Monday, February 2, 2015

Keeping Your Hands Safe and Functional in A Protracted Emergency

The actual photographs of paronichaie are very graphic.  I chose to post this rendering. (Rendering at:
      Paronychia can be so nasty and so severe that they can, on occasion, cause sepsis, and they unquestionably can  cause uncontrolled blood sugars in diabetics.

           Recently, I posted an article on the importance of maintaining our feet and anticipating the difficulties that will occur with them during a wide variety of emergency situations when we will be using them differently than we may now.   (See: Important Thoughts Regarding Your Feet and Preparedness )

               Today, I would like to mention, the importance of our hands during emergencies or some type of collapse.  Most of us have endured a fairly minor injury of our hands or fingers and found that it was exceedingly difficult to change diapers, wash dishes, do laundry, care for animals, or even to type out an article when you have a deadline.  Today, I want to mention some things that can happen to our hands and plans we can make for them in anticipation of such difficulties.

                Some years ago now, my husband and I tired of suburban life and the "skills" our children were learning which focused on consumerism as much as anything else, by virtue of where we were living.  We wanted them to experience a bit more of some of the important rural things we had experienced growing up.  With this in mind, we bought large acreage and began to seek a builder for our first farm. Within a year we were living there and learning a number of  things, not all of them fun or pleasant !

                  I thought that as a nurse, I knew a fair bit about my own hands and how chapping could so easily occur with frequent hand washing.  However, I was a novice when it came to "farm hands" and how to treat them.  When a new farm is constructed in many places, there is an abundance of red clay.  Red clay gets on everything from children's shoes and socks to boots and everything else. Simply taking a dog for a walk on a rainy day can result in your getting red clay on your hands. This results in drying and cracking which can be resistant to simple moisturizing creams.  Cold weather and near frostbite will cause small cracks to develop, particularly on the edges of nail beds, especially thumbs.  This can be very painful, and it can be difficult to excuse yourself from your normal activities in order to allow them to heal.   Dry cracked hands can lead to infections around nail beds, which are also called paronychia (pronounced par-on-IK-ee-ah)   Most of us can treat our own paronychia to resolution, but for those taking immune suppressive medication for autoimmune disorders, for cancer, or for those who are diabetic, paronychia can be especially dangerous and should be treated by your family physician or primary health care provider.
                The hazards for hands are many.  Paronychia may occur, chapping, cuts, lacerations, and even fractures may occur.   We need to prepare in advance to avoid hand injuries in anticipation of emergencies where we might use our hands differently than we do today.

                  If we were to experience an emergency where we perhaps did not have access to our dishwashers or washing machines then many of our hands would be exposed to water and detergents more often than they are now.   Painful hands can make optimal dexterity difficult. During an emergency where you may need to do a number of things that are not well practiced for you, is the wrong time to have hand discomfort, pain or to have an infection in your hand when you need to treat a wound on someone else.

Damage to your hands in an emergency is not inevitable. These are some things you can do to help avoid some of the damage that can make optimal dexterity difficult.

1.  Purchase a variety of vinyl gloves online.  (It is my experience that the best buys are online.  If you need them immediately, then Sam's Club has excellent vinyl gloves in tissue box style, for about eleven dollars a box.) They should be sized for each family member, as there are circumstances where each family member should be gloved, not simply the primary "dishwashing" member.      Most hospitals have or are completing the process of switching to all vinyl gloves.  Latex allergy is such a problem and has caused deaths among people who have simply donned a pair of latex gloves.  Latex allergy can develop at any time without warning.    Purchase vinyl gloves and sidestep this serious potential problem entirely..  The least expensive place to do this is online.  Shop around and get boxes which are sized for each family member.  Children will need to do dishes too, and they may need to do some tasks which will require gloves.  We have pink smalls for the tiny handed people here, and blue vinyl for the larger hands.  I tend to buy different colors in different sizes to avoid the frustration and confusion of trying the wrong size. If the gloves are color coded and you buy them that way, you don't need a great deal of light in the room in order to see the size of the gloves on the box.  This is useful for farm and household tasks as well as medical or veterinary clean up.

2.  If you must do a task which requires some dexterity out of doors or in Winter, wear vinyl gloves and then cotton gloves over them.  You can care for animals, change water buckets, tie and untie ropes etc, with protection for your hands from both cold and wet.  This will go a long way to protecting your hands from chapping and cracks, especially during Winter.   You can wash the cotton gloves later when necessary.
Harbour Freight sells packages of twelve pairs of cotton gloves fairly reasonably, either online or in their stores.

3. Every year at the end of Winter, Wal-Mart sells gloves for 50-75% off.   Buy a fair number of them when they are on sale. Bag them in freezer bags to prevent the potential for insects crawling up the fingers in the off season. (Yes, occasionally spiders will nest in gloves, even in heated and cooled closets in new houses.)

4. The best strategy in treatment of frostbite is simple avoidance.  Frostbite will be the subject of another post here in future.

5. Use common sense when using knives and scissors, especially in low light.  A small cut on your finger or hands can be disabling or annoying enough to limit your effectiveness in an emergency situation.  Imagine a cut in an uncomfortable position on a finger which limits your ability to rack the slide on a semi-automatic handgun when you definitely need to.

6. Don't open packages or cardboard containers with your hands and fingernails.  Papercuts and cardboard cuts often become infected. Use scissors or other implements to open packaging, and be careful doing so.

7. Stock up on a mild yet effective hand cream or lotion to be used when the gloves come off, the hands are washed, are dry and they need protection.  This simple strategy is an important way to avoid calluses, peeling skin and irritation, especially in times of heavy hand use or Winter.

8.  Take great care to avoid injuries to your hands whether these injuries occur through dishwashing, opening cardboard boxes, using a handgun, using a rifle,tearing off tin foil from a serrated box etc.   This is one time in which multi-tasking might not be so bright.

9. Stock a well organized first aid kit.  The easier it is to use and the better it is, the more likely you will be to use it. Using the kit and applying either neosporin, apinol or other germicides to a wound is more likely to prevent infection than simply ignoring a small cut on one's hand or finger.

10.  Place the vinyl gloves you bought in strategic locations in your home.  Make them easy to locate so you will actually use them. Wear vinyl gloves when washing dishes, cleaning toilets with a brush, or doing other tasks which could expose your hands to allergens, chemicals or other hazards.   I can use one pair which lasts me all morning in Winter.   In Summer, I use more of them..

11.  I don't use a great deal of machinery, but many machines can be dangerous to hands.  Make sure that you understand how the machines you are using work.  Don't rush through important work.  Don't use your hands to do things that require specialized gloves or another tool.   Don't take food out of the microwave with bare hands !

12.   The use of machines which cause continual vibration leave us particularly vulnerable to carpal tunnel syndrome.   Limit your contact with vibratory machines if you can.   Repetitive motions of other types can also irritate the carpal tunnels.   Try to split up repetitive motions with other activities.

13. Use extreme care in the workshop or when working on your car.  It's not the novices in the workshop who most often lose fingers, it's the experienced man in a rush or who gets distracted.   In a collapse or emergency, the reattaching of a finger might not be a possibility at all.

14. Don't perform difficult or dangerous tasks when you are tired or when you have taken medication which clouds your sensorium.  Even loratadine which is not supposed to cross the blood brain barrier appears to make reaction time just slightly slower than normal for that individual.   Do the work in the morning, and take the antihistamines later.

             This is a start.    Think about your hands and protecting them as we move into challenging times at home, on a farm, or at work.  Even setting up a tent has inherent hazards.   Try to practice the safest and best practices now, in advance of an emergency.