Family Medical Preps – Part 2, by Doctor Dan

(Continued from Part 1. This concludes the article.)

Stockpile Medical Supplies:

• Basic Household First Aid Kits: These are essential for treating the very minor/nuisance injuries one encounters in their daily lives. This is not as comprehensive as any prepper should have on hand, but its low cost is a starter towards having some medical supplies on hand. Many of the items could prevent worse problems, such as Neosporin preventing a life-threatening infection in a TEOTWAWKI situation. (These kits can be obtained at virtually any retailer for under $20.)
• More Comprehensive First Aid Kits: Useful for someone with slightly more advanced medical training than the non-medical lay person. These can be purchased online (from prepper or EMS websites, Amazon, or by assembling your own kit from a “shopping list”)
• IFAK (“Individual First Aid Kit”):
  • Commonly used in military and tactical EMS applications. They are usually packaged in a MOLLE style pouch that can attach to a tactical bag.
  • There are many variances, but all are designed to be used in an austere environment and provide life-saving, but often times not definitive, care.
  • At a minimum, these kits need: tourniquets (at least 2), CPR mask, gloves, Kwik-Clot gauze, and chest decompression needles (at least 2).
  • Every prepper (each member of the family/group) should own his/her own kit, keep it stocked, and know how to use it. My wife and I keep a kit in each vehicle, since we believe that most preparedness skills will be far more likely needed at an “everyday” emergency, than the possibility there will be a total breakdown of our medical system with care unavailable in a WTSHTF. Each member who carries their kit in a vehicle should also maintain a duplicate IFAK for their plate carrier/bug out bag (BOB) or remember to get the IFAK attached to their BOB if TEOTWAWKI occurs.
• Advanced/Specialized Medical Supplies:
  • This can range from sutures for wound management, surgical instruments, diagnostic tests, casting/splinting supplies, to antibiotics, etc.
  • Most of these purchases should depend on the level of training of someone in the preparedness group, or someone who you reasonably anticipate at your bugout location. (For instance, if your brother-in-law was likeminded and also happens to be a board-certified Emergency Physician, but lived 3 states away, you might want to stock up on more pre-positioned advanced medical supplies, if your in-laws’ plan was to bug out to your retreat in a TEOTWAWKI situation. He might even have access to antibiotics and other live-saving medication to add to the larder.)
  • While I cannot legally advocate for anyone to practice medicine above his/her current scope of certification/licensure, I can also say that in a true WTSHTF situation there will be no licensing boards to restrain your actions. At that time, it may be an “every man for himself” world, and your family or friends’ lives may depend on your actions. So, by all means, read/attend seminars/watch YouTube videos on skills that may be useful in such a world. Just remember that you can do harm to a loved one if you do not know what you’re doing, so I would encourage you to learn, train, and continually practice.
  • I highly suggest learning about wound management (including disinfection/ irrigation and debridement/ suturing) and having an abundance of supplies on hand to attend to such wounds. These will be frequently seen in a TEOTWAWKI scenario.
• CPR Equipment and an AED:
  • CPR equipment (Ambu bag/mask, oral or nasal airway, or pocket CPR shield) is useful so that the rescuer is not exposed to body fluids on the patient they are rescuing.
  • AED (automated external defibrillator): AED’s are now found in many public places and can also be purchased for private residences or small businesses. This is a worthwhile skill to have in the event that anyone around you experiences a cardiac arrest.
  • An AED is not a cheap investment (they cost close to $1,000) but early defibrillation saves many more lives than just doing chest compressions, so the question might be, how much would you pay to have an AED in your hand if your loved one just collapsed with a cardiac arrest, and you have 4-6 minutes to save their life?
  • The more remote you live from EMS services and/or the more that members of your family or preparedness group have a history of cardiac issues/risk factors, the more I would recommend emphasizing an AED purchase as part of your preps.
    

Train Up, Practice Up:

• Basic medical preparedness should be a mission of everyone in the group. No matter whether you are in a medical profession or not, there is a high statistical probability that you will encounter a medical emergency situation at some point in your life. It is also likely that this emergency will involve a family member, friend, or co-worker.
• There are many free or low-cost training opportunities available, and these are offered throughout the U.S. on a regular basis. The time commitment is often minimal, usually 1-2 nights total for CPR or Stop the Bleed.
• I strongly encourage everyone, whether in a medical profession or not, to at a minimum become trained in two things: CPR and Stop the Bleed.
  • CPR:
    • Make sure this course also has instruction on the use of AED’s.
    • This course is offered by both the American Heart Association and the Red Cross.
      • https://www.heart.org/en/cpr
      • https://www.redcross.org/take-a-class

• Stop the Bleed (aka- “Bleeding Control” or “B-CON”):
  • This course covers tourniquet application, packing of wounds, and other techniques useful in everyday life as well as prepping. It would be useful in the event of gunshot or knife wounds, chainsaw accidents, or motor vehicle accidents.
    • Again, the more rural you live, the more useful this skill becomes in everyday life as you may be the first person that happens upon such an injury long before EMS arrives, and stopping the bleeding can save a life.
    • The curriculum was developed by the American College of Surgeons in response to recent mass casualty/active shooter incidents where trained bystanders would have been able to save lives from early bleeding control.
    • https://www.bleedingcontrol.org
• First Aid Course: Red Cross offers a First Aid course for the layperson. It would be a good basic course for everyone in your group to attend as well if they are not in the medical profession. (https://www.redcross.org/take-a-class)
• Emergency Medical courses:
  • There are multiple courses available to those who wish to further their medical knowledge in the EMS arena. They are, in increasing order of training/hours required: (https://www.nremt.org/rwd/public/)
    • EMR (Emergency Medical Responder): The equivalent of a “First Responder” course. Many volunteer firefighters and police officers are certified in this as they are tasked with rendering basic life-saving maneuvers until more definitive EMS help can arrive.
    • EMT-B (Emergency Medical Technician-Basic; aka- “EMT”): This course usually can be completed in a few months by going a few hours/week. It is a mix of classroom and hands-on skill stations, and also requires observation shifts with both a Fire/EMS service and in an Emergency Department at a hospital. It would be a useful skill for at least 1-2 members of your group to have.
    • EMT-A (Emergency Medical Technician-Advanced): This course provides additional training (especially hands-on) to the EMT-B skills set. It allows EMT-A’s to render a broader range of therapies under many EMS systems’ protocols. (https://survivalblog.com/advanced-emt-preppers-r-s/)
    • EMT-P (Emergency Medical Technician-Paramedic; aka- “Paramedic” or “Medic”): This is a large time commitment and often only undertaken by those in the EMS/Fire/Hospital professions. It will provide a graduate with a large fund of knowledge and skills, and also has rigorous CME (continual medical education) requirements. The time commitment for training and maintaining a license would be difficult without at least part time work in one of these fields. Paramedics are excellent additions to a preparedness group, if they are otherwise a good philosophical fit with the group.
  • Some state-level Emergency Medicine Agencies are providing low or no-cost EMR and EMT-B training to increase the number of laypersons with medical knowledge. This helps ease the cost burden for those who can take advantage of this opportunity and may also lead to work opportunities in the Fire/EMS field.
  • Fire I and II courses are also publicly available for those who wish to have knowledge of how to deal with fire and rescue threats. These certifications are often membership requirements of (but often paid for by) volunteer fire departments, and also hiring criteria prior to interviews at many paid firefighting positions.
• Dental, Nursing, CST, Pharmacy, and Allied Health Professionals:
  • There are many licensed allied health professionals that can bring medical skills to your preparedness group.
  • Dentists are the experts on tooth and gum disease, which will become much more prevalent in a TEOTWAWKI scenario. They also have advanced knowledge of dental matters, with some training in medical knowledge outside the mouth as well. Most dentists perform surgical skills (the breadth of these depends on their area of practice) which could be used elsewhere in the body in an emergency, and they often have access to antibiotics.
  • Pharmacists will have knowledge of many of the medications (and possible substitutes) your group may have questions about. They may have some working knowledge of other medical topics if they have worked in a clinical setting.
  • Nurses may bring a large fund of knowledge and skills with them to the preparedness group, largely depending on their work background. Experience in Surgery, Emergency Medicine, OB, or ICU would be ideal backgrounds for preparedness group members.
  • CST’s (Certified Surgical Technologists) assist the surgeons daily in the operating room. While they do not perform the operations alone in the OR without the surgeon, they work right alongside of the surgeon, and have a knowledge of many of the key steps many basic surgeries entail. They would also be experienced at wound debridement and management, an invaluable skill in a WTSHTF situation.
  • Physical Therapists, Physical Therapy Assistants, Radiology Technicians, and Medical Technologists (who run the laboratory) all are usually CPR trained and have knowledge in their respective fields which will have some use to a group.
• Physicians (MD and DO’s), Physician Assistants (PA-C’s), and Nurse Practitioners (NP’s):
  • These fields represent the most experienced practitioners. They are the team members who make definitive diagnoses and administer the most complex treatments to patients.
  • Work experience and background training can be widely variable, but here are some of the fields (both physicians and PA-C/NP’s) that would be MOST useful to a preparedness group:
    • Surgeon (especially Trauma, General, Orthopaedic, ENT, and OB/GYN)
    • Emergency Medicine
    • Anesthesiologist/Critical Care Intensivist
    • Hospitalist
    • Cardiologist
    • Primary Care (Family Practice, Internal Medicine, Pediatrics)
  • Many of these medical professionals have sacrificed a great deal of their free time to train in their specialty, and then work the demanding hours of the job. Due to this, they may not be the best shooter or tactician in your preparedness group. They may not have as deep of knowledge of gardening or mechanical repair work as others. Do not expect them to always be able to contribute in those ways as much as others with more “hands on skills.” What they can do for your group from a medical standpoint will more than make up for these deficits, so long as they are willing to participate in group training/meetings, share in the preparedness planning, and purchase their share of supplies so they aren’t “dead weight” to the group.
• Utilize the group members with medical knowledge to help train the others. It is fairly easy for a medical professional to become CPR or Stop the Bleed “Instructor Certified.” If they could become certified, they could officially instruct the rest of the group.
• Often times these team members also have access to “outdated” medical supplies which would otherwise be thrown out at their jobs. (These supplies are usually perfectly good, but have hit an arbitrary manufacturer expiration date.) Obviously, this acquisition needs to be done legally, but many hospitals and EMS services will allow employees to take home outdated supplies for their own use. It may be a great way to add medical supplies to the group.

Affording It:

I acknowledge that many of these medical supplies above can be budget-strainers, especially if bitten off all at once. Here are some tips that may help some readers, depending on your individual budget and insurance situations:

• Preventative Care: The majority of preventative care at the PCP office is covered by many insurance plans now. I urge you to take advantage of this. (This includes your visit with your PCP, necessary preventative labs, and age-related testing such as colonoscopy and mammography.)
• Prescriptions: Cost may be a budget issue filling a large number of Rx all at one time. Several of the large retailers (Walmart, Meijer, Target, Sam’s Club, and Costco) have Rx discount programs where many of these medications are available for very reduced prices. I suggest shopping around a little if you want to invest the time, in order to save some money. (goodrx.com has a good price comparison tool.)
• HSA: If you have a HSA (health savings account), you can receive tax benefits from non-taxable income if you pay with your HSA account. (You can put up to $7,000 into your HSA in 2019 if you have a qualifying HDHP “high deductible health plan”). This can be spent, for you or your qualifying family members, on:
  • Prescription and over-the-counter medications
  • Medical treatments not covered by insurance (e.g.- LASIK vision correction)
  • Dental and Eye care, glasses and contacts, and orthodontic braces
  • Any of the medical supplies mentioned in this article, including an AED
• Health Care Coverage: I realize that everyone’s employment and financial situations are different, and with that comes the availability, or lack thereof, of health insurance. However, running without healthcare coverage of some sort leaves you and your family highly exposed to complete financial devastation. I have seen families acquire six-figure debt loads in one emergency event, and I do not want to see this happen to your family. Here are several options to evaluate for your family’s situation:
  • Health Insurance: If you have good employer-sponsored (usually highly subsidized by your employer) health insurance, this is often your best option. It may also be your best choice if you are self-employed, especially because it is tax-deductible in many circumstances.
  • HDHP with HSA: If your family is blessed with relatively good health, I encourage you to look into the High Deductible Health Plan (HDHP) with HSA option, and fund the HSA as much as possible. This is a highly tax-advantaged account, so it makes good business sense for many to use it as a way to save money for future healthcare needs (including in-home and nursing home care in the future). It also allows you to use it as a “passthrough” to avoid paying taxes on the money you will be putting into your medical preps…just remember to save your receipts. (https://survivalblog.com/letter-re-getting-first-aid-supplies-tax-free/)
  • Christian Medical Sharing plans: If you are not able to have employer-sponsored health insurance, this is a good option for many people. While this is not true “insurance” it functions in a similar fashion to protect your family from catastrophic financial devastation in the event of a large medical bill. I have seen it work out well for many families we know personally.
  • Medicare: For those 65 or older, Medicare plus a good supplement plan can be your best option. You have paid in to it for your entire working life (the “Medicare tax”), so you should not feel guilt for collecting on this in your retirement years.
  • Medicaid, “Marketplace” and/or State-Specific Plans: While many readers probably share my macro perspective that these plans are steps towards a socialized medicine state that I do not agree with, they are other avenues which exist that you might consider if that is your only viable option to provide healthcare to your family and protect against catastrophic financial risk. If these are your family’s only reasonable way to have health coverage, then I encourage you to consider them, rather than to go without health coverage. You simply cannot afford to be without some type of coverage in the event of a major injury or medical condition.

About the Author:

“Doctor Dan” is a board-certified physician anesthesiologist who practices anesthesiology and critical care medicine in a rural hospital. Due to his previous training in trauma surgery, he also maintains an interest in EMS and disaster preparedness medicine. He serves as a Tactical Medical Director for a SWAT team, and as a medical director/training officer for fire departments and EMS services in his area.

Doctor Dan and his family live on a farm, where they hunt and raise a garden. They believe in trusting God, but also doing their part to be prepared so that they can be a help, not a burden, to others when a time of crisis occurs.