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 and assistance to special needs orphans. He describes the devastation of the war in Ukraine and the innovation of the local people in defending their towns. Dennis Price shares his experiences in Ukraine and his work in rescuing sexually trafficked children. He emphasizes the importance of doing the right thing for the right reasons and helping those in need. He also discusses the challenges of rescuing victims of human trafficking, including the influence of Stockholm syndrome and the need for a compassionate and nurturing approach. Dennis encourages listeners to get involved in organizations that are well-vetted and work closely with law enforcement. He also highlights the need to focus on the rescue mission and not engage in illegal activities. Dennis concludes by urging people to follow Heroes for Humanity on Instagram and support their efforts to make a difference. Click the link to support Heroes for Humanity https://www.zeffy.com/en-US/fundraising/a5925aa7-6994-4247-9271-527face51842 Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

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 importance of training and maintaining skills in a resource-constrained environment. The conversation explores the challenges of airway management in austere environments and the training and resources needed to optimize patient care. The speakers discuss the importance of experience and judgment in performing airway procedures and the need for ongoing training and skill sustainment. They highlight the differences between intubation and cricothyrotomy and the factors to consider when choosing the appropriate procedure. The conversation also touches on the training of role-one providers and the need for educational materials on difficult airway management. Takeaways The decision between intubation and cricothyrotomy depends on the resources available in the field. Intubation requires the ability to resuscitate the patient prior to the procedure and access to suction. Obtaining and administering sedation medications can be challenging in resource-constrained environments. Intubation can lead to hemodynamic instability and worsen shock in already unstable patients. Training and maintaining skills in a resource-constrained environment is crucial for successful airway management. Airway management in austere environments presents unique challenges and requires experience and judgment. Training and skill sustainment are crucial for optimizing patient care in these environments. The choice between intubation and cricothyrotomy depends on various factors, including patient stability and available resources. Role one providers need training and educational materials on difficult airway management. Standard of care should be maintained even in field environments, with deviations made consciously and deliberately. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

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 appropriate techniques and tools for airway management. In this conversation, Dr. Jim DuCanto and Dennis discuss various aspects of airway management. They cover topics such as the importance of recognizing the signs of airway compromise, the stages of anesthesia, the role of the spinal cord and reflexes in anesthesia, and the use of different techniques and tools in emergency airway management. They also touch on the potential risks and complications of airway management procedures and the importance of thorough physical examinations. Overall, the conversation emphasizes the need for preparedness, clinical judgment, and the ability to adapt to different situations in airway management. Takeaways Assess the patient's neurologic status and respiratory efforts in emergency airway management Consider the safety of the scene and the need for patient mobility Communicate clearly with the patient and explain the procedure Use appropriate techniques and tools for airway management The patient's ability to hear may persist even when they are unconscious under anesthesia. Emergency airway management requires an understanding of the patient's reflexes and potential resistance. Clinical judgment and the ability to adapt to different situations are crucial in airway management. Thorough physical examinations can provide valuable information in assessing the patient's condition. Preparedness and having the necessary tools and equipment readily available are essential in airway management. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

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 as possible. The key takeaway is that even in difficult situations, medics should strive to do everything they can for their patients. Takeaways Palliative care is an important aspect of patient care at all stages, not just at the end of life. Medics should prioritize efforts and provide pain control and symptom management to expectant patients. It is crucial for medics to reach out for support and guidance when making difficult decisions. Even if the outcome is not favorable, providing closure and knowing that everything possible was done can bring comfort to everyone involved. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

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 guidelines for expectant and end-of-life care. The conversation focuses on the need for guidance and training in making difficult medical decisions on the battlefield, particularly in the context of end-of-life care. The speakers discuss the importance of identifying patients who would most benefit from direct care and the potential moral injury that can occur when undertrained individuals are put in positions of medical directorship. They also explore the challenges of decision-making in mass casualty situations and the need for clear guidelines and policies. The conversation emphasizes the importance of having conversations about death and dying early in training and the need for realistic expectations and shared decision-making. Takeaways Expectant care and end-of-life care are important topics that need to be discussed and addressed in the role one setting. Training for medics and corpsmen in expectant and end-of-life care is currently inadequate and needs improvement. Clear guidance and clinical practice guidelines are necessary to help medics and corpsmen make difficult decisions in the field. Implementing expectant and end-of-life care guidelines may have unintended consequences and require careful consideration. Empowering medical directors to make decisions based on their unit's needs and training is important for effective implementation. The need for guidance and training in making difficult medical decisions on the battlefield, particularly in the context of end-of-life care The potential moral injury that can occur when undertrained individuals are put in positions of medical directorship The challenges of decision-making in mass casualty situations and the need for clear guidelines and policies The importance of having conversations about death and dying early in training and the need for realistic expectations and shared decision-making Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

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 training within the team is essential for operational readiness and risk mitigation. Mentorship and humility play a crucial role in the progression of medical training for non-medics. Cross-training non-medics in medical skills enhances the team's capability and confidence in providing patient care. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

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 rather than relying on algorithms. Overall, the podcast aims to improve the quality of medical training and performance among medics in Special Operations. Takeaways Regular and realistic medical training at the unit level is crucial for improving the skills and performance of medics in Special Operations. Feedback and accountability are essential for medics to identify and address their shortcomings. Familiarity with protocols, equipment, and drug administration is crucial for effective medical care. Training should focus on critical thinking and individualized patient care rather than relying on algorithms. Unit leaders and commanders should prioritize and support medical training to ensure the readiness of their medics. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠ or ⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this conversation, Dennis, Doug, and Justin discuss the development of a Sepsis Clinical Practice Guideline (CPG) for prolonged field care. They highlight the importance of early recognition and antibiotic administration in sepsis management. They also discuss the use of scoring systems like QSOFA and NEWS2 to aid in the identification of septic patients. The conversation covers the role of lactate monitoring and the potential confounding factors. They emphasize the need for a comprehensive assessment of the patient and the importance of not relying solely on one marker or number. The conversation also touches on the importance of proper catheter insertion and the consideration of prophylactic catheter replacement in austere environments. They discuss the use of fluids as the first-line treatment in septic patients and caution against over-resuscitation. The conversation concludes with a reminder to pay attention to the patient's response and not blindly adhere to formulas or protocols. In this conversation, the speakers discuss various aspects of sepsis management, including fluid resuscitation, the use of colloids, the importance of monitoring urine output, and the decision to initiate vasopressors. They also touch on the use of antibiotics and wound management in sepsis cases. The conversation provides valuable insights and practical tips for healthcare providers in austere environments. Takeaways Early recognition and timely administration of antibiotics are crucial in sepsis management. Scoring systems like QSOFA and NEWS2 can aid in the identification of septic patients. Lactate monitoring can be confounded by various factors, and a comprehensive assessment of the patient is necessary. Proper catheter insertion and prophylactic catheter replacement should be considered in austere environments. Fluids are the first-line treatment in septic patients, but over-resuscitation should be avoided. Pay attention to the patient's response and use clinical judgment rather than blindly following formulas or protocols. In sepsis cases, fluid resuscitation is crucial, and the choice of fluid depends on availability. Balanced electrolyte solutions like Ringer's lactate or plasma light are preferred, but normal saline can be used if that's all that's available. Colloids may be used in sepsis patients with high output losses or compartment syndrome. Options include FFP, albumin, or freeze-dried plasma. Monitoring urine output is important in assessing the response to fluid resuscitation. If urine output increases, it indicates a positive response. However, if urine output remains high despite fluid administration, it may indicate over-resuscitation. When considering the use of vasopressors, the decision should be based on the patient's blood pressure and mental status. If the patient remains hypotensive and shows no improvement after a substantial amount of fluid, vasopressors may be initiated. Antibiotics should be given empirically in sepsis cases, and the choice of antibiotic depends on the suspected source of infection. Wound management, including effective debridement and irrigation, is crucial in preventing infection. Regular assessment of wounds is important to identify any signs of infection or non-viable tissue. In austere environments, it may be necessary to make treatment decisions based on the patient's clinical presentation and endemic risk, even without confirmatory tests. The conversation highlights the importance of collaboration and mentorship in developing clinical practice guidelines and acknowledges the contributions of healthcare professionals in the field. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠ or ⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this episode, Doug and Dennis discuss the appropriate use of vasopressors, specifically epinephrine and norepinephrine, in the management of shock. They highlight the importance of fluids in sepsis resuscitation and the potential dangers of using high concentrations of epinephrine. They also discuss the different effects of epinephrine and norepinephrine on heart rate and blood pressure, and the potential side effects of epinephrine, such as arrhythmias and lactic acidosis. The conversation concludes with a discussion on the use of epinephrine in anaphylaxis and the importance of individualizing treatment based on the patient's response. Takeaways Epinephrine is commonly used as a vasopressor in the management of shock, but it should be used with caution due to its potential side effects. Norepinephrine is often preferred over epinephrine in sepsis resuscitation due to its more selective vasoconstrictive effects and lower risk of arrhythmias. Fluid resuscitation is an important component of sepsis management and should be prioritized before initiating vasopressor therapy. Monitoring the patient's response to vasopressor therapy, including blood pressure, heart rate, and organ perfusion, is crucial in determining the effectiveness and safety of the treatment. Individualizing treatment based on the patient's specific needs and response is essential in optimizing outcomes in shock management. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠ or ⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this podcast episode, Dennis and Andrew Fisher discuss the process of setting up a walking blood bank in a military setting. They emphasize the importance of practicing and adapting the process to specific needs. They recommend conducting ABO testing for all potential donors and identifying low-titer O donors as a preferred option. They also discuss the logistics of preparing supplies and coordinating with multiple units. The podcast concludes with a reminder of the importance of communication and planning in order to execute the process effectively. Takeaways Practicing and adapting the process of setting up a walking blood bank is crucial Conduct ABO testing for all potential donors and identify low-titer O donors Prepare supplies and coordinate with multiple units Effective communication and planning are key to executing the process successfully Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠ or ⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

In this conversation, Dennis interviews Victor about his experiences in Burma and his work with Free Burma Rangers. Victor discusses the changing dynamics of the conflict in Burma and the progress made by ethnic forces. He also talks about his role as a medic and the challenges of teaching combat medicine to indigenous groups. Victor emphasizes the importance of focusing on the basics and tailoring training to the specific needs of the students. He shares his experiences with teaching pressure points, tourniquets, casualty drags, and blood collection. Victor also reflects on the challenges of triage and decision-making in a mass casualty situation. During the conversation, Victor shares several lessons learned from his trip to Burma. He discusses the importance of going back to the basics and relying on ground reconnaissance when operating without ISR capabilities. He also highlights the need for movement and noise discipline to avoid detection by the enemy's reconnaissance planes and jets. Victor emphasizes the significance of good topside cover and concealment to protect against airstrikes and mortar attacks. He also talks about the challenges of providing prolonged field care and the importance of being mentally sharp and prepared for the continuous cycle of problems that arise during operations. Victor mentions the disbursement of medical equipment and the need for contingency plans in case of CCP destruction. Overall, the conversation provides valuable insights into the realities and complexities of operating in a hostile environment with limited resources. Takeaways The ethnic forces in Burma have been gaining ground and achieving significant victories in the conflict. Teaching combat medicine to indigenous groups requires focusing on the basics and tailoring training to their specific needs. Training on pressure points, tourniquets, casualty drags, and blood collection were essential for the indigenous groups in Burma. Triage and decision-making in a mass casualty situation can be challenging, but it is important to prioritize casualties based on their chances of survival. Rely on ground reconnaissance and basic skills when operating without ISR capabilities Maintain movement and noise discipline to avoid detection by enemy aircraft Seek good topside cover and concealment to protect against airstrikes and mortar attacks Be mentally sharp and prepared for the continuous cycle of problems during operations Disburse medical equipment strategically and have contingency plans in case of CCP destruction Here are some clips from Victor's experiences: https://youtu.be/dBkTziMluyk?si=DIwvc-SAHCJ81hSM https://youtu.be/wNKHL_OJ4TMsi=vC1WoJWH_hhKme1h Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠ or ⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

This podcast episode focuses on the importance of measuring urine output as a cheap and effective method for monitoring hemodynamics in prolonged field care. The hosts discuss the benefits of using a Foley catheter for urine measurement and emphasize the need for proper sterility during the procedure. They also touch on the topic of hypotensive resuscitation and the challenges of managing patients with low blood pressure in a prolonged field care setting. Takeaways Measuring urine output is a simple and cost-effective way to monitor a patient's hemodynamic status in a prolonged field care setting. A Foley catheter is a reliable tool for measuring urine output and can provide valuable information about a patient's overall health. Proper sterility is important when inserting a Foley catheter to prevent infections. Hypotensive resuscitation is a complex topic that requires further discussion and consideration in the context of prolonged field care. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠ or ⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this conversation, Dennis and Doug discuss crush syndrome and the challenges it presents in dynamic environments such as natural disasters or man-made incidents. They emphasize the importance of scene safety and the need to assess and stabilize any other traumatic injuries before addressing crush syndrome. They also discuss the use of tourniquets and the potential risks and benefits associated with their application. The conversation covers the management of crush syndrome, including fluid resuscitation, monitoring for cardiac complications, and the use of calcium and sodium bicarbonate. They highlight the need for a comprehensive approach to diagnosis and treatment, considering factors such as time of response and the presence of other injuries. In this conversation, Dennis and Doug discuss the management of crush syndrome in a resource-limited setting. They cover topics such as tourniquet use, fluid resuscitation, potassium management, and the use of sodium bicarbonate. They also touch on wound management and the importance of antibiotics. The conversation concludes with a discussion on the use of insulin and dextrose, as well as albuterol, in managing cardiac instability. Overall, the conversation provides a comprehensive overview of the management of crush syndrome in a challenging environment. Takeaways Scene safety is paramount in crush syndrome situations, and rescuers should be aware of potential hazards such as secondary devices, unstable structures, and chemical releases. Assessing and stabilizing any other traumatic injuries is crucial before addressing crush syndrome. The use of tourniquets in crush syndrome is a topic of debate, and a protocol should be in place to reassess their necessity and remove them as soon as possible. Fluid resuscitation is important in managing crush syndrome, and the amount and rate of fluid administration should be based on the patient's condition and available resources. Monitoring for cardiac complications, such as arrhythmias and acidosis, is essential, and interventions such as calcium and sodium bicarbonate may be necessary. A comprehensive approach to diagnosis and treatment is necessary, considering factors such as time of response and the presence of other injuries. Tourniquets can be used to manage crush syndrome in the lower extremities, but there is a risk of unnecessary amputations. Fluid resuscitation is important in stabilizing the patient and increasing urine output. Sodium bicarbonate can be used to manage metabolic acidosis and improve the effectiveness of vasopressors. Calcium can be given to stabilize cardiac rhythm, and insulin and dextrose can be used to manage high potassium levels. Albuterol can be used to treat respiratory acidosis, but it may be challenging to administer in a resource-limited setting. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠ or ⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this episode of the Prolonged Fuel Care Podcast, Dr. Ben Abo and Jordan Benjamin discuss snake envenomation. They debunk common myths about snakebite treatment, such as using tourniquets, extractors, ice, or cutting into the wound. They emphasize the importance of preparing for deployment in snake-infested areas by researching the local hazards and having the appropriate equipment. They provide a standardized snake bite assessment method, which involves a bottom-up top-down approach to identify the type of venom and the severity of the envenomation. They also discuss the decision-making process for airway management and the use of antivenom. The solution to snakebite envenomation is early and appropriate treatment with antivenom. It is important to irrigate the bite site and dilute the venom as quickly as possible. The use of tourniquets is not recommended, and if one is already applied, it should be slowly released. Pain management is crucial, and opioids and ketamine are effective options. Monitoring the progression of symptoms is more important than assigning a grade to the envenomation. Early intervention and proper training in snakebite management can lead to better outcomes. Takeaways Do not use tourniquets, extractors, ice, or cutting into the wound for snakebite treatment. Research the local hazards and have the appropriate equipment when deploying to snake-infested areas. Use a standardized snake bite assessment method to identify the type of venom and the severity of the envenomation. Make decisions about airway management based on the patient's symptoms and use tools like capnography and pulse oximetry. Antivenom is the key treatment for snake envenomation, and there are no absolute contraindications to its administration. The solution to snakebite envenomation is early and appropriate treatment with antivenom Irrigate the bite site and dilute the venom as quickly as possible Avoid using tourniquets, but if one is already applied, slowly release it Pain management is crucial, and opioids and ketamine are effective options Monitor the progression of symptoms rather than assigning a grade to the envenomation Early intervention and proper training in snakebite management can lead to better outcomes Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠ or ⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this podcast episode, Dennis interviews Pete, a former Navy Special Warfare medic with experience in maritime operations. They discuss the unique challenges of providing medical care in a maritime environment, including the need for self-extraction and the difficulties of working on an unstable platform. Pete emphasizes the importance of realistic training and self-reliance in maritime medicine. They also touch on the training of Ukrainian forces and the misconceptions surrounding tourniquet use. Overall, the conversation highlights the need for constant adaptation and a focus on patient survivability in maritime medical operations. Takeaways Providing medical care in a maritime environment presents unique challenges, including the need for self-extraction and working on an unstable platform. Realistic training and self-reliance are crucial in maritime medicine, as medical professionals must be prepared to adapt to the dynamic nature of the environment. Training Ukrainian forces in medical skills requires expectation management and prioritizing the most essential knowledge and skills within a limited timeframe. Misconceptions surrounding tourniquet use in Ukraine highlight the importance of proper training and understanding of when and how to apply tourniquets. In maritime medical operations, constant adaptation and a focus on patient survivability are key to providing effective care. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠ or ⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

Ricky and Justin discuss their research on the administration of calcium in hemorrhagic shock. They explain how they became interested in the topic and the gaps they identified in current medical knowledge. They discuss the importance of calcium in the clotting cascade and the potential role of citrate in contributing to hypocalcemia. They also explain the protocol for administering calcium in the field and the different forms of calcium that can be used. They discuss the risks of overcorrection of hypocalcemia and the need for further research on the topic. Overall, their research aims to improve patient outcomes and reduce mortality in hemorrhagic shock. Takeaways Calcium plays a crucial role in the clotting cascade and may be important in the treatment of hemorrhagic shock. Hypocalcemia is common in trauma patients and may contribute to increased mortality. The administration of calcium, along with blood products, can help prevent hypocalcemia and improve patient outcomes. The protocol for administering calcium in the field includes giving one gram upfront and one gram every four units of threshold blood. There is a risk of overcorrection of hypocalcemia, which can lead to hypercalcemia and increased mortality. Further research is needed to determine the optimal timing and dosage of calcium administration in hemorrhagic shock. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠ or ⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this podcast episode, Dennis interviews Steve Schauer about his calcium study in trauma patients. Steve provides an introduction to himself and his background in emergency medicine and research. He explains that the study aims to determine the prevalence of calcium derangement in trauma patients upon arrival at the trauma center. The study is being conducted at three different trauma centers and has completed enrollment. Steve also discusses the challenges of extrapolating research findings from military trauma to civilian trauma. They also touch on the limitations of the Injury Severity Score (ISS) in assessing military trauma. The conversation then delves into the logistics of the study, including the collection of calcium levels and the potential impact of pre-hospital blood transfusions on calcium levels. They discuss the importance of timing and accuracy in collecting calcium levels and the need for better documentation in trauma care. They also explore the administration of calcium and the differences between calcium gluconate and calcium chloride. Steve emphasizes the importance of administering calcium slowly to avoid adverse effects. They also discuss the timing of calcium administration in relation to blood transfusions and the challenges of determining the optimal calcium levels in trauma patients. The episode concludes with a discussion on the need for iStat machines in trauma centers to monitor calcium levels in real-time. In this conversation, Dennis and Steven Schauer discuss the administration of calcium in trauma patients. They explore the role of calcium in the coagulation cascade and its potential benefits in improving hemodynamics. They also discuss the challenges of administering calcium in the field and the need for further research to determine its efficacy. The conversation highlights the importance of prioritizing blood and tranexamic acid (TXA) administration before considering calcium. Overall, the conversation provides valuable insights into the use of calcium in trauma care. Takeaways The study aims to determine the prevalence of calcium derangement in trauma patients upon arrival at the trauma center. Extrapolating research findings from military trauma to civilian trauma poses challenges due to differences in injury mechanisms. The Injury Severity Score (ISS) has limitations in assessing military trauma. Timing and accuracy are crucial in collecting calcium levels in trauma patients. Calcium administration should be done slowly to avoid adverse effects. Determining the optimal calcium levels in trauma patients is challenging. iStat machines can be valuable in monitoring calcium levels in real-time. Calcium is a cofactor in the coagulation cascade and may play a role in improving hemodynamics in trauma patients. The administration of calcium should be prioritized after blood and tranexamic acid (TXA) in trauma care. The optimal method of calcium administration, such as infusion plus drip, is still under investigation. Further research is needed to determine the efficacy of calcium in trauma care. The availability of resources and logistics may influence the choice of calcium formulation for administration. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠ or ⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this episode, Jim discusses the importance of adapting to the changing world and the need to prioritize the well-being of soldiers. He emphasizes the need for commanders and medical providers to understand the risks and challenges faced by the national treasure, the sons and daughters of the nation. Jim highlights the changing nature of warfare and the need to adapt to austere and rapidly evolving environments. He also discusses the importance of whole-of-government approaches and the need for joint, inter-organizational, and multinational collaboration. Jim encourages listeners to develop adaptive thinking and to be prepared to win in a complex world. Takeaways The well-being of soldiers should be the top priority for commanders and medical providers Adapting to the changing world and the challenges of warfare is crucial Whole-of-government approaches and collaboration are essential for success Developing adaptive thinking and being prepared to win in a complex world is necessary Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

In this podcast episode, Dennis interviews Alex McDonald, a medical student and member of Tactical Medicine New Zealand, about the republishing of the book 'Guerilla Surgeon.' The book tells the story of Dr. Lindsay Rogers, a New Zealand-born surgeon who served with the Special Operations Executive in Yugoslavia during World War II. The conversation covers topics such as the challenges of providing medical care in resource-limited environments, building trust with local forces, and the importance of cultural competency. Alex also discusses the mission of Tactical Medicine New Zealand and their partnership with the Special Operations Medical Association (SOMA) to republish the book. Takeaways The book 'Guerilla Surgeon' tells the story of Dr. Lindsay Rogers, a New Zealand-born surgeon who served with the Special Operations Executive in Yugoslavia during World War II. Providing medical care in resource-limited environments requires improvisation and making the most of available resources. Building trust with local forces is crucial for successful medical operations in foreign nations. Cultural competency is important for effective communication and collaboration with partner forces. Tactical Medicine New Zealand aims to promote and advance tactical medicine in New Zealand and has partnered with SOMA to republish 'Guerilla Surgeon.' Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠www.prolongedfieldcare.org ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

Dr. Van Wyk discusses updates in traumatic brain injury (TBI) management, focusing on the CRASH 3 trial and the use of tranexamic acid (TXA). He explains that TXA is safe and reduces head injury-related death, particularly in patients with moderate and mild TBI. He also discusses the use of hypertonic saline and recommends considering higher concentrations, such as 23.4%, which have been shown to be safe and effective. Dr. Van Wyk mentions the use of sodium bicarbonate as an alternative and emphasizes the importance of clinical judgment in determining the appropriate treatment. He also discusses monitoring options for cerebral edema and increased intracranial pressure, such as optic nerve sheath diameter measurements. Finally, he touches on the topic of decompressive hemicraniectomy and the considerations for performing this procedure in austere environments. Takeaways Tranexamic acid (TXA) is safe and reduces head injury-related death in patients with moderate and mild traumatic brain injury (TBI). Higher concentrations of hypertonic saline, such as 23.4%, may be considered as they have been shown to be safe and effective. Sodium bicarbonate can be used as an alternative to hypertonic saline, particularly in austere environments. Optic nerve sheath diameter measurements can be used to monitor cerebral edema and increased intracranial pressure. Decompressive hemicraniectomy may be considered in severe TBI cases, and general surgeons may be trained to perform the procedure in the absence of a neurosurgeon. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

Summary: In this conversation, Dennis and Ian discuss the new high altitude Clinical Practice Guideline (CPG) in the Joint Trauma System. They cover topics such as acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). They discuss the pathophysiology, symptoms, diagnosis, and treatment options for these conditions. They also touch on pre-treatment strategies and the use of portable hyperbaric chambers. Overall, the conversation provides a comprehensive overview of altitude-related illnesses and their management. In this conversation, Dennis and Ian discuss the treatment options for altitude illness, specifically AMS, HAPE, and HACE. They cover the use of pharmacologic therapy, oxygen, and portable hyperbaric chambers to stabilize and bring down patients with altitude illness. They also discuss the use of dexamethasone as the primary treatment for HACE and the potential use of hypertonic saline for extreme cases. They touch on the side effects of dexamethasone and the importance of protecting the airway. They also mention the use of acetazolamide for prophylaxis and the benefits of intermittent hypoxic exposure. Finally, they discuss the importance of good nutrition and hydration and the new medic encounter form for recording data on altitude illness. Takeaways: Acute mountain sickness (AMS) occurs when the body does not have enough time to acclimatize to the physiological stress of altitude. High altitude cerebral edema (HACE) is characterized by ataxia and can occur even without AMS symptoms. High altitude pulmonary edema (HAPE) is characterized by decreased exercise tolerance and tachypnea. Assessment of vital signs, such as heart rate and respiratory rate, can help differentiate between altitude illnesses. Portable hyperbaric chambers can be used to stabilize patients with altitude illnesses until they can be brought down to lower altitudes. Pharmacologic treatments, such as acetazolamide and dexamethasone, can be used for prophylaxis and treatment of altitude illnesses. Improvement in symptoms of HAPE can be rapid with oxygen therapy. Pre-treatment strategies, such as using acetazolamide, can help acclimatize the body to altitude before ascent. Pharmacologic therapy, oxygen, and portable hyperbaric chambers can be used to stabilize and bring down patients with altitude illness. Dexamethasone is the primary treatment for HACE, and hypertonic saline may be considered for extreme cases. Side effects of dexamethasone include increased sugar, gastric erosions, gastric bleeding, and adrenal suppression. Acetazolamide can be used for prophylaxis, and intermittent hypoxic exposure may help with acclimatization. Good nutrition, hydration, and iron status are important for preventing altitude illness. The new medic encounter form is a valuable tool for recording data on altitude illness. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

In this podcast episode, Jay Baker discusses the topic of SOF surgical support in Special Operations Forces (SOF). He compares the different types of missions that soft surgical teams might be called upon to support and describes the gap that exists in institutional experience for surgical support in the setting of unconventional warfare. Baker highlights the lessons learned from surgical support in World War II and emphasizes the need to prepare for providing surgical support in more challenging environments. He also discusses the efforts being made to improve soft surgical support, including the development of RSOF surgical teams and the Prolonged Field Care initiative. Takeaways Sof surgical support in Special Operations Forces (SOF) is an evolving problem set that requires preparation for providing surgical support in more challenging environments. Lessons can be learned from surgical support in World War II, where surgeons provided care in dangerous and challenging environments. Efforts are being made to improve soft surgical support, including the development of RSOF surgical teams and the Prolonged Field Care initiative. Training and experience in caring for critical patients over longer periods of time, performing tactical evacuations, and developing innovative solutions to resupply challenges are important for soft surgical teams.

Maggot therapy, also known as maggot debridement therapy (MDT), is a treatment that uses live maggots to clean and heal wounds. The therapy has a long history, dating back thousands of years, and has been used in various settings, including war zones and modern hospitals. Maggots are effective in wound healing because they eat necrotic tissue, have antimicrobial properties, and promote the growth of new tissue. The therapy is cost-effective and can be used in low-resource settings. It can be applied directly to the wound or placed in a mesh bag. Maggot therapy is often used as an adjunct to antibiotics and other wound treatments. Takeaways Maggot therapy is a cost-effective and efficient treatment for wound healing. Maggots eat necrotic tissue, have antimicrobial properties, and promote the growth of new tissue. The therapy can be used in various settings, including war zones and low-resource environments. Maggot therapy can be used as an adjunct to antibiotics and other wound treatments. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

In this podcast episode, Doug discusses the use of End-tidal CO2 monitoring in medical practice. End-tidal CO2 is used to monitor the percent of carbon dioxide in blood that has been returned to the lungs. It is commonly used to confirm the placement of an endotracheal tube and to monitor ventilation during surgery. In the field, End-tidal CO2 monitoring is particularly useful for trauma patients and those with severe traumatic brain injuries. However, it is important to note that End-tidal CO2 should be used as part of a comprehensive approach to patient care, and clinical judgment is still crucial in making treatment decisions. Takeaways End-tidal CO2 monitoring is used to confirm the placement of an endotracheal tube and to monitor ventilation during surgery. In the field, End-tidal CO2 monitoring is particularly useful for trauma patients and those with severe traumatic brain injuries. End-tidal CO2 should be used as part of a comprehensive approach to patient care, and clinical judgment is still crucial in making treatment decisions. Other markers of resuscitation, such as lactate levels, may provide more valuable information in certain situations. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

In this episode, Dennis interviews John and Paul about the Abdominal Aortic and Junctional Tourniquet (AAJT). They discuss the background and reasons for inventing the AAJT, including the need to control bleeding in the pelvis. They also talk about the first application of the AAJT and the positive results seen in combat situations. The conversation then moves on to study data and research on the device, including some negative studies that have been conducted. They also discuss the pressure levels used with the AAJT and the potential for extending the application time. Finally, they address the negative consequences of high pressure and the comfort level of wearing the device. The conversation explores the application and function of the Abdominal Aortic Junctional Tourniquet (AAJT) and its potential use in pre-hospital care. It discusses the challenges of prolonged application and the risks associated with it. The conversation also delves into alternative techniques and future developments in the field. The importance of reperfusion and monitoring is highlighted, along with the impact of the AAJT on breathing and inspiratory pressure. The discussion touches on the considerations for reducing pressure during reperfusion and the duration of application. The risk-benefit analysis of heroic interventions is examined, emphasizing the need for rapid hemorrhage control. The limitations and risks of Roboa are discussed, and a cadaveric study on the AHAT is presented. The conversation concludes with the role of the AHAT in preparing for future wars and its potential use in traumatic cardiac arrest. Takeaways The AAJT was invented to control bleeding in the pelvis and junctional areas. The device has been successfully used in combat situations and has saved lives. There have been several studies conducted on the AAJT, with mixed results. The device applies pressure to occlude blood flow, but the pressure levels are safe and well-tolerated. The Abdominal Aortic Junctional Tourniquet (AAJT) is a fielded device that can be used for rapid hemorrhage control in non-compressible torso hemorrhage. Prolonged application of the AAJT should be avoided, and it is important to consider the risks and benefits of its use. Alternative techniques and future developments, such as foams, are being explored for the treatment of non-compressible torso hemorrhage. Reperfusion and monitoring are crucial considerations when using the AAJT, and the pressure can be reduced during transfusion to mitigate ischemic change. The AAJT has shown promising results in traumatic cardiac arrest and can be a valuable tool in pre-hospital care. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

In this podcast episode, Dennis and Ian discuss heat injuries and illnesses. They cover the background science of body heat and heat transfer, as well as the different types of heat injuries, including heat cramps, heat syncope, heat exhaustion, and heat stroke. They emphasize the importance of hydration and urine color as indicators of hydration status. The treatment for heat stroke involves cooling the body as quickly as possible, with immersion in ice water or the use of ice sheets being the most effective methods. They also discuss the importance of acclimatization to heat and the need for prompt evacuation in cases of heat stroke. Takeaways Heat injuries and illnesses can range from minor heat cramps to life-threatening heat stroke. The body dissipates heat through radiation, conduction, convection, and evaporation. Hydration is crucial in preventing heat injuries, and urine color can be used as an indicator of hydration status. Heat stroke is a medical emergency that requires immediate cooling of the body. Acclimatization to heat and proper planning can help prevent heat injuries. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

In this episode, Dennis and Alex discuss the truth about pelvic binders and their relevance in trauma care. They explore the background and experience of Alex, who has extensive knowledge in trauma surgery. They delve into the anatomy and injury patterns of pelvic fractures, as well as the different phases of damage control surgery. They also discuss the importance of understanding research and the levels of evidence. The conversation highlights the contradictory evidence surrounding the use of pelvic binders and emphasizes the need to critically evaluate citations and research findings. This conversation covers blast injuries, types of pelvic fractures, mortality rates, considerations for prolonged field care (PFC), the flow of care in PFC, normalization and observation, initial stabilization, massive transfusion protocol, futile transfusions, clinical decision making, pelvic binder design, imaging challenges, ultrasound for pelvic fracture assessment, duration of pelvic binder use, preventing pressure sores, consulting with medical professionals, proper application of pelvic binder, retroperitoneal hemorrhage, the role of telemedicine, critical care and decision making, and resources for further learning. Takeaways Understanding the anatomy and injury patterns of pelvic fractures is crucial in trauma care. The levels of evidence in research range from high-quality studies to expert opinions. The use of pelvic binders in trauma care is a topic of debate, with conflicting evidence and opinions. It is important to critically evaluate citations and research findings to make informed decisions in patient care. Understanding blast injuries and the different types of pelvic fractures is crucial in providing effective care in PFC. Mortality rates for pelvic fractures vary depending on the severity of the injury and associated injuries. Clinical decision making in PFC requires a thorough understanding of the patient's condition and available resources. Proper application and duration of pelvic binder use are important considerations in PFC. Consulting with medical professionals and seeking skeptics' opinions can help in making informed decisions in PFC. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

In this podcast episode, Dennis and Ricky discuss how to pick and evaluate research papers to inform medical practice. They differentiate between causative research papers and retrospective observational studies, emphasizing the importance of reading the methods section to determine the validity of the research. They also highlight the common mistakes people make when reading research papers, such as relying solely on the title and abstract. The conversation delves into the challenges of conducting pre-hospital research and the difficulties in applying research findings to practice. Ricky also shares his experiences in mentoring aspiring medical school applicants and launching a new podcast.Takeaways Differentiate between causative research papers and retrospective observational studies when reading research papers. Read the methods section to determine the validity of the research and understand the inclusion and exclusion criteria, statistical analysis, and potential biases. Avoid common mistakes when reading research papers, such as relying solely on the title and abstract. Consider the challenges of conducting pre-hospital research, including data collection and controlling for environmental factors. Extrapolate research findings to pre-hospital practice by discussing and collaborating with other providers. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠ or ⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

This conversation explores the topic of gas anesthesia, its historical background, and its use in various environments. The conversation covers the shift to the TIVA technique, the importance of the anesthesia machine and equipment, and the training required to administer gas anesthesia. It also discusses the combined techniques used in the operating room and the stages of anesthesia. The conversation highlights the advantages and disadvantages of ether and chloroform as anesthetics. It emphasizes the need for vigilant monitoring and the use of IV induction agents for safety. The conversation concludes by discussing the duration of gas anesthesia and the importance of witnessing wakeups. Takeaways Gas anesthesia has a long history and is still used today in various environments. The TIVA technique is a popular approach to gas anesthesia, especially in field environments. The anesthesia machine and equipment play a crucial role in administering gas anesthesia. Vigilant monitoring is essential during gas anesthesia to ensure patient safety. Witnessing the stages of anesthesia, including wakeups, is important for understanding the process. Ether and chloroform were popular anesthetics in the past but have been replaced by safer alternatives. IV induction agents are used to quickly transition patients through the stages of anesthesia. The duration of gas anesthesia depends on the amount and length of use. Observing gas anesthesia in the operating room provides valuable insights into its application. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠ or ⁠www.lobocoffeeco.com/product-page/prolonged-field-care

This episode of the PFC podcast focuses on in-route casualty care. The guest, Nikki, shares her background and experience in the Navy and explains why she started an in-route care training course. The conversation covers common mistakes in preparing patients for flight, securing lines and equipment, and the importance of constant assessment and monitoring. Nikki also discusses the training scenarios she uses to prepare nurses and corpsmen for in-route care. The episode concludes with a discussion on effective handovers, monitoring endotracheal tube placement, and the importance of collaboration in in-route care. Takeaways Proper planning and assessment are crucial in in-route casualty care. Securing lines and equipment and packaging the patient appropriately are important considerations for flight. Constant assessment and monitoring are essential during in-route care. Effective handovers and communication are critical for patient care during transport. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care

In this conversation, Dennis and John discuss chest trauma management, specifically the use of chest seals and the sequence of interventions. They explore the overuse of chest seals and the potential complications they can cause. They also discuss the importance of assessing the patient and determining if a chest seal is necessary. John shares his insights on the use of finger thoracostomy and the technique for performing it. They also touch on the revision of the TCCC algorithm and the need to prioritize hemorrhage control. The conversation explores the challenges and approaches in operational medicine, emphasizing the need to align policy and guidelines with the experiences of field practitioners. It highlights the importance of preserving the rich experience and lessons learned by experienced personnel. The discussion also delves into the management of chest trauma, specifically focusing on emergent situations and the challenges in current practices. The conversation concludes with the anticipation of future discussions and the potential for further exploration of the topics. Takeaways Chest seals should be used specifically for sucking chest wounds or open pneumothorax. Chest seals can cause tension pneumothorax if used inappropriately. The decision to use a chest seal should be based on the patient's breathing status and the nature of the injury. Negative suction can be beneficial in re-inflating the lung and improving oxygenation in patients with chest trauma. The TCCC algorithm may need revision to prioritize hemorrhage control. Operational medicine requires a balance between algorithmic approaches and the practical experiences of field practitioners. Preserving the experience and lessons learned by experienced personnel is crucial for the development of effective policies and guidelines. Chest trauma management involves various emergent situations, including tension pneumothorax, hemothorax, and pneumothorax. Challenges in chest trauma management include the use of occlusive dressings and the need for surgical interventions. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠ or ⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this podcast episode, Dennis interviews Monte from Delta Development about the need for a small blood refrigerator for prolonged field care. Monte shares his military background and experiences in Afghanistan and Iraq, where he realized the importance of carrying blood products in the field. They discuss the challenges of storing and transporting blood, including temperature control and cumulative time. Monte explains how Delta Development's blood refrigerator solves these issues and can even be used to run a mini blood bank. They also touch on the future possibilities of resupplying blood in the field. Overall, the podcast highlights the critical role of blood in prolonged field care and the importance of proper storage and transport methods. Takeaways Carrying blood products in the field is crucial for prolonged field care. Temperature control and cumulative time are key factors in blood storage and transport. Delta Development's blood refrigerator provides a solution for maintaining proper blood temperature in austere environments. The device can be used to run a mini blood bank and facilitate blood resupply in the field. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective

In this conversation, Dennis and Mike discuss the process of providing medical care and education in austere environments. They emphasize the importance of understanding the requirements and asking the right questions to ensure success. They also discuss the significance of analyzing the environment, finding reliable sources of information, and building relationships with partners and friends. Planning and preparation are highlighted as crucial steps, along with effective teaching methods and the use of the Learning to Listen, Listening to Teach technique. The conversation concludes with a discussion on measuring performance and effectiveness, and the importance of flexibility and focusing on the student. Takeaways Understand the requirements and ask the right questions to ensure success in providing medical care and education in austere environments. Analyze the environment and find reliable sources of information to make informed decisions. Build relationships with partners and friends to enhance understanding and collaboration. Plan and prepare thoroughly, focusing on the basics and acquiring the necessary knowledge. Use effective teaching methods and the Learning to Listen, Listening to Teach technique to engage and educate students. Measure performance and effectiveness to assess the impact of the medical care and education provided. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective

In this conversation, Dennis and Justin discuss lessons learned in analgesia and sedation. They emphasize the importance of understanding medications and dosages, as well as having a plan for drug administration. They share case studies and examples of the wrong drug being used in the wrong situation. They also highlight the need for a strong foundation in medication knowledge and the importance of setting measurable goals for pain control. They caution against following trends and emphasize the importance of individual patient responses and safety measures. Takeaways Understand the medications and dosages you are using Have a plan for drug administration and set measurable goals for pain control Avoid using the wrong drug for the situation Build a strong foundation in medication knowledge Avoid following trends and focus on individual patient responses and safety measures Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠deltadevteam.com⁠⁠⁠ For more content go to ⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠ Consider supporting us: ⁠⁠⁠patreon.com/ProlongedFieldCareCollective

In this conversation, Aaron Epstein from GSMSG discusses the background and formation of GSMSG, their focus on training partners rather than providing services, and their work with military and security forces around the world. He shares lessons learned in surgical resuscitation, dealing with mass casualties, and planning for different phases of war. Aaron emphasizes the importance of tourniquet use and the need for more surgeons in combat situations. He also discusses the challenges in the training pipeline and the need for more medical training. The conversation concludes with a discussion on transportation challenges and lessons learned, as well as how to get in contact with GSMSG.Takeaways GSMSG focuses on training partners rather than providing services. Tourniquet use is vital in combat situations and should not be removed from the treatment algorithm. Planning for different phases of war, including defensive, static, and offensive actions, is crucial for effective medical support. There is a need for more surgeons and better medical training in combat situations. Transportation challenges in combat zones require innovative solutions. GSMSG can be contacted through their website, www.gsmsg.org. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠deltadevteam.com⁠⁠ For more content go to ⁠⁠www.prolongedfieldcare.org⁠⁠ Consider supporting us: ⁠⁠patreon.com/ProlongedFieldCareCollective

In this podcast episode, Dennis talks with Doug (an ICU doctor) about acute kidney injury. They discuss the causes and types of acute kidney injury, how to recognize it, and the treatment options available. They also cover the recovery and prognosis of acute kidney injury, as well as the crush injury protocol and managing potassium levels. The episode provides valuable insights for healthcare practitioners dealing with acute kidney injury in prolonged field care situations. Takeaways Acute kidney injury can be caused by a drop in perfusion to the kidneys, blockage of urine flow, or toxic injury to the kidneys. Recognizing acute kidney injury is important, and urine output and laboratory tests can help in the diagnosis. Treatment of acute kidney injury involves preventing further injury, ensuring adequate volume replacement, and adjusting medication dosages. Most young healthy kidneys will recover from a hypoxic type of injury, but toxic injuries may cause irreversible damage. The crush injury protocol includes bicarbonate, albuterol, insulin, and glucose to manage potassium levels. Monitoring and adjusting treatment is crucial, and Lasix may be used in certain cases of acute kidney injury. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠deltadevteam.com⁠ For more content go to ⁠www.prolongedfieldcare.org⁠ Consider supporting us: ⁠patreon.com/ProlongedFieldCareCollective

In this podcast episode, Dennis interviews David Hardin, a general surgeon with experience in austere environments. They discuss the differences between surgeons in first-world and austere environments, the importance of improvisation, training and manpower considerations, supplies and procedures in austere surgery, moving patients in austere environments, preparing for austere surgery, making decisions in austere environments, logistics and equipment, dealing with loss, preparing for unknowns, coping with emotional stress, and finding joy in austere surgery. Takeaways Austere surgery requires improvisation and resourcefulness due to limited supplies and equipment. Training and teamwork are crucial in austere surgery, and having a resilient and adaptable team is important. In austere environments, decisions must be made based on available resources and the best interest of the patient. Preparing for austere surgery involves pre-planning, understanding the environment, and being mentally and physically prepared. Coping with loss and emotional stress is a challenge in austere surgery, and supporting and insulating team members is important. Finding joy in the work and being grateful for the opportunity to help others can sustain surgeons in austere environments. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠deltadevteam.com⁠ For more content go to ⁠www.prolongedfieldcare.org⁠ Consider supporting us: ⁠patreon.com/ProlongedFieldCareCollective⁠

In this podcast episode, Dennis talks with Mark, a trauma surgeon, about lower extremity trauma and limb salvage. They discuss the decision-making process for determining if a limb is salvageable or not, the risk vs reward of tourniquet approximation, assessing motor function and arterial supply, the importance of preserving limb length, and the use of traction in pelvic fractures. They also touch on the struggles medics face in making these decisions and the importance of training and experience.Takeaways Assessing motor function and arterial supply are key factors in determining if a limb is salvageable or not. Preserving as much length and soft tissue as possible is important for future prosthetic use. The risk vs reward of tourniquet approximation should be carefully considered, weighing the potential for continued bleeding against the need to preserve tissue. In cases of pelvic fractures with concomitant femur fractures, traction may be necessary but should be monitored to prevent skin necrosis. Training and experience are crucial in making informed decisions about limb salvage in traumatic injuries.

In this podcast episode, Dennis and Antonio discuss the challenges and friction points that arise when working with providers from different countries. They explore how to iron out these issues efficiently to provide good care. The conversation covers topics such as common friction points on the ground, resolving conflicts and revamping protocols, establishing leadership, and learning from local providers. They also discuss the importance of adapting to different practices and resolving conflicts during handovers. Antonio shares insights from his own experiences and highlights the need for effective communication and collaboration in international healthcare settings. Takeaways Working with providers from different countries can lead to friction due to different protocols and approaches. Resolving conflicts and ironing out issues early on is crucial for providing good care. Effective communication and collaboration are key to navigating challenges in international healthcare settings. Learning from local providers and adapting to different practices can enhance patient care and outcomes. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org Consider supporting us: patreon.com/ProlongedFieldCareCollective

In this podcast episode, Dennis and Doug discuss the importance of team dynamics in critical care, specifically when dealing with critically injured patients. They highlight the challenges that arise when team members work individually and fail to communicate effectively. The conversation explores the team dynamics at Baltimore Shock Trauma, where roles and positions are protocolized to ensure efficient patient care. The role of the team leader is emphasized as crucial in overseeing the entire resuscitation process and preventing crucial details from being missed. The episode concludes with a discussion on training for team dynamics in both solo medic scenarios and mass casualty situations. Takeaways Effective team dynamics are crucial in critical care settings to ensure efficient and comprehensive patient care. Protocolizing roles and positions within a team can help streamline the resuscitation process and prevent crucial details from being missed. The team leader plays a vital role in overseeing the entire resuscitation process and maintaining a global perspective. Training for team dynamics should be conducted in both solo medic scenarios and mass casualty situations, with an emphasis on empowering all team members to contribute and communicate effectively.

In this podcast episode, Dennis interviews JR Pickett, an ER physician and EMS medical director, about excited delirium. They discuss the definition and history of excited delirium, the challenges faced by law enforcement and medical providers in managing these cases, and the importance of timely intervention. They also explore the differences between excited delirium and other conditions, such as combative patients in combat situations. The conversation highlights the need for proper assessment and observation of patients exhibiting excited delirium and the selection of appropriate medications for sedation. The podcast concludes with a discussion on the criminalization of medical care and the impact it may have on patient outcomes. Takeaways Excited delirium is a complex condition characterized by a disturbed state of mind, violent behavior, and physiological elevation. It has a long history and has been associated with various names over the years. Law enforcement and medical providers face challenges in managing patients with excited delirium, as they must balance the need to protect the individual and others with the potential risks of sedation. Differentiating excited delirium from other conditions, such as combative patients in combat situations, can be challenging but is crucial for appropriate management. Proper assessment and observation of patients exhibiting excited delirium are essential for determining the most appropriate interventions and medications for sedation. The criminalization of medical care is a concerning trend that may discourage medical providers from engaging in high-risk situations and could have negative consequences for patient outcomes. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org Consider supporting us: patreon.com/ProlongedFieldCareCollective

Dr. Mark Shapiro discusses resilience and teamwork in the medical field during the COVID-19 pandemic. He highlights the differences between the civilian medical system and the military's approach to stress and resilience training. Dr. Shapiro emphasizes the importance of identifying and teaching resilience in medical professionals, as well as integrating stress inoculation into medical education. He also discusses the challenges of working in a crisis and the need for effective team composition and communication. Dr. Shapiro concludes by sharing his hopes for the future of the medical system and the lessons learned from the current pandemic. Takeaways Resilience and stress inoculation are crucial in the medical field, but are often lacking in the civilian medical system. Teaching resilience and stress management should be integrated into medical education to prepare medical professionals for high-stress situations. Effective team composition and communication are essential in crises to ensure the best patient care. Experience and exposure to stress and difficult situations can help medical professionals develop resilience and adaptability. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to ⁠www.prolongedfieldcare.org⁠ Consider supporting us: ⁠patreon.com/ProlongedFieldCareCollective

Today I chat with the Godfathers of PFC and discuss the concept of Prolonged Field Care (PFC) and its importance in military and civilian medical settings. It highlights the need for PFC in situations where evacuation is delayed or not possible, and the challenges faced by medics in providing care in such scenarios. The conversation also explores the civilian analog of PFC and the importance of risk management and training. It emphasizes the principles and evidence-based medicine behind PFC and the need for creativity and improvisation. The conversation concludes with gratitude towards the community involved in advancing PFC.Takeaways Prolonged Field Care (PFC) is essential in situations where evacuation is delayed or not possible, and medics need to provide extended care to patients. The concept of PFC is not limited to the military and has applications in civilian medical settings as well. Risk management and training are crucial in preparing medics for PFC scenarios. Principles and evidence-based medicine form the foundation of PFC, and creativity and improvisation are key in finding solutions in resource-limited environments. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org

Dr. Ryan Maves discusses clinical medicine topics, specifically malaria and other tropical diseases. He emphasizes the importance of preventing infections when traveling in tropical and remote areas through vaccination, hand hygiene, malaria prophylaxis, insect repellents, and safer sex habits. He also provides resources for pre-deployment information. Dr. Maves shares a cautionary tale of a Marine Corps Lance Corporal with severe malaria and highlights the need for vigilance in diagnosing and treating tropical diseases. He discusses major tropical diseases, the workup of febrile travelers, and treatment options for malaria on deployment. He concludes by emphasizing the importance of improving care for infections in prolonged field care.Takeaways Preventing infections is crucial when traveling in tropical and remote areas, and measures such as vaccination, hand hygiene, malaria prophylaxis, insect repellents, and safer sex habits should be followed. Vigilance is necessary in diagnosing and treating tropical diseases, especially malaria, which can have severe consequences if not promptly addressed. Major tropical diseases to be aware of include malaria, dengue, zika, chikungunya, yellow fever, meningococcus, and cholera. The workup of febrile travelers should include a detailed chronology of illness, assessment of exposures and syndromes, and appropriate diagnostic tests. Treatment options for malaria on deployment include Malarone and Coartem, with Coartem being the preferred oral antimalarial therapy. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org

In this podcast episode, Dennis and Jeff discuss anoxic brain injury, its causes, progression, and treatment. They emphasize the importance of preventing anoxic brain injury by following the March algorithm and maintaining blood flow, airway patency, and oxygenation. They also discuss the role of monitoring and airway management in identifying and treating anoxic brain injury. The podcast covers the decision-making process for airway management and the importance of maintaining adequate oxygenation and blood pressure. The hosts also highlight the need to prevent secondary problems, such as pain, agitation, and seizures, and discuss resuscitation goals for anoxic brain injury. Takeaways Preventing anoxic brain injury is crucial and can be achieved by following the March algorithm and maintaining blood flow, airway patency, and oxygenation. Monitoring and airway management are essential in identifying and treating anoxic brain injury. The decision-making process for airway management should consider the patient's condition, available resources, and the provider's proficiency. Maintaining adequate oxygenation and blood pressure is crucial in preventing and treating anoxic brain injury. Preventing secondary problems, such as pain, agitation, and seizures, is important in the management of anoxic brain injury. Resuscitation goals for anoxic brain injury include maintaining a systolic blood pressure of 120-140 and a pulse oximetry saturation of at least 90%. Collaboration with neurocritical care specialists can help optimize fluid management and prevent further brain injury. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org

In this podcast episode, Dennis discusses the history and evolution of medical support in guerrilla warfare. He explores the role of unconventional warfare in the Army and provides examples of guerrilla warfare campaigns. Dennis also delves into the importance of surgical teams and the challenges of providing medical care in prolonged field care scenarios. He highlights the shift from the golden hour concept to the need for prolonged care in remote areas. Dennis concludes by discussing the future of medical support in guerrilla warfare and the importance of reevaluating medical norms. Takeaways Unconventional warfare (UW) has always been a challenge for the Army, but it plays a crucial role in achieving strategic objectives. Surgical teams are essential in guerrilla warfare scenarios, providing medical care to both indigenous forces and American personnel. The concept of the golden hour, where medical care is provided within 60 minutes, has been a significant development in recent conflicts. In the future, medical support in guerrilla warfare may require a focus on prolonged field care, local care, and the use of organic surgery capability. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org

In this podcast episode, Dennis interviews Eric and Ted from Prytime Medical about the P-REBOA catheter. They discuss the training process in Ukraine, the differences between the P-REBOA and the original REBOA catheter, the benefits of the P-REBOA in terms of balloon times and blood product use, and the complications and monitoring for reperfusion injury. They also address the placement of the catheter and the challenges of using it in the field. The episode concludes with information about future plans and research, as well as contact information for Prytime Medical. Takeaways The P-REBOA catheter is used to stabilize patients with severe hemorrhage in the field, particularly in situations where immediate surgical intervention is not possible. Training for the P-REBOA catheter involves a combination of didactic instruction and hands-on practice with simulation devices. The P-REBOA catheter has a semi-compliant balloon that allows for partial occlusion, maintaining some blood flow below the balloon and reducing the risk of reperfusion injury. The P-REBOA catheter can be used to extend the time window for surgical intervention, allowing for stabilization and transport of critically injured patients. Securing the P-REBOA catheter during transport involves suturing or using a catheter clamp to prevent dislodgement. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org

In this podcast episode, Dennis interviews Ian, an ER physician with experience in wilderness medicine, about spinal trauma. They discuss the initial approach to spinal trauma, the process of clinically clearing the spine, the neuro exam for spinal trauma, and the treatment of neurogenic shock. They also cover the goals of fluid resuscitation, the use of vasopressors, and the prevention of complications such as pressure injuries and hypothermia. The episode concludes with a discussion on the use of steroids in spinal cord injuries. Takeaways The initial approach to spinal trauma involves utilizing the MARCH algorithm and maintaining C-spine precautions until the patient can be clinically cleared. The neuro exam is crucial in determining the grade of spinal trauma and whether neurogenic shock is present. Treatment of neurogenic shock involves fluid resuscitation and the use of vasopressors to maintain blood pressure. Nursing care for spinal trauma includes preventing pressure injuries, monitoring for respiratory complications, and preventing hypothermia. Steroid use is not recommended in spinal cord injuries due to the associated risks. Thank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.com For more content go to www.prolongedfieldcare.org Consider supporting us: patreon.com/ProlongedFieldCareCollective