by Cody Lundin
Do yourself, your family, and your community a favor by enrolling in a basic first-aid and CPR course. Call your local community college, fire station, hospital, CERT (Community Emergency Response Team) program, or the Red Cross extension in your area today to learn the basic skills necessary to support life when accidents happen or health-related emergencies fall into your lap. Many basic first-aid and CPR courses last a day or two at most and give you a condensed version on what to expect and how to deal with rudimentary injuries and health issues.
For those who wish to know more, Wilderness First Responder (WFR) courses are taught that go well beyond a standard first-aid course and are extremely handy when you're beyond traditional medical care, such as in the wilderness or after a disaster when emergency services may be slow to respond. Many community colleges also offer Emergency Medical Technician (EMT) training for a more advanced look at the human body and how it can be repaired. EMT courses, while worth their weight in gold, rely heavily on transportation to a regular medical facility and technical goodies beyond the scope of ordinary folks. Many ambulance and fire-fighting crews also have a paramedic onboard for even more advanced life-support options. The human body is what you're trying to keep alive, yet it's amazing how little survival students and even survival instructors know about human physiology. The more you know about the human body and how to patch it back together, the better off you may be after a crisis.
Home Sweet Home?
According to a dated, 1985 version of the book Family Safety and First Aid, put out by Readers Digest, about 9 million Americans each year called a physician to deal with an injury sustained in their home. Within a twenty-four hour period, 63,000 people cut, bruised, scalded, poisoned, or burned themselves while in the comfort of their own homes. More than twenty years later, this number has probably doubled or tripled if not more. Most of these accidents could have been prevented by simply paying attention, or by correcting the potential causes of accidents in the first place.
What do you think would happen to these statistical numbers after an emergency? How would they be affected if people were forced to rely on unfamiliar disaster supplies for a number of days or weeks? There can be little doubt that even a well-stocked family has not taken the time to learn how to use their supplies on a sunny pleasant day in the backyard let alone when all hell is breaking loose environmentally and otherwise.
If your home is an accident waiting to happen, it ain't gonna get any better under extreme stress. Get your ducks in a row by making needed repairs and upgrades as soon as possible for the safety and convenience of your family.
The Creepin' Crud and You
"WE DON'T KNOW THE TIMING OF THE NEXT PANDEMIC, HOW SEVERE IT WILL BE. WE DON'T KNOW WHAT DRUGS WILL WORK. WE DON'T HAVE A VACCINE, YET WE ARE TELLING EVERYONE TO PREPARE FOR A PANDEMIC. IT'S TRICKY. . . THIS IS SCARY AND WE DON'T KNOW. . .THAT'S THE MESSAGE."
—DICK THOMPSON, WORLD HEALTH ORGANIZATION (WHO)
Despite annual vaccinations, run-of-the-mill influenza in the United States kills more than 36,000 people and lands 200,000 more in hospitals each year. In addition to the body count, influenza is annually responsible for a total cost of over $10 billion in the United States alone.
There are very nasty things floating around the planet such as SARS and the avian flu (bird flu). Apparently forgetting about the sinking of the continents Lemuria and Atlantis, Secretary Michael Chertoff of the Department of Homeland Security said, "The avian flu bears the potential for societal disruption of unprecedented proportion." According to the Centers for Disease Control (CDC), a pandemic, or worldwide outbreak of a new influenza virus, could make the above paragraph look like a fart in the wind. A flu pandemic in this day and age would utterly overwhelm this country's health and medical capabilities, with effects, to quote the CDC, "potentially resulting in hundreds of thousands of deaths, millions of hospitalizations, and hundreds of billions of dollars in direct and indirect costs." Pandemics have occurred throughout history. The last three occurred in 1918 (40 million dead), 1957 (2 million dead), and 1968 (1 million dead) worldwide. The Spanish influenza epidemic of 1918 has been studied by health professionals over and over again for clues on how to better mitigate a modern-day pandemic, and unfortunately, it has left more questions than answers.
According to the CDC, the next pandemic "is likely to come in waves, each lasting months, and pass through communities of all sizes across the nation and world. While a pandemic will not damage power lines, banks or computer networks, it will ultimately threaten all critical infrastructure by removing essential personnel from the workplace for weeks or months." A worst-case scenario pandemic plan from the CDC involves the general public staying in their homes; no school, no shopping, no nothing, for up to three months. Do you have the supplies, skills, and psychological fortitude to stay in your home for three months? You sure would have time to put a dent in that favorite book you've been wanting to read (or write!).
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REDUCING THE SPREAD OF THE FLU FROM YOU
According to the CDC and common sense, an infection carried by one person can be transmitted to dozens, even hundreds of other people. Because of this fact, your action or lack of in mitigating the spread of disease is perhaps the most important part of preparing for a pandemic outbreak. If you or one of your family members gets the flu, take the necessary steps to prevent it from spreading to others. Be prepared to follow public health recommendations that may include limiting attendance at public gatherings and travel for several days, weeks, or months. The obvious end result of this is to have the necessary emergency supplies in your home to deal with isolation for a long time. Fear mongering? Paranoia? Months at home you say? Yep. And it's not my opinion. All of the information in the above paragraph was pulled from the Centers for Disease Control Web site about a potential influenza (flu) pandemic.
STUFF YOU CAN DO TO AVOID THE FLU
Stay healthy. Eat right, exercise, and limit bad habits, such as smoking, drinking alcohol, and having too much stress.
Wash your hands frequently with soap and water.
Liberally use waterless hand sanitizers.
Cover your nose and mouth with a tissue if you cough or sneeze.
Safely dispose of your tissues in a wastebasket.
Cough or sneeze into your upper sleeve if you don't have a tissue.
Wash your hands after coughing or sneezing or use a waterless hand sanitizer.
Avoid touching your eyes, nose, and mouth.
Avoid close contact with others who are ill. Take precautions and wear a medical mask or quality dust mask purchased from a hardware store if necessary.
Stay home if you're sick.
Purchase several copies of this book to give to friends and family.
Pay attention, use common sense around others, and maintain a positive attitude. After all, the true nature of all disease is "disease."
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Our little hamlet has already done a body count, so to speak, on how many corpses the county could handle at once due to a flu pandemic by compiling information on available space from local hospitals and morgues. No doubt your town or city has done likewise although you haven't heard anything about it—which is not necessarily a bad thing.
There are researchers who study not just diseases, but how human minds and emotions will react to diseases when they threaten to manifest themselves as full-blown epidemics, and the results are not pretty. The first thing researchers learned is that the mob is indeed fickle, and people either act irrationally by rushing to hospitals before they have symptoms or stay home even when they are extremely ill and need treatment. And, of course, chaos breeds more chaos, so the more "freaked" people become after an outbreak, the more difficult the disease is to contain. This irrational behavior spawned by a lack of prevention training could hit America's pocketbook hard. Estimates from the Congressional Budget Office put the potential costs of a flu pandemic at $675 billion. And, as proof of our nation's half-assed prepar
edness training for the public, half of this cost will be because of fear and confusion! How much preparedness training could the American people get for a little over $337 billion? We have some of the best-trained disaster response personnel in the world, but the general populace—forget about it!
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WE HAVE BECOME FAMOUS FOR EXPERTLY PICKING UP THE PIECES OF THE SMASHED LAMP INSTEAD OF REALIZING IT WAS TOO CLOSE TO THE EDGE OF THE TABLE TO BEGIN WITH.
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Now, the chances are very high that if you're reading this book, you are not a dyed-in-the-wool "sheeple" (people + sheep = sheeple). You have the intelligence and foresight to recognize what the government apparently has not, that strength and independence come from the ground up, and that the best disaster plan is to have everyone empowered, prepared, and on the same page—not just the wonderful agencies who are expected to mop up the mess after the fact. We have become famous for expertly picking up the pieces of the smashed lamp instead of realizing it was too close to the edge of the table to begin with. Fortunately, you have the choice to prepare as you want for the unexpected, and it's you who should ultimately prepare for the safety and welfare of your family, not the government. If you need a refresher on the concept of self-reliance, flip back to the first part of the book.
Although I'm a wilderness EMT, I'm not about to cut and paste together a chapter on emergency first aid. It's not my forte, although I know a lot about human physiology and its repair, and the psychological nuances that influence it. What I do want to cover in this chapter are basic remedies and preventions for some of the more common problems that may be experienced during and after a compromising situation. Trials such as nausea, diarrhea, blisters, or burns will be common for a population that is suddenly forced to whip out and use their survival supplies under stress. I repeat, take a qualified class on first aid with a known health care provider in your area. Do it soon—don't put it off and have to learn the hard way when all hell breaks loose.
Open Wounds
Flesh wounds will be a very common injury during a disaster. There are many types of wounds, from incisions and scrapes to puncture wounds and full-on amputations. Some require specialized treatment, yet there are more similarities than differences when the protection of the skin is breached.
Control the Bleeding
Wounds that bleed freely must be controlled. The following guidelines should be used when you need to prevent excessive bleeding. Protect yourself from blood and body fluids at all times!
1 If you have the time, wash your hands with soap and water before caring for a wound.
2 Put on latex gloves to protect yourself from bloodborne infections and body fluids. These can be improvised from plastic bags or other nonpermeable membranes.
3 Have the patients sit or lie down. If large amounts of blood have been lost, they will experience shock, so keep them warm and have them lie on their back and elevate their legs nine to twelve inches. Even small wounds can cause people to become nauseous, dizzy, or faint, so play it safe and get them on the ground.
4 Expose the wound and apply direct, even pressure over the entire wound area with a clean dressing or cloth for five to ten minutes or longer until the bleeding has stopped. Bleeding from an extremity such as an arm or leg can be slowed by elevating the limb above the heart while applying the pressure. If the bleeding continues after ten or twelve minutes, apply greater pressure over a greater area of the wound or use a pressure dressing, which is nothing more than tightly tying thick dressing materials over the wound site using bandaging material such as a strip of fabric or clothing. If using a pressure bandage, don't tie it so tightly that you reduce the circulation in the rest of the limb. If the limb feels colder or turns a blueish color, loosen the bandage. If the dressing material that was used on top of the wound is removed too quickly in order to clean the wound, it may pull away the blood clots that have stopped the bleeding. Use discretion and seek medical care for large wounds.
Cleaning and Caring for the Wound
The next step in proper wound care is to properly clean and bandage the wound to prevent infection and promote proper healing. While wounds should be cleaned and kept as clean as possible, I have pushed the envelope many times over the years on back-country field courses. As I go barefoot most of the time, I've lost count of how many superficial wounds I've had on my feet with which I've marched through miles of filthy water and dirt for several days with no other initial care than washing off the blood in the river. I don't bandage or cover the wounds as it would fall off anyway due to environmental circumstances. In each incident the wound healed fine. I'm not recommending that you blow off treating your wounds, yet some wounds, especially the superficial kind, can go through hard times with a minimum of care and be OK. Don't psych yourself out that you'll lose your arm or a leg because you can't keep a wound spic-and-span clean.
The following guidelines for the treatment and care of generalized wounds are standard practice and can prevent many simple mishaps from growing into a major infection problem.
Basic Wound Care
Shallow Wounds
1 Clean the wound and the surrounding area thoroughly with soap and water. This may restart bleeding but it needs to be done. Smaller wounds should be encouraged to bleed at first to flush out potential debris that may be in the wound itself.
2 Cover the wound with a sterile or clean dressing and bandage in place. Although I rarely do so myself, you can use a thin layer of antibiotic ointment on the cleaned wound before covering with the dressing.
3 Inspect your wound(s) for infection morning and evening for the first few days and clean and change bandages as needed.
Deeper Wounds
Deeper wounds will need to be "irrigated" as part of their cleaning ritual. Irrigation involves forcefully squirting potable water into the wound itself to wash out pieces of dirt, sand, metal flakes, blood clots, tissue or anything else that will start an infection. (Note: See the water disinfection methods starting on Chapter 13 for treating nonpotable water. Don't use full-strength topical disinfectants such as iodine or povidone-iodine in the wound itself as they may damage the tissue and delay healing. Instead, use them to disinfect the skin around the wound. A diluted povidone-iodine solution using ten to twenty parts clean water can be used directly on the wound if desired.)
You'll need to spread some wounds open to reach their depths for proper irrigation. Protect your eyes and mouth when irrigating wounds as things can get messy. Many first-aid kits have a large-diameter syringe that can be filled with fluid for this purpose. You can easily improvise an irrigation option from a clean zipper-lock freezer bag or other baggie although it will not be as effective as a syringe. Fill the baggie with the disinfected solution and use a needle sterilized with a flame to pop a small hole into one of the corners of the baggie. Squeeze the baggie as necessary to obtain as much of a forceful spray as possible. Any chunks of foreign matter that remain will need to be wiped out or picked out with sterilized tweezers.
Small, clean wounds can be closed with tape or butterfly bandages if the edges can be pulled together. Deeper, larger wounds can be treated in the same manner but may need advanced medical care. Large gaping wounds should be cleaned the best that you can, packed with sterile dressings, and carefully bandaged until the person can receive proper medical care.
Inspect the wound(s) for infection morning and evening for the first few days and clean and change bandages as needed.
Infection
Any breach in the skin provides an area for possible infection. Deep or large wounds that are difficult to clean and keep clean are the most susceptible to infection but even superficial surface abrasions can become infected. Some of the following signs will be experienced in a wound without an infection but will be much more pronounced when infected. The pain from most soft tissue injuries begins to subside after two or three days. If the pain continues or increases, the wound is infected.
Signs of Infection
; Redness surrounding or spreading from the wound. In more advanced cases of infection, a "red line(s)" or streak(s) may travel from the wound to the heart. (I've had more than one friend involved in the art of brain-tanning deer hides whose small cuts on their hands became open doors to infection from nasty funk from the hides. In each case, they required large doses of intravenous antibiotics at the local hospital to kill the infection.)
Increased pain and tenderness
Swelling
Pus. Pus can be off-white to light green, pinkish, or even straw-colored or clear and drain directly from the infected wound or collect in an abscess or boil under the skin. The discharged pus may or may not smell. Abscesses will eventually form a whitehead like a pimple (which can be accelerated by hot compresses or soaking in hot water) and should then be drained and kept clean
