While no single clinic setup will work for every situation, a common baseline and checklist can make it far easier … More
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.
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.
So what is different than what we already have in the THOR recommendations, the JTS DCR clinical Practice Guideline and … More
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, it is important to do the simple interventions which we know make a difference for combat casualties such as tourniquets, wound packing, needle decompression and airway adjuncts. Wounds causing non-compressible hemorrhage to the torso need additional strategies to bridge the time and space gap to definitive treatment. A non-surgical adjunct which has shown the most promise to this point has been the early transfusion of whole blood and blood products. Our newest Clinical Practice Guideline on Remote Damage Control Resuscitation details what should be done and why.
There is an entirely separate working group, The Tactical Hemostasis, Oxygenation and Resuscitation (THOR) group dedicated to exactly those principles. Despite all that effort and brain power however, blood remains a finite resource in the austere environment and Medics have faced terrible situations where even blood administration is not enough and surgery is too far away. It is in these times of worst-case desperation that we want to do more for our patients. Some of the adjuncts discussed in this episode are abdominal tourniquets, REBOA and open surgical procedures. We don’t take any of this lightly and realize that for the vast majority of our pre-hospital audience, many of the procedures discussed are far outside the current scope of practice.
What is possible?
What is responsible?
What is sustainable?
Enjoy the talk.
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.
Alex Potter and Global Response Management positioned themselves far forward on the front lines of the battles for Mosul when times were tough and the International military and humanitarian response to the ISIS was in its infancy.
A Special Operations Battalion Surgeon explains how to easily navigate the logistics of setting up a battalion wide blood transfusion program.
Which burn fluid resuscitation formula is best? Does it really matter? What can happen if you over resuscitate? Under? What … More
Telemedical consult is one of the most important core capabilities in a prolonged field care situation.