Deploying as a responder to a disaster may result in minor illnesses (upper respiratory infections, stomach upset, rashes, allergies) or injuries (sprains, strains, insect bites). For instance, those deploying to unfamiliar areas could experience previously unknown environmental allergies, such as “cedar fever” (generalized allergic reaction to the pollen of the mountain cedar tree) in Central Texas. It is even worse to discover the uncomfortable rash of poison oak, ivy, or sumac (Toxicodendron dermatitis) or the intense itching of chiggers (Trombiculid mite bites) while working outdoors. Also, large numbers of responders sleeping and showering in makeshift quarters (tent base camps, church gyms, or schools) can result in “camp crud” (viral bronchitis) and athlete’s foot (tinea pedis).
Under normal circumstances, these conditions are treatable at home with non-prescription medications. However, these treatments may not be available while deployed unless they are part of the pre-deployment planning. In certain circumstances, the availability of non-prescription medications may mean the difference between a successful deployment and needing to return home ahead of schedule. In addition to first responders, the following information is also useful to individuals and families preparing for disasters (e.g., hurricanes, tornados, blizzards, wildfires) at home.
Pre-Deployment Considerations
Before selecting the medications for a deployment medication kit, consider the following categories:
- Allergies – If a kit is for personal use, the kit user should consider any known medication allergies. In this case, there is no reason to waste money and space on a medication known to cause the intended user an allergic reaction. However, if a group plans to use the kit, these medications may need to be available for other group members.
- Generic vs. Brand-Name Medications – By law, all Food & Drug Administration (FDA) approved medications must meet the same performance criteria as brand-name products. They may have differences (i.e., colors, shapes, or tastes), but they must have the same effectiveness as the brand-name product. One significant advantage of generic medications is that they usually cost less than their brand-name counterpart (sometimes much less). However, if it is known from an earlier experience that a brand-name product works better for a particular individual than a generic, its inclusion would be appropriate despite the increased cost.
- Medication Forms – Non-prescription medications come in a variety of forms. Liquids, tablets, capsules, creams, and ointments are the most common. Of these, liquids, creams, and ointments should be avoided if possible due to the potential for leakage or freezing. Also, depending on the medication, tablets may be enteric coated to decrease the possibility of causing stomach upset. This desirable feature makes tablets less likely to disintegrate during storage and transport. Scored tablets are also preferred as they are easier to cut in half to individualize the dosage.
- Medication Quantities – Various factors will influence how much of each medication to include in a kit. For individual use exclusively, the quantities should be sufficient to last for the duration of the deployment. For example, a single-tablet allergy medicine taken daily would require a minimum of 14 tablets for a two-week deployment. To support more than one person, increase the quantities accordingly. However, other considerations also come into play. For instance, a package of 24 tablets may come in the same size child-proof bottle as a package containing 100. Depending on the cost, it may be reasonable to include the 100-tablet bottle, especially if it is a commonly used medication.
- Medication Packaging – The ideal answer is to keep all the medications in their original packaging. Unfortunately, the original packaging may consist of a child-proof plastic bottle inside a cardboard box (which takes up extra space and retains moisture). If it is necessary to replace the original packaging, child-resistant medication bottles of assorted sizes are readily available online. Also, avoid glass containers due to possible breakage. And, like traveling on commercial airlines, do not mix multiple medications in one package; each should have its own bottle or plastic bag. Lastly, if the kit has any liquids, creams, or ointments, they should be placed in a zip-top plastic bag to prevent damage to kit contents in case of leakage.
- Medication Labeling – If it is necessary to remove the original packaging, all information on the discarded packaging (indications, dosage instructions, warnings, contraindications, expiration date) should also appear on the new label. If not, this information must be duplicated and kept with the kit for future reference.
- Kit Container – The container chosen for the kit must be durable and waterproof. If space is critical (for instance, inside a deployment bag or in a carry-on bag), use a zip-top plastic freezer bag for storage. However, these types of bags are not child-resistant and require protection from unwanted access. A better choice would be a watertight plastic household storage container. If possible, choose a size large enough to keep the medications in their original child-proof containers. A larger waterproof storage case may be more suitable for kits supporting a team of responders.
- Medication Sources – When buying the medications for the kit, choose a reputable source. A large retail pharmacy may be the best option to get the most competitive price and comprehensive selection. Because none of these medications require a prescription, they may be easy to purchase online. However, buying locally allows purchasers to examine the packaging and confirm the expiration dates. Avoid outlets selling medications with short (or expired) expiration dates, regardless of how amazing the price is.
Assembling the Kit
The last step is to select the medications to put in the kit. If individuals use any non-prescription medicines regularly, they should include them in their personal kits. To help with this process, the following extensive, yet not all-inclusive, list of non-prescription medications includes an assortment that would be useful on a deployment. The various categories have up to three options for each, with the dollar-sign ($) markings indicating cost comparisons for generic medications. Do not hesitate to discuss these and other options with a healthcare provider or pharmacist.
Hopefully, all responders will return home healthy following a rewarding deployment in response to a disaster. With some pre-planning, non-prescription medications to treat minor illnesses and injuries will be readily available to keep responders comfortable and working at their peak performance during often difficult times.
Richard (Kirk) Higgins
Richard (Kirk) Higgins, PA-C,has a 31-year history as a nationallycertified physician assistant(PA-C),in addition to being actively involved in disaster response and emergency management. His experience as anemergency medical technician, U.S. Coast Guardhospital corpsman, paramedic, surgical technician, pharmacy technician, and physician assistanthasserved him well in his roles as arural physician assistant, the deputy commanderof the TX-4 Disaster Medical Assistance Team (DMAT),and a company commander inthe Texas State Guard (TXSG) Medical Brigade. His latest position as theemergency management coordinatorfor a small city in rural North Texas has been the most challenging and rewarding thus far.
- Richard (Kirk) Higginshttps://www.domesticpreparedness.com/author/richard-kirk-higgins