Letter Re: How Hygiene and Sanitation Have Increased Human Life Spans

Sir; While obtaining law doctorate, one of my classes was Health Law, which is two parts navigating your way through the morass of Federal intrusion. One part was actual policy. But, I digress. Only one thing of significance stuck in my mind from that whole class: “Of the forty years increased life expectancy enjoyed in the past one-hundred years, 35 of those years are the result of improvements in hygiene and sanitation. Five years are due to clinical medicine.” I translate that to: “you owe more for your health to the trash man and plumber than you do your doctor.” …




Antibiotic Use in TEOTWAWKI, by GeorgiaDoc

I am a board certified Internist, and I’ve read with interest the SurvivalBlog articles on antibiotics. I believe that the one by FlightER, MD was the most informative, but a little over the head of most lay people. In a TEOTWAWKI situation, I think this might be helpful to lay people. I think it would be wise to have both prescription and over-the-counter (OTC) medications on hand. But they are worthless if not used correctly. That is the problem if you are not trained and experienced in recognizing infections, and thus providing the correct antibiotic for the identified infection. I …




Post-SHTF Anesthetic Medicine Options

[Introductory Note from JWR: The following article is presented for educational purposes only. As previously discussed in SurvivalBlog, using vinyl ether for anesthesia can be very tricky. Not only are its vapors highly flammable, but it can can induce deep levels of sedation much more quickly than desired. Thus, at a minimum can can compromise the patient’s airway, and thereby very possibly kill the patient. So unless you have both the equipment and the regularly-practiced expertise to safely intubate and extubate your patient, then do not use ether!] Pain is not my friend!  In some circumstances, it is useful, perhaps …




Seven Basic Steps, by Jared O.

I first became fascinated with the art of preparedness in my youth during the days and months leading up to Y2K. The thought societal meltdown and global collapse seemed almost too much to bear, hard to wrap my head around. I was 17years old, just starting my life — now faced with a potential situation that I had little training or experience to deal with. But my parents had instilled in me a valuable lesson early in childhood; fear is derived from the unknown and the lack of preparedness. With knowledge, preparation, a “never quit” attitude and maybe a little …




Two Letters Re: Prepping as an Active Duty Servicemember Overseas

Mr Rawles, Having seen the info on EMT training that has been on your blog recently, I decided to throw in my 2 cents. The National Dept of Transportation (DOT) sets all standards for Emergency Medical Services (First Responder through EMT-Paramedic) for the entire country. These standards include training and standardized interventions for certain trauma and illnesses by EMTs. These can all be found at NREMT.org. All questions on certifications, training requirements, etc can be answered there. Some courses claim that they can accelerate you and get you certified. DOT has requirements that must be met to be nationally certified. …




Letter Re: Prepping as an Active Duty Servicemember Overseas

Mr. Rawles, I wanted to pass this along to you and the readers of your site. I’ve been looking to increase my medical skills and training and, I found these schools and programs. I intend on going to a few of them when I return to CONUS. Anyone considering taking any of these classes should account for all associated costs and time to attend. This kind of training isn’t cheap but it is well worth it. The first is Deployment Medicine International (DMI). It’s been set up to augment military and contract personnel that are deploying overseas. As far as …




Three Letters Re: Sources for Prescription Medications?

Mr. Rawles, As a physician I take significant offense to Lawrence R.’s letter regarding antibiotics. The fact is over 90% of infections presenting to US hospitals are antibiotic resistant in some form or other. He is correct that some of the older medications may be effective and that is why bacterial cultures are performed to determine antibiotic resistance. He is sadly misinformed regarding the idea that we prescribe the most expensive or newest antibiotic available. We prescribe the least expensive antibiotic that is effective against the specifically cultured infection as long as a patient is not allergic to that class …




Four Letters Re: Sources for Prescription Medications?

Editor’s Note: As previously mentioned, when this thread was started, the use of anything other than USP Human Grade antibiotics on humans should only be considered in the most dire of circumstances, where there is no other choice. Jim, In reference to the question of sources for prescription medications, I recommend that readers interested in stocking up on medicine take a copy of Wilderness Medicine, Beyond First Aid, by William Forgey, to their primary care physician and show them the list of medications listed in the book. Explain to the doctor that you are preparing and that you would like …




Growing Your Own Pain Medicine, by David G.

Editor’s Proviso: Please note the following article is presented for educational purposes only. Implementing the steps described below is illegal in most jurisdictions. This article is presented in the context of total collapse of society and government, in which government has become nonexistent. Pain management is one of the most serious aspects of any medical situation whether it is life threatening or not. Many of us have chronic pain issues which get worse as we age or as our physical workload increases. Pain exacerbates shock when traumatic injuries are sustained. Pain management can comfort us in during palliative care and …




Four Letters Re: In Praise of Betadine

Hello Jim, A. Woofer should be commended for his excellent article on Betadine. An excellent way to use/carry Betadine in a small personal first aid kit is Betadine swab sticks. There are normally used for skin prep before minor surgical procedures. Take care, – Jeff in Ohio Jim, I’m writing to take exception with the author’s affinity for using Betadine in open wounds to “prevent infection.” While the liberal application of Betadine was relatively standard practice in the Emergency Medicine community when I started practicing 20 years ago, recent studies have changed this practice considerably. As the author himself points …




Two Letters Re: Tourniquets in Combat Medical Planning

Sir, That was a great article on the revival of tourniquets. One very important point that the author briefly touched on is the ability of the wounded individual to apply the tourniquet without assistance. The central tenant of it’s use by our forces in the field today is that the wounded individual must be able to tend to his own ‘blowout’ while everyone else continues to engage and suppress the enemy. Otherwise the risk is that one wounded troop might multiply into more if the enemy gains fire superiority and/or individuals expose themselves to aid a wounded comrade. Individuals who …




Letter Re: Sources for Lactated Ringer’s Solution?

Jim: You recently mentioned Ciprofloxacin in your blog. Cipro is an antibacterial, a fluoroquinolone. It’s useful for urinary tract infections, bacterial (not viral) sinusitis, post-inhalation exposure to anthrax, traveler’s diarrhea, and in combination with other drugs for abdominal infections. Resistance to various sexually transmitted diseases and some bacteria that cause pneumonia (Pseudomonas aeruginosa) is increasing. Ringer’s isn’t usually given with dextrose. It can be, but not normally. Ringers is an electrolyte (salt) solution, dextrose is used to replace (just) water or water and add some carbohydrates. Electrolyte solutions are used in cases of electrolyte depletion or dehydration (often combined with …




Letter Re: Sources for Prescription Medications?

James, I love your blog, I read it daily. Good article on the field craft of tourniquet applications. I do have one question to add–where can I get medical supplies for treating trauma? I love the fact that we have the blood clotting bandages available to the civilian–long live the free market. In the Army, I was a Combat Life Saver and I may be out of practice, but when truly required of me I am certain that I can start an IV to keep someone from going into shock. I have tried to find lactated ringers on the Internet, …




Tourniquets in Combat Medical Planning, by Robert U.

As an instructor of multiple combat medical courses, I have had the privilege of instructing many courageous and dedicated young corpsmen and medics in Tactical Combat Casualty Care (TCCC), Pre-Hospital Trauma Life Support (PHTLS) and Combat Lifesaver (CLS), as well as other courses.  Out of all of the information I have taught, I am amazed at the feedback I receive from many of these students returning from the wars in Iraq, Afghanistan and other areas of the world. Tourniquet use is documented as far back as Roman times; examples have been found composed of bronze and leather.  The first practical …




Letter Re: Free Local EMS Training

Jim, I would like to let your readers know that there is an opportunity for them to get free medical training in there community, I have just done this and am working on going further. I joined a volunteer fire department (VFD). No, not everyone has to fight fires, in our department only 10% do. In my area we have a mandatory three hours per month that we have to be at the station and [respond to] any calls that come up. So out of this we all get free EMT training and they actually pay us to go do …