Medical Emergency Sheets - Part 1, by K.B., M.D. . Anaphylaxis.

Today begins a four-part article series called “Medical Emergency Sheets” in an effort to assist fellow readers who may face certain emergencies. Why? During an emergency, people panic and may forget what to do or may never have had any medical training whatsoever. Circumstances may also require immediate action which won’t allow time to peruse medical articles or books. While we still have it, call 911 first and always get help from medical professionals! I do, however, encourage you to make a notebook with dividers for certain categories (various body parts, diseases) and place these Medical Emergency Sheets as the first page in the appropriate sections. Read, review, and practice what you would do in different emergencies. I also hope that you will obtain some of the fine medical reference materials available and print off many of the excellent medical articles from SurvivalBlog. Consider making notebooks for your grown children or other relatives and have them readily available in each residence or cabin along with a medical treatment bag.

To review, the article series Medical Action Sheets was published in SurvivalBlog December 26-29, 2018. I am a M.D., now retired disabled, previously educated at a prestigious U.S. medical school with five years additional specialization and years of medical experience. I strongly encourage anyone with medical concerns to seek assistance from a certificated medical professional. Do not, repeat, do not, consider the following information as complete or as any attempt to advise, diagnose, treat, or manage anyone’s medical condition. As readers of SurvivalBlog, we are all aware of the possibility of TEOTWAWKI or, at the least, of a serious emergency where we may find ourselves alone and without professional medical help. During those times, having a prepared summary to turn to for *initial* information can be of assistance. Further reading in other sources can then occur after the immediate emergency and preferably the seeking out of medical experts as soon as possible! Reliance on any information provided is solely at your own risk. Ask your own medical professional for advice and treatment.

Note: Please do not be offended by the use of all capitals in the Medical Emergency Sheets. Capitals are utilized here for easy readability. Some of us are older or have visual limitations. Give thought to storing a pair of reading glasses on top of each emergency notebook. Larger print is helpful when reading under emotional stress or in reduced lighting. These sheets could even be laminated and put in an emergency treatment bag. I will be covering fourteen subjects in this four-part series. How did I make my selection of topics? I chose ones that not only happen frequently, but also have occurred among my family and friends. Maybe I can help you.

Anaphylaxis

Anaphylaxis is a serious allergic reaction which can quickly result in death. The first episode is a

very frightening event for all. I speak from personal experience. My beloved husband picked some

flowers and a few minutes later noted symptoms of itching which progressed to whole body weakness with near collapse. I gave him diphenhydramine (generic Benadryl) and called 911. While waiting, his mouth and lips swelled, his skin developed hives and his entire body became as red as a hot dog. In the ambulance, his blood pressure dropped therefore epinephrine was administered followed by steroids at the hospital. He now carries an epipen and had a second less severe episode a year later with a different plant. Fortunately, we were able to treat him at home without resorting to the use of epinephrine. What can trigger anaphylaxis? The answer is anything that your body has become sensitized to such as a bee or wasp sting, a particular plant, food, or medication. Symptoms can include itching, hives, swelling of lips, tongue, and airway with possible death in as little as 5 minutes. I encourage you to read more about anaphylaxis as this brief summary is by no means complete. Please find below your Medical Emergency Sheet. I am well aware that some of the suggestions are beyond the capability of untrained individuals, but we can all do something to help. Note that liquid diphenhydramine will act a little faster than the pill form but has a shorter shelf-life. Not all steps are appropriate for all cases. H2 blocking acid reducers such as cimetidine are available over the counter. Also note that hives do not necessarily indicate that you will go into anaphylaxis. Please do not be intimidated by the complexity of this protocol as this is the most complicated one that I will present. Easier ones will follow, rest assured. Always check with your medical practitioner in advance as to the safety of any of these medications for your personal use.

ALLERGY/ANAPHYLAXIS MEDICAL EMERGENCY SHEET FOR ADULTS

REMOVE ALLERGEN IF POSSIBLE.
GIVE 50 MG BENADRYL LIQUID. CAN GIVE ADDITIONAL 25MG IF NEEDED.
GIVE PREDNISONE 20MG. TAKE ONE OR TWO. SEE DETAILS LATER BELOW.
GIVE CIMETIDINE 200MG. (THIS H2 BLOCKER MAY HELP.)
IF HAVING SHORTNESS OF BREATH, STRIDOR(noisy breathing), WHEEZING, OR FACE AND MOUTH SWELLING, USE EPIPEN AND CALL 911.
TURNING BLUE? PERFORM ORAL INTUBATION OR TRACHEOSTOMY IF TRAINED.
MARK CIRCLES AROUND HIVES WITH AN INK PEN AND OBSERVE FOR INCREASE IN SIZE.
EXAMINE MOUTH FOR SWELLING. LISTEN TO LUNGS FOR ABNORMAL SOUNDS.

USE PULSE OXIMETER AND RECORD DATA. CHECK AND RECORD BLOOD PRESSURE.

GIVE I.V. SALINE IF HYPOTENSIVE.
REMOVE HOT CLOTHING AND APPLY ICE PACKS TO THE WORST HIVES.
USE AIR CONDITIONING AND/OR FANS IF THE WEATHER IS HOT.
KEEP THE PATIENT COOL. GIVE LORATIDINE FOR 3 DAYS. DON’T LET HIM/HER BREAK A SWEAT.

(loratidine or other long-acting antihistamine)

DISCONTINUE PREDNISONE WHEN NO HIVES REMAIN.

PREDNISONE HAS A PEAK EFFECT IN 6-12 HOURS.

DAY 1- TAKE 40MG BY MOUTH AND LATER ANOTHER 20MG TO TOTAL 60MG IN 24HRS

DAY 2- TAKE 20 MG TWICE DURING THE DAY.

DAY 3- TAKE 20 MG ONCE AND MAYBE AGAIN ON DAY 4.

IT IS BEST TO AVOID TAKING PREDNISONE AFTER 3PM TO DECREASE THE RISK OF INSOMNIA.

Bites

We are bound to experience bites and stings during our lives, but some are definitely more dangerous than others. Study up on the types of venomous snakes where you live and know how to identify them. Do likewise for poisonous spiders. Prevention is important for example wearing boots against snake bites, donning gloves before reaching into dark places or fishing out the desired item with a device, and daily checking one’s skin if exposed to ticks. Some people suggest applying a paste of activated charcoal to poisonous bites. Others suggest application of various herbs. Use your own judgment. Brown recluse spider bites can be especially nasty resulting in areas of necrotic flesh that continue to enlarge over time. These may necessitate surgical excision and repair. Sad-to-say, my great-grandmother died of pneumonia secondary to prolonged bed rest necessitated by a large necrotic brown recluse spider bite on her leg. I read of one layman’s suggestion to swab poke root tincture on brown recluse spider bites but have not found any further references for that. Below is your next sheet. For more information on Lyme disease or Rocky Mountain spotted fever I refer you to my 2018 Medical Action Sheet.

BITES MEDICAL EMERGENCY TREATMENT SHEET

SNAKE- DID THE SNAKE HAVE A TRIANGULAR HEAD, SLIT PUPILS, RECOGNIZABLE COLORING,

FACIAL SENSING PITS OR RATTLING TAIL TO INDICATE A VENOMOUS SNAKE?

IS IT STILL AROUND AND DANGEROUS? IT CAN STILL BITE FOR UP TO 24 HRS AFTER

DEATH. TAKE THE SNAKE CORPSE IF POSSIBLE TO THE EMERGENCY ROOM FOR

ACCURATE IDENTIFICATION.

EXAMINE THE WOUND FOR TWO PROMINENT FANG MARKS OF A VENOMOUS BITE.

A BITE MAY BE DRY, NO VENOM INJECTED, IN 25% OF CASES.

SYMPTOMS OF A POISONOUS BITE MIGHT INCLUDE ANY OF THE FOLLOWING:

PAINFUL BURNING AT THE BITE, RAPID SWELLING, BRUISING OR BLISTERS,

NUMBNESS AT BITE/FACE/LIPS, METALLIC OR OTHER STRANGE TASTES IN THE MOUTH,

IRREGULAR HEART BEAT, DIFFICULTY BREATHING, UNUSUAL BLEEDING ELSEWHERE.

CALL 911.

REMOVE ANYTHING TIGHT THAT MIGHT CONSTRICT WHEN THE AREA SWELLS.

DO NOT, REPEAT, NOT CUT THE BITE WITH A KNIFE OR SUCK THE WOUND.

WASH THE WOUND WITH SOAP AND WATER TO REMOVE ANY SURFACE VENOM.

IMMOBILIZE THE AREA OF THE BITE. KEEP IT STILL AND SLIGHTLY BELOW HEART LEVEL

TO SLOW THE SPREAD OF VENOM.

MAKE A SLIGHT PRESSURE DRESSING BETWEEN THE BITE AND THE HEART.

(USE AN ELASTIC WRAP JUST ABOVE THE BITE. NOT TOO TIGHT.)

CIRCLE WITH INK THE AREA OF SWELLING OR BRUISING TO FOLLOW PROGRESSION.

CALL FOR AN AMBULANCE OR GO TO THE HOSPITAL CALL AHEAD INFORMING THEM

THAT YOU MAY NEED ANTIVENOM.

START IV OR ORAL FLUIDS IF YOU ARE WITHOUT MEDICAL HELP.

SOME SUGGEST APPLYING A PASTE OF ACTIVATED CHARCOAL TO THE BITES.

REAPPLY AFTER 15 MINUTES, THEN 30 MIN, 1 HOUR, 2 HOURS, ETC.

WILL NEED ORAL ANTIBIOTIC TREATMENT.

RABID ANIMAL- WASH THE BITE WITH SOAP AND WATER.

IRRIGATE ASAP WITH 2% BETADINE. USE ALCOHOL IF BETADINE IS NOT AVAILABLE.

IRRIGATE WITH PRESSURE USING AN 18G NEEDLE AND SYRINGE.

SQUIRT INTO BITE HOLES FLUSHING THROUGHLY.

KEEP THE WOUND OPEN AND CLEAN IT ONCE OR TWICE DAILY.

SEE THE DOCTOR! TAKE THE ANIMAL/HEAD IF POSSIBLE. USE GLOVES.

WATCH FOR BACTERIAL INFECTION. SIGNS INCLUDE RED SWELLING MORE THAN

A HALF INCH AWAY FROM THE BITE OR RED STREAKS SPREADING AWAY.

WHEN WAS THE LAST TETANUS SHOT?

SPIDER-

BLACK WIDOW- SEE A RED HOURGLASS ON BACK. BITE, WITH SMALL RED DOT, IS OFTEN PAINFUL.

WASH THE WOUND WITH SOAP AND WATER.

CONSIDER APPLYING A PASTE OF ACTIVATED CHARCOAL TO THE BITE.

SEE INSTRUCTIONS UNDER SNAKE BITE.

MAY EXPERIENCE SEVERE MUSCLE CRAMPS FOR 1 TO 3 WKS. USE NSAIDS.

SEVERE CHEST OR ABDOMINAL PAIN LIKE HEART ATTACK OR APPENDICITIS MAY

DEVELOP IN MINUTES TO HOURS AND/OR HYPERTENSION NEEDING TREATMENT

CONSIDER TREATMENT WITH ANTIVENOM IF EXPERIENCING A SEVERE CASE.

BROWN RECLUSE- SEE VIOLIN MARK ON BACK, SMOOTH ANGLED LEGS AND TAN/BROWN COLOR.

APPLY ICE PACK TO SLOW VENOM’S SPREAD. ELEVATE SITE AND REMOVE

ANY JEWELRY OR TIGHT CLOTHING NEAR THE BITE.

CONSIDER APPLYING A PASTE OF ACTIVATED CHARCOAL TO THE BITE.

SEE INSTRUCTIONS UNDER SNAKE BITE.

TAKE A BITTEN CHILD IMMEDIATELY TO THE DOCTOR AS THEIR BODY CANNOT

CANNOT HANDLE THE TOXIN LIKE AN ADULT CAN.

EXPECT THE REDNESS TO SPREAD AND TO TURN BLACK AND DEAD CENTRALLY.

KEEP IT CLEAN, COVERED, AND TREATED TOPICALLY WITH ANTIBIOTICS OR HONEY.

NECROTIC TISSUE WILL NEED TO BE EXCISED.

USE OVER THE COUNTER PAIN RELIEVERS.

TICKS- REMOVE ASAP. GRAB THE HEAD WITH TWEEZERS AND GENTLY PULL. ANY ADHERENT PART

WILL FALL OUT IN A FEW DAYS. CONSIDER THE TICK TO BE CONTAMINATED WITH

DISEASE AND PLACE IT IN A ZIPLOCK BAG OR BOTTLE LABELED WITH DATE AND INITIALS.

WASH THE SITE WITH SOAP AND WATER THEN WITH ALCOHOL. DO THE SAME WITH THE

TWEEZERS AND HANDS IF UNGLOVED.

MARK A CALENDAR WITH THE DATE, BITE SITE, AND YOUR INITIALS.

WATCH FOR ANY ILLNESS (SUCH AS ROCKY MOUNTAIN SPOTTED FEVER IN FIRST 3 TO 5 DAYS)

OR ANY RASH AT TICK BITE SITE (LYME DISEASE).

ALPHA GAL DISEASE CAN CAUSE A NEW ANAPHYLACTIC REACTION TO RED MEAT.

Burns

We all experience minor burns in our lives but need to know what to do for more serious ones if there is no medical care available. Do not consider the following information as complete. During those times, having a prepared summary to turn to for *initial* information can be helpful. Further reading in other sources can then occur after the immediate emergency and preferably the seeking out of medical experts as soon as possible! Reliance on any information provided is solely at your own risk. Ask your own medical professional for advice and treatment. Again, consult your medical care provider for tailoring any Medical Emergency Sheet to your own health needs.

BURNS MEDICAL EMERGENCY TREATMENT SHEET

COOL THE BURN SEVERAL MINUTES WITH COLD WATER. THE LARGER AND DEEPER THE BURN,

THE LONGER IT NEEDS TO BE COOLED. DON’T USE ICE OR FOLK REMEDIES SUCH AS GREASE.

CUT OFF OR REMOVE ANY CLOTHING OR JEWELRY BEFORE SWELLING BEGINS. A TIGHT RING CAN

BE REMOVED BY USING DENTAL FLOSS. STICK A STRAND UNDER THE RING TOWARDS

THE HEART. WIND THE REST OF THE FLOSS SQUEEZING THE FINGER AS YOU WRAP TOWARDS

THE FINGER TIP. THEN PULL THE END OF THE STRAND CLOSEST TO THE HEART TO SLIP THE RING

OFF AS THE FLOSS UNWINDS. (Instructional video available on You-Tube.)

ELEVATE THE BURNED AREA ABOVE THE LEVEL OF THE HEART TO DECREASE SWELLING.

SEEK IMMEDIATE MEDICAL HELP FOR LARGE OR DEEP BURNS.

COVER THE BURN WITH A STERILE DRESSING. IF THE BURN IS SEVERE AND NO MEDICAL HELP IS AVAILABLE, APPLY TRIPLE ANTIBIOTIC CREAM, OR SILVADENE CREAM, OR RAW HONEY.

DO NOT USE RAW HONEY ON INFANTS.