Podcast 180: Deep Dive into Crush with Doug
In this conversation, Dennis and Doug discuss crush syndrome and the challenges it presents in dynamic environments such as natural disasters or man-made incidents. They emphasize the importance of scene safety and the need to assess and stabilize any other traumatic injuries before addressing crush syndrome. They also discuss the use of tourniquets and the potential risks and benefits associated with their application. The conversation covers the management of crush syndrome, including fluid resuscitation, monitoring for cardiac complications, and the use of calcium and sodium bicarbonate. They highlight the need for a comprehensive approach to diagnosis and treatment, considering factors such as time of response and the presence of other injuries. In this conversation, Dennis and Doug discuss the management of crush syndrome in a resource-limited setting. They cover topics such as tourniquet use, fluid resuscitation, potassium management, and the use of sodium bicarbonate. They also touch on wound management and the importance of antibiotics. The conversation concludes with a discussion on the use of insulin and dextrose, as well as albuterol, in managing cardiac instability. Overall, the conversation provides a comprehensive overview of the management of crush syndrome in a challenging environment.
Podcast 178: Calcium and Trauma with Steve Shauer
In this podcast episode, Dennis interviews Steve Schauer about his calcium study in trauma patients. Steve provides an introduction to himself and his background in emergency medicine and research. He explains that the study aims to determine the prevalence of calcium derangement in trauma patients upon arrival at the trauma center. The study is being conducted at three different trauma centers and has completed enrollment. Steve also discusses the challenges of extrapolating research findings from military trauma to civilian trauma. They also touch on the limitations of the Injury Severity Score (ISS) in assessing military trauma. The conversation then delves into the logistics of the study, including the collection of calcium levels and the potential impact of pre-hospital blood transfusions on calcium levels. They discuss the importance of timing and accuracy in collecting calcium levels and the need for better documentation in trauma care. They also explore the administration of calcium and the differences between calcium gluconate and calcium chloride.
Podcast 177: Guerrilla Surgeon with Alex
In this podcast episode, Dennis interviews Alex McDonald, a medical student and member of Tactical Medicine New Zealand, about the republishing of the book ‘Guerilla Surgeon.’ The book tells the story of Dr. Lindsay Rogers, a New Zealand-born surgeon who served with the Special Operations Executive in Yugoslavia during World War II. The conversation covers topics such as the challenges of providing medical care in resource-limited environments, building trust with local forces, and the importance of cultural competency. Alex also discusses the mission of Tactical Medicine New Zealand and their partnership with the Special Operations Medical Association (SOMA) to republish the book.
AEC is PFC!
The Austere Emergency Care Course is a prolonged field care course based on 10 years of knowledge gained from our original Prolonged Field Care Working Group and Ragged Edge Solutions’ experience and background in training military special operations to operate around the world without traditional medical Support. Over time, and after many inquiries by civilian/non-military clinicians it was realized that the need and demand signal is robust outside of the military. Just like PFC was developed as an adjunct for military medics once they reached the end of Tactical Combat Casualty Care (TCCC,) AEC was created with the civilian provider in mind once they reached the end of Tactical Emergency Casualty Care algorithms. From this Specialized Medical Standards and the Austere Emergency Care Course was born. Read more…
Podcast 175: Maggot Therapy
Maggot therapy, also known as maggot debridement therapy (MDT), is a treatment that uses live maggots to clean and heal wounds. The therapy has a long history, dating back thousands of years, and has been used in various settings, including war zones and modern hospitals. Maggots are effective in wound healing because they eat necrotic tissue, have antimicrobial properties, and promote the growth of new tissue. The therapy is cost-effective and can be used in low-resource settings. It can be applied directly to the wound or placed in a mesh bag. Maggot therapy is often used as an adjunct to antibiotics and other wound treatments.
Podcast 174: The Abdominal Aortic Junctional Tourniquet with the Inventors, John and Paul
In this episode, Dennis interviews John and Paul about the Abdominal Aortic and Junctional Tourniquet (AAJT). They discuss the background and reasons for inventing the AAJT, including the need to control bleeding in the pelvis. They also talk about the first application of the AAJT and the positive results seen in combat situations. The conversation then moves on to study data and research on the device, including some negative studies that have been conducted. They also discuss the pressure levels used with the AAJT and the potential for extending the application time. Finally, they address the negative consequences of high pressure and the comfort level of wearing the device. The conversation explores the application and function of the Abdominal Aortic Junctional Tourniquet (AAJT) and its potential use in pre-hospital care. It discusses the challenges of prolonged application and the risks associated with it. The conversation also delves into alternative techniques and future developments in the field. The importance of reperfusion and monitoring is highlighted, along with the impact of the AAJT on breathing and inspiratory pressure. The discussion touches on the considerations for reducing pressure during reperfusion and the duration of application. The risk-benefit analysis of heroic interventions is examined, emphasizing the need for rapid hemorrhage control. The limitations and risks of Roboa are discussed, and a cadaveric study on the AHAT is presented. The conversation concludes with the role of the AHAT in preparing for future wars and its potential use in traumatic cardiac arrest.