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Prepper Medical Myths That Drive Me Nuts!

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Editorโ€™s Note: This post is another entry in the Prepper Writing Contest from Huples. In this article, Huples address some medical myths that he believe is being advanced through some of the information on prepper sites and his perspective on steps you might need to take after a disaster.


First off please do not take this as encouragement or advice. This article is strictly theoretical so stay safe and legal!

My background is a couple of decades in trauma intensive care nursing and recently the excellent article on this site Ultralight Get Home Bag List prompted me to make a long-winded critique comment in which I said “One N95? Carry ten. Pandemic one is worse than none. Hum. Maybe an article about that is needed!” and so this is that. I also have a few things to say about wound care, hand washing, dealing with the dead, euthanasia, and suturing based on reading and viewing a few prepper articles.

Supplies below are obtainable from a Pharmacist or a friendly nurse but the suggestions to obtain prescription medications and equipment is, as I said, theoretical, and do not do so as it is likely to be both illegal and dangerous.

I look forward to the comments and I expect you all to be rough on me ๐Ÿ™‚

N95 Masks

These are seen as the gold standard for pandemics and gas/smoke situations.

For gas/smoke they might help a bit but frankly a wet bandanna or a specific smoke hood/gas mask is the prep.

In pandemics they reduce but never eliminate the chance of droplet infection. The 95 means 95% of suspend particulate in the air won’t be inhaled IF you are using it right. So avoid heavy breathing and looking into people’s mouths!

In a pandemic you will need these. I’d suggest 100 per individual for urban preppers. More if you can get them as their cash value will soar.

In my get home bag I have four not one. They last about 20 minutes to one hour depending on your activity level. You breath out moisture. They rapidly fail when damp. They won’t be of much use beyond that except as a reminder to never, ever touch your face/hair. In rain, especially heavy rain keep 6-12 feet away from people and you will be fine without a mask. In dry conditions stay 12-20 feet away.

3M 8511 Particulate N95 Respirator with Valve

Shave your mustache and beard if you feel the need to use one.

Put it on with the bottom strap under your ears/on your neck. Then pull the top strap over your ears and touch only the nose bridge area (it should be metal) and tighten it by pressing. After this do not touch it except to discard. Wash your hands, remove the bottom strap pulling it over your head, and then pull it swiftly off using the top strap. Never, ever treat the discarded mask as anything but a germ laden death trap. Into a plastic bucket by dropping it in and then close it tightly. Then wash your hands.

They cannot be reused and they should never be dangling under your chin and then reused. Do not draw lips on them either. It looks cute but puts you at risk. They are ideal to put on if fleeing a train or stadium. They are required to deal with new people or the ill.

Wound care

Some people seem to believe that antibiotic ointments are antibiotics and seem determined to use them for all wound care. The amount of antibiotic is minimal.

suture-259662_640

There are two types of wounds – superficial and deep. Clean both with sterile normal saline [0.9%]. The deeper ones really need flushing. The superficial wounds dab away with sterile gauze. Remove all foreign objects using your tick forceps (you have these right?). Use antibiotic ointment to cover superficial wounds and burns. Lightly apply it not thickly. Cover lightly if large and leave open if small. Reapply three times a day.

Deep wounds should never have antibiotic ointment put in them. It is not sterile and is really hard to remove when doing three times a day cleaning. Nor should you shove tampons, etc in unless you can easily remove them and the bits of cotton wool that flake off. Use saline and squirt it in.

Remember blood is dramatic and always looks much more than it is. In survival if the patient is talking to you it is not the time to panic and if they are unconscious should you be using supplies on them at all?

Loosely pack all deep wound fully with sterile dressing gauze or those quick blood stop sterile packages. Around deep wounds and burns the antibiotic ointment is awesome to promote healing. Yes use tampons if you have no real gear but I’d not count on survival as likely. If you have real antibiotics use them on people with deep wounds day one.

For deep and superficial wounds I use 3% hydrogen peroxide for the first cleaning. Bubbles and does not hurt. Great to push out debris but then flush well with saline as it will retard healing. However debris left inside the body will cause sepsis and death.

Hand Washing

Few prepper videos ever show hand washing but it is the single most important medical prep there is.

In most scenarios a simple bottle of hand sanitizer will work but plain old soap and water works better, is cheaper, and can be made long after Costco closes. Sure you can make alcohol and use it but I’d rather drink my post SHTF alcohol and sell it. Basic hand washing before eating and drinking seems forgotten by many yet hand to mouth spread of germs is one of the most common way people die in many less developed parts of the world. Boil your water but wash your hands first every time!

For medical stuff have all rings, watches, paracord bracelets off, and wash for two minutes with soap under running water starting at the finger tips and going up to both your elbows. Do this if a radiological or biological event has occurred before entering your retreat and do it again after changing your clothes.

Dealing with the Dead

BurialAfterDisaster

The problem is likely not germs or disposal as is often thought. It is the post STHF Coroner!

Avoid them wherever possible especially if they are moldy or wormy. If a loved one dies during a pandemic photograph their illness, take dated notes, and then use trash bags with duct tape to make a body bag. Remove them and bury them 3 feet (6 to 10 feet is ideal) underground away from water sources. Cover this with heavy wood and rocks. Photograph everything in case a post SHTF Coroner shows up. You do not routinely need an N95 mask or gloves for the freshly dead unless it is a pandemic. The dead will expel gas and body fluids. That will freak you out until you get used to it. If you leave them a few hours they will go rigid and are much easier to move but beware as they will be dead weight!

Euthanasia

This remains illegal so I am in no way suggesting it as a solution.

Theoretically I would have an ample stock of rapid acting insulin {Humulin R} and a syringe. Injecting 1-2 ml of the 5ml stock into a vein will likely cause overwhelming glucose movement and rapid death. Expect a seizure but they won’t feel anything and death will be rapid. 1ml is 100 units. A lot of nonsense is said about storing insulin but it is fine at temperatures below 20C so use a root cellar in hot climes. As with everything it will expire gradually so just up the dosage.

The newly dead by this method are also edible so a theoretical solution to pet concerns in a really bad SHTF scenario. Again photograph them (humans not Fido!) and then after they are dead. Do not mention euthanasia or insulin ever to anyone. As I said this is theoretical but if you have to kill only a bullet is nicer than this. Lots of aspirin and Tylenol works but they cause a hideous death that is prolonged. Massive narcotics would be ideal if available but insulin will be much faster.

Suturing

This seems to becoming a growth area in prepping yet steri-strips work better and are less invasive for smaller wounds. The October 2015 Apocabox had some cheap ones (sorry Creek!) but most nurses can grab much better ones.

Practice and use sterile sutures. Do not pull them tight as you want the edges of the wound to be touching but not rammed hard together. Remove them Day 7 or 14 and take alternate ones out the first days. Stop if obviously infected. Treat as fresh wound and consider opening it up and flushing with saline again and restarting the suturing. If you use normal sewing thread please, please boil it and needle for at least 30 minutes before using it and avoid touching it afterwards. Sterile is the goal not merely clean for anything you insert into the human body in a medical situation.

Take a course in wilderness medicine but really you need to talk an ED or ICU nurse into joining your group. MDs and Vets are great but many of us nurses are the ones who actually deal with the stuff and figure out how to treat rather than just ordering treatment.

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  • TheMountainRN

    Ironic to find many myth in an article on mythbusting. First, N95 only require in closed environment not in open area. Cotton mask have show some efficiency in the disaster literature. Also, on my last fitting i ask how long they can last. If no structural damage to them and they stay on the whole time up to 8 hour. The 20 min is associated to surgical mask. Also they cannot be used in an hypoxic environment. The seal they do would put someone unconscious in matter of min if the seal is proper.
    Wound care does not need any antibiotics unless it show infection using the NERDS/STONES criteria that the litterature as supported. Also, clean is sufficient no need for sterile. Many litterature as show that. When irrigation is done the most important, less discuss topic, is having the right gear to achieved proper PSI.
    Why suture when stapling is easier to carry, easier to use and less complications rate? Also, can be used to improvised different wound care approach for complex wound.
    Lastly, interesting question for euthanasia. I think CO poisoning would be easier to do, more accesible and seem painless. There a reason a lot of people choose it for suicide.

    • tman

      I’m not game for euthanasia.

      • Huples

        It is illegal and many consider it unethical. I am in no way suggesting it. However if I am burned over most of my body I’d like a way out of the pain in SHTF. It is something we should consider even if the answer is never.

    • Huples

      Thanks for the reply MountainRN and I love your stuff. Sorry about the long winded reply and please understand i am talking both to you and the general audience. I get it that you get it!

      8 hours is pushing it if you are doing anything other than sitting at a desk writing. They get damp quickly from breathing. Does your hospital use 8 hour shifts? That might explain the figure in these $ strapped days! I am sure in reality the maximum safe zone is between 1 hour and 8 hours but the risk of fatigue causing hand touching the outside of the mask rises with length. If you need it on more than an hour I’d suggest leaving, removing, hydrating, and returning. I have done 6 hours with no break in a SARS room. It was not safe. When I returned again I had the Hepa Hood on but no N95. I had forgotten.You sweat badly giving isolation care so wear tight fitting breathable sports clothes not thick material.

      As MountainRN said “if the seal is proper” so the N95 mask should have both straps so tight you get lines on your face for a while after removing it. It should not be loose at all. remember always the outside of the mask is actually gathering droplets so never, ever touch it or your face or your hair until away from the infection source and after really good hand cleaning.

      I agree about the risk of passing out in a low oxygen environment (hypoxia is low blood oxygen levels for those not in health care) and I’d not use one myself. However if volcanic ash is falling I’d be a fool not to use one. Inhaling silica into the lungs even at the risk of unconsciousness is a risk I’d take. Again it is very situation dependent but I agree using one to escape a burning building is not smart for exactly the reasons you state. I wonder how many preppers though would have considered using one in that situation?

      “N95 only require in closed environment not in open area” is not something I’d ever agree with. Generally there is no need in the open as I said but if someone can get within 3 feet of you in an open area in a pandemic they can easily infect you in a droplet caused scenario. If you have people approaching you put the mask on before you need to put it on. Droplets do not magically disappear just because you are outside. They have a harder time getting to you for sure but travel they can if the infected person (who may have no symptoms) is close enough to you.

      Again, for those not in health care, the biggest risk here is hand to face/hair transmission not inhaling. SARS in 2003 was initially spread internationally by a few people using an elevator button in China. If they had washed their hands maybe they would not have been infected? However there was none verified airborne spread of SARS in Toronto despite everyone claiming it had to be physical contact (personal experience).

      A cloth mask or a cheapo paper one is better than nothing but if you can get a decent supply of N95 then go that route. I have boxes of them and no yellow (cheap) ones which I could easily get. Get the best you can and use the best you can is my personal prepping philosophy but I am aware some go the route get what works as cheaply as possible. If I am giving personal care to someone in a pandemic I want an N95. If I have to talk to my neighbour at close quarters in a pandemic I want an N95.

      Antibiotics if you have them should be used for all deep wounds day one in a SHTF situation i.e. one where medical care is only ever going to be you. The risk of sepsis is extreme, the chance of curing it is low, and hitting early on with antibiotics might help and certainly in SHTF has minimal risk. Many limbs were lost in wars before the advent of antibiotics. If my leg is broken from a gun shot I’d start antibiotics immediately.

      Sterile versus clean for deep wounds is a no brainer in SHTF. I disagree with the guidelines when there is no other medical care ever going to be available. Clean might infect and sterile will not. Sterility is an absolute and clean is a hope. If you can boil the needle and thread why not? I am aware that clean is fine for most issues but those not working in health care need to give themselves every chance. Clean is better than dirty but sterile is best.

      I believe in STHF all deep wounds should be cleaned with hydrogen peroxide, flushed with sterile saline (or clean water that has boiled and cooled), inspected with a decent flashlight and your magnifying fire starting device, and any debris removed with sterile tweezers/forceps. The ability to squirt sterile saline or recent boiled water at high pressure (PSI) into the wound is one every first aid kit should have. I use small pink bottles designed for flushing endotracheal tubes. The higher the pressure the more likely to remove foreign objects. Obviously an impact wound the penetrates deep (more than 0.25 inches) into the body may leave clothing, wood,metal, dirt inside the body. If left there the chances post SHTF of infection is high. No doubt bodies and clothes and the general environment will be dirtier. Chances are the patient is also partially starved. Chance of IV antibiotics if they get infected is minimal though I have some ability to use those most people would not.

      I agree about stapling versus suturing but decided not to make the article to complex for a none health care worker to follow. I still think steri-strips are best for most people to focus on. I have seen an RN attempt to remove staples using scissors not a staple remover and decided to leave the issue alone here until maybe staples are more widely available. I also considered discussing using ostomy products over deep wounds to cut down on dressing materials and to make dressing changes easier but again decided it was getting to technical.

      Theoretically 100% carbon monoxide (CO) killing would be a great idea if you have a combustion source, if you can make it fairly airtight, if you want the person to die alone, and if you can be sure you can build up enough gas. A running car in a small garage with lots of gasoline in the tank would work fine.

      I knew that euthanasia might be too much for some people to consider as an abstract idea so I did offer to have that section deleted. I am sorry if it upsets people but it is illegal and unethical so I am not advocating it. If I or my loved ones have 75% deep burns in SHTF it is something I’d consider and have planned for especially if there are no narcotics available.

      • lfhpueblo

        I agree about the mask in an outside situation. I don’t think most people realize how far, wide, strong and fast a big sneeze can travel. So if you can see people, they likely can see you as well. If they then had a big sneeze and you didn’t have a mask on, I don’t think you’d likely have enough time to get one on, especially if mother nature helps it on its’ way towards you with a good breeze. I say better safe than sorry. I also agree on the moisture breathed out compromising the effectiveness of any mask over time.

      • Arcangel911

        I guess I should have been more specific with my idea of antibiotic cream in earlier reply to another post as limiting it’s use. Although, used sparingly, if your going to be treking, hiking and running home… the best defense is a good offense. A superficial wound can be just cleaned with soap and water and bandaged. But if the pus starts to set in, a little extra I think would help. No sense in losing your health on your way home. The last thing I would want is anyone showing up at home after bugging out for the last four days, sick, infected and a fever. You got more stuff to worry about then.

        • Huples

          Very true Arcangel911. For superficial grazes and minor cuts clean it out and apply cream (antibiotic cream works well) in a thin layer. Clean it off three times a day and reapply. Keep it covered. The antibiotic part really does nothing much but as a skin lubricating agent it is good. My concern came from some bug out videos showing people carrying sachets of it and I was worried they’d squirt it into deep wounds and trap dirty foreign objects inside.

  • AtomicMetroid

    This just isn’t realistic.
    Most people aren’t gonna have access to stuff like this. Especially months after a SHTF scenario.
    It would be better to show people how to use items that are common(depending where you are). Like using fishing line to sew a cut or natural antibiotics that can be found or made. Or how to use tree sap to close wound if you have nothing else. You all are gonna be screwed if SHTF. But for me, that will be fine because I need your stuff.

    • Huples

      It is very realistic if you are a Prepper to have some or all of this stuff before shtf.
      Long term you might be right about going natural but if you read the article’s introduction you will see why I did not write the article you wanted.
      I did not address mental health issues so I won’t bite to your closing odd remarks

  • Jay_Sherman

    Best way to prevent infection is to let the wound bleed a little- rather than stopping the bleeding immediately (unless we’re talking massive wound)- The flowing blood pumps out all the crud. I see people who get a cut and stop the bleeding immediately; they are always the ones who end up with infections.

    And man! If articles like this were the winners, I’d hate to see the losers!

    All this crap is just totally unrealistic. In a true SHTF scenario, there is going to be NO WAY to carry all the crap that these various articles recommend; and likely, the real event will not be anything like what you expect.

    I’m beginning to think that “preppers” will be the least prepared, because they will be weighed down by tons of crap; and their pre-conceived ideas will likely mean that they will not be able to deal with a scenario that they are not expecting.

    And no, Fido will not be eating a euthanized grandma…mor will we be eating Fido! And seriously, with the picture of survival that many of these articles paint, I think I’d rather just croak.

    If you know that something bad is going to happen sooner or later in your part of the world, why not extricate yourself from that locale long BEFORE it comes down to a mad dash for survival???

    • Huples

      Hi Jay,

      Thanks for the feedback. I can only assume Lemmy’s untimely death is making everyone irritated! “You win some, lose some, all the same to me,
      The pleasure is to play, makes no difference what you say,” ๐Ÿ˜‰

      You are very wrong in saying letting it bleed a bit is the best response. It is a good response but for deep wounds caused by none sterile penetration you have to ensure there is nothing external and dirty remaining inside the wound or you will die. Leaches work but they need help ๐Ÿ™‚

      The article is not about first aid, it is not about bugging out, and I’m sorry if you cannot imagine a scenario where keeping Fido alive is a bad choice. I would hate to lose my English Bull Terriers, they are literally our children yet in some scenarios keeping them going would be a horrific act of selfishness on our part.

      I wrote the article based on some web videos and some articles. I am sorry if it is upsetting to you. I knew when writing it that some people would have an emotional reaction to it. Still I stand by it. Wash your hands and use any medical preps wisely and with knowledge.

      You make a bunch of assumptions about my personal plans which are all incorrect but that’s okay. My partner and myself have near 5 decades of level 3 trauma nursing between us. Why on Earth would we not prepare to our skill set? Why would you assume I would have to bug out and if I did why would you think I’d be stupid enough to try to carry more than 25 lbs of gear? In many scenarios we’ll be offering health care using well planned and large amounts of supplies stationed in our primary bug out location which happens to be a concrete house 60 km from any major target, impossible to flood, and fairly defensible. I appreciate your concern for my well being but the article is about something else entirely.

      Your final question is a good one but it has, perhaps, been debated to death, and has nothing at all to do with this article. I plan on bugging in. I can bug out. The rest will be fate.

      • Jay_Sherman

        Hello Huples!

        Awww, no, the article didn’t upset me- and I didn’t mean to criticize YOU personally- as you said, for someone in your particular position, and with your background, I’m sure what you say is very appropriate- and it is very kind of you to be prepared to help others. It’s just that, to the average person, such an article likely has little relevance- I tend to think that many prepper types are just “dreamers”- caught up in a little subculture ; thinking that they are prepared to hop in the SUV at a moment’s notice with a “bug-out bag” and able to survive the apocolypse…but that reality will be quite different for them, and catch them quite unprepared; and that thinking they are prepared, they will in-fact be the least prepared when things don’t pan-out as expected.

        Like yourself, I too am hunkering-in. I think that the remote rural area I now live in (former New York City-ite!) is one of the safest and least likely to be affected by most calamities. If I did have to hit the road, I’d just have to play it by ear and do what I could, because I see no way of preparing for the unknown, nor of surviving on the run in country full of 300 million people, if it were in mass turmoil. I think being realistic and knowing one’s limitations, is a form of preparedness.

        Keep up the good work!

        • Huples

          Thanks Jay,

          Appreciated. A fair number of none health care trained Preppers seem (by videos) to have a possibly unrealistic goals and some have equipment for advanced trauma. I just wanted to reach out a bit as frankly the obsession with antibiotic ointment and Israeli trauma bandages annoys me. Clean your hands a lot and really clean wounds by bleeding and powerful flushing before shoving stuff in is the take home I guess:-) The other stuff is just food for thought.

          I’m preparing for the end of everything and hoping it won’t be that bad. I cannot drive as I never learned how to so I’m not rushing north in an SUV if things go bad. Nice small market town with light industry and great neighbours for me. I need occupation post shtf as creating Eden in the forest won’t work, at least for me and becoming a warlord is unattractive. I’ve a ways to go but these articles and the comments help me a lot.

          Happy New Year

    • Chuck Findlay

      (I’m beginning to think that “preppers” will be the least prepared, because they will be weighed down by tons of crap)

      Only if they bug-out with a backpack and a rifle. But most of us will stay home and likely have a basement full of supplies to draw from so it is realistic to expect people to have a supply of medical items.

      PS” Another name for bugging-out is a refugee, and history shows us that refugees are at the absolute bottom of the list as far as survival goes.

      It’s sad that TV, Prepper fiction books, numerous U-Tube videos, prepper web sites and movies teach that bugging out is the answer to every SHTF situation.

      Yea it’s the answer to a few of them, but most times it’s best to stay put in your prepared home.

      I’m not saying to not have a go-bag, (I have a few) but to think you can survive on the run with what you can carry in a backpack is a good way to get dead. And most of us don’t have a stocked retreat (as most prepper books say to have) to go to. A stocked retreat will get ransacked quite soon if it is not constantly attended to by an on-site person living there. This is something prepper books tend to not deal with. That’s why they are called fiction, they can turn out however the writer wants them to.

      • Huples

        Hi Chuck,

        Good points. Tactically my home is safer than the two retreats, at least initially. I think the country farm and the cottage will get hit by locals very early on but the house is solid and a good local community here. I have supplies buried at all three places in areas that I can safely get to if the place is unsafe.

        It depends on the situation but I know I like having my preps at hand and enjoy looking them over. That’s the hobby bit! For 2016 I intend to get this bad habit fixed and bury most of the long term stuff. The refuges are all in a triangle 100 miles a part from Toronto. Some would say that is too far but I did once do 100 miler trail foot race in 24 hours and have caches along the lines of march. I have some gasoline and cycles but I’m assuming foot power. I’m not in that shape but I know what it entails to force march and have planned accordingly. Anyone carrying more than 25lbs including water without resupply is going to be in deep trouble very quickly. I’m aiming for 25lbs as the maximum and that includes all gear. Aim for 20-30 miles a day. 40 is possible but not repeatedly.

        I think the die of from most major scenarios would be worse than people thinking especially in the northern states and provinces. If I can get through the first winter I’m guessing community will form rapidly from the 2-5% remaining. First year people will be a curse but the second year a blessing unless it is like The Road in which case I’m breaking into my scotch and quitting trying to hang on!

  • Defiant

    This was a terribly written article.

    • Huples

      Sorry

  • NewDadPrepper

    Great article! Definitely takes dealing with these post SHTF events to a whole new, and more real, level.

    • Huples

      Thanks. Appreciated. I’m hoping those with current skills in wood working, hunting, metal work, food preserving, etc might consider doing something similar to help me learn and think about the issues in actually doing their work in a bad shtf scenario. Books and videos are okay but skilled people must look at many of them and choke! Maybe not

  • Kifflette

    Do NOT use tampons. They are a strong soaker and will pull blood out instead of holding it in place to clot and seal the vessels. The aim is not to ‘hide’ the bleeding, the aim is to STOP the bleeding.

    • Huples

      Thanks. I’d not planned on using them but now you mention it that is very true.