Day After Disaster: 4 Scenarios to Test Your Basic Survival Medicine Skills | The Survival Doctorby James Hubbard, MD, MPH

I thought I’d have a little fun today and walk you through what to do in some scenarios to test your basic survival medicine skills.

To get the most out of this post, wait for a minute after reading each scenario and think what you’d do in such a situation. Then you can see my answers. And maybe together, we can come up with a better plan. You know, two heads and all that. (In this case, thousands of heads.) I think if you really participate we’ll all be the better for it.

Thanks to Sara Hathaway for providing the scenes from her new novel, Day After Disaster. “The novel takes place in a world being ravaged by earthquakes and rising water levels,” Hathaway says. A good world to know some survival medicine in.

Scenario 1: Travel Threats

The main character, Erika, starts out trapped in Sacramento, CA, and must make her way back to the foothills of the Sierra Nevada Mountains. Sacramento has been inundated with toxic water, making it a treacherous journey to dry land. Toxic water aside, once Erika reaches dry land and is journeying through the mountain territory. What do you feel her biggest medical threat would be?




JH: Hypothermia and dehydration. Anytime you’re in the wild and the temperatures dip into the 40s or below, hypothermia ia a risk. And mountain regions can be cold all year, especially at night. Lack of water and food make it even harder to produce needed heat. I have a whole bunch of articles about surviving the cold. Click here for my five-part series on hypothermia.

Scenario 2: Gunshot Wound

Along the way, Erika adopts a daughter, Star. The two are connected immediately and continue the adventure together. They are hiding from a rogue gang and eventually end up in a confrontation. In a wild dash on a horse, Star is shot through her calf. How would you treat and heal this wound in a survival situation and how long would that healing process take?




JH: The first thing to do with any wound is stop any bad bleeding with direct pressure if possible or a tourniquet if not. If a gunshot wound were to damage an artery, the bleeding could be severe enough to be life threatening. (Spurting blood, rather than oozing, is a sign the artery’s been damaged. But even without spurting, there could be a bad internal bleed. A clue would be a rapidly swelling calf.)

To try to stop the bleeding, I would do the following:

  1. Wrap a cloth directly and tightly over her wound, but not so tight that the circulation is cut off. (Check for a pulse in the foot. Exception: If a large artery is has been damaged, there may be no pulse no matter how loose the dressing. In that case, getting expert help is essential to save the leg. Until then, your main objective has to be to stop the bleeding. Otherwise, you may lose a life.)
  2. Have her lie down down, with the wound at or above heart level. This can help stop bleeding also. Because of the extra blood pressure in the leg with standing or walking, the bleeding is more likely to break through any pressure she puts on it.

If these things didn’t work, I’d use a tourniquet.

After stopping the bleeding, I’d press on the bones around the wound. If I thought the bullet had broken a bone, the leg would need to be splinted, and she must not bear weight, at least without crutches or a cane.

The long-term concern is infection. When it comes to cleaning, a bullet wound is like a puncture wound. Irrigate it thoroughly with clean water. A pressure washing is best.

Apply antibiotic ointment. Honey is a great alternative for people over 2 years old. Repeat the irrigation and ointment once or twice or more per day. If a bone is broken near the wound, this becomes an open fracture and the risk of infection is especially great.

If you have oral antibiotics, start on them. That’s especially important if a bone is broken.

One thing I wouldn’t do is go digging after an embedded bullet. There’s too much of a risk for further tissue damage and for further spreading infection.

It’s only a guess as to how long the wound would take to heal. Maybe a couple of weeks? Maybe a lot longer? But until it did completely, I’d keep up the cleaning process.

Here’s my interactive e-book on wounds, which would be mighty handy to have in such a situation.

Scenario 3: Fires and Burns

While Erika is reenergizing at another camp in the small town of Cool, the earthquakes strike again. The town is completely ravaged into a horrible mass of burning flames. The inhabitants scramble to recover what little supplies they have left and barely any medical supplies are salvaged. How would you attempt to triage this event and what could be done for these burn victims without access to traditional medical supplies?




JH: I’d get out of any dense smoke as soon as possible. It can be a killer. Fresh air is your friend.

Then I’d cool the wounds with clean water, if it was available. I’d also immediately remove any burned clothes and any jewelry. If there were burns around the face or neck, it would be especially important to cool these areas to keep down swelling.

The biggest long-term risk for burns is infection. So the long-term steps are:

  1. Irrigate burns with clean water and cover them. If clean water is scarce, use whatever liquid you have (using common sense—no harsh or toxic chemicals, bleach, etc.).
  2. Apply antibiotic ointment or, for people over 2 years old, honey.
  3. Cover the burns with a clean cloth.

At a minimum, cover the burn with the cleanest cloth you have. In the wild, with no chance for expert care and minimal water and shelter, the chances of surviving a deep burn covering more than 20 percent of the body is slim.

For more guidance, check out my e-book The Survival Doctor’s Guide to Burns.

Scenario 4: Mountain Lion Attack

In Day After Disaster, horses become very important to navigate the broken landscape with any type of speed. These animals have lived their lives as little more than pets roaming a pasture and taking an occasional joy ride with their owners. There is a huge need to retrain many of the animals to pull carts and plows, and how to fight in battles. Two young girls in the story are trying to trail break a fluttery horse when a famished mountain lion attacks. One of the girls received a slash on her calf from the giant cat. In a survival situation how would you treat this wound and ensure it stayed free of infection?




JH: See the information on wounds above. I’d stop the bleeding, clean the wound.

If it was a bite, these often have damaged tissue deeper than you can see. If it was a large wound, I’d keep it open and clean and pack it daily. If it was a slash from a claw and I could be pretty certain I could clean it well, I’d be more prone to close it, especially if oral antibiotics were available, but the risk of infection would still be pretty high.

Sara F. HathawayAbout the Author of Day After Disaster

Sara F. Hathaway is the international author of the fictional novel Day After Disaster. She is an avid student of wilderness and urban survival.

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