Ragnar Benson - Ragnar's Urban Survival

City survivors are also faced with the fact that because of the large number of people they may encounter in cities, they will also come across some who require long-term nursing care. We should understand that because of the nature of our existence, we will be called on to nurse many friends, family members, and close acquaintances found around us in cities who have also received less than ideal or even adequate initial care.

Standards of cleanliness were still primitive by today’s standards, but during our own Civil War, it was received truth that patients quickly evacuated from central hospitals into private homes had the best chance of survival. Often it was not the shot-off legs or shattered ribs that killed patients, but rather horrible, raging, epidemic infections. Hospitals and central receiving areas for the wounded were notorious pest houses, which was intensified by the fact that no one in the medical profession knew what caused infections. In that regard alone, modern city survivors are at great advantage.

Patients allowed to remain even a few days at these central medical. areas were virtually 100-percent certain of acquiring an infectious disease for which there was little hope. Two lines on the graph crossed creating this horror: the native strength of wounded men lying in bed ebbed while infections spread and raged.

Some knowledgeable folks still maintain that even today there is great risk of infection in our modern hospitals. Perhaps this is an overstatement, but only because rigorous measures are taken to minimize infectious conditions in hospitals. To a certain extent these measures are also available to city survivors.

Along with modern miracle disinfectants for both the patient and the room, modern hospitals have crews that do little but scrub, scrub, and scrub all day long. Even within the past 10 or 12 years, remarkable new technologies have come on the scene that give disease-causing germs less chance to hide and prosper. These include disease abatement, construction techniques, new and remarkable construction materials, special paints, sealers, and finishes that really keep dirt, filth, and infection in check and, of course, disinfectants that—by Civil War standards—are nothing short of miraculous.

One of the keys to survival nursing is getting your friend or loved one out of any central medical treatment area into a nursing retreat as quickly as possible. Then it is vital that the retreat not become a hospital. That is, treat this one patient or, at most a small batch of two or three patients, and then quit. Most nurses recommend waiting 3 or 4 months after the retreat is cleaned and disinfected before starting with the next batch of patients! The overlap of patients quickly leads to great concentrations of uncontrollable disease and infection.

City survivors have some dramatic modern disinfectants available to them. For patients themselves, we have Betadine, gentle iodine and hydrogen peroxide, among others. These materials are generally used to clean and treat personal wounds, but other especially good disinfectant materials useful on floors, walls, and ceilings are available from veterinary or farm supply stores. These are Bioguard X-185 containing 30 percent cresylic acid, Roccal D, 1 Stroke Environ, and even raw formaldehyde.

Because disinfecting barns and pig stalls is much tougher than disinfecting most bedrooms or tents, these materials are high powered, highly concentrated, state of the art, and extremely effective. They are certainly as good as anything in local hospitals.

Flies and lice may be a problem for survivors left too long in central receiving areas or in dirty, filthy retreats used by numbers of different people. At Stalingrad lice were epidemic among German soldiers. Lice just show up and prosper in those sorts of conditions. Again, some effective materials are available over the counter from your friendly vet supply store. These will give you the upper hand over flies and lice. Look for treatments with high concentrations of lindane and pyrethrins. These materials may also be used to help sterilize bedding, clothes, draperies, rugs, and tent bottoms. As a practical matter, survival nursing quarters should be on stone, cement, or finished wood. Avoid rugs or other porous materials.

Modern hospitals use mostly throwaway plastic kits for their procedures. Specialized kits, some of which are breathtakingly expensive, exist for virtually everything. They range from simple little packets designed to facilitate intravenous medications to great, elaborate affairs required for complete laparoscopic surgery. We won’t have these pre-sterilized kits. Even if we did we couldn’t afford to throw them out after just one use. Reportedly, some of these kits are presently recycled to some extent, but one wonders.

Survival nurses will have to make provisions to sterilize all of their instruments that will be used repeatedly. Boil for at least 20 minutes all gear, including needles, hemostats, scalpels, and the like. In a survival context most of these tools are irreplaceable. All must be cleaned up and resterilized. In cases where boiling vigorously in a shallow, open container will either ruin the apparatus or may not clean and sterilize it, strong disinfectants can be used as a wash. Many times we do both. To an extent, infections are treatable with modern veterinary-grade antibiotics, but in a survival context these materials will be scarce. Why ask for additional trouble?

Likely we won’t think of it now, but provision should be made to thoroughly incinerate bandages, cotton, infected clothes, bedding, and other miscellaneous contaminated items. Thorough burning will consume even more of our scarce energy supplies and could conceivably compromise our position, but it may be necessary to limit the chances of spreading disease.

Other disinfecting of bedding, clothes, and linens can be undertaken at the retreat in a kind of homemade, temporary autoclave. This device can be as simple as an old-fashioned covered cooker with a coarse rack in the bottom into which a pint of clean water is placed. When the water is boiled, steam penetrates upward into the clothes, doing a job on growies and little critters. Hopefully, it is obvious that clothes and bedding so treated are first thoroughly washed, using up yet more of our precious water supplies and time.

Place the covered container with cloth to be sterilized inside, over a gentle fire. Heat till the water is long gone, virtually scorching the clothes inside. During our Civil War, women working as nurses who were sufficiently fastidious to hot-iron all their laundry basically accomplished similar effects. Private people could do this work for individual patients, but on an areawide basis after a major battle it was unthinkable. Ironing clothes is easier today but not as widely done in our wash-and-wear society. At any rate, few clothes irons will be working after a collapse.

Good, sound shelters are necessary if our patients are to recover. These must be secure places that can be kept warm and dry, where meals can be provided and where waste disposal doesn’t become an issue. Patients kept comfortable, without undue stress, for extended periods obviously are more likely to make it.

In cases of nursing situations, it may be necessary to pull way, way back, away from the conflict to a place of really deep seclusion. Great amounts of convenience, including accessibility to vital supplies, may need to be sacrificed for the sake of the patient and his recovery.