
Prolonged Field Care Podcast
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This podcast and website is dedicated to the healthcare professional who needs to provide high quality care in a very austere location.
For more content: www.prolongedfieldcare.org
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Latest episodes

Dec 19, 2022 • 25min
Recycled Prolonged Fieldcare Podcast 54: SOP of the Ideal SOF Clinic
While no single clinic setup will work for every situation, a common baseline and checklist can make it far easier in customizing a clinic in similar circumstances. This is not professed to be THE way but it is A way in which ONE experienced team has created, tested, revised and rehearsed a clinic with different casualties. Their pictures and diagrams are provided in the hopes that this audience will help refine and finalize a common baseline which any medic can use in he future. Please leave comments on your thoughts. This builds upon clinic setups in SOCM, SFMS and other courses such as SOFACC and combines all into a single, ergonomic clinic in which all members of a team can easily assist the primary medic or in the worst case, effectively treat the wounded medic.
For more content, visit www.prolongedfieldcare.org

Dec 12, 2022 • 29min
Prolonged Fieldcare Podcast 117: Shock Index
Sean and Dennis talk about the Shock Index, how it relates to our treatment decisions, and how it can guide our training. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057268/

Dec 5, 2022 • 31min
Recycled Prolonged Fieldcare Podcast 39: ETCO2 Applications and Limitations
Upgrading your airway kit with a portable end tidal CO2 monitor can help in a couple situations. While it has its limitations, it is essential for quickly determining if your tube is in the trachea during an intubation. This can be accomplished most accurately via a device with a quantitative waveform such as the Emma Capnograph. If you can’t get your hands on an Emma, the qualitative colormetric device that changes color when exposed to acid in the exhalations. False positives can occur due to other acids in the airway such as vomitus or even if the patient has recently had a carbonated beverage. While those are rare, you should be aware of the possibility. Having a visual indication of tube placement can be extremely helpful during loud transports such as on aircraft.
Another time that ETCO2 monitoring is very useful is during CPR. There will likely be a very low reading despite high quality CPR. If the heart begins to beat spontaneously, you should see an immediate increase of the numbers on the display of your device. ETCO2 can also be used as a prognostic indicator. If the ETCO2 remains below 10mmHg for 20 mins of CPR this may indicate that the patient has a very poor prognosis. After you listen to our podcast, Check out Scott Weingart’s EMCrit podcast on the subjects to hear his thoughts on this.
ETCO2 is also useful the intubated TBI patient. Per our clinical practice guideline, ETCO2 in a patient with moderate to severe TBI should be kept between 35-40mmHg. In a patient with herniation, you can temporarily increase ventilators rate in order to vasoconstrict the blood vessels in the brain, thus reducing swelling. This can only be done for a short time because hyperventilation worsens cerebral ischemia. Also avoid hypoventilation (EtCO2 45mmHg or more) that will increase ICP.
For more content, visit www.prolongedfieldcare.org

Nov 28, 2022 • 53min
Prolonged Fieldcare Podcast 116: Ketamine Deep Dive
Kevin schools me up on real world use of Ketamine.

Nov 21, 2022 • 43min
Recycled Prolonged Fieldcare Podcast 42: Woundcare Basics and Beyond
Justin, JJ, and I go over the Woundcare CPG.

Nov 14, 2022 • 41min
Prolonged Fieldcare Podcast 115: Surgery for Non-Surgeons part Deux
Well, maybe emergency laparotomies are not for field medics, but there are a lot of other interventions that are 100% in our court. Dennis and Sean discuss what can be done.

Nov 7, 2022 • 47min
Recycled Prolonged Fieldcare Podcast 61: TBI update with Van Wyke
Dr. Van Wyke and Dennis go over what can be done when managing a severe TBI in an austere environment.

Oct 31, 2022 • 49min
Prolonged FieldCare Podcast 114: Analgesia and PTSD
Can controlling pain alone have an effect on PTSD? If so, how much? We deep dive into analgesia and sedation and it's effect on the body and the mind.

Oct 24, 2022 • 46min
Recycled Prolonged Fieldcare Podcast 60: Cold Weather Injury
It's getting to be that time of year again, Ian schools us treating cold weather injury.

Oct 23, 2022 • 16min
Prolonged Fieldcare Podcast 113: Emergent Airway ALIBI
One more piece of advice.