Post SHTF: Making Medical Decisions, Part 2 by JUDY
(Dr. Bones says: This is part 2 of an erudite submission by aspiring preparedness writer Judy about making tough medical decisions in a survival situation. Here she discusses food and water borne illness, influenza, deciding when to seek hospital care in precarious scenarios, and more.) Be sure to read part one as well.
Instituting the best home treatment you have available to treat symptoms:
Treat the symptoms. In vomiting or diarrhea, try to prevent dehydration. Oral fluid and electrolyte replacement is important, especially for the very young and the very old. Gatorade or other sports drinks can be given to adults for electrolyte replacement, but Pedialyte is better for infants and young children. If you don’t have Pedialyte or other brands, you can make a homemade substitute.
HOMEMADE ORAL REHYDRATION SOLUTION
1 liter water , boiled
8 teaspoons sugar
1 teaspoon salt
(Dr. Bones says: you could also consider adding 1/2 teaspoon of salt substitute (Potassium chloride) and a pinch of baking soda (Sodium Bicarbonate) to make an even more complete rehydration fluid)
1. Boil the water and let cool.
2. Stir in sugar and salt while the water is still warm, for better dissolving.
3. Add any desired flavourings.
The BRAT diet (Bananas, Rice, Applesauce, Toast), helps to manage electrolyte loss by adding potassium to the diet. Fruit juices should not be drunk while diarrhea is present, except for orange juice. Orange juice does not worsen diarrhea like most juices, and helps replace potassium. Do not use Pepto Bismol for children or for pregnant women. It has an ingredient that is related to aspirin, and can cause a risk of Reyes Syndrome in children, a possibly fatal condition. For the same reason, aspirin is never to be given to children who have fever. Pregnant women should not be given aspirin due to the risk of bleeding disorder. Emetrol, a syrup given for vomiting, contains concentrated glucose and phosporic acid. If you don’t have Emetrol, you can give teaspoons of heavy syrup from canned peaches. (I learned this from my father in law, who said this was given to the soldiers who got seasick on board ship enroute to Korea).
(Dr. Bones says: Reye’s syndrome is a rare illness that can be life-threatening and causes damage to the liver and brain. It occurs in children with viral infection such as colds and flus. It is almost always seen after a child is given aspirin to treat viral fevers.)
If vomiting is severe, give the rehydrating liquid a spoonful at a time, rather than drinking several ounces at once. The fluid and electrolytes begin absorbing from the moment they hit the tongue, and fluid is rapidly absorbed in the stomach, so if the fluid is kept down for even a few minutes, some will be absorbed. Be patient and persistent. Imodium can be given for diarrhea, used according to the package directions regarding dosage for age group.
Flu symptoms can be treated with the usual over the counter medications for the symptoms. This includes the most recent pandemic H1N1 flu. An antiviral can be given within 48 hours from first onset of symptoms and may help reduce the severity and length of the illness. This information is from the CDC, in reference to pandemic flu:
“Not everyone with flu in the general population needs to get antiviral medicines. Flu antiviral medicines should be used mostly to treat people with the flu who have a condition that increases their chances for serious problems from flu, such as pregnant women and women who have given birth or lost a pregnancy in the past two weeks. These medicines are also used to treat people with flu who have more severe flu illness or who are in the hospital.”
(Dr. Bones says: antiviral drugs like Tamiflu are most effective if used in the first 2 days of symptoms; after that, they have little effect. Caregivers may consider a half dosage when first exposed, as it may have some preventative value.)
Because most people with flu are able to recover with home treatment, and since the antiviral is not always helpful (immunity to the antivirals is developing), it is probably not going to be worth the risk to travel during an extreme emergency. If a person becomes severely ill, the risk benefit/ratio changes. The worst cases of flu may require ventilator support due to lung failure. In the worst case scenario of a powerful pandemic flu, it is expected that the need for ventilators will far surpass the availability. CDC and the government have reserves of antivirals and ventilators to move to areas as needed, but this is projected not to be enough for all those who need it. This is another instance where communication is vital; there is no need to risk a trip to get to a hospital that has no available ventilators.
Re-assess the situation (degree of illness/risk of transfer to hospital) on an ongoing basis:
An information network is vital, here, to be kept informed of the availability of medical care, and the safest route of travel. Give thought to contingencies that may come up. If it becomes a matter of life and death to get someone to the hospital, how do you accomplish this? How many adults are available to go with you, and who will remain behind to care for the other family members? Is it just you and one other adult and several children? If your assessment of the situation is that travel is risky, you may decide that it is too risky to take the small children along and one of you must remain behind.
Your family may be separated for quite some time. If you don’t have a means to communicate while you are apart, there is going to be a great deal of worry and stress. Will you take the injured/ill person to the hospital, get them checked in, and leave them there? In that case you could be coming back fairly quickly. If you need to remain with the person at the hospital, or if travel is too hazardous to attempt the return trip, will you have the means to let your partner know? Will your partner be able to keep home and family safe while you are gone? If you are part of a larger group, travel and home security may become much safer, due to the additional manpower (and woman power!).
What can you do when you can’t do any more?
If you do not have the means to get your family member to help, what is the fallback plan? What comfort measures can you give to reduce pain and allay fear? It may become evident that there is no chance of getting help. In this case, medical treatment regresses by two hundred years. It may end up that you have nothing else available except prayer and compassion. Just as you prepare for the food, shelter, and protection needs of your family, you should recognize that spirituality is a human need also. Everyone should do soul searching on a frequent basis. Find your best understanding of the world, and your place in it, and what your beliefs are regarding what lies beyond. When it reaches the point that you have nothing else to give a dying man or woman, you give them the comfort of your faith. It is not necessary to share the same religious beliefs. More important is acceptance that circumstances have brought you together, and yours is the hand that holds theirs as they let go.
In our modern culture, we have become very distanced from the process of birth and death. We take our sick to a hospital, our dying to a hospice, and our dead to a funeral home. We treat our health care system much like a grocery store; we depend on it to provide the things we no longer produce for ourselves. And while we can develop more independence in growing or producing the food and services we will need if TEOTWAWKI happens, we are not going to have access to a fraction of the services of the modern medical system.
A century or so ago, we would have cared for our family member at home to the best of our abilities; in the absence of complex medical treatments, we would have relied on the comfort of having loved ones constantly near by. Usually, a minister would be there to give spiritual comfort; neighbors helped by bringing meals and helping with chores. When a person died, they were bathed by their family, dressed in clean clothes. A coffin would have been built, and burial usually took place in a family plot, within 24 hours of death. Grieving was expected, and encouraged. Openly showing grief was accepted, and the community was a vital asset to the bereaved. Death comes to everyone, and neighbors offered help, knowing that they would also be receiving support in turn.
Our preparing focuses on life after TEOTWAWKI, and that is necessary. It is also necessary to reflect upon death, and to plan so that we will be prepared to give and receive the support our family and community needs when all else has been done.