Making Sense of Retreat Medical Care Requirements, by Brett H.

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Recently I attended a three day class on medical response in hostile environments presented by Medical Corps in Caldwell, Ohio.  The presenters were terrific, the topics important, and the hands on lab sessions made the whole thing come together very well.  I have already had considerable medical training but I left with a better understanding of what may be required in the future. I gained additional confidence in my ability to perform many of the basic and lifesaving medical functions.  After talking to a number of people I realized a few things about medical preparedness could be presented to this blog for thought and discussion.  The everyday American seems poorly equipped for medical emergencies, basic medical or dental care requirements for a grid down situation.  The majority of our individual healthcare needs are provided by the giant US healthcare system. We have become a population with limited medical skills, knowledge, and have no definitive plan to carry us through a serious societal breakdown.

Medical professionals possess a high level of training that may or may not be available to you or your group.  There are tens of thousands of doctors and nurses living in this country but I rarely hear or read where any prep groups are including or recruiting medical professionals.  I have been deeply involved in surgical and medical procedures for over 25 years and consider myself well educated on a wide variety of medical products and their use, but find myself nearly overwhelmed with the various aspects of medical prepping. The information that is available on an assortment of medical procedures and conditions is scattered around the internet and is difficult to understand.  Any numbers of sites praise the use of herbal remedies that they say will be growing in a roadside ditch while many others sell battle bandages and magic powder guaranteed to stop an arterial blood shower when your child gets shot by a band of ruthless marauders. People are wondering should we buy bird antibiotics in pills, capsules, can we freeze it, is it enough, will it last, what exact one should we buy, how much do we give someone, will it expire, what about other drugs, and suture, or dental instruments, and IV fluids, or what about shock treatment, or this , or that, or the other? Many people don’t know what information to look for or what they may actually need to do to provide for future medical needs.  Countless people are not even sure what they may be facing in the event someone falls ill or a grave injury occurs to a family or group member.  The choices and availability of medical provisions are, quite simply, dizzying and far too expansive for the average person to begin to make the right purchasing and stockpiling decisions regarding critical items.  Medical textbooks and manuals are readily available to the public but many describe techniques and procedures that call for far more knowledge and proficiency than average people genuinely possess.  In reality, people can’t expect to open a medical text book during an emergency and follow the directions.   In all seriousness, legitimate layperson medical skills training classes and study need to be a part of every preparedness plan.   All of these questions have answers but we must have a little help.         

While attending the Medical Corps training class I had the opportunity to talk openly to other people that made the decision to invest in essential formal medical and dental training.  Each person that attended the class shared some common beliefs.  The universal feeling was that the economic conditions in the US are near a catastrophic end point and that someday we would no longer enjoy our current way of life.  That ‘we the people’ will be required to take care of ourselves and our medical needs or people we care about may end up in a FEMA camp or worse.  They made the conscious decision to serve as at least one of the primary caregivers for their family or group.  Many of them felt like the proverbial deer in the headlights when it came to medical care in a hostile or grid down environment.  Like most of us they have entered the vast maze and had the online medical industry staring back at them from their computer screen.  These people realized they needed some help.  Attending the Medical Corps program was a big step in the right direction for many of those folks.  After a lot of searching I have come to the conclusion that medical and dental training for civilians is not readily available just down the road.  Organizations like the Medical Corps are few in number and seem to be located a long away from everywhere. Fortunately the cottage industry is growing and several quality organizations that offer authentic civilian medical training do exist.  I hope the following can help:

Trained Medical Personnel

A group, large or small, should designate a member as the medical director.  This person must be a responsible and intelligent member of the group.  A doctor, dentist, veterinarian, corpsman, nurse, chiropractor, pharmacist, surgical technologist, or respiratory therapist would all be good choices. Many of these people would be a great addition to a group and a few have access to things that will be difficult to obtain. In lieu of an experienced person, pick someone that will be able to keep a cool head and be prepared to make life and death decisions.  In reality it may be the father or mother of a family. Someone has to take the lead.  Ideally, the group should invest in the education of this person. A single 3 day class is only a start.  Someone must make a real effort to find and attend multiple training courses and become a student of medical skills.    Medical training classes, courses, workshops, and the ancillary materials are expensive.  The airline travel and lodging for multiple day programs and time off from work can definitely add up so the reliability and dedication of this person to the group must be without question. If financial restraints only allow one person to attend, then this person can start immediately sharing the information with others.  One fundamental for learning medical skills is: watch one, do one, teach one.  The long term health of the group or even your own family may depend on it.  Once your group is active and living in a hostile situation, it is vital to protect your doctor from harm.  There is a reason that the military avoids sending doctors into battle.  Doctors cost a small fortune to train and without them a lot more people die. Do not designate your primary, battle ready, gung ho group leader to this position.  Don’t exempt your medical personnel from tactical training and leave them vulnerable, but do not send them into dangerous situations. Military surgeons are generally armed at all times in hostile areas. Not a bad practice. The hopeful reality of a post crash society is that surviving groups of good and decent people will come together and form communities.  These communities will almost surely have doctors and nurses that will rebuild along with everyone else.  Our responsibility is to get our people to that point alive, in as good a condition as possible and provide a relatively functional medical support system.
Take a hard look at medical care and keep some things in mind about what will be needed.  We could all give some thought to a few categories:

Acute Trauma
 Acute trauma may be something as simple as a severe ankle sprain, bone fracture, laceration, or as bad as a gunshot wound to the head.  The most important job in a grid down acute trauma situation is to stabilize the person and get them to a location (your home or retreat) for more definitive care.  This may mean stopping the bleeding from a laceration or correctly taping an ankle.  It may mean more advanced care like stabilizing a fracture with plaster or a SAM splint.  Under almost all conditions it is far better to have the person walk out on their own, or at least walk out with assistance.  Proficiency in splinting and taping can make this possible some of the time.  In a hostile, hot, or rugged environment carrying a full size adult for anything other than a short distance may well create other causalities.  Carrying someone, even with a well designed liter it is an enormous, backbreaking ordeal.  You may be tasked with making an airway for someone that has a severe reaction to an insect sting or poison.  You may be forced to stop your best friend from bleeding out after a severe wound.  The key to successful, and potentially lifesaving intervention is to get some training before anything happens.  At a minimum every group member should do what it takes to learn the skills to stabilize bones and joints, open airways, stop bleeding, and get fluids into the patient. (There are some interesting ways to hydrate a person)  If you can perform these procedures and carry a carefully crafted medical kit you may keep someone alive.

Acute Care
This is care that should be able to be provided at your base location after a patient presents from the field or down the street.  People will come in here with all types of injuries. The “oh I cut myself” patient to the people that are going to die. This location will for all practical purposes be your hospital. The types of care will include cleaning, suturing and bandaging wounds.  It may also include setting, splinting, and casting fractures and joint dislocations.  Minor and perhaps not so minor, surgical procedures will ultimately be performed by qualified people with the right supplies and equipment. Burns are a common hostile setting injury and will be initially treated in this location.  Sucking chest wounds, head wounds, and foot blisters may all show up on a given day. This area must be kept exceptionally clean, ordered, well lit, and standing by for use at anytime.  If there is anywhere that clean water will be available in quantity it needs to be here.  Infection must be stopped here and copious washing of wounds and hands is vital.    If your group has stored medications and antibiotics, this is the place for those.  A stove top pressure cooker can be used as a sterilizer, but you must learn how to do it.  Many people are visual learners and there could be large human anatomy posters (commercially available) and step by step diagrams of common procedures on the walls in here. This location (in a separate but attached room) will be where the largest percentage of your stored medical supplies will be housed and used. In a grid down situation a well prepared community may want to limit foot traffic and keep this spot guarded at all times.  Some of the available civilian medical courses can help us with setting up and stocking this type of area.  

Dental Care
The Medical Corps training program provides a very good foundation for field dentistry.  The lectures were down to earth and the hands on lab sessions were a popular part of the class.  Basic techniques and procedures like extractions, fillings, and cleanings will be absolutely necessary for your group.  The class literally stripped away the mystery surrounding the basics of extractions and fillings.  A lot of people are of the mindset that a tooth can just be grabbed with a set of pliers and pulled.  I guess it could, and the tooth will come out eventually, but every physician lives by the oath “first, do no harm”. After attending this class I would never attempt to remove a tooth without the proper preparation and tools.  But now that I have completed the class and gotten the necessary tools I will never be in that situation. The point is that with a basic education and the proper instruments field dentistry can be added to your group medical care plans.  For those who are dedicated to providing group care and are committed to furthering their field dental education, the Dentist/instructor offers an additional 3 day advanced dental class.  My own preparation plans include attendance at the next scheduled class.  An untreated abscessed tooth can turn into a life threatening emergency.

Medical Supplies
This is one area of medical preparedness where a lot of money is being spent.  This is also a prime area of confusion for a lot of people.  There appears to be somewhat of a feeding frenzy going on. A lot of people are not sure what to buy so they just start ordering. Medical product and first aid companies have tens of thousands of product line items to choose from.  Many sites appear to list a single type of bandage ten or more times, with slight variations in the product, making it difficult to actually order what you wanted. This process is repeated over and over on thousands of products. Even a very savvy medical supply shopper remains hopelessly confused and many times will exit the site without buying anything.  There are literally thousands of all inclusive first aid kits being sold on the internet.  Be careful what you buy for there may be some kits that fall more in the realm of marketing and not medicine.  Please understand, there are great first aid kits out there and they can be an excellent start to medical prepping but purchase from a reputable company and really understand exactly what you are getting. This is not a blanket denigration of first aid kits that are sold on the internet.  However, it is a gentle word of warning to be careful what you buy.  Medical products are much like any other consumable manufactured goods.  There are a lot of choices of similar products from various companies.  Some products are great and some not so great.  Some store well long term while others degrade rather quickly. I have learned a lot about first aid kits and supplies by doing my own research, attending medical training, and trial and error. Trial and error gets expensive. Many people’s preference is to assemble their own kits with products and supplies that they have the knowledge, or plan on obtaining the knowledge, to use. Educating yourself before you buy is important.  With proper guidance we can get our hands on most of the medical and dental supplies needed for our group or family.  Organizations like the Medical Corps help you make the right decisions and steer you in the right direction. They honestly tell you “buy this exact one because we use it in battle and it works”.  Finally!  As you or your designated medical officer press forward in your education you can add supplies to support your skills. Many of the exact same products used in hospitals, dental clinics, and operating rooms can be purchased by the average citizen.

In closing I hope that I have not added to the confusion of medical preparedness.  If you seek out and ultimately take advantage of the training opportunities that are available I sincerely hope you will get the feeling of empowerment that can only come from knowledge and preparation.  Finally, THE PRACTICE OF MEDICINE OR DENTISTRY WITHOUT A LICENSE IS ILLEGAL IN THE USA.  Thankfully, education is not.

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This page contains a single entry by Jim Rawles published on September 27, 2012 12:57 AM.

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