Spotter Up: The EDC Tourniquet

Eugene Nielsen at Spotter Up has a pretty comprehensive article on The EDC Tourniquet.

According to published research, reported in the October 2017 issue of the Journal of the American Medical Association (JAMA)), the average response time in the US from the time of a 911 call to arrival of EMS on scene was seven minutes. This increased to more than 14 minutes in rural settings. A person can bleed out from a severed femoral artery in less than five minutes. You do the math.

By the time EMS arrives it may be too late. You need to be your own first responder.. Photo: Public Domain.

In an active shooter or terrorist incident, emergency personnel won’t reach victims until the threat has been neutralized. During the Paris attacks on 13 November 2015, it was over 160 minutes from the time the terrorists fired the first shots in the Bataclan theater until the responding emergency personnel were able to reach those inside the venue.

The reality is that you’re going to be your own first responder. Bystanders will always be first on the scene, whether it be terrorism or other criminal act or an accident. In the Boston Marathon bombing on 15 April 2013, bystanders employed improvised tourniquets to save lives. Time consuming and inefficient, but it was all that they had. Don’t plan to improvise if the need arises. Always have a real tourniquet.

Data from the Boston Marathon Bombing found that six of the rubber and improvised type tourniquets had to be subsequently replaced with C-A-T® tourniquets. Additionally, the most common EMS tourniquet on scene consisted of rubber tubing and a Kelly clamp.

Roughly 80% of combat deaths and 50% of civilian trauma deaths are attributable to hemorrhage. It’s the most preventable cause of death in compressible injuries. The proper use of tourniquets saves lives.

Hypovolemic Shock

Time is of the essence. Hypovolemic shock occurs where there is an acute fluid or blood loss in the body. It’s a life-threatening emergency. Hypovolemic shock is most often secondary to rapid blood loss (hemorrhagic shock). It causes inability of the heart to pump the essential blood needed to the body, resulting in multiple organ failure due to inadequate cellular oxygenation. There are four stages of hypovolemic shock.

No, it’s not an ancient torture device, although Roman soldiers may have begged to differ. It’s a Roman thigh tourniquet circa199 BCE to 500 CE. It’s made from bronze. Photo: Welcome Collection. Licensed under the Creative Commons Attribution 4.0 License.

Stopping the blood loss before patient goes into Stage II shock, ie., blood volume loss up to 15% (~750 mL), keeps survivability at around 94%. If blood loss continues and the patient is in Stage II (30% or ~1500 ml) or greater, the survivability goes down to 14%, without any blood being administered. These figures are based on a US Army Institute of Surgical Research (USAISR) study conducted in 2006 and 2007.

Tourniquets

While I recommend that everyone carry a trauma kit, a tourniquet (and gloves) needs to become part of your everyday carry (EDC) at the at the very minimum. Tourniquets have emerged as the standard of care in the tactical environment due to their ease of use, rapid application, and complete stoppage of blood loss. Current protocol considers the tourniquet an initial lifesaving intervention to control massive hemorrhage from an extremity.

The old dogma of “save a life, lose a limb” has been proven to be false. A tourniquet can safely remain in place for up to two hours. Thousands of combat veterans are walking around today with all their limbs because their lives were saved by tourniquet use.

The use of tourniquets on the battlefield isn’t new. As far back as Alexander the Great’s military campaigns in the fourth century BC, tourniquets were used to staunch the bleeding of wounded soldiers. The term “tourniquet” dates from the 17th century and originated from the French “tourner” meaning “to turn”. .

Tourniquets have emerged as the standard of care in the tactical environment. Combat Application Tourniquet (C-A-T) is recommended by CoTCCC and standard issue to the US military. First responders and others are most likely to have trained with the C-A-T. Photo: North American Rescue.

Tourniquets lost popularity after the US Civil War, having been blamed for complications that resulted in amputation. This misunderstanding has unfortunately persisted, especially as it pertains to tourniquet use in civilian settings.

Although there have been several studies in the past that have looked at tourniquet use in civilian settings, the survival benefit for patients has been unclear. However, new research shows that for civilian patients with peripheral vascular injury, prehospital tourniquet use is associated with dramatically improved odds of survival.

The study, titled “Civilian Prehospital Tourniquet Use Is Associated with Improved Survival in Patients with Peripheral Vascular Injury,” was published 29 March 2018 and reported in the May 2018 issue of the Journal of the American College of Surgeons (JACS). This study was a multi-institutional retrospective review of all patients sustaining peripheral vascular injuries admitted to all 11 urban Level I trauma centers in the state of Texas from January 2011 to December 2016.

The study found that “Although still underused, civilian prehospital tourniquet application was independently associated with a 6-fold mortality reduction in patients with peripheral vascular injuries. More aggressive prehospital application of extremity tourniquets in civilian trauma patients with extremity hemorrhage and traumatic amputation is warranted.” Simply put, tourniquets save lives.

Popular commercial tourniquets include the Combat Application Tourniquet® (C-A-T®), SOF® Tourniquet, RevMedx® TX® Series Ratcheting Medical Tourniquet -Tactical™ (RMT-T™), SAM Extremity Tourniquet (SAM-XT™), Tactical Mechanical Tourniquet™ (TMT™), SWAT-T® and Rapid Application Tourniquet System®® (R.A.T.S.®) / Rapid Tourniquet. Each has its pros and cons. All are capable of occluding blood flow when properly applied.

No longer a last resort, a tourniquet is now considered an initial lifesaving intervention to control massive hemorrhage from an extremity. SWAT-T is a versatile tourniquet that has proven effective in studies and has been successfully fielded in combat. Photo: H&H Medical.

As of this writing, the C-A-T, RMT-T, SAM-XT, SOF Tourniquet (SOFTT-W), TMT and TX Series (TX2 and TX3) are  the only US military Committee on Tactical Combat Casualty Care (CoTCCC) recommended non-pneumatic limb tourniquets. It’s important to keep in mind that the CoTCCC, a division of the DoD Joint Trauma System, is looking at tourniquets for use on adults in combat by trained military personnel. not for use by civilians with limited training or for use on children.

The C-A-T, RMT-T, SAM-XT, SOF Tourniquet, TMT and TX Series are windless/ratcheting tourniquets. The SWAT-T (Stretch, Wrap and Tuck Tourniquet®) and R.A.T.S. are elastic wrap tourniquets.

A plus to elastic wrap tourniquets is that they pack down into a significantly smaller size, making them easier to carry. They’re also considerably less expensive than windless/ratcheting tourniquets. On the downside, elastic wrap tourniquets require a wider range of motion to apply. The latter can make self-application more difficult.

The SWAT-T and R.A.T.S. can be be employed for higher axillary and groin applications than windless tourniquets. They may also be employed for pediatric and K-9 applications, where standard windlass tourniquets cannot. A study of commercial tourniquets conducted in Israel, and reported in a paper submitted to the 2018 NAEMSP Scientific Assembly, found that the SWAT-T and R.A.T.S. were the best tourniquets for use on children.

It should be noted that North American Rescue states that the C-A-T has been shown to be effective on limbs as small as five inches in circumference. It should also be noted that the TX Series ratcheting tourniquet is available in a pediatric model designed specifically for children.

The SWAT-T is a versatile medical multi-tool that may be employed not only as a tourniquet, but also as pressure dressing, occlusive device, elastic bandage, sling and swathe, used to secure a splint, and more. If the SWAT-T is employed as a pressure bandage or dressing, it’s important to check for a distal pulse after application. Although not a CoTCCC-recommended tourniquet, the SWAT-T has been the subject of several studies which demonstrated it’s efficacy.

PHLster Flatpack is a great way to EDC a windlass tourniquet. Flatpack is shown with SOF Tourniquet (SOFTT-W). Photo: PHLster Holsters.

PHLster Flatpack Tourniquet Carrier

No tourniquet does you any good if you don’t have it with you when you need it. I have found the PHLster Flatpack® Tourniquet Carrier from PHLster Holsters to be a great, low-profile way to EDC a windlass tourniquet for easy, one-hand deployment. Designed for versatility, it allows you to carry a folded and staged windlass tourniquet on your belt, in a pocket or with MALICE CLIPS® for MOLLE/PALS mounting..

Training

Having the necessary tools is only part of the equation. Equipment is only as good as your training. Basic emergency medical training should cover the entire spectrum of lifesaving skills. And like shooting, they’re perishable skills.

Emergency medical training should be part of the basic skill sets of every firearms owner. In fact, it should be part of the basic skill sets of everyone. The time to learn isn’t when someone is bleeding out.

The National Association of Emergency Medical Technicians (NAEMT) and STOP THE BLEED® are excellent resources that can direct you to courses in your area. Dark Angel Medical offers a free online introductory course designed to teach the basics of bleeding control.

Kerry Davis of Dark Angel Medical discussing hemorrhagic injury management and tourniquet placement with two students in Direct Action Response Training (D.A.R.T.) course. Hemorrhage is the most preventable cause of death in compressible injuries. It accounts for approximately 80% of battlefield deaths and 50% of civilian trauma deaths.

Dark Angel Medical also offers an outstanding two-day Direct Action Response Training (D.A.R.T.) course at various locations around the country. All participants receive BCON (Bleeding Control) certification from the American College of Surgeons. It also provides 16 hours of CEU’s, per CECBEMS, to NREMT EMT-Basics/Advanced and Paramedics. I have taken the D.A.R.T. course and highly recommend it. Dark Angel Medical is also a great source for trauma kits and components. I have taken the course and highly recommend it. Idid an article on the D.A.R.T. course recently for Spotter Up.

The online learning platform Deployed Medicine is also valuable resource. It’s used by the Defense Health Agency (DHA) “to trial new innovative learning models aimed at improving readiness and performance of deployed military medical personnel.” Learning assets include the standardized Tactical Combat Casualty Care All Service Members (TCCC ASM) Course curriculum developed by the Joint Trauma System, which is part of the DHA. You don’t have to be a member of the military to take advantage of its resources.

Some Final Thoughts

Preparedness requires the proper mindset, training, and tools. It doesn’t just happen. It’s a way of life and takes some effort. And it’s about preparing for possibilities, not just probabilities.

Carry a proven tourniquet. Not all tourniquets are created equal. I recommend carrying at least two tourniquets. This will leverage your capability. I carry a C-A-T as my primary EDC tourniquet and a SWAT-T as my secondary/backup tourniquet

Buy from a reputable source. If you try to save a few bucks you may wind up with poorly made counterfeit. Counterfeit tourniquets are a growing problem. They can cost lives. The life you save may be your own or that of a loved one.

Practice with the tourniquet in situations that are similar you may encounter. Get a spare/training tourniquet for this purpose. Don’t use the actual tourniquet that you will be counting on in an emergency. Practice both strong and support side applications.

The Medic Shack: Amputation – First Aid and Post Aid

Chuck at The Medic Shack talks about amputating injuries, first aid for them, and post aid while using photos from his son’s recent injury. So be warned of finger amputation photos through the link.

This post is on Amputation. What first aid and also post aid needs to be done.

NOTE: Some of the images at the end of this are graphic. They are of my son’s finger and the wound. 

This site contains affiliate links to products. We may receive a commission for purchases made through these links. This does NOT increase the price of the product you may purchase.

Background

Normally when I write a blog post its from current events, past experiences both civilian and or military. This time I am using my youngest son as our topic. This past week (Tuesday the 4th of August) he had a pretty normal day at work. He works at a motorcycle accessory shop. Sells gear and he is about the most requested tire man in the city.

People bring him tires to mount that they bought from all over. From the store he works at to mail order The reason he is so requested is he cares for the customer and the motorcycle. Never scratches or damages a rim. He recently did a set of tires that the rims cost 2 grand each. Personally requested by the bike owner. Not bad for a 19 year old young man. Today’s post ties in to one from may on one we did years ago on Emergencies 

Where did my finger go?

He and his manager were moving out the old tire machine for the brand new one the store bough. As they were lifting it on the pallet the old one came on, the bead breaker slipped out of position, dropped down and amputated his lift index finger between the 3rd knuckle and the nail bed. (Knuckles are counted from nearest to the hand to the finger tip. Think of drawing and angle from the cuticle backwards from that point at a 45 degree angle to the 1st knuckle. If folks have taken my classes or shooting classes from some of my friends, you have heard me say that a traumatic injury is not a painful as it looks. For a while at least.

According to Ryan it felt like he pinched his finger. Not to bad. He went to keep lifting and he looked down and saw the blood covering the floor and tire machine. His mechanic glove was torn and the end of it was missing. The body has amazing self preservation tools. I’ve know gunshot victims who were shot, walked down a flight of stairs with a suspect in custody, put them in the patrol car and then died.

First Aid

STOP THE BLEEDING! This cannot be stressed enough STOP THE BLEEDING. Even an injury like my son Ryan has can be dangerous if the bleeding is not stopped. When blood is spilled on the floor it looks 5 times as much as it is.

The blood loss Ryan had was about ¼ a cup 60 cc more or less. It looked like more. MUCH more. 2 fluid ounces is not much in the grand scale of the body. An adult will have approximately 1.2-1.5 gallons (or 10 units) of blood in their body. The average us 1.2 gallons or 5 liters

Now the scary part. The ½ cup of blood he lost was in the first minute! And it was not pure arterial flow. It was a mixed flow. The finger tips do not have large arteries in them The vessels are about 1/32nd of an inch in diameter (.79 mm). DIRECT PRESSURE.

Ryan has been trained extensively in first aid. Well he HIS my and his mom’s son. Growing up in a medical family has advantages. He squeezed below the wound and yelled he needed something to help hold it. His manager and the vendor grabbed shop towels and put pressure on it. Sat him down with his hand higher than his heart and called 911.

If at all possible retrieve the amputated part, wrap in clean cloth or sterile bandage material, place in a baggie, and place that baggie into one containing ice. This gives the surgeons the best chance of re-attachment.

To tourniquet or to not tourniquet.

There is a sorted history on the tourniquet. Lets go back to the 1980’s As an old medic, when we had a wound that needed a tourniquet, we put it on, marked a “T” on the patients forehead with date and time of application. If your patient was going to be with you for a few hours, every hour or so we would loosen the tourniquet for a short time to allow blood to the part below the tourniquet. The reapply it.

This did not work as well as expected. For a tourniquet to work it has to be tight. TIGHT. When it is applied correctly. Tissues will be damaged. When tissue is damaged there is swelling. We call it edema. So when we let off the tourniquet, let some blood down, then re applied it, the bleeding would stop and all was good in the world. Until the patient bled out. What happened was when the tourniquet was re-applied, it compressed the edema, and stopped the flow. But once the edema had been moved, the tourniquet was now loose…(continues)

Click here to read the entire article at The Medic Shack.

The Human Path: Herbal First Aid Kit

Sam Coffman, author of The Herbal Medic, at The Human Path has this video about The Herbal First Aid Kit.

Sam Coffman from The Human Path (an herbalism and survival school in Austin and San Antonio, Texas) explains the most fundamental concepts around creating and using your own herbal first aid kit. Sam’s experience as a former Special Forces Medic, while blending that world with herbalism, gave him some unique insights into making and using herbal first aid kits that are highly effective in a variety of situations. He uses the herbal first aid kit that The Human Path sells, as the starting point for talking about the packs, the containers, the herbs, the practicality of what works and what doesn’t, and why you would want to use an herbal first aid kit in the first place.

https://www.youtube.com/watch?v=PIhXY1q2cv4

Doom and Bloom: Heat-Related Emergencies

The Altons at Doom and Bloom Medical have a post up on Heat-Related Emergencies for the summer heat.

  • noaa heat index chart

    Summer is here with a vengeance and parts of the Midwest and Southern U.S. are experiencing record high temperatures in major heat waves. Officials predict a high-risk situation for 200 million citizens as places as far north as Buffalo, NY hit 90 degrees Fahrenheit for a week straight, while Pheonix, Arizona will have multiple days in the 110s. The air temperature in Death Valley, California may reach as high as 125 degrees.

    Even in places where the air temperature isn’t as high, the “heat index” is surpassing the 90s, 100s, and the 110s. The heat index is a measure of the effects of air temperature combined with high humidity.  Above 60% relative humidity, loss of heat by perspiration is impaired and exposure to full sun increases the reported heat index by as much as 10-15 degrees F. All this increases the chances of heat-related illness such as heat stroke and heat exhaustion.

    In the next few weeks, we can expect the power grid to be challenged by tens of millions of air conditioning units set on “high”. Major health issues may arise if the electricity goes out and people have to fight the heat with hand fans, like they did in the “good old days”.

    HEAT ISLANDS

    graph of temperatures from urban to rural

    Things are even worse in the city. Buildings and roads replace open land and vegetation. Concrete and asphalt surfaces in the sun become much hotter than air temperature, resulting in a “heat island” effect in large populated areas. Rural areas are more moist and cool, leading to less heat-related emergencies.

    Another factor may increase the risk of heat-related emergencies. Homes without air conditioning will not only become sweatboxes, but many people cooped up in closed environments are a recipe to increase the number of COVID-19 cases (so much for the summer giving us a break from the pandemic).

    HEAT WAVES ARE NATURAL DISASTERS

    man,it’s hot!

    You might not consider a heat wave to be a natural disaster, but it most certainly is. Heat waves can cause mass casualties, as it did in Europe when tens of thousands died of exposure (not in the Middle Ages, but in 2003). India, Pakistan, and other underdeveloped tropical countries experience thousands of heat-related deaths yearly.

    HOW HEAT KILLS

    So how exactly does heat kill a person? Your body core regulates its temperature for optimal organ function. When core body temperature rises excessively (known as “hyperthermia”), inflammation occurs, cells die, and toxins leak. Fatalities can occur very quickly without rapid intervention. Even with modern technology, hyperthermia carries a 10% death rate, mostly in the elderly and infirm. Those who are physically fit, however, are not immune.

    HEAT EXHAUSTION AND HEAT STROKE

    The ill effects due to overheating are called “heat exhaustion” if mild to moderate; if severe, these effects are referred to as “heat stroke”. Heat exhaustion usually does not result in permanent damage, but heat stroke does; indeed, it can permanently disable or even kill its victim.  It’s a medical emergency that must be diagnosed and treated promptly.

    Simply having muscle cramps or a fainting spell doesn’t necessarily signify an imminent heat-related medical emergency. You will see “heat cramps” often in children that have been running around on a hot day.  Getting them out of the sun, massaging the affected muscles, and providing hydration will usually resolve the problem.

    Heat exhaustion’s signs and symptoms include:

    • Confusion
    • Rapid pulse
    • Profuse sweating
    • Flushing
    • Nausea and vomiting
    • Headache
    • Temperature elevation up to 105 degrees F

    If no action is taken to cool the victim, they could easily progress to heat stroke. In addition to all the possible signs and symptoms of heat exhaustion, heat stroke will manifest as loss of consciousness, seizures or even bleeding (seen in the urine or vomit).  Breathing becomes rapid and shallow. Shock and organ malfunction may ensue, possibly leading to death.

    heat exhaustion (left) vs heat stroke (right)

    In heat stroke, the skin is likely to be red and hot to the touch, but dry; sweating might be absent.  Once the body core hits 105 degrees or more (it varies from person to person), thermoregulation breaks down and the body’s ability to use sweating as a natural temperature regulator fails. In heat stroke, the body core can rise as high as 110 degrees Fahrenheit or more.

    (Aside: The highest body temperature ever recorded was 115 degrees: On July 10, 1980, 52-year-old heatstroke victim Willie Jones of Atlanta was admitted to the hospital with a temperature of 115 degrees Fahrenheit. He spent 24 days in the hospital and recovered.)

    In some circumstances, the victim’s skin may actually seem cool. Despite feeling “clammy” to the touch, it’s important to realize that it is the body core temperature that’s elevated. You could be misled unless you take readings with a thermometer to reveal the patient’s true status.

    Avoid giving fluids unless the victim is awake and fully oriented

    When overheated patients are no longer able to cool themselves, it is up to their rescuers to do the job. If hyperthermia is suspected, the victim should immediately:

    • Be removed from the heat source (for example, out of the sun).
    • Have their clothing removed.
    • Be drenched in cool water (with ice, if available)
    • Have their legs elevated above the level of their heart (the shock position)
    • Be fanned or otherwise ventilated to help with heat evaporation
    • Have moist cold compresses placed in the neck, armpit and groin areas

    Why the neck, armpit and groin? Major blood vessels pass close to the skin in these areas, and cold packs will more efficiently cool the body core. Recent studies by the military suggest that cold packs to feet and hands are also helpful.

    Oral rehydration is useful to replace fluids lost, but only if the patient is awake and alert. If your patient has altered mental status, he or she might “swallow” the fluid into their airways; this is known as “aspiration” and causes damage to the lungs.

    Heat stroke is preventable in many cases. The Arizona department of health recommends the following:

    • Drink at least 2 liters (about a half-gallon) of water per day if you are mostly indoors and 1 to 2 additional liters for every hour of outdoor time. Drink before you feel thirsty, and avoid alcohol and caffeine.
    • Wear lightweight, light-colored clothing and use a sun hat or an umbrella to deflect the sun’s rays. Use sunscreen if available.
    • Eat smaller, more frequent meals instead of large ones.
    • Avoid strenuous activity.
    • Stay indoors as much as possible.
    • Take regular breaks if you exert yourself on warm days.

    In a heat wave, it’s important to check on the elderly, the very young, and the infirm regularly and often. These people have more difficulty seeking help, and you might just save a life if you’re vigilant. You can bet there’ll be more than one heat wave this summer, so know the warning signs and how to help those with hyperthermia.

Practical Self Reliance: 50+ Ways to Use Yarrow

An earlier post on elderflower mentioned its use in combination with yarrow and mint to fight fevers. Yarrow grows prolifically in our garden, filling in the edges and between rows. In damp conditions, it makes for a pretty soft ground cover — enough so that the kids want a yarrow yard. In this post from Practical Self Reliance, Ashley Adamant discusses many more uses for yarrow – 50+ Ways to Use Yarrow.

Yarrow is a common wild herb that’s useful in both the kitchen and medicine cabinet.  This list of yarrow uses covers everything from biscuits and beer to salves, soaps, and tinctures.

Yarrow uses

Yarrow’s always seemed magical to me, and I remember lounging in my room as a teenager, reading through 16th-century herbals and dreaming of the day I’d spot it in real life.  (Yes really, that’s actually how I spent my free time as a teenager.  I know, I’m such a nerd.)

The problem is, while yarrow grows ALMOST everywhere, I happened to grow up in one of the very few places outside of yarrow’s range…the Mojave Desert.  Now on my homestead in Vermont, it grows in every untended nook and cranny.  We’ll see our first yarrow blooms in early summer, and it’ll keep right on producing through fall, meaning I have a virtually unlimited supply of yarrow (even leaving plenty for the bees).

Yarrow Identification

Though yarrow is incredibly common, so are its look-alikes.  Once you’ve actually spotted yarrow, you’ll agree that the look-alikes aren’t really all that close.  There are lots of low growing herbs with white flower clusters, but yarrow really stands out in a crowd.

Start with the flowers.  They’re white, but not really.  If you were looking at paint samples, they’d have the name “Victorian white” or some other fancy title, because in reality, they’re a muted off white color.

Yarrow leaves are also distinctive, and there’s a reason its species name is “millefolium” or thousands of leaves.  The leaves are feathery, as opposed to the more distinct leaves of Queen Anne’s Lace and other white flowering herbs.

Identifying Yarrow by the feathery leaves and distinct white flower clusters

Make sure you’re 100% certain on your identification, as there are white-flowering plants within its range that are deadly toxic (namely, Water Hemlock).  To my eye, they don’t look anything alike, but as an optimistic teenager desperate to find yarrow in some stray ditch…I may well have made that mistake.

Read this guide to Yarrow Identification for more information.

Benefits of Yarrow

So why is yarrow so magical?  Many reasons!

A wide geographic distribution means yarrow made it into the traditional pharmacopeias in Asia, Europe and the new world.  Yarrow is used in everything from food and drink, to salves and tinctures, to ritual divination and ceremony.

This quick list will give you some ideas, but is by no means comprehensive:

  • Stops Bleeding
  • Skin Toner & Astringent
  • Bitter Tonic
  • Treats Cold and Flu
  • Lowers Blood Pressure
  • Improves Circulation
  • Induces Sweating
  • Reduces Fever

Be aware that while it’s generally considered safe, individual reactions are always possible.  It’s also contraindicated for pregnant women, as it can induce menstrual flow and possibly increase the risk of miscarriage.

Recipes for Cooking with Yarrow

While yarrow is perhaps best known for its uses as a medicinal, both internally and externally, it’s also a tasty culinary herb.  It’s not the only one of course, and many culinary herbs (thyme, sage, rosemary, and more) are potent medicinals, taken in the right dosage at the right time.

These yarrow recipes incorporate a small amount of yarrow, just enough to flavor the dish without reaching a “medicinal” dosage.

Recipes for Yarrow Beverages

Believe it or not, hops are actually a relatively recent brewing ingredient.  Before hops became common in beer, herbal beers, or gruits, were all the rage.  Yarrow was one of the most common brewing ingredients, and it was known to create an extremely intoxicating brew.

While hops are a sedative, that dulls the senses and slows the sex drive, yarrow based brews do just the opposite.  There’s a reason yarrow beers (and meads) were popular historically because they lifted you up and sent you home ready to put a few buns in the oven (if you catch my drift).

Our own homemade yarrow beer

Our own homemade yarrow beer

If you’re interested in learning to brew with herbs, specifically yarrow, I’d highly recommend the book Sacred and Herbal Healing Beers, which takes you through literally thousands of years of herbal brewing tradition (with recipes for each herb discussed).

The Wildcrafting Brewer likewise includes recipes for yarrow brews and approaches the subject more from a foraging perspective (rather than a historical one).

While the traditions have but been forgotten, a few brewers keep the traditions alive.  Here are a few yarrow beverage recipes to wet your whistle, both alcoholic and non.

Harvesting Flowering Tops for Yarrow Tincture

Harvesting Flowering Tops

Yarrow Uses for First Aid

My most common use of yarrow is as a first-aid treatment for bleeding.  Yarrow tincture in a spray bottle is a powerful astringent, and I’ve watched it pucker closed wounds in seconds.

I always keep a small spray bottle on hand just in case, and it’s worked wonders on all manner of small (but persistent) topical injuries.  It’s also made into styptic powder and DIY quick clot, for similar purposes.

Homemade Yarrow Tincture (Alcohol extract of yarrow)

Over the longer term, something like a yarrow salve is wonderful for treating injuries and promoting healing.  It’s also commonly employed as an itch remedy topically.

Making a yarrow salve is no different than making any herbal healing salve, and it comes together quickly with just a few ingredients.

Yarrow has been used for millenia to stop bleeding and treat minor wounds. A healing salve helps preserve the herb, and ensures that it's on hand when needed.

Yarrow has been used for millennia to stop bleeding and treat minor wounds. A healing salve helps preserve the herb, and ensures that it’s on hand when needed.

More yarrow uses for first aid:

Yarrow Herbal Remedies

Beyond yarrows use as a topical first aid remedy, it’s also commonly used in preventative remedies and internal medicine…

 

Continue reading at Practical Self Reliance.

 

 

 

 

 

 

 

See also this video from Cat Ellis, the Herbal Prepper:

Doom and Bloom: Suture Basics For The Off-Grid Medic: Needles

Continuing their earlier article on suturing, the Altons at Doom and Bloom Medical followup with an article devoted to suture needles in Suture Basics For The Off-Grid Medic: Needles.

Basic diagram of a suture (by medscape.com)

In my recent article “Suture Basics For The Off-Grid Medic “,  I gave some thoughts on suture materials, especially as they apply to closing skin lacerations. Your skin is your armor, and anything that breaches it can cause a life-threatening infection.

Although the decision to close a wound should never be automatic, simple skin lacerations can often be cleaned and closed successfully by the off-grid medic. Sutures are just one of a number of ways to accomplish this goal and allow acceleration of the healing process. Today, we’ll discuss the qualities of suture needles.

(Note: This article is for educational purposes only. If the medical system in your area is intact, seek it out to treat lacerations or other medical issues!)

Suture needles are made of a corrosion-resistant stainless steel alloy that is sometimes coated with silicone to permit easier tissue penetration.

Basic diagram of a suture (medscape.com )

A suture needle has three sections: the point, the midportion or body, and the swage. The swage is the “end” of the needle and is where the thread is attached. The midportion is usually curved at an arc, and the point is, well, pointy.

SWAGING

Before about 1920, suture needles had “eyes” and string was separate; the surgeon had to thread the eye of the needle. Since then, sutures became a single continuous unit. This process of connecting suture needle and string is called “swaging”.

Swaging dealt with a number of disadvantages associated with using separate needles and thread. In the old method, two lengths of string were formed on either side of the eye. Passage of a double strand of suture through tissue led to more tissue trauma and, perhaps, a higher risk of infection. Also, the suture string was more likely to become unthreaded or frayed.

THE IDEAL SUTURE NEEDLE

Suture needles perform based on a number of qualities, including strength and sharpness. The strength of a needle refers to its resistance to deformation during use, limiting the amount of trauma to tissue. Sharpness measures the ease of penetration into tissue and is dependent on factors involving not only the point, but the shape of the body of the needle.

Just as suture thread has ideal characteristics, the effective suture needle would be:

  • Made of high-quality stainless steel
  • The smallest diameter possible
  • Stable in the grasp of the needle holder
  • Capable of running suture material through tissue with minimal trauma
  • Sharp enough to penetrate tissue with minimal resistance
  • Sterile and corrosion-resistant to prevent introduction of microorganisms or foreign materials into the wound
  • Rigid enough to go through tissue, but flexible enough to bend before breaking

Not all suture needles meet the above criteria, but will suffice for the basic needs of the medic.

NEEDLE TYPES

There are a number of different needle types variations at the point, body, and swaged end:

Common needle types with cross sections at midportion and point (ethicon.com)

Cutting Needles: The shape of the suture needle on cross-section may vary dependent on the particular need. The point of this shape to have more cutting edges. On cross section, it appears triangular. These needles are effective in penetrating thick, firm tissue, like skin.

There are two common types of cutting needles. “conventional” and “reverse”. Conventional cutting needles have the third edge of the “triangle” on the inner surface of the needle. Reverse cutting needles have the third edge of the triangle on the outer surface of the needle’s arc. The reverse edge is even stronger and able to penetrate tendons and other tough tissues, while decreasing the amount of trauma during the procedure.

Tapered Needles: These needles are round on cross-section and can pass through tissue by stretching more than cutting. A sharp tip at the point becomes round, oval, or square shape as you approach the swage. The taper-point needle minimizes trauma in delicate and easily-penetrated tissues such as organs or intestinal lining.

Blunt Needles: These don’t come to a sharp point, but are rounded at the end. These are best used for suturing liver, kidney, and other delicate organ tissue without causing excessive bleeding.

BODY SHAPES

Suture comes in many shapes, but 3/8 circle and 1/2 circle are most commonly used for learning

The body of a needle is important for interaction with the needle holder instrument and the ability to easily transfer penetrating force to the skin. A needle must be stable in the jaws of the needle holder to give maximum control and prevent bending.

The midportion comprises most of the needle’s length and is commonly curved into a 3/8 circle arc for skin or 1/2 circle for close spaces. Of course, other curvatures are available. Straight needles may be used if dealing with easy-to-reach tissues such as certain types of skin closures.

Next time, we’ll discuss the instruments you’ll use when closing a laceration with sutures.

The Medic Shack: Less Than Lethal Rounds. Are They?

Chuck at The Medic Shack has an article about Less Than Lethal Rounds, what damage they do and how to treat the wounds in the field. If you’re particularly squeamish to wound pictures, there are a couple of photos in the article which may disturb you.

Last time we were here, we talked about Chemical Defense. The week we move to things that can make a hole in you. This week its all about Less than lethal rounds.

What is the Rubber Bullet

The so called rubber bullet is not non lethal. It is a less lethal bullet. It has and will cause death if not used correctly or with malice.

A rubber bullet (LL round) is normally blunt to a flat tip. When it hits think of getting hit with a golf ball at close range. It will hurt like hell. Also it will cause massive bruising around the area of impact.

 

 

If fired at close range it will penetrate and act like a low velocity pistol bullet. It’s wound channel is wide and can cause severe damage to tissue, tendons, nerves and blood vessels.

If a person is taking blood thinners rubber bullets can cause severe bleeding under the skin which can be dangerous.

In 2016 a study was performed on the damage caused by rubber bullets. The results were eye opening to say the least. All images in this section are taken from the study

Pattern of rubber bullet injuries in the lower limbs: A report from Kashmir 

One thing noticed was when a LL round was fired at close range its wound channel was much larger than the bullet diameter. It was found that on impact a large portion of these rounds skewed sideways and a few tumbled a few times after impact…

As seen in the above image the wound is oblong, not round as one would expect. This tissue damage is seen though the wound channel.

Should You Remove a Rubber Bullet? Disclaimer

Before we go any further…

Use of the information on this site is AT YOUR OWN RISK, intended solely for self-help, in times of emergency, when medical help is not available, and does not create a doctor-patient relationship. We here can not diagnose, prescribe medication or treatments. We are not doctors, NP’s or PA’s

The information on this site is meant to be used only during times when improvisational, last-ditch efforts are all that is possible. When writing posts, the author often assumes that if anyone uses the advice, the person will have no access to regular medical equipment or supplies. This author always assumes that the person will not have access to professional medical care. DO NOT USE THIS INFORMATION WHEN YOU CAN GET MORE TRADITIONAL OR PROFESSIONAL CARE.

First off, see the disclaimer above. /\

Problems with Removing a Rubber Bullet

With that out of the way, the big question is, “Do I or Do I NOT remove the rubber bullet?”

Blindly probing around in a wound is dangerous. You can cause extreme bleeding by dissecting and/or damaging a blood vessel, such as an artery or a large vein. This can cause your patient to bleed out. It doesn’t take long.

You can also cause permanent and crippling damage to the person.

In the modern world when a bullet is removed, we take X-rays and CT scans. Ultrasound is also used to guide the surgeon to the object. It is NOT the toss the Bowie Knife on the fire and take a slug of whiskey and start digging.

Even in the worst of times I would usually clean the wound and then pack and dress it and let the docs with a MD degree or who came out of Ft. Sam Houston take out the bullet.

BUT…….

An old friend and mentor of mine who passed away about 15 years ago from pancreatic cancer taught me a lot about surgery. He told me that the best surgical instrument ever made was the index finger. He also said that the sharpest object one should ever put in the human body is, you guessed it, your index finger.

There were (and will be) times when a DUSTOFF was unable to come, or it was not in our best interests to go to a civilian hospital. If it was not in a dangerous area, I would remove one. Notice, I said I would remove one. I was trained in the best facility on the planet for combat medicine. The United States Army Medical Department and School, Fort Sam Houston Texas. as a 91B40.

However that is something that is too involved to cover safely and responsibly in a blog post. You really want to learn? Let’s get a class together and I’ll do a live, in person one. It is dangerous to do. And, without the proper training, you’d be a menace to your patient.

What we will go over is the first aid needed to treat these in the field and let the professionals do the fixing.

Treating a Rubber Round Injury In the Field

In a SHTF situation, the treatment of this is flushing the wound with copious amounts of saline. Water can be used, but an isotonic saline solutionis much more effectiveand a bit less painful than water. As a combat medic, I would flush a wound like this with a mixture of 500cc ( ½ quart) of saline and 30 cc ( 1 ounce) of Betadine. Using a 60 cc syringe or a turkey baster style bulb syringe

This is from a advanced class I taught on gunshot wounds, showing how I flushed the wound track in the tissue, (pork shoulder).

 

Let’s look at some real life wounds from the Kashmir report, linked to above…

LL rounds are NASTY. They HURT, and a lot of people after being shot with one refuse advanced medical care.

So lets talk about GSW care, MINUS the removal.

First you will need a REAL first aid kit. No not the 5.99 one from Walmart. A true blow out kit. These are a 1 time use kit that has only the items you need to stop the bleeding of a GSW (Gun Shot Wound).

This Kit, Everlit Emergency Trauma Kit is a decent kit.  It has everything you need to treat a variety of traumas. This stuff is not cheap. The trauma kit with chest seal will set you back  70 bucks or so. And, it is a one time use.

Yes, there are cheaper. And, there are much more expensive. This set up is a mid-range kit that fills your needs. You will see kits with many different style of tourniquets. This one comes with the industry standard. the Combat Action Tourniquet (CAT). In my opinion there is none better.

Train with Your Kit

So you have this kit. Pop Quiz Medic. What do you do with it?

Grab the Israeli bandage from the kit, or this 6 inch Israeli compression bandage. Open it and practice putting it on.

The kits come with a CAT tourniquet, and it is reusable. But, having 2 is better (remember, 2 is 1 and 1 is none). Here’s an extra CAT Tourniquet.  Practice putting one on…

 

Doom and Bloom: Suture Basics for the Off Grid Medic

The Altons at Doom and Bloom Medical have an article on Some Suture Basics for the Off-Grid Medic. More photos at article.

suture basics

Many animals, (insects, spiders, shrimp, crabs) have an exoskeleton as a protective covering. Humans have their skeleton on the inside, so we depend on the largest organ of the body, our skin, instead.

Skin represents the armor that protects the body from invasion by debris and microbes. A breach in that armor increases the chance of infection that may spread throughout (called “sepsis”) and become life-threatening.

As such, there are circumstances where a break in the skin should be closed with materials known as sutures. The decision to close skin should not be automatic and depends on many factors (discussed in previous articles on this site). Once that decision is made, however, the correct choice of suture material impacts the strength and effectiveness of the healing process.

THE IDEAL SUTURE

All wound closure methods have their advantages and disadvantages. Your choice should depend on the careful evaluation of the wound, as well as an understanding of the properties of a given suture material.

The optimal suture should be:

·           Sterile

·           Easy to use

·           Strong enough to hold wound edges together

·           Able to retain strength for the time needed to heal

·           Unlikely to cause infection, tissue reaction, or significant scarring

·           Reliable in its everyday use with every type of wound

It’s difficult to find a single suture type that meets all of the above criteria, but there are many that will do if chosen properly.

TISSUE HEALING

The time needed for healing should impact the choice of suture materials. The interval it takes for a tissue to no longer require support from sutures will vary depending on tissue type:

Days: Muscle, subcutaneous tissue like fat, and skin

Subcutaneous tissue is sometimes called the “hypoderm”. It’s connected to the deep layer of skin (the “dermis”). The skin and muscle in many areas of the body are separated by a layer of subcutaneous fat. Fat will appear as yellowish globules below the whitish dermis.

Weeks to Months:  Fascia or tendons

Fascia is connective tissue beneath the skin that attaches, covers, stabilizes, and compartmentalizes muscles and other internal organs. A tendon is connective tissue attaching a muscle to a bone.

CATEGORIZING SUTURE DIAMETERS

Around a century ago, the average suture consisted of a needle through which a separate string was threaded. This method was used for thousands of years until the process of swaging was invented. A swaged suture has the thread built into the blunt end of the needle, making surgical sutures a single unit for the first time.

In the United States and many other countries, a standard classification of sutures has been in place since the 1930s.  This classification identifies stitches by type of material and size of the “thread”.

The first manufactured sutures were given sizes from #1 (thinnest) to #6 (thickest). #4 suture would approximate the string on a tennis racquet.

As technology advanced, even thinner sutures were produced that were titled beginning at 0 (pronounced “oh”). Just like double-ought buckshot is bigger than triple-ought, 2-0 (pronounced “two-oh”) suture is thicker than 3-0 (pronounced “three-oh”). If you are doing microsurgery, you’re going down all the way to 8-0, 9-0, or 10-0. Size 7-0 is about the diameter of a human hair.

The suture thread used should be the smallest size which will give adequate tensile strength to keep skin together. Finer sutures have less tissue reaction but are more difficult to handle for the inexperienced. The off-grid medic should consider using somewhat thicker sutures that can be more easily handled.

ABSORBABLE SUTURES

Absorbable chromic gut suture

In addition to diameters, sutures are classified as absorbable and non-absorbable.  An absorbable suture is one that will break down spontaneously over time (but not before the tissue has mostly healed).

Absorbable sutures have the advantage of not requiring removal.  They can be used in a number of deep layers, such as muscle, fat, organs, etc.  A classic example of this is “catgut”, actually made from the intestines of cows or sheep. Since these sutures are made from multiple fibers, they remain extremely strong in the first few days of healing.

plain “catgut”

Catgut is usually found in “plain” and “chromic” varieties. Plain gut absorbs very quickly but has a tendency to cause tissue inflammation. When dipped in a chromic salt solution, catgut retains tensile strength in the body longer and causes less of a reaction, while still remaining absorbable.

Gut sutures are used today to close tissue that heals rapidly, such as vaginal lacerations from childbirth or in the oral cavity.

Newer absorbables are synthetic. These include:

  • PDS (polydiaxonone)
  • Monocryl (poliglecaprone 25)
  • Vicryl (polyglactin)
  • Maxon (polyglyconate)
  • Dexon (polyglycolic acid)

These sutures retain their tensile strength for varying lengths of time. They cause less tissue inflammation due to an absorption process different than that of gut.

Vicryl sutures are used for approximating muscle or fat layers, as well as lower layers of skin. Maxon and Monocryl can also be used for soft tissue as well as for cosmetic procedures where visible sutures aren’t desired. PDS is used to stitch muscle and fascia tissue.

Besides the classic synthetic sutures, new subtypes such as Vicryl Rapide, Vicryl Plus and PDS II exist. These may take less or more time to dissolve than the originals.

(Aside: Every physician has their own preference for sutures that relate to their experience, schooling, and other factors. For example, it is considered old-fashioned by many to use stitches for closing surgical incisions on skin, as most close skin wounds with staples. A randomized, clinical trial, however, found that women who had C-sections with dissolvable stitches were 57% less likely to have wound complications than those whose wounds were closed with staples. I used this method (known as a “subcuticular” closure) with good results for 20 years.)

NONABSORBABLE SUTURES

Nonabsorbable sutures are those that stay in the body indefinitely or, at least, for a very long time. Normally. They are best used in skin closures or situations that require prolonged tensile strength.

Nonabsorbable sutures can be used in deep layers in certain situations. They cause less tissue reaction, although a small remnant may be felt where the body’s immune system walled it off (known as a “granuloma” or “encapsulation”).

Nonabsorbable sutures can be separated into synthetic single-stranded monofilaments and braided natural or synthetic multifilaments.

Single-stranded monofilaments include Ethilon (nylon) and Prolene (polypropylene). Braided natural multifilaments include braided surgical silk or cotton. Ethibond is the most commonly-used synthetic multifilament.

Nylon monofilament suture

Monofilaments like Nylon are slightly less likely to harbor bacteria, whereas braided multifilaments have tiny nooks and crannies which may serve as hideouts for microbes. The difference in infection rate is very small, however.

Monofilaments also glide more easily through tissue, but may require more knots to stay in place than a braided multifilament like silk. While multifilamentous thread tends to come out straight, monofilaments retain the same S-shape in which they were packaged. This is more an annoyance for the inexperienced than anything else.

Braided surgical silk suture

Braided surgical silk is easier to handle than nylon, especially for novices, and is often used for teaching purposes. 2-0 and 3-0 are sizes considered too thick by many surgeons, but are useful for teaching aspiring off-grid medics to learn surgical knot-tying. Although scarring may be more noticeable, this is a secondary issue in survival scenarios.

The off-grid medic must know skills ordinarily not taught to the average citizen. Wound closure is one of these skills, but must be combined with a working knowledge of when closure is appropriate and when it isn’t. We’ll discuss these issues in future articles.

The Medic Shack: Triage

Chuck at The Medic Shack has an article introducing people to the concept of Triage.

Triage. An introduction to combat medicine.

Welcome to the next level of preparedness. Trauma. Trauma can come from many sources. A slip with an knife in the kitchen. A smashed thumb in the workshop. A terrible cut from a chainsaw. Being at the wrong place at the wrong time and caught up in a riot. Now add in those same injuries, but multiply times 10. You now have a MCE. Pick the scenario. It can happen. Learning how to prioritize, delegate, investigate, assess and treat are skills anyone can learn.

Applying them with out emotion is a different beast altogether. It is doable. One of the hardest things to master in triage is seeing the injuries, and not getting personal with them. Another is being able to itemize the injuries, almost coldly and place them in the order of severity, and the order of treatment.

This is a HUGE deviation from the basic first aid that we talk about. With the fast moving changes sweeping the country and the world, Cat from The Herbal Prepper and I decided that we need to change up some of our topics and delve into more advanced lifesaving.

A word of warning and disclaimer. We are not doctors. We can not diagnose, prescribe or treat injury nor illness outside of a SHTF situations. This blog post is for informational use only. Pagan Preparedness, nor the owners, operators, instructors or author’s claim any responsibility for people using this information in any manner.

Glossary of terms

MOI= Method Of Injury

LOC=Level Of Consciousness

LOR = Loss of Resistance

MCE Mass Casualty Event

Triage= The process of sorting people based on their need for immediate medical treatment as compared to their chance of benefiting from such care.

The military triage flow sheet.

This is the method I used as a combat medic. There are terms here that people may be uncomfortable with. Items like balancing resources that you have now, to what you may have to what benefit it will give the patient, AND what loss/benefit of the expending those supplies will have on the group

Triage Decision Flowchart

Triage Decision Flowchart, showing the five steps in the triage process.

Step 1: Remove GREEN patients. Get help, you can’t do it all yourself

ASSESS:

2: MOI

3: LOC

4: Breathing.

 

Always remember. There are many more patients than rescuers.

Triage is designed to separate patients into categories according to their injuries, level of consciousness , and yes even if they are alive. It is important to do the examination quickly but be very complete with it. Lives depend on it. This is one the things that gives us medics bad dreams. At the triage station you may have to make a decision on if someone lives or dies.

The triage that we’ll go over here, is slightly different than what one will see in the local emergency room. The basics are the same, but the application of a hostile or dangerous environment adds a new level of difficulty,

An example of the difference between combat and civilian triage is the Boston Marathon bombing. The civilian medics on site risked their lives and rushed to the aid of the victims. And treated them where they fell. There also was a detachment of Army Medics to support the Army team running. They risked their lives and rushed to the aid of the victims AND SNATCHED THEM UP AND BROUGHT THEM TO SAFETY BEFORE TREATING THEM. The civilian medics triage and treated on site. Military medics, train to if at all possible get the victim to a safe or at least safer area before triage or treating…(continues)

Human Path: Making your own Herbal Medic First Aid Kit – Online Course, Aug. 2020

The Human Path is hosting an eight hour, online course on Making your own Herbal Medic First Aid Kit Aug. 3 – 16, 2020 for $100 ($65 if you register by July 13).

Making your own Herbal Medic First Aid Kit

Building your own first aid kit can be a daunting task – trying to find the best pack to hold your gear, keep the weight manageable and have all the equipment you need in one place..

It even becomes more complicated when you want to add herbal remedies to your first aid kit.

Do you know the essential equipment you must have in your kit?

Do you know the best type of packs to use for small, medium and large first aid kits?

What are the most important herbal first aid preparations to include in every kit and why?

Do you know how to improvise bandages, splits, packs and kitchen first aid herbs?

This is an 8-hour course that includes lectures, videos and resources on:

FIRST AID KIT CONTAINERS

  •  The top three items every kit MUST haves
  • Improvisation – making a great herbal first aid kit from containers EVERY household has
  • How a kit opens and why this is important
  • Compartmentalizing: containers within containers
  • Sizing and weight
  • Car kits, work kits, go bags and mini (every day carry) kits

ESSENTIAL TRAUMA FIRST AID SUPPLIES

  • Necessary bandaging equipment from minor to life-threatening
  • Wound & burn management
  • Sharps from A to Z
  • Hydration, nutrition and recovery
  • First aid improvisation: using materials on hand for your kit (and in emergencies when you have no kit)

MUST-HAVE HERBAL PREPARATIONS

  • Infection control for respiratory, UTI, Gut and Skin
  • Nervines/Adaptogens for anxiety and trauma
  • Immune supportive herbs for medical emergencies
  • Venomous bites and stings
  • Salves and powders (which to use, when and contraindications)
  • Working with herbs you probably have in your kitchen

The Herbal Medic First Aid Kit Course will include eight hours of video lectures, resources for supplies and materials, slideshows and handouts.  Students will also receive access to ‘The Top 25 herbs for the end of the world’ pdf and the ‘Building Your Own Herbal First Aid Guide’ pdf for download. 

In addition, students will be mailed two full-size glossy 11”x17” posters:  “First Aid Kit Essentials” and “Herbs for Emergency First Aid”. One of these posters includes an organized and visual layout to help you understand what to pack in your first aid kit and how to organize it, whether you know nothing about first aid or you are a medical doctor. The other poster includes an organized structure that will help you pick the most essential herbs you need for your kit, with over 50 herbs spanning multiple health care issues from acute to chronic!

This incredible online course will open on August 3rd with 60 days access. All course materials can be downloaded for personal future reference and use, and the posters will ship out on receipt of tuition.

Dates: The online classroom access will open on August 3rd, 2020, with materials made available for download.

Live Session TBA.

Registration will remain open until August 16th, 2020.

Location: This is an online class – you do not have to be in our area to participate! You only need access to the internet to take this class.

Click here for the class info and registration page.

Columbia Safety Holding Classes Again

Medical skills trainer Columbia Safety of Kennewick, WA is holding classes again. You can check out their calendar of classes here. Retired St. Louis police captain David Dorn was murdered earlier this week, shot by looters breaking into a friend of Dorn’s pawn shop. Some of the incident had been posted as video to Facebook. I watched a good portion of the video. He was conscious and while he was verbally encouraged to stay alive, he didn’t appear to have received any first aid. While I don’t know if rapid first aid would have saved his life, it is a good reminder that 20% of people who have died from traumatic injuries could have survived with quick bleeding control. Please take a Stop the Bleed or first aid course!

Some courses coming up:

Red Cross Adult and Pediatric FA/CPR/AED – Sat, June 13, 9:00am – 3:30pm

Stop The Bleed – Mon, June 15, 6pm – 9pm

Red Cross Adult FA/CPR/AED Hybrid – Tue, June 23, 1:00pm – 2:30pm

Stop The Bleed – Wed, July 15, 6pm – 9pm

Doom and Bloom: Fever

The Altons at Doom and Bloom Medical have an article up on fever – what is it? Why does it happen? What should you do about it?

  • COVID-19 is running rampant throughout the globe. Contagious and sometimes deadly, it’s likely to cause severe illness in millions and ruin economies before it’s done.

    You probably know the classic symptoms: Fever (also known as “pyrexia“) occurs in 88 percent of cases, followed by a dry cough. One in five or six go on to develop pneumonia. Of these, a percentage will succumb to the disease. You should know about these symptoms and others associated with COVID-19 and other infections. Today we’ll discuss fevers.

    Why do we get fevers when we’re sick? There seems to be a body of evidence that suggests a higher body temperature kills many viruses and bacteria that do just fine at a normal temperature (98.6 degrees Fahrenheit). Fever is a weapon against disease-causing organisms.

    What constitutes a fever? An elevated body temperature, of course, but how high? In medical school, I learned that it wasn’t a fever until you hit about 100.4 degrees Fahrenheit. This equals 38 degrees Celsius. In older people, the immune system is often too weak to mount that high a temperature. Any elderly person at 99.6 or so should be considered as “febrile” (having a fever).

    Your temperature is a fluid statistic, however. In the morning, it is lower than it is in the late afternoon or evening, sometimes by a degree or more. The temperature also varies dependent on the method used to measure it.

    Old-style glass thermometer

    In the past, people used mercury thermometers. These were made of glass and required no battery, a useful item long-term off the grid. Unfortunately, they could break, causing cuts and dispersing mercury (a toxic substance).

    Today’s thermometers are electronic and non-toxic. There are various types on the market that use the mouth, armpit, rectum, ear, and forehead. Compared to the standard normal oral temperature of 98.6 degrees, you can expect:

    • A normal armpit reading to be one half to one degree lower (97.6)
    • A normal rectal temperature to be one half to one degree higher (99.6)
    • A normal temperature using an ear thermometer to be one half to one degree higher (99.6)
    • A normal forehead scanner (such as those used in many airports) temperature to be one half to one degree lower (97.6)

    So, if a person’s temperature is 100.4 F orally, it could be 99.4 in the armpit or forehead and 101.4 in the rectum or ear. Rectal temps are thought to be most accurate, while armpit temperatures are thought to be least accurate.

    Note: An oral thermometer reading may be inaccurate if you ate or drank something recently. A precise value may not be obtainable for 15-30 minutes afterwards.

    The ability to use the thermometer properly is an important factor. This isn’t difficult for adults that read the instructions, but a fussy, sick toddler may not cooperate. In this case, a rectal temperature reading may be the most accurate.

    Many use the ear thermometer. This is also known as a tympanic thermometer, named after the tympanic membrane or “eardrum”. Tympanic temperature readings average about the same as rectal. To be accurate, take the temperature in both ears and use the highest reading. The reading may be artificially elevated if you have been laying on your side with your ear on a pillow. As well, it’s said that those with a very short, curved ear canal may not have reliable results. This is a tough one to tell unless you ask your doctor to take a look during an exam.

    “Forehead” thermometers actually scan the temperature of the temporal artery. This item is superior to forehead strips, which are better at measuring skin temperature than body temperature. Be aware that they can be expensive.

    Here’s advice from Seattle Children’s hospital on how to properly use each type of thermometer…

Click here to read the entire article at Doom and Bloom.

The Herbal Prepper: Respiratory Relief Tea

Who’s up for a healing, herbal tea when you start feeling a bit Ill? Certainly me, for one. Cat Ellis, The Herbal Prepper, has a nice, lengthy post on making an herbal tea for the remedy of cold/flu/respiratory issues – Respiratory Relief Tea.

This tea is one of my favorite cold and flu season remedies. I make it every year, tweaking it a little bit each time. I make this in large batches in September in anticipation for cold and flu season.

Around the house, I nicknamed it, “herbal tussin tea”. I wrote one version of my tea blend here. In my book, Prepper’s Natural Medicine, I list is as “Respiratory Infection Tea”. Since it addresses common, respiratory symptoms, and not any specific infection, I’ve renamed it, “Respiratory Relief Tea”.

I have also updated this recipe to allow for more effective tea-making techniques. It blends cold infusion, hot infusion, and decoction preparations.

Want the Lazy Version?

If you want an easier method with fewer steps, check out my easier version here. It’s less of a potent remedy, but it has fewer steps and is still effective.

Relief for Common Respiratory Complaints

The herbs in this tea are a blend of expectorant, decongestant, diaphoretic, analgesic, immunostimulant and demulcent herbs. This will support your body as it heals from a respiratory infection by:

  • Making coughing more productive and easier.
  • Supporting natural immune response.
  • Soothing irritated mucosal tissues.

Methods Used

This preparation is a bit more involved than my previously published respiratory tea recipes. Once you get the hang of it, it’s really not that hard.

This tea utilizes three different water extraction methods:

  1. Cold Infusion
  2. Decoction
  3. Hot Infusion

Cold infusions are made by steeping herbs in room temperature water for 4 to 8 hours. I tend to make them in mason jars, filling the jar 1/4 of the way. Then I fill the with water and secure the lid.

I use tend to use wide mouth jars for ease of filling and emptying the jars. I also use left-over lids from canning, or these reusable, plastic lids.

Decoctions are made by simmering hard plant material, such as roots and bark. To 4 cups of water, add between 1/2 and 1 cup of herbs, depending upon your needs and how concentrated you want your end product. Add the herbs to a pot of cold water, bring to a boil, then reduce to a simmer. Allow to simmer for 20 minutes, and the water will have reduced by half. Strain, and the resulting liquid is your decoction.

Hot infusions are made by steeping delicate plant parts, such as leaves and flowers, in hot water. I use anywhere from 1 tablespoon up to 4 tablespoons per 1 cup (8oz) of water, depending upon how strong I want the end result.

Measurements

I have listed the ingredients by volume, not by weight. For example, I measure by cup, not by ounces. So, 1 cup equals 1 part.

If you want a smaller batch, use a 1/2 cup or a even 1/4 cup to represent your measurement of “1 part”, and maintain the ratios throughout.

Weighing everything would be more precise, but I haven’t found weighing everything out to exact amounts to matter much with this tea.

How to Make Respiratory Relief Tea

Follow the instructions below on how to make the Cold Infusion Phase, the Decoction Phase, and the Hot Infusion Phase.

Here are the steps to combine the phases:

  1. Make the cold infusion phase first.
  2. Use the resulting liquid as the water for your decoction.
  3. Strain out the herbs and reserve the liquid.
  4. Reheat the decoction (the liquid) if needed to just before boiling.
  5. Add the herbs for the hot infusion, turn off the heat, and cover.
  6. Allow herbs to steep covered for at least 15 minutes.

This takes a bit of time from beginning to end. I suggest making it in larger batches, once a day, and reheat just before consuming.

Honey is a perfect addition to this tea, as it helps to both sweeten the tea and to relax coughing. If you are diabetic and cannot have honey, you can sweeten your tea with something like this monkfruit-based syrup.

Respiratory Relief Tea- Cold Infusion Phase

Ingredients

  • 3 parts slippery elm
  • 1 part marshmallow root
  • 4 parts room temperature water

Directions

  • Combine slippery elm bark and marshmallow root
  • Cover with the water, and allow to steep at room temperature between 4-8 hours.
  • Strain, reserve liquid and discard the plant material.
  • Store cold infusion in refrigerator for up to 2 days if needed.
  • Use this as the water for the decoction phase

There are concerns with slippery elm, as it is an endangered wild plant. If you can, buy organic. That should ensure that it came from a managed population, not from a wild population that might have been overharvested. Otherwise, feel free to substitute Siberian elm instead, or just use 100% marshmallow root.

A quart mason jar will allow for 1 cup of plant material and 4 cups of water. This is the correct ration of plant material to water, and the jars have easy-to-read measurements on the side of each jar.

Use cut and sifted instead of powdered forms. Powdered slippery elm and marshmallow will be much more difficult to strain out. It’s a mess. Ask me how I know…(continues)

Click here to read the entire article in full glory at The Herbal Prepper.

Related:

Wholefully: 5 Cold-Busting Herbal Tea Blends

Learning Herbs: Hyssop Oxymel: A Cold, Flu and Bronchitis Home Remedy

Doom and Bloom: Medical Improvisations – DIY Techniques for Survival First Aid & Hygiene

The Altons at Doom and Bloom Medical have an article published in OffGrid magazine by Recoil, issue 36 – Medical Improvisations – DIY Techniques for Survival First Aid & Hygiene

We live in a world where established safety measures, if followed, prevent a lot of injuries. Unfortunately, they’ll never prevent all injuries. There were an estimated 45 million incidents of trauma in the U.S. last year that required an emergency room visit. Car wrecks, outdoor injuries, industrial accidents, and other mishaps contribute to a whole lot of hurt in good times. That leaves us to wonder: How would this change in bad times?

Let’s face it, people get injured and sick whether or not there’s a rescue helicopter on the horizon. Broken bones, bleeding, sprains, and other issues will need to be treated.

If the modern emergency system breaks down, is overloaded, or simply too far away, someone in the family or group will become the highest medical asset left. Certified or not, they’ll be the end of the line with regards to the medical well-being of their people. Without equipment and know-how, deaths will occur that could’ve been prevented with a good medical kit and knowledge of basic first aid.

People prepare for the worst by accumulating food, water, personal protection items, and more. The wisest of them also stockpile a good supply of medical equipment and medicines as well. In a short-term event, those with training and equipment will save many lives. But what happens when the medic bag is empty?

All is not lost. Necessity, they say, is the mother of invention. The resourceful will make do with found objects. A variety of items on the trail or in abandoned buildings can serve as medical supplies. All it takes is an instinct to explore, a good eye, and some imagination.

Before we begin, it should be mentioned that the medical improvisations below are stopgap measures for dire situations when traditional medical resources and treatment are not available — unfortunately, the current Coronavirus / COVID-19 outbreak may be one such circumstance, if it continues to worsen. Improvised methods are rarely as successful as modern technology and equipment (if used properly). Having said that, some of the strategies below might just save lives in times of trouble.

WATER BOTTLES AS FILTERS

You can last quite a while without food, but only about three days without water. Even when there’s a water source nearby, you can’t see the microscopic organisms that make you sick. In survival settings, more lives may be lost by diseases due to contaminated water than bullet wounds.

With a clear plastic PET (polyethelene terephthalate) bottle, you can make water safer. It shouldn’t be hard to find; approximately 500 billion are produced every year. Unless you have a purpose-built water filter like the Sawyer Mini or LifeStraw, you’ll need containers to: 1) filter out particulates that make the water cloudy, and 2) destroy disease-causing microbes in the water.

To improvise a filter, you’ll need the following items that you might find by scavenging, or in your medical kit…