Medical Prepping in Three Months — Part 2 of 2, by Cynthia J. Koelker, MD

As of today, many families are still suffering from the effects of Superstorm Sandy.  Are you prepared, should such a disaster strike your area?
The following is offered as an outline for medical prepping, should you someday find yourself without access to professional medical care.  (Part 1 of this series covered weeks 1 through 6.)
Please note the following abbreviations:
ORG = organizational concerns
OTC = over-the-counter products
Rx = prescription products
ED = education and skills
The supplies listed under OTC can all be purchased without a prescription, though some are only available online.  For prescription items, assess what your group has and what each member is likely to be able to acquire. 
The three-month period is divided into 13 weekly tasks, divided according to topic, making the project more readily manageable.  The outline could also be divided into months, rather than weeks, to cover a year instead.
For more detailed information on medical prepping, please visit www.armageddonmedicine.net

Week 7

ORG

MID-PROGRESS REVIEW and SECURITY

Assess your progress to date and establish a plan for securing your medical supplies

Identify individual(s) to establish security to protect both patients and caregivers
Identify and acquire secure storage arrangements for your medical supplies

OTC

GASTOINTESTINAL

Constipation:  Metamucil, Dulcolax, Surfak, or generics
Diarrhea:  Imodium, Pepto-Bismol, or generics
Nausea and vomiting: meclizine, Dramamine
Heartburn, gastritis, or ulcers:  Pepcid, Zantac, Axid, Tagamet, Prilosec, Prevacid, Tums, Maalox
Solar oven to warm/disinfect water/heat food without electricity or fire

Rx

CORTICOSTEROIDS

Request a supply of prednisone or a Medrol Dosepak from your physician for emergency use, such as an asthma attack, acute bronchitis, acute gout, bee sting allergy, hives, seasonal allergies, or acute flares of chronic diseases such as rheumatoid arthritis, lupus, or sciatica
Consider requesting a similar supply from your veterinarian for pet (or human) use

ED

PROTECTION AGAINST INJURY and INFECTION

Discuss potential sources of injury and infection with your group, including necessary but potentially dangerous activities
Educate yourself regarding isolation and quarantine, and make appropriate plans for your location
Educate yourself regarding spread of serious illness, in particular droplet-borne infections
Procure appropriate clothing to protect against sunburn, heatstroke, frostbite and hypothermia, mosquito and other insect bites, stinging insects, chiggers, poison ivy, foot blisters
Educate yourself regarding avoiding acquisition of scabies, lice, impetigo, fungal disease

Week 8

ORG

BUG-OUT KIT

Begin assembling easily transportable bug-out medical kits for identified group members (more than 1)

Assess your group for short-term needs (3–7 days, or longer if desired)
Assemble a bug-out medical kit for each group member

OTC

URINARY

AZO for temporary relief of urinary burning or pain
Cranberry pills or juice
Multistix 10-SG or other urine dipstick
Saw palmetto for middle-aged men with prostatic enlargement
Urinary catheters for anyone with obstruction or potential obstruction; catheter lubricant

Rx

NITROGLYCERIN and OXYGEN

Request a prescription for an oxygen concentrator if anyone in your group suffers from heart or lung disease, or may be exposed to carbon monoxide, fumes, extreme altitude, or other cardio-respiratory threat
Consider purchasing oxygen or an oxygen concentrator without a prescription (available online)
For anyone who has ever used nitroglycerin (current or prior angina, history of heart attack, stent, or heart by-pass), request additional nitroglycerin from your physician in small bottles of 25 tablets, which will remain potent long-term if unopened and stored under conditions printed on the bottle

ED

NUTRITION

Educate yourself regarding nutrients essential to human health
Educate yourself regarding edible wild plants available in your area, and locate potential sources
Assess your food supply for inclusion of sufficient fluids, calories, protein, essential fats, fiber, vitamins, and minerals
Assess your seed supply to assure an adequate supply of “colored” vegetables – yellow, green, red
Assess your supply of medicinal plants and seeds
Assess your group for the possible development of scurvy (lack of vitamin C), dementia (lack of vitamin B12 in the elderly), and rickets (lack of vitamin D and calcium, in children)

Week 9

ORG

BUG-IN KIT

Begin assembling one or more base-stations for your supplies

Assemble and organize secure storage areas as identified on Week 7

OTC

REPRODUCTION

Condoms and/or other birth control
Pregnancy tests
Pregnancy calculator
Gyne-Lotrimin for yeast infections
Pads and/or tampons
Vitamins with folate for pregnant women

Rx

SLEEPING MEDICATION

Request a prescription for Ambien (zolpidem) from your physician for occasional (or future) use
Other prescription alternatives include any sedating medication, such as low-dose amitriptyline, a benzodiazepine (Xanax, Ativan, Valium), muscle relaxers (such as Flexeril, Norflex, or Soma)
If unavailable, procure sedating antihistamine (Benadryl, Zyrtec, Nyquil) or nausea drug (meclizine)

ED

SPECIAL NEEDS FOR GROUP

Have group members share personal health needs (such as diabetes, hypothyroidism, or chronic pain) with other group members for improved understanding and chance of individual and group survival
Make sure at least one other group member has the knowledge to help some with any chronic problem

Week 10

ORG

ACQUIRE BARTER ITEMS

Make a wish list of items you cannot acquire at this time

Identify and acquire items to barter for medical goods
Identify and acquire health care items to barter for other goods (pain meds, dressings, vitamins, inexpensive reading glasses, etc.)

OTC

SKIN PREPARATIONS

Bacitracin for mild bacterial infection
Lotrimin or Lamisil or other topical antifungal for fungal and yeast infections 
1% hydrocortisone cream (and plastic wrap to cover it with to enhance its strength) for itchy rashes
Bleach to dilute 1:1000  for bathing for recurrent skin infections, eczema, possibly ringworm
#11 scalpel for abscess incision and drainage
Rid and/or Nix for head lice; nit comb; Vaseline to smother lice; hot hair dryer to kill head lice
Wart freeze or salicylic acid for treating warts, or Duct tape to cover for 2 weeks
Warm clothing for preventing frostbite
Long sleeves and long pants for preventing insect bites, stings, chiggers, mites, tick bites
Good shoes to prevent blister and callus formation

Rx

STEROID CREAM

Request a prescription for an inexpensive, strong steroid cream for non-facial use, such as betamethasone, which is very useful for itchy skin problems such as poison ivy, eczema, and contact dermatitis

ED

PREGNANCY and CHILDBIRTH

Assess group and community need for current or future pregnancy and childbirth
Acquire midwifery or obstetric books and/or videos for use by your group or possibly others
Consider having group watch videos of childbirth
Locate and become acquainted with midwife or physician in your area

 

Week 11

ORG

MAKE ARRANGEMENTS WITH HEALTH CARE PROVIDERS OUTSIDE YOUR GROUP

Identify others you may need and who may need you
Make tentative arrangements for contact and/or access should the need arise

OTC

MENTAL HEALTH

Spiritual preparation; Bible, hymnbook, inspirational reading
Acoustic musical instruments and/or DVD/MP3 player and power source
Books, both fiction and non-fiction, including how-to books
Games and other forms of entertainment
Arrange group bonding activities to build trust before disaster strikes
Make sure everyone has a meaningful purpose and contribution to your group
Identify spiritual and/or emotional leader of your group
Purchase St. John’s Wort for potential depression
Nyquil or Benadryl for sleep
Caffeine or pseudoephedrine for needed wakefulness/alertness
Meclizine for potential anxiety

Rx

BACTROBAN ANTIBIOTIC CREAM or OINTMENT

Request a prescription for Bactroban (mupirocin) topical cream or ointment for superficial skin infections, mildly infected lacerations or abrasions, or small areas of impetigo

ED

MENTAL HEALTH AND ILLNESS

Spend time bonding with your group, focusing on hope, purpose, and faith
Assess each member for prior and expected reactions under stress
Discuss how your group will respond if confronted with suicidal, panicky, or psychotic patient

Week 12

ORG

STOCK FOR A DOC

Obtain additional supplies a doctor or nurse could use, even if you can’t use them yourself

Suturing supplies
Plaster splinting and casting supplies
IV supplies

OTC

LIQUIDS and PERISHABLES

Hydrogen peroxide
Medical alcohol
Distilled vinegar
Johnson’s Baby Shampoo
Sterile saline
Nyquil
Baby formula
IV fluids
Nutraceutical thyroid preparation
Potassium iodide

Rx

NERVE MEDICINE

Anxiety is a common problem now, and will likely worsen if disaster strikes

Discuss nerve medication with your physician and request a (small) supply of fast-acting medication for occasional use.   Possibilities include benzodiazepines (Valium, Xanax, Ativan – which are controlled substances, and so your doctor may not agree), and Vistaril (a sedating, prescription antihistamine)
Consider requesting a slow-acting medication for chronic use, such as Buspar (a non-addicting medicine, but takes days to weeks for relief), or an SSRI (Zoloft, Prozac, Celexa, Paxil) (equally slow to act)

ED

RADIATION and BIOTERRORISM

Determine the proximity of nearest nuclear reactor and typical wind patterns
Decide on radiation detection (dosimeter, Geiger counter) and consider procuring
Purchase KI (potassium iodide) for each member of your group (have multiple doses for children)
Decide which (if any) bioterrorist threats you plan to prepare for (anthrax, plague, botulism, others)
Educate yourself on how to protect yourself against specific bioterrorist threats

Week 13

ORG

REVIEW

Group meeting to assess any additional needs and to affirm success of preparations

Review each group member’s medical history and needs, especially for important life changes, such as pregnancy, childbirth, and any new health problems
Review each group member’s medical responsibilities, should disaster strike
Affirm each member’s contributions and success

OTC

REVIEW

Make written inventory of supplies you have acquired, location, and purpose
Review weeks 1 through 12 to assess for additional needs and/or shortages
If budget allows, procure additional stock of items most essential for your group
Check dates on items with short shelf-life (insulin, liquids) and re-stock as necessary
Be thankful that so many items are available over-the-counter to help your group and others

Rx

REVIEW

Make written inventory of prescription medications you have been able to acquire, location, and purpose
Make written list of supplies you would still like to procure
Have various group members make appointments with their physicians, who may have changed their position on personal preparedness, and may be more willing to prescribe

ED

REVIEW

Review what you have learned, and organize material into notebook(s)
Make sure all group members have access to needed information and know location of notebook(s)
Assess group members for progress, gaps in knowledge, and intentions for future learning
Encourage and thank all for their efforts and cooperation