Prolonged Field Care Podcast

Summary: In this conversation, Dennis and Ian discuss the new high altitude Clinical Practice Guideline (CPG) in the Joint Trauma System. They cover topics such as acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). They discuss the pathophysiology, symptoms, diagnosis, and treatment options for these conditions. They also touch on pre-trea...

In this podcast episode, Jay Baker discusses the topic of SOF surgical support in Special Operations Forces (SOF). He compares the different types of missions that soft surgical teams might be called upon to support and describes the gap that exists in institutional experience for surgical support in the setting of unconventional warfare. Baker highlights the lessons learned from surgical support...

Maggot therapy, also known as maggot debridement therapy (MDT), is a treatment that uses live maggots to clean and heal wounds. The therapy has a long history, dating back thousands of years, and has been used in various settings, including war zones and modern hospitals. Maggots are effective in wound healing because they eat necrotic tissue, have antimicrobial properties, and promote the growth...

In this podcast episode, Doug discusses the use of End-tidal CO2 monitoring in medical practice. End-tidal CO2 is used to monitor the percent of carbon dioxide in blood that has been returned to the lungs. It is commonly used to confirm the placement of an endotracheal tube and to monitor ventilation during surgery. In the field, End-tidal CO2 monitoring is particularly useful for trauma patients...

In this episode, Dennis interviews John and Paul about the Abdominal Aortic and Junctional Tourniquet (AAJT). They discuss the background and reasons for inventing the AAJT, including the need to control bleeding in the pelvis. They also talk about the first application of the AAJT and the positive results seen in combat situations. The conversation then moves on to study data and research on the...

In this podcast episode, Dennis and Ian discuss heat injuries and illnesses. They cover the background science of body heat and heat transfer, as well as the different types of heat injuries, including heat cramps, heat syncope, heat exhaustion, and heat stroke. They emphasize the importance of hydration and urine color as indicators of hydration status. The treatment for heat stroke involves cool...

In this episode, Dennis and Alex discuss the truth about pelvic binders and their relevance in trauma care. They explore the background and experience of Alex, who has extensive knowledge in trauma surgery. They delve into the anatomy and injury patterns of pelvic fractures, as well as the different phases of damage control surgery. They also discuss the importance of understanding research and th...

In this podcast episode, Dennis and Ricky discuss how to pick and evaluate research papers to inform medical practice. They differentiate between causative research papers and retrospective observational studies, emphasizing the importance of reading the methods section to determine the validity of the research. They also highlight the common mistakes people make when reading research papers, such...

This conversation explores the topic of gas anesthesia, its historical background, and its use in various environments. The conversation covers the shift to the TIVA technique, the importance of the anesthesia machine and equipment, and the training required to administer gas anesthesia. It also discusses the combined techniques used in the operating room and the stages of anesthesia. The conversa...

This episode of the PFC podcast focuses on in-route casualty care. The guest, Nikki, shares her background and experience in the Navy and explains why she started an in-route care training course. The conversation covers common mistakes in preparing patients for flight, securing lines and equipment, and the importance of constant assessment and monitoring. Nikki also discusses the training scenari...

In this conversation, Dennis and John discuss chest trauma management, specifically the use of chest seals and the sequence of interventions. They explore the overuse of chest seals and the potential complications they can cause. They also discuss the importance of assessing the patient and determining if a chest seal is necessary. John shares his insights on the use of finger thoracostomy and the...

In this conversation, Dennis and John discuss chest trauma management, specifically the use of chest seals and the sequence of interventions. They explore the overuse of chest seals and the potential complications they can cause. They also discuss the importance of assessing the patient and determining if a chest seal is necessary. John shares his insights on the use of finger thoracostomy and the...

In this podcast episode, Dennis interviews Monte from Delta Development about the need for a small blood refrigerator for prolonged field care. Monte shares his military background and experiences in Afghanistan and Iraq, where he realized the importance of carrying blood products in the field. They discuss the challenges of storing and transporting blood, including temperature control and cumulat...

In this conversation, Dennis and Mike discuss the process of providing medical care and education in austere environments. They emphasize the importance of understanding the requirements and asking the right questions to ensure success. They also discuss the significance of analyzing the environment, finding reliable sources of information, and building relationships with partners and friends. Pla...

In this conversation, Dennis and Justin discuss lessons learned in analgesia and sedation. They emphasize the importance of understanding medications and dosages, as well as having a plan for drug administration. They share case studies and examples of the wrong drug being used in the wrong situation. They also highlight the need for a strong foundation in medication knowledge and the importance o...

In this conversation, Aaron Epstein from GSMSG discusses the background and formation of GSMSG, their focus on training partners rather than providing services, and their work with military and security forces around the world. He shares lessons learned in surgical resuscitation, dealing with mass casualties, and planning for different phases of war. Aaron emphasizes the importance of tourniquet u...

In this podcast episode, Dennis talks with Doug (an ICU doctor) about acute kidney injury. They discuss the causes and types of acute kidney injury, how to recognize it, and the treatment options available. They also cover the recovery and prognosis of acute kidney injury, as well as the crush injury protocol and managing potassium levels. The episode provides valuable insights for healthcare prac...

In this podcast episode, Dennis talks with Mark, a trauma surgeon, about lower extremity trauma and limb salvage. They discuss the decision-making process for determining if a limb is salvageable or not, the risk vs reward of tourniquet approximation, assessing motor function and arterial supply, the importance of preserving limb length, and the use of traction in pelvic fractures. They also touch...

In this podcast episode, Dennis and Antonio discuss the challenges and friction points that arise when working with providers from different countries. They explore how to iron out these issues efficiently to provide good care. The conversation covers topics such as common friction points on the ground, resolving conflicts and revamping protocols, establishing leadership, and learning from local p...

In this podcast episode, Dennis and Doug discuss the importance of team dynamics in critical care, specifically when dealing with critically injured patients. They highlight the challenges that arise when team members work individually and fail to communicate effectively. The conversation explores the team dynamics at Baltimore Shock Trauma, where roles and positions are protocolized to ensure eff...

In this podcast episode, Dennis interviews JR Pickett, an ER physician and EMS medical director, about excited delirium. They discuss the definition and history of excited delirium, the challenges faced by law enforcement and medical providers in managing these cases, and the importance of timely intervention. They also explore the differences between excited delirium and other conditions, such as...

Dr. Mark Shapiro discusses resilience and teamwork in the medical field during the COVID-19 pandemic. He highlights the differences between the civilian medical system and the military's approach to stress and resilience training. Dr. Shapiro emphasizes the importance of identifying and teaching resilience in medical professionals, as well as integrating stress inoculation into medical educati...

Today I chat with the Godfathers of PFC and discuss the concept of Prolonged Field Care (PFC) and its importance in military and civilian medical settings. It highlights the need for PFC in situations where evacuation is delayed or not possible, and the challenges faced by medics in providing care in such scenarios. The conversation also explores the civilian analog of PFC and the importance of ri...

Dr. Ryan Maves discusses clinical medicine topics, specifically malaria and other tropical diseases. He emphasizes the importance of preventing infections when traveling in tropical and remote areas through vaccination, hand hygiene, malaria prophylaxis, insect repellents, and safer sex habits. He also provides resources for pre-deployment information. Dr. Maves shares a cautionary tale of a Marin...

In this podcast episode, Dennis and Jeff discuss anoxic brain injury, its causes, progression, and treatment. They emphasize the importance of preventing anoxic brain injury by following the March algorithm and maintaining blood flow, airway patency, and oxygenation. They also discuss the role of monitoring and airway management in identifying and treating anoxic brain injury. The podcast covers t...