Medical Myths That Drive Me Nuts!
First off please do not take this as encouragement or advice. This article is strictly theoretical so stay safe and legal!
My background is a couple of decades in trauma intensive care nursing and recently the excellent article on this site Ultralight Get Home Bag List prompted me to make a long-winded critique comment in which I said “One N95? Carry ten. Pandemic one is worse than none. Hum. Maybe an article about that is needed!” and so this is that. I also have a few things to say about wound care, hand washing, dealing with the dead, euthanasia, and suturing based on reading and viewing a few prepper articles.
Supplies below are obtainable from a Pharmacist or a friendly nurse but the suggestions to obtain prescription medications and equipment is, as I said, theoretical, and do not do so as it is likely to be both illegal and dangerous.
I look forward to the comments and I expect you all to be rough on me
N95 Masks
These are seen as the gold standard for pandemics and gas/smoke situations.
For gas/smoke they might help a bit but frankly a wet bandanna or a specific smoke hood/gas mask is the prep.
In pandemics they reduce but never eliminate the chance of droplet infection. The 95 means 95% of suspend particulate in the air won’t be inhaled IF you are using it right. So avoid heavy breathing and looking into people’s mouths!
In a pandemic you will need these. I’d suggest 100 per individual for urban preppers. More if you can get them as their cash value will soar.
In my get home bag I have four not one. They last about 20 minutes to one hour depending on your activity level. You breath out moisture. They rapidly fail when damp. They won’t be of much use beyond that except as a reminder to never, ever touch your face/hair. In rain, especially heavy rain keep 6-12 feet away from people and you will be fine without a mask. In dry conditions stay 12-20 feet away.
3M 8511 Particulate N95 Respirator with Valve
Shave your mustache and beard if you feel the need to use one.
Put it on with the bottom strap under your ears/on your neck. Then pull the top strap over your ears and touch only the nose bridge area (it should be metal) and tighten it by pressing. After this do not touch it except to discard. Wash your hands, remove the bottom strap pulling it over your head, and then pull it swiftly off using the top strap. Never, ever treat the discarded mask as anything but a germ laden death trap. Into a plastic bucket by dropping it in and then close it tightly. Then wash your hands.
They cannot be reused and they should never be dangling under your chin and then reused. Do not draw lips on them either. It looks cute but puts you at risk. They are ideal to put on if fleeing a train or stadium. They are required to deal with new people or the ill.
Wound care
Some people seem to believe that antibiotic ointments are antibiotics and seem determined to use them for all wound care. The amount of antibiotic is minimal.
There are two types of wounds – superficial and deep. Clean both with sterile normal saline [0.9%]. The deeper ones really need flushing. The superficial wounds dab away with sterile gauze. Remove all foreign objects using your tick forceps (you have these right?). Use antibiotic ointment to cover superficial wounds and burns. Lightly apply it not thickly. Cover lightly if large and leave open if small. Reapply three times a day.
Deep wounds should never have antibiotic ointment put in them. It is not sterile and is really hard to remove when doing three times a day cleaning. Nor should you shove tampons, etc in unless you can easily remove them and the bits of cotton wool that flake off. Use saline and squirt it in.
Remember blood is dramatic and always looks much more than it is. In survival if the patient is talking to you it is not the time to panic and if they are unconscious should you be using supplies on them at all?
Loosely pack all deep wound fully with sterile dressing gauze or those quick blood stop sterile packages. Around deep wounds and burns the antibiotic ointment is awesome to promote healing. Yes use tampons if you have no real gear but I’d not count on survival as likely. If you have real antibiotics use them on people with deep wounds day one.
For deep and superficial wounds I use 3% hydrogen peroxide for the first cleaning. Bubbles and does not hurt. Great to push out debris but then flush well with saline as it will retard healing. However debris left inside the body will cause sepsis and death.
Hand Washing
Few prepper videos ever show hand washing but it is the single most important medical prep there is.
In most scenarios a simple bottle of hand sanitizer will work but plain old soap and water works better, is cheaper, and can be made long after Costco closes. Sure you can make alcohol and use it but I’d rather drink my post SHTF alcohol and sell it. Basic hand washing before eating and drinking seems forgotten by many yet hand to mouth spread of germs is one of the most common way people die in many less developed parts of the world. Boil your water but wash your hands first every time!
For medical stuff have all rings, watches, paracord bracelets off, and wash for two minutes with soap under running water starting at the finger tips and going up to both your elbows. Do this if a radiological or biological event has occurred before entering your retreat and do it again after changing your clothes.
Dealing with the Dead
The problem is likely not germs or disposal as is often thought. It is the post STHF Coroner!
Avoid them wherever possible especially if they are moldy or wormy. If a loved one dies during a pandemic photograph their illness, take dated notes, and then use trash bags with duct tape to make a body bag. Remove them and bury them 3 feet (6 to 10 feet is ideal) underground away from water sources. Cover this with heavy wood and rocks. Photograph everything in case a post SHTF Coroner shows up. You do not routinely need an N95 mask or gloves for the freshly dead unless it is a pandemic. The dead will expel gas and body fluids. That will freak you out until you get used to it. If you leave them a few hours they will go rigid and are much easier to move but beware as they will be dead weight!
Euthanasia
This remains illegal so I am in no way suggesting it as a solution.
Theoretically I would have an ample stock of rapid acting insulin {Humulin R} and a syringe. Injecting 1-2 ml of the 5ml stock into a vein will likely cause overwhelming glucose movement and rapid death. Expect a seizure but they won’t feel anything and death will be rapid. 1ml is 100 units. A lot of nonsense is said about storing insulin but it is fine at temperatures below 20C so use a root cellar in hot climes. As with everything it will expire gradually so just up the dosage.
The newly dead by this method are also edible so a theoretical solution to pet concerns in a really bad SHTF scenario. Again photograph them (humans not Fido!) and then after they are dead. Do not mention euthanasia or insulin ever to anyone. As I said this is theoretical but if you have to kill only a bullet is nicer than this. Lots of aspirin and Tylenol works but they cause a hideous death that is prolonged. Massive narcotics would be ideal if available but insulin will be much faster.
Suturing
This seems to becoming a growth area in prepping yet steri-strips work better and are less invasive for smaller wounds. The October 2015 Apocabox had some cheap ones (sorry Creek!) but most nurses can grab much better ones.
Practice and use sterile sutures. Do not pull them tight as you want the edges of the wound to be touching but not rammed hard together. Remove them Day 7 or 14 and take alternate ones out the first days. Stop if obviously infected. Treat as fresh wound and consider opening it up and flushing with saline again and restarting the suturing. If you use normal sewing thread please, please boil it and needle for at least 30 minutes before using it and avoid touching it afterwards. Sterile is the goal not merely clean for anything you insert into the human body in a medical situation.
Take a course in wilderness medicine but really you need to talk an ED or ICU nurse into joining your group. MDs and Vets are great but many of us nurses are the ones who actually deal with the stuff and figure out how to treat rather than just ordering treatment.