Medical Emergency Information, Resources for Wildcat Firewise Community: For educational purposes only.

FROM Ken Berniker MD and fellow contributors

Hello Wildcat Canyon area neighbors: This is a follow up to my remarks at the Neighborhood Night Out on medical preparedness for an emergency, such as an earthquake, in which we might have to fend for ourselves for days or longer. Those of us with medical experience urge all of you to make good preparations. The following suggestions combine the thoughts of: Dr. Jon Beauchamp, who was on duty in the emergency department after the Loma Prieta earthquake; a former physician colleague of mine who has volunteered in disaster and hot zones around the world, including recently in Ukraine with Doctors Without Borders (MSF); and information widely available online.

1) Water & food (for both humans and pets) is a top priority. This is something that each household should stockpile and think of water purification tablets and devices. Get high-protein, high calorie items that have a long shelf-life and don’t require much, if any, water to prepare. If some of us wanted to go in on packaged disaster rations or the like, perhaps we could buy in bulk at a discount. Keep a manual can opener. Rotate food stocks periodically. Look at some survivalist websites.

2) Hygiene. People need to urinate and move bowels no matter what. Having adequate equipment/facilities to attend to this in a safe and hygienic fashion is important - think of the water you’ll need and/or consider a camping toilet. Rainwater catchment could help.

3) Being able to cook and/or boil water. Hot meals and a warm beverage are important in times of crisis. Small camping stoves and a supply of propane are a good idea (maybe something that could be bought in bulk at a discount).

4) Power. Consider a portable generator to run a refrigerator and charge small electrical devices, or splurge on a permanent generator system. Power is especially critical for anyone who relies on a powered device for respiratory or other support, or needs refrigerated medicine. Harbor Freight and Single Cylinder Repair have good selections. Fuel storage is a potential issue, but we can siphon gasoline from cars. Other generators can run on propane. All have pros and cons, and maintenance is an issue.

5) Medicine. Always keep a supply of necessary meds on hand. The Red Cross advises maintaining at least a seven-day supply of all your necessary meds. My friend in MSF recommends a 30-day supply. It may be hard to get your physician, pharmacy, and health plan to all cooperate on this. One idea might be to request extra meds from your physician or health plan and specifically cite the Red Cross recommendation, which appears on their website, and appeal to a higher authority if necessary. (If you have any success there, please let us know!) In the absence of such cooperation, think of any other way to stockpile your important medications. Again, remember any need for refrigeration, and consider asking your doctor whether a non-refrigerated alternative could work for you.

6) Gas: Keep at least a half a tank of gasoline in your cars at all times for possible evacuation.

7) SUPPLIES: Stay up to date on tetanus and other vaccinations. - Here are two lists from leading websites - regard them as a bare minimum. From the Federal Emergency Management Agency (FEMA) -

Ready.gov: Plan Ahead for Disasters⁠

- ● Masks (for everyone ages 2 and above), soap, hand sanitizer, disinfecting wipes to disinfect surfaces ● Prescription medications. ● Non-prescription medications such as pain relievers, anti-diarrhea medication, antacids or laxatives ● Prescription eyeglasses, contact lens solution, hearing aid batteries ● Infant formula, bottles, diapers, wipes and diaper rash cream ● Feminine supplies and personal hygiene items ● First aid kit ● Dust mask (to help filter contaminated air) ● Moist towelettes, garbage bags and plastic ties (for personal sanitation) ● Home: Keep this kit in a designated place and have it ready in case you have to leave your home quickly. Make sure all family members know where the kit is kept. ● Work: Be prepared to shelter at work for at least 24 hours. Your work kit should include food, water and other necessities like medicines, as well as comfortable walking shoes, stored in a “grab and go” case. ● Car: In case you are stranded, keep a kit of emergency supplies in your car. ● Keep canned food in a cool, dry place. ● Store boxed food in tightly closed plastic or metal containers. ● Replace expired items as needed. ● Update your kit every year as your family’s needs change.

From the American Red Cross -

https://www.redcross.org/get-help/how-to-prepare-for-emergencies/anatomy-of-a-first-aid-kit.html⁠

*2 absorbent compress dressings (5 x 9 inches) * 25 adhesive bandages (assorted sizes), also found within our Family First Aid Kit * 1 adhesive cloth tape (10 yards x 1 inch) * 5 antibiotic ointment packets (approximately 1 gram) * 5 antiseptic wipe packets * 2 packets of aspirin (81 mg each) * 1 emergency blanket 1 breathing barrier (with one-way valve) 1 instant cold compress, also found within our First Aid Kit 2 pair of nonlatex gloves (size: large) 2 hydrocortisone ointment packets (approximately 1 gram each) (Similar item found …..within the Be Red Cross Ready First Aid Kit) 1 3 in. gauze roll (roller) bandage 1 roller bandage (4 inches wide) * 5 3 in. x 3 in. sterile gauze pads * 5 sterile gauze pads (4 x 4 inches) * Oral thermometer (non-mercury/non-glass), also within the Deluxe All Purpose First Aid Kit 2 triangular bandages * Tweezers Emergency First Aid guide * Similar item found in the Red Cross Store.

Dr. Art Swislocki enthusiastically recommends sanitary pads as emergency bandages. Other items to consider: 1 bottle isopropyl alcohol - to clean instruments, do not use on broken skin 1 bottle hydrogen peroxide - to remove blood, do not use on broken skin Alcohol wipes - do not use on broken skin Tape: paper and/or micropore, 1” and 2” wide 2” x 2” gauze sponges Small scissors / bandage scissors Tongue depressors or other similar tailor’s sticks (can splint a finger) re-cut cloth strips (6 by 24 inches) (to secure splints to limbs) Pre-cut cloth (6 by 40 inches) for binder Ace bandages: 2” wide, 4 or 5” wide Wash cloths (for padding or cleaning) Stretchy tubular material (tubigrip or cotton sock tops: for padding/compression when using tapes for support of hand, wrist, or ankle) Self-adhering bandage (Coban or others) 1 inch and wider Moleskin (12” x 12”) for blisters Steri-strips and/or liquid bandage and/or Zip stitch Q tips / cotton swabs Bottled water/saline solution/wound flush (for cleaning wounds/eyes/mouth if no water supply) Blood pressure kit Vaseline Magnifying glass for splinters Benadryl or other anti-histamine Saline eye drops (for smoke irritation or other) Headlamp/flashlight/lantern Pulse oximeter Toothbrush / toothpaste First-aid -

Dr. Jon Beauchamp describes the injuries that followed the Loma Prieta earthquake - 1) Lacerations, particularly of the arms and upper body (trying to catch falling mirrors and aquariums was a common theme); 2) Comminuted fractures and dislocations, particularly of the lower extremities (a lot of people tried jumping out of second- and third-story windows and off balconies); 3) Assorted soft tissue injuries from dodging falling objects and trying to run/climb over debris. Aside from realizing to avoid such injuries, educate yourself on dealing with these injuries or worse - look for online or in-person courses in first-aid, wilderness medicine, CPR. (And use work gloves, sturdy shoes around hazardous situations). Here are links to a few of many websites on splinting, controlling bleeding, general wound care. (“CSM” stands for circulation, sensation, movement - things to watch in any injury.) Wilderness first aid - showing improvisation -

https://www.youtube.com/watch?v=nnUQHKZqnkw⁠

Wilderness Medicine by Coast Wilderness: several short and practical 3-5 minute videos of various body parts featuring inventive splints, such as using hiking poles for a leg and arm splint. 1)

https://www.youtube.com/watch?v=jY5AxRkZOok⁠

⁠

https://www.youtube.com/watch?v=7zYOUqZVst8⁠

⁠

*Next are just two examples of the short videos in a bigger series, each covering immobilization of a limited part of the body. They’re aimed at EMTs and may use materials we won’t have but emphasize general principles that can be applied with materials at hand.

Ankle splints

https://www.youtube.com/watch?v=TXek0jFc3lo⁠

Upper extremity sling -

https://www.youtube.com/watch?v=sOhtqC6T_UQ⁠

*Here’s a 32-minute video for EMTs that demonstrates splinting every part of the body while emphasizing important concepts -

https://www.youtube.com/watch?v=nSwvijgLxwA⁠

STOP THE BLEED -

https://www.youtube.com/watch?v=3FBIydzl1Ss⁠

(one of many similar videos)

For relatively minor wounds - “Take Care of Wounds” -

https://www.cdc.gov/disasters/woundcare.html⁠

An app for the phone which is simply called "First Aid" (phone icon is a bandaid) is also done by the Red Cross. It’s free from the App Store and has a lot of basics. Many thanks to Debbie Hamati, Jon Beauchamp, MD and Art Swislocki, for their contributions to this. Here’s to all of our good health! Ken Berniker MD, ken.berniker@gmail.com

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