Fighters #3: Individual First Aid Kits (IFAKs) And Related Kit

Western Rifle Shooters Association

What do you know about the people within 5 km of your bed?

Western Rifle Shooters Association

Open thread on this medical gear topic; please focus on these issues.

What do you have?

Where did you get it (links are important)?

What should folks avoid?

Go.

Update: Commentary on this deck welcome:

https://www.dropbox.com/s/uwrzz2kkgs1n6re/tactical-combat-casualty-.ppt?dl=0AuthorConcerned AmericanPosted on

52 thoughts on “Fighters #3: Individual First Aid Kits (IFAKs) And Related Kit”

  1. Dirksays:Thanks CA, I seriously need to review my kits. I foresee upgrades. Need to review our bigger surgery kits aswell.This is the kind of stuff we all need to be reviewing.Dirt
    1. tfA-tsays:i’ll save ewe the trouble dirt-bag5 easy steps four your type of scumget a shovel
      dig a 6ft x 2 ft hole
      lay down in it
      eat some shit
      die
      1. Mountain Crackersays:tfA-t I am going to challenge you to change your tone on this latest iteration of WRSA. Sounds like you can accomplish amazing things when so inclined. Is there anything you can do to help those of us that MAY be worth saving?
        1. Bonaventuresays:If yer looking to tFat for advice to save you, you ain’t worth saving.Run along now.
          1. Mountain Crackersays:Acting like a bunch of niggers isn’t helping Bonaventure…
        2. Name (required)says:Sounds to me like he can’t do a damn thing useful. He’s no good to anyone, and that’s why he has plenty of time to be a pain here, when they let him on the free computer at the library.
      2. Dirksays:Tee, fuck , I spit my coffee up.. Dude your are quick witted for a fucking retard. Seriously, good one.Dirt
      3. Deathraysays:That right there is why you’re the asshole on this sight
        You add nothing of use to a single topic.
        1. SemperFi, 0321says:Obviously you have no understanding of Yin-Yang, his hateful sarcasm offsets the mindless smary comments from the flag waving rainbow unicorn fart crowd here.
          He’s a realist, sees life for what it is, not the illusion of suburban white America that refuses to get their hands dirty. The game is about to start, let’s see how suburban America scores.PS, your own leaders have deceived you.
          1. tfA-tsays:human life is the same as life in naturejust with lies, deception, and false hope…the strong still eat the weak………………..
        2. Bonaventuresays:“No lies detected.”via GIPHY
      4. oughtsixsays:Do the world a favor tflatulence… take your own advice, it’ll save you a lot of pin later and clean up Pete’s place quite bit.
        1. oughtsixsays:“PAIN!” Trust me, it’s coming………………..
          1. tfA-tsays:what do you know about pain?you’re an old fool who lived in la la land your entire lifehttps://www.youtube.com/watch?v=0bw8UM1eLFo
  2. joe nobodysays:https://www.northwestfirearms.com/threads/diy-individual-first-aid-kit-ifak.180831/page-2#post-1170898
  3. DMV GRINGOsays:My advice (as a much experienced military medic) is to never by pre-packaged med kits, regardless of the source. The kits are mostly packed with items that are expired, and the remaining items are cheap worthless nicknacks that don’t justify the overpriced total cost of the kit. You will always be better off, in cost and volume, buying an empty med-kit
    and stoking it yourself, with first-aid items found at chain pharmacies, bulk stores, and medical supply stores. A hint: you can never have enough supplies for dealing with blood loss, life threatening or otherwise……all bleeding is life threatening if it goes on long enough.
    1. Concerned Americansays:Any more detail based on your experience?Thanks.
      1. Anonymoussays:“All bleeding stops.”A solid principle of Emergency Medicine.
        1. Anonymoussays:Even for experienced and well-trained personnel, a flexible bougie set-up helps OT and CT intubations (obviously unnecessary for NT intubations).In the spirit of “go big or go home,” get the 10-gauge needle aspiration kit. Don’t forget some kind of one-way valve for that kit.
      2. DMV GRINGOsays:Medical kits and supplies should be tailored to your specific needs and requirements, i.e. long term at home/bug-out residence vs mission requirements. And the important consideration to remember, about field requirements, is not to be the factor that defeats you and your team, by trying to imitate a walking pharmacy/hospital/ICU, that’s not the purpose of a field medic.
      3. ghostsnipersays:Thing is, if you don’t have the know how to use the stuff, it will do you little good, and it might cause you some harm.
        If you do have the know how you already know what you need.I agree, don’t buy a kit, but that is from the perspective of someone that has worked in the field and knew what I wanted in my kits. Yes, plural. So my suggestion is for all people, even kids on a limited level, should get some basic first aid education and experience however they can. Then they will be able to go into a Walmart/Amazon and buy what they need and know how to use it.
        1. Name (required)says:“Thing is, if you don’t have the know how to use the stuff, it will do you little good, and it might cause you some harm.”Do you know someone who might know how to use it? An EMT or a PA or something? Have it for that somebody to use ON YOU, and if you don’t know how to use it, don’t plan to use it yourself or anyone else.Remember, the FAK you carry is for someone to use ON YOU when you’re discombobulated. Get your friends trained up.
    2. chucksays:All bleeding stops…..eventually.
  4. SWRichmondsays:EMT shears
    Surgical tape
    Quickclot EMT rolled gauze X 2
    Sterile scalpel
    Sterile gloves
    Forceps X 2 (straight)
    Sterile sutures
    Alcohol wipes
    Betadyne surgical scrub
    6″ First Care hemorrhage control bandage
    Soft T (in addition to the one I wear)
    Self-adhesive bandage X 2
    Sterile eye rinse X several
    Nasal trumpet and sterile lube
    Oral rehydration salts
    HyFin chest seal
  5. Learning to Flysays:Found a first aid kit that fell off a fire truck while out for a heel and toe (walk) and kept it.
    Just basics bandages, salves, ointments, but I added sealed syringe, pain killers, tourniquet, space blanket. It is a work in progress just like everything.
    Backpacks full of useful items is my technique and that is where the first aid kit is.
  6. Veritassays:A tourniquet is an easy and life-saving item everybody that carries a firearm should also carry at all times. It does require a little bit of training and practice much like a firearm so spend the 15 minutes to learn. Also in terms of what to avoid there has been a fair amount of controversy around the RATS tourniquet. I’m not going to tell anybody what they should or should not buy but I do recommend doing some research first. There are lots of good options out there as a byproduct of the global war on terror.
  7. 15Fixersays:1st-gen First Aid kits (off ebay) in the plastic boxes with ALICE-clip pouch filled with bandaids, bacitracin pack-ettes, alcohol wipes, butterfly sutures, a few q-tips, just general first-aid incidentals. Plus, the box and case make a good place to store and attach other small things to keep with you, like batteries….. Improved FAKs from ebay, surplus stores, friends, that contain the ‘serious’ “immediate” first-aid stuff like naso-pharangeal airway with lube, gauze pads, compression wraps, quick-clot of some sort, and an extra tourniquet of some sort. (In addition to the one carried up front) I have a separate pouch with tweezers, forceps, more and other stuff mounted on the side of my backpack. Sort of like 3 levels of priority…. immediate action; take care of business; and then sweat the smaller stuff. Hope it helps…..
  8. The Gray Mansays:https://www.americanpartisan.org/2019/07/whats-in-your-ifak/Highly recommended reading.
    1. Centurion_Corneliussays:Big thanks, Gray Man.As always, thanks CA for bringing this up.
  9. Mountain Crackersays:CA looks like I may have short stroked a post, this is what I intended to post:This is a good thread in that I need to go over all my supplies again, (it’s an iterative process!)This is the difference between us and those niggers at Stone Mountain is we will move, shoot, communicate and TREAT OUR WOUNDED. White people have been fighting outnumbered through history and 10 or 11 to 1 is not unusual. We are the most efficient killing machines in history. Make them pay when the time comes. Don’t forget that!I use Eagle industries V2 IFAK pouches. They are compact and efficient (worry about the IR signature of MJK though.) The USGI ones suck. I have a chest seal (HALO and one other brand), decompression needle, nasopharyngeal airway, israeli bandage, medical shears, and quik-clot combat gauze (unfortunately not z-fold,) and a CAT tourniquet. Finally plenty of fingertip and knuckle and other band-aids (again USGI band-aids suck. Get the strong adhesive J&J’s from Walmart.) A tube of “Neosporen +pain relief” is handy and I have used it at training classes.I have and enough equipment to outfit a small casualty bay for FREEFOR. Collected all this stuff over the years in preparation for what’s to come. ARFCOM EE is a good source (just keep your pie-hole shut in dealing with them, but many are WRSA friendly.) I found 2 platoon level medic kits (minus catheters) in a surplus store full to the brim and bought them on sight. They had blood-pressure cuffs, hemostats and scalpels, well worth the price for all I got.NARP (North American Rescue Products) is the gold standard but may not sell everything to civilians. Police supply are also good sources, again some have varying degree of civilian-friendliness. Use a critical eye for any stuff on eBay, counterfeit tourniquets are not what you want! Some stuff like combat gauze is hard to source, but the civilian version may serve.We can never have enough training with this equipment! Live training is better but PrepMedic on YouTube is better than going in blind. Even if you are not as trained up as you need to be, someone may be able to use YOUR IFAK ON YOU.A word on expiration dates, all of my stuff is probably past it’s dates. The dates are calculated based on how long it would take a pathogen, caught in the packaging, to grow to a point of being a threat to the user. That is from a manufacturer. Bottom line: if you can keep your stuff in-date that is preferable, but expired is far better than nothing and likely ok. I would be suspicious of Pakistani/Israeli/Russian etc supplies more than US/EU stuff. Rotate it out as best you can.Good luck brothers, even you people I take issue with. It’s time to start setting that shit aside for the time being and unite. We’re behind the curve, but we can catch up damn quick. That’s what my people do.
    1. Centurion_Corneliussays:MC,
      Much obliged.Yr obt svt
    2. Steady Stevesays:I agree NARP and Chinook are good companies to deal with. I suggest taking a first responder course from an accredited instructor. It’s not too expensive if you get a group together and you’ll find it easy to deal with these companies when you can fax or email a PDF of your certificate. Galls is also an excellent source for many products.
  10. Thomassays:From an LPN perspective;
    Stop the bleeding and stay in the fight.
    Applying maxipads with electrical tape can stop/slow bleeding.
    36 inch zip ties can stop/slow bleeding.
    Paper towels/napkins secured with a sock can stop/slow bleeding.
    Understand that there will be no timeouts if you are in a life or death scenario. And you may be adding minutes to your life and nothing more. Make them pay for what they did to you. And don’t leave a functioning weapon behind for your enemy.
    1. DMV GRINGOsays:STICK a tampon in it, your efforts will be better rewarded…..cause guess what, tape of any kind, skin, and (slick) blood DO NOT EFFECTIVELY ADHERE.
      1. Rogue Elementssays:Never use a tampon to staunch blood, it absorbs blood but does not staunch or coagulate blood. Every combat medic and EMT will tell you this.Here’s one, all made in USA and new materiel and etc. Bear Independent is on Patreon and youtube.https://www.bearindependent.com
  11. wheelseesays:I have 3 different kits – an IFAK, a vehicle kit, and a home kit.IFAK (I adhere to TC3 and MARCH)
    – SOFTT-W Tourniquet (several, one on my body everyday – I work in a Level 1 trauma Center, 2 on my PC, 1 on my rifle) – https://www.chinookmed.com/05189/softt-w-tourniquet.html
    – Olaes dressing (has eye cup, pressure dressing- https://www.chinookmed.com/05176/olaes-modular-bandage-6.html
    – Chest dart for needle decompression – https://www.chinookmed.com/500863/ars-decompression-needle
    – Chest seal (2) – https://www.chinookmed.com/601042/hyfin-vent-chest-seal-compact-twin-pack
    – Nasopharyngeal airway (NPA) – https://www.chinookmed.com/pre-lubricated-nasal-airway-28fr
    – Gerber strap cutter for removal of clothes/boots – https://www.amazon.com/Gerber-Strap-Cutter-Coyote-30-000132/dp/B001PTGOKK/ref=pd_bxgy_2/136-9203991-6890437?_encoding=UTF8&pd_rd_i=B001PTGOKK&pd_rd_r=0bc9b96f-53ba-4338-be88-77dbb3dad6b7&pd_rd_w=NMYdF&pd_rd_wg=PgAgN&pf_rd_p=4e3f7fc3-00c8-46a6-a4db-8457e6319578&pf_rd_r=B1B0Z1F0C5AWTRR6G5BV&psc=1&refRID=B1B0Z1F0C5AWTRR6G5BVHaving used a variety of pouches, I have finally settled on these – https://sotechtactical.com/products/vfifaka1b which I keep at my 6’o’clock on my belt and another one on the R side of my PC cummerbund .THE MOST IMPORTANT THING – TRAINING!! All the equipment in the world is worthless if you don’t know how to use it. Though I would still recommend adhering to MARCH (TC3 approved list) since your IFAK is designed to be used ON YOU! (your buddy or another teammate may have the knowledge, experience to use your IFAK on you).
    1. Milo Mindbendersays:I concur training is tbe most important item, cheap to locate, but invaluable when needed. Almost every external self aid buddy care item can be improvised. Training is paramount, whether first reponder, combat lifesaver, basic trauma, or any other program will enable you to have a clue and a mental checklist on what to do in what order.
      Applying a tourniquiet to a leg injury is useless if they are not breathing as well.
      Vebicle kit has more space than an EDC kit, but not as much as a home kit. Your mileage may vary.
  1. wheelseesays:Go here (free) for TC3 (Tactical Combat Casualty Care) information (Ive downloaded a copy on my phone) – https://deployedmedicine.com/market/11Go here (also free) for TC3 updated recommended devices and adjuncts – https://deployedmedicine.com/market/11/content/100
    (IOW, is your TQ on the list?? No?? rethink it….lessons learned in blood)
  2. chucksays:Kerlex, Coban, Vaseline gauze and Elastikon.
    If anyone has training in cric’s, nasal trumpets or chest decompression then those items too. Otherwise, keep it simple stupid. This is mostly stuff for someone else to use on you anyway and unless your crew knows what they are doing……
    Kerlex wrapped several times around a limb then with a windlass thrown in is cheaper than a CAT or RAT and can also be used to fill a bleeding hole
    Chest seals are nice but expensive and VG sticks on its own (a little) and Elastikon will hold it in place.
    Kerlex and Coban work better than Israeli bandages especially when you can push kerlex into the hole before applying pressure with the Coban.
    Blood stop powder (or Celox) doesnt burn the shit out of you (or the patient) like quik-clot and is less expensive and available from your local vet supply store.
    If you’ve got the money to buy several high end things, consider instead, a case of Kerlex and some boxes of Coban , Vaseline Gauze, and Elastikon. Nothing worse than having your limited supply of high end shit getting used up and having to watch the next casualty bleed out.
    As the Soviets used to say, “Quantity is a Quality all its own”
    Just my 2 cents worth.
    1. Berglandersays:Thanks for this, Chuck!
    2. Centurion_Corneliussays:Hellava lot more than .02, chuck! Good tips. Good practical stuff.Will keep me and my guys ‘in the fight.’
  3. SemperFi, 0321says:look over their entire products column, I have bought numerous things here, even several survival sleeping bags (trauma blanket).
    https://persysmedical.com/products/hemorrhage-control/
  4. Jamessays:I put together a bunch of these kits from Aesop’s site,link: https://raconteurreport.blogspot.com/2018/05/first-aid-first-aid-kits-ifak-and-beyond.html ,the site also includes places to buy/some basic med links ect.,still,do shop around as prices can be varied to a large degree.I made up a bunch of these for me vehicles/construction site and many for friends.Tis compact and takes very little space but may buy the time you need till pros can get to the injured.I was willing to pay and take the time to take a WEMT course but even though had no interest in making it a career(nothing against it for those that do)I would have been required to take over 10 vaccines,something I was not willing to do.I and am sure others would find it helpful to have a source(s) of training in emergency first aid that does not require me to become a pin cushion,so,any thoughts appreciated.
  5. Estevesays:This guy thinks his IFAk is great. https://www.bearindependent.com/online-store/Bear-Independent-Bear-Minimum-Kit-p178484593 Its what he does. Besides daily reports on youtube and such.
  6. TNsleepersays:16 years doing anesthesia at a level 1 trauma center. No not a combat vet. But I have seen the local knife and gun club at 3am. What you need is your med kit. THINGS YOU KNOW HOW TO USE! If you don’t know where to put the needle for a chest seal you could make it worse. Does it go on top of the rib or bottom? WHY? NP airway.– do they have skull Fx? why does that matter? What is a secure airway? Whats a chin lift?
    Training Training Training.
    Unless someone in your group is trained having advanced medical equip. can make things worse.
  7. Berglandersays:Each of my rigs and packs have the following:
    HSGI Bleeder pouch or Dark Angel IFAK
    CAT
    Trauma shears
    NPA and lube
    NAR Compact chest seals x 2
    Burn Shield dressing
    Compressed Gauze
    NAR gloves
    Israeli Bandage (Oy vey)
    Quick ClotHappy to add if I am missing things-the HSGI Bleeder pouches are PACKED with all of the above.
  8. Polumetissays:Trauma doc here – trained 18DsTQ first – real CAT (not airsoft) or (preferably) SOFT-W – at least 2 – practice self aid, high and TIGHT
    Quickclot gauze (not powder) to pack those soft tissue holes
    Olaes bandage or Kerlix + Coban for pressure dressing
    Chest seals (pair)
    Forget the needle decomp – rarely needed and can do a lot of harm in the wrong hands
    Get hands-on training – doesn’t take long
    Everything else (bandaids, etc) goes in a different kitSadly, all this presupposes a CASEVAC within an hour to definitive care, but we do what we can…
  9. Gafarmboysays:Something often overlooked, but as important as the ifak, is to carry some common everyday otc meds in a small sturdy zip lock bag. Keep the bag in the pocket of your cargo pants or whatever you wear. First off, you don’t have to dig around in your ifak for an aspirin or Imodium or eye drops. Secondly, you will most likely need those everyday items a shit ton more than you will ever need a blow out kit. Articles such as small capsules of eye wash, Imodium, Ibuprofen, aspirin, Tums, Vaseline, etc. can save the day. So to speak. Configure the bag to your specific needs and desires. I highly recommend Vaseline for many reasons or Bag Balm. It’s better, but taste weird. Really, it tastes like sheep shit if you use it on chapped lips, but works great.
  10. Annon E Mousesays:One item to have is a SAM splint. Flexible plastic covered aluminized foam. Can be flat packed or left rolled can be cut to size if need be with your shears. You take a bad fall on rough terrain or even level ground and break something, this will prevent you from needing to find splinting material. Can also be used as an improvised ‘C’ collar. A couple of triangular bandages will both help in securing it so you do not need to cut up your clothes as well as be used as a sling if needed not only for breaks, but also to secure dislocated shoulders. A couple of cleaned Popsicle sticks or a few liberated tongue depressors at your next Dr.’s visit to help with buddy splinting finger injuries. Take up a whole lot less room than purpose bought finger splints. Just a few things to have after the blood and air gear.
  11. Dirksays:Anybody have a reasonably priced quick clot source. Like 20/30 of em, .Dirt.
  12. mtnforgesays:Issue blow-out kits:https://www.fortbraggsurplus.us/IFAK-2-Multi-Cam-OCP-Improved-First-Aid-Kit-p/ifakii.htm
    https://www.fortbraggsurplus.us/IFAK-Improved-First-Aid-Kit-p/ifak.htmAll I can say about CCC is its as good as self care under fire and buddy assisted care for the 3 things that used to cause mire loss of life in combat can be without some scientific wizard break thru to replace it.
    Had the good fortune of learning combat casualty care from one of its Doctor proponents at a small unit infantry combat course.
    The system is incredibly basic, amazingly well thought out, takes about 15 minutes to teach, and as regards Freefor and other nobody is coming to save you festivities, IS for most of us the only way to save life from bleeding to death, choking to death, or dying from a sucking chest wound, or other non limb bleed-out wounds.
    There’s no nice professional meat wagon coming to save us by taking us to a nice fully equipped and staffed hospital or trauma center.Stock up on:
    Fish med anti=biotics
    Cases of wound dressings
    Alchohol
    Hyd-per-oxide
    Betadine Solution
    Anti-biotic ointment
    Sutures
    Syringes
    A large American Foundry cast aluminum pressure canner for sterilization
    Vinegar and a high quality pump sprayer:
    50-50 mixed with water, and sprayed on surfaces, including fresh meat, including human skin and wound area, kills an amazing range of bacteria, its great for after dressing a meat critter, apply liberally all over-inside the carcus, presto, meat that has no bad bugs so you can hang it and age or simply allow meat to firm up. Stops mold, mildew and a wide variety of sources of rotting meat, a practical “sterile” wash to sanitize hands instruments, surfaces, patient etc. An old butchers trick, still used and approved by the WV Dept of Agriculture for licensed custom meat cutting shops.Aside from the dangerous old timey method of anesthesiology of using a sand bag to knock a patient unconscious, there is a method of home made, 1-2% injectable lidocaine solution, which you can purchase in dry crystaline form without a license.
    Must be melted mixed with sterile saline ampules, heated double boiler method, at 180F, used within that day or so, must be the non pure grade lidocaine, only use HCL grade.here’s a couple decent resources:A PDF file, with exceptionally fine pencil drawings of plastic surgery techniques:Practical Plastic Surgery for Nonsurgeons
    Nadine B. Semer, MD
    https://www.practicalplasticsurgery.org
    nadine@ppsurg.orgBasic info on anti-biotics and their use:Infectious Disease in the TEOTWAWKI World- Part 3, by Militant Medichttps://survivalblog.com/infectious-disease-in-the-teotwawki-world-part-3-by-militant-medic/How Do Antibiotics Work? (continued)
    Antibiotics work in a number of different ways, but perhaps it would just be easier to talk about each one individually. I will focus on the pet antibiotics, since these are the ones most of us can stockpile easily. Again trying to make this as simple as I can, I have omitted many technical details. (A cellular biologist may take exception to what I say, saying “He didn’t even discuss peptidoglycan cross linkages by the DD-transpeptidase enzyme!! Who does he think he is!!??” However, I think most of the prepper army will appreciate omission of the technical fluff.)
    Penicillin (Fish-Pen)
    Penicillin was the first really effective antibiotic discovered and the starting point from which other antibiotics were developed. The original penicillin worked best if injected, but eventually an oral preparation was developed (called Penicillin VK or phenoxymethylpenicillin potassium), and this is what you get when you buy Fish-Pen.
    The penicillin antibiotics are part of the beta-lactam family of antibiotics due to a chemical structure common to these antibiotics called a beta-lactam ring. Other members of the beta-lactam family are the Cephalosporins. Penicillin (and the other beta-lactams) function by deactivating an essential cell wall-building enzyme in the bacteria. With the bacteria unable to repair its cell wall, the cell wall begins to break down and the bacteria literally pops and dies.
    Penicillin once treated a wide variety of bacteria, but overuse allowed most bacteria to develop resistance. The most common form of resistance to penicillin is the beta-lactamase enzyme, which cuts the beta-lactam ring, which deactivates the penicillin and renders it harmless to the bacteria. This caused penicillin’s spectrum to become more and more narrow over time as fewer and fewer pathogens responded to it. Today, penicillin is only used as first choice for one infection– strep throat. That’s it. Penicillin’s spectrum is so narrow (because so many things are resistant to it) that we only use it for one thing– killing Streptococcus pyogenes, which is the bacteria that causes strep throat. It can kill a few other bacteria, like Streptococcus pneumoniae (a cause of pneumonia) and Fusobacteria (a cause of trench mouth and dental abscesses). However, because you don’t know if the pneumonia is caused by S. pneumonia or if the dental abscess is caused by Fisobacteria, you don’t use penicillin first.
    Because penicillin selectively targets an enzyme that we humans don’t have or need, the side effects of this antibiotic are usually very mild.
    Because the spectrum of penicillin has become so narrow, I do not recommend that anyone stock this antibiotic. Other antibiotics are the same price and have more than one use. Continue reading to see which antibiotics to keep on hand for strep throat.
    Ampicillin (Fish-Cillin)
    Ampicillin was invented by sticking an amino group onto the side of Penicillin. This increased the antibiotic’s ability to penetrate into bacteria, which broadened the spectrum of this antibiotic to include some gram negative bacteria. Like penicillin, it is a beta-lactam antibiotic. Like penicillin, it works by inhibiting cell wall repair leading to bacterial cell death.
    It is classified as an intermediate-spectrum antibiotic. While broader in spectrum than penicillin, it is still pretty narrow. It kills the three bacteria penicillin kills plus Group C strep (enterococcus) and the gram-negative bacteria Haemophilus influenzae, Neisseria meningitidis, and members of the Enterobacteria family (like Shigella, Salmonella, and E. coli).
    Because ampicillin selectively targets an enzyme that we humans don’t have or need, the side effects of this antibiotic are usually very mild.
    Ampicillin is a good first line choice for strep throat, sinus infections, ear infections, some urinary tract infections, and other respiratory infections like pneumonia. Of the available pet beta lactams, it has the best CNS (central nervous system) penetration, and so it is a good choice for meningitis.
    Amoxicillin (Fish-Mox)
    Amoxicillinis the big brother of Ampicillin and another child of Penicillin. Like Ampicillin, it is made by adding side groups to penicillin. In Amoxicillin’s case, one side group broadens its spectrum (making it, like ampicillin, an intermediate-spectrum antibiotic) and another side group increases its absorption from the human gut. Like penicillin, it is a beta-lactam antibiotic. Like penicillin, it works by inhibiting cell wall repair leading to bacterial cell death.
    It has the same spectrum as ampicillin, but it also kills Borellia (the causative agent of Lyme disease) and Moraxella (a cause of ear and sinus infections) and Heliobacter pylori (the cause of bleeding stomach ulcers). Amoxicillin is used for basically the same infections as ampicillin with the addition of being effective against lyme disease and stomach ulcers.
    Because amoxicillin selectively targets an enzyme that we humans don’t have or need, the side effects of this antibiotic are usually very mild.
    If I had to pick one of the three penicillins to stock, Amoxicillin would be the one. It has a broader spectrum than Penicillin (without being too broad) and is better absorbed from the stomach than Ampicillin.
    Cephalexin (Fish-Flex)
    Also known as Keflex in the retail world, Cephalexin is a first generation Cephalosporin. After Penicillin was discovered, mold scientists went looking at other molds to find other antibiotics (a process called bio-prospecting), and it was thus that the Cephalosporins were discovered.
    They are closely related to the Penicillins in that they have a beta-lactam ring and act by inhibiting cell wall repair. Like the penicillin family, they are most effective against bacteria with thick cell walls (Gram positive) and are intermediate in spectrum. They are effective against streps (so this is a fine choice against strep throat) and the staphs. However, unlike the penicillins, they are more resistant to bacterial defenses and so work against more and different bacteria. This is especially important for one reason– Staphlococcus aureus.
    Staph aureus (which I will just call Staph from now on, even though there are many other strains of Staph) is a common and very aggressive bacteria that is the cause of many infections. Staph is found on our skin and in our noses, and as long as it stays there it does not cause many problems. However, if you get a little cut or scratch, staph may get in and make an infection. STAPH IS THE #1 CAUSE OF WOUND INFECTIONS WORLDWIDE. It can cause small abscesses if your immune system gets it walled off fast enough, but if not you get more severe infections like cellulitis, necrotizing fasciitis, sepsis (infection traveling in the bloodstream), osteomyelitis (infection of the bone), endocarditis (infection of the heart), or meningitis (infection of the spinal cord). Obviously, many of these can lead to death. Being in the nose (part of the respiratory tract), it can also cause sinusitis and pneumonia. Staph was one of the first bacteria to develop a resistance to the penicillin family of antibiotics. Worldwide today over 80% of Staph strains are immune to penicillin, and in some areas as many as 97% of strains are resistant. However, they are not resistant to Keflex! So this is an antibiotic you really want to keep on hand.
    Keflex is first line for infections by Streps and Staph, including skin abscesses, boils, folliculitis, mastitis, mild cellulitis, impetigo, erysipelas, and strep throat. It can also be used for ear infections, respiratory infections, and UTI’s, but it is not the best choice for these infections.
    Three important notes: First is that Keflex treats regular Staph aureus, but it does not treat Methycillin Resistant Staph Aureus (MRSA). Keep reading to see what antibiotic you will need to treat that. Second is that it does not penetrate into the brain and spinal cord. So it is a very poor choice for meningitis. Third is it has a fairly short half life and usually needs to be taken three if not four times a day to get best effect.
    Because Keflex selectively targets an enzyme that we humans don’t have or need and because it doesn’t wipe out all your gram negative gut bacteria, the side effects of this antibiotic are usually very mild.
    In a TEOTWAWKI scenario, I foresee a lot of manual labor and violence. Both of these things lead to cuts, scratches, and puncture wounds, which means a lot of staph infections. This means you will need Keflex.
    Ciprofloxicin (Fish-Flox)
    Now for something completely different– an antibiotic that isn’t a beta-lactam! Ciprofloxicin belongs to the Fluoroquinolone family of antibiotics, which were discovered by accident in the lab by a chemist trying to make malaria medication, but they sure work.
    Cipro works by inhibiting bacterial Topoisomerase enzymes, which makes the bacteria unable to reproduce by blocking DNA replication. This works in both gram positive and gram negative bacteria. Bacterial resistance to Cipro is increasing and spreading, but at this moment in time is still pretty rare.
    Cipro is a broad-spectrum antibiotic that kills a wide variety of gram positive and gram negative bacteria. It kills Staph aureus and Pseudomonas– two bacteria that are resistant to many other antibiotics. Because it is so broad in spectrum, it is not generally recommended for less complex infections where a narrower spectrum antibiotic would work. You don’t want to use this for a strep throat or simple skin abscess, if you have Keflex on hand.
    Cipro is considered the first line agent for complicated UTI’s and kidney infections, bone and joint infections, typhoid, prostatitis, abdominal infections, gonorrhea, plague, and anthrax. It is also frequently used for infections acquired in the hospital where resistances are more likely. It can also be used for sinus infections, community acquired pneumonia, strep throat, or ear infections, but it is generally considered a little too strong for these infections. Most MRSA bacteria will respond to Cipro, but resistance is developing, and there are better choices. Cipro also penetrates the blood brain barrier well and so is a good choice for meningitis.
    Like any medication, Cipro is not without potential side effects, and in Cipro’s case there is a big one. In fact, it carries a Black Box warning because of it. Cipro is associated with tendonitis and tendon rupture. The risk is increased if you are over 60 and/or on steroids. It’s rare (0.1% chance or one in a thousand), but being on Cipro makes it three times as likely compared to the general population. Also, the tendon that ruptures most often is the Achilles tendon that connects your heel with your leg. So think long and hard about taking this drug, especially if it is for something less severe. Getting through the wasteland as a cripple will not be easy.
    Having Cipro on hand is a good idea, though. It will treat some things nothing else will, but it should not be used frivolously. Other antibiotics will often do the same job with fewer side effects and won’t put your tendons at risk.

tnforgesays:

https://griddownmed.com/2015/04/25/from-modern-survival-online-make-your-own-lidocaine-topical-anesthetic/https://modernsurvivalonline.com/how-to-make-injectable-lidocaine-hcl/

How to make injectable Lidocaine HCL
The following post was previously published here on MSO – it can be seen in its original format HERE.
by RalphP
Almost every other prepper / survivalist that I’ve met shares a similar “hope for the best, but prepare for the worst” philosophy about life.  If this pretty much describes you too, than you’ve probably considered a SHTF situation where, with no access to doctors or dentists, you might be forced to perform some type of minor surgery at home.  Draining an abscess or pulling a tooth maybe.  These are common minor surgeries, but with no anesthesia (or only over-the-counter varieties) they might be very painful.  You’ve probably also thought about how you might treat trauma, like lacerations, punctures, or burns – where suturing, debriding, or removing foreign objects from a wound might be necessary.  Painful enough for an adult, but worse for a child to have to endure.  And while no sane person really wants to think about the worst cases, like having to treat a gunshot, knife, or chainsaw injury to a loved one, you know that ignoring the possibility doesn’t make it any less likely to happen either.  Hope for the best, but prepare for the worst.  TEOTWAWKI might be a dangerous place to live.
Everyone also agrees on the need for First-Aid training and supplies; but in cases of more severe trauma, First-Aid is just that – the “first aid” provided to the victim to limit further harm while getting them to a hospital for professional care.  If the SHTF than the “hospital” is most likely going to be your home, and it’s there that the bandage will need to be removed, the damage accessed, and a decision made on how best to promote healing.  This may require invasive, and painful, examination and treatment.  Some might be able to ‘bite the bullet’, but others, particularly children and certainly animals, couldn’t.  Recoiling from pain is an involuntary response and one of the most primitive instincts.  The lack of an effective local anesthetic would not only limit what medical procedures could reasonably be performed, but also result in unnecessary pain in those that could be.  Now fantasies about an untrained medic performing vascular surgery, nerve or tendon repair, or a bowel resection aside – it is a fact that for some injuries the penalty for surgical failure isn’t going to be any worse than if you do nothing at all, so you may want to try.  Local anesthesia will be needed to help the patient to remain still, or if nothing else than to help ease their pain.
 What you’ll need:
◦ Lidocaine Hydrochloride (HCL) powder (roughly $1 per gram in small quantities) [Grouch adds: please buy this from a reputable place, like Sigma-Aldrich, not Made-in-China.com. And yes, both of those are actual sites that sell (or claim to sell) lidocaine. As noted below (1) lidocaine is a common agent used to cut cocaine, as cocaine also has a local anesthetic effect. Sellers attempt to fool their buyers into thinking they have more of the real stuff than they actually do. Be advised that the DEA might develop a sense of curiosity if you order in bulk.]
◦ Sterile saline, or distilled water (varies, $10 for 24 of the single-use saline vials I chose)
◦ Thermometer, accurate up to 200 degrees F or so ($10 and up)
◦ Scale, accurate down to 1mg or less. ($25 and up)
◦ Funnel, small
◦ Surgical clamp
◦ Scissors
◦ A clean work area with a stove or other way to heat water
Lidocaine Hydrochloride (HCL) powder is available in lab grades from online distributors if you can’t obtain it in USP grade.  You want “Lidocaine HCL” which is water soluble, not the straight “Lidocaine powder” or “Lidocaine base” which isn’t.  It should be stored at room temperature according to its Material Safety Data Sheet, and has no predetermined shelf life or expiration date if stored in an airtight container – or at least none that I’ve been able to determine anyway. (see note 1) [Grouch adds: I’ve seen some information I consider unreliable enough to not reprint it here, that shelf life may be around 1 year. It’s highly unlikely that the shelf life is truely indefinite.]
The supplies and materials I used:

The isopropyl alcohol shown above isn’t part of the solution, it’s used for cleaning the equipment.  Before you begin, all the equipment and anything they might touch, including you, should be thoroughly cleaned with a disinfectant or antiseptic.  Boil any items that can be.  Scrub and glove your hands.
For the sterile saline, I chose a type packaged in 15ml plastic vials and marketed for nasal irrigation purposes.  Search on “ModuDose” and you’ll find it (see note 2).  Mine were dated as expiring in one year, I plan to use them beyond that date unless they turn cloudy or have particulates in them.  I like this particular kind as they’re the perfect size for creating single doses with minimal waste, and they lessen the chance of contamination by not having to mix and transfer the solution between multiple containers during the process.

To produce a 2% lidocaine HCL solution (weight/volume), weigh out 0.3 grams (300mg) of lidocaine HCL, snip the top of the 15ml saline vial about half way down the neck with scissors, insert the funnel securely into the neck of the vial, and pour the lidocaine HCL powder into the funnel.  The powder tends to stick to the funnel, so you’ll probably need to gently squeeze the vial to force the saline up into the funnel, then release to allow the saline to flow back down into the vial carrying the lidocaine HCL powder with it.  Repeat as necessary to get all the lidocaine into the vial. Remove the funnel, and seal the neck of the saline/lidocaine vial using a surgical clamp or needle holder.
With the 2% lidocaine/saline solution vial now sealed shut, place the vial into a small pan of normal tap water, being careful not to submerge it fully – we don’t want any tap water to enter the vial.  Heat the water past 176 degrees Fahrenheit (I found it easiest to place a small glass filled with tap water into the pan the water, like a double boiler) and allow it to remain slightly above that temperature for 2-3 minutes.  Lidocaine HCL melts at 176 degrees F (80C), and dissolves in water.  Allowing the lidocaine HCL to melt, not just dissolve, in the saline ensures even distribution with no chance of particulates.  If particulates do remain at this point, they’re not lidocaine HCL and the solution shouldn’t be used.

Remove the vial from the pan, and keeping it securely clamped closed, allow it to cool.  You now have 15ml of 2% lidocaine HCL ready for use, which is also about the maximum recommended safe dosage for an adult. [Grouch adds: 1) you have also just pasteurized your solution, which should kill most bateria, and 2)overdose of lidocaine leads to lethal cardiac arrythmias.  Amusingly enough it can also be used to treat cardiac arrythmias, but the dose is different. This stuff is great and I use it every day in the hospital, but I offer up this Pro Tip: don’t overdose.]

Use it the same as you would any other vial of Rx injectable solution:  With the vial still clamped shut, clean a section near the top of the vial with an alcohol pad, invert the vial, insert the needle through the plastic section just cleaned, and draw out the desired amount into the syringe.
For different amounts of solution, or to make it in different concentrations, the formula is:
[Weight of lidocaine in grams  /  Volume of saline in milliliters] x 100.  For example, 1 gram lidocaine / 100 milliliters of saline = .01 X 100 = 1% solution.
As my first real test, I used a 0.5ml insulin syringe with a 30G needle, and performed three injections for a total of 1.5ml of 2% lidocaine in a 1″ square area just above the knee.  In a real situation a 6-10ml syringe with a longer needle would probably be better, I just have a lot of insulin needles stored so I used them instead.  Surprisingly, there was no sting from the lidocaine solution over that of the saline alone (tested first as the control).  I had expected some mild stinging, as is normally reported with Rx lidocaine without any sodium bicarbonate solution added, but there was no noticable difference. [Grouch adds: about 20% of people don’t experience the sting.  The other 80% have a bee-sting like sensation that lasts about 30 seconds.]
[Grouch furthermore adds: you should take steps to ensure that the skin you are injecting into is clean.  It’s very bad form to inject through a superficial infection into deeper tissue, thereby bypassing your first and most effective infection barrier. In the hospital, you rub the injection site with alcohol swabs before injection.  Any other antiseptic would do, such as rubbing alcohol, 70% ethanol, or chlorhexidine.]

Anesthetic effect was good and as expected.  In other words, the area injected and the immediate vicinity around it was completely numb.  Hospital / Clinic / Prescription Strength numb.  It reached full effect in about 10 minutes, and lasted a little over 30 minutes total before wearing off rather quickly.  The lack of epinephrine and, I suspect, the lower viscosity of the saline used here than in the lidocaine solution available by Rx probably allows it to disperse, and wear off, faster.  In further testing, I’ve used up to 6ml of 2% lidocaine in a single application, and even had some success at performing digital (fairly easy) and radial (not so much) nerve blocks.
In closing, I think it’s safe to assume that the solution should be used within 24 hours and any leftover discarded since it doesn’t contain any preservatives or antibacterials.  With practice and the materials handy it only takes about 20 minutes to make more.  I created a small kit with all the supplies, including pre-weighed lidocaine packets in tiny zip-loc bags that are clearly marked, in case I need to make it in a hurry.  Hope no one ever needs to.

Comment: I wouldn’t recommend making an injection under any circumstance, but if you felt you needed to this would be much better. Amazon has the items you would need. Look up Sterile, empty vials and syringe filters. Use sterile saline, for injection if possible but if not you could use what is described in the article.
Dissolve the lidocaine (it dissolves easily at the strengths of 1 or 2%) in the saline. Pull up all of the solution in a syringe.
Attach a syringe tip filter to the syringe, then a needle to the filter.
inject the solution through the filter into the sterile vial.
This is a much more closed system process and stands a much better chance of being sterile, as well as filtering out particulates almost guaranteed to be in the lidocaine powder. I am a compounding pharmacist who has been trained in sterile procedures.

Notes:
(1) Most sources of Lidocaine HCL that I found listed it as “Reagent ACS” grade, which is not for any medical use.  But that grade does require certification by the American Chemical Society, who tests batches from a production run and provides a Certificate of Analysis (COA) to the manufacturer as part of their certification.  A description of the different chemical grades is available here: https://www.reagents.com/products/reagents/grades.html.  Many sellers will provide this COA on request, but who can say what contamination may have occurred while the seller was repackaging the product into smaller quantities for retail sale?  Or even that the COA is from the same batch they sold you?   If that concerns you then it might help to consider that  thousands, if not millions, of people are snorting this same Reagent ACS grade lidocaine daily, as it’s a common dilutant added to street cocaine.  It’s also a fair question to ask if lab grade chemicals today are less pure than medical grade chemicals used 50-100 years ago.  But then again, what if your seller confused your lidocaine order with someone else’s strychnine order (both being white crystalline powders)?   Just trying to give both sides as I see them – and make a plea that you choose carefully and test cautiously if you decide to try this.  One bit of good news is that you’ll probably only ever need to test a single batch, since one $50 order would be a lifetime supply.
[Grouch adds: reagent grade is likely fine for a grid-down, SHTF situation. Folks have been known to crush pills (with all the associated preservatives, dyes, and so forth) and inject them directly on the spine for surgical anaesthesia. If you have reagent-grade stuff, you are well ahead of the game.]
(2) Most OTC sterile saline solutions are labeled “not for injection”, which I believe indicates they haven’t been tested as being pyrogen free, and which is one requirement to be USP certified “for injection” purposes.  More on pyrogens here: https://www.fda.gov/iceci/inspections/inspectionguides/inspectiontechnicalguides/ucm072906.htm   There might be other factors I missed that separates “for injection” versus “not for injection” sterile saline.  For infrequent use and in the amount discussed here, the risk seems minimal.   I’d think that factory sealed “not for injection” sterile saline is still a safer option than using distilled water, but I’m not a doctor.
[Grouch adds: sterile saline would be a better option than distilled water, as the latter is not considered sterile per se. “For injection” is the best, obviously.]

  1. wheelseesays:Go here (free) for TC3 (Tactical Combat Casualty Care) information (Ive downloaded a copy on my phone) – https://deployedmedicine.com/market/11Go here (also free) for TC3 updated recommended devices and adjuncts – https://deployedmedicine.com/market/11/content/100
    (IOW, is your TQ on the list?? No?? rethink it….lessons learned in blood)
  2. chucksays:Kerlex, Coban, Vaseline gauze and Elastikon.
    If anyone has training in cric’s, nasal trumpets or chest decompression then those items too. Otherwise, keep it simple stupid. This is mostly stuff for someone else to use on you anyway and unless your crew knows what they are doing……
    Kerlex wrapped several times around a limb then with a windlass thrown in is cheaper than a CAT or RAT and can also be used to fill a bleeding hole
    Chest seals are nice but expensive and VG sticks on its own (a little) and Elastikon will hold it in place.
    Kerlex and Coban work better than Israeli bandages especially when you can push kerlex into the hole before applying pressure with the Coban.
    Blood stop powder (or Celox) doesnt burn the shit out of you (or the patient) like quik-clot and is less expensive and available from your local vet supply store.
    If you’ve got the money to buy several high end things, consider instead, a case of Kerlex and some boxes of Coban , Vaseline Gauze, and Elastikon. Nothing worse than having your limited supply of high end shit getting used up and having to watch the next casualty bleed out.
    As the Soviets used to say, “Quantity is a Quality all its own”
    Just my 2 cents worth.
    1. Berglandersays:Thanks for this, Chuck!
    2. Centurion_Corneliussays:Hellava lot more than .02, chuck! Good tips. Good practical stuff.Will keep me and my guys ‘in the fight.’
  3. SemperFi, 0321says:look over their entire products column, I have bought numerous things here, even several survival sleeping bags (trauma blanket).
    https://persysmedical.com/products/hemorrhage-control/
  4. Jamessays:I put together a bunch of these kits from Aesop’s site,link: https://raconteurreport.blogspot.com/2018/05/first-aid-first-aid-kits-ifak-and-beyond.html ,the site also includes places to buy/some basic med links ect.,still,do shop around as prices can be varied to a large degree.I made up a bunch of these for me vehicles/construction site and many for friends.Tis compact and takes very little space but may buy the time you need till pros can get to the injured.I was willing to pay and take the time to take a WEMT course but even though had no interest in making it a career(nothing against it for those that do)I would have been required to take over 10 vaccines,something I was not willing to do.I and am sure others would find it helpful to have a source(s) of training in emergency first aid that does not require me to become a pin cushion,so,any thoughts appreciated.
  5. Estevesays:This guy thinks his IFAk is great. https://www.bearindependent.com/online-store/Bear-Independent-Bear-Minimum-Kit-p178484593 Its what he does. Besides daily reports on youtube and such.
  6. TNsleepersays:16 years doing anesthesia at a level 1 trauma center. No not a combat vet. But I have seen the local knife and gun club at 3am. What you need is your med kit. THINGS YOU KNOW HOW TO USE! If you don’t know where to put the needle for a chest seal you could make it worse. Does it go on top of the rib or bottom? WHY? NP airway.– do they have skull Fx? why does that matter? What is a secure airway? Whats a chin lift?
    Training Training Training.
    Unless someone in your group is trained having advanced medical equip. can make things worse.
  7. Berglandersays:Each of my rigs and packs have the following:
    HSGI Bleeder pouch or Dark Angel IFAK
    CAT
    Trauma shears
    NPA and lube
    NAR Compact chest seals x 2
    Burn Shield dressing
    Compressed Gauze
    NAR gloves
    Israeli Bandage (Oy vey)
    Quick ClotHappy to add if I am missing things-the HSGI Bleeder pouches are PACKED with all of the above.
  8. Polumetissays:Trauma doc here – trained 18DsTQ first – real CAT (not airsoft) or (preferably) SOFT-W – at least 2 – practice self aid, high and TIGHT
    Quickclot gauze (not powder) to pack those soft tissue holes
    Olaes bandage or Kerlix + Coban for pressure dressing
    Chest seals (pair)
    Forget the needle decomp – rarely needed and can do a lot of harm in the wrong hands
    Get hands-on training – doesn’t take long
    Everything else (bandaids, etc) goes in a different kitSadly, all this presupposes a CASEVAC within an hour to definitive care, but we do what we can…
  9. Gafarmboysays:Something often overlooked, but as important as the ifak, is to carry some common everyday otc meds in a small sturdy zip lock bag. Keep the bag in the pocket of your cargo pants or whatever you wear. First off, you don’t have to dig around in your ifak for an aspirin or Imodium or eye drops. Secondly, you will most likely need those everyday items a shit ton more than you will ever need a blow out kit. Articles such as small capsules of eye wash, Imodium, Ibuprofen, aspirin, Tums, Vaseline, etc. can save the day. So to speak. Configure the bag to your specific needs and desires. I highly recommend Vaseline for many reasons or Bag Balm. It’s better, but taste weird. Really, it tastes like sheep shit if you use it on chapped lips, but works great.
  10. Annon E Mousesays:One item to have is a SAM splint. Flexible plastic covered aluminized foam. Can be flat packed or left rolled can be cut to size if need be with your shears. You take a bad fall on rough terrain or even level ground and break something, this will prevent you from needing to find splinting material. Can also be used as an improvised ‘C’ collar. A couple of triangular bandages will both help in securing it so you do not need to cut up your clothes as well as be used as a sling if needed not only for breaks, but also to secure dislocated shoulders. A couple of cleaned Popsicle sticks or a few liberated tongue depressors at your next Dr.’s visit to help with buddy splinting finger injuries. Take up a whole lot less room than purpose bought finger splints. Just a few things to have after the blood and air gear.
  11. Dirksays:Anybody have a reasonably priced quick clot source. Like 20/30 of em, .Dirt.
  12. mtnforgesays:Issue blow-out kits:https://www.fortbraggsurplus.us/IFAK-2-Multi-Cam-OCP-Improved-First-Aid-Kit-p/ifakii.htm
    https://www.fortbraggsurplus.us/IFAK-Improved-First-Aid-Kit-p/ifak.htmAll I can say about CCC is its as good as self care under fire and buddy assisted care for the 3 things that used to cause mire loss of life in combat can be without some scientific wizard break thru to replace it.
    Had the good fortune of learning combat casualty care from one of its Doctor proponents at a small unit infantry combat course.
    The system is incredibly basic, amazingly well thought out, takes about 15 minutes to teach, and as regards Freefor and other nobody is coming to save you festivities, IS for most of us the only way to save life from bleeding to death, choking to death, or dying from a sucking chest wound, or other non limb bleed-out wounds.
    There’s no nice professional meat wagon coming to save us by taking us to a nice fully equipped and staffed hospital or trauma center.Stock up on:
    Fish med anti=biotics
    Cases of wound dressings
    Alchohol
    Hyd-per-oxide
    Betadine Solution
    Anti-biotic ointment
    Sutures
    Syringes
    A large American Foundry cast aluminum pressure canner for sterilization
    Vinegar and a high quality pump sprayer:
    50-50 mixed with water, and sprayed on surfaces, including fresh meat, including human skin and wound area, kills an amazing range of bacteria, its great for after dressing a meat critter, apply liberally all over-inside the carcus, presto, meat that has no bad bugs so you can hang it and age or simply allow meat to firm up. Stops mold, mildew and a wide variety of sources of rotting meat, a practical “sterile” wash to sanitize hands instruments, surfaces, patient etc. An old butchers trick, still used and approved by the WV Dept of Agriculture for licensed custom meat cutting shops.Aside from the dangerous old timey method of anesthesiology of using a sand bag to knock a patient unconscious, there is a method of home made, 1-2% injectable lidocaine solution, which you can purchase in dry crystaline form without a license.
    Must be melted mixed with sterile saline ampules, heated double boiler method, at 180F, used within that day or so, must be the non pure grade lidocaine, only use HCL grade.here’s a couple decent resources:A PDF file, with exceptionally fine pencil drawings of plastic surgery techniques:Practical Plastic Surgery for Nonsurgeons
    Nadine B. Semer, MD
    https://www.practicalplasticsurgery.org
    nadine@ppsurg.orgBasic info on anti-biotics and their use:Infectious Disease in the TEOTWAWKI World- Part 3, by Militant Medichttps://survivalblog.com/infectious-disease-in-the-teotwawki-world-part-3-by-militant-medic/How Do Antibiotics Work? (continued)
    Antibiotics work in a number of different ways, but perhaps it would just be easier to talk about each one individually. I will focus on the pet antibiotics, since these are the ones most of us can stockpile easily. Again trying to make this as simple as I can, I have omitted many technical details. (A cellular biologist may take exception to what I say, saying “He didn’t even discuss peptidoglycan cross linkages by the DD-transpeptidase enzyme!! Who does he think he is!!??” However, I think most of the prepper army will appreciate omission of the technical fluff.)
    Penicillin (Fish-Pen)
    Penicillin was the first really effective antibiotic discovered and the starting point from which other antibiotics were developed. The original penicillin worked best if injected, but eventually an oral preparation was developed (called Penicillin VK or phenoxymethylpenicillin potassium), and this is what you get when you buy Fish-Pen.
    The penicillin antibiotics are part of the beta-lactam family of antibiotics due to a chemical structure common to these antibiotics called a beta-lactam ring. Other members of the beta-lactam family are the Cephalosporins. Penicillin (and the other beta-lactams) function by deactivating an essential cell wall-building enzyme in the bacteria. With the bacteria unable to repair its cell wall, the cell wall begins to break down and the bacteria literally pops and dies.
    Penicillin once treated a wide variety of bacteria, but overuse allowed most bacteria to develop resistance. The most common form of resistance to penicillin is the beta-lactamase enzyme, which cuts the beta-lactam ring, which deactivates the penicillin and renders it harmless to the bacteria. This caused penicillin’s spectrum to become more and more narrow over time as fewer and fewer pathogens responded to it. Today, penicillin is only used as first choice for one infection– strep throat. That’s it. Penicillin’s spectrum is so narrow (because so many things are resistant to it) that we only use it for one thing– killing Streptococcus pyogenes, which is the bacteria that causes strep throat. It can kill a few other bacteria, like Streptococcus pneumoniae (a cause of pneumonia) and Fusobacteria (a cause of trench mouth and dental abscesses). However, because you don’t know if the pneumonia is caused by S. pneumonia or if the dental abscess is caused by Fisobacteria, you don’t use penicillin first.
    Because penicillin selectively targets an enzyme that we humans don’t have or need, the side effects of this antibiotic are usually very mild.
    Because the spectrum of penicillin has become so narrow, I do not recommend that anyone stock this antibiotic. Other antibiotics are the same price and have more than one use. Continue reading to see which antibiotics to keep on hand for strep throat.
    Ampicillin (Fish-Cillin)
    Ampicillin was invented by sticking an amino group onto the side of Penicillin. This increased the antibiotic’s ability to penetrate into bacteria, which broadened the spectrum of this antibiotic to include some gram negative bacteria. Like penicillin, it is a beta-lactam antibiotic. Like penicillin, it works by inhibiting cell wall repair leading to bacterial cell death.
    It is classified as an intermediate-spectrum antibiotic. While broader in spectrum than penicillin, it is still pretty narrow. It kills the three bacteria penicillin kills plus Group C strep (enterococcus) and the gram-negative bacteria Haemophilus influenzae, Neisseria meningitidis, and members of the Enterobacteria family (like Shigella, Salmonella, and E. coli).
    Because ampicillin selectively targets an enzyme that we humans don’t have or need, the side effects of this antibiotic are usually very mild.
    Ampicillin is a good first line choice for strep throat, sinus infections, ear infections, some urinary tract infections, and other respiratory infections like pneumonia. Of the available pet beta lactams, it has the best CNS (central nervous system) penetration, and so it is a good choice for meningitis.
    Amoxicillin (Fish-Mox)
    Amoxicillinis the big brother of Ampicillin and another child of Penicillin. Like Ampicillin, it is made by adding side groups to penicillin. In Amoxicillin’s case, one side group broadens its spectrum (making it, like ampicillin, an intermediate-spectrum antibiotic) and another side group increases its absorption from the human gut. Like penicillin, it is a beta-lactam antibiotic. Like penicillin, it works by inhibiting cell wall repair leading to bacterial cell death.
    It has the same spectrum as ampicillin, but it also kills Borellia (the causative agent of Lyme disease) and Moraxella (a cause of ear and sinus infections) and Heliobacter pylori (the cause of bleeding stomach ulcers). Amoxicillin is used for basically the same infections as ampicillin with the addition of being effective against lyme disease and stomach ulcers.
    Because amoxicillin selectively targets an enzyme that we humans don’t have or need, the side effects of this antibiotic are usually very mild.
    If I had to pick one of the three penicillins to stock, Amoxicillin would be the one. It has a broader spectrum than Penicillin (without being too broad) and is better absorbed from the stomach than Ampicillin.
    Cephalexin (Fish-Flex)
    Also known as Keflex in the retail world, Cephalexin is a first generation Cephalosporin. After Penicillin was discovered, mold scientists went looking at other molds to find other antibiotics (a process called bio-prospecting), and it was thus that the Cephalosporins were discovered.
    They are closely related to the Penicillins in that they have a beta-lactam ring and act by inhibiting cell wall repair. Like the penicillin family, they are most effective against bacteria with thick cell walls (Gram positive) and are intermediate in spectrum. They are effective against streps (so this is a fine choice against strep throat) and the staphs. However, unlike the penicillins, they are more resistant to bacterial defenses and so work against more and different bacteria. This is especially important for one reason– Staphlococcus aureus.
    Staph aureus (which I will just call Staph from now on, even though there are many other strains of Staph) is a common and very aggressive bacteria that is the cause of many infections. Staph is found on our skin and in our noses, and as long as it stays there it does not cause many problems. However, if you get a little cut or scratch, staph may get in and make an infection. STAPH IS THE #1 CAUSE OF WOUND INFECTIONS WORLDWIDE. It can cause small abscesses if your immune system gets it walled off fast enough, but if not you get more severe infections like cellulitis, necrotizing fasciitis, sepsis (infection traveling in the bloodstream), osteomyelitis (infection of the bone), endocarditis (infection of the heart), or meningitis (infection of the spinal cord). Obviously, many of these can lead to death. Being in the nose (part of the respiratory tract), it can also cause sinusitis and pneumonia. Staph was one of the first bacteria to develop a resistance to the penicillin family of antibiotics. Worldwide today over 80% of Staph strains are immune to penicillin, and in some areas as many as 97% of strains are resistant. However, they are not resistant to Keflex! So this is an antibiotic you really want to keep on hand.
    Keflex is first line for infections by Streps and Staph, including skin abscesses, boils, folliculitis, mastitis, mild cellulitis, impetigo, erysipelas, and strep throat. It can also be used for ear infections, respiratory infections, and UTI’s, but it is not the best choice for these infections.
    Three important notes: First is that Keflex treats regular Staph aureus, but it does not treat Methycillin Resistant Staph Aureus (MRSA). Keep reading to see what antibiotic you will need to treat that. Second is that it does not penetrate into the brain and spinal cord. So it is a very poor choice for meningitis. Third is it has a fairly short half life and usually needs to be taken three if not four times a day to get best effect.
    Because Keflex selectively targets an enzyme that we humans don’t have or need and because it doesn’t wipe out all your gram negative gut bacteria, the side effects of this antibiotic are usually very mild.
    In a TEOTWAWKI scenario, I foresee a lot of manual labor and violence. Both of these things lead to cuts, scratches, and puncture wounds, which means a lot of staph infections. This means you will need Keflex.
    Ciprofloxicin (Fish-Flox)
    Now for something completely different– an antibiotic that isn’t a beta-lactam! Ciprofloxicin belongs to the Fluoroquinolone family of antibiotics, which were discovered by accident in the lab by a chemist trying to make malaria medication, but they sure work.
    Cipro works by inhibiting bacterial Topoisomerase enzymes, which makes the bacteria unable to reproduce by blocking DNA replication. This works in both gram positive and gram negative bacteria. Bacterial resistance to Cipro is increasing and spreading, but at this moment in time is still pretty rare.
    Cipro is a broad-spectrum antibiotic that kills a wide variety of gram positive and gram negative bacteria. It kills Staph aureus and Pseudomonas– two bacteria that are resistant to many other antibiotics. Because it is so broad in spectrum, it is not generally recommended for less complex infections where a narrower spectrum antibiotic would work. You don’t want to use this for a strep throat or simple skin abscess, if you have Keflex on hand.
    Cipro is considered the first line agent for complicated UTI’s and kidney infections, bone and joint infections, typhoid, prostatitis, abdominal infections, gonorrhea, plague, and anthrax. It is also frequently used for infections acquired in the hospital where resistances are more likely. It can also be used for sinus infections, community acquired pneumonia, strep throat, or ear infections, but it is generally considered a little too strong for these infections. Most MRSA bacteria will respond to Cipro, but resistance is developing, and there are better choices. Cipro also penetrates the blood brain barrier well and so is a good choice for meningitis.
    Like any medication, Cipro is not without potential side effects, and in Cipro’s case there is a big one. In fact, it carries a Black Box warning because of it. Cipro is associated with tendonitis and tendon rupture. The risk is increased if you are over 60 and/or on steroids. It’s rare (0.1% chance or one in a thousand), but being on Cipro makes it three times as likely compared to the general population. Also, the tendon that ruptures most often is the Achilles tendon that connects your heel with your leg. So think long and hard about taking this drug, especially if it is for something less severe. Getting through the wasteland as a cripple will not be easy.
    Having Cipro on hand is a good idea, though. It will treat some things nothing else will, but it should not be used frivolously. Other antibiotics will often do the same job with fewer side effects and won’t put your tendons at risk.
  13. mtnforgesays:https://griddownmed.com/2015/04/25/from-modern-survival-online-make-your-own-lidocaine-topical-anesthetic/
    https://modernsurvivalonline.com/how-to-make-injectable-lidocaine-hcl/How to make injectable Lidocaine HCL
    The following post was previously published here on MSO – it can be seen in its original format HERE.
    by RalphP
    Almost every other prepper / survivalist that I’ve met shares a similar “hope for the best, but prepare for the worst” philosophy about life.  If this pretty much describes you too, than you’ve probably considered a SHTF situation where, with no access to doctors or dentists, you might be forced to perform some type of minor surgery at home.  Draining an abscess or pulling a tooth maybe.  These are common minor surgeries, but with no anesthesia (or only over-the-counter varieties) they might be very painful.  You’ve probably also thought about how you might treat trauma, like lacerations, punctures, or burns – where suturing, debriding, or removing foreign objects from a wound might be necessary.  Painful enough for an adult, but worse for a child to have to endure.  And while no sane person really wants to think about the worst cases, like having to treat a gunshot, knife, or chainsaw injury to a loved one, you know that ignoring the possibility doesn’t make it any less likely to happen either.  Hope for the best, but prepare for the worst.  TEOTWAWKI might be a dangerous place to live.
    Everyone also agrees on the need for First-Aid training and supplies; but in cases of more severe trauma, First-Aid is just that – the “first aid” provided to the victim to limit further harm while getting them to a hospital for professional care.  If the SHTF than the “hospital” is most likely going to be your home, and it’s there that the bandage will need to be removed, the damage accessed, and a decision made on how best to promote healing.  This may require invasive, and painful, examination and treatment.  Some might be able to ‘bite the bullet’, but others, particularly children and certainly animals, couldn’t.  Recoiling from pain is an involuntary response and one of the most primitive instincts.  The lack of an effective local anesthetic would not only limit what medical procedures could reasonably be performed, but also result in unnecessary pain in those that could be.  Now fantasies about an untrained medic performing vascular surgery, nerve or tendon repair, or a bowel resection aside – it is a fact that for some injuries the penalty for surgical failure isn’t going to be any worse than if you do nothing at all, so you may want to try.  Local anesthesia will be needed to help the patient to remain still, or if nothing else than to help ease their pain.
     What you’ll need:
    ◦ Lidocaine Hydrochloride (HCL) powder (roughly $1 per gram in small quantities) [Grouch adds: please buy this from a reputable place, like Sigma-Aldrich, not Made-in-China.com. And yes, both of those are actual sites that sell (or claim to sell) lidocaine. As noted below (1) lidocaine is a common agent used to cut cocaine, as cocaine also has a local anesthetic effect. Sellers attempt to fool their buyers into thinking they have more of the real stuff than they actually do. Be advised that the DEA might develop a sense of curiosity if you order in bulk.]
    ◦ Sterile saline, or distilled water (varies, $10 for 24 of the single-use saline vials I chose)
    ◦ Thermometer, accurate up to 200 degrees F or so ($10 and up)
    ◦ Scale, accurate down to 1mg or less. ($25 and up)
    ◦ Funnel, small
    ◦ Surgical clamp
    ◦ Scissors
    ◦ A clean work area with a stove or other way to heat water
    Lidocaine Hydrochloride (HCL) powder is available in lab grades from online distributors if you can’t obtain it in USP grade.  You want “Lidocaine HCL” which is water soluble, not the straight “Lidocaine powder” or “Lidocaine base” which isn’t.  It should be stored at room temperature according to its Material Safety Data Sheet, and has no predetermined shelf life or expiration date if stored in an airtight container – or at least none that I’ve been able to determine anyway. (see note 1) [Grouch adds: I’ve seen some information I consider unreliable enough to not reprint it here, that shelf life may be around 1 year. It’s highly unlikely that the shelf life is truely indefinite.]
    The supplies and materials I used:

    The isopropyl alcohol shown above isn’t part of the solution, it’s used for cleaning the equipment.  Before you begin, all the equipment and anything they might touch, including you, should be thoroughly cleaned with a disinfectant or antiseptic.  Boil any items that can be.  Scrub and glove your hands.
    For the sterile saline, I chose a type packaged in 15ml plastic vials and marketed for nasal irrigation purposes.  Search on “ModuDose” and you’ll find it (see note 2).  Mine were dated as expiring in one year, I plan to use them beyond that date unless they turn cloudy or have particulates in them.  I like this particular kind as they’re the perfect size for creating single doses with minimal waste, and they lessen the chance of contamination by not having to mix and transfer the solution between multiple containers during the process.

    To produce a 2% lidocaine HCL solution (weight/volume), weigh out 0.3 grams (300mg) of lidocaine HCL, snip the top of the 15ml saline vial about half way down the neck with scissors, insert the funnel securely into the neck of the vial, and pour the lidocaine HCL powder into the funnel.  The powder tends to stick to the funnel, so you’ll probably need to gently squeeze the vial to force the saline up into the funnel, then release to allow the saline to flow back down into the vial carrying the lidocaine HCL powder with it.  Repeat as necessary to get all the lidocaine into the vial. Remove the funnel, and seal the neck of the saline/lidocaine vial using a surgical clamp or needle holder.
    With the 2% lidocaine/saline solution vial now sealed shut, place the vial into a small pan of normal tap water, being careful not to submerge it fully – we don’t want any tap water to enter the vial.  Heat the water past 176 degrees Fahrenheit (I found it easiest to place a small glass filled with tap water into the pan the water, like a double boiler) and allow it to remain slightly above that temperature for 2-3 minutes.  Lidocaine HCL melts at 176 degrees F (80C), and dissolves in water.  Allowing the lidocaine HCL to melt, not just dissolve, in the saline ensures even distribution with no chance of particulates.  If particulates do remain at this point, they’re not lidocaine HCL and the solution shouldn’t be used.

    Remove the vial from the pan, and keeping it securely clamped closed, allow it to cool.  You now have 15ml of 2% lidocaine HCL ready for use, which is also about the maximum recommended safe dosage for an adult. [Grouch adds: 1) you have also just pasteurized your solution, which should kill most bateria, and 2)overdose of lidocaine leads to lethal cardiac arrythmias.  Amusingly enough it can also be used to treat cardiac arrythmias, but the dose is different. This stuff is great and I use it every day in the hospital, but I offer up this Pro Tip: don’t overdose.]

    Use it the same as you would any other vial of Rx injectable solution:  With the vial still clamped shut, clean a section near the top of the vial with an alcohol pad, invert the vial, insert the needle through the plastic section just cleaned, and draw out the desired amount into the syringe.
    For different amounts of solution, or to make it in different concentrations, the formula is:
    [Weight of lidocaine in grams  /  Volume of saline in milliliters] x 100.  For example, 1 gram lidocaine / 100 milliliters of saline = .01 X 100 = 1% solution.
    As my first real test, I used a 0.5ml insulin syringe with a 30G needle, and performed three injections for a total of 1.5ml of 2% lidocaine in a 1″ square area just above the knee.  In a real situation a 6-10ml syringe with a longer needle would probably be better, I just have a lot of insulin needles stored so I used them instead.  Surprisingly, there was no sting from the lidocaine solution over that of the saline alone (tested first as the control).  I had expected some mild stinging, as is normally reported with Rx lidocaine without any sodium bicarbonate solution added, but there was no noticable difference. [Grouch adds: about 20% of people don’t experience the sting.  The other 80% have a bee-sting like sensation that lasts about 30 seconds.]
    [Grouch furthermore adds: you should take steps to ensure that the skin you are injecting into is clean.  It’s very bad form to inject through a superficial infection into deeper tissue, thereby bypassing your first and most effective infection barrier. In the hospital, you rub the injection site with alcohol swabs before injection.  Any other antiseptic would do, such as rubbing alcohol, 70% ethanol, or chlorhexidine.]

    Anesthetic effect was good and as expected.  In other words, the area injected and the immediate vicinity around it was completely numb.  Hospital / Clinic / Prescription Strength numb.  It reached full effect in about 10 minutes, and lasted a little over 30 minutes total before wearing off rather quickly.  The lack of epinephrine and, I suspect, the lower viscosity of the saline used here than in the lidocaine solution available by Rx probably allows it to disperse, and wear off, faster.  In further testing, I’ve used up to 6ml of 2% lidocaine in a single application, and even had some success at performing digital (fairly easy) and radial (not so much) nerve blocks.
    In closing, I think it’s safe to assume that the solution should be used within 24 hours and any leftover discarded since it doesn’t contain any preservatives or antibacterials.  With practice and the materials handy it only takes about 20 minutes to make more.  I created a small kit with all the supplies, including pre-weighed lidocaine packets in tiny zip-loc bags that are clearly marked, in case I need to make it in a hurry.  Hope no one ever needs to.Comment: I wouldn’t recommend making an injection under any circumstance, but if you felt you needed to this would be much better. Amazon has the items you would need. Look up Sterile, empty vials and syringe filters. Use sterile saline, for injection if possible but if not you could use what is described in the article.
    Dissolve the lidocaine (it dissolves easily at the strengths of 1 or 2%) in the saline. Pull up all of the solution in a syringe.
    Attach a syringe tip filter to the syringe, then a needle to the filter.
    inject the solution through the filter into the sterile vial.
    This is a much more closed system process and stands a much better chance of being sterile, as well as filtering out particulates almost guaranteed to be in the lidocaine powder. I am a compounding pharmacist who has been trained in sterile procedures.Notes:
    (1) Most sources of Lidocaine HCL that I found listed it as “Reagent ACS” grade, which is not for any medical use.  But that grade does require certification by the American Chemical Society, who tests batches from a production run and provides a Certificate of Analysis (COA) to the manufacturer as part of their certification.  A description of the different chemical grades is available here: https://www.reagents.com/products/reagents/grades.html.  Many sellers will provide this COA on request, but who can say what contamination may have occurred while the seller was repackaging the product into smaller quantities for retail sale?  Or even that the COA is from the same batch they sold you?   If that concerns you then it might help to consider that  thousands, if not millions, of people are snorting this same Reagent ACS grade lidocaine daily, as it’s a common dilutant added to street cocaine.  It’s also a fair question to ask if lab grade chemicals today are less pure than medical grade chemicals used 50-100 years ago.  But then again, what if your seller confused your lidocaine order with someone else’s strychnine order (both being white crystalline powders)?   Just trying to give both sides as I see them – and make a plea that you choose carefully and test cautiously if you decide to try this.  One bit of good news is that you’ll probably only ever need to test a single batch, since one $50 order would be a lifetime supply.
    [Grouch adds: reagent grade is likely fine for a grid-down, SHTF situation. Folks have been known to crush pills (with all the associated preservatives, dyes, and so forth) and inject them directly on the spine for surgical anaesthesia. If you have reagent-grade stuff, you are well ahead of the game.]
    (2) Most OTC sterile saline solutions are labeled “not for injection”, which I believe indicates they haven’t been tested as being pyrogen free, and which is one requirement to be USP certified “for injection” purposes.  More on pyrogens here: https://www.fda.gov/iceci/inspections/inspectionguides/inspectiontechnicalguides/ucm072906.htm   There might be other factors I missed that separates “for injection” versus “not for injection” sterile saline.  For infrequent use and in the amount discussed here, the risk seems minimal.   I’d think that factory sealed “not for injection” sterile saline is still a safer option than using distilled water, but I’m not a doctor.
    [Grouch adds: sterile saline would be a better option than distilled water, as the latter is not considered sterile per se. “For injection” is the best, obviously.]

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Author: Alfred E. Neuman

EDITOR ONLY, 74 year old geek, ultra-conservative patriot.

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