Wound Suturing, Gluing, and Bandaging, by David in Israel

James
Having suture equipment even if you don’t have the skills to use it is useful since you can hopefully find a veterinarian, doctor, nurse, PA, or Dentist qualified to use them. Having your own sterile medical equipment for the medical professionals you find is still a common bit of advice for people planning to visit third world countries.

If there is an injury requiring suture and you are not qualified especially in the highly enervated regions where suture can cause serious nerve damage and local paralysis of the body such as the hands and face there is a better way to use steri-strips and butterfly bandages.

Super-Glue related adhesives made of newer 2-octyl-cyanoacrylate instead of the skin irritant traditional Super-glue or cyanoacrylate (that have been in use in surgery and wound management since the 1970s). Qualified health care providers can provide treatment using surgical adhesives like Dermabond as a substitute for suture in many cases. I understand that the FDA in the United States may now allow these safe adhesives to be sold under several names over the counter, if not then Vetabond is a safe alternative.

Any cyanoacrylate related adhesive is reasonably safe to be used topically on the outer surface of the skin to help anchor your butterfly bandages in cases where suture or direct bonding of a wound is impossible because of training or supply issues.

-Use sterile technique at all times, if possible use autoclaved or pressure cooker steamed surgical tools instead of gloved hands just as with sutures
-Observe standard precautions when dealing with blood borne pathogens including eye protection for the care provider
-Clean the wound with antiseptic and remove any foreign debris, iodine based antiseptics are preferred, excellent lighting and visibility is required
-Use alcohol and sterile swabs to remove skin oils from the area to improve bandage adhesion
-consider irrigating or injected epinephrine or epi-lidocaine mix to reduce blood flow and anesthetize the area if you are trained in their safe use
-Close the wound
-Once the edges are aligned apply butterfly bandages
-Glue around the edges of the sticky pads of the butterfly bandage, do not allow adhesive into the wound
-If there is no allergy lightly apply triple antibiotic ointment over wound
-Apply sterile gauze over site
-Assess perfusion and neurologicals below the site
-Change dressing regularly, every few hours at first
-Reassess for infection, perfusion, and neuros after every bandage change
-If there is a question or problem a qualified medical provide should be sought immediately

If there is sign of infection you might need to open, drain, and irrigate the wound. You should seek qualified assistance and antibiotics at this point.

In some cases athletic tape stuck to a larger area of surrounding skin over your gauze dressing may be required to keep the edges of the wound held together. Regular dressing changes are still required.

You must never use circumferential taping (tape which is connected around the circumference of a limb) for any reason as it can act as a tourniquet cutting off blood supply and potentially damaging the limb to the point of requiring amputation especially if there is swelling or bad circulation.

If you have run out of sterile gauze clean white T-shirt material which has been steamed in a pressure cooker works well, only use when dry.

In a world without access to antibiotics an infected wound is one of the leading causes of untimely death so use sterile technique, equipment and supplies. Treat early and aggressively to prevent amputation or mortality.

Shalom, – David in Israel

Economics and Investing:

Brett G. sent this: Fed’s Bullard: US at Danger of Japan-Style Financial Crisis.

The latest over at Dr. Housing Bubble: Banks cherry picking individual foreclosures that show up on the MLS.

Frequent content contributor K.A.F. sent this: SEC Provision Shocks Observers

“A modern day depression” Rosenberg sees “tough slogging” for the economy. (Thanks to Trent H. for the link.)

Rep. Bachmann: U.S. Faces ‘Disaster’ From Financial Reform Bill

K.A.F. forwarded this one: AP survey: A bleaker outlook for economy into 2011

Odds ‘n Sods:

Kevin S. forwarded a link to a piece on building with compressed earth bricks (CEBs) (Also called compressed earth blocks.)

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Reader Joshua H. sent this: Tight budgets and fewer cops; time for citizens to ‘arm up’

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Ready Made Resources now has just one or two full mil-spec AN/PVS-14 Gen 3+ weapons sight monoculars remaining on hand, in their special sale. These are autogated and complete with military issue monocular head mounts, manuals, sacrificial lenses, mil-spec soft nylon carry cases, et cetera. The price is just $2,995, which is less than most dealers charge for a standard Gen 3 scope. (As I mentioned before, these are the much more sought-after Gen 3+ variety.) Once they’ve sold out, that will be the end of the special sale price, so don’t miss out!

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Courtesy of KAF: Gel that can help decayed teeth grow back could end fillings and pain

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T.M. mentioned the other big oil spill: Michigan oil slick spans 20 miles; 19,500 barrels

Jim’s Quote of the Day:

"Whoever looks upon them merely as an irregular mob will find himself much mistaken. They have men among them who know very well what they are about, having been employed as rangers against the Indians and Acadians; and this country being much covered with wood and hilly is very advantageous for their method of fighting." – Hugh Percy, 2nd Duke of Northumberland, from a letter written April 20, 1775

Note from JWR:

Today we present another entry for Round 29 of the SurvivalBlog non-fiction writing contest. The prizes for this round will include:

First Prize: A.) A course certificate from onPoint Tactical. This certificate will be for the prize winner’s choice of three-day civilian courses. (Excluding those restricted for military or government teams.) Three day onPoint courses normally cost between $500 and $600, and B.) Two cases of Mountain House freeze dried assorted entrees, in #10 cans, courtesy of Ready Made Resources. (A $392 value.) C.) A 9-Tray Excalibur Food Dehydrator from Safecastle.com (a $275 value), D.) A 500 round case of Fiocchi 9mm Parabellum (Luger ) with 124gr. Hornady XTP/HP projectiles, courtesy of Sunflower Ammo (a $249 value), and E.) An M17 medical kit from JRH Enterprises (a $179.95 value).

Second Prize: A.) A “grab bag” of preparedness gear and books from Jim’s Amazing Secret Bunker of Redundant Redundancy (JASBORR) with a retail value of at least $400, and B.) two cases of Meals, Ready to Eat (MREs), courtesy of CampingSurvival.com (a $180 value).

Third Prize: A.) A copy of my “Rawles Gets You Ready” preparedness course, from Arbogast Publishing, and B.) a Royal Berkey water filter, courtesy of Directive 21. (This filter system is a $275 value.)

Round 29 ends on July 31st, so get busy writing and e-mail us your entry for Round 30. Remember that articles that relate practical “how to” skills for survival have an advantage in the judging.

Living In A Non-Residence, by Scrap Metal Man

I have been reading SurvivalBlog for a few years now, and have noticed that many folks think outside the box on a variety of issues, but when it comes to building or modifying a structure for a retreat – or even a full-time place – they lapse into conventional thinking.  So many times I have come across the words “house”, “cabin”, “home” or even “residence”.   I guess the idea is that we have to “reside” somewhere, and the rest of the world may as well know where that is.  Allow me a chance to share some of my thinking on this issue, and you may decide to avoid anything “residential”.

With just my wife and myself to plan for, we have decided that for the next decade at least, we’d like to keep as low a profile as possible.  We are also building new, but if modifying an older structure, we would use the same techniques.  Our first goal, already met, was to purchase the land for cash.  This was not as big an expense as it sounds, as very rural undeveloped land can often be found quite cheaply.  

We bought this land in a state that allows purchase by land trust.  This is important for some of you to think about, especially if you have any problems from the past that may resurface.  We did not name it the “The XYZ Family Trust” as many attorneys just automatically do; we used a name of a fictional agricultural facility.  Anyone looking for property that we own will not find us there.  No GPS coordinates will mark our property, and no bureaucratic thugs will be smashing down our doors at 3 a.m.  Even traditional incorporation or LLC would not provide this degree of anonymity.  And buying for cash leaves no mortgage trail.

I say this quite sincerely: I would rather live in a 5th wheel or a tow-behind trailer, on a piece of land that I own outright, than in a fine “house” with a mortgage on it.  Many are still employed right now, but what if they lose the job?  What if the dollar becomes worthless?  What if there is a bank holiday, and funds are not available?  How will they make the payments?  We all need to think this through very carefully.  We maintain that not having to make “payments” for the roof over our heads is of the highest priority.

We also needed to keep building costs very low.  In most parts of the country, building a “home” means dealing with all sorts of bothersome building codes.  Granted that many of them are for safety, but stop and think about this: banks make more interest on loans if the building costs more to put up; insurance companies get larger premiums if the value of the building is higher; and tax collectors pull in more revenue on expensive structures.  Think about all those greedy hands held out, grasping at your hard-earned cash!  We did, and decided that there had to be a better way!

We settled on the idea of building a “barn” and an “agricultural building”.  Neither one of these will officially be a “residence”.  This allows us to by-pass all sorts of nonsense.  As a team, my wife and I know how to build stick-frame, as well as post-and-beam.  If we could hire some local unskilled labor for part of the work, the “structures” would be up in a jiffy.  If any building inspection is required, this is the point where it would be done.  Once the inspector signs off, the owners are free to secretly finish the inside as they see fit.  In our case, we intend to finish off the interiors as very comfortable homes.

What is the point of all this, you may wonder?  By owning the property as a land trust for say, some sort of agricultural institute, it won’t appear on any municipal or county lists of “residences”.  In this day and age of computerization, you need to be careful what types of lists your property and your name show up on.  Disappearing from the face of the earth might not be such a bad thing!  Any utilities used would be in the name of the trust, not your name.  You’d never be visited by the Census (for those of you not comfortable with that issue) as no one would “live” there.  If the Golden Horde came out your way, they wouldn’t find any house.  The NAIS people would not be registering your premises (and no, the NAIS scheme is not yet dead. [JWR Adds: Yes, indeed it is “on the back burner” under different names.] If the government sent troops door-to-door, they’d pass you by. Owning “residential” property sets you up for all sorts of interference.  You can probably imagine a hundred other scenarios you’d “miss”, so I won’t go on.

Do take some care not to look like a business.  In this age of tax revenue shortfalls, everybody from the local fire marshal to town hall busybodies have been deputized to spot potential “businesses” for extra tax revenue.  You need to be totally non-profit.  If questioned, people are on the property only as volunteer workers.  They don’t live there.

In order to live in a non-residence, there are a few items you’ll need to attend to.  First, you’ll likely have some neighbors, somewhere.  Our advice is to be friendly, neighborly, and helpful, invite them over if you wish, but say nothing.  Another big item is making sure that from the outside, your non-residence does not end up looking like a residence.  In our case, our backdrop is woods, woods, and more woods.  We intend to paint the place in natural, earth tone colors: brown, forest green, dark tan – you get the picture.  There will be no white window or doorframes, no shutters, no pretty garden paths leading to the doorstep.  In fact, you’ll need to look closely to even find the doorstep.  We intend to keep the window area on the sidewalls minimal, with skylights in the roof for natural lighting.  There will be nothing to catch the curious eye.  We’d like to blend into the woods.

The next item is the address.  The property should not have any marked address, and certainly no roadside mailbox stuck out in plain sight, with a number on it!  Nobody lives there, remember?  Just some folks who volunteer to work there.  I can’t think of a better way to advertise “residence” than a mailbox! Any mail going to the land trust (say, for utility bills), would go to the trustee, not to the property.  Any mail addressed to you in your own name, is another issue entirely.  Let me count the ways…post office box, re-mailing service, local RV campground that will accept your mail for a small fee, relatives, whatever you can think of, as long as it’s reliable.  There will be issues with registering your vehicles (which can also be owned by a trust), buying insurance, dealing with your bank, etc, but all that can be worked out with a bit of thought.  I’m just trying to lay a foundation for you here, to consider.

I find the idea of living this way to be sort of a thrill!  If the same idea turns you totally cold, consider this: for probably the next 10 to 15 years, we are likely to be living in dangerous times. If you have a spouse, young kids, older parents, and others that you care about, you should consider doing whatever it takes to ensure their safety. There are those in government that, as you read this, are hatching new and sneaky schemes to invade your privacy.  There are those in the tax-collection system looking for nefarious ways to snatch more of your income.  There are low-lifes out there just waiting to prey upon you and yours.  There are snoops expecting you to just live in the conventional manner.

The idea of hiding in plain sight – and living comfortably while doing so – has a lot of appeal.  By not living in a “residence”, you exempt yourself from a lot of expense and bureaucracy.  Perhaps, in another 15 to 20 years, after whatever is going to happen has happened, when the country is rebuilding, when it is safe for civilized folks to come out in the open again, then you can paint that agricultural building white, put up blue shutters, add a bay window, plant some pretty flowers along the walkway, fly Old Glory, and put up a mailbox.   Life will go on, after all.  Better times will be coming, and I hope to meet some of you on the other side!

[JWR Adds: Some friends of our family in the Inland Northwest live in a well-insulated pole frame steel shop building. They call it their “Shouse.” (Shop-House.) From a distance it looks a lot more like a shop building or a barn than it does a house. Their original plan was to temporarily live in the shop until they built their dream house. But the years went by and they got more and more comfortable in the shouse, as they added interior amenities. In the end they’ve settled into the shop very comfortably, and instead of being burdened by a mortgage, they live debt free.]

Letter Re: Riots and Civil Unrest in America

Mr. Rawles,
I had one more observation to add to B.B. in California’s letter about the 1992 Los Angeles riots. At the time, I was living in Bakersfield, a city a two hour drive from L.A., and I vividly recall watching the news coverage of the events. This was followed by stories of similar, albeit much smaller, incidents of ‘unrest’ in cities as far away from L.A. as Fresno, and Oakland, California. The most alarming thing was this: Each of these cities, indeed, even the city I lived in, had already sent some of the Police Officers (mostly California Highway Patrol) normally stationed there to assist in trying to restore order to L.A. In other words, the incidents of unrest had started to spread, even as the officers who were to stop it from spreading were sent someplace else.

Now obviously the incidents in other cities were very minor, and didn’t amount to much. However, the fact that [active component] U.S. Army troops were called in from Fort Ord (over 5 hours away) and even U.S. Marines from Camp Pendleton shows how this one, relatively short, localized incident, stretched the abilities of the government to reestablish Law and Order. (As I recall the riots lasted for less than a week, and major rioting occurred in only one major U.S. city) Can you imagine what might happen if major nationwide civil unrest occurred today, when so many of our brave National Guard and active duty U.S. Military troops are stationed overseas?

In this day and age when people will riot over the whether or not their favorite sports team has lost or won a game, and the economy is teetering on the edge of deep, dark, depression, we are closer to edge of anarchy then we have been in a very long time. If you think that living far away from a major urban center means that you are safe from the effects of such things, or if you think that help is coming during an incident of rioting or civil unrest, then you are sorely mistaken. – Krys in Idaho

Seven Letters Re: A Doctor’s Thoughts on Antibiotics, Expiration Dates, and TEOTWAWKI

Hi Jim,
In response to the letters sent to you regarding my article, the FORTE version of the antibiotics described would be appropriate for full-grown men and all but the most petite women (less than, say, 100 pounds or so). Children would be best served with the 250mg fish antibiotic dose. Frequency of these medications is from 2-4 times a day, depending on the individual drug. The risk of under-dosage would be suboptimal progress in healing. Overdosage often manifests itself as diarrhea.. Treatment length is usually from 5-10 days.
A good internet drug index can be found at rxlist.com.

If you suspect that you have influenza (a viral illness), antibiotics will do you little good. Instead, you should get Tamiflu and take it 2 times a day for 5 days. It is most effective when taken very early in the onset of the illness.

I would recommend stockpiling as many antibiotics as you can afford. Over the course of time, I guarantee you will need it; if you don’t need it, it will be an excellent barter item. Thanks again, – Dr. Bones

Hello Jim,
Here are a couple of resources for looking up drug information and recommended dosages:

At the NIH web site

At the FDA web site

Keep up the good work! – G.W. in Ohio

James Wesley;
Antibiotics, or any internally consumed medication for that matter, have a dosage range. To find the dosage range of a particular drug based on body weight, a drug information handbook will be needed. This will detail the appropriate milligrams of drug / Kilogram of body weight / per day (essentially the maximum dosage per day based on body weight) of the particular drug you need. All dosage amounts are in the metric system (mg) so you will need to convert it to the English pound system. Once you find the range, you can decide (based on the weight, age, medical status, virulence of infection and extent of infection) how much you would like to dispense.

A simple formula for converting the mg. of drug / Kg. of body weight / per day into mg. of drug / pounds of body weight / per day is:
(mg. of drug x weight in lbs. of person) / 2.2 lbs = maximum mg. of drug per day based on weight in lbs.

So, an example for the mathematically challenged using Amoxicillin:

The drug handbook lists Amoxicillin:
Child: 20-50 mg/kg/day in divided doses every 8 hours.
Adult: 250-500 mg every 8 hours.

If your child’s weight is 50 lbs. and he is in good general health (using the upper limit of the drug), multiple 50mg of Amoxicillin x 50 lbs. divided by 2.2 lbs = 1,136 mg/ lbs./ per day. So, 1,136 mg of Amoxicillin should not be exceeded per day.

Now, take the 1,136 mg and divide by 3 (because it is taken every 8 hours) = 379 mg every 8 hours (not to exceed ,1136 mg in a 24 hour period). The drug is only dispensed in capsule form as 250mg or 500mg capsules. So, based on the above child, I would prescribe a 250mg capsule every 8 hours for 7 days and monitor his response. If he starts to feel better, continue with the medication. If he gets worse, then up the dosage to 500mg every 8 hours and monitor or switch to a different antibiotic drug class.

The problem with under-dosage would be the bacterial infection is not eradicated from the body and the infection gets worse and possible resistant to the antibiotic. Over-dosage of an antibiotic when be difficult to do and the results even harder to estimate in my opinion. I would postulate that a prolonged over-dosage of an antibiotic (depending on the type of antibiotic) would alter the normal micro flora of an individual leading to gastrointestinal problems (diarrhea). I hope this helps, – Tennessee Dentist

Dear Jim,
I am board certified in family medicine. In general, I agree with the antibiotics recommended by Georgia Doc. Ten day courses of Levaquin and Bactrim are usually adequate for most infections. I have found Alldaychemist.com to be a reliable and reasonably priced source for most common antibiotics and other medications. It is based in India. Perhaps some of your pharmacist readers, can comment on if it is true the eighty percent of the world’s generic medications are manufactured in India. Keep up the good work. Sincerely, – Dr. Jim

 

Dear Mr. Rawles,
Please let your readers know that there are three resources available to help determine the drug and dosage needed for specific illnesses. The first is The Merck Manual, which is a thick book with every known disease and syndrome. It’s used by doctors and gives dosage recommendations for adults and children (including how to calculate dosage); it also provides alternative drugs should the patient be allergic to the first drug of choice.
The second resource is The Pill Book which is for sale at many pharmacies and most bookstores. It’s a little less technical and is organized alphabetically rather than by disease, as The Merck Manual is.
Finally, everyone should be aware of what drugs they take for frequently occurring disorders such as tonsillitis, sinusitis, cystitis, etc. If your doctor regularly prescribes 500 mg Amoxicillin, you can be assured the drug and dosage are correct for you.
Thanks so much for your blog. – S.S. in Tennessee

 

Hello JWR,
First off, thank you for the site. My wife and I have just recently ‘woke up’ regarding preparedness (less than a month ago). It’s really been a great bonding experience and also allows us to get back to basics. We are nowhere near ‘ready’, but we are working on it daily and have a plan of action. Hopefully we’ll never really use any of this, but again, thank you for potentially saving our lives! We are very grateful, maybe I can give back a little with this e-mail.

I am writing regarding the recent pharmacy articles. Very well written and I agree with them completely. As a pharmacist and owner of an independent pharmacy myself, I can’t stress enough that if SHTF, the pharmacies at CVS (I used to work there), Walgreens, Wal-Mart, and the like will be locked up. Count on it. I know if times became truly bad, I would take everything home with me and work from there while I had supplies left to prevent looting. I’ve stocked up on antibiotics, blood pressure meds, pain relievers, diuretics and other ‘survival meds’ (the cheap ones anyway) in bulk for the communities that I serve for awhile, but I doubt that most places have. I worry about my diabetic patients, along with those in the nursing home and homebound. I guess that the only thing that keeps me awake more than the Golden Horde is the image of those patients in the nursing homes that I serve, post SHTF, it really breaks my heart to think what could happen there.

I would just like to add a couple more products that I haven’t really seemed mentioned anywhere that would be extremely beneficial, potentially lifesaving in my opinion.

Meclizine, brand names Bonine, some versions of Dramamine, (double check the active ingredient which are usually highlighted in yellow on the back of the box) can be used for multiple uses, but it’s main function is preventing and treating nausea and dizziness. I imagine needing to gather firewood, hunting, or other outdoor activities while undergoing a dizzy spell. Not a good combination, although the job may need to be done You can get a generic bottle of 100 tablets with a long shelf life at my pharmacy (I’m assuming others as well) for around $5. The brand name is much much more expensive for the same amount. Be careful giving to children though, there is a Bonine for Kids that is a different ingredient that I use for my kids on car trips. Make sure that you’re not confusing dizziness with dehydration.

Silver Sulfadiazine (brand names SSD and Silvadene). This is a prescription medication but if the opportunity presents itself, get hold of some. Treats burned skin to prevent secondary infections and it greatly increases healing time. Will work for cuts, burns, infected bug bites, etc. Similar product to Neosporin (triple antibiotic cream, without a prescription), except much more effective. My suggestion to get hold of some, next time you get a normal burn from the lawn mower muffler or curling iron, instead of treating it at home, go see your physician. Tell them a friend used SSD and you would like some. Shouldn’t seem like a strange request. I’ve heard you may be able to get the same stuff from your Vet, but I’m not sure on that. This product is inexpensive, so ask for [a prescription for] a large quantity. Also, be careful if your have a sulfa allergy, since SSD has sulfadiazine in it, which is sulfa based.

Prednisone is another prescription that would be extremely beneficial post-SHTF. Can be used for strains and the like (although ibuprofen and naproxen are over the counter and much safer with far fewer side effects). However I envision it for near emergency situations with flu and breathing issues. Prednisone has a lot of side effects both short term and long term so be careful.

Sun Screen in bulk. You run the risk of dehydrating much much faster with a sunburn. At least wear a hat and loose lightweight long sleeve clothing. Dehydration will kill quickly and it is not a pleasant way to go.

Get a hardcopy of a medication book (I recommend The Pill Book by Harold Silverman, but there are others). Invaluable in my opinion. It will tell you side effects, common uses, common dosages, some interactions, etc.

I can’t stress this one enough: Get healthy, now. Quit smoking/chewing, lose weight, get in shape. You may not even need that blood pressure, diabetic or cholesterol med if you loose the gut. It’s hard work but it does work. You are going to have to become much more active post-SHTF, might as well get in shape before hand. Makes the whole civilization ending thing easier to handle. I’m working on my caffeine addiction now, I can’t imagine these headaches after the Pepsi shelf is empty.

There are so many others to be addressed (diuretics, pain meds, anxiety meds, vitamins, etc.) but this would be a place to start along with Michael’s advice. Just my two cents. – Dustin in Kansas

 

Mr. Editor:
Thanks to Dr. Bones for the tip on sourcing antibiotics from aquarium supply stores.

The main bacteria present these days in open trauma wounds is called methicillin (penicillin family) resistant Staph Aureus (MRSA). The Centers for Disease Control (CDC) in Atlanta) top recommended oral
antibiotic for MRSA is Bactrim DS, 3-4 tablets per day for 10 days. This is more than the classic Bactrim dose of two tablets a day that got used for female urinary tract infections and other less serious infections. Pharmacists sometimes challenge the higher dosage, but only because they are uneducated on this use for the drug. Other drugs that are often prescribed for for open trauma are Levaquin, and Augmentin. Levaquin cannot be given to kids. Augmentin syrup is the number one antibiotic for kids.

Here are the contents of the first-aid pack attached to our G.O.O.D. bags:

1- Trauma Pack; Tac-Pack Battle Pack, Option 2;
2- CELOX-A Hemostat syringe;
2- Betadine scrub, B-D Easy Scrub Brush
2- Sterile pairs of gloves
1- Sterile instrument set, tweezers, scissors, forceps, and needle driver, all in a sterile double peel pack
2 -1% Lidocaine 5ml syringes with capped needle
2 -No. 15 Sterile scalpel
1 – 5-0 Monofil suture
1 – 6-0 Chromic Gut suture
2- Steril gauze, Israeli 4″ Field Dressing;
1- Coban, 2″ Tan roll
1- Cheaper Than Dirt Universal Splint;
10 – Fever/Pain medicine, Tylenol travel packets-Extra Strength
Antibiotic tablets, Bactrim-DS: qty 30 (3/day x 10 days)
Antibiotic ointment, Bactroban cream, one tube

I am looking to add a transfusion kit, such as described in your novel, “Patriots”. Thanks, – Ragnar in Texas

Economics and Investing:

Flagged by G.G.: Jim Rogers predicts a new recession in 2012

Also from G.G.: Drip after drip of deflation data

I was doing some web wandering, and found this over at Gold Eagle: The Coming Silver Supernova

Reader K.S.B. sent a link to a CBO report on the U.S. debt crisis that is a must read. The key word: unsustainable levels of debt. There are some articles discussing the CBO report in The American Spectator and in The New American.

John L. mentioned an article about counterfeit silver coins.

Frequent content contributor KAF sent this: North Dakota, Alaska lead US job creation, study says.

Another link from KAF: Home Vacancies Rise as U.S. Ownership Falls to Lowest in Decade

Odds ‘n Sods:

Remember what I wrote about cross-border threats in my book “Rawles on Retreats and Relocation”? Well here it is, even before TEOTWAWKI, folks: Mexico Drug War Spills into U.S. (A hat tip to B.B., for the link.)

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Phil K. sent this item: Power grid upgrades could pose security risks, experts says. And meanwhile, we read: Power grid hacking fear grows as industrial-targeted virus emerges. (Thanks to B.B. for the link.)

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National Guard troops to head to border states August 1st. (A hat tip to John B. for the link.)

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KAF sent this troubling article: Seven People Have Been Entrusted With The Keys To The Internet. Oh, and five of the seven people, from all over world need to gather in the U.S. to re-start the Internet, in the aftermath of the disaster. This sounds like something out of a Michael Crichton novel.

 

Note from JWR:

Today we present another entry for Round 29 of the SurvivalBlog non-fiction writing contest. The prizes for this round will include:

First Prize: A.) A course certificate from onPoint Tactical. This certificate will be for the prize winner’s choice of three-day civilian courses. (Excluding those restricted for military or government teams.) Three day onPoint courses normally cost between $500 and $600, and B.) Two cases of Mountain House freeze dried assorted entrees, in #10 cans, courtesy of Ready Made Resources. (A $392 value.) C.) A 9-Tray Excalibur Food Dehydrator from Safecastle.com (a $275 value), D.) A 500 round case of Fiocchi 9mm Parabellum (Luger ) with 124gr. Hornady XTP/HP projectiles, courtesy of Sunflower Ammo (a $249 value), and E.) An M17 medical kit from JRH Enterprises (a $179.95 value).

Second Prize: A.) A “grab bag” of preparedness gear and books from Jim’s Amazing Secret Bunker of Redundant Redundancy (JASBORR) with a retail value of at least $400, and B.) two cases of Meals, Ready to Eat (MREs), courtesy of CampingSurvival.com (a $180 value).

Third Prize: A.) A copy of my “Rawles Gets You Ready” preparedness course, from Arbogast Publishing, and B.) a Royal Berkey water filter, courtesy of Directive 21. (This filter system is a $275 value.)

Round 29 ends on July 31st, so get busy writing and e-mail us your entry for Round 30. Remember that articles that relate practical “how to” skills for survival have an advantage in the judging.

Home Pharmacy Preparedness, by Michael V.

Don’t plan on your pharmacy being open or not looted after Day 1 after the SHTF.  Just like most cops have reported on this site that they will leave their posts to protect their families, pharmacists will do the same.  Most chain pharmacists have no loyalty other than a paycheck, so unlike “One Second After” it would be unlikely that a chain pharmacist would show up to work and risk their life after the SHTF.  Independent pharmacists who own their own store, and have their fortune tied to it have a better chance of being there, armed, with a more controlled environment, but even those will only last for a few days, at most.  Once armed bands of thugs start roaming, they will be long gone.  All pharmacies get deliveries every business day. (I have worked as a pharmacist in both chain & independent stores as well as hospital pharmacy, so I am familiar with all three types of facilities).  Most pharmacies have to pay for their drug orders within seven days, and many drugs are so expensive that inventories are kept low, (typical inventories are about $200,000) since re-supply is almost daily it is not a problem until deliveries dry up.  Within one day, many drugs will be dispensed, especially if patients are given a larger than normal supply.

Insurance companies, Medicaid, and Medicare Part-D all try to stop patients from stockpiling drugs.  So, what can be done?  First of all, as mentioned here on this site; improve your health by diet & exercise.  Stock up on the vitamins & supplements your family uses.  Keep all over the counter (OTC) drugs in the sealed, original container, and rotate your stock.  Store all medicine according to the storage directions from the manufacturer; I’ve seen mentioned on this site or others where drugs should be stored in the refrigerator, but not all drugs should; so read the label or check with your pharmacist.  Have your Doctor write prescriptions for a year supply as a quantity and you should be able to purchase whatever quantity you can afford at the pharmacy.  Use the generic or ask your pharmacist if there is a generic available that is similar to the brand name in the same therapeutic drug class; he may be able to get the doctor to change your prescription for you.  Pharmacies typically carry much larger quantities of generics than the high priced brand names.  If you are on high priced brand names (like Insulin), try refilling your prescription every 23 days, a little known fact is that many insurances will allow an early refill as long as it is within 7 days.  Begin to stockpile your insulin or expensive brand name drugs by marking your calendar and getting a refill whether you need it or not; every 23 days.  Some insurance companies like Medco keep track and won’t allow any early refills, so ask your pharmacist and try.  Work with your doctor and pharmacist to increase the quantity of critical expensive medicine like insulin so you can increase the number of vials you can get, and get it refilled regularly until your stockpile grows. 

Ask your pharmacist if you can have your long term storage meds dispensed in the sealed original containers with the expiration dates visible and rotate your stock.  If not; ask that they include an “adsorbent” which is typically found in the original containers, and have the pharmacy staff write the expiration date of the drug on your label.  Having anti-virals like “Tamiflu” and antibiotics like Ciprofloxacin, a broad spectrum cephalosporin like Cephalexin, an antibiotic eye drop like Gentamycin, an antibiotic ear drop like generic Cortisporin at home is also a good idea.  Avoid Tetracycline; one of the few antibiotics that is toxic once it expires. Doxycycline is the drug of choice for Lyme disease, but is related to Tetracycline and should be discarded after the expiration date. Clearly mark your bottle with the expiration date, and rotate your stock.  Pain meds like Hydrocodone or Acetaminophen with Codeine will be useful too.  Don’t forget anti-fungal creams, topical steroids, and assemble a great first aid kit. 

In my years of being a Boy Scout leader and dealing with scouts at summer camp I have treated a large number of ‘usual cases’; so these are conditions that regularly occur while away from civilization: diarrhea: use Loperamide it’s OTC now and a good drug, prescription drugs like Diphenoxylate/atropine are better and Belladonna Alk with PB help with cramping if available. Stomach aches: have an antacid like Tums EX, plus a PPI like Omeprazole (now OTC). 

For cuts and scratches, have Hydrogen Peroxide and triple antibiotic ointment (and Band-Aids).  Knife cuts: use Steri-strips are a great product made by 3M. I have used many times to avoid an ER visit, works great except for hairy areas that are difficult to shave.  Head lacerations may require stitching or staples; so get a suture kit with 1% Lidocaine (to deaden the area before stitching).  How to suture a wound can be found in this US Army video.  Poison ivy: use Tecnu wash to cleanse the area after exposure and treat with topical steroids like Hydrocortisone or non-steroid Domeboro. Both of these are OTCs that work, but prescription steroid creams like Desoximetasone or Fluocinonide are better.  Topical fungus are common (ringworm, jock-itch); use Clotrimazole (OTC) or Ketoconazole (prescription).   Developing a relationship with your doctor and pharmacist is crucial in getting the supplies you need before TSHTF. 

Are your vaccinations up to date?  Recommended immunization schedules can be found at the CDC’s web site. If TEOTWAWKI does happen having your family up to date on vaccinations will improve your chances of staying healthy.  Many of the diseases that are found in third world countries are controlled here in the United States by vaccinations, proper hygiene, sanitation and working sewer infrastructure; when that disappears these diseases will reappear here.  The CDC has a very cool web site with travel information and vaccines for every part of the world. It is worth a look.

Is your training up to date?  We had not only our leaders, but all our scouts in the Venturing Crew take the Standard First Aid Course with CPR from the American Red Cross.  I have taken the Wilderness First Aid Course by them also, which is a ‘step up’ in training.  The National Outdoor Leadership Schools (NOLS) has some of the best training available for wilderness medicine; check out their web site.  Their web site is also useful in planning a good first aid kit.  Click on the WMI store tab, and search their first aid kits to get the list of items they recommend.

If you are planning on going to your pharmacy on the day TSHTF, remember; with no electricity your pharmacist is going to have to rely on knowing you and seeing your bottle before you are going to get any medication, since he cannot access any of his records.  Also, developing a relationship with an independent pharmacist if you are on life saving medication is critical, since he is going to be taking a lot of that inventory back to his home or retreat to use it for barter.  Walking into a pharmacy where the employees don’t recognize you (big box stores) and especially without your bottle is going to get you nothing.  Hopefully, by planning ahead you won’t have to be one of the hundreds of people trying to get a refill on life saving medicine with no electricity available and no deliveries coming. – M.V. in Missouri

Two Letters Re: A Doctor’s Thoughts on Antibiotics, Expiration Dates, and TEOTWAWKI

JWR,
Regarding the recent post on antibiotics, I would love to hear the good doctor or someone else with relevant knowledge describe how to determine dosage (I’m assuming based on weight), as well as any risks associated with over- or under-dosage. Thanks! – E.W.

Sir;
I’m a relatively new reader of your excellent site and have learned an incredible amount of valuable information from you and my fellow readers. Thank you for such a wonderful service.
I read Dr. Bone’s submission with great interest since the medical issues of a SHTF scenario are a great concern of mine. I’m knowledgeable in First Aid, and small trauma treatment, but major injury and illnesses are far beyond most untrained personnel such as myself.
Dr. Bone’s listing of available antibiotics answered one big question, and the shelf life hint answered another, however I have one more that wasn’t answered.
Could you, Dr. Bones, or even some other reader, tell me what is the usual length of an antibiotic regimen for an infection? Also, is there any difference in regimens for ‘flu-like’ infections and septic wounds?
The issue for me is the quantity needed to have a reasonable supply on hand when necessary. I’m in good health but always manage to catch ‘cold’ once a year and the ‘flu’ every third or so. I’m also wise enough to realize that since I’m such a city boy that I will probably get quite a few minor wounds,(many accidental and self inflicted most likely). I would hate to have a few thousand tablets stored and discover that it was sufficient for a few wound treatments and a handful of illnesses, especially in regard to contagion rate among family members. Thanks again for all you do, everyone of you, in helping us get ready. – WJN

JWR Replies: Antibiotic dosing, typical uses, and courses of treatment were covered thoroughly in the article Antibiotic Use in TEOTWAWKI, by Georgia Doc that was posted in December of 2009.

Economics and Investing:

AmEx (American Expatriate) sent us this piece by Charles Hugh Smith: Six Reasons to Expect Slow Economic Growth Ahead

G.G. sent this: Hussman: Betting on a Bubble, Bracing for a Fall.

GIC (Singapore ) Says World May See Recession Sooner Than Expected. (A hat tip to M.W. for the link.)

Phip flagged this from Phil Stock: America is 234 Years Old, and Today it is Finished.

Reader Steve K. suggested this news piece: America Now: Friends and Neighbors. NBC’s Ann Curry travels to Ohio to take a personal look inside the lives of families who have lost jobs, homes and dreams.

Paul W. liked this article by Marty Weiss: Four Shocking Bombshells Bernanke Did Not Tell Congress About Last Week