Prolonged Field Care Podcast

In this podcast episode, Dennis discusses the history and evolution of medical support in guerrilla warfare. He explores the role of unconventional warfare in the Army and provides examples of guerrilla warfare campaigns. Dennis also delves into the importance of surgical teams and the challenges of providing medical care in prolonged field care scenarios. He highlights the shift from the golden h...

In this podcast episode, Dennis interviews Eric and Ted from Prytime Medical about the P-REBOA catheter. They discuss the training process in Ukraine, the differences between the P-REBOA and the original REBOA catheter, the benefits of the P-REBOA in terms of balloon times and blood product use, and the complications and monitoring for reperfusion injury. They also address the placement of the cat...

In this podcast episode, Dennis interviews Ian, an ER physician with experience in wilderness medicine, about spinal trauma. They discuss the initial approach to spinal trauma, the process of clinically clearing the spine, the neuro exam for spinal trauma, and the treatment of neurogenic shock. They also cover the goals of fluid resuscitation, the use of vasopressors, and the prevention of complic...

In this episode, Sean McKay discusses the challenges and considerations of subterranean mobility and rescue. He emphasizes the importance of understanding the geology and environmental pathology of underground environments, as well as the need for continuous training and innovation in equipment usage. McKay also highlights the significance of risk assessment and uncertainty management in rescue op...

In this podcast episode, Nate, a Special Forces Detachment Commander, discusses the importance of incorporating medical training into team operations. He shares his journey of realizing the limitations of his own medical knowledge and the need to improve his personal medical capabilities. Nate emphasizes the importance of creating formalized Standard Operating Procedures (SOPs) for team clinics an...

In this episode, Dennis and Brad discuss the use of fentanyl in medical settings. They provide an overview of the background and development of fentanyl, highlighting its reliability and predictability as an opioid. They explain the characteristics and benefits of fentanyl, including its rapid onset, peak effect, and short duration. The conversation also covers the side effects and considerations...

Dennis is interviewing Dr. John Quinn who's on the ground working Role 1 medical operations for an NGO somewhere in Ukraine. The lessons being learned by John and others during the early days of this conflict and the past 8 years can be used to help those on the ground now and into the future. This is an amazing opportunity to stay informed of current events and prepare ourselves by narrowing...

Today, I'm joined by Rick, a senior medic with 18 years of experience in AFSOC and the Green Berets. We dive into lessons learned from mass casualty events, focusing on reactive and proactive scenarios. Rick recounts a harrowing mission in Eastern Afghanistan, where planning mishaps led to a challenging situation. They had to adapt on the fly, dealing with casualties and limited resources. Ric...

Merry Christmas...Today, we're diving into the nitty-gritty of ketamine – that mind-bending stuff, you know? So, ketamine's like this receptor blocker, messing with your brain's signals. It's a mixed bag, really. In low doses, it kills pain like a champ. But crank it up, and bam! You're in a world of dissociation. Picture it: brain's top half talking gibberish with the bott...

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This Podcast was from June of this year. This is Dennis, and today I'm joined by Anri, a Ukrainian medic who will share some lessons learned from the battlefield. Anri talks about how wound patterns change in urban versus rural areas, with urban areas having more trauma from shrapnel and secondary trauma from debris. He mentions the challenges medics face in treating these complex wounds, incl...

In the latest episode of the PFC podcast, I spoke with Evan and Doug about airway management. As experienced airway takers in both pre-hospital and hospital settings, they had some valuable insights. We discussed the controversy over intubation versus cricothyrotomy. Evan and Doug raised some valid points, such as the need for suctioning and the difficulty of obtaining post-intubation sedation med...

In today's podcast, I chat with Aebhric OKelly the founder and Dean Emeritus of the College of Remote and Offshore Medicine (COROM) about Improvised medicine. I will be the first to say, as cool as it is to learn Improvised techniques, this is an emergency plan, not a way to lighten your ruck. We run through items for MARCH and principles to apply to this problem. This is only part one, so ple...

Dennis and Kevin Worth talk about combat anesthesia. The podcast discusses the four pillars of anesthesia, which are amnesia, analgesia, akinesia, and autonomic stability. The focus is on the importance of autonomic stability in combat situations. The best medication for amnesia in a downrange environment is Midazolam or Versed, and ketamine is a potent analgesic. The podcast also covers the MAP (...

Now, let's dive into treating tension pneumothorax. Joined by Andy Fisher, our favorite surgery resident and social media provocateur. We're talking IFAC essentials and the needle decompression debate. Andy's been stirring the pot, suggesting ditching Needle D's from the IFAC due to lack of official backing. The IFAC's about saving lives for non-medics, but is it hemorrhage, no...

For the rest of the month, every Mon, Wed, and Fri, I will be posting the top 10 podcasts of '23. I will resume with the regular schedule on New Year's Day. Happy Holidays. This podcast discusses the importance of patient positioning in prolonged field care. The guest, Ethan Miles, a board-certified family medicine physician with extensive military experience, emphasizes that patient posit...

Dennis discusses MDMA therapy for PTSD with guest Emily, a pharmacist. They explore how MDMA is being researched as a treatment for combat-related PTSD, especially when conventional medications like SSRIs and SNRIs fall short. MDMA offers a unique approach by providing stimulating effects while fostering empathy and helping patients reprocess traumatic memories. Emily emphasizes the importance of...

Dr. Givens talks about dealing with CBRNE patients in the field. They discuss the need for standardized approaches and clinical guidelines. I'm all about simplifying things and making them user-friendly. The hot zone requires quick thinking and auto injectors for CBRNE agents. They emphasize the importance of TCCC and teamwork. Dr. Givens covers various agents like nerve agents, cyanide, chlor...

"Correction: The correct initial dose of lipid emulsion is 1.5mL/kg, not 1 mL/kg" Dennis interviews Sandeep, an anesthesiologist with military experience, about the use of IV lidocaine for acute pain management. Sandeep explains that IV lidocaine can be a useful opioid-sparing option, especially in austere environments with limited resources. While it has a narrow therapeutic window, proper dosing...

Dennis hosts two special guests, Stacy Shackelford and Doc Rush, to discuss rethinking triage. They emphasize the need for a shift in the way medics are trained and how triage is approached. They challenge traditional triage algorithms and encourage a more flexible, data-driven approach that prioritizes time-sensitive interventions such as hemorrhage control and airway management. The conversation...

Just in case....

Dennis and guest Jeff Siegler, an assistant professor of emergency medicine, discuss the use of ketamine in managing status epilepticus. Status epilepticus is a prolonged seizure lasting more than five minutes, which can be life-threatening. They explore the challenges of treating seizures in the field and the role of benzodiazepines in initial treatment. Ketamine, while generally considered an ex...

Dennis and guest Shawn McKay discuss the basics of confined space rescue. They touch upon the importance of understanding the environment and potential risks, the need for monitoring equipment, and the selection of the right personnel for specific tasks during rescue operations. They also mention the relevance of NFPA standards and the importance of choosing appropriate equipment. The conversation...

Dennis and Brad discuss the use of Nubain, also known as Bufene. Nubain is a non-controlled narcotic that was FDA-approved in 1979 and gained popularity in the 1980s and 1990s. It is similar in strength to morphine but lacks some of its side effects like respiratory depression. Nubain's unique properties include its ability to reverse itching caused by other narcotics and its use as an adjunct...

Jay Baker, a brigade surgeon with limited special operations experience, discusses the evolving landscape of surgical support in Special Operations Forces (SOF). He highlights the differences between traditional trauma care provided during the Global War on Terror and the potential challenges of unconventional warfare. Drawing from historical examples of surgeons supporting resistance movements in...