin Conce ntration, and Oxygen Content in Climb ers on Mount Everest. And last year, British guide Kenton Cool chose to immediately descend former Olympian Victoria Pendleton from Camp 2 after a pulse oximeter put her Sp02 levels at a death-defying 28%. And pulse oximetry technology has been used in clinical settings for many years—but few devices have the right combination of features for use in the extreme conditions of the Himalayas. With input from their guide, they must roughly calculate their oxygen flow rate. A pulse oximeter shows blood oxygen saturation (SpO2), which provides insight to how well a person’s heart and lungs are working. Pulse Ox data should not be treated as any type of medical diagnosis or treatment of disease. Continuous SpO2 measurement, along with flow valves they can read and control, can help climbers stay healthy by managing their oxygen supplies effectively at high altitudes. Twenty years ago, a Yale University team monitored an array of vital signs at Base Camp and up to Camp 1. My top choice pulse oximeter for 2020 is the excellent and very affordable Innovo Deluxe.. “Thinner Air” is an oversimplification to make the article more readable. The concept was first conceived in 1953 by Edouard Wyss-Dunant, a Swiss doctor, who called it the lethal zone. Climbers who plan to reach those heights bring supplemental oxygen, but still risk hypoxia. It can’t be stated often enough, do not confuse oxygen conservation with adequate oxygenation. Pulse ox readings can be skewed by movement and if the pleth is erratic looking this may be the case. Pulse ox is 85, but she's a smoker. The watch’s pulse ox and heart rate sensors. Photo: Summit Oxygen. P Everest = 101,325 x (1 - 2.25577 x 10 -5 x h) 5.25588. I groggily clipped the oximeter … It could also detect abnormal heart rate changes, which could indicate if a climber is about to suffer cardiac arrest; or changes in body temperature, which could alert to hypothermia. Als u uw zuurstofsaturatie weet, kunt u beter voor bergsporten en expedities bepalen hoe uw lichaam zich aanpast aan hoge hoogten. Necessary cookies are absolutely essential for the website to function properly. The Nonin WristOx2 3150 BLE met all the requirements for this expedition, and for connection to the WiCis I-Streme app. Dr. Piris considers pulse oximeters fickle devices in the best mountaineering circumstances. Zacurate Pro Series 500DL Fingertip Pulse Oximeter Blood Oxygen Saturation Monitor with Silicon Cover, Batteries and Lanyard (Royal Black) 4.7 out of 5 stars 63,285.

Is Popeyes Halal In Usa, Can Mealybugs Jump, Vitamin C Serum For Hyperpigmentation Reddit, West System Slow Hardener Cure Time, Why Is There A Green Light In My Bathroom Fan, Food Of Punjab, Bacardi Lime Rum Review,

Classé dans Non classé | Commentaires (0)

Poser une question par mail gratuitement


Notre voyant vous contactera rapidement par mail.