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 excitatory drug, is being studied as a potential option when seizures become refractory to standard tr...
Nov 20, 2023•35 min
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 emphasizes the significance of training and preparedness in handling complex rescue situations. Tha...
Nov 17, 2023•1 hr 6 min
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 to ketamine or other pain management drugs. Dennis emphasizes the importance of monitoring respiratory ...
Nov 13, 2023•46 min
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 World War II, he emphasizes the need for adaptable and resourceful surgical teams capable of extend...
Nov 10, 2023•19 min
Dennis and Josh discuss ventilator training on the PFC Podcast. Josh, a former ranger medic now working in a level one ICU, shares insights. They emphasize the importance of proper ventilation in the field and address common mistakes, like setting inappropriate rates that lead to patient agitation. Josh advises cautious opioid use, balancing sedation with patient needs. They delve into adjusting PEEP, flow, and waveform, emphasizing patient synchronization. Josh highlights the significance of ad...
Nov 06, 2023•58 min
Dennis and Doug discuss the fundamentals of ventilatory management in trauma cases. They emphasize the distinction between the need for an airway and the need for a ventilator. Patients requiring an airway may have issues like swelling or trauma obstructing their airway, while those needing a ventilator typically have respiratory failure. They explain the importance of monitoring compliance, tidal volume, minute ventilation, and peak and plateau pressures. Additionally, they touch on the importa...
Nov 04, 2023•45 min
Dennis interviews Thomas Trust Have, a former Danish Special Forces operative turned doctor, discussing the challenges of providing medical care in Arctic environments. Thomas emphasizes the extreme conditions, highlighting a hypothetical scenario involving a special operations team enduring frigid temperatures and harsh winds. He underscores the importance of preparation, teamwork, and proper gear in these situations. Thomas also addresses medical considerations such as tourniquet use, fluid wa...
Oct 30, 2023•51 min
Dennis and Doug discuss the critical importance of effective team dynamics when dealing with critically injured patients. They highlight the challenges faced by medical teams who often work in silos, failing to communicate and coordinate efficiently. Doug, drawing from his experience at Baltimore Shock Trauma, emphasizes the value of well-organized roles and protocols in high-volume trauma facilities. He underscores the need for designated positions and a clear team leader to oversee the patient...
Oct 27, 2023•28 min
In today's episode, we're diving into the topic of tourniquet conversion. With conflicts happening globally, it's crucial to understand the difference between tourniquet conversion and replacement. Conversion means finding an alternative to control bleeding when the tourniquet is no longer needed. Replacement involves swapping a tourniquet for a more effective one. Conversion timing depends on the tactical situation and patient's resuscitation status. You should consider resuscitating the patien...
Oct 23, 2023•49 min
Today, we're diving into the crucial topic of medical contingency planning. Evan and I discuss the importance of planning for medical emergencies in various scenarios, emphasizing that timely evacuation is often more effective than improvised solutions. We stress the significance of conducting thorough risk assessments, considering factors like location, climate, endemic diseases, and enemy threats. It's essential to evaluate local healthcare resources and potential evacuation options, even in r...
Oct 19, 2023•1 hr
Dennis hosts a discussion with various military medics. They explain the role of Special Operations Forces (SOF) medics, emphasizing their training and responsibilities. Each guest represents different SOF units, such as Rangers, Navy SEALs, and Special Forces. They discuss the extensive training, medical capabilities, and the need for trust and support from other team members and medical professionals. The conversation highlights the unique challenges SOF medics face, as they often operate in a...
Oct 16, 2023•1 hr 18 min
In this podcast, Dennis discusses cold weather injuries, particularly frostbite and non-freezing cold injuries like trench foot. He highlights their historical significance, citing examples from military campaigns. Prevention is emphasized, including proper clothing, buddy checks, and staying hydrated. Dennis explains the stages of frostbite, the importance of rapid rewarming, and the risks of refreezing or overheating. He also mentions the Kachi classification system to assess severity. Antibio...
Oct 12, 2023•46 min
Dennis welcomes his friend Pac to discuss S-Ketamine. Pac, an anesthetist with extensive experience, shares insights on using S-Ketamine in various medical settings. He highlights its potential advantages, such as improved analgesia and reduced hallucinogenic effects in mid-doses. They discuss its use in austere environments, especially during military operations, and Pac emphasizes the importance of adapting dosages based on transportation methods and patient conditions. They touch on the role ...
Oct 09, 2023•51 min
Welcome back to the PFC Podcast. Mark and I chat about feeding the critically ill. Now, look, when you're done stitching folks up and pumping them with antibiotics, there's a point you'll need to feed them. Mark shed light on how crucial nutrition is, whether you're in a remote outpost or a high-end trauma center. Nutrition aids in healing, plain and simple. We dove into the nitty-gritty – feeding patients with head injuries, burns, and other nasty stuff. And hey, feeding ain't just about the be...
Oct 05, 2023•1 hr 11 min
Today, we've got Brett, a paramedic legend from El Paso County Search and Rescue. The mountains? Tricky business. One moment it's beach weather, the next it's a frigid winter wonderland – and that’s in the summer! Know what you're packing; it's not a weekend getaway! And those space blankets? Not the lifesavers you might think. Weight's your enemy up there, but be smart. And remember, it's not just about the med kit; weather's unpredictable, avalanches are sneaky, and a good medic knows that it’...
Oct 02, 2023•30 min
Today, on the PFC Podcast, we dived deep into altitude illness with the experienced Dr. Moon from Duke University and Patrick O'Boyle, a senior medical instructor. Dr. Moon's been to Everest Base Camp, studies altitude physiology, and works with the Navy. He shared that altitude illness, including symptoms like nausea, vomiting, and insomnia, is not fully understood. The dangerous forms like cerebral edema (brain swelling) and pulmonary edema (fluid in lungs) can be deadly. Rapid altitude change...
Sep 28, 2023•35 min
Here's the lowdown from the PFC Podcast episode 150 with Dennis and Alex, diving into ETCO2. Dennis chats with Alex, who's had a colorful career, from being a 68 Whiskey and a paramedic to now working with Massimo. They discuss the Emma capnograph, a handy gadget that monitors exhaled CO2. It's essential to keep everything sealed, or the readings might be off. The device runs on batteries with different lifespans, depending on the type. Calibration? It's a must, but hold the buttons longer than ...
Sep 25, 2023•40 min
Bryce joined the podcast to share insights on training non-medics. Why bother? Well, Bryce emphasized the value of cross-training within teams. While it's not always easy to motivate folks to grasp medical tasks, it's a lifesaver. Literally. The key? Make it competitive! And remember, it's not just about the skills, but the trust built within the team. If teammates can handle tasks without needing constant supervision, it makes everyone more effective. But, it's not just about having a skill; un...
Sep 21, 2023•26 min
This is part 2 of our 2.5 hour conversation 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 PFC when the gear starts running out. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolong...
Sep 18, 2023•1 hr 25 min
Today, we're diving deep into pneumothorax and hemothorax. Pneumothorax can quickly become an emergency, especially when it's not about the pressure but the declining SPO2. But where's the line between tension and hemothoraces? Our ICU doc expert clarifies that it's all about the impaired blood return to the heart. When your preload drops, it affects the cardiac output. If vitals are stable, though, it's not tension physiology. Also, did you know there are folks walking around with untreated pne...
Sep 14, 2023•33 min
Today's podcast is part one of a 2.5 hr 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 plenty more in the next episode, when we go through PFC and improvised gear. Thank you to...
Sep 11, 2023•1 hr 7 min
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, not tension, we should focus on? Special ops pushed decompression needles, but is it justified? Andy questions the success...
Sep 07, 2023•50 min
Welcome back, folks! Had a chat with Ephraim Matto, who's seen the thick of things in Burma. He spent the last six months there, amidst security crises and medical emergencies. Burma's ethnic minorities are resisting subjugation, and the mountainous borders provide relative safe areas. Still, things are pretty dire. On top of internal conflicts, there's interference from the Russians and Chinese. On the medical front, there's a dire need. His crew operates ambulances and boats to get folks the c...
Sep 04, 2023•57 min
Let's cut to the chase about field blood transfusion. Dr. Andrew Cap came on the PFC Podcast to drop some knowledge. We talked about a high-stakes op in Afghanistan where two soldiers suffered intense injuries. First patient? Lost both legs and showed clear signs of shock. Second guy? Shot in the gut and leg, started strong but slowly faded out. Dr. Cap then gave us the rundown on resuscitation. Key points: control bleeding first, whole blood is the MVP for treatment, but sometimes, there ain't ...
Aug 31, 2023•44 min
Today's episode, is all about "Versed." We've got Kevin and Paul here, chatting about patient positioning and the intricacies of using Versed, a benzodiazepine, for sedation. They touch on how different patients react to the drug, emphasizing the art of medicine over strict calculations, especially in challenging scenarios. The podcast delves into dosing strategies, dealing with hemodynamically unstable patients, and the complexities of maintaining sedation during procedures. Remember, every pat...
Aug 28, 2023•1 hr 11 min
Today, I'm chatting with Colin about the new Prolonged Fieldcare Airway CPG. Basically, it's a guideline for managing airways in tough situations. Colin's a special ops medic and he helped put this thing together. CPGs are like gold for medics, so Google "PFC CPG" for info. Airway's vital, but sometimes overlooked. We're diving into the details, from procedures to training. It's not just about sticking a tube in; it's a whole process. Training's key – keep practicing. Units need to back it up to...
Aug 24, 2023•35 min
Welcome back to the PFC podcast! Today, it's Dennis here with Casper and Paul. We're discussing a leadership tool called the Tactical Timeout, which helps teams ensure everyone is on the same page. Casper, a NATO Special Operations combat medic, gives a shout-out to the timeout used in the medical community, ensuring correct procedures. Using the Tactical Timeout, they discuss the tactical situation, security, and evacuation plans, ensuring efficient shift changes and patient updates. It fosters...
Aug 21, 2023•32 min
Kevin schools me up on Ketamine and it's use in the field.
Aug 17, 2023•53 min
Hey there, it's Dennis from the Prolonged Field Care Podcast, episode 144. Today, Winston and I dive into pain pathways. You know, those definitions of pain like visceral or psychogenic, they've never helped me treat pain practically. So, understanding the nervous system might just boost my pain management skills. The pain pathway consists of transduction, where energy turns into nerve impulses, ascending pathways, spinal cord travel, brain processing, and descending pathways. Remember, understa...
Aug 14, 2023•58 min
Today, I'm joined by Brad, a former special operations medic and instructor, to talk about a harrowing experience during a night raid in Afghanistan. They faced a barricade shooter situation and multiple casualties. Despite the danger, their medical training and preparedness shone through. Brad emphasizes the importance of casualty training and incorporating it into every mission. They stress the need for repetition and selecting the right equipment for efficient treatment. The podcast covers va...
Aug 10, 2023•32 min
