How To Make Injectable Lidocaine

Disclaimer.  I am not a licensed health practitioner.  This is just another post on knowledge and understanding you might wish to acquire in advance of a disaster in case no higher care is available.  As long as our society is functioning, you should leave anything more substantial than applying a Band-Aid to the professionals.  No medication, including those available over the counter, should be taken without consulting a physician.  Information shared here is for educational and entertainment purposes only.  It is not medical advice nor a substitute for licensed medical care. 

 
Just to reiterate the disclaimer, this is a post on supplies and knowledge you want to have before you need it.  Everything about making injectable lidocaine should only be done by a licensed physician or pharmacist or under their direction and supervision.

The instructions for making injectable lidocaine when our society has totally collapsed and there is no higher medical care available were first posted online in 2013.  A few years later a physician reviewed those instructions and added his own comments.  (Addresses for those articles are provided below.  I provide addresses rather than links because sometimes a link will disappear, but with an address it may still be possible to track down the desired article.  I've had that happen quite a few times.)

Making injectable lidocaine is not at all complicated, but it is important to be careful and very precise.  It is easy to overdose a patient with lidocaine.  You want to avoid that.

Let's assume you already have scissors, a surgical clamp of some sort, and a candy thermometer or similar, as well as the lidocaine HCL, as was covered in an earlier post.  Here are the additional supplies you'll need:

• Sterile saline.  Preferably labeled as being for injection.  But that can be hard to come by for unlicensed individuals.  A grid-down, out in the wilderness hours or days away from a hospital solution is the single-use vials of sterile saline mentioned last week.  
• Scale that can accurately measure milligrams.  Digital scales start at about $20.  Non-electronic scales start around $30.  I have no experience with either yet.  A lot of reviewers on Amazon indicate that they use both scales for reloading ammunition.  If you have someone like that in your family, and they have a scale, I would love to have confirmation that their scale (with brand and model information) will accurately measure minute quantities of powder.
• A very small funnel to transfer the lidocaine HCL into the bottle of sterile saline.   

Before beginning, make sure all the instruments are sterilized--clamp, scissors, funnel.  Disinfect the scale thoroughly, especially the pan that will hold the lidocaine.  Wash and scrub your hands thoroughly and put on gloves.

To make a 1% lidocaine HCL solution:

1. Weigh 150 mg of lidocaine HCL on the scale.  
2. Cut off the top of a 15 ml sterile saline vial about halfway down the neck.
3. Insert the funnel securely into the neck of the vial.  
4. Pour the lidocaine into the funnel.  (If the powder sticks to the funnel, squeeze the vial gently to move some saline into the funnel.  Then release so that the saline drains back into the vial, taking the lidocaine with it.  You may have to repeat this procedure a few times to get all the lidocaine into the vial.) 
5. Remove the funnel.
6. Close the neck of the vial using your surgical clamp. 

To make a 2% lidocaine HCL solution:

1. Weigh 300 mg of lidocaine HCL on the scale.
2. Follow steps 2-6 above.

For both 1% and 2% lidocaine solutions:

1. Create a double boiler with a small canning jar almost filled with water placed in a pan of water over the stove.  You just need clean tap water; it doesn't need to be sterile or distilled.
2. Place the vial in the canning jar, but be especially careful not to submerge it near the openings.  Do not let any tap water enter the vial, which would contaminate the solution.
3. Heat the water past 176 degrees Fahrenheit.  (Lidocaine dissolves in water, but it doesn't melt until it reaches 176 degrees F.  Melting ensures even distribution.) 
4. Remove the vial from the jar.  Do not remove the clamp.
5. Let cool.
6. You now have a 1 or 2% solution of lidocaine HCL.
7. This solution should be used within 24 hours and discarded thereafter.

To use this solution, with the clamp still in place, clean the top of the vial with an alcohol pad.  Invert the vial, insert the needle through the top of the vial, and draw out the desired amount of lidocaine into the syringe. 

Links to related posts:
Lidocaine
Little Vials of Sterile Saline
Benadryl
Rubbing Alcohol 

For further reading: 
https://modernsurvivalonline.com/guest-post-how-to-make-injectable-lidocaine-hcl/
https://griddownmed.blog/2015/04/25/from-modern-survival-online-make-your-own-lidocaine-topical-anesthetic/
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=C7A7D3D2-7638-4570-9EB8-A5E2BEC82B5D
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3433813/
https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/inspection-technical-guides/pyrogens-still-danger

© 2019, PrepSchoolDaily.blogspot.com

4.26.23

Homemade Fritos

Comfort food goes a long way in a crisis.  Difficulties are just so much more manageable when you've got good food to sustain morale.  And for one of my daughters, QOTPE, that food is Fritos.

Being a good mom (at least, some days) and having been known to enjoy more than a few corn chips myself, I decided to see if there was a way to make them at home.  There are exactly three recipes online as of this writing (addresses below).  I tried two of the three.  The third one was so far off the Fritos ingredients (real Fritos do not have cayenne pepper or flax seed oil or safflower oil) that I didn't bother. 

No matter what I did--rolling thinner, salting more, sprinkling fairy dust, or just hoping really, really hard, they were nothing like real Fritos.  Now, I wouldn't call them an epic fail, because in this case, I believe an epic fail would call for barfing.  There was definitely no vomiting involved.  But there was nothing anyone would want to keep eating, either.  Sorry, QOTPE.

I have a couple of suspicions as to why DIY Fritos just don't work.

The first is that Frito-Lay company has industrial equipment for mechanically processing the grain and the chips.  We can't duplicate that at home.  Even with the edges of the chips that were rolled out so very thinly, the texture and taste just weren't there.

The second is that I also suspect that Frito-Lay has a certain variety of corn that they use for their chips.  The dent corn I have here, and which I suspect most people would be using, just doesn't have that true corn chip essence to it.  What I made here was far closer to regular tortilla chips, which would also be more easily made just by making corn tortillas and then frying those.

Just in case you want to confirm for yourself how right I am, here are the addresses for the recipes I tried, and the one I passed on:

https://www.justapinch.com/recipes/snack/chip-snack/homemade-fritos.html
https://eatup.kitchen/homemade-fritos/
https://www.splendidtable.org/recipes/corn-chip-strips

Links to other recipes that just don't work:
Rice Krispiesd educat

Foreign Body in Nose

It is the dreaded FBIN.  Foreign body in nose.  Your otherwise adorable, brilliant toddler decided TEOTWAWKI would be a great time to see if shoving peas up her nose would keep her from having to eat them. 

This is not good.  And because you are not a physician with the cool tools of the emergency department, the options for removing the FBIN are limited.  However, if you start to panic, your child is going to stress out as well, and that will make everything worse.  Just to add more pressure, statistics show that your child is only going to allow one or two attempts at most for clearing her nose.  This has to be done right the first time.

The very first thing to do, as soon as you know you've got a problem, is to get the child to breathe through her mouth.  Sniffling may move the object farther up the nasal passage.   Depending on exactly what is up her nose and how painful it is, pain medication may be required to help calm her down.  In a situation like this, many doctors turn to an anti-inflammatory like ibuprofen and in some cases would consider a sedative as well. 

Most of the time, you are going to know what is up her nose.  She was playing with beads, or Legos, candy, batteries, magnets, or pencil erasers.  Beans, seeds, bugs.  Maybe pebbles.  How you approach removing the FBIN is going to depend largely on what exactly it is.  Is it hard?  Soft?  Round?  Square?  Smaller?  Larger?  Smooth?  Rough?  Metallic?

A physician has several options in a grid-down situation where there is no ER:

• Positive pressure (child).  The child pinches the clear side of the nose closed, takes a deep breath, and exhales forcibly through the side with the foreign body.  This method is good for solid objects like beans and beads.  It is difficult for small children to perform.
• Positive pressure (parent, kissing technique, mouth-to-mouth).  While pinching the clear side of the nose closed, a parent performs mouth-to-mouth, forcefully blowing air through the child's mouth in an effort to dislodge the object.  
• Positive pressure (straw).  It's the same as the positive pressure parent technique above, but using a straw between the two mouths instead.  Quick puffs are delivered through the straw.
• Bulb syringe.  This is also primarily for removing round, smooth objects.  Make sure you have a good seal with the nostril and suck the foreign body out.  The syringe may need to be trimmed to work.  Do not risk pushing the object farther up the nasal passageway with a bulb syringe that is too long. 
• Derma-Bond, Vet-Bond (do not use super glue!).  Put a little of this glue on a small stick, like a Q-tip with the cotton removed.  Make contact with the foreign body and hold in place for at least 60 seconds before attempting to remove.
• Saline washout.  Fill a bulb syringe with 7 ml of sterile saline.  Insert the bulb syringe in the opposite nostril and advance it until you form a tight seal between the nostril and the bulb syringe.  Squeeze the bulb forcibly to eject the saline to the other side.  The saline will hopefully carry the object out the other nostril.  This method is good for friable objects like crackers.  
• Tweezers.  May work for some objects.  Don't risk pushing the object further up the nasal passage.
• A bent paper clip or a wire loop held by a hemostat.  Either of these can be used to rotate around the inside of the nostril between the object and the mucous membrane to dislodge and remove the foreign object. 

Sometimes children do things that escape our notice, and some of the foreign bodies children choose to shove up their noses don't cause immediate discomfort, or even any discomfort.  Peas and raisins are nice and soft and squishy.  Something like that is going to eventually start giving off a very foul odor.  And there will be a runny nose, but only on one side.  (Unless, of course, the objects were shoved up both nostrils.  A parent's natural reaction is to panic, thinking there's some type of infection.  However, there will be no fever.  Careful questioning may reveal that the child did indeed shove something up her nose. 

Other items you are going to want for this situation include a very good headlamp with a strong light to it and a small pair of pliers to hold the nostril open (unless, of course, you have a nasal speculum on hand).

Links to related posts:
Glues
Saline solution

For further reading: 
https://www.oatext.com/20-ways-of-removing-a-nasal-foreign-body-in-the-emergency-department.php
https://www.webmd.com/first-aid/foreign-body-nose-treatment
https://www.drugs.com/cg/nasal-foreign-body-in-children.html
https://www.healthline.com/health/foreign-body-in-the-nose#treatment

© 2019, PrepSchoolDaily.blogspot.com  

4.16.23