Preparing for the PAW (Post Apocalyptic World) ModNote: COPY of original

GF, try open office. it saves automatically for you. Plus it's free.

AME3, about P-school... I'd advise against.

The only upside is that your medical director is more likely to Rx you meds. There are many down sides. For starters, while there are a couple of programs where you go straight through, most states demand that you get your EMT first, then work for 1-2 years in the field and then get your medical directors sign off before you are allowed to attend. Second, if you go through this school on the civi side, the concentration will be on cardiac care. In austere situations, these people die. There is also an emphasis on a "golden hour" - primarily from a trauma situation. The assumption that the person will end up in an advanced medical facility shortly. This isn't the case in a TSHTF situation. You won't be taught long term care or the effects of your interventions and needed recovery from such. As one example, I know of one program that teaches how to do a C-Section. To put it bluntly, if you deliver a child this way ("Amateur C-Section") every future child she has will have to be delivered the same way. Consider C-Collars. Totally worthless if you don't have a X-Ray capability and are able to put someone in a halo. What about IV fluids? Useful for a lifeline, but if a person is bleeding out, their veins are going to be pushing saline and no O2 in short order, if you can't deliver them to a surgical facility or do that yourself. HOWEVER! - 500cc's can keep them alive, or rather their brain, long enough to establish a sterile field and perform an intervention that will save their life - but also land you in jail for performing medicine without a license - in this country. BP cuffs are over rated. You can tell if a pt is going south by comparing pulses at various locations though they are useful for pressure irrigation around a IV bag to clean out a wound and you can Dx a fracture or broken bone with a tuning fork and a stethoscope.

There are SHTF and relief/missionary med classes available that will serve you much better, as the assumption is "you're it"... Other classes focus on expeditions, wilderness medicine, and "medical person in charge" for ships. Massively delayed to no terminal care available. That's the kind of class you want. They tend to run 3 days to a month, and they are long days. Going through EMT then P-School is a minimum of 2 years.

It's hard to find a doc that will Rx you drugs - but not impossible. We live in one of the most repressive countries in the worlds as to getting meds. As to team members, look for MD's, PA's and NP's.

-t
 
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GF, try open office. it saves automatically for you. Plus it's free.

-t

So is TextWrangler, and it actually does what I need it to. ;) If I want a word processor I use Pages or InDesign, for long structured work I use Scrivner, and for text I use TextWrangler or BBEdit. So don't you worry about me contributing to the M$ demon. ;)

On a POSIX system I suffer a catastrophic failure, what -- once every 2-3 years? It almost never happens in a protected memory environment where an app failure cascades into a system failure. I will re-write the reply, had a run of jobs and am putting out bushfires and getting materials set up for the campaign.
 
I agree with most of what you said, especially about the paramedic training. In regards to the value of fluid therapy (IV'S) in a PAW, as I stated previously awhile back , IV's can definitely be life saving in cases where external hemmorhage has been controlled and the patient hasn't lost more than a few liters of blood.

A normal adult only has 5-6 liters - if you've lost 3+ you are not going to be in good shape, and very possibly not salvageable.

They are also great for correcting dehydration ( another cause of hypovolemia) and replenishing electrolytes which may have been caused by a loss of fluid via diarrhea, vommiting, or hyperthermia.

ORS is generally going to be a better solution, but in the IV situation - go ringers. It's harder to make, though...

Pulses when palpable, can give one an aprox blood pressure, which is mostly useful in a trauma setting. A sphygmomanometer (BP cuff) also has other beneficial medical uses too, and I keep one calibrated and in my med pack along with my stethoscoe which is also a valuable tool in the right hands.
I practiced and taught emergency medicine through a third service provider and the local college for thirty years. I also worked in the local ER.

re: BP cuff - what other beneficial uses? - just curious? I can think of as an aid to breaking into a locked car, cannibalized for newborn suction, possibly as a tourniquet or maybe an aid to stop a vaginal bleed... what else?

"third service provider" ???

-t
 
Now that the iodine thing is behind us Gunny, let us continue to discuss this PAW survival thing. What other if any, considerations are there? Should we all stock up on the survival equipment and supplies, take a paramedic course, secure a homebase with water and protection, etc.? Should we focus more on nuclear events than bio or chemical ones?
Do you think, and I am almost certain that you do, (your having been in the Corp), that there are some skills and tips etc. in regards to organizing a group (post event) and establishing a council or committee to create an alliance or team which would improve everyones chances of survival? Like having a security team and leader, medical personnel, resource procurers, ...etc.
How also, would one approach others for purposes of barter and trade in a safe and controlled fashion?

Well, in re to focusing more on nuclear than bio -- NBC prep is really all the same. You prep for one you pretty much prep for all three. Other than the immediate gamma and blast damage from a nuke, particulate and fallout contamination protection is pretty much the same as for chem or bio.

Difference is with Chem or bio you will probably have some idea it's coming, especially if you do not live on top of a high value target. NBC prep is really about having a box with a crap ton of plastic and duct tape and hoping it just collects dust for the next 70 years.

If you do have to use it, set up black, grey, and white zones, and make certain your have one full bath in the white zone. Your direct entry way could be "black" meaning dirty, your main house could be "gray" meaning partial, and your master suite and living room could be "white" meaning clean. Section with plastic and armor your white zone against gas grenades if the threat is chemical.

If you can set up a "shower" transition from grey to white, then you are at the top of the game. If you can set up overpressure, then you are as almost as advanced as the pro's.

Survival is more about a mindset than knowledge and equipment really. Someone with the right frame of mind but naked and possessing a single blade of grass will survive longer than a suicidal nut-bar with all the stocks and equipment in the world.

Everything depends on the situation that confronts you. In some situations, it will be important to bring the neighborhood together. There will be a call for the kinds of political skills picked up during the Ron Paul effort. In other situations, it may be best to make all the world think your place is abandoned and worthless.

I am relying on some 1oz silver for barter, but also a lot of extra ammunition, toilet paper, some food laid aside for use as currency, and some heirloom seeds for growing goods of value.

As to how to approach given persons neighborhoods markets for trade, it would be hard to settle on specifics given that every situation may be completely different. Are you negotiating with a neighbor? Some stranger? The Black Market? Each one requires different levels of security precautions. If you are bartering with a stranger and you have something he wants, make sure he does not know where you are from, lest he show up with 50 friends one day. If you are bartering with a black marketeer, then it may be a good idea to take an armed squad and place a fire-team on over-watch in a neutral location far from either of your home territories. If it's someone within your own neighborhood, you may get a bargaining advantage by meeting them in their own house -- if you trust them. So it's hard to say, really. It's a matter of tailoring the method to the circumstances.
 
.Thanks gunny...were you a medic?

Intelligence, though we had to be "just a little bit" of every MOS in the Marines. We referred to ourselves generally a s"Jack of all trades, master of none." Although in school I topped out the analysis exercise, Intell turned out to be more about knowing how to do everybody's job in the entire Corps than about knowing how to analyze disjointed data into organized information. Actually, just FYI, all the medics in the Marines are actually Navy. :cool:
 
Intelligence, though we had to be "just a little bit" of every MOS in the Marines. We referred to ourselves generally a s"Jack of all trades, master of none." Although in school I topped out the analysis exercise, Intell turned out to be more about knowing how to do everybody's job in the entire Corps than about knowing how to analyze disjointed data into organized information. Actually, just FYI, all the medics in the Marines are actually Navy. :cool:

Yeah and the higher up the rank structure you got the more this was true, once I hit E7 there was no telling where I was gonna wake up the next morning. LOL
 
Yeah and the higher up the rank structure you got the more this was true, once I hit E7 there was no telling where I was gonna wake up the next morning. LOL

As I mentioned before, and especially want to mention again in response to this post, "Gunny" Freedom is a guerrilla politics character created for two boards, Liberty's Price, and then Ron Paul Forums. Glen Bradley only ever made Corporal, or E4.

That said, you are exactly right. I stuck at home more than your average 0231 because they were prepping me for an early chief spot, but on a day to day basis I might have found myself attached to any Marine on the station of E6 (Staff Sergeant) or better.

I'm not sure if it's cultural or experiential, but it is a hard truth that they want Intell guys to have pretty much every MOS in the book under their belts.
 
I think it was based on 4 tendencies either:

A. You were a hard charger who sought and took responsibility and the more you did the more they wanted you to do.

B. You were a maggot they kept shuffling you around to get you outta their hair.

C. Once you hit E7 you are mainly concerned with managing people, knowledge in a specific field depended on the technical complexity of the field and in some cases a security clearance but in most cases leadership was more important.

D. And of course the all time favorite "It ain't what you know but who ya know".

I suspect you were a A type having talked to you.
 
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I think it was based on 4 tendencies either:

A. You were a hard charger who sought and took responsibility and the more you did the more they wanted you to do.

B. You were a maggot they kept shuffling you around to get you outta their hair.

C. Once you hit E7 you are mainly concerned with managing people, knowledge in a specific field depended on the technical complexity of the field and in some cases a security clearance but in most cases leadership was more important.

D. And of course the all time favorite "It ain't what you know but who ya know".

I suspect you were a B type having talked to you.

Actually, it was probably more of an A type for 3 years, as I actually made S2 chief as only a Corporal, which is unusual. It was only about 3 years and 2 months in that I ran aground of bad politics and had to deal with a jerk captain who had no business being in the Corps. It was only after that that I let down the hard charger and just became 'one of the guys.'

If I had been a little more mature at the time, I would never have dropped the hard charger attitude, and I'd probably still be in the Corps. But at the time, I was young, dumb, and full of... well, you know. I didn't know any better. I got the idiot attitude that this one bad captain was representative of the Corps and I wanted out.

It wasn't a year after I got out that it occurred to me that one bad captain does not a bad Marine Corps make. :rolleyes:

Ahhh youth. :rolleyes:
 
Sorry I edited that I know your story. A it is. Nobody who is a B would be as dedicated as you are.

Yes, we met behind the NCCM thing. An effort I am still given to, actually. I appreciate it. I really was created to be a lifer. From my earliest memory I had no plans excep 30 years in the Service. I was that guy who some Marines hated because I was alwas so serious and duty oriented. Funny, I became the most popular guy in the squadron just because after the thing with the captain I decided (stupidly) that I was NOT a lifer, that I had been let down, so I relaxed and stopped caring, and then all the Marines who didn't used to like me, suddenly did. It was very strange.

But I would not have been able to campaign for RP if I were still in, so I have finally decided that things just might have worked out just how they were supposed to.
 
I have posted your candidacy on the NCCM site I hope it brings you some help from that direction, I'll be real disappointed if it doesn't.

To be perfectly honest Glen though I am proud of my years in the Marines, if for no more then the physical accomplishment, the longer I look at it from the Liberty movement the more I question the real value of it, so it goes both ways dude.
 
I have posted your candidacy on the NCCM site I hope it brings you some help from that direction, I'll be real disappointed if it doesn't.

To be perfectly honest Glen though I am proud of my years in the Marines, if for no more then the physical accomplishment, the longer I look at it from the Liberty movement the more I question the real value of it, so it goes both ways dude.

Well, thank you, very much for stepping up and helping in every way that you have helped. At this rate, it looks like I'll be meeting my goals of $500 by the 11th and $1000 by the 17th, and can have the kind of kickoff event we really need!

The next thing will be setting up a moneybomb page for the 28th of September, I'll call it the "Save The Republic Money Bomb" or something similar based on the Ben Franklin quote referenced elsewhere.
 
Well, Tangent4RonPaul:

I initially erased all of the stuff I had written (or thought I had), and decided to just let it go, and go with the flow, I really do not enjoy conflict. I was surprised tonight, to see that it got posted anyway, and not real happy about it either. I will, out of respect, however, attempt to respond to your curiosity.

First of all, a "third service provider" is a term used to describe a pre-hospital medical care and transportation system which is government operated. Some are user fee supplemented and tax supported, while others are totally tax supported. In either case, a City, County, State, or Federal entity is the operational authority and provider of service. I apologize for using the term, I am so used to speaking to groups who are familiar with such terms, forgive me. Hey, I'm old too...heck, I was working a flight deck before the gunny was born! My professional career is older than he is....hell I probably got socks older than him...but I do know my medicine.

As for the use of normal saline 0.9%, half normal saline solution, lactated ringers, ringers sol, D5W, or any of the other variations of intravenous fluids commonly used. Normal saline is the one most commonly employed, and the safest (it is called "normal saline 0.9% because it is equal to the bodies normal fluid salinity), except for patients who have cardiac conditions and the salt in the solution may be detremental (some controversy here however). The saline can be used for wound or eye irrigation, whereas the other fluids L/R included can not. N/S is also the only one used for the admin. of a blood trans. as L/R will cause a clumping of the cells...not a good thing. NS is also a fluid of general choice through which various IV meds can be administered through, whereas ringers can not be mixed with several meds. There is an ongoing controversy in regards to whether or not ringers or saline is preferrable for fluid loss from trauma. As you pointed out, saline is easier to manufacture and that is a plus too in a PAW setting. Loss of fluids from dehydration or burns can kill you just as quickly and dead as can external loss by trauma (gunshots, lacerations, internal bleeding, etc.), and Saline is the preferred fluid. I could further justify saline by discussing the fact that it is an isotonic fluid whereas the others are hypotonic or hypertonic which would require me to explain osmolarity and human physiology, etc. and that would take me all night.

Blood pressure readings in medical care are useful in the diagnosis of head injuries, hypertension, hypotension (e.g. shock), the establishment of a base line (an individuals normal) to monitor for changes which may indicate the presence or evolvement of a disease process or condition. Aside from the upper (systolic) and the lower number (diastolic) values, the pulse pressure (i.e. the distance between the two) is useful in recognizing cardiac tamponade (a very dangerous condition requirring prompt intervention) and heart failure. The comparison of pressures taken in the right arm and compared to the left can be very useful in detecting the presence of an aortic aneurysm. In short, it is an essential diagnostic tool in the management of many life threatening conditions. In the hands of a layperson, its use is admittedly limited, and if it is a cost concern, can be eliminated from the kit. I do however, reccomend one if possible, if not just to record the pressures of a patient periodically, along with other vital signs so that someone who is more knowledgable (e.g. a medical professional) that comes along can be given the information which could, potentially be a life saving thing for sure, or at least have access to the equipment.
I would like to know how one would position a b/p cuff for the control of vaginal hemmorhage....or maybe I wouldn't...lol. Incidentally, a cuff can be very useful in applying direct pressure (the first step in the control of external bleeding) in an extremity or when used with a roll of gauze placed directly over the pressure point above the wound, thusly cutting off the flow of blood through the vessel supplying the wound. A tournequet, is always a last resort (for various reasons) and a cuff would not apply the pressure necessary in most cases.

There is a big difference between the care rendered to stabilize an ill or injured person until they can be handed over to a tertiary (higher) level of care. A combat medic, is like a street medic and is severely limited in what they are trained and equipped to do in the field. But both, given the right circumstances, like in a PAW, where there is no one to hand the patient over to, can do many things that they would not do in the field setting that can indeed save that life. A simple infusion of a couple of liters of fluid, has saved many lives before the patient ever got to the ER, and in fact many are discharged home soon after arrival. These patients had lost fluid and gone into shock (were critically close to death) who did not require any surgical or other intervention to correct their problem.

In closing, I apologize for my poor grammar, spelling and typing.
 
Yeah, I know gunny. They are called corpman. Corpman are navy and gunnies are sargeants in the marine corp. No offense intended.
 
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"third service provider"

This is a term I have never heard. Perhaps it is above my pay grade, or perhaps it's a regional issue. Then again, it might just date you. I have worked in the conditions you defined as this covering.

I do know my medicine.

Of this I have no doubt!

As for the use of normal saline 0.9%, half normal saline solution, lactated ringers, ringers sol, D5W, or any of the other variations of intravenous fluids commonly used. Normal saline is the one most commonly employed, and the safest (it is called "normal saline 0.9% because it is equal to the bodies normal fluid salinity), except for patients who have cardiac conditions and the salt in the solution may be detremental (some controversy here however). The saline can be used for wound or eye irrigation, whereas the other fluids L/R included can not. N/S is also the only one used for the admin. of a blood trans. as L/R will cause a clumping of the cells...not a good thing. NS is also a fluid of general choice through which various IV meds can be administered through, whereas ringers can not be mixed with several meds. There is an ongoing controversy in regards to whether or not ringers or saline is preferrable for fluid loss from trauma. As you pointed out, saline is easier to manufacture and that is a plus too in a PAW setting. Loss of fluids from dehydration or burns can kill you just as quickly and dead as can external loss by trauma (gunshots, lacerations, internal bleeding, etc.), and Saline is the preferred fluid. I could further justify saline by discussing the fact that it is an isotonic fluid whereas the others are hypotonic or hypertonic which would require me to explain osmolarity and human physiology, etc. and that would take me all night.

partially yawn, partially interesting and your lack of explaining the tonic issues is a cop out – I've seen it done is several short para's. I am, however impressed that you know some IV fluids are incompatible with some drugs. Had a list of them around here somewhere. However, the topic was replenishing electrolytes which is why I said ringers.

Your comment on N/S being used w/ blood transfusions has me ???? Prior to – maybe. In conjunction with – NOT!

Blood pressure readings in medical care are useful in the diagnosis of head injuries, hypertension, hypotension (e.g. shock), the establishment of a base line (an individuals normal) to monitor for changes which may indicate the presence or evolvement of a disease process or condition. Aside from the upper (systolic) and the lower number (diastolic) values, the pulse pressure (i.e. the distance between the two) is useful in recognizing cardiac tamponade (a very dangerous condition requirring prompt intervention) and heart failure. The comparison of pressures taken in the right arm and compared to the left can be very useful in detecting the presence of an aortic aneurysm. In short, it is an essential diagnostic tool in the management of many life threatening conditions. In the hands of a layperson, its use is admittedly limited, and if it is a cost concern, can be eliminated from the kit. I do however, reccomend one if possible, if not just to record the pressures of a patient periodically, along with other vital signs so that someone who is more knowledgable (e.g. a medical professional) that comes along can be given the information which could, potentially be a life saving thing for sure, or at least have access to the equipment.
I would like to know how one would position a b/p cuff for the control of vaginal hemmorhage....or maybe I wouldn't...lol. Incidentally, a cuff can be very useful in applying direct pressure (the first step in the control of external bleeding) in an extremity or when used with a roll of gauze placed directly over the pressure point above the wound, thusly cutting off the flow of blood through the vessel supplying the wound. A tournequet, is always a last resort (for various reasons) and a cuff would not apply the pressure necessary in most cases.

OK – I'm fairly impressed with your answer, but at the same time not interested in getting into a pissing match. Some good examples of cardiac Dx, but ppl who would die in an austere situation – probably. So you can tell they have this problem – in an austere situation how would you care for them?

The problem with the cuff being able to apply the appropriate pressure has to do with the failure point of Velcro. Can you say “Duct Tape”? Salvage ability of a limb post tourniquet has a lot to do with how long that tourniquet has been on and how wide it was.

As to vaginal hemorrhage I was thinking of various means of compression as well as a very entertaining lecture in one of my EMS classes that had to do with genito-urinary injuries. Specifically, some of the things young girls like to stick up themselves for sexual enjoyment – sometimes glass and rather fragile... as well as OB injuries during deliveries. The point being making the path of least resistance not being bleeding out. I might also mention “gerbils” in certain applications, within certain communities – ahem... I would imagine only a part of the cuff being used within a glove... but total improvisation, and I know of no case where either approach has been used.

There is a big difference between the care rendered to stabilize an ill or injured person until they can be handed over to a tertiary (higher) level of care. A combat medic, is like a street medic and is severely limited in what they are trained and equipped to do in the field. But both, given the right circumstances, like in a PAW, where there is no one to hand the patient over to, can do many things that they would not do in the field setting that can indeed save that life. A simple infusion of a couple of liters of fluid, has saved many lives before the patient ever got to the ER, and in fact many are discharged home soon after arrival. These patients had lost fluid and gone into shock (were critically close to death) who did not require any surgical or other intervention to correct their problem.

In closing, I apologize for my poor grammar, spelling and typing.

Totally agree!

Ps: you really need to get a spell checker.

-t
 
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http://en.wikipedia.org/wiki/Emergency_Medical_Services_in_the_United_States#Publicly-operated_EMS


Lactated Ringers:
The presence of calcium limits their compatibility with certain drugs that form precipitates of calcium salts, and also prohibits their simultaneous infusion through the same administration set as blood because of the likelihood of coagulation (piggybacking).
Ideally, one would have access to both. How about the left arm (large bore of course) with a liter of saline, and the right arm (another large bore of course), with Ringers?
I tend to come from an administrators point of view, probably because of all my years as one. Technically I agree with you that Ringers is better than saline for the replenishment of fluid and electrolytes. Given the choice of having one or the other in my bag...I choose saline. From an admins position, I prefer Saline simply because it is safer when you are looking at a large operation with a lot of green medics in the batch...

The pledge that I took when I began my career, which I continue, and always will, bind myself to:
Be it pledged as an Emergency Medical Technician, I will honor the physical and judicial laws of God and man. I will follow that regimen which, according to my ability and judgment, I consider for the benefit of patients and abstain from whatever is deleterious and mischievous, nor shall I suggest any such counsel. Into whatever homes I enter, I will go into them for the benefit of only the sick and injured, never revealing what I see or hear in the lives of men unless required by law.
I shall also share my medical knowledge with those who may benefit from what I have learned. I will serve unselfishly and continuously in order to help make a better world for all mankind.

Spell checker? Yeah, yeah, I know....Damn I miss my admin. assistant.
 
History Channel has jumped the shark.

I just flipped on it and they're talking about bug-out bags!

The actual term!
 
I am reading "The Road" and it is a good reminder to work on my preps.

Terrifying book when you realize such a scenario is possible.
 
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