Prolonged Field Care Podcast Podcast Por Dennis arte de portada

Prolonged Field Care Podcast

Prolonged Field Care Podcast

De: Dennis
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Become a Paid Subscriber: https://creators.spotify.com/pod/show/dennis3211/subscribe This podcast and website is dedicated to the healthcare professional who needs to provide high quality care in a very austere location. For more content: www.prolongedfieldcare.org Consider supporting us on: patreon.com/ProlongedFieldCareCollectiveDennis
Episodios
  • PFC Podcast 261: Stop teaching Palliative Care

    PFC Podcast 261: Stop teaching Palliative Care
    Jan 12 2026

    The conversation delves into the complexities of end-of-life care, emphasizing the importance of thoughtful training and education in healthcare. It highlights the potential moral injuries that can arise from decisions made in this sensitive area, particularly when medics are tasked with determining the futility of care without adequate resources.


    Takeaways

    • There's a ripple effect from each one of these decisions.
    • We have to be very thoughtful about how we train and educate.
    • Moral injury can result from poor decision-making in healthcare.
    • Medics determining early futility may not have the necessary resources.
    • Championing certain ideas can lead to operational inefficiencies.
    • End-of-life care requires a balance of ethics and practicality.
    • Training should encompass both education and practical skills.
    • Healthcare decisions impact not just patients but the entire system.
    • Moral injury is a significant concern in medical ethics.
    • Operational effectiveness can be compromised by hasty decisions.


    Chapters

    00:00 Introduction to Palliative Care in Combat Medicine

    00:29 Operational Effectiveness vs. Palliative Care Messaging


    For more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

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    46 m
  • PFC Podcast: Hypothermia Management

    PFC Podcast: Hypothermia Management
    Jan 8 2026
    In this essential episode of the Prolonged Field Care (PFC) Podcast, host Dennis sits down with CRNA Kevin to dive deep into one of the most overlooked yet critical issues in trauma care: Hypothermia prevention and management. Even in warm environments, trauma patients can rapidly become hypothermic—leading to coagulopathy, increased bleeding, wound infections, and worse outcomes. Dennis and Kevin break down the science, real-world lessons from deployments, and practical strategies for austere and prolonged field care settings.Whether you're a medic, provider, or anyone involved in combat casualty care, this episode will change how you approach keeping patients warm under fire or in remote locations.Episode Highlights:The four main mechanisms of heat loss: radiation (40-60% of total loss), convection, conduction, and evaporation—and how to counter each one effectively.Why even healthy patients cool rapidly under anesthesia, and why trauma patients in the field are at much higher risk.Practical tips for austere environments: using tents, inflatable structures, insulation from the ground, wool blankets, and body heat to raise ambient temperature.Common mistakes that actively cool patients: wet clothing, cold airways (LMAs/ventilation), uncovered exposure, and cold blood/fluid administration.Best bang-for-buck interventions: covering the head, minimizing exposure, drying the patient, using HME filters, and insulating from the ground.Real deployed experiences: keeping trauma bays warm, pre-warming gear, using camping pads on litters, and limitations of Ready-Heat and HPMKs at altitude or in extreme cold.Advanced rewarming techniques (when available): fluid warming, bladder lavage, peritoneal lavage, and ECMO.Temperature monitoring challenges in the field: esophageal, nasopharyngeal, rectal, Foley, and forehead strips—plus how to interpret trends.Chapters:00:00 – Introduction & Why Hypothermia Matters in Trauma Care02:30 – Heat Loss in Anesthesia: Vasodilation and the First-Hour Temperature Drop04:50 – Mechanisms of Heat Loss: Radiation, Convection, Conduction, Evaporation07:10 – OR Strategies: Room Temperature, Head Covering, Fluid Warming, Bear Huggers09:29 – Environmental Control in the Field: Raising Ambient Temperature & Reducing Wind11:52 – Using Tents and Structures to Trap Body Heat14:14 – Insulation from the Ground: Litters, Wool Blankets, Camping Pads, Air Mattresses17:53 – Preventing Conduction & Pressure Sores with Padding19:56 – Avoid Actively Cooling Patients: Cold LMAs, Unheated Ventilation, Wet Clothing22:21 – Heat Moisture Exchangers (HME) & Humidified Gas26:40 – Blood Resuscitation: Cold Fluids vs. Hypovolemia—What Kills First?31:17 – Team-Based Rewarming: Minimize Exposure, Pre-Warm Gear, Dry HPMKs35:22 – Limitations of Battery-Powered Warmers & Bear Huggers in Austere Settings40:04 – Prevention First: Insulate, Cover, Dry—Then Active Rewarming Works Better42:24 – Downstream Effects of Hypothermia: Lethal Triad & Wound Infections44:51 – Aggressive Rewarming Options: Chest Tubes, Gastric/Bladder Lavage, ECMO47:15 – Temperature Monitoring in the Field: Probes, Strips, and Trend InterpretationFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠⁠
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    55 m
  • PFC Podcast 260: Evolving Guidelines for LSCO

    PFC Podcast 260: Evolving Guidelines for LSCO
    Jan 5 2026

    In this conversation, Jessica Patterson and Florian Schmitzberger discuss the evolution of clinical practice guidelines (CPGs) from the Department of Defense (DOD) and their application in different contexts, particularly in light of the changes from the Global War on Terror (GWOT) to new healthcare environments. They emphasize the need for data to understand how these guidelines will perform in varied systems.


    Takeaways

    This isn't GWOT, this isn't Iraq, this isn't Afghanistan.

    Clinical practice guidelines (CPGs) evolved during GWOT.

    The performance of CPGs in different systems is uncertain.

    Data gathering is essential to assess guideline effectiveness.

    Understanding ground truth is crucial for guideline application.

    The DOD's CPGs were refined for specific contexts.

    New healthcare environments may challenge existing guidelines.

    The evolution of CPGs reflects changing military and healthcare needs.

    Questions arise about the adaptability of CPGs.

    Future research is needed to evaluate guideline performance.


    Chapters

    00:00 Introduction to the Podcast and Guests

    00:32 Data Collection and Research Methodology


    For more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

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    52 m
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