# My Professional Reccomendation on SHTF First Aid (0-72 Hours)



## PreparedRifleman73 (Nov 2, 2012)

I have worked full time on an ambulance service for several years. I've asked so many questions here and received such great answers that I thought I would try to contribute in some way or another. To put things into context, my experience primarily involves stabilizing critical patients for transport either to the hospital or to a larger facility. Obviously, we rely on the grid and generator in hospital; but I'll try to adjust it a bit for SHTF as I am also trained in Wilderness Emergency Medicine (i.e. off-grid) but with less experience.

*To Fit Into Your BOB/GHB: Taking care of yourself*
Emergency Medicine should be addressed in your bug-out-bag or get-home bag of course. I do see that people are often missing important items, but more often than that, have items they don't need. The first issue is going to be size - eliminating items you don't need. Also, don't bother carrying items you can't use on yourself. Having a medical bag for your family is addressed later.

We're worried about surviving for approximately 72 hours. At that timeline, you should be at your BOL or home where you have a more definitive supply.

*1. Address your specific medical needs*
Carry items that you need to maintain your current health situation. For example, if you're a diabetic you should carry insulin and oral glucose. If you have cardiac issue and are on daily aspirin, carry some. When SHTF, you could potentially suffer a major trauma. Progressively declining medical conditions like uncontrolled diabetes are only going to confound the issue. If you have a condition, you will understand what you need.​
*2. Don't worry about your airway*
"_If you don't have an airway, you don't have a patient._" While this is a maxim of emergency medicine, you are not going to be able to perform an intervention on your own airway. Most people can accept self-placement of a nasal-pharyngeal airway or even an oral - but if you actually need such an intervention, you will be unconscious (Dead post-SHTF). Certainly, if you're asthmatic or something similar, carry the appropriate intervention as stated in #1.​
*3. Prepare for threats to appropriate breathing*
You are certainly not going to perform interventions on yourself like bag-valve-mask ventilations or anything of that nature. The largest threat to appropriate respirations in SHTF is going to be a sucking chest wound or collapsed lung, known is a pnuemothorax. You can have more complicated cases such as a tension pnuemothorax or a tension hemopnuemothorax with or without flail chest segments. Your immediate 72 hour needs will be pretty basic.

Basically, you are going to want to create a dressing that will allow air pressure or blood to escape your chest cavity - but will prevent air from going in. The only thing you need to buy is Saran Wrap or even a ziplock bag from elsewhere in your BOB. Place a dressing on the opening. Then, place saran wrap over it (wrap it around your whole chest if need be when self-administering). Now tape Buy some clear medical tape. Get something wide, you can easily rip it narrower. If you have the white kind, just throw it. You want clear. down 3 sides and leave one side open. When you breathe in, your lungs will fill but not the cavity around them. When you breathe out, air will expel out of the cavity. This will create a low pressure environment in the chest cavity (which is desired). This is what it should look like:








You *DO NOT* need to buy special fancy and bulky equipment like this:






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*4. Bleeding out is the largest 72 hour threat*
A small cut can make you bleed out gradually over 72 hours. It can ruin a lot of clothing in the meantime. Not to mention that tactical disadvantage of leaving a trail of blood. And a large cut can render you unconscious in minutes, which means death when SHTF.

*Direct pressure dressing*
Buy good abdominal and trauma dressing. A good abdominal dressing will be one that can be sealed against your skin with tape. A good trauma dressing is one that can physically help coagulation - a plain old bandage.
Buy at least 1 5x9 Bandage
Buy at least 2 smaller bandages 
Brand does not matter. Just make sure it is labeled sterile. Buy some wide gauze that will adhere to itself (like Kerlix) to hold it on.








It's also not a bad idea to buy extra and try them out ahead of time

*A word on QuikClot and Tourniquets*
I know if I tell people they don't need QuikClot, I could get run out of town. Go ahead and buy it. But I caution you: Do not use QuikClot unless it is absolutely your life and you can't get to a hospital for SEVERAL DAYS. QuikClot is pretty much guaranteed to cause you a serious infection in the long run. It is terribly nasty to dig out of wounds and will cause more damage than the initial trauma probably did.








A better option is a tourniquet that you can apply yourself.A combat application tourniquet is an ABSOLUTE NEED. You can certainly jimmy one up with other things in your BOB, but you will pass out before than. This combat application tourniquet, or CAT can easily be applied in seconds. You turn the "stick" until the bloodflow is controlled. *Do NOT attempt to completely stop the bleeding with this.* Then, you velcro it shut.

Now, people will argue that quikclot could save a limb. The information on this is rather misleading. If there are hospital around, you can go 3-4 days with a tourniquet and still save your limb with little intervention. If possible, don't remove it yourself or the injured limb could throw a clot out on you.
​​
*5. Oh shit, you broke something*
It is pretty simple to immobilize a possible break. If there is external bleeding, take care of that first. If you broke a bone (or two, think your forearm or lower leg) you want to immobilize the joint above and below.

*Immobilize in the position of comfort if possible. Remember, the idea isn't that it will be impossible to move. But, it will remind you not to move it too.*

*To immobilize your shoulder* just make a sling:














To immobilize most breaks, have 4 square cloths - like a sheet or dishrag. You can fold them into triangles and tie them in knots for a lot of stuff.

*To immobilize your wrist or ankle* use a SAM splint:







You NEED one of these
They are aluminum wrapped in a waterproof coating. You just form them to support a joint. Then, tie it on with the dishcloth you have! *SAM splints are also great for forming a funnel and pouring liquids! You no longer need a funnel for your water bottle.*

*To immobilize your elbow or knee*:
This is probably the easiest. Just find something long and rigid, like a stick, pole or hell - a long gun. Tie it on with the dishcloth above and below the break!

*If your femur (big leg bone) breaks*
Don't **** with it or you're going to die! Stop the bleeding if possible. Immobilizing yourself without special training and large equipment is going to lead to your untimely demise.
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*6. The best tool in your arsenal*
You probably thought I'd have a witty answer like "your positive mental attiude" but NOPE, it's trauma shears!







Those life hammers look cool, but I will always stick loyally to the trauma shears. One time, I was hanging upside-down in -20*F. It cut horizontally through the zipper of Carhartt overalls. Go for the longer 5 1/2" ones. I find brightly colored ones are less likely to walk off.​
*Conclusion*
I hope I didn't forget anything! Although if I am missing something, it is probably by design. Feel free to reply or PM if you have suggestions or questions. One day I'll get around to making a list for a more long term medical bag that you can use to help others around you.


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## phxrising (Jun 24, 2012)

Thanks Hawkmiles for such helpful information. I have no medical training, not even basic first aid, so for me this is great. I am convinced among other things this board does, it can help us pool our skills to share with others.


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## prepper2012 (May 8, 2012)

that is very good information. i may need to add some of these items in my BOB.


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## oldasrocks (Jun 30, 2012)

phxrising said:


> Thanks Hawkmiles for such helpful information. I have no medical training, not even basic first aid, so for me this is great. I am convinced among other things this board does, it can help us pool our skills to share with others.


Its about time to go get some training then. Get a basic First Aid course and then an EMT.


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