Medical Action Sheets, by K.B., M.D. – Part 1

It is ideal and important to seek out medical care from qualified professionals. However, preppers are concerned about scenarios that can prevent access, such as weather extremes (hurricanes, ice storms, blizzards), civil unrest (riots, curfews), EMP, TEOTWAWKI, or pandemics/disasters, which can swamp the medical system. When illness or injury strikes, you will not have the time or inclination to read books or articles. I, therefore, propose the use of medical action sheets, and I want to share a few of those that I have written. In truth, I have given binders of these to my loved ones with the caveat that they use them only in a genuine situation as listed above and if I am unavailable to help them. As you read these lists, remember that I am not prescribing and urge you to review any plans with your medical professional who will tailor medical action sheets to your specific medical needs, conditions, allergies, and abilities.

Abscess and New Shingles Treatment (Herpes Simplex 2)

In Part 1, we will cover abscesses, which will happen more frequently under less sanitary situations and outdoor work, and shingles, which will occur more often under extreme stress. As with most medical problems, deal with them as soon as possible.

Abscess Overview

An abscess is a localized collection of pus due to infection. This may occur as a result of puncture or abrasion of the skin allowing bacteria to enter or may be secondary to obstruction of a hair follicle or oil or sweat gland.

In more difficult times, there will be more dirt on the skin and more opportunities for injury, which may lead to abscess formation. Those with weakened immune systems will be susceptible to more frequent abscesses. A collection of pus may come to a point and rupture on its own or may require hot soaks to promote formation of a head. At that time, incision and drainage may be performed under sterile conditions. Keep in mind that the pus pocket may have more than one chamber, necessitating the breaking down of interior walls to permit adequate emptying of the abscess. The pocket must then be irrigated/flushed with a syringe until the contents are thoroughly removed and only pink-tinged water returns. Warning signs of a more serious situation include fever, red streaks leading away from the abscess, or an abscess on the face. As always, seek help from a medical professional, if at all possible.

Medical Access Sheet- Abscess

The following is the medical access sheet for dealing with an abscess.

Exam

Examine to see if there’s a red, swollen, warm, painful mass, a yellow head/point or fluctuant surface, sometimes accompanied with fever. If not, apply hot soaks/cloth for 15 minutes every 2 hours to bring it to a head or “ripen” the abscess.

Treatment

Do not squeeze. It may force the infection into deeper tissues or into the bloodstream causing dangerous sepsis (blood infection). For treatment, incise (cut) and drain the ripe abscess.

Steps to Incise and Drain the Ripe Abscess:
  1. Ice to numb (or lidocaine), cleanse skin, insert sterile blade perpendicular to skin, and use sterile hemostat to open any pus chambers. Can be multi-chambered.
  2. Irrigate with clean water in syringe until pus is gone.
  3. If medium or large abscess, very loosely pack it with betadine moistened gauze strips, leaving end(s) outside of skin. (Consider having a jar or two of ready-made iodoform gauze on hand. Grab the end of the gauze with a sterile hemostat and stuff it loosely into abscess chamber inch by inch. Cut the gauze near jar top with sterile scissors when cavity is nearly full.)
  4. Apply antibiotic ointment (if unavailable use raw honey) to bandage and cover wound. (Raw honey is only for people over age 1 year, due to risk of botulism.)
  5. Change gauze packing once or twice daily. Remember: Pack loosely so the chamber will collapse and heal and also be comfortable.
  6. If the wound won’t heal, begin oral antibiotics (e.g. amoxicillin or cephalexin) or if there is fever, red streaks, or other warning signs.Note 1: If it is a dental abscess with swollen face, use oral antibiotics and do not apply hot packs. Instead, use a hot saline mouth rise (1 tsp salt to glass of very warm water) to ripen the abscess. Read further on dental abscess— a more complicated situation. Treatment is incision, drainage, and tooth extraction.Note 2: If it is a finger pad abscess (felon), it’s more serious. You can lose a finger!

Shingles Overview

Shingles is a very painful condition caused by the reactivation of chicken pox virus (varicella zoster) in a previously healthy immune system now weakened by aging, chemotherapy, or extreme stress. It normally remains dormant in the nervous system. An outbreak begins with a band of pain, often unilateral on the chest, with the appearance of a rash a couple of days later. The rash is so miserable that even the light touch of clothing is intolerable. The problem is, time is ticking!

Without adequate treatment, you are at a higher risk of more severe and longer lasting pain for months. The standard treatment is with prescription drug Zovirax, started within 72 hours of the beginning rash, but what if you can’t reach the doctor? Use over-the-counter cimetidine (anti-gi ulcer H2 blocker aka Tagamet). It is effective in suppressing not only herpes zoster (chicken pox virus) but also herpes simplex (lip and genital blisters). It decreases not only the severity/pain of the outbreak but also the duration. That’s great to know in a disaster. In one study, cimetidine decreased the duration of shingles active lesions from 35+ days to 10 days!

Medical Action Sheet- Shingles

Below is your medical action sheet for adults with shingles:

Exam

In the exam, is there a band-like area of tingling, stinging, burning, stabbing pain often unilateral in chest, fever or headache? A few days later a painful rash with blisters that crust over in 7 to 10 days, a history of chicken pox long-ago aged, physical trauma, on chemotherapy, or extreme stress suppressing immune system? Beware: Face/nose shingles can result in eye damage, and vision problems shingles near ear can cause hearing related damage.

Time

Within 72 hours, maximum, it is time to begin effective treatment once rash appears.

Contagious

Contact with skin lesions transmits virus to those not immune to it. Use gloves, and properly dispose of all bandages, et cetera.

Medications

Prescription antiviral medication, such as Zovirax (Acyclovir), or over-the-counter cimetidine (Tagamet) 200mg three times daily and 400mg at bedtime. Continue cimetidine for 1 to 2 weeks until outbreak symptoms have lessened. Anti-inflammatory for pain control. (These include acetaminophen, ibuprofen, or naproxen.)

Remember to see your doctor ASAP, if possible!

Tomorrow

Join us tomorrow for Part 2, which will contain medical action sheets on “New Influenza Treatment, Colds, and Pneumonia”.

See Also:

SurvivalBlog Writing Contest

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Round 80 ends on January 31st, so get busy writing and e-mail us your entry. Remember that there is a 1,500-word minimum, and that articles on practical “how to” skills for survival have an advantage in the judging.




18 Comments

    1. Brad, I always recommend printing anything that you think would be helpful and keep it in a binder. I do not know if you are the same way as I, but the biggest lie I tell myself is I will remember – where I stuck something for safe keeping, or something I would need in an emergency – thus, printing and placing in a binder. Should TSHTF, and you need to remember something critical, it is likely that you will also have about 50 million other things on your mind as well, and having something as important as this printed will be a very welcomed thing.

  1. I did some research when I had shingles. I had a small rash over my right eye and the pain was on top of my head. I took a cotton swab and doused it with apple cider vinegar. This stopped the pain. I couldn’t believe it. I did see a doctor and got medication for it but it didn’t stop the pain until I used the vinegar.

  2. Wish I had this information sooner!! I had an infected tear duct which turned into an abscess, due to delayed medical care. I had gone to the emergency room for treatment but they would not lance the abscess; they gave me antibiotics. My right eye swelled up to the size of a walnut before I could get an appointment to see an eye specialist. When I was finally able to get in to the ophthalmologist she lanced it, puncturing in three spots. Although I fainted with the pain, once the pus began to drain, the relief was immense and I was give 3 more types of antibiotics. It took 3 weeks to heal and my skin around that eye was blue for about a month.

    Please keep the information coming!!

  3. My shingles experience was totally different. I had a stabbing pain that went through my chest and back when I bent over, coughed, hiccuped, or sneezed. Nothing else. No fever, no itching. When I finally went to the doctor, he examined my back and asked how long I’d had the rash. What rash? I hadn’t felt any itching or discomfort on my back. He gave me something to relieve inflammation and help the pain; it made me violently sick, so I tossed it. At KMart I bought every anti-itch medicine there was–and never used any of it. I didn’t itch. Once I knew what was causing the pain, I ignored it and in about a week it was gone. For me, it was much ado about nothing.

    1. I am MORE than thrilled that your experience with shingles was that ‘mild’ if you can call it that with stabbing pains whenever you bent over, coughed, hiccuped or sneezed. My grandma got shingles and was bedridden for over a month. She also lost over 60 lbs during that time, the pain was so terrible.

  4. I have a question, I hear the vacinate-don’t vacinate debate and would like some feedback from others more knolagable than me. I am female, 61 years. A nurse has told me I should get EVERY vacination I can, as this will boost my immunity, so I will be more able to cope with situations that might arise. Others say don’t get any. Any input would be appreciated.

    1. VCC, to get every vaccination available is a big decision; I would think it would depend on your medical history and current health. Do some research on each type of vaccination and weigh the pros and cons. My parents suffered with shingles and don’t want to, plus I had chicken pox as a child so I got the vaccination.

  5. Excellent information. Can’t wait for next installments.

    I’m on the vaccinate side. Like some people are allergic to penicillin a few may be allergic to a particular vaccination. I personally believe the odds are infinitesimal that any average person will have a problem.

    The people that do the research on the matter suggest vaccination. Go to the NIH site and other reputable sites to research what is right for you.

    I personally believe that the return of certain childhood diseases, which were alleviated as a result of vaccination, and which are coming back, are the result of parents listening to non-experts and refusing to vaccinate their children. But it puts others around them at risk also. Throw on a pandemic or other serious country wide health issue and we will be worse off for it. IMHO.

    Please do your own research on this matter.

  6. Thank you Dr. K.B. for the information. This is one of the articles I will definitely print and keep for future reference.

    Elderberry should help with shingles as well, I know it certainly stops an outbreak of herpes in it’s tracks, but the knowledge that over the counter Tagamet helping as well is priceless. My grandma’s experience with shingles tells me to whack it with everything I’ve got in my arsenal.

    I looked up elder in my ‘PDR For Herbal Medicines’ and there is no listed interaction with Tagamet, so it would likely be safe to mix the two.

    Thank you for this article and in advance for the 3 others due over the next few days.

      1. Pregnant women, very young children, people with health issues preventing vaccination and people with health issues that severely lower their immune systems response. Plus many diseases are herd diseases in that they literally require a million or 10 million people living in the same environment for it to become epidemic.

        1. Hmmmm……. I didn’t know that pregnant women couldn’t get vaccinated but I do know newborns and young children are vaccinated. People with the health issues may soon be forced to get vaccinated by law the way things are going.

  7. Hi CuzMike.

    Just in case Ladywest doesn’t get your message, I’ll jump in…with apologies. Your question regarding how opting out of vaccination puts others at risk is a good one. Before the medical explanation, a word about the political philosophy implications is warranted: unless you believe that all vaccines are a scam to make money, the decision boils down to two issues: 1) the risk:benefit analysis regarding the individual receiving the vaccine, and 2) the societal implications of this decision. In this day of politico-social polarization, we conservatives (I count myself in this camp) have a tendency to always place the interests of the individual over the interests of “society” (I believe this to be generally right, as “society” is a construct of individuals). Also, we have a tendency to mistrust government (well-earned!). Since societal benefits are often touted when vaccination is discussed, and since the CDC strongly recommends vaccination, I find that most of the anti-vaccine folks are generally more of my political leanings.

    Here’s the truth (as far as a clinical pharmacist in practice for 36 years can see it): Though I believe vaccination to be one of the greatest medical advancements of the last 250 years, NO vaccine is 100% effective. The very best defense against disease is NOT BEING EXPOSED! When a substantial portion of a population has been vaccinated against a disease, with a vaccine which has a fairly high rate of seroconversion (i.e., induces our immune system to make antibodies against the disease for a long period), it results in “herd immunity” (don’t like being called a herd, but what ya gonna do with those silly epidemiologists?!?). This “herd immunity” drastically reduces transmission, and thus, exposure to the disease. So, as more and more people opt out of vaccination based on the belief that their personal risk:benefit analysis falls on the side of risk (notwithstanding some pretty good science to the contrary), the herd immunity is lost, the disease spreads, and more folks, both vaccinated and unvaccinated, are exposed and develop the illness (remember, vaccines are not 100% effective at preventing the illness).

    So, in my humble opinion, choosing to opt out of vaccinations (especially the major childhood vaccinations) may hurt those who have not been vaccinated, as well as those who HAVE been vaccinated, by creating an environment in which exposure to the disease is more likely.

    Now, there is, of course, some individual risk associated with vaccination. It varies somewhat with the type of vaccine, but the great majority of these adverse reactions are far milder than the disease! Of course, the risk of the disease is dependent upon how prevalent it is in the population in question, i.e., the status of “herd immunity”. On the plus side, consider how many friends you’ve lost to small pox lately. The analysis becomes somewhat harder when the question is, for example, assessing the risk:benefit of vaccinating a teenage boy against human papilloma virus. Do your research.

    Sorry this is longish…I think it’s important. I know there are many people who consider childhood vaccinations as nothing short of child abuse. I must respect the sanctity of parenthood. But, I would BEG you to review the data with a medical professional whom you trust (if there is such a critter) and evaluate the risks and benefits carefully, in light of the initial vaccination, as well as “the boomerang effect” of falling vaccination rates.

    For those who don’t wholly mistrust the government, much useful information can be found at https://www.cdc.gov/vaccines/index.html.

    I wish you all the blissful afterglow of our Lord’s birthday, and coming excitement of a new year! Let’s make the most of it!

    Best Wishes from TX

  8. I’ve had an encounter with Shingles. It’s nasty stuff. Mine was not a large rash, but painful. As the article notes, clothing or bedding contact is nearly unbearable. A topical steroid cream was more effective in dealing with it than the anti-viral. My mom’s case lasted 22 years…until she passed. Hers was on her head and face. Terrible pain! ER doctor was unconcerned and dismissive, possibly contributing to her prolonged case because of inadequate treatment at onset. The steroid creme is Triamcinolone Acetonide Cream USP 0.1%. This stuff also swats chigger bites, psoriasis outbreaks down with a vengeance. A tube lasts me for years. Use SPARINGLY. Prescription only.

    I had a dental abscess, and the cause was mold dust from moldy firewood I had handled. From contact with the wood to abscess was only a few hours. [Originally I thought it was a root canal gone bad] I mentioned the moldy firewood to my dentist and he prescribed metronidazole, an antibiotic usually used for Giardia, but also attacks anaerobic bacteria. Clobbered the infection in two days and surgery was avoided. To prevent repeated exposures I wear a dust mask in my firewood storage container when sweeping the floor. You should have a good stash of metronidazole for treating Giardia anyway. Doesn’t work on cryptosporidium. That requires a super-expensive drug.
    My physician knows me well enough to know I do not self-medicate and prescribes various antibiotics I ask for to have on hand for emergencies. If your doctor balks, there are more in the phone book. Antibiotics are very dangerous drugs, and should only be taken if the risk of NOT taking them is higher. Risk attaches to everything you do….including nothing.
    Useful article, will acquire the mentioned medications immediately.

  9. Regarding abscess, I had one under my arm that would return every year. Usually when the weather was hot. That thing would blow up from nothing to walnut size within days, and have me in the ER getting lanced.
    Finally, when having surgery for something else, I asked the surgeon to also remove the residual capsule which was the nexus for the repeat abscesses. Since then, it’s never come back. I considered that surgery as part of my preparations.

  10. Thank you for that reply SH in TX. I do appreciate your concern and the fact that you have been 36 yrs as a pharmacist. Duly noted……

    I won’t say that I am against all vaccinations, especially the ones tendered toward the major diseases like polio. But I have personally witnessed family suffering from vaccinations and so lean heavily toward caution when it comes to getting them. I appreciate what you had to say about prevention being the best and wholly agree. This would include a diet composed of mainly of fresh fruits and vegetables. Of course in a grid down situation that might not be possible unless a person is raising their own.
    Here is just one of hundreds of articles that are out there about vaccines. It is negative towards them but probably a person could find just as many positive ones.
    https://www.westonaprice.org/the-cdc-has-lied-about-vaccines-and-autism-for-14-years-lets-put-a-stop-to-it/

    Thanks again for your reply.

  11. I have the issue concerning such a huge dump of crap in the first handful of vaccines a child recieves. It’s a lot of stuff that is foreign to a new born baby. I have to question it, given the articles I have read and the ingredients listed.

    I’ve also watched the CDC leave our borders wide open and then ship out busloads of illegals after they have been corralled for days on end exhanging their germs and all. What kind of CDC does this? The same kind that gives us endless vaccines. Then ya got Bill Gates and his statements over the years…etc….

    I do like this article, and wish I could stock some of these items….we will see.

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