Hello all,
I'd like to introduce myself to the forum. I have been a prepper for many years, and I am a doctor in the south of England. I am looking forward to learning lots of new things, and I can bring some of my medical experience to bear where relevant. I have worked in emergency medicine, obstetrics, paediatrics, general surgery and general practice.
I am very much of the "bug-in" variety, partly because we live in a semi-rural environment and partly because with a young family it is difficult to conceive that we will find a safer location than our own home.
Having a young family brings quite a lot of challenges in prepping that I would like to share!
I hope to get to know you all better.
Ask Dr Apocalypse
Re: Hello from a new member with medical background
Welcome onboard. Would be interesting to hear, with your experience, what you would include in a family first aid box ahead of a SHTF situation. Obviously, something aimed at people without extensive medical experience.
Re: Hello from a new member with medical background
Welcome! Great to be in a semi-rural environment, absolutely.
As Kernewek said, it'd be really interesting to know what you regard as a good first aid kit for non-medical people (and the extras for a medical person too, actually
).
Do you get time to grow your own veg at all? My impression of the medical profession right now is that hours worked is a real issue.
As Kernewek said, it'd be really interesting to know what you regard as a good first aid kit for non-medical people (and the extras for a medical person too, actually
).Do you get time to grow your own veg at all? My impression of the medical profession right now is that hours worked is a real issue.
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DrApocalypse
- Posts: 10
- Joined: Sun Nov 15, 2015 10:21 pm
Re: Hello from a new member with medical background
Hello and thanks for the warm welcome.
We have capacity for some self sufficiency in terms of growing. The hours are definitely an issue but we do try and grow when we can, if just to keep our hands in. We have just enough space to put up a couple of polytunnels if needed, but that would be pretty much all of our space. More land would be ideal and this is something I sorely crave!
The first aid kit subject is a book in its own right. I think it will be really interesting to see what everyone has in their kits and I am sure we will continue this discussion in the health/medical forum area in the future. My own medical kit is fairly extensive for several reasons. I am known locally to be a doctor so I expect people to seek me out in times of crisis. My skill set is naturally broader so it makes sense to have a wider range of kit, but I have had to hold back from going crazy because it gets very expensive very quickly.
In terms of what my suggestions would be for a non medically trained prepper, I think that there are some crucial items but overall an inexpensive basic kit will cover most eventualities.
First, if you have a chronic disease, knowledge is power. Make sure you know your medications, what they do, and always have at least a month in supply. It may be difficult to persuade your doctor to let you have more, but ensure you know where to get it in an emergency. Know where your nearest pharmacy is and make it a priority if the worst happens. The chances of total collapse is pretty remote, so a month supply is going to be plenty for 99% of the time, but have a contingency.
I would reccommend everyone gets seasonal flu jabs, if you are not NHS elegible then get one at boots it costs about £10. I have seen influenza kill a 21 year old athlete who was at the peak of his fitness, it really is no joke and the flu jab gets a bad press but probably saves about 20,000 lives in the UK each year.
From the point of view of first aid, I don't think the average prepper needs to go crazy I have to say.
The things that are most likely to affect your health in societal collapse, the potential for violence aside, is infectious disease. This will be due to sewer drainage failure, and water treatment failure, and the potential for disease spread amongst refugee concentration.
From the first aid kit point of view, water purification methods are crucial, and have redundant forms. Although not strictly first aid I always have puritabs in my first aid kit because of their importance to health, and that you can use them to sterilize dressings and instruments if needed. purification tablets are good, as are the ultra fine particle filter straws you can get (they filter 100,000 litres mechanically and are about the size of a large matchbox and filter out even the smallest bacteria).
I would ensure that you have some basic kit items that you would expect in any standard kit - dressings, bandages, wound closure (strips and glue are generally fine, sutures if you really know what you are doing). Antiseptic cream (my preferred is fucidic acid cream which is antimicrobial), steroid cream (hydrocortisone 1% is usually sufficient and available over the counter and is useful for irritant skin conditions) and antifungal cream (clotrimazole 2% again over the counter). I would have some iodine as it is phenominally toxic to bacteria but seems to have no adverse effect on human cells and is amazing for cleaning out wounds. Hurts like hell in a deep wound believe me but is very effective.
Tablet wise I would just keep a good supply of the basics. paracetamol, ibuprofen, aspirin, antihistamines. There is always a lot of concern amongst preppers about ensuring a supply of antibiotics. I totally understand this, especially as my first line was that about infectious disease, and I shall come on to that in a moment, however for the vast majority of preppers I would not recommend stockpiling antibiotics. My personal reason for this is that, hand on heart, unless you have had years of experience with the use of antibiotics and prescribing them, you are more likley to do yourself harm than good by taking them. different antibiotics obviously are used for different types of infection, and there is quite a lot of regional variation throughout the UK in terms of what bugs are causing what infections. Local hospitals put out guidance to their doctors on a regular basis to reflect this, so it really is not a straightforward case.
My suggestion there would be, if you are prepping for a "there is no help" scenario, know where you can get antibiotics if things fall apart, and if that happens you want to find a doctor and make friends with them. I am thinking of creating a UK relevant antibiotic resource, for WHAT antibiotics for certain infections (for absolute worst case scenarios) but there is still the issue of WHEN it is appropriate to use antibiotics, and this is by no means a straightforward issue.
I digress. Other important items also address the issue of infectious disease and that is good old diarrhoea, and horrible nasty cholera specifically. In cholera you die essentially because The little git V. Cholerae produces a toxin that causes your body's salts to flood out into your guts. Because water likes to move into areas of high salt concentration, your body's water follows the salt and you get massive diarrhoea. You die of dehydration and salt loss (hypovolaemia/hyponatremia) and if you get it obviously in unsanitary conditions in exactly the sort of SHTF scenario we are prepping for. If you get it and it is not treated, you will almost certainly die, but if you have plenty of dioralyte or similar rehydration salts then you will almost certainly survive with just that plus copious rehydration with fluids. Get lots of them because the risk of such illnesses is very high. Failing that, your store cupboard should have plenty of table salt and sugar in it and you can make the rehydration salts just with them.
This has turned into a bit of an essay. What I have put above is absolutely not exhaustive in terms of first aid but to be honest these are the things that save the most lives. Make sure your water is clean, and be able to treat yourself if you do get severe diarrhoeal disease. Be able to clean out a wound and strap/glue/strip it up proficiently enough that you don't get an infection in the first place. Have some basic medications to treat pain, fever, and allergic reactions. Have clean dressings and the ability to sterilise them to reuse if needed.
The other thing that I would say is that information is the most important thing once you have got the basics. Know where to find the information you need to treat more complex problems, whether that is by finding a doctor or other health care professional, or written resources.
My first aid kit on the other hand is MASSIVE and crammed with cool stuff. Happy to talk about that too!
We have capacity for some self sufficiency in terms of growing. The hours are definitely an issue but we do try and grow when we can, if just to keep our hands in. We have just enough space to put up a couple of polytunnels if needed, but that would be pretty much all of our space. More land would be ideal and this is something I sorely crave!
The first aid kit subject is a book in its own right. I think it will be really interesting to see what everyone has in their kits and I am sure we will continue this discussion in the health/medical forum area in the future. My own medical kit is fairly extensive for several reasons. I am known locally to be a doctor so I expect people to seek me out in times of crisis. My skill set is naturally broader so it makes sense to have a wider range of kit, but I have had to hold back from going crazy because it gets very expensive very quickly.
In terms of what my suggestions would be for a non medically trained prepper, I think that there are some crucial items but overall an inexpensive basic kit will cover most eventualities.
First, if you have a chronic disease, knowledge is power. Make sure you know your medications, what they do, and always have at least a month in supply. It may be difficult to persuade your doctor to let you have more, but ensure you know where to get it in an emergency. Know where your nearest pharmacy is and make it a priority if the worst happens. The chances of total collapse is pretty remote, so a month supply is going to be plenty for 99% of the time, but have a contingency.
I would reccommend everyone gets seasonal flu jabs, if you are not NHS elegible then get one at boots it costs about £10. I have seen influenza kill a 21 year old athlete who was at the peak of his fitness, it really is no joke and the flu jab gets a bad press but probably saves about 20,000 lives in the UK each year.
From the point of view of first aid, I don't think the average prepper needs to go crazy I have to say.
The things that are most likely to affect your health in societal collapse, the potential for violence aside, is infectious disease. This will be due to sewer drainage failure, and water treatment failure, and the potential for disease spread amongst refugee concentration.
From the first aid kit point of view, water purification methods are crucial, and have redundant forms. Although not strictly first aid I always have puritabs in my first aid kit because of their importance to health, and that you can use them to sterilize dressings and instruments if needed. purification tablets are good, as are the ultra fine particle filter straws you can get (they filter 100,000 litres mechanically and are about the size of a large matchbox and filter out even the smallest bacteria).
I would ensure that you have some basic kit items that you would expect in any standard kit - dressings, bandages, wound closure (strips and glue are generally fine, sutures if you really know what you are doing). Antiseptic cream (my preferred is fucidic acid cream which is antimicrobial), steroid cream (hydrocortisone 1% is usually sufficient and available over the counter and is useful for irritant skin conditions) and antifungal cream (clotrimazole 2% again over the counter). I would have some iodine as it is phenominally toxic to bacteria but seems to have no adverse effect on human cells and is amazing for cleaning out wounds. Hurts like hell in a deep wound believe me but is very effective.
Tablet wise I would just keep a good supply of the basics. paracetamol, ibuprofen, aspirin, antihistamines. There is always a lot of concern amongst preppers about ensuring a supply of antibiotics. I totally understand this, especially as my first line was that about infectious disease, and I shall come on to that in a moment, however for the vast majority of preppers I would not recommend stockpiling antibiotics. My personal reason for this is that, hand on heart, unless you have had years of experience with the use of antibiotics and prescribing them, you are more likley to do yourself harm than good by taking them. different antibiotics obviously are used for different types of infection, and there is quite a lot of regional variation throughout the UK in terms of what bugs are causing what infections. Local hospitals put out guidance to their doctors on a regular basis to reflect this, so it really is not a straightforward case.
My suggestion there would be, if you are prepping for a "there is no help" scenario, know where you can get antibiotics if things fall apart, and if that happens you want to find a doctor and make friends with them. I am thinking of creating a UK relevant antibiotic resource, for WHAT antibiotics for certain infections (for absolute worst case scenarios) but there is still the issue of WHEN it is appropriate to use antibiotics, and this is by no means a straightforward issue.
I digress. Other important items also address the issue of infectious disease and that is good old diarrhoea, and horrible nasty cholera specifically. In cholera you die essentially because The little git V. Cholerae produces a toxin that causes your body's salts to flood out into your guts. Because water likes to move into areas of high salt concentration, your body's water follows the salt and you get massive diarrhoea. You die of dehydration and salt loss (hypovolaemia/hyponatremia) and if you get it obviously in unsanitary conditions in exactly the sort of SHTF scenario we are prepping for. If you get it and it is not treated, you will almost certainly die, but if you have plenty of dioralyte or similar rehydration salts then you will almost certainly survive with just that plus copious rehydration with fluids. Get lots of them because the risk of such illnesses is very high. Failing that, your store cupboard should have plenty of table salt and sugar in it and you can make the rehydration salts just with them.
This has turned into a bit of an essay. What I have put above is absolutely not exhaustive in terms of first aid but to be honest these are the things that save the most lives. Make sure your water is clean, and be able to treat yourself if you do get severe diarrhoeal disease. Be able to clean out a wound and strap/glue/strip it up proficiently enough that you don't get an infection in the first place. Have some basic medications to treat pain, fever, and allergic reactions. Have clean dressings and the ability to sterilise them to reuse if needed.
The other thing that I would say is that information is the most important thing once you have got the basics. Know where to find the information you need to treat more complex problems, whether that is by finding a doctor or other health care professional, or written resources.
My first aid kit on the other hand is MASSIVE and crammed with cool stuff. Happy to talk about that too!
Re: Hello from a new member with medical background
Thats lots! BrilliantDrApocalypse wrote:We have capacity for some self sufficiency in terms of growing. The hours are definitely an issue but we do try and grow when we can, if just to keep our hands in. We have just enough space to put up a couple of polytunnels if needed, but that would be pretty much all of our space. More land would be ideal and this is something I sorely crave!
My one novel contribution to the first aid debate (ages agoThe first aid kit subject is a book in its own right. I think it will be really interesting to see what everyone has in their kits and I am sure we will continue this discussion in the health/medical forum area in the future.
) was a head lice comb 
since widened to tick tweezers, as well as the other stuff.Argh. My immune system is wet-paper-bag level, and I haven't got a jab yet. Am I too late?I would reccommend everyone gets seasonal flu jabs, if you are not NHS elegible then get one at boots it costs about £10. I have seen influenza kill a 21 year old athlete who was at the peak of his fitness, it really is no joke and the flu jab gets a bad press but probably saves about 20,000 lives in the UK each year.
I'm good there.From the first aid kit point of view, water purification methods are crucial, and have redundant forms. Although not strictly first aid I always have puritabs in my first aid kit because of their importance to health, and that you can use them to sterilize dressings and instruments if needed. purification tablets are good, as are the ultra fine particle filter straws you can get (they filter 100,000 litres mechanically and are about the size of a large matchbox and filter out even the smallest bacteria).
Mostly good there, but I've not even head of fucidic acid cream, and on googling found its prescription only?I would ensure that you have some basic kit items that you would expect in any standard kit - dressings, bandages, wound closure (strips and glue are generally fine, sutures if you really know what you are doing). Antiseptic cream (my preferred is fucidic acid cream which is antimicrobial), steroid cream (hydrocortisone 1% is usually sufficient and available over the counter and is useful for irritant skin conditions) and antifungal cream (clotrimazole 2% again over the counter). I would have some iodine as it is phenominally toxic to bacteria but seems to have no adverse effect on human cells and is amazing for cleaning out wounds. Hurts like hell in a deep wound believe me but is very effective.
I like that!... for the vast majority of preppers I would not recommend stockpiling antibiotics. My personal reason for this is that, hand on heart, unless you have had years of experience with the use of antibiotics and prescribing them, you are more likley to do yourself harm than good by taking them. different antibiotics obviously are used for different types of infection, and there is quite a lot of regional variation throughout the UK in terms of what bugs are causing what infections. Local hospitals put out guidance to their doctors on a regular basis to reflect this, so it really is not a straightforward case.
What proportions, Dr A? I've seen so many differing recommendations, I wouldn't follow any non-medical person's advice on that.Failing that, your store cupboard should have plenty of table salt and sugar in it and you can make the rehydration salts just with them.
Yay! Thank you!This has turned into a bit of an essay.
When you're readyMy first aid kit on the other hand is MASSIVE and crammed with cool stuff. Happy to talk about that too!
Re: Hello from a new member with medical background
Great reply DrApocalypse. What's your opinion in terms of aspirin? How much of a potential lifesaver is it in terms of a heart attack, what dose (think I've got 300mg in my kit) and swallow or chew?
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DrApocalypse
- Posts: 10
- Joined: Sun Nov 15, 2015 10:21 pm
Re: Ask Dr Apocalypse
Thanks for your interest and your questions are all very pertinent!
Regarding the flu jab – you are not too late. I am sure that the high street pharmacies are still offering them for very little money and you can just walk in and ask for one. This will be the case until the new year, and I would definitely recommend getting one.
You are absolutely right about the fucidic acid, it is prescription only as far as I am aware so actually might not be readily available. Keep it on your wish list though as it is very handy for minor skin infections. Your best over the counter bet may be something like Germoline or any of the other antiseptic creams you can get. You can also use neat medical iodine solution on dirty wounds or infected skin patches if you don't have access to fucidin.
Regarding rehydration salts, your store cupboard version of dioralyte does not need to be perfect but it needs to replenish your salts and sugars without overdoing it. The “isotonic” or naturally balanced concentration of sodium in your blood is 0.9% which is equivalent to nine grams of sodium chloride in one litre of body fluid. That is what you would get if you had intravenous fluids administered. Similarly the isotonic concentration of glucose is 5%, or 50 grams of glucose in one litre of fluid. Because you want to replace fluid volume and a BLEND of salts and sugars, I would use a rough guide of about 20 grams of sugar and 2.5 – 3 grams of table salt dissolved in one litre of purified water in order to replace lost salts in an emergency. That is for ORAL administration obviously! Dioralyte is overall a bit better because it also has potassium and a few other things in it I think.
If you wanted to be a super nerd and find a store cupboard way of supplementing lost potassium (which in itself can be dangerous in severe diarrhoeal illness) you can buy one of the low sodium salts like “Lo-Salt” which is a blend of 66% potassium chloride (KCL) and 33% sodium chloride. Dioralyte contains 0.3g KCL for 200ml reconstituted volume, so if we multiply that out we get a desired KCL load of 1.5g/l. Lo-Salt is only 66% KCL so we would put in a bit more Lo-Salt to make it up. In this scenario a reasonable emergency replacement blend of sugar/salts would be:
20 grams sugar
2.5 grams table salt
2 grams Lo-salt
All dissolved in one litre purified water and administered orally.
Phew!
And regarding the very good question about aspirin:
Aspirin is a great drug. Powerful pain killer, good anti inflammatory, lots of uses that we can discuss if there is interest. In the specific occurrence of a heart attack it is widely used as the first treatment. If I ever see someone who I think is having a heart attack the first thing I get them to do is chew an aspirin and spray a medicine called GTN under their tongues. Traditionally it is chewed because there is absorption of the aspirin through the cheeks even before you swallow so this is the quickest way to get benefit.
In a situation where there is help available it is a good medication to give immediately but this is obviously not enough by itself and they need hospitalisation if at all possible. If the S has truly hit the F and NO HELP is coming then get them to munch 300 or 600mg aspirin. If they have typical heart attack symptoms (central crushing chest pain or tightness like a band round the ribs, shortness of breath, with or without pain going up into the neck or down the left arm and looking clammy and horrible) and the pain is persisting AND there is no help, then find a survivor who suffers with angina, and ask them very politely to borrow their GTN spray. Use that and see if it helps. If it doesn't then they are in trouble because they need treatments that only a hospital can provide.
Hope that is useful, perhaps we should move this across to the health area for further discussion, or is that what a “sticky” is? Let me know if I should start a new thread in the right place we can always copy this all across.
Have a good evening all...
Regarding the flu jab – you are not too late. I am sure that the high street pharmacies are still offering them for very little money and you can just walk in and ask for one. This will be the case until the new year, and I would definitely recommend getting one.
You are absolutely right about the fucidic acid, it is prescription only as far as I am aware so actually might not be readily available. Keep it on your wish list though as it is very handy for minor skin infections. Your best over the counter bet may be something like Germoline or any of the other antiseptic creams you can get. You can also use neat medical iodine solution on dirty wounds or infected skin patches if you don't have access to fucidin.
Regarding rehydration salts, your store cupboard version of dioralyte does not need to be perfect but it needs to replenish your salts and sugars without overdoing it. The “isotonic” or naturally balanced concentration of sodium in your blood is 0.9% which is equivalent to nine grams of sodium chloride in one litre of body fluid. That is what you would get if you had intravenous fluids administered. Similarly the isotonic concentration of glucose is 5%, or 50 grams of glucose in one litre of fluid. Because you want to replace fluid volume and a BLEND of salts and sugars, I would use a rough guide of about 20 grams of sugar and 2.5 – 3 grams of table salt dissolved in one litre of purified water in order to replace lost salts in an emergency. That is for ORAL administration obviously! Dioralyte is overall a bit better because it also has potassium and a few other things in it I think.
If you wanted to be a super nerd and find a store cupboard way of supplementing lost potassium (which in itself can be dangerous in severe diarrhoeal illness) you can buy one of the low sodium salts like “Lo-Salt” which is a blend of 66% potassium chloride (KCL) and 33% sodium chloride. Dioralyte contains 0.3g KCL for 200ml reconstituted volume, so if we multiply that out we get a desired KCL load of 1.5g/l. Lo-Salt is only 66% KCL so we would put in a bit more Lo-Salt to make it up. In this scenario a reasonable emergency replacement blend of sugar/salts would be:
20 grams sugar
2.5 grams table salt
2 grams Lo-salt
All dissolved in one litre purified water and administered orally.
Phew!
And regarding the very good question about aspirin:
Aspirin is a great drug. Powerful pain killer, good anti inflammatory, lots of uses that we can discuss if there is interest. In the specific occurrence of a heart attack it is widely used as the first treatment. If I ever see someone who I think is having a heart attack the first thing I get them to do is chew an aspirin and spray a medicine called GTN under their tongues. Traditionally it is chewed because there is absorption of the aspirin through the cheeks even before you swallow so this is the quickest way to get benefit.
In a situation where there is help available it is a good medication to give immediately but this is obviously not enough by itself and they need hospitalisation if at all possible. If the S has truly hit the F and NO HELP is coming then get them to munch 300 or 600mg aspirin. If they have typical heart attack symptoms (central crushing chest pain or tightness like a band round the ribs, shortness of breath, with or without pain going up into the neck or down the left arm and looking clammy and horrible) and the pain is persisting AND there is no help, then find a survivor who suffers with angina, and ask them very politely to borrow their GTN spray. Use that and see if it helps. If it doesn't then they are in trouble because they need treatments that only a hospital can provide.
Hope that is useful, perhaps we should move this across to the health area for further discussion, or is that what a “sticky” is? Let me know if I should start a new thread in the right place we can always copy this all across.
Have a good evening all...
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DrApocalypse
- Posts: 10
- Joined: Sun Nov 15, 2015 10:21 pm
Re: Ask Dr Apocalypse
I should add, regarding the Aspirin:
Aspirin will not make a heart attack go away. Aspirin works by reducing the ability of the blood's platelets (little sticky fragments that are part of the clotting system) to stick together in clumps. In a heart attack, one of the coronary arteries becomes blocked. The coronary arteries carry blood and therefore oxygen to the heart, so if an artery becomes blocked obviously that part of the heart is in trouble. The extent of the trouble depends on which part of which artery is blocked. The blockage usually occurs because a narrowing has happened over time, where an "atheroma" has formed. this is basically a clump of fatty proteins, general crud and a thin covering of internal skin lining over the top. In a heart attack, the atheroma ruptures and your body treats it as if it is a wound - so a clot is formed. Aspirin will not dissolve that clot BUT it might reduce the rate that it grows and buy you some time. That is why we give it. It is not a treatment in its own right. There are clot busting drugs, but these are definitely hospital only, and the other treatment is angioplasty, or "stenting", where a wire is passed into the artery and a little mesh scaffold opened out to allow blood to pass through. Genius.
Aspirin will not make a heart attack go away. Aspirin works by reducing the ability of the blood's platelets (little sticky fragments that are part of the clotting system) to stick together in clumps. In a heart attack, one of the coronary arteries becomes blocked. The coronary arteries carry blood and therefore oxygen to the heart, so if an artery becomes blocked obviously that part of the heart is in trouble. The extent of the trouble depends on which part of which artery is blocked. The blockage usually occurs because a narrowing has happened over time, where an "atheroma" has formed. this is basically a clump of fatty proteins, general crud and a thin covering of internal skin lining over the top. In a heart attack, the atheroma ruptures and your body treats it as if it is a wound - so a clot is formed. Aspirin will not dissolve that clot BUT it might reduce the rate that it grows and buy you some time. That is why we give it. It is not a treatment in its own right. There are clot busting drugs, but these are definitely hospital only, and the other treatment is angioplasty, or "stenting", where a wire is passed into the artery and a little mesh scaffold opened out to allow blood to pass through. Genius.
Re: Ask Dr Apocalypse
All very informative, thanks for taking the time to go over it, much appreciated.
Oh and welcome to the forum.
Oh and welcome to the forum.
Re: Ask Dr Apocalypse
Welcome aboard, looks like we'll keep you busy 
in fact you could probably have a section all to yourself 
in fact you could probably have a section all to yourself I have a strategy, it's not written in stone, nor can it be, this scenario has too many variables, everything about it depends on those variables, being specific is not possible.