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I'm not trying to be a dick here, but I'm going to be frank with you. If you don't have enough background or knowledge to form your own educated opinion on this, you really have no business self-medicating with serious drugs. |
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Seems like way overkill for daily carry to have more than a couple of OTC basics.
That said, if you're actually going to be remote, most docs will outfit you with meds based on your plans and medical history. Before I left for a multi-week solo backpacking trip in the Alaska interior, my doc gave me a couple of different types of ABX with specific instructions on which situations to use them in, and a week supply of opioid painkillers because I have a history of kidney stones. If you're an honest, regular patient, and you lay out your plans openly and honestly, most docs I've had are willing to at least hear you out. |
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EMT-P/former corpsman... As said above, just grab tylenol, Aspirin(81mg chewables) and Motrin for your snivel gear side of the kit, Aspirin, motrin and other NSAIDs reduce clotting ability so you don't want them for an emergent bleed issue(and why Mobic is in the pack) Pill packs are predicated on being in an austere environment/far away from definitive care. Also meant for soldiers with and open wound, still able to fight and don’t need to/aren’t getting tended to by a higher echelon of care for some time. Antibiotics are easy to obtain through online foreign pharmacies. No body is getting prosecuted for possessing antiobiotics with out a prescription. DEA has much bigger problems to worry about. Pain killers are available on the street if you have those types of connections, ketamine for example was a commonly abused drug when I was younger. Although this is very inadvisable because of the obvious legal issues and since you usually can't be sure of the quality/strength of street drugs. |
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Prescription only, not available in "alternative forms". Quoted:
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why isnt moxifloxacin obtainable???? |
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IFAKs are for MARCH items only, a separate bag with additional and extra supplies should have some meds in it. If you wanting some basic framework here you go, it’ll at least get you an idea and a direction.
Attached File If you’re thinking long term: Alton's Antibiotics and Infectious Disease: The Layman's Guide to Available Antibacterials in Austere Settings https://www.amazon.com/dp/057841452X/ref=cm_sw_r_cp_api_i_y6JiCbNQ7PZR7 |
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I printed out the TCCC guidelines and handed them to my Doc to look over and she gave them to me. Your millage may vary, it made sense in for my circumstances. Quoted:
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Joe Blow is getting Joe Blow meds. How do you plan on getting fentanyl, ketamine, or antibiotics? Just get acetaminophen and ibuprofen. |
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Severe trauma and swallowing pills (or anything else) do no mix. Now for your regular first aid boo boo kit I would recommend some imodium, tylenol or aleve, benadryl, triple anibiotic ointment, and something for rashes like zinc oxide. Those should help out with just about anything you run across that will not lead to a hospital trip, or in the case of the benadryl let you drive to the hospital at a reasonable speed. That is the regular stuff every one should have. If you have regular medical problems or special needs that can be met or helped with over the counter meds or prescription drugs then you should add those. If you are prone to sinus problems like I am then some sudafed would be nice. If you or someone you are around frequently have hypoglycemia or type 2 diabetes then some glucose gel would be a good addition. If you have kids add some chew-able ibuprofen or tylenol for fevers. This is especially useful on road trips. An epipen is good for those with serious allergies, but after the epipen you will still want to give benadryl and get to a hospital. |
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if you have to take pain killers if you're by yourself you're probably not gonna make it. I would keep, lots of bandages and self applied blood management tools and the basic/OTC pain relief Quoted:
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For me this would be used for the one in a million chance I'm seriously injured while near any of my equipment, to include my car kit. I would keep, lots of bandages and self applied blood management tools and the basic/OTC pain relief |
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Trump banned that as well For antibiotics.....local pet store and fish medicine. Quoted:
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Joe Blow is getting Joe Blow meds. How do you plan on getting fentanyl, ketamine, or antibiotics? Just get acetaminophen and ibuprofen. For antibiotics.....local pet store and fish medicine. It’s unwise. |
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I wouldn't bother with the antibiotics and I would avoid the opiate. Getting an antibiotic rolling that soon after a wound is probably irrelevant if you're within hours of hospital care and only serves to complicate doctors job. As to the opiate it is difficult to get, will prompt hard questions, and will dull you mentally and it won't be doing you any favors physically.
If it's a back country kit I a few carry meds - Benadryl, Imodium (plenty), Ibuprofen, and Tylenol. I think that's it. Edit: also some salt Reasons- allergic reactions are a concern and can range from ruining a trip to killing you. Diarrhea will kill you right quick, and pain sucks. I don't worry too much about meds for the range but I occasionally throw a travel pack of Tylenol in my shooting bag if I'm worried about a headache |
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Survival kit contents check. In them you will find one .45 caliber automatic, two boxes of ammunition, four days concentrated emergency rations, one drug issue containing antibiotics, morphine, vitamin pills, pep pills, sleepin' pills, tranquilizer pills, one miniature combination Russian phrase book and Bible, $100 dollars in rubles, $100 dollars in gold, nine packs of chewin' gum, one issue of prophylactics, three lipsticks, three pair of nylon stockin's. Shoot, a fella could have a pretty good weekend in Vegas with all that stuff. |
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You run the risk of incapacitating yourself at a time when you need to be playing a major role in keeping yourself alive. Quoted:
Quoted: A simple broken bone would call for pain meds. Doesn't mean your gonna die. |
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Im not talking about injecting yourself with morphine or dilaudid. But a Vicodin or T3 to ease the pain a bit. Quoted:
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Quoted: A simple broken bone would call for pain meds. Doesn't mean your gonna die. |
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I'm a fan of Cipro, indomethacin, some form of pain killer, and a good general purpose steroid like prednisone. Do not assemble any sort of pill pack without consulting a physician, but the stuff I listed should be relatively common for most adults in good health to obtain and use. Eta: Not really for an IFAk though, more like an aid bag or a bug out bag. |
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800mg ibuprofen works just about as well and doesn't have the sedation effects. Quoted:
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Quoted: A simple broken bone would call for pain meds. Doesn't mean your gonna die.  .
Ok heres a example of what I was talking about. My 2nd time I blew my acl and tore my meniscus I was completely fucked and only 200 meters from home. Im talking rolling in the mud, ripping out grass, shoot yourself in the face type of pain. My deer hunting spot is 4 miles from where I park my truck. No cell reception. If I blew my acl for the 3rd time way out there, 800mg motrin or Vicodin. Pain meds might make you able to make a crutch and hobble to your car. 800mg motrin not so much. |
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Truth NDC needles too! Quoted:
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I'm not trying to be a dick here, but I'm going to be frank with you. If you don't have enough background or knowledge to form your own educated opinion on this, you really have no business self-medicating with serious drugs. |
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Your doc wrote you scripts for fentanyl and ketamine based off of something you printed off of the internet? Quoted:
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Joe Blow is getting Joe Blow meds. How do you plan on getting fentanyl, ketamine, or antibiotics? Just get acetaminophen and ibuprofen. |
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Quoted: If you think that the TCCC is just something floating around on the internet you have no business preforming anything medical on anyone. It's reasonable to be curious about the circumstances under which an MD would write a script for fentanyl and ketamine for a civilian to carry around. What forms and doses were prescribed? |
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In my BOB, I have some pills (APAP, Ibuprofen, etc.) I also put in some excedrin migraine that has caffeine in it and a couple of multi vitamins. I wanted the caffeine in case you need it for withdrawals assuming you are going to be without coffee/coke’s etc. for a couple of days. Multi vitamin was just because I had an empty slot in my little pill pack I picked up. In my wife’s pack, I replaced the multi vitamin with midol in case she needed it. While serious pain relievers like opiates would be nice in certain situations, I don’t feel it is worth the hassle to try and get them, the cost and then having to replace them every couple of years. If you want some amoxicillin from a fish place go ahead, but I’d consider that and nice to have and not a need to have. |
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The question remains. It's reasonable to be curious about the circumstances under which an MD would write a script for fentanyl and ketamine for a civilian to carry around. What forms and doses were prescribed? Quoted:
Quoted: If you think that the TCCC is just something floating around on the internet you have no business preforming anything medical on anyone. It's reasonable to be curious about the circumstances under which an MD would write a script for fentanyl and ketamine for a civilian to carry around. What forms and doses were prescribed? She gave me a couple 800 mcg fentanyl suckers, I believe a 10mg ketamin amp, and I had the rest of the stuff already. You may be surprised what would happen if you know your doc and lay out what you think you need and why. These are not abuse level perscriptions and fairly safe compaired to what they routinely perscriptions. |
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This. Adding more shjt to an IFAK is a lack of focus on what it is for. More is not better. Quoted:
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Absolutely pointless in an IFAK. Put Tylenol and Ibuprofen in a boo boo kit not IFAK. IFAK is for fix shit right now so I don't die. Adding more shjt to an IFAK is a lack of focus on what it is for. More is not better. |
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This. Adding more shjt to an IFAK is a lack of focus on what it is for. More is not better. Quoted:
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Absolutely pointless in an IFAK. Put Tylenol and Ibuprofen in a boo boo kit not IFAK. IFAK is for fix shit right now so I don't die. Adding more shjt to an IFAK is a lack of focus on what it is for. More is not better. If I'm an 11B that's a part of a larger team with a great deal of support, a standard stop the bleed IFAK would be what I want. If I'm just a dude who wanders around the woods hunting, camping, shooting, and doing general dude stuff by myself with little support available to me, I'd want something more. Since I fall into the second category, my first aid kit is more expansive than a basic ifak. I've got standard stop the bleed stuff, extra bandages & band aids, and OTC meds. Gear should be adjusted to what you do & need. |
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Quoted: A good doc will take some time and look at all of the circumstances surrounding any requests. For me I had a health history of episodic recurring injurie/illness that required pain control, used narcotics responsibly, had a good deal of training and professional experience, have a wife who is an ER nurse, a good relationship with my doc and finally spend a lot of time in remote locations that would require at least a couple of hours travel to primary level medical care. She gave me a couple 800 mcg fentanyl suckers, I believe a 10mg ketamin amp, and I had the rest of the stuff already. You may be surprised what would happen if you know your doc and lay out what you think you need and why. These are not abuse level perscriptions and fairly safe compaired to what they routinely perscriptions. |
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I overthink everything. That's how I roll. Serious question, why? Is it a matter of possibly negative drug interactions if they try putting something in you and aren't aware of whatever you took? Overdose? Other? |
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I know, GD, but the medical training forum is slow. TCCC guidelines lay out the contents of Combat Pill Packs, or as they're now officially called Combat Wound Medication Packs. For me this would be used for the one in a million chance I'm seriously injured while near any of my equipment, to include my car kit. I'm not a cool guy or 0p3rat0r, just Joe Blow who does normal ass Joe Blow stuff. That said, what are your opinions on this? Forget about it? Make some up? It depends? Other thoughts? Cliff notes for those unaware, a proper CWMP generally consists of-
I had something much longer and more intricate typed out but we'll see if this turns into an actual conversation or not before I post all that. Both acetaminophen and meloxicam are selected for a very specific reason: pain control without fucking up your clotting cascade like Asprin, Motrin/ibuprofen, both of which have adverse effects on clotting factors. Bad news if you’re on daily asprin for your heart: the reason asprin is prescribed is the exact reason it’s bad to take it if you’re shot. Everything else that isn’t a painkiller is a preventative antibiotic to aid in prevention of infection in a dirty environment. Likely not necessary in a EDC pack with a hospital 20minutes away tops. They were also selected for specific reasons dealing with gram positive ca negative bacteria etc. if that’s over your head, don’t fuck with it. Actually if you’re in the US you can’t buy that shit OTC anyway. TL;DR: TCCC is a SOCOM directive, put forth by arguably some of the smartest doctors the DOD has after long consideration and annual peer review. if you must, carry 1000mg of Tylenol. Better though left to Paramedics if you get shot since you can’t carry fast-acting narcotics legally anyway and that Tylenol ain’t gonna help for 20-30 minutes. |
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I'm not worried about antibiotics in an IFAK. The IFAK is to stop me from bleeding so I can stay alive until I get to the doctor.
Same thing with painkillers. Nothing I'm worried about can be fixed by Ibuprofen or Acetaminophen and killing the pain won't fix the problem anyway. Since I'm not allowed to have "real" painkillers I'll just have to suck it up and take the pain. Since I don't know jack or shit about antibiotics I'll probably treat myself for a urinary tract infection by mistake and end up creating a super bug UTI that kills me slowly. No thanks. |
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Quoted: You obviously missed overthinking about how you’re going to dose and administer fentanyl and ketamine, two exteremely potent drugs. One which will stop your breathing and the other which could possibly give you paralysis and hallucinations. None of which are desirable in the situations you have planned for these kits. The biggest source of underthinking in this entire thread stems from a complete lack of understanding of the TCCC protocols and stages of care. Ketamine is not administered in the first phase of care... it might not even be administered in the second phase of time doesn’t cooperate. Though, I REALLY want to see [email protected] figure out how to carry his IV admin set in his daily routine |
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Part missed about ketamine is that it’s administered intravenously. It doesn’t come in a fucking auto-injector. The biggest source of underthinking in this entire thread stems from a complete lack of understanding of the TCCC protocols and stages of care. Ketamine is not administered in the first phase of care... it might not even be administered in the second phase of time doesn’t cooperate. Though, I REALLY want to see [email protected] figure out how to carry his IV admin set in his daily routine Quoted:
Quoted: You obviously missed overthinking about how you’re going to dose and administer fentanyl and ketamine, two exteremely potent drugs. One which will stop your breathing and the other which could possibly give you paralysis and hallucinations. None of which are desirable in the situations you have planned for these kits. The biggest source of underthinking in this entire thread stems from a complete lack of understanding of the TCCC protocols and stages of care. Ketamine is not administered in the first phase of care... it might not even be administered in the second phase of time doesn’t cooperate. Though, I REALLY want to see [email protected] figure out how to carry his IV admin set in his daily routine https://www.google.com/url?sa=t&source=web&rct=j&url=https://academic.oup.com/milmed/article-pdf/180/3/304/21861929/milmed-d-14-00257.pdf&ved=2ahUKEwi_5sLI6rvfAhUyO30KHc7-DiYQFjACegQIChAB&usg=AOvVaw3xH2B9bhJ2N4S-x1fDumBQ |
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Benadryl has been mentioned and is an H1 or histamine type 1 antagonist or blocker.
Zantac (Ranitidine) acid reducing drug is an H2 or histamine type 2 antagonist. Both together can be used to treat anaphylaxis in the event epinephrine is unavailable. H2 blockers with H1 blockers have additive benefit over H1 blockers alone in treating anaphylaxis. Ranitidine (Zantac) probably preferred over cimetidine (Tagamet) in anaphylaxis in light of the risk for hypotension with rapidly infused cimetidine and the multiple, complex drug interactions with cimetidine. Other commonly used H2 blockers are:Famotidine (Pepcid as a prescription, Pepcid-AC as an OTC medication) Cimetidine (Tagamet and Tagamet-HB) Nizatidine (Axid and Axid AR) Ranitidine (Zantac and Zantac 75) Histamine is a biologically active substance that potentiates the inflammatory and immune responses of the body, regulates physiological function in the gut, and acts as a neurotransmitter. Drugs that antagonize these effects by blocking or inhibiting histamine receptors (H receptors) are called antihistamines. Antihistamines are divided into two classes (H1 antihistamines and H2 antihistamines), based on the type of H receptor targeted. H1 antihistamines are mostly used to treat allergic reactions and mast cell-mediated disorders. This subtype is further divided into two generations. While the first-generation H1 antihistamines have a central effect and, thus, are also used as sedatives, second-generation H1 antihistamines have less central effects and are used primarily as antiallergenic drugs. H2 antihistamines are indicated primarily for gastric reflux disease because they reduce the production of stomach acid by reversibly blocking the H2 histamine receptors in the parietal cells of the gastric mucosa. Use of most H1 and H2 antihistamines is contraindicated during pregnancy and childhood. First-generation H1 antihistamines are specifically contraindicated in angle-closure glaucoma and pyloric stenosis. UpToDate - Emergency Treatment of Anaphylaxis |