What You Won’t Have…

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

For part 2: http://www.doomandbloom.net/2012/05/the-mass-casualty-incident-triage-part-2.html

For part 3: http://www.doomandbloom.net/2012/05/the-mass-casualty-incident-triage-part-3.html

To learn more about survival medicine, visit Dr. Bones and Nurse Amy’s website www.doomandbloom.net

Many of us have first-hand accounts of what being without heat for a period of time feels like. Although I live in Texas where the cold weather is nothing compared to what some of you go through, there have been a handful of times where I have woken up to the after effects of a winter storm knocking out my electricity and immediately felt worry and panic about keeping my babies warm enough.

If you live in an area that experiences extremely cold temperatures, aside from a fireplace and an ample supply of firewood, the number one thing to invest in for your survival retreat is a gas oven/stove as opposed to an electric one. When the power goes out, the gas usually stays on, and there is no better way to heat a powerless house (or kitchen at the very least) than with 4 gas burners on high. Wood or pot-belly stoves work well too, and when you have one in the basement as backup to your normal electrical furnace, it sure does come in handy.

We Are All At-Risk for Hypothermia

People can develop hypothermia with temperatures above freezing. The fastest way to become hypothermic is being in the cold with wind and rain. In this case, you body loses heat 25 times faster than it would by just being out in the cold.

When the cold hits the body and the core temp drops, your body will kick into survival mode by cutting off circulation to the outer extremities first, like when a lizard detaches its tail. The fingers, toes, nose, ears, and lips are the first places your body ceases to keep alive when faced with death by freezing. These are also the first parts of the body to show signs of frostbite.

Older individuals and small children are at the greatest risk of hypothermia. Diabetics and those who suffer from low thyroid levels are also more at risk. However, anyone who is subjected to the elements long enough will surely be affected.

According to The Doom and Bloom Survival Medicine Handbook by Joseph Alton, M.D. and Amy Alton, A.R.N.P., the body loses heat in several ways:

• Although alcohol may give you that “warm” feeling,  it actually causes your blood vessels to expand, resulting in more rapid heat loss. This also goes for recreational drugs. Sorry guys.
• Unprotected body surfaces such as the head, ears, fingers, etc.
• Direct contact with anything cold, especially over a large area of your body, will cause rapid cooling of your body core temperature.
• Wind chill is an important factor that causes heat loss. Wind removes body heat by carrying away the thin layer of warm air that exists at the surface of your skin.

Look for “Umbles”

The best way to identify someone with hypothermia is to look for the “umbles” – stumbles, mumbles, fumbles, and grumbles. Changes in a person’s behavior may indicate that the cold is affecting how well their muscles and nerves work. If you suspect that someone is suffering from exposure to the cold, take his or her temperature. If their body temperature is 96 degrees or lower, then emergency measures must be put in place. Dr. Doom and Nurse Amy also state that if left untreated, hypothermia leads to a complete failure of various organ systems and to death.

People who develop hypothermia due to exposure to cold are also vulnerable to other cold related injuries, such as frostbite and immersion foot.

Frostbite, or freezing of the body tissues, usually occurs in the extremities and sometimes the ears and nose. Symptoms include:

• “Pins and needles” sensation and numbness.
• Skin color changes from red to white to blue. If the color then changes to blacks, a condition known as “gangrene” has set in. Gangrene is the death of tissue resulting from loss of circulation. This usually results in the loss of the body part affected.

Immersion foot causes damage to nerves and small blood vessels due to prolonged immersion in water.

• When seen in areas other than the feet, this condition is referred to as chilblains.
• Immersion foot appears similar to frost bite, but might have a more general swollen appearance.

How to Treat Symptoms of Hypothermia

Dr. Doom and Nurse Amy also suggest the following steps be taken to treat someone who has been exposed to frigid temperatures and may have symptoms of hypothermia:

1. Get the person out of the cold and into a warm, dry location.
2. Wrap the person in blankets, towels, coats – whatever is handy. You can also use your own body heat to keep the person warm. Lie close to the victim but be gentle if you rub their arms and legs because an older person’s skin may be easily damaged.
3. Monitor breathing. Begin CPR if necessary. While you are monitoring them, take a  moment to look for any signs of frostbite and immersion foot.
4. Share body heat.
5. Give warm oral fluids that are nonalcoholic.
6. Use warm compresses. Apply a compress to only to the neck, chest wall or groin. These areas will spread the heat much better than putting warm compresses on the extremities, which sometimes worsens the condition.
7. Don’t apply direct heat. Don’t use hot water, a heating pad or a heating lamp to warm the person. The heat can damage the skin or cause strain on the heart and even lead to cardiac arrest!

Keep the C.OL.D. Away

The best way not to be subjected to hypothermia is to prevent it through layering the clothing and preventing the loss of body heat. Moreover, if you find yourself spending long hours outside in cold weather, prepare accordingly and wear plenty of warm layers, have a ready supply of hand and feet warmers on stand-by. Remember that when all power, gas, and wood run out, your only option is to layer up liberally.Therefore, keep the C.O.L.D acronym in mind when you are out in the cold weather:

Cover. Protect your head by wearing a hat. This will prevent body heat from escaping from your head. Instead of using gloves to cover your hands, use mittens. Mittens are more helpful than gloves because they keep your fingers in contact with one another.

Over-extension. Avoid activities that cause you to sweat a lot. Cold weather causes you to lose body heat quickly, and wet, sweaty clothing accelerates the process.

Layering. Loose-fitting, light weight clothing in layers insulates you well. Use clothing made of tightly woven, water repellent material for protection against the wind.

Dry. Keep as dry as you can. Get out of wet clothing as soon as possible. It’s very easy for snow to get into gloves and boots, so pay particular attention to your hands and feet.

In the event of a prolonged or long-term power disruption, without heat to warm yourself and your home, winter will be a nightmare to endure if you are not properly prepared for it. Finding a way to maintain warmth will inevitably be left up to you to provide.

To conclude, another VERY important part of winter and heat preparedness is in the head. Just remember CLAP:

Calm

Level-headed

Alert

Positive

People tend to panic when confronted with an obsticle such as no heat in the winter. Survival is in the mind, and only the smart will survive. So stay positive and you will come through.

In order to provide the readers of this website with accurate and to-date medical advice, this article has excerpts that were taken out of The Doom and Bloom Survival Medicine Handbook by Joseph Alton, M.D. and Amy Alton, A.R.N.P pages 161-167.

1 person out of 10 will need an appendectomy during their lifetime. Although most appendicitis cases occur during the teenage to young adult years, young children and adults have been known to have appendicitis. Appendicitis usually occurs when a firm piece of stool blocks the pea-size opening of the appendix, allowing bacteria to flourish inside. Knowing the symptoms to look out for can help you get the medical care you need before the symptoms exacerbate.

Some symptoms include:

• Persistent or worsening symptoms.
• The pain stays in one portion of the abdomen. Pain on the right side could be an appendicitis.
• An oral temperature above 102 F (38.8 C) develops.
• Repeated vomiting occurs.
• Blood is being passed in stools (red, dark red or black).
• Persistent vomiting for 24 hours (cannot keep anything down) or blood is vomited.
• There is a swollen or bloated abdomen.
• Dizziness develops.
• Your child pushes your hand away or screams when their belly is touched.
• You notice extreme irritability in infants or weakness in older children.
• You child develops new or severe problems or becomes dehydrated.

If these one or more of these symptoms occur, fear the worst and seek medical attention immediately. The only way to cure appendicitis, if it is in the late stages, is to remove the appendix with surgery. However, it has been suggested that if detected on time, it can be cured naturally, using home remedies.

Preventing and Curing Through Natural Means

Getting more fiber in your diet can be a natural way to prevent an appendicitis from occurring. Since fiber absorbs water, a high-fiber diet causes the stool to become larger, softer, and less likely to break apart. This prevents stray particles from blocking the appendix and helps the stool to move faster through the digestive tract.

 According to the home remedy website ILoveIndia.com to naturally cure an appendicitis:

• The best home remedy for appendicitis would be a mix of 100 ml cucumber juice, 100 ml beet juice and 300 ml carrot juice. Intake this juice regularly, two times a day.
• Buttermilk helps in curing chronic appendicitis. A liter of buttermilk should be consumed, on an everyday basis, for about a fortnight.
• In a liter of cold water, add 1 tsp. fenugreek seeds and let it boil. Now, strain the water and have it while it’s still warm, but not too hot. This would prove effective to cure appendicitis naturally.
• Appendicitis can also be cured by having green grams. 1 tsp. of sprouted green grams, twice or thrice a day; will prove to be worthwhile in treating appendicitis.
• Include coriander juice, radish juice and spinach juice in your regular diet. They will help treat appendices problem.
  For people who suffer from fever, along with appendicitis, decoction of the basil leaves will prove beneficial. Steep the leaves in boiling water and let them stand for 5 minutes. Strain it and your decoction is ready.
• Ginger helps in those appendicitis cases where the patient also has the tendency to vomit. Add a pinch of rock salt to 1 tsp. of ginger juice and drink it. Alternatively, you can store raw cut pieces of ginger, with some rock salt, in a bottle and have it with your meals.
• Ginger and turmeric act as a good combination for treating appendicitis. They can be taken in a raw or powdered form. It reduces the pain and swollenness resulting from appendicitis.

To Conclude

When it comes to abdominal pain in children you want to take it seriously. Aside from bouts of constipation, children should not have severe pain in this region of the body. Not having the skills or  medical training to properly assess the child’s illness can make a parent feel absolutely helpless. That being said, make a commitment to develop some emergency medical skills or purchase some reference materials to turn to when your child needs to rely on you the most. After all, we are prepping today to care for tomorrow’s problems. And, we can all agree that we never know what tomorrow may bring.

This article is for informational purposes only.

Having necessary emergency resources to turn to can help you provide adequate care, as well as be able to fall back on knowledge if there are any additional signs to look for regarding infections, secondary infections, etc. Resources such as “When There Is No Dentist” by Murray Dickson has a wealth of knowledge that one could use during a disaster (Click here to download a PDF version of this resource). Familiarizing yourself with the most common types of dental emergencies, and knowing what dental supplies would be best to invest in will hep you be more efficient in your preparations.

Here’s what to do if you face one of the following dental emergencies in a short-term emergency:

1. You lost a filling. The first thing to do is to rinse out the cavity with warm water. Take a cotton ball or a special dental filling product like Dentemp and press it firmly into the cavity. Arrange for someone to treat you soon.

2. You lost a crown or cap. Missing crown won’t trigger “immediate pain,” but it definitely can if you don’t do anything about it, especially as you eat and food gets in the exposed area. Don’t wait more than two days to get this treated if a cap or crown is displaced. Placing dental wax or a temporary cap can help aleive sensitivity while you eat.

3. You have a toothache. A severe toothache is one of the most painful forms of trauma you can face with a dental emergency. If it happens to you, immediately rinse your mouth out with warm water and place a cold compress against your cheek for 20 minutes to alleviate swelling. Remove the compress and let the afflicted area warm up again or use a hot pack, then re-apply the cold compress. One mistake people make with a toothache is to apply pain medication directly against the gum. Dentists say that could inflame the gum and potentially do more damage to the teeth. In any case, make sure to visit your dentist to check for a bacterial infection that might have caused the toothache in the first place. If left untreated, bacteria can lead to serious problems.

4. You chipped or broke a tooth. The first thing to do is to save the chipped or fully dislodged tooth. Then, once again, rinse the area inside your mouth with warm water. Also make sure to rinse the tooth that’s been displaced. If there is bleeding, apply some gauze or cotton to the area for five to 10 minutes. Then apply a cold compress to the outside of your mouth, over the impacted area, until the swelling goes down.

5. You knocked a tooth out of your mouth. Dentists say that your best chance of saving a tooth that’s been fully removed from your mouth is to visit a dentist within one hour. Until then, keep the tooth safely tucked away – in a small container of milk, or in water with some salt added. Then head straight to your dentist.

Tips courtesy of Main Street

These natural reoccuring disasters tend to occur suddenly and without warning. According to the Center for Disease Control (CDC), serious, deadly contagious disease outbreaks can and do happen. CDC investigates new contagious diseases—averaging one new contagion per year. These new contagious diseases can emerge right here or only a plane-ride away from here. It’s not just new diseases that threaten the United States. Some diseases long thought controlled in the United States, like tuberculosis, can reemerge and be more deadly than ever.

Looking back at the Black Plague, those living in high populated areas were hit hardest by this pandemic.  The Black Death is estimated to have killed 30–60 percent of Europe’s population. Given our vast array of transportation systems, modern society causes infectious disease to spread far more rapidly compared to any other time in recorded history; and because pandemics are fast moving, vaccinations would be useless.  Further, in regards to the world’s transportation system, the morbidity rate in a future pandemic could result in millions seeking medical care at the same time thus overwhelming hospitals and emergency departments.

Many believe the misuse of antibiotics in the past has led to the dangers of super bugs such as the spread of MRSA — or methicillin-resistant Staphylococcus aureus. In fact, nearly all significant bacterial infections in the world are becoming resistant to commonly used antibiotics. If antibiotics are used too often for things they cannot treat such as viral infections,  they become less effective against the bacteria they’re intended to treat. Further, not taking antibiotics exactly as prescribed also leads to problems. For example, if you do not take the full course of prescribed antibiotics, it does your body more harm than good because the antibiotic may wipe out some but not all of the bacteria. The surviving bacteria become more resistant and can be spread to other people. When bacteria become resistant to first line treatments, the risk of complications and death is increased.

Before we get into the meat and potatoes of pandemic preparedness, let’s look at the changes that will likely occur in your community if this disaster were to occur:

• Challenges or shut downs of business commerce
• Breakdown of our basic infrastructure: communications, mass transportation, supply chains
• Payroll service interruptions
• Staffing shortages in hospitals and medical clinics
• Interruptions in public facilities – Schools, workplaces may close, and public gatherings such as sporting events or worship services may close temporarily.

When an outbreak occurs, many will remain in a state of denial about any approaching epidemics. Simply put, most people believe themselves to be invincible to negative situations and do not like the idea change of any kind. They will remain in this state until they realize they are unable to deny it to themselves any longer. Being prepared before the mass come out of their daze will ensure that you are better prepared before the hoards run to the store to stock up.

Community Preparedness Will Play a Large Role

Preventing the transmission of an illness rests in the hands of not only the individual, but the community as well. Proper planning and prevention plays a very large role in preparing for a pandemic. There is a lot to be said for preventative measures.

As a whole, communities should take the necessary steps to be prepared for potential challenges before a threat exists. Understand that areas where there are large congregation areas i.e., malls, schools, airports, grocery stores  also pose a hazard to spreading the epidemic more quickly. Breakdowns in communications, supply chains, payroll service issues, and healthcare staff shortages should be anticipated when preparing for a pandemic. To assist communities planning for a pandemic, the Federal Government has developed a Pandemic Severity Index. This index assists the government in gauging the severity of the epidemic based upon the amount of fatalities. If the government sees fit, they can activate pandemic mitigation measures. Some of these measures include the following:

1. Isolation and treatment (as appropriate) with influenza antiviral medications of all persons with confirmed or probable pandemic influenza.  Isolation may occur in the home or healthcare setting, depending on the severity of the individual’s illness and/or the current capacity of the healthcare infrastructure.
2. Voluntary home quarantine of members of households with confirmed or probable influenza case(s) and consideration of combining this intervention with the prophylactic use of antiviral medications, providing sufficient quantities of effective medications exist and that a feasible means of distributing them is in place.
3. Dismissal of students from schools (including public and private schools as well as colleges and universities) and school-based activities and closure of childcare programs, coupled with protecting children and teenagers through social distancing in the community to achieve reductions of out-of-school social contacts and community mixing.
4. Use of social distancing measures to reduce contact between adults in the community and workplace, including, for example, cancellation of large public gatherings and alteration of workplace environments and schedules to decrease social density and preserve a healthy workplace to the greatest extent possible without disrupting essential services.  Enable institution of workplace leave policies that align incentives and facilitate adherence with the nonpharmaceutical interventions (NPIs) outlined above.

Source

My largest concern with pandemics is that supplies would be quickly exhausted leaving many unprepared to handle the ordeal. This unpreparedenss will only fuel a more chaotic situation. These concerns are not new to most governments and steps have been taken  to ensure communities are prepared and are able to contain most epidemics. To view the U.S. government’s protocols for pandemic preparedness, click here.

One precaution the government may consider  is a social distancing strategy or voluntary/involuntary home quarantine. If this occurs, the responsibility falls on our shoulders to ensure that we are able meet our needs. However, this is not anything new to a prepper. We believe in being self reliant, and if you have followed the 52-Weeks to Preparedness series, you should well be on your way to handle such a disaster.

Individual Prevention Starts At Home

So how does the average person properly prepare for this type of emergency? Similar to other emergencies, we simply prepare as much as we can because any steps taken toward preparedness are better than none at all.

In the event of a pandemic, because of anticipated shortages of health care professionals and widespread implementation of social distancing techniques, it is expected that the large majority of individuals infected with the pandemic illness will be cared for in the home by family members, friends, and other members of the community – not by trained health care professionals.  Bear in mind that persons who are more prone to contracting illnesses includes people 65 years and older, children younger than five years old, pregnant women, and people of any age with certain chronic medical conditions.

So what can you do to be ready for a pandemic outbreak?

• Store a two week supply of water and food. During a pandemic, if you cannot get to a store, or if stores are out of supplies, it will be important for you to have extra supplies on hand.
• Have a supply of face masks to wear around those who may be ill or exposed to the illness. 
• Periodically check your regular prescription drugs to ensure a continuous supply in your home.
  Have any nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins.
• Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home.
• Prepare a sick room for the home to limit family member’s exposure to the virus.

To decrease the chances of the virus spreading and infecting other household members as well as members of your community, it is important that every effort be made to limit exposure to the illness.  Some considerations on how to prevent exposure to a pandemic outbreak are:

1. Avoid close contact with those who are ill.
2. Stay inside and avoid contact with others.
3. Avoid touching your mouth, nose and eyes during any pandemic.
4. Cover your mouth and nose with a tissue or your sleeve when coughing or sneezing. It may prevent those around you from getting sick.
5. Keep your hands clean. Washing your hands often will help protect you from germs. If soap and water are not available, use an alcohol-based hand rub or make your own natural hand sanitizer.
   Avoid touching your eyes, nose or mouth.
6. If you are ill, stay indoors or keep your distance from others.
7. Keeping your immune systems up by getting lots of sleep, having a good diet and taking antioxidants in protecting your health.

Pandemic outbreaks are fast moving and vaccines may not be able to stop it. This natural occurring diseaster is not one you should take likely. Several overarching themes emerge from the discussion of pandemic preparedness. Not only are our bodies under attack, but our way of life is as well. Community and individual preparation are critical in regards to prevention.

Characteristics of the Ideal Sick Room

To ensure that the sickness is as contained as possible, set up the sick room in a bedroom or another separate room in the house. Ensure that the room has good lighting, a window that opens, and easy access to a personal bathroom with a sink and running water.

Prevention is Key

To avoid other family members falling ill, try to limit the exposure of the sick person to the other family members. This includes making sure that any communal areas (kitchen, bathroom, etc) be thoroughly cleaned with disinfectant each day to avoid the transmission of germs. Towels, water bottles, drinking glasses, and other personal care items used by the sick person, should not be used by other family members.

Other preventative measures for the sick room could be made ahead of time to make the room ready before it is needed. Having all necessary items in the room will make for easy accessibility as well as containment of illness. Consider these 9 preventative measures:

1. All tissues, utensils, equipment, bedding, and clothing in contact with the sick person should be handled as if the germs of the illness were on them. Dishes and equipment should be washed in hot soapy water or wiped with 10% bleach or other disinfectant.
2.  Use disposable dishes when possible so they can be discarded in plastic bags in the room.
3. Place all used tissues directly into a plastic bag that can be closed at the top before leaving the sick room. Have alcohol-based hand cleaning solution (Purell) at the bedside so the person can wash their hands after they cough or sneeze.
4. Gently fold or roll clothing and bedding into a plastic bag, being careful not to shake them, possibly releasing the germs into the air. Clothing and bedding should be washed in hot water.
5. Clean items in the room with a 10% bleach solution (made by combining 1 ounce of bleach with 9 ounces of water) or other disinfectant. Clean bathroom faucets and sink with 10% bleach or disinfectant wipes after the sick person has used them.
6. Wear a raincoat or other washable gown/coat over your clothes when in the room caring for the sick person. This gown will help to protect you from getting the germs on your clothes while caring for the person. This gown should stay in the room.
7. Wash your hands or use a alcohol-based cleaning solution (Purell) on your hands every time you leave the room. If disposable gloves are available, they can be worn while in the room but they should be removed in the room and discarded in the room, and then your hands must be washed.
8. Limit the people in close contact (within 6 feet) of the sick person. Keep the door to the sick room closed. Have a bell or cell phone by the bedside so the person can call for assistance when needed.
9. If respiratory masks (N95) are available, they should be worn by the sick person and the caretaker when they are in close contact.

Some items to consider when stocking a sick room are:

• Bed with linens, pillow and blanket
• Small wastebasket or a bucket lined with a plastic garbage bag.
• Pitcher or large bottle for water
• Large plastic dishpan
• Clipboard with paper and a pen for writing in the daily log.
• Clock
• Hand crank or battery-powered radio
• Good source of light
• Flashlight with extra batteries
• A clothes hamper or a garbage can lined with a plastic garbage bag can be used to collect soiled clothing and bedding before they are washed.
• A bell or a noisemaker to call for assistance.
• Thermometer
• Tissues
• Hand wipes or a waterless hand sanitizer
• Cotton balls
• Rubbing alcohol, disinfectant or bleach
• Plastic garbage bags
• Measuring cup capable of holding 8 ounces or 250 ml
• Over-the-counter medications for use in the sick room
• Aprons or smocks (at least 2)
• Latex household cleaning gloves (2 pairs)
• Disposable vinyl gloves (2 boxes)
• Garbage bags
• N95 respirator masks (2 boxes) for use when the sick person is coughing or sneezing (can be purchased at hardware stores and some drugstores)

To prepare for longer-term scenarios, consider adding other medical supplies to the sick room. Further having some medical response packs pre-packaged cuts down on response time, and gives the caregiver more of an advantage in properly caring for the wounded. To prepare for a SHTF scenario, it would be beneficial to take into account the most likely medical situations you may come in contact with and plan accordingly.

To conclude, preventing the transmission of an illness can be done with proper planning and preparation. A little forethought will help the caregiver be as efficient as possible in treating the ill patient, and in the process, keep the rest of household as healthy as possible.

Sections of this article were adapted from the book Pandemic Home Care

It must be said that not all antibiotics are created equal. Understanding this can help you find the right antibiotics that will work best for the specific medical conditions you are trying to target. Because there are such a wide range of antibiotics, before you buy them do some research on your own or talk with a medical professional to see which antibiotics would be best for you and your family.

Certain antibiotics should not be mixed with other drugs, foods or alcohol. For instance, drinking grapefruit juice with erythromycins or taking erythromycin with theophylline (a drug used for respiratory ailments) can cause fatal heart arythmias. There are many other interactions that doctors know about that the layman does not. That being said, if you do plan on storing these medications, have a pharmaceutical or drug guide on hand to ensure that correct medicines and dosages are given. Used copies of this reference can be purchased at college book stores at a discounted price.

Keep in mind that when antibiotics are used to treat an infection, the “good” bacteria in the large intestine may also be destroyed as a result. Therefore, consider investing in some probiotics to help restore the microbial balance that is disrupted by antibiotics and infections. Probiotics are usually sold in the vitamin section of most pharmacies as well as in health food stores. They can be stored along wtih your vitamins in your reserve supplies.

www.SurvivingHealthy.com is a great website where you can purchase antibiotics securely online without using a prescription.

It should be emphasized that antibiotics should only be used as a last resort. Give your body a chance to fight the infection. If the infection continues, consider using a course of antibiotics.

Please consider the following concerns before purchasing antibiotics:

• They are not a first line of defense.
• You could be allergic to certain types of antibiotics and could cause other medical issues.
• The antibiotics may not work due to being past their expiration, from improper storage, from the wrong dosage administered or from your body building up an immunity.
• Antibiotics can also exacerbate an issue by destroying the good bacteria in the body. Investing in some probiotics can help restore the good stuff though.

According to the Patiot Nurse, the five most popular types of antibiotics (including their generics) are:

1. Zithromax – UTIs, URIs, Sepsis (used in an IV), STDs, and ear infections.
2. Ampicillan – This a more broad spectrum antibiotic that treats skin infections, STDs, Sepsis and ear infections.
3. Cipro – This antibiotic has a lot of toxicity issues and should be taken sparingly. Can be used for UTIs, infectious diarreah, bone and joint infections.
4. Amoxicillan – This is a very popular antibiotic used in upper respiratory, ear, nose and throat infections, and teeth abcesses.
5. Doxycycline - An effective antibiotic used for malaria, and Rocky Mountain Spotted Fever.

She also suggests Clindamyacin, Flagyl and Bactrim as some back ups to the aforementioned.

Fish antibiotics are also becoming popular storage items amongst preppers because no prescription is required to purchase them. It is true that many fish antibiotics contain the same active ingredients as those formulated for humans. However, there are few considerations to keep in mind, such as using the correct dosage as to not over medicate yourself, and the differences in human metabolism vs. the metabolism rate of a fish.  Anyone who is planning on storing up fish antibiotics to use needs to do proper research, and it wouldn’t help to discuss your findings with a medical professional.

In an article on Survival Blog, the contributing author, who happens to be a doctor was able to purchase the below fish antibiotics online without any demand for medical license or prescription.  A paraphrase of the article and a list of the drugs are listed below. They are:

•FISH-MOX (amoxicillin 250 mg)
•FISH_MOX FORTE (amoxicillin 500 mg)
•FISH-CILLIN (ampicillin 250 mg)
•FISH-FLEX Keflex 250 mg)
•FISH-FLEX FORTE (Keflex 500 mg)
•FISH-ZOLE (metronidazole 250 mg)
•FISH-PEN (penicillin 250 mg)
•FISH-PEN FORTE (penicillin 500 mg)
•FISH-CYCLINE (tetracycline 250 mg)

In a SHTF or long-term emergency scenario, tooth paste may be less accessible and we will need to fall upon more traditional means to clean our teeth.

Although certain foods can have a cleaning affect on your teeth, there are other natural alternatives that you can turn to keep your teeth and gums clean. Below are six alternatives to toothpaste that can be used to not only promote healthy teeth and gums, but most of these alternatives have antibacterial and antimicrobial properties that assist in preventing dental issues such as gingivitis, canker sores and gum disease.

Chew sticks - Traditional peoples the world over use natural tooth brushes made from healing plants. These primitive twig “brushes” actually work quite well, and provide a natural-bristle, disposable brush with healing herbs already incorporated right in the plant. People would chew on the tip of a twig to make it spread out into several small strands. They would then use it in the same way that a toothbrush is used. If this is the only option to brush your teeth, look for twigs that contain oils to help stimulate blood circulation, tannins that tighten and cleanse gum tissue and other materials, such as vitamin C, which maintain healthy gums. Bay, eucalyptus, oak, fir, and juniper and twigs of the neem tree are good choices to make primitive toothbrushes with.  

Salts - Salt is a multipurpose prep that every prepper should have a good supply of. In the case of dental health, it is a mild cleanser that can be used multiple times daily or as a mouthwash to help with bad breath or used as a disinfectant rinse. Salt has a natural healing property to it, as well as removes plaque, tartar and bad breath.

Cleaning teeth – Mix one part salt to two parts baking soda after pulverizing the salt in a blender or rolling it on a kitchen board with a tumbler before mixing. It whitens teeth, helps remove plaque and it is healthy for the gums. Another recipe for cleaning teeth is one teaspoon each of ground sage, baking soda, and table salt.

Washing mouth – Mix equal parts of salt and baking soda as a mouth wash that sweetens the breath.

Baking soda - Baking soda is a classic amongst natural teeth cleaning methods, and is harmless. It is very effective in removing stains and killing plaque-causing bacteria, and it also reduces acids which harm your tooth enamel. Hippocrates recommended a mixture of salt, alum, and vinegar as a mouthwash for preventative measures.

Essential oils -  Incorporating essential oils into your dental preparedness supplies can function as natural antibacterial and antimicrobial agents, as well as natural cleansers for a well-rounded mouth health. Essential oils such as peppermint and spearmint can be mixed with water to make dental rinses too.

Three popular essential oils amongst preppers are:

• Clove oil contains eugenol, a natural pain killer and antibacterial. Mix 2 to 3 drops of pure clove oil with 1/4 teaspoon olive oil. Saturate a cotton ball with the mixture and place the cotton ball beside the tooth.
• Cinnamon oil -  Cinnamon naturally contains antimicrobial and antibacterial properties and can help fight harmful mouth bacterias. Cinnamon bark oil has been known to effectively destroy 21 different types of bacteria. Rinsing with diluted cinnamon oil after you brush your teeth, or using a toothpaste made from cinnamon oil  may help you kill harmful bacteria and prevent cavities. It’s warming properties will also stimulate the blood circulation in gums. Note: Using cinnamon oil can cause some irritation and inflammation, therefore if you plan to use cinnamon oil, always dilute it first. If you suffer from any inflammation in your mouth, discontinue using cinnamon oil and the symptoms should disappear within 24 hours.
•  4 thieves oil – A combination of  clove, lemon, cinnamon, eucalyptus, and rosemary, this oil possesses both antimicrobial, and antibacterial properties. A few drops of this oil can be used to prevent and treat gum disease, drops can be applied orally to maintain healthy teeth and reduce cavities, to clean teeth and be used as an effective mouth wash, or applied to gums and teeth for pain relief from toothaches.

If you are faced with swollen gums, nightly gum packs made from herbs or herbal infused oils rolled in gauze can be tucked into the corners of the mouth. In auyervedic medicine, a combination of turmeric, aloe, willow bark, vitamin E, and powdered alum can help relieve pain and swelling. If this regimen is regularly used and followed with a healthy diet and vitamin supplements, it can reduce symptoms significantly.

Hydrogen peroxide 3% - This product assists in healing canker sores, helps kill off bacteria living in the mouth, and fights gingivitis. There is conflicting information about the abrasiveness of hydrogen peroxcide on teeth, so to be on the safe side, dilute this product with water if you decide to use it in your mouth.

A mouth rinse can be made by mixing equal parts of water and a 3% solution of hydrogen peroxide. This mouth rinse should be swished (not swallowed) around the entire mouth for 15-30 seconds. Using the diluted mouthwash and then following it with your normal brushing regimen will thoroughly clean the mouth and teeth, as well as kill off harmful bacteria. Don’t limit using hydrogen peroxide to inside your mouth, you can even clean your toothbrush with hydrogen peroxide after use to kill off any remaining bacteria that may still be left on the toothbrush.

Water - This is the most basic a person can get with cleaning their teeth. Brushing your teeth with water may not have any healing properties, but it will at least get any residual food off of your teeth. And anything is better than nothing at all.

To conclude, without our normal dental items being readily available to us during a long-term emergency, we may have to fall upon more natural approaches to dental health. Having supplies and possessing knowledge on natural alternatives to maintain healthy teeth and gums will prevent and may control any current issues from exacerbating.

Infused oils provide therapeutic benefits to the body through absorption of the skin and through inhalation of the lungs. Using the right type of oil to carry the medicinal and therapeutic properties to the skin is key. Carrier oils are typically plant-based and do not contain a concentrated aroma or evaporate like essential oils, which are more volatile. Oils that are unrefined, cold pressed and/or organic oils are the best types of oils to purchase. This ensures that all the nutrients and benefits are still present in the oil. Below is a list of suggested plant-based oils that can be used for making infused oils.

• Almond oil – Good for all skin types, alleviates dry skin, soothes inflammation, relieves itching from skin conditions (eczema, psoriasis and dermatitis), relieves and soothes sunburns.
• Avocado oil – Contains essential vitamins A, D and E, moisturizes and soothes sensitive skin, assists in soothing scaly skin and scalps, has anti-bacterial properties, helps to stabilize oil-in-water emulsions.
• Coconut oil – Moisturizes dry skin and dry hair, soothes irritated skin and has a longer shelf life than most plant-based oils.
• Grape seed oil – Strengthens tissue cells, preserves natural moisture in skin, absorbs quickly.
• Olive oil – Moisturizes dry skin and relieves itching, helps the synthesis of substances like collagen and elastin
• Sunflower oil – Deeply conditions weathers, aged or damaged skin.
• Wheat germ oil – Treats dry and aging skin, assists in cell regeneration, aids muscle and lymph function, relieves dermatitis symptoms, prevents and reduces scarring.

Store the oils in a cool, dark place to prevent spoilage. If, over time they have a rancid smell, throw the oil away.

Infused oils are easier to make than you think. In fact, you do not need any formal training to make infused oil. Do some research beforehand to find the herbs best function for your overall health. Click here to view 30 of the most popular herbs to consider.

Equipment:

1. Air tight container that has been cleaned and preferably sterilized.
2. Fresh or dried herbs
3. Plant-derived oil

Instructions:

1. Gather the herbs or flowers you wish to infuse. Ensure the herbs are clean and dry to the touch. Dried herbs can also be used, however, many herbalists feel using dried material will render an inferior product.
2. Chop or tear the herbs or flowers in order to release the oils more quickly (leaves, flowers or roots). When using fresh herbs, you will need enough to fill your jar. When using dried herbs, fill jar 1/3 full.
3. Label the jar with both the contents and the date.
4. Add plant-derived oil.  Be sure to fill the jar completely with oil, covering the top of the herbs or flowers, then seal tightly. Ensure there are no air bubbles.
5. Set your jar on a shelf, window sill or counter that is NOT in direct sunlight. Once a day, gently turn the jar upside down for a few seconds, then return it to a right side up position. Repeat this process for a minimum of 2-6 weeks to get the appropriate infusion. Note: Different herbs have different infusion times, so be patient. 
6. Strain your oil using a cheesecloth or by adding a paper coffee filter to the mesh type strainer. Be sure to transfer only to clean and moisture free containers. Infused oils that you are going to use in food preparation should be stored in the refrigerator.

When there is a medical emergency, time is of the essence. Typically, medical recue workers who respond to accidents work swiftly by having their supplies organized and at times, pre-assembled (wound care, trauma packs) to treat patients more efficiently. Having these items pre-packaged cuts down on response time, and gives the responders more of an advantage in properly caring for the wounded. That efficiency can easily be replicated for your medical supplies or added to your SHTF sick room.

Medical first response packs can be made ahead of time using most of the medical products that you have on hand. In fact, these first response packs are not limited to medical emergencies, they can also be used for dental emergencies as well. To prepare for a SHTF scenario, it would be beneficial to take into account the most likely medical situations you may come in contact with and plan accordingly.

Knowledge is Power

Not all of us have a background in medicine. Therefore, it is a good idea to have medical books or instruction guides on hand to correctly guide you through the proper ways to treat a wound. There are some great medical books that can help you gain a better medical perspective for dealing with these types of scenarios. Some books to consider are:

• When There Are No Doctors
• First Aid Full Manual
• Emergency War Surgery

Keep It Organized

Many preppers use gallon sized zip-loc bags or their vacuum sealers to seal up the necessary items for future use. Label your response packs according to the pre-determined disaster and store with your existing medical supplies.

Advanced Wound Care Supplies

It is important to emphasize that proper medical tools and advanced wound care supplies are a good investment for a long-term emergency. Caring for open wounds, deep lacerations and bleeding cuts will be very likely during this time and hospitals may not be available.

Note: This website has an extensive amount of medical products and surgical tools.

For instance one advanced wound care product to consider is a blood clotting agent called Celox. Many emergency responders, as well as military personel are now carrying Celox in their medic packs. This product is made from a natural polymer extracted from shrimp shells called chitosan and has the capacity to stop bleeding in 30 seconds.

Many preppers have found that buying the ultra absorbent sanitary pads to use for wound care is another product to invest in. These absorbent pads can be used on gunshot wounds or any bleeding wounds. The adherent strip on the back is helpful in that it will assist in holding the pad in place.

Here are some suggested items to include in different types of response packs:

Response packs for superficial wounds

• Latex-free Gloves
• Alcohol wipes
• Antiseptic
• Antibiotic ointment
• Gauze
• Tape
• Scissors
• Steri-strips
• Bandage
• Instant cold packs

Response packs for hikers

• Adhesive bandages (assorted sizes)
• Knuckle adhesive bandages
• Butterfly closures
• Gauze pads (assorted sizes)
• Non-adherent pads
• Sterile top sponges
• Moleskins
• Abdominal/pressure pad
• Stretch gauze roll
• Medical tape
• Antibacterial wipes
• Triple-antibiotic ointment packets
• Sting relief wipes
• Iodine wipes or swabs
• Antimicrobial hand wipes
• Safety pins
• Latex-free medical gloves
• Bandage scissors
• Splinter forceps

Response Kits for wounds that require sutures

• Latex-free Gloves
• Hemostat, probes, forceps, surgical scissors, suture lip scissors
• Alcohol pads
• Antiseptic
• Non-adherent sterile pads
• Gauze bandage rolls
• Absorbing and non-absorbing sutures or nylon fishing line
• Non-Suture wound closure strips
• Suture needles

Suture Removal Kit

• Suture scissors
• Forceps
• Tweezers
• Gauze sponge
• iodine swabs
• Gauze wrap

Response packs for advanced wound care: bleeding wounds, gunshot wounds, stab wounds

• Sterile and non-sterile Latex-Free Gloves
• Roll Bandage
• Gauze
• Iodine swabs
• Abdominal Pad
• Respirator Mask
• Triangular Bandage
• Tape
• Occlusive Dressing
• CPR Microshield
• QuikClot® Sponge or Celox

Response packs for advanced wound treatment: open or bleeding wounds fractures, falls

• Sterile and non-sterile Latex-Free Gloves
• Roll Bandage
• Gauze
• Iodine swabs
• Sterile medical sponge
• Abdominal Pad
• Triangular Bandage
• Tape
• Antiseptic Wipes
• CPR Microshield
• Respirator Mask
• Blood Clotting Agent

Response packs for 72-Hour Kits: Intended for the treatment of open or bleeding wounds caused by gunshots, knife cuts or punctures

• Sterile and non-sterile Latex-Free Gloves
• Roll Bandage
• Gauze
• Abdominal Pad
• Triangular Bandage
• Tape
• Antiseptic Wipes
• Iodine swabs
• CPR Microshield
• Emergency Signal Whistle
• Thermal Mylar Blanket
• Blood Clotting Agent
• Tourniquet

Note: Items in the response pack for hikers can also be included in your 72-hour response pack

We must prepare for the unexpected, and there are times when the unexpected will be time sensitive. Having medical response packs pre-assembled for those time crucial moments can help in better and more efficient medical care.

Disclosure: The information in this article is for informational purposes only. Nothing contained on this web site should be construed nor is intended to be used for medical diagnosis or treatment. Consult your physician or other qualified health care providers with any questions regarding medical care.