Prolonged Field Care Podcast

This conversation explores the topic of gas anesthesia, its historical background, and its use in various environments. The conversation covers the shift to the TIVA technique, the importance of the anesthesia machine and equipment, and the training required to administer gas anesthesia. It also discusses the combined techniques used in the operating room and the stages of anesthesia. The conversation highlights the advantages and disadvantages of ether and chloroform as anesthetics. It emphasizes the need for vigilant monitoring and the use of IV induction agents for safety. The conversation concludes by discussing the duration of gas anesthesia and the importance of witnessing wakeups. Takeaways Gas anesthesia has a long history and is still used today in various environments. The TIVA technique is a popular approach to gas anesthesia, especially in field environments. The anesthesia machine and equipment play a crucial role in administering gas anesthesia. Vigilant monitoring is essential during gas anesthesia to ensure patient safety. Witnessing the stages of anesthesia, including wakeups, is important for understanding the process. Ether and chloroform were popular anesthetics in the past but have been replaced by safer alternatives. IV induction agents are used to quickly transition patients through the stages of anesthesia. The duration of gas anesthesia depends on the amount and length of use. Observing gas anesthesia in the operating room provides valuable insights into its application. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠ or ⁠www.lobocoffeeco.com/product-page/prolonged-field-care

This episode of the PFC podcast focuses on in-route casualty care. The guest, Nikki, shares her background and experience in the Navy and explains why she started an in-route care training course. The conversation covers common mistakes in preparing patients for flight, securing lines and equipment, and the importance of constant assessment and monitoring. Nikki also discusses the training scenarios she uses to prepare nurses and corpsmen for in-route care. The episode concludes with a discussion on effective handovers, monitoring endotracheal tube placement, and the importance of collaboration in in-route care. Takeaways Proper planning and assessment are crucial in in-route casualty care. Securing lines and equipment and packaging the patient appropriately are important considerations for flight. Constant assessment and monitoring are essential during in-route care. Effective handovers and communication are critical for patient care during transport. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

In this conversation, Dennis and John discuss chest trauma management, specifically the use of chest seals and the sequence of interventions. They explore the overuse of chest seals and the potential complications they can cause. They also discuss the importance of assessing the patient and determining if a chest seal is necessary. John shares his insights on the use of finger thoracostomy and the technique for performing it. They also touch on the revision of the TCCC algorithm and the need to prioritize hemorrhage control. The conversation explores the challenges and approaches in operational medicine, emphasizing the need to align policy and guidelines with the experiences of field practitioners. It highlights the importance of preserving the rich experience and lessons learned by experienced personnel. The discussion also delves into the management of chest trauma, specifically focusing on emergent situations and the challenges in current practices. The conversation concludes with the anticipation of future discussions and the potential for further exploration of the topics. Takeaways Chest seals should be used specifically for sucking chest wounds or open pneumothorax. Chest seals can cause tension pneumothorax if used inappropriately. The decision to use a chest seal should be based on the patient's breathing status and the nature of the injury. Negative suction can be beneficial in re-inflating the lung and improving oxygenation in patients with chest trauma. The TCCC algorithm may need revision to prioritize hemorrhage control. Operational medicine requires a balance between algorithmic approaches and the practical experiences of field practitioners. Preserving the experience and lessons learned by experienced personnel is crucial for the development of effective policies and guidelines. Chest trauma management involves various emergent situations, including tension pneumothorax, hemothorax, and pneumothorax. Challenges in chest trauma management include the use of occlusive dressings and the need for surgical interventions. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠ or ⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this conversation, Dennis and John discuss chest trauma management, specifically the use of chest seals and the sequence of interventions. They explore the overuse of chest seals and the potential complications they can cause. They also discuss the importance of assessing the patient and determining if a chest seal is necessary. John shares his insights on the use of finger thoracostomy and the technique for performing it. They also touch on the revision of the TCCC algorithm and the need to prioritize hemorrhage control. The conversation explores the challenges and approaches in operational medicine, emphasizing the need to align policy and guidelines with the experiences of field practitioners. It highlights the importance of preserving the rich experience and lessons learned by experienced personnel. The discussion also delves into the management of chest trauma, specifically focusing on emergent situations and the challenges in current practices. The conversation concludes with the anticipation of future discussions and the potential for further exploration of the topics. Takeaways Chest seals should be used specifically for sucking chest wounds or open pneumothorax. Chest seals can cause tension pneumothorax if used inappropriately. The decision to use a chest seal should be based on the patient's breathing status and the nature of the injury. Negative suction can be beneficial in re-inflating the lung and improving oxygenation in patients with chest trauma. The TCCC algorithm may need revision to prioritize hemorrhage control. Operational medicine requires a balance between algorithmic approaches and the practical experiences of field practitioners. Preserving the experience and lessons learned by experienced personnel is crucial for the development of effective policies and guidelines. Chest trauma management involves various emergent situations, including tension pneumothorax, hemothorax, and pneumothorax. Challenges in chest trauma management include the use of occlusive dressings and the need for surgical interventions. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠ or ⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this podcast episode, Dennis interviews Monte from Delta Development about the need for a small blood refrigerator for prolonged field care. Monte shares his military background and experiences in Afghanistan and Iraq, where he realized the importance of carrying blood products in the field. They discuss the challenges of storing and transporting blood, including temperature control and cumulative time. Monte explains how Delta Development's blood refrigerator solves these issues and can even be used to run a mini blood bank. They also touch on the future possibilities of resupplying blood in the field. Overall, the podcast highlights the critical role of blood in prolonged field care and the importance of proper storage and transport methods. Takeaways Carrying blood products in the field is crucial for prolonged field care. Temperature control and cumulative time are key factors in blood storage and transport. Delta Development's blood refrigerator provides a solution for maintaining proper blood temperature in austere environments. The device can be used to run a mini blood bank and facilitate blood resupply in the field. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective

In this conversation, Dennis and Mike discuss the process of providing medical care and education in austere environments. They emphasize the importance of understanding the requirements and asking the right questions to ensure success. They also discuss the significance of analyzing the environment, finding reliable sources of information, and building relationships with partners and friends. Planning and preparation are highlighted as crucial steps, along with effective teaching methods and the use of the Learning to Listen, Listening to Teach technique. The conversation concludes with a discussion on measuring performance and effectiveness, and the importance of flexibility and focusing on the student. Takeaways Understand the requirements and ask the right questions to ensure success in providing medical care and education in austere environments. Analyze the environment and find reliable sources of information to make informed decisions. Build relationships with partners and friends to enhance understanding and collaboration. Plan and prepare thoroughly, focusing on the basics and acquiring the necessary knowledge. Use effective teaching methods and the Learning to Listen, Listening to Teach technique to engage and educate students. Measure performance and effectiveness to assess the impact of the medical care and education provided. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective

In this conversation, Dennis and Justin discuss lessons learned in analgesia and sedation. They emphasize the importance of understanding medications and dosages, as well as having a plan for drug administration. They share case studies and examples of the wrong drug being used in the wrong situation. They also highlight the need for a strong foundation in medication knowledge and the importance of setting measurable goals for pain control. They caution against following trends and emphasize the importance of individual patient responses and safety measures. Takeaways Understand the medications and dosages you are using Have a plan for drug administration and set measurable goals for pain control Avoid using the wrong drug for the situation Build a strong foundation in medication knowledge Avoid following trends and focus on individual patient responses and safety measures Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠deltadevteam.com⁠⁠⁠ For more content go to ⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠ Consider supporting us: ⁠⁠⁠patreon.com/ProlongedFieldCareCollective

In this conversation, Aaron Epstein from GSMSG discusses the background and formation of GSMSG, their focus on training partners rather than providing services, and their work with military and security forces around the world. He shares lessons learned in surgical resuscitation, dealing with mass casualties, and planning for different phases of war. Aaron emphasizes the importance of tourniquet use and the need for more surgeons in combat situations. He also discusses the challenges in the training pipeline and the need for more medical training. The conversation concludes with a discussion on transportation challenges and lessons learned, as well as how to get in contact with GSMSG.Takeaways GSMSG focuses on training partners rather than providing services. Tourniquet use is vital in combat situations and should not be removed from the treatment algorithm. Planning for different phases of war, including defensive, static, and offensive actions, is crucial for effective medical support. There is a need for more surgeons and better medical training in combat situations. Transportation challenges in combat zones require innovative solutions. GSMSG can be contacted through their website, www.gsmsg.org. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠deltadevteam.com⁠⁠ For more content go to ⁠⁠www.prolongedfieldcare.org⁠⁠ Consider supporting us: ⁠⁠patreon.com/ProlongedFieldCareCollective

In this podcast episode, Dennis talks with Doug (an ICU doctor) about acute kidney injury. They discuss the causes and types of acute kidney injury, how to recognize it, and the treatment options available. They also cover the recovery and prognosis of acute kidney injury, as well as the crush injury protocol and managing potassium levels. The episode provides valuable insights for healthcare practitioners dealing with acute kidney injury in prolonged field care situations. Takeaways Acute kidney injury can be caused by a drop in perfusion to the kidneys, blockage of urine flow, or toxic injury to the kidneys. Recognizing acute kidney injury is important, and urine output and laboratory tests can help in the diagnosis. Treatment of acute kidney injury involves preventing further injury, ensuring adequate volume replacement, and adjusting medication dosages. Most young healthy kidneys will recover from a hypoxic type of injury, but toxic injuries may cause irreversible damage. The crush injury protocol includes bicarbonate, albuterol, insulin, and glucose to manage potassium levels. Monitoring and adjusting treatment is crucial, and Lasix may be used in certain cases of acute kidney injury. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠deltadevteam.com⁠ For more content go to ⁠www.prolongedfieldcare.org⁠ Consider supporting us: ⁠patreon.com/ProlongedFieldCareCollective

In this podcast episode, Dennis interviews David Hardin, a general surgeon with experience in austere environments. They discuss the differences between surgeons in first-world and austere environments, the importance of improvisation, training and manpower considerations, supplies and procedures in austere surgery, moving patients in austere environments, preparing for austere surgery, making decisions in austere environments, logistics and equipment, dealing with loss, preparing for unknowns, coping with emotional stress, and finding joy in austere surgery. Takeaways Austere surgery requires improvisation and resourcefulness due to limited supplies and equipment. Training and teamwork are crucial in austere surgery, and having a resilient and adaptable team is important. In austere environments, decisions must be made based on available resources and the best interest of the patient. Preparing for austere surgery involves pre-planning, understanding the environment, and being mentally and physically prepared. Coping with loss and emotional stress is a challenge in austere surgery, and supporting and insulating team members is important. Finding joy in the work and being grateful for the opportunity to help others can sustain surgeons in austere environments. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠deltadevteam.com⁠ For more content go to ⁠www.prolongedfieldcare.org⁠ Consider supporting us: ⁠patreon.com/ProlongedFieldCareCollective⁠