Home The First 100 Tier Nine

The First 100 · Tier Nine of Ten · Items 81–90

Longer Reach

Your household can handle a longer medical interruption, and get home or get out in a vehicle that is ready.

Why this tier, in this order

Tier nine extends two clocks. The first is medical: the seven-day prescription buffer from tier two grows to thirty days, wound care deepens past the household kit, and the entries turn toward the people whose dependence on a device or a medication makes a supply interruption a different kind of event. The second is mobility: most people are not home when things happen, and a vehicle that can start itself, hold its air, and carry a night's worth of warmth is preparedness for the majority of hours in a life.

This tier also contains the most contested exclusion in the document, and it deserves its argument in the open. Tourniquets save lives, the bleeding-control movement that promotes them is right about that, and this list still does not include one as a purchase. The reason is the same precedent set at item 15: where a capability is dangerous to improvise, training precedes equipment, every time. A tourniquet bought, binned, and never trained on is the item most likely to be applied wrong by a frightened person, and the counterfeits that dominate online marketplaces make the untrained purchase worse still. Take a bleeding-control class, then buy a real one from a verified supplier. That is not a refusal. It is a sequence, and sequence is what this document is for.

A quieter theme runs under the conditional items here. Spare glasses, hearing aid batteries, a glucometer with strips: general-purpose lists drop these because they do not apply to everyone, and the households that need them are exactly the ones least able to improvise around their absence. A list built for real households makes room for the ways real households differ.

The threshold

Your household can handle a longer medical interruption, and get home or get out in a vehicle that is ready.

Rough tier cost: $150 to $450, varying widely with the conditional items.

Items 81–85

Thirty-day prescription buffer

$$$

Extending the seven-day cushion from item 16.

Why here. Regional events disrupt pharmacy supply chains for weeks, not days, and the seven-day buffer is a starting position rather than a finishing one.

“You already had this at item 16.”

Item 16 is a week and it is achievable for almost everyone. This is a month and it takes planning, prescriber cooperation, and sometimes several refill cycles to build. Different item, different difficulty, correctly separated.

The checklist

Expanded wound care

Larger dressings, more roller gauze, wound irrigation, splint material.

Why here. Deeper than item 14, for the situation where professional care is genuinely delayed rather than merely inconvenient.

“Where is the tourniquet? Every serious list has one.”

This is the most contested exclusion on our list and it deserves a straight answer. Tourniquets work and they save lives. They are also the item most likely to be bought, never trained on, and then applied incorrectly by someone under stress. Our position is that a tourniquet follows a bleeding-control class rather than preceding it, in the same way item 15 precedes the medical items around it. Take Stop the Bleed, then buy the tourniquet, and buy a real one rather than the counterfeits that dominate online marketplaces. We are not telling you to skip it. We are telling you the order.

“What about a suture kit or a skin stapler?”

No, and this one is not close. Closing a contaminated wound at home traps infection inside it. One AI system we tested recommended a skin stapler for use when emergency rooms are inaccessible, which is exactly backwards: the wounds you can close safely do not need closing, and the ones that need closing need irrigation and judgment you do not have. Clean it, dress it, and get it seen.

Emergency dental kit

Temporary filling material and topical numbing agent.

Why here. A lost filling or a cracked molar during a week when no dentist is available produces pain severe enough to stop a person functioning, and the fix costs almost nothing.

“Nobody needs this.”

It appeared on exactly one of the dozens of lists we reviewed. Dental problems are a common reason for emergency room visits in ordinary times, dental pain is unaffected by whether the power is on, and the category is entirely absent from mainstream preparedness content.

Sensory and mobility spares

$$conditional

Hearing aid batteries, a spare pair of glasses with a current prescription, spare cane tips, catheter or ostomy supplies, whatever applies.

Why here. For a household member who depends on a device, a spare is not a convenience.

“This is too specific to be on a general list.”

That is precisely why it is here. General lists drop it, and the households that need it are the ones least able to improvise. Someone who cannot see their prescriptions or hear a warning is in a substantially worse position than the list acknowledges.

Condition-specific monitor

$$conditional

A glucometer with strips, a blood pressure cuff, a pulse oximeter, whatever the household's conditions require.

Why here. Monitoring is what allows a chronic condition to be managed at home when the routine appointment does not happen.

“Home monitoring leads people to self-treat badly.”

A real risk, and the answer is that these are for the conditions someone already monitors under a clinician's direction, not for diagnosing new ones. Buying a pulse oximeter to decide whether you need a hospital is a different and worse use.

Items 86–90

Lithium jump starter

$$conditional

For households with a vehicle.

Why here. A dead battery is the most common vehicle failure, and a jump starter does not require a second vehicle or a stranger.

“Cables and a neighbor are free.”

They are, and they require a neighbor who is home, a vehicle that can reach yours, and someone who knows the sequence. A jump starter also charges phones and runs a light.

Tire inflator and pressure gauge

$$conditional

Why here. Slow leaks become roadside failures, and pressure is the single most neglected vehicle maintenance item.

“Every gas station has air.”

For a dollar in quarters, when it is working, when the station has power. A twelve-volt inflator in the trunk handles the leak in the driveway before it becomes the flat on the shoulder.

Reflective warning triangles

$conditional

Why here. A disabled vehicle on a shoulder is a serious hazard, and secondary collisions with stopped vehicles are a recurring cause of roadside deaths.

“Flares are better.”

Flares burn out, are a fire risk in dry conditions, and are illegal in some places. Triangles need no batteries and no fuel and work all night.

Vehicle kit: water, blanket, light, food

$$conditional

Why here. Most people are not home when things happen, and the winter storm that strands drivers on an interstate is a recurring event rather than a hypothetical.

“Water freezes and food goes bad in a hot car.”

Both true, which is why this is a seasonal rotation rather than a sealed box. Swap it twice a year when you change the clocks. Bottled water can be left partly empty to allow for expansion.

Our review The checklist The kit

Escape ladder for upper floors

$$conditional

For households with sleeping areas above the ground floor.

Why here. House fire remains the disaster most likely to happen to any given household, and a second exit from an upper bedroom is the difference between an escape and a trap.

“You will never use it and it is a burglary risk.”

Stored inside, under a bed or in a closet, it is not an entry point. It is one of the few items here that addresses a genuinely likely fatal scenario, and it is routinely absent from lists that find room for a gas mask.

The checklist

Keep the sequence

One tier at a time, in order.

Tier Eight Tier Ten

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