Special Operations Medical Association

Latest Episodes:

23: JTS Clinical Practice Guidelines for the SOF Medic Jul 08, 2017

Show notes

While at the 2017 Remote Damage Control Resuscitation(RDCR) conference put on by the Tactical Hemostasis, Oxygenation and Resuscitation(THOR) network in Norway, Sean took the time to corner Dr. Shackleford to get her thoughts on the Joint Trauma System Clinical Practice Guidelines. Be sure to check out the new JTS Facebook, LinkedIn Pages, Instagram and Twitter feeds and YouTube Channel for more updates.

22: On Blood, Geir Strandenes at SOMSA2017 Jun 20, 2017

Show notes

This talk was recorded live during the Prolonged Field Care Pre-Conference Lab during the Special Operations Medicine and Scientific Assembly(SOMSA). Dr. Geir Strandenes is a founding member of the THOR(tactical Hemostasis, Oxygenation and Resuscitation) Group, the Senior Medical Officer of the Norwegian Naval Special Operations and a Researcher in the Department of Immunology and Transfusion Medicine at Haukeland University Hospital in Bergen, Norway. He has worked hand in hand wit the US Army Institute of Surgical Research and the US Armed Forces Blood Program.

21: Optimizing Traumatic Ventilation Jun 03, 2017

Show notes

Dennis was finally able to corner an anesthesiologist who was actually more than happy to sit down and talk about his years if experience working from the head of thousands of patients. While we are working on an Airway Clinical Practice Guideline with the Army Institute of Surgical Research, this will go along with our earlier posted airway recommendations until we can get a consensus and get it published.

20: TBI Round Table and Case Discussion May 11, 2017

Show notes

This podcast is a follow up from our last post on managing traumatic brain injuries in austere environments. We included a scenario discussion with David, Jamie, Daryl, Jay, Doug and I with much needed answers to some frequently asked questions.

What are your priorities? How do you assess in the field without labs and imagery? Do you include severe TBI injuries in your trauma training? What if he also has a pelvis injury or internal bleeding? When do you take the airway, if at all? When do you provide positive pressure ventilation in these patients? When is that dangerous?

19: Infection, SIRS and Sepsis Apr 30, 2017

Show notes

If you sit on a patient long enough, infection has a greater chance of taking hold and progressing to sepsis, or may receive a patient who has already been sick for days. Doc Jaybon walks us through the full spectrum from infection and SIRS to sepsis, shock and death. Despite firm CoTCCC recommendations for early antibiotics, in the past we may have foregone that luxury because of lighting fast evacuation times, maybe even thinking, 'they'll take care of it at the next echelon.' A great medic should not only treat their patient but set them up for success at the next echelon, as Sepsis is a testament to how poor care during the TCCC phases of care can cost our patients days and weeks in a hospital later.

But what if you are your own next echelon? Point of injury to Role 1+ could be your own team house or single litter aid station. Go down the checklist on the right side of the PFC trending chart and make sure you are taking care of anything that could result in an infection. Have you given those antibiotics? How is your airway and respiratory care? Did you replace any dirty IV or IO sites you placed in the field? Are you doing all your procedures an as aseptic manner as much as possible? When will you debride? Are you doing everything you can to prevent pressure ulcers?

When will you call for a telemedical consult? When your patient develops a fever? Blood pressure falling? Altered mental status?

Listen in...

18: TBI Management in PFC Apr 25, 2017

Show notes

Be sure to visit www.prolongedfieldcare.org for the associated quiz and show notes! Dr. David Van Wyck an Intensivist and Neurointensivist Fellow at Duke Medical Center in North Carolina explains the evolving management of TBI in the field for medics in austere environments. Go to www.prolongedfieldcare.org for the accompanying blog post, shownotes and quiz.

17: Expectant Patients and Palliative Care Apr 03, 2017

Show notes

Despite our best efforts, endless training, and reading, some of our patients will die. This has been a taboo subject that is difficult to broach in the best of times. We aim to start a conversation here with the hope thatit continues with your Medical Director, PA, Surgeon and fellow Medics before you are ever faced with this difficult situation out on your own. Often prolonged field care involves treating the most critically sick or injured patients longer than you expect to. Inevitably some of these "sickest-of-the-sick" will not make it in time to see definitive care and you will be left to ease the suffering during end of life care alone. While you may have to deliver end of life care by yourself, you may not have to make all the decisions alone.

In this episode Dennis and Doc Powell discuss how to treat expectant patients. This could be as part of a multi-patient MASCAL or a happen to a single patient who is critically ill or injured. If it happens during a MASCAL, once you are done treating your urgent patients, what do you do when you go back to your expectant patients? It's common to skip over discussing and training on losing patients... Taboo even. The fact is that it will eventually happen; No matter how good of medics we are, patients may die. Doc Powell has spent innumerable hours in Intensive Care Units with the best and brightest medical teams a patient could hope for. Often in this setting the top notch care, medicines and interventions are not enough and patients code and die. This is part of medicine whether we talk about it openly or not.

16: Sedation in PFC Mar 17, 2017

Show notes

A follow up to our last analgesia podcast, Dennis hosts Doug and Paul to talk about pearls when dealing with sedation in the ICU and how they translate to care in the field by medics.

15: Analgesia Case Discussion Podcast with a word on Emerging PTSD Research Jan 02, 2017

Show notes

Just snow your patient with ketamine and versed to prevent PTSD right? Maybe not. While talking through some more analgesia and sedation strategies, Doc Powell shares his thoughts on what he has read recently and it might blow your mind. It did mine andI'll definitely have to dig in and do more research of my own. We also go through some of the answers to our survey we put out on our last post. For the most part we did pretty good as a whole. There were, however, some dangerous answers such as using propofol or benzodiazepines for pain control, and we will discuss why that's not necessarily such a great idea.

14: Round Table Crush Injury Discussion Nov 01, 2016

Show notes

In this episode we gathered around a microphone to discuss the management of crush injury in austere environments including a scenario and the answers to our poll. Go to www.prolongedfieldcare.org to take the follow-up, 3-question quiz to make sure you understand the principles of the latest evidence based recommendations.

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