American Partisan: Ditch Medicine – Medications

The medical staff at American Partisan have a good post up about medication, how long it stays effective on the shelf, and what you might want to have on hand in case of emergencies. Ditch Medicine: Medications.

Most oral medications are given a rather arbitrary expiration date which may vary depending on the manufacture date, sell date, or type of medicine and concern over poor storage environments at home. Some manufacturers of medications indicate their desire to have their medicines expire, because they want patients to have up to date information about the medicine on the newer packaging.

The Pentagon shelf-life extension program has shown that many medications are safe and completely effective many years after the expiration date listed on the product, especially if stored in a favorable environment.  This is also extensively supported with numerous articles found by looking up “Myth of Medication Expirations” on the internet.

Many drugs stored under favorable conditions retain over 90% of their potency for at least five years beyond the expiration date on the label, and sometimes much much longer. Ciprofloxacin, for instance, was found to be completely safe and effective when tested nearly 10 years after the expiration date. Some medications appear to be more stable and therefore retain a greater amount of potency after expiration; these seem to include Cipro, Flagyl, lidocaine, atropine and possibly the penicillins.

Some medications are more unstable and do have an expiration such as insulin, nitroglycerin, aspirin and water purification tablets. A disputed article in one publication suggests expired Tetracycline may have caused toxicity in one patient (personally I don’t believe it since I am sure millions of doses of expired tetracycline have been used in 3rd world countries with no other reported complications; also, that old formulation of tetracycline is no longer available anyway, so I would be willing to expired tetracycline if I needed the medication). I am not aware of any other expired antibiotics having this risk.

Preferred storage environments would be cool, dark, and dry. Blister packaged medications might be preferable because they are kept dry and are waterproof but have the disadvantage of being slightly more bulky. Tablets are typically more stable and therefore have longer storage life than do elixirs/liquids. Many medications may be ordered over the internet as pet medications. Quality controls for pet medications seem good and I would be willing to use them on myself in an emergency.

The below is a list of commonly encountered medications that you might want to know about, and I would recommend finding a drug dose reference book from a bookstore or the internet; sometimes you can find them very inexpensively from book sections at Christian/Salvation Army stores…

Click here to read the entire article at American Partisan.

American Partisan: Ditch Medicine – Laceration Management

From the medical staff at American Partisan is this primer on the care of lacerations in austere conditions, Ditch Medicine: Laceration Management.

Lacerations are trauma which result in cutting or tearing of skin and possibly underlying tissue. Please note that deep lacerations that are complicated by the involvement of injuries to major arteries, tendons, nerves or abdominal cavity contents are not usually treatable in primitive conditions.

Initial Care for Lacerations

Most bleeding is initially controlled with pressure. Wounds without deep involvement should be surgically repaired if possible to speed healing, reduce infection, and improve cosmetic and functional results. The approximation of the skin edges can be achieved with steri-strips, skin glue, staples, or sutures (stitches). Before any wound is repaired, a few simple rules should be understood.

  • The longer a wound is left open to the environment, the more bacteria it will collect and therefore has a greater chance of infection, especially if the wound is closed by trapping these bacteria within the wound.
  • Most wounds can be closed within 12 hours of the injury (since the bacteria count won’t be terribly high). Since the face and neck have increased blood flow compared to most other body parts this extra blood flow helps the wounds fight infection and promotes healing, therefore wounds to the face and neck may be closed up to 48 hours after the injury.
  • Wounds that are to be closed must be thoroughly cleaned of any debris using forceps (tweezers) and using generous washings with clean or sterile water or saline. One source suggested using fresh urine from person without urinary infection since that should be sterile (I think I would rather use boiled water).

Creating Saline Solution for Laceration Washes

Saline solution can be made by adding one tablespoon of salt to 1 gallon of water or adding 1 teaspoon of salt to 1 L of water. Another irrigation solution can be made by adding 5 mils of household bleach to 1 L of clean water. Washing the area with Betadine or hibiclens before closure should be performed. Ragged wound edges and the tips of angularly cut tissue should be removed so that the wound edges to be approximated are smooth and will be likely to heal.

Steri-Strips, skin glue, and sutures may be the most useful ways to close a wound in a primitive environment. Staples may be used but require removal with a specialized removal tool which may not be readily available. Steri-Strips (tape) and skin glue can be applied to many wounds to hold the skin edges together until healing occurs. These are less secure than sutures (especially in larger deeper wounds) but maybe faster, require less technical skill, and may offer an improved cosmetic result.

For larger deeper wounds, sutures may be best for closure. Some wounds may have skin loss such that closure of the skin edges may be under some tension. The strength of sutures would be better for that closure, over glue or Steri-Strips. Sometimes tissue loss may be extensive enough that complete skin edge approximation may not be successful. Some gap in the skin edges may be allowed in these circumstances. Tissue loss with tension on the closure would require that the sutures be left for a longer period of time until the skin has stretched and relaxed enough so that there is no significant tension at the wound before removal of the sutures. In wounds without tension on the face, the sutures may usually be removed in about 3 to 5 days (this rapid removal is because of the high blood flow which speeds healing). The sutures on wounds of the trunk without tension may be removed in about 10 days. Sutures in the hands and feet are usually removed in about 10 to 14 days…

Click here to read the entire article at American Partisan.

The Medic Shack: Pandemics

The Medic Shack has a short article up about preparing for pandemics, Pandemics. The Media, Food and YOU. It is not a comprehensive guide, as he admits in the article; rather, it is meant to assure the reader that the risk is real and how to get a start on thinking about preparation.

A couple of weeks ago I wrote a bit on Typhus in the US. 3 years ago it was barely on the radar. The talk of the town was Ebola. It is making a guest appearance in Congo. Oh guess what. There is a bit of a civil war going on there. What happens when war and deadly communicable disease meet? People leaving to escape the war. And bringing the little friends with them. Cat Ellis The Herbal Prepper and I talked about the dangers of modern air travel and the rapid spread of violent viruses. What we didn’t talk about then was our family car.

Right now Typhus is having a resurgence in California and in Texas. And its coming on the winter travel season. OMG DO WE NEED TO SEAL OUR STATE BORDERS TO PREVENT THE SPREAD OF THE PURPLE CREEPING FUNGUS???????ARRRRRRRRRRRRRRRRRRRGH!

OK. A little melodramatic. But a valid concern.

NO we are not going to start bouncing about in a panic like a fork dropped into a garbage disposal.

Fact is is if a pandemic is going to start there is not much in the 21st century way of life that will stop it. Until we get “Star Trek level Bio Scanners” that will screen and kill pathogens, we need to be smart about protecting ourselves and family

Last year was the deadliest flu season in decades. @ 80,000 deaths were attributed to the flu. CDC Brief on Flu Deaths 2017-2018 (Also NO I am not going to get into the pros and cons of flu shots) I’m just using it as an example of how bad a virus spread can be.

Viruses are not the only “bugs” that can kill us. For people who do not live in the desert southwest or mountain west have not heard much about Bubonic Plague. Except out of history books. My son Jake’s boss at the local blood bank in Anchorage thought he was joking when he talked about how plague kills people every year. Until he showed them the stats.

So how do we prevent the spread of disease or the start of a pandemic when things go bad if the technology of the 21st century can not do it?

Do we isolate ourselves behind walls and barriers? Or do we learn how to stop or at least slow down the spread of disease.

Quarantine.

It is one of, and in all reality the best way to stop the spread of disease. In todays world it is a “dirty word” We say that we need to quarantine Fido for a few days before bringing him to the summer retreat in Hawaii its all good. But when we say we need to quarantine a group of people from Outer LithuUnitedia because the Purple People Eating Fungus is running rampant there. People get up in arms and the cries of discrimination and racism fly though out social media and the 24/7 news outlets…

…This article is one of those that was and is tough to write. In reality it needs to be broken into a host of smaller articles detailing different facets. This one is written to provoke. No promote discussion. Please take the time to converse with me or with anyone about the different scenarios. My email is medic@themedicshack.net Facebook is The Medic Shack or Mewe at The Medic Shack

Pandemics are real. Not the product of imagination. Time is way past to learn how to protect ourselves from them. The first link of the chain, and one that is ALWAYS broken, is. Communication. There is no real, concise, and most of all believable source. But wait! What about the CDC? Yes they send out warnings. But are dependent on the national and local media. Ok so what about the local or national media? Good question. What is the general media talking about. When there is something on the news about illness it is sandwiched between politics, hate crimes and the Hollywood Who’s Who. Do a news site search for the current Ebola outbreak in the Congo. See what you find in the news.

As I said earlier. I have no intention of doing the fork in the garbage disposal routine of panic. I am just wanting to pass on information. The most powerful weapon we have is not our weapons. Its our mind. We need to employ it. And to employ it we need to arm it. Knowledge is ammunition. And used correctly it is the most powerful weapon and more importantly, the best tool for survival.

Cat Ellis The Herbal Prepper has written a book on pandemics. Its called Prepping for a Pandemic and its on Amazon. Get a copy and read it.

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

Backdoor Survival: Become More Medically Self-Reliant

Backdoor Survival has an article up on using essential oils to become more self-reliant medically, including examples and instructions. Here’s an excerpt from Become More Medically Self-Reliant: Put Essential Oils to Work for You. It’s a bit lengthy, but it may give you a good start on using essential oils if you have been hesitant to try them.

When people first purchase essential oils they are excited to use them and to discover their benefits but sadly, a good percentage of those purchasers fail to move ahead and often don’t learn how to use them with much success. In fact, I know quite a few people who have good oils languishing in their cupboards for want of knowledge. This article gives suggestions and examples that may motivate a robust use of the essential oils you already have or have been thinking about trying.

Once understood and mastered and their efficacy established by successful application, there may be a desire to find other oils and other ways to include them in your home and emergency medical preparedness.  It is exciting to see a medical problem solved by an essential oil or a healing herb and thereby feeling a little more medically self- reliant, moving step by step. This knowledge is only acquired through using the oils correctly and experiencing what they can do to improve a medical concern. My small personal experiences build more confidence and put one more tool into my medical bag to help my family and others who may ask for help.

essential oils work for you

 

Three Successful Examples of Oil Use

Here are three examples of the many ways oils have worked. Please forgive me for sharing personal experiences. I do this with the hope that these stories will help others see that if essential oils worked for me, they may also work for you…making us all more medically prepared and better able to care for ourselves in our ailments and small accidents now and in harder times…

Click here to read the entire article at Backdoor Survival.

American Partisan: Ditch Medicine – Sterilization

Medical staff at American Partisan have an article up about the importance of and method to sterilize medical instruments in primitive settings, Ditch Medicine: Sterilization.

Sterilization is a term referring to any process that kills all forms of life on or in a material. Heat, chemicals, and irradiation are commonly used for sterilization. Any instruments to be sterilized will need to have surface debris removed to allow the sterilizing environment to reach the surface of the equipment. Expeditious sterilization or disinfection may be achieved in primitive settings using chlorine bleach, boiling water, pressurized steam, dry heat or open flame…

Sterilization may be one of the most critical parts of surviving some kind of disaster or other disruption event. It’s important to understand the methods available to you in a primitive situation, and prepare to have what you need on hand.

Doom and Bloom: How to Perform a Neuro Exam

Dr. Alton and Nurse Amy from Doom and Bloom have put out a video on how to conduct a neuro exam.

The medic for a survival group needs to be able to stop a wound from bleeding and splint an ankle sprain. For a long-term situation, however, a caregiver needs to know how to perform exams that would identify other medical issues. Here’s Joe Alton MD giving you a demonstration of a simple exam of the nervous system that would tip you off to a number of problems.

Nurse Amy acts as a volunteer for this video. While her exam is normal, future videos will discuss a number of neurological problems that the medic should be able to identify.

American Partisan: Medical Care When the Lights Go Out

An American Partisan staff member who is a surgeon has written Who’s On Call: Medical Care When the Lights Go Out about the basics

…We tend to think of collapse scenarios as abrupt, but through history they have often occurred in slow motion. One could argue that our health care system is already in a state of partial, ongoing collapse, especially since 2009. Anyone currently working in that sector knows it, as from a boots-on-the-ground, practical standpoint the PPACA may have actually reduced effective access to care and utilization and has engendered a rather unique set of patient and provider survival skills for the prevailing medical landscape that share commonality with the grid down world. The most important of those are mental, emotional and psychological. Long wait times, restricted access to providers, high deductibles and out-of-pocket expenses, third-party bureaucracy, system consolidation (i.e Aetna + CVS) and increasing use of non-physician providers (not a denigration of them, so please no hate mail, I love my NP) are all potential barriers to care that have parallels in the austere environment. Developing skills for self-care and outright avoidance of the system are increasingly necessary, as things are inexorably getting worse, and it’s not just domestic. The Gray Lady just outlined slo-mo collapse of health care in China.

Primacy of basic, mundane grid-down issues such as water purification, sanitation and disinfection cannot be understated. They are the three most important areas to address; dismiss them at your peril. Grid-down medicine, like all things military and surgical, is mostly boring and even mind-numbing. It’s not all sexy trauma stuff. Most of that will leave you dead. While the products of human violence will most certainly be faced, failure to provide clean water, properly address latrinage, and keep wounds clean will kill many more than bullets and bombs. Monsoon rains after the Haiti earthquake led to a cholera outbreak (traced to Nepalese relief workers) that killed thousands. Dysentery is a big inflictor of suffering and death after disasters. Modern trauma care is very complex, needful of extensive resources and still can not prevent all death. In a grid-down world, my specialty will likely be reduced to Civil War-era skillsets: draining pus and amputation…

Click here to read the entire article at American Partisan.

Beyond Antibiotics: 20 Medical Supplies to Store

Who doesn’t like talking about first aid? Everyone wants help for the hurts. The Prepper Journal has an article up, Beyond Antibiotics: 20 Medical Supplies To Store for TEOTWAWKI (h/t to John Mosby for the link). We’ve talked about first aid kits in the past. Check your supplies.

When it comes to medical supplies, some preppers store antibiotics, Band-Aids, Tylenol, maybe a bit of gauze and call it good. Perhaps a few more things, but not much because they’ve got a doctor in the group, or barring that, silver or barter goods and skills to be able to make arrangements with a doctor.

Unfortunately, that approach may not work out so well.

Realistically, how many supplies can a physician be expected to stockpile for a community? How many physicians are actually preppers who foresee a need? Post-disaster, it will be far easier to locate a physician who knows how to use supplies than it will be to locate the supplies themselves. While obtaining prescription medications in quantity is a challenge, fortunately many life-saving supplies and medications can be purchased right now, by anybody.

 

So let’s discuss some of these medications and medical supplies that we should acquire before TEOTWAWKI. It’s not an exhaustive list, but it is a good start…

Click here to read the entire article.

Managing Pain in a Pinch

the american civil defense assn.

Pills in woman hands.

by Cynthia J. Koelker, MD

Excerpt from Armageddon Medicine, How to Be Your Own Doctor in 2012 and Beyond

The daily queue of suffering seems endless. Toothache, stomachache, headache, earache, back pain, leg pain, joint pain, neck pain, sore throat, sore feet, sore muscles, sore eyes. People come to you seeking relief – relief from their pain, and relief from fear. Are you up to the task of helping others, or ready to run away? Becoming a healer is not for the faint of heart.

If and when the medical community collapses, those left to carry on will need an armamentarium of tools to deal with pain. Even if it’s only your own problems and those of your family that you’ll be facing, learning how to relieve pain now, before you’re in the midst of crisis, will spare you needless worry. Pain is the #1 symptom that drives patients to physicians today…

View original post 3,248 more words

First Aid and Medical Kit Contents

The following information on first aid and medical kits is excerpted from the Survival & Austere Medicine manual. It reproduces in part the section on medical kits based on increasing comprehensiveness. Minor changes have been made in order and figure numbering. The manual goes into additional detail about each of the categories of kit contents, and what you want to look for in those products. This high-level overview leans more toward supplying the list of contents for each kit type in a more condensed format. The Survival & Austere Medicine manual is a free resource with much good information. Please consult it for more detail.

Personal bag/blow out kit: Carry this with you at all times. It contains basic first aid gear or in a tactical situation the equipment to deal with injuries from a gunshot wound or explosion (figure 1). This includes things to immediately render aid – it’s almost like a pre-first aid, first aid kit!

A list might include:

Combat dressings/Israeli dressings

A hemostatic gauze compound

Chest seals – Asherman chest seals stick poorly on wet, hairy chests despite being relatively common place. Hyfin or Halo seals or even a rat glue trap works better. Studies have shown no advantage to vented dressing chest dressings vs. not vented.

Long IV cannula or specific pneumothorax decompression needle

Tourniquets x2

Oral and/or nasal airways

Figure 1 Blowout bag: Personal medical equipment for a tactical situation (dressings, HemCon bandages, Chest seals, oral and nasal airways, IV cannula and a tourniquet

 

First response bag: Carry this in your car; take it with you when you go camping, family trips to the river, etc. It contains more advanced first aid gear and some medical items than a basic level medical kit.

Large kit bag: This is your home/retreat/bugging out medical kit. It contains your medical kit as opposed to simple first aid supplies.

Storage area: In your home/retreat. It contains duplicate and bulk supplies. Large plastic storage bins are ideal for this.

Continue reading “First Aid and Medical Kit Contents”

Survival and Austere Medicine, 3rd Edition Link

In 2017, the Remote, Austere, Wilderness & Third World Medicine discussion board moderators released their third Edition of the Survival and Austere Medicine ebook. The third edition grew to over 600 pages compared to the second edition’s 200+pages.

While the original content of the FAQ and the subsequent edition remains valid, we thought it was time it underwent an update again. We hope you will find it useful. It is offered in good faith but the content should be validated and confirmed from other sources before being relied on even in an emergency. It is a tool to help you with medical care in an austere or ‘grid-down’ environment.
When the original FAQ and previous edition were written, there were very few books aimed at the “Practicing Medicine after the End of the World as We Know It” market – however over the last couple of years several books of varying quality have been published, offering information on this topic.
We like to think we are the original “Medicine at the End of the World” guide and our uniqueness in the current market place comes from our history and that it is the collaborative work of a group of experienced medically orientated preppers and survivalists. Between us, we have extensive experience in pre-hospital, austere, remote and third world medicine – both with the military and NGO’s. We do this stuff – we understand the limits of the environment and the issues of supply and improvisation. We have trained lay people to do complex medical procedures and provide health care in their remote communities. We have undertaken community medical needs assessments and the delivery of health care after natural disasters. We have given anaesthetics and done surgery in tents in the back of beyond. While the [stuff] hasn’t hit the fan in Western Countries yet, you don’t have to look far to find accurate analogies to likely Collapse Medicine and between us we have experience working in these locations and situations. This makes our book unique.
The other unique fact about this book is that it remains free! It’s a labour of love for us and we have enjoyed the comradery of putting it together. We are passionate about helping to improve the neglected ‘Band-Aid’ bit of the “Beans, Bullets and Band-Aid’s” mantra
common in prepper and survivalist circles. We have spent countless hours on this book project, not to make money, but to genuinely improve
people’s levels of medical preparedness.

 

Short Contents:

Medicine at the end of the world

The Context of Austere Medical Practice

What do I need to know?

Organizational Issues

Medical Kits

Clinical Assessment

Emergency Care in an Austere Environment

The Clinical FAQ’s

Infectious Disease and Antibiotics

Sedation and Anesthesia in an Austere Environment

Major Surgical Procedures

Wounds

Family planning, pregnancy, and childbirth

Considerations in Children

Austere Dental Care

The Basic Laboratory

Sterilization and Disinfection

Medical Aspects of Nuclear, Biological, and Chemical Warfare

Medical Aspects of Shelter Living

Austere Mental Health Care

Nursing Care in an Austere Environment

Botanical and Herbal Medicine

Primitive Medicine

Survival Aspects of Veterinary Medicine

Austere Medicine Sound Bites and Lessons Learned

Survival Medicine fiction

Reference Books

PDF Link from the Austere Medicine site (22MB)

Local PDF Link if the above does not work (22MB)

Related:

DHS Austere Emergency Medical Support Field Guide (5MB)

The Ship’s Medicine Chest and Medical Aid at Sea (3MB)

Ship Captain’s Medical Guide 22nd Ed. (3MB)

Ethicon Wound Closure Manual (3MB)

Emergency War Surgery 4th Ed. (7MB)

Fundamentals of Combat Casualty Care (7MB)

Communicable Diseases Following Natural Disasters (97KB)

Surgical Care at the District Hospital (7MB)

Primary Trauma Care Manual in District and Remote Locations (744KB)

Where There Is No Dentist (6MB)

Field Manual 4-25.11 First Aid (2MB)

Ditch Medicine: Advanced Field Procedures for Emergencies (9MB – scanned document)

Ranger Medic Handbook (4MB)

A Guide to Medicinal Plants (9MB)

Traditional Herbal Remedies for Primary Health Care (8MB)

The Survival Nurse (20MB)