Prepper’s Pain Protocol- Part 2, by ShepherdFarmerGeek

If you’re like most preppers, you don’t have a prescription bottle of Morphine on hand to deal with pain. And you don’t think dosing your friend or child with a big swig of whiskey (or two) is all that good of an idea.

Over-the-Counter “Pain Pack™”

Well, one option is the non-narcotic, over-the-counter “Pain Pack™” concept described at and promoted by Next Generation Combat Medic ^[1] as “just as good for moderate pain as oxycodone, hydrocodone and even codeine.”

Please read all their original information. What follows is but a small tweak of the “Pain Pack™” plan that I’d like to call the “Prepper’s Pain Protocol.” I’m not a “medical” anything, much less an “expert” in anything. But I know a good thing when I see it.

Editor’s Introductory Proviso: I’m not a doctor, and I don’t give medical advice. Mentions of any medicine or medical treatment is for informational purposes only and are in no way endorsed or accredited by SurvivalBlog.com, or its principals. SurvivalBlog.com is not responsible for the use or misuse of any product advertised or mentioned on the SurvivalBlog site. – JWR

I’ve already disclosed Strategy #1 and #2 of the “Pain Pack™” in Part 1 of this article series. It includes the use of over-the-counter medications as well as prescription pain meds and considers those meds that have been available in Canada but not in the U.S.

When That’s Not Enough

What if that’s not enough? Traumatic injuries can cause a lot of pain, pain that is not going to be bearable even with the “Prepper’s Pain Protocol” or the enhanced version with Canadian codeine. So what do you do? Without writing an entire book on the subject, here are some suggestions:

More Ways to Help Reduce Pain

1. Guide them in Tactical Breathing ^[2]
2. Gently immobilize their injury.
3. Keep them hydrated. (Dehydration makes everything worse.) Oral rehydration ^[3] solution is your friend. Either make it yourself or buy it commercially. Give it orally or by proctoclysis. (See the notes at the end of this article!)
4. Keep them warm ^[4]. This probably means adding heat to them, not just trying to retain their heat by insulating them with a blanket. Note the comments about hypothermia. For an example, see this ^[5].

Reducing Fear and Anxiety to Calm and Reduce Pain

1. Recognize that they are afraid, possibly overwhelmed. Take that into account with everything you do for them or to them.
2. Ask them if you can pray for them, and ask them if they want to say a prayer. Repeat this often.
3. Handholding. I know, I know. It sounds new-age-y, but it works. Want to help them through this? Hold their hand ^[6] from time to time!
4. Along that same line, give them eye contact, establish rapport, help them to trust you, speak soothingly yet firmly and reassuringly. Coping with severe pain is a mind game even more than it is an issue of the right drugs.
5. Answer their questions, tell them the truth, and relieve their worry and anxiety.
6. Minimize loud noises, jarring, disruptions, and anything that’s going to break their focus and make them jerk or tense. That said, complete silence isn’t what you want either, as it will make the victim focus back on their pain more. Distracting sounds, like music, will help.
7. Don’t discuss the victim in their hearing. Don’t assume the patient is asleep or unconscious. (Conversations can influence unconscious patients.)

Don’t Get Overwhelmed

Don’t get overwhelmed yourself. You may be all the victim has. Man up (woman up), suck it up, and do what needs to be done. You can fall apart later. And it’s not selfish to say stay safe. You cannot become a second victim of what injured your friend/family member. You cannot be so focused on treating the victim that you become the next victim.

Trust God’s will for the victim. You know some situations are no-win. Ask God to help you do your best, and then trust Him that He will. That’s all you can do!

“For I am persuaded, that neither death, nor life, nor angels, nor principalities, nor powers, nor things present, nor things to come, nor height, nor depth, nor any other creature, shall be able to separate us from the love of God, which is in Christ Jesus our Lord.” – Romans 8:38-39

Trust God. Be prepared. We can do both.

Supporting Notes

Keeping Notes and Managing Drug Dosages

Using a notepad or paper, write down the times and the amounts of each drug as you give them. This is important and will keep you from making dosage mistakes or overdoses!

Dumping big doses of Tylenol and ibuprofen into someone’s empty stomach is just asking for vomiting or at least a nasty stomach ache. These meds should always be taken with food, such as crackers or ginger candy, to minimize gastrointestinal discomfort.

Taper off these meds at the earliest opportunity. NSAIDS, such as ibuprofen (not Tylenol or aspirin), have been implicated in causing heart damage and strokes. The more you take (and the longer you take it at a time), the higher the risk. Just because the “Pain Pack™” says you can take this combination for five days doesn’t mean you should. Personally, my goal will be to limit this protocol to just three days ^[7].

Vitals should be monitored while receiving the “Prepper’s Pain Protocol.”

Dosages of Tylenol

If you want to give precise dosages of Tylenol, by victim’s weight, the proportions are listed below:

Acetaminophen (most popular brand name: Tylenol), pediatric dose for pain, birth-12 years: 10-15 mg/kg/dose. Give orally every 4-6 hours and do not exceed more than five doses (2.6 g) in 24 hours. This comes from an online resource ^[8].

Acetaminophen, adult (over 12 years old/more than 110 lbs) dose for pain: 325 mg to 1 g orally every 4 to 6 hours. The minimum dosing interval: every 4 hours. Maximum single dose: 1000 mg. The maximum daily dose: 4 g per 24 hours.

Rectal administration of acetaminophen is 65% less than an oral dose! If the victim is an alcoholic, has liver impairment (injury/disease), is malnourished, or is hypovolemic from bleeding, the dose must also be reduced. Avoid grapefruit and garlic during pain treatment.

Acetaminophen Overdose and Treatment

If more than the dosage above is given, it must be considered an overdose and treated with NAC: N-acetylcysteine (a common nutritional supplement) is the antidote for acetaminophen overdose. It is nearly 100% hepatoprotective (liver protective) when it is given within eight hours after an acute acetaminophen ingestion. Start with a loading dose of 140 mg/kg, followed by 17 doses, each at 70 mg/kg, given every four hours. This information comes from here ^[9].

Administering Medication to Unconscious Victim

Proctoclysis is a simple and effective method of administering fluids and medicines in the event a victim is unconscious, unable to swallow (throat or facial injury), unable to keep food down (nausea, abdominal injury), or has an injured gastrointestinal tract. All of the components, including laxative, can be liquefied and given via proctoclysis along with the oral rehydration.

Do you give analgesia to an unconscious victim? Well, you need to start them on hydration anyway, and they’re probably going to come around at some point. They’re going to really need analgesia when that happens. You should know how to do it ^[10].

Dosages of Ibuprofen

If you want to give precise dosages of ibuprofen, by victim’s weight, the proportions are listed below:

Ibuprofen, pediatric dose: 4-10 mg/kg/dose. Give orally every 6-8 hours. Maximum single dose is 400 mg/dose, and maximum daily dose is 40 mg/kg/day up to 1200 mg/day.

Ibuprofen, adult dose: maximum is 800 milligrams per dose or 3200 mg per day (four maximum doses). This information comes from https://draxe.com/ibuprofen-overdose/ .

Rectal Administration of Ibuprofen

Rectal administration of ibuprofen is safe and effective, though there is a slower rate of absorption ^[11]. If the victim is an alcoholic, has liver impairment (injury/disease), is malnourished, or is hypovolemic from bleeding, then the dose must be reduced.

Don’t combine ibuprofen with aspirin; they both thin the blood. Avoid grapefruit and garlic during pain treatment.

Ibuprofen Overdose and Treatment

Ibuprofen overdose symptoms are wide ranging. They include: an increased risk for heart attacks and stroke (which can be fatal), increased risk for seizures or a coma in the case of severe toxicity, intestinal bleeding especially in older adults, dangerously low blood pressure levels, ringing in the ears, blurred vision, headaches, confusion, dizziness, drowsiness, digestive and gastrointestinal problems, including diarrhea, nausea, vomiting, heartburn, and stomach pain, trouble urinating, trouble breathing, shallow breath, and wheezing, and skin rashes.

Ibuprofen overdose ^[12]is treated with laxatives to speed bowel movement, activated charcoal to absorb remaining drug (if given within one hour of ingestion), and IV sodium bicarbonate (baking soda, possibly administered via proctoclysis, speculative) to treat acidosis. Syrup of Ipecac (induced vomiting) is no longer recommended.

Study of Pain Pack Given to Children

One study ^[13]shows the rectal administration of both acetaminophen and ibuprofen rectally to children after surgery, so we know it works.

U.S. Laws About Canadian Codeine

Canadian Codeine. Title 21 Code of Federal Regulations PART 1301 — REGISTRATION OF MANUFACTURERS, DISTRIBUTORS, AND DISPENSERS OF CONTROLLED SUBSTANCES. EXCEPTIONS TO REGISTRATION AND FEES §1301.26 Exemptions from import or export requirements for personal medical use. Any individual who has in his/her possession a controlled substance listed in schedules II, III, IV, or V, which he/she has lawfully obtained for his/her personal medical use, or for administration to an animal accompanying him/her, may enter or depart the United States with such substance notwithstanding sections 1002-1005 of the Act (21 U.S.C. 952-955), provided the following conditions are met: (a) The controlled substance is in the original container in which it was dispensed to the individual; and (b) The individual makes a declaration to an appropriate customs officer stating: (1) That the controlled substance is possessed for his/her personal use, or for an animal accompanying him/her; and (2) The trade or chemical name and the symbol designating the schedule of the controlled substance if it appears on the container label, or, if such name does not appear on the label, the name [[Page 36]] and address of the pharmacy or practitioner who dispensed the substance and the prescription number. (c) In addition to (and not in lieu of) the foregoing requirements of this section, a United States resident may import into the United States no more than 50 dosage units combined of all such controlled substances in the individual’s possession that were obtained abroad for personal medical use. (For purposes of this section, a United States resident is a person whose residence (i.e., place of general abode—meaning one’s principal, actual dwelling place in fact, without regard to intent) is in the United States.) This 50 dosage unit limitation does not apply to controlled substances lawfully obtained in the United States pursuant to a prescription issued by a DEA registrant. [69 FR 55347, Sept. 14, 2004, as amended at 81 FR 97019, Dec. 30, 2016] https://www.deadiversion.usdoj.gov/21cfr/cfr/1301/1301_26.htm ^[14]

If Giving Codeine To A Victim

If you’re going to give anything containing codeine you should start the victim on a stool softener (like Docusate Sodium) and laxative (like Ducolax). When giving the victim multiple doses of codeine over a couple of days, their stools are going to turn into bricks if you don’t. Having a Fleet Enema or two on hand wouldn’t hurt either.

SurvivalBlog Writing Contest

This has been part two of a two part entry for Round 75 of the SurvivalBlog non-fiction writing contest ^[15]. The nearly $11,000 worth of prizes for this round include:

First Prize:

1. A $3000 gift certificate towards a Sol-Ark Solar Generator from Veteran owned Portable Solar LLC. The only EMP Hardened Solar Generator System available to the public.
2. A Gunsite Academy Three Day Course Certificate. This can be used for any one, two, or three day course (a $1,095 value),
3. A course certificate from onPoint Tactical for the prize winner’s choice of three-day civilian courses ^[16], excluding those restricted for military or government teams. Three day onPoint courses normally cost $795,
4. DRD Tactical is providing a 5.56 NATO QD Billet upper ^[17]. These have hammer forged, chrome-lined barrels and a hard case, to go with your own AR lower. It will allow any standard AR-type rifle to have a quick change barrel. This can be assembled in less than one minute without the use of any tools. It also provides a compact carry capability in a hard case or in 3-day pack (an $1,100 value),
5. Two cases of Mountain House freeze-dried assorted entrees ^[18] in #10 cans, courtesy of Ready Made Resources (a $350 value),
6. A $250 gift certificate good for any product ^[19] from Sunflower Ammo,
7. Two cases of Meals, Ready to Eat (MREs), courtesy of CampingSurvival.com (a $180 value), and
8. American Gunsmithing Institute (AGI) is providing a $300 certificate good towards any of their DVD training courses ^[20].

Second Prize:

1. A Model 175 Series Solar Generator provided by Quantum Harvest LLC (a $439 value),
2. A Glock form factor SIRT laser training pistol and a SIRT AR-15/M4 ^[21] Laser Training Bolt, courtesy of Next Level Training, which have a combined retail value of $589,
3. A gift certificate for any two or three-day class from Max Velocity Tactical (a $600 value),
4. A transferable certificate for a two-day Ultimate Bug Out Course from Florida Firearms Training (a $400 value),
5. A Trekker IV™ Four-Person Emergency Kit from Emergency Essentials (a $250 value),
6. A $200 gift certificate good towards any books published by PrepperPress.com,
7. RepackBox is providing a $300 gift certificate to their site.

Third Prize:

1. A Royal Berkey water filter, courtesy of ^[22] Directive 21 (a $275 value),
2. A large handmade clothes drying rack, a washboard, and a Homesteading for Beginners DVD, all courtesy of The Homestead Store, with a combined value of $206,
3. Expanded sets of both washable feminine pads and liners, donated by Naturally Cozy (a $185 retail value),
4. Two Super Survival Pack seed collections ^[23], a $150 value, courtesy of Seed for Security, LLC,
5. Mayflower Trading is donating a $200 gift certificate for homesteading appliances, and
6. Two 1,000-foot spools of full mil-spec U.S.-made 750 paracord ^[24] (in-stock colors only) from www.TOUGHGRID.com (a $240 value).

Round 75 ends on March 31st, so get busy writing and e-mail ^[25] us your entry. Remember that there is a 1,500-word minimum, and that articles on practical “how to” skills for survival have an advantage in the judging.