A Medic of Last Resort – Part 2, by Tunnel Rabbit

(Continued from Part 1.)

Learning As We Go

Without the basic knowledge and skills to use our supplies, that first aid kit is actually a ‘last aid’ kit. By shopping shrewdly and avoiding items that we do not know how to use, one might acquire a larger store of items that we can actually use. Given the possible savings that result from shopping hard and long for bargains, and limiting ourselves to the basics, we can then purchase more of the basics supplies that are needed most of the time.  And we should strive to continually improve our knowledge and skills, and expand our equipment accordingly. And we might also save enough to purchase items that make the job easier, such as an automated blood pressure cuff, or a fingertip pulse/oxygen meter, and other such equipment.

Managing resources and priorities is not easy.  It is harder when one can not afford to buy a ‘hospital in a box’, a comprehensive and large kit assembled by a medical professional with the survivalist in mind.  While such a kit is highly desirable, the survivalist also contends with competing priorities, limited resources, not to mention a finite amount of time.  It would certainly be nice to have it, and not need it. But then again, as most do, including myself, buying stuff that they do not know how to use, is a waste of resources.  Unless of course, one has a medical professional they know, who can use a ‘hospital in a bag’, these specialized items would not be useful and in fact could be dangerous in untrained hands.

Fortunately, I have such connections and could trade my services, or medical supplies for either medical or dental services. In fact, I already do barter for these services.  Barter works!  For those who can afford to make such an investment in medical supplies and equipment that they themselves cannot use, that strategy could pay a future dividend, if put into knowledgeable hands.

It might be of help in some way to see what one person does. You can learn from my oversights, omissions, and outright mistakes, as well. The omissions might be due to an oversight, lack of funds, or intentional. For example, as a rule, I would never close a wound, and therefore have no need for staples or sutures.  I might use steri strips to stabilize a laceration on the face, or by improvised means, partly close the wound to protect it, yet leave it open enough to let it drain, but in no way would I close a wound. That is for the professional in a clinical setting. Leaving it open to drain and heal naturally is the safest way to prevent a serious infection that we might not be able to combat with oral antibiotics if the wound was closed.  The wound will heal more slowly, and leave noticeable scar, yet that is an insignificant trade-off given the risks of closing a wound.

A Prioritized Shopping List for the Basics

Rather than purchasing a comprehensive kit that costs an amount that goes beyond our finances and abilities at this time, the aim is to get the ‘mostest for the leastest’ amount of money, and to first purchase a kit that addresses life-threatening wounds, first.

The shopping lists are broken into four categories in order of importance.  The kits or categories can be used, first separately to stabilize the injured, and together.  The items listed in each category consist of only the basics and do not include items that could be used by more knowledgeable persons. We can of course get proper training and learn more, and expand each kit as we can afford to.  This shopping list is intended to get the common prepper who contends with competing priorities as they prep, and have limited funds.  Everyone is on a budget.  After establishing a baseline of medical supplies, I would continue to deepen it over time as I have done in each department such as communications, guns and ammo, food, transportation, etc. The four categories are in order of importance, namely:

  • IFAKs
  • Emergency Medical Supplies for Wilderness Situations
  • Bulk Wound Care Supplies
  • Personal hygiene.

After the first category is acquired for each family member, then begin to acquire items for the next category.  By prioritizing our purchases in the order of importance as suggested, we are reducing the risk of death as soon as one can financially afford to fill our larder with the first, and then next category of medical supply kit.  Even if the buyer would prefer different items, this prioritized approach and categorization, could make the endeavor and the money spent, more effective. That said, as we are in abnormal time, and as an exception to these guildlines, if I had not already purchased a broad and deep supply of oral antibiotics, that would be the first and most important investment one could make. After June 2023, veterinarian antibiotics will no longer be available. After that date, only antibiotics for fish will be available. Prices may rise as a result of a diminished supply.  A full explaination and details are in this video:

The Future of Pet Antibiotics, Aquatic/FISH and Bird, with Dr. Alton

Let’s Go Shopping

Category #1, The IFAK

The Individual First Aid Kit (IFAK) is designed to stop bleeding from a traumatic incident such as a gunshot wound, car accident, or from a major wound from a chainsaw, axe, or blade. You’ll want at least 2 tourniquets, if not 4 per load out, and one with you at all times when only carrying a handgun. Combat vets recommend 4 tourniquets as they have 4 limbs.  And there is the possibility that a second TQ might have to be applied to the same limb if the first TQ does not completely stop the bleeding.  I have deluxe IFAKs for each load out. One for each type of rifle, the AR, and another for the AK, and one for my EDC.  It is easy enough to put a compact tourniquet into a pants pocket, but not the larger ones.

If funds are particularly tight, the expensive blood clotting gauze can be replaced with standard rolled, or a compressed gauze, or the more expensive and desirable ‘rolled S’ type compressed sterile gauze from H and H. There is some debate about the necessity of a blood clotting agents as compression techniques work most of the time, however, it would be nice to have it. Quick Clot and other blood clotting agents are optional, yet it would be very nice to have if the bleeding wound is located within the torso area, and not in the extremities where a tourniquet can be applied to stop the hemorrhage. In place of Quick Clot should be at least one, if not two compressed gauze bandages.

The Israeli Bandage is optional, yet it can take the place of a tourniquet if there are not enough tourniquets, and if we might stop the bleeding with a compression bandage, that is a better solution than a tourniquet. And while I prefer the 4 inch Israeli Compression Bandage, because the additional compression it can provide over other types of compression bandages, the H and H brand flat compression bandage is said to be easier for some people to use. Note that it is more compact if the flat version of this bandage is ordered.

If bright red blood is spurting out, then I would immediately apply a tourniquet. I would then have no more than 7 hours to get to the hospital if I hope to save the limb.  Never release that tourniquet, the toxins built up in the limb could kill the patient.

EMT Shears are a necessity. If there is bright red in color blood gushing or spurting out, we must get at the wound to visually to assess it, to pack it, and immediately apply compression bandage or a tourniquet if needed. I could bleed out and die in about four minutes if an artery were severed.

The Basic IFAK (Individual First Aid Kit)

There are more comprehensive, and additional items that comprise a better IFAK, yet many of those items require training or additional money. An advanced IFAK would contain a decompression needle, nasal airway, Sharpie marker, and more.  However, if one can afford such items, and expects that they will soon acquire the training, get these items. In the event that the patient is dying, it would impossible to do more harm.

For those defending the homestead, this one idea of what would be a ‘basic’ IFAK:

  • One hemostatic gauze such a Quick Clot (optional)
  • One or two sterile compressed, or rolled gauze
  • 2 to 4 CAT or SOFF-T Tourniquets
  • A pair of HYFIN Chest Seals
  • One 4 inch wide Israeli/Emergency Bandage
  • EMT scissors
  • Mylar Emergency Blanket

Here, I’ll mention an example of a commercially offered and basic IFAK.  If funds were tight, I would forego the hemostatic gauze, and buy up to 4 tourniquets instead, and one sterile compressed gauze.  If funds were not tight, and because the IFAK is the most important, and first kit we should acquire and carry, I would buy an additional 3 tourniquets and one compressed S-rolled gauze from H and H to add to this kit.

As a compact and easy-to-carry package, a CAT tourniquet and trauma sheers in a holster specifically designed for the purpose, would be ideal as it can be located in the front of the web gear or belt. It takes up much less real estate on the web gear than the entire IFAK. Locate the rest of the kit elsewhere on your gear, yet at a location that is easy for both hands to access.

The USMC IFAK includes additional items.  The most important to consider is BurnTec.  There are other brands available.  This is a sterile 4×4 wet jell occlusive dressing that can adequately cover the palm and fingers. It can be held in place by a compressed rolled gauze.  This is presumably included to address hands that are burnt while handling hot rifle barrels. My rifle once became so hot that it ignited the leather strap that connected the sling to the end of the barrel. Such burns to the hand can also occur while using a wood stove, or while at a campfire.  Burns are very prone to infections, and should be cared for immediately if possible to prevent infection.  Water Gel dressings also provide the necessary cooling that is needed immediately to prevent a burn from burning deeper into the next and deeper layer of skin that covers bone and muscle.  If little to no water was available to rapidly cool off the burn, immediate application of BurnTec or another water jell product might reduce the severity of a burn.

In addition to the IFAK, we can also carry a small first aid kit that contains items such as small and large adhesive bandages, steri strips for lacerations to the forehead or face, an antibiotic ointment, chapstick, and ibuprofen. A few feet of two-inch wide Gorilla tape can be wrapped around itself on a card and be flattened, and easily stored. The purpose of this kind of kit is to help us remain comfortably out in the field. This is good preventative medicine that is self-applied.

(To be continued, in  Part 3.)