The RAVINES Mnemonic was created to help the medical provider on the ground in an austere environment with a very sick patient. Most medics will do a decent TCCC SMARCH survey and when they get to the end of that, get vital signs to begin trending and repeat the MARCH sequence while adding E-PAWS-B…
E for Eyes
P for Pain
A for Antibiotics
W for Wounds
S for Splinting
B for Burns round out the MARCH-E-PAWS-B mnemonic.
The Battle of Bentonville was fought 154 years ago just a short distance from Fort Bragg, NC. Each year the North Carolina Historic Site Staff and reenactors commemorate the battle with different types of reenactments. This year the focus is on Civil War Medicine and the originally preserved Union XIV Corps Field Hospital at the Harper house. This Event was called, “A Fighting Chance For Life.” It is important for us to look deep into the past and hold close the lessons learned which now benefit all mankind. Continue reading Video Recap of a Civil War Field Hospital Reenactment and PFC Display at Bentonville Battlefield in NC→
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.
Powdered High Strength Calcium Hypochlorite (Ca(ClO)₂) is essential for a medic to keep in the team house or aid station in an austere environment. It can easily be bought, transported and reconstituted for many purposes…
Colonel Warner “Rocky” Farr has made an important contribution to the body of SOF knowledge with this well-researched monograph. He advances the understanding of the many challenges and accomplishments related to guerrilla warfare medicine—care provided by predominantly indigenous medical personnel under austere conditions with limited evacuation capability— by providing a survey of the historical record in UW literature. Colonel Farr relates many historical experiences in the field, assesses their effectiveness, and lays a foundation for further in-depth study of the subject. The Joint Special Operations University is pleased to offer this monograph as a means of providing those scholars and operators, as well as policymakers and military leaders, a greater understanding of the complex and complicated field of guerrilla warfare medicine.
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→
There were some truly interesting ideas, research and products showcased on the exhibition floor. If you missed the 2017 Special Operations Medicine Scientific Assembly this year in Charlotte or never made it all the way back to the poster boards, here are the posters from the 2017 assembly. Continue reading SOMSA ’17 Poster Presentations→
The following is a letter from Sean sent out on our big email list. If you’re not on the list don’t worry because it is posted here in it’s entirety. The letter highlights what we have done over the last year and, more importantly, what we have planned for the year to come, specifically a whole day of Prolonged Field Care specific training
Ultrasound: The most powerful diagnostic tool available to SOF Medics […]. It should be a top procedural skill goal for all SOF providers to become subject matter experts in point-of-care ultrasonography.
I’ve been thinking about this post for a while… searching for the right format. And then it finally hit me! Why on earth would I re-invent the wheel, if I can channel this message through the paths you are quite familiar with!? Especially after Doug Powell gifted me such a brilliant introduction in a previous post!
If you were one of the lucky guys packed into a small classroom yesterday, then I don’t have to tell you how great that talk was. Mike and his guys have been tackling the issues associated with prolonged field care for a few years now and had quite a bit to tell us including his butcher block presentation on
Need for “Nutrition” has been hotly debated and somewhat blindly held up as a critical need according to the mnemonic “HITMAN.” This should not be the case! Though important in some less injured patients, feeding a patient, especially one who requires feeding by NG tube, can be fraught Continue reading Podcast Episode 3: Nutrition in Prolonged Field Care→
Building prioritized care plans has completely changed and revolutionized the way I think about medicine and treating casualties. Before this my thoughts were rather chaotic, attempting to “put out fires,” handling emergencies as they occurred. This is an unorganized and stressful way to handle a crisis.
It’s been a while since we have posted anything but I feel the wait was worth it. Many of us have been deployed, traveling and busy spreading the word. Thanks to everyone who helped contribute and add advice to this lecture. I wanted to create this lecture to simply share some information I recently became aware of Continue reading PFC Video Series Ep 2: PFC Airway Management→
Due Outs are issues that we have identified without complete or perfect answers. This is our attempt to crowd source ideas and solutions from as many different perspectives as possible. If you are a medic, this is your opportunity to speak up and let your surgeons or director know what could work for you. If you are a provider and have had success with something, please let us know. Our medics are Continue reading Sustainment Training and Continuing Education→
The following was originally recorded on the white board at the warehouse during the SOMSA training scenario with input from the entire group. If anything was left out be sure to add it in the comments. As always, you can read it in full here or download it now and read/reference it later.
I usually start any PFC lecture I give with a common case such as this in order to drive home the realities of the operational context; a small team operating in the middle of nowhere dealing with a critically ill patient with little to no support.