A word of caution: NTM infections

seems we all have some story about nasty infections. My second year in AK the in-town ambulance (ran on the train tracks connecting the town to the highway ) and in-town EMS were dispatched to a salmon boat that had come in from a week long trip. The mate had a leg injury that had gone ignored due to good fishing.
He was septic and was in shock. They got him on the ambulance and took off to meet an on-road ambulance from Anchorage.
 20 minutes in, in the middle of a 3/4 mile long tunnel through the mountain, the ambulance ran into a rockslide and wrecked. The driver had walk back into town. They ended up carrying the patient the rest of the way through the tunnel to Grizzly meadows. Time to the actual hospital from arrival in the port was approximately 10 hours.
I gotta re-up my 1st aid kit I carry....

Thanks for cautionary report. Glad your feeling better.

I had a reaction to a vermillion i tossed on the deck of my boat that flopped around and sliced across my big toe  with the serrated plate on its head ( wearing flip flops ). Within seconds my toe was pulsating and hurt like heck . Rinsed out the cut immediately . By the end of the day i was fine fortunately.

Add Dakins solution to your first aid list

In 2020 when my thing happened by the time we went to the ER I was already delirious and close to septic

Long story short I woke up with an open surgical wound 6” by 2” deep I’d post pics but you would never eat steak again

Surgeon’s didn’t stitch it closed because risk of reinfection was too high so I had to pack and unpack it twice a day with antiseptic ribbon, more f bombs flying out of my mouth in the next 2+ months than the whole rest of my life combined

This all started with a skin rash that got out of hand which I might’ve got from surfing Linda Mar during dirty water times but whatever

Microbes migrated from external to internal and I’m lucky to have two legs but could’ve been worse

Antibiotics did squat for the rash and as a result I spent a week in the hospital and months w some serious pain factor

While I was stuck in the hospital I asked for a derm consult which my primary should have a year earlier

Team came in and the boss listed all the topical stuff that hadn’t done shit but added one thing, Dakins solution which was invented in WWI and saved countless lives and limb amputations

I went home and stopped all the bullshit that wasn’t working and did only dakins solution and the rash I was trying to get rid of for 1-2 years was gone in under two weeks

You don’t want something like MRSA making its home in your lungs, take my word I’ve seen it up close

DAKINS solution is the first thing we reach for with all our external wounds, right down to the little scratches

Topical antibiotics are pretty useless against tough resistant organisms  But they can’t develop resistance to antiseptics

There are recipes for Dakins solution on the internet but some are way too strong so stick to ones posted by medical institutions

The recipe my son’s dermatologist gave us:

1-2 teaspoons pure bleach (not anti-splash or additives stuff) in a a gallon of water

If it sounds really diluted it is, but the solution the hospital sent me home with was even more dilute and worked like a miracle

You can buy medical version for $15-20 a bottle but is the same thing

That’s interesting. Good old bleach. I was just reading about it, and it sounds like a lot of versions add boric acid to make it less irritating(!).

If it’s irritating the solution is too strong

The solutions commercially available as DI DAK SOL are very dilute, applying w a paper towel is like water w  little bleach smell

In the mix I made up it’s 2 teaspoons to a gallon of water, the dermatologist emphasized teaspoons not tablespoons

As w everything else a lot of bullshit on the internet

Just don't drink it...

I'm making some of this asap for my first aid kit on da yak...thanks Paul...

 No, and don’t inject it…

Hard to believe somebody would even suggest something so ridiculous

The Dakin's Solution story is very interesting, thanks for bringing that up.

Just don't drink it...

I'm making some of this asap for my first aid kit on da yak...thanks Paul...

According to Wikipedia, "The solution, while unstable, remains effective for at least a week, if made to the correct pH."

https://en.wikipedia.org/wiki/Dakin%27s_solution

But pre-made formulations are sold in stores, and they must sit on the shelf for a lot longer than a week, so who knows.

Maybe there’s a chemist out there who can explain the short shelf life, if it’s really a thing or not. Bleach is bleach but maybe it becomes less stable when you dilute it with water(?)

When the hospital discharged me with a bottle of it no mention was made about shelf life, and neither did the dermatologist

A few weeks ago we made up a gallon of it and refill a smaller bottle from that. As dilute as it is you’d need a syringe and have to be a lot more precise to make up a small batch

I see the commercial stuff is sold in dark plastic, like hydrogen peroxide.
maybe it's the exposure to sunlight that degrades it?

Bleach is bleach but maybe it becomes less stable when you dilute it with water(?)

B-I-N-G-O !!!

Sodium hypochlorite (bleach) activates with water and immediately starts to break down.

Expiration date for the bottle they gave me in December 2020 is 08/2022

Maybe there’s a chemist out there

  

Bleach (sodium hypochlorite) does degrade, as mentioned - generally disproportionates to sodium chloride (table salt) and oxygen gas.  Furthermore, degradation can be catalyzed by metal contamination (ex: iron), heat, and light, which could follow a different degradation pathway to chlorine gas, chlorates, and other downstream redox products.  That said, if protected from these elements, stability should be pretty decent.  The degradation should also be pretty concentration independent, meaning the rate of degradation should not be too affected by concentration in water.  The balanced chemical equation for bleach degradation shows two molecules of bleach being required to degrade to two molecules of NaCl and one molecule of O2.  Generally, the rate of degradation increases with concentration due to the kinetics depending on two species interacting with each other in solution (bimolecular).  So, the more dilute, the slower the degradation.  With the expiry at 8/22, and if the bottle was amber, protected from light, and was protected from excess heat for a long period of time, I would say it is likely still good.  Now there are ways to titrate bleach to find out, but that is a bit extra, and you could just go buy more, since it is dirt cheap. 

Wow-loving where this thread has gone. Shows what a cool community this can be with knowledgeable folks from all walks of life.

downstream redox products.

Really managed to trigger my ochem trauma back from undergrad....I actually had to look up the electron pushing diagrams to walk thru the explanation.

Expiration dates of pharmaceutical products is usually pegged at 90% active ingredient stability factoring in degradation under recommended storage requirements. Not sure if Dak's is FDA regulated, but if it is, that's how the expiration date would be calculated. Commercial solutions will usually have stabilizers in them, homemade solutions obviously not.