

Prolonged Field Care Podcast
Dennis
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This podcast and website is dedicated to the healthcare professional who needs to provide high quality care in a very austere location.
For more content: www.prolongedfieldcare.org
Consider supporting us on: patreon.com/ProlongedFieldCareCollective
This podcast and website is dedicated to the healthcare professional who needs to provide high quality care in a very austere location.
For more content: www.prolongedfieldcare.org
Consider supporting us on: patreon.com/ProlongedFieldCareCollective
Episodes
Mentioned books

Nov 20, 2025 • 1h 7min
PFC Podcast: Training Scars
The conversation explores the importance of balancing realism and learning in training scenarios, particularly in medical training. It emphasizes the limitations of achieving true realism in training and the potential negative effects of unrealistic training scenarios.TakeawaysYou want to balance realism and learning in training scenarios.You can't be trying to pop dudes' cherries in training.You can get pretty close with like force-on-force type stuff.You're often going to get into the unwinnable gotcha scenarios that have an incredibly negative training effect.Chapters00:00 Introduction to Training Philosophy00:30 Building Confidence in Medical TrainingFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

Nov 17, 2025 • 27min
PFC Podcast 255: Combat Anesthesia in PFC
In this episode of the PFC Podcast, Dennis and Kevin discuss the complexities of using narcotics in long-term care, particularly in a military or austere environment. They delve into the importance of understanding drug metabolites, context-sensitive half-times, and the implications for patient care. The conversation covers various anesthetic agents, their effects, and the clinical considerations necessary for effective pain management and sedation during and after surgical procedures.TakeawaysMetabolites of narcotics can significantly impact patient care.Fentanyl infusions can provide prolonged analgesia but require careful monitoring.Midazolam has a longer context-sensitive half-time compared to other anesthetics.Morphine's metabolite can lead to increased potency and potential overshooting.Dilaudid is preferred over morphine for its predictability in effects.Vecuronium's metabolite can cause prolonged neuromuscular blockade, especially in renal impairment.Ketamine can have unexpected, prolonged effects postoperatively.Timing of drug administration is crucial in prolonged field care scenarios.Patients with low urine output may require adjusted medication dosages.Understanding context-sensitive half-times is essential for effective anesthesia management.Chapters00:00 Introduction to Narcotics in Long-Term Care01:43 Understanding Metabolites and Context-Sensitive Half-Time05:02 Fentanyl Infusions and Prolonged Analgesia06:54 Comparing Anesthetic Agents: Midazolam, Ketamine, and Propofol10:11 Clinical Implications of Metabolites in Anesthesia13:27 Challenges with Ketamine and Other Narcotics16:03 Timing and Context-Sensitive Half-Time in Anesthesia20:39 Managing Post-Operative Pain and Sedation23:29 Key Takeaways on Metabolites and Infusion TimingFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

Nov 13, 2025 • 51min
PFC Podcast: Arctic TCCC
In this episode of the PFC Podcast, Dennis and Thomas Trust Have discuss the complexities of practicing medicine in Arctic environments. Thomas shares his extensive experience as a consultant in anesthesiology and critical care medicine, particularly in remote and austere settings. The conversation delves into the unique challenges faced by medical personnel in extreme cold, including the importance of hypothermia prevention, the need for specialized training, and the critical role of teamwork and preparation in ensuring effective medical care in such conditions.TakeawaysThe practice of medicine in extreme cold requires modifications to standard protocols.Hypothermia is a significant risk for both patients and medical personnel in cold environments.Thorough preparation and scenario-based training are crucial for effective medical response in Arctic settings.Medical gear must be adapted for cold weather, including considerations for clothing layers during treatment.Shelter and environmental control are essential for patient care in cold conditions.Team roles and responsibilities should be clearly defined for efficient shelter setup and patient management.Drugs and medical supplies must be kept warm to maintain efficacy in extreme cold.Training should include practicing medical procedures with gloves on to simulate real conditions.The distance to a safe shelter can vary greatly depending on the tactical situation and environmental factors.Prioritizing warmth and hypothermia prevention is critical in cold-weather medical emergencies.Chapters00:59 Thomas Trust Have: Background and Experience02:46 Challenges of Arctic Medicine08:52 Tactical Care in Cold Environments13:33 Shelter and Environment Considerations24:29 Medical Equipment and Drug Management38:32 Planning for Arctic Operations47:04 Final Thoughts on Cold Weather MedicineFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

Nov 10, 2025 • 1h 29min
PFC Podcast 254: Mastering Shock Management in Trauma
Explore the intricacies of shock management in trauma cases, particularly hemorrhagic shock. Mental status changes are vital indicators, with early intervention being crucial for patient outcomes. Discover the importance of massive transfusion protocols and the role of TXA and calcium during resuscitation. Hear insights on resource management in trauma settings, and the necessity of adapting protocols to unique scenarios. Overall, the talk emphasizes prioritizing mental status and timely interventions to prevent patient deterioration.

Nov 6, 2025 • 40min
MSIW Podcast: Practical Guide to Prolonged Casualty Care
Missy Givens, an emergency physician and author, delves into her groundbreaking guide aimed at non-professionals for prolonged casualty care. She highlights the need for accessible medical knowledge, emphasizing community preparedness and the challenges of making complex medical concepts understandable. The discussion includes practical insights on wound care, alternative treatments, and the role of telemedicine during crises. Givens also stresses the importance of building local networks to enhance emergency response capabilities.

Nov 3, 2025 • 42min
Prolonged Field Care Podcast 253: Cadaveric Blood Donation
In this episode of the PFC Podcast, Dennis engages with Patrick, Mason, and Jonathan to discuss the emerging research on cadaveric blood and its potential applications in military medicine. The conversation explores the historical context of deceased donor blood, the pressing need for alternatives in blood supply during large-scale combat operations, and the ethical considerations surrounding blood donation from deceased individuals. The team shares their preliminary findings and outlines future research directions, emphasizing the importance of collaboration in advancing this critical area of trauma care.TakeawaysBlood is essential for trauma care in combat situations.Current blood supply systems may not meet future demands.Historical use of deceased donor blood shows promise.Ethical considerations are crucial in cadaveric blood research.Research methodologies must be robust and thorough.Collaboration is key to advancing medical research.Understanding the limitations of blood supply is vital.The potential for cadaveric blood to save lives is significant.Military personnel may support blood donation after death.Future research will focus on improving blood safety and efficacy.Chapters00:00 Introduction to Cadaveric Blood Research04:49 The Need for Cadaveric Blood in Combat09:47 Historical Context of Deceased Donor Blood14:16 Research Findings on Cadaveric Blood19:33 Ethical Considerations in Blood Donation29:22 Future Directions in Cadaveric Blood ResearchFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

Oct 30, 2025 • 46min
PFC Podcast: Surviving the Freeze: Mastering Cold Weather injuries in PFC
In this episode of the PFC Podcast, the discussion revolves around cold-weather injuries, particularly frostbite and trench foot. Ian shares his extensive experience in wilderness medicine and military operations, highlighting the historical significance of these injuries in military conflicts. The conversation covers prevention strategies, treatment protocols, and the importance of rapid rewarming for frostbite. Additionally, the episode delves into the differences between frostbite and non-freezing cold injuries, emphasizing the need for proper care and evacuation plans in cold environments.TakeawaysFrostbite and trench foot have significant historical military implications.Prevention is crucial in avoiding cold-weather injuries.Rapid rewarming in warm water is the best treatment for frostbite.Buddy checks can help prevent cold-weather injuries.Non-freezing cold injuries require different treatment protocols than frostbite.TPA can be beneficial in reducing tissue loss from frostbite.Proper insulation and hydration are key to preventing cold injuries.Frostbite injuries can lead to long recovery times and potential loss of digits.Awareness of symptoms and timely evacuation are critical in cold environments.Maintaining dry and warm conditions is essential to prevent trench foot.Chapters00:00 Introduction to Cold Weather Injuries00:59 Historical Context of Cold Weather Injuries05:04 Understanding Frostbite and Non-Freezing Cold Injuries10:11 Prevention Strategies for Cold Weather Injuries13:31 Treatment Protocols for Frostbite19:49 Evacuation and Recovery Considerations37:45 Non-Freezing Cold Injuries: Trench Foot43:40 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

Oct 27, 2025 • 35min
PFC Podcast 252: Prolonged Tourniquet Conversion
In this episode of the PFC Podcast, Dennis and Dr. John Holcomb discuss a study on ischemia reperfusion injury related to prolonged tourniquet use in combat settings. They explore the rationale behind the study, the criteria for patient inclusion, and the assessment of limb viability. The conversation delves into the implications of compartment syndrome, the management of reperfusion injury, and the importance of training medics in tourniquet conversion and replacement. The episode emphasizes the need for continuous learning from wartime experiences to improve combat medicine practices.TakeawaysThe study focuses on ischemia-reperfusion injury after prolonged tourniquet use.A significant number of tourniquets applied in combat were unnecessary.Assessing limb viability involves the four C's: color, consistency, contractility, and capillary refill.Compartment syndrome can occur even with effective tourniquet application.Reperfusion injury management is critical to prevent acute kidney injury.Dialysis needs vary based on tourniquet duration and injury severity.Training for tourniquet conversion and replacement is essential for medics.Seasonal variations may affect injury patterns on the battlefield.Continuous reassessment is vital in trauma care.Effective pressure dressings are crucial for managing bleeding post-tourniquet.Chapters00:00 Introduction to the Study on Ischemia Reperfusion Injury02:52 Understanding the Cohort and Inclusion Criteria05:48 Assessing Limb Viability and the Four C's08:47 Compartment Syndrome and Its Implications11:46 Reperfusion Injury: Assessment and Treatment14:47 Managing Potassium Load and Tourniquet Release17:50 Dialysis Needs and Outcomes20:31 Training for Tourniquet Conversion and Replacement23:46 Seasonal Variations in Injury Patterns26:31 Future Training Recommendations for Medics29:39 Pressure Dressings vs. TourniquetsFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

Oct 23, 2025 • 32min
PFC Podcast: Walking Blood Bank - Mastering ROLO Transfusions in Combat
A seasoned medic shares a gripping story from a night raid in Afghanistan, highlighting the intense challenges of casualty management under fire. The conversation emphasizes the critical importance of having a blood supply readily available and the necessity for rigorous training and preparation. Common mistakes, such as inadequate medical supplies, are discussed alongside the need for effective communication and teamwork in high-pressure situations. Brad stresses that repetition in training can lead to flawless execution during emergencies.

Oct 20, 2025 • 1h 40min
Prolonged Field Care Podcast 251: Hemorrhagic Shock Progression - Classes, Compensation, and Resuscitation Strategies
Dive into the world of hemorrhagic shock as Dennis and Max break down its classifications and the critical differences between compensated and uncompensated states. Learn how vital signs play a key role in assessing patient conditions and why special populations like children, pregnant women, and the elderly require unique care considerations. Discover essential resuscitation strategies and the importance of continuous patient reassessment, ensuring that trauma care is both effective and informed.


