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: 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.

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!

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.

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

 

 

Vaccines and Disaster Preparedness

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huntlh / Pixabay

In the event of a disaster, communicable diseases greatly increase the risk of death. The major causes of communicable diseases in disasters are contaminated food and water, respiratory infections, vector and insect-borne diseases, and infections due to wounds and injuries.

Keeping up to date with vaccinations is one important way you can be prepared for a disaster. Vaccines can’t prevent every disease you may encounter in a disaster situation, but they can protect you from many. Vaccinations teach your immune system to recognize and eliminate organisms that may make you sick, so your body is already prepared if you’re ever exposed, which might be even more likely in an emergency situation where many people are crowded together or if you have injuries.

In recent years, opposition to vaccinations has been discussed in the news. Some concerned parents have chosen not to vaccinate their children, primarily out of fear that vaccines can cause autism. It’s important to note that multiple studies have shown vaccines do not cause autism. Vaccines have been researched extensively, and are considered very safe.

Unfortunately, the misconceptions around vaccine safety have lead to serious health problems. Due to the large number of people refusing vaccines, diseases that were thought to be eradicated in the U.S., such as measles, have reemerged. Pertussis, or whooping cough, another potentially deadly disease, has also made a resurgence.

The best way to prevent you or your child from contracting a preventable illness is to stay up to date with vaccines.

The recommended vaccinations for infants and young children are:

  • HepB protects against hepatitis B
  • RV protects against rotavirus
  • Tdap protects against diphtheria, tetanus, and pertussis
  • Hib protects against Haemophilus influenzae 
  • PCV protects against pneumococcal disease. PCV is given in a series of four doses.
  • IPV protects against polio
  • Influenza (flu) protects against the flu
  • MMR protects against measles, mumps, and rubella
  • Varicella protects chickenpox
  • HepA protects against hepatitis A

An immunization schedule for infants and children is available on the CDC website.

Recommended vaccinations for adults are:

  • Tdap: You’ll need a booster dose every 10 years. Protection from tetanus is especially important in the event of a disaster, where you may be exposed to rusty metal which greatly heightens your risk for this disease. You’ll need this vaccine in the event of an emergency surgery.

  • Inflluenza: Adults should get this shot once a year.

Other vaccinations recommended for adults on a case-by-case basis are listed here, but always check with your doctor to see if they apply to you.

In short, getting vaccinated and staying up to date with vaccinations is an easy way to protect yourself, your family, and the whole population. Vaccines can prevent the outbreak of serious illnesses and save many lives. There are some groups of people who may not be able to get vaccinated, such as pregnant mothers, newborn infants, or people with a compromised immune system. If you can get vaccinated, you’re helping protect the people who can’t by containing the disease through “community immunity.”

The post Vaccines and Disaster Preparedness appeared first on American Preppers Network.

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

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

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.

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!

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: 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.

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

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

11 First Aid Supplies You Can’t Have Too Much Of

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Next to food, water, and shelter, nothing is more important in a survival situation than medical supplies. Without the right supplies, diseases and injuries that would normally be completely treatable could be a death sentence. Unfortunately, many first aid supplies such as medication and bandages are not reusable, meaning you will want to have ample […]

The post 11 First Aid Supplies You Can’t Have Too Much Of appeared first on Urban Survival Site.

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

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.

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

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: 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

LabCoatsBonesAmy1

joe and amy alton

Choosing Sutures

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Sutureneedleholder1

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

 

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

 

·        Be sterile

·        Be easily worked with

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

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

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

 

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

 

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

 

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

 

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

 

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

 

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

suturenylon

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

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

 

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

 

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

 

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

 

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

suture needles

typical suture needles (chromic catgut)

 

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

 

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

 

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

 

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

 

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

 

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

 

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

Joe Alton, MD

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

Video: Storing Medications

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medicines

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

 

 

JoeAltonLibrary4

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!

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

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antibiotics1

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.

medic_memorial_700-1

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

joealtonlibrary4

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

JoeAmyLabcoatSMALL300x300

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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homestead-cabin-pixabay

image by pixabay.com

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

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

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

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

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

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

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

Prepper Medical Supply Kit

Family Medical Kit

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

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

PERSONAL PROTECTION 

N95-Surgical-Mask

N95 mask

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

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

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

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

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

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

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

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

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

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

MINOR INJURIES

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

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

ORTHOPEDIC INJURIES

samsplints

The popular SAM Splint

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

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

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

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

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

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

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

HEMORRHAGIC WOUNDS

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

EMT shears or bandage scissors can help expose a bleeding wound

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

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

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

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

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

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

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

OPEN WOUNDS

stabwound

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

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

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

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

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

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

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

HOW MUCH TO HAVE?

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

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

Joe Alton, MD

joealtonlibrary4

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

 

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

10 Often-Overlooked Medical Supplies To Stockpile For A Societal Collapse

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10 Often-Overlooked Medical Supplies To Stockpile For A Societal Collapse

Image source: Pixabay.com

There are certain mistakes I see made over and over again among those in the preparedness community. Most of them are understandable. We live in a society where we have a plethora of resources and support available to us, and breaking out of that mindset and thinking of how to be truly self-sufficient is hard, even for those of us who are trying.

But if we are going to survive a major natural or man-made disaster, we’ve got to be ready to make it on our own. That means having both the knowledge and the supplies to do everything we need, for ourselves.

One area that is commonly overlooked is the area of medicine. Oh, we all have first-aid kits, and I’ve even seen some pretty good ones around. But that’s not the same as medical preparedness.

Let me enumerate some of the problems:

  • Medical facilities and personnel becoming overwhelmed with the large number of people who get injured in the crisis and its aftermath.
  • Lack of transportation making it difficult to get injured or sick personnel to medical facilities.
  • Modern medical doctors and facilities not having electricity. Many hospitals only have about 48 hours of fuel for their generators.
  • Breakdown of the supply chain, making resupply of even the most basic medical supplies iffy at best.

With all of this in mind, it’s clear that we need to be ready to take care of our own medical needs. That means much more than just having a little first-aid kit on hand. First of all, most first-aid kits can’t take care of a serious injury. And even those that can will quickly get depleted.

Here are a few of the top items you’ll need to stockpile, and stockpile well.

1. Bandages of all kinds (in bulk)

Injuries are common and will be even more common in a survival situation. When medical care is difficult to come by, any injury is serious. Injuries create openings in the skin by which bacteria and other pathogens can enter.

Learn How To Make Powerful Herbal Medicines, Right in Your Kitchen!

So, it’s important to clean, disinfect and protect even the smallest of injuries.

  • For smaller injuries, cloth adhesive bandages are great. They stick better than the plastic kind, so they protect you better. That makes them worth the extra money they cost.
  • For large injuries, one of the best bandages you can have is a sanitary napkin. They are sterile, and designed to absorb a large quantity of blood. They are also much cheaper than other sterile bandages.
  • The new “cohesive” medical tape is much better than other types, in that it sticks to itself, rather than the patient. So, when you take it off, you won’t be pulling any hair out and causing the patient any extra pain.

Bandages really should be changed every 24 hours, or faster if they become blood soaked. So it’s easy to see how you could go through a lot of bandages quickly. It’s not unreasonable to think in terms of a few hundred of each size.

2. Gauze (in bulk)

Gauze is great for larger injuries, for times when you have to soak up blood or for cleaning off a wound. You can buy it in several forms, but probably the most common and most universally useful is in four-inch squares. These come in both sterile and non-sterile varieties.

When bandaging a wound, you need to use sterile dressings directly on the wound. But the second layer doesn’t have to be sterile. So, if you have a bleeding wound, you can use those four-inch non-sterile gauze pads on top of a sterile one, and save a lot of money.

Stretchable gauze is also useful, especially in cases where you need to protect the skin, but not necessarily soak up a lot of blood. Skin rashes are such a case. Once you medicate the rash, you should cover it for protection. Stretchable gauze is an easy way to do this. It can also be used in place of medical tape, although it doesn’t work quite as well.

3. Antiseptic cream, alcohol and hydrogen peroxide (lots of it)

Any wound needs to be cleaned and disinfected. The first step is to flush it with a sterile solution to remove debris. This could be clean drinking water. If it’s safe enough to drink, it’s safe enough for cleaning out a wound, too. But after that, something that will kill bacteria and other germs must be used.

Many people clean the wound with alcohol or hydrogen peroxide and then apply an antiseptic cream. This is ideal, as it provides the maximum protection. You really can’t be too careful where the possibility of infection exists.

4. Clotting agent

Image source: QuikClot

Image source: QuikClot

Clotting agents, like Quikclot or Celox, help to get wounds to stop bleeding and scab over quicker. This can be very useful in a situation where a wound is bleeding quickly. The more blood a person loses, the longer it takes them to heal. So, using a clotting agent helps to reduce their recovery time. It also can prevent them from bleeding out and dying.

These clotting agents are available either in a granulated powder that is sprinkled on the wound or embedded in bandages of various types (including a sponge). Either will work. The powder is useful for smaller wounds, but larger wounds require the bandages with the clotting agent included.

5. Personal protection equipment

It is important to do everything possible to prevent the spreading of infection and disease. For this reason, medical staff wear masks, gloves and eye protection. Well, if you’re going to be treating patients, you’ll need the same. Non-sterile gloves, which are sufficient for everything short of surgery, come in boxes of 100, in a variety of sizes. Buying them like that helps ensure that you’ll have them when you need them.

The most common place for pathogens to enter the body is the face. You have more naturally occurring openings in your skin, there in your face, than anywhere else in your body. That makes it necessary to protect your face from splashing blood and the droplets of sneezes. A medical face mask and simple plastic goggles is sufficient for this.

6. Sutures

Gaping wounds need more than a bandage; they need the skin brought back together and held there for healing. In a hospital, they accomplish this with stitches. You can do the same, although it’s recommended to practice beforehand, as sewing up someone’s body is different than sewing on a button.

‘Miracle Oil Maker’ Lets You Make Fresh Nut Oils Within Minutes!

But there’s an easier way — adhesive sutures. 3M’s Steri-Strips and butterfly bandages both work well for this. While both are good, the Steri-Strips come in a package of five, which makes them much easier to work with.

7. Elastic bandages

Elastic bandages are useful for a host of things, especially dealing with broken or sprained limbs. Keep an assortment of sizes on hand, so that you have the right size for every need.

In order to be able to splint broken limbs, you’ll need something to use with the elastic bandages. In a pinch, sticks will work. But a Sam Splint is even better. This is a sheet of foam rubber-coated soft aluminum sheet, four inches wide. You can form it to fit the limb, and then attach it in place with the elastic bandages. Properly done, this will work almost as good as a cast.

8. Pain relievers

There are several different over-the-counter pain relievers available; if you consume mainstream medicine, stock them all. Different ones work differently with different people. That’s why ibuprofen might work well for one person, but not for another. You should have as a minimum:

  • Aspirin
  • Ibuprofen (Advil)
  • Acetaminophen (Tylenol)
  • Naproxen (Aleve)

While it would be nice to have some stronger pain relievers on hand, those all require a prescription. If you have a good enough relationship with your doctor, you might be able to get some; but if not, you can’t even buy it in Mexico.

9. Antibiotics

10 Often-Overlooked Medical Supplies To Stockpile For A Societal Collapse

Image source: Pixabay.com

Antibiotics are another thing you usually need a prescription to buy. That’s mostly to protect people from misusing them. So if you do stock any, make sure you have written information on how to use them properly, specifically information on dosage and which one to use for which ailments.

Many homesteaders buy veterinary grades of antibiotics, for which you don’t need a prescription. They usually come out of the exact same factories from which human antibiotics come. Another way is to buy them in Mexico, if you happen to be traveling that way. In Mexico, you can buy them in any pharmacy.

10. Over-the-counter medicines

Finally, stock up on all of the common over-the-counter medicines you use. Remember, you won’t be able to get them during a disaster, and even though they don’t actually cure most things, they do alleviate the symptoms, making it much easier to carry on and do the things you need to be doing. Specifically, you should have:

  • Antihistamine (Benadryl) — for runny nose.
  • Decongestant — for stuffed up nose or sinus headache.
  • Loperamide (Imodium) — anti-diarrheal.
  • Meclizine (Dramamine) — helps prevent nausea and vomiting.
  • Hydrocortisone cream — to help alleviate itching, such as from poison ivy.
  • Omeprazole (Zantac) — for heartburn
  • Clotrimazole (Lotrimin cream) — for fungal infections on the skin

When the next crisis hits — or the next snowstorm or flood – don’t be left wishing you had the right medical supplies on hand. Stock up now.

What would you add to our list? Share your tips in the section below:  

hydrogen peroxide report

Grab-N-Go Medical Bag: 50+ Essential Items

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The Urban Prepper is probably the most organized prepper on Youtube, as evidenced by his video on prepping circles. In this video, he talks about what items you should include in your grab-n-go medical bag and why. To make it easier for you, he created a PDF file that lists and explains every item and […]

The post Grab-N-Go Medical Bag: 50+ Essential Items appeared first on Urban Survival Site.

13 Safety Tips For Floods

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Mid Atlantic Coast Prepares For Hurricane Sandy

Storms often bring flooding

The recent Louisiana floods which claimed 11 lives and damaged 40,000 homes show how easily low-lying areas can be devastated by bad weather. Floods can occur even in normally dry areas and are so common that they represent 75% of presidential disaster proclamations. They are often seen in conjunction with other disasters like hurricanes and other storms.

 

You’d have to live on a mountaintop to avoid a flood but, even then, you’re still at risk for mudslides as a result of heavy rains. In view of this, we recently added flood and mudslide preparedness as chapters to the new Third Edition of “The Survival Medicine Handbook”. Clearly, floods are a disaster that can happen, and you should know how to keep your family safe.

 

TYPES OF FLOODING

 

A flood is defined as an overflow of water that submerges land which is normally dry. In the United States, there are various causes for flooding, including:

 
Flash Floods: Flash floods usually develop shortly after a nearby heavy rain. I say nearby because it doesn’t have to be raining at your location for rising water to endanger you. These floods create a rapid rise of water, especially in low-lying areas like floodplains. Causes of flash flooding include heavy rain, ice jams, and levee or dam failures. This is especially common in the western United States where normally dry areas next to steep terrain might fill with rushing water.

River Flooding: River flooding can be caused by heavy rainfall, dam failures, rapid snowmelt and ice jams. Normally flow can become turbulent rapidly as in a flash flood. In other cases, water levels may rise slowly but steadily. Either way, the result threatens structures and populations along its course.

Storm Surges: Tropical (or even non-tropical) storm systems can bring heavy winds, but most damage occurs as a result of flooding due to the storm surge. Storm surge is the rise in water generated by the storm above normal tide levels. When the storm approaches the coast, high winds cause large waves that can inundate structures, damage foundations, and cause significant loss of life.

Burn Scars: The Western U.S. has had significant wildfire activity, most recently in California. After a fire, the bare ground can become so hardened that water can’t be absorbed into the ground. This is known as a “burn scar”. Burn scars are less able to absorb moisture, leading heavy rains to accumulate water wherever gravity takes it.

Ice Jams: Northern areas of the continental U.S. and Alaska may have flooding as a result of ice jams. When moving ice and debris are blocked by an obstruction, water is held back. This causes flooding upstream. When the obstruction is finally breached, flash flooding occurs downstream. Many ice jams occur at bends in a river.

Snowmelt: Snowmelt flooding is common in mountainous Northern U.S. states. Snow is, until temperatures rise above freezing, just stored water. When it gets warmer, the snowmelt acts as if it were rain and flooding can occur.

Barrier Failures: When a dam or levee breaks, it can be due to excessive rainfall, erosion, landslides, earthquakes, and many other natural causes. Some dams fail as a result of man-made issues, such as negligence, improper maintenance, and even sabotage. As a result, water level can overflow the barrier or water can seep through the ground.

 

 

FLOOD PREPAREDNESS



Most people have heard of hurricane or tornado watches and warnings, but the U.S. weather services also tries to warn the populace of flooding. A “flash flood watch” means that flash flooding is possible in the near future; a “flash flood warning” means that flooding is imminent in the area.

 
If you live in a low-lying area, especially near a dam or river, then you should heed warnings when they are given and be prepared to evacuate quickly. Rising flood waters could easily trap you in your home and you don’t want to have to perch on your roof waiting for help.

 

FLOOD SAFETY TIPS

floods_02

Flood water may not recede quickly

 

To make it safely through a flood, consider the following recommendations:

 
Hit The Road Early
Make the decision to leave for higher ground before flooding occurs and roads are blocked. Having a NOAA weather radio will keep you up to date on the latest advisories. When the authorities tell you to leave, don’t hesitate to get out of Dodge.
Be Careful Walking Through Flowing Water
Drowning is the most common cause of death during a flood, especially a flash flood. Rapidly moving water can knock you off your feet even if less than a foot deep. Most vehicles can be carried away by water just two foot deep.
Don’t Drive Through a Flooded Area
In a flood, many people drown in their cars as they stall out in moving water. Road and bridges could easily be washed out if you waited too long to leave the area. Plan before a flood occurs to see if there is a “high road” to safety.

Beware Of Downed Power Lines
Watch for downed power lines; electrical current is easily conducted through water. You don’t have to touch the downed line to be electrocuted, only step in the water nearby. There are numerous instances of electrocutions occurring as a result of rescuers jumping into the water to try to save victims of a shock.
Don’t Drink The Water
Water, water everywhere, but not a drop to drink: Flood water is not clean water. It is contaminated by debris and water treatment plants may even have been compromised by the disaster. Have a reliable way to purify water and a good supply of clean water stored away. 12-16 drops of household bleach will sterilize a gallon of water (a teaspoon for 5 gallons), but a filter might also be needed to eliminate debris. Wait 30 minutes after sterilization to drink.
Have Supplies Handy
Flood waters may not recede quickly. Besides water as mentioned above, have non-perishable food, bottled water, heat and light sources, batteries, tools, extra clothing, a medical kit, a cell phone, and a NOAA weather radio among your supplies.
Turn Off The Power

If you have reason to believe that water will get into your home, turn off the electricity. If you don’t and the water reaches the level of the electric outlets, you could easily get electrocuted. Some warning signs might be sparks or strange sounds like crackling, popping, or buzzing.

Beware of Intruders
Critters that have been flooded out of their homes may seek shelter in yours. Snakes, raccoons, insects, and other refugees may decide your residence is now their territory. Human intruders may also be interested to see what valuables you left behind.
Watch Your Step
After a flood, watch where you step when you enter your home; there will, likely, be debris everywhere. The floors may also be covered in mud, causing a slip-and-fall hazard.
Check for Gas Leaks
Don’t use candles, lanterns, stoves, or lighters unless you are sure that the gas has been turned off and the area is well-ventilated.
Avoid Exhaust Fumes
Only use generators, camping stoves, or charcoal grills outside. Their fumes can be deadly.
Clean Out Saturated Items Completely

If cans of food got wet in the flood, their surfaces may be covered with mud or otherwise contaminated. Thoroughly wash food containers, utensils, and personal items before using.

 

Don’t use appliances or motors that have gotten wet unless they have completely dried. You might have to take some apart to clean debris out of them.

 

Use Waterproof Containers for Important Stuff

Waterproof containers can protect food, personal items, documents, and more.  If your area is at risk for flooding, have the important stuff protected by storing them correctly.

 
Floods are just one of the many natural disasters that can endanger your family and turn your home into a ruin. With planning and some supplies, however, you’ll be able to keep your loved ones safe and healthy.

 

 

Joe Alton, MD

JoeAltonLibrary4

Dr. Alton

Flood and mudslide survival are just some of the new chapters in the 700 page new Third Edition of the Survival Medicine Handbook: The Essential Guide For When Help Is Not On The Way. Get a copy for your survival library!

 

 

 

 

 

 

 

Building an Emergency Medical Bag

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Building your own emergency medical kit is a huge priority and can be some what over whelming. Having first aid supplies for different types of emergencies is important as well. You will want these on hand at home, in you’re vehicle or in a bug out situation.

From a different perspective, most of us have already started our own kits with out even realizing it, especially if you have children. A lot of times it is simply scattered all over the house and needs to be brought together in one bag being easily accessible when it is needed.

You Tuber PreparedMind101 has prepared an updated video of the medical to-go bag he carries. As he puts it, his “Holy crap what just happened bag”. The bag is really nice and seems well constructed. He has invested around $200 into it so far with a few items left to go. (Voodoo Tactical Men’s Universal Medic Bag) He shares the items he has put in there and asks for comments on things he might of missed. (For a list of the items shown in the video, look under the video.)

Whether you are buying a pre made kit or building your own that is tailored for your family, it’s going to cost you a pretty penny. All I have to say about that is “You get what you pay for”.

Building an Emergency Medical Bag

 Listed in the order presented in his video

Cat Tourniquet

Israeli combat bandage

Celox Blood Clotter

Celox A – Syringe Applicator

Bleed Stop Bandages

Cayenne Pepper

Suture Kit

Instant Ice Compresses

Oral IV’s

Emergency Blanket

Povidone Swab Sticks

Burn Cream

Alcohol Pads

Iodine Pads

Antiseptic Wipe

Eye Wash Kit

Hemostats

EMT Shears

Tweezers set

Disposable Skin Stapler and Remover

Halo Chest Seal

Tension Pmeumothorax Kit

Universal Splint

Nitrile Rolled gloves

Oral Airway Devices

Manuka UMF Approved MediHoney

 

 

The post Building an Emergency Medical Bag appeared first on American Preppers Network.

Preparing for the Big One!

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First Aid and Other Supplies You’ll Need When Preparing

Make no mistake about it: The Big One is coming. This isn’t an irrational fear promoted by extreme preppers or the companies that market to them. It is a real fear that is fueled by real science. And, while many preppers are mistaken for people who believe that the Walking Dead could really happen, what we know is that our infrastructures are simply not built to withstand major earthquakes or other disasters.

On the West Coast, for example, Cascadia isn’t a rumor or an urban legend; it is a reality that is no longer a matter of “if” but “when.” And when that quake happens, the roads, the electrical grid, the municipal water supply, internet connectivity–they are all going down. Some experts say that it could take more than a year to simply get the basic necessities back into place. Estimates on life getting back to “normal” (like we take for granted now) say it will take a lot longer than that.

So: while a giant meteor strike or nuclear Armageddon might feel a little far-fetched, for a lot of our readers, the possibility of being cut off is something that must be dealt with. The best way to deal with that reality is to make sure you are prepared.

Experts agree that, at minimum, you should have enough clean water and food supplies on hand to last for six months to a year. You should also make sure that you are stocked up on first aid supplies and other necessities like comfortable and durable clothing, shelter supplies, etc.

If you are new to prepping, this can seem incredibly overwhelming. The good news is, you don’t have to go overboard with your disaster prep right now. We recommend building up your supplies slowly over time. Here is a tip list on how to start preparing for the worst:

1. Water

It is vital that you have enough clean water on hand to get you through at least a few weeks of living once disaster strikes. Remember, this water won’t just be used for drinking. You’ll also use it for cooking, bathing, etc. Collect enough for your entire family, both humans and pets. The simplest way to do this is to buy 1-2 five gallon drums of fresh water every time you go to the grocery store.

You will also want to purchase a portable filter and supplies for making polluted water drinkable. These will come in handy if and when your clean water supplies run dry.

2. Medical Supplies

Those cute little first aid kits that you keep in your bag or your vehicle are great for minimal needs, but you’ll want to step that kit up a few notches for your emergency supply. You are most likely going to want to stock up on disinfectant supplies and sterile bandages. After that, you’ll also want to keep basic sewing supplies and gauze in your kit, creating a small surgical kit of sorts. And, of course, this is a good place to store some extra matches–in addition to sterilizing instruments; fire can also cauterize deep wounds.

With all of this in mind, you might want to spring for a course on some basic medical training that you can use in the field. Sign up for first aid and CPR classes. Make sure you know what to do when you can’t call an ambulance, as being able to reach emergency personnel will be out of the question.

 

3. Food

Focus on non-perishables that don’t require cooking in order to be edible. Canned beans,  dried fruits and veggies, are a just a few examples. Add a few family sized cans to your cart every time you go grocery shopping to build up your supplies. There are some great checklists available that detail the types of food you’ll most want to have in case of emergency.

 

 

4. Shelter

You will want to be sure that you are sheltered from the elements in the event of an emergency. You don’t necessarily need to have an expensive or expansive tent, but a tent that can shelter your family and can be easily assembled and disassembled is recommended. Be sure to practice putting up and taking down the tent a few times to ensure that you know what you’re doing. Taking a wilderness survival skills course that will teach you how to build shelters “from scratch,” how to tell good plants from bad, how to make snares to catch small pretty, etc. will only further increase your chance of survival.

The main reason to do all of this, of course, isn’t to be the King of the Mountain once disaster strikes, but to simply survive long enough to have normalcy return. Having supplies on hand and knowing how to use them will help you stay calm in an emergency. Your calming presence, more than anything else, will help you keep you and your family alive in scary and dire situations.

The post Preparing for the Big One! appeared first on American Preppers Network.

Survival Medicine Hour: Animal Bites, Bears, Economic Forecaster Gerald Celente

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animalbite1

In this episode of the Survival Medicine Hour with Joe Alton, MD and Amy Alton, ARNP (aka Dr. Bones and Nurse Amy), we discuss animal bites, how to avoid them and what to do if someone gets bitten. Plus, what to do if you encounter a bear on that hike in the woods, or even rummaging through your trash. Special guest Gerald Celente, famous for forecasting economic events and trends, joins the Altons to share some troubling news about the world’s economy and how the U.S. might be in for some tough times ahead.

gerald celente

Gerald Celente

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2016/07/17/survival-medicine-hour-animal-bites-bears-gerald-celente-on-economic-collapse

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

Joe and Amy Alton

AmyandJoePodcast400x200

The Altons

Can’t bear to be without medical supplies in times of trouble? Check out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net, #1 Top Supplier at survivaltop50.c0m!

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Cheap Medical and Prepping Supplies

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Cheap Medical and Prepping Supplies

ThePatriotNurse shares with us how she shops for her medical prepping supplies, Wonder Woman and a few other things you may not have considered.  She walks us through Costo and shows us some of their best deals to get your medical supplies stored up fast. I have to say, she definitely makes shopping fun.

Medical supplies are very important to have in case of an emergency or bug out/in circumstance. Medicine can mean the difference when it comes to preventing or treating infection, fever, cough, acid reflux etc. Preventing a cough, allergies or vomiting can also mean not giving away your location should you need to remain quiet.

Medical training is also a very important thing to consider working towards. After all, what good are medical supplies if you don’t know how to use them?

Hope you enjoy ThePatriotNurse and shopping with her bubbly personality.

 

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The post Cheap Medical and Prepping Supplies appeared first on American Preppers Network.

What Is The Government Preparing For?

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Survival World News

UN Vehicle - Jeff Stern

By Michael Snyder – The Economic Collapse Blog

You may not be getting prepared for a major national disaster, but the government sure is.  I have been informed that in recent months numerous emergency food companies have been contacted by the government, and they have been told that their inventories could potentially be seized in the event of a significant emergency.  And as you will see below, the government recently participated in an exercise that simulated “an unprecedented global food crisis lasting as long as a decade”.  In addition, NPR has just revealed details about the very secretive Strategic National Stockpile program that is storing billions of dollars worth of medical supplies in warehouses around the nation.  This is a program that most Americans do not even know exists.  On top of everything else, strange reports of military vehicles with UN markings have been coming in from all over the…

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Filed under: News/ Current Events, Prepping

Survival Medicine Hour: Zika Death, Reporters and Prepper Events, More

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Disasters happen, whether reporters believe it or not

The U.S, records its first Zika death in an elderly man from Puerto Rico, where 700 cases have been confirmed and thousands more suspected. The mainland U.S. hasn’t been immune either: 93 cases so far in Florida and 77 in New York (no subtropical climate but still a home for the Aedes mosquito). They explore how politics is infecting the Zika debate over funding, and holding up appropriations for mosquito control just as warm weather is arriving in the U.S, Their new book “The Zika Virus Handbook” is an all-you-need-to-know about Zika virus, and now available at Amazon.com. It’s the only book (far as we can tell) on the subject written by a physician.

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Zika Virus Handbook

The Atlanta Journal Constitution reports that prepper events, like the ones Dr. Bones and Nurse Amy are speaking at as of this writing are in “the business of fear”. If that’s the case, are car insurance salespeople also in the business of fear? How about health insurance plan and Obamacare? Our hosts discuss how insurance takes many forms, and tangible items like food and medical supplies might just be another form of it. Also, is it fear or common sense that drives a small percentage of the population to take measures to be prepared for disasters? Who are the crazy ones, “preppers” or the general population who scramble to the supermarket and empty shelves in a frenzy before a big storm? You decide.

asian-tiger-mosquito

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/2016/05/02/survival-medicine-hour-zika-death-reporters-and-prepper-expos-more

 

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

 

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

JoeAmyPortrait2013

Survival Medicine Hour: New Normal, Zika Handbook, More

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High Resolution Front Cover_6093961

Joe and Amy Alton announce their latest book, “The Zika Virus Handbook“! It’s the first book on everything you need to know about the infection written by an MD. It’s concise at 138 pages, but still way more information than the other books on Amazon. You’ll find out how to identify, prevent, and treat the disease, all about the mosquito that transmits it, and every measure you can take to protect your family. You’ll also hear about what our government is doing about it, plus some alternative theories about why so many cases are occurring on this side of the Atlantic. Zika’s this year’s pandemic, and with warm weather approaching, you should know about it.

Also, are people who prepare for disasters normal? Are “normal” people who don’t prepare for disasters normal? Well, in the New Normal, they might be, but normal sure doesn’t mean “sane”. Dr. Bones and Nurse Amy discuss the difference between “normal” and “sane” and why it’s even more important, given recent events, for people to wake up and get together knowledge and supplies that might help in times of trouble.

cicada

17-year Cicada

Also, it’s time for the 17 year cicadas to come out! Will it be a plague of biblical proportions, and do you have anything to worry about? All this and more on the Survival Medicine Hour with Doom and Bloom’s Joe Alton, MD, and Amy Alton, ARNP.

To lIsten in, click below:

http://www.blogtalkradio.com/survivalmedicine/2016/04/24/survival-medicine-hour-the-new-normal-zika-handbook-more

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

 

Joe and Amy Alton

AmyandJoePodcast400x200

 

VIDEO: Active Shooter Bleeding Control Kit in Action

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cover celox with roller gauze

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

Small Bleeding Control Kit image

Bleeding Control Kit

To watch, click below:

 

 

 

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

 

Amy Alton, ARNP and Joe Alton, MD

Amy Alton Everglades Close up 400 x 600

Amy Alton, ARNP

Video: Active Shooter Bleeding Control Kit, Part 2

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

Small Bleeding Control Kit image

 

To watch, click below:

 

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

 

Amy Alton, ARNP, aka Nurse Amy

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

Survival Medicine Hour: The New 3 R’s, Ear Infections, 5 Second Rule, More

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ear_drum

healthy eardrum

Given the rash of bombings and shooting in recent years, should first aid 101 be taught in schools and should bleeding control kits be placed next to the fire extinguishors in schools, workplaces, and malls? Find out about the new 3 R’s of learning with Joe and Amy Alton, aka Dr. Bones and Nurse Amy. Also, does the 5-second rule really work? Hear what scientists have to say, plus how to deal with ear infections using conventional and natural remedies. All this and more on the latest Survival Medicine Hour with Joe Alton, MD and Amy Alton, ARNP.

active shooter

To listen in, click below:

 

http://www.blogtalkradio.com/survivalmedicine/2016/03/28/survival-medicine-hour-ear-infections-first-aid-in-schools-much-more

 

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

 

Joe and Amy Alton

American Survival Radio

Video: Bleeding Control Kit

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Small Bleeding Control Kit image

In her latest video, Nurse Amy shows off her recently designed Bleeding Control Kit for active shooter or terrorist events. Packaged in highly visible mylar, it’s meant to be kept anywhere there are crowds that might be a tempting target for those who would do us harm. Especially useful for workplaces, schools, malls, arenas, and other locations, but also works for homes or vehicles. See it by clicking the video link below:

 

 

 

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

 

Amy Alton, ARNP
NurseAmyBook

Video: New Way To Sterilize Instruments

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suturingsupinated

                    clean instrument

It’s important to have medical supplies if you’re the family medic for times of trouble, but a lot of these items, once used, must be discarded. Other, more reusable items and improvised bandages must be sterilized or otherwise disinfected. We’ve talked about how to sterilize instruments before, but now an article in the journal Wilderness and Environmental Medicine has proposed a novel new way that might have applications for the survival medic. See the topic discussed and the method (really quite simple) demonstrated in Joe Alton, MD’s latest video…

 

 

 

To watch, click below:

 

 

 

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

 

 

Joe Alton, MD

JoeAltonLibrary4

Survival Medicine Hour: New Sterilization Method, Skin Infections, Ginger

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woundinfection

One big issue in remote locations is the sterilizations of instruments and dressings. Now, the U.S. Army Medical Research Institute for Infectious Disease has tested a new method that claims 100% sterilization using portable items that won’t break the bank. Joe Alton, MD explains the procedure and talks about infections you’ll find in soft tissues as a result of poor disinfecting practices and dirty wounds. Also, Amy Alton, ARNP talks about one of her favorite natural remedies: Ginger. All on the latest Survival Medicine Hour with Dr. Bones and Nurse Amy.

To Listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2016/01/11/survival-medicine-hour-new-methods-of-sterilization-ginger-skin-infections

Nurse-Amy-Ginger

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

 

Joe Alton, MD and Amy Alton, ARNP

joe and amy radio

The Survival Dental Kit

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dentist

Over the years, we have written hundreds of articles on medical preparedness for short or long-term disasters. Many now include medical kits and supplies to add to survival food storage and items for personal protection. Yet, 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.

History tells us that problems with teeth take up a significant portion of the medic’s patient load. In the Vietnam War, medical personnel noted that fully half of those who reported to daily sick call came with dental complaints. In a long-term survival situation, you certainly will find yourself as dentist as well as nurse or doctor.

Anyone who has had to perform a task while simultaneously dealing with a bad toothache can attest to the effect on the amount and quality of work done. If your teeth hurt badly, it’s unlikely that your mind can concentrate on anything other than the pain. Therefore, it only makes sense that you must learn basic dental hygiene, care, and procedures to keep your people at full work efficiency. It could easily be the difference between success and failure in a collapse.

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. You would want it to be easily distinguished from the medical kit.

MasksN95Loop

different masks

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.

We’ve researched dental items that should be in the dental kit of those that would be medically responsible in a long-term survival community. After consulting with a number of preparedness-minded dentists, we have put together what we believe will be a reasonable kit that can handle a number of dental issues. Items that would be practical for  the survival “dentist” include:

• Dental floss, dental picks, toothbrushes, toothpaste or baking soda.

• Dental or orthodontic wax as used for braces. Wax can be used 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 eraser would serve the purpose.

• Cotton pellets, Cotton rolls, Q tips, gauze sponges (cut into small squares).

• Compressed air cans or a bulb syringe for drying up saliva on teeth.

• Commercial temporary filling material, such as Tempanol, Cavit, or Den-temp.

essentialoils2

• Oil of cloves (eugenol), a natural anesthetic. Often found in commercial preparations such as:

-Red Cross Toothache Medicine (85% eugenol)
-Dent’s Toothache Drops (benzocaine in combo with eugenol)

It’s important to know that eugenol might burn the tongue, so be careful when touching anything but teeth with it.

• other oral analgesics like Hurricaine or Orajel (Benzocaine)

• Zinc oxide powder; when mixed with 2 drops of clove oil, it will harden into temporary filling cement.

Here’s a video of the procedure:   https://www.youtube.com/watch?v=I3rTF4c26Po

• 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 can of compressed air may be an alternative.

• An irrigation syringe to flush areas upon which work is being done

• Scalpel #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 questionable areas.

• Spoon excavators. These instruments have a flat circular tip that is used to “excavate” decayed material from demineralized areas of 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.

dental_extraction_forcep

• Extraction forceps. These are like pliers with curved ends. They come in versions specific to upper and lower teeth and, sometimes, left and right.

Although 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 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. It comes a fabric square that can be cut to size and placed directly on the bleeding socket or gum.

chromic catgut

Chromic Catgut Suture

• Sutures: A kit consisting of a needle holder, forceps, scissors, and suture material is helpful for the control of bleeding or to preserve the normal contour of gum tissue. We recommend 4/0 Chromic catgut as it is absorbable. It’s small 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. These antibiotics are discussed in detail in the section dedicated to them in this book.

Just as obtaining knowledge and training on medical issues likely in a disaster is important, the study of dental procedures and practices is essential for the aspiring survival medic.

Joe Alton, MD

JoeAmyPortrait2013

Nurse Amy has expanded her dental preparedness kit to include almost all the items you see in the list above. Check our her dental kit, and many other kits and supplies for survival medical issues, at her store at store.doomandbloom.net.

 

Survival Medicine Hour: Vitals, Dakin’s Solution, Fungal Meds, More

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shutterstock_161673146

Using Dakin’s solution for wound infections

Is ISIS causing an outbreak of the parasite Leishmaniasis by dumping bodies on the street? Plus, are there fungal meds in veterinary medicine that could be used in survival scenarios for humans? Plus, how to treat wound infections with Dakin’s solution and the simple formula that can save your precious supply of antibiotics. All this and a primer on vital signs for the survival medic with Joe Alton, MD and Amy Alton ARNP in the Survival Medicine Hour podcast.

 

To listen in, click below:

 

http://www.blogtalkradio.com/survivalmedicine/2015/12/13/survival-medicine-hour-vital-signs-dakins-solution-fungal-meds-more

 

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

 

Joe and Amy Alton

Gatlinburg Amy View 2015

Nurse Amy

Video: Metronidazole as a Survival Antibiotic

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antibiotics1

Antibiotics will be a key but scarce commodity that could be a major weapon in the survival medic’s arsenal. In this part of our continuing series on antibiotics, Joe Alton, MD,aka Dr. Bones, explores the potential of  Metronidazole (Flagyl, Fish-Zole) for use in austere settings. To watch, click below:

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

 

Joe Alton, MD

tent joe's kids

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

Video: Glue as a Wound Closure Method, Part 2

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dermabond in place

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

 

 

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

 

 

Joe Alton, MD

AuthorJoe

 

 

Video: Glue as a Wound Closure Method, Part 1

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skin glue applied

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

 

 

 

 

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

 

 

Joe Alton, MD

tent joe's kids

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Metronidazole as a Survival Antibiotic

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Antibiotics

Antibiotics are an important part of any medical arsenal in tough times. Many infections easily treated today would possibly be life-threatening in an off-grid survival setting. Indeed, if such a thing occurred, you can bet that these drugs would no longer be produced. There would be a lot of otherwise avoidable deaths due to simple cuts that become infected or dehydration from diarrheal disease. We only have to look at mortality statistics from pre-antibiotic times like the Civil War to know that this is true. More soldiers died then from infectious disease that from bullets or shrapnel.

 

 

This article is part of a series on antibiotics and their use in survival settings. Today we’ll talk about an antibiotic that would be useful to deal with some organisms that can cause a number of major problems. Metronidazole (aquatic equivalent: Fish-Zole) 250mg is an antibiotic in the Nitroimidazole family that is used primarily to treat infections caused by anaerobic bacteria and protozoa.

 
“Anaerobes” are bacteria that do not depend on oxygen to live. “Protozoa” have been defined as single-cell organisms with animal-like behavior. Many can propel themselves randomly from place to place by the means of a “flagellum”; a tail-like “hair” they whip around that allows them to move.

 

giardia

Giardia (Protozoal Parasite)

 
The antibiotic Metronidazole works by blocking some of the functions within bacteria and protozoa, thus resulting in their death. It is better known by the U.S. brand name Flagyl and usually comes in 250mg and 500mg tablets. Metronidazole (Fish-Zole) is used in the treatment of these bacterial diseases:

 

 

• Diverticulitis (an intestinal infection seen in older individuals)
• Peritonitis (an inflammation of the abdominal lining due to a ruptured appendix, ruptured cysts, and other causes)
• Certain pneumonias (lung infections)
• Diabetic foot ulcer infections
• Meningitis ( an infection of the spinal cord and brain lining)
• Bone and joint infections
• Colitis due to a bacterial species known as Clostridia (sometimes caused by taking Clindamycin!)
• Endocarditis (a heart infection)
• Bacterial vaginosis (a very common vaginal infection)
• Pelvic inflammatory disease (an infection in women which can lead to abscesses, often in combination with other antibiotics)
• Uterine infections (especially after childbirth and miscarriage)
• Dental infections (sometimes in combination with amoxicillin)
• H. pylori infections (a bacteria that causes peptic ulcers)
• Some skin infections

 
And those are just the bacterial infections that metronidazole can deal with. It also works with these protozoal infections:

 
• Amoebiasis: dysentery caused by Entamoeba species (contaminated water/food)
• Giardiasis: infection of the small intestine caused by Giardia Species (contaminated water/food)
• Trichomoniasis: vaginal infection caused by parasite which can be sexually transmitted

 
Amoebiasis and Giardiasis can be caught from drinking what appears to be the purest mountain stream water, and these infections are seen right here in the Great Smoky Mountains and elsewhere. Never fail to sterilize all water, regardless of the source, before drinking it.

 
Metronidazole is used in different dosages to treat different illnesses. You’ll find detailed information in our book “The Survival Medicine Handbook” and in other standard medical references such as the Physician’s Desk Reference. You’ll also find this information at drugs.com or rxlist.com.

 
Here are the dosages and frequency of administration for several common indications:

 
• Amoebic dysentery: 750 mg orally 3 times daily for 5-10 days. For children, give 35 to 50 mg/kg/day orally in 3 divided doses for 10 days (no more than adult dosage, of course, regardless of weight).

 
• Anaerobic infections (various): 7.5 mg/kg orally every 6 hours not to exceed 4 grams daily.

 
• Clostridia infections: 250-500 mg orally 4 times daily or 500-750 orally 3 times daily.

 
• Giardia: 250 mg orally three times daily for 5 days. For children give 15 mg/kg/day orally in 3 divided doses (no more than adult dosage regardless of weight).

 
• Helicobacter pylori (ulcer disease): 500-750mg twice daily for several days in combination with other drugs like Prilosec (Omeprazole).

 
• Pelvic inflammatory disease (PID): 500 mg orally twice daily for 14 days in combination with other drugs, perhaps doxycycline or azithromycin.

 
• Bacterial Vaginosis: 500mg twice daily for 7 days.

 
• Vaginal Trichomoniasis: 2 g single dose (4 500mg tablets at once) or 1 g twice total.

 
All drugs have the potential for side effects, also known as adverse reactions. These are different from allergies, where your body actually mounts an immune response to a drug, such as in a penicillin allergy.

 
One particular side effect has to do with alcohol: drinking alcohol while on Metronidazole will very likely make you vomit.

 

Metronidazole should not be used in pregnancy. but can be used in those allergic to Penicillin.

 
Having antibiotics will give you an additional tool in the medical woodshed that just might, one day, save a life. They’re not toys, however, and should only be used when absolutely necessary.

 

Joe Alton, MD

joe bleachLearn more about antibiotics and their use in survival settings in our book “The Survival Medicine Handbook“, with over 250 5-star reviews on Amazon.

Skin Glue in Survival

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laceration2

 

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

 

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

 

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

 

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

 

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

 

Benefits of Topical Skin Adhesives

 

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

 

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

 

Indications for skin closure with glue

 

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

 

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

 

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

 

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

 

Comparing skin adhesives to sutures and staples

Sutureneedleholder1

 

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

 

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

 

 

How to use topical skin adhesive glue:

skin glue applied

 

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

 

When you are ready to close the skin:

 

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

 

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

 

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

 

 

What about Super Glue for skin closure?

super glue

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

Joe Alton, MD

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First Aid for Preppers – Part 4: Stings, Bites & Stomach Bugs

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First Aid For Preppers: Stings, Bites & Stomach BugsSo a disaster has struck setting bug-out plans into motion. There’s no place to stay, hotels are full, extended family and friends have been turned out of their homes leaving everyone on their own to seek out shelter. Left out to the whims of the environment, the humans unfortunately, are on the receiving end of insect bites and stings resulting from the occasional misunderstandings. Other times, we do nothing but sip some unfiltered water or take a few bites of food left out just a little too long.
So what to do when the itching, pain, allergic reactions begin? Or how about when the stomach starts churning sending things up and out every which way? Fortunately, there are things you can do, first aid to alleviate the pains and provide at least a modicum of comfort to the discomforted.

Insect Stings & Bites

ITEMS NEEDED:

Tweezers should be part of any first aid kit and bug out bag

Tweezers should be part of any first aid kit and bug out bag

Tweezers
disinfecting or cleaning solution (alcohol swabs, soap & water or hand sanitizers)
cold pack (or cloth to douse in cool water)
ibuprofen
anti-itch cream
antihistamine
prescription epinephrine injector (EpiPen)

Bees, Wasps & Hornets

Bees infrequently sting (compared to wasps or hornets) and do usually so when overtly bothered or when swarming. A sting is death to bee, so they don’t take stinging lightly. Wasps and hornets are more aggressive and can sting at the drop of a hat. And when they do, they do so repeatedly.

To minimize irritating the latter, stay alert and avoid their nests. Wasps and hornets will build nests under roof overhangs, sheds, garages and on tree limbs. Hornets will also nest underground, in shrubbery and hollow trees. Both are attracted to meats, fruits and sugary foods and drinks which may bring them in contact with people.

What to do if stung:

1) If stung by a bee, the stinger will probably remain stuck in the skin. Remove immediately with fingernails or tweezers. Hornets and wasps will not leave a stinger behind but will inject a protein venom.
2) Use a cold pack to reduce swelling and pain and swelling
3) Administer an oral antihistamine will help alleviate minor allergic reactions.

If the person stung is one of those who are severely allergic to stings (characterized by difficulty breathing, tightness of the chest, swelling of the throat, dizziness) give them a dose of epinephrine delivered most often with an EpiPen auto-injector. A prescription is required for this device.
Seek out medical attention ASAP, as the reactions could return when epinephrine wears off.
EpiPens typically come in twos, so keep a second injector handy and give an antihistamine every 4 to 6 hours.

Ticks and Fleas

If Ticks are Prevalent in our Area you may consider the TickEase Tick Remover For your Bug Out Bag

If Ticks are Prevalent in our Area you may consider the TickEase Tick Remover For your Bug Out Bag

Flea and tick bites can irritate the skin but they can also transmit disease. Typically, these bites will not amount to much beyond slight irritation and redness around the immediate area. Having said that, familiarizing yourself with any illnesses they spread that occur around general region you’re in is worth doing (Lyme disease throughout the Northeastern US and flea transmitted plague in the American Southwest, for example). Avoiding rodent borrows and checking yourself at least twice a day for ticks will go a long way to preventing any problems. If you are bitten:

1) Wash the area around the bite with water and soap or even hand sanitizer
2) If a tick is found attached, grab the tick with a pair of tweezers at skin level and pull straight out, gently.
3)Should a rash develop contact a doctor.

Venomous Spiders

Within in the US there are not many highly poisonous spiders. Most bites are similar to other insect bites, irritating and possibly tender for a few hours. The black widow and brown recluse, however, are two worth watching out for. Reactions to bites from either of these can vary widely, depending on the person and the amount of venom delivered, ranging from mild to severe.

If someone has a more serious reaction than some pain around the site from a black widow bite such as; muscle cramps, intense pain, abdominal and back pain, nausea, vomiting and/or dizziness; seek out medical attention ASAP. Typically, about 90 percent of brown recluse bites will show nothing more than a red spot that heals quickly. But for an unlucky 10%, a bite can develop into an open wound with significant tissue damage that takes 8 weeks to recover.

Initial first aid for both bites involves:

1)Cleaning around the bite area and applying cold to the site
2) Administer an antihistamine to help with itching, while ibuprofen will help with pain.
3) For those exhibiting acute reactions seek out medical attention ASAP and bring the spider with you, if you’re able.

Bites from these spiders are rarely life-threatening.

Animal Bites

Venomous Snakes

Snake BIte Kits are Handy and contain antiseptic wipes and suction cups for withdrawing venom

Snake Bite Kits are Handy and contain antiseptic wipes and suction cups for withdrawing venom

From copperheads to cottonmouths to rattlesnakes, venomous snakes range across the US. Most bites occur when people wander, unwittingly, too close. At least rattlesnakes will give a bit of a warning before striking and you will know when you’re bitten. Depending on the species the symptoms include;

  • Redness and swelling around the area of the bite which will likely spread
  • Severe pain at the site
  • Nausea and vomiting
  • Labored breathing (in extreme cases, breathing may stop altogether)
  • Disturbed vision
  • Increased salivation and sweating
  • Numbness or tingling around face and/or limbs

A snake bite will require medical attention and the faster a victim can reach a hospital the better. Try to remember the type of snake it was or at the very least its coloration and shape to help doctors identify the species.

In the intervening time provide first aid:

1) Keep the victim still and calm. A slower heart rate will slow the circulation of the venom.
2) Remove or loosen any restrictive clothing or jewelry before swelling cuts off circulation.
3) Keep the bite area and/or limb below the level of the heart. Do not elevate as you would with other types of wounds.
4) Wash the site with soap and water
5) Cover the wound with a dry, loose dressing

According to the CDC do not do any of the following:

  • Do not pick up the snake or try to trap it.
  • Do not wait for symptoms to appear if bitten, seek immediate medical attention.
  • Do not apply a tourniquet.
  • Do not slash the wound with a knife.
  • Do not suck out the venom.
  • Do not apply ice or immerse the wound in water.
  • Do not drink alcohol as a painkiller.
  • Do not drink caffeinated beverages.

Mammals

Bites from mammals can range from a barely-breaks-the-surface, playful bite from your cat to a full blown gash from an animal attacking or trying to defend itself. Apply first aid to the latter as you would with any other, paying specific attention to cleaning out the wound, itself.

1) Apply pressure to stop the bleeding.
2) Thoroughly wash and clean the wound immediately with soap and water. This is very important as animal bites are prone to infection.
3) Rinse clean and generously apply antibacterial ointment before covering with sterile dressings. Do NOT try to suture the wound closed as this could foster infection.
4) Seek medical attention ASAP for any wound worse than a superficial scratch given the risk of infection.

Take special note of the animal. If it is/was acting noticeably strange, staggering, circling, appeared disoriented or was convulsing tell medical personnel as it may be an indication of rabies. Treatments are very effective if started promptly.

Gastrointestinal Illness

Gastrointestinal (GI) illnesses are caused by a host of bacteria, viruses and parasites. They all cause distress along the gastrointestinal tract, that is the stomach on down (hence the name). This distress tends to cause either diarrhea, nausea or vomiting and for the unlucky person, all of the above. These illnesses spread easily, infecting a lot of people quickly. Given the general range of symptoms and mode of transmission, there are universal steps to follow to curtail their spread and help provide comfort to those dealing with the symptoms.

Stopping Transmission

Hand washing is perhaps the best defense against these stomach bugs. Wash with hot water and soap scrubbing for at least 30 seconds, working fingertips and under nails.
Use latex-type gloves when caring for ill people and handling any of their waste.
Clean countertops and other surfaces with bleach-water solution or other commercial bleach-based cleaners.
Spread doesn’t always stop when symptoms do. A person recovering from norovirus, for instance, will continue shedding the virus for up to 2 weeks after symptoms have dissipated.

Treating for Diarrhea and Vomiting

1) Give as much fluid as the patient will tolerate to prevent dehydration.
2) Avoid caffeinated beverages.
3) Offer fluids with electrolytes (Gatorade, for example).
4) Try giving the patient easily digestible foods like crackers, oatmeal, rice, toast. Avoid fatty foods and dairy products.
5) If vomiting worsens, blood shows up in stool or if a fever starts, find a doctor.

If you and your family have been forced to bug-out, camping in the wilderness and have to drink natural sources of water, you can prevent contracting this type of illness by filtering water and boiling it before drinking. Taking those two steps will kill off virtually any organism that could cause a problem.

 

If you missed the previous article in this series, check out First Aid Part 1: Blisters, Burns & Nasty Wounds, First Aid Part 2: Sprains & Broken Bones & First Aid Part 3: Shock, Heatstroke & Hypothermia and get all the information on how to be prepared to administer successful first aid in any situation.

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First Aid for Preppers – Part 3: Shock, Heatstroke & Hypothermia

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First Aid for Preppers - Shock, Heatstroke & HypothermiaWhen a disaster drives us from the shelter of our homes, forced to bug-out in a hurry the family is subjected to the elements whatever they may hold in store. In the middle of summer, marching out with hefty packs strapped to their backs the situation is ripe for someone succumbing to heat exhaustion or heatstroke. Winter conditions present problems from the opposite end of the spectrum, exposing anyone without shelter to freezing temperatures, temperatures of which an unprepared body may not be able to cope. Laid atop these worries and the possibility of injury is the specter of shock anyone can fall victim to spurred by any given body jarring event. As concerning these problem may be, knowing how to provide first aid within those critical moments can make the difference between life and death.

In this, the third in US Preppers’ four part First Aid series, we will delve into recognizing the signs and symptoms of traumatic shock, heatstroke, hypothermia and frostbite and how to provide initial treatment and care to those afflicted by these conditions.

First Aid for Shock

ITEMS NEEDED:
Blankets
extra clothing or sleeping bag
an object to prop up legs

Assume shock will occur with any traumatic injury, after significant blood loss, may accompany heatstroke or potentially any other body jarring incident. Shock occurs when there is not sufficient blood circulating throughout the body. It can cause organ shutdown and heart failure. If untreated, this can lead to permanent organ damage or even death.
Be aware of the signs of shock include:

  • Cool, clammy skin
  • Pale appearance
  • Rapid pulse and/or breathing
  • Nausea and possibly vomiting
  • Dilated pupils
  • Weakness, lightheadedness or fainting spells
  • Behavioral changes with increased anxiety or agitation, confusion

After any traumatic injury or if any of these symptoms are present take the following precautions to guard against shock:
1) Lay the victim down and raise their legs above the level of the heart. In this position, the legs do not need to be raised very high. Prop the up on a couple of pillows or another person’s lap. This will improve blood flow to the brain and the body’s core. (Do not attempt if there is a head, neck, torso, hip or leg injury)
2) Loosen tight or restrictive clothing.
3) Keep the victim warm by covering them with a blanket or extra clothing and do not move them unless there is imminent danger.
4) If the victim is vomiting or bleeding from their mouth turn them on their side. If injuries prevent this turn the person’s head and take measures to ensure they do not choke.
5) Provide first aid to obvious injuries.
6) Seek out medical attention as soon as possible.

Should you find yourself alone in such a situation, treat yourself for shock by following the same steps. Elevate your legs above the heart or position yourself at a decline (downhill). Keep warm by covering yourself in a blanket or crawling into a sleeping bag.

***Always assume shock is a threat and take precautions to prevent its onset***

Heatstroke and Hypothermia

MSR E-Wing 2 Person Minimalist Shelter

An Emergency Shelter could offer shade from heat, or shelter from cold to help treat Heatstroke or Hypothermia

Heatstroke (or hyperthermia) and hypothermia occupy opposite ends of the spectrum but deserve equal precaution and attention. Both are instances of a body unable to regulate a stable temperate, either unable to cool down or warm up, most likely caused by outside conditions.

Heatstroke

ITEMS NEEDED:

Cool water
cloth to douse
ice packs (optional)
shaded or air conditioned area
nonalcoholic, non-caffinated drinks

Heatstroke occurs when your body temperature rises to abnormally high levels and it’s unable to cool down. The condition usually occurs due to overexertion while not taking in enough fluids or being in an overheated environment for too long. The elderly frequently become victims of heatstroke during summer months in a residence with no air conditioning. All too often people exerting themselves in hot temperatures ignore the initial signs until it becomes life-threatening with the potential to cause damage to the brain and vital organs. These signs and symptoms of this form of hyperthermia are:

  • Sudden dizziness
  • confusion
  • irritability
  • slurred speech or mumbling after an extended period in a hot environment
  • Hot, dry skin or lack of sweating
  • Flushed skin
  • Rapid pulse
  • Rapid breathing
  • Headache
  • Muscle cramps
  • Nausea and vomiting
  • Fainting (possibly the first sign in older adults)
  • Fever of 104 F or greater

Seek out medical attention if the more serious symptoms manifest, if the person does not respond to first aid measures or symptoms worsen. The focus of first aid efforts is to cool the person down in any possible way. In any case begin first aid immediately;

1) Get the person out of the heat, into the shade or into an air conditioned area.
2) Remove unnecessary clothing.
3) Sponge with cool water.
4) Fan while misting with cool water.
5) Place ice packs or cool wet towels on the neck, armpits and groin.
6) Cover with cool damp sheets.
7) If the person is conscious and able to, allow them to drink nonalcoholic, non-caffeinated fluids (approximately 32 fl oz (1 L) to 64 fl oz (2 L) over 1 to 2 hours)

DO NOT immerse the victim in cold, ice water.

Guard against the onset of heatstroke by staying aware of your surroundings, to the temperature, to the physical exertion you and your family are subjected to. Drink plenty of water while avoiding alcoholic and caffeinated fluids due to their dehydrating qualities. Watch one another for symptoms of exhaustion and heatstroke.

An Emergency Blanket can help with Shock and Hypothermia

An Emergency Blanket can help with Shock and Hypothermia

Hypothermia

ITEMS NEEDED:
Warm dry shelter
dry coverings (blanket, sleeping bag, extra clothing)
nonalcoholic, non-caffeinated drinks (if person is conscious)

When a person’s body is unable to produce sufficient heat to counter heat loss, hypothermia will set in at varying levels of severity. An elderly person or infant child left in a cold room overnight can develop mild hypothermia. As hypothermia worsens pronounced symptoms present themselves:

  • Shivering, (a sign that the person’s heat regulation system is still working) but may stop as hypothermia worsens
  • Slow, shallow breathing
  • Slurred speech or mumbling
  • Fumbling hands or stumbling, general loss of coordination
  • Confusion and memory loss
  • A slow or weak pulse
  • With severe hypothermia, a person may be unconscious without obvious signs of breathing or a pulse
  • Watch infants for cold-to-touch skin, bright red appearance and unusually low energy

With the onset of these symptoms begin providing first aid to the victim(s):
1)Help the person to a warm, dry place. The nearest place may be a tent or other temporary shelter.
2)Remove any wet clothing and replace with dry clothes, blankets or into a sleeping bag.
3)Offer warm, nonalcoholic, non-caffeinated fluids if the person is able to drink.

If there is no shelter available and you’re exposed to the elements locate a place out of the winds. Build a fire to warm the person and yourself. If a sleeping bag and tarp is available, zip the person into the sleeping bag and wrap the tarp around them to help reduce heat loss.

Frostbite

ITEMS NEEDED:
Warm dry shelter
warm water or other warm heat source
dry sterile dressing
gauze pads or cotton balls

Typically occurring in the extremities (fingers, toes) as well as ears, noses and cheeks, the skin first becomes very cold and red, then numb, and finally hard and pale when tissue has frozen. While there is little first aid for the latter, there are actions to take before freezing sets in and the person can receive medical care;
1) Retreat to a warm place and remove any wet clothing
2) Avoid walking on frostbitten feet or toes.
3) Only attempt to warm the affected areas if you are able to keep them warm. Re-cooling and re-warming may cause further damage.
4) Use warm (not hot) water to warm the afflicted area or with an alternate heat source until the skin appears red and warm. Another option is to hold the problem area to your body and breath on it through cupped hands.
Do not expose to direct heat from heating pads, radiator, or fires.
Do not try to rub or massage the affected area or break blisters.
5) Using loosely wrapped, dry sterile dressing, bandage the area. Place gauze or other sterile dressing between toes or fingers to keep the separated.

Take these lessons, familiarize yourself with the steps provided, include the family in their practice and stow them away in a safe place to refer to when problems strike. Then keep an eye open for the fourth and final installment in our First Aid for Preppers series when we’ll look into insect and animal bites along with those stomach bugs that cause so many problems at the worst possible times.

Check out our selection of emergency essentials, or catch up on Part 1 and Part 2 of the First Aid for Preppers series.

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