We have all heard the phrase “hydrate or die.” unfor­tu­nate­ly most Amer­i­cans fail to heed this advice.  When I was work­ing the Ari­zona desert I noticed an increase in the inci­dence of pul­monary embolisms. So I did a small study and found that every sin­gle per­son was chron­i­cal­ly dehy­drat­ed. Most of them had been in the area for less than two years and had moved from an area of high humid­i­ty. I asked them how much they drank in a day be it milk, cof­fee, soda, what­ev­er as long as it was wet and I was shocked by how lit­tle mois­ture peo­ple were putting into them­selves. I drink at least one gal­lon per day if I am doing noth­ing but pound­ing the key­board. In the ER peo­ple knew I was there because I always had a one gal­lon jug that I would drink every shift, every once in a while I would drink two of them in a twelve hour shift. Bear in mind that I drank that while work­ing in a nice air con­di­tioned build­ing tak­ing care of patients through the night and there were days I still felt dry after it was all done.

Recent­ly I con­sult­ed for a com­pa­ny that has a lot of per­son­nel work­ing out­side in the heat for up to six­teen hours a day. I start­ed to instruct these guys to drink more and had the com­pa­ny sup­ply every­body with a hydra­tion pack to encour­age them to drink more.  This com­pa­ny was doing every­thing it could to encour­age the employ­ees to drink more and even sup­plied the drinks free of charge. Unfor­tu­nate­ly most of them were too stub­born and paid the price with headaches, mus­cle cramps, and fatigue. I give this exam­ple to once again illus­trate that even with the infor­ma­tion and the sup­plies we have to make the choice to do the best for our­selves and our bod­ies.

Let’s look at ways to hydrate.

  • Drink it! This is by far the eas­i­est, cheap­est, and gives us so many choic­es with regards to fla­vors and ways to store our favorite drinks. Water is always num­ber one. The more you work the more you need. The down­side to this is after a while you will wash out elec­trolytes along with those you are sweat­ing out. If we are eat­ing a prop­er diet this will be mit­i­gat­ed.
  • Sports drinks are a good choice also with regards to elec­trolyte replace­ment the down­side is they are gen­er­al­ly high in sug­ar, which we do need just not in a mas­sive quan­ti­ty. There are plen­ty of elec­trolyte pow­ders that can be added to the water, my per­son­al favorite is H3O by Herbal­ife.
  • Milk, yes it does a body good and hope­ful­ly in a post shtf sit­u­a­tion there will still be plen­ty of them around to milk.
  • Teas and cof­fees may also be used. I like herbal teas myself that have no caf­feine and since the base is water it will do us good also. There are many that will say that the caf­feine will dehy­drate you. Yeah if that is all you drink it will have that effect even­tu­al­ly, but it will nev­er remove more than you can take in. Post shtf you can make your own teas if you know how.
  • Soda, avoid this crap. If it is all that is avail­able that is fine but most­ly it is sug­ar or a blend of chem­i­cals that can­not be pro­nounced. There are com­plete­ly nat­ur­al chem­i­cal free sodas that are less dam­ag­ing to our bod­ies but dam­ag­ing they are. Besides post shtf where are you going to get it? End your addic­tion to this stuff now.

What if you can­not drink? Well that real­ly sucks. That means that some­body will have to help you to get hydrat­ed because if you are at this point you are already have one foot in the grave.

The Intra­venous or IV. This is a way to quick­ly and safe­ly deliv­er flu­ids into the body. It can also be used to deliv­er med­ica­tions such as antibi­otics and anal­gesics. The down­side to this method is that you need to know how the start an IV and have all the need­ed sup­plies. Guess what, the sup­plies are read­i­ly avail­able at most farm or vet­eri­nary sup­ply stores. If you are near a col­lege with an EMT, Para­medic, or Nurs­ing pro­gram go and check out their book store. The col­lege near me has all three and I can buy com­plete IV packs includ­ing the flu­ids, tub­ing, and IV catheters for three IVs for $20. Try and get that from the local ER for that price. Gen­er­al­ly in the ER I would give you an IV of 0.9% saline, also known as Nor­mal Saline. This is the per­cent­age that our bod­ies nat­u­ral­ly run on. Occa­sion­al­ly I would give Lac­tat­ed Ringers or D5W- a 5% dex­trose in water solu­tion. LR will prob­a­bly be less avail­able and is not some­thing you could make at home. The prob­lem with using D5W is that it will was out the sodi­um if it is used con­tin­u­ous­ly and the sodi­um is not being replaced then your bud­dy will die, which would real­ly suck.

Post shtf IV treat­ment will most like­ly not be done in a hos­pi­tal. Rather one will have to “guess” as to the lev­el of hydra­tion you have reached for your patient. Eas­i­est way is to eval­u­ate the lev­el of urine pro­duc­tion. If it comes out as fast as it goes in then you can prob­a­bly stop with the IV. Lis­ten to what they are telling you.

Home­made Nor­mal Saline Solu­tion, NSS — First gath­er your sup­plies, pre­vi­ous­ly puri­fied water, salt, pot, ster­ile ves­sel for the flu­id. In a pot place 1/ 4 tsp. salt for every 1 cup of water and boil for 15 min­utes. Once it is cool place in ster­ile ves­sel. Remem­ber this a is a last ditch post shtf way to make an IV solu­tion

As for start­ing the IV, it is not that hard for a gen­er­al­ly healthy indi­vid­ual and should be prac­ticed pri­or to you need­ing or giv­ing that type of help. There are plen­ty of cours­es out there for learn­ing how to start an IV, a local one for me is a wilder­ness first aid course.  I encour­age every­one read­ing to get out there and do such a course.

Next is sim­i­lar to the intra­venous but should only be attempt­ed by some­body that has been trained and that is the Intraosseus or IO. This tech­nique involves insert­ing a nee­dle direct­ly into the bone. It is very easy to do cor­rect­ly and just as easy to screw up. This should be the absolute last ditch if I do not do this my bud­dy dies method, most­ly because of the risk for tis­sue injury and infec­tion. Should you have instruc­tion in this method and want to prac­tice this type of inser­tion, use a Turkey leg to prac­tice the inser­tion.

Anoth­er way to intro­duce flu­ids that is sim­i­lar to the IV is the sub­cu­ta­neous line, SC, which entails insert­ing a nee­dle under the skin. The eas­i­est way to start this is the pinch the skin and inset the nee­dle at the base of the tent formed by the pinch. Most peo­ple use the but­ter­fly type of nee­dle but a reg­u­lar IV catheter can also be used. Prime the IV tub­ing and attach it to the SC nee­dle. Tape it well and do not let the flu­ids free flow or they will look like they have Pop­eye arms, not good. Run it as fast as their tis­sue will absorb the flu­id. If it starts to get all puffed up, back it off until the swelling goes down.

Final­ly a method that is super sim­ple and just about every­body can do it.  All you need is a long tube, a fun­nel, and a source of the clean­est water pos­si­ble, the NSS describe above would be best. Insert the fun­nel into the hose; insert the oth­er end of the hose into the rec­tum. Be sure and push it in as gen­tly as pos­si­ble and remem­ber they may have to return the favor one day. Insert the tube rough­ly the same length as that person’s mid­dle fin­ger. The tube should be rough­ly the diam­e­ter of that person’s pinkie fin­ger. In a pinch for a full grown adult a short length of gar­den hose could be used. Try to purge the air from the line pri­or to inser­tion or the first thing in will be air, not water. Add the water until it no longer flows freely and just sits in the fun­nel. Remem­ber to keep the fun­nel a few feet high­er than the patient, because grav­i­ty works. As soon as they can drink remove the tube.

Some assort­ed IV, IO, SC, catheters, IV Tub­ing, and a bag of NSS, Click for Larg­er Image

For ref­er­ences, on how to prop­er­ly start any of these lines please seek pro­fes­sion­al instruc­tion. At the very least get a med­ical text­book that shows the prop­er tech­niques.  There are a few good videos on Youtube, but they are real­ly not geared for a post shtf sit­u­a­tion. As always this is just for infor­ma­tion pur­pos­es and should be used at your own risk.

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