Prolonged Field Care Podcast

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.   Here are some of the resources and pearls he mentioned in the episode:       Infection plus organ dysfunction is sepsis  &n...

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 s...

For more content: www.prolongedfieldcare.org

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 working despite  lack of help or resources in a...

Many efforts in the pre-hospital combat environment had been aimed at  prolonging the viability of a patient until they are able to make it to a  surgeon. The goal of military triage and evacuation is to have urgent  surgical patients to a waiting surgical team within 2 hours. Despite our  best efforts, this is not always possible. When it is not possible,it  is important...

When properly and safely administered regional anesthesia can augment  your limited supply of narcotics and ketamine in resource poor  environments. It can also preserve your patient’s mental status while  providing targeted pain relief. This can be accomplished using a nerve  stimulator and the techniques found in the Military Advanced Regional  Anesthesia and Analgesia H...

For more content, visit www.prolongedfieldcare.org

For more content, visit www.prolongedfieldcare.org

For more content, visit www.prolongedfieldcare.org

Colonel Warner “Rocky” Farr has made an important contribution to the  body of SOF knowledge with this well-researched monograph. He advances  the understanding of the many challenges and accomplishments related to  guerrilla warfare medicine—care provided by predominantly indigenous  medical personnel under austere conditions with limited evacuation  capability— by provid...

Whether working on a casualty with a small team of medics or as a single  medic with the help of other non-medic team members as helpers, someone  has to be in charge of the situation in order to maintain a global view  of priorities.  The minute you get sucked in to do a specific task you  are losing situational awareness of the complete patient and  environment. &nb...

Upgrading your airway kit with a portable end tidal CO2 monitor can help  in a couple situations. While it has its limitations, it is essential  for  quickly determining if your tube is in the trachea during an intubation.  This can be accomplished most accurately via a device with a  quantitative waveform such as the Emma Capnograph. If you can’t get your  hands on a...

For more content, visit www.prolongedfieldcare.org

Non-Governmental Organizations, Non-Profits and Volunteers have been  providing critical services on the battlefield for millennia.  Historically the traditional view of medical care in conflict zones was  that the military focused on victory and everything else was ancillary,  even care of their own wounded. Only in the last few centuries has there  been an evolution of c...

The Trauma Hemostasis and Oxygenation Research (THOR) Network including  the 75th Ranger Regiment, NORNAVSOF, and others have led the way in  re-implementing type-O, low titer fresh whole blood far forward with the  Ranger type-O Low titer(ROLO) program. In 2015 the Ranger medical  leadership along with founders of the ROLO program published the paper,  “Tactical Damage Co...

Which burn fluid resuscitation formula is best? Does it really matter?   What can happen if you over resuscitate? Under?   What can cause an increase or decrease in the demand of fluids?   What can you do if you are running out of Lactated Ringers?   As a Lt. CMMDR. with the U.S. Navy, Dr. Cairns was on duty and a  principle responder to the KAL flight that crashed in 1997...

Telemedicine is a crucial capability that must be planned and practiced.  The base of knowledge that a SOF medic’s knowledge encompasses includes  many areas of medicine but generally lacks  the depth of knowledge and experience of specialists available to  consult. This depth of knowledge is almost universally available when  making a simple telephone call to any number o...

Rick Hines has spent the last 20+ years in service to his country much  of it deployed to combat zones and other unstable, austere environments  and is dedicated to improving SOF Medicine.  He made it a point to spend  a fair amount of time with surgical teams when possible and has gained  quite a bit of real world knowledge that we hope to pass on to a wider  audienc...

When do you give a burn patient antibiotics? Which ones?   How do you calculate TBSA and the rule of 10s?   What do you use to guide fluid resuscitation? What fluid?   When is an escharotomy in the field appropriate?    Burns present another wound pattern that can be extremely difficult and  time consuming for any level of provider to manage.  So much so tha...

In this live recording, guest lecturer COL Missy Givens shares the CBRNe  knowledge she has learned while working as a clinical toxicologist,  among many other positions, around the world including as the SOCAFRICA  Command Surgeon.  For more content, visit www.prolongedfieldcare.org

You are in your Team House or BAS. You have given FDP, Whole blood, TXA  calcium and don’t have much left despite the few units from the walking  blood bank. Your patient continues to bleed internally. Nothing in the  chest or upper abdomen. Probably pelvic. Damn. MEDEVAC is en route. They  will have some blood too. You just need your patient to hold on for  another hour b...

Dr. Cap has been leading the way here in the US with the Armed Services  Blood Program on fresh whole blood transfusion research in conjunction  with the THOR Network and answering tough questions that different  Special Operations Units come up with when analyzing how best to  implement a fresh whole blood resuscitation protocol. In this episode  Dennis presses him on the...

Training materials were the number 1 most requested item from our SOMSA  AAR.  We have put out other training recommendations in the past but  wanted to also highlight some important skills that will help you  identify gaps in your PFC training program, plan future training and  measure progress.  We will get more into this cycle in the future  however, this shou...

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This Clinical Practice Guideline was written by a fellow 18D with input  from around the surgical community.  It reconciles the differences  between wound care done in a role 2 or 3 facility, such as serial  debridements, with what is taught in the 18D Special Forces Medical  Sergeant Course with regards to delayed primary closure.  One way is not  “right” while...