Common Summertime Medical Ailments, by Dr. J.

I’m a board-certified family physician currently working as an urgent care provider in the southeastern United States. I really enjoy the work and split my time between a larger urban urgent care center and a small rural ‘fast-care’ facility about an hour outside the city. I grew up rurally and having always enjoyed country living and the self-sufficiency that comes with it, this also led to my interests in preparedness and survivalism. One of the most important aspects of preparedness is being comfortable in dealing with the variety of medical issues that will inevitably arise, ranging from inconveniences to emergencies. In this article, I plan to discuss some of the most common medical complaints I come across during the summer months in urgent care, as well as their background and first-line treatments. I also plan on writing a similar article in a few months covering fall/winter common complaints and treatment strategies.

While is it prudent to be prepared and supplied for significant or life-threatening injuries, you’re much more likely to encounter these more commonplace injuries and annoyances in day-to-day life, perhaps even moreso in a survival situation. Proper and prompt treatment of these conditions can shorten their duration and prevent them from progressing to more dangerous and debilitating conditions. So while I’d encourage you to hang onto your CAT tourniquets and Israeli pressure dressings (and learn how to use them!), keep some room in your med kit for more commonplace medications and supplies. You’ll likely need them more often than you think. For convenience and ease of acquisition, I’ll try to keep treatment strategies mostly to medications and supplies you can get without a prescription. Let’s get started!

Disclaimer:

The opinions and information in this article are for entertainment and general education purposes in a hypothetical survival situation. This article does not constitute medical advice and should not replace diagnosis and standard medical care performed by a qualified medical professional. A doctor-patient relationship does not exist and is not implied between the author and readers of this article.

Ankle Injuries:

These are a common occurrence during the summer months as everyone is out and about running, hiking, etc. They can also be expected in a survival situation, as people will likely be much more mobile and physically active. So how do you know if that rolled ankle is broken or not? The Ottawa Ankle Rules provide a good reference point to know whether you should x-ray (or be concerned for a fracture):

  • Bony tenderness over lateral or medial malleolus (the bony mounds on the inside and outside of your ankle)
  • Inability to bear any amount of weight and walk at least 4 steps at the time of injury or at the time of evaluation.

So if you have no bony tenderness in the ankle and are able to bear some weight and hobble around a bit, the ankle is most likely sprained as opposed to broken. The Ottawa Foot Rules add another caveat:

  • Bony tenderness at base of 5th metatarsal (the most lateral bone in the foot, extending down from the pinky toe)
  • Bony tenderness at the navicular (follow the big toe straight back towards the ankle)

Joint instability, deformity (your foot is twisted 90 degrees to one side), bony tenderness, and/or inability to ambulate all indicate a 3rd degree sprain (most severe) or a fracture, and require prompt medical attention. If none of the Ottawa rules apply to your injury, you may just have a sprain.

Treatment:

  • Compression: I prefer Ace bandages because they’re versatile. Compression with an ace wrap provides support and helps with swelling. Try to wrap from above the injury on down, then back up again. Wrap tightly, but don’t cut off circulation!
  • Ice/heat: I usually recommend icing the injury during the first 48 hours and using heat or warm water soaks thereafter.
  • NSAIDs, or Non-Steroidal Anti-Inflammatory Drugs: Ibuprofen (Advil, Motrin) and Naproxen (Aleve) help decrease pain and inflammation. Ibuprofen can be dosed 600-800mg about every 6 hours. Naproxen can be dosed 220-550mg every 12 hours. Don’t use NSAIDs with other NSAIDs, and don’t use if you have kidney disease or stomach ulcers.
  • Acetaminophen (Tylenol): can be used in conjunction with an NSAID, as they are processed by your body differently. Use 650-1000mg no more often than every 6 hours. Do not use if you have liver disease, and do not drink alcohol while taking Acetaminophen.
  • Rest: For a sprained ankle, you do not need to keep all of your weight off of the leg. I usually advise progressive weight-bearing, walking as you are able while avoiding long walks, hikes, heavy exercise, etc.
Broken Toes:

With summertime comes bare feet and flip-flops, and with exposed toes comes toe injuries. Whether due to dropping something on an exposed foot or ‘stubbing’ your toe, injured toes must be properly protected. I will not go into detail on treating subungual hematomas, ingrown toenails, nailbed suturing, or toenail removal as these all involve minor surgery that should be performed by a medical professional, if possible.

Treatment:

  • Suspected toe fractures do not always need x-ray imaging. If no angulation or open fracture, bruised or broken toes can be managed conservatively with ice and NSAIDs as discussed above.
  • A shoe with semi-rigid sole that prevents flexing should be used to protect the toe and decrease toe movement. Consider footwear like workboots or thick-soled walking shoes.
  • Buddy taping may be used if it adds comfort or reduces pain, but it is not always necessary.
    • Buddy taping is using an adjacent toe as a ‘splint’ and taping the injured toe to it, using several thin strips of tape wrapping the toes together. A thin piece of gauze may be used in between the toes as a cushion.
  • Do not buddy tape a deformed toe injury, if angulated the patient will need a digital nerve block of the toe and reduction by a medical provider.
  • Open toe fractures (bone protruding through skin) should not be buddy taped, they will likely need reduction, possible washout and closure, and antibiotics. These should be evaluated by a medical professional.
Bee Stings:

Warmer weather brings people outside and into contact with bees, wasps, and hornets. These stings are painful and can cause local inflammatory and hypersensitivity reactions to the venom, or in rarer cases can cause systemic reactions and anaphylaxis.

Treatment:

  • For minor stings, an ice pack will help with pain relief and swelling, as will an NSAID or acetaminophen.
  • Usually several hours after the initial sting, we develop a local hypersensitivity reaction to the bee’s venom that involves increased swelling, redness, itching, and/or pain. This is not an infection and does not require antibiotics.
    • Treat with an antihistamine like Diphenhydramine (Benadryl), 25 to 50mg orally, for some relief from itching and swelling.
    • Topical steroid cream like hydrocortisone or triamcinolone may also provide relief.
    • For more severe local reactions, oral steroids like prednisone may be used if you have access to them.
  • Severe allergic reactions (anaphylaxis) include systemic symptoms, i.e. symptoms that spread over your whole body instead of just the localized area where you were stung.
    • These reactions often require immediate treatment in an urgent/emergent setting.
    • Signs/symptoms include generalized hives, decreased blood pressure, wheezing, tongue/back of mouth swelling, chest tightness, weakness/confusion. These symptoms most often appear during the first hour after the sting.
    • Treat with oral Benadryl, oral steroids if you have them, an H2 blocker like ranitidine (Zantac) or famotidine (Pepcid). The patient will likely also need intramuscular injections of epinephrine, steroids, and antihistamines in a hospital setting.

 

Tick Bites:

Another common summer occurrence, but not every tick carries Lyme disease or Rocky Mountain Spotted Fever (RMSF).

  • For tick removal, grasp the tick with narrow forceps near where the tick is attached to the skin. Pull straight up with gentle traction. Try not to squeeze the tick’s body or twist.
  • If the tick’s head is still attached, clean the area with alcohol or betadine and gently scrape the head or mouth parts away with a scalpel or knife.
    • Of note, burning or using bleach or other substances to remove a tick doesn’t work well and may increase chance of infection. Stick to tweezers and blade.
  • When to use prophylaxis for Lyme or RMSF?
    • If the tick is not a deer tick (Lyme transmission) or dog tick (RMSF in eastern US) or wood tick (RMSF in Western US) prophylaxis with doxycycline is NOT needed.
    • If the tick was attached less than 36 hours and is not engorged, prophylaxis is NOT needed.
    • If the tick is a deer/dog/wood tick and appears to be engorged with blood, no matter how long it was attached, use a one-time, oral, 200mg dose of Doxycycline as prophylaxis.
    • If the tick is confirmed to be a deer tick and was attached longer than 36 hours, the one-time, 200mg oral dose of Doxycycline may be used as prophylaxis.
  • When to treat for Lyme or RMSF?
    • To make it simple, any signs of fever, muscle aches, joint aches, headache should warrant treatment with Doxycycline, typically 100mg twice per day (morning and evening) for 14-21 days.
    • Any sign of erythema migrans, which is the typical “bulls-eye” red rash associated with Lyme disease, warrants treatment with Doxycycline as above.
      • Erythema Migrans has a red outer ring, paler area in the middle, and redness surrounding the bite. This gives it the typical “bulls-eye” or “target” appearance.
Rhus Dermatitis

Rhus dermatitis is the itchy, weepy rash that comes from contact with the oils of poison ivy, poison oak, or poison sumac. This is a common reason for an urgent care visit in the summertime.

Treatment:

  • Do not use bleach or other caustic substances to try to treat the rash. The rash is your body’s reaction to the plant oils, not an infection that can be killed by bleach.
  • After known exposure to poison ivy, oak, or sumac, try to shower or rinse off with cool to lukewarm water. A hot shower can open your pores more, and allow the oils to soak further into your skin. Change your clothes. Over the Counter poison ivy washes, such as “Zanfel”, also work well and can bind the oils and prevent spread.
  • If the rash appears in just one area of your body, treatment with topical steroid cream will help treat the rash and associated itching. The stronger the steroid cream, the better.
    • Steroid creams should not be used extensively on the face, as they can cause some skin thinning and blanching.
  • With a widespread reaction, involvement of face, hands, or genitals, or history of severe reaction, systemic steroids will be needed. Oral prednisone at 60-80mg per day for at least 1 week or intramuscular steroids should be used; as you may not have access to these medications, seek treatment with a medical provider.
  • Baking soda/cornstarch bath (1 cup each in half full bathtub) or oatmeal baths (1 cup in half full tub) may provide relief from itching. Diphenhydramine and other antihistamines can also provide itching relief.
  • Keep open, irritated rash areas clean. These put the patient at greater risk for secondary infection!

As always, prevention is key. Learn to recognize these plants and dress appropriately when working near them.

Corneal Abrasions

Another common complaint during the summer, these most often occur after foreign body hits the eye or the eye is scraped by a finger, tree branch, etc.

Formal diagnosis of these injuries may be difficult, as proper equipment is needed to see the actual abrasion. However, suspect abrasion with symptoms of light sensitivity, excessive tear production, pain, and blurred vision in the affected eye with a history of being poked in the eye or feeling pain after insertion/removal of contact lenses.

Treatment:

  • Use numbing drops if available, then remove any noted foreign bodies and flush the eye repeatedly with saline solution or drops.
    • Lift up and evert the eyelids to look for any retained foreign bodies.
  • Antibiotic drops or ointments are recommended, however there are studies that suggest just using normal saline drops and keeping the eye clean and protected will result in similar healing. This may be the only option in a prepping/survival situation where there isn’t much access to antibiotic drops or ointments.
    • Erythromycin ointment or drops are usually used for people who do not wear contacts.
    • Contact wearers usually require a ciprofloxacin ointment/drop.
  • Keep eye clean, use normal saline drops as needed, and use oral medication for pain control. This is important as corneal abrasions can be quite painful.
    • Alternating an NSAID and Tylenol about every 3-4 hours can help control pain for less severe corneal abrasions. Larger abrasions may need prescription pain meds for 1-2 days.
  • If patient is a contact wearer, use glasses until eye is fully healed. Do not put contacts back into the injured eye.

Most corneal abrasions improve and fully heal within a few days, minor abrasions within about 24 hours. If the eye continues to worsen instead of improve, develops worsening redness, thick drainage, or worsening pain/vision, follow-up with a medical professional is necessary.

Heat-Induced Illnesses

Summertime sun, heat, and humidity exposure can be more dangerous than we realize. Long exposures to heat and sun can quickly spiral out of control, sometimes resulting in death. The spectrum of heat illness spans from the milder heat edema, heat cramps, heat syncope up to more serious heat exhaustion, and finally heat stroke (which is a medical emergency).

Treatment:

  • For all levels of heat illness, remove patient from the hot environment and get them to a cooler, indoor area if possible.
  • For heat edema, patients may notice mild swelling to extremities. The problem is benign but the swelling can sometimes last for a few weeks. Keep extremities elevated when able.
  • With heat cramps, a combination of muscle stretching, muscle massage, and rehydration with an electrolyte solution should resolve the issues. Stress the importance of hydration during outdoor activities.
  • Similar interventions should be made for heat syncope (fainting) or pre-syncope. Patient should be taken to cool environment and rehydrated, either orally or intravenously. If resources and medical facility are available, patient should have a workup to evaluate for other causes of syncope (heart conditions, stroke, head injuries, etc).
  • Heat exhaustion can entail dehydration, weakness, mild confusion, muscle cramps, and/or fatigue after prolonged exposure to heat.
    • Temperature may be normal or patient may be hyperthermic (with body temperature up to 104 degrees Fahrenheit).
    • Tachycardia (elevated heart rate) and profuse sweating usually present.
    • Patient’s mental status is normal.
    • Treat heat exhaustion, especially in hyperthermic patient, with evaporative cooling (spraying or sponging patient with lukewarm water and fanning them to enhance evaporation) or cold water bath if tolerated. Oral or IV rehydration with water and/or electrolyte solution is also necessary.
    • Patient should be evaluated in a medical facility, as their labs may show altered levels of electrolytes and need to be corrected.
  • Heat exhaustion, if not caught and treated in time, may progress to heat stroke. This is a medical emergency and should be treated in an emergency room or similar setting. Patients will have altered mental status and usually have hot, dry skin as they can no longer sweat to regulate their temperature. They are usually hyperthermic with temperatures above 104 degrees.
    • Treat similarly to heat exhaustion with evaporative cooling, cool water baths, ice packs near armpits, groin, or neck (as major blood vessels run close to the skin here). IV fluid rehydration is necessary.
    • Do not force the patient to drink if they are unconscious or have altered mental status, as this could lead to aspiration.
    • Again, this is a medical emergency that can lead to arrhythmias, severe lab abnormalities, shock, and death. All efforts should be made to get patient to an appropriate medical facility.

For heat-related illnesses, it is important to recognize the earliest signs and symptoms and prevent the patient from progressing to more severe stages. Treating a friend or family member with heat cramps or heat presyncope is much easier and safer than treating heat exhaustion or heat stroke.

Conclusion

As I’ve mentioned a few times throughout the article, preventing these injuries and ailments is much easier than treating them. ‘An ounce of prevention is worth a pound of cure’! Wear appropriate clothing for the activity you’ll be undertaking, stay hydrated, and wear protective gear when necessary. Take breaks when working in hot weather; check yourself for ticks after walking/working in wooded or high-grass areas. Carry an EpiPen if you have a history of anaphylaxis; keep an extra pair of glasses readily available. Keep extra Acetaminophen, NSAIDs, ACE bandages, antihistamines, eye drops, and steroid cream on-hand. If you can get them, oral steroids and oral antibiotics are useful in certain cases. And as always, review and practice your skills so you can use them when the time arrives.




31 Comments

  1. We are going to need to treat ourselves, so all the medical instruction, and reference manuals, we can get, the better. When at the thrift store, I often check for any books on the topic, and have a pile of reference materials on hand. This last winter, I had to rely on them, and was successful at a result. Total cost for the 1987 edition Merck manual, and old Physicians Desk Reference that provided the necessary information… about 2 bucks. I could have suffered serious secondary infections had I not invested, 2 bucks. Of course there was hours of reading involved, and soon discovered that a single reference source would not have provided enough information to have got the job done.

    I am certainly not qualified to be a medic, but I’ll unfortunately be the only person around here with a clue. Any background in medicine is bound to help. The ability to diagnose is half the solution, and the most critical part. That is why having reference books with plenty of pictures is so important. Having stuff ain’t gonna be enough. We are more likely to be taken out with a bug, rather than a bullet. So, rather than another rifle, I would invest in antibiotics, essential meds, bandages, disinfectants, antiseptics, adhesive tape, and a long list. It takes a huge amount of dressing material to treat a serious wound. If your linen closet isn’t packed full, you ain’t got enough. Instead of antibiotics, the first line of defense against infection will be the ability to clean a wound, and keep it clean. At least be prepared to do that.

    Again, the thrift store is the only way I can pile up such a quantity of supplies. And I might have to use the best, and only multi-purpose adhesive tape I can afford, duct tape. Brutal, but effective. It does not have to be the best, but it better be effective.

  2. Excellent information. I would like to add one thing. When dealing with poison ivy there is one simple tool to keep at hand and that is Dawn dish soap. Dawn not only Cuts Grease in your kitchen sink does an excellent job of removing the poison ivy oils from your skin and clothing. I recommend a triple wash, back-to-back-to-back all while using a nylon scrub brush to help with the oil removal. I have found this to be very effective.

  3. Re poison ivy/oak rash treament–you mention not to use caustic (basic?) substances to treat the rash. What about vinegar?

    Awhile back, a friend got a significant case of it. Her forearms were a weepy mess. Finally, she wiped them off with vinegar, which dried up the rash, and really sped the healing.

    We always used soap, water, and Vitamin E oil.

    Then, we moved to a higher elevation that has no poison oak.

    1. Aspirin works well BUT..It is more irritating to the stomach and can cause ulcers. Especially when it breaks down in to salicylic acid (Corn Plasters) which causes a strong vinegar smell in the bottle. Also Aspirin has a stronger anti-clotting effect than NSAIDS and can increase risk of bleeding. Aspirin is also risky in children as it has been linked to a dangerous condition called Reyes Syndrome in young people with fever. Use with caution. It probably would be allowed on the market today by the FDA if a new drug application was made.

  4. Excellent article. Reading the comments got me thinking. As an OR nurse, please use caution regarding Duct tape and all tapes really. I can’t tell you how many patients I have seen with skin sensitive to adhesives in tape. One application sometimes results in blisters that are extremely painful. Try to use tape on just the dressing itself if placing on a limb. In olden days people utilized safety pins. Extra material might be used for wrapping around the entire body if needed for say an abdominal wound. A snug fit without being overly tight helps keep those dressings in place. As the author says ace wraps are great as well as something called coban. You should be able to find this at medical supply places and I feel sure Amazon, but it is not cheap. When changing dressings, I have always utilized water soaked gauze or cloth, and gently tease the tape away from the body. Never rip tape away from your patient.

  5. I’ve not tried dish soap for poison ivy type rashes, however I scrub the affected area with Fels Naphtha bar soap that is easier to maintain in a ruck than a liquid soap. Fels will cut the oils on clothing as well and can be shaved into the laundry wash. Follow Fels when washing the skin with a milder soap such as Ivory as the residue can form a rash itself. Fels Naphtha is an old old solution for Ivy rash.

    https://www.toolboxsupply.com/products/purex-04303-fels-naptha-heavy-duty-laundry-bar-stain-remover-soap-5-0-oz?utm_source=bing&utm_medium=cpc&utm_campaign=TBS_Shopping_3&utm_term=4574861725206165&utm_content=Ad%20group%20%231

    PR

  6. I humbly must disagree with the doctor.
    I am also a family doc working in urgent care. I trained in Massachusetts and have seen hundreds of tick bites and cases of Lyme. I must disagree with the doctors comments on tick bites prophylaxis and treatment of Lyme or potential Lyme disease. The doctor is absolutely in-line with the CDC’s recommendations but in my opinion there are not aggressive enough. ILADs is a Lyme specific group of providers and they recommend 20 days of Doxy for tick bite prophylaxis and 6-8 weeks of Doxy for Lyme disease. This is a huge difference in treatment but the potentially life altering complications of Lyme disease merit a more aggressive approach to care (in my opinion). The study done on Doxy prophylaxis was almost 20 years ago and only claimed to decrease the rash associated with Lyme… Not the disease. The numbers in the study were small. Until we have a good test for Lyme and better research we need to treat it more aggressively. We treat acne with Doxy. A kid with pimples on his back will get far more aggressive treatment than someone with Lyme.
    Sorry to preach but I know first hand the morbitity of Lyme Disease. Please push for aggressive treatment and prophylaxis.
    Sincerely,
    Dr. B

  7. I knew the duct tape would raise eye brows. Yes, you are right to warn others. Duct tape as suggested is user friendly, yet not necessarily friendly for the patient. It is not designed for this job, yet it is an alternative. I would, and do use it in a manner as you describe, and limit the amount of tape used directly on the patient. In some cases, shaving the area would be a good idea. I also have lots of ace wraps, and safety pins of all sizes, even one in my BOB for weak or injured ankles.

  8. Not a doctor, but for minor eye irritations I would also recommend keeping viscous eye drops on hand. Refresh Celluvisc and Systane Ultra are a couple brand names (I am not affiliated with either). They’re just regular eye drops, like Visine, but slightly thickened so they serve as a bit of a cushion to keep your eye lid from rubbing over the scratch. That in turn keeps you from having the urge to rub your eye. They are a real godsend. They come in little individual use containers so your dose is always sterile. They do make your vision a little blurry for awhile but it’s manageable.

    1. Re: Prednisone, and antibiotics

      Hi SOG,
      Prednisone is prescription only in the U.S. The VA is quite restrictive, but perhaps there is another way. And Mexico is hot this time of year. The stuff is hard on the immune system. However, I know guys who cannot function well without it, and it could be a life saver in a few extreme cases…..

      Antibiotics can be purchased at a veternian supply without a prescription.
      Try this place: https://fishmoxfishflex.com/

      Buy this book on what to buy and how to use antibiotics, it is easy to read for a medical book.
      https://www.amazon.com/Altons-Antibiotics-Infectious-Disease-Antibacterials/dp/057841452X/ref=as_sl_pc_as_ss_li_til?tag=doomandbloom-20&linkCode=w00&linkId=77860cfd7f4da6716d740a52943c8e9e&creativeASIN=057841452X

      Go here for supplies:
      https://www.doomandbloom.net/

  9. Good information! Thanks.

    One caveat: Tight boots won’t prevent a break, but can mask the seriousness of the injury. I was snowboarding one time, when a skier cut me off rather aggressively and in my twisting dodge, I fell and broke my ankle. The pain was pretty bad, but I was able to continue down the mountain on my board (albeit very uncomfortably). I quit for the night, but was able to limp along in my boots to get home. It wasn’t until I took off the boots–which I wear pretty tightly laced–that I realized it was broken. The tightness of the boots kept things in place and prevented swelling. Taking off the boot was a real eye-opening experience!

    Also, if you are stung by a bee (not a wasp), the stinger remains in your flesh. DO NOT try to pull it out. pinching the venom sac (still attached) will put more venom into you. Instead, scrape it with a credit card or knife edge. This will usually remove the stinger and sac without adding more venom to the injury.

  10. Fels Naphtha soap is sure to cut poison oak and ivy oils from the skin, clothes and tools. If you don’t clean off the oil healing time will be significantly extended. The oils will also get on your dogs and can be transmitted that way. Jewelweed grows in the same places as poison ivy. It has orange slipper shaped flowers and seed pods that burst if touched when ripe. The watery sap will help with poison ivy, nettle rash and even athlete’s foot.

  11. Good article Doc. I would add (as a health care provider), I see a lot of fungal rashes in the summer which can be treated OTC. A few products to stock up are; Clotrimazole topical 1% cream, use twice a day for 2-4 weeks. Terbinafine topical cream 1% (the strongest OTC), apply twice a day for 1-4 weeks. Tolnaftate topical cream or spray, apply twice a day for 2-3 weeks. I usually recommend the spray to toe/foot fungus (not the nails) since it is easier to apply, and I also would spray inside the shoes. Stubborn topical fungus I would use Terbinafine, but probably start with Clotrimazole, which is much cheaper. (These all used to be RX drugs at one time). Nail fungus is difficult to treat, usually I recommend a visit to your health care provider for an oral tablet. There is a Clotrimazole 1% solution available, but the tablets are more effective (Terbinafine 250mg). Fungal rashes are hard to kill, you must be regular in applying the treatment, and do it for a length of time. Be religious. Fungi like dark, damp places, so keep things clean and dry. My 2 cents. I agree with the ‘sewNurse’, the coban is an excellent product, it has been renamed to 3-M Nexcare ‘no hurt’ tape or Nexcare Athletic wrap, basically it is a wrap that sticks to itself (and not you), and doesn’t require the metal fasteners that the ACE wrap does. We use it all the time, great product. It can be reused once or twice if careful removing it, but definitely put away some ACE wraps, as they will last much longer.

  12. This is the coban I bought. At first I thought (12 rolls???). But the price is cheap.

    https://www.amazon.com/Ever-Ready-First-Aid-Adherent/dp/B00IQTQU6K/ref=sr_1_4?crid=D436FK6S5LMX&keywords=coban%2Bself%2Badherent%2Bwrap&qid=1565760801&s=gateway&sprefix=coban%2Caps%2C242&sr=8-4&th=1

    Only $11.95.

    And I put 2 rolls in each of our first aid packs, including both our vehicles, bugout, etc.

    The leftover 4 are with our bulk trauma bucket. The bucket is a plastic, square topped bucket with lid and handle, from the deli, that used to hold cake icing.

    The trauma bucket is very durable, could be used to haul water, and large enough to accommodate a realistic amount of supplies for an amputation, bullet trauma, chain saw accident, etc. I urge you all to get a realistic amount of trauma items to stop the bleed, especially for more than one person.

    The bucket capacity enables packing lots of roller and square gauze, coban, large pads and tourniquets, disinfectant bottle, sutures, bottles of alcohol and distilled water, etc, etc. I usually keep the bucket handy in my shop, and toss it into the pickup when I go places for carpentry, shooting, cutting firewood, etc.

  13. “””Vinegar is great for reducing the pain of a bee sting, and the itch of mosquito bites. Just dab on with a cotton ball.”””

    Most don’t know about toothpaste–yes, stops pain instantly.

  14. I have had too many personal experiences with poison ivy. I too have found washing with cool water using a generous application of oil cutting soap (Dawn for me) is usually effective in preventing a rash, even from heavy exposure.

    Sometimes I don’t realize I’ve been exposed and hence get a rash. My typical heal time with no intervention for a rash is about two weeks – starting from the time blisters first appear, to skin being only cosmetically disfigured and not itchy any more. I have found two things that consistently help – If I apply Lavender and Peppermint essential oils (diluted in Fractionated Coconut oil) several times a day every day, the rash will heal in one week instead of two, and there is some minor relief from the itching.

    The second help is purely for the itching. I put the affected area (e.g. arm) under a flow of hot water from the sink, about as hot as healthy skin can take. This creates an intense itching sensation on the rash for about 30 seconds, and then it subsides leaving the area itch free for the next 4-6 hours.

    I have found the hydro-cortozone creams provide me almost no relief.

  15. Outstanding article. Very informative and well written. It highlights the value and the quality of the Survivalblog. I am a big fan of the web site and offer my “ well done and thank you” to the owner and editors.

  16. Being the “proud”owner of a couple stents, and therefore on anticoagulants, may I add another warning regarding NSAIDS? DO NOT use NSAIDS while taking anticoagulants.

    It’s sort of (morbidly) amusing just how very excited emergency department staff get, when their heart patient (me) has a hemoglobin of 7 when they expect 13 or 14. But, then, a bleeding stomach ulcer will do that. And some gastric bleeding commonly occurs with NSAIDS. It’s typically trivial, but when your Plavix or Brilinta or Xarelto or Eliquis or Pradaxa or warfarin (among others) binders your body’s mechanisms that normally limit that blood loss, well, things can get exciting.

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