# Medical what would you do.



## ApexPredator (Aug 17, 2013)

I want to contribute more to the community but find it hard to do so. Anyways if your interested ill try posting some medical issues for you and see what you all come up with. 

SHTF law and order is completely broken (no hospitals) your at your BOL or whatever your particular situation is. 

During an altercation with some unsavory types your (fill in whatever is significant to you) took a nasty hit with a blunt object to their lower right leg below the knee and now it has swollen up so badly that you can no longer feel a pulse in their toes (or for you medical types cap refill is NON existent). Your worried this injury could turn fatal what would you do given your preps.

Again just want to be helpful.


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## nephilim (Jan 20, 2014)

Tourniquet for stemming blood flow, which should increase any feeling of a pulse. If you can feel it, generally you will be OK, just the after affect of a "dead leg" which can hurt for many days.
If no feeling of a pulse, then check for the pulse using a stethoscope over a major artery on the limb, if you hear it, see above. 
If any part of the foot turns white (or black), then start on antibiotics fast as it could be gangrenous. 
If gangrene sets in, heat a VERY sharp blade to sterilise it, cut affected limb OFF and cauterise to stem blood flow. Bandage and learn to continue without said limb.


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## slewfoot (Nov 6, 2013)

My wife a retired nurse with a Masters degree after 40 years. With her knowledge and the medical supply's we bring back when we travel to Mexico I am not really concerned.


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## spokes (Feb 22, 2014)

Avoid injury, avoid situations that will cause injury. Even if you survive the injury you could be crippled for life. Being crippled would make you vulnerable to being over powered by those who are not. Confrontation and the potential for injury is something that you would want to avoid. Survival is the number one priority. 

I'm a retired nurse also. No masters degree but 39 years of experience under my belt and I worry constantly about a medical emergency during a SHTF scenario simply because some emergencies are beyond any scope of knowledge or experience outside of a hospital situation. 

I've been watching nature around me.Coyotes will avoid a confrontation unless they are in numbers sufficient to overpower whatever they are after. Why? They instinctively know that if they are injured, they are dead. There is no vet who will patch them back up and send them on their way to hunt again. If they cannot hunt, they will starve or become a statistic to an infection or injury that could potentially kill them. Or make them prey to a stronger, healthier animal.

You cannot go around thinking that you can get into a firefight or fist fight with somebody and be guaranteed that you will not be injured in the melee. Survival is your number one goal even if it means laying low and retreating in order to do it.


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## Spooky110 (Apr 3, 2014)

ApexPredator said:


> I want to contribute more to the community but find it hard to do so. Anyways if your interested ill try posting some medical issues for you and see what you all come up with.
> 
> SHTF law and order is completely broken (no hospitals) your at your BOL or whatever your particular situation is.
> 
> ...


Drink water and do pushups....Oh wait, I'm not in the Army anymore.

Find a safe area, stay low, attempt RICE.


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## paraquack (Mar 1, 2013)

I would hopefully never allow someone to get close enough to be in an altercation.


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## Beach Kowboy (Feb 13, 2014)

spokes said:


> Avoid injury, avoid situations that will cause injury. Even if you survive the injury you could be crippled for life. Being crippled would make you vulnerable to being over powered by those who are not. Confrontation and the potential for injury is something that you would want to avoid. Survival is the number one priority.
> 
> I'm a retired nurse also. No masters degree but 39 years of experience under my belt and I worry constantly about a medical emergency during a SHTF scenario simply because some emergencies are beyond any scope of knowledge or experience outside of a hospital situation.
> 
> ...


Very true! We have all kinds of meds and even medical know how.. When it comes down to it the BEST thing to do is AVOID an altercation! I hear and see people all the time talkin about how much experience they have and they have the best equipment. I'm sure it is. But when it comes down to it, the best thing you can do is AVOID a situation where you might get hurt!!

Listen, stock your meds,train for every situation you can encounter and then avoid EVERYTHING you possibly can. That is how you are going to survive a long term SHTF scenario.... Hope for the best and prepare for the worst...
.


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## sparkyprep (Jul 5, 2013)

ApexPredator said:


> I want to contribute more to the community but find it hard to do so. Anyways if your interested ill try posting some medical issues for you and see what you all come up with.
> 
> SHTF law and order is completely broken (no hospitals) your at your BOL or whatever your particular situation is.
> 
> ...


Ok Apex, I'm all ears. Educate me. What is the proper course of treatment here?


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## Rigged for Quiet (Mar 3, 2013)

spokes said:


> Avoid injury, avoid situations that will cause injury. Even if you survive the injury you could be crippled for life. Being crippled would make you vulnerable to being over powered by those who are not. Confrontation and the potential for injury is something that you would want to avoid. Survival is the number one priority.
> 
> I'm a retired nurse also. No masters degree but 39 years of experience under my belt and I worry constantly about a medical emergency during a SHTF scenario simply because some emergencies are beyond any scope of knowledge or experience outside of a hospital situation.
> 
> ...


No truer words were ever spoken/written. I have training and I have the gear to use it, what I don't have is the same team and logistical support behind me that I once did. That training and experience came with a price tag, and that's why if you have followed my posts on tactics why I stress learning how to break contact.

You win every single fight you DON"T have. There may come a time when you simply can't avoid the engagement, those are the breaks, but looking for one is just stupid, IMHO.


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## tirednurse (Oct 2, 2013)

ApexPredator said:


> I want to contribute more to the community but find it hard to do so. Anyways if your interested ill try posting some medical issues for you and see what you all come up with.
> 
> SHTF law and order is completely broken (no hospitals) your at your BOL or whatever your particular situation is.
> 
> ...


Apex...accidents like this could happen in your own yard without having and altercation with anyone. If the leg is so swollen there is no pulse to be palpated and can not be heard with stethoscope you run the risk of tissue death in the lower leg within minutes. this pressure needs to be relieved. If elevating and ice do not bring down the swelling, or if not available, I would probably slice down the leg in an attempt to relieve the pressure. It is better to take the chance at having an infection than to loose the leg completely. You can cure infection, you cant regrow a leg


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## BagLady (Feb 3, 2014)

I have no medical training. I agree that avoiding hand to hand altercations is best, but I am interested in learning what to do in certain emergencies. In our area, venomous snakes are a concern. What's the best course of action if your out in the woods and get bit?


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## ApexPredator (Aug 17, 2013)

Tirednurse Your right something needs to be done about the pressure. The treatments I know for field care of the issue is fairly simple point injections of a corticosteroid elevation and pressure wraps if caught early this can handle most of the injuries coming from a contusion type MOI. If that didnt work then yes a myofasciotomy would be the next step. 

Baglady this is also relevant to snakes. Most snakes in the US are hemotoxic/cytotoxic snakes and cause a severe compartment syndrome the result is the above with death resulting from a secondary infection. You may not even need antivenom for some envenomations if proper supporting care is available.

Yes an once of prevention is worth a pound of cure. Also you can find out how to preform one with the SOF medical handbook its free online it will also cover supporting care.


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## Gunner's Mate (Aug 13, 2013)

Id Pull Out my 45 and shoot the SOB that clubbed me and I would shoot him in the knees that's how I roll, Id pop a couple of vicodin  and chase it down with some wild turkey, I find that pain killers and good whiskey generally cure my aches and pains pretty good.


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## Deebo (Oct 27, 2012)

Apex- thank you, and Please, keep posting! I enjoy learning.
Thank You for your service.


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## bigdogbuc (Mar 23, 2012)

Apex, I was going to go with Rest, Ice, Compression, Elevation. But yes, if that didn't work, the alternative is pretty "gruesome". I'm going to check out the link because the closest thing I've ever seen to a myofasciotomy was a Diagnostic Peretoneal Lavage. 

But in this instance, if the mechanism of injury is severe enough to eliminate the Distal Pulse, how likely is it that you're facing an enclosed fracture on top the pressure? 

Good post by the way.


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## ApexPredator (Aug 17, 2013)

Its very likely and without xray there is only one device that may tell you if there is a fracture a tuning fork when placed against the bone through the skin will elicit pain if there is a fracture its odd I know but it does work most of the time because it will vibrate one side of the fracture and that of course hurts.
Just to be clear the compression you would normally use for RICE is not enough you are literally trying to force the fluids back into circulation against pressure this type of pressure wrap when applied to both legs individually can actually force blood back into the core and give a hypovolemic pt a little more blood to work with.


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## Guest (Apr 15, 2014)

@baglady
Do not cut the area and try to drain the venom this way. That will just spread the venom faster. After you are safely away from the snake or have killed it, It is best to lay down and relax and try to slow your heart beat. if you have a snake venom kit use that to suck out as much venom as you possibly can. The snake venom kits have a tube vacuum syringe with multiple bite sizes. you place the suction tube over the bite site and pull the lever up. This is the safest way too attempt surviving venomous snake bites. There is another way that is much more painful. Depending on the bite site if you act fast enough you can save your life by removing the bite site. In India there are stories of people who got bitten by king cobra on their hands and fingers then without hesitating they chop off the finger or hand. One thing to do is identify the snake that bit you and then make your decision as fast as possible.


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## RNprepper (Apr 5, 2014)

I agree with tirednurse that the leg case could very well be compartment syndrome. Immediate surgical release of the pressure is absolutely necessary to restore circulation and nerve function. Sadly, the reality is that even well prepared preppers are going to die from the same things that killed people prior to antibiotics, vaccinations, and modern surgery. Appendicitis, bladder stones, penetrating puncture wounds, measles, tetanus, influenza, pneumonia, head trauma, crush injuries, childbirth, to name a few.


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## BagLady (Feb 3, 2014)

ApexPredator said:


> Tirednurse Your right something needs to be done about the pressure. The treatments I know for field care of the issue is fairly simple point injections of a corticosteroid elevation and pressure wraps if caught early this can handle most of the injuries coming from a contusion type MOI. If that didnt work then yes a myofasciotomy would be the next step.
> 
> Baglady this is also relevant to snakes. Most snakes in the US are hemotoxic/cytotoxic snakes and cause a severe compartment syndrome the result is the above with death resulting from a secondary infection. You may not even need antivenom for some envenomations if proper supporting care is available.
> 
> Yes an once of prevention is worth a pound of cure. Also you can find out how to preform one with the SOF medical handbook its free online it will also cover supporting care.


I'm afraid I don't understand the medical jargon, but Nightshade said I can carry a snake bite kit. I'd just have to find out where to get one. Is a tourniquete (sp?) also nessessary?


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## jro1 (Mar 3, 2014)

Peace out, and let nature take care of Buddy! :grin:


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## BagLady (Feb 3, 2014)

nightshade said:


> @baglady
> Do not cut the area and try to drain the venom this way. That will just spread the venom faster. After you are safely away from the snake or have killed it, It is best to lay down and relax and try to slow your heart beat. if you have a snake venom kit use that to suck out as much venom as you possibly can. The snake venom kits have a tube vacuum syringe with multiple bite sizes. you place the suction tube over the bite site and pull the lever up. This is the safest way too attempt surviving venomous snake bites. There is another way that is much more painful. Depending on the bite site if you act fast enough you can save your life by removing the bite site. In India there are stories of people who got bitten by king cobra on their hands and fingers then without hesitating they chop off the finger or hand. One thing to do is identify the snake that bit you and then make your decision as fast as possible.


Thanks for the info. It was easy for me to understand. I will see about getting a snake bite kit, but keeping relaxed to try to slow my heart rate is probably not gonna happen. I know I would go into "spazz" mode...:-o


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## ApexPredator (Aug 17, 2013)

You don't always have to go surgical I know hospitals jump on it first thing but try to alleviate the pressure with wraps point injections antinflammatorys elevation. 

Baglady the bite kits are debatable have been will be for the foreseeable those kits have only proven effective if applied in under 30s according to my knowledge and the docs I work for. The Tourniquet idea is not a new one but you need to know your local snake most American snakes are not neurotoxic therefore a TQ would worsen the tissue damage however in Australia where they have a boatload of neurotoxic snakes a restricting band (significantly slowing, but does not stop blood flow) has proved invaluable this is also true if the local snakes act on your cardiac system. If your Interested in buying something plz consider the SOF medical handbook it was written for the very intent of helping people survive these types of accidents in a no hospital situation, but it also free online.


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## ApexPredator (Aug 17, 2013)

skip the message hospitals will use 1-3inch wide rubber banding approx 1mm thick and wrap legs to force blood back into the core for severely hypovolemic pts (think shock trousers) you can do the same with ace wraps and then apply manual compression on top of that if that is not available i would go with systematic manual compression starting proximal to the head this could act just like the skeletal pump that naturally helps to return blood to the core.


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## Guest (Apr 16, 2014)

BagLady said:


> Thanks for the info. It was easy for me to understand. I will see about getting a snake bite kit, but keeping relaxed to try to slow my heart rate is probably not gonna happen. I know I would go into "spazz" mode...:-o[/QUOTE
> 
> yeah it would be hard to stay calm if it were a rattler or copperhead that bit. the good news is many times most snake species bite dry at first and just warn you that they mean business. A good repellent in snake territory are gators for your feet and legs and a walking stick to defend. i got a snake kit at academy try there or outdoor world.


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## ApexPredator (Aug 17, 2013)

Old SF Guy said:


> OK so manual pressure forcing blood flow through the affected area could be effective...what would be the indications of successful attempts...coloration of the toes nails, blood refill following compression? Some other visual indication?


Your going to fighting it continuously for awhile but you should begin to see the swelling go down if youve ever seen dependent edema it will follow a similar pattern where you press it will "deflate" and then you deflate another area while the one you just did begins to inflate once you get it down to some point the body will start taking care of itself again/not overeating. If you didnt have a "strechy wrap" you could use any fabric to systematically apply compression in that case you would start at the distal end remove and reapply every 5-10 mins.


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## SoCal92057 (Apr 12, 2014)

In a SHTF scenario, routinely available prescription medications will be hard to come by. I suggest that as your personal meds become no longer needed, the bottle be recapped and secured in an air tight ammo can. The ammo can to be stored where extreme temperature variations do not occur. Google "prescription medications shelf life" or similar words and you will find lots of authoritative sources reporting that many meds can be safely used even decades after the expiration date. Instead of trashing the expired medications, simply preserve them against the possibility of future need. A packet of desiccant might also be placed in the can to remove moisture from the trapped air. Also, your family doctor may be willing to prescribed a sulfur based or other general antibiotic even though there is no immediate need for the drug.


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## BagLady (Feb 3, 2014)

nightshade said:


> BagLady said:
> 
> 
> > Thanks for the info. It was easy for me to understand. I will see about getting a snake bite kit, but keeping relaxed to try to slow my heart rate is probably not gonna happen. I know I would go into "spazz" mode...:-o[/QUOTE
> ...


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## BagLady (Feb 3, 2014)

ApexPredator said:


> You don't always have to go surgical I know hospitals jump on it first thing but try to alleviate the pressure with wraps point injections antinflammatorys elevation.
> 
> Baglady the bite kits are debatable have been will be for the foreseeable those kits have only proven effective if applied in under 30s according to my knowledge and the docs I work for. The Tourniquet idea is not a new one but you need to know your local snake most American snakes are not neurotoxic therefore a TQ would worsen the tissue damage however in Australia where they have a boatload of neurotoxic snakes a restricting band (significantly slowing, but does not stop blood flow) has proved invaluable this is also true if the local snakes act on your cardiac system. If your Interested in buying something plz consider the SOF medical handbook it was written for the very intent of helping people survive these types of accidents in a no hospital situation, but it also free online.


Thanks for the info. I do know what kind of snakes we have here, so now I also know NOT to use a turniquette.


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## ApexPredator (Aug 17, 2013)

Get the SOF medical handbook, As far as chronic issues I cant say you know the people we treat just generally don't survive into adulthood if they have anything wrong with them.


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