Prolonged Field Care Podcast

This conversation delves into the critical aspects of tourniquet management in trauma care, focusing on the distinction between tourniquet conversion and replacement, the importance of resuscitation, and the physiological implications of prolonged tourniquet use. The speakers discuss techniques for safe conversion, the challenges faced in the field, and the assessment of limb salvageability, empha...

The conversation delves into the complexities of end-of-life care, emphasizing the importance of thoughtful training and education in healthcare. It highlights the potential moral injuries that can arise from decisions made in this sensitive area, particularly when medics are tasked with determining the futility of care without adequate resources. Takeaways There's a ripple effect from each on...

In this essential episode of the Prolonged Field Care (PFC) Podcast, host Dennis sits down with CRNA Kevin to dive deep into one of the most overlooked yet critical issues in trauma care: Hypothermia prevention and management . Even in warm environments, trauma patients can rapidly become hypothermic—leading to coagulopathy, increased bleeding, wound infections, and worse outcomes. Dennis and Kevi...

In this conversation, Jessica Patterson and Florian Schmitzberger discuss the evolution of clinical practice guidelines (CPGs) from the Department of Defense (DOD) and their application in different contexts, particularly in light of the changes from the Global War on Terror (GWOT) to new healthcare environments. They emphasize the need for data to understand how these guidelines will perform in v...

In this episode of the PFC Podcast, Dennis and John discuss the ongoing updates and changes within the Tactical Combat Casualty Care (TCCC) guidelines. They delve into the role of the TTC Committee, the importance of literature reviews in developing algorithms for trauma care, and the proposed changes to the March algorithm, emphasizing the need for resuscitation before decompression. The conversa...

In this episode of the PFC Podcast, Victor, a former Ranger medic, shares his experiences and lessons learned from a mass casualty event during a humanitarian mission in Burma. He discusses the historical context of the conflict, the challenges faced in providing medical support, and the innovative solutions developed in a denied environment. The conversation emphasizes the importance of training,...

In this gripping conversation, trauma surgeon Max Sirkin MD shares his harrowing experience of being a patient in a mass casualty situation following a helicopter crash. He recounts the chaos of the event, the physical and emotional trauma he endured, and the profound lessons learned about resilience, brotherhood, and the importance of being present for others in crisis. Sirkin's narrative hig...

In this episode of the PFC Podcast, Dan McGraw discusses the critical need for gender-specific medical training in military settings, drawing from personal experiences and extensive research. He highlights the disparities in treatment outcomes between male and female patients, the physiological differences that affect trauma care, and the cultural challenges faced by medical personnel when treatin...

In this episode of the PFC Podcast, Dennis and Master Sergeant Dan McGarra discuss the evolving role of females in combat and the challenges faced in medical treatment for female casualties. They explore discrepancies in medical protocols, cultural implications, and the need for gender-neutral approaches in military medicine. The conversation highlights the importance of understanding physiologica...

This podcast episode delves into the complexities of unconventional warfare, particularly focusing on the historical context, the evolution of medical support within special forces, and the challenges faced in modern warfare. The speaker discusses the importance of guerrilla warfare tactics, the role of medical personnel in combat situations, and the concept of the 'Golden Hour' in trauma...

In this episode of the PFC podcast, Dr. Jim Ducanto, an experienced anesthesiologist, discusses the critical aspects of airway management in emergency situations. He emphasizes the importance of decision-making, assessing neurological status, and effective communication with patients. The conversation also covers the necessity of planning and preparation for airway interventions, as well as the si...

In this episode of the PFC Podcast, Dennis and Max delve into the complexities of hemorrhagic shock, discussing its classifications, the importance of understanding compensated versus uncompensated shock, and the vital signs that indicate a patient's condition. They explore resuscitation strategies, emphasizing the need for careful assessment and decision-making in trauma care. Special conside...

In this episode of the PFC Podcast, Dennis and Max discuss the evolving landscape of modern combat injuries, focusing on neck and upper chest injuries. They delve into the anatomy of the neck, the importance of understanding different zones for surgical intervention, and effective hemorrhage control techniques. The conversation emphasizes the critical role of teamwork in trauma care and the necess...

In this episode of the PFC Podcast, Dennis and Max delve into the complexities of managing shock, particularly hemorrhagic shock, in trauma patients. They discuss the importance of mental status as a key indicator of a patient's condition, the critical role of early intervention, and the protocols surrounding massive transfusions. The conversation also covers the use of TXA and calcium in resu...

The conversation delves into the complexities of medication stability, particularly focusing on how environmental factors can affect the efficacy of pharmaceuticals. It highlights the stringent storage parameters set by pharmaceutical companies and the lack of testing in combat-simulated environments, raising concerns about medication reliability in critical situations. Takeaways Medications can a...

In this episode of the PFC Podcast, Dennis and Rick discuss the sensitive and often overlooked topic of what to do with patients after they die. They explore the emotional and cultural complexities involved in handling death in a medical context, particularly in military settings. The conversation covers the importance of cultural sensitivity, legal considerations, personal experiences, and the em...

In this episode of the PFC Podcast, Dennis interviews Nicholas Samuels, a humanitarian worker in Ukraine, discussing the critical aspects of medic safety, planning for evacuations, and the importance of understanding the broader context of the ongoing war. Nicholas shares insights on the challenges faced by medical volunteers, the necessity of being aware of threats like drone warfare, and the bal...

In this episode of the PFC Podcast, Dr. Van Wyk discusses the latest updates in traumatic brain injury (TBI) management, focusing on insights from the CRASH-3 trial, the use of TXA, hypertonic saline, and sodium bicarbonate. He emphasizes the importance of monitoring intracranial pressure and the potential for surgical interventions in austere environments. The conversation also touches on the con...

In this episode of the PFC Podcast, Dennis and Ben Garfin discuss the critical importance of clinical experience for combat medics. They explore the challenges and benefits of clinical rotations, the need for real-world experience, and the design of effective training programs. The conversation emphasizes the necessity of mentorship, the legal and ethical considerations of international rotations,...

The conversation emphasizes the critical role of timely nutrition in patient healing, highlighting the risks associated with delayed feeding and the broader implications for healthcare providers. Takeaways Feed patients within 24 to 36 hours to avoid risks. Delaying nutrition can lead to serious consequences. Nutritional deficiencies affect patient recovery. Healthcare providers must prioritize ti...

In this episode of the PFC Podcast, Dennis and Jennifer Gurney discuss the critical aspects of wound management in trauma care, particularly in military settings. They cover the importance of cleaning wounds, the risks associated with early closure, effective irrigation techniques, and the role of nutrition in healing. Jennifer shares insights on Dakin's solution, debridement strategies, and i...

The conversation explores the importance of balancing realism and learning in training scenarios, particularly in medical training. It emphasizes the limitations of achieving true realism in training and the potential negative effects of unrealistic training scenarios. Takeaways You want to balance realism and learning in training scenarios. You can't be trying to pop dudes' cherries in tr...

In this episode of the PFC Podcast, Dennis and Kevin discuss the complexities of using narcotics in long-term care, particularly in a military or austere environment. They delve into the importance of understanding drug metabolites, context-sensitive half-times, and the implications for patient care. The conversation covers various anesthetic agents, their effects, and the clinical considerations...

In this episode of the PFC Podcast, Dennis and Thomas Trust Have discuss the complexities of practicing medicine in Arctic environments. Thomas shares his extensive experience as a consultant in anesthesiology and critical care medicine, particularly in remote and austere settings. The conversation delves into the unique challenges faced by medical personnel in extreme cold, including the importan...

In this episode of the PFC Podcast, Dennis and Max delve into the complexities of managing shock, particularly hemorrhagic shock, in trauma patients. They discuss the importance of mental status as a key indicator of a patient's condition, the critical role of early intervention, and the protocols surrounding massive transfusions. The conversation also covers the use of TXA and calcium in resu...