Since the vast majority of you guys couldn't go to SOMSA '25, I'm bringing SOMSA '25 to you. Paul and I got our steps in this year and recorded a ton of presentations. These presentations with slides will only be available for subscription members...Enjoy

In this episode of the PFC Podcast, Dr. Jason Hiles discusses the challenges and strategies of providing medical care in unconventional warfare environments. He shares insights from his experiences in Southeast Asia, focusing on the importance of adaptability, community engagement, and training local medics to ensure sustainable healthcare practices in resource-limited settings. The conversation covers various surgical techniques, trauma management, and the significance of building trust within the communities served.

Takeaways

The need for trained personnel in war zones is critical.

Adaptability in surgical techniques is essential in resource-limited environments.

Community engagement fosters trust and improves healthcare access.

Surgical care must be tailored to the specific needs of the environment.

Triage and evacuation strategies are vital in managing war wounds.

Training local medics ensures continuity of care after foreign personnel leave.

Simplicity in medical kits can enhance operational efficiency.

Understanding local customs and languages improves patient care.

The impact of war on civilian health requires innovative solutions.

Building relationships with local communities can lead to better health outcomes.

Chapters

00:00 Introduction to Unconventional Warfare Medicine

03:12 Operational Challenges in Resource-Limited Environments

06:07 Surgical Techniques and Patient Care in Conflict Zones

09:00 Managing War Wounds and Trauma

11:55 Triage and Evacuation Strategies

15:10 Community Engagement and Building Trust

18:14 Training Local Medics and Sustainable Practices

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In this episode of the PFC Podcast from last year, Dennis interviews Victor, a former Ranger and current tactical medicine program manager, who shares his experiences in Burma with the Free Burma Rangers. Victor discusses the evolving situation on the ground, his transition from military to humanitarian work, and the challenges of training indigenous forces in combat medicine. He emphasizes the importance of basic medical techniques, the complexities of blood collection and transfusion, and the management of mass casualties in a combat environment. Throughout the conversation, Victor reflects on the lessons learned from his experiences and the realities of operating in a conflict zone. In this conversation, the speaker shares their experiences and insights from operations in Burma, focusing on air operations, reconnaissance techniques, and the challenges of medical planning in hostile environments. They discuss the importance of movement discipline, ground reconnaissance, and resource management in ensuring the safety and effectiveness of their operations. The conversation highlights the complexities of providing medical care in combat situations and the need for adaptability and strategic planning.

Takeaways

Victor transitioned from military service to humanitarian work.

The situation in Burma is rapidly changing with ethnic forces gaining ground.

Training indigenous forces requires cultural understanding and respect.

Basic medical techniques are crucial in combat medicine training.

Blood collection and transfusion present significant challenges in the field.

Managing mass casualties requires effective triage and resource allocation.

Training local medics can lead to successful outcomes in emergencies.

Logistics and communication are vital in combat scenarios.

The experience highlighted the importance of adaptability in medical training.

Victor learned to appreciate the resources available in military medicine. The Burma army utilizes advanced air operations for reconnaissance and strikes.

Movement and noise discipline are critical in combat situations.

Ground reconnaissance is essential for safe movement and operational success.

Medical planning must account for the capabilities of local hospitals.

Prolonged field care requires careful consideration of resources and logistics.

Effective communication and teamwork are vital during operations.

Understanding enemy tactics can enhance operational planning.

Pre-packing medical supplies can save time during emergencies.

Adaptability is key in unpredictable combat environments.

Continuous learning and preparation are necessary for effective field care.

Chapters

00:00 Introduction to Victor's Journey

01:57 The Situation in Burma

04:08 Transitioning from Military to Humanitarian Work

05:50 Training Indigenous Forces in Combat Medicine

12:07 Implementing Medical Techniques in the Field

19:47 Challenges of Blood Collection and Transfusion

28:03 Managing Mass Casualties in Combat

39:48 Lessons Learned from the Experience

41:58 Air Operations and Reconnaissance Techniques

47:12 Engaging with the Enemy: Capturing Prisoners

50:16 Ground Reconnaissance and Movement Discipline

55:29 Medical Planning in Hostile Environments

01:01:40 Challenges of Prolonged Field Care

01:07:13 Logistical Considerations and Resource Management

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In this episode of the PFC Podcast, Dennis and Doug delve into the complexities of bradyarrhythmias, discussing their recognition, causes, and treatment options. They explore the importance of vital signs, differential diagnosis, and the various pharmacological and electrical interventions available for managing bradycardia. The conversation also touches on the implications of overdoses and the long-term management of patients with bradyarrhythmias, emphasizing the need for a comprehensive approach in emergency medicine.

Takeaways

Recognizing bradycardia involves checking vital signs and symptoms.

Not all bradycardias are the same; context matters.

Altered mental status can indicate shock in bradycardia cases.

Lyme disease is a significant cause of bradycardia in younger populations.

Narcotic overdose can lead to bradycardia and requires immediate attention.

Atropine is a quick and handy treatment for bradycardia.

Transcutaneous pacing is a common emergency intervention.

Dopamine is preferred for its targeting of heart rate in bradycardia.

Glucagon is an expensive but necessary treatment for beta-blocker overdose.

Treating hypoxia is crucial before addressing bradycardia.

Chapters

00:00 Introduction to Bradyarrhythmias

03:01 Recognizing Bradycardia and Its Symptoms

06:14 Causes of Bradycardia

09:02 Differential Diagnosis in Bradycardia

11:57 Stabilization and Treatment Approaches

14:46 Pharmacological Interventions for Bradycardia

17:59 Electrical Interventions: Pacing Techniques

20:55 Managing Overdoses and Bradycardia

23:48 Long-term Management and Follow-up

26:54 Conclusion and Key Takeaways

Link to full podcast:

⁠⁠https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-228-DImE-e32aek2⁠⁠

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Posting tomorrow..Not all cardiac issues have to do with the heart.

In this episode of the PFC Podcast, Ian Wedmore, an expert in high altitude medicine, discusses the newly released Clinical Practice Guidelines (CPG) for altitude-related illnesses. The conversation covers the pathophysiology of acute mountain sickness, high altitude pulmonary edema, and high altitude cerebral edema, as well as their diagnosis and treatment protocols. Ian emphasizes the importance of understanding the symptoms, utilizing technology, and implementing prevention strategies to effectively manage altitude illnesses in military and wilderness settings.

Takeaways

The new CPG for altitude medicine is a significant advancement.

Acute mountain sickness occurs when the body ascends too quickly without acclimatization.

Diagnosis of altitude sickness relies heavily on symptom scoring systems.

Vital signs are crucial for diagnosing high altitude pulmonary edema.

Dexamethasone is essential for treating high altitude cerebral edema.

Pre-exposure prophylaxis can reduce the risk of altitude sickness.

Acetazolamide is the primary medication for preventing acute mountain sickness.

Understanding the pathophysiology of altitude illnesses is key for treatment.

Good hydration and nutrition are critical for acclimatization.

Data collection through medic encounter forms will improve altitude care.

Chapters

00:00 Introduction to High Altitude Medicine

02:51 Understanding Acute Mountain Sickness

06:13 Diagnosing and Differentiating Altitude Illnesses

08:56 Pathophysiology of High Altitude Pulmonary and Cerebral Edema

12:04 Treatment Protocols for Altitude Illnesses

15:08 Utilizing Technology in Altitude Medicine

18:00 Prevention and Prophylaxis Strategies

20:45 The Role of Medications in Altitude Care

24:13 Future Directions in Altitude Medicine

27:01 Conclusion and Key Takeaways

Link to full podcast:

⁠https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-228-DImE-e32aek2⁠

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Help with what they actually need. Having a long-term view will bring lasting success.

Link to full podcast:

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In this episode of the PFC Podcast, Dennis speaks with Dr. Jim Czarnik, a retired Army officer with extensive experience in military medicine and operations. They discuss the complexities of military medicine, the importance of communication between medical and operational personnel, and the challenges of adapting to future conflicts, particularly in the context of large-scale combat operations (LISCO). Jim emphasizes the need for honest discussions about the role of medicine in the military and the moral dilemmas faced in battlefield situations. The conversation also touches on the integration of technology in tactical medicine and the necessity of training for real-world scenarios. In this conversation, the speakers delve into the complexities of military operations, focusing on the moral dilemmas faced by medics, the importance of understanding diplomatic language, and the necessity of being well-informed about national interests when engaging in foreign nations. They emphasize the need for courageous vulnerability in communication and the importance of preparation and information gathering to ensure successful missions. This conversation delves into the complexities of military operations, particularly focusing on the importance of resource management, the necessity of basic medical skills in prolonged field care, and the critical role of clinical judgment in medical training. The speakers emphasize the need for cultural sensitivity and effective patient interaction in combat situations, as well as the importance of strategic engagement and long-term planning in military medicine. They discuss the challenges faced by medics in adapting to different environments and the need for a collaborative approach to healthcare in military operations.

Takeaways

Medicine exists to serve the line, highlighting its role in military operations.

There is often a lack of understanding between medical and operational personnel.

Training for LISCO requires adapting to the environment, not just changing it.

Time is a critical factor in military operations and training.

Moral dilemmas in battlefield medicine need to be addressed beforehand.

Technology can enhance tactical medicine, but must be integrated thoughtfully.

Honest discussions about roles and expectations are crucial in military settings.

The complexity of military medicine requires a balance between operational needs and medical capabilities.

Future conflicts will demand innovative approaches to medical care on the battlefield. It's not just about the mission; it's about the relationships.

Engagement with foreign nations requires understanding their systems.

Courageous vulnerability is essential in military interactions.

Clinical judgment is often lacking in medical training.

The command element must prioritize medical training.

Long-term planning is necessary for successful military engagement.

Chapters

02:51 Winning in a Complex World: Insights from Jim

19:32 The Role of Technology in Tactical Medicine

27:15 Adapting to Future Conflicts: LISCO and Beyond

42:51 Warrior's Will and Moral Dilemmas

45:07 Understanding the Medic's Role in Military Operations

47:20 Navigating Diplomatic and Military Language

52:00 Engagement Strategies in Foreign Nations

01:01:11 Understanding National Interests and Engagement Plans

01:07:57 Information Gathering and Preparation

01:12:43 Courageous Vulnerability in Military Engagements

01:20:26 The Future of Military Operations and Resource Management

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Medicine is no different. You either adapt to the environment or you will fail.

Posting tomorrow..

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This conversation delves into the critical aspects of tourniquet management in trauma care, focusing on the distinction between tourniquet conversion and replacement, the importance of resuscitation, and the physiological implications of prolonged tourniquet use. The speakers discuss techniques for safe conversion, the challenges faced in the field, and the assessment of limb salvageability, emphasizing the need for preparedness and patient assessment in high-stress environments. This conversation delves into the complexities of patient care in trauma situations, focusing on the challenges faced by medics in making critical decisions about limb salvage, managing acidosis, and understanding reperfusion injury. The speakers emphasize the importance of resuscitation, the need for adequate resources, and the moral dilemmas that arise in emergency medical situations. They provide practical advice for medics on how to navigate these challenges effectively while ensuring patient safety and care quality.

Takeaways

Tourniquet conversion is essential in trauma care.

Understanding the difference between conversion and replacement is crucial.

Resuscitation is a key factor before converting a tourniquet.

The two-hour mark for tourniquet use is based on physiological considerations.

Prolonged tourniquet time can lead to significant metabolic issues.

Be prepared for reperfusion injury when converting a tourniquet.

Confidence in tourniquet conversion skills is often lacking among providers.

Patient assessment is critical before converting a tourniquet.

Limb salvageability can vary and should be assessed carefully.

The decision to convert a tourniquet should prioritize patient stability. Imperfect situations require difficult decisions in patient care.

Triage decisions are crucial when resources are limited.

Resuscitation is the primary goal in trauma care.

Understanding reperfusion injury is essential for medics.

Managing acidosis can significantly impact patient outcomes.

Blood transfusions are critical in trauma situations.

Medics must be prepared for potential complications.

Always monitor and assess the patient's condition continuously.

Reading medication labels is vital for safe practice.

Confidence in converting tourniquets is essential for medics.

Chapters

00:00 Introduction to Tourniquet Management

02:56 Understanding Tourniquet Conversion vs. Replacement

06:10 Resuscitation Goals and Tourniquet Timing

08:58 Physiological Implications of Prolonged Tourniquet Use

11:47 Techniques for Safe Tourniquet Conversion

15:09 Challenges in Tourniquet Management

17:53 Assessing Limb Salvageability and Patient Stability

25:44 Navigating Imperfect Situations in Patient Care

30:32 Triage Decisions: When to Save a Limb

31:03 Understanding Reperfusion Injury and Its Challenges

35:43 Managing Acidosis in Trauma Patients

46:34 Advice for Medics: The Importance of Conversion

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

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The hardest thing in medicine is to dial back a treatment.

Link to full podcast:

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