In the midst of preparing for any and every disaster that might come along, one thing that is often overlooked is the need to prepare for medical emergencies. Few of us have any real medical training, farther than giving aspirin and putting on a band-aid, and we tend to look at the profession of medicine a bit like the black arts. We see it as something beyond us, so we don't bother studying it.
But medicine, like any other skill, can be learned. Have you ever gone to a doctor who you didn't' think was all that bright? Well, if that doctor can make it through medical school, then you can learn at least the basics as well. You really don't need to know everything a doctor knows, just how to deal with most emergency situations and how to diagnose basic illnesses.
The thing we have to realize is that medical facilities and services tend to become overloaded in any sort of crisis. Not only do they have to deal with their normal workload, but they also have to deal with the surge of new patients that the crisis creates. This taxes the medical community to the limit.
With the medical community so overworked, it is hard to get the care you need. Triage becomes more critical than ever, with many patients left to wait, while more serious cases are attended to. There have even been cases in the past where patients who had little chance to survive were left to die, so that the doctors and nurses could attend to those whose chance of survival were higher. While that sounds cruel, at times it is a very real necessity.
Then there's the whole problem of getting patients to medical help. You won't necessarily be able to get an ambulance, as the ambulance crews will be as overworked as everyone else. So, you'll probably be better off driving them there yourself, assuming the roads are passable and you have gasoline.
Regardless of what is going on with the medical community, prompt application of first-aid to the patient is probably the greatest lifesaving technique known to medical science. Emergency room doctors regularly say that the EMTs riding in the ambulances save more lives than they do. That's because the EMT is the first one who treats the patient. In doing so, they lessen the impact of the three biggest killers in any accident:
- Blood loss
So, being able to apply effective first-aid is an important lifesaving skill; one that we all should know. Many survival teams try to have at least one person who is medically trained, to fulfill that role. But one may not be enough. What if you can't meet up with your team? At least one person in your family should have enough medical training to be able to apply effective first-aid and stabilize a patient.
What Exactly is First-Aid?
First-aid refers to the first medical treatment provided by the person known as the "first responder." Let's just assume that we're talking about you, in this case. It includes evaluating the patient's condition and doing whatever is necessary to stabilize them. More than anything, first-aid is about making sure that they don't get any worse, before they get to a medical facility.
You are not going to be able to provide full medical treatment to someone who is injured. However, in many cases, the first-aid you apply will be the single most important treatment they can receive. In fact, I'll go as far as to say that good first-aid treatment can at times take care of the patient well enough that they don't need any further treatment. This is especially true in the case of minor wounds.
Remember the biggest killers I mentioned earlier? Those are dealt with by the person who provides first-aid, not by the doctor in the emergency room. Yes, doctors will often clean out a wound in the emergency room and will prescribe antibiotics to prevent infection. But if you don't clean out the wound in the field and stop the blood flow, the patient may not make it to the emergency room in severe cases. A lot depends on the size of the wound; but a lot depends on the first-aid applied as well.
More than anything, first-aid is about keeping the patient from getting worse from the point of the accident to the emergency room, where they can get further medical treatment. If you can do that, you've accomplished a lot. Those first minutes are critical, especially when it comes to blood loss.
True medical professionals study a lot about how the human body works. While I can understand the needs that a doctor or nurse has for that information, I'm not totally convinced that you need it in order to apply first-aid in an emergency situation. Being able to tell the gall bladder from the appendix isn't going to help you bandage a wound. However, basic anatomy and knowledge of how the body functions will help keep you from making some serious mistakes.
There are many places which offer first-aid training, from your local Red Cross office, to schools that train medical technicians and emergency medical personnel, to online courses that you pay for. But perhaps some of the best training around can be found on YouTube.
Granted, you're going to find some of the worst training around on YouTube as well, so you have to be careful about what you choose. As a general rule of thumb, I'd recommend watching two or three videos about the same specific treatment, in order to ensure that you are receiving the correct information. If the videos are in agreement, the repetition will help you to remember; if they aren't you'll quickly be able to spot the bad information.
Watching without practicing isn't enough though. When the time comes, you're going to have to be able to act quickly. There won't be time to review the video in your mind and remember the steps. You'll have to know those steps like the back of your hand; either that, or have them tattooed there.
Effective practice requires using the same sorts of medical supplies as you will use when you have to do it for real. That dissuades many people, because medical supplies are expensive. But if you don't use real medical supplies, you won't get a "real" reaction. That could be enough to throw you off when the time comes.
Make sure that you follow all the steps, such as cleaning your hands and putting gloves on them. If it tells you to fill a syringe with clean water to irrigate the wound, then do so. Otherwise, you'll never encounter the difficulty of doing so in gloves, until an emergency comes. You don't want to be learning how to do it then. About the only thing you want simulated is the wounds that you're dealing with. It's really not necessary to cut up your family members, in order to practice bandaging them.
Okay, so your training needs to include both instruction and practice; but what exactly do you need to study?
- How to treat a basic wound - What to do when someone is cut open, whether by working with a chainsaw, being in a knife fight or having an accident in their car. The issues here, more than anything else, is cleaning, closing, medicating and bandaging the wound.
- How to treat a gunshot wound - While gunshot wound are similar to other types of wounds, the internal trauma caused by a bullet passing through the body at high velocity creates a lot more internal damage than a knife can. Therefore, study gunshot wounds separate from basic wounds, so that you'll know what things to look for.
- Treating a "sucking chest" - Lung wounds are extremely serious, but can be survivable. The main thing you have to do, besides keeping the patient from bleeding out, is to keep them from drowning in their own blood while transporting them to the emergency room. Take the time to learn how to do this.
- Dealing with a head wound - Head wounds bleed a lot, because one-fourth of the body's blood supply goes to the brain. This creates some special challenges in treating the wound, as you can't really reduce the blood flow to the wound, like you can in an extremity.
- How to treat severed or nearly severed limbs and digits - Hopefully you'll never run into a case like this, but auto accidents and working with power tools can cause some extreme trauma. In addition to what you need to know for treating any other wound, you need to know how to properly use a tourniquet, to control the flow of blood.
- Recognizing and treating broken bones, sprains, and damage to tendons or ligaments - You really can't do much more than stabilize broken bones and damaged ligaments; but you have to be able to recognize and stabilize them. The main purpose here is to prevent further damage caused by the broken ends of the bone.
- Recognizing potential spinal injuries and preparing the patient for transport - Spinal injuries can lead to partial or complete paralysis, if the spinal cord becomes damaged. This makes it crucial to immobilize the spine and transport the patient in such a way as to prevent possible movement, even when there is only a possibility of spinal injury.
In addition to these injuries, you should also take the time to learn how to deal with the following conditions:
- Recognizing and treating hypothermia and hyperthermia - People always mix up these two. But if you can remember that a "hyperactive child" is one that moves around too much, then it becomes clear that "hyperthermia" is too much temperature or too much heat. Hypothermia must then be not enough heat. These conditions are much more likely to occur when we aren't hiding in our air conditioned and heated homes. How do you recognize them and what can you do about them?
- The difference between a cold and the flu - Both are infections by microorganisms, but they are quite different. So is the treatment for them. Many other viral infections will start out looking like the flu as well, so early identification is necessary for dealing with a pandemic situation.
- How to survive a pandemic - More than anything, this is about how to protect you and your family from becoming infected by the pandemic.
- The causes and cures for dysentery - This is a common problem during a crisis situation, as clean water and hygiene may not be up to par.
- Treating infections - Everything from ear infections to urinary tract infections is caused by microorganisms; bacteria, protozoa or viruses. Not all of them are treatable. Antibiotics only work on bacteria, not viruses. But even then, not all antibiotics are equal. You need to know which ones to use when.
- Over-the-counter medicines - Which over the counter medicines work for which needs. Do you know the difference between an antihistamine and a decongestant and when you should take each? That's valuable information to keep you from wasting valuable medicines.
- Recognizing and testing for low blood sugar - Low blood sugar can happen to anyone, not just diabetics, especially if you are not on a well-balanced diet.
- Recognizing and testing for dehydration - Another common problem in a crisis situation, especially when there isn't adequate clean water. But dehydration can kill, if it goes too far.
- Herbal medicines - If the crisis lasts long enough, medical supplies may run out. Knowing which common plants can be used as medicines could be a lifesaver in such a time. Concentrate on those that either grow in your garden or grow wild in your area. There's no real advantage in knowing all about some herb that you can't find.
There are many other diseases and medical conditions that require more specialized knowledge than you can possibly learn. Not even all doctors know them, as medicine has become highly specialized, with doctors only learning a specific specialty. The subjects mentioned above are those that you can deal with on a first-aid level. Beyond that, you'll need the help of medical professionals.
Building up Your Supplies
Of course, to deal with these situations you're going to need the right sorts of medical supplies on hand. Your typical first-aid kit, that you can buy for $19.99 at your local pharmacy or big box store, isn't going to do it. That's okay for minor cuts and scrapes, but it isn't going to do the least bit of good in a case where you have a major injury. For that, you need a full trauma kit.
You can buy trauma kits online from a number of sources. Some of them are quite good, even without the expense of buying a professional grade kit. More than anything, you need a kit that has bandages and other supplies that are big enough to deal with the larger wounds. An adhesive strip may hide a bullet hole, but it won't soak up enough blood to do any good. You've got to have bigger bandages.
In addition to size, you also need to consider quantity. During a crisis and its aftermath, chances of injury are increased greatly. You probably won't just have to deal with one injury, but several. Make sure that your kit is big enough to handle several wounds.
It doesn't hurt to have extra supplies stashed away in a box, either. I've got a fairly large first-aid kit that I've built, but then I have a box in the bathroom closet, which contains extras of many of the key supplies in that kit. While I don't have extras for everything, I do have extras for the things that I am most likely to need.
Quality is an important factor as well. Some people try to get by cheap on their first-aid supplies, but that doesn't work. Cheap first-aid supplies, like cheap anything else, are going to let you down, when you need them the most. For example; cheap adhesive bandage strips will come off when you move, while cloth adhesive bandages are flexible and will move with you. Cheap medical scissors will bend when you try to cut blue jeans off from around a wound, while good ones will go right through that denim.
So, what exactly should you have in your first-aid kit? Well, there are a lot of opinions on that; partially because products overlap each other in their use and effectiveness. But let me take a stab at it.
Basic trauma include all small-scale injuries, such as a cut finger or a scraped knee. You'll need to clean those injuries, put some sort of disinfectant on it and cover it with a bandage to protect it. The wound should be cleaned and re-bandaged daily.
- Cloth adhesive bandages - To include knuckle bandages and fingertip bandages. These specialty bandages are designed to stay on in places where a normal adhesive bandage will just come off
- Irrigation syringe - For cleaning out the wound with sterile water. If you don't have sterile water, then clean drinking water can be used
- Alcohol wipes - To clean off the site of a wound
- Antibiotic ointment - To kill any bacteria that might have gotten into the wound
- Sharp-pointed tweezers - For removing any foreign matter in the wound, such as gravel, slivers and splinters
- Medical tape - For those situations when the adhesive on the bandages isn't enough.
- Benzoine - This is used to clean around the wound, so that the bandage will stick better. While not always needed, it's a good idea to have it on hand for those times you do need it
This particular area is my biggest concern. Dealing with severe trauma is much harder than dealing with minor trauma, simply because of the greater blood flow. Controlling that blood flow is important, as a severe loss of blood can kill the patient. Even if you stop the bleeding before they die, the greater the blood loss, the longer their recovery time will be. The body will have to make new blood cells to replace those lost, if blood for a transfusion is not available.
I'm only going to add those things that are not mentioned above. You may need those items as well, but I don't want to repeat, in order to save space in this article.
- Large bandages - Women's sanitary napkins actually work quite well for this, as they are sterile and designed to soak up a lot of blood. You might also consider getting a good stock of 4"x " gauze pads
- Cohesive medical tape - Any medical tape will work, but cohesive tape doesn't stick to the skin. Instead, it's a rubber tape that stretches and sticks to itself. That's easier on the patient
- Pressure bandage - Putting pressure on the wound is one of the best ways to slow down bleeding. The SWAT tourniquet is one of the better solutions for this need
- Clotting agent - There are several of these on the market, sold under names like QuikClot and Celox. Putting this on the wound helps to reduce bleeding by promoting clotting
- Israeli bandages - These bandages, designed for the Israeli Army, come in two sizes; 4 inch and 6 inch. They combine a bandage that contains a clotting agent with a pressure bandage; making it very easy to treat the wound.
- Steri-strips or butterfly closures for closing the skin over open wounds (like knife cuts) - These replace sutures for those who don't know how to suture correctly
- Stretch gaze - Used for covering a dressing and keeping it in place. You don't use this and the cohesive tape together, just one or the other
- Tourniquet - If you don't have the SWAT tourniquet in your kit, you want to have some sort of tourniquet. I prefer the kind that can be operated one-handed, so that you can use it on yourself, if necessary
- Hemostats - For closing off a severed blood vessel that is pumping blood
Broken Bones & Sprains
Most broken bones are simple fractures that don't puncture the skin. This is good, as you can just treat the fracture, without having to deal with a wound that could get infected. The major thing you will want to do is immobilize the bone, so that it can't be moved.
- Sam Splint - The Sam Splint is a shapeable splint made of soft sheet aluminum, coated with a foam-rubber layer. The foam rubber is there for comfort, while the aluminum will immobilize the broken bone
- Elastic bandages (various sizes) - For use in holding the Sam Splint in place. They can also be used to provide support to sprained limbs and ligaments
- Combat cravat - A triangular piece of cloth, which is large enough to make a sling out of. It can also be used as a tourniquet or pressure bandage, if needed
- Cold packs - Applying cold for the first 15 minutes after a sprain or twisting an ankle will help limit the swelling so that healing can happen sooner
Skin Rashes, Burns, and Irritations
There are times when you don't do anything that breaks the skin, but you still get injured. In those cases, you need to treat the skin, while protecting it from any further damage. A bandage can do this, but there are other ways as well.
- Tagaderm - These are clear plastic bandages, which have adhesive all around the edges. They come in a couple of different sizes. The idea is that you put the treatment cream on the burn or irritation and then cover it with tagaderm to protect it.
- Hydrocortisone cream - Used for reducing itch, such as caused by poison ivy
- Aloe Vera juice - Probably one of the best treatments for burns and other skin irritations
While those items will take care of a lot of areas, there are some other items you want to include in your kit, so that you are ready to take care of every need.
- Rubber gloves - You always want to wear gloves while treating patients, to protect both you and your patient from protection
- Medical masks - If you know the patient has an infectious disease, you want to make sure that you wear a mask to filter out the viruses and protect yourself. Likewise to protect the patient, if you are the one with the disease
- Antibacterial hand cleaner - Always clean before treating anyone
- CPR mask - Used when administering CPR, to prevent the spread of disease
- Thermometer - While you might be able to tell if someone has a fever with the back of your hand, a thermometer will give you a more accurate reading
- Blood pressure monitor - For checking blood pressure. Many people suffer from high blood pressure, which you'll want to be able to check. Low pressure can be a sign of internal bleeding
- Glucose meter - For checking blood sugar levels.
The list of medicines you might want to consider having on-hand for a crisis can be endless. However, you can accomplish a lot with just a few basic medicines. Other than the antibiotics, the rest of these can be purchased over the counter.
- Pain relievers - Ibuprofen and Acetaminophen. You'll want both, as some work better for some people than the other. You can also give both to a patient, as they don't react with each other.
- Antihistamine - For dealing with runny noses
- Decongestant - For dealing with clogged nasal passages
- Anti-diarrhea medicine - Lopermadine or Imodium
- Pepto-Bismol - For upset stomachs and diarrhea
- Meclizine - Used to prevent nausea and motion sickness
- Opeprazole - Zantac or Tagamet - For excess stomach acid
- Clotrimazole or Micnazone - For treating fungus infections on the skin, such as athlete's foot
- Antibiotics- Unfortunately you need a prescription for these, but you can find veterinary equivalents which will take care of most things
- Dental repair paste - Can eliminate the pain from chipped teeth and cavities until you get to a dentist