
Prolonged Field Care Podcast
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Latest episodes

Jun 9, 2025 • 35min
Prolonged Field Care Podcast 233: Females in Combat
In this episode of the PFC Podcast, Dennis and Master Sergeant Dan McGarra discuss the evolving role of females in combat and the challenges faced in medical treatment for female casualties. They explore discrepancies in medical protocols, cultural implications, and the need for gender-neutral approaches in military medicine. The conversation highlights the importance of understanding physiological differences and social dynamics that affect treatment outcomes, as well as the necessity for training that prepares medics for real-world scenarios involving female patients. Dan proposes solutions to improve medical protocols and training to ensure that all soldiers receive appropriate care, regardless of gender.Listen ad free with membership.TakeawaysThe percentage of females in the military is increasing, necessitating discussions on their treatment in combat.Studies show discrepancies in trauma treatment between genders, affecting outcomes for female casualties.Cultural and social factors influence how medics respond to female patients in emergencies.Training scenarios often fail to prepare medics for the realities of treating female casualties.Gender biases can lead to inappropriate prioritization in triage situations.Medical protocols need to be updated to reflect the physiological differences between genders.There is a need for gender-neutral training in military medical education.International military practices can provide insights into better treatment for female soldiers.The Sharp training program must include medical emergency protocols to protect both patients and medics.Open discussions about gender and medical treatment are essential for improving care in the military.Chapters00:00 Introduction to Female Participation in Combat02:48 Challenges in Medical Treatment for Female Casualties06:06 Discrepancies in Medical Protocols and Gender Bias09:56 Cultural and Social Implications in Medical Emergencies17:01 Learning from Global Military Practices21:12 Addressing the Sharp Training and Medical Protocols28:46 Proposed Solutions for Gender Neutral Medical TreatmentThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

Jun 6, 2025 • 50min
Prolonged Field Care Podcast: Tension Pneumothorax
In this episode of the PFC Podcast, host Dennis engages with Andy Fisher to discuss the controversial topic of needle decompression in Individual First Aid Kits (IFACs). They explore the historical context of IFAC contents, the effectiveness of needle decompression, and the challenges in identifying tension pneumothorax in the pre-hospital setting. The conversation also delves into the training and decision-making processes in combat medicine, assessment techniques for pneumothorax, and potential alternatives to needle decompression. In this conversation, the speakers delve into the evolving perspectives on thoracostomy and its application in pre-hospital settings, particularly in combat medicine. They discuss the implications of tension physiology in hemothorax and the prevalence of massive hemothorax in recent years. The conversation also revisits treatment protocols for chest injuries, emphasizing the need for a shift towards simple thoracostomy over needle decompression. Finally, they evaluate the use of pigtail catheters versus traditional chest tubes, weighing the pros and cons of each in emergency situations.TakeawaysNeedle decompression is debated in the context of IFACs.Historical context shows that needle decompression was not originally included in official DOD lists.Hemorrhage is the leading cause of mortality in trauma cases.Tension pneumothorax is rare, occurring in only 1.1% of cases.Identifying tension pneumothorax in pre-hospital settings is challenging.Medics should rely on objective data for decision-making.Training often prioritizes speed over thorough assessment.Prophylactic interventions for tension pneumothorax may not be effective.Chest tubes are not always life-saving interventions.Exploring alternatives like finger thoracostomy may be beneficial. Evolving views on thoracostomy emphasize its selective use.Needle decompression may be overused in practice.Tension physiology can occur with blood accumulation in the chest.Massive hemothorax is increasingly recognized in trauma cases.Up to 49% of combat casualties require chest tubes.Simple thoracostomy should be prioritized over needle decompression.Patient monitoring is crucial in pre-hospital settings.Pigtail catheters may not be suitable for pre-hospital use.Chest tubes are preferred for their reliability in emergencies.Comfort for the patient is important but should not compromise urgent care.Chapters00:00 Introduction to the Podcast and Guest01:01 Debate on Needle Decompression in IFACs03:20 Historical Context of IFAC Contents06:40 Effectiveness of Needle Decompression09:09 Challenges in Identifying Tension Pneumothorax12:00 Training and Decision-Making in Combat Medicine16:21 Assessment Techniques for Pneumothorax21:29 Interventions for Tension Pneumothorax25:19 Exploring Alternatives to Needle Decompression25:50 Evolving Perspectives on Thoracostomy31:38 Understanding Tension Physiology in Hemothorax36:41 Revisiting Treatment Protocols for Chest Injuries43:12 Evaluating Pigtail Catheters vs. Chest TubesThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

Jun 4, 2025 • 29min
SOMSA '25 - Ready for the other 19%?
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 TrainingThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

Jun 2, 2025 • 36min
Prolonged Field Care Podcast 232: Hemorrhagic Fever
In this conversation, Dennis and Ryan Maves delve into the complex world of hemorrhagic fevers, discussing various viral infections such as Ebola, Lassa fever, and dengue. They explore the symptoms, diagnosis, and treatment options available for these dangerous pathogens, emphasizing the importance of supportive care and proper waste management. The discussion also highlights the challenges faced in resource-limited settings and the need for medical intelligence and preparedness when dealing with potential outbreaks.TakeawaysViral hemorrhagic fevers are highly dangerous pathogens.Ebola is a prototype for understanding these diseases.Symptoms often start as nonspecific febrile illnesses.Diagnosis can be challenging due to overlapping symptoms.Supportive care is crucial for patient survival.Fluid management is a key aspect of treatment.Preventative measures are essential in endemic areas.Waste management is critical in handling infected materials.Medical intelligence plays a vital role in outbreak preparedness.Expertise and resources are available for managing these diseases.Chapters00:00 Introduction to Hemorrhagic Fevers03:07 Understanding Viral Hemorrhagic Fevers05:48 Symptoms and Diagnosis of Hemorrhagic Fevers14:46 Treatment and Supportive Care24:01 Preventative Measures and Waste Management32:00 Expertise and Resources for CareThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

May 30, 2025 • 57min
Prolonged Field Care Podcast: AAJT
In this episode of the PFC Podcast, hosts Dennis, John, and Paul delve into the development and application of the Abdominal Aortic Junctional Tourniquet (AAJT). John shares his background as an ER doctor and military medic, explaining the need for a device to control pelvic hemorrhage in trauma cases. Paul discusses the first applications of the AAJT in combat situations, highlighting successful case studies. The conversation also covers research findings on the device's efficacy, application techniques, and user experiences, emphasizing its importance in modern trauma care. This conversation delves into the application and implications of medical devices in emergency situations, particularly focusing on ventilation, prolonged application challenges, reperfusion injury, and the comparative effectiveness of RABOA and AJT. The discussion highlights the importance of rapid intervention in traumatic cardiac arrest and the need for ongoing research to improve outcomes in combat and emergency medicine.TakeawaysThe AAJT was developed to address junctional hemorrhage in trauma cases.John's experience in military medicine influenced the design of the AAJT.The device aims to control blood flow to the pelvis effectively.Initial applications of the AAJT have shown promising results in saving lives.Research indicates that the AAJT can be safely applied for up to two hours.Studies have shown that the AAJT is effective in controlling hemorrhage in combat situations.User experience suggests that the AAJT is less painful than traditional tourniquets.The device's design allows for easy application without extensive medical training.Ongoing research is exploring the potential for extended application times.The AAJT has been adopted by multiple military units and allied nations. Ventilation can be maintained even with device application.Prolonged application of medical devices can be challenging.Preparedness is crucial in emergency situations.Every minute of delay in hemorrhage control increases mortality.RABOA has shown to cause harm in some studies.The AJT device offers a promising alternative for hemorrhage control.Research is ongoing to validate the effectiveness of AJT.Traumatic cardiac arrest requires immediate and effective intervention.The future of emergency medicine must adapt to new challenges.Understanding the risks and benefits of interventions is essential.Chapters00:00 Introduction to the AAJT and Its Creators05:09 The Development and Purpose of the AAJT09:59 First Applications and Case Studies14:47 Research and Study Data on the AAJT20:03 Application Techniques and Pressure Management25:09 Practical Demonstration and User Experience26:35 Ventilation and Device Application29:15 Challenges of Prolonged Application32:13 Reperfusion Injury and Monitoring36:59 Risk-Benefit Analysis in Emergency Interventions39:41 RABOA vs. AJT: A Comparative Discussion42:09 Research Insights on AJT Effectiveness45:53 Future of Non-Compressible Torso Hemorrhage Treatment50:03 Traumatic Cardiac Arrest and New ApproachesThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

May 28, 2025 • 19min
SOMSA '25 - Squaring the Foundations
In this episode of the PFC Podcast, Rick Caldwell, a seasoned sof medic, discusses the critical foundations of medical education and training for combat medics. He emphasizes the importance of quality over quantity in medic training, the need for a solid understanding of both combat and humanitarian support, and the challenges faced in modern combat medicine, particularly in prolonged field care scenarios. Caldwell advocates for a shift from mere training to comprehensive teaching that fosters critical thinking and adaptability among medics. He concludes with a call to action for improving medical education to better prepare medics for the realities of combat situations.TakeawaysHumans are more important than hardware.Quality is better than quantity in medic training.Medics cannot be mass produced; quality is essential.Combat medics must provide both combat and humanitarian support.Good medicine is the foundation of T-Tricy.Training should focus on teaching critical thinking skills.Most patients evacuated are DNBI, not just trauma cases.Current training methods may set medics up to fail.Medicine is fundamentally a logistics function.Medical education must evolve to meet modern combat challenges.Chapters00:00 Introduction to Combat Medicine03:06 The Role of Combat Medics05:55 Training vs. Teaching in Medical Education08:47 Challenges in Modern Combat Medicine11:56 The Importance of Critical Thinking15:13 Principles Over Procedures in Medical Training17:56 Conclusions and Future DirectionsThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

May 26, 2025 • 46min
Prolonged Field Care Podcast 231: Emergence
In this episode of the PFC Podcast, Dennis and Kevin discuss the intricacies of waking patients after sedation, focusing on procedural sedation techniques, managing emergence delirium, and the challenges of airway management. They share insights from real-world experiences, particularly in combat and austere environments, emphasizing the importance of monitoring and patient safety during the awakening process. The conversation also covers extubation strategies, the differences between Cric and ET tube management, and the significance of having a well-thought-out emergence plan from the start of anesthesia.TakeawaysWaking a patient requires careful monitoring and reorientation.Emergence delirium can occur with ketamine; vigilance is key.Communication with the patient is crucial during awakening.Airway management is critical, especially in trauma cases.TIVA can complicate the emergence process; planning is essential.Extubation should be based on patient readiness and safety.Cric tubes may be better tolerated than ET tubes.Ventilation support may be necessary during the emergence phase.Understanding the patient's history aids in sedation decisions.Always be prepared for unexpected airway challenges.Chapters00:00 Introduction to Patient Awakening01:16 Procedural Sedation Techniques06:24 Managing Emergence Delirium10:40 Airway Management in Sedation15:27 Waking Up After Long Procedures24:23 Extubation Strategies and Considerations30:29 Cric vs. ET Tube Management39:06 Ventilation and Monitoring During EmergenceThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

May 23, 2025 • 38min
Prolonged Field Care Podcast: Patient Positioning
In this episode of the PFC Podcast, Dennis and Ethan discuss the critical role of patient positioning in emergency and prolonged field care. They explore various aspects of patient positioning, including its importance for TBI management, ventilation, and airway management. The conversation also addresses the risks associated with changing patient positions, the need for a safety net in patient care, and the operational considerations for medics in the field. They emphasize the significance of training and cultural factors in reducing preventable deaths in combat situations, concluding with a call to focus on the basics of patient care.TakeawaysPatient positioning is often overlooked but crucial in care.Elevating the head of the bed can help with TBI.Ventilation improves with proper patient positioning.Patients can manage their airways better when allowed to position themselves.Reassess interventions after changing patient positions.Improvisation is key in resource-limited environments.Equipment design can enhance patient care in the field.Cultural factors in military medicine impact patient outcomes.Training in patient positioning is essential for medics.Mastering the basics can significantly reduce preventable deaths.Chapters00:00 Introduction to Patient Positioning02:21 The Importance of Patient Positioning06:01 Patient Positioning for TBI and Ventilation09:20 Airway Management and Patient Positioning14:25 Risks and Downsides of Changing Patient Position19:18 Building a Safety Net in Patient Care20:22 Operational Considerations for Patient Positioning24:29 Improvisation and Equipment in Patient Care27:46 Positioning in Prolonged Field Care30:03 Cultural Factors in Reducing Preventable Deaths36:40 Conclusion and Key TakeawaysThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

May 21, 2025 • 24min
SOMSA '25 - Optimizing the use of Tactical Medications in the Extreme Cold Operational Environment.
This presentation explores the challenges and needs of military operations in the Arctic, particularly focusing on cold-weather medicine and the stability of medications in extreme conditions. Emily emphasizes the urgency of improving medic training and resources, the lack of solid data on medication efficacy in cold environments, and the need for innovative solutions to ensure medics can operate effectively. She calls for collaboration and data sharing among partner nations to enhance medical care in extreme cold environments.Sorry, if you would like to see the slides, you'll have to become a paid member. TakeawaysWe don't have a whole lot of military presence above the Arctic Circle.Cold is the enemy; we need to get used to it.The greatest need is initial care at the point of injury.We need to improve the ability of our medics to operate efficiently in cold environments.Most medication stability data is from controlled environments, not extreme conditions.We need to test medications in field environments to understand their stability.Base layer transport is a promising method for carrying medications in cold weather.We need actual inventions that work for medics in the field.Siloing up information is not the answer; we need collaboration.Identifying high-priority medications is crucial for effective cold-weather operations.Chapters00:00 The Arctic Military Landscape02:47 Challenges of Cold Weather Medicine05:59 Medication Stability in Extreme Conditions08:54 Innovative Solutions for Cold Weather Operations11:52 Data Collection and Research Needs15:04 Practical Tips for Medics in Cold Environments18:02 Future Directions in Cold Weather Medical CareThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

May 19, 2025 • 21min
Prolonged Field Care Podcast 230: One Surgeon's Experience with the Resistance
Since the vast majority of you guys couldn't go to SOMSA '25, I'm bringing SOMSA '25 to you. Paul and I got our steps in this year and recorded a ton of presentations. These presentations with slides will only be available for subscription members...EnjoyIn this episode of the PFC Podcast, Dr. Jason Hiles discusses the challenges and strategies of providing medical care in unconventional warfare environments. He shares insights from his experiences in Southeast Asia, focusing on the importance of adaptability, community engagement, and training local medics to ensure sustainable healthcare practices in resource-limited settings. The conversation covers various surgical techniques, trauma management, and the significance of building trust within the communities served.TakeawaysThe need for trained personnel in war zones is critical.Adaptability in surgical techniques is essential in resource-limited environments.Community engagement fosters trust and improves healthcare access.Surgical care must be tailored to the specific needs of the environment.Triage and evacuation strategies are vital in managing war wounds.Training local medics ensures continuity of care after foreign personnel leave.Simplicity in medical kits can enhance operational efficiency.Understanding local customs and languages improves patient care.The impact of war on civilian health requires innovative solutions.Building relationships with local communities can lead to better health outcomes.Chapters00:00 Introduction to Unconventional Warfare Medicine03:12 Operational Challenges in Resource-Limited Environments06:07 Surgical Techniques and Patient Care in Conflict Zones09:00 Managing War Wounds and Trauma11:55 Triage and Evacuation Strategies15:10 Community Engagement and Building Trust18:14 Training Local Medics and Sustainable PracticesThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care