Medical  FAQ version 1.02
August 1997
Craig Ellis
(Copyright.(c)  Craig Ellis 1997)

Excluding contributions attributed to specific individuals, all material is copyrighted to the author and all rights reserved. This work may be copied and distributed freely as long as the entire text and all disclaimers and copyrigt notices remain intact, unless my prior permission is obtained. This FAQ may not be distributed for financial gain, included in any commercial collections or compilations or included as any part of a wed site without the permission of the author.

Thanks to Richard DeCastro, Alan Hagan and Pat Turner for comments and suggestions.

Any constructive comments and debate welcome. I welcome correction in any errors of fact. this is the first version, I apologise for any errors of grammer or spelling.

Disclaimer: The author accepts no responsibility for the use or misuse of this information. The practice of medicine is something that should only be practiced by trained professionals. If you start administering medical or surgical treatments without the appropriate skills you will kill someone. Even in emergency situations often no action is better than uninformed and untrained action. Any practice of survival medicine should be backed up with appropriate training. This information is offered as my personal opinion and should not be taken to represent a professional opinion or to reflect any widely held views from the medical community.

CONTENTS

1) Survival Medicine
2) What do you need to know ?
3) Training
4) Organisation
5) Reference Books
6) Medical Kits
7) Common sense
8) Low Tech Medicine  (not yet finished) 
9) Alternative medicine

Before I start, the most important thing about medicine, survival or otherwise is :  *** WASH YOUR HANDS ***.

1.0   Survival Medicine :

What is survival medicine ? My definition is : " the practice of medicine in a environment or situation where standard medical care and facilities are unavailable, often by persons with no formal medical training " This includes medical care while trekking in third world countries, deep water ocean sailing, in some cases isolated tramping and trekking in a developed country and of course post-TEOTWAWKI.

The basic assumption is that trained doctors and hospital care will be unavailable for a prolonged period of time and that in addition to providing first aid; definitive medical care and if required rehabilitation will need to be provided.  Also the basics of personal and public hygeine will also need to be considered.

As is the case with any aspects of preparedness you need to decide what you are preparing for and plan accordingly. For some it will only be a 72 hr crisis for others it will be a major long term event. Your medical preperations will need to reflect your own risk assessments, in terms of what knowledge and skills you develop and what you store. This FAQ is more slanted to longer term preparedness, but much is applicable to shorter term situations.

2.0   What do you need to know ?

The more the better. Keep reading and attend all the courses you can. In addition to an advanced EMT course the following skills are what I feel the person filling the role of " medic ", should aim to be able to do :

* Use a medical dictionary and a basic medical textbook
* Basic bandaging and dressings. Cleaning a would, debriding a burn. 
* Use local anaesthetic to numb a wound
* Debride and suture a wound, but also know when not to suture a wound, and  leave it open or to perform delayed closure
* Deliver a baby and afterbirth. Suture a tear, manage a post-patum bleed.
* Reduce and immobilise a short and long bone fracture/dislocation
* Basic councilling skills
* Understand basic hygeine and preventive medicine practices
* Recognise and treat common infections 
        - viral flu
        - pneumonia
        - urinary infection
        - wound or skin infection
        - common STD's
* Recognise and treat common medical and surgical problems
        - asthma/respiratory distress
        - abdominal pain - renal stones/appendix/bilary stones
        - allergic reactions/anaphylaxis
*  Look after some one who is bed bound eg basic nursing care,    
   managing the unconscious patient, catheterisation
*  Basic dental skills, simple fillings, infections, extractions.
*  Insert an IV and understand basic fluid resuscitation
*  Improvising medical equipment and supplies

3.0   Training
 
The most important aspect of survival medicine is obtaining knowledge and the skills related to it. Medicine is dangerous and uninformed decisions and actions will kill people. But having said that alot of medicine is common sense and anyone with a bit of intelligence, a good anatomy and physiology book and a good medical text can easily learn the basics. Although I have to stress there is no alternative to a trained health care professional and anything else is taking risks. Obviously in survival situation any informed medical care is better than no medical care. Notice I said informed, if you really dont have a clue what you are doing, you will be very dangerous.

3.1     Formal training

        * Professional medical training : One option is undertaking
college study in a medical area eg Medicine, Nursing, Physcians
Assistant, Paramedic, Vet etc. Obviously this is not an option for many but is the ideal situation

        * EMT/Wilderness EMT Course : The much more realistic option. These courses give an basic background in anatomy and physiology, medical terminology and the essentials of emergency medicine. It provides the basis for additional self-directed learning. Most community colleges offer these courses. The basics are well covered in the " first responder " courses, which although very elementary provide a good stepping stone in to more advanced courses, while not requiring the same time commitments as full EMT courses.

3.2     Informal Training

There are a variety of options here. Certainly locally  (New Zealand, and I realise the US may be different) it is possible to gain some experience in an ER. In our emergency department we regularly have a variety of people coming through for practical experience, from army medics, to off-shore island forest service staff, to fishing boat medics. If you can provide a good reason for wanting to gain skills in the emergency room such as "sailing your boat to the south pacific", then the potential to gain practical experience in suturing, inserting iv's, burns management is there. Another option is befriending (or recruiting ) a health care professional and arranging teaching through them. It is common for doctor to be asked to talk to various groups on different topics, so an invite to talk to a "tramping club" about pain relief or treating a fracture in the bush would not be seen as unusual.

3.2     Volunteering

Many ambulances and fire services have volunteer sections or are completely run by volunteers. Through these services you may be able to obtain formal EMT training and at the same time gain valuable practitical skills and experience, overcome fear of dealing with acutely sick people and also work with some great people.
  
4.0 Organisation

4.1  If you are alone or just a couple then organising your medical care is relatively straight forward. However the larger the group the more formalised and structured your medical care should be. Someone within your group, ideally with a medical background, should be appointed medic. Their role is to build up their skill and knowledge base to be able to provide medical care to the group . There should also be a certain amount of cross-training to ensure that if the medic is the sick one, there is someone else with some advanced knowledge. The medic should also be responsible for the development and rotation of the medical stores and for issues relating to sanitation and hygeine. In regard to to medical matters and hygeine their decisions should be absolute.

4.2  Another important area is that of confidentiality and trust. This is a corner stone of any medical relationship. It may seem an odd thing to mention in regards to a survival situation, but all doctors, nurses, paramedics will tell you without trust you carn't practice. You need to trust that what you tell your medic will go no further and personal problems wont become dinner time conversations. Obviously this has to be weighed against the " common good " of the group, but unless it would place the group in danger there should be an absolute rule of confidentiality.

4.3  The persisting survival theme of how you deal with the "have nots" when they approach you, applies to medicine as much as to food and other supplies. Obviously complete isolation is one option, but this is unlikely to be that common. How do you deal with the stranger dumped on you with the gunshot wound or pneumonia. Its one thing to give them a meal, but do you give them them the last of your IV antibitotics or your one dose of IV anaesthetic? You need to have thought about these things. People can often "live of the land" and forage for food, but they can not forage for penicillin. 

5.0   Reference Books

Good medical reference books are vital. The following is a list in two parts. First are books I think are a really solid starting point for a survival medicine library and then a selection of other useful medical books with varying strengths and weaknesses. What you prefer is to a great extent personal opinion.  Most can be obtained from any university book shop, paladin press  or from Amazom.com. There are titles and authors for all books, but only ISBN's and approximate prices (US$) for some.. 

5.1  Must have's :

1) A good medical dictionary.
        * Dorlands illustrated medical dictionary. By Dorland 1994 $40
        * Mosbys Medical Dictionary. By Anderson 1993 $30

2) An Anatomy and Physiology reference.
        * Functional anatomy and physiology. By Yamamoto. 1996 $30
        * Essentials of anatomy and physiology. By Scancon. 
                ISBN 0803677359
        * An anatomy atlas such as Grays or Grants are also excellent 
                     fo any do-it-yourself surgery. :-)

3) Where there is no doctor. By Werner. Hesperian Foundaton 1992 $20
     The must have of survival medicine. Obviously slanted to the
     third world and the tropics, but if you have limited medical
     knowledge it should be first on your to buy list.
 
4) Where there is no dentist. By Dickson. Hesperian Foundation 1983 $9
     The only book of its kind. Very good. Dental care is a very under
      estimated survival problem.

5) An emergency medicine reference
        * Emergency Care in the streets. By Caroline. 1995. $50
          My choice, but both are good books. Textbooks of 
          paramedic care.
        * Mosbys Paramedic textbook. By Sanders $50

6) A drug reference guide
        * In USA - Physicans Desk reference
        * In UK - British National Formulary
        * In Aust - PIMS
        * In NZ - New Ethicals catologue

7) Ditch Medicine. Coffee. Paladin press. ISBN 0873647173 $25
        Vital for basic emergency surgical procedures and a steeping
        stone into more advanced stuff

8) A Herbal/Medicinal Plant guide to your area. The basis of most of 
   the modern drugs is in plants and large numbers have potent
      medicinal properties. Also local indigenous  peoples often have
    books about their traditional medicine. You need to be careful
    seperating out what's useful and whats not, but it may be very
    valuable in a major long term event.

5.2  General Books

Oxford Handbook of Clinical Medicine. Hope. Oxford University Press.1995. $25   excellent coverage of basic medical principles aimed at the junior docotr level.

Oxford Handbook of Clinical Specialities. Collier. Oxford University Press.1993 $25 as above except covers the specialities including OBGYN, paediatrics,orthopaedics and anaesthetics.

Current Medical Diagnosis and Treatment. Tierney. Lange. 1997 Up to date management of common medical problmes, requires some advanced knowledge.

Oxford Handbook of Emergency medicine in general practice. Lawrence. Oxford University Press. 96. $30 good coverage of the basics of emergency medicine in easy to read format.

Merck Manual Vol 1: General Medicine. Berkow. MSD. 93. $15 Good reference, but can be complicated and verbose

Merck Manual Vol 2: Specialities. Berkow. MSD. 93. $15

International Medical guide for Ships. W.H.O. ISBN 9241542314

Ships Captains Medical Guide. Her Majesty's Staionary Office. 1983 My personal favourite. I would recommend this book to everyone. It covers the management of most common problems in an excellent format, designed for ships isolated at sea. Also good description of drugs and when to use them.

Advanced First Aid Afloat. Eastman. 

Onboard Medical Handbook. Gill. $15

Medical Emergencies at Sea. Kessler. ISBN. 0688043402

Medicine for Mountaineering. Wilkerson. $15

Wilderness Medical Society : Practice guidelines for Wilderness Emergency Care. Forgery. 1995 $10

Wilderness Medicine : management of wilderness and environmental emergencies. Ed Auerbach  $175. Have not seen this book, but it is recommended to me by several knowledgable people.

Book for Midwives : A manual for traditional birth attendents and midwives. Klein. Hesperian Foundation. ISBN 0942364228 Best book of its kind. Safe childbirth in a low tech environment with minimal backup.

Mayes Midwifery textbook. Sweet. ISBN 070201236X

Survivalist Medicine Chest. Benson. Paladin Press. 1983  ISBN 0873642562  $10. A little dated. Some advise I consider a little suspect but generally a good book.

Do-It-Yourself Medicine. Benson. Paladin Press 1996 .  ISBN 0873649184 $ 20. I have not seen this book but understand it is the up dated version of medicine chest, and addresses some of that books problems. recommended by many.

US Special Forces Medical Handbook. Paladin Press. 1987 Again a little dated but still an excellent book. Even the new edition is still not completely up to date. But its strengths overcome this. Good coverage all areas including surgery, dentistry and preventive medicine.

Wounds and Lacerations - emergency care and closure. Trott. Pub Mosby.

Emergency War Surgery. Bowen. 1994  ISBN 0788102915 $60 Excellent book but very technical.

Emergency War Surgery : US revision of Nato Handbook. G.P.O 1988 $50 ISBN 9999814328. The do-it-yourself surgery guide. Designed for junior doctors with minimal trauma experience going into a war zone. Starting to be a little dated, but the basics dont change.

Field Surgery Pocket Book. Her Majesty's Stationary Office. Brithish version of the above. I personally prefer this one to the NATO handbook, but each are equally good.

6.0   Medical Kits

6.1  What you stock up on should be related to what you know how to use and what you can obtain. Potentially there are thousands of drugs and different pieces of medical equipment and you carnt stock everything. Fortunately it is possible to manage 90% of medical problems with only a moderate amount of basic equipment and drugs. Obviously sometimes the treatment may not be as such  high quality as that provided by a proper hospital, but it may be life saving and reduce long term  problems. For example a broken tibia is usually managed by a general anaesthetic, an operation for an internal tibial nail, followed by pain relief and physio. But it  can be managed with manipulation with analgesia and immobilistion with an external splint for 6-8 weeks and as a result the patient may be in pain for a few weeks and have a limp for life, but still have a functioning leg. Also appendicitis has been treated with high dose antibiotics when surgery has been unavailable such as on a submarine or in the antarctic. Although in  both  cases management is sub-optimal and may have some risk,  in a survival situation it can be done and may be successful, with limited medication and equipment.

6.2  Obtaining medications can be differcult. The problems is two fold. Firstly is access and secondly is cost. Below are some suggestions for legally obtaining medicines for use in a survival medicine situation.

        * Talk to your doctor. Be honest explain exactly why and what you want, that you want to be prepared for any disaster and have some important basic meds available for if medical care isnt freely available. Demonstrate an understanding of what each drug is for and that you know how to safely use it. Most MD's would probably be very supportive. Although I would suggest that you dont request narcotics the first time. Then return the meds when they have expired, this will confirm that you are not using them inappropriately.

        * Discuss with your MD your plans for a trekking holiday. Most MDs recognise the importance of an adequte medical kit if you are travelling in the 3rd world or doing isolated backbacking. Most would prescribe antibiotics, rehydration fluid, simple pain killers, anti-diarrhoea meds, antibiotic and fungal creams, and if climbing steroids and frusemide for AMS.

        * Buy a boat. Australia, New Zealand and the UK, require all boats sailing beyond costal limits to carry a comprehensive medical kit. This includes antibiotics, strong narcotic analgesia and a variety of other meds. Although not a legal requirement in the US, I imagine most MD's would happily equip an ocean going yacht with a comprehensive medical kit. Especially if you can demostrate a basic medical knowledge. The US Public Health service offers suggested medications and equipment, depending on numbers and expected isolation.

        * Prescription medicines are available over the counter in many third would countries. I am unsure of the legalities of purchasing these. I imagine a single course of antibiotics would be unlikely to be a problem, but that large amounts or narcotics would be illegal.  

        * Not for human use. Veterinary meds are widely available and relatively cheap. Several books discuss obtaining them ( Benson's books, see book list), so I wont cover it in detail here. I personally dont recommend this, but obviously for some it is the only viable option. My only advice is to make sure you know exactly what drug you are buying, avoid preperations which contain combinations of drugs and also obscure drugs for which you can find no identical human preperation and avoid drug preperations for specific animal conditions for which there is no human equilvent eg Pink eye.

        * Obtaining general medical supplies is often easier. Basic bandages and stethoscopes etc, can be bought from any medical supply house. I understand there is no federal law prohibiting the purchase of things like sutures, syringes, needles, ivs etc, but some states can make it differcult. The above approaches can also be used for obtaining medical equipment if you do have problems.The most important point is to be able to demostrate an understanding of how to use what you are requesting.

6.3  Ive included three kits. The first is designed for someone with some limited medical knowledge and a good book, a lot of common problems can be managed with it, minor trauma ( cuts and minor fractures ), simple infections and medical problems.The second is designed for someone with extensive medical training and should be able to cope with 90% of common medical problems, including some surgery, spinal and regional anaesthesia, general anaesthesia with ketamine, treating most common infections and medical problems, and moderate trauma. Obviously there is  a vast middle ground between the two. The kits are designed for long-term care rather than to cover short (48 hrs) delays in getting to formal medical care. The third is a reprint of the medical scales for an ocean going yacht leaving new zealand waters, to give you an idea of what the " experts " believe is required for isolated intermediate term survival medicine.

NOTE : 

1) Ive tried to use the international generic name for drugs, however there are some differences between the british and the US pharmacopias and where possible Ive tried to include both
        eg Lignocaine (UK & NZ) = Lidocaine (US)

2) I have not included any quantities. This is dependent on what you are planning for and what you can afford. Unfortunatly most medications require rotation, with 1-5 year shelf lives, making this a costly exercise, as they are not like food you can rotate into the kitchen

3) Always store a supply of any medicines you take regularly. Blood pressure pills, allergy pills, contraceptive pills, asthma inhalers etc.

** Small Kit **

Combines Dressings
Small quaze squares
Rollar Bandages elastic + cotton (2in/4in/6in)
Triangular Bandages
Bandaids -assorted sizes and shapes (ie finger tips)
Sleek Tape 1in ( waterproof, plastic/elasticated tape )
cotton buds ( q-tips, cottone tips)

Chlorhexidine and cetrimide (antiseptic) or Povidone-Iodine
Antibacterial Soap
Lignocaine 1% (local anaesthetic) ( USA = Lidocaine)
Augmentin  (antibiotic) (a broad spectrum antibiotic)
Tylenol  (mild analgesic)
Dicolphenic  (mod analgesic)    ( a nonsteroidal antiinflammatory )
Oral Rehydration powder
Loperamide  (anti-diarrhoeal)
Benedryl &/or Claratyne  (antihistamines, short + long acting))
Adrenaline autoinjector or Anakit  (USA = epinephrine)
Morphine Sulphate (strong pain killer) if avaiable


Paramedic scissors
Surgical scissors
Needle holder
Sm curved clamps
Tissue forceps
Scalpel blades

Vicryl 2/0 suture material
        Your choice of suture material is up to you. Vicryl is a 
        synthetic dissolvable one, but takes upto 4-6 weeks to
        dissolve, so I think it is the ideal survival thread. But a 
        variety of non-dissolvable sutures are available which 
        will last forever.
5ml syringes
20g needles

Oil of cloves (tooth ache)

A smaller kit for your bug-out bag could be made up from the above. Include some combined dressings, a couple of bandages, bandaids, tape, some tylenol, benedryl and some loperamide. 

** Large Kit  **  

This list may seem extreme, but is designed for a well trained person in a worst case scenario. Even though it is a long list, it all packs down, mine which has a similar content packs into two medium size nylon multi-compartment bags and a plano rigid 747 box. I havent included descriptions of what specific items are, on the assumption that if you dont know what it is, you shouldnt have it or try to use it.

General

Sm gauze squares
Combined wound dressings large
Battle dressings
Petroleum gauze 
Plastic bags
Bandaids - assorted sizes and shapes
Elastoplast dressing
Steristrips - assorted sizes
Tinture of Benzoin
Rollar (elasticated + cotton) bandages (2in/4in/6in)
Triangular bandages
Safety pins
Cotton buds
Paper tape ( 1/2 in/1in)
Sleek tape ( 1/2in/1in)
Oropharyngeal airways
Resuscitation face mask with one way valve
BP cuff
Stethoscope
Otoscope
Sm Torch  (flash light)
Thermometer
Heavy duty scissors
Space blanket
Air splints ( arm/long-leg/short-leg)
SAM splints
Plaster of paris ( or fibreglass ) rollar bandages (4in/6in)
Multidip. urine test strips
Pregnancy test kits
Sterile and unsterile latex gloves
Scrub Suits
Fluroscene eye strips
Eye patches
Sm eye magnet ( for FB's)
Snake bite kit ( for those of you unlucky enough to have them :-) )
    - The sayer suction kit is recommended. It is slightly more expensive, but I understand more effective in removing venom.

IV Kit

Normal Saline
Haemaccel or Pentaspan ( a colloid resus fluid )
IV giving sets - maxisets + standard sets
Blood collection bags + filter giving sets
Syringes 2/5/10/20 ml
Needles 20/22/24 g
IV cannulas 16/18/22g
Spinal needles 22g
Leur locks/Heparin locks
Tornuiquet
Alcohol Wipes

Surgical Kit

Mayo scissors
Dissecting forceps
Sm curved clamps
Sm straight clamps
Lg curved clamps
Scalpel Handle + Blades (size 11,12,15) or disposable scalpels
Sm Bone Saw
LIft Out obstetric forceps
Emergency Obstetric Kit 
Suture Material Vicryl 0/,2/0
                   Chromic 0/,2/0
                   Dermalon 0/, 2/0     
Surgical stapler and remover
Hemilich flutter valve
Penrose drains
Foley Urethral Catheters
Urine Bags
N-G tubes  + spiggots

Dental KIt

Oil of cloves
Zinc Oxide paste
Dental mirror
Sharp probe
Compacter
Extraction forceps

Medications

Povidone - Iodeine Prep                 antiseptic skin prep and/or
Alcohol prep                            antiseptic skin prep 
Chlorhexidine and cetrimide             antiseptic handwash
Benalkium Chloride                      antirabies skin wash
Antibacterial Soap
Tylenol         oral                    mild analgesic
Aspirin         oral                    wonder drug
Diclophenic     oral                    mod analgesic (nsaid)
Morphine        iv/im/sc                        strong analgesic
Narloxone       iv                      antagonist to morphine
Ketamine        iv/im                   iv anaesthetic
Diazepam        iv                      hypnotic/sedative
Atropine                iv                      pre-med/poison anti
Lignocaine      top/spinal              local anaesthetic
Metoclopramide  iv/im                   anti-emetic 
Augmentin       oral/iv                 penicillin antibiotic
Metronidazole     oral                  anaerobic antibiotic
Keflex          oral                    cephalsporin antibiotic
Ceftriaxone     iv                      cephalsporin antibiotic
Ciprofloxacin   oral                    quinolone antibiotic
Mebendazole             oral                    antiparasitic
Adrenaline      iv/im                   (USA = Epinephrine)
Salbutamol inhaler                      asthma/anaphylaxis
Rehydration formula                     dehydration
Benedryl &/or Claratyne oral            antihistamine ( short + long acting)
OTC Cough surpressent
Betnesol        oral                    steroid
Hydrocortisone  iv/cream                        steroid
Loperamide      oral                    antidiarrhoeal
Ergometrine &/or Oxytocin       im/iv   ecbolic for PPH
Neomycin eye drop                       antibiotic eye drops
Pilocaine eye drops                     local anaesthetic
Starr Otic Drops                                antibiotic ear drops
Bactroban       top                     topical antibacterial cream
Water for injection/normal saline for injection
Femodene 28                             oral contraceptive
Condoms

** Ocean Kit **

Not added yet. Im just checking copy right issues out, will be included shortly.

6.4. Antibiotic Recommendations. In some cases access to antibiotics may be very limited. The following is my heirache of antibiotics. If your limited in what you can get, I suggest you perchase and expand in this order. All are good broad spectrum antibiotics and have different strengths and weakness. I suggest you purchase an antibiotic guide, most medical bookshops have small pocket guides for juinor doctors detailing which drug to use for which bug and oulining sensitivities.

        1st     Ciprofloxacin or another fluroquinolone (oral)
        2nd     Amoxycillin + Clavulanic Acid (oral + iv) 
        3rd     A Cephalosporin (oral +iv)
        
        +/-     Erythromycin (oral + iv) if any of your group is allergic to penicillin

7.0  Common Sense

There are hundreds of little saying within medicine about dozens of topics. At first some of them sound extremely basic or stupid, but the all have a basis in fact. Medicine is made up of common sense.  Here's a selection. I welcome additions

* Knowledge is power
* First do no harm
* Masterful inactivity saves lives
* The placebo effect has cured more people than any doctor
* If it hurts rest it or immobilise it
 * Always wash your hands before touching a patient
* Its better to boil all your water, than die of diarrhoea
* Dont shit in the water you are going to drink (or let anyone else) 
* A comfortable, warm bed fixes many problems, a good meal fixes many more.
* Direct pressure stops bleeding
* Pretend you know what you are doing and people will believe you do
* Dont stitch a dirty wound
* Clean boiled water is a great antiseptic ( so urine but we wont start that one )
* If youve got a rash, if its wet dry it, if its dry wet it.
 
8.0  Low tech medicine

Note :  not yet finished, some of the topics are below, Ill finish them when I have time, any suggestions for more or hints to include?

8.1   * Rectal Fluid Resuscitation

The standard technique of giving fluids to an unconscious, shocked or dehydrated person is with intravenous fluids. However this may not be possible in a survival situation. An alternative is to give fluids rectally. This method will obviously not work if the cause of the problem is severe diarrhoea. This is included for interest only and I do not recommend this procedure :-)

The person is placed on their side, with the bottocks raised on two pillows. A lubricated plastic tube with a blunt end (a large urinary catheter or naso gastric tube is ideal) should be passed through the anus into the rectum for about 9 inches. It should pass with minimal pressure and should not be forced. The danger is perforating the bowel 

The tube should be taped to the skin. A longer length of tubing and a drip bag or funnel should be attached to the end, and elevated.Then 200mls of fluid slowly driped in over 15 to 20 minutes. The catheter should then be clamped. This can be repeated every 4 hours with a further 200mls. Upto 1000-1200mls/24hrs can be administered this way. If 200mls is tolerated it can be worth increasing the volume slightly or reducing the time to 31/2 or 3 hrs. If there is over flow the volume should be reduced. A rectum full of faeces does not absorb water very well, so the amounts may need to be reduced, but given more frequently.

8.2   * Death
        
        People are going to die, one way or another it will happen and you need to be prepared for it.

Diagnosing Death : No pulse
                     No respiations
                     No heart sounds
                     No pupil response to light

        If all of the above are  present,  your dead !

Handling a dead person : The human body decomposes very quickley, especially in hot weather. A decomposing body rapidly becomes a health hazard. A dead person should be buried quickley, in a  reasonably deep grave to avoid predation by scavengers.  Ill post some historical information on preservation of bodies when I update this FAQ in a couple of months. 

8.3   * Managing a bad case of the flu.
8.4   * Diarrhoea and dehydration.
9.0  Alternative therapies.

9.1  Finally I feel I should make a passing comment on alternative therapies. I exclude herbal and plant based medicines from the following comments, because obviously these  medicines form the basis of modern pharmacology and post-TEOTWAWKI will do so again. I stress these are my opinions. If you find a particular alternative treatment works, and wish to practice it and use it post-teotwawki then thats fine. However I think it would be unsafe to ignore conventional medicine. The alternative therapies are most commonly used and successful with low grade chronic problems. I would suggest that what will kill you and what you need to prepare for is not chronic lower back pain or irritible bowel syndrome, but major trauma, or cholera, or severe pneumonia and I dont think arnica (?sp) or a good foot rub will fix the problem.Things which are currently annoying or distressing chronic problems may pale into insignificance alongside finding enough to eat and drink and avoiding the baddies. ( But who knows, under survival stress it may make them worse :-)

9.2  Colloidal Silver should be specifically mentioned as it receives alot of questions on the news group. IMHO its merits have been exaggerated in the extreme. There is no reputable scientific evidence that it has any useful in-vivo (in the human body, rather than in a lab) antibiotic or antibacterial effects. If its proponents can supply recent case/controlled trials, published in a reputable scientific or medical journal, I am prepared to revise my opinion and include the results here.  I just advise caution to those who plan to rely on CS as their antibiotic in a survival situation.

The most important thing to remember is that good hygeine can prevent many problems, wash your hands and boil your water.

Any more suggestions ? Comments ?

Craig Ellis
loucr@globe.co.nz
All views in this FAQ reflect only my opinions and is not to be considered in any way a professional opinion or advise.

