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 answering Continue reading Podcast Episode 29: Dr. Cap on Fresh Whole Blood and Resuscitation for PFC
Stories and experiences can sometimes bring relevancy to a situation you are in or to a point you are trying to make while instructing. These singular stories are called anecdotes and while powerful and personal do not represent similar patient outcomes even in similar situations. They are not science. They do not take into account the vast number of variables that were present in that particular situation. Often these stories can mislead and misinform medical practice by inexperienced medics and practitioners due to that powerful personal experience clouding that person’s own judgment.
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. We will get more into this cycle in the future however, this should be a good place to start. Many thanks go out to Andrew who labored over many versions of the list over the past few months. One last thing, be sure that you are already at 100% T for Trained on your TCCC task list. There is no use in getting into PFC training prior to mastering TCCC. If you see something we may have overlooked and would like to see it on future versions, please comment below and let us know.
This Clinical Practice Guideline was written by a fellow 18D with input from around the surgical community. It reconciles the differences between wound care done in a role 2 or 3 facility, such as serial debridements, with what is taught in the 18D Special Forces Medical Sergeant Course with regards to delayed primary closure. One way is not “right” while the other wrong, it has more to do with Continue reading Podcast Episode 26: ICRC Style Wound Care and the NEW Acute Wound Care Management Clinical Practice Guideline
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?
While at the 2017 Remote Damage Control Resuscitation(RDCR) conference put on by the Tactical Hemostasis, Oxygenation and Resuscitation(THOR) network in Norway, Sean took the time to corner Dr. Shackleford to get her thoughts on the Joint Trauma System Clinical Practice Guidelines. Continue reading Podcast 23: Clinical Practice Guidelines for the SOF Medic
Are you familiar with the concept of oxygen debt or oxygen deficit? What constitutes a “dose” of shock? What systolic BP constitutes hypotension on the battlefield? Where did the concept of permissive hypotension come from? Is it still valid? How long can fresh whole blood last?
Blood Transfusions were a huge topic at this year’s meeting in Charlotte with no less than 3 major speakers giving multiple talks on the subject. This talk was recorded during the Prolonged Field Care Pre-Conference Lab during the Special Operations Medicine and Scientific Assembly (SOMSA). Dr. Geir Strandenes
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
TheJoint Trauma System joined up with us and several of our working group members to bring you this, our third CPG, for PFC.As with every PFC CPG, this is the time that goes beyond TCCC. With this specific CPG you are expected to provide appropriate analgesia and/or sedation
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, live anesthesiologist who was actually more than happy to sit down and talk about ventilation after his years of experience working at the heads of thousands of patients. This episode starts right off with a difficult scenario discussion that includes a hypovolemic patient with a GSW to the pelvis, RR 35
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 much needed answers to some frequently asked questions. Continue reading Podcast Episode 20: TBI Round Table and Case Discussion
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 sick for days. Doc Jabon Ellis walks us through the full spectrum from infection and SIRS to sepsis, shock and death.
“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 about two days into our training mission/jungle slog, when we happened upon a vehicle at the base of the mountain that had been pushed off the road by a
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. We aim to start a conversation here with the hope that
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 and safety are an issue? Continue reading Podcast Episode 16: Sedation
Members of Prolonged Field Care Working Group wrote this article in an attempt to educate our operational leadership on the challenges faced when dealing with medicine in austere environments. This is important because medicine normally takes a backseat to the operational mission. While this is true for good reason, commanders need to understand that the old axiom that, “an 18D can take care of a casualty for 72 hours,” is outright false in many situations. Continue reading Special Warfare Magazine Articles: “Loss of the Golden Hour” & “18D: The Lifeline.”
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 Continue reading Deployment Downloads
Tactical Trauma Casualty Care(TCCC) and Prolonged Field Care can be heavy on the medication administration, but during training we can’t really give our real role player patients or even our mannequins a bunch of narcotics and other controlled substances, so it’s often verbalized in training. Not training on the medication they carry downrange, far from providers, can lead to improper Continue reading How to make labels to practice Medication administration:
I wanted to take a moment to wish everyone a Happy, fruitful (safe) Year in 2017! This past year has proved to be a tremendous transition for the PFC SOF medicine community. It was the year where we took
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 he has read recently and it might blow your mind. It did mine and
This is the newest version (v22.2) of the single page Prolonged Field Care Card. It is in use in both the Special Forces Medical Sergeant (SFMS) Course as well as the Special Operations Combat Medic Course (SOCM) at the Joint Special Operations Medical Training Center (JSOMTC) at Fort Bragg. Print it out, laminate it and stick it in the back of your aid bag. It takes up almost no space and weight and it’ll be there for you when you run out of space on your TCCC card.
The Prolonged Field Care(PFC) Working Group has been working hand in hand with the Joint Trauma System (JTS) for almost a year in writing and editing new guidelines for medics and providers who may have to take care of casualties for longer than normal planning guidelines in resource constrained environments. This could be Continue reading JTS/PFC Clinical Practice Guideline on Crush Injury for Medics and Role 1 Providers
Our case discussions are provided to get you, the medic or provider, to think about treatment and logistical issues. The following case is a ‘simple’ scenario constructed to get you thinking about long term pain control
I like Eisenhower’s quote: “Plans are useless, Planning is everything.”
Everyone knows that during a crisis your plan may fall apart. This is why the process of planning and researching is so important. It gives you options that wouldn’t otherwise exist
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
If you can’t bring the patient back to the capability you must bring the capability to the patient.
Our working group has identified 10 of these capabilities that we feel to be critical in making a difference in the morbidity or even mortality of a patient. Continue reading MEDAUSA Symposium
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 problem to address in depth first, Continue reading Podcast Episode 12: Crush Syndrome From a Prolonged Field Care Perspective
The Special Operations Medical Association (SOMA) was founded in 1992. It now consists of hundreds of members in pre-hospital, tactical, wilderness, austere, disaster and deployed medicine. The primary goal of the association is to advance the art and science of special operations medical care through the education and professional development of special operations medical providers. This is where the Prolonged Field Care Working Group and our website come into play. Continue reading PFC Sponsored by SOMA
The following article was published in the Journal of Trauma and Acute Care Surgery. If you haven’t read it, it’s a great look into the amount of time and effort being put into the research and solving of problems having to do with Prolonged Field Care based on our 10 Capabilities model. This includes everything from improvement of enroute care to organ replacement and futuristic methods of targeted resupply. Check out table 2 in the article linked below to get a better idea of what I’m talking about.
Authors: Todd E. Rasmussen, MD, David G. Baer, PhD, Andrew P. Cap, MD, PhD, and Brian C. Lein, MD, Fort Detrick, Maryland
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 environments. Continue reading Podcast Episode 11: Beyond the Golden Hour: Austere Critical Care in Future Operating Environments
This post is for the both the PA charged with training medics in the Battalion Aid Station as well as the medic with the initiative to take their medical education Continue reading Prolonged Field Care Classes for 68Ws
Not all blood programs are created equal. For Fresh Whole Blood (FWB) transfusions in an operational environment, Continue reading THOR Fresh Whole Blood Triage and Screening Tool
This was my third time attending SOMSA and each time I seem to be more and more busy with my involvement in the working group, networking and just catching up with buddies I haven’t seen in a while. In the past I would try and naively
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 a wide variety of applications. Continue reading Podcast Episodes 9 &10: Scott Weingart SOMSA Podcasts on Ketamine for PFC
A U.S. service member sustains deep partial thickness burns to both arms and the chest while burning the trash…
This is an amazing opportunity for clinicians and researchers to make needed advances in the operational medicine provided far forward by our medics. Continue reading $47 Million For Prolonged Field Care
A U.S. service member sustains pelvic trauma secondary to a vehicle rollover in the middle of nowhere. The patient complains of severe pain and you initially opt to control his pain with
Congrats to our patch winners! In order of correct answer submission:
First of all congrats to our patch winners! In order of correct answer submission:
- Kevin Mitch
- WJ Bowman
After witnessing certain trends from participating in, and observing many training scenarios and AARs. These principals glare at me each time I watch a medic go through a PFC
First of all congrats to our very first patch winners! In order of correct answer submission:
- Dennis Jarema
- Dave Schneider
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 thanks to the JTS Team for their kind invitation!
The 500th weekly Joint Theater Trauma System Trauma Teleconference out of San Antonio featured our own SOLCUS Point of Injury Ultrasound curriculum. It was specifically geared to the level of enlisted SOF medics and up. This is a great way to earn CEUs CNEs or CMEs while hearing about recent cases and the latest and greatest in combat medicine.
A small team surrounded in a compound, active firefight, helicopter attempting MEDEVAC inside the walls but blades strike the building, TCCC, Prolonged Field Care, blood transfusions, 6 attempts at converting a tourniquet over 17 hours…
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
Here is an issue that has come up more than once over the past year. It sparked good discussion with some great points that we will attempt to repopulate in the comment section: Continue reading Foley in the Aidbag??? Open Mic Post
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 to as “phoning a friend.” Continue reading Podcast Episode 8: Phone a Friend – Telemedical Consult