OK, so I have questions and a rant is for BLS, ALS and doctors on this forum. First I want to say that I know that I'm not an EMT or Medic or MD. I've taken some courses to help me to understand how to help someone if no medical professional can come to the rescue such as in a SHTF situation. I've studied the Sun and believe that I will see a grid down situation in my lifetime. I've tried to prep for that scenario since about 2008. I've taken Stop the Bleed, CPR, TECC, Paramedic Affiliate and PHTLS courses so while I'm not an EMT, Medic or Doctor I've at least know some basics. I'm confident that I can use the items that I carry in my blow out bags in my cars, home and work to help someone in need. I live in a neighborhood where doctors are plentiful and some are pretty good friends. None to my knowledge   believe in prepping and have minimal supplies if something were to happen.  In my classes we have been taught the proper use of a tourniquet, pressure bandage, chest seal, direct pressure, how to pack a wound, how to start an IV, how and when to use a BVM, nasal airway, oral airway, intubation and needle decompression. My rant starts with the lack of availability of items like Tranexamic Acid (TXA) and Ketamine to someone that is not a medic and the fact that everyone and their brother can get Narcan for drug overdoses. It sure would be nice to add them to my kits even if one of my doctor friends were to administer. I believe that you can get OTC the pill form of TXA but that isn't going to help someone quick enough that has a massive bleed. My question is obvious, is there any way to get these products?

https://www.reliablerxpharmacy.com/catalogsearch/result/?q=Tranexamic

Need Injectable, I don't think the pill form is fast enough and the person might not be conscious to be able to take a pill

Laughs in malpractice insurance......

It wouldn’t be malpractice insurance. It’s practicing medicine without a license that he wants to do.

I’m an ER doc.

Out of all the medical things I would want in a  SHTF  event, TXA would not be in the top 200.  It may have a small contribution towards survival When you’re facing exsanguination when you have also have   Multiple  units of packed red cells available for transfusion and an operating room  and surgeon readily available, but if the SHTF  then likely you’re not going to have any of those things.

Ketamine could be useful for example for reducing dislocations  or fractures. How many  dislocations have you reduced ? How many  fracture reduction’s have you done?  How are you going to manage emergence phenomenon?  What are you going to do you if the patient has laryngeal spasm?  Are you used to managing an airway? Do you have suction  available? Do you have oxygen available? Do you have cardiac monitoring? Do you know how to interpret end tidal CO2?   Without those things, I would say that the risk of ketamine can easily outweigh the benefits and  I do  sedation regularly. I do not use it without all of those things in place. Could I get away with it with just a pulse ox, BVM, some oxygen and some suction? Probably. But then I’ve done maybe a hundred sedations with it.  I rarely use it Except in specific situation as I much prefer propofol.

If I were you, I would spend your time and energy worrying about other things.    My first aid kit involves Sam splints, some rolls of coban, israeli trauma dressing,   A triangular bandage, a few14 gauge needles, some 20s and 18‘s, IV fluids And drip sets,  A tourniquet, sutures, bupivicaine,  A few syringes and needles,  as well as a few different Antibiotics, and multiple over-the-counter medications.  No ketamine, no TXA.

Even before you get into all the anatomy, physiology, pharmacology, indications, contraindications, adverse reactions, interactions with other drugs, and all the other things that doctors have to take into account when prescribing and treating people using medicines, there's the legal hurdles to consider.

Ketamine is a Schedule III drug. You're not going to be able to find it (legally) without a prescription. And distributing a Schedule III drug is a felony in Virginia, and likely in other states as well.

I've been doing EMS for over 20 years now.

Not once have I ever thought about having ketamine on hand like you want to do.

There are plenty of other things I would want readily available instead of the things you are asking about.

Concentrate on the basics.

In a long term scenario you're most likely to encounter not as much trauma and more medical problems. In an emergency kit I'd be more inclined to to carry albuterol, epinephrine(epi-pen), chewable aspirin,and injectable benadryl.

You may also want to consider taking a course not as reliant on rapid transport. Have you considered a wilderness first responder course?

Spent 10 years doing ER work. Avoided conscious sedation unless absolutely necessary. Never used TXA. I like this BOB content, seems potentially useful.

Your many points are well taken and contraire to Luke_31, I'm really not looking to practice medicine without a license and I respect BLS, ALS and doctors knowledge more than you will ever know. I just trying to gain some knowledge to try and help my family and friends if at sometime 911, doctors and hospitals are not going to be there to help if it ever happens. The Ketamine I know is a drug that would be widely abused so that was a bad example and really my rant was that .gov and insurance restricts so many drugs that are not abused that people depend on for life, but allow safe injection sites to shoot up, Naloxone without a prescription and now many are talking about making more abused drugs available to all. I have many of the items that you mention and have done my best to know how to use them. CFCW suggest carrying albuterol, epinephrine(epi-pen), and injectable benadryl. Which I believe all require a prerscription, don't they? Any other suggestions of items to carry are appreciated. END RANT

Yes, I guess like the others here if you're going to carry prescription drugs my view is I would at least carry the ones that you'll be most likely to get use out of.

If we're speaking to strictly non prescription I'd probably do chewable aspirin( for a suspected heart attack), oral benadryl (they have some that melt in your mouth sold as sleep aids)  and oral glucose in the emergency kit. Although you have naloxone I'm not sure I would bother to carry it in a SHTF unless you are likely to encounter it due to a family member being an addict or you're in law enforcement.  For longer term kits  other non prescription drugs would be to add , loperamide, loratidine, , other non prescription cold meds, and a buttload of ibuprofen and  acetaminophen

Are blow out bags a new name for bug out bags, or is that a first responder term for bags containing advanced first aid supplies?

Intubation and Needle Decompression are skills that constitute the practice of medicine.  Trained or not, you need the delegated authority of a physician (or a license to practice as a physician) to perform them.

As for the medications, Narcan is a relatively benign medication in the settings where it is indicated.  Ketamine and TXA are not.

No, I don't carry Naloxone, I do have chewable aspirin, Benadryl (not the one's that melt yet)some cold meds, loperamide, ibuprofen and acetaminophen.  Thanks

Trauma bags, things to stop bleeding, some call them blow out bags

Prolonged field care is simply attempting to keep your pt in as good a condition as possible until they can get to definitive care. Surgery is definitive care and everything else is just trying to get them there.

In a real SHTF scenario the people that would benefit from what you're wanting are likely dead anyway, the meds would only delay that a bit.

Do yourself a favor, get the formal training and get some road time doing the work.  It will change your perspective on what you need, you cannot replace experience.

20

How reliable are these foreign pharmacies as far as product quality and actually receiving your order?

I'd love to pick up a few things for the family medicine chest, but would hate to have the order seized by customs.

I wish I could as I understand that experience is golden. I'm going to be 62 in April. I've been working 50-60 hours per week for the last umpteen years. I just cut back to 8 hr days, but still have hours from home. The only way that I could go for formal training like EMT or Medic is in a few years when I retire and I'm not so sure it would be worth it then.

Any local volunteer ambulance or fire departments by you?

Maybe the Red Cross?

I'm going to look into that, I think most are paid.

Just call your local station and ask to do a few ride alongs.  Most places will allow an observer.

Attending the classes and passing the tests are entirely different than hands on training and experience.

You mention bag masking, airway management, and intubation like you're gtg.

I've seen plenty of licensed professionals screw up all the above.

I recommend you stick to the basics and stay out of the fast lane with things like administering Rx meds, IVs, any airway management beyond NPA/OPA.

This x 87.

Intubating a mannequin is a first step in airway management training, but in and of itself it means precisely dick.  Actual management of a real airway under close supervision is the only way to truly learn.  And repeated application of the skillset is the only way to be able to reliably perform when the time comes.

Unrecognized esophageal intubation = death.  Are you (the OP) really proficient in verifying tube placement in an actual patient?

Wait, wut?
Are you serious?

Get a high pressure cylinder of Nitrous Oxide, and call it a day.

What antibiotics do you stock?  Is Cipro or Levofloxacin worth storing?

I have Clindamyicin, Keflex, Amoxicillin, Sulfa/Trim, Doxycycline, Azithromycin, and Metronidazole.  I do have some Levofloxacin on hand, but not a lot.  Was considering also Cipro, Levofloxacin, penicillin, augmentin, clarithromycin, and/or ampicillin.

Where can non-docs get bupivicaine or other local type anesthetics?

@juslearnin

Nowhere, hopefully.

I was involved in a case where a 16 year old kid received Bupivicaine intravascularly by accident. Irreversible cardiac arrest immediately followed.

Definitely nothing laypeople need to be fucking with.

Aww ok, any type of locals useable for SHTF, or just the topical stuff?

QFT

And this is why lay folks need to stay out of the fast lane of IV fluid management, administering Rx meds, and advanced airway management.

STICK TO THE BASICS.  Being good at the basics makes you a good man to have around.  Being ignorant and driving in the fast lane makes you reckless and dangerous.

I see bvm and automatically question what kind of training they got. If it was 1 man or 2 man bvm.