TC3 Class November 7-8 and some other updates.

It’s been about a week since the last TC3 class. What an amazing class it was. I am constantly updating and improving my curriculum. The students we had ranged from little to no medical training, to some old military medical training, and even a Wilderness First Responder. Quite an age range of the students as well. It’s always heartening to see such impressive young people showing up to classes. From the young man that took charge during the first lane, to the young women who is the head of her church’s medical response team AND is quite the seamstress. I do expect to see some TTM nylon gear here soon. Maybe even hopefully a Stuck Pig Medical IFAK pouch. This was the first class with the TC3 handout. I have already come up with modifications for it and need to rework it. Hopefully I can find a better program than microsoft publisher to put it together on. If anyone has a suggestion then let me know. I also added a new section to the website. A resources section. I tried to put a few useful files and such on there, if you have any suggestions, I put a comments section on the bottom of the resources library, so go ahead and leave them in the comments on that page.

The fellowship Friday and Saturday night were my personal highlights of the class, and always are. Things are getting… weird. Training of ALL kinds is going to be A LOT more important in the next few years. I know I have some holes I need to plug (heh, wound packing puns) with classes. And most of them will be with NC Scout because I trust him and I know he puts out quality information. Expect to see me at a few of his classes and as a student, not an instructor. I am also in the process of putting together a one day trauma medical basics class. This class is more oriented towards church security teams, or anyone interested in learning the absolute basics of trauma care. Also in the pipeline is a 3 or 4 day class. It will more closely resemble a CLS class for anyone who know what that is. But I am trying to do more than just the 2 day TC3 class. Speaking of, we already have the next TC3 class on the training schedule. February 27-28. Sign up at https://brushbeater.wordpress.com/.

Onto a different not, I am working on branding. I am in need of someone that does graphic design for a logo. If you or someone you know does graphic design email me at mechmedic@tutanota.com. The logo would go on the web page here, on patches, shirts, class handouts, and anything else I decide to slap swag onto.

Hopefully I can get more posts on here in the future, I am trying to put more energy into all of this, but bear with me. Thank you again to those of you that came out to the class, it was a blast to teach all of you.

Don’t get left bleeding out like a stuck pig.

Prepper Camp 2020

Prepper camp had been something I had heard about a few times since I got started with prepping in NC. But it was after NC Scout of Brushbeater Training and Consulting offered to pay for my ticket this year that I finally went. After a 6 hour long drive with Wynn of the Dope Farm Podcast, I had arrived. We showed up a day early to get our spot fully set up. It is definitely best done while glamping. I had initially thought that I would “rough it” and live out of my get home bag. Thank God that Wynn talked me out of it, and that he brought an extra cot. Also thank you for all the bear and venison you fed everyone. What prepper camp sells it self as is a weekend of classes and vendors. But what isn’t as talked about is the fellowship.

The people I met were definitely the highlight of the whole weekend. Such a broad range of people. From old snake-eaters, to guard vets, to ems personnel, to regular people. Of course I spent a good amount of my time hanging out with NC Scout and Jesse James from American Partisan. They did pay for my ticket after all. Phil and Andrew from MOF Podcast are amazing and I’m sad that I missed out on them recording the Prepper Camp episode. There was a Sasquatch roaming around, the one who runs the Tactical Buffaloes podcast. The conversations ranged from prepping to non prepping related topics and were all lively. Especially once we decided to start pouring drinks each day.

The old snake-eaters that camped near us were probably the highlight of that whole weekend. Just listening to the stories was more than enough, but I also met Paul Avallone among all the other amazing men at that camp site. He spent quite a while as a Green beret, but also has a great gift as a writer. He wrote for Soldier of Fortune, several newsprint agencies, and also wrote his own book. Tattoo Zoo is not only a full frontal look at the War in Afghanistan, it is a realistic look at an Infantry platoon. If you have spent any time at all in one, you’ll recognize several of the characters. Every platoon seems to be made up of the same types of characters and the Zoo is no different. He has managed to skip all of the “military war book cliches” while also nailing every aspect of life in an infantry platoon. I will be doing a full review of Tattoo Zoo because it deserves a post all it’s own. Safe to say, after reading it on kindle, I will be purchasing a physical copy of the book to put on my shelf.

The area we camped at had water, power hookups, and was right next to the bathrooms (with showers) so it definitely made the trip classify as glamping. But as Wynn said, “I aint rucking” so it definitely makes sense to take advantage of the facilities available. Showering every day was such a nice thing. The longest I’ve spent without showers and real bathrooms was two weeks, and I never want to miss the opportunity for a shower again. The power and running water made cooking and clean up a breeze. For clean up I would recommend the three tub method pulled straight from the Boy Scout manual. One tub of hot soapy water with a sponge to scrub off food bits, one tub of water to rinse all the soap off, and one tub of bleach water (we generally just used one cap full of bleach for the whole tub) to sanitize. But just a tub of hot soapy water to scrub everything off and a hose to rinse the soap off should work just fine.

All in all it was a GREAT weekend with some amazing people that I can not wait to see again next year. If you can make the trip next year I would highly recommend it. Even if you don’t make it out a single class, the people you meet will be more than worth the cost of a ticket. I’ve already started work on my own packing list for next year, and now the wife wants to go too! Hopefully I’ll see some of you out there, and if you’ve been to Prepper Camp before or if this year was your first year comment on this post about it. Or just write your own blog post about it and link it in the comments.

Prepper Camp 2020

Just got back last night from prepper camp out in Saluda NC. Met up with some amazing people, some of whom I already called brother. Most though were met for the first time there. It was a really good event, and I would recommend going just for the networking alone. But there were several classes being taught. I’ll be doing a much longer write up in the coming days. I’ll definitely be going again next year.

New class dates!

NC Scout and I were able to get dates figured out for this year.

More so than ever the need for quality training is becoming ever apparent. 25-26 September and 7-8 November are the dates we’ve got scheduled for this year. So go ahead and sign up now before spaces fill up! They should both be good classes and I’m excited to see both new and returning students.

Link to NCScouts training calendar https://brushbeater.wordpress.com/training-calendar/

Someone else gives me time to run my suck

A week ago or so I recorded an episode of Radio Contra with the amazing NCScout of Brushbeater Training and consulting. He’s a very good friend of mine and an amazing instructor on a multitude of topics. I had the good fortune of teaching a TC3 class with him last year and hope to do several more in the future, we’re in the process of working out dates. He brought up having me on his amazing podcast Radio Contra and I happily accepted a chance to talk about anything medical. If you haven’t been listening to Radio Contra you need to start. There is a whole wealth of information shared there. In this episode I talked about battlefield medicine and what should be in an IFAK. I will be making a video about this to clear up some things and to be able to talk more in depth and include some different options for how to carry one. It was an amazing experience to be on his podcast and to talk about these things. And yes, I shamelessly plug myself and this site on the podcast. I’m a red blooded capitalist at heart. But enough chit chat. Go listen to the podcast and especially the episode I’m on. We talk about some good stuff. https://www.americanpartisan.org/2020/03/radio-contra-episode-16/

Medical Monday 9 Dec 2019

Another week, another Medical Monday post! This week we will be covering stab wounds. I will also include animal bites since the treatment and wound pattern is almost identical.

Stab wounds can be very frightening to think about. With the lack of imaging that a grid down situation causes you will be hard pressed to see what below the skin is actually damaged. The lucky thing is our body is very resilient. Organs have been noted to shift out of the way of a knife or other penetrating object. Most of that has to do with velocity.

If there is any major bleeding you are going to want to stop that first. If it requires a tourniquet use that, or if direct pressure works just use that. You might have to pack these wounds especially if they are in a junctional area. The junctional areas are where an extremity and the trunk meet. Armpits, groin, and neck. If the object that made the wound is still embedded then do not try to remove it. Just bandage around it enough to secure the object so it won’t move and cause further damage. These patients need to see a higher level of care.

If there is no major bleeding these wounds will need to heal on their own. Debridement should be performed using Dakin’s solution. Do not close these wounds up, do not suture these closed or try to use butterfly bandages. Use an antibiotic cream topically. Cover with gauze and check on them every few days to monitor for signs of infection. Clean the wound with Dakin’s solution every time you remove the gauze to examine it. Reapply the antibiotic cream and cover with a clean sterile dressing.

All the of the above applies for an animal bite, but you need to make sure you clean the wound extremely well. Use lots of Dakin’s solution and pay extra attention to these for signs of infection.

This was the last post that I already had the idea for. Now I will start posting polls on Unchained Preppers to get ideas. So if you want input for the next posts, join the forum and vote! Check out the rest of the forum as well, there is plenty of good information there on a multitude of subjects.

If you have any questions post them below in the comments section. Don’t forget to share these posts with anyone you think could benefit from the information, and subscribe to the blog as well. Don’t be left bleeding out like a stuck pig!

Medical Monday 2 Dec 2019

Another week and another month! I hope everyone had a great Thanksgiving and hopefully the holiday season is stress and injury free for everyone. This week we are going to be talking about blisters! Everyone has probably dealt with blisters in one way or another. Whether it be from burns due to cooking, or from hiking, blisters can be a miserable issue to deal with. If left untreated they can lead to infection which can be very dangerous even in a grid up situation.

Blister can be caused by many different things. Ranging from friction, heat, chemical reactions, and even allergies. The main ones we are going to look at today are ones caused my friction and those related to burns.

Friction blisters are some of the most common injuries seen in a military setting with light troops. Hiking long distance with heavy weight in any kind of climate can cause blisters, specially if someone doesn’t know how to properly care for their feet. Boots that are too tight can cause friction points on your foot, or boots that are too loose can allow your feet to slip around and cause massive blisters. Wet feet can be an issue all its own or can compound one of the previously mentioned causes. Make sure your boots are properly broken in before you step off to help prevent blisters from forming. Proper socks are also crucial. Most people, myself included, swear by wool socks. A big plus is to add very thin liner socks. An old grunt trick was to wear nylon or silk pantyhose or leggings underneath their issued socks. The liner sock will wick moisture away from your feet and to the wool sock. It will also let the friction be between the liner sock and the outer sock, instead of between your foot and the wool sock. Changing your socks after a long ruck is key to bringing your feet back down to a regular moisture level, more so if you had to cross any body of water. Dry feet do not blister hardly at all compared to wet feet, which is why the liner socks are so helpful. Sometimes crossing water is unavoidable and you won’t have the ability to change your socks at regular time intervals. Or you’ll have to chop more wood than you expected. You will end up with a blister. How to you take care of it? Well it all depends on when you catch it, and what it looks like when you do catch it.

Before the blister forms you will end up with a hot spot. A hot spot is just a reddened area of skin that will be tender to the touch and in an area where friction has been occurring. You will treat this with a donut of moleskin. Just cut a circle of moleskin about a 1/4th of an inch (6 mm for those of you still stuck on the metric system) bigger than the hot spot itself and then cut a hole inside the size of the edges of the hot spot. Slap on enough of these to prevent the hot spot from getting rubbed, and keep hiking.

If you don’t take care of a hotspot a blister will form. A blister is a pocket of fluid between the upper and lower layers of the skin. The fluid should be clear, if it is bloody that means that capillaries underneath the skin have been damaged. If it looks like puss then you have an infection and it’s not a new blister. Try to avoid draining these at all costs. If you have to drain a blister clean the skin and your hands with soap, disinfect a very sharp needle with alcohol (or use a very small hypodermic needle) and go in at the base of the blister with the needle level with the surrounding skin. Do not remove the skin covering the blister as it acts as a natural barrier to prevent infection. Once all of the fluid has been drained clean the area again and apply a topical antibiotic cream. Cover the blister with gauze and tape around the edges completely. A bandaid that mimics this would work depending on the size of the blister.

If the roof of the blister (the skin that covers the fluid) has been partially torn you will need to clean out the exposed area and make sure that no debris got stuck under the remaining skin. Try not to remove any of the remaining skin if you can. Dakin’s solution (talked about last week) would work well for the cleaning. Once it has been cleaned apply a non adherent dressing over the blister and tape it in place. Do not place tape directly over any blister as that will stick to the top layer of skin and rip it off when you go to change it. Use moleskin to protect the dressing and blister from further damage.

If the roof of the blister has completely been removed then clean all of the exposed skin with Dakin’s solution and apply a hydrocolloid dressing. A hydrocolloid dressing contains a gel forming material with gelatin that will absorb the fluids that will seep out of the now exposed skin. They are backed with a waterproof material that prevents that that fluid from evaporating. This keeps the moisture on the skin which encourages proper healing, decreases pain, and prevents any new tissue from being ripped off when you change the dressing. These are only for blisters where the entire roof has been removed. You would want to cover this as well with moleskin if you have to keep walking.

If the blister was caused by a burn you first want to treat the burn, reference https://stuckpigmedical.com/2019/11/20/medical-wednesday-20-nov-2019/ for burn treatment. Then treat the blisters. Leaving these blisters intact is more important because the surrounding skin is already prone to infection. Moleskin isn’t necessary on these blisters since they aren’t caused by friction. But situations are unique, so if it is needed then use it.

If you haven’t noticed by now, prevention is the best treatment for any injury, which is why I always talk about it on every post. Blisters are preventable, but not always. Pay attention to what your body is telling you, and make sure your footwear is broken in before you attempt to use them in a situation that matters. Get training! Don’t be left out in the woods bleeding like a stuck pig!

Medical Monday 25 Nov 2019

The internet here has not been cooperating at all the last few days so I am writing this on Monday. The extra post from last week is still coming. But enough excuses, on to the post.

This week we are going to talk about lacerations. Lacerations are tears in the skin, underlying tissues, muscles or organs caused by blunt force trauma. These are different from cuts or incisions.

Lacerations can vary in size and depth. You need to keep in mind basic anatomy as well, what underlying structures could have also been damaged? If it’s on their abdomen, are their intestines damaged? What about their kidneys, or their spleen? If it’s on their chest did they break some ribs, rupture their lungs? Depending on what is underneath, the damage can lead to much bigger issues than just an opening in their skin.

Our skin is our largest organ. It serves many purposes, one of those being our first line of defense against the environment. Once you break the skin it lets in all sorts of nasties that we wont to keep out. Infections are no joke either, before modern antibiotics and wound care techniques, it was the leading cause of death on the battlefield.

The first step after stopping any life-threatening bleeding is going to be cleaning the wound. Cleaning not only removes contaminants that can cause infection but it allows you to fully inspect the wound to check severity and size. Cleaning does not need to be performed with massive amounts of hydrogen peroxide or isopropyl alcohol. The military has found that the use of those and similar fluids have no noticeable effect on infection rates. At a minimum, you can get by with just potable water. The more fluid the better. Pressure higher than 15 psi not only damages tissue but it has little to no effect on decreasing infection rates. It simply pushes contaminants and bacteria deeper into the wound. One recommended way is to puncture a hole in a water bottle and use that in combination with mild scrubbing. The recommended solution is Dakin’s solution. Dakin’s solution is a cleaning fluid made of water, household bleach, and baking soda. It was first used in the First World War before the creation of modern antibiotics. The dilution recommended is known as a modified Dakins. Take 1 liter of potable water, add 5 ml of unscented household bleach, and 1/2 teaspoon of baking soda. Shake to mix it all up and it should keep for about a week in this form, but bleach and baking soda separately will keep for much longer. Then to use this for irrigation dilute that 1:10 with more potable water for irrigation. Use 1-3 L for small or clean lacerations, 4-8 L for intermediate or dirty wounds, and >9 L for large or very dirty wounds. Make sure you remove all sources of infection and any puss that is visible. Squeeze it to make sure you have all the puss and infection out. Topical creams like bacitracin or Neosporin work great for care after you have cleaned the wound. Just make sure to not put it inside of the wound.

After you’ve fully cleaned and inspected the wound you want to decide if you need to close it or not and how to dress it. This all depends on several factors. Location, size, and depth of wound all play a factor in whether or not to close it and how to dress it. You don’t want to close a wound when it is infected or is about to become infected. If you close an infected laceration it will form an abscess and may lead to an infection in the blood called sepsis, which untreated is deadly. Infected wounds will be red, the area may be hot, swollen, and it may be draining purulent discharge (fancy word for pus). Normal drainage will be light yellow or clear. If you start seeing large amounts of white puss you need to re-clean the wound and make sure you got all of the infection out. Also if the area you are at is normally dirty you want to leave the wound open as well. These types of wounds we want to heal through granulation, or from the inside out. You also don’t want to try to close a wound that is over a joint, the constant movement will just cause it to rip stitches out and the healing may prevent full range of motion further down the line.

Wounds you can close will be small, cleaner wounds, anything that isn’t over a joint, and wounds that don’t create pressure when you try to close it. Butterfly bandages work great if you don’t know how to suture. Superglue works great as well. Both have been used in third world countries for decades with lots of success. I even keep superglue in my larger aid bag and at home for situations just like this. If you do know how to suture you can do so here as well.

After you’ve made the decision to close or not close you are going to want to keep it covered to prevent infection. If it’s larger or more wide you will want to place a non-adherent pad down first to allow the healing process to be restarted every time you do a dressing change. You can always cut larger pads down to size to help make your supplies stretch. Medical tape will also be your friend here. There are a few things that I am brand particular on, and tape is one of them. I prefer 3M durapore medical tape in 1, 2, and 3-inch widths. I don’t like duct tape because if left on for too long it can cause tissue damage. Don’t overuse the tape, a little can go a long way. Always cover non-adherent pads with regular gauze.

Now on to dressing changes, they do not need to be performed daily. You can look at the wound daily, but you don’t need to change it daily. Current recommendations from the US Military’s CPG’s on prolonged field care are 2-5 days between dressing changes, depending on how the wound is healing. When you do the dressing change you are looking at the wound to see how it is healing and to check for signs of infection. Every wound doesn’t require antibiotics. It depends on the environment and the wound. This is where clinical judgment comes into play. This is also why it is really important to have a true medical provider in your group. Even just having a Physitians Assistant is your group is a HUGE advantage medically. They provide a much higher depth of knowledge than just a medic or a nurse can provide. Even if they aren’t directly where you are, having the ability to telemedicine with them can make a difference in the level of care that you can provide.

If you have any questions feel free to comment below and I will try to clarify the best I can. And remember, all the information in the world means nothing without quality training behind it. So go get training. NC Scout offers some great training, and I do teach medical classes (which I plan to start back up when I get back stateside). If you like what I am doing here share it with everyone you know! Don’t be left bleeding out like a stuck pig!