Medical Emergencies on the Homestead

This was the Year of the Broken Bone in our family.

We had 4 people in casts and splints by the end of 2023.

Jackson, 16 years old, was helping his father cut up some firewood. He knew most of the safety rules when running a saw, but he was 16 and that meant his knowledge and his actions weren’t always the same thing.

He finished the piece of wood he was working on, stepped over the log and caught his boot on a branch. He had stopped the chain, but his finger was on the trigger.

When he tripped his hand gripped down and the saw-chain began to run on the bar. The saw came down on his mid-thigh, putting a 12 cm x 1 cm gash through skin, fascia and muscle.

He dropped the saw and went to his knees. His dad immediately applied pressure and got him to the house, which was nearby.

We live about 100 yards from their house so I got the call. I grabbed my first aid box, a few extra dressings and ran up to assess the damage.

The first thing I noted was, though he was bleeding quite a bit, the blood wasn’t pumping out.

He had, somehow, missed the femoral artery.

We didn't need a tourniquet, EMS, and LifeFlight.

I cut away clothes, irrigated with saline, applied more pressure, controlled the bleeding and applied a heavy dressing. Off to ER for suturing.

From injury to leaving for ER was less than 20 minutes.

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Medical emergencies, by their very nature, are unexpected.

You need to be ready to respond in mere moments and have the tools to actually help the situation.

We have had medical emergencies on our homestead. Dislocated shoulders, broken bones, lacerations, insect stings, sprains, and burns to name a few. We also see allergic reactions to chemicals, hives, ring worms, unexplained rashes, colds, flu, smashed fingers, fevers, bruises……..the list is endless.

We live 20 miles from medical care. Our volunteer fire personnel are wonderful but as EMT’s, they aren’t able to provide advanced medical care.

Being able to help my family in the case of an emergency has prompted me to build a well-stocked medical cupboard. I’m an RN so I have supplies that some folks wouldn’t. I also have professional reference books.

The good news is that there are many books, supplies, and trainings available for non-medical folks.

First of all: Get OVER IT!

I am shocked at the number of adults who are put off by blood, poop, mucus, and other bodily fluids.

Here’s the thing: 

I have blood. You have blood. Everyone has blood. When the integrity of the skin is broken, people bleed. Stay focused. The injured person needs you.

Everyone pees. If you don’t, you have bigger problems than the guy you are helping. Good news, it’s sterile and won’t hurt you, even if you’re kneeling in it. When the emergency is over, wash up, change your clothes, you’ll be fine.

You poop. I poop. Everybody poops. Sometimes poop is an involuntary reaction to pain and vagal stimulation (when blood pressure and heart rate drop in response to pain or injury). If you get poop on you, wash really good. Use a scrub brush. Wash again. Lemon scented soap helps. You’ll live.

Some people stink, especially when they are scared. They might be sweaty, dirty, smelly, even gross. Breath through your mouth and stay upwind. Eucalyptus essential oil helps clear lingering odors out of a room. Also, blow your nose really good after the emergency is over.

That gets the lingering “I can still smell it” out of your nose.

Second, build a good medical kit and first aid kit before you need it.

I have a medical closet with my supplies organized by type on shelves. I also have a large plastic tool box (Harbor Freight) with dressings, tape, ointments, scissors, etc. in it. I can grab this and go quickly to an emergency.

Here is a breakdown of what I have, listed by use or type:

General Equipment:

Stethoscope

BP cuff (automatic is good, you won’t be fumbling to take a pressure when you are providing other care. Check the batteries regularly.)

Pulse oximeter

Glucometer and test supplies

Thermometers

Small flashlight

Wound Care:

Dressings:

o   Bandaids

• All sizes and shapes

• Include hydrocolloid for blisters, small burns, non-healing wounds

o   2x2

o   4x4 

• Sterile and non-sterile. My primary go-to

o   Abdominal Dressing or Combine Dressings

o   Gauze 2”, 3”, 4”  for wrapping wounds

o   Telfa

• Non-stick

o   Vaseline gauze

• Good for burns, abrasions

o   Israeli or Trauma dressings - they act as tourniquets and pressure dressings.

• Quick Clot to stop bleeding

o   Hibiclens

o   Tape

• prefer Microporous. It’s a clear tape that sticks well, tears easily, and comes off without damaging skin.

• I never use paper tape

o   Cobain wrap

• aka Vet wrap. This is a self-sticking wrap to use in place of tape or gauze.

o   Wound closure devices

• a new thing on the market, these have been used in hospitals for a few years. They pull together wounds that would traditionally have needed sutures. Look them up – a great thing to have on hand.

• Expensive.

These neat wound closure devices work like a zip tie. They come in many sizes and once you place it on the skin, you pull the zip ties until the sides of the wound are approximated (brought together). They don't work on every cut and laceration, but are definitely an alternative to expensive suturing in an ER. Also, you will need to trim any hair and apply Benzoin around the wound so the bandage sticks until the wound heals shut. Don't be shocked at the price. Amazon carries them.

o   Sutures and instruments to suture

o   Bandage scissors

Additional supplies:

o   Sterile Saline

• I use contact lens 16 oz sterile saline for wound washing or flushing

• Also, individual 5 – 10 ml plastic vials. For eye flushing or dampening a dressing

o   Hydrogen Peroxide

o   Wound wash

o   70% Alcohol

• Disinfecting instruments

o   Lidocaine ointment

• Sold as ‘Bikini Zone ointment’ in the feminine hygiene area.

• Make sure it is lidocaine, and not just aloe or other emollient.

o   Triple antibiotic ointment or herbal equivalent

o   Black salve / Drawing salve

• To ‘pull’ an infection from a deep wound

o   Aloe Vera gel

o   Burn Care cream

• Look for one with Silver Sulfadizene in it

o   Anti-fungal creams

• Often sold in the foot care area

• Buy more than one type to combat organism resistance common to ringworm

-clotrimazole (Canesten)

-terbinafine (Lamisil)

-fluconazole (Diflucan)

    -ketoconazole (Daktarin)

     -nystatin (Nystan)

Orthopedic Care

·      Crutches

·      Walker

·      Walking boots

·      Splints

• Cut to size to fit ankle, arm, elbow

• Malleable metal and foam

• Finger splints various sizes

·      Braces

o   Ankles

o   Wrists

• Ace wraps

o   All sizes and lengths

• Slings

• Heavy scissors

Medications:

·       Ibuprofen

·       Tylenol

o   Used together, ibuprofen 600 mg and Tylenol 1000 mg are as effective as Percocet/Vicoden without the opioid side effects. They work on different pain pathways. Can be taken every 6 hours as needed for a limited time. Avoid all Tylenol products if a heavy drinker or have liver disease.

·       Aspirin

·       Benedryl

·       Immodium

·       Kayopectate

·       Miralax

·       Ducolax

·       Urologic care medications

• Useful for early UTI

• Azo and similar drugs help with pain of UTI

• An out-of-control UTI can kill you. Antibiotics are needed.

·       Guaifenesin

• congestion

·       Dextromethorphan

• Cough relief

·       Severe cold medicine

• Contain Tylenol, guaifenesin, and dextromethorphan

• Read your labels

·       Primatene Mist aerosol

• Epinephrine for severe/anaphylactic allergic reactions

• Not the same dose as an epi-pen, but could buy you time until a squad gets there

• I had to have my pharmacy order it

• Expensive

• Non-prescription

·       Midol

·       Excedrin Migraine

• Tylenol/Aspirin/Caffeine

·       Calcium/Magnesium

·       Iodine tablets

·       Activated charcoal

·       Extra prescription medication

·       Herbal supplements that address health conditions

• Hawthorn berry

• Cinnamon / Chromium

• Thyroid support, etc

·       Herbal teas for sleep, congestion, etc

·       Essential oils

Ear Candles

Manuku Honey

• A specialty honey with antibacterial and healing properties.

• Great for wounds which are slow to heal.

General Medical supplies

·      Disposable gloves

·      Masks

• Blue, paper ones

• N95

·      Incentive Spirometer

·      Hand washing supplies

·      Plastic goggles

·      Chux

• Disposable absorbent pads

• Multiple uses

·      Bath wipes

• Larger and sturdier than baby wipes

• Found in the medical equipment area of a pharmacy

• Good for big clean ups when you can’t bath patient

·      Stretcher

• We live surrounded by rugged hills and forests. It is very difficult to access some areas, except on foot. I bought a heavy canvas stretcher designed to be carried by 6 people and will hold up to 500 pounds.

• We can use it to bring someone to an area accessible by vehicles.

·      Urinal

·      Bedpan

·      Bleach and bleach tablets

• Unscented

• Use for disinfection of equipment, surfaces, laundry

• Make Dakins solution to irrigate contaminated or grossly infected wounds

·      Water from your stock

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It has taken me a few years and some money to gather everything. There is no way to prep for all possible emergencies, but I have done my best.

·      The Dollar Tree is a good place to start. They have a variety of dressings, medications, and small supplies. Build a basic first aid kit and then start adding to your stock.

·      Garage sales and second-hand stores often carry used medical equipment like walkers, crutches, bedside commodes.

·      Amazon has everything else.

Medical basics are at Dollar Tree. For $20 you can put together your own starter medical and first aid kit.

Start with the basics - some medications, bandaids and dressings, ointments.

Build from there.

A good first aid book is important. Look through them occasionally to familiarize yourself with the layout. Here are a few I have:

·      A pocket sized one for my first aid kit.

·      A large one for my cupboard.

·      A wilderness one in case I am really up against the wall and need to perform a ‘minor’ surgery.

·      ‘Where There is No Doctor’

·      ‘Where There is No Dentist’

·      ‘Where There is No Midwife’

 Medical emergencies happen and on the homestead you may be far from medical care.

Don't get caught unprepared.

Stay safe,

Polly