It is time for a drill! I am a retired, disabled physician who is going to submit to you real-life scenarios that have happened in my family—-at home. In this practice, you are to imagine yourself and your loved ones in each of the following situations. What would you do? Do you have what you would need? Pretend that you are the first responder and decision-maker due to a SHTF situation in your region of the country. (Otherwise, always seek help from a trained and licensed medical care provider!) The phones are down and the roads are impassible.
Disclaimer: I am neither prescribing nor diagnosing and recommend that you always consult with your own medical provider when making decisions about past, current, or future care. Whatever you do is at your own risk.
Case 1- Act in Haste, Repent in Leisure
The lady of the house is scurrying around gathering up the family’s laundry in a rush. She picks up a pair of slacks that still have a belt in place. She grabs the tip of the belt and whips it out suddenly feeling the hard narrow metal buckle at the other end strike her eye. No pain……yet. She looks at herself in the mirror and sees a gouge out of her cornea and comes to you for help. She is in pain by the time she finds you. What do you do?
Answer: Watch this Doom & Bloom medical video [1]. I encourage you to watch that brief video on how to deal with eye trauma.
Disclaimer: I receive nothing for recommending any videos, websites, or products in my article.
My mother was the person in the aforementioned situation, about 60 years ago. As medical help was available, she went to the emergency room for examination. Treatment consisted of an eye patch and a few days rest to promote healing. Fortunately, the injury was located over the iris (colored part of the eye) and not the pupil (black “window” through which we see). Vision loss could have been a complication if in the latter location. If deeper, then leaking of vitreous humor from puncturing the globe (eye ball) could have also been a serious result. Keep in mind that if you do have and use fluorescein dye strips (if concerned about a possible corneal abrasion) to inquire first if the patient is allergic. It is helpful to have the patient close the normal eye during rest because each time it moves, the injured eye will too. Motion slows healing. Oral nonprescription pain relievers may also help with discomfort, if needed.
Case 2- Slip Slide and Away
The basement floor is damp from a recent load of laundry and you go upstairs to tend to other chores.
Your four-year-old comes crying to you and you notice that he is leaving wet bloody footprints on the floor due to a laceration on his right big toe. He slipped and fell on the wet floor jamming his foot into nearby metal. What do you do?
Answer: Please begin by reading this nice concise summary [2]. It is a good review of basic care of lacerations.
The patient was my son. My husband drove to the emergency room while I held compression on the wound and reassured my worried son that he was going to be fine, “Am I going to die Mama?” The emergency doc gave us the choice of either giving him stitches or keeping my mischievous active son off his feet and in bed for a few days. We opted for the sutures knowing that patient cooperation would be nil. Remember that compression and elevation are your friends. Hold firmly and don’t look for about 10 to 20 minutes unless bright red blood continues to spurt actively in which case consider a tourniquet if the patient may bleed out. It is helpful to have supplies of gauze, topical antibiotics, and steristrips on hand for superficial wound closure. For those with the appropriate training, consider having some suture available along with the necessary sterile tools and sterile gloves for closure of deeper wounds. Age-appropriate nonprescription pain relievers may be given if needed but avoid aspirin which may increase bleeding risk.
Case 3- The Not So Good Old Ways
A four-year old girl is staying with her grandmother who fears she may have a fever. Grandma only has an old mercury thermometer and puts it into her mouth cautioning her not to bite or break it.
(Please cut Grandma some slack as this occurred 64 years ago, yet it still serves as an example of accidental ingestion of a poisonous substance.) Unfortunately, a couple of minutes later the little girl does that very thing. What would you do?
Answer: Grandma had me spit out everything and rest quietly lying down while she quickly whipped up a big bowl of raw egg whites. She then took me out onto the back porch where she had me eat them spoonful by spoonful which elicited repeated vomiting of stomach contents just in case any mercury might have been ingested. Nowadays, after emptying and rinsing out the mouth we’d call the poison control center at 1-800-222-1222 for prompt expert advice. Also, see the Poison Control website [3]. In this scenario, phones are out so you are on your own. I strongly encourage you to spend some time reviewing (and maybe copying) materials available on this website. Please note that at the top are subdivisions by substances and also by age.
If caustic material has been swallowed, quickly have the patient drink milk or water to dilute it. Neither caustic products (bleach, acids, bases) nor petroleum (gas, kerosene, etc) should be vomited as that can cause further damage. For some items, ingestion of activated charcoal powder may be prescribed. Consider printing off suggested treatments for the most likely ingestion accidents to occur in your home. As always, keep chemicals, medications, supplements, button batteries et cetera securely locked up if children reside in your home. Have some locks and lockable boxes or cabinets available just in case you have unexpected guests with children seeking refuge with you during a disaster or TEOTWAWKI situation. Oh, and make sure to have some child-safe thermometers on hand. Note the plural. One is none. Two is maybe one etc.
Case 4- A Hot Time in the Summer
Grandma, Grandpa and the two visiting grandkids are gathered in the kitchen for lunch and standing around the stove. The pressure cooker on the stove suddenly blows its weight and starts spewing scalding steam. What would you do?
Answer: Evacuate! We all ran out onto the back porch and I can still hear Grandma say, “Anyone of us could be in an ambulance on the way to the hospital!” (In those days, having to go to town for treatment was indeed considered a dire illness or accident.) Action- first check that each person is O.K. This goes especially for children who can sometimes be unreliable reporters for whatever reason.
See the Mayo Clinic’s advice on treating burns [4]. Consider quickly reviewing burn treatment in the above article. ASAP cool a thermal burned area with flowing cool water or if not possible at least a cool cloth for a full 10 minutes. During this time, elevate the afflicted area if possible and remove any constricting clothing, jewelry, etc before swelling commences. This article [5] details how to remove a ring that is stuck. Dental floss is very handy (grin) in removal. For more serious wounds, watch for shock and treat for pain and dehydration. Calm and reassure the patient that everything will be fine no matter how serious the situation. Supplies of burn gel, sterile dressings, sterile gloves, and silvadene cream may prove helpful if the patient is not allergic to sulfa. Third degree burns definitely need advanced care as soon as help can be obtained in order to perform debridement/excision, grafting, and reconstruction.
Case 5- Close Encounters of the Nasty Kind
A man in your household is outside picking up a couple of pieces of fallen wood when a snake suddenly lunges at him latching onto his forearm. The snake will not release. What do you do?
Answer: This happened to my son while moving debris in preparation for mowing the yard. The copperhead would not let go so he shot off the body right behind the head and then carefully removed the fangs from his arm being aware that the head could still bite again by reflex. He promptly washed the deep wound with soap and water and read what to do since he didn’t want to worry Dr. Mom! (He “neglected” to tell me about this incident for a few years.) Fortunately, it was a copperhead bite in an adult human, so serious consequences were much less likely and he declined to obtain the expensive antivenom. Please consider reading this brief article [6] and watching this informative video [7]. After cleaning the wound, remove any constricting rings, jewelry, or clothing and rest the limb below the level of the heart to slow the spread of venom. Consider Ace bandage wrapping the limb beginning two to four inches above the two fang marks and continuing up the limb and then back down. Make sure that the distal digits (fingers or toes) still quickly re-pink when the nail is gently squeezed.
In order to monitor the swelling that may occur, measure the circumference of the afflicted limb now and at appropriate intervals marking down the diameter on a piece of paper. It may also help to draw a circle around the wound and follow for increasing redness, bruising, swelling, blistering, etc. Although snake bites tend to be less filthy than those of cats or other animals, my son nevertheless gave himself a course of fish antibiotics due to a friend’s uncle dying of sepsis (blood poisoning) from the bite of a black snake. Do not cut or bite the wound to suck out the venom. It is usually too late to remove any reasonable amount. Also, some bites are dry. If the bite is that of a rattlesnake, the situation is far more serious if venom has been injected. It is time for fervent prayer and the seeking of advanced care if at all possible.
My son also had another couple of encounters with snakes that deserve mentioning. When gathering eggs in the darkened hen house, he noticed a rattlesnake in the nest where he had just placed his hand! He pulled his gun and blasted the nasty beastie which had slowed reactions due to feeling ill from having swallowed a couple of golf balls placed in the nest for chicken education and encouragement. On another occasion, when he was checking fence, a baby rattlesnake coiled up and repeatedly tried to strike his booted foot. He has noticed a welcome decrease in the local snake population due to increased brush hogging and the addition of several rodent-eating barn cats. Bless their little feline hearts.
Conclusion
If you happen to be the “chief medical officer” for your group, periodically remind people to work slowly and carefully while using all safety precautions and gear (gloves, safety goggles…) in order to reduce the incidence of accidents. Also, keep an eye on children as they quickly get into mischief and ask everyone to wear shoes or preferably boots when outside. Do not go barefoot due to parasites, snakes, rusty nails, etc. Have a weapon at hand for dangerous critters. My grandma always had a hoe in her hand long ago when outside but other means of protection are in order these days due to the dangers of the two-legged “animals” plus feral dogs etc.
So, dear readers, please stay safe and take what precautions you can. It is my hope that this accident drill will be a help and blessing to some of you. Learn what you can and get what you need while there is still time. Best wishes, K.B.