Letter: Updated Survival & Austere Medicine Book


As many of your readers already know, the newly revised, highly recommended book, Survival & Austere Medicine: an Introduction, has been published free online in .pdf format (click the picture!). There are several editions online. Make sure you download the 2017 3rd edition edited by the group collectively known as RAWTWMDBM.

Available in Hardcover

And now this 2017 edition (589 pages) has been published in hardcopy by Lulu. It’s available in hardcover with black & white illustrations for $29.25; paperback black & white for $19.28; paperback with full color illustrations for $111.91; and hardcover full color for $126.35. This is the update to the 2014 edition. (The black and white editions are quite adequate; you probably don’t need to pay extra for the full color editions.)

I would be remiss not to mention that there are also a wide variety of medical references available free online, and I continue to appreciate The Survival Medicine Handbook by Dr. Alton and Nurse Amy, as they’re known. (2016, 700 pages, $37.99)

But I would also like to take this opportunity to bring yet another remarkable medical reference to everyone’s attention. The book, Save Lives, Save Limbs: Life Support for Victims of Mines, Wars, and Accidents, is available free online (239 pages). I’m so impressed with the book that I’m taking it to the local copy place and printing the whole thing so I can have a hardcopy of it! (Note: Large sections don’t really need to be printed.)

Teaching Tool

This is a manual and teaching tool intended to train third-world villagers and non-medically trained people how to treat severe limb injuries (primarily) from start to finish. Many medical references will help you save the person’s life and get them to advanced medical care. This manual is for where there is no advanced medical care and it’s up to the “villagers” to care for the victim or they’re not getting medical care at all- something like the scenarios many preppers have in mind.


Most interesting to me is that the authors of this book, The Norwegian National Advisory Unit on Trauma, do not recommend the use of tourniquets in a totally austere environment. (Their main beef is incorrectly applied or tourniquets left on too long.) They have developed an approach that not only saves lives but saves limbs that would otherwise be amputated. Maybe you won’t agree with their strategy, but you owe it to yourself, and the family and friends who are depending on your skills, to at least consider the approach promoted in this book. And you should know that Save Lives, Save Limbs is recommended reading in the latest version of Survival & Austere Medicine: An Introduction.

God help us if we ever have to know this stuff. And you’re going to have to have a strong stomach to read either of these books, but with these online, inexpensive medical references and a few carefully chosen basic tools and supplies, we too can save lives!

Trust God. Be Prepared. We can do both. – ShepherdFarmerGeek


  1. Jim and Hugh.
    I regularly print out ‘downloaded’ manuals on my home printer, in color no less, double sided. I did print out the recent ‘Survival and Austere Medicine’ manual, cost was approx. $6 in materials (ink/paper/report cover). I use card stock for my covers (front and back), and ‘Premium Bright’ paper for the pages (24lb weight and 96 bright), a 3-hole punch and either a heavy-duty (school) report cover or a 3-ring binder. (*note*-the binder does add to the cost. Viola! I now have a quality ‘hard-soft cover’ FM/TM type manual. My last tip is to make sure you have full or back-up ink cartridges during your printing. I’m printing out the ‘Save Lives, Save Limbs’ manual as we speak. Thank you

  2. My understanding of wounds that are bleeding so profusely that a tourniquet is required is you have 30 seconds to a couple minutes or so to apply the tourniquet before you bleed out. How than could the discussion of are tourniquets good or bad possibly enter into that equation? It would take me 30 seconds to a minute or so to find something that could be used as a tourniquet and begin to apply it. There is virtually zero time to consider what ifs.

  3. I will check out the Norwegian source.

    What I can tell you with a certainty, however, is that during the Vietnam era, standard Marine Corps doctrine was to apply a tourniquet only after a decision was made that the limb was already lost (i.e., boobtrap or mine damage) or that applying a tourniquet and risking the loss of the limb was the only way to save his life because he was going to bleed out anyway. In the latter circumstances, the risk of the loss of the limb was simply an unfortunate choice that needed to be made.

    When I became aware in recent years of such things as CAT tourniquets, I thought, “Boy, how things have changed.” I suppose that in the military it has to do with faster evacuation to higher level medical treatment. I have always wondered whether, in a World Gone Feral, when no professional medical treatment is available, the same approach concerning the administration of tourniquets is a good idea.

    I would like to see an article on this blog by a qualified individual who has a sufficient background to address the use of saline solution for horses for humans. I see that this solution is commonly available on veterinary supply web sites. Having it on hand for emergency use might be the difference in life and death after an ugly incident post-TEOTWAWKI.

  4. TOURNIQUETS. OneGuy was right, if you don’t have one on you, you’re out of time. That’s why my friends and family CARRY one on their bodies all the time. That’s what those sexy cargo pockets are for on most serious trousers now days. Throw in an Israeli Battle Dressing, a roll of gauze, and if you take a battlefield medicine class and learn how to deal with sucking chest wounds (tension pneumothorax), a 14 gauge angiocath. You can deal with a lot of trauma on the spot if you are so equipped..as long as you only have to treat ONE PERSON. I prefer the CAT tourniquet.
    A friend returned from Iraq without a scratch. While there, he carried TWO CAT tourniquets, out of the wrapper, rubber-banned to his harness. Returning stateside, he resumed his job as a Salt Lake City PD patrol officer. Not long after coming home, he was shot high in the thigh by a felon at point blank range. As he collapsed to the ground the felon tried to shoot him in the face, but he batted the muzzle away as the gun discharged. His partner dealt with the felon and he deployed his CAT to his spurting wound in 20 seconds. Sure, it hurt like hell as he compressed all those sharp bone fragments and the torn femoral artery, but it saved his life. Had his CAT been in a pack tucked away in the trunk of his beat car, he’d have been DRT. Training AND availability RIGHT NOW, saved his life.
    The manuals described above will be on my To-Do List, but these won’t matter if you aren’t able to get the patient through the first few minutes. The patient might be YOU.
    Work alone? On a farm or ranch? A CAT should be in your future. A tourniquet can be left on for up to 6 hours without permanent harm to the limb according to surgeons we have consulted. In a functioning society, that’s plenty of time to get to an ER.

  5. Responding to Paul Seyfried’s comment, yes, times have changed. It is my understanding that every soldier or Marine in an area of serious risk has his own individual tourniquet. A person applying a tourniquet is suppose to use the victim’s tourniquet, not his own. “Back in the day,” only a Navy Corpsman carried a tourniquet, and I am not sure how many he carried.

    About the saline solution, I should add that I have already asked a highly qualified medical researcher who is also a very experienced horseman about using saline solution. She has had experience using the horse saline on her own horses. Her view is that “if it doesn’t hurt a horse, it won’t hurt a human,” and that, in an emergency, she wouldn’t think twice about using horse saline solution if that was the only thing available.

    “Two heads are better than one.” If the weight of prepper medical opinion is that horse saline solution is safe to use in humans, perhaps this would be a good “work-around” in the preparedness area, just like fish antibiotics are for different applications. I am all ears.

    About how to insert an IV line, there are professionally produced videos for nursing students on YouTube about this procedure.

    I could be wrong, but I do not believe that preppers/survivalists can buy saline solution for human use over the counter. At a “preparedness show” perhaps three years ago, I was able to buy some. When I contacted the seller later via the internet about buying more, he apologized, saying that he found out that he “wasn’t supposed to be selling that.” Oh, well.

    In my opinion, should anyone be concerned about the misuse of saline, in my opinion, only an idiot would use saline solution on a human unless it was a matter of life and death and there were no professional medical services available. In that situation, could anyone disagree with the saying, “A man’s gotta do what a man’s gotta do.”

  6. There is histologic evidence of muscle damage as early as 30 minute after tourniquet application and as late as 60 minutes. “Muscle damage” means damage that can be seen by a microscope. The whole muscle isn’t dead, but individual muscle cells may start to die. If this process goes on long enough, there can be significant muscle injury. In a controlled setting (hospital knee surgery) the tourniquet time is usually around 60 minutes. Nerve injury is the most common complication, which can be transient (less than 6 weeks), but can be permanent—even with hospital/physician use.

    Obviously, if one is bleeding to death, use the tourniquet—Life over Limb. For those who don’t see a lot of bleeding, a little blood can look like a lot. Direct pressure on a bleeding wound is still the first and fastest action.

    Sharma J, Salhorta R. Tourniquets in Orthopedic Surgery. Indian Journal of Orthopaedics; 2012;46:377-383
    Mingo-Robinet J, et al. Tourniquet-related iatrogenic femoral nerve palsy after knee surgery: case report and review of the literature. Case Rep Orthop. 2013;2013:368290 on line publication

  7. I have had medical training since the 4th grade, thanks to Boy Scouting. I was allowed to take the Adult Red Cross course as a Freshman in High School.
    The Explorer Post I was a part of was a Sheriffs office affiliated SAR team. ( mainly searching for lost kids and older adults who wandered out into rougher parts of West Texas )
    Because I was a #2 draft pick out of high school (Uncle Sam’s draft) I wound up being a Field and Hospital medic. I was trained to a point where within limits I could diagnose and prescribe. Then we got our first batch of PA’s in and off to the ER I went.
    I was a Fire Fighter/EMT/Rescue while in college.
    I’ve reached a point where I have no current certifications but I do have a bunch of knowledge.

    A list of medical books you might want to have/read/study before bad times happen.

    MY OPINION – If you work thru this list, in the order it appears, you will obtain a broad range of good medical knowledge, starting with the basics then working up. The first 5 are downloadable for free. The rest, as noted below, cost

    However, without training and practice……………..
    Remember, a BOOK a COOK does not make.
    If you have time/money etc – take the Red Cross 1st Aid courses, join a CERT team, GET TRAINING.

    Survival and Austere Medicine: An introduction V3

    Where There Is No Doctor
    Where There Is No Dentist

    The Ship Captain’s Medical Guide

    2007 Ranger Medic Handbook

    Save Lives Save Limbs


    BEGIN the you have to pay money for these section.

    The following two books were recommended as being better than the Where There Is No books listed above.
    One of the primary authors of Survival and Austere Medicine: An introduction V3 made the recommendations.

    I do not have nor have I read them but I’ll the recommendation as being a good one

    Wilderness and Survival Medicine 2014: 2nd Edition

    Emergency Dentistry Handbook: Providing Dental Care In Disaster Areas, Combat Zones, and Other Austere Environments

    Ditch Medicine
    Ditch Medicine: Advanced Field Procedures For Emergencies (Paperback)
    Hugh Coffee
    ISBN-10: 1581603908
    ISBN-13: 978-1581603903

    Special Operations Forces Medical Handbook (Book Only Edition) (Ring-bound)

    AND NOW:
    Special Operations Forces Medical Handbook, 2nd Edition (Paperback)

    I have both (including the 1st edition companion CD).
    The 1st. has stuff the 2nd does not have.
    The 2nd. has stuff the 1st does not have.
    If you can afford it – my opinion – get both.

    HOWEVER, the original Special Force’s medical guide was completely supplanted by the SOF medical handbook noted above.
    The following are some quotes about the original SF manual:


    “That manual is a relic of sentimental and historical interest only, advocating treatments that, if used by today’s medics, would result in disciplinary measures,” wrote Dr. Warner Anderson, a U.S. Army Colonel (ret.) and former associate dean of the Special Warfare Medical Group. “The manual you reference is of great historical importance in illustrating the advances made in SOF medicine in the past 25 years. But it no more reflects current SOF practice than a 25 year-old Merck Manual reflects current Family Practice. In 2007, it is merely a curiosity.”
    “Readers who use some of the tips and remedies could potentially cause harm to themselves or their patients.”

    In order to use that manual, you would have to already know what is still useful vs what isn’t. I have a copy and I know the parts that are and aren’t. It’s still a fascinating read, especially the parts that are in there that “would result in disciplinary measures”.

    Fundamental Skills in Surgery [Hardcover]
    By Thomas F. Nealon, William H. Nealon
    ISBN-13 : 9780721664606
    Binding : Hardcover
    Pages : 468
    Publisher : W.B. Saunders Company

    Fundamental Skills for Surgery
    Richard Perry
    ISBN13: 9780074713358,
    ISBN10: 0074713353,
    Division: Professional,
    Pub Date: OCT-08,
    Pages: 320
    Edition: 02

    ALL of the following books are in use over the world by those who are not necessarily trained in surgery to perform any number of surgeries.

    These 3 books are in the “Buy these to round out your already extensive Medical Library” category.
    They are a bit pricey. The wikipedia source for copy/paste into Word/Print is incomplete.

    Primary Surgery: Non-Trauma v.1: Non-Trauma Vol 1 (Paperback)
    by Maurice King (Editor), Peter C. Bewes (Editor), James Cairns (Editor), Jim Thornton (Editor)
    Paperback: 656 pages
    Publisher: OUP Oxford; New edition edition (14 Jun 1990)
    Language English
    ISBN-10: 0192616943
    ISBN-13: 978-0192616944


    Trauma: 2 (Primary Surgery) (Paperback)
    by Maurice H. King (Author)
    Paperback: 381 pages
    Publisher: OUP Oxford (22 Jan 1987)
    Language English
    ISBN-10: 019261598X
    ISBN-13: 978-0192615985


    Primary Anaesthesia (Primary Surgery) (Paperback)
    by Maurice H. King (Author)
    Paperback: 288 pages
    Publisher: OUP Oxford (19 Jun 1986)
    Language English
    ISBN-10: 0192615920
    ISBN-13: 978-0192615923


    One additional book suggested by one whom I know to be knowledgeable. I do not have the book nor have I read it.
    It is on my list to get books.
    Atlas of Minor Surgery
    I.D. Cracknell & M.G. Mead
    Publisher: W.B. Saunders Company, 1 edition (June 1998)
    ISBN-10: 0443053049
    ISBN-13: 978-0443053047
    Pages: 86

    Available in German as well: http://www.amazon.com/Kleine-Chirurgie-Ian-D-Cracknell/dp/3456831315/

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