Ultimate Worst-Case Scenario Survival Handbook

by David Borgenicht

HOW TO SURVIVE THE FLU PANDEMIC

  Wear a surgical mask in public.

  Influenza is a virus that enters the body through contact with mucous membranes, so you must protect your nose and mouth. If you cannot get a mask, keep a bandanna tied securely over your nose and mouth. Do not touch or rub your eyes, nose, or mouth.

  Restrict and ration towel usage.

  Each member of the household should have an assigned towel, washcloth, dishcloth, and pillow. (All household members should sleep in separate bedrooms, if possible.) Label towels with masking tape to avoid mix-ups. Wash all towels with bleach.

  Sneeze and cough into your elbow.

  Sneezing and coughing into your elbow will prevent germs from reaching your hands and being spread through contact. Recommend that others follow suit.

  Keep your hands clean.

  When washing hands in a public restroom, first pull the lever on the towel dispenser to lower a towel, then wash your hands. Rip off the dispensed towel, then use it to pull the dispenser lever again and to turn off the water faucet. Discard the first towel. Tear off the second towel and use it to dry your hands and open the bathroom door, then discard.

  Sanitize before touching areas with high germ potential.

  Disinfect light switches, doorknobs, keyboards and mice, telephone receivers, refrigerator door handles, sink faucets, and the flush handle on the toilet. Do not use public telephones.

  Empty the trash often.

  Do not let used tissues pile up in wastebaskets; they may carry the flu. Wear rubber gloves when emptying trash. Wash the gloves frequently, or throw them out after each use and get a new pair.

  Avoid areas with recirculated air systems.

  Do not get on an airplane. Avoid entering buildings that use recirculation systems designed to reduce fuel consumption. (In the United States, many such structures were erected during the 1970s energy crisis.)

  Do not enter areas where people congregate.

  Hospitals, prisons, day care centers, college dorms, movie theaters, checkout lines, and other places where large numbers of people cohabitate or group closely together should be avoided during the pandemic.

  Limit Exposure

  Cough into elbow.

  Use only your own towel.

  Avoid places where children gather.

  Avoid recirculated air

  Disinfect everyday objects.

  Light switches

  Doorknobs

  Faucets

  WARNING!

  Get a flu shot as soon as they become available.

  Wash hands frequently and immediately upon returning home from being outdoors.

  Not all masks are equally effective. For best protection, use an N95 “respirator” mask that completely covers the nose, mouth, and chin.

  Te Common Cold

  Rest. Drink plenty of fluids. Gargle with warm salt water for scratchy throat. Chicken soup may help fight infection through intake of salt, heat, and fluid. Zinc interferes with cold-virus replication in lab settings—zinc nasal sprays may reduce symptoms if used at first sign of cold. There is no clear evidence of colds being prevented or eased by echi-nacea or vitamin C, or being caused by overheating or chills.

  HOW TO SURVIVE FOOD POISONING

  1 Stay hydrated.

  The symptoms of food poisoning vary depending on the type of microorganism or toxin ingested, but it can generally cause severe stomach cramping, fever, vomiting, and diarrhea, leading to dehydration. Drink lots of water.

  2 Replenish mineral salts.

  Eat bland foods, in moderation, as soon as you are able. Diarrhea depletes the body of salts, and drinking water alone will not replace them; sports rehydration drinks are effective. Nibble on dry salted crackers or plain rice to replenish salts, too.

  3 Do not induce vomiting.

  Depending on the microorganism or toxin involved, food poisoning may cause vomiting, which does not clear the bacteria from the body but will cause further dehydration.

  4 Do not take anti-peristaltic medication.

  Some anti-diarrhea medications work by slowing the movement of waste in the gut, causing the toxins to remain in the body for a longer period of time.

  5 Avoid alcohol, spicy foods, and milk products.

  These drinks and foods may aggravate the gut and cause additional gas and cramping. Never follow a suspect meal with a drink of alcohol to “kill” the germs; this is not effective.

  6 Be prepared for several days of discomfort.

  Food poisoning may induce a severe headache and sweating. Keep the body cool: never try to sweat out the germs. The symptoms of food poisoning are usually short-lived. If the symptoms persist for more than a week, or if you detect bleeding, consult a health care professional.

  WARNING!

  Food poisoning is caused by a range of microorganisms or their by-products. Each bug has its own properties and set of symptoms: Some must be alive and present in large quantities to cause harm, while others, such as E. coli 0157, can inflict a lethal dose from just a few bacteria.

  To avoid botulinium toxin, do not eat food from dented cans.

  Oysters should be eaten cooked. Poultry should be fully cooked, with no traces of pink or red, to an internal temperature of 165°F. Beef and game should be cooked to at least 140°F.

  To prevent bacteria growth, keep hot foods piping hot and cold foods chilled; do not allow hot foods to cool to room temperature before storing them.

  Wash hands before handling food.

  Do not use the same knife on meat and vegetables unless they will both be cooked.

  Shigellosis, a foodborne illness, may be in the body for seven days before symptoms appear, including diarrhea, fever, abdominal cramps, and vomiting.

  If you get food poisoning from a restaurant, alert your local health department to prevent an outbreak.

  Common Diseases and Means of Transmission*

  strep throat direct contact with saliva or nasal fluid; less easily from crowded environment

  measles travels very easily, from droplets expelled into the air by sick person coughing and sneezing

  chicken pox direct contact with infected person, or through coughing and sneezing

  herpes direct skin-to-skin contact only

  malaria bite of an infected mosquito

  lice most often direct hair-to-hair contact, or through a shared brush or hat

  flu through coughing and sneezing, to persons up to six feet away

  * The most reliable means of stopping all contagious diseases is thorough and consistent hand-washing.

  FIRST AID

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  HOW TO STITCH A GAPING WOUND

  You will need three clean, dry hand towels or other cloths, clean water, tweezers, small pliers, scissors, a high-proof liquor (preferably vodka or gin), diphenhydramine (a liquid antihistimine), a sewing needle, unused fishing line or dental floss, and tissues.

  1 Stop the bleeding.

  Hold one of the hand towels over the wound for 15 minutes, using firm pressure. Do not use a tourniquet because you will cut off the blood supply and may force an amputation. Raise the affected limb above the level of the heart to slow bleeding. Do not attempt to stitch the wound until bleeding is under control.

  2 Clean the wound.

  Soak the injured body part in warm water. Gently scrub the wound, taking care not to dislodge any obvious blood clots. Irrigate by running cool water over the wound for five minutes.

  3 Inspect the wound carefully for foreign material.

  Use tweezers to remove any foreign objects, then irrigate again. (Remember the phrase, “The solution to pollution is dilution.”)

  4 Sterilize your equipment.

  Wash the needle, tweezers, pliers, and scissors in hot, soapy water. Rinse once with warm water, then again with alcohol. Lay the tools to dry on one of the towels.

  5 Wash your hands.

  Lather for at least five minutes.

  6 Prepare the victim.

/>   Instruct the victim to lie down on a table or the floor, preferably on his back. Do not allow the victim to sit or stand. Rinse the wound again with warm water and pat it dry. Splash lightly with alcohol and wait three minutes. Pour several capfuls of the diphenhydramine directly into the wound to provide some anesthesia.

  7 Prepare a clean work space.

  Cut a hole in the center of the third towel. Place this “smock” over the wound, making sure the complete wound is visible through the hole.

  8 Prepare the needle and thread.

  Using the pliers, bend the needle into a “C” shape. Measure out 10 times the length of the wound in fishing line or dental floss. Cut. Run the “thread” through the eye of the needle so the needle rests one-quarter of the way down the thread. Rewash your hands.

  Grip the needle with the pliers so that the needle’s point curves upward.

  Enter the skin 1/4 inch from the wound’s edge. Pull the needle through the skin using the pliers.

  Wrap two loops of thread from the “needle” side of the thread around the nose of your pliers. Grab the two-inch tail of the thread with your pliers, and gently pull it through the looped thread to create the knot.

  9 Make the first stitch.

  You should “throw” the first stitch at the midpoint of the wound. First, grip the needle with the pliers, clamping over the needle’s hole. Next, hold the pliers so that the needle’s point curves upward. Turn your wrist and aim the point directly down at the skin. Use your other hand to hold up the wound edge with the tweezers. Finally, enter the skin one-quarter inch from the wound’s edge, come through the wound, enter the other side of the wound’s edge, and come out one-quarter inch from the other edge of the wound.

  10 Knot each stitch.

  Pull the needle through the skin using the pliers, then pull the thread with your hand until two inches are left on the side where the needle entered the skin. Loosely wrap two loops of thread from the “needle side” of the thread around the nose of your pliers. Grab the two-inch tail with your pliers, then apply gentle upward pressure to bring both edges of the wound together. Pull your pliers back through the looped floss to create the knot, pulling gently in opposite directions so that the knot lies flat on the skin.

  11 Lock the knot.

  Quickly arc your pliers-hand toward the needle side of the thread, and pull both ends of the thread down onto the skin. Doing so “locks” the knot and moves the knot onto the skin rather than over the wound.

  12 Secure the knot.

  Repeat the looping and knotting five times, alternating the direction of the looping; this will avoid “granny” knots that will not hold. If you notice that your hands are alternating back and forth in a rhythmic pattern as you tie each knot, you are tying correctly. Double-check that the knot is pulled to the side so that it lays over the skin, not on the wound itself.

  13 Cut the thread.

  Cut both ends of thread. Leave a 1/4 inch tail of thread so that the stitching can be removed later.

  14 Continue stitching.

  Choose the midpoint between the first stitch and one end of the wound, and repeat steps 9 through 13. Continue to bisect the wound between stitches, throwing additional stitches and tying knots until the wound is closed.

  Tourniquets

  Use a tourniquet to temporarily stop severe bleeding from a limb.

  Apply tourniquet (a band, cloth, etc.) tightly between the wound and the heart, close to the wound and above the elbow or knee.

  Tourniquets stop all blood flow and can kill the tissues in the limb, eventually necessitating the loss of the limb.

  How to Make a Splint or Sling

  Immobilize the injury site with a splint extending to a joint above and below the break. Wrap the fracture in soft material (cloth, cotton, moss). Bind with firm material (branches, poles, boards, magazines) and tie with shoelaces to secure.

  For fractures below the elbow, make a sling by securely tying together the sleeves of a buttoned-up shirt or jacket and slipping it over your head and around the back of your neck. Tuck the injured arm in the bulk of the shirt or jacket.

  For fractures above the elbow, make a sling by running string or shoelaces around the back of your neck and tying them to the wrist of the injured arm. Place a pad of soft cloth material into the armpit.

  HOW TO TREAT A LEG FRACTURE

  1 If skin is broken, do not touch or put anything on the wound.

  You must avoid infection. If the wound is bleeding severely, try to stop the flow of blood by applying steady pressure to the affected area with sterile bandages or clean clothes.

  2 Do not move the injured leg—you need to splint the wound to stabilize the injured area.

  3 Find two stiff objects of the same length—wood, plastic, or folded cardboard—for the splints.

  4 Put the splints above and below the injured area—under the leg (or on the side if moving the leg is too painful).

  5 Tie the splints with string, rope, or belts—whatever is available.

  Alternatively, use clothing torn into strips. Make sure the splint extends beyond the injured area.

  6 Do not tie the splints too tightly; this may cut off circulation.

  You should be able to slip a finger under the rope or fabric. If the splinted area becomes pale or white, loosen the ties.

  7 Have the injured person lie flat on his back.

  This helps blood continue to circulate and may prevent shock.

  WARNING!

  Do not push at, probe, or attempt to clean an injury; this can cause infection.

  Do not move the injured person unless absolutely necessary. Treat the fracture and then go get help.

  If the person must be moved, be sure the injured part is completely immobilized first.

  Do not elevate an injured leg.

  Do not attempt to move or reset a broken bone; this will cause severe pain and may complicate the injury.

  Do not move the injured leg.

  Find two stiff objects of the same length—wood, plastic, or folded cardboard.

  Place the splints above and below the injured area.

  Tie the splints with string, rope, or belts—whatever is available.

  Do not tie the splints too tightly—you should be able to slip one finger under the rope, belt, or fabric.

  Symptoms of a Fracture, Sprain, or Dislocation

  Difficult or limited movement

  Swelling

  Bruising of the affected area

  Severe pain

  Numbness

  Severe bleeding

  A visible break of bone through the skin

  EMERGENCY MEDICINE

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  HOW TO TREAT A SEVERED LIMB

  1 Locate any individual bleeding arteries on the stump.

  The arteries will bleed in pulsating spurts.

  2 Pinch off the large arteries that are bleeding the most.

  The brachial artery in the arm and femoral artery in the leg carry blood into the limb, and are the major vessels you should find. Someone (the victim or another person) should continue pinching while you proceed to the next step.

  3 Apply a tourniquet.

  Choose a strip of material at least an inch wide, and tie it around the stump as close to the end as possible so that the tourniquet will not fall off when it is tightened. Tie the tourniquet moderately tight, but do not immediately cinch it as tight as possible or you may crush and destroy viable tissue. Tighten the tourniquet just enough to stop most of the remaining bleeding. Keep pinching the arteries.

  4 Tie off the ends of any blood vessels being pinched.

  Use fishing line, dental floss, or heavy thread (in that order of preference) along with a sewing needle if available to carefully tie off the arteries. Pass the line completely around the blood vessel being pinched, as far up as possible. Tighten the first knot down hard, then place several securing knots on top of the first one. You may want to tie the vessel down in two places, in case o
ne of the stitches comes apart later.

  5 Clean the stump thoroughly.

  Preventing infection is very important:

  Pick out foreign material lodged in the wound.

  Cut off crushed tissue remnants still attached to the stump. Use a sharp knife or scissors.

  Wash the wound, vigorously irrigating it with a stream of water.

  6 Optional: Cauterize remaining bleeding sites.

  Using an iron or piece of heated metal, identify the vessels that are still oozing blood. This is simpler during irrigation, when debris and clotted blood are washed away. Dab at each vessel lightly with cloth or gauze to allow yourself to see exactly where its end appears in the wound, then apply cautery at that point. Do not worry about completely eliminating bleeding. If rapid bleeding is well controlled, oozing will be controllable once the dressings are applied.

  7 Loosen the tourniquet.

  As the pressure from the tourniquet decreases, you will be able to check your ties and ensure that more ties (or cautery) are not needed. If bleeding is just a moderate ooze, you have been successful and the tourniquet can be removed. To preserve tissue at the stump, do not leave a tourniquet applied for more than 90 minutes.