It has been our experience that high quality prolonged field care training takes time, resources and expertise by dedicated trainers well versed and experienced in critical care concepts. That being said we also believe that there are fundamental principles which can help
Stories and experiences can sometimes bring relevancy to a situation you are in or to a point you are trying to make while instructing. These singular stories are called anecdotes and while powerful and personal do not represent similar patient outcomes even in similar situations. They are not science. They do not take into account the vast number of variables that were present in that particular situation. Often these stories can mislead and misinform medical practice by inexperienced medics and practitioners due to that powerful personal experience clouding that person’s own judgment.
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. Continue reading Podcast 23: Clinical Practice Guidelines for the SOF Medic
Here is an issue that has come up more than once over the past year. It sparked good discussion with some great points that we will attempt to repopulate in the comment section: Continue reading Foley in the Aidbag??? Open Mic Post
The U.S. Institute Of Surgical Research Joint Trauma Service and PFC Working Group need your help:
The JTS is working to conduct a retrospective case review relating to PFC in order to conduct an aggregate analysis.
We are currently collecting as many cases as we can obtain relating to prolonged role 1 care (anything greater than 4 hours) both trauma and non-trauma. We are accepting unclassified AAR’s, medical records, powerpoint summaries from meeting presentations, or even just personal memory/war stories. If the medic is available, we would like to interview them if possible. As there is really no database of such cases, many of the cases will be identified by word of mouth, although we are also searching the trauma registry, SOMA and SOCMSSC databases.
The results of our analysis will include the epidemiology of PFC cases and aggregate lessons learned. The report will be returned to the PFC working group and operational communities and published (likely in JSOM).
Thank you for any assistance you can provide to help identify these cases and the medics who provided such care. Cases may be submitted to email@example.com
Who should medics call for help while managing a critical patient for prolonged periods of time? Different aspects of this have been discussed via different forums such as the SOMSA lunchtime working sessions and email chain. We are posting it here in order to reach a wider knowledge base including those who it affects directly such as the medics on the ground.
What research would help Medics on the ground provide better care to sick patients in an austere, environment today? Has anyone ever told you any dogma that you hear but question and can’t find studies for such as; less than 8 intubate, trendelenberg position for hypovolemic patients, etc.? We have the opportunity to make some of this research happen and use real science to find the best practice for our patients. We simply need ideas and suggestions for research to be conducted.
What measurement or technology, knowing BP measures aren’t always best, and mental status and peripheral pulses aren’t reliable, would be reasonable to field medics as a measure of resuscitation? Would a cost-efficient field lactate monitor be worthwhile?
Here is a message from one of our brothers serving in Germany. I copy and pasted verbatim so that you don’t miss any nuances. My thoughts will be pasted as a new comment after the post to get some discussion going. Please speak up and let us know what we forgot!
During a break from the lectures at the last SOMSA one of the first issues identified was the lack of knowledge of PEEP and the absence of PEEP valves on BVMs. Within a few weeks the paper Why we need PEEP valves on BVMs was written, edited and posted for distribution. Our unit ordered the extremely inexpensive valves and they were distributed down to the medics. It is now standard to be using PEEP valves and considered less-than-best practice without.