Stay-awake medication in FAK

Posted by: nursemike

Stay-awake medication in FAK - 07/20/08 04:47 PM

Background: years ago, I purchased a home from an ex-merchant mariner. In the cellar, I found an issue first aid kit, presumably dating to 40’s or 50’s. It was one of those charming, obsessive-compulsive items with each module of the kit contained in a 14small cardboard box with instructions on the outside. Merthiloate, tourniquet, triangular bandage .Each box was identical in size, and the container itself was fairly heavy steel with a rubber gasket and 4 locking clamps. A hell of a FAK, in all. The only empty box was the one that had contained the amphetamine sulfate tablets. This was the traditional military stay-awake tablet, until provigil came along and kept folks awake without annoying side effects like paranoia and hallucinations, which might be problematic when the folks experiencing them have cannons and shaped charges at their disposal. Apparently the kit designers were worried that the seamen might sleep through the crisis. Question: Do you include in your kit any kind of stimulant drug, like caffeine or amphetamines, other than that contained in coffee, chocolate, or caffeine-enhanced snickers bars (available, god help us, at Costco)?
Posted by: wildman800

Re: Stay-awake medication in FAK - 07/20/08 05:12 PM

Sorry, just coffee, (dark) chocolate, & Snickers/Baby Ruth addict here. If that doesn't keep me awake, then it's past time for me to have found/made a burrow and stretch out.

I'm not in it for the love of God and Country anymore.
Posted by: Anonymous

Re: Stay-awake medication in FAK - 07/20/08 05:31 PM

TEA is my addiction. But I agree, with the dark choc. too. But no I don't personally ever rely on anytype of stimulant, simply due to the crash and burn effects later.

Posted by: CDVXF7

Re: Stay-awake medication in FAK - 07/20/08 05:35 PM

I pack No Doz or similar in my BOB's FAK's. I'm considering Jelly Belly Brand Extreme Sport Beans. Gotta compare the shelf life of the two. I like longer shelf lives for consumables. Less maintenance. Now that I think about it, the jelly beans may not hold up in the high heat of a trunk.
Posted by: climberslacker

Re: Stay-awake medication in FAK - 07/20/08 06:43 PM

in 98.6degrees, the art of keeping your @$$ alive, the author recomends a mixture of pills that he calls Uncle peppys power stack

basicly what it does is keep you awake and up when your about to die but still need to keep moving... he warns about using it casually however

but here is the recipie

two sudafed (a nasal decongestent)
one vivarian (caffiene pill)

for smaller people and females

two sudefed
1/2 of a vivarian tablet

*I have never tried this!!! I in no way advocate the abuse of any drug. Consider the preceeding information, if you choose to use it, as it is intended, as one more tool to keep you alive*

for more info on this just read the book,

98.6 degrees the art of keeping you @$$ alive by Cody Lundin

(I am in no way affiliated with the author or the publisher of this book)
Posted by: Blast

Re: Stay-awake medication in FAK - 07/20/08 07:15 PM

Quote:
caffeine-enhanced snickers bars (


WHY DIDN'T ANYONE TELL ME ABOUT THESE?!!

I always keep a package of caffeinated gum with me, especially if I'm on the road. I sense this is about to change...

-Blast
Posted by: wildman800

Re: Stay-awake medication in FAK - 07/20/08 07:26 PM

I don't know about the caffeine other than what's in the chocolate but the sugar and nuts give you a boost.

Remember that the caffeine in coffee is only useful as long as you're putting energy into your body as well.
Posted by: nursemike

Re: Stay-awake medication in FAK - 07/20/08 08:30 PM

Blast, i thought your life was so exciting that you did not need caffeine!

working in a rural er, we had 3 LEO's in 3 hours in with dog bites. turned out that the local cow college had a K9 certifier, and these guys were doing he practical part of the exam, trading off being the bad guy subdued by the dogs. I asked about the big brown protective suits for dog training. response: we can't get the real bad guys to wear the big brown suits, so we train the dogs on volunteers in jeans and shirts with soccer pads under the clothingdog sometimes don't bite where the pads are. so one of the leos wised me up to Water Joe, a still caffeinated water product. He said they made their coffee with it, and it made their teeth vibrate.
Posted by: Anonymous

Re: Stay-awake medication in FAK - 07/20/08 08:32 PM

Tea has been proven to release caffeine into your system more slowly than coffee. I tested the claim out of pure need when I was a college student trying to work on 2 hours of sleep a night and tea was the best. Coffee wore out too quickly and Cola (even stuff like Jolt) just put me to sleep after a few hours...not good when that time line leaves you asleep in Calculus class. Even drinking lots of water was better than Coke...especially in the mornings.
Posted by: dweste

Re: Stay-awake medication in FAK - 07/20/08 10:09 PM

What first aid purpose is served by a stay-awake stimulus? Dosage, etc.?

I can see a use for such in a BOB / PSK; but not for EDC unless your job is somehow consciousness-challenging.

In the interests of full disclosure my current stimulants of choice are Diet Pepsi and regular tea. Fear has worked well a few times, also.

Posted by: climberslacker

Re: Stay-awake medication in FAK - 07/20/08 10:31 PM

Yeah, adrenaline is pretty good at keeping you awake smile
Posted by: samhain

Re: Stay-awake medication in FAK - 07/20/08 11:34 PM

I don't have anything to keep me awake.

I figure if my body's telling me it's tired I'm better off listening to it. Even if it is short naps. In a crisis I need all 4 cylinders (i.e brain cells) running as well as possible.

Sleep deprivation has it's costs that could affect someone's survival in decreased reaction time/judgment/ etc.

I remember vaguely some studies out regarding residents and the number of medical errors that are made when they pull very long shifts without sufficient rest.

Posted by: Grouch

Re: Stay-awake medication in FAK - 07/20/08 11:56 PM

Originally Posted By: dweste
What first aid purpose is served by a stay-awake stimulus?

Perhaps to keep a concussion victim awake? Isn't it bad for them to go to sleep?
Posted by: dweste

Re: Stay-awake medication in FAK - 07/21/08 12:02 AM

Is the ammonia or whatever capsules you break and hold under their nose for that? If they are unconscious how do you administer internal stimuli like the one's discussed here?

So far I think the thread is focused on keeping yourself awake.
Posted by: nursemike

Re: Stay-awake medication in FAK - 07/21/08 12:40 AM

Stimulants are a bad idea. A very, very popular bad idea. But there is some convincing research that indicates that caffeine improves performance in some athletic events.9http://www.intelihealth.com/IH/ihtIH/%20WSSAN008/35320/35322/384533.html?d=dmtHMSContent)
der to improve our performance. Why not add caffeine?
Posted by: nursemike

Re: Stay-awake medication in FAK - 07/21/08 12:50 AM

The ammonia inhalants are a noxious stimulus that is used, if at all, to sort out the folks who are feigning from those who are fainting. Fun for torturing colleagues,perking up malingerers, annoying the bosses. Medically useless, though, as suggested earlier, amusing as heck.

We wake up concussion victims to make sure that we can. Sleep is good, coma is bad. Declining level of consciousness is the earliest sign of serious closed head injury, and indicates a need for, probably, opening the skull and relieving the pressure. AMK does not currently manufacture an FAK equipped for craniotomy, but it's only a matter of time.
Posted by: Anonymous

Re: Stay-awake medication in FAK - 07/21/08 01:04 AM

My body can keep me awake via naturally produced chemicals if need be (such as adrenaline and dopamine). I do not train my body to rely on an introduced stimulant of any kind.
Proper nutrition, exercise, skills practice to increase efficiency, perceptual and mental acuity training, activity compatibilty management and time management, rest at appropriate times, and good attitude, are for the most part, all that is needed.
You don't need a pill. You are a dynamic being with inherent systems and subsystems galore.
Don't believe the hype about stimulants. They act disharmoniously in the human body. There are addictive. But, I think that if I was addicted to caffeine already, I would only drink small amounts of white tea, which has less caffeine than green or black.
Aside, tea also has flourine in it, and the general consensus concerning it is "No".
Posted by: Ranter

Re: Stay-awake medication in FAK - 07/21/08 01:05 AM

My friends serving in the middle east use the infamous little bottle of tabasco from an M.R.E... Just a little drop in one eye and your NOT going to fall asleep on the night watch. (Hint, don't put it in your "strong" IE: aiming firearms eye)
Posted by: red

Re: Stay-awake medication in FAK - 07/21/08 01:07 AM

Originally Posted By: wildman800
Remember that the caffeine in coffee is only useful as long as you're putting energy into your body as well.


I didn't know this. (I'm not a coffee drinker) Care to elaborate?
Posted by: KG2V

Re: Stay-awake medication in FAK - 07/21/08 01:22 AM

Yeah - caffeine, or any stimulant works a HECK of a lot better with fuel to burn - and "long term" stores (aka your body fat) doesn't really cut it - basically you need to ingest either some carbs, or sugars (or a mix of both) to give the caffeine to work with. So have a slice of bread, or a Clif Bar, or just dump a bunch of sugar and milk in your coffee

I've actually thought of asking my MD to wirte me a scipt for some provigil. I actually have real sleep issues that can actually make me droze off at times, sometimes while doing important tasks
Posted by: red

Re: Stay-awake medication in FAK - 07/21/08 01:30 AM

Hmmm, so caffeine without carbs doesn't work as a stimulant?
Posted by: ironraven

Re: Stay-awake medication in FAK - 07/21/08 01:37 AM

I agree with cutting caffeine out, mostly, for daily use. But we aren't talking about daily use here. I keep a small quantity of it, and psuedoephadrine, in my gear for times where I need mental clarity and energy for just an another hour or two. I understand, and accept, the potential short term risks. But adrenaline doesn't always last long enough, your body will only make so much before it stops. Then you crash.

Caffeine works if you don't overuse it. But just like an analgesic, antipyretic, antibiotic, or heavy duty pain meds, if you use it when you need it, it helps you. Saying "my body can keep me awake" is like saying "my body can keep me healthy" and completely ignoring the value of vaccines. We have technology. Those who abuse it are no greater fools than those who ignore it.
Posted by: red

Re: Stay-awake medication in FAK - 07/21/08 01:40 AM

That's some wisdom spoken, Ironraven.

I wish I could tell you how many people believe that "if a little of this drug is good, then more must be better." I can't remember all of the times that people come in for early refills on meds that affect their CNS.

Posted by: Jeff_M

Re: Stay-awake medication in FAK - 07/21/08 04:18 AM

I carry provigil. I work 24 hr shifts. I learned about it from my wife, who does research in aerospace and military medicine.

Jeff
Posted by: Anonymous

Re: Stay-awake medication in FAK - 07/21/08 04:29 AM

Originally Posted By: red
I can't remember all of the times that people come in for early refills on meds that affect their CNS.



Not just people but the doctors who prescribe them. My doctor has put me on 'preventative' antibiotics many times and the instructions on the bottle are very specific to TAKE THEM ALL! The last few times I haven't filled the prescription. I don't need to built a tolerance to something that could save my life later.

Lately I've just stopped going. If I get the sniffles I just take care of myself and it passes. If I keep it up after I feel better, I continue to feel better. I've been feeling under the weather once in the last year...that's some real prevention.
Posted by: dweste

Re: Stay-awake medication in FAK - 07/21/08 04:36 AM

Originally Posted By: nursemike
The ammonia inhalants are a noxious stimulus that is used, if at all, to sort out the folks who are feigning from those who are fainting.


How so?
Posted by: Anonymous

Re: Stay-awake medication in FAK - 07/21/08 07:41 AM

I used to drink coffee. It has a very short-term kick, but it never kept me awake when I was truly tired, regardless of how much I drank. It's just not that powerful, at least not in my body. I have since overcome my caffiene addiction and I cannot imagine a situation where I honestly believe it would be useful. But I did not use it religiously. So for people who do, they may have trained their bodies to be awake longer if on caffiene, but certainly not necessarily so, as without caffiene, the body can remain just as aware and awake, at least in my opinion. Maybe, though, my tolerance to it had gotten so high that it didn't effect me anymore.
Posted by: BillLiptak

Re: Stay-awake medication in FAK - 07/21/08 10:33 AM

I use so much caffiene I feel no effects from it. When I was a child in kindergarten I used to go to bed at 8. Stay up until 11, and then sneak down into the basement kitchen and drink 2 mugs of heavily sugared tea with my gran while watching Hogan's Heros and M.A.S.H. re-runs. My soft drink of choice has been Mountain Dew since it was introduced in the north east. Even now as I try to cut back on sugar, I still drink iced tea. Caffine just does nothing to me, awake wise.

-Bill Liptak
Posted by: NAro

Re: Stay-awake medication in FAK - 07/21/08 11:09 AM

"A flight simulation task was chosen for the assessment of the stimulants in a counter-balanced, within-subject design under four different conditions: baseline (no drugs), placebo, caffeine (200 mg), and modafinil (200 mg). The equal effectiveness of both drugs in abolishing the nocturnal drop in cognitive performance...."

From: Cognitive Performance during Sustained Wakefulness: A Low Dose of Caffeine Is Equally Effective as Modafinil in Alleviating the Nocturnal Decline
by Dagan Y, Doljansky JT. Chronobiol Int. 2006;23(5):973-83.

Provigil is a controlled substance. Cafeein isn't. Yet.
Posted by: SwampDonkey

Re: Stay-awake medication in FAK - 07/21/08 01:39 PM

I live by the coffee cup, I am actually drinking it right now. I consume caffeine daily and over the past 3 days have been doing a lot of night driving so caffiene has been my co-pilot.

After reading about caffeine pills on ETS a few months ago I bought some at Walmart but have not tried them yet. It just seems abnormal to take a pill when you are used to drinking a "food" product.

When I was younger I could drink coffee right up to bed time and have no trouble falling asleep, now I cut out caffeine after supper or I will have trouble sleeping later.

Mike
Posted by: nursemike

Re: Stay-awake medication in FAK - 07/21/08 02:13 PM

neurologists have a variety of noxious stimulants available to them to determine level of consciousness, or depth of coma, or coma vs faking a coma: nipple twisting, pubic hair pulling, thumb pressure on eyeballs , knuckle rubbing on chest, rectal exam...and ammonia capsules. The physician's choice of stim probably tells you more about the physician than it does about the patient. Anyway, if the patient is goofing on the doctor by pretending to be comatose, or is in a relatively light coma, or is just asleep, these stims are annoying enough to cause a reaction; if the level of consciousness is lower (or the patient a really good actor), there is no reaction to the stimulus.

Provigil is indeed a controlled substance, I guess because of its abuse potential, rather than because of side or toxic effects. Its side effect/toxic profile seems pretty benign, certainly better than amfetamine and arguably better than caffeine or nicotine, both of which are legal by heritage rather than by rational evaluation.
Posted by: red

Re: Stay-awake medication in FAK - 07/21/08 02:26 PM

Originally Posted By: Hacksaw
Originally Posted By: red
I can't remember all of the times that people come in for early refills on meds that affect their CNS.



Not just people but the doctors who prescribe them. My doctor has put me on 'preventative' antibiotics many times and the instructions on the bottle are very specific to TAKE THEM ALL! The last few times I haven't filled the prescription. I don't need to built a tolerance to something that could save my life later.

Lately I've just stopped going. If I get the sniffles I just take care of myself and it passes. If I keep it up after I feel better, I continue to feel better. I've been feeling under the weather once in the last year...that's some real prevention.


I'm glad that you are in great health...never take that for granted!

(I'm assuming the antibiotics are for something other than acne.)
Many prophylactic antibiotics are for when you've had something stitched up, or pre-post-surgery or stuff like that. Your decision not to take it is certainly yours to make. But you are rolling the dice if you DON'T take them. If you wait until you get cellulitis and it's speeding up your limb, you have a real emergency.

And your doctor is 100% correct to tell you to TAKE THEM ALL. The "tolerance" you are cautious of is actually the bugs surviving a subtherapeutic dose of the antibiotic... much more likely to occur if you DON'T take them all. Your body doesn't develop a "tolerance" for antibiotics, the infecting bacteria do!
Posted by: Anonymous

Re: Stay-awake medication in FAK - 07/21/08 07:01 PM

Tea bags have other uses too. They're good for tooth aches.
Posted by: Glock-A-Roo

Re: Stay-awake medication in FAK - 07/21/08 08:23 PM

IIRC 'Dayquil' keeps some people up. For those relying on adrenaline, my reading from combat vets is that it's great for the first 20 minutes or so but after that it leaves you. Then it's a function of your training, fitness and whatever stimulants you have on hand.
Posted by: BlueSky

Re: Stay-awake medication in FAK - 07/22/08 12:54 AM

I keep caffeine tablets in my kit because I get headaches if I miss my morning coffee. I'd hate to have to deal with a splitting headache while dealing with an emergency.

In college, I used to take sudafed on occasion when coffee wasn't doing the trick. It works, but it has some side effects like drying you out that make it less than optimal. You need to drink lots of water with it.
Posted by: jshannon

Re: Stay-awake medication in FAK - 07/22/08 12:57 AM

Bad idea to me. Alot of the stay awake meds will have a diuretic effect and will make hydration harder if water may be scarce.
Posted by: dweste

Re: Stay-awake medication in FAK - 07/22/08 01:00 AM

Caffeine is a drug of choice for many, so I guess if it is part of your everyday it makes sense to keep a maintenance hit ot two in your kit in case your usual pushers are not around.

I would still like to understand what other first aid purposes are served by stimulants.

Thanks.
Posted by: OldBaldGuy

Re: Stay-awake medication in FAK - 07/22/08 01:56 AM

"...nipple twisting, pubic hair pulling...rectal exam..."

Medicine seems to have gotten kinkey when I wasn't looking...
Posted by: OldBaldGuy

Re: Stay-awake medication in FAK - 07/22/08 02:00 AM

I have seen that too. Makes my eyes water just thinking about it...
Posted by: OldBaldGuy

Re: Stay-awake medication in FAK - 07/22/08 02:02 AM

Me too. But I have to stop prior to noonish...
Posted by: SARbound

Re: Stay-awake medication in FAK - 07/22/08 02:19 AM

No stimulants for me. If you really wish to stuff something in a survival kit, i'd use sugar packets. Otherwise, I rely on M&Ms or other kinds of chocolate bars.

I think sugar is a better solution for your body than caffeine.
Posted by: Todd W

Re: Stay-awake medication in FAK - 07/22/08 06:07 AM

I know for me that caffeine does pretty much nothing while if I have a LOT of sugar I can really tell. I think this is due to fast metabolism and processing the sugar rapidly also possibly why caffeine has no affect it gets processed away fast?

I know the caffeine thing runs in my family on my mothers side too.

Posted by: nursemike

Re: Stay-awake medication in FAK - 07/22/08 09:44 PM

[quote=dweste]
"I would still like to understand what other first aid purposes are served by stimulants."

Not sure that the amphetamines were in the FAK for first aid purposes, (tho both amphetamines and caffeine have been used in the past as respiratory stimulants-we had IV caffeine sodium benzoate on the crash cart in 1974, and caffeine is similar to theobromide, an old school asthma treatment). I think it got stuck there cuz thats where the aspirin and other meds were housed, and it made more sense than putting it in the toolbox.

Alternatively, there is a case to be made that stimulants improve mental acuity and physical performance in some stamina-dependent activities, and might therefore be useful in crisis response. At one level, we dress the wounds and treat the pain to improve performance in other activities-this would be analogous, perhaps, to popping a tab of caffeine. Might could make a case for a sleeping pill in the kit, to promote rest-but there is usually some benadryl anyway, and that works just fine.
Posted by: red

Re: Stay-awake medication in FAK - 07/22/08 09:53 PM

I'm not a big fan of Provigil.
Posted by: Mike_H

Re: Stay-awake medication in FAK - 07/22/08 10:50 PM

Originally Posted By: Grouch
Perhaps to keep a concussion victim awake? Isn't it bad for them to go to sleep?


I believe this is no longer a standard practice. They do suggest you wake a person every hour or so to check on them, but it is no longer necessary to keep them awake.
Posted by: Mike_H

Re: Stay-awake medication in FAK - 07/22/08 10:53 PM

Originally Posted By: Hacksaw
Tea has been proven to release caffeine into your system more slowly than coffee.


I like to drink a tea blend called Mate Vana or Mate Lemon Blast... It is Yerba Mate with some tea or lemongrass in the 2nd case... It is a much better boost than coffee as well...
Posted by: Mike_H

Re: Stay-awake medication in FAK - 07/22/08 11:35 PM

Originally Posted By: NightHiker
Oh, I also have Excedrine Migraine tabs in my FAK, they have caffiene in them too. If I got really desperate I'd use them for the caffiene.


I have the same in my psk fak. For the same reason.

People who take caffeine all the time certainly build up a tolerance to it. Then it takes more and more to achieve the same results.

I stopped drinking caffeine for a while... Then I remember having a coke and boy was I buzzed.

Here's one for you:

Shower Shock Caffeinated Soap

Disclaimer, blah blah blah, etc... Not affiliated... usw...
Posted by: OldBaldGuy

Re: Stay-awake medication in FAK - 07/22/08 11:43 PM

Man, where was that stuff when I was working graveyard shift???
Posted by: Jeff_M

Re: Stay-awake medication in FAK - 07/22/08 11:45 PM

Originally Posted By: NAro
"A flight simulation task was chosen for the assessment of the stimulants in a counter-balanced, within-subject design under four different conditions: baseline (no drugs), placebo, caffeine (200 mg), and modafinil (200 mg). The equal effectiveness of both drugs in abolishing the nocturnal drop in cognitive performance...."


I find that Provigil has far fewer side-effects, for me, than caffeine does, such as nervousness and edginess, irritability, fine muscle tremors, and dyspepsia. I also find that I can return to sleep when the opportunity presents when on Provigil, but not when on caffeine. YMMV

Jeff
Posted by: NAro

Re: Stay-awake medication in FAK - 07/23/08 11:41 AM

My blurb regarding the provigil/caffeine research didn't go far enough. IMHO the issue isn't staying awake. It is staying awake with unimpaired cognitive performance.

Again IMHO, no one (without objective testing)has a really good idea regarding such performance decreases with sleep deprivation, or mitigation with caffeine, provigil, or other stimulants. How many times have you heard of someone who had too much to drink slugging down a few cups of coffee so they could drive home safely? Nothing but a wide-awake impaired drunk! Of a driver who is sleep deprived, tanks up on nodoze, and get's "white line hypnosis" and kills someone.

So my opinion is (since most of us aren't going to spend the time and money getting this personally objectively tested)... use whatever you're comfortable with. Just don't bet your life on any substance overcoming the negative effects of sleep deprivation.