The Prepper Pharmacopoeia.

The Prepper Pharmacopoeia.

There are hundreds of list about of what put in to your first aid kit. In all reality as many methods as there are preppers.

But what to stock in your home for medication. The majority if of Pharmaceuticals have an herbal equal or better and vice versa. This week we’ll get the down and dirt on what we both stock in herbal and modern medications.

The issues with storing large quantities of both herbal and modern medicine can be summed up in a few bullet points

• Space. How much space are you willing to part with to store medicine.
• Light. ALL medicine, both modern and herbal need it dark.
• Temperature and Humidity. The cooler and drier the better for modern medicine, but herbal medicine need a bit higher humidity.
• Packaging. The original is always the best for modern medicine. Herbal medications need a lot more than the plastic ziplock they come in.
• Portability. One of the things that a lot of preppers put of. But what if you have to bug out?

This week Cat and I will both present our lists of both herbal and modern medicines that we both use and included all the details as to the WHY. A lot of other places will give you the how but not the why. We want to be sure that our reasoning is understood. Our audience is not children where we tell them Because we SAID so.

Last week we took the weekend off and I failed to get the news letter out. So this week you get a 2 fer!

Last week I meant to talk about the stethoscope and how to use it . So here it is in this weeks letter

The stethoscope.

It’s practically the symbol of physicians, nurses, techs most anyone in medicine. Most of us know the basics: you put the things in your ears, the other end on a sick person, and listen. But stethoscopes can do much more. The stethoscope is one of the medical tools that all preppers NEED to have. And a lot of preppers have one.

But they do not know how to use it

This weeks VERY late news letter is on how to use this very valuable tool of medical diagnostics.

The most important parts to know are the diaphragm, which is larger, flatter side of the chest piece, and the bell, which has the smaller, concave piece with a hole in it. Switch between the two by twisting the chest piece 180 degrees. You’ll hear a click. Then tap each side to see which one is “on.”

Parts. Even modern scopes are fairly simple The following diagram will provide you with the important vocabulary:

A stethoscope with bell facing, diaphragm away.

“Tunable diaphragms” can be used to to listen to high

pitched sounds by gently on the patient for low sounds

and more firmly for high ones.

How it works. The diaphragm is a sealed membrane that vibrates, much like your own eardrum. When it does, it moves the column of air inside the stethoscope tube up and down, which in turn moves air in and out of your ear canal, and voila, you hear sound. Since the surface area of the diaphragm is much greater than that of the column of air that it moves in the tube, the air in the tube must travel more than the diaphragm, causing a magnification of the pressure waves that leave the ear tip. In your ear, larger pressure waves make louder sounds. This is how stethoscopes amplify sounds.

How to wear it. Place the ear tips in the ears, and twist them until they point slightly forward (toward your nose). If you do it right, you’ll make a good seal, and sounds in the room will become very faint.

Holding it. The important tip here is that in most cases you’ll want to hold the chest piece between the distal part of your index and middle finger on you dominant hand. This grip is better than using your fingertips around the edge of the diaphragm/bell because it allows you to press against the patient without your fingers rubbing it and creating extra noise. A gentle touch is best.

Placing it. Place the chest piece (diaphragm or bell) directly against skin for the best sound transmission. If you’re in a hurry you can hold it over one thing layer of clothing, such as a T-shirt, but this isn’t recommended, as doing so risks missing nuances that might be crucial.

What you can do with it: If you learn the following, you’ll be using yours more than 90% of clinicians. The links will take you to free pages on the specific technique.

1. Measuring blood pressure. Probably the most common use, but often done poorly. Placement of the blood pressure cuff is critical. Also, many students are taught that the diastolic BP (e.g. 120/80) is the point in which they can no longer hear the thump of the brachial artery. More accurately, diastolic BP is the number at which the volume of the thump drops dramatically. This is often 4-10 mm Hg higher than when the sound disappears completely.

2. Assessing lung sounds: allows you to identify the rate, rhythm and quality of breathing, any obstructions of the airways, as well as rubs that indicate inflammation of the pleura. Don’t forget to start above the clavicle, since lung tissue extends that high. Also, when you listen to the back, have the patient lean forward slightly to expose the triangle of auscultation. To listen for lung sounds we listen in six paired areas on the chest, and seven paired areas on the back. I remember this with the mnemonic “6AM – 7PM,” (6 anterior pairs, and 7 posterior pairs). Always listen to left and right sides at the same level before moving down to the next level – this way you get a side-by-side comparison, and any differences will be more apparent.
3. Assessing heart sounds. We listen for rate, type, and rhythm of heart sound, as well as any sounds that shouldn’t be there (adventitious sounds), such as Gallops Mummers and Clicks All hearts sound the same at first. But after listening to many hearts, eventually sounds will seem to jump out at you. For heart sounds, we listen to the four primary areas: left and right of the sternum at the level of the 2nd rib, left of the sternum at the 4th rib, and on the left nipple line at the level of the 5th rib. Remember these with the mnemonic “2-2-4-5.” The names of the valves that you are hearing in these locations are: (2 right) aortic, (2 left) pulmonic, (4) tricuspid, (5) mitral. Remember these with the mnemonic “All Patients Take Meds.” Some of my friends use the mnemonic Apartment M2245 (APT M2245).
4. Assessing Bowel Sounds. This is easy to do, and important if there may be a bowel obstruction or paralytic ileus. ( Inability of the intestine (bowel) to contract normally and move waste out of the body.)The gurgling, bubbling noises are called borborygmi. Go figure.
5. Detecting bruits. A Bruit (pronounced “broo’-ee,”) is an abnormal whooshing sound of blood through an artery that usually indicates that the artery has been narrowed, causing a turbulent flow, as in arterioscleroisis. Bruits are abnormal – if the patient is healthy and “normal,” you should not hear any bruits. Bruits can be detected in the neck (carotid bruits), umbilicus (abdominal aortic bruits), kidneys (renal bruits), femoral, iliac, and temporal arteries. The first true bruit I ever heard was umbilical, just above a patient’s belly button, and when I heard it I knew immediately that the patient had an abdominal aortic aneurysm (AAA). It was an exciting find for me, and it might have saved my patient’s life.
6. Measuring the span of the liver. Usually this is done with percussion (tapping the belly), but another neat way is to place the stethoscope below the right nipple, the other index finger just above the belt line in line with the nipple, and gently scratch the skin up toward the chest piece of the stethoscope. When you are over the liver, the sound will become more dull. Marking the location where the dullness begins and ends provides a decent measurement of the liver size in that location. About 10 cm is normal at the nipple line.
7. Hearing Aid. Finally, the stethoscope makes a nice hearing aid with hearing impaired patients. Put the eartips in the patient’s ears, and talk into the chest piece. Handy in the ER!

Diaphragm vs. Bell. The diaphragm is best for higher pitched sounds, like breath sounds and normal heart sounds. The bell is best for detecting lower pitch sounds, like some heart murmurs, and some bowel sounds. It is used for the detection of bruits, and for heart sounds (for a cardiac exam, you should listen with the diaphragm, and repeat with the bell). If you use the bell, hold it to the patient’s skin gently for the lowest sounds, and more firmly for the higher ones.

The stethoscope is an useful tool in your bag. In addition to the uses above, using it as a hearing aid for hard to hear patients. I’ve used mine in diagnosing engine noises. And they do okay in a pinch but to really be able to hear the bodies sounds that you depend on to treat someone, you need to spend as much as you can afford. I have 3. My Litman that is my work scope. It cost me 70 bucks in 1995. Then a couple of 20 dollar ones that are in my medic bag and one in our bug out kit.

The cheap ones at Walmart will get the basics done, taking a blood pressure. But they really are lacking for listening to the lungs. It is hard to tell the difference between the different sounds

• Rales (clicking, rattling, bubbling)
• Wheezing (a high-pitched whistling sound caused by obstruction of the bronchial tubes)
• Stridor (a harsh, vibratory sound caused by obstruction of the trachea)
• Rhonchi (snoring sounds)

And for listening to the heart sounds

Through a cheap stethoscope they can all sound the same. They are however treated differently. And this is where the old saying of you get what you pay for. And here cheap will not cut it.

So tune in to The Medic Shack LIVE on the Survival Circle Radio network

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