Wednesday, July 28, 2010

Miscellany: Mulliga's Urban Survival Kit, Part 2

While my blog is mainly about escaping the mundane through art and adventure, this series of posts addresses "escape" in a more literal sense. Here, I present my ideas on a lightweight, inexpensive collection of items for surviving an urban or suburban disaster. Part 1 introduced the concept and went into my choice for the survival kit's container (a CountyComm EOD Utility Bag). Part 2 delves into M.U.S.K.'s most important subsystem: the first aid kit.

I think breaking my arm taught me, on a visceral level, that I am not invincible. None of us are. Yet a lot of people go through their daily routine without ever thinking they could be seriously hurt.

The risk goes up exponentially during a major disaster like a hurricane. If there are 130+ mph winds outside and you get hurt, help may not be coming for a long time. The same goes for breakdowns in the rule of law, such as mass rioting or looting - even if 911 still works, the ambulance may take awhile.

Since injuries are so common, every survival kit, no matter the size, should have a first aid kit. How much you add to the kit depends a lot on where you are (treating snakebites doesn't come up very often in a city) and what your skills are (Ever see a paramedic's kit? It's big). I've managed to fit all the items below in a large Ziploc bag; for a tougher, more water-resistant, and more expensive option, try Aloksak bags.

-- FIRST AID KIT CONTENTS --

Blood sponge - If someone has a medium to severe wound, there's going to be blood all over the place. In order to stop the bleeding and dress the wound, you need something that can soak up a lot of blood. To this end, I pack several Surgipads (a Johnson & Johnson surgical dressing available at many big box stores and pharmacies). If cash is really tight, you can load up your kit with menstrual pads - slightly embarrassing, but effective.

Dressings - Try to bring both adherent and nonadherent. Adherent dressings (example: standard gauze) should come into play for serious or deep wounds where there isn't a lot of leftover abraded skin to stick to the dressing. The nonadherent dressings (example: Telfa non-stick pads) are good for injuries like road rash or skinned knees, as well as for protecting minor burns from further damage.

Medical tape - Pack both breathable and waterproof tape. Waterproof tapes help keep water from getting to the wound, which can be desired in some situations. Breathable tapes allow air to reach the skin - okay for wounds where you'll be doing a lot of dressing exchanges anyway. In a pinch, you can sub in duct tape or electrical tape if you need to hold a dressing in place.

Secondary wound closure options - butterfly closures/Steri-Strips/tape strips, super glue - The first and best option for wound closure is direct pressure and elevation above the heart - it may take some time, but the vast majority of wounds close this way. If a wound does not close, you may have to try other stuff - the tape type closure methods are easiest to use and should be tried first, and the super glue can be used for small but nonclosing wounds.

Roll bandage/gauze roll/self-adhering roll - Not every wound is on a flat surface. If someone gets cut around their leg, arm, or neck, a roll bandage might be the most efficient way to dress the wound. This item adds substantial bulk to your kit, however, so you may not be able to take a full roll.

Latex/Vinyl/Nitrile Gloves - Latex gloves will be cheapest, but there are people who have latex allergies...since this is an emergency kit meant mostly for personal and family use, I just stuck with regular latex; hopefully I don't run into someone who reacts severely. Be sure to have at least a few pairs of gloves packed in your kit - it's much safer than sticking your naked hand on someone's body.

Scissors/EMT shears - Used for cutting tapes and for shearing off clothing to get to a wound. Basic office scissors will do the job if you're on a budget - watch the points, though.

Tweezers - Mainly for splinter removal. The small pointed kind is most convenient in terms of size, but the bigger cosmetic variety can work better due to a larger grabbing surface. Don't bother with the cheapo plastic ones inside store-bought first aid kits.

Alcohol wipes/Iodine Swabs - Used to clean knives, tweezers, and other instruments. You can also take an iodine pad and dump it into a water bottle to create a dilute iodine solution to irrigate a wound. Don't use these pads to swab a wound directly (basic rule of thumb: never put anything in a wound that you wouldn't put in your eye).

Band-aids - Stick as many of them in as you can. Thankfully, this is what you'll use most.

First Aid Primer - You may not be the only person using the first aid kit. A sheet of paper showing CPR and common first aid procedures will help other people immensely.

Medications - in plastic bag or in separate carrier

- As many days' worth of necessary prescription medications as is feasible (diabetics should pack everything they need into a portable kit like this one).

- Aspirin/ibuprofen/acetaminophen (pack all three, in case someone can't take one - all three can have side effects)

- Diphenhydramine (Benadryl) (antihistamine, sleep aid, motion sickness remedy. Can cause profound drowsiness - use with care!)

- GI meds - Dulcolax, Immodium, Pepto, Pepcid (Of these, Immodium is a priority - you lose water quick when you have diarrhea. Dulcolax is nice if you're living off fiberless dried and canned food for awhile. Pepto and Pepcid are luxury items.)

- Misc. meds - cold/flu symptom relief, anti-itch cream, etc.

-- ITEMS NOT IN MY KIT THAT ARE WORTH LOOKING INTO --

QuikClot - This is a powdery coagulant that is best when you do not have the available time to apply direct pressure to stop external bleeding (i.e. in the middle of a gunfight). It's pretty expensive - for the price of one packet, you can buy a decent ready-made first-aid kit from Wally World. It's worth noting that the military has moved away from QuikClot in its powder form (on a windy day in Iraq, the stuff goes everywhere); I believe they use coagulant-impregnated bandages now.

Airway kit - If someone doesn't breathe, they die. Unfortunately, clearing an airway can be a lot more involved than scooping stuff out of someone's mouth like they show in CPR classes. An airway kit includes flared tubes designed to be inserted up someone's nose or into someone's mouth in order to secure an open airway. Obviously, not something you want to mess with without a little training.

Moleskin - Traditionally used for blister prevention. I've found band-aids to work just as well.

Scalpel/Razor - Good things to have, but a big no-no in airports and most courthouses.

Suture kits - Suturing a wound to close it is a last resort best left to people with medical training.

Kelly Forceps (hemostats) - Beyond my capabilities. An EMT or doctor who is without any supplies would probably love a good set of clamps, though.

Triangular bandage, Compression bandage - Useful, but big and bulky.

-- FLAMBEAU BLUE RIBBON WATERPROOF MINI FLY BOX REVIEW --

Sometimes you see something on the InterWebz so ingenius, so perfect for a particular purpose, that you just have to have it. Here's one such item:



The fly box is smaller than it looks on YouTube - it's about the size of a new bar of soap. Nevertheless, it can carry about a dozen different medications, all neatly separated and ready to use.

After some testing in my bathroom sink, I've found that the fly box's main compartment will indeed survive a 30 second dunking, but that water leaked into the two top compartments. Still, the fly box works mostly as advertised, and it's not expensive for how solid it is. If you have the space, it makes for a neat addition to a first aid kit.

Phew! That does it for Part 2. Tune in next time for M.U.S.K.'s food and water subsystem.

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