Prolonged Field Care Podcast

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.

In this gripping conversation, trauma surgeon Max Sirkin MD shares his harrowing experience of being a patient in a mass casualty situation following a helicopter crash. He recounts the chaos of the event, the physical and emotional trauma he endured, and the profound lessons learned about resilience, brotherhood, and the importance of being present for others in crisis. Sirkin's narrative highlights the stark realities of military medicine and the bonds formed in the face of adversity. In this conversation, Max shares his harrowing experience in the trauma bay after a serious injury, reflecting on feelings of inadequacy and failure in the face of trauma. He discusses the psychological impact of moral injury and the importance of behavioral health in recovery. The conversation emphasizes the principle of 'less is more' in trauma care, highlighting the need for careful decision-making in chaotic situations. Max also recounts his experience with ketamine during treatment, illustrating the limited situational awareness of patients in trauma. Finally, he underscores the significance of camaraderie and support among peers in the recovery process. In this conversation, Max Sirkin shares his harrowing experiences in a life-threatening situation, emphasizing the importance of training and preparation in chaotic medical environments. He discusses the critical role of behavioral health in recovery from trauma and the necessity of learning from failures in medical practice. The dialogue highlights the need for teamwork, effective communication, and continuous training to ensure readiness in emergency situations.TakeawaysHe shares his unique perspective as a patient in a mass casualty situation.The chaos of a mass casualty requires quick and effective decision-making.Surviving a helicopter crash was a life-altering experience for Sirkin.The importance of brotherhood and support in crisis situations is paramount.Sirkin emphasizes the need for medical professionals to be present for their patients.He reflects on the emotional toll of being unable to help others in distress.The narrative illustrates the unpredictability of trauma care in combat zones.Sirkin's story serves as a reminder of the resilience of the human spirit.The conversation sheds light on the realities faced by military medical personnel. It's hard to face the reality of failure in trauma situations.Moral injury can be as impactful as physical injuries.Behavioral health is crucial for recovery after trauma.Less intervention can sometimes lead to better outcomes.Situational awareness is limited when you're a patient.Keeping injured individuals together can aid in recovery.The importance of communication in chaotic medical situations.Ketamine can provide pain relief but also alter perception.Understanding the dynamics of trauma care is essential for providers.Camaraderie among peers is vital for emotional support. Training is essential for managing chaos in medical emergencies.Behavioral health is crucial for recovery from trauma.Surgeons should not consider themselves special; everyone is vulnerable.Daily medical practice is necessary for readiness.Teaching non-medical personnel basic medical skills saves lives.Failure in medicine is inevitable; learning from it is essential.Hope alone is not a strategy in critical care.Understanding trauma can lead to better coping mechanisms.Team dynamics and communication are vital in emergency situations.Every medical provider should be prepared for the unexpected.For 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, Dan McGraw discusses the critical need for gender-specific medical training in military settings, drawing from personal experiences and extensive research. He highlights the disparities in treatment outcomes between male and female patients, the physiological differences that affect trauma care, and the cultural challenges faced by medical personnel when treating patients of the opposite sex. Through case studies and real-life scenarios, Dan emphasizes the importance of understanding these differences to improve survival rates and ensure equitable treatment for all service members.TakeawaysDan shares a personal story about losing a friend due to medical negligence.The importance of gender-specific medical training is emphasized.Research shows that female casualties have different treatment needs.Physiological differences between genders affect trauma care.Cultural challenges hinder effective medical response to female patients.Case studies reveal biases in treatment during emergencies.Medical errors often occur due to gender biases in treatment protocols.Training must address the discomfort of treating opposite genders.The military must adapt to increasing numbers of female service members.Future training programs need to incorporate gender-specific considerations.Chapters00:00 Introduction and Personal Story02:57 The Importance of Gender-Specific Medical Training06:11 Research Findings on Female Casualties08:54 Physiological Differences in Trauma Treatment12:06 Cultural and Training Challenges in Medical Response15:08 Case Studies and Real-Life Scenarios18:07 Addressing Medical Errors and Gender Bias21:03 The Future of Gender-Inclusive Medical TrainingFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠⁠