Episode 161 S4-37
Disaster Medicine Basics
Battle for the South Ch 37
The Battle for the South adventure draws to a close, loyalties are revealed and lives are threatened. In any disaster scenario we are going to be facing many medical scenarios. Here today to discuss the basics of what you should learn to be prepared is field medic, Kevin Reiter.
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Having to perform a life saving activity in a medical emergency can be very intimidating. However it is a situation we are likely to face, not only in everyday life, but in a wilderness setting or a long term survival scenario.
You should begin your medical emergency preparedness activities with planning. Planning can keep you out of trouble, prevent accidents and ensure you have the right equipment. During your planning you should put together a well stocked first aid kit. You can decide if you want to have one large group bag or individual kits (IFAK) or both. You need to know how to use everything in the kit and where it is located so that in a high stress moment you can get what you need quickly.
When medical emergencies happen often the care providers develop tunnel vision and forget things. Practice during the planning phase helps ensure you can perform under pressure.
When learning medical knowledge go back to your basics. Learn how to do proper assessments so you can accurately identify what the problem is. Understand that touching people is a part of providing medical care. Any sigmatism about touching the other sex must be overcome during practice.
Learn to document vitals and symptoms. This documentation is priceless information for EMS providers. If help is not available, it is still essential to document vitals. They can reveal patterns and problems. You can't rely upon your memory when you are in a high stress environment to remember a series of numbers.
In your go bag you should have a notebook and a pen/pencil. Rite in the Rain spiral notebooks and pens are great options to invest in. Accidents don't happen under perfect conditions and these products allow you to record the necessary numbers, no matter the condition. You can also make medical cheat sheet cards and laminate them. Store them everywhere so you know what to do when you need to. Even if you have been practicing, it may help in the moment. It also helps you remember medical acronyms.
Start with learning the basics of what you may encounter, everyday: blisters, minor burns, small cuts, abrasions, contusions, etc. The majority of things in your kit should be the basic items: Roller gauze, gauze pads, Band-Aids, tape, antiseptic, etc.
If you have a victim with a fever, find out what the cause is or you will only be treating the symptom. This is done with proper assessments and documentation. As a basic medic you are not going to be able to fix everything and you may need to get help from a more qualified individual. Stick to your basics. Maintain a level head and do not panic. Overreacting to the situation will make everything worse. If the fever is from something like a wound, apply some Silvasorb or anti-bacterial cream. Keep assessing wounds. Are they clean? Is the redness growing?
A good first step on your medical journey is taking a Stop the Bleed class. It only takes three minutes to bleed out from the femoral artery if it is compromised. The priority is to stop the bleeding, assess the wound and document your findings. You need to rapidly decide if the individual needs to be evacuated or if they are good to go. If they require a tourniquet, acrylics or Quik Clot you need to make the decision to evacuate them or go get help early and make it happen rapidly.
Learn to recognize what you can and can't take care of. In a survival situation, when there is no help, you will need to understand the reality that some things you will not be able to fix. Remember the first tenant is medicine is to do no harm. Don't make things worse trying to fix something you can't.
Get as much training now as you can. A basic first aid class is only four to eight hours long. An advanced class is fifteen to nineteen. Both classes will cover the basics of what you may encounter. This types of training builds confidence. If you appear confident you will calm everyone. If not you will make everyone panicky and your patience may not be cooperative with the treatment. This could cause them to have a higher blood pressure and increased heart rate.
In your MAG (mutual assistance group), cross train a few people in medical knowledge. That way if someone doesn't make it to a rally point, your team still has a qualified medical person.
In the survival community a lot of attention is paid to learning how to suture. Keven is an advocate against learning this skill. There are so many things that people need to and should know before they suture a wound. The average American doesn't have the anatomy and physiology knowledge to do it properly. Patients can have allergic reactions to suture materials. There's many different styles that are used for many different conditions. This skill should be left to trained individuals who do it daily. Suturing is mostly used to make the scar more attractive and it is not necessary to save the patient, unless it is an artery. Suturing should never be done in he field, unless it is a highly skilled individual. You need a clean, sanitary environment. Suturing hurts! If we are in a survival situation and it ends, you could be liable for any damage you did during the event. Use a butterfly bandage and roller gauze instead. Improperly suturing can cause serious damage and you need to be able to control the pain level of the patient.
It would be great to have a doctor in you MAG, however that is not always possible. Try to know where a few live within you community. Don't be weird but be nice and ask them if they would like to join you group or provide an educational sounding board for the group. Even if you don't have them in your group, you may be able to get their help in a survival situation by providing an adequate trade for their services.
For broken bones, take the basic first aid class to learn to deal with it. There are all kinds of things to learn. Should you use traction? What bone is it? Should you apply traction to an open or closed fracture? Go get trained so you know the why and then the how to properly treat the problem.
Keep training and practicing after your class. Your local EMS provider may have expired supplies that they can no longer use and have to get rid of. They make great practice supplies. Keep practicing, time will deteriorate knowledge. Help out your local EMS provider by volunteering to be a victim in training exercises. You will learn a lot with them. Develop a relationship with them so you have a resource to go to.
If you need to move an injured or elderly person during a bug-out or evacuation scenario you better plan for it well ahead of time. You need to determine can they walk? If so, they walk. If they are elderly you have two choices: leave them behind or take them with you. Remember that you will only be able to travel as fast and as far as your weakest member. However, there is no way I'm leaving a loved one behind. Preplanning allows you time to develop a mode of transportation for them that you could pull on foot over rough terrain.
Know your group. Identify high risk problems and plan for them. Shake up your practice and challenge yourself. Practice in all weather conditions. You have never properly trained if you haven't heard the saying, "If it ain't raining, you ain't training." Be prepared for anything.
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Kevin has had an avid interest in the outdoors since his father took him fishing at age 3, and has continued to pursue many outdoor activities for over 45 years, such as hiking, camping, fishing, trapping, and hunting. While serving as a Reconnaissance Specialist in the US Military, he started his diving career, and holds the certifications of DiveMaster and Master Scuba Diver, with over 15 specialties. For most of his life, he has not only been continually learning, but has used that knowledge about nature and the outdoors to teach others.
Kevin has taught members of Search and Rescue teams, participated in numerous SAR missions, given lectures on diving medicine at university hospitals, volunteered as an EMT and firefighter in his local community, served as an Assistant Scoutmaster with a local Boy Scouts Troop, and actively participates in educational podcasts and videos for EMS providers and the Preparedness community.
In 2010, Kevin was certified by the National Board of Diving and Hyperbaric Medical Technology as a Diver Medical Technician (DMT). At that time, he was one of less than 2,000 people to ever receive this certification in the United States.
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