How to Disinfect and Sterilize Medical Instruments in a Survival Situation

Print Friendly

Remaining whole and healthy in a survival situation is something we all strive for.  But what happens if an accident, or worse, an attack, results in wounds that need tending?  This is a question that every prepper asks themselves.

It is fairly easy to accumulate supplies for first aid and wound control but what about the tools you will use to tend to the  hurt or wounded member of your group?  Given an austere setting where traditional medical facilities are not available, how do you ensure that your instruments are clean, sterile, and fit for use?

How to Disinfect and Sterilize Medical Instruments in a Survival Situation | Backdoor Survival

These are important questions and to provide you with answers, Dr. Joe Alton is back with some advice not only relative to six ways you can sterilize your medical supplies, but also a general discussion of clean versus sterile and the difference between disinfectants, antiseptics, and antibiotics.

Sterilizing Instruments In Austere Settings

A significant factor in the quality of medical care given in a survival situation is the level of cleanliness of the equipment used. You may have heard of the terms “sterile” and “clean”. Certainly, ideal conditions warrant both, but they are actually two different things.

Do you know the difference?

Sterile Vs. Clean

When it comes to medical protection, “sterility” means the complete absence of microbes. Sterilization destroys all microbes on a medical item to prevent disease transmission associated with its use.

To achieve this, we want to practice “sterile technique”, which involves special procedures using special solutions and the use of sterile instruments, towels, and dressings. Sterile technique is especially important when dealing with wounds in which the skin has been broken and soft tissue exposed.

Of course, it may be very difficult to achieve a sterile environment if you are in the field or in an extremely austere setting. In this case, we may only be able to keep things “clean”. Clean techniques concentrate on prevention of infection by reducing the number of microorganisms that could be transferred from one person to another by medical instruments or other supplies. Meticulous hand washing with soap and hot water is the cornerstone of a clean field.

If you are going to be medically responsible for the health of your people in a survival setting, you will have to strike a balance between what is optimal (sterility) and what is, sometimes, achievable (clean).

The “Sterile” Field

When you’re dealing with a wound or a surgical procedure, you must closely guard the work area (the “sterile field”) to prevent contact with anything that could allow micro-organisms to invade it. This area is lined with sterile “drapes” arranged to allow a small window where the medical treatment will occur.

Although there are commercially-prepared drapes with openings already in them (“fenestrated drapes”), using a number of towels will achieve the same purpose, as long as they are sterile.

The first step is to thoroughly wash any item you plan to reuse before you sterilize it. Using a soft plastic brush removes blood, tissue particles, and other contaminants that can make sterilization more difficult. Consider using gloves, aprons, and eye protection to guard against “splatter”.

6 Ways to Disinfect and Sterilize Instruments

Now, the question of how to sterilize your medical supplies: There are a number of ways that you can accomplish this goal. I list them below in approximate order of effectiveness.

1. Simply placing them in gently boiling water for 30 minutes would be a reasonable strategy, but may not eliminate some bacterial “spores” and could cause issues with rusting over time, especially on sharp instruments like scissors or knives.

Note: always sterilize scissors and clamps in the “open” position.

2. Soaking in bleach (Sodium or Calcium Hypochlorite). 15-30 minutes in a 0.1% solution of bleach will disinfect instruments but no longer or rusting will occur. Instruments must be rinsed in sterilized water afterward.

3. Soaking in 70% isopropyl alcohol for 30 minutes is another option. Some will even put instruments in a metal tray with alcohol and ignite them. The flame and alcohol, or even just fire itself (if evenly distributed) will do the job, but eventually causes damage to the instruments.

4. Chemical solutions exist that are specifically made for the purpose of high-level disinfection (not necessarily sterility) in the absence of heat, something very important if you have items that are made of plastic.  A popular brand is Cidex OPA, a trade name for a solution with phthalaldehyde or glutaraldehyde as the active ingredient.

Insert the instruments in a tray with the solution for 20 minutes for basic disinfection. Soaking overnight (10-12 hours) gives an acceptable level of “sterility” for survival purposes. There are test strips which identify when the solution is contaminated. If negative, you can reuse it for up to 14 days. As an alternative, some have recommended using 6-7.5% hydrogen peroxide for 30 minutes (household hydrogen peroxide is only 3%, however).

5. Ovens are an option if you have power. For a typical oven, metal instruments are wrapped in aluminum foil or placed in metal trays before putting them in the oven. The oven is then heated to 400 degrees Fahrenheit for 30 minutes or, alternatively, 325 degrees Fahrenheit for 2 hours.

6. Although ovens and microwaves have been used to sterilize instruments, probably the best way to guarantee sterility in an austere setting is a pressure cooker. Hospitals use a type of pressure cooker called an autoclave that uses steam to clean instruments, surgical towels, bandages, and other items. All modern medical facilities clean their equipment with this device (I hope).

Having a pressure cooker as part of your supplies will allow you to approach the level of sterility required for minor surgical procedures. As you can imagine, this isn’t easy to lug from place to place, so it’s best for those who plan to stay in place in a disaster scenario.

Here’s a link to the procedure:  Sterilizing Instruments Using a Pressure Cooker

In most survival settings, “clean” may be as good as it gets, but is that so bad? Modern medical facilities have the ability to provide sterility, so there is very little research that compares clean vs. sterile technique.

In one study, an experiment was conducted in which one group of patients had traumatic wounds that were cleaned with sterile saline solution, another group with tap water. Amazingly, the infection rate was 5.4% in the tap water group as opposed to 10.3% in the sterile saline group. Another study revealed no difference in infection rates in wounds treated in a sterile fashion as opposed to clean technique.

Therefore, clean, drinkable water is acceptable for general wound care in survival scenarios. That doesn’t mean that you shouldn’t use antiseptic solutions if you have them, especially for the first cleaning.

Disinfectants, Antiseptics, Antibiotics

So what’s the difference between a disinfectant, an antiseptic, a decontaminant, and an antibiotic?

To maintain a clean area, certain chemicals are used called “disinfectants”. Disinfectants are substances that are applied to non-living objects to destroy microbes. This would include surfaces where you would treat patients or prepare food. An example of a disinfectant would be bleach.

Disinfection removes bacteria, viruses, and other bugs and is sometimes considered the same as “decontamination”. Decontamination, however, may also include the removal of noxious toxins and could pertain to the elimination of chemicals or radiation. The removal of non-living toxins like radiation from a surface would, therefore, be decontamination but not necessarily disinfection.

While disinfectants kill bacteria and viruses on the surface of non-living tissue, “antiseptics” kill microbes on living tissue surfaces. Examples of antiseptics include Betadine, Chlorhexidine (Hibiclens), Iodine, and Benzalkonium Chloride (BZK).

Antibiotics are able to destroy certain microorganisms that live inside the human body. These include drugs such as Amoxicillin, Doxycycline, Metronidazole, and many others.

Having disinfectants, antiseptics, antibiotics, and clean instruments will give the medic a head start on keeping it together, even if everything else falls apart.

By Joe Alton, MD, of www.doomandbloom.net
Co-Author, The Survival Medicine Handbook
Creator with his wife, Nurse Amy, Doom and Bloom SURVIVAL! Board Game

The Final Word

Up until now, I have held off on adding anything but the most basic of medical instruments to my emergency kit.  That has been foolhardy.  Just last week, I spoke with someone whose son had a huge splinter embedded under his fingernail.  In spite of his extreme pain, the 24 hour emergency clinic sent him away telling him to “see a doctor in the morning”.

If something like this happens in a survival situation, having a set of medical instruments along with a means to ensure they are sterilized will be important.  Even without being in a survival situation, they are useful and can be put to good use..

At the end of the day, none of us know what our lives will be like down the road.  The best we can do is prepare for the worst and hope we will never have to use our preps for survival purposes.

Enjoy your next adventure through common sense and thoughtful preparation!
Gaye

If you enjoyed this article, consider subscribing to email updates.  When you do, you will receive a free, downloadable copy of my e-Book, The Emergency Food Buyer’s Guide.

Emergency Food Buyers Guide 2016-02-26

You can also vote for Backdoor Survival daily at Top Prepper Websites!

Bargain Bin:  When it comes to medical preparedness, there is a seemingly endless list of supplies that are needed just in case.  Here are the items mentioned in today’s article.  Sorry for the long list but this is important. For the items in my own first aid kit, visit How to Create an Emergency Ammo Can First Aid Kit.

The Survival Medicine Handbook: A Guide for When Help is Not on the Way: This book teaches how to deal with all the likely medical issues you will face in a disaster situation, including strategies to keep your family healthy even in the worse scenarios. It covers skills such as performing a physical exam, transporting the injured patient, and even how to suture a wound.

The Ultimate Survival Medicine Guide: Emergency Preparedness for ANY Disaster: This is a slightly abridged version if you can call 328 pages abridged. The print version is currently only $13.49 and the Kindle version $9.99.

Stainless Steel Medical Instruments:  This is a basic, 18 piece set of medical instruments.  You just never know when these will be needed.  A single use at the right time will more than cover the cost of this well-priced set.  (Currently less than $25.)

Disposable Fenestrated Towel Drape , Sterile Box of 50:  These sterile drapes are for use in minor surgical or therapeutic procedures where a sterile field or drape is required. Poly-interlined, three ply construction – tissue/poly/tissue – provides absorbency while preventing possible moisture or bacteria migration. 18 x 26″.

3M TEKK Protection Chemical Splash/Impact GogglesThe Sunday Survival Buzz #129 Backdoor Survival:  I am pleased with these eye protection goggles and the price is reasonable.

Presto 6-Quart Aluminum Pressure Cooker (Non-Electric): This pressure cooker is modestly priced and modestly sized.  It would work perfectly for sterilizing your instruments as well as for general food preparation.

DryTec Calcium Hypochlorite, 1-Pound:  This is 68% Calcium Hypochlorite.  As of this writing, the price is under $10 with free shipping.  I have also purchased Ultima Pool ShockThe Sunday Survival Buzz #128 Backdoor Survival which is 73% Calcium Hypochlorite.  For more information, read How to Use Pool Shock to Purify Water.

Dynarex Black Nitrile Exam Gloves, Heavy-Duty, Box/100:  This brand is the #1 seller on Amazon.  Pick your size; both Shelly and I wear a medium.

Betadine Antiseptic or Dynarex Povidone Iodine Prep Solution: Either can be used diluted as a disinfecting solution for wounds.  Also good for day to day cuts and scrapes.

Doom and Bloom SURVIVAL! Board Game:  This is board game developed by Joe and Amy Alton, aka Dr. Bones and Nurse Amy.  Here is a description:

“The global SuperFlu has come and gone, and you have survived. The wilderness is ravaged by raiders; there are resources to be found, but you have to overcome challenges to get them. You can use them to gain an edge in an encounter, but need to have a certain amount to win the game. Your mission is to scout settlements that may serve as a safe haven for your survival group. Are you prepared to make the journey? Can you succeed even if everything else fails? Easy to learn and fun for the whole family!”

~~~~~~~~~~

   Shop the Emergency Essentials Daily & Monthly Sales for Fantastic Deals!

For over 25 years Emergency Essentials has been providing the highest quality preparedness products at great prices.  Plus, each month they feature sales that quite honestly are fantastic.

June Sales

Emergency Essentials carries a wide variety of equipment and supplies – all at competitive prices.

~~~~~~~~~~

Need something from Amazon (and who doesn’t)? I earn a small commission from purchases made when you begin your Amazon shopping experience here. You still get great Amazon service and the price is the same, no matter what.

Amazon has a feature called Shop Amazon – Most Wished For Items. This is an easy tool for finding products that people are ‘wishing” for and in this way you know what the top products are.  All you need to do is select the category from the left hand side of the screen.

The Amazon Top Most Wished For and Best Selling Outdoor Items
Emergency Preparedness Items from Amazon.com
Shop Amazon Tactical – Great Selection of Optics, Knives, Cases, Equipment
Amazon Gift Cards

Help support Backdoor Survival. Purchases earn a small commission and for that I thank you!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Spark Naturals 2016 | Backdoor Survival




Comments

How to Disinfect and Sterilize Medical Instruments in a Survival Situation — 15 Comments

    • All N95 masks should remove the same amount of stuff from the air, but there are also N99 masks if you want to remove more particulates from the air you’re breathing.
      That said, most surgical masks are not N95 or N99, they are just designed to stop your breath from infecting a wound or incision you’re working on – in other words, they are designed for the safety of the patient, not the doctor. In Japan it’s polite for anyone with a cold to wear a surgical mask to keep from infecting the folks around them, at least when they are out in public. To protect the medical professionals, face shields and impervious garments to keep blood and other fluids from skin contact is important. Check out the requirements for Ebola personal protective gear to understand how much has to be done to be as safe as possible.
      Oh, and if you’re sick and want to wear an N95 or better mask, that’s fine, but if it has an exhalation valve then you aren’t protecting folks around you….

  1. Amazing article. Although I love all the articles on Backdoor Survival, this may be the best yet. I absolutely needed to know everything explained in the article. I thank you greatly for posting this. Up to this point I have stock piled alcohol and hydrogen peroxide but really didn’t know what to do with them or about other very important solutions. I had no idea what the difference is between clean and sterile. I think this article is going to save lives in the future for those who have read it.

  2. I want to encourage my fellow readers here to really look deep inside and question themselves about the difference between assuming they know something v really truly knowing it. That is because today in reading this article I discovered a massive gap between what I thought I knew and how little I actually know.

    We have learned from Ebola that sterility is a life or death matter. I have plastic goggles, plastic gowns, gloves, N95 masks, commercial grade lysol, antibacterial wipes, garbage bags, and many types of bandages. NONE of what I have prepped is sterile. I assumed I could just clean my hands, instruments, and the patient’s wounds rubbing alcohol. I assumed all I had to do was pack a wound with antibiotic ointment, bandage it and change the dressing a couple times per day. Right now I am really shaken ip by how little I know, grateful for this article because hopefully there is still time to learn.

    • Karen

      With highly infectious pathogens such as Ebola sterility has very little to do with it unfortunately. It’s the achievable (and often even the attempted) ‘barrier’ method that is crucial.

      Ebola requires a Class IV level precautions in the laboratory (think ‘men in space-suits’, complete isolation, even a piped/separate air supply). In ‘the field/home’ it requires ‘strict’ quarantine, respiratory and ‘splatter/droplet’ skin protection – and ‘a personnel sufficiently trained/experienced that they can both treat the patient, but crucially, dress/undress without exposing themselves/others to the pathogens which ‘will’ be on their protective equipment’ (That is where all the ‘medical’ transmission has occurred, a failure of the basics).

      That may seem ‘not a lot’ but if you check out the débâcle of VRSA spread in Japanese hospitals (these were specialist infectious disease hospitals using specialist staff, established procedures and negative pressure rooms – which all failed miserably) you’ll see it isn’t as easy as you’d think.

      These are extreme examples but for most infective diseases the most basic – hand-washing after ‘any’ patient contact, isolation (including equipment such as stethoscopes, specific to patients – many an ‘outbreak’ has been traced to a doctors/nurses stethoscope or pen), disposal of infective material, a ‘clean’ environment (no more is needed although I ‘may’ have a number of UV led lights and, gulp!, even experimented with a copy of Listers ‘carbolic steam spray’. Oh OK I do have a respirator should TB become an issue, so sue me!).

      Part of the issue is ‘terminology’. Medically/scientifically terms mean very different things to ‘we the public’. Most (general public understanding) ‘respiratory’ transmission is actually via droplets – so a basic mask/goggles/apron will suffice. And, a personal bugbear, most ‘contact’ transmission, rather than being some failure of medical/nursing staff, is generally either patient (‘helping’ another patient) or relative (touching, or already colonised [carrying asymptomatically], if not the original source in many cases, and then ‘wandering’ about the area. The UK’s MRSA and C. Diff problems have been caused by …. a significant proportion of the public being carriers [60% are carrying MRSA in some areas], a fact only becoming apparent when they are debilitated or transmit it to someone who is).

      So? Basic common sense precautions (include vile threats to patients and relatives) are more than sufficient for all but the most extreme scenarios (Florence and Lister had it right you know).

      As to wounds? Hand-washing, hand-washing, hand-washing. Never touch another patient (or another wound on the same patient) with something you haven’t washed/changed. Clean everything an infected patient touches regularly (or better isolate for single use, bathrooms, tables/chairs, cutlery, diagnostic equipment … and then clean regularly). Dispose of dressings (burn) safely. Isolate/allocate even the apparently silliest things (such as ‘cleaned’ linen or ‘reading material’ – guess how many infections are spread via newspapers?).

      The basics, like I said, are all that is required. We manage now OK, and post event/collapse, can easily maintain this with Gaye’s cleaning solutions, no?

      (As to an Ebola, or similar, pandemic? Isolation, an extended [months/years] self-quarantine of you and ‘all’ your loved ones, is the only real recourse I suspect. Read ‘the Hot Zone’ or ‘The Black Death: the Worlds Biggest serial killer’ to get an idea).

      • Oh, I should have added, when I say ‘clean’ that soap and water are quite sufficient for most applications (or Gaye’s white vinegar). When it comes to hand-washing, soap is again the preferred option but should you use an anti-bacterial wash – rotate the types regularly or you’ll get/develop resistant strains (hospitals here rotate hibiscrub and betadine aquaeous wash on a weekly basis).

        Sorry for being long-winded, I’m a bit naturally verbose (my doctor has me on an exercise regime and has given me cream for it though).

        • Hi Alec, thank you for breaking down all these situations. I have read Hot Zone. It made an enormous impression and I began to understand why Ebola was so difficult to bring under control. Indeed I had read another article on how miserable the healthcare workers were in the heat of West Africa once their protective gear had been upgraded. I’m currently reading a book about the failure of Public Health and have another 5 or so books on virology to read.

          • It’s an area (one of many) I find interesting (both personally and professionally).

            The Black Death is appropriate when considering a pandemic scenario because it’s the last major one where masses of data is available – although limited by the technology, understanding and length of time (the 1918 H1N1 ‘Spanish Flue’ has data but that was ‘manipulated’ and ‘covered up’ for political reasons at the time and since).

            Most of the data shows it was most likely a viral haemorrhagic fever (similar to Ebola) rather than the commonly assumed Bubonic Plague. The rats were innocent and transmission was person to person (shown by the speed of spread and that isolation prevented transmission). It’s ‘sad’ (and humbling) to read of whole towns/villages that self-isolated post an infection in their midst so as to not infect others – that died out almost to the last resident. But at the same time it is heartening to read of villages in the midst of regions devastated by the disease that due to geographical isolation remained entirely untouched.

            Isolation is the key!

            Also, you may not be aware but recent research on ‘herbal’ remedies of the period are now being shown to be considerably more effective than previously thought (admitted). A recent ‘concoction’ being shown to completely eradicate MRSA (and yes, I’ve been trying to source Ox bile and the complete recipe ever since – it’s fascinating in that all the many ingredients have apparently been shown to have little to no effect separately, but an amazing one when combined in precise/prescribed amounts. I take a special enjoyment in citing this [repeatedly] to all those ex-colleagues who dismissed herbal and essential oil effects – does this make me a bad man? ;-D ).

            It may be a personal bias but I’ve read and dismissed the ‘usefulness’ of microbiological and virology texts for personal planning/behaviour in such a scenario, preferring the many ‘infection control’ (medical and nursing) texts instead (an analogy would be the engineer and the mechanic. I have no need, and there’s little applicability, for the ‘esoteric’ knowledge of metallurgy and laminar flows involved in ‘designing’ an engine, but much for how best to ‘repair’ it. I don’t need to know the cell structure and intricacies of a pathogen, I need to know how best to prevent/treat it. But that’s just me).

        • Just make sure it’s a foaming soap or something that generates lots of suds. Anti-bacterial is nice, but it’s the sudsing action of the soap that lifts the germs and other nasties off your skin and washes them away. It’s why soap is preferred over hand sanitizers, although if you don’t have soap then use what you have to do the best with what is available.
          For Ebola type protection, it’s best to use a chlorine disinfecting solution (10% bleach) to spray down the exterior of the protective gear before you try removing it. I have a few of those pesticide spray bottles ready to fill up with bleach solution in case it becomes necessary (and they have never been used for anything, so no weird chemical reactions…)

  3. I would also add that you can use an ultraviolet light sterilizer. Handheld units are readily available from Amazon or other retailers online. They are extremely effective and run on batteries making them an ideal field solution.

  4. Very useful advice (as always from Dr. Alton).

    I carry a minor surgical procedure kit of pre-sterilised and packaged instruments (plus all the ancillary ‘disposables’ that will be required – a small-pack, think an M3 pack as a bare minimum for the field – my ‘full response kit’ is ‘heavy’ and three rucks. Think you’re going to deal with anything other than a minor traumatic injury with a pocket kit and I hate to disillusion you – but you really aren’t).

    If we aren’t talking an elective/emergency surgery situation here, the (as I have been trained) priority in ‘the field’ is to ‘treat the injury’. Infection becomes a ‘secondary’ (deal with it later) issue when you consider the probable ‘means of injury’ (a very dirty bit of wood for example). Yes you must clean (saline sachets) and irrigate the wound as much as possible (maybe even debride in certain circumstances and dowse with antiseptic – Betadine, aqueous povidine iodine is common here) but ‘treat the wound’ first.

    I’m sure Dr. Alton will confirm the standard procedure (in such a situation) is to (once a ‘major’ wound is ‘stabilised’ and they aren’t going to ‘bleed out’, etc.) is to pack, dress and allow the wound to ‘drain’ (many wounds, even in a hospital setting are worsened by closing them prematurely whilst infected). So ‘forget’ your sutures, Ramboesque ‘sewing’, and pack steristrips and pressure dressings.

    In a more stable ‘long term collapse’ (home/base) scenario? Get training (I have decades as a [tip of spear] medic, a decade as an A&E/ER/ITU/OR nurse and whilst I regularly do minor surgical procedures – someone needs a traumatic/emergency major surgical procedure and I’m looking for a doc – and not just your local GP/family practitioner either – it’s a major ‘use it or lose it skill’. In a situation where ‘I’ am ‘forced’ to do such a procedure – infection will be the least of my concerns. Knowledge and skill are major issues yes but a primary for me is ‘analgesia/anaesthesia’ – regional/local is achievable, general not so much).

    For a ‘long term’ situation I have both standard instruments (chemical and then a small autoclave and pressure cooker back-up – hospital CSSD sterilisation is a multi-step procedure for a reason) but I also have a boatload of ‘single-use’ instruments (check medical supplies companies – they’re cheap and sold in bulk. Instruments and sterile ‘wound packs’ for less than a $/£ is standard).

    For a long long-term (think complete collapse/reconstruction) situation? Check out:

    https://griddownmed.com/

    A bunch of doctors who consider ‘alternative’ (and historical updated) methods for a long-term sustainable health-care provision.

    (Check out their ‘long term provision of lidocaine’ thread as an example).

    Not to rain on anyones parade but whilst ‘your own A&E/OR’ isn’t a realistic option, minor procedures (even long term) are readily achievable. Download (the freely available) NATO’s ‘Emergency War Surgery’, ‘The Special Forces Medical Handbook’ and other surgical text-books and read them ‘now’ to see just how specialised a task is being discussed. But best case? Have a tame surgeon available 😉

  5. Very useful advice (as always from Dr. Alton).

    I carry a minor surgical procedure kit of pre-sterilised and packaged instruments (plus all the ancillary ‘disposables’ that will be required – a small-pack, think an M3 pack as a bare minimum for the field – my ‘full response kit’ is ‘heavy’ and three rucks. Think you’re going to deal with anything other than a minor traumatic injury with a pocket kit and I hate to disillusion you – but you really aren’t!).

    If we aren’t talking an elective/emergency surgery situation here, the (as I have been trained) priority in ‘the field’ is to ‘treat the injury’. Infection becomes a ‘secondary’ (deal with it later) issue when you consider the probable ‘means of injury’ ( a very dirty bit of wood for example the wound is already massively contaminated/colonised). Yes you must clean (saline sachets) and irrigate the wound as much as possible (maybe even debride in certain circumstances and dowse with antiseptic – aqueous povidine iodine is common here) but ‘treat the wound’ first.

    I’m sure Dr. Alton will confirm the standard procedure (in such a situation) is to (once a ‘major’ wound is ‘stabilised’ and they aren’t going to ‘bleed out’, etc.) is to pack and/or dress and allow the wound to ‘drain’ (many wounds, even in a hospital setting are worsened by closing them prematurely whilst infected). So ‘forget’ your sutures, Ramboesque ‘sewing’, and pack steristrips and pressure dressings.

    In a more stable ‘long term collapse’ (home/base) scenario? Get training (I have decades as a [tip of spear] medic, a decade as an A&E/ER/ITU/OR nurse and whilst I regularly do minor surgical procedures – someone needs a traumatic/emergency major surgical procedure and I’m looking for a doc – and not just your local GP/family practitioner either – it’s a major ‘use it or lose it skill’. In a situation where ‘I’ am ‘forced’ to do such a procedure – infection will be the least of my concerns. Knowledge and skill are major issues yes but a primary for me is ‘analgesia/anaesthesia’ – regional/local is achievable, general not so much).

    For a ‘long term’ situation I have both standard instruments (chemical and then a small autoclave and pressure cooker back-up – hospital CSSD sterilisation is a multi-step procedure for a reason) but I also have a boatload of ‘single-use’ instruments (check medical supplies companies – they’re cheap and sold in bulk, even to the public. Instruments and sterile ‘wound packs’ for less than a $/£ is standard).

    For a long-long-term (think complete collapse/reconstruction) situation? Check out:

    https://griddownmed.com/

    A bunch of doctors who consider ‘alternative’ (and historical updated) methods for a long-term sustainable health-care provision.

    (Check out their ‘long term provision of lidocaine’ thread as an example).

    One important caveat! Clean versus sterile. In many situations (such as the splinter scenario) clean is more than sufficient (unlike in an OR you aren’t concerned with preventing introduction of a pathogen into a ‘clean’ area, you’re using them in an already massively contaminated area. NB: hospital sterilisation of multi-use instruments is concerned with that, but primarily with the transfer of pathogens from ‘patient to patient’. It’s much like the old, disproved, technique of ‘clean hand, dirty hand’ in wound dressing – what are you going to ‘introduce’ to the wound if you use a dirty hand? [assuming you’ve used even basic hand-washing/glove precautions] The very same pathogen that is already there – duh!). So consider, is the wound ‘surface’/’superficial’? Is it already contaminated? Are you going to use the instrument ‘invasively’? Are you using it on more than one wound area (ie. Don’t!). Clean vs. Sterile is generally basic common sense.

    Wounds ‘will’ become colonised (even if only by your own skin fauna/flora), the aim is to prevent infection. So stock up on irrigation and anti-septic solutions, many more dressings than you’d think and (if allowed) anti-biotics. (and don’t close them prematurely).

  6. Thank you for your answers on mask. I am not a med type I am wanting a good mask to put in my bags and also wear that protects the wearer/care provider from the infection. I see putting a mask on the sick one; reason I have added more mask to my bags. I do not know what is a good fold-able mask that will do the best to protect the wearer if from sick one and airborne issues. I have read N95 but not sure… Amazon has so many.

    Gaye I am so glad you brought up this issue I always enjoy your site.

    • N95 masks with an exhalation valve are a decent choice under most conditions. Just make sure you fit it properly so nothing is sneaking in around the edges. While N99 masks block more particulates, they are harder to breathe through so aren’t as comfortable as N95 masks.
      Also, don’t forget eye protection if you aren’t an eye glass wearer. I have chemical splash goggles AND swim goggles depending on the event. But ski goggles or even just safety glasses will protect you from splatter which is good enough for most things. Basically it’s a balancing act between perfect safety, the ability to move fairly normally, and how much you can carry with you all the time. In my Get Home Bag, I keep two N95 masks and a pair of swim goggles for dust protection as much as splash protection. My half face respirator I keep at home along with a LOT of replacement filters as well as various goggles (chemical splash, wood working, ski goggles, etc.) and some full face splatter shields. But all that gear is too much to carry every day, so I keep just a few things in the GHB until I get back and have access to all my preps.

Leave a Reply

Your email address will not be published. Required fields are marked *

Notify me of followup comments via e-mail. You can also subscribe without commenting.