Livestock for Survival

With a cynical eye on the rapid downward spiral of events, it seems prudent to plan for a very long time of sustainable living. In this case survival depends not only on your stockpiled preps, but also in your ability to sustain food production past the end of your stored supply.

Let’s assume, to begin with, that you have reasonably stocked retreat. I’m not talking a stock to the level described in “Patriots”, but rather one that includes a year (or more) of food, basic ammo, firearms, reliable water, heat and power source … the basics.

Now it’s time to look past the first year or so and decide how you will continue to produce food and supplies for your family. Hunting is often an option, but it can’t be considered a long-term complete food source, as it is not nutritionally complete.

Much has been said about keeping heirloom (open pollinated) seeds, and this cannot be stressed enough. But you have to plant and harvest a crop each year to continue to re-supply your seeds. Most retreats seem to be in colder climates as they tend to have a lighter year-round population load. If you’re up in the mountains, altitude will play a significant factor in what you can hope to grow. Staples such as corn require heat days in order to properly pollinate and “set”. You generally want to lay in a supply of varieties that have the shortest maturity date. That means from the time you plant that seed to the time you harvest the crop is the shortest possible number of days.

Using “short season” varieties gives you two advantages. First, if you have a crop failure for some reason, you can often have time to replant. Secondly, if you’ve harvested your first crop, you have time to put another crop in the same space.

As summer approaches, consider a great time to practice crop production, if you haven’t already. It is not as simple a poking a seed into some dirt. Get a couple of good gardening books, or better yet, books on basic farming. Carla Emery’s Encyclopedia of Country Living and the Reader’s Digest Back to Basics are both excellent reference books that cover everything from farming to livestock to making basic necessities.

Having a huge variety of seeds is not as important as having plenty to the right seeds for your needs. If you just can’t live without brussel sprouts, by all means, lay in some seeds. But stick mostly to the basics: wheat, corn, squash/pumpkin, beans, peas, tomatoes, onions, potatoes, peppers, and your basic herbs. If you haven’t planted fruit trees, now is the time to get started on that. It takes several years for trees to be come productive. Also give consideration to other perennials such as strawberries, raspberries, blackberries, blueberries and grapes. Again, it take a few years for these (except for strawberries) to get into full production.

Besides your garden, fields and orchards, you’ll need to take a serious look at what sort of livestock will fit in to your situation. Eventually, you will probably need some sort of animal power for transportation and heavy work.

The most efficient feed-to-food converter is a chicken. One hen will lay approximately one egg every other day. Peak production (during the summer) generally is an egg a day. Winter drops to an egg every third day or so without significant extra light in the chicken coop. You can expect to raise two or three sets of chicks each summer. Hens will get “broody” and sit on eggs to hatch them once the weather is warm. In order for the eggs to be fertile, you of course must have a rooster. The best ratio is one rooster to every ten hens. A family of four would do well with 25 laying hens and three roosters. The extra eggs produced during the warm months can be frozen or used for feed for other animals. You can even feed the [well-pulverized and unrecognizable] eggshells back to your chickens to give them adequate calcium. During the spring, summer and early fall, you don’t even have to provide chickens with any feed. They are excellent consumers of all sorts of insects and bugs. “Free range” chickens pretty much feed themselves during the warm months. If predators are an issue though, you’ll want to keep them in a moveable cage (called a “chicken tractor”) so they don’t become a snack for some varmint. Raccoons are especially fond of chickens, as are weasels.

If you know that the stuff is hitting the fan, try to order 50 chicks or so [and buy a 50 pound sack of chick starter feed at your local feed store]. Chicks arrive in the mail. Ideal Poultry and Murray McMurray are two excellent sources. If you order “straight run” chicks, you’ll get a mix (about 50/50) of hens to roosters. The best all-round chicken in my opinion is the Astralorp. They start to lay early (at about five months of age) and consistently, they are good mothers and are big enough to still be a reasonable source of meat. The roosters tend to stay calm and usually are not aggressive. Chicks will cost you around $1.50 each. The price varies with the breed, the supplier and the time of year. Ideal tends to have good sales, which you can keep up with by signing up for email alerts.

Another excellent feed-to-food converter is the basic goat. I’ll say right off that they are tough to keep fenced in. Goats are terrifically intelligent and are phenomenal escape artists. If you keep goats, make absolutely certain that your gardens, crop grounds and trees are well fenced off and well protected. Goats can decimate fruit trees in minutes. Goats produce milk, meat and leather. A doe can kid as early as eight months old, but it’s best to wait until they are yearlings. Goats’ gestation is about five months and they tend to only breed in months that have “R” in the name (Sept, Oct, Nov, Dec, Jan, Feb, Mar, Apr). There are some aseasonal breeders, but don’t count on it. If your does are bred in early September, you might be about to get them bred back again in April, two months after kidding. Goats usually have twins and triplets. Bucks can be smelly and can be aggressive during rut.

The breed of goat really is an individual preference. Goat enthusiasts will extol the virtues of their particular breed, but mostly it comes down to basics: good dairy does will give about a gallon of milk a day. Goat milk, properly processed, is indistinguishable from fresh cow’s milk. If you have never consumed fresh milk, you ought to give it a try. It is completely different from what you purchase in the store. It makes store-bought taste like water. Goat milk is white, it does not separate as easily as cow’s milk (it takes longer to skim enough cream for butter), and it is often well-tolerated by people with lactose issues. During grazing months, a goat will produce milk just with pasture (grasses, clovers, and browse). A small amount of grain is nice at milking time so the does will be excited to come in to the milking area. It beats chasing them all over Creation. IN the winter, they will require hay and a little grain if you intend to keep milking. Some people “dry off” their does in the winter in preparation for kidding. You have to allow about two months of no milking before the doe kids so that her body has time to produce the colostrum the kids need in order to survive.

Goats are capable of pulling small, fairly light carts and helping with basic garden work (muzzled, of course). They can work individually or as a team of no more than two. They are also good packers capable of carrying about 30 pounds (for a full grown adult goat). For a family of four, two or three does and one buck is plenty. And yes, you can keep doe kids and still breed them back to their sire (or their brothers). Line breeding is not recommended over the long-haul, but it’s perfectly fine until things stabilize and you can trade genetics with a neighbor.

Sheep are extremely important, in my opinion, but are rarely discussed. They don’t have a terrific feed-to-food ratio, as they require a bit more protein. But for what they give you in return, they are an excellent survival animal. Besides meat and terrific hides, sheep produce wool. Wool is one of the very best natural fibers. It is somewhat flame retardant, retains its warmth even soaking wet, and is incredibly versatile. It can be spun into yarn, felted, woven, and even worked with “raw”. Lanolin is the “grease” on the wool. Once cleaned, it is an excellent, lasting softener for badly chapped/burned skin.
Sheep are not very smart, and so they really require looking after. If you have a predation problem, you’ll want to keep sheep close-in, or have some sort of guardian (human or animal) with them at all times. Sheep are similar to goats in breeding and birthing habits. In fact, you can keep sheep and goats together without any problems. They do not interbreed (although you may see the males trying it anyway).
Merino sheep are the best for fine wool production: the kind of wool you can wear next to your skin and not feel “itchy”. They are hard to find in the United States. Virtually any sheep, except “hair sheep”, will work for survival purposes. Larger breeds such as Columbia, Suffolk, and Corriedale will have more coarse wool, but they will produce bigger (meatier) lambs on less feed.

Like goats, you’d want two or three ewes and one ram. Rams can be dangerous. Repeat: rams can be dangerous. There is a product available called a “ram shield”. It is a leather piece that fit over the ram’s face so that he can’t see straight ahead to charge. However, his vision is fine for eating and wooing the ewes. (By the way, it works on goat bucks, too). After one Suffolk ram kept charging me, it is standard on our rams except for the Merinos. I’ve never had an aggressive Merino ram. Not to say it couldn’t happen; it just hasn’t happened yet. Merinos are smaller and when the rams fight during rut, the Merinos can take quite a beating. With the other rams wearing shields, it helps keep the Merinos from getting clobbered. It’s best to have a separate ram area away from the ewes once the girls are bred. It’s just safer for the shepherd/ess during feeding and lambing time.

Hogs are not for everyone, but they are one of my favorites. They produce a lot of meat, they are smart and easy to manage if you treat them decently, and they can grow fat on table scraps, roots, and forage. One sow can produce 20 or more piglets in a year. That a lot of meat and useful fat (soap-making). My experience is that colored pigs do better on pasture and forage than white pigs. I have no idea why this is true, but it seems to be. I don’t think the breed makes much difference, as long as the pigs aren’t white. Contrary to the stories, pigs do not like to be dirty. However, they cannot sweat to lower their body heat, and they must be provided with a place to cool off. A shallow concrete “pool”, access to a creek or pond, or even occasional hosing off will work. If pigs cannot get cooled off any other way, then they will wallow in a mud source.

Pigs “root” (dig) almost from the minute they are born. This is a terrific help in the fall when you want to get your garden turned over. They are omnivores and will graze, browse, and yet still consume table scraps and meat. Pigs are a good way to dispose of any accidental animal carcasses that you can’t eat yourself. Pigs are extremely smart (some say smarter than dogs). Boars can be dangerous, just like any other male, especially when he’s chasing a female. If you see the boar slobbering (white foam), stay out of the pen. He’s wooing a lady. We tame our pigs by hand-feeding eggs to them. After a few days, the pigs will come when you call. I have never even been charged by a pig, and I feel comfortable around ours. However, I never forget that they have razor-sharp teeth and that they weigh about 600 pounds when full grown! I never let the kids go into the hog pens unless I am standing right there. We’ve never had a problem, but I don’t believe in being foolish either.

Sows’ gestation is 3 months, 3 weeks and 3 days. Sows will have between 8 and 15 piglets per litter. Many times, sows will have fewer “faucets” than piglets and you’ll have to make sure every gets their fair share of food in the beginning. Within a week, the piglets will be running everywhere and helping themselves to whatever Mom is eating. Piglets can be weaned at one month, but we generally leave them on until the sow weans them herself. The nutrition they receive from the sow doesn’t cost me anything and it helps the piglets get an excellent start.
Pigs can be butchered at about 160 pounds, which will give you about 80 pounds of meat and 20 pounds of lard. Pigs raised on pasture have much less lard and more lean meat. A little corn each day will help them gain weight faster, but much of that weight gain is fat and is probably a waste of valuable resources.
One sow and one boar will keep your family fed and provide lots of meat for trade.

As for larger stock, cattle and horses are generally what most people think of. They have great benefits but also great draw-backs.
Cattle produce milk, meat and hides. They also have a poor feed-to-food ratio compared to smaller stock. However, cattle can provide muscle as oxen for pulling, farming, and carting things around. Oxen can be male or female, so even your milk cow can be your ox in a pinch. Cows eat a lot. Figure on a milk cow eating 30 to 50 pounds of hay a day in the winter time. That’s a lot of hay if you’re putting it up by hand. Bulls are dangerous, but necessary to keep your cow bred (unless you can trade for the service a neighbor’s bull). It takes about a year or so to get a calf to butcher size, which means you’re going to be feeding that calf over the winter (more hay). However, your cow will produce five to eight gallons of milk a day (on average). That’s a lot of milk for your household, for trade, or for feeding chickens and hogs. Cow milk separates easily.

A cow’s gestation is about nine months and they will breed any month of the year. You can continue to milk the cow up until about two months before she calves. Cows usually have just one calf. Dairy cows produce far more milk than beef cows, but they have less meat. A good solution is to have a dairy cow and a beef bull. The resulting calf will have more meat at butcher time. However, if you’re trying to raise a replacement milk cow, this won’t work in the long run.

There are many breeds of dairy cows. Dexters are excellent dual purpose (milk/meat) for a small group. They are little cows, about the size of a pony. They consume half the feed of a full size cow, produce two to three gallons of milk daily and have a beefier carcass. They dress out at about 65%. The down side is that they are still relatively expensive ($1000 for a cow/$800 for a bull). If you look carefully, especially in this down economy, you can probably find them quite a bit cheaper. Dexters are docile and make excellent oxen.

Jerseys are another “homestead” favorite due to their smaller size and high percentage of butterfat in the milk. Jerseys are 800-1,000 pounds full grown and produce 5-to-8 gallons of milk daily. The milk is rich in butterfat and slightly sweet. I think it’s the best milk. We have a Jersey cross milk cow for our family’s use.

Horses are a huge help, but not necessary to survival. They consume a lot of feed without producing any food in return. Most of the work horses do can also be done by oxen. However, I’d rather ride a horse than an ox any day. If you have plenty of pasture, plenty of feed and plenty of shelter during storms, then by all means keep a couple of horses. Again, a mare or two and a stallion keeps things sustainable.

It’s unlikely that most people would be able to keep each of these animals, or even that they would want to. The idea is to carefully consider what you need to supply for your family over a period of years. What livestock can you add to your retreat planning to help insure a sustainable food supply? Other possibilities include rabbits (meat/hides), geese (down/eggs), ducks (higher protein eggs) or domestic turkeys. Both of the books mentioned above for farming practices have a wealth of information for small-scale livestock production.

The other thing to consider is mobility. If you’re already living at your retreat, adding large stock is relatively simple. If you’re going to have to bug out, you’ll have to consider what you can take. I know that I can put three goats, three sheep, six piglets, and 30 chickens in and on the back of my Suburban. I know because I tried it. It took me 30 minutes to get all of them safely loaded and/or crated. I’d have to leave my cattle and horses if I had to bug out, but I could take enough livestock to keep us going for the foreseeable future.

So give consideration to what you will do when your stash runs out. How will you feed your family, your neighbors, your group if hunting is difficult or impossible? What can you do that is sustainable and practical? Think about what works for you in your situation. It’s easy to butcher poultry. It’s a bit more complicated for sheep or goats, and it takes some serious planning for a 600 pound pig!

Think ahead and be prepared.

by Bobbi A. source

Published in: on March 31, 2009 at 3:54 am  Comments (1)  
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TEOTWAWKI Medical Skills Wilderness First Responder

Background
Most people I know prepare for medical emergencies by buying a first-aid kit, maybe taking a class, maybe buying some additional supplies, and calling it good. In an urban setting we typically expect to have professional assistance in less than an hour, but natural or man-made disasters could change this to days, weeks, months – or longer. I often work and play outside – skiing and motorcycles, construction and heavy-equipment, and off-grid living. I’ve fallen from horses, bicycles, and a roof. I live in earthquake and volcano country, and I’ve helped raise three sons.

I’ve been motivated for more than 40 years to be ready for whatever comes my way – “expect the unexpected”. And part of my prep has led me to study “improvisational backcountry medicine”(ditch medicine).

In an emergency, providing medical care requires knowledge, practice, equipment and supplies, and the right mind-set. Emergencies are charged with emotion and unpredictability. In this brief commentary I’m advocating two things: investing (time/money) in a comprehensive training program that provides hands-on, real-world scenarios, and then, putting together a full kit that will meet the needs of your current or probable family/community, and allow you to fully utilize your skills.

As a teen–in the 1960s–I took Red Cross courses (First Aid, Lifesaving, and Water Safety Instructor). Then the Army sent me to Vietnam for a couple of years where I had the “opportunity” to get some up-close and personal trauma-care experience. A decade later I went to back to school and earned a nursing degree. And just recently I took a Wilderness First Responder (WFR or “woofer”) class, eighty hours of realistic instruction and practice with dozens of what-if scenarios (medical and trauma). Without question the WFR is the best program I know for a 360-degree approach to survival medicine.

Wilderness First Responder – The Training

A Wilderness First Responder is an individual who has completed a structured, accredited training program and passed both a written and practical exam. Most of the people I trained with had a professional motivation – they work for an organization that made the WFR credentials a requirement of employment. Our group included river-rafters, mountain climbing guides, “executive training retreat” leaders, a couple of Emergency Medical Technician (EMT)s, and Search & Rescue (SAR) volunteers. The program is designed to help you deliver individual medical-delivery skills, but just as importantly to be an effective team-member or even the medical leader (“chief medical officer”).

My class was hosted by The Mountaineers in Seattle, and conducted by Remote Medical International (RMI). There are other good providers, all over the country (and the world). The orientation of my program was wilderness recreation, but my interest is living and working off-the-grid and the training was perfect for that, also.
In class we defined “remote medicine” to mean that you have limited equipment and supplies, you’re an hour or more from additional help, and you may be the only one providing care – or your helpers may know little or nothing, and may even impede you. You are the one in charge, the one responsible. Think about the implications if the individual needing help is you, or someone you love. And then make the time to get ready. Prepare to be a survivor.

A cardinal rule of medicine is “do thy patient no harm”. If someone is down, do you stay? Do you go for help? Should you leave him on his back, on his side, or as he fell?
We used makeup and prosthetic “broken bones”, “internal organs” and protruding “broken bones” to make it all seem more real. The responders were not told in advance what to expect when they came on the scene. We had outdoor night-practice sessions. No matter their background or experience, everyone learned something new.

Quoting from the curriculum documents, here is an overview of what we covered:
Day One: Course Overview & Patient Assessment
Introductions & Course Overview
What is Remote Medicine?
Role of the Medical Officer
Communications/Telemedicine
Medical-legal Considerations
Primary Survey
Physical Exam
Vital Signs
Patient History
Documentation

Day Two: CPR
CPR for the Healthcare Provider
Considerations for Remote Environments
Oxygen Administration

Day Three: Trauma Management
Orthopedic Injuries
Shock
Neurological Trauma & Injury

Day Four: Trauma Management
Wound Management & Infection
Chest Injuries
Dental Emergencies
Lifting & Moving Patients
Patient Packaging & Transportation

Day Five: Medical Emergencies
Cardio-respiratory Emergencies
Acute Abdominal Pain
Metabolic Illness & Allergic Reactions
Medication Administration Lab

Day Six: Medical Continued/Environmental
Genitourinary Medicine
Neurological Illness
Altitude Related Illnesses
Psychological Emergencies & Rescuer Stress
Lightning
Mass Casualty

Day Seven: Environmental
Frostbite & Non-Freezing Cold Injuries
Hypothermia
Heat Illness
Immersion & Near-Drowning
Health & Hygiene
Search and Rescue & Group Management
Austere Patient Care and Survival

Day Eight: Environmental/Logistics
Dive Emergencies
Plant & Chemical Poisoning
Animal Attacks & Envenomation
Pre-Expedition Health Screening & Planning
Remote Medical Kit & Supplies

Day Nine: Testing
Practical Exam
Written Exam
Debrief & Evaluations

The Skills
And here are some of the skills we learned (and practiced, and demonstrated to each other and to our instructors!)
* demonstrate comprehension of the legal concepts related to medical care, and relate their interpretation to patient care.
* demonstrate a working professional vocabulary for communicating their patient assessment and care with other responders.
* demonstrate skill at gloving and de-gloving, and describe the techniques of body substance isolation.
* demonstrate rudimentary execution of a Scene size-up, Primary Survey, and Secondary Survey, assessing and managing the scene for safety; demonstrate rapid, effective moves out of harm’s way, application and management of the tourniquet, verbalize a General Impression, assess the ABC’s, and effect interventions, obtain multiple sets of vitals signs, a patient history and a thorough head-to-toe physical exam.
* demonstrate a basic skill in making SOAP notes. [Subjective (Location, age, sex, MOI/history of events, Symptoms), Objective (LOC, RR, HR, SCTM, ROM [repeat at 15 min.]), Assessment (Fracture/Hyothermis/ …), PLAN (clean, bandage, splint, …)]
* be able to describe the introduction of pathogens into the body, and the body’s inflammation responses.
* be able to accurately assess and manage oxygen delivery, airway interventions and management, and use of the bag-valve mask (BVM).
* recognize the potential danger of thunderstorms, respond appropriately to an approaching storm, assess and manage related injuries.
* describe the management of submersion incident (drowning) casualties.
* describe and demonstrate the assessment and management of shock.
* assess and manage chest pain, satisfactorily and appropriately perform CPR, and know the backcountry protocols for initiating and stopping CPR.
* demonstrate competence in carefully approaching the study and use of medications.
* communicate the responsibility of the WFR in public health matters (water, food handling, and hygiene).
* understand North American bites and stings; recognize and manage intoxication, envenomations, and allergic reactions, provide wound care. Students can assess, measure, and administer 0.3ml volume intramuscularly.
* demonstrate command of assessing and managing the three levels of injuries to the head and provide long-term care.
* demonstrate command of spinal cord/spinal column assessment criteria, conduct a thorough physical exam for cord injury (“clear” the spine), improvise a C-collar, and demonstrate correct rolls, moves, and lifts with spinal precautions.
* demonstrate recall of prevention, assessment, and management of hypothermia, frostbite, non-freezing cold injuries.
* be able to prevent, recognize, and manage dehydration, heat exhaustion, heat stroke, heat cramps, and sunburn.
* be able to prevent, recognize, and manage high altitude problems (AMS/HAPE/HACE).
* demonstrate competence at safely conducting carries (pacstrap, split-coil, piggyback, backpack, and fireman’s)
* fabricate a manageable, comfortable, and protective hypowrap.
* demonstrate correct packaging, organization, communication, and carrying skills with a spine-board and the Stokes litter.
* demonstrate competence with the fundamental principles and operations of a technical rescue, can safely tie-in, and demonstrate rudimentary team skills with communicating, anchoring, belaying, lowering and raising a low-angle-configured rescue litter.
* demonstrate familiarity with “essential” items, search-victim care items, and radio conduct.
* demonstrate knowledge of the purpose, principles, and parameters for trek planning.
* relate the principles and conduct of SAR operations, the considerations for evacuation options, and conduct around helicopters.
* demonstrate proper management of open wounds, describe infection assessment and care.
* relate the dynamics of missile wounds, the assessment criteria for evacuation, and expedient field treatment for missile, and arrow / spear injuries.
* describe evaluation and management techniques of burn injuries.
* describe the steps and technique for assessing and managing the sprained ankle, and demonstrate effective taping of the ankle.
* be able to demonstrate assessment and management of fractures; apply commercial and improvised stabilizing and traction splints.
* demonstrate ability to assess and manage dislocations, and demonstrate skills to relocate the shoulder, patella, and digits, and forearm.
* demonstrate effective teamwork in managing patients with insults to multiple primary systems.
* demonstrate organizing and managing a response to a multiple casualty scene, rapidly sorting, prioritizing, and managing patients for critical care and evacuation.
* describe the assessment and management of common EENT problems.
* demonstrate thorough, courteous technique in assessing the “medical” patient.
* assess and manage abdominal problems, demonstrate improving skills in getting a medical history, and demonstrate knowing when to evacuate the patient.
* describe assessing for, and managing diabetic emergencies.
* relate the assessment and management of common genitourinary (GU) illnesses, and instruct others in hygiene and prevention in the backcountry.

Reading about this stuff is not enough. There is no substitute for hands-on experience and developing muscle-memory. And by the way, certified WFRs are required to take a refresher every couple of years so they don’t get rusty.

Disclaimer: I mention Remote Medical International (RMI) in this article – they were great, and they provide medical training, equipment, and supplies. I have no financial stake in the firm. There are other great companies out there – search for “WFR” and you’ll turn up a handful.

About the Author: Richard B. has worked as a general contractor, business consultant, US Army combat photographer, Registered Nurse, railroad carpenter and brakeman, and as a forest fire-fighter.

source

Published in: on March 30, 2009 at 8:48 pm  Leave a Comment  
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Finding Shelter and Water Video

Finding drinking water and shelter is critical to wilderness survival. It’s not always this easy to find shelter and water, but knowing your location and where to look for clean water, such as between mountain ridges or near oceans can help a great deal.

As always, staying observant and aware of your surroundings will help you survive no matter the conditions. Many people would walk past or ignore obvious shelters and sources of water simply because they haven’t trained themselves to be aware of such things.

Published in: on March 27, 2009 at 10:02 pm  Leave a Comment  
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19th Century Home Retrofit

By now most survivalist readers have gone about your preparations for your ideal home or retreat cabin, all storage food and tools acquired, fuel stored, generators ready, PV panels carefully concealed and hooked up to the battery bank. You and your family or group are ready to handle the coming collapse, but are you really? Are you ready to do without? Without that generator when the fuel runs out, or a critical piece is worn out and a new one cannot be had? At some point your supplies will be used up, storage fuel consumed and there may not be any to refill your tanks or more realistically you may be priced out, or it will be too dangerous to “run-the-gauntlet” and get more. Can you manage in your place without electricity? Can you cook with wood? Do you have space enough to process the abundant food you grow and must preserve either by canning or other means? Can you move throughout your buildings without being seen from the outside?

My point, is your place set up to function as a 19th century homestead?

My wife and I bought an old New England farmhouse many years ago, it is nothing fancy and looks like so many others in our area, it is a traditional connected farmhouse meaning that the buildings are all linked-up, yet they have different roof lines and are of different sizes. It is best summed up as a “Big House, Little House, Back House, Barn” and this is the title of a wonderful book written by Thomas C. Hubka which details the reasons for the ways structures developed. (If you want a leisurely read on the history of these buildings, I highly recommend this book.) Anyway, we bought this type of farm house and have been in the process of renovating it over many years, although the renovation could more reasonably described as going back to the future. One of the many wonderful things about an old house, and when I say old I mean over 150 years old, is the ability to reuse much of the lumber in the walls, floors, and ceilings or the masonry whether it is brick or stone, Ours is a timber frame with some masonry on the exterior and is incredibly well built and has a brilliant house plan. I realize that many people are not up to the task of going through this sort of process, but you could build your current retreat or home to some of these specs. Our home for example was built just after the War of 1812 it was fully functional for a family of eight with room for boarders/labors and or relatives. The kitchen is large while many of the adjacent rooms are small (less space to heat) all the rooms are situated around two large central fireplaces and have thimbles to allow for a small wood stove in each, the rooms can be closed off when not in use, thus not taking valuable heat from other areas. In the basement there is a large hole in the floor; it was a cistern, but was allowed to fill in with junk, perhaps it was considered a “sump hole” by later inhabitants since there was evidence of long overworked pumps in under the silt and gravel. I have cleaned this up and now have a source of water right in the house, (this water will still need to be treated since it is technically surface water being only ten feet below grade), but it still offers water for cleaning or for our animals.

There is a large “root” cellar to store food stuffs and canned goods. (It could double as safe room or vault if needed and may well have been at one point since the opening is nondescript and hidden from plain sight). Also there is a summer kitchen, at first I wondered why this was necessary, it appeared to be redundant, but further study enlightened me to the fact that this area was a vital part the home complex. First it served to allow a large un-insulated cook area that was necessary during the harvest time to allow heat to escape from the constant fire in the cook stove during the canning, it was also a place that field labors had their meals prepared and ate without having to clean themselves up much and not dirty up the regular kitchen. The buildings between the summer kitchen and barn (sometimes it is one long building divided only internally or there are up to three distinct roof lines and end walls that divide them) any how these areas were used in a variety of ways to allow a small cottage industry to occur, in-fact these were simply work areas that were sheltered from the often harsh and wild weather we experience. One could be for wood storage, for tools (a sort of machine shop), or areas for processing wool from sheep. The point is not to recreate that lifestyle but to utilize that mindset and build similar multi-purpose structures.

Our Home:
We have “renovated” our home to fully function without electricity. Now, we have multiple generators, a significant storage of fuels and food. I and am currently finishing up with the PV panels and battery bank/inverter set-up, going through all the motions to secure some sense of normalcy; but in-fact we do not “need” those items to exist here, they are an extra. We can heat with wood and with a solar hot water system connected to baseboard radiators as well as a copper coil running through the wood fired furnace [for when there is not solar gain or during a heavy snowfall]. (The hot water moves via thermo-siphon no electricity needed only check-valves to keep the hot water moving in one direction). Our kitchen is “modern” but if the power is out we can cook on our wood fired cook-stove, it is about 120 years old and with a little “TLC” is now fully functional not to mention beautiful to look at. We can also bake in a bee hive oven built into the massive central chimney which I rebuilt and lined with modern flues. I left one of the original fireplaces, installed airtight doors and an exterior air vent, while on the other side made the other fireplace into a large wood storage container.

Overall, your retreat needs to be functional without electricity, things will eventually break, or you simply run out. Focus upon knowing how to live your life with little to no electricity or “conveniences”. The primary goals must be on heating your home and preparing food without petrochemical fuels, most modern homes are particularly horrible in this area. Change your mindset; you cannot store enough for the really long haul.

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Published in: on March 27, 2009 at 9:52 pm  Leave a Comment  
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Growing Food in Times of Scarcity

Today I got a call from a very good friend and one that has contact with some pretty prominent people. He was so sad, scared and worried, didn’t want to pass on bad news but felt he should let me know. One of his close friends has a good source of information plus a high security clearance informed him that over the summer you would see more and more deployment by the military, come the end of summer into the early fall there “WILL” be martial law. The food source is being dried up gradually. Food will become so scarce and expensive families will be going hungry. This will be the start of a civil uprising and the military will be called into service to quell the looting, stealing, killing and destruction of property. This is all planned. Believe it or not but at least take the time to prepare for it just in case.

I am not telling you this is the gospel but I know where the information came from and it is certainly a credible source.

People, it more than likely cannot be stopped.. WAKE UP…You can still protect your family from most of the hard times with some planning. Do you want to see your children’s eyes with hunger in them? Do you want to be on your knees begging for food ? I don’t and I won’t.

It is the beginning of spring now. Plant every square inch of land you can find, buy pots, buy dirt, buy food and put it away now while it is still here.

Those of you that say you don’t have room… MAKE ROOM.. there are so many ways to increase space for your gardens, use your imagination.

How about a wall of food? simple, use PVC pipe, hook it to a rack or your fence or your patio supports. I have done this before just to see if it worked and to dress up a area of our patio that was not that attractive. I used 6″ PVC pipes 10 feet long. just packed with good dirt and wired screen over the ends to allow drainage. Drilled holes in the pipe and planted. I grew flowers but vegetables can be grown just as easily. Just think.. put the smaller plants on the top tier, larger ones below. The only drawback is watering which with smaller containers you have to do regularly or you could just install a drip system?

gardening

gardening

How about planting your potatoes, asparagus and peanuts in bags? Easy to do and so much more prolific in production. Find some of the Tyvec we used for banners and signs during the campaign, cut into 4′ lengths, stitch up two sides making a sack, poke holes for drainage in the bottom and add dirt. Plant all those potato eyes in the bags, add more compost or good dirt. As the plant grows add more dirt and when they are ready to harvest just dump out the bags, there are your future dinners. One bag can produce up to 30 pounds of potatoes. Do the same for Peanuts. The bags can be lined up alongside your garage, house, any out of the way place. ( Don’t try using paper bags they will of course fall apart when wet)

How about all of those hanging baskets you saved from last years flowers? Cut holes in the bottoms and use coffee filters to keep in the dirt. Plant your cukes, squash, any vining plant in these and watch them grow. Easy to harvest and prolific producers as long as you keep them moist and fertilized. Ever heard of the upside down planters? Make your own.

I spent a couple of hours yesterday starting some seeds for the garden. Easy and relaxing work. I splurged and bought some new 6 pack containers which comes with a bottom tray and a top clear plastic dome cover to protect the seedlings from being washed away by heavy rain, cold, etc.

I like to use a sterile medium, Peat Moss and Perlite, it is free of diseases and bugs and insures a good start to your little plants. Use one part Perlite with 20 parts peat and you will have a perfect medium for starting anything.

starting seeds

starting seeds

Get your hands dirty and fill your little pots with the mix, leave about a half inch on the top of each section. Put in your seeds ( usually 2 seeds per container) add more soil to cover the seeds and press it down to insure good contact with the medium… Make sure you wet your peat mixture down before filling the containers. Peat is hard to wet totally and takes some mixing by hand to insure it is wet all the way through.

Then just cover and wait for nature to take its course:

starting seeds

starting seeds

Tim brought in a truck load of ruined hay to mulch our garden with and will get that on the garden tomorrow. Then the real work begins.. planting peas, beans, okra, peppers, eggplants and all the greens I love so much.. collards, kale, mustard and broccoli. These will do well even with some cold nights left to go.

Please people stock up your pantry, have enough food for your family for at least 6 months. A year would be better but I know how much it costs. Don’t listen to the experts, buy what you normally eat no need to stock up on items that are recommended but you rarely eat. Make sure you have enough salt, sugar, oil, coffee, tea, chocolate and spices of all kinds. These will be the things people forget to store up on and will become good items to barter. Flour is already becoming scarce in our area, corn meal the same, Meat will become so expensive it will be out of reach for most of us but by buying now and canning it ( freezing is ok but if your power is cut off your meat will spoil so I just can it all) I must have 10 cases of hamburger canned, beef stew, Chicken “N” dumplings, Pork Chops, vegetable soups and spaghetti sauce all ready to go. Just open the jar and heat and eat. So much better than the store brands and you know exactly what is in them. Roasts can be canned also very easily. If you don’t have a pressure canner yet get one by hook or crook. It will be a Godsend if things go sour and I think they will shortly.

Think about building a dehydrator, easy to build, I used one of those closet bags for hanging suits etc and replaced the plastic with screen wire. Added shelves and I can hang it outside in the fresh air with all the vegetables on it to air dry. The Indians did it hundreds of years ago and it is still a good idea. Dried food lasts a long time, can be stored easily and is ready to just add water and heat and eat.

Everyone is busy buying all the expensive water purifiers.. why? Build one.. easy.. look at how a alcohol still is built, make a small one. You will be making distilled water in no time. I made one out of a old pressure cooker just take off the jiggler and attach a metal or glass tube ( The first one I made used Aquarium tubing )to run to your water bottle. fill the cooker, turn it on and just watch the water start coming out of the spout. All the impurities will remain in the cooker and only pure steam will be put out to condense back into water. Add a pinch of salt to make it have some taste and you are in business.

When you go to the flea markets, yard sales etc make sure to snap up any and all canning jars and lids, you will need to can your produce for the next winters use.

Please take heed and start today. There is no time to lose and if you wait you may be one of the ones that are just begging for help from our wonderful Government which means you have to obey. You have to comply, you have to agree to be what ever they want you to be or you could just be left to starve !

DO NOT make your plans known to your neighbors unless they are also doing the same thing. When the SHTF there will be so many people on the streets looking for food for their families you will be a target. Just remember even a honest hardworking Christian will turn to anything to feed his children. He will steal, lie, even kill to keep his children from starving. Wouldn’t you?

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Published in: on March 27, 2009 at 2:59 am  Leave a Comment  
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Ditch Medicine and Minor Surgery

Dealing with ingrown toenails and infections during emergency situations.

Onychocryptosis (ON-ee-ko-krip-TOE-sis), an ingrown toenail, is a very common problem that usually affects the big toe. This occurs when the corner of the toenail grows into the soft tissue on the side of the toe. This can cause pain, redness, inflammation, and even an infection. Signs of an infection are warmth and drainage of pus. Prevention and treatment of an ingrown toenail is relatively basic, and it is a valuable skill to have at TEOTWAWKI.

Causes
An ingrown toenail is caused when the nail curves down and grows into the skin at the nail border. The most common causes of an ingrown toenail are improperly trimmed toenails and poorly fitting footwear. Other causes include unusually curved toenails, excessive sweating, trauma, fungal infections which cause the nail to grow abnormally, cancers, and even obesity.

Complications
If an infection is left untreated, it can spread into the toe bones. This may lead to amputations, and even death, in rare, worst case scenarios.

Prevention
If you are working outside a lot, which would be most of us in a TEOTWAWKI scenario, then study boots are recommended; consider steel-toed boots if you don’t already have them. Regardless of the footwear you use, make sure that they fit properly! There should not be too much pressure on the top of your toes, and shoes should not pinch your toes together.

Toenails should be kept at a length even with, or just barely shorter than, the tips of your toes. Too long and toenails can break easily or get jammed into the toenail base. Too short and the toenails can be pushed down by your shoes and grow into the soft tissue of the toe. Trim your toenails straight across or with a slight curve. Do not curve your nails to match your toes, and do not trim the outer angles of your toenails. Finally, do not pick, tear, (or bite!) your toenails; only use a toenail clipper and file.

Non-Surgical Treatments – this treats 70%+ of ingrown toenails
* Wear very comfortable shoes; consider wearing sandals until the ingrown nail resolves.
* Soak the foot in warm water 3-5 times a day for 15-20 minutes. Add 1 teaspoon of salt per pint of water.
* Gently push the tissue away from the nail and gently lift the nail up after each soaking.
* Place small, clean tufts of cotton under the edge of the ingrown nail. This relieves some pressure and helps the nail grow above the skin edge.
* Rub a topical antibiotic ointment (such as Neosporin) over the ingrown nail.
* Place a soft bandage over the ingrown nail.
* Keep the foot dry.
* Take some acetaminophen (Tylenol) or ibuprofen (Motrin, Advil, etc.) as directed on the bottle for pain relief.
* If there is no improvement in 2-3 days, then consider the surgical option.

Surgical Treatments: Toenail Removal
Note: If you have had ingrown toenails in the past, there is a good chance you will have ingrown toenails again. If you have had repeated ingrown toenails, consider having your nails surgically treated before TSHTF. A surgical option, regardless of the problem, is always best treated by someone who has been trained to perform the procedure. You don’t want to be patient number one in a survival situation. Finally, while I am explaining how to do this procedure, I only recommend that you attempt this in a post-TEOTWAWKI scenario where there are no other healthcare options. Proceed at your own risk.

The most effective way to treat an ingrown toenail that has not responded to non-surgical treatment is lateral nail avulsion with matricectomy. What does that mean? Let’s break it down. Lateral nail avulsion is digging out and removing one side of the toenail all the way down to the base. Imagine the nail is roughly a square. The ingrown part is on the left side for example. About 1/5 of the nail, the left 1/5, is removed from top to bottom. The remaining 4/5 is left completely intact. Macticectomy is the process of destroying the matrix, or root, of the nail. By removing one side of the nail, the pressure is removed because there is no nail pressing on the tissue any more. This also allows the infection to drain. By destroying the root on that side there is a very slim chance of the toenail growing back in that area. Over time the skin will heal and you will be left with a skinnier toenail that is unlikely to become ingrown again. Now how do you do this?

Supplies
Light (a bright headlamp works well. Consider working outside in the bright sunlight.)
Non-sterile gloves
Sterile gloves
10-mL syringe
27 to 30-gauge needle
Lidocaine 1% or 2%
Povidone-iodine solution (sold as Betadine at most drug stores)
Gauze pads
Drape (sterile sheet)
Iris scissors (small, 3-4 inch long scissors with fine, sharp points)
Bandage scissors if desired (scissors with one side’s outer edge flattened for protection)
Nail splitter if desired (heavy duty scissors with very short, thick blades)
Hemostats (small device that resembles scissors but has clamps instead of blades) a pair of needle nosed pliers (sterilized) can be used in a pinch
Sterile rubber band if desired
Cautery device – read the step-by-step instructions for details
Dressing Materials:
Antibiotic ointment such as Neosporin
Gauze for wrapping the toe
Roll of 1-inch tape

Step-by-Step Instructions
1. Have the patient lie down on a table with their knees bent. Their feet will be flat on the table. Pull up a chair and put on non-sterile gloves.

2. Clean the entire toe with povidine-iodine.

3. Numb the toe with medicine: If you have lidocaine (1% or 2%) without epinephrine, keep reading to learn how to perform a digital block, i.e. numbing, of the big toe.
Note: Make sure the lidocaine does not have epinephrine in it. Epinephrine is a vasoconstrictor, meaning it clamps down blood vessels. This can prevent circulation to the toes. If you stop circulation with medicine, you have no idea how long it will last, and you could kill the tissues in the toe. Your patient won’t feel you remove their toenail, but in a few weeks their toe may fall off! Bottom line: Never use epinephrine on the fingers, toes, ears, penis, or nose.

3A.) Load the lidocaine into the syringe. I have no idea what kind of container of lidocaine you will have, but the standard container is a small jar with an injectable, rubber stopper. Remove the cap and clean the stopper with alcohol. Draw back the syringe to draw in about 8-10 mL (or cc’s) of air. Then push the needle into the rubber cover. Inject the air into the jar of lidocaine; this prevents a vacuum from forming after repetitive uses. (If the jar is full, you may have fill the syringe a bit at a time so the rubber cover doesn’t pop off when you inject a full syringe of air – I learned this the hard way!) Invert the jar so the needle tip is completely covered with lidocaine. Draw back the syringe to the 8-10 mL mark. Remove the needle from the jar. Point the needle up. Tap the syringe to get the majority of the air bubbles to the top. Slowly depress the syringe to express the air bubbles from the syringe. Usually a little of the lidocaine will shoot out. It is not vital to remove all the air, just as much as you can.

3B.) Find the MTP joint (metatarsophalangeal joint). The first joint next to the big toenail is the PIP joint (proximal interphalangeal). The second joint, and usually larger of the two, is the MTP – it connects the toe to the rest of the foot.

3C.) Find the injection sites. They are about one-eighth inch above the MTP joint (that is one-quarter inch down the toe, closer to the nail). There are three injection sites: one directly on top of the toe, one exactly on the right side, and one exactly on the left side.

3D.) Inject the lidocaine. Always inject a needle perpendicular to the skin. Puncture the skin with the needle and insert to a depth of about 2 mm (skin is about 1.5 mm thick). Pull back on the syringe to make sure you are not in a blood vessel; if you are, you will see a bunch of bright red blood fill the syringe (if this happens, withdraw the needle and try again a little to the side). You will want to inject about 2 mL of lidocaine at each site. This will sting and burn and then go numb.

3E.) Wait. Wait 5-10 minutes for the block to become effective. If need be, you can give another 1-2 mLs if your patient is still feeling pain. When the toe is numb, proceed.

4. Dull the pain with no medicine: If you do not have lidocaine, things are going to be painful. There are topical numbing medicines available, but these are not nearly as effective as an injection. Most of them are in the same family as lidocaine and are mixed with a cream to make application easier. Another option is to try a topical dental pain reliever such as Orajel or Anbesol (these are topical benzocaine), but again this will only take the edge off. A final option, if you have access to it, is ice; cold temperatures can numb a toe pretty well. An ice water (or snow water) bath is likely the safest way to numb a toe; but be mindful that a cold, numb toe is also a sign of frostbite. It’s a careful balance, and I would always err on the side of too much pain. Pain will go away eventually, but a frostbitten toe may never heal. Keep in mind, depending on the person and their pain tolerance, your patient may be able to just grin and bear it.

5. Re-wash the toe with povidine-iodine. Put on sterile gloves. Place a sterile drape over the foot. A small hole in the drape to pull the toe through will keep your surgical field clean.

6. Insert the tip of your closed iris scissors under the corner of the nail on the side it is ingrown. Work the tip down the entire side freeing it from the tissue of the toe. If there are no pain medications, this will be very painful. You should now have the entire side unattached.

7. Split the nail into two pieces. Using a nail splitter, bandage scissors, or iris scissors cut the nail from the free end straight back to the base. You should now have split the nail into 2 pieces (1/5 is the side with the ingrown nail; 4/5 is the healthy side). These pieces are still connected at the root.

8. Apply tourniquet. Some physicians use a sterilized rubber band to wrap around the toe a few times. This acts as a small tourniquet to reduce blood loss which makes it easier to see what you are doing. Having done both, I personally like having a tourniquet in place. Remember to use the tourniquet for the shortest amount of time possible to avoid permanent damage (less than 10 minutes).

9. Remove the toenail. Grab the ingrown toenail with a hemostat. Attempt to grab as much as possible with one bite. Pull straight out toward the end of the toe and to the side at the same time (do not pull up or down or twist). If the nail breaks, just re-grab the remaining nail and pull in the same motion as before. No piece of nail should remain. Some other tissues can look like a nail deeper at the root, but the nail to be removed is hard to the touch of your hemostat.

10. Destroy the matrix. There are a few ways to do this. The most effective and the easiest to perform at home is cautery. Cauterize (i.e. burn) the nail forming matrix (root) in only the area where the nail root was removed. This is probably the most delicate part of the whole procedure. The idea is to burn just the root and not the surrounding tissue – think of the old game Operation. Cauterize the entire area twice to make sure you didn’t miss a spot. Since most people will not have an electrocautery machine, a small soldering iron [with a fresh tip] will work in a pinch (haven’t you read “Patriots” ?). If you have no electricity, you can consider heating up a thin piece of bare wire in a flame to keep it very hot and use small needle nose pliers to hold it. Another method is to apply a Q-tip soaked in phenol solution to the root. This chemically cauterizes the matrix. This is not as effective and you have to buy and store the solution, but it is another option. Again only apply it to the root; it will kill any tissue it touches.

11. Apply antibiotic ointment over the raw tissue. Apply a bulky gauze wrap, but do not wrap it too tight. It will throb as sensation returns.

12. Change the dressing, clean with warm water, and apply topical antibiotic ointment daily. Use acetaminophen or ibuprofen for pain. Avoid strenuous exercise for at least a week.
13. The empty nail bed will fill in with normal tissue in the next few weeks. Your patient will be left with a healthy, but skinnier, toenail.

Surgical Complications
1. Not all the nail was removed or not all of the root was destroyed: This may happen, even to the best of us. The best course of action is to just wait and see if the nail that grows behaves or not. If it does not, just repeat the procedure.

2. Infection: The toe will have some initial throbbing, but should start to improve dramatically in a few days. If your patient is having an increase in pain, swelling, redness, warmth, or drainage, there is likely an infection. If this occurs in the first few days, it is likely a bacterial infection from Staphylococcus aureus. Oral antibiotics are your best choice and are usually very effective.

Any of the following oral antibiotics (unless there is an allergy) should be used for 10 days (search past Survivalblog posts for medication procurement):
Adults
Cleocin (clindamycin) 300 mg three times a day
Augmentin (amoxicillin with clavulanate) 875 mg / 125 mg twice a day
Dicloxacillin 500 mg every 6 hours
Keflex (cephalexin) 500 mg every 6 hours
Children
Cleocin (clindamycin) 30-40 mg/kg per day divided in 3-4 doses
Dicloxacillin 25-50 mg/kg per day divided in 4 doses
Keflex (cephalexin) 25-50 mg/kg per day divided in 3-4 doses
If the infection occurs after a week, there is an increased chance it is a fungal infection. Fungal infections can usually be treated by stopping the antibiotic ointment and applying a topical anti-fungal cream such as Lotrimin (Clotrimazole), Nizoral (Ketaconazole), or Naftin (Naftidine hydrochloride).

3. The toe is taking a long time to heal and is dusky in color. Some parts are turning black. What happened? The tourniquet was kept on too long, the toe was kept in/on ice for too long, or the cautery was too deep. Don’t let this happen to you! Don’t keep the tourniquet on for too long. 5-10 minutes should be plenty of time to remove the nail and cauterize – use a stop watch. Remember to err on the side of too little numbing with ice. Be gentle with the cautery – this is a shallow procedure. This is not common, but if this does happen consider oral antibiotics and consider attempting to remove the blackened tissue. This would be a case where attempting to find a physician may outweigh the risks of leaving your retreat.

Things to consider
If an ingrown toenail is really severe, has a severe infection, and is affecting both sides of the nail, it is better to remove the entire nail and not do cauterization. Remove the nail. Let things drain. Let things grow back. If things are heading in the same direction, then you can treat it surgically as described above. It is much safer to operate on a toe that is not infected.

Training
It will be difficult to acquire hands on training for this procedure unless you work in the medical field. One way to see how it is done is to go with a friend or family member who is having this procedure. Let them know that you are interested in health care (that you love the Discovery Health Channel or something like that) and you would be honored to help them through this event. Another option is to do an online video search for “toenail removal surgery”. Keep in mind that every practitioner does things a little different. For example, some use cautery (this has been proven to be the most effective), but some still use the chemical phenol. Some use the tools listed above, and others have their own favorites. There are many ways to skin a cat and to remove a toenail.

The skin has three layers.
1. The epidermis is the outermost layer. It protects our bodies from the environment and has pigment cells.
2. The dermis is the middle layer, and it contains hair follicles, sweat glands, oil glands, and capillaries.
3. The hypodermis (or subcutaneous layer) is the inner layer, and it contains layers of fat that provides cushion and insulation for our body… some more than others.
Any of these layers can become infected, in whole or in part. In a TEOTWAWKI scenario, that minor scratch could lead to a painful death. Knowledge is vitally important. Understanding how to prevent and treat a skin infection is relatively straightforward, and it could be a matter of life and death when TSHTF.
Signs of a skin infection are pain, redness, swelling, warmth and/or drainage of pus.

Definitions
Cellulitis: a diffuse infection of the dermis and subcutaneous tissues. Signs of cellulitis are red, warm, swollen, and tender skin.
Erysipelas: similar to cellulitis, but this infection is more superficial and has very clear borders.
Skin abscess: a collection of pus that is in the dermis and subcutaneous tissues. An abscess presents as a tender mass just under the skin. It is pink to red and may be warm to the touch.
Furunlce (or “boil”): an infection of the hair follicle that causes an abscess.
Carbuncle: a collection of several boils that grow together. This looks like a very large abscess.

Causes
These skin infections can develop in any individual and most are caused by bacteria. Having minor scrapes and cuts, insect bites, rashes, burns, swelling, or being around another person with a skin infection can increase your risk. Having diabetes, being immunosuppressed (HIV, on chemotherapy medicines, autoimmune disease, etc.), or having a history of methicillin-resistant Staphylococcus aureus (MRSA) infections also increases your risk.
Complications
If an infection is left untreated, it can keep spreading into the surrounding tissues and into the bloodstream. This may lead to local tissue damage, a body-wide infection, and even death in a worst case scenario.
Prevention
All skin wounds, no matter how minor, should be cleaned and dressed immediately. Changing the dressing when it becomes wet or dirty will aid in prevention. In a TEOTWAWKI scenario, you cannot afford to brush aside that thorn scratch or knife nick. Take the time to clean it right away. Skin infections don’t care how tough you think you are.

Antibiotics
Cellulitis and erysipelas are sometimes watched and not treated with antibiotics right away. However, if these infections become severe (which can happen quickly), IV antibiotics are the best choice. In a TEOTWAWKI scenario, IV antibiotics will be much harder to store and/or obtain. Because of this, I recommend using oral antibiotics with cellulitis and erysipelas immediately.
Antibiotics are typically not needed with a draining abscess or after an incision and drainage (I&D). Once the pus pocket is ruptured, your immune system usually takes care of things rather well. However, I would start antibiotics if a growing redness and warmth develops after the wound has been drained.
Also, I would start antibiotics right away if the patient has multiple skin infections, the patient is immunosuppressed, the patient has previous MRSA infections, or if the patient has signs of body-wide infection (feeling ill, fever, nausea and/or vomiting, increased heart rate, low blood pressure, etc.).
Any of the following oral antibiotics (unless there is an allergy) should be used for 10 days minimum, but can be used longer as long as the infection is improving (search past Survivalblog posts for medication procurement):
Adults
Cleocin (clindamycin) 300 mg every 6 hours (currently treats most MRSA)
Dicloxacillin 500 mg every 6 hours
Keflex (cephalexin) 500 mg every 6 hours
Children
Cleocin (clindamycin) 30-40 mg/kg per day divided in 3-4 doses (treats most MRSA)
Dicloxacillin 25-50 mg/kg per day divided in 4 doses
Keflex (cephalexin) 25-50 mg/kg per day divided in 3-4 doses

Non-Surgical Treatment
Small boils and small abscesses may respond very well to non-surgical treatments:
* Keep the infected area elevated.
* Warm compresses (a clean wash cloth soaked in hot water and wrung out) and warm water soaks will help promote drainage.
* If it comes to a head, continue with warm compresses until it ruptures.
* Wash with antibacterial soap.
* Continue to use warm compresses until the pus stops flowing.
* Apply antibacterial ointment (such as Neosporin) over the wound.
* Keep a clean and dry dressing in place over the wound.
* Wash the wound and change the dressing 2-3 times a day.
* There should be improvement in about a week.
* If there is a growing area of redness and warmth, consider antibiotic treatment.

Surgical Treatments:

Incision and Drainage
Larger boils, larger abscesses, and carbuncles require incision and drainage (I&D) to heal.
Note: A surgical option, regardless of the problem, is always best treated by someone who has been trained to perform the procedure. You don’t want to be patient number one in a survival situation. Finally, while I am explaining how to do this procedure, I only recommend that you attempt this in a post-TEOTWAWKI scenario where there are no other healthcare options. Proceed at your own risk.
Supplies
Light (a bright headlamp works well. Consider working outside in the bright sunlight.)
Non-sterile gloves
Sterile gloves
Alcohol or povidone-iodine solution (sold as Betadine)
Gauze pads
10-mL syringe
25- to 30-gauge needle
12- to 18-gauge needle if desired
Lidocaine 1% or 2%
No. 11 or 15 blade scalpel or sterile razor blade
Curved hemostats (small device that resembles scissors but has curved clamps instead of blades) a pair of needle nosed pliers (sterilized) can be used in a pinch
Packing material (such as iodoform gauze which are thin medicated gauze strips)
Scissors

Dressing Materials:
Antibiotic ointment such as Neosporin
Gauze for wrapping the wound
Roll of 1-inch tape

Step-by-Step Instructions
1. Have the patient get into a comfortable position. Have them lie down if possible just in case they pass out – it can happen to anyone! [JWR Adds: Vasovegal and other fainting responses are highly unpredictable. Just the sight of spurting blood can induce a faint in even someone that big and macho. In two separate incidents, I’ve personally witnessed two “manly men” who claimed “no problem, it won’t bother me” pass out, unconscious, within moment of seeing their own blood.]

2. Clean the wound. Put on non-sterile gloves and clean the entire wound and surrounding tissue with povidine-iodine or alcohol.
3. Numb the wound with medicine: The easiest method is a field block. Inject the lidocaine around the base of the wound on all sides. If the wound is not on a small body part, you can use lidocaine with epinephrine.
Note: Make sure the lidocaine does not have epinephrine in it if the wound is on a small body part. Epinephrine is a vasoconstrictor, meaning it clamps down blood vessels. This can prevent circulation. If you stop circulation with medicine, you have no idea how long it will last, and you could kill tissue. Your patient won’t feel the procedure, but they may lose a body part! Bottom line: Never use epinephrine on the fingers, toes, ears, penis, or nose.

4. Make an incision. Using the scalpel blade or sterile razor blade make a straight cut the entire length of the abscess (the deepest red central portion of the abscess). The cut should be deep enough to go to the subcutaneous tissues. Try to follow the natural skin folds for a more cosmetic healing (do an online image search for “cleavage skin lines” to see an illustration). For small infections, you may be able to drain the abscess by perforating it with the large bore (a 12-18 gauge) needle.
5. Probe the incision if large enough. If there are no pain meds, this will be painful. Insert the curved hemostats to slowly spread out the tissues under the cut. This will break up some of the connective tissues that may be holding pockets of pus. You also may find a foreign body (thorn, glass, etc.) that was actually causing the infection.
6. Express the wound. Provide gentle pressure to the sides of the wound to squeeze out any extra pus and blood. Do not be aggressive here.
7. Pack the wound. If the wound is big enough to leave a pocket, then filling the wound with a medicated packing material (iodoform gauze) will aid in healing. Using the hemostats, stuff the material into the wound until full. Leave about a half inch hanging out of the wound. This tail aids in drainage. Trim to size with a pair of scissors.
If the wound is not very large, you do not need to pack it.
8. Dress the wound. Apply antibiotic ointment over wound. Apply a bulky gauze wrap, but do not wrap it too tight. It will throb as sensation returns. Use acetaminophen or ibuprofen for pain.
9. Check the wound after 24 hours. If there continues to be more pus draining, remove the packing material, repack the wound, and change the dressing. Keep checking every 24 hours. When the drainage stops, perform warm water soaks 3-5 times daily, change the dressing, and apply topical antibiotic ointment. Healing should occur in 7 to 10 days.

Surgical Complications
Infection: The wound will have some initial throbbing, but should start to improve dramatically in a few days. If your patient is having an increase in pain, swelling, redness, warmth, or drainage, there is likely a continuing or secondary infection. If this occurs, start antibiotics as described above. Consider probing the abscess a second time to make sure no pockets of pus are hiding.

Things to consider
If the wound involves the hand or the abscess is very large, it will be very difficult to treat without IV antibiotics and potentially major surgery. This would be a case where attempting to find a physician may outweigh the risks of leaving your retreat. In rare cases a skin infection can spread to the facial tissue (this is called necrotizing fasciitis or “flesh eating disease”). Signs of this infection are intense pain out of proportion to the wound, fast swelling, spreading redness, fever, and vomiting. This would be a case where lack of immediate surgery by highly trained physicians will mean death.

Training
It will be difficult to acquire hands on training for this procedure unless you work in the medical field. However, this is a fairly straightforward procedure. If you see it once, most people should be able to repeat it. One way to see how it is done is to go to the doctor with a friend or family member who has an abscess or boil. Another option is to do an online video search for “I&D”. There are currently a few videos up that give a nice demonstration.

source: part 1 part 2

Published in: on March 26, 2009 at 4:18 am  Comments (2)  
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