Discussion in 'Survival Medicine' started by melbo, Aug 4, 2005.
What's up with that "read first post?" I was just gonna call if I had an emergency........
If I can ever get phishi to drop into this spot, he'll want a disclaimer. as a RN in training, he's not really supposed to be handing out advice.
I just don't want to get sued over someone stuffing a rag in a bullet hole and getting gangrene
Duely noted for the record..........
I'll post when I can get my head back above water.
Phishi is currently in a program that crams 3 years of study into one. Not a lot of free time and it's do or die.
At this point , you're all we have so..... poof, you're the Medic/Mod
Um.......Thanks. I'll do my best, you might have to bail me out once in a while.
If you need help I think my wife would love to help out.
She's a Med student.
Not in school, LOL, but with being a mod.
Roger mis-understood ya.
phishi - we can all help you.
Well I was just about done with my post on medical bags and the damn power went off so I lost everything. So starting over on this thing. I got to thinking about medical bags when someone stated that they really didn't have much of one and didn't know what to buy. I can only give you a idea of what I have in mine, But first the disclaimer....
Your medical bag should contain what you are trained to use. If you don't know how to use it don't carry it. Without proper training you may end up making the situation worse or killing someone, which, at some point will come back to haunt you. So if you want to get more advanced in your medical bag get the training first. I also am not a Dr. so take this as it's intended just advice. Now since we got that out of the way lets get on with it.
I don't want to step on any toes so if that happens I apologize. So lets get going.
First thing we need is the bag. If you go to buy a actual medical bag you are going to end up spending anywhere from 50 to 150.00. Furthermore the bags are designed to attract attention so their colors are hunter orange, yellow etc. If you want to buy a "tactical" bag then your looking at the upper range of prices. Buying a backpack is a good idea but since it doesn't have many pockets on it you are going to have to layer things which means digging for stuff when you can least afford the time to do so.
A solid cheap alternative is to go to your fabric store and buy some heavy duty denim. This way you can add extra layers to the bottom and straps which are going to take the most abuse. You can dye it any color you want and add pockets on the outside for easy access.
As far as contents this is pretty much mine. Some things the average person won't have or need (see disclaimer) but alot of it is over the counter type things. If you folks see somthing that I don't have let me know the goal is to have a good medical kit, and my feelings don't get hurt that easy... hell I claim to know Quig. Lastly these are in no particular order to buy but the top five I would recommend heavily as first purchases.
1. Blood pressure cuff:
You'll use it alot to get a quick general idea of what a persons body is doing. Plus if needed you can use it as a restrictor cuff to stem the flow of blood from a massive wound.
These range from 20 to 450.00 I would say a 40 or 50.00 one is all you will ever need. You'll need one anyway to go along with the B/P cuff. If you can find a package unit with both of them great. Just make sure they are seperate pieces.
You can buy one of the old types or a new battery operated one either work fine the batt. type is faster tho'. If you do get the battery one make sure you have extra batteries and rotate them regularly.
4. Info sheets:
This doesn't cost you a dime. Get height, weight, age, dob, blood type, B/P, allergies, ANY surgerys; when, what for, outcome. Medications their on, dosage, frequency of use. Immunization records, last check up, dental records in short you want to know as much as any medical file they may have somewhere. If they can get you a copy of the file so much the better.
5. Medical books/ training.
The more you know the better off you are. Sounds stupid but remember sometimes the best ideas sound mudane.
From here on pick these up as you can.
6. rubber tubing / or strap to use as a restrictor.
7. Alcohol Gel: works great comes in all sizes of bottles just remember you will be using this stuff alot so.... also get the regular stuff it doesn't have to be scented.
8. Calamine lotion: Works great for stings ,no see ums etc.
9. Betadine: skin cleaner and great germ killer.
10. Triple antibiotic: we all know what this is for.
11. CPR mask: self explanitory
12. Eye patches:
13. Band Aids: A couple boxes of Lg, Med, Small. (the assorted ones tend to give you alot of small) Also a couple of boxes of butterflies.
14. Peptobismal caplets: Better than carrying the liquid work just as fast.
15. Anti-acid gum: works well and stores long and light in weight and size.
16. Throat Lodgenzers: Get what ya want I prefer the "Fishermans Friend" don't taste great but work well. Also if you have a diabetic in the group have them buy the type they can use.
17. Vivarin: don't use it often but when ya need the pick me up....
18. Anti-Diarrheia: Caplets or tablets. No liquid to bulky
19. Stool softeners: see above.
20. Dramamine: Some people just need it.
21. Aspirin: You are going to use this the most buy in bulk. rotate regularly.
22. Tylenol/ Motrin: some people can't take asp. Still buy it in bulk rotate reg.
23. Misc. Meds: Think sinus meds, otc allergy meds etc.
24. Tounge depressors: buy a box of em. Most the time you won't use em but on smaller children they work.
25. Splints/ Air splints: get assorted sizes and types. You can't cover em all but a good selection doesn't hurt.
26. Snake Bite/ Sting Kit:
27. Ben Gay: Get what ya want here. I use Bio Freeze I think it is about the best on the market but we know what opinions are like.
28. Ammonia Inhalant: Nice to have every now and then.
29. Slings: You can buy them or make them. use a good dense thread count sheet and cut it into triangles about 3'x3'. This way you can use them as slings or wraps.
30. Wire and Plaster: Just in case you have to make a old fashioned cast.
31. Ace wraps: Look at getting a couple of the smaller ones and one of the 3", 4", and 5".
32. Knee/Wrist braces: work better than the ace wraps and save the wraps for other purposes.
33. Oxygen Tank and masks:
34. Rubber Gloves: Buy a box or two theres only about 50 pairs per box.
35. Super Glue: Sounds crazy but works great for smaller cuts. Just remember to rotate it regularly.
36. Ambu Bag: Unless you've got the training don't get it.
37. Tampons and Pads: They work great on larger cuts and their self adhesive. Tampons are sterile and work on stopping bleeding on penetrating wounds.
38. 4x4, 3x3, 1x2's: Pick up a couple of boxes at least. They don't go bad and are sterile till opened. The 1x2's will be the most used.
39. Ashelmen Seals: not bought otc. If you get them you'll have to order them from a medical warehouse and expect to pay ALOT for a few of em.
40. Mole Skin: buy a butt load. You'll use it, and it never goes bad.
41. Space Blanket: Obvious reason.
42. Intubation Tubes: As far as I know Not bought otc and if ya don't have the training don't try.
43. Sheets: Get the High tread count wash them and put them in a ziploc bag.
44. Tweezers: Another no brainer.
45. Gold Bond Powder: Is ohhh so nice on those lil places that rub and chafe.
46. Pen light: Use it to check pupils, look in ears, nose, throat etc.
47. Insta Ice Packs: These aren't cheap but well worth it. Just remember these are a one time use only. So either invest a small fortune in them or use sparingly.
Well thats it. I hope I didn't bore you folks to death or worse yet put you to sleep half way through it. Like I said at the top I don't mean to step on any toes and hope I haven't. If you folks see anything that needs to be added let me know.
Take care Be safe Poacher.
Not bored at all. I have some of that stuff, but some of what you list is on my list of things to get. It is an excellent start for a heavy bug out or bug in. Thank you.
Your welcome Ghrit. Yeah it can be a heavy BOB or bib, but I run a scaled down version for the most part. Obviously you aren't going to go around with everyones med file but those are nice to have as long as you keep them updated.
Take care Be safe Poacher.
Ok after I finished this decided should make sure it was clear from the start Im not mad at anyone for anything theyve said here, just passionate about the topic.
One thing I would have to disagree with, while I understand the reason why it is stated I have to say that while BY FAR the best option is to get the training before you need it, if it is a critical situation and trained personel are not there to do what needs to be done DO WHAT YOU CAN ANYWAY.
Like I say its far better to get the training before hand and by all means if someone is right there that dose know what they are doing then get out of their way unless asked for help and let them do it, but one of the big examples I noticed was where you mentioned on the intibation that if you are not trained on it dont try it, I have to say if they cant breath or the heart has stoped and help is not there then do whatever you can think of even if it may be wrong because if you dont then theres basicly no question they are going to die if you try and get it wrong they may be maimed to some degree or may die but they also may live which is a lot better chance than they have if you do nothing.
I made the mistake of falling into that mindset at the worst time possible (along with the mindset of help is only seconds away) early last year when I went to pick my buddy up from the hospital (they said he was fine to come home with some pills and be ok) and he coded in the parking lot under their chopper pad and within 100 yards of the ER where they had an empty ambulance setting. I only knew the CPR that anyone whos watches TV knows and the very basics from some demos and since we were at the hospital, and he didnt fit the norm (500 lbs, COPD, osteoperoses, etc.) I didnt know if the same things would apply for CPR or if they would cause more damage like tearing the lungs from mouth to mouth or some such so just tried to turn up his O2 to saturate his lungs for how ever much good could do and wait for the 'pros'. Well had to wait over 30 minutes and he died.
Basic point is that while there is no question it is by far best to be trained on what to do and how to do it properly and such, if you havent gotten the training before you need it AND theres not someone who has RIGHT THERE then I would have to say that it is far better in a CRITICAL situation to fake it and hope for the best rather than stand there and wait while they die. This also (I hope its obvious that was my thought) dose not apply the same to things which are not imediately critical where the person will be able to survive without help for 30 minutes or an hour or whatever untill help gets there. If they have a pipe in their leg and you are not a Dr then dont screw with it, call help, keep them awake, calm and do what you can to prevent shock and wait for the folks who know what they are doing but if they cant breath or the heart aint pumping you are not going to do any more damage by doing something wrong than by doing nothing unless you make them look worse in their casket.
I understand about your post and no I don't see how it could be taken that you were just mad. Yes there are situations where doing anything is better than nothing.
That being said there are a few things where the haven't been trained don't try is applicable. The intubation tubes does fall into that catagory. Since it is a tube that goes down the throat to hold the airway open and move the tounge out of the way if it is put in wrong you end up blocking the airway or knocking the tounge down the persons throat.
You also have a valid point in the learn it before you need it. I think that anyone that is going to have a complete kit needs training, it just goes hand in hand. If you prefer to recruit someone that has the training great, but basic knowledge and cross training should be manditory IMO.
Take care Be safe Poacher. (WUHOOO the big 50 post.)
Congrats on the 50th. If you got this far, you might stay around. Please do.
When the tribe gathers, a couple EMTs will be very welcome with the training they have in trauma and to a lesser extent long term care. We need to find and cultivate an MD, too.
I see two trains of thought on Med Kits.
Only have what you know and can use and have everything so if SHTF and you discover a Doc walking up the road he/she can help out.
I know phishi is pretty steadfast on only letting me have what he can show me how to use. I can see that logic and so I don't worry about trying to have a Vent for my future MASH tent. Same with that IV pump I saw on Ebay.... But, I do believe in preparing for the worst in everything I do.
I have never sewn a wound but I have sutures. I think I have a few sets of staplers too. I also have quite a few books for reference.
Good stuff here. Thanks Poacher. I had forgotten about this thread
A knowledgable herbalist may be of even more use than a Dr in a long term situation since most modern Drs wouldnt have a clue what to do for you if there wasnt a pharmacy to fill the Rx and they didnt have all the lab to send all the stuff to with all the equiptment to tell them what was going on. Even on a lot of trama stuff if they had to do surgery for instance with no power and no modern conveniences or meds. If you have a knowledgable enouph herbalist though then most areas have plants that can be used and or combined to fix a majority of things. The EMT would most likely be of at least as much use as the Dr if not more after the stocked meds run out especialy.
MM and others,
I take a bit of a different take concerning who would be best as a medical care provider in a SHTF situation. First, anyone with any training is better than someone with zero training. There are situations where doing the wrong thing is just as bad as doing nothing. Training can let you know what your limitations are, when you should push them, and when it really is not going to make a difference.
An example is CPR in a wilderness setting (defined as a higher level of medical care being greater than 2 hours away). CPR in and of itself can wipe you out. Now imagine that you must transport the individual over rough, uneven terrain, while still performing CPR. For the record, you would need to have a team (read as greater than 3, hopefully 5) to pull this off. The chance of the patient surviving this ordeal is tiny. The odds of a member of your team getting injured is magnified. Now you have a choice to make, do you continue giving CPR, knowing that you have to also transport a second patient? Sometimes the heroic measure is not worth the cost. Training and good situational awareness can be a huge asset when the chips are down.
Getting back to who is better at what.....
IMO, the ideal individuals to have would be an ER doctor, nurse practioner, or nurse. These individuals are, in my experience, the closest one can come to a "country doctor". Yes it could be argued that they are worthless without a lab/x-ray/CT/MRI/insert your argument here. However, on a daily basis they also see the most variance in what they are treating. Anything from a simple scrape to a full blown code will occur over the length of their shift. As a result, they are the least specialized, and there for the most likely to have seen, what ever needs to be treated.
ER doctors have the license and training to stay out of potential legal problems that may occur while running an out of the way aid station. If a SHTF situation was to reverse itself, they would likely have the least amount of trouble from a government curious as to what exactly was going on there. ER nurses, while trained to give both short and longterm care must still practice under the license of a doctor. As such, they could have some serious questions to answer when things return to normal. Nurse Practioners are a hybrid of a doctor and a nurse. They can write scrips, but still must have a doctor sign off on what they are doing. They would probably have some questions to answer, but would be in a better situation than a nurse if they where to step out of their scope of practice.
EMTs and Paramedics would be next on the list. They are trained to stabilize a patient on the scene and transport to higher levels of medical care. They are not trained in long term medical care, making them useful,but only to a point. Please do not think that I am coming down on this profession. They are a needed part of medical care, and do recieve some unique training that doctors and nurses do not. However, they are best in the field, not running an aid station. Best bet would be someone with Wilderness EMT or Wilderness Paramedic certification. Those individuals would be used to longer care times and transporting patients over rough terrrain.
Herbalists are, IMO, the future pharmacologists of a SHTF situation. That means that they are good at handing out something to fix what ailes you, not diagnosising what that maybe. I believe that they would have incredible value working with a current mainstream medical care provider. They would be someone that I would seek out to include in a group, but I would not place them as the only medical care provider available. They have unique skill sets, but they are lacking in areas such as trauma.
just my .02
Would have to agree with your ideas as to what medical folks would be best ESPECIALY if it was something moderatly short term like say the NO thing or anything like that and even on longer term for tramma. My main point was in a full blown TEOTWAWKI situation and especialy with say a general practicioner. Just figure many would be totaly lost with no stocked hospital and figure most long term care would be less of an issue since with no meds if good food and rest dont fix it after stopping bleeding and such then not much could likely be done beyond comfort them as they pass.
The herbalists value would depend GREATLY on the particular herbalist. I for instance know a little but by no means enouph to be of much great value if couldnt buy the herbs and had no one to aid in diagnosis but have known a couple who could diagnose better than the labs and knew every plant in their area and one who knew at least most on the globe to an absolutely amazing level.
Another health person not mentioned often that would be of supreeme value in a long term situation would be a dentist. Anyone ever have a rotten or broken tooth and no insurance or money to get it fixed for a while? Been there done that and if there had been enouph to get ahold of with pliars it would have come out sooner since a ball bat to remove it would have been much less painful. Someone who can fix or remove teeth and especialy if they can make dentures from basic materials would be sought out by folks for miles around and valued at least as highly as other Drs if not even more so after a time. Granted the dentist would also not be able to do very well at makeing it like the modern 'painless dentistry' without supplies but at least if they can run a still they may be able to get it done a bit easier.
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