Medical Prepping in Three Months: A Guide to Safeguarding Your Family — Part 1 of 2, by Dr. Cynthia J. Koelker

Week 1

ORG

ASSESSMENT

Identify each member of your group and begin a medical chart or notebook to include each individual

p Identify current and probably future medical needs of each member, including reproductive concerns
p Identify current medical training and abilities within your group
p Identify needed medical training within your group (First Aid, CPR, suturing, casting, special concerns)
p Identify transportation concerns
p Designate one or more go-to individuals who will be responsible for the medical needs of your group
p Determine an approximate budget for your medical prepping and how costs will be distributed
p Schedule weekly to monthly meetings to assess your prepping progress

OTC

WOUND CARE and MEDICATIONS DIFFICULT TO OBTAIN IN QUANTITY

Begin purchasing items with a long shelf life:

p Dressings, gauze, Band-Aids, Telfa pads, medical tape, Coban, Ace wraps,
p Kotex for large wounds
p Wound cleaning supplies including antibacterial soap and/or Hibiclens, clean or sterile water or saline
p Wound closure supplies including suture kits, suture, staplers, staple removers, and Steri-Strips
p Thermometers, blood pressure cuffs, stethoscopes, adult and pediatric scale

Begin acquiring medications that cannot be purchased in bulk, and continue purchasing these as desired throughout your preparation period

p “Real” Sudafed (pseudoephedrine – requires signature; can only be purchased in small amounts)
p OTC Insulin, if needed
p OTC Primatene Tablets (or preferably Mist, if available)

Rx

MEDICATION-DEPENDENT PERSONS

Medication-dependent persons should assess their long-term needs and make a list of needed long-term prescription refills to request from their physician.  This is best done in person, per Week 2, below.

p Diabetics should also request testing strips, lancets, needles, and other supplies from their physicians.
p Hypothyroid patients should consider stocking up on nutraceutical desiccated thyroid, and/or locate an adequate source of mammalian thyroid tissue to make their own.
p Asthmatic patients should request nebulizer medications in quantities of 100 vials.
p Oxygen-dependent persons should obtain a concentrator and reliable power supply.

ED

RECORD-KEEPING

p Obtain or create forms for medical record keeping

Week 2

ORG

OPTIMIZING YOUR HEALTH

Schedule needed appointments for each member, as appropriate, to include the following:

p Medical concerns, including current, recurrent, acute and chronic problems, as well as reproductive status
p Dental exam, cleaning, and restorative work
p Vaccines (Tdap, influenza, pneumonia, MMR, chicken pox, shingles, hepatitis A and B, as needed)
p Vision (make sure to get a copy of your eyeglass or contact prescription to order extras online)

OTC

ORTHOPEDIC CARE

Order the following in quantities sufficient for the ages and size group you’ll be caring for:

p Casting supplies:  Plaster rolls, stockinet, cast padding, gauze rolls, Ace and/or Coban, bucket for water
p Pre-formed splints and braces (for wrist, knee, ankle)
p Slings
p Crutches for adults and children, walker, cane, wheelchair

Rx

PAIN MEDICATIONS

p Those who suffer from back pain, arthritis, or other chronic or recurrent painful condition should request a small quantity of Tylenol #3, Vicodin, or tramadol from their personal physician, perhaps 15–30 tablets.  Note:  it is currently a felony to share these with other individuals, but should society collapse, a physician in your community could re-allocate them to a needy individual within your family or group.

ED

SKILLS TRAINING

Schedule needed training identified in Week 1

p First Aid
p Special concerns (such as diabetic training, catheter care, fluid administration)
p Suturing
p Splinting and casting
p CPR (primarily useful for near-drowning victims and obstructed airways, otherwise rarely successful)

Week 3

ORG

RECORD-KEEPING

p Make a medical chart or page in a notebook for each member of your family or group.
p Discuss confidentiality issues and how you plan to keep private information secure.
p Designate who should have access to your personal health information and who should not.
p Discuss consequences for breach of trust.

OTC

NUTRITION and EYECARE

Acquire the following items, as appropriate for your group:

p Vitamins, including folic acid for pregnant women, Vitamin B12 for the elderly, Vitamin K for newborns
p Salt, sugar, water, and fruit juice for Oral Rehydration Solution
p Calcium and Vitamin D for all when milk/calcium and sunlight not accessible
p KI (potassium iodide, for potential radiation exposure)
p Order extra inexpensive glasses and/or contacts online
p Order pinhole glasses online and obtain multiple pairs of inexpensive reading glasses
p Purchase OTC eye meds including contact solution and Alaway or Zaditor for allergic eyes

Rx

ANTIBIOTICS

p Have all group members begin requesting antibiotics from their personal physicians, one at a time, to include the following: amoxicillin or penicillin, doxycycline or tetracycline, erythromycin or azithromycin, amoxicillin-clavulanate or cephalexin, trimethoprim-sulfamethoxazole, metronidazole, ciprofloxacin.  Upcoming travel outside the US is commonly a legitimate reason to procure antibiotics for potential use.  In some countries, these are sold OTC as well.
p If this is unsuccessful, see “Infection” in Week 4, below.

ED

SKILLS PRACTICE

p Practice suturing on a pig’s foot, chicken breast, turkey, or hot dog. (Online videos available)
p Practice working with plaster, making splints and casts. (Online videos available)

Week 4

ORG

PRINT RESOURCES

Order appropriate books to build your library including:

p Survival medicine book, such as Armageddon Medicine
p General medical book such as a used copy of a textbook of Family Practice and/or Emergency Medicine
p PDR (Physician’s Desk Reference) – an older/used copy is fine
p General pediatric textbook – a recent used textbook is fine; also get a copy of Dr. Spock’s classic book
p General obstetrics textbook – a used textbook up to about 30 years old is fine
p Wild edible plant reference
p Medicinal plant reference

OTC

INFECTION

p Johnson’s Baby Shampoo for eye rinse
p Topical Bacitracin antibiotic cream or ointment
p Topical antifungal cream such as Lotrimin or Lamisil (or generics)
p Antibacterial soap and/or Hibiclens
p Pepto-Bismol for traveler’s diarrhea
p Distilled vinegar for ear rinse and possible vaginal douche
p Veterinary injectable Lincocin and Penicillin for life-threatening infections
p Refrigerator with power supply for Penicillin and certain other meds (Insulin, certain liquid antibiotics) (and consider a “pot-in-pot” refrigerator/cooler)
p Oral “fish” antibiotics (amoxicillin or penicillin, doxycycline or tetracycline, erythromycin or azithromycin, amoxicillin-clavulanate or cephalexin, trimethoprim-sulfamethoxazole, metronidazole, ciprofloxacin)
p #11 and #15 scalpels for abscess incision and drainage

Rx

TOPICAL ANESTHETIC FOR SUTURING

p Request Lidocaine (with and without Epinephrine) from your personal physician.  If he or she refuses, ask if they would be willing to order it and keep it on hold for you at their office, if you paid for it ahead of time, and only for a TEOTWAWKI scenario. 
p Otherwise, obtain additional OTC topical anesthetic such as tattoo cream.

ED

SUTURING, ANESTHESIA, and INCISION & DRAINAGE

p Search internet for videos of “Local anesthesia” and “Suturing” – then watch and practice
p Search internet for videos of “Abscess, Incision and Drainage” – then watch and practice

Week 5

ORG

BUILDING YOUR COMMUNITY

p Identify others within your greater community who may be of potential help, should the need arise, including nurses, doctors, dentists, veterinarians, chemists, pharmacists, biologists, medical assistants, physician assistants, midwives, paramedics/EMTs, firefighters, law enforcement officers, medics
p Decide whether to contact these individuals now and whether to consider inviting them to join your group

OTC

PAIN MEDICATIONS

Since these are very inexpensive, purchase 1,000s for treatment and/or barter

p Aspirin
p Tylenol
p Ibuprofen
p Naproxen sodium
p Topical anesthetic cream (lidocaine, for example, tattoo cream, Solarcaine)
p Sedating antihistamines (Benadryl, Nyquil)
p ? Poppy seeds

Rx

IV FLUIDS

p Ask your local physician if he/she is willing to prescribe IV fluids for your group, or possibly order them for you (pre-paid) to be held at their office if and until the need arises. (Suggested fluids: D5-Normal or ½ Normal Saline and/or Lactated Ringer’s Solution)
p If not, order the 250 or 500 mL products available online (at inflated prices)
p Don’t forget 21 to 25 gauge butterfly needles and IV administration kits (available online OTC)

ED

FLUID REPLACEMENT THERAPY
p Educate yourself about Oral Rehydration therapy and rectal fluid administration
p Download protocol for hypodermoclysis, several of which are available free online
p Procure an adult and pediatric balance scale (non-electronic), vital to monitoring weight and fluid status

Week 6

ORG

IDENTIFY POTENTIAL RESOURCES

p Identify potential resources for additional medical supplies, should society collapse, including pharmacies, grocery stores, convenience stores, medical supply houses, hospitals, clinics, medical offices, dental offices, veterinary offices, libraries, schools, universities, etc.

OTC

RESPIRATORY and ALLERGY

p Antihistamines: Benadryl (diphenhydramine), loratadine, cetirizine, chlorpheniramine, Nyquil
p Decongestants: Sudafed PE and pseudoephedrine
p Primatene Pills and/or Mist
p Saline nose spray
p NasalCrom nose spray
p Nebulizer machine, nebulizer chambers with tubing, and power supply
p Bicycle pump for nebulizers if no electricity
p Rapid strep kit
p Peak flow meter and charts

Rx

EPINEPHRINE

p Request an Epi-Pen from your physician for emergency use.  If anyone in your group is allergic to bees or has had an anaphylactic reaction to another allergen, this should be no problem.  If you expect to travel outside the US in the near future, this might be reason enough for your doctor to grant your request, even if you do not have known allergies. 
p If an Epi-Pen cannot be obtained, scour your local pharmacies and mega-stores for Primatene Mist, which is no longer being manufactured, but sometimes can still be found lingering on the shelves.

ED

DERMATOLOGY and RASH IDENTIFICATION

p Procure a used, inexpensive copy of a good dermatology book with a color picture atlas
p Or make your own by downloading images (one good source is DermAtlas.org)