The conversation explores the topic of unconventional medical networks and how to establish them. The guest, Regan Lyon, discusses his thesis on this subject and the challenges involved. They discuss the historical context of guerrilla hospitals and the need for medical care in unconventional warfare scenarios. They also touch on the limitations and constraints of current medical doctrine and the importance of training, blood supply, hospital capacity, and evacuation routes. The conversation hig...
Sep 13, 2024•1 hr 2 min
In this conversation, Kevin and Dennis discuss nursing care in a prolonged field care (PFC) setting. Kevin, an experienced nurse anesthetist, provides insights into when PFC nursing care begins and the importance of gathering data and assessing patients. He emphasizes the role of nurses in providing interventions such as pulmonary toileting, turning patients, skincare, dressing changes, medication infusions, and more. Kevin also discusses the challenges of training for PFC and the need to have a...
Sep 09, 2024•1 hr 6 min
In this podcast episode, Dennis and Andy Fisher discuss the co-administration of ketamine and Versed. They explore the reasons behind the common practice of adding Versed to ketamine, the concept of emergence reactions, and the appropriate use of Versed. They also touch on the potential risks and side effects of both drugs and the importance of individualized dosing. The conversation emphasizes the need for critical thinking and careful consideration when administering these medications. Takeawa...
Sep 06, 2024•22 min
In this conversation, Dennis and Dave discuss procedures like cricothyroidotomy (cric) and chest tube placement in the context of extended care. They explore the challenges of managing patients with airway interventions and the importance of considering the context and resources available. They also discuss the criteria for removing a cric or chest tube and the potential complications that may arise. The conversation highlights the need for careful assessment and monitoring of patients to ensure...
Sep 02, 2024•44 min
In this podcast episode, Dennis and Pac discuss the use of ketamine in medical settings, particularly in austere environments. They cover topics such as the differences between S-ketamine and R-ketamine, the dosing and administration of ketamine for sedation and analgesia, and its use in hemodynamically unstable patients and refractory seizures. They also touch on the importance of proper training and monitoring when using ketamine, as well as the potential benefits of combining regional anesthe...
Aug 30, 2024•1 hr 11 min
In this conversation, Dennis and Monti discuss the process of product development. They cover topics such as generating ideas, validating ideas with potential customers, protecting intellectual property, and deciding whether to build a business or collaborate with another company. Monti shares his experience with developing the APRU and Delta Ice products, highlighting the importance of customer feedback and iteration. They also touch on the challenges and time commitment involved in bringing a ...
Aug 26, 2024•53 min
In this conversation, Rick, a senior medic for the 10th Special Forces Group, shares lessons learned from a mass casualty event in Eastern Afghanistan. He discusses the different types of mass casualty situations and the challenges faced in both reactive and proactive scenarios. Rick emphasizes the importance of realistic training scenarios and the need to think critically and adapt in high-stress situations. He also highlights the significance of effective communication, pre-coordination with m...
Aug 23, 2024•1 hr 28 min
In this podcast episode, Dennis, Rick, and Paul discuss the challenges of training in the field of prolonged field care (PFC) and advanced medical training. They address the common problems of miscommunication and unrealistic expectations when it comes to training requests. The conversation covers topics such as setting realistic goals, creating effective scenarios, and the importance of having flexible and experienced instructors. They also discuss the value of worst-case scenario training and ...
Aug 19, 2024•58 min
In this podcast episode, Dennis and Ian discuss the process of disposition in emergency medical care. They explore how to transfer patients who cannot be evacuated to a higher level of care and instead need to be sent back to their families or local medical systems. The key steps in the disposition process include evaluating life threats, stabilizing the patient, determining if continuous medical care is necessary, assessing if the patient can be cared for at home, and ensuring they have access ...
Aug 16, 2024•31 min
Mikola, a combat medic from the Ukrainian Special Operations Task Forces, shares his experience and challenges in providing medical care in the war-torn region of Ukraine during SOMSA 24. He discusses the difficulties of operating in a large and constantly changing frontline, with different terrain and medical systems in each administrative region. Mikola explains the concept of medical evacuation and the various facilities and modes of transportation used. He also highlights the dangers faced b...
Aug 12, 2024•34 min
In this podcast episode, Dr. DeMello discusses the management of burns in a pre-hospital setting. He emphasizes the importance of following the MARCH approach and not letting the burn distract from other life-threatening injuries. He also highlights the challenges of accurately calculating the total body surface area (TBSA) affected by the burn and recommends using the serial halving method. Dr. DeMello advises against over-resuscitating with fluids and suggests using a simple fluid resuscitatio...
Aug 09, 2024•42 min
In this episode, Dennis and Alex discuss the importance of reading research papers and critically analyzing their applicability to the operational environment. They review a paper on the role of red blood cells in thrombosis and post-transfusion hypercoagulability. The study found that red blood cell aggregation increased in the presence of tissue factor and calcium. While the study had limitations in terms of sample size and external validity, it raised questions about the use of calcium and tr...
Aug 05, 2024•1 hr
In this episode of the PFC Podcast, Colonel Stacey Shackelford discusses abdominal trauma and exsanguinating hemorrhage. He highlights the findings from studies on casualties who died before reaching a surgical hospital, with close to 90% of those deaths caused by bleeding. The majority of potentially survivable injuries resulting in death were from torso hemorrhage, particularly abdominal injuries. The current toolkit for managing abdominal trauma includes pressure dressings, blood transfusions...
Aug 02, 2024•39 min
The conversation revolves around the topic of ether and its use in surgery. Mike and Brad, both medical professionals, discuss the benefits and drawbacks of using ether as an anesthetic. They highlight its historical significance, safety profile, availability in developing countries, and field expediency. They also mention the flammability and pungent smell of ether, as well as its slower uptake and potential for post-op nausea and vomiting. The conversation emphasizes the importance of understa...
Jul 29, 2024•46 min
In this episode of the PFC Podcast, Dennis and Jamie discuss the importance of tourniquet conversion in the context of combat medicine. They explain the difference between tourniquet conversion and tourniquet replacement, emphasizing the need to control bleeding and save tissue. They discuss the timing of tourniquet conversion, highlighting the importance of resuscitation and patient stability. The conversation also covers the physiological effects of tourniquet conversion, including reperfusion...
Jul 26, 2024•49 min
In this podcast episode, Dennis interviews Tom Avery, a surgeon who worked in Myanmar with the Free Burma Rangers. Tom shares his experience providing critical care in a war-torn area and the challenges he faced. He discusses the importance of stabilizing patients and bridging the gap between the frontline and higher echelons of care. Tom emphasizes the need for flexibility and creativity in an austere environment and the importance of communication and cooperation with local forces. He also hig...
Jul 22, 2024•48 min
In this podcast episode, Dennis and Brad discuss the use of fentanyl as an opioid analgesic. They explore the history and development of fentanyl, its pharmacological properties, and its advantages over other opioids. They also discuss the administration of fentanyl, including IV and lollipop forms, and the importance of titrating the dose to the patient's respiratory rate. The potential side effects and contraindications of fentanyl are also addressed. Takeaways Fentanyl is a synthetic opioid t...
Jul 19, 2024•49 min
In this part of the conversation, Dennis and Andy discuss common health issues and injuries that can occur in the jungle. They specifically focus on heat illnesses, musculoskeletal conditions, dermatological conditions, and tropical diseases. They provide tips on how to manage exertional heat illness, such as stopping activity, finding shade, and using water to cool down. They also discuss the importance of proper hydration, nutrition, and hygiene in the jungle. Additionally, they talk about the...
Jul 15, 2024•46 min
This podcast episode discusses the topics of PTSD, TBI, sleep, and suicide, particularly in relation to military personnel. The speaker, Joe Cooper, provides insights into the overlapping nature of these conditions and the need for a comprehensive approach to treatment. He emphasizes the importance of therapy as the primary treatment for PTSD and highlights alternative therapies such as stellate ganglion block, ketamine, acupuncture, cannabis, mindfulness, and testosterone replacement therapy. T...
Jul 11, 2024•1 hr 21 min
In this podcast episode, Dennis interviews Andy, a former UK Special Forces paramedic, about working in the jungle. They discuss the challenges and skills required to operate in the jungle, such as personal administration, environmental health, and communication. Andy emphasizes the importance of being physically fit and mentally prepared for the jungle environment. He also provides tips for preparing and packing essential medical equipment. The conversation highlights common mistakes made by ro...
Jul 08, 2024•32 min
In this podcast episode, the hosts discuss regional anesthesia and its role in the priorities of analgesia. They explain that regional anesthesia is a tool that allows for pain control without taking away consciousness or respiratory drive. They discuss the decision-making process for when to use regional anesthesia versus other forms of pain management. The hosts also cover topics such as indicators for when a patient is light enough for a regional block, the risks and complications associated ...
Jul 05, 2024•33 min
Phil Gonzalez, a combat medic, shares his experiences in Vietnam and his journey to becoming a medic. He discusses the intense situations he faced in Vietnam, including being in dangerous situations and witnessing the horrors of war. He also talks about the importance of medics in Special Forces and the impact they have on the people they treat. After Vietnam, Phil pursued a career in medicine and worked in various locations, including Panama and Salvador, providing medical care to those in need...
Jul 01, 2024•1 hr 42 min
The conversation discusses patient positioning during procedural sedation and the use of Versed (Midazolam) as a sedative. The speakers explore the importance of patient positioning and the need to have a plan for airway management in different positions. They also provide insights into the mechanism of action and dosing of Versed, highlighting the importance of individual patient factors and context in determining the appropriate dose. The conversation emphasizes the need for a staged approach ...
Jun 28, 2024•1 hr 11 min
Dennis Price discusses his experiences in organizing rescues in Afghanistan and Ukraine. He attributes his success to the blessings of God and his strong faith. In Afghanistan, he formed a company called Polaris. They were able to save 55 Americans and CIV interpreters in two weeks. Later, he joined a committee called Save Our Allies and worked with the government to rescue and vet interpreters. In Ukraine, he formed a nonprofit called Heroes for Humanity and led a team to provide medical aid an...
Jun 24, 2024•1 hr 14 min
In this conversation, Dennis, Evan, and Doug discuss the debate between intubation and cricothyrotomy (cric) in the field. Dennis confesses his belief that intubation is the better option, while Evan and Doug argue for the use of cric in certain situations. They discuss the resource limitations in the field, the need for resuscitation prior to intubation, the challenges of obtaining and administering sedation medications, and the potential complications of intubation. They also touch on the impo...
Jun 21, 2024•1 hr 15 min
In this podcast episode, Dennis interviews Dr. Jim DuCanto, an anesthesiologist with a special interest in airway management. They discuss the decision-making process in emergency airway management, particularly in challenging situations such as facial trauma. Dr. DuCanto emphasizes the importance of assessing the patient's neurologic status and respiratory efforts, as well as considering the safety of the scene. He also highlights the need for clear communication with the patient and the use of...
Jun 17, 2024•48 min
In this episode, Dennis, Doug, and Paul discuss how to treat expectant patients in a medical setting. They explore the concept of palliative care and its role in providing comfort to patients at all stages of care. They also discuss the challenges medics face when dealing with expectant patients and the importance of reaching out for support and guidance. The conversation emphasizes the need to prioritize efforts and provide pain control and symptom management to make the patient as comfortable ...
Jun 14, 2024•14 min
The podcast episode discusses the controversial topics of expectant care and end-of-life care in a role one setting. The panel of experienced medics and docs share their personal experiences and concerns regarding training and implementation of these types of care. They highlight the need for clear guidance and training for medics and corpsmen to make difficult decisions in the field. The panel also discusses the potential obstacles and unintended consequences of implementing clinical practice g...
Jun 10, 2024•56 min
Bryce, an 18 Delta out of the Special Forces group, discusses the challenges and strategies for training non-medics in medical skills. He emphasizes the importance of building a culture of medical training within the team and the benefits of cross-training. Bryce also highlights the impact of medical training on operational readiness and risk mitigation. He shares insights on mentorship, humility, and the progression of medical training for non-medics. Takeaways Building a culture of medical tra...
Jun 07, 2024•26 min
In this episode of the PFC Podcast, the speakers discuss the state of medics in Special Operations Medicine and offer recommendations for improvement. They highlight the importance of regular and realistic medical training at the unit level, as well as the need for feedback and accountability. The speakers also address specific issues such as lack of familiarity with protocols, equipment shortfalls, and training scars. They emphasize the need for critical thinking and individualized patient care...
Jun 03, 2024•44 min
