The principles of High Reliability Organizations are necessary in those professions where mistakes can cost lives. The airline industry is the classic example and referenced many times in the articles below. Others included are those that could result in massive loss of life such as power plants, refineries, and many industrial chemical plants. Ideally, health … Continue reading Podcast Episode 55: JJ and Dennis on HROs. Part 1
Podcast Episode 54: SOP for the Ideal SF Clinic?
While no single clinic setup will work for every situation, a common baseline and checklist can make it far easier in customizing a clinic in similar circumstances. This is not professed to be THE way but it is A way in which ONE experienced team has created, tested, revised and rehearsed a clinic with different … Continue reading Podcast Episode 54: SOP for the Ideal SF Clinic?
Podcast Episode 53: Ventilating in the Prone?!
What happens when your patient has been given a cric or intubated but continues to decline... SpO2 continues to slowly drop despite taking control of the airway. You have placed your patient on a ventilator and slowly adjusted the PEEP up to 20cmH20... which quickly leads to hypotension. Do you go lower? Higher? Change volume … Continue reading Podcast Episode 53: Ventilating in the Prone?!
Podcast Episode 52: Walking the Fence of Evidence, Environment and Experience with a word on Proning
After a few discussions with JJ who has also appeared in several Element Rescue podcasts, Doug and Dennis talk about using evidence based medicine whenever possible and what to do when no prospective randomized controlled trials exist for a specific problem you face. What do you do when no evidence exists for a specific problem … Continue reading Podcast Episode 52: Walking the Fence of Evidence, Environment and Experience with a word on Proning
Podcast Episode 51: Tropical Medicine Considerations with CAPT Ryan Maves
Not all PFC is trauma. Malaria, Dengue, Chikungunya and others will take you out of the fight if given the chance. In this episode CAPT Ryan Maves talks about some of the more concerning and prevalent diseases encountered by deployed military personnel and partner forces and what you can do about it before an infection becomes debilitating or life threatening.
Protected: All things Airway, Ventilation, Oxygenation and COVID19
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Podcast Episode 50: Simple Sepsis Recognition and Intervention for Prolonged Field Care
Why do we care about sepsis in prolonged field care? What can we do about septic shock with what we are normally carrying on a deployment? How do you mix an epinephrine drip? Dr. Maves lays it all out in about 20 minutes.
Podcast Episode 49: Set Up a Walking Blood Bank with Andy Fisher
When you can’t take Cold Stored whole blood with you and not all of your soldiers are titered, a walking blood bank can mean the difference between life and death for a patient in hemorrhagic shock. With the mounting evidence suggesting early blood is essential and not just a good idea, you need to have a plan in order to hit the 30 minute target. I have seen students struggle for hours trying to get access in both the patient and the donor. An emphasis on early recognition and early access will save lives.
Podcast Episode 48: Maximizing Hospital Rotations and Medical Proficiency Training
Hospital rotations for medical proficiency training give medics who operate in the field the opportunity to see what "right" looks like. Knowing this and understanding treatment principles can allow a flexible medic to adapt to unique situations in the absence of protocols, guidelines and evidence. If properly coordinated and supported, MPTs can be an invaluable and eye opening experience. When thrown together with a naive or indifferent staff or un motivated medic, it can be a huge waste of time and money for everyone involved. In this episode Dennis and Dr. Mark Shapiro talk about several MPT programs, and strategies to maximize the effectiveness of an MPT.
Podcast Episode 47: Andy Fisher and his Damage Control Resuscitation for Prolonged Field Care CPG
So what is different than what we already have in the THOR recommendations, the JTS DCR clinical Practice Guideline and the Ranger Regiment TDCR? No hextend?! Calcium with the 1st unit of blood?! TXA slow push?! What if the patient is not responding to resuscitation efforts? This is a guideline truly written for the Medic … Continue reading Podcast Episode 47: Andy Fisher and his Damage Control Resuscitation for Prolonged Field Care CPG