MEDICAL MONDAY - Dealing with GUNSHOT Wounds w/ Sam Coffman The Herbal Medic

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Hello, this is Sam Kaufman with the Human Path of the Human Path.com.

In the show, I'd like to help you out with ideas, with concepts, and with information to help you live your life a little more prepared for disaster.

Also to help you live your life a little more fully, and to help you be the best possible person even in the worst possible circumstances.

I may form a green beret or special forces medic from the US Army, I have over 25 years experience both living and teaching survival and survival concepts to civilian and military.

I also have over 20 years experience with plant medicine as an herbalist.

In today's podcast, I'm going to talk about gunshot wounds.

Now this is a really tough subject, of course, to talk about in a podcast, and certainly from a medical perspective, there's much more depth necessary to talk about something like this than you could possibly get in a podcast.

So don't please don't assume that I'm going to teach you everything there is to know about to reading a gunshot wound in a simple podcast.

First of all, this is aimed at people with their own needs.

Second of all, it's aimed towards the situation of not having any kind of higher definitive care or even any kind of higher medical training available.

Now this is again the post disaster, a post collapse type situation, this is what we're generally talking about here, where you don't have the luxury of any kind of medical clinic or a doctor or medical training.

Or even a nurse or anybody with any kind of higher medical training and yourself or a loved one or a person who is with you, gets shot.

Because firearms are prevalent, of course, in this country and people are going to have them in a post collapse situation where there's no rule of law.

rule of law, you have to assume that gunfights are going to be something that happens.

So the first rule of thumb, of course, is to stay away from gunfights.

Don't get in one in the first place.

Avoid that at all costs.

But it's the point that it happens and you don't have a chance or an ability to avoid it,

then your second priority is of course not to get shot.

Now, that's difficult.

That's like saying, if you're in a knife fight, not to get cut.

You know, it's very difficult to be in a gunfight unless you have absolute tactical superiority

and superior training and you're able to overwhelm someone else.

But generally speaking, let's assume again the worst is we always do in my podcast.

We try to assume the worst because if you can deal with the worst, then the rest is, you know,

pretty much icing on the cake, right?

So we're going to talk about gunshot wounds from a standpoint again of that.

So we're not going to be getting into any kind of surgical intervention, surgical procedures.

Obviously, first of all, I'm certainly not qualified to talk about that whatsoever.

My surgical experience and OR experience is either, you know, in assisting or being,

you know, in any kind of surgical procedures is being, you know, anything from an OR

attack to assisting to nothing more than basically, basic suturing, basic computations

and wound to be, to breedment from my standpoint.

So although some of those things are actually valid, you know, from a standpoint of a field

surgical procedure for a gunshot wound possibly, they are certainly not something

that are valid if we're talking about procedures in the field in the first place

because we have to set up a, you know, we have to set up a sterile field.

We have to actually be able to operate, which is way beyond the scope of an hour podcast.

So instead, what we're going to talk about here are, first of all, kind of the psychological

or the emotional issues that you have to, I think you have to be aware of around an actual

gunshot wound, the realities, the survival prognosis rate of a gunshot wound, depending

on where it occurs.

I mean, and then there's some part of the body it occurs and the reality of that.

And some of those issues, and then we're going to talk about some of the basic first aid

all the way to last aid.

In other words, you know, as a medic, as I always say, you're the only medical help maybe

for the first few minutes, to the first few hours, to the first few days, to even the

first few weeks or months.

And there's no higher definitive care during that period of time.

So it's you.

And so what would you do?

How would you deal with this?

And so we'll try to talk about some of the most practical aspects that I can give you

over that hour or so that we're going to be talking.

So that's the subject for today.

Now, before I get to that, let's go ahead and have a word from our sponsors and we'll

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OK, I'm back.

Now, as I mentioned, the first thing I kind of want to start with is more the psychological

aspects, which I think you have to be very aware of.

Because unless you have a medical background, unless you've seen people bleeding out in

front of you, unless you've been in an operating room or somebody dies, or seen that type

of, you know, have that kind of an emotional impact upon yourself, have seen somebody

very severely injured that isn't going to make it, that I think you need to think about

that a little bit.

Because thinking about it is, it's maybe not the same thing as experiencing it physically,

but it is better than not thinking about it at all and then being confronted by it.

And so what I wanted to say is that depending on the caliber of the, you know, the bullet

that you're hit with and depending on the location on your body that a person has struck,

there are, you know, the prognosis can range from decent, you know, possibly, you know,

no problem at all in a possible recovery, all the way to pretty much not going to make

it in a field and again in a non sterile field or post-disaster environment.

So first thing, of course, we have to think about, right off the bat, is the tissue damage,

the initial damage that happens on the inside of the body as a bullet strikes the body.

And what happens is, of course, we're assuming most people are wearing clothing, you know,

when they're, or are hit in a place where they're wearing clothing.

So all the way from the outer, the outer edge of the clothing, the outer surface of the clothing,

all the way into the body, every bit of bacterial, you know, bacteria and infectious, you know,

pathogenic type, type bacteria and organisms that are residing on the outside of the body

and the bullet are going to make their way not only into the body, but they're going to make

their way into the body with great force.

So there's not only an impact, an initial impact, that there's also a concussive force

that goes on inside the body that affects, aside from the actual travel of the bullet as it goes

through the body, aside from all of that direct damage, there's also a collateral type of

damage that goes on from the shockwave around that bullet as it travels through the body.

And that shockwave, of course, has a radius to it.

And so that can damage organs, that can certainly cause contusions, internal contusions,

all the way to actually rupturing blood vessels, it'll make your blood vessels even to fracturing

bone and damaging connective tissue and damaging certainly the function of organs themselves,

depending on what they are.

So obviously, you know, this probably goes without saying, but you're much better off,

your chances of survival are much better off in a situation if you're shot in an extremity,

you know, such as the arm, the hand, the leg, or the foot, then they would be if you're shot in the torso

or certainly in the head.

So these are things to do, you know, if this is the first thing to just kind of steal yourself to,

you know, let's say that somebody that's close to you or a family member, they get shot,

and they get shot in the abdomen, they get shot in the chest.

You know, that is a poor prognosis if you don't have medical and surgical intervention capabilities.

It's a poor prognosis if you don't have the ability to work with pharmaceutical medicine.

Now, I give a lot of a podcast about the wonderful attributes and the wonderful help that we can get from herbal medicine,

no doubt.

And that includes the antibacterial.

And I don't do that because I'm trying to, you know, I'm trying to cut down pharmaceutical medicine.

I have no problem with pharmaceutical medicine.

I have a problem with the system behind it, the for-profit system behind it.

But man, let me tell you, if I got shot, you know, by somebody I would much rather be in a first world hospital

that had antibiotics than I would in a situation where I had to use herbal medicine.

You know, very, very difficult to deal with those kinds with this kind of of an injury,

this depth of injury, this depth of infection with herbal medicine.

Can it be done? Absolutely.

It can be.

But is it going to be easy? Probably not.

It'll be very difficult.

And your chances of survival are going to be lower than if you had the advantage of having antibiotics

and having surgical intervention, of course.

So this is why I'm a big fan of integrative medicine.

Use the herbs where you can because there's a lot of places where herbs and plant medicine

actually works better than pharmaceutical medicine.

Lack of side effects and more of a holistic approach to health that includes diet and lifestyle

and all of that kind of stuff that is more pronounced than you find with orthodox medicine,

of course, is just part of the history of it, the history of how people work with it,

and the actual natural effect of a plant medicine that has thousands of constituents to it.

And there are, and it's a natural evolutionary process, co-evolutionary process we've had

with this plant medicine, both as food and as medicine, for tens of thousands of years

and our bodies know how to work with it, versus a single constituent medicine that has evolved

over the last few decades, and our body has absolutely no idea what to do with it.

So that's why we have so many bad effects, side effects, and problems with it.

And that's bad, you know, that's bad enough by itself, but then the whole four-profit system

behind it that covers up these kinds of approaches that we can get to actually cure people.

And instead, it's actually a system to help keep customers waiting in line, which means

we don't want to actually heal everybody.

In fact, we don't want anything more than maybe a 30 or 40% healing rate of people, because

if we had more than that, then we're starting to cut into our profit margin.

So that's the problem that I have, I just want to clear the air there on a little bit.

So when we're talking about gunshot wounds, man, if we have the ability to go back and

if we've stored up, we've got our antibiotics that we've stored up and we may talk a little

bit about some specifics on that, this podcast, if we have time, then that's what we want.

That's what we want to be able to go to.

But, here's the other issue of this.

This is the emotional kind of preparedness that you have to, I think, have in your mind.

There are going to be situations in a post-divastor, in a post-collapse environment.

There are possibly going to be, you might possibly be exposed to a situation where the prognosis

without surgical intervention by a trained and very competent surgeon, the prognosis of

that person is going to be pretty much, they're going to die.

It doesn't matter what you do.

And even if you had an OR and a person got shot in the emergency room, the prognosis

might be really bad.

So you can't put this blame on yourself.

At the same time, let's say that you only have a certain amount of pharmaceutical medicine

saved up, that you've got stored, and now you're faced with somebody that's a loved one

or a friend or maybe just a person that's a friend of a friend and you've got a community

and you can't just, you know, you can't just cut that person off.

You know, they're important.

There's a lot of issues that go along with that socially if you do that.

And you know, for sure, this person isn't even going to make it.

You know, are you going to waste an entire dose of antibiotics and other medications on

them?

You have to, probably, you know, maybe people, it's sort of like that concept that we

have in Western, in first world medicine, where you have to be trying to save a person

no matter what.

You see this a lot with emergency medicine, with EMS workers, with EMTs and paramedics on

the street.

And I, you know, I've seen this.

I've seen this myself where you'll see paramedics and EMTs doing CPR on somebody, you

know, because it's in front of the family and they're doing CPR on the corpse.

That's all, you know, it's not the guy, the guy or the woman is not coming back and they

know it.

But they got to pretend.

And so they're doing CPR and they load the person in the back of the ambulance and they

sit around and basically smoke and joke or, you know, don't smoke, but they sit around

and joke around and have conversation until they get to the hospital, doors open and they're

doing CPR again.

Okay, you know, don't kid yourself, this goes, this happens, this goes on.

And it's not anything to say, there's nothing wrong with the EMS system.

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You know, people that work in the system tend to get pretty cynical because they see a

lot of, they see a lot of death and they see a lot of people who are ungrateful and don't

really appreciate what it is that these EMS workers do, how much they put their lives

on the line to try to save people in the street.

The problem is with society because society doesn't, is untrained and doesn't understand.

This person's dead, you could do CPR on them for the next six hours, it doesn't matter.

You could get them to the OR right now or to the emergency room right now and we're still

not going to pull them back, they're dead.

But you know, we have to pretend.

And so that's the position that, you know, we've come from, from our first world, you

know, environment.

So I'm just telling you, so if we have, you know, it might be different if we were in

a post-collapse situation that had lasted, let's say, two years.

By that point, the culture will have caught up and people, people will have seen other people

die enough.

And we've understood that and become immune and sort of sort of sort of inoculated, stressed

and inoculated to that, that idea that people just don't make it and that death is something

that is going to happen to everybody and maybe more often in this environment.

They're going to be inoculated enough to where they understand, yeah, you know what?

We're not going to waste, you know, waste a regimen of these, you know, of our antibiotics

and this person and the person that's injured might be the first one to say, don't waste

your drugs on me, you know.

But at the beginning, at the beginning, you're going to be faced with a lot of that kind

of thing.

And again, this is a hypothetical situation.

I'm kind of giving you the worst case scenario.

It's two or three weeks after complete collapse.

It's going to last for a long time.

And here we've got, and somebody gets shot, you know, there's people shooting in Lutin

for food and water and medicine all around.

And somebody in your crew or you're with your people in your neighborhood, your whatever

your group, your family gets shot and they get shot in the gut and, you know, they've

got, you know, they've got, you can actually see, you know, some feces and blood oozing

out of their back, you know, somewhere between their kidneys and they've got it best they're

going to live maybe 24 hours, you know, or there's no absolutely no reason to give them

a bunch of antibiotics, you know, but that's not the way that we were thinking yet because

we're thinking to save them, save them.

They're still alive.

They're still breathing.

They're still talking.

So this is what I, this is kind of, you know, I think something that you should really

think about.

So we're going to talk through some of the different parts of the body to get shot and

talk a little bit about the prognosis or rather just, you know, what are some of the things

that go wrong and what should we be looking for?

So hopefully that will kind of help you get an idea as we work from when, let's start

with the easiest part of the body and as I mentioned before, that would be the extremities.

So depending on the distance, you know, that your, that your, that the bullet is before

it actually hits the, you know, the body, that part of the body, the extremity.

So how much energy is still in that bullet but the time of the hits and, and depending

on the actual caliber of the round and depending on where on the extremity, you know, it actually

hits a number of things can happen.

You know, if you shoot yourself in the foot accidentally with the 308, you're probably

pretty much already going to have amputated a good part of the, of your foot, especially,

you know, the, the end of your foot if you shoot yourself there.

That's a lot of, that's a lot of energy that you just released into that, into that

foot. But, you know, if you get shot by a 22 from 100 yards or 50 yards, you know, in

the hand, yeah, you know, you're, you're going to be your side affections probably going

to be our worst issue, going to be our worst problem.

You know, you're obviously if it's hit some nerve and connective tissue and bone and

we've got some issues there too, but you're probably going to be, you're probably going

to be able to pull through there, even in a field, you know, assuming we can deal with

the infection issue.

So these are things to kind of think about.

So the first thing that you should always, always consider in a gunshot wound situation

is, is there an exit wound?

So you see an entry wound immediately look for an exit wound.

The location of that exit wound is very important too.

So if the location from that exit wound is, is pretty much opposite or, you know, close

to being opposite within a close distance opposite of the entrance wound, then you're

probably, then that's a good thing.

It's a good thing.

But if the exit wound, if you see an entrance, an entry wound in the, let's say, in the

lower right quadrant of the gut, you know, and then, and you see an exit wound coming

out the back that's over on the, the left side of the body, you know, about halfway

up the back, that, that's a bad thing.

That means that there was a lot of tissue in between there that potentially got damaged.

And this can happen because bullets can come in as they, as they hit the body and they

can depending on the type of bullet, depending on the velocity, and depending on what they

do once they actually hit, the type, in other words, you know, the type of bullet.

Again, whether they, you know, a hollow point, for instance, versus, you know, versus

other types of bullets, what they will do, and how they break apart inside the body,

and, and the route that they might follow, if they hit something hard, the hard tissue,

like, for instance, like bone, if they might follow and deflect up that hard tissue and

then come out somewhere else.

So the best possible scenario we can hope for is, well, the best possible scenario if

we're actually hit, if somebody is actually hit by a gun, has a gun, shall wound, is just

that it's a grazing wound, that it's no, no worse than getting to see a knife laceration

across the shoulder or across an extremity or something like that.

That's the best case.

The next best case would be that there's an entry and an exit wound, and the entry and exit

wound is just through soft tissue, like a muscle tissue and doesn't hit any vessels, doesn't

hit any nerves, doesn't hit any connective tissue.

That's good.

We can deal with that.

The next situation is the same thing, but, but we're now we're talking about hitting

connective tissue and nerve or bone.

So in this case, even though we again have a perforating gun shot wound where there's

an entry and an exit wound, there is more damage in between those two wounds.

There's more functional damage.

If you remember, I think I've talked about this before when I talked about first aid for

laceration, so for anything where we actually have open and open wound, I talk about some

mnemonic as if and there's the F stands for functional or further damage where we have

to explore and find out what kind of further damage there is.

So what we're looking for there is we're looking for damages or damage to a blood vessel,

you know, major, in other words, a major blood vessel such as an artery where we actually

have internal bleeding that we have to deal with, is there neural involvement?

So do we have, you know, issues with nerve, especially major nerves that we'd have problems

from functionally from that, or do we have connective tissue issues, you know, ligaments

and or even tendons, and do we and or do we have bone involvement as well?

And maybe we have all of those things depending on where the, you know, the bullet hits.

I mean, imagine at a high velocity, you know, and an amount of energy that I talked about

is the bullet travels through the body.

What kind of damage can be done not only from the direct impact, but for any charge or

pieces of that bullet that might break off?

And of course, from the concussion force, the force of the shock wave force that passes

through the body as well, especially if there's, if it's passing through soft tissue or

so, but the next, you know, I talked about it being, you know, this is sort of on a spectrum

of disaster, of medical disaster, and how much you're going to be able to take care of.

And so if it's an extremity, and we have bone involvement or soft tissue involvement,

I'm sorry, connective tissue involvement, or major vessel, major blood vessel involvement,

and we have to deal with those accordingly, of course, we would do those the same things

that we would do for first aid.

Which means that if there's bone involvement, we're going to stabilize the broken bone,

we're going to stabilize the joint above and the joint below, we're going to prevent that

fracture from further damage, you know, through splinting and bandaging and padding.

We are also, and we're used to restricting the amount of movement that you can make with

it.

We're going to take care of any kind of bleeding with its arterial or very heavy,

evanus bleeding by compression bandage, probably, you know, and maybe elevation.

We're going to take care of any kind of functional damage, such as nerve or connective tissue

damage by preventing movement, preventing usage of that extremity and preventing further

damage.

And then most importantly, more than anything else, we're going to treat for shock.

So a person's been shot inevitably, they're going to go into shock, and it may be minor,

maybe major, but there's going to be a point where the realization that they've been shot

catches up and there's a mental aspect to this, along with the physical aspect, of course,

where there's loss of blood or where there's organ shut down because of, you know, organ

sort of been affected.

But the shock is going to set in, and usually it is the mental aspect that hits in first

the psychogenic aspect, as it's called.

And so keeping the patient warm, keeping them comfortable, talking to them, reassuring

the patient, and letting them know that you are there to help, and that they are being

taken care of, not using trivial statements, such as it's going to be okay, everything's

going to be fine, things that they won't believe, but rather reassuring them in an honest

and sincere manner, making eye contact, communicating, making sure that their needs are met,

you know, within limitations, we'll talk about a few of those limitations, like what

you can't do for them, depending on where they've been shot.

We'll talk about that in a minute.

All of that is extremely important, maybe as important as it is with anything, in any

kind of injury, shock is maybe one of the most important things to deal with in a gun

challenge.

So this is, I started kind of off with extremity, and the shock issue, of course, extends

and becomes a greater, you know, arguably a more important aspect of the injury, the

more damaging that the injury is, which means as we move from extremity into the torso

of the body, you know, where most of our organs are, or the cervical spine, or the head,

as we get an injury in any of those areas, and the potential for it being much more damaging

starts to increase, and then the need for treating for shock becomes even greater.

So let's do that, let's kind of move so extremities.

We talked about that, we're just talking about first aid, and we're going to come back

around, this is the first aid aspect, this is the first couple of minutes to the first

couple of hours, what we're doing on this, we're going to come back around and talk about

some of the more long-term issues later, but right now we're just trying to stabilize

them first aid, and if we can get, if there is higher medical care, that's what we want

to get to, of course.

Now we talked a little bit about extremities, and gunshot wounds extremities, let's talk

a little bit, and let's talk more about gunshot wounds to the trunk, or the head, the

trunk of the body, or the head, or anywhere where we have organs, organ systems, and we're

going to have a lot more damage, obviously this is a much more serious situation.

Now, as I mentioned earlier, when I first started this, I think I talked a little bit about

the resulting damage that goes along with a bullet, with a gunshot wound, based upon the

force of that bullet traveling through the body, and that is a force that is determined

by a lot of different things, most of all, or possibly, you know, the most primary physical

component of that is the actual speed of the bullet itself.

So what this means is that a handgun gunshot generally will not cause as much damage as

a high-velocity rifle bullet traveling through the body.

What happens is the speed increases, and we get a high-velocity, a rifle caliber, such

as a 308 or a 306, traveling through the body at a very high-velocity, is that it's not

just the path of the bullet that's the problem, it's not just the things that are inside,

you know, that the bullet intersects, you know, physically, but it's also the shockwave

that that bullet leaves behind.

And so that shockwave, depending on the speed of the bullet, can be huge, you know, it

can be about 20 or 30 times a diameter of the bullet as it expands and contracts, and

as it does that, as you can imagine, you know, forming if you were to watch it in very,

you know, if you've ever seen this, some of the different experiments done, elliptic tests

that are done, recorded with a high-speed camera, are done on what happens as the bullet

travels through gelatin or through some sort of, you know, something that duplicates or

emulates the tissue of the human body.

You'll see that shockwave slowly expanding and contract, and as it does that, of course,

it also creates an actual physical vacuum that pulls in bacteria and anything that is outside

the body, that, you know, from the outside, both the entry and the exit wound, you get bacteria

and all that stuff, particulate coming into the, into that wound area as well.

So we not only have the immediate damage, immediate tissue damage, depending on where that

bullet is traveling through, depending on the velocity of the bullet, and depending on

what organ systems is hitting, we also, we get the reaction of those things, but we also

get the long-term damage from bacteria, from, from massive amounts of bacteria, pathogens

that have now entered the body.

But let's talk about the short-term stuff, what, what the issue is really on that, in terms

of not just the bullet itself and what it's hitting, but also in terms of the shockwave,

is how susceptible the organ systems are around it to absorbing that shock.

So different types of different organ systems will, will not necessarily be able to handle that

shock, and at the point that they can't, they start to rupture and tear and even burst.

This is where, for instance, a headshot, you know, is so damaging because of the brain matter

inside, because of the fact that there's nothing but hard tissue or bone and, and hard tissue

around that, the brain, and so if there's nothing for the soft tissue on the inside of that,

the gray matter, to be able to push against without actually literally exploding through

that hard tissue.

So of course, it helps, as if any of my podcasts, I talk about when I'm talking about, you know,

medical related, medically related subjects, it of course helps you to have some idea of anatomy.

Of the gross anatomy of the human body, so that you know if there was a high velocity round,

a hunting rifle or something, you know, that a person got shot by, and it went through the torso,

you have a general idea based upon the entry wound, and perhaps based upon the exit wound,

as to what organ systems or organs, at least, are between the entry and the exit wound,

or what organ systems may have been affected, if not directly by the path of the trajectory of the

trajectory of the bullet rather, but have been directed at least by the shock wave that went

through the body as well, so if the bullet went through the right upper quadrant, approximately,

of the abdomen, we know that they're, you know, the livers in there, for instance, and the liver

may have been affected by the shock wave, even if it wasn't directly affected.

So this can, of course, as I mentioned before, cause rupturing and cause tearing, it can even

cause fracturing of bone, so when we're looking or dealing with somebody who has suffered a high

velocity bullet wound, a gunshot wound, anywhere on the torso, we need to immediately assume that

this is a life-threatening injury. It doesn't matter what you might think it presents as, or what,

you might think it was a clean entry and exit wound, it doesn't matter. You assume that this

is a life-threatening injury, okay, because of the fact that if not directly, if the bullet didn't

directly affect something, certainly the shock wave may have directly affected that, you know, tissue,

as I talked about before, bursting tearing, you know, any number of things. And the two biggest

issues that we really are concerned with off the bat, right, you know, for immediate issues,

are going to be bleeding and breathing, depending on...

If the things that are going to tell us a bleeding problem, because we may not be able to see it,

we may not be able to see any kind of bleeding externally, because if you think about it,

if there's bleeding in any of the cavities in the torso, they generally are going to stay in the

cavities. You might not actually have blood, you know, leaking out of the cavity much, you might not

see much bleeding at all, and yet internally, you might actually have a huge amount of blood that's

being stored in those cavities, so you're bleeding to death, even though it's not visible. So the way that

we look at that, or the way that we determine that, has to be more through external,

scientific symptoms that the patient would be showing. These symptoms would be things like

tachycardia, and that's a really big one. So in other words, increase in pulse, because if you

think about it, the cardiovascular system has to pump and work that much harder to be able to

perfuse tissue, because there's less volume of blood, there's hypovolemia, and they're going into

what we call hypovolemic shock, gradually. We would have a...if you had the ability to test the

blood pressure, we would find that the blood pressure would be dropping. If you were to monitor

the patient's mental status, you would see that it was starting to alter. There would start to lose

mental faculties to some degree cyanosis, which would mean turning blue, kind of the bluish tint

or bluish color, especially around the lips, to begin with, and so these are some of the signs that

we used to monitor and loss of blood. So if we're seeing that, especially within the first few

minutes, we know there's probably a massive internal hemorrhaging that was caused by this.

Now, the other thing that I mentioned is extremely life-threatening is breathing. Depending,

again, on where that bullet wound penetrated and or perforated the body, it may have affected

the diaphragm from the diaphragm on up in terms of breathing. So the diaphragm or the lungs,

or anywhere along the airway from upper to lower respiratory airway, we may have affected that

system. The most common system you would probably...I'm sorry, the most common issue you would

probably see would be the chest cavity in the lungs, the pleural cavity itself, in what we call

a pneumothorax or a hemothorax, because of the fact that the lungs taking up a large space

there, that's probably what you would see. Now, this means basically that the actual cavity,

the pleural cavity that your lungs are encased inside of, your lungs being empty sacks basically

that fill based upon the pressure difference between the outside and the inside of your body,

your lungs don't have a musculature that causes them by themselves to expand or contract,

they are expand or contract based upon the space that expands or contracts from the diaphragm,

the movement of the diaphragm. Now, if that space is compromised, then what happens is

the area between where the lungs attach to the pleural wall, that area becomes compromised,

and suddenly it gets filled with air or blood or air and blood, and it starts to be pushed to the

side or pushed in from one direction or another and starts to basically collapse. So that's what we

would call a collapse lungs, but it's usually a gradual process as that cavity starts to fill with

air or blood. So here again, what we get is a lack of perfusion, so we're going to get the same

issues, we're going to get tachycardia, we're going to get a lowering of blood pressure,

we're going to get a increased anxiety because a person just feels like they're not getting enough

air, they may start to try to breathe with auxiliary muscles and change their position to try to

feel like they're getting more air, feel very anxious because they're not getting enough air,

showing signs of cyanosis, as I mentioned before, later on we get signs called

jugular vein distension or JVD where depending on which side the lung is pushing in on it actually

starting to occlude the jugular vein, you'll see the jugular vein standing out on one side or

another of the neck, we might get what's called tracheal deviation where the trachea actually

starts to get pushed to one side because you can imagine the entire pleural cavity that's filling up

is pushing the lung and everything else over to the other side of the chest, starts to actually

move the trachea as well, again this is a little further along in this situation, so these

are some of the things that we would see in a chest injury, so the way that we deal with these,

now we talked briefly about internal bleeding and how you would determine if it was happening,

the actual treatment for internal bleeding is very, very difficult to talk about in the first

age situation, another first there's not a lot of things you can do if you're not medically

trained and you don't have surgical exploratory type capabilities to get in there and actually

occlude the bleeding, there's not a lot you can do with breathing, with a breathing compromise,

like I've just talked about, there's a little bit more you can do, at least short term to help

that and one of the first things that you can do is you actually can stop the air from entering

that hole that's been penetrated into the chest wall and to the pleural cavity, and so

if you can imagine when you breathe every time you take a breath, you know air comes in through

your mouth, through your upper respiratory tract, right, and it goes down through your trachea

and into your lungs basically, through your bronchioles and into your lungs, well if you have a hole

in your chest cavity that goes into that same parietal or that same space that your lungs are

held in, if you can imagine as your diaphragm moves and your chest expands, wherever that pressure

differential exists, it's going to fill anyway, it can't, so the air is not going to just come in

through your mouth, it's also going to come through that hole in your chest, so what you have to do

is block up that hole in your chest, and one of the best quick ways to do that is what's called

an occlusive dressing, which is just basically a fancy word for addressing that blocks the air

and what we can use of course for that would be plastic, so any kind of plastic wrapper

on any of your bandages for instance, that you might have in your first aid kit,

you know, they make the vatholine gauze type bandages which you can use as well, but you can

just basically use plastic, put it over the wound and the wound on the chest and a clued air

from coming in, and normally what's done is what's called a three-sided occlusive dressing,

which allows the air to escape as your chest wall moves, as your diaphragm moves, as your

chest wall expands and contracts, as you're pushing out air, you want air to come out of that space

that's been created as well, if you can, you want to try to bleed that air out and get it out of

there to make room for your lung to have room and expand up again, and then anytime that air is

trying to come in, you want to suck it down, so it's like a one-way valve, so a three-sided occlusive

dressing is just a fancy term for a bandage for a piece of plastic of preferably a flexible

piece of plastic that'll stick to your skin and do this, and it's taped on three sides,

okay, you're generally speaking, it's taped on the three sides, the upper and the two sides,

and then the lower is left open, and so that allows, again, the air to flow out, okay,

this is not the only treatment for this, it's just the initial treatment, now if you have a

perforating gunshot wound that goes through the front, the first thing you do, as I mentioned,

if you see a gunshot wound, is you check for an exit wound immediately, so the person got shot

in the chest, and they're lying on their back, and you're looking at them, and you see a hole

in their chest, or you see a hole maybe in their shirt, and you see some, you know, maybe some

frothy kind of a bubbly looking pinkish blood around that, it's kind of seeping out, then you know,

you've got, they got shot in the chest, and you know that probably the airway is effective,

the breathing is affected, you know, and so the first thing you need to do is to, aside from stopping

that hole and stopping air from getting that hole, is also to roll them and look at the back,

and see if there's an exit wound, and if there is, you need to occlude that as well.

Now in the back, you just put a foresighted occlusive dress in, which can just be a piece of

plastic, all taped all the way around, you don't have time for that right off the bat,

so just any kind of plastic would work, if you have an MRE container, or a bandage, or you know,

a crevada, you know, a triangular bandage in a plastic wrap, or something that will occlude that,

you can just put that underneath it, and roll them back over the top so their body weight keeps

the plastic, you know, keeps the air from coming in at all on the back, because you're going to be

working at them from the front, so you put the three sides on the front and put the foresighted

on the back, and you can get back to it later and tape an actual bandage down, but to begin with,

just get something over covering that hole so there's no air coming in from the back.

This is if again, if there's a perforating wound through the chest, through the chest cavity.

So this is how we, this is an initial first aid for this, and again there's more that we can do,

there are some other terms, and I'm not going to get into, there's not time, and certainly there

isn't really, it's beyond the scope of any podcast, I think, to talk about things like a needle

force and thesis, and certainly beyond what would happen in the surgical capacity, which would be a

chest tube, to be able to actually drain the fluid or the air out of that. Now positioning

can help to some degree two, and that is if you know it's a pneumothorax, you know, it's just air

in there, that you position them so that air is up, and if it's a hemothorax, your position

so the blood is down, so that would be side to side probably. However, determining whether

between you have air, whether you have air or blood in that chest cavity is difficult to do,

and requires, you know, in the field, the best you can really do is what we call percussing

to see if there's a, you know, a difference in sound as you move up the chest wall, and that's

very difficult to do. Even with training, it's difficult to do, let alone if you actually have,

you know, ambient sound around you, this going on, if people are shouting or screaming or there's

noise, you're never going to hear that. So that's just kind of beyond the scope of what we're talking

about, too. It's one of those things is kind of a nice deal if you can do it, but you're probably

not going to be able to do it. So that's the initial first aid. This is, as you can tell, as I

talked, when I started this podcast off, I told you, you know, this is really, this is a topic that

it does not necessarily have a happy ending to it. There's not, you can't just expect a weight

into a gunshot wound in a post-disaster environment with no higher definitive care, no trained surgeons,

no trained doctors, no pharmaceutical medicines, no clinic, no sterile field to be able to operate in,

even if you didn't have those other things, and you were just, you know, kind of working on the fly,

and what you could do, you know, just if you see a bleed, you know, you're clamping it off,

and anybody can do that with common sense to some degree. If you have none of those things

available to you, this is a losing battle, you know, and this is really the mental side of it,

and I'm not telling you this to get you depressed or get you discouraged, but, you know,

I just think you have to be very realistic if you are a prepperous to thinking about some of these

things through, and if you think them through ahead of time, it's less difficult to deal with them

later, and it's easier to make decisions that might be difficult decisions if you've already

thought them through to some degree. So be thinking about that a little bit, that, you know,

there's just not necessarily going to always be an easy answer and a happy ending,

if somebody gets shot with a high velocity round through the gutter through the chest, you know,

because now, what's on the tail end of this, of course, assuming that we stop the bleeding,

or assuming that we actually take care of a chest, you know, of a pneumothorax or a humothorax,

and we're probably not going to be able to fix it completely, but let's assume that we did,

or even a diaphragmatic rupture or something like that, there was small enough, minor enough,

the person was young and strong enough, and their body was amazing, and we actually had even

some of the right herbs to be able to help and, you know, pull it for a tissue, and help that

healing, and they actually healed up from it, we still have to deal with, on the other end of this,

we have to deal with infection. The infection is a big deal. Now, some of you have listened to my

other podcasts, and I have lots of information on there about antibacterial herbs, how they work,

it's, you know, it's limited to what I can possibly talk about in an hour on a podcast,

but still it gives you some of the ideas, so you can go back to those and listen to some of the,

the different antibacterial herbs, if we don't have pharmaceuticals, and the dosages on there

are just huge, you know, you just basically give people gigantic dosages of this really,

until you start to get side effects from the herbs, which you certainly can get, and then you back

off a little bit, and you keep them that, keep them those dosages, and what we're trying to do there,

is we're not just giving them antibacterials, but we're also giving them really intense stimulants

to their own immune system, we're boosting that, we're doing everything to help their body,

of course, heal itself, which is what our body does anyway, whether we're giving them pharmaceuticals

or not, it's really up to the person's body, and the person is to whether or not to heal.

It doesn't matter how much of an amazing surgeon you are, if it weren't for the fact that the

body could heal, you'd be nothing more than a serial killer, right? So you cut somebody open,

if their body wasn't willing to heal, you would be killing them. So we have to remember that,

and it's the same with herbal medicine, of course, as well, it's just that it's a much more

gentle approach, and it's not. You know, depending on the herbs we're using, and certainly the

harder part of this is determining what the dosage would be, because herbs vary from plant to plant,

from season to season, and from how they're prepared and dried, and all that kind of stuff.

So we have to be thinking about antibacterials. We have to be thinking about infection and

drawing that infection out. One of our most useful tools in that, in our first aid kit for that,

would be charcoal, activated charcoal, you know, USP grade or food grade is best if we can get it,

to be able to draw infection out if that infection is close enough to the surface of the skin,

to where we can actually, you know, get an interaction between the infection and the charcoal.

You think of charcoal as really something, nothing more than a very, very fine and delicate sponge.

It's a sponge that you can use to pull out some of the finest bacteria and clean and wound out

really, really well, but it's not necessarily going to do much beyond that. It's certainly not a

tissue proliferent. It's not an antibacterial necessarily. It's just a cleaner. It just pulls

that bacteria out and it pulls it out anywhere it touches it. So it's a very useful tool,

but it's a tool that we use at the very beginning of an infection generally. I mean, at the very

beginning of the treatment of an infection, then once we've cleaned it out, then we can start to use

our herbs on it. Okay. So I don't know if I mentioned that I was going to talk about herbs or not.

I'm getting close to the end of this podcast and so I don't think I'm going to, at this point,

go into specifics on herbs. I've talked about data again and other podcasts in terms of bacterial

infections. I would like to talk about wound healing and herbs and I think I'm going to save that

for another podcast or maybe one I'll do real soon, in fact, maybe next week and talk a little

bit about how tissue grows and how we can increase our ability to heal and minimize infection

and maximize, minimize inflammation, minimize infection and maximize tissue growth and healing

by using some of these herbs that really increase our body's ability to do that. They increase

micro-circulation and they do things like that and those are important herbs also because

really as important as, you know, the kind of the western orthodox viewpoint on infection is

take antibiotics in order to just nuke all the bacteria and it nucks, of course, there's a lot less

of the infectious and pathogenic bacteria as there are the millions of different species of regular

non-pathogenic bacteria in our body and in an infection, you know, that percentage grows from

maybe less than 5% to up to 5.1% or something. You know, it's very minimal amount of growth but,

you know, it shows you on what a fine line our body's function, right? I mean, how sensitive that

balance is and so that's the western orthodox approach whereas from the herbal approach,

although we can do that, we can't do that nearly as efficiently as we can or it's not necessarily

efficiently but we can't do that as severely as we can with a single constituent pharmaceutical

drug so instead what we do is we support the body, we kind of go out from the other side and we say,

well, let's help the body do what it does best by supporting that tissue and helping the tissue

proliferate, helping the tissue, you know, recreate micro-circulation and get rid of all the

toxins because that's what that micro-circulation does and of course give some antibacterial support

there too. So that's kind of the approach from that and that would be the approach you would take

also from something like for something like a gunshot wound. Once you've got past the initial first

aid and the initial life threatening injuries, we would start working towards repairing that tissue,

supporting the tissue and of course giving as much antibacterial support or anti-pathogenic

bacterial support as we could too to help, you know, the infection. But it's a big task, you know,

this is not this is not something to take lightly or to be cavalier about or to think, you know,

we'll just use herbal medicine in this, you know, I never have claimed and I never will claim

that herbal medicine is an adequate substitution as we get into the critical care and trauma care

and that type of thing, you know, I've always said this, you know, if I get shot by, if I get shot

or if I get hit by a bus or whatever, you know, I want our, you know, American emergency rooms and

our American emergency physicians who are, in my opinion, the finest trained in the world and I want

that kind of care if I have a choice, but if I don't have a choice, you know, that's what my

school's all about, what if I don't have a choice, then what do we do, you know, how can we deal

with that? So taking away that factor of just, you know, thinking we can always fall back on,

you know, that kind of care instead of having something else as a backup. So this is not, you know,

it's not the the alternative that you want, but it's the alternative that you may be forced to have,

and so that's what, that's what the purpose of this podcast was. So I apologize if this seemed

like it was kind of a depressing podcast and one that doesn't leave you feeling like you're in

complete control and able to deal with any situation that comes your way, but, you know, I think it's

important to be very realistic about what this kind of trauma means. And, and one of the biggest

issues, again, I'll kind of close by saying is that in herbal medicine, we just don't have the

practice. We don't have the ability to practice. I mean, how many herbal clinics do you know that

are set up on war zones where that's what we're using? We can't, we don't even have herbal clinics

that are set up really in any kind of number to be able to gather data for just basic, you know,

chronic issues that you normally see in an herbal, herbal clinic. And I'll tell you the kind of

people that I get in my herbal clinic is people who are have tried everything else and has failed,

and they're willing to do anything, they're willing to try anything for whatever their health

problem is. These are people who are ready for herbal medicine, they don't care, they will actually

be compliant, they'll take the herbs, they'll take the change their diet, they'll change their lifestyle,

and guess what? They almost always walk away with the cure, you know, they walk away and they say,

oh my god, this stuff really works. Well, the reason it works is because, you know, we looked at it

from a whole perspective, and herbs absolutely, of course, they work, if they didn't work,

pharmaceutical companies wouldn't be in doing what they're doing and spending the billions of

dollars of research that they are to try to find new medicines from plants. In fact, all of our

medicines do in one way or another at some point, the idea for it or the actual original compound

for it came from a plant, period. So, you know, in terms of medicines of pharmaceutical medicine,

pharmaceutical manufactured medicine. So, you know, it's those kinds of people that come into the

clinic that are helped by herbal medicine that it works for, but my point to all of this was,

that I'm just a tiny, tiny drop in the bucket, and if you put all of the herbal clinics across

the country together, we're just a tiny drop in the bucket in regards to the number, the thousands,

the millions of people seeking health care. So, what that means is we just don't have the data,

we don't have the empirical data to be able to say, yes, this always works for this particular

condition, this works better for this kind of a person and this kind of a condition, and you know,

that kind of data is missing and we don't have residency programs and we don't have, you know,

we don't have that ability to get that kind of experience because the system has stacked the deck

against us. And instead of being the people's medicine that's out there that's available for

everybody like it should be, as is our constitutional right, instead of what we have is we have a

profit-based, you know, corporate oligarchy that presides over the distribution of

profit-based medicine. And that's what it's all about. I'm not going to get into that soap box.

You know, I think I've been there a little bit, but I'm not going to go there now, but I just

wanted to say that that's why, you know, I'm only able to give a certain amount of data out really

because I don't have all the data that I would like to have. And so my entire life as an herbalist,

you know, anything I've been doing about an herbalist, most of it is spent researching other

people's experience, going over my own notes, gathering my own experience, looking at ethnobotanical data

from historical and historical herbal data from eclectic physicians, for instance, back in the

1800s, from the 19th century, when they were actually logging and cataloging this information,

and putting that all together, compiling that together, and then actually, you know, using that when

I have a chance to use it. And that is using with a person who comes in who is ready to actually use

it and actually comply and actually work with the herbs. That's a lot of, yes, that's a lot of

steps to take to be able to verify that this particular plant works a certain way. So, you know,

with all of that said, you know, this is why this is kind of my long disclaimer and my long excuse

here, my long-winded excuses to why I am unable to give you as much data as I would like to,

and not just you, but anybody in any of my classes. And I hope that situation changes. I mean,

that's really what my whole nonprofit herbal medics is all about, is trying to create an open,

you know, environment, an open forum, an actual live forum, an experientially-based forum

for integrative medicine to create, to start to be born, you know, between doctors of all types,

of all specialties, and plant medicine, you know, herbalists, and to be able to work side by

side and see that some things work better to work with, you know, plant medicine just plain

works better. And there's some natural therapies that just plain work better. There's no question

about that. And then there are some therapies and there are some issues that need to be solved

using surgery. There are some things that absolutely have to have pharmaceutical medicine.

So, you know, that's my goal, is to be able to create that kind of environment at that point,

then I think we'll be able to have a lot more data coming in as well. You know, if we ever reach

that point, I don't think we will before we break down, but if we do, then that's a good thing.

So, it's always good to have something positive going on as well as, you know, thinking about the

worst case scenario too. All right, so that's been my podcast for tonight. I hope you enjoyed it.

And thanks for listening. And until next week, this has been Sam Kaufman. Goodbye.

Today's broadcast has come to you through the courtesy of the Prepper Broadcasting Network.

See our hosts, show schedules, and archive programs and more at Prepper Broadcasting.com.

Thanks for listening.

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