Tuesday, September 11, 2018

Guest Post: Thoughts on Ear Infections and Sepsis

by George Groot
George is a member of our Facebook Group and has written for us before.

Last month I spent some time observing a multinational military exercise out in the Pacific. One of the participants was living in an old military installation where all of the bathing water was non-potable, meaning that it was unsafe for consumption. He bathed in that water, and got a pretty bad ear infection as a result. Luckily, he was eventually prescribed antibiotics which helped his body clear the infection.

What should he have done? 
He should have followed the guidelines for drying his ears after leaving the shower, and then sterilizing his ears with hydrogen peroxide or other mixture which would have killed any bacteria trying to get in.

The lesson to be learned here is that non-potable water shouldn’t be used for hygiene purposes if you can avoid it.

In another case, last week I had a run-in with a family member who came down with a case of systemic infection by gram-positive bacteria through, as best we can tell, a cut to her skin. We don’t know if it was a self-inflicted cut that was the vector, but given the location of where the abscess formed in her body, I assess it as likely. Had she not been cutting herself as a coping mechanism for other stresses in her life she could have avoided sepsis entirely.

She also picks at scabs (also a dysfunctional coping mechanism), and if the wound wasn’t already infected, opening up the wound again increased the risk of infection. A proper antibiotic ointment and a covering bandage would have avoided sepsis entirely if this were the infection vector.

What did we do?
First, we got her medical treatment, which included two visits to the emergency room, multiple blood cultures to identify what sort of bacteria was multiplying in her body, and hospitalization to administer antibiotics via intravenous delivery.

Second, I mixed a bleach solution in a spray bottle and sprayed down all the surfaces that I knew she’d touched in the house. Generally sepsis is not contagious, but it can spread, and sterilizing surfaces is a smart thing to do. 

Finally, all of her clothes were washed in accordance with CDC MRSA sterilization guidelines or thrown away. The CDC guidelines for washing linens are to use hot water as high as your washer can go, use detergent, and dry in a dryer on high heat.

In the end, she got the advanced medical treatment she needed to deal with the infection, and we're working on the behavioral health issues as well.

How does this apply to prepping? 
The worst time to get a systemic infection is during an emergency when normal services are interrupted, so self-care is very important, especially for people who may have to deal with individuals who are less than highly functional in dealing with normal life.

Self-care is important and you will need to ensure that you have some sort of way to wash your body using soap and water, as well as have an adequate supply of antibiotic ointment on hand for minor scrapes and cuts. With a background in biochemistry, I know that the average person already has some type of staph bacteria on their skin. There are many different varieties of staph, and normally they can’t get inside to do much harm, but the moment your skin is opened up you are definitely at an increased risk of letting something on the outside get into the inside.

The old wisdom of “an ounce of prevention is worth a pound of cure” applies here:
  • Have powdered bleach on hand (it lasts indefinitely, where liquid bleach has a pretty short lifespan before it reduces down to saltwater), as bleach can turn non-potable water into sterile water pretty effectively. 
  • Have antibiotic ointment on hand, and I recommend getting two different generic store brand types (zinc-based and triple antibiotic ointment) in case someone shows allergy symptoms to one of the ointments. 
  • Have a good supply of covering bandages on hand. 
  • Have a way to wash yourself with sterile water and soap. 
  • Hydrogen peroxide to dry out ears after swimming or other immersion in non-potable water should also be on hand (although a mixture of vinegar and rubbing alcohol has also been said to work as an ear drying mixture).

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