Prolonged Field Care Podcast

In this episode, Dennis discusses the role of sodium bicarbonate in medical protocols, particularly in the context of rhabdomyolysis and hyperkalemia. He emphasizes the importance of fluid management and the potential over-hyping of bicarbonate as a treatment. The conversation explores the risks associated with rhabdomyolysis, the mechanisms of potassium management, and the clinical considerations...

In this episode of the PFC podcast, Dennis and Kevin delve into the critical aspects of patient care, particularly focusing on hypothermia management. They explore the mechanisms of heat loss in patients, strategies to prevent it, and the challenges faced in austere environments. The conversation emphasizes the importance of maintaining patient warmth during trauma care and the implications of blo...

In this conversation, Dennis and Aubrick discuss the critical importance of improvised medicine in austere environments, particularly focusing on the MARCH algorithm for trauma care. They delve into various techniques for managing massive hemorrhage, including improvised tourniquets and pelvic binders, as well as airway management strategies. The discussion emphasizes the need for practical skills...

In this episode of the PFC Podcast, Dennis interviews Mark Little, a recently retired Navy medic with extensive maritime experience. They discuss the unique challenges faced in maritime operations, including planning for casualties, the importance of waterproof gear, and the need for thorough preparation. Mark emphasizes the significance of mastering basic skills and being an asset to the team, wh...

In this episode of the PFC Podcast, Dennis and Burjor Langdana delve into the intricacies of maxillofacial surgery, particularly in austere environments. They discuss critical aspects of managing facial trauma, including hemorrhage control, airway management, and techniques for treating various injuries. The conversation highlights the importance of understanding the anatomy and physiology of faci...

In this episode, Dennis interviews Justin, a second-year medical student and co-founder of Special Operations Forces to School of Medicine (SOFTSOM), a nonprofit organization that helps Special Operations Forces service members and veterans in their journey to become physicians. Justin explains that SOFTSOM provides mentorship, guidance, and support to individuals from the SOF community who are in...

Dr. Burjor Langdana discusses dental care in austere environments and provides tips for handling dental emergencies. He emphasizes the importance of preventive care, such as dental check-ups and good oral hygiene, before embarking on a trip. He advises carrying a dental kit with essential materials like temporary filling material and an intra-oral bandage. Dr. Langdana also shares strategies for m...

In this conversation, Dennis and Mark discuss the importance of understanding wound ballistics in trauma surgery. Mark shares his experience working with special operations teams and developing medical proficiency training. They delve into the impact of high-energy rifle wounds and the fragmentation of bullets inside the body. They also discuss the role of entrance and exit wounds, the risks of pa...

The conversation explores the topic of unconventional medical networks and how to establish them. The guest, Regan Lyon, discusses his thesis on this subject and the challenges involved. They discuss the historical context of guerrilla hospitals and the need for medical care in unconventional warfare scenarios. They also touch on the limitations and constraints of current medical doctrine and the...

In this conversation, Kevin and Dennis discuss nursing care in a prolonged field care (PFC) setting. Kevin, an experienced nurse anesthetist, provides insights into when PFC nursing care begins and the importance of gathering data and assessing patients. He emphasizes the role of nurses in providing interventions such as pulmonary toileting, turning patients, skincare, dressing changes, medication...

In this podcast episode, Dennis and Andy Fisher discuss the co-administration of ketamine and Versed. They explore the reasons behind the common practice of adding Versed to ketamine, the concept of emergence reactions, and the appropriate use of Versed. They also touch on the potential risks and side effects of both drugs and the importance of individualized dosing. The conversation emphasizes th...

In this podcast episode, Dennis and Pac discuss the use of ketamine in medical settings, particularly in austere environments. They cover topics such as the differences between S-ketamine and R-ketamine, the dosing and administration of ketamine for sedation and analgesia, and its use in hemodynamically unstable patients and refractory seizures. They also touch on the importance of proper training...

In this conversation, Dennis and Monti discuss the process of product development. They cover topics such as generating ideas, validating ideas with potential customers, protecting intellectual property, and deciding whether to build a business or collaborate with another company. Monti shares his experience with developing the APRU and Delta Ice products, highlighting the importance of customer f...

In this conversation, Rick, a senior medic for the 10th Special Forces Group, shares lessons learned from a mass casualty event in Eastern Afghanistan. He discusses the different types of mass casualty situations and the challenges faced in both reactive and proactive scenarios. Rick emphasizes the importance of realistic training scenarios and the need to think critically and adapt in high-stress...

In this podcast episode, Dennis, Rick, and Paul discuss the challenges of training in the field of prolonged field care (PFC) and advanced medical training. They address the common problems of miscommunication and unrealistic expectations when it comes to training requests. The conversation covers topics such as setting realistic goals, creating effective scenarios, and the importance of having fl...

In this podcast episode, Dennis and Ian discuss the process of disposition in emergency medical care. They explore how to transfer patients who cannot be evacuated to a higher level of care and instead need to be sent back to their families or local medical systems. The key steps in the disposition process include evaluating life threats, stabilizing the patient, determining if continuous medical...

Mikola, a combat medic from the Ukrainian Special Operations Task Forces, shares his experience and challenges in providing medical care in the war-torn region of Ukraine during SOMSA 24. He discusses the difficulties of operating in a large and constantly changing frontline, with different terrain and medical systems in each administrative region. Mikola explains the concept of medical evacuation...

In this podcast episode, Dr. DeMello discusses the management of burns in a pre-hospital setting. He emphasizes the importance of following the MARCH approach and not letting the burn distract from other life-threatening injuries. He also highlights the challenges of accurately calculating the total body surface area (TBSA) affected by the burn and recommends using the serial halving method. Dr. D...

In this episode, Dennis and Alex discuss the importance of reading research papers and critically analyzing their applicability to the operational environment. They review a paper on the role of red blood cells in thrombosis and post-transfusion hypercoagulability. The study found that red blood cell aggregation increased in the presence of tissue factor and calcium. While the study had limitation...

In this episode of the PFC Podcast, Colonel Stacey Shackelford discusses abdominal trauma and exsanguinating hemorrhage. He highlights the findings from studies on casualties who died before reaching a surgical hospital, with close to 90% of those deaths caused by bleeding. The majority of potentially survivable injuries resulting in death were from torso hemorrhage, particularly abdominal injurie...

The conversation revolves around the topic of ether and its use in surgery. Mike and Brad, both medical professionals, discuss the benefits and drawbacks of using ether as an anesthetic. They highlight its historical significance, safety profile, availability in developing countries, and field expediency. They also mention the flammability and pungent smell of ether, as well as its slower uptake a...

In this episode of the PFC Podcast, Dennis and Jamie discuss the importance of tourniquet conversion in the context of combat medicine. They explain the difference between tourniquet conversion and tourniquet replacement, emphasizing the need to control bleeding and save tissue. They discuss the timing of tourniquet conversion, highlighting the importance of resuscitation and patient stability. Th...

In this podcast episode, Dennis interviews Tom Avery, a surgeon who worked in Myanmar with the Free Burma Rangers. Tom shares his experience providing critical care in a war-torn area and the challenges he faced. He discusses the importance of stabilizing patients and bridging the gap between the frontline and higher echelons of care. Tom emphasizes the need for flexibility and creativity in an au...

In this podcast episode, Dennis and Brad discuss the use of fentanyl as an opioid analgesic. They explore the history and development of fentanyl, its pharmacological properties, and its advantages over other opioids. They also discuss the administration of fentanyl, including IV and lollipop forms, and the importance of titrating the dose to the patient's respiratory rate. The potential side...

In this part of the conversation, Dennis and Andy discuss common health issues and injuries that can occur in the jungle. They specifically focus on heat illnesses, musculoskeletal conditions, dermatological conditions, and tropical diseases. They provide tips on how to manage exertional heat illness, such as stopping activity, finding shade, and using water to cool down. They also discuss the imp...