Survival Medicine Hour: Wilderness Safety, Snake Bite, More

Click here to view the original post.

Survival Medicine Hour #347

wilderness safety

In this episode of the The Survival Medicine Hour with Joe Alton, MD, aka Dr. Bones, and Amy Alton, ARNP, aka Nurse Amy, discusses how to make those summer outdoor outings with your family, as well as off-grid survival scenarios, safer for all involved. To make a wilderness experience memorable (in a good way), you’ll need to know what factors will make the environment friendly or not-so-friendly, with injuries as the end result. Amy and Joe tell you what you need to bring in your medical kit.

Pit vipers!

One thing you might not bring is that old snake bite kit! Dr. Bones talks about current thinking regarding the old standard, and what to do if you have a group member suffer a venomous snake bite when modern facilities are not an option.

All this and more on the latest Survival Medicine Hour with the Altons! To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/07/14/survival-medicine-hour-wilderness-safety-snake-bites-more

 

Hey, do us a huge favor and….

Follow us on: Twitter @Preppershow      Facebook at DoomandBloom(tm)     YouTube at DrBones NurseAmy     Instagram at DoomandBloomMedical

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

Joe and Amy Alton

Nurse Amy and Dr. Bones

Find out more about snake bites and 150 other medical topics in times of trouble by getting a copy of the 700 page Third Edition of The Survival Medicine Handbook, now available on Amazon! And don’t forget to get a solid medical kit from Nurse Amy’s often-imitated, never-equaled entire line of supplies at store.doomandbloom.net! You’ll be glad you did.

Snake Bites in Austere Settings

Click here to view the original post.

rattlesnake (image by wiki)

Off the grid, you will find yourself outdoors a lot, with activities like gathering wood for fuel, foraging, and hunting required to keep body and soul together. In warm weather, you just might find yourself face-to-face (or maybe face-to-ankle) with a snake.

Most snakes aren’t poisonous, but a few are, including some species common in North America. The term “poisonous snake” is probably incorrect, as venoms and poisons are not the same thing. Poisons are absorbed in the gut or through the skin, but venom must be injected into tissues or blood via fangs or a stinger. Interestingly, it’s usually not dangerous to drink snake venom unless you have a cut or sore in your mouth. Having said that, please don’t test this out at home.

Venomous snake bites have a distinct appearance due to the hollow fangs at the front of the mouth. This differs from non-venomous snakes, which have a more uniform appearance.

Since snakes are most active during the summer, most bite injuries occur then. Not every bite from a venomous snake transmits toxins to the victim, however; indeed, 25-30% of these bites will be “dry” and show little or no ill effects.  This could be due to the short duration of time the snake has its fangs in its victim or whether the snake had bitten another animal shortly beforehand. Many other snake bites are only slight “envenomations” and resolve without major intervention.

In most cases, it’s not hard to tell whether there’s venom in the bite. Snake bites containing venom tend to cause a painful burning sensation almost immediately. Swelling at the site may begin as soon as five minutes afterwards, and may travel up the affected area towards the body core.

Venomous Snakes in North America: Pit Vipers and Elapids

Many snakes have enough venom to deliver more than one bite

The two to worry about in North America are the pit vipers and the elapids. Of these, the pit vipers are responsible for the grand majority of venomous bites in the United States.

Pit vipers like rattlesnakes and water moccasins are identified by the presence of a heat-sensing “pit” organ between the eye and nostril on both sides of the head. They are, perhaps, more easily recognized by their triangular-shaped heads and slit-like eyes.  Rattlesnakes will, of course, have rattles that make noise when they’re threatened.

Pit viper bites tend to cause bruising and blisters at the site of the wound.  Numbness may be noted in the area bitten, or perhaps on the lips or face.  Some victims describe a metallic or other strange taste in their mouths. Serious bites might cause spontaneous bleeding from the nose or gums, irregular heart rhythms, or difficulty breathing.

Red touches yellow, kill a fellow…

The elapids include cobras and mambas, but the main North American representative is the colorful coral snake. Coral snakes appear very similar to their look-alike, the non-venomous king snake.  They both have red, yellow, and black bands and are commonly confused with each other. The old saying goes: “red touches yellow, kill a fellow; red touches black, venom it lacks”.  In other words, if the red band is next to the yellow band, it’s a deadly coral snake. If the red band touches the black band, it’s a non-venomous king snake. It should be noted that this old saying only applies to coral snakes in North America.

red touches black, venom it lacks…

Coral snake bites are “neurotoxic” and will cause mental and nerve issues such as twitching, confusion, and slurred speech.  Later, nerve damage may cause difficulty with swallowing and breathing, followed by total paralysis.  Luckily, only 73 coral snake bites were reported in the U.S. in 2013.

Preventing Snake Bites

Wear high tops in snake country

An ounce of prevention, they say, is worth a pound of cure.  High-top boots and long pants are always a sound strategy when hiking in the wilderness. It’s important to be aware of where you’re putting your hands and feet.  Be especially careful around areas where snakes might like to hide, such as hollow logs, under rocks, or in old shelters. Wearing sturdy work gloves would be a wise precaution if you can’t avoid these places.

If you let snakes know you’re near, they tend to leave the area. Snakes have no outer ear, so treading heavily creates ground vibrations much more easily “heard” by them than, say, shouting.

In warm weather, many snakes like to be active at night. This means that nocturnal outdoor activities are inadvisable without a good light source.

Treating a Snake Bite in Austere Settings

Pit viper bites often have bruising, sometimes blisters

The standard treatment for a venomous snake bite is “anti-venin”, also called “anti-venom”. Anti-venin is an animal or human serum with antibodies capable of neutralizing a specific biological toxin. Any hospital will have it, but in survival scenarios, this product will be a scarce commodity. If there’s no help coming, consider these steps:

  • Keep the victim calm. Stress increases blood flow, thereby endangering the patient by speeding the venom into the system.
  • Stop all movement of the injured extremity. Movement transports the venom into the circulation faster, so do your best to keep the limb still.
  • Clean the wound thoroughly to remove any venom that isn’t deep in the wound.
  • Remove rings and bracelets from an affected extremity. Swelling is likely to occur.
  • Position the extremity slightly below the level of the heart; this slows the transport of venom.
  • Wrap with clean, loose bandages further up the limb than usual. Pressure bandaging is thought to be helpful for elapid bites, but may be risky for pit viper bites, as it may cause tissue damage.In any case, keep the wrapping somewhat less tight than when dressing a sprained ankle. If it is too tight, the patient will reflexively move the limb, and spread the venom around.
  • Avoid tourniquets, which do more harm than good.
  • Draw a circle around the affected area. As time progresses, you will see the area shrink if it improves or grow if it worsens. By the way, this is a good strategy to follow for any local reaction, infection, abscess, or hematoma.

The limb should then be rested and, perhaps, immobilized with a splint or sling.  The less movement there is, the better. Keep the patient on bed rest, with the bite site lower than the heart, for 24-48 hours. This strategy also works for bites from venomous lizards, like Gila monsters.

Snake bite kits aren’t always recommended anymore

It is no longer recommended to make an incision and try to suck out the venom with your mouth.  The amount of venom removed is thought to be very little and oral bacteria could introduce an infection. Snake bite kits are available for your backpack, but are out of favor with most wilderness medical professionals. The Sawyer Extractor (a syringe with a suction cup) is modern and compact, but ineffective in eliminating more than a fraction of the venom. These methods fail, mostly, due to the speed at which the venom is absorbed by the body.

You may wonder why I haven’t suggested antibiotics as a treatment for snake bite. Interestingly, snake bites don’t cause infections as frequently as bites from cats, dogs, or humans.  As such, antibiotics are used less often.

Parting Thoughts on Snake Bite

A snake doesn’t always slither away after it bites you.  It’s likely that it still has more venom that it can inject, so move out of its territory or abolish the threat in any way you can. To many, this entails killing the snake. Even severing the head from the body may not render it harmless, however: it can reflexively bite for a period of time.

Elapids and pit vipers may respond differently to an encounter with a human. Coral snakes are not as aggressive as pit vipers and prefer fleeing to attacking.  Once they bite you, however, they tend to hold on. Rattlesnakes prefer to bite and let go quickly. Unlike elapids, though, pit vipers may be reluctant to relinquish their territory to you, so leave the area as soon as possible.

Snakes can be dangerous, but they want to avoid you as much as you want to avoid them. Keep an eye out, wear decent gear, and both you and the snake will be the happier for it.

 

Joe Alton MD

Ol’ Doc Bones

Fill those holes in your medical supplies by checking out Nurse Amy entire line of kit and individual items at store.doomandbloom.net!

 

 

Survival Medicine Hour: Wound Debridement, Shock Treatment, More

Click here to view the original post.

 

THE SURVIVAL MEDICINE HOUR #345

Wound Debridement

In this episode of The Survival Medicine Hour, Joe and Amy Alton, aka Dr. Bones and Nurse Amy, discuss the Wilderness Medical Society’s special edition on combat casualty care guidelines applied to survival settings, where they coincide and where they diverge. Also, some basics on an important part of wound care, wound debridement, the removal of dead skin from a healing open wound. Studies show that antibiotics are important to prevent and treat wound infections, but debriding dead tissue from a wound is important to aid recovery as well.

People in shock lose heat quickly

Also, more on the different types of shock, and what to do if you have to treat someone deteriorating rapidly from some of the various types. 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/2017/07/07/survival-medicine-hour-shock-wound-debridement-more

 

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

 

Joe and Amy Alton

Nurse Amy and Dr. Bones

Hey, fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and individual items at store.doomandbloom.net. You’ll be glad you did. And don’t forget, the 700 page third edition of the Survival Medicine Handbook: The Essential Guide for when Medical Help is Not on the Way is the most comprehensive book you’ll find written on medical care in times of trouble!

Wound Debridement in Survival

Click here to view the original post.

Wound Debridement in Remote Settings

Maggot debridement of open wound

Injuries in remote settings like a wilderness trail or survival homestead pose challenges to the medic not experienced in long-term wound care. Ordinarily, a system exists to evacuate victims of such injuries to modern medical facilities. In situations where that option doesn’t exist for the foreseeable future, however, the average person may be medically responsible from the point of injury to full recovery.

This is a novel (and sobering) thought for most, and the tools needed to provide regular wound care and the medications to prevent and treat infection may not be at hand. For this reason, I have spent years writing articles on the importance of antibiotics as part of a prepared individual’s medical supplies.

Although I’ve written extensively on antibiotics in survival settings, I’ve written less on wound debridement. Originating from the French “desbrider (to unbridle), debridement is the act of removing dead or foreign material in and around a wound.

Debridement was likely first discovered to be a useful medical tool in wartime, where grossly contaminated wounds were common. The horrific wounds incurred in armed conflict seemed to do better if damaged and dead tissue was aggressively removed. This tissue may be on the edges or throughout the injury. It usually appears discolored, often blackish with a foul odor, although it could also appear white.

By removing dead tissue that, by definition, will not heal, you eventually reach a level where live tissue exists. After debridement, the remaining tissue can recover in a cleaner environment or might, in certain circumstances, be a candidate for wound closure.

Why Should You Debride a Wound?

Sharp debridement

Despite the benefits of debridement, some less-trained survival medics might (understandably) be reluctant to intervene. It is important for them, therefore, to understand the detrimental effects of allowing non-viable tissue to remain in an open wound.

The first is lack of exposure. An open wound is best evaluated when all the dead tissue is removed and the amount of viable material is known.

Next is the suppression of the healing process. Tissue that is no longer viable serves as a place for bacteria to grow, especially the nasty ones that cause serious issues like gangrene. These bacteria slow the healing process in open wounds by competing with growing cells for nutrients.

Necrotic (dead) tissue also causes inflammation in nearby tissues and increases the chance of sepsis (a body-wide infection).

Finally, failure to remove non-viable tissue interferes with the ability of live tissue to naturally close an open wound (a process called granulation).

Removal of non-viable tissue by debridement and treatment with antibiotics helps a wound to heal, but either treatment alone does not give you the best chance of avoiding infection, according to studies cited in a recent issue of Wilderness and Environmental Medicine (2017; Vol. 28, #2S).

The above article referenced an evaluation of open fractures, a severe injury found in both wilderness and survival settings. The results seem to show that surgical intervention and antibiotics given within 2 hours is associated with the lowest rate of infection. When antibiotics are given on time but surgery is delayed, higher rates of infection are seen. When surgical intervention occurs on time but antibiotics are delayed, even higher rates are noted, although signs of infection may not appear for three days or so.

Wound Debridement in Survival Settings

There are various ways to debride a wound, but only the following, in my opinion, would be options in a survival scenario:

Sharp Debridement: Using a scalpel and scissors, dead tissue can be quickly removed. Some surgical skill is useful for the best results.

Mechanical Debridement: Aggressive wound irrigation helps remove debris and leads to a cleaner wound, but results aren’t as complete or as rapidly seen as with sharp debridement. Less skill is required, however, to achieve the end result.

Biological Debridement: Maggot therapy. The larvae of the green bottle fly is used to digest dead tissue and bacteria. One way to collect maggots is to place, say, a dead rat or squirrel in a bag with small holes at the bottom and hang it over a plate or pan to collect the maggots that fall out after a few days. More on maggot therapy in a forthcoming article.

Here is a video from “authority guide”‘s YouTube Channel demonstrating the technique of sharp debridement:

Your goal in debriding a wound is to have clear margins of live healthy tissue on all sides. This tissue will bleed somewhat (a sign of life!), but is unlikely to hemorrhage. Moist dressings should then be used to cover the wound and changed regularly.

Debridement takes place at modern facilities in normal times. In survival scenarios, the procedure should take place where there is good lighting (and the bulk of your medical supplies). Having an assistance to help is always a good idea. In the inexperienced, the anatomy of a deeply necrotic wound may be unclear; the medic should have a good textbook on anatomy in their survival library and learn as much as possible before a long-term disaster takes place.

Bottom line: Live tissue heals, dead tissue doesn’t. Debridement allows you to remove the dead material so the live tissue can heal.

Joe Alton MD

Joe Alton, MD

Find out more about long-term wound care in austere settings by getting a copy of our 700 page 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 by checking out Nurse Amy’s entire line of medical kits and supplies at store.doomandbloom.net.

The Survival medicine handbook Third Edition 2016

The Survival Medicine Handbook 2017 Third Edition

 

 

 

Survival Medicine Hour: Dakin’s Sol’n, Shock, HPV, Garlic

Click here to view the original post.

Survival Medicine Hour #344

Direct Pressure on Bleeding Wound

Bleeding wounds need long-term care. Are you ready?

In this episode of the Survival Medicine Hour, Joe and Amy Alton, aka Dr. Bones and Nurse Amy, tackles a number of tough topics like, what can you put in an open wound to prevent and treat infection if a disaster happens and all you have is household items? Here’s how to use bleach and baking soda to make Dakin’s solution, used for over 100 years to prevent death from infected wounds.

Also, Nurse Amy discusses the uses of garlic, it’s not just for cooking! It’s got great antibiotic properties and more…

garlic

Plus, there are a variety of types of shock, and we’re not talking about the emotional kinds. Dr. Bones discusses hypovolemic, hemorrhagic, and cardiogenic shock in this ongoing series about dealing with a life-threatening event.

Finally, Joe Alton MD answers a question for the Survival Podcast’s expert council about whether the HPV exam is worthwhile to give to preteens. Find out more about this virus and the controversy surrounding it.

All this and more on the Survival Medicine Hour! To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/06/29/survival-medicine-hour-dakins-solution-garlic-shock-hpv-more

 

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

Joe and Amy Alton

The Altons

Hey, fill those holes in your medical storage by checking out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net. You’ll be glad you did!

Dakin’s Solution for Wound Care

Click here to view the original post.

Dakin’s Solution

Dakin’s Solution by Century Pharm.

One of the challenges facing the caregiver in austere settings is how to prevent infection in open wounds. After a disaster, people may be forced to perform activities of daily survival to which they are not accustomed. Injuries may occur as a result. Infections will be more likely in areas where hygiene and sanitation are questionable; without advanced medical care, a bad outcome may be the end result.

A simple and affordable method that was used as far back as World War I may be the answer for the medic: Wound care with Dakin’s solution.

Dakin’s solution is the product of the efforts of an English chemist, Henry Drysdale Dakin, and a French surgeon named Alexis Carrel. In their search for a useful antiseptic to save the lives of wounded soldiers during WWI, they used sodium hypochlorite (household bleach) and baking soda to make a solution that had significant protective effect against infection. The chlorine in the solution had a solvent action on dead cells, which prevented the accumulation of bacteria in open wounds.

(As an aside, both sides in the war were also using chlorine in gaseous form as an anti-personnel weapon!)

Today, Dakin’s solution is still considered effective enough to be used after surgery and on chronic wounds, like bedsores, by many practitioners. It’s easily prepared and can be made stronger or milder by varying the amount of bleach used. Use it simply to clean the wound during dressing changes by pouring onto the affected area, or to moisten dressings used in an open wound.

Dakin’s Solution Recipe

pan with lid (image by pixabay)

To make Dakin’s solution, you’ll need just a few items. This recipe is from Ohio State University’s Department of Inpatient Nursing:

  • Unscented household bleach (sodium hypochlorite solution 5.25%, avoid more concentrated versions).
  • Baking soda (sodium bicarbonate)
  • A pan with a lid
  • Sterile measuring cup and spoon (sterilize by boiling)
  • Sterile canning jar and lid

Of course, wash your hands beforehand, just as you would with any medical procedure. Then:

1. Put 4 cups (32 ounces) of water into the pan and cover with the lid.

2. Boil the water for 15 minutes with the lid on.

3. Remove from the heat source.

4. Use the sterile spoon to add ½ teaspoon of baking soda to the water.

5. Add bleach (sodium hypochlorite 5.25%) in the amount needed (see below).

6. Pour into sterile canning jar and close with a sterile lid.

7.  Label and store in a dark place.

The amount of sodium hypochlorite to add:

Full Strength  (0.5%):       95 ml (about 3 oz. or 6 tablespoons)

Half Strength (0.25%):     48 ml (3 tablespoons plus ½ teaspoon)

!/4 Strength   (0.125%):    24 ml (1 tablespoon plus 2 teaspoons)

1/8 Strength  (0.0625%):  12 ml (2 ½ teaspoons)

Note: 3 teaspoons = 1 tablespoon = 14.7 ml; 2 tablespoons = 1 US ounce = 29.5 ml

Once canned, it’s been said that Dakin’s solution will remain potent for about 30 days. For survival purposes, however, I would make it as I need it for wounds or maybe have just make just a few jars at a time. Once open, discard the remainder after a day or so. You may also consider Century Pharmaceutical’s buffered version of Dakin’s that is thought to last about a year.

Using Dakin’s Solution on Wounds

dressing an open wound

Pour into wound once daily for mildly infected wounds, twice daily for heavily infected wounds with drainage of pus. Alternatively, moisten (not soak) dressings used inside the wound (not on top of the skin) with a mild strength solution and observe progress. I would prefer using it as a cleanser as opposed to a regular component of a wet dressing. Some studies show that use in this manner may be injurious to developing cells. Having said that, if you’re dealing with a severe infection (as opposed to preventing one), it may be reasonable to incorporate Dakin’s into the dressing.

Dakin’s solution can be used as a mouthwash for infections inside the oral cavity, but must never be swallowed. Swish for about a minute before spitting it out no more than twice a week.

Full strength may irritate skin, so consider protecting skin edges with petroleum jelly or other skin protectant/moisture barrier. Look for evidence of skin rashes, burning, itching, hives, or blisters. If irritation occurs, drop down to a milder strength or discontinue. Do not use in those allergic to Chlorine.

It should be noted that not all practitioners agree about the benefits of Dakin’s solution. Certainly, there may be other options with regards to regular wound care, including sterile normal saline and sterilized tap water. Antibiotics also play an important role in treating infected wounds, and a good supply is important for any medic in a remote setting. However, Dakin’s is well tolerated by patients and is simple to make with affordable ingredients. It’s another tool in the medical woodshed for scenarios where modern medical help is not on the way.

Joe Alton MD

Joe Alton MD

Learn about wound infections and 150 more medical topic in remote or disaster settings by getting a copy of our 700 page third edition of The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way.

Benadryl as a Local Anesthetic in Survival?

Click here to view the original post.

Benadryl as a Local Anesthetic in Survival?

diphenhydramine (Benadryl)

A major obstacle in the ability of the survival medic to deal with the issue of wound closure is the lack of an easily available (and stockpile-able) form of anesthesia. With the most popular local anesthetic, lidocaine, a prescription item, it may be difficult to obtain enough to adequately fill the need in long-term disaster scenarios.

We often mention in our podcast that we learn as much (really, more) from our readers and listeners than they do from us. Now, we are informed that diphenhydramine (Benadryl) may serve, in its injectable form, as a reasonable alternative for local anesthesia.

You won’t find this information at drugs.com or other general medical information sites. Ordinarily, you’ll read that diphyenhydramine (DPH) is an antihistamine that reduces the effects of natural chemical histamine in the body. Diphenhydramine is used to treat sneezing, runny nose, itching, watery eyes, rashes, and some cold or allergy symptoms. It also serves as a remedy for motion sickness, a hypnotic (sleep-inducer), and even to treat certain aspects of Parkinson’s disease.

Benadryl comes in oral form as well as an injectable solution. Although controversial, the injectable has been used as a local anesthetic since 1956. It has been used in minor skin, dental, and podiatric procedures, especially in those allergic to lidocaine. This comment from a pharmacist’s emergency medicine blog:

“In one validation study for its use as a dermal anesthetic, a prospective, randomized, double-blind, placebo-controlled study was conducted to assess both the degree of anesthesia (in square millimeters) and pain associated with injection in 24 subjects who received 0.5-mL injections of 1% DPH, 2% DPH, 1% lidocaine, and 0.9% sodium chloride placebo. Subjects who received 1% DPH achieved equivalent level of anesthesia relative to 1% lidocaine (p = 0.889); in addition, 1% DPH more effective in this outcome compared to 2% DPH. However, subjects did experience greater perception of pain at injection with both concentrations of DPH relative to 1% lidocaine (more pain perceived with 2% DPH), with some subjects experiencing persistent discomfort in the injected area for up to three days following injection. In another study evaluating other concentrations of  DPH for local anesthesia, although a concentration of 0.5% DPH was deemed similar in perception of pain by patients upon injection compared to 1% lidocaine and a viable alternative to 1% lidocaine in maintaining local anesthesia, it was less effective than lidocaine when used for repairing minor skin lacerations in the face. In other head-to-head comparisons of 1% DPH and 1% lidocaine, similar levels and depths of local anesthesia were achieved.”

Like all drugs, there are possible adverse effects. The use of DPH as a local anesthetic may be associated with local necrosis (tissue death) at the site of injection. This usually occurs from the use of excessively high concentrations of the medication. As such, you will see it contraindicated as a local anesthetic on most medical websites. At normal dosages, sedation may be noticed, as well as local soreness. Be aware that it might burn as it is administered and that its safety is not confirmed in distal areas like fingers, toes, ears, and nose.

Injecting local anesthetic

The recipe is as follows, again from our pharmacist’s blog:

“Steps:

Draw up entire contents of vial containing 50 mg/mL diphenhydramine into the syringe. This should measure to a volume of 1 mL.

Dilute the contents of the syringe with 4 mL of 0.9% sodium chloride to yield a final volume of 5 mL.

Clearly label the contents of the syringe with the medication label as “Diphenhydramine 1% (10 mg/mL).”

Usually, the appropriate effect can be achieved with 2 ml or so of the injectable Benadryl. Use as little as possible to achieve the desired effect.

From the standpoint of availability, I was able to order the product as a private citizen (as opposed to a physician) from at least one veterinary website. That doesn’t mean that it is widely available, however.

The survival medic’s job is a difficult one. Searching for additional tools in the medical woodshed isn’t easy, but necessary if the medic is to be effective in an austere off-grid setting. Of course, in normal times, seek modern and standard medical care from qualified professionals.

 

Some additional support from conventional medical journals for the anesthetic effect of diphenhydramine:

Green SM, Rothrock SG, Gorchynski J: Validation of diphenhydramine as a dermal local anesthetic. Ann Emerg Med 1994; 23:1284-1289.

Ernst AA, Marvez-Valls E, Mall G, et al. 1% Lidocaine versus 0.5% diphenhydramine for local anesthesia in minor laceration repair. Ann Emerg Med 1994; 23:1328-1332.

Dire DJ, Hogan DE. Double-blinded comparison of diphenhydramine versus lidocaine as a local anesthetic. Ann Emerg Med 1993; 22:1419-22.

Ernst AA, Anand P, Nick T, et al. Lidocaine versus diphenhydramine for anesthesia in the repair of minor lacerations. J Trauma 1993; 34:354-7.

 

Joe Alton, MD

Joe Alton MD

Fill those holes in your medical storage by checking out Nurse Amy’s entire line of medical kits and supplies at store.doomandbloom.net. You’ll be glad you did.

some of Nurse Amy’s kits

Safe Summer Camping

Click here to view the original post.

SAFE SUMMER CAMPING

 

Camping Safety

 

The kids are out of school, the weather’s great, and families are planning this summer’s camping trip. Camping is a great way to create bonds and memories that will last a lifetime. A poorly planned outdoor vacation, however, becomes memorable in the worst way, especially if someone gets hurt. A little planning will make sure everyone enjoys themselves safely.

KNOW YOUR LIMITS

Not the best choice for a family camping trip

If you’re not a veteran camper, don’t start by attempting to climb Yosemite’s El Capitan. Start by taking day trips to National Parks or a local lake.  Maybe you could start using that firestarter tool, setting up your tent, and making a campfire in your backyard to get through the learning curve. See how things work out when you don’t have to stay in the woods overnight. If the result is a big thumbs-up, start planning those overnighters.

Whatever type of camping you do, you should always be aware of the capabilities and general health of the people in your party. Children and elderly family members will determine the limits of your activities. The more ambitious you are, the more your plans may be beyond the physical ability of the less fit members of your family. This leads to injuries as the end result.

PLANNING

An important first step to a safe camping trip is knowledge about the weather and local terrain you’ll encounter. Talk with park rangers, consult guidebooks, and check out online sources. Some specific issues you’ll need to know:

  • Temperature Ranges
  • Rain or Snowfall
  • Location and Status of Nearby Trails and Campsites
  • Plant, Insect, and Animal Issues
  • Availability of Clean Water
  • How to Get Help in an Emergency

COMMON MEDICAL RISKS 

hypothermia polar bear club

Probably Not Dressed for Success in the Snow

A very common error campers make is not bringing the right clothing and equipment for the weather and terrain. If you haven’t planned for the environment, you have made it your enemy.

Although Spring and Fall have the most uncertainty with regards to temperatures and weather, storms can occur in any season. Conditions in high elevations lead to wind chill factors that could easily cause hypothermia. Here’s the thing with wind chill: If the temperature is 40 degrees, but the wind chill factor is 20 degrees, you lose heat from your body as if the actual temperature were 20 degrees. Be aware that temperatures at night drop precipitously. Even summer rain can lead to a loss in body temperature if you get soaked.

In cold weather, you’ll want the family clothed in layers. Use clothing made of tightly woven, water-repellent material for protection against the wind. Wool holds body heat better than cotton does. Some synthetic materials work well, also, such as Gore-Tex.

That’s all well and good in cool temperatures, but if you’re at the seashore or lakefront in the summer, your main problem will be heat exhaustion and burns. Have your family members wear sunscreen, as well as hats and light cotton fabrics. Sunscreen should be placed 15 minutes before entering a sunny area and re-applied to skin that gets wet or after, say, a couple of hours.

If you don’t take the environment into account, you have made it your enemy

In hot weather, plan your strenuous activities for mornings, when it’s cooler. In any type of weather, keep everyone well-hydrated;  dehydration will cause more rapid deterioration in physical condition in any climate.

The most important item of clothing is, perhaps, your shoes. If you’ve got the wrong shoes for the activity, you will most likely regret it. If you’re in the woods, high tops that you can fit into your pant legs will provide protection against snakebite and tick bites. Tick populations are on the rise in the Northeast and Midwest, so beware of signs and symptoms of Lyme Disease. If you choose to go with a lighter shoe in hot weather, Vibram soles are your best bet.

Special Tips: Choosing the right clothing isn’t just for weather protection.  If you have the kids wear bright colors, you’ll have an easier time keeping track of their whereabouts. Long sleeves and pants offer added protection against insect bites and poison ivy.

YOUR CAMPSITE

Real estate agents’ motto is location, location, location and it’s true for camping safety too. Scout prospective campsites by looking for broken glass and other garbage that can pose a hazard.

Look for evidence of animals/insects nearby, such as large droppings or wasp nests/bee hives. If there are berry bushes nearby, you can bet it’s on the menu for bears. Berries that birds and animals can eat are often unsafe for humans to eat. Advise the children to stay away from any animals, even the cute little fuzzy ones. Even some caterpillars are poisonous.

bear poop

Bear Droppings! Camp somewhere else!

Learn to recognize poison ivy, oak, and sumac.  Show your kid pictures of the plants so that they can look out for and avoid them. The old adage is “leaves of three, let it be”. Fels-Naptha soap is especially effective in removing toxic resin if you suspect exposure. The resin can stick to clothes, so cur chips off and use for laundering.

Build your fire in established fire pits and away from dry brush. In drought conditions, consider using a portable stove instead, like the EcoZoom.  In sunny open areas, the Sun Oven will give you a non-fire alternative for cooking. About fires: Children are fascinated by them, so watch them closely or you’ll be dealing with burn injuries. Food (especially cooked food) should be hung in trees in such a way that animals can’t access it. Animals are drawn to food odors, so use re-sealable plastic containers.

If you camp near a water source, realize that even the clearest mountain stream may harbor Giardia, a parasite that causes diarrheal disease and dehydration.  Water purification is basic to any outdoor outing.  There are iodine tablets that serve this purpose, and portable filters like the Lifestraw and the Mini-Sawyer which are light and effective.  Boiling the water first is a good policy in any situation, although time-consuming. Remember to add one minute of boiling for each 1000 feet of elevation above sea level. Water boils at lower temperatures at higher altitudes, and takes longer to kill microbes.

GETTING LOST

Glen Martin’s Book on Navigation

Few people can look back to their childhood and not remember a time when they lost their bearings. Your kids should always be aware of landmarks near the camp or on trails.  A great skill to teach the youngsters is how to use a compass, a skill you can find in Glen Martin’s new book “Prepper’s Survival Navigation“. Besides a compass, make sure children have  a loud whistle that they can blow if you get separated.  Three consecutive blasts is the universal distress signal. If lost, kids should stay put in a secure spot instead of roaming about. Of course, if you have cell phone service….

INSECT BITES

Even if you’ve clothed the kids in protective clothing, they can still wind up with insect bites.  Carry a supply of antihistamines, sting relief pads, and calamine lotion to deal with allergic reactions.  Asking your doctor for a prescription “EpiPen” is a good idea if anyone has ever had a severe reaction to toxins from insect bites or poison ivy.  They’re easy to use and effective, and few doctors would refuse to write a script for it.

Citronella-based products are helpful to repel insects; put it on clothing instead of skin (absorbs too easily) whenever possible. Repellents containing DEET also can be used, but not on children less than 2 years old. Don’t forget to inspect daily for ticks or the bulls-eye pattern rash they often cause.  If you remove the tick in the first 24 hours, you will rarely contract Lyme disease.

YOUR CAMPING FIRST AID KIT

Get a Medical Kit!

Besides appropriate clothes, insect repellants, and a way to sterilize water, you will want to carry a medical kit to deal with common problems.  This should contain:

  • Antiseptics to clean wounds (iodine pads are good)
  • Bandages of different types and sizes: butterfly, roller, pads, moleskin, elastic (Ace wraps)
  • Cold packs to reduce swelling
  • Splints (splints and larger conforming ones)
  • Burn gel and non-stick dressings like Telfa pad
  • Nitrile gloves (some people are allergic to latex)
  • Bandannas or triangular bandages with safety pins to serve as slings
  • A bandage scissors
  • tweezers (to remove splinters and ticks)
  • topical antibiotic cream
  • Medications:

Oral antihistamines (such as Bendadryl)

Pain meds (Acetaminophen, Ibuprofen, Aspirin, also good for fever)

1% hydrocortisone cream to decrease inflammation

BZK (Benzalkonium Chloride) wipes for animal bites

Your personal kit may require some additional items to handle special problems with members of the family that have chronic medical issues.  Take the above-listed  items and add more to customize the kit for your specific needs. Maybe adding a tourniquet, hemostatic gauze, and an Israeli dressing for more significant injuries? Perhaps some antibiotics for longer backcountry outings?

In an emergency, the most important thing to do is to simply stay calm. If you have the above supplies, you can handle a lot of medical issues in the wilderness. Gain some knowledge to go along with those supplies, and you’ll have the best chance to have a safe and fun outing with your family.

.

Joe Alton, M.D., aka Dr. Bones

AuthorJoe

Joe Alton MD

Are you ready to deal with medical issues when the you-know-what hits the fan? You will be, if you get a copy of our #1 Amazon Bestseller “The Survival Medicine Handbook”.

The Survival medicine handbook Third Edition 2016

The Survival Medicine Handbook Third Edition

Survival Medicine Hour: Nailbed Injuries, Wound Closure, Mass Casualties

Click here to view the original post.

American Survival Hour #340

Nailbed Injuries

In this episode of the Survival Medicine Hour, Joe and Amy Alton discuss small injuries like those to the nail bed, and large, massive injuries like those seen in mass casualty events. What do you do if you’re the first on the scene of a bombing or other multi-injury event? These days, as the recent events in England have taught us, a mass casualty incident (MCI) can occur anytime and anyplace there’s a crowd.

Plus, Joe and Amy talk about  the factors to consider before deciding to close a wound. Wounds should only be closed in certain circumstances in off-grid settings. Find out how to use the best judgment in this week’s Survival Medicine Hour with Dr. Bones and Nurse Amy!

When to close a wound?

To Listen in, click the link below:

http://www.blogtalkradio.com/survivalmedicine/2017/06/02/survival-medicine-hour-nailbed-injuries-wound-closure-mass-casualties

 

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

Joe and Amy Alton

Dr. Bones and Nurse Amy

Joe and Amy Alt

Don’t forget to check out Nurse Amy’s entire line of medical kits and individual items at her store at store.doomandbloom.net. You’ll be glad you did!

 

By the way, do us a Yuge favor and follow us on:

Twitter:@preppershow

Facebook:  drbonesand nurseamy     Facebook Group: Survival Medicine Group

Youtube: DrBones NurseAmy channel

 

 

 

 

To Close or Not to Close a Wound

Click here to view the original post.

To Close or Not to Close a Wound?

typical laceration

typical laceration

When a laceration occurs, our body’s natural armor is breached and bacteria, even species that are normal inhabitants of our skin, get a free ticket into the rest of our body.  Microbes that are harmless outside the body could be life-threatening inside the body.

It only makes common sense that we want to close a cut (also known as a “laceration”) to speed healing and prevent infection. There is controversy, however, as to whether or not a wound should be closed.  When and why would you choose to close a wound, and what method should you use?

A laceration may be closed either by sutures, tapes, staples or medical “superglues” such as Derma-Bond or even industrial “Super-Glue” (the prescription product tolerates getting wet better).

After rendering first aid, which includes controlling the bleeding, removing any debris, flushing debris out of the wound (known as “irrigation”), and applying antiseptic, you will have to make a decision.

What are you trying to accomplish by closing a wound?  Your goals are simple.  You close wounds to repair the defect in your body’s armor, to eliminate “dead space” (pockets of air/fluid under the skin which could lead to infection), and to promote healing.  Although less a consideration in normal times, a well-approximated wound also has less scarring.

It sounds, you’d think, as if all wounds should be closed. Unfortunately, closing a wound that should be left open can do a lot more harm than good, and could possibly put your patient’s life at risk. Take the case of a young woman injured some years ago in a fall from a “zipline”:  She was taken to the local emergency room, where 22 staples were needed to close a large laceration. Unfortunately, the wound had dangerous bacteria in it, causing a serious infection which spread throughout her body.  She eventually required multiple amputations (including her hands!).

We learn from this an important lesson: Namely, that the decision to close a wound is not automatic but involves several considerations. The most important of these is whether you’re dealing with a clean or a dirty wound.

Most wounds you’ll encounter in an off-grid setting will be dirty.  If you try to close a dirty wound, such as a gunshot, you have sequestered bacteria, bits of clothing, and dirt into your body.  Within a short period of time, the wound may show signs of infection. An infected wound appears red, swollen, and hot. In extreme cases, an abscess may form, and pus will accumulate inside. The infection may spread to the bloodstream, a condition known as “septicemia”, and become life-threatening.

wound infection

wound infection

It may be difficult to fight the urge to close a wound. Leaving the wound open, however, will allow you to clean the inside frequently and directly observe the healing process.  It also allows inflammatory fluid to drain out of the body.  The scar isn’t as pretty, but it’s the safest option in most cases. In addition, if you’re truly in a long-term survival scenario, the suture material or staples you have aren’t going to be replaced. It’s important to known when a closure is absolutely necessary and when it’s not.

Other considerations when deciding whether or not to close a wound are whether it is a simple laceration (straight thin cut on the skin) or whether it is an avulsion (areas of skin torn out or hanging flaps).  If the edges of the skin are so far apart that they cannot be stitched together without undue pressure, the wound should be left open.

avulsion

avulsion

Another reason the wound should be left open if it has been open for more than 6-8 hours. Why? Even the air has bacteria, and there’s a good chance that they have already colonized the injury by that time.

Let’s say that you’re certain the wound is clean. It’s less than 8 hours old. Here are some other factors that would suggest that closure is appropriate:

  • The laceration is long or deep. The exception would be a puncture wound from an animal bite. These bites are loaded with bacteria and should be kept open in austere settings, in my opinion.
  • The wound is located over a joint. A moving part, such as the knee, will constantly stress a wound and prevent it from closing in by itself.
  • The wound gapes open, but loosely enough to suggest that it can be closed without undue pressure on the skin.
sutures

An item unlikely to be found after the you-know-what hits the fan

It’s important to realize that you will only have a limited supply of staples and sutures. Feel free to mix different closure methods like alternating sutures and Steri-Strips, or even adding duct tape improvised into butterfly closures when you’ve run out of medical supplies. You’d be surprised to see what qualifies as medical supplies when the chips are down.

If you are unsure, you can choose to wait 48 to 72 hours before closing a wound to make sure that no signs of infection develop.  This is referred to as “delayed closure”.  Some wounds can be partially closed, allowing a small open space to prevent the accumulation of inflammatory fluid.

Penrose Drain

Penrose Drain

Drains, consisting of thin lengths of latex, nitrile, or even gauze, might be placed into the wound for this purpose. Although these can get quite expensive, “Penrose” drains are a reasonably priced version of these that are still used in some operating rooms. Drains have a tendency to leak, so place a dressing over the exposed area.

Many injuries that require closure (and some that don’t) also should be treated with antibiotics in oral or topical form to decrease the chance of infection.  Natural substances with antibiotic properties, such as garlic or raw, unprocessed honey, may be useful in survival scenarios.

The decision to close a wound involves developing sound judgment, something that takes some training and experience. For that reason, we’ve taught wound care classes throughout the country, not just to teach the mechanics of how to “throw” a stitch, but to impart the knowledge of just what makes for a “close-able wound”.

Injuries are part and parcel of survival. Make sure that you can handle them, as well as infectious disease and all the other problems that will confront the medic in times of trouble.

Joe Alton, MD

dr. bones

Joe Alton, MD

Find out more about wound closure and 150 other off-grid medical topics in the third edition (700 pages!) of The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, available here or at Amazon.com.

Mass Casualty Triage Basics

Click here to view the original post.

mass casualty incidents

Given the horrific events surrounding the Ariana Grande concert in Manchester, UK, we have come to realize that we may never be safe in today’s world. The bombing is new evidence, however, that no target is off limits to the terrorists in our midst. We can expect more episodes of terror in the western world in the future, and many will involve mass casualties.

The Mass Casualty Incident

The responsibilities of a caregiver is usually one-to-one; that is, the healthcare provider will be dealing with one ill or injured individual at a time.  This encounter usually falls within their expertise and resources.  There may be a day, however, when you find yourself confronted with a scenario in which multiple people are injured.  This is referred to as a Mass Casualty Incident (MCI).

A Mass Casualty Incident is any event in which your medical resources are inadequate for the number and severity of injuries incurred.  MCIs can be quite variable in their presentation.

Types of Mass Casualty Incidents

MCIs can be quite variable in their presentation:

  • Doomsday scenario events, such as a nuclear weapon detonation
  • Terrorist acts, such as occurred in Manchester
  • Consequences of a storm, such as a tornado or hurricane
  • Consequences of civil unrest or battlefield injuries
  • Mass transit mishaps (train derailment, plane crash, etc.)
  • A car accident with, say, four people injured (and only one ambulance)

 Responding to a Mass Casualty Incident

The effective medical management of any of the above events required rapid and accurate triage.  Triage comes from the French word for “to sort” (trier) and is the process by which medical personnel can rapidly assess and prioritize a number of injured individuals and do the most good for the most people. Note that I didn’t say: “Do the best possible care for each individual victim”.

Let’s assume that you were at the concert in Manchester, the Christmas market in Berlin, or the Boston Marathon when a bomb went off.  You are the first one to arrive at the scene, and you are alone.  There are twenty people on the ground, some moaning in pain.  There were probably more, but only twenty are, for the most part, in one piece.  The scene is horrific.  As the first to respond to the scene, you are “Incident Commander” until someone with more medical expertise arrives on the scene.  What do you do?

Your initial actions may determine the outcome of the emergency response in this situation.  This will involve what we refer to as the 5 S’s of evaluating a MCI scene:

  • Safety
  • Sizing up
  • Sending for help
  • Set-up of areas
  • START – Simple Triage And Rapid Treatment

Safety Assessment:  An insidious strategy on the part of terrorists when they target crowds is to set off primary and secondary bombs.  The main bomb causes the most casualties, and the second bomb is timed to go off or is triggered just as the medical/security personnel arrive.  This may run counter to your instinct to help, but your primary goal is your own self-preservation. Keeping the medical personnel alive is likely to save more lives down the road.  Therefore, you do your family and community a disservice by becoming the next casualty.

As you arrive, be as certain as you can that there is no ongoing threat.  Do not rush in there until you’re sure that the damage has been done and you and your helpers are safe entering the area.  In the immediate aftermath of the 1995 Oklahoma City bombing, various medical personnel rushed in to aid the many victims.  One of them was a heroic 37-year-old Licensed Practical Nurse who, as she entered the area, was struck by a falling piece of concrete.  She sustained a head injury and died five 5 days later.

Scene at the Boston Marathon bombing

Sizing up the Scene:  Ask yourself the following questions:

  • What’s the situation?   Is this a mass transit crash?  Did a building on fire collapse?  Was there a bomb?
  • How many injuries and how severe?  Are there a few victims or dozens?  Are there “walking wounded” that could assist you?
  • Are they all together or spread out over a wide area?
  • What are possible nearby areas for treatment/transport purposes?
  • Are there areas open enough for vehicles to come through to help transport victims?

Sending for Help:  If modern medical care is available, call 911 and say (for example):  “I am calling to report a mass casualty incident involving a multi-vehicle auto accident at the intersection of Hollywood and Vine (location).  At least 7 people are injured and will require medical attention.  There may be people trapped in their cars and one vehicle is on fire.”

In three sentences, you have informed the authorities that a mass casualty event has occurred, what type of event it was, where it occurred, an approximate number of patients that may need care, and the types of care (burns) or equipment that may be needed.

Set-Up:  Determine likely areas for various triage levels (see below) to be further evaluated and treated.  Also, determine the appropriate entry and exit points for victims that need immediate transport to medical facilities, if they exist.  If you are blessed with lots of help at the scene, assign triage, treatment, and transport team leadership roles.

S.T.A.R.T.:  Triage uses the acronym S.T.A.R.T., which stands for Simple Triage and Rapid Treatment.   The first round of triage, known as “primary triage”, should be fast (30 seconds per patient if possible) and does not involve extensive treatment of injuries.  It should be focused on identifying the triage level of each patient.  Evaluation in primary triage consists mostly of quick evaluation of respirations (or the lack thereof), perfusion (adequacy of circulation), and mental status.  These are known as “RPMs” and are a (very) basic indication of the level of injury.

Other than controlling massive bleeding and clearing airways, very little treatment is performed in primary triage. Controlling hemorrhage is best done with commercial tourniquets, for example, the SOF-T, CAT, or SWAT. It’s a sad sign of the times that I recommend carrying one of these if you have to go to areas where there are large crowds and little security. Tourniquets can be improvised with belts, bandannas, and other items, but are more difficult to apply effectively.

Although there is no international standard for this, triage levels in the U.S. are usually determined by color:

Immediate (Red tag): The victim needs immediate medical care and will not survive if not treated quickly.  (for example, a major hemorrhagic wound/internal bleeding) Top priority for treatment.

Delayed (Yellow tag): The victim needs significant medical care within 2-4 hours. Injuries may become life-threatening if ignored, but can wait until Red tags are treated. (for example, an open fracture of the femur without major hemorrhage)

Minimal (Green tag): Generally stable and ambulatory “walking wounded”, but may need some medical care. (for  example, broken fingers, superficial burns)

Expectant (Black tag): The victim is either deceased or is not expected to live.  (for example, a large open fracture of cranium with brain damage, multiple penetrating chest wounds

Patients may be identified with colored tape or triage casualty cards, but you’re unlikely to have these on hand. In that case, simply mark the victims’ foreheads with the numbers 1,2,3, and 4 indicating the priority for urgent care

casualty card produced by sos products

Knowledge of this system allows a patient marking system that easily allows incoming medical personnel to understand the urgency of a patient’s situation.  It should go without saying that, in a power-down situation without modern medical care, a lot of red tags and even some yellow tags will become black tags.  It will be difficult to save someone with major internal bleeding without surgical intervention.

The surviving victims of the Manchester bombing were “fortunate”, if I may use the word, that emergency personnel were on the scene in minutes. Although the death count is currently at 22, many more of the 60 wounded would not have survived without their assistance and transport to modern medical facilities.

We live in a more dangerous world these days, something I call “The New Normal“. In the New Normal, increased vigilance and situational awareness will be needed if you want to stay safe in crowds. In future articles, we’ll explore further how to deal with mass casualty incidents as a medical asset, and also how to avoid becoming a victim of those who want to disrupt civilized society.

Joe Alton, MD

Dr. Alton

Learn more about mass casualties, active shooter, terror events, and 150 other medical topics in times of trouble in the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way.

Survival Medicine Hour: Eye Issues, Fractures, TENS units

Click here to view the original post.

THE SURVIVAL MEDICINE HOUR: EYE ISSUES, FRACTURES, TENS UNITS

Pink Eye, aka Conjunctivitis

In this episode of the Survival Medicine Hour, Joe Alton, MD and Amy Alton, ARNP, aka Dr. Bones and Nurse Amy, discuss how to deal with various eye issues that can confront a medic in an off-grid survival setting, like Pink Eye, foreign objects, styes, and more. Plus, our hosts impart some basics on how to deal with broken bones.

Ouch!

Dr. Bones also answers a question from Jack Spirko’s Survival Podcast Expert Council, of which he’s a member, regarding the potential for use in survival scenarios of TENS units. TENS units are battery-powered items that deliver electrical stimulation to muscles and nerves to help with pain relief.

All this and more in the latest Survival Medicine Hour! To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/05/19/survival-medicine-hour-eye-issues-fractures-tens-units

Hey, do ol’ Dr. Bones a big favor and follow us on twitter @preppershow, YouTube at DrBones NurseAmy, and Facebook at Doom and Bloom(tm). You can also join our Facebook group at Survival Medicine DrBones NurseAmy!

Joe and Amy Alton

Joe and Amy Alton

Find out more about survival eye issues, fractures, 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, available at Amazon. Also, check out Nurse Amy’s entire line of kits and individual supplies for the survival medic at store.doomandbloom.net!

Survival Medicine Hour: John Steinbaugh of Xstat, Wound Packing, Obesity

Click here to view the original post.
cover celox with roller gauze

Packing a Bleeding Wound

In this episode of The Survival Medicine Hour with Joe Alton, MD and Amy Alton, ARNP, aka Dr. Bones and Nurse Amy, we welcome John Steinbaugh of RevmedX to discuss his XStat product (which we previously mentioned was not an ideal product for the preparedness community), plus new products that his company has to help stop hemorrhage in wounds. Learn about the XGauze and Parabelt, plus some realities about TCCC guidelines and the issues that companies go through getting new technology to the public.

obesity fat

extra weight will decrease chances for survival

Plus, a question for Dr. Bones as a member of Jack Spirko’s popular Survival Podcast Expert Council, this time about what to do with obese group members once the trigger event occurs for a SHTF situation.

Lastly, Dr. Alton talks about how to pack wounds effectively, and some recommendations from a doctor-paramedic team’s recent article in the Journal of Emergency Medical Services.

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/2017/04/28/survival-medicine-hour-wound-packing-obesity-john-steinbaugh-of-xstat

 

Follow us on Twitter @preppershow

YouTube: DrBonesNurseAmy channel

Facebook: Doom and Bloom

 

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

Joe and Amy Alton

AmyandJoePodcast400x200

Dr. Bones and Nurse Amy

Learn more about bleeding wounds and 150 other survival medicine topics in the Third Edition (700 pages!) of The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, available at Amazon.

How To Pack A Bleeding Wound

Click here to view the original post.
bleeding wound

Bleeding Wound

The failure to control hemorrhage is a common cause of death in trauma situations. With the increased number of active shooter events in the United States, the average citizen should have knowledge of basic methods to stop heavy bleeding. The government’s Stop The Bleed Initiative is attempting to foster awareness of the importance of this type of education.

In the April 2017 issue of the Journal of Emergency Medical Services (JEMS), Dr. Peter Taillac and EMT-P associates Scotty Bolleter and A.J. Heightman put forth their recommendations for the packing of hemorrhagic wounds with plain and/or hemostatic gauze such as Quikclot, Celox, and others. In addition, they reinforce the principles of direct pressure and tourniquet use to control bleeding and save lives.

In 2012, The American College of Surgeons (of which I’m a retired Fellow) and other organizations formed a joint commission to improve survival in heavily bleeding injuries. While endorsing direct pressure as a primary technique to reduce hemorrhage, the commission reviewed evidence for the use of hemostatic gauze, finding it to be an effective tool in 90% of cases.

Packing of wounds is useful in many situations, but not all. Wounds of the neck are problematic, for instance, due to the risk of compressing airways. Packing injuries in the abdomen, pelvis, and chest may not be effective due to the deep nature of the bleeding vessels. This is one reason why, in an off-grid setting, the death rate (called “mortality”) from these wounds is so high. Statistics from the Civil War put mortality rates for major injuries in these regions at close to 70 per cent, a figure that might be expected in long-term survival scenarios.

CeloxHemostatics

Celox Gauze is approved by the TCCC

Tactical Combat Casualty Care guidelines approve hemostatic gauze as dressings of choice for severe bleeding. These products use materials that enhance or produce clotting. QuikClot uses Kaolin, an original ingredient in Kaopectate; Celox and Chitogauze use Chitosan, a product made from the shells of crustaceans. XStat, made by RevMedX, is preferred by TCCC for hemorrhage in areas like the axilla (armpit) and groin. A new product, Xgauze, was recently described to us by John Steinbaugh of RevMedX as an effective item to control bleeding without kaolin or chitosan, using instead expanding sponges built into the dressing itself.

xgauze by revmedx

Xgauze by RevmedX

According to Dr. Taillac’s team, proper packing of wounds with plain or hemostatic gauze include the following steps:

  • Quickly and aggressively apply direct pressure with a gloved hand, clean dressing or cloth, or even the knee or elbow while breaking out your supplies. Explore the wound with your fingers to find the source of bleeding, using nearby bones, if possible, to increase the effectiveness of pressure.
  • Tightly (and I mean, tightly) pack the wound cavity as deeply as you can while continuing to apply pressure on the bleeding vessel. Pack directly onto the vessel itself. Although hemostatic gauze is effective, sufficient pressure with plain gauze may be enough.
  • Maintain pressure on the packed wound for at least 3 minutes.
  • Place a tight pressure dressing (Israeli Battle Dressing, Olaes Bandage, etc.) over the whole thing.
  • Splinting the wound will immobilize it and help prevent re-bleeds during transport.
Direct Pressure on Bleeding Wound

Direct pressure with a gloved hand and cloth barrier

The above method, along with appropriate use of tourniquets, should be effective in controlling hemorrhage. If the dressings become saturated, however, it may be necessary to use more packing or to start over. A second tourniquet may also be needed. In normal times, this might best be done during transport to a modern medical facility. In long-term survival settings, get the victim to where the bulk of your supplies are.

It is thought that 1 in 5 deaths from hemorrhage may be prevented by rapid action. Know the procedure and, have no doubt, you will save lives in disasters or other times of trouble.

 

Joe Alton, MD

AuthorJoe

Joe Alton, MD

 

Learn more about hemorrhage and over 100 other survival medicine topics  in the 700 page Third Edition of The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, available at Amazon. Plus, check out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net.

 

Survival Medicine Hour: Jack of Black Scout Surv., Gallstones, Fish Hooks, More

Click here to view the original post.
jack richland black scout

Jack of Black Scout Survival

In this episode of the Survival Medicine Hour podcast, Joe Alton, MD and Amy Alton, ARNP, aka Dr. Bones and Nurse Amy, welcome back Jack of Black Scout Survival‘s popular YouTube channel to talk about his work and other important issues. Plus, Dr. Bones tells you all you need to know about gall bladder stones, a condition that affects 10-15 percent of the populations, and certainly would be an issue for the medic taking care of a large mutual assistance group.

gall bladder stones

Lastly, some ways to remove a fish hook from an outdoor mishap.

fishhookremoval

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/2017/04/14/survival-medicine-hour-jack-of-black-scout-survival-gallstones-fish-hooks

 

 

Some of the items mentioned in today’s interview with Jack of Black Scout Survival:

Benchmade SOCP

https://www.amazon.com/Benchmade-Dagger-Combo-Sheath-Skelentonized/dp/B008NBBTAS

BENCHMADE SOCP MEDICAL EDITION

https://www.amazon.com/gp/aw/d/B06XD3J9LR/ref=pd_aw_sbs_200_2?ie=UTF8&refRID=H44CQTRPYXX6XPD852DR&dpPl=1&dpID=51a-lo20aYL

FELLHOELTER TIBOLT PEN

http://fellhoelter.com/shop/

Zebra pen f701

https://www.amazon.com/Zebra-Stainless-Ballpoint-Retractable-29411/dp/B002L6RB80

 

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

Joe and Amy Alton

joe and amy radio

Dr. Bones and Nurse Amy

 

Fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and individual items at store.doomandbloom.net

MedBag-ADpic

The family medical bag and just some of its conten

Self Defense Laws in Australia.

Click here to view the original post.
Another Australian citizen is attacked and he has no way to defend himself from these thugs using machetes. It is against the law in Australia to carry anything specifically for use in self defence. We are not allowed to carry guns, knives, batons, pepper sprays, or tasers. Women are getting raped & murdered, men are being attacked and killed, but the Australian government will not do anything to help us protect ourselves, not on the streets, and not even in our own homes.

Survival Medicine Hour: Dental Exams, Bleeding Control, Tourniquets

Click here to view the original post.
dentalcare

The basic dental exam

The Survival Medicine Hour, on March 11, 2017, is hosted by Joseph Alton, MD aka Dr. Bones and Amy Alton, ARNP, aka Nurse Amy of https://www.doomandbloom.net/. In today’s show, Dr. Alton reviews the steps of a dental exam for those who find themselves in a remote area or post-disaster and who need to care for someone with an immediate dental issue. Expect more segments on individual dental problems that might confront the medic in remote or post-disaster settings.

soft-t tourniquet

The Sof-T tourniquet

Accidents happen everyday and you may find yourself as the person responsible for saving a life of someone who’s hemorrhaging. Severe injuries with bleeding can be scary to non-medical persons. Knowing some basic steps to stop bleeding are important to understand and share with your family members. Plus, a review of different tourniquets that might be useful for your medical kit.

 

All this and more on the Survival Medicine Hour! To listen in, click below:

 

http://www.blogtalkradio.com/survivalmedicine/2017/03/10/survival-medicine-hour-dental-exam-bleeding-and-tourniquets

 

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

 

Joe and Amy Alton

AmyandJoePodcast400x200

Dr. Bones and Nurse Amy

If you’re concerned about a disaster taking you off the grid long term, have you thought of putting some dental supplies in that medical kit? Check out Nurse Amy’s dental kit at store.doomandbloom.net! Compare it with any other and you’ll know it’s the essential kit for long-term survival settings.

How To Make Natural Tiger Balm

Click here to view the original post.

How To Make Natural Tiger Balm The time-proven blend of herbal ingredients in Tiger Balm provides safe and effective topical pain relief for sore muscles, arthritis, neck and shoulder stiffness, and just about any other minor muscle or joint aches or pains that may come your way. Tiger Balm is a topical analgesic (pain reliever) …

Continue reading »

The post How To Make Natural Tiger Balm appeared first on SHTF & Prepping Central.

Choosing Sutures

Click here to view the original post.

Sutureneedleholder1

As we go around the country teaching the art of suturing pig’s feet to aspiring porcine podiatrists, we are often asked about how to choose the appropriate suture needles and material for different types of injuries.  There are a wide variety of choices and, today, we’ll discuss what is available and what is most effective for different types of wounds.

 

First, let’s identify some of the qualities of the optimal suture.  The suture should:

 

·        Be sterile

·        Be easily worked with

·        Be strong enough to hold wound edges together while they heal

·        Be unlikely to cause infection, tissue reaction or significant scar formation

·        Be reliable in its everyday use with every type of wound

 

It is rare, if not impossible, to find a single suture type that meets all of the above criteria, but there are many that will serve if chosen properly.

 

In the United States and many other countries, a standard classification of suture has been in place since the 1930s.  This classification identified stitches by type of material and the size of the “thread”.  Suture diameters most commonly used in humans (and pigs, I would think) is measured in zeroes, much like buckshot.  2-0 (00) suture, for example, is thicker than 5-0 (00000) suture. The more zeroes, the finer the “thread”. Finer sutures have less tissue reaction and heal faster, but are more difficult to handle for those without experience.

 

In addition to size, sutures are classified as absorbable and non-absorbable.  An absorbable suture is one that will break down spontaneously over time but not before the tissue has had sufficient time to heal.  Absorbable sutures have the advantage of not requiring removal after healing has taken place. This type of suture is commonly used in deep layers, such as muscle, fat, organs, etc.  A classic example of this is “catgut”, actually made from the intestines of sheep or cows.

 

(Aside: Catgut was once also used in the manufacture of stringed musical instruments and tennis racquets.)

 

Catgut is usually found in “plain” and “chromic” varieties. When dipped in a chromic acid salt solution, catgut lasts longer in the body while remaining absorbable.

 

Although still popular, catgut has been replaced by synthetic absorbables for many applications. examples of synthetic absorbable suture include “Vicryl” (polyglycolic acid), “PDS” (polydiaxanone), and others. These tend to last longer than catgut sutures, but will eventually be absorbed by the body.

suturenylon

Nylon suture package depicting size, needle shape, and length of “thread”

Nonabsorbable sutures are those that retain their character for a very long time, and will stay in the body until removed.  As such, normal immune response will cause the development of scar tissue, sometimes called “encapsulation”, around these sutures if used in internal body structures. 

 

Nonabsorbable sutures are best used in skin closures and situations that require prolonged tensile strength. They include monofilaments (such as “Nylon” and “Prolene”) and braided multifilaments (such as ”Surgical Silk”). Monofilaments like Nylon are useful because of less likelihood of harboring bacteria, whereas braided multifilaments have nooks and crannies for these organisms to hide. Monofilament also glide more easily through tissue. In trade, braided Silk is somewhat easier to handle than Nylon for many and often used for teaching purposes.

 

I recommend Nylon in most survival situations, with 2-0 or 3-0 Nylon ideal for those new to the suturing skill.  This size “thread” is easy to handle and useful for aspiring medics to learn surgical knot-tying.

 

The size of the “thread” you’ll use depends on the area of the body being repaired. Slowly healing tissues such as skin and tendons require nonabsorbable sutures; wounds in rapidly healing areas such as the inside of the cheek and vagina (childbirth) are best repaired with absorbables. 

 

In survival settings, cosmetic results are less important, but surgeons generally use smaller sutures in delicate areas such as areas on the head and face.  5-0 or 6-0 Nylon would normally be the choice here, but require more skill in handling.  Skin sutures should be placed, in my opinion, about 1/2 inch or so apart in most instances. This will allow drainage while keeping the wound together.  Areas over joints or other moving parts should be closer together. In wounds not near joints, say, the forearm, the sutures may be further apart and could be interspersed with Steri-Strips or butterfly closures.

suture needles

typical suture needles (chromic catgut)

 

The type of needle is also an important factor in choosing suture material. Needle that are less traumatic to sensitive tissues, like the lining of the bowel and other deep structures, are round on cross-section. These are known as “atraumatic” or “tapered”. Needles that are best on tough areas like skin are triangular in shape on cross-section and are referred to as “cutting” needles. Most suture needles that are useful for skin form a 3/8 circle; needles for deep work are often ½ circle in shape.

 

Having said all of the above, the choice of suture needles and material will vary depending on the user. Each surgeon will have his or her preferences based on their experience.

 

How long skin sutures remain in place before removal is dependent on the body part repaired.  Face wound sutures are usually removed relatively soon (5 days) compared to, say, a forearm wound (7-10 days).  Thicker skins, such as the sole of the foot should stay in somewhat longer.   Sutures placed over the knee or other joints should remain in place longer, 2-3 weeks, in my opinion.

 

Remember that the act of suturing is more traumatic than using butterfly closures, Steri-Strips, surgical glue, and others due to the fact that you are making more punctures in an area of skin already injured.  Each extra “hole” you create could allow the entry of bacteria into the wound. 

 

One last relevant point:  When you practice suturing on your pig’s foot, you are learning a skill, not a trade.  The practice of medicine without a license is illegal and punishable by law; as long as modern medical care exists, seek it out.

 

We’ll talk about staples, medical glues, and Steri-Strips/butterfly closures in future articles.

 

To see me suture in real time, here’s my YouTube video:

Joe Alton, MD

joealtonlibrary4Find out more about wound closure and 150 other topics in our 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for when Medical Help is Not on the Way“. Find suture kits and individual sutures at Nurse Amy’s store.

How to Survive Field Injuries

Click here to view the original post.

How to Survive Field Injuries From snake bites to sore teeth, this guide will help you tackle almost any accident. All of these injuries are quite common and a little trip to the doctor can normally sort these out! What if there were no doctor? What if you were stranded or SHTF? I would recommend …

Continue reading »

The post How to Survive Field Injuries appeared first on SHTF & Prepping Central.

Oakland Warehouse Fire: Surviving in a Crowd

Click here to view the original post.

wildfire

The fire in an Oakland warehouse that was a refuge for artists and a venue for dance parties has now claimed 36 lives with several persons still missing. In the past, I’ve written about safety in wildfires and also in homes over the years; this time, I’ll explore the issue relating to fires in public venues like concert halls.

Concerts and theatres have long been areas at risk for fire. In 1903, Chicago’s Iroquois theatre was the site of an inferno which caused 600 deaths. In 1942, the Cocoanut Grove nightclub in Boston claimed 492 lives. In 2003, 100 perished in the Station nightclub in Warwick, R.I. during a concert by the rock band Great White.

Most public venues have important fire protection strategies such as sprinkler systems, fire exits, and fire extinguishers. Indeed, fire codes have evolved to make most of these places quite safe.

The phenomenon of “flash concerts”, however, places crowds of people in locations without these safeguards. This puts the onus on concert-goers to become more situationally aware, something few patrons of these events even think about.

What is situational awareness? Situation awareness involves understanding what’s going on in your immediate vicinity that might be hazardous to your health. I don’t mean second-hand smoke here; I’m talking about knowing what dangers may exist that you can avoid or abolish with your actions. Especially important for soldiers in a combat zone, it’s now become just as important for the average citizen in any large crowd.

The situationally aware person is in a constant state of what I call “Yellow Alert”, a relaxed awareness of their surroundings. At Yellow Alert, a concert-goer has a much better chance to identify threats than someone with their nose buried in their smart phone. Although many might enjoy the use of recreational drugs, like marijuana or ecstasy, it’s much safer to have your wits about you at these events. Mentally marking nearby exits, fire extinguishers, and alarms when you first arrive will allow you to have a plan of action if the worst happens.

A good spot at a concert is front and center, but you might be safer at the fringe of the crowd. In the center, your choice of escape route is governed by the crowd rather than good judgment.

Who’s at fault? Although Derick Almena, the manager of the Oakland warehouse, was understandably distraught during an interview with the TODAY show, he must bear responsibility for the conflagration, as must the owner, Chor N. Ng (whose daughter claims, says the LA Times, that he didn’t know people lived in the building). Here are some reasons why:

·        The 10,000 foot warehouse, also known as the “Ghost Ship”, had no sprinkler system nor fire alarms. No word on the number of fire extinguishers, if any.

·        Piles of discarded furniture dotted the interior.

·        Staircases were partially supported by wooden pallets.

·        Construction and electrical work was performed on an impromptu basis, often without permits or proper inspections.

·        A number of recreational vehicles, presumably with gas in the tanks, were in the warehouse.

Oakland city officials, however, are also culpable. The LA Times reports that, since 2014, several complaints were lodged for building and fire code violations without apparent action by the city after investigation. The Fire Marshall blames severe understaffing for the shortcomings, the responsibility for which must also be borne by Oakland’s city government. Zac Unger, an official with the firefighter’s union, was quoted as saying “Had a fire inspector walked into that building and seen the conditions in there, they would have shut the place down.”

Unfortunately, the responsibility for your safety may ultimately lie with the average citizen. Incorporate situational awareness into your mindset when in any public venue, and you’ll stand the best chance to avoid and escape becoming a casualty of a fire or any other calamity.

For more information on becoming situationally aware and how to deal with building fires, read my articles “How a Fighter Pilot’s Strategy Could Save Your Life: The OODA Loop” and “Surviving a House Fire”.

Joe Alton, MD

When to Close a Wound

Click here to view the original post.

laceration2

There are many injuries that a medic will face in a survival scenario, and a common and potentially life-threatening one occurs whenever the skin is broken. Your skin is your body’s armor; when it is breached, infectious organisms enter a highway which can transport them to just about any part of the body. Therefore, it makes common sense that you’d want to close that breach to speed healing and lock out infection. Indeed, that’s exactly what happens thousands of times daily in emergency rooms in normal times.

The off-grid medic has a dilemma, however: Most wounds in survival will be dirty, and providing a sterile environment for a surgical procedure is a difficult challenge. You could make the work area as clean as possible, but sterile? Not likely. As such, you should wisely choose what wounds should be closed and what wounds should be left open.

Many medics can’t imagine not closing a tear or cut in the skin (called a “laceration”), but it’s a reasonable way to deal with contaminated wounds in situations where you can’t assure a sterile, or even clean, field on which to work. Lacerations that are kept open must be dressed and cleaned regularly until they’re fully healed.

Open wounds heal through a process called “granulation”, where new tissue forms at the base and sides until the defect in the skin is fully healed. Essentially, “from the bottom up”. This tissue is somewhat granular in appearance, hence the name.

hamlet-wiki

To Close or Not to Close?

To paraphrase Hamlet, “To close or not to close? That is the question!” To answer this questions, we must examine what our goals are in closing a wound. Among other reasons, you close wounds to:

  • Repair the defect in the body’s armor, thus preventing infection in a clean wound.
  • Accelerate the healing process. Wound edges that are touching heal faster than those that aren’t.
  • Decrease scarring. Scarring is less of an issue in survival, unless the scar would, say, limit the range of motion of a joint in extremity.

A note about bleeding: Although closing a wound may apply pressure to bleeding areas, it is not a substitute for hemorrhage control, also known as “hemostasis” before closure. Consider the application of direct pressure first on the bleeding area, a method that succeeds in many cases. Also, for major blood loss, have tourniquets, hemostatic agents like Celox or Quikclot, and pressure dressings as part of your medical storage.

So what factors come into play when deciding to close a wound or to keep it open? Consider keeping the wound open in these circumstances:

The wound is dirty. Are the circumstances suspicious for contamination? In survival scenarios, the answer is often yes. In austere environments, even WHO (the World Health Organization) agrees that the safest course of action is to keep it open.

infectedcut

Candidate for closure IF clean

Here are some circumstances where wounds should be kept open:

  • The wound is infected. Infected wounds have a certain appearance: They are red, swollen (sometimes appearing “shiny”), warm to the touch, and may drain pus.
  • The wound is colonized (infected but not yet showing signs). Even the air has bacteria; you can expect a wound to be colonized within 6-8 hours or so.
  • There is dead tissue in the wound. This tissue won’t bleed when it is cut and often appears discolored or black. No closure should be performed without removing dead tissue first (a procedure known as “debridement”).
  • Puncture wounds, especially from mammalian (including human) bites have lots of bacteria and shouldn’t be closed. Interestingly, snake bites become infected less often than, say, cat or dog bites, but don’t close them either.
  • The wound edges are so far apart that closing them would cause undue pressure. This occurs with injuries like “avulsions”, where entire areas of tissue are missing.
infected-cut

wound infection

Here are situations where you should consider closing the wound:

  • You’re certain the wound is clean. This usually requires witnessing the injury as it happens.
  • The wound has been open less than 6-8 hours.
  • The laceration is long or deep enough to penetrate the entire thickness of the skin. A deep wound would allow you to see underlying tissue such as subcutaneous fat.
  • The wound is located over a joint. A moving part, such as the knee, will constantly stress a wound and prevent it from closing in by itself.
  • The wound gapes open loosely, suggesting that it can be closed without undue pressure on the skin (and won’t close at all without your intervention).

In future articles, we’ll explore wound closure materials, techniques, and theory.

Joe Alton, MD

AuthorJoe

Joe Alton, MD

Learn all about wound care and wound closure methods via our DVD or in the Third Edition of The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way.  View our entire line of medical kits and supplies at store.doomandbloom.net

Wildfire Preparedness and Our Gatlinburg Home

Click here to view the original post.
2015 Birdhouse Inn Mountain Paradise View!

The view from my home as I’d like to remember it

It’s been a very busy year for firefighters, with heat waves, drought, and human malice or carelessness causing large areas to burn from Canada to California. You may have heard me say that you probably won’t  be affected by a disaster today, tomorrow, or next week. Over a lifetime, however, the chances aren’t quite as small. Add in your children’s lifetimes, and their children’s, and the odds are greater still. I’ve personally been through hurricanes, tornadoes, civil unrest, and the Mariel Boatlift unscathed other than for some missing roof tiles and a conversion to positive for tuberculosis (thanks, Fidel). We were even stranded in Europe due to a volcanic eruption in Iceland.

And now wildfire. A particularly intense one recently struck a place I know and love: Gatlinburg, Tennessee. Home to the entrance of the Great Smoky Mountains National Park, I’ve had a vacation home there for 20 years and spend Spring and Fall there. I love hiking in the backcountry, and if I cannot say that I’ve walked the entire length of the Appalachian Trail, I can say I’ve walked its entire width.

With multiple fires spreading through the popular resort town, the mountain that my house is situated on lit up like a match.  In the dry, windy conditions, hundreds of homes were burnt to the ground. As of this writing, I have not yet heard of the fate of the home in which I’ve accumulated 20 years of memories. The likelihood is that it no longer exists. Much more importantly, homes of many permanent residents have been destroyed, leaving them homeless; the businesses that employed those people were incinerated.

Putting my feelings aside for a moment, let’s talk about what you can do in the face of an irresistible force like a wildfire. How can you protect your property (and yourself) from being devastated by fire? Two main principles for property defense are 1) vegetation management and 2) creating a “defensible space”. The main strategy for personal defense is “Get Out Of Dodge”.

An important factor in wildfire preparedness is what we call “vegetation management”. With vegetation management, the key is to direct fires away from your house. There are several ways to accomplish this, all of which require vigilance and regular maintenance. 

You’ll want to clean up dead wood and leaf piles lying within 30 feet of your building structure. Pay special attention to clearing off the roof and gutters. Although you may have spent time and money putting lush landscaping around your home, you may have to choose between attractive, yet flammable plants and fire protection.

You’ll want to thin out those thick canopied trees near your house, making sure that no two canopies touch each other. Any trees within 50 feet on flatland, or 200 feet if downhill from your retreat need to be thinned, so that you’re pruning branches off below 10-12 feet high, and separating them by 10-20 feet. No tree should overhang the roof. Also, eliminate all shrubs at the base of the trunks.

Lawns and gardens should be well-hydrated; collect lawn cuttings and other debris that could be used as fuel by the fire. If water is limited, keep dry lawns cut back as much as possible (or remove them).

wildfire1

From a wildfire perspective, a defensible space is an area around a structure where wood and vegetation are treated, cleared, or reduced to slow the spread of flames towards a structure. Having a defensible space will also provide room to work for those fighting the fire.

The amount of defensible space you’ll need depends on whether you’re on flat land or on a steep slope. Flatland fires spread more slowly than a fire on a slope (hot air and flames rise). A fire on a steep slope with wind blowing uphill spreads fast and produces “spot fires”. These are small fires that ignite vegetation ahead of the main burn, due to small bits of burning debris in the air.

Woodpiles and other flammables should be located at least 20-30 feet away from structures. Gardening tools should be kept in sheds, and those sheds should be at a distance from the home.  Concrete walkways and perimeter walls may serve to impede the progress of the fire.

Attic and other vents should be covered with screening to prevent small embers from entering the structure. Additional strategies for the home can be found at firewise.org.

Of course, once you have created a defensible space, the natural inclination is to want to, well, defend it. Unfortunately, you have to remember that you’ll be in the middle of a lot of heat and smoke.

The safest recommendation, therefore, would be to get out of Dodge if there’s a safe way to leave. It’s a personal decision but realize that your family’s lives may depend on it. If you’re leaving, have a bag already packed with food, water, extra clothes, batteries, flashlights, and more. Don’t forget to bring your cell phone, any important papers you might need, and some cash.

As an added precaution, make sure you shut off any air conditioning system that draws air into the house from outside. Turn off all your appliances, close all your windows and lock all your doors. Like any other emergency, you should have some form of communication system established with your loved ones in case you’re not together.

Medical kits should contain masks, eye and hand protection, burn ointment (aloe vera is a natural alternative) and non-stick dressings. Specialized burn dressings are available that incorporate both. Gauze rolls and medical tape can be used for additional coverage. Round out your kit with scissors, cold packs, and some eyewash (smoke is a major irritant to the eyes).

If your routes of escape are blocked, make sure you’re dressed in long pants, sleeves, and heavy boots. A wool blanket is very helpful as an additional outside layer because wool is relatively fire-resistant. Some people think it’s a good idea to wet the blanket first: Don’t. Wet materials transfer heat much faster than dry materials and will cause more severe burns.

If you’re inside a building, stay on the side farthest from the fire and with the least number of windows (windows transfer heat to the inside). Stay there unless you have to leave due to smoke or the building catching fire. If that’s the case and you have to leave, wrap yourself in the blanket, leaving only your eyes uncovered.

If you’re having trouble breathing because of the smoke, stay low, and crawl out of the building. There’s less smoke and heat the lower you go. Keep your face down towards the floor. This will help protect your airway, which is very important. You can recover from burns on your skin, but not from major burns in your lungs.

As of this writing, I’m still waiting for public access to my part of the mountain in Gatlinburg to be reinstated. If my home survived, it could have been due to the principles I’ve followed above, but it could also be just the wind direction or some timely rain. I’d like to believe it’s the former, but, heck, I’ll take the latter.

Joe Alton, MD

Please take a moment to include firefighters, medical personnel, and the citizens of Gatlinburg in your prayers. Also, a donation to the American Red Cross can be sent to First Tennessee Bank to aid fire relief efforts. The Johnson City Press reports that the First Tennessee Foundation will match donations up to $50,000. Send a check for any amount payable to the American Red Cross to:

First Tennessee Bank              

P.O. Box 8037

Gray, TN 37615

attn: Ms. Teresa Fry

Medical Supplies for the Homestead

Click here to view the original post.
homestead-cabin-pixabay

image by pixabay.com

If you’re a homesteader, you’ll want to be ready for any eventuality. In a remote location or austere environment, the importance of medical self-reliance can’t be overemphasized. Injuries and illness can happen anytime due to a storm, wildfire, earthquake, or other disaster.

Medical strategies abound for these mostly short term scenarios that are both reasonable and effective.  An entire medical education system exists to deal with limited wilderness or disaster situations. This system is served by a growing emergency supply industry and, in some cases, supported by federal taxes.

When you happen upon a victim in normal times, your goal is to:

  • Evaluate the injured or ill patient.
  • Stabilize their condition.
  • Transport them to the nearest modern medical facility.

This series of steps couldn’t make more sense; you’re not a physician, after all.  Somewhere, there are facilities that have a lot more technology than you have.  Your priority is to get the patient out of immediate danger and then ship them off to a higher medical resource.

It seems reasonable for the average citizen to expect the rescue helicopter to be on the way. But what if it isn’t? Some homesteads are far from the nearest hospital. When modern medical help isn’t at hand, quick action on your part may be necessary to save a life.

You never know when you might be the medical “end of the line” in the uncertain future. To be effective in that role, you need supplies.

Prepper Medical Supply Kit

Family Medical Kit

The availability of medical supplies may just save a life in troubled times, but without an idea of what medical items should be stockpiled, your effectiveness as an emergency caregiver may be compromised. Not having the right equipment at hand is like trying to eat a steak with a wrench and a screwdriver instead of a knife and fork. Purchasing these items all at once would be hard on the wallet, so the best strategy Is to slowly stockpile the medical supplies you need.

This article is meant to be a guide to which supplies would help you become an effective caregiver as opposed to being an in-depth discussion of how to use each one. To help you become a well-equipped homestead caregiver, we’ll list common medical issues and what items you’ll need to deal with them.

PERSONAL PROTECTION 

N95-Surgical-Mask

N95 mask

To begin with, however, let’s talk about personal protection.  No, I’m not talking about condoms, although they can be important additions to your storage. I’m not talking about firearms, either, although military medics are now usually armed.  I’m referring to protecting yourself and others from injuries and infectious disease.

Don’t ignore the power of prevention. In any remote environment, you will be performing daily activities that carry risk of injury.  Chopping wood for fuel would be one example. Eye and hand protection in the form of goggles and work gloves could prevent various injuries. Here are some other items that would be protective:

Gloves: I recommend nitrile gloves due to the increasing number of latex allergies reported recently. I would use size 8 or “large”, as gloves that are too small tend to break.  Gloves come in both sterile and non-sterile varieties.  Get lots of the non-sterile for everyday work, but don’t fail to have some sterile pairs as well.

Face Masks: These can be simple ear-loop versions or could be more advanced in the form of N95 and N100 “respirators”. These are masks that block out 95 or 100% of airborne particles larger than 0.3 microns.

Coveralls, Boots, and Headgear:  In mosquito-infested areas, there are special coveralls and headgear made from netting that are lifesavers. In epidemics of infectious disease, however, hazardous material suits that cover the body, head and feet are more pertinent for the person in charge of the sick room.

General items: Some items are of good general use for medical issues.  One of my favorites is the “EMT shears” or “bandage scissors”.  This is a special scissors meant to allow you to cut through clothing so that you can accurately assess the level of injury that you’re dealing with.

Another general item that would be highly useful would be a headlamp.  Injuries can occur at night as well as during the day. Using a headlamp frees up both hands to better handle emergencies.

A good supply of antiseptics will be important to keep your people healthy. Antiseptics are germ-killing substances that are applied to living tissue, usually skin, to reduce the possibility of infection. Antiseptics are different from antibiotics, which are meant to destroy bacteria within the body, and disinfectants, which destroy germs found on non-living objects, like kitchen or survival sick room surfaces.

I consider household bleach to be the simplest disinfectant for cleaning sick room work surfaces, but it’s too strong to apply to living tissue. Instead, consider Betadine (Povidone-Iodine solution), Chlorhexidine (Hibiclens), Alcohol , Benzelkonium Chloride (BZK), or Hydrogen Peroxide.  These can be found in small bottles, gallon jugs, and in wipes impregnated with the antiseptic.

Some of the most important medical supplies you’ll accumulate will be those used to deal with injuries. Let’s outline what you’ll need in your role as a homestead medic:

MINOR INJURIES

In an austere environment, it might be difficult to get through the day without some minor injury, such as a burn while cooking, blister while hiking, or a splinter from hauling wood. The average person has, over the course of their lives, dealt with more than one of these. Helpful items to have include:

  • Soap and water and antiseptics: To clean out minor wounds. Antibacterial soap is not necessary, however. The FDA (Food and Drug Administration) determined that it doesn’t give additional protection against infection.
  • Adhesive Bandages: various sizes and shapes to protect a scratch or abrasion from getting worse.
  • Moleskin: Have a supply of these to deal with common blisters on areas that receive friction.
  • Tweezers: With a magnifying glass, these will be useful to remove splinters or other small foreign objects.
  • Styptic Pencil: Although most minor bleeding stops with direct pressure, a styptic pencil can be used for razor cuts and is a helpful addition to your kit. For a natural alternative, Cayenne pepper powder is reported to have similar effects on minor bleeding.
  • Eye wash, cups, and patches: For minor eye irritation and injuries.
  • Gauze packing: for nosebleeds.  Dental cotton rolls and tampons are alternatives.
  • Burn Gel or Aloe Vera: To apply to small burns.

ORTHOPEDIC INJURIES

samsplints

The popular SAM Splint

Few of us, even couch potatoes, have avoided the occasional sprain or strain.  In situations where we are exerting ourselves, these will be more common, not to mention the possibility of fractures. You should have available:

Cold Packs:  These are available commercially or can be made with ice.  Cold packs help reduce the swelling often seen in sprains and strains, as well as provide some relief from pain.

Elastic Wraps: Elastic “Ace” wraps help stabilize an injured joint and decrease the chance of re-injury. Use compression in tandem with cold to decrease pain and swelling.  Don’t forget to elevate the injured limb above the level of the heart. Elastic wraps can also be used to cover bandaged wounds and to secure splints in place.

Slings: Commercial triangular bandages or improvised bandannas both are well suited to make a sling, these are useful to stabilize an arm or shoulder injury. The commercial versions usually come with safety pins.

Splints: Commercial “SAM” splints are flexible and can be cut or shaped to immobilize a sprain or fracture.  These vary in size to fit anything from a finger bone to a thigh bone. You can improvise with sticks and strips of cloth or even a folded-over pillow and duct tape.

Anti-inflammatory medications:  Ibuprofen is an over the counter medication to reduce swelling and pain in orthopedic injuries, and can be accumulated in bulk.  Salicin from the green underbark of willow trees is helpful for pain and, incidentally, was the base substance for the first aspirins ever made. Natural remedies such as Arnica salves are useful to decrease bruising, swelling, and pain (use on intact skin only).  Various anti-inflammatory medications also come in patches that can be applied to the back or other strained areas.

Heat Packs:  These won’t reduce swelling much, but can be used during recovery from an injury to help relax and loosen stiff tissues. They also stimulate blood flow to injured areas.

HEMORRHAGIC WOUNDS

expose-wound-to-see-the-full-extent-of-the-injury

EMT shears or bandage scissors can help expose a bleeding wound

The injury that non-professionals fear most is the bleeding wound.  With the right supplies, however, even heavy bleeding can be staunched successfully.  In addition to a blunt-edged scissors to expose the injury, the well-prepared medic will have:

Gauze: Bulk non-sterile gauze (some of our kits carry bricks of 200 at a time) is valuable as a medical storage item to apply pressure to bleeding areas.  Even one hemorrhagic wound could require you to use all the dressings that you had accumulated over years of stockpiling,  so get plenty.

Dressings come in squares of varying sizes and shapes. Roller bandages wrap around the area, and non-stick pads of various sizes (not technically “gauze”) are good for burns and other injuries. Carry a variety to increase the versatility of use.

Although I recommend storing tampons, it is more for its traditional use than to treat gunshot injuries, which vary in size (especially exit wounds). A tampon would not always be the right size for the cavity created by the projectile; they are best used for nose bleeds combined with compression.  Maxi-Pads, however, are excellent items for your medical storage.

Specialized Pressure Dressings:  It’s difficult to keep pressure on a wound with your hands without becoming tired, so special dressings like the Emergency Bandage™ (aka the “Israeli Battle Dressing”) allow you to wrap wounds that have the tendency to bleed.  These are an absorbent pad attached to an elastic bandage that comes with a “pressure applicator”. Used correctly, each turn of the wrap increases the pressure on the wound, which can help control bleeding.

Tourniquets:  In circumstances where bleeding can’t be stopped with pressure alone, a tourniquet may do the job. Tourniquets can be improvised with a bandanna and a stick or they can be high-tech commercial items such as the CAT or SOFT-T tourniquet.  Some tourniquets, like the SWAT, can serve double duty as a tourniquet, back-up tourniquet, or pressure dressing.

Blood-Clotting Powders/Dressings:  Also known as “hemostatic agents”, these are effective and easy to use. Available as a powder or powder-impregnated dressings, Celox™  (the most popular brand) is made from Chitosan, a component of crustacean shells. Celox™ will even stop bleeding in patients on blood thinners.  Although it is made from shrimp shells, the company states that can be used on people allergic to seafood.  Hemostatic agents are useful but expensive items. Remember, however, that they might save a life.

OPEN WOUNDS

stabwound

Dealing with open wounds in a remote setting requires good judgment as well as supplies. Most of these wounds should be kept open, but there are various supplies to help you close a wound as well as supplies that allow you to care for an open wound until it closes on its own by a process called “granulation”. In a remote homestead or survival setting, you never know when or if help will be on its way. You’ll need to be ready to care for that wound from beginning to end.

Antiseptics and sterile gloves:  As mentioned earlier in this article.

Sterile Gauze: Although non-sterile gauze is often used to stop hemorrhage, sterile dressings are best to use in open wounds as they heal. With commercial sterile saline or water solutions (or even boiled water), you’ll provide the type of environment that newly forming cells need to fill in a wound.  Dry sterile dressings to cover the moist dressing in the open wound will help keep the area clean. Some call this technique “wet to dry”.

Certain dressings, such as “Telfa™”, are non-stick and especially useful for burns or other injuries where removal might be painful. Some burn dressings like “Xeroform™” are dipped with petrolatum to protect healing areas where the skin was damaged or burned off. Alternatively, petroleum jelly could be added to improvise a similar item. Honey has also been used for this purpose, but make sure to get the raw, unprocessed version.

Wound Closure:  Closing a wound is risky (most wounds acquired outdoors are contaminated) but there are circumstances where it may be appropriate. Always start with the least invasive method such as Steri-Strips or even duct tape fashioned as butterfly closures. Sutures and staples can form a strong closure, but they also add more punctures to the skin that could become infected. Super glue is a safe method unless you happen to be allergic to the chemical (Cyanoacrylate). It is used in some underdeveloped countries without incident.

Additional Supplies:  Dry sterile dressings to cover the moist dressing in the open wound will help keep the area clean. Medical tapes to hold everything in place are helpful and come in cloth, self-adhesive, and paper (least allergenic).  Tincture of Benzoin is an adhesive liquid that comes in ampules that will help secure the tape. Triple antibiotic ointment and oral antibiotics are likely to be needed to prevent and treat infected wounds.  Consider having a thermometer to determine whether a fever is present.

I’ll bet you can think of other useful items that you’d want to keep in that homestead medical cabinet. We haven’t discussed, for example, the medications and natural remedies you should have on hand. We’ve addressed these before on this website, though, and will update in a future article.

HOW MUCH TO HAVE?

I commonly see books that give you numerical amounts of medical items to have if you’re the caregiver in an austere environment or in a long-term survival scenario.  My opinion is simple:  You can never have too many of any medical supply.  They are expended more quickly than you think. If you’re in a remote location or other austere setting, have as much as possible in your storage.

A parting thought: You can have all the beans in the world and all the bullets in the world, but it won’t amount to a hill of beans and you’ll just shoot yourself in the foot, if you don’t have the bandages.

Joe Alton, MD

joealtonlibrary4

Whether you’re a homesteader or a city dweller, you need medical supplies to deal with injuries and illness in the uncertain future. Check out Nurse Amy’s entire line of kits and individual items at store.doomandbloom.net. Also, keep a copy of our brand new Third Edition of “the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way” in your survival library.

 

Portions of this article were first published in Backwoods Home magazine.

Video: The OODA Loop of Situational Awareness

Click here to view the original post.
crowd

Are you safe here?

In this companion video to a previous article, Joe Alton, MD, aka Dr. Bones, discusses a fighter pilot strategy that might save your life in a terror event. Originally meant for aerial dogfights, the OODA loop was developed by Colonel John Boyd and has been used in everything from business to active shooter scenarios. Incorporating the OODA loop into your mindset will help instill the culture of readiness that is so important in the New Normal of the uncertain future.

To watch, click below:

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

 

Joe and Amy Alton

AmyandJoePodcast400x200

The Altons

Survival Medicine Hour: Tom Martin of APN, Shooter Issues, Summer Germs, Natural Remedies

Click here to view the original post.
shutterstock_53362708

Summer Germs

In this episode of the Survival Medicine Hour with Joe and Amy Alton, aka Dr. Bones and Nurse Amy, Tom Martin of American Preppers Network joins us to talk about his new show, plus a serious look at the recent shooter events and when violence is the answer to stop the fatalities. Also, places you’ll be this summer that could make you seriously sick if you’re not careful. Nurse Amy continues her discussion of natural remedies that will help for orthopedic injuries. Dr. Bones also talks about what the medic’s priorities should be when under fire in hostile survival scenarios. All this and more on the latest Survival Medicine Hour.

DBS_character_hunter

 

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2016/07/08/survival-medicine-hour-shooters-summer-germs-tom-martin-of-apn-more

 

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

 

Joe and Amy Alton

joe and amy radio

Don’t forget to check out our brand new Third Edition of the Survival Medicine Handbook, as well as our Zika Virus Handbook, both available on Amazon. And fill those holes in your medical supplies at Nurse Amy’s store!

Alligator Attacks

Click here to view the original post.
danger alligator

Take this sign seriously

 

While reading of the tragic attack by a Florida alligator on a two year old boy recently, it struck me that, although I’ve written about bear encounters, animal bites, and shark attacks, I’ve never written about alligators or crocodiles. Yet, we sometimes see gators in the lake behind our home here in South Florida, and they can be very dangerous.

Alligators are crocodilians, which also include crocodiles, caimans, and some other species. Solidly built and reaching large sizes, you might be surprised to know that these powerful reptiles’ closest relations still in existence are birds. Although humans are usually not on these carnivores’ menu, they aren’t the pickiest eaters. As a result, there are about 300 attacks reported yearly worldwide that lead to injury or death. Attacks by crocodilians occur mostly in Africa and Asia, mostly by Nile river crocodiles, but have also been reported in North America, South America, and Australia.

alligator range

BE AWARE

alligator smile

Looks slow and clumsy; it’s not.

Although alligators look clumsy and slow on land, they can actually reach a speed of 10 mph. In the water, however, they can be agile and seriously fast. It makes sense to give them a wide berth whenever they are seen. This isn’t always easy, as their modus operandi is to stalk and ambush with only their eyes, ears, and nostrils above water. Once they grab hold of their victim, they hold it underwater until it drowns.

Situational awareness, so important in survival, will help avoid an encounter with an alligator. Attacks can occur both in the water and the water’s edge.Watch for mounds of vegetation that could represent a nest and stay away from murky water or shallow swampy areas of vegetation. Swimming in alligator territory is unwise, and they are especially attracted to splashing around. If you find yourself in the water unexpectedly, get out as quietly and quickly as possible.

alligator vegetation

Alligators might be hard to spot in swampy vegetation

Attacks by crocodilians most often occur at dusk or at night. Nesting mothers are, unlike other reptiles, protective of their young, and have a nasty temper. Having a flashlight or head lamp will alert you to their presence at night in or out of the water by the reflection of light from their eyes.

KEEP A DISTANCE

alligator in water

Most images for this article by pixabay.com

If you spot a gator on land, stay 75 feet away. If you’re camping in alligator country, make sure that your tent is six feet above the water line and at least 150 feet from the water’s edge. Store all food securely and avoid leaving scraps around that might attract them. Especially keep a close eye on dogs and children near the water’s edge. Alligators prefer smaller prey that they can easily drag into the water.

Alligators will sometimes hiss when they feel threatened. If they charge, run as fast as you can in the opposite direction from the water. If they catch you, they’ll try to drag you in. Once you’re in, your chances of survival drop greatly.

ATTACKED!

alligator above water

alligators can jump vertically out of the water

Let’s say you, somehow, find yourself in the jaws of an alligator or crocodile. If it lets go, it was just a defensive reaction, but if it holds on and tries to get you in the water, you must fight. The eyes are most vulnerable, and gouging at them might be your best chance. After that, any trauma you can inflict to the head might discourage it enough to let you go.

If all has failed and you’re in the water, there’s still a chance. The alligator has a flap of tissue in their throat that prevents it from drowning. If you can grab hold of or damage this tissue, called the “palatal valve”, water will flow down its windpipe and your attacker might just release you.

If you manage to get out of the water, realize that any bite wound is probably already colonized with the huge amount of bacteria that alligators have in their mouth. Even  a minor bite will become infected if not treated with antibiotics.

Joe Alton, MD

AuthorJoe

Hey, check out the brand new 2016 edition of The Survival Medicine Handbook at amazon.com, over 670 pages of medical info you’ll need in times of trouble.

 

Survival Medicine Hour: Urban Survival, Slowly Healing Wounds

Click here to view the original post.

shutterstock_281220074

In this episode of the Doom and Bloom(tm) Survival Medicine Hour, Joe Alton, MD and Amy Alton, ARNP discuss what it takes to be an effective medic in an urban survival setting. From dealing with contaminated water to controlling a bleeding wound, there are special considerations that must be taken into account when surviving in place in the town or city. Find out what items you should have and how to approach the bleeding wound. Plus, Dr. Alton answers a question from “rancher”, a member of Jack Spirko’s Survival Podcast audience, about how to deal with thinning skin as you age and spend time in the outdoors. Conventional and natural remedies are discussed to help wounds in fragile skin heal faster.

Also, the new 2016 Third Edition of the Survival Medicine Handbook has hit Amazon, and it’s 670 pages of plain English advice on what to do in a disaster when the hospital is far away or just plain no longer exists. Get a copy today for your survival library.

To listen in to the podcast, click below:

http://www.blogtalkradio.com/survivalmedicine/2016/06/12/survival-medicine-hour-urban-survival-slowly-healing-wounds

 

Wishing you all the best in good times or bad,

 

Joe and Amy Alton

JoeAmyPortrait2013

 

 

 

VIDEO: Active Shooter Bleeding Control Kit in Action

Click here to view the original post.

cover celox with roller gauze

Would you be able to stop severe hemorrhage in the aftermath of a terror attack? In Amy Alton, ARNP, aka Nurse Amy’s latest video, she puts on a realistic demonstration of her First Aid Bleeding Control Kit in action after a simulated active shooter event. Each item in the kit is demonstrated as if utilized by a civilian with no training. We believe a kit like this should be available in every workplace, mall, school, and, really, any place at risk for this type of event. The items in the kit are meant to be easy to implement and effective in the control of bleeding.

Small Bleeding Control Kit image

Bleeding Control Kit

To watch, click below:

 

 

 

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

 

Amy Alton, ARNP and Joe Alton, MD

Amy Alton Everglades Close up 400 x 600

Amy Alton, ARNP

Video: Brown Recluse Spider Bites

Click here to view the original post.

brown recluse penny

In this companion video to the article on the same subject, Joe Alton, MD discusses what he believes to be a brown recluse spider bite incurred by his wife Amy Alton, ARNP while tending to her medicinal and vegetable garden. Learn all about Brown Recluse Spiders, how to recognize their bites, and how to treat injuries caused by spider venom. And don’t worry, Amy is slowly but surely recovering.

Amy Alton Everglades Close up 400 x 600

To watch, click below:

 

 

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

 

Joe and Amy Alton, aka Dr. Bones and Nurse Amy

 

Brown Recluse Spider Bites

Click here to view the original post.
Brown Recluse wiki

Brown Recluse Spider (wikipedia)

You might have seen our articles and videos on snakebite, but in a survival scenario, and really, everyday life, you will see a million insects for every snake; so many, indeed, that you can expect to regularly get bitten by them. Insect bites usually cause pain with local redness, itching, and swelling, but are rarely life-threatening, although some fleas and mosquitoes can transmit some pretty nasty diseases.

Amy Alton Everglades Close up 400 x 600

Nurse Amy

This time, we’ll talk about spider bites, and for a very specific reason. My lovely wife, Nurse Amy, has what we suspect is a brown recluse bite. As you know, we’re big on gardening and Amy spends a lot of time putting her green thumb to work growing some food. Well, there are bugs in any garden, and wouldn’t you know it, Amy got bitten by something. It started off as a blister, but then eroded the skin before stabilizing, and is now slowly healing.

brown recluse penny

adult brown recluse (wikipedia)

Although tarantulas and other large spiders cause painful bites, most spider bites don’t even break the skin.  In temperate climates, two spiders are to be especially feared:  The black widow and the brown recluse. Today, we’ll talk about the brown recluse.

 

The brown recluse spider is, well, brown, and has legs about an inch long.  Unlike most spiders, it only has 6 eyes instead of 8, but they are so small that it’s difficult to identify them from this characteristic.

 

Victims of brown recluse bites report them to be painless at first, but then may experience these symptoms:

 

  • Itching
  • Pain, sometimes severe, after several hours
  • Fever
  • Nausea and vomiting
  • Blisters

 

The venom of the brown recluse is thought to be more potent than a rattlesnake’s, although much less is injected in its bite. Substances in the venom disrupt soft tissue, which leads to local breakdown of blood vessels, skin, and fat. This process, seen in severe cases, leads to “necrosis”, or death of tissues immediately surrounding the bite. Areas affected may be quite extensive. The same venom that acts to liquefy an insect’s innards for consumption causes the “flesh rotting” effect in human wounds.

Brown Recluse Bite

Amy’s spider bite

A common appearance of a brown recluse bite is the formation of a reddish blister, surrounded by a bluish area, with a narrow whitish separation between the red and blue, giving a “bull’s-eye” pattern. In some people, however, very little effect is noted or the appearance can be quite variable, as seen in the above image of Nurse Amy’s bite.

 

Once bitten, the human body activates its immune response as a result. Immune reactions can go haywire, destroying red blood cells and kidney tissue, and sometimes hampering the ability of blood to clot appropriately.  These effects can lead to coma and, eventually, death.  Almost all deaths from brown recluse bites are recorded in children.

 

The treatment for spider bites includes:

 

  • Washing the area of the bite thoroughly
  • Applying ice to painful and swollen areas
  • Pain medications such as acetaminophen
  • Enforcing bed rest in severe cases
  • Warm baths for those with muscle cramps due to black widow bites, but stay away from applying heat to the area with brown recluse bites
  • Antibiotics to prevent secondary bacterial infection

 

Home remedies include making a paste out of baking soda or aspirin and applying it to the wound. The same method, using olive oil and turmeric in combination, is a time-honored tradition. Dried basil has also been suggested; crush between your fingers until it becomes a fine dust, then apply to the bite. One naturopath uses Echinacea and Vitamin C to speed the healing process.  Be aware that these methods may be variable in their effect from patient to patient.

 

There are various vacuum devices and kits available that purport to remove venom from bite wounds. Unfortunately, these suction devices are generally ineffective in removing venom from wounds. Tourniquets are also not recommended and may be dangerous.

 

Although antidotes known as “antivenins” exist and may be life-saving for venomous spider and even scorpion stings, these will be scarce in the aftermath of a major disaster. Luckily, most cases that are not severe will subside over the course of a few days, but the sickest patients will be nearly untreatable without the antivenin.

 

Now, brown recluses are relatively new in Florida, but have been frequently reported recently in Florida, usually in the North. In the year 2000 alone the Florida Poison Control Network had recorded nearly 300 alleged cases of brown recluse bites in the state. Having said that, other infections or bites may appear similar, and some doctors feel that the brown recluse is often blamed for reactions that have nothing to do with it. other insect bites and some infections may also be the culprit.

 

Amy’s bite is getting better, but it’s important to know that spiders exist and to keep a close eye out for them as you tend to your survival garden.

 

Joe Alton, MD

tent joe's kids

Are you ready to deal with medical issues you might encounter in a disaster? With our #1 Amazon bestseller The Survival Medicine Handbook and Nurse Amy’s entire line of medical kits and supplies, you’ll get a head start on keeping it together, even if everything else falls apart.

Video: Active Shooter Bleeding Control Kit, Part 2

Click here to view the original post.

AmyWomensPanel

In part 2 of a series on hemorrhagic wounds incurred in a terror or other active shooter event, Amy Alton, ARNP discusses what she believes would be a reasonable item for a bleeding control kit and why she chose specific items for the kit she designed for the average citizen in the workplace, school, or mall.

Small Bleeding Control Kit image

 

To watch, click below:

 

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

 

Amy Alton, ARNP, aka Nurse Amy

NurseAmyBook
Are you equipped with the supplies you’ll need to deal with medical issues in times of trouble. Check out Nurse Amy’s entire line of kits at her store at store.doomandbloom.net

Video: Mass Casualty Triage, Part 2

Click here to view the original post.

ambulances

In this part of Joe Alton, MD’s series on Mass Casualty triage, Dr. Bones discusses the RPMs of primary triage, plus the various triage levels. In the comments section, you’ll find 10 victims to triage. We’ll go over these in part 3, coming up soon!

 

To watch, click below:

 

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

 

Joe Alton, MD

tent joe's kids

Videocast: Rib Fractures, Pneumothorax, Sleep Deprivation

Click here to view the original post.

rib fracture

Dr. Joe and Amy Alton, aka Dr. Bones and Nurse Amy put on a live videocast every first and third Wednesday of each month in collaboration with the nice folks at aroundthecabin.com. This time, they talk about rib fractures, collapsed lungs, chest seals, and do some demonstrations. Also, they discuss some important things you should know about sleep deprivation, a major issue in any SHTF scenario…

 

To watch, click below:

 

 

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

 

 

Joe and Amy Alton
TentMEDIUM

Fill those holes in your medical supplies by checking out Nurse Amy’s entire line of medical kits at store.doomandbloom.net.

Traumatic Brain Injuries

Click here to view the original post.

shutterstock_8530189

Most head injuries cause superficial damage and are not life-threatening. Indeed, most head injuries amount to only a laceration of the scalp, a black eye, or a painful bump. These wounds, however, can hide damage inside the cranium, the part of the skull that contains the brain. Injuries that affect the brain are called traumatic brain injuries (TBIs). It’s important for the medic to recognize when trauma to the skull has caused damage that is more than superficial.

 

 

Concussions are the most common type of TBI. A concussion is associated with a variety of symptoms that are often immediately apparent. The presentation differs from one individual to the next. Although you might expect a loss of consciousness, the victim may remain completely alert. Headache is actually the most commonly seen symptom. Other symptoms include:

 

 

• Dizziness
• Confusion
• Nausea
• Loss of motor coordination
• Blurred or double vision
• Slurred speech
• Ringing in the ear (also called “tinnitus”)
• Difficulty focusing on tasks at hand

 

 

A person with trauma to the head may be knocked unconsciousness for a period of time. In most cases, they will “wake up” in less than 2 minutes. You can expect them to be “foggy” and behave inappropriately (put me in, coach!). They may not remember the events immediately prior to the injury.

 

 

Loss of consciousness is a serious concern. If the victim is “out” less than two minutes, the patient will merit close observation for the next 48 hours. You should examine for evidence of superficial injuries and determine that the patient has regained normal motor function. Make sure they can move all their extremities with normal range and strength.

 

 

Rest is prescribed for the remainder of the day. When your patient goes to bed, it will be appropriate to awaken them every two or three hours, to make sure that they are easily aroused. In most cases, a concussion causes no permanent damage unless there are multiple episodes of head trauma over time, as in the case of boxers or other athletes in contact sports.

 

 

It should be noted that a physical strike to the head is not necessary to suffer a concussion. A particularly jarring football tackle or the violent shaking of an infant can cause a concussion or worse traumatic brain injury. This is because the brain “bounces” against the walls of the cranium. When injury occurs at the site of a blow to the head, it’s called a “coup” injury. Just as often, it can occur on the opposite site of the head, known as a “contrecoup” injury.

 

 

In many cases, evidence of direct trauma to the skull is visible. An “open” head injury means that the skull has been penetrated with possible exposure of the brain tissue. If the skull is not fractured, it is referred to as a “closed” injury. An indentation of the skull is clear evidence of a fracture and the outlook may be grim, due to the likelihood of bleeding or swelling in the brain. A closed injury may still become life-threatening for the same reasons.

 

 

The brain requires blood and oxygen to function normally. An injury which causes bleeding or swelling inside the skull will increase the intracranial pressure. This causes the heart to work harder to get blood and oxygen into the brain. Blood accumulation (known as a “hematoma”) could occur within the brain tissue itself, or between the layers of tissue covering the brain.

 

 

Without adequate circulation, brain function ceases. Pressure that is high enough could actually cause a portion of the brain to push downward through the base of the skull. This is known as a “brain herniation” and, without modern medical care, will almost invariably lead to death.

 

 

There are a number of signs and symptoms which might identify those patients that have a serious TBI. They include:

 

 

• Prolonged loss of consciousness
• Convulsions (Seizures)
• Worsening headache over time
• Nausea and vomiting
• Bruising (around eyes and ears)
• Bleeding from ears and nose
• Worsening confusion/Apathy/Drowsiness
• One pupil more dilated than the other
• Indentation of the skull

 

 

If the period of unconsciousness is over 10 minutes in length, you must suspect the possibility of significant injury. Vital signs such as pulse, respiration rate, and blood pressure should be monitored closely. The patient’s head should be immobilized, and attention should be given to the neck and spine, in case they are also damaged. Verify that the airway is clear and breathing is regular. In a collapse, this person is in a life-threatening situation that will have few curative options if consciousness is not regained.

 

 

Other signs of a traumatic brain injury are the appearance of bruising behind the ears (Battle’s sign) or around the eyes (raccoon sign). This indicates internal bleeding in the cranium, despite the impact not occurring in those areas. Bleeding from the ear itself or nose without direct trauma to those areas is another indication. The fluid that drains out may be clear; this may represent spinal fluid leakage.

 

 

In addition, intracranial bleeding may cause pressure that compresses nerves that lead to the pupils. In this case, you will notice that your unconscious patient has one pupil more dilated than the other.

 

 

A severe consequence of bleeding in the brain is a stroke, (also known as a cerebrovascular accident or CVA). It represents damage to the brain caused by lack of blood supply. This could occur in a head injury due to a blockage of blood flow to a portion of the brain. This blockage could be due to a clot, a hemorrhage, or anything else that compromises the circulation in the area. Another possibility is a defect in a blood vessel known as an “aneurysm” which could rupture even in the absence of a traumatic event.

 

 

Whatever functions are associated with the part of the brain affected will be lost or impaired. These patients often present with an inability to speak, partial or complete blindness, and paralysis or weakness of one side of the body and face. The stroke is usually heralded by a sudden severe headache.

 

 

Strokes may also occur due to other reasons as well, such as uncontrolled high blood pressure. Although it may not be difficult to diagnose a major CVA in an austere setting, few options will exist for treating it. Blood thinners might help a stroke caused by a clot, but worsen a stroke caused by hemorrhage. It could be difficult to tell which is which without advanced testing.

 

 

Keep the victim on bed rest; sometimes, they may recover partial function after a period of time. If they do, most improvement will happen in the first few days.

 

 

Trauma to the head may have negligible consequences, or it could have life-threatening consequences. In some circumstances, there may be little that you, the medic, can do in a long-term survival situation.

 

 

Joe Alton, MD

 

Learn more about traumatic brain injury and over 100 other medical topics in austere settings in our Amazon bestseller “The Survival Medicine Handbook“, with over 270 5-star reviews!

Injuries to the Nail Bed

Click here to view the original post.

ingrown-toenail-featured1

 

Minor injuries can sometimes be a major detriment to the function of a member of your survival group. Although perhaps not as life-threatening as a gunshot wound or a fractured thighbone, nail bed injuries are common; they will be more so when we are required to perform carpentry or other duties to which we’re not accustomed.

 

 

Nail Anatomy

 

 

Your fingernails and toenails are made up of protein and a tough substance called keratin. They are, as you can imagine, similar to the claws of animals. When we refer to issues involving nails, we refer to it as “ungual” (from the latin word for claw: unguis).

image#107

The nail consists of several parts:

 

 

The nail plate (body): 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. Like all skin, blood vessels and nerves run through the nail bed.

 

 

The nail 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.

torn_fingernail1

In a nail “avulsion”, the nail plate is ripped away by some form of trauma. The nail may be partially or completely gone, or may be lifted up off the nail bed. Ordinarily, depending on the type of trauma, an x-ray would be performed to rule out a fracture of the digit; you won’t have this tool available without modern facilities, but you can do this for an avulsed nail:.

 

 

 

• Clean the nail bed thoroughly with saline solution, if available, and irrigate out any debris. Paint with Betadine (2% Povidone-Iodine solution) or other antiseptic. If you have local anesthesia, you might want to use some; this area is going to be tender.

 

 

• Cover the exposed (and very sensitive) nail bed with a non-adherent (Telfa) dressing. Some add petroleum jelly for additional protection. Change frequently. Avoid ordinary gauze, as it will stick tenaciously and be painful to remove.

 

 

• If the nail plate is hanging on by a thread, remove it by separating it from the skin folds using a small surgical clamp. You can consider placing the avulsed nail plate on the nail bed as a protective covering; it is dead tissue but may be the most comfortable option. Avoid scraping off loose edges, as it may affect the nail bed’s ability to heal.

 

 

• If the nail bed is lacerated, suture it (once cleaned) with the thinnest gauge absorbable suture available (say. 6-0 Vicryl). Be sure to remove any nail plate tissue over the laceration so the suture repair will be complete.

 

 

• Place a fingertip dressing. You might consider immobilizing the digit with a finger splint to protect it from further damage.

 

 

• Begin a course of antibiotics if the nail bed was contaminated with debris.

 

 

In some crush injuries, such as striking the nail plate with a hammer, a bruise (also called an “ecchymosis”) or a collection of blood may form underneath (a “hematoma”). A bruise will be painful, but the pain should subside within an hour or two. A hematoma, however, will continue to be painful even several hours after the event. A bruise will likely appear brownish or blue, but a hematoma may appear a deep blue-black.

nailhematoma

 

For a bruised nail, little needs to be done other than giving oral pain meds, such as Ibuprofen. For a significant hematoma, however, some suggest a further procedure called “trephination”. In this instance, a very fine drill (or a hot 18 gauge needle or paper clip) is used to make a hole in the nail plate. This opening must be large enough to allow blood that has collected under the nail to escape. Once the pressure is relieved, the pain will abate.

 

This procedure should not be performed unless absolutely necessary, as the pain will eventually decrease over time by itself. If you go too deep through the nail, you may further injure the nail bed. The finger must be kept dry, splinted and bandaged for a minimum of 48 hours afterwards.

 

image#136

 

It’s important to know that damage to the base of the nail (the germinal matrix) may be difficult to completely repair, and that future nail growth may be deformed in some way. In situations where modern medical care is available, a hand surgeon is often called in to give the injury the best chance to heal appropriately. Even then, a higher incidence of issues such as “ingrown” nails may occur over time. A completely torn-off nail will take 4-5 months to grow back, maybe more.

 

Joe Alton, MD

Self Aid

Click here to view the original post.

A Basic Self-Reliance Approach To Self Aid: Part 1
Josh “7P’s of Survival

Self AidThis week we will be talking about all things first aid or self aid; whichever, you prefer in a woodland environment. I have been a first responder since I was sixteen and have served in a variety of capacities including wilderness First Responder and EMT along with a few levels of Ambulance based certifications. Over the last, well almost 20 years now, I have been presented with a wide variety of challenges, situations, training scenarios and just plain weird situations that have helped me deal with most injuries using a very simple kit which will all easily fit in a haversack with room to spare for your 10 Piece kit.

During the show we will:

2-9-16 thCA7XBOBI1) discuss what I prefer to carry when going into the woods alone (which is 99% of the time for me);

2) Discuss what I would take into the woods if I’m planning on acting as a first responder or primary care giver; and

3) Common Medicinal Plants/Trees that I like to use and generally keep in my kit (there are 10 right now I believe) and how to use them generally.

I believe this will take up the bulk of the hour, but if for some strange reason I have extra time I will start work next weeks show which will be a very compact wilderness first aid class.

It is my hope to speak with many of you during the show about what you carry in you IFAK (Individual First Aid Kit) and why you chose those items. I will then show how you can potentially lighten your load utilizing the technology in your kit, nature and a few tips/tricks for increased success!
Visit 7P’s Survival Blog HERE! 
Join us for The 7P’s of Survival “LIVE SHOW” every Tuesday 9:00/Et 8:00Ct 6:00/Pt Go To Listen and Chat

Listen to this broadcast or download “Self Aid” in player below!

Get the 24/7 app for your smart phone HERE! 
Put the 24/7 player on your web site HERE!
Archived shows of 7P’s of Survival at bottom of THIS PAGE!

The post Self Aid appeared first on The Prepper Broadcasting Network.

Survival Medicine Hour: Bleeding Control Kit, Herbal Teas, Zika update, more

Click here to view the original post.
Direct Pressure on Bleeding Wound

Bleeding wound

Would you have the materials and knowledge to stop heavy bleeding if you were confronted with it? In these violent times, you should be prepared to deal with injuries that could be life threatening and have the equipment that might save a life. Hear Amy Alton, ARNP, explain her thinking in designing a compact med kit that deal with hemorrhage that she believes should be in every workplace, classroom, and homestead. Also, Joe Alton, MD, talks about natural remedies when he goes over some herbal teas. Plus: Why does Zika Virus in Brazil cause birth defects, while no major history of the problem seems to occur with Zika virus in its original territory (Africa and Asia)? Is a mutation the cause? All this and more on the latest Survival Medicine Hour with Dr. Bones and Nurse Amy.

shutterstock_93431647

To listen in, click below:

 

 

http://www.blogtalkradio.com/survivalmedicine/2016/01/31/survival-medicine-hour-bleeding-control-kit-herbal-teas-zika-update-more

IMG_0945

 

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

 

 

Joe and Amy Alton

 

Check out Nurse Amy’s latest kit “The First Aid Bleeding Control Kit” at her store at store.doomandbloom.net

 

 

videocast

Guest Post: Top Ten Things To Know About Ballistic Protection

Click here to view the original post.
BodyArmorJoeShirtFront

Covert body armor can be worn under clothes

 

(DR BONES SAYS: From time to time, we post articles from aspiring writers in the field of medical preparedness. This time, our guest author is Chris Taylor of SAFEGUARD body armor who gives a top ten countdown of important things to know about ballistic protection. And now, Chris’s article ).

 

 

Preparedness is no easy task; it requires an understanding of the situations you will find yourself in and the methods by which you can survive them. The most important thing to safeguard is your safety, as only by being properly protected can you keep yourself alive.

 
Proper protection can mean a number of different things, from first aid, to self-defense. However, an often overlooked method of keeping oneself safe is by employing body armor. Bullet proof vests are more accessible and protective than ever, and yet there are still a number of important things to understand before grabbing the nearest vest. Here are the top ten most important aspects of body armor everyone should know:

 

body-armor
10.) Body Armor is Available for Everyone
Body armor usually conjures up images of high-visibility protective vests worn by the Police, or ultra-protective tactical armor worn by SWAT teams and the Military. Similarly, many assume that these products are difficult to obtain, and are only reserved for these people. While there are some restrictions on how body armor may be purchased and used in some areas (check local regulations before you purchase), body armor is available for anyone to purchase and wear. Indeed, anyone who faces the threat of attack or injury should consider a protective vest, as it could help save their life.

 
9.) Body Armor covers a lot of products
As we’ve seen above, body armor refers to a wide range of protective clothing; everything from stab proof vests to helmets is considered body armor, and it can be difficult to know exactly what you need and what you are getting. The products can be loosely grouped into ‘soft armors’ and ‘hard armors’, depending on the materials they use to offer protection. However, within each of these groupings there are variations that need to be considered.

 

female body armor

female body armor

8.) Different threats mean different protection…
These variations exist in order to combat different threats, as certain weapons or attacks require different materials to provide protection. For example, bullet proof vests cannot protect against many stab wounds, which cannot protect against spike attacks like ice picks. Similarly, ‘soft’ bullet proof vests cannot protect against high-velocity ammunition. To add to the confusion, many vests meant to protect injury from sharp objects also come with ballistic protection. While this will be discussed later, it is important first to know what threats you need protection against; if you will be facing rifles, you need armor with rigid plates. If you will be facing edged weapons, you need armor with stab protection. If you are facing spiked weapons, you need spike protection. All of these protections can be found in addition to ballistic protection.

 
7.) Not completely bulletproof
However, even a bullet proof vest is not completely bullet proof. There is no such thing as complete protection against a bullet, particularly when bullets come in all shapes and sizes. A bullet proof vest will certainly increase your chances of surviving an attack involving a firearm, but it should never replace caution and diligence.

 
(DR. BONES SAYS: EVEN THE BEST VESTS WON’T PROTECT YOU FROM THE FORCE OF THE BULLET. BLUNT TRAUMA FROM IMPACT AGAINST THE VEST MAY BREAK RIBS, COLLAPSE LUNGS, AND CAUSE INTERNAL BLEEDING)

 
6.) Levels
While no vest can offer 100% guarantee against bullets, vests at different levels offer some assurance against certain ammunition types. Ballistic protection is tested and graded by the National Institute of Justice, which assigns ‘levels’ to bullet proof vests. These NIJ Levels outline exactly what threats a vest can protect against. This means that vests at lower levels cannot protect against higher caliber ammunition, whereas higher levels can offer greater protection. The highest level of ‘soft armor’ available is Level IIIa, which will protect against the vast majority of handgun ammunition. The highest level of ballistic protection available is Level IV, which is only achievable with rigid plates, and can protect against even armor-piercing ammunition.

 
5.) How it works
Many do not know exactly how a bullet proof vest provides protection, and understanding how the materials involved work helps distinguish between the different levels and types available. ‘Soft armor’ uses fabrics like Kevlar, which have an incredibly high strength-to-weight ratio. This allows them to trap bullets and disperse their energy, slowing them to a complete stop. These materials are lightweight and flexible, allowing them to be worn even under clothing. Higher levels, however, need rigid plates that use materials like Ceramics and Polyethylene, which are incredibly strong and even deflect or absorb bullets. These plates are much thicker and heavier, and yet still light enough to be worn in covert vests.

 

 

4.) Different Styles
In addition to being split along numerous protective lines, body armor can also be found in ‘covert’ and ‘overt’ styles. This means that a vest is designed either to be worn under clothes or over clothes. Covert armor offers discreet protection at all levels, and can even use rigid plates. Some covert vests are even designed to help keep the wearer cool. On the other hand, overt vests are worn over clothing and have more variety in the materials used and the extras available. For example, overt vests can use waterproof and high-visibility covers, and can be equipped with additional pockets and clips, as well as logos and insignia.

 

body-armor-hard

Overt body armor

3.) Proper fitting
It may sound obvious, but ensuring your vest fits you properly is just as important as ensuring you have the right level of protection and style. In a hostile situation, freedom of movement is very important, and you need to be comfortable in order to perform to the best of your ability. Body armor should be comfortable enough to be worn for extended periods, meaning you don’t have to worry about your protection. Armor that does not fit properly may also have gaps in protection, leaving you vulnerable. Many vests are fully adjustable, but making sure you have the right size is very important.

 
2.) Keep it clean
Just as important is keeping your armor well maintained. Many do not realize that body armor and the materials used only have a limited lifespan, and without proper maintenance, this will be reduced dramatically. Vests need to be cleaned regularly and stored correctly, just like all clothing. The carrier, which is the vest itself, can usually be machine washed and often only consists of materials like cotton. The protective inserts, on the other hand, should only be cleaned with a mild cleaning agent and a gentle sponge, to avoid causing damage to the protection. Armor should be stored out of sunlight, should not be crumpled, and should have nothing stored on top of it. Moreover, all vests should be inspected regularly, and if any damage or deformity is found, you should replace your armor immediately. Many manufacturers recommend having multiple carriers to ensure you always have clean armor to wear.

 

greek-body-armor

looks great, but not much help against bullets

1.) Wear it
The most important thing to know about a vest is that it can only protect you when it is worn. Again, this seems obvious, but all too often people are injured or even killed despite owning body armor. Choosing the right vest and keeping it well-maintained is important, but unless you wear it when it is needed, it cannot protect you.

Head Wound & Concussion Care

Click here to view the original post.

Head Wound & Concussion Care!
Host: Dr Bones & Nurse Amy “Survival Medicine Hour”

Head Wound  gash 001In this episode of the Doom and Bloom(tm) join Dr. Bones and T. D. Bird, the African Gray Parrot (T. D. stands for “That Darn”) as he discusses head wound injuries and some new research on concussions, the open head wound, and issues related to gastric reflux. Also, the FDA does an about-face regarding whether to use aspirin as primary prevention for heart attack.

When the medically-responsible person evaluates a head wound, the following question must be asked: What am I trying
to accomplish by stitching this wound closed? Your goals when performing wound closure are simple.

You close wounds to:Head Injuries th (1)
Repair the defect in the body’s armor.
Eliminate “dead space” that can lead to infection.
Promote healing.
Provide a pleasing cosmetic result (less scarring).
Sounds like every wound should be closed, doesn’t it? Unfortunately, it’s more complicated than that. Closing a wound that should be left open can do a lot more harm than good, and could possibly put your patient’s life at risk.

Head InjuriesAlthough a daily low dose of aspirin has been shown to be effective in preventing a re-occurrence of a heart attack or stroke, the FDA is now warning people who have not had a first heart attack or stroke that taking an aspirin every day may not have a benefit. In fact, doing so may actually cause serious side effects.

Suffering a concussion can be a different experience for everyone – and now, new imaging research has revealed that the recovery process may actually be more difficult for one gender than the other. Dr. Bones talks about head injuries in general and the new research.
Get “The Survival Medicine Handbook” HERE!
Visit Joe and Amy’s web site at: www.doomandbloom.net

Listen to this broadcast or download “Head Wound & Concussion Care” in player below!

Get the 24/7 app for your smart phone HERE! 
Put the 24/7 player on your web site HERE! 
Listen to archived shows of all our hosts . Go to schedules tabs at top left of page!

The post Head Wound & Concussion Care appeared first on The Prepper Broadcasting Network.

Survival Medicine Hour: Active Shooters, SWAT-T, Superbugs

Click here to view the original post.

hemorrhage

Would you know the right plan of action if you were caught in an active shooter situation? Having a plan of action in advance may mean the difference between life and death? Joe Alton, MD gives his take on what to do in a mass casualty incident. Also, Dr. Alton discusses antibiotic-resistant superbug CRE, as well as Dr. Brock Blankenship’s SWAT-T, a tourniquet that might be a good addition to many workplace and schools’ first aid kits.

medic-in-action

To listen in, click below:

 

http://www.blogtalkradio.com/survivalmedicine/2015/12/06/survival-medicine-hour-active-shooters-swat-t-new-superbug

 

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

 

 

Joe and Amy Alton

AmyandJoePodcast400x200

Joe Alton, MD and Amy Alton, ARNP

 

Survival Medicine Hour: Nosebleeds, Flu Vaccines, Natural Diabetes Remedies, More

Click here to view the original post.
fluad

Last year’s vaccine was 20% effective, is next year’s any different?

 

What do you know about FLUAD, the latest flu vaccine? How is it different from older versions? Also, are there any natural remedies that might have a beneficial effect on diabetes (more than you think)? Joe Alton, MD discusses these topics plus using Afrin for nosebleeds, and how to approach head trauma. All this and more on Amy and Joe Alton’s Doom and Bloom(tm) Survival Medicine Hour.

 

To listen in, click below:

 

http://www.blogtalkradio.com/survivalmedicine/2015/11/28/survival-medicine-hour-flu-vaccine-nosebleeds-natural-diabetes-remedies-more

shutterstock_84827734

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

 

Joe and Amy Alton

videocast1

Hey, looking for a Christmas present for that older child or prepper in your family? Check out our board game Doom and Bloom’s SURVIVAL!, a great way to get the whole family together  and have a fun family game night!

DBS_character_hunter

Top 5 Injuries People Will Get After The SHTF

Click here to view the original post.

Today I want to share another interesting video by The Patriot Nurse. In this one she talks about the 5 most common injuries people will get after the SHTF. This is a very helpful list because if you know what the most common injuries will be, you’ll know […]

The post Top 5 Injuries People Will Get After The SHTF appeared first on Urban Survival Site.

Videocast: Bear attacks, E. Coli, more

Click here to view the original post.
black bear

bear

What would you do if you came upon a full-grown bear on the trail? There’s black bears all over the place here in the Great Smokies, and you should know how to stay safe in a encounter with one of these beautiful, but potentially dangerous, animals. Also, Joe and Amy Alton discuss the latest E. Coli outbreak, this time originating in some Northwest Chipotle restaurants.

squirrel

Not a bear

 

To watch, click below:

 

 

http://aroundthecabin.com/show-archives/wednesdays/

 

 

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

 

 

Joe and Amy Alton

2015 Birdhouse Inn Mountain Paradise View!

Bear Attacks

Click here to view the original post.
black bear

Black Bear

The Great Outdoors is, well, great, but there’s also danger in them thar hills, and it pays to know what to do when you encounter it.

 

 

I’ve talked about animal bites in videos, but I haven’t shown you any actual animals. Although we’re here at the Birdhouse Inn, the best bird’s eye view of the mountains in the Great Smokies, we’re not talking about birds today. We’re talking about bears.

 

 

Bears are mammals of the family Ursidae, and I’ll bet you don’t know what their closest living relative is: It’s seals. There are a number of species of bear but the one around here is the American black bear. 1800 bears live in the Smoky Mountains and many of them have become very accustomed to humans.

 

 

There are several in the area around this property, mostly youngsters that have decided that Halloween pumpkins are a tasty treat. I guess we should have known, because bears, indeed, eat more plant matter than meat, taking in opportunistically whatever they can find, like acorns. Poor crops of such foods, called mast, result in bears moving out of their back country territory to look for alternative food sources, like your trash. Even though black bears are only 8 ounces when they’re born, males (also known as boars) can wear 500 pounds or more. This puts you in danger, no matter how “cute” you think these critters are.

newborn black bears

Newborn black bears

 

To prevent injuries from bear encounters, situational awareness is the order of the day. Watch for disturbed trash, fresh tracks, and of course, actual bears.

bear droppings

Probably from an actual bear…

Some basic advice: Don’t hike alone. Whenever possible you should hike in groups, 90% of people injured by bears (mostly grizzlies, I suspect) in Yellowstone National Park were alone or with only one other hiking partner.

 

 

Avoid hiking at dawn, dusk, or at night, times that bears are out in warm weather months. You’re just as likely to come upon a bear as it is to come upon you.

 

 

You might think it’s not too smart to yell “Hey, Bear!” or sing “The Star Spangled Banner” on the trail but, actually, bears don’t like noise and it’s actually a pretty good strategy, especially when traveling near babbling brooks or other settings where normal hiking noises might be muffled. Just don’t do it with a hamburger or hot dog in your hand.

 

 

When you encounter a bear, it will, hopefully, be at a distance: If so, and the bear doesn’t see you, keep out of sight and go slowly behind and downwind of the bear. If the bear does see you, slowly retreat the way you came. A bear in defensive mode will huff, hiss, or slap the ground with its paws, telling you that you’re too close. So put some distance between you and the bear. However, don’t run, it might activate a chase response in the animal.

 

 

If the bear follows you quietly, ears erect, and its attention is clearly directed at you, it is likely in predatory mode and not acting defensively. Make yourself appear larger, louder, and threatening. Groups should stay together to look like a bigger threat. A bear that is initially curious or testing you may become predatory if you appear meek. A deterrent like pepper spray, at least, or other items of personal defense will become very handy. Pepper spray is most effective at close range, say 5-10 feet.

 

 

If the bear attacks, don’t run. You can’t outrun a black bear. Don’t climb a tree unless you’re a squirrel, you’re not 10 years old anymore, it takes longer than you think, and your pursuer is a very good climber. Use your deterrent and fight for your life, because that’s what’s at stake. Kick, punch or hit the bear on the face, eyes, nose, with whatever you have.

squirrel

Probably a better tree climber than you

You also should not play dead. Bears will feed on carrion like deer carcasses, so why pretend to be one? If you do, however, keep your backpack on, lie face down and clasp your hands over the back of your neck with your elbows protecting the sides of your face. A bear that’s just protecting its cubs may decide you’re no longer a threat.

 

 

Which leaves you with bite and claw injuries that may be bleeding, so make sure that backpack has dressings, tourniquets, antiseptics, and other supplies needed for treating wounds. Here’s an article on dealing with animal bites and one on active bleeding

 

 

http://www.doomandbloom.net/treating-an-animal-bite/

 

 

http://www.doomandbloom.net/stab-wound-management/

 

 

Studies have shown that bears accustomed to humans never live as long a life as truly wild bears. Bear lose their fear of people by being fed by them. As a result, many of these are hit by cars or end up euthanized. Remember this: A bear that’s fed is a bear that’s dead.

 

 

Joe Alton, MD

TentMEDIUM

Can’t bear to be without a good medical kit? Check out Nurse Amy’s entire line over at store.doomandbloom.net!

 

 

images via commons.wikipedia

Video: Glue as a Wound Closure Method, Part 2

Click here to view the original post.

dermabond in place

In part 2 of his series on skin adhesives, Joe Alton, MD, aka Dr. Bones, compares skin glues to traditional sutures/staples as a method of skin closure, the procedure to apply glue to a wound, and about how commercial super glue compares to the much more expensive (10-15 times or more) medical glues. To watch, click below:

 

 

Here’s wishing you the best of health in good times or  bad,

 

 

Joe Alton, MD

AuthorJoe

 

 

Video: Glue as a Wound Closure Method, Part 1

Click here to view the original post.

skin glue applied

There are lots of ways to skin a cat, but how many ways can you close a cat’s skin? Well, just about as many as you can close a human’s skin! Joe Alton, MD, aka Dr. Bones, co-author of the Survival Medicine Handbook, talks about the benefits of skin adhesives as a wound closure method and their limitations. Part 1 of a 2 part series corresponding to a recent article on the same topic.

 

 

 

 

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

 

 

Joe Alton, MD

tent joe's kids

If you like our content, please subscribe to our YouTube channel and follow us on Twitter  or Facebook!

House Fire, smoke inhalation and burn care!

Click here to view the original post.
House Fire, smoke inhalation and burn care!
Cat Ellis “Herbal Prepper Live

House Fire FRFD TrucksA couple of months ago, our smoke detectors went off. I didn’t think much about it at first, as they had only ever done that when one of their batteries was near dead. Then the doorbell rang, and the elderly man who lives on the first floor of our house yelled through our intercom to get out, there was a fire.

I had just finished working out when the alarms went off. I had just ordered the kids to grab their emergency bags and get out, when my husband had come running up three flights of stairs from the basement to get us. The smoke was already all the way up to the third floor in the stairwell. It was so dark from the smoke, we could barely see. And as we got closer to the first floor and the fire, it got harder to breathe.

House Fire Grease fire 1st floorFor someone with a bad knee, I hustled it down those stairs as fast as I could. My husband had to carry our daughter. Even though we had run fire drills, she froze at the sight of the smoke at the top of the stairs. My husband went back in to get the elderly woman on the first floor. She was still trying to put the fire out. It didn’t click in her head that it was time to leave.

House Fire Damage through ceilingThankfully, the fire was put out quickly and didn’t get an opportunity to travel through the walls of the house. Thankfully, the only injuries were minor smoke inhalation (my husband), and some minor burns (the elderly tenant on the 1st floor).

You prepare for emergencies. That’s what preppers do. But, sometimes it takes an emergency to show you where the holes in your plans are. We found some major holes in our plans. We also did some things exactly right. We were extremely lucky, though, that this was only a minor housefire. We got to learn a lot without any major injuries or worse.

Let me share with you what we learned going through this experience, what we have changed as a result, plus some thoughts on dealing with smoke inhalation and burn care. Let our experience help you get better prepared for a house fire.
Herbal Prepper Website: http://www.herbalprepper.com/

Listen to this broadcast “House Fire, smoke inhalation and burn care”  in player below!
Download this show HERE!
Get the 24/7 app for your smart phone HERE! 
Put the 24/7 player on your web site HERE! 
Listen to archived shows of all our hosts . Go to schedules tabs at top of page!

The post House Fire, smoke inhalation and burn care! appeared first on The Prepper Broadcasting Network.

Skin Glue in Survival

Click here to view the original post.

laceration2

 

There are many ways to skin a cat, but how many ways are there to close a cat’s skin? Pretty much, the same number of ways that you can close a human’s skin. Sutures, staples, and tape butterfly closures like steri-strips are common methods, but there’s another one: topical skin adhesive glues.

 

Topical glues have been around since the 1940’s, but it took more than 3 decades for them to be approved for human use. Since that time, they have become the favorite method of closure for some surgical procedures.

 

This article will discuss the properties and uses of skin adhesives, especially as they apply to survival scenarios. Therefore, we will forego a discussion of cosmetic results, as they would be less important in austere settings.

 

Topical skin adhesives (or glues) are liquids made from a mixture of cyanoacetate and formaldehyde called cyanoacrylate. These glues become solid upon contact with skin, thus holding wound edges together.

 

The original cyanoacrylates (methyl-cyanoacrylate) comprise what is now industrial Super Glue. Medical versions were then developed (octyl- and butyl-cyanoacrylate) that were meant specifically for human skin. Some brands include Dermabond, Surgiseal, Liquiband, and others. These are mostly by prescription only, and are roughly ten times the cost of regular Super Glue.

 

Benefits of Topical Skin Adhesives

 

Topical skin adhesives are useful in a number of specific circumstances, and have some benefits not seen with some other methods of wound closure:

 

• They are quick to apply.
• They are a relatively painless method of closure.
• They don’t leave the “hatch marks” seen with sutures and staples.
• They don’t require removal. Skin glues slough off by themselves spontaneously after 5-10 days.
• They don’t require anesthetic injections, which makes them less problematic to use in children or those afraid of needles.
• They create an environment which speeds healing.
• They decrease the risk of wound infections with certain bacteria (gram-positive like Staph).

 

Indications for skin closure with glue

 

Topical skin adhesives are best used for simple cuts such as some traumatic lacerations. Use them for:

 

• Wounds that are completely dry (no longer bleeding).
• Areas where there is no skin tension (not difficult to pull together manually).
• Hair-free areas .
• areas not inside the mouth.
• children, to avoid pain of local anesthetic injection.
• Short-medium length lacerations

 

Topical adhesives are not helpful or may be dangerous if used:

 

• Inside the mouth or other internal cavity.
• In other high-moisture areas such as the groin or armpit.
• Around the eyes without extreme caution.
• On joints (unless immobilized with splints).
• Very long lacerations
• On avulsions (areas where skin flaps have been torn off due to trauma) or very jagged lacerations.
• Infected wounds.
• Wounds with dead tissue, like gangrene.
• In those with known hypersensitivity to the chemical compound.

 

Comparing skin adhesives to sutures and staples

Sutureneedleholder1

 

Traditional methods of skin closure include sutures and staples. The following are considerations when comparing these to topical skin glues:

 

• The wound strength with glues is less than with staples or sutures, probably only 10 per cent or so in the early going. After several days, the healed skin strength with glue is nearly equal to other methods, especially if used in conjunction with butterfly closures.
• Although anti-bacterial ointments can be applied on top of suture/staple closures, they weaken the strength of skin adhesives.
• Blood or fluid may collect under the adhesive. Although drainage from the wound is acceptable with suture or staple closures (and may be preferable to collection under the skin), infection risk may be increased with glues or even prevent skin healing.

 

 

How to use topical skin adhesive glue:

skin glue applied

 

Before using any method of skin closure, meticulous care must be taken to completely flush out debris and bacteria in the open wound. This should be done with an antiseptic solution like betadine or sterile saline. Any bleeding must be completely controlled. If deep layers are needed to close dead space, sutures can be used for this purpose as well as to decrease any tension on the wound edges.

 

When you are ready to close the skin:

 

• Approximate the wound edges carefully (best done by an assistant).
• Gently brush the glue over the laceration, taking care not to push any below the level of the skin.
• Apply about three layers of the adhesive over the wound, preferably widening the area of glue to increase strength of closure.

 

• Once completely dry, consider adding steri-strips to increase the strength of the closure.

 

It should be noted that some people experience a sensation of heat to the area when the glue is first applied. Encourage your patient to avoid picking at the closure or scratching it.

 

 

What about Super Glue for skin closure?

super glue

 

Many underdeveloped countries may not be able to afford the expensive medical glues. In some, like Cuba, emergency rooms have had to resort to industrial Super Glue. As a closure method, it is comparable, but it should be noted that Super Glue closures must be kept dry as they may break down more easily that medical glue.

 

 

Some people will experience skin irritation or even mild burns from the industrial version. You can test for this beforehand by having those in your group place a drop of Super Glue on the inside of their forearm. If there is a significant reaction such as redness or itching, avoid this method of closure on that person, or use the prescription version.

 

 

In my experience, gel versions of Super Glue are easier to handle due to less dripping.

 

 

Of course, standard medical texts will tell you to avoid Super Glue altogether. In a survival setting, you will have to make decisions based upon what you have available. The medic will often have to “make do” with suboptimal methods and equipment, but something is better than nothing. It will be easier to stockpile commercial glue than the more expensive medical skin adhesives.

 

 

As the survival medic, you should know how to use all the tools in the medical woodshed. If you learn the pros and cons of every method of skin closure, you’ll be better able to succeed, even if everything else fails.

 

Joe Alton, MD

blaze tv 2

Stop Bleeding Fast With This Weed

Click here to view the original post.

This article first appeared at The Prepper Project I was out in the yard one beautiful May afternoon when I made an exciting discovery. It was a tall, scraggly plant towering a good foot and a half above the other weeds scattering our overgrown yard. I crouched down to get a closer look and immediately … Continue reading Stop Bleeding Fast With This Weed