The contents of a bug out first aid kit should not only contain band-aids and other such dressings for minor wounds. The bug out first aid kit should also contain a vast amount of items in various classifications to be discussed below. The use of these items has been historically documented, however care should be used in their administration and these items should be used only as a last result when no other means of medical care are available. Persons should use these items if death is imminent and the risk of using these items would not sufficiently out weigh the potential benefits of their use.
During a survival situation, regardless of length or severity, one must constantly use what is commonly referred to in the military as operational risk management (ORM) goes through the steps to determine if the risk outweighs the potential benefit. This type of determination can best be envisioned by determining whether one should bug out or hunker down in place. Every single aspect of survival must be weighed to determine if the benefits are greater than the potential risks, this includes advanced medical techniques.
One of the first most important things that anyone can have in their bug out bags (or more specifically in a unit standardized location on their person) is a quick application tourniquet. These range from varying styles and applications, though my preferred one is the Combat Application Tourniquet (CAT). These can be had for anywhere from $15 to $20 from various web sites and various police supply stores. Items such as these are extremely effective when used in an ambush situation where someone has sustained a wound to the extremities. Ideally the injured person would be able to place this on himself and continue to put lead down range. Remember what I told you last time, the most effective preventive medicine is overwhelming, well-aimed firepower. Another way of stating this is if you kill all of the enemies you will not have to mop up as many bodies and blood of your comrades as if you didn't defeat them.
Another thing that everyone should consider, as I previously mentioned, is a surgical kit. These can be had from numerous sources on the Internet. Be sure to get something that is stainless steel and can thus be sterilized with high temperature steam, such as that found in a dishwasher. I do not recommend using a dishwasher a a sterilization method in a Rule of Law situation, however it will suffice if that is the only means of sterilization around. Ideally I would boil the stainless steel surgical instruments in water over an open flame for one hour.
Along with a surgical kit every bug out medical kit should contain some spray bottles of Diethyl Ether, also known as Diesel Engine Starting Fluid. This was originally used as early as 1846 as an anesthetic. This will be of untold importance when the need arises to handle appendicitis (to be covered in a later article), Caesarean section deliveries , and even the resetting of broken bones. Hand in hand with the Diethyl Ether should be some extra large coffee filters, at least two packs. One simply places 10-15 coffee filters together and sprays the ether on them for approximately 2-3 seconds then immediately places it over the nose and mouth of the individual to be sedated, allowing them to breathe in the fumes. This will allow for a numbing effect similar to that of modern anesthetics. [JWR Adds This WARNING: Please see the many warnings about ether that have been published in SurvivalBlog! Ether and chloroform can be very tricky to use, with a high risk of accidentally killing your patient. Ether is also very flammable, and it has some of the same un-even dosing and side-effect issues as chloroform. I would recommend it only for someone with current training in anesthesia, and only as a last resort if no modern anesthetics were available. Also note that engine starting fluids sold commercially are not pure Diethyl Ether. They commonly include other fractions including petroleum ether (naptha), unspecified "petroleum oils", and heptane. They should not be used medicinally!]
Survivalists should be cautioned against the use of Chloroform as an anesthetic. Although it is effective as an anesthetic it also has some unfortunate side effects that are difficult to manage in a kitchen table surgery scenario. Side effects include intense vomiting, nausea, gastrointestinal problems, headache, confusion, cardiac arrhythmias, kidney and liver damage. [JWR Adds: See the preceding warning. It has also been identified as a carcinogen.]
Survivalists should also have the books mentioned in previous articles, Emergency War Surgery, Ditch Medicine, and the U.S. Navy Hospital Corpsman handbook. This books will prove invaluable when dealing with problems ranging from splinters to abdominal eviscerations (guts hanging out). One should also be well versed in various surgical techniques that may become vitally important. Various techniques to study would be appendectomies, cesarean sections (discussed in a later article), tooth extractions and treatment of gunshot wounds in various parts of the body.
The bug out medical kit should also contain some sort of anticoagulant/blood stopping devices. Many such devices are readily available both online and at police supply stores. These devices range from Hemcon, Quik-Clot, Celox and Zeolite. There has also been some progress shown in some of the potato based products, however these have yet to be released to the civilian market. Something to consider when using a hemostatic agent such as those listed above are the need for both water to minimize heat transfer, gloves to prevent the person using the agent from getting burned, and the need to surgically remove the particles once the bleeding has been stopped and operational time permits.
I would highly recommend the survivalist from using hemostatic agents except in the case of sever uncontrollable bleeding to the neck, face, or head. These agents are not to be used, under any circumstances, in the chest or abdominal area as they may interact with the lungs and/or be absorbed by the organs in the stomach area. For most cases of bleeding on can use a tourniquet and be just fine, however hemostatic agents are useful in the neck, face, and head provided the airway is still intact and the airway will not absorb the particles.
Every bug out medical kit should also contain a basic complement of medicines. Whether the medicines have expired or not will have some effect on them, however most medicines can be equated to nuclear materials. The FDA recommends medicines to expire in half the time of their half life. That means that if you double the time the FDA states the drug is to expire after manufacture it will be half as effective (more or less there is a little more involved than this, but this is just a dummied up version to illustrate a point), if you expand that time frame out again it will now be ¼ effective. So on and so forth throughout the life of the medicine.
Some medicines to consider would be anti-histamines such as Benadryl, sudafed, and dramamine. Pain relievers such as Motrin, Tylenol, and Aleve. Cough medicines such as Dimetap, Guaifenesin, and Dextromethorphan. Also one should include at least a 3 month supply of any medicines they take on a regular basis such as heart medicines, cancer medicines, asthma inhalers and any other medicines taken on a regular basis. One might also consider the benefits of including such medicines as are beneficial in the treatment of nuclear exposure.
Medicines for the treatment of anthrax exposure include ciprofloxacin, amoxicillin, and doxycycline. These medicines have efficacy for treatment of plague, tularemia, brucellosis and Q Fever. Medicines for the treatment of Ricin poisoning include activated charcoal (which has many other uses in an end of the world medical sense). A good web site to consult in regards to symptoms and treatments for many CBRNE agents is the eMedicine library. Another good resource is the Army web site for CBRNE training. One will notice that in addition to the distance courses offered online they also offer the opportunity for civilians to attend the classroom based courses for a minimal fee.
This list is not an all inclusive list, however it is designed to give the survivalist ideas that not most think of when it comes time to organizing a survival medical bag. Due to the very nature of survival and different mindsets and preparedness/knowledge levels individual kits will vary greatly. As stated previously the individual survivalist (or survival groups) must evaluate their own ORM and determine what types of items they would be most likely to use in the event of a complete breakdown of the health care system. They must then determine what is beneficial, or potentially beneficial to them and load up the supplies accordingly.
It should go without saying, however given the current state of the entire world's IQ I feel the need to emphasis that any medications or tools included in the bug out medical bag should be known backwards and forwards. The survivalist should strive to understand not just the intended uses of such items, but also the side effects, alternative uses, possible interactions and means by which the devices work. One should endeavor to understand all the finer aspects of the molecular interactions that medicines have on the body, for each medicine used. It is instrumental not just for the individuals survival but also for that of the group. The survival medic must endeavor to learn all they can about anatomy and physiology, molecular biology, pharmaceutical biology, neurobiology and pharmacological interventions for common diseases and injuries. Being a survival medic is a life of constant, never ceasing learning and understanding of the greatest system of them all, that of the human body and it's interactions with the world we currently or may in the future live in.