There are many shortages that exist in any disaster, post-disaster or emergency survival situation. As preppers, we try to minimize those shortages in our own lives, by stockpiling the necessary food, water and other supplies ahead of time. But stockpiling alone isn’t enough, especially if we don’t know how to utilize the things we are stockpiling.
That’s why, after a while, so many preppers turn to educating themselves, learning new skills. Ultimately, having the right skills is more important than having a huge stockpile, although having the stockpile and the skills together is the best situation we could hope to find ourselves in.
One of the shortages that typically exist isn’t material, but service oriented. That is, medical services. Hospitals, clinics and other medical facilities are usually overrun, especially in the first, critical days after the disaster occurs. Many people get injured and medical professionals are hard pressed to keep up with the influx of new patients, especially if the power goes out and their backup generators run out of fuel.
On top of that, there could be problems with transportation, making it difficult to get to a hospital. In an extreme case, like an EMP, cars might not run. But even lesser disasters can make it hard to get to a hospital, simply because of the roads being blocked by traffic, trees or power lines that were blown down.
Considering the importance of good medical care and the general lack of people who have any medical training, medics are one of the most prized people to have in a survival team. Sadly, most teams are lacking in this area, hoping to pick up a doctor, nurse, EMT or military-trained medic in the wake of a disaster. But even that is risky; leaving an extremely critical team need to chance. Yet if they don’t have a trained medic on the team, what are they to do?
Let me ask a question here. How much survival training did you have, before you started training? Sounds like a trick question, right? But I’m serious. None of us entered our path towards being a survivalist or prepping fully trained. At the most we might have had some camping experience or some skills which would be useful in a survival situation, but we weren’t trained survivalists by any means.
Yet somewhere along the way we learned. We either read enough articles, bought enough books or watched enough videos to become proficient in a wide range of skills necessary for survival. Looking back, we can see that we’re a long ways from where we were when we started, even if we’re not yet at the place we want to get to.
Okay, so if that’s the case, if we’ve learned the necessary skills to survive, why can’t we learn medical skills as well? Why can’t you or I simply learn what is necessary to make ourselves into an effective team medic for our survival team?
I can already hear some of you cringing at that idea, thinking that it’s too much to take on. But wait a minute. I’m not talking about becoming a full-fledged doctor, I’m talking about becoming a team medic. There’s a huge difference between the two. Expecting yourself to become a doctor is a bit more than most of us can handle. But learning how to be a medic is within our reach.
I’ve spent some time in the military and known a few medics along the way. While all of them were relatively bright people, I can’t say that any of them were geniuses. They didn’t need to be. Their job wasn’t to find a cure for cancer or perform brain surgery; their main job was to stabilize wounded people, preventing them from bleeding out and dying. In addition to that, they were the first line of (medical) defense for the troops, dealing with everything from a headache to the crabs.
But these medics weren’t doctors and didn’t try to be. Many did some amazing things, taking care of wounds that were way beyond their training and ability. But while they might stretch the limits of their training and ability in a combat situation, in order to keep a soldier alive, they knew what those limits were. They couldn’t save everyone, even thought they would try.
The thing is, those medics saved more lives than any battalion aid station or mobile hospital ever did. Good doctors will readily admit that. Fast care, even if it isn’t the best care, is more important to ensure a patient’s survival, than anything.
Considering the similarity that exists between a survival situation and a combat situation, we can see that the same level of care that those medics were able to provide, is the most important medical care to be able to provide in a survival situation, and anybody can learn that level of care. You don’t need to be anyone special to become a medic for your survival team; you just need to be willing to learn.
Where to Get Medical Training
There are a variety of resources that you can find for learning basic medical skills. Much depends on where you live and the level of skill you want to acquire. Professionally, emergency care is broken down into four basic levels of certification:
- First Responder – This requires 40 to 60 hours of instruction. People who are trained as first responders usually work some other type of job and have accepted the additional duty of being a first responder in their place of work. They are trained in Automatic External Defibrillators (AED), CPR, oxygen administration, bandaging, splinting and emergency childbirth.
- Emergency Medical Technician (EMT) Basic – This is the first level of professional certification, which comes after about 150 hours of training. At this level, the medic is able to do everything that a First Responder can, as well as being trained on nonvisualized airways, blood glucose level testing and administration of nitroglycerin, epinephrine (done with an Epi-Pen), aspirin and activated charcoal.
- Emergency Medical Technician (EMT) Advanced – This is the next level of training, normally accomplished by people who are already certified as EMT 1 and working in that field. They will have already taken the Basic EMT training and then gone on to another 100 hours of additional training. Advanced EMTs can do everything that an EMT 1 can do, plus use manual defibrillators, intravenous access (giving the patient an IV), cardiac monitoring and the administration of several medications.
- Paramedic (also known as EMT Paramedic) – The jump from EMT 2 to Paramedic is much larger, as the training requires about 1,500 hours. This training usually requires 18 to 24 months to complete and includes a fair amount of field experience. In addition to the skills learned by EMTs, Paramedics are trained in a number of more advanced procedures, most of which require equipment that you wouldn’t have access to. However, there is one critical skill they have, which is worth learning. That is treatment to reinflate collapsed lungs.
If all you want is First Responder level training, you can probably find it at your local Red Cross. Most chapters of the Red Cross offer such training, as well as basic First-Aid training. However, if you want more training than that, you many need to find a private school that offers such training.
Most large cities have at least one private school that offers EMT level training, and you can also find a number of websites online which provide it. There are even some online courses which offer certification as an EMT for free.
What Do You Really Need to Know?
Deciding how much training to get is one of those questions that has no right answer. The problem, like many others in prepping, is that you won’t know what you’re going to need, until you are faced by an emergency. With that in mind, the more you know, the better.
However, there are practical limitations on what you can learn, simply because of your time and other resources. So, the best thing to do is to start learning, without worrying about how far you will go in your educational process. Eventually, you’ll either reach a point where you can’t go any farther, due to some limitation or you’ll still be studying when a disaster strikes.
Don’t expect yourself to become a medical doctor and don’t expect that you’ll be able to save everyone. Sadly, even the best trained doctors can’t save everyone. What you’re training for is to save those who can be saved, so that you can hopefully get them to better medical care.
The other thing to keep in mind is that you will be limited by equipment and laws. Since you won’t be a doctor, you won’t have the knowledge or ability to medicate your patients, except in a very limited way. Neither will you have the full resources of an ambulance or an emergency room at your disposal. So there are things you aren’t going to be able to diagnose or treat.
What you really need to learn is how to deal with medical emergencies. Mostly, this means treating patients who have been in accidents or have been wounded in an altercation. Just learning that will be enough to save many lives, handing them off to medical professionals for further treatment.
In addition, it is good idea to study herbal medicine. Any disaster which is serious enough to require your medical training may also be serious enough that you will have trouble finding the medications that you need. In such a case, the best thing you can do is to go back to the origins of medicine, which is herbal medicine. There are many excellent ways of using herbs to treat those who have injuries or illness. Learning those could be very useful, especially in a major catastrophe, where medicines run out.
Dealing with Injuries
In medical parlance, injuries are referred to as “trauma.” Therefore, a trauma first-aid kit is one that is intended for dealing with injuries, specifically injuries that are larger than your typical adhesive bandage can handle.
You’ll need a good trauma first-aid kit to work with. You can either buy one online, or make your own. I have written an article on how to build your own survival first-aid kit, which is actually a trauma kit. Building your own will save you money and allow you to make sure that you are buying quality components to put in the kit. It also becomes a great way of familiarizing yourself with what’s in your first-aid kit.
Most of what you’re going to be training yourself to deal with is trauma. Whether those injuries are caused by weapons or tools, it really doesn’t matter. I tend to think in terms of two basic injuries, when I think of treating trauma. One is a gunshot wound and the other is a leg sliced open by an axe or machete. In my mind, these are the most likely injuries I would face in an urban survival situation.
The other type of injury that is likely to occur is broken bones. While technically that also falls into the category of trauma, dealing with broken bones is considerably different than dealing with cuts and puncture wounds. Different medical supplies are needed and different techniques are required.
The most basic rule of medical science is this: “First of all, do no harm.” That’s a pretty good rule, if you think about it. If your intent is to help people who are sick or injured, the last thing you want to do is to increase their injury. Rather, you want to eliminate the injury that they have, stabilize them, and help them on the road to recovery.
The skin is a major part of our body’s immune system, blocking the entrance of harmful pathogens (bacteria and other microorganisms). Therefore, any puncture of the skin is to be taken seriously, especially in a post-disaster world, where hygiene may not be up to our normal standards. Bacteria which gain access to the body through cuts, scrapes, abrasions and puncture wounds can cause serious damage, infecting the person or even leading to disease.
Treating these wounds consists of two basic elements, each of which has numerous steps. The two elements are:
- Cleaning the wound to prevent infection
- Stopping the bleeding
Both of these are equally important, but it is often necessary to allow some bleeding, so that the wound can be cleaned out. Fortunately, bleeding helps clean the wound. But excessive bleeding has its own risks, as the body cannot afford to lose much blood and still remain healthy.
Keep in mind that a wound can be much more serious on the inside, than it appears on the outside. The average gunshot wound really doesn’t look all that serious from the entry side; but does considerable tissue damage inside the body. Bullets, especially smaller caliber ones, can ricochet off of bones, causing damage in unexpected areas. Exit wounds are often larger and bloodier than entrance wounds are, especially if hollow point ammunition is used.
The proper sequence of steps to treat an open wound are:
- Apply pressure – The best way to stop excessive bleeding is to apply pressure directly over the wound, not to apply a tourniquet. Place a sterile bandage directly onto the wound and apply pressure, or have someone else apply it, such as the patient. Please note that this step will need to be interrupted to accomplish others in this list. Nevertheless, apply pressure whenever possible.
- Irrigate the wound – Clean the wound out with purified water to flush out foreign objects and pathogens. While you want to use the purest water you have available, if water is safe for drinking, it is also safe for irrigating a wound. Irrigating with an irrigation syringe is more effective than just pouring water into the wound, but if all you have is a bottle of water, pour away.
- Clean the wound – Clean out the wound with alcohol or hydrogen peroxide. Both will kill bacteria and other pathogens. If you don’t have these in liquid form, use alcohol towlettes, the same kind they use in the doctor’s office, when giving an injection.
- Clean off excess blood and water – Clean the area around the wound, drying the skin and clearing off blood and water.
- Apply antibacterial ointment – Like the alcohol, this is to kill bacteria. However, it won’t evaporate away in a moment, like the alcohol will. Cover the entire area of the wound generously, but don’t waste it.
- Apply Benzoin – If you are concerned that the medical tape or the adhesive on an adhesive bandage won’t stick to the person’s skin, apply a coating of Benzoin around the wound.
- Close the wound – In some cases, especially larger wounds, you may need to close the skin over the wound. This is done with butterfly closures or Steri-strips. Both of these are adhesive strips, with a non-adhesive section to go right over the wound. They come in a variety of sizes, so you’ll want to stock a good assortment in your first-aid kit.
- Bandage the would – Apply a sterile dressing to the bandage to protect it and soak up blood. The pad on the bandage or the gauze pad used need to be large enough to cover the entire wound area. If necessary, use multiple bandages, overlapping them, but don’t use adhesive bandages. Additional layers of non-sterile gauze can be applied over the sterile layer, if needed to soak up blood.
- Tape the bandage – Apply medical tape to hold the bandage in place. The new, cohesive tapes work better than the classic medical tape, avoiding the problem of pulling out hairs when removing it.
- Apply pressure – If necessary continue applying pressure to the wound, until it stops bleeding.
Obviously, a couple of those steps are optional, as they only pertain to serious wounds. For example, you wouldn’t need to close a wound that isn’t open. But if you learn the procedure like that, you’ll be ready to deal with most injuries you encounter.
Treating Broken Bones
The other type of trauma you are likely to encounter is broken bones, although I would think this won’t be anywhere near as common as the other injuries. Nevertheless, this is something you need to be ready to deal with.
Before treating any broken bone, you need to analyze the situation, determining the seriousness of the break. You also need to take into consideration how quickly you’ll be able to get the patient to medical help. In cases where you will be able to get them to medical professionals immediately, simply immobilizing the bones is enough. But in cases where it may be days before they see a doctor, you may actually have to set the bone, so that it doesn’t start healing out of place.
This is also complicated by the fact that broken bones are often accompanied by other injuries. The ends of the bone itself may cause serious damage, including coming out through the skin of the patient in what’s known as a “compound fracture.” In those cases, you have to combine treating the broken bone with treating the other injuries.
If there is another injury on the limb that is broken or there is a compound fracture, the injury must be treated, before the limb can be splinted. You will need to use extra care in the placement of the splint, as well, so as to not irritate the other injury.
If we assume a simple fracture, one break only, that hasn’t penetrated through the skin, treatment is fairly easy. All you need to do is to immobilize the bone by immobilizing the joints above and below the break. So, for example, if the forearm is broken, you need to immobilize the wrist and the elbow; but you don’t need to immobilize the fingers or shoulder.
While there are a number of excellent products on the market for immobilizing bones in these cases, you can use literally anything you have at hand. A couple of strong sticks and some rags or paracord to tie them in place will work, if you don’t have anything better on hand.
One of the best solutions is to use what’s known as a “Sam Splint.” This is a thin sheet of soft aluminum, coated with foam rubber on one side. The splint can be formed to fit any limb and cut with normal medical scissors if needed. Sam Splints or their generic equivalent (which are much cheaper) are typically tied to the broken limb with Ace elastic bandages or a SWAT tourniquet.
In cases where the bone has to be set, rather than just splinted, the bones can usually be slid back into place, with the ends meeting correctly, simply by pulling on the limb. You’ll need to get the patient to relax for this, which won’t be easy. You’ll also need an assistant, so that they can hold the patient’s body in place, while you pull on the end of the broken limb. Use your hands, feeling through the skin, to see if the bones are properly in place. Ideally, you don’t want any ridge.
This will be very painful for the patient, possibly to the point of them passing out. If you have alcohol available, a few strong drinks, administered several minutes before setting the bones will help.
Keep in mind that once the bone starts to set, it can’t be moved again, except by breaking it again. Obviously, that’s not something you want to do. So, it’s best to get it set right the first time, even if you have to take a little longer to do it.
Sickness and Disease
Much of what doctors learn in medical school deals with the function of the human body and diagnosing the various maladies that can afflict it. For the most part, this is going to be beyond your ability, even if you do take the time to study emergency medicine. However, you may be the only one who is available in your team to treat these infirmities.
One of the problems with diagnoses of illnesses is that the same symptoms can indicate a wide variety of diseases. Typically, medical doctors look at the symptoms and then order tests to either eliminate or confirm possible causes for that set of symptoms. Sometimes, it takes several different tests to confirm the doctor’s diagnosis.
You won’t have the availability of a medical laboratory or the tests that the doctor uses, so your ability to diagnose will be rather limited. More than anything, you’ll need to see what the symptoms are and make a judgment call, based upon that. A good reference book, such as “Where There is No Doctor” or the Doom and Bloom Survival Medicine Handbook” can be very useful in your diagnosis and treatment of your team.
One key to keep in mind is that in most cases you want to assume something simple is wrong, rather than something serious. Just because someone has chest pain, doesn’t mean they are having a heart attack. They could just have a pulled muscle. Dehydration will give similar symptoms as well, to the point of convincing the patient that they are having a heart attack.
For treatment, you will be limited to over the counter medicines, herbal remedies and possibly some antibiotics. Most doctors won’t give you a prescription for antibiotics unless you have a need for them, but there are ways of buying them. One is to buy veterinary versions of the antibiotics, which are usually made in the same factory, on the same production line, but packaged and named differently. I talk about what these are in my article on building a first-aid kit. Another is to buy your antibiotics in either Canada or Mexico. I have never bought them in Canada, but in Mexico, you can buy them over the counter.
The most valuable antibiotics to stock are:
As I am not a medical doctor, I am not going to make any suggestions to you about dosage or usage of these antibiotics. Information about them is readily available from a number of reputable medical websites online. I would recommend reading up on them, when they should be used and the dosages that should be administered online. You might also want to print out the key information for use in a survival situation.
As for over the counter medicines, you should stock:
- Antihistamine (Benadryl) – for colds, runny nose and allergies
- Decongestant (Sudafed) – for clogged sinuses
- Pain relievers (Ibuprofen and Acetaminophen)
- Anti-diarrha medicine (Loperamide or Imodium)
- Hydrocortisone cream – for reducing itching from rashes
- Ipecac syrup – to induce vomiting. Please note that not all medical professionals are in agreement with the use of Ipecac syrup
- Activated charcoal capsules – for the treatment of stomach and gastrointestinal ailments, including food poisoning
- Throat lozenges
- Filling repair – for temporary repair of lost fillings, cavities and chipped teeth