Prolonged Field Care Podcast

This is part 2 of our 2.5 hour conversation with Aebhric OKelly the founder and Dean Emeritus of the College of Remote and Offshore Medicine (COROM) about Improvised medicine. I will be the first to say, as cool as it is to learn Improvised techniques, this is an emergency plan, not a way to lighten your ruck. We run through items for PFC when the gear starts running out. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org

Today, we're diving deep into pneumothorax and hemothorax. Pneumothorax can quickly become an emergency, especially when it's not about the pressure but the declining SPO2. But where's the line between tension and hemothoraces? Our ICU doc expert clarifies that it's all about the impaired blood return to the heart. When your preload drops, it affects the cardiac output. If vitals are stable, though, it's not tension physiology. Also, did you know there are folks walking around with untreated pneumothoraces? The literature suggests only treating those affecting over 30% of the thoracic cavity. And, oh boy, many pneumothoraces come from trauma, but spontaneous cases exist. Especially with COVID, the lung scarring has made things fragile. Add trauma and narcotics, and things can get dicey. But remember, before deciding to treat a pneumothorax, be sure it's the right move. Better safe than sorry! 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

Today's podcast is part one of a 2.5 hr chat with Aebhric OKelly the founder and Dean Emeritus of the College of Remote and Offshore Medicine (COROM) about Improvised medicine. I will be the first to say, as cool as it is to learn Improvised techniques, this is an emergency plan, not a way to lighten your ruck. We run through items for MARCH and principles to apply to this problem. This is only part one, so plenty more in the next episode, when we go through PFC and improvised gear. 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

Now, let's dive into treating tension pneumothorax. Joined by Andy Fisher, our favorite surgery resident and social media provocateur. We're talking IFAC essentials and the needle decompression debate. Andy's been stirring the pot, suggesting ditching Needle D's from the IFAC due to lack of official backing. The IFAC's about saving lives for non-medics, but is it hemorrhage, not tension, we should focus on? Special ops pushed decompression needles, but is it justified? Andy questions the success rate of needle decompressions and suggests focusing on actual tension physiology. Training rush may play a role. Is sticking needles in pre-emptively smart? Well, let's focus on true tension signs instead. I mention tension either shows up or it doesn't, and hemodynamic changes trigger action. Thoracic trauma, mostly hemothorax, outweighs tension pneumothorax deaths. Andy, if king for a day, would adjust chest injury treatment. Surgical insights, plain talk, only on the PFC podcast. 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

Welcome back, folks! Had a chat with Ephraim Matto, who's seen the thick of things in Burma. He spent the last six months there, amidst security crises and medical emergencies. Burma's ethnic minorities are resisting subjugation, and the mountainous borders provide relative safe areas. Still, things are pretty dire. On top of internal conflicts, there's interference from the Russians and Chinese. On the medical front, there's a dire need. His crew operates ambulances and boats to get folks the care they need, and of course, the logistics! The rainy season and challenging terrain make things tough. Tragically, the Burma army isn't holding back. Just recently, 17 villagers, including children, were brutally murdered. It's heavy stuff, and the situation demands attention. 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

Let's cut to the chase about field blood transfusion. Dr. Andrew Cap came on the PFC Podcast to drop some knowledge. We talked about a high-stakes op in Afghanistan where two soldiers suffered intense injuries. First patient? Lost both legs and showed clear signs of shock. Second guy? Shot in the gut and leg, started strong but slowly faded out. Dr. Cap then gave us the rundown on resuscitation. Key points: control bleeding first, whole blood is the MVP for treatment, but sometimes, there ain't enough to go around. So we talked alternatives like starches and crystalloids. However, normal saline? Originally for cholera, not ideal for trauma. Oh, and calcium plays a bigger role than you might think. TXA? Super useful for clot stability, but blood circulation's the real deal. Prioritize, act fast, and always be prepared to adapt. 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

Today's episode, is all about "Versed." We've got Kevin and Paul here, chatting about patient positioning and the intricacies of using Versed, a benzodiazepine, for sedation. They touch on how different patients react to the drug, emphasizing the art of medicine over strict calculations, especially in challenging scenarios. The podcast delves into dosing strategies, dealing with hemodynamically unstable patients, and the complexities of maintaining sedation during procedures. Remember, every patient is unique, so adapt the approach accordingly. 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

Today, I'm chatting with Colin about the new Prolonged Fieldcare Airway CPG. Basically, it's a guideline for managing airways in tough situations. Colin's a special ops medic and he helped put this thing together. CPGs are like gold for medics, so Google "PFC CPG" for info. Airway's vital, but sometimes overlooked. We're diving into the details, from procedures to training. It's not just about sticking a tube in; it's a whole process. Training's key – keep practicing. Units need to back it up too. 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

Welcome back to the PFC podcast! Today, it's Dennis here with Casper and Paul. We're discussing a leadership tool called the Tactical Timeout, which helps teams ensure everyone is on the same page. Casper, a NATO Special Operations combat medic, gives a shout-out to the timeout used in the medical community, ensuring correct procedures. Using the Tactical Timeout, they discuss the tactical situation, security, and evacuation plans, ensuring efficient shift changes and patient updates. It fosters cohesion, especially with non-medical personnel. Dennis emphasizes the importance of contingency planning and clear communication, while Paul urges junior medical team members to ask questions to avoid confusion. Stay tuned for more on the PFC podcast! 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

Kevin schools me up on Ketamine and it's use in the field.