Mr. Rawles,
After reading J.V.’s article on “Packing your Bug Out First Aid Kit” I feel the need to comment on his approach to anesthesia. Anesthesia as practiced today is safe and effective due to the training and equipment modern medicine provides. The technique of “open drop” anesthesia, which is what J.V. describes, was utilized until the mid 1960s. Aspiration, anesthetic overdose leading to respiratory or cardiac collapse occurred in major hospitals at an alarming rate. Current anesthetic death rates run at 1:30,000 cases, while in the late 1950s (a comprehensive study out of Boston) showed anesthetic mortality of 1:1,500. This poor outcome was in centers with the finest equipment and training of the time. What J.V. proposed is completely untrained individuals using diesel primer to attempt this technique on injured friends and family. I am a board certified anesthesiologist in practice for 20 years and I would not even try this if I had a bottle of medical grade diethyl ether and diesel primer is not pure diethyl ether. It contains petroleum oils that if inhaled could cause an acute lung injury. This would be just as fatal as an anesthetic overdose, just not as quick.
Anesthesia is not a binary state of awake or asleep but rather a continuum. To perform a safe anesthetic of this type you must be able to vary the depth of anesthesia in relation to the surgical stimuli. There are time lags between administration of the anesthetic agent and its physiologic effects. Not understanding this aspect alone could cause someone inadvertently kill another by overdose. Being a prepper and an anesthesiologist, I have spent some time attempting to build a reasonable medical kit. Given the facts above, I have focused on local infiltration and regional anesthesia as the techniques of choice in the event of the end of modern medicine. Regional anesthesia focuses on blocking specific nerves using the injection of local anesthesia. There are some significant advantages to this technique:
First, the patient stays awake. Being able to talk to your patient is the best way to assess how they are doing. Second, you provide post operative pain control. Third, the equipment is portable, small and light. Regional anesthetics require a needle, syringe and local anesthesia. Local anesthetics such as lidocaine, bupivicaine and tetracaine are inexpensive, non addicting and not controlled substances. While regional can be an effective anesthetic for many surgical procedures, it is not well-suited for cases involving the chest, neck or head. However, in these cases, serious injury would most likely be fatal in a grid down situation. Performing a regional anesthetic takes years of practice and training.
I would caution readers that regional anesthesia is technically difficult and in untrained hands dangerous. While prepping is about being prepared, there are limits. If you are thinking about how to live in a grid down situation you are also accepting that medical care will rapidly slide back to the 1860s where most gunshot wounds resulted in amputation for the lucky and death for the rest, infant mortality was 10% – 15% and everyone knew someone that had a wife die in childbirth. Life will be brutal and short.
My best advise on how to prep fro m a medical standpoint is get all your vaccines up to date, have some antibiotics on hand, have some basic medical supplies, live healthy, pray hard and let the folks you care about know you love them. If the grid goes down, most of the medicine provided for the seriously injured will be love, prayers and compassion as you watch them die. You just can’t prep for the skills and missing infrastructure that medicine requires. – Dr. John F.