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About AarounPierce

  • Birthday 07/02/1982

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    Medicine, Mathematics, Physics, Philosophy, Sociology, Politics, Survival...many many.
  1. I must apologize for my absence in this month of May, in all truth it has been just a combination of school-finals and work related projects hitting all in this month. I'm writing this article as to, hopefully, create some insight in the importance of field sanitation in populated areas. Anyone who knows me personally knows I hold a strange fascination for epidemiology, particularly bacterial epidemics. Recent events in India, Eastern Europe, and Vietnam have bothered me a bit, and the focal point of these worries are the growing numbers of cholera outbreaks. For those who have not been exposed to what this diseases is, I will give a short summary. Cholera is a bacterial disease that is transmitted from person to person by ingesting food or water that has been contaminated by cholera vibrios. This bacteria, produces massive amounts of toxin in the linings of the small intestine of the host, causing extremely-debilitating diarrhea in its victims. The most frightening parts about cholera is that it can be rapidly fatal if not treated (can be fatal in less than 24 hours if not treated) and how quickly it can spread in a less-than-perfect world. In all honesty, the United States has not seen a serious cholera outbreak since the first decades of the 20th century. But with the downturn of the economy and Cold-War style thermonuclear rhetoric on the news all day, one can not rule out the possibility of our way of life changing drastically. ----------------------------------------------------------------------- Symptoms of Cholera Infection: Depending on the health of the individual infected, symptoms can begin to manifest between 12 and 48 hours after infection. Many of these symptoms are shared with many other gastro-intestinal infections, most notably salmonella. - Rapid onset of diarrhea. - Vomiting - Muscle cramps. - Fever. - Reduced urine output. - Some people experience increased heart-rate. - Most notable symptom of Cholera infection is the appearance of the infected individual's stool, commonly called 'rice-water'. It will have a gray-ish appearance and lack little substance. Treatment: As scary as the symptoms sound, treatment for cholera infection is relatively simple, but is time consuming. - The number one factor you must consider in treatment is your own personal protection. Cholera cannot be transmitted by inhalation, but by placing a disposable covering over your face is a very good idea for the simple fact that it will force you to not touch anywhere around your face. Non-latex gloves is another mandatory item, the bacteria cannot be absorbed into your skin by simple touch, but this will keep you from contaminating other items by touch. Personal protection is key. - Second is controlling the spread of the infection. Sterilization is key here. In a household setting, plastic sheeting and lots of spare linens are ideal. Strip the current bedding from the resting area and lay down a layer of plastic sheeting, then the patient can use the spare linens for resting purposes. Any porous items (such as stuffed animals and the like) should be removed from the area unless they can easily be replaced. When a caretaker is changing the bedding, great care should be taken to bag and seal all items in question for disposal, burning is ideal...but items can be sterilized with non-potable water and chlorinated bleach. - The main cause of widespread outbreak in the third world is the lack of adequate waste-water management. Fecal matter making its way into the water system is the main cause widespread infection. That being said, if modern plumbing is available, the patient using the normal toilet is fine as long as sanitation concerns are met. The toilet should be throughly cleaned using chlorinated bleach after use, the floors should be mopped and all touched surfaces should be wiped down as well. All toilet tissue used should be placed in a bag and sealed. After the 'episode' has passed, make sure the patient does not have any fecal matter on their backside, aid them in washing their hands properly before flushing and helping them back to the resting area. **Side note, very important one. Anyone with a severe gastro-intestinal infection where extreme diarrhea is a factor, you should not leave the person alone in the restroom. Extreme diarrhea has been known induce hypotensive shock (sudden drop in blood pressure), which can lead a person to become disoriented and pass out...very bad thing as most restrooms have multiple hard surfaces and sharp corners. Individuals with high blood pressure, are taking blood-thinners, or blood pressure lowering medication should be aware the episodes of extreme diarrhea can increase the affects of sudden blood-pressure drops. Those individuals with those particular afflictions should be carefully observed.** - With the sanitation concerns out of the way (safeguarding those in the household and community), now we get on to treating the patient, which is actually...the easy part. The human body can easily destroy the bacteria responsible for Cholera, the reason it is so deadly though is that the bacteria kills by attrition, quickly depleting the body of vital fluids and electrolytes. So in a situation where no medical care can be reached, cholera infection can be treated by treating the symptoms and letting the body do its work. Oral re-hydration salts are a very good item to keep in your homes in large quantities because of the variety of uses, but here is a simple recipe for making your own (note, for type-I diabetics, simple salt water in the same proportions will suffice). . 1 liter (1/3 of a gallon) of water. 8 teaspoons of sugar 1 teaspoon of salt 1/2 cup of orange juice (or a 1/3 of a banana potassium is what you're looking for) - Keep the patient very WELL hydrated to replenish lost fluids due to the diarrhea, water and other juices are fine as long as the patient is taking in proper salts and sugars in their foods. Potassium intake is important to help with the abdominal cramps. It should be noted that urine output will be abnormally low during the worst of the infection and this is how you will tell when the worst has passed. If all goes well, the diarrhea episodes will drop in frequency after 2-3 days and urine output will increase. Patient sterilization and isolation practices should continue for up to 2 days after stool consistency and urine output returns to normal. **A few notes to all this. This disease is especially dangerous for children under 5 years old, so special precautions should be observed if small children are at risk. Severe cases of cholera infection may require IV intervention to assure fluid/nutrient replenishment and antibiotics many be needed (where the immune system may already be weakened). During an infection, it is advised that the household should treat their water by normal chlorination treatment and/or boiling practices. ** ---------------------------------------------------------------- Disposal/treatment of contaminated items: Items that can be destroyed, should be destroyed by through incineration. But linens can be cleaned by being soaked in chlorinated water (copious amounts of chlorine can be used), then re-washed in standard treated water. This water should not be used for drinking afterward. ---------------------------------------------------------------- Conclusion: Remember that infection control is key when dealing with anyone suffering from the Cholera disease. Many people in the third world know how to treat cholera, but outbreaks still happen because proper sanitation is not observed. I've read first hand accounts of aid-workers who are observing family members, treating their loved ones, wash their hands in the same wells that everyone else in a village drinks out of...thereby spreading the infection. Poorly constructed outhouses leak into the drinking water system. When proper sanitation is practiced and these simple measures of treatment are practiced, Cholera drops from a 50-60% mortality rate to 1%. In closing, be smart and be safe.
  2. Greetings everyone and welcome to the first installment of my Emergency Treatment blog, this installment will cover bone fractures with primary emphasis on the extremities. First things first, what is a fracture? What is the difference between a fractured bone and a broken bone? A bone is considered 'fractured' when the structural integrity of the bone has been comprimised in any way. A break and a fracture are actually the exact same thing, a broken bone medically is referred to as a compound fracture. There are four common types of bone fractures and each require a different type of stabilization. Oblique fractures occur at an angle and are generally the resultant of a sharp-edged blow. Comminuted fractures generally refer to a bone that has been splintered and/or crushed. This form of fracture is common in MVAs (motor vehicle accidents) and construction site accidents because of the increased risk of high-momentum blunt force trauma. Spiral fractures result in a motion that twists the extremities into positions that are beyond anatomical norms. A number of times, these injuries occur as a result of falling injuries...falling out of a tree or down a flight of stairs. Compound fractures (or complete breaks) are the most dangerous types of fractures where the bone itself perforates the skin and is exposed to the outside air. This type of fracture is generally the most dangerous to the individual for a number of reasons because of the mechanism of injury for this type of fracture, massive trauma. Shock is very common for individuals during the inital injury, when in doubt...always treat a patient as if they could go into shock at any moment. Compound fractures also have a tendency result open bleed wounds, so extra care must be taken when rendering first aid to stop the blood-loss. With compound fractures, there is a risk of bone matter entering the blood-stream as well. ----------------First Aid for Fractures-------------------------- When in doubt, always treat any fracture as the most serious type, a compound fracture. For the purpose of this article, we will concentrate on injuries in relation to the arms/legs (most common) and this will be the only major injury sustained. When encountering a situation where a person is in need of medical aid, remember the ABC's first. Check the scene first to verify your own safety before rendering aid, PUT ON YOUR GLOVES. Talk to the person, gauge their responsiveness, make sure they are breathing, and check for a pulse. When preparing to splint any fracture for medical transport...look and touch but do not force any large movements. Oblique, comminuted, and spiral fractures are all treated the same way from first aid standpoint. Compound fracture have one other step, which will be notated in the process listed below. Notate the affected area and severity of pain, check for a pulse toward the body and away from the body in the affected area. If you notice a diminished pulse rate in the area away from the fracture, expediate transportation. If responding to the injury fast enough, remove any constricting items before swelling begins. This includes jewelry (rings especially), watches, gloves, shoes, any clothing on the affected limb can be cut away. Anything that could constrict around the area once swelling really takes hold... Here's the step for compound fractures...control the bleeding (PUT ON YOUR GLOVES). Irrigate and clean the wound while taking extreme care in not applying extreme pressure, the injured WILL respond to these actions, so be ready for it. Once the area has been cleaned of debris (glass shards and bits of plastic are very common in vehicular accidents), use plenty of gauze to pad around the point where the bone is protruding from the skin while applying gentle pressure. Once the free-flowing bleed has stopped, do not remove the soaked gauze pads. Simply apply more padding around the wound and over the bone. Use a gauze roll (not pressure bandages-ETDs) to secure the padding. Ace bandages are a bad idea to secure a compound fracture due to the swelling that the person will experience, gauze rolls are ideal...keep plenty in your aid-bags. Prepare your splint on a limb that was not affected by the wound if possible, if not, prepare it on yourself or another person. Then transfer it to the injured. This helps in speeding up the process of securing the injury, as well as limiting the pain experienced by the patient from un-necessary "readjustments". Make sure your splint goes above and below the location of the fracture. If a splint it not available for an injury to a person's arm, pad the injury as much as possible (standard t-shirts and sweatshirts make great padding) and secure the arm in a sling. If no splint is available in the event of a lower body injury (leg), pad the injury in the same way, then secure the injured leg to the uninjured leg as best as possible. When splinting a fracture, always check circulation before splinting and FREQUENTLY after splinting, about every 10 minutes. If circulation diminishes while enroute to medical aid or while awaiting EMS, check for swelling and loosen splint/padding as needed. As long as circulation is ok, you can help keep the swelling at bay by elevating the injury (as best as possible without injury). Have the patient lie on his/her back, a splinted arm laid across the person's chest is sufficient, and an injured leg can propped up just above chest-level to be effective. Applying cold-packs will aid in pain and swelling as long as they are not applied directly to the skin. Remember, when dealing with fractures, always keep the risk of shock in mind. Keep going over the patient's ABC's while awaiting medical aid. Keep the patient warm with anything on hand, blanket...jacket...a few spare overshirts laid over them. --------------Recommendations-------------------------- SAM Medical makes GREAT preform splints and they are not that expensive. Their site offers many free video tutorials on the use of their product. **I am in no way affiliated with SAM Medical** Most first-aid courses that are readily available do not cover splinting, that being said, EMT-B schooling is something that is very cost effective for more advanced medical training (as well as a certification to put on your wall). Depending on your state's mandated requirements, most EMT-B training can be completed in one semester with reasonable class schedules for all walks of life. You can also check with your local fire department and sherriff's department, in some states, those organizations offer advanced first-aid classes to civilians...and if they don't, they can always point you in the proper direction for your region. In closing, be smart and be safe. **EDIT, PPE - Personal Protective Equipment...bare minimum are non-latex gloves. Adding another link. Ring Cutter ------------------------------------------------------------------------
  3. I had actually started this series of Emergency Aid posts with an article on fractures (broken bones), but I realized I was going about this in the wrong order... First things first, the ABC's of First-Aid/Emergency-Aid. Whenever an incident occurs where you will personally be the first person on the scene, the VERY FIRST thing you should do is secure the area. No treatment you could ever possibly render would make the situation any more tragic than if the 'rescuer-needs-rescue'. These situations are very scene specific and can be as simple as having someone direct traffic at an accident scene or making sure the overhead area is free from falling debris in a construction/logging accident. Always take a few moments to stop, look around and understand what is actually going on before you act. Ok, with that established and hopefully understood...I will move on to what the ABC acyronm means. Whenever you encounter someone who has been injured, you need to make a quick assessment that can truly mean the difference between stabilization or death in moments. A = Airway, check the individual to see if the pathway from the mouth to lungs is clear. If the person is concious, ask the patient to talk to you. Ask questions like "What's your name?" "Where do you hurt?" When you hear paramedics ask these questions, they're not only asking them for their records. If you have a patient who is unresponsive (with the exception of possible spinal injuries), open the person's mouth and look for any obstruction, pay careful attention to the positioning of the tongue. B = Breathing, if the patient is screaming and/or communicating verbally, chances are they are breathing normally. When in doubt, CAREFULLY listen for respirations from the nose or mouth. If you cannot hear anything from an unconcious patient, perform a mandibular jaw thrust (Another Method) paying careful attention to avoid excessive movement in any situation where you may suspect spinal injury. Another commonly overlooked part of the breathing assessment is make sure the injured has bilateral respirations (breathing properly from both lungs). You may either use the stethoscope or simply place your ear over the ribcage just under the pectoral region and listen for clean respirations. C = Circulation, check for a pulse, below are two pictures for the best areas on the body to check for a pulse without moving a patient. Count the beats you feel for 15 seconds, then multiply by four...this will give you your patients heartrate in bpm, keep a record of this figure. As well as pulse, you'll want to take notes of other circulatory problem signatures. How is the patient's color? Pale, flushed, cold/clammy skin? Depending on your level of first-aid training, the C also refers to the control of any openly bleeding injuries. Watch for a future edition on the methods of hemorrage control. As long as you verify the ABC's and can act accordingly if one of the three have not been met, the injured should have a good baseline for survival until emergency professionals arrive. Keeping a blanket around to keep the person warm won't hurt either. **Extra Links** Adult CPR Pediatric CPR Red Cross First-Aid Courses American Heart Association Training Locator
  4. Here we go with my BOAT. Closed. Open and packed. Contents exploded. My bit of creativity... Here's how it fits together. Ok, contents: (6) Hoop Fishing Weights (6) Bait Fish Hooks (taped to the lid) (5) Matchsticks (3) Water Purification tablets (inside the bag with the matchsticks) Utilities from a broken Leatherman I had laying around. (Serrated Knife, Mini-saw, Can-Opener, Probe, Puncture tool, and Flat-head) (1) cut down No.2 Pencil (1) Mini-Bic 20ft of 12lb Fishing Line 8ft of duck tape (4) 1" wide by 1.5ft long pieces of tarry cloth 3ft of boot-string Future Upgrades Replace the 3ft of boot-string with 8ft of 550 paracord Replace the Leatherman salvage-job with a mini-multitool...maybe. Replace New version of the Altoids tin with an old version (when I can find one) because the new versions are stamped on the lid and I eventually want to put reflective tape on the top of the lid. For the tarry-cloth (firestarter/wilderness toiletry)/duck tape/fishing line contraption. I took a bit of cardboard and used my knife to cut out the interior support ribbing. I then looped one end of the fishing line around it and wrapped the 8ft of tape around the exterior of the cardboard strips (to hold them together). I looped the fishing line into a coil around three of my fingers, then folded the tarry-cloth neatly so they both slide easily into the cardboard pocket. I did this mostly to keep my tarry-cloth as dry as possible (as cardboard has a tendency to suck moisture out of anything) and to keep my fishing line from getting tangled with the rest of the BOAT contents. Comments/suggestions are welcome. Thanks
  5. I'm sorry, Bug Out Altoids Tin. That will be my next blog post is the contents of my personal B.O.A.T. They're generally designed for bare-essentials survival needs (usually one-day).
  6. Continuation of my survival preparations in the Urban/Rural mixed environment I am currently in. The everyday bag has gone under serveral variations based on who you ask. The EDC (Every Day Carry), the GHB (Get Home Bag), Bauer Bag (Taken from the TV Show 24, the man purse Jack Bauer carries), the Day Bag/Murse (Man-Purse). Personally, it is the EDC for me...it contains everything I use in my personal life and professional life throughout the day. It also contains everything I would need if I was without the resources for food/water/shelter for two days. First of all, is the bag. The bag itself is a County Comm EOD Mine Bag, it is a great bag for $20 and can be found at the following link. The bag comes with the MOLLE attachment system on both sides, allowing for modular attachment of external packs...as you can see, I have a medical pouch attached to mine (medical pouch will be covered in this article). A peek inside. I removed a couple of items from the main bag compartment to make visualization easier. One is the Nalgene bottle seen in the picture below. Contents: Mountain House Beef Stew Pro-Pak Nalgene 32oz Wide Mouth Bottle LED Headlamp My B.O.A.T. Electrical Tape Emergency Poncho Chapstick Water Purification Tablets TI Calculator Waterproof Matches Lighter with 15ft of Duct Tape wrapped around it. 256MB USB Key Compass Pen & Pencil Playing Cards Bandanna Mini-Maglight Off Deep Woods Spray repellent Benadryl Anti-Itch Gel Work Gloves AA Batteries (x2) Can Opener/Bottle Opener Lockpicks (kept in an old Leatherman pouch) Winchester Folding Pocket Knife Mini-Screwdriver Set 20' of 550 OD Paracord Now, for the medical section of this EDC. Keep in mind, I am moderately trained in medical care in emergency situations. And equipment can never substitute for training and experience, but everyone should carry a first-aid kit based upon their skill level. Accidents happen, and sometimes...help is not going to be johnny-on-the-spot and you will have to intervene. Parents can really appreciate that fact... This is the 5.11 Tactical Medical Pouch, found at this link for $20, and it is a great pouch for the price. Anyone who has ever looked for first-aid solutions that do not scream out visibly "first aid kit" know that good pouches are hard to come by. Hopefully, the following pictures will turn some people on to this often over-looked solution. This is the IFAK (Improvised/Individual First Aid Kit) opened up. In the center, I have a pair of individually rolled latex free nitrile examination gloves. A ziplock bag full of other ziplock bags with individual meds within. And an 3M N95 dust mask. People ask, why the dust mask? Very easy answer...you never know. Remember footage from office building fires or even pedestrians trying to help after 9/11. They were running around with their shirts covering their faces because of dust/smoke in the air. Another reason is in traumatic injuries, blood-borne pathogens can easily get into your mouth or eyes in the case of open bleeds. Center items removed. The meds...carefully selected to cover a broad spectrum of ailments that afflict us throughout our normal days. Everything from headaches to tummy aches, the sore throat or food-borne illness that causes rapid bowel evacuation (you know what I mean). The front flap, aka...Normal Care. As you can see, fairly comprehensive. Minor injury care mostly for cuts and burns. There are some items there for topological itch relief (anti-fungal and anti-histamine gels). Hand cleaner, glucose tablets for the diabetics I know, 3M Durapore tape...pretty much the best d**m bandage tape you can buy. Triple antibiotic, an eye dropper filled with normal saline wash (contact solution wash), a 20cc syringe (no needle) for suction, sunscreen, eye pads, alcohol and cleaning pads, an assortment of band-aids and butterfly strips, as well as a package of oral rehydration salts. The Trauma Flap Two rolls of Kerlix 4.5"x4.1yds rolled gauze, great stuff...can be used to pack wounds and pad injuries. Two Kendall 5"x9" Petrolatum Gauze, this stuff is great for injuries to your skin...burns and bag scrapes. 5"x9" Abdominal Pads, these thing will absorb a ton of fluid, great for applying direct pressure to a badly bleeding wound. Dynarex 4"x4" Gauze Pads, five in total, pretty much for anything...bleed control, padding, cleaning, etc. Safety pins...because you never know. And a package of moleskin for blisters and abrasions. This is one of the items I had to remove from my EDC so you could see the contents easily. This is the Ambu Res-Cue reusable CPR mask, can be found for a whole $10 from Chinook Med. This device has a one-way valve, meaning when you blow air into it (into the patient) the air does not come back out into your mouth. Also keeps you from having physical contact with someone who may make you a little uneasy about administering CPR to. Remember...training first, CPR classes are offered for ~$50 from any of your local Red Cross or American Heart Association facilities. Extremely worthwhile for ANYONE...I highly recommend it. Finally...the last item of my EDC. I leave it last because it calls for some explanation. This is the Sig Sauer P226 9mm pistol. I leave this last in my listing for my EDC because there are certain conditions you must understand if you are planning to carry a firearm. First, check your State's firearm laws, many states will not allow you to carry a concealed weapon PERIOD, much less allow you to carry with a CCW permit. Luckily, I live in a state that allows both open carry, and concealed carry with a CCW permit. I have taken all the courses and registered my weapon with my State and I am legally permitted to carry my firearm in places that it is not explicitly denied (such as my workplace, banks, educational facilities, Federal/State offices, etc etc.). A person's opinions on firearms and the enforcement of our 2nd Amendment Rights is their own. I choose to exercise my right to bear arms and I allow myself the dignity of self-defense without having to depend on law enforcement IF I ever found myself in a dangerous situation. I am fully educated on the laws and am fully aware of the possible ramifications of anything that happens with my weapon, and I accept that. If you want to do it, do it right...don't be a moron and put all this effort into a EDC system, worrying about possible survival scenarios just to be busted because you're carrying an unregistered concealed weapon. I have no sympathy for you.
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