Podcast 146: Versed and Procedural Sedation with Kevin and Paul

This episode, is all about “Versed.” We’ve got Kevin and Paul here, chatting about patient positioning and the intricacies of using Versed, a benzodiazepine, for sedation. They touch on how different patients react to the drug, emphasizing the art of medicine over strict calculations, especially in challenging scenarios. The podcast delves into dosing strategies, dealing with hemodynamically unstable patients, and the complexities of maintaining sedation during procedures. Remember, every patient is unique, so adapt the approach accordingly. We also get into patient positioning for procedural sedation and using the reversal agent, romazicon (flumazenil.)

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The SOCS-P Tactical Timeout with Casper and Paul: Article, Checklist, and Episode 145 Show Notes

In our work within the domain of Special Operations medicine, situational awareness, precise coordination and effective decision-making are key factors for success.   Whether it is in the high-stakes realm of aviation or the critical environment of the operating room, the implementation of time-outs has proven to be a valuable practice. These time-outs provide a structured approach for teams to pause, reassess, and align their actions, ensuring that everyone involved is fully informed and prepared for the tasks at hand. The Tactical Time-out Format brings this concept to the SOF-medical setting…

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Podcast 26: Beyond Basic Wound Care-The ICRC Way

This Clinical Practice Guideline was written by a fellow 18D with input from around the surgical community.  It reconciles the differences between wound care done in a role 2 or 3 facility, such as serial debridement, with what is taught in the 18D Special Forces Medical Sergeant Course with regards to delayed primary closure.  One way is not “right” while the other wrong, it has more to do with

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PFC Basics: Documentation-Chart then Trend

The primary reason for the development of the PFC documentation is to enable the medic to more effectively and more efficiently take care of a patient beyond anticipated timelines. When we designed the PFC flowsheet, we wanted a single document that a medic could laminate and stick in the back of their aidbag, hopefully, without ever having to pull it out except for in training. Ideally, every patient would receive a quick evacuation and the medic would only have to do good TCCC. Since we know that this is not the case, the PFC documentation was custom built to enable anyone, regardless of level of training and proficiency, to help improve what they were already doing. Non-Medics, Resuscitation teams, Medics, it doesn’t matter. When technology fails, and it will, we think that having a dedicated, analog record of treatment can help reduce the cognitive burden faced by a small team who is most likely tired, and overwhelmed. The integrated checklists and visual reminders should act as cues to action.

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Podcast 129: Combat Medic Arctic Trauma Course

In this episode Dennis talks with Brett and Sean about the Combat Medic Arctic Course based in Alaska, the Siberia Drill and other lessons learned from working in extremely low

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Podcast 128: Traumatic Cardiac Arrest With Doug

In this podcast, the Dennis and Doug discuss the challenges of treating traumatic cardiac arrest in the field…

and the importance of early intervention to improve outcomes. They also cover various topics such as identifying reversible causes, utilizing resuscitative thoracotomy, and managing hypovolemia. They also get into a great discussion on roles and responsibilities and the importance of having a plan for the team.

Doug and Dennis talking about teamwork in traumatic cardiac arrest.

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A Grassroots Approach to Building National Resilience for Comprehensive Defense, Deterrence and Crisis Response

The foundation of comprehensive defense and deterrence is a trained populace who are willing and able to respond during times of crisis.

Efforts by external, intervening entities should initially focus on enabling and empowering the people of the partner nation to support themselves.

External intervention without strategy is medical tourism at best and may be detrimental to defined initiatives.

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Let’s jump right in. No one wants to be in a prolonged care situation. It is a contingency like a MASCAL. Maybe even a subset of a MASCAL: Being overwhelmed with the complexity and severity of a single, critically ill or injured patient vs being overwhelmed by many patients. As discussed in yesterday’s post,

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PFC and The Surgical Team Deficit

The vast majority of SOF deployments occur outside combat zones where the SOF Medic is expected to care for the entire team without a credentialed provider.  

Faced with a low level of risk, SOF Commanders opt to accept it.

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Prolonged Care and Technology: A PFC Op-Ed

If trained sufficiently, integrated responsibly, and not relied upon, some technology may enhance the awareness of a task-saturated medic dealing with a critically ill patient. However, much of it may be a waste of money, space, and weight without

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