Monday, November 26, 2018

The Partisan's First-Aid Kit

This article was originally published on American Partisan.

Whether you consider yourself to be a prepper, patriot or partisan, there is no argument to made against having a robust emergency medical kit and the training and knowledge to put it to use. I'm going to show you my own medical kit that I keep nearby at all times. Before I proceed, first I want to make sure that you understand how important it is to acquire some level of medical training. Getting trained in the latest standards and techniques for Basic Life Support for adults, children and infants is easy and valuable. The American Heart Association is the gold standard for this training in the US, and can be completed in one day. Opportunities for additional medical skills training are available all over your local community as well. I recommend that anyone with a little spare time and money enroll in the EMT course at your local community college. Most EMT courses can be completed in one semester. I don't necessarily expect everyone to go and get employed as a full-time EMT or paramedic, but going through the EMT course and occasionally practicing those skills may end up saving the life of someone in your family or in your survival group. I'm going to assume that I'm talking to an audience that has some medical knowledge or intends to acquire some at a later time.


To start off, let me first say that you need to be able to take a full set of vital signs on someone. You need to be able to assess blood pressure, heart rate (and assess for perfusion to the extremities), respiration rate, temperature and oxygen saturation. Here is a pretty good video instructing on the basic technique for manually checking blood pressure.







Next, you're going to need to be able to respond to an immediate emergency involving the ABC (The AHA has rearranged these letters, but my kit still applies). Airway, breathing and circulation. Here, you see a nasopharyngeal airway, a CPR mask with valve and a trauma tourniquet. These things address ABC. Also in the photo, you see an emergency blanket, some scissors and other tools, and a seat belt cutter. If you've got additional space in your bag, fill it with something that you can use in a situation you don't have another tool for. That's where my seat belt cutter came to find a place in the bag.




You need to ensure that you've got some ability to protect yourself and the person you're treating from infection. Iodine and alcohol are used to clean wounds and skin. Saline can be used as a rinse for wounds and eyes. Hydrogen peroxide should not really be used anymore as a straight antiseptic if you can avoid it, because it has the tendency to destroy healthy tissue as well as infectious organisms. With that said, it can be used as a stand-in chemical debridement tool if you've get the assessment skills and training to create such a wound dressing as necessary. If possible, don gloves before responding to an emergency. Stash several pairs in your kit so anyone who is assisting you can wear them. Size large is good enough for most people in a pinch.




If you've got the training, the assessment skills and are not able to move the patient to a professional medical facility, they may require IV fluids. In the photo you see a bag of 0.9% normal saline and a bag of lactated ringer's IV fluids. These are isotonic crystalloids and can be used as volume expanders when a patient's blood pressure is too low or for re-hydrating a dehydrated patient. Again, I want to stress that you need to have the requisite training and assessment skills before administering IV fluids to a patient. However, looking around at the website you're reading this on, can you imagine that you may be in a situation where giving someone these fluids may save their life? Imagine having these supplies in war-torn Africa, Sarajevo 1996 or even Venezuela today.




Being in such a situation would undoubtedly require you to tend to wounds. Some of the supplies for wound treatment can be seen here. Keep various sizes of gauze and "cling" wraps. The Bulkee gauze is great for wrapping and giving a protective cushion over wounded areas. ABD pads are absorbent and great for covering open wounds to protect them from the environment. Those Tegaderms in the top left corner of the photo below are great for making a pressure dressing. Take one or two of those 4x4 gauze pads and fold them into a wad, place onto a small bleeding wound and place the Tegaderm tightly over it.




It's important to have a few eye pads and a bottle of saline eye wash. Also below you'll see a few things that I managed to find additional space for. Non-adhesive pads can be placed on a wound site that you don't want to cause further trauma to when removing the bandages.




Xeroform petroleum dressing is made to placed over wounds that need to maintain a degree of moisture for healing. Maintaining a moist environment has been shown to increase the movement of new skin cells to the surface. This is especially helpful in burns. The bottle contains Iodoform dressing strips which are meant to pack inside small wounds. The strips help prevent infection and assist healing from the inside out.




Below I have some methods to stop bleeding and seal cuts. You've all probably seen war movies where the medic dumps a pack of powder onto a wound? Yeah, we still use that stuff. Pack it into bleeding cuts, don't just pour it all over the place. The Skinaffix is basically skin glue.




In a post-SHTF event, I expect to need a lot of bandages, so I've made sure to include several different types of bandages. The triangular bandage is great for making a sling for an injury to someone's arm.




If you've got the skills and need, you may have to stitch up a wound on a buddy or on yourself. It's very important to have the tools to do it right and the supplies to ensure the wound stays clean and doesn't get infected. If you can get some 2% lidocaine, a syringe and small gauge needle, you can greatly reduce the pain associated with the suturing procedure, which means less movement while you're doing the work. You'll also need a pair of short nosed clamps, sometimes called a "needle driver"to grip the needle without slipping.




Post-SHTF, there is likely going to be a great lack of hygiene and cleanliness. This can result in abscesses and other types of wounds that may require lancing and draining. The theme once again is possessing the training and assessment skills to conduct such a procedure and do it using aseptic techniques. Syringes, needles and sometimes a sharp blade is needed for this, and it's better to have something like a scalpel (below you see a #10 blade) than your everyday carry pocketknife for this job. Lidocaine is handy for this as well, if you've got it.




Don't overlook the importance of medication. Tylenol is great for reducing fevers (but NOT for use in reducing high temps resulting from heat related injuries), ibuprofen for injuries and aches (can also reduce fevers), benadryl for allergic reactions, loperamide for diarrhea, which can cause rapid dehydration (in case of suspected food poisoning, allow for permissive diarrhea so the body can rid itself of the toxins). Odansetron, aka Zofran, is great for treating nausea and vomiting (reread the point above on food poisoning and apply it to temporary vomiting). Also make every effort to obtain children's versions of these medications if you feel you're going to be possibly treating children. Aspirin should never be given to children under 12 years old.




Tongue depressors and long-stem Q-tips are handy if you've got the space.




A wealth of knowledge can be found on the shelves of your local bookstore. Even those with extensive training prefer to keep reference material at arm's length.




Here is what my finished product looks like. Everything pictured above fits inside this 20'' medical bag, even with some of the supplies doubled up. Your kit is likely to look different and I encourage you to take stock of your own abilities and needs. This is by no means and final solution to all medical situations, but is always a work-in-progress. I try to tell anyone who will listen that one of my top eight priorities as a prepper/survivalist is MEDICAL capabilities (the other seven being shelter, water, food security, commo, intelligence and transport). Your group needs someone (or multiple someones) with training, assessment skills and supplies. I urge you to fill this important gap in your preparations before the big test. There will be no do-overs.

4 comments:

  1. There is only one medical supplier in the area i live. They provide terrible service and treat me like shit every time i go to their show room. If you are not a major company going to purchase commercial levels of supplies you will be treated very poorly long story short. is there a website you could suggest where I can buy medical supplies or do you just go through amazon/ ebay?

    ReplyDelete
    Replies
    1. A lot of the supplies you see above, like the wound care stuff, gauze and Betadine, alcohol pads, bandages and bandaids, can be picked up at Walgreen's, CVS, Walmart or similar places. GovX.com has large discounts on thousands of products that military, police and first responders would be interested in, and they have some great kits to get people started. For that website, you'll have to show them proof of military/police/first responder status, which they make very simple for you.

      Tonight I will be sitting down and compiling a source/vendor list for 90% of the items shown. I've had people from WRSA ask as well. I'll have that done before morning tomorrow.

      Delete
  2. Ref your including Xeroform petroleum dressing: Back In The Day, when I worked on the road, we got a bunch of shootings. (well it WAS Da City, in the late 70's/early 80's). When we had a chest puncture that appeared to have penetrated the pleural space, we woudl open one of the vaseline gauzes we had purloined, pitch eht gauze, and use the greasy, sterile, foil wrapper as a chest seal. The clever-er of us would tape three sides, and thereby produce a flutter valve for our patient.

    ReplyDelete
    Replies
    1. Good tips. The yellow and silver package for the petroleum gauze above would work well for that.

      Delete