# Wound Care in the Remote / Austere Environment



## jumper13 (Aug 13, 2011)

Hello, Preppers. 

I've seen alot of discussion regarding wound care and medical / trauma kits. As a medical professional, I treat serious trauma patients on a daily basis, but like virtually everyone else, my practice has been limited to somewhat controlled situations in a clincal environment, or at least with a clinical environment quickly accessible. Also, there are numerous injuries that can be effectively treated by trauma surgeons and cricial care / life support units that would not be survivable otherwise. 

Now let's say that a catastophic event (take your pick) has taken these advanced medical assets out of the equation. Now what? 

The biggest concerns when dealing with trauma are the following: 
1. Immediate death from hypovolemia or vital organ destruction
2. INFECTION setting in days later

The art of taking care of a significant trauma patient in a remote environment, from initial injury through recovery, without access to clinical or medical facilities, is very difficult and requires much preparation, knowledge, and skill. 

I'd like to have a conversation with other folks about their experiences or ideas regarding care of serious traumatic injuries when a hospital is not (and will not be) available. Let's talk about what you really need (and what you don't) and how to properly use it. 

I'll open the floor for input, ideas, questions, thoughts...


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## Elinor0987 (May 28, 2010)

Having a solar and bicycle generator to power equipment would be a great asset. Using rechargeable batteries for the equipment that requires batteries is better than the disposable ones. Finding counterparts for items/medicines would be a plus. For example: adding glass thermometers and manual blood pressure cuffs with the newer, battery-operated ones will reduce dependency on electrical power. Another example is growing plants with medicinal qualities to use when the pharmaceutical supplies come to a halt. Distilling and measuring equipment would be great to have for extracting the beneficial components of the plants. Also, bleach powder and tablets would store longer than the liquid kind and would be an important part of the sanitation process.


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## stayingthegame (Mar 22, 2011)

remembering to "look around" and keep safe yourself. You can not help someone or be of help if you get YOUR A## in a sling.  

also for those who don't know the BIG medical words, simple language and discriptions maybe necessary. Hypo = low or slow, Hyper = high or fast.


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## Beanie (Aug 26, 2011)

You say 'trauma'....but what type are you talking about? I'm not trying to be difficult but the intervention for internal trauma would be very different from a puncture wound. Also - trauma can be the end effect of a traumatic incident. (shock) 

So it's pretty broad to ask about treatment for trauma. Narrow the scenario down.


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## NaeKid (Oct 17, 2008)

jumper13 said:


> Hello, Preppers.
> 
> I've seen alot of discussion regarding wound care and medical / trauma kits. As a medical professional, I treat serious trauma patients on a daily basis, but like virtually everyone else, my practice has been limited to somewhat controlled situations in a clincal environment, or at least with a clinical environment quickly accessible. Also, there are numerous injuries that can be effectively treated by trauma surgeons and cricial care / life support units that would not be survivable otherwise.
> 
> ...


I take it that your job is an EMT or something similar?

Both of my parents have worked in the medical field their whole lives. When I was still just a young child, I was reading medical texts the way other kids would read Dick-n-Jane. My dad, as an Industrial FirstAid Officer was being re-certified every couple of years, I had access-to (and used) his training books to learn stuff.

I went and got my general St.John's FirstAid badges when I was in Jr.High, certified for my LifeSavings badges through the local swimming pool and about 10 years ago got certified in Wilderness FirstAid. I have been re-certified many times in FirstAid over the years and out of all the courses that I have done, I would say that the best one I have taken has been the Wilderness courses.

Not only are you taught how to take care of "normal" problems (things like car-accidents) but also taught how to take care of severe troubles (animal attacks, gun-shots, arrow-wounds, multiple breaks from falls from tree-stands) in areas where you do not have a proper first-aid kit available.

As a Wilderness FirstAider, I was taught how to rely on what is available in order to stabilize someone, how to build shelters, how to recognize and use the natural surroundings (trees, bushes, etc) in order to help. How and when to go for help and what to do before going for help. How to transport if it is possible ... and ... finally - how to say goodbye if it is required.

My knowledge is no replacement for a doctor in a well equipped hospital, but, my knowledge is enough that I might just be able to get someone to that hospital so that they can be properly repaired.


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## stayingthegame (Mar 22, 2011)

perhaps we should discuss treatment of different scenes. such as what to do for a gun shot to the chest or arm. what to do for a chain saw cut. a fall thru a plate glass window. neck and back injuries from falls and auto accidents.


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## SageAdvicefarmgirl (Jun 23, 2011)

jumper13 said:


> Hello, Preppers.
> 
> Now let's say that a catastophic event (take your pick) has taken these advanced medical assets out of the equation. Now what?
> 
> ...


I am all ears for input on this thread! I have sewn up goats and horses that have been attcked by dogs or gotten into fence, I birthed my four children at home with the help of a midwife and I've assisted a midwife with 3 other births. I attended my own daughter's son's birth that, after 32 hours of labor ended in a Cesarean (which I was permitted to watch standing next to her). I am not squemish and consider myself to be stable and in control in emergency situations, but other than that my medical knowlegde is negligable!

Naekid: I have learned how to say goodbye when the time comes, I watched my mom meet her death (and, I believe, her new life in heaven) in hospice care. That is a skill not to be taken lightly in the times to come!


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## jumper13 (Aug 13, 2011)

*soft tissue injuries*

Stayingthegame, you had an excellent idea. We can start with discussing wound categories. You mentioned a gunshot or chainsaw cut, so we can start with bleeding control in the field. First things first...

When dealing with a serious wound, you obviously first have to stop any dangerous blood loss. You never attempt to clean a wound at this point---you only want to stop the bleeding, and any attempt to clean the wound will rip away blood clots that are beginning to form. Stopping dangerous blood loss is best accomplished with a pressure dressing.

To fashion a pressure dressing for a gaping, badly bleeding wound, get clean (preferably sterile) packing material and tightly pack the wound with it. Simply covering the outside of a deep wound won't stop the bleeding. The best wound packing material is sterile z-fold wound packing or sterile 4x4 gauze pads---a lot of them (both of these items are very inexpensive and you should have them in your kit). Use them to pack the wound firmly, then cover it with a separate bandage, wrapping the wound site very tightly. An elastic bandage such as an Ace wrap works great as an outer layer, since it automatically applies pressure when wrapped tightly.

However, for a deep puncture wound such as a gunshot, stab wound, etc, applying pressure deep inside the wound is difficult. This is where Celox and z-fold packing material really comes in handy.

If you are dealing with a very large wound with arterial involvement, the bandage will likely bleed through. When that happens, you can take off the outer layer of wrapping, replace it, and wrap tighter, but NEVER remove any soaked wound packing material from inside the wound until all bleeding has stopped for several hours. If you do, you will destroy the blood clots that have formed in the wound, and bleeding will start again.

So, for treating virtually any serous hemorrhage, just a few simple and inexpensive items will save the day: 
-4x4 gauze pads (lots of them)
-z-fold wound packing
-Gauze bandanging material (lots of it)
-Ace wrap
-Celox

Any comments, questions, ideas, or input so far? Has anyone else had to do this in the field?


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## Beanie (Aug 26, 2011)

Celox looks like an awesome product.


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## NaeKid (Oct 17, 2008)

jumper13 said:


> So, for treating virtually any serous hemorrhage, just a few simple and inexpensive items will save the day:
> -4x4 gauze pads (lots of them)
> -z-fold wound packing
> -Gauze bandanging material (lots of it)
> ...


Something that most trained EMT's (and related fields) don't think about is something that can help control large amounts of bleeding and can be put into place and "glued" to the inside of clothing (if required) and that is a maxi-pad as it soaks up the blood quickly and easily. It doesn't draw the blood out, it just controls it. For "small" issues, I will agree that the 4x4 gauze does wonders and combine that with a roll (or two) of medical tape.

For a chest-wound (gun-shot, arrow, tree-branch, ski-pole, etc) you want the blood to drain away, so, using a plastic-bag taped on three-sides (top and two sides) allows the blood to drain out the bottom. When the person breathes in, the vacuum created by the lungs will hold the soft plastic plastic in place allowing fresh oxygen to enter the lungs - therefore the person will be less likely to suffocate. You will need to work fast to get the person to a hospital, but, you have just bought yourself some serious time.


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## Meerkat (May 31, 2011)

jumper13 said:


> Hello, Preppers.
> 
> I've seen alot of discussion regarding wound care and medical / trauma kits. As a medical professional, I treat serious trauma patients on a daily basis, but like virtually everyone else, my practice has been limited to somewhat controlled situations in a clincal environment, or at least with a clinical environment quickly accessible. Also, there are numerous injuries that can be effectively treated by trauma surgeons and cricial care / life support units that would not be survivable otherwise.
> 
> ...


 Welcome,
Thanks Jumper,good info. Hope thats airplanes your jumping out of.
Never heard of this blood clotting stuff,but have seen the vet stop bleeding from dogs paws when they cut too deep clipping nails,is this the same kinda stuff?
I've heard of spider webs stopping bleeding in the old days,wonder if they are sterile? And of course you have to have a spider handy or save the webs.


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## Meerkat (May 31, 2011)

Beanie said:


> Celox looks like an awesome product.


 Sure does.Wonder what it is and how much it cost?:scratch
All kidding aside this site has some very smart people on it.


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## Beanie (Aug 26, 2011)

Found this...
How Celox Works

Amazon.com: CELOX First Aid Temporary Traumatic Wound Treatment 2g, 10-Pack: Home Improvement


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## BillM (Dec 29, 2010)

*Lacerations*

For lacerations in the wild where no antibiotics are available.

Clean the wound as well as possable useing boiled water and anticeptic.

Do not attempt to close the wound. It needs to heal from the inside out.

Expose the wound to direct sunlight for several hours each day.

Change the dressing daily.


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## jumper13 (Aug 13, 2011)

NaeKid said:


> Something that most trained EMT's (and related fields) don't think about is something that can help control large amounts of bleeding and can be put into place and "glued" to the inside of clothing (if required) and that is a maxi-pad as it soaks up the blood quickly and easily. It doesn't draw the blood out, it just controls it. For "small" issues, I will agree that the 4x4 gauze does wonders and combine that with a roll (or two) of medical tape.
> 
> For a chest-wound (gun-shot, arrow, tree-branch, ski-pole, etc) you want the blood to drain away, so, using a plastic-bag taped on three-sides (top and two sides) allows the blood to drain out the bottom. When the person breathes in, the vacuum created by the lungs will hold the soft plastic plastic in place allowing fresh oxygen to enter the lungs - therefore the person will be less likely to suffocate. You will need to work fast to get the person to a hospital, but, you have just bought yourself some serious time.


Naekid,

A maxipad will not stop bleeding--it only soaks up blood. However, a tampon inserted into a deep puncture wound such as a gunshot or stab wound does help by applying pressure inside the wound. Pressure is what stops bleeding. The worst wound can be effectively treated with properly-applied 4x4 packing and pressure. The trick is proper technique, not the actual material.

Also, a three-sided occlusive bandage is only beneficial for preventing a pneumothorax caused by a "sucking chest wound." A "sucking chest wound" is usually caused by a gunshot, stabbing, or other large object that has penetrated through the chest wall. Sucking chest wounds will bubble and make an actual "sucking" sound when a person breathes. When that person breathes, the respiratory effort pulls air from the outside into the chest cavity throught the wound, causing the lung to collapse (pneumothorax). If the pneumothorax continues to grow, the person could die. The "three-sided occlusive dressing" you mentioned is placed over the sucking chest wound to prevent the pneumothorax from expanding while allowing air to escape the chest cavity. This technique stabilizes a pneumothorax but does not fix it. To fix a pneumothorax, the solution is to insert a decompression needle into the chest cavity to release the pressure and allow the lung to re-inflate. However, this should never be attempted by someone who has not had advanced medical training and has not been specifically trained to do this procedure.

Blood in the chest cavity, called a "hemothorax," can only be drained by a chest tube. In the field, one should never allow a chest wound to continue bleeding. Once in the hospital, a chest tube would be inserted to finish draining the pneumothorax and/or hemothorax.

Applying a three-sided occlusive dressing and decompressing a pneumothorax are both life-saving skills, but again, they do nothing to control bleeding and are only useful in this particular situation. Just clearing this up to avoid further confusion...


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## Meerkat (May 31, 2011)

jumper13 said:


> Naekid,
> 
> A maxipad will not stop bleeding--it only soaks up blood. However, a tampon inserted into a deep puncture wound such as a gunshot or stab wound does help by applying pressure inside the wound. Pressure is what stops bleeding. The worst wound can be effectively treated with properly-applied 4x4 packing and pressure. The trick is proper technique, not the actual material.
> 
> ...


 A bullet wound is very small.
My mother was shot in 1972 when she came home and surprised a burgler,he shot her with a 38.They used long hollow needle to drain her lungs.She had blood coming out of her mouth,nose and ears,everytime her heart beat blood would spurt out somewhere.
She left the hospital and came to me in a taxi! .I had to clean the wound and keep her moving so pnemonia would'nt set in.The bullet was there for the rest of her life,lodged right under the skin on her back.
I have taken care of lots of trama types injuries,includign my own.


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## Clarice (Aug 19, 2010)

I got to seriously thinking about emergency medical needs this weekend. While helping DH drive metal fence post the head came off the 8# sledge hammer hitting me in the forearm. Though not broken my forearm is badly bruised. If it had been broken what would we have done???? Need to bone up on my first aid.


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## stayingthegame (Mar 22, 2011)

years ago while I was fixing a fence I put the tip of the fence tool through my lower lip. the bleeding was very heavy due to the wound being on my face. the wound itself was small and healed on its own. remember that any head wound will bleed what appears it be excessive, but it is due only to the fact that there are a lot of veins in the skin of the face and head.


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## jumper13 (Aug 13, 2011)

*face and scalp wounds*



stayingthegame said:


> years ago while I was fixing a fence I put the tip of the fence tool through my lower lip. the bleeding was very heavy due to the wound being on my face. the wound itself was small and healed on its own. remember that any head wound will bleed what appears it be excessive, but it is due only to the fact that there are a lot of veins in the skin of the face and head.


Good point. Scalp and facial wounds are especially dangerous. The face and scalp are extremely vascular, and there are numerous arteries that run along the outside of the skull under the hair line and along the cheek like a spider web (if you press your cheek just under your upper jaw, you can feel a very strong pulse!). If the scalp or facial wound is large enough, the injured person can bleed to death very quickly. If the wound is gaping, pack it tightly with z-fold or 4x4s, then wrap tightly around the head with a bandage or Ace wrap (or whatever you have on hand---even a belt will work!), keeping continuous pressure directly on the wound.

For a torn or lacerated lip, pinch the lip tightly in your fingers until bleeding has stopped (this can take up to 30 minutes for a bad cut). Torn lips are very painful and can bleed profusely but are rarely life-threatening.

Remember---pressure stops bleeding.


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## neldarez (Apr 10, 2011)

What an awesome thread this is............I haven't ever done any of the things you guys have but I have set DH and I up with the red cross instructor for sept 10 and he's teaching us 1st aid and cpr.............Please keep on teaching, I'm reading it all and will take notes...........


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## jumper13 (Aug 13, 2011)

*wound cleaning and irrigation*

Now that the bleeding has finally stopped, it's time to clean the wound.

If you had to apply a pressure dressing to stop a dangerous hemorrhage, you should leave it in place for at least 24 hours, giving the body time to close the bleeding vessels securely. Ideally, the only person that should remove a pressure dressing or wound packing is a physician in a clinic or hospital. However, if this is not an option, you will have to do it yourself.

Make sure you being this step by providing a clean environment! Wash your hands, use a clean work area, and make sure that any instruments you use (such as tweezers) are boiled clean. Our primary goal now is to avoid infection!

If the wound is on the scalp, then trim away all the hair around it before beginning. The hair will contaminate the wound and will get in your way as you work. Don't worry---it will grow back!

Carefully unwrap the pressure dressing and watch for any new bleeding. If the wound was deep enough to have required packing, VERY CAREFULLY begin to remove the wound packing, again noting any additional bleeding. The wound may ooze a little fresh blood as you reopen it, and this is OK. However, any gushers need to be stopped and the pressure dressing put back in place.

The wound must now be aggressively irrigated with clean water under pressure. The ideal tool for this is a bottle of sterile saline eyewash from Walmart or any pharmacy. A liter bottle will cost you about $1.00, and they are worth their weight in gold for wound care. You can also use a syrringe full of clean / sterile water or saline if you have it. Use your tweezers or similar tool to hold the wound open, and shoot a strong stream of water into the wound, washing it out completely. As you do this, you will loosen a few blood clots and the wound will ooze some blood as well, and this is OK! Repeat this process several times. You can also use your tweezers to remove any bits of debris that the irrigation is unable to remove. If the wound is really dirty, then use some clean, sterile 4x4 gauze pads to gently scrub the wound while irrigating. Once you are convinced that the wound is clean, wash it out again! Remember, you cannot irrigate it too much!

After the wound has been irrigated, apply a generous amount of triple-antibiotic ointment to all the wound surfaces, then cover the wound with a clean gauze bandage to protect it.

*Note: Never use alcohol, hydrogen peroxide, or iodine to clean deep, open wounds. These should only be used for cleaning skin. Alcohol, hydrogen peroxide, and iodine will destroy viable flesh and should never be applied to open wounds. *

Supplies needed for wound cleaning: 
-bottles of sterile eyewash (stock up a whole case!) 
-more sterile 4x4s (stockpile a case of them--they have hundreds of uses)
-tweezers
-triple antibiotic ointment (keep a bunch on hand!)

I'm sure some other folks have some more tricks and tips for wound irrigation and wound cleaning in the field. Let's hear 'em...

We'll discuss wound closure and healing techniques a little later.


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## CulexPipiens (Nov 17, 2010)

jumper13 said:


> ...To fashion a pressure dressing for a gaping, badly bleeding wound, get clean (preferably sterile) packing material and tightly pack the wound with it. Simply covering the outside of a deep wound won't stop the bleeding. The best wound packing material is sterile z-fold wound packing or sterile 4x4 gauze pads---a lot of them (both of these items are very inexpensive and you should have them in your kit). Use them to pack the wound firmly, then cover it with a separate bandage, wrapping the wound site very tightly. An elastic bandage such as an Ace wrap works great as an outer layer, since it automatically applies pressure when wrapped tightly....


Any comments on the Isreali Battle Dressing product?

I've seen it offered in 4 and 6" sizes. Amazon.com: The Emergency Bandage 4" (Israeli Bandage): Health & Personal Care


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## jumper13 (Aug 13, 2011)

CulexPipiens said:


> Any comments on the Isreali Battle Dressing product?
> 
> I've seen it offered in 4 and 6" sizes. Amazon.com: The Emergency Bandage 4" (Israeli Bandage): Health & Personal Care


It's a great product. So is the US GI-issue pressure dressing. I currently have a couple of the US-issue ones and have used the GI-issue pressure dressings numerous times in the past. Both the Israeli and US versions do the job, do it fast, and do it well. They are ideal for stuffing in your pocket or pack. I'd recommend having a couple on hand for really bad stuff like gunshot wounds or chainsaw accidents, etc, not for small stuff. They are somewhat expensive.

If you have the supplies stocked up that I mentioned earlier, they work just as well when used with proper technique and are alot cheaper to buy in bulk for treating numerous injuries.


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## nanosilver (Jun 21, 2012)

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Be well... Don


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## SARSpecialist (May 31, 2012)

Keep in mind folks that "allot" of times an amputation that is NOT caused by a large kenetic event such as an explosion, large bullet ect will not bleed excessivly for a short period of time. Once the arteries relax and veins dialate post injury thats when the bloodloss will occure. You will have a short window in such an injury to ensure that treatment will diminish blood loss if it begins to bleed freely.

Case in Point: 29 y/0 male was on top of a large vessle, as he entered the hatch to climb down the vessle lid 200 lbs slammed shut on his arm severing it between the wrist and elbow.. when we arrived he was awake alert and in great pain, his fellow workers did a great job at securing his injury with a towel, rags and duct tape.. he lost what I guess was only 12 -16 oz of blood at the injury site.. when he recieved pain meds, 02 and an IV while in route to the hospital it began to bleed more freely but was controled with pressure points and a BP cuff as a constricting band (NOT A TOURNIQUET).. by the way it was re attached but the graphs failed to take and infection set in. I guess my point is this, just because an injury looks terrible and gross it may not be what is going to kill the person; focus your assesment on life threats and fix those... the rest will be a cake walk.


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## CrackbottomLouis (May 20, 2012)

Good thread. You guys are getting me excited about starting nursing school this spring. I was wondering about the shelf life of painkillers that would be appropriate for more severe trauma. For obvious reasons these are difficult to stockpile and I think the gov would consider it improper to grow poppies even for more legitimate purposes. The process seemed simple in Afghanistan however. What are some legal things I can grow for when I need something stronger than willowbark?


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## CrackbottomLouis (May 20, 2012)

My medical kit for home base for trauma would most likely include bleach, clean bandages, a whole bunch of sterile gauze, tourniquets, astringents, surgical tools, some way to cauterize, antibiotics, and pain killers. In date saline, IV materials, tape, and ace bandages as well. I have most of this stuff from my army med kits and personal prepping but wouldnt whip it out unless it was a dire situation. Besides army cls and a bunch of science classes my lack of training makes me more dangerous than helpful in my opinion. If the situation was that bad I could give something a try I suppose. Cant wait to read more of this thread, finish school and get some actual experience so I can be more useful to those around me!


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## jumper13 (Aug 13, 2011)

CrackbottomLouis said:


> My medical kit for home base for trauma would most likely include bleach, clean bandages, a whole bunch of sterile gauze, tourniquets, astringents, surgical tools, some way to cauterize, antibiotics, and pain killers. In date saline, IV materials, tape, and ace bandages as well. I have most of this stuff from my army med kits and personal prepping but wouldnt whip it out unless it was a dire situation. Besides army cls and a bunch of science classes my lack of training makes me more dangerous than helpful in my opinion. If the situation was that bad I could give something a try I suppose. Cant wait to read more of this thread, finish school and get some actual experience so I can be more useful to those around me!


Hi, Louis.

What is the bleach for in a trauma situation? Or is it for other survival uses such as water decontamination?


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## NurseAmyfromDoomandBloom (May 13, 2012)

Medical Supplies with Natural Remedies
Here's my list of Collapse medical supplies with natural remedies included( we should have these as back-ups or for first use supplies to save commercially made items!). Dr.Bones and I spend a lot of time and energy researching "back-up" plans for traditional medicine. We want YOU to have the knowledge to provide medical help if we have a collapse. I have planted over 60 different medicinal herbs in my raised beds and am learning how incredible natural remedies can be.
Collapse medical supplies: 
oral antibiotics-(or if emergency, fish meds) may also include garlic oil, honey,cayenne,thyme oil,peppermint oil and eucalyptus oil as herbal alternatives or fresh garlic or ginger OR if you can't acquire Rx antibiotics, see our 4 part series that discusses antibiotics/their fish antibiotic equivalents and how to use them, this is part one: http://doctorbonesandamyshow.blogspot.com/2011/11/antibiotics-and-their-use-in- collapse.html 
antibiotic ointment and/or antibacterial herbal salve ( with calendula/tea tree oil/lavender oils) 
multi size bandages- lots of these in several sizes, spot, knuckle, size 1×3 is great to cover most lacerations 
ace bandages- 
steri strips and butterfly bandages to close minor lacerations 
TONS of gauze/dressings (sterile and non-sterile 4x4s) include lots of "telfa" pads( non-adherent-so healing wounds won't stick to the dressing) and a xeroform petroleum dressing (non stick) 
ABD pads (usually 5×9) also called combine dressings 
10×30 trauma 
dressing tapes- include duct, adhesive and paper ( for adhesive tape allergies) 
quality bandage scissor/trauma shear ( ALL METAL, the plastic handle ones break cutting jean material!) 
Pliable fracture material 
mole skin padded- for blisters scalpels
LOTS of nitrile gloves 
a few pair of sterile size 7 1/2 or 8 gloves (or more!)
hand sanitizer 
antibacterial soap
betadine swabs/wipes- wipes are great to make a betadine solution with water
60cc syringe- for wound irrigation and cleaning
BZK wipes-to clean hands/wounds 
alcohol pads -to clean instruments/hands
masks- surgical(for sick people) and 
N-95s(for healthy people to keep them from getting sick!) 
dermabond (Rx) OR super glue ( may burn the skin) 
needle holder and 
sutures (2-0 nylon- don't bother with 3-0 or smaller- higher the number=smaller the needle!) - watch Dr.Bones' youtube.com/drbonespodcast video on How to Suture for instructions (in a collapse)
skin stapler/remover (if you or someone you know knows how to use properly)
curved kelley clamp ( to remove foreign objects from wounds) 
tweezers 
several large safety pins 
magnifying glass 
pen light or good flashlight
lighter- to start fires for boiling water or sterilizing instruments
tongue depressor(s) 
clotting powders/dressings- cayenne ppepper powder may help minor bleeding 
styptic pencil- minor bleeding 
quality tourniquet- only use in severe bleeding that will not stop with direct pressure or clotting agents in a severe emergency
pressure dressing - olaes modular bandage or Israeli bandage

blood stopper dressings (dressing with 2 kerlix attached for wrapping) 
Q-tips 
cravet triangle bandages 
snake bit kit 
rubber bag (hot water bottle) 
Re-useable GEL packs- can be cooled OR heated 
aquatabs 
Fels naptha soap- to wash off poison Ivy,oak or sumac from skin and clothes (also a great clothes detergent) 
dental kit- toothpicks, 
dental mirror, 
cottontip applicators, 
dental filling material ( commercial or mix zinc oxide powder and 2 drops clove oil), pill cups for mixing the dental filling, 
baking soda, 
hydrogen peroxide and 2 drops of peppermint oil make a great gum treatment and toothpaste 
extra essential clove oil (numbs dental pain when applied directly 
Eye cup 
eye wash 
eye pads/eye patch 
an Ear oil natural remedy ( usually has garlic oil and mullein oil)- use 2 warmed drops in the affected ear and place a cotton ball over the ear canal secured with paper tape, repeat 3 times daily. 
claritin (non-drowsy antihistamine)- hay fever/allergies 
benadryl ( drowsy antihistamine)-allergic reactions to stings/medication/food/contact with irritants/this is the other
ingredient in tylenol PM! It really puts you to sleep at 50mg dose, but this is a better dose for serious allergic reactions! epipen (Rx), if needed for serious allergic reactions sudafed-decongestant, 
eucalyptus essential oil- also a decongestant and good for coughs ( direct or steam inhalation/ a good insect repellent pain relievers/analgesics- 
aspirin (not for children) /
Tylenol/
ibuprofen
arnica essential oil/salve (great mixed with St.John's Wort)- also an analgesic used externally in very dilute amounts (6-12 drops per ounce of carrier oil) see my articles (doomandbloom.net) on Natural Medical Kit:Essential oils. Great for bruises, joint and muscle pain, fracture pain, use ONLY on intact skin. 
Other Analgesic Essential Oils -Consider 1 or 2 of these - lavender,chamomile,rosemary,eucalyptus, marjoram 
Imodium-for diarrhea tx
hydrocortisone cream- anti-inflammatory, good for rashes 
helichrysum essential oil- also anti-inflammatory and additionally an analgesic 
Lip balm-I love carmex brand
A&D ointment-great for rashes 
Bag Balm-also great for rashes
Aloe vera- for burns 
zinc oxide cream-rashes and a sunscreen 
zinc oxide powder medical grade- to mix with Clove bud essential oil, and make a temporary dental filling 
RAW honey-externally for serious burns and wound treatment/internally mix with garlic oil for an antibiotic and sore throat tx
vinegar 
tea tree essential oil-antiseptic/antifungal/insect bite tx/burn tx 
lavender essential oil-analgesic/antiseptic/calming effect for insomnia,stress/skin care-rashes and cuts 
peppermint essential oil-respiratory and nasal congestion/Headache tx 1 drop to temples or inhale vapors/also good for digestive disorders/achy joints and muscle tx/ use 2 drops on toothbrush with baking soda 
geranium essential oil- decreases bleeding when applied to wound/lowers blood sugar/burn tx /antibacterial 
thieves blend essential oil- A mix of clove,lemon,cinnamon,eucalyptus and rosemary oils- Antibiotic/antiseptic/and a host of other actions.

chamomile tea bags- internally relaxing,headache tx and digestive problems/ external compress for burns,bee stings 
ginger tea bags- internally good for nausea, stomachaches, digestive problems like gas and bloating, also good for motion sickness (crystallized ginger is an alternative, but weighs more) 
echinacea/elderberry tea bags- supports immune system, decreases flu and cold duration aloe vera laxative tea bags- usually contains senna mixed with other herbs for a better flavor powdered 
Gatorade or rehydration tablets/powders- for rehydration drinks ( to tx dehydration) multi-vitamins, extra vit c (tablets and powder)and zinc

With the above list you can handle: 
colds/flu/cough/sore throat/lung congestion aches and pains 
allergies/allergic reactions 
skin irritations and conditions 
digestive upsets and nausea constipation/diarrhea
bug bites/ bee stings/ 
contact dermatitis( poison ivy/oak/) 
burns/sunburn minor cuts. 
scrapes and lacerations-including suturing 
headaches, 
sinus congestion 
ear/eye/dental issues 
stress and anxiety 
oral hygiene and 
basic dental tx 
surface disinfectant 
insect repellent and 
wash clothes!
I hope this helps, I have spent almost 2 years researching what would be really helpful and USEFUL in a collapse situation. Airways and ambu bags without a hospital to transfer the patient to, are mostly a waste of money. I would concentrate on the supplies you will need most and will likely be able use without too much training. Knowledge is power! 
Nurse Amy
www.doomandbloom.net


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## jumper13 (Aug 13, 2011)

Sounds like a very good medic bag. I like your emphasis on natural remedies as well, an area in which I'm not to familiar, but currently studying.

Your last statement: "Airways and ambu bags without a hospital to transfer the patient to are mostly a waste of money" is unfortunately very true post SHTF. They are a waste of space as well. Too often, preppers want to prepare a "military, combat-ready major trauma kit" rather than concentrating on what they need to actually be able to treat and heal people long-term. Post SHTF, a major trauma patient leaking red stuff out of multiple holes that we intubate, stick full of IVs going wide open, insert chest tubes, and piece back together with duct tape might make us medical folks feel like we are doing something grand, but the patient is still going to die, regardless of the priceless medical supplies we waste on them. We should concentrate on those we can save! This will mean making some very difficult decisions...

Very nice post, Nurse Amy. I'll be looking at your website.


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## NurseAmyfromDoomandBloom (May 13, 2012)

Thanks Jumper! It really is a matter of flipping the mindset from "stablize" to "treat". You aren't sending your patient off for further care in a modern medical facility, you are the end of the line. Triage will have many more "black tags" because of this. Once internal bleeding has been diagnosed, that person is most likely going to die without surgical intervention. Tough reality will be hard to swallow. So our goal is to provide some education for the issues we CAN handle and TRY to solve. Survival Medics won't be able to perform internal surgery, but they will be better prepared for most issues we may all face if there are no hospitals to help us. 
I really appreciate the knowledge you are sharing here, if we all continue to teach each other the skills we have then we will all be better prepared if something terrible occurs.
So I'm here to learn also, no one knows it all, even though we WISH we did! 

Pearls of wisdom are appreciated, and I want to thank everyone who takes the time to share them with us and other preppers. Without each other we can't survive.

Thanks again,
Nurse Amy


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## netandtim (Oct 8, 2008)

I know we've moved pretty deep into this topic and I'm a little late to the party. But the one thing that keeps running through my head is "scene size up". This was drilled into our heads in the fire department as well as EMT work. Too many people get far too excited about the 'red stuff' be it flames or blood as soon as they pull on scene. For me, the first rule of wound care in ANY enviroment must be self-preservation.


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## goatlady (Nov 7, 2011)

As for those snake bite kits, testing/experience has shown they are basically useless. Regardless of the snake venom toxic, hemo or neuro, it moves way to fast to be drawn out with any effect. To wit, I personally was bitten twice, full venom releases, by a copperhead on the side of my ankle. By the time I walked 8 steps into the house the foot and 6" up the ankle was swollen all out of proportion. By the time I got to the hospital in 30 minutes the swelling was up to mid calf. BUT the hospital did NOTHING except hydrate with normal saline, inject Demerol, and monitor the rise of swelling and drew blood for 20 hours observation. Now I know how to treat at home! One thing they failed to mention to me at discharge and on the followup visit was than copperhead venom can make a person extremely anemic for quite a while. I finally tracked that tidbit down trying to figure out why I was dragging my body around barely 2 months after the bite. Added some sort of liver twice a week (chicken was real tasty wrapped in bacon and baked) intake and vitamins and was back to normal in 30 days. Also did you folks know you can sterilize equipment and dressings, etc. in a pressure cooker, even over an open fire, 10 pounds pressure for 10 minutes = autoclave. Premake packets of homemade dressings using a vac-packer, toss in the pressure cooker and those packets are shelf stable and sterilized until they are opened and used. Might come in handy in the far future.


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## SurvivorBoy1 (Jul 15, 2012)

Goat lady!
What do you wrap dry supplies in to Autoclave in pressure cooker and how do you pack the cooker to keep them out of the water in the bottom ? My mom is OR nurse so we understand the theory.


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## goatlady (Nov 7, 2011)

I was taught to use vac-pack food bags - they are boilable and the water will not damage them at all. I pack a dozen in a single pack. Yes, it will wrinkle and look crushed, but they will get sterilized in the centers. Of course that predicates having a bit of electricity handy (genie) OR having a goodly amount already packed up, sterilized and in your packs/packed in tots, etc. ready for future use. Doesn't matter when you are sterilizing metal instruments, they can just go in the cooker/canner as is


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## Shiningstone (Jul 31, 2012)

Once we went out camping and one of our colleagues got a deep cut from a sharp knife, started bleeding heavily, Luckily we had some extra clothing and some first aid equipments.


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