I'll discuss bringing someone into the world the old-fashioned way. I realize that as a man I may not be considered by some readers to be the most qualified person to write this post - but hear me out.  I have four kids, all four of which I've helped to deliver, the last two of which were done at home, three of which were assisted by midwives, and one of which was done without any assistance at all.  I’ve also had EMT training, including classes on emergency childbirth.  Nothing in this article, however, is medical advice.  If you need medical assistance, you should seek a doctor.  What I’m trying to do by writing this is help you to prepare for a pregnancy and birth in such a way that you have options.

Essentially, survival is a mindset and prepping is a lifestyle.  Both will be affected by a pregnancy.  This article is meant to be a guide for the father in a prepper household, though others should benefit as well. 

Part I - Pregnancy
The first consideration is pregnancy itself.  You must approach pregnancy from the right perspective.  A normal pregnancy is not an illness.  It's not a disease.  It's a normal process - and a beautiful one at that.  If you can keep this in mind, you'll be a lot better off. 

Medical Care During Pregnancy
Do you need a doctor during the pregnancy?  I feel that pre-natal care, if it's available, is a must.  That doesn't, however, automatically require a physician.  If the pregnant woman is otherwise healthy and you have access to a midwife, I think midwives are the better route.  Doctors are trained to treat illnesses, midwives are trained to help grow and birth babies.  Plus, quite frankly, midwives usually know a lot more about pregnancy and childbirth than most doctors.  Besides, you don't go to a mechanic to buy a car; you don't go to a veterinarian to buy a dog - why would you go to a healer to have your baby?  Much of the care given during pregnancy is about alleviating the concerns and fears of the mother.  In the end, midwives are usually better at that part too.

Food Preps
Mommy and baby need good, nutritious foods from wholesome sources.  Whole grains, proteins, vegetables, and fruits.  Dairy isn't a bad option either.  Lots of water.  Eggs, containing everything needed to sustain life, are wonderful things.  A 10-15% increase in your prep supply for all of these things for the pregnant person will be more than sufficient.  You also need a good supply of small, healthy snacks - I've never seen anything that works better for staving off morning sickness than regular, healthy snacking.  A hungry pregnant woman is likely a nauseous and/or cranky pregnant woman.  Pay particular attention to what types of things she's craving - they can indicate where her dietary needs are not being met.

Medical Preps & Supplies
Vitamins: a good supply of pre-natal vitamins and probably an iron supplement.  Get a few different types of morning sickness.  Prenatal vitamins can increase morning sickness, but many women eventually find a brand that doesn’t make them sick.  Most people agree that the benefits of taking a prenatal vitamin make it worth the nausea. The iron will help with a lot of things, not the least of which is slowing the bleeding after the birth.  You need a supply of both sufficient to last her through the duration of the pregnancy.
You also need to go ahead and purchase everything mentioned in the Childbirth section of this article.
Remember, you don't need to worry about the baby - you need to worry about the woman.  Her body will take care of the baby as long as you help her take care of herself.

Books
There are a few books I recommend for the pregnancy.  One is Husband-Coached Childbirth , which is the manual used by the teachers of "The Bradley Method" of childbirth.  The Bradley principle is a sound one and the book is great.  Dr. Bradley was an old farm doctor and he basically said, "Animals know what they're doing during birth, humans are animals, let's imitate animals."  My wife and I took Bradley classes and she later became a Bradley instructor.  It's a method I know and trust and I’ve seen it work four times for my family and countless other times for other families. 

The second book is The Expectant Father.  Most books for Dads-to-be take one of two forms - a) they try to be funny and don't give out much information; or b) they try to be clinical and don't offer much comfort.  This book, on the other hand, is both entertaining and full of information

The third book I recommend is Emergency Childbirth: A Manual.. Yes, I’m aware that book was published in 1958.  Shockingly, the process hasn’t really changed much since then.  Read this book.  Read it again.  Get another copy and keep it in the glove box.  Put the other one with your birthing supplies.

You may want to pick up a book or two that deal with what types of medications and/or herbs can be consumed or should be avoided by a pregnant woman.  I don't have a good source to recommend here - but you can search Amazon.com and find several.  Your midwife or OB can usually recommend a good one too.  As a rule of thumb, if she can avoid taking it, she probably should.  Don’t get sucked in by labels with words like “natural” or “organic.”  That has nothing to do with safety for the baby.  Remember, hemlock is an herb.  That doesn't mean it's safe for baby. 

Clothing
Physical comfort:  From a clothing standpoint, have the mother-to-be spend some time talking to someone at a maternity store about how best to prepare for the changes that are coming.  Every woman is different, every pregnancy is different.  My wife typically looks like she's carrying a basketball by the time she's 4-1/2 months pregnant.  Other women barely show at 9 months.  The tendency, from a male standpoint, is to buy sweats or something similar.  It's practical and cheap.  If the pregnant woman is someone whose moods are adversely affected by wearing “frumpy” clothes, you may want to reconsider this approach.  If she's not, you may still want to reconsider.  Maternity clothing is cheaply made and overpriced as a rule.  That said, the nicer stuff can help her feel beautiful - which, I've learned in 10 years, is extremely important.  This really should be her decision and her opinions are not to be taken lightly.  Of particular importance: bra and underwear. 

Bedding & Other Odds & Ends

• Pillows.  Lots and lots of pillows. 
• Some extra sheets. 
• A waterproof mattress cover. 
• Many women find a yoga/pilates ball exceptionally comfortable in late pregnancy (and even during labor).

Emotional Comfort:
Your otherwise sane and logical spouse/girlfriend will have moments of completely irrational insanity.  You are never to tell her she is having one of those moments.  Just be reassuring, comforting, and patient.  She needs your support. 
Most of the time, she needs you to listen - not to problem solve.  Offer comfort, but don’t jump immediately into finding solutions.  For example, if her problem is fear, the answers could be 1) you need to be her rock; 2) she needs to educate herself; or 3) you need to simply say some soothing words. It could also be all three or none of these things. 
So what do you do?  First of all, stop feeling sorry for yourself.  She didn't get this way all alone and you aren't the one whose body is changing so quickly that it's full of aches and pains and whose hormones make it tough to think clearly.  You aren't the one who is about to squeeze something the size of a watermelon through an opening the size of a lemon.  Imagine what she's going through.  Second - listen to what she's saying and watch what she's doing.  If she's talking about fear and clinging to you physically, she needs you to be strong and soothing.  If she's asking lots of questions, she needs you to be strong, soothing, and work with her to educate her (and yourself) about the process.  Common threads: listen, man up and soothe her.  Offer solutions if she's asking.  A foot rub or back rub will go a long way.  If all of that fails, toss her bite size pieces of chocolate and back away slowly.  When safe and practical, grab a beer with the guys and complain – just make sure you’re out of earshot.
Men also tend to get focused on two things during pregnancy: work and money.  This is how we prepare the nest.  That's fine, just realize what you're doing and make sure you're meeting her needs as well.

Sex
I’ve sat through dozens of pregnancy classes with my wife, both as a student and a co-instructor.  This question always comes up, so let me address it.  Yes, you can have sex during pregnancy.  No, it won't hurt the baby.  Yes, it still feels good for you and your partner.  Yes, she's likely to still have a sex drive.  Spooning works best, but you’ll figure that out.

Final Thoughts on Doctors & Pregnancy
I have nothing against medical doctors.  If I get hit by a car, please take me to the emergency room.  But Doctors treat illnesses and injuries.  Pregnancy is neither.
While I strongly recommend against doctors for a normal healthy pregnancy, nothing I've said in this article is a recommendation for unassisted birth or for not getting prenatal care.  I've done births unassisted and assisted, and I much prefer the assisted kind.  Just in case.  Again, pre-natal care, if available is a must in my opinion.
If there are any complications with the pregnancy, involving a doctor where necessary is of course the right thing to do.

Part II - Childbirth
Warning: I'm not embarrassed by bodily functions and I'm not grossed out by birth.  If you are, then stop reading now - unless you're an expectant father - in which case, suck it up you wuss - you need to know this stuff!
Medical Care during Childbirth
First rule: if she wants medical care - you get some. 
Second rule: If the pregnancy has been abnormal, you need medical assistance.
Third rule: Trust Your Gut.  If something seems “wrong” get help.
Other than those three rules, do you need a doctor during the childbirth? If everything is normal, then no.  In fact, when my wife teaches birth classes, I often sit in.  Many of her clients are second time mothers who had a bad experience with their first birth.  The bad experience almost always goes like this - so often that I've coined it a "snowball birth" because one step inevitably leads to the next and the whole mess gets bigger as it rolls downhill.  1) Doctor induces labor for no good reason; 2) Doctor gives an epidural [anesthetic] ; 3) Mother fails to progress to Doctor's satisfaction; 4) Doctor gives mother [pitocin, commonly called "Pit",] a drug to make her contractions stronger; 5) Mother can't push effectively (usually a side effect of the epidural); 6) Doctor tells Mother she needs a C-section; 7) Doctor performs major surgery without proper emotional support or mental preparation for the mother; and 8) Mother feels like a failure and Doctor leaves for his golf game.
What everyone fails to see is that this whole process happens because the baby isn't ready to come yet.  If the Doctor hadn’t induced labor, there would have been no problem in the first place.  [In most cases] the baby will come when it’s time.


Pain Management
Most mothers who have had a "modern" birth - those with epidurals and doctors - will tell you how much it hurt despite the epidural and often have complaints about the doctor being rough or rude or even threatening...e.g., "if you don't push, I'll need to use suction."
When you talk to a woman who had a natural and uneventful childbirth - no drugs and a midwife, they rarely talk about pain. They use the word "pressure".  There are medical reasons for this involving hormones released after pregnancy that affect memory.  Do you remember "The Flashy Thing" in the movie Men in Black, that erases memory?  The body has a hormone that does the same thing for pain memories.  If you have an epidural, it often doesn't triggered and you will remember the pain. If you're normal and healthy and you have the option - go with a midwife.

But what if …
Let’s say it's an emergency.  The baby is coming, it’s going to happen at home and no one can come and help ... the pregnancy, up to this point has been normal and healthy.  Now what?  Do you call 911?
Some of you may be tempted to tune out right now because you aren’t planning on having a home birth without assistance.  Well, guess what? Even if you aren't planning to deliver unassisted at home - remember that the baby may not have gotten that memo.

Supplies for the actual birth:

1. You need something to clamp or tie-off the cord.  I've used dental floss and cord clamps.  I highly recommend the cord clamps.  You can buy them here.  You'll want to order those ahead of time.  You need at least two.  People have used clean, unopened packages of shoelaces as well. Again, I recommend the clamps.
2. You need lots and lots of clean towels.  We used beach towels.  How many do you have? You need more.
3. You need a large deep bowl to catch the placenta in.  It will likely come out with a good amount of force.  If the bowl is shallow, it will slide right back out and land on you.
4. You need tissues.  It's quite possible she's going to poop during labor.  If she does, she most likely didn't intend to and she probably won't even realize it happened.  It won't be very much.  Just grab it with a tissue and put it somewhere out of the way.  You don't want it touching the baby and there is no need to embarrass mommy.
5. You need a sharp pair of scissors and a way to sterilize them.  Alcohol works.  Just have it handy.  There will be no hurry for the scissors.
6. Hydrogen peroxide is good at getting stains out of carpet.  I told you that you needed to get more towels, but you didn’t listen.

The Birth Process
She'll have contractions.  They may be fast coming, or not.  They may be hard or not.  They may be regular or not.  I know the movies say that they'll be regular, fast coming, and painful.  They're movies and neither the baby nor the mother’s uterus has seen them.  On a related note, the water may not break until well into the process of birth.  Occasionally, in fact, babies are born with the water in tact.  Don't count on the water breaking to be a sign - that's also just in the movies.
First things first: what's your job?  You are whatever mama wants and needs.  You make mama comfortable and hydrated.  You do not complain about your problems and you don't share your fears with mama.  You are strong when she is not.  You are soothing when she needs to be soothed.  You just need to help get mama to the point where her body and instincts take over, then you catch.
If you need to time the contractions, that's fine.  Do it discreetly, and don't give mama reports.  Above all, don't tell mama she's having a contraction or when one is about to happen.  It's fairly likely that she already knows.
Watch mama...she's likely to go through some telltale stages (these can last for more than 24 hours or be over in less than an hour):
Nervousness, insecurity, a sense of "I'm not ready" - I'm still talking about mama here, not you - focus!  These are all signs of early labor when they're coupled with contractions.  She'll likely be talking to you through her contractions...that's because they're still mild.  Have her rest, use the bathroom, and drink water.  Maybe eat something.  If that doesn't stop the contractions, this is probably the real thing.  It could be 24 hours or 20 minutes.  It's up to baby.  Keep mama as calm as possible, comfortable, moving, and hydrated.  Help her walk around, walking helps labor progress.  Close the blinds, lower the lights - if she wants soothing music, now is the time, wash your hands very well.  Gather your supplies - especially the towels.

There is also a period of emotional swings, if contractions were regular before, they may get irregular during this period.  That's normal.  This is a transition period.  Contractions will get more intense.  She'll likely stop talking during the contractions - you should too.

Unless she tells you otherwise, keep touching her - gently, soothingly.  Look for areas that are tense and help her relax them.  Tell her she's doing great.  Tell her you love her.  Tell her you find her amazing. Comments like: "you're hardcore," "you're a trooper," and "no pain, no gain," are probably ill-advised. When the contractions get to the point that she wouldn't move out of the way of oncoming traffic when she's having one - you're in the real deal.

At some point around this time, she's going to shed her modestly - and likely her clothes too.  That's why I had you shut the blinds earlier.  Keep her drinking water between contractions.
Now you should be watching/listening for a few things: 1) grunting; 2) clenched muscles during contractions ... the same ones you clench when you're trying to have a bowel movement (if you’re behind her and she’s removed her clothes, watch her sides just above her hips – when that area tenses, she’s pushing); and 3) her saying "I feel like I need to poop."  All of these are signs baby will be arriving very soon.

Then you'll go into the final stage - and men tend to want to say "PUSH!"  She won't have a choice but to push.  Pushing makes things feel better.  Her body will compel her to push.  This is not a 30 second process.  Our first child required more than four hours of pushing.  Keep her hydrated and comfortable.

In the movies (and at hospitals) they put mama on her back with her legs up.  They are idiots.  Nothing could be less helpful to mama and baby.  That position is only helpful for the Doctor, and the Doctor isn’t here.  This position is unhelpful because it doesn't use gravity to help and it makes the opening narrower.  It’s like trying to swallow food while standing on your head.  You can do it, but it doesn’t make the process easier.  Instead, have her get on all fours, or better yet in a standing squat.  This opens the birth canal and helps baby come.  True, it makes it harder for you to "catch," but this isn’t about you.   Keep your hands properly positioned, because babies can come out fast and you don't want the baby's introduction to the world to be a thump onto the floor.

The water will break at some point if it hasn't already - look at it.  If it's dark or brown, you may have a problem - but you already know that because you read the Emergency Childbirth manual, right?  Normal is slightly less than clear with flecks of white stuff that looks and feels like lotion floating around in it.
If you see anything other than a head coming out first, then call 911.

Crowning - the part where the head is coming out of the opening - can be a tough time for mom.  For dad, it's tough to look at - but get over yourself...she needs you now more than ever.  Believe me, everything will go back to normal after a few weeks.  Try to help her push baby out gently - too fast and you could have a serious tear.  In the end, the baby will come out however it wants.  But you can try. 
Follow the book's directions on clearing the mouth and checking the cord.
After the head comes out, the rest will follow quickly.  Catch!  Your baby is slippery, small, and may come out with surprising force.  Don't drop it. Don't pull it out and don't yank on the cord, the placenta (which the cord is still attached to) will come out in a few minutes.
Put baby on mama's belly, cover it with towels or blankets and get ready to catch the placenta.  Mama will feel it coming.  She can be on her back for this part.
Keep your hand up and keep the bowl in place.  This can take up to 30 minutes, but when it happens it will go quickly.   This is the messy part.  It's also the gross part.  Catch the placenta in the bowl.
You should expect about a cup of blood during this process.  That's easy to say because a cup doesn't sound like much.  It looks a lot worse than it sounds when it comes from someone you love.
Once the cord has stopped pulsing and goes limp, clamp the cord about an inch or two away from baby's navel and then about an inch further than that. 
Sterilize your scissors and make the cut between the two clamps.

Part III – Caring for Mama & Baby Post-Partum
Baby is easy.  Keep it warm and in contact with Mama’s skin.  Mama should be trying to nurse as soon as she feels up to it.
Mama will be shocky.  That means she'll be pale and shaky and may alternate between being hot and cold....make her warm and comfortable.  Hydrate her.  Orange Juice is good (and a Bradley Method tradition).   Keep her warm.  She'll still be leaking blood for awhile.  Don't make her move until she's ready - that could be hours.  Be ready for her to faint - you need to have hands on her at all times if she's walking.
At some point, she'll need to pee.  That can be really difficult for a newly un-pregnant mama.  Something that makes it easier is a thing called a peri-bottle.  Basically, it's a little bottle that you can fill with warm water and mama can use it to clean herself after peeing. 

Big, thick pads for her nether regions are important here.  She'll still have some blood coming out.  These look like giant maxi pads and she'll know what to do with them - you are still actually speaking to her aren't you?  She's a human being after all!  Some people even soak them in various herbal solutions and freeze them beforehand to use them as cold compresses - just beware of freezing the skin.  Or you could buy perineal cold-compresses.

Seek medical care if available at this point.  Unless something seems wrong, there's no real hurry here.  We didn't even go to a midwife until four hours after our third child was born and that wasn't really even necessary.  Consider it a wise precaution. The main concerns are baby's breathing (usually indicated by color), overall health, and whether mama is doing alright post-partum. 
Again, nothing I've said here is to be construed as medical advice.  You need to consult a professional if possible.  These are just tips from my experience with my kids - all of whom were born healthy and without any serious complications.  I'm very lucky in that way.

As a father – the time after baby is born is the easiest part.  You take care of mama and the other household members and she'll take care of baby.  Taking care of mama sometimes means changing diapers and cleaning up spit-up.  It means sometimes holding the baby.  It may even mean cooking and doing laundry.  I said this part was easy, but it sounds like a lot of work, right?  It’s easy because your role is well defined.  The process works like this:  Ask yourself what needs to be done.  Then, compare the answer to that question with this sentence - "Feed the baby with my breast."  If the two answers are not identical - then it's your job.  Simple, right?
Let's try one:  What needs to be done?  Someone needs to drink a beer.  Okay - does "someone needs to drink a beer" equal "Feed the baby with my breast?"  No?  Then you have to do it.
One more: What needs to be done? Dinner.  Does dinner equal feed the baby with your breast? No.  You make or otherwise acquire dinner.
What kind of food does baby need? - None.  Mama will handle that.  Breast milk is the best possible thing for baby.  Your only role here is not getting jealous. 

Diapers - disposable or cloth.  We use cloth.  From a prepper standpoint there is no other option.  We can buy all the cloth diapers we need for three years for about $600-$1,200.  That doesn't even cover the first year for disposables.  Storage room is minimal.  It takes a shelf.

Other things you'll need - gentle shampoos, onesies and/or baby clothes. If you're buying in advance think about seasonal weather. Grandparents are famous for buying cute little shorts and t-shirts for babies born in November. You'll also need soft blankets.

We co-sleep [with our babies], so we don't even need a crib - but if you'd like a crib, get one.  If you drink or use drugs (including prescription ones) or if you are obese or have a disorder like narcolepsy, then please don't co-sleep. If you breastfeed and co-sleep, then babies are much easier.  Most rarely cry or get colicky.

Now, if you're about to get upset over my views on co-sleeping, save it.  I know the arguments better than you do.  Bottom line: humans have co-slept with babies for millennia.  When was the last time you rolled out of your bed in the middle of the night?  Exactly.  You're equally likely to roll on top of a baby.

Now on to mama - what does mama need?  She needs you to check on her and make sure she's okay.  She needs moral support.  She may need help or counseling with regard to nursing - there are specialists for that called Lactation Consultants - there is also La Leche League.

She's likely to be bored and tired.  She needs your companionship.  She needs to rest.  You may have to force that one on her or she may love it.  She needs your companionship.  She needs food and water.  She needs to urinate regularly.  She needs your companionship.

When the doctor or midwife follow up they're going to seem oddly interested in bodily functions.  There's good reason - they are indicators of overall health.  She'll want to know if mama is peeing normally.  She'll want to know how often the baby is peeing and/or pooping.

For the first day at least you'll want to keep an absorbent pad under mama in bed.  She'll be oozing blood.  The big perineal pads will catch most of it, but more protection never hurts.

Oh, one more tip: the first few baby poops will be black and tarry.  That's normal.  They're a pain to clean off of the baby unless you put a little olive oil in the baby’s crack.  I know it sounds silly, but this first poop is called meconium and it's nasty and sticky.  The oil keeps it from sticking to the baby. 

I hope this has been helpful.  Enjoy your baby, they grow fast! - Ranger Squirrel

One of the skills that has served me best in life is my tendency to make everything modular.  I think I learned it in the Army, but regardless of where I picked it up, it has saved my rear end at home, at work, in emergencies, and even in my hobbies. 

Let’s pick on Average Joe for a second.  Average Joe is exactly that.  He likes a beer now and again, listens to classic rock and some country, and works in a job that just barely pays the bills.  He has a commute of about 50 miles round-trip every day and drives a little sedan.  Today, for lunch, he decided to ride with a work buddy to a Chinese place downtown about five miles from the office.  While they were eating a riot broke out and Joe got separated from his buddy and despite all efforts, he can’t find him.  When he gets back to his buddy’s car, it’s gone.  Worse, it appears that the rioters have managed to knock out power for most of the area.  Police sirens are blaring, and Joe has a feeling they won’t be too discriminating in who they label as “rioter.”  He finds a place of relative safety and takes inventory.  He’s got $25 cash, a credit card, a jacket, and a pocket comb.  He may need to run, he may need to hide, he may even need to lay low for a day or two until things calm down.  In a word, Joe is screwed.

Let’s say Joe carries a basic everyday carry (EDC) pocketknife.  He now has some basic gear and maybe a way to defend himself.  He’s better off, but will it be enough to get him to safety?  Where is safety?

Let’s revisit Joe after we talk about modular systems and how they can affect your preps.  Effective modular design gives you improved flexibility and even more importantly, redundancy in your preparations.  If every component in a modular design has some way of making fire and a cutting tool, it’s not long before you’ve got 4-5 backups each for both of those key elements in your system.

My basic everyday preps are modular in nature.  Level 1 is the stuff that is always in my pocket, organized into an easy to carry/can’t leave anything at home by accident fashion.  Its purpose is to get me through the day-to-day routine and to give me the means to get back to my car in an emergency.  With just Level 1, for 12-24 hours, I have the means to obtain or improvise food, shelter, and water, I can signal, I have a means of security, and I can administer some self-aid.  Level 2 is kept is in my car and will give me enough supplies to sustain myself in relative comfort for 48 hours or more in most emergencies.  Combine the two and I’m up to 72 hours.  The purpose of the level 2 kit is to get me home to pick up the family so we can decide whether to bug-out or bug-in.   Level 3 is modular, in and of itself.  There are some components that can simply be thrown in the back of a truck, and there are other components that are meant for staying put.  Depending on whether we’re evacuating or staying home, we’re good for anywhere from two weeks to several months – plus a day or two more with my Level 1 and Level 2 kits added in.  Having the Level 1 and 2 kits along for the ride also offers me the ability to split up from the main family temporarily if necessary.

Now let’s give Joe a similar setup to the one I use.  Joe has enough gear to get himself the five miles back to his car.  Or he can hide out for a day and hope things calm down.  He’s got the gear for that too.  His Level 1 has given him options.  If he gets to his Level 2, located in his car, he has even more options and enough supplies to camp out in the office for a few days, or maybe – at a stretch – a week.  He could also try to get home.

That’s one example, but in the end modular design and its benefits is only limited by your imagination and your circumstances.  There are, however, certain things that need to be true in all modular systems.  Once you understand these elements, you can use modular design in pretty much every aspect of your life.

1. Each module should be able to stand on its own.  The stuff that lines your pockets is never going to sustain you for weeks at a time.  But each level of your system should address, in some way, the basic needs of survival for some period of time in the environment you are most likely to encounter.  I’m referring to shelter, water, food, signaling, security, and self-aid.  My Level 1 does that for 12-24 hours in a semi-rural environment.  My level 2 does the same thing, but for a longer period of time and greatly increases my weather range.  Level 3 takes me still further.  All are functional by themselves without the help of the others.  In preparedness terms, this is mainly true because you have to assume that you will use up each module during the process of getting to the next level.
2. The whole should be greater than the sum of its parts.  Consider the Army’s Modular Sleep System for a second.  It’s made up of four components.  1) A bivy sack made of GoreTex; 2) a thin sleeping bag we called a patrol sack; 3) a thicker sleeping bag we called the black sack (normally called an intermediate sleeping bag); and 4) a stuff sack.  Each component individually gives you protection in different temperature ranges, and all of the components combine to take you down to temperatures in the -20 degrees Fahrenheit range.  But the real added benefit comes in the redundancy.  Because there are layers, if any one component is damaged or torn, I’m still warm because of the other components.  The whole is greater than the sum of its parts.  You can do the same thing with your stored food.  I can store the complete seven day nutritional and medicinal needs for one person in a 5-gallon bucket, but there are six people in my family.  If I give each person their own self-sustaining, complete one-week bucket, but I make sure to vary the stored ingredients a bit, I can greatly increase my food preparation options and everyone can benefit from the combined food wealth.  Moreover, if something goes bad in one person’s bucket, there are backups in other buckets.
3. You must plan it out.  You can’t throw together an effective system on the spur of the moment.  It needs to be planned out.  You need to define the purpose and duration intended for each module of your system.  Then, for every item you put into a module, you need to identify all of the intended and potential uses for the item when used alone and with other items from its module.  Finally, you need to list all of the intended and potential uses when combined with kit from other modules.  Let’s say hypothetically that you’re in a minor emergency.  You open up your level 1 kit and find $25 and some gear.  You now have options that will, hopefully, see you through to your Level 2 kit.  When you get to your Level 2 kit you find $100 and some more gear.  Combined with the remaining Level 1 money and gear, your options have greatly expanded. 
4. You must test your system.  When I say test, I mean both theoretical and actual.  You need to occasionally use the items in your kits.  Take your bug out bag and nothing else camping, for example.  You also need to constantly ask questions like, “okay, let’s say the power goes out right now, how will I get by?”  Test the individual modules as well.  Using nothing but your Level 1 gear, can you really get through a day?  Remember: Even the best-designed system in the world is essentially useless without the skills to put it into use.
5. You must put the system together.  This sounds so obvious that I almost hesitated to include it, but the tendency is for us to think things through and then just let them go.  You have to actually put together your kit, or you won’t have it when you need it.

As I mentioned in the beginning, in addition to using them in my preps, I use modular systems at work, at home, and at play.  I’m betting that if Joe had seen the benefits beforehand, he would use modular design too.

Sir:
I thought that you and your family might be encouraged by the following: There was an extraordinary occurrence in Haiti on February 17th. Here is a blog entry with a YouTube link about a nationally declared three days of fasting and prayer in Haiti. Amazing grace.

The final sentence in the entry is the most sobering:

"The only sadness that I feel today is for our nation. While a nation that has long been under Satan's domination is turning to God with total commitment, our nation, founded on Godly values, has rejected God and is rapidly trying to forget that His name even exists. Let us pray for revival." - Sheila M.

Hi James,
Its been a while. I just spent eight days in Haiti building a radio station in Crois des Bouquets. We were working with a church and pastor I have worked with before. He had about thirty Haitian people who lost everything in his home, plus 10 Americans, three on our radio team, and an evangelistic team out of Florida.

Our team went in with tent, MREs and Mountain House food. a water filter plus all of our necessities. fortunately we didn't need our food but donated it to the house hold to aid others. We left our tents, sleeping bags, and air mattresses behind and told the Pastor to give them to people he knew who really needed it.

We got a radio message from the states inquiring about an internally displaced persons (IDP) camp who had been sent aid
by a ministry in Indiana. Apparently they had not received their aid yet. We checked and thought we had the right IDP camp. They had not had anything to eat or water in over a week.

My first thought being an old army sergeant was: "Where are the privies?" There were no sanitation pits dug, and people were relieving themselves out in the open. This was just about three miles from the airport at the river bridge. There were two large tent cities in the same location with absolutely no sanitation facilities.

I talked with the leader of one camp and ask why they had no latrines dug. They had absolutely nothing to dig a hole with. I told him that if they didn't do something immediately about the problem, that disease would go through that camp in short order, and could wipe them all out. I told him I would get a pick and some shovels. I did so the next day.

On the following day we were leaving and the camp had a team out digging privies. Praise the Lord.
James, and readers, there was at that time absolutely nothing being done about sanitation in the camps. The U.S. Army was really concerned about this issue, but their hands were tied. There were no NGOs addressing the problem either. It is a major issue with the medical people I met.

I did see about ten brand new porta Johns at the IDP camp across the street from the presidential palace. But there was no one using them. I'm sure they were put there for the news nosies, just for the cameras. I know in the next month there will be a second disaster developing, and there already is in one camp. (I got word from a person that I trust and that is in the know, that a large TB outbreak had already occurred in one of the IDP camps.

The Haiti government is very inept and un prepared for any disaster. the UN, USAID, UNICEF, Red Curse, et cetera are all just having meetings and doing very little to help the situation.

All I saw when I was there was Christian ministries getting the job done. I know the Samaritan's Purse, Operation Blessing, Friend Ships, Catholic Relief, Mennonites, Baptists, et cetera are in there getting their hands dirty and getting the job done.

I would just say in closing that the first thing after a disaster strikes, and people are having to camp out, or go into a camp is to dig a suitable latrine, and make some effort to keep clean. One of the first things that our servicemen in all of our services learn in basic training is field sanitation. If our military were turned loose to help I know full well they would go in there and help provide some form of field sanitation.

I do have to say the Christians are pulling together in Haiti, and people are turning to Christ by the thousands.
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Blessings, - Dave M. (A Blessings For Obedience World Missionary Radio volunteer)

Mr. Rawles,

I thought I'd drop a note having been in Haiti from the day after the quake to a couple weeks ago, and having run an ongoing program there for a few years now. I wanted to comment on the issue of rioting in Haiti versus. Chile. I think the core issue was that people in each country were faced with different immediate challenges.

In Haiti, like many other developing countries lacking Chile's level of building codes and construction standards, Port Au Prince was extremely vulnerable to a quake. Because the quake hit only a few miles from Port Au Prince you had complete destruction of entire zones of the city, with entire blocks where 4/5 of the buildings just collapsed. As a result the death toll was 220,000 people.

The immediate job for a large percentage of the city became how do I dig through these buildings to rescue those 220,000 people or at least recover the bodies. The self organized work crews were pretty incredible. For much of the rest of the population the immediate task became how do I find my family and find shelter. Most of those alive were in front of completely destroyed houses (1.5 million homeless) Even when looking for a few immediate resources because so much was destroyed people were salvaging collapse sites more often than looting.

In addition the atmosphere was somber and surreal, the work crews pulling out bodies everywhere in the city and piling them, the people crying for help, the surgery taking place on the street. I would say that everybody I spoke to who emerged from that situation left with a truly profound sorrow in their hearts. Missing a day or two of food was pretty secondary for most people. Many Haitians have dealt with food insecurity and hunger before, that wasn't as much of an immediate issue. Even for aid workers it was hard to even remember to eat much less worry about it.

Outside Port Au Prince people were largely just melancholy, it is a small country, everybody had somebody who died, everything was shut down, you couldn't get money from banks or buy food in stores for a week, yet there weren't people in the streets till the very end of that, and even then it was just some organized marches in front of the banks for them to re-open. Within four days in Port Au Prince many of the aid services started emerging and food and water started to become more readily available. Within 6 days some money transfer services started opening in the rest of the country and commerce started again.

Thankfully in Chile, outside of the terrible devastation in the Tsunami zone, comparatively many of the structures in the earthquake zone stood. So the challenges faced were different. The people seen on television looting seem more concerned about scarce resources than trying to dig out their trapped friends and family out of the rubble. With a death toll under 1,000 so far the number of people who are directly missing people or who came back to find their home collapsed on their family must be much lower. Which leaves more people concerned about "Where do I get food, where do I get water" than "How do I dig these people out, dear god there are so many people dead, everywhere"

I think in the end the Chilean people will look back on this tragedy and realize how prepared they were as a nation, that they had put the standards in place to keep their buildings standing and they will take that to heart in preparing on a personal level. I am hopeful things will calm and they will find the strength to rebuild.

For the readers who want to know how to prepare for seismic situations let me offer 3 bits of gear advice, always have a full unbreakable water bottle on you, always carry a whistle, and always keep a respirator (even if just an n-95 mask in a pocket, you would not comprehend the toxic cloud that is created when a city collapses, it was like 9-11 everywhere). Beyond that if you are in a developing country in a seismic area with poor cement block construction (lots of parts of Peru, Guatemala, Thailand, Dominican Republic, India, Pakistan, etc) in older style buildings try to sleep near an exit to an open courtyard, try to stay in one story buildings, stay away from adobe. The safest bet is to try to stay in modern hotels, the big chains force proper construction techniques. If the quake hits get out and watch for falling hazards. Many prayers that the readers of this blog never have to face anything like what people are facing in Chile or Haiti. Sincerely, - Peter H.

Hi Jim,
In Section 2 – Packing, Blake in Arkansas talks about using 1 gallon Zip-Loc bags for packing items. This is an excellent idea which I have used over the years in my sea-kayaking camping trips. However, another way of evacuating the air from these bags is to use a straw.

Method: With bag ready for closure, insert a straw into the Zip-Loc bag. Zip the bag up to the straw. “Press” out as much air as possible (not smash). Then, use the straw to suck out the remaining air from the bag. Remove straw, and zip closed. Voila! A human powered vacuum bag sealer. Regards, - Douglas in Connecticut

Jim,

I've just found your site and love it! In response to the "humping a pack" letters, the best defense is a good offense regarding blisters.

I have very wide feet with a narrow heel so finding boots that fit well is a challenge. On long hunting trips and hikes, duct tape is my best friend.

Since most of my blister issues are on my heels/ankles the first thing I do is shave them. Yes shave them. Nothing like pulling tape off a sensitive area and giving yourself a Brazilian wax at the same time. Ouch! To protect my heel first I apply an 8" strip of duct tape along the back of my heel, under my foot and extending up over the Achilles tendon. Be sure to stretch your toes/foot as far up towards your shin as possible when applying to get the best possible fit. Your foot has to be absolutely dry to get the tape to stick and a quick wipe with rubbing alcohol helps remove skin oils.

Then apply three pieces of tape approximately 4-5" long horizontally across the back of my heel and up my ankle. Keep the tape as smooth as you can and avoid any lumps or flaps. Cutting the tape where it bunches and laying the flaps down flat works well to avoid "grinders" or humps of tape that will rub a hole in your foot in short order.

After you finish armoring your soft spots with good duct tape, give your feet a healthy shot of unscented antiperspirant. Layer on a thin polypro sock (or other wicking synthetic) then a pair of quality wool socks. Cheap socks are the #2 cause of blisters behind poor fitting boots. I am frugal to say the least but will happily shell out $9 for 1 pair of quality wool socks with good elastic. To remove the tape, pull it off immediately after you finish your hike when your feet are still good and steamy, or wait until you get out of the shower and the adhesive is warm and soft. - David in TN.

Hi Mr. Rawles,

The initial article, as well as the feedback letters, are all great and provide a lot of material for the individual to take into consideration. People with special needs, or medical conditions such as diabetes, should certainly pay attention to blisters or other problems. As [SurvivalBlog reader] S.H. in Georgia pointed out, "stop and prevent" is your best course of action.

Our daughter (18 years old, adopted at age 4) is very small in stature, less than 5 feet, and of muscular build. She runs, bikes, shoots, plays softball and basketball, has run cross country, and is generally very active and has a unbelievable sense of balance. She's also missing the lower part of one leg and uses a below-knee prosthesis full time. Her walking gait is so smooth you'd never know anything was 'wrong'. The below-knee prosthesis she uses is very high tech with a brightly colored lightweight carbon-fiber socket, silicone liner, and dynamic response foot.
Basically, she gets around about as well as is possible- but a long hike
carrying a load will still cause problems.

This is where planning ahead really comes into play. Do you know where you will be going or what types of terrain you'll be encountering? Have you practiced a trial run with your weighted pack and seen how it impacts your residual limb?
Our daughter's limb loss is due to amniotic banding, thus her 'little leg' has a odd shape plus numerous surgical scars. Even with a very well fitted, custom-built, socket and silicon liner she gets chaffed along the sides and in the back of the knee after being on the trail for a long period of time.

Unfortunately, we have discovered that there is no hard and fast answer to these sorts of problems. There are approaches that help for amputees:
-Stop every now and then, remove the prosthesis and liner and dry everything out as well as let the leg cool off. A sweaty liner slides around and can bunch up and cause more problems. A sweaty residual limb and liner can allow the prosthesis to move out of position causing not only more chaffing but a increased danger of trips and falls. When running cross country in hot weather,
our daughter often had problems keeping the leg in it's proper position.
-Keep a spare, dry, liner and/or prosthetic socks that you can change into.
-Amputees know that the size of the residual limb changes during the day. Fluid pools in the limb at night when the prosthesis is off, and is pushed back out when the limb is on. Thus the fit is slightly tighter in the morning than in the afternoon or evening. Keeping a supply of different thickness socks on hand to act as shims between the limb and the socket can help keep the proper fit.
-There are different balms that can help reduce chaffing. My wife and daughter actually cooked up a type of lip balm that works great for chaffing. We always try to have some on hand.

As if your pack isn't big enough already: Don't forget the spare leg, emergency repair materials, and crutches when you bug out. Our daughter has broken a socket wide open playing basketball before- what if we were bugging out and that happened? We repaired the socket with fiberglass casting tape, and subsequently do not leave home with having a roll or two in the vehicle's
medical kit.

The previous leg might not fit very well anymore, but if it'll work at all it's worth having as a spare. Do the feet attach the same way? Are the pylon tubes and adapters the same so you can cannibalize a old prosthesis for spare part if needed? Are you carrying the proper size wrenches to tighten loose screws? If there are usable parts with common attachment fittings on old limbs, feet for example, it is probably worth your time to throw at least one in the repair kit.

I know there are many aspects to this I haven't even touched. Limb loss is so individualized there really aren't many 'catch all' techniques. Thus, it is really important that the amputee know their bodies, their prostheses, and individual needs before hand and prepare to the best of your abilities. You don't prepare for a marathon by putting on running shoes and warming up for the
first time at the starting line- you work on technique and equipment over time and work towards the the goal. Whether you have special needs or not, it's exactly the same with bugging out. There's no need for anyone to be left out or viewed as a burden and left behind. Yes, there is more planning involved, but our daughter has taught us that it's all part of the adventure. The Lord created all of us with the same heart and soul and everyone has something to contribute. Even in the hardest of
times, that's something I hope we never forget. - Jeff B. in Louisiana

Hello Mr. Rawles,
Blake's recent post on the fine art of "humping a pack" is much appreciated. I'm a bit of a backpacker, but have never been subjected to the rigors of "forced humping" for Uncle Sam. I've found that I rapidly become an unhappy camper when my pack weight exceeds 45 pounds. Thanks go to Blake for his service to our Country!

The magic (but painful) blister remedy to which he referred is Tincture of Benzoin (sometimes abbreviated Tr. Benzoin). This mixture of specific tree resins in alcohol, and it's cousin, Compound Tincture of Benzoin, are used in health care as a skin protectant when applying adhesive devices to skin. It has the added benefit of enhancing the tape's adherence, so the bandage stays on longer. Some in the hiking community have used it as Blake described, when the blister has already formed ,and you have no choice but to keep going (other hardcore folks use duct tape. I guess that's okay, until removal time!) As far as I can tell, there is little science available to confirm the "skin toughening" property that some attribute to Tr. Benzoin. Most probably it kills, or anesthetizes the superficial sensory nerves responsible for pain generation.

If you don't have a drill sergeant breathing down your neck, the best way, by far, to deal with blisters on the trail is prevention. As soon as you feel a hot spot, sit down, take off the boot and sock(s), rub your feet, let them dry out, find the hot spot, and plaster it with moleskin or one of the transparent bandages like New Skin (Tegaderm will also work). It is also critically important to stop and remove any pebble or debris in your boot as soon as you feel it. I've pushed it just a few more hundred yards, only to be sorry when a blister or abrasion occurs.

Once a blister has formed (again, if you have the luxury of tending to it without being shot or court-martialed) your primary focus should be prevention of infection. Try to protect the skin over the blister - as long as it's intact, bacteria have no access to the denuded dermis. A donut of moleskin covered with an adhesive bandage may help take the pressure off and preserve the skin. If there's just too much fluid in the blister to stand, clean the blister with an antiseptic (you do have alcohol pads or povidone iodine in your med kit, don't you?), insert a hypodermic needle near the edge (but still into the dead skin), and aspirate the fluid. Re-clean the blister and cover with a sterile bandage. Perhaps a little antibiotic ointment would help prevent infection and reduce friction.

At any rate, use your head. If you have the freedom to stop and prevent, then stop and prevent. If not, do the best you can, but always trying to prevent infection. One other thing that Blake said that bears repeating - sock liners are great! I like the thin, white ones that you can buy cheap at outdoor stores. When used with good hiking socks, the friction is reduced dramatically. They're so light you can take multiple pairs and stretch the smelly expiration date of your hiking socks, while keeping something clean against your feet. They're also easy to wash and dry quickly. I highly recommend them!

One more thought about on-the-trail foot care: be sure to trim (and file smooth) your toenails before a backpacking trip! I forgot this once, and a toenail attacked the adjacent toe! Trimming toenails with a survival knife is an adventure, at best! I now remember this prep duty, and have allocated 1 oz. in my pack for nail clippers (yes, I know I'm a weenie).

Best to all, and, as always, thank you for all you do Mr. Rawles. - Pharmacist S.H. in Georgia

James:
This is a well written article full of excellent information – my thanks to Blake!

I have never been in the military but have been backpacking most of my life. I agree that moleskin is a waste of time and will do more harm than good. But one item I always carry in my first aid kit is a Second Skin Moist Burn Pad. These not only work well on burns but blisters as well. To apply, first clean the area; cut out a section about twice as large as the blister; peel the covering off one side; apply the peeled side to the blister; then carefully tape it on. The pads are sterile, so they are fine on open blisters as well. Just make sure you put the remaining portion in a Ziploc and squeeze out the air so that it doesn’t dry out.

Blisters can incapacitate you quickly and lead to some nasty infections, so treat those feet with respect! Make sure you put on those boots and that pack and hit the trail at least once a week so that if the SHTF, your equipment and your body are ready. - C.W.B.

Mr. Rawles,

I wanted to make a few comments on this Blake's Art of Humping a Pack. Having been in Special Forces I have spent more than enough time ‘humping’. Most things I read here I can only agree with, now I feel I have something to add.

Taking care of your feet, Blake is right on. Changing socks often is critical. Dry feet are happy feet. I have found problems with cotton socks, I recommend wool or synthetic. Always powder your feet when putting your socks on. If you feel a hot spot, stop and fix it before it becomes a blister. My worst blister came from a short ruck march when I didn’t want to stop and fix what I knew was becoming a blister.

With regards to Tincture of Benzoin, it really does work! If you are going add this to your kit be advised that most tincture of benzoin that you find at your local drug store has an aloe mix and does not work. You need to go to a medical supply store to get the pure tincture of benzoin! I have found that if you put a hole on one side of the blister, inject the tincture from the other side, until all the pus is flushed out, and then push the skin down to stick it together. "Painful" is an understatement but it does work. If you don’t have tincture of benzoin, another solution is to use needle and white thread (colored threads will cause infection) and run it through your blister leaving the thread in your blister. The thread will act as a wick to allow the pus to drain. With this method there is a higher risk of infection but if you have to get somewhere and you feet aren’t cooperating, this will work.

Waterproof bags in your pack is critical. Water is weight, the only water you want in your pack is the water you can drink. I have seen soldiers come out of a creek with their pack weighing much more than when they went in. Painful and unnecessary.

I recommend layering your equipment. I would always carry a survival kit (built out of a M16 Ammo Bandolier, under my shirt which contained some food, a water packet, small candle and matches, space blanket, simple medical kit, small knife and flashlight. Then I had my pistol belt with butt pack which is your fighting load which includes food, water, ammo, a couple pairs of socks and whatever basic cold weather gear might be needed. Last comes the pack with everything else; more water, more food, more socks, more ammo, … . That way if you have to dump your gear you can still get by.

Lastly, as much as good physical conditioning can allow you to carry a lot of gear the Marines did a study of the soldiers load and determined that 4/5ths of 1/3rd of your body weight is the optimum load for sustained load carrying. (The rule of thumb for pack animals I understand to be 1/3rd of body weight). So optimum load for a 200 lb male comes out to 53.3 lbs. Again, this is for optimum sustained load carrying.

Keep up the good work. - Steve T.

James Wesley;
I've only recently started reading your site. I'm enjoying both the current posts and the archives.

The article on humping a pack is consistent with my own experience. I'd like to add two points for your consideration.

First, the issue of how to carry a handgun when carrying a large pack. You get over 30 pounds pretty quickly when loading a pack. Any weight that high demands a good hip belt. You then carry most of the weight on your hips, not your shoulders. With both a hip belt and shoulder straps, all of the usual places to carry a hand gun are occupied. Neither belt holsters nor shoulder holsters work. You can do a thigh rig if you don't mind open carry. I never liked them. I much prefer concealed carry wherever legal. The best solution is a thing called a Safepacker, which you can find at The Wilderness web site. It was designed and made by a guy who needed to carry a large handgun on mountain search and rescue operations. It pads and conceals most any size self defense handgun you might carry. I hang mine on my hip belt. Looks just like any other part of the pack, is quick to access, is very secure, lasts a long time. You can hang them most anywhere on the pack. They come in both left and right hand models and have room for spare ammo and a nice velcro pocket for paper or ID. One tip - go with a larger size if in doubt which one to get. In most jurisdictions, carry in a Safepacker is regarded as concealed, not open carry.

Second a large pack makes you an unsteady bipod. In anything but swamp, a walking stick or two is a great tool. It makes you more stable, is handy for discouraging dogs and snakes, allows you to rig an effective bipod to steady a rifle or use as a monopod for the rifle if you give some thought to the handle end of the thing, gives you a handy way to poke at anything suspect, and gets your arms working a bit, defeating the dreaded "sausage fingers" that happens when you hump a pack with your arms dangling down for a few hours. The only down side is that you cannot do this if conditions demand you carry a rifle or shotgun at the ready. You can take your pick of many available walking sticks marketed for backpackers. Look for light weight. You don't need or want ones with built in spring shock absorbers. Too noisy. You do want to be able to pick your "basket" so you can get a big one if needed to stop from sinking deeply into snow or mud. You can get ones that telescope into small sizes so you can strap them to your pack. You can get ultra light carbon fiber ones that are maybe too fragile for most folks to use. You can get a rubber tip to use the sticks on pavement. You can also forgo commercial ones in favor of something more stout you can make yourself out of wood or metal - makes for a better weapon, but ounces count, so I like light ones. When I first saw walking sticks, I scorned them as trash for urban tree huggers. Then, I sprained an ankle and learned to love the things. On ice or scree, they can save your life. - JEJ

Greetings Jim,
I hope this Email finds you well. I would like to respond to the art of "Humping a pack". Some regard me as a bit of an expert, I have been backpacking the Northwest Cascades and the Pacific Crest trail for the last 20 years, including climbing a few of the more well known Mountains and have week-long excursions down to a science in terms of needs and weight. One of the misconceptions that people have with regards to backpacking is focusing on the military as a general guideline for equipment. Things like ALICE packs, MREs and camelback hydration systems work fine when you are backed up by [logistical] support, But these Items will only prevent you from truly being totally sufficient in a time when there is no support.

High quality internal frame backpacks with compression straps and gear are designed specifically for the task of self sufficiency and comfort, this includes climbing mountains, rock scrambles, and traversing uneven ground and doing this while hauling enough food for a week, plus gear.

MREs - Fine for a few days, but if you won't be around a food source for a week or longer, Lightweight Mountain House is a much better choice you can haul a weeks worth of food, and perhaps more if you are willing to eat late, and small, with their pro-paks.

Camelbak hydration systems - Guesswork is your only option here as to how much water is left, because you cannot see your consumption level because it is buried in your pack. Not a good thing when water is a primary concern. a better choice is two common water bottles, one packed inside at center-pack close to your back, the other rides topside for convenience.

Clothing, and this includes Socks - Clothes with any cotton are a giant no-no. We have a couple of sayings in the backpacking world, "Wool is worse" and "Cotton Kills!" all clothing should be synthetic, and wool blends only if you have to, with wool being around 35 to 40%. you only need two pair of socks: one to wear while the other is drying, synthetics dry fast, cotton absorbs, takes a long time to dry and clings to skin. Wool takes forever to dry. The objectives are to wick the moisture away from your skin, evaporation, and fast drying. Backpacking outlets carry clothing that is designed to keep you warm/cool, and wick moisture, soaking wet clothes can dry in minutes.

Moleskin - Only works in conjunction with rubbing alcohol, the area must be thoroughly free from oils and dirt before applying. if done correctly Moleskin can last for up to four days with a single application. if you have been fitted with right boots, moleskin probably wont be needed

Foot powder - We avoid it, as it only makes a mess of your feet, socks, and boots. The right socks make foot powder un necessary. Clip your toe nails short to avoid problems with the added weight and to save your socks from holes.

Boots - Spend the money. (Do web searches on Asolo and Vasque,) All feet may be different, but if you have to backpack across the country, or just across town, in the rain, snow, or blistering heat, these two companies make the boots that can do it.

Packing - Heavy items go center-pack against your back.

Packing enough gear goes hand in hand with packing the right gear, and knowing how to use what you pack. If you do it properly, some Items can serve more then one purpose, and you can be self sufficient for seven days or longer with as little as a 38 pound pack, this includes tent and sleeping bag, food, clothes, with rainwear, water filtration, stove. - Larry

Walking with a loaded pack on your back is what the United States Marine Corps Infantryman refers to as "humping".  And while it may not take a lot of brains to put a loaded pack on and walk, it has definitely become an art, science, or skill that is constantly honed by infantrymen of all types.

With eight years as a Marine Corps Infantryman I have learned quite a lot about the art of humping myself.  There are several factors that come into play before you strap on your pack and take your first step.

1. PHYSICAL FITNESS:  What is your current level of physical fitness?  For those of you who have thought about or have a plan for when the SHTF, you know that this is an important factor of yours and your family’s survival.  If throwing on your BOB and heading for the door with fifty lbs. of survival gear on your back is the first step of your plan, then your not going to get very far if you haven’t conditioned your body to take this kind of physical exertion.  The best type of physical conditioning for humping is humping.  You don’t have to be a long distance runner to be a good humper.  The best thing to do is to just strap on your pack and step off for a mile or three and then gradually increase the distance each time you go out, or at a reasonable rate (add a mile a week).  Every time you increase your distance you should also increase the weight of your pack.  I don’t recommend starting out with a fifty pound pack.  As with any kind of body conditioning you should start out light and work your way up as your body becomes used to your training.
   
   
2. PACKING:  Got a good pack?  If you don’t you better get one.  If the pack you have isn’t a good one you’ll find out once you start humping with it.  I won’t recommend much gear, because all personal gear is just that, personal.  Its your preference.  I will say this, you can’t go wrong with an ALICE pack. Are there better packs out there?  Yes, but when it comes to affordability including durability…it’s a proven product.  In the end it all comes down to what you prefer.  Packing is a separate art in itself.  The first rule in packing is “Ounces make pounds!”.  Nothing goes into the pack that you don’t absolutely need or can’t live without.  You should consider the weight and size of everything as you pack.  One of the most important packing aids that I’ve found through the years is one gallon zip-lock bags (buy the good ones they’ll last longer).  Use these to pack things separately inside your pack.  Stuff them full and then zip up the bag almost to the end, then (if packed with non-breakables) smash the bag to get all the air inside the bag out.  Then zip the bag up the rest of the way.  This will help keep you from wasting space inside your pack.  I would recommend packing breakable items in outside compartments, or packed in between zip-locks of underwear and T-shirts or something soft.  Zip-locs also help waterproof your gear inside your pack.  Using a waterproof bag or a trash bag as a liner will also work but this will give you added protection. Zip-locs also help keep your pack organized.  These can also be used as a washing machine as I found out in Iraq.   Stuff everything into your pack as tight as it will go, then cinch down the outer straps as tight as you can get them.  Second rule in packing is “A tight pack is a comfortable pack!”  If your adding or strapping items to the outside of the pack make sure they are secure.  When theses outer items shift our flop around they will cause you to sway and possibly fall if they are heavy enough.  Just the movement alone can cause you discomfort.  I would also recommend not strapping things to the top of your pack (sleeping bags, etc.) unless they are small.  These will push on the back of your head and cause unneeded neck pains, and you will have plenty of pains to worry about already.  These may also hinder your vision.  Strap them to the bottom of your pack if possible.  I would recommend food or energy bars and often used items to be in outside compartments.  This makes for easy access on short halts and maintains spillages to separate compartments.  Field strip your MREs down to the individual packages, get rid of the cardboard containers.  You can over-pack a few pounds on food.  Because you will be eating the food and essentially lightening your pack at the same time.  And your route to wherever your going may be unexpectedly altered, and you may be on the hump longer than you anticipated. And the third rule of packing, “If you can't put it on by yourself, It’s probably too heavy!”
   
   
3. GEAR POSITION: When you put your pack on make sure it’s adjusted to the center of your back.  Make sure all of the straps are secured to the pack frame properly and that they are tight around your body.  You may have to alter positioning of your personal gear that you are carrying on your body (canteens, ammo pouches, butt packs, etc.).  I recommend that your gear be positioned so the back pad of your pack frame sit squarely in the small of your back, adjust your pack straps accordingly.  Improper ride of the pack will cause extra back pain, and shoulder pain as the straps will be digging into your shoulders.  And setting the pack on top of your pouches may cause damage to them that you may not be able to repair.  I recommend your weapon go on last.  Be sure you are able to deploy your weapon as needed and get to spare ammo without the pack getting in the way.  And if you have to dump your pack, then make sure you can do so without it getting caught in your high speed sling and choking you.  You should know in the first mile whether you need to adjust your gear and pack. 
   
   
4. BOOTS & FEET:  An Infantryman or “Grunt” can probably tell you as much about foot care as a foot doctor, as these are generally their primary mode of transportation.   As before, I can’t and won’t recommend a boot.  Its personal preference.  However, please consider your local weather and terrain in selecting the proper boot.  Boots weigh a lot and take up a lot of space.  You can pack a spare set, but you may not have the room.  The best way to break in a new boot is to hump in it.  (Don’t forget to pack extra laces.) The only recommendation I’ll make is don’t skimp when it comes to buying boots.  They should be considered one of your most valuable survival tools.  Because having feet means you can still survive.  Pack plenty of socks, cotton or wool.  When humping, if you will wear a pair of dress socks under a pair of cotton or wool boot socks this will help prevent blisters.  Although you may still get them.  Only extensive humping and conditioning of the feet will prevent blisters.  They also make humping socks made out of Teflon that work good.  From my experience moleskin doesn’t work well if you are going to continue humping.  It just pulls the blister off. Ouch!  The best cure for blisters is Tincture of Benzoin Be ready for some pain.  It feels like someone is putting a blowtorch to your feet for about ten minutes.  But after that you will only experience minor pain or no pain at all from the blister.  You can put it on an open blister or draw the puss from the blister with a syringe then insert the tetra-benzoine into the blister with the syringe.  I’ve had it both ways.  I prefer the syringe method because it leaves the skin on over the blister.  This method once cured me of two half dollar-sized blisters, one on each heel.  After only a ten miler in broke in boots.  I felt no pain within fifteen minutes, remained in the field the whole week and we speed-humped out that Friday and I got no blisters.  It works.  But it will make a grown man cry.  Or want to.  Don’t forget foot powder and anti-fungal powder or cream.  Change socks daily, or soon after your feet get wet.  Also when humping don’t take your boots off until the end of the day, or unless changing socks.  When you stop for a break take off your pack but try not to sit down.  This makes your feet hurt when you stand back up and start walking again.  Let your feet air out in the open every chance you get.
   
   
5. HYDRATION:  Water is good for you anyway, but you will need a lot if you are humping.  You may have to plan your route around watering spots.  Try and hump as much water as possible.  Don’t forget to consider the weight though.  Get a camelback or similar hydration system.  These work great while humping since you don’t have to mess with screw caps or bottle tops.  If you can wear the hydration system under your pack it’s beneficial in case you have to drop your pack you don’t loose your water.  Always keep some kind of water on your body with your personal gear.  I recommend filling the hydration bladder on each stop to prevent running out between scheduled stops.  Some type of sports drinks or powder are good to have on hand as you will loose a lot of electrolytes while humping and these are good sources for replenishing those and will do so faster than plain water. 

Now I know that a lot of this information may not apply to everyone since a lot of you will only be moving so far to a retreat or cache.  And you will all be moving at your own pace, or as fast as the slowest person in your group.  A lot of you may not even be going anywhere.  But if a time comes when you have to "Ruck Up” then this may come in handy.  I may have some more points to add later. 

Hi SurvivalBloggers,
Have you have ever had a foreign object in your eye, and had a hassle finding and removing it,with or without help? I recommend that you get a big, powerful enlarging bathroom type mirror,the type you see on a swivel,usually with lights around it. These are about a foot square, and have a normal mirror on a swivel with an enlarged mirror on the reverse side. As a regular mirror gives you a half size image, examining your own eye for a tiny object can be difficult. With an enlarging mirror, its lots easier. I use a mirror like that, with a large hand held magnifying lens set directly on the mirror for even greater magnification. The mirror on a swivel and the magnifying lens in combination with a good light on your face, allows a really detailed examination, revealing details the unaided eye can't see and leaving the hands free to use tweezers or a swab,etc.. Don't forget some small hand held dental mirrors of good quality and good quality needle nose tweezers.

If you are way out in the boondocks and really need to examine your face, then this is a portable way to see yourself well. Having a good set of mirrors and various hand lenses on hand can serve a variety of functions such as fire starting, signaling, and so forth. These bathroom mirrors are inexpensive, and can be found often in a second hand store or thrift stores such as Goodwill for next to nothing. But the difference this item could make in first aid care could be life saving or at least eye saving. I now always have a smaller version of this setup when traveling and use it to clear sleep crud caked eyelids. Cheers, - Jose Noway

For many, the idea of preparedness seems like an impossible undertaking. The amount of equipment and supplies needed is staggering. When I first came to the realization that I was under prepared, the gap between what I had and where I needed to be was too much for my public servant’s paycheck to bear.

I would spend a lot of time discussing preparedness with a group that I would go shooting with, and all of these meetings would always gravitate to “which weapon do you plan for X meters?” or “how many rounds do you think I need for X weapon?” I love to talk guns, but if we were discussing preparedness as a whole, we were leaving out lots of basic needs!

It seemed that the plan was to square one area of preparedness away before moving on to the next. I asked myself “what happens if I have to leave tomorrow?” I realized that having a little bit of everything to survive was better than having a pallet of ammo, but no food or water. This is where I decided that being honest about what I actually set aside for emergencies and developing a starting point was the best plan.

A friend of mine once said “you can’t boil the ocean; you have to start one pot at a time”. I developed the idea of categorizing my list of necessities then deciding what was a minimal level all the way to when I felt fully prepared.

This Good/Better/Best approach has helped me get a handle on the holistic approach to preparedness while still allowing me to keep my bills paid. A side benefit is that this incremental approach was that it was easier to get my wife to think about being more and more prepared without being in the poorhouse.

The first step is to categorize what types of things you deem necessary to survive. There are great resources already written that lay out categories and what goes in each, and this is not the the purpose of this article. For ease of discussion, I will use a couple examples such as food, water, communications, medical, etc.

The second step is to determine what your realistic plans will be, and set minimums for each option. Looking at these plans through the good/better/best approach I will explain how this incremental plan allowed us to stick with a plan and grow it as we can.

Good Plan (Bug In). This is most likely for many of us, such as floods/tornadoes/earthquakes. I know, to many people, planning on bugging in is not considered a ‘good’ plan, but this is compared to being totally unprepared, so being self sufficient at your house is a good start. The fall of 2008 and the beginning of 2009 gave my wife and I a wind storm that knocked out power for 10 days at our house, and an ice storm that knocked out power for an additional 8 days. Now the situation was not dire enough to pick up and leave, therefore the “bug in” was appropriate for us both times. Having set minimum supply requirements for a ‘good’ plan allowed us to manage the wind storm without any problems. Now lessons learned during the wind storm allowed us to plan for the following ice storm. We were better prepared for the second storm than the first, and it was fortunate since the weather conditions were worse. I can guarantee that we are better prepared now from those experiences.

Better Plan (Bug Out). A better plan would be to not only be prepared to bug in, but have the ability to mobilize with needed supplies and move to a predetermined location. This would be some factor that makes it not safe to remain at home. My wife and I have just built on to the existing supplies by adding the proper vehicle, and storing supplies in such a manner that they can be loaded into the vehicle in a matter of minutes. One thing that we both had to agree on was where were we going in case we had to pick up and leave. We still aren’t in a financial place to acquire retreat land, but we have trusted friends on a farm that we have that agreement with, and not only do we have our routes planned, but we have also stored some additional supplies at this ‘better’ location.

One thing that my wife and I have agreed on is certain red flags that prompt a bug out. We both work in emergency services and watch the news and the general demeanor of the public that we deal with on a daily basis. While nothing has necessitated a evac, there have been plenty of times when I drive to work loaded down with supplies and plans to meet her on the way out of town.

Again, let me reiterate that we weren’t comfortable moving to bug out plans until we felt that we could sustain ourselves at home for one month, since this was the what we considered as our minimum criteria. I wanted to get a bug out vehicle first, but after thinking about it, if I didn’t have a minimum supply of things such as food/water/shelter, then the vehicle wasn’t going to do a lot of good. Once our minimum amounts were met, then a truck was squared away, while also adding more to our supplies. The key was not to let the ‘fun’ purchases such as guns and vehicles get ahead of more mundane things such as spare medications and kerosene.

Best Plan (Retreat Living). As Mr. Rawles has pointed out, this is the ideal plan. Being able to weather any problems that befall us from within the confines of our own well prepared retreat is great. This is our ultimate goal, and with each bill paid off, it comes a little closer. However, I would guess that the most of us don’t wake up one morning and decide that ‘I think I’ll go buy a remote tract of land and build an uber-retreat on it’. You will have to decide when you can financially make this move, but you can’t go unprepared while you are saving for that moment.

I can’t give you a perfect plan to see you through incremental preparation, since no two people will have the same situation. What I can suggest is that you start with a pencil and paper, and be honest with what is set aside for rough times. Decide what supplies you will need per person (don’t count regularly used groceries, these are off limits until they near their shelf life- then replace, use or donate), and set a minimum of each category so you can gauge where your gaps are.

If you’re like us, when you sit down and write out what you have in the house, then separate those supplies from the others, you may be surprised at how prepared you are compared to what you thought. You may be well above minimum on certain things and seriously deficient on others.

Setting benchmarks for your categories should keep you on track as far as reaching each level of preparedness in a holistic way. Without these benchmarks, it becomes too easy to focus on one area, and neglect others.

Using the Good/Better/Best approach as it pertains to specifics.
Another place that I use the good/better/best approach is in each category of our preparedness. I consider a good (minimum) is having a quantity on hand, a better is having the means to get more, and best is having a sustainable/replaceable supply. I will give some examples of how this approach may be interpreted.

Water.
Good- One gallon per person per day, for X number of days.
Better- In addition to stored water, having purification means such as chemical/UV/filtration systems.
Best- Having a well, spring or refillable cistern in addition to the aforementioned.

Food.
Good- MRE’s and stored food.
Better- Stored food as well as hunting supplies and seeds
Best- Healthy land to hunt and farm, as well as canning means.

Communications.
Good- A single 50w HAM radio and some training
Better- 50w mobile base station and 5w handhelds for members of the group.
Best- A base station/repeater, 50w mobiles in every vehicle, and 5w’s for the group.

Medical (training)
Good- EMT
Better- Paramedic
Best- Wilderness Paramedic.

These are just some examples of how the good/better/best approach can allow you to become prepared all around incrementally, without running yourself into serious debt while doing so. Notice how each step builds on the last, as this allows you to constantly improve your preparedness, while not neglecting any area.

One last note- I challenge everyone to thrive by learning to adapt, rather than artificially maintain your comfort level. To clarify, during our winter power outage, my wife and I found alternate means to bathe, heat the house using our woodstove/kerosene heater, and worked by lamplight. Some neighbors tried to run their homes via generators, to find that some were stolen, broke down, and frequently ran out of fuel.

My challenge to you is to become familiar with your comfort zones and push past them. How long can you go without hot coffee? How about cigarettes or alcohol? How picky an eater are you or your family? These are not things to deal with when TSHTF. If you can quit any vices and expand your comfort level to outside the norm, then when the time comes, your stresses will be lessened.

My preparedness background started as a youth.  My father took us camping often and had an amazing gun collection; I’ve been able to teach my kids what he taught me – great memories both then and now!  In the 1970s, my mom and step-dad bought a little 2-acre farm in the middle of nowhere.  We kept a dozen or so chickens, had a few garden spots (that seemed to grow and multiply with each new season), homemade soap, homemade root beer (an acquired taste!) a “sewing room”, a small orchard, solar heating, our own 250-gallon fuel tank, and a year supply of food (much of it canned at home) for a blended family of 10.  In the late 80’s, I got married and had my wife encourage me to follow the counsel of a church leader “to be prepared for anything”.  I did some homework, organized my gear and ended up teaching others for the last 15+ years the basics of being prepared.   My greatest mentor has been Glenn Anderson, who I met from the Yahoo group PrepJr.  (Check out his survival notebook section in the files).  I have taught disaster education for the Red Cross and served as a police reservist in a couple of small towns.  I enjoy ham radio, beekeeping, shooting, Dutch Oven cooking, serving in my church, backpacking/camping, canoeing, and delving into the many facets of being prepared and independent.  After reading (in quick succession) Lights Out [a free e-book], "One Second After". and "Patriots", I’ve been taking it up a notch and inviting anyone who will listen to join me in a more advanced state of preparedness.  I’ve bought extra copies of the books to loan out (or sent out links to acquire the e-books).  In my church, I am responsible to help some of our local units get better prepared.  During this process, I’ve thought how other churches might want to consider the same thing, and thought I could use this format to share what I have learned over the years.  Being a “work in progress”, here are the thoughts that I’ve come up with so far to help a congregation get better prepared:

Initial goals for this year:

1.  Basic “phone tree” functioning – map out and divide the church boundaries into geographical districts.  Assign each family 2 or 3 other households within a district to do welfare checks, especially during a significant event where loss of phone service is minimal.  Help your members become their brother’s keeper.

2.  List of those with special needs – physical handicaps, mentally or emotionally challenged, critical medicines and/or durable medical equipment.  Make plans on how they can be helped.

3.  Define resources across your membership: specialized skill sets (medical, transport, security, heavy equipment & operators, “prepared”/food storage, etc.)

4.  List of homes willing and able to take in refugees (consider list from #3).  Consult the map to help determine closest options and alternate routing if needed.

5.  Emergency Communications training – locate current ham radio operators across the area and establish a scheduled net to practice traffic handling and prepare to facilitate communications in the event of an emergency.  Use their homes as focal points for the collecting of information.  (If ham operators are non-existent, skip to item #7.) Also, consider befriending local hams and arrange the use of their skills and equipment until such time as you can provide your own Emergency Communications.  Local church leadership can help coordinate assistance as information comes in from across the area.

6. Hold a “Preparedness Fair” to help motivate/kick start the basic concepts of home storage and self-reliance.  Plan to hold mini-classes as members start to see the wisdom of being prepared.

Goals for next year:

7.  Begin ham radio classes – encourage those in church leadership to at least obtain a Technicians license in order to allow “local” communications.  It’s not that hard. Invite the membership to participate.  As more members obtain their licenses, the geographical districts become more manageable and communication is simplified.  Information sharing, especially health hazards, is absolutely critical in allocating the resources available.  It is also a psychological boost to be able to share and learn about local conditions.  Contact your local ham radio club(s) for assistance or go to www.arrl.org

8.  "Disaster Communication" tree – those who choose not to get their ham radio license, make use of what is available outside of phones/internet:  (FRS radios, CB, GMRS, car, bike, foot).  Practice communicating without normal means and check on those in each district. Set up specific hours and frequencies and see how well the equipment works.  For those who are unable to participate “electronically”, a runner will need to knock on the door.  Might encourage more to consider other options.  The goal is to be able to check on each member of your congregation.  Use local weather events to activate communications (flash floods, snow storms, ice, etc).  Encourage acquisition of NOAA weather radio with Specific Area Message Encoding (SAME).

9.  Advanced prep classes (designed for those who have at least a couple of months of food storage and have a basic vision of preps):

• Camping skills and equipment (the foundational layer of being prepared in general)
• First Aid and CPR
• Alternate water/lighting/cooking and fuel storage options
• How to stay warm/freeze protection – alternative heat sources for the home
• Real "Bug-out-bags" and optional transport
• Pressure canning, dry-pack, dehydrating, local cannery, etc – food preservation
• Gardening & herbs - no matter where you live you can grow something
• Beekeeping
• Hunting & game "preparation" – team up “novices” with experienced hunters willing to share.  Opportunity to teach many outdoor skills.
• Home defense & security
• Practical map & compass and GPS use
• Raising farm animals
• EMP preparations (grounded Faraday cages for all critical electronic devices)
• Prep library – fiction and non-fiction, a never-ending collection. Begin discussion groups to open up the thought process of what we can do right now.  Helps keep “the eye on the ball”.

Goals for the following year:

10. Pre-positioning & movement of gear - trucks & trailers available to haul members gear to a centralized point if personal safety becomes an issue.
11. Rally points: Look for areas that allow for shelters/tent sites, water sources, firewood, pre-dug latrines, defense trenches, LP/OP, graves, etc dug while machinery is easily available; perhaps a members property/farm or hunting camp.
12. Backup plans for those unable to report (see #3) due to their own challenges or needing to use there own "resources" elsewhere.  Cross train.
13. Security detail:  Safety, Training, practice, CCW,  proper storage of guns and ammo.

Other considerations:

- Any members with large tracts of land that would be willing to “invite” the membership and like-minded individuals to gather for safety (see point #10 & #11)
- Airplane/ultra-lite for recon
- “EMP proof” vehicles (plan to have necessary spare parts on hand)
- Those with farm animals, fuel storage, solar panels, wood lot/firewood
- Potential access to a pharmacy, backup refrigeration for critical meds
- Organized responsibilities: Medical, Security, Sanitation, Burial, Water collection/treatment, Hunter/Gatherer, Construction/Home repair, Firewood collection, Mechanical, Plumbing, Electrical, Communications, etc.

I have appreciated the opportunity to organize my thoughts as I am preparing to implement the plan above.  I just recently discovered SurvivalBlog,\ and found that it is a treasure of knowledge.  Thank you for your time and efforts to help us be better prepared.

It seems a part of preparing for extremely hard times is acquiring knowledge and honing skills to maximize resources. SurvivalBlog has been tremendously helpful in developing exhaustive lists of needs, supplies, strategies and defenses. In addition, provision is made for faith, charity and quality of life to improve a healthy mental state.

As a landscape contractor for 32 years, I am now seeing more potential for self-reliance that most property owners could develop with some planning and a better awareness of the resources they may already possess. This form of preparation could substantially improve our situation both short and long term. So much of our storing up - though most vital - is of a finite nature. Just as a woodlot on our property can supply continuous fuel, the well planned garden should not only include non-hybrid seeds, building up soils through composting, manures and cover crops, but also include a small greenhouse and/or cold frame that could yield early and late fresh greens that would provide a welcome and healthy addition to food storage.

By learning now and purchasing the types of vegetables that your family will use and enjoy, you have done just the kind of preparing that we are learning about through JWR's books and blog. You will find that quite a few of your favorite vegetables are available as open pollinated or non-hybrid seeds. Many of the beans and peas are not hybrid anyway, as are lots of the salad crops. However, most of the sweet corn we know are hybrid varieties so you might want to look for Golden Bantam or True Gold sweet corn. Most of the great tasting tomatoes we grew up with were non-hybrid. My grandparents saved the seed from year to year and if you have ever wondered why its so hard to find a good tasting tomato, it is because most hybrids are bred for shelf-life and not taste for commercial producers. It seems these genes are somewhat incompatible. Most tomato hybrids however do have the designation of VF hybrid. That is important to know because it indicates resistance to verticullum and fucaidin wilt also known as early and late blight of tomato. Knowing this allows you to store some fungicides - either organic or chemical or both in my case. Another worthwhile gem is knowing how to avoid having tomatoes rot on the bottom before they ripen. This is called blossom-end rot and stems from a calcium deficiency. This can be avoided, more easily than it can be cured, by adding a small amount of lime at planting. The lime contains calcium and raises the PH which also makes the calcium that is present more available to the plant minimizing this frustrating problem.

This is not intended to be a complete guide to anything, but rather to stimulate awareness of your own potential resources and encourage some garden planning to optimize your own property.

As JWR has mentioned here before, rose bushes planted under a window could discourage entry. If you take that idea a little further, there are some lesser known plant selections that can make your property far less accessible. If you have an open field of view and perhaps a place where you would like to incorporate an impenetrable hedge, take a look at Julian Barberry. I never used it much in landscape design because it is so mean I did not figure anyone would want to get near the thing! Now it is looking a lot better to me. I cannot imagine anyone getting through a hedge of that, yet viewed from any distance it simply appears to be an attractive addition to the landscape rather than the vicious barrier that it is. Here you have an example of security hidden in plain sight.

Another option, if you have the room, is pyracantha. This is an angry plant I have also avoided. The Latin word for pyracantha is "firethorn". That should tell you something. When you get stuck with its thorns, it remains sore as it injects you with a little toxin to keep it sore. The beauty is it starts hurting immediately. At a glance you would see a landscape plant that flowers with a heavy white display in Spring and yields orange or red berries in the late summer.

Most folks have forgotten about a tree call osage-orange or hedge apple. Hardy across much of the country, the osage orange was originally planted as a living fence. It lost its appeal with the introduction of barbed wire for livestock. The attributes of this tree do not end there. The fruit of this plant has been used for decades to repel insects inside places such as cellars or closets. It is a natural insect repellent. The wood of hedge apple is extremely strong and was used by the Osage Indians to make their bows, thus the name, osage orange.

We have a 10 acre tract in Tennessee, mostly wooded, for a good supply of firewood for heating and cooking if needed. This past year we built a pond for additional water and fishing and to take the guesswork out of wondering if it would stay full in dry times. I decided to put a 45 mil rubber pond liner in to make sure it held water. A Y-diverter has been installed with the gutters on our house to give the option to fill rain barrels, pipe water to pond, or fill underground tanks for irrigation.

By planting fruit trees and blueberries, we hope to extend and enhance our food storage. When selecting fruit trees to plant, be sure and learn which varieties you will need as pollinators. I have planted Fuji, Honey Crisp, Mt Boomer and Early Transparent for favorite apples, but also a Golden Delicious because it is a great pollinator for many other apples. Planting several varieties can also extend the season in which you can have fresh fruit. The some principle applies with the blueberries. Here you will find early, mid-season, and late varieties. They provide an attractive naturalizing grouping that does not attract attention. I would recommend purchasing bird netting to cover the plants so you can enjoy your crop instead of just feeding the birds.

Another little known ornamental plant that provides food is the Service Berry. A shrubby tree that blooms in early Spring before the dogwoods, it produces a delicious berry that is extremely rich in Vitamin A and is great to eat fresh or made into jam. This addition to the "prepared property" does not appear in the least cultivated, yet subtly yields another source of food. Hidden in plain sight again.

Native already to this property are walnuts, mulberries, raspberries, elderberries, and of course, blackberries. These elements should help provide some variety of jams and jellies for all that wheat bread we are going to have.

A trip to the health food store can be an educational experience for those seeking medicinal plants to grow. Items such as Sambucol, Echinacea, St. Johns Wort, and Solomon's Seal are very common, easy to grow plants that would never appear as anything but ornamental. Sambucol is elderberry, found wild throughout Appalachia. Remember the song Elderberry Wine? St. John's Wort is hypericum, a vigorous yellow flowering ground cover. Echinacea is a brightly colored perennial and Solomon's Seal is a native perennial found in shady areas. All of these and many more have multiple uses and are only meant as an introduction to plants for medicinal purposes. A couple of good books in your library could prove a valuable resource, but will not do you much good unless you have the plants available to you as not all are wild plants. By simply learning some of the more useful perennials and herbs and incorporating them in your garden now, you can have available to you a selection of plants for cooking, for medicinal purposes, and for a variety of teas.

One final invaluable resource could prove to be the woodland around you. Many years ago the uses and properties of trees were better known and much of that knowledge has been nearly lost. Once when replacing a roof on an original log house, I discovered the lath strips holding the tin on was a wood I could not quite identify. A very old fellow I thought might have a guess told me very matter of factly "Well I reckon its probably Black Gum, that's what folks used to hold their roofs on". Black Gum lumber, while not very good for most things, is excellent lath because the wood fibers seem as if they are woven rather than straight grained. This quality is ideal for holding nails in tight forever on a roof through constant tugging of wind. Without this explanation, one might waste the tree for firewood and find it impossible to split. A fellow I know used to keep a few blocks of it around just to embarrass city folks that wanted to try their hand at "bustin' wood".

We are just finishing up sawing some lumber with a portable band saw mill to have on hand lumber I will need for a barn, a garden shed, and some extra lumber for projects or barter. We are fortunate to have lots of very mature trees and I selected those that appeared to be thinning in the top, a sign that they were "going the other way", and any potential problem trees that could go down in a storm near buildings. Now sawed and stuck with spacer sticks is white oak, poplar, hickory, walnut, cherry, sassafras, maple, and of course black gum for the lath on the barn roof.

The root cellar is half-way constructed and the solar project only in the planning stages. It seems there is far more to do in front of me than behind me. Thanks for all the wisdom and encouragement to all of us.

The more I read, the more I plan, the more I prepare, I find myself thinking, "Boy, I do not want to be caught without my coconut oil." While many who know me might get a good chuckle from this thought, they wouldn't be surprised either. In fact, one of my friends jokingly refers to me as the "Coconut Oil Lady". Not a month goes by without her talking to me about some problem or ailment to which I'll respond, "Well, you could put some coconut oil on that,", or, "If you just used some coconut oil..."

Dr. Bruce Fife wrote a great book called The Coconut Oil Miracle. He does a great job of talking about how it works as well as listing all sorts of situations in which one might use coconut oil. While I recommend reading this book, I also thought it prudent to share some real-world experience with those who might consider adding the "miracle" to their preparedness cache.

Coconut oil is the ultimate multitasker. How many items in your preparedness stash can be used for food, medicine, hygiene, and preventative treatment?

Unlike olive oil, there isn't "extra virgin" coconut oil. There is, however, "virgin" coconut oil, and this is the kind of coconut oil you want to buy. While refined coconut oil tastes less "coconutty" and it's still calorically-dense, the refining process causes it to loose many of it's health-protecting and medicinal benefits. If you open your coconut oil and it doesn't smell like coconut, you've purchased the wrong stuff. I opt for organic, virgin coconut oil from Mountain Rose Herbs (http://www.mountainroseherbs.com) because their product is excellent and their prices are the best I've found. (I am in no way affiliated with this company, by the way. I'm just a very satisfied customer.)

As far as food goes, coconut oil is an excellent choice for baking. As a saturated fat, it works like shortening in baked goods, but because of it's unique structure, it actually protects the heart from heart disease (as opposed to shortening which often contains trans-fat.) It's stable at room temperature for years, and it's solid at room temperature (although its melting point is low -- 76 degrees Fahrenheit.)

Coconut oil is an easy addition to most any food to increase that food's caloric density. It's one of the few fats that doesn't require bile to digest it, so it's often used in infant formula (not only as an easily-digested fat but also as a supplement because it contains essential compounds that are found in human breast milk.)

Coconut oil can help regulate blood sugar too, so if it's used in unrefined, high-fiber items (like some amazing coconut cookies found in Dr. Fife's book), diabetics will have a much easier time dealing with the effects of a high-carbohydrate diet often eaten when living on stored foods.

In my home, we use coconut oil every day as a treatment and a preventative measure. Coconut oil is an amazing moisturizer. I've found nothing else that helps heal my cracked and bloody winter skin faster, and even better for me, I don't break out into hives when I use it. (When I have problems with my skin in the winter, most commercial treatments will cause hives for me.)

Virgin coconut oil has amazing antifungal properties, so I've used it on yeasty diaper rashes with my children as well as thrush and yeast overgrowth on the skin. For those who have a systemic yeast overgrowth (sometimes called "candida" or "candidiasis"), the consumption of too much coconut oil in food can cause "die-off" and some intestinal upset. For this reason, I usually recommend that people not start out eating lots of coconut oil every day until you know how it'll affect you.

My favorite use for coconut oil is as a sunscreen. I have very fair skin, and I burn quite easily. With commercially-available sunscreens (which are a lot more expensive, I might add), I burn much quicker and much more severely than I do with coconut oil. During my last trip to Florida, I was able to use coconut oil as a sunscreen during the worst parts of the day (for sun exposure), and I ended up with a very mild sunburn. Previously, I'd used a commercial sunscreen for the same amount of time during the same time of day, and I was burned much more severely.

Coconut oil can also be used as a carrier oil for other essential oils. Essential oils like clove, tea tree, and oregano can be extremely irritating to the skin on their own. My mixing them with coconut oil though, you get a much bigger bang for your buck.

We also make bath soap using coconut oil. The recipe calls for coconut, olive, and palm oils, and it's not at all drying on my sensitive skin. The soap also works as an excellent stain pre-treater, and when the soap is ground for homemade laundry detergent, I've really gotten superior cleaning results (for a lot less money than standard detergents, I might add.)

Coconut oil also has antimicrobial properties, so whenever someone in my home is injured, we use it as one might use an antibiotic ointment. The good thing about it is a little goes a long way, so the 16-ounce container that we keep in the bathroom for topical use lasts a very long time.

I strongly encourage everyone to have this essential supply on hand. Grab some from the pharmacy section of your local grocer (since the stuff that you find in the cooking section is almost always refined) and give it a try. Once you discover the myriad of uses for this amazing food, you'll never want to be without it either!

Jim,
In "Dental Preparedness, by Pat" the author mentions "using 400mg of Ibuprofen taken with 800mg of Tylenol at the same time, every 4-6 hours." That could result in taking 4,800mg of Tylenol in a day. Online resources state the maximum safe dose is 4,000mg per day, or liver failure could result. [JWR Adds: Thanks for pointing that out! Clearly, at that dosage, that course of treatment must either end or the dosage be reduced after just18 hours.] - SunDog

You and your group are sitting around a roaring campfire enjoying the end of a long days hunting. You bite down on some trail mix and suddenly get a shooting pain in your mouth. You’ve just broken your first molar and are four hours from the nearest dentist. Now what? Believe it or not, this happens more often than we would like to believe. In a survival scenario, it may be days or weeks or never that you get to a dentist. So, what do you do? 

The most important thing to do is to prepare for a dental emergency, just like you have prepared for food, electricity, shelter and self-defense. Prevention is the key to avoiding these situations.   What does that mean? We have heard it since we were kids, “Brush twice a day, floss, and see your dentist twice a year.” Routine visits to the dentist can often times prevent those emergencies from happening. Often times those small cavities can be taken care of before they get out of control requiring crowns, root canals or extractions.

Brushing and flossing regularly make the difference. When under stress the body will tend to develop inflammation more easily, including gingivitis, an inflammation of the gum tissue. So, when prepping for the worst-case scenario, be sure you have multiple toothbrushes and plenty of floss. In a pinch, you can use your finger or a washcloth to wipe the teeth clean.  Even a twig can be used to stimulate the gums and clean the teeth.

So, what should you pack in your medical kit for dental emergencies? Here are some basics that need to be included:

1. Dental floss- also good for tying things down in a pinch.
2. Dental wax- can be melted down and used to make a candle if needed. Should be a soft type of wax.
3. Some type of Temporary filling material such as Cavit
4. Temporary dental cement such as Den-temp for re-cementing crowns.
5. Cotton pellets for use with;
6. Oil of cloves, which is a substitute for Eugenol
7. A set of dental tweezers
8. Tight fitting latex or vinyl gloves. The mouth carries more bacteria than any place in the body.

What causes a toothache and what should you do about it? A toothache is the result of injury to the nerve of the tooth. This can be the result of trauma or a deep cavity. If the nerve becomes infected, it can result in an abscess, which is an infection of the bone around the tooth that can be extremely painful. Often times an abscess can cause swelling around the tooth. The infection can spread to other parts of the head and neck resulting in difficulty swallowing and even in the ability to breath.  This type of infection, if left untreated, can eventually cause an infection of the blood, which can lead to death. Don’t mess around with it.

How do we treat this on our own? First, figure out which tooth is causing the problem. Be sure the area in the tooth  is cleaned out.  Take a cotton pellet and soak it in Oil of Cloves, and place it in the cavity. Be sure you don’t get it on the soft tissue because it can burn.  Other products you can use include Dent’s Toothache Drops, Orajel and Red Cross Toothache Medicine. When you have the cotton in place, cover it up with some Cavit or other temporary dental filling.

For pain, I highly recommend using 400mg of Ibuprofen taken with 800 mg of Tylenol at the same time, every 4-6 hours. If that doesn’t do the trick then a narcotic such as Codeine or Vicodin can be taken every 4-6 hours. Be sure to take these with food. If infection is present, an antibiotic should be taken for 5-7 days. Under no circumstances should you place aspirin on or next to the tooth. It can cause serious burns to the gum tissue.

What about treating gum inflammation, commonly known as gingivitis? This is usually the result of poor oral hygiene. Proper brushing and flossing can prevent it. If pain and bleeding are taking place, increasing your brushing and flossing can often help.  Be sure that you are getting enough Vitamin C in your diet, a deficiency can also have a negative impact on the gums. A side note on gum inflammation: Studies have shown that people with bleeding gums have a substantially higher incidence of heart attack and stroke.

So, you bite into a nice leg of venison and break off a filling, what now? If you have access to a dentist, get to them as soon as possible. If that is not possible, you can use a small amount of temporary filling material such as Cavit to fill the hole. Be sure to bite down on the material while it is soft so it will not interfere with your bite after it hardens. In a pinch you can use some soft dental wax to fill the cavity.

Crowns (caps), inlays and onlays can come out when you eat sticky foods such as caramels or taffy. If the tooth isn’t sensitive, save the restoration and take it to a dentist as soon as you can. If that is not possible, or the tooth is sensitive, it may be necessary to try and re-cement the crown temporarily. To do this, clean out any material on the inside of the restoration.  Mix a thin layer of temporary dental cement such as Den-temp and place it inside the restoration.  Carefully align the restoration with your tooth and gently bite it down all the way to place. Since the crown is only in temporarily, be very careful about chewing on it, so that you don’t jar it lose and swallow it. See a dentist as soon as possible.

What happens to a tooth if you fall or get hit in the mouth? Usually this can result in injury to the upper front teeth. The teeth can be knocked out of position, either forward or backward. They can be loose or hanging out of their sockets. Or they can be knocked out completely. If possible, see a dentist immediately. If this isn’t possible, the tooth can gently be repositioned to line up with the other teeth. Be aware that this process can be extremely painful.  Biting on a piece of gauze gently can help hold it in position.  Get to a dentist as soon as you can so that the tooth can be splinted to other teeth. 
           
A tooth that has been completely knocked out is known as an avulsion.  The first 30 minutes of a knocked out tooth are the most important. If treated correctly, the tooth can often be saved. If the tooth can be replaced in the socket within the first 30 minutes, there is a good chance that the body will accept it. After about 30 minutes the body will treat it as a foreign object and reject the tooth. 
           
Once the tooth has been found, pick it up by the crown, not the root and gently clean it off using sterile water or milk.  Use gauze to stop any bleeding from the socket in the mouth.  Gently place the tooth back in the socket and using steady pressure, push it back into place.  Have the person use gentle biting pressure on some gauze and get to a dentist ASAP to have the tooth stabilized. If for some reason the tooth can’t be immediately placed back in the mouth, place it in a container of Hank’s solution, designed specifically for this situation. If this is unavailable, use a container of sterile saline or milk and get the person to the dentist immediately.

As with any other type of prepping, preparation for dental emergencies is extremely important and needs to be well planned out. The nice thing about preparing for a dental emergency is that it is not very expensive to do. See your dentist regularly, brush and floss, and Keep Smiling.

Introduction
There seems to be a lot of talk among the survivalist community regarding dental care and particularly dental extractions.  I am a practicing dentist at an urgent care facility and have addressed thousands of patients in varying situations that have had abscessed teeth that require extraction, and have subsequently extracted thousands of teeth.  I would like to provide some insight on dental care and in particular on the subject of tooth extraction and the materials required to perform a successful extraction without complicating the existing dental problem.  Also note that many medical problems particularly those relating to bleeding, stress, blood pressure, etc will additionally complicate things.

Prevention
First, I will point out the obvious due to a nagging sense of professional obligation.  Prevention is the best medicine.  Topical application of fluoride is critical to preventing a cavity that may put you in a bad situation.  Brushing your teeth with an abrasive (toothpaste or otherwise) that does not contain fluoride will be of marginal benefit, however, the real bulk of the cavity prevention will be significantly diminished.  If your retreat location is supplied by a natural water source (spring, pond, well, etc) it might be prudent to have it tested for fluoride content.  If your water is high in fluoride then you could utilize it as a topical mouth rinse (i.e. hold it on your teeth, the longer the better) .  If not consider stockpiling fluoride containing toothpaste or mouth rinse.  I know this is stretching it a bit, but flossing: would it really kill you?  The natural reduction in the amount of refined sugar that you consume will also benefit you.

Equipment
Now that that is out of the way, here is a list of the things I would consider necessary for taking out a tooth.

1. Anesthetic-  Obviously this is not “necessary” but will make the experience must more enjoyable for all parties involved.  Lidocaine and septocaine are both common local anesthetics and sufficient for all dental work.  Septocaine is my preference because it comes in 4% formulations that just plain work better.  Upper anesthetic is applied to both the check and palate side of the tooth in question.  For the lower numbing is much more difficult.  Anesthetic must be applied high in the jaw bone.  As a general rule, have the patient open as wide as possible and you should see a fold on the cheeks posterior to the teeth.  Put the needle just anterior to that fold and aim toward the TMJ.  Injecting adjacent to the tooth is also helpful but will not be sufficient for complete anesthesia.  Assuming you have access and intend to stockpile these things (a syringe, needles, and anesthetic) I would recommend reviewing and perhaps printing for your survival library the following web pages (not mine, just nice pictures): http://www.fice.com/course/FDE0010/c12/p01.htm  http://www.fice.com/course/FDE0010/c12/p02.htm
2. Dental mirror- being able to see is good.
3. Bite block- This is just a piece of rubber that is designed to prop the person’s mouth open.  It will come in especially handy if you don’t have anesthetic.
4. Straight elevators- One with a small tip (2mm-3mm wide), one with a medium tip (3mm - 4.5mm wide)
5. Extraction forceps- #150 – Universal upper, #151 Universal lower, #23 Cowhorn

One additional thing you could do to potentially make your life easier.  Have every member of your retreat group obtain a copy of their latest panoramic x-ray from their dentist.  This is the big x-ray they take that images all of your teeth and the jaw bones.  In particular take note of any upper teeth that have roots that approximate the sinuses, any teeth with extra or curved roots, or any teeth with bulbous roots.  Don’t worry too much about keeping these records up to date.  What you are concerned with is the root structure of the teeth which doesn’t change over time.

With these basic tools you should have the equipment required to extract almost any tooth. 

Dental Assessment
When one of your retreat members presents with a dental problem first evaluate your situation.  Teeth with large cavities, cracked, or broken teeth will likely require extraction.  If you try to put off extracting a tooth because it “just isn’t that bad yet” it will likely be abscessed and be exponentially worse (with or without anesthetic) when you actually do get the tooth extracted.  As much as you won’t want to do it at the time, act early.  When a tooth starts to hurt and no dental care is available, take care of it before it gets infected and threatens your life rather than just your tooth. 

If, however, you miss the early action window and are presented with an abscessed tooth (and here be abscessed I am referring to draining puss/visibly swollen) consider a course of antibiotics or making a small incision into the swelling to allow the infection to drain before attempting tooth extraction.  Contrary to popular belief, this isn’t because there is an increased risk of infection (the chance of infection is 100% it’s already infected).  The real reason is twofold.  First, it will be a lot less painful to have the tooth extracted.  Second, if the patient is more comfortable it will make it easier for the operator to get the tooth out.

Once you’ve decided there is a problem (whether you are early or late) the first step is to decide which tooth is the problem.  Sometimes it will be obvious to the patient via pain when pressure is applied to a particular tooth.  Sometimes it is obvious to the operator via swelling or a small “blister” on the gums beside the tooth.  However if it is not obvious, the most convenient way to decide which tooth is the problem will be to apply cold to each tooth individually.  A tooth that is dying or dead will either give intense pain which lingers for ten or more seconds or will have no feeling at all.  Whatever the result of this test is, compare to known healthy teeth to verify your result is indeed abnormal.

Extraction Procedure
When you are ready to begin tooth extraction, get your tools ready by sterilizing them (in this scenario boiling may be the best you can do).  Always clean your mirror, elevators, bite block, and the forceps required for the particular tooth in question (for upper teeth you will be utilizing the 150 forcep only, for lower teeth that are incisors, canines, or bicuspids you will be using the 151 forcep only, for lower molars you will be using either the 151 or 23 forcep). 

All teeth extractions will begin the same way.  Prop the patient’s mouth open.  Insert the small straight elevator between the tooth and the gum in the space between the tooth to be taken out and the tooth in front of it.  While applying firm downward pressure, slowly turn the elevator and begin to move the tooth to be removed.  Do not use excessive force at any point.  When you can get no additional movement switch to the medium elevator and repeat.  The key to easy tooth extractions is getting them loose before you grab them with the elevator.  Be careful not to put pressure on other adjacent teeth, your elevator should leverage the tooth to be removed against the bone.  If the tooth does not loosen at any point you may consider peeling the gum tissue back on the cheek/lip side a bit and chipping away some of the bone on that side only (the small straight elevator can double as a half decent chisel).  When the tooth in question has a little movement to it you are ready for the forcep.

For removing an upper tooth: Use the 150 forcep and place it as far down the tooth as possible (well above the gum).  Slowly wiggle the tooth back and forth while putting pressure downwards (toward the bone).  Every few wiggles choke the forcep up on the tooth.  The tooth should be really moving at this point.  Rotate it towards the cheeks/lips with firm pressure and remove it. 

For removing a lower incisor, canine, or bicuspid: Use the 151 forcep and use the same technique described for upper teeth. In addition to the rocking motion described above you can also typically (meaning as long as these teeth have no extra roots) rotate these (twist rather than rock) to remove them more easily and less traumatically.

For a lower molar:  Examine the x-ray.  If the molar has two separate roots the 23 forcep would be appropriate.  If the roots of the tooth are fused together then use the 151 and follow the instructions for removing an upper tooth and disregard what follows.  Note that the vast majority of the time there will be 2 separate roots.  Place the points of the forcep in the middle of the tooth as far below the gums as you can get them.  The attempt is to get the points right into the area where the tooth roots separate.  Once you believe the forceps are in place, lightly squeeze the handles together while moving the forcep up and down.  If it doesn’t slip it is probably in the right place.  Next, continue light pressure on the handles together and move the forcep in a figure 8 [motion].  As you move it, you should naturally feel that every so often, the handles will close slightly.  This will slowly lift the tooth up.  Continue this motion until it feels like the handles are closed together, then rotate the forceps toward the cheek (twist) and remove the tooth.  If you have difficulty with the 23 try the 151 and follow the directions for removing an upper tooth.  Having said that, the denser bone in the mandible will be harder to chisel away, and slower to loosen the tooth.  Take your time and don’t break it.

Always examine the extracted tooth!!  Make sure the tooth looks like it does on the x-ray and that none of the roots broke and/or are missing.

Only one thing remains, what if it breaks?
First, don’t feel bad, you are in good company.  Even if you do everything right, you still have a decent chance at breaking the tooth.  If you act early and it’s a small portion that broke you may choose to leave it and see if it heals.  If the tooth is really abscessed when you act, the broken piece will perpetuate infection if not removed.  In order to remove a residual root, some bone may need to be removed.  If this is attempted it should be done from the cheek/lip side only.  Often a forcep (150 or 151) can be used to grab the bone adjacent to the root on either side crush it, grab the root, and remove it.  This is a difficult technique, but if it’s that or dealing with infection, give it a shot.

Post op
After 24-48 hours rinse with warm salt water a few times per day.  Don’t spit, smoke, or perform any serious chores or exercise for several days.

Note that in most jurisdictions it is illegal to do any of these things to another person unless you are a licensed dentist, but in TEOTWAWKI that probably won’t matter to you.

I’ve been reading SurvivalBlog for almost a year.  I am thankful for the advice that I receive each day.  I have had a “be prepared” attitude for about 30 years, although the past two years have thrown several speed bumps and roadblocks my way.  Two years ago my son and his family were in a life threatening accident.  I spent almost every penny I had saved toward retirement to help my daughter-in-law recover.  This year I fought for and won custody of three of my grandchildren from my daughter.  So now, instead of planning for TEOTWAWKI for just myself, a 50 something divorced woman, I now am the proud “parent” of three elementary aged children.  Even with these changes to my situation, I am still actively preparing.  I wanted to share what I am doing with your readers, so that those who are still in the thinking stages rather than the action stage can see that it’s not too hard to begin. 

Years ago I decided to create a written plan.  I started with my basic premises.  First, I assume that I will live where I’m at forever.  I live 10 miles from a city of 100,000 and 15 miles from a city of 500,000.  While it’s really close to a lot of people, it’s not in the direction that the masses of people would head toward.  I have five acres with a good house, a good well, a great climate for growing food and lots of storage.  With that in mind I need to set up the house and yard to fully sustain me and now the three grandkids.  I also need to make some changes along the property boundary to make it less welcoming.

Second, I assume that when I retire from my government job that my pension income will exist.  That doesn’t mean that it won’t be reduced, I expect the government to steal some of my pension.  (Most people just think that we are given money but I put in 20% of my income into this pension fund) I also expect to receive some social security benefits and plan to start collecting my money as soon as I hit the minimum age.  Barring any additional family disasters, I also plan on having cash on hand.  I am working hard to cut my expenses to almost nothing.  That way I can retire sooner and live prepared rather than being in a state of getting prepared. 

Third, I assume that the weather patterns may fluctuate as they have throughout time, but I will not buy into any of the global warming and cooling as something that we can truly prevent.  If the environmentalists wanted us to change our habits and become more energy efficient, I wish they would have just come out with that statement.  Or, they should say that we can alter our microclimate (planting trees lowers the temperature around our homes, paving roads and parking lots raises the temperature in the city, lakes add to the humidity) rather than trying to scare people into believing that we are destroying the world. 

Fourth, I will practice, as I know that when you practice, the act becomes second nature. Times of trouble is not when you should be learning new things.    

Fifth, I do not panic.  Part of this is because I practice.  Part is because I do not allow myself to be influenced by the news story crisis of the day.  I behave very level headed and am rational.  I know that my attitude and my actions will influence those around me to be either calm or crazy.  I vote for calm.

Sixth, I trust God.  I know that God expects me to take care of myself…or at least to prepare myself to take care of myself.  I can not say I don’t need to be educated, or prepared, or dedicated because God will provide.  I am expected to work hard.  God will take care of me if I try to take care of myself.

The first thing I did in my quest for independence was to determine what I really needed.  The stuff.  I also figured I probably have 30 more years to live, although I hope I’m blessed with much more.  Now I have three more people in the house.  How would I figure how much I need?  I decided to keep track of what I did and what I used.  I started by going through my entire house, room by room, and making an inventory of everything. 

Let’s start with household items.  There are items that can last forever: dishes, glasses, pots, pans, furniture.  There are items that are used up daily, weekly, monthly, and yearly.  Well, how much do you need for the next 30 years?  I started keeping track of what I was using.  Keeping track of exactly how much food purchased, how much toilet paper, paper towels, soap, shampoo, etc. was used in a year gave me a very good idea of what I would need for 10 or 20 or even 30 years.  Then I just started buying extra.  It was simple.  Every time I went to Costco I’d buy an extra laundry detergent, bleach, dish soap, 409, Simple Green, vinegar, etc.  I probably have a 10 year supply on hand without any pain at all. 

I don’t have a basement but I do have a huge garage.  It holds my truck, tractor, freezer, tools, and what seems like miles of floor to ceiling shelves.  It looks like a mini Wal-Mart.  Now that I have the grandchildren, I have devoted space for bins of clothing.  The bins include the basics in every size: jeans, t-shirts (long and short sleeve), sweatshirts, jackets, socks, underwear, hats, gloves, and shoes.  I also sew and have fabric, thread, and am well stocked with sewing supplies. I keep it very organized.  I witness my friends buying things that they know they have somewhere in their homes but they are so disorganized they have no clue what they have or where to find it. 

I’m not going to discuss weapons to any real extent.  This topic is definitely best left to someone who knows what they are talking about.  I really get into this topic on this blog so as to learn more.  I do have a .22 pistol, a .22 rifle, and a 12 gauge shotgun.  The last thing I shot was a rooster who was roaming my yard and continuously tried attacking me.  I know I should have more protection and I also need to involve the children in gun use.  Maybe this summer we will all go to gun camp and then set up a practice target in the back yard. 

Change your diet! Stop eating instant boxed stuff.  If nothing else, you will save lots of money.  Learn to cook.  Learn to bake.  You can buy a pound of yeast at Costco or Sam’s for the same price as three small packages of yeast at the grocery store.  I love the 5 minute bread recipe.  6 cups flour, 3 cups warm water, 1 ½ tablespoon yeast, 1 ½ tablespoon chunky salt (kosher, sea, etc.).  Mix it together with a spoon. Let it rise an hour.  Put some flour onto the counter and pour the dough onto the flour.  (At this point I like to add Italian seasoning to half the dough) Shape into individual rolls or two round loaves.  Bake 350 for 15 minutes.  Noodles are another one of our favorites.  Flour, egg yolk, water, salt. Mix and roll out.  Cut into whatever shape you want.  We use the pizza cutter and make crazy shapes.  Boil for about 10 minutes. 

My garden is my hobby but also something that I’ve set up to feed myself, the grandkids, and my animals.  Since moving to my property 12 years ago I’ve planted fruit trees and plants with most of my spare money.  I have oranges, grapefruit, lemons, limes, kumquats, apples, avocados, cherries, peaches, nectarines, pears, plums, apricots, kiwi, figs, olives, loquats, mulberry, blackberries, raspberries, almonds, asparagus, and probably some others that I’ve forgotten.  I’ve been canning for 30 years now.  If I can’t can it or freeze it we eat fruit and vegetables in season or we don’t eat them.  The only fruit or vegetables I buy are bananas, pineapple, and mushrooms.  I have lots of gardening tools, at least one for each of us so we can all work together: shovels, rakes, hoes, hoses, irrigation parts.  I also have seeds on hand.  It is crazy to spend the money on the latest fad of “non-hybrid seeds in a container for only $150.” Sure, it will grow you a garden, but is it what you like to eat?  Will those varieties do well in your area?  Go to your local nursery and pick up seeds of vegetables you eat.  Have a garden like mine.  Each year I let some of the beets go to seed in the beet section of my garden, I smash a pumpkin on the ground in the pumpkin section, I let broccoli go to seed, etc.  I don’t have to replant the entire garden each year.  The stuff just comes back.  I do replant the corn, eggplant, and peppers.  I do save seed each year to make sure I have a several year supply of all my vegetable seeds.

We have sheep and goats for meat and chickens for eggs.  Although they are easy to raise, I don’t raise rabbits or hogs due to religious dietary restrictions.  I don’t have enough property for a steer because I don’t want to have to rely on buying hay.  I don’t milk the goats because I don’t have time.  I do buy beef and chicken from the store but know that at any time those purchases can stop and we can provide all our meat needs. 

I have a 500 gallon propane tank that never has less than 250 gallons in it .  The propane is used for cooking, heating the house, and the hot water.  We don’t use much for heating the house.  I try to keep the heater turned off during the week.  Since I am at work and the kids are at school, I don’t need to waste propane heating an empty house.  On the weekends I use the woodstove.  Worst case scenario, I would use wood to cook with, heat the house with my wood stove, and at some near future point, set up a solar hot water system. 

We are on a well so we aren’t relying on city water.  My next project (with money from my tax return) will be to set up a solar power system to charge batteries for running the well.  We don’t usually have much wind so I don’t think a wind generator would work.  I’d also like to set up solar for a backup for my appliances.  I don’t need a huge solar system since we use minimal amount of electricity.  We really do conserve on electricity.  My electric bill is only about $40 a month for the refrigerator, freezer, washer, dishwasher, microwave, television, computers, and the kids leaving all the lights on.

Fortunately, we don’t get sick often.  I keep a good stock of vitamins and OTC medicines.  I haven’t been able to convince our doctor to write a prescription for extra medications but I have been able to stock up on some. I do have a large stock of supplies for injuries.  I have a rescue bag in each vehicle plus a large supply at home.  I do want to remind people that even minor injuries can use up lots of supplies.  You need lots of gauze, gauze, and more gauze.  And, gloves, gloves, and more gloves.  Rescue workers will change their latex gloves every 5-15 minutes.  Read the articles already posted about medical supplies.  Go through your cabinets and see what you use.  Buy lots of them. 

We have a great library at home.  Classic books, new books, survival books, cook books, just about all topics for all reading levels.  I also have school books: math, science, grammar, and history for each grade level.  We also have games, puzzles, and cards.  Lots of indoor activities for the kids to do.

We have tons of office supplies: paper, pencils, erasers, pens, paint, crayons and markers, tape, staples, and glue.  Whatever amount you think you need, double it, or triple it!  Take advantage of the end of summer back to school sales. 

Exercise and being active is important.  This past summer I made an obstacle course for the grandkids (and me).  We have tires to run through, a sprinting area, cones to zigzag around, ropes to climb up trees, nets to crawl under, and a cross country running track.  I also set up a tetherball pole, a basketball hoop, badminton and volleyball net, croquette, whiffle ball, and a soccer goal.  We also go hiking and bike riding.  They think it’s just for fun.  I know that being in good condition helps keep the mind in good condition.

Preparedness and survival are becoming increasingly popular discussions in these days of economic and political instability. Head to a diner in the morning and you’ll hear ol’ timers talking about their deer rifles they have with extra ammunition. Pass in a supermarket and you’ll hear middle aged housewives speaking of the class they are taking on home canning. Most people have the mental image of a worldwide doomsday when “survival” is brought up. That fact is that survival is simply that…survival. Whether your family is snowed in for a few days in a cabin, an earthquake ruptures water and power, all the way to nuclear bombs dropping, survival is a must. From my view, the first thing that you can do is to prepare yourselves is to put your faith, trust and life in the hands of the Lord. Through Him, you will find strength and knowledge that will help you survive until He decides to call you home. The next steps for preparing are what you can do for you, your families, and your friends.

Read, take a class, and learn! There are literally hundreds of books to help you become prepared. This aspect is especially crucial for people who are not familiar with the process of surviving a tragedy. Having all the guns in the world will not help you if your weapon and ammunition have ceased to be useable because you didn’t know how to properly store them. Literature on weapons is certainly, if not the top, near the top of the list for reading material. Firearms are extremely dangerous, and are meant to be that way. Firearms are dangerous to you if you do not understand how they properly function. Pick up some books on basic firearm components and functions. Find a firearms safety class near you to get hands on and practice. I strongly recommend classes from the NRA. If you decide to buy an AR-15 semi-auto rifle, it would be prudent to purchase books on maintenance.  Even Rambo can’t be Rambo if he’s not taking care of his weapon. In the same, Julia Child is not a cook if she doesn’t have the right ingredients. During a disaster, food and water will more than likely be in high demand. Proper food and water storage is more than just keeping a few extra cans of beans in the pantry. Ask someone that knows to show you the proper methods of canning. When dealing with food and water, one cannot be too careful on storage. Illness can befall a family if food was not properly canned, dates weren’t checked, or water is not in the correct containers. Most books on this topic can give rough estimates of how much food and what type to store for a specific number of members. Just as illness can present with bad food, it can show up with anything. Anything from the common cold to a fractures arm can strike at any time. With the means of getting to a doctor diminished and EMS services at nil, first aid is crucial. Sign up for CPR and a First Aid class at your local community college or American Red Cross. Once you have developed basic skills, there is a bountiful supply of resources on primitive medicine and military combat style first aid. Don’t let your skills expire! You must be persistent on keeping your certificates and hands on training up to date. Like the saying goes, if you don’t use it, you lose it!

All the brain food in the world won’t be of assistance if you don’t have the tools to perform your skills. Purchase your first firearm if you do not already have one. Go out and get some cold weather clothes. Buy that solar panel that you know could be a lifesaver. In discussions of preparedness, many folks have the knowledge either from living a certain lifestyle or by reading. Some do have quite a bit of products already bought and stored away somewhere. How many have the stuff they really need?  You must look at what is most important to you and your situation. If you have a small budget and live in south Florida, is it wiser to buy the really neat camo cold weather jacket for $350 or extra screening for your windows. Do you even have a six month supply of food before you buy that extra screening? All the high tech GPS systems, voice activated handheld radios, and night vision goggles won’t do you any good if you and your family die of dehydration in three days. Start with the most basic items first and work your way up. Begin with food and water storage and move your way to appropriate clothing. Move on to an advanced first aid kit with basic medications and vitamins. Figure out if you want to stockpile store bought ammunition by the thousands or buy some reloading equipment. Only once the basics are acquired should you be worrying about the GPS that also cooks your dinner for you. When purchasing an item, do your research. Find out if it is at its lowest price. Is it the most trustworthy and durable? Hopefully with all of the reading you did before will give you great insight of what you need.

Training is the last step after reading/researching and purchasing. Once you become comfortable with firearms, take and advanced course such as combat shooting or self defense with a side arm. If you’re strapped for cash, hook up with a combat veteran or law enforcement officer that has experience in these topics. Since practice makes perfect, make sure you are hitting the range at least once a week and are trying different styles. Weapons training is one of the tasks that you can practice on your own. Since performing CPR and first aid on a healthy human being is harmful, ask your local fire department if you can become a volunteer. Adrenaline runs high for non-medical personnel during routine medical treatment let alone during a medical emergency. You may find yourself surprised when someone’s ribs break while you doing CPR. Your mind and body must also be accustomed to the lifestyle and events that may occur during a survival situation. Get your body in physical shape. This involves being used to the cold and heat. Start with hiking in good weather and advance to backpacking in the dead of summer of during a cold spell of winter. Just take the proper precautions so as to not injure yourself, others, or become stranded. A small garden is a grand way to embark on your agricultural skills. If you live in an area such as an apartment where a garden is not feasible, try a few tomato plants and carrots in a normal houseplant pot. This is something that even children can help with. They will enjoy helping you out and will learn valuable lessons at the same time. Children require the same steps that you go through as well. Start with them young and have them read and take classes. Buy them their first .22 rifle. Take them camping and fishing with you so they can get their training in as well. Remember that children are all different. Never force your child to do something that puts them in a dangerous situation, but guide them so that when the time is right, they are well taught and eager. Training is not for just one person, but for the whole family.

These three cycles are meant to repeat. Do not spend six months reading everything you can on survival, then dump twenty thousand on some supplies. Start small so you do not overwhelm yourself or your family. Begin with reading on gardens, buy the tools, and start one. Move on to firearms, and so on. With so many people just talking about being prepared, they don’t realize that they themselves are not prepared. None of us are God, thus we can’t just speak things into existence. One aspect to remember is that once you have the basics covered, continue on with your own personal items. Remember that children will need to have toys to keep up morale, so is a video game or board game more feasible? If you are taking care of an elderly family member how will they handle a difficult situation? What if they have a specific medical condition? Literature on basic psychology and of the medical condition would be of great help. My desire is for this article to get you thinking. There aren’t enough books in the world to tell you how to prepare for every type of disaster and every item that you must have. The important rule is that you learn, then buy, train, and repeat. Talk’s great, but doing is greater!

JWR,
I've just done First Responder training because the school I go to, a good one, won't let me jump right into EMT training without taking First Responder first. A gold-digging measure? You decide! I think it may be, but it's a good policy too.

I urge your readers to take a First Responder, a.k.a. CPR + Advanced First Aid. My course was $300. A cheapie way to do this would be to go on Amazon and get the book, but I highly urge a course. I plan to do EMT-1 then EMT-P and don't expect to get paid for EMT-ing. We'll be in full on collapse in a year or two, and it's not about the money.

The thing is, there are nuances to medical care. You don't just put a Vaseline-covered bandage on a sucking chest wound, you put an airtight bandage on, Vaseline on gauze or a piece of T-shirt's one way, but the nuance is, a piece of plastic is fine, but it has to be set up to work like a flapper valve, taped down on three sides. For a tension pneumothorax, you use a "big" needle, what's "big"? 12 gauge is a good idea, but there's also a way you draw the skin down because there's a vein that runs down along each rib and you need to miss that.

The thing is, I hope the article you published makes people want to go out and get training not just go, "OK, I read about this on the Internet once..." Beans, bullets, band-aids, and books, my friend.- Alex

Mr. Rawles,
The "The Tactical Combat Casualty" article was great. The reason Cowpuncher can't get rofecoxib (brand name Vioxx) is that it was withdrawn from the market in 2004 by its maker due to claims of heightened rates of heart attacks compared to similar drugs like Celebrex). Rofecoxib was a new generation NSAID (like ibuprofen). Their claim to fame was that it caused less GI upset. It was a great pain drug but not much more so than regular 600mg or 800mg Ibuprofen or naproxen 500mg. There is a "class" effect of analgesia of drugs in this class so all are very similar in the right dose. In addition, rofecoxib was a lot more expensive (as is Celebrex). I am both a practicing physician assistant and family nurse practitioner 30 years in general medicine. Greatly appreciate your work. I am slowly winning my wife and four grown sons into the survivalist boat, but it is a slow process. Thanks. - R.P.

Jim:
Excellent post by Cowpuncher. I think too few people realize that we are talking about a two-way firing range here. I have had long discussions about this with my survivalist friends and the consensus is until we get some kind of medical professional into our group, it's in the hands of God. We can carry tourniquets ("TKs") and pressure bandages, along with faith, and drive on. Kinda emphasizes the importance of having someone in your group that can handle gunshot wounds. And keeping low profile, out of situations where you are being shot at.

A key point that I'd like to emphasize again is that you must be thinking about self-aid as much as possible. If you are hit, you have to try to treat yourself, and stay in the fight. With the small numbers we are talking about, we need every gun in the fight. My buddy, another SF dude, says they carry several TK's on their kit and train to throw one on quickly and keep fighting. This goes to combat mindset, in that you must try not to shut down because you're hit. I know, it is easy say, hard do.

I also like the TR "Ventilated Operator Kit" (VOK). Probably one of the best priced, most complete gunshot wound kits on the market. It's one of the only places I know of that includes a de-comp catheter/needle.

Also worth mentioning is the "Olaes" pressure bandage by Tac Medical Solutions. Made by 2 former 18-Deltas, it includes a pressure bandage, with extra crilex that you can pull out to dress the other side of the wound, and has a piece of plastic that pulls out if you need an occlusive dressing. All in one package.

And finally, also from TMS, I carry the "SF" tourniquet, which is the black nylon one with metal windlass.

I have combined the de-comp needle and NPA from the VOK, with 2 Olaes Bandages, and TK from TMS for my gunshot wound kits. Since I carry pretty much around the clock, at work as well as at home, I keep a kit with me at all times. S/F - Diz

JWR,
The National Institute of Alcohol Abuse and Alcoholism notes that liver damage may occur with as little as 2.6 grams of acetaminophen (four to five "extra-strength" pills) taken over the course of the day in persons consuming varying amounts of alcohol (NIAAA, Seeff). The damage caused by alcohol-acetaminophen interaction is more likely to occur when acetaminophen is taken after, rather than before, the alcohol has been metabolized.

This liver damage is so serious it leads to the need for liver transplants. Since 1998, the Food and Drug Administration in the United States has required a specific warning on labels about acetaminophen. That warning reads: "Alcohol Warning: If you consume three or more alcoholic drinks every day, ask your doctor whether you should take acetaminophen or other pain relievers/fever reducers. Acetaminophen may cause liver damage." Thanks, - Jacketch

The SurvivalBlog thread on wound-clotting agents got me thinking about this subject and its apparent lack of dissemination amongst the “survivalist” community. I decided I would write about it. I know the recent military vets will probably have heard about it, and some (most) will have practiced it. Many will have used it in action.

For the record, I received Tactical Combat Casualty Care (TCCC or TC3) training in the beginning of the program, so any new information I have gleaned since 2002 is based on studying the protocols as presented in the SOF Medical Handbook and the Ranger Medics Handbook that have been published in the last three years. Prior to that, I was combat lifesaver qualified in 1994 and 1996, and received my EMT-I license in 1997 which has since not been renewed. Eventually I intend to get my EMT-P.

The TC3 program began in the late 1990s under the auspices of the U.S. Navy’s Medical Bureau for combat first-aid training for special warfare units like the SEALs. It quickly spread throughout USSOCOM and then to the rest of the military from there.

The TC3 is broken down into three areas, or phases, of care. These are Care Under Fire (CUF), Tactical Field Care (TFC) , and Combat Casualty Evacuation (CASEVAC) Care. I will discuss the first two, since the third is largely the provence of actual medical doctors and surgeons and is beyond my area of expertise.

1) Care Under Fire

The underlying tenet of the CUF phase is that, if you’re being shot at, your focus should be on killing the enemy, not playing doctor. The only real concerns at this point should be returning effective fire at the ABC-type exam as is usually taught in civilian first-aid courses is not conducive to the continued survival of either the casualty, the medic, or the rest of the unit at this time.

If the casualty is capable of continuing the fight, he should be fighting, not worrying about his boo-boo. It may also be critical for the medic or corpsman to continue to engage the enemy. The following quote, from a doctrinal publication on the subject, refers to this need.

“It may also be necessary for the combat medic or corpsman to help suppress hostile fire before attempting to provide care. This can be especially true in small-unit operations where friendly firepower is limited and every man’s weapon may be needed to prevail.” (Emphasis added-a survivalist group certainly falls under that category!)

If hostile fire is not immediately suppressed, it may be necessary to move the casualty to cover though. One of the critical elements of TC3 training then is the importance of expedient casualty transport.

The Basic Management Plan for Care Under Fire looks like this:

1) Expect the casualty to remain engaged as a combatant if appropriate.

2) Return fire as directed or required.

3) Try to avoid being shot yourself (for the medic/aidman/corpsman)

4) Try to prevent the casualty from sustaining further wounds (move him out of the line of fire if he is unable to do so himself.).

5) Defer worrying about airway management tasks until after the fight. (The risk of the casualty choking to death on his own blood or teeth is significantly less than the risk that he will die if the unit is overrun by the enemy. Worry about killing the enemy first.)

6) Stop any life-threatening hemorrhage. Don’t worry about cuts and scrapes (or flesh wounds—said in best Monty Python voice). All wounds should be dressed with a simple pressure dressing initially (I like the Israeli Battlefield Dressings that are issued). If that is insufficient to stop the blood-loss, then wounds on the torso should have a HemCon agent applied, while wounds to the extremities are treated with a tourniquet.

7) Communicate with the casualty throughout the treatment process. Offer reassurance and encouragement (note to self—“Suck it up p**sy!” is not reassurance or encouragement). Explain the actions you are taking (this serves the double purpose of reassuring the casualty and allowing you to remember the proper course of action without skipping anything critical.).

8) Direct the casualty to return to the fight once treatment is “complete,” if this is possible and/or necessary.

Pretty self-explanatory, right? In the middle of the fight, the only concerns should be, finishing the fight, stopping life-threatening blood-loss, and keeping anyone else from being wounded.

2) Tactical Field Care

The first thing to look for in the Tactical Field Care phase is an altered mental state. An armed combatant with an altered mental state is a serious risk to others in his unit if he should employ the weapon inappropriately (such as mistaking the platoon leader for an enemy soldier/combatant…). He should be disarmed immediately.

Under field conditions, there are four primary causes for an altered mental state. These include Traumatic Brain Injury (TBI), pain, shock (possibly from blood-loss or simple emotional shock), and analgesic pain medication.

The Tactical Field Care phase is relegated to situation requiring medical attention, under field conditions, when there is no direct threat from enemy fire. Whether during patrolling missions, in a mission-support site, or following the cessation of hostilities on the battlefield, the Tactical Field Care takes over when the bullets are not flying.

As such, for the survivalist, the Tactical Field Care (TFC) phase will be the most commonly applied medical protocol if the TC3 program is adopted as a group’s standard for medical training (a course of action which I highly recommend).

The Basic Management Plan for the Tactical Field Care Phase

1) Casualties with an altered mental state should be disarmed immediately.

2) Airway Management

a) Unconscious without airway obstruction: (i.e. knocked out)

· Chin-lift or jaw-thrust maneuver as taught in standard first-aid courses

· Nasopharyngeal Airway should be inserted if the chin-lift and jaw-tilt are insufficient. (I have discussed this with both an attorney and a medical doctor. Both have assured me that because NPAs fall under Airway Management and are not surgical procedures that, as long as you have been trained in their application, such use is covered under the “Good Samaritan Laws” of most states. I know it is in Wyoming, Montana, Idaho, and Utah.)

· Place the casualty in a recovery position, as taught in standard first-aid courses.

b) Conscious or Unconscious Casualty with an airway obstruction or an impending airway obstruction (i.e. he got shot in the jaw or mouth and cannot breath through the mouth, throat is crushed, etc):

· Chin-Lift or Jaw-Thrust maneuver as above.

· Nasopharyngeal Airway as above.

· Place casualty in recovery position as above.

· If these are insufficient, a surgical cricothyroidotomy may be indicated, (using a local anesthetic such as lidocaine, if the casualty is conscious). This would fall under the category of a surgical procedure and would not be protected under the “Good Samaritan Laws” even if you received specific training on it during a military TC3 course of instruction. As such, I cannot recommend it as a course of action for survivalists in any but TEOTWAWKI-type situations. However, I will tell you that if it were someone I cared about, in the sort of environment I am typically in, such as 90 miles from town, down a snow-covered gravel or dirt road, and I knew that a surgical “cric” was going to save their life….I’d do the cric. That having been said though, I’ve had numerous classes on the procedure and know how. I would still feel uncomfortable though.

3) Breathing

· Be aware of the risk of a tension pnuemothorax if the casualty has suffered from a trauma injury to the torso and is in respiratory distress. If a tension pneumothorax occurs, treat with a needle thoracostomy, also known as a “chest punch,” (No, it does not involve striking the casualty with your closed fist.)This also involves a surgical procedure and is not protected under the “Good Samaritan Law” even if you received proper formal training during a military TC3 course. The same issues apply to it (across the board) as to the surgical cric.

· Treat sucking chest wounds with a Vaseline-treated gauze dressing, covered with tape. Place the casualty in a seated position and monitor for tension pneumothorax.

4) Bleeding

· Assess the casualty for previously undiscovered hemorrhage and treat any unresolved bleeding injuries.

· Assess for the discontinuation of tourniquet treatments following the application of a HemCon agent and/or pressure dressings.

5) Intravenous Therapy

· Start an 18-gauge IV/saline lock if indicated.

6) Fluid Resuscitation

· Assess for hemorrhagic shock ( altered mental state in the absence of a head injury, and/or weak or absent peripheral pulse along the radial artery are the best field expedient indicators of hemorrhagic shock).

a) If the casualty does not appear to be in shock, no IV fluid resuscitation is indicated. Instead, provide fluids orally if thirst is indicated by the patient.

b) If the casualty is in shock, the .mil response is a 500mL bolus of Hextend, then repeat after 30 minutes if the casualty is still in shock. The doctrinal literature indicates that you should not provide more than 1000mL of Hextend under field conditions. For the survivalist unable to procure Hextend, saline solution or a lactated Ringer’s solution may be an adequate alternative, since both were used prior to the introduction of Hextend into the military care program.

· Continued efforts towards fluid resuscitation must be considered in light of the logistical and tactical concerns of the risk of further casualties when continuing the mission. In other words, don’t waste IV fluid if you don’t think you’re going to be able to save the casualty, because you might need them later for someone who can be saved!

· If a casualty with TBI has no peripheral pulse (but does display a carotid pulse), resuscitate with IV fluids to restore the peripheral pulse.

7) Dress all known wounds with appropriate bandaging. This is an opportunity to remove HemCon agents and/or pressure dressings and tourniquets, in order to care for the wounds with more reliable semi-permanent dressings that may be required to stay in place for an extended duration. Check for additional, previously undiscovered wounds and injuries at this time as well.

8) Provide analgesia pain relief as necessary and available. (Note: providing medication to someone is called “practicing medicine without a license.” It is severely frowned upon by the medical professions, the court systems, and if you do so, you may be setting yourself up for serious legal problems, including imprisonment. Forewarned is forearmed. It may also be frowned upon by the casualty if you provide the wrong medication and they die from it, just sayin’…)

a) If the casualty is capable of continuing the mission and/or fight, the doctrinal response (in my literature, it may have changed recently, do your research) is 50mg of Rofecoxib by mouth and 1000mg of Acetaminophen by mouth, every six hours. Since I do not have access to Rofecoxib, I have discussed the issue with several Special Forces Medics, two SF-qualified physician’s assistants, and three civilian medical doctors. Their unanimous response was, “Give them the Acetaminophen and a couple shots of whiskey. It’ll do.” Thus, my non-TEOTWAWKI solution is just that. Be forewarned however, that alcohol will thin the blood, so individuals with significant blood loss should be provided whiskey only under the strictest of circumstances, if at all. In a TEOTWAWKI-type scenario, I believe I MAY be able to procure Rofecoxib or a similar suitable analgesic if I move quickly and surely.

b) If the casualty is unable to continue the mission, the doctrinal answer for the .mil is to provide 5mg of morphine intravenously, and reassess in ten minutes. Continue providing the same dose every 10 minutes, as necessary to control pain, until the casualty is exfiltrated. Assess for respiratory distress . Treat further with Promethazine, 25mg intravenously or intramuscularly, very four hours. Since there is no way in Hell I can legally procure morphine, I am currently unequipped to provide this portion of care. Should TEOTWAWKI occur, I will either procure morphine immediately, from a pharmacy, or I will procure a similar opium-based product that is regularly available in this country without a medical license (yes, I’m talking about heroin, which will probably still be available…) Please note that I am not, in any way, shape, or form, advocating armed robbery of a pharmacy, even in TEOTWAWKI. I know of three or four licensed pharmacists that have assured me, in the event of a TEOTWAWKI-type of collapse, they would much rather provide me the pharmaceuticals I need/want than have them fall into the hands of recreational drug addicts. The discussion of possible barter, should that occur has already taken place.

9) Splint any fractured bones and recheck pulse. Pretty self-explanatory, although I will note the following. While I do have the knowledge and equipment to improvise splints in the event of a severe medical emergency, my aid bag contains several (five at last inspection) SAM splints. These are a valuable tool that I recommend every survivalist include in their aid bag. It beats the holy living hell out of trying to scrounge up an improvised, field-expedient solution in the midst of an emergency.

10) Prophylactic antibiotic treatment is recommended for all open combat wounds. Even if your bandages and dressings are sterile, I can assure you, neither the surface of the casualties skin, his clothing, or the injury-causing instrument were sterile. Treat any open wounds as infected.

· The latest manuscript I have that recommends a specific antibiotic, indicates Gatifoxacin by mouth (400mg daily).

· If the casualty is unable to take the Gatifoxacin orally, the doctrine calls for a slow push over the course of 3-4 minutes of 2g of cefotetan intravenously, or intramuscularly. Again, I don’t currently have access to these, and disbursing medicine is practicing medicine without a license. However, I have in the past, treated myself with prophylactic antibiotic, using Penicillin G intramuscularly with no ill effects. There is a long history of self-aid amongst agricultural workers in the U.S. using medications packaged for veterinary supply. That may be a reliable source of antibiotics for survivalists, as Ragnar Benson points out in several of his books, including “The Survivalist’s Medicine Chest” and “Do-It-Yourself Medicine.” If this is a course of action you choose to follow, make sure you do your research prior to needing to apply it! For instance, LA-200 is a common antibiotic provided to cattle intramuscularly. Unfortunately, it is an oil-based medication and has been known to cause severe side-effects in humans…So, know your meds and know what you are providing!

11) Communicate with the Patient. The same principles apply regarding this as in the CUF phase. Talk your way through every thing you do. It will assist you in getting it right.

12) Cardiopulmonary Resuscitation. I suggest that everyone should complete an updated CPR program, as provided by the American Heart Association and/or the American Red Cross. You are far more likely to utilize your medical aid training and knowledge during run-of-the-mill daily activities than you are to provide the TC3 level of care. That having been said, I feel obligated to include the last bit of information in my literature regarding CPR. “Resuscitation on the battlefield for victims of blast or penetrating trauma who have no pulse, no ventilations, and no other signs of life will not be successful and should not be attempted.” While this does not exempt you from the moral obligation to provide aid in daily life, pre-WTSHTF, it may be sensible to consider the implications of that statement when dealing with triage during major accidents and calamities, such as multiple vehicle accidents and/or terrorist attacks/active shooter situations.

For survivalists interested in further TC3 training, several of the major shooting schools, such as Tactical Response and Gunsite (I believe), offer Tactical Medicine courses for non-medical personnel, which rely heavily on the TC3 protocols.

For those interested in developing or purchasing a TC3-type aid bag or blow-out kit, there are several companies manufacturing them. I am personally fond of Tactical Response Gear’s Ventilated

Introductory Note from JWR: Warning! The following article is presented for educational purposes only. As previously discussed in SurvivalBlog, using vinyl ether or chloroform for anesthesia can be very tricky. Both can induce deep levels of sedation much more quickly than desired. Thus, at a minimum can can compromise the patient's airway, and thereby very possibly kill the patient. So unless you have both the equipment and the regularly-practiced expertise to safely intubate and extubate your patient, then do not use vinyl ether or chloroform. Chloroform is also a known carcinogen. Generally, local anesthetics are the best choices for austere medicine! You should only consider using a general anesthetic when there are absolutely no other options, and when aid from trained medical professionals is absolutely unavailable!

Merry Christmas Jim,
I'd like to add something to your knowledge concerning "do it yourself anesthetics": chloroform.

Be advised: chloroform is carcinogenic and should only be used if no safer alternatives (including no sedation and no operation) are available. Synthesis should only be carried out with regard to proper safety procedures (ventilation, eye protection, ...) and consideration for any pertinent laws. I am not a doctor, I do not have any formal medical training. I do however hold a degree in chemistry, I have synthesized chloroform and used it to carry out extractions of organic compounds.

Chloroform has long been used as an anesthetic as well as being a common chemical in many laboratories. It went out of use in medical practice as its carcinogenic nature became known. Yes, this stuff will increase your risk of contracting cancer and should only be used after due consideration. The decision to go ahead and use this on an elderly person will be taken differently than when dealing with a youth for
instance.

Production
I am not a doctor, I will not advise you on how to use chloroform. I will however teach you how to manufacture it. The easiest way to manufacture chloroform is by reacting a methyl ketone with chlorine dissolved in an aqueous environment. In plain English: by mixing bleach with acetone. "Bleach" being any plain hypochlorite bleach solution, will react with acetone and form Acetic acid and chloroform. Chloroform will separate from the solution and float on top. (Theoretically, methyl ethyl ketone [aka 2-Butanone; ethyl methyl ketone, or MEK] could be used instead of acetone, I have no experience with this)

The purest product can be obtained by taking a small amount of bleach and slowly (while stirring) adding drops of acetone in solution until no more chloroform forms. (this minimizes the loss of acetone through evaporation which poses a potential fire hazard) The top layer can be off quite well, but it will be difficult to get every drop without spilling some concentrated acetic acid over as well. A better separation can be accomplished with a separatory funnel, if available.

The amount of each chemical can be difficult to calculate in advance as the purity/concentration of bleach is not a constant, if it is even accurately labeled. There are differences between sodium- ,potassium-and calcium hypochlorite to take into account. You need (ideal ratios) 3.8 grams of sodium hypochlorite bleach for every gram of acetone, or 30 grams per 10 ml of acetone, this would yield roughly 5 ml of chloroform. You will need a sizable amount of bleach to produce enough chloroform to keep someone sedated for any period of time.

The produced chloroform should be washed with water to flush out as much bleach and acetic acid as possible. Mix chloroform with half its volume of water, stir well and pour off the water. Do this twice and your chloroform is ready for storage or use.

"A text-book of practical organic chemistry" by Vogel Lists a more advanced method of producing Chloroform. A web search on "Vogel chemistry" should allow you to review the book in .pdf format on one of the many sites which host it. I would wholeheartedly advise a couple of decent chemistry books in every survival library (aseptics, medication, explosives, glue, dye, ... your modern life is supported by practical chemistry, do you know anything about it?)

Uses
Chloroform can be used as an anesthetic by a qualified anesthesiologist. In addition, it may be used as a recreational drug by those truly daft or already dying and therefore may qualify as bartering tender.
A far better use is its use as an apolar solvent. Ether can be used to extract organic compounds from biological matter. For example: the aroma's from flowers, natural dyes and alkaloïds. (Alkaloïds including the active compounds from narcotic and/or medicinal plants.) Generally, the chloroform is distilled off after the extraction is complete, preferably under vacuum to preserve the extracted compound.

The acetic acid can be purified by boiling off any remaining acetone and most water. There may be small amounts of bleach present. This concentrated acetic acid can be diluted to make strong vinegar. I suppose this vinegar may be useful as a cleaning agent. I doubt it could be considered food safe and useful for food preservation or preparation. Dehydration to yield acetic anhydride would be a chemists preferred destination, but is highly illegal under current drug precursor regulations.

Hazards
(The following is not an exhaustive list of the hazards associated with chloroform)
Chloroform is carcinogenic and contact should be avoided! Do not inhale the fumes or ingest, avoid skin contact.
Chloroform is relatively fire-safe, making it suited for many extractions as it can be distilled off (though presently largely replaced by alternatives)

Storage
Chloroform must be kept away from light, ideally in an amber glass bottle in a cool room not prone to extreme temperature shifts.

I'd also a bit on chloral hydrate as well, but aside from me not having any practical experience with its synthesis, that sort of information may attract the wrong kind of attention (criminals as well as those who hunt them). Still, if you need a powerful sleeping aid post SHTF, any "lab" chemist should be able to synthesize some for you if you bring alcohol, sulphuric acid, salt and a source of electricity or hypochlorite powder. Happy new year and many a year after! - Hawkins

Sir;
While obtaining law doctorate, one of my classes was Health Law, which is two parts navigating your way through the morass of Federal intrusion. One part was actual policy. But, I digress. Only one thing of significance stuck in my mind from that whole class: "Of the forty years increased life expectancy enjoyed in the past one-hundred years, 35 of those years are the result of improvements in
hygiene and sanitation. Five years are due to clinical medicine." I translate that to: "you owe more for your health to the trash man and plumber than you do your doctor."

I hope yours was a Merry Christmas. - Ben W.

JWR Replies: As prepared individuals, we need to recognize the public health risks posed by any major disruption of utility water, sewers, and garbage collection. Again: It the power grids go down for more than four or five days, it will mean The End of the World as We Know it. (TEOTWAWKI)

I am a board certified Internist, and I've read with interest the SurvivalBlog articles on antibiotics. I believe that the one by FlightER, MD was the most informative, but a little over the head of most lay people. In a TEOTWAWKI situation, I think this might be helpful to lay people.

I think it would be wise to have both prescription and over-the-counter (OTC) medications on hand. But they are worthless if not used correctly. That is the problem if you are not trained and experienced in recognizing infections, and thus providing the correct antibiotic for the identified infection. I can describe the most common infections one would most likely encounter, and the best antibiotic to use in each circumstance. Please note, that if medical personnel are available, seek medical advice first, because a mistake could cost you your life if you have a serious infection. My advice is only for use in a situation where seeking medical advice is impossible, like TEOTWAWKI.

PREVENTION (Adults)

Preventing infection is better than treating an infection. The biggest advance in health was the improved sanitation in the early 1900s. Disposing of waste as far as possible from living and cooking and eating areas will prevent the common diarrhea illnesses that kill many when modern medical care is not available.

Any wound, even the most minor scratches should be thoroughly cleaned with soap and water. If dirt and debris is in the wound, do your best to scrub and irrigate with water to clean it out as best as possible. This simple thing will prevent most wound infections. Antibiotic ointments help, but simple washing and copious irrigation of open wounds is the most important.

Good hygiene helps as well. Bathing regularly as much as possible. Wiping after going to the bathroom from front to back for the ladies to prevent urinary tract infections. Brushing your teeth to prevent cavities and gum and dental infections. Having a single intimate partner to prevent STDs. We all know about condoms.

Keep your skin in good condition. Use sunscreens to prevent sunburn, and skin cancers. Use moisturizing cream to keep your skin in good condition as well. If your skin is damaged, dry, scaly which can easily happen if you are doing a lot of manual labor, or out in the hot sun, you are less resistant to skin infections. This includes the feet. If you sweat a lot, take your shoes and socks off twice daily and fan dry them to prevent fungal infections. If your feet are dry and scaly, then use a good moisturizing cream.

Use insect repellant to prevent insect borne infections.

Make sure you have had a recent tetanus booster. In TEOTWAWKI, vaccinations will be difficult to obtain, so make sure you are up to date. You should update your tetanus vaccine every 10 years. The current tetanus vaccine includes diphtheria, and pertussis (whooping cough). Make sure you get this triple vaccine, called Tdap ("T-DAP"). All three of these are rare in the US because of our vaccination campaigns. In some parts of the world where vaccines are not available, these are major killers. Also get your influenza vaccine every year, and ask your Doctor for the pneumonia vaccine. Pneumonia is one of the most common, serious infections, and prevention is always best.

TREATING THE MOST COMMON INFECTIONS (Adults)

PLEASE NOTE THERE ARE MANY DRUG INTERACTIONS, SIDE EFFECTS, AND POSSIBLE ALLERGIC REACTIONS. I CANNOT DETAIL ALL THE POSSIBILITIES IN THIS SHORT ARTICLE, SO ALWAYS CONSULT A PHYSICIAN IF POSSIBLE. A PDR IS A GOOD RESOURCE TO HAVE IN TEOTWAWKI. PREGNANT WOMEN SHOULD NEVER TAKE DOXYCYCLINE, CIPRO, AVELOX, LEVAQUIN, AND BACTRIM. THE SAFEST ANTIBIOTICS IN PREGNANCY GENERALLY ARE AMOXICILLIN, AUGMENTIN, ERYTHROMYCIN, CEPHALEXIN, MACRODANTIN.

If prevention fails, these are the infections you are most likely to encounter.

1. Common cold. Symptoms are: runny nose, sore throat, cough. You might get a little achy, fatigued, even have a low grade fever up too 100.5 or so. Just take some cough and cold meds. It will go away by itself. Please do not take antibiotics for this. It is a total waste of your resources. Antibiotics will not help, and may make you worse if you have an adverse reaction.

2. Cellulitis . This is a potentially serious infection. It usually arises from an injury, like a cut, or puncture wound. It is easily recognizes as an expanding area of redness. It is warm, and tender to touch. As it enlarges, you will eventually develop a fever, and have chills. Swollen lymph glands may appear nearby. This may also develop into the classic "red streak" going up an arm or leg. This is called "lymphangitis," but is a type of cellulitis. The idea is that it is expanding/enlarging, usually quickly, over hours you can see a difference. This is life threatening, and requires antibiotics. It might have been prevented by washing a wound, and applying antibiotic ointment, but now it is too late for that. Systemic antibiotics are necessary. This is usually a type of streptococcus ("strep") infection, similar to what causes strep throat. It is sometimes Staph. The best antibiotic for this is Cephalexin (Keflex), or Erythromycin if you are allergic to Penicillin.

3. Sinusitis You will know you have a sinus infection if you have sinus pressure or pain, discolored drainage, and swollen glands in the neck. Sometimes a fever will be present. Usually Amoxicillin will work for this, or Augmentin. If you are allergic to penicillin, then Bactrim is a good choice.

4. Bronchitis This is almost always viral, and does not require antibiotics, unless you have chronic lung disease, or if you are a smoker. In that case, Amoxicillin will work for this, or Augmentin. If you are allergic to penicillin, then Bactrim is a good choice.

4. Pneumonia Pneumonia is not easy to diagnose, even for a Medical Doctor without x-rays, but if you have a cough, and fever above 101 degrees F, I would assume it is pneumonia, especially if you are having chest pain or shortness of breath. The best choices here are Avelox, Levaquin, and Azithromycin. If these are not available due to cost, Amoxicillin, and Augmentin will usually work, as will Erythromycin.

4. Urinary tract infections (UTIs) The symptoms are painful urination, and the feeling of needing to urinate frequently, and an urgent feeling to urinate. In women, this is usually a bladder infection, and three days of Cipro, Bactrim, or Macrodantin will usually work. If there is also flank pain, and fever, I would assume it is a kidney infection, and treat with Cipro or Bactrim for two weeks. For men, unless you have some abnormality in your bladder or kidneys, it is almost always a prostate infection (prostatitis). A fever may or may not be present. This requires 30 days of either Bactrim or Cipro.

5. Gonorrhea and chlamydia For men, the symptoms are painful urination, and a discharge. We always assume both gonorrhea and chlamydia are present, and treat for both. Ideally, this would be treated with an injection of ceftriaxone, or oral Suprax (cefixime) 400mg, and a week of doxycycline. In TEOTWAWKI, I would try a single dose of Cipro 500mg orally for the gonorrhea, and a week of Doxycycline 100mg twice daily. Resistance to Cipro is being reported, so it is not ideal treatment. If you have Azithromycin, a single oral dose of 1 gram (1000mg) will take care of Chlamydia, so the simplest regimen would be Cipro 500mg orally, and Azithromycin 1000mg orally as a single dose. For women, the symptoms are pelvic pain and discharge (PID), and sometimes fever. Please do not treat this at home unless you have no alternative. This is a serious infection, and it is easy to confuse this with appendicitis, or other serious, life threatening conditions. The only oral regimen recognized for PID is Levofloxacin 500mg daily for 14 days.

6. Boils These are easily recognized. They are enlarging, painful cysts. Like giant pimples, they usually come to a head eventually, and open and drain pus. The best treatment is to open them, and drain using a scalpel. Do not squeeze them, because if they rupture internally, you have converted a minor thing into a serious thing. It is best to apply heat, and take antibiotics until the boil is "mature." It will come to a head (have a white point in the center) and can be easily drained, or will become fluctuant (mushy feeling) where you can lance it open to drain. The best antibiotic today is Bactrim, as this is almost always a Staph infection, and many are resistant to other antibiotics. These are MRSA Staph infections.

7. Impetigo These are superficial skin infections. They are weepy, crusted patches on the skin. Children are most prone, but adults can get it also. It is usually strep or staph infections, and the best antibiotic is Cephalexin, or Augmentin. Erythromycin will work also.

8. Middle ear infection The symptom is a painful ear. Sometimes also a fever. It is not always easy to differentiate it from "swimmers ear," which is an infection in the ear canal. If the ear hurts, and there is not obvious swelling and tenderness in the ear canal, I would assume it is a middle ear infection. Amoxicillin, Bactrim, Augmentin, Cephalexin would all work.

9. Swimmers ear This is the other "earache." The ear hurts, and if you look in the ear canal, and compare with the normal ear, the canal will be obviously swollen, sometimes swollen shut. If you gently wiggle the ear, to put some traction on the ear canal, it will be very tender. Middle ear infections will not be tender. Antibiotic ear drops are needed here. If you want to conserve money for supplies, have some antibiotic eye drops on hand. These can be used for eye infections, and will also work in the ear. DO NOT TRY THE REVERSE. DO NOT PUT ANTIBIOTIC EAR DROPS IN THE EYE. IT REALLY HURTS!!!

10. Toothache This is always caused by mouth bacteria. They are always sensitive to penicillin, so Amoxicillin is best. Erythromycin is a good alternative if you are allergic to Penicillin .[JWR Adds: But of course don't ignore treatment for any underlying cause of the ache such as impaction!]

11. Pink eye This is usually viral. So cold compresses, and artificial tears will do. If the drainage is especially foul, discolored, then it could be bacterial, and antibiotic eye drops may help. Sulfacetamide ophthalmic solution is inexpensive and should work fine. Ofloxacin if you are allergic to Sulfa.

12. Diarrhea illnesses These are usually viral infections, and will resolve on their own in a few days if left alone. Just take Imodium, and drink plenty of fluids. If you are having a lot of abdominal pain with the diarrhea, or are having blood tinged diarrhea, and running a fever, it could be a bacterial infection, so in TEOTWAWKI, I would try Cipro. This will treat most of the bacterial causes of diarrhea. Remember also, these are usually sanitation failures. So good sanitation, and hand washing are good preventatives.

13. Cold sores/ genital Herpes These are caused by essentially the same virus. They are easily recognized as clustered small blisters, and are very painful. The blisters are easily ruptured, so sometimes all you see are small ulcers. The key thing is that they are very painful. Acyclovir is effective for cold sores on the lip, and genital herpes. Acyclovir also works for shingles.

14. Influenza Influenza is usually only seen in the "flu season." It is also easily recognized. It is like a cold on steroids. It is a respiratory illness, causing a cough, sore throat, runny nose, headache, muscle aches, and fever. Fever is usually 101 F or higher. One hallmark of influenza is extreme fatigue. If you are not exhausted, you are not likely a "flu" victim. Tamiflu is effective, but must be started within 48 hours of onset of illness to be effective.

15. Animal bites Animal bites are considered infected from day one. Most Doctors initiate antibiotics immediately. The best thing to try to prevent infection is to thoroughly cleanse the wound. If the wound is open, that is actually better, because you can more easily irrigate copiously with water. Sterile saline is not necessary. If you have clean tap water, that is fine. Use liters of irrigation. Bandage the wound, apply antibiotic ointment, and immediately start antibiotics. Augmentin is usually used because of the bacteria which usually cause the infection.


Antibiotic Medications to have on hand in TEOTWAWKI

OTC antibiotic medications

1. Bacitracin or Double antibiotic ointment (do not use Triple antibiotic, or Neosporin ointment, these are highly allergic).
2. Povidine (Betadine) is a great solution to cleanse wounds. It contains iodine. Those who are allergic to iodine should avoid.
3. Hibiclens This is a good alternative as a cleansing solution for those allergic to iodine. Several gallons would not be too much.



Prescription antibiotic medications

1. These antibiotics are relatively inexpensive, and would be effective for almost anything you would encounter: Amoxicillin, Cipro, Bactrim DS, Doxycycline, Erythromycin, Cephalexin, and Sulfacetamide Ophthalmic solution.

2. If you have antibiotic allergies, or if you want a more complete armamentarium of medications, I would include: Augmentin, Zithromycin, Avelox, Suprax, Macrodantin, Acyclovir, and Tamiflu.


This is the usual doses for adults of the antibiotics mentioned

Amoxicillin 500mg three times daily for 10 days

Augmentin 875/125 twice daily for 10 days

Cipro 500mg twice daily for 10 -30 days

Azithromycin 250mg take 2 tablets the first day, then 1 tablet daily after that for 4 days.

Avelox 400mg daily for 10 days

Suprax 400mg as a one time dose

Macrodantin 100mg twice daily for 7-10 days

Acyclovir 400mg three times daily for 5-14 days

Tamiflu 75mg twice daily for 5 days

Doxycycline 100mg twice daily for 10 days

Bactrim DS 1 tablet twice daily for 10-30 days

Erythromycin 333mg three times daily for 10 days

Cephalexin 500mg four times daily for 10 days

Sulfacetamide eye drops 1 drop in affected eye four times daily for 7 days. For the ear, 3-4 drops in the affected ear 4 times daily for 7 days

[Introductory Note from JWR: The following article is presented for educational purposes only. As previously discussed in SurvivalBlog, using vinyl ether for anesthesia can be very tricky. Not only are its vapors highly flammable, but it can can induce deep levels of sedation much more quickly than desired. Thus, at a minimum can can compromise the patient's airway, and thereby very possibly kill the patient. So unless you have both the equipment and the regularly-practiced expertise to safely intubate and extubate your patient, then do not use ether!]

Pain is not my friend!  In some circumstances, it is useful, perhaps to help guide workout intensity or to let you know that something is wrong.  As an emergency physician I frequently perform painful procedures on my patients. The last 10 years or so have seen major strides in our ability to sedate patients using [dissociative] agents like ketamine and propofol. This makes my job much easier, to say nothing of making life more pleasant for the patients who have to undergo procedures like drainage of abscesses, repositioning of fractured limbs and dislocated joints, spinal taps and repair of complex lacerations.

Luckily, to make it easier on them, and frankly possible for me, we have drugs.  Gone, for the time being, are the days of biting the bullet after a shot (or more) of whiskey, then having a few friends hold you down.  Before the invention of anesthesia, surgeons were often lauded for speed:  doing the fastest amputation was a plus for a surgeon’s career, for example. Now, we have loads of options for sedation, pain control and anesthesia.  I love giving ketamine!  It works great, and is generally very safe.  There are others, too, but obviously they all have potential drawbacks in a Schumeresque situation.

I started thinking about this when my wife, pregnant with twins, jokingly asked me late in term to “do a C-section on the kitchen table.”  Being a disaster planner at my local hospital, I inwardly cringed:  what would I do if we got hit with EMP or a coronal mass ejection (if she couldn’t deliver the old-fashioned way) to keep her and our babies from dying? 

A number of recent novels like"Patriots" and "One Second After" describe various post-crash scenes of severe infrastructure disruption that impair delivery of routine medical care. Many of these books also illustrate excellent preparedness on the part of some of their characters, who stockpiled ketamine and other medications in advance to have them available. Lidocaine, Novocaine and other local anesthetics can be used for nerve blocks and other “regional anesthesia” techniques, good to know if you are serious, but demanding of practice and subject to the same logistical concerns. 

This wonderful concept might not be realistic in some cases:  many useful medications are only available by prescription, and you may not have a sympathetic physician willing to prescribe them to you.  This applies especially to mood-altering drugs that are prone to abuse. How do you get hold of these controlled substances without a nocturnal visit from your local DEA special agents?  Sure:  you could grown your own, but poppies give an impure hodgepodge of drugs, and the druggies may be attracted to your garden as much as the cops.  Your doctor will prescribe them, you say?  Well, supposing you find someone willing to prescribe them, these medications may simply not be available:  even with prescriptions, you must figure out how to afford and store these medicines.

"Special K" is but one of many street names for ketamine, and propofol was recently made famous as a drug of abuse courtesy of Michael Jackson. What happens after TSHTF?  Count on your friendly pimps, dealers and druggies to know where this stuff is used and stored. They will surely take advantage of the lack of LEOs to gobble up as much as they can. With significant damage to the grid, we can envision stressed people resorting to violence or breaking and entering to obtain drugs of abuse. Keep in mind these are the same people who roam around the dumpsters over at the local nursing home looking for discarded narcotic fentanyl patches. They chop these up and use them to make tea, and also have been known to place them as rectal suppositories to get their high. (I'm not joking about this.)

Under these circumstances, you may not have access to anesthetic medications, and you may not choose to go looking for them, either.  For any grid crash scenario, you must have alternatives, like using “old” tools when nothing else is available.   This might include using a medication that can be produced from materials at hand to provide sedation for painful procedures.  Luckily, a few smart guys used just such a drug as an anesthetic after learning about its use as a recreational drug:  Yep, they were "huffing" in the 19th Century! Of course I am talking about ether, or more correctly diethyl ether.  You may have poured starter fluid into your carburetor in the past.  Many brands are mostly ether.  In a pinch, you can make pure ether yourself. 

All the usual SurvivalBlog.com kitchen chemistry safety caveats apply:  Make sure you know what you're doing, as this is explosive stuff.  It is highly flammable, and since its vapor is denser than air, ether fumes may travel along the ground, creating the conditions for distant explosion or fire. Ether attacks plastic and rubber. Because of all this, it poses a serious fire risk when you are making or using it.  You should try to find a person knowledgeable about chemistry and preferably volatile/explosive chemicals for your intentionally chosen prepper community if you have any thoughts about doing this!!! 

Ether has a number of advantages.  Like ketamine, it stimulates respiration and doesn't lower blood pressure, so it is good for patients in shock.  When too much ether is given, respiration becomes depressed, and the patient breaths in less, potentially self-correcting the problem.  It causes bronchodilation, so it doesn't worsen asthma. It is a good pain reliever, so you don’t have to have other drugs, and it gives good muscle relaxation. It is especially useful for caesarean section (because the baby tolerates it and the uterus contracts well after delivery.)  Overall, it is considered medically to be a safe agent for high-risk cases (using lower doses) and is the agent of choice when general anesthesia is needed but oxygen isn't available.

Ether anesthesia was largely abandoned due to its explosive risk. Its flammability means you should not use open flames or filaments (like cautery) with this agent nearby.  To minimize risk, keep at least 40 inches between electrical equipment and ether; vent the space naturally or with a fan.  Don’t use any electrical appliances, live plugs or sockets lower than 18 inches above the ground in the area you are using ether.  Watch out for static electricity; consider using only cotton drapes and clothes for patient and staff.  You probably will be doing many of these things by the same circumstances of TEOTWAWKI that force you to make and use ether. 

Ether has some disadvantages besides its aforementioned volatile nature.  Its effects begin and end slowly, and it may cause coughing. Finally, it causes a lot of secretions, and most folks have postoperative nausea and vomiting after ether. The main benefit, of course, is that you could make ether with simple materials that are widely scavengable, or that you can make from other simple materials.  Just to show that this is not a hypothetical suggestion, the proof is in the experience of Allied POWs during World War II who made ether in captivity. One prisoner (a surgeon) needed to tie off an aneurysm on one of his fellow POWs, digging deeply around his shoulder to do so.  His hosts, unfortunately, neglected to provide any medications to allow the procedure.

The surgeon turned to another prisoner and asked him for help.  The chemist (as pharmacists were known then) demanded two simple materials:  ethanol and sulfuric acid.  He got the ethanol from sake that some [camp guard] NCOs were making illicitly in their hut from burnt rice, and sulfuric acid stolen from batteries in the Japanese auto shop some prisoners staffed.  Two weeks later, they had brewed enough ether to do over 40 surgical procedures!  

Ether has drawbacks, no question, but if it’s all you got, you could make it and use it.  Consider, for example, that ether is still used in parts of the third world to provide anesthesia.  With some tools we have now that weren't available to earlier anesthetists, we might be able to make it better and safer.

If you think you might use ether, you should have a few other things and more importantly, some knowledge, prior to using ether.  You should know basic airway support like chin-lift or jaw-thrust, plus use of Sellick’s maneuver to reduce aspiration, placement of oral airways, and bag-valve-mask ventilation.  Ideally, knowledge and supplies for more advanced airway management like intubation are good to have as well.  You should have atropine or glycopyrrolate (to decrease secretions) and an anti-emetic (like zofran, for nausea) when using ether as an anesthetic agent.  Suction and oropharyngeal airways will help increase the safety of ether as well. 

Use a portable pulse oximeter to monitor heart rate and oxygen level.  Nonin sells a nice portable model that gives you an audible pulse and cues you to a drop in oxygen saturation in the patient's blood. (Obviously a pulse oximeter has many other applications in medical aid, like deciding when a pneumonia patient is sick enough to need some of the precious antibiotic you've stored up.)  
Your patient should have an IV for administration of fluids and medicines.  If you have ketamine, you can give one dose of this agent to make the patient sleepy, and begin having them breath in ether.  By the time the ketamine wears off, the ether will have taken effect. 

 The World Health Organization web site has a free downloadable book on austere surgery, with a good description of the techniques for using ether anesthesia.   In a pinch, you could do it the way the non-physician anesthetists use ether in many places even today:  dripping it into a piece of gauze using an ether mask like the Schimmelbusch mask, which you can improvise out of a regular medical facemask, or sometimes find on eBay.

The old style “open drop method” is to place a towel over the patient’s eyes, then drip some ether onto 10-to-12 layers of gauze held by the mask.  The mask is held a few inches above the towel and gradually lowered to cover the patient’s nose and mouth as they fall asleep.  The pupils dilate with etherization, and the muscles relax.  When the pupils dilate, you should place an oropharyngeal airway.  Further ether can then be dripped slowly onto the gauze as needed to keep the patient under. 

Stop giving ether about 20 minute prior to the end of the procedure, and assist patient respirations with a bag-valve mask to wash out the drug and speed awakening.  This may mean you put the patient out then stop giving ether, doing the procedure while the patient “emerges” from anesthesia, for short procedures. 

If you have all the know-how, all the stuff, and can safely make your own ether, you could use it for a lot of painful procedures like caesareans sections, wound care, chest tubes, fracture manipulation and the like. You may not choose to do (or even be able to do) a lot of complex surgeries, but those are probably unrealistic under the conditions where you'd want to make your own ether anyway. As always, what you can do is so much more important than what you have.

I first became fascinated with the art of preparedness in my youth during the days and months leading up to Y2K. The thought societal meltdown and global collapse seemed almost too much to bear, hard to wrap my head around. I was 17years old, just starting my life -- now faced with a potential situation that I had little training or experience to deal with. But my parents had instilled in me a valuable lesson early in childhood; fear is derived from the unknown and the lack of preparedness. With knowledge, preparation, a “never quit” attitude and maybe a little luck, any situation can be overcome. Granted, the Y2K scenario came and went without incident, but I swore never to carry the same fears again. Ten years later the same feeling has swept over our country, a feeling of loss, impending doom, fear and a myriad of other things is accompanying this New Year. I started my journey all those years ago with an “Armed Services Survival Manual” given to me by my father. Reading every word, memorizing every picture, I studied it tirelessly. It just didn’t seem enough. By knowing a little, I really knew nothing at all. The potential scenarios that we face are larger in scope than anything covered in a typical survival manual. So what should we do?

The military taught me several things, but most importantly it taught me to fight the enemy that lies within before I ever face an external adversary. Start from scratch to combat your fear.

Step 1: Analyze Your Life
You know better than anyone what you are capable of, whether you have had extensive military or law enforcement training, or are a highly trained civilian. The greatest lies are those we tell to ourselves, don’t lie to yourself. By being truthful with your self assessment you will achieve more than if you are not. Determine what areas are strengths and weaknesses; increase the balance by becoming a well-rounded person. Increase your knowledge in weak areas, while maintaining your strengths.

Step 2: Location
Just like in real estate, "location, location, location." Where you live is so very important. It dictates many of your needs and precautions. Do you live in a house? An apartment? The city? The country? Are you close to a major interstate? What is your climate? Do you have a local food source? Do you have room to store equipment? Land to grow food? How far away is your closest neighbor? Do you have a close fallback point? A secondary? A tertiary fallback point? Do you have an out-of-state fall back point? If you must evac quickly, will there be others around you with similar needs? What is the local population? State population? All of these questions have roots in different scenarios, application of preparation techniques and above all, pure survival. This is just the start, challenge yourself to continue your list of questions, learn why these things are important how to use your location to benefit you.

Step 3: Visualization
In the martial arts I learned the technique of visualization. Really it is a continuation of using your childhood imagination. Develop that skill and it will provide you answers to questions that you never even knew to even ask. Start by picking a scenario an EMP attack, economic meltdown, a nuclear surface detonation; go through your day such as that event took place. By imagining what would be changed in your lifestyle you will be able to determine what holes need to be plugged. You don’t have to even tell a soul what you are doing, but it will remove the “rose colored glasses” that sit upon your face. Life takes a turn for the worse when there is no available food, water, medicines. The possibility of having to leave your home makes it even more challenging.

Step 4: Equipment
Weapons. Some people shy away from this, but defense is always necessary. Don’t make this complicated, you don’t need a tricked out $4,000 battle rifle, you do need something battle proven. It also needs to use a cartridge that can always be replenished. Stick with NATO standard calibers: 5.56x45, 7.62x51, 9mm Parabellum or other very common cartridges like .45 ACP, 40 S&W, 12ga. I prefer the 7.62x51 (somewhat interchangeable with .308 Winchester) over the 5.56x45 (somewhat interchangeable with .223 Remington) due to its increased range and power. Same goes with the 40 S&W over the 9mm. I try to stay away from Soviet cartridges; once that supply is dried up it will be gone forever. Most importantly go get professionally trained. Clothing and other gear, make sure it is good quality. Nothing is more demoralizing than when your equipment fails when you most need it. Test it, train with it, and make the equipment prove its worth to you before you stake your life on it. You will figure out what you need through research and training.

Step 5: Medical Concerns
Learn basic first aid. This should go without saying; we should all know basic first aid. Get some medical supplies on hand, Israeli bandages, a one-hand tourniquet, clotting agent (if trained), sutures (if trained), antibiotics, your daily meds. Again, learn how to use these things correctly. If you don’t, you could cause more harm than good. Staying healthy is of great concern. Dying from something as simple as an infection is very possible in a survival situation. Knowing basic things such as what antiseptics work best or complex techniques like wound debridement are invaluable.

Step 6: Physical Fitness
An old SEAL once told me, “Guys need to push themselves away from the desk, put down the 'tactical wannabe gear,' and run!” There is incredible amount of truth to this statement. You need to be physically fit to handle the stress encountered in a survival situation. Start working out regularly! All of the gear in the world can’t help you if you are not physically able to use it.

Step 7: What’s Next?
I don’t know, that is for you to decide. Pick your scenario, study it, live it through visualization, prepare for it, get the necessary knowledge, visualize it again and again, over and over until your fear is gone. Make checklists for each scenario, to remind you of tasks that need to be completed or gear that needs to be packed. By training hard you will have overcome the event before it even happens. Your mind is the most powerful tool you have at your disposal; don’t be afraid to use it. How deep you want to dive into this is your choice, but don’t take shortcuts with your level of training, equipment or the quality of information; it could be the difference between life and death.

These are basic areas to start with, expand upon them, and add too. Remember, this is a journey, a lifestyle; not of sacrifice, but of increased knowledge and security. God forbid you encounter a life threatening scenario, but if you do, you can take comfort in knowing that it is a mountain you can climb without hesitation. One that you can guide others to the top of if need be. Carry the weight of knowledge and leadership instead of being weighted down by fear.

Louis Pasteur said: “Chance favors the prepared mind.” Good luck and Godspeed.

Mr Rawles,
Having seen the info on EMT training that has been on your blog recently, I decided to throw in my 2 cents. The National Dept of Transportation (DOT) sets all standards for Emergency Medical Services (First Responder through EMT-Paramedic) for the entire country. These standards include training and standardized interventions for certain trauma and illnesses by EMTs. These can all be found at NREMT.org. All questions on certifications, training requirements, etc can be answered there.

Some courses claim that they can accelerate you and get you certified. DOT has requirements that must be met to be nationally certified. These include specific skill sets and minimum hours of training requirements. All states are required to participate in the NREMT Registry. States can require you to complete a written and or skills test to get a state license in addition to the national registry. Some states allow you to do procedures that other states don’t. In Wisconsin, we can insert a combi-tube down your throat in certain situations to help you breath and use a laryngoscope and Magill Forceps to remove a visualized blockage in your trachea.

In other words, “caveat emptor” buyer beware. Make sure the course you are taking or plan on taking meets the Federal DOT guidelines for the National Registry. Be prepared for the NREMT skills test and written test. Both must be passed to become Nationally Registered. The benefit of Nationally Registry is transfer of EMT Licenses throughout the country.

One other thing to remember. In a TEOTWAWKI situation, all the EMT training in the world won’t save you if you don’t have a doctor to complete the treatment for a major trauma or illness. As an EMT, We perform interventions to keep people alive until they can get to the doctor that can fix what’s broken or not working correctly.

I am deeply indebted to you for all the information you have provided and allowed to be posted on your blog. You have made my commitment to my family’s preparedness and survival an easy task. - R.T., Somewhere in the ice and snow in northwestern Wisconsin

Mr. Rawles,
In response to this article. People need to be aware that just because they are a NREMT regardless of the level, basic or paramedic, not all states recognize the National Registry. For instance, I have been an EMT-B for 25 years in the state of Minnesota, and an EMS Instructor for 12 years. Neither Iowa or Wisconsin will recognize my NREMT certification in their state. Just make sure you research which states allow reciprocity and which ones don't. - Brenda L.

Mr. Rawles,
I wanted to pass this along to you and the readers of your site. I've been looking to increase my medical skills and training and, I found these schools and programs. I intend on going to a few of them when I return to CONUS. Anyone considering taking any of these classes should account for all associated costs and time to attend. This kind of training isn't cheap but it is well worth it.

The first is Deployment Medicine International (DMI). It's been set up to augment military and contract personnel that are deploying overseas. As far as I can tell anyone can go and get trained. The courses they offer are: Operational Emergency Medical Skills, SOF Operational Emergency Medical Skills, Deployment Medicine Operator's Course, Combat Trauma Management, Mission Performance at High Altitude, Basic Combat Trauma Training, Advanced Combat Trauma Training, and an Accelerated EMT-Paramedic Program.

A lot the course descriptions are the exact same thing after you get past the first two or three paragraphs wit some differences. The school is in Maine and is being used by some operators looking to broaden their skill sets. There program description say they are a benefit all who attend. I can see how they would be and I'll be going there after I get my NREMT-Paramedic certification/license.

The next school is Tech Pro Services. They have EMT courses you can take online. You take the didactic (lecture) portions online and then in order to complete the certification process, you must travel to their location in Abilene, Texas and complete the Hands On Skills training, testing, clinicals, and ride-alongs.

Upon successful completion of all portions you receive a National Registry EMT certification at whatever level you've been working on. If your state, or Commonwealth, is a member of, and recognizes, the National Registry EMT system, your able to return to your state or Commonwealth and challenge the EMS governing body for reciprocity. Once you have reciprocity you would then be certified/licensed in two states.

At this time, Tech Pro Services is the only school to offer an online EMT program that will provide you with this certification. They offer other useful courses but, I'm focusing on the medical training only at this time. I'd recommend any of their classes as all of them are useful.

For those wanting another option for an accelerated EMT-P program, Tidewater Community College in Virginia has an accelerated EMT-P program that is five months long. The only prerequisite is that you already have an EMT-B certification/license. I've no idea if they are able to take out of state certifications or licenses.

As I understand it, this course can also provide you with college credits, if you attend their program in that fashion. Good luck getting in touch with them by phone or email though. It took me a few weeks. Why they didn't answer their phones, return my calls after I left messages, or return my emails in a timely fashion is beyond me, but I'll be taking their class prior to attending some of the more high speed classes with DMI regardless.

For those that didn't catch it previous mentions, Medical Corps has some very informative classes that would be useful as well. I've spoken with one of the people there and hope to get there in a few years.

For those on a really tight budget you can start learning about some aspects of the EMS field by taking the free Independent Study courses from FEMA's Emergency Management Institute. You can download the books and files and test online. I'd recommend the first few courses such as IS-1, IS-3, IS-5.a, and IS-& for starters and then take the National Incident Management System (NIMS) courses. A lot of agencies require them to operate as an EMT.

Frederick Community College in Maryland accepts this training and will convert the classes into single credit courses. They are the only college in the country that will do so. They also have an AAS Degree in Emergency Management that these courses can be applied to. The cost of converting the courses to college credit used to be $60 per course. I don't know if it is still the same or if it's changed.

I've no affiliation with any of these schools, organizations, or facilities nor have I attended any of these classes or programs. This isn't intended as a review of them. I thought this would be extremely valuable information to pass along for properly preparing for medical emergencies that will undoubtedly arise WTSHTF. Anyone who's seen someone shot or unlucky enough to be near an IED when it goes off will truly understand why you must always have at least one medic on hand, and if possible, two with other personnel trained to assist. Good luck and God bless to all, - D. in Dubai

Mr. Rawles,
As a physician I take significant offense to Lawrence R.'s letter regarding antibiotics. The fact is over 90% of infections presenting to US hospitals are antibiotic resistant in some form or other.
He is correct that some of the older medications may be effective and that is why bacterial cultures are performed to determine antibiotic resistance. He is sadly misinformed regarding the idea that we prescribe the most expensive or newest antibiotic available. We prescribe the least expensive antibiotic that is effective against the specifically cultured infection as long as a patient is not allergic to that class of antibiotic.

I wish him luck using penicillin for 90+ percent of soft tissue infections obtained outside of the hospital as the large majority of community acquired soft tissue infections are resistant to penicillin.
A good broad spectrum antibiotic which can be obtained very inexpensively is Sulfamethoxazole/trimethoprim otherwise known as Septra or Bactrim. This can be had at large chain stores for $5 for a two week supply and is widely used as there is low resistance to this class of antibiotic as of this time. This applies to localized soft tissue infections only, such as a cut, scratch, abscess or boil.
I had to correct this misinformation posted on your superlative blog. Thank you for your time, - Kevin C.

Jim;
After reading the suggestion from Lawrence R about antibiotics, I think this email that I sent you back in 2007 bears repeating, with just a few changes.

Terramycin is a trade name for tetracycline, a common antibiotic. It's value has changed over the years due to antibiotic resistance (not drug company lies)....but it's useful as

* an alternative in PCN-allergic patients: syphilis, yaws, Vincent's infections, and infections caused by N. gonorrhoeae, B. anthracis, L. monocytogenes, Actinomyces sp., and Clostridium sp.
* URI and lower respiratory tract infections; skin and soft tissue infections; Granuloma inguinale;psittacosis caused by Chlamydia psittaci.
* Typhus infections,Rocky Mountain Spotted Fever, rickettsial infections, and Q Fever.
* Infections caused by Chlamydia trachomatis.
* Urinary tract infections.
* Infections caused by Borrelia sp., Bartonella bacilliformis, H. ducreyi, F. tularensis, Y. pestis, V. cholerae, Brucella sp., C. fetus.
* Adjunctive to intestinal amebiasis cause by E. histolytica.
* Infections caused by susceptible strains of E. coli, Enterobacter aerogenes, Shigella sp., Acinetobacter sp. Klebsiella sp., Bacteroides sp.

NON-FDA APPROVED USES

* H. pylori-related peptic ulcer disease (in combination with bismuth subsalicylate and metronidazole - a very large percentage of ulcers are caused by this bacterial infection).
* Gingivitis/periodontitis
* Acne vulgaris

As you can see, it's useful for specific infections.....

There is no 'one best antibiotic' for all purposes. Antibiotics have to be administered based on the specific type of bacteria causing an infection. Administering the wrong antibiotic doesn't just NOT work, it causes different bacteria that are not killed outright to become resistant to it - which can cause problems down the road. People have pathogenic bacteria in and on them all the time, when something causes them to go out of balance and cause disease. At the very basic level, antibiotics are based on the cell wall of the bacteria (which determines if it will stain pink or blue with the Gram microscopic stain process), and their shape. Once that determination is made, certain bacteria have been shown to be sensitive to certain drugs, for example Gram-negative bacillus (say, E. coli) is usually sensitive to the fluoroquinolones like ciprofloxacin (Cipro).

If I were to recommend a basic armamentarium of oral antibiotics, I'd have to pick at least five different ones. I actually carry these, plus 4 or 5 IV/IM only drugs, and pick the best drug for the problem at hand, because once again, the wrong drug isn't just not as good, it's no good and a waste of valuable, scarce resources that might be needed more appropriately for another patient.

1. Ciprofloxacin (Cipro) 500mg twice a day
for infectious (bacterial) diarrhea (5 days max), anthrax prophylaxis (x60 days),uncomplicated UTI (7 days max), gonorrhea (1-2 tabs, once)

Given the incidence of certain bacteria that are resistant to ciprofloxacin, it is also wise now to also carry azithromycin

2. Azithromycin 250mg Comes in packs of 6 for 5 days dosage, take 2 the first day, then 1 a day until gone.
for bronchitis, pneumonia, or serious throat infection.

3. Ampicillin 500 mg 4 times a day for , or
amoxicillin-clavulanate 875 mg twice a day (Augmentin, very $$$)
for sinus infection, skin infection, or ear infection, GI, GU,

4. Trimethoprim-sulfamethoxazole 160/800mg (double strength) twice a day, 7-10 days or
doxycycline 100 mg twice a day, for 7 days for methicillin-resistant Staphylococcus aureus (MRSA) infection, UTI, otitis media, sinusitus, bronchitis

Doxycycline is also a chloroquine-resistant malaria prophylaxis, take 1 daily starting 2 days before travel until 4 weeks (28 days) after return from endemic area, effective against Rickettsials (Rocky mountain spotted fever)

5. Metronidazole 500mg 4 times a day for 7-14 days
effective against Giardia lamblia and for dental infections, trichomoniasis

Augmentin is very good for animal (especially cat) bites, but is quite expensive. Amoxicillin is a synthetic penicillin, the clavulinic acid (clavulanate) contributes penicillinase (an enzyme some bacteria produce that inhibits penicillin effectiveness) resistance.

This list is in no way comprehensive, nor are the indications the only possible uses for the drug, or the only drug for a condition.

Take care, and keep up the good work. - FlightER, MD

Mr. Editor,
I feel compelled to write you about a couple of recent medical posts by other SurvivalBlog readers. One writer stated that Cipro is good for sinus infections. Generally this is not true. Given a severe infection and no other antibiotic options, [if it is] TEOTWAWKI, then sure go head and try it, but think of Cipro as a below the diaphragm antibiotic, urinary tract infections, diverticulitis (preferably combined with Flagyl, an inexpensive antibiotic/antiparasitic), and so forth. Physicians will sometimes try it for skin and soft tissue infections, such as cellulitis, but the results with this generally are quite poor in my first-hand experience.

The real reason I take keyboard in hand, however, is to reply to the posting of Lawrence R.. It pains me to see someone who appears to be a former Coastie (Semper Paratus) making the claims he does about antibiotic resistance. It is not my intention to start an argument or negatively toned debate on your excellent blog, but to state that antibiotic resistance is a lie is patently false. Resistance among some of the most common pathogenic bacteria to penicillins, cipro, and other commonly used antibiotics is a substantial problem physicians contend with every day. An internet search using the terms antimicrobial resistance and the name of their state, community, and perhaps even a local hospital may reveal tables of statistics with the frequencies of resistance to common pathogens to readers. Additional light reading may be found here. Lawrence's comments that ranchers and farmers treating themselves with antibiotics devoid of trained medical advice is done "with no deleterious effects" is a disingenuous and potentially dangerous statement. Certainly, people - with or without physician advice, often in today's world, will take antibiotics when they are not needed, and suffer no apparent harm. The lack of direct, obvious and immediate consequences does not turn this uneducated practice into a virtue. This practice is one of the primary reasons for the significant levels of antibiotic resistance prevalent today.

Further, complications from partially treated infections, delays in seeking proper medical attention for medical problems because one thought the antibiotic in the cupboard would take care of it, and direct consequences of antibiotics on the human system are all problems physicians help patients with every week. Ask the next woman you see about yeast infections with antibiotics and you may begin wondering how much Diflucan to stock at the retreat. Or, instead of that common but relatively minor example, ask one of my patients who now must be on antifungal medicines for the rest of his life because prior to seeing me he partially treated a series of sinus infections until a yeast infection took hold, ate into the bones of his skull, creating an infection in his skull which can be contained, yet never cured. Also, ask anyone who has had C. dificle colitis after an antibiotic course if antibiotics have no deleterious effects. C. dificile colitis can emerge up to a year after the last course of antibiotics. In a TEOTWAWKI situation this makes stockpiling some Flagyl especially helpful, though I have seen patients have to take it for up to 3-6 months for the colitis to be resolved. There are other antibiotics which can be used for this problem, but they are cost-prohibitive for stockpiling. Oh, BTW, think that the appendix has no meaningful function? It's use is as a reservoir of normal colon flora to be used to repopulate the colon after a severe diarrheal illness. Since this discovery was made I have noted that the distinct majority of patients I have seen with C. dificile have undergone previous appendectomies. In either case, with or without your appendix, it is an unnecessary risk of health and "antimicrobial OPSEC" to randomly treat oneself without medical input from someone with relevant training.

In another vein however, my personal opinions about the ongoing prevalence of antibiotic resistance in TEOTWAWKI may be of interest. Most forms of antibiotic resistance mounted by bacteria require the expenditure of energies and resources by the bacteria themselves. Because we live in a world in which antibiotic exposure is unnaturally common, from prescription medications as well as the indiscriminate use of antibiotics in our food supply - reference Lawrence's own assertion that the local feed store is an easy and ample source of antibiotics. (I have close family members and patients who are livestock farmers and have witnessed flagrant misapplication of antibiotics to livestock first-hand as well.) This environment creates a scenario in which a survival advantage for the bacteria who express the resistance factors is generated. Interestingly, in TEOTWAWKI, the world-wide presence of antibiotics in the ecosystem should rapidly revert back to the natural state, where microbes such as fungi, for example, who release penicillin naturally (the original source of the "discovery" of penicillins), will be the only source of organic antimicrobials. In this scenario the bacteria who are consuming their energies and resources to make antibiotic resistance defenses will be at a survival disadvantage to other bacteria who are not dividing their resources between survival & replication and antibiotic resistance. Thus, in relatively short order, measurable declines in resistant antibiotic populations could be expected. If this theory pans out, then the utility of Penicillin, Cipro and other stockpiled antibiotics, when recommended by your survival group's medical officer, could be greater than present day patterns of resistance would suggest. Certain microbes will always be resistant to certain antibiotics, as inherency of their natures, but reviewing such examples may be tedious and unhelpful to those of us surviving, as the tools and opportunity to perform gram stains, cultures and sensitivity testing may not be practical.

On a final note, in addition to my specialty specific text books, Harrison's Internal Medicine being the most well known of the comprehensive ones, I also keep for emergency/survival scenarios copies of Auerbach's Wilderness Medicine and Goldfrank's Toxicologic Emergencies as well as DOD field manuals. Those two books are rather thick and heavy, so may be worth reading through and pre-positioning at the bug out site, or having at the site for the designated medical officer of your group. There is a field guide version of Wilderness Medicine which is easier on the wallet. The Washington Manual General Internal Medicine is another portable resource which should be excellent for your group's medical officer. Medical libraries at medical schools and hospitals often have second hand sales of books that are outmoded by new editions and lightly used copies of these books can sometimes be found at bargain prices there. OBTW, other medical books at these sales can also make very convincing "book safes" if one has glue, sharp instruments, and time on one's hand.

In parting, common sense is essential, but it isn't a substitute for medical experience and training. Make sure your survival group has at least one experienced medical person, be they medic, physicians' assistant, ARNP, physician or surgeon. The life they save may be your own! - Dr. G.

Editor's Note: As previously mentioned, when this thread was started, the use of anything other than USP Human Grade antibiotics on humans should only be considered in the most dire of circumstances, where there is no other choice.

Jim,
In reference to the question of sources for prescription medications, I recommend that readers interested in stocking up on medicine take a copy of Wilderness Medicine, Beyond First Aid, by William Forgey, to their primary care physician and show them the list of medications listed in the book. Explain to the doctor that you are preparing and that you would like to get prescriptions for the medications listed in the book. You may have to try several doctors before you find one willing to work with you, but they are out there if you keep looking.

Forgey's book has an amazing amount of information on the most common medical problems which the average person can apply in the field. There are several uses for each medication listed in the book.

A very good source of vet medicine (including lactated ringers for vet use) is SHOPMEDVET.COM. They also have sutures, instruments etc which are priced very reasonable. Amazon.com also has a large amount of medical supplies and medicines available on their website.

One other suggestion for obtaining some of the medical supplies that individuals may be looking for is to look for pharmacies going out of business. We obtained several boxes of sealed syringes, bandages and other supplies recently at a pharmacy that was closing. Thanks for a great site. - Sandy M.

Jim:
Your readers may find Atlantic Medical Supply useful as a mail order source for IV fluids.
Regards, - H.S.

Sir,
For the past three decades our pharmaceutical industry has been telling us the 'bugs' are resistant to antibiotics, so they must constantly look for new antibiotics, which is expensive. They lie. The truth is, they don't make any money on simple Penicillin G, tetracycline, terrramycin, and staple sulfa powder anymore, and they are in business to make money for their investors.

So, where do you get a long term supply of simple basic antibiotics? The Answer: Your local feed store. They try to tell you such antibiotics are not for human consumption, but that's a lie. It never made economic sense to have two assembly lines for antibiotics--one human, one animal--when just one line can service both humans and animals with just a change of label. The drug companies are run by economics too. Ranchers and farmers know this, and it is rare the rancher or farmer that doesn't treat himself with antibiotics that they bought for their animals, with no deleterious effects.

Terramycin powder is used for hogs, chickens, birds of all sorts, and bees. It is a water soluble powder, and will last for many years. Penicillin G, shaken once each two weeks and stored in an ammonia absorption refrigerator at 36 degrees, (no electrical grid necessary), will remain good to use about three years beyond the posted expiration date. Oxytetracycline, same thing. It will last for years if kept cool.

With any injectable antibiotic, follow the instructions on the label, inject by weight of the subject. Of course don't inject anyone who is allergic to eggs or has had obvious reactions to Penicillin or Tetracycline. But, you can stockpile Epinephrine for such reactions. Again, simply follow the directions on the label.

Stockpile over the counter medications too, one of the best is simple Benedryl or the store-brand generic substitute. Stockpile plenty of simple Aspirin. Got a dog that's rattlesnake bit? Give him an aspirin (300 mg) in a small piece of meat that he'll swallow without chewing. He won't even swell up if you get it into him in the first few hours. This works well on humans too.

Use some common sense, people! Survivalism isn't an arcane science. It's mostly common sense and simple action.

We discuss this all the time on my group: SurvivingTheDayAfter@yahoogroups.com and SurvivalBlog is linked as a must read resource. Semper Paratus, - Lawrence R.

Editor's Proviso: Please note the following article is presented for educational purposes only. Implementing the steps described below is illegal in most jurisdictions. This article is presented in the context of total collapse of society and government, in which government has become nonexistent.

Pain management is one of the most serious aspects of any medical situation whether it is life threatening or not. Many of us have chronic pain issues which get worse as we age or as our physical workload increases. Pain exacerbates shock when traumatic injuries are sustained. Pain management can comfort us in during palliative care and make the transition into the next world easier – both for the person who is dying and to ease the anxiety of loved ones. The reality is that pain management should be a concern for all of us who are preparing to meet whatever the future holds.

Most of us do not have access to effective pain management medications beyond Tylenol, Aspirin and Ibuprofen. Narcotics that are regularly prescribed for serious pain are unavailable to add to our medical kit, and will certainly be unobtainable when TSHTF. All is not lost, however, but we must be prepared to grow our own painkillers. Fortunately, this is neither expensive nor difficult. The answer is to begin growing opium poppies just as our ancestors did up until a century ago. Opium poppies are used to produce morphine and codeine, and do not require much processing to create a useful painkiller that can be grown in your garden.

Which Poppies to Grow?

Opium producing poppies are known by their botanical label Papaver somniferum. Variants go by the names Giganteum, Hens and Chicks, Persian White, Persian Blue, Danish Flag. Each type will have a different morphine content genetically, and conditions will also affect the potency of the poppy. They are readily available as seeds and are legal to order and possess. 500 to 1000 seed packages can be had for $10 to $20 and are viable if stored in an airtight container in a cool dark place for 3 to 5 years. One poppy pod can produce several hundred seeds that are easily harvested, so a rotating seed stock is easy to maintain.

Growing the Opium Poppy

Opium Poppies tend to like a cooler environment for germination, warmer for the growth phase and into maturity for opium production. Early Spring is a good time to plant when there is still snow on the ground. Some folks plant in the Fall and let the poppies sit dormant over winter to spring to life as it warms up. I have found it best to plant seed directly in the garden and let them germinate there. They require only a shallow covering of topsoil. Soil should be well drained, and sandy soil works well for this. The poppy roots near the surface and does not extend roots down into the soil very far. Sowing many seeds close together and then thinning the group a couple of times early in the growing season works well. The mature poppy needs space – 10” to 12” around the poppy is a good idea. A soil and water pH level of 7 (neutral) is good. Manure based fertilizer is excellent. Water and fertilize the poppies regularly. Poppies are quite hardy, but they don’t like weeds, so weeding your plot is essential.

Poppies grow tall (4’ is common), and so must be somewhat sheltered from the wind. Full sun in a temperate climate is good, but in very warm climates partial shade is appropriate. Once the poppies reach their full height, they will develop a lovely flower and seed pod. The petals of the flower will last less than 2 weeks and will be shed completely leaving the pod. Once the petals appear, cut back on watering, but do not allow the roots to dry out. This will push the pods to produce more opium.

Harvesting the opium

Once the seed pods have shed the petals and the pods are mature, you can begin to score the surface of the pod with a sharp blade. Draw the blade from near the bottom of the pod to near the top. Do not go deeper into the skin than 1/16”. Immediately you will see a milky substance appear. After a couple of hours the substance will begin to get gummy and you can scrape it off the pod with a blade or flexible piece of thin steel like a putty knife. This is the raw opium and will contain a quantity of up to 20% morphine.

The pods can be scored multiple times over multiple days until the plant dies. Once the plant has perished, cut the poppy at the stalk about 5” from the bottom of the pod. The pod will contain hundreds of seeds, and once it has dried, the pod can be crushed and the seeds extracted. The remaining plant matter can be collected and ground up to make a vile tasting tea that has many of the painkilling properties as the raw opium. Seed pods can be harvested and stored for future use and may deteriorate slower than grinding and storing the powder, but they will take up more room.

What to do with the opium

For centuries opium was ingested orally. From the 16th to the late 19th Century, it was sold as Laudanum, which was simply the opium “latex” (the raw scrapings from the pod) that was powdered and mixed with alcohol. As well as being more soluble than water, alcohol aided the painkilling properties of the opium and likely preserved and increased the shelf life. Small bottles of 10% opium and 90% ethanol alcohol would make excellent barter goods and be a way to dispose of excess opium.

As discussed earlier, tea made from adding crushed poppy plant matter to hot water makes a fairly powerful painkiller, but getting the dosage right could be a problem, so using multiple small doses is the best way to start with opium tea.

The best way to meter dosage is to actually smoke the opium latex. Direct heat to the latex works, but not as effectively as vaporizing it. Simple vaporizing is done by heating the pipe bowl rather than applying heat to the opium directly. Small, match-head size pieces can be smoked and the effects are fairly immediate.

Another use for opium

Opium also acts as a good anti-diarrheal agent. The opiate derivatives of opium – morphine, codeine and heroin are known to stop up users. This can be a problem in a survival situation, so starting a laxative regimen may be necessary. But, where diarrhea is accompanied by pain, opium may be the best solution in a self-sufficient environment.

Potential Problems

Opium is addictive and should be treated with due care and respect. Coming off of protracted usage is difficult and painful both physically and psychologically. However, if used for managing real physical pain, addiction is often not an issue as long as the usage is stopped when the pain subsides for good. Opiates are still the most used and often most effective painkillers prescribed today.

Legal issues. While it is widely legal to own opium poppy seeds, it is also just as widely illegal to grow poppies for opium production. Having hundreds of poppies growing in your garden prior to TSHTF will invite arrest. Growing a few poppies for decorative purposes will go unnoticed, and the dried seed pods are widely available for decorative flower arrangements. Growing just a few poppies every year and storing the seeds is what I do.

Where to get seeds

I got my first seeds online after searching Papaver somniferum. There are many dealers, and they are inexpensive to buy. I know have several strains growing in my garden, as do relatives and friends. They are beautiful plants, and will certainly come in handy some day.

Editor's Proviso: I must reiterate that the preceding article is presented for educational purposes only. Implementing the steps described below is illegal in most jurisdictions. This article is presented in the context of total collapse of society and government, in which government has become nonexistent.

Hello Jim,
A. Woofer should be commended for his excellent article on Betadine. An excellent way to use/carry Betadine in a small personal first aid kit is Betadine swab sticks. There are normally used for skin prep before minor surgical procedures. Take care, - Jeff in Ohio

Jim,
I’m writing to take exception with the author’s affinity for using Betadine in open wounds to “prevent infection.” While the liberal application of Betadine was relatively standard practice in the Emergency Medicine community when I started practicing 20 years ago, recent studies have changed this practice considerably.

As the author himself points out, “It kills everything”. While this may be the desired effect against microorganisms Betadine is also cytotoxic, meaning it kills healthy cells of the patient as well. Studies have shown that this delays healing, increases scar formation and may lead to chronic wound formation – wounds that never close or heal. Other studies comparing Betadine with wound cleaning detergents (Shur-cleanse) or tap water or sterile water overwhelmingly conclude that tap water is the best agent for wound cleaning. While this may sound far fetched it has changed the way many Emergency Departments (including my own) treat wounds. A couple of good references for anyone interested in this subject would be:

Durani P, Leaper D: Povidone-iodine: use in hand disinfection, skin preparation and antiseptic irrigation. Int Wound J 5:376, 2008
Moscati RM et al: A multicenter comparison of tap water versus sterile saline for wound irrigation. Acad Emerg Med 14:404, 2007

You can find these journals available to the public at any medical school library.

Additionally, the author briefly mentions irrigation using a pin-hole in a plastic bag filled with irrigating solution. This too has been studied recently, along with other field expedient irrigation methods, and the conclusions are that you cannot get enough pressure using this method to dislodge debris from a wound. It requires 15psi for irrigation to have the desired effect. These pressures are best achieved in the field setting using a standard syringe and flexible IV catheter along with copious amounts of clean water.

I commend the author for teaching first aid techniques to lay people. I do this myself and know first hand the amount of work involved in preparing and presenting quality training. We owe it to our students to incorporate (into our teaching and our practice) the latest changes in the field so that what we teach is better than what we ourselves were taught years ago. - PA Matt

Sir:
Readers should be reminded: Don't confuse Betadine solution with Betadine soap. Both are available, but the soap should not be used to purify water. Betadine solution can be used as stated in the article. Please note these soaps and solutions should not be used on persons having a history of anaphylactic reaction to iodine or shellfish. Hibicleans (Chlorhexidine), manufactured by Regent, can be used for wound cleansing instead. Hibicleans is not as broad spectrum as Betadine solution, but is the standard substitute. - Mike in Tennessee

James Wesley:
Just finished reading the information from Woofer on betadine for wounds. About a week ago, my spouse took a tumble and fell about three feet into some planter boxes filled with dirt. He had some big belly scratches and a nasty arm gash. He was covered in dirt. Immediately had him shower with soap and water to get rid of the dirt and then I poured betadine on the wounds, bandaged up the big gash, and took him to the Emergency Room (ER). Apparently, these days the family physicians no longer want their patients to come to the office for such things like they used to do. As the ER physician told us, "this is new medicine and the doctor's office wants to churn through patients and suturing takes time." It was debatable about the arm gash being sutured or not but instead the ER physician cleaned some and then used wound glue to close it. The ER did nothing to my wound cleaning job for the belly scratches. Guess I must have done as good a job as the ER physician would have done. (Husband got his first tetanus vaccine with diphtheria. We don't like vaccines but these were some pretty nasty dirt filled wounds. I told the ER doctor that I was worried about both tetanus and 'flesh eating disease". She responded that tetanus and 'flesh eating disease' are the same thing. It sure doesn't appear to me to be the same bacterium but maybe one of your readers would know?) Within a day the belly wounds were healing very, very nicely. I think the the arm gash will leave a dented scar but it too is healing up pretty nicely. It has been many, many years since I had a first aid class. Looks like I did the right things.

I had planned to use the Thanksgiving weekend to get my first aid supplies organized so that I could pull out a container for wound treatments, one for colds, etc. Instead, I was running from one location to another to pull things together. Also, I had only been focusing on the wounds as the visible impact and a possible concussion but didn't think of possible broken bones nor internal injuries.

What would I have have done differently? I wish had had my supplies readily available instead of my hunting for my supplies for wound treatments. I wish I had taken the refresher first aid, advanced first aid, and the wilderness training program. And, wish I had done a better overall accounting of the situation to ask about broken bones or think of possible internal organ injuries. Finally, I have several first aid books but again I would not have been able to locate them easily and I would have had to read through them instead of as, Woofer, pointed out being very familiar with the written materials.

I was prepared for a modest crisis but would have been ill prepared for a major crisis simply because I was not and am not well organized. Some things are here; other things are there -- and in a crisis one doesn't want to be running here and there gathering things together. Regards, - Still Getting Ready

Sir,
That was a great article on the revival of tourniquets. One very important point that the author briefly touched on is the ability of the wounded individual to apply the tourniquet without assistance.

The central tenant of it's use by our forces in the field today is that the wounded individual must be able to tend to his own 'blowout' while everyone else continues to engage and suppress the enemy. Otherwise the risk is that one wounded troop might multiply into more if the enemy gains fire superiority and/or individuals expose themselves to aid a wounded comrade.

Individuals who carry these devices as part of an individual first aid kit should practice applying it to arms/legs at varying heights while laying in awkward positions. - Greg L.

Mr. Rawles,
I have read your blog for several years and found some interesting concepts in the posts. A little about myself: I am a 34 year old former soldier. I spent seven years in army special operations including three years at 1/75th Ranger. I have worked on large cattle operations throughout the west since returning from Afghanistan after my last deployment and subsequent ETS. I have also been a lifelong "survivalist," or "prepper" to use the newest term du jour.

In regards to the recent post by Robert U, entitled "Tourniquets in Combat Medical Planning." It was a well-written overview of one aspect of the TC3 protocols. I would respectfully disagree with his conclusion however that "many of the advanced skills taught in TCCC are beyond application by the average person due to both the medical knowledge required and the materials used..."

That's nonsense. The TC3 protocols are being taught to 18 and 19 year old kids right out of high school. The average thirty-something "survivalist" can certainly wrap their head around those skills as well. Both the Care Under Phase and the Tactical Field Care phases should be implemented into any serious survivalists preparation training.

Not just the tourniquet, but the application of Israeli Battlefield Dressings, priMed gauze bandages, etc, HemCon agents like Quickclot and others, the use of a naso-pharyngeal airway, and others are relatively simple to teach and to learn. All are legal to use in most jurisdictions due to the fact that they all apply to the traditional "ABCs" of first-aid.

Even the use of needle decompression of tension pneumothorax is a simple skill set to teach and learn.

Any restrictions to the TC3 phases that would apply to the general survivalist would be as a result of legal restriction to access to narcotic analgesics and by-prescription anesthetics. - Cowpuncher

Jim:
You recently mentioned Ciprofloxacin in your blog. Cipro is an antibacterial, a fluoroquinolone. It's useful for urinary tract infections, bacterial (not viral) sinusitis, post-inhalation exposure to anthrax, traveler's diarrhea, and in combination with other drugs for abdominal infections. Resistance to various sexually transmitted diseases and some bacteria that cause pneumonia (Pseudomonas aeruginosa) is increasing.

Ringer's isn't usually given with dextrose. It can be, but not normally. Ringers is an electrolyte (salt) solution, dextrose is used to replace (just) water or water and add some carbohydrates. Electrolyte solutions are used in cases of electrolyte depletion or dehydration (often combined with electrolyte depletion), normal saline is often given more or less interchangeably with Ringers (in fact, all I carry these days is normal saline).

And for trauma supplies (not drugs) a good source I've found is ChinookMed.com. Regards, - Flighter, M.D.

James,
I love your blog, I read it daily. Good article on the field craft of tourniquet applications. I do have one question to add--where can I get medical supplies for treating trauma? I love the fact that we have the blood clotting bandages available to the civilian--long live the free market. In the Army, I was a Combat Life Saver and I may be out of practice, but when truly required of me I am certain that I can start an IV to keep someone from going into shock. I have tried to find lactated ringers on the Internet, but they require a medical license (as would the needles and tubing sets I imagine) or a doctor's prescription. How can one stock up on the supplies that can save some one's life after the tourniquet is applied? I have considered having "the talk" with my doctor about prescribing such items, but that hardly seems likely without putting him in an awkward place. I searched the archives in your fantastic blog to no avail--are there any foreign distributors? I hate to think that I would have to "back door" to get supplies, but if it came down to preventing one of my family from going into shock and possibly death after grid-down, you better believe it is worth pursuing this during grid-up times.

Thank you for all that you do, - SBC

JWR Replies: Here in the US and other First World countries, to obtain USP-listed prescriptions medications there are few alternatives to finding a sympathetic doctor. (And, by the way, that must be one acting "within the scope of one's practice", so don't expect your local dermatologist or podiatrist to be able to write you a scrip for Ringer's or for an antibiotic medication like Cipro.)

One alternative often mentioned by SurvivalBlog readers is buying veterinary pharmaceuticals. A Strong Proviso: This is mentioned for educational purposes only. Buying veterinary medications is only recommended for absolute worst-case contingency planning--for when there is no other source of medical aid and supply.

One starting point for your quest is Jeffer's. Among other items they sell a veterinary dextrose solution, by mail order, without a prescription. (IIRC, Lactated Ringer's is often used with a 5% dextrose soliution.)

As an instructor of multiple combat medical courses, I have had the privilege of instructing many courageous and dedicated young corpsmen and medics in Tactical Combat Casualty Care (TCCC), Pre-Hospital Trauma Life Support (PHTLS) and Combat Lifesaver (CLS), as well as other courses.  Out of all of the information I have taught, I am amazed at the feedback I receive from many of these students returning from the wars in Iraq, Afghanistan and other areas of the world.

Tourniquet use is documented as far back as Roman times; examples have been found composed of bronze and leather.  The first practical tourniquet use was by Joseph Lister, and it was improved upon over the course of time by utilizing pneumatic air bladders and control pumps designed to restrict the flow of blood past the device itself.  Tourniquets were issued and used by US military medical personnel during the course of our conflicts,  but eventually the use of these tourniquets fell off due to inadequate control of bleeding, or irrecoverable damage to limbs, causing loss of most or all of the limb below the tourniquet.

In 1945, an article in the Journal of the Army Medical Department, a physician cited the following:  “We believe that the strap-and-buckle tourniquet in common use is ineffective in most instances under field conditions... it rarely controls bleeding no matter how tightly applied.” 

In the 1970's, civilian emergency medical training was instituted, and Emergency Medical Technicians took to the streets.  Training for the use of tourniquets was minimal, as they were to be used only when direct pressure over the wound, elevation of the wounded extremity and utilization of pressure points to restrict arterial blood flow had failed.  The mantra 'use only if you have to save life versus limb' truly discouraged most emergency medical personnel from using these devices.

Even in the mid 1990s, the strap-and-buckle tourniquet was still being used; medics and corpsmen were still receiving them as issue, but were encouraged not to use them.  However, in the mid 1990s, Special Operations personnel began looking for another way to treat heavy bleeding from limbs due to combat trauma.  Dr. Frank Butler, a Navy physician working with the elite Navy SEALs published an article in the 1996 Military Medicine supplement titled 'Tactical Combat Casualty Care in Special Operations'. This marked the birth of a radical change in combat medicine. 

Current Use

While many of the advanced skills taught in TCCC are beyond application by the average person due to both the medical knowledge required and the materials used, the tourniquet is easily acquired, quickly taught and understood, and effective in immediate lifesaving.  Currently, tourniquets are used for 6+ hours in surgical procedures such as knee joint replacements to prevent patients from severe bleeding during the actual operation.

Currently, the US military is using the Combat Application Tourniquet, or CAT.  As described at  CombatTourniquet.com, it is a simple device that can be applied (with practice) one-handed to oneself, or to another victim to rapidly control severe bleeding.  The windlass and strap system is simple to use, and when properly applied, will hold pressure well.  Other tourniquets are available on the market, but this is the one most commonly referred to in our courses.

A word of caution:  Modern tourniquets work because they are broad bands which apply pressure to all the vessels around an arm or a leg.  The broad band prevents tissues underneath the band from being crushed – this is vitally important, as crushing or strangulating the tissues with a narrow width, such as a rope or a bootlace, will cause the tissues to die, followed by the possibility of the dead tissues entering the blood stream and poisoning the body.  Do not use any item as a tourniquet except on specifically designed for use as a tourniquet!

Why Use A Tourniquet?

It's five o'clock in the morning, and the goblins have decided that now is the time to get into your retreat.  You, or a partner are wounded, be it in an arm or a leg (you are wearing body armor during the assault, right?), from a bullet or a shrapnel wound.  What will happen to the wounded person?

When an artery is severed, a casualty can bleed to death in three minutes.  Shock will probably occur, and will deteriorate your ability to think and fight back.  Your defense has now lost two people – the casualty, and a person who is now trying to stop the bleeding.  While this is appropriate in a non-emergent situation, it is vital to 'get back into the fight' as quickly as possible.  The tourniquet can be applied to control the bleeding and allow one, or possibly both individuals to continue resistance; multiple testimonies from wounded Soldiers, Sailors, Airmen and Marines can attest to this.

Because of it's construction, the CAT tourniquet can be applied to yourself,.  This will save your life if  you are alone and bleeding severely.  Apply the tourniquet, and tighten until the bleeding has stopped.  In practice, you will find that a tourniquet properly applied will stop a person's pulse in their wrist or   foot.  In addition, you will find that it hurts like the devil!  I tell my students 'if it doesn't hurt, it's not tight enough' – followed by a yank which dislodges the tourniquet, proving that it didn't work.

If the first tourniquet hasn't stopped the bleeding, a second should be applied just above the first; the combination will usually stop the bleeding.  However, don't apply the device on the elbow or knee, and don't apply over items in pockets, holsters or other bulky items – it won't work properly. 

The most difficult decision is when to use it.  It is quite startling to see a person bleeding – after 18 years in emergency and combat medicine, I'm still startled when I see copious amounts of blood.  But you have to assess the situation – is this life threatening bleeding?  I've been cut and have bled a mess all over my clothes and the floor – but it's not life threatening, just ugly and in need of stitches.  Arterial blood is the most common indicator of needing a tourniquet, as well as gunshot wounds and crushing injuries.  It's a judgment call – in the end, it's all based on the knowledge you've learned and practiced.

It's On – What Next?

In the TCCC course, once a tourniquet is applied and the bleeding is stopped, that is all that you should do until the danger is over.  Once this is done, and you are certain that it's safe, the tourniquet can be addressed.  Once you've identified the fact that you are safe, you can proceed.  However, if a tourniquet is applied, it should not be loosened to 'let the blood flow'.  This will cause more blood loss and will dislodge any blood clots that are established; it will allow more poisonous materials into the bloodstream, leading to infection.  You should not remove the tourniquet - you have to get your casualty to 'definitive medical care' – a doctor or other medical personnel capable of doing surgical interventions.  You should not remove the tourniquet if the limb was 'traumatically amputated' (blown into hamburger).  If your casualty is in shock, Do not remove it! They are already battling the effects of blood loss, more will make it worse.  Instead, use your medical training to treat for shock, and get them to whatever advanced medical care you can reach.

In Conclusion

The tourniquet has come quite a way from it's origins in Roman times.  It is saving multiple lives every day since it's new birth into combat medicine.   They are light weight, easily purchased, go into any first aid kit, easy to use - and it could save your life or the lives of your loved ones in an emergency as well.

Jim,
I would like to let your readers know that there is an opportunity for them to get free medical training in there community, I have just done this and am working on going further. I joined a volunteer fire department (VFD). No, not everyone has to fight fires, in our department only 10% do. In my area we have a mandatory three hours per month that we have to be at the station and [respond to] any calls that come up. So out of this we all get free EMT training and they actually pay us to go do this, there are also different types of training that we can also take but for me this is the best we can go all the way to EMT paramedic. Try that in college, [paying for your own tuition]. In addition to the training you will meet some of the nicest people ever, so check it out it might be a good way for you to get some great training. And sometimes you even get to drive a big red fire truck. Best Regards, - ElectroMech

James:
First, thanks for the blog useful information is so hard to come by nowadays. With regards to alcohol I would add a few bits

First, Everclear 190 is a great addition it any backpack or bail out bag, This wonder bottle has a subject all its own. If for barter purpose you choose booze there is a bit of an OPSEC point to make. Trading liquor has risks especially if you are dealing with someone who may be looking for a lucrative target. Trading a sealed bottle of bourbon or even worse taking said bottle from a visible case can leave the impression of plenty which is simply dangerous in TEOTWAWKI. If you have liquor on hand to trade it will be important to disguise it so that you do not appear “rich” [in tangible goods]. Personally, I am not going to place a lot of faith in liquor jumping in value there are a lot of things I do use that I will need to stock up on (namely, the three Bs--Beans, Bullets, and Band-Aids). But if I were to invest in liquor I would go with no more than a case of pints of a popular brand (Jack Daniels or Jim Beam come to mind) and when it came to trading I wouldn’t bring new sealed bottles, instead I would use a small amount out of one bottle (say for a cake or sauce) and use the now not quite full bottle to trade. So now I am trading something that looks like my last bottle.( This can apply to anything being used for trade.)

Appearing like you have little, but that little will be very is hard to take can mean the difference between having a robber problem or not. - Stephen from Idaho

JWR Replies: Thanks for those important barter OPSEC tips. As I've mentioned before in the blog, in addition to storing denatured alcohol for external use (and as a fuel), high grade medicinal ethyl alcohol (sans denaturants, such as Everclear) is important to keep on hand, for creating your own herbal infusions and decoctions. These are described in detail in the book The Complete Medicinal Herbal, by Penelope Ody. (This was one of the late Memsahib's favorite books.)

In 1940, Reserve Constable Albert Alexander scratched his face.  Accounts differ on whether this occurred while shaving, or an encounter with a rose bush.  In either case, the Constable had a minor scratch  which became infected. What makes Constable Alexander’s story notable, is that his was the first wound infection treated with the then-new antibiotic, penicillin.

It almost worked. 

When first treated, Constable Alexander improved dramatically, but the hand-purified supply of antibiotic available ran out before the infection was eliminated. The infection returned, and he died from the combined staph and strep infection of the wound.  Welcome to the reality of wound care without antibiotics.  A minor scratch can kill you.

With TEOTWAWKI, we would rapidly re-enter the pre-antibiotic era.    So what are we to do with the routine nicks and scratches, let alone, major wounds? The simple answer is that primary wound care, with an emphasis on preventing infection becomes paramount to avoiding the fate of Constable Alexander.  Non-antibiotic antiseptics – such as Betadine® -- should be a part of your kit and routine practice. Note that Betadine® is the registered trademark of Purdue Products for their povidone-iodine products – I’ll use the term Betadine® in this article, but the discussion below applies to any 10% povidone-iodine solution.

First, get yourself some basic first-aid training.  I teach first-aid, CPR and Wilderness First Aid (WFA), and strongly suggest seeking out a WFA course as your basic first-aid training.  Standard “urban” first-aid assumes that your victim will have advanced medical care – a hospital – within an hour or so of an incident.  WFA assumes that advanced care is delayed – perhaps for days.  Providers of WFA training include Stonehearth Open Learning Opportunities (SOLO), National Outdoor Leadership School (NOLS), some chapters of the American Red Cross, and others.  A good basic course should have at least sixteen hours of instruction – this is not a one-afternoon class.

Second, get some reference materials for your bookshelf.  My favorite WFA references are NOLS Wilderness First Aid (NOLS Library), Wilderness Medicine, Beyond First Aid, by William Forgey, and Wilderness First Responder, by Buck Tilton.  These are not tiny “reminder” [or checklist] pamphlets for your kit, but serious texts to be read and practiced in advance of an injury.  Practice and drill in first-aid is as essential as in marksmanship.

Finally, lets look at primary wound care.  Where you start depends on the wound.  In the case of severe bleeding, you must first control the bleeding.  I won’t attempt to teach first-aid by typing, but applying a gauze or cloth to the wound to aid clotting, along with direct pressure, elevation and pressure-points are in order. If required, a tourniquet can control severe bleeding in an extremity.   Always pay attention to the ABC’s of life first: Airway, Breathing, and Circulation.

With bleeding controlled (and the rest of the ABCs addressed)  you need to pay attention to cleaning the wound and controlling infection.  If you don’t, as William Forgey points out in Wilderness Medicine,, Beyond First Aid, your patient will still die from infection, but it will take longer and be more painful than bleeding to death.  And remember, cleaning and caring for a wound applies to any wound, not just severe ones.  The good Constable died from an infected scratch!

Cleaning minor wounds:  Simple scratches and minor, shallow cuts can be simply cleaned with soap and water followed by a daub of Betadine®.  Do this as soon as possible after the injury.  If you are away from soap and water, at least apply the Betadine®, and let it dry on the wound.  I’ve used this simple treatment in my home for nearly twenty years and avoided the need for follow-up antibiotic ointment, let alone oral antibiotics.

Larger wounds and abrasions:  The best technique for deep or heavily contaminated wounds is take a hint from hospital ERs, and use irrigation.  You probably won’t have sterile saline handy, but a dilute 1:10 solution of Betadine® in clean drinking water serves quite well – you’ll need at least a quart for most wounds. The best irrigation device is a simple no-needle syringe.  In my pocket first-aid kit, I carry a 10cc oral medication syringe (available at any drug store).  In my larger first-aid kits, I carry a 90 cc “flavor injector” plastic syringe (from Bed, Bath and Beyond).  In a pinch, a plastic bag with a pinhole will do. 

Flush the easily removed dirt and blood from the wound, inspecting closely for particles of embedded debris.  If there had been severe bleeding, gently remove the clotted dressing with irrigation, being ready to staunch bleeding again. Using tweezers or a gauze pad, remove embedded bits of dirt and flush again.   Using a sharp, sterile blade or scissors, trim  and remove disconnected strips of dead flesh – they’ll only serve as a focus for infection.   Repeat the process of irrigation, inspection and irrigation until the wound is clean.  Gently scrub with the gauze pad if you have to, always toward the outside of the wound.  Did I mention that this would hurt, a lot?

If the wound is completely clean, you can consider closing it, but you increase the risk of serious infection if you do.  I’ve closed wounds in the field without infection, but they have been “clean” uncomplicated wounds.  I’d recommend 3M Steri-Strips for closing uncomplicated wounds, unless you’ve have the materials and practice needed for suturing.  This is also the time to use some of your limited stock of antibiotic ointment on a sterile dressing (or dampen the dressing with diluted Betadine®.  Infection in a closed wound is a major problem.

If you are unsure if the wound is clean, then pack it open with non-stick sterile dressings dampened with diluted Betadine® and let it heal “open”.  Yes, the scar will be nasty, but that is cosmetic, not functional, and you reduce the risk of  an infected, abscessed wound.  Change the dressing twice daily, and if signs of infection arise (the wound is hot, reddened,  tender, swollen, oozes foul pus, or a fever is present), then irrigate again, and apply antibiotic ointment to the dressing.

If you know the wound is still contaminated, then pack the wound with gauze dampened with the diluted Betadine® solution, and let it partially dry before removing.  Clotted blood, some of the dirt and dead skin will lift off with the gauze (again, this will hurt).  Irrigate the wound, and repeat the wet-to-dry dressing process until the wound is clean, then pack open as above, monitoring for an infection.

A hint for monitoring infection:  A normally healing wound is often red, slightly swollen and a little tender, so how do you tell when you have a serious infection?  Starting with the first dressing change, gently mark the margin of the red/swollen area with a pen.  If the area is getting larger the next day, then you likely are dealing with infection and need to consider irrigation and antibiotics, if available.  Even severely infected wounds can heal, so be sure to treat the whole patient, not just the wound:  sufficient fluid intake and easily digested foods are important during long term care.

So, why Betadine?

1. It kills everything.  Viruses, gram negative and gram positive bacteria, fungi and even protozoa.  Even iodine-resistant organisms such as cryptosporidium go down with enough contact time.
2. It is versatile:   You can use is as a surgical skin prep, a simple topical antiseptic for scratches and abrasions, diluted as an irrigation solution for severe wounds,  a dental irrigant following tooth extraction, and even as a water purification agent for lake or stream water (8 drops per quart of clear water, with a contact time of 30 minutes at room temperature).
3. It stores well, unlike most antibiotics.  The manufacture’s published shelf-life is three years at room temperature: in practice, Betadine lasts much longer. The bottle in my medicine cabinet “expired” in 2007, but it is still effective. So long as free iodine is released, the antiseptic qualities of Betadine® remain.  This is easily tested by mixing a drop or two of Betadine with a paste of flour and water:  if the mixture turns deep purple or blue-black, then free iodine is present, and the Betadine® is still effective as an antiseptic.
4. It is cheap.  A gallon of Betadine® sells on-line for less than $50, and an 8 oz bottle for about $5.  Unless you plan to do daily surgeries at home, skip the gallon bottles and buy multiple small bottles that can be unsealed one at a time – this will reduce the chances of contamination and potentially increase shelf life.   The hard to find  one-ounce bottles are great for pocket kits.
5. It is safe.  Allergic reactions to iodine or Betadine® are rare, and typically no worse than a minor skin rash.  The irritant effects can be avoided by ensuring that Betadine doesn’t dry on tender skin, especially in skin folds such as the inside of the thigh or elbow. 

Disclaimer:  The author is not a physician.  He is an avid outdoorsman and wilderness first aid instructor.

Hello,
Here is a "barter material" idea your many readers may find of interest. I am located in Kansas City and, after telling friends who are also into "survival" my idea it caught on such that one liquor store here is suddenly the largest reseller of this liquor in North America.

I have friends who, for their store of barter items, have stockpiled extra food, ammunition, guns and other items people would want in a breakdown of society. But they are all items that may only have a storage life of a few years, takes up a lot of room or are items you can't have enough of (i.e. food).

After writing down all of the "musts" the answer suddenly came to me - liquor. The "musts" are (1) a shelf life of 10+ years, (2) relatively compact, (3) easily broken down into individual items that would not be expensive and, as a plus, it would probably go up in value. And, most important, something that you would not need to survive: Liquor. My cousin owns a liquor store and he suggested Luksusowa Polish vodka. [Wódka Luksusowa. or "Luxury Vodka".] Airline size bottles come 120 to a case. Liquor might even go up more in value than gold in a TEOTWAWKI situation. A cloth bag of 50, or
so, of these bottles can easy be carried around. Try to get change using a one ounce gold coin after buying bread and milk from the back of a truck! Good luck! And worry about others seeing you have one gold coin so you must have more at home. You put yourself at great danger.

Why Luksusowa vodka? It's half the price of any other vodka and tastes just as good (I'm told). They are selling cheap in the United States trying to use price to build a market. They are a small company so they don't have the money for advertising. Liquor stores may carry as much as a case but any liquor store in a major city can order as much as you want having it for you within 48 hours. I bought 50 mil airline size bottles for 90 cents each. The bottles are thick glass that could probably be dropped on anything short of concrete and not break. And well sealed so shelf life is probably at least 20 years.

I'm guessing people will not care what brand of vodka you have to barter. They also come in two larger sizes. My cousin gave me a special price but buy enough cases and you can probably get it for close to 90 cents a bottle. So instead of a room filled with canned goods having to rotate them to beat the average one or two year date code on each can or trade away items they
really need as much as possible of (like food and ammunition). So I have a floor space in my basement of about a yard square of cases piled to the ceiling that is all the barter material I should ever need. Not a room full of much more fragile items with shorter shelf live and might not go up in value. Personally, I can't think of anyone that will be in demand in such situations other than ammunition and food. One caveat - anyone who has anyone in their group who has ever had a problem with liquor consumption should not do that. Personally, I don't drink due to an illness (Lyme disease) that makes liquor taste like acid to me. I never drank much before contracting Lyme disease.

I hope this idea is of interest to your many readers. I know every person I've mentioned this idea to has quickly loaded up on ten to a hundred cases of Luksusowa small airline size bottles. Best Regards, - Gary Y.

JWR Replies: I'm not much a drinker--I'm a "one beer a year" type--so I don't feel qualified to comment on storing particular types of sipping barterable. Also, after seeing alcoholism ruin so many lives, and wrecking so many families, I have chosen not to store anything more than a few bottles of Everclear. And I consider that supply multi-purpose: for medicinal/sterilizing use, for making tinctures, and for emergency fuel. It is too strong for sipping, but I suppose that it could be used very heavily diluted in mixed drinks. As I mention in the "Rawles Gets You Ready" family preparedness course, there are two varieties of Everclear sold: 151 Proof and 190 Proof. The latter (which is 95% alcohol), is the most versatile for preparedness. Everclear is not legal in all states, with the most common restrictions on the 190 Proof variety.

Dear Sir,

I was perusing your blog for the first time and saw the post about dehydration due to diarrhea. I have five sisters and one brother (yeah mom!) so my mother is quite the home medic. My eldest sister had been prescribed a very strong antibiotic for a common infection she had. After she took the course of the antibiotic, she also began having severe chronic diarrhea (we're talking months here).
She began going to a specialist after her regular doctor couldn't diagnose her. My mother, conscious of her medical history, realized the antibiotic she had taken for her other ailment had killed all the good bacteria in her intestines which help make it possible for food to be digested and absorbed into her body. She had my sister tell her new GI specialist and the doctor confirmed as much.

My mother also told her that she had to eat Goat yogurt with live bacteria in it to get the bugs back. She had to eat yogurt and banana (which is nutritious and also is a "binder") for 80 days. She couldn't vary from her diet. If she tried to eat anything beyond her bland diet, she found out real fast that it was a mistake.

The GI team was going to put her on a much fancier drug for a much longer period of time with far more life impacting side effects.
My sister started taking the drug (I don't know what it was) and didn't have much relief. Out of desperation she started eating the goat yogurt and felt immediate relief in her bowels. Yeah mom, again!
I vote for the yogurt! My mom learned about the yogurt method from a female doctor in Saudi Arabia who had to help travelers when they drank the water and all the bugs got killed in their systems. She didn't prescribe medicine, she had them eat yogurt and banana for 80 days.

I just finished reading "Patriots," I greatly enjoyed it, found it inspiring, and can't wait to talk about it with the friend who lent it to me. I was glad they had goats in the book, so they can make goat yogurt! May God bless and protect your ministry! - Hilary C.

Mr R.,
First, my condolences on the loss of Mrs. Rawles. One of your contributors mentioned using non-nutritive sweeteners in rehydration solutions. That is an absolute No - No! Non-nutritive sweeteners are not absorbed. They increase the solute load in the gut, will elicit GI mucosa fluid dump to maintain isotonicity . Translation to plain speak: the gut will maintain - or attempt to maintain - the same ration of solvent and solute. Nutrasweet isn't absorbed, and the gut lining will dump fluid into the system to maintain ideal balance. Net Result? Diarrhea. This will occur in healthy, uncompromised individuals, let alone those with lower GI distress. Gum chewers who load up with Xylitol and sorbitol-laden gums experience this in a low grade way. In an emergency medicine situation, with absolute requirements to maintain fluid and electrolyte levels, it's potentially fatal.

One quart of verified safe water (boiled or treated as necessary) with a couple tablespoons of sugar or Karo syrup (for better mix ability) and 1/4 teaspoon of salt and baking soda, sipped by spoonfuls works very well. Slowly sipping approximates the rate achieved via IV line, and prevents "overburdening" an already inflamed intestinal wall. You maintain fluid, Na+, HCO3- , glucose levels and body function while immune response and other measures come to bear. - Murray P.

JWR Replies: Thank you for mentioning that. While I'm not a proponent of the extensive use of refined sugar in a regular diet, it is certainly preferable for prophylactic use in oral rehydration solutions versus using artificial sweeteners. In my opinion, it is likely that in another 20 or 30 years, following extensive testing and correlative statistical analysis, some artificial sweeteners will have been proved to have profound deleterious health effects, and hence they will eventually be banned. I predict that they'll have a reputation on the par of that currently held by Red Dye #2.

For details on do-it-yourself oral rehydration solutions, see the "Rawles Gets You Ready" preparedness course.

Jim,
During my many travels in Asia and Central America I never brought along medications to stop diarrhea, only to prevent it. Diarrhea is natures way of getting rid of something your body doesn't want in it. Preventing that can lead to serious problems. Water and food born bugs (bacteria, not parasites) can be dealt with by taking Doxycycline Hyclate as a prophylactic.
Prior to the likely encountering of suspect food and water, such as a bug out situation, a pill a day will keep you reasonably safe. You should be able to talk your doctor into proscribing for emergency use only or you can pick them up over the counter in any Third World country.
I also take along Keflex in case of wound infections. Google has a wealth of info on these and other medications if you can't find a doctor willing to advise on TEOTWAWKI situations. - LRM in Perth, Western Australia

Sir:
My mother was recently hospitalized and learned the hard way. She had taken some antibiotics to fend off an infection. Antibiotics kill off the bacteria in our intestines (the good and bad kind). In her case, it killed off a larger portion of the good bacteria which led to an imbalance. The bad bacteria began to thrive. The diarrhea she had would've helped get rid of the build up of that bad bacteria. However, she took an anti- diarrhea

When the bad bacteria builds up like that and your body can't get rid of it, the bad bacteria begins to poison you (as it did her). She couldn't eat or drink anything without throwing up because her stomach was no longer in a condition to absorb any water or nutrients. She suffered from severe dehydration and malnutrition.

Her condition [Clostridium difficile] is commonly referred to as "C-Diff". She was in the hospital for a week and a half and is slowly recovering now.

So, if you get diarrhea after taking antibiotics, it may be best to just let nature "run" its course. Just be sure to drink lots of fluids. - Daron in San Diego, California

Jim,
You recently posted a letter from a reader inquiring about oral rehydration solution. I have chosen to stock up on oral rehydration salts instead of pre-mixed solutions such as Pedialyte.

The salts are packaged in little foil sachets. When mixed with water, each sachet produces one liter of oral rehydration solution. They can be purchased in bulk from a company called Jianis Brothers either by the carton (125 sachets) or by the case (5 cartons = 625 sachets). I don't recall how much I paid but I believe the unit price was around 50 or 60 cents per sachet - much less expensive than Pedialyte.

The sachets are convenient, compact and durable and I believe they would make a great little barter item if the need should ever arise.

The web site of The Rehydration Project contains a wealth of information on dehydration due to illness as well as treatment using oral rehydration therapy: Contact information for Jianis Brothers is also available on the same site. Sincerely, - Michael in California

Dear Mr. Rawles,
In reference to the recently-posted question/answer concerning anti-diarrheals, I have just a couple of comments from a pharmacist's perspective.

1. As the poster mentioned, loperamide (aka, Imodium) is available over-the-counter (without a prescription) in the same strength as the old prescription product. This effective anti-diarrheal is not considered an opioid, and does not appear on the DEA's Controlled Substance list, as does diphenoxylate/atropine (aka Lomotil - Schedule V). Be aware that individual states can add drugs to their own controlled substance list, but I don't know of any that have done so with loperamide. The dosing depends on recurrence of diarrhea episodes, but take no more than 8 tablets (16mg) per 24 hours period.

2. The bismuth subsalicylate-containing anti-diarrheals, such as Pepto-Bismol and Kaopectate and their generics, contain an active ingredient similar to aspirin, and in quantity, can have a similar effect on bleeding (inhibits platelet function). Therefore, be sure to stay under the daily maximum dosage of 8 30ml (1oz.) doses. Also, if you have any ongoing bleeding problem, such as active gastric ulcers, shy away from these products.

Thank you for all you do! Best Wishes, - S.H. in Georgia

Sir,
The most effective anti-diarrheal medications are usually sulfa drugs.

In my travels there have been times when I have lost 20 lbs. in a few days time due to the effects of diarrhea. I've had it so bad that the Air Force took a C-141 out of service to decontaminate it.

And my travels started when I was three years old (42 years ago now) so I have lots of practice in dealing with this issue. Outside of the US and Western Europe you have to assume that the water supply is contaminated and you will come down with something at some point. I've reached the point where I routinely add purification tablets to even bottled water in some countries.

First and foremost, if diarrhea is not caused by a virus then usually it is caused by a bacterial bloom in the body. When you travel from one area to another the normal flora and fauna in the body change to match what is local to the environment. As a result the balance of the flora and fauna in the body gets out of whack and you end up with the common traveler's diarrhea. If you have not drunk/eaten food in your home environment that was not processed/packaged/etc. etc. then you can get the same effect the first time you eat natural foods (farmer's market ...). A low dose of a sulfa drug usually is enough to take care of this problem. (Sulfa drugs are usually over the counter in most countries outside of the US.) In the US the doctor will normally prescribe Ciprofloxacin. Living and working in Turkey I learned to say "Streptomagma var mu?" or "Do you have Streptomagma (a sulfa drug)" -- and the same phrase will work across the near east (from Turkey through Afghanistan).

One of the tips/tricks that I have picked up over the years is to eat yogurt or other foods that contain live bacteria and/or drink a shot or two of hard alcohol. This helps stave off but does not 100% prevent diarrhea. But it is critical to continue to eat yogurts once you are treating the diarrhea symptoms with medicines as it helps to re-balance the flora in your body and prevent a second round of problems.

For viral infections (or protozoa) you just have to suffer unless you can get your hands on prescription only drugs. Nitroimidazoles seem to have the best effect on Giardia but when I've taken them in the past (seven Giardia infections to date) they are rough on the body. Hence oral rehydration is probably the best route unless you have a severe case of it. Amoebic dysentery is also common in many parts of the world -- and is almost untreatable and you have to suffer with it for years after your initial infection. Again oral rehydration (and having a wee bit more than 7% body fat) helps the most.

One of the better oral rehydration products out there is Ceralyte. Gatorade and other sports drinks usually are too much sugar and the wrong types of salts for long term oral rehydration (such as during an attack of Giardia which I have now had several times). You will also find Crystal Lite (and the store brand generic equivalents) makes a sugar free rehydration mix. My preference for these two routes comes down to portability and long storage life. (I mentioned that I carry several packets of rehydration powder with me in my travel kit.) I also lean towards using the Crystal Lite mix as I have a tendency at my age to pack on pounds even with a vigorous workout schedule.

The other tip to add? Always carry toilet paper with you. It is horrible to have dysentery in a country like Indonesia where the public toilets (even in office buildings) don't have toilet paper and you are using leaves and newspapers in a vain attempt to clean up afterwards. - Hugh

Hi,
I read the recent post about dealing with diarrhea, and while I have made sure we have some OTC pills such as Imodium stored, I have also stocked up on dried Blackberry Leaf and made tinctures. It works extremely well in ending diarrhea, our family has had the chance to use it a few times over the years and it does indeed work. My darling husband says it tastes kinda 'woodsy', and I admit is is not the best flavor, but it certainly works. Just a teaspoon at first and maybe another teaspoon if there is another 'episode', but we have found that one teaspoon usually does the job the majority of the time, only a few times have we had to use a second dose. It can also be put in water or juice and taken that way.

I just wanted to pass this on. Dried blackberry leaf can be found at any online herbal store like www.MountainRoseHerbs.com [in Oregon] and a one pound bag is very inexpensive, around $8. Id suggest that interested people buy two bags and tincture them up right away with any 80 proof vodka to have it on hand when needed. Though it can be made into a tea or decoction, I prefer to tincture for long term storage.

All the best to you and yours and God Bless. - Karen F. in Colorado

Sir:
My recent trip to the library and skimming through a few books on diseases led me to the conclusion that some of the secondary or follow-on effects are often bigger killers that the diseases themselves. I'm talking about pneumonia and diarrhea. Respiratory bugs often develop co-infections like pneumonia. And stomach bugs often cause diarrhea, which can cause such severe dehydration, that the patient dies. Obviously, [some forms of] pneumonia can be avoided by getting a pneumovax innoculation. So how do we deal with diarrhea? It can be controlled with over the counter (OTC) medicines. According to FamiliyDoctor.org, some of the best available OTC meds include loperamide (such as Imodium) and bismuth subsalicylate (such as Kaopectate and Pepto-Bismol).

My questions to you are: what about prescription antidiarrheals? And what should I store for re-hydration? Thanks for your great blog and books. The number of lives that you will save, by encouraging people to get really and truly prepared will go beyond counting! Sincerely, - H.F.I. in St. Louis

JWR Replies: OTC antidiarrheals are usual sufficient in all but the most severe cases. Most of the prescription antidiarrheals are opium-based so they are on the controlled list. As my late wife learned in the last few weeks of her life, heavy opium-based pain medicines slow down the gastrointestinal tract dramatically. (And in fact, many pain patients have to take stool softeners like colase and laxatives like docusate and senna, to keep their bowels moving.) Because of their scheduled drug legal status, it would be almost impossible to get opium-based drugs by prescription from your friendly local doctor to keep on hand for contingencies. However, some of opium-derived meds to keep in mind for disaster situations include diphenoxylate (with atropine) and the industrial strength version loperamide (a synthetic opioid). Because of their side effects, and obviously because some of them are addicting, these meds are reserved for only the most severe cases of diarrhea

As you noted, and has been previously discussed in SurvivalBlog Oral Rehydration Solutions (ORSes) are very important to keep on hand. Every family should storing a few bottles of Pedialyte (or better yet, one of its many commercial equivalents, which are identically-formulated and often self for about 40% less). It is vitally important to know how to make your own ORSes. This is described in detail in the "Rawles Gets You Ready" family preparedness course.

Hello James,
Regarding wound irrigation, wound preps, surgical site prep, etc., folks would do well to purchase a gallon each of Betadine, Povidone, or other generic tamed iodine, in both the scrub and solution formulations. These are not terribly expensive and one likely could talk his/her Veterinarian into getting some for them, as they are not controlled substances. [JWR Adds: They are also available in the vet supply department at some of the larger feed stores, and via mail order and Internet vet supply companies like Jeffers.] These are concentrates and can be diluted, and used on wounds if the patient has no iodine allergies. Sincerely, - Mike M., DVM

Jim,
The key to stopping a wound infection is to change the physical characteristics of the wound to make it hard for the bacteria to live. Most bacteria are very specialized and sometimes something as simple as oxygen will kill them dead. Irrigation is a great help too, it gets rid of a large numbers of bacteria and the pure water causes bacteria to swell up and pop. You can also change the pH of the wound, or the salinity.

Wound care in the Third World is almost always a problem. It seems that you never have all the supplies you need. Antibiotics and even antiseptics are scarce.

One of the key pieces of kit used by some NGOs in Africa is something called "sugardine". It's just plain old table sugar, mixed with a mild solution of iodine. Either one works pretty well, but for a raging infection, plain old table sugar (granulated sugar or sucrose), will cause bacteria to dehydrate. Your body will respond by oozing liquid into the wound, which also helps dislodge bacteria. The normal way of using it in Africa is to unwrap the wound, irrigate it with clean water and then pack it full of sugar and re-wrap it loosely. (Don't worry too much about dry dressings. It's going to ooze quite copiously.) After a couple of hours, you can open it back up and irrigate it again and let it air out with loose, cry bandages until the next sugar treatment.

Repack the wound with sugar twice a day and the results are amazing. - Jon

TEOTWAWKI will result in a lot of wounds, including not just lacerations but scrapes and burns as well.  These will happen regardless of if the injury is the result of a disaster or if post-crash efforts lead to injury.  This is bad enough, but you could be in even more trouble if infection sets into one of these wounds. 

A lot of preparedness/survival-types focus on suturing, including having access to suture material and instruments to allow for laceration repair. While this is all well and good, you shouldn't focus too much on actual wound repair without first being sure that you can provide wound closure with minimal risk for infection. Additionally, abrasions and burns are also at risk for infection and will benefit from good cleaning.

For any wound, infection prevention after injury consists of “irrigation” because as the poison control folks say: when it comes to pollution, dilution is the solution!  Irrigation not only aids in prevention of infection, but also increases the chances of a wound healing without too much pain, functional impact or cosmetic disfigurement.

What should you use to irrigate wounds? In most health-care settings, sterile solutions such as saline are used. Under the best of circumstances, these are expensive. After the Schumer hits the fan, they will probably be in very short supply. If you have access to stored saline, you are in good shape, but what happens if it has run out or you don’t have any?  Lucky for us, there are alternatives.
One “solution” is to make saline with water treated with bleach.  Clean contact lens solution, bottled water or tap water can be treated with household bleach, resulting in a solution that is sterile and non-toxic. The residual bleach may actually have bacteria killing effects as well.  Simply add a tablespoon of table salt to each gallon of clean water to make a suitable solution for wound irrigation. 

There are even options if the grid is down and we can’t rely on delivery of clean water, either from a tap or in a bottle.  Military doctors in one study took surface water from lakes, ponds and creeks. The water was “non-turbid”, so you may need to let it settle and/or filter it.  Next, they treated it with 1 teaspoon (or 5 mL) of common household bleach in each liter of water. This killed 99% of the bacteria in the samples, and even the 1% left was thought to be contamination from the air picked up during testing. Their technique gives us a field-expedient method for obtaining water suitable for irrigation of wounds.
You can also purchase distilled water in advance, store it at room temperature, and make your own irrigation fluid later simply by adding salt (a tablespoon, again) to each gallon.  When stored in a refrigerator at or below 48°, home-made solutions like this were sterile at least 3 weeks after they were made. Theoretically, using sterile (bleach-treated) water derived from the sources above could even be used in place of distilled water as well.  Thus you can replace expensive or unavailable sterile saline without buying it from your pharmacy. Researchers used this fluid safely as peritoneal (abdominal) dialysis fluid as well. 

You don’t need to worry about adding antibiotic to the irrigation solution either.  A physician from the University of Missouri showed that patients with compound fractures of their legs did better if they were treated with irrigation solutions made from non-sterile tap water and Castile Soap rather than water containing bacitracin, a common antibiotic.  Researchers from SUNY-Buffalo also showed that straight tap water was just as effective as sterile saline irrigation in preventing infections in lacerations closed in their emergency room. [JWR Adds: Castile soap is multi-purpose, and a has a long shelf life. Stock up. watch for it a discount stores, or find discount Internet vendors. Dr. Bronner's Peppermint Castile soap is a standby, here ate the ranch.]

Once you have your solution prepared, you need to use it to wash the wound. In general, burns and abrasions should be washed until they're free of visible dirt. Lacerations, on the other hand, may need a little bit more work: It’s best to irrigate them through a syringe and intravenous catheter or needle such that you get good pressure, in order to the blast germs out of the wound. The textbook standard is 50 mL per centimeter of length; this converts to about 4 ounces for each inch long the wound is (not how deep it is.)  Obviously, if the wound was grossly contaminated, you need to make sure to rinse it under pressure (ideally with pulsatile flow like from a WaterPik) until the wound is clean, with no foreign bodies left behind. Only then should you think about suturing a wound closed. [JWR Adds: Wound drainage is subject unto itself. My general advice, based on that reiterated by several experienced trauma doctors that have contributed to SurvivalBlog is to delay wound closure for an extended period, and even then a drainage tube should be left in place, even longer.]

If you don’t have a suitable syringe and catheter set-up for irrigation, one austere alternative is the ubiquitous 2 liter soda bottle; just be sure to clean it well beforehand, and don’t use one that held anything besides drinks!  Next, drill two small (1/16th inch, for example) about 1/8th inch apart in the lid.  Put your solution in the bottle and then cap it tightly with your modified.  Now, simply squeeze the bottle while sweeping the stream across the wound.  Keep in mind that if you don’t know the person is free of disease that you must use personal protective equipment to protect you from body fluids.
Finally, in a severe pinch, remember that we all have our own supply of sterile saline with us:  yes, I am talking about urine.  Dr. Gene Lam, then a Battalion Surgeon in the US Army, was held captive by North Korea.  He describes many ingenious and heroic medical improvisations, including use of urine to rinse off burns and other wounds.  Just be sure that the person “donating” the urine has no pain or burning on urination, cloudy or bloody urine, or other signs of bladder/kidney/urinary infection.  Place it in your irrigation container and use it immediately as well. 

All of the aforementioned techniques are only for a truly Schumeresque situation!  If you have access to the usual care systems, that is the way to go.  Otherwise, if you must provide your own wound care, the cornerstone of good care is meticulous wound preparation with copious irrigation. When you’re in the Schumer, making your own irrigation fluid will work in place of commercially made irrigation solutions and gives a lot of advantages in the fight against infected wounds.

Dear Mr. Rawles,

Greetings! I saw a blog letter mentioning FSA (Flexible Spending Accounts)-one medical plan that helps the average person. Basically, one’s employer (private, public, etc.) has some amount taken out before taxes and this money is put into a plan with a pre-set amount that must be used by the end of the plan year.

Okay, what many people do not know is that IRS laws allow the following:

Once the plan is started, the full year's funds are present, even if you have not had that total amount saved up yet. Example: I set the plan to $1,000, and at the start of my plan $20 is taken each paycheck (50 weeks). But, I can start applying the plan immediately for the full $1,000. These funds are used to reimburse co-pays, over the counter drugs, reading glasses, or other prescription and generic [medication] costs.

Here are two important points I found out last summer:

First, the medical supplies reimbursed for by this plan include medical supplies, including Quik-Clot, Celox, (Yep! Even the Quik-clot for nose bleeds). Other first aid supplies (usually not found in the local drug store-but commonly found in survival catalogs) are covered (check with the FSA firm handling the reimbursements first!).

I got lots of Band-Aids, Celox, and Quik-clot this summer.

Oh yes, my former employer admitted (yes, I called both the FSA company and my employer at city hall to confirm), that due to IRS laws, a person can access the entire amount for that year, get reimbursed for all of it, and leave employment before the completion of employee payments are made-and no refund is required from the employee by either the former employer or the FSA company! This may prove useful for many people who have these plans and think that TEOTWAWKI is coming soon. [JWR Adds: But purchasing supplies without the intent to fully fund a FSA would be unconscionable.]

Also, real survival medical supplies can be obtained (again, check with the FSA first!) with the plan covering the expenses. (From your pre-tax dollars, of course!).

Food for thought. - L.F. R.

Hi James,
First let me thank you for your wonderful blog, which I read every day. This is just a reminder that fall is typically Open Enrollment at many large and small companies for next year's benefits elections. My company's three week window to sign up for 2010 benefits opened yesterday. This is the time when a person can choose to participate in a ["before tax"] Flexible Spending Plan. While some people are justifiably nervous putting money away in a, "use it or lose it," program, the I.R.S. made the decision a lot easier a few years ago when it allowed Flexible Spending Plan funds to be used for over the counter medications. Even if you are blessed with perfect health and never see a doctor all year, the Flexible Spending Plan is great way to put some money away to stock up on your "Band-Aids," tax free!

My prayer for you and your family is that you have happy memories without pain in the shortest amount of time possible. - D.

JWR Replies: Thanks for that suggestion. One proviso for readers: Be sure to to mark your calendar for a date two weeks in advance of the spending deadline!

JWR,

Regarding Eye Surgery: I am an optometrist. Unfortunately some of what was most recently posted is misleading if not flat-out wrong.

1. Laser Vision Correction (LVC) will not make you more prone to problems with your near vision. However, if (a) you are nearsighted before the surgery (and thus able to see up close without correction), and (b) you are over age 42 or so, then you will struggle with your near vision. Prior to the surgery, of course, you can see fine up close if you remove your glasses or if you have bifocals. But the LVC does nothing to make this problem worse; it simply corrects your distance vision. Of course all these points are moot if you are younger than age 42. But at around age 42 it will be a problem, so be aware of that.

2. Implantable Contact Lenses (ICLs) are very, very rarely an improvement over LVC. LVC sculpts the front portion of the eye, ICLs involve cutting the eye open and putting a synthetic lens into it. Contrary to the original poster, they are not “swapped out” at your whim, they can in fact correct farsightedness, and they do not have any different effect on your near vision than LVC. ICL’s are significantly more expensive and significantly more risk (of both post-operative infection and of cataract creation due to jostling of the natural lens in the eye) than LVC, which is why we do not recommend them often. Their greatest benefit is for those whose prescription is so high that LVC is not an option.

3. If you are really serious about refractive surgery, I strongly recommend PRK as opposed to Lasik. Both are forms of LVC, however the former is an operation that does not create a flap, while Lasik does create a flap. That flap can be dislodged in the future at any time.

4. Lastly, while I cannot fault many people for looking to the Internet for advice-—I do it too-—neither can I overemphasize the necessity of having an eye doctor who knows you go over the implications, benefits, and risks of refractive surgery with you. Last week I had a new patient who was 62 years old who had amblyopiia [commonly called "lazy eye"] in his right eye. No one had ever spoken with him about this condition or what caused it, even though he had it since he was a child. I explained it thoroughly to him, and he was impressed and thankful. I then smiled and said, “You’ve been going to the discount eye places, haven’t you?” He admitted he had been.

Fight the good fight, keep spreading the Gospel, - WPR

James,
You've had two good letters on woodstoves recently. I'd like to add a few thoughts based of heating and cooking with wood for a couple of decades in the Colorado mountains. I have never been more contented than when there's a blizzard raging outside and I'm inside next to a nice warm woodstove. That being said, woodstoves and chainsaws account for the vast majority of domestic emergencies in many rural areas and a constant source of amusement for EMTs.

As has been written, the importance of a properly installed chimney cannot overemphasized. Do get a quote for a good professionally installed chimney and then source the woodstove based on how much money you have left, not the other way around. A semi-okay chimney may not be a problem for years, but eventually that rafter up in the ceiling crawl space that's been getting too warm all those years will eventually cook off one cold winter night when the woodstove is nice and hot. Also get the chimney top nice and high and serviceable. Downdrafts will occur even if they are built to the 2'/10' rule if you have a higher addition near by and the wind is in the right direction. Smoke will also condense on the chimney top spark arrester and clog it up so figure out a way to brush that clean in a safe way. Best to do that as regular maintenance and not in the middle of the night when you find your chimney won't draw and the room is filling with smoke. Lightning will also find the chimney one day. Get a lightning rod installed before you're hit. Do attach a magnetic chimney pyrometer to the chimney. It will tell you how the stove is doing by just glancing at the meter and will also alert you if things are getting too hot. My house did survive my youthful learning curve, but only just. Hopefully, some of your readers will profit from my experiences.

One thing that hasn't been mentioned is the area around the stove. I've seen red hot coals from resinous pine fly through a small slot in the air intake and all the way across the room. You'll never get a good night sleep if you just have a small fireproof pad around your stove. Woodstoves and carpet don't mix well. If nothing else the dirt tracked in from carrying wood will drive the wife crazy. If you do have carpet, pull it up and put down tile or stone flooring. If you have a modern springy framed plywood floor, a couple of layers of 1/4" plywood glued and screwed in alternating directions to the existing ply will stiffen it enough for tile.

Also, the wall behind the stove is equally important. Unless you're several feet away from a framed wall do something like this:
Cover the wall behind the stove with fire stop drywall a couple of feet above the top of the stove (or chimney if it exits through the wall). Install a steel lintel at floor level using large bolts screwed into the studs. Leave an inch air gap between the lintel and drywall using spacers. Lay up a brick wall on the lintel and tile over that. The air gap behind the brick wall allows a cooling draft. The brick also provides a good source of thermal mass which leads to a final point.

There's nothing much worse than getting out of a warm bed in the morning to start up a cold, dead woodstove. The stove that I owned when I lived in Colorado was made of Soapstone by a company in Woodstock, Vermont. They aren't cheap to buy but they are worth ever cent they cost. Once that stone gets warm, it stays warm for hours, even if the stove runs out of wood. I used to load my stove in the evening with whatever wood I had, generally pine, aspen or even hem/fir framing offcuts, not oak or hickory by any means and yet that great little stove heated the entire second floor of my house and the stove was still toasty warm well into the next day. Although I had been told this, I still was amazed at how a small properly built stove could heat such a large space and still not cook me out of the room it was in.

I cannot recommend highly enough the use of thermal mass over cast iron in a stove. There are other manufacturers of soapstone woodstoves but if and when I move back to a cold climate, I'll be getting another Woodstock Soapstone Stove. Thanks again for the interesting blog. - LRM, Perth, Western Australia

In September, 2008, Hurricane Ike--a Category 4 hurricane--pounded the Gulf Coast of the southern US. Some coastal communities like Crystal Beach no longer really exist. Inland, life was severely disrupted. For those of us on the South Coast hurricanes are a frequent reality. We were quite well prepared, but used the disruptions and dislocations as a test and opportunity to tune up our preparations.

1. Be ready to help others and to accept help We didn't need much during Ike, but the power went out before a neighbor finished boarding up his house. My 1 KW inverter, hooked up to his idling truck provide the juice for a Skilsaw and a few lights; allowing him to finish. Usually it is skills and not "stuff" that helps others and yourself. Besides strengthening a neighborly friendship, the number of damaged houses was probably reduced by one.

2. Keep your stuff squared away.. I repaired a few generators during and after Ike. I observed that every one suffering from lack of use; i.e. gasoline that resembled turpentine in the carburetor. People were at a complete loss to understand this. My daugher-in-law owned one of the generators that I repaired. She ignored my admonition to change the dirty oil ASAP and then once every 50 hours. Early in the next week it [ran out of oil and] threw a rod. She was in the dark for another week. Just a $2.99 quart of oil would have saved discomfort, ruined food, etc.
 
My portable genset, loaned to my daughter, was ready to go;  fresh oil, filters, valves set, exercised, load tested. It started on the first try. I came to check it and change it's oil as soon as it was safe to travel. The first thing that I did was turn it so the exhaust faced away from the house! She had placed it so that the starter rope was in a convenient spot. At least she had, like I had asked, chained and locked it to a foundation pier.

After every hurricane Darwin gets a few through accidental carbon monoxide poisoning. Don't join them. If you have a generator, get a carbon monoxide detector in case the wind changes and wafts exhaust in your windows.

Our own [permanently-installed] genset uses natural gas (a tri-fuel generator) which in the majority of cases is superior and much cheaper to operate. Over the 11 days that we didn't have power it consumed $100 worth of natural gas. I estimate that an equivalent amount of gasoline would have cost more than $300. I stopped it every 75 hours for oil and filter. If your genset doesn't have an hour meter, then add one. There are some inexpensive self contained hour meters made for lawn equipment that work very well and require no hard wiring. It's really the only practical way to keep track of operating time, without which, intelligent maintenance is impossible.

I noticed that many generators, some still in the box, on Craigslist following Hurricane Ike at bargain basement prices. I recommended to a friend he latch onto one of these and purchase a dual-fuel gasoline/natural gas carburetor] kit. Ants can profit from short-sighted grasshoppers.

It goes without saying have all your vehicles filled up and serviced so they can be depended upon with out much attention. Pay particular attention to cooling systems, oil changes, tire pressures, belts and battery terminals.

Develop a pre-event SOP: When we hear of a hurricane in the Gulf, we pick up loose items like branches that can be thrown by high winds and cause damage (aviators call this rubbish FOD), trim trees, check prescriptions, recharge everything rechargeable, treat the swimming pool with "shock" chlorine, get all the laundry and dishes done, get all the trash out for pickup, take “before” pictures, etc., etc., etc.

3. Have backups for your backups. The portable generator above was our backup to the natural gas-fueled genset. Then an inverter and ups. After that is a 100 Watt solar array I've been tinkering with to provide power for security lighting,etc.

My daughter spent up to two hours a day foraging gas, mostly waiting in lines. She found out that the problem with gasoline-fuel generators is gasoline! It's expensive, in short supply (when it is needed most), and it takes gas to go and get gas! Needless to say I rounded up the parts and the portable is now a dual fuel machine. Had it been able to use natural gas then she could have stayed home and been one less person waiting in line. And the machine still retains the capability to burn gasoline!

Since gasoline became hard to come by (it was impossible to get for a week after Rita) but diesel fuel was plentiful we did any necessary traveling in my old diesel Mercedes (which is EMP proof, BTW).

One important word on generators: Treat yours like it is the last one you'll ever get. Try and get a good one, I prefer either a Honda or Briggs Vangard engine. My Vangard portable is approx 10 years old and absolutely dependable. The difference is methodical maintenance. Keep the manuals, and read 'em ! Keep the oil changed, keep a fresh spark plug, keep spare [oil, air, and fuel] filters. Most importantly run it under load once a month. Unless it's new, pull off the cowling and clean all the dirt and dust from fins on the cylinder jug. Closely examine the starter rope, the fuel lines, et cetera. Replace 'em if they ain't perfect.

If you get a permanently installed generator carefully consider installing a manual transfer switch and other upgrades. With the exception of automatic "exercising" fully automatic generators these add a layer of complication and cost.

Don't store gasoline in the machine other than enough for one periodic test run. Develop a ritual on test runs: such as every other payday, or the last Saturday in the month, to reduce it to a ritual. I run mine monthly whilst cutting the back yard lawn. (The mower makes more noise.)

For storage between test runs: On portable gensets [with the ignition off, slowly ] pull the cord until you can feel that the engine is at the top of the compression stroke. This is where the engine feels like you are pulling it through a "detent". It puts the piston at the top of the bore and closes both valves. This protects the cylinder from moisture. If you store gasoline then use stabilizer, after six months burn it in your car and replace it. Few experiences are worse that trying to clean out a carburetor by a dim flashlight whilst being consumed alive by salt marsh mosquitoes. Trust me on this. BTW, I've had better results storing "winter" blended gas, since t has more light fractions and starts easier year round.

If you use gas cans; stick with metal, preferably safety cans. Plastics are slightly permeable and it will go bad much faster in a plastic can. On that note, [in humid climates] don’t keep spare spark plugs with the machine. This is because in outdoor storage the insulators can absorb moisture [and the metal parts can corrode]. Keep them inside or in a sealed can with some silica gel. An old one-quart paint can is ideal.

If you have a dual-fuel machine, then break the engine in on gasoline and make sure it operates properly on both fuels under load. Keep the necessary connectors for gas operation on the machine so that you don't have to go searching for that 3/8ths-inch pipe nipple with a flashlight.

Use high quality oils, and have enough. Don't forget to also store plenty of 2-stroke [fuel mixing] oil and chain oil if you intend to use a chainsaw. Maybe store some extra for your neighbors that are less prudent. I use Rotella brand synthetic oil and Wix brand filters, and have had good results with them.

Make sure you have enough oil, filters and plugs for at least two weeks (336 hours), or longer. Don't forget about your equipment after the crisis is over: There are valves to set, oil and plugs to change, etc. Even if you own two generators and have enough flashlights, automatic emergency lights, et cetera, things can, and may likely go wrong. Small children usually do not take kindly to being plunged into total darkness. Unless it is TEOTWAWKI, keep the candles in the cupboard, especially if there are small children about.

4. Double your plans for helping other people. Several relatives from coastal areas evacuated to our house (approximately 50 miles inland). I keep a 55 gallon drum of stabilized gasoline to fill up their cars to get them home. This was a lesson learned after the Rita evacuation cluster. How much food you will go through will surprise you. It finally dawned upon us that we almost always eat dinner (lunch to you Northerners) and sometimes breakfast away from home. So what we consumed whilst hunkered down seemed out of proportion.

We also sent some food home with people to hold them over. I was able to "lend" a retired neighbor enough generated power to keep his freezer, television, and fan going. He was genuinely happy. This also meant that he was one less person in line for ice, food, and so forth.

5. Keep a dial up phone line around, after 24 hours the cell phone tower generators started running out of propane, the cable modem (and the cable) went down with the power. Remember how to make that dial-up modem work.

If you're not a Ham radio operator, then find out where the local hams conduct their emergency nets, and listen on your shortwave radio (HF) or scanner (2-meter and 440 band) and you'll know a lot more that the local television news truck can find out.

If you have cable television, then keep a traditional antenna handy. If you live near a major market the local AM news station, then it is probably a good bet. Have a good UPS, plug the computer and the desk lamp into it. If you have a cordless phone, plug it into the UPS too. The UPS will take the "bumps" out of the generator's power; your computer will thank you. Make sure you test the UPS periodically by plugging in a 100 Watt lamp and pulling the plug on the UPS. I find I need to replace that UPS battery about every 2-to-3 years.

6. Plan for the guests. Have plenty of soap, have a small flashlight (preferably with rechargeable batteries) for each guest. Have things other than television to keep youngsters occupied. Try and get plenty of rest. You'll probably be plenty busy after you can poke your head out again. In this vein don't forget dishwashing supplies, laundry supplies, baby supplies, etc. If it's a predictable event such as a hurricane, have all the dishes and laundry done. before it hits.

A television in a room by itself will keep the racket contained from those who want to read, play games or just sleep. If you have the space, then a “quiet room” where  people can just rest, read, be alone, have some privacy or get a fussy to baby to sleep cuts down on contagious stress.

7. Make sure you are medically prepared. Have a rather complete first aid kit that includes a backboard and splinting materials. There will be plenty of cuts,scrapes, bruises, sunburns and sore muscles in the aftermath. Have Band-Aids, 4x4s, neosporin, peroxide etc. Have plenty of acid reducer and immodium on hand (stress and unfamiliar cooking), have at least two weeks of prescription drugs on hand [and preferably much more for any chronic health issues]. Have a good assortment of Tylenol, cold and sinus preparations, BenGay [muscle ointment], good  multivitamins, etc.

8.Be extra, extra, extra careful. You getting sick or more likely injured can really mess things up for everyone you have prepared for. Not to mention that the local fire/ambulance is probably already overtaxed. Be extremely careful handling fire and fuels. A lot of us are not entirely fluent in using chainsaws, small engines, fixing roofs, trimming trees and moving debris.[JWR Adds: safety equipment including heavy gloves, kevlar chainsaw safety chaps, and a combination safety helmet with face shield and muffs are absolute "musts"!] Don't get in a hurry unless there is a threat to life. Be hyper cautious, be very aware of your surroundings and things that can go wrong. Don’t toil alone. Make sure you have a clear path to beat a hasty retreat if things go wrong. Wear those gloves, safety glasses, boots and maybe a hard hat.

Don't overtax yourself. Getting a fallen the tree off of the roof today avails you little if it triggers a heart attack or heat stroke. Ask God's assistance and start over tomorrow.

Keep fire extinguishers near the gas generator, in the kitchen, and near the camp stove.

Avoid using candles at all costs, and absolutely prohibit smoking indoors for the duration. Have more than enough battery smoke detectors around.

9. Be ready to make temporary repairs.. The missing shingles, damaged windows, etc. Have some plywood, a few 2x4s, some Visqueen polyethylene sheeting, batting boards, duct tape, a tarp, some nails, and so forth around. If you happen to have a good cordless drill, then you'll find sheet rock and deck screws are very superior to nails. If you're squared away then you already have this stuff , but a neighbor might be in need, so buy extra.

Debris creates flat tires for quite some time after many events. Have a tire plug kit and a 12 VDC compressor in each vehicle. Repairs to structures, especially roof repairs guarantee nails in tires. Be ready for them..

Have everything rechargeable recharged. Make sure you have some traditional non-power tools, I have a handsaw that I've had for decades, a good bow saw, ax, maul, sledge and an old eggbeater style hand drill still get regular use.

10. If I had my choice of just one utility it would be running water. Fortunately where we reside is served by a well run rural utility district which has prepared well for hurricanes. Failing this, in addition to stored water I have a portable gas utility pump (Robin brand) that can pressurize our water system from our pool and has sufficient capacity for a fire line. The pool got a good jolt of shock a day before the storm hit.

11.Keep some cash money handy. For a few days [with no utility power] there were no functional ATMs, and no way to use credit or debit cards.

12. Keep a low profile. About a week after Ike a passerby indignantly asked "How'd you get your lights turned on?" This showed his ignorance on several levels. He seemed to think someone just had to flip a switch downtown and "shazam!" his lights are on. I couldn't make him understand there has to be an unbroken physical link between a power plant and consumer, this seemed to aggravate his obvious helplessness. Telling him that we had been making our own juice seemed to irritate him. I wonder who he voted for? People with this mindset (that the world owes them something) could be a genuine liability in a real catastrophe. (BTW on a news show during a piece about energy, I actually heard a lady refer to natural gas as “just another dirty fossil fuel”) and not be challenged on the facts. Little minds scare me. I think that the hyper-liberals would love to use the heavy hand of government to force the ants take care of the grasshoppers.  Keep a low profile. The best advice I ever heard on the subject (I believe it was Howard J. Ruff ) was to "keep your principles public and your actions private".

13. Keep a notebook, keep a record of what happened, but especially keep a record of preps you overlooked or screwed up, or stuff you ran out of, or skills that need to be added or honed. That's where most of the preceding information came from! Also keep tabs on what's scarce after an event. Gas was scarce, but diesel plentiful after Rita. In contrast, after Ike there was plenty of fuel, but few operating stations due to lack of power. (There was a "mandatory evacuation" during Rita which turned out to be a fatal traffic jam for a few poor souls which quickly emptied the filling station tanks.) Out our way the local Wal-Mart made a heroic effort and opened up on locally-generated power, two days after Ike. The sheriff’s department was there to “maintain order”. (Let’s just say that they actually wear brown shirts here.). This event was a lifetime opportunity to study the varied behaviors of people under stress.

There were plenty of canned goods and auto supplies. But fresh fruits and veggies were a little thin, no meat due to lack of refrigeration for a few days, batteries, Coleman fuel, trash bags, paper plates, disposable diapers, formula, and nails evaporated. The pharmacy was closed.

Even with the numerous mistakes we made, we were able to stay safe, secure and comfortable and help others while "victims" were standing or idling their car engines in lines. It was an opportunity to try things out under more or less controlled conditions. WTSHTF there will not be controlled conditions!

Jim,

I thought that I would respond to Jake G.'s letter on "Preparations for Eyesight & Hearing". I feel I can offer a little insight (no pun intended) on eyesight and Lasik.

I had Lasik a little less than two years ago. I had just turned 43 and, after 22 years of wearing glasses or contact lenses, I was ready to make the jump. I didn't take it lightly, as having any procedure contains some degree of risk, but having surgery on arguably the most important of your five senses is scary. I had been in love with the idea of ditching glasses for good, but I was not willing to have the procedure until it had been around for a while and was more comfortable with it. After many friends and relatives had Lasik, I researched eye surgeons in my area and found one with the facilities and qualifications that made me most comfortable. I wanted a physician who had done this before, many times before. The doctor I selected had done over 14,000 surgeries. I wanted someone who had seen almost anything before. I wasn't pressured to have it done, nor was I even encouraged to schedule a date while I was there.

I went in for the surgery, accompanied by my wife, who would be needed to drive home. While I was in his office for a good two and a half hours, the procedure itself took less than ten minutes and was relatively painless. It felt like someone was pressing on my eyeballs for a few seconds. I left the office feeling great and had little discomfort, although many people say they feel like they have sand in their eyes for up to 24 hours. I had a follow up appointment the next morning and went to work.
From a preparedness standpoint, it's the best thing I could have done. I am 20/20 in both eyes for the first time since I was 21 years old. I don't have to worry about contacts in a field situation, nor do I have to worry about losing or breaking my glasses. I can wake up in the middle of the night and can confront any situation without fumbling for eyeglasses. It is very comforting.

As Jake stated, the potential change in one's close up vision is an issue. I was gradually noticing that reading was a bit more difficult, particularly in low light situations, but I didn't require corrective lenses. After Lasik, I noticed that I was having more trouble reading and I found that I was unable to read comfortably without reading glasses. I picked up several cheap pairs of "cheaters" from the local drugstore. It is true that people begin to notice a decline in their vision when reading sometime after age 40. Lasik can make it more pronounced. It has now been almost two years and my near vision has not worsened any further. Wearing glasses while reading is a bit of a pain and a concession to the advancement of Father Time, but the freedom from glasses in everyday life has been fantastic. I would highly recommend Lasik for those interested with the caveat that they do their research and choose a well qualified physician who explains all the risks to their satisfaction. All the best, - Ken B. on Long Island

Sir,
The discussion about Lasik and contact lenses prompted me to write about an alternative: implantable contact lenses (ICLs). The surgery is more-or-less the same as cataract surgery, except that unlike cataract surgery (which replaces the natural lens of the eye with an artificial lens), ICL leaves the natural lens in place along with an artificial lens. Because it is essentially a variation on cataract surgery, which has been around since the 1940's, unknown negative long-term effects from ICL are unlikely.

The advantages of ICL over Lasik are several-fold. First, the result is significantly superior to Lasik surgery -- vision is far more clear (mine is now 20/15) and with fewer and less severe optical "halos" (mine disappeared entirely within a few months of surgery).

Because you're not changing the physical structure of the eye, you're less likely to wind up with poor results.In fact, if you're not happy with the results, the lens can be removed entirely and your vision returned to its pre-surgery condition. If your prescription changes, the implanted lens can be exchanged for a new one. If you develop cataracts, your natural lens can be removed and your artificial lens can be changed out if necessary.

During the surgery, local anesthesia is used along with a paralytic to prevent the eye from moving. This is a boon to those of us who have difficulty controlling our blink reflex. IV sedatives are also provided, making the surgery both pleasant and completely comfortable (as compared to Lasik, which is often described as "sucking my eyeball out of my head!").

ICL does not impact your ability to participate in extreme activities: since my surgery, I have been both scuba diving and sky diving with no negative effects.

Finally, people who have been turned down for Lasik -- such as those with corneas that are too thin for Lasik -- may be eligible for ICL.

ICL is more expensive than Lasik; I paid $3,000 per eye in 2005. It cannot correct farsightedness, and won't prevent the need to wear reading glasses (however, it will not increase the need for reading glasses like Lasik can).

I've had ICL for nearly four years now and I can't recommend it enough. The web site for the group I used is www.GoodEyes.com. - E.

I am unable to make my home self-sustaining.  So, unfortunately, my family will probably become refugees in a true SHTF scenario.  My focus presently is in becoming desirable refugees rather than shunned refugees.  The key is minimizing any negative impact (extra logistics of all sorts) and maximizing any positive impact (filling in weak spots) to someone that is geographically fortuitous.  I was challenged to figure out how a small family could best become a wanted commodity when food is tight and security isn’t. I determined the key for us was that everything carried needed to be dense in value. Density equals mass divided by volume. In our case, mass would be the battered value of the item; volume was limited by the size of our packs. We can’t carry enough bulk food, but we can carry items that will have an excellent post-SHTF (bartered) value, an example would be trading  batteries for an illuminated-reticle or starlight scope in exchange for food.  Keeping our packs small (but danged heavy) will give us an additional advantage if we need to make a small camp.

Skill sets are valuable.  I am fortunate to have become a physician.  Talk about (trading) food for thought! I am trained in Internal Medicine, so much of my skill set depends on a working infrastructure, that is, availability of medications, imaging (X-rays, CT, MRIs and the like) which will be useless once the grid goes down.  To make up for that, I have been certified in ATLS (Advanced Trauma Life Support) and ACLS (Advanced Cardiac Life Support), the former being far more useful in extended emergencies.  Further, I have also trained in mass casualty scenarios.  I have been stashing typically needed and well tolerated medications in a FIFO set-up in my home, from antibiotics to blood pressure pills.  In a legally gray area, I have some potent narcotics (barter/ransom/medical use). I also have a good stock of scalpels, retractors, Celox and the like to maximize my worth. The first lives my first aid kit may save might be my family’s. My skill set will be in demand, and I hope with the other positives below, worth enough to take in extra mouths to feed. But I recognize, perhaps better than non-medical people, that the quality of medical care will quickly revert to the level practiced before the advent of antibiotics and other modern pharmaceuticals. Think Civil War or WWI where a gut-shot was a death-sentence.  Garlic may have some ant- microbial properties, but it pales compared to a few doses of modern antibiotics.  Being a doctor in a SHTF scenario may be like being a sailor in the middle of a desert: lots of knowledge but only able to apply a small fraction of it.

My wife is an educator and now teaches special needs kids.  If the Collapse is a bad one, kids will still need to learn, and there is more to teaching than just putting material in front of kids, as anyone that homeschools will agree.

Those are our special skill sets. You can never have enough skill sets, and we plan to further develop our skills.

Our two children are too young to be useful for anything except giving us joy, . And dirty laundry.

We have been buying weapons in standard calibers – 45 ACP, 5.56, and 22LR.  I have given myself the luxury of owning a PS90. I rationalized the purchase by the fact that it supports a 50 round magazine of 5.7 rounds and bridges the gap between a pistol and a longer rifle. In reality, it looks really cool. Four mags on my hip (and one in the rifle) gives me 250 rounds. In an urban/suburban location, which will be the most difficult part of our journey, I do not see a need to shoot over 100 m. Most action will likely be under that, and that is the niche for the PS90. Additionally, it’s bullpup design keeps it short and maneuverable in a vehicle without sacrificing accuracy (it has a 16 inch barrel).  More importantly, we have packed way about 150 pounds worth of ammo in our G.O.O.D .bags and another 70 lbs in our BOB’s. We have so far two extra ARs and three Glocks for barter/trade. We don’t have a weapon for the 22LR, but either we will (Ruger’s 10/22) or it’s for barter. Our bags are meant to carry the lead at the sacrifice of food. It may be easier to barter rounds (heavy but small) for food (light but large).  If we do make to the hinterlands, having our ammo added to the favorably situated ‘castle’ will be a bonus.  My wife and I both shoot accurately to 200 m, and well enough at 300 - 400 m to keep the philistines away. We continue to practice our shooting skills by range time and class time. We will get far.

I’ve begun a ‘collection’ of survival knives and high quality folders by buying two at a time (again, two is one, and one is none).  They will be needed en route and, like ammo, possess an excellent weight to bartered value.  My guess is that knives will lost or broken and there will be a demand for them.  In the same category, are redundant Katadyn water filters kits.  Extras were purchased because they are small and will barter well. Bolt cutters were bought because they will be useful traveling and also in barter. Bic lighters, assorted tiny screws for spectacles with jeweler screwdrivers , rechargeable CR123 and AA batteries, extra Gerber multitools, quality compasses, 550 cord, several small but bright flashlights (Fenix brand – 1 or 2 CR123 batteries and they pump out over 180 lumen and fit on a keychain or a rifle), two Old Testaments, and 2 American flags fill the small spaces in the gear.  We keep thinking on how to improve our “stock” and get more bang for the buck with ‘value dense ‘ items. I thought of the extra eye-glass screws after having my own come apart just as I got to work and spent a miserable day squinting.  Someone missing their glasses won’t function at near capacity and the eye glass screw may be the equivalent of the nail that caused a horse to be lost, then a rider to be lost etc.

We also have our own gear and clothing, using the layer approach with an outer hardshell in camouflage.  We both have packed two pair of extra boots, either for the long haul or barter.

These items get thrown into the trunk along with our Camelbaks, and our mountain bikes (with extra tubes and tires) go on top supporting a few jerry cans of gasoline lashed between them.  If we can’t get to a refuge with available gas or the roads become impassable, then we load the bikes up and ride/walk until we are welcomed.

If we’re lucky, the Collapse will wait until we can move to a more geographically desirable location and all these purchases will remain useful while we focus on new needs (stored food, long term water and power and etc). If not,  I have improvised a plan that adapts to our situation and hopefully will change our refugee status to a valued team-member.

This is written in part because there has been no view from the prepared refugees.  There may be more preppers without a safe haven than those able to develop a safe haven, not because of any deficit or laziness on their part, but because of reality.  In addition, all preppers cannot move to a sparsely populated area in the US for if they did (imagine merely 10% of NYC, LA, and DC doing so during by the end Obama’s administration), those areas would no longer be sparsely populated! So think of what you can carry that can be bartered for things you can’t carry and that will make you into a valuable  team member.

I have worked hard to become a doctor (and perhaps even harder to remain a doctor is this crazed system) and to be able to give charity rather than receive it.  If I am to receive the charity of shelter from someone who is able to do so, I will be sure that we do more than just pull on own weight.  We will add security, in the short and long haul.

So if TEOTWAWKI happens, keep a lookout for strangers who may have much to offer. But for the grace of God, it might have been you unable to live in a geographically desirable area and looking to add to an established sanctuary.

Mr. Editor:
Just a quick note to follow-up regarding preparations for Eyesight and Hearing. I checked into lasik and contacts long ago (I am slightly near-sighted – too many hours staring into cameras and computers I guess). Although Lasik advances have come a long way, please be sure you talk to your eye surgeon at length before you commit to this serious expense. If you are near-sighted, a successful lasik procedure will improve your long-distance vision, but may impede your “up close” vision. I talked with my eye doctor at length about this, and after many questions he acknowledged that in many cases, near-sighted people would require reading glasses in as little as 3-5 years.

Also, remember that as a person gets older, the eye muscles simply weaken, which is why many people need reading glasses by their mid-40s. For those of you who were genetically lucky enough to not need glasses, oh how I envy you! (Forgive me Lord!) For those of us who do need glasses, contacts are a nice thing. Remember that eye solutions do have expiration dates and never sleep with your contacts in because it can lead to eye infections. Make sure your hands are “hospital surgery clean” (HSC) when you place the contacts in your eyes. A post-TEOTWAWKI eye infection is not something you want to deal with.

If there are any ophthalmologists reading, I’d be interested in hearing from you about eye-related injuries and treatments, etc. For example, I imagine there will be a lot of people chopping wood without wearing safety glasses who end up with one of nature’s toothpicks embedded in their eye.

As a side note, I recommend going to Costco and picking up extra pairs of reading glasses. Buy several different strengths, including some that “stronger” than what you currently need. They are cheap, but somewhat durable. Even if you don’t need them now, someone else may. - Jake G.

Hello Mr. Rawles,

This is just a quick note from a new reader. If what I mention to you has been covered on your site, I apologize; your site takes more than a few multi-hour reads to digest!

I see very little talk about contact lenses/solution and hearing aids/batteries post-TEOTWAWKI in most preparedness articles. I would think it would be most unfortunate to train, learn and prepare for any upcoming abnormalities and shortly thereafter not be able to see or hear.

It would seem to me that at least a couple year's supply of contact lenses on hand at all times would be wise, and perhaps an extra hearing aid or twenty for those that need? And I bet you saline solution for contacts and extra hearing aid batteries would be great barter items in the event of a major catastrophe. Those items will be worth their weight in gold (if not more valuable) to the unprepared masses.

Perhaps a wise suggestion would be Lasik surgery or something similar very soon for those who would benefit from it; those that depend on contacts would be wise to think about that procedure or something similar to eliminate their dependency on visual aids. And to say the least, several pairs of sturdy, mil-spec frame prescription glasses would be a great investment for the well-prepared.

One is reminded of the old "Twilight Zone" episode ["Time Enough, At Last", starring Burgess Meredith] where the bookworm comes out of the bank vault, sees the world in post-nuclear destruction....and drops his glasses, smashing them. A true nightmare scenario indeed! Thank you for your wonderful blog site and books. Sincerely, - Rick T.

Once you realize the importance of being prepared for coming hard times, you may ask yourself, “How can I possibly prepare for any scenario?  This is an insurmountable undertaking.”  The more you ponder this, the more the reality of this seems to be confirmed.  Let not your heart be troubled.  As with almost any endeavor, the road to success begins with the first step and continues one step at a time.  Consistent, prioritized, careful preparation over a period of time, preparation built around what your personal situation (budget, job, family, medical needs, etc.) will allow, can get you in a position in relatively short order to weather the scenarios that are most likely to occur.  The mere fact that you have considered the possibilities of what may lay ahead can very quickly put you ahead of the vast majority of the population.

Consider the possible scenarios whereby preparedness would prove to be literally a lifesaver.  These scenarios range from very geographically localized events, either natural or man-made, to the proverbial TEOTWAWKI.  The likelihood any of these events occurring generally becomes decreasing likely in a given time frame as the geographical scope and severity of the event increases.  Therefore the occurrence of a total multi-generational societal collapse, requiring the maximum amount of preparation is far less likely to occur over the next year or two or five than relatively local, relatively short term events such as tornados, hurricanes or floods, or even some major terrorist events, all requiring far less preparation than TEOTWAWKI situation previously mentioned.  This should be considered in the early stages of preparation as priorities for investment are made.

Therefore, your preparation should follow a well planned, measured, prioritized process that enables you to be positioned to go through the most likely scenarios first followed by progressively increasing severe scenarios.  Ongoing preparation will build on the past.  No effort goes wasted.  This should be encouraging to the beginning prepper.

How should you start?  Start with a careful analysis of the most likely localized events that may occur in your area or region, or events from another region that may impact your local area (remember passenger air service after 9/11).  Shutdown of transportation systems, especially trucking and rail should be of paramount concern.  What is the probable time frame that these events may cause you to rely on your own resources?  Make a list of all the items and quantities you will need to get through that period of time.  This constitutes the Phase I physical resources preparation plan.

Prioritize the list and within the constraints of your budget begin to acquire the items you have listed.  Keeping an Excel spreadsheet makes this task much easier and allows you to see at a glance exactly how much physical resource preparation you have achieved, how much you still need, the value of those resources, the cost to complete your initial Phase I purchases, etc.  Your spreadsheet should include rows listing each item with columns for:

• Priority
• Category or subcategory
• Quantity Needed (for the given preparation Phase)
• Quantity on Hand
• Difference Needed vs. On-Hand (Calculated Value)
• Cost Each
• Acquisition Cost (Calculated Value)
• On Hand Value (Calculated Value)
• Total Value (Calculated Value)
• Percent Complete for the Item (Calculated Value) – you can color code this Red/Yellow/Green for and at a glance dashboard view
• Subtotals as you feel appropriate for each Category or Sub-Category

In the same way you used Excel to track your Phase I resources preparation status, use your spreadsheet to list categories, sub-categories, items and quantities that you wish to acquire for future Phases, up to and including a Phase for TEOTWAWKI.  This allows you to systematically build your level of preparedness a Phase at a time.  As you start with Phase I, you can also see how well you are gearing up for future Phases as well.  Remember, on-hand quantities, pricing, etc, can carry from the Phase I sheet to the Phase II through Phase “n” sheets so redundant data entry isn’t required!  Don’t forget to make hard copies of your files and save them in a three ring binder.

Additional Tips for getting started.

So you have determined what you need to acquire and have begun to do so.  But prepping isn’t just about acquiring tangible goods. 

It is also about skills.  It is especially about skills.  Even what I have called “Phase I” preparation should include training in the plan.  A diversity of skills within your group (which may start out as just your family) is important.  Take advantage of any relevant training available to you at low or no cost.  Programs available in many communities include CERT, First Aid, CPR and similar.  Use these opportunities to increase your skill base.  These are great skills to have in normal times and are great skills to build upon.  Even these basic courses could prove to literally be lifesavers in “normal” as well as tougher times.

Learn to garden.  Even if you don’t have a retreat with the space, perfect soil, and water supply, you should garden on a smaller scale in your city or suburban back yard.  This will give you a head start in knowledge and experience (i.e., harvesting and saving seeds for future years) when you are able to move to that retreat location.  Plus, fresh garden vegetables are healthier and taste so much better than what you purchase from the store, especially if the store bought vegetables are poured from a can!  Nothing beats enjoying a hand picked, vine ripe tomato fresh from the garden (and I confess, I take the salt shaker out back with me!).

Put away the foods you eat today.  Nitrogen packed survival foods are expensive and likely should and may be a part of your plan.  However, many foods that you eat today can be more immediately utilized to kick start your storage pantry at moderate cost while you save for other more expensive longer term options.  You can buy or easily build out of plywood a FIFO rotation canned goods rack, set it in a pantry or closet and start loading it up today with the foods you already eat.  This accumulation can be done for little perceived cost if done over time.  Simply buy a little extra of what you already purchase each time you are at the store.  You will be amazed at how quickly you can build up a 30, 60, 90 day supply of canned goods that will never go bad because they are what you currently eat so you rotate them via the FIFO system into your daily meals.  Canned vegetables, meats, soups, fruits and sauces can all be stored in this simple way.  All at very moderate expense.

Learn about your firearms.  Practice with them as much as you can afford to.  Get professional instruction.  Basic courses for novices are available at moderate expense.  There are NRA sanctioned courses for basic safety, handling and shooting skills.  Work toward completion of an NRA course or equivalent in self defense in the home and self defense outside the home.   If you are or once you get to be more advanced, get even more advanced training.  If your budget doesn’t initially allow this, do the best you can but plan for more advanced tactical training in a future Phase.  The key now is to get what you can afford and build on that.  Practice, practice, practice.

Don’t think you must necessarily purchase a complete set of new firearms right out of the gate for your survival armory.  Conventional wisdom suggests .45 ACP pistols for carry, .308/7.62 NATO semi-autos for your MBR (with expensive red-dot optics), a good .308 bolt action for long range and / or large game hunting, and perhaps a more expensive shotgun than you have budget for.  If you already have 9mm pistols, that AR-15 you bought a few years ago “because you wanted one”, the scoped .303 you inherited from Dad and an old but functional Remington 870 Express in 12 gauge, you are good to go for now, as a beginner prepper.  Make sure that adequate ammunition is part of your plan, but with this or a similar adequate set of calibers and shotgun you are set for your initial Phases of preparation.  Early on, food, water, medical supplies and the like are likely a higher priority than new firearms.  You can upgrade in a future Phase.  Focus on firearms training at this stage.  It’s about prioritization.  Besides, later phases prepare for scenarios that will be more likely to require the capabilities of upgraded firearms.

A basic principle.  Standardize.  If you pick .45ACP for your personal carry weapon, it is advantages for all members of your group to do the same.  The same principle applies for your MBR, self defense and hunting shotguns, etc.  Ammunition and magazine plans will appreciate this.  Try to standardize on 1 or 2 battery types for your battery operated devices.  Or more correctly standardize by using devices requiring only 1 or 2 battery types.  You don’t want to have to store and/or maintain charges on AA, AAA, CR123, C, D, N and CR2032 batteries, when you could be more efficient and effective with perhaps using only AA batteries.  This principle applies to anything that you have more than one of.  Radios, flashlights, etc.  Remember the axiom, two is one and one is none.  Standardization means simplicity, efficiency, spares.  There may be exceptions, but take standardization into consideration when you develop or modify your plan.  Initially, you may have to have a wider assortment of devices depending on the devices you currently have, but have a strategy to standardize.

Plan to read or more correctly, to learn by reading.  Whenever you come across a useful article, print it out and save it in a three ring binder with other useful articles you have saved.  Even if it is something you can’t purchase or do or use until a future Phase, save it now and add it to the plan now.  There is an incredible amount of useful information in SurvivalBlog.com.  Read and save (and purchase through Jim’s site when you decide to purchase goods from one of his advertisers).  Jim helps us so we should help him where we can.

If you have relatives or friends in a rural location that you can get too and who are willing to take you in during appropriate events, have a G.O.O.D. plan.  This includes hard copy maps with routes and alternate routes.  Practice all routes before the big day.  Practice your load out plan, again, prior to the big day.  Search SurvivalBlog.com for loads of information on G.O.O.D.  There are many concerns related to evacuation in certain scenarios.  Educate yourself and make educated decisions.

This article is the tip of the iceberg with regards to beginning prepping, but hopefully it has a few pointers to get you thinking and to get you started and is an encouragement that this can be done, that you can successfully prepare for the future.  You don’t have to purchase all nitrogen packed long shelf life survival foods or the perfect arsenal with one of every conceivable firearm type for every circumstance (in fact limiting (standardizing) models and calibers has some clear advantages) in order to successfully prepare for the likeliest of scenarios.  Remember, methodical, prioritized preparing is the way to go for those of us on a budget.  Start small, build your knowledge base, supplies and skills, and very soon you will be in the enviable position of weathering the most likely calamities to occur in the next few years.   If you continue this methodical, ongoing process, you will continue to improve your situation and continue to put your self in a position to weather increasingly more severe and longer lasting scenarios.  The important thing for those on a budget is not to wish you could do it all now by immediately trading cash for all the tangibles and training you need, but to start and to start now and to consistently build to our plan as we can afford to do so.

This two part series of articles is meant to address a basic physiological need that may be severely threatened both in a TEOTWAWKI situation and any time a lesser emergency takes us out of our bubble of comfort and preparedness. That issue is warmth: specifically how you stay warm and avoid hypothermia when your car slides off the road in a snow storm or you don’t get out of dodge fast enough and find yourself hoofing it overland with only what you can carry, through rain and wind. Part two deals with the possibility you or a loved one or team mate is succumbing to the cold, how you can best treat your patient to stabilize and revive them most effectively. Throughout this article I will not only lay out some basic concepts, examples, and treatments, but just as importantly I will debunk some of the myths about cold weather survival. My qualifications come from numerous years leading wilderness trips in the mountains, alpine search and rescue operations, and teaching wilderness medicine at the university level to doctors, nurses, EMTs and paramedics, and laymen alike.

To begin with, it is easier to stay warm than to get warm. The classic newbie mistake when traveling outdoors in cold weather is invariably some variation of the following: you get up in the morning, and it is cold. You layer up, putting on your puffy down jacket and hat and gloves, eat a bite, strike camp, and make ready to move. You are cold and not real excited about taking off your many warm layers to start hiking, so you hoist your pack and set out. 15 minutes later you are warm, 30 minutes later you are hot, and 60 minutes later you stop to take off your warm layers, drink some water, adjust your boots and consult the map. Now soaked in sweat you cool rapidly, and before you finish your snack break you are chilly, so you toss your coat on. When it is time to get moving again, you do so with your coat still on. Every subsequent break follows the same pattern, so start moving warm, get hot, stop, get cold, put jacket on again and get hot again. This is the exact opposite of what you should be doing. Instead follow the habits of every mountaineer: start cool, almost cold in the morning. When you stop to rest, even before you get cold, throw on a warm layer. When you are ready to move again, drop the layer. You will avoid sweating and avoid wasting valuable calories to thermo-regulate. Stay warm, don’t get warm.

Notice in that piece I kept referring to layers. This is how you need to dress outdoors. A t-shirt and parka doesn’t cut it. You want a base layer (think polypropylene or wool or silk long underwear) amid layer (fleece pull over, wool sweater) and a shell layer (windproof/waterproof) at a minimum, with an option for a puffy layer like a down jacket or vest. How heavy and warm these layers are depends largely on the environment you anticipate, colder equals heavier. But the concept of layering stays the same. Notice what I did not include here: cotton. The oft repeated adage of wilderness medicine is: cotton kills. The cell structure of the cotton fabric collapses when wet, destroying its ability to insulate (keep you warm). Wet cotton in a cold environment is worse than nothing. Excellent in a desert for its breathability and also the same habit of retaining moisture and evaporating to keep you cool, in a cold environment is an invitation to disaster. Fabrics should be wool, silk, or synthetic. Wool and synthetic do not collapse when wet and will keep you warm even soaking wet (albeit not quite as warm, but better than nothing and much better than cotton). So the white cotton long johns you find at Wal-Mart are out. Invest in polypro or wool for you layers (don’t forget socks).

Why do I keep hammering away at sweat and cotton? Because moisture is the enemy when it comes to keeping you warm. Water conducts heat away from the body 15 times faster than air. You can survive a lot longer in 32 degree air than 32 degree water, whether you are immersed in it or because your clothes are wet.

So how to stay warm in the field? First, fuel the machine. We are talking food, calories, fats and carbs. No time for a diet, eating foods with a high fat content will keep you warm longer. I have been on winter expeditions where before going to bed each night my hot drink consists of hot cocoa powder, milk powder, peanut butter, a handful of chocolate chips, and a spoonful of butter or margarine, with brown sugar and topped off with hot water. Sounds terrible in August in the flat lands, but on a winter’s night the body craves it when the temperatures drop. While we are on the topic, let’s talk about sleeping warm. Aside from fueling the machine, you need to think of your sleeping bag as a thermos: keeps hot things hot and cold things cold. So don’t go to bed cold. Do jumping jacks, walk around, get in and do push-ups and rub your feet to get the blood flowing and get them warm. Start out warm in your bag and you will stay warm. A mat or pad is essential to getting you off the cold hard ground, not because it is hard, but because it is cold! Conduction will draw heat out of you all night long. I like a closed cell foam pad from my shoulders to knees because it is cheap, light, and nearly indestructible. Thermarest air pads are great and comfy but have the potential to leak air with extreme use. Pine boughs, pine needles, coiled rope, empty backpacks, clothes you aren’t wearing; all help keep you off the ground and warm. Speaking of clothes, there is the old saw about sleeping naked in your bag. This is really only applicable if the clothes you would be wearing are either: 1) cotton 2) wet or 3) constricting blood flow. And I usually overlook #2 if they are only damp. Otherwise wear you layers to bed and you’ll be warmer than if you had slept naked. Other tips: empty your bladder. Yes, I know it is cold out there and warm in your bag, but do you know how many kCal it takes to keep that ½-1 liter of urine in your bladder at 98.6 degrees? Lots! And that is energy that could be keeping you warm, so empty your bladder, feel better, be warmer. If it is a snow camping situation, do as most mountaineers do and use a pee bottle (be sure it has a different tactile feel in the dark than your regular water bottle). Yes, there are female adapters out there. Speaking of bottles, taking a hot water bottle to bed with you insulted in a wool sock and stashed in your sleeping bag at the foot to keep your toes warm or on your chest to keep your core warm. Done properly it will still be warm in the morning. If I’m not in bear country I keep a high energy snack close at hand for a midnight warmer; peanut butter, cheese, or chocolate all work well. Wearing a wool or synthetic hat to bed, which covers the ears, and scarf around the neck if your upper layers don’t zip up that high are also big time heat retainers. Avoiding the temptation to roll over and cover your face with your sleeping bag will keep your breath from condensing into water, possibly freezing, and then melting and wetting your sleeping bag when you pack up in the morning. A final consideration for sleeping warm addresses this issue of a potentially wet sleeping bag: down is warmer on a per/weight basis than any other insulation but clumps and fails entirely when wet. Synthetic is almost as light and warm as down, but will still insulate when wet. Cotton or square shaped Coleman brand type bags should be used as dog house liners or for indoor kid’s sleep-overs.

Take home points for staying warm and preventing hypothermia:

1) Fuel the machine

2) Stay dry

3) Sleep warm

4) These concepts are not for winter snow expeditions alone; most hypothermia happens in the fall and spring in what are normally considered “moderate” temps because people aren’t prepared or don’t consider the possibility of rain, wind, or nighttime.

Next time I will address signs and symptoms of hypothermia and how to treat it effectively in the field. - Lumberjack

Dear Mr. Rawles,
I have a few suggestions to add to the recent article about survival and preparedness for diabetics, particularly type 1 diabetics. I've had type 1 diabetes for 13 years and one of the few things I learned pretty quickly is that the power will go out and even if the bottle of insulin is unopened, temperatures higher than 40 degrees Fahrenheit for a long period of time will degrade the activity of the insulin. This will require a much higher dose than what would otherwise be necessary if the insulin is stored properly, if the insulin works at all. Some of the newer insulins will not survive more than a month at room temperature, and less if they're opened.

A few other suggestions on diabetes survival:
1. Be familiar with how to use all types of insulin, because there would not be any guarantee of a specific insulin type being available for use in an emergency situation. Nor would there likely be doctors and nurses familiar with anything other than humulin Regular and NPH (which are considered to be "old" insulins and are more familiar to those who went to medical school twenty years ago.) Be prepared to revert back to "feeding the insulin", meaning taking a rigid schedule of two or three injections daily and eating evenly spaced meals of specific amounts of carbohydrate, instead of eating various amounts at different times of day and using several injections of the newer, fast insulins to cover. Those insulins may not be available, and so a "normal" diet would be out of the question.
2. Know how much insulin you need, and how to measure this amount in any type of syringe. Like before, insulin syringes with .5 unit/1unit/2 unit measure may not be widely available.
3. If you do not immediately have insulin available, try to keep in mind what was done prior to its invention in the 1920s, starvation. They knew that carbohydrate seemed to make diabetes worse, and eating large amounts of carbohydrate increased the amount of sugar in the urine. So to prevent this, carbohydrates were restricted. It's much like a very strict form of the Atkins diet, but even protein is reduced to small amounts, because protein is eventually converted to glucose. There are books from the 1900s on recipes and menus to use to starve diabetic patients, as well as some of the "old-fashioned" methods of screening for glucose in the urine and blood, one good book is freely available on the gutenberg online library web site called The Starvation Treatment of Diabetes. Starvation would not be a viable long-term option because of the obvious end result, but would serve some for a short period of time until insulin becomes available to them. It would kill a diabetic faster, however, to continue to eat normally without insulin.

I have a 6 month stockpile of diabetes supplies, as well as translations of my current insulin regimen using different types of insulins and a plan on how to follow a starvation diet. For 1 month on a standard two injections per day of Regular and NPH insulin, testing urine glucose twice or three times per day and assuming blood glucose meters are unavailable, one would need:
2 bottles of Keto-Diastix strips (measures glucose and ketones in the urine; once opened, a bottle will last 3 months)
1 box of U100 insulin syringes (100 syringes - 60 syringes used in one month = 40 syringe surplus)
1 box of 100 alcohol swabs
1 or 2 bottles of Regular insulin
1 or 2 bottles of NPH insulin
4 bottles of 50ct glucose tablets (which would likely not be completely used)
2 16 oz bottles of light corn syrup (a very efficient method for reversing hypoglycemia/low blood sugar)

Diabetes has really only become complicated to manage in the years since the invention of blood glucose meters and excess information. Those of us with type 1 diabetes have been convinced that in order to "survive" we need so many little pieces of expensive technology, super fast "boutique" insulins and constant monitoring of our glucose levels, so that we are utterly lost if these things aren't available to us. There are type 1 diabetics alive today who "survived" very well on one or two injections of beef or pork insulin a day, testing their urine for glucose using Benedict's solution, and avoiding "sugary" foods. If they can do it and live to be 60, we all can. Thank you, -- Amber C.

James,
That was good info from Mr Fenwick. A great attitude for everyone to emulate.

As a type 2 diabetic I wonder if part of the Diabetics problem might be solved naturally in the worst case of TEOTWAWKI.

I lost 25 lbs and lowered my blood sugar by 50 to 75 points. The weight came from a period of inactivity after multiple surgeries. I rarely need insulin except when I fall off my diet. Oral meds take care of it normally and I am now able to exercise some. More weight loss is in my near future. My M.D. says Diet & exercise will take care of it when the weight stabilizes at my proper weight.

Considering my experience and from all I read, I'd guess many Diabetics will be helped by lowered food consumption and exercise brought on by TEOTWAWKI. Possibly to the point of needing no meds. I am hoping for that result. - E.H.

I ran across an article on survival and diabetics written by a nurse. It was what we call a basic brush and floss kind of article that quoted from some well-known medical books. I call it a brush and floss article because it contained mostly information which a diabetic already knows, much like the way a dentist tells you what your mom has told you a bazillion times about brushing your teeth.

However at the end of the article the nurse pretty much consigned type 1 diabetics to doom and even referenced Darwin and the "survival of the fittest". I know in the novel One Second After, the diabetic daughter died because of lack of insulin, but the part in the book about it going bad because of temperature variations is not accurate.

Here’s some information which will be of help to those who use insulin, specifically Humulin. We've been helping with diabetic preparedness for several years and there are some important things which are not common knowledge. Humulin--unopened--has a shelf-life of at least one year at room temperature. And Humulin can be frozen without ill effects to the user. Lilly won't tell you this, but I know of a type 1 diabetic who froze a year's supply for Y2K.

Her name is Madeline and in 1999 she called me to ask if I knew if insulin could be safely frozen. I told her that I didn’t know, but I would find out. Several of us in the Medical Corps organization started making calls and found out it could. I relayed the good news to Madeline. I suggested that if she were going to freeze it that she keep a log of her blood sugar test values with un-frozen insulin and then with the frozen insulin. She did and her blood sugar did not vary. In fact, Madeline still practices that type of preparedness with her disease.

As for the Darwin and the natural selection mindset, EMP or not, this country is not the Titanic. There are lifeboats for everyone. As medical people, and for non medical as well, our job is not to pick who gets to live or die simply because we may not know the answer to the problem. Our job is to solve the problem and not bow down to Darwin or "selection" or ignorance. Diabetics, preemies, old people, retarded children and the like are not mass causalities and a matter of triage. They are just a people problem which can be solved. I do not have the moral right to pronounce doom on the sick or injured. I do have a moral obligation to at least try to solve a problem.

To say that a Type 1 diabetic wouldn’t have a tough time of it if the system collapsed would be untrue, but problems can be solved. People who are insulin dependent or dependent on any medications need to put away extra supplies for treatment and support of their condition. I would not solely count on electronic devices either. Telemetry has a bad habit of failing, so old fashioned ways of checking blood sugar might not be that old fashioned if we lose telemetry because of an EMP. Keep in mind that there are several other diabetic problems and that there are medications to treat them. Therefore, it is not just insulin which will be in short supply if the system fails.

These supplies will only be a cushion though if a disaster of the magnitude presented in, One Second After, happens. That cushion will give us some time to work on finding answers for a myriad of problems which would surface.

As for diabetics we will have to find a way to duplicate the work of Banting and Best and other researchers of the early 1920s. This isn’t a survival-of-the-fittest type of thing. It is a problem to be solved. Just recently some Canadian researchers injected capsaicin into the excess pain receptors of the pancreas of diabetic mice. Then a neuropeptide was used to soothe the inflammation. The pancreas immediately started producing insulin and 4 months later the previously diabetic mice were still “cured”.

Is the diabetic survival problem complex? Of course it is. All TEOTWAWKI problems tend to be complex. But they are still just problems to be solved. Keep in mind that if an EMP wiped out all type one diabetics, it would not be an end to type 1 diabetes. If it could be ended by some sort of natural selection then where did it come from in the first place?

Summary:

1) Humulin can be frozen without damaging the contents, bottle or seals and then used without ill effect to the patient.

2) Unopened Humulin has at least a one year shelf-life at room temperature (70 degrees F.)

3) Darwin wasn’t a diabetic or a survivalist so who cares what he said.

- Chuck Fenwick, Medical Corps

Mr. Rawles,
I have read your blog for awhile, I would like to know if you about the following: I was diagnosed with Graves Disease over two years ago. They cured the Graves Disease and the way that was done was to completely remove my thyroid gland, If the main concern with radiation is thyroid cancer, without a thyroid what would radiation do are what organ would it damage the most. I would like to also know if there would be any need for myself to take Potassium Iodide (KI).

JWR Replies: There would be no need for you to take KI, since it only serves to "load" a thyroid gland with iodine and hence prevent the accumulation of radioactive isotopes that would otherwise accumulate there. Beyond that, in terms of "internal emitters", all that you should remember is to avoid fresh dairy products (since isotopes like Strontium-90 tend to accumulate in milk), and to drink a regular quantity of fluids, to keep your kidneys flushed.

Since you are post-operative, you can jokingly refer to yourself as partially "radiation proof." (At least you don't have to worry as much as the rest of us about radioactive iodine isotopes.)

From a preparedness standpoint, you should look into stocking up on your regular hypothyroid (glandular replacement) prescription, (assuming that you have one). Do so as much as possible, up to the maximum shelf life. And of course you should consistently rotate this supply, using the first-in, first-out (FIFO) method.

Children play a part in many of our lives. Protecting them becomes an important issue in daily life as well as in an end of the world as you know it moment. However, what happens when adults can’t be there to protect them? What happens when they may need to protect us?
           
Our government and even many schools across the country, as well as parents and other adults, often do not see the potential in children. I am not talking about the educated potential one might find in the youth of a suburban school, but the potential to rise to the occasion when it is necessary to help themselves or their families.
           
The key to survival is knowledge. What you do with that knowledge and how you apply it at the right moment determines if you survive or not. Why can’t our children have the same knowledge?
           
We have many threats facing our world. Swine Flu or even other pandemics have been brought to the fore front this year. The WHO. is telling the world to expect an explosion of H1N1 cases. What happens if you and your spouse get Swine Flu? Who will take care of your children? Your sick neighbors? Your aging grandparents whom live three states away? Give your children the knowledge to take care of themselves and their families.
           
The following are some ideas on how to engage your children in survival learning (please gauge these ideas on the maturity levels of your own children):

• Cooking ~ Sit down and plan out a list of easy foods to cook with the least amount of required steps. Make sure you include some easy recipes for items in your food storage pantry. Most children can begin to learn to cook around age 8, provided you explain the dangers in the kitchen and teach them how to properly use the range, oven, sharp knives, etc. Many libraries and booksellers, as well as the internet, offer cooking books or recipes geared towards children. Cook through the recipes with your child, but try to be as hands off as possible, while teaching them proper techniques.

• Chores ~ Again, start out slowly, but instill an understanding in your children they can and are able to do most any chores in the home. By age 5, most children can at least do the simplest of chores like folding laundry, dusting, and putting away silverware. Give your children a responsibility and work along side them at first. Add laundry and yard work for older children. Again, teaching the safety protocols for certain items. When it comes to cleaning with chemicals, use alternatives made from natural ingredients. Label bottles and provide instructions. However, even children should not use certain chemicals and you should exercise caution.

• Pets ~ Children always want pets. Make them responsible for those pets. Teach them how to bathe and groom Fido. Show them how to properly and safely remove ticks. Have your child learn the commands to control your dog as well. Let your child clean out the gerbil cage or feed the fish. All these things teach children how to be more responsible.

• Protection ~ Enroll your child into a Mixed Martial Arts program or a boxing class with the understanding this is not for beating up little brother but to protect his/her self from others whom might want to harm him/her. For older children, teach gun safety. Show them your weapons, take them to the firing range, and let them understand what it feels like to shoot your P22 or your 12 gauge. Let them practice at shooting targets as well as clays. Take them hunting if you can. And if you have a bow set-up teach them how to shoot arrows as well. By properly teaching gun safety, archery, and self defense your child would be well prepared to defend themselves or to hunt for food.

• Bartering ~ As odd as it may sound, take your child to garage sales or flea markets. Any age can do this. Make them use their good manners when approaching the seller to barter or haggle over prices. Teach them about good deals and help them to find things that may be useful at a later time.

• First Aid ~ Children as young as five years old can put a band aid on a wound. Get a first aid manual and teach your children the proper way to care for cuts, scrapes, and other wounds. Let them know what alcohol and peroxide are used for as well as other medical topicals. Show them the difference between when to use a large butterfly bandage or gauze and tape. Teach them the proper way to take someone’s temperature. Explain when professionals should be called in to help or if you are in a situation where there are no professionals available what should be done. If you have a child that gets woozy at the sight of blood help them to get over their fear as best as possible or make sure that particular child has a different responsibility.

While many of the aforementioned tasks may sound obvious for all parents or care-givers, it always helps to remember your children can accomplish many tasks as long as they are given the chance to try. There are a variety of adult survival activities that you can tailor towards your children. Teach your child about your own family op-sec and basic safety when it comes to dealing with strangers. Above all, always remember to stress safety when teaching your children.

Give them a chance to hone their skills by taking them camping. Allow them to start the campfire (with parental guidance), cook the camp dinner, pitch the tent, etc. Get “lost” in the woods and have them bring you back to camp using a compass and map. Then later, have them look for a cache using your GPS. Teach them about the animal tracks your family sees and what animal crossing look like. In the evening, teach them the major constellations and how they can use those for direction as well.

I personally recommend the book The Boy's Book of Outdoor Survival by Chris McNab. Although it is titled "for boys" and has pictures of boys in the book, I think it is highly appropriate for girls as well. Every child should know how to take care of themselves in survival situations.

If you can help your children and give them the knowledge to help themselves and others, even at a young age, you will enable them to be more responsible for themselves for the rest of their lives. As a parent, you are responsible for teaching your children.

I am a retired Marine Corps officer and Naval Aviator (jets and helicopters), commercial airplane and helicopter pilot, and most recently, an aircraft operations manager for a Federal agency.

I graduated from numerous military schools, including the U.S. Army Airborne (“jump”) School, U.S. Navy Divers School, Army helicopter, and Navy advanced jet schools. In addition, I have attended military “survival” courses whose primary focus was generally short-term survival off the land, escape from capture, and recovery from remote areas.  Like most Marine officers, I attended The Basic School, an 8-month school (only five during the Vietnam era – my case), which is still designed to produce a second lieutenant who is trained and motivated to lead a 35-40 man platoon of Marines in combat.  This course covers everything from field sanitation to squad and platoon tactics, artillery and other ordnance delivery, communications, reconnaissance, intelligence, firearms training, and much more.   Later, I attended the Marine Amphibious Warfare School and the Command and Staff College, both follow-on schools and centered upon the academic study of tactics and strategy as they applied to the missions of the Marine Corps.  I flew helicopters offshore in the Gulf of Mexico and across the U.S. I found out first hand how thoroughly corrupted is the federal bureaucracy and the government, in general.  Not a pleasant experience. I’d rather have been flying. I have bachelor's and master's degrees.

As a result, my wife of forty years and I seem to have been moving endlessly from place-to-place.  Nevertheless, I have tried in each place to do what I could to maintain a level of self-sufficiency for my family that varied greatly with locations and personal finances. My intention here is to try to share some of the less-than-perfect ways that I have tried to accomplish that end. 

Only in the last few years, primarily as a result of the political and fiscal situation in the U.S., have I begun reading some of the huge amounts of literature about how one can prepare for serious long-term off-the-grid survival.  I have found that the preparation required to be ready for that contingency seems to be endless.  I do not want to talk about all of those preparations.  Others have done so very well, and besides, I’m not there, yet.  What I would like to do is to talk to those, perhaps like me, who are not true survivalists in the commonly referred-to sense, but who are genuinely concerned about the future of this country, and might desire, like me, to begin to prepare. Perhaps my elementary and simplistic efforts might be of help to someone else who is beginning to think about the subject of preparedness.  There are many scenarios that might require this, but the two that I am thinking most about are economic collapse and electromagnetic pulse (EMP) attack. I’m building small Faraday boxes, but not doing much else for EMP.

My thinking on begins with my own estimation of the basic problems:  shelter, water, food, fuel, and security.  I view these as the most critical needs, whether living in a tent or other outdoor shelter or here in our rural home in West Virginia. Here I have and often take for granted what I have -- shelter, well water, a small stream, a pond, a rain barrel; canned, dried, frozen, and freeze-dried foods; fuel for the generator and portable stoves, kerosene heater and lanterns; factory-made and reloaded ammunition for any one of several firearms.  Edible plant books. Gardening books. Encyclopedia of Country Living-type books. Reloading books. Hunting books. Tracking books. A few novels devoted to the “what ifs” of the future, including Jim Rawles' excellent "Patriots: A Novel of Survival in the Coming Collapse", for example.  Books to fill an entire bookcase.  The Boy Scout Field Book sits right there next to the military survival manuals, as do Tom Brown's Field Guides, the The Foxfire Book series, a canning book, field medical books, and quite a few others.

Those are the basic things about which I think. I have been thinking about them for quite a while, in fact, longer than I even realized.  Perhaps I’ve been thinking about them ever since I was a young lad.   For example, my very first “survival book” was the Boy Scout Field Book, the original of which I still have (circa late-1950s edition). It is still a great reference if one is looking for an all-in-one manual for starting fires, making simple shelters, recognizing game tracks, tying knots, and much more.  I note that it is still available on Amazon.com. (It’s probably been scrubbed to favor the politically correct, but don’t know [JWR Adds: Yes, I can confirm that unfortunately it has been made politically correct--with the traditional woodcraft skills showing any injury to innocent and defenseless trees duly expunged. So I advise searching for pre-1970 editions!] ) One does not necessarily need the SAS Survival Handbook or the U.S. Army survival manual. I have them and have read them. They do cover security problems, but then don’t cover other topics.  Alas, there appear to be no “perfect” manuals, and the Boy Scout Field Book is no exception.  But it’s not a bad beginning. And so I was beginning the journey even before I knew that I was. 

I think that my first education in “survival” came at about fourteen. That’s when I first shot a .30-06, an old [Model 19]03 Springfield. It pretty much rattled my cage.  Mostly, my older brother and I used to track and shoot small animals in the deep woods of Missouri as youngsters.  We were “issued” ten rounds of .22 LR ammo by our father, a retired USAF pilot, to be used in a bolt action, single shot, .22 rifle with open sights.  One would be surprised what that meager handful of loose ammunition could do for one’s choice of shots, one’s ability to be patient in waiting for the shot, and for one’s great satisfaction at having brought home six or eight squirrels for the cooking pot, having used just those ten rounds – and sometimes, but not often, less.  My point is that the knowledge of firearms is, in my view, basic to the notion of preparedness and in surviving in the wild. And it need not be exotic or overly complicated in nature.  One can surely attend modern schools that will teach one to double-tap a cardboard target or silhouette at seven yards with a semi-auto pistol, as well as basic and advanced tactical rifle courses, but very basic survival skill with a rifle can be had without much cost if one is committed to learning the skill and if one disciplines oneself. Start with only one round, and work up from there.  As Col. Jeff Cooper used to say, “Only hits count.”  In a purely off-the-grid survival scenario, I can envision that .22 LR rounds would be very precious, indeed.

Consequently, and even though I own handguns and rifles that will shoot .45 ACP, .44 Magnum/.44 Special, .357 Magnum/.38 Special, .380 ACP, .223, .25-06, .270, 7mm-08, .308, .7.62x39, .30-30, .30-06, and .45-70/.457 WWG Magnum (a wildcat), I shoot a .22 rifle and pistol more than all of the others, combined, and normally at least twice a week. And I’m hoarding them, as well as shooting them.  I have the capability to reload all the calibers (except .22 LR/Magnum, of course) above, as well as shotgun ammo in 12 and 20 gauge. I wasn’t really thinking of “survival” when deciding to do this about twenty years ago, but was interested only in having the capability to shoot more, and to do it more cheaply. Yet it appears that much of that ammo could be used for barter. I had never even considered this until reading some of the recent “survival novels.”

My apologies.  I’ve wandered into the weeds here, as I could do forever on my favorite subject.  Suffice it to say that whatever firearm one chooses – and make no mistake, one is necessary in my opinion -- there are all kinds of reasons to choose one over the other, depending on the situation and the person. One must endeavor to shoot it well. Owning a firearm is of almost no consequence, at all, unless it is properly employed.  Personally, I prefer a M1911 .45 ACP pistol and a 7.62 M1A SOCOM, while my wife is comfortable with the milder .38 [S&W] revolver and 20 gauge. pump shotgun.  I won’t even begin to get into the debate over .223 vs .308 and 9mm vs. .45 ACP.  Suffice it to say that in Vietnam I had the opportunity to see the effects of all of these, and I chose for my own security the .308 and .45 ACP.

Having got my favorite subject out of the way, I’ll talk about one that is likely even more important.  Water.  It is amazing how complicated this can be, and how many choices one has to solve this problem.  I have not yet solved it.  I have put up a rain barrel, and plan to get a couple more.  It’s amazing how rapidly a 55 gallon barrel will fill in even a moderate thunderstorm.  I got mine from Aaron’s Rain Barrels. http://www.ne-design.net/. I’ve camo-painted the first one to make it recede into the bushes that surround it.  

We have a very shallow stream down the hill that I need to dam so that it keeps only about a foot-or-two deep pool for gathering some water. It flows into a large pond, of which we own half (The owner of neighboring property owns the other half.).  But that’s over a hundred-yard trek downhill with empty buckets, and the same distance uphill with full ones.  Now, while that is okay for a backup, in my thinking, because I’m going on 63 years, I prefer to have something closer.  So my next “big” purchase will be a Simple Pump that allows one to drop a pump and pipe though one’s existing well casing down to below water level and extract water by means of a hand pump or DC motor attached to a battery which, in turn, will connect to a solar panel.  This is much, much cheaper than a Solar Jack.  At $1,200 for the hand pump capability (I’ll add on the DC and solar later), it’s a bargain, for me. See: http://www.survivalunlimited.com/deepwellpump.htm.  
I’m not recommending it for anyone, yet, as I haven’t got one. It has plenty of good reviews, and I’m willing to try it.  My apologies, but I am just talking about how I, for one, intend to solve my “water problem.” 

I’ve also started collecting clear plastic soda bottles for use in Solar Disinfection (SODIS), see; http://en.wikipedia.org/wiki/Solar_water_disinfection.  I’ve set up a rack for putting out the bottles in a sunny place.  Again, that’s a backup, but I’ll use it.

I have bought three different water filtering devices, the best of which is the Swiss-made, all-stainless Katadyn Pocket Microfilter.  It works wonders in that shallow stream and pond down the hill.. [JWR Adds: The same Katadyn filter model is available from several SurvivalBlog advertisers. They deserve your patronage first, folks!]

With the exception of the Simple Pump, these solutions are relatively cheap and effective, if not producers of great volume.  So far, they are what I’ve come up with.

I won’t go much into the food problem. It isn’t quite as complicated as the water problem.  I’ve either got to have it [stored], grow it, or kill it.  I’ve started storing all kinds of Mountain House freeze dried #10 cans (with expiration date dates in 2034), two-serving meals from Mountain House (expiration dates circa 2016), and numerous grocery store-type canned foods (expiration a couple years), in addition to dried beans, rice, Bisquick (sealed in plastic bags with desiccant inside), salt, sugar (Domino, which are sold in one-pound plastic tubs), olives, peanuts, wheat, etc.  Basically hit-or-miss, so far.  I need to get this “food problem” organized and do it right.  But it’s a start.  I think we’ve got only about a 60-day supply now, for two.

I’ve got two Coleman two-burner stoves.  One is a butane stove, and the other a dual fuel (white gas or unleaded gas), as well as several small backpacking stoves, the best of which is a MSR Whisperlite International, which uses virtually all fuel (unleaded, white gas, kerosene, diesel, and maybe even corn oil).   I was heavily into backpacking when we were stationed in Hawaii in the late 1970s, and still have all the gear.  After having one knee replacement and hedging doing another, I’ll not be backpacking if I can help it.  Nevertheless, I have two bug-out bags with essentials in them, ready to hit the trail if need be.  I’ve saved up and bought two good Wiggy's bags and a couple of his poncho liners.

Concerning backpacking stuff, I can recommend a book that I read back then called The Complete Walker, by Colin Fletcher. I haven’t read it in at least a decade, but its import is such that I remember much of it.  He emphasizes simplicity in gear.  That is to say, don’t pack a tent if you can get by with a tent fly – which you cannot in cold weather. I’ve still got my old three-season tent, but am saving up for a four-season. And he emphasizes: don’t worry about pounds – worry about ounces.  That is to say, if one is packing tea bags, remove the labels from the bags.  Ounces.  Remove all packaging material unless it is absolutely necessary (usually never). Don’t carry a “mess kit,” nor a knife, fork and spoon set.  A spoon will do (I’ve done it) along with a pocket knife. Now I have so many knives of so many types that I can’t remember them.  Personally, I’d go for a multi-tool.  But it’s heavy.  I never used to carry a weapon while backpacking.  Of course, it was (and is) illegal in Hawaii, but I think one would be remiss in not doing so today.  There was so much good advice in that book that helped me in the USMC, if nothing more than when packing my helicopter before a mission, or a car, trailer, or truck to move across the country.  “Think ounces, not pounds.”  I always think about Mr. Fletcher’s advice when I pack.

Anyway, I think I’ve got the camping stove angle covered in spades.  That is, until the fuel runs out.  Same goes for kerosene heater and lanterns (5).  My plan is to pull out our pellet stove and replace it with a free-standing wood stove.  Pellets are nice, but they must be bought, and the price is getting exorbitant, according to my pocket book.  They likely will be non-existent in a crunch. 

I connected a 12,000 Watt/50amp gasoline generator when we moved into this house nine years ago, as I have with every house in which we’ve lived for the last two decades.  I’ve got it wired through a transfer box to the circuit-breaker panel, a job that I did myself. It works, and it’s safe.  The main reasons for having this were to run the 220V[olt AC] well water pump and to run the refrigerator and our free-standing freezer during power outages.  But I’ve got it wired, anyway, to nearly every circuit in the house, except the other 220V appliances – water heater and heat pump.  It is somewhat selectable. That is to say that I can choose which circuits I want to power by engaging or disengaging the switches on the transfer box.  The problem is that it uses gasoline. So in a long-term outage it would soon become useless.  I’ve had the propane gas company come out to estimate what it would cost to get a dedicated 100 gal propane tank for the generator.  It would be about $500, but then, in addition to the 50+ gallons of gasoline, butane tanks, and white gas that I keep stored in a separate outbuilding, it would make a great explosion when hit with a tracer round.

Which brings me to the subject of security.  We live in a split-level home on about ten acres of forest.  The property is surrounded by other similar-sized properties of seemingly like-minded individuals.  I gleamed this because everyone out here shoots.  The sweet sound of gunfire can be heard at times in a full circle.  West Virginia, at least, has still got its priorities straight in this regard.  But I digress. This is a frame house with half of it below ground in front, but framed in back, which faces the forest.  The forest, itself, is a maze of downed pine trees blown over by the wind, interspersed with small saplings, vines and low brush.  Not a likely avenue of approach for anyone but the most determined.  For those who are determined, the downed trees would make excellent cover and concealment.  So I have a security problem to solve there, as well as at the front. 

I’ve started buying rolls of barbed wire and baling wire.  Unfortunately, I do not have access to dynamite, which we used to be able to buy in a hardware store in the 1960s.  We used it back then to blow stumps while clearing the land for our house.  I am thinking of buying a bunch of used railroad ties to build cover in the back; I’ve thought also of bricks and sandbags.  Problem is we’re reaching the point in all of this where the house would begin to look like a fortress, of sorts, to all but the most ignorant observers.  So there’s a line here concerning security versus “normalcy” that I must cross sooner or later.  Inasmuch as my wife is a few years older than I and is on constant medications, I’m afraid that finding a retreat (if we could even afford one) would be out of the question, as access to doctors, hospital and pharmacy are a necessity. Nevertheless I’ve got the bags packed and gear ready to throw into the pickup (Toyota 4x4 – like to have one of those older model American trucks, but I think they are getting rare, at least around here.  And what there are will likely go to the Cash for Clunkers Program….grumble, grumble. What will they think of next?).

So it looks to me as if we are here for the duration of the crisis, or sooner, if they try to take the guns from my cold, dead hands.  Speaking of, I still have to build a cache or two for guns and ammo and a few other necessities. 

And since I’ve more-or-less made that decision (here for the duration), I’ve thought of organizing the apparently gun-loving neighbors.  I’ve begun to buy walkie-talkies, if not field phones and commo wire.  I’ve got solar panels and several batteries (need to get a mega deep cell or two, however) to run the small battery chargers and the CB radio. My shortwave is up and running.

I will have to wait to talk to the neighbors, whom I rarely see, much less know.  I can just imagine the words that would come out of their mouths if I were to mention to them the notion of forming a security “company” and establishing a perimeter.  “That old retired Marine down the road is nuts!”

So that’s what I’ve got to say.  I do hope it at least stimulates some thought for those who are starting out trying to prepare, as I am.  All of this shows me that one “problem” in this “survival” business leads to several more, and they in turn lead to even more problems.  Lots to do. So I’m glad I’m retired.  I’ve got time to think about it.  If I were rich, I could do a lot more and likely in a far away place, but as it is, we do with what we have.   I have to use the lessons taught to every Marine:  Improvise, Adapt, Overcome.  

Long Live America.  Keep the Faith. - “Two Dogs”, Col. USMCR (ret.) in West Virginia

Greetings!

I have an idea that I have been wanting the patriot survival community to consider. Here it is:

Basically we are able to go without food for much longer than most people know. This is not true with water to be sure. A normal, reasonably healthy human body is easily capable of going three to six weeks on very, very little nutrition and remain completely mentally alert and even physically active. During a prolonged fast you will not be able to pick up as much furniture as normal but you may easily be able to walk for 100 miles!

The biggest concern with fasting is that it not begin too abruptly. Most trouble comes from toxic reactions not lack of nutrients. Its better to reduce junk foods, sweets, red meat and unnecessary drugs & medications before embarking on a serious fast. A series of single-day or two and three day fasts are rejuvenating like nothing imaginable! Juice fasts and broth fasts and even solid, bland diet (rice & red lentils) are intermediate steps. Health food stores often have written material on fasting techniques.

Fasting is very healthy and has an unmistakable spiritual side to it as well. It increases mental health and will power. It is an excellent occasion to practice prayer, meditation and all sorts of mental work. Benjamin Franklin, for one, extolled the virtues of keeping the mind full and the bowels empty. This is all in the preparatory phase while you are teaching yourself how to fast, how your body reacts, how your mind reacts, what to make of any "hunger pains" and in general learning that you don't need to consume all you are accustomed to. Watch your will power grow!

Once you are "hardened off" and experienced in "coming closer to your own inner nature" (you now know how to consume your own substance without cutting off an arm or leg to try to keep the stomach full) you should wax serene in circumstances where others may easily fall prey to panic. In cases of stand off, siege, emergency or just plain prolonged lean rations you can totally, effortlessly and fearlessly rise above the circumstances.

I can tell you of how it has worked for me, in Hurricane Andrew for example, where people rioted or scuffled needlessly over ice. But I had not intended to write so much. I just wanted to get the idea across. Best Regards, - WL

JWR Replies: Those unaccustomed to fasting should first consult their doctor for a checkup. Your tolerance for fasting will vary greatly, depending on your diet, your body type (fat reserves), your blood sugar chemistry, and your activity level. Rather than water fasting--which can be debilitating and precipitate some acute health problems--I recommend occasional juice fasting, to maintain your electrolyte and blood sugar balance. My general advice is to build up to fasting gradually, while very carefully watching for adverse reactions, such as dizziness, confusion, or hallucinations. Even someone with regular fasting experience should never fast more than 36 hours while living alone. There must be someone there to watch for signs of distress or incipient syncope (fainting). Fasting can be beneficial, but as with anything else, when done to excess, it can be harmful.

I frequently stress the importance of well-balanced preparedness in my writings. All too often, I've seen people that go to extremes, to the point that these extremes actually detract from the ability to survive a disaster situation. These range from the "all the gear that I'll need to survive is in my backpack" mentality to the "a truckload of this or that" fixation. But genuine preparedness lies in comprehensive planning, strict budgeting, and moderation. Blowing your entire preparedness budget on just one category of gear is detrimental to your overall preparedness.

Another common mistake that I see among my consulting clients is an over-emphasis on either very old technologies or on the "latest and greatest" technologies. In the real world, preparedness necessitates having a bit of both. At the Rawles Ranch we have both 19th century technology (like hand-powered tools) and a few of the latest technologies like passive IR intrusion detection (Dakota Alerts), photovoltaics, and electronic night vision. My approach is to pick and choose the most appropriate technologies that I can maintain by myself, but to always have backups in the form of less exotic or earlier, albeit less-efficient technologies. For example, my main shortwave receiver is a Sony ICF-SW7600GR. But in the event of EMP, I also a have a pair of very inexpensive Kaito shortwaves and a trusty old Zenith Trans-Oceanic radio that uses vacuum tubes. Like my other spare electronics, these are all stored in a grounded galvanized steel can when not in use.

Here is my approach to preparedness gear, in a nutshell

• Redundancy, squared. I jokingly call my basement Jim's Amazing Secret Bunker of Redundant Redundancy (JASBORR)
• Buy durable gear. Think of it as investing for your children and grandchildren. And keep in mind that there'll be no more "quick trips to the hardware store" after TSHTF.
• Vigilantly watch Craigslist, Freecycle, classified ads, and eBay for gear at bargain prices.
  
• Strive for balanced preparedness that "covers all bases"--all scenarios.
• Flexibility and Adaptability (Examples: shop to match a 12 VDC standard for most small electronics, truly multi-purpose equipment, multi-ball hitches, NATO slave cable connectors for 24 VDC vehicles, Anderson Power Pole connectors for small electronics--again, 12 VDC)
• Retain the ability to revert to older, more labor-intensive technology.
• Fuel flexibility (For example: Flex fuel vehicles (FFVs), Tri-fuel generators, and biodiesel compatible vehicles)
• Purchase high-quality used (but not abused) gear, preferably when bargains can be found
• If in doubt, then buy mil-spec.
• If in doubt, then buy the larger size and the heavier thickness.
• If in doubt, then buy two. (Our motto: "Two is one and one is none.")
• Buy systematically, and only as your budget allows. (Avoid debt!)
• Invest your sweat equity. Not only will you save money, but you also will learn more valuable skills.
• Train with what you have, and learn from the experts. Tools without training are almost useless.
• Learn to maintain and repair your gear. (Always buy spare parts and full service manuals!)
• Buy guns in common calibers
• Buy with long service life in mind (such as low self-discharge NiMH rechargeable batteries.)
• Store extra for charity and barter
• Grow your own and buy the tooling to make your own--don't just store things.
• Rust is the enemy, and lubrication and spot painting are your allies.
  
• Avoid being an "early adopter" of new technology--or you'll pay more and get lower reliability.
• Select all of your gear with your local climate conditions in mind.
• Recognize that there are no "style" points in survival. Don't worry about appearances--concentrate on practicality and durability.
• As my old friend "Doug Carlton" is fond of saying: "Just cut to size, file to fit,, and paint to match."
• Don't skimp on tools. Buy quality tools (such as Snap-on and Craftsman brands), but buy them used, to save money.
• Skills beat gadgets and practicality beats style.
• Use group standardization for weapons and electronics. Strive for commonality of magazines, accessories and spare parts
• Gear up to raise livestock. It is an investment that breeds.
• Build your fences bull strong and sheep tight.
• Tools without the appropriate safety gear (like safety goggles, helmets, and chainsaw chaps) are just accidents waiting for a place to happen.
• Whenever you have the option, buy things in flat, earth tone colors
• Plan ahead for things breaking or wearing out.
• Always have a Plan B and a Plan C

If you are serious about preparedness, then I recommend that you take a similar approach.

Some of you are probably asking yourself what this has to with Survivalism. Pain is our brain's way of letting us know that something is not right. You touch a hot stove and it warns you to pull away. With any number of things that can set off TEOTWAWKI,  The result will be the same. Traumatic, stressful, pick your favorite term; it’s all the same. Increased stress levels in the body create tension. We have all heard the term ”your psychology affects your physiology”, nothing could be more true. I think it is an excellent idea to go through practice drills in as many what if scenarios as you can fathom. One of the things I have not seen accounted for however is the effect of stress and pain has on our daily routines .The moment the hammer drops we will probably get by on adrenaline for a short period. The first part is preparing our bodies for the culture shock that will probably happen overnight. I would say the majority of the people reading this have an ample food supply, guns, ammo maybe even a detailed plan on what to do. But how many of us have a way to reduce stress? If you do not have one during ”peaceful” times, how much less ready will your mind and body be prepped when the situation demands it of you? I am not here to tell you what method you should choose. One of mine is prayer. Whatever yours are, cultivate them now as you do everything else. This leads me to the title of the article.

Unless you are Amish or are like the few readers of SurvivalBlog that are already modern versions of Grizzly Adams, the overnight transition will be more mental and physical than you have been accustomed to. Mentally I have already explained the mind-body connection..What can we do in the physical? An ounce of prevention is worth a pound of cure. Here it comes: ”exercise”. This is much more than dropping a few here and there for the yearly family photo. A stronger, fitter body will not only reduce stress levels but will be able to handle a greater physiological demand. A stronger body will put you in a better position to defend yourself. When the last tick of the clock hits it’s point, you are where you are, and that’s it! That said, even the strongest bodies get sore and get injured. I have heard horror stories at the gym (where us city folk exercise). A man dropped some weights on his finger. The trainer urged him to stick his finger in the hot tub. That was a big mistake. This is an easy way to remember what to do INJURY = COLD (the area is already inflamed, heat will expand tissues more) SORENESS = HOT (heat soothes sore muscles, not injuries!) There are different ways to approach it. Without an MRI, you cannot know just how serious but you can start reducing the impact. After an injury, the area should be iced (if possible) 15 minutes on and 15 minutes off. This should be done [during waking hours] for several days. Anymore than 15-20 minutes of direct contact will have the same effect as heat, counterproductive. All that work on the Ponderosa will not only have you singing shoulda coulda woulda’s on being better prepared, it will also leave every muscle in your body begging for mercy. I have done massage on some of the strongest men around (the “Power Team”) and I assure you that pain is universal. Here is a non-medicinal pain survival equipment list for you:

1. Two tennis balls
2. A huge encyclopedia
3. A low-back chair(like you used to have in school)
4. Any good simple book on acupressure or trigger points
   
5. A rolled-up towel
   

I could make a list a mile long but these five will do wonders for you.
 
Using tennis balls: this is good, no, great for the back. Laying on your back on the ground, place one tennis ball on either side of your spine (not on the spine). Start with the cervical, then move down to thoracic, then lumbar. Typically 10 minutes in each area should do the trick. Another way to stretch that lower back out is lying once again on your back. Place the large book or encyclopedia under your sacrum for 10 to 15 minutes. This technique uses your own body weight to release the muscles they surround, thereby relaxing them. Have you ever cooked a chicken? When you pull the skin off that milky white layer over the muscle is the fascia, it holds the muscle in place. Changing the angle of your lower back does wonders. The next thing is the low back chair. I like chairs that go about mid back. Sitting in the chair in the normal way, reach behind the chair grabbing the top of the legs (you can go lower as you stretch). Do not bounce! Pull for a few seconds at a time while leaning backwards over the chair edge, creating tension on your arms but stretching your back. At this point you probably wondering what in the world a rolled up towel can do for you. Hopefully by then you have already memorized all of your survival books , but chances are if you have not, you will be doing some serious reading. Sitting in a higher back chair or even a wall, place a rolled up towel east to west underneath your shoulder blades. This will help keep you in alignment and take pressure off your upper and middle back that develops from slouching as we read.

If these things seem too simple, well then I can assure you that they work. "Simple" is the key when your resources are limited. The American Indians used to have the children of the tribe walk on their backs for those with ailing backs, so I think you can adapt to these simple cures.  Why not just pop an aspirin? Well, first off all if you have access to pain meds, they will be very valuable and the less you have to rely on them the better off you will be. Keep in mind that no pill will cure an injury or eliminate the cause of the pain. It will merely cover it up for awhile. Why not just treat the cause of the problem instead of the symptom? We have little control over the circumstances that come our way. We can either be more prepared or less prepared. Learn how to take care of your body if you want it to take care of you.

Dear Mr. Rawles,

Pat C.'s recent post regarding the acquisition of prescription drugs in quantity includes many good thoughts. As a pharmacist of more years than I like to admit, I feel compelled to add to a few of Pat's points.

Pat mentions FDA restrictions on quantities of several types of medications, including some "powerful antibiotics, pain drugs, and highly abused drugs". I'm unaware of FDA restrictions on dispense quantities of any drugs, except regarding a very small number of drugs with unusually high-risk of adverse reactions. These few drugs would rarely come into play in stocking for calamities. The point that I believe Pat is driving at involves the Drug Enforcement Administration (DEA) restrictions on "Controlled Substances", which, as a matter of definition include drugs with addictive potential, such as the opiate analgesics (pain relievers), many anti-anxiety agents (Valium, Xanax, etc.), and the amphetamines and related substances used for treatment of ADHD. The Federal list of these agents can be found at the DEA web site, for those who have time on their hands and are not eas