The first chapter of this series recommended a few basic yet useful medical references that might reasonably extend one’s knowledge and skills beyond simple first aid measures. Because we prep for uncertain futures the majority of any reference recommendations made in these articles will be for physical hardcopies that are not subject to loss due to (insert your favorite apocalyptic scenario here).

There are invaluable medical references available that are well worthy of consideration save that they are primarily or even solely available in electronic format only. One important reason for choosing physical copies over electronic is their ability to survive many of the scenarios we prepare for.  Electronic format has the advantage of being easy and cheap to distribute and store but it is also more fragile than physical paper stock. A book can be taken into the wilderness and if kept from moisture and given a modicum of care it can last in usable form for many decades. An electronic version will be only available as long as the battery lasts for whatever device is used to store and display it, or the device itself fails.

With these limitations in mind the remainder of this series will concentrate primarily on making recommendations for physical publications. There will be a few recommends for electronic references, made with the caveat that they are subject to the above noted limitations. They should not be relied on for long term availability.

With this installment we are going to look at more advanced references that will allow us to build on what was previously recommended. The last set of recommendations would help us to train to the level of a competent home or ranch healthcare provider. This next set will prepare us for town or village level care. Another way of looking at it would be like graduating from a Certified First Aider to an Advanced EMT. Just as the increase in level of training increases so does the required time spent to achieve the next level.

Before proceeding further I’d like to emphasize the intent of this series of articles: the various recommendations that already have been or which will be made in the future are intended to benefit people who are preparing for a grid-down world. The term grid down has different meanings for many people but it has one trait in common across the board: the system we have now of transportation, communication, shelter, supply, social support and medical care will be seriously broken, perhaps to the point of not retuning for a generation or much longer. Only the why changes according to the scenario: war, pestilence, a Carrington-type event, extreme financial collapse, massive social upheaval or civil unrest, hurricane or major multi-state blizzard, or even the Hollywood-and-fiction-inspired zombie apocalypse.

One area of reference I will not be addressing at this time is military or conflict care. That is an entirely different area that deserves its own separate treatment. It will be addressed at a later date.

The Concise Book of Muscles

The first book to make the list deals with anatomy and function, specifically our muscles. People generally tend to think of muscles as large structures that are relatively few in number, with one large muscle comprising say the calf of the leg, etc. The truth is nothing like that. Fiction writers love to ignore this fact, treating gunshot wounds as mere holes of inconvenience for the heroes.

To begin, I need to clarify something: due to the differences between the editions I specifically recommend the 2nd one as I can personally vouch for it. Thus I am speaking with regard to same. The newest – 4th – edition relies on photos which may be more difficult for the novice provider to study from.

The book uses 6-color illustrations which are quite clear and concentrate on one muscle per page. The result is an easy to use learning guide. Of equal importance is that each muscle is identified according to its basic functional movement, common problems resulting from spasticity (a chronic tightness or shortening), the action of each and the central nerve that serves that particular muscle. Because muscles are normally layered it is important to note that all the muscles in a given area do not perform the same actions.

Without a reasonable understanding of how various muscles work your ability to plan care will be greatly hindered. Believe it or not the infamous gunshot wound to the shoulder does not always hit the same muscle or muscles and have the same long-term effects.

Wounds and Lacerations: Emergency Care and Closure

A classic work authored by Alexander T. Trott. Now into the 4th edition any version will serve our purposes. We want to learn proper wound closure, not how to perform intricate plastic surgery.

John Rambo made self-suturing look easy if not painful. In truth suturing another person, much less ourselves using one arm only, is an acquired skill that requires practice. There is also no one technique that applies across the board.

This book is one of if not the best guide for the basic medic who wants to add a variety of wound closure techniques to their regimen. Being able to sew up Ol’ Bossy after a C-section using a carpet needle and baling twine doesn’t translate into repairing a joint on a human. Bossy can likely survive a few years until she becomes hamburger, but your patient may have to manage 50 more years with reduced mobility because you *thought* you knew how to sew a wound.

Combine this book with the free Ethicon Wound Closure Manual in pdf format. Be aware that the Ethicon manual is one of those electronic editions I warn about, and it dedicates dozens of pages to promoting specific products rather than technique. It is useful but should not be relied on as your primary wound closure manual.

I also highly recommend obtaining a decent wound closure practice kit such as a Kenley Suture Pad or similar for practice. Pigs feet also work very well.

Mosby’s Medical Dictionary 10th Edition (Trade Version)

Before you start choking and sputtering let me explain. Books such as Trott’s (above) use terms most people are not familiar with, even if they happen to be certified EMTs or entry-level nurses. The Mosby’s edition recommended is one I consider to be very useful for people who need to ascertain the definition of a term or to match an anatomical reference. This is not an Allied Health or Nursing level edition and it is much easier to use by laypersons.

It is very well illustrated with full color plates and other useful charts and graphs. Believe me, you will find yourself using it to better understand what you are reading in other books. Unlike others you do not need to be a doctor or a medical transcriptionist to understand the definitions as written.

The Merck Manual Home Health Handbook 3rd Edition

Remember, we are trying to educate you to a decent entry-level provider level. This is the layman’s version of the famous Merck Manual of Patient Symptoms. Much easier to understand and geared towards non-professionals. At over 2,000 pages it will carry you farther than Where There Is No Doctor, though you still will not qualify as one after studying it. And you will be much farther ahead in your quest to be a competent intermediate level provider.

The purpose of this recommendation is to guide you through making basic working diagnoses so you can proceed accordingly. All stomach pains are not equal, and neither are all fevers.

Pharmacology Made Incredibly Easy

This is NOT a nursing drug handbook. It is a simple to understand guide to pharmacology (medicines) that guides the user through various classes of medications – Pain, Gastrointestinal, Psychotropic or Respiratory for instance – and how they are used. It also teaches the difference between a true allergy and an intolerance or sensitivity. One means absolutely no further use of the medication, the other may proceed with caution and awareness. Likewise, the difference between a true overdose and the merely unfavorable side effect.

Anyone who has not had the fortune of a full pharmacology course would benefit from this, be they a Paramedic or a Nurse, or even some physicians operating outside of their normal comfort zone medication-wise.

Wrap Up

If you plan to care for only a handful or even a few dozen people the previous references and these will serve well for you as the chances of encountering a wide variety of medical issues lessens with the reduced numbers.

Future articles will continue to first advance the skill levels, and then branch out into various specialty areas. Infectious disease and antibiotic guides will have their own articles, as likewise will mental health, nursing care and others.

 

Reasonable Rascal has been plaguing the internet since 1997 and refuses to go away despite years of jeers. He began his medical career using all the skills the Boy Scouts could teach him and eventually found his way into a more formal career as a Paramedic and Registered Nurse. He is one of the authors of Survival and Austere Medicine, 3rd Edition, available here at American Partisan at no cost in e-book format.

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