Heat-Related Illness

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Heat-Related Illness

HEAT-RELATED ILLNESS

Extremes of heat and cold are part and parcel of a long-term survival scenario. In long-term survival settings or even in normal times, you may find yourself without shelter to protect you from the elements.  If you don’t take the weather into account, you have made it your enemy; it’ll be something you regret very quickly.

In the heat of summer, you might encounter someone suffering from the ill effects of overheating, otherwise known as hyperthermia.  Even in cold weather, significant physical exertion in an over-dressed and under-hydrated individual could be life-threatening.

Heat-related illness runs the spectrum from simple muscle cramps to shock. If mild to moderate, the condition is referred to as “heat exhaustion”. If severe, “heat stroke”. Heat exhaustion usually does not result in permanent damage, but heat stroke does; indeed, it can permanently disable or even kill its victim.  The effects of very high body core temperatures constitute a medical emergency that must be diagnosed and treated promptly.

The risk of heat stroke correlates strongly to the “heat index”, a measurement of the effects of air temperature combined with high humidity.  Above 60% relative humidity, loss of heat by perspiration is impaired, increasing the risk of hyperthermia.  Exposure to full sun increases the reported heat index by as much as 10-15 degrees F. In other words, the equivalent of being out in much hotter weather.

Simply having muscle cramps or a fainting spell does not necessarily signify a major heat-related medical event. You will see “heat cramps” often in children that have been running around on a hot day.  Getting them out of the sun, massaging the affected muscles, and providing hydration will usually resolve the problem.

A significant rise in the body’s core temperature is required to make the diagnosis of heat exhaustion. As many heat-related symptoms mimic other conditions, you should include an accurate thermometer as part of your medical supplies.

In addition to muscle cramps and/or fainting, heat exhaustion is characterized by:

  • Confusion
  • Rapid pulse
  • Flushing
  • Profuse sweating
  • Nausea and Vomiting
  • Headache
  • Temperature elevation up to 105 degrees F

If no action is taken to cool the victim, heat stroke may ensue. Heat stroke, in addition to all the possible signs and symptoms of heat exhaustion, will manifest as loss of consciousness, seizures, or even bleeding (seen in the urine or vomit).  Breathing becomes rapid and shallow. You’ll notice that the skin turns red, not necessarily because it is burned, but because the blood vessels are dilating in an effort to dissipate some of the heat.

The skin will likely be hot to the touch, but in some circumstances, the patient’s skin may actually seem cool.  A person in shock may feel “cold and clammy”, but it’s important to realize that it is the body core temperature that is elevated. Taking a reading with your thermometer will reveal the patient’s true status.

Heat stroke differs from heat exhaustion in that sweating might be absent. This is a significant change, as the body uses sweating as a mechanism to cool itself down. Once the core reaches a temperature of about 106 degrees, thermoregulation breaks down and the body’s ability to use sweating as a natural temperature regulator fails. In heat stroke, the body core can rise to 110 degrees Fahrenheit or more. If not dealt with quickly, expect shock and organ failure, with death as the final outcome.

When overheated patients are no longer able to cool themselves, it is up to their rescuers to do the job. If hyperthermia is suspected, the victim should immediately:

  • Be removed from the heat source (for example, the sun).
  • Have their clothing removed.
  • Be drenched with cool water (or ice, if available).
  • Have their legs elevated above the level of their heart (the shock position).
  • Be fanned or otherwise ventilated to help with heat evaporation.
  • Have moist cold compresses placed in the neck, armpit and groin areas.

Why the neck, armpit and groin? Major blood vessels pass close to the skin in these areas, and you will more efficiently cool the body core. In the wilderness, immersion in a cold stream may be all you have in terms of a cooling strategy. This is a worthwhile option as long as you are closely monitoring your patient.

Oral rehydration is useful to replace fluids lost, but only if the patient is awake and alert. If your patient has altered mental status, fluids may enter their airways. This is called “aspiration” and makes the situation much worse.

You might think that acetaminophen or ibuprofen could help to lower temperatures, but this is actually not the case.  These medications are meant to lower fevers caused by an infection, and they don’t work as well if the fever was not caused by one.

Hyperthermia is largely preventable with some planning. Wear clothing appropriate for the weather.  Tightly swaddling an infant with blankets, simply because that is “what’s done” with a baby, is a recipe for disaster in hot weather. Have everyone wear a head covering. A bandanna soaked in water, for example, would be effective against the heat. Much of the sweating we do comes from our face and head, so towel off frequently to aid in heat evaporation.

If you can avoid dehydration, you will likely avoid heat exhaustion or heat stroke. Work or exercise in hot weather (especially by someone in poor physical condition) will easily cause a person to lose body water content.  Consider at least a pint or two of fluids (preferably Gatorade or another electrolyte-rich product) per hour while working in the sun. Keep a close eye on the elderly, who are at high risk for heat-related illness.

Carefully planning your outdoor work in the summer heat and keeping up with fluids will be a major step in keeping healthy and avoiding heat-related illness.  Monitor the workload (and the workers) and you’ll stay out of trouble.

Joe Alton MD

Fill those holes in your medical supplies with kits and individual items from Nurse Amy’s entire line at store.doomandbloom.net!

Video: Parasitic Worms, Pt. 1

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Video: Parasitic Worms, Pt. 1

VIDEO: PARASITIC WORMS, PART 1

It’s important to realize that infections not commonly seen today may become major issues if a disaster throws you off the grid. Knowing which disease-causing organisms exist in your area, even if they are not common problems today, will be important to keep your loved ones healthy.

The word “parasite” comes from the Greek word Parastos, meaning “someone that eats at someone else’s table”. When we think of parasites, none give us the creeps more than the thought of having worms.

In this video, Joe Alton MD discusses some of the basics of parasitic worm infections, including what to expect in terms of symptoms, and much more. Part 1 of a 2 part series.

To watch, click below:

Wishing you the best of  health in good times or bad,

Joe Alton MD

Fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kit and medical supplies at store.doomandbloom.net. Our products are all eligible to be covered under health and flexible savings accounts.

Get your family medically prepared.  You’ll be glad you did!

Survival Medicine Hour: Backcountry Safety, Doxycycline, Lyme Disease

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Survival Medicine Hour: Backcountry Safety, Doxycycline, Lyme Disease

SURVIVAL MEDICINE HOUR PODCAST

School’s out and a great way to teach your family survival basics is by taking them camping. The skills needed for successful camping are akin to those required for the activities of daily survival. Once learned, these lessons last a lifetime. There’s no greater gift that you can give young people than the ability to be self-reliant.

Camping trips create bonds and memories that will last a lifetime.  A poorly planned campout, however, can become memorable in a way you don’t want, especially if someone gets injured. Luckily, a few preparations and an evaluation of your party’s limitations will help you enjoy a terrific outing with the people you care about, and maybe impart some skills that would serve them well in dark times.

Plus, identifying a common summer infection, Lyme disease, that can have long-term effects. Treatment, prevention, and more, plus a discussion of a popular broad-spectrum antibiotic that treats Lyme and many other diseases, Doxycycline. Learn indications, side effects, dosing, and much more.

Plus, a discussion of an exaggerated form of a common pregnancy complaint: nausea and vomiting. When it’s excessive, it’s called hyperemesis and can cause dehydration, weight loss, and in austere settings, can become life-threatening.

All this and much more on the latest Survival Medicine Hour with Joe Alton MD and Amy Alton ARNP!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/06/08/survival-medicine-hour-backcountry-safety-doxycycline-lyme

Wishing you the best of health in good times or bad,

Joe and Amy Alton

Learn more about all of the above and 150 other medical topics with a copy of the award-winning Third Edition of the Survival Medicine Handbook, available at Amazon or at https://store.doomandbloom.net!

Sulfonamides (Sulfa Drugs) in Survival

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Sulfonamides (Sulfa Drugs) in Survival

SULFONAMIDES IN SURVIVAL SETTINGS 

The availability of antibiotics to the family medic in survival and other austere settings may prevent the unnecessary deaths of loved ones due to infection. When help is not on the way, the average citizen will find these drugs to be important tools in the medical woodshed.

You might think that Penicillin family drugs were the first to be used by the general public, but another popular family of antibiotics called sulfonamides, or sulfa drugs, were actually on the market even earlier. Indeed, it has been called “the first miracle drug”. Sulfonamides deserve credit for saving tens of thousands of lives during World War Two. It was so widely used that many soldiers’ first aid kits came with the drug in pill or powder form. Medics were told to pour it into any open wound.

Sulfonamides were first identified to have antibacterial action by a German scientist named Gerhard Domagk, who evaluated certain dyes for possible medical uses. He found a red dye produced by Bayer (yes, that Bayer) that apparently eliminated bacterial infections in mice. This became “Prontosil”, credited as the first broad-spectrum antibiotic. Interestingly, it didn’t show a lot of antibacterial action in test tubes; Prontosil’s effect was much more noticeable on a live subject.

Another interesting tidbit about Sulfa drugs is that the active ingredient had been used by the dye industry for decades, so no patent could be obtained. Bayer had to share the ingredient with anyone who wanted to use it, eliminating the potential for big profits. This led to many different variations, some of which were “snake oil” that contained toxic ingredients. One such elixir killed a hundred people in 1937, leading to the enactment of the first serious oversight of pharmaceuticals, the Federal Food, Drug, and Cosmetic Act of 1938.

HOW SULFA DRUGS BATTLE INFECTION

Sulfonamides act to inhibit an enzyme involved in folate synthesis, an important aspect of bacterial DNA production. This family of drugs is bacteriostatic; that is, they don’t directly kill the bacteria, but inhibit growth and multiplication. If bacteria are unable to multiply, they can’t sustain the population needed to damage the body.

A commonly used sulfonamide is the combination drug sulfamethoxazole 400 or 800mg and trimethoprim 80 or 160 mg, known by the brand names Bactrim or Septra in the U.S. In Great Britain, it is called Co-Trimoxazole (Cotrim). A veterinary equivalent is known as Fish-Sulfa or Bird-Sulfa.

ASIDE: Different antibiotics (or other drugs) may be combined into one product. Usually, this is done because the two work together to have a stronger effect against an infection or other condition than they would if used alone. This is called “synergism”.

INDICATIONS

Broad-spectrum Sulfamethoxazole/Trimethoprim is effective in the treatment of many infections, including:

· Some upper and lower respiratory infections (chronic bronchitis and pneumonia)
· Kidney and bladder infections
· Ear infections in children
· Cholera
· Intestinal infections caused by E. coli and Shigella bacteria (a cause of dysentery)
· Skin and wound infections, including MRSA
· Traveler’s diarrhea
· Acne

Of course, as an antibiotic, no sulfonamide has any effect on viruses or viral illnesses.

DOSING

The usual dosage in adults is sulfamethoxazole 800-mg/Trimethoprim 160mg twice a day for most of the above conditions for 10 days (5 days for traveler’s diarrhea).

The recommended dose for pediatric patients with urinary tract infections or acute otitis media (ear infection) is 40 mg/ kg sulfamethoxazole and 8mg/kg trimethoprim per 24 hours, given in two divided doses every 12 hours, for 10 days. 1 kilogram equals 2.2 pounds. This medication should not be used in infants 2 months old or younger.

In rat studies, the use of this drug was seen to cause birth defects; therefore, it is not used during pregnancy.
Another sulfa drug, Sulfadiazine, is combined with Silver to make Silvadene, a cream useful for aiding the healing process in skin wounds and burns. Cover completely twice a day.

Sulfamethoxazole/Trimethoprim and other Sulfonamides are well known to cause allergic reactions in some individuals. These reactions to sulfa drugs are almost as common as Penicillin allergies, and usually manifest as rashes, hives, and/or nausea and vomiting. Worse reactions, however, can cause blood disorders as well as severe skin, liver, and pancreatic damage. Those with conditions relating to these organs should avoid the drug.

Although an allergy to Sulfa drugs may be common, it is not the same allergy as to Penicillin. Those allergic to Penicillin can take Sulfa drugs, although it’s possible to be allergic to both.

Sulfonamides and other antibiotics aren’t candy, and they must be used wisely and only when absolutely necessary. In normal times, seek out qualified medical professionals before you consider their use.

Joe Alton MD

Learn more about Sulfa Drugs and other survival antibiotics in the Book Excellence Award winner in Medicine, The Survival Medicine Handbook: The Essential Guide for when Medical Help is Not on the Way, available on Amazon or this website.

What Are Pathogens?

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What Are Pathogens?

PATHOGENS (DISEASE-CAUSING ORGANISMS)

An infection is defined as the invasion of the body by microscopic organisms. A pathogen is any agent that can cause a disease, but the term is usually used to describe a microbe. Microscopic germs cause injury to tissues in a number of ways, often by producing toxic substances that damage the cells.

Before we give every micro-organism a bad name, it’s important to know that they are not all pathogenic. In fact, some are beneficial or even necessary for human life, such as many intestinal bacteria.

Pathogens are often carried by “vectors”, from the Latin word vectus, “one who carries”. These are humans, animals, or microbes that carry and transmit a pathogen to others. A vector does not have to be ill to carry a disease: A mosquito, for example, carries the organism that causes malaria in humans but doesn’t experience the disease.

Another example of a disease vector was a domestic servant known as “Typhoid Mary”. She carried Typhoid fever to many people at homes where she worked without feeling sick herself. The elimination of a vector from the environment (terminating Mary’s employment, for example) usually ends the outbreak of disease.

BACTERIA

There are a number of different pathogens that cause infectious disease. Perhaps the one we hear most about is bacteria.  By the way, the word bacteria is the plural form. A single one is called a bacterium.

Bacteria were among the first life forms on Earth and are present everywhere from the soil to the bottom of the ocean to the inside of your body. They may even exist on Mars. If you took the entire population of bacteria on the planet, they would probably have a mass about equal to the entire plant and animal population combined. 

Bacteria have a number of shapes, ranging from spheres to rods to spirals. When bacteria reach a certain size, they reproduce by splitting in two, a process called binary fission.

Many bacteria are good guys. Some, however, are pathogens and cause infectious diseases, including cholera, syphilis, anthrax, leprosy, and bubonic plague. The most common fatal bacterial diseases affect the lungs, with tuberculosis alone killing about 2 million people a year, mostly in underdeveloped countries.

There are many different types of bacteria. Most bacteria don’t need to enter the host’s cells to reproduce, they do just fine in, for example, your blood. A subgroup of bacteria called Rickettsia, however, does depend on entry, growth, and reproduction within a host cell.

Rickettsiae are the cause of typhus, Rocky Mountain spotted fever, and a number of other infectious diseases. Rickettsia do not, however, cause rickets, a deformity of long bones in young children which is a result of vitamin D deficiency.

Although many bacteria have become resistant, they can usually be killed with antibiotics. Different bacteria are sensitive to different antibiotics.

VIRUSES 

Viruses are microscopic pathogens that, unlike most bacteria, can reproduce only inside the living cells of other organisms. Viral particles without a host are known as “virions”, and only act as a living organism when they enter a host cell. Indeed, they stretch the definition of life itself. Viruses can infect all types of hosts, from animals and plants all the way down to bacteria.

Examples of common human diseases caused by viruses include the common cold, influenza, chickenpox, rabies, hepatitis, herpes, Ebola, and Zika.

Viruses can be spread by:

•            Mosquitoes and other vectors

•            Airborne droplets in coughs or sneezes

•            Contact with blood or other bodily fluids

•            Ingestion of contaminated food or water

A normal immune system can often kill the infecting virus. However, some viruses evade these immune responses and result in chronic infections, such as HIV or Hepatitis C. There are antiviral drugs, but it’s important to know that antibiotics have no effect.

PROTOZOA

Protozoa are one-celled microbes, a step up on the scale as they exhibit animal-like behavior, such as the ability to move. Many have a tail-like appendage called a flagella that they whip around for locomotion. They are restricted to moist or aquatic environments. Therefore, transmission is mostly by drinking contaminated water, although some are transmitted by animal vectors.

Protozoa cause infectious diseases in humans such as malaria, giardia, some dysenteries, sleeping sickness, and amoebiasis. A common vaginal infection is caused by a protozoan called trichomonas.

Protozoa are usually susceptible to treatment with certain antibiotics, such as metronidazole (also known as Fish-Zole in its veterinary equivalent).

FUNGI

A fungus (plural form: fungi) is a microorganism family that consists of such yeasts and molds. Fungal infections most commonly affect skin and mucous membranes like the oral cavity and vagina, but can invade other areas. Fungus affecting the toes is known as tinea pedis, or “athlete’s foot”. “Ringworm” is another type of fungal infection. Severe internal fungal infections can occur in individuals with weakened immune systems. Anti-fungal medications exist in topical or oral form, like miconazole or clotrimazole.

These are just some of the hazards that you’ll face if you take responsibility for the medical well-being of others in times of trouble. Learn about them, get some training and skills, and you’ll keep it together, even if everything else falls apart.

Joe Alton MD

Survival Medicine Hour: School Safety Solutions, Fungal Infections, More

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Survival Medicine Hour: School Safety Solutions, Fungal Infections, More

SURVIVAL MEDICINE HOUR PODCAST #390

SCHOOL SAFETY SOLUTIONS

Recently, Joe Alton MD wrote about school safety solutions in the wake of mass killings perpetrated by the disgruntled and deranged. Some of these strategies aren’t expensive, and those that are should make you ask: How much is it worth to save the lives of our young people by aborting these murderers? Find out what simple changes would lead to a much safer environment for our young people in these uncertain times.

ATHLETE’S FOOT

 

Plus, Joe and Amy Alton tackle a questions from a listener in Germany that asks about how to deal with fungal infections in situations where modern pharmaceuticals aren’t available. All this and more on the latest Survival Medicine Hour with Joe Alton MD and Amy Alton ARNP, aka Dr. Bones and Nurse Amy!

To listen, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/06/01/survival-medicine-hour-school-safety-solutions-fungal-infections-more

Wishing you the best of health in good times or bad,

Joe and Amy Alton

The Altons

The Altons

Follow them on twitter @preppershow, Facebook at Doom and Bloom(tm) and YouTube at DrBones NurseAmy Channel, and check out their medical kits, books, and other supplies at store.doomandbloom.net!

Some Alton medical kits

 

Video: Lyme Disease

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Video: Lyme Disease

VIDEO: LYME DISEASE

Summer is upon us, and with school out, families will be out and about in our national parks and elsewhere in the great outdoors. The Great Outdoors is, indeed, great, but there are risks, and they include more than falling off a cliff or encountering an irritable moose. Some of God’s smaller creatures, like the blacklegged tick pictured above, can carry diseases that have long-term consequences. One of these is Lyme Disease, first identified as such in the 1970’s in Old Lyme, Connecticut.

In this video, Joe Alton MD tell you all about the basics of Lyme Disease, and together with his last video on tick bites, will give you a sound fund of knowledge that will help you identify, treat, and prevent it.

To watch, click below:

Wishing you the best of health in good times or bad,

Joe Alton MD and Amy Alton ARNP

Find out more about Lyme Disease and 150 other medical topics on or off the grid with the award-winning 700-page third edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way!

VIDEO: All About Tick Bites

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VIDEO: All About Tick Bites

ALL ABOUT TICK BITES

Backcountry hikes are a great way to commune with nature, but not by encountering bears, cougars, or an irritable moose. In Spring and Summer, we also have to worry about insects like mosquitoes and ticks. Insects like ticks are agents that transmit some pretty serious infections to the unprotected and unwary. In this video, Joe Alton MD discusses everything you need to know about tick bites: Identification, protection, tick removal, and much more.

To watch, click below:

Wishing you the best of health in good times or  bad,

Joe Alton MD

Joe Alton, MD

Fill those holes in your medical supplies by checking out our entire line of medical kits and supplies at store.doomandbloom.net!

Survival Medicine Hour: Stroke, Ebola 2018, Med Storage, More

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Survival Medicine Hour: Stroke, Ebola 2018, Med Storage, More

SURVIVAL MEDICINE HOUR PODCAST

Ebola outbreak in Congo

Ebola outbreak in Congo

In 2014, Joe Alton MD began reporting on an outbreak of a little-known disease called Ebola in West Africa. At the time, there were less than 100 cases, but eventually became a major epidemic with 28000 cases and 11000 deaths. Now Ebola has broken out in urban areas in Congo, where it was first identified. With cities of 1 and 11 million in the area, could it become a major epidemic? Find out the latest in developments in Ebola research since the West Africa epidemic in 2014, and is the new vaccine panning out to be protective?

Also, Joe and Amy Alton, ARNP discuss a major challenge in austere settings: stroke, aka cerebro-vascular accident (CVA). Find out how to quickly identify a stroke in progress and what to do to increase the chances of full recovery for the victim.

Plus, a listener asks about the reliability of the medications he has in his vehicle’s medical kit, which spends a lot of time in the hot Texas summer sun. What are the effects on medications and what should be done?

All this and more in the latest Survival Medicine Hour with Dr. Bones and Nurse Amy!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/05/25/survival-medicine-hour-stroke-ebola-2018-med-storage

Wishing you the best of health in good times or bad,

Joe and Amy Alton

The Altons

The Altons

Follow us on twitter @preppershow

Follow us on Facebook at Doom and Bloom(tm)

Folllow us on YouTube at DrBones NurseAmy Channel

Strokes (CVAs) On and Off The Grid

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Strokes (CVAs) On and Off The Grid

STROKES ON AND OFF THE GRID

Often, medics in remote areas are confronted with a major challenge. Some of these challenges relate to wilderness exposure, or perhaps, an accident while performing activities of daily survival. Give me an axe and set me to chopping wood and you’ll probably see what I mean.

Sometimes the challenge faced by the medic isn’t from some external trauma, but internal; problems so severe that, even in normal times, there are limits to the options available for treatment. One issue that fits this description is the Cerebro-Vascular Accident (CVA), also known as a “stroke”.

Although modern medicine can do more for stroke victims than the pioneer medic, it’s important for an off-grid healthcare provider to recognize the signs and symptoms of a stroke and to act quickly to improve a victim’s chances of survival.

WHAT IS A STROKE?

A CVA, or stroke, is a medical event in which a blood vessel that supplies the brain with oxygen becomes blocked or leaks blood. The effect is that tissue served by that blood vessel becomes starved of oxygen. Within a few short minutes, the region affected begins to die, and functions controlled by that part of the brain are lost or impaired.

Uncontrolled high blood pressure is considered to be a major risk factor for a stroke. Other predisposing factors include diabetes, tobacco, obesity, and some heart irregularities. In a sizable number of cases, however, no obvious cause is ever identified.

According to the Centers for Disease Control and Prevention, stroke is the fifth leading cause of death in the United States, with about 800,000 cases a year. Of those that survive a stroke, many are left with significant permanent disability; a percentage do not survive more than a year afterward.

TYPES OF STROKES

The failure to provide oxygen-carrying blood to the brain could happen in one of two ways:

  • A blood clot obstructs a blood vessel that is needed to maintain circulation (“perfusion”) to the brain. This is called an “ischemic” stroke and is the most common type.
  • Blood from an artery, vein, or an abnormal structure leaks into brain tissue or the space between the brain and the membranes that cover it. This can happen due to trauma, blood-thinning medication, or other causes, and is known as a “hemorrhagic stroke”.

Sometimes, hemorrhage can occur in the area of an ischemic stroke, blurring the line between the two types.

ISCHEMIC STROKES

Ischemic strokes can be caused by a number of issues, including:

  • Thrombosis: A blood clot forms locally, causing obstruction.
  • Embolism: A blood clot forms elsewhere in the body and travels through the circulation to lodge in the brain.
  • Systemic Hypoperfusion: An inadequate amount of blood gets to the brain due to, say, severe bleeding, as in hemorrhagic shock.

HEMORRHAGIC STROKES

When blood leaks into brain tissue, it places pressure on sensitive brain cells, causing significant damage. Hemorrhagic strokes can be caused by uncontrolled high blood pressure or, less commonly, by a malformation of a blood vessel known as an “aneurysm”. An aneurysm is a weakness in a vessel wall that looks like a tiny balloon; if it bursts, a catastrophic bleed into brain tissue can occur.

Certain medications that suppress blood clotting may increase the risk of CVA. I mention this as a nod to my father, who survived a heart attack only to have a hemorrhagic stroke from blood thinners given to him in the aftermath. He died a few weeks later.

Hemorrhagic strokes can occur:

In the brain tissue itself: This is known as an “intracerebral” hemorrhage and is the most common hemorrhagic stroke.

Between the brain and the thin membranes that surround it: This type, albeit less common, can accumulate a significant amount of blood and cause severe pressure on brain tissue.

TRANSIENT ISCHEMIC ATTACKS (TIAs)

Occasionally, the medic may encounter a short-term event called a “Transient Ischemic Attack (TIA)”. Sometimes referred to as a “mini-stroke”, a TIA can present as minimal or significant symptoms, which are, well, transient in nature. In a classic TIA, symptoms will disappear for the most part within two hours or so.

Despite this, it is impossible to know whether you’re dealing with a major stroke or a TIA when first presented with the victim. Those who experience a TIA, even if all symptoms disappear, will be at higher risk for a major stroke in the near future.

Click the link below to read an account by a real person of her TIA experience:

https://www.cdc.gov/stroke/survivor_stories/blanche.htm

IDENTIFYING A STROKE

The CDC has compiled a list of symptoms that point the medic to the diagnosis of a stroke. By learning these (often unmistakable) signs, quick action may lead to lives saved and function restored. Stroke victims will often exhibit the sudden onset of:

  • Severe headache
  • Numbness or weakness affecting (usually) one side of the face, arm, or leg.
  • Trouble speaking or inability to understand speech.
  • Difficulty with vision in one or both eyes
  • Confusion or dizziness
  • Trouble walking
  • Loss of coordination

The CDC recommends the memorization of “F.A.S.T.”, a simple way to help with stroke diagnosis and treatment:

Face: Smile. Does one side of the face sag?

Arms: Raise both of the victim’s arms and see if one droops.

Speech: Have the victim say a common phrase: Does it sound strange or slurred?

Time: Call 9-1-1 right away if you notice any of these symptoms (of course, this won’t be an option off the grid).

It’s important to note when symptoms started and when the victim was last seen well. The longer the time frame between wellness and debilitation, the more likely there’ll be long-term consequences.

TREATING A STROKE

The presentation of a stroke victim is oftentimes quite striking and an observant medic will make the diagnosis quickly. Rapid action may help preserve function and even life.

The majority of CVAs are ischemic in nature. In normal times, a patient with this type of stroke can be treated with a powerful IV therapy called tPA that helps break up clots (must be given within three hours). Procedures can also be performed that might be successful in removing the clot that’s blocking the circulation.

In the absence of modern medical facilities, blood thinners like aspirin may be of use. If no aspirin is available, Salicin from the underbark of willow trees will have a similar effect.

It should be noted that a hemorrhagic stroke may actually worsen with the use of blood thinners like aspirin. As many of these are caused by elevated blood pressures, anti-hypertensive meds may help to reduce damage caused. Blood pressure is usually at its lowest if the patient is placed on their left side. If caused by an aneurysm, surgical procedures may be necessary.

Recovery from a stroke is not impossible. The National Stroke Association reports 10% will experience almost complete recovery, with another 25% with minor impairments. Reports suggest that most recovery occurs soon after a stroke, but improvement may still occur over a longer period of time, especially with rehabilitation.

With the lack of modern medical facilities in the aftermath of a disaster, the hard reality may be that major medical events like strokes may be very difficult to deal with. The medic’s motto may have to be: “Do what you can, with what you have, where you are.”

Joe Alton MD

Learn about 150 medical issues and how to deal with them when the ambulance is not just around the corner, by checking out The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, available at Amazon or on this website.

Survival Medicine Hour: Ticks, Volcanoes, Special Guests

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Survival Medicine Hour: Ticks, Volcanoes, Special Guests

SURVIVAL MEDICINE HOUR PODCAST

Old Faithful is a sign of a mass of superheated water and rock below Yellowstone National Park

Old Faithful is a sign of a mass of superheated water and rock below Yellowstone National Park

Can you prepare for a day at the beach? Can you prepare for an asteroid strike? Well, preparing for volcanic eruptions is in the middle, actually closer to an asteroid strike that anyone would like. Joe Alton MD and Amy Alton ARNP discuss what can and can’t be done to prepare for a volcano, and whether volcano preparedness is an oxymoron!


Also, school’s almost out and families will out hiking and camping. Ticks will also be out, and ready to make a meal out of the blood of your loved ones. The Altons discuss how to avoid being a blood donor to a tick this summer, and avoid diseases they transmit like Lyme disease.

All this and more in this episode of the Survival Medicine Hour with Dr. Bones and Nurse Amy!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/05/18/survival-medicine-hour-ticks-volcanoes-interviews-more

Follow us on Twitter @preppershow; on Facebook at the Doom and Bloom(tm) page; on YouTube at the DrBones NurseAmy channel

Also, check out Nurse Amy’s entire line of medical kits and supplies at store.doomandbloom.net!

Joe and Amy Alton

Survival Medicine Hour: Emerging Infectious Diseases, Malaria

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Survival Medicine Hour: Emerging Infectious Diseases, Malaria

SURVIVAL MEDICINE HOUR PODCAST

e. coli bacteria

e. coli bacteria

Joe Alton MD and Amy Alton ARNP often  talk about infectious diseases on the Survival Medicine Hour, a number of which are called emerging infectious diseases.

Emerging infectious diseases are infections that have recently appeared within a population or those whose frequency or geographic range is increasing or likely to increase in the near future. They say there’s nothing new under the sun, so how is this possible? Emerging infections can be caused by:

  • Previously undetected or unknown infectious agents (SARS, MERS)
  • Known agents that have spread to new geographic locations or new populations (Zika, Ebola, Chikungunya)
  • Previously known agents whose role in specific diseases has previously gone unrecognized. (like some viruses now being thought responsible for certain illnesses)
  • Re-emergence of agents whose incidence of disease had significantly declined in the past but whose incidence of disease has reappeared, say measles. This group is known as re-emerging infectious diseases.
Asian Tiger Mosquito

Asian Tiger Mosquito

The World Health Organization warned in its 2007 report that infectious diseases are emerging at a rate that has not been seen before. Since the 1970s, about 40 infectious diseases have been discovered, including SARS, MERS, Ebola, chikungunya, avian flu, swine flu and, most recently, Zika.

More information on emerging infectious disease can be heard on this episode of the Survival Medicine Hour!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/05/11/survival-medicine-hour-emerging-infectious-disease

Wishing you the best of health in good times or bad,

Joe and Amy Alton

The Altons

The Altons

E. Coli Contamination

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E. Coli Contamination

E. COLI CONTAMINATION

Romaine Lettuce

Romaine Lettuce

The Centers for Disease Control and Prevention reports that food poisoning from romaine lettuce harboring the bacteria E. Coli spread recently to 29 states and sent at least 150 people to the hospital. The areas involved include all parts of the country from Florida to North Dakota to California, and new cases are making it the worst E. Coli outbreak nationally since 5 people died and 200 were hospitalized in 2006.

Although E. Coli is a common inhabitant of the intestinal tract, some strains, especially O157:H7,  produce a toxin known as “Shiga” that causes bloody diarrhea, nausea and vomiting, dehydration, and other symptoms. Victims range from 1 to 88 years old, and a number are experiencing kidney failure, which has killed one person so far. Several E. Coli varieties are common causes of urinary tract infections.

E. Coli

E. Coli

Sources of Shiga-toxin producing E. Coli may include:

·       Contaminated water (even swimming in it may cause infection)

·       Undercooked ground beef

·       Unpasteurized milk or juice

·       Cheese made from raw milk

·       Raw fruits, vegetables, and sprouts

·       Contact with animals and their enclosures

·       Feces of those infected

After the organism enters the system, it usually takes several days for symptoms to appear. Unlike many infections, E. Coli tends not to cause high fevers, but the abdominal pain, diarrhea, and vomiting can be severe. Dehydration can cause decreased urine production, dark urine, weakness, and fatigue.

Rehydration is the main treatment

Rehydration is the main treatment

Re-hydration support during the illness will help support the victim for the 6-8 days it takes most to get over the infection. Antibiotics are rarely indicated, as it usually goes away by itself; it is even thought that taking anti-diarrheal medicines may slow the recovery process by preventing the elimination of the organism through bowel movements. Dairy products or items with high fat content or fiber can make your symptoms worse.

If it occurs, kidney damage will begin to become apparent after the first week.

Simply avoiding bagged lettuce at the grocery store is not enough, as many of those made ill ate the lettuce in salads served in restaurants. It is not yet known where in the chain from farm to consumer that the contamination with the bacteria took place. A farm in Yuma, Arizona may be involved.

Prevention involves avoiding poorly prepared food and water.  Use different cutting boards for raw fruits and vegetables than you would for raw meat.  

The most important factor in preventing E. Coli outbreaks is strict diligence applied to washing hands before cooking, after caring for animals and their environments, and diapering infants or otherwise disposing of human waste. 

Eating salads is a healthy option for most, but always be sure to make yours with freshly-washed hands and vegetables.

Joe Alton MD

Dr. Alton

Dr. Alton

Find out more about E. Coli contamination and 150 other medical issues when the ambulance may not be just around the corner! Check out a copy of the award-winning Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the way, available at Amazon or at doomandbloom.net. Also, be sure to find a medical kit that will help keep your people healthy in good times or bad: Check out store.doomandbloom.net

The Third Edition

The Third Edition

Can You Prepare For A Volcano?

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Can You Prepare For A Volcano?

Can You Prepare For A Volcano?

Uh oh...

Uh oh…

There are a number of disasters, natural or man-made, where a great deal of preparation greatly increases your chances of survival. Then there are others, like volcanic eruptions or asteroid strikes, where your option are, to say the least, more limited. You might not consider a volcano as the most likely event to ruin your day, and you’d be right. Still, it makes sense to know about them and what you might be able to do to prevent being a victim of one.

A volcano is a rupture in the crust of the earth which allows lava (molten rock at 750-1250 degrees Fahrenheit), ash, and gases to escape from deep below the surface. The violence of volcanic eruptions is so great that boulders can come raining down from the sky to flatten houses and, perhaps, you.

Most have the impression that a volcano is a conical mountain with smoke and fire spewing from the top, such as you see today in Hawaii. In actuality, however, most volcanos can be active without displaying physical signs for thousands of years.

Volcanoes can also take a number of forms: In Yellowstone National Park, a huge dormant super-volcano looks more like flat land than a cone. Indeed, it takes some observation to know you’re walking on top of it. Geysers like ‘Old Faithful” exist as evidence that there’s still a great deal of pressure and molten rock below the surface.

Old Faithful Geyser

 

One doomsday scenario includes the eruption of this huge land feature, which is called a “caldera” (meaning “cauldron” or “cooking pot”). This disaster last happened 640,000 years ago, but it’s thought to be an event that is likely to occur again “soon”. In geologic time, “soon” means in the next 40,000 years or so.

If you live in a volcanically active area, there are a few things that you can do to decrease the chance of becoming a victim. Monitor volcanic activity reports via NOAA radios and evacuate the area if authorities believe an eruption is imminent. Have a plan in place to get the family together via texting, email, social media, etc.

Know several routes out of the area; roads may be blocked by fire, thick ash, or lava flows. Visibility and breathing might become difficult, so respirator masks and goggles should be worn by every member of the group.

That's not snow, it's volcanic ash!

That’s not snow, it’s volcanic ash!

Ash can also damage engine parts and stall escape vehicles, so be prepared to go on foot if necessary. Any equipment with moving parts that must remain outside as your evacuate should be covered with tarps.

The most intelligent decision is to hit the road, Jack, and take a good amount of supplies with you. There are circumstances, however, where you might be unable to leave your home. While you can’t expect even the most solid house to be much protection from a wall of lava, you might still be able to achieve protection from volcanic ash:

·       Close all windows and doors

·       Block chimneys

·       Stay under the sturdiest part of the roof (ash can be very heavy)

·       Have food and water stored in quantity

It imperative to have at least several days supplies packed and ready to go at a moment’s notice. I call this a “G.O.O.D.” bag (Get Out Of Dodge!).

It’s also important to have a good kit to deal with medical issues. You’ll need materials that that treat burns and orthopedic injuries as well as masks, goggles, and flashlights for every member of the family. You might not consider these items to be medical in nature, but they’ll help you breathe and see even if the ash is falling thickly, and you’ll be in better physical shape and more likely to survive.

Masks

Masks

No masks and no shelter? Place a damp cloth over your nose and mouth and cover your skin as much as possible. Of course, protection in the form of work gloves, sturdy high-top boots, and head coverings (a hard hat even seems prudent here) will decrease your chance of injury as you escape the area. Avoid low-lying areas that might be a natural conduit for lava. Stay clear of areas downwind of the volcano; ash and flying debris will be thickest there.

Don't let this happen!

Don’t forget the pets

Don’t forget your pets: Have a “G.O.O.D.” bag for them as well. Here’s the Red Cross’s recommendations for emergency pet kits and a plan of action that will increase your animals’ safety in times of trouble:

http://www.redcross.org/get-help/how-to-prepare-for-emergencies/pet-disaster-preparedness#Pet-Emergency-Kit

You might not always have a lot of options in a disaster, but you can always improve your chances of surviving even in the worst situations.

Joe Alton MD

Dr. Alton

Dr. Alton

Find out more about disaster preparedness and 150 medical topics you might face off the grid in the award-winning Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. Plus, fill those holes in your medical supplies at store.doomandbloom.net!

Third Edition

Third Edition

ASIDE: Can you stop a lava flow? Here’s some ways they’ve tried:
https://www.msn.com/en-us/news/us/people-have-tried-to-stop-lava-from-flowing-this-is-why-they-failed/ar-AAwVk3t?ocid=spartanntp

Survival Medicine Hour: Causes of Abdominal Pain Off The Grid

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SURVIVAL MEDICINE HOUR PODCAST

After a disaster or at a remote homestead, we all know that the medic for the family may not have ready access to modern medical technology. That means many conditions that are commonly identified with ultrasounds or CAT scans may be more challenging to diagnose. One of these challenges is abdominal pain. There are various medical issues that cause it, and Joe Alton MD and Amy Alton ARNP discuss several common diseases that must be identified and treated, such as appendicitis, gall bladder stones, stomach viruses, and more. These issues have some telltale signs that clue you in on what’s going on.

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/05/03/survival-medicine-hour-appendicitis-stomach-flus-gall-bladder-disease-more

Don’t forget to follow Dr.Bones and Nurse Amy on Twitter @preppershow, Facebook at Doom and Bloom, and YouTube at DrBones NurseAmy Channel!

Inflamed Appendix

Inflamed Appendix

Here’s wishing you the best of health in good times and bad…

Joe and Amy Alton

Joe and Amy

Joe and Amy

Find out more about abdominal pain and 150 more medical issues in survival settings with the award-winning Third Edition of the Survival Medicine Handbook: The Essential Guide For When Medical Help is Not on the Way! And fill those holes in your medical supplies with kits and individual items from Nurse Amy’s store at store.doomandbloom.net

Malaria: Important Things To Know

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MALARIA

World's most dangerous creature?

World’s most dangerous creature?

The world is full of dangerous critters, and we’re lucky not to run into the grand majority of them during our daily lives. Animals that present a threat to humans usually live in habitats that are in the wilderness or the deep ocean, where population densities of people are low and encounters infrequent.

You might consider the Great White Shark to be the most dangerous animal in the world, but you’d be wrong. It’s not the black mamba snake of Africa, nor the cone snail of tropical waters; Indeed, in terms of the sheer number of human deaths, a creature much smaller is involved: The lowly mosquito, which puts Jaws and all the classic creatures from our nightmares to shame.

Mosquitoes, especially those in the Anopheles, Aedes, and Culex families, are responsible for more deaths than any other animal (humans excluded). According to the World Health Organization, mosquito bites are the cause of one million deaths every year. But a mosquito bite is a direct way of getting a disease indirectly; the mosquito itself isn’t the cause, it’s a “vector”, a way-station for a microbe on its way to its eventual host. These organisms are rarely, if ever, fatal to the mosquito they live in, but can be to their eventual host: Warm-blooded animals that the mosquito bites, like humans.

MALARIA

Life Cycle of Malaria

Life Cycle of Malaria

The majority of deaths from infectious diseases transmitted by mosquitoes are caused by a disease known as malaria. It was originally thought that the disease came from foul marsh air, thus came to be known as  “mal aria” or “bad air”.

The World Health Organization believes that 300-500 million cases of malaria occur every year, with 1 million deaths. 1700 cases are reported to the Centers for Disease Control and Prevention (CDC) annually in the United States, mostly by those traveling outside the country.

Malaria is caused by one of four species of microbe called “plasmodium“, of which p. falciparum seems to be the worst. Plasmodium lives in the gut of mosquitoes. When female mosquitos (only females bite humans) of the anopheles species inject these micro-organisms into a human body, they colonize organs such as the liver. Once there, they travel through your circulation to damage blood cells and other organs.

modern range of malaria organisms

modern range of malaria organisms

Looking at the map of the current range of anopheles mosquitoes, you would think the United States is immune to issues relating to malaria. This is primarily due to the common availability of air conditioning systems, drained swamp areas, and improved health care in modern times. Malaria was thought, however, to be a significant problem, especially in the South, in the 18th and 19th centuries; even today, a remote homestead or a community off the grid due to a major disaster might still be vulnerable to an outbreak.

It should be noted that, besides anopheles, other species of mosquitoes carry micro-organisms that invade and cause damage to organs. One instance that created a sensation recently was the aedes mosquito that transmitted Zika virus to the brains of fetuses in Brazil in a 2015-16 epidemic.

SYMPTOMS OF MALARIA

Plasmodium organism under the microscope

Plasmodium organism under the microscope

Symptoms of Malaria appear flu-like and present as periodic chills, fever, and sweats.  The classic appearance includes:

High fever (often reaching up to 104° F or more)
Chills
Shaking
Extreme sweating
Fatigue
Discomfort (known as “malaise”), joint, and body aches
Headache
Nausea, vomiting, and diarrhea

Some develop jaundice, a yellowing of the skin and eyes due to liver damage.

Although most people begin to experience symptoms 10 days to 4 weeks after infected, it is possible to be without symptoms for up to 1 year after you are infected. Bouts of severe symptoms every two or three days is common.

Some types of malaria can lead to repeat bouts of sickness. The parasites can go dormant in the liver for a period of time after infection. When they become active again, the person gets sick again, known as a “recurrence”.

Over time, the patient becomes anemic as blood cells are lost to the infection. With time, periods between episodes become shorter and permanent organ damage may occur.

DIAGNOSIS AND TREATMENT

Malaria can be treated and controlled

Malaria can be treated and controlled

Diagnosis of malaria cannot be confirmed without a microscope, but anyone experiencing relapsing fevers with severe chills and sweating should be considered candidates for treatment.  The medications used for Malaria include Chloroquine, Quinine, and Quinidine; other, later-generation drugs, are also available.

Sometimes, an antibiotic such as Doxycycline or Clindamycin is used in combination with the above. Physicians are usually sympathetic towards prescribing these medications to those who are contemplating trips to places where mosquitos are rampant, such as tropical climates. These drugs are also available as veterinary equivalents in avian or aquatic form.

MOSQUITO CONTROL

Of course, the fewer mosquitos near your retreat, the less likely you will fall victim to one of these diseases. You can decrease the population of mosquitos in your area and improve the likelihood of preventing illness by:

  • Looking for areas of standing water that could serve as mosquito breeding grounds. Drain all water that you do not depend on for survival.
  • Monitoring the screens on your retreat windows and doors and repairing any holes or defects.
  • Being careful to avoid outside activities at dusk or dawn. This is the time that most mosquitos are most active.
  • Wear long pants and shirts whenever you venture outside.
  • Have a good stockpile of insect repellants. If you are going to use sunscreen, apply it first and then apply the insect repellant.

Some insect repellants are meant to be applied to clothing only, such as Permethrin. DEET, however, is acceptable for exposed skin; those areas not covered with clothing.  DEET is acceptable for pregnant and breastfeeding women when used correctly (and, preferably, at 35% or less concentrations).

Many are reluctant to use chemical repellants, and there are EPA-accepted natural remedies. Plants that contain Citronella may be rubbed on your skin to discourage bites.  Lemon balm has been recommended in the past, but, despite having a fragrance similar to citronella, does not have the same bug-repelling properties.

When you use an essential oil to repel insects, re-apply frequently and feel free to combine oils as needed. Besides Citronella oil, you may consider:

  • Lemon Eucalyptus oil
  • Cinnamon oil
  • Peppermint oil
  • Geranium oil
  • Clove oil
  • Rosemary oil

A large amount of damage can occur to humans as a result of small insects. Knowing how to recognize major insect-borne diseases, along with a program of systematic control of bug populations can decrease the number of people that have to deal with signficiant illnesses.

Joe Alton MD

Joe Alton MD

Joe Alton MD

Lear more about malaria and many other infectious diseases in austere settings by checking out the award-winning Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. Also, consider becoming more medically prepared with supplies and kits from Nurse Amy’s entire line at store.doomandbloom.net.

Survival Medicine Hour: Spring Camping Safety, Snakebite, More

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Camping Safety

Camping Safety

School is winding down, and families are starting to think about that camping trip to the mountains or shore. Camping safety is important, and a lot of factors need to be considered like weather, gear, and more to make a camping trip memorable (and I mean in a good way, not a bad way). What you need to do to deal with common injuries, supplies you’ll need, and even a little about snakebite, since those critters are waking up from their cold-weather slumbers.

venomous snake bite

venomous snake bite

all this and more on the Survival Medicine Hour with Joe Alton MD and Amy Alton ARNP!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/04/27/survival-medicine-hour-spring-camping-safety-snakebites-more

Wishing you the best of health in good times or bad,

Joe and Amy Alton

The Altons

The Altons

Follow us on Twitter @preppershow  YouTube at drbones nurseamy channel

Facebook at our Survival Medicine Group DrBones NurseAmy or Doom and Bloom pages

Check out our kits and books at store.doomandbloom.net

 

Appendicitis Off The Grid

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Appendicitis Off The Grid

Blocked appendix

Blocked appendix

After a disaster or at a remote homestead, the medic may not have ready access to modern medical technology. As such, many conditions that are commonly identified with ultrasounds or CAT scans may be more challenging to diagnose. One of these challenges is abdominal pain. There are various medical issues that cause it, with the classic example of an abdominal emergency being appendicitis. Over 300,000 Americans have their appendix removed every year.

The Appendix

The “vermiform appendix”, as it is formally known, is a hollow tubular organ a few centimeters long and a centimeter wide. It looks like a worm (vermiform means worm-like).  Attached at the entrance to the large intestine (the “cecum”), it resides in the lower right portion of the abdomen in almost all people. Inflammation of the appendix can become a medical emergency quickly; if ignored, it may represent a life-threatening situation.

ASIDE: When the appendix (or any other organ, for that matter) is inflamed, the suffix “-itis” is added; thus, inflammation of the appendix is called “appendicitis”.

What purpose does the appendix serve? Charles Darwin believed it was a left-over from an earlier time, as horses and some other animals have larger ones that help them digest vegetation. Today, it is thought by many that it serves an immune function for fetuses and children. It is also thought to be a reservoir for good gut bacteria. After a bout of, say, dysentery or cholera, it may help repopulate the gastro-intestinal tract with beneficial micro-organisms.

Having said that, there seems to be no major ill effects from having an appendix removed, although some studies suggest a small increase in diseases, such as Crohn’s Disease.

What Happens in Appendicitis

A grossly inflamed appendix

A grossly inflamed appendix

Appendicitis is related to an obstruction of the organ by, usually, calcified feces; it some cases, blockage can be caused by foreign objects, trauma, or even intestinal worms.  How does this lead to a possibly life-threatening situation?

Once blocked, the mucus produced by the appendix is unable to drain into the cecum. The organ swells as a result. Once swollen enough, the ensuing pressure on the appendix walls prevents the circulation necessary to keep tissue alive. The dying tissue causes the appendix to fill with pus and, without treatment, will be either walled-off by the body’s defenses or will burst (a “ruptured appendix”).

Once ruptured, an inflammation of the lining of the entire abdomen called peritonitis occurs. From there, it can progress to an infection throughout the body (sepsis) if untreated. Death may be the final outcome.

How to Identify Appendicitis

Many illnesses will be difficult for the medic to diagnose in austere settings. Although ultrasounds and CAT scans help confirm suspicions, appendicitis can be identified with some reliability based on physical signs and medical history.

Classic signs and symptoms that suggest appendicitis as the cause of abdominal pain include:

  • Pain starting at or around the belly button, usually dull and aching
  • Loss of appetite, followed by nausea and vomiting
  • Abdominal swelling
  • Fever
  • Inability to pass gas
  • Pain evolving to become sharper and migrates to the lower right abdomen

The pain tends to localize to a specific spot one-third of the way from the hip bone to the belly button, an area known as “McBurney’s Point”.

McBurney's Point

McBurney’s Point

Once an appendix has ruptured, the pain becomes general throughout the abdomen in many cases. The belly may appear stiff and swollen, with tenderness on exam, both on pressing down (“guarding”) and when letting go (“rebound tenderness”, often worse).

It should be noted that other symptoms may present in a significant minority of patients. Cramping may occur, with some complaining of painful or otherwise difficult urination. As with any condition, signs and symptoms may vary from person to person.

Mimics of Appendicitis

Causes of abdominal pain by area

Causes of abdominal pain by area

Other conditions may lead you to erroneously suspect appendicitis when, in actuality, something entirely different is going on. Urinary infections, right-sided tubal pregnancies or ovarian cysts, diverticulitis, Crohn’s disease or ulcerative colitis, and pelvic inflammatory disease may mimic an inflamed appendix to one extent or another and must be ruled out. These topics will be discussed in future articles.

Treatment of Appendicitis

Appendicitis is the most common cause of abdominal pain treated by surgery today, and the procedure is usually curative. The earlier the surgery is performed, the faster the recovery and the less likely scarring will occur. Below is a video of a (bloodier than usual) open removal of a swollen appendix:

Appendectomy can be performed, using a very small incision, under sedation and local anesthesia off the grid. This procedure is not without difficulty for the inexperienced surgeon, as there is intervening small intestine and other structures that must be moved out of the way to visualize the inflamed area. Of course, patient discomfort is a major obstacle.

Recent studies have explored the possibility of using antibiotics to nip early appendicitis in the bud. The patient should be placed on bedrest and restricted to small amounts of clear liquids as soon as you make the diagnosis.

Intravenous treatment is the preferred way to deliver antibiotics to treat appendicitis, but may not be an option off the grid. In that case, a combination of Ampicillin (veterinary equivalent Fish-Cillin) and either Clindamycin (veterinary equivalent Fish-Cin) or Metronidazole (veterinary equivalent Fish-Zole) might be useful. In cases of Penicillin allergy, Ciprofloxacin (veterinary equivalent Fish-Flox) may be a suitable alternative to Ampicillin.

Look for other common causes of abdominal pain to be examined in future articles.

Joe Alton MD

Dr. Alton

Dr. Alton

Find out more about appendicitis and conditions that mimic it in the Third Edition of the award-winning Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the way, available at Amazon or along with an entire line of medical supplies at store.doomandbloom.net.

The Third Edition

Survival Medicine Hour: E. Coli Outbreak, Mudslides, Water Disinfection, More

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SURVIVAL MEDICINE HOUR #386

MUDSLIDES

MUDSLIDES

Spring has sprung, and snowmelt plus heavy rains may increase the risk of mudslides, aka debris flows, in many areas. Find out more about this dangerous natural phenomenom which is akin to a river of wet concrete, plus some early warning signs that you property is at risk. Joe and Amy, aka Dr. Bones and Nurse Amy, also discuss a new E. Coli outbreak that is hitting several states across the country but is still mysterious in its origin, plus their recommendations for water disinfection and how it compares to official EPA directives.

bacterial outbreak in 7 states

bacterial outbreak in 7 states

Also, some examples as to when the medic has to make tough decisions in survival settings, like giving medicines to someone who is really sick but claims to have an allergy to the only drug or natural option you’ve got in your medical supplies.

All this and more in the latest Survival Medicine Hour with Joe Alton, MD and Amy Alton, ARNP!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/04/13/survival-medicine-hour-e-coli-outbreak-mudslides-disinfection-more

Wishing you the best of health in good times or bad,

Joe and Amy Alton

Joe and Amy Alton

Joe and Amy Alton

 

Follow Joe and Amy on twitter @preppershow; Facebook at Doom and Bloom, and on Youtube at drbones nurseamy channel!

Find the award-winning third edition of The Survival Medicine Handbook at Amazon.com

Survival Medicine Hour: Allergies, More

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Survival Medicine Hour #385

all about allergies

all about allergies

In certain seasons, like Spring, pollens and other substances are at high levels. For most, it’s a great time of year to be outside, but for allergy sufferers, well, not so much. Joe Alton, MD,aka Dr. Bones, and Amy Alton, ARNP, aka Nurse Amy, go into detail to tell you the history of allergies (the word didn’t even exist in the year 1900!), what exactly happens in your body during an allergy attack, and how to identify it from, say, a simple adverse reaction to a medicine.

Also, a little about severe allergic reactions and your treatment options in good times or bad, plus why most people that tell their doctor they’re allergic to something may actually not have an allergy at all!

All this and more on the latest Survival Medicine Hour with Joe and Amy Alton!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/04/06/survival-medicine-hour-allergies-more

Wishing you the best of health in good times or bad,

Amy and Joe Alton

The Altons

The Altons

Follow the Altons on twitter @preppershow, Facebook at Doom and Bloom(tm), and YouTube at DrBones NurseAmy Channel! Drget to get a copy of their 2017 Book Excellence 1st Place Award winner in medicine, The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, and medical kits and supplies at store.doomandbloom.net.https://store.doomandbloom.net/

The Survival Medicine Handbook, Third Edition

The Survival Medicine Handbook, Third Edition

Video: Hygiene and Comfort Issues

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VIDEO: Hygiene and Comforts Issues in Survival Settings

Comfort and Hygiene in Survival

Comfort and Hygiene in Survival

Amy Alton, ARNP, aka Nurse Amy, again steps in front of the camera to discuss issues relating to hygiene and “comfort” in disaster settings. Supplies include important items that will help assure both physical and mental preparedness even in tough times.

To watch, click below:

Please subscribe to our YouTube channel!

 

Wishing you the best of health in good times or bad,

Amy and Joe Alton

The Altons

The Altons

Don’t forget to fill those holes in your medical storage by checking out our books, DVDs, kits, and individual supplies at store.doomandbloom.net!

medical kits

medical kits

Third Edition: Book Excellence Award Winner in Medicine

Third Edition: Book Excellence Award Winner in Medicine

Survival Medicine Hour: Wound Closure in Survival Settings, More

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SURVIVAL MEDICINE HOUR #382

wound closure

Important factors when deciding to close a wound off the grid

Injuries occur in disaster and other off-grid settings, and some of those break the skin or even go into deeper layers, like subcutaneous fat and muscle. When do you close a wound and when is it wiser to keep it open? Also, if you’re going to close it, what materials should you use and why? Joe Alton MD and Amy Alton ARNP, aka Dr. Bones and Nurse Amy, take you through the decision making process and much more in this episode devoted to wound closure in survival situations.

Suture Training is important, but so is open wound care

Suture Training is important, but so is open wound care

Follow Joe and Amy on Twitter @preppershow, plus their YouTube Channel at drbones nurseamy, and Facebook on their Doom and Bloom(tm) page!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/03/30/survival-medicine-hour-wound-closure-in-survival

Wishing you the best of health in good times or bad,

Joe and Amy Alton

Amy's garden

Amy’s garden

Fill those holes in your medical supplies with kits and individual supplies at store.doomandbloom.net.

The Survival Medicine Handbook, Third Edition

The Survival Medicine Handbook, Third Edition

 

Survival Medicine Hour: Preparedness Expos, Stop The Bleed Day, More

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Preparedness Expo

Preparedness Expo

We’ve been supporters of and speakers at the Self-Reliance Expo for many years, and we thought it might be interesting to talk to some of the speakers and exhibitors at the event. You’ll hear our friend Rich Beresford of AroundtheCabin.com, 17 year old survivalist Blake Alma, and other popular YouTubers and celebs of the survival community. Listen to the stories of people who are members of the preparedness community.

Plus, Joshua Remer and Max Dodge of Stop The Bleed Day talk about the importance of teaching how to stop bleeding from traumatic wounds. Also, a short discussion of how the antihistamine Benadryl, in injectable form, is actually a reasonably strong local anesthesia. Is it an option for the survival medic? Find out on this out-of-the-box program,

Wishing you the best of health from good times or bad,

Joe and Amy Alton

The Altons

The Altons

Survival Medicine Hour: Wound Cleaning, Medical Backpacks, More

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SURVIVAL MEDICINE HOUR #380

dealing with open wounds

dealing with open wounds

The right equipment is important for anyone to do a job efficiently. You wouldn’t expect a steak knife to cut a tree down better than a saw, or see a hunter have the same success with a catapult as opposed to a rifle. The same goes for the containers you put supplies in, especially one you have to carry with you while bugging out or away from your retreat. The right medical backpack allows you to work effectively as a medic, while giving you the ability to have plenty of materials and minimizing back problems. Dr. Bones and Nurse Amy discuss what goes into choosing a good medical backpack.

A loaded first aid kit with medical supplies for trauma,burns, sprains and strains and other medical issues

Picking the right medic bag

Plus, some basics of wound cleaning off the grid. In normal times, you can pass off a person with a wound to a hospital, but after a disaster, it’s your responsibility to see the wound to full recovery. That means diligent and strict attention to wound cleaning. We talk about some strategies for wound care off the grid that will decrease the risk of wound infections and increase the chances for survival.

All this and more on the Survival Medicine Hour with Joe and Amy Alton!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/03/16/survival-medicine-hour-would-cleaning-medical-backpacks-more

Wishing you the best of health in good times or bad,

Joe and Amy Alton

Dr Bones/Nurse Amy

Dr Bones/Nurse Amy

Follow us on Twitter @preppershow, Facebook at Doom and Bloom’s page, and YouTube at DrBones NurseAmy channel

Plus, get a copy of the Survival Medicine Handbook’s award-winning Third Edition at Amazon.com

2017 Book Excellence Award Winner in Medicine

2017 Book Excellence Award Winner in Medicine

Survival Medicine Hour: Pregnancy, Labor and Delivery Off The Grid

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Survival Medicine Hour #378

Birthing a Baby Off The Grid

Birthing a Baby Off The Grid

It may not be the wisest move to be fruitful and multiply in the early going after a disaster. You need all your people at 110% efficiency, and that isn’t part of the deal with pregnancy, with all that fatigue, discomfort, nausea, and other symptoms. The best plans of mice and men often go awry, however, and you might find yourself taking care of a pregnancy and, eventually, delivering a baby.

Old Dr. Bones, retired obstetrician, and Nurse Amy, retired nurse-midwife, give you their perspectives on how to make labor and delivery manageable and result in a healthy baby and healthy mother. There’s more to it that we can fit in a one hour podcast, but you’ll learn a lot I’ll bet your didn’t know!

All this and more on the latest Survival Medicine Hour with Joe Alton MD and Amy Alton ARNP…

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/03/02/survival-medicine-hour-labor-and-delivery-off-the-grid

Wishing you the best of health in good times or bad,

Joe and Amy Alton

Joe and Amy Alton

Don’t forget to fill those holes in your medical kit at store.doomandbloom.net. You’ll be glad you did.

All About Arthritis

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ARTHRITIS

Arthritis Pain and Inflammation

Arthritis Pain and Inflammation

The human body is a marvel of engineering. Its dexterity, strength, and stamina allow amazing feats of athleticism and, yes, survival in the worst adversity; but wear and tear takes its toll over time on just about everything with moving parts (even you). The resulting loss of work efficiency and mobility, bad enough in normal times, can decrease your chances to succeed after a major disaster.

The moving parts in our skeletal frame are known as joints. Each one has varying amounts of range of motion and strength. They are remarkably durable, but break down with time and strain. The longer lives of modern humans has, thus, caused a high prevalence of joint disease called “arthritis”.

It’s thought that 54 million Americans today suffer from some form of arthritis, and that the number will rise to 78 million by the year 2040.  Although you might consider arthritis a disease of the elderly, two-thirds of the cases occur in pre-retirement age individuals.

Some cases of arthritis get their start with an injury

Some cases of arthritis get their start with an injury

Risk factors for arthritis include:

Age: Many types of arthritis are more common as people get older

Sex: Women are more likely to get certain types, such as rheumatoid arthritis, while men are more prone to a form of arthritis known as “gout”.

Family history: Some types of arthritis seem to run in families.

Injuries: Increased strain can injure joints, which can eventually lead to arthritis. This is seen in athletes, but can occur from manual labor, after surgery, or an accident.

Obesity: Those who lead sedentary lifestyles and are obese suffer long-standing strain on the joints in the hips, knees, and back, which can lead to arthritis.

Symptoms of Arthritis

Swollen knee

Swollen knee

Symptoms of arthritis may include:

  • Pain
  • Swelling
  • Joint stiffness and decreased range of motion
  • Reluctance to use the affected joint due to discomfort
  • Accumulation of fluid or other material (like uric acid in gout) in the joint space
  • Muscle weakness (with chronic arthritis)
  • Fever (if caused by an infection)

Types of Arthritis

 

Osteoarthritis

osteoarthritic changes to the knee

osteoarthritic changes to the knee

Osteoarthritis is the most common form of arthritis, especially in older individuals.  It can affect just about any joint in the body.  Hands, feet, back, hip, and knees are most commonly affected, but osteoarthritis can occur even in the spinal column.

Osteoarthritis is acquired by daily wear and tear on the joints, although it can also be a long term effect of a previous injury which accelerates degeneration. Obesity can increase stress on joints and lead to osteoarthritis, as well.

Warm compresses are useful to treat discomfort and stiffness.  Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin are helpful, as is Capsaicin cream or ointment.

arthrocentesis

arthrocentesis

The worst cases may require oral or injectable steroids.  Sometimes, a needle is placed to drain excess fluid from an affected joint to give relief. This is call “arthrocentesis”. This procedure may decrease pain, but could introduce infection into the joint if not performed with care.

 

Rheumatoid Arthritis

Severe rheumatoid arthritis

Severe rheumatoid arthritis

Rheumatoid arthritis (RA) is the most common auto-immune disease in the world today. In RA. the body’s immune system attacks its own tissues. The attack is not only directed at the joint but to other parts of the body.  Unlike some other joint diseases, rheumatoid arthritis tends to affect the same joint on both sides of the body. Women seem to be more susceptible than men.

Rheumatoid arthritis especially affects joints in the fingers and wrists, but is also common in knees and elbows. Over time, it can lead to severe deformities if not treated. Rheumatoid arthritis occurs in younger populations than osteoarthritis, even striking children on occasion.

Changes seen in rheumatoid arthritis

Changes seen in rheumatoid arthritis

Other symptoms associated with rheumatoid arthritis that you might not see with degenerative osteoarthritis:

  • Dry mouth
  • Dryness, Itching or burning in the eyes
  • Insomnia
  • Strange sensations in the hands or feet
  • Nodules under the skin
  • Chest pain when taking a breath

At present, there is no cure for rheumatoid arthritis. Treatments concentrate on easing the symptoms. Medical therapy includes strong anti-inflammatory medications such as oral steroids (example: Prednisone).

Another auto-immune disorder that can cause joint disease is known as Systemic Lupus Erythematosus (SLE). Although usually diagnosed by blood testing, Lupus can be differentiated from rheumatoid arthritis due to its one-sided nature. You will also see patients with SLE experience hair loss and body rashes. Lupus is often treated with long-term oral steroids.

Even though rheumatoid arthritis cannot be cured, it is thought to be possible to prevent the condition from worsening. Weight loss is one way to improve symptoms and prevent progression. Physical therapy to strengthen muscles and joints is also thought to be helpful.

 

Bacterial Arthritis

Bacterial arthritis (sometimes called “septic” arthritis) is often the result of some penetrating injury that allows organisms to invade the joint space. It can also occur from within, as when a blood infection (septicemia) or bone infection (osteomyelitis) has spread to a joint.

Common skin bacteria, such as Streptococcus and Staphylococcus, are the usual suspects; certain sexually transmitted diseases, like gonorrhea can also be the cause, although viruses and even fungi may be involved.

Typical symptoms of a bacterial arthritis are the same as osteoarthritis, except that the patient may have a fever and may exhibit redness or warmth over the affected joint. In addition to treatment for pain, arthrocentesis (removal of fluid with a needle) and intravenous antibiotics in the Keflex family (cephalosporins) or others may be helpful if the cause is bacterial.

 

Psoriatic Arthritis

Psoriasis

Psoriasis

Psoriasis is a relatively common skin condition that causes the formation of multiple red, scaly patches. This leads to itching and may be considered by some unsightly, but 30 per cent of sufferers also develop inflammation of the joints known as “psoriatic arthritis”.

Psoriatic arthritis victims may be differentiated from degenerative arthritis by nail changes that look like fungal infections, redness in the eyes, excessive fatigue, and swollen fingers and toes (the areas most commonly affected). The condition is most commonly treated with NSAIDs like ibuprofen for pain, steroids, and anti-psoriasis pharmaceuticals. Early treatment may lead to less severe damage to joints.

 

Gout

Gout with Tophi

Gout is another condition that destroys joints over time. Inflammation is caused by deposition of uric acid crystals in the joint.  Some people simply produce too much uric acid or don’t eliminate it well.  Obesity is a major risk factor, as is diabetes. This illness occurs primarily in men; a history of certain types of kidney stones may be associated with episodes of gout.

The presentation of gout will appear as:

  • Inflammation in one or two joints. The big toe is the classic example, but knees and ankles may also be affected.
  • Warm, red, painful joints. The pain is throbbing and often severe. Even laying a sheet over it may cause pain.
  • Fever.
  • Episodic repeat attacks (50% of cases).
What gout feels like

What gout feels like

After multiple episodes, permanent damage occurs and the joint loses its range of motion. Chronic sufferers may also develop lumps composed of uric acid crystals called “tophi”.  Tophi are lumps below the skin, mostly around joints like the big toe. They may drain chalky material from time to time.

Specialized prescription drugs are available for gout, such as Colchicine and Allopurinol.  If you have a family member with gout, encourage them to stockpile extra medications; they won’t be found in your standard medic’s storage.

Lifestyle and dietary changes may be helpful in improving the quality of life of individuals with gouty arthritis. Consider:

  • Avoiding alcohol
  • Reducing how many uric acid elevating foods you eat. These include: Liver, red meat, herring, sardines, anchovies, kidney, beans, peas, mushrooms, asparagus, and cauliflower. .
  • Avoiding fatty foods
  • Eat enough carbohydrates

Natural Options For Arthritis

Glucosamine/Chondroitin

Glucosamine/Chondroitin

From an alternative standpoint, there are various treatments for joint pain caused by arthritis.  Glucosamine supplements are popular. It should be noted that glucosamine sulfate preparations have more evidence for their effectiveness than glucosamine hydrochloride. Take 1,500 milligrams once a day on a regular basis.

Glucosamine, when paired with chondroitin sulfate 800-1,200 milligrams a day, has been shown to possibly slow progression of some arthritic conditions.

Two teaspoons of lemon juice or apple cider vinegar mixed with a teaspoon of honey twice a day is a time-honored treatment.  Other oral supplements reported to be effective against joint pain are:

  • Turmeric powder
  • Soybean Oil
  • Avocado Oil
  • Rose hips
  • Fish Oil (no more than 3 grams per day)
  • Selenium
  • Bathua leaf juice
  • Alfalfa tea

For external use, warm and cold compresses are useful. Warmth increases blood flow to the joint, while cold decreases inflammation and swelling. Other options include:

  • Capsaicin ointment or cream
  • Use Arnica essential oil on affected areas (good for muscle aches as well)
  • Apply warm vinegar to aching joints.
  • Mix powdered sandalwood into a paste; it has a cooling effect when rubbed on a joint.

A number of other modalities may alleviate the pain of arthritis and improve range of motion. Acupuncture, massage therapy, and physical therapy may alleviate muscle spasms. Electricity delivered by a device known as a TENS (Transcutaneous Electrical Nerve Stimulation) unit may be helpful. Other suggest magnets applied to injured joint. These are just a few of the many alternative remedies available. Do your own research and make your own conclusions.

Joe Alton MD

Joe Alton MD

Joe Alton MD

Fill those holes in your medical supplies with kits and individual items from Nurse Amy’s store at store.doomandbloom.net.

And don’t forget your copy of the latest edition of the award-winning Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way!

The Third Edition

The Third Edition

Video: Amputation in Survival Settings

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Amputation in survival settings

Amputation in survival settings

One of the worst injuries that can occur in a disaster or other off-grid setting is the traumatic amputation. In the Civil War era. amputations on the battlefield or later in the field hospital resulted in 1/4 to 1/2 of the victims succumbing to their wounds. In an EMP attack, we could easily be thrown back to that era medically, and we should consider what can be done for those injured so horrifically.

Joe Alton MD attempts to tackle this delicate subject that others won’t touch in this video, knowing the limitations on the medic and the lack of sterility in most instances. See him explain his thoughts and rationale on what can and can’t be done, and some tips on what to do when confronted with the traumatic amputation.

To watch, click below:

Wishing you the best of health in good times or bad,

Joe and Amy Alton MD

Dr. Bones and Nurse Amy

Amy and Joe Alton

Fill those holes in your medical supplies with individual kits and supplies from Nurse Amy’s entire line at store.doomandbloom.net.

three compact first aid kits great for hiking and camping made by Amy Alton of store.doomandbloom.net

Survival Medicine Hour: Family Planning, Anxiety and Depression Off The Grid

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Family Planning in Survival?

You’ve heard “Be Fruitful and Multiply”, but in the early aftermath of a major long-term disaster, getting your women pregnant and having babies might be problematic when your garden isn’t doing so well and you need every person at 110% efficiency. But how to prevent pregnancy when IUDs, Birth Control Pills, and other high tech methods aren’t available. Joe and Amy Alton, aka Dr. Bones and Nurse Amy, tell you what you need to know about natural family planning.

Anxiety and depression are part and parcel of long-term survival

Anxiety and depression are part and parcel of long-term survival

Plus, your may associate a long-term disaster with a lot of gunfights at the OK corral, but you’re much more likely to deal with anxiety and depression than bullet wounds (we hope). Find out Dr. Alton’s thought about the subject as he answers a question from a listener of the Survival Podcast as part of good friend Jack Spirko’s Expert Council.

All this and more on The Survival Medicine Hour with Amy Alton ARNP and Joe Alton MD!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/02/23/survival-medicine-hour-family-planning-anxiety-and-depression-off-the-grid

Wishing you the best of health in good time or bad,

Joe Alton MD and Amy Alton ARNP

The Altons

The Altons

Hey, do us a favor and please follow us on twitter @preppershow, YouTube at DrBones NurseAmy Channel, and Facebook at Doom and Bloom ™; and don’t forget to check out our third edition of the award winning Survival Medicine Handbook at Amazon or on our website!

Video: Getting Rid of Rodents

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VIDEO: Getting Rid of Rodents in Good Times or Bad

not a very welcome guest

not a very welcome guest

Every year, a percentage of our food supply is contaminated by the dropping and urine of rats and mice. It’s bad enough in normal times, but it can be a disaster off the grid. Rodents also carry diseases that can affect the health of your group members at a time when modern medicine may not be available. Therefore, it makes sense to eliminate your unwanted guests!

In this video, which follows up on a previous video on rodent-proofing a home, Joe Alton MD tells you what to do if you already have an issue with rat and mice infestation. Various ways to tell that you’ve got visitors and methods to get rid of them are discussed in some detail.

To watch, click below:

Wishing you the best of health in good times or bad,

Joe and Amy Alton

Joe and Amy Alton

Joe and Amy Alton

Learn a lot about over 150 medical issues in the 700 page Book Excellence Award winner in Medicine, The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way.

And don’t forget to fill those holes in your medical supplies with kits and items from Nurse Amy’s entire line at store.doomandbloom.net.

Can We End Active Shooter Events?

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Can we end active shooter events?

active shooters part of the New Normal?

active shooters part of the New Normal?

A mentally disturbed man entered a South Florida high school and killed at least 17 people with an AR-15 rifle. Nikolas Cruz was expelled from the school for erratic and violent behavior and was reported to have an obsession with guns. Social media posts were also thought to be “disturbing”. At present, at least a dozen people are still in the hospital, some in critical condition.

The recent shootings in diverse settings greet Americans with tragic news on a regular basis. Schools, churches, concerts, and other public venues are now fair game for those with bad intentions. Armed not only with weapons but with a blueprint from previous incidents, gunmen identify soft targets more and more easily and are more “successful” in achieving their goal of creating mass casualties.

Mass shootings are considered to be something that happens elsewhere, not your home town. This time, however, the attack at Marjory Stoneman Douglas High occurred just a few miles from our house. There’s no reason to believe your area is immune.

There is no place safe from the deranged, disgruntled, or politically-motivated. The number of vehicular attacks, bombings, and shootings indicate that these events have become part of the “New Normal”. Should we just get used to them?

You might think that the “successes” achieved of late by active shooters occur at random. The increase in the sheer number of casualties, however, reveal a strategy that is being refined, and to deadly effect.

The selection of soft targets is becoming a science, and is leading to higher numbers of deaths and injuries. In the South Florida school shooting, for example, the gunman activated the fire alarm to make sure there would be a wealth of targets in the hall. To create confusion, he tossed smoke bombs (but prudently wore a gas mask).

If the ill-intentioned are now that much better at creating mayhem, it stands to reason that our society must become better at thwarting those intentions. Here are ways that would, in my opinion, decrease the number of shooter incidents and the deaths caused by them:

Improve security in areas at risk. I would define an “area at risk” as just about anywhere where a crowd of people would gather. Better protection at malls may just be a matter of hiring more trained personnel, but establishing and training a safety team in other places, such as a church, school, or workplace, can increase the level of vigilance and identify threats early.

Establish volunteer safety officers in rural areas and small towns where there may not be law enforcement and emergency medical personnel just around the corner. These persons should have training in security, firearms, and first aid for bleeding wounds. If there are volunteer fire departments, while not trained volunteer safety departments?

Instill a culture of situational awareness in our society. Situational awareness is a state of calm, relaxed observation of factors that might indicate a threat. These are called “anomalies”; learning to recognize them can identify suspicious individuals and save lives.

Situational awareness also involves always having a plan of action when a threat occurs, even if it’s as simple as making a note of the nearest exit at a concert. Seems like common sense, but in these days of smartphone distractions, many are oblivious of their surroundings.

Learn how to stop bleeding in wounds

Learn how to stop bleeding in emergencies

Teach our citizens to avoid the natural paralysis that occurs in an unexpected event. This paralysis occurs as a result of “normalcy bias”, the tendency to discount risks because most days proceed in a certain standard manner; we assume that today will be the same.

By teaching simple courses of action such as the Department of Homeland Security’s “Run, Hide, Fight” triad, the decision-making process may be more intuitive and more rapidly implemented. This is more effectively taught and ingrained at a young age.

Teach our students simple first aid strategies to stop bleeding, the most likely cause of death in these scenarios. Rapid action by bystanders is thought to decrease the number of deaths from hemorrhage. Add “Reduce” hemorrhage to “Reading, ‘Riting, and ‘Rithmetic” as part of school curriculum, and lives might be saved.

Identify persons of interest through their social media posts. Many active shooters are vocal about their intentions. You might be concerned about “big brother” monitoring our public conversations on Facebook and other sites, but you must answer this question:  How many deaths are you willing to accept in your community due to a lack of vigilance?

We must always be on the lookout for signs of trouble. Even if this drives some potential gunmen underground, it might identify others in time to abort their mission. As such, each municipality must set a mechanism (and a trigger) for the authorities to apprehend and interrogate suspicious characters.

SWAT tourniquet

Simple kits can be effective in the hands of Good Samaritans

Provide first aid kits for bleeding in public venues that can be accessed by those at the scene. With supplies, the Good Samaritan will be more likely to save a life. I predict that these kits will be fixtures on the wall next to the fire extinguisher in the uncertain future. Although you might consider it overkill, putting a tourniquet in your high school student’s backpack (and teaching them how to use it) may not be a bad idea.

Despite the above recommendations, our response as a nation has been to do little to correct the problem. I say that era must end. Let’s stop being “soft” targets. We must forsake the notion that shootings are just part and parcel of the New Normal, and begin the process by which we change our attitude and level of vigilance, not in isolated cases, but as a society.

You don’t have to be a Department of Homeland Security official to know that there are more active shooter events on the horizon. A prepared nation wouldn’t be invulnerable to attacks, but its citizens would have a better chance to survive them.

Joe Alton MD

Dr. Alton

Dr. Alton

 

Medical kits to stop bleeding are good items to have in these uncertain times. Check out kits specially designed by us for workplaces, schools, places of worship, and other public venues that might save a life in these troubled times.

multi-person bleeding kit

multi-person bleeding kit

Survival Medicine Hour: Nosebleeds, Pregnancy Complications, Flu Recurrence, More

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SURVIVAL MEDICINE HOUR PODCAST

 

Cauterization with silver nitrate sticks

Cauterization with silver nitrate sticks

You might not think it’s possible, but there are enough different flu viruses circulating this season that you could actually get the flu again before Spring! H3N2 is the most common form around this year, but late season flus like Influenza B could bring you down again before things warm up. Joe and Amy talk about their recovery from a nasty case of the flu and give you some important advice.

Plus, how to deal with nosebleeds with limited supplies. Nosebleeds, also known as epistaxis can occur in young or old, and for a dozen different reasons. Learn all you need to know about this common, but scary, medical problem.

pregnancy complications off the grid

pregnancy complications off the grid

Also, survival settings require your people to be at 100% efficiency, but what happens when people get pregnant? Back pain, nausea and vomiting, and much more can intervene to take out a productive member of your crew. Dr. Alton tells you about some of the issues that might complicate what is usually a normal and natural process.

All this and more in the latest Survival Medicine Hour Podcast with Amy Alton, ARNP and Joe Alton MD!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/02/09/survival-medicine-hour-nosebleeds-flu-recurrences-pregnancy-complications

Wishing you the best of health in good times or bad,

Joe and Amy Alton

The Altons

The Altons

To learn more about survival medicine, get a copy of the award-winning Third Edition of the Survival Medicine Handbook!

Third Edition

Third Edition

Video: Adding Natural Remedies to First Aid Kits

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natural remedies

natural remedies

If you’re putting together a solid first aid kit, you have to decide if that kit is going to have to perform in long-term survival settings. You can put together a decent kit or even consider one of our specially-designed kits, but what if a disaster turns out to be a long-term event that knocks you off the grid for months, maybe longer?

It’s pretty clear you’ll eventually run out of standard medicines and other supplies quickly, especially if you’re taking care of an extended family. That’s why it’s not only important to have more materials than you think you’d need for the group, but also have some natural remedies like essential oils, herbal teas, and maybe even a medicinal garden.

Here’s a video that discusses the topic in detail. It’s something you might want to consider if you believe some long-term disaster could one day affect your area.

To watch, click below:

Wishing you the best of health in good times or bad,

Joe Alton MD

Dr, Alton

Dr, Alton

Read more about natural remedies, plus 150 other medical topics, in the award-winning Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. Plus fill those holes in your medical storage with kits and individual items from Nurse Amy’s store at store.doomandbloom.net.

Nosebleeds

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HOW TO STOP A NOSEBLEED

Trauma is a common cause of nosebleeds

Trauma is a common cause of nosebleeds

A common, often minor, problem that causes significant anxiety for both the patient and the caregiver is the nosebleed, also known as “epistaxis”. More than 50% of the population will experience a nose bleed during their life, although only about 10% will require medical aid to stop it. Most significant bleeds will occur either at a very young age (2-10 years) or much later (50-80 years of age).

NASAL ANATOMY

Nasal Anatomy (common area of nosebleed origin circled)

Nasal Anatomy (common area of nosebleed origin circled)

The lining of the nose is supplied richly with blood vessels. When this lining is eroded, bare veins and arteries have a tendency to “leak” in a constant ooze.

About 90% of the time, the hemorrhage is coming from the front of the nose (“anterior”), near the cartilage-bearing septum. This location, known as “Little’s Area” or “Kiesselbach’s Plexus” contains numerous small arteries and veins where bleeding can originate. Bleeding comes from one nostril only in the grand majority of cases.

In a small percentage of cases, bleeding starts in back of the nose (“posterior”) where other arteries are located. These nosebleeds have a tendency to occur more often in the elderly, be heavier in volume, and more difficult to stop. The diagnosis is usually made when the usual measures for an anterior nosebleed have failed. A posterior nosebleed may be suspected by heavy bleeding from both nostrils or by blood draining down the back of the throat.

where posterior nosebleed originate (compare with anterior illustration above)

where posterior nosebleed may originate (compare with anterior illustration above)

WHY NOSEBLEEDS OCCUR

Epistaxis may occur for a number of reasons. Of course, trauma to the nose and face is a common cause. This trauma may be caused by anything from a blow to the face to excessive nose-picking. Other risk factors include:

  • Exposure to dry air, especially if very cold or very warm (say, from space heaters in winter)
  • Sinusitis and other infections affecting the nasal cavity
  • Foreign objects in the nose
  • Excessively forceful nose-blowing
  • Allergies
  • Nasal septum abnormalities or complications from surgery to correct them
  • Use of drugs inhaled through the nose. These can be recreational, such as cocaine, or therapeutic, such as afrin (oxymetazoline) or neo-synephrine. Note that Afrin and neo-synephrine are habit-forming!
  • Blood clotting disorders
  • Liver or kidney disease
  • Chronic alcohol abuse
  • Tumors in the nasal cavity
  • Non-inhaled medications that “thin” the blood, like coumadin, aspirin, plavix, nsaids, etc.

High blood pressure (Hypertension) is associated with nosebleed, but it is uncertain which is the “chicken” and which is the “egg”. Is the elevated pressure causing the bleeding or does anxiety associated with seeing blood cause the blood pressure to rise?

SIGNS OF EXCESSIVE BLEEDING

Nosebleeds rarely cause life-threatening hemorrhage, but some signs may tip you off to excessive blood loss, including:

  • Weakness
  • Fainting
  • Dizziness
  • Confusion
  • Rapid heart beat
  • Bleeding from any place other than the nose
  • The presence of fever

If modern medical facilities are available, persons with these symptoms should present there for care.

FINDING AND TREATING THE NOSEBLEED

Luckily, few nosebleeds will cause heavy bleeding and most can be treated at home by following a few general steps:

  • First and foremost, stay calm. Anxiety will speed the pulse and cause more rapid bleeding.
  • Sit up but not back; leaning forward will more effectively prevent blood from flowing down the back of your throat.
  • Using your index finger and thumb, apply pressure by tightly pinching the area of cartilage below the bony part of the nose (pinching the bony part does little to stop the bleeding). Pinch towards the face. A commercial nasal clip is available for the purpose (see image below).
  • Breathe through your mouth while holding pressure for 10 minutes.
  • If the bleeding successfully stops, don’t blow your nose, bend over, or strain for the next day.
  • If bleeding doesn’t stop, blow out residual clots and consider a spray like Afrin with 5-10 more minutes of pinching the nose.
Nasal Clip for nosebleeds

Nasal Clip for nosebleeds

If these simple instructions fail to achieve the desired result, a more thorough evaluation is warranted. To determine the location of the bleed, caregivers may spray a decongestant or saline solution into the nostrils. This will constrict the blood vessels, make visualization easier, and may even stop the bleeding. An instrument called a nasal speculum is then placed into the nostril to look inside.

using a nasal speculum and silver nitrate to cauterize an anterior bleed

using a nasal speculum and silver nitrate to cauterize an anterior bleed

If the bleeding is from an easily-seen blood vessel towards the front of the nostril, it may be cauterized with a swab stick containing a chemical called silver nitrate.

PLACING A NASAL PACK

If this fails to stop bleeding, a packing with petroleum jelly may be required to apply pressure to the leaking vessel. Other packing materials contain blood-clotting agents like Celox, which comes in a ribbon option, or drugs like oxymetazoline (Afrin) or neo-synephrine to help stop the bleed (beware of elevating blood pressures with the last two). Sometimes, synthetic sponges (Merocel) and balloons are needed to stop bleeding, especially posterior bleeding.

Placing an anterior pack

Placing an anterior pack with a “bayonet” forceps

To place a simple anterior packing into the nose, gauze impregnated with petroleum jelly is gripped with a “bayonet” forceps and inserted into the anterior nasal cavity.  The first packing layer is inserted straight back along the floor of the anterior nasal cavity, not at an upward angle. Additional layers of packing are then added in accordion-fold fashion. A nasal speculum (pictured in a previous image) can be used to hold the positioned layers down while a new layer is inserted.  Packing is continued until the nasal cavity is filled. Be aware that you could traumatize the nasal cavity if placement is poorly performed.

It should be noted that nasal packing is an uncomfortable procedure usually performed in the emergency room. Significant pressure is usually required to be effective and the packing must stay in place for a good 48 hours or so.

A true posterior bleed may be difficult to stop without specialized equipment like balloon catheters such as the Rhino-Rocket, The Epistat catheter, or the Simpson Plug. A urinary Foley catheter balloon may also be an option to apply pressure to a posterior bleed.

The "Rhino Rocket" balloon catheter

The “Rhino Rocket” balloon catheter

Although cold temperatures are known to constrict blood vessels, it is unlikely that an ice pack would effectively deliver enough cold to the origin of the hemorrhage while at the same time allowing the application of pressure to the area. Given the choice, applying pressure is more important. Having said that, ice packs are important in nasal trauma cases to decrease swelling.

Here’s a useful video on various ways to stop a nosebleed:

PREVENTING NOSEBLEEDS

Once you’ve had a significant nosebleed, you’ll do everything possible to not have another one. Here are some strategies that will decrease the chances of a recurrence:

  • Prevent nasal dryness. Moisten your nasal cavity with petroleum jelly or antibiotic ointment. Use a cotton swab to gently smear a thin layer inside several times a day, especially before going to sleep. Alternatively, use a saline nasal product. Spraying it in your nostrils helps keep the inside of your nose moist.
  • Use a humidifier to increase the humidity in your home during winter.
  • Don’t smoke. Smoking can dry out the inside of your nose.
  • Don’t pick your nose or allow your child to do so.
  • Don’t blow your nose forcefully.
  • Keep fingernails short so as not to traumatize the lining (if you must pick).
  • Avoid excessive use of decongestants and allergy medications, which can dry out your nose.
  • Discuss other medicines you take with your health care provider to make sure they aren’t a factor in your nosebleeds.

Nosebleeds can be scary, but most can be dealt with successfully with limited supplies, even in an austere environment. With some materials and knowledge, they can be a bump on the road, not the end of the road for the prepared individual.

Joe Alton MD

Joe Alton MD

Joe Alton MD

Learn more about nosebleeds and 150 other medical topics in the Third Edition of the Survival Medicine Handbook, the 2017 Book Excellence Award winner in medicine! Also, fill those medical holes in your survival supplies by checking out Nurse Amy’s entire line of kits and individual items at store.doomandbloom.net.

Survival Medicine Hour: The Flu Hits The Hosts, Antibiotic Use, More

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Antibiotics not helpful against the flu

Antibiotics not helpful against the flu

Joe and Amy Alton, aka Dr. Bones and Nurse Amy, come down with the flu after their successful appearance at the SHOT show in Nevada, just one of 47 states reporting widespread outbreaks of influenza. Find out how hard it is to escape becoming a victim, even if you walk around with hand sanitizer in your pocket all day! Nurse Amy gives her advice for speeding recovery and Dr. Bones talks about the anti-viral drug Tamiflu and how it works to shorten the duration and severity of the illness.

It's good to have antibiotics, even fish versions, in your medical storage, but how to use them wisely in survival?

It’s good to have antibiotics, even fish versions, in your medical storage, but how to use them wisely in survival?

Also, Dr. Alton was the first physician to write about the use of fish and bird antibiotics as a survival tool, but this stuff isn’t candy, and has to be used wisely if at all. Having a supply, however, may avoid the preventable deaths from infected cuts and other minor ailments that could become big trouble in hard times. Some general advice regarding appropriate usage is given, and a useful antibiotic called  metronidazole (Flagyl, Fish-Zole) is spotlighted.

All this and more in the latest Survival Medicine Hour with Joe Alton MD and Amy Alton ARNP!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/02/02/survival-medicine-hour-the-flu-hits-the-hosts-wise-antibiotic-use-more

Follow us on Twitter @preppershow, FB at Doom and Bloom(tm), and YouTube at DrBones NurseAmy Channel!

Joe and Amy Alton

Amy and Joe Alton

Amy and Joe Alton

Learn more about respiratory infections, anti-viral drugs, and antibiotics in the award-winning Third Edition of The Survival Medicine Handbook, The Essential Guide for When Medical Help is Not on the Way.

 

Avalanche Survival

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Avalanche!

Avalanche!

An avalanche, also called a “snowslide”, is a mass of snow, ice, and debris sliding rapidly down a mountainside, and is a risk to any winter hiker. Just as a snowball rolling down a hill picks up more snow as it goes, an avalanche can achieve significantly more volume and mass as it travels.

Although they rarely make the news, avalanches cause an average of 28 deaths a year. This event may seem like a rare occurrence, but it happens a lot more often than you’d think; certainly more than, say, shark attacks (which get a lot more press).

Snowslides are part and parcel of the winter wilderness experience, and it pays to know what to do if you’re caught in one.  If you’re not prepared to deal with issues associated with your environment, then you have made it your enemy.  This is not just good advice for skiers or backcountry hikers; anyone driving on mountain roads in winter could get in caught in an avalanche if not prepared.

Avalanches may be caused by simple gravity, a major snowfall, seismic tremors, or human activity. The speed and force of an avalanche may depend on whether the snow is “wet” or “dry powder”. Powder snow avalanches may reach speeds of 190 miles per hour. Wet slides travel slower, but with a great deal of force due to the density of the snowpack.

What Kills An Avalanche Victim?

These members of the 1912 Scott Expedition froze to death, but avalanche victims more likely succumb to trauma or suffocation.

These members of the 1912 Scott Expedition froze to death, but avalanche victims more likely succumb to trauma or suffocation.

You might assume that the main cause of death in this circumstance is freezing to death. There are other ways, however, that are more likely to end the life of an avalanche victim:

Trauma:  serious injury is not uncommon in an avalanche, and not just due to the weight of the snow. Debris, such as rocks, branches, and even entire trees, can be carried along in the cascade and cause life-ending traumatic wounds.

Suffocation:  When buried in the snow, asphyxiation is a major risk.  Densely packed snow is like concrete; many victims may find themselves immobilized and unable to dig themselves out of trouble.

Hypothermia: Hypothermia is, surprisingly, the cause of death of only a small percentage of avalanche victims. It’s much more likely that they will perish due to traumatic injury or suffocation before they freeze to death.

Factors involved in deciding your fate include:

  • The density of the snowpack
  • The presence of air pockets for breathing (or the lack of them)
  • The position of the body in the snow (if not upright, you’ll be disoriented)
  • Traumatic injuries sustained
  • The availability of rescue equipment at the scene

Important Avalanche Survival Basics and Equipment

On any wilderness outing, it makes sense to go prepared. Appropriately warm clothing for the weather is, of course, a basic concern in winter. Food, water, heat packs, spare dry clothing, and a cell phone are just some of the items you should take with you if you’re attempting a mountain hike in January.

In avalanche country, space yourselves out

In avalanche country, space yourselves out

Most backcountry expeditions are best attempted in a group. That goes for avalanche country, as well, except for one thing: Space yourselves out far enough so that there’s not too much weight on any one area of snow. If a member of your party is buried in the snow, know that you have to act quickly to find them and dig them out. It’s unlikely that going for help will end in a successful rescue. Therefore, it’s especially important to have some specialized items in avalanche country.

Recommended gear (besides warm clothing) would include:

PIEPS avalanche beacon

PIEPS avalanche beacon

An avalanche beacon:  A device that emits a pulsed radio signal.  Everyone in the group carries one. If a member gets buried in an avalanche, the rest of the party picks up the signal from under the snow. The receivers interpret the signal into a display that aids the search.

An avalanche shovel:  Lightweight short aluminum shovels that fit inside your backpack and help chop and remove snow and debris on top of a buried hiker. These shovels usually have telescoping shafts. Shovels with D-shaped grips can be used with mittens.

rescue team with avalanche probes

rescue team with avalanche probes

An avalanche probe: Essentially, a stick that helps you pinpoint the exact location of an avalanche victim and see how far down he/she is. 2 meters or more in length, you can use the probe to tell a victim under the snow from the ground; the victim will feel “softer”.

A helmet: Many fatalities occur due to head trauma from rocks and debris flung around by the snow.

Skier’s Air Bags:  Relatively new, these brightly colored air bags auto-inflate with a trigger; they work like a lifejacket to keep you buoyant and, therefore, closer to the surface and easier to find.

Ortovox Skier Air Bags

Ortovox Skier Air Bags

avalanche air bags in action

avalanche air bags in action

What To Do As The Avalanche Starts

83% of avalanches in recreational settings are triggered by the victim. To survive, quick thinking and rapid action will be needed:

Yell: Let everyone in your group know that you’re in trouble. At the very start of the slide, wave your arms and shout as loud as you can to alert as many people as possible to your location.

Move. If you started the avalanche, you may notice a crevice forming in the snow.  Jump uphill of it quickly and you might not get carried off.  If this isn’t an option, run sideways as fast as you can away from the center of the event, which is where the snow will be moving fastest and with the most force.

Get Lighter. Heavier objects sink in snow, so jettison unnecessary heavy equipment so that you’ll be closer to the surface. Throwing off something light isn’t a bad idea either: A loose glove or hat on top of the snow could signal rescuers to your general location and save precious time.  Deploy your avalanche air bag if you have one.

Hug a tree (or rock). If the avalanche is relatively small, you could grab the nearest immobile object and hold on for dear life.  In a very large avalanche, trees and rocks may not be safe anchors; trees can be uprooted by the force of the snowslide.

"Swimming" in an avalanche

“Swimming” in an avalanche

Swim!  To survive an avalanche, the key is to stay as close to the top of the snow as possible. Increase your surface area by spreading your legs (feet downhill) and raising your hands. While in this position, swing your arms while trying to stay on your back (it’s easier to breathe if face up), similar to swimming backstroke.  With any luck, this strategy will keep you towards the surface of the snow.

What To Do If You’re Buried In The Snow

You did your best, but still got completely buried in the snow.  You’ve got maybe 15-30 minutes, on average, before you suffocate.  Snow may be porous, but warm breath melts the snow which then refreezes as solid ice.  This makes breathing difficult.

As the snow slows: The larger the air pocket you have, the longer you’ll survive.  As the snowslide slows to a stop, put one arm in front of your face in such a way as to form a space that will give you the most air. If possible, raise the other arm straight up toward the avalanche surface.  Your glove might signal your location to rescuers.  Expand your chest by inhaling deeply so that you have more room to breathe once the snow has settled.

Once buried: Once you are completely buried, the snowpack may be so dense as to prevent you from moving. Stay calm, in order to use up less oxygen.  If you’re not sure which way is up, spit.  The spit will go towards the ground due to gravity.  If you can move, work to make a bigger air pocket in the direction of the surface.

You’ll only have a second or two to act to avoid most avalanches.  Rapid action, and some basic rescue equipment, may prevent you from being the harsh winter’s latest victim.

Joe Alton MD

Joe Alton MD

Joe Alton MD

Find out about how to survive avalanche and just about every other kind of natural disaster, plus much more, in the 700 page Third Edition of the Survival Medicine Handbook!

Winner of the 2017 Book Excellence Award in Medicine

Winner of the 2017 Book Excellence Award in Medicine

Survival Medicine Hour: James Rawles, Staph, Chest Trauma, More

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Survival Medicine Hour #373

rib fracture

rib fracture

Joe and Amy Alton, aka Dr. Bones and Nurse Amy discuss chest trauma, including rib fractures, ballistic and projectile trauma, and pneumothorax. Plus, an interview with Survival Blog’s James Rawles on a book he wrote about a hypothetical Christian homeland in his novel “Land of Promise”.

James Rawles' Land of Promise

James Rawles’ Land of Promise

Plus, a series of listener questions about things like Staph infections, food-grade diatomaceous earth, and much more!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/01/26/survival-medicine-hour-james-rawles-chest-trauma-staph-more

Wishing you the best of health in good times or bad,

Joe and Amy Alton

Nurse Amy/Dr. Bones

Nurse Amy/Dr. Bones

Learn about 150 medical topics off the grid in the award-winning Third Edition of The Survival Medicine Handbook: The Essential Guide For When Medical Help is Not on the Way.

Survival Medicine Hour: Sleep Deprivation, Flagyl in Survival, Eye Injuries, Face Masks, More

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Survival Medicine Hour #372

sleep deprivation

sleep deprivation

Sleep deprivation is part and parcel of any post-apocalyptic setting, and you’d better know how to recognize it and deal with the issue in times of trouble. We discuss diagnosis, treatment, and use of natural remedies to help your anxious and depressed people stay work-efficient.

Eye Injuries

Eye Injuries

Plus, eye injury questions from a Survival Podcast listener, and a discussion of how to recognize and treat pneumonia off the grid, and a discussion of the basics of the use of face masks in the survival sick room.

Also, a discussion of the popular antibiotic Metronidazole, also known as Flagyl, and its possible uses as the fish antibiotic Fish-Zole in long-term survival settings.

All this and more in the latest survival medicine hour with Joe and Amy Alton, aka Dr. Bones and Nurse Amy!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2018/01/19/survival-medicine-hour

Wishing you the best of health in good times or bad,

Joe and Amy Alton

The Altons

The Altons

Fill those holes in your medical supplies with kits and individual items from Nurse Amy’s store at store.doomandbloom.net! #1 Top Supplier at SurvivalTop50.com!

Just some of our kits

Just some of our kits

Diseases Caused By Food And Water Contamination

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Even healthy-looking fruit can contain contaminants

Even healthy-looking fruit can contain contaminants

The primary necessity for survival is the availability of air. Once you have air to breathe, water, food, and shelter become the next requirements for your continued existence on the planet; that is, clean water and properly prepared food.

Even in normal times, there are many instances where an outbreak of infectious disease occurs due to water of poor quality. Ingesting food that was incompletely cooked caused the deaths of medieval kings in medieval times and may even have sparked the Ebola epidemic in 2014.

Epidemics caused by organisms that cause severe diarrhea and dehydration have been a part of the human experience since before recorded history. If severe enough, dehydration can cause hypovolemic shock, organ failure, and death. Indeed, during the Civil War, more deaths were attributed to dehydration from infectious diseases than from bullets or shrapnel.

More soldiers died from infectious disease than from bullets or shrapnel in the Civil War

More soldiers died from infectious disease than from bullets or shrapnel in the Civil War

Off the grid, water used for drinking or cooking can be contaminated by anything from floods to a dead opossum upstream from your camp. This can have dire implications for those living where there is no access to large amounts of IV hydration.

Therefore, it stands to reason that the preparation of food and the disinfection of drinking water should be under supervision. In survival, this responsibility should fall to the community medic; it is the medic that will (after the patient, of course) be most impacted by failure to maintain good sanitation.

Many diseases have disastrous intestinal consequences leading to dehydration. They include:

Cholera: Caused by the marine and freshwater bacterium Vibrio cholera, Cholera has been the cause of many deaths in both the distant and recent past. It may, once again, be an issue in the uncertain future.

Cholera toxins produce a rapid onset of diarrhea and vomiting within a few hours to 2 days of infection. Victims often complain of leg cramps. The body water loss with untreated cholera is associated with a sixty per cent death rate. Aggressive efforts to rehydrate the patient, however, drops the death rate to only one per cent. Antibiotic therapy with doxycycline or tetracycline seems to shorten the duration of illness.

This is the bowel movement of someone with Cholera

This is the bowel movement of someone with Cholera

Typhus: A complex of diseases caused by bacteria in the Rickettsia family, Typhus is transmitted by fleas and ticks to humans in unsanitary surroundings, and is mentioned here due to its frequent confusion with “Typh-oid” fever, a disease caused by contaminated, undercooked food.

Although it rarely causes severe diarrhea, Typhus can cause significant dehydration due to high fevers and other flu-like symptoms. Five to nine days after infection, a rash begins on the torso and spreads to the extremities, sparing the face, palm, and soles. Doxycycline is the drug of choice for this disease.

Typhoid: Infection with the bacteria Salmonella typhi is called “Typh-oid fever”, because it is often confused with Typhus. Contamination with Salmonella in food occurs more often than with any other bacteria in the United States.

In Typhoid fever, there is a gradual onset of high fevers over the course of several days. Abdominal pain, intestinal hemorrhage, weakness, headaches, constipation, and bloody diarrhea may occur. A number of people develop a spotty, rose-colored rash. Ciprofloxacin is the antibiotic of choice but most victims improve with rehydration therapy.

Dysentery: An intestinal inflammation in the large intestine that presents with fever, abdominal pain, and severe bloody or watery mucus diarrhea. Symptoms usually begin one to three days after exposure. Dysentery, a major cause of death among Civil War soldiers, is a classic example of a disease that can be prevented with strict hand hygiene after bowel movements.

Shigella

Shigella dysenteriae

The most common form of dysentery in North America and Europe is caused by the bacteria Shigella and is called “bacillary dysentery”.  It is spread through contaminated food and water, and crowded unsanitary conditions. Ciprofloxacin and Sulfa drugs, in conjunction with oral rehydration, are effective therapies.

Another type is caused by an organism you may have read about in science class: the amoeba, a protozoan known as Entamoeba histolytica. Amoebic dysentery is more commonly seen in warmer climates. Metronidazole is the antibiotic of choice.

Traveler’s Diarrhea: An inflammation of the small intestine most commonly caused by the Bacterium Escherichia coli (E. coli). Most strains of this bacteria are normal inhabitants of the human intestinal tract, but one (E. coli O157:H7) produces a toxin (the “Shiga” toxin) that can cause severe “food poisoning”. The Shiga toxin has even been classified as a bioterror agent.

In this illness, sudden onset of watery diarrhea, often with blood, develops within one to three days of exposure accompanied by fever, gas, and abdominal cramping. Rapid rehydration and treatment with antibiotics such as Azithromycin and Ciprofloxacin is helpful. The CDC no longer recommends taking antibiotics in advance of a journey, but does suggest that Pepto-Bismol or Kaopectate (Bismuth Subsalicylate), two tablets four times a day, may decrease the likelihood of Traveler’s Diarrhea.

Campylobacter: The second most common cause of foodborne illness in the U.S. after Salmonella, this bacteria resides in the intestinal tract of chickens and causes sickness when meat is undercooked or improperly processed. It’s thought that a significant percentage of retail poultry products contain colonies of one variety, Campylobacter Jejuni. It is characterized as bloody diarrhea, fever, nausea, and cramping which begins two to five days after exposure. Although controversial, Erythromycin may decrease the duration of illness if taken early.

Trichinosis: Trichinosis is caused by the parasitic roundworm Trichinella in undercooked meat, mostly from domesticated pigs. Trichinosis causes diarrhea and other intestinal symptoms, usually starting one to two days after exposure. Fever, headache, itchiness, muscle pains, and swelling around the eyes occur up to 2 weeks later. Recovery is usually slow, even with treatment with the anti-helminthic (anti-worm) drugs Mebendazole and Albendazole (Albenza).

Giardia Lamblia

Giardia Lamblia

Giardiasis: The most common disease-causing parasite in the world is the protozoa Giardia lamblia. It has even been found in backcountry waters in many national parks in the U.S. Symptoms may present as early as one day after exposure, although it more commonly presents in one to two weeks. Patients complain of watery diarrhea, abdominal cramping, violent (often called “projectile”) vomiting, and gas. Metronidazole is the drug of choice in conjunction with oral rehydration.

There are many other pathogens that can cause life-threatening dehydration if untreated. Although we have mentioned common antibiotic treatments where applicable, most of the above will resolve on their own over time with strict attention to oral (or intravenous) rehydration. Many antibiotics (Cipro is an example) are associated with adverse effects that can be worse than the illness they’re designed to treat, so use judiciously.

It should be noted that some of these illnesses may be mimicked by viruses that are completely unaffected by antibiotics, such as Norovirus. Norovirus has been implicated in many of the outbreaks you read about on cruise ships.

Air, food, water, and shelter is necessary for survival. Bad air, food, water, and shelter leads to the next requirement, and that is medical supplies. Have a good medical kit and know how to use all its components. If you can accomplish this goal, you’ll be an effective medic if things go South.

Joe Alton MD

Joe Alton MD

Joe Alton MD

Find out more about infectious disease and 150 other survival medical topics in the award-winning “Survival Medicine Handbook“, now in its 700-page Third Edition. Plus, fill those holes in your medical supplies with kits and individual items from Nurse Amy’s store at store.doomandbloom.net.

Video: Waters Filters and Storage

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VIDEO: WATER FILTERS AND STORAGE OPTIONS (with Nurse Amy!)

You're mostly made of this

You’re mostly made of this

Humans are made mostly of water, and many survival settings have either a lack of it or questionable quality. Therefore, it’s important that the water you find is safe to drink, but even the clearest  mountain stream may harbor organisms like Giardia and Entamoeba that can cause serious illness. In natural disasters like floods, there’s water everywhere, but almost always highly contaminated.

In this video, Nurse Amy steps in front of the camera to give a review of some water filter and storage options.

To watch, click below:

Wishing you the best of health in good times or bad,

Amy and Joe Alton

The Altons

The Altons

Find out more about hydration, dehydration, and disinfection, as well as 150 other medical topics, with the award-winning Third Edition of the Survival Medicine Handbook: The Essential Guide For When Medical Help Is On The Way!

Survival Medicine Hour: Mudslides, Antibiotics, EMPs

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SURVIVAL MEDICINE HOUR #372

Aftermath of a mudslide

Aftermath of a mudslide

In this episode of the Survival Medicine Hour, Joe and Amy Alton discuss California’s double whammy of drought wildfires, then mudslides and flash floods when the rain finally comes. A mudslide can be like a river of wet concrete, is there any way to survive one? If you know the signs, maybe, and is plan out that mountain retreats with mudslides in mind, definitely.

Dr. Alton, aka Dr. Bones, also gives you some common sense advice about the use of fish antibiotics, and tells the story of how he came to be the first medical doctor to write about them as a tool in the survival woodshed. More to come about individual antibiotics in future shows.

the wise use of antibiotics

the wise use of antibiotics

Also, Anthony Furey comes back to discuss the risk of an electromagnetic pulse attack on the United States by saber-rattling North Korea or another irrational regime. His book “Pulse Attack” is in bookstores across North America.

To listen in, click here:

http://www.blogtalkradio.com/survivalmedicine/2018/01/12/survival-medicine-hour-mudslides-antibiotics-emps

Wishing you the best of health in good times or bad,

Joe and Amy Alton

Joe and Amy Alton

Joe and Amy Alton

Fill those holes in your medical supplies with kits and individual items from Nurse Amy’s entire line at store.doomandbloom.net

Some Doom and Bloom Kits

Some Doom and Bloom Kits

Surviving A Mudslide

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CAN YOU SURVIVE A MUDSLIDE?

mudslide aftermath

mudslide aftermath

Southern California can’t catch a break. Enjoy a sunny climate, get wildfires. Wish for rain, get mudslides.

After record-setting wildfires that lasted all the way to late December, the first rain in Southern California in months caused a major mudslide that killed more than 15 people, injured others, and destroyed several dozen homes. Rescue teams are still searching for survivors in the wreckage.

I probably should write more about landslide events. We live part-time in Gatlinburg, Tennessee, with a mountain home overlooking town and the Great Smoky Mountains National Park.  As such, we live on a slope. How much of a slope? Let’s just say you wouldn’t want to take a dive off our deck.

A mudslide, sometimes called a “debris flow”, is a landslide with a high water content. Mudslides act like a river that, if the mud is thick, has the consistency of wet concrete. Mud, rocks, trees, and other large objects are carried along and can cause homes to collapse and a huge amount of traumatic injury to residents.

Another type of landslide is a “mud flow“, which is characterized by a very rapid flow of water and debris. A mud flow is more “liquefied” due, at least partially, to a lot of rain in a short period of time. A third of the rainfall in Southern California when the rains finally came occurred in five (yes, five) minutes.

In the U.S., 25-50 deaths occur on average as a result of landslides.

Mudslides occur for a number of reasons: Periods of heavy rainfall or snow melt saturate the ground and cause instability in sloping areas. Areas prone to earthquakes, hurricanes, wildfires, and other natural disasters are especially susceptible. In the case of the California mudslide, soil which had been charred by recent fires made the it less absorptive; as such, water that couldn’t get through hard earth quickly formed a flash flood that cascaded down slopes, picking up soil and debris to become a mudslide.

CAN YOU PREVENT A MUDSLIDE?

Humans contribute to the risk of mudslides by planning poorly: Roads cut into hills and mountains and scenic mountain homes make mudslides more likely. River retreats at the base of a hill or mountain (in the “holler”, as we say in Tennessee) are also vulnerable.

mudslide1mudslide

Once you’ve built that home on a hillside, there’s a limited amount of preventative measures that can be undertaken. It’s a different story, however, when planning out that dream home:

  • -Beware of steep slopes, natural or man-made runoff conduits, or eroded areas.
  • -Have the county Geological Survey specialist assess your property for possible mudslide risk.
  • -Consider flexible pipe fittings (installed by pros) less prone to gas or water leaks.
  • -Consider building a retaining wall in likely mudslide channels.
  • -Avoid areas that have experienced mudslides in the past.
  • -Plan out an evacuation route.
  • -Have a battery-powered NOAA weather radio.
  • -Have a medical kit with items to deal with both traumatic injury and water sterilization.

WARNING SIGNS OF A HOME AT RISK

Sometimes, pressure from unstable earth may give you a hint that trouble is on the way and give you time to evacuate. Mudslide prone areas will begin to show signs of strain:

  • -Cracks develop in walls, flooring, paving, driveways, or foundations.
  • -Outside structures (for example, stairs) begin to separate from buildings
  • -Doors and windows start becoming jammed.
  • -Utility lines start breaking.
  • -Fences, trees, and utility poles start tilting.
  • -Water starts accumulating in strange places
  • -Roads and embankments along slopes start breaking off at the edges.
  • -The Terrain starts to “bulge” or starts slanting at the base of the slope.

DURING THE EVENT

mudslide2

  • -Turn on the NOAA radio and listen to warnings as they are reported.
  • -Warn your neighbors!
  • -If a mudslide is imminent, get out of Dodge if at all possible, with the understanding that roads may be washed out.  Stay away from mudslide areas; new mudslides may still occur.

In some mudslides, as in Southern California, things happen very quickly and you don’t have time to evacuate:

  • -If you stay home, get to the second story if you have one.
  • -Watch for and avoid downed power lines.
  • -As the slide passes through, get under a table and curl into a ball, protecting your head.
  • -If you’re trapped in the mud, survival rates go up if you can form an air pocket around you.
  • -it’s a good idea to carry a cell phone with you at all times in case you are trapped in the house.

Mudslides, like wildfires, leave scars on the land but are part and parcel of living with Mother Nature. Plan before you build, know the danger signs, and hit the road if at all possible in the face of an imminent threat.

Joe Alton MD

Dr. Alton

Dr. Alton

Fill those holes in your medical supplies with some of Nurse Amy’s kits or individual items at store.doomandbloom.net.

Civil Defense In The Uncertain Future

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WHY DON’T WE HAVE A CIVIL DEFENSE STRATEGY FOR NUCLEAR ATTACKS?

ICBM launch

ICBM launch

With nuclear buttons on more and more desks these days, one thing that’s clear is that the future is anything but. With trials, tribulations, and rogue nations all about, even the U.S. Centers for Disease Control and Prevention (CDC) is concerned about preparedness in the face of a nuclear threat.

As such, the CDC is planning a teaching session about nuclear war after officials took part in radiation drills last Spring. This time, they are planning to target medical professionals, including veterinarians, and the local agencies that would lead immediate responses to a nuclear event.

The Jan. 16 event, titled “Public Health Response to a Nuclear Detonation“, is thought by many to be in response to recent saber-rattling by North Korea and other countries with interests in the region (including the US).

This from the CDC: “Despite the fear surrounding [a nuclear] event, planning and preparation can lessen deaths and illness. For instance, most people don’t realize that sheltering in place for at least 24 hours is crucial to saving lives and reducing exposure to radiation.” (more on why later in this article)

NUCLEAR ATTACKS

exploding nuclear blast from the ground with a fireball explosion up into the sky

Nuclear blast

The classic image of a nuclear attack is the detonation of a nuclear bomb on a heavily populated city, as was done to Japanese cities during World War II. The age of long-range bombers approaching a country’s air space with intents to drop the Big One may be over, but nuclear submarines and container ships have the capability to launch missiles with much shorter notice.

In addition to the classic image of cities demolished by nuclear explosions, there is the possibility of an electromagnetic pulse event (EMP) caused by a nuclear detonation high up in the atmosphere. This wouldn’t cause massive devastation (at first), but could knock out the electrical grid we depend on for just about everything. In short order, the citizens would be causing the massive devastation as food becomes unavailable and the rule of law collapses.

CAN YOU SURVIVE?

Stay in place or hit the road?

Stay in place or hit the road?

You might consider a nuclear attack to be hazardous to your health. Indeed, if anywhere near ground zero, you’re probably right. However, a suburbanite’s chances of surviving a blast that hits downtown might be better than you think.

In Shane Connor’s excellent article “The Good News About Nuclear Destruction”, he says that the vast majority of families will survive, especially if they makes some basic preparations before the event.

In his article, he takes 2004 Department of Homeland Security (DHS) calculations using a 10 kiloton bomb detonation at ground level in Washington, D.C. The DHS estimates 15000 immediate deaths from those close to ground zero, and another 15000 from explosion and thermal effects and massive radiation exposure. While this seems like a lot of deaths, it only represents 1% of the city’s population. Of course, the rest of the city (hundreds of thousands) would be at risk from radioactive fallout.

DUCK AND COVER

Duck and cover

Duck and cover

You may have seen old films showing children hiding under school desks to escape the wrath of a nuclear explosion. Like me, you may have found these “Duck and Cover” films quaint (and perhaps silly) to think that you can survive a blast by just getting down and covering yourself with, in this case, some wood and metal. Yet, placing a shield between you and the effects of the detonation is the basis for the “bomb shelter”.

Although “Duck and Cover” won’t prevent incineration for those very close to ground zero, it can prevent severe injuries from broken glass. In the Chelyabinsk meteor explosion incident in 2013, 1500 people suffered from lacerations due to flying glass from the shock wave. If those people had hit the deck as soon as they heard the meteor explode instead of going to the window to have a look, much fewer casualties would have been recorded.

Chelyabinsk meteor event

Chelyabinsk meteor event

THE EFFECTIVE FALLOUT SHELTER

 

In the DHS’s Washington, D.C. scenario, hundreds of thousands were at risk for radiation sickness. Yet, fallout drops 99% by 48 hours after a blast. If citizens would just remain inside or, better, in a planned-out bomb shelter, the chances for survival are much greater. Having four walls and a roof is helpful, but more can be done to enhance the protective effects of a shelter, both against radiation and blast effects.

The more material that you can use to separate yourself from fallout, the less likely you’ll suffer ill effects. Barrier effectiveness is measured as “halving thickness”. This is the thickness of a particular shield material that will reduce gamma radiation (the most dangerous kind) by one half.  When you multiply the halving thickness, you multiply your protection.

For example, the halving thickness of concrete is 2.4 inches or 6 centimeters.  A barrier of 2.4 inches of concrete will drop radiation exposure by one half.  Doubling the thickness of the barrier again (4.8 inches of concrete) drops it to one fourth (1/2 x 1/2) and tripling it (7.2 inches) will drop it to one eighth (1/2 x 1/2 x 1/2), etc.  You’re shooting for ten halving thicknesses (24 inches of concrete), which would drop the total radiation exposure to 1/1024th that of being out in the open.

Here are the halving thicknesses of some common materials:

  • Lead: 4 inches or 1.02 centimeter
  • Steel: 1 inch or 2.54 centimeters
  • Concrete: 2.4 inches or 6.09 centimeters
  • Soil (packed): 3.6 inches or 9.14 centimeters
  • Water: 2 inches or 18.28 centimeters
  • Wood: 11 inches or 27.94 centimeters

By looking at the list above, you can see 1 centimeter of lead gives the same radiation protection as 6 centimeters of concrete.

CIVIL DEFENSE

You might consider the 1950’s “Duck and Cover” to be pretty anemic as a civil defense measure, but it’s more than is practiced today with regards to preparing people for nuclear attacks. So little emphasis is placed on this kind of preparedness that few citizens have even thought about it, or even understand the term.

Civil defense is the organized effort to protect the citizens of a state from military attack. We don’t even have a nuclear civil defense agency, as it is now the purview of the Department of Homeland Security. Lately, “civil defense” efforts have instead been targeting natural disasters like hurricanes, floods, and the like.

We certainly need to plan for natural disasters, which will occur much more commonly in the future than nuclear explosions (I hope). Utilities are considering what to do about rogue squirrels more than they are considering rogue nations.

We need, however, to put together a national plan for nuclear attacks that don’t just include the protection of high-level government officials. We need to formulate a strategy that will give the average citizen the best chance of surviving the aftermath as well.

Despite the risks, we are doing less today to counter the consequences of nuclear attacks than before, especially when it comes to EMPs. The Department of Defense recently allowed the funding for the national EMP commission, headed by Dr. William Graham and Dr. Peter Pry, to lapse. This effectively disbanded the only body that was responsible for advising the government on how to protect the populace against nuclear electromagnetic pulse attacks.

There’s still time to harden the grid and encourage Americans to put together a plan of action in case of nuclear attack. Hostile actions by the world’s bad actors can easily hit home, and every citizen is at risk. If we put together a national strategy to cope with the consequences, we’ll be better prepared to deal with whatever challenges face us in the uncertain future.

Joe Alton MD

Dr. Alton

Dr. Alton

Find out more about nuclear events and 150 other topics in the 2017 Book Excellence Award winner in medicine “The Survival Medicine Handbook: The Essential Guide For When Medical Help Is Not On The Way”.

Survival Medicine Hour: Cold Weather Issues On The Trail, In The Car, At Home

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Dang, it's cold!

Dang, it’s cold!

It’s January, and bitter cold has already engulfed much of North America, with heavy snowfall and high winds causing all sorts of issues that might be hazardous to your health. Nurse Amy and Dr. Bones (Joe Alton MD and Amy Alton ARNP) go over a myriad of cold weather issues like hypothermia, winter car survival if stranded, and more. .

We pleased to announce that KYAH in the great state of Utah is now carrying our show on land-based radio!

We wish you the best of health in 2018!

Joe and Amy Alton

The Altons

The Altons

For medical kits, individual supplies and our books/dvds, go to store.doomandbloom.net

How To Survive Home Fires

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6 Important Things To Know To Help You Survive A Home Fire

Apartment house fire

Apartment house fire

At least 12 people, including four children, were killed, with several others injured, in a massive apartment building fire in the Bronx, NY this week. Although the circumstances are unclear, it appears that it was started by a child playing with a stove.

170 firefighters were dispatched to the four-alarm fire, located in a five-story walk-up in the Bronx, just a block from the world-famous Bronx zoo. The crews (the first of whom arrived in three-five minutes) worked to control the blaze in 15-degree temperatures.

Having written about the recent wildfires in California, the story made me think about what you should do to protect your family from becoming victims of a building fire.

New York City, which has many older buildings, has been the site of winter fires causing multiple casualties in the past; I wrote about one in 2015. Gas leaks and frayed wiring are often the culprits, as well as inappropriate use of space heaters.

6 Things To Know About The Nature Of Home Fires

The nature of fire in buildings

The nature of fire in buildings

Every year, millions are at risk for, and thousands of people are killed or injured by, fires in the U.S. Many of these deaths and injuries can be prevented with some knowledge of the nature of fire. You must understand the following six points:

1) Most people who die in fires don’t die because of burns as much as from asphyxiation (suffocation). Fire consumes available oxygen that you need to breathe, and produces harmful gases and smoke. Inhalation of even a small amount of these can disorient you and affect your ability to respond appropriately. Even if there is little smoke, some poisonous gases are invisible and odorless. Some people who die in bed appear to have not woken up at all, most likely a result of toxic inhalation. That doesn’t mean the bodies can have burns on them, but they are often not the cause of death.

2) Fire spreads rapidly. A small fire can go out of control in less than a minute if not extinguished rapidly. Many house fires occur at night when everyone is asleep, making it possible for smoke and flames to engulf the entire building before you are even aware of it. Sometimes, rooms can combust all at once, a phenomenon known as a “flashover“. Opening hot doors can cause a fire effect called a “backdraft“, which appears similar to an explosion.

3) The environment in a fire is likely to be dark, not bright as you might think. Black smoke can easily make it impossible to see clearly as well as cause eye irritation. This leads to confusion as to where the best avenues of escape might be.

4) Heat from a fire can burn you, even if you’re in a room that isn’t on fire itself. Breathing in super-heated air can burn your lung tissue and is more lethal than burns on the skin.

5) Hot air rises. Most people understand this concept, but not the extremes you’d experience in a fire. Air that is just hot at floor level becomes much hotter at eye level. This is why you should stay close to the floor as you make your way out of the building.

6) Fire needs fuel (and oxygen) to survive and grow. People unwittingly feed fires by keeping all sorts of flammable clutter around the house. Don’t collect old newspapers or other combustibles, especially near heaters or stoves.

What To Do In A Fire

A plan of action made before a fire occurs will greatly increase the chances for survival. Here are some important considerations:

  • Make it clear to everyone that there’s a fire. Hit the fire alarm or loudly yell “Fire!”. You should have previously identified at least two exits and conducted fire drills with your family so that they know exactly what to do.
  • Get the heck out of there if it’s clear the fire isn’t the kind that can’t be doused easily by your fire extinguisher (you should have more than one placed in susceptible areas). Don’t wait to grab personal items, you might have only seconds to safely leave.
  • Get down low and crawl to an exit to be least exposed to heat and smoke. Cover your nose and mouth with a cloth if possible. Authorities often suggest wetting it, a good idea if you can do it quickly without delaying your leaving the building. Covering your body with a wool blanket is an option, but don’t use a wet one; when wet, wool will conduct heat more quickly and cause burns.
  • Once you’re at the exit, touch the doorknob or the door itself before opening. If very hot, leave it closed and pick another exit. If the door isn’t hot, open it slowly; close it if fire or heavy smoke is present.
  • Call 911 as soon as you exit the house. If you are missing someone, tell the firefighters where they might be located in the building. Same with pets. Returning to a burning building to search for someone may be heroic, but it is also extraordinarily dangerous. One person was killed when he re-entered the building in the Bronx fire to look for more victims.
  • If someone catches fire: stop, drop, and roll. Stop them immediately, drop them to the ground, and roll them until the fire is out. Smother the flames with a thick towel or blanket if available.

Trapped in the Building

Trapped in a burning building

Trapped in a burning building

Many peoples’ worst nightmares involve being stuck in a burning building. There are a number of things, however, that you can do that will give you time until help arrives.

First, stay calm. People who are agitated may panic and make decisions that lead to very bad outcomes.

Do everything possible to let rescue personnel know you are there. If you can communicate with firefighters, let them know where you are, using either your cell phone or by signaling for help from a window. If possible, hang a sheet out to make it obvious where you are.

Speaking of windows, tear off any window treatments, like curtains. They are flammable and might prevent you from being seen. Make sure that your windows are not secured  in a fashion that prevents opening them in an emergency.

If there’s a bathroom or sink, fill it with cold water and soak whatever cloth items are available. Use them to block the ventilation duct (turn the system off) and the spaces under and around doors. If you’re in a bedroom, soak the mattress and put it up against  the door; secure with a chair.

If there’s a bathroom, there’s likely to be an exhaust fan. If it works, you can clear some smoke with it.

If you still can’t get out of the building and smoke is building up, wet a towel and cover your nose and mouth with it. Grip the towel with your mouth and breath through your nose (it’s a longer route to your lungs). Get down low to the ground, as mentioned above.

Many deaths and injuries from fires are preventable with a little planning and quick action. Be aware of fire hazards in your home and work to eliminate them before a disaster strikes.

Joe Alton MD

P.S. I have great respect for the firefighters who fought this huge blaze is such difficult conditions. They are true heroes.

Joe Alton MD

Joe Alton MD

Find out more about fires, burns, and 150 other topics in disaster settings in the award-winning Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way.

The Survival Medicine Handbook

The Survival Medicine Handbook

Survival Medicine Hour: Surviving Building Fires, Truths About Medical Preparedness, More

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Survival Medicine Hour #370

surviving a building fire

surviving a building fire

12 people die in an apartment house fire in New York City, despite the presence of outdoor fire escapes on each floor. Winter is associated with the cold, but the heat from a fire is also part of it, as gas leaks and frayed electrical heating wires combust and cause major damage. Dr. Alton discusses 6 important things to know about the behavior of fire, and just what to do to get out of that burning building alive.

medical preparedness

medical preparedness

Plus, many folks are well-prepared with regards to extra food and water, but relatively few are medically prepared. Why are the Altons still just starting to get people involved in putting together medical supplies. They make their case for being medically prepared in this episode.

All this plus updates on the California wildfires, and a welcome to radio station KYAH in Utah, the latest network to carry the Survival Medicine Hour!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/12/29/survival-medicine-hour-surviving-house-fires-medical-preparedness-more

Wishing you the best of health in good times or bad,

Joe and Amy Alton

Dr. Bones and Nurse Amy

The Altons

Increase your level of medical preparedness with a medical kit or some individual items from Nurse Amy’s store at store.doomandbloom.net!

Just some of our family of products

Just some of our family of products

 

 

Acute Mountain (Altitude) Sickness

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Acute Mountain Sickness

Acute Mountain Sickness

Altitude SicknessThe journal PNAS (Proceedings of the National Academy of Sciences) reports that 33.5% of the population lives below an elevation of 100 meters above sea level. That means that, in any major disaster, getting out of Dodge often means heading for the hills.

There’s a possibility that we might have to abruptly relocate from a home at sea level to a “bug-out” location in the mountains. Many people adjust to changes of climate and altitude easily, but others don’t; the rapid change in elevation may cause a condition known as Altitude Sickness or Acute Mountain Sickness (AMS).

A certain amount of oxygen is needed to maintain the body physically and mentally. The availability of this oxygen is less as air pressure decreases at higher elevations, leading to “hypoxemia”, a major issue in mountain sickness. It occurs most commonly at elevations of 8,000 feet above sea level or more, although some experience symptoms somewhat lower.

At present, there is little hard data that predicts exactly which flatlander in your party is most likely to develop symptoms. The speed of ascent and the altitude reached (8000 feet or greater) are general factors.

The effects of altitude sickness are more noticeable with the exertion caused by traveling up mountainous terrain by foot. Although most will improve with rest, complications can develop that rapidly become life-threatening.

Identifying Acute Mountain Sickness

Monitor for early symptoms

Monitor for early symptoms

The typical victim of altitude sickness will present to you with (hopefully) mild symptoms, often within 8 hours or so of ascent. They will resemble someone with a hangover or a case of the flu without the associated fever.  You can expect to see:

  • Fatigue
  • Insomnia
  • Dizziness
  • Headaches
  • Nausea and Vomiting
  • Lack of appetite
  • Tachycardia (fast heart rate)
  • “Pins and Needles” sensations
  • Shortness of breath

A percentage of these sufferers will progress to a more severe state. You will notice:

  • Cough
  • Chest congestion (but not nasal)
  • Worsening shortness of breath
  • Confused and apathetic behavior
  • Cyanosis (a blue or gray appearance of the skin, especially the fingertips and lips)
  • Loss of coordination
  • Dehydration
  • Hemoptysis (coughing up blood)
  • Loss of consciousness
Cyanosis

Cyanosis

The severe cases are characterized by the accumulation of fluid (known as edema) in certain organs. In altitude sickness, this may occur in the lungs (“high altitude pulmonary edema or HAPE”) or brain (“high altitude cerebral edema or HACE”), either of which can be life-threatening.

Treating Acute Mountain Sickness

Exertion can worsen altitude sickness

Exertion can worsen altitude sickness

In most cases, the treatment of altitude sickness is simple: The patient requires rest, if only to stop further ascent and allow more time to acclimate. Wiser still would be to descend to a lower elevation.

If a lack of available oxygen is the problem with rapid rises in altitude, it makes sense to have a portable canister as part of your medical supplies.  In climate-controlled studies, a small amount of supplemental oxygen had the result of reproducing the effects of descending to a lower altitude.

A medication commonly used for both prevention and treatment is the prescription drug Acetazolamide (Diamox). It has a “diuretic” effect, which means that it speeds the elimination of excess fluid from the body by urination. Therefore, it will help prevent the accumulation of fluid in the lungs or brain.

Acetazolamide is superior to many other diuretics in that it also forces the kidneys to excrete bicarbonate. By increasing the amount of bicarbonate excreted, the blood becomes more acidic. Acidifying the blood stimulates ventilation, which increases the amount of oxygen in the body. This effect may not be immediate, but will speed up recovery.

It should be noted that Acetazolamide is a prescription medication, but physicians shouldn’t have problems prescribing it if you let them know you’re planning a trip to high altitude areas. Your doctor should also be able to determine the right dosage, usually ranging from 125mg to 1000mg (average 250 mg twice daily). Some side effects include a strange taste and tingling of the fingertips.

Other medicines known to have a beneficial effect include other prescriptions meds like the blood pressure drug Nifedipine and the headache med Sumatriptan (Imitrex). Ibuprofen 600 milligrams three times daily was found to be effective for mild cases in a study done in 2012.  The strong steroid Decadron is used for those with edema in the lungs and brain.

Once down to more reasonable altitudes (immediately essential in HAPE or HACE) or with oxygen and acclimatization, you can expect symptoms of ACS to subside over one to two days in most cases.

Prevention of Acute Mountain Sickness

Other than using meds like Acetazolamide for prevention, there are simple strategies that will help decrease the risk of altitude sickness. Choose your route to your retreat so that the ascent is as gradual as possible. Do not attempt more than 2,000 feet of ascent per day. Ensure that your personnel do not become dehydrated as they ascend, and, especially, avoid the consumption of alcohol.

If there is no choice but to make a quick ascent, it’s important to monitor members of your party for their hydration status and response to exertion, as well as the symptoms and signs described above.

There is some evidence that Gingko Biloba may be helpful in the natural prevention of altitude sickness. A small amount of an extract of this substance has been shown to allow the brain to tolerate lower oxygen levels. More research is needed to determine the appropriate amount for the desired effect.

Joe Alton MD

Dr. Alton

Dr. Alton

Find out more about Mountain Sickness and 150 other topics in the award-winning Third Edition of the Survival Medicine Handbook: The Essential Guide for when Medical Help is Not on the Way. Also, fill those holes in your medical supplies with kits and individual items from Nurse Amy’s store at store.doomandbloom.net!

Video: Colds Vs. Flus

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VIDEO: COLDS VS FLUS

Colds vs Flus

Colds vs Flus

Colds and flus have similar symptoms, but there are ways to tell the difference. In his latest video, Joe Alton MD goes through the signs and symptoms that give clues as to which is which, and what you should do to treat and prevent respiratory infections this cold and flu season.

To watch, click below:

Wishing you the best of health in good times or bad,

Joe and Amy Alton

Joe Alton MD and Amy Alton ARNP

Joe Alton MD and Amy Alton ARNP

Learn about respiratory infections and 150 other topics in the Alton’s 2017 Book Excellence Award winner in medicine, the Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way!

1st Place at the Book Excellence Awards!

1st Place at the Book Excellence Awards!

Survival Medicine Hour: Cellulitis, Spirituality of and Realities for the Medic, More

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SURVIVAL MEDICINE HOUR #369

spirituality and survival

spirituality and survival

In this episode of the Survival Medicine Hour, Joe Alton MD and Amy Alton ARNP discuss the role of spirituality in survival, and the role hope plays in keeping people resilient in the face of adversity. Also, some hard realities the medic must confront in long-term survival scenarios and the role natural plant products will play in keeping people healthy when the medications run out.

Cellulitis: An epidemic off the grid?

Cellulitis: An epidemic off the grid?

Plus, a discussion of one of the most common issues that will attend injuries in survival settings: cellulitis, or soft tissue infections. People performing activities of daily survival get injured and those injuries can get infected. How do you recognize these infections, and what can you use to treat them?

All this and more in the Doom and Bloom(tm) Survival Medicine Hour with Joe and Amy Alton!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/12/22/survival-medicine-hour-spirituality-and-survival-cellulitis-medic-realities

 

Wishing you the best of health in good times or bad (and a Merry Christmas)!

Have a Corgi Christmas!

Have a Corgi Christmas!

Follow us on Twitter @preppershow; on Facebook @Doom and Bloom(tm);on Youtube’s DrBones NurseAmy channel!

Don’t forget the award-winning Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, as well as the kits and supplies at Nurse Amy’s store at store.doomandbloom.net.

 

Burn Injuries On and Off The Grid

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second degree burn

second degree burn

BURN INJURIES

 

burn injuries

burn injuries

Whether caused by a raging wildfire or due to an accident while preparing food, burns are a major challenge both on and off the grid. Injuries from burns that require medical help top one million each year in the United States, with thousands of deaths reported. These numbers are alarming, given the fact that, in modern times, few are us are exposed to fire as often or directly as our ancestors were. Despite this, only a small percentage of families have formulated and practiced an escape plan for their own homestead.

There are different types of burns. the American Burn Association’s statistics show their relative frequencies:

  • 44 per cent: burns from flames
  • 33 per cent: scalds caused by exposure to hot fluids (50 per cent of burns in children)
  • 9 per cent: contact with a heat source
  • 4 per cent: electrical burns
  • 3 per cent: chemical burns
  • 7 per cent:   miscellaneous causes

Of course, anyone who sustains a serious burn should be transported immediately to a hospital, preferably one with a dedicated burn unit. After a disaster, however, these facilities may be inaccessible or overwhelmed by a large number of casualties. Therefore, it is possible that the average citizen may be required to provide burn care in disaster settings.

Off the grid long-term, the risks are even greater. Without power, we will be cooking over fires more frequently.  The potential for significant burn injuries will rise, especially if small children get too close.  It’s important for the “medic” to have a working knowledge of burns and their treatment.

Rule of 9's: Front torso 18%, back 18%

Rule of 9’s: percentages slightly different in babies

The percentage of body surface area is often used to determine the severity of injury. A system known as the “rule of 9’s” is thought to give a rough estimate of the risks involved. Any burn covering more than the size of, say, your palm is serious enough to be medically evaluated. In survival settings, the general health (not to mention work efficiency) of a group member already under stress may be impacted.

(Note: Normally, the palm area measure is used only for burns that are more than superficial, but I believe that all burns this size or greater should be brought to the attention of the medic.)

burn degrees

burn degrees

Off or on the grid, burns are best categorized by “degrees”, a measure related to the depth of penetration. The deeper the burn damage, the graver the consequences for the victim.

1st degree burn (sunburn)

1st degree burn (sunburn)

FIRST DEGREE BURNS:  First-degree burns affect the epidermis, the topmost layer of the skin. A typical example would be a “sunburn”. These burns appear red, warm, and dry, and are painful to the touch. Mild swelling may occur. Dry, dead skin will cause itching, but peels off after a period of time. No scarring is expected.

Although most first-degree burns are minor, extensive ones must be watched closely. They can cause dehydration and even enough heat loss to cause hypothermia.

Treating a first-degree burn: Treatments for a first-degree burn include:

  • Cool water soaks for five to ten minutes (many make the mistake of running cold water over the burned area for only a few seconds). Avoid ice, which traumatizes already-damaged skin by decreasing circulation to it.
  • Pain relievers like ibuprofen (Advil) or acetaminophen (Tylenol). After a day or so, the pain will subside.
  • Anesthetic ointments and burn gels containing aloe vera.
  • Antihistamines for itching.

Expect complete healing in a week or so.

second degree burn

second degree burn

SECOND-DEGREE BURNS:  Second-degree burns, sometimes called “partial-thickness” burns, affect the deep layer of the skin (the “dermis”). You will see areas that are painful, swollen, and appear moist rather than dry. The area will have a tendency to weep clear or whitish fluid. These injuries often have a number of blisters of various sizes.

Treating a second-degree burn: Treatment for a second-degree burn should be quick and intensive. The faster treatment is begun, the faster the recovery. Consider:

  • Running cool water on the burn for 15 minutes or longer.
  • Quick removal of rings, bracelets, and necklaces due to rapid swelling that occurs.
  • Bandaging the wound with non-stick dressings like Telfa pads. Avoid the use of cotton balls as dressings due to the sloughing off of fibers that can increase the likelihood of infection.
  • Using specialized burn dressings like Xeroform; similar dressings can be improvised using gauze and petroleum jelly.
  • Giving pain medicines as needed.
  • Applying antibiotic cream to blisters to prevent infection.

Blisters may be numerous, but should be broken only if very large or it is clear they would break during normal activity or in bed. The “Popping” of blisters may increase the risk of infection. If you feel it’s necessary, puncture with a sterilized needle at the base and leave the skin covering the raw area.

Keeping the area protected from infectious organisms is important; dressings should be changed at least daily. Most second-degree burns heal in 2-3 weeks without thick scars, but may leave the skin darker than its original color.

third-degree burn

third-degree burn

THIRD-DEGREE BURNS:  A severe type of burn injury, third-degree burns damage the full thickness of the skin and, often, deeper structures like the nerves and blood vessels below the skin. Once the damage goes through the skin, you have lost your body’s “armor”, causing the rapid loss of fluids and ensuing dehydration. Loss of body heat is also a major issue.

Third-degree burns can vary in appearance based upon the type of burn incurred. They may appear white and waxy, charred brown, or black.  The area may feel stiff or “leathery”.

Treating a third-degree burn: Start by following the steps for a second-degree burn. Long-term care is much more complex, however. The skin lost in an injury is normally replaced by new skin cells produced by the dermis. The dermis, however, has been destroyed in a third-degree burn, so skin can only grow from the edges of the wound. This not only takes more time than the patient has, but also results in thick scarring.

Sometimes, skin edges have dead tissue which must be cut away so living tissue behind it can grow; this (sometimes painful) process is known as “debridement”.

In normal times, gaps left by extensive burns are treated by “skin grafting”. A skin graft is skin taken from an uninjured area and placed on the site of the burn. Skin taken from the injured person is less likely to be rejected than if taken from another individual.

Of course, the technology needed for skin grafting won’t be accessible off the grid. The best that might be done in a remote setting would be covering the area where skin no longer exists with products like honey or aloe vera gel. A non-stick covering is then applied for protection. Celox hemostatic gauze, when wet, makes for a serviceable burn bandage. Dressing major burns, however, can compromise blood flow as swelling occurs. As such, these wounds shouldn’t be wrapped tightly, if at all. Vigilance is needed to keep the wound clean so as to prevent infection.

Expect these wounds to require a very long time to heal. Often, a “contracture” will develop as a result of scarring. This is a condition where deformity or loss of movement occurs in joints due to the stiffening of muscles and other tissues. The result, at the very least, is loss of range of motion.

Fourth degree burn

Fourth degree burn

FOURTH-DEGREE BURNS: Once considered just a severe case of a third-degree burn, the damage extends down through subcutaneous fat to muscle and bone. The tissue appears dark, dry, and “crispy”. Third and fourth-degree burns are often described as painless, as the nerve endings have been destroyed. These burns, however, often have second-degree and first-degree components at their peripheries, which can be very painful.

Treatment for Fourth-Degree Burns: Even in the most advanced settings, treating fourth-degree burns is complex and may even involve amputation of an affected limb. Without a modern burn unit, the survival rate for third- and fourth-degree burns covering any significant portion of the body will be very low. This is due not only to destruction of tissue; the inability to replace fluids rapidly in these patients and the high frequency of infection will be factors, as well.

COMMON MISTAKES WHEN TREATING BURNS

-Failing to run cool water on the burn for the time recommended.

-Using ice on burnt skin.

-Ignoring airway burns. With smoke inhalation, airways may swell rapidly and cause breathing difficulties. Signs include severe coughing, hoarseness, black-specked sputum, and facial burns.

-Popping blisters unnecessarily. Intervene only when they are very large or interfere with function.

-Assuming a burn is less of an issue than it is. Even a first-degree burn, like an extensive sunburn, can be dangerous if steps aren’t taken to avoid further exposure and keep up the level of hydration.

-Using lard or butter as a home remedy. These substances can trap heat in and cause a delay in healing. Other home remedies, like aloe vera, are more preferable.

BURN PREVENTION

Toddlers and Campfires = Burns

Toddlers and Campfires = Burns

Burn care in an off-grid setting is difficult, so it makes sense to do everything possible to prevent these kinds of injuries. As your people may be performing activities of daily survival to which they are not accustomed, perhaps the most important advice is to be certain that they are wearing appropriate personal protection like gloves, masks, goggles, and footwear. Any burn injury prevented is one less headache (and perhaps, heartache) for the medic. Other considerations:

  • never allow children to be unsupervised near a campfire or wherever food is being cooked or water boiled.
  • Don’t let kids play with matches or lighters.
  • Apply sunscreen 15 minutes before going out in the sun and reapply frequently.
  • Avoid cooking if you are impaired by exhaustion (or alcohol/drugs).
  • Avoid smoking inside your shelter or anywhere there are flammable materials (or maybe not smoke at all).
  • Keep firewood and other flammables away from buildings.
  • If you have power, be wary of space heaters; leave a good space between them and anything combustible.
  • Avoid using frayed electrical cords.
  • Learn how to recognize gas leaks.
  • Have and know how to use fire extinguishers.
  • Have functioning smoke alarms.

Last but not least, have a plan of action for a fire at your homestead, and practice drills so that family members will know exactly what to do. This includes a method of communication and a place to meet in the event that you are separated from each other.

The risk for burn injury exists even in the best of times. Off the grid, they represent a major challenge to the caregiver. The ability to recognize and treat different degrees of burns will be an important skill for the medic in tough times.

In future articles, we’ll review electrical, chemical, scalds, and other burns, as well as ways to recognize and treat them effectively. We’ll also discuss some natural remedies that will work to help speed recovery from burn injuries.

Joe Alton MD

Dr. Alton

Dr. Alton

Find out more about treating burns and 150 other medical issues in disaster settings in the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide For When Medical Help Is Not On The Way.

 

 

 

 

 

 

Video: EMPs And Our Unprotected Grid

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EMP VIDEO

ICBM launch

ICBM launch

A natural disaster could knock you off the grid for a time and make it difficult to keep your family healthy. Imagine, then, what the effect of an electromagnetic pulse event, especially one perpetrated by one of the world’s rogue nations, on the health of the entire continent.

In his latest video (a companion to a recent article) Joe Alton MD discusses the risks of EMPs caused by a low-yield nuclear weapon detonated in the atmosphere. Once thought highly unlikely, it’s now an official part of North Korea’s plans for the U.S. Find out what we’ve done (or not done) to harden our electrical grid against EMP attacks.

To watch, click below:

Wishing you the best of health in good times or bad,

Joe Alton MD

Dr. Alton

Dr. Alton

Still have holes in your medical supplies? Fill them up with kits and supplies from Nurse Amy’s entire line at store.doomandbloom.net!

Essential Oils As Medical Tools

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ESSENTIAL OILS

Essential Oils As Survival Tools

Essential Oils As Survival Tools

Recently, I wrote an article about the use of herbal teas for their medicinal benefits. For the medic who is concerned about long-term survival scenarios, a hard reality is that stored pharmaceuticals will run out over time. This leaves them with only natural options, such as the plants that grow in their own backyard. These were used with skill by our ancestors, who had little else to treat sickness and injury.

While teas are the simplest way to utilize your medicinal herbs, many swear by essential oils as a storage option with other medical supplies. These items have much more longevity than fresh plants and can include those that don’t naturally grow in the area.

Essential Oils Contain Various Compounds

Essential Oils Contain Various Compounds

An essential oil is distilled from whole plant material, not a single ingredient; therefore, each one has multiple compounds that might be medically useful. To take an example, English lavender has about 20 different chemicals, including esters, ketones, and terpenes. These combinations make each oil unique. Oils may be produced from leaves, bark, flowers, resin, fruit or roots. For example, Lemon oil comes from the peel, Lavender oil from flowers, and Cinnamon oil from bark.

Although you might not realize it, you’ve been using essential oils all your life in soaps, furniture polishes, perfumes, and ointments. Previous generations of conventional physicians commonly included them in their medical bags. Indeed, many standard medical texts of the past were really instruction manuals on how to use these products.

Distilling Essential Oils Requires Equipment

One Way To Make Essential Oils: Distillation

Essential oils aren’t easy to produce without distillery equipment. Although it only takes a few leaves of peppermint to make a tea, you would need 5 pounds of leaves to make 1 ounce of essential oil. One source states that it takes an entire acre of peppermint to produce just 12 pounds of oil. The same source says that 12,000 rose blossoms are required to produce a tablespoon of rose oil. These concentrated versions are the ones you see marketed in small, dark bottles. Unless you intend to buy distilling materials, you should accumulate essential oils in quantity but use them sparingly.

The strength or quality of the oil is dependent on multiple factors, including soil conditions, season harvested, subspecies of plant, rainfall, and, in some cases, even the time of day. This is akin to the conditions that determine the quality of a particular vintage of wine. It also explains the significant variance you’ll see in the effects of the same oil from year to year.

You might be surprised to learn that the Food and Drug Administration only requires 10% essential oil in the bottle for it to be marketed as “Pure Essential Oil”. Beware of claims of FDA certification; the FDA has no certification or approval process for these products.

Making Essential Oils

The manufacture of essential oils, known as “extraction”, can be achieved by various methods:

Distillation Method: Using a “still” like old-time moonshiners, water is boiled through an amount of plant material to produce a steam that travels through cooled coils. This steam condenses into a “mixture” of oil and water from which the oil can be extracted

Pressing Method: The oils of citrus fruit can be isolated by a technique which involves putting the peels through a “press”. This works well only with the oiliest of plant materials, such as orange skins.

Maceration Method: a fixed oil (sometimes called “carrier” oil) or lard may be combined with the plant part and exposed to the sun over time, causing the fixed oil to become infused with the plant “essence”. Oftentimes, a heat source is used to move the process along. The plant material may be added several times during the process to manufacture stronger versions. This is the method by which you obtain products such as “garlic-infused olive oil”. A similar process using flowers is referred to as “Enfleurage”.

Solvent Method: Alcohol and other solvents may be used on some plant parts, usually flowers, to release the essential oil in a multi-step process.

As each essential oil has different chemical compounds in it, it stands to reason that the medicinal benefits are also different. An entire alternative medical discipline has developed to find the appropriate oil for the condition that needs treatment. The method of treatment may differ, as well. Common methods are:

1) Inhalation Therapy: This method is also known as “aroma- therapy”. The simplest  way to perform direct inhalation therapy involves putting 2 or 3 drops of essential oil on your hands, rubbing them together, and inhaling.

Steam inhalation therapy utilizes the addition of a few drops of the essential oil in a bowl of steaming water (distilled or sterilized), which is then inhaled. This method is most effective when placing a towel over your head to catch the vapors.

Many people will place essential oils in potpourri or use a “diffuser” to spread the aroma throughout the room. This technique probably dilutes any medicinal effects, however.

2) Topical Application: The skin is an amazing absorbent surface, and using essential oils by direct application is a popular method of administration. The oil may be used as part of a massage, or directly placed on the skin to achieve a therapeutic effect on a rash or aching muscle.

It’s wise to always test for allergic reactions before using an essential oil in this manner: Even though the chemical compounds in the oil are natural, you could still exhibit an allergy to it or be irritated by it (case in point: poison ivy).

A simple test involves placing a couple of drops on the inside of your forearm with a cotton applicator. Within 12-24 hours, you’ll notice redness and itching if you’re allergic. Mixing some of the essential oil with a “carrier” oil such as olive oil before use is a safer option for topical use. Another concern, mostly with citrus oils applied to the skin, is “phototoxicity” (an exaggerated burn response to sun exposure).

Although we have seen many sources recommend applying essential oil over the location of an internal organ, some reservations exist about whether such an application will really have an effect on that organ. It is much more likely to work on skin issues or, perhaps, underlying muscle tissue.

3) Ingestion: Direct ingestion is unwise for many essential oils, and this method should be used with caution. Professional guidance is imperative when considering this method, except for a very few instances. A reasonable alternative to consider is a tea made with the dried herb. This is a safer mode of internal use, but the effect may not be as strong.

Hard Data?

Hard Data on Oils is Not Always Easy To Find

Hard Data on Oils is Not Always Easy To Find

Essential oils have been used as medical treatment for a very long time, but it’s difficult to provide definitive evidence of their effectiveness for several reasons. Essential oils are difficult to standardize, due to variance in the quality of the product based on soil conditions, time of year, and other factors that we mentioned above.

In addition, there are many subspecies of plants that may differ in their effects. An essential oil of Eucalyptus, for example, may be obtained from Eucalyptus Globulus or Eucalyptus Radiata; these plants may have their own unique properties. These factors combine to make scientific study problematic.

In most university experiments, a major effort is made to be certain that the substance tested caused the results obtained. As essential oils have a number of different compounds and are often marketed as blends, which ingredient was the cause of the effect? If the oil is applied with massage, was the effect related to the oil itself or from the physical therapy?

The majority of studies on essential oils have been conducted by the cosmetics and food industries. Others have been conducted by individuals or small companies with a vested interest in the product.

Definitive studies of possible medicinal benefits are usually performed in universities sponsored by the pharmaceutical industry. Unfortunately, they generally have little interest in herbal products because they are hard to patent. Therefore, serious funding is hard to find because of the limited profit potential.

Commonly Used Essential Oils

There are many types of essential oils

There are many types of essential oils

Despite the lack of hard data, essential oils have various reported beneficial effects, mainly based on their historical use on thousands of patients by generations of healers. Although there are many essential oils, a number of them are considered mainstays of any herbal medicine cabinet. Here are some of the most popular:

purple colored lavender flowers smell really good and they have medicinal properties

Lavender is a very popular oil

Lavender Oil: An analgesic (pain reliever), antiseptic, and immune stimulant. It is thought to be good for skin care and to pro- mote healing, especially in burns, bruises, scrapes, acne, rashes and bug bites. Lavender has a calming effect and is used for insomnia, stress and depression. It has been reported effective as a decongestant through steam inhalation. Lavender oil may have benefit as an antifungal agent, and has been used for athlete’s foot or other related conditions.

Eucalyptus Oil: An antiseptic, antiviral, and decongestant (also an excellent insect repellent), Eucalyptus oil has a “cooling” effect on skin. It aids with respiratory issues and is thought to boost the immune system. Consider its use for flus, colds, sore throats, coughs, sinusitis, bronchitis, and hay fever. Eucalyptus may be used in massages, steam inhalation, and as a bath additive. Although eucalyptus oil has been used in cough medicine, it is likely greatly diluted and should not be ingested in pure form.

Melaleuca (Tea Tree) Oil: Diluted in a carrier oil such as coconut, Tea Tree oil may be good for athlete’s foot, acne, skin wounds, and even insect bites. In the garden, Tea Tree oil is a reasonable organic method of pest control. In inhalation therapy, it is reported to help relieve respiratory congestion. Studies have been performed which find it effective against both Staphylococcus and fungal infections. Some even recommend a few drops in a pint of water for use as a vaginal douche to treat yeast. Tea Tree oil may be toxic if ingested or used in high concentrations, around sensitive areas like the eyes.

Peppermint Oil: This oil is said to have various therapeutic effects: antiseptic, antibacterial, decongestant, and anti-emetic (stops vomiting). Peppermint oil is claimed to help for digestive disorders when applied directly to the abdomen. Some herbalists prescribe Peppermint for headache; massage a drop or two to the temples as needed. For achy muscles or painful joints, massage the diluted oil externally onto the affected area. As mentioned previously, definitive proof of topical application effects on deep organs is difficult to find.

Lemon Oil: Used for many years as a surface disinfectant, it is often found in furniture cleaners. Many seem to think that this disinfecting action makes it good for sterilizing water, but there is no evidence that it is as effective as any of the standard methods, such as boiling. Lemon oil is thought to have a calming effect; some businesses claim to have better results from their employees when they use it as aromatherapy. Don’t apply this oil on the skin if you will be exposed to the sun that day, due to increased likelihood of burns.

Clove Bud Oil Is A Dental Anesthetic

Clove Bud Oil Is A Dental Anesthetic

Clove Oil: Although thought to have multiple uses as an anti-fungal, antiseptic, antiviral, analgesic, and sedative, Clove oil particularly shines as an anesthetic and antimicrobial. It is marketed as “Eugenol” to dentists throughout the world as a natural painkiller for toothaches. A toothpaste can be made by combining clove oil and baking soda. When mixed with zinc oxide powder, it makes a temporary cement for lost fillings and loose crowns. Use Clove oil with caution, however, as it may have an irritant effect on the gums if too much is applied.

Arnica Oil: Arnica oil is used as a topical agent for muscle injuries and aches. Thought to be analgesic and anti-inflammatory, it is found in a number of sports ointments. As a personal aside, we have tested this oil on ourselves and found it to be effective, though not very long lasting. Frequent application would be needed for long term relief. Although some essential oils are used as aromatherapy, Arnica oil is toxic if inhaled.

Chamomile Oil: There are at least two versions of Chamomile oil, Roman and German. Roman Chamomile is a watery oil, while German Chamomile seems more viscous. Both are used to treat skin conditions such as eczema as well as irritations due to allergies. Chamomile oil is thought to decrease gastrointestinal inflammation and irritation, and is thought have a calming effect as aromatherapy, especially in children.

Geranium Oil: Although variable in its effects based on the species of plant used, Geranium oil is reported to inhibit the production of sebum in the skin, and may be helpful in controlling acne. Some believe that it also may have hemostatic (blood-clotting) properties, and is often recommended for bleeding from small cuts and bruising. When a small amount of oil is diluted in shampoo, it may be considered a treatment for head lice.

Helichrysum Oil: Thought to be a strong analgesic and anti-inflammatory, Helichrysum is used to treat arthritis, tendonitis, carpal tunnel syndrome, and fibromyalgia as part of massage therapy. It has also been offered as a treatment for chronic skin irritation

Rosemary is a versatile oil

Rosemary is a versatile oil

Rosemary Oil: Represented as having multiple uses as an antibacterial, anti-fungal, and anti-parasitic, Rosemary oil is proven to control spider mites in gardens. Use a few drops with water for a disinfectant mouthwash. Inhalation, either cold or steamed, may relieve congested or constricted respiration. Mixed with a carrier oil, it is used to treat tension headaches and muscle aches

Clary Sage Oil: One of the various chemical constituents of Clary Sage has a composition similar to estrogen. It has been used to treat menstrual irregularities, premenstrual syndrome, and other hormonal issues. Sage is also believed to have a mild anticoagulant effect, and may have some use as a blood thinner. Clary Sage also is thought to have some sedative effect, and has been used as a sleep aid.

Neem Oil: With over 150 chemical ingredients, the Neem tree is called “the village pharmacy” in its native India. Many Ayurvedic alternative remedies have some form of Neem oil in them. Proven as a natural organic pesticide, we personally use Neem Oil in our garden. Reported medicinal benefits are too numerous to list here and seem to cover just about every organ system. It should be noted, however, that it may be toxic when the oil is taken internally.

Wintergreen Oil: A source of natural salicylates, Wintergreen oil is a proven anticoagulant and analgesic. About 1 fluid ounce of Wintergreen Oil is the equivalent of 171 aspirin tablets if ingested, so use extreme caution. It may also have beneficial effects on intestinal spasms and might reduce elevated blood pressures.

Frankincense Oil: One of the earliest documented essential oils, evidence of its use goes back 5000 years to ancient Egypt. Catholics will recognize it as the incense used during religious ceremonies. Studies from Johns Hopkins and Hebrew Universities state that Frankincense relieves anxiety and depression in mice (we’re unsure how, exactly, this was determined, but it probably involved a cat). Direct application of the oil may have antibacterial and antifungal properties, and is thought to be helpful for wound healing. As a cold or steam inhalant, it is some- times used for lung and nasal congestion.

Blue Tansy Oil: Helpful in the garden as a companion plant for organic pest control, Blue Tansy is sometimes planted along with potatoes and other vegetables. The oil has been used for years to treat intestinal worms and other parasites. One of its constituents, Camphor, is used in medicinal chest rubs and ointments. In the past, it has been used in certain dental procedures as an antibacterial.

Oregano Oil: An antiseptic, oregano oil has been used in the past as an antibacterial agent. It should be noted that Oregano oil is derived from a different species of the plant than the Oregano used in cooking. One of the minority of essential oils that are safe to ingest, it is thought to be helpful in calming stomach upset, and may help relieve sore throats. Its antibacterial action leads some to use the oil in topical applications on skin infections when diluted with a carrier oil. Oregano Oil may reduce the body’s ability to absorb iron, so consider an iron supplement if you use this regularly.

Thyme Oil: Reported to have significant antimicrobial action, diluted Thyme oil is used to cure skin infections, and may be helpful for ringworm and athlete’s foot. Thyme is sometimes used to reduce intestinal cramps in massage therapy. As inhalation therapy, it may loosen congestion from upper respiratory infections.

“Thieves’ Oil”: Many essential oils are marketed as blends, such as “Thieves’ Oil”. This is a combination of clove, lemon, cinnamon bark, eucalyptus, and rosemary essential oils. Touted to treat a broad variety of ailments, studies at Weber State University indicate a good success rate in killing airborne viruses and bacteria. Of course, the more elements in the mixture, the higher chance for adverse reactions, such as phototoxicity.

I’m sure I missed some of your favorites. There are as many oils as there are species of plants.

Many oils aren't proven safe in pregnancy

Many oils aren’t proven safe in pregnancy

Some important caveats to the above list should be stated here. Many of the essential oils listed are unsafe to use in pregnancy, and some may even cause miscarriage. Also, allergic reactions to essential oils, especially on the skin, are not uncommon; use the allergy test we described earlier before starting regular topical applications.

Even though essential oils are natural substances, they may interact with medicines that you may regularly take or have adverse effects on chronic illness such as liver disease, epilepsy, or high blood pressure. Thorough research is required to determine whether a particular essential oil is safe to use.

Having said that, essential oils are a viable option for many conditions. Anyone interested in maintaining their family’s well-being, especially off the grid, should regard them as another weapon in the medical arsenal. Learn about them with an open mind, but maintain a healthy skepticism especially about “cure-all” claims.

Joe Alton MD

Dr. Alton

Dr. Alton

Learn more about natural remedies and 150 other topics on survival medicine with the 2017 Book Excellence Award winner in medicine, “The Survival Medicine Handbook: The Essential Guide For When Medical Help is Not on the Way”.

Herbal Teas as Medicinal Tools

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HERBAL TEAS

herbal teas

herbal teas (image by pixabay)

In a long-term disaster setting where you are knocked off the grid, medical supplies expended and medicines dispensed over time may not be easily replaced. When confronted with dwindling access to the tools needed by the survival medic to keep people healthy, it becomes clear that knowledge of natural remedies is important.

Every medic must determine whether they believe a long-term survival scenario is a possibility. If this is their concern, they must not only have a sizable amount of supplies and medicine, but also a realization that they eventually must turn to the plants in their own backyard that may have medicinal benefit.

For long term storage, the preparedness community has turned primarily to essential oils as a natural alternative. These are, indeed, some of the best natural products the medic can stockpile due to their longevity. Producing new supplies of them, however, is problematic. Without distilling equipment and a large amount of plant material, you will not be able to replenish oils in any significant quantity.

purple colored lavender flowers smell really good and they have medicinal properties

It takes a lot of lavender to make an oil

A more realistic option for sustainable herbal medicines is using fresh or dried plant materials in teas. These require little more than a garden and some knowledge regarding each herb.

It should be noted that the term “tea” is incorrect: The word actually refers to various drinks made from the leaves of one species, Camellia sinensis. Green, black, white, and oolong teas are made from the same plant; only the processing differs. The proper term for a drink made by steeping herbs in hot water would be an “herbal infusion” or “tisane”. For simplicity’s sake, though, we’ll call them teas.

Standard teas from Camellia Sinensis, like green, black, white, and oolong, are high in antioxidants with many health benefits ascribed to them for various medical issues. These include heart disease, type 2 diabetes, liver dysfunction, and more.

Making a tea is one of the simplest ways to prepare medicinal herbs. If you can boil water, you can brew tea. You just:

  • Bring some water to a roiling boil in a pot or other container. Crush the herb leaves, roots, and/or flowers.
  • Pour the boiled water over 1 teaspoon of herbs and let steep for about five or ten minutes
  • Keep a cover on while steeping.
  • Unless using a tea bag or “bob”, place a strainer over a cup, and pour.
  • Use honey or lemon to add flavor if desired.

A tea doesn’t have to be ingested to be of benefit: Some may be used as an eye wash, an irrigation solution for wounds, or in cold or warm compresses.

There are many herbs that can be made into a tea. Although some of the information below lacks hard scientific data, these are just some of the teas made by your ancestors for medicinal purposes.

Alfalfa: The seeds and leaves contain vitamins A, C, E, and K, as well as calcium, phosphorous, iron, and potassium. It has been used as a diuretic to help urine flow and for upset stomachs. There are claims that it helps arthritis pain and may lower cholesterol. Use 1 to 2 teaspoons of dried leaves, steeped in 1 cup of boiling water, for 10-20 minutes.

Burdock: The dried root has been used in teas to help clear acne and to treat psoriasis. Use 2 tablespoons of fresh grated root or 1 tablespoon of well-dried root in 3 cups of boiling water.

Catnip: Leaves and flowers are used to treat intestinal cramping, indigestion, diarrhea, and other stomach ailments. Also thought to treat respiratory infections like the common cold. A substance in catnip called nepetalactone is thought to produce a mild sedative effect. Use 1 teaspoon of dried leaves or 1 tablespoon of fresh leaves per cup.

Chamomile: This popular tea contains the amino acid Tryptophan, which gives it a sedative and relaxing effect. As such, it may help treat anxiety and insomnia. Antioxidants in chamomile may help slow down progression of visual, kidney, and nerve damage in diabetics. Use 2-3 teaspoons of dried flowers per cup.

Chicory: When supplies of coffee ran out, soldiers in the Civil War used the root of this common plant as a substitute. It doesn’t have caffeine, though, and has more of a sedative than stimulant effect in large amounts. Chicory root has an effect against intestinal worms, and has been shown in animal studies to improve calcium absorption and bone mineral density. Scrape the “bark” off the root before drying; use 1 teaspoon to 1 cup of water. Tea made from leaves has a laxative effect.

dandelion tea

dandelion tea

Dandelion: You might be surprised to know that the common dandelion contains vitamins and minerals. Indeed, it’s thought to have more beta-carotene than a similar serving of carrots. Young flowers and leaves make a good tea for constipation (steep for 20 minutes). Roasting the roots produces a coffee-like drink; use 2 teaspoons of dried chopped root in 1 cup of water.

Echinacea: Well-known to decrease the duration of colds and flus, Echinacea boosts the immune system and may have some antiviral activity. Steep 1-2 teaspoons of leaf, flower, or ½ teaspoon of root to 1 cup of boiling water.

Elder: Elderberry flowers make a tea that is used for many upper respiratory infections such as sinusitis, colds, flus, and laryngitis. Applied in a compress, the tea may be helpful for wound healing and some skin conditions.

The blue or purple berries are high in antioxidants and may be made into a juice or syrup: Put two pounds of elderberries and four cups of water and bring to a boil, then simmer for a half hour. Use a fine mesh strainer to press out the juice. Sugar may be added under medium heat to make a syrup.

Eucalyptus: Tea made from eucalyptus leaves offers relief from asthma as well as respiratory infections, mostly by opening airways and loosening thick mucus. It may have antibacterial and antiviral effects. Steep ½ teaspoon of dried or fresh leaves in 1-2 cups of water.

ginger rhizome

ginger rhizome

Ginger: The underground stems, or rhizomes, of Ginger are used to treat nausea of all types from morning sickness to motion sickness. Slice one inch of the rhizome into small pieces and simmer in two cups of water on low heat for 15 minutes. Then strain. ¼ – ½ teaspoon of ginger powder is another option.

Ginseng: Both Asian and American Ginseng root can be made into herbal teas that are thought to lower blood sugar levels, a useful benefit for those with diabetes. Simmer three to six teaspoons of the root for 45 minutes in three or four cups of water, then strain.

Lavender: Used in aromatherapy, lavender may improve nausea and other digestive symptoms when drunk as a tea. It’s thought to decrease migraine headaches and possibly limit convulsions and muscle spasms. Use 1 tablespoon of dried herb in 1 cup of water.

Lemon Balm: An herb with antiviral effects, it’s a member of the mint family. A tea made from lemon balm leaves and flowers was used in the past to treat mouth, throat, and dental infections like gingivitis and herpes sores. It’s also thought to decrease anxiety, aid sleep, and may help improve intestinal spasms and nausea. Add 1 teaspoon of dried herb or 5-6 fresh leaves to one cup of boiling water.

Licorice: Better known as an ingredient in candy, its coating properties may help with sore throats, coughs, and heartburn. Licorice can, however, raise blood pressure and should be avoided during pregnancy. Add 1-2 teaspoons of chopped root to 2 cups of boiling water. Drink ½ cup at a time.

Passionflower: Tea made from passionflower has a beneficial effect on anxiety and may serve as a sleep aid if taken regularly. Boil 1-2 teaspoons of herb (avoid the root) in 2 cups of water for 5-10 minutes.

Peppermint: A long-standing herbal remedy, tea made from peppermint calms the stomach and helps Irritable Bowel Syndrome (IBS), but can worsen heartburn. The tea helps thin respiratory mucus and relieves nasal congestion. Put 1 teaspoon of dried herb or 6-8 fresh leaves over 1 cup of boiling water.

rose hips

rose hips

Rose: Rose “hips” make a tea with vitamin C, as well as calcium, selenium, zinc, manganese, and others. It boosts the immune system and is thought to be beneficial for the adrenal gland, responsible for the stress hormone cortisol. Boil 1 teaspoon of dried rose hips in water and steep for 20 minutes.

Sage: Sage leaf tea is a time-honored remedy for sore throat as well as the common cold as a tea or gargle. It may also aid digestion, decrease cramping, and may even improve memory. Steep 1 teaspoon of dried leaves in one cup of water.

Stinging Nettle: Stinging nettle root is thought to have benefits as a diuretic to improve urine flow, even in those with enlarged prostates. The leaves may decrease the pain of arthritis in joints. Use 1 teaspoon dried leaves in 1 cup boiling water or boil 5 grams of dried root in 2 cups of water for 5-10 minutes.

St. John’s Wort: One of the few herbs that has known activity against minor depression, it has been called “herbal Prozac”. Beware of interactions with prescription drugs, however. Pour 1 cup of boiling water over 1 teaspoon of herb.

Thyme: Teas made from thyme will loosen thick phlegm and may help coughs. It’s known to inhibit bacteria, viruses, and fungi, including many that cause respiratory infections. Steep 1 to 2 teaspoons of fresh or dried leaves in 1 cup of water.

Turmeric: This herb contains curcumin, an anti-inflammatory compound that may treat Crohn’s disease and other digestive tract issues. As well, it may have beneficial effects on joint pain due to rheumatoid arthritis and other disorders.

Valerian

Valerian

Valerian: The dried roots of this plant have been utilized for centuries to deal with anxiety and insomnia. It may even decrease the frequency of seizures in patients with epilepsy. Its mild sedative effect eases pain and promotes sleep. Avoid taking with alcohol or sedative drugs.

Willow: The green underbark of willow trees contain salicin, the original ingredient used to produce aspirin. It is especially useful for muscle aches and joint pain. Simmer 1 teaspoon of bark in 1 cup of water for 10 minutes.

There is much research to be done to confirm all of the effects of these plants, and there may be other benefits not mentioned. Many other plants have medicinal effects other than the ones in the list above. These, however, are easily made into teas that can be produced even while on the move.

I’m sure you have your own herbal teas that have helped with various medical issues. The bottom line: Learn how to grow your own medicinal herbs. You may find they are all you have to keep people healthy in the long run. Using all the tools in the medical woodshed will make you a more effective medic.

Joe Alton MD

Dr. Alton

Dr. Alton

Learn more about natural remedies in the 2017 Book Excellence Award winner in Medicine “The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way”.

Survival Medicine Hour: Acid Reflux, Colds vs Flus, Medical Barter Items, More

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Survival Medicine Hour #366

Colds vs. Flus

Colds vs. Flus

Joe Alton MD and Amy Alton ARNP, aka Dr. Bones and Nurse Amy, discuss a number of topics, including honey as a treatment for burns, how to tell colds vs. flus, medical barter items, acid reflux, using glues to close wounds, and much more!

Honey, if raw and unprocessed, has antibacterial effect and may be useful to treat burns in situations where modern medical care is not a possibility.

Honey as a treatment for burns

Honey as a treatment for burns

Do you have a cold or the flu? Here’s some tips on how to tell the difference.

Most survivalists consider ammunition to be the most important barter item, but how about items that could heal, instead of cause, wounds? Dr. Alton bets that medical supplies would be important barter items in a post-disaster economy.

Glue in place

Glue in place

Medical glues and even Super-glue, may be valuable items for closing wounds. Here’s how to use glue to close a wound (remember, that it’s more important to know when a wound should be closed and when it should remain open!).

acid reflux

acid reflux

How many people do you know that have problems with stomach acid? In a disaster, those people will still be there, and they need your help. Dr.Alton tells you everything you need to know about gastroesophageal reflux disease (G.E.R.D.).

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/11/30/survival-medicine-hour-acid-reflux-medical-barter-items-colds-vs-flus-more

Wishing you the best of health in good times or bad,

Joe and Amy Alton

The Altons

The Altons

Follow us on twitter @preppershow, Facebook at Doom and Bloom(tm), and YouTube at DrBones NurseAmy channel.

Fill those holes in your medical supplies with kits and individual items from Nurse Amy’s store at store.doomandbloom.net!

 

 

 

 

Video: Influenza 2017

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Influenza On and Off The Grid Video

respiratory tract and virus

respiratory tract and virus

In this video, Joe Alton MD discuss everything you need to know about influenza on and off the grid. Millions will visit their doctor for treatment, and some mostly elderly, very young, or infirm sufferers may not survive the illness.

Dr. Alton tells you how to identify, treat, and prevent outbreaks of influenza in good times or bad, important knowledge to have to keep your family or survival group healthy this flu season. Companion video to a recent article.

To watch, click below:

Wishing you the best of health in good times or bad,

Joe and Amy Alton

The Altons

The Altons

A good medical kit is a big factor in surviving a disaster, and you can find some of the best at Nurse Amy’s site at store.doomandbloom.net. Use coupon code THANKS15 for 15% off your items. Offer ends Monday night, Nov. 27, 2017, so act now.

Survival Medicine Hour: Natural Burn Remedies, Ingrown Nails, Lone Wolves

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Survival Medicine Hour Podcast #365

lone wolf

Lone Wolf?

Does the “lone wolf” have an advantage or disadvantage in situations where you’re knocked off the grid and long term survival is not a sure thing? Joe Alton MD and Amy Alton ARNP discuss the importance of community in tough times, even if it’s just an extended family.

3rd degree burn

3rd degree burn

Plus, after discussing first and second degree burns last week, Dr. Alton, aka Dr. Bones, tackles third degree burns, a difficult challenge for the survival medic, as well as natural burn remedies that might help speed recovery for some of the injured.

off grid ingrown toenail strategy

off grid ingrown toenail strategy

Lastly, minor conditions like ingrown toenails may not seem like much to those who watch The Walking Dead, but they’re a major impediment to work efficiency. Not being able to take a step without pain isn’t likely to increase your chances for survival. Dr. Alton talks about what can be done to prevent and treat this condition off the grid.

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/11/25/survival-medicine-hour-natural-burn-remedies-ingrown-nails-lone-wolves

Wishing you the best of health in good times or bad!

Joe and Amy Alton

The Altons

The Altons

Hey, follow us on twitter @preppershow, YouTube at DrBones NurseAmy channel, and Facebook at Doom and Bloom. And check out the Third Edition of the Survival Medicine Handbook on Amazon!

Third Edition

Third Edition

 

 

 

 

 

G.E.R.D. (Severe Acid Reflux) Off The Grid

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Acid Reflux Off The Grid

G.E.R.D.

Acid Reflux

In this high-stress world, you probably know someone who suffers from G.E.R.D. (Gastroesophageal Reflux Disease). “Gastro-“ refers to your stomach; “-esophageal” refers to the tube that runs from it to your throat. Acid “reflux” is essentially acid that escapes the stomach and can go all the way up to your throat. G.E.R.D. is a severe form of acid reflux that can ruin a person’s quality of life.

Normally, an area called the “lower esophageal sphincter” (LES) is what separates the contents of the very acidic stomach from entering the esophagus. In G.E.R.D., the LES allows food to enter the stomach but fails to close tightly enough to keep juices from going back up, causing what we call “heartburn” and other symptoms.

Up to 20 per cent of the U.S. population suffers from some form of G.E.R.D., which means that it’s likely that the medic will eventually encounter this issue in a remote setting or survival scenario. Off the grid, we won’t have the stress that goes with the modern rat race, but there will be more basic issues just as concerning like “where’s my next meal coming from?”.

hiatal hernia

Hiatal Hernia

G.E.R.D. may occur in those with a “hiatal hernia”. This condition occurs when the top of the stomach moves up through a weak area in the diaphragm (the muscle that separates chest from abdomen and helps you breathe). As such, acid can more easily leave the stomach.

Although the stomach has a lining that can handle acidic environments, the esophagus becomes inflamed when exposed to too much. The lining becomes weakened and can erode, a condition known as an “ulcer”. Ulcers can occur in the esophagus, stomach, and upper part of the small intestine.

To make the diagnosis of ulcer or acid reflux disease as opposed to, say, chest pain from heart issues, the timing of the discomfort is important. Ulcer and acid reflux discomfort occurs soon after eating but is sometimes seen several hours after a meal. It can be differentiated from other causes of chest pain in another way: it gets better by drinking milk or taking antacids. As you can imagine, this wouldn’t do much for heart problems. Also, it often worsens when lying down or eating acidic foods. In the worse cases, such as with ulcers, blackish stools may be seen or vomiting may occur that looks like coffee grounds. This is a sign of bleeding high up in the GI tract.

ulcers

ulcers

Certain lifestyle changes are often helpful for people with G.E.R.D. Eating smaller meals (say, 5 a day) and avoiding acidic foods before bedtime may help prevent reflux. Give your stomach at least 3 hours to empty before you lie down or add a pillow or two behind your shoulders, head, and neck.

You would think chewing gum would increase stomach acid; chewing gum, however, produces saliva: Saliva acts to buffer acid.  Also, you swallow the saliva, which might force some of that acid further down the esophagus.

Spicy foods may worsen G.E.R.D.

Spicy foods may worsen G.E.R.D. (image by pixabay)

Your patient may benefit from avoiding certain foods. These commonly include:

  • Acidic fruit (for example, oranges or other citrus)
  • Fatty food
  • Coffee
  • Certain teas
  • Tomatoes
  • Onions
  • Peppermint
  • Chocolate
  • Alcohol
  • Spicy foods

Medicines like aspirin, ibuprofen, and others may also cause stomach issues. As well, smoking is thought to worsen G.E.R.D.

One thing about milk: although it may be helpful as a treatment, avoid regular milk intake and stick with low-fat, as high levels of fat ingestion may actually increase stomach acid. Obese individuals seem to suffer more from this problem:  Excess abdominal fat can press against the stomach, forcing acids up into the esophagus. Weight loss may help, something that’s likely in survival scenarios.

Medications that commonly relieve acid reflux include calcium, magnesium, aluminum, and bismuth antacids such as Tums, Maalox, Mylanta or Pepto-Bismol, as well as other medications such as Ranitidine (Zantac), Cimetidine (Tagamet), and Omeprazole (Prilosec). These medications are available in non-prescription strength and are easy to accumulate in quantity.

In modern times, G.E.R.D. can be definitively identified by procedures such as upper G.I. endoscopy, X-ray tests like an upper GI series, and other high technology. Of course, off the grid, these aren’t an option.

There are many alternative remedies reported to be helpful to deal with G.E.R.D. Home remedies for acid reflux include:

Organic apple cider vinegar: Mix one tablespoon in four ounces of water, drink before each meal.

Aloe Vera juice: Mix one ounce in two ounces of water before a meal.

Baking soda: Mix one tablespoon in a glass of water and drink right away when you begin to feel heartburn

Glutamine: An amino acid that has an anti-inflammatory effect and reduces acid reflux. It can be found in milk and eggs.

Melatonin might be useful  for some (more study is needed on this one).

I’m sure you have some home remedies of your own.

Off the grid, many stoic individuals in the preparedness community may be unlikely to tell the medic about something they consider trivial, like heartburn. Someone in pain, however, loses sleep and work efficiency. Always question these people to find out what their symptoms are. You might be able to help.

Joe Alton MD

Dr. Alton

Dr. Alton

Find out more about G.E.R.D. and 150 medical issues in tough times by checking out the 2017 Book Excellence Award winner in medicine “The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way”.

Influenza On And Off The Grid

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Influenza On and Off The Grid

influenza

influenza

Even with modern medical technology, few can avoid the occasional respiratory infection. Viral illnesses like colds and flus are common issues even for those who are in prime physical condition. Human illness involves the respiratory tract more commonly than any other organ system. Influenza is particularly contagious as germ-laden droplets are expelled during coughs and sneezes, entering the nose, mouth, or eyes of others.

You can expect influenza viruses to hit your part of the country anywhere from late fall to early spring, and most people weather their illness just fine. Some folks, however, especially the very old, very young, and those with chronic medical conditions, may not survive. Because of this, influenza-related pneumonia has earned the title “the old man’s friend” (because it ends their suffering).

The flu may not be life-threatening in normal times, and you might (foolishly) not take measures to prevent it. Survival scenarios, though, are a different story. 100 years ago, a flu epidemic ran rampant throughout the world, killing 50-100 million people. In a survival setting, we’ll be thrown back medically at least that far back.

Without strict adherence to hand washing and respiratory hygiene, it would be very easy for your entire community to become ill, and the physical stress associated with activities of daily survival might lead a weakened respiratory system to allow secondary infections like pneumonia to cause major trouble. At the very least, influenza can affect work efficiency at a time when everyone must be at one hundred per cent. If you’ve had the flu, you know what I mean.

influenza came lead to pneumonia

influenza came lead to pneumonia

Influenzas are usually caused by Influenza type A (the most common) and Type B viruses. They are classified according to the proteins that exist on their surface. These are called Hemagglutinins (HA) and Neuraminidases (NA). There are more and more different HA and NA subtypes discovered every year. The Swine flu, for example, is H1 N1. The flu this year is thought to be H3N2.

Symptoms of influenza begin anywhere from one to four days after exposure. They  include:

  • High fever
  • Cough
  • Headache
  • Severe fatigue
  • Severe muscle aches

Colds will resolve themselves over a week or so, but influenzas may last longer. The flu could weaken you enough that secondary bacterial infections will set in. Indeed, these secondary infections are the most probable causes of death related to flu cases. If this happens, you’ll notice that you are getting worse, not better, over time despite the usual treatments.

The old man's friend?

The old man’s friend?

These include medications like ibuprofen for muscles aches and fever, decongestants for nasal congestion, expectorants to thin out phlegm, cough suppressants (although they should be used only when there is difficulty breathing or sleeping) and others. As the flu is a viral illness, it’s important to know that antibiotics will be ineffective.

There are, however, a few anti-viral flu medications such as Oseltamivir (Tamiflu) or Zanamivir (Relenza). These drugs will shorten the course of the infection if taken in the first 48 hours after symptoms appear. After the first 48 hours, there’s less medicinal effect.

Therefore, you might consider asking your doctor in normal times for a Tamiflu prescription at the beginning of every flu season, since it might be hard to get an appointment on short notice. For a caregiver with a number of flu patients to treat, taking a half dose daily for five days may decrease your chances of catching it.

The CDC recommends the flu vaccine for everyone over 6 months of age, but it’s important to know that the effectiveness of the vaccine may be less in years when the current virus is different from the previous years. Therefore, it’s important to take measures to prevent the flu and to isolate those who are infected from those that are healthy.

face masks may help decrease contagion

face masks may help decrease contagion

Other actions you can take to decrease the chance of getting or spreading the flu are:

  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • If no tissue is available, cough or sneeze into your upper arm, not your hand.
  • Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
  • Clean and disinfect surfaces and objects, like doorknobs, that may be contaminated with germs like the flu.
  • Establish an effective “survival sick room” that will decrease the chances of spread throughout the entire family or group
  • Use face masks when sick or around others who are.
  • Wait 24 hours after the last episode of fever before exposing yourself to others.

The flu may be a bump on the road in your survival journey, but it doesn’t have to be the end of the road.

We’ll talk about natural remedies in the near future.

Joe Alton MD

Joe Alton, MD

Learn more about respiratory infections and 150 other medical issues in the 2017 Book Excellence Award winner in medicine “The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way”. And fill those holes in your medical supplies with kits and individual items from Nurse Amy’s store at store.doomandbloom.net

Ingrown Toenails Off The Grid

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Ingrown Toenails

In the typical zombie apocalypse movie or TV show, you’ll see gunshot wounds and broken bones. Off the grid, however, minor conditions can be a major detriment to the performance of many activities of daily survival. One of these is the ingrown toenail, also known as Onychocryptosis.

You rugged individualists out there might think toenail problems are no big deal, that is, until you have one. When you have to be at 110% efficiency just to survive, you don’t want to be in pain every time you take a step. In the worst scenarios, ingrown nails can cause skin ulcers, blood infections (also called “septicemia”), or even total loss of circulation (“gangrene”).

Your fingernails and toenails are made up of a protein called keratin. It is the substance that forms the claws (and covering of horns and hooves) of animals. When we refer to issues involving nails, we refer to it as “ungual” (from the latin word for claw: unguis).

 

The nail consists of several parts. They include:

The nail plate: this is the hard covering of the end of your finger or toe; what you consider to be the nail.

The nail bed: the skin directly under the nail plate. Made up of dermis and epidermis just like the rest of your skin, the superficial epidermis moves along with the nail plate as it grows. Vertical grooves attach the superficial epidermis to the deep dermis. In older people, the nail plate thins out and you can see the grooves if you look closely. Blood vessels and nerves run through the nail bed.

The nail (or “germinal”) matrix: the portion or root at the base of the nail under the cuticle that produces new cells for the nail plate. You can see a portion of the matrix in the light half-moon (the “lunula”) visible at the base of the nail plate. This determines the shape and thickness of the nail; a curved matrix produces a curved nail, a flat one produces a flat nail.

An ingrown toenail occurs when the edge of the nail grows downward and into the skin of the toe. It can occur for a number of reasons, but poorly fitting shoes and poorly trimmed toenails are the most common causes. The big toe is usually affected, but any toenail can become ingrown.

Symptoms of an Ingrown Toenail

The skin along the edge of a toenail that is ingrown may appear:

  • Red
  • Swollen
  • Painful
  • Warm to the touch

These are signs not only of pressure on the skin, but also the beginning of an infection. If not treated, the condition worsens, possibly even leading to the drainage of pus.

Ingrown Toenails and Your Shoes

Shoes that are either too tight or too loose can cause ingrown toenails. If too loose, it causes continual pounding of your big toe against the inside due to movement within the shoe as you walk. With shoes that are too small for your foot (or even high heels), extra pressure is placed on your toes which prevents normal nail growth.

Improper Trimming

Nails that are not trimmed properly can also cause ingrown toenails. This happens when your toenails are trimmed too short or you cut your toenails in a rounded fashion instead of straight across. Rounded cuts are appropriate for fingernails, but not toenails. The edges of the nails will tend to curl downward and grow right into the skin.

Other Causes

While the above problems can be rectified, some less avoidable factors like heredity, injuries, or medical conditions may also cause ingrown toenails. Some people are born with nails that are curved and naturally tend to curve inward. Injuries to the nail bed can also cause ingrown toenails, especially if it affects the germinal matrix, the living part of the nail that produces new cells.

People with diabetes or other illnesses that cause poor circulation are also at higher risk for these problems. A diabetic, for example, may experience nerve damage and not realize that excessive pressure is being applied to the toes by ill-fitting shoes. They may not even notice that the nail is growing into the skin.

Badly ignored ingrown nail

Badly ignored ingrown nail

Of course, in normal times, there are doctors like podiatrists or orthopedic specialists you should visit to deal with the problem. Off the grid, however, here’s some tips on how to treat an ingrown nail:

  • Soak the foot in warm water with Epsom salts 3 to 4 times a day. In between soaks, keep the toe dry.
  • Use an antiseptic to decrease the bacterial count in the area
  • Place a small piece of moist cotton, waxed dental floss, or other material  under the nail to help it grow away from the skin.
  • Consider wearing sandals until improved.
conservative management of ingrown nail

conservative management of ingrown toenail

Aggressive Treatment

At some point, you may have no choice but to intervene more aggressively. In these circumstances, you may have to remove the offending segment of nail.

Wedge resection of Ingrown Toenail

Wedge resection of Ingrown Toenail

Take the ingrown curved side, about 1/5 of the nail plate width or less. You may have to cut all the way down to the base in some cases. This procedure is more easily done after injecting some numbing medicine into the area, such as lidocaine. Avoid lidocaine with epinephrine; it may compromise the circulation and possibly lead to gangrene. If you have plain lidocaine, consider establishing a “digital block”, seen below:

After Ingrown Toenail Removal

If the toe is infected, antibiotics might be appropriate. Triple antibiotic ointment may be helpful here, but oral antibiotics, such as Keflex (fish-flex), Clindamycin (Fish-Cin) and Amoxicillin (fish-mox forte) may be necessary.  For more information about antibiotics, go here for the first of a 4 part series.

If a portion of the nail is cut off, patience is required as it will take months for the nail to regrow. If you have a genetic tendency toward ingrown toenails, be prepared to deal with recurrences.

Wearing properly-fitted and protective shoes, managing medical conditions, and teaching appropriate foot grooming methods will make sure that the steps on your journey to medical preparedness won’t be painful ones.

For my youtube video on this topic, click below:

Joe Alton MD

Find out more about ingrown toenails and 150 other medical topics when help is not on the way in “The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way”, now in its award-winning Third Edition.

Survival Medicine Hour: Active Shooters, Respiratory Infections, More

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Survival Medicine Hour: Active Shooters, Respiratory InfectionsCurbing the active shooter

Curbing the active shooterThe shooting at a Texas church came fast upon the Las Vegas shooting and the shooting at a church in Tennessee. it seems like you can’t get away from headlines about some deranged, disgruntled, or politically motivated person out to do harm to innocent people. Joe Alton MD and Amy Alton ARNP discuss some common sense tips for average citizens and some advice for our society to prevent becoming soft targets.

Also, Dr. Alton goes through various respiratory infections so that you can identify, treat, and prevent infections. Different infections require different treatments, from the common cold to strep throat to influenza to pneumonia. Plus, how infectious diseases spread from person to person to cause an epidemic.

All this and more on the latest Survival Medicine Hour with Dr. Bones and Nurse Amy.

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/11/09/survival-medicine-hour-influenza-active-shooters-infection-spread

Wishing you the best of health in good time or bad,

Joe and Amy Alton

Joe and Amy Alton

Joe and Amy Alton

Learn more about respiratory infections and many more medical topics in our Third Edition of the Survival Medicine Hour: The Essential Guide for When Medical Help is Not on the Way.

 

 

 

Disaster Supplies

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DISASTER SUPPLIES

Disaster Supplies

Disaster Supplies

A natural disaster can disrupt the lives of average citizens, and having the right supplies when it hits can mean the difference between life and death. Assembling these supplies in advance is the key to success.

 

If you’ve ever lived in a community that was in the path of a hurricane, you’ve seen the empty shelves and crowds at local supermarkets.  Panic buying is a poor alternative to an organized plan of action, with many supplies unavailable by the time you get to the store.

 

But where to start? Lists of recommended items are long and sometimes so detailed that you mind just explodes at the thought of gathering it all. You can’t finish if you don’t start, however; begin to accumulate a few items each month and you’ll be much more likely to weather the storm.

 

I split my personal supplies into three types: short-, medium-, and long-term. A typical short-term event would be, say, a blizzard or other event that takes you off the grid for just a few days or not at all. A medium-term event could be the aftermath of a major hurricane, where weeks may go by without electricity. A classic long-term event would be an electromagnetic pulse (EMP), where years may go by without power.

 

Preparing for any emergency involves knowing who you will be responsible for. If you have family with special needs, consider extra supplies tailored for them. Infants and children require even more thought when gathering supplies, like formula and diapers. Older members of your family may need items to keep them safe and healthy, like extra medications, adult diapers, or walkers.

 

The categories of items you’ll need (called “preps”) don’t really change with the length of time off the grid, but the quantities and variety do. The amount you stockpile depend upon what event your community is most at risk to experience.

 

Just the mere fact of not having enough drinkable or “potable” water puts you and your family in danger. Knowing how to turn unsafe water into drinkable water may save your life. Knowledge is the greatest power, but having supplies will make that knowledge work much better.

A way to disinfect water is imperative

A way to disinfect water is imperative

If you need to leave your house, consider making “go bags” for each member of the family, including pets. Keep them lightweight and easily carried. Look for compact items, like energy bars and small water filters (Lifestraw and Mini Sawyers are examples).

 

 

Here’s a list of useful items grouped by category:

 

  1. Water: Just the mere fact of not having enough drinkable or “potable” water puts you and your family in danger. Knowing how to turn unsafe water into drinkable water may save your life

 

To avoid dehydration, have at least 1 gallon of drinkable water per person, per day. Have a way to store water and methods to make water safe to drink through filtration, and purification. You can use plain, non-scented, household bleach, at 12-16 drops per gallon, to help purify water (filter first if needed). Be sure to wait 30 min for the bleach to take effect, then shake to aerate which makes it taste better.

 

  1. Food: Most municipalities recommend you have at least 3 days of food. This is somewhat arbitrary; I suggest at least 7-10 days, as loss of power can easily last longer. Get non-perishable food and have a manual can-opener. Some freeze-dried foods come in packets that last for 15-30 years and only require boiling water to prepare.

 

  1. Warmth and Shelter: Have ways to start fires (outside only) to stay warm, cook food, and boil water. Get tents, tarps, rope and paracord. Learn how to make shelters and seal off roof or window leaks. Have extra plywood for doors and windows in case of a hurricane; taping windows is no longer recommended.
three compact first aid kits great for hiking and camping made by Amy Alton of store.doomandbloom.net

medical kits

  1. First Aid: Have at least a basic first aid kit and OTC medicines to deal with common injuries and illnesses seen in the aftermath of disasters, such as cuts, bleeding, sprains and strains, diarrhea, pains and aches, colds and flus, etc. Don’t forget prescription medications for those with chronic medical issues.

 

  1. Hygiene: In order to stay healthy, you must keep your family clean. Get extra toilet paper, paper towels, buckets for washing, moist towelettes, feminine supplies, and supplies for waste disposal (like garbage bags and ties).

 

  1. Lighting: Have ways to light up the night. Get flashlights, of course extra batteries (rechargeable are better), solar lights, crank powered lights (power discussed later). The medic should consider a head lamp to keep both hands free.

 

  1. Whistle or Loud Sound Producing item: Have a method to make a loud noise to alert emergency response personnel to your whereabouts.
useful multitool

useful multitool

  1. Tools: Get multiuse tools, like the Swiss army knife and Leatherman. Have a wrench to turn off utilities, some duct tape, an axe, and a saw. If you are in a flood zone, place the axe and saw in your roof space to aid you in escaping to the roof.

 

An escape ladder may be necessary if you are getting out of a roof or higher than a 1-story building. Make sure you know where the fire extinguishers are and that they are not expired.

 

  1. Communication: Text messages will be delivered easier than voice in some circumstances. A CB radio, Ham radio (you need a license), and two-way radios are good to have. To keep updated on the news and emergency bulletins, have a battery and hand-crank radio with NOAA Weather tone alerts. Don’t forget the extra batteries.

 

  1. Power: If the electricity is out, you will need a way to recharge batteries and other items. Solar panels along with a solar storage “battery” can help. There are several on the market. Small solar charged battery storage products are lightweight and can recharge a cellphone or power a radio. These may be best for your “go bag”.

 

Generators that use gasoline must be outside and far away from open doors and windows, to avoid being overcome by fumes.

 

  1. ID and Important Document Storage: Back-up all computers on external hard drives (more than one). Put important scanned documents on an icloud account (which you can then access anywhere later), and on memory USB sticks (several).

 

Place them in different locations like a water/fire-proof safe, in a bank safety deposit box and mail to a trusted relative). Store documents in small waterproof containers for your “go bag”. Include insurance policies, driver licenses, passports, birth certificates, and photos of every room of your house (for insurance purposes).

 

You can also email these scanned documents to yourself for later printing. Don’t forget ID and passwords for accounts, I write mine in a way only I can interpret (for safety).

 

  1. Money: When we talk about a power outage, there may be another loss of power: purchasing power. If the electricity is out stores will not be able to process credit cards or make change. Have cash on hand in small denominations. Keep small bills and coins in a waterproof case/bag, and consider a little silver as well.

 

  1. Evacuation: Your GPS may not function, so have maps and a compass to help guide your escape. You may end up in an area you are not familiar with.

 

Plan routes of escape for fires and flooding and make sure each family member practices drills and has a specific meeting point. As mentioned earlier, each person should also have their own personal “go” bag with appropriate items, including the kids and pets.

 

  1. Writing Tools: You may want to document events or communicate with others, so having pens, pencils (and a sharpener) and notebooks should be considered.

 

  1. Distractions and Fun: Stress is not good for people long-term. Get some playing cards and a book with rules for lots of different ways to play games. Put an extra toy or favorite stuffed animal in your child’s “go bag”. Get some board games, puzzles and hobby craft supplies. (Don’t focus on the disaster and all the horrible details with your children; keep it light if you can.)
Consider the needs of kids and pets

Consider the needs of kids and pets

  1. Pets: Have extra pet supplies including food and medications. Have a way to get them out of the house safely if needed. Few people know that hotels cannot refuse to rent you a room during officially-declared states of emergency just because you have a (small) pet, but don’t expect them to let your family goat or chicken in the room. Have a plan for larger pets if possible.

 

Knowledge is power, but having supplies will make that knowledge work much better! Have a survival library in print books (not digital) with the knowledge you don’t have right now; A flashlight or fire is all you will need to read them in the dark.

Amy Alton, ARNP

Amy Alton ARNP

Amy Alton ARNP

Find lists of medical items you should have, and a lot  more information, in the 2017 Winner of the Book Excellence Award in Medicine “The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way”.

Survival Medicine Handbook, Third Edition

Survival Medicine Handbook, Third Edition

 

Video: Using a SteriPen

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the SteriPen

the SteriPen

Learning how to make water safe to drink is important in any backcountry or disaster scenario. One method that is gaining popularity is using an ultraviolet light handheld water purifier. Outdoor activities, like hiking, can make having a portable water purifier a lifesaver. In this video hosted by Amy Alton, ARNP of https://www.doomandbloom.net/ , she demonstrates the item and its use in the backdrop of the Great Smoky Mountains National Park.

How does it work? Ultraviolet germicidal irradiation (UVGI) uses short-wavelength ultraviolet (UV-C) light to kill or inactivate bacteria and parasites by disrupting their DNA, leaving them unable to perform the functions needed to survive.

To watch, click below…

Wishing you the best of health in good times or bad,

Amy Alton MD

Amy Alton

Amy Alton

Hey, fill those holes in your medical supplies by checking out Nurse Amy’s entire line of medical kits and supplies at store.doomandbloom.net. You’ll be glad you did.

Award-Winning Survival Medicine Handbook (third edition)

Award-Winning Survival Medicine Handbook (third edition)

Survival Medicine Hour: Disaster Supplies, Vehicular Terror, Pain Relief

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Survival Medicine Hour #362

vehicular terror

vehicular terror

The NYC attack, which occurred very close to our daughter’s workplace, killed 8 and injured a dozen more. More and more, terriorists are using vehicles to cause mayhem. What are some ways that you might be able to use rapid action to avoid losing your life in such an incident. Joe and Amy Alton discuss some options that might save some lives in these uncertain times.

Also, disasters seem to always be in the news, but are people spending enough time getting supplies to get through tough times? Some important tips from Nurse Amy on what you need to have in your storage closet or “GO” bag before a disaster occurs.

pain relief

pain relief

Plus, our hosts discussed the mechanisms of pain last week, but what should you have in your survival medicine cabinet to deal with the inevitable pain and inflammation that goes with the activities of daily survival? Some pharmaceutical AND natural options to deal with discomfort off the grid.

All this and more in the latest Survival Medicine Hour with Joe and Amy Alton!

To Listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/11/03/survival-medicine-hour-vehicular-terror-disaster-supplies-pain-relief

Wishing you the best of health in good times or bad…

Hey, follow us on twitter @preppershow, YouTube at DrBones NurseAmy, and FB at Doom and Bloom. Plus, don’t forget to get a copy of the third edition of The Survival Medicine Handbook, 2017 Book Excellence Award winner in Medicine!

Joe and Amy Alton

Joe and Amy Alton

We’re pleased to announce that our third edition of “The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way” is the 2017 winner of the Book Excellence Award in Medicine!

Video: Disaster Supply List

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disaster items

disaster supplies

In this video with Nurse Amy, she goes over some of the most important items that should be in your storage and GO bag in times of trouble. Having supplies is key to survival, but the right ones with greater increase your chances of success, even when everything else fails. Amy goes over various categories and demonstrates some of her favorites. Water, Food, Medical, and much more are covered.

To watch, click below:

Wishing you the best of health in good times or bad,

Amy Alton ARNP

Amy Alton

Amy Alton ARNP

Be sure to fill those holes in your medical storage with kits and individual items from Nurse Amy’s entire line at store.doomandbloom.net.

Survival Medicine Hour: Plague, Hepatitis, Pain Issues

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SURVIVAL MEDICINE HOUR #361

Plague Doctor

Plague Doctor

An outbreak of plague in Madagascar has killed 124 people and infected 1200. Although not an uncommon occurrence in the rural areas, this epidemic has hit the larger cities in the island nation, and is the deadlier version called “pneumonic plague“. Pneumonic plague can be cured if found very early but if not, invariably results in death. Dr. Alton tells you all about bubonic, pneumonic, and septicemic plague and what the off-grid medic could do to prevent this terrible infectious disease from running rampant.

ascites

hepatitis damage

Also, inflammation of the liver, called “hepatitis“, is caused by various viruses which are harder to cure than a bacteria like what causes the plague. There are several types of hepatitis, and it’s important to know what to do to avoid becoming a victim of it. Symptoms, diagnosis, and prevention are discussed by our hosts Joe Alton MD and Amy Alton ARNP.

Plus, we start a series on pain issues, discussing different types of pain and also the government’s categorization of drugs into “schedules” from 1-5.

All this and more in the latest episode of The Survival Medicine Hour with Joe and Amy Alton!

To Listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/10/27/survival-medicine-hour-plague-hepatitis-pain-issues

Follow us on Twitter @preppershow/Facebook: Doom and Bloom/YouTube: DrBones NurseAmy Channel

Wishing you the best of health in good times or bad,

Joe and Amy Alton

The Altons

The Altons

Fill those holes in your medical supplies with kits and individual items from Nurse Amy’s entire line at store.doomandbloom.net!

We’re pleased to announce that the Third Edition of The Survival Medicine Handbook has been named the 2017 winner of the Book Excellence Award in Medicine!

Hepatitis in Survival Settings

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BASICS OF HEPATITIS

liver

liver

There are various infectious diseases that may confront the caregiver in off-grid settings. These can affect various organs of the body, one of which is the liver.

Although your skin is the largest organ you have, the liver is the largest organ that resides inside the body. It is located on the right side of your abdomen just under the lowest rib.

The liver is susceptible to damage from drugs and alcohol, as well as inflammation from certain viruses, a condition known as “hepatitis”. If the liver is diseased, it can become enlarged and tender. This compromises its ability to perform functions like helping your body eliminate toxins, digest food, store energy, and more.

There are various types of hepatitis, listed as A, B, C, D, and E. Each has its own characteristics, but many symptoms are similar. Some types are related to poor hygiene, others from poorly prepared food or contaminated water, and some are even transmitted sexually, but all cause liver dysfunction and scarring. Symptoms can range from none at all (but still contagious) to life-threatening, and may include:

  • Loss of appetite
  • Nausea and vomiting
  • Diarrhea
  • fever
  • Dark-colored urine and pale greyish bowel movements
  • Stomach pain
  • Itching
  • Muscle and joint aches
  • Fatigue
  • General ill feeling (also called “malaise”)
jaundiced eyes

jaundiced eyes

Although sufferers may experience several of the above symptoms, the hallmark of hepatitis is jaundice, a yellowing of skin and eyes that occurs due to an excess of a yellowish substance called “bilirubin” in your system. Bilirubin is formed by the breakdown of old red blood cells in the liver. A healthy liver eliminates bilirubin as part of this process.

jaundiced skin

jaundiced skin(wiki)

HEPATITIS A

Hepatitis A virus is caused by oral-fecal contamination; it can be gotten, for example, by drinking water that has particles from the bowel movements of infected individuals. It’s begins as a flu-like syndrome, then quickly manifests many of the symptoms mentioned above 2 to 6 weeks after exposure. It can also be transmitted sexually.

In survival, failing to properly purify water can cause an epidemic of Hepatitis A. In normal times, a restaurant employee who doesn’t wash his hands after using the bathroom can pass the disease along to customers.

Hepatitis A usually gets better without treatment after a few weeks. Interestingly, children rarely get symptoms, while 80% of adults do. In areas at risk, a vaccine is available.

HEPATITIS B

Hepatitis B can be spread by exposure to infected blood products, semen, and vaginal fluids. Symptoms are usually indistinguishable from Hepatitis A.

ascites from chronic liver disease

ascites from chronic liver disease

Hepatitis B. however, may cause scarring in the liver that leads to a chronic condition known as “cirrhosis”.  In cirrhosis, the functioning cells of the liver are replaced by non-functioning nodules. Cirrhosis may also be caused by long-term alcohol or drug abuse. Besides jaundice, the condition can lead to “ascites”, an accumulation of fluid that causes swelling of the abdomen, swollen legs, and other symptoms.

HEPATITIS C

Hepatitis C can cause acute or chronic infection, and is seen most often in older individuals. It may be contracted by intravenous drug use, transfusion, and unsafe sexual practices. A percentage of these patients will progress to cirrhosis over time and, sometimes, complete liver failure. A vaccine is now actively promoted by the government that may protect infected individuals from future damage.

HEPATITIS D

The hepatitis D virus is unusual because seems to only occur in those with an active Hepatitis B infection. In tandem, the two viruses cause a significant “superinfection”.

HEPATITIS E

Hepatitis E is typically an acute infection that is sometimes associated with eating poorly cooked pork or wild game. It is self-limited, which means that it gets better without treatment after several weeks. Some types of hepatitis E virus are spread by oral-fecal contamination similar to Hepatitis A.

PREVENTION AND TREATMENT OF HEPATITIS

Make the patient comfortable by encouraging rest, encouraging rest and hydration, and giving antihistamines like diphenhydramine for itching. There are limitations about can be done in an austere setting regarding this condition. The anti-viral and immune drugs used for this condition will simply be unavailable.

Wash your hands!

Wash your hands!

The austere medic can, however, practice good preventive medicine by encouraging the following policies:

  • Wash hands after using the bathroom and before preparing food
  • Wash dishes with soap in hot water
  • Avoid eating or drinking anything that may not be properly cooked or filtered
  • Make sure children don’t put objects in their mouths
  • Use condoms to avoid sexual transmission
  • Don’t share personal items, if at all possible, like toothbrushes or razors with infected persons

Some natural substances may encourage good liver health and were used in the past to treat those with hepatitis. Avoiding fatty foods and alcohol Increase, taking zinc supplements, and staying hydrated may help.

There is little hard data proving their effectiveness, but they may be your only options in a survival setting. They include:

  • Milk Thistle
  • Artichoke
  • Dandelion
  • Turmeric
  • Licorice
  • Red Clover
  • Green Tea

Although viral diseases are difficult to treat off the grid, a focus on prevention will help make sure your people have the least chance of getting hepatitis.

Joe Alton MD

Dr. Alton

Dr. Alton

Learn more about hepatitis and 150 other medical topics in the 700 page third edition of the 2017 Book Excellence Award winner in medicine, The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way,

Survival Medicine Hour: Mudlslides, OTC Drugs, More

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SURVIVAL MEDICINE HOUR PODCAST #360

A loaded first aid kit with medical supplies for trauma,burns, sprains and strains and other medical issues

Your medic kit should contain various OTC meds

Your survival medicine cabinet should have plenty of different meds that can handle pain, inflammation, fever, respiratory infections, stomach upset, diarrhea, and many more of the common issues that the survival medic will confront off the grid. Here’s a good list and explanation of why you should have these medicines in your storage.

mudslide

mudslide

Plus, Living in a cliffhanging home on Ski Mountain in Gatlinburg, TN, gateway to the Smokies, puts ol’ Dr. Bones and the lovely Nurse Amy at risk for a mudslide, especially since the 2016 wildfire, destroyed so many trees that were preventing erosion in the area. What are warning signs of future mudslides and what can you do to prevent becoming a victim?

All this and more in the Latest Survival Medicine Hour with Joe Alton MD and Amy Alton ARNP!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/10/20/survival-medicine-hour-mudslides-otc-drugs-more

Wishing you the best of health in good times or bad,

Joe and Amy Alton

The Altons

The Altons

We’re pleased to announce that the Survival Medicine Handbook’s 700 page Third Edition has won the 2017 Book Excellence Award in the category of medicine. Earlier editions are out there, so make sure get the latest edition!

Survival Medicine Hour: Labor and Delivery, Wildfire, More

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off grid labor and delivery

off grid labor and delivery

In any long-term survival situation involving a group or community, eventually the issue of pregnancy and childbirth arises. The medic for the group should know basics about pregnancy and childbirth. Childbirth is a natural process that usually doesn’t require a doctor or even a midwife to manage, as long as some simple steps are followed. Joe and Amy Alton, aka Dr. Bones and Nurse Amy, take you through a typical labor and delivery process.

Calilfornia wildfires

Calilfornia wildfires

Also, wildfires are raging through Northern California, with 40 killed and hundreds unaccounted for. What should you do to prepare for wildfires from both a personal and a property perspective? Dr. Alton gives you some common sense recommendations that could save life, limb, and location in a conflagration.

All this and more on the latest Survival Medicine Hour with Joe Alton MD and Amy Alton ARNP!

To Listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/10/13/survival-medicine-hour-labor-and-delivery-wildfires-more

Wishing you the best of health in good times or bad,

Joe and Amy Alton

the Altons

the Altons

Find out more about wildfire safety and much more with the Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, 2017 winner of the Book Excellence Award in the medical category.

Plus, don’t forget to check out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net.

The Effective Survival Medic

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THE EFFECTIVE SURVIVAL MEDIC

 

Amy Alton ARNP

Nurse Amy

(This article first appeared in American Survival Guide, a great magazine for backcountry, short-term, or long-term survival. Each issue is so packed with great information, I can’t bear to let go of them!)

 

After water, food, and shelter, many consider personal defense to be the most important priority in a long-term disaster. They’ve got the beans and bullets, but what many of these rugged survivalists don’t realize, however, is this: You can have all the beans and bullets there are, but it won’t mean a hill of beans, and you’ll just shoot yourself in the foot, unless you have the bandages.

Few in your group will be accustomed to performing activities of daily survival like, say, chopping wood for fuel. This fact will lead to injuries, burns, infections, and other medical issues that must be treated. Someone, therefore, has to assume the role of survival medic. This person might have to be you, an average citizen with little formal medical training. In a circumstance where the ambulance is no longer just around the corner, you may be the only medical asset left to your family or group.

When you become the end of the line, medically, for your people, how can you be certain that you’ll be an effective caregiver? This is a question that I’m often asked as I travel the country speaking on disaster medical preparedness. The success of the survival medic depends on the accumulation of three things: knowledge, training, and supplies. These can be obtained, over time, with effort and dedication.

One thing that isn’t easy for an inexperienced medic to obtain is the ability to avoid feeling squeamish at the sight of blood. A response similar to the “fight or flight” mechanism, it’s a natural fear reaction that causes blood vessels to dilate, blood pressure to drop, and slowing of the heartbeat, all leading to lightheadedness and nausea.

Of course, repeated exposure to blood is one way to become accustomed to it. One medical center director says that his students learn to compartmentalize fear reactions by repeating words or numbers in their head, rocking side to side, tensing and relaxing leg muscles, or even drinking a sugary caffeinated beverage to raise blood pressure, stay hydrated, and avoid low glucose levels (called “hypoglycemia”) that make them feel faint.

(As an aside, coffee is commonly thought to be dehydrating, but it doesn’t cause you to lose more fluids than you ingest in the drink.)

The designated medic must assume a number of roles besides that of chief medical officer. These include sanitation supervisor, dental technician, medical quartermaster, counselor, and archivist.

As sanitation supervisor, it is your duty to ensure that water is purified, food is prepared properly, and human waste is disposed of appropriately. Failure to, for example, construct an effective latrine could cause infectious disease to run rampant among your people.

If you are worried about a week without power due to a storm, you won’t have to deal with a lot of dental issues. In long-term survival, however, people start having dental issues like broken teeth, abscesses, and toothache that threaten their work efficiency, if not their life. Dental supplies become as important as medical supplies in this scenario.

Let’s say you’ve prepared and have a lot of medical supplies. Who determines when these precious items, many of which will be scarce after a disaster, are dispensed? Who gets the last course of antibiotics? That decision must be clearly defined as yours to make.

In the aftermath of a life-changing catastrophe, anxiety and depression will be more likely to be daily issues than gunfights at the OK corral (I hope). You must be a calm, understanding, confidential presence to keep your people focused on staying alive and productive.

Finally, you must be the archivist for the group. It’s your job to know the history of those for whom you are medically responsible: their illnesses, medications taken, past hospitalizations, allergies, and more. If you anticipate the likely problems you will confront as medic, you can stockpile supplies accordingly.

Speaking of supplies, you will need more than you have currently. How can I know this, not having seen your kit? Because you will responsible for more people that you think. You may be preparing to care for the number of people in your mutual assistance group, but be certain that they will bring relatives or that you will find additional survivors that have skills that would increase your chances for survival. These folks may be useful but will cause additional strain on your medical resources.

Lack of enough supplies for the number of people in your group is the biggest mistake made by the survival medic. You can never have enough; any extras would be valuable barter items. Be wary of kits that claim to be sufficient for 25 or 50 people, as they are often advertised: Just one major hemorrhage can take up the entirety of the bandages in these products. If you doubt this, empty a liter or two of fluid onto the floor and see how many bandages are needed to absorb it.

Although I suggest that medical supplies may be useful for barter purposes, I believe it is best to conserve them while freely offering to help all who are in need of medical help. Once it is known that you have skills, supplies, and a willingness to help, you’ll become so valuable to others in your community that they will expend resources to protect you.

Another mistake made by the medic is preparing for traumatic injuries while ignoring the lesser issues that can affect work efficiency. Toothaches, foot fungus, and hemorrhoids are just some of the problems that can plague group members and make them less productive.

Still another is the failure of the medic to know what plants and other natural substances in their area might have medicinal benefits. Aloe plants can be helpful for burn care. The green underbark of willow trees and others contain Salicin, the original ingredient in the first aspirins. Eventually, commercial products will be expended; it’s important to learn what’s in your own backyard that can help you keep your people healthy. Use all the tools in the medical woodshed.

It’s important to realize that, as the survival medic, you may not have the luxury of stabilization and evacuation to modern medical facilities. That means that you are responsible for wound care and infectious illness from beginning to end, something even experienced paramedics may not be ready to handle. You must enter the mindset that you are the highest medical resource left, and must deal with issues without the hope of transport for the foreseeable future. It’s important to set up a reasonable sick room or hospital tent to care for your patients.

What medical conditions will the medic be most likely to confront in long-term survival? Here are some you can expect:

Trauma

  • Minor Musculoskeletal injuries (sprains and strains)
  • Minor trauma (lacerations, abrasions, etc.)
  • Major traumatic injury (fractures, occasional knife and/or gunshot wounds)
  • Burn injuries

Infections

  • Respiratory infections (pneumonia, bronchitis, influenza, common colds)
  • Diarrheal disease (sometimes a community-wide outbreak)
  • Infected wounds
  • Minor infections (for example, urinary infections, “pinkeye”)
  • Lice, Ticks, Mosquitoes, and the diseases they carry

Allergic reactions

  • Minor (bees, bed bugs, or other insect bites and stings)
  • Major (anaphylactic shock)

Dental

  • Toothaches
  • Broken or knocked-out teeth
  • Lost fillings
  • Loose crowns or other dental work

Women’s issues

  • Pregnancy and delivery
  • Miscarriage
  • Birth control

Your environment will also factor into your effectiveness as a medic. At various times of the year, issues such as heat stroke or exhaustion, hypothermia, and dehydration may be encountered. If you don’t take into account the environment, you have made it your enemy, and it’s a formidable one.

All of the issues I mention here can quickly take up everything you have stored to help you function as the medic. Therefore, it just makes common sense to consider preventative measures to avoid headaches and, perhaps, heartaches. An ounce of prevention is worth a pound of cure, and that old saying is never more true than in survival.

It’s important to enforce the use of protective gloves, boots, and eyewear in any situation where injuries might occur. Clothes should be appropriate for the climate at your location. You might not consider these items to be medical supplies, but they can prevent a lot of problems that will take up your time and resources.

Personnel that carry firearms and knives must be trained in their safe use. Prevention extends not only to injuries, but also to infectious disease. When you suspect a group member of being ill, you must make sure that they are isolated from those that are healthy. These concepts may seem obvious to you, but you’ll be surprised (unpleasantly) at how many will forget to take precautions to avoid injuries and infection.

There is one last essential characteristic of the successful survival medic: a strong instinct for self-preservation. Although you might want to rush to the aid of the sick and injured, even in the face of hostile fire, you must realize that you are an indispensable asset to your group. If you frequently place yourself in harm’s way, you will eventually find yourself as the patient more often than you or anyone else would like. Always determine first if you can care for a victim without placing yourself at undue risk. You must abolish all threats; if someone has a gunshot wound, it stands to reason that there’s a guy with a gun out there. Don’t become the next casualty.

The Survival Library

For more resources on becoming an effective caregiver, consider these books for your survival library:

The Survival medicine handbook Third Edition 2016

The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way: Now in its 700 page third edition, our book covers 150 different medical issues that you might face after a disaster eliminates the option of modern medical care. Includes lists of recommended medical supplies and a guide to veterinary antibiotics in post-disaster settings.

(As an aside, The Survival Medicine Handbook’s Third Edition won the medical category of the 2017 Book Excellence Awards)

The Physician’s Desk Reference (Amazon Link): No longer available in print form, this guide to drugs, their uses, dosages, and side effects is still around on Ebay and elsewhere. Includes pictures of individual drugs to help identify unknown meds. Find an edition that’s a year or two old for your survival library.

Where There Is No Doctor and Where There Is No Dentist (Amazon Links): Guides for medical and dental care in underdeveloped countries.

Gray’s Anatomy (Amazon Link): The classic textbook of human anatomy

The Merck Manual (Amazon Link): Classic handbook for diagnosis and treatment

Davidson’s Principles and Practice of Medicine: Standard medical textbook

This is, by no means, a complete list of every book that might be useful in survival situations, but it’s a good start.

DISCLAIMER: Be aware that, where there is an existing modern medical system, the practice of medicine or dentistry without a license is illegal and punishable by law. If modern medical professionals and facilities exist, seek them out.

Joe Alton MD

joe alton md

joe alton md

While you’re checking out American Survival Guide don’t forget to get the 2017 Gear Guide, where we’re privileged to have a number of our medical kits featured. For all Nurse Amy’s kits and individual supplies, check out her store at store.doomandbloom.net.

 

Survival Medicine Hour: Off-Grid Pregnancy Care, Cloves, Bleeding Kits

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The Survival Medicine Hour Podcast #357

off-grid pregnancy care

off-grid pregnancy care

What if you had to care for a pregnancy off the grid? Would you identify it as early as you should without pregnancy tests and ultrasounds? How can you assure the well-being of mother and baby during the pregnancy. Joe Alton MD and nurse-midwife Amy Alton, ARNP discuss how to keep an eye on that pregnant lady in your group from beginning all the way to 9 months (labor and delivery coming next time).

Amy's multi-person bleeding kit

Amy’s multi-person bleeding kit

Also, what would be the items you’d want in a kit for a public venue where a gunman could cause multiple casualties? Nurse Amy discusses what’s in her multi-person kit specifically meant for bleeding wounds at schools, churches, workplaces, etc.,  and how it could be a lifesaver in active shooting incidents and other disaster settings.

Plus, natural remedies are important in good or bad times, but especially when modern medicines aren’t being produced, such as in survival scenarios. Joe Alton MD discusses the health benefits of cloves and why you should have some in your survival medicine cabinet.

All this and more in the latest episode of the Survival Medicine Hour with Joe and Amy Alton!

To Listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/10/06/survival-medicine-hour-pregnancy-management-cloves-bleeding-kits

all the best,

Joe and Amy Alton

Joe and Amy Alton

Joe and Amy Alton

We’re pleased to announce that the third edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way has won its category (medical) in the 2017 Book Excellence Awards! Thanks to all for their support.

Why Do Active Shooters Succeed?

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Why Do Active Shooters “Succeed”?

location of vegas shooter and targets

location of vegas shooter and targets

You might associate armed attacks with wars or survival scenarios, but they can occur in normal times as well. The recent mass shooting at the Mandalay Bay in Las Vegas is a reminder that, in these toxic times, no one is safe from those with bad intentions.

It’s hard to read the news without seeing reports of the latest mass shooting by terrorists, the deranged, the disgruntled, and in the shooting in Las Vegas, people with no apparent motivation at all. Few believe that they could possibly wind up in the crosshairs of a gunman’s sight, but it can happen anytime and anywhere. Why do they seem to “succeed” so often and what would be your response to the “active shooter”?

Many of the concert-goers in Las Vegas were victims of what we call “normalcy bias”: That’s the tendency for people to believe everything follows a pattern and that the day will proceed normally because, well, it usually does. It’s a natural response for most, and is reinforced by the rarity of mass casualty incidents.

But when a shooter event breaks that pattern, the unprepared brain takes time to process the situation. People think that the sound of gunfire is, instead, a burst of firecrackers, a blown tire, or anything less threatening than an assassin out to kill them. This pause leads to a type of paralysis than was worsened in Las Vegas by the ready availability of alcohol. By the time good judgment came into play, many were already victims.

Given the circumstances, the rapid action of Las Vegas law enforcement is to be commended. Remarkable, in fact. Police were receiving multiple false reports that made it appear that there were multiple shooter events in a half-dozen casinos. There was even a car with wires sticking out of the trunk at New York New York casino’s valet that was thought to represent a bomb. Listening to police radio communications during the event, it’s amazing that such a coherent response was possible.

(Note: You might be interested to hear what was said on the radio. If so, you’ll find a partial transcript of the first hour or so of the event at the very bottom of this page)

mandalay bay

The shooter was at Mandalay Bay, but reports of shooters also came in from several other casinos (all false)

Most citizens, indeed, believe that the good people of law enforcement and homeland security are always right there. While these agencies do the best they can to counter situations like this, most mass shooting events end so quickly (the Orlando nightclub shooting is an exception) that the chances are slim that help will be immediately at hand. It took just one 31 second period for the Las Vegas gunman to shoot 280 rounds, and possibly just 9-11 minutes (according to Las Vegas Police) before he ended his own life.

Without a plan of action, the average person follows the herd. If fifty people around you (or in Las Vegas, 22,000) drop to the floor, your natural tendency is to do the same. Cowering in fear in plain view of the shooter, however, is a recipe for a very bad outcome. By having a plan before a shooting event occurs, you’ll have a better chance of getting out of there in one piece.

These are things you should be thinking about, calmly and rationally, whenever you’re in a crowd. It may seem extreme to have to consider such options, but the headlines suggest otherwise. This relaxed vigilance is called “situational awareness“, a concept first put forth by a military pilot to pertain to dogfights but which has special importance today for the average citizen.

The standard recommendation, in order, by the Department of Homeland Security is “Run, Hide, Fight“. In the case of the Mandalay Bay shooter, the distance between the shooter and his targets effectively precluded the ability to fight, so running away from the kill zone and/or hiding in buildings and vehicles saved lives. Situationally-aware concert-goers were saved by a high index of suspicion and, hopefully, a low blood alcohol level when the bullets started flying.

If you’re inside, know where the exits are. If you’re outside, know the nearest route away from the area or reasonable nearby shelters. Know who near you appears nervous or suspicious. If you’re in a crowd, stay in the periphery, not center stage. Assume that the sounds of gunshots are gunshots, not firecrackers. Know the direction the gunshots are coming from and head the other way. Primed for a possible emergency, you’ll decrease the chance of becoming a victim.

Sounds simple, doesn’t it? But in this era of people immersed in their smartphones, few are situationally aware. In the old days, this might result in a bump on the head from walking into a lamp post. Today, the results can be tragic.

Don’t be the soft target that assassins look for. Remain situationally aware at all times, and decide how important it is for you to be in the midst of large crowds. Perhaps it was once paranoia, but in these uncertain times, it’s more like common sense.

Joe Alton MD

Dr. Alton

Dr. Alton

Learn more about situational awareness, disaster medical preparedness, and much more in the 700 page third edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, 2017 winner of the Book Excellence Award in the category “medical”. Also, Nurse Amy has designed two kits specifically meant to stop bleeding in one or several victims after a disaster such as occurred in Las Vegas. You’ll find them at store.doomandbloom.net.

AS PROMISED: THE RADIO TRANSCRIPT OF THE ACTIVE SHOOTER EVENT IN LAS VEGAS (as best  as I could hear and understand it, call signs omitted):

We got shots fired! Sounds like an automatic firearm.

Anyone have eyes on the shooter?

It’s coming from up there. It’s coming from Mandalay Bay. I see shots coming from Mandalay Bay, halfway up!

We have multiple 415 (assault/battery with a gun)… do we have surge?

We have an active shooter! We have an active shooter inside the fairgrounds!

Just advising, there are people down on stage left.

Dispatch: We now have an open line with a female saying there is a shooting.

Control, that is correct, shots fired from Mandalay Bay. There’s many people down, stage left, just be advised.

If anyone covering southwest corner between Mandalay Bay and the venue…

I need eyes. Somebody in the CP, can you tell me where it’s coming from?

Dispatch: We’re hearing it’s from Mandalay Bay!

I’m at Mandalay Bay and the boulevard. I need five officers on me.
We have multiple casualties, GSWs in the medical tent! Multiple casualties!

Be advised, shots are coming from Gate 7.

We have a rifle deployed, we’re in front of Mandalay Bay. We’re trying to see where shots are coming from. If anyone can advise if they’re coming from Mandalay…

Dispatch: It sounds like it’s either Mandalay, or Luxor, we cannot tell…

We need the boulevard shut down at Russell northbound right now.

I’ll shut it down, I’m coming back that way

It’s coming from, like, the 50th or 60th floor, north of the Mandalay Bay. Coming out of a window.

Seeing multiple flashes in the middle of Mandalay Bay on the north side. Kind of a, on the west tower, towards the center of the casino. Like one of the middle floors.

Multiple GSWs, on the east side…

On the 31st floor, I can hear automatic fire coming from one floor ahead.

Be advised, it is automatic fire, fully automatic fire from an elevated position. Take cover.

That’s correct, it is full automatic fire.

Multiple GSWs to the chest, legs, femoral arteries, at the medical tent, (Gate) 4A, off of Giles south of Reno!

Flashing coming up from a third of the way up center tower of Mandalay Bay!

All units stop coming northbound on Las Vegas Boulevard, because he’s shooting this way, horrible cover spot.

I have a gunshot victim at gate 4, in the leg.

I got one down, gunshot wound to the leg, Reno and Giles, I also have another female gunshot in the mouth.

We need to send medical when you can over to Reno and Giles, expedited, please.

Dispatch: They’re being advised.

Just be advised, we’re pinned down on the east side las vegas boulevard. We’re gonna be north of Mandalay Bay drive, we’re about 40 or 50 people pinned against this wall. We’re taking gunfire. It’s going right over our heads. There’s debris coming over our heads. So we’re pinned down here with civilians.

I have a gunshot victim at gate 4. Gunshot to the leg.

Hey, we can’t worry about victims. We need to stop the shooter before we have more victims.

Officer shot…

We have multiple, multiple victims shot. Get the medical kit, we got a victim shot in the leg.

Hey, officers please stay calm, just relax, we’re trying to get this set up, just stay calm.

I’m running out of blankets here…

Shut down the elevators, take the stairs.

South Central, make the CP (command post) south central
Lots of people with wounds…

32nd floor

He’s still firing. There’s just the two of us

Hey guys, we got a female with a gunshot wound to the head
I’ve got a gunshot officer

Shut down the 15 for medical, officers going to the hospital
Does anybody have eyes on the shooter

Do we have Mandalay Bay shut down

Get people out and start covering the walls

I got two victims at gate 6, chest and head. We need immediate medical

Be advised: we are taking fire from a very high floor, we believe coming from The Mandalay Bay

Any officers that respond here, gonna be in plain sight.

Any officer coming will be in plain sight

Dispatch: Do not go on the boulevard

Strobe light coming from the east side of Mandalay Bay
I need a lieutenant to set up another command post on las vegas and Tropicana

All units need to start staging so we come from Tropicana
We’re getting from civilians that there might be three shooters.
Set up a perimeter, Tropicana and Russell, and lock a good outer perimeter down. We need a perimeter now.

Arriving, I’ll establish a command post now.

I’m here on the 32nd floor, room 135, I need the SWAT.

UNC Trauma, shoulder wound

We can’t worry about the wounded right now, we have to eliminate the threat

A white car going the wrong way down las vegas boulevard
Multiple GS victims over here on the east side of this building. I got numerous victims, got a five man team to provide cover

We need multiple medical evacs on the south stage

We also have a security officer shot in the leg on the 32nd floor. He’s standing right be the elevator

He shot down the hallway and hit the security guard

We have a four man team up here and another element coming to us

We’ve got at least two shooters, 29th and 32nd floor

Shut the lights down in the venue

Please be advised have all units have vehicles locked. People trying to get in there trying to grab shotguns

Put the CP at South Central, we have logistics

I need a unit to establish command. I’m pinned down with another officer, I need radio instructions

Dispatch: Is there a unit that can establish command
Stuck in traffic on the boulevard

Multiple casualties on the concert floor, stage right

We need the northbound boulevard shut down

Please take all EMS personnel to gate 2B, no sorry, gate 4A, gate 5 for evac

We’re gonna need a medical triage set up close to the CP when we get evacs. If we can get a medical liaison there, start setting that up

Setting up a temporary triage area at the boulevard and Tropicana at the southwest corner

I’ve got an officer with a gunshot wound to the neck just north of the venue

Multiple people running across the runway

I have multiple resources here, we are setting up IC here, is that what we want to do?

Just be advised, there are multiple trucks loading people to send to the hospital. Just let them know.

Black possible Chevy truck ripping out of here, several people confirmed, just keep an eye out

All officers, do not respond to the east side of the boulevard north of the Mandalay drive. This is not a secure position. We will be pinned down.

At the convention center entrance, we are moving into the casino
We have an eight man element clearing casino floor, moving up to the 32nd floor

Be advised, we have a medical tent

SWAT: Has anyone from the outside heard any further shots?

That’s negative, for about 15 minutes we have not heard any shots

(whispering) In the hallway on the 32nd floor

We are clearing the left wing now.

We have two more strike teams making their way to Mandalay Bay by foot

We’re trying to clear the event, pushing everyone to the east
We have a white RV with an older white male in fatigues and a black bag. Came from that area of the shooting. Went into the motor home. Need additional units.

I had a civilian take a patrol car. Need somebody be over here at Giles. I need medical.

Need some more units over here. I’m being overrun by citizens trying to take patrol cars.

We have several thousand people making their way from Gate 5
Giles and Ali Baba. Several, several casualties

(whispering) We believe it’s the northernmost room on the 32nd floor of the Mandalay Bay

I need a couple of officers to come help me push citizens off of the main stage

We have a lot of 419s (dead bodies) on the main stage inside the concert area

Probably about 20 419s around here

Confirming that I have casualties at Ali Baba and Giles east of the Catholic shrine as well as in the Mandalay Bay so we have two scenes.

They’re trying to send medical, send over all of them

Whoever with the maintenance guy at the Mandalay Bay, we need the key for the elevator at the main bank of elevators. We have a whole bunch of us waiting to go up.

I need to know if I have that floor evacuated other than our suspects. We got snipers going up so I need to know that’s evacuated.

That’s gonna be a negative.

We’re still clearing floors. We got two on floor 32 in the hallway
We’re doing evacuations down the hallway

SWAT: we’re coming up the stairwell

We have several 419s on the main stage. I need a couple more officers to help me clear this area.

Confirming that Mandalay Bay and Giles and Alibaba are the two shooting locations. Is there a third?

SWAT: We need to be careful of booby traps. On the stairwell, talk to y’all later

Be aware there’s an officer coming down the stairwell

We have a 12 man element coming into the Mandalay Bay. Strike team.

Is it confirmed that there were no shots from the Luxor?

Do you need more resources up there or you good?

We have the hallway contained.

I have three critical patients in my vehicle, I’m taking them to sunrise. Is there any available vehicles to assist me to get the traffic out of my way?

We have a ton of rescues that are available.

We need to roll now!

Go ahead and go.

Please be advised I’m now transporting five critical to Sunrise.

Please call and let them know I have five in route.

We are going to start establishing certain roles. First, we’re going to have a casualty collection point at Tropicana and the boulevard. I will get someone to liaison that in a moment. We’re going to contain around Mandalay Bay. I will get you a lieutenant for that in just a moment.

I am at Tropicana, I can fill that role for you.

SWAT: We are right outside the door.

Medics are asking if they can proceed to four seasons and Las Vegas boulevard or if they can have officers drive the vehicles that are there with injured civilians down to a safe area.

I have strike teams available, I need to know where to deploy them.

Medics are saying if there’s any reports of civilians in vehicles on four seasons and the boulevard. They can’t get to them safely, but if officers can drive those vehicles to a safe area, they can service them.

We are near the sports book at Mandalay Bay, we have one male WMA wearing a maroon or black shirt near the entrance.

Possible suspect at Circus Circus, we need an ETL on that.

We’re going to have a lot of people transporting in pickup trucks en route to the hospital. Please advise the hospital.

Please be advised we have the singer and citizens on the bus and the manager is adamant that they do not want to exit the bus.

We’re going to develop a route for them to exit.

UNC is at capacity. All units be advised do not transport unless it is life threatening. They need to go to Valley.

We have possible reports of shots fired inside New York New York…

Dispatch: We are getting reports there is a possible 415 at the front desk, New York New York

Black Audi with a possible 445 at the Luxor valet.

SWAT: We are at the end of the hallway, there are officers to acknowledge so we don’t have a crossfire.

We acknowledge, go ahead.

SWAT’s in place.

We have another GSW at the Motel 6.

Do we have a 415A at New York New York?

It originally came in to say many subjects were down.

Two shots were fired inside New York New York, we have approximately 150 people sheltered in place in the kitchen. Two shots were fired inside casino floor, And there are several subjects down at New York New York “Zumanity”.

No answer from security.

In Valet, waiting on a strike team to arrive. Everything seems quiet here.

I need someone to get in through the cameras to see if this is a diversion. I have three metro SWAT basically assembled, two are going up the tower, one is heading over to New York New York so we don’t completely split our forces.

Dispatch: Ok, now I’m getting information on an active shooter at Tropicana.

Please advise bomb squad to deal with the issue over there at Luxor. The 445 device.

Dispatch: Please be advised, there is an active shooter at Tropicana. There is an active shooter at Tropicana. Please be advised, we’re getting multiple reports of shooters at multiple locations. May or may not be diversion.

Entering New York New York with a SWAT team.

I’m outside Tropicana, not hearing any 434s (illegal shooting). This could be a diversion.

Dispatch: Be advised, 70 civilians at the stand aviation hunkered down. We’re getting calls from people sheltered in place, they’re not injured. Do you have any instructions for remaining sheltered in place? Please assign someone in there to keep track of people who have injured calling in.

We have a bunch of ambulance on Tropicana. Do they have Force Pro with them if there’s a e a 415A at the Trop?

Dispatch: Please be advised, we have a hispanic male, dark skin with an afro and dark clothing with a backpack at the Hooters squatting in the driveway. Looks like a suspect.

Do we need more strike teams, we have other agencies calling.
Dispatch: If we have other Tac teams, if we have bodies available, have them come in to our staging area, south central command.
We’re gonna need a roll call of those in Mandalay and the strike teams.

SWAT: I’m at the suspect’s door. I need everyone to be aware of the hallway and get back. I need to pop this to see if we can any response from this guy, see if he’s in here or if he’s moved somewhere else.

Dispatch: SWAT has explosive breach, all units move back, move back.

SWAT: (whispering) breach breach breach

(explosion heard)

We’re in this room, one suspect down.

One suspect down in room 135, 32nd floor Mandalay Bay

SWAT: Preparing to breach adjoining room, floor 32. Explosive breach.

(breach)

SWAT: We got the east room secure, one suspect down, multiple firearms. This is definitely where he was firing into the crowd.

I’m getting reports that medics are getting shot at, at the Tropicana.

We have made contact inside Tropicana, no shots fired.
We are at Tropicana. No shots fired.

Security at New York New York says no shots fired.
Do we have an update on the possible 445 at Luxor?
We have it locked down.

Clear the area, do nothing else for the time being.

Now we’re getting shots fired at Caesar’s and the Bellagio…..

Can Churches Be Made Safe Again?

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Can Churches Be Made Safe Again?

Can Churches Be Made Safe?

church safety

A gunman entered the Burnette Chapel Church of Christ in Antioch, Tennessee, killing one and injuring several others at a September 24th Sunday religious service. This heinous act of violence in a place of worship underscores the need for a strategy that churches can implement to keep congregants safe.

There is no place where crowds gather that is immune to the bad intentions of a disgruntled, deranged, or politically-motivated individual. Therefore, a culture of situational awareness must be instilled in every citizen. This attitude of calm vigilance is especially needed in religious venues.

Unfortunately, not all pastors prioritize church safety at the level needed in this toxic climate. The premise that their ministry is based on peace fails to take into account that there are those who consider places of worship to be “soft”targets. In this era of active shooters and anti-Christian feeling, pastors must make sure their flock is safe, just like any shepherd. In the New Normal, it’s has become part of the job description.

In my role as medical preparedness writer, it’s my mission to help the average citizen promote the well-being of loved ones in disasters. Lately, I’ve written about hurricanes and earthquakes, but shooter events like the one in Antioch are also instances where mass casualties can occur. These casualties might be minimized with a plan of action and quick action.

Large churches may choose to hire security professionals and install video surveillance technology. Smaller and less affluent churches, however, might benefit by establishing what I call a “safety ministry“. This group should be comprised of parishioners who have some security experience, such as active and former law enforcement, military veterans, and carefully selected others. Members should evaluate the layout of the church and grounds for weak spots and organize a plan of action for calling 911 and other measures when needed.

This goal might best be accomplished with the cooperation and assistance of local police. They can help train church members in how to identify the behavior of possible perpetrators of violence. The pastoral staff should be actively involved in this training to assess liability issues that might arise, and to insure that the safety ministry is not perceived as a “goon squad”.

The call for volunteers for such a ministry should be made publicly and their purpose should be frankly (but calmly) explained so as to emphasize their benefits to all those attending the church. The formation of a security group in private might otherwise tend to cause concern instead of reassurance.

A simple way to avoid or abort acts of violence in places of worship is the placement of friendly but visible “greeters” or ushers at church entrances. These people can look for anomalies, such as someone inappropriately dressed for the weather. If a person seeking entry is wearing an overcoat in hot weather, it could be because they are concealing a weapon. Having greeters outside could also make it easier to identify those acting nervously, loitering in the parking lot, or otherwise exhibiting suspicious behavior.

Safety ministry personnel should have the ability to close and lock doors to prevent a gunman from entering. Conversely, they can also open all the exits that could be used to direct congregants out of harm’s way when necessary. Ushers can also look for packages left behind that might hide an explosive device.

In an active shooter event, multiple casualties are incurred, leaving wounded and bleeding victims at the scene. Safety Ministry personnel should have training on how to stop bleeding and equipment such as first aid kits geared to help them accomplish this goal. Indeed, the church might consider arranging such training for their entire congregation.

Although this article is geared towards security during services, a plan of action should be organized for other times during the week as well, and certainly for youth group meetings and other activities sponsored by the church.

Of course, the elephant in the room is the question as to whether non-professional security personnel should be armed. I can’t give you the answer. This is a decision that must be made taking local laws, risk levels, and the wishes of the congregation into consideration.

Sadly, I envision a future where safety ministries are standard operating procedure for our places of worship. Additionally, I predict that first aid kits will be fixtures next to the fire extinguishers on the walls of every place where crowds gather.

It may be a major challenge to protect people of faith these days, but preparing for untoward events should be the responsibility of every pastor and congregant. With a plan of action, they’ll have the best chance to keep our churches safe in the uncertain future.

Joe Alton MD

dr. alton

Joe Alton MD

(Note: I don’t claim to be a security professional, just an old country doctor. If you have additional advice on how to improve the safety of people of faith, send your tips to drbonespodcast@aol.com!)

 

Besides Church, it’s never a bad idea to have a first aid kit for the home and/or vehicle. Feel free to check out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net. You’ll be glad you did.

The Survival medicine handbook Third Edition 2016

The Survival Medicine Handbook Third Edition

Survival Medicine Hour: Earthquake, Birthing Supplies, Hemorrhage, More

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Survival Medicine Hour #355

earthquake damage

earthquake damage

What would you have done if you were in Mexico City during the recent earthquakes? Is there anything that might have increased your chances of survival? In this episode of the Survival Medicine Hour, hosts Joe Alton MD and Amy Alton ARNP talk about earhtquakes in general and give you safety tips that could save a life.

birthing supplies

birthing supplies

Plus, what supplies would you need for delivering a baby and caring for a pregnancy in tough times? Nurse Amy put on her Expert Council hat from Jack Spirko’s Survival Podcast to answer a listener’s question. In addition, one of our readers sends us an entertaining story about her son’s hornet sting and some natural remedies she uses for her allergy-prone family.

Direct Pressure on Bleeding Wound

Bleeding wound

Lastly, is it time to add a 4th R to Reading, ‘Riting, ‘Rithmetic in school curriculums? Should Reduce hemorrhage classes be talk in view of the risk of injury during natural disasters, shooter events, even car crashes? Sounds crazy, but would it save a life?

All this and more in the latest episode of The Survival Medicine Hour with Joe and Amy Alton, aka Dr. Bones and Nurse Amy! To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/09/22/survival-medicine-hour-earthquakes-first-aid-hornets-birthing-supplies

 

BTW, you can follow us at twitter @preppershow, YouTube at DrBones NurseAmy channel, and Facebook at our Doom and Bloom page or our survival medicine group “survival medicine dr bones nurse amy”

Thanks!

Don’t forget to check our medical kits and supplies at store.doomandbloom.net, plus our latest edition of The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, available at Amazon and on this website.

The Survival medicine handbook Third Edition 2016

The Survival Medicine Handbook Third Edition

Earthquake Safety: What You Need To Know

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EARTHQUAKE SAFETY

Scene from 1985 earthquake that killed 10000

Scene from 1985 earthquake that killed 10000

A 7.1 magnitude earthquake struck Mexico City on Tuesday, September 19, collapsing buildings, killing at least 250, and injuring hundreds more throughout the region.  The latest tremor event came hard on the heels of an 8.1 magnitude quake off the coast just 2 weeks ago, which killed almost 100 and even generated a small tsunami wave. Various aftershocks measuring up to 4.9 have been recorded since Tuesday’s quake hit at 1 pm local time.

Although there is no “season” for earthquakes like there is for hurricanes, yesterday’s tremors occurred on the exact date that a 1985 event killed close to 10,000 Mexicans in the capitol.

The United States, especially (but not exclusively) the West Coast, is also susceptible to natural disasters like earthquakes. Indeed, just a few days ago, citizens in Los Angeles experienced 3.6 magnitude tremors, but no deaths or major damage was reported.

FAULT LINES AND MAGNITUDE SCALES

The West Coast and some areas of the Midwest are located over what we call “fault lines“.  A fault is a fracture in a volume of base rock in the earth’s crust. Mexico City itself is not located on a fault line, but sits on an old lake bed that amplifies nearby tremors. This disrupts buildings that were constructed on the surface, making them prone to collapse.

Earthquakes have been blamed on climate change by some, but the movement of the earth’s plates occurs miles below the surface. This shifting releases a tremendous amount of energy, sometimes referred to as a “seismic wave”.

The strength of the Mexican earthquakes have measured using something called the “Richter scale“.  This measurement (from 0-10 or, theoretically, more) identifies the magnitude of tremors at a certain location.  Quakes less than 2.0 on the Richter scale are common occurrences unlikely to be noticed by the average person. Each increase of 1.0 magnitude, however, increases the strength by a factor of 10. The highest-intensity earthquake ever recorded was The Great Chilean Earthquake of 1960 (9.5 on the Richter scale).

Most people have heard of the Richter Scale and assume that all earthquakes are measured using it. However, a newer measurement, the Moment Magnitude scale, is thought to be more accurate for higher intensity quakes. The Moment Magnitude scale calculates each point of magnitude as releasing more than 30 times the energy of the previous one.

If the fault lines shift offshore, a “tsunami” or tidal wave may be generated.  In Fukushima, the 2011 earthquake (8.9 magnitude) spawned a large tsunami which caused major damage, loss of life, and meltdowns in local nuclear reactors. Tsunami warning were issued for both the Japanese and Ecuadorian earthquakes reported this week. The tsunami generated by the quake 2 weeks ago off the coast of Mexico was only 2.3 feet, however.

AN EARTHQUAKE SURVIVAL PLAN

A major earthquake is especially dangerous due to its unpredictability. Although researchers are working to find ways to determine when a quake will hit, there is usually little warning. This fact makes having a plan of action (before an earthquake hits) a major factor in your chances of survival.

This plan of action has to be shared with each family member, even the children. It’s unlikely that a disaster will occur at the moment that the entire clan is together. Unless the earthquake happens in the dead of night, it’s unlikely everyone will be together in the house. You might be at work, your spouse at home, and the kids at school. An important part of an earthquake survival plan is making everyone aware of where to meet. It could be your home, or perhaps more sturdy public buildings like a school or office building that might be earthquake-resistant. In any case, knowing where to meet in the event of (really, any) disaster will give you the best chance of gathering your family and surviving together.

EARTHQUAKE SUPPLIES

Grab and Go Deluxe First Aid Trauma Kit

Have a good medical kit

To be prepared, you’ll need, at the very least, the following supplies:

  • Food and water (including water filters like the LifeStraw, Mini-Sawyer, and Katadyn)
  • Power sources like batteries, solar rechargers, and generators
  • Medical supplies and medicines
  • Tents, sleeping bags, and other camping equipment
  • Clothing appropriate to the weather
  • Fire extinguishers
  • A tool kit, including  an adjustable wrench to turn off gas, water, etc.
  • Means of communication like cell phones, walkie-talkies, radios
  • Cash! (don’t count on credit or debit cards if the power’s down)
  • Copies of important documents, including insurance policies

(these supplies are discussed in detail in the latest edition of The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way.

In areas at risk for earthquakes, the school system and municipal authorities usually have formulated a disaster plan. They may even have designated a quake-proof shelter; this may be the best place to go. Make certain to inquire about your town’s precautions in case of a seismic event.

Besides the general supplies listed above, it would be wise to put together a separate “get-home” bag to keep at work or in the car.  Nonperishable food, liquids, and a pair of sturdy, comfortable shoes are useful items to include in this kit.

HOME EARTHQUAKE SAFETY

In the home, it’s important to know where your gas, electric, and water main shutoffs are.  Make sure that everyone of age knows how to turn them off if there is a leak or electrical short.  Know where the nearest medical facility is, but be aware that you may be on your own; medical responders are going to be overwhelmed and may not get to you quickly. In addition, roads may be impassible due to damage or traffic snarls.

chandelier

Something you shouldn’t stand under during an earthquake

A good look around your house might identify fixtures like chandeliers and bookcases too unstable to withstand an earthquake. Examine cabinets for heavy objects on high shelves, and replace them to bottom shelves where they will help with stabilization.

In the family room, flat screen TVs, especially large ones, could easily topple.  Be sure to check out kitchen and pantry shelves for glass objects or pots and pans that could topple. In the bedroom, check the stability of anything that might be hanging over the headboard of your bed and could fall on you as a result of a nighttime quake.

WHEN THE EARTHQUAKE HITS

drop cover hold

3 words to remember when an earthquake hits

What should you do when the tremors start?  When things start shaking, you’ll have to keep a cool head and, if indoors, get under a table, desk, or something else solid and hold on. Cover may protect you from falling objects. This strategy is called “Drop, Cover, Hold“. If hard cover isn’t available, even a mattress could serve as a shield. If no cover is available at all, considering heading to the corner of an inside wall.

Of course, you might choose to run out of the building. You’re more stable, however, on your knees than standing or running, so get down to prevent a fall from causing injuries. While the building is shaking, don’t try to run out (especially if you’re on an upper floor); you could easily fall down stairs or get hit by falling debris.  Don’t try to use elevators. You should stay clear of windows, shelves, and kitchen areas.

It’s often taught that you should stand in the doorway because of the frame’s sturdiness. It turns out, however, that in modern homes, doorways aren’t much more solid than any other part of the structure. Even if it were, you could still get hit by falling objects.

Once the initial tremors are over, go outside.  Once there, stay as far out in the open as possible, away from power lines, chimneys, walls, and anything else that could fall on top of you.

IN YOUR CAR

You could, possibly, be in your automobile when the earthquake hits.  Get out of traffic as quickly as possible; other drivers are likely to be less level-headed than you are. Don’t stop your car under bridges, trees, overpasses, power lines, or light posts. They’re likely to topple in a major quake. Stay in your vehicle while the tremors are active; turn on the radio to find out more about the event.

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AFTER THE EARTHQUAKE

Even after the tremors stop, there are still dangers. Gas leaks are one issue to be concerned about; make sure you don’t use your camp stoves, lighters, or even matches until you’re certain all is clear (and, certainly, never inside). Even a match could ignite a spark that could lead to an explosion.  If you turned the gas off, you might consider letting the utility company turn it back on.

Buildings that have structural damage may be unstable or have loose concrete which could rain down on the unsuspecting. Falling stone from damaged buildings killed rescuers in the Oklahoma City bombing and the World Trade Towers collapse.

Power may be down, and many will be tempted to use generators. It’s important that generators are used, not just outside, but well away from the interior of the home. A family of four in Florida after Hurricane Irma was hospitalized when a generator was used outside but too closely to the home’s entrance.

Don’t count on telephone service after a natural disaster.  Telephone companies only have enough lines to deal with 20% of total call volume at any one time.  It’s likely a much higher percentage of lines will be occupied after a disaster.  Interestingly, this doesn’t seem to apply to texts; you’ll have a better chance to communicate by texting than by voice due to the wavelength used.

That cell phone will also come in handy if you’re trapped under rubble after an earthquake. Voice calls or texts might alert rescue personnel to your plight. If you live in quake country, you might consider a whistle on your keychain. It’s loud and will last longer than your voice as a signal for help. Don’t give up if help doesn’t arrive immediately; people can live several days without water, and much longer without food. With any luck, rescuers will find you.

Even if you have been injured, your house, even if  earthquake-resistant, will probably require some cleanup. Remember to wear sturdy shoes, work gloves, and protective goggles while you’re picking up after the quake. Enter damaged buildings at your own risk, and look before your step.

Joe Alton, MD

Joe Alton MD

Joe Alton MD

Find out more about infectious disease and much more with the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And don’t forget to fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net.

The Survival medicine handbook Third Edition 2016

The Survival Medicine Handbook Third Edition

7 Serious Infections from Contaminated Food and Water

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7 Serious Infections from Contaminated Food and Water

Just Hanging Out (and I mean just hanging out)

Just Hanging Out (and I mean just hanging out)

 

Recently, I watched a few episodes of “Naked and Afraid“, a series that puts two individuals in extreme environments with few supplies and, for some reason, no clothes. In this program, many of the participants come down with various infections; some of which cause bowel disturbances. Life then becomes, well, even more miserable than walking around for three weeks naked in the jungle.

Epidemics characterized by diarrhea and dehydration have been a part of the human experience since before recorded history. Cholera is an example of one particularly dangerous infection that was epidemic in the past. It and other bacterial diseases, many of which are now rare, may once again become a problem in the uncertain future.

Off the grid, water quality is questionable and may lead to misfortune if not properly purified. Using bad water to cook food in a remote setting can also lead to major problems that manifest as diarrhea, and later, dehydration. When dehydration is not treated, deaths may occur.

typical bacteria

typical bacteria

Many diseases with diarrhea as the main symptom are caused by poor sanitation. These including the following:

Cholera: Caused by CTX, a toxin produced by the marine and freshwater bacterium Vibrio cholera. Cholera toxins produce a rapid onset of diarrhea and vomiting within a few hours to 2 days of infection. This was a major issue in Haiti after the earthquake there several years ago.

The diarrhea caused by cholera looks like water after rice has been cooked in it. In addition, victims complain of nausea, leg cramps, and other symptoms. The body water loss with cholera is so severe that it is associated with a sixty per cent death rate if untreated. Aggressive efforts to rehydrate the patient, however, drops the death rate to only one per cent. Antibiotic therapy with doxycycline or tetracycline seems to shorten the duration of illness.

typhus rash (brittanica.com)

typhus rash (brittanica.com)

Typhoid (and Typhus): Salmonella typhi is a bacterium of the Enterobacteriaceae family that is found in contaminated and undercooked food. The illness it causes is called “typh-oid fever” because it often confused with Typhus.

Typhus is a complex of diseases caused by bacteria in the Rickettsia family that is transmitted, not by contaminated food and water, but by fleas and ticks in unsanitary surroundings. Although it rarely causes severe diarrhea, Typhus can cause severe dehydration due to high fevers and other flu-like symptoms. Five to nine days after infection, a rash begins on the torso and spreads to the extremities, sparing the face, palm, and soles. Doxycycline is the drug of choice for this disease.

Typhoid rash

Typhoid rash (emergencymedicinecases.com)

Contamination with Salmonella in food (leading to typhoid fever) occurs more often than with any other bacteria in the United States, with a major outbreak in turkey meat causing more than 100 hospitalizations in 2011. In Typhoid fever, there is a gradual onset of high fevers over the course of several days. Abdominal pain, intestinal hemorrhage, weakness, headaches, and bloody diarrhea may occur. A number of people develop a spotty, rose-colored rash, hence the confusion with typhus. Ciprofloxacin  is the antibiotic of choice, but most victims improve just with rehydration therapy.

Dysentery: Caused by a number of different pathogens (disease-causing organisms), dysentery is an inflammation of the large intestine that presents with fever, abdominal pain, and severe bloody or watery diarrhea. Symptoms usually begin one to three days after exposure. Dysentery was a major cause of death among Civil War soldiers. It is a classic example of a disease that can be simply prevented with strict hand hygiene after bowel movements.

civil war hospital

civil war hospital

The most common form of dysentery in North America and Europe is caused by the bacteria Shigella and is called “bacillary dysentery”.  It is spread through contaminated food and water in crowded unsanitary conditions. Ciprofloxacin and Sulfa drugs, in conjunction with oral rehydration, are effective therapies.

Another type of dysentery is caused by an organism you may have read about in science class: the amoeba, a protozoan known as Entamoeba histolytica. Amoebic dysentery is more commonly seen in warmer climates. Metronidazole is the antibiotic of choice.

Traveler’s Diarrhea: An inflammation of the small intestine most commonly caused by the Bacterium Escherichia coli, commonly known as E. coli. Most strains of this bacteria are normal inhabitants of the human intestinal tract, but one (E. coli O157:H7) produces a toxin (the “Shiga” toxin) that can cause severe food poisoning. The Shiga toxin is so potentially dangerous that it has been classified as a bioterror agent.

In this illness, sudden onset of watery diarrhea, often with blood, develops within one to three days of exposure accompanied by fever, gas, and abdominal cramping. Rapid rehydration and treatment with antibiotics such as Azithromycin and Ciprofloxacin is helpful. The CDC no longer recommends taking antibiotics in advance of a journey, however, but does suggest that Pepto-Bismol or Kaopectate (Bismuth Subsalicylate), two tablets four times a day, may decrease the likelihood of Traveler’s Diarrhea.

Campylobacter: The second most common cause of foodborne illness in the U.S. after Salmonella, this bacterium resides in the intestinal tract of chickens and causes sickness when meat is undercooked or improperly processed. It’s thought that a significant percentage of retail poultry products contain colonies of one particular variety, Campylobacter jejuni. Symptoms include bloody diarrhea, fever, nausea, and cramping which begins two to five days after exposure. Although controversial, Erythromycin may decrease the duration of illness if taken early.

Trichinosis: Trichinosis is Caused by the parasitic roundworm Trichinella in undercooked meat, mostly from domesticated pigs. Trichinosis causes diarrhea and other intestinal symptoms one to two days after exposure. Fever, headache, itchiness, muscle pains, and swelling around the eyes occur as much as 2 weeks later. Recovery is usually slow, even with treatment with the anti-helminthic drugs Mebendazole and Albendazole (Albenza).

beautiful but could harbor giardia

beautiful, but could harbor giardia

Giardiasis: The most common disease-causing parasite in the world is the protozoa Giardia lamblia. It has even been found in backcountry waters in many national parks in the U.S. Symptoms may present as early as one day after exposure, although it more commonly presents in one to two weeks. Patients complain of watery diarrhea, abdominal cramping, violent (often called “projectile”) vomiting, and gas. Metronidazole is the drug of choice in conjunction with oral rehydration.

There are many other pathogens that can cause diarrheal disease and dehydration if untreated. Although we have listed antibiotics in this article (many of which you can read about in this website), most of the above will resolve on their own over time with strict attention to oral (or intravenous) rehydration. Without hydration support, however, the situation may become life-threatening in some cases.

An important point is that some of these illnesses may be mimicked by viruses that are unaffected by antibiotics, such as norovirus, so employ them only when absolutely necessary. The U.S. is in the midst of an epidemic of antibiotic resistance that is partly due to overuse in humans. You might be surprised when I say “partly”; close to 80% of antibiotics in the U.S. are given, not to humans, but to food-producing livestock.

recipients of most antibiotics

recipients of most antibiotics

If you see post-apocalyptic disaster movies, you’ll see a lot of gunfights at the OK corral. Certainly, this may occur in the aftermath of a major catastrophe. The most deaths will occur, however, due to failure to assure that water is clean, food is prepared properly, and human waste is safely disposed. The medic for a survival group must understand this and enforce good sanitary practices. If he/she is successful, the group will have a better chance of staying healthy even in the worst of situations.

Joe Alton MD

Joe Alton MD

Joe Alton MD

 

Find out more about infectious disease and much more with the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And don’t forget to fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net.

a small first aid kit with items shown such as a tourniquet, gauze, mini compression dressings, ace, scissors and more

Motorcycle and hiking first aid kit

How to Handle Dental Emergencies In Survival Situations

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Video: How To Apply A SOFT-T Tourniquet

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Direct Pressure on Bleeding Wound

Bleeding wound

The Special Operations Forces Tactical Tourniquet (SOFT-T) is one of the most popular tourniquets made, with many selecting it as their item of choice to control severe extremity bleeding. The SOFT-T is reliable, sturdy, and easy to apply, especially when only one hand is available to the casualty. The US Army Institute of Surgical Research reports a 100% effectiveness rate in stopping hemorrhage.

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Tourniquets like the SOFT-T are used in a life-threatening situation, and its ease of application is a major advantage when no time is available for training purposes. Having said that, it’s important to become acquainted with the use of every item in your medical kit.

The SOFT-T particularly shines during transport, with a screw that that can be fastened to prevent accidental release during the jostling that can occur during evacuation to a modern medical facility or, in a survival scenario, to your sick room or hospital tent.

Here’s Nurse Amy to show you the method of application of the SOFT-T.

For 10 critical principles of tourniquet use, check out her video on the subject here:

<iframe width=”560″ height=”315″ src=”https://www.youtube.com/embed/1zI5j5a1VL8″ frameborder=”0″ allowfullscreen></iframe>

Wishing you the best of health in good times or bad,

Amy and Joe Alton

Dr. Bones and Nurse Amy

 

For a review of several popular tourniquets (and much more), check out the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And don’t forget to fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net. You’ll be glad you did.

Just some of our kits and supplies

Just some of our kits and supplies

Learn how to stop bleeding in emergencies

Hurricane Preparedness Tips: What You Need To Know

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hurricane image by pixabay

hurricane image by pixabay

Hurricane Irma, already a powerful storm, is steaming its way towards the Caribbean and the U.S. East Coast. With Texas and Louisiana still reeling in the aftermath of Hurricane Harvey, it’s just one more reason to always be prepared for disasters.

 

You only have to read the news to know that hurricanes are dangerous, but they don’t have to be life-threatening for those who prepare.  Unlike tornadoes, which can pop up suddenly, hurricanes are first identified when they are hundreds, if not thousands of miles away.  We can watch their development and have a good idea of how bad the situation might become and how much time we have to get ready.

 

Even before it’s clear that your area is in danger of being hit by the storm, you should have considered factors like food, water, power, and shelter. Here are a few (actually, 28!) tips to help those preparing for the worst, while hoping for the best:

 

GETTING OUT OF DODGE

hurricane winds

hurricane winds

Make a G.O.O.D. (Get Out Of Dodge) decision: Rugged individualists may want to ride out the storm, but as we learned from Harvey, coastal residents would be best served by hitting the road. When the authorities say it’s time to evacuate, you should be ready to go. Don’t forget to turn off the power, gas, and water before you leave.

 

Head Inland: Hurricanes gain their strength over warm ocean waters, and lose strength quickly as they get further into the interior. Therefore, the further inland you go, the safer you’ll be.

 

Have a “GO” bag: Always have a set of supplies ready to take with you on short notice. Non-perishable food, bottled water, extra clothing, flashlights and batteries, a NOAA weather radio, medicines, and a first aid kit are just a few of the items you should have ready at all times.

 

(you might see recommendations online to have a 72-hour supply, but this figure is arbitrary. A week’s worth would be even better.)

 

Have a portable cell phone charger: Communication is important, so have a car charger or other mobile method to power up the phone. Consider a small solar charger kit, like Goal Zero Venture 30 Solar Recharging Kit.

 

Have cash on hand: One power shortage you don’t want to experience is the loss of purchasing power. Power for credit card verification could be down after a hurricane; keep some cash on hand. Have small bills to prevent needing cash back that the store may not have available.

 

Let’s say you haven’t received an evacuation order, and you’re going to ride out the storm in place. Here are some considerations you want to take into account:

 

SHELTER

tent

Not a good choice for a hurricane shelter

Without shelter, you’re at greater risk for a bad outcome in a hurricane. If you can’t leave the area, find a sturdy haven from the storm. Most buildings are required to withstand at least 90 mph winds (125 mph in South Florida), but for the strongest hurricanes, it’s best to find the nearest municipal shelter. f there isn’t time, most coastal municipalities will have designated a sturdy building as a hurricane shelter.

 

Put Up The Shutters:  If you have hurricane shutters, put them up at least 24 hours before hurricane landfall. It’s no fun to have to stand on a ladder in gale force winds and pouring rain to install them. Been there, done that.

 

Move Furniture/Plants Inside: Move the patio furniture and potted plants indoors. If you can’t, chain them together against an outer wall downwind from the direction of the storm.

 

Prune Trees: Prune all trees near your home so that wind can easily flow through the crowns. Otherwise, expect some to be downed by the storm. Branches, fruit (in South Florida, coconuts!), and other debris can act as missiles in high winds.

 

Pick a “Safe Room”: If you have a basement, good for you. If not, choose a room in the interior of the home, preferably one without windows. Get the storm supplies into this area for safe keeping. Put a sharp axe in this room in case you must get out through the roof in a severe flooding.

 

Place candles in pans: Candles are handy, but they can be knocked over by winds and cause fires. If you must use them, stick them in a pan with shiny sides that would be deep enough to cover the flame.

 

Have Tarps at the Ready: Large tarps can be used to cover windows and, after the storm, to cover any areas of the roof that might have been damaged. Keep extra rolls of plastic sheeting and duct tape to secure broken windows or doors.

 

Come to the local municipal shelter with a full stomach, blankets, and a favorite pillow: Meals and other comforts may be limited in supply. Supplies for that infant or toddler, like diapers and formula, will likely be scarce. Also, inquire as to whether the county shelter accepts and has supplies for pets.

 

FOOD

Keep food cold

Keep food cold

 

Keep it Cold: Have the refrigerator and freezer down to their coldest settings so that food will stay fresh longer. Go shopping as early as possible and get non-perishable food items as staples for long-term.

 

Collect Ice: Collect ice in plastic bags or empty plastic containers and place them among refrigerated foods to prolong freshness. Empty plastic soda bottles/milk jugs will do in a pinch. The fuller the fridge is with ice, the longer the items in it will stay cool.

 

Wrap It in Foil: Wrap food items in aluminum foil, eliminating air pockets, and cram the foil packs together as closely as possible.

 

Cook ‘Em and Freeze ‘Em: Cook meats before the hurricane gets close and freeze them. As cooking requires fuel, have some full propane tanks or charcoal briquettes in your supplies for when the power goes out.

 

Eat the Perishables Now: Eat the perishable food first, canned foods later. Make sure to have a manual can opener, paper plates, cups and plastic utensils. Have a plan so you can cook food and boil water after the storm and the electricity is out. Fuel (as mentioned above), a small portable stove or grill and appropriate pans will be needed.

 

Keep It Closed: Don’t leave the refrigerator door open while deciding what food to take out. Visualize where a particular item is and then open the door. Close it as quickly as possible.

 

WATER

Flood waters won't be this clean

Flood waters won’t be this clean

 

Water, Water everywhere: Have a stockpile of 5-gallon bottles of water or a plentiful supply of smaller bottles. After the storm, don’t expect that flood waters will be clean enough to drink.

 

Fill the Tub: Fill all bathtubs with water. You might think this is overkill, but every member of your family needs 1 gallon of water per day. It goes fast, even faster if you use it to keep clean.

 

Drink the Melted Ice: As the ice you refrigerated in containers melts, don’t waste it. Use it as an additional source of drinking water.

 

Hot Water Heaters Hold…Water!: Hot water heaters have gallons and gallons of drinkable water; don’t hesitate to raid them if you get low. First, turn off the electricity or gas. Attach a hose to the drain valve and release the vacuum in the tank by opening a hot water faucet. There might be some sediment at the bottom that should be filtered or drained out first.

 

Purify It: Have some household bleach available to purify questionable water (like from the water heater). 12-16 drops per gallon should do the job. It takes a while, so wait 30 minutes before drinking, shaking the water container to aerate will make the water taste better.

 

Have A Water Filter: Handheld filters like the Lifestraw or Sawyer Mini, or larger ones like the Berkey can be useful to deal with cloudy water. Using a cotton cloth will help get out the dirt and debris before using the commercial filter.

 

OTHER IMPORTANT CONSIDERATIONS

 

The Kids: Have board games, toys, and books to keep the children’s minds off scary winds. If you’re evacuating, let kids bring their favorite stuffed animals, blanket, or pillow to keep them calm. Give each child their own flashlight to use.

 

Your Other Kids: Don’t forget to take into account the needs of your pets. Have food, water, and their favorite toy available, whether you leave or stay at home.

 

Your Other, Other Kid: Make sure your car is in good working order and filled with gas. Already, there’s a run on gas at South Florida gas stations in advance of Hurricane Irma. An extra supply in gas cans will be useful in case of a shortage at the pumps, and can be used to run generators (although never inside).

 

Important Documents: Place important papers like birth certificates, passports, insurance documents, and others in waterproof containers. Scan them and send them in an email to yourself and keep a few memory sticks in waterproof bags in different areas of the house, a safe and/or on yourself.

 

Keep The Radio On: A NOAA weather radio, battery-powered, solar powered or hand-cranked, will be an important source of information on the progress of the storm, and for community updates. Have solar or battery powered flashlights (and extra batteries) and lanterns (inflatable ones are very safe).

 

No Outside Selfies During The Storm! A number of preventable deaths occur during or in the early aftermath of a hurricane due to foolish choices. Flood waters, downed power lines, and high winds are just some of the ways that lives end unnecessarily.

Here is our Flood Safety Article: https://www.doomandbloom.net/13-flood-safety-tips/

flooding water in a neighborhood

Beware of flood waters

Being prepared for a hurricane can make sure that a hurricane is just a bump in the road, and not the end of the road for you and your family. Have a plan of action, get some supplies, use your common sense, and you’ll weather the storm.

Joe Alton MD

Joe Alton MD

Joe Alton MD

Find out more about disasters (natural and man-made) with the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And don’t forget to fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net.

Doom and Bloom Kits

Doom and Bloom Medical

Herbal Teas from Medicinal Gardens

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HERBAL TEAS IN AUSTERE SETTINGS

medicinal herbs

Herbal Products as Medicine

In long-term disaster settings, even prepared medics may end up using their entire supply of commercially-made medicines. As such, caregivers should consider the medicinal benefits of the plants in their own backyard as additional tools in the medical woodshed.

 

Due to their longevity, essential oils are probably some of the best natural products the medic can stockpile. Producing them, however, requires knowledge, experience, and equipment. In addition, you’ll need a lot of plant material. It takes 250 pounds of lavender flowers to make 1 kilogram of essential oil, and that’s if you have the right variety, soil conditions, weather conditions, and other factors in place.

lavender field

It takes a lot of lavender to make a little essential oil

In the long haul, a more realistic option for sustainable herbal medicines is using fresh or dried plant materials in teas. These require little more than a garden and some knowledge regarding each herb, the parts of the plant used, and the medicinal effect.

 

It should be noted that the term “tea” is incorrect: The word actually refers to various drinks made from the leaves of one species, Camellia sinensis. Indeed, green, black, white, and oolong teas are made from the same plant; only the processing differs. The proper term for a drink made by steeping herbs in hot water would be an “herbal infusion” or “tisane“. For simplicity’s sake, though, we’ll call them teas.

 

Standard teas from Camellia Sinensis, like green, black, white, and oolong, are high in antioxidants with many health benefits ascribed to them. These include heart disease, type 2 diabetes, liver dysfunction, and more.

 

Making Teas

making tea

It’s easy to make tea

Making a tea is one of the simplest ways to prepare medicinal herbs. If you can boil water, you can brew tea. You just:

 

  • Bring some water to a roiling boil in a pot or other container.
  • Crush leaves, flowers, and/or roots, depending on the plant.
  • Pour the boiled water over 1 teaspoon of herbs and let steep for about five or ten minutes.
  • Keep a cover on while steeping.
  • Place a strainer over a cup and pour (alternatively, use a tea bag or “bob”).
  • Use honey or lemon to add flavor if desired.

 

A tea doesn’t always have to be ingested to be of benefit; some may be used as an eye wash, an irrigation solution for wounds, or in cold or warm compresses.

 

There are many herbs that can be made into a tea. Although some of the information below lacks hard scientific data, these teas were used by your ancestors for their medicinal benefits:

 

Alfalfa: The seeds and leaves contain vitamins A, C, E, and K, as well as calcium, phosphorous, iron, and potassium. It has been used as a diuretic to help urine flow and for upset stomachs. There are claims that it helps arthritis pain and may lower cholesterol. Use 1 to 2 teaspoons of dried leaves, steeped in 1 cup of boiling water, for 10-20 minutes.

 

Burdock: The dried root has been used in teas to help clear acne and to treat psoriasis. Use 2 tablespoons of fresh grated root or 1 tablespoon of well-dried root in 3 cups of boiling water.

catnip

catnip

Catnip: Leaves and flowers are used to treat intestinal cramping, indigestion, diarrhea, and other stomach ailments. Also thought to treat respiratory infections like the common cold. A substance in catnip called nepetalactone is thought to produce a mild sedative effect. Use 1 teaspoon of dried leaves or 1 tablespoon of fresh leaves per cup.

 

Chamomile: A favorite tea of many, it contains the amino acid Tryptophan, which gives it a sedative and relaxing effect. As such, it may help treat anxiety and insomnia. Antioxidants in chamomile may help slow down progression of visual, kidney, and nerve damage in diabetics.  Use 2-3 teaspoons of dried flowers per cup.

 

Chicory: When supplies of coffee ran out, soldiers in the Civil War used the root of this common plant as a substitute. It lacks caffeine, though, and has more of a sedative than stimulant effect in large amounts. Chicory root has an effect against intestinal worms, and has been shown in animal studies to improve calcium absorption and bone mineral density. Scrape the bark off the root before drying; use 1 teaspoon to 1 cup of water. Tea made from leaves has a laxative effect.

 

Dandelion: You might be surprised to know that the common dandelion contains vitamins and minerals. Indeed, it’s thought to have more beta-carotene than a similar serving of carrots. Young flowers and leaves make a good tea for constipation (steep for 20 minutes). Roasting the roots produces a coffee-like drink; use 2 teaspoons dried chopped root in 1 cup of water.

echinacea

echinacea

Echinacea: Well-known to decrease the duration of colds and flus, Echinacea boosts the immune system and may have some antiviral activity. Steep 1-2 teaspoons of leaf, flower, or ½ teaspoon of root to 1 cup of boiling water

 

Elder: Elderberry flowers make a tea that is used for many upper respiratory infections such as sinusitis, colds, flus, and laryngitis. Applied in a compress, the tea may be helpful for wound healing and some skin conditions.

 

The blue or purple berries are high in antioxidants and may be made into a juice or syrup: Put two pounds of elderberries and four cups of water and bring to a boil, then simmer for a half hour. Use a fine mesh strainer to press out the juice. Sugar may be added under medium heat to make a syrup.

 

Eucalyptus: Tea made from eucalyptus leaves offers relief from asthma as well as respiratory infections, mostly by opening airways and loosening thick mucus. It may have antibacterial and antiviral effects. Steep ½ teaspoon of dried or fresh leaves in 1-2 cups of water.

 

Ginger: The underground stems, or rhizomes, of Ginger are used to treat nausea of all types from morning sickness to motion sickness. Slice one inch of the rhizome into small pieces and simmer in two cups of water on low heat for 15 minutes. Then strain. ¼ – ½ teaspoon of ginger powder is another option.

ginseng root

ginseng root

Ginseng: Both Asian and American Ginseng root can be made into herbal teas that are thought to lower blood sugar levels, a useful benefit for those with diabetes. Simmer three to six teaspoons of the root for 45 minutes in three or four cups of water, then strain.

 

Lavender: Used in aromatherapy, lavender may improve nausea and other digestive symptoms when drunk as a tea. It’s thought to decrease migraine headaches and possibly limit convulsions and muscle spasms. Use 1 tablespoon of dried herb in 1 cup of water.

 

Lemon Balm: An herb with antiviral effects, it’s a member of the mint family. A tea made from lemon balm leaves and flowers was used in the past to treat mouth, throat, and dental infections like gingivitis and herpes sores. Also thought to decrease anxiety and aid sleep. Lemon balm may help improve intestinal spasms and nausea. 1 teaspoon of dried herb or 5-6 fresh leaves to one cup of boiling water makes a fine tea.

 

Licorice: Better known as an ingredient in candy, its coating properties may help with sore throats, coughs, and heartburn. Licorice can, however, raise blood pressure and should be avoided during pregnancy. Add 1-2 teaspoons of chopped root to 2 cups of boiling water to make a decoction. Drink ½ cup at a time.

 

Passionflower: Tea made from passionflower has a beneficial effect on anxiety and may serve as a sleep aid if taken regularly. Boil 1-2 teaspoons of herb (avoid the root) in 2 cups of water for 5-10 minutes.

 

Peppermint: A long-standing herbal remedy, tea made from peppermint calms the stomach and helps Irritable Bowel Syndrome (IBS), but can worsen heartburn. The tea helps thin respiratory mucus and relieves nasal congestion. Put 1 teaspoon of dried herb or 6-8 fresh leaves over 1 cup of boiling water.

 

Rose: Rose “hips” make a tea with vitamin C, as well as calcium, selenium, zinc, manganese, and others. It boosts the immune system and is thought to be beneficial for the adrenal gland, responsible for the stress hormone cortisol. Boil 1 teaspoon of dried rose hips in water and steep for 20 minutes.

Sage leaves

Sage leaves

 

Sage: Sage leaf tea is a time-honored remedy for sore throat as well as the common cold as a tea or gargle. It may also aid digestion and decrease cramping, and may even improve memory. Steep 1 teaspoon of dried leaves in one cup of water.

 

Stinging Nettle: Stinging nettle root is thought to have benefits as a diuretic to improve urine flow, even in those with enlarged prostates. The leaves may decrease the pain of arthritis in joints. Use 1 teaspoon dried leaves in 1 cup boiling water or boil 5 grams of dried root in 2 cups of water for 5-10 minutes.

 

St. John’s Wort: One of the few herbs that has known activity against minor depression, leading it to be called “herbal Prozac”. Beware of interactions with prescription drugs, however. Pour 1 cup of boiling water over 1 teaspoon herb.

 

Thyme: Teas made from thyme will loosen thick phlegm and may help coughs. It’s known to inhibit bacteria, viruses, and fungi, including many that cause respiratory infections. Steep 1 to 2 teaspoons of fresh or dried leaves in 1 cup of water.

 

Turmeric: This herb contains curcumin, an anti-inflammatory compound that may treat Crohn’s disease and other digestive tract issues. As well, it may have beneficial effects on joint pain due to rheumatoid arthritis and other disorders.

 

Valerian: The dried roots of this plant have been utilized for centuries to deal with anxiety and insomnia. It may even decrease the frequency of seizures in patients with epilepsy. Its mild sedative effect eases pain and promotes sleep. Avoid alcohol or sedative drugs.

 

Willow Bark: The green underbark of willow trees contain salicin, the original ingredient used to produce aspirin in the late 19th century. It is especially useful for muscle aches and joint pain. Simmer 1 teaspoon of bark in 1 cup of water for 10 minutes.

 

There is much research to be done to scientifically confirm all of the effects of these plants, and there may be other benefits not mentioned or yet discovered. As well, many other plants have medicinal effects other than the ones in the list above; you might know of some yourself. The herbs above, however, are easily made into teas that can be produced even while on the move.

 

In any case, learning the use of natural substances for their medicinal benefits will make the off-grid medic an effective provider even in the most remote settings.

 

Joe Alton MD

Joe Alton MD

Joe Alton MD

 

Find out more about disasters (natural and man-made) with the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And don’t forget to fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net.

stomp supreme

The Stomp Supreme Medical Kit, ideal for large groups, camps, outfitters, and much more (available in various colors)

Survival Medicine Hour: Skin Issues, Instruments, Sterile vs. Clean

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Survival Medicine Hour #354

Keeping Instruments Clean

Keeping Instruments Clean

In this episode of the Survival Medicine Hour with Joe Alton MD and Amy Alton ARNP, aka Dr. Bones and Nurse Amy, our hosts discuss the difficulties in achieving sterility off the grid when it comes to techniques for procedures and for the proper cleaning and maintenance of important instruments. Plus, skin conditions that the medic will likely have to treat after a disaster, including contact dermatitis, psoriasis, stasis dermatitis, shingles, and much, much more.

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/08/24/survival-medicine-hour-skin-conditions-sterile-vs-clean-instruments

Wishing you the best of health in good times or bad,

Joe and Amy Alton

Amy and Joe Alton

Amy and Joe Alton

Hey, do us a huge favor and follow our YouTube channel at Drbones Nurseamy, Twitter @preppershow, and our Facebook page at Doom and Bloom ™! Also, join our survival

Fill those holes in your medical storage by checking out Nurse Amy’s entire line of medical kits and supplies at store.doomandbloom.net

Skin Problems and Their Treatments

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SKIN PROBLEMS AND TREATMENTS

Dermatitis Herpetiformis is not actually associated with herpes virus

Treating medical problems in a remote homestead or after a disaster won’t always be about gunshot wounds and broken bones.  Sometimes, little things can make people miserable and affect their ability to contribute to group efforts. Skin inflammation, called “dermatitis“, is one of the issues that a caregiver can’t ignore if the group is going to function at 100% efficiency.

This condition has various causes and varies in appearance from case to case, although most present with redness and itchiness, sometimes with swelling. You might not consider itchiness to be a problem worth the medic’s attention, but continuous scratching traumatizes the skin, your natural armor, and may lead to a type of infection called “cellulitis“ once the skin is broken. Cellulitis has nothing to do with “cellulite”.

TYPES OF DERMATITIS

skin rashes can be caused by contact with allergens

contact dermatitis

Contact dermatitis is caused by physical contact with allergy-causing substances called “allergens”. The allergen involved is so varied as to include almost everything, including:

  • laundry soap and detergents
  • Household cleaning products
  • Rubber or latex
  • Perfumes, makeup, deodorants
  • Metals, such as nickel
  • Preservatives
  • Weeds, such as poison ivy, oak or sumac

Usually, the first exposure only produces antibodies but not major skin reactions. Once antibodies exist against a certain substance, the next exposure can cause significant irritation (or worse general reactions such as anaphylaxis).

Once the allergen is identified, avoidance is the best way to prevent contact dermatitis. Corticosteroid creams and cool moist compresses are the cornerstones of treatment. Use these only until the rash is improved. Antihistamines such as Benadryl or Claritin will help relieve itching.

Atopic Dermatitis may be associated with hay fever or food allergies

Atopic Dermatitis

Atopic Dermatitis or Eczema is a chronic itchy rash that can be found in various areas at once (oftentimes, the face) that may be accompanied by hay fever or asthma. Dust mites, animal dander, and food allergies are possible causes. Atopic dermatitis sometimes flares up in cold weather.  Treatment is similar to contact dermatitis.

seborrheic dermatitis

Seborrheic dermatitis is a condition that affects areas that contain oil-rich glands called sebaceous glands. It is characterized by scaling, redness, and itching. The most common version of this is dandruff or, in infants, “cradle cap”. The area near the nose and lips is another place where you might see this type of dermatitis.

Scalp irritations caused by Seborrhea may be treated by shampoos that contain tar or pyrithione zinc (Head and Shoulders). It also can be treated by the anti-fungal ketoconazole, which supports the belief that yeast plays a part in the development of this condition.

neurodermatitis

Lichenification

Neurodermatitis is a type of dermatitis that manifests as chronic itchy and raised patches, sometimes red and sometimes just darker than normal skin. The cause is unknown, although insect bites, tight clothing, dryness, and even anxiety have been implicated as possibilities. A vicious cycle of itching and scratching leads to thick, scaly, and leathery skin called “lichenification”.

Treatment includes Antihistamines such as diphenhydramine (Benadryl) and steroid creams, especially at night when some people scratch irritated areas without knowing. Injections of corticosteroids are given into the affected area in severe cases. Anti-anxiety medications are given to those who scratch out of nervousness.

Herpes Zoster

Shingles (Herpes Zoster)

Shingles is also known as herpes zoster, and is seen in people who have previously been infected with Chicken Pox. The dormant chickenpox virus, called varicella zoster, becomes active in nerves and appears as a blistering rash with itching, burning, and pain, usually localized to the distribution of a particular nerve.

Shingles usually resolves after a very uncomfortable 2-4 weeks but may be treated with anti-viral agents, such as Acyclovir, Valtrex, or Famvir (but not by the anti-viral Tamiflu, a commonly used antiviral for influenza).

dermatitis herpetiformis is not actually associated with herpes virus

dermatitis herpetiformis

Shingles is sometimes confused with dermatitis herpetiformis, a chronic skin condition characterized by blisters that is actually not associated with herpes virus.

stasis dermatitis is associated with poor circulation

stasis dermatitis

Stasis dermatitis appears as an inflamed area caused by fluid and poor blood flow under the skin. It is commonly seen on the lower legs of individuals with varicose veins.  Rarely seen in those under 50, poor circulation is a major factor although trauma damaging the circulation may be a factor. To deal with dermatitis related to poor circulation, you may have to use support stockings and mild steroids. In normal times, varicose veins may be dealt with surgically or with other high technology. See our article on varicose veins.

what causes rosacea

rosacea

Rosacea is an extremely common condition that manifests as a reddened area on the face that is caused by swollen blood vessels, usually in fair-skinned individuals beginning in middle age. It is accompanied by spider veins, flushing, and, sometimes, a markedly red nose and an appearance like acne. It is not acne, however, and will not respond to over-the-counter acne medicine. Antibiotics are sometimes used, and Vitamin A-related medications like Accutane may help.

What does psoriasis look like?

Psoriasis

Psoriasis is a series of thickened patches of reddened skin with silvery flaking.  The most common areas affected are the elbows, knees, scalp, armpits, scalp, and lower back. An auto-immune condition, Psoriasis causes the buildup of new skin cells where the body mistakenly thinks an injury has occurred. Moisturizers as well as corticosteroids and coal tar ointments are helpful; Psoriasis responds to sunlight, so phototherapy using special lamps are used for this type of dermatitis.

Natural supplements that improve dermatitis are numerous and often involve Omega-3 fatty acids, which have an anti-inflammatory effect.  Used with evening primrose oil, it is especially effective. Chamomile cream is thought to be as potent as a mild hydrocortisone. Calendula has skin-soothing properties and may protect against contact dermatitis. Be aware that it may trigger an allergic reaction on broken skin. I’ll bet you have your own home remedies for various skin problems as well.

MEDICAL SUPPLIES FOR SKIN

Clearly, the medic will need to include some skin treatments in their medical kit. Some useful items, some with links to medical issues we’ve covered before,  include:

Hydrocortisone Cream: Various mild steroid creams are useful in decreasing inflammation in an area of the skin that is inflamed.

Clotrimazole (Lotrimin in the U.S.): Helpful in the treatment of skin yeast infections, including athlete’s foot, ringworm, and others.

What can treat athlete's foot

Athlete’s foot

Triple Antibiotic Cream: Helpful in preventing infections in areas of minor scrapes and cuts.

Insect Repellant: These are useful in preventing insect bites, which may prevent more serious medical problems such as malaria, Lyme disease, and severe allergic reactions.  Commercial products usually contain DEET. Natural products, like lemon eucalyptus, lemongrass and citronella, also serve to repel insects and can be grown in many areas.

Fels-Naptha soap: This time-honored item helps to remove toxins from poison ivy, oak, and sumac from both skin and clothes. Studies show pre-bathing with Fels-Naptha may decrease effects of these rash inducing plants.

What does poison ivy rash look like

severe poison ivy rash

Permethrin shampoos/lotions (NIX, Elemite in the U.S.):  Helpful in the treatment of lice and mite-related issues (head lice, scabies, etc.)

Sunscreen:  Often overlooked as a medical supply, sunscreen will help prevent many skin problems down the road.

Aloe Vera:  Natural product useful in treating burns. Others which may be effective include vinegar, witch hazel, diluted lavender and tea tree essential oils, etc.

Non-stick gauze dressings (e.g., Telfa brand dressing):  these dressings have a shiny non-stick surface and are especially used for burns and other raw skin areas to prevent removal of healing tissue during dressing changes.

Diphenhydramine (Benadryl in the U.S.): Useful for suppressing minor reactions to bug bites and allergy-causing agents such as hives, redness, or swelling, but can cause drowsiness. Claritin and Zyrtec are milder antihistamines, but do not usually cause severe sleepiness like Benadryl can.

Epi-Pens: A self-contained prescription injection of epinephrine (adrenaline outside the U.S.) that will improve severe allergic reactions, also referred to as anaphylactic shock.  Few physicians would deny you a supply of this important item, especially if they are aware that you are often outdoors.

Soothing rash ointment with oatmeal called Stop the sting

Colloidal Oatmeal Ointment to treat insect bites and stings.

Natural Remedies: Vinegar, witch hazel, diluted lavender and tea tree essential oils,used as a compress is calming to rashes and burns. Baking soda or an oatmeal paste or bath are both very soothing to irritated or itchy skin. Apply raw honey to open skin areas for healing and infection prevention, and cover with non-stick dressings.

Other Natural Remedies: Balms containing Arnica are useful for pain relief in many people. French green clay paste used as a pack or mask has been studied for it’s healing properties. Warm tea bags (especially Chamomile) or a tea leaves poultice, (add raw honey for extra healing) contains tannins that help calm irritated skin. Just like the French green clay, cornstarch paste can be used as a soothing pack.

Joe Alton MD

Joe Alton MD, survival medicine writer

Dr. Alton

Find out more about poisonous plants and 150 other medical topics in the survival mindset with the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And don’t forget to fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net!

motorcycle medical kit

New Biker/Hiker Kit

Survival Medicine Hour: Nuclear Blasts, Water Safety, Eclipse Eye Safety

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SURVIVAL MEDICINE HOUR #353

Solar Eclipse (via Wiki)

In this episode of the Survival Medicine Hour, Joe Alton MD, aka Dr. Bones and Amy Alton, ARNP, aka Nurse Amy discuss the types of nuclear weapons and the damage they cause in the form of shock and heat waves. Plus, the different types of radiation emitted by detonations of nuclear bombs: Alpha, Beta, Gamma, X-ray, and Neutron radiation. Also, what are the damage zones for, say, a Hiroshima type bomb and what are the chances you’ll survive?

Plus, it’s still pretty hot out and the kids will want to be at the pool, lake or beach. Here’s 12 water safety tips that can prevent a near-drowning mishap, the second most common cause of death in those 14 years old and under by injury. Find out what actually happens when you drown (hint: it’s not all screaming and thrashing around).

Prevent Drowning

Lastly, how to safely view the coming solar eclipse. Did you know that old eclipse glasses more than three years old no longer give you protection, and that homemade filters or sunglasses will not do the job?

All this and more on the latest Survival Medicine Hour with Joe and Amy Alton! To listen in, click the link below:

http://www.blogtalkradio.com/survivalmedicine/2017/08/18/survival-medicine-hour-nuclear-blasts-water-safety-eclipse-eye-safety

 

Wishing you the best of health in good times or bad,

Joe and Amy Alton

Amy and Joe Alton

Follow us: Twitter @ preppershow, Facebook at Doom and Bloom(tm), and YouTube at drbones nurseamy channel

Don’t forget to check out Nurse Amy’s entire line of medical kits and supplies at store.doomandbloom.net. You’ll be glad you did.

 

 

 

 

 

 

Shoulder Dislocations

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SHOULDER DISLOCATIONS

Anterior shoulder dislocation accounts for 95-97% of cases

Of all the joints in your body, the shoulder has the greatest range of motion. This flexibility comes at the cost of low joint stability. 50% of all major joint dislocations seen in U.S. emergency rooms involve the shoulder joint.

A dislocation is an injury in which a bone is pulled out of its joint by some type of trauma. Dislocations commonly occur in shoulders, fingers, and elbows, but knees, ankles, and hips may also be affected.  The joint involved looks visibly abnormal and is unusable.  Bruising and pain often accompany the injury.

If the dislocation is momentary and the bone slips back into its joint on its own, it is called a subluxation. Subluxations can be treated the same way that sprains are, using the R.I.C.E.S. method.  It should be noted that the traditional medical definition of subluxation is somewhat different from the chiropractic one.

SHOULDER ANATOMY

Detailed shoulder anatomy (wiki)

First, a short anatomy lesson. Unlike the kids’ song, there is no “shoulder bone” connected to the “arm bone”. The shoulder actually consists of three bones: the upper arm bone (known as the “humerus“), the shoulder blade or “scapula“, and the collarbone, also called the “clavicle“. The head of the humerus fits into a socket in the scapula. This socket (the “glenoid cavity“) is stabilized by ligaments, strong connective tissues that keep the humerus centered in the socket. These connective tissues, along with muscles and tendons, form a capsule that keeps the joint stable. Significant weakening of the capsule can cause the humerus to be dislocated.

The patient with a shoulder dislocation will come, usually holding their forearm for support, with complaints of pain and an arm that will appear obviously out of place. Swelling is not unusual. You might notice that the shoulder appears “lower” than on the uninjured side.

Of course, if there is medical care readily available, the patient with a shoulder dislocation should go directly to the local hospital. Indeed, some dislocations may only be reduced surgically under general anesthesia. In an off-grid setting, however, you are on your own and will probably have to correct the dislocation yourself.  This is known as performing a “reduction”.

HOW TO REDUCE SHOULDER DISLOCATIONS

Reduction is easiest to perform soon after the dislocation, before muscles spasm and the inevitable swelling occurs.  Not only does reducing the dislocation decrease the pain experienced by the victim, but it will lessen the damage to all the blood vessels and nerves that run along the line of the injury.  The faster the reduction is performed, the less likely there will be permanent damage. Unfortunately, a joint that experienced a dislocation may have a tendency to go out of place again in the future.

If help is not forthcoming, expect significant pain on the part of the patient during the actual reduction procedure. Giving some pain relievers like ibuprofen or stronger might be useful before the procedure to decrease discomfort.  Prescription muscle relaxers such as Cyclobenzaprine (Flexeril) are also helpful.

The use of traction will greatly aid your attempt to fix the problem. Traction is the act of pulling the dislocated bone away from the joint in such a fashion as to give room for it to slip back into place. This goal can be accomplished in various ways, depending on the type of dislocation.

The following procedures for reducing a shoulder dislocation are just some of the techniques used in this excellent video from Larry Mellick, MD of the Medical College of Georgia:

Method 1: Have the patient lie face down on a surface high enough that the arm (including the shoulder joint) dangles without hitting the ground. Place the patient’s arm into position slowly for the least discomfort.

Wrap a 15-20 pound weight around the forearm and wrist (again, not hitting the ground). Although they could hold the weight in their hand, this may tense the muscles, and you need them to relax. Once the muscles are relaxed enough (maybe 10 minutes or so), the arm should pop back into place.

Method 2: Have the patient lie on their back. With their elbow at a 90-degree angle, slowly rotate the arm outward with the palm facing the sky. This should be a slow movement, and pain should be a sign to slow down.

Now, raise the arm so that the hand is behind their head, as if they were scratching the back of their neck. The action is similar to a baseball pitcher about to throw a ball. Once their hand is behind their head, slowly help them reach for the opposite shoulder. This motion should move the arm back into place.

Method 3: If you are alone with your patient, place your foot against the side of the patient’s chest and apply slow traction by pulling the arm while holding the wrist with the palm facing up. This, again, must be done slowly and gradually until the arm pops back into place.

If you’re fortunate enough to have an assistant, wrap a towel or sheet around the upper chest of the patient and have the assistant pull in the opposite direction to provide counter-traction. This avoids having to use your foot for that purpose.

If these procedures are successful, pain and movement should be immediately improved, although it is normal to have some continued discomfort in the injured shoulder. Your patient may benefit from the placement of ice packs to reduce swelling and a sling to immobilize the joint while it heals.

Full recovery will take about 4-12 weeks, depending on the age and physical condition of the patient. should be noted that the dislocation itself or the reduction procedure could possibly disrupt blood vessels or nerves, leading to circulation issues as well as effects to sensation and motor function.

Orthopedic injuries will be common in any austere setting. The medic has to be ready to take the initiative when the ambulance is not on the way if full use of an injured extremity is to be recovered.

Joe Alton MD

Joe Alton MD

 

Find out more about orthopedic injuries in remote settings (and much more) with the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And don’t forget to fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net.

Grab and Go Deluxe First Aid Trauma Kit

Our Grab N Go Medical Kit

Types of Nuclear Weapons and Their Effects

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TYPES OF NUCLEAR WEAPONS AND THEIR EFFECTS

Ground Blast with Fireball

Given the fragile state of affairs on the Korean peninsula, fears of a nuclear incident are higher than at any time since the Cold War. With good reason, most people associate use of nuclear weapons with devastating outcomes. Few, however, know much about the different types and their actual effects.

(by the way, It’s pronounced “noo-clee-ar”, not “noo-cu-lar”)

TYPES OF NUCLEAR WEAPONS

Until the recent missile launches by North Korea, most people were concerned about the use of “dirty bombs“ by terrorists. A dirty bomb is not technically a nuclear weapon. It uses conventional explosives to disperse radioactive material in the general area. Usually, the effect of the explosion causes more damage and casualties than the radioactive elements.

Our concept of an “atomic bomb“ as developed by the Manhattan Project in the 1940s is one that uses “nuclear fission”. The explosion is caused by a chain reaction that splits atomic nuclei. The result is a wave of intense heat, light, pressure, and kinetic energy equaling thousands of tons (also called kilotons) of TNT. This is followed by the release of radioactive particles in a cloud that resembles a mushroom (if a ground blast). Mixed with dirt and debris, the particles fall back to Earth, contaminating crops, animals, and people. This will happen in the area of the detonation, but will also be blown elsewhere by the prevailing winds.

Atomic bombs gave way to hydrogen bombs, which are best described as “thermonuclear” weapons due to the generation of extreme heat during detonation. H-Bombs use a process known as nuclear fusion, which takes two light nuclei and forms a heavier one, using variations of hydrogen atoms called “isotopes”. This fusion process requires high temperatures and usually involves a fission reaction as discussed above to initiate. H-Bombs don’t just generate power in the kilotons; they can reach levels in the megatons (millions of tons) of TNT.

Another type of thermonuclear weapon is the “neutron bomb“, which generates much less kinetic energy and thermal damage, but much more radiation. Enhanced radiation weapons like the neutron bomb generate a fusion reaction that allows neutrons to escape the weapon with only a limited blast. Originally designed by the United States to counter massive Soviet tank formations, the neutron bomb is an example of a tactical nuclear weapon. The effect is to leave infrastructure mostly intact while wiping out human targets due to massive radiation.

Blast and Heat Waves cause more % damage than radiation in a fission bomb detonation

DAMAGE CAUSED BY A NUCLEAR ATTACK

The impact of a nuclear bomb is dependent on its “yield”, a measure of the amount of energy produced. The Hiroshima A-Bomb had a yield of 15 kilotons, while the “Tsar Bomba” detonated by the Russians in 1961 had a yield of 51 megatons (51,000 kilotons!). Most of the weapons stockpile of the U.S. and Russia consist of bombs in the 100 to 500 kiloton range, much stronger than Hiroshima and much weaker than Tsar Bomba. This is because they are meant to be fired at major cities in clusters rather than one large bomb, which would be easier to intercept than, say, 20 smaller ones.

Damage is caused by:

  • Blast effects (kinetic energy) – damage due to the explosion and resulting shock wave
  • Heat (thermal energy) – damage generated by extreme heat
  • Radiation (initially and later via fallout) – both local and, later, far-reaching
  • Electromagnetic pulses (EMPs) – disrupts telecommunications, infrastructure

You can expect a generally circular pattern of local damage, but various factors come into play besides the yield of the weapon. The altitude of the explosion, weather, wind conditions, and nearby geologic features play a role. The U.S. government estimates the distribution of damage for fission bombs to be distributed in the following manner:

  • 50% shockwave
  • 35% heat
  • 5% initial blast radiation
  • 10% fallout radiation

Hiroshima Burn Victim

(Note: I don’t have the data in front of me, but it stands to reason that H-bombs would likely cause a higher percentage of heat damage while Neutron bombs would cause more radiation damage than the above model for a standard fission bomb.)

The atom bomb dropped on Hiroshima in 1945 flattened buildings over a roughly 4 square mile area and killed 60,000 people immediately. Another 90,000-140,000 succumbed later to injuries and radiation exposure. Although this represents a total of 150,000 to 200,000 fatalities, the entire population did not perish. At the time of the explosion, there were about 350,000 people in Hiroshima, including 43,000 soldiers. This shows that, although horrific in its effects, that distance from ground zero and other factors play a role in a nuclear weapon’s lethality, as does the power of the bomb itself.

A 50 megaton H-Bomb like the Russian “Tsar Bomba“, however, would cause a much larger circle of devastation than the Hiroshima bomb, with widespread fatalities at least 20 miles from ground zero and third-degree burns 50 miles away. Windows were reported shattered from the test detonation as far away as Norway and Finland.

You might think there isn’t anything you can do in a nuclear attack, and if you’re at ground zero at the moment of detonation, you’re right. But your chances of survival, given some time, distance, and protection, may be better than you think. Well talk about’ what you can do to increase your chances of survival in future articles.

Joe Alton MD

Joe Alton MD

 

Find out more about disasters (natural and man-made) with the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And don’t forget to fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net.

Doom and Bloom(tm) Med Kits

What is Radiation from a Nuclear Blast?

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TYPES OF RADIATION FROM NUCLEAR BLASTS

radiation meter

In my last article, I discussed the various aspects of radiation sickness, but haven’t yet defined just what radiation is. The quick definition of radiation is energy given off by unstable matter in the form of rays or high-speed particles. Some basic chemistry paraphrased from the US Nuclear Regulatory Commission (US NRC): All matter, including you, is composed of atoms. Atoms are made up of various parts; the central nucleus contains minute particles called protons and neutrons, and the atom’s outer shell contains other particles called electrons. The nucleus has a positive electrical charge, while the electrons has a negative electrical charge. Neutrons are, well, neutral.  These entities work within the atom toward a stable balance by getting rid of excess atomic energy (called radioactivity). Unstable nuclei want to become stable, and may emit  energy; this emission is what we call radiation.

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All matter is composed of atoms. Atoms are made up of various parts; the nucleus contains minute particles called protons and neutrons, and the atom’s outer shell contains other particles called electrons. The nucleus carries a positive electrical charge, while the electrons carry a negative electrical charge. These forces within the atom work toward a strong, stable balance by getting rid of excess atomic energy (radioactivity). In that process, unstable nuclei may emit a quantity of energy, and this spontaneous emission is what we call radiation

Put simply, radiation is divided into “ionizing” and “non-ionizing”. We are bombarded daily by radiation from multiple non-ionizing sources: the sun’s visible light and heat, microwaves, radio waves, radar, and others. This type of radiation deposits energy in the materials through which it passes, but doesn’t break molecular bonds or destabilize atoms. These effects, however, can be caused by ionizing radiation, where the atom becomes charged and unstable, not a healthy state for living cells.

There are several types of radiation given off by a nuclear weapon: Alpha, beta, and neutron particles, and gamma and X-rays. All are caused by unstable atoms, which, in order to reach a stable state, must release energy in the form of radiation. Atoms can do this by , for example, shedding election, which causes them to become ionized.

penetration power of different radiation types (image by NRC)

Alpha radiation occurs when an atom undergoes radioactive decay, giving off an alpha particle. Due to their charge and mass, alpha particles only travel a few centimeters and don’t even penetrate the outer layer of skin. If ingested, inhaled, or somehow injected, however, alpha particles are capable of causing considerable damage to living cells.

Beta radiation takes the form of particles. Due to the smaller mass, it is able to travel further in air than an alpha particle, but can be stopped by a thick piece of plastic, a stack of paper, even clothing. It can penetrate a short distance into exposed skin, though, causing “beta burns“ which may require treatment. However, the main threat is from ingesting it, perhaps from crops growing in fallout areas.

Gamma and X-rays, unlike alpha or beta, are two types of radiation that do not consist of any particles at all, but instead, pure electromagnetic energy. Think of gamma rays as X-rays on steroids. Gamma radiation can travel much farther through air than alpha or beta particles (which have mass) and is responsible for the most ill effects on humans after a nuclear explosion. It can, however, be blocked by various materials. The thickness required for each material depends on the density; you’ll see various shielding options and thickness requirements described in our articles and videos on radiation sickness.

(Note: Examples of elements that are gamma ray emitters include iodine-131, cesium-137, cobalt-60, and radium-226.)

Lastly, Neutron radiation consists of high-speed particles with high penetrating power. Neutron particles travel further in air than other forms of radiation, but can be blocked by materials that contain hydrogen, such as water (H20) and concrete.  When neutron particles are absorbed into a stable atom, they make it unstable and more likely to emit radiation. Therefore, it’s the only type discussed here that can turn other materials radioactive.

More damage is caused by the blast and heat waves than radiation effects

Although radiation is a major issue after a nuclear blast, it should be noted that most damage from such weapons are the result of massive amounts of the energy generated by shock and heat waves. The blast kills people close to ground zero, and causes major trauma much further away. Flying debris and falling buildings account for more casualties. The heat is so intense that almost everything close to ground zero is vaporized. At a distance, the extreme heat still causes severe burns and starts firestorms.

You might think that missile defense systems will protect us, and perhaps they would if someone targeted us with one huge 50 megaton bomb. Unfortunately, what will happen is that large cities will be hit with clusters of smaller bombs, but still 10 times larger than the bombs that hit Japan in 1945. We might be able to intercept one, maybe several, incoming missiles, but all of them? I’ll let you answer that question.

 

Joe Alton MD

Dr. Alton

Find out more about survival medicine with the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And don’t forget to fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net.

Some of Nurse Amy’s Medical Kits and Supplies

Survival Medicine Hour: Survival at Sea, Pt.2, Radiation Sickness, More

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SURVIVAL MEDICINE HOUR #352

Burn victim of Hiroshima detonation

In this episode of the Survival Medicine Hour, Joe and Amy Alton, aka Dr. Bones and Nurse Amy discuss the recent saber-rattling from North Korean leader Kim Jong Un, our responses, and what to do if your area is hit by radiation from an atomic blast (or a nuclear reactor meltdown). Dr. Alton also talks about what to do if you’re lost at sea: How to get food and water, protection from the elements, and even a little about shark attacks!

Solar Still

All this and more on the Survival Medicine Hour with Joe Alton MD and Amy Alton ARNP.

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/08/11/survival-medicine-hour-survival-at-sea-pt-2-radiation-more

Wishing you the best of health in good times or bad,

Joe and Amy Alton, aka Dr. Bones and Nurse Amy

Nurse Amy and Dr. Bones

Find out more about radiation sickness, survival at sea, and 150 other medical topics with the 700-page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And don’t forget to fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net.

 

Radiation Sickness

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RADIATION SICKNESS

Radiation sickness

Many consider a nuclear attack an outlandish scenario to which only conspiracy theorists subscribe. Unfortunately, the threat of a nuclear incident, accidental or purposeful, exists, perhaps more than in recent years, due to recent developments in the Korean peninsula.

Atomic weapons can decimate a population from thermal blasts, but it also causes illness and death due to exposure from radiation. Although populated areas have experienced detonations only twice, (Hiroshima and Nagasaki in 1945), nuclear reactor meltdowns and other events have occurred from time to time since then, such as in Fukushima in 2011 and Chernobyl in 1986.

In an atomic explosion, radiation is just one of the possible causes of casualties; heat effects and kinetic energy damage near the blast will cause many deaths and injuries. Radiation released into the atmosphere, however, can have devastating effects far from “ground zero”.

A nuclear event produces “fallout”.  Fallout is the particulate matter that is thrown into the air by the explosion. It can travel hundreds (if not thousands) of miles on the prevailing winds, coating fields, livestock, and people with radioactive material.

The higher the fallout goes into the atmosphere, the farther it will travel downwind.  This material contains elements that are hazardous if inhaled or ingested, like Radioiodine, Cesium, and Strontium. Even worse, fallout is absorbed by the animals and plants that make up our food supply. In large enough amounts, it can rapidly become life-threatening. Even in small amounts, it is hazardous to your long-term health.

A nuclear power plant meltdown is usually less damaging than a nuclear blast, as the radioactive material doesn’t make it as high up in the sky as the mushroom cloud from an atomic bomb. The worst effects will be felt by those near the reactors. Lighter particles, like radioactive iodine, will travel the farthest, and are the main concern for those far from the actual explosion or meltdown. The level of exposure will depend on the distance the radioactive particles travel from the meltdown and how long it took to arrive.

RADIATION SICKNESS

The medical effects of exposure are collectively known as “radiation sickness” or “Acute Radiation Syndrome”. A certain amount of radiation exposure is tolerable over time, but your goal should be to shelter your group as much as possible.

To accomplish this goal, we should first clarify what the different terms for measuring the quantities of radiation mean.  Scientists use terms such as RADS, REMS, SIEVERTS, BECQUERELS or CURIES to describe radiation amounts. Different terms are used when describing the amount of radiation being given off by a source, the total amount of radiation that is actually absorbed by a human or animal, or the chance that a living thing will suffer health damage from exposure:

Marie and Pierre Curie

BECQUERELS/CURIES – these terms describe the amount of radiation that, say, a hunk of uranium gives off into the environment. Named after scientists who were the first to work with (and die from) radioactivity.

RADS – the amount of the radiation in the environment that is actually absorbed by a living thing.

REMS/SIEVERTS – the measurement of the risks of health damage from the radiation absorbed.

This is somewhat confusing, so, for our purposes, let’s use RADS.  A RAD (Radiation Absorbed Dose) measures the amount of radiation energy transferred to some mass of material, typically humans.

Some effects of radiation exposure (wiki commons)

An acute radiation dose (one received over a short period of time) is the most likely to cause damage.  Below is a list of the effects on humans corresponding to the amount of radiation absorbed. For comparison, assume that you absorb about 0.6 RADs per year from natural or household sources.  These are the effects of different degrees of acute radiation exposure on humans:

  • 30-70 RADS: Mild headache or nausea within several hours of exposure.  Full recovery is expected.
  • 70-150 RADS: Mild nausea and vomiting in a third of patients.  Decreased wound healing and increased susceptibility to infection. Full recovery is expected.
  • 150-300 RADS: Moderate nausea and vomiting in a majority of patients.  Fatigue and weakness in half of victims.  Infection and/or spontaneous bleeding may occur due to a weakened immune system. Medical care will be required for many, especially those with burns or wounds.  Occasional deaths at 300 RADS exposure may occur.
  • 300-500 RADS: Moderate nausea and vomiting, fatigue, and weakness in most patients.  Diarrheal stools, dehydration, loss of appetite, skin breakdown, and infection will be common.  Hair loss is visible in most over time.  At the high end of exposure, expect a 50% death rate.
  • Over 500 RADS: Spontaneous bleeding, fever, stomach and intestinal ulcers, bloody diarrhea, dehydration, low blood pressure, infections, and hair loss is anticipated  in almost all patients.  Death rates approach 100%.

The effects related to exposure may occur over time, and symptoms are often not immediate. Hair loss, for example, will become apparent at 10-14 days.  Deaths may occur weeks after the exposure.

PROTECTION AGAINST EXPOSURE TO RADIATION

radiation dosimeter

In the early going, your goal is to prevent exposures of over 100 RADS. A radiation dosimeter will be useful to gauge radiation levels and is widely available for purchase.  This item will give you an idea of your likelihood of developing radiation sickness.

There are three basic ways of decreasing the total dose of radiation:

1) Limit the time unprotected. Radiation absorbed is dependent on the length of exposure. Leave areas where high levels are detected and you are without adequate shelter.  The activity of radioactive particles decreases over time.  After 24 hours, levels usually drop to 1/10 of their previous value or less.

2) Increase the distance from the radiation. Radiation disperses over distance and effects decrease the farther away you are.

3) Provide a barrier. A shelter will decrease the level of exposure, so it is important to know how to construct one that will serve as a shield between your people and the radiation source. A dense material will give better protection that a light material.

DIFFERENT MATERIALS AS BARRIERS

Radiation burns post-Hiroshima bombing

The more material that you can use to separate yourself from fallout, the more likely you won’t suffer ill effects. Barrier effectiveness is measured as “halving thickness”. This is the thickness of a particular shield material that will reduce gamma radiation (the most dangerous kind) by one half.  When you multiply the halving thickness, you multiply your protection.

For example, the halving thickness of concrete is 2.4 inches or 6 centimeters.  A barrier of 2.4 inches of concrete will drop radiation exposure by one half.  Doubling the thickness of the barrier again (4.8 inches of concrete) drops it to one fourth (1/2 x 1/2) and tripling it (7.2 inches) will drop it to one eighth (1/2 x 1/2 x 1/2), etc.  Ten halving thicknesses (24 inches of concrete) will drop the total radiation exposure to 1/1024th that of being out in the open.

Here are the halving thicknesses of some common materials:

  • Lead:   4 inches or 1 centimeter
  • Steel: 1 inch or 2.5 centimeters
  • Concrete: 4 inches or 6 centimeters
  • Soil (packed): 6 inches or 9 centimeters
  • Water:  2 inches or 18 centimeters
  • Wood:  11 inches or 30 centimeters

 

By looking at the list above, you can see that the same protection is given with 1/6 the thickness of lead plating as that of concrete.

TREATING RADIATION SICKNESS

Eliminating external contamination with fallout “dust” is important before absorption occurs. This can be accomplished d with simple soap and water. Scrub the area gently with a clean wet sponge. Safely dispose of the sponge and dry the area thoroughly.

Internal contamination is a more difficult issue. Emergency treatment involves dealing with the symptoms.  Once the diagnosis is made, methods that may help include antibiotics to treat infections, fluids for dehydration, diuretics to flush out contaminants, and drugs to treat nausea.  In severely ill patients, stem cell transplants and multiple transfusions are indicated but will not be options in an austere setting.  This hard reality underscores the importance of having an adequate shelter to prevent excessive exposure.

Protection is available against some of the long term effects of radiation. Potassium Iodide (known by the chemical symbol KI), taken orally, can prevent radioactive Iodine from damaging the specific organ that it targets, the thyroid gland. The usual adult dose is 130 mg daily for 7-10 days or for as long as exposure is significant. For children, the dosage is 65 mg daily. KI is available in a FDA-approved commercial product called Thyrosafe.

Thyrosafe (Potassium Iodide)

Taking KI 30 minutes to 24 hours prior to a radiation exposure will prevent the eventual epidemic of thyroid cancer that will result if no treatment is given. Radiation from the 1986 Chernobyl disaster has accounted for more than 4,000 cases of thyroid cancer so far, mostly in children and adolescents. Therefore, if you only have a limited quantity of KI, treat the youngsters first.

Although there is a small amount of KI in ordinary iodized salt, not enough is present to confer any protection by ingesting it.  It would take 250 teaspoons of household iodized salt to equal one Potassium Iodide tablet.

Pets may also be at risk for long-term effects from radioactive iodine. It is recommended to consider 1/2 tablet daily for large dogs, and 1/4 tablet for small dogs and cats.

ALTERNATIVE REMEDY FOR RADIATION EXPOSURE

Don’t depend on supplies of the drug to be available after a nuclear event. Even the federal government will have little KI in reserve to give to the general population. In recent power plant meltdowns, there was little or no Potassium Iodide to be found anywhere for purchase

Betadine Solution

If you find yourself without any KI, consider this alternative:  Povidone-Iodine solution (brand name Betadine). “Paint” 8 ml of Betadine on the abdomen or forearm 2-12 hours prior to exposure and re-apply daily. Enough should be absorbed through the skin to give protection against radioactive Iodine in fallout.

Betadine as an alternative for KI

For children 3 years old or older (but under 150 lbs or 70 kg), apply 4 ml. Use 2 ml for toddlers and 1 ml for infants. This strategy should also work on animals. If you don’t have a way to measure, remember that a standard teaspoon is about 5 milliliters. Discontinue the daily treatment after 3-7 days or when Radioiodine levels have fallen to safer levels.

Be aware that those who are allergic to seafood will probably be allergic to anything containing iodine. Adverse reactions may also occur if you take medications such as diuretics and Lithium. It is also important to note that you cannot drink tincture of iodine or Betadine; it is poisonous if ingested.

Although many don’t view a nuclear event as a likely disaster scenario, it’s important to learn about all the possible issues that may impact your family in uncertain times.

Joe Alton MD

Dr. Alton

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