Grid-Down Medicine — A Guide for When Help Is NOT on the Way
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Summary
If you read most first aid guides, the last step in treating someone who s gotten injured or sick is always get the victim to professional medical help. But what if you found yourself in a situation where hospitals were overcrowded, inaccessible, or non-functional? What if you were the highest medical resource available in a grid-down, long-term disaster? Dr. Joel Alton is an expert in what would come after the step where most first-aid guides leave off. He s a retired surgeon and the co-author of The Survival Medicine Handbook, the essential guide for when help is not on the way.
Transcript
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Brett McKay here, and welcome to another edition of the Art of Manliness podcast.
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If you read most first aid guides, the last step in treating someone who's gotten injured
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or sick is always get the victim to professional medical help.
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But what if you found yourself in a situation where hospitals were overcrowded, inaccessible,
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What if you found yourself in a grid down, long-term disaster, and you were the highest
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Dr. Joel Alton is an expert in what would come after the step where most first aid guides
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He's a retired surgeon and the co-author of The Survival Medicine Handbook, the essential
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Today on the show, Joe argues that every family should have a medical asset and how to prepare
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We discuss the different levels of first aid kits to consider creating, from an individual
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kit all the way up to a community field hospital.
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And we talk about the health-related skills you might need in a long-term grid down disaster.
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From burying a dead body, to closing a wound with superglue, to making an improvised dental
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filling, to even protecting yourself from the radiation of nuclear fallout.
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After the show's over, check out our show notes at aom.is slash medic.
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So you are a retired obstetrician and pelvic surgeon, and you've stayed busy in your retirement
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by helping families prepare medically for long-term disasters.
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Well, Brett, you know, I was exposed to disaster medicine very early in my career as a volunteer
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DMAT member, disaster medical assistance team member for the aftermath of Hurricane Andrew
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And that led me, like many Floridians, honestly, are now, to become what you would call a hurricane
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And that means instead of the three days' worth of food and supplies the average American
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has on hand, we'd have a couple of weeks' worth.
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But I really have to say it was Hurricane Katrina in 2005 that opened my eyes to medical preparedness,
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I mean, it was then that I saw what happens when the ambulance isn't just around the corner.
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And that's not because we didn't have hundreds of medical personnel converging on the Gulf Coast.
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So that was going on even before the storm was completely through.
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But the providers and the technology were just not able to get to victims due to all the flooding.
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I figured that any number of disasters could actually do that.
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An earthquake, for example, could make roads impassable and people couldn't get to you,
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for example, really any disaster with enough casualties can overwhelm the existing infrastructure.
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If there's a three-car wreck in a two-ambulance town, I mean, you could have a bad outcome.
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So I figured if I can teach the average person how to deal with injuries and illness and put
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some supplies in their hands, well, then maybe some tragic outcomes might be avoided.
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So my mission became to place a medically prepared person in every family before a disaster occurs.
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So you co-authored a book called The Survival Medicine Handbook.
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You co-authored this book with your wife, who's also a nurse practitioner and a midwife.
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And your goal is, again, it's a comprehensive guide to medicine in a situation where it's
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And so how to manage things you might encounter in that period.
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I'm sure a lot of people have read first aid books on, say, wilderness first aid or maybe
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But you argue that those books will only get you so far in a long-term disaster scenario.
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Well, you know, there are a lot of books on first aid, even for wilderness settings.
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But they fail to take into account that in a true survival, long-term survival scenario,
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there's no access to medical medicine, modern medicine, rather, for the foreseeable future.
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And that becomes a problem when every chapter of your first aid book or your medical book
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ends with, and get to the hospital or, and seek a qualified medical professional.
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Because in real terms, no such thing exists when the medical infrastructure is collapsed.
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And so our entire book is pretty unique in that it assumes that some disaster has happened
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and you no longer have the option of accessing modern medical care, maybe for the long run.
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And the book addresses the average citizen in plain English as if they were the last line
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of defense when it comes to your family's well-being in a disaster.
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So a lot of the first aid books out there are geared towards taking care of the situation
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But in a long-term disaster, professional medical help may not be available.
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So what considerations do you have to think about to deal with that situation?
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I mean, what is the difference between today and in a grid-down situation when it comes to
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Let's say, let's say even in normal times, let's say they broke their leg in a car accident.
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You want to stabilize that person, do what you can for them, and get them to the nearest medical
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And once you ship the patient off, your responsibility has been discharged and you're on your merry way,
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I mean, grid-down, your responsibility extends from the point of injury to full recovery.
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Will you be able to provide daily wound care for this person?
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Would you be able to identify if a wound infection is occurring?
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Would you have a plan of action to rehab that person and get them on their feet again, make
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them productive as a group member as they most certainly would have to be in an off-grid
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You have to be ready to be the highest medical asset left and be effective in that role.
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And another thing we're going to talk about in detail later on in a bit, another thing
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you have to think about as the medical asset in your family is you have to think about preventative
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You know, it's just basic things you don't have to think about because we live in the
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21st century, sanitation, hygiene, things like that to prevent sicknesses.
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The important thing to know is that you can prevent headaches and heartaches as the family
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medic if you have a plan to enforce sanitation and water disinfection and food preparation,
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And these are sort of part of your job description.
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So one of the things you talk about in the intro of the book, in the first few chapters
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is before you start thinking about buying medical gear.
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It's the one thing I think a lot of guys love about survival or prepping is buying gear.
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But you say before you even do that, there's two things you probably need to think about
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One is establish a community, put yourself in a strong community.
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And then two, get your personal health in order.
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So first, how can being part of a robust community help with medical care or health care in a
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Well, I mean, as a community, let's take some examples from TV.
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In Alone, they drop you off alone with some supplies, probably as much as a person might
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be able to reasonably carry a fair distance, and they plop you off into the off-gridest
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They have to deal with injuries and other medical issues that occur along the way.
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I mean, how much easier would it be to have a group of like-minded individuals
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I mean, these guys survive, and they survive for an extraordinary amount of time, in my
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I mean, they're there for 90 days, and at the end of 90 days, they look pretty ragged.
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You know, a person can survive alone for a time, but you can see on Alone, on the show
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So that's something that I think is so important to have people that can thrive.
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I mean, I have medical skills, but I have very few tactical skills.
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For example, you know, I probably couldn't take a part in AR-15.
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I probably, you know, wouldn't be very good in a firefight, but there probably are people
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And having people with skills that can complement each other would make for the possibility
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Now, we had an Alone contestant, a winner on the podcast a while back ago, Jim Baird.
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And one of the big takeaways from that conversation I had with him, and also watching the season
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that he was on on Alone, it was amazing to see how little tiny injuries could just devastate
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Like, that actually, it ended people's time on the show.
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You know, you just, you sprang an ankle, and you're done.
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Even having another person there, like, it wasn't enough.
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You needed to have maybe two or three more people, because that one person couldn't do,
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like, you're basically working for two people now, and they just didn't have the energy
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Like, what parts of your personal health should you have in order in order to be ready
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Well, what I hope people are doing now, I mean, eating a healthy diet, exercising, staying
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away as much as possible from addictive substances that wouldn't be around in a grid-down
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On top of that, and this is something that people are surprised to hear me say, is that
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you should be using the high-tech available today to fix issues that would be a problem
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I mean, if you have a bum knee, that's not going to be very helpful off the grid, and would
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certainly not increase your chances of survival.
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So see an orthopedic surgeon now, get it fixed.
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I got it done probably 30 years ago, probably one of the first people to get it.
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And now I have the eyes of an eagle, a very old eagle now, I'll admit, but still.
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Okay, so yeah, get your health in order, so you're ready for that scenario.
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So you talk about becoming a medical asset in your family, and when you're a medical
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asset, it means you take on different responsibilities.
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You're not just providing first aid, but there's other roles you take on.
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You're sort of the chief sanitation officer of your family.
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Any other responsibilities that a medical asset needs to take on in order to take care
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Well, Brad, I mean, of course, you're the chief medical officer, but you're going to
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You're going to have to deal with dental issues as well.
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Now, I'm not talking about a week without power due to a storm.
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I'm talking about a long-term scenario, a few months off the grid, and you're going
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to wind up facing as many patients on a daily basis with dental problems as medical problems.
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And you'll even have to extract a tooth now and then.
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90% of dental emergencies in the past were treated that way.
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I'm talking about the early to mid-20th century.
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You're going to be responsible also for making sure, we talked a little bit about water
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disinfection, you've got to make sure water is disinfected property, food's prepared and
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cooked thoroughly, human waste is disposed of safely.
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These are things that are part of your job description.
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You may not have to deal with bullet wounds on a daily basis, at least I hope not, but
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you're going to see anxiety and depression on a daily basis if some major disaster hits.
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You need not only to be sympathetic and understanding, but you're going to also have to be confidential
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You know, nothing loses the trust of a group than a non-confidential medic, somebody that
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doesn't keep people's private things to themselves.
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But one other thing, you're also actually going to be the quartermaster who decides when
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your limited supplies of medical items are dispensed.
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So you've got to keep track of people's issues.
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And that's something you should probably do now.
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If you knew who was going to be in your extended family or in a mutual assistance group, you
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You know, keep everything, of course, confidential, as I mentioned.
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And you should definitely learn what their medical issues are, what their family history is, you
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I mean, are they heavy smokers or, you know, do they drink a lot?
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And you should try to sort of steer them in the direction of getting healthier.
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And the fact that you would know what medicines, let's say, a person is on would help you sort
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of encourage them to get more of these medicines, stockpile some of them so that, you know, you
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don't have somebody with very high blood pressure showing up at your retreat, you know, with
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their last three days of blood pressure medicine, that's it.
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Do you recommend people, like just a lay, just an average citizen, take any sort of formal
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intensive training to get ready for a grid down disaster scenario when it comes to healthcare?
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I think a good start is just go through your municipality and see what courses that they
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Many times they have free courses available for first responders or certain members, you
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know, community emergency response team members, other people that will be willing to volunteer
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Sometimes they'll have stop the bleed courses, you know, seek these out.
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And there are, of course, a lot of wilderness first aid courses out there, a lot of companies
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I'm sure your experience may vary with them, I have to say.
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But all these courses do prepare you to do what you need to do, stabilize and transport
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victims in normal times, but not so much for long-term care.
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Therefore, what I recommend to people is that when you take each class, think about what
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you would do if transport to a modern medical facility was not an option.
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What would you do with that particular individual, you know, that particular sickness or that
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And that's the key is to have the right mindset and a plan of action in situations where you're
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not going to be able to take that person to a higher medical asset.
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One of the most useful things that I've done, I really enjoyed it too.
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I need to go back and do it again, is I took like a first aid CPR certification class.
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It was done at one of the community colleges here in town.
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But not only did you do the CPR, but they just went over like basic first aid, what to do
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But what I realized is that knowledge and like we actually practice some skills, like how
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to, you know, how to bandage things and things like that.
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But I realized that stuff, that knowledge and those skills, they degrade if you don't
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Like you have to constantly refresh yourself on it.
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We teach a wound care class and wound closure class.
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And I teach people how to suture closed simple wounds and things like that.
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And more importantly, when to close a simple wound and when to leave it open and provide
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And I always make sure I give people extra sutures to take home and they keep their instruments
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But, you know, you have to develop muscle memory for just about any of these things.
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And the more you do it, the more effective you'll be at.
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But as you do, kind of keep in mind, well, how can I take this further?
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And how would I apply this in a long-term grid down situation?
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And you've got, I love this section because I love checklists.
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You have these checklists for different medical kits you think people should start building
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up so they're ready for that long-term situation.
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What are some of the things that you would recommend people keep in this individual
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So every person in your house or your group is going to have one of these, correct?
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Ideally, you would want everybody in the group to have it.
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In the military now, everybody carries, every infantryman, for example, carries an IFAC kit.
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And the medic carries a more advanced kit that allows him to put an IV in and things like
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But these guys will carry things like a tourniquet to stop bleeding, maybe a burn gel and dressings,
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elastic wraps to wrap orthopedic injuries, things like that.
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And I think that that would be a good start for a first aid kit.
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We have a number of kits on our store that we designed that are very compact, but they
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manage to deal with a number of different issues that are most commonly seen.
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So an individual first aid kit, I think, for every member of the family would be good,
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especially in situations where you have to be on the road.
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I mean, does your 10-year-old have to carry a first aid kit to school?
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But in a true long-term disaster situation, which is what I write about, I mean, this is
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Yeah, this is good just to have if you go on a hike or backpacking trip.
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And it's got things, you know, Band-Aids, got Benadryl in there.
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And you also have like, I thought it was raw honey packets.
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Raw honey has actually very strong and actually accepted medically antibacterial properties.
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And so you can use raw honey for a number of things.
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And of course, you can use it to treat hypoglycemia, low blood sugar in cases, but you can also put
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it on burns and other injuries, and it actually would have an antibacterial effect.
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Start building up a basic individual first aid kit.
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Well, the vehicle kit is more extensive, and it really allows you to carry things that you
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If you found yourself stranded in a blizzard or something like that, and you have to actually
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go somewhere, although, of course, it might be better at staying in the car.
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It would have foldable multi-tool shovels, tow ropes, flares, rock salt, things that would
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help you in situations where you're in your vehicle.
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Also, it has more of every item, and the reason why is because you're not physically carrying
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this, and so you have the ability to deal with not only things, but you deal possibly
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Yeah, we got an article on the site about what to keep in your car, and people are like,
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So my dad, I remember, this was probably 30 years ago, he was driving from Oklahoma City
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to Albuquerque on I-40, and in the middle of the Texas panhandle, he got stuck in a blizzard,
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I mean, I think it was like a day, but it was well-stocked.
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Like, he had blankets, and he had some stuff, and so he was able to ride it out until he
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It's something that can be a serious thing if you have to make the right decisions.
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There's one guy who got stranded in a blizzard, he decided he was going to go for help, and
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they found him the next morning, and he did not make it.
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You're going to keep this at your home, or if you've got a retreat somewhere, you're going
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This was a lot of fun to look through, because it's so big.
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So what sorts of modules do we have in this family kit?
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Well, of course, we talked about dental situations, so a dental module would be there.
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You would have, depending on the makeup of your group, you would have maybe a module for a
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You might have your surgical modules with the ability to do more extensive things, like
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sewing some tendons together, things like that.
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A lot of daily wound care items, because this is something that you can easily do if you
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Eye care modules, things like that, in case there's foreign objects.
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And, you know, a lot of people, when they do activities of daily survival that they're
00:21:01.260
not really accustomed to, they can injure themselves.
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And so you could be chopping wood and wind up getting a splinter in your eye.
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So we have the ability to deal with foreign objects, you know, that could get caught in
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We're beginning to get to kits that have hundreds of items.
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And indeed, you know, some of our biggest kits in our entire line will have hundreds of items
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One potential module you might have if you've got small kids, a pediatric module.
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So you have, make sure you have medications for them.
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And in these situations, you want to have maybe growth diaries.
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And then you can identify, you know, basically how well your young people are doing by if
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Like, you know, your CPR mask for an infant would be different than a CPR mask for an adult
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So there are a lot of items that are sort of size differential.
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So the fourth kit is, this is if you're going all in, you want to actually have a field hospital.
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So, I mean, you would have everything from, gosh, biohazard suits to operating tables to,
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I mean, we're talking about a real mash unit kind of deal.
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I mean, you have a question in the book that you try to answer, which is, how much is enough?
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Like, when do you know, well, yeah, maybe I'm good at the family kit and I don't need to go
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Well, I think that it's probably very few people that will reach the point where a field hospital
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is what they're going to wind up being responsible for.
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So I think that people really just need to get the items that are going to be able to deal with
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the most common issues that they'll expect to be confronted with.
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And what we have here, I mean, you know, we're talking about medical, I'm looking through my
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list right here because I don't remember all 500 things that are on here, but we're talking about,
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you know, automatic portable defibrillators and we're talking about oxygen concentrators
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and things like that, things that you would need if you had, you would have to have some solar
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power, for example, to get enough power to, let's say, do some oxygen concentration.
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These are some of these items that you're going to need a little power.
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And if you're ready to put together a field hospital, you will have taken power into account.
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Well, another point you make, kind of a broader mindset point you have to take when it comes to
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medical care and a long-term disaster scenario is that you have to adjust your expectations of
00:24:05.580
I can just go to the doctor and I've got medicine or if, you know, even like a serious
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I mean, I guess, you know, what I've read is that people are surviving gunshot wounds
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more often because our, our, just our skill and technology has gotten better.
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One of the points you make is that in a long-term situation, long-term disaster situation, the
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best you can do is maybe just make people feel comfortable and you might not be able to cure
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We have to be very, very realistic about what can be done and what can't be done.
00:24:41.280
In an off-grid situation, you can expect a gunshot wound to the abdomen or a gunshot wound
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to the chest to probably have a 70% death rate.
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And it's a terrible thing to say and certainly not the case today with modern medical facilities,
00:25:00.420
And if it's not the actual trauma from the injury itself, it's the chances for infection
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And so once you have breached that armor, you have that chance of infection.
00:25:14.040
That brings up a point I want to talk about in the book, you talk about how you can plant
00:25:19.580
So you can have that have medicinal purposes, but what do you do about prescription medicines
00:25:28.960
There are some companies that are beginning to offer, quote, emergency antibiotic packs
00:25:35.000
with a televisit, as long as you fill out an application and do a televisit.
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And I believe that there'll be a thriving industry in this probably in the next few years,
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or at least until the state medical boards get a hold of them.
00:25:57.980
You know that insulin, insulin like that are basic insulins, like regular and MPH are actually
00:26:07.480
We're going to take a quick break for your word from our sponsors.
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I hope we can talk about some specific skills here in a bit, but I want to turn to this idea
00:26:24.840
Because if anyone's read any history book about war, war up until the 20th century, really,
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most of the casualties came from poor sanitation.
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Men were dying of dysentery, cholera, things like that.
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In a grid-down scenario, there might be a situation where you no longer have flushing toilets.
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So what do you do about human waste in a grid-down scenario?
00:26:51.480
Well, human waste should always be buried if you don't have a toilet.
00:26:55.360
Now, if you have a toilet, you have two gallons of water, even if it's waste water, you can
00:27:00.920
actually flush that toilet if it's the typical configuration of the toilet in your home today
00:27:05.780
by flushing two gallons of water into the toilet, and it will actually flush.
00:27:12.000
But if you're out, let's say you're on the road, you've been driven from your home, you're
00:27:16.640
on the road, human waste, and you're in a retreat in the forest somewhere, human waste should
00:27:21.860
be buried no closer than 200 feet away from the main water source to prevent contamination.
00:27:26.380
And the medic, if you're in a community, let's say you're the medic for an actual community,
00:27:32.180
that you should have an idea of how to put together a community latrine.
00:27:35.340
And so the dimensions would depend on the length of time, of course, that's needed, and the
00:27:41.240
If you had a small group, an 18-inch eye wide by about 24-inch deep, several feet long,
00:27:48.360
A longer trench and some kind of partition sheet if your group is big enough to have more than
00:27:52.620
one person using it at a time, and you keep the dirt from the trench that you dug in a
00:27:58.740
nearby pile with a shovel, and that covers up the waste after each use.
00:28:02.860
So that's something that would be good for dealing with human waste.
00:28:06.900
But you're absolutely right about the importance of sanitation.
00:28:11.280
In the past, entire populations succumbed to diseases that cause diarrhea, leading to severe
00:28:21.280
I mean, more soldiers in the Civil War died of these issues than from bullets or shrapnel.
00:28:26.520
So again, this is probably the third or fourth time we have mentioned it already, but the
00:28:31.040
medic has to strictly enforce water disinfection, proper food preparation, waste removal, and
00:28:37.420
more, or infection is going to run rampant among other people.
00:28:40.920
So here's something I'm sure people may have thought about.
00:28:43.720
They kind of do these hypotheticals in their head of like a long-term disaster scenario where
00:28:48.720
you're not going to have access to the comforts of modern life for a long, long time.
00:28:57.180
Because like, you know, 200 years ago, when someone died in your family, like you knew
00:29:02.020
Today, you call the funeral home and they take care of everything.
00:29:07.340
This is something that most people have absolutely no idea what to do.
00:29:10.620
And you have to figure out what to do with the body.
00:29:15.500
These are currently commercially available, by the way.
00:29:17.880
And some of them actually have handles that to facilitate transport.
00:29:22.000
But if you don't have these, you can found items like plastic sheeting, bed sheets from
00:29:31.840
I mean, it should be at least 200 to 250 meters, that's about 800 feet, from any water that
00:29:42.620
But the funny thing is that if you can properly dispose of the dead body and in that type of
00:29:49.440
location, it doesn't have the ability, it doesn't really cause major contamination of
00:29:57.520
Current grave guidelines suggest a depth of about 5 or 6 feet, that's 1.5 meters, and
00:30:04.900
preferably that amount of space above the water table.
00:30:07.460
In some places, that's really difficult to achieve.
00:30:09.320
Down here, our water table is like 6 inches below the ground.
00:30:14.160
That's why you see in this area, the older crypts are either concrete, and they bury them
00:30:23.260
Or if you can go to places like New Orleans, you see that everybody's buried above the ground.
00:30:28.940
Now, you also use something called quicklime, and that's calcium oxide.
00:30:34.520
It's been used in burials for centuries, but people think that it's being used to speed
00:30:39.760
the decomposition of the body, but it actually preserves tissue, which is funny.
00:30:46.200
Because it actually eliminates odors that attracts flies and animals.
00:30:51.280
And there's actually a formula for that, 1 kilogram or 2.2 pounds of lime per 10 kilograms
00:31:01.060
You might not think that you have to take care of a dental problem in a long-term situation,
00:31:06.300
I mean, what are some of the dental issues you think are treatable in a long-term disaster
00:31:11.480
Well, the grand majority of dental issues can be dealt with by extraction, as I mentioned
00:31:17.980
You also need to learn how to fasten loose crowns, replace loose fillings, lost fillings,
00:31:27.220
broken teeth, knocked-out teeth, tooth abscesses, gum inflammation.
00:31:30.940
These are all things that you can easily deal with with the right materials.
00:31:38.080
But you can definitely take care of dental decay.
00:31:41.100
Lost fillings, you can put together with clove oil, two drops of clove oil, and zinc oxide
00:31:47.820
We'll put together a hardening, filling material, material type of cement that will last for a
00:32:03.900
There are extractors for different types of teeth.
00:32:06.180
And there are probably as many different types of extractors as there are different types of
00:32:11.600
And of course, with dental care, an ounce of prevention is worth a pound of cures.
00:32:15.720
Like, yeah, take care of your teeth, even in a grin-down scenario.
00:32:18.540
Brush your teeth, floss, and avoid all the sugary foods.
00:32:29.300
So in this book, you cover lots of different medical care skills that you think someone
00:32:37.140
What do you think are, let's say, five skills you recommend people prioritize learning?
00:32:42.160
Either because they'll be especially common or because they're not the kind of things you'll
00:32:47.420
have time to consult a textbook or your book to figure out how to do it in an emergency.
00:32:54.980
Well, I have like 40 that I'd like you to know.
00:32:58.540
But if I had to pick five, of course, there's a sexy, sensational stuff like how to stop
00:33:06.400
And there's a whole stop the bleed apparatus nationally that will help you learn that.
00:33:14.700
And we also describe all the different tourniquets and things like that in our book.
00:33:21.140
You can also expect to deal with a lot of orthopedic issues, ankle sprains and things
00:33:27.100
Of course, there's going to be respiratory infections.
00:33:32.800
You need to deal also how to deal with significant problems.
00:33:35.920
I think the ability to use a flexible splint to treat a bunch of different issues, I think
00:33:44.200
The use of a cravat or a bandana or triangular bandage.
00:33:50.160
We have videos to show you how to use that in seven different ways for different things.
00:33:55.700
I think those are good skills to have because they handle different issues.
00:34:01.100
And of course, as we mentioned before, maybe the most important skill to obtain is how to
00:34:06.400
enforce preventative strategies against injuries and illnesses.
00:34:10.660
You know, and to do that, you have to actually get the knack of observing simple things such
00:34:15.860
as whether your people are dressed for the weather and enforcing the use of hand and eye
00:34:24.600
I mentioned you can really save yourself a lot of headaches as a medic and maybe heartaches
00:34:29.500
if you can keep these people protecting themselves and adequately dressed for the weather.
00:34:35.780
Of course, you know, you want to be able to treat burns and you want to treat open wounds
00:34:40.780
and you want to be able to close a wound if you absolutely have to.
00:34:44.740
But more importantly, you need to know when to close a wound and when to not close a wound
00:34:48.960
because you can lock in some bacteria and it could cause some major issues.
00:34:53.800
So we got know how to stop bleed, know how to use different splints for orthopedic, you
00:35:01.180
Knowing how to do preventative medicine and then how to deal with wounds.
00:35:05.300
On the wound issue, like, how do you know if you should leave a wound open or close?
00:35:11.720
Well, if a wound is obviously dirty, in which a lot of wounds will be, if you happen to be
00:35:17.020
on the road and in a situation where, you know, you're not in a controlled environment,
00:35:24.920
And so if it's an animal bite, for example, it's going to be dirty.
00:35:28.400
And these days in the emergency room, they'll actually close some of these wounds, but off
00:35:33.820
the grid, you should definitely not close them.
00:35:36.520
You should treat them as an open wound and just make sure that you keep them clean.
00:35:40.680
And we talk about in detail the ability to perform that daily wound care.
00:35:44.840
And that's why I think that's a very important thing to be able to know.
00:35:48.320
And you have to be able to identify when a wound is not getting better and when you may need to
00:35:56.080
break out that last course of antibiotics that you've been saving.
00:36:05.460
If you decide you can shut this wound, can you superglue it?
00:36:09.940
Take a superglue and I want you to use the gel version of it.
00:36:13.460
It's much easier to handle than the liquid version.
00:36:15.540
So take superglue gel and hold the skin together, the cut edges of the skin together,
00:36:22.260
and apply a line of superglue gel on top of that, holding it together.
00:36:28.760
Wait for it to dry and then take a second layer, put a line over the first layer,
00:36:35.040
and then go around and around in an ever-widening oval for a couple of layers.
00:36:41.940
Then hold that together and let that dry and then do it one more time on top and even a little
00:36:50.620
And if you do that and allow that to dry properly between, then it should be okay.
00:36:56.840
And the good news is that it will have an even less chance of infection than if you close it
00:37:01.800
almost any other way because of the sealing of the superglue.
00:37:05.220
Now, if you don't hold the skin together properly, you're going to put superglue in
00:37:09.900
between the two cut edges and it's not going to close.
00:37:14.840
You might practice on a, make a cut in a pool noodle and try to practice with that until
00:37:22.500
In regards to tourniquet, I know tourniquet use can be controversial.
00:37:28.740
Anything people should take into account when they think, well, maybe I need to use a tourniquet
00:37:33.920
Well, I'll tell you that the Committee on Tactical Combat Casualty Care has stated recently that
00:37:41.720
you know that you're dealing with heavy bleeding, that the use of a tourniquet should be your
00:37:48.020
Normally, they recommend direct pressure, you know, with your hands and, you know, with either
00:37:53.580
gloved hands or a hand with a barrier between the wound and the hand, but some sort of cloth
00:38:01.140
But they're saying if you know you're dealing with arterial bleeding or the bleeding is just
00:38:05.660
of a volume that is serious, then use that tourniquet as the first course of action.
00:38:17.080
And in World War I, they actually called it the devil's instrument because a lot of people
00:38:23.100
just left it on too long and wound up causing nerve damage or even amputation.
00:38:28.620
But you can definitely keep a tourniquet on for a period of time, at least two hours,
00:38:34.940
I mean, okay, so the idea of a tourniquet, you're supposed to put that on there so you
00:38:40.400
Like, what do you do, you have severe bleeding in a long-term situation?
00:38:44.700
What I would say is you would transport that person to where the bulk of your medical supplies
00:38:50.300
And there is a way to transition from a tourniquet to a, let's say, a compression bandage that
00:38:58.860
Now, in normal times, you want to just get that person to the hospital, but if you don't
00:39:04.780
have the ability to get somebody to a hospital, then you might just have to transition that
00:39:11.620
And if you do, then you want to use, on the actual wound itself, something called a hemostatic
00:39:19.820
And a hemostatic dressing is impregnated with material like kaolin or chitosan, and this is
00:39:29.540
And so what you do is you apply it directly on the bleeding vessel, and you hold it in
00:39:37.100
And it actually will stop the bleeding, even arterial bleeding, if you apply pressure and
00:39:44.480
I actually was talking to somebody who was a follower of our website, and he was a purchaser
00:39:57.260
And he talked about a study that they did in which they basically hung up a pig, and they
00:40:04.980
shot it with a nine millimeter and severed its artery, its femoral artery.
00:40:12.660
And so they used the quick clot material, which is a type, a brand of hemostatic dressing,
00:40:19.660
held the pressure on it, and it stopped the bleeding.
00:40:23.220
And then what they did is they shot the other leg, and they took the dressing out, the hemostatic
00:40:29.080
dressing out, and then put the hemostatic dressing in the second wound and actually stopped
00:40:35.640
So it is something that if you know how to use these things, when you have the right
00:40:40.780
materials, the right hemostatic dressings, you can actually stop the bleeding in at least
00:40:51.180
Related to this idea of bleeding, like gunshot wounds, are there any special things you got
00:40:55.780
Gunshot wounds, of course, are going to be difficult to treat off the grid.
00:40:59.480
You have to remember that there's things that happen when there is a projectile that enters
00:41:05.220
the body, and it forms a permanent channel, which is where the bullet actually went, physically
00:41:15.740
But it also forms something called temporary cavitation.
00:41:18.880
And temporary cavitation is a shockwave that occurs as a result of the bullet passing through
00:41:26.740
And so if you shot me just under my liver, for example, I would have a channel that went
00:41:37.420
But there would be liver damage, and it could bleed to death as a result of the temporary
00:41:41.900
shockwave that went through and disrupted liver tissue.
00:41:48.200
I'm sure everyone's thought about this at one point.
00:41:50.580
What do you do in the case of a nuclear disaster?
00:41:53.320
Because I think people have heard about radiation sickness.
00:41:58.700
Well, you know, nuclear disasters, believe it or not, if you're not standing at ground
00:42:02.140
zero, you actually have a pretty good shot at surviving.
00:42:04.880
In Hiroshima, they lost more than 100,000 people total to the bomb.
00:42:08.740
But it was a city that included the military that was there at the time had swelled to 450,000
00:42:19.800
In the early going, your goal is to prevent exposure.
00:42:22.820
And you want to prevent exposure over 100 rads, let's say.
00:42:26.240
Rad is the amount of radiation that's absorbed by a living thing.
00:42:30.120
So you might want to have a radiation dosimeter.
00:42:37.780
This item predicts the likelihood that you're going to develop it.
00:42:40.700
But there are three basic different ways to decreasing the total dose of radiation.
00:42:48.320
Radiation damage is dependent on the length of exposure.
00:42:50.840
So leave areas where high levels are detected and no adequate shelter is available.
00:42:55.820
The activity of radioactive particles decreases over time, which is great.
00:42:59.720
After 24 hours, the levels have dropped a tenth of their previous value or less.
00:43:04.200
Then you want to increase the distance from the radiation source.
00:43:11.340
And the effects will be decreased in proportion.
00:43:14.860
In nuclear reactor meltdowns, common evacuation patterns include a complete 10-mile circle.
00:43:20.640
Or if you looked at the pattern, it looks like a keyhole or an old-timey keyhole comprising
00:43:26.160
of a, let's say, a two-mile circle and an additional three miles radiation radiating from the direction
00:43:39.520
Shield your people to decrease radiation where they are.
00:43:42.440
In many cases, they're going to have to shelter in place.
00:43:45.200
And the shielding is going to decrease exposure exponentially.
00:43:49.100
So it's important to know how to construct a barrier between your people and the radioactive
00:43:54.160
And denser materials will give greater protection.
00:43:56.860
Now, let me talk about halving thickness for a second.
00:44:00.320
Now, when I say halving thickness, I'm saying H-A-L-V-I-N-G.
00:44:04.880
The shielding effectiveness is measured in terms of this.
00:44:08.140
This is the thickness of a particular material that will reduce gamma radiation, the most
00:44:14.760
So when you multiply halving thicknesses, you multiply your protection.
00:44:18.480
So let's say the halving thickness of concrete is 2.4 inches or 6 centimeters.
00:44:24.420
So a barrier of 2.4 inches of concrete is going to drop between you and the radiation.
00:44:32.900
If you double that and make it 4.8 inches, it drops it to one-fourth.
00:44:40.200
And 10 halving thicknesses drops the total radiation exposure to one in 1,024ths.
00:44:46.140
So if you're in a concrete bunker that's 24 inches thick, you are 10 halving thicknesses
00:44:53.100
And so you're exposed to only one 1,024th of the outside environment.
00:44:58.920
Now, treating radiation thickness, you treat them as you would burn patients.
00:45:02.280
But once you've received 400 to 500 RADs, however, there's not too much that can be
00:45:09.360
And is that a medication you take for your thyroid?
00:45:13.080
Well, that's also a protective thing for one thing only, and that is thyroid cancer.
00:45:19.820
And an adult would take 130 milligrams of potassium iodide once a day or 65 milligrams a day if
00:45:28.120
And it's very useful to prevent thyroid cancer down the road.
00:45:33.940
And the people that are getting thyroid cancer from Chernobyl, those people were children
00:45:41.380
So if you have a limited amount of this, the brand is called ThyroSafe.
00:45:47.320
And this is something that you would only give, if you had limited amount, only give it to
00:45:55.480
Where can people go to learn more about the book and your work?
00:46:00.260
The main one now is called The Survival Medicine Handbook, The Essential Guide for When Help
00:46:07.580
You can find it in black and white on Amazon in color and spiral-bound versions on our site
00:46:12.500
at store.doomandbloom.net, along with an entire line of medical and dental kits for the serious
00:46:19.620
Now, our website at doomandbloom.net now has over 1,500, 1,500 articles, videos, podcasts,
00:46:29.420
We also have a YouTube channel called Dr. Bones Nurse Amy.
00:46:35.740
You'll also find my articles on the newsstand in Backwoods Survival Guide, Off Grid Recall,
00:46:41.880
Backwoods Home, Prepper Survival Guide, and other magazines in the homesteading and survival
00:46:47.360
Oh, and on Facebook, we have Survival Medicine, Dr. Bones Nurse Amy groups.
00:46:57.460
You'll get all my articles and videos on that too.
00:47:13.360
He's the co-author of the book, The Survival Medicine Handbook.
00:47:17.620
You can find more information about his work at his website, doomandbloom.net.
00:47:20.940
Also, check out our show notes at aom.is slash medic, where you can find links to resources
00:47:33.380
Well, that wraps up another edition of the AOM Podcast.
00:47:36.140
Make sure to check out our website at artofmanlies.com where you can find our podcast archives,
00:47:39.740
as well as thousands of articles that we've written over the years about pretty much anything
00:47:43.160
And if you haven't done so already, I'd appreciate it if you take one minute to get
00:47:50.000
Please consider sharing the show with a friend or family member who you think brings something
00:47:53.560
As always, thank you for the continued support.
00:47:56.920
Remind you to not listen to the AOM Podcast, but put what you've heard into action.