Should I Stay, Or Should I GO?

Aesop, of The Raconteur Report, recently had an exchange with “B”, the proprietor of the “In The Middle Of The Right” blog

“B” had opined that the advice provided by Sumdood, a “Newspaper Doctor”, quoted in The Daily Mail, was wrong. He then elaborated upon his perspective why, in his area, waiting for their version of EMS was more likely wrong, than not (outside of specific outlier circumstances).

Aesop, who has been an ED RN for many years, presented a contrary appraisal, suggesting an action plan wherein in nearly every single case, calling EMS, and awaiting their arrival was more likely to be a superior plan, than any “snatch ’em up and boogie to the hospital” alternative plan of action. He then enumerates his concerns with that get-up-and-go course of action.

“B” responded, citing his rural setting and the assertion that he, “B”, a civilian, could make the trip in his personal vehicle in an estimated 16 minute trip, compared to his estimate of EMS responding in around 15 minutes, and an estimate time-to-ER adding up to something like 35 minutes. He opines that contrary views seem ”..let us say, city-centric”.

I responded as follows, edited for typos:

“You do make some good points. OTOH, having lived in a rural county (our hospital was the only one in two counties this away, or three counties, thataway), I, as a former medic, can authoritatively state that having your partner drive the ambulance, is orders of magnitude better, from a patient care perspective, than you barreling yonder to your local hospital. There are, of course, exceptions. If you have the expertise to differentiate A from B, or G, then feel free to make that determination. As I told my daughter ref her wheezing child, do you know CPR? Can you perform same in a moving automobile? What’s your notification plan, to warn the hospital that you’re coming in hot with a critical child?

One Weird Trick? Your local medics, at whatever level of licensure, CAN do those things, DO have those capabilities. Yes you likely can phone whoever, WHILE driving essentially “Code 1”, AND wondering how you’re gonna provide care, while simultaneously driving, navigating, communicating, and assessing your patient.

Reflect on the deleterious effects of task stacking, on each one of those mission critical tasks, while under stress that most of us will never have experienced in our lives.

Which one of those tasks are you willing to compromise?

So, yeah, there will be occasions wherein scoop-and-go is reasonable and prudent. In my experience on thousands of EMS runs, and decades as ER RN those are uncommon.

Like, use-a-tourniquet-as-a-civilian uncommon. “

Mr. “B” replied, citing his assessment that his local EMS “was only a transport service”. He asserted that “...even heart attack victims...” received this level of care. Again I responded. 

“TBH, field care of an MI or an ischemic/hemorrhagic stroke is, at best, ongoing assessment, supplemental oxygen. Again, every fraction of a second you are watching traffic is another fraction of a second you are NOT assessing your patient. Conversely, every fraction of a second you glance at your patient, is a fraction of a second for some kid to run into traffic/some granny to bust a red light/other trip stopping additional calamity.

But, you are correct. Aesop’s years in ER, my 2+ GENERATIONS of EMS and ED experience mean nothing, because “city”. Or something.

You indeed DO know your AO better than I do. You, indeed, know the risks you are willing to undertake, better than I do. And, finally (in both senses of that word), you know the risks that you are willing for your loved ones to assume, in this hypothetical situation.

My 2 cents worth of advice, is worth exactly what you paid me for it.

I’ll E-mail you, your change.

I genuinely hope that you never need to field trial your plans. Just as I pray that I never again have to field trial my own plans.”

Another exchange, with my response:

(“B” observes:) “THEN a 16-18 minute drive to the ER (close to 35 minutes) is better than a 16-18 (or even less, yeah, I am that good of a driver with the equipment to match, even under the stress you refer to…I’ve done it once before) minute trip to the ER for a real medical professional to treat is the better option? ”

(Reltney McFee responds) Well a coupla things: in my experience, folks who are in arrest, generally have measurably better outcomes (even if any outcome from an arrest trends toward “dismal”), should they receive, say “16-18 minutes…” of, say, cardiopulmonary resuscitation. Hell, taking your numbers, even 45 minutes of CPR is more likely to produce a “good” outcome (for whatever value of “good” you select) than 16 minutes of anoxic cardiac arrest.

Again, your circus, and you ought to organize your monkees in the manner that you think is best.

Aesop and I are presenting alternate viewpoints, that’s all. In my case, since around 1988, I have been in rural areas as EMT, ER RN, and midlevel provider. Again, in my case, I have carried a pager for my local fire department exactly so that SOMEBODY would show up at someone’s house, who was having the worst day of their lives, in order to attempt to mitigate same.

My opinion derives from 2 generations in the sick people business, in rural areas. No, not Four-Corners-Of Arizona rural, but Upper-Midwest rural.

Should a summary be worthwhile, my baseline is to encourage everybody to become an EMT, at least at the basic level. It’s around a semester at Lansing Community College (to select a venue near to my “neighbor”, Eaton Rapids Joe, aka ERJ), and should you find yourself in hard circumstances, you will NEVER EVER think, “Gosh, I sure wish I had known less about that problem!”

If you have read ERJ’s thought experiments formulated as tales, you have narratives of scenarios wherein basic EMT skills might be life saving. Hell, if you listen to “B” from In The Middle Of The Right, you will hear him describe living in an area where, should YOU! Have basic EMT skills, your family will for a fact be measurably safer than if you do not.

As with anything I tell y’all, (hell, for that matter, with anything I tell my patients!), none of you are in my chain of command. You are, however, in my “chain of nag”, so, consider yourselves nagged to train up. Hard times are looming, and whatever form that they take, you will not ever think “Dammit! I wish I had not known how to respond to that!”, when “that” threatens your child, or spouse, or neighbor.

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High Trust Environments

Not so very long ago, The Darling Wife-Mark II and I went on a cruise. As is common, our cruise stopped at a port, and allowed those interested to disembark, wander around the area, or take excursions (such as snorkeling, visiting attractions, or having a guided tour). We elected to wander about the area adjacent to the pier.

There were interesting things to be seen, including a pretty little waterfall as well as the shops.

The interesting thing, for the purposes of this tale, was documentation of what others have called a “high trust society”.

Others have observed that Western civilization generally functions as a “high Trust Society”. That is to say that folks generally act as if those about them are not out to “get” them, in whatever manner “get” might mean. The classic illustration is the observation that “When I was a kid, we never locked out doors (at night)(when going away)(when out running errands).”

In contrast, “Low Trust Societies” have relatively low levels of interpersonal trust, and lack commonly shared ethical values. (per Wikipedia). Wikipedia continues relating that low trust societies are typically kinship based, which can be reflected in tribal loyalty being paramount (rather than primary loyalty being national in scope). Kinship based society will see folks not among one’s clan, as not to be trusted.

With that said, on to my story. There are many opportunities to take photographs, as you might imagine. Furthermore, at these vantage points, there are throngs of people. What I saw, brings hope about everyday people’s innate goodness and righteousness.

First off, everybody appeared to recognize that, should we all push forward, nobody would get the photo that they wanted. Therefore, we all lined up, a ways back from the vantage point, and took turns walking forward, posing, and getting our pictures.

Secondly, and material to this epiphany, folks simply turned to the visitors in line immediately behind them, spoke for a couple of minutes, and handed them their cell phones, posed, and smiled while these perfect strangers, to whom they had just handed an instrument whose replacement cost could pass $1,000, took their pictures, and, handing the phones back, reciprocated, smiling all the while. So, they got their pictures taken, as well.

Let’s stop and think about that for a second. When I say, “perfect strangers”, I literally mean individuals that the visitors had not ever seen before in their lives, who likely were from another cruise ship altogether, and whose paths would never cross again.

This little social interaction repeated itself over, and over, and over again, as strangers, tanned and pale, old and young, likely well off as well as likely struggling, recreated this little slice of trust and thereby enriched each others’ lives.

Closer to home, we can see this theme again: we trust that the clinician caring for us actually intends to help us, despite likely not being in any way familiar with him/her. We generally assume that the clerk, the waitress, the teller, has our change correct, and give it only a cursory review befor stuffing it in our pockets, wallets or purses.

Trust is the lubrication that facilitates our daily interactions, and eases the coordination of efforts that constitute our very complex economy, to everybody’s benefit.

“A ROOKIE MISTAKE”

So, TINS, TIWFDASL….Ok, I was NOT FDASL, rather, I was en route home from vacation. TDW-Mark II and I had made it about to mid day, and it was time to stop for a pit stop. We were at the awkward point where we weren’t hungry, yet, the gas tank was about 2/3 full, but Nature Called.

So, I entered the rest area, and entered the stall to set a spell. Now, cue the Rookie Mistake. I had secured my sidearm, locked the door, settled in, and started to relax. Now, boys ‘n girls, what did I overlook?

Yep. Was there any toilet tissue in the stall? Nope.

I looked again, thinking that, occasionally, there is a spare roll hidden behind some sliding door or something.

Nope.

No newspaper left behind. (DYSWIDT?)

No magazines.

By this point, I was well into, well, my “celebrations”, and the absence of tissue was appearing to present a dilemma.

Then I recalled that my Dear Departed Father had drilled into his childrens’ heads to ALWAYS have a handkerchief. That, I did have. It occurred to me that, for those of a cottony bent, one might consider employing a bandanna (for, I did indeed have a bandanna!) as a, well, hygienic tool.

I did so, and discarded the kerchief into the trash on my way out.

And washed my hands very, very thoroughly.

“The overdose is over there!”

So, TINS (“This Is NO Shit”), TIWFDASL (“There I Was, Fighting Disease And Saving Lives”), one lovely autumn evening in Da City, and my partner, Doug, and I caught a run for an overdose.

Now, at this point in time heroin was very, very “popular”. We had considerable experience with identifying narcotic overdoses, and managing them. (at least, “managing” them as much as we were going to, in a basic life support ambulance, in Da City with all the attendant financial constraints, and in circa 1980) The unbreathing/microscopic pupils/diaphoresis (wringing wet sweat) presentation is difficult to forget, once you have seen it a few…hundred times.

So, we arrived on the scene, and knocked, Our knock was answered by this huge guy, wringing wet (remember: autumn night in the northern tier of states, temp running around 60 degrees in the daytime) and, as I played my Mag Light over his face, I could not see any pupils. I remember thinking, “Jackpot! Only, how come he’s standing yet?”

That was answered when he gestured over his shouolder, as if to direct us, and announced, “The overdose is over there!”

Al-righty, then! We went as directed, promptly digging out the bag-valve-mask resuscitator. THIS fellow was not only wringing wet as well as having microscopic pupils, he was, into the bargain, not breathing at all!

We wrestled him onto our cot, wheeled him out to the ambulance, and coded our way to TSBTCIDAC. (The Second Best Trauma Center In Da City). There, after a brief ceremony featuring the Ghawd Narcan, he arose, figuratively picked up his pallet, and walked (well, ok: more like stumbled) out of the door.

The Cat Watcheth!

Am I the only one reminded of Mark Twain’s cat, who, having once sat on a hot stove, would never again sit upon a cold stove?

We ate our survival food!

AND LIVED-AND LEARNED- TO TELL ABOUT IT!

Smarter folks than I have deliberated upon food storage, and typically counsel us to lay up that which we eat every day. Under stressful conditions, most folks poorly tolerate additional novelty. I have a tale illustrating the folly of storing that which you have never eaten before.

I have eaten freeze dried foods before, most memorably on a seven day backpacking trip to a National Park. My partners and I deliberated in depth on meal plans, reading widely on the issues of back-country backpacking in the middle of Lake Superior.. Our first night’s meal produced the review that “This mess tastes like salty cardboard!” By the third night, the meal appraisal was that “this mess tastes like salty cardboard. Say, are you going to finish that?” On our final night on the trail (night #6), we agreed that “This mess tastes like salty cardboard. And, they sure are stingy with the portions!” One might imagine that I would take a lesson from this experience. One might be mistaken.

I suppose it was half a dozen years later, circa 1995, that we took one particularly memorable vacation. Money was tight (…in contrast to today, right?), and I had the bright idea that we could save money by a) camping, and b) eating the survival food I had bought as a bachelor, on special, from some mail order survival supply house since closed. My normally clear thinking wife went along with this idea, as I suspect that she herself had had her fill of town living and daily routine.

As per our routine, we packed up, collected kids, and set off for a state forest campground (again, frugal accommodations). We set up the camp and set to fixing dinner. Life Lesson Number One: think through your camping menu. I glibly assumed that I’d open the can of freeze dried beef patties, and we’d have burgers over the campfire. It developed that freeze dried beef requires a bit more prep than “open can: heat meal. Repeat”. For example, if the patties are not re hydrated, they retain the texture of charcoal briquettes. For another, if they are prepared by the freeze dry house with (say) stew in mind, then they will not perform particularly well when you desire them to hold the shape of, for example, a hamburger. Indeed, they will perform just as if they were about to be crumbled into a stew. That likely will prove unsatisfactory to the children eagerly awaiting burgers. I had, foolishly, spoken my mind regarding the possibilities these freeze dried foods had presented. The lesson of managing expectations remained for me to master another day.

In addition, some greater variety in the menu than “burgers” would have been welcome. This would serve both as backup in the event that plan “a” did not meet expectations, and balance the meal. I did neither.

Number One Son, a smart aleck even at that tender age, noted that the patties briquettes were quite flammable. He dubbed them “fire starters”, and proclaimed them more successful at this than as food. This was not especially helpful as Their Mother and I attempted to extemporize a suitable meal within our constraints of time (dark approaching) and money (not much). He, on the other hand, amused himself greatly.

I had thought that I could redeem myself with freeze dried ice cream. Again, think it through. My children typically do not embrace novelty, and freeze dried ice cream was not an exception. The “not ice”, “not cold”, and “not creamy” observations were precursors to Number One Son (again) determining that these were to be known as “pot scrubbers”, due to their resemblance to nylon abrasive pads used for dish washing. Evidently, this resemblance was both in texture as well as taste, although I do not know how he had researched the taste of scrubbing pads. Not a success.

After a night’s sleep, we awakened to face the Breakfast Conundrum. Typically, we would enjoy scrambled eggs, bacon, toast and juice for camping breakfast. Some of these items were snatched from the frig at home. As it developed, I had a can of freeze dried eggs. In addition, I had no clue as to how to transform the yellow dust into breakfast. In short, breakfast fail.

It seems that adding water and scrambling is not a winning strategy breakfast wise. The result, runny yellow syrup, wasn’t especially appetizing in appearance. In addition, it didn’t respond very well to my efforts to scramble it. It never did take on the consistency of eggs, it did not fry up at all well, and (this may be a surprise to you who haven’t been following closely) the children and Long Suffering Spousal Unit (LSSU) were not impressed the least bit favorably. We went with the jelly sandwich alternative breakfast strategy, and moved along with our day (“…there is nothing to see here, folks! Just move along…”).

That evening, the LSSU bravely leaped again into the campaign of canned beef. This time, having learned from my Dinner Fail the previous evening, she created some sort of stew, blending (re-hydrated) freeze dried beef from the can with canned vegetables and seasonings. She thereby created a repast even the eldest child pronounced satisfying and wholesome. A good time was had by all, dishes were washed, and the evening festivities commenced.

In the morning, we awakened. The LSSU evidently was inspired overnight, because she set to breakfast with enthusiasm, wisely chasing me away from the food prep area. Recreating her victory of the previous evening (this time with the freeze dried eggs, christened “Yellow Rain” after our last poisonous experiment), the LSSU adapted the preparation such that food, recognizably scrambled eggs, appeared as if by magic upon our plates along with the toast, sausage and juice denied us the previous day. Another Meal Win for the LSSU.

The years passed, things changed, stuff happened. Eventually, my marriage failed and I found my (teenaged) sons left home alone while I worked two jobs, and my (soon to be ex) wife was out Ghawd Knows Where, without establishing a meal plan for my children. I worked (more!) overtime and purchased a freezer and lots of food to stock it. I cooked in liter lots on my day off, and repacked it in “unit dose” containers, which I then froze. Voila! When the boys called me at work seeking food, I could tell them to snatch a meal from the freezer, microwave it, and dig in. To address the potential for power failure and loss of freeze, I began to purchase extra cans of the food I was using regularly. I expanded my stock to canned meats, so as to have something to make (say) spaghetti with in the event of power failure.

This year, I realized that I had not established a plan to rotate my canned foods. Indeed, I had no idea which cans would out-date at which time. I remedied this problem, and arranged my cans on a modified “first in-first out” system, with the new cans going in the back. I wrote the out-dates on the top of the cans in bold marker (so as to approach idiot resistance). In the process of this endeavor, I noted a couple of cans that were approaching out-date-hood. The years had taught me lessons that I heeded.

First, the canned chicken and dumplings that had looked so appealing in the picture on the can, found new life as a casserole. My clever (if naive and innocent) girlfriend (she is, after all, spending time with ME) whipped up a casserole of the canned dumplings with some canned cream soup, added a little flour and some seasonings from the spice cabinet, and baked it up for about 40 minutes. We enjoyed that for a couple of meals.

That success behind us, we turned out attention to the soon-to-out-date sloppy joe mix. Perhaps it was cheating of a sort, but I thawed some of my (copious) frozen ground beef from the previously mentioned freezer, and whipped up some supper for my two youngest sons. Toasting some (previously) frozen buns, a meal fit for an adolescent resulted for however briefly it lasted in the face of two hungry teenaged boys!

I then turned my attention to the canned chicken nearing its own out-date with destiny. One of our household favorite recipes is Chicken tetrazzini. This is a chicken dish, in a cream sauce served on noodles. The only non-storage food I used was the milk (not dried), margarine (although I keep a considerable quantity in my freezer), and wine. Otherwise, storage food all down the line. It also was a successful effort. I awakened each morning of my boys’ visit to find empty tetrazzini containers assembled in the sink. The one container that I managed to hide from my sons served as my dinner at work tonight.

To summarize the lessons learned: Store what you eat every day. Rotate your stores (ya know, like by eating it). Think through your menu. Recognize that (you or) your children may not embrace novelty. Freeze dried food has a learning curve: travel that curve at your leisure, not under stressful circumstances. Tabasco, as well as other spices, are your friend. If you are going to experiment with new stuff, perform those experiments during good times, not when the county loses power (or during whatever crisis convinces you to eat your survival food).

SOMETIMES, I AM ON THE RECEIVING END OF BLESSINGS

So, TINS, TIWFDASL…..Ok, well, not so much. I had taken a break from FDASL (Fighting Disease And Saving Lives), that which the majority of humanity would call “a vacation”, and was on a cruise. In a breach of my usual practice of formulating pseudonyms to protect the privacy of otherwise uninvolved parties, I will call out this particular cruise company, Carnival Cruises, for EXEMPLARY! Customer service.

TDD (The Darling Daughter, Brenda), of whom I have spoken, had four children, we might denominate them as Ariel, Beatrice, Charlie, and Danielle. She had married a man of whom I vigorously approved, and they (the parents) had forged a partnership of the first rank.

So, Beatrice had been ill last year with a periorbital cellulitis (an infection of the tissues surrounding one’s eye). She had recovered, after a bout of IV antibiotics (which intervention she had NOT approved of) and an inpatient hospital stay.

Something on the order of a month ago (as I write this), it appeared that she had developed a recurrence, and so her mother took her off to ED. These folks treated her with IV antibiotics, but, when things did not promptly resolve, further investigation followed. It appeared that she had an inflammation of her one optic nerve, and this being very (very) uncommon, well, eventually she was transferred from The Mothership Hospital, to The House Of Ghawd. THESE worthies treated her for a variant migraine, (since, she had been on high dose steroids for several days), and sent her home.

About the time TDW-Mark II and I were depart on our vacation, she (Beatrice) returned to ED, since her headaches had not improved. My daughter reassured us, stating that there was nothing I/we could add to things, and it seemed foolish to her for us to forfeit the payments made for this vacation, and that she (Brenda) had things as under control as they were going to get, in the near future.

Since my daughter has a spine of ordnance steel (just as does her mother, The Plaintiff), is smart and has a finely calibrated “This sounds like bullshit” detector, we reluctantly set out. TDW had internet on her phone in this trip, so that updates, if required, could be communicated.

This is where the “Carnival has my business until the heat death of the Universe” part comes in. TDW received a message, relating that another ED visit had resulted in (another) spinal tap, and that this had revealed increased CSF (cerebrospinal fluid) pressure. They (the ED doc) had drained a small amount of CSF, which dropped the pressure, and improved Beatrice’s headache. That was unexpected.

So, the question becomes (a) why does Beatrice have this increase in CSF pressure? (b) Why does she have a headache mitigated by reducing this pressure? (c ) what treatment implications arise from the preceding two answers? And (d) who are the “pros from Dover” to ascertain the above answers?

So, here I am, afloat in the Caribbean, my vehicle no less than 1,000 miles from my grandchild, and no phone service. How might I back up my daughter?

I went to the Guest Services on this ship, and asked if there was some way I could pass along a 24 hour shoreline ships operations number, that my daughter could call in the event that she needed to contact me Right Freaking Now!?

Yep.

The Guest Services rep handed me a phone, told me the “make a phone call to CONUS” code, and invited me to phone my daughter. He stated, “The phone number that will show up on her caller ID, will get her straight to this desk, which is manned 24/7. If she calls, we can find you and get done whatever is needed.” He continued, “There will be a charge, but we will reverse it. Simply tell us once it shows up, we will make it disappear.” He offered us internet, under the same terms, so that we could e-mail back and forth as needed. I thanked him, and told him that presently, we had communications in other than urgent settings, addressed adequately.

Chapter Two, in why “Carnival Cruises Will Have My Business Until The Heat Death Of The Universe”: So, two days later, Beatrice is going home, Brenda has ‘lebenty thousand referrals and followup appointments, and it appears, presently, that things are improving. This Is No Shit, There I Was, lolling around our cabin and contemplating a nap (such is MY exciting life!), when the stateroom phone rang. I picked up, and there was Guest Services on the line, asking how we were doing, how was my grand daughter, did I require any other assistance.

Very, very rarely am I on the receiving end of this sort of care. I am a cynical bastard, and generally am calm in any sort of dilemma. This, well, I teared up and developed a catch in my voice.

And, present reports (as of this writing) Beatrice is improved (sort of), and we have hopes of unraveling this conundrum.

POSTSCRIPT: I just now went downstairs to talk to the supervisor of Guest Services, to give the personnel there an “Attaboy”. The line supervisor requested I (hand!) write a note summarizing my observations. I have three thoughts in this regard: firstly, asking ME to hand write anything is soon to be an exercise in cryptology, requiring skills similar to those employed in deciphering the Rosetta Stone. Secondly, regarding the concept of “summary”: y’all have read my blog: does anybody really think that the phrase “summarize”, and my long winded bloviations, belong on the same page at all? Thirdly, it occurred to me that I have cried, perhaps, 4 times in the past 20 years. This being number 4.

BATTERIES

Material from an “Away Game”.

I commented, recently, on a post from “Notes From The Bunker: https://www.commanderzero.com/?p=9858 . Commander Zero had noted that he had noted several batteries had leaked, and his reolution for that problem. My comment follows:

I’ve had so many Duracells leak, and destroy the light that I had (foolishly) put them away with the batteries inside, that they are nigh unto pen pals by now. That’s the bad news.

The good news, so to speak, is that they have been very good about attempting to replace the damaged lights: I send them a note, identifying the broken whatsit, citing Amazon’s replacement cost, and in a couple of weeks, I get a check. Cross that one off the “dammit!” list, and correspond about the next one.

So far, so “good”. AND, I replace the batteries with Energizers. For not-everyday-use lights, NOW, I put the batteries into a separate zip lock bag, label the bag with lot #, purchase date, and predicted expiration date. That way, even if the batteries croak, the damage is contained.

A Model For A Twelve Month Checklist: Part Three

This was first published on Survivalblog https://survivalblog.com/2023/01/27/12-month-preparedness-checklist-part-1-reltney-mcfee/ The publisher, James, Rawles, kindly allowed me to reprint it here, for your benefit. Thank you, Jim!

Abruptly changing gears, and (at least for now, on this topic) demonstrating some foresight, August is time to repack my Bug Out Bag (or, in my case, most likely to be a Get Me Home Bag). I checked licenses and documents of various sorts in May: in August I check the copies I have with me in my BOB. You may elect to carry hard copies, or copies on a thumb drive, or on an encrypted thumb drive. If hard copy, assessing condition/legibility of these documents that you elect to have with you, is reasonable. If hard drive, well, function test your drive, and make sure (a) that you can read the documents, as well as (b) that you can recall, and successfully enter, your key so as to access encrypted documents.

August is a good time to begin to change my summer load out for my winter/autumn load out. Doing so in August allows me time to address shortfalls or spoiled items, before the need for a cold weather bag drops on me.

BUG OUT BAG

Prep winter bag: inspect, inventory contents: (condition)(serviceability)(out-dates)

Change out BOB food, water

Change to winter bag 15 September

Emergency Cash: (Amount? Specie? Bills or coins?)

Documents: Marriage/professional licenses/certifications. ID. (passport copy?) Deed, vehicle titles. (thumb drive vs hard copy)

(FINISH CHECKS FROM JULY)

RECURRING CHECKS

FLUSH HOT WATER HEATER

CHANGE STORED WATER

CHECK RADIOS AND BATTERIES

SERVICE AMMO CAN DESSICANT PACKS (if not performed in July)

September is the month that I have selected to apply to medical and first aid matters. Should my CPR, first aid, or other training approach need for renewal/re-certification, I have 3 months to accomplish same in this calendar year. In my circumstance, my employer provides funds for continuing medical education, and this is a reasonable target for such an expenditure.

In addition, we put up the camper for the winter around this time, and that should be a trigger to inspect the camper itself, and, along with that, the supplies that go with it. Removal of the first aid kit and boo-boo kits from the camper, triggers a review of the contents of all the medic bags, first aid kits, and boo boo kits. After all, after a summer in the trunk/back seat/other of the camper/vehicle one/vehicle two, it’s reasonable to wonder what these hot adverse conditions have had on the contents. Tape, in particular, tends to coalesce into a useless gummy mass, and that ought to be identified, and replaced, BEFORE I find myself at the roadside at a rollover collision. Or, more prosaically, BEFORE I send my foot through the rotted deck of a trailer that I am loading, abrading the bejabbers out of my leg, and allowing me to provide all and sundry a continuing medical education moment on Field Care Of The Mark 1, Mod Ø Geezer-on-Anticoagulants Hematoma. Ya know, hindsight IS 20/20!

Since I am a midlevel, and routinely suture wounds (where that is appropriate), I have suture sets. I recheck these, evaluate for contamination as well as out-dates, and replace/repack as indicated.

Since I attempt to keep a couple of month (or more) cushion of my essential prescription meds, it is (again) reasonable to inventory these meds, and while doing so, take note of out dates. Similarly, over-the-counter (OTC) medications: decide what your desired baseline stock level is, decide the stock level that will trigger a restock shopping trip, and decide what your assortment of OTC meds ought to look like. AND! FOR EVERY MEDICATION THAT YOU STORE, KNOW, BEYOND QUESTION, THE DOSAGE, INDICATIONS, CONTRAINDICATIONS, ADVERSE REACTIONS (SIDE EFFECTS), AND OVERDOSAGE SIGNS OF EVERY MEDICATION THAT YOU ANTICIPATE ADMINISTERING TO SOMEONE! WRITE! THAT! STUFF! DOWN!

AND, KEEP IT WITH YOUR MEDICATIONS!

MEDICAL/FIRST AID

Check medic bags: Out-dates, spoiled supplies (TAPE!)

HOUSEHOLD MED STORES

OTC MEDS

(I have grandchildren in my life, so I not only keep OTC meds for TDW-Mark II and myself, I also put aside pediatric meds)

Acetaminophen/Ibuprofen/Naproxen/Nasal Steroid Spray/Cetirizine/diphenhydramine/Sore Throat Spray/Liniment (may be known in your household as “muscle rub”)

Inventory. Out-dates. Restock/Shopping List

PRESCRIPTION MEDICATIONS

Inventory.

Check out-dates.

Generate a restock/shopping list.

FEMININE NEEDS

Contraception

Menstrual Products

EMERGENCY CHILDBIRTH KITS

RECURRING CHECKS

Medic Bags/First Aid Kits/Boo-Boo kits: Replace meds, inspect contents

BOB: Change out for Winter load out

Check Radios and Batteries

October has a short list of evaluations. That provides an opportunity to do those checks that got past me earlier in the year.

WATER

Change stored water

Inspect, test assemble water filters.

RECURRING CHECKS

Check radios and batteries

Change BOB food, water

(have ALL the guns been cleaned?)

(has ALL the ammo been inspected and inventoried?)

November, having opening day of firearm deer season, is a sort of secular faux-holy-day in rural The Un-Named Flyover State. THAT precipitates thoughts of meat, and THAT triggers the thought that the freezers need defrosting, their contents require inventory, and restocking is pending.

FOOD

Freezers

Defrosting

Inventory Contents: Beef. Chicken. Bread. (other: decide for your household)

Compare present stock to desired baseline

Generate shopping list

Canned Food

Inventory

(Have any cans outdated or spoiled? What does that tell me about my baseline stocking levels, and required adjustments?)

Dried Milk

Dried Cheese

(MREs, freeze dried foods, etcetera)

RECURRING CHECKS

Check radios and batteries

December is the opportunity to review the preceding year’s plans, successes, and failures. Indeed, December 2022 was the month in which I developed this “calendar”, so as to systematize my checking up on my preps. I gathered scattered checklists, and assembled them into one document. I attempted to level the workload from month-to-month. (a cursory review of my efforts will reveal that THAT is a process improvement opportunity!) I drafted a few plans for 2023, and provided a copy to TDW-Mark II for critique/review. This document is a result of that review, this past December.

YEAR IN REVIEW

Review previous year:

What months went well?

What months went poorly?

Which preps went well?

Which preps went poorly?

Severe shortfalls? Where? Why?

Overstock? What/where? Why? (what was it that revealed an overstock to indeed be an overstock?)

Spectacular fail? Describe. Why did that fail? How to remedy?

Spectacular success? Describe. What went well? Could it have been improved further? How?

PLAN FOR NEXT YEAR FROM ABOVE ANALYSIS

Fitness plan for coming year

Bugout Plan: Review, walk through, identify fails, how to remedy?

Financial plan for coming year. (How did last year’s plan go? Why success/why fail?)

RECURRING CHECKS

Check radios and batteries

Check, change if indicated, BOB food and water

Let’s see what December 2023 reveals! I pray that my preps are even more dusty than they are at present, and that all the ammunition that I expend is expended at the range!

A Model For A Twelve Month Checklist: Part Two

This was first published on Survivalblog https://survivalblog.com/2023/01/27/12-month-preparedness-checklist-part-1-reltney-mcfee/ The publisher, James, Rawles, kindly allowed me to reprint it here, for your benefit. Thank you, Jim!

March is Personal Care Supplies, because I lack imagination, and it had to be somewhere, right?

Notice that I have question marks beside feminine products, as well as contraception. TDW-Mark II and I are out of the baby business, but if you, or some woman in your life is NOT definitively out of the baby business, plan for “romance”. I guarantee that somewhere around number 60 on your “Top Ten Things I Want To Do In TEOTWAKI” list, is deliver a child for a woman that you love. Under austere conditions. Likely, in the dark.

Similarly, if there are (or will be) women of near child bearing age in your household during Hard Times, they will think very highly of your having planned for their periods.

PERSONAL CARE

Razors # 52

Toothbrushes # 52

Dental Floss # 24

Toothpaste #26 tubes

(Feminine products?)

(Contraception?)

CLOTHING REPAIR

Sewing Needles #25

Buttons #100 (assorted sizes)

Thread (12 spools)(various colors, weights)

Shoelaces (#24)(different lengths: shoe length, boot length)

Patching Material

TREADLE SEWING MACHINE

Belts (#4)

Needles #100

Sewing Thread (12 spools)

RECURRING CHECKS

FLUSH HOT WATER TANK

CHANGE STORED WATER

CHK RADIOS/BATTERIES

April is gardening and outdoor items. Yes, I DO realize that active gardeners likely begin their planning in, oh, February. (That might be one reason that this is “A Model”, and not “THE MODEL”, eh?)

As you may guess from my map list, I work something like two counties over from my residence. So, when fully polished, my return home plan has multiple alternate routes, that do not rely upon the expressway system being open, with at least one alternate following tertiary roads. If I am forced to hike home, way-points that allow me to top off my water will be welcome. Identifying alternatives during leisurely meanders home seems like a prudent way to spend some time.

MAPS: LOCAL: COUNTY

(my county)(the county to the north)(south)(east)(west)

(county maps en route to work)

(topo maps for the above)

(state highway maps: my state, state north/south/east/west)(frequent destination states)

Gazetteer (see above list of states)

Water Sources (about home)(en route to work)

GARDENING:

Seeds

Fertilizer

Tools

Canning Jars #48

Canning Lids #300 +

Pressure Canner

Pressure Canner Gasket x 4

(Solar) Dehydrator

RECURRING CHECKS

Check Radios/Batteries

CHANGE BOB Food and Water

May is communications and finances. For one thing, it appears reasonable to assess how the budget decisions made in December, are coming along, before the wheels come off /I get too far along with the year. Doing these ruminations in May provides some time to correct assumptions that did not develop, as well as to adapt and rethink in the face of new realities, should such crop up.

In addition, inspecting my communication gear, and associated licenses, helps me get into gear for Amateur Radio Field Day, held annually on the last full weekend in June.

FINANCES

Status of Rainy Day Fund (compare to goals)

Status of particular savings accounts (eg, new vehicle, new camper, Moar! Guns!, etcetera)

Progress on paying off target accounts (credit card, student loan, mortgage, etcetera)

Check house deed

Vehicle titles, license plates

Out dates of licenses? (driver/concealed carry/amateur radio/GMRS/professional licenses and certifications)

Lay hands on marriage license, passports, other important papers. Are they where you thought that they were? Are they as secure as you intended for them to be?

RECURRING CHECKS

Check medic bags.

Change out meds in subordinate first aid kits: vehicle/camper/house

Service ammo can desiccators

Check Radios and Batteries (I have it twice, because it is THAT important!)

Clean Guns

June is the month to assess the animals: are their vaccinations current? How is that Veterinary Medic Bag coming along? (Hint, hint…) In addition, while I am out and about, June might be a nice month to function test my generator, and, following the thought that a power failure might require my generator to function, would it not be nice to have, gosh, LIGHT, while poking around getting such things set up?

Why, now that you ask, yes! Yes, light would be pleasant! I checked the batteries in January, and this month’s check both rides on January’s coat tails, as well as specifically focuses on the lights that I carry daily. Years ago, I was an RN working ICU on midnights. On a couple of occasions, the mains power failed and (to my dismay) the emergency generator at the hospital employing me did NOT power up.

It gets might, mighty dark in an ICU at oh-dark-hundred! I now carry two belt flashlights because “1 is none, and 2 is 1”. Due to this “2=1, 1=none” calculus, I also have two pen style flashlights in my shirt pocket at all times, as well as one coin cell click light on my badge, and an Streamlight Proton Light (powered by 4 x LR 41 batteries) on my key ring.

ANIMALS

Are vaccinations current?

Veterinary care supplies: (list)(out-date)(status/condition)

GENERATOR

Function Test/Run under load (heater)

Preventative maintenance: oil change? (Belts/other) need (inspection/servicing)?

LANTERNS AND BATTERIES (see battery list for locations)

Battery charge?

Battery condition?

EVERYDAY CARRY LIGHTS

Penlights

Click Light

O Light

Sure Fire light (on belt)

Thor Fire light (on belt)

RECURRENT CHECKS

Check Radios/Batteries

Change BOB Food and Water

July is the month I captioned “Transport and Security”. Transport, because TDW-Mark II and I like to travel and camp. You might wonder if that might be something to accomplish in, say March or April, rather in the thick of let’s-go-camping season. You would be correct in this wondering. Your list might well juggle which task(s) get assigned to which month(s), which is as it should be.

For myself, every month, when I enter into my checks, I review just that thought, and fine tune my calendar just a bit.

Security audits consist of, fundamentally, assessment of potential threats, and review of plans to address each threat. Some of the threats are addressed by responses to other threats. For example, should you have a plan for Antifa style rioting, it is likely that your plans would prove helpful in the event of a Zombie uprising. On the other hand, a plan for a B & E of your dwelling might not successfully address the hazards to be found in a wildfire approaching your home. You need to triage, or rank-order, what threats you consider a significant threat, and plan for those easily thwarted, and those whose attack would be catastrophic. THAT analysis is an entirely different topic, but you ought to annually consider what threats that you may face, and evaluate your plans to address them.

TRANSPORT

Gasoline: Amount, age, condition. Stored safely? (generally, storage in accordance with fire codes maps pretty neatly onto safe storage)

Propane: Amount, age, condition. Stored safely?

Kerosene: Amount, age, condition. Stored safely?

Charcoal: Amount, age, condition? Stored safely?

Butane: Amount, age, condition? Stored safely?

TRANSPORT: Medic bags/first aid kits/Boo-boo kits (my vehicle)(TDW-MarkII’s vehicle)(Camper) (house)

Out-date check. Condition check: visually inspect.

SECURITY

GUNS

Inventory. Clean/lubricate

AMMO

Inventory. Visually inspect: condition/age/recharge desiccant packs.

Restock/shortfall list

SECURITY AUDIT:

House

Vehicles

Clean, service guns for vehicles

Recurring Checks

CHECK RADIOS AND BATTERIES