Tag Archives: medical

Fall guy

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I’m not super-extensively well-travelled. I’ve been to portions of Europe several times, but in a touristy capacity. I’ve never been to the ‘stans or that region. But..I can say that I’ve seen varied living conditions to give me a pretty broad base of experience.

So, I ask with all sincerity, why…why…WHY,,would anyone live in Texas? I just spent a couple days in the Houston area and I have never, ever, EVER!!11!11111 seen a climate less hospitable to human life. There was heat, humidity, fire ants, scorpions, and unrelenting sun baking everything. People say “So what? You just go from one air-conditioned building to another.” Dude, if you want to live in an artificial environment because the natural one outside your door will freakin’ kill you then you may as well be living on Mars. SpaceX needs volunteers to colonize Mars? Send the Texans…theyre already living in a climate that will kill you just as soon as look at you. They actually went to war with Mexico for that place? You know that saying, “All my exes live in Texas?”…well, yeah..because most people tell their exes “go to hell”. Well, there you go!

So..why was I there? I was helping someone move. I volunteered. And since I had to fly, I mailed a Glock and S&W 642 to myself ‘just in case’. What I did not mail ahead, and I should have, was one of my IFAKs. I didn’t want to take one in my luggage because I didn’t feel like having the grepos at TSA rummaging through my QuickClot and Dermabond. Bad move. Why?

Well, after several hours of unloading a storage unit into a rental truck in 103 degree heat, being covered in dirt, bruises, scrapes, and sweating faster than I could powerload on Gatorade, it was time to wrestle a ginormous fridge up the ramp to the truck. And….at the top of the ramp, it went sideways. I jumped clear to avoid ‘death by Frigidaire’ and I rolled up to my feet. The fridge missed me but I was a tad bruised.

  • Them: are you okay?
  • Me: Yeah. The only thing that can kill me is me.
  • Them: are you sure you’re okay?
    Me: Yeah, my heel feels a bit weird though.

And I took off my shoe and beheld this:

A close look showed a hole in the bottom of my shoe. When I leapt clear of the ramp, one foot landed in a bin of tools. Something drove right through my shoe and tore a hole in the bottom of my foot.

So, NSTIW, sitting on the curb by the storage unit wondering why I stupidly sent ahead my pistols and not my first aid kit. I had to scrounge through the storage unit…found some ancient Bactine, an elastic bandage, and a clean paper towel. Well, you do what you can, where youre at, with what you have.

SO..bandaged it up as best I could and carried on until I could send someone into a Walgreens and, like some scene in a gangster movie, have them go to the checkout clerk while carrying an armload of gauze, pads, tape etc, and trying not to be suspicious.

After that, it was..better. But it needs to be..ah..trimmed..in a few places. Hence, the doc in the box. (also some tetanus shot and keflex.)

So, other than wearing a more resilient pair of shoes, what could I have done differently? I should have been smart enough to realize that doing something like loading/unloading a truck could lead to this sort of thing and I should have mailed one of my first aid kits ahead. Failing that, I should have gone to Walgreens before I started the job and purchased materials to be prepared ‘just in case’. Honestly, I shoulda sucked up the $60 to ship and just mailed my Bag O’ Tricks to myself. That woulda covered me for bloody near anything that might go wrong.

Moral of the story: ‘remote’ preps don’t start and stop at guns.

And I shoulda just swung by Home Depot and grabbed a few Mexicans to unload /load the stupid truck.

Also, Texas might as well be the surface of Mars.

Article – How long you can take medications like ibuprofen and aspirin after opening them

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One of the things on the Preponomicon that I am trying to get into the green is some OTC medications. Presumably, these things are going to sit on a shelf for, at least, several years. Does aspirin turn into some sort of toxic acid a few years after its ‘Best By’ date?

Just like food, medication is required by law to have an expiration date on its packaging. But how long past that date can you keep using your over-the-counter and prescription drugs? And is it safe to take expired medicine?

INSIDER talked to medical experts to find out how long you can keep using some common medications after opening them.

The answer, it seems, is ” a usefully long time”. But, honestly, this is one of those times where I’m probably going to disregard the common advice, as well as the small financial hit, and simply throw out and replace my 500-tablet bottle of ibuprofin every five years.

Hunter S. Thompson’s Continental breakfast

However, up until a few years ago I was still using a gigantic bottle of Advil that I’d bought at CostCo with an ‘Expiration date’ in 1997. Made my headaches go away just fine.

TL,DR: your Tylenol, Advil, and aspirin are GTG for about 5 years.

 

ETA: I was sent this in email:

The military did a study back in the 80’s examining the bioactivity of stored drugs…  And found that almost all of them were good to go years after their expiration dates. These are drugs that were stored in climate controlled warehouses, in original factory packaging.

ProTip:  Don’t buy one big bottle of a drug, buy lots of little ones… Drugs are hermetically sealed at the factory, and once  you open them and start shaking things out, moisture gets in and starts degrading the drug.  Not to mention whatever you may introduce with your finger..

For drug storage, put the unopened drugs in a refrigerator – don’t freeze them.  Why keep them cool?  In general (rule of thumb time) for every 10-degree C reduction in temperature a chemical process (like a drug, degrading) experiences, the rate of the process reduces by 1/2.  So, your drugs will last about 4 times longer in the refrigerator at 2-c, then at room temperature at 22-c.

Why not freeze them?  Because they may degrade (especially liquid or ointment products) and separate (the various components freeze at different temperatures).  When they thaw, they melt at different temps too, and don’t reconstitute.  This is ESPECIALLY important for drugs like insulin, a protein: Freezing the protein breaks it apart, and then it is done.  No longer useful…   So, cold:  Not frozen.

The military did a study back in the 80’s examining the bioactivity of stored drugs…  And found that almost all of them were good to go years after their expiration dates. These are drugs that were stored in climate controlled warehouses, in original factory packaging.

Disclaimer:  I am a physician. I am NOT your physician.  This is not medical advice.

https://www.propublica.org/article/the-myth-of-drug-expiration-dates

https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/expiration-dating-extension

Tourniquet arrival

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You guys remember a couple months back I told you the tale of the son of a buddy of mine who had a bit of an accident while processing his deer and almost bled out. He was lucky in that he was able to get to a neighbor who called 911 for him. (As it turned out, when your hands are slick with blood the touch screen on your smartphone becomes quite unresponsive.)

A few weeks after that, while looking around the /gundeals Reddit, I came across a deal on some tourniquet kits from a respected dealer. Well, they finally shipped.

Two is one, yadda yadda yadda. I must say, I’m very impressed with the value here. It was, as I recall, about $50 ea and the tourniquet is usually about $30 of that. And while there are better deals to be had on Amazon and eBay it was absolutely not worth the risk of winding up with made in China knockoffs spawned from Peoples Glorious Moulding Factory #52.

It occurs to me that the tourniquet itself is not actually visible in the picture. Its in an exterior pouch separate from the zippered one. But, trust me, it’s there.

Nearest Stop The Bleed course, for me, is in Hamilton (40 miles) at the end of the month but I have a scheduling problem. Gonna have to keep an eye open,.

Tying one on

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As I’d mentioned last year, it seems like tourniquets are sort of a ‘newest and coolest’ sorta thing for the ‘serious’ first aid kit. I’ve been into survivalism for a long time and any references in fiction and non-fiction to tourniquets was almost always of the ‘loop a belt around it’ sort of variety. There were no ‘dedicated’ or purpose-built tourniquets that were readily available for Joe Sixpack survivalist…or if there were, you seldom read about them or came across them.

Cut to today’s episode. I’m talking with a fella I know and ask what’s up in his world. Turns out, his adult son had to go to the emergency room last night. Why? He was home, had a deer hung up and was cutting it up when he came to a frozen part of it. He put some extra oomph into his cut to get through it and the knife went into his wrist and severed a radial artery. Being alone and not precisely sure of how much damage he’d just inflicted on himself, he wrapped a towel around it and applied pressure. And applied. And applied. And the puddle at his feet just grew larger. So, he walks over to his neighbors house where the neighbor takes one look at him and calls 911. Medics arrive and….they apply a tourniquet …since at this point he’s about a quart low. They hustle him to the hospital and stitch up the leak. How close was he to cashing in his chips? Hard to say, I wasn’t there. But I am told that the amount of blood loss was rather significant and without something stopping it he probably would have been in some big trouble.

So, apparently there is a reasonable chance of need for a tourniquet outside of the apocalypse. Its not something I ever really thought to add to the first aid gear I keep around here because…well…it never seemed terribly likely to be needed. That mindset has now, of course, been kicked to the wayside. I’ll be finding a reputable vendor (to avoid Chinese fakes) and ordering a couple up for myself and one for a friend.

In talking to a few other people, it seems that severe cutting injuries resulting from deer processing/skinning/butchering are not that uncommon. Makes sense. Some guy standing alone in his garage with a hanged deer or elk slips and cuts himself deeply…I can totally see finding him the next day or two later laying DRT on the floor. Never thought about it before, but I can see it happening.

This is how you learn.

Mylar after two years of exposure

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A few years back I picked up a heat-sealer and a supply of heavy-duty mylar pouches. The goal was to use them to store small first aid items in a protective package that would be impervious to dirt, moisture, etc. (Links are still good in that post, so if you want your own sealer and bags go hit those links.)

SO, I went through my extensive piles of first aid supplies and pulled out the basics, loaded them into a mylar bag, and sealed them up. This was, ostensibly, for me to basically throw under the seat in the vehicle.

At some point, I needed to clean out the accumulated detritus in the vehicle and loaded all the loose items that were kicking around (water bottles, pens, loose ammo, maps, e-tool, etc.) into a milk crate and kept that milk crate in the vehicle. One day, I needed to maximize the space in the vehicle so I pulled out the milk crate and tucked it away in a corner of the yard while I did what needed doing. And then forgot about it. That was two years ago.

So, I was straightening things up and found this mylar pouch of first aid supplies that had been sitting out in the elements – snow, rain,sun, heat, cold – for two years…completely unprotected. Seems like a good opportunity to see how it held up.

Two years in the sun, rain, snow, heat, and cold of Western Montana. Dusty, but otherwise undamaged.

Tear it open and take a look inside. Contents appear to be undamaged and just fine.

Everything appears as good as it was when I packed it up two years prior.

Unfortunately, I loaned my heat sealer to someone last year and despite my occasional requests for it back they’ve not returned it, so unless they get a sudden dose of responsibility I’m probably going to have to order another one. I still have a goodly supply of pouches and the evidence seems to show that they are very good at protecting important items from the elements. In addition to the obvious things like a bit of first aid supplies, small objects that need to stay clean and dry would be suitable candidates….small electronics like radios and such spring to mind.

I rather like the convenience of having several of these pouches sitting in a bin in storage and I can just grab one and throw it in a pack or bag if I’m going somewhere. And when you buy the stuff in bulk like I do, it’s ridiculously cheap to put one of these together. Cheap enough to the point that I can just give them away to friends and like minded individuals, keep on e in every bag, stash a bunch at some offsite location, etc. Of course, if you’re willing to pop for the larger size pouches you can put together some extensive kits.

By the by, these pouches are the resealable kind…so once open, the contents can be put back inside and the bag ‘zipped’ closed. But if you really wanna go the suspender-n-belt route you could easily stuff a ziploc bag in there to perform the same function.

Saving space

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So youre a somewhat serious survivalist and you’ve come to the conclusion that a few medical supplies might not be a bad idea to stash back for the day the hospitals are overwhelmed and supplies are short. Off to eBay you go. And you realize that for the price of, say, two boxes of band aids at the local supermarket you can buy an entire case of 2,500 band aids from eBay vendors. Good band aids, too…not made in China crap. Same for gauze, pads, tape, etc, etc.

And then you realize that while 2,000 packages of 4×4 gauze might be useful after the apocalypse, until that time apocalypse happens it sure takes up a lot of room.

Thats pretty much what happened to me. As I was rearranging things the other week it occurred to me that the bulkier first aid supplies took up a lot of room. Not because they were bulky on their own, necessarily…but rather because there was so much of it.

Since I had the vacuum sealer out, I figured that perhaps vacuum sealing some of these items might cut down the space they took up, in addition to providing a lovely level of protection.

How much space? Well, lets grab a couple boxes of 3×8 non-adherent dressings and check…


So there’s a full box of dressings. Fifty per. Let’s see how they stack up…
One stack of fifty compresses down to a rather significantly smaller package.

So after a few hours I compared ‘before and after’. For example, the original box that held 18 ABD pads now held 35. That’s about a 50% savings in space and a thousand percent increase in protection from environmental factors.

The end of this long story is that I managed to clear off almost an entire shelf’s worth of supplies and compact them down to fit into one large plastic tub…and in the process add a layer of survivability to the packaging. (Everything was packaged in paper envelopes, like you get a band aid in, so there wasn’t exactly a tremendous amount of resistance to humidity, moisture, dust, dirt, etc, going on there.)

Do I ever think there’s going to be a time in my existence I need 50 rolls of rolled gauze? Man, I hope not. But once you divvy everything up between your primary location, the Beta Site, first aid kits, vehicles, etc, you can wind up going through quite a bit of stuff.

My first go-to for eBay medial stuff is these guys. After that, it’s just a matter of knowing the SKU or product number of what youre looking for and searching eBay. Oh…and having one of these.

 

Single-serving burn gel

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I’m a big fan of the Water Jel burn relief product. This stuff is the most awesome thing in the world for taking the pain out burns. Years ago I made the mistake of picking up a lawnmower by the exhaust manifold. Ow. I literally could not sleep unless my hand was clutching a bag full of ice cubes, the pain and ache was that strong. Nowadays, I slap some of this stuff on it and -presto- the pain goes away. Nothing magical, its just a topical anesthetic, but when you burn yourself, especially on parts of the body that really make you feel it…like fingertips…the stuff is a wonder.

20150605_181355I keep the large bottle of it around the house but thats really too large for most first-aid kits. Fortunately, they offer single-serving ‘ketchup packets’ of the stuff. Several of these are going into the various FAKs that go in the hunting/fishing bags. Nine times out of ten the burns I get outdoors are the simplest and stupidest ones….those stupid wire handles on the canteen cup. Its a long day of chasing Bambi, you stop to heat some water on the esbit stove to mix up some lunch, your hands are a little cold so you don’t notice how hot the wire handles are at first, and…ouch. And while burns are never fun, the ones on fingers..esp fingertips….really suck. So…a couple packets of this stuff will go into each FAK.

As I was ordering the stuff up offa Amazon I noticed they even make a ‘military’ kit that is suitable for white phosphorus injuries. Kinda cool, although if I’m in a situation where there is a genuiune risk of Willy Pete injuries then things have truly gone off the rails.

I’d posted a while back about Water Jel but didn’t mention the extremely convenient single-serve packets. I ordered them up a few days ago and they just arrived. Figured I’d mention it because it is some really awesome stuff and there’s really no excuse for not having some in your kits when you can get it in something as convenient and small as the single-serving packets.

 

Fixing first aid kit foibles

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As you may (or may not) remember, a few posts back I described how the first aid kit I left in my bicycle pannier turned into something less-than-optimal as a result of being left out over the winter.

The problem was that it’s a tough balancing act to have a first aid kit in a watertight/airtight container of some fashion but still be quickly accessible with one hand when youre trying to keep all the red stuff inside you. Turned out that the bicycle pannier may not have been nearly as weather resistant as I thought and as a result my first aid kit suffered a great deal of moisture damage. (Although, to be fair, the items that were wrapped in plastic or sealed in foil fared just fine.)

Okay, spring is (somewhat) here and I’m back to riding my bicycle more. Time to replace that first aid kit. On my bike, my needs are simple – I need some stuff to patch up scrapes/cuts/tears from me being suddenly introduced to the road surface by that great facilitator of ouchies – gravity.

An assortment of gauze, pads, bandaids, some tape, and some antibiotic ointment should do it. Lets see what we have:

20150405_120652It’s just for a bicycle accident, not a splenectomy….the skin stapler, betadine and other over-the-top stuff is in the other kit. For the most common boo-boos related to me flying over the handlebars, this’ll handle most of it. Now, to package it up so it stays clean and dry. In this case, we’ll go with a heavy mylar foil resealable bag. With a reasonable amount of care, and a modicum of force, everything fit into the pouch and left enough room to have a bit of extra material to form a seal:

20150405_121911Make sure the jaws of the sealer are hot enough, slide the open end of the pouch between ’em, squeeze jaws shut for a ten-count, and…voila:

20150405_122632I have a rather…exhaustive….supply of first-aid supplies from an episode of eBay purchasing that may have been a bit over-the-top. I’m dead serious…I’ve got something on the order of 9,600 band aids. Since I had to buy the mylar bags in quantity to get a discount, I should probably but together a dozen similar packages, label ’em appropriately, and pass ’em out as Paratus gifts this fall.

Anyway, I’ll toss this in the bag on the bike and be good to go. Should be watertight, airtight, and pretty much impervious to just about any environmental concern.

First aid kit foibles

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Years back,I used to have a bicycle that would, at irregular intervals, try and kill me by locking up the chain for no particular reason. I eventually got a newer, better, bicycle but the old Death Machine taught me to keep a first aid kit handy. On my bike I have one of these mounted. I find it very useful, and keep my first aid kit in there. The first aid kit is one of these (Maxpedition FR-1 Pouch) loaded with what I feel is necessary gear. Now, if you’re keeping track, that is a first aid kit contained in a cordura pouch, which is itself contained within a cordura bicycle bag. What could go wrong?

Well, here’s the lesson for today… I left my bike chained up in the yard over the winter. As a result, the rain and snowmelt made its way through the bicycle bag and through the first aid pouch. Check this out:

20150308_164940Thats not dirt, kids….thats mold. Most first aid stuff is packaged in sterilized paper envelopes and those are less waterproof. So, virtually everything was moist/damp/moldy and had to be discarded. However, some things were not damaged. Observe:

20150308_165152Basically, anything packed in foil or sealed in plastic weathered it just fine.

So, by now, you’re thinking “No problemo, just seal up all the individual contents and you’ll be good to go.” A reasonable way of thinking, but it overlooks a big issue – when you need a first aid kit, theres a pretty good chance you’re under stress, your hands might be a little shaky, and you may only have one hand to work with since your other arm/hand might be injured. So, sealing things up in a manner that required two hands to open (or requires several repeated pouch-opening-procedures) might not be conducive to effective use of your gear.

Now, I rather like the Maxpedition FR pouch. It’s reasonably compact, fairly easy to organize, and has several methods for attachment to other gear. I’d hate to give it up. So, to me, the choices are two: a) individually seal the contents of the kit or b) put the whole kit into a waterproof container of some sort.

I’m leaning towards ‘A’. Best method? Well, there’s this:

IMG_1863Those are heavy-duty mylar bags with ‘tear away’ tops and zip-seals, and a 6″ heat sealer that I picked up off Amazon. The bags, in various sizes and thicknesses, are from Sorbent Systems. I got them expressly for the purpose of making small, weatherproof, resealable, firs-aid kits for my hunting and outdoors gear. For example:

IMG_1865That pouch contains most of the important stuff…gauze, non-stick pads, compress bandage, antibiotic ointment, bandaids, aspirin, tape, etc, etc. Not enough to do surgery or fix a detached aorta, but for the cuts, burns, scrapes and bloody messes that sometimes happen from bicycle accidents, knife slips, falls in blowdown snag, etc, its pretty good. And, it is now completely waterproof. Tear open at the upper corner there with your teeth and open it like a bag of chips. When done, you can reseal it with the ziploc-type closure. When the crisis is over, since I have a stack of these bags, I can simply transfer the contents to a new bag to seal. I’ll wind up getting a larger back, drop the Maxpedition FR into it, throw in a few oxygen absorbers to snug it up tight, and tuck it into my bike bag.

Now, if you have a vacuum sealer, you can very much accomplish a similar setup using your sealer and bags. Two big differences though: the mylar pouches pictured have a ‘tear notch’ to allow easy access (which a vacuum sealed bag does not); and the mylar pouch, in this heavy thickness, is much more puncture resistant than a vacuum seal bag (however, you can always wrap the vacuum seal bag in something to protect its integrity).

I have learned my lesson and won’t be leaving this gear outside over the winter again, but walking around in a solid rain for a few hours would have probably induced the same amount of moisture into things. Waterproofing/weatherproofing an important bit of gear like this makes sense. Fortunately, today I noticed it because I was thinking I should probably check to see how the gear fared over the winter…it would have been a different story if I was a couple miles down the road, sitting on a rock, trying to bandage a gash in my leg with wet and moldy 4″ gauze and pads.