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 the Ranger Regiment TDCR? No hextend?! Calcium with the 1st […]
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.
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 […]
Telemedical consult is one of the most important core capabilities in a prolonged field care situation.
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 […]
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 […]
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. […]
Dr. Cap has been leading the way here in the US with the Armed Services Blood Program on fresh whole blood transfusion research in conjunction with the THOR Network and […]
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.
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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?
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, […]
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 […]
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 […]
“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 […]
Despite our best efforts, endless training, and reading, some of our patients will die. This has been a taboo subject that is difficult to broach in the best of times. […]
Being able to calm and sedate patient in operational or prolonged field care situations may be a valuable skill. Here are our thoughts on sedating your patients when patient comfort […]
Pre-deployment checklists, cheat sheets and other resources now updated! Everything I am posting below could help anyone who finds themselves in over their heads
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 […]
Effectively taking away pain can be one of the most important things you can do as a medic. It will enable you to
This podcast is a follow up from our last post on managing crush injuries in austere environments. We included a scenario discussion with
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 […]
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 […]
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 […]
As 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 […]
Here’s a podcast we recorded last year. There are some key points in this that we cover in overview lectures, and continue to teach medics individually, about what we refer […]
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 […]
Podcast Episode 5: Part 2 of the Pharm Series… The MSMAID Acronym From Anesthesia Adapted to Prolonged Field Care
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
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 […]
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; […]
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 […]
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 […]
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 […]