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Survival and Preparations Long and short term survival and 'prepping'.

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  #1  
Old 01-21-2017, 8:01 AM
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Default Wish list medical supplies

Do you guys have any "wish list" items/drugs for an emergency/trauma/survival/bug out kit that you just can't get at the store or online because they are restricted?

I'm thinking of things along the lines of pain meds, antibiotics, syringes/needles, etc.

Lets limit these items to things that are labeled for human use - for example a wish list item might be a sealed bottle of amoxicillin capsules. You can't just go and pick that up at the pharmacy.

Lets also assume that if its on your wish list, you or someone with you is trained to use that item properly.
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Old 01-21-2017, 9:06 AM
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Originally Posted by cgates View Post
...Lets limit these items to things that are labeled for human use - for example a wish list item might be a sealed bottle of amoxicillin capsules. You can't just go and pick that up at the pharmacy...
Why the limit? Same stuff. Or you can go to Mexico.

http://www.lambertvetsupply.com/otc-...tibiotics.html
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Old 01-21-2017, 10:59 AM
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Actually, antibiotics for fish is the same for humans. Just because it says fish doesn't mean there is a difference.
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Old 01-21-2017, 11:03 AM
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Same exact stuff. Get several different kinds for your supplies: penicillin, amoxicillin, cephalexin.
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Old 01-21-2017, 11:16 AM
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Propofol
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Old 01-21-2017, 12:09 PM
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Injectable Lidocaine.
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Old 01-21-2017, 1:12 PM
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Simply for the sake of discussion. I was hoping this would not turn into a discussion about where to get fish antibiotics or what is the best pharmacy in Tijuana to get z-packs. I think that's been done many times already.

To the same extent, assuming one would know how to properly use the item or med would be assumed. I read other threads and I would also hope by us all making this assumption we can avoid things devolving in to a discussion/argument on whether or not you should or should not have something like morphine or epi because you might overdose somebody.

So, speaking of morphine and epi, those would probably be on my wish list, along with injectable lidocaine and some other things.





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Originally Posted by olhunter View Post
Why the limit? Same stuff. Or you can go to Mexico.

http://www.lambertvetsupply.com/otc-...tibiotics.html
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Old 01-21-2017, 2:08 PM
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Originally Posted by FeuerFrei View Post
Injectable Lidocaine.
Yeah, that could be useful, but I don't know the nerve anatomy to numb a particular finger or such.

A quick look on line finds mostly dental-related materials.
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Old 01-21-2017, 5:52 PM
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...Simply for the sake of discussion. I was hoping this would not turn into a discussion about where to get fish antibiotics or what is the best pharmacy in Tijuana to get z-packs. I think that's been done many times already....
Yeah, it has. But that's what you asked.

You wanted "....a sealed bottle of amoxicillin capsules. You can't just go and pick that up at the pharmacy."

Yes you can.

And it's perfectly fine for human use.

You can have it delivered right to your door. No prescription. At the link I gave you. And several others if you look.

So where else did you think you might buy amoxicillin without a prescription?
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Old 01-21-2017, 8:35 PM
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Standard sterile saline solution in IV bags. I suppose I could make my own, but seriously. It is just saltwater. Why the restriction?
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Old 01-21-2017, 8:38 PM
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Saline IV solution, also available on line, in a variety of sizes.
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Old 01-21-2017, 8:42 PM
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Saline IV solution, also available on line, in a variety of sizes.
Found some, thanks.
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Old 01-21-2017, 8:48 PM
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Quote:
Originally Posted by FeuerFrei View Post
Injectable Lidocaine.
This is priceless stuff. Finger injuries it's a godsend, even when doing a bandage change.

Librarian mentioned nerve anatomy. Pretty simple. Just infiltrate about 2-3cc on the medial and lateral aspects of the digit using a 22g needle just distal to the "web space"...imagine where a wedding ring would go for a simple visual... (you can use smaller gauge, but you loose "feedback" in terms of the amount of pressure on the plunger).
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Old 01-21-2017, 8:52 PM
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Originally Posted by olhunter View Post
Yeah, it has. But that's what you asked.

You wanted "....a sealed bottle of amoxicillin capsules. You can't just go and pick that up at the pharmacy."

Yes you can.

And it's perfectly fine for human use.

You can have it delivered right to your door. No prescription. At the link I gave you. And several others if you look.

So where else did you think you might buy amoxicillin without a prescription?
Yep. I've purchased and used both fish amoxicillin and fish cephlexin. ID'd the pills with a pill finder site- they were absolutely legit pharmacy grade antibiotics.


As for things I can't get, that I'd like to be able to have a small stock of - IV or injectable antibiotics, IV or injectable pain killers,and a good prescription antiviral, just off the top of my head.
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Old 01-21-2017, 8:53 PM
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Originally Posted by Librarian View Post
Yeah, that could be useful, but I don't know the nerve anatomy to numb a particular finger or such.

A quick look on line finds mostly dental-related materials.
Ring block. Simple and easy to do, even if you're not practiced. I do them regularly at work. NO EPI.

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Old 01-21-2017, 8:56 PM
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Injectable Lidocaine.
Marcaine is better, it lasts a LOT longer.
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Old 01-21-2017, 8:57 PM
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Originally Posted by bigdawg86 View Post
This is priceless stuff. Finger injuries it's a godsend, even when doing a bandage change.

Librarian mentioned nerve anatomy. Pretty simple. Just infiltrate about 2-3cc on the medial and lateral aspects of the digit using a 22g needle just distal to the "web space"...imagine where a wedding ring would go for a simple visual... (you can use smaller gauge, but you loose "feedback" in terms of the amount of pressure on the plunger).
Yep. A nerve block is what the ER doc called it when I had to have it done. It truely was a godsend. That and the morphine.
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Old 01-21-2017, 9:11 PM
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Ring block. Simple and easy to do, even if you're not practiced. I do them regularly at work. NO EPI.

Very nice. Thanks!
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Old 01-22-2017, 9:50 AM
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Great vid divern.
Thanx!

Sent using 2 cans and a long string.
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Old 01-22-2017, 10:24 AM
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Never could figure out why IV bags were controlled too, I almost have to wonder if its because they are in short supply. Atleast the internet provides a way to get them. If addicts can find brachial or cephalic veins then normal people with the will to learn for productive situations can too. And its called for in so many instances of trauma and injury. Oh well.

I will say one tool that you may want asides from your trusty medical shears is Ring Cutter. Its not really controlled, just hard to get a good one.



I do want a FAST1 Intraosseous Infusion System. Ofcourse if I ever had to use it I want the helicopter and medical facility the patient pretty much needs too.
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Old 01-22-2017, 11:05 AM
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I seen a bunch of IV starter kits, all had 'for training purposes' on them


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Old 01-22-2017, 11:06 AM
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Never could figure out why IV bags were controlled too, ...
It has to do with intended use. Saline for medical use has physiological effects just like medical grade oxygen and as such is classified as a drug. As an IV drug, it has to be regulated.

However, if you have or know of someone with large animals, they can often get it from a vet easily enough. Same stuff. I get mine from a large animal veterinarian here, but of course, I only use it on animals.

Saline and LR are the best ones to have in inventory. Wondrous for hangovers.
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Old 01-22-2017, 12:49 PM
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Never could figure out why IV bags were controlled too, I almost have to wonder if its because they are in short supply.
I have also read elsewhere that there is currently a 'shortage' of IV fluids. If true, any ideas about the cause?


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It has to do with intended use. Saline for medical use has physiological effects just like medical grade oxygen and as such is classified as a drug. As an IV drug, it has to be regulated.

However, if you have or know of someone with large animals, they can often get it from a vet easily enough. Same stuff. I get mine from a large animal veterinarian here, but of course, I only use it on animals.

Saline and LR are the best ones to have in inventory. Wondrous for hangovers.
Yet you can purchase sterile saline solution for irrigation, opthalmic and nasal purposes just about anywhere. I guess the 'IV' intended use is what makes the difference in terms of availability. I used to have a good guy feed store owner who helped me out a few times with medical supplies for my animals (dogs and goats). He retired and sold his business to a younger couple. I don't know how 'self-reliant friendly' they are.

The medical O2 reference reminds me that I have some full O2 cylinders and need to pick up a regulator and accessories.
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Old 01-22-2017, 1:15 PM
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Isotonic, Hypertonic and Hypotonic solutions and the whole osmosis thing. It is not as simple as "well it's just salt water". Not at all. An Isotonic solution is .9% NS(Normal Saline). Neutral. Saline, salt, is great importance to the cardiac cycle.

As much as it is knowing when a medication is indicated, it is just as important to know when not to give.

EPI for blocks below the wrist: NEVER, EVER! Vasoconstriction is bad in hands and feet. Divern is right.

Antibiotics: use the right drug for the right bug. If you cannot perform an accurate differential diagnosis then it's just bad medicine.


The 5 R's to medication administration:

Right drug.
Right patient
Right dose
Right route
Right time


Pharmacology is not easy. No really. Go read a PDR, then Structure an Function of The Body. PDR is details about medications, and the latter is anatomy an physiology. Why the body works and why and how it does what it does. Might as well go nuts and get a Merck Manual. http://www.merckmanuals.com/professional

The above is not medicolegal advice and a patient-provider relationship does not exist.
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Old 01-22-2017, 4:02 PM
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And, for those interested, the Merck Manual Professional is available as a free app for IOS and for Android.
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Old 01-22-2017, 7:41 PM
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And, for those interested, the Merck Manual Professional is available as a free app for IOS and for Android.
Thanks for that.
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Old 01-22-2017, 8:34 PM
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I will say one tool that you may want asides from your trusty medical shears is Ring Cutter. Its not really controlled, just hard to get a good one.



https://www.amazon.com/gp/aw/d/B00BH...TNCJ5QXZ8XHYYM
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Old 01-22-2017, 8:54 PM
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I do want a FAST1 Intraosseous Infusion System.
Oh man! Reminded me of this video I saw a few months back... WARNING: NSFLunch

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Old 01-22-2017, 9:04 PM
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Antibiotics: use the right drug for the right bug. If you cannot perform an accurate differential diagnosis then it's just bad medicine.

I get what you're saying. But If when a major quake comes our way (I'm a mile from the Hayward fault) and the hospitals are totally jacked? I'm taking that fishmox for my laceration should it come to that. Wife's a nurse, I'll make her do the sutures.
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Old 01-22-2017, 9:26 PM
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I get what you're saying. But If when a major quake comes our way (I'm a mile from the Hayward fault) and the hospitals are totally jacked? I'm taking that fishmox for my laceration should it come to that. Wife's a nurse, I'll make her do the sutures.
Do good, basic wound care and infections are very rare.

Further, it's not just the drug, it's how it's delivered, i.e. route. Example, I can give Midazolam IV, IM, but not via ET, Endotracheal Tube.

As to suturing, I can teach a monkey to sew. Go get a pigs foot, needle and thread and go to town.

There are a lot of things being proposed in this thread that come with major complications. Some here may be providers, some may not. People are talking about IO's. Grinding a piece of stylette guided steel into a childs, medullary cavity in his or her tibia can cause problems. If you are doing an IO the kid or adult is ****ed up and hitting the kids epiphyseal plate is not a major concern, but you must be aware. Drawing bone marrow up after popping into the cavity is a must, and IO's don't flow like a venous or arterial line does.

Many community colleges offer basic EMT courses. It is a rock solid education in the basics of emergency medicine.

Learn the basics first, and cool **** later. I can accomplish a lot with good, basic care.

Direct pressure and elevation for bleeding.

Elevate the legs before an IV for hypotension.

Head tilt chin lift and an OPA before Oral Endotracheal Intubation.

Good aseptic technique to head off infection as opposed to relying on anti biotics.
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Old 01-22-2017, 9:34 PM
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I get what you're saying. But If when a major quake comes our way (I'm a mile from the Hayward fault) and the hospitals are totally jacked? I'm taking that fishmox for my laceration should it come to that. Wife's a nurse, I'll make her do the sutures.
Probably the wrong drug:
Quote:
Protocol 3: Antibiotic prophylaxis and treatment
Antibiotic prophylaxis

Antibiotic prophylaxis is indicated in situations or wounds at high risk to become infected such as:

contaminated wounds, penetrating wounds, abdominal trauma, compound fractures, lacerations greater than 5 cm, wounds with devitalized tissue, high risk anatomical sites such as hand or foot. etc. These indications apply for injuries which may or may not require surgical intervention. For injuries requiring surgical intervention, antibiotic prophylaxis is also indicated and should be administered prior to surgery, within the 2 hour period before the skin is cut.

Recommended prophylaxis consists of penicillin G and metronidazole given once (more than once if the surgical procedure is > 6 hours).

• Penicillin G ADULT: IV 8-12 million IU once. CHILD: IV 200,000 IU/kg once.
• Metronidazole ADULT: IV 1,500 mg once (infused over 30 min). CHILD: IV 20 mg/kg once.

Antibiotic treatment
If infection is present or likely, administer antibiotics via intravenous and not intramuscular route.

Penicillin G and metronidazole for 5-7 days provide good coverage.

• Penicillin G
ADULT: IV 1 - 5 MIU every 6 hours.
After 2 days it is possible to use oral Penicillin: Penicillin V 2 tablets every 6 hours.

CHILD: IV 100mg/kg daily divided doses (with higher doses in severe infections),
In case of known allergy to penicillin use erythromycin.

In case of sudden allergy reaction (seldom):
IM adrenaline 0.5 - 1.0 mg to adults. 0.1 mg/ 10 kg body weight to children.

• Metronidazole
ADULT: IV 500 mg every 8 hours (infused over 20 minutes).
CHILD: IV 7.5 mg/kg every 8 hours
http://www.who.int/hac/techguidance/...0infection.pdf

IV penicillin is likely a more effective drug than oral amoxicillin for the kinds of wounds/infections associated with injuries. There's some overlap, so it should be somewhat effective if that's what you have.

See also http://www.emedexpert.com/compare-me...nicillin.shtml

Also note Fish-Pen is penicillin ...
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Old 01-23-2017, 12:06 AM
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The one I stock for prophylaxis is cephalexin (fish-flex), simply because when I had an injury that involved soft tissue trauma, bone trauma, and exposed bone that's what the doc gave me. (Keflex).

Quote:
Generic Name: Cephalexin (multiple manufacturers)
Common Brand Name: Keflex (MiddleBrook Pharmaceuticals – U.S.)
Popularity: Seventeenth most commonly prescribed drug between 2002-2006 (U.S.)
Class: First generation cephalosporin antibiotic

Treatment Uses — For treatment of bacterial infections including group A beta-hemolytic Streptococcus, Staphylococcus, Klebsiella pneumoniae, E. coli, Proteus mirabilis and Shigella. Cephalexin is primarily used in susceptible skin and soft tissue infections, lower respiratory tract infections, bone (osteomyelitis) and joint infections, strep throat (streptococcal pharyngitis), ear infections (otitis media), and urinary tract infections (UTIs). Can be used as prophylaxis against bacterial endocarditis in high risk surgical procedures or dental patients allergic to penicillin, for who pretreatment with antibiotics is indicated. At least one study, however, found cephalexin ineffective for dental prophylaxis. Has been effective in treatment of both acute and chronic sinus infections (sinusitis). Cephalexin has been effective for treatment of infections associated with diverticulitis and for prevention of UTI following prostatectomy (prostate removal). Cephalexin has not been effective for long-term prevention of respiratory tract infections in cystic fibrosis patients. It has also not been effective for treatment of Lyme disease or for prevention or treatment of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
https://www.ems1.com/ems-products/ed...lex-Drug-Whys/

Dosages:

https://www.drugs.com/dosage/cephalexin.html

Quote:
Usual Adult Dose for Bacterial Endocarditis Prophylaxis
2 g orally as a single dose one hour before the procedure

Usual Adult Dose for Cystitis
250 mg orally every 6 hours or 500 mg orally every 12 hours for 7 to 14 days

Usual Adult Dose for Otitis Media
500 mg orally every 6 hours for 10 to 14 days

Usual Adult Dose for Pharyngitis
250 mg orally every 6 hours or 500 mg orally every 12 hours

Usual Adult Dose for Skin or Soft Tissue Infection
250 mg orally every 6 hours or 500 mg orally every 12 hours

Usual Adult Dose for Osteomyelitis
500 mg orally every 6 hours
Therapy should be continued for approximately 4 to 6 weeks, depending on the nature and severity of the infection. Chronic osteomyelitis may require an additional one to two months of antibiotic therapy and may benefit from surgical debridement.

Usual Adult Dose for Prostatitis
500 mg orally every 6 hours for 14 days

Usual Adult Dose for Pyelonephritis
500 mg orally every 6 hours for 14 days

Usual Adult Dose for Upper Respiratory Tract Infection
250 to 500 mg orally every 6 hours for 7 to 10 days

Usual Adult Dose for Bacterial Infection
250 to 500 mg orally every 6 hours
Therapy should be continued for approximately 7 to 21 days, depending on the nature and severity of the infection.

Usual Pediatric Dose for Otitis Media
12.5 to 25 mg/kg orally every 6 hours

Usual Pediatric Dose for Pharyngitis
Over 1 year of age:
Streptococcal pharyngitis: 12.5 to 25 mg/kg orally every 12 hours

Usual Pediatric Dose for Skin or Soft Tissue Infection
12.5 to 25 mg/kg orally every 12 hours

Usual Pediatric Dose for Bacterial Endocarditis Prophylaxis
As an alternative in penicillin-allergic patients (non-anaphylactoid type): 50 mg/kg (maximum 2 g) orally once, 1 hour before procedure

Renal Dose Adjustments
CrCl 10 to 40 mL/min: The usual dose should be administered every 8 to 12 hours.
CrCl 9 mL/min or less: The usual dose should be administered every 12 to 24 hours.

Liver Dose Adjustments
Data not available

Dose Adjustments
Infections that are more severe or caused by less susceptible organisms may require dosages up to 4 g per day in divided doses.
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Old 01-23-2017, 12:19 AM
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Do good, basic wound care and infections are very rare.

Further, it's not just the drug, it's how it's delivered, i.e. route. Example, I can give Midazolam IV, IM, but not via ET, Endotracheal Tube.

As to suturing, I can teach a monkey to sew. Go get a pigs foot, needle and thread and go to town.

There are a lot of things being proposed in this thread that come with major complications. Some here may be providers, some may not. People are talking about IO's. Grinding a piece of stylette guided steel into a childs, medullary cavity in his or her tibia can cause problems. If you are doing an IO the kid or adult is ****ed up and hitting the kids epiphyseal plate is not a major concern, but you must be aware. Drawing bone marrow up after popping into the cavity is a must, and IO's don't flow like a venous or arterial line does.

Many community colleges offer basic EMT courses. It is a rock solid education in the basics of emergency medicine.

Learn the basics first, and cool **** later. I can accomplish a lot with good, basic care.

Direct pressure and elevation for bleeding.

Elevate the legs before an IV for hypotension.

Head tilt chin lift and an OPA before Oral Endotracheal Intubation.

Good aseptic technique to head off infection as opposed to relying on anti biotics.
Amen brother! Well said.
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Old 01-23-2017, 9:49 AM
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And some light reading about Lidocaine Toxicity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791737/

Lidocaine Prolonged Q-T. Some "caine" drugs can cause Prolonged Q-T and can cause people to go into Asystole. The absence of all electrical activity.

https://www.merckmanuals.com/profess...ar-tachycardia

Personally, I like Amiodarone for Atrial and Ventricular Tachydysrhthmia's.

My point is, medications are chemicals first. In most cases the good outweighs the bad. For every drug approved for use, there are many that never even make it clinical trials. Want to know what an outstanding painkiller is? Diamorphine, Heroin. But it is so addictive it is a Schedule I drug. MS04, Morphine Sulfate is much better, and Fentanyl even stronger.

Is all of this above basic needs in a disaster situation? Yes, but I post this to give you more info than is needed so that you give pause and consider a bit more than is needed. Not all is as it appears.

Fun fact: Morphine gets its name from Morpheus, The God of Dreams.
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Mr. Madison, what you’ve just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul.

Last edited by Desertdoc; 01-23-2017 at 10:00 AM..
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Old 01-23-2017, 10:10 AM
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Having these life saving medications are great but"

Most people are not medically trained in use of many or all of these useful antibiotics & such (Injectable's/pill tables in SHTF situation/Emergencies/disasters)

It would be advantageous to have a cheat sheet with tests & directions for use of these medications IMHO.

It may be likely that only one (if even that) that who could do this who has training might be the one needing such treatments.

Is there such a cheat sheet ?

An is this better than letting you young child die for lack of services ?
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Old 01-23-2017, 10:17 AM
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Quote:
Originally Posted by Dano3467 View Post
Having these life saving medications are great but"

Most people are not medically trained in use of many or all of these useful antibiotics & such (Injectable's/pill tables in SHTF situation/Emergencies/disasters)

It would be advantageous to have a cheat sheet with tests & directions for use of these medications IMHO.

It may be likely that only one (if even that) that who could do this who has training might be the one needing such treatments.

Is there such a cheat sheet ?

An is this better than letting you young child die for lack of services ?
Please, everyone, take a basic EMT class. Learn good basic skills. Advanced level care is very complex and emergency care is an entire field of study. Years of training are needed and continuing education. Then there is ACLS, PALS, NRP, PHTLS, ATLS.

Folks, a VERY harsh reality is that if the SHTF, emergency services will be overwhelmed, people will die, to include those providing emergency services. It is a sad reality.
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Mr. Madison, what you’ve just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul.

Last edited by Desertdoc; 01-23-2017 at 10:24 AM..
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Old 01-23-2017, 1:53 PM
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Basic Emergency Medical Technician training is only a semester and would be hugely more valuable than a whole room full of "stuff" you do not fully understand how to put to good and proper use. I would certainly have an EMT class at the top of my medical preparations list.

There are things you can do to buy time or avoid the need for advanced care all together in a time of limited access to health care using ordinary household things on hand. An excellent book on this topic has fairly recently come out and I highly recommend it. It is called The Doomsday Book of Medicine by Ralph La Guardia M.D. https://www.amazon.com/Doomsday-Book...y+medical+book

In this book, Dr. La Guardia does a very thorough job of describing alternative ways of treating a wide range of illness and injuries, using in some cases old techniques nearly forgotten, when access to the more modern techniques and medications are not accessible. He has a very good chapter on wound care using only things found on hand in the average household. Some of the techniques described come from the time before antibiotics were discovered and are still sound techniques today when antibiotics are not an option.

I have made some changes in what I stock for emergencies based on some very good advice I found in his book. For example, someone who was quite dehydrated for whatever reason, might end up getting an IV of normal saline to more quickly rehydrate them while the underlying cause is addressed. But what do you do if you don't have access to an IV? He goes on to describe the range of alternatives to manage dehydration when you don't have access to some of the standard remedies.

For the home brew oral rehydration solution he describes, I found that I was missing one of the ingredients so I ordered it to have on hand and then went on to mix up and prepackage a few doses so it's ready to go when needed.

It's always cool to have a bag full of nifty stuff but sometimes the class you took last semester or that certain book on the shelf might become your greatest assets in a prolonged crisis.
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Old 01-23-2017, 1:57 PM
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^^^^^Foshizzle. LMAO.

Also skills are perishable. Once you learn stick with it. Go join any D-MAT or SAR team. D-MAT 6 is in San Francisco http://www.ca6dmat.org/ . Truely want to learn? Teach. See one, do one, teach one.

The more you learn, the more you will realize how very little you know. It was a hard but needed lessen for me. At that point, I was far more capable of learning.

ETA:

Trauma is easy to learn but can be stressful to manage and is dramatic because people see blood and loose their damn minds. EMT's do well here because it requires no medications to manage. Popsicle sticks work wonders.

Medical is much more complex.

Treatment modalities change, forget those and learn anatomy and physiology ie structure and function of the body. This NEVER changes. THEN various treatments and or interventions.

https://www.amazon.com/Structure-Fun.../dp/0323357253
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Primum Non Nocere

Good Medicine, Bad Places.

Do No Harm, Do Know Harm.

Mr. Madison, what you’ve just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul.

Last edited by Desertdoc; 01-23-2017 at 3:50 PM..
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  #39  
Old 01-23-2017, 11:32 PM
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Some of my santa drug med list is Lidocaine patches and cream, fentanyl pops, epi, versed, nitro, etc etc.
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