Hygiene – Dental Treatment

1. Hygiene – Dental Treatment Tooth Abscess • Symptoms • Major jaw swelling along with a cavity,pus, or gum bubble/boil indicates a toothabscess. • Tooth hurts when tapped • Usually other symptoms such as bad cavities, dark tooth, or gum issues. • 16-22 year olds with jaw swellingand no other symptoms may just have molars growing in. • Treatment (Advanced) • If there is no swelling, tooth must beextracted immediately. • If there is swelling, do not take out the tooth until swelling is treated withantibiotics (penicillin, amoxicillin,or erythromycin)

2. Hygiene – Dental Treatment Broken teeth • Treatment (Semi-Advanced) • Nerves cannot be exposed • Root must be intact • Push broken tooth and feel gumsimultaneously. If both tooth and rootmove, the tooth is intact. • If nerve is exposed or root broken,tooth must be extracted. • File any sharp edges of the toothto prevent mouth/tongue lacerations.

3. Hygiene – Dental Treatment Knocked out teeth (permanent) • Treatment • Must be within 12 hours, ideally within1 hour. • Do not scrape away any tissue fromtooth or gum • Wash tooth with saline, milk, or sterile water. (NO h202 or OH!) • Push tooth back into place using a rocking back and forth motion (Orajel or clove bud oil for anesthetic). Tooth must be level with surrounding teeth. • Fix the tooth in place with wax. • Keep wax in position for 3 weeks.

4. Hygiene - Body • Among several other diseases that can happen from poor body hygiene, typhus (body louse) attributed to hundreds of thousands of deaths during WWI & WWII. Both for soldiers and for those caring for the sick. • Stock up on soaps and detergentsfor basic body/clothes washing. • Hands are arguably the most important part of the body to keep clean (as per previously slides). • Smoke baths can help prevent parasites and bacteria. Juniper & pine tend to have better smelling smoke and may be more efficacious. • Remove clothes and stash away for 7 days to kill louse. • Stay away from crowded areas.

5. Hygiene - Wastes • Toilets can still be manually flushed with buckets of water. • If there is not enough water, use grocery bags or garage bags over a bucket or toilet to collect waste until a suitable place can be found to dispose of it. Wood ash, kitty litter, etc. can be used to overlay and use the bag more than once. • If on toilets, ensure waste is buried in designated areas at least 200 feet from living areas, water sources/rain run off, food storage, etc. Hole must be 6-8” deep.

6. Hygiene - Utensils • Cookware and preparation surfacesshould be cleaned and disinfected as appropriate. Use common detergents, disinfectants, or boiling water. • Utensils that have been or will be in contact with blood need to be sterilized. This can be accomplished by: • 30 minutes of boiling in water. Add 5 spoonful's of oil to help prevent rusting. • 30 minutes of pressure steam (pressure canner) at 20lb pressure. Use 1 spoonful of oil for each cup of water used. • Dry heat (350F) takes 2-3 hours for sterilization and is not practical.

7. Microorganisms • Virus or Bacteria? • Without microbiology culturing, it is still difficult for doctors to determine infection origin. Hence their safeguard of routinely prescribing antibiotics and creating anti-biotic resistance strains. For preppers, we are more concerned with using limited resources (antibiotics) for the right purpose. • Eyes (usually viral) • Ears (usually viral) • Mouth (both) • Upper respiratory (Usually viral, bacterial secondary) • Digestive (Both) • Urinary Tract (bacterial) • Skin (trauma – bacteria. Rashes – both)

8. Bacterial vs. Viral “General” Guidelines on Distinguishing • Location – Bacterial infections are usually initially localized to a specific region of the body. Viral infections can tend to cause more widespread symptoms. • Discharge/phlegm – Viruses usually create clear bodily discharge vs. bacterial which is usually colored yellow/green/off color. • Duration – Viral illnesses last 2-10 days. They tend to have major symptoms which then reside. Bacterial infections tend to get worse over time. • Fever - Viral infections may or may not cause fever and is usually short in duration. Bacterial infections notoriously cause fevers.

9. Microorganisms – Antibiotics & Dosing A good starter guide to antibiotic types, uses, fish equivalents, and dosing is on The Preparedness Review (TPR) fall edition.

10. Microorganisms – Non-OTC General Treatments • Holistic prevention & treatments include: • Elderberry syrup (1tbls daily or every 3-4 hrs) • Echinacea (1 tsp tincture or every 3-4 hrs or topical) • Yarrow tea (1 tsp tincture or every 3-4 hrs or topical) • Fresh Garlic (1-2 cloves daily) • Thieves or four Thieves essential oil (inhalation/topical) • Zinc supplement (oral) • Fevers (adult >104F) 100-103 beneficial • Cool packs at critical blood flow areas • Apple cider vinegar compress • Head/neck pain • Willow tree (salicylate) • Wintergreen essential oil 1:4 dilution external • Lavender essential oil (external directly) • Arnica (topical ONLY!)

11. Microorganisms – Non-OTC General Treatments • Expectorants / Congestion • Potassium iodide 300-600mg 3-4 times daily (also radiological thyroid prevention) SSKI • Stinging nettle, Tumeric, ivy extract, peppers (cayenne) • Apple Cider Vinegar • Steam • Cough / Sore Throat • Saline rinse • H202 gargle • Garlic • ManukaHoney • Flat/pop or syrup with high proof alcohol. • Vomiting/Diarrhea/Nausea/Upset Stomach • Ginger • Peppermint essential oil • Apple Cider Vinegar (1-2 tbls) • Charcoal (5-10g)

12. Microorganisms - Eyes Conjunctivitis Diagnosis - Viral - Commonly associated with concurrent sickness in the URI. Watery discharge, itchy eyes, Bacterial may have fever, swelling of the eyelid, and a pus discharge. Prevention – Keep hands away from face and practice good hygiene.As we know, pink eye is highly contagious.Treatment – Viral will remedy itself. Use saline, antihistimine drops,and cold packs to control itching. Bacterial infections will require antibiotics. Bacterial v Viral or allergy

13. Microorganisms - Ears Diagnosis - Symptoms can be ear pain, trouble hearing, fluid coming from ears, balance issues, ringing, and/or fever. Ear infections generally occur due to spread of organisms from URI’s. They are generally viral, however antibiotics (mox) are typically prescribed as untreated bacterial infections can lead to loss of hearing or greater infection. Prevention – Same as URI prevention (later) Treatment– Hot compresses near ear and olive oil. Does not treat the infection, only symptoms.

14. Microorganisms – mouth • Periodontal (gum ) disease – bacterial. Antibiotics only necessary in extreme cases. • Herpes (cold sore) – Virus. No treatment. Usually on lips. • Canker sores – May be virus, usually on inside of cheeks/lips. • Prevention – Follow prior dental slides for good dental hygiene. • Treatment - As in our dental hygiene slides, treatment can be H202 and saline rinses with pain controlled by Orajel or clove bud essential oil.

15. Microorganisms - URI • URI’s Diagnosis - Typically viral and are our common colds (rhinoviruses) and influenza. Common bacterial infections are usually secondary to the viral infection, occurring several days (7-10) after a persistent virus. Common bacterial infections include: whooping cough (pertussis), tuberculosis, pneumonia, etc. Insert video

16. Microorganisms - URI • As with other infections, if symptoms do not improve or the infection lasts longer than 7-10 days, antibiotics may be warranted. Again, refer to the general guidelines to help determine bacterial origin. • If cough is productive, do not use anti-cough medication. This is the body’s natural response to remove phlegm.

17. Microorganisms - URI • Streptococcus Diagnosis - is most common bacterial infection of the throat and tonsils. Generally, it can be determined by white pus and redness of the throat/tonsils. Serious cases will require antibiotics. • Prevention – See previous slides • Treatment – See previous slides

18. Microorganisms - Digestive • Digestive disease can be caused by bacteria (salmonella, e. coli, etc.) or viruses (rotovirus, norovirus, etc.) Follow the general guidelines to help determine which and when to administer antibiotics. The biggest threat to patient health is dehydration through diarrhea.Serious cases of diarrheal dehydration yield decrease/dark urine, increased pulse and respirations, and a drop in blood The pt experience fatigue and loss of coordination. • Prevention – follow safe hygiene, food and water practices shown prior.

19. Microorganisms - Digestive • Treatments include: Besides the ginger/peppermint/vinegar treatments, limit the pt to a fluid diet for 12 hours. Provide rehydration salts during this period or create your own: • 1 liter water • 6-8 tsp sugar • 1 tsp salt • ½ tsp salt substitute (potassium chloride) • Pinch of baking soda (sodium bicarb) When tolerance of food has built up, simple foods may be given (bananas, rice, applesauce, toast, etc.)

20. Microorganisms - UTI • Symptoms/condition • Women are more prone to UTI’s then men. • Painful & frequent urination, cloudy urine, pressure/cramping. • More serious UTI is high fever, general ill feeling (fatigue, chills, nausea), and pain in the side/back or groin area. • Preventions • General hygiene, condoms • Treatments • Cranberry Juice • Goldenrod tea (wild medicinal) • Increase water intake • 1tsp baking soda to 8oz water • 1 tbls apple cider vinegar to 8oz water • Antibiotics if suspected that bacteria has infected the kidneys.

21. Microorganisms - Skin • Any open wound on the skin is most prone to bacterial infection. Antibiotics may be needed if infection cannot be controlled. (covered later) • Non-microorganism allergic rashes may be common. This is an important part of the general patient assessment (A – allergies, L – last oral intake, E- events leading up to) • Other bodily rashes - the general guidelines that viral infections tend to be widespread (chickenpox, shingles, measles, rubella) whereas bacterial are initially localized (lymedisease, impetigo, skin boils, etc.). There are exceptions (e.g. – herpes)

22. Microorganisms - Skin • Treatments include: • Gentian Violet – fungal infections • Potassium permanganate soak • Manuka honey • Tea tree, lavender, thieves essential oils • H202 or OH (only on very minor abrasions) • Colloidal silver • Yarrow, Echinacea, or plantain poultice.

23. Mental / Emotional • Insert Movie

24. Mental / Emotional • Don’t be a your mind • Physical stress (exercise) • Winter camping • Hiking in unideal conditions • Stock comfort items • Essential oils • Gum • Chocolate • Paper photos of family (BOB) • Etc.

25. Triage Assessment SammiZipf

26. Before START – Simple Triage and Rapid Treatment • Determine if environment is safe • Size up the situation • What kind of event • How many people up vs. down • Send for help • Set up designated areas for triage categories • Begin START

27. START – Simple Triage and Rapid Treatment

28. Triage - Case Study 1 • A male is in his 40s, he has 2nd degree burns on his face, chest and arms.Respirations 22 bpmPulse – 100bpmCRT – 1.5 secondsFollows commands Yellow

29. Triage - Case Study 2 • A male child has multiple penetrating injuries. Respirations are absent.You reposition the airway and the child starts breathing.You check pulse and it is absent. CRT is 2 seconds. The child is still unresponsive. Red

30. Physical Trauma & Interventions SammiZipf

31. CPR • American Red Cross has CPR/AED certifications for around $50. With additional first aid class, they run around $75. http://www.redcross.org/take-a-class

32. Head Injuries / Concussion • Head injuries may have any of the following symptoms: Loss of consciousness, seizure, headache, nausea and vomiting, bruising, ear/nose bleed, confusion/drowsiness, one pupil more dilated than the other.If the pt has lost consciousness for a brief period (2 min), they have had a concussion. Have the pt rest for the next 24-48 hours. Ensure they have normal movement and range with their extremities. It may be necessary to check on them every 2-3 hours during the night. If the unconsciousness lasts for >10 min, try using ammonia inhalants to revive. Vital signs must be checked routinely. Ensure the pt is stabilized and airway is open.

33. Wounds – Stop the Bleeding • Elevation • Pressure & Pressure Points (DEMO) • Tourniquets • CAT (DEMO) • Wraps/Clothing (DEMO)

35. Wound Cleaning • Get it clean, Keep it clean • Observe Wound color, drainage, odor • Abrasions • Soap, H202, OH, Iodine, Manuka Honey, essential oils (lavender, thieves, tea tree), wild poultice (yarrow, Echinacea, plantain), and bandages. • Deep open wounds • Flush with sterile saline, contact lens solution (without additional detergents), or sterile water. 30-60 ml syringe with 18 gauge needle provides the 5-8psi needed • Sutures (advanced technique) may be needed. For this course, you may attempt granulation healing with adhesive skin closures if you have the right supplies to keep the wound free of micro-organisms. • May need daily or more frequent changing of bandages.

36. Choking • Identify signs/severity of choking • Mild • Pt can cough and still make sounds • Let pt try to cough up object • Severe • No sounds can be made, universal choking sign, turning blue • Responsive pt: (DEMO) • perform Heimlich or abdominal thrusts (chest thrusts for obese or pregnant) • Non-responsive: • Perform CPR, try to visualizeobject • Perform a finger sweep

37. Burns

39. Burn Treatment • 1st • Cool wrap/cool compress, Lavender, tea tree or thieves essential oil, Neosporin, anti-inflammatory medications or herbals (e.g. – plantain, yarrow, etc.) • 2nd • Cool wrap/compress, ointments, and anti-inflammatory/pain medications. Dressings will need changed daily, and dead skin removed. Follow previous slides on blister maintenance. Essential oils may be used but will require further dilution in the ointments used depending on severity of the burn. • 3rd • Flush the area with saline and debride any dead skin • Treat for shock (fluids or IV) • Keep bandages moist with saline • May use anti-biotic ointments to help keep the wound moist.

40. Shock • Hypovolemic • most common kind • causes include uncontrolled bleeding (internal/external); burns or crush injuries (where plasma is lost) • Cardiogenic • Causes: • heart attack; inadequate pumping of blood by the heart • CHF (congestive heart failure) • malfunction of the electrical system of heart • Low blood pressure, edema in legs • Neurogenic • uncontrolled dilation of blood vessels due to nerve paralysis • Septic • caused by massive infection • Anaphylactic • caused by reaction to an antigen

41. Shock Severity • Severity of shock • Compensated • body attempts to compensate for shock • ↑ HR, ↑ respirations, pale and clammy skin • Decompensated • when body can no longer compensate for the shock • ↓ BP • Irreversible • shock cannot be reversed; organ systems start to fail

42. Shock Treatment • Treatment: • Maintain airway • stop the cause of shock • maintain perfusion • Elevate legs 8 to 12 inches of ground • prevent heat loss

43. Seizures • Can be caused by epilepsy, head injury, low blood sugar, heat stroke , certain poisons • loss of muscle control, jerking of the body (commonly arms and legs), non-responsiveness • Seizure less than 5 minutes: • move pt to the ground, move items away from pt, insure pt is breathing, roll pt onto side after seizure • DO NOT place anything into the pts mouth • Seizure lasting longer than 5 minutes: • “Same as above” • give diazepam

44. Medical Kit Contents • Essential Oils Overview • Medical Kit Templates

45. Essential Oil Overview • What is an essential oil? • Concentrated hydrophobic oils containing volatile aroma compounds from plants. It carries the being or “essence” of the plant as it is distilled or treated from large quantities of the plant matter.

46. Essential Oil Use • Pregnant or nursing mothers should not use due to insufficient medical research. • Generally, do not use on babies. • Generally, do not ingest oils (some are ok) • You must research route of administration, and appropriate dilution. • First time oil users should use caution as allergic reactions can happen – after all, they are still plants. • Essential oil vendor should have adequate quality control

47. Medical Kit examples • The following handouts are some templates for building an Individual First Aid Kit (IFAK) or a nuclear home medical kit. These kits are just beginning templates. You will need to modify based on your circumstantial needs and experience/training.

48. Special Conditions (If there is time) Allergies Asthma Diabetes

49. For more learning • The Patriot Nurse • Where There Is No Doctor • Where There Is No Dentist • The Survival Medicine Handbook • Surviving when Modern MedicineFails – Essential Oils • And many others which will beavailable on the “Page” sectionof the website.

50. Thank you!Discussion