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The Real Risks of Fire

By Jay Whimpey, PE, TACDA Board Member

firemen at housefire

Fire Safety and Survival

There are over 360,000 house fires in the United States every year with a substantial number of injuries and deaths. Eighty percent of the deaths and injuries occur in residential structures, with most of those fatalities occurring while those people are asleep. We can reduce the risk of death or injuries by fire through understanding how and where fires start and how to prevent the fires and ensure prompt notification if a fire occurs.

Studies of fires during emergency situations show a substantial increased risk because of the frequency and severity of fires when individuals and families are using cooking and heating methods that are less familiar and more hazardous than they normally use. The principles and methods for preventing fires and protecting ourselves apply both in our everyday lives and emergency situations.

Asphyxiation, or lack of oxygen, causes most fatalities in fires. A fire is dangerous because of the direct exposure to heat and flames that can burn us, super-heated air that can damage the lungs and breathing passages, inhalation of toxic smoke and gases, and simple lack of oxygen. Calculations show that a typical house with 2000 square feet of living space with 8-foot ceilings has 16,000 cubic feet of air and 20.8% of that air by weight is oxygen. At normal conditions, there is roughly one pound of air in 13 cubic feet. So, there are about 1,230 pounds of total air and about 260 pounds of oxygen in the house. If a fire starts and begins to use that oxygen to support the combustion, it only has to use about half of the oxygen before a human would be largely incapacitated and incapable of escape due to lack of oxygen. A human will lose consciousness and die when an additional 5% of the oxygen is gone. When most materials or fuels burn, they use roughly two pounds of oxygen for each pound of fuel. This includes most carpets, plastics, and wood furniture. So, a fire only has to burn 65 pounds of fuel before it is impossible for people in the house to save themselves from the advancing fire. That corresponds to the weight of a single piece of relatively small furniture or a moderate section of carpet.

In an underground shelter that is 10-feet in diameter and 50-feet long there is only 4000 cubic feet of air and it would only take 16 pounds of fuel burning to make the entire shelter deadly to any occupants.

Studies have indicated the average house today can overwhelm the inhabitants by asphyxiation in roughly two minutes once a fire starts because of the fast burning nature of many of the materials that we use for making carpets, furniture, and electrical appliances. The cotton, wood, and wool that we formerly used to make carpet and furniture have been replaced by nylons, polyesters, and other plastics that burn much more readily. The solid wood that was formerly used in furniture has been replaced by plywood and particle board which contain a substantial amount of highly combustible glue or resins. Prompt notification of a fire, especially when we are asleep, is critical to survival.

Fire Prevention and Elimination

The most common type of fire in the home is caused by cooking on a stove top. Of course, most of the fires are small and can be contained quite easily. The fire inside a pan can be snuffed immediately but we should remember to keep a pan lid within easy reach while cooking. A small fire blanket is another option for fires that have spread beyond the pan but are still contained on the cook top. The use of salt or baking soda is also useful but we should be careful not to spread the flaming materials while applying the salt or baking soda. Other combustible powders such as wheat flour or sugar will feed and spread the fire. A fire extinguisher is also useful but can possibly spread the fire if not used properly. The cook top should always be attended to prevent small fires from growing.

Electrical appliances can also be the source of a fire. A loose electrical connection where the resistance at a connection can generate heat and start a fire on the wiring insulation and surrounding combustibles. A short in the power supply or transformer can also create heat and start a fire. The fires that may have been largely contained in the steel case of the appliances in the past are now able to spread to the plastic on circuit boards and electrical leads and then on to the plastic housing. It reduces risk to unplug appliances when not in use and reducing the overall number of appliances that we use. For example, we should carefully consider whether we need an electric can opener. Such appliances have started fires before.

The use of candles, lanterns, and heaters with a live flame should be minimized and such devices should never be left unattended. Fuel should be stored in a separate area and the fuel should not be added to the devices when they are hot. Fueling should preferably be done outside.

Electrical outlets should not be overloaded and the connections on power strips and other electrical distribution equipment should be cleaned regularly. The dust buildup behind cabinets and entertainment centers where there are electrical connections should be cleaned to control dust buildup. Inspect electrical connectors for signs of heat or poor connections.

The storage of fuels and other chemicals in the garage or utility areas of the house should be minimized. The dryer vent and dryer itself should be cleaned regularly to clear lint and other combustibles. The storage of combustible materials in the laundry and utility areas of the house should be minimized.

Bathroom fans should periodically be cleaned and inspected.

Fire Response

It should be emphasized that the primary responsibility of everyone in the house is to get out of the house as quickly as possible if there is a fire. To that end, an escape plan should be prepared that includes designating multiple escape routes for every room in the house, a single meeting area outside the home, and plan to notify the emergency response personnel. It is important to discuss and demonstrate the plan for younger members of the family and make sure they can actually open windows and exit the window openings if that is part of the plan.

Proper equipment should be stationed at appropriate areas such as fire extinguishers near the doors. Fire blankets should be provided near the kitchen for smothering kitchen fires and other fires where appropriate. A wooden bat or similar tool should be provided to help open windows where appropriate. A fire can create a significant vacuum draft in a home when it finds a place to vent and that can put a negative pressure on widows, making them difficult to open. Thus, a wooden bat for breaking the windows, if necessary, should be stationed near the windows designated for escape. A step stool near the window can help to egress the window and a flexible ladder for the outside of the window, if the window is on the second story of the structure, are also advisable. Special locator stickers should be placed on bedroom windows to notify emergency responders or even neighbors where people in the house normally sleep. The stickers can save time in rescuing the people in the house by directing the response to the right rooms.

Fire Alarm Equipment

The most important pieces of fire equipment for protecting the people in the house are the smoke, heat, and carbon monoxide detectors. The people in the house must rely almost entirely on the detectors while they sleep. As stated earlier in this article, the lack of oxygen kills or incapacitates most victims in their sleep and they die in their beds with no chance to escape.

The most disturbing information about the common smoke detectors in most homes is that they do not work in a timely fashion in many actual fires. The documentation that accompanies most ionizing smoke detectors indicate that they will not work in up to 35% of all fires. There is also a substantial amount of information enumerating the situations and types of fires where the detectors would not be expected to work that seem designed to limit the amount of liability for the manufacturers.

Actual studies have found that the ionizing smoke detectors do not work in roughly 55% of actual fires. They do work many times when the toaster burns a piece of toast or when food is broiled leading to a false sense of security, but when it comes to a real fire burning the actual furnishings or carpets in a house that produce fewer larger particles than when the toast burns, they do not warn the occupants in the structure in time to allow them to escape. Please refer to a short video on YouTube called “When Seconds Count” for some additional information and accounts of testing and actual fires where the smoke detectors failed to provide adequate warning.

To corroborate the findings of several other studies, I conducted some testing on available fire alarms from three different manufacturers. Two ionizing smoke detectors and one combination ionizing smoke detector and CO detector were subjected to some informal testing. Fires with various fuels such as wood, particle board, carpet, and electrical cords with vinyl insulation were established in a portable fire pit about 30 inches in diameter. All three detectors were placed in the smoke plume about 36” above the fire for a period of up to two minutes. The results varied but there were several instances where the detectors failed to trigger when placed directly in the smoke plumes. Even the newest smoke and CO detector failed to trigger after a full two minutes in the electrical cord fire that had the most noticeable black smoke. All the detectors triggered in at least some of the tests after being in the smoke for only 10 seconds which added some validity to the test method, but the findings confirmed that the results were varied and the smoke detectors were not entirely reliable.

There are optical smoke detectors on the market today that are substantially more reliable than the ionizing smoke detectors in most homes. They have been manufactured since the 1970’s and there has never been a fatality from a fire where they have been employed. Applied Fire Technologies of Coppell, Texas manufactures a line of smoke, carbon monoxide, and heat sensors that network together so that every alarm on the local network sounds when one alarm is triggered, thus alerting everywhere in the home. The units have permanent batteries that last for up to 20 years and they run internal diagnostics continuously to ensure that they are operating correctly. They are normally installed by a company representative after an on-site review of each home. You can contact the company and find your local dealer by going to http://www.crossfirealarms.com and going to the “contact us” tab.

Fire extinguishers can be very useful once you have been alerted to a fire but they must be kept in good working order. They are normally fitted with a pressure gauge but they should also be checked to ensure that the powdered fire-retardant material has not solidified. The condition of the fire retardant can be checked by testing the weight balance when the fire extinguisher is gently turned on the side and most of the retardant should be at the bottom. Then the extinguisher can be pushed on its side from a vertical position on a soft carpeted surface. If the horizontal weight balance changes substantially after the “fall” on its side then it can be assumed that the retardant is still loose inside and the fire extinguisher has a high probability of working appropriately when required.

Summary

The images we see on television and in the movies with bright flames of a house on fire with people moving around inside the house and trying to rescue someone are very misleading. Most actual house fires create an environment with thick smoke so that you cannot see anything and acrid and toxic smoke, where an individual cannot maintain consciousness for more than a few seconds. We need to prepare to survive by minimizing the risk of a fire starting with installing the appropriate alarm equipment in place to ensure that we can escape during the early stages while it is possible.

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Roadblocks to Civil Defense

Eugene Wigner

By Eugene P. Wigner

A renowned physicist and civil defense analyst probes behind the mask of apathy in the United States. (Originally printed in the first Journal of Civil Defense, May-June 1968, Vol. 1 No. 1)

I have often tried to explain the need for a vigorous civil defense effort, why and how such an effort would go far in preserving peace and how it could save many millions of lives if war should come nevertheless. “Why Civil Defense?” would be an apt title for this subject because we want the civil defense effort to be strong and vigorous. But my subject is also the opposite: “Why No Civil Defense?”. What are the roadblocks? Why isn’t the civil defense effort as strong and effective as we would like it to be? Why is there not a popular demand for it? There are, it seems to me, three principal reasons for this.

The first reason is the power of the anti-civil defense establishment. What provides this strength? What are the motives of the establishment?

There are, of course, those who would like to see our country become a second or third-rate power, the nakedness and vulnerability of its people forcing its government to accede to the demands of those governments whose people are better protected or who care less for human life. Persons who have these desires are, however, small in number, and they contribute but very little to the undeniably very great strength of the anti-civil defense establishment. Can this establishment muster valid arguments against civil defense? I think it can, and this is the reason for citing this cause for our lagging civil defense efforts as the first of my “principal reasons”.

If we install shelters, store food and other supplies, we make preparations against an attack on our country. Such preparations naturally set us apart from those against whose attack we protect ourselves and render it more difficult to develop a true friendship between the governments of communist countries and ourselves. This is the theory of Festinger, often derided by social scientists, but I do think there is something to it even if not in the extreme form propounded by Festinger. It is, of course, true that the hate propaganda of the other side also interferes with the development of the true friendship, and it is sad – very sad – that this is never criticized by the anti-civil defense establishment.

The second reason why the civil defense effort is not more vigorous and why there is not more public demand for it is that it is unpleasant to think about disasters, particularly disasters as severe as nuclear war. Let us note that insurance policies offering compensation in case of fire are called fire insurance policies, but that the policies protecting our families in case of our death are called life insurance policies. No similarly euphemistic name has been invented for civil defense, and it would not help much if one were invented. Building shelters would remind us in any case of a great and terrible calamity that could befall us, and we all are reluctant to think about such calamities. Why dig a hole in the ground where one may have to live for weeks if one can, instead, walk in the sunshine? We have a tradition for work, and many of us enjoy it, but we do not have a tradition of thinking about disasters which may strike us. However, whereas our reluctance to face the temporary nature of our sojourn in this world does not, as a rule, shorten our lives, our reluctance to protect ourselves may bring war nearer.

The third reason that we do not take civil defense very seriously is that we are all too conceited. Sure, other people have been stricken by disasters, other nations have been wiped out or subjugated. But this cannot happen to us, we say. It is not even decent to think about it. I once went to see the now deceased Albert Thomas, who prevented a good deal of civil defense legislation from being enacted in the House of Representatives. He listened to me for a few minutes and then said: “Take it easy, young man, take it easy. This country is so strong it does not need any civil defense.” Most of us would express this self-defeating doctrine less clearly and less bluntly than did Mr. Thomas. But what he said is present in the minds of all of us. On a peaceful day like today, when we are absorbed by so many more pleasant thoughts, is it not unreasonable to think about some country attacking us with nuclear weapons?

In a very real sense, I believe, it will be a test of the democratic ideal whether our people can resist burying their heads in sand or not, whether or not they, can muster the foresight and maturity to carry out the unpleasant and unpopular task of protecting themselves, their country, and their freedom against dangers which seem far away. Nothing but illusory comfort can be gained by closing our eyes to these dangers.

 

  • Eugene P. Wigner – 1963, Nobel Prize in Physics won for contribution to theory of the atomic nucleus and elementary particles specifically the discovery and application of fundamental symmetry principles.

Managing Pain in a Pinch

Pills in woman hands.

by Cynthia J. Koelker, MD

Excerpt from Armageddon Medicine, How to Be Your Own Doctor in 2012 and Beyond

The daily queue of suffering seems endless. Toothache, stomachache, headache, earache, back pain, leg pain, joint pain, neck pain, sore throat, sore feet, sore muscles, sore eyes. People come to you seeking relief – relief from their pain, and relief from fear. Are you up to the task of helping others, or ready to run away? Becoming a healer is not for the faint of heart.

If and when the medical community collapses, those left to carry on will need an armamentarium of tools to deal with pain. Even if it’s only your own problems and those of your family that you’ll be facing, learning how to relieve pain now, before you’re in the midst of crisis, will spare you needless worry. Pain is the #1 symptom that drives patients to physicians today. Pain will remain a fearsome opponent tomorrow, no matter what catastrophe brings the world to its knees.

Pain and fear go hand in hand, two sides of the same coin. Fear is pain’s best friend, its evil ally. Relieve one and the other may subside, at least to tolerable levels. I know what it is to fear pain. Every time I visit the dentist my childhood dread of drilling on a nerve rears its ugly head. It’s not a rational process. My childhood dentist didn’t believe in novocain. I’ll never get over it.

People can often tolerate an amazing degree of pain if given hope that the condition is only temporary. Labor pain is every bit as bad as any other sort of pain, yet how many women suffer through hour after hour of gut-wrenching torture without requesting so much as an aspirin? People will also endure an incredible amount of pain if they believe good will come of it – such as a new baby, or saving another’s life.

As a healer, you’ll need to dispense more than a dose of narcotics. Having enough medical knowledge to understand a disease process will help you foresee the course of the disease and offer hope of recovery. Even if you cannot relieve the pain, you can relieve fear – both fear of unending pain, and fear of being alone. If you lack the tools to deaden the pain, don’t think you’re doing no good. Like a child who wants his boo-boo kissed, adults, too, want to know that someone cares.

In this regard, doctors are not necessarily the best healers. Physicians are aloof by training and sometimes by nature. Once you try helping others, you’ll learn that part of the patient’s suffering becomes your own. Taking on the pain of the world is a crushing burden. Doctors cannot function when they are overwhelmed by too heavy a load, and so often limit their emotional involvement. But emotional involvement is a powerful salve. An infant with an earache may be comforted in its mother’s arms. “Hold me” may be a laboring wife’s request of her husband, knowing he cannot take the pain away.

I emphasize the non-medicinal treatments of pain because: 1) sooner or later they may be all you have; 2) stretching your supply of pain relievers will help you treat more patients; and 3) many people are intolerant of or allergic to pain medications.

The best way to relieve pain is to eliminate the underlying cause. Deliver the baby, lance the abscess, pass the kidney stone. Pain is your friend when it comes to diagnosis, but sometimes you’ll just have to treat it regardless of cause.

The English language has many words for various kinds of pain: aching, stabbing, burning, stinging, piercing, numbing, cramping, throbbing, tingling, smarting, lancinating, agonizing, and nagging, to mention the most common. The type of pain will clue you as to both cause and severity. The fluent or bodily-aware patient will be able to describe their discomfort in some detail. Others will simply say they hurt.

Beyond what a patient may say, their body language will alert you to the intensity of their distress. A smiling teenager flirting with her beaux does not need narcotics, even though she says she’s dying of pain. A silent man curled up in the fetal position has something serious going on.

The art of medicine includes deciphering both what a patient wants and needs. Some patients request no medicine, if they can only be permitted a day off work. Others prefer to pop a pill and keep going. In America, we overmedicate because we rest too little. Sleep is a powerful analgesic. If pain medication is not available, simply getting a person to rest and/or sleep may be the ticket to relief.

Doctors use many classes of drugs to alleviate or prevent pain: anti-inflammatories, steroids, narcotics, antidepressants, anti-anxiety drugs, anti-seizure drugs, beta-blockers, calcium channel blockers, triptans, muscle relaxers, sedating antihistamines, caffeine, nitroglycerin, antacids, oxygen, anesthetics, and even alcohol. We don’t always know how these drugs work. A patient does not have to be depressed for an anti-depressant to relieve pain. Thinking beyond traditional pain medications will broaden your ability to offer relief.

On treating pain-

Whereas patients focus on pain abatement, doctors often focus on functional improvement. Generally speaking, physicians do not necessarily aim for complete relief of pain, but rather sufficient improvement to permit adequate functioning. Relieving all pain can actually make a situation worse, allowing the patient to injure himself. A truck driver with chronic back pain may say he’s feeling no better, but now is able to unload his cargo. A migraine patient may report her headaches are as bad as usual, but hasn’t missed a day of work in a year. It is difficult to measure how much a patient hurts. It’s much easier to measure how well a patient functions.

Despite current medical thinking, I’m not much of a believer in patient-reported pain scales, though others find them useful. Among my patients, they seem to make little difference in clinical treatment, at least with chronic pain. Patients have difficulty remembering how much they were hurting last week or last month compared to now.

The one situation where a pain scale may be useful is where short-term observation (hours to days) of a hurting patient is possible. Asking the patient to report pain on a scale of 0 to 10 may yield a measure of improvement, or lack thereof. In the current medical environment, pain scales are often more a matter of documentation than a meaningful addition to medical care. It makes little sense to collect the information if it is not going to be used as a basis for treatment. Patients must understand the scale well to offer significant feedback. Many patients will report their pain as 8 or 9 out of 10 when it is obvious from their behavior that it is not this intense. If you are going to use a pain scale, take the time to explain it thoroughly. It also helps to use words or pictures to demonstrate the degree of pain, as in the list* below. Check online if you want an example with pictures.

0 – No pain

2 – Annoying

4 – Uncomfortable

6 – Dreadful

8 – Horrible

10 – Agonizing

When doctors evaluate pain, one of the immediate goals is to determine if it is life-threatening or not. Is chest pain a heart attack? Is abdominal pain appendicitis? If you think you have an emergency on your hands and have the option of referring to a hospital or physician, please do so. But the goal of this discussion is to focus on what you can offer on your own, without emergency back-up. Here are a few examples to consider:

Up to this point, we haven’t mentioned pain relievers per se. Oxygen, positioning, and nitroglycerin may not only improve the underlying problem, but also relieve the patient’s discomfort to a degree. As for direct pain treatment, you probably won’t have injectable morphine available, but oral Vicodin, Percocet, or even tramadol may offer some relief. Nausea frequently accompanies severe heart pain, and you may need to treat with OTC meclizine or a prescription anti-emetic (Phenergan, Vistaril, Compazine) to allow the patient to keep narcotics down. Also, if the patient is agitated, calming him may decrease his oxygen consumption, thereby decreasing chest pain. Valium, Xanax, or Ativan (all controlled prescription drugs) may be helpful.
Say a patient is experiencing excruciating chest pain in association with a likely heart attack. What can you do about it? First, give the patient an aspirin, to thin the blood a little, and perhaps limit further damage. This will not alleviate the pain, but may do some good in the long run. If you have oxygen available, have the patient inhale it at a rate of 2–3 liters per minute (per the machine’s gauge). The pain of a heart attack is partly due to inadequate oxygen within the heart muscle, somewhat like leg pain in a runner, and improving oxygenation may lessen the discomfort. Assuming you don’t have oxygen available, have the patient lie in the bed with his upper body propped up on several pillows. This decreases the work of breathing compared to lying flat, with less demand on the cardiac muscle. Next, give nitro. Nitroglycerin lessens heart pain by opening up the coronary circulation, thus delivering more oxygen to the heart. Nitroglycerin sublingual (dissolved under the tongue) offers very quick but short-term relief; nitroglycerin paste, patches, or delayed release capsules offer longer-term relief, but are slower to take effect.

Medically speaking, this is about all you can do – but still it’s not all you can do. Hold the patient’s hand or rub their neck, if this seems to comfort them. Offer a cool washcloth if they are sweating. Allow a calm, supportive family member to assist you. Keep disturbing or anxious relatives out of the room. Offer to pray with the patient, if this seems appropriate. Offer fluids unless the patient is vomiting. Two reasons fluids are withheld in the hospital are that the patient is getting an I.V. anyway, and that a surgical procedure may be around the corner, with associated anesthesia and risk of vomiting. Your post-Armageddon patient is not going to undergo a heart bypass or stenting, and does not need to suffer dehydration on top of a heart attack. Be careful, though, if the patient is short of breath, as excess fluids may worsen a case of congestive heart failure.

Now, whatever you’ve done with the equipment at hand, don’t blame yourself if the patient dies. We are simply not in control of everything. You did not cause the patient’s heart attack and you’ve done what you can to help.

Your next patient is a 45-year-old woman, complaining of chest pain as well, but who doesn’t appear ill. Chest pain in a person under about 50 years of age is more likely related to the lungs, ribs, or digestion than to the heart. In an asthma patient, when the lungs are tight and the patient is short of breath or wheezing, opening the airways (with an inhaler or steroids) may do more to relieve pain than any pain reliever. If the patient is breathing normally but complains of pain on inspiration, this is usually pleurisy (inflammation of the lining of the lungs) or rib-cage pain. Either way, anti-inflammatory medicine such as ibuprofen, naproxen, or even aspirin is helpful. (Remember, though, that if you’re wrong and the pain is coming from the stomach, these drugs may aggravate the problem.) In our index case, there is definite tenderness when you palpate along the rib margins. The heart and lungs cause pain, not tenderness. If rib tenderness is present, you can be fairly confident the problem is musculoskeletal, that is, not serious, and again an anti-inflammatory should help relieve the discomfort. Heat or ice (and not wearing an underwire bra) often help as well.

Next in line is your 30-year-old nephew who works hard and parties harder. His chest is hurting, too, sort of burning, and you can see he’s hung-over. Home-brew will be available even in the worst of times. Chest pain due to acid reflux (often aggravated by alcohol or anti-inflammatory medications) requires a different approach altogether. Pain medication is not the answer. Decreasing the amount of stomach acid refluxing into the esophagus will alleviate this pain. Baking soda and liquid antacids offer almost immediate relief, which is a diagnostic test in itself. Any of the OTC antacid reducers (Pepcid, Tagamet, Zantac, Axid, Prilosec, Prevacid) will afford longer-term acid suppression. Since these medications will not be available forever, avoiding heartburn triggers is only sensible (NSAIDs, alcohol, tobacco, spicy food, fried or fatty food, citrus fruits, tomato products, chocolate, caffeine – yes, avoid all the good stuff).

At first your 40-year-old cousin thought the pain was in her right lung, but now it seems focused in the upper abdomen, toward the right. She’s pretty sure it came on after eating half a jar of peanut butter. The pain is dull to sharp, mostly aching, but with cramps coming in waves, with intermittent nausea. This type of pain is typical of gut pain, probably stemming from gallbladder irritation. With gut pain, narcotics may help, but NSAIDS (anti-inflammatory drugs) should be avoided. Sleep, relaxation, a hot bath, and abstaining from eating also offer partial relief. These same measures help individuals with colitis, kidney stones, kidney infection, diverticulitis, and other intra-abdominal irritations.

Very light massage is a technique that helps gut pain by distracting the mind from the deeper pain. This is part of the basis for the efficacy of effleurage, a TENS unit (transcutaneous electrical nerve stimulation unit), and even a hot shower. Just as an Internet connection can only carry so much information at once, the human nervous system can only process so much neural input at one time. The heat of a hot shower takes at least several minutes to penetrate sore muscles, but partial relief begins the moment the skin is stimulated. Laboring women sometimes massage their own bellies to lessen the deep pain. Anyone can experiment with this superficial massage technique, which works not only for gut pain, but other deep pains as well. Light oil massage works similarly.

Deep massage is best described and taught by a professional masseuse, which I am not. But even an untrained friend can give a good backrub that relieves the tensions of the day. I’ve had many patients obtain as much relief from a professional massage as from medication or physical therapy. The relief may be short-lived, and the massage may need to be repeated in a day or two, but this natural remedy is used worldwide for pain relief. In fact, in countries where there isn’t a drugstore on every corner, touch therapy is the primary mode of pain relief.

Doing anything at all is nearly always better than doing nothing. Placebos, which have no physical basis for helping, still do so about a third of the time. Hope is a natural narcotic, and people will try a multitude of peculiar and likely ineffective therapies on the basis of hope alone. This is also how so many crackpot therapies work their way into the health care field. Anything, even a sugar pill, will help somebody. Part of the benefit is mind over matter; part is giving your body time to heal on its own. Many patients who think an antibiotic cured them overnight were simply going to be better by the next day anyway. Applying cool cabbage leaves to tender, engorged breasts is purported to relieve the discomfort, but perhaps grape leaves, lettuce leaves, or a cool wash cloth would accomplish as much. Still, applying cabbage leaves lies in the realm of “doing no harm,” plus it gives the mother something active to do. People prefer to be in charge of their own bodies.

As a physician I struggle with the need to be honest with my patients versus the desire not to deprive them of the placebo effect. Modern medicine prides itself on “truth.” But for anyone who believes in a certain therapy, even one proven by medical science to be ineffective, for that individual the relief is real. After an Armageddon event, the placebo effect may be a doctor’s strongest ally. A placebo may be a pill, a procedure, an activity, or a dressing. Whatever you do, choose your placebos wisely and first, do no harm.

Natural remedies also include biologically active chemicals such as opium and salicin (from which aspirin is derived). Through the years, the pharmaceutical industry has developed many refinements, but these two are the original basis of all narcotics and anti-inflammatory medications, including codeine, morphine, hydrocodone, oxycodone, ibuprofen, and naproxen. When supplies of pharmaceutical pain relievers run out, healers will need to resort to the original, naturally-available painkillers.

White willow bark contains the natural pain-killer salicin. For a full discussion, see the University of Maryland Medical Center (UMM) website, which includes details of dosing, drug interactions, side-effects, and recipes for willow bark preparations made from commercially available supplies.[1] Of course, stockpiles of willow bark will run out as quickly as stockpiles of aspirin, and it makes more sense to learn to recognize the tree, and either locate it within your community or plant your own. Other types of willow may also be effective.

 

Willow Bark Tea Recipe (from UMM)

 

Boil 1–2 teaspoons of (commercially-available) dried

white willow bark in 8 ounces of water

Simmer 10–15 minutes and let steep for half an hour.

Drink one cup 3–4 times daily as needed.

Narcotics are the strongest pain relievers and will be the hardest for preppers to come by. Doctors are extremely unlikely to prescribe enough to stockpile and so, aside from learning to prepare your own, are there any alternatives?

Tramadol is a prescription painkiller, nearly as strong as codeine or hydrocodone, at least in the narcotic-naïve patient. People who get a “high” on narcotics are not fond of this drug. Whereas a few years ago it was quite expensive, now the cost is on a par with ibuprofen. Because it is less likely to be addicting, doctors are happy to use it more freely for many conditions ranging from headaches and stiff necks to sciatica and broken bones. If you have a good relationship with your doctor, you may be able to obtain a small supply, which you should plan on reserving for serious pain. The normal dose is 50–100 mg every 4 to 6 hours.  (Note: This paragraph was written in 2011, before the change in approach to pain medicine nationwide.  As of 2017 it is much less likely your doctor will give you even a small supply of tramadol unless you have a current need.)

Secondly, the combination of Tylenol plus an anti-inflammatory is nearly as strong as the narcotics hydrocodone or codeine, and in many patients, works as well or even better. As long as a patient can tolerate the ingredients separately, they are well-tolerated in combination. With 500-count bottles of Tylenol, ibuprofen, and naproxen sodium readily available over the counter at minimal cost, anyone can lay in a good supply for future use.

Of course, anti-inflammatories (NSAIDs) are not tolerated by every patient. Any NSAID may cause stomach discomfort or even an ulcer with prolonged use. They should always be taken with food to minimize contact with the stomach lining. Some patients are able to tolerate an NSAID if they take an acid-lowering drug (such as Pepcid, Zantac, Prilosec, or Prevacid). Allergies to NSAIDs are not uncommon, and sensitive individuals may develop hives or wheezing.

For musculoskeletal pain (strains, sprains, fractures, injuries), the NSAIDs, narcotics, and Tylenol are useful, but again, don’t limit yourself to thinking of pills as the only way to alleviate pain. Rest, ice (or heat), splinting, wrapping, and taping are all measures that decrease pain by lessening the stress on the affected body part.

Again, the main point is to get beyond thinking that pain pills are the answer to pain. Yes, they have their place, when the pain is disabling and nothing else works. But overall, especially with the supply of narcotics severely limited, do what you can to avoid them, and save the “big guns” for situations that truly warrant their use.

Checklist – items to include in your medical supplies:

Tylenol and OTC NSAIDs – ibuprofen, naproxen sodium, and aspirin
Prescription tramadol, narcotics, muscle relaxers, sleep aids, antidepressants, beta-blockers, calcium channel blockers
Oxygen tank or concentrator; extra tubing
Hot water bottle or reheatable rice bag
Athletic tape; Coban; elastic wraps; ankle, wrist, finger, and hand splints; slings
OTC Prilosec, Prevacid, Pepcid, Zantac (or generics); liquid Maalox; baking soda
Oil of clove for dental (nerve) pain
Actions to take:
Learn about using willow bark at the University of Maryland Medical Center Web site (at http://www.umm.edu/altmed/articles/willow-bark-000281.htm); also, locate a local source of willow bark or plant your own trees.
Study up on massage and effleurage techniques
Download a pain scale you find useful

[1] University of Maryland Medical Center: http://www.umm.edu/altmed/articles/willow-bark-000281.htm

*originally  written as “table below”.

My disaster preparedness secret weapon: Hydrogen Peroxide

hydrogen peroxide

BY ALEX HOLLINGS

When putting together a disaster plan, it’s important to prioritize human needs in the way that you prepare.  To put together a solid short-term survival plan, you need only to address the most basic of human necessities: water, shelter, food, and security, but as short-term survival transitions into “well I guess this is what’s left of the world now,” it’s important to have a plan in place that can help you get by a bit longer than just the first few days after a disaster.

While ensuring you have adequate food and water will prevent death from hunger or dehydration, it’s important to remember that those are often the very easiest forms of death to avoid.  We worry about supply lines drying up after the collapse of our infrastructure for good reason, but humans have been surviving without grocery stores and running faucets for millennia… what tends to kill us in such situations often isn’t a lack of food, but rather a lack of hygiene.

Enter my favorite survival item: hydrogen peroxide.  Most of us are familiar with the brown bottle of bubbling goodness from our childhoods, when our mothers would pour a bit of the elixir onto our scraped knees to disinfect it before armoring the wound with a Batman band-aid and providing an emergency booboo-kiss for pain relief.  While wound care is certainly one of the things hydrogen peroxide is good to have around for, it’s far from the only thing.

In order to discuss some of the other important uses for the magic brown bottle, I’m going to have to delve into some of the health issues that may impact a person in an extended survival scenario; some of which are likely to sound gross, but it’s important to plan for potential health hazards other than gunshot wounds and zombie bites, because dying of an infection all by yourself will leave you just as dead as the sexier alternatives we see on TV.

Hydrogen Peroxide for Mouth Care

I’m not normally one to close my eyes during a rough scene in a movie – but watching Tom Hanks remove an infected tooth with an ice skate in “Cast Away” was tough for me.  I don’t like going to the dentist, let alone the idea of serving as my own using bits of trash I found on a beach, but I have to credit the movie for including an element of survival that is often ignored in movies and television: dental hygiene.

An infected tooth is a serious issue.  If left unchecked, and infection can spread throughout your body, possibly even killing you without antibiotic treatment.  Beyond that, an infected tooth can make eating an excruciating endeavor and can serve as a serious distraction when you need to keep your wits about you.  If at all possible, one should avoid having to do their own oral surgery, and hydrogen peroxide can help.

That same brown bottle you use on cuts and scrapes is also a FDA approved mouth wash.  Pouring a mix of hydrogen peroxide and water into your mouth and swishing it around once in a while may not give you the same fresh breath you’d get from a tooth-brush and a new tube of Crest Whitening, but it could keep the bacteria in your mouth from going rogue and rotting you from the inside out.  Keeping your teeth intact will keep you eating, and hydrogen peroxide can help stave off infections and even cavities.

Hydrogen Peroxide to Fight Fungus

Athlete’s foot and other fungal infections of the hands and feet can be serious trouble for the long-term survivor.  The reduction in available means of hygiene that may come after a disaster could leave you more vulnerable to this sort of ailment, and yet again, hydrogen peroxide can help kill the fungus causing itching and burning on your extremities.

Perhaps more important though, is hydrogen peroxide’s ability to combat yeast infections.  While we tend to think of such things as a uniquely female issue, and in today’s world, we even see it as more of an inconvenience than a matter of life and death, developing a yeast infection in a survival setting is bad news and must be addressed.

Hydrogen Peroxide is safe to be used as a douche for women suffering from a yeast infection after the stores have long stopped stocking Monistat, and can be used externally for men suffering from the same ailment.  Didn’t know men could get yeast infections?  They absolutely can – and the resulting itching, burning and open sores could lead to any number of further infections, or simply leave you too distracted to handle your day-to-day survival needs with the level of focus they require.  Hydrogen peroxide will not work as well as traditional anti-fungal medications, but as a multi-use tool, it’s good to know that you can keep the swamp-rot off your fingers and toes as well as out of your underoos with the same bottle you keep around for wound care and oral hygiene.  I’d just recommend cleaning the spout before switching between uses (just kidding, do not put the spout inside any part of you, use a different means of application).

Hydrogen Peroxide for Cleaning (everything)

If you wear contact lenses, hydrogen peroxide and water can be used to clean them between uses – extending the life of your contacts and possibly your ability to see if you don’t have access to your glasses.  It can also be used to clean food containers and utensils, water carriers, or even cooking surfaces to kill things like salmonella.

You can also use a mixture of hydrogen peroxide and water to clean and disinfect your clothes.  A clean pair of undies may not sound like the most important thing after the end of the world, but remember, we haven’t evolved to prefer the smell and touch of clean things for no reason.  Cleaning your clothes will help prevent skin irritations and even infections.  In fact, using hydrogen peroxide to clean your underwear could prevent you from having to using hydrogen peroxide to treat a yeast infection in the first place.

Hydrogen Peroxide for Farming

In a long-term survival situation, cultivating your own food may be a necessity, but if you weren’t blessed with a green thumb, you’ll likely need all the help you can get in order to turn your little garden into something that’ll feed your family.  Believe it or not, hydrogen peroxide can also help you start to grow your own food.

Adding a small bit of hydrogen peroxide to the water you pour on your plants can help fertilize the soil, prevent mold and mildew from developing, and even help an ailing plant regain its health.  Soaking seeds in water that contains a small amount of hydrogen peroxide will even make them germinate faster.  It’s important to use the correct amount of hydrogen peroxide however, otherwise it could kill your plants before they have a chance to grow.  Check out this chart to help you determine how much peroxide you should mix with water for various agricultural needs.

These handy uses for the old brown bottle in your medicine cabinet are far from all of the ways hydrogen peroxide can benefit a disaster victim attempting to transition from short-term to long-term survival.  I highly recommend doing some research and attempting to use hydrogen peroxide for things like oral hygiene once or twice before the world comes crashing down on you.

And maybe grab an extra bottle or two of the stuff the next time you go shopping.  Just in case.

ABOUT THE AUTHOR

Alex Hollings served as an active duty Marine for six and a half years before being medically retired from service. As an athlete, Hollings has raced exotic cars, played Marine Corps football and college rugby, fought in cages, and even wrestled alligators. As a scholar, he has earned a master’s degree in Communications from Southern New Hampshire University, as well as undergraduate degrees in Corporate and Organizational Communications and Business Management.

Check out these Water Bricks!

When You Know the Storm is Coming.

iStock_stormseason

We know there are all kinds of great lists out there, especially pertaining to emergency preparedness.  We love this one by blogger, Mike Smith, and wanted to share …

Get them done immediately!

  • Get prescriptions refilled now, especially if your doctor must approve the refill.
  • If you have a relative at home that requires electricity for life-assistance purposes, you will want to move he or she outside of the higher wind zone.
  • If you can get an electrician to install a generator, get it done. Do not try to install a generator yourself. 
  • If you don’t have a generator, get a power inverter or two. Radio Shack and similar stores sell them. They are a “poor man’s generator” and will keep your cell phone, laptop, and similar items charged. Tell the person in the store what you want to run off it so you get one of the right size. Do not try to run the inverter for hours at a time as that is tough on your car’s battery. Charge the cell phone (for example) and let the charge run all the way down, then use the inverter to recharge.
  • Keep your car’s gas tank full.
  • If you live in a 250-year flood plain (you can check at city hall or your library) or on the coast figure out your evacuation strategy now. Make your list of things you will take with you. Be prepared to leave at short notice.
  • Bring in outdoor furniture and other items that could become airborne.
  • Fill a few gas cans (the type you would use for your mower) to have extra in the event of power failures.
  • Purchase extra food staples. Without power, stores will be closed. Things that require less preparation are better. Bottled water is especially important. Get a Coleman stove.
  • Purchase extra batteries for your cell phone and other essential equipment.
  • If you need insulin or other medicine that must be kept chilled make plans now.
  • Consider what you would do if you were without electricity for a two weeks. If you have an invalid living with you that requires electricity, there will be areas that will be without for weeks. Be proactive.
  • If you live in a heavily wooded area, does someone in your vicinity have a gasoline-powered chain saw? Does it have fuel and a reasonably good chain/blade? Test it, now.
  • Get to an ATM. Without power, credit card readers and ATMs will not be working. In a disaster, cash is king.
  • If you are in the high wind or flood area, thoroughly photograph your home and possessions now. You will need it for insurance purposes. This includes trees, shrubs, etc. Then, if using a digital camera, upload to internet so it will be there after the storm in case the worse happens. Be nice to insurance adjusters!

Whether you evacuate or not, stockpile some good books, magazines, board games and keep a good attitude. Look at this as one of life’s adventures.

There is nothing wrong with a few prayers!

(found on http://www.mikesmithenterprisesblog.com/ )

8 Ways to Appear that You are Home when You’re Away.

IMG_0988

Before you head out of town or to visit relatives, you may want to take some security precautions to keep your home safe – even if you have a security system.  Many home intrusions are considered crimes of convenience.  If a criminal thinks your home looks like an easy target, you might get a rude awakening when you return.  Enjoy peace of mind with these tips to make your home look occupied while you’re away:

  1. Ask a neighbor to help.  If you have a neighbor you can trust, work out a buddy system when one household is away.  Ask your neighbor to check your mail, water your plants, and check locks.  Criminals often look at mailboxes to determine whether a homeowner has been by the house recently.
  2. Turn on the radio. You may use satellite radio, your phone, or your television when you’re home, but a simple old-fashioned radio will do the trick when you’re gone.  Turn on a talk radio station loud enough that voices can be heard from outside the home.
  3. Keep a light on. Invest in some motion sensor lights outside and/or some timed interior lights that are scheduled to come on for a few hours at night.  Intruders prefer dark, empty-looking homes to target and can’t tell the difference between you turning on a light and a strategically placed timer.
  4. Check the phones. If you still receive calls through a landline, consider diverting calls to your cellphone or setting the ring on the lowest volume possible.  Phones ringing off the hook are a pretty good indicator that nobody is home.
  5. Reorganize your household schedule. You may think about your home’s cleaning service or landscaping schedule before you leave.  Do not leave a message on the front door.  Arrange for services beforehand or keep important numbers in your cell for a quick call on-the-go.
  6. Avoid posting on social media. Wait until you are home from vacation to post those great beach pictures or to detail the highlights of your adventures.  Unfortunately, many potential intruders could be people in your own network, and giving them updates about your whereabouts could be a go-ahead to ransack your home for valuables.
  7. Be wary of notifying the police. At one time, many experts recommended telling your local police department if you are away.  Today, it’s far too easy for the information you pass along to be stolen or hacked.  Only talk to police if you trust that your information will be secure.
  8. Invest in a modern alarm system. Today, home security systems are designed to keep up with the latest trends in home intrusion.  With some, you can even keep an eye on your home while you’re away through a secure, mobile portal.

 

(Original article found on allsecured.net)