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Episode 87: Medical Preparedness with Kevin Faulk

M4S087_Medical-Preparedness-with-Kevin-FaulkMedical Preparedness | Kevin Faulk with Devil Dog Consulting is here and in this first part of the two-part episode on prepper medicine we’ll be covering:

  • Medical Supplies
  • Managing Expectations with Medical Training
  • Managing Gunshot Wounds and Bleeding Control
  • Vetting Training
  • Comfort Items as Basic Medical Supplies
  • Training with Medical Gear

About Kevin Faulk

A quick note about Kevin. Kevin is a former Marine and long-time paramedic and professional firefighter who has a wealth of knowledge and experience.
Kevin is also a moderator for both the Prepping4Survival and Medical Survivalist Facebook groups.

And, he’ll be speaking online live with Survive First, which you can find on Facebook, on Monday, October 16 at 7 pm.

He'll also be teaching a TCC-All Combatants course with FieldcraftSurvival in Prescott Arizona, this November 16 & 17. Check out FieldCraftSurvival.com if you’re interested in some tactical medicine training.

Medical Supplies

Prepper Medical Supplies

When assembling your medical kit, the first thing is to get your basic first aid supplies, I mean just the basics. A lot of people, they start looking at the medical field and they're like, "Holy cow, I can spend thousands and thousands of dollars," not that you can't do that for your bushcraft and weapons and all that other stuff, but they start looking at how much some of this medical equipment costs. And the fact of the reality is, like the other day when we were talking, people want heart monitors, they want CricKits, surgical cricothyrotomy kits, and things like that, and what you don't understand is, okay, you just did that, what's your plan?

Like we were saying the other day, my thing is I always tell people, "Go take a first aid class. Take a CPR class. Get your basics." When you are looking and you get all your basics down, then start moving into, okay, well, maybe you want to go to a first responder course now; you've taken your first aid, you've got that down, maybe you want to go to a certified first responder course, and then maybe the medical field interests you and you go to EMT, and maybe EMT Advanced and paramedic, nursing, PA, wherever you stop. But the fact of the reality is the more medical training you have, I think with us both having a medical background, you realize that there are pieces of kit that, in theory, they're great pieces of kit and if you need them, you need them.

Your realistic supplies, like the group that I help manage, the Prepping4Survival and the Medical Survivalists, we actually, collectively as a cadre, we actually came up with several lists of things, you may have seen it on the website, on the group, we actually all put our heads together, and like I said, we've got a couple of nurses, a PA, some paramedics, now we have a guy that's a law enforcement that just tactical medicine, and so we've got a pretty good wide array of cadre, so we actually spent, I would say we probably spent a month on all of those lists, like going back and forth of guys saying, "Hey, well, what do you think about this?" "Probably not going to get used," or "Yeah, man, I didn't think about that, that's a great item."

We put together things. The first thing you do is things that need a quick fix fast, that's why I say tourniquets, your first aid, and tourniquets. Most of your basic first aid supplies, you can go to Walmart, Kmart, Publix, wherever you want to go, Walgreens, all your little stores, you can actually ... I tell people the best thing to do, especially, is figure out the little clan that you have; if it's me, Brian, his wife, my wife, let's say one of us has a medical condition, well, we probably want to get some medical supplies, other than the basics, you're going to have to get some medical supplies that are moving you towards being able to keep that person up as well.

And if crap hits the fan, obviously we all know, there's certain medicines that if you had a true austere environment or you're gone and you're out for days, there are certain medical conditions that if you don't have your medicine, there's a slim chance that you'll live, and sometimes you get a lot of people in the prepping community that jump right to, "Well, we'll just put a bullet in that guy's head," like we were talking the other day, "Well, we'll shoot him and cut him up and eat him for supper and be cannibals, or something like that." It's like, well, you know, that may not always be the first thing that you need to do. But there are some conditions that are just not compatible with life-

And like your type I diabetics, right, I mean it's like, hey, I hate it for you ... and there are a lot of type II diabetics running around, that if they work on it, what they can find is they can control their diabetes and their blood sugar levels with diet and get out ... and when I say exercise, I don't mean you got to go to gym, get out and just walk every day. I got a dog and I take him out for walks a couple of times a day and I end up walking miles every day just to get him out.

But people don't get that. And they need to think about how those medical conditions, I think, spiderweb out into their preparedness. What do a lot of people do when they stockpile food? They stockpile rice. Well, rice is huge for spiking blood sugar, so if you're a type II diabetic or even a type I diabetic, you may not want to use so much rice, maybe go more with beans because they don't spike your blood sugar as bad.

Managing Training Expectations

Managing Expectations | Prepper Medical Supplies

I think, also, people need to, within their preparedness group or their families, talk about and do research, if you have type II diabetes or you have some medical problems, find out and inform people within your group. When you explain your situation to people, they are more likely to understand what you're going through. That way, if you seem off or are struggling, they are more likely to notice and help you overcome the issue.

When it comes to diabetics, if you or someone you know is a brittle diabetic, you may have to check your blood sugar three or more times per day. Sometimes when a person has medical training, and a family member or friend becomes ill, the person with medical experience may know that the potential outcome is not an optimistic one. When that happens, it's often best to keep your thoughts to yourself. Doing so is called having a bedside manner, which means using some good sense on how you approach the situation.

The reality is that if a brittle diabetic is involved in a grid-down situation, there's not a lot that anyone can do if they run out of insulin. Unfortunately, people with difficult to manage illnesses and diseases are at higher risk during disasters and sometimes. To overcome this, some preppers talk about creating penicillin out of mold. While it's understandable to try to come up with options, the odds of people successfully making their insulin are slim to none.

Making penicillin is similar to people who think they'll make colloidal silver if there is a need during a disaster. The bottom line is that if penicillin and colloidal silver are easy to make, the manufacturers wouldn't be in business. After all, making colloidal silver is not as simple as melting down jewelry and mixing it up to make your new lifesaver.

While colloidal silver is an excellent choice for many circumstances, it's a far stretch to assume you can make it on your own, much less doing so during an ongoing disaster. In effect, people who think that during an emergency, they can whip up a life-saving concoction such as penicillin or colloidal silver might as well try mixing unicorn blood and leprechaun pee to cure all humanity.

Gunshot Wounds & Bleeding Control

Managing GSWs and Bleeding Control | Prepper Medical Supplies

One of the big things going around now, and a lot of people with experience fall for it is using tampons to treat bullet wounds. The urban legend has people saying something along the lines of, "Well, my dad did it when he was in Vietnam, and it saved this guy's life." The reality is that no, he didn't.

When I hear that, because I believe in educating people, I make sure not to ridicule or demean the person. Educating people is so essential that one of our Facebook group's rules is that if you're going to propose an alternative possibility, we're not going to call each other names. For example, telling someone, "You're a stupid poopoo face," is not an argument. Instead, that's a person showing a lack of intelligence. The truth is, if your argument is calling me a name, that means you don't have a case for what you're trying to tell me.

Now, back to the old tampon thing. It just seems like it won't go away because there are still people carrying tampons in the medical kit. These are often people who have never treated a gunshot wound, much less treated one with a tampon. 

An example is when I took an active shooter class through the University of Miami Medical School, which is a decent class.  During the course, we discussed the Rescue Task Force when one of the active-duty military guys in the class said, "Yeah, I carry tampons in my kit, I know guys that do it, it's a great piece of kit to have." And, I was dumbfounded as soon as he said it. 

While I can't stand the University of Miami when it comes to college football or any of that, there's no doubt that they have one of the top medical schools. I even know some of the trauma surgeons at the trauma center that we go to. They're phenomenal doctors, but I couldn't figure out how they could let somebody sit there and say something like that? If the tampon worked when you put it in that GSW, it's because the wound was not that bad. 

I like to ask people, "Okay, so you're telling me the tampon thing works, I can put a tampon in a bullet hole?" and then I've also heard, along the same lines, "Well, it depends on the bullet wound. Like, a tampon is perfect to fit in a 7.62mm bullet wound." When I hear that, I want to respond with, "Because a 7.62 rifle always leaves the same sized hole?" I then ask the person whether they have ever effectively used a tampon to manage a gunshot wound. So far, nobody has.

Another example is a medic in Iraq that tried to use a tampon because he believed the myth and carried tampons with him. That was until he had to work on a guy who was shot, and he tried to force the tampon into the wound. Finally, somebody had to push him out of the way because the tampon was not going to fit in the wound cavity. Also, what people don't understand is if you somehow get it in that hole, the patient is in for a rough time because as the tampon expands, it makes it next to impossible to remove.

Another thing people don't realize is what a wound cavity is and what happens when somebody takes an AK-47 round to their thigh. People fail to understand how big of a cavity that makes in a person's body and how much tissue it displaces. I tell people that trying to put a tampon in a larger caliber hole is something like throwing a hot dog down a hallway. That's the equivalent to trying to stuff a tampon into a large caliber wound. 

It's also good to know that when a bullet creates a wound cavity, attempting to put a tampon in there, is a lazy approach. It assumes that one tampon will fix everything. The truth is that if it's a severe bullet wound with a lot of bleeding, you have to get in there, find the bleed and address the bleed at its source. That may be an artery or a vein, and you have to get into the wound and pack it. That's why they call it wound packing. Get in there and pack it, because it's that pressure and resistance that helps that blood clot in the bandages. About the tampon, even if it were to work, you're not going to necessarily be able to get it to where it needs to be. 

I believe the guys over at TacMed Australia said it the best. Thay said, "Bleeding control is about pressure." I can take 400 yards of sterile gauze and pack in there, and if I don't have the pressure against that artery or against that bleeding vessel, it will most likely continue to bleed. There are also studies and doctors who say that "... all the hemostatic gauze has made some of the medics and people lazy because they think that all I've got to do is just stuff this in there and the magical pixie dust off of this just automatically stops everything from clotting," which, does sometimes happen.

However, the point is that the studies and doctors are making is that bleeding control is pressure; it's about putting pressure on the bleeding vessel to get it to stop bleeding. When teaching classes, I have the wound simulator that I make the students pack.  While it's a dry packing mannequin, I make them pack that wound and then hold their fist on top of the injury, or however they want to keep pressure. Once they have the force applied, I start my stopwatch and make them hold it for three to five minutes. What most people don't realize is that when they're putting pressure on a wound for three minutes, those three minutes seems like 30 and it doesn't take long until their arm starts going numb, and they can't feel their hand, and they're surprised that only a minute or two has passed. 

Putting pressure on a wound is similar to doing CPR. When I teach CPR, I have the students do chest compressions for a minute or two without stopping. I do that because most people don't realize that performing CPR is a lot of work. Doing CPR is a great cardio workout when you do it for five minutes without stopping.

When it comes to treating gunshot wounds, people need to understand what happens when a bullet strikes someone.  The round destroys all the tissue around the hole. Therefore, people have to know that they're putting the bandages and the gauze in the wound to fill up space and to give something for the blood to be trapped in so its clotting factors can work. Otherwise, if they don't pack the wound thoroughly, the blood may continue to flow out and onto the ground. One way to think about it is to consider a broken vessel to be like a broken pipe. You can't go up there and put your finger on a leaking high-pressure pipe and stop the leak. You have to fill up the volume by packing that wound. When you do, it lets you get enough material in the injury that it helps compress down onto bleed, and that's really what stops the bleeding.

There are some great pieces of kit to treat gunshot wounds. When it comes to medical equipment, most people know about Combat Gauze, which is the original hemostatic gauze. What gives Combat Gauze its ability to clot blood is a substance called is Kaolin. Kaolin is a naturally occurring clay-type mineral within the earth, and it works with your body's clotting system to help it readily form those clots that will help stop the bleeding.

Then, there are bandages made with Chitosan, which is used in products such as Celox Rapid. The studies I've read here in Florida show that Celox Rapid seems to work a little bit better with your civilian population. It appears to work better with people who are on blood thinners, with hypothermic blood.

While we're on the topic of medical myths such as tampons and all that, I still hear some from time to time about QuikClot granules. What initially came out before impregnated gauze came around was QuikClot granules. Unfortunately, what they didn't realize when they first made it, is that the granules caused a thermogenic reaction with the blood. There's a guy that works for our fire department that was over in the war early on, and he said that he got a deep laceration, it may have been a wreck that he was in. Because the gash was deep, the medic used granules to treat him.

What he told me about having the granules used on him is, "Man, I don't know what hurt worse, me getting cut or the medic pouring in the granules. If I wanted to give you equivalent of how it felt, cut yourself on the hand, pour gas on it, and then light it on fire because that's how it felt. It felt like they poured gas on me and lit it on fire," So, the early granules, worked to clot the wound, and also left first and second-degree chemical burns all-around the wounds. While some companies still make the granules, Celox makes granules that are now much safer to use. 

Now, there are people out there who still have the original QuickClot granules. Those people need to know that the early granules are all expired by now. And, because the granules were not cheap, many people want to keep them for an emergency. However, people need to understand that they can cause harm to the person with the burns, as we discussed. Also, when the patient gets into surgery, because of the granules, they will have to go in there and debride most of the wound too. So, if you have the early Quick Clot granules, you may want to consider replacing them with something that is not expired and more patient-friendly. 

One of the other big things is when people say, "Well, something's better than nothing." Unfortunately, that is not the case, and people who say that are saying something similar to"well, I have to rappel down this thousand-foot cliff, and I only have 500-feet of rope. Well, 500-feet is better than nothing." How will that work for you once you hit the end of your rope? 

Vetting Training

Vetting Training | Prepper Medical Supplies

As we talked about earlier, the first thing that you want to do when taking training from somebody, whether it be bushcraft, weapons, medical, or anything like we talked about, is to vet your instructors. There are many people out there that teach classes that they have no earthly idea what they're talking about.

What I tell people is that I'm not the smartest guy in the world, but I can tell you my experiences. I can tell you certain things that work, certain things that don't work based on my experience and education.

So, make sure you vet your educational facility or your instructor. One way do this is if you're near a community college or a local college, look at the school and see what kind of programs they have. Most of the time, colleges and universities aren't going to let just anybody come in and teach, and they'll probably have some vetting process as well.

Comfort Items

Prepper Medical Supplies & Comfort Items | Prepper Medical Supplies

When it comes to necessary medical supplies, people should have some basic bleeding control kit, as we spoke about earlier. They should also consider some saline or pure water for flushing out eyes. It doesn't necessarily have to be saline.

People should also stock up on comfort items. For example, if I grab the aid bag that I carry when we're providing medical services for companies, you'll find that there's a whole lot of stuff in it, that unless there's significant trauma, it's not going to do a whole lot of good. So, the trick is not to be so focused on the small percentage of gear that most people will rarely use. Instead, consider adding things like Benadryl, Tylenol, or other over-the-counter meds.

One tip is to go to Walmart, where you can get some medications for 88 cents a bottle. Another tip I tell people is that they don't have to buy the Benadryl brand. Benadryl is a drug called diphenhydramine, except it's less expensive when purchased as diphenhydramine. For example, many sleep aids are made from diphenhydramine. So, save some money and buy generic diphenhydramine rather than Benadryl. 

When I had a contract providing medical coverage on a shooting range, we were on the range and out in the field, and I had my big Mystery Ranch pack with all the cool trauma stuff in it. I had a collapsible traction splint and all this cool stuff. Now, thank goodness I never had to use any of my trauma gear. However,  Tylenol, Benadryl, Band-Aids, triple antibiotic crème were the majority of what I used.

Another good thing to remember is stuff for your tummy. Whether it's anti-diarrheal medications and stuff like that, they're essential. THat's because the reality is that when you have a bunch of people living together, and somebody gets a little GI bug, everybody's going to get it.

A good piece of kit to pack as well as a good-sized hand towel or a little bigger than a hand towel. A hand towel works great because when people are bleeding, or they're puking, or whatever they're doing, it saves the day when you can use that towel and, for example, if somebody's bleeding, you can wipe off their arm, if you got to wrap it up or look at something. In the end, often it's the simple stuff like that will help you the most. 

Following up on that, the vast majority of the medical skills a person will use are not paramedic-level or higher qualifications. For example, even as a paramedic, I tell people if I run ten calls at the fire department, I only need my paramedic skills for two or three of those calls. The fact is is that there's not a whole lot of prehospital or even austere environment medicine happening that needs advanced skills for major traumas and medical emergencies. The vast majority of supplies required for a medical bag are comfort items.

When it comes down to it, I tell people if they're putting a little car kit together or something to have if you need to leave real quick, pack comfort items. You would be amazed at the people that I've looked at their stuff and been like, "Man, you probably have a better trauma set up than what I do." But what happens when your kid gets stung by a bug? Are you going to put a tourniquet on that limb and hope that the toxins don't systemically go everywhere, or are you going to give her a couple of Benadryl? I vote for the Benadryl.

So, when it comes to medical gear and comfort items, I would say most people have overinflated expectations. People think they're going to have to create airways, deal with collapsed lungs and apply 40 tourniquets, I'm going to have to have 40 tourniquets. Those are all exceptional items to have, and I'm not saying that if you have the skill set to use all those things, to NOT carry them. Just don't forget about your essential stuff.

Another thing to carry is cough drops.  They not only help someone who's coughing, but cough drops work as candy, too. What kid doesn't like candy and who doesn't need a little pick me up when things are crappy. If someone's feeling down, or you come across some kids, you may be able to help make the situation better with something as simple as a cough drop.

Other things to consider carrying are:

  • Foot powder
  • Body powder
  • ACE wraps
  • Anti-diarrheal medications 
  • Salonpas heating pads 

Training with Medical Gear

Training with Prepper Medical Gear | Prepper Medical Supplies

When it comes to keeping up on a person's skills after going through training, people should always buy at least two pieces of it. Buy at least one for real-life use and at least one for practice and training.

Take Israeli bandages, for example. Everybody likes Israeli bandages. They're readily available, they've been around for a long time, and they're great bandages. It's not to take away that the Israeli bandage is outdated or not a quality product; it still is an excellent and relevant bandage.

Talking about Israeli bandages reminds me of a student I taught. During class, he raises his hand and says, "Yeah, I've got a medical kit with an Israeli bandage." So, I responded, "Okay, your wife sitting next to you just got shot in the arm, put your Israeli bandage on her." As soon as I said it, a look of horror came over his face because he had no idea how to use this Israeli bandage. He did what many people do. He had several Israeli bandages in different medical kits, which is good. Unfortunately, he never thought to take one of them, open it, figure out how it works, and then train with it.

A person who doesn't practice and train with their medical kit is similar to a person who buys a home defense gun and never trains with it. Does it make good sense to buy a home defense gun, put it in your safe and say, "I'm not going to shoot this thing until somebody breaks into my house, and I need to defend myself and my family. When that happens, I'll grab it and figure out how it works." When the average person hears that story, they're like, "That's the stupidest thing I've ever heard. Why would someone do that?" The unfortunate reality is it is not good practice, and likewise, neither is buying medical gear you never train with. Medical equipment that you may need to save yourself or a family member. 

In the end, being a good prepper is about not only having the gear you need. It's also about understanding when to use and how to effectively use it when the time comes. How many people know that the Israeli bandage comes vacuum-sealed in a plastic wrapper that is inside of another plastic wrapper. It's situations like a wrapper within a wrapper that can throw a person off when an emergency happens. Therefore, people must practice with their kit so that they are as ready as possible when the worst happens. 

Training with your gear also helps you to figure out tricks of the trade that make things easier when your actions matter. For example, learning something as easy as taking duct tape, putting it on the top of your Israeli bandage packaging and folding it down, so you've got a helpful big tab to grab ahold of during an emergency. The big tabs help to overcome the loss of fine motor skills that happens when working in stressful circumstances. Another trick is that when you train with it, wet your hands. Once your hands are wet, try to put that bandage on somebody. You can even buy simulated blood to use so that you can see how difficult it can be to work on a bleeding patient. 

Resources Related to this Episode

Note: some of the resources mentioned in this episode may be affiliate links, which means I get paid a commission (at no extra cost to you) if you use that link to make a purchase.

Lastly…

Never forget, you’re just one prep away.

If you have any other thoughts or questions about medical preparedness, please leave a comment below.

Stay safe, secure and prepared,

Brian-Duff-Mind4Survival

 

Thanks for reading about medical preparedness.

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