First Aid Without The Kit, Part 1



A guest post by Chris

[This is an entry in our non-fiction writing contest where you could win - First Prize a 10 Person Deluxe Family Survival Kit,  Second Prize an Herb Seed Bank or Third Prize a copy of Dirt Cheap Survival Retreat.  For complete rules and list of prizes see this post.]

As someone who has been an EMT-Paramedic for many years, I’m fortunate enough to have had the pleasure of receiving the training and providing emergency medical care in the pre-hospital setting. Over the years, I’ve learned some tricks and trades and was even part of some cutting-edge new techniques in the field of CPR, now called CCR.

However, I’ve always had access to an ambulance or well stocked emergency vehicle that had all the necessary supplies. For preppers, access to an ambulance vehicle is most likely out of the question and many are trying to buy things they think they need. Some preppers will only have a small first aid kit from the local drugstore while others will have field surgical kits and huge supplies.

Either way, it is important to be able to provide first aid (if need be) regardless of the supplies you may have, but more importantly, have the skill set to use the supplies!

First, talk about training. Many people suggest some sort of emergency medical training. I agree completely. You can get a surprising amount of training by researching the Internet, watching videos, and reading medical books. However, without practice, you may forget what to do, freeze up, and possibly cause more harm than good.

It is a good idea to at least take a local CPR class, perhaps a first aid or first responder class that a lot of times is offered by your local fire department or rescue squad. EMT training can get expensive (sometimes over 100 dollars per credit hour) and is time consuming but well worth the effort.

If you can do it, it will be the best thing you can do for your medical preps and even be able to help your community in the interim. Many preppers learned EMS in the military or are current paramedics and EMT’s. These people may also available to help answer questions. Do the best you can and learn what is important so you’d know what to do.

For those of you who are not able to become EMS trained, let’s peruse into some of the larger ailments and injuries you may encounter in a SHTF situation that you can treat with common household items. This list is not all-inclusive, of course, but will provide you a guide and some ideas to help you get through these situations. These are field treatments, and most likely will require further medical care.

Before I begin, it is extremely important to remember that YOU come first. Period. There is no reason to risk your life unnecessarily to help someone else, especially in an SHTF scenario. We hear all the time that first responders “put their lives on the line to help”, but most aren’t so stupid as to put themselves at unnecessary risk.

Protect yourself! Exam gloves, masks, glasses, and other personal protective adjuncts are important if you’re going to perform care on someone. You have no idea what diseases they have and getting sick just isn’t an option! With that out of the way, here are some situations you may come across that you can provide care for with minimal equipment.

ABC’s!

The cornerstone of medical care to this day is the ABC’s! ABC stands for Airway, Breathing, and Circulation. EMS is big with mnemonics, so this one is one of the first you’ll learn. Without any of these being intact, you cannot go any further until they are established and stabilized.
Airway

  • This includes the mouth, nose and throat. All of the passages in which we use to breathe.
  • These passages must be open and clear. Without them, air cannot pass in and out of the human body, will cause the cessation of breathing and ultimately, death.
  • In a person who is unconscious, airway management is very important since they’re not able to maintain their own airway.
  • There are many tools medical professionals use to keep airways open, except your fingers! Keep your fingers out of a persons’ mouth! (Yes, you paramedics that have performed digital intubations I know you’re out there, you’re not the intended crowd!) In our case, keeping the head (when a person is laying down) in a “sniffing position” will help keep it open. Think of how your head looks when you’re sniffing something, same principle applies!
  • If you need to keep an airway open, a small section of garden hose about 3-4 inches will keep the mouth open and air to pass. Be careful as not to lose it down into the airway!

Breathing

  • ADEQUATE breathing is key.
  • Number of breaths per minute (at least 8 times per minute with 12 being average)
  • Quality of breaths per minute (note shallow breathing or stops in breathing)
  • Mouth to mouth breathing without a personal protective barrier is not recommended.

Circulation

  • Heart beat pulse is present and adequate.
  • This is relative; some peoples’ resting heart beat is 54 (very healthy persons) or could otherwise indicate poor heart circulation. Over 120 is too fast also.
  • Pulses present in body limbs, such as arms and feet. Absence of pulses in the limbs could indicate shock or injury.

Keeping track of the ABC’s is very important; without them your aid may be in vein. Treat the obvious and check that they are there!

Shock
The human body, when sick and/or injured can slip into something called shock. It is important to realize that going into shock is a life threatening situation that needs to be treated. Shock simply means your body tissues aren’t perfusing (bringing nutrients and oxygen in and out of cells adequately) for an underlying reason. There are a lot of different types of causes of shock, but a lot can be summed up in the following:

  • Heart attack or heart failure
  • Blood loss or large drop in body fluids (injury, bleeding, dehydration)
  • Temperature (too high or too low)
  • Allergic reactions such as snake bites or insect stings
  • Poisoning
  • Infections
  • Faintness

The key to treating shock is to identify the underlying condition that could be causing it. For instance, a large laceration (cut) to the arm that is bleeding profusely could cause a person to go into shock from losing blood, the sight of the blood, or an infection from the wound. In this case, stopping the bleeding would help in treating the shock.

How will I know if the person is in shock? Signs and symptoms of shock may include:

  • Feeling faint
  • Clammy skin
  • Bluish coloring to the fingernail beds
  • Feeling weak
  • Pupils slow or absent to respond
  • Nausea, vomiting, or extreme thirst
  • Rapid pulse

Treating for shock includes:

  • Identifying the cause of the shock and attempting to treat the underlying condition. This includes opening airways, restoring breathing, and stopping bleeding.
  • Choosing a good position for the victim is important when treating for shock. Placing the victim on their back, monitoring their ABC’s is good for faintness; putting them on their side for vomiting and prevention of vomit from entering the airway for another. It is best to use the left side and use an arm (if not injured) to cradle the head.
  • Cover the victim with a warm blanket if the victim is cold or move them to the shade or cool area and cool them if they’re hot.
  • Attempt to keep the person calm and quiet. This may slow the progression of shock and allow you to focus on what may be causing it.
  • For people on their backs, elevate the legs slightly above the heart. This will help bring blood flow to the core of the body. Be careful; don’t elevate legs that may have bone fractures or other injuries. Position for comfort.
  • For victims with unsplinted or untreated injuries, place flat on their back until the injury is treated. If you’re unsure what to do, flat on their back without elevation is best.
  • For people with head injuries or oral injuries, elevate the head AND the shoulders. This also helps with people who are having difficulty breathing. Most people with breathing difficulty will not allow you to lay them onto their backs.
  • Do not give liquids to those who are vomiting or in and out of consciousness. They could breathe in the liquid (aspirate) and cause more problems!

With these skills, you’ll be able to help a sick or injured person deal with life-threatening shock while you move on and treat some injuries!

Broken Bones

Broken bones are very painful for the recipient and movement of the injured limb needs to be limited. Since you, as a prepper, are not in an ambulance, here are some simple tools and items you can use to splint different broken bones. Some fundamentals:

  • Splint the injury in the position it has been found. Moving a limb can cause further injury and excessive pain to the victim.
  • If bones protrude through the skin, don’t push them back in. Treat them like a wound and cover it before splinting!
  • For arms and short leg bones, a standard pillow from your bed is an excellent splint. Place the injured arm or short leg bone in the pillow, and fold the pillow up into a “U” shape. I would hope you had a pillow in your preps!
  • Take a tee shirt and wrap it around the pillow, making a knot to tie the shirt and keep the pillow in place. You can substitute the tee shirt with ropes or bandages if you’ve got them. Do not place the knot on top of the knee, especially if a knee injury is suspect.
  • For longer bones or leg bones, use some tree limbs or even 2×4 pieces of wood if you have them. You’re looking for something long and rigid. Place the tree limbs on both sides of the leg and secure them to the leg with a tee shirt or two. For knee injuries, you can take a couple of tree limbs, run them up into a tee shirt and out of the arms, and place it as a cradle under the knee. Pillows work great on knee injuries too! Make them comfortable.
  • Take pulses in the limb furthest away from the body after splinting. If the knot is too tight and you’ve cut off the pulse, you will need to loosen it. The victim’s input will also help.
  • Many times fractures require resetting, which is painful but may be necessary. For arms and shoulders, traction can be applied by manual pulling.
  • For long bone fractures such as the femur in your upper leg, building a traction splint may be needed.
  • Other items that can be used as splints are broomsticks, toys, legs from a stool, etc!

Bleeding

Bleeding can be fatal, period. Whether it is blood loss or potential infection, bleeding needs to be controlled quickly as possible. While it is best to use bandages and items made for bleeding control, sometimes there just isn’t anything available but common household items. Most bleeding can be controlled by applying a dressing and direct pressure. If you don’t have a kit, you can use the following items:

  • Sanitary Pads/Napkins. These items are GREAT for bleeding control, due to what they’re made for. You can apply a sanitary pad directly to a wound and apply pressure. Many come with adhesive strips you can activate to help keep it in place. Be careful not to apply adhesive into the wound.
  • No sanitary pads? Use newspaper, towels, shirts, or anything flexible that can cover the wound. It is important not to remove a dressing once it has been applied, since clotting will include the dressing in the process.
  • If bleeding comes from a puncture wound, brace it in place and don’t remove the item (such as a knife) from the wound. Wrap the item around the item and add to it as needed.
  • Elevate the limb above the heart to assist in clotting.

Now since we’re on a survival site, we will, most likely, have to treat these injuries on our own. However, that scope will be covered in another paper. Field surgery takes skill and not in the scope of this letter.

Chest and Abdominal Wounds

Last but not least for this segment, we’re going to hit on chest injuries, since quick action is needed for the best outcome. Chest injuries are significant because they’re somewhat easy to treat but highly fatal if not treated. Injuries to the chest are common, which can include puncture/gunshot wounds, bruised and broken ribs, lacerations and more. Some common household items that you can use to treat these injuries include;

  • Sanitary napkins
  • Saran or plastic wrap
  • Common clothing
  • Duct tape

Plastic wrap? Duct tape? ABSOLUTELY! The idea here is twofold: we want to keep any abdominal innards that are exposed moist, and we want to limit the movement of air. For instance, a stab wound to the chest can cause air to enter the chest cavity and choke off the lungs and heart with trapped air. We need to get this covered as quick as possible to prevent air from entering while allowing it to escape. Here is what we can do to treat a stab wound in the chest with common household items:

  • Take a piece of plastic wrap and place it upon the wound, making it slightly larger than the wound.
  • Tape it to the chest on THREE SIDES, while leaving a corner untapped. This will allow trapped air to escape while blocking air from entering.
  • Place sanitary napkins, tee shirts, or other soaking items over the wound and exceeding the size of the plastic. Secure it on three sides while allowing a path for air to escape.
  • You can apply pressure to the wound if needed, while watching the victim. If they appear to turn blue or complain of more difficulty breathing, you may be occluding the passage of air out of your dressing. Check it and possibly loosen it up.
  • For other large puncture injuries, such as in the abdomen, a tampon can be used to fill the hole and bandaged around it. Remember to remove the plastic and use the cotton. The string left out will help medical crews retrieve it later for surgery. This is the same practice as “wound packing”, which uses gauze pads instead.

Likewise if you have an abdominal injury where the guts (viscera) might be showing, best thing here to do is:

  • Do NOT force the guts back into the hole. If they’re not placed in the chest cavity right circulation could be cut off or infection can set in.
  • Place plastic wrap over the guts and the wound and cover it. You don’t need to tape it; you can apply your dressings over the top, which will allow the blood to be soaked up.

Summary

In this part, we’ve learned how to deal with several types of injuries and how to treat them using common household items. In medicine, everything is a “practice” and everything is subject to different ways of doing things. Each one of these items we’ve discussed has been used successfully and can be employed by someone with minimal medical training. Again, if this is of concern, get some training! Anything is better than nothing.

Comments

  1. Thanks for the post Chris. Lots of great information. I look forward to part 2. Cheers.

  2. Wow Chris, absolutely incredible article. Copied and pasted into WORD and printed for my first aid binder. Thank you.

    • Lint Picker (Northern California) says:

      You don’t have to copy & paste. Mr. Creekmore includes a print button at the end of each guest post. Thus making it very easy to print these articles. Look for the little green printer-friendly symbol at the end of Chris’s post, click on it and then you can print just the article.

      • Found the little (and its is small) icon – Thanks LP and Mr.C – printed this bad boy up and into the binder it went , also found when my local fire dept. is having free training. Dragging my Lady and the hellspawn that is my pride and joy daughter with me to it. (evil laugh here)mhahahaha……

        just sayin…

      • really like this tidbit of info thanks

  3. tim williams says:

    Awesome info. I agree 100%. As an OIF vet and medic for 8+yrs I hope my stamp of approval means something. I cannot stress enough how important practice is, Especially for bleeding control and chest wounds. IQ goes out the window under stress. ALL YOU HAVE LEFT AFTER IQ GOES IS MUSCLE MEMORY!!! Getting training is good but remember its frangible – use it or loose it! Practice with an ace wrap or duct tape on yourself often. Experience often how much force with how many wraps it takes to start to cutting off circulation on an arm or leg. See how much more a leg takes. Google places you can feel your pulse. These pulse points are places you can press to stop bleeding downstream. FEEL how hard you have to press to cut of circulation. Improvise and practice with (don’t cut your circulation all the way off in practice) tourniquets. Look online at different designs for ideas. Tourniquets aren’t rocket science but when someone you love is spurting blood and your IQ has gone bye bye is not the time to try and improvise one. The Army has gone to tourniquet first where the limb joins the trunk; ask questions later for extremity injuries. I agree with this and I’ve had good success with it in the field. Tourniquets work best and do the least damage over the long bones that are close to the trunk on arms and legs, the big extemity arteries are closer to the surface and easier to compress against the denser muscles and bones close to the trunk, it gives you time to think which is really hard to do under stress. It allows you to see from exactly where and why someone is bleeding. This greatly simplifies bandaging. Once the bandage is applied the tourniquet is slowly loosened and the wound checked, rechecked, then checked again etc., reinforced as needed with the goal of getting rid of the tourniquet. One last thing. Don’t get hung up on an injury. Look at and care for the whole person. Be positive and encouraging. Will to live trumps all! Without it you can probably die from a paper cut. Don’t forget to check the back.

  4. Schatzie Ohio says:

    Awesome post!

  5. Hunker-Down says:

    Chris,

    This is great information. How did you know we don’t have an ambulance in our BOB? LOL.
    I printed your article, it is well written, right at the level of my ignorance on the topic. THANKS! We are looking forward to part 2.

    Your instructions for treating a stab wound is an eye opener. First, I would have never thought of using plastic wrap and more importantly I would have applied the sanitary napkin first, then the plastic wrap over everything. Thanks to you I now know that would be incorrect.

  6. Chris
    I look forward to future installments. I have always carried tampons and napkins for major wounds which my family and friends have normally looked at me like I was a little off. Upon explaining the use, they understand. I like the use what you have instructions, keep it up.

  7. Yup- first things first: “Gloves on, scene safe?”
    Having EMT training is a definite goodnes thing- not something to ever regret even if it’s never used. And yes, the cost can be prohibitive for many- as it was for me. To get around the short bank account, I joined the local volunteer fire department and got on the First Responder Team. I had to put up an initial $200 for the EMT/1stR course at our local college, and was allowed to make payments. The VFD paid the remaining $400 and after a year as a team member, I was reimbursed the money I’d paid.
    Another way to get some ‘inexpenisve’ training is as one of my BIL’s did: got on the National Ski Patrol. He had to pay the entire cost of this advanced Survival Med training, but was reimbursed after two years of patrolling.
    Sanitary napkins… I chuckle every time I think of my Honey asking me why ‘I’ needed a box of napkins- she told me tampons were better. LOL, we do have some moments on the homestead…

  8. Chris, great post. I loved the look when a cashier would say how sweet I was picking up pads and tampons for my gf or wife and I say, they’re for potential gunshot wounds, I’m going over seas. The look was priceless.

    I took the Navy’s Combat Medic Course and later got my EMT Certification but used it working as a jailer and executive protection jobs and pads and tampons are in my first aid kit.

    Glad you focused on the sucking chest wound using plastic, we had been trained to also use the wrap from a cigarette pack or even an I’d if nothing available.

    Great Post!

  9. Nicely done! Copying and pasting this one to my file box!

  10. This is a great post. Very good information to have and skills to have in case something ever happens. For example, an EMP hit. I’ve been researching on how to get prepared for an EMP all month since there’s great sites up for Preparedness Month. I’ve been listening to EMPact Radio’s Podcasts every day. Tonight they are having a guy named James Wesley Rawles back on their show; it’s LIVE at 6pm. He’s going to be answering people’s questions that call in, and he’s going to be talking about EMP and how to get prepared for a hit. I think you’d enjoy listening to this show. Here’s the link if you want to listen: http://empactradio.org/prepcast/ppc21-james-wesley-rawles/

    • Lint Picker (Northern California) says:

      LOL, this is too funny. Is “Mr. American Redoubt” so concerned about the popularity of MD’s blog that he has to send out minions to tease people away from The Survivalist Blog dot net? Me thinks something smells fishy.

      • Lint Picker,

        I noticed that too. Obvious a spam comment, probably by Mr. American Redoubt himself, but I published it anyway with the hope that it could possibly help someone in some way.

        I’m not worried about anyone stealing my readers they know where their family is.

      • It is a bit too tin foil hatted for me over there…

        • WHat wrong with my tin foil hat??? Its in style this year. and it make a statement (That I offically have lost it….:)

          just sayin…..

          • Works for me….I just don’t partake in that kind of hat. I’m partial to cowboy hats HAHAHAHA

  11. Lint Picker (Northern California) says:

    Keep the patient’s head in a sniffing position?? What is that? Sniffing what? Honest, this is not a joke, I don’t know what that position is.

    OK, found something online (from this source: http://vdmtc.org/module01/technique/technique01.htm)
    that explains in detail, :

    Place the Patient’s Head in the “Sniffing Position”
    • flex head forward on a pillow to place the plane of the face on the same level as the anterior chest wall (sternum)
    • extend the neck, or “point the chin towards the ceiling”
    • aligns pharyngeal and laryngeal axes

    The sniffing position is based on the concept of : “the elderly gentleman sniffing the early morning air.” The person is standing and “pushes the head forward” while “lifting the chin up.”

    http://vdmtc.org/module01/technique/mod01-fig12.jpg

    I understand the rest of your post, Chris. Thanks.

    • LP – thanks for the “Sniffing Position”. I thought (incorrectly) it would be how I might sniff a flower, with my chin down.

  12. Chris – We have a package of pull-ups/diapers that were never used. Can these be used to help stop bleeding? I’m thinking coverage for larger areas – abdominal wounds, etc.

    • Theoretically, yes. The idea of the sanitary pads is that you may/should have them on hand for what they are intended for and they are simply made to soak up fluids. The other reason is that they are small and easy to store. Diapers being of larger size might be an issue when it comes to storage but in these situations you’re looking for something to cover the wounds and soak up any blood. Good thinking!

  13. Hey great post, looking forward to the next one.

  14. Sorry, Lint! I went through this thing a bunch of times and missed the explanation for the sniffing position. You’ve hit it on the head so I needn’t go further.

    Next installment will be ready very soon. This one will deal more with dressing wounds and some medical and environmental emergencies. Glad everyone likes it. The Wolf Pack is awesome!

  15. Chris,
    Great article! Good to update my first aid knowledge…it is a bit old and rusty. Look forward to part 2.

  16. Thanks for the article Chris. I do have a question that maybe either you or someone from the pack can answer. My very mature 10 year old wants to take a first aid class with me as he thinks that more than just one person in our family should have this knowledge and of course, he is the logical choice. All first aid classes that I have come across have an age limit of 12. He would like to learn how to treat wounds and that kind of thing. Do you, or anyone here, know of a class that we might be able to take together with him only being 10? I’m not a very good teacher, so me taking the class and then trying to show him isn’t a real good idea. Besides, I’d love to take this class with him.

    • Honestly, try the Cub Scouts/Boy Scouts. They would provide some first aid training in the form of merit badges and he’d be able to get his “feet wet” on the training. By the time he hits 12, he’ll be old enough to take the more advanced classes and be a bit ahead of his peers. A lot of medical trainers won’t teach kids under 12 simply because many of them don’t have the mindset or the ability to sit through classes of this sort and/or retain it. Not to say that your son isn’t ahead of them; his interest in this proves it. If the Cub/Boy Scouts isn’t the thing then perhaps keep looking. I’ll ask around to some of my former contacts to see what I can find for you.

      • Thanks for your input Chris. He’s already a Weblos in Cub Scouts, but they haven’t done anything so far with first aid, just Band-Aid stuff. I understand the whole mindset for younger kids and that’s why things aren’t offered for his age group. I just keep thinking that if I could find a group that teaches these skills and just talk to them that maybe they would let him in. We’ve even looked into wilderness survival classes (which he is so up for) but they are over $200. Not really in the budget right now. :) Again, thanks for getting back to me.

    • Lint Picker (Northern California) says:

      Gretchen, the Red Cross offers some online classes. You might take a look at this webpage and see if it would serve your needs and provide some training online until your son is old enough to go to the hands-on classes in a couple of years.
      http://www.redcross.org/portal/site/en/menuitem.d8aaecf214c576bf971e4cfe43181aa0/?vgnextoid=46de1a53f1c37110VgnVCM1000003481a10aRCRD

  17. I am a doctor and this post was spot on. Good work and carry on. I enjoy everyone’s posts btw and thanks MD for bringing it to us…

  18. When I was in the service they suggested using your ID card for sucking chest wounds if you had nothing else. I don’t carry saran wrap with me but I always have ID and credit cards.