In this episode of the PFC Podcast, Dennis speaks with John McClellan, a military trauma surgeon, about the use of Tranexamic Acid (TXA) in trauma care. They discuss the mechanism of TXA, its applications in pre-hospital settings, potential complications, and evolving dosing strategies. John emphasizes the importance of TXA in managing hemorrhage and the need for standardized protocols in trauma care, especially for medics in the field.

Takeaways

TXA is a lysine analog that helps stabilize clots.

The ideal patient for TXA is anyone suspected of needing massive transfusion.

TXA is considered a low-risk drug for trauma patients.

Pre-hospital administration of TXA is crucial for patient outcomes.

Complications from TXA are not increasing significantly.

Current dosing strategies for TXA are evolving towards higher initial doses.

Preloading TXA can save time in emergency situations.

TXA has solidified its role in trauma care over the years.

Understanding the pharmacokinetics of TXA is essential for effective use.

Standardized protocols are vital for medics in the field.

Chapters

00:00 Introduction to TXA and Trauma Care

03:12 Understanding TXA: Mechanism and Applications

05:53 Pre-Hospital Administration of TXA

08:48 Complications and Concerns with TXA

12:06 Dosing Strategies and Evolving Guidelines

15:02 Practical Considerations for Medics

17:57 The Future of TXA in Trauma Care

Thank you to Delta Development Team for in part, sponsoring this podcast.

Posting tomorrow...Down and dirty chat with John on TXA and Trauma.

Link to full episode:

https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-212-TXA-e2sss55

Controlling chaos both the environment we're working...and ourselves.

Link to full podcast:

https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-MASCAL-Lessons-Learned-e2t1hd7

A MASCAL will humble anyone. It's always better to learn from other mistakes.

Link to the full podcast:

https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-MASCAL-Lessons-Learned-e2t1hd7

Considering recent events, I thought it would be a good time to push this info back out. In this episode of the PFC Podcast, Dennis and Rick discuss critical lessons learned from military operations, particularly focusing on mass casualty situations. Rick shares his extensive experience as a senior medic in the Special Forces, detailing the complexities of managing casualties in combat, the importance of realistic training, and the challenges of communication and coordination during crises. The conversation emphasizes the need for adaptability, accountability, and principle-driven medicine in the field, as well as the resilience of soldiers in the face of adversity. In this conversation, Dennis shares his experiences and insights as a combat medic during a mass casualty event. He discusses the challenges of managing equipment and space, the importance of airway management, and the emotional toll of making critical medical decisions. Dennis emphasizes the need for effective communication, leadership, and the ability to manage chaos in high-pressure situations. He reflects on the lessons learned from his experiences and the importance of advocating for team members' health and well-being.

Takeaways

Mass casualty situations require a different mindset and approach.

Understanding the tactical implications of casualties is crucial.

Realistic training scenarios prepare medics for actual combat situations.

Communication and coordination are vital during crises.

Documenting patient information is essential for effective care.

Survival in combat can depend on factors beyond medical intervention.

Principle-driven medicine is necessary in unpredictable environments.

Adaptability is key when plans change unexpectedly.

Accountability in casualty management is critical for success.

Resilience among soldiers can lead to unexpected recoveries. Managing equipment effectively is crucial in crisis situations.

Airway management can be severely impacted by equipment damage.

Quick release systems are essential for efficient casualty management.

Senior medics must focus on managing the scene rather than individual patients.

Emotional detachment can aid in making difficult medical decisions.

Advocating for expectant patients is a challenging but necessary task.

Creative solutions are often required for successful evacuations.

Post-mission reflections can lead to valuable lessons learned.

Communication is key in managing chaos during medical emergencies.

Understanding the mission and appropriate equipment is vital for medics.

Chapters

00:00 Introduction to Lessons Learned

03:02 Understanding Mass Casualty Situations

05:54 Planning and Execution of Operations

09:01 Adapting to Changing Situations

11:59 The Impact of Explosions and Casualties

14:54 Managing Casualties in Combat

17:48 Training Realism and Preparedness

21:09 Communication and Coordination in Crisis

24:04 Lessons on Accountability and Documentation

27:00 Survival and Resilience in Combat

29:46 Principle-Driven Medicine in the Field

32:57 Navigating Medevac Challenges

35:58 Final Thoughts and Reflections

44:42 Managing Equipment and Space in Crisis

45:39 Airway Management Challenges

46:06 The Importance of Quick Release Systems

47:31 Lessons from Casualty Management

48:46 The Emotional Toll of Medical Decisions

50:51 The Role of Senior Medics in Crisis

52:11 Expectant Patients and Difficult Decisions

54:35 Creative Solutions for Evacuation

56:33 Post-Mission Reflections and Lessons Learned

01:00:03 Advocating for Team Members' Health

01:02:14 The Aftermath of Combat and Team Dynamics

01:04:17 Managing Chaos in Medical Situations

01:06:14 Communication and Leadership in Crisis

01:09:09 Final Thoughts on Mass Casualty Events

It's very easy to be overwhelmed with events. Having your organization pre-planned, will help out immensely.

Link to the full podcast posting tomorrow:

https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-MASCAL-Lessons-Learned-e2t1hd7

We all use Walk, Crawl, Run..But what does that actually mean and how does training change?

Patients die...That's a fact of life, but how do you train for that without crushing the medics' confidence?

Doing a good AAR or debrief is not as easy as it looks. There are definite right and wrongs when giving feedback.

All students are different and need different approaches to get them were they need to be.

Link to full podcast: https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-211-Training-Scars-e2sq2n3