Episode-1151- Dr. Bones and Nurse Amy on The Survival Medicine Handbook — 42 Comments

  1. For anesthesia.. how about Nitrous oxide?

    Not to knock you out, but just to reduce the awareness of the procedure.

    Then of course, there’s alcohol, but I assume there are problems with blood thinning. (?)

  2. My 11 year old daughter just had a artificial heart valve put in. I would love to know what herbs might replace her warafin blood thinner in an emergency. She can not live without it.


    • Dan. Ginko is a good one, but may be too powerful to use without guidance. You should consult with a clinical herbalist or naturopathic doctor. This is too import & scary to leave to us.

    • Dan,
      Keep in mind that nutrition also affects the actions of warfarin (e.g. green veggies, etc).
      So, even without replacing warfarin, you might be changing her degree of anticoagulation by making nutritional or herbal changes. This does bring up the idea of changing diet to make warfarin more effective. BUT you need to monitor this.
      Agree 100% w/ prior comment: Definitely hook up with a knowledgeable local provider. Finding an MD or DO who works well with complimentary medicine (specifically herbal medicine) would be key.
      This is too high-stakes to “roll your own” with various internet opinions. Esp. if it’s an aortic or mitral valve, stroke is a real risk if you get it wrong.
      Hope this helps,

  3. Anesthesia has been used over to 150 years – the first use was by a surgeon in Georgia in 1842. It was also used on Queen Victoria in 1853 during childbirth. As you mentioned, though, it was dangerous in the early years because surgeons did not understand dosages.

  4. Nurse Amy,

    Believe me, you’re not the only one that’s angry about the privacy stuff.

  5. What happened to the Doom adn Bloom Podcast? I have not received an update and cannot find anything after February.

    • Here is our podcast page:

      I don’t know what happened to our feed? Looks like itunes had an update and I need to resubmit. Also our website has the podcasts uploaded on our podcast category. We have been traveling so much! So glad to be home for 6 weeks, all the shows will be new.
      Thanks for the support,
      Nurse Amy 🙂

  6. Here’s a tip: if flies are crawling trough the wound, STOP SEWING! As sexy (and profitable) as it is to teach suturing, there is really no good reason to learn it unless you have a basic understanding of wound management. The snotty comments by “Nurse Amy” in the interview demonstrate her lack of this basic knowledge. While it may not sell as well as teaching sewing, teaching the plethora of less invasive wound closure techniques (steri strips, tissue adhesive, dressings, tape) would provide much more real world benefit. I believe the most relevant phrase is, “Missing the forest for the trees”.

    • Sounds like you might need to listen to the episode again and better yet that you might need to get to Bones and Amy’s class. Perhaps may be read the CVs or Dr. Joe Alton, M.D. and Amy Alton, ARNP, they are not exactly thin on experience and education.

      • Precisely why I was disappointed to hear Amy’s hostile remarks about the Patriot Nurse. To his credit, Dr. Alton gave a reasoned response, but Amy’s comments were offensive. The reality is that no one person has all the answers and we should avoid engaging in personal attacks on other preppers.
        Having said that, I read their bios and respect their backgrounds but have some different opinions regarding the topics covered.

        • There is a difference in being hostile and responding to what also can be called hostility. PN’s comments on suturing and not being worth learning are DIRECTLY pointed at the Anton’s. I like Patriot Nurse, I really do or she would not be on TSP, and I don’t argue with my guests, I let them say their piece. But let me put it this way I can VERIFY the credential of Joe and Amy Anton, I can’t verify anything about PN, not a damn thing.

          She claims to be an RN, I take her at her word but as she won’t give her last name out I can’t verify that can I?

          Her comments on

          Cayane Pepper = wrong
          Suturing = wrong and frankly Amy is probably right she probably isn’t qualified to teach it

          Different people have different opinions but Amy is a bit riled up because she feels (and I think rightly) that the only reason that PN craps on suturing is they do it and she doesn’t.

          I did send Amy this picture after the interview, LOL

          Frankly I would have felt a need to challenge a few claims by PN, but since I knew and MD and NP were up soon after didn’t need to. Again I love what she does, but it doesn’t mean she is always right.

      • Can’t they both be right? I listened to both episodes, and I think that each has a perfectly valid reply based on circumstances. I just think that each of them are looking out for their own bottom line and best business interest. Are they not competing for business in the same general marketing audience?

        My guess would be if all three of these folks were in the same room during a SHTF situation, they’d work well together and let each other’s opinions dictate the proper course to take for a patient.

        • They could if PN wasn’t taking an absolute stance of don’t bother it flat out isn’t worth it. If you go to the Anton’s class you will find the MAJORITY of it is based on wound care without sutures. Suturing is one technique, as I said to devin, saying any skill isn’t worth learning is really kind of silly. I can name hundreds of skills I possess I am likely to never need, it is the ONE TIME they are needed we train for.

          I have dealt with injuries, I haven’t ever stitched anyone up BUT I have always been able to stabilize and forward. We train here for when that MIGHT not be an option.

          Again PN and the Anton’s agree right up until PN says, it isn’t worth doing. I really should have asked her how many firearms classes she has taken (more then one) and then asked her if she has ever needed to shoot anyone. Again though I don’t debate my guests I leave it up to the audience to judge for themselves and make their own choices.

  7. Sounds like I needed more background on where that fight came from. I was not aware that PN had taken a swipe at The Anton’s first. I guess I should repeat my earlier statement about not attacking other preppers with emphasis TOWARDS PN.

    I listen to a lot of “medical experts” speak about these topics. Frequently their stories, anecdotes, etc reveal their complete lack of real world experience or reliance upon urban myth as their evidence to recommend treatments, etc. I have heard enough from PN and the Anton’s to have formulated opinions on both.

    I did a cursory literature search on cayenne pepper and hemostasis and came up empty. I would be interested to see the supporting evidence. The suturing question is an entire conversation but can be summed up as: probably NOT a good idea to do except in such rare instances that the time spent learning it would be better spent doing something else. Or consider it as the famed physicist and Nobel Prize winner Richard Feynman did safe-cracking: a hobby not to be used in real life.

    I did try to verify PN’s credentials a few months ago when I first saw her as some of her comments were questionable and I too was interested in what she was saying but couldn’t find much on her.

    Great pic!

    I would be happy to send you my credentials if interested but would prefer to maintain the (really minimal) anonymity I might otherwise preserve on this board.

    Please email me separately if you’d like to hear a different perspective on this topic and to verify my background. Thanks!

    • Um how likely are you to NEED to shoot someone? Have you taken weapons training.

      If we use your above logic your time training with a gun is better spent on another task.

      I have trained myself in all varieties of friction fire. My chances of NEEDING any are almost non existent, I keep ways to make fire with me at all times with multiple redundancies.

      I have taken tactical driving training, my odds of needing it are low, very low.

      I have studied primitive land navigation techniques. Of course I have a GPS (high tech) and know map and compass reading (low tech) and have gear in every kit and go no where without it. So how likely is it that I would have to rely on a sun compass?

      It is really silly to say any skill isn’t worth learning isn’t it?

      FTR DIRT will help stop bleeding. It ain’t a good idea but if someone will bleed out with no other choice it does work.

    • Not to be a total science-geek, but my search on capsaicin (the “active ingredient” in hot peppers) is actually a blood thinner (inhibits platelet aggregation):

      It looks like a bunch of other spices, including cumin and cinnamon have the same effect:

      In fact, this article suggests that one of the chemicals (eugenol) found in cloves is a better blood thinner than aspirin.

      However, this does NOT mean that cayenne pepper doesn’t cause hemostasis in a wound…it might be by a different mechanism.

      • Pepper has numerous contradicting actions. Rather than thinking in pharma terms, it is better to think in herbal terms. Pepper is a circulatory adaptogen. Taken orally for example it will either heat or cool the body temperature based on which the body needs (IE it treats and prevents both hypo- and hyperthermia). It is the secret ingredient to coping with weather extremes. I’m not the least shocked that it would act as a “blood thinner” for people at risk for clots. I’d be shocked if it didn’t have the opposite effect for people with bleeding disorders. Hot pepper tea has also been shown to be about as effective on heart attacks in progress as nitroglycerin.

        • Indeed capsicum when taken internally does thin blood when put on a cut though it causes clotting.

          Here is one well sourced article on it

          The person that doubts it need only take the next superficial scratch that is bleeding, dump some on and find out. Yes it will burn so did iodine when our grandparents put it on every scrape we had and hell that doesn’t even help it just hurts. So don’t be a tea cup doubters sooner or later you will bleed in some meaningless way, try it, it won’t hurt you.

          That said if you put this crap on your face or nether regions, you only have yourself to blame! Either way you will cry but don’t cry to me for that, LOL.

  8. Suturing is what is called a monkey skill. Any monkey can learn to suture. the real art is knowing when to suture. I have been first-hand witness to real harm visited upon patients by people with a skill they possessed but didn’t really understand. it is the very low probability that you will need to shoot someone that requires you to attend more training. if you dealt with shoot no shoot decisions all day long you wouldn’t need more training.

    • I have to agree with Devin on this one (the suturing issue itself; I’ve no knowledge or opinion on the spat between the other parties mentioned…)

      The real value most surgeons bring to a situation is is knowing when to do what. The technical skill is secondary.

      So, sure Jack is right, suturing is a good skill to have. I doubt anyone’s arguing that it’s totally useless. But in many cases it’s not needed and misprioritizes things. Cleaning the wound is primary and ensuring good drainage is part of this.
      If you primarily close a dirty wound, even one that “looks clean”… infection.

      90% of the closure needs can be done with “ghetto steri strips” (strapping tape cut into narrow strips and super glue on the ends, iodine or bacitracin over the middle). A lot more likely to be at hand than a suture set-up (need a clean set up most of the time for a primary closure, and, movie heros aside, you’ll want some anesthetic… want to use $75 worth of supplies to do what you can with tape and glue?)

      In a lot of trauma/first response discussions there is always a big debate about when to use different tools:
      e.g. intubation, chest tube, etc.
      sutures and invasive lines fall into the first-response type area…
      Everyone wants to do the more “technical” thing. IMHO it’s wise to teach some perspective instead of a “right” answer on one side or the other (always/never). I’ve seen it go the other way with some of these procedures because people were afraid to do the more challenging thing.

      Anyway, HTH someone,

    • Ever try using steri strips on a dog? Humans aren’t the only thing you might need skills like that for. Unless you think that going from now where in a lot of areas a vet on the weekend doesn’t exist to a collapse that you are going to take your dog to the local vet after it gets injured.

      Also a side note, I’m just old enough to remember when doing stitches without 15 Novocaine shots was normal. It was common to ice the spot until the cold stopped bothering the person, then sew quick. I could also see something like clove oil being better than nothing.

      • Ice does work but unless it winter in the north there might not be much of it around in a circumstance where this is needed. ;>)

        Clove oil does work somewhat, I bet there are ways to make up a local from the right herbs that would have some effect.

        You an always use bull ants too. Let them bite, cut of the head. This actually works and it isn’t a “sting” they do that with their buts just like wasps/bees.

        • In the continuum I see plenty of grey area where your freezer works fine, but getting to a doctor isn’t practical for a spectrum of reasons.

          I had bull ants down in Brazil and I did mess around with getting them to clamp down on leather so I know how to use them, but I don’t recall ever seeing them in the US. They are a lot of fun to mess with. I know them if I see them so if they are where I end up at great. I’d love to see something that imitates bull ants for trauma kits. They would close that gap between where steri strips aren’t going to cut it, but you don’t want the permanence of stitching either.

        • Now I am not sure what these ants actually are. We had these huge headed ants in Florida growing up, everyone called them bull ants but that doesn’t seem the proper name. Can’t seem to figure out what they were, there is something called big headed ant that is a recent invasive but that isn’t what these were.

        • I don’t remember what the species name was in Portuguese and I never learned it in English, but any ginormous headed ant would probably work. The ones I had about a 3/8″ jaw span when they were open, and about a 3/16″ head that was one giant organic gear box for the jaws. Biggest ant I have local are the big red ants that look a lot like fire ants.

  9. I might be over looking it but I don’t see a stethoscope on their Amazon affiliate store or in the packs that the build. Do they recommend having one? If so what is one, hopefully on amazon, that they would recommend?

    • Yeah I went back and saw them in the bigger kits they offer. Hopefully they will offer/recommend one on the affiliate store since I am slowly building a kit. I know their kit is awesome I just can’t put out all of that cash right now.

      • Oh I get that I do, Amy did everything plus the kitchen sink and the laundry room sink to boot. That adds up.

  10. We spend a grand majority of the class teaching wound CARE including: fluids used for cleaning, what fluids are harmful when cleaning and caring for wounds, techniques used to best clean wounds (serious irrigation, a 60 or 100cc syringe is a good item to have on hand), how to check for debris and removal, how to care for an open wound, preventing wound infections, treating infected wounds, different techniques to close a wound which STRONGLY emphasizes non-invasive methods including steri-strips, butterfly bandages or even a regular bandaid if it works! Greater harm can be caused by closing a wound with staples or suturing and really should be a rare circumstance. Adding two additional holes on either side of a wound is usually NOT a good idea when someone already has a laceration! I hope you are getting the picture that this is not a “let’s all suture” class. It really is a wound care class with all options covered. We are able to teach all the options because of our medical training. I just don’t think it’s mutually respectable that PN goes around telling people (in her classes, on youtube and in interviews) they shouldn’t learn about ALL the options regarding wound care and closure methods just in case, so I’m sorry if I sounded somewhat offended.
    I have tried several times to reach out and communicate with her over the past 2 1/2 years so we could work together in helping teach others, including asking her to be on our show so she can share her knowledge and ideas, but she does not respond.

    I do not think our wound care class is “glitzy”, it’s about helping your patient IF there is no modern medical help available and you have to do what is needed, but always using the LEAST invasive method to pull a wound together. Do no harm!

    We have learned many different skills that we may never use in our lifetime but are happy that we at least have some knowledge about them now. Basic wound care is VITAL, but also knowing when to leave a wound open and when (and how to properly) to close it up may be a skill you wish you had. I certainly hope it never comes to that, I assure you. We just happen to be at these expo events and offer to teach the attendees who may be going anyway.

    It really is our hope to get out medical preparedness knowledge and continue to work with others doing the same. We need to work together, community is everything!! So PN if you would like to contact me, I would be happy to work together and discuss our mutual goals of helping teach medical preparedness…the olive branch has been offered.

    Thanks for the support Jack and others, we really do appreciate it greatly,
    and we will continue to help share what we have learned with others,
    Nurse Amy

  11. Amy, I like this response. As I’m sure you’re aware, much advice of dubious quality can be had in this realm. Perhaps I misjudged your comments based upon an incomplete appreciation of the back story with you all and PN. I believe reckless medical advice can be exciting and fill class seats, but ultimately perpetuates the old “survivalist” stereotype. I’ll try to listen to more of your podcasts and welcome a reply. Thanks!

    • Thanks Devin,
      I wanted to let you and others know a little more about what we are really trying to teach, which is complete wound care, not just suturing. Safety of the patient is #1 and we are very careful about what we teach. Thanks for taking the time to read my response and understanding what I really was really feeling and thinking during the podcast recording.
      Nurse Amy

    • They won’t say it in response to this, but I will,

      ” I believe reckless medical advice can be exciting and fill class seats”

      They have NO NEED OF MONEY, they do what they do today because they have the hearts of teachers. The end, done.

  12. @Nurse Amy, There is something I’ve been meaning to do, but haven’t yet, and it occurred to me that you might already have it. I was planning to tally the contents in your bags to have a comparison grid, and add the cost for the items if I were to buy them from Amazon. That might make for a good marketing page. Also, for those of us that have a bunch of odds and ends, have you ever considered having a “build a bag” type page where the buyer selects the bag, then clicks each of the contents they want as an ala cart? Not sure if it is feasible, but it sure would be a cool option.

  13. Cannabis Indica had been used in the United States for over 100 years as pain relief. While it is currently Federally illegal there are states that have started “medical” programs and two states that have legalized cannabis in small quantities. It also has a synergistic effect with opioids such as hydrocodone, codeine, and oxycontin. This will reduce the need for powerful opioids being used in dangerous quantities, they’ll have a longer shelf life and ,unlike everything else out there, you cannot O.D. on cannabis. You can get really sick ,but it will not shut down your heart, lungs or brain functions.

    And God said, Behold, I have given you every herb bearing seed, which is upon the face of all the earth, and every tree, in the which is the fruit of a tree yielding seed; to you it shall be for meat.- Genesis 1:29

  14. Great show, Jack!
    Dr. Bones, Nurse Amy; You guys were awesome! I never thought medicine could be so fun!

  15. During my EMT-Basic final our instructor snapped at random intervals to distract us. Thing is, if you looked up you failed; “get your stuff and excel elsewhere”. The paramedic school I’m looking at going to requires x amount of PT and a lot of the practical teaching and testing is done outside under stress (temperature, yelling, rain, sun, and real world problems). Thankfully there are still places that realize that knowledge without true mileage is BS.

  16. Just ordered the new book after listening to the podcast! Excited to have a resource like this in my library!