Stuck Pig Medical: Partisan Life Saver Course, Oct 21-23

Learning TCCC at Fairchild AFB

Stuck Pig Medical will be offering its Partisan Life Saver course in Spokane, WA on October 21-23, 2022. Stuck Pig Medical usually offers its courses at the Brushbeater training site in North Carolina, so it is rare to have one out here in Washington. Sign up and pay for the class through the Stuck Pig Medical store part of their website – CLICK HERE. If you’re really serious about some medical training, you can join the second tier of Stuck Pig Medical’s Patreon and have access to twice-weekly, live-streamed, medical classes of one to two hours in length for a cost of about $15 per month. Sign up early before all of the spots are gone.

Partisan Life Saver: $600
A three-day course that is the next step up from the TCCC course. The TCCC course is not a prereq for this. Covers everything that is covered in the basic course, but goes more in-depth on the subject. This is a wet course, which means fake blood is used, bring clothing that you don’t mind being potentially stained.

Topics covered:
*Why TCCC is important
*How to treat battlefield/trauma wounds
*What interventions should you get
*How to pack an IFAK
*How to make things to practice with

Everything is provided for the class, if there is something specific you want to try out, feel free to bring it to class.

If you order an IFAK or Bleeder Kit in conjunction with this, put in the notes if you want it shipped to you, or if you would rather just pick up the kit(s) when you show up for class.

The Human Path Herbal First Aid Course, June-Aug 2022

The Human Path is offering an online Herbal First Aid course beginning June 13, 2002 and running through August 15th.

This module can be taken as a bundle with the Wilderness First Aid Certification, or separately!

Using plant medicine in the field is our trademark and our specialty. Add an additional 8 hours of training to your certification by learning about and showing proficiency using herbs in the field. Learn the essentials of first aid care while also introducing fundamental plant-medicine concepts that apply to austere or post-disaster environments.

Herbal medicine offers extremely effective approaches to acute illnesses in post disaster situations, offering relief to physical ailments while also supporting mental and body system health.

**This module will include herbal Field materials students will use to demonstrate understanding of preparations in remote environments.

Herbal First Aid subjects include:

-Fundamental herbal care concepts

– the necessary shift in thinking

-Wound Care and Infection Management using herbs

-Injury, shock, pain and herbs

-Respiratory herbal first response

-Gastrointestinal herbal first response

-Urinary herbal first response

-Planning, preparing and administering herbs

To pay with cash, checks, Venmo, or money orders send us an email here:

You can review our tuition policies here: https://herbalmedics.academy/about-us/tuition-policies

This tuition rate is for the Herbal First Aid Module ONLY.

Regular Tuition: $125 (Online processing fees apply)

Check/Venmo/Money Order Rate: $125 (No processing fees)

Cash Rate: $115

Doom and Bloom Medical: Bleeding Wound Management, Part. I

The Altons at Doom and Bloom Medical have part one of an article on bleeding wound management.

In a destabilized society, traumatic wounds may be commonplace is scenarios where there is a desperate population and no rule of law. Even routine activities of daily survival may cause injuries that could become life-threatening. Therefore, the family or group medic must always be prepared to deal with bleeding wounds. Some of these, especially those in the abdomen and chest, are likely to be fatal without advanced medical care. In this article, let’s commemorate National Stop The Bleed Month (I’m a certified instructor through the American College of Surgeons) by concentrating on those hemorrhages that are survivable.

Cuts in the skin can be minor or catastrophic, superficial or deep, clean or infected. Significant cuts (also called “lacerations”) penetrate both layers of the skin (dermis and epidermis) and are associated with bleeding, the amount of which depends on the blood vessels disrupted. Knowing how to manage hemorrhagic wounds quickly and effectively will be of paramount importance for the survival medic.

In studies of casualties in recent wars, 50 percent of those killed in action died of blood loss. 25 percent died within the first “golden hour” after being wounded. The golden hour is the time after which a victim’s chance of survival diminishes significantly if untreated, with a threefold increase in death rate for every 30 minutes without care thereafter.

If there is active bleeding and the wrong artery is severed, however, it could take just a few minutes for a person to “bleed out” and be beyond medical help. A severed femoral artery can lose more than a pint of blood a minute. With hemorrhage, the reality should, perhaps, be called the “platinum five minutes” instead.

Venous bleeding manifests as dark red blood that drains steadily from the wound, while arterial bleeding is bright red (due to higher oxygen content) and comes out in spurts that correspond to the pulse of the patient. As the vein and artery usually run together, a serious laceration can have both.

Once below the level of the skin, large blood vessels, muscles, and nerves may be involved. You’ll identify more problems with vessel and nerve damage in deep lacerations and crush injuries. In any case, bleeding control must be achieved.

In response to fatalities due to bleeding in recent military conflicts, the U.S. instituted Tactical Combat Casualty Care (TCCC) guidelines. It is thought that up to one in five deaths from hemorrhage in the field may be prevented with quick action by those at the scene. Civilian and law enforcement authorities have established similar strategies in response to the hard lessons learned by our soldiers; so should the family medic.

BLOOD BASICS

It’s worthwhile for the medic who may be dealing with bleeding wounds to know some basics about blood. Blood is a specialized fluid that comprises about 7-8 percent of a person’s total weight. It’s involved in:

•             Delivering oxygen to the body from the lungs and eliminating carbon dioxide (a process called “gas exchange”).

•             Forming clots that stop hemorrhages.

•             Transporting substances that fight infections and disease.

•             Delivering waste products to the kidneys and liver.

•             Helping to regulate body temperature.

There are four main components to blood:

Red blood cells (RBCs): RBCs are the cells that carry oxygen to body tissues, thanks to a special iron-containing protein called “hemoglobin.” Red cells account for 40-45 percent of total blood volume. They start as immature cells in the bone marrow that mature and are released into the bloodstream. The average lifespan of a red blood cell is about 120 days.

White blood cells (WBCs): These cells account for only about one percent of total blood volume, but are extremely important for fighting infection and disease.  There are several types, including short-lived cells deployed for immediate response and longer-lived ones that regulate the function of immune cells, make antibodies, and directly attack infected cells and tumors.

Platelets and other clotting factors: These are small cell fragments that allow bleeding to stop by gathering at the wound site and helping to form a clot. Like RBCs and WBCs, they originate in the bone marrow.

Plasma: A yellow liquid that transports all of the above throughout the body.

Together, these components are referred to as “whole blood.”

PHYSICAL EFFECTS OF BLOOD LOSS

Evaluating blood loss is an important aspect of dealing with wounds. An average size human adult has about 10 pints (4.73 liters or 4730 ml) of blood. The effect on the body caused by blood loss varies with the amount incurred. The American College of Surgeons recognizes four classes of acute hemorrhage, along with expected signs and symptoms:

Class I:  Hemorrhage is less or equal to 15 percent of blood volume (1.5 pints/750 ml) in an average adult male. 750 ml is the amount in a bottle of wine. A person donating 1 pint of blood is giving slightly less than 500 ml. At this level there are almost no signs or symptoms, although some may have a slightly rapid pulse and feel vaguely faint or anxious.

Class II:  Hemorrhage is 15 to 30% loss of total blood volume (1.5-3 pints/750-1500 ml).  The body’s efforts to compensate for less red blood cells at this point results in a faster heartbeat and breathing rate to speed oxygen to tissues.  This patient will appear pale and skin will be cool.  They’ll feel shaky, weak, and anxious. Blood pressure remains, for now, within normal range. Urine production begins to slow down in order to retain fluid volume.

Class III: Hemorrhage is 30 to 40% loss of blood (3-4 pints/1500-2000 ml).  At this point, the heart will be beating very quickly and breathing very fast as the body encounters difficulty getting enough oxygen to tissues.  Blood pressure drops. Smaller blood vessels in extremities constrict to keep the body core circulation going. This patient will be confused, pale, and in hypovolemic (low blood volume) shock. Urine decreases significantly. In normal times, blood transfusion is usually necessary. 

Class IV:  Hemorrhage is more than 40% of total blood volume (greater than 4 pints/2000 ml). The heart can no longer maintain blood pressure and circulation.  All parameters are well outside normal range and the patient becomes lethargic due to lack of oxygen and circulation to the brain. Without major resuscitative help at this point, organs like the kidneys fail. The patient loses consciousness. Heart rate and respiration slows and eventually ceases as the patient dies.

ABCDE VS. CABDE

The traditional initial field assessment of a victim usually involves the acronym ABCDE. Although ABCDE may mean different things to different people, one interpretation goes as follows…(continues)

Bleyhl Workshops, March – April 2022

Bleyhl co-op has several workshops coming up for the rest of March and early April.

Doom and Bloom: Active Shooters In The New Norm

The Altons at Doom and Bloom Medical write about Active Shooters in the New Norm and training and first aid for the same.

On March 23rd, 2021, a man thought to be mentally disturbed entered a Boulder, Colorado grocery store and began a shooting rampage. 21-year-old Al Aliwi Alissa, born in Syria but living in the United States since the age of three, managed to kill 10 people, including a police officer, before disrobing and surrendering to authorities. It’s thought that the gunman has a long history of anger issues and may have paranoid tendencies.

The shooting follows an incident where another 21-year-old killed 8 people in Georgia at local massage parlors, which he saw as a form of temptation for what is described as a “sex addiction.” The recent shootings in diverse settings follow a lull during the 2020 COVID-19 pandemic.

In the last few years, shooting events by the disaffected, disturbed, and disgruntled have occurred on a regular basis.  Schools, churches, places of business, and other public venues are now fair game for those with bad intentions. Armed not only with weapons but with a blueprint from previous incidents, gunmen can identify soft targets easily and are more “successful” in achieving their goal of creating mass casualties.

Like COVID-19, have these events become part of the “New Normal”? Should we just get used to them?

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

The selection of soft targets is becoming a science and is leading to higher numbers of deaths and injuries. In the 2018 South Florida high school shooting, for example, the gunman activated the fire alarm to make sure there would be lots of targets in the hall. To create confusion, he tossed smoke bombs (but prudently wore a gas mask).

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

Improve security in areas at risk. I would define an “area at risk” as just about anywhere where a crowd of people would gather. Better protection at malls or grocery stores may just be a matter of hiring more security personnel. Given the loss of so many jobs during the pandemic, it’s not a bad idea to train and hire workers specifically to keep an eye out for those with bad intentions. If the money isn’t there, establishing and training a volunteer safety team in places like churches, schools, or workplaces can increase the level of vigilance and identify threats early.

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

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

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

Identify persons of interest through their social media posts. Some active shooter candidates are vocal about their intentions. You might be concerned about “big brother” monitoring our public conversations on social media. It concerns me also, but you must answer this question:  How many deaths are you willing to accept in your community due to a lack of vigilance?

We must always be on the lookout for signs of trouble. Even if this drives some potential gunmen underground, it might identify others in time to abort their mission.

In the case of Alissa, his sister-in-law felt compelled to take a gun away from him when he was acting erratically. In some states, it is possible for family members or police to ask the court to order the temporary removal of firearms from someone who may present a danger to others or themselves. A judge makes the determination to issue the order based on statements made and actions of the person in question. Controversial? Yes, but it could save lives.

Each municipality must set a mechanism (and an earlier trigger) for the authorities to apprehend and interrogate suspicious characters. Indeed, Ali Aliwi Alissa was a known person of interest to authorities before the attack.

Learn how to stop bleeding in wounds
Learn how to stop bleeding in emergencies

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

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

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

Provide first aid kits for bleeding in public venues. In the last few years, bleeding kits have been packed into fire extinguisher wall cabinets in many public venues and can be accessed by those at the scene. Unfortunately, in most places, there isn’t a sign that indicates their presence. With supplies, the Good Samaritan will be more likely to save a life. I predicted, years ago, that these kits will be fixtures everywhere one day. It’s good that they’re there, but let the public know they are.

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

The above recommendations wouldn’t affect the average (sane) citizen’s right to bear arms. It would mean more situational awareness so that people can be more ready to “Run, Hide, Fight”.  

If it means more surveillance, we should realize how much there is already. Watching people who publicly threaten violence more closely makes sense; so does increasing access to mental health resources to, perhaps, prevent someone from going off the rails.

The New Normal is an angry, dangerous place. The American identity has been replaced by many tribal ones; Most seem to hate each other. It’s a recipe for disaster that’s likely to get worse if we don’t reverse course, but that takes fortitude and determination on the part of all parties.

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

Joe Alton MD

CPR, AED & First Aid Certification Class at Bleyhl’s Grandview, Mar. 24, 2021

Would you like to get certified in CPR, AED & First Aid?
Do you need to renew your current certification? We invite you to join us on Wednesday, March 24th for a training led by Firepoint Training Associates, LLC. We will be offering two classes on Wednesday, please see below for more information.
Cost:
$35
Location:
Bleyhl Co•op Main Office
940 E. Wine Country Rd. Suite A
Grandview, WA 98930
Class:
March 24th
8:30am – English
1:00pm – Spanish
Please contact (509) 492-1281 with questions.

Click here to register

Prolonged Field Care: Medical Support to Resistance

Prolonged Field Care published an article originally from the 2019 Special Warfare magazine on Survivability: Medical Support to Resistance  which discusses “a whole-of society approach to preparing military and civilian medical resources that will build readiness and resiliency… improve casualty mortality rates and enable both resistance members and allied forces to sustain the fight.”

Hope is a primary driver of resistance movements, and the best way to keep hope alive in a resistance movement is to keep people alive. There are many aspects to enhancing survivability of a resistance movement, and medical support is one critical part. Doctrinal military health service support constructs, such as combat support hospitals or forward surgical teams, will be wholly inadequate to support resistance movements in a peer conflict in Europe for the primary reasons that they are overmanned and under trained. This article will discuss a whole-of society approach to preparing military and civilian medical resources that will build readiness and resiliency of our allies or partners, improve casualty mortality rates and enable both resistance members and allied forces to sustain the fight to regain territorial sovereignty against an illegal occupation. Medical infrastructure is vastly different in peacetime Europe than in more austere areas frequented by U.S. Special Operations Forces. Medical evacuations begin with calling 112, the European 911 equivalent, ambulances arrive to provide pre-hospital care, sometimes with physicians onboard, the patient is transported to a trauma center, and medical care is generally comparable to U.S. standards. If peer conflict occurs again in Europe, medical infrastructure will be severely degraded and significant obstacles to medical support will immediately arise, especially regarding extremely prolonged evacuation times and scarce resource availability. The U.S. military has not faced as severe a challenge to provide medical support since World War II. The SOF medical community has been bracing for the regression of medical support in emerging conflicts since at least November 2017 when U.S Army COL (Ret.) Dr. Warner “Rocky” Farr published The Death of the Golden Hour and the Return of the Future Guerrilla Hospital; yet the existential threat facing Eastern Europe poses the worst case scenario for medical support to resistance. The restricted mobility for friendly forces in territory occupied by a peer adversary will severely limit external medical support to U.S. SOF and our allied partners, including the resistance. The isolation of U.S. and allied forces in a denied environment will by necessity convert the delivery of medical care from a linear progression of medical evacuations from point of injury to higher echelons of care outside the combat zone, to a cyclical progression of evacuation, treatment, convalescence and return to duty, all completely within occupied territory.

A resistance scenario in Europe presents a unique risk to U.S. SOF supporting resistance movements, as organic capabilities will not be able to provide required medical support in this tactical environment. Recent exercises have demonstrated that U.S. SOF surgical teams will be severely restrained and may not be survivable in a denied environment, and conventional medical forces will likewise be absent. U.S. SOF medics are highly capable within their scope of practice, but over-inflation of their ability results in commanders miscalculating risk; a medic’s ability to reduce serious risk is often predicated on access to definitive care. The Maquis in occupied France and Partisans of Yugoslavia faced similar challenges in World War II but were still able to provide medical support despite great odds. The relevance of these historical precedents might be limited, however, by exponential advances in technology over the last 75 years. Providing medical support to U.S. SOF and resistance forces will be immensely challenging, but there is one great advantage over historical precedence: there is time and space now to enable ourselves and our allies and partners to be prepared to provide medical support to resistance prior to conflict, instead of reacting after a violation of a country’s national sovereignty.

BACKGROUND

In early 2018, SOCEUR conducted a multinational SOF exercise focused on irregular warfare and resistance in the Baltic region of Eastern Europe. Key medical lessons learned from the exercise were that medical evacuation in restricted areas during peer conflict is incredibly challenging, and U.S. SOF surgical teams as currently configured and trained will have low, if any, chance of survival in occupied territory. It was evident that planning medical support solely using only a U.S. military doctrinal construct was impractical and ineffective; civilian medical resources were identified as, and will necessarily be, the center of gravity for medical support to resistance. Resistance doctrine was turned to as a possible solution to the way ahead, but existing doctrine was found to be largely inadequate for the range of potential operational environments in future conflicts against a peer adversary in Eastern Europe. The focus of U.S. resistance doctrine on unconventional warfare and resistance movements assumes that conflicts have already begun or are ongoing. Furthermore, reverse engineering resistance constructs prior to conflict is difficult because it is impossible to forecast who and what will survive the initial invasion. The whole-of-society approach advocated by the Resistance Operating Concept was embraced as a potential solution for addressing critical gaps in providing medical support to resistance.

WHOLE-OF-SOCIETY APPROACH TO MEDICAL SUPPORT FOR RESISTANCE

The SOCEUR Surgeon’s Office has developed a whole-of-society approach to enable medical support to resistance (Figure 01) as a tiered approach to improve trauma care from point of injury through surgical intervention, convalescence and return to duty. Additionally, it aims to increase medical interoperability with Allies and partners in preparation for a resistance scenario in Eastern Europe.

U.S. SOF MEDICINE

The core of this approach begins with increased readiness for U.S. SOF. If peer conflict in Eastern Europe occurs, U.S. SOF medics will be required to treat casualties on extended timelines with limited supplies. Proficiency in Prolonged Field Care improves the SOF medic’s ability to do this, but is dependent on the medic’s ability to transfer casualties to higher echelons of care for definitive treatment or required convalescence. SOF surgical teams may be part of the solution, but will require manning changes and additional training in order to improve survivability in peer-adversary occupied territory.

Previously, the SOCEUR Surgeon’s office developed and conducted a course in UW medicine for surgical teams. This training was conducted as a proof of concept in Fall 2017, and was subsequently turned over to U.S. Army Special Operations Command with a request to further develop UW training for SOF surgical teams. Currently, the SOCEUR Surgeon’s office is continuing to develop Trojan Footprint as an opportunity for U.S. SOF medical units to practice UW medical tactics and techniques in a major exercise. The command is developing training opportunities for U.S. SOF medics and surgical teams to work in partner-nation trauma centers in Eastern Europe. This aims to achieve multiple objectives including enhanced interoperability of U.S. medical personnel and potential partners, information sharing regarding medical materiel and techniques and potentially to raise standards of trauma care as best practices are shared between allies and partners. The strong relationships that would be created by this course of action would be mutually beneficial. These types of training opportunities may be expanded beyond U.S. SOF to other U.S. military medical personnel, further increasing interoperability and alliance building. SOCEUR is also assisting USSOCOM to define the Special Operations Forces Baseline Interoperability Standards for medics and surgical teams. These efforts attempt to link SOF medical requirements to National Defense Strategy priorities in order to develop the force for the future, and not simply to fight the last battle. Finally, current U.S. SOF doctrine on medical support to resistance appears to have gaps in Eastern Europe’s potential operational environment, especially with regard to preparing Allies and partners to conduct resistance prior to conflict. Working with USASOC’s medical teams will help develop future iterations of doctrine in order to prepare U.S. SOF for best success in an extremely challenging environment… (continues)

Click here to download a PDF version of the article.

Urban Survival Network: Nine Important Survival Antibiotics Every Prepper Should Know

Urban Survival Network has an piece on Nine Important Survival Antibiotics Every Prepper Should Know. Someone recently quipped that there are two stages to serious gut infections: Stage One you wonder is you’re going to die, and Stage Two you wish you would die. My wife, who spent some days hospitalized because of such while in the Peace Corps, confirmed the truth of this witticism. Questionable meat/food and bad water, staples of a disaster situation as well as remote third world villages, can lead to just such circumstances. In good times, the doctor and antibiotics may only be a miserable, embarrassing few hours drive away, but in a disaster…

It often happens that preppers overlook antibiotics as a part of their preps, but these wonder meds can actually turn out to be life savers. Effective and easy to use, survival antibiotics will certainly come in handy post collapse and when you’re having to deal with an infection. To be completely honest with you, I had been blissfully unaware of the many types of antibiotics that existed until not too long ago when I developed an infectious colitis in my colon. I didn’t know about the condition until I was in excruciating pain and I went to see my doctor. This infection was triggered by a bacterial infection, and one of the causes may have been through the consumption of uncooked meat.

The situation was life-threatening and it was something I could no longer ignore – this is where antibiotics stepped in and literally saved my life. For no less than 10 days I took a cocktail of two different antibiotics (Metronidazole and Ciprofloxacin) and in less than two weeks I was back on track. I do not even want to think about what could have happened to me if I didn’t take the antibiotics. Now just put yourself in my shoes – what if you were confronted with a similar situation and were in urgent need of medication? This is why stocking up on survival antibiotics could be a serious matter.

In this article you will find the top 9 most efficient and most widely used survival antibiotics, but before we move on to describing each type it is important to understand that I am not a doctor and I am not entitled to give any medical advice. If you want professional and competent advice, I strongly recommend you to consult your doctor as he/she is the only one who can give you the details you need.

Also, it is important to understand that one should never take antibiotics for a simple cold, a small fever or a slight pain – these medications are aimed exclusively at bacterial infections and they should be taken only in case of emergency, and only when your doctor tells you to. If you take antibiotics on a constant basis, you will become immune to them and their efficiency will be decreased in the long term, which means that you will have a hard time trying to treat bacterial infections in the future.

Like any other type of medication, antibiotics may trigger some side effects – if you notice a rash, then you might be allergic to a compound in the antibiotic, and you must stop taking the medication and consult your doctor immediately. Also, the meds must be taken for as long as recommended by your doctor, even though you may feel better after only a couple of days – this does not necessarily mean you have overcome the infection completely!

In a nutshell, there is a wide range of antibiotics available on the market and they come in many different sizes, shapes and strengths. The following antibiotics can treat most bacterial infections, and for further information on antibiotics, their uses and their mechanism of action I strongly recommend you to read some medical books (many of them are available in PDF format as well). Having said that, here are (in my opinion) the top 9 most efficient survival antibiotics:

1. Cephalexyn
Cephalexyn is currently one of the most commonly used antibiotics for respiratory infections of all kind, mainly pneumonia and severe bronchitis. At the same time, doctors prescribe Cephalexyn to treat middle ear infections as well. This survival antibiotic comes with few adverse reactions and what’s most important is that it can be safely used by children as well as by pregnant women.

2. Amoxicilin
Amoxicilin has almost the same mechanism of action as Cephalexyn, keeping in mind that it is aimed at respiratory infections and it deals with the same types of bacteria. Children and pregnant women can safely take Amoxicilin to treat bacterial infections, although this survival antibiotic can trigger serious allergic reactions. If you notice any of the signs that indicate an allergic reaction, stop taking Amoxicilin and get in touch with your doctor immediately.

3. Ciprofloxacin
Ciprofloxacin can be considered an all-purpose survival antibiotic, given the fact that it can treat a wealth of infections, from infections of the prostate and the urinary tract to bronchitis, pneumonia, bacterial diarrhea and even the infectious colitis I was talking about at the beginning of the article. However, it must be mentioned that Ciprofloxacin must never be used by pregnant women and children at all costs!

4. Metronidazole
Metronidazole is widely used for the treatment of anaerobic bacteria and it is commonly used in conjunction with other survival antibiotics to treat colitis, diverticulitis and other infections of the intestines. Moreover, it is also very good for the treatment of meningitis, lung and bone infections as well as for the treatment of bacterial vaginosis. Nursing or pregnant women and children should avoid taking Metronidazole.

5. Sulfamethoxazole And Trimethoprim
This is a combination of powerful antibiotics that are especially created for urinary tract infections and respiratory infections. At the same time, this antibiotic cocktail is highly efficient against staphylococcus aureus that is resistant to Methicillin – a very strong strain of staph .

6. Ampicilin
Ampicilin is certainly one of the most popular survival drugs at the moment, because it carries a very low allergy risk and it is aimed at treating different infections like gastrointestinal infections, bacterial meningitis, infections of the respiratory tract and even the feared Anthrax.

7. Azithromycin
Azythromycin is not exactly the cheapest survival antibiotic on the market, but it is a very versatile and effective medication as it treats Syphilis, Typhoid, Chlamydia, Lyme disease and a wealth of respiratory tract infections. It has some side effects like nausea and diarrhea but they are rare, therefore it is generally safe to use.

8. Erythromycin
Erythromycin treats the well-known Lyme disease, Chlamydia, Syphilis and various infections of the respiratory system and middle ear. Nonetheless, it must be mentioned that Erythromycin can trigger several unpleasant side effects, from diarrhea and vomiting to nausea and severe abdominal pain. Even so, it is still great to have this survival antibiotic around, just in case!

9. Doxycycline
Doxycycline has the same effects as Erythromycin. Doxycycline can treat some dangerous illnesses such as Malaria or Typhus. This antibiotic must never be used by pregnant/nursing women or children. You’ll also need to drink a lot of water while on Doxycycline. This Antibiotic can be found as “Fish Cycline”, and although not intended for humans, it can still be used with little issue (unless of course expired).

Conclusion
To sum it up, you don’t need to have all 9 survival antibiotics when you travel – you only need two or three types that cover the widest variety of infections, just to stay on the safe side. They should be kept in the refrigerator to expand their lifespan (without freezing them, as this affects their efficacy). These antibiotics are cost-effective and they can save your life or the life of somebody dear to your heart, so make sure you do not neglect them! It is better to have them and not need them, than to need them and not to find them at a looted/plundered drug store.

Raconteur Report Reminds “Tourniquets Work”

From Aesop at Raconteur Report, Medical Tip: Tourniquets Work reminds you to get tourniquet training if you don’t have it already.

One of the local constabularies recently encountered Nameless Crazy Person with butcher knife in hand, agitated and in a stabby mood. Despite repeated commands, NCP refused to drop knife, and/or broke the containment bubble, whereupon officer plugged NCP. Unknown number of rounds fired, but two connected.
One to each arm. (-25 points for lousy marksmanship at knifefighting – which is knifefight dying – distance. Bonus points for unintended humanitarian efforts.)
One nicked the right outer bicep. Literally, a flesh wound. Rub some dirt on it (or, in this case, a wad of 4x4s) and walk it off. No harm, no foul.
Other round: in the stabby knife-wielding arm, 9mm or 40SW pellet entered the upraised left arm proximal to the inner elbow, and travelled along the near-horizontal upper arm, and exited just below the left armpit (axilla for medical types).
Neither round close to anything obviously vital, except…
 
Round #2, during its journey through the meaty bicep area, must obviously have punctured/torn/lacerated the L brachial artery, i.e. the one what all the blood from Mr. Heart travels in to arrive in the rest of Mr. Arm.
Result: a steady blurp-blurp-blurp of bright red blood, all over the ground.
To his everlasting credit, Constable quickly applied first an Israeli Battle Dressing to the arm of the now knifeless suspect, to whom the application of lead had reduced his crazy efforts noticeably. Which IBD application slowed the blurp-blurp nary a whit.
So, reverting to academy-standard (nowadays) training, he whipped out his CAT Tourniquet, and lashed that sucker down just like in training videos, and turned off the blurp-blurp in about 6 twists of the windlass, despite the pained response from NCP.
Medics brought NCP to our world, where our trauma nurse and trauma doc were certain that applying a TQ was waaaaaay overkill, but “Bless their hearts for doing too much instead of too little”. So, they untwisted that TQ, and were immediately rewarded with blurp-blurp-blurp of bright red arterial blood, again.
I twisted the TQ back on and tightened it, and we sent NCP directly to trauma surgery for vascular repair, so that he could continue to be crazy with two functioning arms.
And I told the paramedics and the PD officer responsible for the TQ that they’d saved an actual life with that thing, because NCP would have died at the scene in about two minutes if they hadn’t tourniquetted off the flow of arterial blood from a “mere” arm wound. Which not only saved his life, it prevented about two trees-worth of resultant officer-involved homicide paperwork.
TL;DR:
Put the effing TQ on if the bleeding doesn’t stop with pressure, and make it holy by cranking the hell out of it.
 
You needn’t carry four TQs on your body, but you have four limbs, so if you like them, and you enjoy living, you’d be well-advised to have four TQs somewhere close by, like kit/pack/bag, etc.
Not at home in your medicine cabinet 20 miles away.
When you need one (or, God forbid, more than one) it will be Right Effing NOW, and not “in twenty minutes or so”.
If you’d rather ignore that advice: Suture self.
FTR, trauma literature based on medical trauma data from Sandbox I and Sandbox II have documented applications of as long as 4 hours before removal in surgery with no residual harm of any kind to extremities as a result of the TQ application, in young, otherwise-healthy, military-aged troops. YMMV, but they are not in any way “sacrificing a limb to save a life”, anytime in the last 20 years. If you’re within that time span for arrival at definitive medical care, and it’s medically justified, it’s better to slap one on than watch your patient exsanguinate and die.
And now, refresher training for those who wish it:

“This sh*t works!” – everyone who’s ever needed one.

Thus endeth the lesson.

 

Practical Self Reliance: How to Make an Herbal Tincture

Ashley Adamant at Practical Self Reliance has another well written and highly useful article with How to Make an Herbal Tincture. As usual, more pictures and instruction through link.

Herbal tinctures are extracts made from medicinal plants, mushrooms, or lichen.  Whether made with alcohol or glycerite, homemade tinctures are a shelf-stable way to preserve the medicinal benefits of herbs for year-round use.  They’re an easy way to always have natural medicine on hand at a moment’s notice.

Homemade Yarrow Tincture (Alcohol extract of yarrow)

Homemade Yarrow Tincture (Alcohol extract of yarrow)

Making your own herbal tinctures is a deeply satisfying feeling, and once made, it’s incredibly comforting to know that you have shelf-stable herbal medicine ready whenever it’s needed.

Essentially, you’re distilling all of the therapeutic properties of any given plant material into a super-concentrated, super-powerful elixir that can be taken for any number of health concerns. Depending on the tincture in question, the benefits range from preventative to immune-boosting to sleep-inducing — all in a dropperful of herbal extract!

What you might not realize about tinctures is how easy they are to make. All you need to get started is your desired plant material, a solvent, and a solid 6 to 8 weeks for the extraction process to complete itself.

What is a Tincture?

A tincture is a concentrated herbal extract prepared with alcohol, a solvent that extracts the active medicinal compounds from alcohol-soluble plant matter. Tinctures are a means to ingest super-condensed herbal extracts for their medicinal properties.

The use of tinctures isn’t a new activity, people from all over the world have been making tinctures for thousands of years.

Today, the tincture market is rich with options. You could purchase a tincture for every ailment you can think of, but the prices are often high — especially when you’re buying multiple tinctures at once.  Usually, tinctures are around $12 to 15 an ounce, but the same medicine can be made for pennies on the dollar.

When you make your own tinctures at home you can choose the best quality ingredients to make a potent tincture, all at a fraction of the price of a store-bought version.

Homemade tinctures are made with minimal equipment, using the leaves, flowers, roots, bark, and flowers of fresh or dried herbs and mushrooms as plant material.

Tincture vs. Herbal Extract

You might notice the term “herbal extract” is sometimes used interchangeably with the word “tincture” when you’re reading up on the topic, but there is a difference between the two classifications.

A tincture is prepared using alcohol as a solvent to extract the desired compounds from plant material. Glycerite tinctures use vegetable glycerin as a solvent, and are generally considered part of the tincture family.

An herbal extract is an umbrella term that refers to plant material extracts made with various types of solvents including, but not limited to, alcohol, oil, honey, and vinegar.

How are Tinctures Used?

Depending on the particular extract you’re using, tinctures are taken orally or applied externally. Tinctures are dosed by the dropperful, and are often dropped directly under the tongue, where they’re absorbed into the bloodstream more quickly.

Different types of tinctures have different recommended dosages and means of ingestion. Bitter tinctures, which are taken to stimulate the appetite and relieve signs of digestive distress, are typically ingested 15 minutes before eating.

Some tinctures, like those made from lemon balm and motherwort, tend to be fast-acting, and are of the soothing variety.

Tinctures mades from adaptogenic and immune-boosting herbs and mushrooms, such as ginseng root or reishi mushrooms, must be taken continuously over a period of several weeks before their therapeutic benefits are apparent.

Not all tinctures are meant to be taken orally. Tinctures prepared with black walnut and yarrow are, among others, applied directly to the skin or mixed in with a carrier oil or basic lotion.

Topically-applied tinctures are used to treat everything from parasitic infection to eczema, and certain types can even be mixed in with misting sprays or face cream to add powerful herbal benefits (and at a fraction of the cost of commercially-made, herb extract-enriched beauty products).

Types of Tinctures

By definition, alcohol-based tinctures are the only “true” tincture, although some resources are laxer about this than others.  Glycerine based or Alcohol-free “tinctures” aren’t technically tinctures, but they’re often referred to by this name since they’re pretty much equivalent in terms of how they’re used.  (Technically, they’re glycerites.)

Some plant materials, such as dried mushrooms, contain high amounts of both alcohol-soluble and water-soluble compounds. When this is the case, the double extraction method is the way to go. It’s an additional step, but an easy one, and you’ll find that the result is definitely worth the (very minimal) extra time it takes.

If you prefer an alcohol-free extract, you can also make a potent glycerite tincture using vegetable glycerin — the method is almost exactly the same as a tincture with alcohol, which I’ll walk you through below.

Are Tinctures Shelf Stable?

Because tinctures are prepared with ethyl alcohol they have a naturally long shelf life. Alcohol drastically slows down natural decomposition and the growth of bacteria, so if properly stored a tincture can last for a couple of years (even longer if the alcohol is 100-proof or higher).

Never use isopropyl alcohol (rubbing alcohol), it’s toxic to ingest and therefore not suitable for making tinctures — although it can be used to make herbal liniments for external use.

All of my tinctures are made using vodka. I like to use Smirnoff because it’s relatively inexpensive, but not so cheap that it’s completely unpalatable.

Some people prefer to make their tinctures with brandy or rum — pretty much any high-test alcohol can be used. Make sure you choose alcohol that’s at least 80-proof (40 percent) for making tinctures or, if you can find it, 100-proof (50 percent) or higher to ensure safe preservation.

Once the tincture is ready to be decanted, I carefully transfer the extract to a dark amber glass bottle with a dropper and store it in a darkened location away from any light or heat sources — no need for refrigeration.

If stored with care, tinctures will maintain their potency for 2 to 3 years (with some higher alcohol preparations lasting up to 5 years).  The Herbal Academy has an excellent guide to the shelf life of herbal preparations, which has much more specific and detailed estimates, depending on how the tincture is prepared.

How to Make a Tincture

The first step when preparing a homemade tincture is to select your plant material.

One question I see regularly is in regards to using fresh or dried herbs, and if one is better than the other. The answer I would give is: there are advantages to choosing either medium!

Depending on where you live, fresh herbs can be found growing wild or in your garden, which makes them readily available. Fresh herbs have a high water content, which means they’re susceptible to spoilage if they aren’t used immediately after being picked. If you’re fortunate enough to have a surplus of fresh herbs, I would recommend drying them for later projects using this guide to preserving herbs.

If you’re making a tincture from dried herbs, you can use herbs you’ve dried yourself or you can buy the best-quality dried herbs. Dried herbs have a maximum shelf life of 2 years, if you aren’t drying the herbs yourself it’s important to find a source with rapid product turnover.

The main mechanism behind tincture-making is the same: put plant material in a jar, cover with alcohol, and let steep for several weeks. However, a little bit of finesse with herb to alcohol ratios will result in the most potent of tinctures.

For a tincture made with fresh leaves and flowers, finely chop or grind clean plant material (the goal is to expose as much surface area as possible). Fill a jar about 3/4 of the way with chopped leaves and flowers — don’t pack the jar too tightly.

Cover the contents of the jar completely with alcohol and seal with a lid.

How to Make Chickweed Tincture

Making chickweed tincture with fresh chickweed

If you’re preparing a tincture using dried leaves and flowers, you’ll want to fill a jar about 1/2 of the way full with dried plant material.  Dried herbs are more concentrated, and they absorb liquid and expand during the extraction process.  If you fill the jar completely full, your yield will be pitifully small (but intensely concentrated).

Cover the contents of the jar completely with alcohol and seal with a lid.

To make a tincture with either fresh or dried bark, berries, and/or roots, finely chop or grind the plant material to expose optimal surface area or to release the juice of berries.  Roots and bark are especially hard to extract, so increasing surface area is important.

Fill the jar 1/3 to 1/2 full with chopped bark, berries, and roots.  These materials tend to be even more concentrated and expand further than dried flowers or leaves.

Cover the contents of the jar completely with alcohol and seal with a lid.

I always use a standard canning jar, but I use a plastic mason jar lid when making tinctures. There are certain tinctures that will, over time, eat through plastic.

Most tinctures need to sit for a period of 6 to 8 weeks before they can be used, during this time the alcohol extracts beneficial alcohol-soluble compounds found in the plant material.

Store developing tinctures in a cool, dry place away from light. Give them a good shake every couple of days, keeping an eye on alcohol levels. If at any point it appears the alcohol level is getting lower, add more to the jar to completely cover the plant material to prevent unwanted mold growth.

When you’re ready to bottle your tincture, it will need to be strained first. The easiest way to do this is to line a funnel with a cheesecloth, placing the tip of the funnel directly into a dark amber glass bottle.

I often skip the cheesecloth and just use a fine mesh strainer, which is usually fine enough for most tinctures.  If you’re making a tincture with particularly fine material, like pine pollen tincture, definitely go with cheesecloth.

How to Make A Tincture without Alcohol

If you’re abstaining from alcohol for any reason you can still make a tincture using a different menstruum. A menstruum is a term that refers to the solvent chosen for making extracts.

Food Grade Vegetable Glycerine has been used as a solvent to make tinctures called glycerites for close to 200 years. It has a syrupy texture and sweet flavor, making it an excellent choice for tinctures that will be ingested by children.

Most recipes for glycerite tinctures are made with 75 percent vegetable glycerin and 25 percent water, resulting in an herbal extract with a shelf life of 14 to 24 months.

You can also use vinegar as a menstruum when preparing an herbal extract — I like to use apple cider vinegar as a solvent because it has the best taste, but almost any kind of vinegar will work. As long as the tincture is made with no less than 5 percent vinegar, it’s generally shelf-stable for a minimum of 6 months (usually longer).

Like alcohol-based solutions, tinctures made with glycerine or vinegar are made by soaking herbs or mushrooms in the menstruum for several weeks to extract therapeutic and medicinal properties.

Common Herbal Tinctures

Tinctures can be made from most types of medicinal plants or mushrooms, but the specific benefits of each herbal extract will depend on the specific herbs used.  Here are a few of the most common types of homemade herbal tinctures, along with their benefits:

Black Walnut Tincture

If you have black walnuts to harvest, a homemade black walnut tincture is a great way to use those otherwise inedible walnut husks that would normally be discarded. Black walnut tinctures are applied topically and are prized for their anti-fungal and anti-parasitic properties thanks to a natural abundance of tannins.

Tinctures made from black walnut husks are a rare source of land-based iodine, making them a good tincture to have on hand for disinfecting wounds and irritated skin.

My post about the benefits of black walnut tincture provides all the instructions you need to make your own potent tincture…

This article continues with additional specific herbal tinctures.

Doom and Bloom: Anemia

The Altons at Doom and Bloom Medical talk about Anemia and how to recognize and deal with it in survival situations.

In survival scenarios, there are plenty of occasions where the medic will encounter a group member suffering from anemia. Anemia is a condition in which you lack enough healthy red blood cells in your circulation. Red blood cells are what make your blood, well, red; their job is to carry oxygen to your body’s tissues and carbon dioxide away. If you don’t have enough of these tiny, disc-shaped cells, it can have major effects on your health.

Red cells primarily consist of a protein made in bone marrow called hemoglobin. In men, anemia is typically defined as a hemoglobin level of less than 13.5 gram/100 ml and in women as hemoglobin of less than 12.0 gram/100 ml.

Anemia happens for different reasons. Survivors in a prolonged disaster setting are unaccustomed to being off the grid, and could easily injure themselves and bleed heavily from a wound. This is the most sudden cause of severe anemia, but it can also occur from lack of production due to malnutrition or medical conditions that destroy red blood cells or shortens their life span (normally, about 115-120 days).

Depending on the cause, signs and symptoms of anemia may vary.  If your patient’s case is mild and they’ve had it for a while, their body may have accommodated to the extent that they might not have symptoms. If they do occur, they might include:

  • Fatigue
  • Weakness
  • Headache
  • Pale or yellowish skin
  • Cold hands and feet
pale inner eyelid seen in anemia

Simple blood tests could identify the problem, but won’t be available off the grid. Just checking under the lower eyelid, however, may reveal a hemoglobin deficiency. Normally, the inside of the eyelid is light red or pink; in anemia, it’s very pale or yellow. Worse cases can cause major symptoms:

  • Irregular or fast heart rates
  • Shortness of breath
  • Dizziness or lightheadedness
  • Chest pain

The worse the anemia, the less productive your group member will be, so it’s important to do everything possible to treat it and increase the hemoglobin level.

Iron deficiency is the most common cause of anemia. It’s often seen in women who are or were recently pregnant.  Heavy periods will also cause iron-deficiency anemia. Treatment usually involves oral supplements like ferrous sulfate or ferrous gluconate. The usual dose is 325 mg (65 mg of elemental iron) three times a day. Some complain of intestinal issues at that dose: dark stools, constipation, nausea, and cramps. This can take a lot out of a person, so consider a lower dose or every other day dosing in those afflicted. Be aware that caffeinated beverages may delay iron absorption, while vitamin C at 500 mg promotes it.

In addition to iron, your body needs folate (vitamin B9) and vitamin B12 to produce enough healthy red blood cells. A diet lacking in these and vitamin C can impair the production of red cells. Some people get enough B12 but can’t absorb it due to an autoimmune reaction, causing a condition called “pernicious anemia”.  Special B12 injections are given for this and other conditions.

Anemia can also be related to inflammation. Certain diseases, such as cancers like leukemia and lymphoma, AIDS, rheumatoid arthritis, kidney disease, Crohn’s disease and other inflammatory ailments can lower production of red blood cells or destroy them. For these, you have to treat the main problem, a major challenge for the off-grid medic.

Another group of anemias are known as “hemolytic” (blood disintegraters). They develop when red blood cells are destroyed faster than bone marrow can replace them. You can inherit a hemolytic anemia, or you can develop it later in life.

Sickle cell anemia (sometimes called “sick-as-hell” anemia) is a type of hemolytic anemia. It’s caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal (sickle) shape instead of a disc. These irregular blood cells die prematurely, resulting in a chronic shortage. Patients, often African Americans, go into what we call “crises” that can be very painful when these abnormally shaped cells clog small blood vessels.

Hemolytic anemias can also be caused by certain drugs, which can cause the immune system to mistake your own red blood cells for foreign substances. The body responds by making antibodies to attack and destroy its own cells. Make sure your healthcare provider knows if you take any of these medicines:

  • Cephalosporins like Keflex
  • Fluoroquinolones like Levaquin
  • Penicillins
  • Nitrofurantoin (Macrodantin) and phenazopyridine (Pyridium; used for bladder infections)
  • Levodopa for Parkinson’s disease
  • Dapsone for skin disease
  • Quinidine for irregular heartbeats
  • Methyldopa for high blood pressure
  • Aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs

Dietary sources of iron may be helpful, so adjust your food storage and survival garden goals accordingly. Eating a diet high in meats, especially red meats, may help. Nonmeat iron sources include:

  • Spinach and other dark green leafy vegetables
  • Peas and certain other legumes like chickpeas
  • Beans
  • Dried fruits, such as prunes, raisins, and apricots

Some foods are Iron-fortified, like certain cereals and breads. Many also have B12 added, as well. Other food sources of B12 are:

  • Meats, such as liver, beef, fish, and poultry
  • Eggs
  • Dairy products

For folic acid:

  • Spinach and other dark green leafy vegetables
  • Black-eyed peas and other dried beans
  • Beef liver
  • Eggs
  • Bananas, oranges, and related fruits and juices

As mentioned earlier, vitamin C is a tool to help absorb iron. Good sources of vitamin C can be found in many fruits as well. Fresh and frozen fruits, vegetables, and juices usually have more vitamin C than canned ones.  Vegetables rich in vitamin C include tomatoes, peppers, broccoli, brussels sprouts, potatoes, and spinach.

Joe Alton MD

Doom and Bloom: The Case for Fish Antibiotics

The Altons at Doom and Bloom Medical talk about The Case for Fish Antibiotics and their viability for human use in emergency cases when there is no medical system to which to resort.

More than a decade ago, I was the first physician to advocate for the storing of antibiotics marketed for tropical fish and pet birds as a potential tool for the medic in long-term survival settings. Although I never recommended them for use in situations where there is a functioning medical infrastructure, I believe, despite criticism, that having a supply of these on hand will save lives, otherwise lost from bacterial infections, in a prolonged off-grid disaster scenario.

Accumulating over-the-counter drugs for the medic’s storage may be a simple enterprise, but not prescription medicines. Even with a sympathetic physician, the ability to obtain the quantity needed to be an effective caregiver for a survival community is limited, at best. Antibiotics are one example of life-saving medications that would be in short supply off the grid.

The inability to have antibiotics at hand may cost some poorly prepared individuals their lives in a survival situation. There will be a much larger incidence of infection when people have to fend for themselves and are injured as a result. Any strenuous activities performed that aren’t routine in normal times can lead to injuries that break the skin. These wounds will, very likely, be dirty. Within a relatively short time, they might begin to show signs of infection in the form of redness, heat, and swelling.

Treatment of such infections at an early stage improves the chance they will heal quickly and completely. However, many rugged individualists are likely to “tough it out” until their condition worsens and the infection spreads to their blood. If the medic has ready access to antibiotics, the problem can be nipped in the bud before a tragic outcome occurs.

Some solutions for medical issues off the grid without medical help, like fish antibiotics, may save lives

The following is contrary to standard medical practice; it’s a strategy that is appropriate only when help is not on the way. If there are modern medical resources available to you, seek them out.

Antibiotic Options

Small quantities of antibiotics can be obtained by anyone willing to tell their doctor that they are going out of the country and would like to avoid “Travelers’ Diarrhea” or other infections common at their destination. Likewise, asking for medications that must be taken early in an infection, like oseltamivir (Tamiflu) for influenza, is a reasonable strategy; after all, not everyone can get in to see their doctor right away, and the antiviral Tamiflu is most effective in the first 48 hours after symptoms begin.

(Note: Tamiflu is an anti-viral and only works against influenza (and not COVID-19. Antibiotics have no effect against viruses at all.)

This approach is fine for one or two courses of therapy, but a long-term alternative is required for the survival caregiver to have enough antibiotics to protect a family or survival group. In the aftermath of a disaster, some deaths may be unavoidable, but bacterial-related deaths are unacceptable. This concern led us to what we believe is a viable option: aquarium and avian antibiotics.

Betta splendens

For many years, we have kept tropical fish in aquaria and tilapia in ponds. We also have parrots as pets. After years of using aquatic medicines on fish and avian medicines on birds, we decided to evaluate these drugs for their potential use off the grid. They seemed to be good candidates: All were widely available, available in different varieties, and didn’t require a medical license or prescription.

A close inspection of a number of these products found exactly one ingredient: the drug itself, identical to those obtained by prescription at the local pharmacy. A bottle labeled aquatic amoxicillin, for example, had as its sole ingredient amoxicillin, which is an antibiotic commonly used in humans. Unless they’re listed on the bottle, there are no additional chemicals to makes your scales shinier or your feathers more colorful.

Any reasonable person might be skeptical about considering the use of aquarium antibiotics for humans, even in disaster settings. Those things are for fish, aren’t they? Yet, a number of them only come in dosages that correspond to pediatric or adult human dosages.

The question became: Why should a one-inch guppy require the same dosage of, say, amoxicillin as a 180-pound adult human? We were told that it was due to the dilution of the drug in water. However, at the time, there were few instructions that tell you how much to put in a ½ gallon fishbowl as opposed to a 200-gallon aquarium (they have them now, however).

Finally, the “acid test” was to look at the pills or capsules themselves. The aquatic or avian drug had to be identical to that found in bottles of the corresponding human medicine. For example, when (in 2010) we opened a bottle of FISH-MOX FORTE 500 mg distributed by Thomas Labs and a bottle of Human Amoxicillin 500mg (DAVA pharmaceuticals), we found:

human amoxicillin by DAVA pharmaceuticals

Human Amoxicillin:         Red and Pink Capsule, with the letters and numbers WC 731 on it.

Fish amoxicillin (the brand is now defunct)

FISH-MOX FORTE: Red and Pink Capsule with the letters and numbers WC 731 on it.

There are still a number of examples today, including:

fish versions of different antibiotics
Appearance of same antibiotics made by human pharmaceutical companies

Logically, then, it makes sense to believe that they are essentially identical, manufactured in the same way that human antibiotics are. Further, it is our opinion that they are probably from the same batches; some go to human pharmacies and some go to veterinary pharmacies or bottling companies. Over the years, readers in the human and veterinary pharmacy fields have confirmed this.

This is not to imply that all antibiotic medications met the criteria. Many cat, dog, and livestock antibiotics contain additives that might cause ill effects on a human being. Look only for those veterinary drugs that have the antibiotic as the sole ingredient.

There has been significant controversy regarding these medicines as some have chosen to use them in normal times against our recommendations, which only apply to long-term survival scenarios. As a result, the original distributor of these drugs, Thomas Labs, eventually stopped production in response to political pressure.  For now, other brands with names like FISH-AID and others have, at the time of this writing, filled the void by offering a number of veterinary equivalents online. Expect volatility in terms of availability as a number of these drugs are placed under increasing government control in the future.

VETERINARY “EQUIVALENTS”

Having antibiotics in quantity will help the medic save lives in survival scenarios

Here is a list of antibiotics that are commercially available in aquatic or avian form as of the writing of this article:

AMOXICILLIN,  (Amoxicillin 250 mg and 500 mg)

AMPICILLIN 500 MG

PENICILLIN 250 mg and 500 mg

CEPHALEXIN 250 mg and 500 mg

METRONIDAZOLE 250 mg and 500 mg

CIPROFLOXACIN 250 mg and 500 mg

CLINDAMYCIN 150 mg

AZITHROMYCIN 250 mg

LEVOFLOXACIN 500 mg

SULFAMETHOXAZOLE/TRIMETHOPRIM 400 mg/80 mg and 800 mg/160 mg

DOXYCYCLINE 100 mg

MINOCYCLINE 50 mg and 100 mg

FLUCONAZOLE (anti-fungal) 100 mg

Most of the above come in lots of 30 to 100 tablets which can be bought in multiples. This makes them eligible for the survival medic to stockpile for prolonged disaster events. As recently as December 2020, we were able to purchase several without a prescription.

Antibiotics are not candy; they must be used judiciously in survival scenarios

Of course, anyone could be allergic to one or another of these antibiotics, but it would be a very rare individual who would be allergic to all of them. It should be noted that there’s a 10% cross-reactivity between Penicillin drugs and cephalexin (Keflex). If you are allergic to penicillin, you could also be allergic to Keflex. For those who can’t take penicillin, there are suitable safe alternatives. Any of the antibiotics below should not cause a reaction in a patient allergic to Penicillin-family drugs:

  • Doxycycline
  • Metronidazole
  • Tetracycline
  • Ciprofloxacin
  • Clindamycin
  • Sulfamethoxazole/Trimethoprim
  • Levofloxacin
  • Minocycline

This one additional fact: We have personally used some (not all) of these antibiotics as veterinary equivalents on our own persons without any ill effects. Whenever we have used them, their effects have been indistinguishable from human antibiotics.

Having said this, we recommend against self-treatment in any circumstance that does not involve the complete long-term loss of access to modern medical care. This is a strategy to save lives in a post-calamity scenario only.

Finding Out More

Although you might think that any antibiotic will work to cure any disease, specific antibiotics are used at specific doses for specific illnesses. The exact dosage of each and every medication in existence for each and every disease is well beyond the scope of this article. It’s important, however, to have as much information as possible about medications that you plan to store.

This information is available in a number of drug reference manuals (with images) in both print and digital form. Online sources such as drugs.com or rxlist.com are other useful sources, but we recommend a hard copy for your medical library in case a disaster affects the internet.

Your manual should list medications that require prescriptions as well as those that do not. Under each medicine, you will find the “indications”, which are the medical conditions that the drug is used for. Also listed will be the dosages, risks, side effects, and even how the medicine works in the body. It’s okay to obtain a book that isn’t the latest edition, as information about common drugs doesn’t often change a great deal from one year to the next. Try to obtain a recent copy, though, as occasional changes do occur.

For those skeptical of our opinion on this topic, we ask you to imagine this circumstance: A disaster has occurred that has knocked you off the grid and sent you on the road. Your family is performing activities of daily survival like chopping wood for fuel, something they’ve never done before. Your son or daughter cuts themselves and, in a day or so, the wound becomes red, hot, and swollen. There may be the beginnings of a fever. You only have a bottle of “fish” amoxicillin. Would you use it? We’ll let you decide.

Joe Alton MD

Doom and Bloom: When a Person Faints

The Altons at Doom and Bloom Medical have an article about what to do When a Person Faints. I once fainted while standing in early morning PT formation in the Army, probably from a combination of low blood sugar and low hydration. Well, I vomited and then fainted, so I hit at least one of the warning signs which the Altons mention. I think I also hit “momentary lack of attention.” After questions from a medic and a drink of water, I was able to continue with PT as usual with no further issues. Anyone can faint, but sometimes more rest is better.

Even 6’4″ military men may experience fainting

We often write about medical strategies when a society collapses, but, sometimes, an individual may collapse as a result of fainting (also called “syncope”). It usually occurs when a drop in blood pressure (“hypotension”) doesn’t allow enough oxygenated blood to reach the brain.

Someone who has fainted must be differentiated from the person who has “seized” from epilepsy. Fainters won’t exhibit jerky movements as in a Grand Mal seizure or stare into space as in a Petit Mal seizure. Also, a person who has had a seizure tends to be difficult to rouse for a period of time. This is called a “post-ictal” state and may last for 30 minutes or so before it resolves on its own. Most people who have only fainted will regain alertness relatively soon after the episode.

(Note: Grand Mal and Petit Mal are no longer used in the latest nomenclature of seizures. They changed the whole system in 2017, but most people still know them by these names.)

There are a few signs that a person is close to fainting:

  • Cold, clammy skin
  • Nausea or vomiting
  • Complaints of feeling lightheaded or weak
  • A sensation of spinning
  • Tunnel vision or blurriness
  • Yawning
  • Slow pulse
  • Momentary lack of attention

(Note: More than once, I’ve had a surgical intern or other assistant faint dead away during a grueling and long surgical procedure.)

Survival scenarios almost guarantee the medic will be confronted with a person who has fainted at one point or another. Simple activities of survival, such as long hikes to retreats, work sessions in hot weather, and hiding out in hot shelters without climate control, can make certain group members prone to syncope. In addition, skipped meals and dehydration will put many of your people at risk.

Low blood sugar and various other medical conditions can cause fainting. Good hydration and appropriate dietary intake will prevent most episodes. Glucose or honey packets, for example, can help raise a person’s blood sugar that has gone dangerously low. Have some in your kit. Others may pass out due to irregular heart rhythms, extreme stress, or even pregnancy.

If someone feels as if they are about to collapse, they should sit down and put their head down between their knees to increase blood flow to the brain. If you see someone who is fainting from a standing position, hold and gently lower them to the ground on their back. In normal times, of course, you would have someone call emergency medical services as soon as possible.

If help isn’t coming, it’s up to you to quickly evaluate the victim. If the patient fell to the floor, there is always the possibility of a head injury. Evaluate for obvious wounds and rule out concussion.

A person who has had a simple fainting spell will usually be breathing normally and have a steady, regular pulse. Raise their legs about 12 inches off the ground and above the level of their heart and head. This position will help increase blood flow to the brain. Assess the patient for evidence of trauma, bleeding, or signs of a seizure. If bleeding, apply direct pressure to the wound. If no pulse or breathing, begin CPR.

(Seizure disorders are discussed on this website here.)

After the first few seconds, you have determined that the victim is breathing, has a pulse, and is not bleeding. Tap on their shoulder (some say to gently shake) and ask in a clear voice “Can you hear me?” or “Are you OK?”. Loosen any constricting clothing and make sure that they are getting lots of fresh air by keeping the area around them clear of crowds. Look for a medical alert bracelet that may give clues as to their health issues. If you are in an area that is hot, fan the patient or carefully carry them to a cooler area. Cool compresses may be helpful.

If you are successful in arousing the patient, ask them if they have any pre-existing medical conditions such as diabetes, heart disease or epilepsy. Stay calm and speak in a reassuring manner. People oftentimes are embarrassed and want to brush off the incident, but be aware they are still at risk for another fall.

Once the victim is awake and alert (Do they know their name? Do they know where they are? What year it is?), you may have the patient sit up slowly if they are not otherwise injured. Don’t let them get up for 15 minutes or so, even if they say that they are fine. If you are not in an austere setting, emergency medical personnel are on the way; wait until they arrive before having the patient stand up. Off the grid, however, you will have to make a judgment as to whether and when the victim is capable of returning to normal activities. A period of observation would be wise.

As dehydration and low blood sugar are possible causes, some oral intake may be helpful during recovery. This is appropriate only if it is clear that they are completely conscious, alert, and able to function. Test their strength by having them raise their knees against the pressure of your hands. If they are weak, they should continue to rest. Close monitoring of the patient will be very important, as some internal injuries may not manifest for hours.

Doom and Bloom: Asthma in Survival

The Altons at Doom and Medical have an article about Asthma in Survival.

Asthma is a chronic condition that limits your ability to breathe. It affects the tubes that transport air to your lungs, collectively known as the “airways”. Asthma affects 20 million Americans and is the most common cause of chronic illness in children. Off the grid, increased stress and exposure to new substances will only makes things worse. The family medic must know how to recognize and treat symptoms with limited supplies.

When people with asthma are exposed to a substance to which they are allergic (an “allergen”), airways become swollen, constricted, and filled with mucus. As a result, air can’t pass through to reach the part of the lungs that absorbs oxygen (the “alveoli”).

During an episode of asthma, you will develop shortness of breath, tightness in your chest, and start to wheeze and cough. This is referred to as an “asthma attack”. In rare situations, the airways can become so constricted that a person could suffocate from lack of air.

Here are common allergens that trigger an asthmatic attack:

  • Pet or wild animal dander
  • Dust or the excrement of dust mites
  • Mold and mildew
  • Smoke
  • Pollen
  • Severe stress
  • Pollutants in the air
  • Some medicines
  • Exercise

Yes, you can trigger an asthmatic attack with exercise. This doesn’t mean you shouldn’t stay in shape. Exercise strengthens lungs, which helps improve asthma control.

There are many other myths associated with asthma; the below are just some:

Asthma is contagious. (False)

You will grow out of it. (False; it might become dormant for a time but you are always at risk for it re-emerging.)

It’s all in your mind. (False; although may trigger it, it’s very real.)

If you move to a new area, your asthma will go away. (False; it may go away for a while, but eventually you will become sensitized to something else and it will likely return.)

Asthma should only be treated when an episode occurs. (False; asthma is best treated with constant medication to reduce frequency and severity of attacks. Encourage your asthmatic group members to stockpile meds.)

You will become addicted to your asthma meds. (False; inhalers and oral asthma drugs aren’t addictive. It’s safe to use them on a regular basis.)

Here’s are two “true” myths: Asthma is, indeed, hereditary. If both parents have asthma, you have a 70% chance of developing it compared to only 6% if neither parent has it. Also, asthma does have the potential to be fatal, especially if you are over 65 years old.

(Note: In the 1980s, I treated a pregnant patient who had the worse type of asthma attack, called “status asthmaticus.” Once she improved somewhat, she insisted on going home against my advice  to care for her other children. She returned that night in an irreversible state of oxygen loss. Both mother and baby perished.)

PHYSICAL SIGNS AND SYMPTOMS OF ASTHMA

Asthmatic symptoms may be different from attack to attack and from individual to individual. Some of the symptoms are also seen in heart conditions and other respiratory illnesses, so it’s important to make the right diagnosis. Symptoms may include:

  • Cough
  • Shortness of Breath
  • Wheezing (usually of sudden onset)
  • Chest tightness (sometimes confused with coronary artery spasms/heart attack)
  • Rapid pulse rate and respiration rate
  • Anxiety

Besides these main symptoms, there are others that are signals of a life-threatening episode. If you notice that your patient has become “cyanotic”, they are in trouble. Someone with cyanosis will have a blue/gray color to their lips, fingertips, and face.

Cyanosis

You might also notice that it takes longer for an asthmatic to exhale than to inhale. As an asthma attack worsens, wheezing may take on a higher pitch. As the attack worsens, the patient suffers a lack of oxygen that makes them confused and drowsy; they may possibly lose consciousness.

Asthma vs Heart Attack

As an asthma attack may resemble a heart attack, the medic should know how to tell the difference. For Asthma is usually improved by using fast-acting inhalers, a strategy that doesn’t offer relief from a heart attack or other cardiac events. Cardiac patients often have swelling of the lower legs, also called “edema.” This is rarely seen with asthma. Asthmatic also don’t have arm and jaw pain that is often seen with heart attacks. Those with a history of cardiac chest pain improve with the angina drug nitroglycerin.

Although both may be associated with shortness of breath, few will confuse the symptoms of COVID-19 with asthma, but suffice it to say that COVID-19 is associated with fever and loss of taste or smell.

DIAGNOSING ASTHMA

On physical exam, use your stethoscope to listen to the lungs on both sides. Make sure that you listen closely to the bottom, middle, and top lung areas as described in the section on physical exams.

In a mild asthmatic attack, you will hear relatively loud, musical noises when the patient breathes. As the asthma worsens, less air is passing through the airways and the pitch of the wheezes will be higher and perhaps not as loud. If no air is passing through, you will hear nothing, not even when you ask the patient to inhale forcibly. This person may become cyanotic.

typical peak flow meter

Sometimes a person might become so anxious (a “panic attack”) that they become short of breath and may think they are having an asthma attack. To resolve this question, you can measure how open the airways are with a simple diagnostic instrument known as a peak flow meter. A peak flow meter measures the ability of your lungs to expel air, a major problem for an asthmatic. It can help you identify if a patient’s cough is part of an asthma attack or whether they are, instead, having a panic attack or other issue.

To determine what is normal for a member of your group, you should first document a peak flow measurement when they are feeling well. Have your patient purse their lips over the mouthpiece of the peak flow meter and forcefully exhale into it. Now you know their baseline measurement. If they develop shortness of breath, have them blow into it again and compare readings.

In moderate asthma, peak flow will be reduced 20-40%. Greater than 50% is a sign of a severe episode. In a non-asthma related cough or upper respiratory infection, peak flow measurements will be close to normal. The same goes for a panic attack; even though you may feel short of breath, your peak flow measurement is still about normal.

TREATMENT OF ASTHMA

Asthma bronchodilator in inhaler

The cornerstones of asthma treatment are the avoidance of “trigger” allergens, as mentioned previously, and the maintenance of open airways. Medications come in one of two forms: drugs that give quick relief from an attack and drugs that control the frequency of asthmatic episodes over time. In panic attacks, however, these medicines are ineffective; treatment for anxiety is discussed elsewhere in this book.

Quick relief asthma drugs include “bronchodilators” that open airways, such as Albuterol (Ventolin, Proventil), levalbuterol (Xopenex HFA), among others. These drugs should open airways in a very short period of time and give significant relief. These drugs are sometimes useful for people going into a situation where they know they will exposed to a trigger, such as before strenuous exercise. Don’t be surprised if you notice a rapid heart rate on these medications; it’s a common side effect.

If you find yourself using quick-relief asthmatic medications more than twice a week, you are a candidate for daily control therapy. These drugs work, when taken daily, to decrease the number of episodes and are usually some form of inhaled steroid. There are long-acting bronchodilators as well, such as ipratropium bromide (Atrovent HFA). Another family of drugs known as Leukotriene modifiers prevents airway swelling before an asthma attack even begins. These are usually in pill form and may make sense for storage purposes. The most popular is Montelukast (Singulair).

Often, medications will be used in combination, and you might find multiple medications in the same inhaler. The U.S. pharmaceutical Advair, for example, contains both a steroid and an airway dilator. Remember that inhalers lose potency over time. Expired inhalers, unlike many drugs in pill or capsule form, have less effect than fresh ones. Physicians are usually sympathetic to requests for extra prescriptions from their asthmatic patients.

NATURAL TREATMENT OF ASTHMA

Ginger

In mild to moderate cases of asthma, you might consider the use of natural remedies. Some involve breathing exercises:

Pursed-lip breathing: This slows your breathing and helps your lungs work better. Breathe in slowly through your nose for two seconds. Then position you lips as if you were whistling, and breathe out slowly through your mouth for four seconds.

Abdominal breathing: Similar to pursed-lip breathing but focuses on using the diaphragm more effectively. With your hands on your belly, breathe as if you were filling it with air like a balloon. Press down lightly on the belly as you slowly exhale.

There are also a number of substances that have been reported to be helpful:

Ginger: A study published in the American Journal of Respiratory Cell and Molecular Biology indicates that ginger is instrumental in inhibiting chemicals that constrict airways. Animal tests find that extracts of ginger help ease asthmatic symptoms in rodents. Use as a tea or extract twice a day.

Ginger and Garlic Tea: Add three or four minced garlic cloves in some ginger tea while it’s hot. Cool it down and drink twice a day. Some report a benefits from just the garlic.

Other herbal teas are thought to help: Ephedra, Coltsfoot, Codonopsis, Butterbur, Nettle, Chamomile, and Rosemary all have been used in the past to relieve asthmatic attacks.

Caffeine: Black unsweetened coffee and other caffeine-containing drinks may help open airways.  Don’t drink more than 12 ounces at a time, as coffee can dehydrate you. Interestingly, coffee is somewhat similar in chemical structure to the asthma drug Theophylline.

Eucalyptus: Essential oil of eucalyptus, used in a steam or direct inhalation, may be helpful to open airways. Rub a few drops of oil between your hands and breathe in deeply. Alternatively, a few drops in some steaming water will be good respiratory therapy.

Honey: Honey was used in the 19th century to treat asthmatic attacks. Breathe deeply from a jar of honey and look for improvement in a few minutes. To decrease the frequency of attacks, stir one teaspoon of honey in a twelve-ounce glass of water and drink it three times daily.

Turmeric: Take one teaspoon of turmeric powder in 6-8 ounces of warm water three times a day.

Mustard Oil Rub: Mix mustard oil with camphor and rub it on your chest and back. There are claims that it gives instant relief in some cases.

Gingko Biloba leaf extract: Thought to decrease hypersensitivity in the lungs; not for people who are taking aspirin or ibuprofen daily, or anticoagulants like warfarin (Coumadin).

Lobelia: Native Americans actually smoked(!) this herb as a treatment for asthma. Instead of smoking, try mixing tincture of lobelia with tincture of cayenne in a 3:1 ratio. Put 1 milliliter (about 20 drops) of this mixture in water at the start of an attack and repeat every thirty minutes or so

Further research is necessary to determine the effectiveness that some of the above remedies have on severe asthma, so take standard medications if your peak flow reading is 60% or less than normal.

Don’t underestimate the effect of diet on the course of asthma. Asthmatics should:

  • Replace animal proteins with plant proteins.
  • Increase intake of Omega-3 fatty acids and vitamin D.
  • Eliminate milk and other dairy products.
  • Eat organically whenever possible.
  • Eliminate trans-fats; use extra-virgin olive oil as your main cooking oil.
  • Always stay well-hydrated; more fluids will make your lung secretions less viscous.

Finally, various relaxation methods, such as taught in Yoga classes, are thought to help promote well-being and control the panic response seen in asthmatic attacks. Acupuncture is thought by some to have some promise as well.

I’m sure you have your own home remedy that might work to help asthmatics. If so, let us know!

Joe Alton MD