Category Archives: Medical

Nuts & Bolts by Nick: The 911 Bag

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by Nick Romaniello -

ambulanceWith bugout bags, get home bags, EDC, etc, preppers tend to organize many go-to kits for various emergency scenarios. The prepper mentality is largely one of self-reliance, but what happens when injury or health emergency force you to rely on someone else? Do they know everything they should? I have recently experienced a few scenarios, both directly and indirectly, within my own family where medical emergencies rendered a person unresponsive. Without going into too much personal detail, one scenario had me alone with a person who lost consciousness from a drug interaction. Training had allowed me to avoid panic and react properly. A call was placed to 911 and information was conveyed in a calm clear way to assist responders as much as possible. When paramedics arrived on scene, the quest for information continued and I found myself suddenly unable to answer all the questions. “What medications does this person take?” “Who is their Primary Care Physician?” “We are taking them to So and So hospital, do you know the way?” I was suddenly at a disadvantage. A disadvantage that affected this persons effective treatment. What could I do to prevent this disadvantage in the future?

Pregnant women are often the most prepared for a sudden departure to a hospital or birthing center. They know they will be going, but just aren’t sure when. So they get prepared. When “it’s time” they just pick up and (relatively) calmly go, knowing that they will have everything they need. The truth is that we all may be on our way to the hospital and just don’t know when. Remember that “it’s not if, but when” mentality of being prepared and pack a small bag for each household to be grabbed in the event of a medical emergency. When a person is rushed to the hospital (especially if they are unable to speak) you will have important information and gear that will make the difference.

emergency roomWhile I’m sure there are resources out there that discuss this type of prep, I haven’t come across any. Based on my personal experiences alone, I would recommend the following to be included in such a kit:

  • Prescription Information: This includes a list of all current medications, dosage amounts, usual times they are taken, and prescribing doctors contact information.
  • Over-the-Counter or Natural Remedy’s: If the subject is taking anything that may react with prescriptions being taken or medications that may be administered in hospital the ER should be alerted.
  • Allergy Information: If the subject has any allergies to medication, food, latex, etc.
  • Copies of ID: Drivers license, organ donor information, insurance card, and a list of important phone numbers.
  • Personal Essentials: If the subject wears glasses, dentures or anything else needed to function normally be sure to either include spares in the bag, or list a reminder to get them on the way out the door.
  • Hospital Information: Depending on your location, there may be one or many possible destinations for an ambulance. A list of local ER’s with addresses, phone numbers and directions can help greatly when your mind is racing.
  • Clothing and Personal Items: A change of clothes, a book, and some comfort items such as a family photo can bring some peace to a person facing an unexpected hospital stay. Perhaps include some snacks and a book for the person sitting in the waiting room holding the bag. Include dollars and coins for parking and vending machines.

For me this type of kit is a recent concept and is far less refined than the oft-discussed B.O.B. so I would welcome any additional information or ideas to help make the 911 bag, as I am calling it, a more effective piece of prepping gear. A rush to the hospital is never a pleasant experience, but being prepared can help alleviate stress and speed effective treatment.

 

Sarah’s View: What Happens With Your Body When You Die?

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by Sarah Adams -

Death happens. Death happens to all of us, once you are born you will die. Being prepared means being prepared for all aspects of life, and that includes death. And preparing for death includes what happens after death. It’s not a fun topic, in fact it is rather uncomfortable, but having a plan for your body after death relieves your family of at least one decision during a difficult time. Because what happens to your body is definitely a decision they will be asked to make.

One of the things that makes us human is the respect we show for the body after death. For most (all?) of human history there have been rituals surrounding the care and processing of a body after death. These rituals are not universal, they vary with time and culture, but that there is a ritual is universal.

There are many many options available to us today – cremation, embalming, burial in a casket, entombing, donation. What you choose might depend on your religion or family or culture. Do you know how you’d like your body cared for after your death? Does your family know what your wishes are?

Now, since we’re preppers, we need to ask how many of those would be available or practical in a collapse situation?

Coffin-crematoriumA cremator generates temperatures between 1600-1800 degrees Fahrenheit. As far as I know, there’s no way to generate that kind of heat with easy to gather fuels. Modern embalming solutions include formaldehyde, methanol and other solvents. Not only would those materials be difficult to locate in a collapse situation, but people with the skills required to embalm without modern equipment and electricity are few and far between. Even burial is a challenge without modern excavation equipment — think about digging a deep enough hole by hand, now imagine doing it during a collapse. Many of the options we take for granted today would not be practical in a collapse situation.

burialplatform-curtis

So what options should we consider in a collapse? My suggestion would be to look at what native peoples indigenous to your region may have done. Their traditions were probably adapted to the locale. If you live near the coast an ocean burial may be an option. There are also the famous mounds of the Native Americans of the Mississippi River where bodies were “buried” in a mound of dirt instead of in a hole in the ground. Here in the Pacific Northwest it was common to practice “above ground burial” where a body was placed on a scaffold and left for the elements and animals.

I, personally, am a fan of some sort of exposure. In a pre-collapse world I’d like to be donated to the Body Farm; I would like my body to provide some use for science. In a post-collapse world, above ground burial or simple exposure in the forest works for me; my body is put to use, recycled into the circle of life.

The key, as always, is preparation. What do you want? Is it in writing? Does your family know?

 

Nuts & Bolts by Nick: Dual Flush – The Smarter Toilet

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by Nick Romaniello

CrapperWe have come a long way from digging a hole in the ground, to get rid of our bodily wastes, and then wiping with a leaf — but anyone who has been through a disaster can tell you it doesn’t take much to send us back there. Although toilet technology has progressed over the years, most homes still contain toilets that use components developed in the 18th and 19th century. Karl Benz may find nothing in a modern automobile resembling the horseless carriages that he developed in the late 1800’s, but plumbing pioneer Thomas Crapper could easily find his innovations operating virtually unchanged in commodes over 130 years later. While fancy water saving toilets have become the norm elsewhere in the world, the West has been slow to adopt these due to water being plentiful and cheap. We don’t really stop to think about water consumption very often, but the truth is that the average American family uses about 100 gallons of water per person every day! That’s far more than the one gallon per person per day that we consider the survival standard. The biggest household consumer of water is the toilet, responsible for 25-30% of usage. This can be a heavy burden in a water shortage, or even if you have a finite supply such as a private well or small municipal source. Water conservation can help the planet and your wallet, but it can also preserve a precious resource for more important needs.

Dual flushWhile new toilets sold in the U.S. meet EPA guidelines of 1.6 gallons per flush, many homes still contain older, less efficient models that can use around six gallons per flush or more. Replacing an old toilet with a new high efficiency model is an easy project for a do-it-yourselfer, but little effort is needed to take it a step further and install a dual flush toilet. Dual flush toilets look like and install like any other toilet but allow you to choose how much water you flush with. Many have two buttons in place of a flush handle or a flush handle that can be pushed up or down to select the desired amount. When you only have urine and some toilet paper to flush, the first setting only uses a fraction of the amount in the tank. For solids, the second setting uses a full tank to thoroughly flush everything down. Gone are the days of the “If it’s yellow let it mellow, if it’s brown flush it down” mentality of conserving water. I have installed many dual flush toilets and my customers have always been pleased with the planet and cash saving technology. Dual flush toilets come in as many style options as any other toilet and like anything, the fancier you want, the more you will pay. However, a dual flush toilet doesn’t have to be expensive. I have installed several Glacier Bay (Home Depot brand) and Aqua Source (Lowes brand) dual flush toilets which cost around $100. I have had no reports of problems with these less expensive models even after some have been in use for years.

df conversion kitIf you already have a high efficiency toilet that isn’t dual flush, conversion kits are available that replace the flush mechanism in your tank. These conversions are quick, easy and don’t require the removal of the toilet. While the packaging wouldn’t discourage a sale by saying so, these conversion kits do not work on toilets older than 1995 when the low flow technology became the standard. These kits cost from $30 and up.

Upgrading to any dual flush technology will quickly pay for itself with savings on your water bill and keep less of a life giving resource from going down the drain.

 

Momma Bear: Thoughts On The Flu

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My worst-case SHTF scenario: Facing a global pandemic. A pandemic that cuts all supply chains, destroys public services (electricity, water, medical, and government) and throws civilization into uncontrolled chaos.

sick w fluUnless you have had your head in the sand this past month, you are probably thinking about, and watching, this current flu epidemic. I took this as an opportunity to study up on the biggest global bout with the flu, known as the Flu of 1918 or the “Spanish Flu”. We’ve all heard how tons of people died from this flu (it killed 20 to 50 million people — 1 to 3 percent of the world’s population at that time). But there were three giant facts that surprised me:

  • This flu actually lasted two full years (1918-1920), and had three specific “waves” of infection at a time when the world population was not very mobile.
  • It killed quickly (in some instances only one day of symptoms)
  • It killed healthy people in the 20-40 age group (not the norm for flu related deaths).

We are a million times more mobile, as a population, than we were in 1918 so our transmission rates are much higher. Although we have modern medicines, we are also starting to see resistance to those medications. A pandemic is a very believable SHTF scenario.

stop the fluOur family got hit with the flu over the long holiday. Because we instituted some severe tactics, only two of us got moderately sick, one was minimally ill, and three escaped unharmed. When the first person became ill, it started quickly with chills, 102+ fevers, and a croupy, nasty cough. Initially thinking it was just a severe cold, he didn’t go to the doctor right away so he missed the two day window for Tamiflu but he did test positive for flu. The first thing we did was to isolate him to his room. When he wasn’t in his room he wore a mask, hand sanitized multiple times, did not touch any food/cupboards/fridge to serve himself, only used disposable plates and cups, and we sanitized the counter area where he ate. Medications he took, to treat the symptoms, were ibuprofen and MucinexDM (12 hour doses of guaifenesin and dextromethorphan) with moderate success (but he still felt crappy). The second person, our daughter, became ill by accidentally drinking from the first person’s cup. Like the first person, we isolated her at home and treated her with the MucinexDM. Unfortunately she got the vomit portion of the flu and she DID have to go to the emergency room for an IV to treat the dehydration migraine and vomiting. The last person to become ill only suffered from cold symptoms and chills. In all three cases, the people have suffered from a long term dry cough that has taken weeks to go completely away.

Isolation is the best method for treating a big flu outbreak. But in America that is something we just aren’t good at. We are very mobile and we insist on working, shopping and doing pretty much everything while we are sick (all the while spreading our germs as we go along). In Japan though, when we had a big flu outbreak, it was routine to close a public school down (or businesses or whatever) for a week and decontaminate it; while allowing the virus to, hopefully, work its way through the population AT HOME. What a great way to keep from infecting more people!

Medical masks are also key in reducing contamination rates in a mobile population but most people misunderstand how they work. When sneezing or coughing, germs can travel in the air up to six feet or so and remain active for hours. Masks are primarily used to keep an infected person from spraying their germs outward, NOT to prevent a person from breathing in germs. When you see pictures from Japan of people wearing masks, those are the sick people going about their lives while limiting their illness from transferring to others. This is a culture that is centered on being considerate and concerned with how their behavior affects others and it is considered rude to cough and hack in public and NOT wear a mask. Masks are available everywhere in Japan, including a big section at the dollar store where they come in all different sizes, colors and cartoon characters. But here in America you rarely see anyone cover their cough with a mask and most often that masked person is looked down on as being some sort of germaphobe. Our own cultural norms work against us when it comes to how we deal with illness.

mask & sanitizerIn a medical study testing the efficiency of masks at preventing an infected person from spraying their germs, it was found that N95 masks had the same effectiveness rate as a plain medical mask at suppressing the passing of germs into the air through coughing and sneezing. So the good news is that you can stock up on the plain and less expensive masks! You certainly can choose to wear a mask in an effort to prevent breathing in germs, though the masks are not air tight and germs can enter from the sides. You are also still susceptible to any surface contact with germs; they can live up to eigh hours on surfaces so it is important to wash your hands regularly, use hand sanitizer and clean any and all surfaces touched by an infected person. Similarly, most people are contagious with the flu for a day or two prior to experiencing symptoms. If you go out in public, mask or not, you are going to come in contact with the virus.

Our bout with the flu was by no means what I would term as a severe case because in both instances the fever was reduced by medications and overall the symptoms were manageable at home. My daughter suffers from recurring migraines so we do not necessarily consider her ER visit an acute occurrence of the flu. All that said, we were prepared to treat the flu here at home for an extended period of time if necessary, but how many “average citizens” have a stock pile of food, meds, masks, and sanitizer in their closet? Keep up the good preps folks, and cover that cough!

 

Sierra Kate: Reusables, Self-Reliance & Feminine Hygiene, Part 2 – How Do They Perform?

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Last week I wrote Part 1: Options, about alternative reusable menstrual products from a prepper perspective. However, potential users of a new alternative feminine hygiene product will also want to know how well it performs/functions. That is what I am here to discuss this week.

FIRST – OUR CHOICES:

Disposables

  • Pads & Tampons – semi-synthetic rayon
  • Pads & Tampons – cotton
  • Menstrual Cups – elastomer

Reusables

  • Pads – cotton
  • Tampons – natural sea sponges or cotton
  • Menstrual Cups (bell-shaped cup used internally) – natural latex rubber or medical-grade silicone

Let’s compare our options, shall we?

Reusable Menstrual Pads

Reusable Tampons – Sea Sponges

Reusable Menstrual Cup

 

SECOND – REVIEWING PERFORMANCE:

1. Comfort

  • Interior winner – Menstrual Cups. No internal options are felt, but cups win because they are non-drying and do not interfere with one’s healthy and natural lubrication or secretions.
  • Exterior winner – Unclear. It’s a trade-off; next to sensitive skin the winner is probably the more bulky cotton pad that is soft and breathable. But some prefer the thinner, less breathable rayon,  but it does have potential irritants.

2. Convenience

a) Capacity

Winner – Menstrual Cups. The 1-ounce cups have double the capacity of a max-absorbency tampon. That means half the bathroom trips!

b) Portability and Active Living

Winner – Menstrual Cups. You only need one cup at any time, they are easy to clean and there is no trash to hide. Cups are popular with outdoor enthusiasts, including wilderness backpackers. Also, the non-drying cup can be put in the day before you expect your period.

3. Cost

Winner – Menstrual Cups. Both reusable cups and pads last at least 5 to 10 years. A cup costs about $30 to $40; a commercial set of reusable pads about 2 to 3 times that. A set of two sponges costs $13 and last 3 to 12 months.

4. Health

a) Hygiene 

Winner – ALL. No menstrual products are sterile; however they are all sanitary with proper care.

b) Harmful Substances

Winners – Reusables. Processing rayon requires a lot of chemicals that are potential toxins or irritants that may leave traces in the final product.

c) TSS and Microbes

Internal Winner – Menstrual Cup. The cups smooth surface does not lend itself as easily to microbial growth; tampons, especially high-absorbency, seem to be associated with TSS, along with causing micro-abrasions.

d) Odor

  • Internal winner – Menstrual Cup. The menstrual fluid is not exposed to any air, which eliminates odor.
  • External winner – Cotton pads. Cotton allows moisture to evaporate, which reduces odor.

5. Environmentally friendly

Winners – Reusables

6. Anatomical Fit Concerns

For cups a good rule-of-thumb is if the person (this includes virgins) has no problems using tampons then they should be able to use cups. If you can’t use disposable tampons, but dislike pads, consider trying sea sponge tampons. At the bottom I’ve included a link to a positive review of them by a women affected by pelvic organ prolapse.

7. Learning Curve

Cups are more hands on, and require you to be comfortable, or willing to become so, with your body and intimate anatomy. Most users say it takes 2-3 cycles to get the hang of easily inserting and removing them.

8. Customer Service

Winner – Reusables. Companies of reusables are knowledgeable and helpful. They have to be, they mostly advertise by word of mouth.

9. Care, Cleaning, and Storage

Reusable winner – Menstrual Cup. The cup’s smooth surface is simple to clean. It is also easier to care for away from home than the reusable absorbent options. In a pinch, after emptying, if both the cup and your clean hands do not come into contact with anything else then it isn’t necessary to wash the cup before reinserting.

10. OKAY, but are they pretty?

Really…? Sigh. Yes! They have cute pouches. Many pads do come in awesome colours and patterns. A few cups come in bright pretty colours. Sponges, I think, already look decorative. And then you can make your own pads, tampons or carry pouches as beautiful as you like. What I find beautiful is how well reusables work. The disposable synthetic products, to me, are a disappointment, not just environmentally but from a health and performance point of view.

 

Disclaimer: I claim no special medical knowledge. I wrote from my personal experience with rayon products and menstrual cups; most of the rest was obtained from Internet research.

 

RESOURCES

Disposable 100% cotton pads and tampons:

Disposable menstrual cup: http://www.softcup.com/faqs

Reusable cloth pad brands:

Pads4Girls: http://lunapads.com/about-us/donate-pads

To make your own cloth pads:

Reusable sea sponge tampons

Reusable menstrual cups

Lastly, the following is a link to a story with a very rare concern with tampons that is not about rayon, dioxins, chemical irritants or even TSS bacteria. Open at your own risk of being utterly and horrifyingly grossed out: http://www.wfaa.com/news/consumer/Test-Results-Confirm-Mold-on-Tampon-147404735.html

 

Sierra Kate: Reusables, Self-Reliance & Feminine Hygiene, Part 1 – Options

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Contributed by Guest Blogger: Sierra Kate

Question: What can make you self-reliant for longer that uses up less space and money? Answer: Using reusable items instead of one-use disposables. I am here to discuss a much-neglected category under disposables: Menstrual Products. <Crickets>. Humour me for a moment and contemplate this, I read about one family that had an estimated seven years of tampons stocked. You want an idea better than that right? Consider reusables menstrual products. Believe it or not reusables are better in many ways, but that is literally a whole other post.

Pads, tampons, and menstrual cups all come in reusable forms. Reusable cloth pads are typically made of cotton, a breathable absorbent fabric. Commercial cloth pads are about $10 per pad. Many people make their own pads to reduce costs; there are plenty of how-to instructions on-line (see Momma Bear’s post: Home-Made, Reusable Sanitary Napkins). Cloth pads last 5 to 10 years. Commercial cloth tampons, or patterns to make them, are much harder to find, but they are out there. One non-cloth option is reusable tampons made from natural sea sponges, a 2-pack is $13, and they can last 3 to 12 months.

I favour the reusable menstrual cups. They are bell-shaped and are typically made from natural latex rubber, or silicone. About the size of a shot glass, they sit internally and collect menstrual fluid instead of absorbing it. They cost about $30 to $40 and last 5 to 10 years. You can easily increase your self-reliance by stocking up. Doing the math, 4 to 8 individual menstrual cups (or sets of cloth pads) could last a woman until menopause.

What about being able to make them yourself and be truly self-sustainable? Most people wouldn’t consider it on this matter, because it requires a lot of research and hard work, and the above options for self-reliance don’t take up a lot of space. But, out of curiosity, “what if”?

If you are interested in self-sufficiency when it comes to menstrual products you have a few options. Start with growing a natural fiber. Cotton (a sub-tropical bush), soft and absorbent, is the best option. The second best would be low-THC hemp (wide geographic range), however daft legal issues currently abound on this topic. Natural sponges have been harvested for millennia as luxury items; however this is dependent on a viable sponge population living nearby (such as Florida). Lastly, ones made from rubber. Natural latex rubber has many uses, and is created by curing latex, a milky plant sap. A tropical tree is used commercially; other sources of latex are guayule and common dandelions. Silicone rubber is made from silica (a sand used in glass-making) and other compounds and has been produced for about 60 years. You can find rubber mold-making-kits if you want to tinker, as rubber has all sorts of uses. The Native Americans made latex rubber for millennia but theirs may not have had the quality or consistency of modern rubber production.

Ironically, there are many other good uses for disposable tampons after TEOTWAWKI. There are a total of ten(!) survival uses in this article: The Swiss Army Survival Tampon – 10 Survival Uses.

So from a  self-reliance prepper perspective, stocking reusables is great. But perhaps you, or a fellow prepper, are not convinced. If you are wondering if this will work well from a user perspective, I use menstrual cups and I’ll tell why it is better in next week’s Part 2 post.

Sierra Kate’s Bio
Kate currently lives in small-city Canada and has just come across the world of prepping. What initially grabbed her interest in prepping is how well it fits in with her own intellectual inclinations and desires for a healthy lifestyle that has sustainability, self-reliability, utility and minimalism in mind. She enjoys solitude and her hobbies include reading and biking.

 

Momma Bear’s September Preps

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September has arrived and we are seriously looking forward to cooler weather! We decided to shut down the garden a little early in expectation of heavy duty leaf raking. I filled my two compost barrels with the old plant foliage and with the dirt from my container gardens (except the one I am waiting to go to seed). We will be augmenting the barrels throughout the winter with egg shells, coffee grounds, etc. The plan is to use the two barrels of compost to refill the containers in the spring.

As mentioned, my ham radio came and, as I thought, it’s complicated! But I am signed up to take my licensing classes next month. I even discovered that my town has a ham radio store!

Last week Trace mentioned the website aGirlandherGun.org. I met “Girl” at a mutual friend’s house where we had gathered to watch a football game.  Having never met her before, we were talking and something set my antenna buzzing. I finally looked at her and said, “Are you a prepper?” She is the first local prepper I have met! We had a great evening with lots of discussion about guns and self-protection. If you have not yet had a chance to check out Girl’s website, please do. She is a firearms instructor, and is also taking EMT courses with her husband. You will see that prepping is relatively new to her also, and for a very serious reason. Interestingly, Girl is the second woman fire-arms instructor I know (the other being Pistol Packing Ladies, LLC). So along that train of thought…the husband and I will be taking our gun class next week at the Nation’s Gun Show outside of Washington, D.C. This will allow us to apply for our concealed carry permits. Though neither of us have decided yet if we will carry, we want to at least prepare and get permits.

Lastly, I have moved fish antibiotics (see Trace’s post Antibiotics In Your Preps?), and books on medications, to the top of our prepper purchase list. This last week the husband “humped” out of the field with a very deep blister in the ball of his foot (If you are not familiar with this phrase, it means Marine Corps camping in which you train and hike 20 or so miles with a 70-80 pound pack, carrying everything you need to eat, sleep, and shoot). He had done everything right: changed his socks regularly, removed his boots to sleep, powdered his feet, etc. But he still managed to get one really deep blister. As a long time Marine and marathoner, my husband teaches others on the importance of foot care. Initially it looked okay, and there were no visible breaks in the skin. Medical opted not to drain the blister because it was so deep, saying he was “good to go” (military slang for fine). But within 36 hours his foot was swollen, red and angry-looking, and he was running a fever. It looked like he had a Fred Flintstone foot that was about ready to split open. We both knew he had a raging case of cellulitis and needed antibiotic treatment. Cellulitis is a bacterial infection which, if left untreated, can lead to a more serious–even life-threatening–type of infections known as sepsis. It can also be resistant to antibiotics, and it is not uncommon to have to take IV antibiotic treatment. In any event, my husband was fine once he started his antibiotics. I personally am allergic to a number of antibiotics, including the one he was treated with, so it is imperative for us to carefully stock the right antibiotics. This was a good reminder of how something as common as a blister can quickly lead to a serious health risk; imagine how you would treat this in a post-collapse situation…

What’s next on your prepper training schedule?

Momma Bear: Women’s Maladies

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Sometimes being a woman is really the pits. I imagine it will be even worse in a post-SHTF society where our modern, quick-fix, take a pill for it remedies are no longer available. I’m talking about those dreaded conditions that are almost exclusively “women’s ailments”: yeast infections, vaginosis, vulvitis, UTIs, hemorrhoids, leaky bladders, migraines and menopause. Bleck! So what is the best way to prep for these lovely maladies? Like other areas of preparedness, we need to tackle this with a multi-step approach.

Knowledge: Know your body. You need to be able to recognize the warning signs of an impending ailment so that you can attempt to prevent a full-blown illness. Know your genetic predispositions and history. Ask your mother, grandmothers, and aunts about what female health conditions run in your family. Heredity is a funny thing and frequently cannot be avoided. While you may maintain a painstakingly rigorous “healthy lifestyle,” sometimes nature still throws that heredity-curveball at you. You might be young enough that many of these have not yet happened to you, but at least study up and be prepared to recognize and treat them if they occur (to you or others). In my family we get three main conditions: hemorrhoids, leaky bladders, and menstrual migraines. The first two can normally be treated by surgery and the last can be controlled by using birth control pills and prescription meds. But what will we do without access to routine medical care and medications?

Prepare: If there are medications you can get that you might need someday, GET THEM and stock up. You might never have had a yeast infection in your life, but if you live someplace hot and humid and suddenly your life has no A/C, infrequent baths and changes of clothing (because you are washing everything by hand!), you might have a serious run in with a yeast infection. Stock up on any OTC meds that you can. The other way to prepare is to not put off those elective surgeries (this seems to have been mentioned in plenty of other articles). These days both leaky bladders and hemorrhoids can be treated with surgery, but they are not ones that most of us would rush right out to get. I think you will find that surgery is preferred over living with the problem in a post-SHTF world. Last, maybe cleanliness IS next to godliness. Keeping clean and dry will prevent some of these conditions from starting in the first place. The military has been doing this for years…with feet. Every time they stop, they change their socks because it prevents a plethora of foot ailments. I say every time you sweat too much, change those undies. If you can’t stay cool, at least stay dry.

Take your knowledge a step further: None of these ailments are new. How did they treat these ailments in the past? Or how do they treat them now in third world countries? Look for “old school” remedies. Read up, research, ask someone very old who grew up in a rural environment what they did. For instance, yogurt is a common treatment for yeast infections (and I am not talking about eating it). And here I mean all natural, home-made, BASIC yogurt, not the flavored variety they carry in the grocery stores today. Culturing your own yogurt at home is actually pretty easy to do, but few Americans do it. Drinking cranberry juice works well for treating UTIs. There are “alternative” treatments for a number of ailments, but most of us have grown up in a society where these remedies have become obsolete due to our easy access to medications.

It will take time to research and practice these remedies before the SHTF. But it’s better to practice it now when you don’t need the remedy desperately.  Like other types of medical care, it is best to study up long before the SHTF!

(Friday: What We Did This Week To Prep)

Triage For The Non-Medical Responder

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‘Who Goes First and Why’
—
I wanted to write today’s post with the goal of familiarizing a non-medical professional with the process of triaging. This would apply if you’re the first person to arrive–accidentally, or on purpose–at a multi-casualty trauma scene whether that happens in our current world, or after a collapse. Triaging is the same, you determine which patients need priority in transport and treatment. What changes after a collapse is the lack of resources available to care for the patients.

I felt I was very qualified to write this post. As a former military medic and civilian paramedic I have been involved in several actual Mass Casualty Incidents (MCIs) and many simulated MCI drills.

As I was doing research for this post I remembered that Dr. Bones, of Doom and Bloom, had recently written on this topic. At the time I had skimmed the information, feeling relatively confident in my ability to handle an MCI if needed. As I went back to review them for this post I realized anything I say would be redundant. Dr. Bones wrote three excellent and very detailed posts on triaging. They are complete with examples and are directed toward the non-medical responder. As I always say, Dr. Bones and Nurse Amy are my definite collapse medicine specialists (I reviewed their book The Doom and Bloom Survival Medicine Handbook a few months ago).

So instead of trying to reinvent the wheel I am reposting Dr. Bones first triage post:

The Mass Casualty Incident: Triage, Part 1

The responsibilities of a medic in times of trouble will usually be one-to-one; that is, the healthcare provider will be dealing with one ill or injured individual at a time.  If you have dedicated yourself to medical preparedness, you will have accumulated significant stores of supplies and some knowledge. Therefore, your encounter with any one person should be, with any luck, within your expertise and resources.  There may be a day, however, when you find yourself confronted with a scenario in which multiple people are injured.  This is referred to as a Mass Casualty Incident (MCI).

A Mass Casualty Incident is any event in which your medical resources are inadequate for the number and severity of injuries incurred.  Mass Casualty Incidents (we’ll call them “MCIs”) can be quite variable in their presentation.

They might be:

  • Doomsday scenario events, such as nuclear weapon detonations
  • Terrorist acts, such as occurred on 9/11 or in Oklahoma City
  • Consequences of a storm, such as a tornado or hurricane
  • Consequences of civil unrest or battlefield injuries
  • Mass transit mishap (train derailment, plane crash, etc.)
  • A car accident with, say, three people significantly injured (and only one ambulance)
  • Many others

The effective medical management of any of the above events required rapid and accurate triage.  Triage comes from the French word “to sort” (“Trier”) and is the process by which medical personnel (like you, survival medic!) can rapidly assess and prioritize a number of injured individuals and do the most good for the most people. Note that I didn’t say: “Do the best possible care for each individual victim”.

Let’s assume that you are in a marketplace in the Middle East somewhere, or perhaps in your survival village near the border with another (hostile) group.  You hear an explosion.  You are the first one to arrive at the scene, and you are alone.  There are twenty people on the ground, some moaning in pain.  There were probably more, but only twenty are, for the most part, in one piece.  The scene is horrific.  As the first to respond to the scene, medic, you are Incident Commander until someone with more medical expertise arrives on the scene.  What do you do?

Your initial actions may determine the outcome of the emergency response in this situation.  This will involve what we refer to as the 5 S’s of evaluating a MCI scene:

  • Safety
  • Sizing up
  • Sending for help
  • Set-up of areas
  • START – Simple Triage And Rapid Treatment

1. Safety Assessment:  Our friend Joshua Wander (the Jewish Prepper of blogspot fame)  relates to us an insidious strategy on the part of terrorists in Israel:  primary and secondary bombs.  The main bomb causes the most casualties, and the second bomb is timed to go off or is triggered just as the medical/security personnel arrive.  This may not sound right to you, but your primary goal as medic is your own self-preservation, because keeping the medical personnel alive is likely to save more lives down the road.  Therefore, you do your family and community a disservice by becoming the next casualty.

As you arrive, be as certain as you can that there is no ongoing threat.  Do not rush in there until you’re sure that the damage has been done and you and your helpers are safe entering the area.  In the immediate aftermath of the Oklahoma City bombing, various medical personnel rushed in to aid the many victims.  One of them was a heroic 37 year old Licensed Practical Nurse who, as she entered the area, was struck by a falling piece of concrete.  She sustained a head injury and died five 5 days later.

2. Sizing up the Scene:  Ask yourself the following questions:

  • What’s the situation?   Is this a mass transit crash?  Did a building on fire collapse?  Was there a car bomb?
  • How many injuries and how severe?  Are there a few victims or dozens? Are most victims dead or are there any uninjured that could assist you?
  • Are they all together or spread out over a wide area?
  • What are possible nearby areas for treatment/transport purposes?
  • Are there areas open enough for vehicles to come through to help transport victims?

3.  Sending for Help:  If modern medical care is available, call 911 and say (for example):  “I am calling to report a mass casualty incident involving a multi-vehicle auto accident at the intersection of Hollywood and Vine (location).  At least 7 people are injured and will require medical attention.  There may be people trapped in their cars and one vehicle is on fire.”

In three sentences, you have informed the authorities that a mass casualty event has occurred, what type of event it was, where it occurred, an approximate numbers of patients that may need care, and the types of care (burns) or equipment (jaws of life) that may be needed.  I’m sure you could do even better than I did above, but you want to inform the emergency medical services without much delay.

If the you-know-what has hit the fan and you are the medical resource, get your walkie-talkie or handie-talkie and notify base camp of whatever the situation is and what you’ll need in terms of personnel and supplies.  If you are not the medical resource, contact the person who is; the most experienced medical person who arrives then becomes Incident Commander.

4.  Set-Up:  Determine likely areas for various triage levels (see below) to be further evaluated and treated.  Also, determine the appropriate entry and exit points for victims that need immediate transport to medical facilities, if they exist.  If you are blessed with lots of help at the scene, determine triage, treatment, and transport team leaders.

5. S.T.A.R.T.:  Triage uses the acronym S.T.A.R.T., which stands for Simple Triage and Rapid Treatment.

The first round of triage, known as “primary triage”, should be fast (30 seconds per patient if possible) and does not involve extensive treatment of injuries.  It should be focused on identifying the triage level of each patient.  Evaluation in primary triage consists mostly of quick evaluation of respirations (or the lack thereof), perfusion (adequacy of circulation), and mental status.  Other than controlling massive bleeding and clearing airways, very little treatment is performed in  primary triage.

Although there is no international standard for this, triage levels are usually determined by color:

Immediate (Red tag): The victim needs immediate medical care and will not survive if not treated quickly.  (for example, a major hemorrhagic wound/internal bleeding) Top priority for treatment.

Delayed (Yellow tag): The victim needs medical care within 2-4 hours. Injuries may become life-threatening if ignored, but can wait until Red tags are treated. (for example, open fracture of femur without major hemorrhage)

Minimal (Green tag): Generally stable and ambulatory (“walking wounded”) but may need some medical care. (for  example, 2 broken fingers, sprained wrist)

Expectant (Black tag): The victim is either deceased or is not expected to live.  (for example, open fracture of cranium with brain damage, multiple penetrating chest wounds)

Knowledge of this system allows a patient marking system that easily allows a caregiver to understand the urgency of a patient’s situation.  It should go without saying that, in a power-down situation without modern medical care, a lot of red tags and even some yellow tags will become black tags.  It will be difficult to save someone with a major internal bleeding episode without surgical intervention.

In the next part of this series, we will go through a typical mass casualty incident with 20 victims, and show how to proceed so as to provide the most benefit for the most people.

Dr. Bones

Links to Doom and Bloom follow-up posts:
Mass Casualty Incident: Triage, Part 2
Mass Casualty Incident: Triage, Part 3

(Friday: What We Did This Week To Prep)

Hand Washing Laundry

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We’ve decided that our next prepper goal is to be able to hand wash laundry. Washing machines require lots of power and lots of water, if you’re without either of those doing laundry gets much harder. Though we now do laundry every week, in a collapse it will not be as high of a priority or done with that frequency. But cleaning clothes and linens will still be important because they will last longer, keep us healthier, and overall improve moral and make life feel more “normal”.

We’ve never hand washed laundry before, so I began doing research on the process and what equipment we would need. There were several variations of the basic idea:

  • Use a washboard to scrub off stains. Apparently, contrary to popular opinion, washboards are smooth and won’t damage the fabric. They’re said to be a relatively easy way to remove stains.
  • Fill a tub full: This could be anything from a bathtub, a kitchen sink, a 5-gallon bucket, or an old fashion washing tub. Fill with cold, warm, or hot water as needed.
  • Add soap: From my reading I’ll probably just use a small amount of dish detergent. If you use laundry detergent use a very small amount; if it’s powder detergent dissolve it first in water before adding. Historically a bar of soap was grated into the water. You need to find the balance of enough soap to clean the clothes while avoiding too much soap that will be difficult to rinse out. Let clothes soak for at least 30 minutes before washing.
  • Agitate the clothes in the water: It looks like the easiest thing to use would be a clean (preferably new) toilet plunger. We found a ‘Tin-Plated Steel Washer’ in the Lehman’s catalog which looks like a metal plunger. Lehman’s states, “Just plunge up and down to force soap and water through clothes and linens — it’s that simple.”
  • Rinse the clothes, probably more than once. Soap left in the clothes will break down the fibers.
  • Wring the water out of the clothes: This can be done by hand, or much more efficiently with a hand wringer. Again in Lehman’s they state their hand wringers “. . . remove up to twice as much water as a spin dry.”
  • Hang the clothes to dry: This can be done either outdoors on a traditional clothes line, if weather and temperatures permit, or inside on drying racks. (Remember to get clothes pins for outdoor drying.)

So that’s the process. Our plan is to buy:

  • A washboard (Lehman’s $16 – $23)
  • Two galvanized wash tubs (about $40 – $50 each), they’re a good size and easily portable, plus they also have many other uses.
  • A Tin-Plated Steel Washer (Lehman’s $18.95).
  • A hand wringer (wide range of prices and quality).
  • A large indoor drying rack. Living here in the Pacific Northwest we’ll probably have to dry inside most of the time.

Once we get everything we’ll give it a few test runs and, of course, I’ll post about how those go.