Top 9 Injuries During SHTF

Here are the top nine injuries to watch out for in an SHTF scenario, along with some tips for prevention and treatment.

MEDICAL

11/5/20247 min read

Top 9 Survival Injuries to Prepare for in a Crisis: Prevention and Treatment Guide

During a "Sh*t Hits the Fan" (SHTF) scenario, where society faces a major collapse or disaster, injuries can become much more common and challenging to treat. From natural disasters to civil unrest or even pandemics, SHTF situations can increase the risk of injury due to limited resources, difficult living conditions, and heightened stress. Knowing the most common injuries to prepare for can be lifesaving. Here are the top nine injuries to watch out for in an SHTF scenario, along with some tips for prevention and treatment.

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When Doctors and EMTs Are Not Available

While i help with maintaining and rotating protocol for medical supplies, one area that I don't offer with clients is active medical training. I stick with what I am skilled at and prepping is always a learning phase that never ends. That is why it is up to the individual to acquire proper medical skills. I made a youtube video with medical and security tips on how to survive a drone attack, which included pdfs to follow along while you watch. The videos themselves also had a place to pause and take notes. So we must be prepared at all times even during confusion and fog of war. And amid the chaos of a disaster, when the familiar order of daily life collapses and medical professionals are scarce, the human body becomes both a fortress and a liability. Injuries once dismissed as routine escalate into life-threatening scenarios. Understanding these common injuries and their implications can spell the difference between resilience and tragedy.

Lacerations rank among the most frequent injuries during a crisis. Whether caused by shattered glass, jagged metal, or debris, deep cuts can quickly become a gateway for infection. In normal times, a hospital visit would ensure tetanus shots and sterile stitching. But when the closest doctor is days away, improvisation is your ally. The body’s natural defenses are formidable, but they cannot withstand filth and neglect. Unclean wounds invite sepsis, a silent predator that can shut down vital systems with chilling efficiency. To combat bacteria when medical faciliies close during SHTF, you need a plan on how to treat infections without antibiotics. And having homemade soap during disasters is also important with or without gloves, assuming the medical equipment is sanitary. Hygiene internally and externally go together when treating wounds.

Sprains and fractures follow close behind. In the disarray of fleeing or defending, awkward movements lead to twisted joints and broken bones. A fractured tibia in the wild isn’t just painful—it’s immobilizing. The stakes rise when mobility equals survival. Painkillers, splints, and makeshift crutches become your lifeline. Without stabilization, even a minor fracture can turn catastrophic, as bone shards threaten surrounding tissues or arteries.

Burns emerge from the inferno of disasters—whether from a house fire, vehicle explosion, or mishandled equipment. First- and second-degree burns compromise the skin's role as the body’s armor, exposing victims to dehydration and infection. Third-degree burns are even more harrowing. Flesh chars, nerve endings die, and the risk of hypovolemic shock—caused by fluid loss—looms large. Improvisation with clean water, damp cloths, and natural salves becomes critical. Scar tissue might eventually tell the story of survival, but in the moment, the battle is simply to endure.

Head trauma is another specter, whether from falling debris or violent impacts. The brain, encased in its fragile bony dome, is unforgiving when rattled. Concussions cloud judgment, and severe trauma can induce swelling, seizures, or unconsciousness. In the absence of CT scans or neurosurgeons, watching for clear fluids from the ears or nose can reveal skull fractures. The danger lies not just in the immediate injury but in the compounding effects of disorientation in already perilous conditions.

Puncture wounds—insidious and often underestimated—puncture the narrative. Nails, splinters, and even stray bullets leave narrow paths of destruction. Unlike open wounds, punctures conceal the full extent of their damage, allowing bacteria and air to infiltrate the bloodstream. Tetanus thrives here, as does gangrene. Do not ignore the wounds from insects either, which can lead to infection. There are natural remedies for insect repellents that can help keep bugs away, especially during recovery when a wound may be exposed. Cleaning these injuries requires a precision that feels unfairly demanding when resources are scarce.

Hypothermia and heat exhaustion complete this grim roster. The body’s internal thermostat, usually reliable, falters under extremes. Hypothermia sets in quietly, sapping energy and slowing mental faculties. A person doesn’t realize they’re losing the fight until they’re too weak to care. Heat exhaustion, its opposite, strikes fast and brutal, shutting down organs as dehydration spirals out of control. In both cases, shelter, hydration, and regulated body temperature can mean survival. Misjudging the balance invites death to your doorstep.

Each of these injuries carries its own weight, its own set of demands. But what ties them together is their reliance on quick thinking and resourcefulness. Crisis magnifies every choice. A sterile bandage made from a shirt, a makeshift splint from a tree branch—these are the tools of survival in a landscape stripped of modern convenience.

1. Cuts, Lacerations, and Puncture Wounds

During an SHTF scenario, people are more likely to be handling sharp objects or working with tools they’re not accustomed to. Whether from breaking glass, handling sharp debris, or using knives and axes, cuts, and puncture wounds are incredibly common.

Prevention: Wear protective gloves, be mindful of surroundings, and use tools safely.
Treatment: Clean wounds thoroughly with clean water, use antiseptics if available, and apply pressure to stop bleeding. Sterilize the area to avoid infection, and close the wound if necessary with sutures or sterile tape.

2. Sprains, Strains, and Fractures

Navigating rough terrain or running while carrying heavy loads can easily lead to sprains, strains, or even fractures. Slips, trips, and falls are common, especially if people are rushing or moving in darkness.

Prevention: Wear supportive shoes with a good grip, avoid carrying too much weight, and move carefully.
Treatment: Immobilize the injured limb and elevate it. Apply ice if available to reduce swelling, and splint fractures to prevent further movement. In severe cases, a makeshift crutch or stretcher may be necessary.

3. Burns

In an SHTF scenario, people might rely more heavily on fire for cooking, warmth, or lighting, leading to an increased risk of burns. Burns can vary in severity and can be dangerous if not treated properly.

Prevention: Be cautious around open flames, wear heat-resistant gloves, and have fire-extinguishing methods available.
Treatment: Cool burns immediately with clean, cool water, avoid breaking blisters, and cover with a clean cloth to prevent infection. In severe cases, antibiotic ointments can help, but be mindful of hygiene as infections can complicate the healing process.

4. Infections

Even minor injuries can become life-threatening if they become infected, especially when access to antibiotics or sterile conditions is limited. Skin infections from cuts, animal bites, or exposure to unsanitary conditions are common in disaster situations.

Prevention: Keep wounds covered and clean, and practice good hygiene to minimize the risk of infection.
Treatment: Clean the wound thoroughly, use antiseptics, and change dressings regularly. Watch for signs of infection, such as redness, swelling, or discharge, and treat aggressively with antibiotics if available.

5. Dehydration and Heat Stroke

In challenging conditions, staying hydrated can be difficult. Dehydration can lead to heat stroke, especially if individuals are overexerting themselves or are exposed to high temperatures.

Prevention: Drink plenty of water, avoid excessive exertion in extreme heat, and take breaks when needed. always have a sanitized water for drinking or an IV. There are great methods available on how to make a DIY homemade water filter.
Treatment: Move to a cool location, rest, and rehydrate slowly. If dealing with heat stroke, place cool cloths on the skin, especially in the armpits, neck, and groin areas, to help bring down body temperature.

6. Hypothermia and Frostbite

If the SHTF situation involves cold weather or if heating systems are unavailable, hypothermia and frostbite become serious risks. Cold exposure can lead to a rapid decrease in body temperature, which can be life-threatening.

Prevention: Dress in layers, cover extremities, and stay dry. Build or maintain a heat source to avoid prolonged exposure to the cold.
Treatment: Warm the person gradually by moving to a warmer environment, using blankets, or placing warm (not hot) water bottles near the body. Avoid direct heat, as it can shock the system.

7. Head Injuries

Head injuries can occur due to falls, debris, or accidents, and even a minor head injury can become serious without proper medical attention. In an SHTF scenario, monitoring head injuries is crucial, as symptoms can worsen over time.

Prevention: Wear a helmet when possible, be cautious around high or unstable areas, and avoid risky physical activities.
Treatment: For minor bumps, apply a cold compress and monitor for signs of concussion, such as confusion, dizziness, or nausea. Seek medical attention immediately if there are signs of severe head trauma, like unconsciousness or bleeding.

8. Respiratory Issues

In dusty, smoky, or polluted environments, respiratory problems like asthma attacks, bronchitis, or even pneumonia can become prevalent. People with preexisting respiratory conditions may face higher risks during an SHTF event.

Prevention: Wear masks or use cloths to cover your mouth and nose in dusty or smoky areas, and try to stay in well-ventilated spaces.
Treatment: Keep inhalers or breathing medications if needed. Breathing steam or using natural expectorants (like ginger or honey) can help clear airways in the absence of medical treatment.

9. Gastrointestinal Problems

Food and water contamination is a serious risk during SHTF, as people may be forced to eat or drink less-than-ideal resources. Gastrointestinal illnesses like diarrhea, vomiting, and food poisoning can quickly lead to dehydration and malnutrition.

Prevention: Boil water if possible, avoid consuming spoiled food, and practice basic sanitation.
Treatment: Rest and rehydrate. In cases of diarrhea, oral rehydration salts can be lifesaving. Avoid solid foods until symptoms improve and focus on hydration.
NOTE: All of the above treatments and preventions are sourced from well known knowledge bases. Methods may change, this is not to be viewed as medical advice.