Prolonged Field Care Podcast

Here's another great podcast from early '24. This was a great conversation with a legend and finished the year at #6. In this episode of the PFC Podcast, Phil Gonzalez shares his extensive experiences in combat medicine, detailing his journey from the military to becoming a Special Forces medic. He reflects on his time in Vietnam, the challenges faced, and the lessons learned in the field. Phil discusses the importance of teamwork, adaptability, and the unique role of medics in combat situations. He also shares insights into his culinary experiences in the field and his transition to working with indigenous communities, emphasizing the desire to make a positive impact on people's lives through medicine. In this conversation, Dennis shares his transformative journey as a medic, detailing his experiences in tropical medicine, community healing, and the importance of empathy and communication in medical practice. He reflects on the cultural integration he experienced while working in isolated regions, the challenges he faced, and the profound impact of his work on the lives of those he served. Dennis emphasizes the significance of mentorship, adaptability, and the human connection in medicine, ultimately highlighting the legacy of healing and lifelong learning that defines a true medic. Takeaways Phil Gonzalez is a renowned figure in combat medicine. His military journey began in the Army Security Agency. Vietnam was a pivotal experience that shaped his career. The role of medics in combat is crucial and multifaceted. Teamwork and adaptability are essential in high-stress situations. Culinary experiences in the field can be unique and challenging. Phil's epiphany to become a medic came from observing his peers. The mystique of medicine creates a special bond with patients. His experiences in Columbia highlighted the importance of community. Phil's journey reflects a lifelong commitment to helping others. The journey of a medic is filled with challenges and learning opportunities. Cultural integration is essential for effective community healing. Empathy and human connection are at the core of medical practice. Communication is crucial in crisis situations and can save lives. Mentorship plays a vital role in shaping future medics. The word 'doctor' translates to 'teacher' in many cultures. Passion and dedication are key attributes for success in medicine. Every patient deserves to be treated with dignity and respect. Building trust within the community enhances the healing process. The legacy of a medic is defined by the lives they touch and improve. Chapters 00:00 Introduction to Phil Gonzalez and Combat Medicine 02:11 Phil's Early Military Experiences 04:33 Arrival in Vietnam: First Impressions 07:59 The Role of the Army Security Agency 10:23 Memorable Operations and Lessons Learned 15:15 Survival and Reflection in Combat 20:28 The Importance of Teamwork and Adaptability 23:58 Culinary Experiences in the Field 27:21 The Epiphany: Becoming a Medic 30:20 The Mystique of Medicine in Combat 32:43 Experiences in Columbia and the Role of Medics 37:48 Transitioning to a Medic Role 40:47 Life After Vietnam: New Assignments 43:41 The Journey into Archaeology and Medicine 51:43 Working with Indigenous Communities 52:40 The Journey of a Medic 59:59 Cultural Integration and Community Healing 01:10:10 Communication and Adaptability in Crisis 01:20:08 Empathy and Human Connection in Medicine 01:30:13 Legacy of Healing and Lifelong Learning 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

If you like what you hear in this podcast, I can tell you that they are looking for a few good medics. Here's the link: https://capps.taleo.net/careersection/ex/jobdetail.ftl?job=00046711&tz=GMT-06%3A00&tzname=America%2FChicago In this episode of the PFC Podcast, Dr. JR Pickett discusses his role as Chief Deputy Medical Director for the City of Austin, Texas, focusing on medical operations along the Southwest border. He shares insights into the unique challenges faced in remote areas, the common injuries encountered, and the importance of preparation and training for medical missions. The conversation also highlights innovative practices such as the walking blood donor program and the significance of teamwork in emergency medical services. Takeaways Dr. JR Pickett is the Chief Deputy Medical Director for Austin, Texas. Medical operations in remote border areas present unique challenges. Heat-related illnesses are prevalent in desert regions. Common injuries include dehydration, blisters, and trauma from falls. Rescue operations often rely on the compassion of migrants to report injuries. Preparation for missions includes carrying essential medical and survival gear. The walking blood donor program is crucial for remote medical care. Operational planning is vital for effective rescue missions. Training and skill maintenance are essential for medics in the field. Teamwork is critical in emergency medical services, especially in remote areas. Chapters 00:00 Introduction to Border Operations 03:03 Challenges of Medical Care in Remote Areas 05:47 Common Injuries and Illnesses Encountered 09:08 Rescue Operations and Finding Migrants 11:58 Preparation and Gear for Medical Missions 14:51 Innovations in Blood Resuscitation 18:09 Operational Planning and Coordination 20:48 Training and Skill Maintenance for Medics 24:04 Getting Involved in Border Medical Operations 26:58 Conclusion and Final Thoughts 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

Here's another great podcast from early '24. This was a great conversation and finished the year at #7. In this episode of the PFC podcast, Dennis, Jonathan, and Frank delve into the fascinating world of maggot therapy, exploring its historical roots, benefits, and applications in modern medicine, particularly in austere environments. They discuss how maggot therapy can effectively treat chronic wounds, its cost-effectiveness compared to traditional methods, and the importance of integrating it with other treatments. The conversation highlights the potential of maggot therapy as a viable option in military medicine, especially given the challenges of antibiotic supply chains and the need for innovative wound care solutions. Takeaways Maggot therapy has historical roots dating back thousands of years. It effectively removes necrotic tissue and promotes wound healing. Maggots have antimicrobial properties that aid in infection control. Maggot therapy is cost-effective, especially in low-resource settings. Chronic wounds often develop biofilms that resist antibiotics; maggot therapy can help. Early application of maggot therapy can prevent complications. Maggots can be used in both acute and chronic wound care. Maggot therapy can be implemented in austere environments with proper training. Sourcing and cleaning maggots is feasible even in challenging conditions. Maggot therapy should be integrated with other wound care techniques for optimal results. Chapters 00:00 Introduction to Maggot Therapy 01:40 Historical Context of Maggot Therapy 04:57 Benefits of Maggot Therapy 08:36 Maggot Therapy in Acute and Chronic Wounds 11:24 Maggot Therapy in Austere Environments 16:10 Sourcing and Cleaning Maggots 19:36 Application Techniques for Maggot Therapy 24:26 Treatment Protocols and Frequency 36:07 Integrating Maggot Therapy with Other Treatments 45:51 Future of Maggot Therapy in Military Medicine 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

Here's another great podcast from early '24. This was a great conversation and finished the year at #8. In this episode of the PFC Podcast, Dennis and Dr. Brendan Graham discuss the controversial topic of using blood from dying patients for transfusions. They explore the physiological changes that occur in dying patients, the potential risks and ethical implications of such practices, and the future of blood transfusion technology. The conversation emphasizes the importance of understanding the complexities of blood physiology and the moral dilemmas faced in trauma care. Takeaways The concept of 'zombie blood' raises significant ethical concerns. Physiological changes in dying patients can render their blood inferior for transfusion. Using blood from dying patients may not provide the intended benefits and could cause harm. Future innovations in blood transfusion may include stem cell-derived blood products. The medical community is exploring alternatives to traditional blood transfusions. Ethical considerations are paramount when discussing blood donation from dying patients. The risks of infection and coagulation issues are heightened in dying patients. Action bias in medical practice can lead to ethically questionable decisions. Understanding the physiological processes in death is crucial for medical professionals. There is a need for more research and evidence before implementing new transfusion practices. 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

Here's another great podcast from early '24. This was a great conversation and finished the year at #9. In this podcast episode, Winston and I delve into the intricate world of pain and its pathways. They explore the nervous system's role in pain transmission, the different types of pain including nociceptive, neuropathic, and nociplastic pain, and the significance of sensitization in chronic pain conditions. The discussion also highlights practical approaches to pain management, including the use of multimodal therapies and the impact of neuroplasticity on pain perception, particularly in cases like phantom limb pain. In this conversation, Dennis discusses the complexities of pain management, emphasizing the importance of understanding the patient's history and the trajectory of their pain. He highlights the shift from opioid reliance to a multimodal approach that includes various analgesics such as acetaminophen, NSAIDs, lidocaine, capsaicin, cannabinoids, and ketamine. Dennis also covers the role of anticonvulsants and antidepressants in managing chronic pain, providing practical recommendations for healthcare practitioners. Takeaways Understanding pain pathways can enhance treatment effectiveness. Pain transmission involves complex processes in the nervous system. There are three main types of pain: nociceptive, neuropathic, and nociplastic. Peripheral and central sensitization play crucial roles in chronic pain. Ketamine is effective in reducing central sensitization. The placebo effect can significantly influence pain management. Recognizing nociplastic pain is essential for proper treatment. Mirror therapy can help alleviate phantom limb pain. Neuroplasticity affects how pain is perceived and treated. A multimodal approach is necessary for effective pain management. History taking is crucial in understanding pain types. The goal of pain management is to improve function and quality of life. Acetaminophen can be as effective as opioids in certain cases. Lidocaine should be used with caution due to potential side effects. Capsaicin is a natural option for neuropathic pain relief. Opioids have significant side effects and should be used carefully. Cannabinoids are gaining popularity but require more research. Ketamine offers a new avenue for pain management. Anticonvulsants can help with neuropathic pain but take time to work. Amitriptyline is a cost-effective option for chronic pain management. 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

It's that time of year again. Let's finish the year off strong with your favorite podcasts. Don't worry...I already have new episodes in the pipe starting in January. In this episode of the PFC Podcast, Dennis and Jeff delve into the complexities of anoxic brain injury, discussing its causes, recovery processes, and prevention strategies in tactical environments. They emphasize the importance of monitoring, airway management, and resuscitation goals, while also addressing the management of hypotension and shock. The conversation highlights the significance of preventing secondary brain injuries and the role of basic medical practices in saving lives. Takeaways Anoxic brain injury is caused by a lack of oxygen to the brain. Recovery from brain injuries can take time and various therapies. Preventing blood loss is crucial in tactical environments. Monitoring oxygen saturation is essential for early detection. Airway management decisions should be based on the patient's condition. Resuscitation goals should focus on maintaining adequate blood pressure and oxygen levels. Hypotension can arise from various causes and needs to be managed effectively. Resuscitation targets should aim for optimal blood pressure and oxygen saturation. Preventing secondary brain injuries is critical for patient outcomes. Basic medical practices can significantly impact survival rates. 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

We know what it does, but does it really have a real place in DCR? Link to full podcast: https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-care-Podcast-210-Logistics-of-Labs-e2rv043

Use your lab values to check the accuracy of your other diagnostics. Link to full podcast: https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-care-Podcast-210-Logistics-of-Labs-e2rv043

Talk about ICU in a rucksack! Dealing with a crush patient in an austere environment. Link to the full podcast: https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-care-Podcast-210-Logistics-of-Labs-e2rv043

In this episode of the PFC podcast, Dennis and Doug delve into the practical aspects of lab values in trauma care. They discuss when to draw labs, the significance of pH, the role of bicarbonate and calcium in resuscitation, and the interpretation of blood gas values. The conversation also covers the limitations of hemoglobin measurements, the management of potassium levels in crush injuries, and the use of hypertonic saline in head injury cases. The episode emphasizes the importance of understanding lab values in the context of patient care and the need for timely interventions. Takeaways The pH level is crucial for assessing trauma patients. Resuscitation strategies should be based on lab values. Calcium and bicarbonate play significant roles in trauma care. Blood gas values are essential for ventilator management. Hemoglobin levels may not accurately reflect bleeding severity. Lactate levels can be misleading in trauma situations. Frequent lab draws are not always necessary in stable patients. Hypertonic saline can be beneficial in head injuries. Potassium management is critical in crush injuries. Understanding lab values helps in making informed clinical decisions. Chapters 00:00 Introduction to Trauma Labs 03:02 Understanding pH and Its Importance 06:06 Resuscitation Strategies in Trauma 08:58 The Role of Calcium and Bicarbonate 11:53 Interpreting Blood Gas Values 15:04 The Limitations of Hemoglobin Measurements 18:00 Ventilator Management and Blood Gases 20:47 Frequency of Lab Draws in Trauma 23:55 Managing Potassium Levels in Crush Injuries 26:48 Head Injury Management and Hypertonic Saline 30:08 Lactate Levels and Their Significance 33:13 Conclusion and Key Takeaways 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