Prolonged Field Care Podcast

Hey there, welcome back to the PFC podcast! I'm Dennis, and today I'm joined by David and Tim. We'll be discussing the topic of Return to Duty and the important work these guys are doing for our service members. They hope to spread the word and get more people involved in helping out. David shares his background, mentioning his experience as a combat medic and his transition into the field of endoscopic spine treatment. He talks about his own spine injury and how it led him to realize the need for better options for military members. They formed a network of trusted surgeons and started informally helping others. We discuss the challenges service members face in accessing timely and appropriate treatment, and how they aim to bridge that gap. They highlight their unique skill set in advocating for spine care and their collaboration with experienced surgeons who understand the needs of tactical athletes. They also mention the importance of early intervention, proper diagnosis, and tailored treatment plans. They're dedicated to providing top-notch care to all service members, regardless of their location. Overall, their goal is to make a lasting impact and ensure that service members receive the care they deserve. 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

Hey, welcome back to ProlongedFieldCare.org. I'm Paul, and today I want to talk about the importance of documentation in prolonged field care situations. Before you head out, make sure you have a checklist and all the necessary equipment, including medications, fresh whole blood kits, blood typing cards, fluids, specialty equipment, power supply, cables, and filled oxygen bottles. Ensure your team is trained in tactical medicine and prolonged field care, and have a telemed plan in place. Plan for multiple evacuation platforms. Use the 10 essential Prolonged Field Care capabilities worksheet to determine what you need to bring. When you arrive, secure your medications and distribute supplies among the available platforms. Set up your aid station and familiarize your team with the equipment and layout. Have a communication plan in place and double-check all contact information. For documentation, use brain sheets similar to those used by ICU nurses. Consider using PFC casualty cards to track vital signs, injuries, treatments, and plans for each patient. Trend vitals regularly and communicate changes to the team. Prioritize treatments and share care plans with the entire team. Use specialty flow sheets and checklists for specific conditions like burns, fluid administration, and ketamine drips. Finally, consider using the multi-patient evacuation chart for organizing and tracking multiple patients. By implementing these documentation practices, you can improve patient care and enhance efficiency in prolonged field care 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

Welcome back to the PFC Podcast with Dennis and Winston discussing the "Green Whistle". Methoxofluorine, a volatile hydrocarbon similar to modern anesthetics, was used in general anesthesia until 2005 due to renal toxicity risks. However, it continued to be used in Australia, New Zealand, and recently in the UK for pre-hospital care and burns units. In low doses, it acts as an analgesic, while higher doses have an anesthetic effect. The Green Whistle, containing methoxofluorine, is a mouthpiece with an activated carbon chamber to reduce contamination. It provides pain relief for severe pain lasting 30 to 60 minutes. Patient control and comfort are important during its use. Could this be an alternative to the fentanyl lollipop? 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 we have a diverse group of individuals discussing their experiences in Ukraine. Kasha, an emergency pre-hospital critical care expert, spent several months there, while Denys, a physician and medical course director, has extensive experience in training medics for the Ukrainian armed forces. Kevin, a former special agent and tactical paramedic, is currently embedded in a Ukrainian army unit conducting MEDEVAC operations. They emphasize the importance of prolonged field care (PFC) in modern warfare, cautioning against applying strategies from previous conflicts to new battlefields. They share anecdotes about challenging situations and highlight the need for medical leadership, telemedicine, proper training, and logistics in PFC. The discussion emphasizes that PFC is not limited to the military and is relevant to all medical professionals in challenging 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

Welcome back to the PFC Podcast. This is Dennis, and today I'm joined by Anri, a Ukrainian medic who will share some lessons learned from the battlefield. Anri talks about how wound patterns change in urban versus rural areas, with urban areas having more trauma from shrapnel and secondary trauma from debris. He mentions the challenges medics face in treating these complex wounds, including fractures and extensive tissue damage caused by multiple waves of explosions. Anri also discusses the impact of seasonal variations and the difficulties in evacuation due to artillery shelling, long distances, and the use of unconventional methods by the enemy. He emphasizes the importance of adapting medical techniques, such as splinting and triage, to the unique conditions on the front lines. Anri also mentions the use of blood products, saline, and telemedicine for prolonged field 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 the latest episode of the PFC podcast, I spoke with Evan and Doug about airway management. As experienced airway takers in both pre-hospital and hospital settings, they had some valuable insights. We discussed the controversy over intubation versus cricothyrotomy. Evan and Doug raised some valid points, such as the need for suctioning, paralytics, and the difficulty of obtaining post-intubation sedation medication in resource-limited environments. We also talked about the importance of ongoing training to maintain skills and the need for better difficult airway education in training programs. Overall, it was a great discussion. 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 is hosting the PFC podcast with Monty as his guest. Monty is a former army medic who has multiple rotations in Afghanistan and Iraq. He is now part of Delta development, which created a battery-powered blood refrigerator that can store blood between 1 and 6 degrees Celsius, which is vital for prolonged field care. The device can keep blood for up to 10 days on battery power and has a temperature log for easy record-keeping. The goal is to push blood forward to the front lines and eventually back to role three to ensure that blood is available when needed. 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, we're discussing some important topics that have come up recently. One of them has been going on for 10 years, while the other has been around even longer, related to irregular warfare. We're exploring how these two subjects can inform each other. Now, before we begin, I want to clarify that the views and opinions expressed here are solely mine. I also want to mention some disclosures about my upcoming internship and the Prolonged Field Care Collective. If you want more content like this, visit Prolongedfieldcare.org. There are operational environments where the training we provide in the Prolonged Field Care Collective can benefit medics and other providers. We have trained numerous individuals from various special operations and international communities, as well as conventional forces. The challenge lies in the training and the operational context. We adhere to doctrinal timelines for casualties, which vary based on the severity of injuries. It's important to understand the complexity of the operating environment and tailor care accordingly. In the past, there have been issues with overclassifying all patients as urgent, leading to adverse outcomes. While there are ongoing discussions and efforts to standardize terminology and lexicons, we will continue our work and problem-solving under the Prolonged Field Care name. PFC encompasses robust planning, hands-on training, and a strategy for palliative care. Education and training are different, and it's crucial to get hands dirty to truly understand the challenges. We have encountered complex problems in our field and collaborated with various stakeholders, including the Morpheus Group, to crowdsource solutions. Irregular warfare medical support shares similarities with prolonged field care, and there are similar activities worldwide. The aim is to strengthen countries' capabilities to stand on their own during conflicts or degraded civilian infrastructure situations. Training opportunities abound, even in busy schedules, and it's important to optimize and utilize available resources. Feedback and lessons learned from different entities are invaluable. Additionally, initiatives like National Stop the Bleed Month contribute to increased resiliency and readiness, both domestically and internationally. However, it's crucial to understand the legal and operational aspects of medical support in different regions. Humility is key when approaching international missions, as we can learn from past mistakes. By simplifying the complex landscape and using self-guided assessments, we can identify areas for improvement. Global health engagement plays a significant role, as Special Forces have been involved in improving medical care in underserved populations. Civil Affairs and SF have historically been engaged in global health initiatives, and it remains an important aspect of our work. So, despite ongoing discussions and potential changes in terminology, the focus remains on providing effective care in prolonged field care scenarios. 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 Kevin Worth talk about combat anesthesia. The podcast discusses the four pillars of anesthesia, which are amnesia, analgesia, akinesia, and autonomic stability. The focus is on the importance of autonomic stability in combat situations. The best medication for amnesia in a downrange environment is Midazolam or Versed, and ketamine is a potent analgesic. The podcast also covers the MAP (mean arterial pressure) and how to maintain it in trauma patients. Finally, the podcast discusses various scenarios that require different types of sedation or analgesia, including the administration of fentanyl or calcium. 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

This podcast discusses the importance of patient positioning in prolonged field care. The guest, Ethan Miles, a board-certified family medicine physician with extensive military experience, emphasizes that patient positioning is a forgotten aspect of medical training and that simple, low-cost interventions are often overlooked. Miles states that patient positioning is especially crucial in prolonged field care and can help in treating patients with traumatic brain injury, manage airways, and improve oxygenation. However, patient positioning can also have downsides, such as orthostatic hypotension, and should be reassessed regularly. Miles suggests that improvised things can also work well when pre-made things are unavailable. 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