Podcast Episode 35: Priorities of Burn Care With Dr. Cairns of The UNC Chapel Hill Jaycee Burn Center and the AMIT Program

Which burn fluid resuscitation formula is best? Does it really matter?

What can happen if you over resuscitate? Under?

What can cause an increase or decrease in the demand of fluids?

What can you do if you are running out of Lactated Ringers?

As a Lt. Cmmdr. with the U.S. Navy, Dr. Cairns was on duty and a principle responder to the KAL flight that crashed in 1997 in Guam. Dr. Cairns was instrumental in developing the level of preparedness at the Naval Hospital there which received and managed dozens of critical patients in the morning following the crash of the 747.

Continue reading “Podcast Episode 35: Priorities of Burn Care With Dr. Cairns of The UNC Chapel Hill Jaycee Burn Center and the AMIT Program”

Podcast Episode 33: TIVA: Another Look at Pre-Hospital Analgesia and Sedation

Rick Hines has spent the last 20+ years in service to his country much of it deployed to combat zones and other unstable, austere environments and is dedicated to improving SOF Medicine.  He made it a point to spend a fair amount of time with surgical teams when possible and has gained quite a bit of real world knowledge that we hope to pass on to a wider audience here. Continue reading “Podcast Episode 33: TIVA: Another Look at Pre-Hospital Analgesia and Sedation”

New CPG! Traumatic Brain Injury Management in PFC

Traumatic Brain Injuries coupled with other injuries can be one of the most difficult wound patterns to manage in the field. Learn to manage TBI on its own and when other complications arrive you will be in better condition to handle an even more difficult situation.

Traumatic Brain Injuries coupled with other injuries can be one of the most difficult wound patterns to manage in the field. Learn to manage TBI Continue reading “New CPG! Traumatic Brain Injury Management in PFC”

Podcast Episode 26: ICRC Style Wound Care and the NEW Acute Wound Care Management Clinical Practice Guideline

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 debridements, 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 Continue reading “Podcast Episode 26: ICRC Style Wound Care and the NEW Acute Wound Care Management Clinical Practice Guideline”

Podcast 23: Clinical Practice Guidelines for the SOF Medic

While at the 2017 Remote Damage Control Resuscitation(RDCR) conference put on by the Tactical Hemostasis, Oxygenation and Resuscitation(THOR) network in Norway, Sean took the time to corner Dr. Shackleford to get her thoughts on the Joint Trauma System Clinical Practice Guidelines. Be sure to check out the new JTS Facebook, LinkedIn Pages, Instagram and Twitter feeds and YouTube Channel for more updates.

While at the 2017 Remote Damage Control Resuscitation(RDCR) conference put on by the Tactical Hemostasis, Oxygenation and Resuscitation(THOR) network in Norway, Sean took the time to corner Dr. Shackleford to get her thoughts on the Joint Trauma System Clinical Practice Guidelines. Be sure to check out the new JTS Facebook, LinkedIn Pages, Instagram and Twitter feeds and YouTube Channel for more updates.

  • What is the process that the CPGs go through before publication?
    1. Medics identify what guidelines are needed
    2. A team consisting of a medic, unit surgeon and specialist in the field begin a draft.
    3. Additional authors, specialists and SMEs are added as identified
    4. Progress is monitored by the Prolonged Field Care Working Group Steering Committee and advisors from the Joint Trauma System.
    5. Final draft sent out to interested parties, other specialists and PFC working group members for review
    6. Published in the Journal of Special Operations Medicine(JSOM) with proprietary format
    7. Formatted for public release via the JTS website
    8. Presented as a Thursday morning JTS CME Conference Talk.
    9. Posted on prolongedfieldcare.org
      • Interviews with authors are published as podcasts.
      • Primary and Co-Authors may write additional thoughts as a blog post.
      • polldaddy quizzes may be included in the posts or separately.
      • Released and promoted through social media such as our Facebook Pages, Instagram and Twitter feeds.
  • Why not just update the Tactical Medical Emergency Protocols?
    • We wanted peer reviewed guidelines that could be updated individually as needed.  Independent medical providers can now see what studies were referenced per recommendation.  We have partnered with USSOCOM and advised several changes and additions to the TMEPs.  The CPGs will help guide the CEB as they update future additions of the TMEPS as a reference.
  • What are the origins of the CPGs?
    • Sharing lessons learned and best practices accross the theaters of war
  • Why are there CPGs specific to Prolonged Field Care and Critical Care Evacuation Teams(CCAT) in addition to the main JTS CPGs?
    • There are large enough differences in levels of training, equipment and medications available and general logistics involved that make providing an identical care in all environments impossible. The CPGs take into consideration the unique challenges of the operational environment so the the provider is presented with several best options for the unique issues presented with each etiology and environment.
  • What CPGs are in the works and when can we expect to see them published?
  •  Coming Soon
    • Austere Nursing Care – Submitted!
    • Austere Damage Control Resuscitation – Drafted!
    • Austere Airway – Drafted!
    • Sepsis, Recognition and Treatment – Concept
    • Prepare for Flight – Concept
    • Thoracic Injuries – Concept
    • Abdominal Injuries – Concept
  • Why don’t you publish them all at once?
    • Most of them have taken over a year from time of inception to release.  They are meticulously researched, debated and reviewed before publication in the JSOM. Quality is more important than quantity.
  • When will they be updated?
    • They can be individually updated once the need arises.

Here is our page with the current CPGs including Crush, Burn, Analgesia & Sedation and Wound Care


Download the episode from our SOMA Page now!

Analgesia and Sedation JTS/PFC Clinical Practice Guideline

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TheJoint Trauma System joined up with us and several of our working group members to bring you this, our third CPG, for PFC.As with every PFC CPG, this is the time that goes beyond TCCC. With this specific CPG you are expected to provide appropriate analgesia and/or sedation

Continue reading “Analgesia and Sedation JTS/PFC Clinical Practice Guideline”