Prolonged Field Care Podcast

In this episode of the PFC Podcast, Dennis and Josh discuss the critical role of laboratory tests in trauma care, particularly in austere environments. They cover the timing and importance of drawing labs, the significance of arterial blood gases, lactate levels, and the interpretation of hemoglobin and electrolytes. Josh emphasizes the need for medics to understand normal lab values and how to integrate lab data into patient care effectively.

Takeaways

Labs are essential for timely trauma care.

Draw labs after initial assessments in trauma situations.

Arterial blood gases provide crucial information for ventilation management.

Lactate levels indicate tissue oxygen delivery and resuscitation status.

Hemoglobin trends are more important than single values in trauma.

Electrolyte levels, especially potassium and calcium, are critical in trauma management.

Medics should focus on learning normal lab values for effective care.

Integrating lab data with patient context is vital for treatment decisions.

Regularly check kidney function indicators in trauma patients.

Communication with experienced colleagues can enhance lab interpretation skills.

In this episode of the PFC Podcast, Dennis and Doug delve into the complexities of traumatic cardiac arrest, distinguishing it from medical cardiac arrest. They explore the various causes of traumatic cardiac arrest, emphasizing the importance of rapid assessment and intervention. The conversation highlights the need for effective resource allocation during resuscitation efforts and the significance of understanding the underlying causes of cardiac arrest to guide treatment. Doug shares insights on immediate actions to take in traumatic cardiac arrest scenarios, including the prioritization of interventions and the importance of teamwork in emergency situations.

Takeaways

Traumatic cardiac arrest can be caused by external injuries or direct heart trauma.

Understanding the mechanism of injury is crucial in managing cardiac arrest.

Immediate actions should focus on identifying and treating the cause of cardiac arrest.

Massive hemorrhage is a common cause of traumatic cardiac arrest.

Effective CPR can help restore circulation in certain scenarios.

Teamwork and clear roles are essential during resuscitation efforts.

Pre-delegated roles can streamline emergency responses and save lives.

Assessing the situation while performing CPR is vital for effective management.

Recognizing reversible causes of cardiac arrest can guide treatment decisions.

Communication and coordination among team members are key in emergency medicine.

In this episode of the PFC Podcast, Dennis and Brad discuss the transition from fentanyl lollipops to SuFentanyl in military medicine. They explore the characteristics of SuFentanyl, its advantages and disadvantages compared to traditional fentanyl, and the practical implications of administering these drugs in the field. The conversation highlights the importance of understanding dosage, effectiveness, and the challenges faced by medical personnel in high-stress environments. In this conversation, Dennis discusses the critical aspects of medical training, particularly in the context of administering narcotics and managing pain in field care. He emphasizes the importance of After Action Reviews (AARs) for collecting data and improving practices, the need for hands-on experience with narcotics, and the risks associated with long-term use. The discussion also covers the transition between different narcotics and the importance of titrating to effect based on patient response, particularly respiratory rate. Dennis advocates for thorough training and preparation to ensure medics can make informed decisions in high-pressure situations.

Takeaways

Fentanyl lollipops are being replaced by SuFentanyl tablets.

SuFentanyl is significantly stronger than fentanyl.

The characteristics of SuFentanyl make it effective for pain management.

Lollipops were easier to administer in field settings.

Sublingual tablets have absorption challenges compared to lollipops.

Swallowing the tablet reduces its effectiveness drastically.

Field conditions can affect drug absorption and efficacy.

Medical personnel need to adapt to new drug administration methods.

Dosage adjustments may be necessary for effective pain relief.

Feedback from field use is crucial for optimizing drug protocols. AARs are crucial for improving medical practices.

Hands-on experience with narcotics is essential for comfort.

Understanding the risks of addiction is vital in narcotic use.

Transitioning between narcotics requires careful consideration.

Titrating to effect is key in pain management.

Respiratory rate is a critical indicator in narcotic administration.

Training should focus on real-world scenarios and decision-making.

Medicine requires flexibility beyond strict algorithms.

Discussing potential injury patterns can improve team response.

Preparation and training can prevent mistakes in the field.

In this episode of the PFC podcast, Dennis and Winston discuss Methoxyfluorine, a volatile anesthetic agent known as the 'green whistle'. They explore its mechanism of action, indications for use, and practical applications in emergency care, particularly for managing severe pain in pre-hospital settings. The conversation emphasizes the importance of patient control in analgesia, safety considerations, and best practices for using Methoxyfluorine effectively.

Takeaways

Methoxyfluorine is used for procedural sedation and analgesia.

It acts as an analgesic in low doses and anesthetic in higher doses.

The green whistle allows for patient-controlled analgesia.

It is effective for severe pain, particularly in burns treatment.

Safety concerns include potential renal toxicity at high doses.

Patient education and preparation are crucial for effective use.

The onset of analgesia occurs within 6 to 10 breaths.

Contraindications include altered consciousness and significant organ impairment.

The device is designed to minimize environmental contamination.

Effective communication with patients enhances their experience and satisfaction.

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

In this episode of the PFC Podcast, Dennis and JP Kolcun, a neurosurgery resident, delve into the complexities of spinal trauma. They discuss the differences between spinal shock and neurogenic shock, the assessment and management of penetrating and blunt spinal injuries, and the critical importance of addressing secondary injuries. The conversation emphasizes the need for timely intervention and the nuances of trauma care in both field and hospital settings. This conversation delves into the complexities of spinal cord injury treatment, emphasizing the importance of timely surgical decompression, understanding spinal cord perfusion, and the role of intrathecal pressure. The discussion highlights the need for optimizing spinal cord perfusion pressure and the implications of using vasopressors. Innovations in treatment, including the potential for intrathecal medication delivery and advancements in brain-computer interfaces, are explored as future avenues for improving patient outcomes.

Takeaways

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

In this episode of the PFC Podcast, Dennis, Jacob, and Alex discuss the unique challenges of providing medical care in Arctic conditions. They share their experiences and insights on managing cold weather injuries, innovative techniques for treating frostbite, and the complexities of airway management in extreme cold. The conversation also covers the importance of preparation, equipment, and training for military personnel operating in such environments, emphasizing the need for adaptability and understanding of the unique challenges posed by the Arctic.

Takeaways

Cold weather injuries are a significant concern in Arctic operations.

Training for Arctic conditions was previously lacking and is now essential.

Innovative solutions like sous vide for frostbite treatment have proven effective.

Airway management poses unique challenges in extreme cold temperatures.

Maintaining patient warmth is critical during evacuation and treatment.

Shelter and heating solutions are vital for casualty care in cold environments.

Medications can freeze and lose efficacy; proper storage is crucial.

Preparation and knowledge of equipment are key to success in Arctic missions.

Basic soldier tasks must be mastered to operate effectively in cold weather.

The basics of medical care are what ultimately save lives in extreme conditions.

In this episode of the PFC Podcast, Dennis and ICU doctor Doug discuss the intricacies of resuscitation techniques, focusing on the use of freeze-dried plasma (FTP) and its benefits in trauma care. They explore the physiological aspects of trauma, the role of endotheliopathy, and practical applications of FTP in emergency situations. The conversation also touches on the comparison between FTP, whole blood, and albumin, highlighting the challenges and considerations in using these fluids for resuscitation. The episode concludes with a discussion on the future of blood products in trauma care and the importance of making FTP more accessible.

Takeaways

FTP is a viable alternative to whole blood in trauma resuscitation.

Endotheliopathy of trauma can lead to widespread coagulation issues.

FTP helps stabilize the vascular endothelium during resuscitation.

Whole blood is preferred when available, especially in early resuscitation.

Albumin has limited benefits and can dilute clotting factors.

FTP has a longer shelf life and is easier to store than whole blood.

The physiological effects of trauma require careful consideration in resuscitation.

Resuscitation goals should focus on patient stability rather than strict numerical targets.

Acidosis can complicate trauma resuscitation and should be monitored closely.

Increased access to FTP could improve outcomes in trauma care.

In this episode of the PFC Podcast, Dennis Price discusses the efforts of Heroes for Humanity in response to Hurricane Helene's devastation in Western North Carolina. He shares insights on the immediate activation of volunteers, the assessment of needs, and the challenges faced during search and rescue operations. The conversation highlights the importance of community knowledge, the integration of various organizations, and the human behavior observed during crises. As winter approaches, the focus shifts to recovery efforts and the ongoing need for support and resources.

Takeaways

Heroes for Humanity activated volunteers immediately after Hurricane Helene.

Community knowledge is crucial in identifying vulnerable individuals.

The initial response focused on delivering medical supplies and aid.

Search and rescue operations were prioritized in the aftermath of the hurricane.

Integration with government and other organizations improved coordination.

Survival mode affects human behavior during crises, leading to security issues.

The transition to recovery involves addressing winter preparedness.

Hope and faith play a significant role in recovery efforts.

Safety concerns, such as carbon monoxide poisoning, are critical during winter.

Support can be provided through donations and volunteering efforts.

Donations Needed: https://www.zeffy.com/en-US/fundraising/a5925aa7-6994-4247-9271-527face51842

Find Heroes for Humanity @ https://theheroesforhumanity.org/

In this podcast episode, Dennis and Chris discuss the essentials of starting a podcast, including overcoming initial fears, the importance of authentic conversations, essential gear, post-production techniques, and the significance of media hosting. They also address common pitfalls like podfading, the need for quality content, and the importance of energy and authenticity in podcasting. The conversation provides valuable insights for aspiring podcasters looking to create engaging and successful shows.

Takeaways

Podcasting can be for fun or a serious endeavor.

Authentic conversations resonate more with listeners.

Audio quality is more important than video quality.

Starting with a clear purpose helps guide your podcast.

Longer conversations can feel more natural than short, scripted ones.

Invest in good audio equipment for better sound quality.

Post-production is crucial for a polished final product.

Media hosting is essential for distributing your podcast.

Maintaining passion is key to avoiding podfading.

Quality content will keep listeners engaged, regardless of length.