MEDICAL MONDAY: Treat Fractures, Face Masks, and Tourniquets - Dr Bones & Nurse Amy

See and know the world as we know It's not you that we start with the. Twigs, first sticks and narrow planes, any roots, not afraid. I have a betems to bear something the world. And it don't need something in your own nay sweet it him and I got no kind. Of a spear fight down back fire in a fire, seven banks, the government of Hire and a not bad tag. But was coming in r figuring down your next mister Porter Rapp with that boat plane fine, and I'll over bill put corner. The body of the secret world is your own means to see your husband. Show me the recommender of everyone will right. You gotta right to it. In twinty side fifty and the world as we know it begins me and love the world as we know it, Know the world as we know it is not. Welcome to the Demon's Hour with medical preparedness experts, Doctor Bones and Nurse Amy your source for information on how to succeed if everything else fail, and now your hosts, Doctor Bones and Nurse Amy. The alternative world as you know it. In the dark heart of the city, a mysterious figure known as doctor Bones. That's me, a mysterious geezer. How how mysterious do geezers get I don't know, not too mysterious. I think so, you think so, I absolutely do. Well. We appreciate all geezers of the world. Well, I will tell young and old, I'll try it up my yes, I will try to up my mysterious quotion today. So okay, hey, this is the Hour of Doom and Bloom. That's right, friends and neighbors, and welcome to the Doom and Bloom Survival Medicine Hour and Hour of honesty in an onerous world. I'm Joel Mende also known as Doctor Bones of Doom and Bloom dot Net. You'll find over a thousand post videos and podcasts a medical preparedness for any disaster on our website. And this is Amy Alton, also known as Nurse Amy. I am an advanced registered nurse practitioner and a certified nurse midwife. And together we are the masters of disasters, the hosts with the most and a spectacular set of spouses, I would say, and we are here to help the faithful few keep it together even if everything else falls apart. Now this week, we're working to change our format a little bit. Matter of fact, over the next few weeks. We're going to be doing that, so we don't have such a long housekeeping seite know. Sorry about that, guys. For what the past eight years and a half years. Before we get to the medical ste did we started to ten? Yeah? I think we did in different October twenty ten, different incarnations though different networks. And it doesn't matter. We've been doing once every week. Just yes, that's right. I have to figure out how many many total episodes that is. That's quite a few, I've got. Yes, because you don't let me take vacations. That's right, because we have a mission and we have to put a medically prepared person in every family. 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Been talking about tourniquets and stopping the bleed and things like that. This is I think Stop the Bleed month. I know that Stopped the Bleed Day is May twenty third, and it's great actually that the government act is supportive of our efforts to try to get people to have the materials available to stop bleeding if they come apartment upon somebody who's had an accident. It's true. It is a flip from previous beliefs that tournikits would basically kill you and they're going to have to cut your arm off if you leave it on for more than five minutes. So you should never ever use a tournique unless someone's just about to die. Totally flipped from that to hey, tournikits can say lives. Let's teach everyone how to use a tourniquet, exactly like they had a campaign about CPR. Well, you're right about the attitude towards tourniquets. Tourniquets have been used to control bleeding for centuries, and they've sort of gone from being reviled as the tool of the devil. Actually that was a statement made I think in a British Army medical manual from World War One to being praised as a probable first course of action in any real severe bleeding episode. But we've learned a few painful lessons in our armed conflicts recently that also have been evidence for tourniquets being part of the deal for anybody's medical storage. And so we believe the tourniicuts saved lives that would otherwise be lost to hemorrhage. And that is military, but also in civilian life. In civilian life, if you can use a tourniquet rapidly, in effectively at the scene of an accident or at the scene of any situation, any disaster, well it could give valuable time for emergency medical personnel to arrive. Not only that, but every drop in the person's body is blood carrying oxygen to the vital organs. Yes, the less blood, the less oxygen, the more tissue death that that person may sustain, so you want to keep every drop of blood that you can in the body. And someone asked me on the phone yesterday, Actually I had a conversation and he wanted to know how do you know when to put a tourniquet on? And I do think you should write an article specifically just that one little question, because I thought it was pretty interesting. And this is a guy who's pretty well trained. He might even be listening to this podcast. I it seems so clear to me, just I guess because I have medical background, that the simple answer is if what you're doing isn't working in a very short period of time, and for me it would be about twenty to thirty seconds tops. If it just seems like I'm putting my hands on the faucet and the water is not stopping, that I have to put a tourniquet on because I need to keep the blood inside that body. That's the thing. You need to keep the blood, and not inside the body soaked up in gauze, but inside the body, inside the blood vessels, right, that's where you want it. Right. Well, from my end, if I saw any arterial bleeding, that's bright red blood that's pulsing out. And key number one out. You know that is for me a side alert red get it red, red alert. And use your turniquet as a first course of action. There. If the bleeding is just a cut on the skin, even though it could be bleeding some, then you could use some direct pressure, and. Direct pressure works most of the time. You have to have a pretty significant injury or it just has to be in the right place. I shouldn't say significant injury, but it just has to be in the right place, because you could have a you can't put a tourniqut on, but you could have a not too deep cut in the neck and actually hit an artery right and you lead at bleed out very quickly. So it doesn't have to be a deep, horrible wound. It just has to be in the wrong I don't want to say the right spot, the wrong spot. So if you're seeing a lot of blood, what you're doing isn't working. And obviously if it's an extremity, you can't put a tourniquet on a neck. So the key is to do no harm, right, remember that rule number one, well. Number one, So again, so what you said, if it's our bleeding bright red and it's just kind of pulsing out, pumping out, pumping out, pumping out, pumping out, and you're putting direct pressure. There's some material between your hand and the wound, and you're putting direct pressure. It's just not working. You're gonna be going for that tourniquet. Don't keep piling. I know they used to say put just put more gods, put more gus. If you have a tourniquet or an ability to mcgiver an appropriate with of a tourniquet, then try to do that. Don't just keep piling more gauze on because even though you don't see it, if you know that blood is still gushing in there and it's not working, you got to move on to the tourniquet. Don't be scared of tourniquets. They can be taken off in the emergency room when the emergency room doctor is standing there. Maybe they have put them in the o R to do it under a surgical situation, and then they take it off so they are prepared to repair and stop bleeding in a perfect environment. So don't be. Afraid to put it on. It probably won't be on very long if we have modern medicine. Right, well, remember that it usually just takes a few minutes for emergency personnel to arrive in normal times, and those few minutes if since an arterial blea can make somebody have real problems in just a few minutes, right right, What you need to do is to give some time for emergency personnel to arrive there on their way. They'll be there pretty fast. Right. You can really help. You can really help by making sure that you intervene and you do something right away. Yeah, I mean direct pressures for venus bleeding, and I think immediately a tourniquet if you happen to have one for arterial bleeding. It doesn't take by the way off the grid. It doesn't take a Navy seal corman to note that having tourni gets in your medical kit is not a bad idea. So you've got to have that. That's part of your medical kit, and you need to have multiple tourniquets. You can't just have one. Now, for years, the Committee on Tactical Combat Casualty Care that's the TCCC or the T three C, has approved a small number of commercially available tourni gets. These guys decide what the military uses and I'm sure many of you out there have some of these in your medical kit. They include the Combat application tourniquet or CAT tourniquet, and the Special Operations Forces tourni gut the soft tea. These are the tourni guits that many of our military have trained with, and if you've trained with a particular tournique, you're probably gonna want to have it. I in our medical kits, we have these turniicuts, and we also have the swap tourniquet as a secondary tournicut, mostly due to its versatility to act as a tournique, to function as just a pressure dressing, and also to help stabilize splints. So actually pretty versatile stuff that you wouldn't be able to use some of the military style tourniicuts with. So the TC three, I say T three. C T three C T C three, it's TC three. I know it's because it's. Three in the C TC three are rhyming. Well, actually, yeah, you should put the C first. Technically, but you can make up whatever you want, honey. TC three committee. The funny thing is that I actually started calling it that and somebody corrected me. So I'm okay with either one. I hope you guys are flexible out there. So now the TC three committee has widened the range of options that are acceptable for the effective control of bleeding, and that is pretty amazing. One of their additions is the sam XT SAM Extremity Tourniquet and produced by the venerable doctor Sam Sheinberg of SAM Medical. SAM made its name on producing malleable splints that are useful for gosh a number of orthopedic injuries, and now their tourniquet is considered acceptable for even military and law enforcement purposes. So look for a video in near future about the sam XT and Amy's gonna be demonstrating that on a dummy, an extremely old dummy. Well looking forward to that, believe me. Oh boy, I won't make it too tight though. Yeah, okay, Well, the sam X wasn't the only addition to the medical woodshed for the Committee on Tactical Combat Casualty Care. The official list includes, of course, the CAT tourniquet, both the Generation seven which is the current generation and the older generation six, the soft t tactical tourniquet, especially their wide one. The new ones are the Ratcheting Medical Tourniquet, the r MT T the Tactical Mechanical TURNIICUT t MT, and the t X two and t X three turniicuets. The numbers are just mean the width of the actual tourniquet itself. So we'll be looking at some of these. We actually have some of these, but we'll be looking at all of them and seeing how they function and seeing what makes the most sense for us as a prepper or preparedness community. Absolutely, there you go. They're also, by the way, tourniquets that are inflatable or what they call pneumatic in nature, and the tcc C approves of the Delphi d e l FI Emergency and Military tournique that's the e MT and the TPT two that is the tactical pneumatic turn two for specialized tourniquets for junctional areas. Junctional areas are like your armpit and groin areas and areas where the standard tournikeets really don't fit. The There is the combat Ready clamp or the CROC is what they call it. The cro C, the SAM Junctional TURNIICUT SAM JT SAM already had an approved tourniquet there and also the Junctional Emergency treatment tool, the jet J E T T dang. Gotta love those acronyms. It's all acronyms here. In military loves acronyms. But I get it because otherwise you're saying a lot of long words when you need to just get to the point. Get to the point, get me the jet or get me the crock, get or done. You know, just just act there you go, not talk so much. So anyhow, look for future videos from us in the near future demonstrating the use of some of these things. In the mean time, we'll be adding the sam x T tourniquet to our product line eventually at store dot doom. And bloom dot net because I am a distributor medical product and I know Sam and. Doctor Sam. They're so nice. Yeah, good people. Keep in mind that just because the tourniquet is approved by the TC three, it doesn't mean that it would be effective in the hands of an untrained individual. For the military, that training is part of the deal. I mean, you get that training. But for civilians, it still makes the most sense to use the tourniquet that you are accustomed to. So if that's the cat tourniicut or the soft tourniquet for your soft tea for you. Don't feel like you need to run out and buy these other ones. The bottom line, if you can't use it rapidly, effectively and safely, well you know what, it's not gonna do much good in your medical bags. So don't feel like you have to run out and buy all of these new ones. No use what your brain will remember. That's right, the brain, So miracle organ. Hey, we learn as much from you as you do for us, probably more, honestly, So come on connect with the geezer and the goddess. It's easy, and here's nurse Me to tell you how. Absolutely can contact us by email at Dr Bones Podcast at aol dot com. Find us on Facebook at our group Survival Medicine Dr Bones and Narsy, and of course the one stop place to be on Facebook is Doom and Bloom. You can also follow us on Twitter at Prepper Show and don't forget our YouTube channel, Dr Bones Nurse Amy and one more thing Instagram if you want. To see new Instagram kind of. More of a day to day life of doctor Bones and Nurse Amy Instagram, Doom and Bloom Medical one whole word, you know, boom and bloom medical I show you garden pictures. Speaking of vacation pictures, I wanted to ask. You if you put any pictures of the corn that we just harvested corn pictures believe it or not. No, you recorded one of those. You did a little video. I put that little video of me opening one of them up outside. Oh that is awesome. Well, you know we have glass gem corn. Yes, this is like Indian corn, except shiny and really beautiful. That's from Indian heritage corn. Yes, right, and it was just awesome. You may think it's a little weird that in early May we're talking about harvesting corn, but down here winter is our agricultural summer in South Florida. So we managed to get some corn, and the corn is just awesome. You should take some more pictures and put those up because those are great. Well, anyhow, I want you know that last week, wouldn't you know it? After talking about fractures and breaking bones in our last week's show, and after a lifetime and not breaking a bone, I probably broke a toe on the last day or so before we left Gatlinburg to head back to South Florida. Now I say probably because I didn't bother to go get an X ray. We talked about this last week on the show, with that my toe was swollen and it was I was still able to move the joints and oh that's right, okay, but your toe got more bruised. But that's what happens as it heels. It was just amazing. I don't think it was broken, you know what I mean. I'm fine. I think it was dislocated. I think it was a little dislocated. Could be jammed. Yes, you heard of ToeJam. You don't have ToeJam. Honey. You may have jammed a toe, but you don't have ToeJam. Well, we last week we talked about the amazing way that a broken bone heels a miracle. Really, I want to just talk about I just want to say it again because it just it freaks me out a little bit as to one amazing thing the body is. It is a miracle. You know, when a fracture occurs, the body begins to form a clotch within a few hours right around the fracture from little blood vessels that are around the area, and then special immune cells called phagocytes start cleaning up the bone fragments and the debris and whatever germs I actually might get in the way of healing. And the interesting thing is phagocite or fagocite is the Greek word for cells that eat. That's exactly what they're doing. They're eating up all the junk that may impede your ability to heal. Then they have cells to form fibrous sort of car cartilaginous kind of tissue. Those are called chondroblasts, and they make a connection to the to the broken ends of the bones if they are at least aligned, and that's called the soft callus. That takes a few weeks to form, maybe two or three weeks to form, and at least gives you a connection. Doesn't give you much support, but gives you a connection. And then the bone cells come in and they create new bone, adding minerals to strengthen the healed area or the healing area. That's called the hard callous. Appears like a thick bump on the bone, and after a few weeks sometimes well depends on the bones, six to twelve weeks, the bone begins to remodel itself in such a fashion that it wants to resemble what the original bone look like. Whatever the original structure look like, and they have even different cells that come in to do that, and they may work for years to try to achieve a final result that looks very much like the original bone. Now, what we didn't talk about last week is how to treat a fracture when you don't have a hospital to take your victim to, and so let's talk a little bit about that. Basically, what you need to do is you need to determine the extent of the injury. Of course, if the injury occurs in an unsafe area, remember your safety is paramount, So always remember a medic first first priority is self preservation safety. But assuming that it was just some accident happened that happened, what you would do is you use a bandage, scitsors or MT shears to cut away the clothing so that you can get a better idea of the extent of the injury and after you control any bleeding well. The medical treatment of fractures involves a fundamental rule that the broken pieces have to be put back into position their original position and prevented from moving out of place until they're healed. Now, in many cases, the medic has to actively work to restore the bone to its original position. Oftentimes that there are muscles, these muscles that were traumatized. Also, they're swollen, and it can be difficult to get a bone back in its normal position, or at least to keep it in that position. Now that procedure is called a reduction. It's very painful. As a matter of fact. In normal times, most of these are performed under general anesesion, but off the grid. If you don't reduce the deformity in the bone, if you have somebody with an arm that's just pointing in the wrong direction, you've got to fix it and so that it's realigned, so that the victim retains part or all of the function of the injured extremity. And the longer you delay to do this, the more swelling that occurs, and well, the more difficult it becomes. Now after reduction, and even after reduction, the broken ends may not stame place without special efforts. So you may have to use something called traction, and that's something that's maybe required to maintain the normal position. And in normal times, modern orthopedists will put metal pins and screws and all sorts of crazy stuff. It's an insert into the bone to try to stabilize the broken ends. Then they rig up pulleys and all sorts of traction systems, and a lot of this can actually be done on the grid if you are creative about improvisations. So these are things that need to be done. And let's say it was a forearm that was fractured. Basically what you would do is you would hold the upper arm stable, in other words, whatever is closest to the torso on the extremity that is not broke, and you hold that stable in place, and then you take let's say the forearm, and you're gonna have to use some downward pressure to pull the the lower arm broken ends until they actually are together and they're aligned again. Now you may have help for this, and it's best done with two people. If you don't have help, you can even use a fork in a tree if it's at the right level to provide support while you exert traction. In any case, boy, this is gonna hurt own hurt. Just think about it. I mean, remember we took a picture of you in the tree like that with me pulling yes for one of your magazine articles. Yes, that's right. I think you haven't think that was in Survivor's Edge or American Survival Guide, and both of those are great magazines. By the way, make sure you yeah, let's try to find that picture. We could put that up absolutely the blog Talk Pictures. Yeah, I rotate, Yeah, that would be pretty awesome to look for it. I don't know what you called it. Now. The thing is about reduction is that it's not without its risks. So you have nerves and blood vessels that are around the broken bone, and A and D can be traumatized. So you have to attempt this only in situations where there is not any access to modern facilities, and that when I talk about that, I mean for the long term. I'm not talking about for an hour. So the important thing is that you always try to maintain circulation. So you shows check for pulses after you perform reduction, and you shows check sensation beyond the level of the injury after you do it, too, just to make sure that there's still the sensation there. And all you have to do is basically just sort of poke it with a twig or something like that, or a pen whatever you might happen to have. Now, once the broken ends of the bones are together again, ice packs, elevation stabilization. These are the things you need to do to reduce swelling and prevent reinjury. The extremity has to be mobile, immobilized. I'd use a SAM splint, which is something that we have in a lot of our kits, ye or an improvised splint as we've talked about in the past with you know, sticks and strips of T shirt, and don't. Tie those things onto tight right, because again we want to keep the circulation. That's right. So after you put any of these on, just like if you were putting on the regular SAM splint or the malleable aluminum padded splints that they make, always check the pulses below that check the color of the tissue below or beyond is another good word, beyond beyond where you have put the splint. So let's say you did use sticks, but all you had were some sort of cotton ties from a T shirt you tore up and you've tied that on. You want to make sure that that cotton T shirt material or gauze or whatever it is you used didn't push into the t shoot too much, so you're not trying to put it on really really tight hopefully they're not using that to walk on. You just want to kind of stabilize it. You're not putting this on to say, okay, now we're going to walk out of the forest, even though you've got this fracture. That's not going to be possible. So you're going to put it on loosely just to stabilize it. It's not so they can now walk upon it. Right. There are a lot of ways to transport a victim of trauma like that, and we've gone definitely check out our articles and our videos on patient transport. We talk about a lot of different ways that you can do that. When you splin an extremity, you want to do it in the normal position. Now, a normal position is different for each extremity. An arm, for example, should be splinted at a ninety degree angle at the elbow, the leg should be straight with a slight bend that the knee, and the fingers should be splinted if it's a broken finger, as if the victim was holding a glass of water. So these are things that are important that you want to do it in as normal position as possible, so there's the least amount of strain, you know, we always appreciate suggestions from our readers and viewers and listeners, and our good friend James C. Suggests getting a supply of paint stirring sticks at home depot or lows. He says that they're free and that they would make useful splitting materials, even though you might need a few of them for any fracture of a large bone, but certainly for let's say a forearm or wrist, things like that. This certainly would be useful to give some support. Now, if you're going to use them, though, make sure that you put padding. And I think you're going to talk about that exactly, pad anything that comes in contact with the person's skin. Absolutely right now. Of course, when you think about a broken bone, you think about a cast, right, Maybe not on my toe, but certainly almost everywhere else. When there's a broken extremity, you need to immobilize the area around the fracture to allow the healing to occur. Remember, there's a formation of this soft callous over the course of time until it actually has real bone cells in it. It's just sort of mushy cartilage and fibrous tissue and stuff like that. It is not giving you much. Support you know what I could have done, as I could have taken a tongue depressor, wrapped some gauze around it so it was padded, put it on the bottom it was your second toe, put it on the bottom of your foot, and then maybe duct taped that padded tongue depressor just to the one joint that we think was affected. But loose duct tape tape with padding around it. The only thing is that it would make it difficult, if not impossible, to wear shoes unless you had a bigger shoe. Than what you know it was broken. I wouldn't have had you put a shoe on you to just lay it around. I'd just be laying around foot up. I'm thinking about Bible Darling, thinking about what we would do if if it had been broken and we couldn't get to a hospital. How I would have stabilized the toe, just with something I might have had, because even this finger splint is a little too big for your second toe. Well, but you can cut it, yes you. Can't, Yes, you absolutely can cut it. But I was just thinking what would I have had? And I have tongue depressors in our kits, especially the kit that I carry in the car. I carry that that medium kit, and so I could have padded that with gauze and then put tape around it just at that one joint. There are a lot of ways to skin. It might have been pretty comfortable. It wouldn't have been too bad, I. Don't think, you know. It just amazes me how many different uses some of our items that our kids have, and you know. How especially duct tape. Oh absolutely, And we have you know, probably enough plastic bags in our big kits to put together like fifty chest seals. Carry the water in them for irrigation. Irrigation syringes. I put a little hole in one of them and squish the water out fast, and it's not going to be as good as a syringe. But you know, any any port in a storm, right. That's right, And we have syringes whatever I have at the time. All right, So we're talking about casts, yes, so you might consider including casting material in your medical supplies if you are going to be the medic off the grid, because some disasters have they have those in kits. I don't have those right exactly. Now, there's different types of materials casting material using plaster of Paris or fiberglass, that are pretty easy to obtain online for your medical stories. They last a long time, and I don't know if they have a expiration date, but I doubt that it would make much of a different They would You would think they. Wouldn't, because that's that's only activated when it's. Wet, exactly right, you know what I mean. That's why I think it would last for many years. So what's the difference between plaster of Paris and fiberglass. Well, plaster is more appliable. It hardens slower, so it gives you a little more time to apply the cast and that's useful for people that don't have a lot of training home and mold it in the right place right and hopefully you're not breaking bones every day in your survival community. That would be pretty terrible, so you might not have a lot of. If you have somebody who's doing that, you need to just basically put them in a plastic buzz pads, elbow pads. Yes, probably not a long term helmet. Put a helmet on the. Right. Fiberglass. Now, fiberglass is lighter and it's less messy to use, and it comes to all sorts of neat colors, and that's great for normal times, but I think a little bit too noticeable, noticeable off the grid. If you're walking in the forest with a bright pink, bright pink cast, well, probably not something you really want to do in times of trugal. I'm pretty sure we saw those the I guess it's the fiberglass ones come in the camo. I think they had a camo pass. Remember that's pretty cool. Well, you know, if you've got to wear a cast, you might as well make it kind of cool. Yeah, that would be awesome. Yes, absolutely, So each fracture is casted somewhat differently and with various materials. I can't go into all the techniques used for each and every bone, but the basic principles they're pretty much the same. When you place a cast, you'll first go to start with a liner of cotton known as a stocking net, like a stocking, but a little stocking called a stocking et. Now, these are available in rolls that you can cut to the length that you need, and so you can actually use it a number of times for a number of different injuries. So you should get a roll of stocking ets. The stocking et should be measured and cut several inches longer than what the intended cast will be, and you place it without wrinkling, over the area to be casted, just like you would put on a sock now in a pinch. Even a clean long sleeve of a cotton shirt, let's say, would do in a pinch as a stocking. It. Now you don't wear the shirt again unless you want to make a very interesting fashion statement. Arms cut off or just one arm cut off right right, Well, then you'll after that you're gonna need rolls of padding. You mentioned the importance of padding, and that is you need to form a barrier between the skin and the cast. And so as you have these rolls of padding, you're going to unroll it over the injured area. And if you want to advance about one half of the thickness of the role each turn as you go from below the fracture towards the torso, and the padding should be at least two or three layer stick should extend about an inch or two beyond where the cast would end. So extra padding should be applied if you have to place them between fingers or over a bony prominence like you have. Everybody has a bone that sticks out on the wristsp so you want to do that. Oh, by the way, here James C sent us another suggestion. He says, you can improvise a homemade cast padding as the liner. Just cut the arm off a clean sweatshirt and so that can serve as padding. You can cut a hole in the cuff as a thumb hoole, So that's something that you could do if you're doing it over the hand, and the sweatshirt arm is the perfect size and should provide ample padding. So if you want to improvise, you're gonna end up with a lot of one armed shirts and sweatshirts, yes, but would definitely give you the protection that you want. Now, at this point, you're gonna take rolls of plaster of Paris or fiberglass and you immerse it in cool water for about twenty seconds or so. Then you squeeze them to remove the excess water. Now, one thing that's very important. You got to keep the end of the roll between your fingers. Otherwise it's gonna stick to the rest and it's going to look exactly the same as this ball of cast material and it's going to be difficult to find. So hold on to the end of the roll between you put it between your fingers. You're gonna begin to slowly wrap the casting material around the area of the fracture, and you're gonna smooth it out as you go along and advance like you did the padding, one half of the thickness of the role each turn as you go from below the fracture towards the Torso you want to avoid making it too tight. That's very important. You will want maybe three layers of casting material on the area, and more in places where there's a bony prominence like the risks to deal with. Then what you want to do is you want to roll the ends of the stocking end and the padding back over the cast before the last layer is applied, so that you can have some padding for the edges. Otherwise it could be very uncomfortable. So stocking ets, padding, casting rolls, all these are available in different widths and lengths appropriate to the particular fracture. And I'm going to put up an article about placing a cast with the video showing a cast being placed in the near future, so keep an eye out for it on the website. Now here's the word from our sponsors. Hey Joe audenand here when it comes to survival and being prepared, we know the must have items that immediately come to mind are a complete medical kit and a bug out bag. Our friends at Gold Wealth Management reminds us to have our bug out bank in place as well. Your bug out bank should contain physical gold and silver along with three months of living expenses in cash. Called Gold Wealth Management. To get a free education about investing in gold and silver at current prices of gold and silver market is on sale, call eight sixty six gld SLVR. That's eight sixty six gld SLVR or eight sixty six four five three seven five eighty seven. Prepper Net where preppers unite. Looking to me to light minded people in your area. Looking to start your own prepper group already have a group Join preppernet dot com. Preppernet has gathered the biggest names in the industry to help unite preppers everywhere. Join John Jacob Schmidt, Scott Hunt, Doctor Bones and Nurse Amy Glenn Tate, Shelby Gallagher, Charlie Hongwood, Samuel Kolper, Survivor Jane Rick, Austin, Franklin Horton, Ryan Mitchell, and Brian duff Our Team is United. Check us out. That's preppernet dot com, Preppernet where preppers unite, preppernet dot com. And we're back. So we've talked about fractures, but how can you tell a fracture from a sprain. Well, sometimes it's pretty dard obvious. Those are the ones you cringe at for a second when you first see him. But other times, you know what, not so obvious, So it might be hard to determine which is which without X rays or other modern diagnostic tools. Now they're obviously not going to be available if some disaster docks you off the grids. See, you have to go low tech. Look for one or more of the signs. A fracture is probably going to be more pronounced in terms of swelling and bruising than your average sprain. So this is something that you're going to find that there's a big swelling in an area where there is a broken bone, whereas a sprain it will be swollen, it will be bruised, but usually not quite so much. Now by the way, the pain is going to be a lot different too. You can be helped off the field. You sprained an ankle, you probably have to be carried off the field if you broke your ankle. So this is something that's very important to know that there's a degree of severity in terms of pain, swelling, and bruising. Now, a fracture might have a deep cut in the area of the injury. Now, that would be a sign of an open fracture, and that's particularly dangerous because the skin has been broken. The skin is not supposed to be broken. That's your armor and prevents infection. And the bone is not always outside the skin. It may have gone right back inside after the original trauma. So always be suspicious if you see a cut in the area where there is a fracture or a sprain suggested. Now, a fracture also produces a grating sensation. When you press down near the injury, between where the two broken bones are, they will have a tendency to rub against each other and great, and you feel this grating sensation. It sounds awful and it is awful. Fingernails on a chalkboard. Here, and that's exactly what it is. Now, you can use a stethoscope and a tuning fork. The tuning fork that I got a medical school was one hundred and twenty eight Hertz and you place that on the bone just beyond where you think the fracture is, and then you listen with the stethoscope above the level of injury that is closer to the torso, and you compare that to what the bone is like on the other side. Now, if if the bone is intact, you should hear a good vibration on the in on both sides, they should be they should be equal. If there's a broken bone on the questionable side, well you may not hear anything or may be much much much more muffled. So that's something that is an interesting way that not everybody knows about to deal with sprains versus fractures. So those are just a few hints that might help you make the diagnosis there. Hey, you know, we're proud to be part of our good friend Jack Spiriko's survival podcast Expert Counsel, and we get lots of interesting questions from his listeners as well as ours. And here is Nursey answering some questions about face masks in times of trouble, something you definitely should have as part of your medical supplies. And here she is. Well, today's question for the Expert Council is from Luke in Michigan. He says, Hi, Amy, could you explain the differences in n ninety five mass background. I've been reading both your Survival Medicine handbook, thank you so much, that's a side note, and Alton's Antibiotics lately and decided I really needed to add more in ninety five MASS to my medical supplies. While shopping on Amazon, I see that the surgical masks are cheaper than even the standard three M in ninety five MASS without exhaust vents. If I'm looking for these specifically for cold and illness prevention, should I be concerned with any one type more than another. Well, there's a lot of great resources about face masks. You can find some on the CDC and also FDA, so you can take a look at that. And I did get some of this information from there, so if you want something written, that would be a great place to print it or just sort of look at this again. Face masks and IN ninety five's are actually examples of personal protection equipment that are used to protect the wear from liquid and airborne particles contaminating the face. They are part of an infection control strategy and if you guys paid any attention whatsoever to when we had the Ebola outbreak, you definitely saw different kinds of face protection. They started off with generally these face masks, which we'll discuss in a second, moved up into a stronger protection, and eventually they had on these full vitilator masks that had filters and machines attached to them. By the way, those are super expensive. So let's discuss the simple thing first. The face mask. That's actually a loose fitting, which is unfortunately one of the reasons why it is not great or perfect for protecting you. They are disposable, and they create just a physical barrier between the mouth and your nose of the wearer against potential contaminants in the environment that's just around you. Face masks are not to be shared and maybe labeled as surgical isolation, dental or medical procedure masks. They also may come with or without a face shield. Again, a lot of this has changed for your access. Normally, those were hospital supplies that were harder to get. They're made with different thicknesses and with different abilities to protect you from contact with liquids. These properties can also affect how easily you can breathe through the face mask. You may see three ply, which makes it a little bit easier to breathe, but it gives you a little less protection all the way up to I've even seen six ply, and it helps determine how well that face mask is going to protect you if worn properly. In other words, with a good fit. A face mask is meant to help block large particle droplets, splashes, sprays or splatter that can contain germs which you're talking about viruses and bacteria, keeping it from reaching your mouth and nose. Face masks may also help reduce exposure of your saliva and respiratory secretions think coughing or sneezing to others, so it blocks that. While a face mask may be effective in blocking splashes and large particle droplets, a face mask by design does not filter or block very small particles in the air that may be transmitted by coughs, sneezes, and certain medical procedures. Face masks do not provide complete protection from germs and other contaminants because of that loose fit between the surface of the face mask and your face. Face masks are not intended to be used for more than once, so no you can't recycle them, you can't clean them, you can't reuse them. They are absolutely to be disposed of after you use it. If your face mask is damaged your soil, or if breathing through that mask becomes difficult, you should remove the face mask and discard it safely and replace it with a new one. To safely discard your face mask, place it in a plast stick bag and put it in trash. Always wash your hands after handling the used mask. Now in ninety five. Respirators are protective devices specifically designed to achieve a very close facial fit, unlike the surgical mask we were just talking about, and are also very efficient at filtering airborne particles. There are special tests to determine a respirator's level of protection, and that's where we're going to discuss this letter in and the number ninety five. And there's an institute that actually certifies masks to tell you what level of protection you're going to get from them, and that is the NIOSH, which is under the CDC Centers for Disease. They are the National Institute for Occupational Safety and Health. So that's what that means NIOSH, and again it provides a certification, so you know what you're getting from the mask you're buying. And ninety five medical masks are a class of display le they're called respirators. I know that sounds weird, but that's actually the name of this kind of mass that have at least ninety five percent efficiency against particles larger than point three microns in size. I think few people understand just how tiny a micron is. There are charts out there. You should look it up because it's really interesting and how tten tiny a micron is. But the INN and the N ninety five stands for non oil resistant. There are also R ninety fives which are oil resistant, and P ninety five oil proof mass. So that's where you're getting those different letters. The end, the R and the. Paint and the R and the p's are mostly four industrial and agricultural uses. In ninety five mass protect against many contaminants, but are not one hundred percent protective, although use less frequently. In ninety nine mass, which again give you ninety nine percent effectiveness, and in one high hundred masks are ninety nine point seven not quite one hundred, but I guess as close as you're gonna get. Are also available if properly fitted, again very important. The filtration capacities of the N ninety five respirators exceed those of face masks. However, even a properly fitted N ninety five respirator does not completely eliminate the risk of illness or death. You're not one hundred percent protected. One thing that you have to remember about these masks is they're not designed for children or people with facial hair. So all of you folks out there with mustaches and a lot of beard hair, if you don't get a proper fit, you can't achieve the proper filtration. So if you're using it with smaller people or people with facial hair, you're not gonna get the full protection. There is a way to check fit when you put these masks on. Usually they have a metal piece across the nose. You're gonna want to pinch that on your nose and fit that to the shape of the bridge of your ne the side of your nose, and across your cheeks. You're gonna want to pull the mask down if it actually has like an accordion effect, down underneath your chin and onto your neck so that it's fully opened. You don't want to have a crunched up mask that is only barely covering your nostrils and your mouth. You want to have it as wide as possible, and I want to make sure that you put those there are loops, that you put them. Over the ears. And if there's ties, you tie the top one towards the top of your head and the bottom one towards the back of your head, just above the nape of your neck. If you have properly fit your mask, you can breathe in and your mask will actually suck in. You'll see it collapse a little bit if you suck real hard. If you breathe in real hard and you don't get that depression, that means you've got some leakage. And you need to refit that mask and make sure it's on as well as possible. Now, the FDA has cleared certain filtering face piece respirators for use by the journal public. To work as expected, the N ninety five respirator requires a proper fit to your face, like we've just discussed. Please make sure you're checking it adjusted if you need to. The CDC does not generally recommend face masks and respirators for use in home or community settings. However, they may be appropriate for people for increased risk of severe illness. Let's say if you have some immune problems, or if you're just in a household or near people who may have influenza or other respiratory diseases. It can help. Again, you're not going to achieve one hundred percent, but it definitely can help. So that's what they recommend for the public. There are higher grade masks that have vents in them. It allows for easier breathing. The one thing about the vents is if you need a sterile environment. Let's say you're in a surgical suite, they don't allow those ventilated ones because they don't want you to exhale out of them. They're for preventing things from coming in. They're not as good for preventing things from going out. So if you're operating on a patient, they don't want the surgeon to be breathing into the patient's open cavity. So there are very very special ones for healthcare settings. So what's your strategy. You'll need both standard the surgeon mask and some N ninety fives as part of your medical supplies. I'd recommend getting a significant number of each. You can use them as bartering if you need to. I would say you can never have too many, really, and any extras again would be really great for bartering. There's no absolute standards in regards to who wears what in the sickroom. What we generally recommend is that a person who is sneezing and coughing, in other words, the sick person puts on a surgical mask. Either all the time that would be difficult because they're already having trouble breathing, probably from a stuffy nose or a sore throat or congestion in the lungs, but put that on when the caregiver is about to come in. That will kind of help prevent some of those droplets from being thrown onto the care And then the caregiver should be putting on the N ninety five because again you're going to get some filtration of those viruses from the patient who's sneezing or coughing so that they won't breathe it in. What you want to prevent is your caregivers from getting sick, because they're the ones who have to take care of the sick people. So remember, your highest priority is to protect yourself and the healthy members of your group. Plan out a sickroom, and we have talked a lot about a sickroom. You can look up articles and we've done podcasts on it. It's even in our book. Look up sickrooms. Figure out where you're going to put that, and also what other supplies you're going to need besides the mass think of gloves, aprons, I wear. We discussed antiseptics and definitely pay careful attention to every aspect of hygiene because guys, your survival might just depend on it. Thank you so much, and please be safe and healthy. You've been listening to the dooman Bloom Hour with medical preparedness experts Doctor Bones and Nurse Amy. Check out our website at wwwdoomombloom dot net for hundreds of informative articles about survival, medicine, gardening, natural remedies, medical supplies, and lots of other good stuff. Contact us, send your email to doctor Bones podcast at aol dot com, or use a contact form on the main page of the website. See you next week.