Video: Making Dakin’s Solution, Part 2

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Video: Making Dakin’s Solution, Pt. 2

Open wounds are prone to infection

In this video (part 2 of 2), Amy Alton ARNP, aka Nurse Amy, demonstrates how to make Dakin’s solution for the care of open wounds, followed by some comments by Joe Alton MD, aka Dr. Bones, on how to vary the strength from full (5% sodium hypochlorite) down to 1/8 strength, how long it last when stored properly, and some other important things to know about this additional tool for the medical woodshed in survival settings.

To watch, click below:

In case you missed it, here’s Part 1 of the video:

Video: Making Dakin’s Solution, Part 1

https://www.doomandbloom.net/video-making-dak…-solution-part-1/

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

Joe and Amy Alton

The Altons

You can make Dakin’s solution with regular household items, but for medical supplies you can’t make on your own, check out Nurse Amy’s entire line of kits and individual items at store.doomandbloom.net. You’ll be glad you did.

Video: Making Dakin’s Solution, Part 1

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Video: Making Dakin’s Solution for Wound Care, pt. 1

open wound care

In this video, Joe Alton MD and Amy Alton ARNP take turns in front of the camera to discuss and demonstrate Dakin’s solution, a 100 year old recipe that is still used today by some practitioners as a way to treat and prevent infections in open wounds. Dakin’s solution is simple to make with affordable ingredients and is a useful tool in the medical woodshed for those that are off the grid due to a disaster or remote location. Part 1 of 2.

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

 

Joe Alton MD and Amy Alton ARNP

You can make Dakin’s solution on your own, but when you need medical kits or commercially-made individual items, check out Nurse Amy’s entire line of supplies at store.doomandbloom.net. You’ll be glad you did.

Survival Medicine Hour: Bears, UTIs, Kratom for Pain?

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Survival Medicine Hour #348

American Black Bear

In this episode of the Survival Medicine Hour, Joe and Amy Alton, aka Dr. Bones and Nurse Amy, discuss the controversial non-ban of a natural pain reliever, Kratom, the only non-opiate that seems to give major benefits to many, as evidenced by numerous YouTube testimonials. Also, bears love the summer, and they’d love to stay out of your way. If they don’t, however, it can mean trouble for both you and the bear. Here’s some safety tips from Dr. Alton, whose home in Gatlinburg, Tennessee is home to many a black bear.

Kratom may help with pain

Also, the medic in survival scenarios may have to deal with gunshot wounds, but he/she’s more likely to deal with common infections, like those that affect the urinary tract. Learn how to identify, treat, and prevent UTIs, which can travel to the kidneys, and eventually become life-threatening if not treated.

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

To Listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/07/21/survival-medicine-hour-bears-pain-relief-with-kratom-utis

 

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

Joe and Amy Alton

The Altons

Follow us on twitter @preppershow, Youtube at drbonesnurseamy, and Facebook at Survival Medicine DrBones NurseAmy

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

All About Urinary Tract Infections

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Urinary Tract Infections

Urinary Anatomy

Medics in survival scenarios have to deal with major injuries and serious infections, Sometimes, infections aren’t serious to begin with, but worsen if not treated. Some of these infections involve the urinary tract.

Urine directly from the bladder is generally sterile, but most women have experienced a urinary tract infection (UTI) at one point or another.  The areas most commonly contaminated are the bladder, which holds the urine, and the urethra, the tube that drains the bladder.  Although men can also get bladder infections (called “cystitis”), their urethra is much longer and bacteria are much less likely to reach the bladder.

If untreated, bladder infections may ascend to the kidneys via tubes called ureters, causing an infection known as “pyelonephritis”.  Once in the kidneys, it can make its way to the bloodstream and lead to shock or worse.

Symptoms of UTIs

 

Each type of UTI manifests in more or less specific signs and symptoms, depending on which part of the urinary tract is infected.

Inflammation of the urethra (urethritis) may be caused by E.Coli, Gonorrhea, Herpes, and other bacteria and viruses. Sufferers will feel a burning sensation with urination; males may also have a urethral discharge, while women with certain sexually transmitted infections may notice a foul discharge from the vagina.

Bladder infections are characterized by pelvic pressure, lower abdominal pain, and frequency of urination. Some people may feel an urgent need to go without warning (urgency) but notice that the stream of urine is slow to start (hesitancy). The urine itself may be cloudy or red-tinged with blood and have a strong smell.

Kidney Infections signs include one-sided flank pain with fever

Once the infection reaches the kidney (pyelonephritis), other signs and symptoms will become apparent.  Fever and chills are common, with pain on the flank (the side of your back). Normally, it will be noticeable only on one side by tapping the flank lightly at the level of the lowest rib with the side of a closed first. This will elicit no response in a healthy patient, but someone with an infection will grimace and flinch. Kidney stones may be mistaken for a kidney infection, as they also cause tenderness in this region. They are, however, less likely to cause fever.

Treating a UTI

Treatment revolves around the vigorous administration of fluids.  Lots of water will help flush out the infection by decreasing the concentration of bacteria in the affected organs.  Some feel relief with a heating pad or compress in the area of discomfort.

various antibiotics work to treat UTIs

Antibiotics are another standard of therapy. The following are commonly used for UTIs (brand names and veterinary equivalents in parenthesis):

  • Sulfamethoxazole-trimethoprim (Bactrim, Septra, Bird-Sulfa, Fish-Sulfa)
  • Amoxicillin (Amoxil, Fish-Mox)
  • Ampicillin (Fish-Cillin)
  • Cephalexin (Keflex, Fish-Flex)
  • Azithromycin (Zithromax, Z-Pak, Aquatic Azithromycin)
  • Doxycycline (Vibramycin, Bird-Biotic)
  • Ciprofloxacin (Cipro, Fish-Flox)

For dosages, days taken, side-effects, and warnings, use the search engine on this website for the particular antibiotic.

To eliminate the pain that occurs with urination in UTIs, stockpile over-the-counter medications like Phenazopyridine (also known as Pyridium, Uristat, Azo, etc.).  Don’t be alarmed if your patient’s urine turns a reddish-orange color; it is an effect of the drug and is only temporary.

Natural Remedies for UTIs

There are a number of natural remedies to treat someone with a urinary infection. Vitamin C supplements, for example, are thought to reduce the concentration of bacteria in the urine.

Others include:

  • Garlic or garlic oil (preferably in capsules).
  • Echinacea extract or tea.
  • Goldenrod tea with vinegar (1 to 2 tablespoons),
  • Uva Ursi (1 tablet).
  • Cranberry tablets (1 to 3 pills).

Take any one of the above remedies three times per day.

Another home remedy is to take one Alka-Seltzer tablet and dissolve it in 2 ounces of warm water. Pour directly over the urethral area.

One more alternative that may be helpful is to perform an external massage over the bladder area with 5 drops of lavender essential oil (mixed with castor oil) for a few minutes. Then, apply a gentle heat source over the area; repeat this 3 to 4 times daily. The combination of lavender/castor oil and warmth may help decrease bladder spasms and pain.

I’m sure you have a tried-and-true strategy of your own. As with many home remedies, however, your experience may vary. In normal times, consult your physician.

Preventing UTIs 

Preventative medicine plays a large role in decreasing the likelihood of urinary tract infections.  Basic hygienic method, such as wiping from front to back after urinating, is important for women.  Also, emptying the bladder right after an episode of sexual intercourse is a wise choice.

Wear cotton undergarments to allow better air circulation in areas that might otherwise encourage bacterial or fungal growth. Adequate fluid intake, especially cranberry juice if available, is also a key to flushing out bacteria and other organisms.  Lastly, never postpone urinating when you feel a strong urge to go.

Off-grid medics may have to deal with gunfights at the OK corral, but it’s how well they handle everyday problems like UTIs that gauges their day-to-day contributions to their community.

Joe Alton, MD

Joe Alton MD

Learn about UTIs and 150 other medical topics in the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way.

Video On Pathogens, The Germs That Cause Disease

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Video: Germs That Cause Illness

In this video, Joe Alton, MD, aka Dr. Bones, goes back to the basics to discuss the various types of pathogens (germs that cause disease). Dr. Alton tells you about bacteria, viruses, protozoa, and fungi: their characteristics, differences, and some well-known issues for which each is responsible.

To watch, click below:

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

 

Joe and Amy Alton

Joe Alton MD and Amy Alton, ARNP

Learn more about pathogens and 150 other medical topics in troubled times with a copy of the 700 page Third Edition of The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And don’t forget to check out Nurse Amy’s entire line of medical kits at store.doomandbloom.net. You’ll be glad you did.

Survival Medicine Hour: Wilderness Safety, Snake Bite, More

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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

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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

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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

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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

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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!

Video: Dental Abscesses

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dental abscess

In this companion video to a recent article, Joe Alton, MD, aka Dr. Bones, discusses the importance of dental preparedness in long-term survival settings. Perhaps you don’t need a dental kit when the power’s out for a few days, but when you’re stuck in primitive conditions and not likely to get out anytime soon, dental supplies are an important part of being an effective medic.

Let’s face it, pain in your mouth can make you miserable, so miserable that your work efficiency suffers as much as you do. One cause of dental discomfort may be a tooth abscess, which is a serious issue that can turn life-threatening. But what if there is no dentist? Learn what a tooth abscess may look and feel like, plus some possible emergency treatment methods during long-term disasters where there is no dental care available. Hosted by Joe Alton, MD of https://www.doomandbloom.net/

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

 

Joe Alton, MD

 

Dakin’s Solution for Wound Care

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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.

Survival Medicine Hour: Dental Abscess, Local Anesthetic, Pathogens

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Survival Medicine Hour #243

Dental Abscess

In this episode of the Survival Medicine Hour, Joe and Amy Alton discuss the alternative to lidocaine for local anesthesia: injectable Benadryl (diphenhydramine). The pros and cons and its potential use in survival scenarios are explored. Also, dental issues will be a major problem for the medic in any long-term event; Dr. Bones talks about tooth abscesses and how they might be life-threatening if ignored in off-grid settings.

Injectable Benadryl (diphenhydramine)

Lastly, a discussion of the different pathogens that cause disease with Nurse Amy and Dr. Bones. All this and more on the Survival Medicine Hour with Joe and Amy Alton!

 

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

Joe and Amy Alton

Joe and Amy Alton

follow us on twitter @preppershow

follow us on facebook@survivalmedicine drbones nurseamy

follow us on YouTube drbones nurseamy

The Tooth Abscess in Austere Settings

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Tooth Abscess in Austere Settings

dental extractor

Many readers of our Survival Medicine Handbook are surprised to find entire chapters devoted to the treatment of dental problems. Visitors to our store are likewise surprised to find dental supplies in some of our medical kits. Why is it important for the survival medic to be “dentally” prepared as well as medically prepared?

A standard first aid kit will usually suffice for most short-term disasters. When you’re talking about a long-term survival setting, however, you’ll need a more varied set of supplies. Dental issues probably won’t be of major concern if the power’s out for a few days; if you’re off the grid for a few months or longer, though, dental care will become an important part of your role as survival medic.

The effects of dental disease can be severe, and, at the very least, impacts negatively on work efficiency. Have you ever gone to work with a toothache? It’s fair to say you probably weren’t at 100% efficiency, which is where you need your people to be if you’re off the grid long-term.

tooth abscess

 

There are many dental problems, but today we’ll talk about a potentially life-threatening one: Tooth abscesses. In long-term survival, problems maintaining good dental hygiene will make tooth abscesses a challenge for every medic.

A tooth abscess is a collection of pus that’s caused by a bacterial infection. Pus is comprised of dead and live bacteria, white blood cells, and debris.

Most abscesses are related to tooth decay, poor hygiene, dental trauma, gingivitis (gum infections) or problems related to previous dental work. The abscess can occur in different areas, either at the tip of the root (periapical), or in the gum next to a tooth root (periodontal). Periapical abscesses are more common, although both can occur together.

An abscess first forms when bacteria enter through a defect in enamel, the tooth’s armor; a cavity or a chipped tooth is usually where it begins. The bacteria spread all the way down to the root, causing damage to the nerve, which causes pain. Once the nerve is dead, pain in the tooth might cease, but significant painful swelling, inflammation, and accumulation of pus can develop at the base of the root or in nearby gums, soft tissue, and even bone. Left untreated, the bacteria may enter the bloodstream, causing a life-threatening infection called “septicemia“.

tooth abscess (wiki)

It’s important for the medic to be able to recognize an abscess when it forms. It is commonly seen as a swelling in the tissue at the base of the tooth. It may have a pimple-like head. Other signs and symptoms include:

  • Severe throbbing toothache, sometimes spreading to the jaw or ear
  • Sensitivity of the tooth to hot and cold
  • Sensitivity when biting down on food or gnashing teeth together
  • Red, swollen gums
  • Fever
  • Facial swelling on the side of the diseased gum/tooth
  • Tender, swollen lymph nodes under the jaw or in the neck
  • Foul smelling breath

Without modern diagnostic imaging, it may be difficult to tell the difference between a periapical abscess and a periodontal abscess. There are, however, low tech ways to tell the difference: In periodontal abscesses, the swelling usually comes before the pain; in periapical abscesses, the pain often comes before the swelling.

Tapping on the tooth may also give you a hint: If you tap vertically on the tooth and elicit pain, it’s probably periapical. If you tap laterally and get pain, it’s generally periodontal. If the tooth has no obvious crack or decay, it’s probably periodontal. Sensitivity of the tooth to hot and cold may point to a periapical abscess.

The differences between the types of abscesses matter in modern dentistry: An abscess mainly in the gum, for example, might have a relatively healthy tooth nearby which could be saved via root canal surgery or other modern procedures. In survival, however, this is not an option, so extraction of the tooth to eliminate the pain and infection is likely to be the end result. Extraction will be the answer, in my opinion, for the majority of dental emergencies in grid-down scenarios.

Although drainage usually occurs via the tooth socket after an extraction, an incision with a sterile scalpel may be needed to drain the entirety of the abscess. This procedure is called “incision and drainage“ or “I & D“. Thorough flushing of the area with warm salt water or hydrogen peroxide (called “irrigation“) afterwards is helpful. Give pain meds and apply warm moist compresses.

antibiotics are useful to prevent infection

Although extraction, drainage, and irrigation may be all that’s required, it is prudent to begin a course of antibiotics, especially for those with fevers or facial swelling. Options include penicillin (Fish-Pen), amoxicillin (Fish-Mox), clindamycin (Fish-Cin) and/or metronidazole (Fish-Zole). A course of treatment should last 5-7 days. Dosing for each of the above antibiotics can be found in various articles at doomandbloom.net.

Medical preparedness for long-term events involves having dental supplies and some knowledge of dental anatomy. If you believe a major event is coming, consider a good dental kit to go along with the rest of your medical storage.

Some of the supplies in our dental kit

Joe Alton

 

 

Benadryl as a Local Anesthetic in Survival?

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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

Survival Medicine Hour: Survival Navigation w/Glen Martin, Thyroid Issues

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by Glen Martin

In this episode of the Survival Medicine Hour, Joe and Amy Alton, aka Dr. Bones and Nurse Amy, welcome Glen Martin, owner and founder of the 50-show strong Preppers Broadcasting Network to talk about his journey and to discuss his new book on Amazon, Prepper’s Survival Navigation. One way to put your health in jeopardy is not knowing where the heck you are, so listen in as Amy finds out secrets on how to stay grounded and pointed in the right direction in the wilderness.

Effects of low thyroid levels on left, normal on right

Also, a question about thyroid problems with the Expert Council with Jack Spirko, with Joe Alton MD answering questions about what to do about thyroid issues in survival scenarios. All this and more on the Survival Medicine Hour!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/06/16/survival-medicine-hour-survival-navigation-with-glen-martin-thyroid-issues

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

Joe and Amy Alton

Amy and Joe Alton

follow us on twitter @preppershow, on YouTube at drbones nurseamy, and Facebook at Doom and Bloom!

Also, don’t forget to fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and items at store.doomandbloom.net!

 

Safe Summer Camping

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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: Shock, Triage, Mosquito Plants

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Survival Medicine Hour #341

Citronella

In this episode of the Survival Medicine Hour with Joe Alton, MD and Amy Alton, ARNP, aka Dr. Bones and Nurse Amy, the topic is shock: What types there are, the stages of shock, the signs and symptoms of shock, and a lot more that you might need to know in times of trouble. Also Dr.Bones discusses some examples of victims you might encounter in a mass casualty incident, plus the 30-2-Can Do paradigm for telling priority of need for immediate care.

People in shock lose heat quickly; make sure to keep them warm!

Also, Nurse Amy spends some time talking about what plants in your garden can give you some relief from disease-transmitting mosquitoes this summer.

All this and more from our show, remotely broadcast this week from Boston, Massachusetts while on the way to the Mother Earth News Fair event in Burlington, Vermont!

Joe and Amy Alton

Joe and Amy

Follow us on twitter: @preppershow

YouTube: DrBones NurseAmy

Facebook: Doom and Bloom

And for even more info on how to deal with medical issues in times of trouble, check out our Survival Medicine Handbook, now in its 700 page Third Edition!

Video: Using Plants for Natural Mosquito Control

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Video: Natural Mosquito Control

mosquitoes can be vectors of various diseases

Summer is upon us, and mosquitoes are part and parcel of warm weather just about everywhere. Of course, you can use DEET or other chemicals to ward off bites and the diseases that can be transmitted by them, but you could put together a garden as well that would repel the nasty critters. Nurse Amy Alton takes a turn in front of the camera this time to talk about some plants that you might consider for your garden that will repel mosquitoes. Preventing diseases like Malaria, Zika, Chikungunya, West Nile, and others is a great way for a homestead medic to avoid problems in good times or bad!

To watch, click below:

Wishing you the best of health in normal and not-so-normal times.

Amy Alton, ARNP

Amy Alton ARNP

 

Find out more about medical issues on remote homesteads or other off-grid settings in our 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, available at Amazon; and don’t forget to fill those holes in your medical storage by checking out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net…

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

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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

 

 

 

 

Video: Gallbladder Issues in Austere Settings

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Video: Gallbladder Disease

gallstones

In this video, Joe Alton MD, aka Dr. Bones, discusses all you need to know about the gallbladder and the role that stones or buildup plays in disrupting the workings of the GI tract.

The gall bladder is a hollow sac-like organ that is attached to the liver; it stores a thick liquid substance called “bile” that the liver secretes to help you digest fats. After a meal, the gall bladder contracts and bile passes through to the small intestine through tubes called ducts.

Excess bile cholesterol can cause solid deposits inside the gallbladder that range in size from miniscule to, say, the size of a golf ball. These are commonly referred to as “gallstones”.  Gallstones are relatively common; perhaps ten to fifteen per cent of the population has them. That means a large enough group of people in a survival community will likely include someone with the condition. The medic needs to be able to diagnose and treat conditions related to medical problems as well as traumatic injuries.

To watch, click below:

 

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

 

Joe Alton MD

Hey, learn more about medical issues, traumatic injury, and  150 other topics as they relate to survival in the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. Also, check out Nurse Amy’s entire line of kits and individual supplies for the survival medic at store.doomandbloom.net. You’ll be glad you did.

The Survival medicine handbook Third Edition 2016

The Survival Medicine Handbook Third Edition

 

To Close or Not to Close a Wound

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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

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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

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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!

Video: Azithromycin as Survival Antibiotic

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veterinary equivalents for Azithromycin

One of the most commonly prescribed antibiotics is Azithromycin, known in the U.S. as Z-Pak, is now in a new veterinary version known as Bird-Zithro. In survival situations where you’re off grid and there no modern medical care for the foreseeable future, the medic for the family must stockpile medical supplies, and this includes antibiotics.

See how Azithromycin in the form of “Bird-Zithro” might fit into you survival plans to treat your, well, sick birds. Uses, dosages, precautions, and more are more are discussed in this video by medical preparedness writer Joe Alton, MD.

To watch, click below:

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

 

Joe Alton MD aka “Dr. Bones”

Joe Alton MD

 

Hey, learn more about Azithromycin, survival antibiotics, and 150 other medical issues in the Third Edition of The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, available on this website and at Amazon.com. Also, check out Nurse Amy’s entire line of medical kits and supplies at store.doomandbloom.net. You’ll be glad you did.

Survival Medicine Hour: Expired EpiPens, Hepatitis C, Rodent Control 2

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Expired EpiPens Still Effective?

This week’s Survival Medicine Hour with Joe Alton MD and Amy Alton ARNP, aka Dr. Bones and Nurse Amy, discusses a new study from the California Poison Control System that indicates that EpiPens may be therapeutically effective even years after their expiration dates, welcome news given that a two-pack costs $300, even in generic form. Plus, part 2 of rodent control, this time how to get rid of rats and mice that already infest your retreat.

That’s a lot of rats!

 

Plus, Joe and Amy discuss the increasing epidemic of Hepatitis C in people who are using or abusing opioids like heroin and other drugs. Learn the obstacles to controlling this deadly disease and what might be done to help.

 

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

http://www.blogtalkradio.com/survivalmedicine/2017/05/12/survival-medicine-hour-expired-epipens-hepatitis-c-rodent-elimination

Follow us on Twitter @preppershow, FB at Doom and Bloom ™, and YouTube at DrBonesNurseAmy!

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

Joe and Amy Alton

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!

Kits by Alton First Aid

Study: Expired EpiPens Still Effective

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Study: Expired EpiPens Still Effective

EpiPen and EpiPen Jr.

An expiration date is defined as the last day that a medicine is warranted to be safe and effective when stored properly. I’ve written for years that this date is often arbitrarily determined, and that the idea all medicines somehow “spoil” very soon after their expiration dates is incorrect.

I’m not alone in this opinion: A new study now reports that an important medical product that prevents deaths from severe allergic reactions (also called”Anaphylaxis“) can still be used effectively years after the expiration date on the package.

The California Poison Control System in San Diego tested 40 unused, expired Epipens and found that all (yes, all) of them retained at least 80% active epinephrine, the main ingredient.  This was true even for Epipens that closed in on the four-year expired mark. The least potent device was found to be at 81 percent 30 months past its expiration date. Most were at 90% or above.

Epipens are expensive items that are sometimes in short supply. F. Lee Cantrell, lead researcher of the California study, concludes that those unable to replace the product should hold onto it for use past the expiration date.

“There’s still a dose that would be therapeutic in there…” Cantrell also said: “if an expired EpiPen is all that I have, I would use it.” He suggests that it might be appropriate for the FDA (Food and Drug Administration) and Mylan, the company that distributes Epipen, to consider adjusting the expiration dates. Currently, the drug”expires” 12-18 months from the date of manufacture.

Of course, in normal times, the recommendation is to replace expired EpiPens. This new information, however, if of use to those who cannot afford to replace Epipen often and, also, to those in the preparedness community who store medical items in case of disaster.

The recommendation given by the California Poison Control System is a rare departure from standard conventional medical wisdom, which states that drugs should be disposed of as soon as they become expired. However, even the Department of Defense has determined that many medicines are 100% effective and safe to use even if expired. This data can be found in the July 2006 issue of the Journal of Pharmaceutical Sciences.

many drugs remain potent after expiration

The “Shelf Life Extension Program” (SLEP), which initially evaluated 122 drugs commonly stored for use in peacetime disasters, determined that most drugs in pill or capsule form were therapeutically effective for 2 to 10 years beyond the written expiration date. This led to the government issuing “emergency use authorizations” for various expired medicines when a shortage occurred. One example is the antiviral drug Tamiflu: During the 2009 Swine Flu epidemic, existing supplies of Tamiflu were authorized for use up to five years after the expiration date.

Drugs in liquid form did not fare as well in SLEP studies, which makes the Epipen (which uses a liquid solution of epinephrine) data so interesting. Granted, 100% potency would have been better, but 80-90% would still have a beneficial effect on an allergic reaction.

Given the 2016 Mylan scandal where the company increased the price from about $100 per two-pack to $600, an extended shelf life would be welcome news. (Mylan recently released a “generic” version for $300 per two-pack).

It should be noted that potency of a drug is affected by storage conditions. Most medicines should be stored in dry, cool, dark conditions. Allowing Epipens to be exposed to high heat or freezing could adversely affect effectiveness.

Many physicians are greeting the study’s findings skeptically, but I consider it more evidence that expiration dates are sometimes artificially determined, and that those storing medications for use in disaster settings might get more longevity out of their supply than expected. Get fresh medicine if available, but think twice before throwing out your last Epipen. Sometimes, something is better than nothing.

Joe Alton, MD

Dr. Alton:

Find out more about expired drugs, anaphylactic shock, and 150 other medical topics in austere settings with 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. (Be aware that the Second Edition can still be found there; be sure to get the latest edition or just order from store.doomandbloom.net.

Survival Medicine Hour: Ticks and Lyme Disease, Foot Fungus, Rodent Proofing

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THE SURVIVAL MEDICINE HOUR PODCAST #231

Tinea Pedis, aka Athlete’s Foot

In this episode of the Survival Medicine Hour, Joe Alton,MD and Amy Alton,ARNP discuss what’s behind the increasing population of ticks and the record number of Lyme Disease cases being reported in the United States, plus how to avoid tick bites and recognize and treat Lyme Disease early. Also, how to deal with fungal infections like Athlete’s foot with conventional and natural remedies in austere or remote settings.

Tick Bite

Rats!!! Rats and mice in your retreat will contaminate your survival food stores and transmit disease and otherwise lower your chances of survival in times of trouble. Find out how to rodent-proof a retreat with Dr. Bones and Nurse Amy.

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/05/05/survival-medicine-hour-lyme-disease-foot-fungus-rodent-proofing

 

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

Joe and Amy Alton

Joe Alton MD and Amy Alton ARNP

Don’t forget to check out store.doomandbloom.net to fill those holes in your survival medical supplies! Also, The Survival Medicine Handbook is celebrating several years on the Amazon bestseller list in disaster relief, safety/first aid, and survival skills! Check it out at Amazon.com.

 

An “UpTick” in Lyme Disease

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Deer Tick Bites and Lyme Disease

deer blacklegged tick

Blacklegged or Deer Tick

Whether you’re a hiker, camper, or survivalist, you’ll be spending a lot of time in the Great Outdoors.  During your off-grid adventures, you’ll be exposed to all sorts of critters that want a piece of you (watch an episode of “Naked and Afraid” to see what I mean). One of these is the lowly tick.

Ticks are eight-legged spider-like “arachnids” that exist in various species throughout the United States. They latch onto the skin of a host for a meal of blood and transmit various disease-causing microbes (“pathogens”) to humans and animals through infected saliva.

These diseases include:

  • Lyme Disease (also called “Lyme Borreliosis”)
  • Babesiosis
  • Anaplasmosis
  • Tularemia
  • Rocky Mountain Spotted Fever
  • Ehrlichosis
  • Relapsing Fever

In this article, we’ll concentrate on Lyme Disease. Lyme Disease is caused by the corkscrew-shaped bacterium known as Borrelia burgdorferi, commonly transmitted by the tiny blacklegged tick, also known as the deer tick.

borrelia bacteria

Borrelia Burgdorferi

Experts are expecting more cases of Lyme Disease due to recent mild winters and bumper acorn crops, which have increased the populations of animals that ticks like to feed upon. These include mice, a favorite of baby ticks, and deer, popular targets for adults. Because of the abundance of host animals, the Centers for Disease Control and Prevention (CDC) are estimating 300,000 cases of Lyme Disease this year, which is three times the number reported 20 years ago.

In case you’re wondering, Lyme disease has nothing to do with limes. It was first diagnosed in the town of Old Lyme, Connecticut in 1975. Since then, Lyme has become the most common tick-borne illness in the Northern Hemisphere.

tick stages

Deep Ticks in various stages of development

HOW TICKS SPREAD LYME DISEASE

Ticks have a life cycle that can last two-three years and includes egg, larva, juvenile (also called “nymph”), and adult stages. For a larva to develop into a nymph or for a nymph to develop into an adult, a blood meal in needed. It appears that the nymphs cause the most cases of Lyme. The CDC estimates that about 30% carry the disease in the Northeast and Upper Midwest.

To pass along Borrelia burgdorferi to an animal or human, ticks must first find their hosts. They do this in a number of ways: By detecting smells, sensing body heat, or feeling vibrations with movement. Usually, they hang on grasses and bushes, holding on with their back pairs of legs and latching onto passersby with their front pair(s). When the tick finds a favorable place to feed, its mouth parts pierce the skin and start extracting blood.

how to remove a tick

Tick Removal

A thorough examination of the entire body for ticks is warranted within two hours of returning after a day outdoors. This is most easily accomplished during a shower. Look behind the knees, in armpits, behind the ears, even the belly button.

If the tick is found, it may be possible to just brush it off. If that doesn’t work, a number of commercial products are available to remove it. It is reasonable, however, to simply use fine-tipped tweezers to grasp it as close to the skin’s surface as possible, and pull straight upward in an even manner. Twisting or jerking as you pull may cause the mouth parts to remain in the skin.

Thoroughly clean the wound area with isopropyl (rubbing) alcohol and apply antibiotic ointment. Wash hands afterwards. As an added precaution, launder clothing in hot water and dry in high heat. If all this is done soon after the bite occurs, infection is highly unlikely.

DETECTION OF EARLY LYME DISEASE

Sometimes, however, the bite goes unnoticed. Once bacteria are passed to the host by the tick (a process that often requires 24-48 hours), symptoms can become apparent anywhere from 3 days to a month afterwards. You will usually see the following: :

  • Rash
  • Fever and chills
  • Muscle aches
  • Fatigue
  • Joint pain
ticklymerash

Tick feeding

In 70 per cent of patients, the rash occurs before the fever and starts as redness in the area of the bite. It often then develops into a red circular “bull’s-eye” that feels warm to the touch. Usually, very little pain or itching is associated. This pattern, which spreads over time, is called “erythema migrans” and may be enough to confirm the diagnosis. Lyme Disease, however, may be missed or misdiagnosed if symptoms are mild or, especially, if the tick bite was missed by the examiner.

 

erythema migrans bulls eye pattern

erythema migrans

 

When a bite from a blacklegged tick is newly identified, preventative antibiotics may prevent Lyme Disease. A single dose of two 100 mg. doxycycline (Bird-Biotic) may suffice.

For early infection, as evidenced by the presence of erythema migrans, rapid treatment usually results in a cure. Symptoms, however, may last for a time after treatment.

Doxycycline (veterinary equivalent; Bird-Biotic) 100 mg. twice a day for 14-28 days is indicated, or in children (must be over 8 years old) 4mg/kg twice a day for 14-28 days (max of 100 mg.) Avoid doxycycline in pregnant or breastfeeding women.

Alternatively, Amoxicillin (veterinary equivalent: Fish-Mox) can be used in pregnant or breastfeeding women at dosages of 500 mg 3x/day for 14-28 days. 50 mg/kg is the dose for children younger than eight years of age (maximum 500mg 3x/day). Azithromycin (Bird Zithro) has been mentioned as a second alternative and can be used in those allergic to Penicillin-family drugs.

LATE STAGE OR CHRONIC LYME DISEASE

Late stage infections with Borrelia burgdorferi result in a more diverse set of Lyme symptoms, some quite different from those seen early. These may occur months after the tick bite and include:

  • Neck pain and stiffness
  • Severe headaches
  • Multiple rashes away from the site of the bite
  • Joint pain and swelling in knees and other large joints
  • Bell’s palsy (nerve damage that causes drooping on one side of the face)
  • Heart problems such as irregular heartbeats
  • Dizziness
  • Shortness of breath
  • Inflammation of the spinal cord (called “meningitis”)
  • Shooting pains, numbness, or tingling in the hands, feet, or face
  • Memory loss

Many of the above symptoms may persist for long periods. As of yet, there is not a proven cure for chronic or late stage Lyme disease, but a vaccine is now in development. We’ll discuss  some strategies are to deal with this debilitating condition in a future article.

Boots1

Don’t forget the high-tops!

PREVENTING LYME DISEASE

An ounce of prevention is, they say, worth a pound of cure, and this old saying is particularly relevant when it comes to infections caused by tick bites. For prevention, consider:

  • Long pants and sleeves on the trail
  • Thick socks and high-top boots (tuck your pants into them)
  • Walking in the center of trails
  • Using insect repellants like DEET (20% or greater) on skin (oil of citronella or lemon eucalyptus are natural alternatives)
  • Applying Permethrin 0.5% insecticide to clothing, hats, shoes, and camping gear 24-48 hours before using (proper application will even withstand laundering)
  • Thorough exams after a day outdoors; pay special attention to children and dogs
permethrin clothing

0.5% Permethrin for clothing

Paying close attention to the little things, especially ticks, will make sure that your outdoor activities are healthy and memorable (in a good way).

Joe Alton, MD

AuthorJoe

Dr. Alton

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

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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.

Video: Rodent-Proofing A Shelter

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rodents

heckuva rodent infestation

Sanitation is an important factor in staying healthy in rural homesteads and survival scenarios, and one formidable obstacle for the survival medic is the presence of rodents like rats and mice. When these animals are introduced into new areas, they cause a significant amount of environmental and economic damage. Whether in good times or bad, It makes sense to take measures to prevent rodent infestation in the home and to eliminate those already there.   In this video, Joe Alton, MD discusses rodents and how to prevent them from being unwanted guests in your home, shelter, or retreat.

To watch, click below:

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

 

Joe and Amy Alton

 

JoeAmyLabcoatSMALL300x300

Joe Alton MD        Amy Alton ARNP

 

Find out more about rodents, the disease they cause, and 150 other medical topics in grid-down settings by checking out our Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, available at Amazon. Also, fill those holes in your medical supplies with Nurse Amy’s entire line of kits and individual items at store.doomandbloom.net. You’ll be glad you did.

How To Pack A Bleeding Wound

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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: Black Scout, Pt. 2, Azithromycin, Sick Room Set-Ups

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TentMEDIUM

Setting up a sick room

In this episode of The Survival Medicine Hour with Joe Alton, MD and Amy Alton, ARNP (aka Dr. Bones and Nurse Amy), we welcome back Jack of Black Scout Survival’s popular YouTube channel, who discusses a wide range of topics in part 2 of his interview with Amy.

Plus, Joe Alton, MD examines Azithromycin as a survival antibiotic. Thomas Labs has released a new bird drug, Bird-Zithro. Is Bird-Zithro a possible candidate for treating sick birds in your aviary after a disaster? Find out all you need to know about this important drug.

bird zithro 30 count azithromycin

Azithromycin for sick birds

Lastly, when an infectious disease epidemic comes to your town, would you be able to set up an effective sick room that will help the infected recover while keeping the healthy from getting sick? Joe and Amy go over what factors will make for an effective area to deal with infectious disease off the grid.

All this and more on The Survival Medicine Hour with Dr. Bones and Nurse Amy. To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/04/21/survival-medicine-hour-black-scout-pt-2-azithromycin-sick-rooms

Follow us on Twitter @preppershow                YouTube: DrBones NurseAmy 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

Don’t forget to get a copy of the new 700 page third edition of The Survival Medicine Handbook: The essential guide for when medical help is not on the way, available at Amazon or at www.doomandbloom.net

Video: Sulfa Drugs in Survival

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shutterstock_89589424

Add medicines to your medical kit

Without antibiotics in your medical kit, there will be deaths in survival scenarios that could have been prevented. Using certain veterinary equivalents may be an answer as to how to obtain them. This video discusses the family of antibiotics known as “Sulfonamides”: How they work, What they’re good for, How to use them wisely, and more. Remember that antibiotics aren’t candy, and should be used only when absolutely necessary. We’re in the midst of an epidemic of antibiotic resistance in this country (mostly due to their use in livestock!). Companion video to a recent article.

 

To watch the video, click below:

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

 

Joe and Amy Alton

JoeAmyLabcoatSMALL300x300

The Altons

Hey, get supplies for your medical kit, plus a copy of the latest edition of The Survival Medicine Handbook (also available at amazon), at Nurse Amy’s store on this website!

 

(slider image for this article courtesy of pixabay.com)

Setting Up A Survival Sick Room

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medicaltent

A hospital tent

In normal times, we have the luxury of modern medical facilities that can isolate a sick patient from healthy people. In a survival scenario, however, most organized medical care will no longer exist, placing the average citizen into the position of medic for his/her family or community.  

Although we may be thrown back to the 19th century medically by a disaster, we have the benefit of knowing about infections and hygiene.  The knowledge of how contagious diseases are spread and how to sterilize supplies give us a major advantage over medical personnel of bygone eras.

Using this knowledge, it should be possible for a medically prepared person to put together a “sick room” or “hospital tent” that will minimize the chance of infectious disease running rampant through the community. The cornerstone of care is to deal effectively and humanely with the sick while keeping the healthy from becoming infected.

In the face of a looming catastrophe, you must first make the decision to either stay in place or get out of Dodge. If you’re staying in place, choose a room where the sick will be cared for. That room should be separate from common areas, like the kitchen. It must have good ventilation and light, and preferably, a door or other physical barrier to the rest of the retreat.

If the wiser choice is to leave the area, shelter is an issue that may be addressed with, for example, tents. Choose a tent as the sick room and place it on the periphery of the camp. Again, good ventilation is important to allow air circulation.

With sick rooms in a retreat or camp, it is important to designate them before a disaster occurs. For groups where a number of people are living together, procrastinating will cause someone to lose their room or tent for “the greater good”. This invariably breeds resentment at a time when everyone needs to pull together.

Sometimes, you may find that there isn’t a spare room or tent to assign as a sick room. If you only have a common area to work with, raise a makeshift barrier, such as a sheet of plastic, to separate the sick from the healthy. Even if you have a dedicated sick room, keep group members with injuries separate from those with infectious diseases such as influenza. Although wounds will sometimes become infected, they won’t likely be as contagious as epidemic illnesses.

tent joe's kids

The injured should be separate from the infected, if possible

A sick room in a retreat with air conditioning won’t qualify as decent ventilation when the power’s down. In this case, air ducts are actually more a danger than a benefit. Microbes passing through the air ducts in the sick room to other areas may present a risk for transmission of disease. Cover with duct tape. Keep windows or tent flaps open, however, except in particularly bad weather. Screening may be necessary in areas with lots of insects, or netting provided over the beds.

Furnishings should be minimal, with a work surface, an exam area, and bed spaces. In mild weather, some of these bed space can be outside, as long as shade is provided via a canopy or other means. Hard surfaces are preferable to fabric upholstery, as cloth can harbor disease-causing organisms. Even bedding might best be covered in plastic. The more areas that can be disinfected easily, the better.

It’s important to have a way to eliminate waste products of bedridden patients, even if it’s just a 5-gallon bucket and some bleach. Containers with lids should be made available to put used sick room items that need cleaning.

shutterstock_209173573

Keep a basin with soap and water at the entrance to the sick room

A station should be set up near the entrance of the sick room or hospital tent for caregivers’ masks, gloves, gowns, aprons, and other personal protection items (have a good supply of these items). You’ll should also have a basin with water, soap, or other disinfectant. Thermometers should be dipped in alcohol.

Many consider medical supplies to consist of gauze, tourniquets, and battle dressings, but you must also dedicate sets of sheets, towels, pillows, and other items to be used in the sick room. Keep these items separate from the bedding, bathing, and eating materials of the healthy members of your family or group.

Having a lot of these may seem like overkill to you, but there can never be enough dedicated medical supplies. Expect to care for more people that you’ve planned for. There will always be additions that weren’t planned, and medical items will be expended much faster than you’d expect.

Cleaning supplies should also be considered medical preparedness items. You’ll want to clean the sick room thoroughly on a daily basis. Hard surfaces should be regularly cleaned with soap and water, or use other disinfectants such as a 1:10 bleach solution. Don’t forget to disinfect the doorknobs, tables, sinks, toilets, counters, and even toys.

Wash bed sheets and towels frequently; boil them if you have no other way to clean them. As these items may carry disease-causing organisms, wash your hands after use. The same goes for plates, cups, etc. Any equipment brought into the sick room should stay there.

One additional item that will be important to your sick room patients: Give them a whistle or other noisemaker that will allow them to alert you when they need help. This will decrease anxiety and give them confidence that you will know when they are in distress.

The duties of a medic involve more than how to control bleeding or splint an orthopedic injury. Medical problems involving infectious disease may take a heavy toll on your people if the sick aren’t isolated from the healthy. Knowing how to put together an effective sick room will go a long way towards helping the sick get healthy and the healthy stay that way.

 

Joe Alton, MD

AuthorJoe

Joe Alton MD

Find out more about dealing with infectious disease in times of trouble in our 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, available at Amazon or on this website.

The Survival medicine handbook Third Edition 2016

The Survival Medicine Handbook 2017 Third Edition

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

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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

Foot Fungus Diagnosis, Treatment, and Prevention

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athletes-foot-large

Tinea Pedis

The medic in austere settings may have to deal with major medical issues; there are minor issues, however, that don’t threaten your patients’ lives, but can seriously affect their quality of life or work efficiency.  In times of trouble, you’ll need your people at 110%, and many issues, such as toothaches or foot infections, can become a nuisance or worse.

One problem that is very common (and will be more so off the grid) is foot and toenail fungus, also called “Athlete’s Foot”.  When your dogs (by that, I mean your feet) are howling because you aren’t able to change socks often, Athlete’s Foot might be the cause.  Expect this to be particularly relevant in scenarios where you’re constantly on the move.

Athlete’s Foot

Athlete’s foot (also known as “tinea pedis”) is an infection of the skin caused by a type of fungus known as Trychophyton. A fungus is a microscopic organism that likes dark and humid conditions.

This condition may be a chronic issue, lasting for years if not treated. Neglect can lead to its spread from between the toes to hands and groin.

It’s important to know that fungal infections are likely to be contagious. They can be passed by sharing shoes or socks and even from wet surfaces such as shower floors.  Those affected by Athlete’s Foot may also find themselves with other fungal conditions like Ringworm or Jock Itch (“Tinea Cruris”).

What Are Risk Factors For Athlete’s Foot?

 

Any fungal infection is made worse by moist conditions. People who are prone to Athlete’s foot commonly:

  • Spend long hours in closed shoes
  • Keep their feet wet for prolonged periods
  • Have had a tendency to get cuts on feet and hands
  • Perspire a lot
  • Are male
  • Are older or have chronic medical conditions like diabetes

What Does Foot Fungus Look Like?

athletes-foot

typical appearance of tinea pedis

To make a diagnosis, look for whitish flaky skin between the toes or fingers., which often appear red and raw. The nails may be yellowed, thickened, and “crumbly”.  Toenails may even separate from the underlying nail bed. Itching and burning in the affected areas is common and sometimes becomes severe. If the skin has been traumatized by scratching, you might see some fluid drainage.  Often, the damage caused by scratching is worse than the infection itself, leading to secondary bacterial infections like cellulitis.

Although toenails will appear yellowish in Athlete’s Foot, dark spots (brown, blue, or black) under the nail may be just debris or could be related to other issues. After an injury, a collection of blood under the nail (called a “hematoma”) will be dark and, often, painful. Less often, a tumor such as a cancer called “melanoma”, may first present with a dark or mottled appearance.

Treatment of Foot Fungus

If the condition is mild, keeping your feet clean and dry may be enough to allow slow improvement of the condition. Oftentimes, however, topical antifungal ointments or powders such as miconazole or clotrimazole are required for relief.  In the worst cases, oral prescription antifungals such as fluconazole (Diflucan) or terbinafine (Lamisil) are needed.

Although creams and ointments cover the skin between the toes more thoroughly, don’t use them too often; excessive moisture may delay healing.

In the worse cases, an infected nail may require removal. If so, it may take a year to grow back.

Patience is a virtue when monitoring the healing process, which may take more than a month for a significant case of Athlete’s Foot to resolve. In the meantime, disinfect shoes with antifungal powders on at least a weekly basis.

Home Remedies

vinegar

cloudy vinegar useful for relief

A favorite home remedy for Athlete’s Foot involves placing Tea Tree Oil liberally to a foot bath and soaking for 20 minutes or so.  Dry the feet well and then apply a few drops onto the affected area. Repeat this process twice daily. Try to keep the area as dry as possible otherwise. For prevention of future outbreaks of Athlete’s Foot, apply tea tree oil once a week before putting on socks and shoes.

5% Apple cider vinegar foot soaks (2-4 cups) may work as well. The acid will kill the fungus, as well as soften and break down the skin changes it causes. Use a washcloth to gently scrub the infected areas. If you notice irritation from the bath, dilute with water.

Others recommend soaks with other items, such as black tea, cinnamon, betadine, or Epsom salts.

Long-term therapy with Snakeroot extract may help. Apply every third day for the first month, and once a week thereafter for two to three months. Alternatively, dip a cotton ball in the vinegar and hold to affected areas for several minutes.

Vicks Vap-o-Rub, applied with a swab, shows partial important in more than half of cases.

One method that doesn’t work is urinating on your feet in the shower. Although there is ammonia in urine that might kill germs, it’s not strong enough to kill the Athlete’s foot fungus.

You might have your own home remedy for foot fungus. If so, feel free to post it in the comments section.

 

Joe Alton, MD

AuthorJoe

Joe Alton, MD

Find out more about foot fungus and other minor and major medical issues related to survival, check out a copy of our Third Edition (700 pages) of The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, available at amazon.com and here at store.doomandbloom.net.

Gallstones: Diagnosis and Treatment

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gall bladder stones

gallstones

The gall bladder is a hollow sac-like organ that is attached to the liver; it stores a thick liquid substance called “bile” that the liver secretes to help you digest fats. After a meal, the gall bladder contracts and bile passes through to the small intestine through tubes called ducts.

Excess bile cholesterol can cause solid deposits inside the gallbladder that range in size from miniscule to, say, the size of a golf ball. These are commonly referred to as “gallstones”.  Gallstones are relatively common; perhaps ten to fifteen per cent of the population has them. That means a large enough group of people in a survival community will likely include someone with the condition.

Luckily, most people won’t have any symptoms.  In one or two per cent, however, the stones block the ducts, causing pain as the gall bladder becomes distended from excess accumulation of bile. The inflammation caused by this condition is called “cholecystitis”.

There are two main types of gallstones:

1)            Cholesterol stones: The grand majority; these may not be related to the actual cholesterol levels in the bloodstream.

2)            Bilirubin stones: Sometimes called “pigment stones”, this type may occur in people who have illnesses that destroy red blood cells. The by-products of this destruction release a substance called “bilirubin” into the bile and forms a stone. In other cases, however, it’s difficult to identify a cause.

2425_Gallbladder

gall bladder anatomy with bile ducts and liver ( By OpenStax College [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons)

The pain associated with cholecystitis is known as “biliary colic”. It’s is cramping in nature and is usually seen in the upper right quadrant of the abdomen; it may radiate to the back. If not relieved, inflammation of the liver, gall bladder, and pancreas (“gallstone pancreatitis”) can become life-threatening in some cases.

A serious blockage of the bile duct with corresponding liver/pancreas inflammation can lead to fever, nausea and vomiting, and a yellowing of the skin and eyes known as “jaundice”.

Gallstones are commonly diagnosed by ultrasound, but you won’t have modern technology off the grid. The classical finding on physical examination is called “Murphy’s Sign”. Press with one hand just below the midline of the lowest rib on the front right. Then, ask your patient to breathe deeply. If the gallbladder is inflamed, the patient should complain of tenderness at the site.

In a less politically correct era, risk factors for this condition were described as the 4 “F’s”. For historical purposes, here they are:

Fat: The majority of those with gallstones are overweight.

Female: The majority of sufferers are women.

Forty: Most sufferers are over 40 years old.

Fertile: Most women with gallstones have had children.

Today, more sensitive souls prefer the acronym G.O.L.D.

Genetics: Ethnicity plays a role; Native Americans and Hispanics seem to have more gall bladder issues than Caucasians, Caucasians more than African-Americans.

Obesity: Obesity, especially in women, is associated with at least twice the frequency of gall bladder disease.

Location of Body Fat: Those with obesity concentrated in the torso are more likely to be at risk.

Diabetes: Those with Diabetes are more likely to have gallstones.

The most common treatment for gallstones, other than pain meds, is to surgically remove the gall bladder (you can live without it and stay healthy). Over 800,000 gall bladder surgeries (called “cholecystectomies”) are performed every year. New methods include shock-wave disintegration of stones and acid treatments that may show promise for non-surgical therapy.

Operating rooms, surgeons, and high technology, however, are likely to be in short supply when the you-know-what hits the fan, so it’s useful to know some alternative remedies. These are mostly taken orally::

  • Apple cider vinegar (mixed with apple juice or water)
  • Chanca Piedra, (Phyllanthus niruri), a plant native to the Amazon; translated, the name means “Break Stones”.
  • Peppermint
  • Coffee
  • Turmeric
  • Alfalfa
  • Ginger root
  • Psyllium
  • Red Yeast Rice
  • Dandelion root
  • Artichoke leaves
  • Beet, Carrot, Grape, Lemon juices

It should be noted that hard scientific data proving the effect of the above items is still lacking in many cases. Results from use of the items in the above list will vary from person to person.

Sadly, it is very difficult to eliminate some of the known risk factors for gall bladder disease. You can’t change if you’re forty, female, and have children. You may be able to do something about being obese, however. Dietary changes to lower fat intake may help you lose weight and decrease the risk of gallstones.

Joe Alton, MD

JoeAltonLibrary3

Joe Alton, MD

Hey, have you experienced the joy and satisfaction that goes with helping the elderly? Well, make an old man (me) very happy by checking out our brand new 700 page third edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, now available at Amazon.com and doomandbloom.net. Thanks again.

 

Survival Medicine Hour: Sulfa Drugs, Uva Ursi, Quicklime, More

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OLYMPUS DIGITAL CAMERA

Sulfa Drugs

In this episode of the Survival Medicine Hour, Joe Alton, MD (Dr. Bones) and Amy Alton, ARNP (Nurse Amy) examine Sulfa drug antibiotics as an option in survival settings. One of the first antibiotics, sulfa has been credited with saving the lives of tens of thousands in WWII, including Winston Churchill himself, and still has applications today in good or bad times.

Also, the herb Uva Ursi may have some use in urinary tract infections, one of the medical issues that sulfa drugs are effective for. Find out more about this herb in Nurse Amy’s segment on natural remedies.

Uva ursi

Uva Ursi

Plus, Dr. Bones discusses what disasters are most responsible for the most deaths in the U.S. over the last 40 years. The answers will definitely surprise you! Plus, some guidelines on disposal of dead bodies in post-apocalyptic times.

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/2017/04/07/survival-medicine-hour-sulfa-drugs-uva-ursi-quicklime-more

 

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

Joe and Amy Alton

joe and amy radio

The Altons

Please follow us on Twitter @ Preppershow, and don’t forget to check out Nurse Amy’s entire line of medical kits at store.doomandbloom.net!

Sulfa as a Survival Antibiotic

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Fish Sulfa Forte = Bactrim/Septra

In survival settings, it’s reasonable to assume that you’ll be performing activities that aren’t part of your routine in normal times, like, say, chopping wood for fuel. When you’re doing chores to which you’re not accustomed, injuries can occur. Of course, an ounce of prevention is worth a pound of cure. Using protective eyewear, gloves, and boots may prevent an injury that could become life-threatening off the grid.

It might be difficult to envision that a simple cut could turn lethal, but in survival, many of these wounds are “dirty”; that is, they’re contaminated with bacteria or other microbes. Today, the use of drugs called antibiotics can nip infections in the bud. in any situation where modern medicine isn’t available, however, these wounds can become problematic. If an infection enters the bloodstream (a condition called “septicemia”), things can go downhill quickly.  

A while ago, I did a series of articles and videos on antibiotics, and talked about popular drugs like amoxicillin, doxycycline, Cipro and others that you can find in aquarium and avian versions. Available in capsules and tablets that are essentially identical to those provided for human use (even down to identification numbers), the wise medic should have some of these tools in the medical woodshed for when the you-know-what hits the fan.

Quick disclaimer: This doesn’t mean that you should be using them in normal times. Remember that it’s illegal and punishable by law to practice medicine without a license. If modern medical professionals exist, seek them out.

Today we’ll talk about a family of antibiotic called sulfonamides, or sulfa drugs. Sulfonamides act to inhibit an enzyme involved in folate synthesis, an important part of the production of bacterial DNA. Sulfonamides are bacteriostatic, which means that they don’t directly kill bacteria. They do, however, significantly inhibit growth and multiplication, which leads to eventual elimination of bacteria from the body.

Sulfonamides were available even before Penicillin, and are credited with saving the lives of tens of thousands during WWII, including that of Winston Churchill. Soldier’s first aid kits even came with sulfa pills or powder.

bird sulfa

Bird Sulfa

A specific version, Sulfamethoxazole 400mg/Trimethoprim 80mg (veterinary equivalent: Bird- Sulfa or Fish-Sulfa) is a combination of two medications in the Sulfa family. This drug is well-known in the U.S. by its brand names Bactrim and Septra. Our British friends may recognize it by the name Co-Trimoxazole. The two antibiotics work synergistically, which means that, together, they are stronger in their effect than alone.

Sulfamethoxazole/Trimethoprim is effective in the treatment of the following:

·        Some upper and lower respiratory infections (chronic bronchitis and pneumonia)

·        Kidney and bladder infections

·        Ear infections in children

·        Cholera

·        Intestinal infections caused by E. coli and Shigella bacteria (a cause of dysentery)

·        Skin and wound infections, including MRSA

·        Traveler’s diarrhea

·        Acne

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

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

In rat studies, the use of this drug was seen to cause birth defects; therefore, it is not used during pregnancy.

silvadene

Silvadene cream

Another sulfa drug, Sulfadiazine, is combined with Silver to make Silvadene, a cream useful for aiding the healing process in skin wounds and burns. Cover completely twice a day.

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

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

It’s important to understand that antibiotics aren’t candy: they must be used wisely and only when absolutely necessary. The overuse of antibiotics (mostly in livestock) is responsible for an epidemic of antibiotic resistance. Having them in your medical storage, however, can prevent the medic from experiencing headaches, and heartaches, if things go South.

Joe Alton, MD aka Dr. Bones

JoeAltonLibrary3

Joe Alton, MD

Learn more about antibiotics and 150 other medical topics related to survival by checking out 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.

The Survival medicine handbook Third Edition 2016

The Survival Medicine Handbook 2016 Third Edition

Survival Medicine Hour: Disaster Deaths, Antibiotics, XStat, More

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ebola1

In this episode of The Survival Medicine Hour, Joe and Amy Alton, aka Dr. Bones and Nurse Amy, discuss an antibiotic called Clavamox that’s used in dogs and cats as a possible survival med. Also know as Augmentin, is it exactly the same as the human drug, as  Dr. Alton found was the case years ago with certain fish and bird antibiotics? You might be surprised.

Also, the military may be getting taken for a ride with the expensive prescription product XSTAT, a syringe of hemostatic sponges used for severe hemorrhages. Sounds good, but does it work and what’s behind the recommendations for the government to add this item to military supplies? And does it have any application for survival medics?

Xstat-300x225

XSTAT hemostatic syringe

Plus, do dead bodies from natural disasters cause epidemics? Amy and Joe explore this possibility and compare it to Ebola in 2014 and other events. Lastly, a young man wants to take his 6 month old son and wife to Belize, currently under a Zika warning from the CDC. What is Dr. Bones’ opinion?

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/03/31/survival-medicine-hour-antibiotics-dead-bodies-and-disasters-more

 

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

 

Joe and Amy Alton

joe and amy radio

Dr. Bones and Nurse Amy

The Preparedness Dental Kit

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ellis2contempclindent.org_

Dental Fracture

(This article first appeared in Gaye Levy’s Back Door Survival website)

Many of our readers are surprised that “The Survival Medicine Handbook: The Essential Guide for when Medical Help is Not on the Way” devotes a portion of its pages to dental issues. Indeed, few who are otherwise medically prepared seem to devote much time to dental health. Poor dental health can cause issues that affect the work efficiency of members of your group in survival settings. When your people are not at 100% effectiveness, your chances for survival decrease, and anyone who has experienced a toothache knows how it effects work performance.

A survival medic’s philosophy should be that an ounce of prevention is worth a pound of cure. This thinking is especially apt when it comes to your teeth. By enforcing a regimen of good dental hygiene, you will save your loved ones a lot of pain (and yourself a few headaches).

This article will discuss procedures that are best performed by someone with experience. Unfortunately, you’re probably not going to have a dentist in your party. The information here will give you a basis of knowledge that may help you deal with some basic issues

The Prepared Family’s Dental Kit

dental kit

some components for a dental kit

The prepared medic will have included dental supplies in their storage, but what exactly would make sense in austere settings? You would want the kit to be portable, so dentist chairs and other heavy equipment wouldn’t be practical.

We’ve mentioned that gloves for medical and dental purposes are one item that you should have in quantity. Don’t ever stick your bare hands in someone’s mouth! Buy hypoallergenic nitrile gloves instead of latex. For additional protection, masks should also be stored and worn by the medic.

Other items that are useful to the survival “dentist” are

  • Dental floss, dental picks, toothbrushes, toothpaste or baking soda
  • Dental or orthodontic wax as used for braces; even candle wax will do in a pinch. Use it to splint a loose tooth to its neighbors.
  • A Rubber bite block to keep the mouth open. This provides good visualization and protection from getting bitten. A large-sized pink eraser would serve the purpose.
  • Cotton pellets, Cotton rolls, Q tips, gauze sponges (cut into small squares)
  • Commercial temporary filling material, such as Tempanol, Cavit, or Den-temp.
  • Oil of cloves (eugenol), a natural anesthetic.It’s important to know that eugenol might burn the tongue, so be careful when touching anything but teeth with it.  Often found in commercial preparations.
  • Red Cross Toothache Medicine (85% eugenol)
  • DenTemp Toothache Drops (benzocaine )
  • Zinc oxide powder; when mixed with 2 drops of clove oil, it will harden into temporary filling cement.
  • Spatula for mixing (a tongue depressor will do)
  • Oil of oregano, a natural antibacterial.
  • A bulb syringe to blow air and dry teeth for better visualization, and as a diagnostic tool to elicit discomfort in damaged teeth.
  • A 12cc Curved irrigation syringe to clean areas upon which work is being done.
  • Scalpels (#15 or #10) to incise and drain abscesses
  • Dental probes, also called “explorers”.
  • Dental tweezers
  • Dental mirrors
  • Dental scrapers/scalers to remove plaque and probe question- able areas
  • Spoon excavators. These instruments have a flat circular tip that is used to “excavate” decayed material from a tooth. A powered dental drill would be a much better choice, but not likely to be an option off the grid.
  • Elevators. These are thin but solid chisel-like instruments that help with extractions by separating ligaments that hold teeth in their sockets. #301 or #12B are good choices. In a pinch, some parts of a Swiss army knife might work.
  • Extraction forceps. These are like pliers with curved ends. They come in versions specific to upper and lower teeth and, sometimes, left and right.
dental_extraction_forcep

dental extractor

There are more types of dental extractors than there are teeth, you should at least have several. Although every dentist has their preferences, you should consider including the following in your dental kit:

-#151 or #79N for lower front teeth

-#150A or #150 for upper front teeth.

-#23, best for lower right or left molars

-#53R, best for upper right molars

-#53L, best for upper left molars

  • Blood-clotting Agents: There are a number of products, such as Act-Cel, that help control bleeding in the mouth after extractions or other procedures. Act-Cel comes in a fabric square that can be cut to size and placed directly on the bleeding socket or gum.
  • Sutures: A kit consisting of a needle holder, forceps, scissors, and suture material is helpful for the control of bleeding after extraction or to preserve the normal contour of gum tissue. We recommend 4/0 Chromic catgut as it is absorbable and delicate enough for the oral cavity but large enough for the non-surgeon to handle. Don’t forget a small scissors to cut the string. More information on suture materials can be found later in this book
  • Pain medication and antibiotics. Medications in the Penicillin family are preferred if not allergic. For those allergic to Penicillin, Erythromycin can be used. For tooth abscesses, Clindamycin is a good choice. Antibiotics are discussed in detail in our book and in various sections of our website at doomandbloom.net

The Survival Dental Exam

Because your hands and your patient’s mouth are colonized with bacteria, every exam should begin with hand washing and the donning of gloves. All instruments should have been thoroughly cleaned or sterilized between exams. If an instrument has touched blood, consider using heat in the form of boiling water (or steam from a pressure cooker) as previously described in this book. Alcohol or bleach solution may be sufficient in cases where there was no blood involved.

Have your patient open their mouth so that you can investigate the area. A dental mirror and dental probe, also called an “explorer”, are good tools to start with. Does the patient have any problems opening and closing their mouth? Are there sores at the corner of their mouths (sometimes seen in vitamin B2 and other nutritional deficiencies)?

Evaluate the cheek linings, roof of the mouth, the tongue, tonsils, and the back of the throat. Are the gums pink, or are they red and swollen? Do they bleed easily when lightly touched by the probe?

Are there “canker” or “cold” sores? Contrary to popular opinion, these are not the same thing. Cold sore, or fever blisters, start off as small blisters and are caused by Herpes type I virus. They mostly affect the hard gums and the roof of your mouth. Canker sores are less certain in origin. They are shallow ulcers that affect soft parts like the inside of your lips and cheeks, the floor of the mouth, and the underside of the tongue.

Other soft tissues to check out include the tonsils. Are they enlarged? Are they or the back of the throat reddened and dotted with pus? These can be signs of tonsillitis or Strep throat.

Once you have checked the soft tissues inside the mouth, it’s time to examine the teeth. Using your dental explorer, carefully look around for any obvious cavities. A cavity will appear as a dark pit where bacteria has demineralized the enamel. Search for fractures, missing fillings, or other irregularities. Even if there is nothing visible, however, there may still be serious decay between teeth or below the gums. Patients with this issue may have pain, otherwise known as “toothache”. You’ll find information on how to deal with toothache, broken and “knocked-out” teeth, and other dental issues in The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way and in specialty books like “Where There is No Dentist”. We’ll discuss specific issues and how to treat them in future articles.

Once you’ve identified the problem area, you can do your best to deal with the problem. With the items above, you’ll be more prepared for survival dental 99.9% of the population. Our dental kit is designed to have the materials necessary to function in a survival setting and even comes with a free copy of “Where There is No Dentist”. That doesn’t mean that, in normal times, you shouldn’t seek out a qualified dentist; whenever and wherever modern dental care is available, take advantage of it.

Amy Alton, ARNP

NurseAmyBook

Amy Alton, ARNP

 

Find out more about dental issues 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.

Video: All About Dysentery

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Shigella boydii

Shigella bacteria

In this video, Joe Alton, MD, aka Dr. Bones of DoomandBloom.net, discusses the issue of infectious diseases as the main causes of avoidable deaths in survival scenarios. In particular, he talks about dysentery, a disease that is transmitted by bacteria in contaminated food and water. Here’s all you need to know about this killer in past and future times of trouble. Companion video to a previous article on the same topic.

To watch, just click below:

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

 

Joe Alton, MD

JoeAltonLibrary3

Joe Alton, MD

Find out more about dysentery and 150 more medical issues in the latest 700 page edition of the Survival Medicine Handbook: THE Essential Guide for When Medical Help is Not on the Way, available at store.doomandbloom.net or Amazon.com!

 

Survival Medicine Hour: Blood Clotters, Wound Closure, More

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stabwound

In this episode of the Survival Medicine Hour, Joe and Amy Alton, aka Dr. Bones and Nurse Amy discuss improvised tourniquets and some TCCC guidelines regarding hemorrhage under fire or in normal times. Blood clotting agents are introduced and Quikclot/Celox are compared. Plus, when should a wound be closed and when should it be treated as a open wound from beginning to full recovery?

celox

Celox hemostatic agent

All this and more from a Survival Medicine Hour on the road, this time in Chicago, Illinois!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/03/17/survival-medicine-hour-blood-clotters-wound-closure-more

 

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

 

Joe and Amy Alton

AmyandJoePodcast400x200

Dr. Bones and Nurse Amy

Blizzard Safety Tips

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carsinsnow

The March Blizzard

 

 

I find myself a little surprised to be writing about blizzard survival with Spring just around the corner, but weather forecasts are predicting a particularly nasty blizzard for the East Coast. Strong winds and a foot of snow are possible from Maryland to Maine. March came in like a lamb, but it’s acting like a lion for those in the Northeast.

Winter storms (this one is named “Stella”) occur every year in the United States, and cause fatalities among the unprepared. 70% of deaths occur due to traffic accidents and 25% from hypothermia from being caught outside during the blizzard. With Stella’s strong winds, trees and power lines burdened with heavy snowfall may topple, causing additional hazards.

If a blizzard knocks you off the grid but you’re still in your home (a great place to be), keep everyone in an inside room, preferably without windows. The heat from several bodies will make a small space warmer.

Heat in the home can be conserved by shutting the doors of unused rooms and drawing blinds and curtains to add insulation.  Stuff towels under the door to prevent loss of warmth from the room you’re using. If you’re using some form of alternative heat, however, make certain that there is reasonable ventilation. Prepare for mishaps by having a fire extinguisher handy.

Staying hydrated is important. You’d be surprised how much a family uses, so fill the bathtub with water. Plumbing might be kept from freezing by allowing faucets to drip. Stock up on non-perishable food.

Winter conditions don’t just affect people; they affect cars as well. Cold affects rubber and metal; it even decreases the battery’s efficiency. Tires become stiff and flat for the first few hundred yards. Motor oil and other lubricants become thicker at cold temperatures. This makes the engine work harder.

Therefore, vehicles that will be doing duty in extreme cold should be “winterized”. This involves switching to a lighter viscosity oil, changing to snow tires, and choosing the right (anti-freeze) ratio of coolant to water. Gas tanks should be full if at all possible.

blizzard

Not the best time to be outside (image courtesy of pixabay.com)

 

OUTSIDE IN A BLIZZARD

You’re not a bear, so you can’t hibernate through the cold weather; you’ll have to take measures to avoid getting stranded out in the cold. Many deaths from exposure are avoidable if simple precautions are taken

The first thing that you should do before planning a day outdoors in snowy weather is consult your weather radio for the forecast. If a storm is on the way, postpone your outing until the weather improves.

Dress appropriately and in layers. Each successive layer of clothing traps warm air near your body. Wool is the best material for staying warm. Unlike cotton, wool will stay warm even if somewhat wet, and wicks perspiration away from the skin. Wet clothing will cause you to lose body core temperature faster. Mittens will keep your hands warmer than gloves.

SEEK SHELTER

tree well

A Tree Well Shelter

Some people might be caught by surprise when a winter storm hits the backcountry. If you’re in the wilderness, seek some form of shelter immediately to get out of the wind. There are many types of shelters, but one can be made in a “tree well”. A tree well is the sunken area around the trunk in very deep snow. This area is relatively easy to excavate and, if the tree has low-hanging branches, should provide some protection from falling snow. Look for natural barriers nearby that may serve as windbreaks, but beware of slopes where you may be exposed to drifting snow or avalanches.

The space you dig out should be small, as small shelters take less effort to keep warm than large ones. Pack your snow “walls” well, which retains heat better and can support a makeshift roof. Place evergreen boughs and debris on the floor to protect you from the cold ground. Then add some on top to make a roof. Tarps or solar blankets may also be used for this purpose, but winds might easily blow them off. Tie rocks to the corners as weights.

If a tree well is not an option, digging a “cave” out of deep snow can serve to insulate you from the wind (think igloo). If you make a fire, be sure to have ventilation holes in your shelter. Entrances and ventilation holes should open at a 90 degree angle to the prevailing winds.

Stay hydrated but don’t eat snow. Your body must first melt it and loses heat as a result. If you don’t have fire to melt snow, put a container with it in your clothes, but not next to the skin. Hypothermia and other cold-related medical issues are covered here.

STRANDED IN THE CAR

caraccidentwinter

You won’t always be stranded on a busy highway

The first question you should ask before you get in the car in cold weather is “Is this trip necessary?”. If you don’t have to leave the house in a snowstorm, don’t. Period. If you do, drive as if your life depended on it, because it does. Don’t speed, tailgate, or weave from lane to lane. Make turns slowly and deliberately, and be careful to avoid quick stops and starts

Let’s say that, despite your best efforts, you’re stuck on the road in a blizzard. Help may be on the way, but what if it isn’t? It’s important to stay calm and don’t leave the car. It’s warmer there than outside and you’re protected from the wind.

Wet snow can block up your exhaust pipes and cause carbon monoxide gas to enter the passenger compartment. You’ll need fresh air, but don’t crack a window on the side where the wind is coming from. If you’re in a group, huddle together as best you can to create a warm pocket in the car. Rub your hands, put them in your armpits, or otherwise keep moving; this will help your muscles produce heat.

Maybe you can dig yourself out, but beware of overexertion in extreme cold. You’ll sweat, and wet clothes are a main cause of hypothermia. If you have flares, use them to let others know you need help.

THE WINTER SURVIVAL CAR KIT

There are a number of items that you should always have in your car, especially in cold weather. These are meant to keep you safe if the unthinkable happens and you’re stranded without hope of rescue. Your blizzard survival car kit should contain:

  • Wool blankets (for warmth; wool can stay warm even if wet)
  • Spare sets of dry clothes, especially socks, hats, and mittens.
  • Hard warmers or other instant heat packs (activated by shak- ing, they’ll last for hours)
  • Matches, lighters, and fire starters to manufacture heat Flashlights and candles (keep batteries in backwards until you need them to extend life).
  • Small multi-tool with blade, screwdrivers, pliers, etc.
  • Larger combination tool like a foldable military surplus shovel (some are multipurpose and can be used as an axe or saw)
  • Sand or rock salt (to give traction where needed)
  • Tow chain or rope
  • Flares
  • Starter cables (for jump starts)
  • Water and food (energy bars, MREs, dehydrated soups, candies)
  • Baby wipes (for hygiene purposes)
  • A medical kit and medications
  • Tarp and duct tape (brightly colored ones will be more visible and aid rescue)
  • Metal cup or thermos (to melt snow, make soup, etc.) Noisemaker (whistle) to signal for help
  • Cell phone and charger, weather radio

A March storm can be as deadly as one in January. With a plan of action, a few supplies, and a little luck, you’ll survive even in the worst blizzard.

 

Joe Alton, MD

AuthorJoe

Joe Alton, MD

Find out more about cold weather, hot weather, and many other issues in our Third Edition of the Survival Medicine Handbook, The Essential Guide for When Help is Not on the Way!

Survival Medicine Hour: Dental Exams, Bleeding Control, Tourniquets

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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.

Survival Medicine Hour: Dental Supplies, Tornadoes

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tornado1

Tornado in the Midwest

 

The Survival Medicine Hour is hosted by Joe Alton, MD aka Dr. Bones, and Amy Alton, ARNP, aka Nurse Amy, of https://www.doomandbloom.net/, where you can find over 900 posts, videos and podcasts on disaster and survival strategies.

 

In this episode, we’re on the road speaking in places like Memphis and New Orleans! Tornadoes have hit the area as well as the Midwest, so we discuss keeping your family safe in a twister. Plus, a rundown of what you’d need in the line of dental supplies for long term disaster preparedness.

 

dental_extraction_forcep

dental extractor

To listen in, click below:

 

http://www.blogtalkradio.com/survivalmedicine/2017/03/03/survival-medicine-hour-tornados-dental-supplies

 

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

 

Joe and Amy Alton

LabCoatsBonesAmy1

The Altons

Check out our latest 700 page edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, now available on Amazon!

Dysentery in Survival Settings

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bacteria

dysentery may be caused by bacteria or parasites

 

In survival scenarios, many believe that trauma from gunfights at the OK corral will cause the most deaths. The truth, however, is that many avoidable losses will occur due to more basic issues, such as dehydration from infectious diarrheal diseases. These most often occur from failure to assure the sterilization of water, proper preparation of food, and safe disposal of human waste. One of the many duties of the medic in austere settings is to supervise these activities.

 

I’ve written about some of these diseases before, such as Cholera, but I haven’t discussed dysentery in much detail. The World Health Organization (WHO) defines dysentery as diarrhea in which blood is present in loose, watery bowel movements. Unlike Cholera, dysentery is a diarrheal disease that can be caused by several different organisms. It can be spread from human to human or, less commonly, from animals to humans.

 

Most cases of diarrhea are mild and easily treated with fluids and avoidance of certain food products, like dairy. Dysentery, however, is a more serious form where inflammation of the large intestine causes watery stools mixed with blood, pus, and mucus.

 

There are two types of dysentery:

 

Bacillary: Most often caused by several variants of the bacteria family Shigella, but E. Coli, Salmonella, and Campylobacter may also be involved.

 

Amoebic: A parasite, Entamoeba Histolytica, is more commonly seen in tropical and subtropical climates.

 

Dysentery was the cause of death of many soldiers in the Civil War. In total, infectious diseases like Cholera, Typhoid, and others killed more men than bullets or shrapnel.

 

SIGNS AND SYMPTOMS OF DYSENTERY

cholera 1

Nausea and vomiting can be seen in dysentery and other diarrheal diseases

 

About 2-10 days after infection, the patient will begin to show symptoms. Some will experience mild effects but others will progress to more severe disease. Beside frequent watery stools mixed with blood and mucus (sometimes 20-30 times a day!), you may see:

 

·        high fevers

·        abdominal pain and bloating

·        Excessive gas

·        Loss of appetite

·        Weakness and fatigue

·        Urgent need to evacuate

·        Vomiting

 

All of the above leads to significant dehydration, which is complicated in severe bacillary dysentery by erosion of the lining of the gut, leading to ulcers that cause bleeding from the rectum. Combined with the effect of bacterial toxins, death may occur quickly without antibiotic therapy and IV fluids. Amoebic dysentery may follow a similar course or be more prolonged in nature, leading to a weakened system and the formation of pockets of pus in the liver.  

 

TREATING DYSENTERY

oralrehydrationpack

oral rehydration salts

 

As you can imagine, any form of this disease will greatly decrease the chance for survival off the grid. As the well-prepared medic can intervene early with certain medicines, a high index of suspicion will decrease avoidable deaths.

 

For bacillary dysentery like that caused by Shigella, antibiotics like ciprofloxacin (Fish-Flox) or azithromycin (Aquatic Azithromycin) are used as treatment.  Amoebic dysentery can be treated with an anti-parasitic drug such as metronidazole (Fish-Zole). Dosing can be found in our book “The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way” or in various articles at doomandbloom.net. Loperamide (Imodium) and Pepto-Bismol (Bismuth Subsalicylate) are additional items that will be useful tools in the medical woodshed.

 

Of course, it’s especially important to rehydrate victims aggressively. Oral rehydration salts contain electrolytes that will more effectively aid recovery. These can be purchased commercially or improvised using the following formula:

 

To one liter of water (2 liters for children), add:

·        6-8 teaspoons of sugar

·        ½-3/4 teaspoons of salt

·        ¼-1/2 teaspoons of salt substitute (used by people who can’t use regular salt. This item has potassium, an important electrolyte, and can be found wherever regular salt is found.)

·        A pinch of baking soda for bicarbonate

 

PREVENTION

 

vegetables wash

prevent infectious disease with thorough washing

Prevention of dysentery requires understanding of how it’s spread. Transmission often occurs by infected individuals who handle food without washing first or use unsterilized water. Some people may carry the organisms and show no symptoms, at least for a time. As contamination with human feces is a big factor, the medic has to closely supervise the building and use of latrines and other facilities.

 

Dysentery is just one of the issues that can cause headaches and heartaches for the survival medic. With some knowledge and supplies, you’ll have a better chance to keep your family safe in times of trouble.

 

Joe Alton, MD

JoeAltonLibrary3

Joe Alton, MD

Fill those holes in your medical storage by checking out Nurse Amy’s entire line of often-imitated, never-equaled kits and supplies at store.doomandbloom.net!

Tornado Preparedness

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tornado

Tornadoes

 

There are many natural disasters that might befall a community, but a tornado is one of the most unpredictable. Several people were killed in the last few days as a rash of storms wreaked havoc in the South and Midwest. Indeed, hundreds of people are killed yearly by tornadoes, but many injuries and deaths may be avoided with sound preparation.

 

 

A tornado is a violently rotating column of air that is in contact with both the surface of the earth and the thunderstorm (sometimes called a “supercell”) that spawned it. From a distance, tornadoes usually appear in the form of a visible dark funnel with all sorts of flying debris in and around it. Because of rainfall, they may be difficult to see when close up.

 

 

A tornado (also called a “twister”) may have winds of up to 300 miles per hour, and can travel for a number of miles before petering out. They may be accompanied by hail and emit a distinctive roaring sound that will remind you of a passing train. We have personally experienced this at our own home some years ago, and it is terrifying.

 

 

There are almost a thousand tornadoes in the United States every year, more than are reported in any other country. Most of these occur in “Tornado Alley”, an area that encompasses parts of Texas, Oklahoma, Missouri, Kansas, Arkansas, and neighboring states. Spring and early summer are the peak seasons.

 

 

Injuries from tornadoes usually come as a result of trauma from the flying debris that is carried along with it. Strong winds can carry large objects and fling them around in a manner that is hard to believe. Indeed, there is a report that, in 1931, an 83 ton train was lifted and thrown 80 feet from the tracks.

 

 

Tornadoes are categorized as level 0-5 by the Enhanced Fujita Scale, which is based on wind speeds and the amount of damage caused:

 

 

F0 Light: Winds 40-72 miles per hour; smaller trees uprooted or branches broken, mild structural damage.
F1 Moderate: winds 73–112 miles per hour; Broken windows, small tree trunks broken, overturned mobile homes, destruction of carports or toolsheds, roof tiles missing.
F2 Considerable: winds 113–157 miles per hour; Mobile homes destroyed, major structural damage to frame homes due to flying debris, some large trees snapped in half or uprooted.
F3 Severe: winds 158–206 miles per hour; Roofs torn from homes, small frame homes destroyed, most trees snapped and uprooted.
F4 Devastating: winds 207–260 miles per hour; Strong- structure buildings damaged or destroyed or lifted from foundations, cars lifted and blown away, even large debris airborne.

F5 Incredible: winds 261–318 miles per hour; Larger buildings lifted from foundations, trees snapped, uprooted and debarked, objects weighing more than a ton become airborne missiles.

 

 

Although some places may have sirens or other methods of warning you of an approaching twister, it is important to plan for your family to weather the storm. Having a plan before a tornado touches down is the most likely way you will survive the event. Children should be taught where to find the medical kits, and how to use a fire extinguisher. If appropriate, teach everyone how to safely turn off the gas and electricity. For a more complete supply list of items before, during, and after the storm, follow this link on tornado safety from the Red Cross:

 

 

http://www.redcross.org/images/MEDIA_CustomProductCatalog/m4340177_Tornado.pdf

 

 

When you are in the path of a tornado, take shelter immediately unless you live in a mobile home. These are especially vulnerable to damage from the winds. If there is time, get to the nearest building that has a tornado shelter or is, at least, solidly constructed; underground shelters are best.

 

 

If you live in Tornado Alley, consider putting together your own underground shelter. Unlike bunkers and other structures built for long-term use, a tornado shelter only has to provide safety for a short period of time. As such, it doesn’t have to be very large; 8-10 square feet per person would be acceptable. Despite this, be sure to consider ventilation and the comfort or special needs of those using the shelter.

 

 

If you don’t have a shelter, find the safest place in the house where family members can gather. Basements, bathrooms, closets or inside rooms without windows are the best options. Windows can easily shatter from impact due to flying debris.

 

 

For added protection, get under a heavy object such as a sturdy table. Covering your body with a sleeping bag or mattress will provide an additional shield. Discuss this plan of action with every member of your family regularly, so that they will know this process by heart.

 

 

If you’re in a car and can drive to a shelter, do so. Although you may be hesitant to leave your vehicle, remember that they can be easily tossed around by high winds; you may be safer if there is a culvert or other area lower than the roadway. It is not safe to hide under a bridge or overpass, however, as the winds can easily reach you.

 

 

In town, leaving the car to enter a sturdy building is appropriate. If there is no other shelter, however, staying in your car will protect you from some of the flying debris (it should be noted that even a car can be sent flying in a powerful tornado). Keep your seat belt on, put your head down below the level of the windows, and cover yourself if at all possible.

 

 

If you’re out hiking when a tornado hits, get away from heavily wooded areas. Torn branches and other debris become missiles, so an open field or ditch may be safer. Lying face down flat in a ditch or other low spot in the ground may give you some protection. Make sure to cover your head if at all possible, even if it’s just with your hands.

 

 

Joe Alton, MD

 

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

 

How to Control Rodents as Disease Vectors

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rats-in-a-trap

Brown rats may reach 16 inches in length, including tail

 

in survival settings, it’s been said that rats will do a better job of surviving than humans. Rats, mice, and other rodents are well-known causes of “zoonotic” infections.  A zoonotic disease is one that can be transmitted from animals to humans.  The animal in question may not have symptoms of the disease itself, but may serve as a “vector”; that is, it carries the disease to a human target.

Rats and mice belong to the order Rodentia, from the latin word rodere (“to gnaw”).  This order contains various families, including beavers, porcupines, squirrels, and gophers.  As you are unlikely to have an infestation of beavers in your home, we’ll concentrate on rats and mice. Ai pair of rats could produce 1,500 offspring in one year if they all reproduced. Most rats and mice that cause issues for humans come from the “Old World”.  These include:

Brown rats (rattus norvegicus): Also called Norway rats, although they didn’t originate there (Norway has no more rat issues than other countries). Brown rats may reach 16 inches (including the tail) and are good swimmers; the term “sewer rat” was coined for them.

Black rats (rattus rattus): Thought to have introduced the Plague to Europe through their fleas. The black rat, also called the “roof rat”, is slightly smaller than its brown cousin and is an excellent climber.

House mice (Mus musculus): Used to living in close quarters with humans, mice are “nibblers” and can contaminate an entire pantry by taking a few bites out of multiple food items. Mice and other rodents can also chew through electrical wiring, thereby constituting a fire hazard.

Rats and mice are some of the world’s most invasive species. Every year, a percentage of the world’s food supply is contaminated by their droppings, urine, and hair. These items, known as “fomites”, may contain disease-carrying organisms and, as such, render food unfit for human consumption.

hooded rats

Long-Evans hooded rats I worked with in labs help further medical research

Before I go further, let me tell our readers who have rats and mice as pets that they (the pets, not necessarily the owners) are generally clean, intelligent creatures.  I have had the privilege of working with them in university laboratories as a student.  Despite this, it is indisputable that the diseases they may carry are cause for concern.

MEDICAL ISSUES CAUSED BY RODENTS

From a medical perspective, what diseases might one contract from a rodent or its droppings?  These include:

Plague:  The Plague is caused by a bacterium known as Yersinia Pestis. It is carried by fleas. The black rat’s arrival in Europe in the Middle Ages (and with it, its fleas) caused pandemics of the disease that wiped out a third of the population. Even today, Plague exists in developing countries and, there have been hundreds of cases in the U.S. over the past three decades.

Hantavirus: Hantavirus, transmitted by mice in urine, droppings or saliva, causes a serious lung disease that may become fatal without the availability of intensive care.

Leptospirosis: Caused by consuming food contaminated by rat urine, Leptospirosis causes a flu-like syndrome that progresses to kidney and liver failure if untreated.  This disease can also be carried by certain livestock.

Lymphocytic Chorio-Meningitis Virus (LCMV): LCMV may be contracted from mice urine or droppings or from pets in contact with mice, such as hamsters.   It causes a flu-like syndrome that occasionally causes complications in the nervous system, especially in people with weakened immune systems or pregnant women.  LCMV may cause miscarriage or birth defects.

Salmonellosis: Infection with the bacteria Salmonella may occur as a result of handling of pet rats or mice, especially if they have had diarrhea.  It causes severe diarrheal disease in humans, and is one good reason for owners of rats and mice to wash their hands after handling.

Rat Bite Fever: Infection with the bacterium Strebtobacillus occurs from rat bites and scratches or from ingesting food or water contaminated with rat droppings. Abrupt onset of fevers, rashes, vomiting, and headaches are noted at first, with general deterioration afterwards. If untreated, there is a 10% death rate.

RODENT-PROOFING A RETREAT

homestead-cabin-pixabay

rodent-proofing

It’s simply common sense to take measures to prevent rodent infestation in the home and to eliminate those already there. Once an infestation has occurred, much more effort is required to dislodge these unwanted guests. Rodent-proofing a home requires careful evaluation for points of entry from the level of the foundation to the roofline.  This includes sewer lines, bathroom vents, pipes and gutters, doors and windows, and vegetation near concrete slabs.

Some rodent-proofing techniques for homes include:

  • Sealing cracks in building foundations, walls, siding, and roof joints with, for example, mesh hardware cloth or concrete patching. Rodents only need ¼ inch of opening to gnaw their way into your home. Metal mesh scouring pads or galvanized window screening (not steel wool, which quickly deteriorates) may be stuffed into crevices as a temporary solution.
  • Installing vent guards in bathroom or washer/dryer vents.
  • Placing barriers to prevent climbing rodents from going up pipes or gutters.
  • Trimming trees so that branches don’t come close to the roof.
  • Contacting the utility company for strategies to prevent rats from traveling along power lines to your house.
  • Preventing rodents, especially rats, from tunneling under the foundation by placing flat concrete pavers or gravel for the first 3 feet from the base of the house.

Rodent control also involves careful attention to both indoor and outdoor sanitation.  Here are some suggestions for the wise homeowner:

  • Never leave food or water out overnight. Keep your countertops clean and disinfected.
  • Breadboxes may seem old-fashioned, but they are there for a reason: To keep the bread away from rats and mice.
  • Never leave pet food outside, clean all bowls daily, whether they are used inside or out. Rodents love to eat dog and cat food.
  • Clean under kitchen appliances. Even a few crumbs will make a meal for a mouse or rat.
  • Keep garbage disposals and sinks clean with a cup of bleach once a month.
  • Never flush grease down the sink drain.
  • Keep toilet lids down until needed.
  • Store dry foods, even pet foods, in sealed containers at least 18 inches off the floor.
  • Construct barriers around birdhouses and bird-feeders to prevent seed from being accessible to rodents.
  • Remove any fruits or vegetables from your garden that you won’t use.
  • Keep garbage can lids tightly closed.
  • Keep the side and back yards free of debris that might serve as shelters.
  • Deny access to water by fixing leaky faucets.
  • Avoid putting animal products in your compost bin.

IDENTIFYING INFESTATIONS

Rodent droppings

rodent droppings (source: city of Berkeley, CA)

If you’re not sure that your home is currently rodent-free, you might consider:

  • Looking for any partially eaten food, gnawed containers, or nesting material.
  • Inspecting your home’s interior at night with a flashlight; look especially closely at the bases of walls, as rats and mice prefer to travel along them. Little used areas of the home should be especially targeted.
  • Looking for rodent droppings. Mice and rat defecate 50 times a day; if they are in your home, you should be able to find their feces along floorboards, in attic crawl spaces, and in basements.
  • Setting out a thin layer of flour or talcum powder by areas through which rats and mice might enter your home. Place some, as well, along floorboards; rodents prefer to travel along walls. The rodents will leave tracks which will prove their presence.
  • Having cats and dogs as “mousers”. They may or may not be efficient, but they usually will alert you when a rodent is near.
  • Listening for squeaking and scrabbling noises inside walls at night.
  • Check for unusual smells. If there are a lot of rats in your home, you may notice an odor from their urine.

ELIMINATING THE PROBLEM

rats as food

A method of rodent control not discussed in this article

Once you have made the determination that you have rats or mice in your home, it’s time to reduce the population.  It should be noted that long-term control will be difficult if you haven’t followed my earlier suggestions for indoor and outdoor sanitation.

There are myriad mouse and rat-traps on the market and a number of poisons available to kill rodent invaders. It makes more sense to use traps, in my opinion, as poisons may leave you with a bunch of dead, rotting animals inside your walls. The stench may last a month or more, and sometimes deodorizer is needed to be inserted through a hole drilled in the wall.

If you have a lot of rats in your yard, you shouldn’t use poisons, as they may be ingested by neighborhood pets or even children. You should, however, consider trapping boxes. These can be snap traps, electronic “zappers”, glue traps or even catch and release versions. Both rats and mice will readily go for a small amount of fresh peanut butter as bait. Advice to the soft-hearted: Brown rats, black rats, and house mice are not native wildlife; besides other damage, some will cause casualties among endangered songbird eggs and young if released.

Glue traps are popular but controversial.  They are better weapons against mice than rats. Unfortunately, they usually leave you with a live animal to kill.  If you must use them, euthanize the rodent by throwing the trap and animal into a bucket of water or by striking it with a stick several times just behind the head. Another disadvantage of the glue trap is that it loses effectiveness in dusty areas or in extreme temperatures.

Snap traps should always be placed in perpendicular fashion, with the bait side against the wall.  Never use just one trap: Place a number of them several feet apart in the rodent’s usual path. Traps can be fastened to pipes with wire or thick rubber bands.

When cleaning out a building that has been infested with rats or mice, specific safety precautions should be followed to avoid infection. First and foremost, remember that you should never handle a wild rodent, alive or dead, without disposable gloves. Masks should be worn when cleaning. Other steps to follow:

  • Open windows and doors before cleaning to allow it to air out, then leave for an hour.
  • Avoid raising dust if at all possible.
  • Steam-clean all carpeting and upholstery.
  • Clean all surfaces with a diluted bleach solution or other household disinfectant, soaking areas that held dead animals, nests, or droppings.
  • Wash all bedding linens, pillows, etc. and use the high heat setting on your dryer.
  • Eliminate any insulation material contaminated by rodent urine, feces, or nesting material
  • As ultraviolet light can kill viruses, place contaminated items that cannot be thrown away (such as important documents), outside in the sun for several hours. If this isn’t possible, “quarantine” the items for a week in a rodent-free area.  This should give enough time for viruses to be inactived.
  • Dispose of any contaminated items or dead rodents in a plastic bag, and then place them in an exterior garbage can.
  • Thoroughly wash hands after cleaning. Consider showering with soap and hot water.

We share our world with many other creatures. Some of these creatures invade our homes and can damage our possessions and, more importantly, our health. With careful attention to sanitation and the occasional surgical strike, we can eliminate unwanted guests and make our homes safe environments for our families.

Joe Alton, MD

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Dr. Alton

Learn more about animal-borne diseases and 150 other medical topics in the Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, now available at Amazon.com.

 

 

 

 

 

Anaphylaxis: Causes, Diagnosis, and Treatment

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dandelion allergy

Allergies

In a disaster or any other situation that takes us off the grid, we will expose ourselves to insect stings and poison ivy, as well as strange food items that we aren’t accustomed to. Allergic reactions may ensue in susceptible individuals. When we develop an allergic reaction, it might be mild or it might be severe. If severe enough, we refer to it as anaphylaxis or anaphylactic shock. Anaphylaxis is the word used for serious and rapid allergic reactions involving one or more parts of the body which can become life-threatening.

Anaphylactic reactions were first identified when researchers tried to protect dogs against a certain poison by desensitizing them with small doses. Instead of being protected, many of the dogs died suddenly the second time they got the poison. The word used for preventative protection is “PROphylaxis”. Think of a condom, also known as a prophylactic. A condom protects you from sexually transmitted diseases. The word “ANAphylaxis”, therefore, means the opposite of protection. The dog experiment allowed scientists to understand that the same can happen in humans, and had application to asthma and other immune responses.

Severe allergic reactions may cause body-wide reactions called anaphylaxis that can be life-threatening. Anaphylaxis has become a timely issue because of the increased numbers of cases being reported throughout the world. When drugs are the cause, the explanation is likely that we are simply using a lot of them these days. Why foods should be causing anaphylaxis more often, however, is more perplexing. Is genetic manipulation of food crops to blame? Could contaminants be an issue, or perhaps pollution in general? In any case, the cause of many anaphylactic events is never identified; most are lumped into the “idiopathic” category (another word for “unknown”).

The likely causes of anaphylaxis are:

• Drugs: dyes injected during x-rays, antibiotics like Penicillin, anesthetics, aspirin, ibuprofen, and even some heart and blood pressure medicines
• Foods: Nuts, fruit, seafood
• Insects stings: Bees and Yellow Jacket Wasps, especially
• Latex: rubber gloves mad of latex, especially in healthcare workers
• Exercise: often after eating
• Idiopathic: This word means “of unknown cause”; a substantial percentage of cases

Fumes from chemicals like Chlorine gas and other toxins can be dangerous in their own right without causing an immune or anaphylactic reaction.

anaphylaxis symptoms

signs and symptoms of anapylaxis (wiki commons)

Although few die from simple allergic reactions, anaphylaxis is much more severe and, without intervention, the victim can die from respiratory or cardiac arrest. Body-wide swelling and rashes far from the site of a bee sting, for example, would be an example of an anaphylactic reaction. Other symptoms are exaggerated versions of typical allergies symptoms, with perhaps the addition of lowered blood pressure and fainting. In some cases, abdominal tract symptoms like cramping or diarrhea could be seen.

anaphylaxis

signs/symptoms of anaphylaxis

 

Treating Anaphylaxis

The treatment for anaphylactic shock is straightforward: epinephrine via injection. Other methods of delivery, such as oral doses of antihistamines, are generally too slow in their effect to be of much use.

Known as adrenaline in Europe. Epinephrine is given via auto-injector, with the most popular being the Mylan Corporation’s “Epi-Pen”. The process is simple with a dose delivered to the upper outer thigh. Once given, epinephrine narrows blood vessels and opens airways in the lungs. These effects can reverse hives, swelling, severe wheezing, low blood pressure, severe skin itching, and hives.

epi-pen

The “Epi-Pen”

A recent 600% price hike from the company that makes the Epi-Pen may put the drug out of the financial reach of many. If the auto-injector isn’t an option, vials or ampules of epinephrine are available (by prescription).

1:1000 epinephrine solution contains 1mg of drug per milliliter or cc of solution. For a person weighing 30 kg, 66 pounds, or greater, give 0.3 to 0.5 mg (0.3 to 0.5 mL) into the anterolateral thigh about the level of the bottom of your Jeans pocket. Repeat the dose every 5 to 10 minutes, alternating left and right thighs until improvement is noted (one dose if often sufficient). Remember that epinephrine will cause a fast heartbeat, nervousness and, perhaps, a number of other side effects. Of course, get the victim to modern medical care as soon as possible.

THE HYGIENE HYPOTHESIS

dog-and-kid-pixabay

It’s okay to get a little dirty!

The increased number of allergies seen in the modern world may actually be the product of “good parenting”. Our efforts to keep our children with their noses wiped and their hands clean are helpful to stop colds and flus but may be a factor in making them more prone to allergies and infections later on.

In 1989, researcher Dr. David Strachan suggested the hypothesis that the failure of children to be exposed to infectious bugs and parasites may be responsible for the epidemic of allergic conditions like asthma. This was called the “Hygiene Hypothesis”. The lack of exposure to microbes have since been tied to other diseases ranging from hay fever to multiple sclerosis.

When most of us lived on farms or in less-than-pristine cities, we were exposed to plenty of germs from a young age due to time spent outside with animals or with lots of other people. Now the majority of kids aren’t motivated to go outside or, certainly, get dirty. In the final analysis, never getting dirty as a child may be hazardous to your future health.

Here are some things you might consider:

Avoid antibiotics: The medical profession may have been remiss in over-prescribing antibiotics, but there are antibiotics in food as well. Indeed, 70-80% of antibiotics are given to livestock, not to treat infection, but to make they grow faster and get them to market sooner. Stick with antibiotic-free eggs, milk, and meats.

Avoid anti-bacterial soaps: Triclosan, the active antibiotic ingredient in many brands, has recently been banned by the FDA due to the risk of antibiotic resistance and the lack of evidence of any medical benefit. Use regular soap and water for washing.

Tailor Handwashing Strategies to the Situation:  If you’re in a city where open sewers run through the streets and people are tossing buckets of excrement out the window, have your kids wash their hands conscientiously. In clean environments where there isn’t a raging epidemic, however, don’t freak out over dirty hands.

Don’t Bathe Every Day: Not only should your kids be exposed to dirt to develop their immune system, but bathing too often might do more harm than good. Daily showers removes protective skin oils and causes drying and irritation. You’re also washing away the good bacteria that lives on your skin.

Get Your Kid a Pet: Not every kid has the good fortune of living on a farm, but they’ll benefit from a furry pet. Dogs seem to give more resistance to colds and allergic skin conditions like eczema than cats, but early cat exposure might give more protection against asthma. Why not have both?

Get your kids outside when they’re young: In these days where we have legitimate concerns about children’s safety, you might be reluctant to let your kids go outside by themselves. Here’s an idea: Go out with them, to parks, wilderness areas, and other places where both adults and kids can reap real benefits. How about helping them plant and manage a garden?

The more you encourage outdoor activities early, the more they become part of the next generation’s culture; let the kids get a little dirty, and you might give them a healthier future.

 

Joe Alton MD

AuthorJoe

 

Learn more about your immune system, allergic reactions, and over 100 other topics in our Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way.

Survival Medicine Hour: Anaphylaxis, Ear Infections, Hemorrhage

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earanatomy-ftr300

Ear Anatomy

The Survival Medicine Hour, hosted by Joe Alton, MD aka Dr. Bones and Amy Alton, ARNP, aka Nurse Amy of https://www.doomandbloom.net/ brings you a few topics, including ear infections, bleeding control and the final part 3 of the allergy series: anaphylaxis. Monday, February 20, 2017 is President’s Day, but do you know about the pre-George Washington “Presidents”? Do you also know who held the presidential office twice, but not with consecutive terms?

anaphylaxis

signs/symptoms of anaphylaxis

Severe allergic reactions may cause body-wide reactions called anaphylaxis that can be life-threatening. Although few die from simple allergic reactions, anaphylaxis is much more severe and, without quick intervention, the victim can die from respiratory or cardiac arrest. Having an epi-pen handy is advisable, although you can learn how to dose with epinephrine solution from a sterile vial.

 

Ear infections are fairly common in babies and children, and an ounce of prevention is worth a pound of cure. Keep your ear canal as dry as possible during and after swimming. Feed babies in a head-up position, to prevent formula or milk from entering the passages into the ear. Beware of early warning signs before the ear infection becomes severe, such as: pain and itching, drainage from the ear canal and redness and swelling in the ear canal. babies may tug at their ear.

 

Plus, an introduction to hemorrhage and its effects on the human body.

 

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/02/17/survival-medicine-hour-ear-infections-bleeding-anaphylaxis

 

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

 

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

joe and amy radio

The Altons

Allergies: What You Need To Know, Pt. 1

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immunity

allergies: What You Need To Know

Allergies are reactions caused by a hypersensitivity of the immune system to a substance ingested or in the environment (an “allergen”). These substances may cause little or no effect in most people, but a percentage of the population may experience significant symptoms that can affect quality of life, or even threaten life itself.

A SHORT HISTORY OF ALLERGIES

If you told a doctor a little more than a hundred years ago that you had an allergy, he/she wouldn’t recognize the word. “Allergy” was coined in 1906 by an Austrian pediatrician and immunologist named Clemens Von Pirquet. The word is derived from the Greek allos meaning “other” and ergon meaning “reaction”.

 

Von Pirquet and his associates noted that certain people who received a variety of smallpox vaccine had more severe reactions than most. Another scientist, Charles Mantoux, used this knowledge to develop a test for tuberculosis where an allergic skin reaction to a substance isolated from the microbe revealed previous exposure. A form of this test is still used today.

The worst allergic reaction, known as anaphylactic shock, was discovered by a french physiologist Charles Richet, who with his partner Dr. Paul Portier, injected the venom of a sea anemone into a number of dogs. Hoping to find some substance that would protect humans (called prophylaxis) from jellyfish stings, they instead found that a second injection killed many of the dogs. Since this was the opposite of protection, they termed it anaphylaxis.

HOW ALLERGENS CAUSE REACTIONS

Common allergens to which people are exposed include pollens, metals, insect stings, medications, and certain foods. There are also internal factors such as age, sex, race, and family history. How do these all combine to cause the physical symptoms of an allergy?

Put simply, an immune reaction against an allergen occurs when it’s encountered for the first time; let’s say it’s a bee sting. Cells in the body called “T-cells” identify the bee venom and interact with other cells called “B cells”. The B cells, in turn, produce certain antibodies called “IgE”. IgE attaches to the surface of cells called “basophils” and “mast cells”. These cells are now “sensitized” to the venom. No physical effects are usually noticed at the time by the victim beyond the sting itself.

When a second exposure to the allergen occurs, however, it’s a different story. The sensitized mast cells and basophils are activated and produce a large amount of histamine and other inflammatory chemicals. The flood of these into the system can cause possibly severe physical reactions.

SYMPTOMS OF ALLERGIES

bee

Toxin Allergies

Allergies may appear in various forms, from mild to life-threatening. These conditions include hay fever, food allergies, local skin reactions (called “atopic dermatitis”), drug/toxin reactions, and allergic asthma. Common symptoms include red eyes, itching, nasal congestion, difficulty breathing, and swelling. In the worst situations, a body-wide reaction called “anaphylaxis” causes rashes, major swelling, and difficulty breathing to the point of suffocation.

Hay Fever:  Hay fever is a (usually) seasonal reaction to high pollen counts in the air from certain plants. People with hay fever won’t likely have a fever, but they will have sneezing from a runny, clogged nose, red, itchy, watery eyes and “postnasal drip”, a condition where a cough is caused when mucus runs down the throat from the back of the nose.

Different grasses, trees, and flowering plants will release pollens at different times of the year, and it is often difficult to identify what allergen is causing the symptoms.  Skin “patch”, scratch, or blood tests may determine if a particular substance is causing the sensitivity.

Atopic Dermatitis: Most people who have atopic dermatitis have had allergies before or a family member with similar problems such as hay fever or asthma. Common allergens include animal dander, dust mites, exposure to certain foods, stress, and dry, cold weather.

The condition usually starts with itchy, dry skin.. Scratching causes inflammation, swelling, and redness, and may initiate an infection in the area. Small, oozy blisters sometimes occur that crust over with time. Although mild versions cover small areas and are improved with lotions, severe versions require more intense therapy.

Rashes may recur over the same area time and again, leading to toughened, thick skin that appears darker than other areas. These areas are usually on the scalp and cheeks of infants but may be seen on the baby’s knees or elbows. Other areas may be affected with age, such as the ankles, wrists, legs, the buttocks, and the nape of the neck.

Food Allergies: Four or five percent of the population is allergic to some kind of food. In children, eggs, milk and peanuts are often responsible; in adults, shellfish, nuts from trees (for example, walnuts), milk and eggs are common triggers to a reaction. It should be noted that an allergy to milk is different that intolerance caused by a deficiency of the enzyme needed to digest it (otherwise known as “lactose intolerance”.

Drug Allergies: A drug allergy is caused after repeated exposure to a medicine. Some of the most common include Penicillins, Sulfa Drugs, non-synthetic Insulins, seizure meds, and those containing iodine.

Drug allergies are often confused with what are called “adverse reactions”. An adverse reaction is a known ill effect that can occur with the use of a medication. For example, if a drug is known to cause nausea in some patients, that is considered an adverse reaction as opposed to an allergy.

Despite this, many will report an allergy to a particular drug to their healthcare provider. Some of the reasons that people will write “allergic” on their medical interview sheet include:

  • The drug causes symptoms that makes them feel unwell.
  • A family member has a history of an allergy to the drug, and they assume that the same goes for them.
  • An incident in their childhood resembled an allergic reaction, so better safe than sorry.
  • Negative comments online or elsewhere cause reluctance to take the medicine.
  • Philosophically opposed to a particular type of drug (antibiotics, psychotropics).
  • An actual allergy.

Note that a true allergy is placed last on this list; the World Allergy Association reports that less than 10% of reactions to medications are actually allergies caused by an immune response. Most symptoms that people get after taking medicine are, instead, adverse or “side” effects. It may not always be easy to tell the difference, but a true drug allergy will show immune-mediated symptoms such as hives, itchy skin or eyes, rashes, lip and tongue swelling, and wheezing. Blood pressure may drop precipitously in some cases.

Toxin Allergies: It’s common to have local redness, discomfort, itching and swelling when a toxin, such as bee venom, is introduced into the body. Your immune system, however, may respond strongly in the form of an allergy. Common insects involved are bees, wasps, hornets, and fire ants.

When the immune system gets involved, the reactions may be more severe, with hives, redness and swelling affecting large areas of skin. Swelling may extend to the tongue, throat, lips, and elsewhere. Stomach upset, nausea and vomiting, and diarrhea are common. The effects may take days to completely resolve.

DRUG TREATMENT OF ALLERGY SYMPTOMS

Allergies, when mild, are treated with medications that help relieve the specific symptoms.

Antihistamines in oral, intranasal and ophthalmic (eye drop) form are useful to deal with the sneezing, runny nose, and itchy eyes associated with hay fever. Nasal decongestants like oral pseudoephedrine (Sudafed) and the nasal spray oxymetazoline (Afrin, Dristan) are useful drugs to have in the medicine cabinet. It should be noted, however, that the nasal sprays are addictive when used for more than three days. That is, if you stop using them, your nose will become stuffy again.

Others like diphenhydramine (Benadryl) may help, but are prone to causing drowsiness in higher doses. Longer term therapy with intranasal steroids like Atrovent (ipratropium) or NasalCrom (cromolyn sodium) is another option. These drugs are best for long term therapy, however, as the effects are not felt immediately.

In the worst cases, epinephrine (also known as adrenaline) is necessary as an injectable to improve symptoms that affect the entire body. A future article will discuss this type of event in detail.

NATURAL TREATMENT OF ALLERGY SYMPTOMS

neti-pot

Neti Pot

Many experience relief from allergies when they use an item known as a “Neti pot” to relieve congestion and pressure. The Neti pot essentially looks like a version of Alladin’s lamp, and allows the delivery of sterile solutions into the nasal cavity.

Neti pots work by thinning out mucus. The hairs in the nose, called “cilia” are aided in their attempts to eliminate mucus and allergens by the flushing action of the sterile saline solution delivered by the Neti Pot.

Some may have doubts about the effectiveness of the Neti Pot, but research backs up the benefits of nasal “irrigation” to relieve some allergy symptoms. Nasal irrigation via a Neti Pot may help decrease the need for drugs.

One concern related to Neti pots, however, is the importance of ensuring that you are using sterile solution when you irrigate. Non-sterile solutions, even tap water, may transmit infections directly into the body; two deaths in Louisiana were attributed to Neti pot use of contaminated water. Neti pots also must be washed after every use, as you would wash your dishes after every meal.

A natural remedy getting some serious attention lately is Butterbur. In a recent British Medical Joural study, butterbur extract (ZE 339) four times daily equaled the effects of a popular antihistamine–without causing drowsiness!

Goldenseal, Nettles, Resveratrol, Quercetin, and Vitamin C as well as saline spray may be helpful. Ragweed sufferers, however, should realize that some plants commonly used in herbal remedies, like Chamomile and Echinacea, might cross-react in hay fever sufferers to make symptoms worse.

You might be surprised to know that acupuncture has some evidence for effectiveness against certain allergies. acupuncture. Based on the idea that stimulating certain points on the body can cause effects inside, a study of 26 hay fever patients found in the American Journal of Chinese Medicine and described in WebMD appeared to improve symptoms in all without adverse effects. Another experiment eliminated allergic symptoms in half the patients studied.

Allergies can be nuisances or they can be life-threatening. In situations where we might spend a larger part of our day outdoors, as in survival, it’s important to know the signs, symptoms, and treatments when our immune systems go into overload.

Joe Alton MD

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Joe Alton, MD

Hey, Find out more about allergies and over 150 other medical topics in times of trouble with our 700 page third edition of The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And for your medical storage, there’s no better place to get a good medical kit than at Nurse Amy’s store!

 

Survival Medicine Hour: Allergies, pt.2, Water Issues

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Safe Water

The Survival Medicine Hour this week, with your hosts, Joe Alton MD, aka Dr. Bones, and Amy Alton, ARNP, aka Nurse Amy, discusses water pollutants and part 2 of the series on Allergies. Your hosts request feedback on the show and other topics you may like to hear in future episode. They would also like to have any suggestions you might have about outdoor sport or activity first aid supplies and what you might experience as first aid incidents during those activities. Write to drbonespodcast@aol.com anytime!

 

Water contaminants are many and are reviewed in this episode. A guest post at https://www.doomandbloom.net/guest-post-10-things-you-didnt-know-were-in-your-drinking-water/ , by Jennifer Moran from https://theberkey.com/ is discussed and expanded upon in detail. Pollutants like lead, fluoride, BPA (Bisphenol A), iron and arsenic are just a few covered during this show.

 

In this part 2 series on allergies, Dr. Alton reviews a few allergies from the last show and continues with drug allergies, atopic dermatitis, food allergies, and toxin allergies. Helpful medications that relieve specific symptoms can include Afrin (beware of too much, and you will learn why), antihistamines, and oral meds.  A few natural remedies to relieve symptoms, like a Neti Pot, are reviewed. One important hint when using a Neti Pot, always make sure the water or saline is a sterile solution, or you could get sick from the contaminated solution.

 

To Listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/02/10/survival-medicine-hour-water-pollutants-allergies-pt2

 

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

 

Amy and Joe Alton

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Amy Alton, ARNP

 

Learn about allergies, water safety, and 150 more topics in off-grid settings with the 700 page Third Edition of The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. You’ll be glad you added it to your survival library.

 

Hey! Like board games? Well, check out our fun survival board game SURVIVAL! at survivalboardgame.com!

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Doom and Bloom’s SURVIVAL! board game unboxed

Guest Post: 10 Things You Didn’t Know Were in Your Drinking Water

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water

What’s in your water?

 

(Dr. Bones says: From time to time, we accept submissions from promising writers in the field of preparedness. Today’s post comes from TheBerkey.com’s social media manager Jennifer Moran. In this article, Jennifer discusses some substances that you might not expect to be in your drinking water. Thanks to Jennifer for her submission.)

 

The most common substance in this world is water and therefore it is essential that we could say by default it is greatly important! We learned that only 1% of the Earth’s water is suitable for drinking, 97% of it is ocean or sea and where does the 2% go? It is unusable, it’s frozen. Now, we always wanted what is best and safe for our drinking water. As a matter of fact, Americans drink more than a billion glasses of tap water per day.

 

Your day has been sluggish and you die to drink that glass of water even from the tap just to quench you. But do you really know if whether or not it’s secure for your family? Or let me be more direct, do you even bother to know what’s on it? No matter how we can say that that water is clean by just basing it from your bare naked eyes, there are things in there that might not be good for you.

 

Here are some surprising substances that you didn’t know might be in your drinking water.

 

 1. Lead

Just like any stubborn bad guy, this colorless, odorless and tasteless metal can leach from lead pipes and plumbing fixtures will definitely go undetected.  Excessive amounts of lead place adults at higher risk for cancer, stroke, kidney disease, memory problems and high blood pressure. At even greater risk are children, whose rapidly growing bodies absorb lead more quickly and efficiently. Just because your home is less than 20 years old doesn’t necessarily mean you’re lead-free. Just ask the people of Flint, Michigan.

 

2. Fluoride

Fluoride develops naturally in water; though rarely at the optimal level to protect teeth. Many assume that consuming fluoride is only an issue that involves your dental health. But according to a 500-page scientific review, fluoride is an endocrine disruptor that can affect your bones, brain, thyroid gland, pineal gland and even your blood sugar levels. More people drink fluoridated water in the US alone than in the rest of the world combined. In Western Europe, for instance, 97% of the population drinks non-fluoridated water. Adding fluoride is definitely a forced medication.

 

3. Iron and Manganese

Iron and Manganese are non-hazardous elements but can be a nuisance to your drinking water. They are similar metals and can cause similar problems: offensive taste, appearance, and staining. When the water is aerated they are oxidized, which creates significant discoloration and turbidity. Iron is frequently found in water supplies. Manganese is often found in water that contains iron.

 

4. Perchlorate

Perchlorate is a man-made chemical primarily used in the production of rocket fuel, missiles, fireworks, flares, and explosives. It has been found in drinking water and surface waters in the United States (at least 26 states) and Canada. Although it is a strong oxidant, perchlorate is very persistent in the environment. At high concentrations perchlorate can interfere with the production of thyroid hormone.

 

5. Bisphenol A

Bisphenol A (BPA) is an important chemical building block and additive in a wide variety of plastics. It is manufactured worldwide for approximately 3.2 million metric tons/year. This can be found in some plastic water bottles and the dangerous part is that it can leach into food and drinks. According to National Institute of Environmental Health Sciences, it may acquire health risks, especially to infants and children. One good thing: there are quite a number of BPA-free bottles that are available now. However, you still have to be extra careful: NPR reports that some BPA-free plastics may leach unwanted chemicals into your water when exposed to sunlight, microwaves or dishwashers.

 

6. Arsenic

Arsenic is a natural element that is tasteless and odorless; you wouldn’t be able to distinguish that it’s in your water. It is found widely in the earth’s crust and may be found in some drinking water supplies, including wells. Research shows that exposure to high levels of arsenic can cause health effects, even cancer.

 

Bacteria rods

bacterial contamination

7. Pathogens

Bacteria are a natural part of life; in fact, there are many forms and functions of bacteria we couldn’t live without. Coliform bacteria may not cause disease but can be indicators of pathogenic organisms that cause serious diseases. It can cause intestinal infections, dysentery, hepatitis, typhoid fever, cholera, and other illnesses. Luckily, these pathogens are much better controlled today than they once were. We just have to be practical on having our water tested but definitely the best strategy is to get rid of these pathogens.

 

8. Agricultural chemicals

Agriculture is heavily dependent on fertilizers and pesticides that boost crop production. The major contaminant here is nitrate, found in both fertilizer and animal waster. Nitrates and other chemicals end up in our water resources, and can cause health risks. One example is methemoglobinemia, sometimes called “Blue-Baby syndrome”, in those infants under 3 months of age that are bottle-fed.

 

9. Chlorine

Chlorine is effective as a disinfecting treatment in killing off most microorganisms in the water. As a matter of fact, it is a powerful oxidant added to the water by several municipal water systems to control these microbes.  While learning that the United States has one of the safest water supplies in the world because of this disinfecting agent, it is also appropriate to check it once in a while. It can be absorbed through physical consumption as well as through your skin while bathing and can severely dry skin and hair. It can also cause irritating effects to your eyes and nose.

 

10. Mercury

This silvery heavy metal can be found in various natural deposits. Mercury can flow into water supplies from improperly discarded devices containing it, as runoff from landfills & farm land, dumped by factories, or from natural deposits. With this being said, this extremely toxic liquid metal must be precaution in handling or disposing of it. Being exposed to high levels of mercury over time can cause kidney damage.

 

 

Water can be purified of many contaminants if treatment facilities are available, but supplies must be monitored so that contaminants can be properly identified in the first place. The safest way to ensure that these toxins do not make it into your body is to have your water tested to determine which contaminants your tap water may contain. Once you have identified the contaminants present, you can select a water filtration solution that is best for you.

 

Jennifer Moran

(When she isn’t glued to a laptop screen, Jennifer spends time playing tennis, practicing yoga, and trying very hard not to fall sleep during meditation classes. If you have questions for Jennifer, contact her at Jennifer@theberkey.com.)

 

 

13 Tips on Surviving a Protest

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closed fist protest

Anti-Free Speech?

As a Free Speech advocate, I support the people’s right to protest and make their opinions heard. Unfortunately, demonstrations in the U.S. these days are becoming more frequent and violent. From what I saw happen at UC-Berkeley, I expect them to become more extreme as times goes on.

 
I haven’t been at a protest since the Vietnam era, and that was just on the way to class. Back then, I was fit enough to hightail it out of there when the pepper gas flew. However, there is so much civil unrest in the news these days that it’s a good idea to have a riot survival strategy, whether you’re involved or just a bystander. It goes without saying that your objective should be to stay away from the where the violence is occurring.

 
Of course, if you walk smack dab into a demonstration, things can get dicey pretty fast. I’ve written a lot about situational awareness, and that mindset will serve you well. Here are some simple tips that will help you avoid injury at a protest:

 
1. Always be in a state of “Yellow Alert”. Yellow alert simply means being aware of your surroundings and the people around you. When people are behaving strangely, take note and avoid them.
2. Always mentally map out routes of escape as you walk along. Where’s the nearest side street? Is there a building or subway entrance that will get you off the street? If you don’t know the area, move away to where you know the lay of the land.

 
3. If you have to make your way through the crowd, stay on the fringes. Don’t get caught in the masses of people surging away (or towards) the violence. If you do, they are deciding your movements, not you.

 
4. Avoid confrontation with protesters. In other words, take off your “Make American Great Again” hat if it’s an anti-Trump demonstration. At Berkeley, things like this got women pepper-sprayed and men beaten.

 
5. Have a bandanna handy. This essential survival supply isn’t a gas mask, per se, but it works at riots when tear gas is sprayed. Some advocate the soaking of the cloth with lemon juice or apple cider vinegar. Avoid black bandannas, though; at Berkeley, organized masked “ninjas” in black caused most of the damage. You don’t want to be confused with one of these people.

 
6. Wear sneakers or other footwear that will allow you the most mobility. The only women wearing heals are reporters. Make sure you’re well-clothed so that your skin is protected. You’ll need to wash clothes thoroughly that have been exposed to tear gas, or throw them away.

 
7. Be aware of the movement of law enforcement officers, but don’t approach them. Their job is tough enough, and they won’t be able to hear you above the roar of the crowd.

 
8. Don’t run if you can help it. Unless everyone else is running, you will attract unwanted attention. Walk fast and purposefully around a corner, to higher ground, or other safe spot.

 
9. Be inconspicuous. This may be difficult if you’re 6 foot 7 inches tall, but otherwise, do you best to be “the gray man”.

 
10. If you’re with friends, stay together. If you can’t, agree on a meeting place beforehand in case you get separated moving through the crowd.

 
11. Avoid being caught against walls, fences, blockades, or other solid objects. People can get crushed by masses of protesters.

 
12. Carry some water, milk, or diluted liquid antacid (like Maalox) in a container if you know you’re heading into a protest area. If sprayed with tear gas, move quickly into an area of fresh air and pour the liquid on your face (especially your eyes). Drink it if sprayed in the mouth. Milk or liquid antacid are thought by some to work better than water, but there’s no hard data one way or another. The effects of the tear gas will resolve over a relatively short time in most cases.

 
13. If you’re involved in a protest, carry a basic medical kit that will help to treat injuries and stop bleeding.

 
It’s likely you’ll never get caught in civil unrest, but having a solid plan of action in these troubled times just makes common sense. We must be prepared for man-made disasters just as we should be prepared for hurricanes, tornadoes, and earthquakes.

 

Joe Alton, MD

AuthorJoe

Joe Alton, MD aka Dr. Bones

Survival Medicine Hour: Protest Survival, Capsizing, Allergies, Pt.1

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closed fist protest

Surviving a Protest

The Survival Medicine Hour with your hosts Joe Alton, MD aka Dr. Bones and Amy Alton, ARNP, aka Nurse Amy discuss Protest Safety, How to survive a capsized boat or cold water immersion, and part one of a series on allergies. Our website https://www.doomandbloom.net/ is a source for these and other topics.

 

Getting caught in the middle of the crowd in the frenzy of protesting could be dangerous, especially if you are wearing anything that identifies you as their “enemy., Knowing how to extricate yourself and be the “gray man” can help you stay safe. Don’t approach lines of police officers in riot gear, they are focused on getting the crowd under control and could mistake you for a rioter. Try to stay with friends and escape as quickly as possible. Many more tips!

H.E.L.P.

Strategies for capsized boats or other water immersion

 

If you find yourself in the water due to a capsized boat or other water incident. the first step is to try and stay calm. Always wear a life jacket if possible while boating, which enables you to stay warmer since you don’t have to kick or try to swim to keep your head above the water. If any debris is nearby, try to elevate some of your body out of the water. These and more mportant steps to take are presented in the show today.

 

In an introduction to allergies, an immune reaction against an allergen occurs when it is encountered the first time, and may cause little to no reaction at all. The second exposure to this allergen is when the allergic cascade of symptoms and reactions are seen. Allergic reactions may appear in various forms. Part one of this allergie series is discussed on today’s show.

 

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

http://www.blogtalkradio.com/survivalmedicine/2017/02/03/survival-medicine-hour-protest-safety-capsize-allergies-pt1

 

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

 

Amy and Joe Alton

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Amy and Joe Alton

Guest Article: Homeopathy and Preparedness

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homeopathic meds

Nurse Amy and I are conventionally trained medical professionals that incorporate an integrative philosophy into our writings. We don’t know everything, however (far from it), and sometimes find writers on specific topics that are outside of our wheelhouse and cannot speak to authoritatively. Here’s an article by Becky Rupert, a board-certified homeopath, to introduce you to her field:

 

When preparing for any emergency, we all know it is a good idea to have basic things on hand such as first aid kits, bandages, extra medications, analgesics, essential oils, herbs, wraps, blood stop powder, and all of those things to help us when we have minor injuries or emergencies.  It is also a good idea to have extra skills such as how to make tinctures, or herbal products, or the many wonderful first aid skills taught at organizations such as the Red Cross.  Suturing skills are a plus, as well as classes in nursing or EMT classes.  These are wonderful adjuncts to your preparedness portfolio!

 

However, I think there is one more thing that is incredibly useful to add to your “tool kit”.

 

What I am going to teach you about today is a form of alternative medicine that is easy, safe and very effective in an emergency when you have no access to standard medical care.  You can use this method with little cost input to start, and you can use it right now for your family in acute situations such as:

 

  • colds
  • flu
  • sprain
  • strain
  • injuries

You can start learning now to give remedies in acute situations so that you can understand how to give remedies in situations where there is a dire need, so you can help family and friends with a safe, holistic healing method.  It is not difficult to do, and it is very rewarding.  It can require a shift in how you think about healthcare. Homeopathy is quite different from what you may be used to.

 

First, some background:

 

Let’s first talk a bit about what homeopathy is, what it is not, and how it can help your family!  Homeopathy is a 200 year old system of medicine created by a physician and chemist, Dr. Samuel Hahnemann.  In his time, physicians used toxic crude substances which had many side effects and harmed more than healed.  Dr. Hahnemann devised a way of using dilutions of substances to help the body heal without the toxic effects, even if the original substance was toxic.

 

Homeopathy means “similar suffering”.   Remedies are made from just about anything from plants, to animals, to minerals and each has a specific pattern of symptoms associated with it.  Right now there are about 5,000 remedies and more are being made every day.  They are sustainably sourced and they are “FDA approved drugs”.  Some are over the counter, and some are prescription based.  In fact, Samuel Hahnemann wrote the good manufacturing practices that are still in use today.

 

Homeopathy is not herbalism, although we may start with an herbal “mother” tincture at the base of the remedy, we often use the entire plant, something that herbalists rarely do because at times the parts of a plant may not have therapeutic value or may be toxic.  In the homeopathic remedy, there are  no molecules of the original substance left once you go above 12c (explained below), which renders them non toxic and safe for infants, animals, or the elderly.

 

Homeopaths don’t use machines, muscle testing, herbs or supplements.  We (generally) don’t make remedies ourselves (there are special pharmacies for that).  Constitutional Homeopaths also don’t give you more than one remedy at a time, and we don’t use machines to figure out what remedies you need (with the exception of a computer program to go through all of your symptoms).  The pellets we use are small, pleasant tasting and dissolve under the tongue.  Children readily take them and usually respond quickly, as do animals.

 

What do the numbers and letters mean on a homeopathic remedy package?

 

The remedies all have latin names, such as apis mellifica (honey bee) and the number tells you how many times the remedy was diluted, the “C” stands for the amount of water it was diluted in, in this case, 99:1=100 (99 parts alcohol and water to one part mother tincture).  If you remember your roman numerals, you will see they are common in homeopathy.  There are also “X” potencies, that is 1 in 9=10.

 

C potencies last longer than X potencies, but all you really need to know is to stick with 12c or 30c if you  can, for best results.  There are situations that 6c, or 200c is much more preferred, and if that’s the case, I will let you know.  Generally, you can’t go wrong with a 12 or 30c.  That is a great potency for beginners and they are readily available, and in the common remedy kits for home use.

 

How does it work?

 

We don’t know the exact mechanism of action of the remedies.  We know they are not placebo, because they work on infants and animals very well.  If you have the wrong remedy, nothing happens and there are no side effects or unwanted symptoms.  There are instances when people can be sensitive to remedies and if you are the type that is very sensitive to everything around you, then I would consider having someone walk you through the process so you know how to take remedies.  Sensitive folks can aggravate which means that the symptoms they already have get worse before they get better.  This is rather unusual but does happen on occasion, and usually sensitive people are sensitive to so many other things such as medications, perfumes, everything sets them off.  This is not to say that chemically sensitive people shouldn’t use homeopathy, I have lots of clients who are environmentally sensitive and they are often fine with remedies. We often need to dilute them a bit in about 4 oz of water.

 

The wonderful thing about homeopathy is that it works to heal the entire person, mentally, emotionally, physically, all at the same time.  We do not have one remedy for asthma and one for headaches, and one for eczema and one for autism, we see the person as a whole and give a remedy and potency based on that person’s unique set of symptoms.  Homeopathy is so safe, you can give it during labor and delivery.

 

We recommend that home prescribers use remedies for acute situations (self limiting situations such as colds, flu, injuries, sunburn), and leave the chronic situations to the professionals.  Chronic symptoms are symptoms such as PMS, fatigue, headache, asthma, autism, eczema, etc.

 

My clients come from all over the US and abroad and I teach them to be able to care for themselves during acute situations.  I see people for acute situations and chronic ones and some people want to learn everything they can and some just want me to fix it!  Either way is fine, but here we’ll get your feet wet so you can learn more.  Even if the only thing you do is use arnica for bumps and bruises, that’s a step in the right direction.  Carry arnica with you wherever you go and you’ll be amazed at how it stops pain fast!  Learn to give some remedies in a few situations and soon you’ll be learning more and more.

 

Homeopathy is a wonderful addition to your medical kit or bug out bag.  Remedies are easy to use and pretty forgiving.  Dosing depends on the individual, the amount of pellets is not based on body weight or age.  In homeopathy, frequency of dose is what is important.

 

The most important thing to remember is:

 

  • Give the remedy as needed, not on a schedule. If you have an aggravation from a remedy DO NOT REPEAT, wait and watch, usually this is minor and improvement will follow; then repeat as needed by putting a pellet in 4 oz of water and sip only as needed.
  • Give the remedy 2 doses before moving on to the next remedy if nothing happens… unless you are very sensitive.
  • Most people in an acute situation will know how often to take the dose, their symptoms relapse after improvement. If you have hit yourself with a hammer, and you take hypericum, the pain will come back and you will know when to repeat, more is not better!
  • In a situation like a cold, you may need 3 doses in one day to determine if you should switch to another remedy.
  • Remedies come in different pellet sizes, large pellets like the decorating balls for cookies – you can use one at a time, tiny, poppy-seed sized pellets, the dose is about 5 pellets. Generally, the amount of pellets is not important, the frequency of dose is.
  • In critical situations such as shock, you may need a stronger dose or the remedy may be needed more frequently then you expect, don’t be surprised if the remedy lasts for minutes or a half hour and you need to repeat. The doses should start lasting longer and longer until the problem resolves or you get help
  • Try to get help if the situation is beyond your skills or training
  • If there is a very high fever (104 or above), you may need to seek out care or diagnosis. Obviously, use your judgement, but some of the scenarios in this article are for those who can’t get to medical care.  Medical care is important in a critical situation, if you are having a heart attack, get help if you are able.  It sounds silly but people have called me in the middle of a heart attack!

 

Bumps, Bruises, Head injuries, Fractures, etc.

 

Arnica Montana:

Everyone should have arnica on hand for emergencies, it a wonderful first aid remedy and often the one that people pick up whenever there is an injury.  Especially useful for bruising and head injuries, I use 200c for head injuries and 30c for minor bruising.  This remedy is often useful to help heal damage from surgery.

 

(Dr. Bones says: I don’t have a lot of experience with some of the substances mentioned in Becky’s article, but can vouch, from personal experience, for the effectiveness of Arnica in alleviating pain from injuries.)

 

Bellis Perennis:

Bellis is in the same family as arnica and is useful for deep muscle trauma, deep incisions or heav blows when arnica doesn’t offer much help.  I use 6c three times a day until it is no longer needed.

 

Ruta Graveolens:

Ruta is wonderful for ligament and tendon injuries or sprains and strains.  I use 200c followed by 6c three times a day until unnecessary.  I found that sprains heal in half the time with ruta.

 

Symphytum Officionales:

The best remedy for fractures, It is used after being set to knit bones quickly.  I use 200c for pain if arnica doesn’t help and then 6c three times daily for 3-6 weeks.  Also very useful for eye injuries at the same potencies.

 

Staphysagria:

Useful for healing cuts and knife wounds after stitching or approximating wounds.  For a deep wound may need 200c one dose or 30c three times a day for 2 days.

 

Calendula Officionales:

Used in tincture or potency this is excellent for skin abrasions and can also be used diluted 1:10 parts water in eye infections, abrasions, or as eyewash.  This can be also used as an antibacterial for wounds or lacerations, but some homeopaths also like Echinacea tincture for this purpose as well.

 

Silica:

This remedy is often used to expel splinters or foreign material embedded in skin.  I use 6c or 30c three times a day for 2 days.

 

Cantharis:

This remedy (like all others) has many uses, but is very useful for burns and scalds, and can also be used for urinary tract infections with a great amount of burning with urination.  I use 30c as needed for pain control.  For sunburn I prefer sol 30, but it can also be used for sunburn.

 

Apis Mellifica:

One of the best remedies for bee or wasp stings or even anaphylactic shock, apis has redness, edematous swelling and heat.  It is also used for cellulitis.  If you have severe allergies it is a good idea to have epi pen around but if you don’t have one, apis may be a lifesaver.  It is always a good idea to have other alternatives such as Benadryl just in case!  A 30c of apis may not be strong enough of a dose, so I recommend having a 30c and 200 on hand.

 

Fevers/Infection/Shock:

 

Pyrogenum:

I have used pyrogen 1M potency for tooth infections with great results, it is also generally used for septicemia.  At this high of a dose, it is given only as needed for fever or pain control.

 

Belladonna:

The most used homeopathic remedy for fever, it is useful in high fevers of many kinds.  The skin is usually hot and dry, and it has been used for decades for scarlet fever.  Useful in situations where there are delusions or hallucinations with fever.  Belladonna is very violent and sudden and is also used in heat stroke or heat exhaustion.  Symptoms tend to be hot red and violent and tend to be right sided.  Aggravation time is often 3 AM or PM and can be used for childhood ear infections of sudden onset when these symptoms match.

 

Ferrum Phos:

Often useful in situations where there are mild symptoms and you aren’t sure which remedy to give, ferrum phos has vague symptoms and is often given at the beginning of an illness to stop it before it starts.

 

Aconitum Napellus:

Aconite is incredibly useful in shock and there can be fright or anxiety and restlessness.  There is a sudden onset of symptoms like in belladonna.

 

Phosphorus:

This is a remedy that is often useful in hemorrhaging, and nosebleeds, which are often left sided.  I usually use 30c in minor cases and would use 200c in severe cases.

 

(Dr. Bones says: With regards to significant hemorrhage, it’s always important to know appropriate first aid techniques like you’ll find in many of my articles on this website.)

 

I hope this helps you get your feet wet with what homeopathy can do.  I recommend that people use Homeopathy in every day acute illness such as colds, flu, or minor injuries to see how remedies are used.  Don’t keep them on a shelf, becoming proficient with their use helps so when you really need them you will know how to use them.  A side benefit is that they last forever unless they are exposed to extreme heat so you can store them long term without expiration.  These are the remedies that are very useful for a bug out bag or emergency kit and can be used for the barnyard or home.  We offer kits with 40 remedies for those who are interested.  I hope you never have to use a kit in an extreme emergency, but I personally feel better knowing they are around if I need them!

 

I wish you good fortune on your journey to health…

 

Becky Rupert, ND, CCH

Board Certified Homeopath

Becky has been homesteading for 20 years while practicing and teaching homeopathy to laypeople to help themselves, their families and their animals.  She consults with people all over the US and abroad and can be reached at beckyrupert@frontier.com or by phone EST at (419) 853-3805. Please address any of your questions to Becky.

 

Survival Medicine Hour: Expiration Dates, Face Masks, More

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N95-Surgical-Mask

N95 mask

This episode of the Survival Medicine Hour, with your hosts, Joe Alton, MD aka Dr. Bones and Amy Alton, ARNP, aka Nurse Amy, discusses the significance, or sometimes, the lack of significance of expiration dates when it comes to medicines in pills and tablets. Also, face masks as a medical supply, all you need to know about this important piece of medical protection. Also, some tips on medical storage of drugs.

Antibiotics

expiration dates

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/01/27/survival-medicine-hour-expiration-dates-masks-and-med-storage

 

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

Joe and Amy Alton

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joe and amy alton

Video: Surviving a Building Fire

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wildfire21

Joe Alton, MD’s latest video discusses some tragic building fires, especially in public venues. He examines what happens in a fire, how fire behaves, and what you can do to increase your chances of surviving the conflagration.

 

To watch, click below:

 

 

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

 

Joe Alton, MD

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Find out more about house fires, wildfires, burns, and much more in Joe and Amy Alton’s Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, available at Amazon.

Survival Medicine Hour: Hypothermia Pt. 3, Frostbite, Winter Hazards

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Frostbite with gangrene

The Survival Medicine Hour with Joe Alton, MD, aka Dr. Bones and Amy Alton, ARNP, aka Nurse Amy discusses altitude sickness, winter car survival, falling through the ice or into very cold water and more. Car Survival equipment should include wool blankets, instant hand warmers, flashlights and extra batteries (fresh), small tool with blade, screwdrivers, pliers etc, foldable shovel, sand or rock salt, flares and reflective large triangles, tow chain or tough rope, jumper cables, water and food, a first aid kit (Doom and Bloom makes a grab and go bag), tarp, noisemaker and more.

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Winter car survival

To increase your chances of survival in cold water you should wear a life jacket whenever you are on a boat. It enables you to stay alive longer by keeping you afloat without burning too much energy. A built-in whistle is a great item to have on the life jacket also. Keep your clothes on while you are still in the water. Button or zip up to retain some body heat. The layer of water between your clothing and your body is slightly warmer and will help insulate you from the cold.

 

To listen in, click the link below:

http://www.blogtalkradio.com/survivalmedicine/2017/01/20/survival-medicine-hour-hypothermia-pt3-frostbite-winter-hazards

 

Wishing you all the best in good times or bad,

 

Joe and Amy Alton

joe and amy radio

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

 

 

Video: Cold Prevention Myths and Facts

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colds

In this video, Joe Alton, MD, aka Dr. Bones, discusses some common misconceptions about colds and how to prevent them. Companion video to a recent article.

To watch, click below…

 

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

 

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

 

 

drbones-nurseamy

Car Survival in Winter

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It’s predicted to be another harsh winter and, for most in the U.S., this means trouble if someone gets stuck out on the road during a blizzard or other extreme conditions. Hypothermia (the effects on the body from exposure to cold) may occur on the wilderness trail, but also right in the driver’s seat of the family car. It’s important to have a plan in case you are stranded in your vehicle.

 

Your Car

 

Winter conditions don’t just affect people, they affect cars as well. Cold affects rubber and metal; it even decreases the battery’s efficiency. Tires become stiff and flat for the first few hundred yards. Your oil and other lubricants become thicker at cold temperatures. This makes the engine work harder.

 

Therefore, vehicles that will be doing duty in extreme cold should be “winterized”. This involves switching to a lighter viscosity oil, changing to snow tires, and choosing the right (anti-freeze) ratio of coolant to water. Gas tanks should never be less than half full.

 

Your Life 

 

You’re not a bear, so you can’t hibernate through the cold weather; you’ll have to live in it, so take measures to avoid becoming a victim of it. Many deaths from exposure are avoidable if simple precautions are taken.

 

The first question you should ask before you get in the car in cold weather is: What’s the forecast? Is it possible that you’re driving straight into trouble? Checking the weather beforehand is a lot better than finding out about it on the road.

 

The second question should be: “Is this trip necessary?” If the answer is “no”, you should stay home. For most people that work, however, the answer is “yes”. If you have no choice but to hit the road during a winter storm, drive as if your life depends on it (because it does). Brush ice and snow off windshields, side mirrors, or anywhere your view might be blocked. Don’t speed, tailgate, or weave in and out of traffic. Make turns slowly and deliberately; avoid quick stops and starts.

 

Notify someone of your travel plans before you head out, especially if you’re in rural areas. Take your cell phone with you but save it for emergencies. Your focus has to be on the road, not on texts from your friends.

 

Stranded!

 

If you live in an area that routinely has very cold winters, you may not be able to avoid being stranded in your car one day. Your level of preparedness will improve your chances of staying healthy and getting back home. So what should your plan of action be?

 

  1. Stay calm and don’t leave the car. It’s warmer there than outside and you have protection from the wind. Having adequate shelter is one of the keys to success, whether it’s in the wilderness or on a snow-covered highway.
  2. Ventilation is preferable to asphyxiation. Crack a window on the side away from the wind for some fresh air. People talk about water and food being necessary for survival but, first, you’ll need air to breathe. Wet snow can block up your exhaust system, which causes carbon monoxide to enter the passenger compartment. Colorless and odorless, it’s a deadly gas that kills in enclosed spaces without ventilation. Clearing the exhaust pipe of snow and running the engine only ten minutes or so an hour will help prevent monoxide poisoning.
  3. Group Hug. If you’re in a group, huddle together as best you can to create a warm pocket in the car.
  4. Keep Moving. Rub your hands, put them in your armpits, or otherwise keep moving to make your muscles produce heat.
  5. Don’t overexert yourself. If your car is stuck in the snow, you’ll want to dig yourself out. A lot of sweat, however, will cause clothing to become wet. Wet clothing loses its value as insulation and leads to hypothermia.
  6. Let others know you’re there. If you have flares, use them. Flashing emergency lights on your vehicle will drain battery power, so use them only if you think someone might see them.

The Winter Car Kit 

caraccidentwinter

If you’re going to travel in very cold conditions, there are a certain number of items that you should keep in your vehicle. This is what an effective winter survival car kit contains:

 

  • Wool Blankets. Wool can stay warm even when wet.
  • Spare sets of dry clothes, including socks, hats, and mittens.
  • Hard warmers or other instant heat packs (activated, usually, by shaking, they’ll last for hours)
  • Matches, lighters and/or firestarters in case you need to manufacture heat.
  • Candles, flashlights (keep batteries in backwards until you need them).
  • Small multi-tool with blade, screwdrivers, pliers, etc.
  • Larger combination tool like a foldable shovel (acts as a shovel but also an axe, saw, etc.)
  • Sand or rock salt in plastic container (to give traction where needed.)
  • Tow chain or rope.
  • Flares.
  • Jumper cables.
  • Water, Food (energy bars, MREs, dehydrated soups, candies).
  • Baby wipes for hygiene purposes.
  • A first aid kit.
  • Medications as needed.
  • Tarp and duct tape (brightly colored ones will be more visible and aid rescue.)
  • Metal cup, thermos, heat source (to melt snow, make soup, etc.)
  • Noisemaker (whistle)
  • Cell phone and charger

The items above will give you a head start in keeping safe and sound even if stranded. With a plan of action, a few supplies, and a little luck, you’ll survive even in the worst blizzard.

 

Joe Alton MD

AuthorJoe

Dang, It’s Cold! Treating and Preventing Hypothermia

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hypothermia (and bad judgment)

This winter has already seen deadly cold snaps where people have found themselves at the mercy of the elements. Whether it’s on a wilderness hike or stranded in a car on a snow-covered highway, the physical effects of exposure to cold (also called “hypothermia”) can be life-threatening.

 

Hypothermia is a condition in which body core temperature drops below the temperature necessary for normal body function and metabolism. Normally, the body core is between 97.5-99.5 degrees Fahrenheit (36.0-37.5 degrees Celsius). Cold-related illness occurs once the core temperature dips below 95 degrees (35 degrees Celsius).

 

When it is exposed to cold, the body kicks into action to produce heat. Muscles shiver to produce heat, and this will be the first symptom you’re likely to see. As hypothermia worsens, more symptoms will become apparent if the patient is not warmed.

 

Aside from shivering, the most noticeable symptoms of hypothermia will be related to mental status. The person may appear confused, uncoordinated, and lethargic. As the condition worsens, speech may become slurred; the patient will appear apathetic, uninterested in helping themselves, and may lose consciousness. These effects occur due to the effect of cooling temperatures on the brain: The colder the body core gets, the slower the brain works. Brain function is supposed to cease at about 68 degrees Fahrenheit, although there have been exceptional cases where people (usually children) survived even lower temperatures.

 

Prevention of Hypothermia

 

An ounce of prevention is worth a pound of cure. To prevent hypothermia, you must anticipate the climate that you will be traveling through; include windy and wet weather into your calculations. Condition yourself physically to be fit for the challenge. Travel with a partner if at all possible, and have more than enough food and water available for the entire trip.

 

It may be useful to remember the simple acronym C.O.L.D.  This stands for:  Cover, Overexertion, Layering, and Dry.

 

Cover. Your head has a significant surface area, so prevent heat loss by wearing a hat. Instead of using gloves to cover your hands, use mittens. Mittens are more helpful than gloves because they keep your fingers in contact with one another, conserving heat.

 

Overexertion. Avoid activities that cause you to sweat a lot. Cold weather causes you to lose body heat quickly; wet, sweaty clothing accelerates the process. Rest when necessary; use those rest periods to self-assess for cold-related changes. Pay careful attention to the status of the elderly and the very young. Diabetics are also at high risk.

 

Layering. Loose-fitting, lightweight clothing in layers trap pockets of warm air and do the best job of insulating you against the cold. Use tightly woven, water-repellent material for wind protection. Wool or silk inner layers hold body heat better than cotton does. Some synthetic materials, like Gore-Tex, work well also. Especially cover the head, neck, hands and feet.

 

Dry. Keep as dry as you can. Get out of wet clothing as soon as possible. It’s very easy for snow to get into gloves and boots, so pay particular attention to your hands and feet.

st. bernard

Pet the Dog, Skip the Booze

One cold-weather issue that most people don’t take into account is the use of alcohol. Alcohol may give you a “warm” feeling, but it actually causes your blood vessels to expand; this results in more rapid heat loss from the surface of your body.

 

Alcohol and recreational drugs also cause impaired judgment. Those under the influence might choose clothing that might not protect them in cold weather.

 

Treating  Hypothermia

 

If you encounter a person who is unconscious, confused, or lethargic in cold weather, assume they are hypothermic until proven otherwise. Immediate action must be taken to reverse the ill effects of hypothermia. Important measures to take are:

 

Get the person out of the cold. Move them into a warm, dry area as soon as possible. If you’re unable to move the person out of the cold, be sure to place a barrier between them, the wind, and the cold ground.

 

Monitor breathing. A person with severe hypothermia may be unconscious. Verify that they are breathing and check for a pulse. Begin CPR if necessary.

 

Take off wet clothing. If the person is wearing wet clothing, remove gently. Cover the victim with layers of dry blankets, including the head, but leave the face clear.

 

Share body heat. To warm the person’s body, remove your clothing and lie next to the person, making skin-to-skin contact. Then cover both of your bodies with blankets. Some people may cringe at this controversial notion, but it’s important to remember that you are trying to save a life. Gentle massage or rubbing may be helpful. Avoid being too vigorous.

 

Give warm oral fluids if awake and alert. If, and only if, the affected person is alert and able to swallow, provide a warm, nonalcoholic, non-caffeinated beverage to help warm the body. Coffee’s out, but how about some warm apple cider?

 

Use warm, dry compresses. Use a first-aid warm compress (a fluid-filled bag that warms up when squeezed), or a makeshift compress of warm, not hot, water in a plastic bottle. Apply to the neck, armpit, and groin. Due to major blood vessels that run close to the skin in these areas, heat will more efficiently travel to the body core.

 

Avoid applying direct heat. Don’t use hot water, a heating pad or a heating lamp directly on the victim. The extreme heat can damage the skin, cause strain on the heart, or even lead to cardiac arrest.

 

Joe Alton, MDAuthorJoe

Find out more about cold-related injuries in our Third Edition of the Survival Medicine Handbook, now at 700 pages! Also, fill those holes in your medical supplies at Nurse Amy’s store at store.doomandbloom.net. You’ll be glad you did.

Survival Medicine Hour: Hypothermia, Pt. 2, Avalanches, Blizzard Survival

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shutterstock_90110446

In this episode of the Survival Medicine Hour with Joe and Amy Alton: Bees are having a hard time these days and new attention is being given to their plight. The Fish and Wildlife Service have added the Rusty Patched Bumble Bee to the endangered species list, which join seven species of the Yellow-Faced bee that were added in September.

 

Hypothermia (part 2) is discussed regarding treatments including: getting the person out of the cold or sheilding them from the weather as much as possible, monitoring their breathing, begining CPR if needed, warming them up with your body heat or warm dry compresses and more. Keep a Winter Car Survival Kit and supplies handy to help when disaster or accidents happen.

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Avalanches are dangerous, but only a small percentage of victims die from hypothermia, most perish due to traumatic injury or suffocation before they freeze to death. Snow slides are part and parcel of the winter wilderness experience and it pays to know what to do if you’re caught in one. Blizzards occur every year in the United States, and cause fatalities among the unprepared. In these storms, 70% of deaths occur due to traffic accidents and 25% from being caught outside during the blizzard. Learn safety tips to prevent these deaths and keep you and your family safe and healthy during the winter.

 

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/01/13/survival-medicine-hour-hypothermia-pt2-avalanches-blizzards

 

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

 

Joe and Amy Alton

joe and amy radio

The Altons

Hey, are you prepared to deal with medical issues in the uncertain future? Find out more about 150 topics as they relate to survival in our new Third Edition of The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way.

Video: Norovirus, the Stomach Flu

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hot-dog-stand

In this video, Joe Alton, MD discusses a recent experience with the stomach flu on a trip to New York. Norovirus is the most common cause of the “stomach flu”, a debilitating and dehydrating intestinal illness that affects millions every year throughout the world. Often caused by contaminated food on cruises, 800 students at a high school in Illinois were recently affected, presumably due to cafeteria issues. Learn more about the norovirus and what to do if you or a loved one comes down with it.

 

To watch, click below:

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

 

Joe Alton, MD

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Choosing Sutures

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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.

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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.

Survival Medicine Hour: Hypothermia, Nightclub Terror

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hypothermiaoldmanincoldwater

It’s January, and a cold blast from the North is hitting parts of the Deep South. Hypothermia is a big issue for those not prepared for cold weather, and a number of people die every year from being unready to deal with Nature’s challenges. Find out about hypothermia, how the body loses heat, and some strategies for prevention this winter.

 

Also, the Turkish nightclub shooting almost exactly duplicates the blueprint established by last year’s Orlando Nightclub shootings. Along with vehicular terror, Dr. Bones makes the argument that this strategy is going to be repeated again and again, and tells you what you have to do to survive such events.

 

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/01/06/survival-medicine-hour-hypothermia-nightclub-terror-shootings

 

Follow us on twitter @preppershow

Follow our Youtube Channel at DrBones NurseAmy

Follow us at Facebook at DoomandBloom or join our Survival Medicine group at Survival Medicine DrBones NurseAmy

 

All the best for a happy and healthy 2017!

 

Joe and Amy Alton

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Survival Medicine Hour: Vehicular Terror, Hangovers, RP Ruggiero of Brushfire Plague

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The Survival Medicine Hour, with Joe Alton,MD aka Dr. Bones and Amy Alton, ARNP aka Nurse Amy, wish you a Happy and Healthy New Year on this last day of 2016. With holiday parties all around us, some will find themselves with a celebration full of alcohol and perhaps a hangover to remember the night before. Before you attend that party, you should listen to this podcast for tips to both prevent and cure that aweful hangover.

Amy Alton, ARNP, interviews the author of the Brushfire Plague Trilogy series after he has recently completed the third book. Mr. R.P. Ruggerio lives in Colorado with his wife and two sons, and spends as much time outdoors as possible. He strives to live by Robert Heilein’s credo ” Specialization is for insects.” The Brushfire Plague trilogy are novels grounded in neighboorhood defense duringa devastating plague. Brushfire Plague, according to R.P., “also has useful lessons about the value of being prepared for possible disruptions to our normal way of life woven into the fabric of the story.  One unique aspect I focus on is the interpersonal dynamics one will be forced to deal with in any crisis situation.  This adds a lot to the drama and storyline and enhances the realism of the novel.”

Vehicular terror is the new blueprint for those wishing to cause mass casualties. Simple to obtain compared to guns and bombs, we can expect more events like the Berlin Christmas Market truck attack. Find out what you need to know to stay safe in these troubled times.

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2016/12/30/survival-medicine-hangovers-rp-ruggiero-vehicular-terror

Wishing you a Happy and Healthy New Year!

Joe and Amy Alton

JoeAmyPortrait2013

See more information about RP Ruggiero’s books at http://brushfireplague.com/? and at Amazon http://amzn.to/2ilH0e7?.

Don’t forget to follow us on our store, facebook, and twitter:

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Surviving A Hangover

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hangover-the_tower-1

In normal times or times of trouble, New Year’s Eve is a time where many break out the Smoky Mountain Moonshine and end up regretting it the next morning. For you teetotalers, a hangover is a group of symptoms that occur in many people after a night of drinking. Hangovers vary in appearance and severity, but one thing is sure: You’d rather not have one.

 

A study in college students found that and 29% reported (not to their parents, though) losing school time for hangover recovery. Close to 10% of American workers report having gone to work with a hangover; Lost work days run in the millions.

 

What Causes Hangovers?

 

Despite thousands of years of people having hangovers from drinking too much alcohol, the process which causes the condition isn’t very well understood.  Dehydration, sleep disturbances, lack of food intake, low blood sugar, the presence of certain by-products of alcohol in the body and other factors are likely involved.

 

Substances known as “congeners” found in alcoholic beverages may play a role; one of these, methanol, is metabolized to toxic chemicals like formaldehyde and formic acid. Other congeners, like acetaldehyde, are much more toxic than the alcohol itself, acting like an “anti-antioxidant”.

 

Symptoms of Hangovers

 

Each person’s hangover is a little different, but you can expect to see some of the following symptoms:

 

  • Headache due to blood vessel expansion (called “vasodilation”)
  • Sensitivity to light and sound
  • Tremors (possibly due to low blood sugar, or “hypoglycemia”)
  • Dizziness
  • Malaise (general sensation of feeling ill)
  • Irritability, depression, and/or difficulty concentrating
  • Nausea and vomiting
  • Stomach discomfort (alcohol increases stomach acid)
  • Fatigue
  • Weakness
  • Thirst
  • Loss of appetite
  • Rapid heartbeat

Symptoms begin when the alcohol level has dropped down to zero, usually the morning after a bender. They can last several hours, or in the worst cases, a couple of days.

 

Treating a Hangover

headachebarbie

 

Doctors actually don’t spend a lot of time researching hangover remedies, simply because they consider hangovers as effective deterrents to frequent alcohol abuse in many people. Although there is no certain cure for hangovers (other than time), there are a number of treatments; some of these have basis in scientific fact and some, well, not so much.

 

Consider these options as you try to pick yourself off the floor:

 

Drink some fluids.   You’re dehydrated, and some water, Gatorade, or juice (without alcohol, please) will help you recover faster. Skip acidic juices like orange juice; they won’t help your upset stomach.

 

Go back to bed. The more sleep you can get, the more you’ll sleep through some of the worst part of a hangover

 

Take a headache medicine. Ibuprofen can help your headache, but it can irritate your stomach. Tylenol might be a better choice, but is associated with liver disease if you’re a heavy drinker.

 

Eat something. You might be nauseous, but a little chicken broth and some crackers will help settle your stomach and give your blood sugar a boost. Some prefer dry toast with a little peanut butter. Pepto-Bismol (Bismuth Subsalicylate) isn’t a bad idea to deal with that stomach upset as well.

 

Home Remedies for Hangovers

 

The above measures are thought to be of likely medical benefit for hangovers, but there are a lot of home remedies that people swear by. Below are just a few.

 

Ice:  An icepack to your throbbing noggin might just be the thing to help that headache. A cold, moist washcloth will work just as well.

 

Bananas. Bananas are a good source of potassium, something you might be low on after a night of drinking.

 

Ginger:  Ginger root is a time-honored natural remedy for nausea and vomiting, and many people feel seasick when they have a hangover. Ginger Ale is the easiest way to ingest some, but a ginger tea may be even better.

 

Honey and Lemon: Ingredients of a hot toddy (hold the alcohol), mixing some honey and lemon will boost your blood sugar.

 

Vitamin B: A 1973 study found that Vitamin B6, in very large doses, can improve a hangover. Later studies, however, found no such benefit and possible risks to the liver and pancreas. Vitamin B-complex, a combination of B1 (thiamine), B2 (riboflavin), folic acid, B6 and B12 has also been proposed as a cure. It isn’t, but a dose of a vitamin supplement probably won’t hurt you.

 

Vitamin C: A popular ingredient and antioxidant in commercial “hangover supplements”, there’s little scientific data backing up any significant effect on a hangover. Like Vitamin B, however, there’s no reason to think it would hurt to take some Vitamin C.

 

Coffee: People like to think that some coffee will help their hangover, and it may do something for your headache. But caffeine is dehydrating, something that’s isn’t helpful when you’re already low on fluids.

 

Tomato Juice: While acidic and not so helpful for upset stomach, a non-alcoholic Bloody Mary is thought by some to metabolize alcohol from the body more quickly.

 

Exercise: If you can’t even move after a night of drinking, how can you exercise? Some feel, however, that sweating out the toxins will help a hangover. If you do decide to exert yourself, hydrate well beforehand and keep it to low-impact activities or you might be worse off than before. How about trying a walk around the block first?

 

Oxygen: Those with access to O2 canisters tout their benefits with regards to hangovers, but little evidence exists to support it.

 

The Prairie Oyster: V8 juice with Worcestershire and Tabasco, a little salt, a little pepper and a raw egg stirred together makes a Prairie Oyster, long thought to be a cure for a hangover. Little hard data confirms this concoction works, however, and eating uncooked eggs carries a risk for certain infections. Cooked eggs, however, contain taurine and cysteine, two substances that might help detoxify you. A number of other esoteric elixirs combining several incongruent ingredients also exist, but none have been scientifically shown to work. They will likely help raise your blood glucose, but you’re probably better off with a sports drink to get sugar, electrolytes, and hydration.

 

Hair of the Dog: Hair of the Dog is just another name for drinking more alcohol. It works because a hangover is essentially a form of alcohol withdrawal. Getting your drink on again, however, is the worst idea of all in the long run.

 

PREVENTION

 

An ounce of prevention is worth a pound of cure, and that is the honest-to-God’s truth when it comes to hangovers. Make sure to:

 

Eat before you drink: Drinking on an empty stomach equals big trouble. Beer has calories, but it’s not dinner. Having a full stomach before drinking may help you keep your blood alcohol level down.

 

One alcoholic drink, one non-alcoholic: Matching one Old-Fashioned with one glass of water will help keep your alcohol intake down and decrease your chances of a hangover in the morning.

 

Pick the right poison: If you’re not picky about your poison, try to stay away from dark liquors like, say, bourbon. These have more congeners and are more likely to cause hangovers than clear liquors like vodka. Clear liquors are less associated with severe hangovers.

 

Be Bubble-Free: Alcohol in carbonated drinks, like Champagne, may be absorbed more quickly and lead to worse hangovers.

 

Head it off at the pass: Take two aspirin with a full glass of water before going to bed. Fatty acids that reduce inflammation in aspirin can avoid a bad hangover.

 

Abstain: Do I really have to say why? If you really don’t want a hangover, don’t drink. Be the designated driver.

 

I’ll bet you have a tried and true method to deal with hangovers. If so, let us know on our Facebook page at https://www.facebook.com/doomandbloom/ or our Facebook Survival Medicine Group page.

 

Joe Alton, MD

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Surviving a hangover may not be true survival medicine, but you’ll find over 150 medical issues for disasters and epidemics in our 700 page Third Edition of The Survival Medicine Handbook: The Essential Guide for when Medical Help is Not on the Way.

Using Epinephrine in Vials

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The EpiPen

 

We’re in the midst of an epidemic of allergies in the U.S., and severe allergic reactions like anaphylaxis could be life threatening. Epinephrine is used For the emergency treatment of allergic reactions to stinging or biting insects, foods, drugs, and other allergens, as well as exercise-induced anaphylaxis; yes, you can be allergic to exercise, but don’t use that as an excuse to be a couch potato!

 

Epinephrine is most commonly used these days in an autoinjector that’s fast and easy to use. In the United States, one brand of autoinjector, the EpiPen, manufactured by a subsidiary of Pfizer pharmaceuticals, and marketed by Mylan corporation, is considered the gold standard. Annual sales of all epinephrine autoinjectors were about $200M; EpiPen had around 90% of the market; in 2015 the market size grew to $1.5B and epipen still has the lion’s share. Well, in a move that some might describe as profiteering, Mylan raised the U.S. price from around $100 for a package of two EpiPens in 2007 to around $600 in 2016, although it’s still less expensive in the UK and Canada. The devices, by the way, deliver about $1 worth of drug.

 

In a public relations move, Mylan made savings cards worth up to $300 available to some patients to purchase EpiPens, Unfortunately, these can only be used by a small number of people who need the drug, and doesn’t seem to include people on Medicaid. The high prices paid by insurers, however, haven’t changed and they pass the cost onto consumers in the form of higher and higher health insurance premiums every year.

 

(update: Mylan recently released a half-price generic version of the Epi-pen in response to the widespread resistance to their price increase.)

 

So what’s your best option if the Epipen is now outside of your financial reach? It might be using vials or ampules of epinephrine, small syringes, and some antiseptic wipes. The 1:1000 epinephrine ampules are 1 ml and contains enough for a one-time use of up to 2 doses. The same concentration vials are usually 30 ml and made for multiple uses. Here’s how to use epinephrine that’s packaged this way :

 

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1:1000 epinephrine in vials (from WebMD)

1:1000 epinephrine solution contain 1mg of drug per milliliter or cc of solution. For a person weighing 30 kg, 66 pounds, or greater, give 0.3 to 0.5 mg (0.3 to 0.5 mL) into the anterolateral thigh about the level of the bottom of your Jeans pocket. Repeat the dose every 5 to 10 minutes, alternating left and right thighs until improvement is noted. Remember that epinephrine will cause a fast heartbeat, nervousness and, perhaps, a number of other side effects. Of course, in normal times, get the victim to modern medical care as soon as possible, especially if more than 2 doses were needed.

 
For children weighing less than 66 pounds, the formula for anaphylaxis is 0.01 mg/kg, so a small child weighing 10 kg, or 44 pounds, would receive 0.2 mg, that’s .2 ml if you use 1:1000 epinephrine solution. The maximum pediatric dose is up to 0.3 mg, that’s 0.3 ml of epinephrine (1:1000).

 
This might seem complicated, and indeed, it does take longer to deliver the product than with an autoinjector like the Epipen unless you keep some small syringes prefilled with the medication. In a 2010 article in the ASIAN PACIFIC JOURNAL OF ALLERGY AND IMMUNOLOGY, manually prefilled syringes were recommended as a way to keep ready to use epinephrine available at all times, and it appears that the medication remains potent and uncontaminated by bacteria or fungus for 3 months. After that, it changes color and all bets are off. This also assumes that the syringes are stored at room temperature, as high temperatures will affect potency considerably over time.

 

(This article can be viewed in video form HERE)

 

 

Joe Alton, MD

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Dr. Joe Alton

 

Learn more about allergic reactions, anaphylactic shock and 150 other topics related to survival in good or bad times by  getting a copy of the 700 page Third Edition of The Survival Medicine Handbook: The Essential Guide for when Medical Help is Not on the Way, now available at Amazon.

Survival Medicine Hour: Norovirus, Cold Myths, Man Flu?

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Norovirus: The Stomach Flu

In this episode of the Survival Medicine Hour with Joe and Amy Alton, aka Dr. Bones and Nurse Amy, a bout of acute gastroenteritis, also called “stomach flu” caused by Norovirus sends Nurse Amy to urgent care. Find out about the microbe that sends two million victims to their doctors every year in the U.S., how to prevent it and some other important advice to stay healthy this winter.

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Also, top ten myths people believe will prevent a cold. We know there’s one or two in there you think are true! Also, why do men seem to have worse symptoms than women when they get the flu or other viruses? Is there such a thing as the Man Flu?

All this and more on the latest episode of the Survival Medicine Hour with Joe Alton MD and Amy Alton, ARNP. To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2016/12/16/survival-medicine-hour-norovirus-cold-myths-man-flu

Wishing you the best of health in good times or bad, and Merry Christmas!

Joe and Amy Alton

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Dr. Bones and Nurse Amy

The “Stomach Flu” Virus

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Oysters may harbor norovirus

We often write about disaster situations that we personally experience. We’ve been through hurricanes, tornadoes, and epidemics, just to mention a few. Recently, our home in Gatlinburg, Tennessee was threatened by the wildfires there, which killed 14 and wiped out more than 1700 buildings and over 100 on the mountain where the house is located.

 

We’ve written about a number of medical issues that we’ve experienced as well. For example, I converted to positive for Tuberculosis during my work with Cuban refugees during the 1980 Mariel boatlift. I still carry a small walled-off nodule on X-ray, even after months of multi-drug therapy.

 

On a recent trip to New York City to visit our daughter, we both experienced a medical issue so common that it surprised us that we haven’t yet written about it: acute gastroenteritis, or the “Stomach Flu”. When this infection hits you, it makes even the healthiest individual miserable. Nurse Amy required an urgent care visit, no small issue in a strange and heavily-populated city. She was just one of nearly 2 million outpatient visits caused by norovirus in the U.S. every year.

 

Norovirus is the most common cause of viral gastroenteritis in humans. It was originally called “Norwalk Virus”, after the area where it was first identified in the 1960s. Since then, it’s been blamed for 50% of all gastroenteritis in the U.S. Worldwide, there are more than 200 million cases of norovirus infection a year. It affects people of all ages, but it’s particularly dangerous in the elderly, the very young, and those with weakened immune systems. Winter is the most common time for outbreaks.

 

Norovirus is very contagious (just 5-20 viral particles can cause illness) and is easily transmitted through contaminated food or water, close personal contact, and by air droplets from vomit, contaminated food counters, and even toilet flushes. Infection can be passed from person to person for a time even after apparent recovery.

 

Here’s how contagious the norovirus is: In one outbreak reported in 1998, 126 people were dining at a restaurant when one person vomited onto the floor. Despite a rapid cleanup, 52 fell ill within three days. More than 90% of the people who later dined at the same table reported symptoms. More than 70% of the diners at a nearby table got sick; at a table on the other side of the restaurant, the rate was still 25%.

 

Norovirus is a hardy microbe, and is known to survive for long periods outside a human host. It can live for weeks on countertops and up to twelve days on clothes. It can survive for months in still water. Disinfectants containing chlorine, however, like bleach will quickly eliminate it, as will sufficient heat.

 

The symptoms of the stomach flu include nausea and vomiting, watery diarrhea, and (sometimes severe) abdominal pain, usually within 12 to 48 hours of exposure. Along with this, muscle aches, headache, and fever may be seen. Luckily, life-threatening illness is rare, with dehydration being the main danger in those infected with the virus.

 

Unlike some viruses, immunity to norovirus is only temporary, maybe six months, after recovery.

 

Outbreaks of norovirus infection often occur in closed spaces such as cruise ships, nursing homes, schools, camps, and prisons. Shellfish, such as oysters, and salad ingredients are the foods most often implicated in norovirus outbreaks. In our case, it might have been a kiosk advertising “the World’s Best Hot Dogs”.hot-dog-stand

As is the case with most viruses, there is no cure for norovirus infection. Antibiotics will not be effective, as they are meant to kill bacteria, not viruses. Treatment involves staying well-hydrated. Dehydration can be noted by these symptoms:

 

  • ·        Dry mouth

  • ·        Decrease in quantity or dark color of urine

  • ·        Dizziness when standing up

  • ·        Decreased elasticity of skin (it “tents” when pulled)

  • ·        No tears when crying or unusual irritability in infants

Using antidiarrheal meds like loperamide (Imodium) and anti-vomiting drugs like Ondansetron (Zofran) may also help.

 

A cure may not be available but prevention is another issue. To decrease the chance of norovirus infection:

 

·        Wash your hands frequently with soap and water (norovirus is relatively resistant to alcohol), especially after using the restroom or handling food. Be especially sure to do this for 2 weeks after becoming infected (yes, you can be contagious for that long).

·        Wash food before cooking; cook shellfish thoroughly

·        Frequently disinfect contaminated surfaces with a bleach solution (the EPA recommends 5-25 drops of bleach per gallon)

·        Keep sick individuals away from food preparation areas

·        Avoid close contact with others when you are sick, and don’t share utensils or other items

·        Wear disposable gloves while handling soiled items

·        Immediately remove and wash clothes that may be contaminated with vomit or feces. Machine dry if possible.

 

It may be difficult to completely eliminate the risk of norovirus infection, but careful attention to hand and food hygiene will go a long way towards avoiding the stomach flu.

 

Joe Alton, MD

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 Check out Nurse Amy’s entire line of medical kits and individual supplies at her store at store.doomandbloom.net.

 

Zika Defects More Common Than Previously Thought

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microcephalic infant

A recent U.S. study published in the Journal of the American Medical Association has found that 6% of 400 babies infected with Zika virus born here had one or more related birth defects. The study pales in comparison, however, to a Brazilian study of 125 women just reported in the New England Journal of Medicine. In that study, 46% of babies had abnormalities or did not survive the pregnancy. Previous studies had shown a risk of defects of 1 to 13 per cent.

Troubling evidence has now emerged that suggests that babies may still develop issues even as they approach their first birthday. Previously, it was thought that all damage occurred while still in the womb. Now scientists are asserting that the virus may continue to destroy nervous tissue for a time after birth.

The timing of the infection seemed to have an impact, with 11% of U.S. pregnancies diagnosed with Zika in the first trimester yielding babies with birth defects, less in mid- or late-pregnancy. Although Zika virus lasts only a short time in the blood, it appears to possibly last for months in brain tissue. The overall incidence of 6% in the U.S. was the same for women who experienced symptoms of Zika illness and those who were asymptomatic.

Most cases in the continental United States were diagnosed in women who had traveled to the epidemic zone, although an epidemic of more than 30,000 locally transmitted cases was seen in Puerto Rico and a local outbreak of more than 200 cases was noted in South Florida. More recently, a case of local transmission was reported in the Brownsville area of Texas.

Zika virus is known to cause increased numbers of newborns with microcephaly, an abnormality of growth in the brain and fetal head normally seen in less than 1% of all births. In the lab, Zika has been shown to kill brain cells. Other defects in sight, hearing, joints, and elsewhere have also been detected, according to Margaret Honein, lead author of the U.S. study and head of the U.S. Centers for Disease Control and Prevention’s National Center on Birth Defects and Developmental Disabilities.

Another troubling aspect is that the Zika virus is completely asymptomatic in 80% of those infected. This means that the actual number of cases may be five times the recorded numbers. Additionally, it is unknown what developmental milestones may be delayed over the first few years of life, and whether school performance may be affected.

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The best way to prevent Zika virus is still to prevent mosquito bites by wearing appropriate clothing and using repellent when in at-risk areas (or avoid travel there altogether), Pregnancies should be delayed for 8 weeks in women who have had the virus or traveled to the epidemic zone. Men shouldn’t attempt to impregnate their partner for at least 6 months.

 

Joe Alton, MD

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Get 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”, available on this website and also at amazon.com.

It’s not too late to get a copy of the premiere board game of the preparedness community “Doom and Bloom’s SURVIVAL!” as a Christmas gift! Find out all about it at survivalboardgame.com.

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Doom and Bloom’s Survival, now with free miniatures

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Survival Medicine Hour: Pneumonia, Natural Remedies

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survival medicine

The Survival Medicine Hour, with Joe Alton, MD aka Dr. Bones and Amy Alton, ARNP aka Nurse Amy, bring you a tremendous amount of information today. Are you going to be the medic or caretaker in a disaster or survival situation?  Our mission is to help put a medically prepared person in every family for any disaster.

Pneumonia is an infection affecting the aprt of the lungs that absorbs oxygen from the atmosphere. Pneumonia may be viral, bacterial or fungal infection. The infection usually starts by affecting a portion of one lung (a “lobe”) before spreading to the entire organ. If enough fluid clogs the air clogs the air sacs (alveoli), it’s possible, while listening to lung sounds, you actually won’t hear any sounds at all.

Natural remedies are available for help with respiratory infections to reduce symptoms and build a person’s immunity. Antioxidants, like Vitamin C and Vitamin E and other antioxidants taken regularly are supposed to decrease the frequency and severity of respiratory infections.

Some of the best essential oils for symptoms are Lavender, Eucalyptus, Rosemary, Peppermint and Geranium. Herbal teas such as Stinging Nettle, Licorice Root, Peppermint, Anise Sage and Dandelion are all made better with a bit of raw, unprocessed honey and fresh squeezed lemon.

Joe Alton, MD

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Joe Alton MD

Oakland Warehouse Fire: Surviving in a Crowd

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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

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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.

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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.

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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.
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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

Survival Medicine Hour: Respiratory Infections, pt. 3, Foot Care, More

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colds

Respiratory Infections

The Survival Medicine Hour, November 25, 2016, with Joe Alton, MD aka Dr. Bones, and Amy Alton, ARNP aka Nurse Amy explore various respiratory infections and their symptoms. We classify respiratory infections as upper and lower. Upper respiratory infections invlove the troat, nasal passages, sinuses and larynx. Lower respiratory infections invlove the trachea (wind-pipe), bronchi and lungs.

Discover the common treatments and medications commonly used to treat these infections, and some special tips to help prevent them. What do you do with your toothbrush after you recover from a respiratory infection? Are you still using anti-bacterial soap to wash your hands? Find out what you should be doing to stay healthy and why.

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Pick the right shoes!

Christmas holidays are the time for shopping and lots of walking. Wear the wrong shoes and you may be in a world of hurt. Nurse Amy shares some good advice on what kind of shoes to wear on long walks and how to pick the right shoes for your feet.

To Listen in, Click below:

http://www.blogtalkradio.com/survivalmedicine/2016/11/25/survival-medicine-respiratory-infections-pt3-foot-care-happy-thanksgiving

 

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

 

Joe and Amy Alton, MD

 

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Doom and Bloom’s SURVIVAL! board game

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game miniatures (an added bonus!)

Video: Storing Medications

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Storing Meds

In good times or bad times, having a strategy for the proper storage of medicines will help preserve their potency for when they’re needed. Here’s a video by Joe Alton, MD about the factors to consider when putting away those needed medications for later use. Companion video to a recent article.

To watch, click below:

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

 

Joe Alton, MD

 

 

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You’ll need more than just medicine to get you through a disaster, so check out Nurse Amy’s entire line of medical supplies at her store at https://store.doomandbloom.net/    You’ll be glad you did!

Sleep Deprivation

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sleep deprivation

In our roles as preparedness experts for disasters and epidemics, we’re often asked to come on various media outlets to give our opinion, mostly on medical issues. Occasionally, we get the interview request that seems to be a medical topic but has obvious political overtones. Just yesterday, a radio station asked me to comment, as a doctor, on whether Donald Trump’s 4-hour a night sleep habit impacts his ability to make rational and sound decisions.

As for my opinion on this particular question, I’ll refer you to americansurvivalradio.com, but suffice it to say that he’s actually in pretty good company with regards to sleep habits.  Five hours was reported as a good night’s sleep for Bill Clinton while president. Winston Churchill liked naps but slept little at night. Martha Stewart is just one of many business leaders that get less than the recommended 7-8 hours per night. There are, in fact, quite a few highly successful folks who seem to do just fine with little shut-eye.

Sleep deprivation is a pretty serious issue: Some researchers believe that it can carry a mortality risk approaching that of cigarettes or heart disease. Indeed, sleep deprivation has been used as a torture method in interrogations. The CDC estimates that up to 50-70 million Americans suffer from some kind of sleep disorder. In the aftermath of a major disaster, you can imagine that issues with sleep deprivation will only increase.

How does sleep deprivation decrease your chances of succeeding in times of trouble? Not getting enough sleep can significantly impair your brain’s function. The parts of the brain involved in alertness and attention (the thalamus) and the area that controls many higher-level thought processes (the prefrontal cortex) are especially vulnerable.  If the brain doesn’t get enough rest, you may become incapable of putting events into the proper perspective and taking appropriate action, a pretty big issue whether you’re president of the United States or the survivor of a major disaster.

Scientific studies bear this out. Indeed, The British Medical Journal equates the effects of 17-21 hours without sleep as the equivalent, in terms of affecting behavior, of having a blood alcohol level close to the legal limit of intoxication. A number of articles that evaluated the performance of medical residents show that those getting less than 4 hours of sleep made more medical errors that residents who slept 7-8 hours a night.

What about the elderly? Don’t older people naturally sleep less hours and less deeply? Studies show that that the elderly do get less sleep, but it’s not necessarily because they need less. Sleep could be affected for all sorts of reasons: sleep apnea, arthritis pain, heart issues, etc. Those in their later years also might develop something called “advanced sleep-phase syndrome”. These folks’ bodies want to go to sleep earlier and wake up earlier but their minds (and HBO, I expect) keep them from getting to sleep at a reasonable hour. Result: Sleep Deprivation.

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In addition to what’s happening in your brain, the failure to get 7-8 hours of sleep every night causes a whole set of symptoms, none of which are particularly good for a survivalist. Here are just some:

  • Irritability
  • Depression
  • Tremors
  • Bloodshot, puffy eyes
  • Headaches
  • Confusion
  • Memory loss
  • Muscle aches
  • Hallucinations and other psychotic symptoms
  • Ill effects on control of diabetes and high blood pressure
  • Blackouts lasting up to 30 seconds (also called “microsleeps”)

There are a number of people that seem to function just fine with less than the average number of sleep hours. No one is quite sure why this is so, but it appears to involve about 5% of the population and may be related to genetics. For the rest, it rapidly becomes clear that they need more sleep.

There are things that you can do to get a few more hours of shut-eye each night. The best start is to consider a concept we’ll call “sleep hygiene”.  Sleep hygiene involves adjusting your behavior to maximize the amount of restful sleep you get.  Consider:

  • Sticking to a standard bedtime and wakeup time
  • Making your nighttime environment as comfortable as possible
  • Avoiding Nicotine, Caffeine, and Alcohol before going to bed.
  • Staying awake from heavy foods for at least 2 hours before going to sleep
  • Exercising regularly, but not right before going to bed
  • Eliminating as much light as possible in the room at bedtime
  • Keeping your mind clear of stressful issues at bedtime

After a disaster, many of the above strategies are difficult to implement. Of course, there are drugs like Ambien and Halcion that you can use, but a better alternative to start with might be some form of natural sleep aid.  Some of the common alternative remedies for sleeplessness include the following teas:

  • Chamomile
  • Kava Root
  • Lavender
  • Valerian Root
  • Catnip

Good nutrition is important for general health, but some foods are also thought to be helpful in promoting a good night’s sleep.  They contain sleep-inducing or muscle-relaxing substances like melatonin, magnesium, or tryptophan. Some examples:

  • Oatmeal – melatonin
  • Milk – tryptophan
  • Almonds – tryptophan and magnesium
  • Bananas – melatonin and magnesium
  • Whole wheat Bread – helps release tryptophan

Yoga, massage, meditation, sound machines, and even acupuncture might also be effective ways of dealing with sleep deprivation.

Staying healthy in normal times or in the aftermath of disaster involves, not only maintaining good physical hygiene, but maintaining good sleep hygiene as well. To be at 100% efficiency, get some rest!

Joe Alton, MD

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Joe Alton, MD

Survival Medicine Hour: Respiratory Infections, Part 2, Effects of Stress, More

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This week on the Survival Medicine Hour, Joe Alton, MD aka as Dr. Bones and Amy Alton, ARNP aka Nurse Amy, November 19, 2016, discuss some tips to help “survive” the possibly stressful Christmas shopping experience. Ebay did a study that found 88% of shoppers had elevated heartbeats similar to an athlete running a marathon. What are the effects of a rapid heart rate on the body, and learn why you feel so exhausted after an anxiety attack.

The latest update on Zika theories about why some countries are experiencing a higher rate of birth defects than others. What is going on with the progress of a Zika vaccine and a breakthrough medication to limit the ill effects of the virus on unborn babies.

Respiratory infections affect millions of people each year. Knowing how to tell the difference between different types will help you, as the survival medic, determine the best treatment plan. Colds vs flus, how to tell the difference, and more…

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2016/11/18/survival-medicine-hour-respiratory-infections-pt2-effects-of-stress-and-morehttp://www.blogtalkradio.com/survivalmedicine/2016/11/18/survival-medicine-hour-respiratory-infections-pt2-effects-of-stress-and-more

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

 

Joe and Amy Alton aka Dr. Bones and Nurse Amy

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The Altons

 

Why The Disparity In Zika Affected Newborns?

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zika virus

Zika Virus under the microscope

Zika virus hasn’t been on the front page much lately, but case numbers continue to rise in many countries. The World Health Organization stated recently that Zika infection has been documented in 75 countries throughout the globe.

One of the many unusual aspects of Zika virus is that Brazil has, far and away, the most cases of babies born with birth defects. The most prominent of these is microcephaly, a condition where the brain fails to grow normally, causing a striking appearance where the head is much smaller than normal. Brazil has about 2000 cases of this abnormality, while Colombia has the second highest with only 57; the U.S. is third with 31 cases, including miscarriages. Within Brazil itself, the Northeastern part of the country has the highest number of infants affected by the debilitating effects of the virus.

The American Society of Tropical Medicine, in its annual meeting in Atlanta, discussed this disparity, which has fueled a hotbed of speculation about the disparity.

A  Brazilian health official, Pedro Fernando da Costa Vasconcelos, suggests that vaccination against  Yellow Fever, a virus in the same family as Zika, may be a factor. In Northeastern Brazil, few receive this vaccine compared to other parts of the country. It’s possible, he says, that the vaccine may give some cross-protection against Zika.

A number of other theories exist, including effects on humans by certain pesticides used in the epidemic zone and, perhaps, contaminated lots of vaccines. However, no hard data has, as yet, implicated these and other possibilities as part of the equation.

Another factor may be the growing tendency of women to terminate their pregnancies in the face of a diagnosis of Zika infection. Still another, according to Albert Ko, a Yale professor, relates to the difficulty tracking numbers of abortions for this reason and the fact that many never know they had the infection at all. Zika has no symptoms whatsoever in 80% of patients. The rest experience fever, joint aches, rashes, and eye redness.

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Microcephalic Infant

What is obvious, however, is that there are wide variations in the percentage of Zika infections to birth defects. Puerto Rico recently reported its first case of microcephaly in a newborn, but has catalogued  more than 30,000 people infected with Zika.

Professor Ko says that a new large-scale study will follow thousands of pregnant women with Zika diagnoses. Genetics, prior viral infections, and even the mosquitoes that transmit the virus will be evaluated. It’s possible that, with this information, a more definitive picture of factor involved in Zika-related birth abnormalities will emerge.

An issue not commonly considered is what effect Zika infection may have long-term in apparently unaffected infants. Will they reach normal milestones like walking and talking at the appropriate time? Down the road, will they perform adequately in school? It will take years to find out.

Meanwhile, cases continue to accumulate, mostly travel related. A total of close to 36,000 cases have been documented by the Centers for Disease Control and Prevention (CDC) in the United States and the U.S. territory of Puerto Rico. New cases are still being reported in Florida by the Department of Health, which says that 1,165 total cases (153 in pregnant women) exist in the state as of November 11, 2016. Of these, 225 were transmitted by local mosquitoes.

Some good news: A vaccine called Zika Purified Inactivated Virus, or ZPIV, seems to be showing promise in research conducted, and human trials have begun at the Walter Reed Army Institute of Research. In addition, Dr. Michael Diamond of the University of Washington has identified an antibody that might protect the unborn fetus against the effects of the Zika virus on nervous tissue. Research is ongoing on these and other fronts in the battle against what has become a worldwide epidemic.

Joe Alton, MD

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Dr. Alton

 Find out more about the Zika Virus in Joe Alton, MD’s book “The Zika Virus Handbook“, available at amazon.com

 

 

Survival Medicine Hour: Storing Meds, Respiratory Infection, Pt. 1

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How to store meds

The Survival Medicine Hour (November 11, 2016) exposes the issues we all face when looking at an uncertain future. If you prepare for long-term survival due to man-made or natural disasters, one looming problem is how to keep your much needed medications in the best condition possible. Nurse Amy. aka Amy Alton, ARNP and Dr. Bones, aka Joe Alton, MD cover some techniques and methods to help you solve this medication storage problem.

Part 1 of respiratory infections is also covered in this episode, plus a discussion of the reappearance of the respiratory virus that originates in the intestine, Enterovirus D68.

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Medic Memorial

On this Veteran’s day, Dr. Bones and Nurse Amy want to say thanks to all of our military staff new and old; we greatly appreciate your service to our country!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2016/11/11/survival-medicine-hour-storing-medications-longterm-respiratory-infections-pt1

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

 

Joe and Amy Alton

 

AmyandJoePodcast400x200Find out more about medical issues in times of trouble with the Third Edition of The Survival Medicine Handbook: The Essential Guide for when Medical Help is Not on the Way, available at Amazon.com.

Storing Medications

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medicines

Storing Medications

Being prepared for disasters means storing food, but it also means putting together a stockpile of medical supplies. While bandages and instruments may keep acceptably in a variety of environments, medications are another story.

How medicines are stored can affect their potency over time. To maintain the effectiveness of the drugs, there are several factors that deserve your attention:

Heat: Most medications are meant to be stored at room temperature. Insulin and some antibiotic elixirs are an exception, and should be stored in the refrigerator. A good rule of thumb is that, unless the bottle contains labeling that says otherwise, it’s unnecessary (and in many cases, harmful) to freeze or otherwise diverge from the advice given by the manufacturer.

Excessive heat is another factor in losing drug potency. Given the choice, somewhat cooler is probably better than hotter. It’s thought that drug effectiveness fades twice as quickly if stored at 90 degrees Fahrenheit than if stored at 50 degrees.

Moisture: Most folks store medications in the bathroom medicine cabinet, but you might be surprised to know that the moisture from showers and baths can degrade the drug significantly. Instead, consider a high shelf in a closet or a dedicated storage box.

Light: Much like excessive exposure to the sun could damage skin, light sometimes could have an ill effect on certain drugs. These meds are commonly stored in brownish-colored bottles. Keep all medicines in their original containers. It might be a good idea, however, to remove the cotton ball commonly placed with the drug as it could pull moisture into the container.

Many times, it might be hard to tell if a drug has been affected negatively, but some others are pretty obvious. Aspirin pills, for example, can develop a vinegar-like smell (even before the expiration date). Besides smell, a change in color or consistency may signal that a medication has degraded. If pills or capsules are harder or softer than normal or stick together, be wary.

Some people get their meds through the mail. If so, choose overnight shipping whenever possible to avoid prolonged travel time. ABC news reported recently that a 1995 FDA study found that a standard black mailbox can reach 136 degrees in the summer heat. Excessive time in the hot sun or extreme cold for a long period of time causes drug deterioration. A better alternative may be to send them to where you can take possession personally and immediately. For many, this might be their workplace as opposed to their home.

One of the questions I’m often asked is whether drugs will benefit from vacuum sealing. Although you’ll find opinions everywhere, there doesn’t seem to be any hard data on the issue. I would expect that more drugs would be vacuum packed by the manufacturer if it was that important to maintain potency. Having said that, pharmaceutical companies want you to discard older meds so they might not be motivated to do so.

Vacuum packing would affect moisture but wouldn’t affect important preservation aspects like temperature or light. As meds do best in their original containers, it seems that, with the possible exception of powder packets, it wouldn’t be an essential storage method.

So, consider storing all meds in cool, dark, dry conditions. It’s especially important to be sure that all medications are kept out of the reach of children. Childproof lids are meant to help you achieve this goal, but consider a storage box with a lock as well.

The wise family will keep a good medical kit and a supply of over-the-counter and needed prescription medicines stored safely in their home. In a disaster, attention to proper storage methods might just save a life.

Joe Alton, MD

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Dr. Alton

Besides medicine, you’ll need a variety of medical supplies to deal with medical issues in times of trouble. Check out Nurse Amy’s entire line of medical kits at store.doomandbloom.net.

Video: Fish Antibiotic Update

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2015 Birdhouse Inn Mountain Paradise View!

Mount LeConte at sunrise, Great Smokies

In this video, Joe Alton, MD addresses the concerns of those in the preparedness community who store veterinary equivalents of human antibiotics for use in post-apocalyptic scenarios. The FDA’s upcoming Veterinary Feed Directive has cast the availability of these items in doubt for 2017. As the first physician to write, years ago, about the utility of these products to save lives in long-term survival, Dr. Alton has evaluated the FDA’s action and knows their goals. He discusses how this affects, if at all, the future of fish/bird antibiotics’ availability for your survival medicine cabinet. Companion video to a recent article on the same topic.

This video has as its backdrop Mt. LeConte, highest peak in the Great Smoky Mountains National Park.

To watch, click below:

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

 

Joe and Amy Alton

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Joe Alton MD/Amy Alton ARNP

Find out more about antibiotics, infectious disease, and many other medical issues in 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, now available on this website and also at Amazon.

 

Medical Supplies for the Homestead

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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

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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

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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

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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

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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.