Bag Drop: The Wildfire Bug-Out Bag

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I live in a mountain oasis — my little taste of heaven. My closest neighbors are three miles away. My little off-grid retreat is surrounded by pine, mahogany, and juniper. I’m relatively self-sufficient here — comfortable enough to survive the zombie apocalypse. However, my biggest threat every year is one that’s not confined to the realm of fiction: wildfires.

Wildfire season in Nevada typically lasts from June through November, with seasons in surrounding states sometimes lasting through January. Dry weather combined with strong wind gusts could burn thousands of acres within hours. I know if a wildfire approaches, my best and safest bet is to grab my bag and evacuate to town. Ideally, this would mean notification during the day with ample time to get in my truck and drive the five miles of dirt road down the mountainside to the paved road that leads to civilization.

However, with unfavorable winds, I could be looking at a 0200 wake-up and sprint to the side-by-side because our only egress route is blocked. I have to be prepared for both scenarios. With this in mind, I chose a hiking pack to be my Wildfire Bug-Out Bag. After all, the situation could mandate I travel via truck, side-by-side, or on foot based on the fire location, thickness of the brush, and unfriendliness of the terrain.

The Bag

The bag itself is an Osprey Ariel 65. I’ve had this pack since 2013 and haven’t been disappointed. While I could talk all day about the multitude of features and the Osprey’s reputation for solid products, I’ll focus on the final selling point for me: an adjustable, female-specific design. As a 5-foot-3 woman, it was imperative that I found a pack I could customize to my body shape. Like many vertically challenged people, my torso is quite short. Combine this fact with mother nature’s birthing hips, and you can understand the challenge of finding a hiking pack that fits.

The Osprey Ariel 65 women’s version has an adjustable harness system, curved shoulder straps for the female form, and a heat-moldable hip belt to ensure a snug fit around your unique body shape. There are many companies that currently offer female-specific packs. Not every pack fits every body shape well, so try on each brand until you find one that suits you.

Osprey no longer makes this particular model, but you can find the updated Ariel AG 65 version on the company’s website.

The Contents

My intent is simple: get to safety and be prepared to rest in place for five to seven days until I’m cleared to go home or able to link up with friends or family. To me, this means probably spending a few days at an evacuation center or pop-up shelter. Do I still have long-term survival tools in my pack? Absolutely. I’m still prepared. However, they take up a small fraction of the space available, and these are items I’d rather have and not need than need and not have.

I’ve strategically placed items in the pack based on how quickly I need to reach them. The outside hip pockets contain the items I want to use without having to take the pack off: knife, flashlight, female urination device, and RATS tourniquet.

Above: Having a bag-within-a-bag, in the case of the author’s hygiene supplies, can help compartmentalize and prioritize survival needs if shedding excess gear becomes a necessity.

The pack lid is completely removable. Inside, I’ve packed items I’d need to access rather quickly. These include welders’ gloves in case I come across burning items that need to be removed, safety goggles to protect my eyes from ash, and other basic supplies — first-aid kit, LifeStraw, poncho, collapsible water bottle, and instant energy gels.

The first item inside the main compartment is my hygiene bag. This is a small Creek bag with pockets to keep supplies separate and easy to access. Under the secure flap, I hold my travel toothbrush and toothpaste, deodorant, wilderness wipes, pocket shampoo, and body wash leaves from Trek & Travel. In the zippered pocket, I carry a small microfiber hand towel, larger body bathing wipes, sunscreen, lip balm, and spare Colgate wisps. Again, the intent is to stay hygienic and healthy while displaced. Here, I also keep my “survivalist” gear: waterproof matches, compass, 550-cord, extra batteries, and multi-tool. I also keep a few hundred dollars in cash in the event I couldn’t grab my wallet as I was leaving.

Inside the pack are items to use once I’ve reached a safe destination: a sleeping bag, small blanket, an extra set of clothes and Goretex layers I’ve vacuum-sealed, shower shoes, a set of hiking boots, and a few trash bags. Additionally, I have some freeze-dried food, just in case.

Closing Thoughts

I’m fortunate enough to have a fireproof vault where I keep all of my important documents. Otherwise, I’d be packing another bag to place inside this pack. But that’s the beauty of this particular bag — it can fit a lot of stuff! It also still has plenty of room for me to shove those last-minute additions: wallet, phone, and pistol with extra mags. I hope I never need to use this bag, but knowing it’s there makes me feel a lot better about the one threat that could force me from my refuge. Until then, I’ll keep my ear on the scanner and watch for fire planes above.

Make & Model
Osprey Ariel 65

MSRP
Original version seen here discontinued. Updated version $310.

URL
www.osprey.com

The $50 Apocalypse Challenge

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Preparation makes you better-equipped to deal with an emergency before it happens — hopefully years, months, or at least a few days ahead of a disastrous event. But what if you found yourself in a situation where your preparation window was a matter of minutes, and your resources were limited? Although none of us would ever want to be in that position, it’s an interesting exercise in quick decision-making and gear prioritization. In a recent video, Shawn Ryan of Vigilance Elite and Mike Glover of Fieldcraft Survival used their experience as survival instructors and former U.S. Special Operations team members to approach this problem. Specifically, they gave themselves $50 and 10 minutes to buy SHTF gear at WalMart for their Apocalypse Challenge.

After a few minutes of speed-shopping, Ryan and Glover sat down to unpack and analyze their purchases, from first to last. Glover’s first few items, a tarp with bungee cords and a water bottle, addressed some of key points in the “Survival Rule of 3s” — three minutes without shelter (in severe conditions) or three days without water can be fatal. Ryan went straight for a tool that provides the means of acquiring other tools: a crowbar. This item could be used for forced entry and scavenging in dire circumstances, but also serves as an impact weapon for self defense.

Their other picks diverged slightly — a folding knife versus a multitool for cutting tasks, and a LifeStraw versus a large bottle of bleach for water purification. In the end, each looked at their picks in retrospect and discussed what they would’ve done differently. Check out the full 34-minute video below, and even if you don’t spend real money on this Apocalypse Challenge, keep it in mind next time you’re out shopping. You never know when you might need to grab some last-minute survival gear, and it’ll be easier if you think about it before that day comes.

Louder Than Words: Behavioral Cues for Situational Awareness

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One of the preeminent facets of self-defense is situational awareness. Unfortunately, those two words have become a catch-phrase-turned-mantra beaten to death by nearly every book, video, instructor and Internet forum about personal protection. But so much of the talk about situational awareness seems to be just people yelling at each other to make sure they have it. Rarely do we see a concise, level-headed, repeatable explanation as to exactly what mental processes make up this mystical “awareness” and how exactly we use them to protect ourselves from potential threats.

In contrast stands Orbis Operations — a company that provides training and support services to government agencies and military units around the country. Among their offerings is a set of classes on Situational Awareness Training. This training is based off a process that Orbis refers to as Human Behavior Pattern Recognition & Analysis. There are several variations of their SAT curriculum, including a five-day SOFSAT or Special Operations Forces Situational Awareness Training. We had the opportunity to attend a couple days of SOFSAT and came away with a much better understanding of exactly what situational awareness consists of and how we use it to our advantage.

The Orbis website has this brief header on it: “All individuals give off signals when they are measured against context, relevance, and the local societal baseline. In certain circumstances, these ‘signals’ can, with the proper training, be read as anomalies. Establishing a baseline, detecting (and then acting on these anomalies is the essence of Situational Awareness Training …” In class, the instructors further refined this down into a concise, easy-to-remember formula they referred to simply as BAD, or B + A = D, Baseline + Anomaly = Decision. This is, in our opinion, the crux of the Orbis methodology. So let’s break down this formula and see how one is able to go about living it.

Baseline

The baseline of any given social group or geographic area is, in short, what is normal. But since normal can sometimes be a touchy word to define, maybe it’s better to say that the baseline of an area is what’s habitual. What are the attitudes, actions, and overall behavioral patterns that constitute the routine tempo of the world around you? To avoid any vagaries or generalizations, the instructors at our SOFSAT class outlined six individual facets, or domains, of situational awareness:

Heuristics: Heuristics are “mental shortcuts” that can be used when other information is limited to influence a snap-decision and help prime you for action as necessary. This may be explained by the old phrase “if it walks like a duck …” or Occam’s Razor that, very loosely translated, says the simplest answer is most likely the correct answer.

Proxemics: How people interact with each other in groups. This could include things like how far or close people stand while interacting, if people in a group all seem to focus on or mimic the demeanor of one individual or if certain individuals routinely travel with an entourage of followers.

Geographics: How people interact with their physical terrain. This can be particularly important in natural gathering places like parking lots, stadiums, stores, and street corners that may be claimed as “turf” by criminal actors.

Atmospherics: Atmospherics is the overall “feel” of a place — the sights, smells, sounds, and general demeanor. For example, if we asked you to close your eyes and imagine a carnival, we’re guessing your mental picture might include flashing lights, bells ringing, people screaming on rides, the smell of fried food, and an overall air of excitement or joy. Those inputs, and the overall feeling they create inside you, make up the atmospherics of your surroundings.

It’s safe to say that the interaction between these two people isn’t pleasant. But how we know could be a...

Biometrics: Biometric cues are more focused on an individual and their body’s response in connection to their interactions. Are they sweating, is their skin flushed, are their pupils dilated, can you see the pulse pounding in their neck or the vein popping out of their forehead? These are biological indicators of a feeling or an intention that a person may be attempting to hide under the surface.

Kinesics: Kinesics is about body language. Separate from biometrics, which deal in the body’s automatic responses, kinesics focuses on physical movements. Things like cracking your knuckles, stretching, rubbing the back of your neck, or “grooming gestures” like consistently stroking your face or wiping your nose could all be kinesic indicators of something being not quite right.

All of these six domains are like pieces of a puzzle. A thorough understanding of every domain will give you the fullest, most complete picture of your neighborhood, patrol beat, or area of operations. But, as with a partially completed jigsaw puzzle, you don’t necessarily need every piece in place to figure out what the picture is.

Anomalies

Any behavior, whether from an individual or a group, which breaks from an established baseline, qualifies as an anomaly. Some can be really subtle, while others are blatantly obvious. But neither one will do you any good if you’re not attuned to them. One of the easier types of anomalies to quantify is the proxemics pull/push. A proxemic pull or push is any stimulus that causes people to gather or disperse outside of regular patterns. When you’re driving home and you pass an accident on the side of the road with a group of people pulled over on the side of the road standing around, that’s a proxemic pull — the car crash has literally drawn people to it and created a crowd who wouldn’t normally be there. Likewise, a mosh pit breaking out at the front row of a concert may cause a proxemic push, causing everyone else to drift quickly away from their assigned seats to avoid a stray elbow to the head.

The goal of Orbis Operations’ Situational Awareness Training is to understand the nature of a threat before it gets...

A geographic anomaly may be as simple as walking across a dark parking lot and noticing a tightly knit trio of people huddled in a pocket of shadow beyond the street lamp. Everyone else is walking directly to or from the store, but this one group of individuals just seems to be hovering in an area that most people simply transit without stopping.

Other anomalies are much more discreet. One of the most fascinating examples we heard from SOFSAT went something like this: you’re walking down the street when a man approaches you and asks for directions. While you’re trying to remember the street names, he begins rubbing the back of his head and neck. Might just be a stiff neck. But inside your brain is a small gland called the hypothalamus. It controls automatic functions in the body like blood pressure, heart rate, and alertness. It’s a stress indicator. When a fight-or-flight response occurs, the hypothalamus heats up and begins to work overtime. He’s literally getting hot under the collar. Watching somebody begin to rub the back of their neck or head — when measured against other cues — may actually indicate that they’re preparing for a fight you don’t know is coming.

Having said all this, there are vast numbers of individual behavioral anomalies that could be identified in any given situation and people often exhibit seemingly “odd” or “abnormal” behaviors for perfectly good, benign reasons. So how do you process this running mental calculation to avoid going through life in a state of tweaking paranoia?

Decision

There are a couple of different mental processes you can execute once you’ve established a baseline and spotted an anomaly. The framework of this article is Orbis’ own B + A = D procedure. Now that you’ve arrived at a decision point, what can you (or should you) decide do to? Our instructors put forward a three-prong answer to this question. You can act, report, or continue to observe.

The “act” decision can be any range of things from drawing your concealed pistol to simply taking a different route home, or waiting to stop for gas until you’re in a better neighborhood. Reporting options may include notifying a police officer or security guard, or your chain of command if you’re a first responder. Finally, keeping an eye on the situation for further developments is indeed a legitimate option. While you don’t necessarily need all the information to take action, you still need enough information. What that threshold is will be different for every person and every situation. One caveat to this, which was advised to us during our training, was that you must take action if you observe three anomalies in any domain or combination of domains.

The science of behavioral analysis is one of the most effective self-defense tools you can have in your skillset. But just like any skill, you must build a proper knowledge base and then practice it consistently. Orbis Operations teaches different versions of their Advanced Situational Awareness (ASAT) curricula to various government and commercial entities across the country. There are also a number of books available on the subject. Just check your local Internet search bar. We may not be able to prevent danger from entering our lives but, with some well-studied awareness and analysis, we’ll have a much better chance to see it coming.

Source
Orbis Operations > www.orbisoperations.com/sat

Battle Belt Setup with Dan Brokos

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If you carry a handgun on a daily basis, you’ve probably put quite a bit of thought into how you carry it — holster type, material, placement, cant, and so on. You may also carry associated every-day carry items, such as a spare magazine, medical kit, and flashlight. For EDC purposes, it’s likely that you’re concealing these items to maintain a low profile. However, there are also times when concealment is no longer a priority, such as range days, hunting trips, or even long-term disaster scenarios. In these cases, an overt battle belt setup offers a comfortable and immediately-accessible way to carry a larger assortment of gear.

In a recent RECOILtv episode, Dan Brokos of Lead Faucet Tactical covered the basics of setting up a battle belt, and showed off his personal setup. Aside from the obvious holster and spare pistol mag pouches, his setup also includes an extra rifle magazine, dump pouch, Blue Force Gear individual first aid kit, and Leatherman multi-tool. Depending on your environment and needs, you might add various items, such as a fixed-blade knife, handheld flashlight, or general-purpose pouch with communication, signaling, or navigation tools. A battle belt is a blank canvas that can accommodate any of this gear.

Watch the full episode below, and check out RECOILtv for more tips on guns, gear, and training.

Improvised Weapons with Ed Calderon

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Those of you who follow me on Instagram will know that over the weekend I attended a two-day “Surviving Inside the Kill Zone” class taught by Ernest Emerson of Emerson Knives and Ed Calderon of Ed’s Manifesto. The class conveyed a wealth of useful survival skills and lessons, which we will be covering in detail in a future article.

Above: A post-class photo with Ed Calderon and Ernest Emerson. Don’t let my above-average height fool you — both of them could absolutely wreck me in a fight, thanks to their decades of hard-earned experience and training.

One exercise was especially crafty — those who have attended Ed’s weaponology and counter-custody classes in the past know where I’m going with this. For our homework assignment after day one of the class, all students were told to construct a deadly improvised weapon from scavenged materials in approximately 5 minutes. The intention was to get students thinking like criminals (an “adversarial mindset”) so we could develop a better understanding of what threats we might be up against in the real world. The results were fascinating.

Above: An assortment of weapons students created, including spikes, punch daggers, slash-cut “ventilator” tubes, slicing blades, and impact weapons. The pink Hello Kitty fruit knife is part of Ed’s personal collection — a demonstration of how a less-threatening appearance can help you sell the narrative that you don’t intend to use it as a weapon.

During this class, I was staying with family, so I raided my dad’s garage for an old tool he wouldn’t mind giving up. In a toolbox drawer full of paint scrapers and putty knives, I found the scratched and rusty scraper pictured below. Its thin metal blade was strong enough to hold its shape, but flexible enough to prevent immediate chipping or breaking. In the same toolbox, I also found a Sharpie marker, tin snips, a file, and some scraps of thin cardboard packaging.

Constructing the Improvised Weapon

Priority one was to meet one of Ed’s recommendations: the Rule of Thumb. His previous interactions with hardened killers in Mexico indicated that many of them constructed stabbing weapons with blades the length of an outstretched thumb. This is long enough to cut through key weak points on the body, such as the heart and subclavian artery. That may sound gruesome, because it is. But it’s exactly the type of cold logic used by those looking to employ brutal violence against unsuspecting victims.

I used the Sharpie and a ruler to trace out a rough shape for the pointed blade — not so thin that it’d snap or bend, and not so thick it’d get caught on clothing or fail to puncture. Then, I carefully trimmed the scraper’s square corners into a sharp point. The sharpness was enhanced using the metal file, working it back and forth quickly on each side to create a simple dagger. I also used the file to add a few crude grooves on the sides of the handle for additional grip.

Next, a few items from my every-day carry backpack came in useful. A few passes through the carbide and ceramic notches on a Lansky knife sharpener got the edge even sharper and removed burrs from filing. I folded the cardboard I found in the garage tightly around the blade, then wrapped it in duct tape, punched a hole in the end, and added a knotted piece of paracord. This cord allows the sheath to be tethered to a belt loop, so when the knife is pulled from the waistband, its improvised sheath falls away in a single swift movement.

Satisfied with my creation and not looking to drastically overshoot the 5-minute time frame, I put the DIY shiv into my backpack and brought it to the second day of the class. I was glad to hear Ed give it some positive feedback, saying it looked capable of inflicting some serious violence.

Lessons Learned

In the end, what did the students learn from this improvised-weapon-crafting exercise?

First, we learned to think creatively about alternate uses of everyday items — a metal windshield wiper blade, half a pair of scissors, sharpened chopstick, or even a meat thermometer (one of my personal favorites due to the irony factor) can make a very effective weapon for self-defense in a pinch. Many of these tools are just as capable of lethal force as the fancy $250 fixed blades seen all over Instagram pocket dumps.

This brings us to a second lesson: disposability. Unlike that fancy fixed blade, these weapons are naturally inexpensive (or free) and difficult to trace. That’s why bad guys around the world tend to commit crimes with them, rather than serial-numbered production knives that could easily lead investigators right to their doorstep.

A third lesson is more mental than physical. A few people we’ve mentioned this project to don’t see the value at first. Why make a crude shiv like a criminal if you’re not planning to use it for nefarious purposes? The answer is simple — know thy enemy. If you understand how the average bad guy chooses weapons, the most common characteristics of these weapons, and the most common ways they’re used, you’ll be more prepared to defend against them. Much of the “Surviving Inside the Kill Zone” class focused on common edged weapon attacks, evasion methods, and potential counterattacks. In other words, the “software” that matches this improvised “hardware.”

If you’re interested in learning more, keep an eye out for our class recap article in a future issue of RECOIL OFFGRID. You can also check EdsManifesto.com for future class dates, or just go try this exercise in your own home. Think like a bad guy — if you face one someday, you’ll already be better prepared.

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Video: Quick-Deploy Tarp Shelter Setup

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Whether you’re camping, backpacking, or preparing a bug-out bag, a good shelter is essential for staying warm and dry. In many cases, this means a tent, but tents have some noteworthy downsides. Many tents are heavy and bulky, and those that aren’t — especially those in the ultralight category — can be expensive and complicated to set up. If you’re looking for a minimalist shelter from the rain, a tarp is a great option. In the following video, British YouTuber MCQ Bushcraft shows how he constructed a quick-deploy tarp system for overnight stays in the woods.

The tarp itself is nothing special, but the way it has been configured intrigued us. It’s packed with a permanently-attached paracord ridgeline with a pre-tied loop at one end and prusiks for tensioning. Short elastic cords have been added to the tie-out points, and these can be connected to the prusiks on the ridgeline with a simple toggle stick, as seen above.

Once it’s time to tear down the shelter, just pull out the sticks and start packing the tarp back into its waterproof stuff sack. Building a setup like this won’t cost much money, won’t occupy much space in a backpack, and won’t take much time to construct when you arrive at your campsite. It’s a great way to get out of inclement weather, even if you don’t have the luxury of a store-bought tent.

Check out the full video from MCQ Bushcraft below:

All Choked Up: How to Relieve Airway Obstructions

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We’ve all been there — you swallow a piece of food that was too big and begin to panic that it won’t go down. For some people, it actually doesn’t go down and starts to become a medical emergency. However, taking too big a bite isn’t the only thing that could cause you to stop breathing. Let’s look at some common airway obstructions and methods to relieve them.

What is the Airway?

Let’s talk about the airway first. It’s the gateway to your respiratory system and can be divided into two sections: the upper airway and the lower airway. The upper airway is comprised of the nasopharynx (nose and throat) and the oropharynx (mouth and throat). The lower airway consists of the larynx (voice box) and trachea (windpipe) before it branches off into the lungs via bronchioles and, finally, alveoli, the small clusters of air sacs where oxygen and carbon dioxide are exchanged via the bloodstream.

What’s an AO?

An airway obstruction is, quite simply, some type of blockage in any part of the respiratory tract that’ll prevent you from being able to get enough oxygen to breathe. The obstruction can be partially or totally obstructed, and it may have various causes.

Types of AO

There are several ways to characterize different types of obstructed airways. One way is based on the location of the obstruction. If you have an upper airway obstruction, you would have an issue with the nasopharynx (nose and throat). A lower airway obstruction would be from your voicebox down to your lungs. A second way is to describe if there’s some air movement or no air movement in the airway. Some are partial, meaning that, while there’s some obstruction, air is still moving in and out of the airway, albeit with varying degrees of difficulty. The size of the obstruction will determine the level of difficulty breathing. In the event of a total, or complete, airway obstruction, the airway is 100-percent stopped up and no air will pass. Once the airway is blocked, respirations stop. This is called respiratory arrest (cessation of breathing). Once respirations stop, oxygenation stops, and, if not relieved quickly, cardiac arrest (cessation of heart activity) will follow.

The third way to characterize an obstruction is based on the timing of the obstruction. Some airway obstructions are acute, meaning they occur suddenly, while others are chronic — a result of issues causing the obstruction to stay in the airway for a long period of time. It might also refer to a blockage that has slowly grown and gradually closed off the airway.

Causes

The most common kind of airway obstruction we think of and see is an acute obstruction, either partial or complete, associated with the inhaling of some type of foreign object — also known as choking. These objects become lodged in the airway and either prevent or completely block off air from entering the lungs, thus preventing adequate oxygenation. The airway could also be blocked off as a result of an illness like epiglottitis, croup, tonsillitis, or any other type of inflammation in the airway, causing acute partial or chronic obstructions.

Airways can also be damaged via heat, as they are made of soft tissue — when injured, they swell quickly, thus compromising the airway. So a person who has inhaled a lot of smoke in a house fire could have some definite airway injuries due to a combination of smoke and heat, which could lead to an acute partial or complete obstruction. A fall, motor vehicle accident, or other traumatic injury could also lead to an acute partial or complete obstructed airway due to bleeding or soft tissue swelling in the airway or by introduction of foreign objects, like teeth, into the airway.

The biggest offender to the stability of the airway seems to be the tongue flopping against the back of the airway in an unconscious individual. When someone is rendered unconscious, the muscles in the body relax. The tongue happens to be a muscle. When it’s relaxed, it can fall against the back of the throat (pharynx) and block the airway. When that happens, we need to act quickly and decisively to open the airway because the longer we wait to get the airway open, the longer the brain is deprived of oxygen.

We can only live for a finite time without that and without suffering brain damage as a result of an anoxic (no oxygen) event. Some chronic disease processes like tumors, asthma, chronic bronchitis, COPD (chronic obstructive pulmonary disease), and emphysema can also cause a progressive narrowing of the airways, limiting the amount of airflow into the lungs. Over time, this can cause a chronic partial obstruction in the airway.

How to Recognize AO

How many of you snore? Yep, that’s a partially — and for some of you at times, a totally — obstructed airway (e.g. obstructive sleep apnea). Snoring is an easy-to-recognize symptom of an obstructed airway. However, depending on the level of obstruction, there are several other signs you can observe. One sign is our respiratory rate. Our normal, adult breathing pattern is fairly steady with a respiratory rate of around 12 to 20 breaths per minute. If we see any deviation from that normal pattern, we need to look closer at what could be causing it. If the patient is breathing more rapidly than normal or shallow, we need to discover the root issue before it gets worse. With partially blocked airways, the patient may be coughing, wheezing, or having other abnormal sounds, like stridor, which is a high pitched or even squeaking sound coming out of the airway.

If the patient can vocalize any sounds, their airway is only partially obstructed. One of the worst things you might see is absolutely no chest rise and fall or unorganized chest wall movements with no sound at all coming from the airway. These are very ominous signs. In a completely obstructed airway, you’d expect to see, in a conscious patient, panic and anxiety with the universal choking signal of putting the hands up to the throat and maybe even mouthing, “I’m choking” or “Help.” If the patient’s oxygen level is dropping, you might also notice a bluish hue in the lips, skin, or nail beds. This is called cyanosis. Finally, if the oxygen levels drop too much, then the brain isn’t getting what it needs — this can lead to unconsciousness in the patient. This is respiratory arrest and, as mentioned earlier, if not relieved, will lead to cardiac arrest and death.

How to Treat AO

If a patient’s airway is completely obstructed, it may be necessary to perform the Heimlich maneuver.

When you’re snoring and get elbowed to turn over, you self-correct your own partially obstructed airway by turning over. The offender in this situation is your own tongue. This type of scenario isn’t an emergency. However, if the person isn’t able to correct their own obstruction, it can most certainly turn into one, such as respiratory arrest leading to cardiac arrest. So, how do you treat an airway obstruction? Well, that depends on what’s obstructing the airway.

If the obstruction is an acute partial obstruction, then the patient is moving air and, more than likely, attempting to clear the airway on their own by coughing, which will hopefully dislodge the obstruction.

Rolling a patient into a recovery position can help reopen a partially obstructed airway.

If it’s an acute complete obstruction such as choking, performing the Heimlich Maneuver is the best option — with no sounds coming from the victim and/or no coughing, the responder wraps their arms around the victim’s waist, slightly above the belly button, makes a fist with one hand, bending the thumb with the knuckle pointed out, covers the fist with the opposite hand, and sharply pulls upward with sets of five abdominal thrusts until the obstruction is relieved. If the airway is partially obstructed due to swelling, either acute or chronic in nature (noted by abnormal sounding respirations, i.e. high pitch, wheezing, etc.), this is a definite emergency and definitive care must be sought out immediately.

Occasionally, you may be alone and have to self-administer abdominal thrusts. In order to do this, you’ll have to find something like a chair or couch to lean over, placing the top of it firmly around your belly button and forcing yourself downward to mimic the same movement of someone else’s hands performing upward abdominal thrusts. The same principle we just mentioned still applies: keep trying in sets of five thrusts until the obstruction is relieved. Different types of airway obstructions will require different interventions, usually based on the severity of the obstruction. This could range from medication inhaled via a nebulizer, placement of a nasal or oral airway, emergent endotracheal intubation, and in worst case scenarios, emergent surgical airway placement.

What to Do if You Can’t Relieve an AO

Above: The insertion of a nasopharyngeal airway (NPA) is one method of restoring airflow if the patient’s oropharynx is obstructed. It also offers a pathway for nasal intubation.

In the event the obstruction cannot be removed or the victim becomes unconscious, more actions must be initiated, like CPR. In addition, call 911 for emergency medical services. For more information on CPR and to gain certification, contact your local American Heart Association or American Red Cross office for classes.

If the tongue is the offender and has flopped against the back of the airway, then we can place the affected individual into a recovery position. In this position, the person is rolled onto their side as a unit, with the bottommost arm up and underneath their head to act as support and the uppermost leg acting as a kickstand to support them as the bottommost leg is extended. The victim’s uppermost arm is then placed up in a bent position as a support for their head, while their head is angled toward the ground in an effort to allow gravity to pull the tongue from the back of the throat in order to open the airway.

This allows the person to breathe and also lets blood, saliva, emesis, or anything else to drain out onto the ground rather than going back down the airway, thus creating an aspiration risk. This position can be used if the person still retains a “respiratory drive” or a visible respiratory effort, which can be visualized by the chest rising up and down or the abnormal sounds of respiration from a partially obstructed airway (via the tongue), which in this case would be snoring sounds. This is a very quick and effective method to create a patent (open) airway in someone exhibiting these symptoms while keeping the patient’s airway protected.

Summary

No one wants to be unable to breathe. It’s terrifying. However, understanding what’s going on and how to alleviate it can make the difference between life or death. Seek out the proper training so that if one of these situations occurs, you can be mentally and physically prepared to react. If you act quickly and decisively, everyone involved will breathe a whole lot easier.

About the Author

Kerry Davis is the founder of Dark Angel Medical. He’s a registered nurse who has worked in the critical care and emergency department fields since 2003. Prior to 2003, he was a flight medic in the USAF and worked as a civilian paramedic.

Coronavirus: How Concerned Should We Be?

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By now you have certainly heard of coronavirus in the news. From the media reports, you would think we should be prepared for the end of days. But should we? We first need to understand what the virus is and what to expect from it. We should also compare it to some other outbreaks of viruses as well.

Currently, there are seven strains of coronavirus that infect humans. The newest is the novel coronavirus (nCoV). It is similar to a different coronavirus that has caused the Middle East Respiratory Syndrome (MERS –CoV), which has been sporadic in northwest Africa since 2012. This MERS – CoV infected nearly 2,500 people worldwide in 2019. As for the new nCoV, as of February 4, 2020, there have been 20,630 cases reported worldwide with 23 countries reporting cases. In the United States there have been twelve reported cases (as of Feb. 5), according to the World Health Organization. Eight of the cases in the US have been associated with travel from China, two from person to person contact within the US and two more that have yet to be classified. These cases have occurred in California (six cases), Illinois (two), Washington (one), Arizona (one), Massachusetts (one) and Wisconsin (one).

The website WuFlu.live tracks confirmed cases of the Novel Coronavirus around the world.

Coronavirus Origin

This particular novel coronavirus (nCoV) started in Wuhan, China and has been named the Wuhan Flu. It just so happened to have its epicenter near a lab that studies the virus.

Hubei, the province where Wuhan is located, has been hit the hardest. (Graphic: WuFlu.live)

Although reports suggest animal to person contact from a market in Wuhan, my suspicion is that there was probably a breach of protocol in that lab where someone became contaminated and allowed the virus to spread to other people. The reason it is called a ‘novel’ coronavirus is that it is a little different genetically than previous coronaviruses and had not previously been found to infect humans. Typically, the coronavirus is seen in animals and infrequently spreads to humans. When it infects humans, its symptoms and severity are worse than the typical influenza virus.

WuFlu.live also created this graphic, which represents the number of cases by country.

Symptoms

Once a human is exposed, symptoms can begin in 2 – 10 days with a mean of 5 days. Symptoms may include fever, cough, and significant shortness of breath, along with fatigue, muscle aches, and headache. Watery diarrhea may also be present. The shortness of breath can be progressive through the course and the diarrhea, if present, usually appears in week two of the illness. People who are at risk of infection are those people in close contact with those infected, as well as those with chronic diseases (e.g., diabetes, chronic kidney disease, chronic lung disease, and immunocompromised patients). The contagious period is most likely in the second week of illness.

Treatment

There is no specific treatment for the virus and care is supportive in nature. Hospitalization may be needed for administration of fluids for dehydration and supplemental oxygen for the shortness of breath. Acetaminophen can be given for the fever. Presence of concomitant diseases (mentioned above) also increases the risk of hospitalization. Of course, the patient should get as much rest as possible to allow the body to heal. Symptoms can last two weeks with recovery following according to the severity of disease.

How Contagious Is It?

(Graphic: CDC / Alissa Eckert, MS; Dan Higgins, MAM)

Regarding contagion, there is a mathematical term called R0, or R naught. This reflects the relative contagious capacity of infectious disease. If a disease has a R0 value of 1.0, this reflects that for every person infected, they will spread it to one other person. Influenza’s value is 1.28. MERS was reported to be less than one while SARS was estimated to be between 2 – 3. This Wuhan Flu is thought to have a R0 of 1.5 – 3.5 with some suggesting the upper limits of that range. Keep in mind that a value of less than one will cause the outbreak to diminish. Ways that public health can control the spread is to limit travel to endemic areas as well as to quarantine those travelling. We have already seen flights being limited to and from China as well as two cruise ships being quarantined due to case reports of Wuhan Flu on board the cruise ships.

Detecting the Virus

With the timing of this outbreak, in the midst of flu season, how do you know if you have influenza versus coronavirus?

Initially, you may not know the difference, as some of the symptoms overlap. As the shortness of breath progresses during the first week, it may require a visit to the doctor. But keep in mind that you should wear your N95 mask and take precautions as if you ARE infected. There is a test that can be done for flu in most physicians’ offices and in hospital labs to test for influenza; however, testing for the nCoV is only done by the Centers for Disease Control at present. The CDC is working on releasing the protocol to test on a more widespread basis. Another factor to distinguish between the two viruses is whether you have traveled to an area that has reported cases of the nCoV or have come in contact with someone who has tested positive. Last, if you were diligent in getting your flu shot this year, this will likely reduce your severity of illness due to the influenza virus. Although that vaccine has no impact on whether you catch coronavirus, it may help health officials decide how to distinguish between the two in the early phases.

Comparing the Mortality Rate

So why should we care if it’s the flu or coronavirus?

From what has been observed to date, this novel coronavirus kills about 3% of those infected. This is compared to about 0.01% of those affected by influenza. Keep in mind this percentage of nCoV is potentially an early underestimation of mortality while the number of total cases rises exponentially. It will only be after the dust settles that we truly know what the mortality was with this disease. And, while 3% doesn’t sound like much, it is certainly more deadly and more contagious than the flu.

Above: This graphic from The New York Times compares the fatality rate and contagious capacity of the Novel Coronavirus.

In addition, the number of severe complications for Wuhan flu is reported to be in the 20 – 30% range. These persons will spend time in the intensive care unit of the hospital and have prolonged hospitalizations as well. And as far as the two other coronaviruses mentioned above, in 2003, Severe Acute Respiratory Syndrome, or SARS –CoV, which was thought to have come from the Chinese civet cat, had a mortality of about 10%, and the Middle East Respiratory Syndrome (MERS –CoV) had a mortality of 35%. (This appeared as recently as last year in Saudi Arabia and was thought to be transmitted initially from camels.) Both of these two latter viruses had R0 factors less than what the nCoV show so far.

A highly-magnified, colorized view of MERS-CoV virions. (Photo: National Institute of Allergy and Infectious Diseases)

Because there are no vaccines for coronavirus, the Centers for Disease Control and the World Health Organization recommend avoiding crowds, frequent handwashing, wearing masks (N95 preferably) while in public, avoiding touching eyes, nose, or mouth, and using disinfectants or hand sanitizers. Common sense should also encourage you to stay home when sick.

Conclusion

From a public health perspective, this Wuhan Flu is potentially 3 – 4 times more contagious than the influenza virus and three times more likely to result in death. The World Health Organization declared the Wuhan Flu to be a global health emergency and, along with the Centers for Disease Control, is taking significant measures to limit the spread of the virus outside of China. Personal responsibility to limit your exposure should also come into play. Stay home if you are sick. Wash your hands frequently. Cover your mouth when you cough.

Anytime a new kid comes to town, or a new infectious disease, it gets people excited. This particular novel coronavirus is of interest because it has the potential, if it gets out of control, to have significant health and even economic impact globally (watch George Gammon’s YouTube video for more details).

We are all familiar with influenza and are too often blasé about its impact on our lives. But we have faith in our influenza vaccines and our ability to recover from influenza. Think about your chances of recovery if you contracted the Wuhan Flu, though. You may feel horrible for two weeks and be on the mend. Or you could be one of the 20% who end up in the intensive care unit and on a ventilator. Or you could be one of the 3% who die. So, should we be concerned? While a 3% chance of death doesn’t sound like much, in medicine, it’s more risk than we like to see.

About the Author

David L. Miller, DO FACOI, is an internist in private practice for 20 years. His experiences away from the office have included time as a fight doctor in regional MMA events and as a team physician for 10 years at a mid-major university in the Midwest. Currently, he serves as the lead medical instructor for the Civilian Crisis Response team based out of Indianapolis.

RECOILtv: B&T Veterinary Pistol for Covert Operations

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Weapons, like other tools, are often built with a specialized purpose in mind. Some, however, may have an officially-stated purpose that differs from how they’re typically used. Take the icepick, for example — it might be marketed for chipping pieces off a block of ice to cool a drink, but it serves a totally different purpose on the street. The B&T VP9 Veterinary Pistol seems to fall into this category.

As the name indicates, the official purpose of the bolt-action Veterinary Pistol is to quietly euthanize animals. Its barrel includes ports to slow down a standard supersonic bullet to subsonic speed, and it comes with a matching suppressor that includes consumable discs that enhance noise reduction for the first few shots. The end result is a very quiet weapon that can put an injured animal out of its misery without alerting the nearby populace. But as you’ve probably guessed, it’s capable of being used on more than animals.

The B&T VP9 bears a clear similarity to the Welrod pistol that was developed by the British Special Operations Executive (SOE) for use in assassination missions during WWII. Like the Welrod, the VP9 is a single-shot, bolt-action gun that’s easily dismantled and concealed. In the RECOILtv video above, B&T founder Karl Brugger explains the pistol’s origins, and RECOIL Editor in Chief Iain Harrison test-fires this unique weapon.

Book Review: “Visual Guide to Lock Picking, 3rd Edition”

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The Premise: In Issue 32, our feature “A Look at Locks” provided an overview on common household locks, and elsewhere in our latest issue Chad McBroom did up a nice primer on lockpicking as well. In many survival, escape, resistance, evasion (SERE) courses, you’ll find that lockpicking is often a common part of the curriculum. Whether it’s defeating locks to find food, seek shelter, or escape from unlawful incarceration, there’s no denying that understanding how to bypass locking mechanisms is a critical part of survival training. The Visual Guide to Lock Picking, 3rd Edition is a good starter manual to familiarizing yourself with the anatomy of many of the most common locks you’re likely to encounter.

The 411: The information is provided in very straightforward, easy-to-understand prose. Everything is clearly explained, and a helpful glossary of common terminology is provided at the end of the book. The authors dissect how to identify warded locks, tumbler locks, combination locks, tubular locks, lever locks, and wafer locks and describes what the differences are on each category’s variations. The book also discusses how the aforementioned locking mechanisms operate and the tools and techniques used to bypass them. Each chapter contains a healthy dose of black-and-white illustrations, so the reader has numerous references to visualize the instruments and systems described. Each chapter starts out explaining the basic theory behind how each lock category works and progressively builds on information from previous chapters.

The Verdict: Will you be an experienced locksmith by the time you finish this book? No more than you’d be an experienced doctor after you graduate with a degree in medicine. The next logical step, and the book encourages this, is to experiment with various locks and gain a tactile understanding of the methods and lock types described. However, the book does a good job explaining things clearly to give the reader a baseline of how common locks work and the differences between them.

Because the Visual Guide to Lock Picking, 3rd Edition is primarily focused on portable locks, it barely touched on dead bolts. Be that as it may, it’s bereft of security countermeasures, such as strike plates, security bars, and reinforcement locks. To be a bit more idealistic, the authors would’ve earned points with us if they’d included tips on defeating security latches commonly found on hotel room doors and older homes.

We were surprised there were no descriptions of different handcuff types and would’ve liked to have seen that included. It would’ve also been helpful if they’d included a few chapters dedicated to basic automotive locks. If you’re looking for information on electronically controlled locks, you won’t find it here. That’s a whole other animal involving a greater deal of technical savvy that this book isn’t intended to address.

Also, a page at the end of the book offers a DVD or VHS version of the book and is intended to be torn out and mailed in with payment info. What’s discouraging is that the website shown on the cover of the book is no longer active and a search for “Standard Publications” doesn’t turn up any info. It makes us wonder if the company has gone out of business since the book’s 2006 copyright. No such DVD or VHS could be found through an internet search either.

The book begins and ends with disclaimers about the potential legal implications of lockpicking, but understandably doesn’t go into detail about what exactly could provoke repercussions. Since laws change over time and vary from region to region, it’s basically letting the reader know it’s incumbent on them to do the research and make sure they aren’t breaking any laws.

Book & Author
Visual Guide to Lock Picking, 3rd Edition
by Mark McCloud and Gonzalez de Santos

Publisher
Standard Publications

MSRP
$20 (Amazon)

URL
N/A

Pages
208

Rating
Thrive
> Survive
Die

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