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#48994 - 09/15/05 08:07 PM Re: Medical Kits
paramedicpete Offline
Pooh-Bah

Registered: 04/09/02
Posts: 1920
Loc: Frederick, Maryland
Asthma can and often is a life-threatening event. Approximately 20% of children and 5% of adults suffer with asthma within certain populations. Age, ethnicity, environmental factors, medications, other medical conditions and whole host of other factors can influence not only the prevalence in a given population, but the degree to which any individual will respond to an attack. There are many triggering factors, emotions, environmental, medicine, etc. and what will trigger an attack in one individual, another asthmatic will weather fine.

Reported deaths due to asthma range in the 1000+ per year, so I would not consider asthma to be self-limiting, unless you consider death to be a resolution. With that said, many individual asthmatics can resolve an attack without medications. I would not however, rely upon that method solely. If an individual were having an attack, he or she hopefully would have their medication on hand. Whether they did or not, I would still activate 911 or take the individual to the hospital, as some attacks are only temporally resolved through medications, etc. and another attack can come on quickly.

Pete

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#48995 - 09/15/05 08:07 PM Re: Medical Kits
CJK Offline
Addict

Registered: 08/14/05
Posts: 601
Loc: FL, USA
Hyperventilation will either calm down or pass out.....asthma can kill. Yes it is good to go the psycological route of calming them down but a true asthma attack is a pysiological event where the bronchioles narrow. Some patients require Rx intervention to open them up.

With hyperventilation you will have the 'panicky looking' patient. What I mean by that is they are anxious and panicky but have good color and their respirations are not labored. They will be breathing at a rate of 40 per minute plus. Usually they have tingling in their hands, feet and around their mouth. They will have (sometimes severe) cramping in their hands.

An asthmatic will be anxious because they CAN'T breathe. They can sometimes be heard wheezing even without a stethescope. They may even be turning blue. We have a list of questions that we ask them and the further down the list we get then the more critical the situation could be.

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#48996 - 09/15/05 08:23 PM Re: Medical Kits
lazermonkey Offline
Enthusiast

Registered: 12/27/04
Posts: 318
Loc: Monterey CA
A technique called "Pursed Lip Breathing" works well and is much of the same thing as paramedic pete described.
You inhale SLOWLY through the nose as much as you can and then press your lips together and blow out SLOWLY as if you were blowing bubbles or extinguishing a candle.
For more on asthma hear is a start American Lung Association


<img src="/images/graemlins/blush.gif" alt="" />


Edited by lazermonkey (09/15/05 08:34 PM)
_________________________
Hmmm... I think it is time for a bigger hammer.

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#48997 - 09/15/05 08:35 PM Re: Medical Kits
GoatRider Offline
Old Hand

Registered: 08/28/04
Posts: 835
Loc: Maple Grove, MN
I have asthma, and it's very much under control. The only time it really scared me was when I was selling vacuum cleaners (or rather, trying to).

One thing I've read is that although it seems like you're having problems getting air in, the real problem is you're having trouble getting air OUT. When it comes time to pull air back in, your lungs are still full, so it SEEMS like you're having trouble getting air in. I've experimented with that when I have a bit of a problem while jogging- I'll work hard to give my lungs a bit of extra squeeze at the end of exhaling. It seems to help a bit. What helps me more though is to wear a heart-rate monitor, and use that to pace myself better and not let the asthma activate.

I don't know how this information will help with someone else though, this is purely how my lungs work.
_________________________
- Benton

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#48998 - 09/15/05 08:48 PM Re: Medical Kits
Anonymous
Unregistered


The main purpose of surgical kits & sutures in a medical kit is to impress people who don't know any better. Except for perhaps removing splinters or lancing a blister, they are almost useless. Yes, I know the conventional wisdom about leaving blisters intact, but they are very painfull to walk on and unless you are independently wealthy & can afford 4 bearers with a sedan chair, you have to drain them. If you have to hold wound edges together, use butterflys or Steri strips instead of sutures.

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#48999 - 09/15/05 08:51 PM Re: Medical Kits
Malpaso Offline
Old Hand

Registered: 09/12/05
Posts: 817
Loc: MA
<<If you have to hold wound edges together, use butterflys or Steri strips instead of sutures. >>

In a no $hit emergency, you can use super glue. It was invented for that specific purpose in Vietnam.
_________________________
It's not that life is so short, it's that you're dead for so long.

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#49000 - 09/15/05 09:34 PM Re: Medical Kits
lazermonkey Offline
Enthusiast

Registered: 12/27/04
Posts: 318
Loc: Monterey CA
It has been said before and I will say it now, duct tape and super glue rule.
Through some thermal resistance on it and you could probably use it to fix the space shuttle.

<img src="/images/graemlins/cool.gif" alt="" />
_________________________
Hmmm... I think it is time for a bigger hammer.

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#49001 - 09/15/05 10:13 PM Re: Medical Kits
Anonymous
Unregistered


My apologies as I was not very clear in my original post. I will try to answer all, but...
I was originally posting about surviving in place. I am not going to tote a portable hospital about, especially since I am not a MD.
I have a laryngoscope, but it is a tight fit in the case. I did not intend to imply that one should just jam the forceps down the throat and grope about.
Scalpels & scissors are good in your kit. A scalpel is good for splinters, opening abcesses (did that on myself)etc.
The medical items given were just examples, not a complete list.
The meds are for me & my family, people who are not likely to sue me. I would not give meds out to others, esp. prescription ones.
I am not a surgeon by any stretch of the imagination. I used the incision & drainage method (used before antibiotics) after a cat bite got infected. after 3 days of daily opening & drainage, it healed up. I also did part of a root canal on myself. I had an abcess at the upper end of an upper tooth root. The DDS drilled a hole, prescribed the wrong antibiotic & said "Wait ten days and let it drain". On the second day the hole got plugged & the pain was enormous. No drug would touch it. I was at work & it was at night, so I opened the hole myself. I used a piece of wire sterilized with alcohol and pushed until blood came out. The pain was gone within 3 min. The next day, the doc changed the antibiotic & all was well after that.




Edited by riedmur (09/15/05 10:20 PM)

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#49002 - 09/15/05 10:34 PM Re: Medical Kits
Anonymous
Unregistered


I forgot to mention this previously: I don't recommend sealing a wound in the field. Especially, don't do it if you are going to take the patient to a hospital emergency room. The doc there will be really annoyed if he has to try to unseal it to check for abcesses, dirt & whatnot. He cannot be responsible for the condition of the wound if he cannot see what is really involved. He will be really steamed if he has to remove some amateur stitches. One time, when doing my observation time in the ER, a biker guy was brought in. He had gotten into a fight and got hit in the head with a 2x4 with nails in it. He was way too tough to go to the ER, so he had his significant other sew him up with ordinary sewing thread. After the wound got grossly infected, he decided that perhaps a visit to the hospital was in order. He was admitted & put on IV antibiotics.

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#49003 - 09/16/05 12:22 AM Re: Medical Kits
GardenGrrl Offline
newbie

Registered: 09/12/05
Posts: 26
In general, people with severe life threatening asthma never go anywhere without their inhaler(s) and an epi pen. If I were to come across an asthmatic trapped in rubble, I would ask them where it is, retrieve it for them, and help them use it. People with moderate asthma can usually, with breath control techniques, remain functional. When I have an asthma attack, I can drive and walk and do everyday tasks, but I can't run, talk for a long time, or do algebra :-). I also become very cranky at people who try to draw me into long conversations. Don't they know that every breath is precious!

Usually, my asthma is provoked by allergies. I inhale a bad thing, say, for example, mold; my body reacts by shutting down the airways. If I move myself to an environment with cleaner air and sit quietly for a while, breathing becomes easier. But I won't be "normal" for another day or two. This is not "all in my head" or "self limiting"; it's documented by lots of expensive tests. But, emotions can certainly contribute to making it worse. As long as I remain calm, I can function well enough to not need help (unless I'm trapped under rubble, in which case, please help me remove the rubble. Inhalers will not be necessary).

People with exercise induced asthma usually normalize a few minutes after they stop the exercise. My brother has this kind of asthma and he uses an inhaler before exercise. He also works out a lot, trying to stretch the lenth of time he can exercise without having an attack. He is definately improving, but it takes work and dedication, not a reliance on medication.

Psychology does play a role in health and non-health, but it is the same role whether the patient has asthma or a broken leg. You wouldn't tell someone with a broken leg that they would get better if their mother stopped being so controlling, would you?

I have an epi pen in my purse, should the need arise, but in two years I've only had one attack that couldn't be solved by moving to an area with cleaner air. That time, I was still functional enough to drive home, hook up my nebulizer, and treat myself.

Still, a paper bag might be a good thing to keep in the FAK, for people who are hyperventilating.

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