In this episode, Dennis interviews Justin, a second-year medical student and co-founder of Special Operations Forces to School of Medicine (SOFTSOM), a nonprofit organization that helps Special Operations Forces service members and veterans in their journey to become physicians. Justin explains that SOFTSOM provides mentorship, guidance, and support to individuals from the SOF community who are interested in pursuing a career in medicine. The organization helps with the application process, offers scholarships for MCAT prep, conducts research on veterans in medicine, and partners with universities to increase soft representation in medical school classes. Justin also emphasizes the importance of tailoring application essays and preparing for interviews to highlight the unique experiences and skills of SOF applicants. Takeaways SOFTSOM is a nonprofit organization that helps Special Operations Forces service members and veterans in their journey to become physicians. The organization provides mentorship, guidance, and support throughout the application process for medical school. SOFTSOM offers scholarships for MCAT prep and conducts research on veterans in medicine. The organization partners with universities to increase soft representation in medical school classes. Applicants from the SOF community should tailor their application essays and prepare for interviews to highlight their unique experiences and skills. 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

Dr. Burjor Langdana discusses dental care in austere environments and provides tips for handling dental emergencies. He emphasizes the importance of preventive care, such as dental check-ups and good oral hygiene, before embarking on a trip. He advises carrying a dental kit with essential materials like temporary filling material and an intra-oral bandage. Dr. Langdana also shares strategies for managing dental emergencies, including broken fillings, infections, and impacted wisdom teeth. He highlights the need for a team approach and training local providers in dental care. The conversation concludes with advice for preparing for a deployment and information about Dr. Langdana's website, which offers free resources on wilderness expedition dentistry. Takeaways Preventive care, such as dental check-ups and good oral hygiene, is crucial before embarking on a trip to an austere environment. Carry a dental kit with essential materials like temporary filling material and an intra-oral bandage. Manage dental emergencies like broken fillings, infections, and impacted wisdom teeth with appropriate techniques and materials. Adopt a team approach and train local providers in dental care to improve access and outcomes. Prepare for a deployment by motivating participants to prioritize dental care and ensuring the availability of necessary materials. Dr. Burjor Langdana's website, Wilderness Expedition Dentistry, offers free resources on handling dental emergencies and basic facial injuries in austere 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 or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

In this conversation, Dennis and Mark discuss the importance of understanding wound ballistics in trauma surgery. Mark shares his experience working with special operations teams and developing medical proficiency training. They delve into the impact of high-energy rifle wounds and the fragmentation of bullets inside the body. They also discuss the role of entrance and exit wounds, the risks of packing hollow viscous injuries, and the importance of clinical judgment in treating gunshot wounds. In this conversation, Dr. Mark Shapiro discusses various aspects of wound ballistics, including gunshot wounds, shotgun wounds, and blast injuries. He shares his experiences treating patients with these types of injuries and provides insights into the different behaviors and treatment approaches for each. Dr. Shapiro emphasizes the importance of relying on common sense and making quick decisions in resource-depleted environments. He also highlights the unpredictable nature of blast injuries and the challenges they present. Overall, this conversation provides valuable information for medical professionals dealing with traumatic injuries. Takeaways Understanding wound ballistics is crucial in trauma surgery to effectively treat gunshot wounds. High-energy rifle wounds can cause significant damage due to the speed and fragmentation of the bullet. Entrance and exit wounds may not always be reliable indicators of the bullet's path inside the body. Packing hollow viscous injuries, such as the abdomen or torso, is generally not recommended. Clinical judgment and assessment of vital signs are essential in determining the appropriate course of action for treating gunshot wounds. Gunshot wounds in the cardiac box can sometimes have unexpected outcomes, and observation can be a valid approach. Shotgun wounds are complex and require careful management due to the extensive tissue destruction and risk of infection. Assessing neurovascular function in conscious patients involves physical exams and evaluating pulse, color, and temperature. In blast injuries, the primary blast wave, secondary injuries from being thrown against objects, and tertiary injuries from fragments all contribute to the overall damage. Treating blast injuries requires addressing the various types of injuries, such as bowel injuries, lung injuries, and infections. Experience and common sense play a crucial role in making decisions and providing the best care in challenging 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 or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

The conversation explores the topic of unconventional medical networks and how to establish them. The guest, Regan Lyon, discusses his thesis on this subject and the challenges involved. They discuss the historical context of guerrilla hospitals and the need for medical care in unconventional warfare scenarios. They also touch on the limitations and constraints of current medical doctrine and the importance of training, blood supply, hospital capacity, and evacuation routes. The conversation highlights the need to adapt to changing environments and the role of technology in both aiding and complicating medical care. In this conversation, Dennis and Regan discuss the challenges of providing medical care in conflict zones and austere environments. They highlight the importance of being prepared for situations where the medical supply chain is disrupted and improvisation is necessary. They emphasize the need for medical professionals to think outside the box and consider alternative solutions when faced with limited resources. They also discuss the importance of coordination and interoperability between different military and civilian organizations, as well as the need to empower and support local communities in providing medical care. Overall, they stress the need for a proactive and adaptable approach to casualty care in unconventional warfare. Takeaways Establishing unconventional medical networks is a complex and challenging task. Historical examples of guerrilla hospitals provide insights into the unique challenges and strategies involved. Current medical doctrine has limitations and constraints that need to be addressed in unconventional warfare scenarios. Training, blood supply, hospital capacity, and evacuation routes are crucial factors in establishing effective medical networks. Technology can both aid and complicate medical care in unconventional warfare situations. Medical professionals need to be prepared for situations where the medical supply chain is disrupted and improvisation is necessary. Thinking outside the box and considering alternative solutions is crucial in austere environments. Coordination and interoperability between different military and civilian organizations are essential for effective casualty care. Empowering and supporting local communities in providing medical care can enhance resilience and response capabilities. A proactive and adaptable approach is necessary for casualty care in unconventional warfare.

In this conversation, Kevin and Dennis discuss nursing care in a prolonged field care (PFC) setting. Kevin, an experienced nurse anesthetist, provides insights into when PFC nursing care begins and the importance of gathering data and assessing patients. He emphasizes the role of nurses in providing interventions such as pulmonary toileting, turning patients, skincare, dressing changes, medication infusions, and more. Kevin also discusses the challenges of training for PFC and the need to have a standard of care before entering the field. He shares practical tips for cleaning patients and changing interventions in a resource-limited environment. In this part of the conversation, Kevin and Dennis discuss the importance of getting to know the patient and recognizing when interventions are not working. They also talk about the need for clear guidelines and parameters for nursing care, as well as the challenges of providing nursing care in a prolonged field care setting. Kevin emphasizes the importance of turning patients, preventing skin breakdown, and doing proper pulmonary toileting. He also suggests learning from historical examples, such as the Navy's approach in the South Pacific during World War II, to solve the challenges of prolonged field care. Takeaways Prolonged field care nursing begins when life-saving interventions are complete and the patient is stable. Nursing care in PFC involves gathering data, assessing patients, and providing interventions such as pulmonary toileting, skincare, dressing changes, and medication infusions. Training for PFC should include working in an ICU to learn the standard of care and understand what gets degraded in the field. In a resource-limited environment, improvisation and prioritization are key in providing nursing care. Monitoring vital signs and recognizing changes is crucial in determining when to involve a provider in the patient's care. Getting to know the patient and recognizing when interventions are not working is crucial in providing effective care. Clear guidelines and parameters for nursing care are important to ensure proper treatment. Turning patients, preventing skin breakdown, and doing proper pulmonary toileting are essential nursing interventions. Learning from historical examples, such as the Navy's approach in the South Pacific during World War II, can provide valuable insights for solving the challenges of 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 or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

In this podcast episode, Dennis and Andy Fisher discuss the co-administration of ketamine and Versed. They explore the reasons behind the common practice of adding Versed to ketamine, the concept of emergence reactions, and the appropriate use of Versed. They also touch on the potential risks and side effects of both drugs and the importance of individualized dosing. The conversation emphasizes the need for critical thinking and careful consideration when administering these medications. Takeaways The practice of adding Versed to ketamine is based on historical protocols and the belief that it provides amnestic properties and prevents emergence reactions. There is no clear definition of emergence reactions, but they can include unpleasant sensations, disconnection, hallucinations, and agitation. Ketamine itself has amnestic properties and should provide adequate amnesia without the need for Versed. The use of Versed should be based on individual patient needs, such as safety and mission comfort, and not protocolized. Careful consideration of dosage, administration speed, and patient physiology is crucial to avoid adverse events and ensure optimal outcomes. 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

In this conversation, Dennis and Dave discuss procedures like cricothyroidotomy (cric) and chest tube placement in the context of extended care. They explore the challenges of managing patients with airway interventions and the importance of considering the context and resources available. They also discuss the criteria for removing a cric or chest tube and the potential complications that may arise. The conversation highlights the need for careful assessment and monitoring of patients to ensure optimal outcomes. Takeaways Context is crucial when considering procedures like cricothyroidotomy and chest tube placement in extended care settings. The decision to remove a cric or chest tube should be based on careful assessment of the patient's condition and the availability of resources. Monitoring the patient's airway and respiratory status is essential after removing a cric or chest tube. Consider the potential complications and risks associated with procedures and weigh them against the benefits. In resource-limited environments, training auxiliary personnel to perform non-clinical tasks can help alleviate the workload of medics. Ultrasound can be a valuable tool for assessing the placement and function of chest tubes and airway interventions. 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

In this podcast episode, Dennis and Pac discuss the use of ketamine in medical settings, particularly in austere environments. They cover topics such as the differences between S-ketamine and R-ketamine, the dosing and administration of ketamine for sedation and analgesia, and its use in hemodynamically unstable patients and refractory seizures. They also touch on the importance of proper training and monitoring when using ketamine, as well as the potential benefits of combining regional anesthesia with IV sedation. Overall, ketamine is seen as a versatile and effective drug for pain management and sedation in various medical scenarios. Takeaways Ketamine, particularly S-ketamine, is a versatile and effective drug for sedation and analgesia in medical settings. The dosing and administration of ketamine depend on the patient's condition and the desired effect, and it can be given via various routes, including IV, IM, subcutaneous, oral, and rectal. Ketamine is especially useful in hemodynamically unstable patients and refractory seizures. Proper training and monitoring are essential when using ketamine, and it is important to have a plan and be prepared for potential adverse effects. Combining regional anesthesia with IV sedation can be beneficial in certain situations. Ketamine is commonly used in developing countries and can provide valuable hands-on experience for medical professionals. Collaborating with local doctors and clinics can offer valuable insights and knowledge about the use of ketamine in specific regions. 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

In this conversation, Dennis and Monti discuss the process of product development. They cover topics such as generating ideas, validating ideas with potential customers, protecting intellectual property, and deciding whether to build a business or collaborate with another company. Monti shares his experience with developing the APRU and Delta Ice products, highlighting the importance of customer feedback and iteration. They also touch on the challenges and time commitment involved in bringing a product to market. The conversation explores the challenges and lessons learned in developing and bringing a medical device to market. The guest, Monti, shares his experience in creating a portable blood storage device for military use. He discusses the regulatory hurdles, the importance of listening to end-users, and the need for patience and perseverance in the business world. Monti emphasizes the significance of timing and market demand, as well as the need to continually innovate and expand product offerings. He also highlights the role of technology in improving medical care on the battlefield. Takeaways Generating ideas for product development often involves talking to potential customers and understanding their needs. Validating ideas with potential customers is crucial to determine if there is a market demand for the product. Protecting intellectual property through patents and non-disclosure agreements can help prevent others from stealing or copying your idea. Deciding whether to build a business or collaborate with another company depends on factors such as the scope of the product, market potential, and personal goals. Customer feedback and iteration are essential in the product development process to refine and improve the product. Bringing a product to market can be a time-consuming and challenging process that requires patience and financial resources. Developing and bringing a medical device to market requires navigating regulatory hurdles and addressing the needs of end-users. Timing and market demand are crucial factors in the success of a product. Patience and perseverance are essential in the business world, as it often takes longer than expected to achieve success. Continual innovation and expansion of product offerings are necessary to stay competitive. Technology plays a significant role in improving medical care on the battlefield. 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

In this conversation, Rick, a senior medic for the 10th Special Forces Group, shares lessons learned from a mass casualty event in Eastern Afghanistan. He discusses the different types of mass casualty situations and the challenges faced in both reactive and proactive scenarios. Rick emphasizes the importance of realistic training scenarios and the need to think critically and adapt in high-stress situations. He also highlights the significance of effective communication, pre-coordination with medevac assets, and documenting patient information. Rick concludes by stressing the need to focus on good medicine rather than striving for perfection. In this conversation, Dennis discusses the importance of managing chaos and effective communication during mass casualty situations. He emphasizes the need to step back, take a breath, and develop a plan to ensure the best possible outcomes. Dennis also highlights the significance of triaging patients and categorizing them based on urgency. He stresses the importance of cross-training medics and being familiar with each other's roles and responsibilities. Additionally, he emphasizes the need for clear and concise communication and the importance of talking about traumatic experiences to promote healing and understanding. Takeaways Differentiate between reactive and proactive mass casualty situations and adapt accordingly Create realistic training scenarios to prepare for high-stress situations Think critically and prioritize patient care in chaotic environments Communicate effectively and pre-coordinate with medevac assets Document patient information and maintain accountability Focus on good medicine rather than striving for perfection Manage chaos by stepping back, taking a breath, and developing a plan Effective communication is crucial during mass casualty situations Triage patients and categorize them based on urgency Cross-train medics to ensure they can treat each other and their patients Talk about traumatic experiences to promote healing and understanding 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