Survival (27)

Vented or Occlusive Chest Seals?

Don't get hung up on the medical words, but we'll have you understanding how to and why you treat a gunshot wound to from Neck to Naval in no timeSuckingChestWound

A Consideration for Austere Management of Sucking Chest Wounds

     Today we are going over one of the leading preventable causes of death on the battlefield: Tension Pneumothorax. Don't get hung up on the medical words,  we'll have you understanding how to and why you treat a gunshot wound from Neck to Naval in no time. The battlefield sets the example for first line care because we learn from our mistakes and translate them into the civilian care. The front line medics are expected to uphold the standard in Austere Medicine where they don't have an ambulance but just the supplies on their back. However, not just the Combat Medics on the battlefield are trained, but non-medical professionals are being taught how and why to save lives in first aid.  This is where the Austere Medical provider comes in, when 911 is not coming and you have to treat and get them to the next level of care by yourself or with the assistance of your Emergency Action Group. Before we can go over how to treat, we must understand "why" we are treating: pneumothorax

 "What is a pneumothorax?"

   As the picture above demonstrates, you have a wound from you neck to your naval, letting air go out of the hole(s) instead of out of your mouth, which is not good. You won't get quality oxygen where you need it and pressure may build up putting pressure on the lungs and heart until failure.

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"Why should I be worried about a pneumothorax?"

    From hunting accidents, negligent discharges on the range, to active shooter and self-defense situations, we may get injured ourselves and that is just including gun shot wounds.  In addition, if Tension Pneumothorax is the second most preventable cause of death in the battlefield where we wear body armor, it's even more likely in an austere situation where we likely don't have body armor. Some medics do not see chest wounds progress from open to tension pneumothorax due to it taking awhile to build up but we have short evacuation times in Iraq/Afghanistan. When it often takes less time to get a bird overseas than it does to get a bird or ambulance in the states, this is another reason to consider this injury a priority where 911 is not coming and this injury has more time to manifest.
" So how do I treat it? I see Vented and Non-Vented Chest Seals." [caption width="300" id="attachment_1484" align="aligncenter"]sucking-chest-wound4 Taping three sides and leaving a corner to vent is an outdated method.[/caption]   If you look around you'll see many variations of the chest seal over the last decade. Occlusive Dressings, Taping on three sides, burp valves and other vents. I'm here to make sure you have an educated decision. This is not a guessing game on what might work, these chest seals are all rigorously tested both on and off the battlefield from U.S. Army Institute of Surgical Research (USAISR) to Committee on Tactical Combat Casualty  Care (CoTCCC). They came out with some new updates, which is important because just because you take a medical class in 2006 does not mean you are "set" and never have to take one again. Doctors take continual classes every year to stay on top of what is current, so when it comes to First Line Care, you should have the same mentality that what is best changes. An emergency is not the time to attempt outdated care or try to save a few bucks by getting a knock off or older chest seal. Using what you have available as a contingency and preparing ahead of time are two different aspects; you know if it was you that was wounded, you would want a superior product: [caption width="300" id="attachment_1483" align="alignleft"]Hyfin Vent Chest Seal in Use Hyfin Vent Chest Seal in Use[/caption]   We have been using occlusive (non-vented) dressings which would trap in the air and increase pressure in the chest cavity AKA Tension Pneumothorax translated simply to "Pressure from Air in Thoracic Cavity." By using a fully occlusive dressing you could take a bad situation like an open pneumothorax and make it into a more lethal Tension Pneumothorax. Instead of letting air escape out of the wounds hole, you are now trapping the air inside, inflating the lungs cavity much like a tire. With a vent you let out enough air to avoid the tension while still assisting proper ventilation through the windpipe.    The CoTCCC guidelines quote, " All open and/or sucking chest wounds should be treated by immediately applying a vented chest seal to cover the defect. If a vented chest seal is not available, use a non-vented chest seal. "

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   Occlusive Seals are proven to work, for those who are trained and ready to recognize when to do a Needle Chest Decompression (NCD). If you use an occlusive dressing, be prepared to perform a needle chest decompression. For someone unprepared to perform an NCD, I recommend getting the Hyfin Vent Two-Pack Instead. If you're dressing has a "burp" such as an Asherman or Bolin, I'd recommend switching to the more reliable Hyfin Vent as well due to the three-vents offering more redundancy when it comes to getting clogged up by debris or blood. If two of the vents are completely occluded, the third can still function enough to work. Final Tips: No matter which chest seal you use,  Petrolatum Gauze ($3.99) , HALO XL, Hyfins, or any other method,  I have a bit of advice:
  •   Prepare your site! Use your sleeves, gauze or clothing to dry the sweat or blood from where you are about to place it. If the patient is hairy, you definitely need to dry it because the hair can make it even more difficult to get on and stay on.  Don't throw it on there in the heat of the moment and cause your intervention to fail. Take  deep breath, take a second and properly dry your site with whatever you have available.
  •   When you find the sucking chest wound during your Trauma Patient Assessment (Click here to see how) , you can use the back of your hand, not palm to cover the wound with your gloved hand. This frees up your fingers to help open the packaging while you prepare your supplies while having the added benefit of making it less likely bear weight on that arm and 'push down' on your patients wound if you have to reach or lean across them.
  •  You've run out of chest seals, had a mass casualty, or your original came off during transport. What now? Use the package it came in as an improvised occlusive dressing and tape it down.
  •   As always, the equipment is only as good as the training. You can use tape and the packaging to practice covering a chest seal for the low-cost of tape. "Dry Firing" isn't only for Combat Marksmanship , It's for Medicine, too!
[caption width="400" id="attachment_1488" align="aligncenter"]Crisis Application Group's Hyfin Vents: 2 for Crisis Application Groups Hyfin Vents: 2 for $14.99. (Click the picture)[/caption]

Irrigating a wound in an austere environment: "The solution to pollution is dilution"

  It must be said, always seek medical advice and a higher medical authority, but now that is out of the way. For those of you who are new to this, before you learn to suture, you need to learn wound care. Treating an open wound is a direct testament to,  "An ounce of prevention is worth a pound of cure." Aggressive irrigation is a basic, low-level medical intervention that is cheap and simple to perform. What's not to love? Your first response can save the wound from being infected, needing further antibiotics, or possibly having to go back in and debride or cut away tissue that isn't healing well. I find some new to the austere medical community are infatuated with doing sutures, yet don't know how to properly irrigate a wound... That is a recipe for infection and why we are here to talk about Irrigation, Irrigation, Irrigation.

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  Irrigation is flushing  wound with water in order to get all the "bad stuff" out. With an open wound such as a laceration (cut),  Keep in mind the saying, "The Solution to Pollution Is Dilution." running_wound_care3   It means don't be skimpy with your flushing, use a ton! Your skin protects us from many foreign bodies we take for granted, so when the skin is opened up, we need to be there for the wound. You now know the "why" of irrigation, next I'll go over some cost-effective and simple methods to irrigate wounds.

      " What fluid do I use... Normal Saline, Purified Water, or anything available?"

Normal Saline:  In an Austere environment, we don't have the luxury to stockpile Normal Saline and do an irrigation as clean as we'd like in a hospital room. It's simply not cost effective, or worth its weight in a Rucksack as far as I'm concerned.  Many studies have come out referencing potable water's effectiveness rivaling, if not exceeding the effectiveness of N.S.

Purified Water: If you have enough stored, I'd recommend "Pool Shock" granular calcium hypochlorite over Bleach. Both work just fine, however Bleach has a short shelf life of around a year as opposed to nearly a decade with properly stored pool shock. While boiling water is the best for purifying drinking water, you may not have those capabilities for wound irrigation on you.

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⦁ Non-Potable Water: Water that is not safe for drinking or has not been tested or purified is still good to go for wound care if you have to in an austere environment. The benefits of a flush from a non-purified water source outweigh the risks. The benefit with using a local body of water or other source is you are not as worried about wasting a finite resource and can afford to be as aggressive as needed.

  As you can see, it's not a big deal about how purified the water is or what is in it. You want to use a ton of water and most importantly you want to create enough pressure.  I recommend you act like you KNOW something is crawling around on the surface, so you don't underestimate how much you need. [caption id="attachment_1411" align="aligncenter" width="300"]2315700 Povidine iodine solution[/caption]

" What can I use to irrigate this wound?"

  1. The most obvious choice is using a syringe as previously shown in previous pictures. If it's not an Irrigation Syringe, using an 18G-20G catheter will increase pressure more than using the syringe by itself. When using a Catheter on a syringe to draw your irrigation fluid, hold it approximately 1/2" to 1" inch away from the wound and steadily keep pressure. Whether a syringe is 10cc, 30cc or 60cc or any other size, it can be used for many roles and is an easy addition to any medical kit.   2. A second option would be using a bottle, preferably 2L but smaller can work, too.  Poke a couple of holes, but keep them small so you can still maintain high pressure by squeezing the bottle.   Remember its the turbulence that knocks loose the sticky stuff, that's why we strive for a jet like stream when we irrigate. two-holes-drilled-into-lid-of-bottle

[caption id="attachment_1412" align="aligncenter" width="271"]    ( Urine not recommended for wound irrigation, This is purely comic relief ) ( Urine not recommended for wound irrigation, This is purely comic relief )[/caption]   There are endless ways you can improvise, even an old fashion turkey baster and flavor injector will work. This is less about a strict set of ways and more about getting the job done right. After the thorough cleaning place a clean bandage on the wound; Now find a Medical Pro, Get Them to One, or Be The Medical Pro, as discussed in the article: "Where Are The Doctors? The Reality of Casualty Evacuation in an Austere Environment." [caption id="attachment_981" align="aligncenter" width="300"]Firearms, Tactical & Defense Training Tactical Ranch: Firearms, Tactical & Defense Training[/caption]

Bug Out Boat (B.O.B) Gear

I’m going to take a few minutes of your time to talk about the gear for a bug out boat. I won’t be giving out specifics, just general ideas to use. You can customize it to suit your needs, and by all means, check the companies on this website for any and all items. Like I had said in my earlier writing, if it is a necessity, bring two. That can’t be more drilled in. I’ve flipped numerous times, and I have lost plenty. It sucks to be stuck with only one paddle. If you are using a two-man canoe, bring 3 paddles, PFD’s (lifejackets) bring 3 and get good quality, don’t forget that these have an expiration date and need to be replaced. Seat backs are a real comfort for a canoe, bring 3! Don’t forget bungee cords and ratchet straps, and lash everything down. So IF you do flip, the items will stay in the canoe.

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Now it’s time to go over the dry bags, because wet gear is useless gear. There are basically 3 types of these bags, duffle, roll top, and hard. The duffle’s are just like you think. It’s a bag that is the same as you already use, just waterproof with a sealed zipper. They are excellent for stowing the camping items, tent, sleeping bag, camp stove, clothes, and all the like. If I’m going on a camp trip, this is what I would be using. Roll top style is a stand up bag. Fill it up and roll the top down about 3 times to create the seal, then the top connects to itself so you can latch it around an item to secure it. Stuffed with items like food, you can fit a lot. They come in assorted sized. Hard cases have a sealed, hinged lid with one or two snaps and keep your items dry. They are good for items you need to get too regularly and fast. For fishing gear, I carry 2 ultralight rod and reels, and a medium/heavy duty rod and reel. Just so I am ready for any types of fish that are biting. Tackle consist of plenty of hooks, sinkers, floats, spoons, spinners, and soft baits. I have found that I can catch just about anything on a spinner. But it never hurts to dig for worms or crickets and try them too. A must would be extra line for the reels; I prefer 4lb for ultralight and 10lb for medium/heavy rods. Don’t forget the extra grease and oil for the reels too. They have to be maintained just like a weapon! Also, I have found that superglue does wonders, reattaching a rod tip to dabbing a bit on a screw to keep it in place.

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Please don’t forget the first aid kit. I know this is for a prepper site, and most people would say “duh”. But sometimes these things are overlooked or not up to par. Plan for anything, from getting a hook lodged into you, to breaking your arm or leg in a rapid. All things need to be considered when getting one of these. Chances are; your first route didn’t go as planned, and this is your plan “B”. Be ready for anything to happen, and as soon as you let your guard down, it will. Finally, Plan it, build it, ready it, and practice it. Take the time to plan river outings on your river of choice. Do one section a month until you run the whole way, look for easy places to put in and take out. See where good camp sites are at, look for any problems that could occur and be ready for them. What’s the use of being a prepper if you’re not going to play with the stuff? And enjoy! Life hasn’t ended…yet! [caption id="attachment_981" align="aligncenter" width="300"]Firearms, Tactical & Defense Training Firearms, Tactical & Defense Training[/caption]


Does your Bug Out Bag suck?

The accepted answer is a 72 survival backpack with everything you need in it. Have you asked yourself why 72 hours? Seems kind of arbitrary if you ask me, why not 48 or 96? How long will your disaster last? A Green Berets take on the Bug Out Bag -or- BoB... What's a BoB? The accepted answer is a 72 survival backpack with everything you need in it. Have you asked yourself why 72 hours? Seems kind of arbitrary if you ask me, why not 48 or 96? How long will your disaster last? If you're trying to pass off a tactical glamping pack as a BoB, I'm calling you out. Preppers should start thinking about the mission goal and not the mission gear. What I mean is the goal for BoB should be to get from point A, to Point B. That's it. Now what tools do you need to do that? If your need to get to point B doesn't exist, well then a BoB is not going to help you much. Having spent a few years preparing for evasions in combat zones across the globe, this is a topic I'm intimately familiar with.

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We strongly encourage the use of caches to supplement your bugging out plans. Get the tick target off your back, and go home as fast as you can! If you're actually "bugging out" you should be able to sustain short duration jogging bursts with the BoB on your back....Food for thought. If you're actually bugging out, you're in for a world of hurt, because it's not going to be an easy stroll down the block. It will be a life changing event. [caption id="attachment_682" align="aligncenter" width="660"]Good grief whose hauling this tick? Good grief whose hauling this tick?[/caption] What goes in a bug out bag and why? So many questions, not a lot of consistent answers... Lets simplify the equation: Do you have a need to go from point A to point B during an emergency? From work to home, home to a school, vice versa? In a vehicle, on foot or on a bike? Because there is a difference between a bag you can easily put in a car, and one you easily walk with... Most of the BoBs I've seen floating around the internet are entirely to large, way to complex and couldn't be hauled by a vast majority of the people who need a BoB. Consider small children have been lost in the woods without any supplies, during the cold and have survived. What exactly is it that you NEED?

This is how I rig my personal BoB If you don't know how to use it, why carry it? It's just weight at that point and during the emergency is the worst time to learn. Start thinking a little more Spartan, and slim down your kit to BARE ESSENTIALS. Weight is brutal...Weight is brutal... We need to stop making these comfort packs and calling it a survival rig. Fact is there's no "list" so each mobile kit you produce MUST be tailored to your individual needs and circumstances. In Special Operations we will build our kits to fit the mission profile and evasion plan we going to exercise. There is no bag we grab and call it good to go.

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72 hours is the national average it takes to restore utilities from the onset of an emergency, making it an almost pointless figure to use for real planning. This ranges all the way from Katrina to a local tornado. The number is irrelevant to the need. It's just a planning tool to get you started, it's not gospel. I've had to build a few BoBs over the years for real world missions. These are some of the things I consider: The bag: Preppers tend to recycle surplus milspec bags because there are comfortable and usually modular. Hiking backpacks are too and also have more useful color schemes than just camo and crye. Have you considered luggage? I have a well seasoned traveler I trust when I'm on the road.... Resist the urge to fill empty space...... Time: How long is this bag really supposed to support you? My experience has taught me that once you go over 24 hrs, you're cutting into your speed and mobility. Again, if the goal is to get home.... then uh.... Food: How much? and what kind? Are you trying to just make it home or live comfortably until rescue? Protein powder and meal replacement shakes are a great way to get the fuel you need while conserving space, but then you need water? If it's an emergency do you care if its tasty? Water: Are you really going to carry 3 days worth of water and expect to go very far? Will you purify by filter or chemical? I like chemical because it reduces weight, can you boil? Medical: You better have at least a trauma pack. Do you have chronic meds? Allergies? Hygiene: Get some baby wipes, the appropriate female necessities and move out. Why do you feel like brushing your teeth is a priority during a time like this? If you're in the field long enough to brush your teeth, your Bug out plan is failing. Ammo: Are you trying to carry a combat load? Is there a hill you have to take or hostage you need to rescue on the way home? If you have the mindset of an assaulter you may be over packing. Lighten up and think evasion. Break contact and go home... Fire: Can you start one? Will you bring fuel for a stove? Shelter: Tents are heavy but provide comfort and moral.... Signal Kits: Are you trying to hide or get noticed? It sucks trying to rescue people who have gone out of their way to be unnoticed. A few flares and a radio go a long way...How about a safety vest? Maps: Yep, you still need them. Batteries die and GPS lose signals. The of course geographic essentials: This all goes out the window in an Alaskan winter or Arizona summer....


[caption id="attachment_698" align="aligncenter" width="259"]In most cases, Bub out webbing makes more sense! In most cases, Bug out webbing makes more sense![/caption] Have you actually hiked with all this gear? Turns out hiking is harder than most people think so many of the BoBs I've seen people suggest just wont work. They are at best vehicle bags. None of this should exceed 25% of your body weight unless you road march Infantry style on a regular basis... If you feel like you need to have supplies on hand in the event of an emergency, consider building caches. This will lighten your carried load, and if you were separated from your BoB you will still have some food and water for the trip. Keep in mind you KNOW where your trying to go, why not set yourself up for success early on and go bury some emergency bacon... The bottom line having a BoB is an ongoing process where you show me yours and I'll show you mine. It needs to be refined and trained with. I have a general rule, if I don't use it on 3 training or real world missions in a row, its gone. As your life circumstances change, so should your BoB. If the training you're doing either doesn't support using your BoB, or has determined you don't need a BoB changes to your program must be made. Don't just build a BoB because that's what all the "cool" preppers do, create a requirements driven approach to the purchases you make, and generate your requirements from effective training. Planning means nothing with out training.....Rehearse rehearse rehearse...





Get noticed during an emergency!

In most cases, when catastrophe strikes near or on you, you're going to need some help. Having a few easy to use, easy to store items near by will go a long ways towards effecting a positive outcome during your time of need.

In most cases, when catastrophe strikes near or on you, you're going to need some help. Having a few easy to use, easy to store items near by will go a long ways towards affecting a positive outcome during your time of need. In this article I am going to focus on tools that get you noticed and versatile enough to support most venues you could encounter. Signal Kits: There are plenty of commercially available, low-cost signal kits that will cover most of what you need. Generally they include

some kind of strobe light and signal mirror, but some may come with colored panels. Lets break down basic signal kit items:

  • stroebflashlightStrobe lights blast bright pulsing light that are easy to distinguish from ambient back ground lighting like in a city, or against a city backdrop. Don't assume you will be somewhere doing any given task, I've seen first hand vehicle accidents just outside of city limits where ambient lighting could and would interfere if you tried to signal with a flashlight. The pulse of a strobe is unique enough that emergency crews would naturally gravitate towards your signal.
  • untitledewqrgwetrSignal mirrors are tried and true. Even on a cloudy day they can reach out for miles. They work along the same lines of a strobe in that emergency crews can easily decipher a distress pulse from any surrounding light ambience. These are handy in and out of the city and are logistically manageable for the pocket Everyday Carry or EDC.
  • untitledSFHzdjxfkcghSignal Panels work because they offer contrast. That's why certain colors are generally reserved for safety, like orange or neon green/yellow. Of course their being bright helps get noticed but when a bright orange panel is flown it doesn't match anything in the immediate area, and more likely to draw attention to the eye. This is important to understand if and when you're trying to create an emergency panel/beacon in a hurry. Contrast is king...

Signal Flares and pen flares: Flares are great because they generate a tremendous amount of explosive light and can even be used during the day. Of course they burn so use caution, but having said that flares are cheap, safe and readily deployable for almost any venue.

  • zgfHGRoad flares have long burns times and require you to create a "clear" area around them so they don't start a fire. Most of them are reusable and are uber handy when you're having a hard time starting a survival fire.
  • untitledfhzdjgxfkgcljhvbPen flares shoot a few hundred feet into the air like a streamer and will broadcast your location thru thick vegetation or over buildings. These are small enough to fit in most pockets and certainly gloves boxes, but take care in aiming and save them for when you actually see the rescuers....You don't want to run out of flares putting on a fireworks display for no one to see!
  • imagesE5U2K4I9Whistles and bangers can be launched from most pen flare sets. If it makes sense to send out an echo against a canyon or city wall, bangers and whistles may be a good addition to your pen flare set. These are also good deterrents for people hiking in the woods where unwanted animal contact is likely...

Beacons: There are three types of beacons used to transmit distress signals, EPIRBs (for maritime use), ELTs (for aviation use), and PLBs (used for land-based applications). I wont go to far into this for this article because its a class all on its own, but NOAA has an excellent article on how they work and how they can be used. Click here to learn more about beacons... sosSOS: There was a time when SOS was a universal distress code, but this day and age I wouldn't bet my life on it. Having said that it's still a good tool to have in your toolbox. 3 short dots followed by 3 long dashes, followed by 3 short dots spells I NEED HELP! While I'm not suggesting you sit back and bang out code over the radio all day, the SOS can still be used to broadcast a visual signal across the international language barrier as well. ergthrywj6q534If its contrast that gets you noticed, the pattern gets you understood! Build your emergency signals into an SOS with both letters AND dots to increase the likelihood a passerby wont mistake your signal for woodland junk! In this example, notice how the shadow gives contrast which allows this SOS to be seen from much farther away. Use the rule of 3: When you finally think your signal is big enough, make it 3 times larger.... In the prepper community a lot of emphasis is placed on staying hidden and living as a ghost, and for the most part we can agree as long as that makes sense. For the vast majority of Americans out there, being prepared means knowing what to do and having what you need to do it with. This means understanding and accepting that help from rescue units is vital and critical to a well prepared family. This article is intended to explain and validate the use of basic survival items for the average American family and is by no means a comprehensive lesson plan. If you have any questions please feel free to hit us on Facebook or leave a comment below! As always thank you!


How to harvest a chicken with your bare hands (Video)

We have all heard about wringing the chickens neck, but unless you do this full-time you may just end up hurting the chicken. For beginners we suggest the "boot" technique and its easy to do for beginners.We have all heard about wringing the chickens neck, but unless you do this full-time you may just end up hurting the chicken. For your first time we suggest the "boot" technique and its easy to do for beginners. Begin by laying a sturdy stick on the ground and place the chicken's head across the stick. Step hard and pull.... If you're in a survival situation consider cutting the skin into strips so you can bait up for the next meal in your trap line. But once you start you have to commit for the sake of giving the chicken a humane kill. This is a good way to harvest an animal if you're a little hesitant to get your hands dirty. We made an intro video for you to see how easy it can be. Enjoy! [embed][/embed]

The incredible edible Kudzu!

[caption id="attachment_59" align="alignright" width="326"]A Kudzu bulb A Kudzu bulb[/caption] Whenever you drive down the interstate in Georgia you see this cool green vine stretched endlessly along power lines, walls and signs. It's Kudzu and it's encroaching mercilessly thru out the south. It's not a native plant species to the area and is largely considered a pest. Despite every effort to tame it, it just keeps coming back. It cant be beat. The secret to Kudzus resiliency is a big beefy bulb at the root base of the vine. It kind of looks like a long sweet potato. Every year the vine dies off but new green sprouts up from the bulb again like clockwork. These things are seemingly bullet proof and that's good news for you the prepper.  It turns out Kudzu is edible. I grew up in the south and had no idea, a SERE school instructor showed us in class and now I think about it every time I see the vine along an old brick wall. Atlanta is literally under attack by food! With a little elbow grease, you can dig up the bulb and throw them in a boil. They can weigh anywhere from 5lbs to 15lbs depending on the age of the plant. They are a little bitter but totally edible. Some restaurants are experimenting with new recipes as we speak in an effort to generate demand to help harvest Kudzu off the streets. You can Google plenty of recipes but in a pinch serve them up like mashed potatoes and you'll be ok. The next time you are out and about looking for a cool new prepper trick, bring home a Kudzu bulb and serve it up. It's everywhere and abundant, even in downtown Atlanta!


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