(This article first appeared in American Survival Guide, a great magazine for backcountry, short-term, or long-term survival. Each issue is so packed with great information, I can’t bear to let go of them!)
After water, food, and shelter, many consider personal defense to be the most important priority in a long-term disaster. They’ve got the beans and bullets, but what many of these rugged survivalists don’t realize, however, is this: You can have all the beans and bullets there are, but it won’t mean a hill of beans, and you’ll just shoot yourself in the foot, unless you have the bandages.
Few in your group will be accustomed to performing activities of daily survival like, say, chopping wood for fuel. This fact will lead to injuries, burns, infections, and other medical issues that must be treated. Someone, therefore, has to assume the role of survival medic. This person might have to be you, an average citizen with little formal medical training. In a circumstance where the ambulance is no longer just around the corner, you may be the only medical asset left to your family or group.
When you become the end of the line, medically, for your people, how can you be certain that you’ll be an effective caregiver? This is a question that I’m often asked as I travel the country speaking on disaster medical preparedness. The success of the survival medic depends on the accumulation of three things: knowledge, training, and supplies. These can be obtained, over time, with effort and dedication.
One thing that isn’t easy for an inexperienced medic to obtain is the ability to avoid feeling squeamish at the sight of blood. A response similar to the “fight or flight” mechanism, it’s a natural fear reaction that causes blood vessels to dilate, blood pressure to drop, and slowing of the heartbeat, all leading to lightheadedness and nausea.
Of course, repeated exposure to blood is one way to become accustomed to it. One medical center director says that his students learn to compartmentalize fear reactions by repeating words or numbers in their head, rocking side to side, tensing and relaxing leg muscles, or even drinking a sugary caffeinated beverage to raise blood pressure, stay hydrated, and avoid low glucose levels (called “hypoglycemia”) that make them feel faint.
(As an aside, coffee is commonly thought to be dehydrating, but it doesn’t cause you to lose more fluids than you ingest in the drink.)
The designated medic must assume a number of roles besides that of chief medical officer. These include sanitation supervisor, dental technician, medical quartermaster, counselor, and archivist.
As sanitation supervisor, it is your duty to ensure that water is purified, food is prepared properly, and human waste is disposed of appropriately. Failure to, for example, construct an effective latrine could cause infectious disease to run rampant among your people.
If you are worried about a week without power due to a storm, you won’t have to deal with a lot of dental issues. In long-term survival, however, people start having dental issues like broken teeth, abscesses, and toothache that threaten their work efficiency, if not their life. Dental supplies become as important as medical supplies in this scenario.
Let’s say you’ve prepared and have a lot of medical supplies. Who determines when these precious items, many of which will be scarce after a disaster, are dispensed? Who gets the last course of antibiotics? That decision must be clearly defined as yours to make.
In the aftermath of a life-changing catastrophe, anxiety and depression will be more likely to be daily issues than gunfights at the OK corral (I hope). You must be a calm, understanding, confidential presence to keep your people focused on staying alive and productive.
Finally, you must be the archivist for the group. It’s your job to know the history of those for whom you are medically responsible: their illnesses, medications taken, past hospitalizations, allergies, and more. If you anticipate the likely problems you will confront as medic, you can stockpile supplies accordingly.
Speaking of supplies, you will need more than you have currently. How can I know this, not having seen your kit? Because you will responsible for more people that you think. You may be preparing to care for the number of people in your mutual assistance group, but be certain that they will bring relatives or that you will find additional survivors that have skills that would increase your chances for survival. These folks may be useful but will cause additional strain on your medical resources.
Lack of enough supplies for the number of people in your group is the biggest mistake made by the survival medic. You can never have enough; any extras would be valuable barter items. Be wary of kits that claim to be sufficient for 25 or 50 people, as they are often advertised: Just one major hemorrhage can take up the entirety of the bandages in these products. If you doubt this, empty a liter or two of fluid onto the floor and see how many bandages are needed to absorb it.
Although I suggest that medical supplies may be useful for barter purposes, I believe it is best to conserve them while freely offering to help all who are in need of medical help. Once it is known that you have skills, supplies, and a willingness to help, you’ll become so valuable to others in your community that they will expend resources to protect you.
Another mistake made by the medic is preparing for traumatic injuries while ignoring the lesser issues that can affect work efficiency. Toothaches, foot fungus, and hemorrhoids are just some of the problems that can plague group members and make them less productive.
Still another is the failure of the medic to know what plants and other natural substances in their area might have medicinal benefits. Aloe plants can be helpful for burn care. The green underbark of willow trees and others contain Salicin, the original ingredient in the first aspirins. Eventually, commercial products will be expended; it’s important to learn what’s in your own backyard that can help you keep your people healthy. Use all the tools in the medical woodshed.
It’s important to realize that, as the survival medic, you may not have the luxury of stabilization and evacuation to modern medical facilities. That means that you are responsible for wound care and infectious illness from beginning to end, something even experienced paramedics may not be ready to handle. You must enter the mindset that you are the highest medical resource left, and must deal with issues without the hope of transport for the foreseeable future. It’s important to set up a reasonable sick room or hospital tent to care for your patients.
What medical conditions will the medic be most likely to confront in long-term survival? Here are some you can expect:
Minor Musculoskeletal injuries (sprains and strains)
Minor trauma (lacerations, abrasions, etc.)
Major traumatic injury (fractures, occasional knife and/or gunshot wounds)
Respiratory infections (pneumonia, bronchitis, influenza, common colds)
Diarrheal disease (sometimes a community-wide outbreak)
Minor infections (for example, urinary infections, “pinkeye”)
Lice, Ticks, Mosquitoes, and the diseases they carry
Minor (bees, bed bugs, or other insect bites and stings)
Major (anaphylactic shock)
Broken or knocked-out teeth
Loose crowns or other dental work
Pregnancy and delivery
Your environment will also factor into your effectiveness as a medic. At various times of the year, issues such as heat stroke or exhaustion, hypothermia, and dehydration may be encountered. If you don’t take into account the environment, you have made it your enemy, and it’s a formidable one.
All of the issues I mention here can quickly take up everything you have stored to help you function as the medic. Therefore, it just makes common sense to consider preventative measures to avoid headaches and, perhaps, heartaches. An ounce of prevention is worth a pound of cure, and that old saying is never more true than in survival.
It’s important to enforce the use of protective gloves, boots, and eyewear in any situation where injuries might occur. Clothes should be appropriate for the climate at your location. You might not consider these items to be medical supplies, but they can prevent a lot of problems that will take up your time and resources.
Personnel that carry firearms and knives must be trained in their safe use. Prevention extends not only to injuries, but also to infectious disease. When you suspect a group member of being ill, you must make sure that they are isolated from those that are healthy. These concepts may seem obvious to you, but you’ll be surprised (unpleasantly) at how many will forget to take precautions to avoid injuries and infection.
There is one last essential characteristic of the successful survival medic: a strong instinct for self-preservation. Although you might want to rush to the aid of the sick and injured, even in the face of hostile fire, you must realize that you are an indispensable asset to your group. If you frequently place yourself in harm’s way, you will eventually find yourself as the patient more often than you or anyone else would like. Always determine first if you can care for a victim without placing yourself at undue risk. You must abolish all threats; if someone has a gunshot wound, it stands to reason that there’s a guy with a gun out there. Don’t become the next casualty.
The Survival Library
For more resources on becoming an effective caregiver, consider these books for your survival library:
The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way: Now in its 700 page third edition, our book covers 150 different medical issues that you might face after a disaster eliminates the option of modern medical care. Includes lists of recommended medical supplies and a guide to veterinary antibiotics in post-disaster settings.
(As an aside, The Survival Medicine Handbook’s Third Edition won the medical category of the 2017 Book Excellence Awards)
The Physician’s Desk Reference (Amazon Link): No longer available in print form, this guide to drugs, their uses, dosages, and side effects is still around on Ebay and elsewhere. Includes pictures of individual drugs to help identify unknown meds. Find an edition that’s a year or two old for your survival library.
This is, by no means, a complete list of every book that might be useful in survival situations, but it’s a good start.
DISCLAIMER: Be aware that, where there is an existing modern medical system, the practice of medicine or dentistry without a license is illegal and punishable by law. If modern medical professionals and facilities exist, seek them out.