In this podcast episode, Dennis, Rick, and Paul discuss the challenges of training in the field of prolonged field care (PFC) and advanced medical training. They address the common problems of miscommunication and unrealistic expectations when it comes to training requests. The conversation covers topics such as setting realistic goals, creating effective scenarios, and the importance of having flexible and experienced instructors. They also discuss the value of worst-case scenario training and the need for integration of medical training into combat training. Overall, the episode emphasizes the importance of effective communication, realistic planning, and collaboration in training scenarios. The conversation focuses on the challenges of training and leading medical teams in high-stress situations. The speakers discuss the importance of team leadership and decision-making, as well as the need for continuous training and learning. They emphasize the value of starting with the basics and building a strong foundation before tackling more advanced skills. The conversation also touches on the importance of understanding the purpose behind medical procedures and equipment, as well as the need for real-world experience and clinical decision-making. Overall, the speakers highlight the need for realistic and practical training that prepares medics for the unpredictable nature of their work. Takeaways Effective communication and realistic planning are crucial for successful training. Setting realistic goals and objectives is essential for effective training. Worst-case scenario training can be valuable in preparing for challenging situations. Integration of medical training into combat training is important for comprehensive preparedness. Flexible and experienced instructors are key to successful training. Team leadership is crucial in high-stress medical situations, and team members need to understand their roles and responsibilities. Training should start with the basics and build a strong foundation before moving on to more advanced skills. Understanding the purpose behind medical procedures and equipment is essential for effective decision-making. Real-world experience and exposure to different clinical settings can enhance a medic's skills and decision-making abilities. Training should be realistic and practical, preparing medics for the unpredictable nature of their work. 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 Ian discuss the process of disposition in emergency medical care. They explore how to transfer patients who cannot be evacuated to a higher level of care and instead need to be sent back to their families or local medical systems. The key steps in the disposition process include evaluating life threats, stabilizing the patient, determining if continuous medical care is necessary, assessing if the patient can be cared for at home, and ensuring they have access to follow-up care. The hosts also discuss the importance of patient education and communication in the disposition process. Takeaways The disposition process involves evaluating life threats, stabilizing the patient, and determining the appropriate level of care needed. Patient education is crucial in the disposition process, ensuring that patients and their families have the knowledge and resources to care for themselves at home. Communication and collaboration with local medical systems are important when transferring patients to ensure they receive the necessary care. The decision to transfer a patient to a higher level of care or to a local medical system depends on the patient's condition and the available resources. In some cases, transferring a patient to a lower level of care, such as an EMS system, may be appropriate if the necessary skills and equipment are available. 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

Mikola, a combat medic from the Ukrainian Special Operations Task Forces, shares his experience and challenges in providing medical care in the war-torn region of Ukraine during SOMSA 24. He discusses the difficulties of operating in a large and constantly changing frontline, with different terrain and medical systems in each administrative region. Mikola explains the concept of medical evacuation and the various facilities and modes of transportation used. He also highlights the dangers faced by medics, including attacks from Russian forces and the use of drones with payloads. Mikola emphasizes the importance of training, supply management, and improvisation in overcoming these challenges. If you would like to see the slides, sign up for our Patreon (link below) and get early access to presentations and more. Takeaways Operating as a combat medic in the war-torn region of Ukraine presents numerous challenges, including a large and constantly changing frontline. Medical evacuation involves coordinating with different facilities and modes of transportation, taking into account the specific terrain and enemy patterns in each administrative region. Medics face significant dangers, including attacks from Russian forces and the use of drones with payloads. Training, supply management, and improvisation are crucial in overcoming the challenges faced by combat medics in Ukraine. 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, Dr. DeMello discusses the management of burns in a pre-hospital setting. He emphasizes the importance of following the MARCH approach and not letting the burn distract from other life-threatening injuries. He also highlights the challenges of accurately calculating the total body surface area (TBSA) affected by the burn and recommends using the serial halving method. Dr. DeMello advises against over-resuscitating with fluids and suggests using a simple fluid resuscitation protocol. He also discusses the use of oral fluids and the benefits of allowing patients to have clear fluids. Other topics covered include pain control, escharotomies, cooling the burn, and monitoring urine output. Takeaways Follow the MARCH approach and prioritize life-threatening injuries over the burn. Use the serial halving method to estimate the TBSA affected by the burn. Avoid over-resuscitating with fluids and use a simple fluid resuscitation protocol. Allow patients to have clear fluids if there is no upper airway burn or evidence of inhalational burn. Consider using ketamine for analgesia in burn patients. Cool the burn as quickly as possible, but not the patient. Monitor urine output and look for trends in color to assess for rhabdomyolysis. Provide compassionate care to reduce anxiety and pain 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 or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

In this episode, Dennis and Alex discuss the importance of reading research papers and critically analyzing their applicability to the operational environment. They review a paper on the role of red blood cells in thrombosis and post-transfusion hypercoagulability. The study found that red blood cell aggregation increased in the presence of tissue factor and calcium. While the study had limitations in terms of sample size and external validity, it raised questions about the use of calcium and tranexamic acid (TXA) in trauma patients. Dennis emphasizes the need to critically assess the need for these interventions based on individual patient factors. The conversation explores the complexity of blood clotting and the challenges of managing critically ill trauma patients. The hosts discuss the activation of blood components, the role of red blood cells in clot formation, and the use of thrombin matrix. They also touch on the age of blood and its impact on clotting, as well as the importance of trauma surgeons in managing these patients. The conversation emphasizes the need for continuous learning and clinical decision-making based on individual patient scenarios. Takeaways Reading research papers and critically analyzing their applicability is important in the operational environment. The study discussed the role of red blood cells in thrombosis and post-transfusion hypercoagulability. Red blood cell aggregation increased in the presence of tissue factor and calcium. The study raised questions about the use of calcium and tranexamic acid (TXA) in trauma patients. It is important to critically assess the need for interventions based on individual patient factors. Blood clotting is a complex process involving the activation of various blood components. Red blood cells play a role in clot formation and can drift to the site of injury. The age of blood does not significantly affect clotting ability. Trauma surgeons are crucial in managing critically ill trauma patients. Clinical decision-making should consider individual patient scenarios and the nuances of clotting. Continuous learning is essential in the field of trauma medicine. 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 episode of the PFC Podcast, Colonel Stacey Shackelford discusses abdominal trauma and exsanguinating hemorrhage. He highlights the findings from studies on casualties who died before reaching a surgical hospital, with close to 90% of those deaths caused by bleeding. The majority of potentially survivable injuries resulting in death were from torso hemorrhage, particularly abdominal injuries. The current toolkit for managing abdominal trauma includes pressure dressings, blood transfusions, TXA, and calcium. However, there is a need for further research and development of advanced pre-hospital care options. Takeaways Studies have shown that a significant number of casualties die before reaching a surgical hospital due to bleeding from abdominal trauma. The majority of potentially survivable injuries resulting in death are from torso hemorrhage, particularly abdominal injuries. The current toolkit for managing abdominal trauma includes pressure dressings, blood transfusions, TXA, and calcium. Further research and development is needed for advanced pre-hospital care options to improve survival rates for abdominal trauma. 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 revolves around the topic of ether and its use in surgery. Mike and Brad, both medical professionals, discuss the benefits and drawbacks of using ether as an anesthetic. They highlight its historical significance, safety profile, availability in developing countries, and field expediency. They also mention the flammability and pungent smell of ether, as well as its slower uptake and potential for post-op nausea and vomiting. The conversation emphasizes the importance of understanding ether anesthesia and maintaining high clinical standards in austere settings. In this conversation, Brad, Mike, and Dennis discuss the use of ether as an anesthetic in prolonged field care scenarios. They emphasize the importance of understanding the different stages of anesthesia and how ether can be used for conscious sedation. They also highlight the significance of logistics and problem-solving in austere environments, where medical supplies may be limited. The conversation encourages listeners to do their own research and learn from historical medicine. Overall, the discussion provides valuable insights into the use of ether in resource-limited settings. Takeaways Ether is the foundation for all gas anesthesia inhalation and has been used in surgery since 1846. Ether is simple, safe, and easy to manufacture, making it a viable option in austere settings and developing countries. Ether has a unique safety profile, making it suitable for high-risk patients and trauma cases. Ether is field expedient and can be administered using simple techniques and equipment. Ether is highly flammable and has a pungent smell, but its availability and low cost make it a valuable option in certain situations. Understanding the stages of anesthesia and maintaining high clinical standards are crucial when using ether in surgery. Understanding the stages of anesthesia is crucial for using ether effectively in prolonged field care scenarios. Ether can be used for conscious sedation and is a versatile option for various medical procedures. Logistics and problem-solving skills are essential in austere environments where medical supplies may be limited. Learning from historical medicine and conducting research can enhance medical knowledge and preparedness in resource-limited settings. 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 episode of the PFC Podcast, Dennis and Jamie discuss the importance of tourniquet conversion in the context of combat medicine. They explain the difference between tourniquet conversion and tourniquet replacement, emphasizing the need to control bleeding and save tissue. They discuss the timing of tourniquet conversion, highlighting the importance of resuscitation and patient stability. The conversation also covers the physiological effects of tourniquet conversion, including reperfusion injury and metabolic waste products. The hosts provide insights into the challenges and decision-making process involved in tourniquet conversion, as well as the use of calcium and bicarbonate to manage potential complications. They emphasize the need for medics to be prepared, assess the patient's condition, and make informed decisions based on the available resources and clinical guidelines. Takeaways Tourniquet conversion involves making positive efforts to control bleeding or determining that the tourniquet is no longer necessary. Tourniquet replacement is done when there is a need for a better or more proximal tourniquet to control bleeding. Tourniquet conversion should be considered after resuscitating the patient and ensuring they are warm and non-coagulopathic. The timing of tourniquet conversion depends on the tactical situation and the patient's resuscitation status. Calcium and bicarbonate can be used to manage potential complications during tourniquet conversion. Medics should be prepared, assess the patient's condition, and make informed decisions based on available resources and clinical guidelines. 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 interviews Tom Avery, a surgeon who worked in Myanmar with the Free Burma Rangers. Tom shares his experience providing critical care in a war-torn area and the challenges he faced. He discusses the importance of stabilizing patients and bridging the gap between the frontline and higher echelons of care. Tom emphasizes the need for flexibility and creativity in an austere environment and the importance of communication and cooperation with local forces. He also highlights the lessons learned, including the need for in-field sterilization, the value of a mobile ultrasound device, and the importance of a standardized trauma kit. Takeaways Stabilizing patients and bridging the gap between the frontline and higher echelons of care is crucial in a war-torn area. Flexibility and creativity are essential in an austere environment. Communication and cooperation with local forces are key to success. In-field sterilization and cleaning of medical instruments are important considerations. Having a mobile ultrasound device and a standardized trauma kit can greatly enhance patient 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 Brad discuss the use of fentanyl as an opioid analgesic. They explore the history and development of fentanyl, its pharmacological properties, and its advantages over other opioids. They also discuss the administration of fentanyl, including IV and lollipop forms, and the importance of titrating the dose to the patient's respiratory rate. The potential side effects and contraindications of fentanyl are also addressed. Takeaways Fentanyl is a synthetic opioid that was developed in the 1950s as a reliable and titratable pain medication. It has a rapid onset and peak effect, making it useful for pain control in trauma and sedation during procedures. Fentanyl is 100 times more potent than morphine and is typically administered in microgram doses. Respiratory depression is a potential side effect of fentanyl, but it can be managed by monitoring the patient's respiratory rate. Fentanyl lollipops are an alternative route of administration, but they require proper technique and can cause nausea and vomiting. Fentanyl patches are not recommended for prehospital use due to their slow onset and potential for unpredictable drug release. Proper education and understanding of fentanyl's pharmacology and administration are essential for safe and effective use. 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