Question for the MD's and RN's

[pbwalker]

For folks who are heading out to the sticks (backwood Mountain West) to do some big time hunting, there are some recommendations for items to keep in your hunting pack to avoid catastrophe if something were to go "tango uniform". It's got me thinking of stuff beyond the Spot Personal Tracker.

For example, it is recommended to keep an Epi Pens in your bag for the off chance you have an allergic reaction / anaphylactic shock situation. Or, something like Zofran (anti-nausea) if you get real sick and can't afford to be dehydrated. Same goes with an Anti-Diarrheal.

Now, many of these require an Rx. How does one go about procuring items like this? Do you just ask your Doc and tell him where you'll be, what you need, and they may give you a script? Having been a combat medic / EMT in a past life, I understand the risks involved. Does this have any bearing on it?

[WildBill]

Now, many of these require an Rx. How does one go about procuring items like this? Do you just ask your Doc and tell him where you'll be, what you need, and they may give you a script? Having been a combat medic / EMT in a past life, I understand the risks involved. Does this have any bearing on it?

I am not an MD, but I found one who was sympathetic to my needs when I was travelling for long periods of time on business. Prior to my trips I got vaccinations for tetanus, Hepatitis A & B and prescriptions for antibiotics [amoxycillin and Bactrim DS], pain medication [hydrocodone] , diarrhea [lomotil], as well as hydrocortisone cream for various skin conditions. As as I said, I was lucky to have a doctor who was sympathic to my needs, you may have to search for one.

[Piney]

Depends on the doc.
For example, my doc back in the piney woods -- I was able to just call and get a prescription for steroid cream when I got into poision ivy. I'd even call ahead and tell him I was going to clear fences and he'd call one in. I moved here-- still have fences- and the doc here said I had to come in. That's OK-- first couple of visits-- new and all. But-- then every time I called, I get the "have to come in" part. I found a new doc.

[Dragonfighter]

For folks who are heading out to the sticks (backwood Mountain West) to do some big time hunting, there are some recommendations for items to keep in your hunting pack to avoid catastrophe if something were to go "tango uniform". It's got me thinking of stuff beyond the Spot Personal Tracker. <SNIP>

I've been a firefighter for 25 years and was a paramedic for over 15. I have served as the church camp medic fore several years and when on mission trips. When I went to South America I had seen one of the ER docs I worked with regularly and I obtained a litany of advanced items, lidocaine, lidocaine/epi, suture kits, epinephrine 1:1000 and syringes, etc. Of course that comes with a modicum of training.

In my own kit I carry:

• BP cuff and stethoscope (BP cuff can stem blood flow if needed)
• A couple of hemostats (you can temporarily close wounds until you hump out of wherever you are)
• Ammonia caps, adhesive bandages (assorted), 4X4 guaze, rolled gauze, at least one trauma dressing ( if something massive happens the worst thing is to not have enough clean dressing to cover the wound and stem the bleeding. FWIW if your wife or other female is with you, sanitary napkins make for a good makeshift)
• ChemIce pack
• Eye shield (If used you need to bandage over the unaffected eye to minimize sympathetic movement)
• A sterilized squirt bottle with povidone and one with normal saline (Irrigation and cleansing) and one with alcohol. (Sanitizing instruments)
• Instruments - 4" or better (clean and sharp) lockback knife for cutting clothes, scraping, preparing splints, etc. Surgical and bandage scissors. A foreign object removal kit (mine has been a life saver). Snake Bite/Sting kit. And a magnifying lens of some type.
• Meds - Epinephrine Inhaler (Primatene, etc.)[Normal dose for epinephrine in anaphylaxis is .5 to 1 mg subcutaneuos or IV. A metered sprayer delivers .2 mg. If faced with an allergic reaction, give at least four puffs and don't exceed 6. Repeat if necessary as a racing heart and elevated pressure are better than choking on your own fluids. Follow with Benadryl.] Benadryl tablets. Tylenol or equivalent (aspirin and ibuprofen can exacerbate bleeding). Arnica Gel (and tablets if no milk allergies). Ssssting Stop, Sting Ampoules, and a small Meat Tenderizer.

A word about meds, even if you have an MD that will Rx narcotics or other potent pain meds, I would recommend against using them. Narcotics and their synthetic counterparts depress the respiratory centers and this can have an exaggerated effect on a trauma victim. Locals with Tylenol are much preferred when away from definitive help. Arnica and Ssssting Stop are miracles in a tube, I have used both (too many opportunities) with amazing results. With meat tenderizer, making a paste and applying it to a sting or a bite goes a long way toward relief and healing. It is carried on ambulances on the coast for jellyfish and ray stings.

Impaled objects (larger than a thorn or stinger) should be stabilized in place and the patient transported to a medical center. Pulling out knives, large sticks, etc. can cause more damage and even kill the patient...the old nail in the tire dilemma.

Everything I have listed fits neatly in a fly-fishing belt kit which can be worn or hung off the back of a ruck sack. When camping we hang it off of a clothesline so everyone can find it quickly. Everything is also available without prescription and with few exceptions are convenient in stores such as Wal-Mart.

Hope this helps.

Added in Edit: With Benadryl tablets, you can crush them, make a paste and apply to a bite or rash to stop a localized reaction.

[gigag04]

These are good to go in any flavor:

http://www.combattourniquet.com/police-tourniquet.php" onclick="window.open(this.href);return false; - I keep one in my go bag

[Dragonfighter]

These are good to go in any flavor:

http://www.combattourniquet.com/police-tourniquet.php" onclick="window.open(this.href);return false; - I keep one in my go bag

That's a good 'n alrighty. But keep in mind that tourniquets are a short term solution. When approaching 30 minutes plus, every thing below it starts to die. That said they are good for pressure bandaging also.

[Divided Attention]

"30 minutes" THis is what I was taught in nursing school, but times they are a changing. When the choice is lose a limb or bleed out, they are leaving tourniquets on for hours now if the need should be there. Recently took 2 "tactical medicine" classes and was enlightened. Also talking to newer grads, this is the recommendations on trauma first aid. I carry a CAT tourniquet in my car, range bag and one for work, just in case.

Edited to add - if you use medications that are prescribed for you on someone else and are not authorized under licensure to "prescribe" it could come back to bite you. While I would have no problem offering over the counter things like Immodium (OTC Lomotil), Benadryl for allergic reactions, acetaminophen and ibuprofen, hydrocortisone and antibiotic ointments, I would be VERY reluctant to administer Rx meds to anyone, regardless of my training. In this letigious society I would much rather aire on the side of caution.YMMV, JMPHO.

[gigag04]

These are good to go in any flavor:

http://www.combattourniquet.com/police-tourniquet.php" onclick="window.open(this.href);return false; - I keep one in my go bag

That's a good 'n alrighty. But keep in mind that tourniquets are a short term solution. When approaching 30 minutes plus, every thing below it starts to die. That said they are good for pressure bandaging also.

Yeah we recently had an ER doc go through the academy as a reserve and he told me me that times are changing too. Some surgeries leave them on for many hours at a time. Even then limb loss > bleeding out.