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  • TCCC
  • Guidelines
    • 1. Crush Injury in PFC
    • 2. Burn Care in Austere Environments
    • 3. Analgesia and Sedation
    • 5. Traumatic Brain Injury Management in PFC
    • 4. Wound Management
  • Training
    • PFC Teaching and Training Recommendations
    • Upgrade Your Operational Medical Program with Prolonged Field Care
    • PFC Core Principles
    • One Way to Run a PFC Scenario (Ft. Carson)
    • 9 Patient Scenario Discussions
    • SOMA 2014 PFC Scenario
    • Pharm Principles for SOF Medics
    • Improve your Operational Medicine with PFC
    • Suture Class
  • Position Papers
    • Removing Tourniquets
    • Operational Context
    • Capabilities
    • Fluid Recommendations
    • Analgesia and Sedation
    • Airway Recommendations
  • Podcast
    • Subscribe on iTunes
    • Episode 41: The Death of the Golden Hour: SOMSA 2018 Talk, by COL (Ret.) Rocky Farr, MD
    • Podcast Episode 40: Medic Team Dynamics with Dennis and Doug
    • Episode 39: End Tidal CO2 Application and Limitations in Prolonged Field Care
    • Podcast Episode 38: Far Forward Surgical Support and Resources
    • Episode 37: PFC from the NGO Perspective With Alex Potter of GRM
    • Podcast Episode 36: ROLO to SOLO: The Logistics of Fresh Whole Blood Transfusion
    • Podcast Episode 35: Priorities of Burn Care With Dr. Cairns of The UNC Chapel Hill Jaycee Burn Center and the AMIT Program
    • Podcast (video) Episode 34: Telemedicine to Reduce Medical Risk in Austere environments
    • Podcast Episode 33: TIVA: Another Look at Pre-Hospital Analgesia and Sedation
    • Podcast Episode 31: CBRN for Dummies By COL Missy Givens
    • Podcast 32: Doug Explains the JTS Burn Care Clinical Practice Guideline For Medics
    • Podcast Episode 30: REBOA?! with Joe DuBose
    • Podcast Episode 29: Dr. Cap on Fresh Whole Blood and Resuscitation for PFC
    • Episode 27: Winning in a Complex World
    • Podcast Episode 28: Critical Skills for Prolonged Field Care Providers
    • Podcast Episode 26: ICRC Style Wound Care and the NEW Acute Wound Care Management Clinical Practice Guideline
    • Podcast Episode 25: Lethal Triad Trauma Class Video
    • Podcast 24: Sepsis Roundtable Discussion
    • Podcast 23: Clinical Practice Guidelines for the SOF Medic
    • Podcast 22: On Blood, Geir Strandenes at SOMSA 2017
    • Podcast Episode 21: Optimizing Traumatic Ventilation
    • Podcast Episode 20: TBI Round Table and Case Discussion
    • Podcast Episode 19: Sepsis
    • Podcast Episode 18: Traumatic Brain Injury
    • Podcast Episode 17: Expectant Patients and Palliative Care
    • Podcast Episode 16: Sedation
    • Podcast Episode 15: Analgesia Case Discussion and a Word on PTSD
    • Podcast Episode 14: Ketamine and Pharmacology SOMSA 2016 Pre Conference Lab Talk
    • Podcast Episode 13: Crush Injury Round Table Discussion
    • Podcast Episode 12: Crush Syndrome From a Prolonged Field Care Perspective
    • Podcast Episode 11: Beyond the Golden Hour: Austere Critical Care in Future Operating Environments
    • Podcast Episode 10: Part 2 Scott Weingart on Ketamine for PFC
    • Podcast Episode 9: Part 1 Scott Weingart Podcast on Ketamine for PFC
    • Podcast Episode 8: Phone a Friend – Telemedical Consult
    • Podcast Episode 7: Part 3 of the Pharm Series… Ketamine and PFC
    • Podcast Episode 6: Part 3 of the Pharm Series… Opiate Analgesic Pain Control
    • Podcast Episode 5: Part 2 of the Pharm Series… The MSMAID Acronym From Anesthesia Adapted to Prolonged Field Care
    • Podcast Episode 4: Part 1 of the Pharm Series… 12 Principles of Pharmacology
    • Podcast Episode 3: Nutrition in Prolonged Field Care
    • Podcast Episode 2: UOP-The Best Field Monitor for PFC… and a Word on Hypotensive Resuscitation
    • Podcast Episode 1: What’s this PFC stuff anyway and why should I care?
  • PFC 101
    • Operational Context Article
    • 10 Core Capabilities Article
    • The PFC Truths
    • Principles for Practicing Effective Prolonged Field Care
    • Create a Prioritized Care Plan
    • PFC Planning
    • Fluid Therapy Recommendations Article
    • Tourniquet Conversion Recommendation Article
    • RAVINES Mnemonic: A Practical Approach to Care after SMARCH-E-PAWS-B
    • 10 Ultrasound-Guided PFC Essentials
  • 10 Capabilities
    • Monitor and Document
    • Airway
    • Ventilate and Oxygenate
    • Analgesia and Sedation
    • Nursing Care
    • Telemedicine
    • Surgical Procedures
    • 10 Ultrasound-Guided PFC Essentials

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Modern SF PFC Medical Exhibition to Contrast a Civil War Field Hospital Reenactment at Bentonville Battlefield in NC 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 was 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. This is the perfect opportunity in which to display the advents of modern combat medicine in order to compare and contrast the care received by those who sacrificed so much on our own home soil under such terrible circumstances. more info at www.prolongedfieldcare.org PODCAST EPISODE 44: PREP FOR FLIGHT AND EN ROUTE CARE: THE 10TH CORE PFC CAPABILITY with @fly_girl_rn available at ProlongedFieldCare.org or your favorite podcast provider. Prep for flight is the 10th Core PFC Capability. Our working group had always deferred to subject matter experts whenever available. This case is no different. Former SAR Corpsman and RN, @fly_girl_rn has been has put an entire career’s worth of effort toward training Corpsmen and Medics all over the world. She is a wealth of knowledge who has recently been working on the Clinical Practice Guidelines from the Committee on En Route Combat Casualty Care. As she transitions out of the military her new job will find her doing more work with the Joint Trauma Service in Performance Improvement. Many CPGs have specific metrics in the back which can be tracked and measured. This allows us to identify what recommendations are being followed and if not, get to the root cause to improve compliance. Planning for flight can include being aware of your intended flight path and time required to fly. Ensuring you have enough drugs, fluids and supplies is crucial. Reversals for any drugs the patient is currently being administered have also proven invaluable. The preflight assessment can alert you to any potential issues which you may be able to address while still on the ground. This is your time to gather any critical information such as drugs administered, trends in vitals and any thing else not readily obvious. Once you have the information you an then ensure that the patient is properly packaged so as to not lose any lines or circuits which may be dangling out. Can you access injuries and iterventions while keeping the patient warm? Are there any other issues such as TBI which may make you consider a different patient position? We had a great time recording an enlightening conversation with @fly_girl_rn in our parachute ward-turned-studio. She was able to share a career's worth of tips and lessons learned for adapting enroute and critical care nursing concepts for the10th PFC Capability, Prep for Flight. Can't wait to get this episode out... It has been our experience that high quality prolonged field care training takes time, resources and expertise by dedicated trainers well versed and experienced in critical care concepts. That being said we also believe that there are fundamental principles which can help a medic or less experienced Role 1 provider who has already mastered tactical combat casualty care. Through this project we will attempt to use your experience, and opinion in creating a standardized training curriculum which can then be adapted to specific operational needs. This will be done through another Google Doc, open for editing by anyone willing to take a look and add some insight by adding learning objectives, tips, or even comments under certain subjects. Dont worry about screwing it up or accidentally deleting anything. That is the beauty of Google Docs, I can recover any version at any time. If you disagree with something being in the curriculum, you can leave a comment and make your case. If you believe the format is flawed or should be overhauled, write it in and articulate your grievance. I have sat around many team rooms and fires where medics have much to say about certain topics. Strong opinion without action changes nothing. Taking a little time to document issues and solutions by improving, creating or eliminating systems and programs will have a far greater lasting effect which a strong opinion or force of personality rarely will. www.prolongedfieldcare.org This is another project I started working on long ago but have never had the bandwidth to create more than a skeleton outline. I need your help with the important parts of filling in the meat, revising and editing. I have been involved in training medics all over the world but every time I come back I do so with a new appreciation for the unique circumstances in which a medic or corpsman will be providing medical care. I also come away from each experience having learned as much or more than I feel I was able to impart onto the students and also the passionate trainers who spend countless hours creating and revising lesson plans, presentations and exercises. NATO SOCM Photo By Jason Johnston Training Support Activity Whole blood for hemorrhagic shock. What are you doing to make this happen for your patients? You have more influence than you think. Don't be part of the problem. Whole blood is even more important if you expect your patient to make it to and through prolonged field care situations. "Normal" Saline causes acidosis and dilutional coagulopathy. Synthetic Hydroxy ethyl starches have an FDA black box warning... "Do not use HES solutions in critically ill adult patients including those with sepsis and those admitted to the ICU. - Discontinue use of HES at the first sign of renal injury. - Discontinue the use of HES at the first sign of coagulopathy. Check out our newest Remote Ramage Control Resuscitation clinical practice guidelines and podcasts at prolongedfieldcare.org and if you need more, go check out nextgencombatmedic.com for their fresh whole blood toolkit and the THOR Group's RDCR.org for more. All of us are smarter than one of us. This project is an opportunity to collaborate and will attempt to use the wider working group audience to identify a standard list of drugs every Independant Duty Medic or Corpsman should have with him on every austere deployment. If put into practice properly across the force and coordinated with MEDLOGs, this will be one less chore for a medic and another place where we can help reduce mistakes and oversight. [ 619 more words ] http://prolongedfieldcare.org/2019/01/03/crowdsourcing-a-standard-pfc-deployment-med-box/

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