E-Mail 'Family Medical Preps - Part 2, by Doctor Dan' To A Friend

18 Comments

1. Doctor Dan thanks for stressing the training! One of the courses that I find to be a little more extensive and Prepper related are the wilderness first aid or responder courses. The premise of most first aid courses is that the patient can get to the hospital quickly where as the wilderness courses assume that advanced care will be delayed.

   Gauze- lots of gauze. A major wound will use up a lot of gauze pads and rollers. A box a pads can be used up in 2-3 days one one wound on one person. How long does it take to heal? Weeks in some cases.

   1. Thanks 3ADscout. I agree on the gauze. It’s cheap, lightweight, lasts a long time (if kept clean and dry in storage).

      AWLS (Advanced Wilderness Life Support) is an organization that has a lot of good courses in outdoor medicine/first aid. Plus, their courses are in some pretty cool destinations for those who already love the outdoors!

      https://awls.org

2. So great to see this information, especially the part about how to get training. CERT Training (Community Emergency Response Team) is another program available in many local areas. It’s a great course which also allows for networking with local emergency personnel.

   I have seen the SWAT-T tourniquet highly recommended. It is the only tourniquet that can be used on children (as well as adults) and can be applied with one hand.

   Israeli Bandage battle dressings and Celox injectors to stop bleeding also are advised. Celox can be broken down by the body and does not have to be removed from the wound like Quickclot does.

   YouTube has lots of videos on how to apply tourniquets and bandages. If you have little to no medical training, you should at least have some idea how to use a tourniquet and Israeli bandage in an emergency until you can get more knowledgeable assistance.

3. I think training here is a big thing. An AED is only as useful as the person using it. The bigger problem is treating the cause of the cardiac arrest and managing care post arrest care down the line otherwise you could very well just be prolonging the inevitable 🙁
   On another note….the poor mans defib…..whats your thought on teaching the precordial thump?

   1. There are many treatable cardiac arrest causes where early defibrillation not only saves lives, but also brain function. If you live in a remote area, there is no way that an ambulance or VFD will be able to arrive fast enough to defibrillate the victim out of the ventricular fibrillation. If you own one and have it easily accessible, it is possible that you might save a life and brain. I would advocate for owning one, as my family personally has invested in one.

      If someone is dying in front of your eyes, and a defibrillator is not available, then what harm does it do to try a “hail mary” precordial thump. If it doesn’t work, the patient is no more dead than he would be had you not given it a try!

4. Thanks for an excellent overview.

   One critical area I found when serving overseas as an advisor, is our lack of recognition of basic Preventive Medicine, especially in the US. We take it for granted and fail to plan for grid-down.

   I spent two tours, advising Afghan National Police Central Region Commander, and Afghan National Army 201st Corps. Lack of hygiene in urination and defecation, food preparation, and water consumption were causing over 23,000 days of soldiers too sick to report for duty in the 201st Corps. That is in conditions far more sanitary than you will have in TEOWAWKI.

   PM is a critical skill for each person, requiring absolute discipline in practice, from the individual survivalist, to anyone touching food, to the person cleaning the surgery and instruments.

   Far more of us will die in bed with intense fever and sweats, while painfully violently vomiting, with diarrhea uncleaned, than from trauma. Even if you are careful yourself, one careless contagious person will gift you those wonderful things.

   When I was a battery (company grade) commander feeding in the field I personally made each soldier wash his hands if he wouldn’t do it voluntarily at the wash station set up at our feeding location.

   My First Sergeant should have done it but he was too chummy with the men.

   We had far less cases of diarrhea than other, undisciplined units. When MRE’s are getting used, you have less issue because the men eat from the pouches with an individual spoon they usually throw away. But

   You may recall photos of Viet Nam where guys had their spoon sticking out of their pocket so the could reuse it. Spoonfuls of gut torture if you don’t sterilize it before sticking it in your pie hole.

   But things aren’t trouble free by using MREs because you cannot ensure that wash feces and urine off their hands before they eat or put tobacco in their mouths. You still get people with violent vomiting and diarrhea that contaminate areas, and thus potentially infecting everyone else who gets exposed.

   After my advisor tour with the ANA, I gained a whole new respect for Preventive Medicine. It is a true combat effectiveness multiplier.

   The point becomes critical for you at your retreat. If you need three people on watch and one is sick at the latrine for hours, the illness is the same as you being attacked by a machinegun instead of a rifle. You can fight off a rifleman, but you probably can’t fight off a machinegun-like violent illness that will defeat your small force.

   God Bless and keep the TP and soapy water handy.

5. I can’t agree with Dr Dan more regarding pre-screening. Early detection of prostate cancer probably saved my life. While it couldn’t have been caught any earlier, one of the 2 locations it was found was 2mm from the edge. If it had moved outside, all bets would have been off. See you doctor for routine testing and blood work!

6. Joining local fire department you get all of your training free or low cost. You might have to take additional classes but firefighter / EMR is great tools to have in your tool box. CERT ( COMMUNITY EMERGENCY RESPONSE TEAM) is another tool.

7. Really good advice Wheatley, I was just re thinking my experience as a medic back in the day. I might not be the best guy in the group for tactical decisions but field sanitation is equally important. Our motto back then was To Preserve the Fighting Strength”.

   Colleen you are so right on about post event care. As a former ER RN I’d add that the most important thing to add to the AED would be an oxygen generator. Most of them run off of 12 volts so a way to recharge the battery would also be important. Not cheap but the first medication to give with a heart attack is oxygen and for advanced cardiac life support, oxygen is considered to be a medication.

   Doom and Bloom is another website to be familiar with.

   Thanks for the excellent insight Doctor Dan

8. Colleen
   I have successfully used a precordial thump many times over 30 years as a critical care nurse, while waiting on a crash cart. I also agree with you about an AED, these are only a stop gap if there is no where to transport for higher level cardiac care, as most arrests are from coronary artery disease. Although I would love to have an AED at home, the expense is too high for the average family/group, and first line cardiac drugs mostly impossible to have on hand……let alone a cath lab at home!! BUT, for times when a cardiac arrest is due to electrocution via lightning strike or electrical accident or hit to the chest such as you sometimes see in baseball accidents, an AED would be a great asset. Undiagnosed cardiac abnormalities seen in young athletes (mostly males) would also fall into this category. Understanding the fact that the 99% of people will probably not have access to an AED in these instances I would not hesitate to try a precordial thump, although it fell out of favor and is not really taught anymore, i’ve seen it work to many times to not try it. I was an ACLS instructor for about 20 years and we did used to teach it. I have not looked but I would not be surprised if there were YouTube videos out there that can demonstrate this relatively easy procedure. The cardiac rhythm seen most often in the above scenarios is usually ventricular fibrillation and using a thump very quickly may just work. I’m not a doctor (but I did stay at a Holiday Inn last night), so take this only as a method to use in a very austere environment.

   1. STEMI and Non-STEMI (types of heart attacks), drowning, lightning strike, electrocution…all of these patients could benefit from early defibrillation with a home AED!

      I agree that a precordial thump is better than watching someone surely die (brain death occurs within about 5 minutes of the onset of V-Fib), although neither a precordial thump nor an AED is a guarantee that someone will live. It just increases their chances of living through said events.

      If you can get someone back into a normal rhythm from V-Fib in a timely fashion, you can save their brain along with their life.

      If I drop over, I hope someone does me the courtesy of early defibrillation!

      1. Me too Doctor Dan! I hope someone can give me early defibrillation also, and I would LOVE to have an AED at home. I also would dearly love that if someone is doing CPR on me that they do CPR & breathing for me, I’m very afraid that if I had some brain damage that I may be able to have respiratory function off of a ventilator, so my husband would not just be able to unplug me!!!

9. Precordial thump
   More info…..if I witnessed let’s say somebody falling over in the grocery store and I actually again “witnessed “ this, I would check their pulse, and if pulseless I would still try this as quickly as possible…the quicker the better. If they had family around them I would also be asking some very quick questions as to their medical history to see if I could rule out other causes for their arrest. Ask for an AED and have someone calling 911 while starting CPR. My next statement is on current recommendations for CPR, they now recommend only doing the chest compressions. My personal opinion on this is if your not going to breathe for me, please do not do chest compressions for me, I do not want to end up as a vegetable, I understand why they recommend this because people are so paranoid about catching something from someone they don’t know if they have to breathe for them. All the crazy things you are thinking you are going to catch, you are not, maybe possibly a cold, or some might say herpes simplex 1 (a cold sore) if you are an adult you have already been exposed to herpes numerous times, you already have a history of this or not but the likelihood of catching it as an adult is probably pretty small. Our lungs have about a 5 min reserve of air, after that time if they are not getting any air you start to have an anoxic brain injury, to what extent it depends on how long your go without oxygen. Remember. …you are trying to save a life, try to save it intact as much as possible! I can honestly say I would not have trouble breathing for a stranger. This is totally my honest opinon.

   1. Just had a brief from our fire chief and EMT today, stating with chest-compression-only CPR, until the ambulance crew takes over, they estimate 80% of patients will live, as opposed to other method incorporating breathing just getting 10% lives saved.

10. Wheatley
    I’m not saying don’t do CPR, but the BEST form of CPR is chest compressions and rescue breathing, especially if you have a second person on the scene. I have many years of experience of seeing CPR delayed or only chest compressions being done, and by the time EMS gets there or when they arrive in the ER and are given correct CPR and first line cardiac drugs, YES they are alive, and are quickly transferred up to ICU on a ventilator, many times cardiac arrest happens again due to the drugs wearing off. Depending on how long their “down” time was (how long before CPR was started or EMS arrived) has everything to do with how much brain can be saved. You would never see EMS personnel, or hospital staff doing only chest compressions. The American heart association changed to chest compressions only for the public because of people’s fear of breathing for a stranger. The majority of people probably live out side of that 5 to even 10 min. distance, I know I sure do. Even in large cities with massive traffic jams, it takes some time to reach a victim. My point in saying “don’t do chest compressions for me if you are not going to breathe for me” is because if I survive, I want to survive with an intact brain! I’ve seen way too many people with anoxic brain injuries. People need to get over their fear of rescue breathing. Everybody needs to take a CPR class every 2 years at least for your family, friends and strangers. What your chief does not see is nurses like me who deal with grieving family members when their loved one is brain dead and we eventually turn that ventilator off.

11. TXnurse, I concur 110%! Hypoxic means loss of function and i have seen way too many impaired or brain dead people after a “successful” resuscitation.

    1. Sorry, but I’ll take my chances. Defibrillate or precordial thump me…my wife can unplug me from life support a few days later if my brain didn’t make it!

12. Regarding IFAK contents, here is what I carry in mine (and my wife carries in hers). Feel free to modify your own, it’s just one possibility:

    Pouch
    Tourniquets x 2
    Chest seals x 2
    Olaes/Israeli Battle banadages
    Quickclot
    Angiocaths 14 ga x 2
    Scalpel
    2-0 silk suture on Keith (straight) needle
    Trauma shears
    Hemostats
    CPR masks
    Nasal airway
    Oral airway
    TCCC cards
    Marker
    Regular bandages
    Nitrile Gloves

Comments are closed.