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

Welcome Back...Let's kick 2025 off with another training discussion.

In this conversation, Dennis and John discuss the current state of medical training, particularly in military contexts. They explore the shortcomings of existing training methodologies, emphasizing the need for a foundational knowledge base and a structured approach to skill acquisition. John introduces the concept of cognitive load theory and advocates for a gradual progression in training stressors to enhance learning outcomes. The discussion also touches on cultural challenges within training environments and the importance of engaging experienced learners effectively. In this conversation, Dennis discusses the intricacies of training in operational medicine, emphasizing the importance of establishing a solid training framework, the need for skill development, and the role of effective instructors. He highlights the significance of providing immediate and actionable feedback to build confidence in trainees while avoiding no-win scenarios that can negatively impact learning. The discussion also touches on the cultural aspects of training and the necessity for instructors to adapt their methods based on the audience's experience and needs.

Link to Paper: https://nextgencombatmedic.com/2024/09/16/a-lost-opportunity/

Takeaways

Training needs a refocus on foundational knowledge.

Skill atrophy occurs quickly without regular practice.

Repetition is crucial for skill mastery in medical training.

Cognitive load theory helps optimize training effectiveness.

Gradual progression in stress is essential for learning.

Cultural issues can hinder effective training.

Experienced learners require different engagement strategies.

Training should have clear objectives and outcomes.

Effective training must balance quality and quantity of practice.

Understanding the audience is key to successful instruction. Establish a clear training framework to guide instruction.

Skill development should be prioritized over complex scenarios.

Instructors must adapt their teaching methods based on audience experience.

Immediate feedback is crucial for effective learning.

Avoid no-win scenarios that can demoralize trainees.

Confidence building is a key goal of training.

Cultural issues can impact training effectiveness.

Deliberate practice is essential for instructor improvement.

Training scenarios should be relevant and realistic.

Instructors should focus on actionable feedback to enhance learning.

Chapters

00:00 Introduction to Training Philosophy

05:09 Identifying Issues in Current Training Methods

09:52 The Importance of Foundational Knowledge

15:11 Cognitive Load Theory in Training

19:55 Gradual Progression in Stress Training

24:53 Cultural Challenges in Training

29:48 Engaging Experienced Learners

33:46 Establishing a Training Framework

39:46 The Importance of Skill Development

44:50 Creating Effective Instructors

50:39 Feedback and Confidence Building

58:12 Avoiding No-Win Scenarios in Training

What are we doing wrong with medical scenarios? Dennis chats with Jon from Next Generation Combat Medics on Training Scars.

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

In this episode of the PFC Podcast, Dennis and Alex discuss the complexities of trauma surgery, particularly focusing on pelvic injuries and the use of pelvic binders. They explore the subjective nature of truth in medical practice, the importance of research and evidence in trauma care, and the anatomy and physiology related to pelvic injuries. The conversation delves into injury patterns, damage control surgery, and the challenges faced in operational environments. They also engage in a debate about the efficacy of pelvic binders, weighing the evidence and risks involved in their use during trauma care. In this conversation, Dennis discusses the critical importance of evidence-based practice in combat medicine, particularly regarding the use of pelvic binders. He emphasizes the need for medical professionals to understand the nuances of pelvic injuries, especially in a combat environment, and how these injuries differ from civilian cases. The discussion also covers the structured approach to prolonged field care, the management of blood transfusions, and the challenges of imaging in trauma assessment. Dennis advocates for clinical decision-making that prioritizes patient safety and effective care, while also acknowledging the emotional weight of these decisions in high-stakes environments.

Takeaways

Truth is subjective and varies by perception.

Disagreement in medical practice can lead to better patient care.

Understanding research quality is crucial in medical decisions.

Venous bleeding is more common in pelvic injuries than arterial.

Damage control surgery involves multiple phases of patient management.

Operational environments present unique challenges for trauma care.

Pelvic binders are debated in their effectiveness and necessity.

Surgical decision-making requires weighing risks and benefits.

Evidence-based medicine is essential but often lacking in operational settings.

The role of pelvic binders in trauma care remains contentious. Evidence is crucial in medical practice to avoid misinformation.

Dismounted IED blasts result in unique injury patterns.

Understanding research and statistics is essential for medical professionals.

Pelvic binders may not always be beneficial in every injury case.

Timely blood transfusions are critical in managing trauma patients.

Imaging plays a vital role in assessing pelvic injuries.

Clinical decision-making should be based on patient stability and evidence.

Prolonged field care requires a structured approach to patient management.

Team collaboration is essential in making difficult medical decisions.

Continuous education and training are vital for operational medics.

Chapters

00:00 Introduction to the Podcast and Guest

02:58 Understanding Trauma Surgery and Pelvic Injuries

06:13 Research and Evidence in Trauma Care

09:06 Anatomy and Physiology of Pelvic Injuries

12:04 Injury Patterns and Their Implications

14:53 Damage Control Surgery and Patient Management

17:48 Operational Environment Challenges

21:03 The Role of Pelvic Binders in Trauma Care

23:52 Debate on Pelvic Binders and Evidence

26:51 Surgical Decision Making in Trauma

29:47 Conclusion and Final Thoughts

45:19 The Importance of Evidence in Medical Practice

52:34 Understanding Pelvic Injuries in Combat

53:59 Prolonged Field Care: A Structured Approach

01:00:03 Managing Blood Transfusions in Critical Care

01:10:06 The Role of Imaging in Trauma Assessment

01:18:00 Clinical Decision-Making in Prolonged Field Care

Here's another great podcast from early '24. This was a great presentation at SOMSA 24 and finished the year at #2.

Takeaways

Not all medics are underperforming, but some are.

Regular training significantly improves medic performance.

Data collection is essential for understanding training outcomes.

Critical thinking is crucial in medical scenarios.

Pass rates indicate the effectiveness of training programs.

Equipment access is a major challenge for medics.

Feedback during training is vital for skill improvement.

Units that conduct regular medical training perform better.

Understanding drug administration is critical for medics.

More robust training at the unit level is necessary.

Chapters

00:00 Introduction to Special Operations Medicine

03:17 Understanding Medic Training and Trends

06:37 Overview of Sustainment Courses

10:51 Evaluating Medic Proficiency

15:42 Pass Rates and Observations

19:05 Identifying Common Medic Challenges

25:40 Equipment and Training Gaps

31:57 Recommendations for Improved Training

37:20 Closing Remarks and Future Directions