Austere medicine
General care when a clinic is far away: clean a wound, recognize trouble, and leave for help when you still can.
General information. Use it at your own risk. Follow the law. Seek a clinician, a licensed tradesperson, or the authorities when you can.
Written for a household in St. Johns County and northeast Florida. This is a planning aid. Orders, zones, and shelter instructions come from the county and the state.
Before
- Download the free Hesperian editions of Where There Is No Doctor and Where There Is No Dentist. Read them before someone is hurt. They are the books for this page.
- A clinician is still the right person. This page is for the hours or weeks when you cannot reach one.
- Wound cleaning starts with the cleanest water you have. Flush grit out. Wash the skin around the cut. Do not pack soap or dirt into a deep wound.
- Closure strips can hold a small, clean, shallow cut after it has been irrigated. Do not close a dirty wound, a puncture, or an animal bite.
- A suture is a stitch that holds the edges of a clean wound together so the skin can heal. Learn hands-on from a trained instructor. This page does not teach the stitch.
- A splint keeps a suspected broken bone from moving. Pad it, include the joint above and below, and do not force a bone back into place. Check that the fingers or toes stay warm and pink.
- Cool a burn with clean water. Do not use ice. Do not pop blisters. Cover it with a clean cloth.
- Dehydration is too little fluid: thirst, a dry mouth, dark urine or little urine, and dizziness. The first drink is clean water in small sips. Packaged oral rehydration salts are the next step for diarrhea or heavy fluid loss. The Hesperian book describes a measured kitchen mix. Too much salt is dangerous, so follow that book rather than a guess.
- Infection can look like spreading redness, pus, a fever, red streaks, or a person who is getting sicker. That is a reason to evacuate, not a reason to experiment.
During
- Stop bleeding you can see with direct pressure and a clean cloth. If it will not stop, that person needs to leave for care.
- Irrigate, then decide. Strips only for a small clean cut. Anything deeper waits for someone trained, or for the book’s first-aid chapter plus a plan to evacuate.
- Offer sips often. If the person vomits everything or becomes confused, stop the home plan and go.
- Write the time, what you did, and any medicine already in the house. Do not start a medicine whose dose you do not know.
After
- Watch the wound for two days. Spreading redness, fever, or pus means leave.
- Replace the supplies you used: clean cloth, salts, and the pages you marked in the book.
- When a clinician is available again, show them what you did.
Checklist
- Hesperian doctor and dentist books saved offline
- Clean water set aside for irrigation
- Closure strips, not a suture kit you have not been taught
- Padding and a board or rolled magazine for a splint
- Oral rehydration salts in the medical bag
- A written list of reasons to evacuate
Download while you are online
Save these on a tablet or a USB stick. This site does not fetch them for you.
Sources
Official pages only. Open them for the full instructions.