Prolonged Field Care Podcast

In this episode of the PFC Podcast, Dennis speaks with Rima, a combat medic in Ukraine, about the critical aspects of unit safety, tactical training, and the challenges faced in medical evacuations during an active war zone. Rima shares insights on the importance of personnel over equipment, the necessity of telemedicine, and the realities of training medics under resource constraints. The conversation also delves into wound manage...

This conversation delves into the critical aspects of tourniquet management in trauma care, focusing on the distinction between tourniquet conversion and replacement, the importance of resuscitation, and the physiological implications of prolonged tourniquet use. The speakers discuss techniques for safe conversion, the challenges faced in the field, and the assessment of limb salvageability, emphasizing the need for preparedness an...

The conversation delves into the complexities of end-of-life care, emphasizing the importance of thoughtful training and education in healthcare. It highlights the potential moral injuries that can arise from decisions made in this sensitive area, particularly when medics are tasked with determining the futility of care without adequate resources.

Takeaways

• There's a ripple effect from each one of these decisions.
• We have ...

In this essential episode of the Prolonged Field Care (PFC) Podcast, host Dennis sits down with CRNA Kevin to dive deep into one of the most overlooked yet critical issues in trauma care: Hypothermia prevention and management. Even in warm environments, trauma patients can rapidly become hypothermic—leading to coagulopathy, increased bleeding, wound infections, and worse outcomes. Dennis and Kevin break down the science, real-world...

In this conversation, Jessica Patterson and Florian Schmitzberger discuss the evolution of clinical practice guidelines (CPGs) from the Department of Defense (DOD) and their application in different contexts, particularly in light of the changes from the Global War on Terror (GWOT) to new healthcare environments. They emphasize the need for data to understand how these guidelines will perform in varied systems.

Takeaways

This isn...

In this episode of the PFC Podcast, Dennis and John discuss the ongoing updates and changes within the Tactical Combat Casualty Care (TCCC) guidelines. They delve into the role of the TTC Committee, the importance of literature reviews in developing algorithms for trauma care, and the proposed changes to the March algorithm, emphasizing the need for resuscitation before decompression. The conversation also covers the overhaul of th...

In this episode of the PFC Podcast, Victor, a former Ranger medic, shares his experiences and lessons learned from a mass casualty event during a humanitarian mission in Burma. He discusses the historical context of the conflict, the challenges faced in providing medical support, and the innovative solutions developed in a denied environment. The conversation emphasizes the importance of training, adaptability, and building sustain...

In this gripping conversation, trauma surgeon Max Sirkin MD shares his harrowing experience of being a patient in a mass casualty situation following a helicopter crash. He recounts the chaos of the event, the physical and emotional trauma he endured, and the profound lessons learned about resilience, brotherhood, and the importance of being present for others in crisis. Sirkin's narrative highlights the stark realities of mili...

In this episode of the PFC Podcast, Dan McGraw discusses the critical need for gender-specific medical training in military settings, drawing from personal experiences and extensive research. He highlights the disparities in treatment outcomes between male and female patients, the physiological differences that affect trauma care, and the cultural challenges faced by medical personnel when treating patients of the opposite sex. Thr...

In this episode of the PFC Podcast, Dennis and Master Sergeant Dan McGarra discuss the evolving role of females in combat and the challenges faced in medical treatment for female casualties. They explore discrepancies in medical protocols, cultural implications, and the need for gender-neutral approaches in military medicine. The conversation highlights the importance of understanding physiological differences and social dynamics t...

This podcast episode delves into the complexities of unconventional warfare, particularly focusing on the historical context, the evolution of medical support within special forces, and the challenges faced in modern warfare. The speaker discusses the importance of guerrilla warfare tactics, the role of medical personnel in combat situations, and the concept of the 'Golden Hour' in trauma care. The conversation also highlig...

In this episode of the PFC podcast, Dr. Jim Ducanto, an experienced anesthesiologist, discusses the critical aspects of airway management in emergency situations. He emphasizes the importance of decision-making, assessing neurological status, and effective communication with patients. The conversation also covers the necessity of planning and preparation for airway interventions, as well as the significance of thorough physical exa...

In this episode of the PFC Podcast, Dennis and Max delve into the complexities of hemorrhagic shock, discussing its classifications, the importance of understanding compensated versus uncompensated shock, and the vital signs that indicate a patient's condition. They explore resuscitation strategies, emphasizing the need for careful assessment and decision-making in trauma care. Special considerations for different populations, ...

In this episode of the PFC Podcast, Dennis and Max discuss the evolving landscape of modern combat injuries, focusing on neck and upper chest injuries. They delve into the anatomy of the neck, the importance of understanding different zones for surgical intervention, and effective hemorrhage control techniques. The conversation emphasizes the critical role of teamwork in trauma care and the necessity of airway management in emergen...

In this episode of the PFC Podcast, Dennis and Max delve into the complexities of managing shock, particularly hemorrhagic shock, in trauma patients. They discuss the importance of mental status as a key indicator of a patient's condition, the critical role of early intervention, and the protocols surrounding massive transfusions. The conversation also covers the use of TXA and calcium in resuscitation, emphasizing the need for...

The conversation delves into the complexities of medication stability, particularly focusing on how environmental factors can affect the efficacy of pharmaceuticals. It highlights the stringent storage parameters set by pharmaceutical companies and the lack of testing in combat-simulated environments, raising concerns about medication reliability in critical situations.

Takeaways

Medications can appear fine but still be ineffecti...

In this episode of the PFC Podcast, Dennis and Rick discuss the sensitive and often overlooked topic of what to do with patients after they die. They explore the emotional and cultural complexities involved in handling death in a medical context, particularly in military settings. The conversation covers the importance of cultural sensitivity, legal considerations, personal experiences, and the emotional toll on medical personnel. ...

In this episode of the PFC Podcast, Dennis interviews Nicholas Samuels, a humanitarian worker in Ukraine, discussing the critical aspects of medic safety, planning for evacuations, and the importance of understanding the broader context of the ongoing war. Nicholas shares insights on the challenges faced by medical volunteers, the necessity of being aware of threats like drone warfare, and the balance between mobility and capabilit...

In this episode of the PFC Podcast, Dr. Van Wyk discusses the latest updates in traumatic brain injury (TBI) management, focusing on insights from the CRASH-3 trial, the use of TXA, hypertonic saline, and sodium bicarbonate. He emphasizes the importance of monitoring intracranial pressure and the potential for surgical interventions in austere environments. The conversation also touches on the controversial topic of seizure prophyl...