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Shockingly, many Americans know next to nothing about first aid. We re fortunate enough to live in a country filled with first rate hospitals and walk in clinics; not only that, an ambulance is only minutes away to most people. Don t get us wrong, this is all a very good thing, but it has one bad side effect the average person depends on other people for emergency medical care. At Family Survival Society, we encourage self-sufficiency and self-reliance, but that doesn t mean we want you to avoid the doctor or hospitals quite the contrary. What we want you to do is learn how to fix yourself in the absence of medical care. When might that be? Well, America has a long history of delayed or suspended medical care in situations like: Hurricanes Tornadoes Earthquakes Civil disturbances and riots Winter storms Forest fires Any of the above events (plus more) will cause the disruption or delay of medical services in the affected area, which will mean you will be quite on your own until the system gets back up and running. At the very minimum, a large event as listed above will cause a triage situation. Triage is simply the sorting of patient priorities to favor the people that are most at risk of imminent death. If your burn or laceration isn t life threatening, you ll be bumped for someone that has a life threatening condition, once again meaning you re on your own! 3
SOME THINGS JUST NEED A HOSPITAL The first thing you need to realize about first aid is that some things will require a fully functioning emergency room. If you are saying to yourself that they didn t have emergency rooms a hundred years ago, you d be right, but keep in mind that many people in those days died of conditions that are treatable today. A modern emergency room stocked with state of the art equipment and well educated trauma physicians and nurses is difficult or impossible to replicate in the field, and there are simply some conditions that will result in death unless a person is promptly brought to a hospital (and the person might still die). This means that if society collapses, many people will die of afflictions that would have been routinely treated in the ER. Consider the following conditions: Depressed skull fractures The loss of half or more of a person s blood Aneurysms Strokes Heart attacks Severe poisoning, whether by reptile or ingesting Advanced infections These conditions, and others like them, will be almost impossible to treat in the field. Even an extremely skilled trauma surgeon will not be able to treat people with the success rate that he or she would have had inside an emergency room, because he simply lacks the advanced equipment. 4
SO WHAT CAN WE REALISTICALLY TREAT? There is much that can be fixed in the field by a person skilled in first aid, and initially treating these conditions can save a person s life: Gunshot wounds Lacerations Burns Minor infections Amputations Broken bones And many more. Realize that if the above are not immediately treated, they almost certainly will lead to death or serious infection. Therefore, even though an emergency room might not be available, there is still much you can do to positively impact people within your community and potentially save lives. STEP ONE TAKE A FIRST AID COURSE While we will show you a couple of lifesaving tips in this guide, nothing within is a substitute for taking a good first aid course that is presented by medical personnel. You ll find that first aid training in America is abundant and inexpensive, and you can easily be trained to the level where you could take care of most injuries that might 5
occur in a grid down scenario. We recommend that at least one person in your home (preferably two) sign up for an advanced first aid course that lasts a minimum of three (3) days. Courses of that length provide sufficient time to really delve into some good first aid techniques. The best scenario is for one adult in the home to take a full-on EMT (Emergency Medical Technician) course and become certified as such. These courses run about three to four weeks, but they will give you the medical knowledge to deal with most any home injury. CPR DOES NOT EQUAL FIRST AID! We really don t recommend spending too much time on CPR training (Cardiopulmonary Resuscitation), and we don t think that simply having taken CPR training, that you somehow have first aid training. There are several reasons why we don t think too highly of CPR for a grid down scenario: Guess who you normally perform CPR on? Dead people. People who either aren t breathing or have no pulse! CPR is only designed to keep the person alive until first responders show up. What if first responders never show up? How long are you going to keep performing chest compressions? A minute? Twenty minutes? One hour? Until you collapse from exhaustion? After performing CPR, and should the person live, advanced medical care is required. Do you have access to such care? 6
We aren t saying that if your loved one collapses during a grid down situation, that you shouldn t try to save them using CPR. You most definitely should try, but realize that if no advanced life support arrives in the form of paramedics or an ambulance, the person is as good as dead. The main reason why CPR training is so popular in America is that with our speedy ambulance systems, it can truly save someone s life, and keep their blood circulating until paramedics arrive, which is a time span usually measured in minutes. In a situation where help will not ever arrive or at best will be hours away, CPR basically has no value. SOME EQUIPMENT IS REQUIRED In order to treat most injuries, you will need at least a basic first aid kit. Improvising is a critical skill to master when it comes to first aid, but first, you need to know what exactly you might be improvising, and that takes at least a passing knowledge of basic first aid equipment. In a future buyer s guide, we will detail to you exactly what should be in a basic first aid kit, so that you can buy the right things. Realize that few off the shelf first aid kits contain everything that you ll need most contain lots of stuff you won t. Don t think that having to purchase some basic equipment is somehow a digression from our prepper triangle, in which skills always trump gear. Rest assured, skills still trump gear if you gave a massive first aid kit to someone that had no medical training, they wouldn t know what to do with it. If you gave that same kit to a trauma physician, they could probably work miracles from it. Yes, skills still reign supreme, but first aid requires at least some equipment. Still, we don t 7
want to clutter this guide with a list of equipment; we want to show you some handy skills first, some skills that could save your life INCISIONS AND LACERATIONS If there is one injury that will manifest itself almost to the exclusion of others in a grid down scenario it will be incisions and lacerations, and it s no mystery why. Most Americans are totally unfamiliar with edged weapons such as knives and axes (as well as other dangerous power tools), and when forced to use them in order to survive, many injuries will result. Some will be accidental; others will be intentionally inflicted by others when things go lawless. Incisions are cuts made by sharp edged objects such as knives and razors, while lacerations are ragged tear-like wounds caused by blunt trauma and other such causes. Either way, both represent holes in your skin where there previously weren t any, and both can potentially cause blood loss to the point of death. So how do you deal with incisions and lacerations? Here s what to do: INCISION / LACERATION CHECKLIST As soon as the person (or yourself) is wounded, you will immediately attempt to control the bleeding. Take any available clean item such as a compression bandage, t-shirt or towel and apply direct pressure over the wound. Do not release! 8
While applying pressure to the wound, use your other hand to feel underneath the injured limb or torso to see if there is an exit wound on the other side this is often forgotten. If there is an object embedded in the wound such as a knife or arrow, you will not remove it. You will leave it in place, because you know that removing it will cause more damage. Watch the wound for the first 30 seconds, and realize that sometimes, even a large wound won t bleed much at all initially, because the body s protective mechanisms will cause blood vessels to constrict (vasoconstriction). Without releasing pressure on the wound, carefully look at the t-shirt, towel, or bandage you are using to apply pressure. Is it soaked in blood? Is it relatively dry? If the bandage is soaked in blood, and the blood flow doesn t look like it shows any signs of stopping, and the wound happens to be on a limb, it s time to apply a tourniquet. Slip the tourniquet over the limb, and position it 2 proximal to the wound. This means closest to the heart if the wound is on a forearm, for example, you apply the tourniquet up by the elbow but not directly over the joint. Stay 2 away from all joints. Tighten the tourniquet using the built in windlass until no pulse is felt distal to the wound i.e. downstream of the wound. Comfort the patient, and avoid giving them water or food for the first little while, even though their natural reaction will be to want water. 9
Wait 15 minutes, then slowly release the tourniquet, and see if the bleeding resumes. If it does not, you can safely bandage the wound. If it still bleeds, cinch up the tourniquet. Tourniquets can be left on for up to two hours, but beyond that point, they need to be removed by a physician. This is because toxicity builds up inside the limb downstream from the tourniquet, and if you release it after too much time, these toxins flow back into the blood stream and poison you (septic shock). Some other tips regarding lacerations and incisions: Don t initially worry about infection. If you need to stuff something in the wound to control bleeding, then do so! Keep in mind that if the patient loses all their blood, they will die. Deal with the threat of infection only after a patient is past the risk of bleeding to death. Large lacerations or incisions can cause a patient to go into shock, which includes such symptoms as rapid or weak pulse, cool or clammy skin, and thirst. The early stages of shock can be treated, but the later stages represent a medical emergency in and of themselves. At the very minimum, lay the person down and elevate the legs. Keep the person warm! Large lacerations or incisions that lead to blood loss can lower the patient s temperature to the point that they are susceptible to hypothermia in even mild conditions. After the blood flow stops, keep them warm! 10
BURNS The second biggest medical emergency we ll see in grid down or survival situations are burns, and the reason for this is simple; open flames mean more burns. We aren t used to cooking three meals per day on open flames, nor are we used to being in such close proximity to fires. There are entire generations of children that have never even seen a fire other than on TV! Keep in mind that burns aren t only produced by fire, they are produced by other heat sources (car engines), chemicals (solvents), and electricity (lightning strikes, grid electricity). There are lots of ways to burn yourself! If someone has been burned, here s what to do: If you suspect the cause of the burn is electrical (such as a person shocking themselves), don t immediately touch the person until you can verify they are not still electrified and in contact with live wires! Make sure the person is no longer in contact with the source of the burn this means pulling them out of a fire or moving them away from a hot object. If the person appears badly burned and has clothes stuck or melted onto his skin, do not remove them. Check for responsiveness such as alertness and breathing. If the person is not breathing or there is no pulse, perform CPR. Early cooling of the wound reduces pain and the depth of the burn. The best thing to use to treat burns is cool water, meaning water that is over 50 degrees in temperature. Never use ice water as hypothermia could result. 11
Remember, burns can induce shock, and too much water can help produce shock. Use a damp cloth to cover a larger burn site, but never put the cloth directly on the burn, instead use a sheet of plastic wrap between the cloth and burn to avoid having the cloth stick to the skin. If the burns are on limbs, elevate the limbs with pillows or something similar to help circulation. Once the patient is stable, go into infection fighting mode. This means clean dressings, clean environment, lots of ventilation, and no salves or ointments. Manage pain by giving the patient over the counter pain remedies. Some further notes on burns: Burns come in three degrees: 1 st degree burns are the least serious, appearing red, and having unbroken skin on the burn site. 2 nd degree burns can be distinguished by a shiny burn site with red blotches and blisters. 3 rd degree burns are quite obvious charred or white skin, and layers of skin missing, with potentially muscle or bone exposed. 12
1 st and 2 nd degree burns can be treated similarly if the extent of the burning is minor. This means cool the burns, and keep them well ventilated and dressed with sterile cloths. 3 rd degree burns, unless tiny in area, are a medical emergency. Keep an eye on shock, as it will be your biggest foe, especially with electrical burns. Never puncture blisters or peel off dead skin; that hastens infection. Don t bother applying salves or folk remedies. Keep the wound sites clean. WHAT NEXT In this first series, we ve looked at the two most common injuries in a grid down situation lacerations and burns. In future series, we will go into more detail regarding other injuries that may crop up, as well as delve into specifics on things like gunshot wounds and airway management. Stay tuned! 13