Power Outages are Getting Longer. Your Medication Plan Hasn’t Caught Up.

couple looking at computer asking questions

Power Outages Are Getting Longer.

Your Medication Plan Hasn’t Caught Up.

By Cayla McGrath

Most households’ mental model for a power outage goes something like this: the lights go out, the fridge holds for a few hours, the power comes back before anything important happens.

That mental model was built for a different era of outages.

Across the West, utilities have been quietly changing how they handle faults on the grid. In wildfire-prone areas, automatic reclosers that used to snap a line back on within seconds have been disabled. The logic is sound: re-energizing a line into dry brush is exactly how a small fault becomes a fire. So when a line goes down, a crew has to physically drive out, inspect the circuit, and clear it before power is restored. What used to be a three-second blip becomes a half-day outage. A real fault becomes days. Xcel’s shutoffs on the Colorado Front Range in December 2025 lasted days, not hours. Storms and grid strain are producing the same result in places that have never heard the term Red Flag.

For most households, a longer outage is an inconvenience. For a household where someone is managing temperature-sensitive medications, home oxygen, or a CPAP machine, the gap between “a few hours” and “a few days” is the gap between fine and a real problem. And that gap is quietly widening.

Here’s what every household should have in place before the next one.

Ask your pharmacist one specific question — and write down the answer

The most common piece of advice about medications and power outages is “keep them refrigerated.” That’s not actually useful guidance when the power is out.

The useful question is: how long is my specific medication safe at room temperature? Ask your pharmacist and write down the answer — it’s product-specific. The FDA guidance for insulin is that open vials and cartridges can be kept at room temperature — defined as 59–86°F — for up to 28 days for most products. But that assumes room temperature, not a house that’s warming up in July. And a pump reservoir, because insulin is exposed to body heat, has a much shorter window — typically around 48 hours. These numbers are product-specific and won’t show up in a general preparedness article. Your pharmacist has them.

The other thing to know: never freeze insulin. Freezing degrades insulin permanently and a vial that’s been frozen looks completely normal — there’s no visible change.

If someone in your household depends on a powered medical device, this conversation cannot wait

Home oxygen concentrators, ventilators, CPAP and BiPAP machines all run on electricity, and “the power is out” is not an acceptable answer if the device is life-sustaining.

If someone in your household depends on any of these devices, contact your equipment supplier before the next outage — not during it. Most home medical equipment suppliers have emergency backup plans that customers can set up in advance: backup battery systems, non-electric alternatives for oxygen, documentation for priority utility restoration. These plans require paperwork and sometimes lead time. A Sunday night outage is not when to find out they exist.

Enroll in your utility’s medical-baseline program

Your utility company almost certainly has a medical-baseline program that qualifies households with electricity-dependent medical needs for lower rates, priority notification during planned outages, and in some cases priority restoration. Enrollment requires a clinician to sign a form certifying the medical need. It takes a few minutes to request, and once it’s done, it’s in place for every outage that follows.

The HHS emPOWER program maintains a public database of electricity-dependent Medicare beneficiaries — over 4.6 million households across the US — and uses it to coordinate emergency response when outages happen at scale. Your local utility program is the household-level equivalent.

Keep a buffer supply and a written medication list

A 7-to-30-day supply of critical medications means that a several-day outage doesn’t immediately become a medication crisis. A written list — drug name, dose, prescriber, pharmacy — means that if you need emergency dispensing, you have the documentation to make it work. During a declared emergency, pharmacists in most states can dispense Schedule III through V medications without a new prescription, typically up to 30 days. That authority exists and pharmacists use it — but it requires documentation. For up to a 12-month supply of your chronic daily medication, check out JaseDaily. 

Where the JaseCase fits

The JaseCase is not a refrigerator substitute. What it covers is the second problem that can develop during a prolonged disruption: the acute infection that starts when healthcare access is interrupted. A UTI on day three of an outage. An ear infection when the pediatrician’s office isn’t taking same-day calls. A skin infection that needs treatment before it spreads.

The JaseCase is the contingency layer for those moments — a physician-prescribed, guidebook-supported supply of antibiotics for defined, common conditions, with Jase telehealth as the backstop when your regular provider isn’t reachable.

Learn more at jase.com/

Cayla McGrath is a content strategist with Jase Medical. This post is for informational purposes only and does not constitute medical advice. Always consult a licensed healthcare provider before using any prescription medication.

 

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For Clinicians | Power Outage Medical Readiness

For Clinicians | Power Outage Medical Readiness

For Clinicians | Power Outage Medical Readiness  Insulin Storage, Oxygen Backup, and Planning for Days Without Power By Dr. Jamie Wilkey, PharmD — Director of Clinical Strategy, JaseMedically reviewed by Kristen Carpenter, PA-C — Clinical Advisory Board Member Why are...

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Medicine That Would Have Changed History

Medicine That Would Have Changed History

Medicine That Would Have Changed History What If the Founders Had a Medicine Cabinet? By Cayla McGrath America turns 250 this July. Most anniversary articles this summer will celebrate with fireworks, founding documents, and famous quotes from Washington, Jefferson,...

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For Clinicians | Power Outage Medical Readiness

couple looking at computer asking questions

For Clinicians | Power Outage Medical Readiness 


Insulin Storage, Oxygen Backup, and Planning for Days Without Power

By Dr. Jamie Wilkey, PharmD — Director of Clinical Strategy, Jase
Medically reviewed by Kristen Carpenter, PA-C — Clinical Advisory Board Member

Why are power outages lasting so much longer now?

I lost power three times in two weeks this month out here in Utah. Two different accommodations, hours-long each time. And neither was some rural place where electricity could kinda expect to be spotty. Just normal neighborhoods in my wild-fire infested Utah. The kind of thing that used to be a flicker, the microwave clock blinking, back on before you’d even found the flashlight. Not anymore.

Here’s what changed, and it changed on purpose. Across the West, when Red Flag fire conditions hit, utilities now switch off the automatic reclosers that used to snap a line back on within seconds of a fault. The logic is sound: a recloser that re-energizes a downed wire into dry brush is exactly how you start a wildfire. So the line stays dead until a crew physically patrols and inspects the circuit before restoring it. That turns a few-second blip into hours, and a genuine fault into days. Xcel’s December shutoffs on the Colorado Front Range came back over days, not hours. And storms and grid strain are doing the same thing in plenty of places that have never heard the term Red Flag.

For most households, that’s an inconvenience. A spoiled fridge, a tense night, some swearing at the breaker box. For a patient on insulin, home oxygen, or a ventilator, the gap between “a few hours” and “a few days” is the gap between fine and a real crisis. And the mental model most of us still counsel from, the fridge holds a couple hours so you’ll be okay, was built for the short outage that’s on its way out.

That’s the shift I want to talk about today. Outages are getting longer, in some places by design, and the patients who can least afford a long one are the same ones we send home with the most temperature-sensitive medications and the most power-hungry devices.The medical side is missing a space. Our medical side has three parts: the medications, the devices, and the systems most patients have never heard of. We’ll take them by acuity, because that’s how you’d triage it anyway.

How long is insulin safe out of the fridge?

Of course we have to start with the big kahuna: insulin, because it’s the one patients panic over and the one where a wrong answer in either direction does harm. The FDA numbers are more forgiving than most patients expect, and stricter than most realize in one specific spot. Vials and cartridges, opened or unopened, hold up unrefrigerated at 59 to 86F for up to 28 days and keep working.¹ The exception that catches people: insulin already in a pump reservoir or tubing is good for only 48 hours, and insulin that’s been diluted or drawn out of the manufacturer’s vial should go within two weeks.¹ All of it assumes the product is still within its expiration date, and is product-specific. Read the label that’s actually in the patient’s hand, not a general number in your head.

Then widen out, because insulin isn’t the only thing in the door of that fridge. Most refrigerated meds want 36 to 46F. A closed refrigerator holds a safe temperature for only about two to four hours once the power’s out, and a full freezer that remains shut buys you roughly 48 hours. After that, the move is a cooler with ice packs as long as the medication is kept off direct contact with the ice. Which brings us to the one instruction nobody should ever get wrong: do not freeze these medications to be safe. Freezing destroys insulin and a long list of biologics outright. The patient who buries a vial in the freezer to be extra careful has just ruined it. Dang it!

And here’s the caveat that should change how we counsel, straight out of a 2025 review of room-temperature stability across 150 refrigerated drugs: stability is drug- and brand-specific, and the same active ingredient can behave differently from one manufacturer to the next.² Worse, a degraded medication can look and smell completely normal. No cloudiness, no off color, nothing to catch by eye. So the cold chain can’t be judged by appearance, and “it looked fine” is not clearance. The real counseling line is: tell me your exact product, how warm it got, and for how long, and we’ll check it against the manufacturer’s data instead of your eyes.

Plenty else in that fridge is temperature-sensitive too: biologics like adalimumab and etanercept, many vaccines, some liquid antibiotics, certain eye drops. The pattern holds for all of them. Know the specific product’s window, keep it cold without freezing it, and when there’s any doubt, the pharmacist has the manufacturer’s stability data so the patient isn’t guessing.

Oxygen, ventilators, and CPAP: build the backup plan before the lights go

Now to the devices, where the stakes spread across a wide range, so we triage by acuity.

At the top are ventilators and home oxygen. For these patients, a long outage isn’t an inconvenience, it’s an emergency, because the equipment has to keep running. The most useful thing we can do is make sure they have a written backup plan, worked out with their equipment supplier before the power ever goes out. A good plan answers three questions: how long the backup battery lasts, whether there’s a backup oxygen supply that doesn’t need electricity, and where this patient goes if the power stays out. The supplier builds the plan. We’re usually the one who has to tell the patient to ask for it, because most never have.

One thing worth flagging to them: not every generator or battery can safely run a medical device. Some will damage the equipment, some just won’t power it.³ So the plan shouldn’t assume the generator in the garage will do the job. Have the patient confirm the right backup equipment with their supplier, and test it once before they’re counting on it in the dark.

Then there’s CPAP and BiPAP, and here I get to lower the temperature a little. These run 30 to 90 watts, they run at night, and a missed night or two, while nobody’s idea of a good time, is not a life-threatening event for the large majority of users. So the counseling here is mostly reassurance plus one practical option: a CPAP battery pack, the kind that covers a night or two, is cheap insurance and easy to keep charged. The CPAP population is huge, and a lot of them are carrying more worry about an outage than the clinical risk actually warrants. Telling them that, plainly, is its own kind of care.

What is the medical baseline program, and the other systems you can put in motion?

Here’s the part most patients have never heard of, and the part where you, specifically, can do something today. There’s a whole support layer behind all of this that most people never see, and the clinician (hey, you!) is often the one who unlocks it.

The medical baseline program (some utilities call it a life-support registry) is the big one. It’s a utility program the patient enrolls in, and it usually takes a licensed clinician’s signature to certify they depend on electricity for medical equipment: oxygen, a ventilator, CPAP, dialysis, a feeding pump, a powered wheelchair. Once they’re enrolled, depending on the utility, they get an extra energy allowance, advance notice of planned shutoffs, and sometimes priority for restoration.⁴ Benefits vary by utility and state, but the form is short and you’re the one who signs it. It may be the highest-leverage five minutes you can spend for an electricity-dependent patient.

A few more worth keeping in your back pocket:

  • Emergency refills. During a declared emergency, pharmacists in many states can dispense an emergency supply, often up to 30 days, without a fresh prescription. And HHS’s EPAP program provides a free 30-day supply to uninsured people in federally-declared disaster areas.⁵ Patients rarely know either one exists.
  • A buffer supply. Push for at least a 7-day cushion of essential medications, 30 days if their plan allows it. The patient living refill-to-refill is the one a long outage hurts first.
  • A current medication list + the pharmacy where the medications are filled. Written down, on paper, kept with them. When someone gets displaced to a shelter or a relative’s house, that list is what lets the next clinician or pharmacist help fast.

And for scale, so none of this feels like an edge case: the federal emPOWER program counts more than 4.6 million electricity-dependent Medicare beneficiaries living independently.⁶ That’s a large, mapped, known-to-be-at-risk population, and some of them are sitting in your case load right now.

Appropriate medical preparation, applied to the grid

Step back from the parts of power outages here and look at the shape of the thing. Everything above is the same move: get the plan in place before access breaks, not during. The buffer supply and the written med list from a minute ago, the backup plan with the DME supplier, the registry form, all of it is preparation done while the lights are still on, so a long outage is something the patient is ready for instead of something happening to them.

That’s the whole idea behind how we think about the JaseCase, and it works in two layers. Layer one is the patient’s own medications: a real buffer of what they take every day, plus that current, written list. Layer two is contingency medications for the acute things that don’t wait for the power company, the infection or the injury that shows up at hour thirty of a blackout when nothing’s open and nobody’s reachable.

Let’s be clear about what the kit is and isn’t, because the temptation in an article like this is to overclaim. The JaseCase does not refrigerate insulin and is not a fix for the cold chain. If your patient’s question is “how do I keep my insulin cold for three days,” the answer is the cooler, the pharmacist, and the registry, not a kit. What the kit is, is the contingency layer: a prescribed, clinician-built set of medications for the predictable acute problems, ready before access is the thing standing in the way.

That’s appropriate medical preparation applied to the grid. We’re a family team of physicians, PAs, and pharmacists, and the standard is the same one running through this whole article: clinically grounded, calm, planned in advance, and a complement to the patient’s own clinicians, never a replacement for them. A longer-outage world doesn’t change that standard. It just makes the case for it harder to argue with.

Last Points

Outages aren’t what they used to be. In a lot of places they run longer now, sometimes on purpose, and the patients who feel it first are the ones depending on a cold medication or a powered device. The good news: almost none of this takes heroics. It takes a plan made early.

So the next time you’ve got a patient on insulin, oxygen, a ventilator, or CPAP in front of you, take the two minutes. Tell them their specific medication’s storage window and where to confirm it. Make sure the device-dependent ones have a real backup plan with their supplier. Sign the medical-baseline form. Nudge the buffer supply and the written med list. None of it is hard, and all of it has to happen while the power is still on.

That’s the whole point. The work of being ready for a long outage gets finished before the lights go out, or it doesn’t get done at all.

Sources

  1. FDA. Information Regarding Insulin Storage and Switching Between Products in an Emergency. Vials and cartridges (opened or unopened) may be left unrefrigerated at 59-86F for up to 28 days and keep working; insulin in a pump reservoir or tubing should be discarded after 48 hours; insulin diluted or removed from the manufacturer’s vial within 2 weeks. (Pairs with CDC, Managing Insulin in an Emergency.) https://www.fda.gov/drugs/emergency-preparedness-drugs/information-regarding-insulin-storage-and-switching-between-products-emergency
  2. Stability of Refrigerated Medications at Room Temperature: Implications for Transport, Delivery, and Patient Safety. Cureus. 2025;17(9):e93213. Of 150 refrigerated medications with room-temperature stability data, 22.8% remained stable for at least 24 hours; stability varied by brand even among products with the same active ingredient, so brand-specific data must be prioritized; degradation is not visually detectable. https://pmc.ncbi.nlm.nih.gov/articles/PMC12465357/
  3. American Lung Association. Preparing for a Power Outage as a Medical Device User. Ventilator users need a manual resuscitation bag plus external batteries and a plan to relocate; oxygen suppliers should provide non-electric backup tanks; CPAP/BiPAP users need a battery or car adapter; notify the utility of life-sustaining equipment and confirm any generator can safely run the device. https://www.lung.org/blog/power-outage-preparation
  4. PG&E / California Public Utilities Commission. Medical Baseline Program. Clinician-certified enrollment for households dependent on electricity for medical equipment; provides an additional energy allowance at the lowest rate and, depending on the utility, outage notification and restoration priority. Benefits and eligibility vary by utility and state. https://www.cpuc.ca.gov/consumer-support/financial-assistance-savings-and-discounts/medical-baseline
  5. HHS ASPR. Emergency Prescription Assistance Program (EPAP): a free 30-day supply of medications, supplies, and limited DME for uninsured people in a federally-declared disaster area, renewable while the program is active. NABP Model Rules and many state boards also permit pharmacists to dispense an emergency supply (commonly up to 30 days) during declared emergencies. https://aspr.hhs.gov/EPAP/Pages/epap-for-patients.aspx
  6. HHS emPOWER Program (ASPR and CMS). More than 4.6 million Medicare beneficiaries live independently and rely on electricity-dependent durable medical or assistive equipment, or essential health services; the data and maps are used by public-health authorities in all 50 states. https://empowerprogram.hhs.gov/

 

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For Clinicians | Power Outage Medical Readiness

For Clinicians | Power Outage Medical Readiness

For Clinicians | Power Outage Medical Readiness  Insulin Storage, Oxygen Backup, and Planning for Days Without Power By Dr. Jamie Wilkey, PharmD — Director of Clinical Strategy, JaseMedically reviewed by Kristen Carpenter, PA-C — Clinical Advisory Board Member Why are...

read more
Medicine That Would Have Changed History

Medicine That Would Have Changed History

Medicine That Would Have Changed History What If the Founders Had a Medicine Cabinet? By Cayla McGrath America turns 250 this July. Most anniversary articles this summer will celebrate with fireworks, founding documents, and famous quotes from Washington, Jefferson,...

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Medicine That Would Have Changed History

couple looking at computer asking questions

Medicine That Would Have Changed History

What If the Founders Had a Medicine Cabinet?

By Cayla McGrath

America turns 250 this July.

Most anniversary articles this summer will celebrate with fireworks, founding documents, and famous quotes from Washington, Jefferson, and Franklin. We thought we’d celebrate a little differently by asking an unusual question: What if the Founders had a medicine cabinet?

Half of early American history reads like a record of people dying from infections, dehydration, and wounds that modern medicine routinely treats in the outpatient setting. That’s not meant to criticize eighteenth or nineteenth-century physicians for practicing with the tools they had. Quite the opposite. It serves as a reminder of just how dramatically the floor of basic medical preparedness has risen in a relatively short period of time.

Antibiotics, oral rehydration therapy, antiseptic wound care, hemostatic dressings, and evidence-based trauma management are not ancient discoveries. Many became standard practice within our grandparents’ lifetimes. At Jase, we spend much of our time helping families prepare for disruptions that may happen next month, next hurricane season, or on their next international trip. In honor of America’s 250th anniversary, we thought it might be fun to look backward instead.

Here are seven moments in American history where a modern Jase kit sitting on the shelf could have dramatically altered the outcome.

#1 Valley Forge, Winter 1777–1778

Saved by: JaseCase + JaseMedic

Most Americans learn about Valley Forge as a story of bitter cold, inadequate clothing, and soldiers enduring a brutal winter. In reality, disease claimed far more lives than frostbite ever did.

Between 1,700 and 2,500 Continental soldiers died during the encampment, making Valley Forge one of the deadliest chapters of the Revolutionary War. Typhus spread through body lice, while dysentery and typhoid fever circulated because of contaminated water sources and poor sanitation. Influenza and pneumonia also moved quickly through an already weakened population. Historians note that nearly two-thirds of these deaths occurred in the spring, after the worst weather had passed.

Unfortunately, the medicine chest available in 1778 offered little relief. Bloodletting, mercury-based purgatives, and opium represented some of the best medical interventions available at the time. Germ theory was still decades away, and oral rehydration therapy had not yet been imagined.

Today, many of the bacterial infections and dehydration-related illnesses that devastated Valley Forge would likely be managed with antibiotics, oral rehydration salts, and improved sanitation practices. Washington still emerges from Valley Forge as a stronger leader, but perhaps he does so with many more soldiers standing alongside him.

#2 George Washington’s Final Illness, 1799

Saved by: JaseCase

Many people assume George Washington died simply because his doctors removed too much blood. The story is slightly more nuanced.

Modern historians and infectious disease specialists believe Washington likely suffered from acute bacterial epiglottitis, a rapidly progressing infection that causes swelling of the tissues surrounding the airway. As his breathing became more labored, his physicians attempted nearly every treatment available to them, including repeated bloodletting, blistering compounds, mercury preparations, gargles, and enemas.

By the end of the ordeal, Washington had lost approximately 40 percent of his blood volume.While the infection itself likely initiated his decline, historians increasingly believe that the aggressive interventions of the era significantly worsened his condition. Had Washington developed the same illness today and received prompt antibiotic treatment, there is a good chance he would have recovered within days and enjoyed several more years at Mount Vernon.

#3 Lewis and Clark’s Expedition, 1804–1806

Saved by: JaseCase + JaseMedic

Lewis and Clark are often remembered as rugged explorers conquering an untamed frontier, but their journals tell a different story. For much of their two-year expedition, members of the Corps of Discovery battled dysentery, skin infections, abscesses, dehydration, and gastrointestinal illnesses.

President Jefferson sent Meriwether Lewis to train under Dr. Benjamin Rush before the expedition departed. Rush supplied the group with dozens of his patented mercury-based purgative pills, nicknamed “Thunderclappers.” The medication was considered cutting-edge medicine in 1804, despite causing severe diarrhea and leaving such high concentrations of mercury behind that archaeologists still use soil testing to locate expedition campsites today.

Clark frequently documented sickness spreading among the group and correctly suspected contaminated water sources were contributing to their illnesses.

Today, many of these predictable travel-related problems could likely be managed with a contingency antibiotic, oral rehydration salts, and wound care supplies. It may not make for exciting storytelling, but it probably would have made for a significantly more comfortable expedition

#4 Sacagawea’s Serious Illness, 1805

Saved by: JaseCase

During the expedition, Sacagawea developed a severe illness that left her weak, feverish, and in considerable pain. Historical descriptions suggest she experienced symptoms consistent with an infection that today would often be treated successfully with a short course of antibiotics.

Instead, physicians of the era relied on opium, bark preparations, salts, and bloodletting.

Thankfully, Sacagawea recovered. Still, it is remarkable to consider that an illness which nearly altered one of America’s most celebrated expeditions might now be addressed with medications that fit neatly inside a household medicine cabinet.

#5 William Henry Harrison, 1841

Saved by: JaseCase + JaseMedic

William Henry Harrison did not die because he delivered a lengthy inauguration speech in the rain.

That explanation persisted for generations, but modern historians believe a much different culprit was responsible: typhoid fever.

At the time, Washington, D.C., had primitive sewage infrastructure, and the White House water supply was located downhill from areas used for waste disposal. Harrison developed symptoms consistent with typhoid infection, including severe gastrointestinal illness and progressive dehydration, before dying only thirty-one days into his presidency.

His physicians attempted treatment with opium, castor oil, mercury compounds, and leeches.

Today, oral rehydration therapy alone has prevented millions of deaths worldwide. Combined with appropriate antibiotic treatment, Harrison’s illness would likely have been highly survivable, potentially changing the course of American political history.

#6 James Garfield, 1881

Saved by: JaseTrauma + JaseCase

James Garfield’s story may be the most compelling example of how much medicine has evolved.

Charles Guiteau shot Garfield in July 1881, but historians and surgeons largely agree that the gunshot wound itself was survivable. The bullet missed his spinal cord and lodged behind the pancreas.

What followed was seventy-nine days of increasingly aggressive medical intervention.

Twelve physicians repeatedly inserted unwashed fingers and non-sterile instruments into Garfield’s wound while attempting to locate the bullet. One physician punctured his liver during an examination. Surgeons gradually expanded a relatively small wound into an incision nearly twenty inches long.

All of this occurred fourteen years after Joseph Lister introduced antiseptic surgical techniques in Europe.

Garfield ultimately died from overwhelming infection, malnutrition, and sepsis.

His story highlights a lesson that remains foundational to modern trauma medicine: not every wound benefits from aggressive intervention. Sometimes the best course of action is surprisingly simple. Control bleeding, protect the wound from contamination, monitor carefully, and resist the temptation to make a survivable injury worse.

#7 Theodore Roosevelt’s Bullet Speech, 1912

Saved by: JaseCase + JaseMedic

Contrary to popular legend, Theodore Roosevelt’s eyeglass case did not stop a bullet.

It merely slowed it down.

After being shot in the chest while campaigning in Milwaukee, Roosevelt quickly assessed himself, determined he was not coughing blood, and proceeded to deliver a ninety-minute speech before seeking medical attention.

Doctors later decided to leave the bullet in place, believing removal posed greater risks than simply allowing it to remain.

Roosevelt carried that bullet for the rest of his life.

Unlike Garfield’s physicians, Roosevelt’s doctors understood an important principle that still guides trauma care today: not every injury requires aggressive intervention. Sometimes, controlling bleeding, preventing contamination, and allowing the body to heal is the wiser course.

The Medical Floor Has Risen

Looking across these seven moments in American history, the common thread is not necessarily bad luck. More often, these individuals simply lived before the medical floor had risen beneath them.

Antibiotics, antiseptic technique, oral rehydration therapy, hemostatic dressings, and evidence-based wound management were not yet available. Many of the illnesses and injuries that once changed the course of history are now the kinds of challenges families can thoughtfully prepare for at home.

Perhaps that’s one of the most meaningful ways to celebrate America’s 250th anniversary.

Not only by remembering what earlier generations built, but by appreciating how much safer, healthier, and more medically prepared ordinary families can be today.

At Jase, we believe appropriate medical preparation means keeping that modern medical floor stocked. It means having thoughtful, clinician-built tools available before you need them, so that when life becomes unpredictable, your doctor and pharmacy are already on the shelf, ready when access to care isn’t.

Cayla McGrath is a content strategist with Jase Medical. This post is for informational purposes only and does not constitute medical advice. Always consult a licensed healthcare provider before using any prescription medication.

 

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For Clinicians | Power Outage Medical Readiness

For Clinicians | Power Outage Medical Readiness

For Clinicians | Power Outage Medical Readiness  Insulin Storage, Oxygen Backup, and Planning for Days Without Power By Dr. Jamie Wilkey, PharmD — Director of Clinical Strategy, JaseMedically reviewed by Kristen Carpenter, PA-C — Clinical Advisory Board Member Why are...

read more
Medicine That Would Have Changed History

Medicine That Would Have Changed History

Medicine That Would Have Changed History What If the Founders Had a Medicine Cabinet? By Cayla McGrath America turns 250 this July. Most anniversary articles this summer will celebrate with fireworks, founding documents, and famous quotes from Washington, Jefferson,...

read more
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For Clinicians | What If the Founders Had a Medicine Cabinet?

couple looking at computer asking questions

For Clinicians | What If the Founders Had a Medicine Cabinet?


7 Times It Would Have Changed American History

By Dr. Jamie Wilkey, PharmD — Director of Clinical Strategy, Jase
Medically reviewed by Kristen Carpenter, PA-C — Clinical Advisory Board Member

In 1799, George Washington’s doctors took 80 ounces of blood out of him in 12 hours, roughly 40% of his blood volume. They also pressed a strip of Spanish fly to his throat to raise a blister, made him gargle vinegar and sage tea, and gave him an enema before he died.

Forty-two years later, William Henry Harrison drank his White House water, which was sourced uphill from a marsh that doubled as the city’s sewage depository. He was dead in 31 days.

Forty years after that, 12 different physicians took turns sticking their dirty fingers in President Garfield’s bullet wound with unwashed hands for 79 straight days. Joseph Lister had published his antiseptic technique in 1867, and European surgeons had adopted it. American doctors? Unfortunately for Garfield, they weren’t onboard.

This week, America turns 250. And whatever else people are pessimistic about right now, here is something that is not up for debate: this is the best place in human history to be alive when something goes wrong with your body. The Friday-night UTI gets treated. The bullet wound gets debrided in a sterile OR. The cipro Rx is at the CVS down the street. We live in a wonderful time medically that was built brick by brick, mostly inside our great-grandparents’ lifetimes.

Jase usually writes about how to be ready for what your body throws at you next week. For our 250th issue, we wanted to do something different and look backward instead. Half of early American history reads like a record of important people dying from infections a household Jase kit would handle today, and we kept finding ourselves wishing we could ship a JaseCase back in time to save them.

Here are seven of the best ones.

#1. Valley Forge, Winter 1777-78

Saved by: JaseCase antibiotic panel + JaseMedic oral rehydration salts

The popular story of Valley Forge is the cold. The actual story is the lice and the latrines.

Between 1,700 and 2,500 of Washington’s 12,000 soldiers died at the 1777-78 winter encampment, roughly one in six.¹ More dead than at any single engagement of the Revolutionary War. And most didn’t go in the worst of winter; two-thirds died in March, April, and May, as the camp’s sanitation problems compounded. The killers were typhus (from body lice), typhoid and dysentery (from contaminated water), and influenza and pneumonia sweeping the barracks.

Period medicine: bleeding, calomel (a mercury-based purgative), and opium. That was the kit. No germ theory. No antibiotics. No oral rehydration concept. If you came down with dysentery, the standard of care was making it worse.

If they had a JaseCase: the antibiotic panel handles the typhus, typhoid, and dysentery, and JaseMedic ORS pulls the dehydrated cases back from the edge. Washington marches out of Valley Forge in spring 1778 with his army intact and combat-ready for the redcoats, instead of gutted by the latrines before the next engagement.

#2. George Washington’s Final Illness, December 1799

Saved by: JaseCase amoxicillin/clavulanate

Bloodletting gets the blame, but the bacterial infection in his throat got there first. The bleeding just finished the job.

Modern medical historians say what actually killed Washington was acute bacterial epiglottitis: a fast-moving throat infection (likely Haemophilus influenzae) that swelled his airway shut during a regional flu epidemic.² His doctors responded with bleeding, blistering, calomel, and an enema. Over twelve hours they took 80 ounces of blood from him in four sessions, about 40% of his total volume. The final draw came out slow and thick, the textbook look of Class IV hemorrhagic shock.

If he had a JaseCase: amoxicillin/clavulanate, taken in the first hours of the illness, treats the bacterial infection before the airway closes. Washington gets a few more years at Mount Vernon and a voice in the 1800 election, instead of dying of a treatable throat infection far too young at age 67.

#3. The Lewis & Clark Corps of Discovery, 1804–06

Saved by: JaseCase ciprofloxacin, doxycycline, metronidazole + JaseMedic ORS

The myth of Lewis and Clark is the tough frontiersmen. The reality is they were sick the entire expedition.

Jefferson sent Meriwether Lewis to Philadelphia for a crash-course in medicine with Dr. Benjamin Rush, who outfitted the corps with 50 dozen of his patented purgative pills (nicknamed “Thunderclappers” for the obvious reason), 15 pounds of Peruvian bark, mercury, and opium. Dysentery and skin abscesses plagued them for two years. Clark’s June 1804 journal entry, verbatim spelling: “The party is much afflicted by boils and several have the deassentary which I contribute to the water.”³ The mercury in those Thunderclappers still tracks the expedition today; archaeologists find the corps’ old latrine sites by testing soil for residue.

If they had a JaseCase: cipro and doxycycline handle the dysentery, metronidazole covers the anaerobes, JaseMedic ORS keeps the dehydrated cases alive, and doxycycline replaces the 15 pounds of Peruvian bark as malaria prophylaxis. Lewis and Clark reach the Pacific on schedule and bring the whole corps home, instead of leaving graves along the Missouri and stalling the mapping of the Louisiana Purchase for years.

#4. Sacagawea, May–June 1805

Saved by: JaseCase doxycycline + metronidazole

Sacagawea almost died in eastern Montana in June 1805. High fever, severe pelvic pain, delirium. The corps assumed she wouldn’t make it; Clark’s journal entries that month read like a death-watch.

Modern medical historians read it as pelvic inflammatory disease, caused by a sexually transmitted infection she’d almost certainly gotten from her husband, the French-Canadian fur trapper Toussaint Charbonneau.⁴ Clark treated her with bleeding, bark, salts, and opium. Lewis added “two doses of barks and opium” to that. The party gave her water from a sulfur spring along the trail. She eventually recovered in spite of these ‘treatments’.

If she had a JaseCase: doxycycline plus metronidazole is the modern outpatient regimen for PID. Days of pills resolve what nearly killed her over weeks. Sacagawea recovers fast, the corps reaches the Shoshone without losing the only person who can speak to her brother’s tribe, and the expedition gets home, instead of stranding in the Rockies with no interpreter and no diplomatic line.

#5. William Henry Harrison, April 1841

Saved by: JaseCase ciprofloxacin or azithromycin + JaseMedic ORS

The story everyone learned: Harrison gave a two-hour inauguration speech in the rain, caught pneumonia, and died a month later. The story we now know: he was killed by his own White House drinking water.

A 2014 paper in Clinical Infectious Diseases identified the killer as enteric fever (typhoid or paratyphoid) from the White House drinking water, which sat downstream of a marsh used as the city’s depository for night soil.⁵ Five days of constipation and abdominal distension. Then watery diarrhea. Then the cold blue extremities of dehydration shock. His doctors gave him opium, castor oil, calomel, ipecac, leeches, and snakeweed. Every treatment compounded the dehydration. He died on day 31 of his presidency.

If he had a JaseCase: ciprofloxacin or azithromycin handles the typhoid, and JaseMedic ORS addresses the proximate cause of death (volume depletion from days of watery diarrhea). Harrison serves out his term, Tyler never becomes president, and the 1840s play out under Whig leadership instead of the third-party lurch the country actually got.

#6. James Garfield, July–September 1881

Saved by: JaseTrauma hemostatic gauze + pressure bandage + JaseCase ciprofloxacin + metronidazole

Charles Guiteau shot James Garfield on July 2, 1881. Garfield died 79 days later. Guiteau did not kill him. His doctors did.

The bullet entered Garfield’s back, passed his first lumbar vertebra without touching the spinal cord, and came to rest behind his pancreas. By the standards of 1881 surgery (meaning, no surgery), this was a survivable wound.

Instead: 12 different physicians took turns probing the open wound with unwashed fingers and unsterilized instruments, starting at the train station on a manure-stained floor. Lead physician Dr. D. Willard Bliss kept it up for 79 days. One probe punctured Garfield’s liver, creating a false channel that filled with pus. The doctors followed the pus, assuming it was the bullet’s track, and widened the original 3-inch wound into a 20-inch incision from ribs to groin. Without sterile technique.

Joseph Lister had published his antiseptic protocol in 1867. European surgeons were already using it as standard practice. American medicine had stuck with miasma theory and considered the British surgeon’s hand-washing crusade overblown.⁶ Garfield wasted from 210 pounds to 130. His body was eating itself trying to fight the infection. He died on September 19, 1881.

If he had a JaseTrauma kit and a JaseCase: hemostatic gauze and a pressure bandage stop the bleeding at the train station; nobody sticks their fingers in the wound; ciprofloxacin and metronidazole cover the polymicrobial flora of deep abdominal trauma. Garfield finishes his civil rights work on his own terms instead of dying of his own doctors over 79 days, and Chester Arthur stays a footnote in New York machine politics.

#7. Theodore Roosevelt’s “Bull Moose” Speech, October 14, 1912

Helped by: JaseTrauma pressure bandage + hemostatic gauze

Garfield got 12 doctors. Theodore Roosevelt got a folded speech and a steel eyeglass case. On October 14, 1912, John Schrank shot Roosevelt in the chest at a Milwaukee campaign stop. The bullet was slowed by two items in his right jacket pocket: a steel eyeglass case and the folded 50-page manuscript of the speech he was about to give. It still pierced his fourth rib and lodged in his chest.

TR was an experienced hunter. He checked himself for coughing blood. None. Concluding his lung wasn’t pierced, he refused the hospital and went on to deliver his 90-minute speech with a bullet in his chest and blood seeping through his shirt. The speech included the line: “It takes more than that to kill a Bull Moose.”⁷ The bullet stayed in his chest for the remaining seven years of his life.

If he had a JaseTrauma kit: hemostatic gauze and a pressure bandage cut the blood loss during the 90-minute speech. But TR’s story isn’t a Jase save — it’s a Jase principle in action. The 1912 doctors did exactly what the 1881 doctors couldn’t, and TR’s bullet went on to outlive several of them.

Wrap Up

What the seven stories above have in common is how recent the things we take for granted actually are. Antibiotics, antisepsis, oral rehydration, hemostatic gauze, the discipline to leave a wound alone: none of it was available to the people in this article. Most of it isn’t even a century old.

That’s a big part of our country’s 250th worth celebrating: the country they built, and the medical floor that’s risen since then.

Jase exists to put that floor in your house. JaseCase puts physician-prescribed antibiotics on your shelf. JaseMedic puts the oral rehydration solution that would have saved Harrison in your travel bag. JaseTrauma puts the gauze and the pressure bandage that would have spared Garfield in your car. It’s the household-level standard of appropriate medical preparation. It complements your primary care doctor, your urgent care, and your ER. Never replaces them.

Happy 250th.

Sources

  1. Valley Forge mortality figures: https://en.wikipedia.org/wiki/Valley_Forge
  2. Modern diagnosis of Washington’s epiglottitis (Morens, NEJM 1999): https://pubmed.ncbi.nlm.nih.gov/16244717/
  3. Clark’s June 1804 journal and Corps medicine (NPS, “Medicine on the Lewis and Clark Expedition”): https://www.nps.gov/articles/000/medicine-on-the-lewis-and-clark-expedition.htm
  4. Sacagawea’s pelvic inflammatory disease (PubMed PMID 18622070): https://pubmed.ncbi.nlm.nih.gov/18622070/
  5. Harrison enteric-fever reread (McHugh & Mackowiak, Clinical Infectious Diseases, 2014): https://academic.oup.com/cid/article/59/7/990/2895539
  6. Lister’s antiseptic technique and American rejection of germ theory (American College of Surgeons): https://www.facs.org/about-acs/governance/board-of-governors/resources/giants-garfield/
  7. Theodore Roosevelt’s Bull Moose speech, October 14, 1912 (TR Presidential Library): https://www.trlibrary.com/bullet-speech

 

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When You Can’t Get to a Doctor, What’s the Real Alternative?

couple looking at computer asking questions

When You Can’t Get to a Doctor, What’s the Real Alternative?

Antibiotic Stewardship vs Antibiotic Access

By Cayla McGrath

Picture any of these scenarios.

A hurricane makes landfall and the pharmacy two miles from your house is closed for two weeks. Your kid develops a dental abscess at a national park four hours from the nearest urgent care. You’re three days into a cruise when a UTI that started as a minor annoyance becomes something that needs treatment — now. Or it’s a Sunday evening, the symptoms started at 7pm, and the urgent care closed at 6.

These aren’t hypotheticals. They’re the kinds of access failures that happen regularly to regular people — and when they do, the question isn’t “should I see a doctor or take an antibiotic from my shelf?” The real question is a different one entirely.

The Comparison Group Most People Miss

When people hear “antibiotics at home,” the instinct is to compare that to the ideal: walk into a clinic, get examined, get a prescription, pick it up at the pharmacy. That comparison makes the at-home option look unnecessary at best and reckless at worst.

But that’s not the comparison that matters. The comparison that matters is what people actually do when the ideal isn’t available.

They order fish antibiotics online. They take leftover azithromycin from a prescription that was supposed to be finished six months ago. They go to a pharmacy across the border. They dig through their medicine cabinet for an expired Z-Pack and cross their fingers.

This isn’t a fringe behavior. In one multisite survey across six safety-net clinics and two emergency departments in Texas, 43.6% of patients reported using antibiotics without a prescription. Of that group, 26% had already self-medicated with leftover antibiotics from a previous course — and 51% said they intended to do it again. The FDA issued nine warning letters to companies selling fish antibiotics for human consumption in December 2023, then followed with another enforcement action against a major distributor in May 2025. The reason those enforcement actions exist: the market is large enough to warrant them.

So when we talk about what it means to have a prepared antibiotic supply at home — one prescribed by a physician, shipped with clinical guidance, and designed for specific, well-defined conditions — the real comparison isn’t a doctor’s office visit. It’s fish antibiotics and a Google search.

This Isn’t a New Idea

Disaster medicine and travel medicine have been working in this space for decades.

After Hurricane Katrina, researchers followed roughly 18,000 evacuees who had relocated to San Antonio. Federal disaster relief teams supplied just 9% of all chronic care medications dispensed to that population. The remaining 91% came from retail pharmacies doing the work outside the normal clinical encounter — because that encounter wasn’t available. The federal Emergency Prescription Assistance Program exists precisely for this reason.

Travel medicine took the logic a step further. The 2017 International Society of Travel Medicine travelers’ diarrhea guideline explicitly endorses prescriber-initiated self-treatment, where the patient leaves the appointment with the antibiotic in hand and takes it themselves when symptoms meet defined criteria. No clinical visit required at the point of use. The CDC Yellow Book chapter on travelers’ diarrhea aligns with this approach.

In both fields, pharmaceutical access outside the normal clinical encounter is recognized as a necessity — not a stewardship problem.

We’re applying the same principle to the predictable access failures that don’t make the news: the Sunday UTI, the weekend dental abscess, the gap between when symptoms start and when a provider is reachable.

What the JaseCase Actually Is

JaseCase is a prepackaged set of antibiotics prescribed by a physician in advance. It arrives at your home with a written guidebook and one explicit instruction: consult a clinical authority before using anything in it.

That’s not fine print. It’s the design. Every medguide we ship ends with the same line: Consult local health officials for event-specific recommendations. Jase telehealth is the backstop when your regular provider isn’t reachable — it exists so that even in a gap, you’re not making this call alone.

The five antibiotics in the JaseCase are selected from the WHO AWaRe framework, the global standard for antibiotic classification and appropriate use. Three of the five are AWaRe Access tier (the most recommended for common bacterial infections). The other two retain WHO first-line empiric status for the specific scenarios they’re included to cover.

The kit is designed for well-defined, common, self-limiting conditions where the evidence is strong and the treatment path is clear. It’s not for complex diagnoses, chronic conditions, or anything that needs an in-person exam. The clinical work happens on the front end — through the prescribing physician — so you’re not doing diagnostics at home at 11pm.

What the JaseCase Is Not

JaseCase is not a replacement for primary care. It doesn’t belong in every medical decision, and it’s not designed for every situation.

Complex diagnoses, ongoing provider relationships, chronic disease management — those belong in the exam room. The kit covers the gap that exists when that exam room isn’t accessible, not the appointments you can schedule.

We also want to be direct about the stewardship side of this. The strongest argument against home antibiotic supplies is that patients will use them inappropriately — not because the antibiotics are dangerous in the right context, but because self-symptom assessment is imperfect. We take that seriously. The consult-before-use instruction isn’t an afterthought; it’s how we try to keep the diagnostic step in the hands of a clinician whenever that’s possible. And evidence from similar models — patients given structured antibiotic access with clear criteria — shows that appropriate guidance can actually reduce total antibiotic use, not increase it.

The Gap Is Already Being Filled

The market for unguided antibiotic access — fish antibiotics, leftover prescriptions, border pharmacies — is not small, and it’s not shrinking. The FDA’s enforcement actions are evidence that demand is significant enough to warrant federal attention.

JaseCase is a structured alternative in that space. A physician-prescribed, guidebook-supported, consult-before-use supply that gives you something better than fish mox when your regular provider isn’t available. It’s not competing with your doctor’s appointment. It’s competing with what you’d do instead.

If you’ve been curious about preparedness options and want to understand what’s in the kit and how it works, you can learn more at Jase.com

Cayla McGrath is a content strategist with Jase Medical. This post is for informational purposes only and does not constitute medical advice. Always consult a licensed healthcare provider before using any prescription medication.

 

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Everyone should be empowered to care for themselves and their loved ones during the unexpected. Check out our recent lifesaving products today.
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Keeping you informed and safe.

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For Clinicians | Power Outage Medical Readiness

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Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!