Medical Plan

Objective   Understand what medical situation you will face

In a crisis, your access to normal medical assistance may be unavailable. The four aspects of a family medical plan include training and supplies for:

Advanced first aid for injuries & illnesses
Infection prevention & management
Pain management

Preparations

1.  Know the closest medical professional in your neighborhood. This person may be a doctor, nurse, paramedic or veterinarian.

2.  Learn medical techniques for:

Skin Disorders - Allergic rashes, fungal infections, burns
Eye Disorders - Pink eye, eye infections, eye injuries
Wounds - Cleaning, suturing, draining and bandaging
Poisoning - When to and when not to induce vomiting, antidotes
Food & Waterborne Illnesses - How to avoid and what to do
Bone Fractures - How to set and immobilize
Hydration Problems - Dehydration & Diarrhea
Fevers - When to warm and when to cool
Sinus and respiratory illnesses
Recognition and treatment for bacterial infections
CPR

3.  Stock a complete medical kit.  Include both trauma and treatment contents. Consider "non-traditional" treatments and preventative home remedies. As an example using a Neti-Pot is very effective for onset of sinusitis to ward off sinus infection.

4.  Stock a large supply of prescription medications required by people in your group.

5.  Post the phone number for the Poison Control Center by your phone or on your refrigerator and in your cell phone.  1-800-222-1222

WARNING - if you choose to stock prescription drugs, non-prescription drugs, ointments, etc, be sure you understand the usage and warnings associated with each.  Consider asking your physician for advice that pertains to you and others in your group, especially medical history and current and past illnesses, injuries, age and conditions.  There are several medical websites that can provide information about specific drug usage, interactions and contraindications (www.drugs.com). Be sure to store all meds correctly and do not use medications that are beyond their shelf life.

What to prepare for...

The basic assumption is that trained doctors and hospital care will be unavailable for a prolonged period of time, and that in addition to providing first aid - definitive medical care and rehabilitation (if required) will need to be provided. Also the basics of personal and public hygiene will also need to be considered. Also assume that medical response in these cases will be without access to modern medical diagnostics or technology.

Your medical preparations will need to reflect your own risk assessments in terms of what knowledge and skills you develop and what supplies/equipment/medicines you store.

What you may have to deal with will depend on what happens. Obviously a nuclear attack will produce a different set of problems than a pandemic. However, regardless of the initial triggering event after the initial wave of injuries, the majority of medical problems will be common every day illnesses and injuries.

Top 10 Most likely Injuries & Illnesses you will face

  1. Bacterial & Viral Infections
  2. Minor Sprains & Strains
  3. Burns
  4. Allergic reactions
  5. Lacerations
  6. Gastroenteritis/Vomiting/Diarrhea
  7. Dehydration
  8. Skin disorders
  9. Heat Stress
10. Flu/Viral illness
 

The most important medical preparations you and your group can take is to optimize your current health by losing weight, exercising, proper diet and aggressive management of chronic health problems.

Action you will need to understand

• Perform a basic assessment

• Established a rough working diagnosis

• Know how to use your medical library

• Follow good medical protocols

• Use of non-prescription and prescription medications

• Pain management

• Infection control and treatment

Know Your Group

It is essential that medical preparations include an evaluation of your group demographics and conduct a detailed medical history of every group member, including blood type, vaccinations, parental and sibling medical history.

1. How many people will I be looking after?

2. What age range will I be looking after?

3. How long will we need to be independent?

4. What are the pre-existing health problems?

5. What physical condition are they in?

8. What physical environment will I be living in?

9. What supplies do I need? How much of each?

Documentation of Medical Conditions

Be prepared to keep a record of every patient you treat. What they complained of, the history and examination, what you diagnosed, and how you managed them, a very clear note of any drugs you administer, and a description of any medical procedure.

The S.O.A.P format is a useful method of recording medical information is. It is easy to follow and provides a consistent format for documentation.  It can be used to document every patient encounter. It provides a structure which is easy to follow and understand

S. Subjective - What the patient has complained about and the history associated with it, e.g. A Headache for 2 days with associated fever, nausea, and a stiff neck.

O. Objective - What you find on examining the patient or from your investigations, e.g. A fever of 39 degrees, looks dehydrated and has a purple rash.

A. Assessment - This is your assessment of what is wrong with the patient after your history taking, examination, and investigations.

P. Plan - Your management plan for the patient, e.g. IV antibiotics and fluids. Isolate from others.

Medical Care Area Attributes

• Clean – and easy to keep clean
• Good lighting – both generally and more focused for examinations
• Adequate space and storage
• Adequate work surfaces and an examination table or bed
• Privacy
• Access to water – preferably hot
• Warm and Dry
• Means for sterilizing equipment

Medical Supplies
Include not only any prescription medications you can obtain, but also a very wide selection of over-the-counter medications and supplies, especially for burns, infection prevention, cuts, allergies and insect bites. A good supply of antiseptics, alcohol and peroxide will be needed as well as a large amount of material that can be used for sterile dressings.

NOTE: Prescription antibiotics can be purchased without prescription from on-line Canadian pharmacies.  Purchasing prescription pain relievers, without a prescription, may be a violation of U.S. Federal Law.

Prescription Medication
If you have a condition that requires medication to stay alive, your plan must include how you will get enough medication before a crisis.  Even short events of a week can put you in peril if you are down to the last 2 pills or injections simply because you planned to get refills "tomorrow".  If you, a family or group member has special medial needs, you know what they are.  Consider what you need to do if cut off from your normal supply.  Ask your physician for help in this planning.  When a crisis is approaching, your doctor may provide you a much larger prescription. One of the first steps is to realistically evaluate your medications.  Are they really necessary, can you change your lifestyle to limit your needs for a specific drug?  Is there a "natural" supplement you could use that would mitigate your medical condition in a pinch.  Can you ration - take less for a short period of time - and still get the benefits of the drug.  Ask your physician what the lowest sustainable dose is in an extended emergency. 

Prescription Glasses
Preparing for long term events that cause a social breakdown included having an extra pair of prescription glasses and/or an extended stock of contact lenses and lens solution.

Dental Health
Maintaining good dental health over a long term crisis is a very important area for the health of your group.  However, even in the best of times, someone will need dental care beyond brushing and flossing.  The following web site provides full and detailed procedures for dentistry in third world countries called Atraumatic Restorative Treatment that can be applied to long term retreat survival situations.