Prolonged Field Care Podcast

In this podcast episode, Dennis interviews Ian, an ER physician with experience in wilderness medicine, about spinal trauma. They discuss the initial approach to spinal trauma, the process of clinically clearing the spine, the neuro exam for spinal trauma, and the treatment of neurogenic shock. They also cover the goals of fluid resuscitation, the use of vasopressors, and the prevention of complications such as pressure injuries and hypothermia. The episode concludes with a discussion on the use of steroids in spinal cord injuries. Takeaways The initial approach to spinal trauma involves utilizing the MARCH algorithm and maintaining C-spine precautions until the patient can be clinically cleared. The neuro exam is crucial in determining the grade of spinal trauma and whether neurogenic shock is present. Treatment of neurogenic shock involves fluid resuscitation and the use of vasopressors to maintain blood pressure. Nursing care for spinal trauma includes preventing pressure injuries, monitoring for respiratory complications, and preventing hypothermia. Steroid use is not recommended in spinal cord injuries due to the associated risks. 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 episode, Sean McKay discusses the challenges and considerations of subterranean mobility and rescue. He emphasizes the importance of understanding the geology and environmental pathology of underground environments, as well as the need for continuous training and innovation in equipment usage. McKay also highlights the significance of risk assessment and uncertainty management in rescue operations. Additionally, he explores the complexities of communication and coordination in subterranean environments. In this conversation, Sean discusses the complexity of rescue operations and emphasizes that there is no one-size-fits-all approach. He highlights the importance of considering various factors, such as team capabilities, training, and environmental conditions. Sean also emphasizes the need for continuous training and seeking weaknesses in order to improve. He encourages rescuers to innovate and find solutions that fit their specific mission and team. Additionally, he emphasizes the importance of knowing and understanding the equipment and being comfortable with improvisation when necessary. Takeaways Understanding the geology and environmental pathology of underground environments is crucial for effective subterranean mobility and rescue operations. Continuous training and innovation in equipment usage are essential for adapting to the challenges of subterranean environments. Risk assessment and uncertainty management play a vital role in planning and executing rescue operations. Communication and coordination are key factors in successful subterranean mobility and rescue operations. Rescue operations are complex and there is no one-size-fits-all approach. Consider factors such as team capabilities, training, and environmental conditions when planning a rescue. Continuous training and seeking weaknesses are crucial for improvement. Innovate and find solutions that fit your specific mission and team. Know and understand your equipment, and be comfortable with improvisation when necessary. 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

Nate, a Special Forces Detachment Commander, emphasizes the importance of incorporating medical training into team operations and creating formalized Standard Operating Procedures (SOPs) for team clinics. Testing and refining medical plans, training medical reps in realistic scenarios, and standardizing medic training are essential. Nate discusses the challenges of convincing higher command about the importance of planning and testing in setting up a clinic. The culture of medicine and the need for collaboration and learning from one another are also highlighted.

In this episode, Dennis and Brad discuss the use of fentanyl in medical settings. They provide an overview of the background and development of fentanyl, highlighting its reliability and predictability as an opioid. They explain the characteristics and benefits of fentanyl, including its rapid onset, peak effect, and short duration. The conversation also covers the side effects and considerations of fentanyl, such as respiratory depression and histamine release. The appropriate administration and dosage of fentanyl are discussed, along with its use for sedation and procedures. The use of fentanyl lollipops and patches is explored, as well as the importance of proper administration and monitoring. The episode concludes with final thoughts on the use of fentanyl and the need for further education and understanding of its use. In this conversation, Brad discusses the use of ampules for protection in combat medicine. He explains various methods of using ampules and emphasizes the importance of protecting them. The conversation concludes with Dennis providing closing remarks and directing listeners to the Prolonged Field Care website and social media channels. Takeaways Fentanyl is a reliable and predictable opioid with a rapid onset, peak effect, and short duration. It is important to understand the side effects and considerations of fentanyl, such as respiratory depression and histamine release. Fentanyl is commonly used for pain control and sedation, and it is particularly effective in trauma scenarios. Proper administration and dosage of fentanyl are crucial, and it is important to monitor patients closely for respiratory depression. Fentanyl lollipops and patches have specific uses and considerations, and their administration should be carefully managed. Ampules can be used in various ways for protection in combat medicine. It is important to protect ampules to ensure their effectiveness. Listeners are directed to the Prolonged Field Care website and social media channels for more information. 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

Dennis is interviewing Dr. John Quinn who's on the ground working Role 1 medical operations for an NGO somewhere in Ukraine. The lessons being learned by John and others during the early days of this conflict and the past 8 years can be used to help those on the ground now and into the future. This is an amazing opportunity to stay informed of current events and prepare ourselves by narrowing expectations and tweaking training. During the interview John stated that anything that can be done to further enable FWB availability and knowledge would be greatly appreciated. In particular, when asked what we could translate, he asked for: Damage Control Resuscitation guidelines to be translated, Prehospital Blood guidelines, anything on Damage Control Surgery for non-surgeons (they have a lot of OB/GYNs and others like OMFS functioning as DCS surgeons at Role 2s). He also stated that they're seeing a TON of TBI "walking wounded" and anything on mild to moderate TBI management would be great. When asked about a trauma registry, John stated that the Ministry of Health is attempting to catalogue all civilian casualty numbers. The Ministry of Defense is VERY close-hold with any info and it would be very hard to elicit the ground-truth there for the time being. John stated that many organizations are using the TCCC cards and all documentation is trying to be written in BOTH Ukranian and English, due to the large number of non-native providers helping in country. They LOVE the DeployedMedicine app, the translation of TCCC and Emergency War Surgery and absolutely look to US and NATO standards of care. 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

Rick, a senior medic with 18 years of experience in AFSOC and the Green Berets, shares lessons learned from mass casualty events, emphasizing improvisation and quick thinking. He discusses the importance of effective communication and maintaining composure in high-stress situations. A must-listen for anyone in the field.

Merry Christmas...Today, we're diving into the nitty-gritty of ketamine – that mind-bending stuff, you know? So, ketamine's like this receptor blocker, messing with your brain's signals. It's a mixed bag, really. In low doses, it kills pain like a champ. But crank it up, and bam! You're in a world of dissociation. Picture it: brain's top half talking gibberish with the bottom half, and you're floating in a weird dream world. 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

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This Podcast was from June of this year. This is Dennis, and today I'm joined by Anri, a Ukrainian medic who will share some lessons learned from the battlefield. Anri talks about how wound patterns change in urban versus rural areas, with urban areas having more trauma from shrapnel and secondary trauma from debris. He mentions the challenges medics face in treating these complex wounds, including fractures and extensive tissue damage caused by multiple waves of explosions. Anri also discusses the impact of seasonal variations and the difficulties in evacuation due to artillery shelling, long distances, and the use of unconventional methods by the enemy. He emphasizes the importance of adapting medical techniques, such as splinting and triage, to the unique conditions on the front lines. Anri also mentions the use of blood products, saline, and telemedicine for prolonged field care. 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 the latest episode of the PFC podcast, I spoke with Evan and Doug about airway management. As experienced airway takers in both pre-hospital and hospital settings, they had some valuable insights. We discussed the controversy over intubation versus cricothyrotomy. Evan and Doug raised some valid points, such as the need for suctioning and the difficulty of obtaining post-intubation sedation medication in resource-limited environments. We also talked about the importance of ongoing training to maintain skills and the need for better difficult airway education in training programs. Overall, it was a great discussion. 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