Wilderness Doc: Hydration and Rehydration

While hydration may seem more like a summer topic, cold, dry weather can cause a decrease in thirst, making it easier to become dehydrated. Here’s an article from Wilderness Doc on Hydration and Rehydration, including using a nasogastric tube for severely dehydrated patients. While Doc doesn’t discuss it in this article, there is also the option of emergency rectal hydration for patients who are unconscious, suffering nausea, or in shock.

Hydration aka water…essential for life. We take for granted this vital substance which we cannot live without. In much of the world, however, clean drinking water is a luxury. In a previous post, I have discussed how to make this water safe to drink. In this post, I want to examine what you might be able to do for yourself or a companion should you become dehydrated.

Oral rehydration is the standard way to rehydrate. This can be accomplished with small sips of water, Gatorade or, in dire circumstances, whatever you have at hand. If you have more resources, making an oral rehydration solution is even better. There are several options to make this. The two most common start with a quart of clean water to which the following is added:

Option 1: One teaspoon of salt, 8 teaspoons of sugar. Mix, then add 0.5 cup orange juice or half a banana (mashed).

Option 2: One-fourth teaspoon of baking soda, 1/4 teaspoon salt. Mix. Add 2 tablespoons of sugar or honey. Mix again. Add 0.5 cup orange juice or half a banana (mashed).

Ideally, the dehydrated patient will drink at least 3 quarts of this solution daily until the diarrhea or other source of dehydration ceases.

Unfortunately, the severely dehydrated patient may refuse or be physically unable to drink the solution. In those cases, consider a nasogastric tube feeding for these patients. Most people are able to easily place such a tube with some lubrication either through KY or other water soluble lubricants applied either to a standard NG tube or to IV tubing or any relatively clean piece of small caliber, flexible tubing. Be sure to test placement by listening over the stomach while blowing into the mouth end (proximal end) of the tube and hearing bubbles in the stomach. You should also start out with a very small (less than 5 ml) test infusion. If coughing occurs, check placement again as you do not want to introduce the solution into the lungs and potentially produce a pneumonitis. The amount of fluid to administer for adults is calculated by adding the patient’s weight in kg’s to 40. An 80 kg patient would need 80+40=120 ml/hr of the oral rehydration fluid. This would be continued until the patient is able to drink the solution on their own, without aid of the tubing.

While there are examples of WWII POW’s utilizing sharpened bamboo sticks and rubber tubing to fashion IV’s, the risk of infection from this would be very high. Further, the art of finding a vein in such a severely dehydrated patient is one most, even with modern and sterile equipment do not possess. If things are so bad as to even consider such a situation, it is likely natural processes will not be stopped. So, while an interesting thought experiment, I would recommend you think more about and ensure adequate knowledge of the above skills instead…

Doom and Bloom: Injuries to the Nail Bed

The Altons at Doom and Bloom Medical have an article about nail bed injuries and how to treat them. If you’re squeamish, there are a few bloody and/or squished finger photos in the article.

A fractured femur or a gunshot wound to the chest are major injuries that affect your chances of survival in disaster settings, but not all injuries are so extreme. “Minor” injuries can also impact the efficiency of a group member off the grid.  Of these, nailbed injuries are some you’ll commonly see.

You can imagine that nailbed injuries will be more common when untrained (and perhaps careless) people perform tasks to which they’re not accustomed. The failure to use work gloves and boots may also increase the risk of mishaps.

NAIL ANATOMY

Your fingernails and toenails are made up of protein and a tough substance called keratin. They are very similar to the claws of animals.  Any issue relating to nails is referred to as “ungual” ” (from the latin word for claw: unguis).

The nail consists of several parts:

The nail plate:  this is the hard covering of the end of your finger or toe; what you normally consider to be the nail.

The nailbed:    the skin directly under the nail plate.  Made up of dermis and epidermis just like the rest of your skin, the superficial epidermis moves along with the nail plate as it grows. Vertical grooves attach the superficial epidermis to the deep dermis.  In old folks like me, the nail plate thins out and you can see the grooves if you look closely.  Like all skin, blood vessels and nerves run through the nailbed.

The nail (germinal) matrix:  the portion or root at the base of the nail under the cuticle (the cuticle is also called the eponychium) that produces new cells for the nail plate.  You can see a portion of the matrix in the  light half-moon (the “lunula”) visible at the base of the nail plate. This is the germinal matrix (actively makes new nail cells) and determines the shape and thickness of the nail; a curved matrix produces a curved nail, a flat one produces a flat nail.

TYPES OF NAIL INJURIES

There are various types of nail injuries. Amputations and fractures may occur due to trauma, but more commonly you’ll see…

Click here for the rest of the article.

Doom and Bloom: Medical Uses for Baking Soda

The Altons at Doom and Bloom Medical have an article on the medical uses for baking soda, which most of us will have around the home in some quantity anyway.

Some folks in the preparedness community consider themselves ready for any disaster if they have some food, water, and a means of personal defense. Being prepared, however, is more than that. You have to be able to treat medical issues. And not just that: Attention to hygiene is equally important in preventing some of those issues.

Those concerned about a long-term event should know that the expenditure of various supplies over time will be a major problem. What will you do when you run out of one item or another? You have to find substitutes that can serve double (and triple) duty. The more versatile the item, the more useful it is to store.

Baking soda is one item you should have in quantity. Yes, baking soda. Many years ago, one of our readers wrote an excellent article on baking soda in survival settings. He opened our eyes to its many uses.

WHAT IS BAKING SODA?

Baking soda (also known as sodium bicarbonate or bicarbonate of soda) is a popular and inexpensive household product. You can actually mine deposits of it if you live in parts of California, Colorado, and Mexico (as well as Botswana). It has been historically used as a leavening agent for baking bread and does a fine job absorbing odors in your refrigerator.

Baking soda is not the same as baking powder. Baking powder contains baking soda, but it also contains an acidifying agent and starch.  Both produce carbon dioxide which causes baked goods to rise and, indeed, you can substitute baking powder in place of baking soda (usually, you’ll need three times more baking powder), but you can’t use baking soda when a recipe calls for baking powder.

MEDICAL USES FOR BAKING SODA

Are there medical uses for baking soda? The answer is yes. So many, in fact, that you might want some around even in normal times.

You can treat insect bites and itchy skin with it. Some find it effective for poison ivy. Make a paste out of baking soda and water, and apply like a balm onto the irritated area. You could shake some baking soda into your hand and rub it onto wet skin.

Baking soda can help unblock nasal congestion by adding a teaspoon to some hot water and inhaling the vapors.

For those who suffer from acid reflux (heartburn), eventually the Tums and Rolaids will run out. Baking soda was what they used before these products came into being.  Just add a teaspoon of baking soda in a glass of water after meals.

Recent medical studies, including one published in the Journal of the American Society of Nephrology, suggest that sodium bicarbonate tablets may help slow progression in those with chronic kidney disease. The researchers concluded, “This study demonstrates that bicarbonate supplementation slows the rate of progression of renal failure to ESRD and improves nutritional status among patients with Chronic Kidney Disease (CKD).”

Baking soda has mild antiseptic and drying properties, and helps keep a wound clean. When a wound is healing, repeated cleaning of the area can result in dry skin and a hard, itchy scab. Baking soda can help soften and remove the scab once the wound is no longer painful or draining. One treatment regimen uses 2 to 3 tablespoons of baking soda with a half cup of water. Leave the paste on the wound for 15 minutes and then rinse thoroughly (be aware that it might burn a little).

You’re not medically prepared until you’re dentally prepared. In long-term events, the family medic will have to deal with a number of dental problems that crop up. Baking soda can be a replacement for toothpaste. Add a little 3% hydrogen peroxide to it and use it as a rinse for bad breath…

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

Basic Pistol and Trauma First Aid Classes Coming in NOV and DEC

Stealth Defense is teaching a few Basic Pistol classes in November and a Trauma First Aid class in December of 2019.

Ladies Basic Pistol Shooting

Tue Nov 5, 5:00 PM – Sat Nov 9, 12:00 PM (PST)
Stealth Defense Firearms Training, 2732 Katie Rd, Kennewick, WA

This course includes a FREE Initiative 1639 required firearms safety training lesson and certificate

Topics covered in this class include: gun safety rules, proper operation of semi-automatic and revolver pistols, ammunition knowledge and selection, selecting and storing a pistol specific to you (the user), safe and correct storage of firearms when not in use, the fundamentals of shooting, the three (3) secrets of accurate shooting, pistol inspection and maintenance, stoppage clearances, shooting positions, and a qualification marksmanship shooting test. A light snack is provided, but you will need to bring a lunch.

This course meets the pistol safety requirements for obtaining an Oregon Concealed Handgun License, and an Idaho Standard Concealed Weapons License. WA has reciprocity in ID, but having a non-resident ID license gives a person reciprocity in the same states as Utah at a lower cost. Students will be responsible for following the state’s requirements for obtaining their concealed carry licenses.

Course fee includes all student materials – NRA Book, Exam, NRA Associate Membership, downloadable exam prep materials, range fees, targets, and certification fees.

Co-Ed Basic Pistol Shooting

Thu Nov 7, 5:00 PM – Sat Nov 9, 5:00 PM (PST)
Fredricks Arms and Smiths, 1904 Airport Way, Richland, WA, USA

This course includes a FREE Initiative 1639 required firearms safety training lesson and certificate

Topics covered in this class include: gun safety rules, proper operation of semi-automatic and revolver pistols, ammunition knowledge and selection, selecting and storing a pistol specific to you (the user), safe and correct storage of firearms when not in use, the fundamentals of shooting, the three (3) secrets of accurate shooting, pistol inspection and maintenance, stoppage clearances, shooting positions, and a qualification marksmanship shooting test. A light snack is provided, but you will need to bring a lunch.

This course meets the pistol safety requirements for obtaining an Oregon Concealed Handgun License, and an Idaho Standard Concealed Weapons License. WA has reciprocity in ID, but having a non-resident ID license gives a person reciprocity in the same states as Utah at a lower cost. Students will be responsible for following the state’s requirements for obtaining their concealed carry licenses.

Course fee includes all student materials – NRA Book, Exam, NRA Associate Membership, downloadable exam prep materials, range fees, targets, and certification fees.

Trauma First Aid (part 1)

Tue Dec 10, 5:30 – 9:00 PM (PST)

Prosser, WA

  1. Performing a patient assessment.
  2. Traumatic emergencies.

Trauma First Aid (part 2)

Thu Dec 12, 5:30 – 8:30 PM (PST)

Prosser, WA

  1. Medical and environmental emergencies.
  2. Creating your own emergency first aid kit.

Pioneer Thinking: Medicinal Uses of Garlic

Autumn has fallen upon us once again. The garden is largely put to bed, but one of the things I’m out planting at this time of year is garlic. Garlic is, of course, a delicious food staple. In addition to being a food source for thousands of years, garlic has been used as a medicinal plant for nearly as long. It’s medicinal uses have been recorded by the ancient Egyptians, the ancient Greeks, ancient China and Japan, and in India’s two thousand year old Charaka Samhita medical text. So, if you weren’t think about garlic already, get out and plant some!

The following excerpt is from an older article by Pioneer Thinking: 14 Medicinal Uses of Garlic

Garlic and Health

Garlic (allium sativum) is a member of the onion family which has been used for culinary purposes for millennia and in recent years has been labelled a super food.

Unsurprisingly in the four thousand year history of this little vegetable or herb, it has been found to have numerous uses for medicinal purposes.

Open Wounds and Infections

Wounds and infections can be cleansed and treated with a garlic solution. After the wound has been cleaned, grate or pound twenty or so cloves of garlic, being careful to use only clean utensils. Mix it with a little water to make a paste which can be spread over a sterile gauze dressing and applied to the wound. Keep in place with a bandage and leave for two days when the process should be carefully repeated. During World War II, when antibiotics were scarce, garlic was often used in this way to treat wounded soldiers and protect against gangrene and septic poisoning. During the first war, garlic was also widely used to treat dysentery and typhus.

Throat and Ear Infections

Because garlic kills bacteria it works both externally and internally and many people use it to treat throat infections, colds etc. More often than not nowadays, garlic is taken as a supplement in capsule form, but making your own linctus could not be easier. Simply boil a head of garlic gently in water for 2 hours to make a light tea, adding syrup or honey to sweeten if necessary. Strain this and allow it to cool slightly before sipping. Garlic is also soothing and beneficial in ear infections if garlic infused oil is gently massaged around the ear area.

Oral Thrush and Digestive Tract Disorders

For a more palatable flavor, garlic can be mixed with apple cider vinegar and sweetened with honey. This can be sipped, used as a gargle or administered with a teaspoon like cough medicine. The combined properties of garlic and vinegar help to destroy harmful bacteria in the mouth and digestive tract. It can therefore be used to cure mouth ulcers and oral thrush.

Boosting the Immune System

Taken little and often, garlic can help to boost the immune system. The allicin in garlic is similar to penicillin, though not as strong. It is produced when the garlic is finely chopped or crushed, which increases its strength. For internal problems, chewing on a clove of garlic can release the antibiotic properties. However it is important to use only white cloves as the green thread which is sometimes found in the center of a clove of garlic is not only indigestible but is also what causes the notorious and lingering garlic ‘pong’ on the breath.

Athletes Foot and other Fungal Infections

For external fungal infections, such as athlete’s foot, a garlic foot bath is both refreshing and effective. You can make this by crushing 4 cloves of garlic with salt or rubbing alcohol into a foot spa or bowl large enough to hold the feet and soaking the feet in this for half an hour. After thoroughly drying the feet, you can rub the infected area with cotton wool swabs soaked in little garlic oil. A twice daily application should help to clear up the fungal infection.

Counteracting ‘Bad’ Cholesterol

The other ingredient of garlic is diallyl sulphide. This is widely believed to be beneficial in combating LDL (low density lipoprotein) or ‘bad cholesterol’ – that scourge of modern society. The phytochemicals in garlic appear to work in the same way as statin drugs which are often prescribed to lower cholesterol. The benefit of using garlic is that, being completely natural, it has no side effects. Studies have shown that garlic can be as beneficial as a low fat diet in reducing cholesterol and by combining both, levels can be reduced by 20%. 800 mgs of dried garlic or 5-10 cloves of fresh garlic should be consumed daily for best results.

High Blood Pressure

There has also been a lot of scientific interest recently in using garlic to lower high blood pressure. Whilst studies are inconclusive, early signs seem to suggest that garlic can help to bring down blood pressure levels. Garlic can be taken as a supplement along with your normal anti-hypertensive medications or as an extract or distilled garlic oil; 600-900 mg daily is the normal recommended dose, which may sound high, but is relatively small in terms of raw garlic. Fortunately, unlike allicin, the health benefits of the diallyl sulphides are not destroyed by cooking, so including garlic in recipes is the easiest way to help lower your cholesterol and your blood pressure

Stroke

Another worrying lifestyle disease these days, which is often linked to cholesterol and blood pressure, is stroke and once again garlic has been found to be beneficial. This is because garlic is rich in anti-coagulant or blood thinning properties, similar to aspirin. Studies have shown that garlic reduces platelet stickiness which is responsible for hindering the circulation of blood around the body. Increasing your dietary garlic intake or taking garlic supplements (500 mg three times a day) can thin the blood and help prevent the onset of stroke.

Why Garlic Benefits Sufferers of Atherosclerosis

Atherosclerosis, or the build up of plaque in the walls of the arteries, is known to be alleviated by garlic. It works directly by reducing the lipid content in cells of the arteries and thus preventing their dangerous accumulation. Recent studies show that women may benefit more than men by increasing their intake of garlic to prevent thrombosis.

An Essential Role in Diabetes

Diabetes is a frightening disease which is growing in number in the United States. It currently affects between thirteen and fourteen million people. It is a metabolic disorder caused when the body is unable to break down foods properly, causing more sugar to enter the blood stream than the pancreas (which produces a hormone called insulin) can deal with. For diabetics, consuming garlic is invaluable as it reduces blood sugar levels, either by stimulating the pancreas to produce more insulin or by making existing insulin more available or more effective at its job.

The Kidneys and Bladder

The function of the kidneys is to filter the blood and help remove toxins from the body. When they become damaged due to diabetes, hypertension or other medical conditions, they become severely strained and serious problems can kick in. The anti-oxidant and anti-inflammatory properties of garlic promote kidney health by eliminating free radical damage and purifying the blood. Garlic is a natural diuretic which means it helps to eliminate excess salt and water through the urine. Garlic therefore is an internal cleanser, helping to flush harmful toxins out of the body.

Respiratory Problems and Lung Disease

The combination of garlic’s antibacterial, antifungal and antioxidant properties, not to mention is high concentration of sulphur makes it extremely effective in combating all manner of respiratory ailments, from bronchitis to pneumonia. Because it acts as an expectorant and a decongestant to clear the lungs, sufferers of chronic bronchitis can benefit considerably from adding garlic to their daily diet.

Anti-Cancer Effects of Garlic

It has been observed for decades that in countries where garlic and onions form a regular part of the diet, the incidence of cancer is much lower, causing scientists to study the link between cancer and nutrition. The ability of garlic to stimulate the gastric juices and restore the intestinal flora is what accounts for its success as a detoxifier and cancer-preventing agent. In the most extreme cases, the best results seen from using garlic to prevent or treat cancer have been from drinking garlic juice or chewing fresh garlic cloves. Stomach cancers have responded particularly well to garlic medications but occasional successes with other forms of cancer, even in the advanced stages, have been claimed.

Worm Infestation

Intestinal parasites are relatively common but extremely distressing and potentially dangerous if left untreated in toddlers and children. Parasites like tapeworms, hookworms, roundworms and pinworms are tiny creatures that find their way into the gastrointestinal tract and sometimes burrow into the muscles. They can cause a whole host of distressing symptoms of varying severity and need to be eliminated. The natural sulphur in garlic helps to expel and eradicate them.

Doom and Bloom: Wound Debridement

The Altons at Doom and Bloom Medical have an article up on the skill of wound debridement – the removal of necrotic tissue and foreign objects from a wound which may impede healing. There are some wound photos, so be warned.

Medical professionals like doctors, nurses, and paramedics and the high-tech equipment they work with are the heart of advanced medical care. When highly-trained personnel are unavailable, it becomes the responsibility of the average citizen to obtain medical education and supplies. Lack of knowledge and materials will cost lives in any situation where modern care is not an option.

Few medical pros can handle every medical issue
Knowing how to stop hemorrhage is very important, but the medic in austere settings will be required to do much more with an open wound. Indeed, they will be responsible for it from the time it was inflicted to full recovery. A good start is knowing “prehospital care”.  Few of us, however (including most medical professionals), are prepared to handle the complexities of the entire healing process when there is no hospital.

In today’s medicine, few providers care for every medical issue experienced by a patient. Even generalists send their patients to specialists for specific problems. In a survival setting, this is no longer possible. Therefore, it’s imperative to understand wound healing and the procedures that help a victim make a full recovery. One of these procedures is debridement.

Debridement is the removal of devitalized (“necrotic”) tissue and foreign objects from a wound. Most minor acute wounds heal just fine with cleaning and regular evaluation, but more severe wounds, burns, and bedsores may require intervention. Debridement is a way to eliminate obstacles to good healing.

Debridement speeds the healing process in various ways. Dead tissue inhibits the development of healthy new cells and makes the area susceptible to infection. It can also hide the signs of bacterial invasion.

Debridement is rarely taught in standard first aid courses. Even high-level education meant to deal with emergency trauma can get your victim to the hospital, but little for days or weeks down the road. I would guess that a volunteer stint with Doctors Without Borders might be closest, short of a surgical residency.

A variety of techniques are used to accomplish debridement and more than one type may be used on the same patient…

Click here to continue reading at Doom and Bloom Medical.

Organic Prepper: Fire Cider – How to Make a Remedy for the Flu

Herbalist and author Cat Ellis writes this post about Fire Cider, a flu remedy, for The Organic Prepper. Cat Ellis also has her own web site Herbal Prepper.

Fire Cider: How to Make a Fast, Effective Remedy for the Flu

One of my favorite remedies for cold and flu season is fire cider. It’s loaded with anti-inflammatory, immune-supporting, and decongestant herbs. Best of all, it’s super simple to make. Even though the combination sounds bizarre, it’s actually tasty in a sweet and sour kind of way.

Fire cider can be made entirely with items from the grocery store, or customized with more exotic herbs from an herb shop. I even have an “instant” version to share with you…

When we have the flu, we feel congested, achy, feverish, and have a bad cough. The traditional recipe for fire cider is loaded with simple, familiar, yet potent, ingredients which address each of those complaints.

Garlic

Garlic is well-known for its immune-supporting effects. It also acts as an expectorant and an anti-inflammatory, which helps those painful coughs and body aches. It is also known as a diaphoretic, which means it causes the body to sweat. This helps to reduce fevers naturally. Thankfully, fresh garlic is a common ingredient in most grocery stores.

Onion

Onion and garlic are both alliums, and therefore are related plants. They also share some similarities in properties. The unassuming onion is a potent expectorant and eases coughs. Onion is often used in cough syrups for this reason. Onions are so accessible in every store, please do use fresh onion.

Ginger

Warming ginger root also helps to induce sweating and fever reduction. Ginger also acts as an antispasmodic, which helps to ease those terrible coughing fits. It is highly recommended to use fresh ginger root (technically, it’s a rhizome, but no one ever bothers to call it that).

Horseradish

Horseradish is excellent for relieving congestion. It is also an effective diaphoretic (sweat-inducing/fever-reducing) herb. On top of that, horseradish is also an expectorant. What could be better for the flu? Sometimes, horseradish can be hard to find at the grocery store. It is in the mustard family, so go ahead and substitute some crushed mustard seed or mustard powder if you need to.

Cayenne

Cayenne is hot, but it is also a superior anti-inflammatory. I use it every time I’m congested to relieve the inflammation in my sinuses which make the sensation of congestion worse. This hot pepper can also get a congested nose running again, making blowing your nose a lot more productive. You can use any kind of hot pepper you wish. You can use fresh hot peppers, cayenne powder, or red pepper flakes.

Turmeric

Is there anyone left who doesn’t know that turmeric is anti-inflammatory? Because of this, turmeric is a huge help for reducing that achy feeling we get with the flu. There’s only one grocery store near me that sells it fresh. If you can find it fresh, great. If not, use the powdered herb.

Apple cider vinegar

Of all natural health products, apple cider vinegar has probably more health claims to it than any other. I’m dubious about most of these claims. However, it is a good menstruum (solvent) to extract the benefits out of the other ingredients. It also does seem to help ease coughing and congestion. I stick with the raw apple cider vinegar, and thankfully, this is also a common grocery store item.

Lemon

There is just something so wonderful about lemon. It lends both its bright flavor and its powerful decongestant properties to this recipe. You can use fresh lemon slices or add lemon juice at the end. Also, play with adding lime and other citrus fruits for fun.

Honey

Honey is effective at calming coughs. Our kids’ pediatrician was thrilled when we told her we keep bees, as cough suppressants had been found ineffective for children, while honey had been shown effective as a cough suppressant. Honey lends the sweet flavor to this hot, sweet, and sour remedy. Honey is added at the end…

I know, I know, a lot of people are thinking, “It takes two weeks or longer to make, but I”m sick now!” That’s ok, I’ve got you covered with an instant version. Check out the video below to see how this herbal wizardry comes together.

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

Click here to read the entire article. If you don’t want to, or can’t, watch the videos, the article has the text instructions for making the two-week fire cider.

Prolonged Field Care: SOP for Ideal Makeshift Clinic

The Prolonged Field Care site of the Special Operations Medical Association has put up a podcast and slides for setting up a clinic in an unconventional warfare situation for Special Forces Operational Detachment Alpha (SFODA) units. This can probably be adapted for makeshift clinics that can be used by medically trained personnel in the event of various disasters, civil war/disturbance, and other emergent situations. The slides include some layouts for a single treatment bed clinic.

SOP for the Ideal SF Clinic

Click to download PDF slides

25 minute podcast

Related:

Pastor Joe Fox of Viking Preparedness also has posted a recent video showing an aid station for a group event.

Also, if you are a Patreon contributor to Mountain Guerrilla Blog, he has a related post Survival Retreat Considerations, Medical Critical Nodes published on Sept. 5.

Wilderness Doc: Pre-Hospital Care in Mass Casualty Shootings

This article from Wilderness Doc discusses a key difference in civilian vs military shooting injuries and how, because of the difference, the first aid focus for civilians may be better served with blod clotting bandages than tourniquets — Pre-Hospital Care in Mass Casualty Shootings.

 

You will likely recognize the above picture as a CAT tourniquet. As programs such as Stop The Bleed and others have focused on the use of tourniquets in the field, these have become a popular item for most to carry in our kits. This is for good reason too. Studies and data coming from military experience in Afghanistan and Iraq have shown, these devices are no longer to be considered the “last ditch” efforts we once thought. That being said, what does the data show about efficacy or applicability of this data in civilian shootings as we have recently seen in El Paso and Dayton?

This very question was addressed in the May/June 2019 edition of the Air Medical Journal. Three studies by Smith, Butler and de Jager were used to discuss differences between the battlefield and civilian injuries. Interestingly, military injuries tend to be to extremities. This is due to several reasons. First, many soldiers are injured by high explosive devices and the fragments coming off of them. Secondly, the battlefield and the highly armed nature of the two sides on the battlefield, tends to separate the combatants much further than what is seen in the civil setting. This separation makes shots to vital areas such as the torso, head and neck less likely. Finally, soldiers tend to wear body armor that covers vital areas. While not fool proof, especially against higher caliber and more powerful rounds, it can protect against many rounds, especially if shot from a distance.

What does this difference mean for civilian first responders in such scenarios? It means that chest, back and head shots are much more likely. These areas are, obviously, not amenable to tourniquet placement. So, while still important, we need to adjust training and prepare our first responders for what they are more likely to see. In particular, the authors advise focusing on chest wounds. While there are many who have survived head shots, the chest can be far more survivable. Focusing on pressure and hemostatic impregnated gauze as well as chest seals and decompression may be the next line in pre-Hospital treatment. Also, ensuring such first responders are well versed in all forms of artificial airways can be lifesaving…

Click here to read the rest of the article at Wilderness Doc.

Doom and Bloom: Dental Kits Off the Grid

The Altons at Doom and Bloom Medical have a good post covering the items you need to have in an off grid or austere medicine dental kit.

Poor dental health, however, can cause issues that affect the work efficiency of members of your group in survival settings. When your people are not at 100% effectiveness, your chances for survival decrease. Anyone who has experienced a toothache knows how it affects work performance.

When modern dental technology is not an option, an ounce of prevention is worth a pound of cure. This strategy is especially important when it comes to your teeth. By maintaining good dental hygiene, you will save your loved ones a lot of pain (and yourself a few headaches).

Let’s discuss some procedures that both you and I know are best performed by someone with experience. Unfortunately, you’re probably don’t have a dentist in the family. The information here will at least give you a basis of knowledge that may help you deal with some basic issues.

The Prepared Family’s Dental Kit

dental kit

some components for a dental kit

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

In the past, we’ve mentioned that gloves for medical and dental purposes are one item that you should always have in quantity. Avoid sticking your bare hands in someone’s mouth. Hypoallergenic nitrile gloves are, in my opinion, superior to latex. For additional protection, masks should also be stored and worn by the medic. The simple “earloop” versions will do for dental exams.

dental “elevators” loosen ligaments that hold decayed teeth in place

Other items that are useful to the off-grid “dentist” include:

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

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

Doom and Bloom: Dengue Fever – A Rising Pandemic

The Altons at Doom and Bloom Medical have an article up on Dengue Fever , its current pandemic status, symptoms, treatment and precautions.

 

  • aedes aegypti mosquito

    Singapore dengue outbreak: Nearly 9000 cases through July – Outbreak News Today

    Nicaragua declares alert over dengue fever – Washington Post

    Bangladesh grapples with country’s worst dengue outbreak – Miami Herald

    Three headlines about Dengue Fever this year? No, actually they’re all headlines just from one day: Aug 1st, 2019. Dengue fever is a true pandemic, with community wide outbreaks in various regions throughout the world. Indeed, rates of Dengue infection are thought to have increased greatly since 1960 due to encroaching civilization and population growth in warmer regions. As a resident of South Florida, I believe that the development of residential air conditioning around that time may have precipitated the explosion in potential victims.

    rash in dengue patient

    What is Dengue fever? It’s an infection caused by a virus that’s transmitted to humans by mosquitoes. If you live between latitude 35 degrees north and 35 degrees south, and lower than 3000 feet elevation, you’re in Dengue territory.

    And you’re not alone. An estimated 400 million people get infected with the Dengue virus every year. Luckily for the grand majority, they don’t even know they have it. 96 million cases, however, aren’t so fortunate and develop sickness.

    The mosquito in question is the Aedes Aegypti, but other species may possibly spread it. A mosquito bites a human with the Dengue virus and becomes infected. It doesn’t get sick, but the virus is now in its saliva for life. The mosquito passes Dengue onto the next human through its next bite.

    Just a few diseases transmitted by mosquitoes

    There are actually four different but related viruses that cause dengue fever, but the symptoms are similar. If you’re in the unlucky minority that gets sick, you can expect to see signs about four to seven days after the infectious bite…

     

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

Doom and Bloom: Heat Wave Safety

The Altons at Doom and Bloom Medical have an article up — Heat Wave Safety — on the dangers of heat exhaustion and heat stroke. Once on an early morning march during AIT at Ft. Benning, I saw a young soldier collapse from heat stroke. He was rushed off in the back of a truck with a drill sergeant performing CPR. I wish that I or someone else would have noticed the signs before it became so serious.

Summer is here and the Midwest and East is experiencing record high temperatures in a major heat wave. Officials predicted a high-risk situation as the heat index surpasses heat indexes in 90s and 100s, and in some case, the 110s. Close to 200 million people might be affected in 32 states, according to the U.S. weather service.

The “heat index”, by the way, is a measure of the effects of air temperature combined with high humidity.  Above 60% relative humidity, loss of heat by perspiration is impaired 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.

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

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). They’ve already experienced one bad one this year and are predicted to have another in the near future. India, Pakistan, and other underdeveloped tropical countries experience thousands of heat-related deaths yearly.

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”), toxins leak, inflammation occurs, and cells die. Fatalities can occur very quickly without intervention, even in those who are physically fit. Even in modern times, hyperthermia carries a 10% death rate, mostly in the elderly and infirm.

 

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

Doom and Bloom: Snake Bite First Aid

The Altons at Doom and Bloom Medical have an article up – Snakebites: First Aid and Prevention. As rattlesnakes are fairly common, venomous, pit vipers in our area, it behooves us to be prepared to treat and avoid bites.

Rattlesnake
Warm weather wakes humans up from their hibernation, but it also wakes inhabitants of the Great Outdoors as well, such as snakes. Inevitably some hiker, camper, or hunter experiences a face-to-face (or face-to-ankle) encounter with a slithering serpent.

Of the 3000 species of snakes on planet Earth, only about 400 are venomous. In North America, those that inject venom into their victims are either pit vipers or elapids. Pit vipers include species of rattlesnakes, water moccasins (cottonmouths), and copperheads. One species or another exists everywhere in the U.S. except for Maine, Alaska, and Hawaii. Elapids include coral snakes, found mostly in the South.

A word about venom: Notice I don’t say “poison”. Poisons are absorbed in the gut or through the skin, but venom must be injected into tissues or blood via fangs or a stinger. Strangely, it’s usually not dangerous to drink snake venom unless you have a cut or sore in your mouth. Having said that, please don’t try this at home.

U.S. PIT VIPERS

Pit vipers account for most snakebites in North America. The “pit” refers to a heat-sensing organ located between the eye and nostril on each side of a triangular head. The eyes have slit-like pupils. Pit vipers include:

Rattlesnakes: Of all pit vipers, rattlesnakes contribute the most to snake bite statistics in the U.S. They get their name from a structure at the end of their tails which makes a loud rattling noise when shaken. The “rattle” serves as a warning to discourage nearby threats.

Copperheads: The copperhead looks similar to a rattlesnake but without the rattle. As the name suggests, it is often copper-colored or pinkish-tan with darker bands.

Water Moccasins: These snakes are very comfortable in water. This snake has no rattle, so is relatively silent, as if walking in “moccasins”. Its response to threats is opening its mouth wide and exposing its whitish oral cavity before biting. This behavior gives it the nickname “cottonmouth”. The water moccasin may have a pattern when young, but as an adult is almost black in color. Its thick body differentiates it from other water snakes, which tend to be slender.

U.S. ELAPIDS

Coral Snakes are related to the king cobra. They’re brightly-colored but unassuming creatures that are rarely aggressive. Their small fangs are less effective in delivering venom than pit vipers. A coral snake tends to deliver venom by holding on and “chewing” on its victim, unlike vipers, which strike and let go quickly.

The marks left by venomous snake bites have a distinct appearance due to the hollow fangs at the front of the mouth. This differs from non-venomous snakes, where the bites have a more uniform appearance.

Not every bite from a venomous snake transmits toxins to the victim; indeed, 25-30% of these bites will be “dry” and seem no worse than a bee sting.  This could be due to the short duration of time the snake had its fangs in its victim or whether the snake had bitten another animal shortly beforehand…

Coral Snake

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

Doom and Bloom: Summer Cryptosporidium Infections

The Altons at Doom and Bloom Medical have an article up describing cryptosporidium parasite infections – symptoms, treatment, and prevention.

Summertime is when you cool off with a dip in the pool, but this year you might be sorry you did. The Centers for Disease Control and Prevention are urging citizens to protect themselves against a hardy parasite called Cryptosporidium.

Public and private pools alike are being colonized with the nasty bug, better known as “Crypto”.  The organism lives in the intestines of infected people and animals. Crypto spreads in pool water when someone who is sick with the parasite goes swimming and has a loose bowel movement in the water. Because of their more liquid nature, diarrheal stools spread the microbe faster than formed ones.

Cryptosporidium

Cryptosporidium is so tough that it can live for up to ten days in the presence of bleach. This year, there are more outbreaks in recreational waters than usual. The frequency has risen an average of 13% annually since 2009. In the last decade, over 400 incidents were reported in the U.S., leading to sickness in 7,500 people.

Note: Organisms that cause sickness in a population are known as “pathogens”.

Swallowing water from pools, hot tubs, and swimming holes isn’t the only way you can get infected. Day care centers and other venues with a large number of small children can also lead to contamination. Contact with infected animals may also pass the organism.

SYMPTOMS OF CRYPTO INFECTIONS

Crypto lives here

Infection with Crypto leads to a disease called “cryptosporidiosis”. Within two to ten days after exposure, the victim starts to have nausea, vomiting, and watery diarrhea that can last for weeks. Other symptoms of the illness may include fever, stomach cramps, and weight loss…

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

Doom and Bloom: Eye Injuries

The Altons at Doom and Bloom Medical have an article up on Eye Injuries. Try to protect your eyes so that you don’t have to do any of this.

The human body is truly a miracle of engineering, from head to toe.  Your skull is just one example. It’s shaped in such a fashion that your eyes are recessed in bony sockets, which helps to protect them from injury. Despite this, there are many different activities of daily living, not to mention daily survival, that can cause traumatic injury to your eyes.

Here are some:

  • Accidents while using tools
  • Splatter from bleach and household chemicals
  • Debris flung while doing yard work
  • Grease splatter from cooking
  • Chopping wood
  • Hot objects near your face, like a curling iron (do people still use curling irons?)

The list goes on and on; heck, you could damage your eye by popping a cork on a bottle of champagne (if you could find champagne off the grid).

The grand majority of eye injuries are avoidable with a little planning but, despite this, it’s likely that the group medic will have to deal with someone’s eye injury at one point or another.

Foreign objects in the eye cause immediate symptoms, especially if they injure the sensitive cornea. You will see the victim complain of:

  • Eye pain or pressure
  • Tearing up
  • Light sensitivity
  • Frequent blinking
  • Redness (a “bloodshot” eye)
basic eye anatomy

The patient will usually tell you that they feel something in their eye. The most common location will be under the upper eyelid…

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