Category Archives: Recommendations

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!

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Podcast Episode 7: Part 3 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

Tactical Damage Control Resuscitation

A medic from the 75th Ranger Regiment conducts combat trauma management training April 15 at Fort Benning. Picture via: http://www.army.mil/article/149250/
75th Ranger Regiment medic – combat trauma management training

This article is a nice review of where we are (U.S. – and Norwegian – SOF) now in implementing a FWB program. It also gives good background and a simple algorithm of when to pull the trigger to initiate FWB transfusions.
In PFC, we may not have the luxury of confirmed typing and anti-A, anti-B titering, but rapid screening and typing at the point of care, as per the TMEPs protocol, should be adequate for “contingency” use of FWB.

                                                          Sean

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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

Position Paper – 10 Essential Core Capabilities for Prolonged Field Care

This post has been a long time coming.  This is where it began and may be the most important tool we have to offer.  This is the 10 Capabilities Position Paper revisited with the grid made easily available.  If you have read the position paper you know that everything we recommend is in the “Minimum, Better and Best” format. Continue reading Position Paper – 10 Essential Core Capabilities for Prolonged Field Care

Joint Trauma Service Clinical Practice Guidelines: The Standard of Deployed Medicine

The Joint Trauma System (JTTS)Clinical Practice Guidelines(CPGs) are the standard of care for all US Military

Medcal Providers.  They are backed by evidence and represent the current expectations of care.  Continue reading Joint Trauma Service Clinical Practice Guidelines: The Standard of Deployed Medicine

Eye Emergencies in Prolonged Field Care

Open Globe Injury

Download the 2016 JTS Ocular Injury Management in PFC Clinical Practice Guideline


Eye emergencies are one of the big 3 concerns; life, limb or eye sight. This will be the first of many installments on PFC specific eye recommendations, Open Globe Injuries. It is presented in a Power Point presentation for easy down load and printing for future reference. This was submitted out of the blue while we were at SOMSA 2014 by a PFCWG partner and a welcomed addition to our reference material.

Download Open Globe Injury Management Graphic

Continue reading Eye Emergencies in Prolonged Field Care