Prolonged Field Care Podcast

Just in case....

Dennis and guest Jeff Siegler, an assistant professor of emergency medicine, discuss the use of ketamine in managing status epilepticus. Status epilepticus is a prolonged seizure lasting more than five minutes, which can be life-threatening. They explore the challenges of treating seizures in the field and the role of benzodiazepines in initial treatment. Ketamine, while generally considered an excitatory drug, is being studied as a potential option when seizures become refractory to standard treatments. The podcast highlights the need for further research and individualized care plans while considering the limitations of pre-hospital settings and state regulations. 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 and guest Shawn McKay discuss the basics of confined space rescue. They touch upon the importance of understanding the environment and potential risks, the need for monitoring equipment, and the selection of the right personnel for specific tasks during rescue operations. They also mention the relevance of NFPA standards and the importance of choosing appropriate equipment. The conversation emphasizes the significance of training and preparedness in handling complex rescue situations. 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 and Brad discuss the use of Nubain, also known as Bufene. Nubain is a non-controlled narcotic that was FDA-approved in 1979 and gained popularity in the 1980s and 1990s. It is similar in strength to morphine but lacks some of its side effects like respiratory depression. Nubain's unique properties include its ability to reverse itching caused by other narcotics and its use as an adjunct to ketamine or other pain management drugs. Dennis emphasizes the importance of monitoring respiratory rates and adjusting doses accordingly. Overall, Nubain is a valuable tool for managing pain in a field environment. 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

Jay Baker, a brigade surgeon with limited special operations experience, discusses the evolving landscape of surgical support in Special Operations Forces (SOF). He highlights the differences between traditional trauma care provided during the Global War on Terror and the potential challenges of unconventional warfare. Drawing from historical examples of surgeons supporting resistance movements in World War II, he emphasizes the need for adaptable and resourceful surgical teams capable of extended missions in hostile environments. Baker also discusses the concept of prolonged field care (PFC) and the development of SOF surgical teams to meet future mission requirements. 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 and Josh discuss ventilator training on the PFC Podcast. Josh, a former ranger medic now working in a level one ICU, shares insights. They emphasize the importance of proper ventilation in the field and address common mistakes, like setting inappropriate rates that lead to patient agitation. Josh advises cautious opioid use, balancing sedation with patient needs. They delve into adjusting PEEP, flow, and waveform, emphasizing patient synchronization. Josh highlights the significance of addressing pain, resuscitation, and lung disease simultaneously. He clarifies end-tidal CO2 readings and the role of kidneys in metabolic acidosis. Josh also stresses IV maintenance and patient assessment. 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 and Doug discuss the fundamentals of ventilatory management in trauma cases. They emphasize the distinction between the need for an airway and the need for a ventilator. Patients requiring an airway may have issues like swelling or trauma obstructing their airway, while those needing a ventilator typically have respiratory failure. They explain the importance of monitoring compliance, tidal volume, minute ventilation, and peak and plateau pressures. Additionally, they touch on the importance of supporting blood pressure during intubation and the need for continuous resuscitation in trauma cases. 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 interviews Thomas Trust Have, a former Danish Special Forces operative turned doctor, discussing the challenges of providing medical care in Arctic environments. Thomas emphasizes the extreme conditions, highlighting a hypothetical scenario involving a special operations team enduring frigid temperatures and harsh winds. He underscores the importance of preparation, teamwork, and proper gear in these situations. Thomas also addresses medical considerations such as tourniquet use, fluid warming, and the complexity of providing care in cold conditions. The episode sheds light on the unique challenges faced by healthcare providers in remote, freezing environments. 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 and Doug discuss the critical importance of effective team dynamics when dealing with critically injured patients. They highlight the challenges faced by medical teams who often work in silos, failing to communicate and coordinate efficiently. Doug, drawing from his experience at Baltimore Shock Trauma, emphasizes the value of well-organized roles and protocols in high-volume trauma facilities. He underscores the need for designated positions and a clear team leader to oversee the patient's care. The conversation also touches on adapting such practices to operational environments, stressing the importance of training, teamwork, and constant vigilance in providing life-saving 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 today's episode, we're diving into the topic of tourniquet conversion. With conflicts happening globally, it's crucial to understand the difference between tourniquet conversion and replacement. Conversion means finding an alternative to control bleeding when the tourniquet is no longer needed. Replacement involves swapping a tourniquet for a more effective one. Conversion timing depends on the tactical situation and patient's resuscitation status. You should consider resuscitating the patient before converting, ensuring they're warm, non-coagulopathic, and ideally have a systolic blood pressure above 90. Science-wise, the two-hour rule may have originated from studies in cooler environments. Converting tourniquets in austere settings requires confidence and proper patient assessment. Crush syndrome, re-bleeding, and metabolic changes can be concerns when converting tourniquets. Use bicarb cautiously to mitigate potential acidosis. Calcium can also help, but pay attention to the specific calcium source and dosing. The goal is to save lives while minimizing limb loss. 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