Tourniquets to control bleeding has been in use for centuries, sometimes praised and sometimes reviled as a tool of the devil. Painful lessons learned in Iraq and Afghanistan, however, lead us to believe that they save lives that would otherwise be lost to hemorrhage. In civilian life, the rapid and effective use of a tourniquet by those at the scene gives valuable time for emergency medical personnel to arrive. In survival settings, it doesn’t take a rocket scientist to know having tourniquets in your medical kit is not a bad idea.
For years, the Committee on Tactical Combat Casualty Care (CoTCCC) has approved a small number of commercially available tourniquets, which I’m sure many of you have in your medical kits: They include the combat application tourniquet or CAT and the special operation forces tourniquet SOF-T.
These are the tourniquets you’ll find in our medical kits. We also add the non-TCCC SWAT tourniquet as a secondary tourniquet in many of them, mostly due to its versatility to also function as a pressure dressing and splint stabilizer.
Now, the TCCC committee has widened the range of options acceptable for the effective control of bleeding. One of their additions is the SAM-XT (pictured at top of page), produced by the venerable Dr. Sam Scheinberg of SAM medical. SAM is well-known for producing malleable splints useful for a number of orthopedic injuries, and now their tourniquet is considered acceptable for even military use…
The Altons at Doom and Bloom Medical have up an article on Kissing Bugs and Chagas Disease. While I was aware of Chagas Disease and its insect spreader from my wife’s time living in Bolivia, I was unaware that the beetle and disease were now present in the US. People can live with Chagas for many years and only start having problems from it later in life.
Recently, my good friend Jack Spirko of the Survival Podcast asked me to produce a special report on Kissing Bugs. No, not kissing bugs, as in how to kiss bugs; I mean THE kissing bug, an invasive species from south of the border that is now found as far north as Pennsylvania and Illinois.
The insect in question is Triatoma sanguisuga. It’s called the kissing bug because it tends to bite human and animal victims around the mouth, although sometimes it might target the eyes or other mucous membranes.
It’s bad enough to have to deal with the redness, itching, and swelling that goes along with insect bites, but there’s more: When the kissing bug sucks your blood, it defecates (poops) on your skin. irritated victims tend to rub the poop into the bite wound while scratching the itchy areas. In kids, a swollen eyelid on one side, also called “Romana’s sign”, is a possible sign of infection.
Even worse, In the excrement lives a parasite called Trypanosoma cruzi that lodges itself in heart, intestine, and elsewhere and causes something called Chagas disease. Most people only experience minor symptoms. But a percentage of victims may develop:
- Diarrhea and vomiting
- Enlargement of the liver or spleen
- An increased chance of having a stroke
- An enlarged heart
- Irregular heartbeats that can be fatal
Chagas disease is not transmitted from person-to-person or through casual contact with infected people or animals. It can be spread, however, by infected blood products or from mother to baby during pregnancy. Rarely, an extreme allergic reaction known as anaphylaxis can occur…
Dr. Alton at Doom and Bloom Medicine has a short article and video dealing with Tactical Combat Casualty Care.
You may have heard me reference something called “TCCC” in previous articles, podcasts, or videos. TCCC, sometimes called T3C or T triple C, is a term that means Tactical Combat Casualty Care. It represents the recommendations with regards to prehospital care of soldiers who have incurred traumatic injuries on the battlefield. Established in the mid-1990s, TCCC guidelines have become so widely accepted that many law enforcement and civilian medical personnel have adopted them.
And well they should. These protocols were developed at the cost of painful lessons in the field in Iraq and Afghanistan. It is thought that there were 1000 preventable deaths in these conflicts. If you add civilian injuries during the same time period, the number of preventable deaths might number in the hundreds of thousands. The TCCC’s primary goals is to save lives, prevent additional casualties, and, in true military fashion, complete the mission…In survival settings, you can’t duplicate the care given at a field hospital or a trauma center. Your final outcomes won’t always be happy. You might, however, use some of the methods in MARCH/PAWS to possibly save the life of those who would otherwise die during or in the aftermath of a disaster…
The Altons at Doom and Bloom Medical have an article up about Which Antibiotics to Have in Survival Settings. This material is covered in detail in their new book about antibiotics, but they have made a brief summary in this article.
…If a disaster throws you off the grid, your risk of traumatic injury increases but also that of infection. When someone thinks of an infectious disease event, they envision a deadly epidemic. Any catastrophe, however, can increase the number of people with infections. When I say “catastrophe”, I’m not talking losing power from a storm for three days; I’m talking about a true long-term survival scenario.
In these horrific events, dirty wounds, contaminated water, poorly prepared food, and inadequate sanitation will turn previously healthy people into desperately sick ones. With antibiotics in your medical storage, you have a good shot of nipping those infections in the bud. Not having them could lead to tragic consequences.
One of the most frequent questions I receive from readers, listeners, and viewers is which antibiotics to have on hand in survival settings. I have received a flurry of these lately in response to our new book “Alton’s Antibiotics and Infectious Disease”: The Layman’s Guide To Available Antibacterials in Austere Settings. In the book, I discuss, well, antibiotics and infectious disease: The infections to be expected in those knocked off the gird and the antibiotics obtainable by the average citizen that help prevent otherwise avoidable deaths.
(NOTE: I don’t sell antibiotics nor own any part of a company that does.)
Certainly, it would be great if you had the financial resources to have all of the medications we talk about in Alton’s Antibiotics and Infectious Disease, but that’s beyond the means of almost everyone. You’ll probably need to pick a limited number to stockpile, but which? Chances are, if you lined up 10 doctors, you’d get 10 different answers.
Your choices would depend on the infections you’re most likely to encounter. Is it wound infections you’re concerned about, or intestinal infections like dysentery or cholera? Does someone in your group have a medical condition that makes them prone to a certain infection? Certainly, one drug doesn’t cure all.
Without knowing your individual situation, I can’t give you specifics. I can, however, still give you my personal recommendation of a few antibiotics available in aquarium and avian form that would be assets in my survival medicine cabinet…
The Altons at Doom and Bloom Medical have an article up about the dangers of hypothermia and how to treat and avoid it. Twenty-five percent of deaths in blizzard conditions are due to hypothermia (the majority are from traffic accidents.) Locally, March has been a bit colder and snowier than usual, so it’s good to keep these dangers in mind. Below is only a brief excerpt. Please read the entire article.
When March comes along, you might think that Spring has sprung. But old man Winter isn’t done with us yet. Although the month of March may exit like a lamb, it often enters like a lion. The Midwest and Northeast can attest to this fact from cold temperatures and heavy snows just in the last few days.
Even in March, winter storms (this one is named “Scott”) occur every year in the United States; Scott brought a foot of snow to some areas. Extreme weather can cause fatalities among the unprepared. In blizzard conditions, 70% of deaths occur due to traffic accidents and 25% from hypothermia from being caught outside during the blizzard.
The key word is “outside”. If a blizzard knocks you off the grid as Scott did to 60,000 people, you might be tempted to travel to someplace warmer, but that’s how most deaths occur from winter storms.
This winter has already seen deadly cold snaps where people have found themselves at the mercy of the elements. Whether it’s on a wilderness hike or stranded in a car on a snow-covered highway, the physical effects of exposure to cold (also called “hypothermia”) can be life-threatening…
If you encounter a person who is unconscious, confused, or lethargic in cold weather, assume they are hypothermic until proven otherwise. Immediate action must be taken to reverse the ill effects.
Important measures to take are:
Get the person out of the cold. Move them into a warm, dry area as soon as possible. If you’re unable to move the person out of the cold, be sure to place a barrier between them, the wind, and the cold ground.
Monitor breathing. A person with severe hypothermia may be unconscious. Verify that they are breathing and check for a pulse. Begin CPR if necessary.
Take off wet clothing. If the person is wearing wet clothing, remove gently. Cover the victim with layers of dry blankets, including the head, but leave the face clear.
Share body heat. To warm the person’s body, remove your clothing and lie next to the person, making skin-to-skin contact. Then cover both of your bodies with blankets. Some people may cringe at this controversial notion, but it’s important to remember that you are trying to save a life. Gentle massage or rubbing may be helpful. Avoid being too vigorous.
Give warm oral fluids, but only if your victim is awake and alert. If so, provide a warm, nonalcoholic, non-caffeinated beverage to help warm the body. Coffee’s out, but how about some warm apple cider?
Use warm, dry compresses. Use a first-aid warm compress (a fluid-filled bag that warms up when squeezed), hand warmers wrapped in a towel, or a makeshift compress of warm, not hot, water in a plastic bottle.
These go in special places: the neck, armpit, and groin. Due to major blood vessels that run close to the skin in these areas, heat will more efficiently travel to the body core. Others areas you might warm include the hands and feet, but avoid applying direct heat to amy area. Don’t use hot water, a heating pad, or a heating lamp directly on the victim. The extreme heat can damage the skin, cause strain on the heart, or even lead to cardiac arrest…
There is much more in the article. Click here to read the whole article at Doomandbloom.net.
The Altons at Doom and Bloom Medical have another good article up — this time on what you do when you need to transport a patient and there is no ambulance: Patient Transport in Austere Settings. The article discusses stabilization as well as many different field-expedient stretcher/transport options.
In normal times, your main goal upon encountering an injured or ill person is to transport them to a modern medical facility as soon as possible. In cases where there is a risk of spinal or neck trauma, you will read that the victim should not be moved until emergency personnel arrive.
That’s all well and good in situations when the ambulance is just a few minutes away, but what about when you’ve been knocked off the grid due to a disaster?
Even in normal times, there are circumstances where a victim must be moved despite the risk. These mostly involve common sense judgements, such as when there is an immediate danger from, say, a building on fire or in danger of collapse.
When help is not on the way, however, you will have to decide whether your patient can or cannot be treated for their problem at their present location. If they cannot, you must consider how to move the victim safely.
Before deciding whether to transport, a patient must be stabilized as much as possible. This means assuring open airways, controlling bleeding, splinting orthopedic injuries, treating hypothermia, and more. If you are unable to do this with the materials at hand, consider having a group member get the supplies needed to make transport safer. If possible, gather a team to assist you before you move the victim. Knowing the amount of help available allows you to choose a method of evacuation that will cause the least trauma to both patient and medic.
MOVING THE VICTIM ONTO THE STRETCHER
When moving a trauma patient, you should be concerned about the possibility of a spinal injury, especially if there is:
• Head or neck trauma
• Altered mental status
• Pain in the head or neck
• Weakness, numbness, or paralysis in the extremities
• Loss of bladder control
A person with a possible spinal injury should be “logrolled” onto a stretcher as a unit without bending their neck or back if at all possible. A cervical collar and supportive blocks with straps can be used to secure the spine of at-risk patients. An unstable neck, especially in an unconscious victim, could easily be traumatized even if not involved in the original trauma. Keep the head in alignment with the spine during transport.
If you have several helpers, transporting the patient is easier but requires coordination. You, as medic, will serve as leader of the transport team. This entails making sure the patient is transferred to the stretcher safely, but also that all team members lift and move at the same time. Simple “Prepare to Lift”, “Lift”, and “March” commands should suffice to get everyone on the same page…
Nurse Amy and Dr. Alton of Doom and Bloom Medicine have the third part of a series on Deadly Viruses up at the website. This installment goes into detail about influenza, the virus that kills around half a million people each year.
During a typical flu season, up to 500,000 people worldwide will die from the illness, according to the World Health Organization (WHO). In the U.S., it’s usually about 30,000, mostly among the very elderly or immune-compromised. But occasionally, when a new strain emerges, a pandemic results with a faster spread of disease and, often, higher mortality rates. Last year, 80,000 U.S. residents failed to recover from the flu.
The deadliest flu pandemic, sometimes called the Spanish flu, began in 1918 and sickened up to 40 percent of the world’s population, killing an estimated 50-100 million people. Indeed, it was a factor in bringing about the end of World War I.
Could such a flu pandemic happen again? If a true long-term disaster scenario occurs, we’ll be thrown, medically, back to that era, so it’s possible. Despite this, many don’t take measures to prevent it.
Infectious disease is of major concern in good times or bad, and the family medic must be able to identify some of the deadliest. Having just written a book about infectious diseases and the antibiotics that treat them (Alton’s Antibiotics and Infectious Disease: The Layman’s Guide to Available Antibacterials in Austere Settings), we’ve done our research on some of the worst illnesses that can occur even in countries with advanced medical systems.
There are infections out there, however, that are often fatal and can’t be treated with antibiotics. These are usually viral in nature. Last time, we talked about HIV, hemorrhagic fevers like Ebola and its relatives, plus the rodent-borne Hantavirus.
In this part of our series on deadly viruses, we’ll go over a few well-known diseases, but also cover some that you may not have heard about.
The World Health Organization reports that this virus kills more than half a million children annually worldwide. They even believe that every child on the planet has been infected at least once with it. You get it by ingesting bad food and water or touching surfaces contaminated with infected feces…
And if you missed it, click here for Part 1.
The Altons, authors of the Doom and Bloom Survival Medicine Handbook, have released a new book, Alton’s Antibiotics and Infectious Disease: The Layman’s Guide to Available Antibacterials in Austere Settings. Their Survival Medicine Handbook has been reviewed 477 times on Amazon with an average rating of 4.7 out of 5 and was well-reviewed elsewhere, too.
…We decided to educate the family medic about how to identify various infectious diseases and the medicines that cure them and their veterinary “equivalents”. We did this over the years in articles, videos, and podcasts.
Now, all the information we’ve accumulated is in one book: “Alton’s Antibiotics and Infectious Disease: The Layman’s Guide to Available Antibiotics in Austere Settings”
In “Alton’s Antibiotics and Infectious Disease”, we discuss:
- How bacteria cause disease
- How the immune system works to fight infection
- Many different disease-causing organisms
- Telling bacterial vs. viral disease
- Common infectious diseases
- Epidemic and pandemic diseases
- How antibiotics work
- Different antibiotic families
- How to use antibiotics wisely
- Issues with antibiotic resistance
- Individual antibiotics and the diseases each one treats
- Dosing, side effects, allergies, pregnancy and pediatric considerations
- Expiration Dates
- Establishing an epidemic sick room
- Dealing with wound infections
- Wound care
- Supplies for the effective austere medic
- Much more
A non-medical person having antibiotics on hand in disaster settings is considered controversial by the conventional medical wisdom, and for good reason. Yet, if there is no ambulance coming to render aid or hospital to treat the sick, you may become the end of the line with regards to the well-being of loved ones. Just as learning how to stop bleeding is important, learning about infection and the medicines that treat it will save lives in difficult times…
The supplies section of the book includes lists of contents for various medical kits: individual first aid kit (IFAK), family kit, dental tray, natural remedy supplies, up to and including a field hospital.
Combined with chronic malnutrition, the report also points to the scale of the collapse of the country’s health system, with practically every major health condition ranging from tuberculosis to malaria reaching crisis levels. For example, the number of malaria cases has risen from 36,000 in 2009 to 406,000 in 2017, while 87 percent of HIV patients now do not receive their necessary drugs…Most of these conditions are going untreated, mainly due to a lack of necessary medical resources and trained specialists.
Dr. Alton and Nurse Amy from Doom and Bloom have put out a video on how to conduct a neuro exam.
The medic for a survival group needs to be able to stop a wound from bleeding and splint an ankle sprain. For a long-term situation, however, a caregiver needs to know how to perform exams that would identify other medical issues. Here’s Joe Alton MD giving you a demonstration of a simple exam of the nervous system that would tip you off to a number of problems.
Dr. Alton at Doom and Bloom Survival Medicine has a post up on Human Waste Disposal Off the Grid, talking about the danger of infectious diseases when the grid and/or utilities are down. If you are in the Cascade Subduction Zone total destruction area, this is relevant for you. It’s also relevant to anyone else who may be subject to a grid-down scenario.