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We are nearing the end of this session but look forward to the dissemination of some of our presentations, especially from this morning which SOMA paid to video tape. Thanks to everyone who attended and participated. It was a great showing again this year. Please let us know what you liked, what you didn't or what you may hope to see next time. Keep your eye on www.prolongedfieldcare.org for updates and additions.

Awesome post from @the_ww2_memoirs Battlefield plasma has made a promising comeback with the liklihood of freeze dried plasma in a plastic bag for transport and delivery instead of the 75 year old glass bottles we are still using when we can get them from France and Germany. This is a great option to temporize a hypovolemic patient while fresh whole blood is prepped or drawn for transfusion. Extremely important in limiting oxygen debt and other sequelae from hypoperfusion. #SOMSA18 #SOMA #Corpsmen #SOIDC

This $10.00 trainer was made with electrical shrink wrap tubing and a sponge from an auto parts store. Don't forget the pencil to use as a trochar. Add fluid and zip tie a drip set for a more realistic experience. Priorities of extremity wound care and reasons for surgical procedures in the field: 1. Stop bleeding 2. Relieve tension 3. Remove contaminants and devitalized tissue One of the most important lessons I was able to take away from my time as an instructor was the need for proper vessel ligation during wound care procedures. Do it right and your patient will be on their way to recovery. Do it wrong and you can bet that you'll get a call around midnight with a bleeding patient who now needs another procedure to fix your mistake. 1. What are a couple scenarios in which the ligation of a vessel would be indicated? 2. What techniques would you use for these vessel presentations? 3. What pitfalls should you try and avoid when ligating exposed or retracted vessels? 4. When should you not tie off a vessel? Big thanks to www.lacerationrepair.com for this one! #bloodbath #cheaptrick #prolongedfieldcare #SFMS #SOIDC #austeremedicine #remotemedic #SOMSA18 #SOMA #JTS #CoSCCC #USAISR #medicaltraining #surgicalskills

More on Austere wound care: Dry heat presents another opportunity for high level disinfection for metal instruments. Check the last pic for an excerpt from the Wound are CPG which details temps and times. Use an oven thermometer if you are going to use any heat source or grill you aren't sure about.  180°C (356°F) for 30 minutes  170°C (338°F) for 1 hour  160°C (320°F) for 2 hours  149°C (300°F) for 2.5 hours  141°C (286°F) for 3 hours https://prolongedfieldcare.org/pfc-pre-hospital-clinical-practice-guidelines/ #grillinandchillin #improvisedmedicine #SFMS #SOIDC #JSOM #SOMSA18 #JTS #cosccc #ICRC #prolongedfieldcare #SOMA #nextgencombatmedic #remotemedic #austeresurgery #woundcare

Me: Do you have any other seat besides my middle seat? American Airlines: I got you bro... #sfms #notcognito #merrell #511tactical #oakley #mollebackpack #oafnation #CoERCCC #JTS

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… Instrument Disinfection: Autoclaving instruments with high pressure steam is the industry standard for sterilization. This is why the SF Medical TACSET includes the infamous portable pressure sterilizer more commonly known to the rest of the team as the lobster pot. If you find yourself in a situation without the lobster pot there are some other techniques for high level disinfection which will get your surgical instruments cleaner than just wiping them on your pants. These techniques include using dry heat, boiling, microwave, UV exposure and chemical dips. To use Calcium Hypochlorite for “sterilization” of surgical instruments be sure to grossly decontaminate with a wire or stiff bristle brush first. Then mix 75g of 70% strength Ca(ClO)₂ into a liter bottle to make a household 5.25% strength bleach solution. Contact time is 5-10mins. Once you have scrubbed in and made yourself as sterile as possible, remove the instruments drom the bleach bath and irrigate with sterile irrigation fluid before use. This solution contains approx 52,500ppm Hypochlorite. One of the weaker solutions described below can also be used as long as contact time is increased. Soaking any longer than recommended will damage the instruments as it is a powerful oxidizer. Do not store in a metal container or in a container with a metal cap. Water Purification: 5 drops of this 5.25% solution can be used to purify a liter of suspect water in order to remove bacteria and viruses to make safe for drinking. This will not kill Giardia or Cryptosporidium cysts. Those must be filtered or purified in another manner. This also will not remove other pollutants such as chemicals or heavy metals. Surface disinfectant: To make a strong disinfecting solution for surfaces exposed to bodily fluids such as patient litters and other non-sterile equipment, mix 100mLs of the 5.25% solution with 900mL of clean water... Read the rest at www.prolongedfieldcare.org

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