Prolonged Field Care Podcast

Frank Stadler, founder of MadeMag Labs with a PhD in maggot therapy supply chains, and Jonathan Liu, a 20-year Special Forces medic, discuss maggot-based wound care. They explore historical resurgence, how maggots debride and disinfect, using them in burns and austere settings, species selection and local sourcing, sterilization options, application methods, and scaling training and supply.

John Dominguez, a former 20-year Army medic and special operations senior enlisted leader, reflects on professionalizing military medical forces and mentoring medics. He talks about balancing rising skill demands with limited training time. Tactical constraints, equipment and logistics, mentorship, and adapting lessons from global conflicts are explored in short, focused conversations.

In this episode of the PFC Podcast, Rick Kelly, a retired 18 Delta Special Forces medic, shares insights into the unique challenges faced by Special Forces medics in austere environments. He discusses the critical role these medics play in providing life-saving surgical procedures in areas lacking medical infrastructure, emphasizing the importance of understanding their training and operational constraints. Kelly highlights the evolution of medical practices within Special Forces, particularly the adoption of methods from the International Committee of the Red Cross (ICRC) to improve patient outcomes in combat situations.Kelly elaborates on the specific surgical techniques taught to Special Forces medics, including wound excision, closure, and amputation, all tailored to the limited resources available in the field. He contrasts these practices with conventional medical approaches, underscoring the necessity for adaptability and efficiency in high-pressure environments. The episode concludes with a call for healthcare providers to better understand the realities of austere medicine, enabling them to support Special Forces medics more effectively.Understanding austere medicine is crucial for effective healthcare delivery.The ICRC's methods have significantly influenced Special Forces medical training.Infection rates can be drastically reduced with proper wound management.Chapters05:30 Adopting ICRC Methods10:39 Challenges in Austere Environments16:46 Conclusion and Key TakeawaysFor more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this episode of the PFC Podcast, Dennis speaks with Rima, a combat medic in Ukraine, about the critical aspects of unit safety, tactical training, and the challenges faced in medical evacuations during an active war zone. Rima shares insights on the importance of personnel over equipment, the necessity of telemedicine, and the realities of training medics under resource constraints. The conversation also delves into wound management, infection control, and the unique challenges posed by winter conditions in the field.TakeawaysThe priority in combat medicine is personnel over equipment.Training for medics is often condensed due to active war conditions.Telemedicine plays a crucial role in providing care in remote areas.Wound management and infection control are critical in combat situations.Adapting to resource limitations is essential for effective medical care.Basic skills in combat medicine can save lives more than advanced techniques.The drone threat complicates medical evacuations significantly.Improvisation is key when standard resources are unavailable.Understanding the basics of medicine is vital for effective care.Every situation in combat medicine requires quick and adaptable responses.Chapters00:00 Introduction to Combat Medicine in Ukraine02:57 Unit Safety and Tactical Training06:00 Challenges of Medical Evacuations08:47 Training Medics in Active War Zones12:02 Telemedicine in Combat Situations14:57 Wound Management and Infection Control17:55 Prioritizing Gear and Equipment21:10 Adapting to Resource Limitations23:46 Winter Challenges in Hemorrhage Control27:01 Concluding Thoughts on Tactical Medicine For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

Explore the critical nuances of tourniquet management in trauma care, including the vital distinction between tourniquet conversion and replacement. Discover the importance of patient resuscitation prior to conversion, and the physiological risks associated with prolonged tourniquet use. The discussion highlights techniques for safe conversions, potential complications like reperfusion injury, and the challenges of assessing limb salvageability in high-stress situations. Gain practical insights on preparing for adverse outcomes and ensuring optimal patient care.

Jennifer Gurney, a trauma and burn surgeon, and JR Pickett, an EMS physician and battalion surgeon, dive into the complexities of end-of-life care in austere settings. They argue against traditional palliative care terminology, highlighting its potential to mislead and jeopardize care effectiveness. Key discussions include the moral injuries faced by medics making early futility calls and the need for training that balances ethical considerations with practical skills. They also emphasize the importance of supporting medics post-decision and the use of mortality reviews for improving care systems.

Explore the critical issue of hypothermia in trauma care, where even healthy patients cool rapidly! Learn about the four mechanisms of heat loss and practical strategies to counter them in the field. Discover common pitfalls that can exacerbate cooling, such as wet clothing and unheated ventilation. Hear real-world experiences from deployments that emphasize the importance of keeping patients warm. Additionally, find out about effective team-based interventions and the trade-offs between cold blood resuscitation and hypothermia management.

Jessica Patterson, an emergency medicine physician with trauma experience and humanitarian work in Ukraine, and Florian Schmitzberger, a military medic turned program director, delve into the evolving clinical practice guidelines in dynamic conflict settings. They emphasize the need for data to assess guideline performance amidst changing environments. The duo shares insights on prolonged tourniquet issues, blood supply constraints, and the influence of rigid protocols on medical decision-making. Their conversation advocates for adaptive training and policy adjustments to enhance frontline care.

Dive into the latest updates on Tactical Combat Casualty Care guidelines. The hosts discuss the vital role of the TTC Committee and how literature reviews shape trauma care algorithms. Discover the shift to prioritize resuscitation over decompression in emergencies. Changes to the MARCH algorithm are on the table, along with a major overhaul of analgesics due to supply concerns. Learn about the simplified antibiotic recommendations and the importance of triage in mass casualty situations. They emphasize the need for innovative solutions and robust training for new practices.

A former Ranger medic recounts a harrowing mass casualty event during a humanitarian mission in Burma. He discusses the historical context of the conflict and the critical challenges in delivering medical support. Innovative strategies emerged in a denied environment, including successful field blood transfusions. The importance of training, adaptability, and building local medical capacity to empower future care is emphasized. Personal motivation and a commitment to purpose guided his actions throughout the intense operation.