Sometimes it's good to go over the basics again. Doug gives us the run down on who needs vent management and how to get started.

Sometimes it's good to go over the basics again. Doug gives us the run down on who needs vent management and how to get started.

92: Ventilation Basics

Everyone knows how hard it is to do good ventilation management using our gear. If the patient is spontaneously breathing in any way it can be next to impossible. Are paralytics the answer? Dennis speaks Evan (ER Doc) and Josh (ICU Doc) about the use of paralytics in vent management.

Everyone knows how hard it is to do good ventilation management using our gear. If the patient is spontaneously breathing in any way it can be next to impossible. Are paralytics the answer? Dennis speaks Evan (ER Doc) and Josh (ICU Doc) about the use of paralytics in vent management.

91: Paralytics and Vent Management

With bleeding from the "Box" causing such a large portion of the potentially survivable deaths, can we go in there? A better question probably "should we?". Stacy goes over how large the actual problem is and better yet, "What can be done", and "what does it take to do it?"

With bleeding from the "Box" causing such a large portion of the potentially survivable deaths, can we go in there? A better question probably "should we?". Stacy goes over how large the actual problem is and better yet, "What can be done", and "what does it take to do it?"

90: Abdominal Trauma with Stacy Shackelford

We're beyond explaining that blood is better than water, when it comes to resus and trauma. Now let's start talking about HOW to do it better. How to collect it faster and give it faster in the austere environment. How can we use the gear we have and optimize this life saving process.

We're beyond explaining that blood is better than water, when it comes to resus and trauma. Now let's start talking about HOW to do it better. How to collect it faster and give it faster in the austere environment. How can we use the gear we have and optimize this life saving process.

89: Getting and Giving Blood with Brad

Usually, we are sending our patients to a higher level of care. What do you do with the patients you can't? Dennis and Ian go over a timely topic.

Usually, we are sending our patients to a higher level of care. What do you do with the patients you can't? Dennis and Ian go over a timely topic.

88: Disposition

Jon does this for a living. Dennis discusses some more practical aspects of analgesia and sedation, such as how to assess for pain when your patient is unconscious. Jon also discusses the practicality  using IV lidocaine in an austere environment. This is another podcast from the study discussed on IV lidocaine.  http://www.oxfordjournals.org/podcasts/bjaed_intravenous_lidocaine_vol_16_issue_9.mp3

Jon does this for a living. Dennis discusses some more practical aspects of analgesia and sedation, such as how to assess for pain when your patient is unconscious. Jon also discusses the practicality  using IV lidocaine in an austere environment. This is another podcast from the study discussed on IV lidocaine. <a href="http://www.oxfordjournals.org/podcasts/bjaed_intravenous_lidocaine_vol_16_issue_9.mp3" rel="nofollow" target="_blank">http://www.oxfordjournals.org/podcasts/bjaed_intravenous_lidocaine_vol_16_issue_9.mp3</a>

87: Analgesia and Sedation part deux

Sometimes our patients are too sick to recieve the care they need. Dennis and Mark discuss the decision points of who goes to surgery and when.

Sometimes our patients are too sick to recieve the care they need. Dennis and Mark discuss the decision points of who goes to surgery and when.

86: Optimize your patient for surgery

Dennis and the guys from the "Dustoff Medic podcast", discuss optimizing your patient for evacuation. We go over the common mistakes and some of the decision making processes of Load and go or Stay and Play whan it comes to the more invasive procedures.

Dennis and the guys from the "Dustoff Medic podcast", discuss optimizing your patient for evacuation. We go over the common mistakes and some of the decision making processes of Load and go or Stay and Play whan it comes to the more invasive procedures.

85: Optimizing your patient for Evac

Sometimes it's not an easy decision to turn around and go home. I talk with Dr. Moon, about taking care of a patient with AMS, HAPE, and or HACE in a PFC environment and when is it worth the consequences to evac the patient.

Sometimes it's not an easy decision to turn around and go home. I talk with Dr. Moon, about taking care of a patient with AMS, HAPE, and or HACE in a PFC environment and when is it worth the consequences to evac the patient.

84: What if you can't descend? Altitude Illness in PFC

I discuss overventilation with Jeff. Should we be using a pediatric bvm?

I discuss overventilation with Jeff. Should we be using a pediatric bvm?

83: Should we be using a pediatric BVM?

This podcast covers medical care targeted to the Special Operations medical community with a focus on providing prolonged care in austere environments.

Great content. Probably need new mics. Audio is a little off.

Great podcast...hard to hear well

Great podcast

Special Operations Medical Association

<a href="https://www.snakebitefoundation.org/" rel="nofollow" target="_blank">https://www.snakebitefoundation.org/</a>

57: Snake Envenomation in Austere Environments

 In this great podcast Justin introduces the principals of pharmacology that have served him well over the years and have done far more for him than simply keeping him out of trouble.  He also introduces Brad Morgans CRNA who is a wealth of knowledge and experience in not only combat and austere theaters but also in working with and relating to, SOF medics and the challenges we face.  This is the first with more episodes in the series to come. So listen, download, read and understand the principals that, if heeded, can make the lives of you and your patients’ safer and more comfortable.  These principals should challenge you and spur you along to learn more about the drugs in the magic, locked narc box and the effects they will have on your patient.  If you have questions or comments add them to the comments section of this post at www.prolongedfieldcare.org

In this great podcast Justin introduces the principals of pharmacology that have served him well over the years and have done far more for him than simply keeping him out of trouble.  He also introduces Brad Morgans CRNA who is a wealth of knowledge and experience in not only combat and austere theaters but also in working with and relating to, SOF medics and the challenges we face.  This is the first with more episodes in the series to come. So listen, download, read and understand the principals that, if heeded, can make the lives of you and your patients’ safer and more comfortable.  These principals should challenge you and spur you along to learn more about the drugs in the magic, locked narc box and the effects they will have on your patient.  If you have questions or comments add them to the comments section of this post at <a href="http://www.prolongedfieldcare.org" rel="nofollow" target="_blank">www.prolongedfieldcare.org</a>

4: Pharm for SOF Medics

Mark Shapiro

46: Bleeding in the Box: Non-Compressible Torso Hemorrhage with Dr. Mark Shapiro

In an attempt ot explain the lethal triad, Dennis may have gone too far...

In an attempt ot explain the lethal triad, Dennis may have gone too far...

25: The Lethal Triad

Ian Wedmore

56: Spinal Trauma with Ian Wedmore

7: Ketamine and PFC

The following video podcast was recorded live at the JSOMTC during the July 21 2016 weekly Joint Trauma System Teleconference.  Dr. Doug Powell talks about providing critical care in austere environments.  He has been answering tough questions that medics have been asking the Prolonged Field Care Working Group for over 2 years as he simultaneously provided intensive care to sick patients in his ICU.  He has proctored and instructed more prolonged field care and other austere medical exercises than anyone I know.  He is now a Battalion Surgeon for a Special Forces Group and has a very good idea of what is required of a Special Operations Medic.  All of the downloads from the talk can be found at our website: www.prolongedfieldcare.org

The following video podcast was recorded live at the JSOMTC during the July 21 2016 weekly Joint Trauma System Teleconference.  Dr. Doug Powell talks about providing critical care in austere environments.  He has been answering tough questions that medics have been asking the Prolonged Field Care Working Group for over 2 years as he simultaneously provided intensive care to sick patients in his ICU.  He has proctored and instructed more prolonged field care and other austere medical exercises than anyone I know.  He is now a Battalion Surgeon for a Special Forces Group and has a very good idea of what is required of a Special Operations Medic.  All of the downloads from the talk can be found at our website: <a href="http://www.prolongedfieldcare.org" rel="nofollow" target="_blank">www.prolongedfieldcare.org</a>

11: Beyond the Golden Hour

Jim originally gave this talk at SOMSA2017. Due to popular demand, we were able to convince him to rerecord after the conference concluded. Enjoy...

Jim originally gave this talk at SOMSA2017. Due to popular demand, we were able to convince him to rerecord after the conference concluded. Enjoy...

27: Winning in a Complex World

41: The Death of the Golden Hour

6: Opiate Analgesic Pain Control

29: Dr. Cap on Fresh Whole Blood for Resuscitation in PFC

49: Set up a Walking Blood Bank

35: Burn Care Priorities With Dr. Cairns of UNC Chapel Hill

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. 

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.

50: Simple Sepsis Recognition and Intervention for Prolonged Field Care

Doug and Dennis talk about the application and limitations of monitoring ETCO2 in prolonged field care situations. 

Doug and Dennis talk about the application and limitations of monitoring ETCO2 in prolonged field care situations.

39: ETCO2

58: Justin on Planning

3: Nutrition in Prolonged Field Care

The Tactical Hemostasis, Oxygenation and Resuscitation(THOR) Group 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 Control Resuscitation" outlining in detail why they chose to bring back fresh whole blood at the point of injury. Since that time further studies have strongly suggested that the earlier fresh whole blood was transfused, the greater the benefit to the patient. Shackleford et al demonstrated that the greatest benefit to a patient receiving fresh whole blood occurred within 36 minutes of injury. After 36 minutes no decrease in 24-hour mortality was found. Blood must be replaced as soon as possible. The Committee on Tactical Combat Casualty Care also recommends FWB as the first line intervention for patients in hemorrhagic shock with blood products in both second and third place. We cannot ignore whole blood any longer if we wish to deliver the best possible battlefield care possible. Excuses citing logistical difficulty, concerns of safety or lack of information are unfounded. There are multiple ways to ensure our casualties are receiving fresh whole blood. The first is through the Armed Forces Blood program delivering cold stored O-Low titer blood to a Role 2 facility where it is picked up and pushed forward from there. Refrigeration is necessary in order to keep it below 4°C. If going out on mission insulated containers such as the Golden Hour or Golden Minute containers can be used to keep the blood within temperature specs for 24, 72 hours or longer. If dismounted, a transfusion can occur at or near the point of injury with pre-typed, screened and titered ROLO/SOLO donors. Other non-Ranger Special Operations units have since followed suit and have tweaked the name to suit them, hence the new SOLO(Special Operations Low-O) acronym.

The Tactical Hemostasis, Oxygenation and Resuscitation(THOR) Group 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, <a href="http://prolongedfieldcare.org/2015/08/03/tactical-damage-control-resuscitation/" rel="nofollow" target="_blank"> "Tactical Damage Control Resuscitation"</a> outlining in detail why they chose to bring back fresh whole blood at the point of injury. Since that time further studies have strongly suggested that the earlier fresh whole blood was transfused, the greater the benefit to the patient. Shackleford et al demonstrated that the greatest benefit to a patient receiving fresh whole blood occurred within 36 minutes of injury. After 36 minutes no decrease in 24-hour mortality was found. Blood must be replaced as soon as possible. The Committee on Tactical Combat Casualty Care also recommends FWB as the first line intervention for patients in hemorrhagic shock with blood products in both second and third place. We cannot ignore whole blood any longer if we wish to deliver the best possible battlefield care possible. Excuses citing logistical difficulty, concerns of safety or lack of information are unfounded. There are multiple ways to ensure our casualties are receiving fresh whole blood. The first is through the Armed Forces Blood program delivering cold stored O-Low titer blood to a Role 2 facility where it is picked up and pushed forward from there. Refrigeration is necessary in order to keep it below 4°C. If going out on mission insulated containers such as the Golden Hour or Golden Minute containers can be used to keep the blood within temperature specs for 24, 72 hours or longer. If dismounted, a transfusion can occur at or near the point of injury with pre-typed, screened and titered ROLO/SOLO donors. Other non-Ranger Special Operations units have since followed suit and have tweaked the name to suit them, hence the new SOLO(Special Operations Low-O) acronym.

36: ROLO to SOLO: The Logistics of Fresh Whole Blood Transfusion

5: Pharm episode II - MSMAID

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 audience here.

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 audience here.

33: TIVA: Another Look at Pre-Hospital Analgesia and Sedation

The best podcast episodes of the most interesting stories and things. From skyping someone while they're in space, to tracking down and meeting a telephone scammer in person, to the story of a Galapagos. These episodes will keep you and all your friends entertained and captivated for hours. Learn something new in every episode! Add episodes you're interested into your queue below!

Best Episodes: Interesting Stories & Things

The best podcast episodes on physical health. Episodes talk about your diet, sleep, exercise and all the things that people do to improve their physical health and live a healthier life. This topic is for everyone, with applications in all of our everyday lives. Add episodes you're interested into your queue below!