Category Archives: Podcasts

Podcast Episode 100 and SOMSA-22

In the 100th Episode of the Prolonged Field Care Podcast Dennis sits down with Jamie, Sean and Paul to talk about the last 100 episodes and how prolonged field care evolved over the past 7 years from when the working group was established at SOMA 2013 in Tampa, FL. Sean has since moved on and retired from the military and founded a non profit, Specialized Medical Standards, dedicated to developing, and distributing high quality education and training resources to the international medical community, much of it based on the lessons learned from his unique experiences and expertise.

Listen here on our Anchor FM page, YouTube Channel or on your favorite podcast app.

Come visit Sean and Dennis at the SMS booth in the SOMSA exhibition room and see the official Prolonged Field Care update from Paul on Friday morning on the main stage.

Podcast Episode 94: We are Back

The Prolonged Field Care Working Group is dead (actually, evolved…).

In its place, the new Prolonged Field Care Collective arises.


Be the first to get our newest episodes on our new Spotify Show by clicking here.

After some time to reorganize, restructure, and strategize, we will be continuing to update best practices, share ideas and raise the important questions faced by medics around the world. We have taken this step to lay the old prolonged field care working group construct to rest and form a new organization (with the same core people): the Prolonged Field Care Collective. Membership is based on participation and contribution. Dennis will continue to record podcasts, which will be posted on http://www.prolongedfieldcare.org, our new podcast feed (Search “Prolonged Fieldcare Podcast”) as well as the same old Special Operations Medical Association Libsyn feed. This will allow us to reach a wider audience, maintain complete control of our content, continue to “push the envelope,” nurture the unconventional Think Tank, and expand what we offer in the future.

Podcast Episode 54: SOP for the Ideal SF Clinic?

While no single clinic setup will work for every situation, a common baseline and checklist can make it far easier in customizing a clinic in similar circumstances. This is not professed to be THE way but it is A way in which ONE experienced team has created, tested, revised and rehearsed a clinic with different casualties. Their pictures and diagrams are provided in the hopes that this audience will help refine and finalize a common baseline which any medic can use in he future. Please leave comments on your thoughts.

Continue reading Podcast Episode 54: SOP for the Ideal SF Clinic?

Podcast Episode 51: Tropical Medicine Considerations with CAPT Ryan Maves

Not all PFC is trauma.  Malaria, Dengue, Chikungunya and others will take you out of the fight if given the chance.  In this episode CAPT Ryan Maves talks about some of the more concerning and prevalent diseases encountered by deployed military personnel and partner forces and what you can do about it before an infection becomes debilitating or life threatening. Continue reading Podcast Episode 51: Tropical Medicine Considerations with CAPT Ryan Maves

Podcast Episode 50: Simple Sepsis Recognition and Intervention for Prolonged Field Care

Why do we care about sepsis in prolonged field care? What can we do about septic shock with what we are normally carrying on a deployment? How do you mix an epinephrine drip? Dr. Maves lays it all out in about 20 minutes.

Continue reading Podcast Episode 50: Simple Sepsis Recognition and Intervention for Prolonged Field Care

Podcast Episode 47: Andy Fisher and his Damage Control Resuscitation for Prolonged Field Care CPG

So what is different than what we already have in the THOR recommendations, the JTS DCR clinical Practice Guideline and the Ranger Regiment TDCR? No hextend?! Calcium with the 1st unit of blood?! TXA slow push?! What if the patient is not responding to resuscitation efforts? This is a guideline truly written for the Medic working despite lack of help or resources in an austere environment…

Continue reading Podcast Episode 47: Andy Fisher and his Damage Control Resuscitation for Prolonged Field Care CPG

Podcast Episode 46: Bleeding in the Box: Non-Compressible Torso Hemorrhage with Dr. Mark Shapiro

Many efforts in the pre-hospital combat environment had been aimed at prolonging the viability of a patient until they are able to make it to a surgeon. The goal of military triage and evacuation is to have urgent surgical patients to a waiting surgical team within 2 hours. Despite our best efforts, this is not always possible. When it is not possible, Continue reading Podcast Episode 46: Bleeding in the Box: Non-Compressible Torso Hemorrhage with Dr. Mark Shapiro

Podcast Episode 45: Regional Anesthesia as an adjunct to Analgesia

When properly and safely administered regional anesthesia can augment your limited supply of narcotics and ketamine in resource poor environments. It can also preserve your patient’s mental status while providing targeted pain relief. This can be accomplished using a nerve stimulator and the techniques found in the Military Advanced Regional Anesthesia and Analgesia Handbook as taught in the Special Forces Medical Sergeant course.  If you have a portable ultrasound machine and a little practice you can also use the safe techniques found in the videos made available in by the New York School of Regional Anesthesia at NYSORA.com. 

Principles Continue reading Podcast Episode 45: Regional Anesthesia as an adjunct to Analgesia

Episode 37: PFC from the NGO Perspective With Alex Potter of GRM

Non-Governmental Organizations, Non-Profits and Volunteers have been providing critical services on the battlefield for millennia. Historically the traditional view of medical care in conflict zones was that the military focused on victory Continue reading Episode 37: PFC from the NGO Perspective With Alex Potter of GRM

Podcast Episode 36: ROLO to SOLO: The Logistics of Fresh Whole Blood Transfusion

The Trauma Hemostasis and Oxygenation Research (THOR) Network including the 75th Ranger Regiment, NORNAVSOF, and others have led the way in re-implementing type-O, low titer fresh whole blood far forward with the Ranger type-O Low titer(ROLO) program. Continue reading Podcast Episode 36: ROLO to SOLO: The Logistics of Fresh Whole Blood Transfusion

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 (video) Episode 34: Telemedicine to Reduce Medical Risk in Austere environments

Telemedicine is a crucial capability that must be planned and practiced. The base of knowledge that a SOF medic’s knowledge encompasses includes many areas of medicine but generally lacks

Continue reading Podcast (video) Episode 34: Telemedicine to Reduce Medical Risk in Austere environments

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

Podcast Episode 31: CBRN for Dummies By COL Missy Givens

In this live recording, guest lecturer COL Missy Givens shares the CBRNe knowledge she has learned while working as a clinical toxicologist, among many other positions, around the world including as the SOCAFRICA Command Surgeon where she personally helped prepare members of 10th SFG(A) to deal with some of the most venomous snakes in the world. Continue reading Podcast Episode 31: CBRN for Dummies By COL Missy Givens

Podcast Episode 30: REBOA?! with Joe DuBose

You are in your Team House or BAS. You have given FDP, Whole blood, TXA calcium and don’t have much left despite the few units from the walking blood bank. Your patient continues to bleed internally. Nothing in the chest or upper abdomen. Probably pelvic. Damn. MEDEVAC is en route. They will have some blood too. You just need your patient to hold on for another hour before he gets to surgery… Continue reading Podcast Episode 30: REBOA?! with Joe DuBose

Podcast Episode 28: Critical Skills for Prolonged Field Care Providers

Training materials were the number 1 most requested item from our SOMSA AAR.  We have put out other training recommendations in the past but wanted to also highlight some important skills that will help you identify gaps in your PFC training program, plan future training and measure progress.  We will get more into this cycle in the future however, this should be a good place to start.  Many thanks go out to Andrew who labored over many versions of the list over the past few months.  One last thing, be sure that you are already at 100% T for Trained on your TCCC task list.  There is no use in getting into PFC training prior to mastering TCCC.  If you see something we may have overlooked and would like to see it on future versions, please comment below and let us know.

Prolonged Field Care Critical Task List Final

Teaching and Training Recommendations from March 2014

 

Podcast 24: Sepsis Roundtable Discussion

You have probably treated someone with an infection and likely even with someone with SIRS criteria at some point in your career.  At what point does a simple infection become concerning to the point that you should call for a teleconsult?

When does it become emergent or life threatening, demanding intervention and treatment?

Continue reading Podcast 24: Sepsis Roundtable Discussion

Podcast Episode 21: Optimizing Ventilation

The Special Operations Medical Association Podcast on Prolonged Field Care is back with a new episode on a long awaited topic, traumatic ventilation.  We were finally able to corner a real, live anesthesiologist who was actually more than happy to sit down and talk about ventilation after his years of experience working at the heads of thousands of patients.  This episode starts right off with a difficult scenario discussion that includes a hypovolemic patient with a GSW to the pelvis, RR 35

Continue reading Podcast Episode 21: Optimizing Ventilation

Podcast Episode 20: TBI Round Table and Case Discussion

This podcast is a follow up from our last post on managing traumatic brain injuries in austere environments.  We included a scenario discussion with David, Jamie, Daryl, Jay, Doug and I with much needed answers to some frequently asked questions. Continue reading Podcast Episode 20: TBI Round Table and Case Discussion

Podcast Episode 19: Sepsis

If you sit on a patient long enough, infection has a greater chance of taking hold and progressing to sepsis, or you may receive a patient who has already been sick for days. Doc Jabon Ellis walks us through the full spectrum from infection and SIRS to sepsis, shock and death.

Continue reading Podcast Episode 19: Sepsis

Podcast Episode 18: Traumatic Brain Injury

Prolonged Field Care PFC TBI Traumatic brain Injury podcast discussion head multi system fluid resuscitation colloid crystalloid hextend lactated ringers LR normal saline NS Fresh Whole Blood FWB herniation hyperventilation raccoon eyes echymosis battles sign

“We were assigned to train the Colombian military in Reconnaissance operations. It was the rainy season, so travel was limited to trucks, ATVs, and good ol’ fashioned walking. We were about two days into our training mission/jungle slog, when we happened upon a vehicle at the base of the mountain that had been pushed off the road by a

Continue reading Podcast Episode 18: Traumatic Brain Injury

Podcast #15 Analgesia Case Discussion Follow Up and a Word on Emerging PTSD Research

Just snow your patient with ketamine and versed to prevent PTSD right?  Maybe not.  While talking through some more analgesia and sedation strategies, Doc Powell shares his thoughts on what he has read recently and it might blow your mind.  It did mine and

Continue reading Podcast #15 Analgesia Case Discussion Follow Up and a Word on Emerging PTSD Research

Podcast Episode 12: Crush Syndrome From a Prolonged Field Care Perspective

Crush injuries are difficult to manage in the best of circumstances.  In an austere environment by a practitioner with little to no experience they can be overwhelming.  In deciding which problem to address in depth first, Continue reading Podcast Episode 12: Crush Syndrome From a Prolonged Field Care Perspective

Podcast Episode 11: Beyond the Golden Hour: Austere Critical Care in Future Operating Environments

The following video podcast was recorded live at the JSOMTC during the July 21 2016 weekly Joint Trauma System Teleconference.  Dr. Doug Powell talks about providing critical care in austere environments.   Continue reading Podcast Episode 11: Beyond the Golden Hour: Austere Critical Care in Future Operating Environments

Podcast Episodes 9 &10: Scott Weingart SOMSA Podcasts on Ketamine for PFC

Scott Weingart, of EMCrit fame, was gracious enough to do a two-part, flipped classroom presentation on the use of ketamine since he pushes the drug on a daily basis for a wide variety of applications. Continue reading Podcast Episodes 9 &10: Scott Weingart SOMSA Podcasts on Ketamine for PFC

SOLCUS @ JTS Tele-Conference #500

Sono in SOF medAs promised, here it is – the SOLCUS talk on ultrasound education in special operations medicine. It was given at the Joint Trauma System Combat Casualty Tele-Conference # 500, on Feb 18th, 2016. Once again – many thanks to the JTS Team for their kind invitation!

Continue reading SOLCUS @ JTS Tele-Conference #500

Podcast Episode 7: Part 4 of the Pharm Series… Ketamine and PFC

This podcast is a direct result from questions, comments and emails we have received along the way.  It helps to clear up some confusion and explain some of the recommendations the working group first made in February of 2014.  Justin begins the episode by talking about 3 different uses of Ketamine in a prehospital or field setting;  The first as an adjunct to opiate analgesia.  The second in procedural sedation for shorter yet painful procedures.  The third for long term sedation in a Prolonged Field Care situation.  He then introduces LTC(Ret.) Jim Reed CRNA who explains field Ketamine use in each of these scenarios.

Throughout the episode several articles and the Working Group’s recommendations on Analgesia and Sedation are discussed or referenced and are included in the show notes below.

Ketamine in Prehospital Care – highlights

Ketamine_for_procedural_sedation_and_analgesia_by_nonanesthesiologists_in_the_field

Svenson Ketamine For Prehospital Use AmJEmergMed 2007

Ketamine Clinical Guideline Annals of EM May, 2011

PFC WG analgesia and sedation comments (Feb, 14)

If you haven’t subscribed to the podcast on iTunes listen now:

Click here to listen on iTunes

Podcast Episode 5: Part 2 of the Pharm Series… The MSMAID Acronym From Anesthesia Adapted to Prolonged Field Care

Pharm Part 2

Justin and Brad continue the discussion of pharmacology started last episode by talking about the MSMAID Acronym/Mnemonic and how it applies to the way SOF Medics should be  Continue reading Podcast Episode 5: Part 2 of the Pharm Series… The MSMAID Acronym From Anesthesia Adapted to Prolonged Field Care

Podcast Episode 4: Part 1 of the Pharm Series… 12 Principals of Pharmacology

Pharm Part 1

In this great podcast Justin introduces the principals of pharmacology that have served him well over the years and have done far more for him than simply keeping him out of trouble.  He also introduces Brad Morgans CRNA who is a wealth of knowledge and experience in Continue reading Podcast Episode 4: Part 1 of the Pharm Series… 12 Principals of Pharmacology

Podcast Episode 2: UOP-The Best Field Monitor for PFC… and a Word on Hypotensive resuscitation

pfc UOP pic

In this episode Justin introduces the importance of properly using urine output to monitor hemodynamics of both trauma and medical patients by interviewing 2 of our contributing working group members; Dr. Phil Mason Air Force Emergency Medicine Physician and Critical Care Intensivist and Dr. Chris Burns who is a Retired Navy Trauma Surgeon.  Both of these doctors have been instrumental in answering the complex questions we have put forth because of their familiarity of our training and equipment available while also putting themselves out there in austere environments from time to time.  Thank you both for taking your time to do this podcast.

Click here to listen to Episode 2: UOP-The Best Field Monitor for PFC…and a Word on Hypotensive Resuscitation

Check out the show notes and handout below:

Continue reading Podcast Episode 2: UOP-The Best Field Monitor for PFC… and a Word on Hypotensive resuscitation

Podcast Episode 1: What’s this PFC stuff anyway and why should I care?

pfc podcast

Our first episode is hosted by Justin, interviewing Colonel Sean Keenan MD who is the 10th Special Forces Group Surgeon.  Doc Keenan has worked tirelessly alongside Justin and the rest of the Prolonged Field Working Group at both our group level and with SOCOM.  The work they are doing is having a lasting impact on military medicine and the way it will be taught and trained in the future.  Many people will say, including the entire working group, that this is nothing new, that SF medics have been trained for the situations we describe for decades.  This may be true but as military medicine progressed the mindset of the medic reverted as unbelievably fast evacuation times took hold in recent conflicts causing a huge loss in the institutional knowledge base.  As medicine, and military medicine especially, progressed at lightning speed, so too has medical technology, research and education.  In order for medics and the providers charged with their training to keep pace a new forum was born with the idea of knowledge retention and sharing across the services, government and international medical community.  Now a conversation a medic has with a surgeon or anesthesiologist while deployed can be recreated in order to enlighten all medics who will likely have similar questions or concerns.  This is the first conversation that explains all of this and more.  We hope that the following series will both educate medical personnel as well as begin the dialogue that will keep our craft moving forward as fast as the entire medical field.  As always be sure to comment and most importantly, share this site with anyone in the health field whom you think it may benefit.

Click here to listen now to Episode 1: What is all this PFC stuff anyway and why should I care?

FOAMed, SMACC and PFC

I hate not knowing an acronym.  In my line of work acronyms are language and the ignorance of one normally results in the ignorance of entire programs or departments.  FOAMed is Free Open Access Meducation a term growing in popularity mostly in part due to the SMACC committee and it’s world wide network of Critical Care, Emergency Medicine and Prehospital care Cadre.  SMACC stands for Social Media And Critical Care. There are now a plethora of  podcasters known as “providers” who attempt to tackle the pressing problems of the aforementioned specialties while striving to educate, for free, the hungry Paramedics, Interns, residents and colleagues at large.  They are succeeding beyond what they thought possible and it is spreading to all facets of medical education.  The first SMACC conference was held in 2013 with the worlds most famous podcasters lecturing and fielding questions from the audience and twitter simultaneously.  It was hailed as the most inspiring and interactive medical conference and if you listen to the podcasts you will see why.  The second was held on the Gold Coast of Australia with even better results.

Continue reading FOAMed, SMACC and PFC

WE ARE LIVE ON iTUNES!

After many, many hours of work collaborating, recording, editing and coding, Prolonged Field Care is live to be downloaded and especially subscribed-to from iTunes!  This is another huge leap forward for us in reaching medics with the information they will need.  With a long drive to work I normally listen to SMACC, EMCrit, or other critical care or emergency medicine podcasts.  As a medic many of them are good to hear and have great info but often don’t apply to my scope of practice or environment I operate in.  These podcasts are hosted by an 18D Medic, interviewing Doctors and nurses of all specialties with the unique challenges we face when taking care of our buddies and partner forces in the worst circumstances with little or no help.

This is exactly what I need as an independent medic in an austere environment. 

Continue reading WE ARE LIVE ON iTUNES!