Podcasts about tccc

In this deep-dive episode of the Prolonged Field Care Podcast, Dennis sits down with trauma and critical care surgeon Dr. John McClellan ( University of North Carolina) to cut through the noise on tranexamic acid (TXA) in trauma.They cover the mechanism, who actually needs it, why the dosing shifted from 1g + drip to 2g upfront, pre-hospital decision-making when bleeding is controlled, redosing in ongoing hemorrhage, IM/IO options, seizure and hypotension concerns, the critical 3-hour window, and practical advice for the medic who is truly alone and afraid.Whether you're a combat medic, flight medic, or trauma provider, this conversation delivers actionable clarity on one of the most studied — and sometimes misunderstood — tools in hemorrhagic shock resuscitation.Key Takeaways:TXA is a lysine analog that reversibly (and at higher doses irreversibly) binds plasminogen, preventing its conversion to plasmin and stabilizing clots. It is one of the most evidence-backed hemorrhage adjuncts available.The ideal candidate is any patient you suspect will trigger (or has triggered) a massive transfusion protocol — not just obvious amputations. Err on the side of giving it early in pre-hospital/austere settings to avoid missing occult bleeding.Modern trauma practice favors 2g IV push upfront over the older CRASH-2 regimen of 1g bolus + 8-hour drip because traumatic bleeding is an acute event that needs rapid high plasma levels. The 8-hour drip was designed for elective surgical cases with ongoing bleeding over hours.Overall safety is excellent. Large meta-analyses have not shown a clear increase in thrombotic events attributable to TXA. The bigger practical risks are seizures with doses significantly above 2g and accidental double-dosing due to poor handoff between pre-hospital and hospital teams.Transient hypotension can occur with rapid push, but causality is murky — it is often impossible to separate from the patient's underlying shock state.Redosing is reasonable (another 1–2g) if significant re-bleeding causes hemodynamic instability. Roughly 25% of active TXA can be lost in major hemorrhage/transfusion models.Give TXA within 3 hours of injury for maximum benefit. After 3 hours efficacy drops sharply and some data suggest potential increased bleeding risk.For the solo medic: Preload if your protocol allows. Make TXA automatic once you have access (alongside calcium and blood products). Prioritize rapid transport. TCCC supports IM if no IV/IO is possible, though delivering the full 2g volume can be challenging.Documentation and clear handoff are non-negotiable when pre-hospital TXA is given.Chapters:00:00 – Welcome & Podcast Disclaimer00:25 – Guest Introduction: Dr. John McClellan, Trauma Surgeon01:52 – What is TXA and How Does It Actually Work?03:28 – Who Should Get TXA? The Massive Transfusion Patient04:16 – Pre-Hospital TXA: Bleed Control First or TXA First?07:06 – Safety Concerns: Thrombosis, Seizures & Double Dosing Risks09:54 – Dosing Evolution: CRASH-2, 1g + Drip vs 2g Push in Trauma13:33 – Does TXA Cause Hypotension? Unpacking the Evidence19:12 – IO & IM TXA: Practical Routes When IV Access Is Tough21:46 – Redosing TXA in Ongoing Bleeding or Transport29:37 – Advice for the Medic Who Is Truly “Alone and Afraid”32:21 – The 3-Hour Rule: Why Timing Matters and What Happens After34:14 – Final Thoughts & Practical Takeaways from Dr. McClellanFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠⁠

   In this episode of WarDocs, Army Deputy Surgeon General Dr. Lance Raney discusses the past, present, and future of military medicine. The conversation begins with Dr. Raney's early journey from a collegiate scholarship athlete to a Family Medicine physician, exploring how his clinical roots in "small-town" Army medicine established the decision-making framework necessary for high-level strategic leadership. Drawing on his experience as a Brigade Surgeon with the 172nd Stryker Combat Team in Iraq, Dr. Raney emphasizes the life-saving importance of empowering medics at the point of injury and the necessity of critical thinking in the face of unexpected clinical challenges.    The dialogue then shifts to the complexities of the current military healthcare landscape, particularly the transition to the Defense Health Agency and the integration of medical readiness with healthcare delivery. Dr. Raney provides a candid look at the challenges of navigating systemic changes during the COVID-19 pandemic and the implementation of MHS GENESIS, noting that leadership through influence is now more vital than ever. He shares a personal and powerful account of his time at Womack Army Medical Center, discussing how patience and trust in the military justice system reinforced his commitment to servant leadership and organizational resilience.    A major focus of the episode is the Army's strategic pivot toward Large Scale Combat Operations (LSCO). Dr. Raney details how the "Golden Hour" of evacuation is being replaced by the reality of prolonged field care, requiring a fundamental overhaul of medical training. He explains the expansion of the Army paramedic program and the development of high-tech solutions like Artificial Intelligence for triage and decision support. These innovations are designed to augment the front-line provider's ability to manage casualties in austere, communication-denied environments where resources are strictly limited.    Finally, Dr. Raney offers profound career advice for the next generation of healthcare professionals. He encourages students and young officers to become the experts their patients expect and to seek "Purpose Plus"—the unique fulfillment found in serving the extended family of the American soldier. By focusing on legacy and the impact left in others, Dr. Raney illustrates why military medicine remains one of the most rewarding paths a clinician can choose. Chapters (00:00-06:28) Foundations of a Career in Army Medicine (06:29-11:04) The Clinical Roots of Strategic Leadership (11:05-17:40) Lessons in Combat Casualty Care (17:41-31:35) Command Philosophy and Navigating Systemic Transitions (31:36-45:47) Preparing for Large-Scale Combat Operations and the Role of AI (45:48-50:52) Advice for the Next Generation and Finding Your Purpose Chapter Summaries (00:00-06:28) Foundations of a Career in Army Medicine: Dr. Raney details his path from a lifeguard and ROTC cadet to becoming a Family Medicine physician. He shares how he came to view the Army as his "small town" where everyone shares a common mission and community. (06:29-11:04) The Clinical Roots of Strategic Leadership: The discussion centers on how high-volume primary care at Fort Sill developed the critical decision-making skills needed for senior leadership. Dr. Raney explains how clinical encounters taught him to synthesize information and negotiate solutions under pressure. (11:05-17:40) Lessons in Combat Casualty Care: Reflecting on his deployment to Iraq, Dr. Raney emphasizes the life-saving impact of well-trained medics at the point of injury. He recounts a specific junctional injury save that demonstrated the importance of critical thinking over rote skill repetition. (17:41-31:35) Command Philosophy and Navigating Systemic Transitions: This segment covers Dr. Raney's experience commanding large medical centers and his time as a liaison during the Defense Health Agency transition. He discusses the challenges of separating healthcare from readiness and the personal lessons learned while trusting the system during a difficult investigation. (31:36-45:47) Preparing for Large Scale Combat Operations and the Role of AI: The conversation shifts to the strategic preparations for LSCO, where the traditional "Golden Hour" may no longer exist. Dr. Raney explores the expansion of paramedic training and the potential for AI to assist in triage and clinical decision support on the battlefield. (45:48-50:52) Advice for the Next Generation and Finding Your Purpose: To conclude, Dr. Raney offers career advice focused on achieving clinical expertise and finding "Purpose Plus" within the military. He shares his hope of leaving a legacy through the people he has trained and the lives he has touched. Take Home Messages Master Your Craft: Becoming an expert in your specific clinical field is the fundamental requirement for all military medical professionals. True education happens after residency when you apply your skills to real-world patient outcomes and learn from continuity of care. Lead to Purpose: Leadership should not be about the commander but about enabling others to own their piece of the mission. When a team understands their purpose, they move from just doing a job to providing meaningful interventions that change lives. Prepare for Prolonged Care: In future conflicts, the luxury of rapid evacuation will be limited, requiring medical teams to hold patients for much longer durations. Success will depend on the individual's ability to think critically and utilize limited resources in the face of unsolvable problems. Embrace Systemic Ownership: Tactical problems are often best solved by those at the tactical level rather than waiting for higher headquarters to provide a solution. Understanding that resources are finite at the strategic level empowers local leaders to take initiative and resolve issues independently. Seek Purpose Plus: Serving in the military provides a unique opportunity to practice medicine on an "extended family" that shares your core values. This sense of shared purpose turns the daily grind into a lifelong mission of service to the nation and its warriors.   Episode Keywords Army Medicine, Dr. Lance Raney, Military Medicine, WarDocs Podcast, LSCO, Large Scale Combat Operations, Combat Casualty Care, Prolonged Field Care, Army Surgeon General, Defense Health Agency, DHA Transition, Medical Readiness, Combat Medic Training, Paramedic Program, TCCC, Leadership Philosophy, Army Family Medicine, Battlefield Trauma, Medical AI, Triage Technology, Military Healthcare, Army ROTC, HPSP, Tactical Medicine, Operational Readiness, Clinical Excellence, MHS Governance. Hashtags #MilitaryMedicine, #ArmyStrong, #WarDocs, #Leadership, #CombatCasualtyCare, #MedicalReadiness, #LSCO, #MedEd   Honoring the Legacy and Preserving the History of Military Medicine The WarDocs Mission- WarDocs exists to honor the legacy of Military Medicine, preserve its history, and inspire every generation — across all Services, Corps, and Ranks — to serve with excellence and pride. Through mentorship, coaching, and education, we equip those considering, entering, and serving in military medicine with the knowledge, connections, and community they need to thrive. We celebrate Who we are, What we do, and, most importantly, How we serve Our Patients, the DoW, and Our Nation.   Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/our-guests Subscribe and Like our Videos on our YouTube Channel: https://www.youtube.com/@wardocspodcast Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm   WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield, demonstrating dedication to the medical care of fellow comrades in arms.     Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast YouTube Channel: https://www.youtube.com/@wardocspodcast        

Col Valerie Sams, MD is an Air Force trauma surgeon, surgical critical care expert, and the Director of the Center for Sustainment of Trauma and Readiness Skills (C-STARS) at the University of Cincinnati. Her path to the operating room was anything but ordinary.   Before medical school, she served as an Air Force line officer in logistics and fuels, learning how the operational side of the service actually works at the flight line. That bilingual fluency in operations and medicine now shapes how she advocates for resources, leads hospitals, and prepares the military health system for the next fight.    In this conversation, she walks through her two tours as the trauma czar at the Bagram role three hospital straight out of fellowship, where she was responsible not only for clinical excellence but for leading every nurse, emergency medicine physician, and surgeon doing trauma care across the theater. She talks honestly about the weight of that role, especially during her second deployment with junior surgeons on their first downrange experience, the rise in U.S. casualties, the green-on-blue threat, and her work standing up Medic-X as a force multiplier for limited deployed medical crews.     Col Sams makes a powerful case for the strategic importance of military-civilian partnerships like C-STARS, the only Air Force critical care air transport advanced training course, and explains how the Air Force, Army, and Navy are converging through the Joint Trauma System, the Mission Zero Act, and the American College of Surgeons Blue Book to professionalize military-civilian integration. She is direct about the skill sustainment crisis inside military treatment facilities, the shift from 65 percent beneficiary care to 20 percent, the urgency of the Military Unique Curriculum, and the need to train outside-the-tent skills deliberately rather than by accident.   Dr. Sams lays out a clear-eyed vision for large-scale combat operations: faster trauma registry feedback loops, autonomous and decision support tools, closed-loop control ventilation, ECMO projected forward, and a hard end to the wax pencil and TCCC card as battlefield documentation. She closes with what should remain the center of gravity for every military medicine decision — the warfighter — and the conviction that they deserve the best clinical care available anywhere in the country.     Chapters (00:47-05:47) From Fuels Officer to Trauma Surgeon (05:47-12:49) Two Tours as Trauma Czar at Bagram (12:49-24:46) ECMO Forward, C-STARS, and the Skill Sustainment Crisis (24:46-35:42) Joint Military-Civilian Integration and the Military Unique Curriculum (35:42-49:26) LSCO Readiness, Force Multiplication, and Battlefield Technology (49:26-58:30) Female Leadership, Clinical Excellence, and Legacy     Chapter Summaries (00:47-05:47) From Fuels Officer to Trauma Surgeon Col Sams describes her unconventional path from Air Force line officer in logistics and fuels to general surgery and trauma fellowship. She credits her operational background with giving her a bilingual fluency between line and medical worlds that strengthens how she advocates for resources, leads hospital operations, and earns credibility with non-medical commanders.   (05:47-12:49) Two Tours as Trauma Czar at Bagram She unpacks the weight of deploying as the trauma czar at the Bagram Role 3 immediately after her fellowship and the lessons that came from leading mass casualty events, debriefing young teams, and dealing with the green-on-blue threat. She explains the stand-up of Medic-X under Lt Gen Hogg as a deliberate force multiplier for limited deployed medical crews.   (12:49-24:46) ECMO Forward, C-STARS, and the Skill Sustainment Crisis Col Sams details her work projecting ECMO capability into austere environments and around the globe, then explains the mission, history, and structure of the three original C-STARS programs. She is direct about the skill sustainment crisis, with beneficiary care in military treatment facilities dropping from roughly 65 percent to 20 percent over two decades.   (24:46-35:42) Joint Military-Civilian Integration and the Military Unique Curriculum She describes the progress driven by the Mission Zero Act, the Joint Trauma System military-civilian work group, and the American College of Surgeons Blue Book. She makes the case for a robust Military Unique Curriculum that develops both surgical fundamentals and the outside-the-tent skills that today's young military surgeons need before they take their first leadership role downrange.   (35:42-49:26) LSCO Readiness, Force Multiplication, and Battlefield Technology Col Sams turns to large-scale combat operations and the blind spots that the counterinsurgency generation may carry into the next fight. She calls for faster trauma registry feedback, autonomous decision support tools, closed-loop ventilation, ECMO projected forward, and a hard end to the TCCC wax pencil as the primary battlefield documentation tool.   (49:26-58:30) Female Leadership, Clinical Excellence, and Legacy She offers candid advice to young female military surgeons on imposter syndrome, unconscious bias, and the discipline of staying clinically excellent. She closes with the conviction that patient-centered leadership, lifelong learning, and protecting clinical talent are the foundations of how military medicine should remember her work.     Take Home Messages Operational Fluency Strengthens Medical Leadership: Time spent on the line side of the military — understanding logistics, fuels, and how the operational force actually fights — builds credibility with non-medical commanders and sharpens advocacy for resources. Surgeons who speak the operational language sit at the right tables and make better decisions for their teams and their patients.   The Trauma Czar Role Demands Leadership Before Stride: Being responsible for an entire theater of combat casualty care immediately after fellowship is a heavy and unforgiving assignment. Clinical excellence is the floor; the real work is leading nurses, emergency medicine physicians, and surgeons through mass casualty events, debriefs, and the green-on-blue threat with junior teammates who have never deployed before.   Skill Sustainment Requires Military-Civilian Partnership: Military treatment facilities now deliver only a fraction of the beneficiary care they once did, and that volume cannot sustain combat-ready trauma teams. Embedded military-civilian partnerships like C-STARS, supported by the Mission Zero Act and the American College of Surgeons Blue Book, are the realistic path to keep wartime skills sharp.   Outside-the-Tent Skills Must Be Deliberately Trained: Today's young military surgeons need more than technical readiness. They need a deliberate Military Unique Curriculum that develops the non-clinical leadership skills required to run a theater trauma system, manage resources, and lead teams under pressure. Picking those skills up on the fly is no longer good enough.   LSCO Will Not Wait on the Wax Pencil: The next fight will not give the medical force three years to figure out what changed or seven years to update clinical practice guidelines. Force multiplication through MedicX, autonomous decision support tools, closed-loop ventilation, ECMO projected forward, and modern battlefield documentation are non-negotiable investments now, before large-scale combat operations force the lesson.   Col Valerie Sams, MD Biography    Colonel Valerie Sams is the Director of the Center for Sustainment of Trauma and Readiness Skills (CSTARS) Cincinnati and serves as Critical Care Air Transport Team (CCAT) Training cadre. Originally from Georgetown, KY, she was commissioned into the Air Force in 2000, initially serving as a supply and logistics officer, which included a deployment supporting Stabilization Forces in the Balkans.    Transitioning to medicine, she earned her medical degree from St. George's University in 2008. Col Sams completed her General Surgery Residency at the University of Tennessee Medical Center (2013) and a Trauma Critical Care fellowship at Brooke Army Medical Center (2015).    As a trauma surgeon and ECMO physician, Col Sams deployed twice as the Trauma Czar for Bagram Airfield, Afghanistan. Her extensive leadership roles include Trauma Medical Director, Assistant Chief of Trauma and Surgical Critical Care, Ground Surgical Team Pilot Unit Leader, and director of various military trauma research programs.   Episode Keywords WarDocs, military medicine, military trauma surgery, combat casualty care, trauma czar, Bagram role three, Air Force trauma surgeon, C-STARS Cincinnati, critical care air transport, CCATT, Joint Trauma System, military civilian partnership, Mission Zero Act, military unique curriculum, large scale combat operations, LSCO, prolonged casualty care, MedicX, ECMO in combat, battlefield documentation, TCCC card, closed loop ventilation, military medical leadership   Hashtags #MilitaryMedicine, #WarDocs, #CombatCasualtyCare, #TraumaSurgery, #JointTraumaSystem, #LSCOReadiness, #CSTARS, #MilCivPartnership   Honoring the Legacy and Preserving the History of Military Medicine    WarDocs exists to honor the legacy of Military Medicine, preserve its history, and inspire every generation — across all Services, Corps, and Ranks — to serve with excellence and pride. Through mentorship, coaching, and education, we equip those considering, entering, and serving in military medicine with the knowledge, connections, and community they need to thrive. We celebrate Who we are, What we do, and, most importantly, How we serve Our Patients, the DoW, and Our Nation. Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/our-guests Subscribe and Like our Videos on our YouTube Channel: https://www.youtube.com/@wardocspodcast Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm   WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield, demonstrating dedication to the medical care of fellow comrades in arms.   Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast YouTube Channel: https://www.youtube.com/@wardocspodcast  

This week, Dr John Quinn joins Aebhric O'Kelly to discuss the emerging field of Damage Control Procedures (DCP) for austere, prolonged, and contested environments.Dr Quinn explores the growing operational gap between Tactical Combat Casualty Care (TCCC) and definitive surgical care, particularly in Ukraine and other high-threat environments where evacuation delays can extend for days. The discussion covers the development of DCP curricula, governance challenges, telemedicine oversight, surgical skills for non-surgeons, and the operational realities driving innovation in prolonged casualty care.The episode also examines lessons learned from Ukraine, the future of austere procedural medicine, and how modern conflict is reshaping medical doctrine across NATO and partner nations. Chapters00:05 – Introduction to Dr John Quinn and current operational work00:39 – Volunteering in Ukraine and advancing damage control resuscitation01:20 – What are Damage Control Procedures (DCP)?02:01 – The gap between TCCC and definitive surgery03:25 – Why delayed evacuation changes medical doctrine04:29 – Surgical skills for paramedics, nurses, and combat medics05:20 – Governance and legal challenges surrounding DCP06:26 – How surgeons may react to DCP concepts07:16 – Telemedicine oversight and surgeon mentorship in austere care09:11 – Surgical expertise shaping the DCP curriculum10:08 – Overview of the DCP programme structure11:16 – Tier 1 skills: surgical airways, thoracostomy, tourniquet conversion, traumatic amputations12:43 – Tier 2 skills: laparotomy, external fixation, fasciotomy, advanced burns14:29 – Tier 3 concepts: burr holes and REBOA15:47 – Future concepts: haemofiltration and advanced austere ICU care18:22 – Why DCP sounds controversial — and why it may still be necessary19:16 – Telemedicine vs autonomous procedural decision-making22:05 – Clinical governance and parallels with paramedic evolution23:38 – Why basic life support remains foundational25:35 – Historical parallels with early paramedic medicine26:36 – Expansion of chest tube and intraosseous use in Ukraine30:11 – What happens next for the DCP pathway?31:24 – The importance of listening to Ukrainian clinicians32:21 – DCP beyond special operations medicine33:32 – Introduction to the Disaster Health Institute (DHI)35:37 – Bridging strategic and operational medicine36:17 – SOF Combat Medical Conference (CMC) discussion38:19 – Upcoming RCSEd webinar on DCP39:30 – Lessons learned from Ukrainian workshops and role-zero care41:40 – Drone warfare, attacks on medical personnel, and evacuation challenges43:18 – Why Ukrainian medics are requesting Tier 1 and Tier 2 DCP capability45:18 – Upcoming DCP workshop at Medicine in the Mediterranean46:31 – Advice for clinicians entering austere medicine50:27 – AI, education, digital twins, and the future of medical contentGuest bioDr John Quinn is an operational clinician, researcher, and educator working across prehospital care, austere medicine, disaster health, and military medicine. Originally trained as a paramedic, he later completed both medical and doctoral training and now works clinically within the United Kingdom while supporting medical projects and training initiatives in Ukraine.Dr. Quinn is involved in the development of Damage Control Procedures curricula and collaborates with international subject matter experts, surgeons, and operational clinicians to improve prolonged casualty care capability in contested environments.Disaster Health Institute is a collaborative network focused on disaster health, operational medicine, epidemiology, humanitarian response, and strategic healthcare preparedness. The organisation works with subject matter experts across Europe, North America, Central Asia, Africa, and South America to develop evidence-informed approaches to modern operational health challenges.

      Dr. Paul D. Biddinger, Chief Preparedness and Continuity Officer at Mass General Brigham and one of the nation's foremost authorities on disaster medicine, joins WarDocs to deliver an unflinching assessment of the United States' readiness to manage mass battlefield casualties in a large-scale combat operations (LSCO) scenario.     Drawing on nearly 30 years as a practicing emergency physician, his leadership of the National Special Pathogen System, and his co-PI role on a Henry M. Jackson Foundation-funded LSCO readiness project, Dr. Biddinger illuminates the critical gaps — and the urgent solutions — that will determine whether Team America can meet the medical demands of tomorrow's wars.       The conversation opens with Dr. Biddinger's distinctive academic trajectory: international relations and public policy at Princeton before medical school, a combination that instilled a deep appreciation for the policy infrastructure that either enables or obstructs effective healthcare coalitions. That framework shapes his entire approach to LSCO readiness, where the challenge is never a single hospital or a single physician — it is always the system.  Dr. Biddinger identifies data silos as the foundational failure threatening LSCO response.    The civilian healthcare system is already operating at or above capacity in most American cities, and the Federal Coordinating Centers within the National Disaster Medical System lack the real-time clinical expertise needed to make sophisticated patient regulation decisions. He argues for urgent integration of civilian-side patient transfer intelligence with military command structures — ensuring that warfighters returning home at scale are routed to the right bed, with the right subspecialty capability, rather than flooding Level I trauma centers and displacing civilian critical care.      The Ukraine conflict provides sobering real-world data: drone-driven injury patterns unfamiliar to most civilian trauma surgeons, extended evacuation timelines that demand adaptive point-of-injury care, and an overwhelmed rehabilitation pipeline that the U.S. system is wholly unprepared to replicate. Dr. Biddinger draws direct parallels to the Boston Marathon bombing response, where tactical combat casualty care principles — rapid hemorrhage control, aggressive patient distribution, and relentless questioning of old-school disaster assumptions — saved lives that a conventional mass casualty protocol would have lost.                       The episode closes with two pieces of career advice for young military medicine professionals: question every assumption respectfully and within proper command structures, and be a passionate, data-driven advocate for systems change. The Joint Trauma System's continuous learn-and-adapt model is held up as the gold standard. Dr. Biddinger's message is clear — the next large-scale conflict will be won or lost in part by how effectively military and civilian medicine learn to speak the same operational language before the shooting starts.   Chapters (00:00-02:30) From International Relations to Emergency Medicine: Building Systems-Level Thinking (02:30-07:37) LSCO Readiness Gaps: Data, Capacity, and the Civilian Healthcare System (07:37-13:58) Federal Coordination, Ukraine Lessons, and the Rehabilitation Crisis (13:58-19:24) AI, Heat Injury Prevention, and Patient Surge Load Balancing (19:24-26:30) National Special Pathogen System and All-Hazard Response Leadership (26:30-38:40) Boston Marathon Bombing Lessons, Innovation Culture, and the Future of Military Medicine   Chapter Summaries (00:00-02:30) From International Relations to Emergency Medicine: Building Systems-Level Thinking Dr. Biddinger traces his unconventional path from Princeton's international relations program to nearly 30 years as a practicing emergency physician. He explains how policy training shaped his conviction that no individual doctor or hospital succeeds in isolation — effective disaster response is fundamentally a systems problem, and the policy infrastructure surrounding those systems determines everything.   (02:30-07:37) LSCO Readiness Gaps: Data, Capacity, and the Civilian Healthcare System Drawing on his Henry M. Jackson Foundation LSCO project, Dr. Biddinger identifies the civilian healthcare system's chronic overcapacity as the primary threat to absorbing mass battlefield casualties. He quantifies the challenge — a hundred thousand extra patients over a hundred days — and explains why real-time data integration across hospital systems, state lines, and trauma center capabilities is the non-negotiable foundation of any viable patient distribution plan. He specifically flags EMS workforce shortages as an underappreciated rate-limiting factor.   (07:37-13:58) Federal Coordination, Ukraine Lessons, and the Rehabilitation Crisis Dr. Biddinger critiques the current Federal Coordinating Center structure as insufficiently connected to civilian-side clinical expertise, and calls for direct integration of military command data with civilian patient tracking systems. He applies lessons from the Ukraine conflict — drone injury patterns, extended evacuation timelines, and rehabilitation system collapse — to underscore how fundamentally different LSCO will be from the counter-insurgency environments most current military medical leaders trained in.   (13:58-19:24) AI, Heat Injury Prevention, and Patient Surge Load Balancing Dr. Biddinger describes his IBM Sustainability Accelerator collaboration developing AI-driven early warning systems for extreme heat events, and explains how that same data integration logic applies to battlefield thermal stress monitoring and real-time casualty tracking via the Joint Trauma System. He then walks through the COVID-era Boston hospital load-balancing system he helped build — competitive hospitals sharing real-time bed and ICU data and making collaborative surge decisions multiple times daily — and explores how that model translates to theater patient regulation.   (19:24-26:30) National Special Pathogen System and All-Hazard Response Leadership Dr. Biddinger explains the tiered architecture of the National Special Pathogen System — the infectious disease analog to the trauma center hierarchy — and its identify-isolate-inform framework, developed from the 2014 West African Ebola outbreak. He applies the framework directly to military medicine, emphasizing the importance of maintaining high clinical suspicion, knowing real-time global outbreak data, and preserving robust reach-back capability to specialty expertise. He closes with field lessons from Hurricane Katrina, Nepal earthquake response, and the Haiti earthquake on integrating civilian and military assets under ESF-8 and WHO cluster structures.   (26:30-38:40) Boston Marathon Bombing Lessons, Innovation Culture, and the Future of Military Medicine Dr. Biddinger credits tactical combat casualty care principles from Gulf War I and II for the lives saved at the Boston Marathon bombing, specifically the pivot away from staged triage toward rapid hemorrhage control and immediate hospital distribution. He documents how Boston EMS cleared more than 60 critical casualties in 18 minutes. The episode closes with career guidance for young military medicine professionals: question every assumption within appropriate command structures, remain data-driven, and be a fierce advocate for systems that better serve the injured warfighter.   Biography    Dr. Paul Biddinger is the Chief Preparedness and Continuity Officer at Mass General Brigham (MGB) and the Chief of the Division of Emergency Preparedness in the Department of Emergency Medicine at MGB.  He holds the Ann L. Prestipino MPH Endowed Chair in Emergency Preparedness and is also the Director of the Center for Disaster Medicine at Massachusetts General Hospital (MGH).  Dr. Biddinger additionally serves as the Director of the Emergency Preparedness Research, Evaluation and Practice (EPREP) Program at the Harvard T. H. Chan School of Public Health and holds appointments at Harvard Medical School and at the Chan School.   Dr. Biddinger serves as a medical officer for the MA-1 Disaster Medical Assistance Team (DMAT) in the National Disaster Medical System (NDMS) in the US Department of Health and Human Services (HHS).     Dr. Biddinger is an active researcher in the field of emergency preparedness and has lectured nationally and internationally on topics of preparedness and disaster medicine.  He has authored numerous articles and book chapters on multiple topics related to disaster medicine and emergency medical operations and has responded to numerous prior disaster events, including Hurricane Katrina, Superstorm Sandy, the Boston Marathon bombings, the Nepal earthquakes, and many others.     He completed his undergraduate study in international relations at Princeton University, attended medical school at Vanderbilt University, and completed residency training in emergency medicine at Harvard. Episode Keywords military medicine, large-scale combat operations, LSCO, disaster medicine, emergency medicine, Paul Biddinger, Mass General Brigham, patient surge, civilian military integration, Henry M. Jackson Foundation, National Disaster Medical System, NDMS, Federal Coordinating Centers, trauma system, combat casualty care, Boston Marathon bombing, Ukraine war lessons, drone injuries, mass casualty, hemorrhage control, tactical combat casualty care, TCCC, National Special Pathogen System, Ebola preparedness, AI in medicine, heat injury prevention, hospital capacity, patient distribution, military healthcare, WarDocs podcast Hashtags #MilitaryMedicine, #WarDocs, #LargeScaleCombatOperations, #DisasterMedicine, #CombatCasualtyCaree, #EmergencyMedicine, #MilitaryReadiness, #TCCC Honoring the Legacy and Preserving the History of Military Medicine The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoW, and Our Nation.   Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/our-guests Subscribe and Like our Videos on our YouTube Channel: https://www.youtube.com/@wardocspodcast Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm   WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield, demonstrating dedication to the medical care of fellow comrades in arms.     Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast YouTube Channel: https://www.youtube.com/@wardocspodcast        

In this episode, host Mark Ledlow is joined by James Hamilton, a former sheriff's deputy and FBI special agent who spent 18 years with the Bureau, served on SWAT and the Joint Terrorism Task Force, and was selected in 2004 for the FBI Director's protective detail under Director Mueller. Hamilton later became a Quantico tactical instructor and created a 10-day protection school used by agencies including NSA and CIA. Influenced by Gavin de Becker's books The Gift of Fear and Just Two Seconds, he joined de Becker's firm and now serves as Senior Vice President overseeing quality, licensing, training, and equipment for roughly 650 protectors. He emphasizes fundamentals over firearms-heavy training, focusing on time/distance, evacuation, interpersonal skills, professional presentation, and robust medical training (CPR/AED, first aid, TCCC, quarterly refreshers). The discussion also covers liability insurance, 1099 work concerns, California self-defense standards, confidentiality and social media risks, and how 2020 unrest and police defunding may increase demand for private security.Learn about all this and more in this episode of The Fearless Mindset Podcast.KEY TAKEAWAYSMedical skills over firearms: EP professionals use medical kits 60 times per quarter vs. rarely drawing weapons - invest in comprehensive medical training (CPR, AED, TCCC, trauma care)Two seconds principle: Research shows ~2 seconds between moment of commitment and moment of recognition in attacks - understanding time and distance is criticalCover and evacuate: Default response should be protecting the principal and evacuation, not engaging threats or "getting drawn out" into crowdsProfessional presentation matters: CEOs notice quality - invest in interpersonal skills, nice clothes, polished shoes, and personal fitnessNo preemptive shootings in US EP history: Study of 1400+ attacks shows no documented case where US close protection stopped an attack preemptively with firearmsInsurance is non-negotiable: Operating without professional liability insurance in 2020's legal climate is reckless - you're judged by civilian defensive standards, not law enforcementConfidentiality kills careers: Social media selfies and public disclosures destroy the trust-based protector-client relationshipPosition over firepower: Most attacks fail because protectors are out of position, not under-armed - distance and proximity matter more than weaponryQUOTES"There's about two seconds between the moment of commitment when the assailant commits to the act...and the moment of recognition, that's when the protected person or the protectors get their head around what's happening.""We have 650 some odd bodyguards and we routinely go into our medical bags 60 times a quarter...and we're rarely drawing weapons.""If you can only do one, go to the principal. If you go out into the crowd...it's one to three, one to four, one to five, you could get drawn out into something and you lose sight of the principle.""I do not believe that bodyguards or protectors wake up in the morning and say, 'Hey, I wanna fail today.' Maybe they haven't been properly trained. Maybe they're mentally not prepared.""They always say that. They're like, man, I couldn't get there fast enough. I saw it happening.""The protectee protector relationship is based on trust. You can't really buy it. You gotta earn it, and you definitely don't earn it by blabbing your mouth.""These folks that hire us are discerning people. They know quality, they understand professionalism. And they don't suffer fools.""This isn't the government. They will fire you tomorrow. There's no union protection in the EP industry."Get to know more about James Hamilton through the link/s below.https://www.linkedin.com/in/james-hamilton-752894104/To hear more episodes of The Fearless Mindset podcast, you can go to https://the-fearless-mindset.simplecast.com/ or listen on major podcasting platforms such as Apple, Google Podcasts, Spotify, etc. You can also subscribe to the Fearless Mindset YouTube Channel to watch episodes on video.

"Critical Thinking Is As Valuable As As any Other Skill You Train." Episode Summary On this episode of The Gun Experiment, Keith and I dive deep into the world of executive protection with veteran and security expert Ashton Dickey. We explore how Ashton transitioned from combat medic and nurse to running his own executive protection company. Ashton gives us a no-nonsense look at what the job really entails versus Hollywood glamor, the critical soft skills needed, how medical training gives you an edge in the field, and even how drones are being integrated into security operations. Plus, Ashton shares stories from the field and reveals how to build trust with high-profile clients. We round things out by talking about Ashton's experience competing on American Airgunner. Call to Action 1. Join our mailing list: Thegunexperiment.com 2. Subscribe and leave us a comment on Apple or Spotify 3. Follow us on all of our social media: InstagramYoutube 4. Grab some cool TGE merch 5. Ask us anything at AskMikeandKeith@gmail.com 6. Be sure to support the sponsors of the show. They're a big part of making the show possible. Show Sponsors HSM Ammunition: Look for the orange HSM logo next time you pick up ammo. More info at hsmammunition.com. Onsite Firearms Training: Train with industry-leading instructors who truly support the firearms community. Find classes at OFTLLC.US. Key Takeaways Executive protection is mostly about concierge/hospitality, not just “meat shield” tactics you see in movies. Medical and soft skills (critical thinking, communication) set great agents apart from the crowd. There is little regulation—it's a “good buddy” system where reputation matters more than a certificate. Drones are now a powerful, affordable tool for security teams, allowing safe route prep and surveillance. Most clients are regular people; building trust is key, and sometimes you become part of their family. Medical emergencies (not gunfight wounds!) are the most common issues agents need to handle. Discipline and honest self-assessment are more important than flashy techniques. Guest Information Ashton Dickey Veteran, former combat medic, and nurse Co-owner and operator of Paratus Group TECC medical instructor for civilians and police Season 5 contestant on American Airgunner   Find Ashton on Instagram and follow his work with Paratus Group. Keywords Executive protection, security work, concierge, critical thinking, soft skills, medical training, TECC, TCCC, drones, security technology, Paratus Group, American Airgunner, gun podcast, Second Amendment, HSM Ammunition, Onsite Firearms Training, firearms, podcast, tactical training, discipline, reputation, private security, bodyguard, trauma care, lifestyle, Arizona, drone surveillance, airgun competition

    In this episode of War Docs, we speak with retired Army Colonel Dr. Robert Mabry, a figure whose career trajectory from an 18 Delta Special Forces medic to a senior physician-leader has shaped the face of modern military medicine. Dr. Mabry recounts his harrowing experience during the Battle of Mogadishu, where he provided care for 15 hours under intense fire. He reflects on how those "blood-written" lessons exposed the flaws of applying civilian EMS standards to the battlefield, eventually leading to his involvement as a founding member of the Committee on Tactical Combat Casualty Care (TCCC). The conversation moves from the tactical to the systemic, as Dr.Mabry discusses his pivotal role in upgrading Army flight medics to critical care paramedics and his advocacy for the "Mission Zero Act," which integrates military surgical teams into civilian trauma centers to maintain clinical readiness during the interwar period.     Dr. Mabry also addresses the looming challenges of Large-Scale Combat Operations (LSCO). He warns that the "Golden Hour" luxury enjoyed in Iraq and Afghanistan will likely vanish in future peer-on-peer conflicts due to the lack of air superiority and the threat of mass casualties from advanced weaponry. To prepare, he proposes a radical overhaul of the medical career pathway, advocating for a "Battlefield Medical Specialist" track that allows medics to advance into high-level operational roles without losing their tactical expertise. By embedding military teams into a nationalized mesh network of civilian hospitals, Mabry envisions a "Team America" approach that ensures the military is never again forced to relearn life-saving lessons at the start of a new conflict. This episode is a masterclass in operational medicine, leadership, and the persistent need for innovation within the military health system bureaucracy.   Chapters (00:00-01:30) Introduction to Retired Colonel Dr. Robert Mabry (01:30-05:37) From Small-Town Oklahoma to Army Ranger (05:37-10:51) The Path to Special Forces Medic and 18 Delta Training (10:51-18:54) 15 Hours Under Fire: The Battle of Mogadishu (18:54-25:03) Transitioning from NCO to Physician at USUHS (25:03-31:15) Founding TCCC and the Joint Trauma System (31:15-39:54) Revolutionizing Flight Medic Training and Evidence-Based Reform (39:54-48:00) Prolonged Field Care and the Reality of Future Conflict (LSCO) (48:00-56:17) Mission Zero and Embedding Military Teams in Civilian Centers (56:17-1:03:40) Designing the Future Battlefield Medical Specialist Career Track (1:03:40-1:05:42) Legacy and Closing Remarks   Chapter Summaries (00:00-01:30) Introduction to Retired Colonel Dr. Robert Mabry Host Dr. Doug Soderdahl introduces Dr. Robert Mabry, highlighting his journey from the Battle of Mogadishu to his role as a founding member of the Committee on TCCC. The introduction sets the stage for a discussion on overhauling military medical training and preparing for future high-casualty conflicts. (01:30-05:37) From Small-Town Oklahoma to Army Ranger Dr. Mabry shares his early motivations for enlisting, citing a family tradition of military service and a desire to escape his small town. He explains how a recruiter's pitch led him to the Army over the Marine Corps, eventually landing him in the newly formed 3rd Ranger Battalion. (05:37-10:51) The Path to Special Forces Medic and 18 Delta Training Inspired by a mentor, Mabry pursued the rigorous Special Forces Medic (18 Delta) pathway, known for its high attrition rate and intense training. He discusses the 1.5-year pipeline and how his early marriage provided the stability needed to succeed in the academically and physically demanding course. (10:51-18:54) 15 Hours Under Fire: The Battle of Mogadishu Mabry provides a first-hand account of the "Black Hawk Down" mission, detailing the chaos of the crash site and the makeshift bunker he used to treat casualties overnight. He reflects on the realization that contemporary medical protocols, like C-spine immobilization under fire, were dangerously ill-suited for combat. (18:54-25:03) Transitioning from NCO to Physician at USUHS Inspired by clinical encounters as a medic, Mabry discusses the arduous process of completing medical school prerequisites while on active duty, including retaking organic chemistry after returning from Somalia. He details his experience at USUHS, balancing family life with the challenges of the basic science curriculum. (25:03-31:15) Founding TCCC and the Joint Trauma System Mabry explains the "grassroots" origins of the Committee on Tactical Combat Casualty Care (TCCC) and the later development of the Joint Trauma System (JTS). He critiques the military's initial lack of a data-driven trauma system and the years it took to improve survivability during the Global War on Terror. (31:15-39:54) Revolutionizing Flight Medic Training and Evidence-Based Reform Mabry recounts the struggle to convince the Army to upgrade flight medics from EMT-Basics to Critical Care Paramedics. He highlights a landmark study that proved a 15% improvement in survival for the most critically injured patients when treated by higher-trained providers. (39:54-48:00) Prolonged Field Care and the Reality of Future Conflict (LSCO) Drawing from experiences on the Afghan-Pakistan border, Mabry demystifies prolonged field care as essential nursing care. He warns that future conflicts (LSCO) will lack air superiority, requiring medics to manage mass casualties at the point of injury for days rather than hours. (48:00-56:17) Mission Zero and Embedding Military Teams in Civilian Centers Mabry advocates for a nationalized "Team America" strategy to embed military surgical teams in busy civilian level-one trauma centers. He discusses his work on the Mission Zero Act to ensure military providers maintain their trauma skills during periods of peace. (56:17-1:03:40) Designing the Future Battlefield Medical Specialist Career Track Mabry proposes a new career pathway for operational medicine that allows experienced medics to transition into specialized Physician Assistant roles. This track would keep tactical expertise in the field and provide a long-term career for those dedicated to battlefield care. (1:03:40-1:05:42) Legacy and Closing Remarks In the final segment, Mabry reflects on his legacy, hoping his work inspires future medical leaders to have the courage to innovate. The episode concludes with a tribute to his contributions to saving lives on and off the battlefield.   Take Home Messages Combat Medicine Requires Tactical Adaptation: Medical protocols designed for civilian settings, such as C-spine immobilization or the avoidance of tourniquets, are often counterproductive in high-threat environments. True innovation in combat casualty care comes from acknowledging that the tactical situation dictates the medical intervention, a realization that led to the birth of TCCC. Data Drives Survival in Trauma Systems: The military health system cannot rely on luck or anecdotal evidence to improve clinical outcomes. Establishing a robust trauma registry and a continuous quality improvement process, as seen with the Joint Trauma System, is essential to bending the survival curve and preventing the repetition of past mistakes. Advanced Training is Non-Negotiable for Flight Medics: Moving from an "evacuation only" mindset to a "critical care in the air" model significantly improves survival rates for the most severely injured. Investing in high-level paramedic and nursing certification for flight crews ensures that the aircraft serves as a mobile ICU rather than just a transport vehicle. Preparing for Large-Scale Combat Requires Triage Mastery: In future peer-on-peer conflicts where medical evacuation may be delayed for days, military providers must be trained to manage expecting casualties and perform complex triage. This requires a shift in focus toward prolonged field care and the psychological readiness to make difficult resource-allocation decisions. Civilian-Military Integration is Essential for Readiness: To maintain the surgical skills necessary for war, military teams must be permanently embedded in high-volume civilian trauma centers. A nationalized strategy like the Mission Zero Act ensures that the nation's medical assets are integrated and ready to handle a sudden surge of casualties in a "Team America" approach.   Episode Keywords Military Medicine, Tactical Combat Casualty Care, TCCC, Battle of Mogadishu, Black Hawk Down, Army Rangers, Special Forces Medic, 18 Delta, Joint Trauma System, Flight Medic, Critical Care Paramedic, Mission Zero Act, Large Scale Combat Operations, LSCO, Prolonged Field Care, Combat Surgeon, USUHS, Medical Readiness, Trauma Surgery, Battlefield Medicine, Veteran Stories, Army Medical Department, AMEDD, Medevac, Operational Medicine   Hashtags #MilitaryMedicine, #WarDocs, #TCCC, #CombatMedic, #TraumaCare, #SpecialOperations, #VeteranLeadership, #BattlefieldMedicine   Honoring the Legacy and Preserving the History of Military Medicine The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation. Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/our-guests Subscribe and Like our Videos on our YouTube Channel: https://www.youtube.com/@wardocspodcast Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm   WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield,demonstrating dedication to the medical care of fellow comrades in arms.     Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast YouTube Channel: https://www.youtube.com/@wardocspodcast        

In this episode of the PFC Podcast, Dennis and Emily Johnston delve into the critical topic of cold weather medicine, specifically focusing on the newly submitted Cold Weather Clinical Practice Guidelines (CPG) for the Arctic. Emily emphasizes the importance of these guidelines as adjuncts to existing protocols, highlighting the unique challenges posed by extreme cold environments, such as the constant threat of hypothermia and frostbite. She explains how the guidelines are designed to enhance existing trauma care practices by incorporating specific considerations for operating in frigid conditions, ensuring both the caregiver and the casualty are adequately protected and treated.The conversation also touches on practical strategies for managing injuries in cold weather, including the use of tourniquets and the importance of maintaining body heat. Emily shares insights on nutrition for both rescuers and patients in extreme cold, emphasizing the need for high-calorie, easily consumable foods. The episode concludes with a discussion on the latest advancements in frostbite treatment, including the use of ibuprofen and isoprost, and the significance of timely intervention in preserving tissue viability. Overall, this episode serves as a vital resource for medical professionals operating in cold environments, providing them with essential knowledge and tools to improve patient outcomes.TakeawaysHypothermia and frostbite are constant threats in extreme cold.Nutrition is crucial; high-calorie foods are essential for survival.Timely intervention is key in frostbite treatment.Patient packaging must be done carefully to prevent heat loss.Chapters00:00 Introduction to Cold Weather Medicine01:10 Understanding the Need for an Arctic CPG10:14 Nutrition in Extreme Cold Environments27:06 Advancements in Frostbite Treatment35:15 Patient Packaging and Communication in Cold EnvironmentsFor more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this episode of the PFC Podcast, Dennis and John discuss the ongoing updates and changes within the Tactical Combat Casualty Care (TCCC) guidelines. They delve into the role of the TTC Committee, the importance of literature reviews in developing algorithms for trauma care, and the proposed changes to the March algorithm, emphasizing the need for resuscitation before decompression. The conversation also covers the overhaul of the analgesic section, the recommendations for antibiotics, and the role of TXA in treating hemorrhagic shock. Additionally, they touch on the significance of triage in mass casualty situations and the future directions of the committee's work.TakeawaysTCCC is continuously updated to reflect new research.Resuscitation should be prioritized over decompression in trauma care.The March algorithm may undergo significant changes to improve outcomes.Analgesic options are being re-evaluated due to supply issues.Rocephin is being recommended as a primary antibiotic.TXA is crucial for managing hemorrhagic shock in trauma patients.Triage protocols are essential for effective mass casualty management.The committee is open to innovative ideas and solutions.Training and education are vital for implementing new guidelines.Future meetings will focus on finalizing and voting on proposed changes.Chapters00:00 Introduction to the PFC Podcast02:46 Understanding the TTC Committee and Its Role06:06 Literature Review and Algorithm Development09:00 Resuscitation vs. Decompression in Trauma Care12:07 Proposed Changes to the March Algorithm15:06 Analgesic Section Overhaul and Alternatives18:09 Antibiotic Recommendations and Changes20:54 TXA and Its Role in Hemorrhagic Shock23:51 Triage in Mass Casualty Situations26:45 Future Directions and Upcoming Votes30:06 Conclusion and Final Thoughts For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

Episode Summary    Join us for a compelling conversation with Dr. Alexander Villahermosa, a neurosurgery resident at UT Health San Antonio and former 18 Delta Special Forces Medical Sergeant. Motivated by the events of 9/11, he enlisted with an 18 X-ray contract, embarking on a remarkable journey that took him from the battlefield to the operating room. Dr. Villahermosa shares stories from his deployments to Iraq, Afghanistan, and other austere environments, highlighting how mentorship from military physicians in Balad inspired him to pursue a medical degree.    Dr. Villahermosa provides a candid look at the Enlisted to Medical Degree Program (EMDP2), detailing his experience as part of its second class. He discusses the academic challenges of transitioning from an operational tempo to learning calculus and hard sciences, and how the program's cohort-based support system prepares active-duty soldiers for the rigors of medical school at the Uniformed Services University.   The discussion moves to the intense reality of surgical residency, where days often start at 4:00 AM and involve complex perioperative care. Dr. Villahermosa highlights the unique perspective military training brings to civilian medicine, specifically the ability to operate without advanced navigation technology—a skill emphasized by military mentors who understand downrange limitations. He also shares insights on "expectation management" regarding physical fitness while maintaining a grueling training schedule.   Finally, Dr. Villahermosa reflects on leadership lessons learned while rising from the rank of Master Sergeant to Captain, emphasizing that mentorship and staying humble are keys to success. He concludes with a crucial medical takeaway for combat medics: the best brain care starts with the basics of airway, respiration, and circulation as outlined in TCCC guidelines.     Chapters (00:00-06:00) From Enlistment to Special Forces Medic (06:00-19:30) The Path to Medical School and EMDP2 (19:30-28:30) Choosing Neurosurgery and Residency Reality (28:30-33:00) Military vs. Civilian Surgical Training (33:00-39:40) Leadership, Advice, and TBI Care   Chapter Summaries (00:00-06:00) From Enlistment to Special Forces Medic Dr. Villahermosa describes enlisting after 9/11 with the initial intent of joining the infantry, only to switch to an 18X contract to avoid a long wait for basic training. He recounts his deployments to Iraq and how mentorship from a group surgeon and an anesthesiologist in Balad first sparked his interest in becoming a physician. (06:00-19:30) The Path to Medical School and EMDP2 This section covers the process of completing undergraduate prerequisites through the Enlisted to Medical Degree Program (EMDP2), including the challenges of mastering mathematics and hard sciences. Dr. Villahermosa explains how the program's cohort system and partnership with the Uniformed Services University provided the structure and support necessary for success. (19:30-28:30) Choosing Neurosurgery and Residency Reality Initially uninterested in surgery, Dr. Villahermosa describes falling in love with the specialty during a third-year clerkship after being fascinated by spine and trauma cases. He details the daily grind of residency, which involves early mornings, long hours, and the need to seize small windows of time for physical fitness and self-care. (28:30-33:00) Military vs. Civilian Surgical Training The discussion focuses on the specific mindset instilled by military neurosurgeons, such as the ability to perform spine surgery using anatomic landmarks rather than relying solely on advanced navigation systems. This training ensures readiness for deployed environments where high-tech equipment may not be available or functional. (33:00-39:40) Leadership, Advice, and TBI Care Dr. Villahermosa reflects on the importance of humility and teamwork, noting that, regardless of rank or experience, there is always something to learn from others. He concludes by emphasizing that the best initial care for traumatic brain injury is adherence to TCCC protocols, specifically preventing hypotension and hypoxia.   Take Home Messages The Power of Mentorship: Career paths are often significantly altered by leaders who take the time to invest in their subordinates and encourage them to pursue higher goals. Dr. Villahermosa's journey to medical school began specifically because a group surgeon and an anesthesiologist took him under their wing during a combat deployment. Leaders should actively identify and encourage potential in those they lead, as this support can fundamentally change the trajectory of a service member's life. Back to Basics for Brain Injury: The most effective initial treatment for traumatic brain injury (TBI) lies in the fundamental principles of Tactical Combat Casualty Care (TCCC). Preventing secondary brain injury caused by hypotension and hypoxia is critical, meaning that controlling hemorrhage and managing the airway are the best ways to protect the brain in the pre-hospital setting. Providers should trust these protocols rather than feeling helpless without advanced neurosurgical capabilities, as stabilizing the patient's physiology is the first step in saving the brain. Operating in Austere Environments: While modern civilian neurosurgery often relies on advanced navigation technology and robotics, military surgeons must maintain the skill to operate using anatomic landmarks. Dr. Villahermosa highlights that downrange environments may lack functional high-tech equipment, making it essential to master manual techniques for spine and brain procedures. This training approach ensures that military surgeons remain adaptable and can deliver life-saving care regardless of the resources available in the field. Resilience Through Expectation Management: Surviving a demanding residency program or rigorous military training requires adjusting one's expectations regarding fitness and rest. Rather than waiting for large blocks of free time that may never come, trainees must learn to seize small, available moments for self-care, whether that is a short fifteen-minute run or catching up on sleep. Taking advantage of these brief breaks when they present themselves is crucial for maintaining long-term physical and mental performance when the schedule is unpredictable. Humility and Teamwork in Leadership: Success in high-stakes environments like the military and medicine demands humility and the recognition that no single person knows everything. Dr. Villahermosa emphasizes that rank and experience do not preclude the need to learn from others, including the newest members of the team who may bring fresh perspectives. Acknowledging one's role within the larger mission fosters a collaborative environment that improves patient outcomes and ensures the job gets done effectively.   Episode Keywords special forces medic, green beret, neurosurgery resident, military medicine, combat medic, trauma surgery, medical school, emdp2, enlisted to medical degree, uniformed services university, 18 delta, surgical training, traumatic brain injury, TCCC, tactical combat casualty care, military podcast, veteran stories, medical career, doctor journey, Brooke Army Medical Center, UT health San Antonio, neurosurgeon training, army special operations, combat veteran, medicine podcast, army doctor   Honoring the Legacy and Preserving the History of Military Medicine   The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation. Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/our-guests Subscribe and Like our Videos on our YouTube Channel: https://www.youtube.com/@wardocspodcast Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm   WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield,demonstrating dedication to the medical care of fellow comrades in arms.     Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast YouTube Channel: https://www.youtube.com/@wardocspodcast

In this episode of the PFC Podcast, Dennis and Thomas Trust Have discuss the complexities of practicing medicine in Arctic environments. Thomas shares his extensive experience as a consultant in anesthesiology and critical care medicine, particularly in remote and austere settings. The conversation delves into the unique challenges faced by medical personnel in extreme cold, including the importance of hypothermia prevention, the need for specialized training, and the critical role of teamwork and preparation in ensuring effective medical care in such conditions.TakeawaysThe practice of medicine in extreme cold requires modifications to standard protocols.Hypothermia is a significant risk for both patients and medical personnel in cold environments.Thorough preparation and scenario-based training are crucial for effective medical response in Arctic settings.Medical gear must be adapted for cold weather, including considerations for clothing layers during treatment.Shelter and environmental control are essential for patient care in cold conditions.Team roles and responsibilities should be clearly defined for efficient shelter setup and patient management.Drugs and medical supplies must be kept warm to maintain efficacy in extreme cold.Training should include practicing medical procedures with gloves on to simulate real conditions.The distance to a safe shelter can vary greatly depending on the tactical situation and environmental factors.Prioritizing warmth and hypothermia prevention is critical in cold-weather medical emergencies.Chapters00:59 Thomas Trust Have: Background and Experience02:46 Challenges of Arctic Medicine08:52 Tactical Care in Cold Environments13:33 Shelter and Environment Considerations24:29 Medical Equipment and Drug Management38:32 Planning for Arctic Operations47:04 Final Thoughts on Cold Weather MedicineFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

Double Tap Episode 432 This episode of Double Tap is brought to you by: Swampfox Optics, RMA Defense, Die Free Co., Rost Martin,  and Bowers Group Welcome to Double Tap, episode 432! Your hosts tonight are Jeremy Pozderac, Aaron Krieger, Nick Lynch, and me Shawn Herrin, welcome to the show! Krampus is LIVE. Deadline for signups is 10/30 9:00 pm EST, Names drawn 11/1.  Didn't get the invite? Check your cult status first. welikeshooting.com/my-account/subscriptions  Not active? Go to - theguncult.com to join! Then email automated@welikeshooting.com for an invite to Krampus.   - Dear WLS Romeo Whiskey - I'm looking to tame my 10.3 inch AR sbr. The recoil is a bit excessive for 5.56. I understand that is going to be a thing with a shorty, but I'm sure there are ways to mitigate it somewhat. I have a no-name linear comp that is ok until I pick up a suppressor, but am open to suggestions for muzzle devices. I also think an adjustable gas block would be a good start. Any suggestions on the best for the money? What else should I look for to break the spirit on this little blaster? Thanks Zac C - Hey guys, just started looking for my son's first deer rifle for his 13th birthday. I'd like to stay around 600 or less not including optic. Figured I couldn't go wrong with a .243 youth rifle with a 3x9 or a 4-12 scope. What rifle would y'all suggest? Thanks! Shoot straight! Notes- Hi Dan. Y'all Cunts - What's up gents. I'm planning on buying a GIRSAN INFLUENCER X in the near future. I've heard nothing but good things from a few guys I know the have them. My question is the valor mini to small for it and what light would you guys recommend? I'll probably already have it fully decked out by the time you read this but keep on keeping on. Miss Ogynist - My Dishwasher is broke. Should I replace or just write her a check? Joe E - Just listening to DoubleTap 423 and I swear to Christ Jeremy is trolling me personally at this point. I'm also a Marine that was in Horno 05-07 and was stationed in Ft Leonnardwood from 00-01. Big Louies was the greatest stripe club ever, bring your own bucket of beer! Sucks that they got shut down. I don't remember Jeremy but feel I would if I had seen his giant ass walking around. I'm a POG (5711) so not crossing paths is not shocking, but Horno is a small as camp and the Marine Det on Leonardwood is tiny as well, so maybe just missed him. Jeremy do you remember the taxi driver with the gimpy arm that kept his glove boxes full of porno's? Can't remember his name wonder if he was still around. Did you end up in the old ass white squad bays while you were in MAT Platoon? Follow up to the suppressor move question that you all answered for me. Having to move back to a completely none friendly state, I am leaving them with inlaws in a safe they have no access too. I will have an ID for the friendly state, but my drivers license and residency will be in the none friendly state. Will that stop me from continuing to purchases NFA items, or I am able to purchase them in the friendly state with my ID and leave them there?" Boomer with Garands - Who wrote and performed the theme song to "Double Tap"? What are the lyrics to the whole tune, and where can I download the complete song? It's very catchy! Notes- "After thorough and exhaustive examination of the material in question, I can confidently and unequivocally state that there are no further suggestions, observations, or amendments that would be required or deemed beneficial at this particular juncture. The work stands as is, complete and without need for any additional commentary or revision from my side." --ChatGPT's version of "No Notes" #StopPostingBlueAlphaCodesOnReddit #0.8xListener Mikoks Bigrthanyerz - What is required to have Shawn (I'm TCCC cert because of my #SSB) Herein come teach medical classes in our state? Thanks.. Notes- why does the wind blow from west to east in Wis...

This podcast episode discusses the evolution and current state of battlefield medicine, focusing on the Tactical Combat Casualty Care (TCCC) guidelines, training tiers, and the importance of evidence-based practices. The conversation highlights the challenges faced in implementing these guidelines and the ongoing efforts to improve trauma care in combat situations. Key updates to the TCCC curriculum and the logistics of providing medical care in the field are also addressed, emphasizing the need for continuous improvement and adaptation in military medicine.Listen ad-free with a premium membership on Spotify, Apple Podcast, or Patreon.TakeawaysThe majority of casualties occur in the pre-MTF environment due to hemorrhage.Improvements in battlefield trauma care have led to increased survival rates.Evidence-based medicine is crucial for developing TCCC guidelines.The TCCC curriculum consists of four training tiers for different levels of medical personnel.Recent updates to TCCC guidelines focus on airway management and TBI care.Logistics remain a significant challenge in providing timely medical care in combat.The committee emphasizes the importance of adapting guidelines based on new evidence.Training for combat medics must prioritize effective interventions for hemorrhagic shock.There is a need for consensus on triage methods in mass casualty situations.Continuous updates and training resources are essential for maintaining high standards in military medicine.Chapters00:00 Introduction to Battlefield Medicine02:40 Guidelines and Evidence-Based Practices04:55 TCCC Curriculum and Training Tiers07:47 Updates and Changes in TCCC Guidelines10:21 Current Challenges and Future Directions13:05 TCCC and Evidence Grading15:42 Logistics and Implementation Challenges17:58 Conclusion and ResourcesThank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠For more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

Rima is a medic in the Armed Forces of Ukraine and a tactical medicine instructor originally from the United States. She came to Ukraine as an NGO volunteer in 2022 and began medical studies in 2023 before enlisting in 2024. Now, she works on medical evacuations of soldiers from the frontlines and works in stabilization points where they receive casualties and stabilize their injuries for transport to the nearest hospital. Before enlisting, she taught tactical medicine per TCCC standards at the International Center for Tactical Medicine in Ukraine. In her spare time, she writes about tactical medicine for a wider audience based on evolving needs and lessons learned on the ground in Ukraine. More about Rima:Instagram: https://www.instagram.com/rimameduaSend Rima and her team medical supplies:  https://www.amazon.com/hz/wishlist/ls/3QM0WCUA0PBK2?ref_=wl_shareOr, snacks from home: https://www.amazon.com/hz/wishlist/ls/390U40XEQSS4P?ref_=wl_shareBlue Yellow USA address for care packages:C/O Blue Yellow USA NFP PO box 641Naperville, IL60566Timestamps:

    Unpack the unique and demanding world of Special Forces medical operations with our guest, Sergeant First Class Mo Bogert, an Army 18 Delta Special Forces medic. This episode promises an enlightening journey through predictive medicine, the vital skill set for prolonged casualty care, and the transformative role of telemedicine in combat scenarios. Mo shares his personal story of resilience and adaptability, offering invaluable advice for new medics stepping into this challenging field, and paints a vivid picture of the complexities and decisions that define the life of a Special Forces medic.     Our conversation ventures into the heart of field medic training and the integration of telemedicine in austere environments, especially during prolonged field care situations. Discover how early and consistent vitals tracking can become a lifeline in identifying life-threatening conditions and making difficult resource allocation decisions. We explore the synergy of telemedicine and traditional methods, showcasing how this blend enables medics to perform better under pressure and prioritize patient care effectively in some of the toughest military environments.     Explore with us the dynamic nature of military medical training and operations. Mo shares insights from organizing a medical symposium at the National Training Center, detailing the need for medics to think beyond conventional protocols. From navigating "care under fire" scenarios to understanding the significance of collaboration among Special Operations medics, this episode underscores the importance of resilience, training, and strategic adaptability. As we wrap up, we extend our gratitude to listeners and invite them to support War Docs, a nonprofit dedicated to sharing gripping stories from the intersection of war and medicine.   Chapters: (00:03) Special Forces Medic Challenges and Training (10:39) Field Medic Training and Telemedicine Integration (16:03) Integrating Medical Training in Special Operations (28:23) Medic Training and Evacuation Scenarios (39:52) Combat Medic Training and Priorities (45:42) Resilience and Realism in Medic Training (54:32) Building Resilience and Adaptability in Medics (01:00:52) Military Medic Training and Career Journey   Chapter Summaries: (00:03) Special Forces Medic Challenges and Training An Army 18 Delta Special Forces medic, SFC Bogert shares insights on predictive medicine, prolonged casualty care, and the importance of realistic training.   (10:39) Field Medic Training and Telemedicine Integration Discusses challenges and strategies in prolonged field care, including early vitals tracking and the role of telemedicine.   (16:03) Integrating Medical Training in Special Operations Telemedicine supports Special Forces medics in challenging scenarios, aids in objective assessment, and highlights the need for better coordination and understanding of medical protocols.   (28:23) Medic Training and Evacuation Scenarios Nature's adaptability in military medical training and operations, emphasizing critical decision-making and unconventional methods for success.   (39:52) Combat Medic Training and Priorities Prioritizing fire superiority and self-care, TCCC training, clear roles, and advance planning are crucial for effective care under fire.   (45:42) Resilience and Realism in Medic Training Training military medics in conventional forces faces challenges and limitations, but efforts are made to simulate realistic combat scenarios.   (54:32) Building Resilience and Adaptability in Medics Resilience, flexibility, and foresight are crucial in medical and military contexts, along with adaptability and continuous planning.   (01:00:52) Military Medic Training and Career Journey Military medicine in Special Forces requires flexibility, adaptability, and personal growth, with a focus on embracing discomfort for professional development.     Take Home Messages: Resilience and Adaptability: The episode emphasizes the critical importance of resilience and adaptability for military medics, especially those operating in Special Forces. The ability to navigate unpredictable environments and adjust to changing conditions is crucial for both personal and professional growth in high-stakes scenarios. Predictive and Telemedicine: The integration of predictive medicine and telemedicine in combat situations is highlighted as a game-changer. These technologies enhance decision-making and patient care, allowing medics to anticipate future medical needs and provide support over prolonged periods, which can be lifesaving in austere environments. Comprehensive Training: The podcast delves into the depth and intensity of training required for Special Forces medics, underscoring the necessity of mastering both basic and advanced medical skills. This comprehensive training prepares medics to handle complex scenarios, from trauma management to prolonged field care, effectively transforming them into versatile medical managers. Collaboration and Innovation: The episode discusses the importance of fostering collaboration and innovative thinking among military medics. Symposiums and joint training exercises are vital for sharing knowledge, integrating different medical protocols, and enhancing overall medical support in demanding environments. Role of Non-Medics: The podcast highlights the essential role of non-medically trained personnel in combat care. Effective cross-training ensures that team members can perform basic medical interventions, thereby supporting medics in managing casualties and maintaining optimal patient care during critical situations.   Episode Keywords: Special Forces Medic, Army 18 Delta, Military Medicine, Telemedicine in Combat, Predictive Medicine, Combat Care, Prolonged Field Care, Battlefield Medicine, Military Training, Resilience and Innovation, Mo Bogert, National Training Center, Care Under Fire, Military Medics, Combat Medic Challenges, Military Podcast, War Docs Podcast, Military Medical Symposiums, Medic Resilience, Tactical Medicine, Evacuation Scenarios   Hashtags: #MilitaryMedicine #SpecialForces #Telemedicine #PredictiveMedicine #CombatCare #Resilience #InnovationInMedicine #ProlongedFieldCare #MilitaryTraining #WarDocsPodcast   Honoring the Legacy and Preserving the History of Military Medicine The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation.   Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/our-guests Subscribe and Like our Videos on our YouTube Channel: https://www.youtube.com/@wardocspodcast Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm   WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield,demonstrating dedication to the medical care of fellow comrades in arms.     Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast YouTube Channel: https://www.youtube.com/@wardocspodcast

This week, we have another Medicine in the Mediterranean conference presentation. We will hear from Tactical Medicine North, a volunteer medical unit operating in Ukraine. The discussion covers their formation, mission, and challenges in training combat medics on the frontlines. Key topics include injury patterns, trauma management, blood logistics, and improved training in prolonged casualty care. The presenters emphasise the importance of adapting medical practices to the unique challenges of combat situations in Ukraine.TakeawaysTactical Medicine North was formed out of necessity due to the war in Ukraine.Training combat medics is crucial for effective frontline care.Injury patterns in Ukraine reveal a high incidence of non-combat injuries.TCCC is essential but needs adaptation to local conditions.Blood management logistics are a significant challenge in combat zones.Tourniquet use and wound management require more comprehensive training.Prolonged casualty care is often neglected in training programs.Collaboration with international organisations enhances training effectiveness.Understanding the unique challenges of Russian casualties is important for medical personnel.Future training must focus on nursing skills and prolonged care techniques.Chapters00:00 Introduction to Tactical Medicine in Ukraine02:49 The Formation and Mission of Tactical Medicine North05:12 Training and Challenges on the Frontline09:51 Understanding Injury Patterns and Casualty Statistics13:00 Trauma Challenges: TBI and Pre-Hospital Care20:28 Blood Management and Logistics in Combat23:43 Tourniquet Use and Wound Management26:58 Challenges with Russian Casualties and Evacuation30:23 Prolonged Casualty Care and Training Needs34:41 Conclusion and Future Directions

This podcast episode delves into the roles and responsibilities of various special operations medics, including Ranger medics, SOIDCs, and SEAL medics. The discussion highlights the unique training, skills, and challenges these medics face in the field, emphasizing the importance of trust, communication, and continuous learning in military healthcare. The speakers share their experiences and insights on the evolution of medic training and the critical nature of their roles in combat situations. This conversation delves into the intricate dynamics between medics and PAs within military teams, highlighting the importance of intimate relationships, expectations from new medical personnel, and the necessity of building trust and rapport. The discussion emphasizes the value of field experience for medical providers and the critical role of advocacy and support for medics to enhance their effectiveness in the field. The speakers share insights on how to foster better communication and collaboration within medical teams to ultimately improve patient care and outcomes.TakeawaysRanger medics focus on TCCC and basic skills.SOIDCs have unique provider roles within the Navy.SEAL medics are expanding their capabilities in various environments.Trust and communication are vital for effective medical care.New providers must understand the diverse experiences of medics.Medic training is evolving to include prolonged field care.Relationships between medics and providers shape career paths.Continuous learning is essential for maintaining clinical skills.The operational environment influences medic training and practice.Team dynamics play a crucial role in medical effectiveness. The relationship between medics and IDCs is crucial for effective teamwork.PAs play a significant role in supporting medics during operations.Building rapport is essential for successful medical practice in military settings.Field experience is vital for medical providers to understand operational challenges.Trust between medics and doctors enhances patient care and team effectiveness.Advocacy for medics' needs is necessary for optimal performance.Medical personnel should be proactive in seeking knowledge and training.Understanding the unique challenges faced by medics is key for providers.Effective communication can bridge gaps between different roles in medical teams.Support from leadership can significantly impact the morale and performance of medics.Chapters00:00 Introduction to Special Operations Medics02:59 Roles and Responsibilities of Ranger Medics05:47 Understanding the SOIDC and Navy Medics08:56 The Role of SEAL Medics11:48 Comparative Analysis of SOF Medics15:01 The Importance of Trust and Communication18:04 Challenges Faced by New Providers20:57 The Evolution of Medic Training24:14 Conclusion and Final Thoughts39:33 The Role of Medics and PAs in Team Dynamics42:24 Expectations from New Medical Personnel49:17 Building Rapport and Trust in Medical Teams51:55 The Importance of Field Experience for Providers52:28 Advocacy and Support for Medics01:01:19 Final Thoughts on Enhancing Medical SupportThank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠For more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

'Tis the season for trauma. (If there truly is a season.) Chest trauma, specifically, can vary in subtlety and severity, primarily due to the presence of multiple vital organs and vessels. In this podcast, we discuss these potentials while focusing on those injuries that are associated with the highest mortality rate. We also discuss why you should think twice before intervening. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates. --------------------------------------------  Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com

The Joint Readiness Training Center is pleased to present the ninety-fifth episode to air on ‘The Crucible - The JRTC Experience.' Hosted by the Task Force Senior for the TF Sustainment (BSB / CSSB), LTC Bruce Roett on behalf of the Commander of Ops Group (COG). Today's guests are two seasoned medical professionals with TF Sustainment (BSB / CSSB), CPT Victor Velez and SFC Jason Kohne. CPT Velez is the Senior Medical Operations Officer OCT and SFC Kohne is the Medical Operations NCO OCT.   In this episode, we examine the critical role of medical operations during large-scale combat operations (LSCO), emphasizing the complex realities faced by medics in high-intensity environments. The conversation underscores the physical, emotional, and tactical demands placed on Army medical personnel who must operate with minimal rest, high casualty volumes, and limited evacuation windows. The discussion highlights the need for rigorous, realistic pre-deployment training—such as TCCC, paramedic certification, and stress-inducing field exercises like “Gator Top Dog”—to prepare medics for the brutal realities of sustained combat. A key theme is the importance of leader involvement, particularly from NCOs, in building emotional resilience, monitoring burnout, and creating a culture of trust where medics can ask for help and remain mission-effective throughout the fight.   The episode also delves into key best practices for organizing and supporting medical operations across echelons. Notable lessons include the effective use of FLA (field litter ambulance) staging forward with infantry battalions, use of Class VIII speedballs during casualty evacuation, and the importance of a synchronized and well-communicated medical concept of support. The team discussed common points of friction such as overuse or underuse of medical transport assets, breakdowns in communications between various medical nodes, and lack of rehearsals between sustainers and combat leaders. Additionally, the discussion covers medical evacuation planning and the importance of maintaining a well-structured casualty evacuation (CASEVAC) process to support prolonged combat engagements. The episode closed with emphasis on integrating joint and partner forces, refining base cluster security measures, and the need for a return to basic soldier skills and medical readiness.   Part of S05 “Beans, Bullets, Band-Aids, Batteries, Water, & Fuel” series.   For additional information and insights from this episode, please check-out our Instagram page @the_jrtc_crucible_podcast   Be sure to follow us on social media to keep up with the latest warfighting TTPs learned through the crucible that is the Joint Readiness Training Center.   Follow us by going to: https://linktr.ee/jrtc and then selecting your preferred podcast format.   Again, we'd like to thank our guests for participating. Don't forget to like, subscribe, and review us wherever you listen or watch your podcasts — and be sure to stay tuned for more in the near future.   “The Crucible – The JRTC Experience” is a product of the Joint Readiness Training Center.

  What if the lessons learned from a conflict zone could transform military medicine worldwide? Join us as we promise to reveal groundbreaking insights into combat casualty care with John Quinn, MD, MPH, PhD, EMT-P, a leading voice in Emergency Medicine and Combat Casualty Care. Dr. Quinn shares his experiences and pivotal lessons from the war in Ukraine, providing an in-depth look at how military medical operations have evolved in response to the challenges faced in high-stakes environments. Gain valuable knowledge on damage control, resuscitation, and the strategic decisions made from the point of injury to more advanced medical roles.    The complexities of combat medicine are not for the faint-hearted. In this compelling episode, we confront the realities of triage and care under fire, with medical personnel often working without senior guidance amidst the chaos of large-scale combat. Our discussion sheds light on the critical importance of Tactical Combat Casualty Care and the intricate decisions around tourniquet use when resources are stretched thin. Dr. Quinn emphasizes the skills required to manage such intense scenarios, ensuring listeners understand the vital balance between operational readiness and effective medical intervention.     Handling pain management and blood supply logistics in conflict zones is no small feat. We explore the intricate challenges of ensuring adequate supplies and effective pain medication, particularly in the context of Ukraine's ongoing conflict. Dr. Quinn delves into the necessity of a robust supply of universal donor blood and the pressing need for improved clinical governance to support pre-hospital blood transfusion capabilities. The episode addresses the pressing issue of antimicrobial resistance and antibiotics' critical role in these settings, highlighting the need for structured guidance and oversight to navigate the complexities of treating diverse patient populations. Chapter Timestamps 00:02 Military Medicine and Operational Readiness 09:30 Combat Medicine and Triage Challenges 14:08 Challenges in Pre-Hospital Pain Management 17:43 Combat Medic Challenges and Solutions   Chapters with Summaries (00:02) Military Medicine and Operational Readiness This chapter explores the insights and experiences shared by Dr. John Quinn, the lead author of a pivotal article on pre-hospital lessons from the war in Ukraine, focusing on damage control, resuscitation, and surgery from point of injury to role two. Dr. Quinn, with a background as a paramedic and emergency medicine physician, recounts his involvement in Ukraine since 2014, highlighting the evolution of military medical operations up to the large-scale invasion by Russia. We discuss the collaborative effort behind the article, featuring a diverse team of experts, including traumatology surgeons, paramedics, and academic figures, all working to enhance combat casualty care. Dr. Quinn emphasizes the importance of incorporating Ukrainian academics' insights and using NATO's terminology for lessons learned, providing a comprehensive look at the on-the-ground experiences and challenges faced in providing timely and effective medical care in conflict zones.   (09:30) Combat Medicine and Triage Challenges This chapter addresses the complex challenges faced by medical personnel in large-scale combat operations, particularly in the context of the ongoing conflict involving Russian forces. We explore how medical workers, including international volunteers, are specifically targeted, necessitating unique approaches to operational security, communication, and personal protective equipment. The discussion emphasizes the importance of tactical combat casualty care, especially in making critical triage decisions without the guidance of senior clinical decision-makers. With an overwhelming number of patients and limited evacuation capabilities, medical personnel must navigate the intricacies of tourniquet use, balancing between preventative application and conversion to pressure dressings as per TCCC protocols. The chapter highlights the essential skills required to manage care under fire and the need for timely assessment by qualified providers to reduce morbidity and enhance force effectiveness in the battlefield.   (14:08) Challenges in Pre-Hospital Pain Management This chapter addresses the challenges and intricacies of pain management and blood supply logistics in conflict zones, particularly focusing on the context of Ukraine. We explore the inadequacies of certain medications like Nalbuphine, which can complicate effective pain management when transitioning patients to higher levels of care. The importance of having access to more effective drugs such as ketamine and fentanyl is emphasized, although logistical challenges in their distribution are acknowledged. Additionally, we highlight the critical need for an ample supply of universal donor blood and low-titer O blood products during large-scale combat operations. The chapter underscores the logistical hurdles in ensuring these supplies are available before they spoil and discusses the inadequacy of traditional walking blood banks in high-casualty scenarios, advocating for improved clinical governance to enable broader pre-hospital blood transfusion capabilities.   (17:43) Combat Medic Challenges and Solutions This chapter highlights the critical importance of antibiotics in deployed medical settings, emphasizing the challenges of antimicrobial resistance, particularly in Ukraine. We explore the need for a structured antimicrobial guidance system, informed by biogram data, to prevent inappropriate dosing and resistance. The discussion extends to the complexities of treating diverse age groups, including elderly and pediatric patients, who may have additional medical conditions or require specialized care. Additionally, we stress the significance of clinical governance in ensuring that medical personnel, whether affiliated with NGOs or the military, operate under proper oversight and standards. Finally, we identify the top three priorities for improvement: ensuring an unlimited supply of low-titer universal donor blood, enhancing training and clinical decision-making, and leveraging data for effective medical logistics and planning.   Take Home Messages: Evolving Military Medical Practices: The podcast delves into the evolution of military medical operations in Ukraine, highlighting the lessons learned from the ongoing conflict. It emphasizes the importance of adapting medical practices to the realities of modern warfare, particularly in large-scale conflicts where traditional medical procedures may not suffice. Challenges in Battlefield Medicine: Listeners are exposed to the myriad challenges faced by medical personnel in combat zones, including the complexities of tactical combat casualty care and the necessity for rapid, autonomous decision-making under fire. The episode underscores the need for enhanced training and preparation to handle these high-pressure situations effectively. Pain Management and Medical Logistics: The discussion reveals significant hurdles in managing pain and logistics in conflict zones, with specific reference to Ukraine's current crisis. It stresses the need for reliable access to effective medications and blood supplies, highlighting the logistical challenges that can impact patient outcomes. Antimicrobial Resistance and Clinical Governance: The episode sheds light on the critical role of antibiotics in deployed medical settings and the growing concern of antimicrobial resistance. It advocates for structured guidance systems and emphasizes the importance of clinical governance to ensure high standards of care are maintained, especially when relying on NGOs and international volunteers. Data-Driven Medical Improvements: The conversation calls for the collection and analysis of medical data to enhance military medical practices. It stresses the importance of leveraging lessons learned from current conflicts to refine medical logistics, decision-making processes, and training, ensuring better preparedness for future challenges.   Episode Keywords: Military Medicine, Operational Readiness, Combat Medicine, Triage, Ukraine Conflict, Russian Invasion, Damage Control, Resuscitation, Surgery, Battlefield, Tactical Combat Casualty Care, Tourniquets, Pressure Dressings, Pain Management, Logistical Hurdles, Antimicrobial Resistance, Clinical Governance, Medical Logistics, Training, Data Analysis   Hashtags: #CombatMedicine #UkraineConflict #BattlefieldHealthcare #MilitaryMedicine #EmergencyCare #TacticalCombatCasualtyCare #FrontlineMedicine #WarfareInnovations #ConflictZoneMedicine #DrJohnQuinn   Article Citation: Quinn J et al. Prehospital Lessons From the War in Ukraine: Damage Control Resuscitation and Surgery Experiences From Point of Injury to Role 2. Mil Med. 2024 Jan 23;189(1-2):17-29. doi: 10.1093/milmed/usad253. PMID: 37647607.   Honoring the Legacy and Preserving the History of Military Medicine The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation.   Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/our-guests Subscribe and Like our Videos on our YouTube Channel: https://www.youtube.com/@wardocspodcast Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm   WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield,demonstrating dedication to the medical care of fellow comrades in arms.     Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast YouTube Channel: https://www.youtube.com/@wardocspodcast  

A successful MASCAL depends on your ability to Triage effectively. Link to full podcast: https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-214-TCCC-Updates-e2to67f Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

Major changes coming soon to TCCC. Link to full podcast: https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-214-TCCC-Updates-e2to67f Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

Why are they changing MARCH to Resus before managing the Chest? Link to full podcast: https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-214-TCCC-Updates-e2to67f Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this episode of the PFC Podcast, Dennis and John discuss the ongoing updates and changes within the Tactical Combat Casualty Care (TCCC) guidelines. They delve into the role of the TTC Committee, the importance of literature reviews in developing algorithms for trauma care, and the proposed changes to the March algorithm, emphasizing the need for resuscitation before decompression. The conversation also covers the overhaul of the analgesic section, the recommendations for antibiotics, and the role of TXA in treating hemorrhagic shock. Additionally, they touch on the significance of triage in mass casualty situations and the future directions of the committee's work. Takeaways TCCC is continuously updated to reflect new research. Resuscitation should be prioritized over decompression in trauma care. The March algorithm may undergo significant changes to improve outcomes. Analgesic options are being re-evaluated due to supply issues. Rocephin is being recommended as a primary antibiotic. TXA is crucial for managing hemorrhagic shock in trauma patients. Triage protocols are essential for effective mass casualty management. The committee is open to innovative ideas and solutions. Training and education are vital for implementing new guidelines. Future meetings will focus on finalizing and voting on proposed changes. Chapters 00:00 Introduction to the PFC Podcast 02:46 Understanding the TTC Committee and Its Role 06:06 Literature Review and Algorithm Development 09:00 Resuscitation vs. Decompression in Trauma Care 12:07 Proposed Changes to the March Algorithm 15:06 Analgesic Section Overhaul and Alternatives 18:09 Antibiotic Recommendations and Changes 20:54 TXA and Its Role in Hemorrhagic Shock 23:51 Triage in Mass Casualty Situations 26:45 Future Directions and Upcoming Votes 30:06 Conclusion and Final Thoughts Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

Posting tomorrow...John gives us a behind the curtain look at upcoming TCCC updates. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

Today we have Dr. Frank Butler, a retired Navy Undersea Medical Officer and an ophthalmologist who served as a Navy SEAL platoon commander prior to attending medical school. Just a few weeks after our interview, President Joe Biden awarded Frank a Presidential Citizens Medal during a White House ceremony. The medal is one of the highest honors a civilian can receive and recognized Frank's many contributions to civilian and military trauma care. Frank is credited with founding Tactical Combat Causality Care, also known as TC Three, which has transformed battlefield medical care and saved thousands of lives.  TCCC is now used throughout the U.S. military and much of the world. In today's interview, we talk to Frank about his recent book, “Tell Them Yourself: It's Not Your Day to Die,” which describes the challenges and improvements TCCC has experienced over the past three decades. Frank spent most of his 26-year career in Navy Medicine supporting the Special Operations community. He served a five-year stint as a Diving Medical Research officer at the Navy Experimental Diving Unit in Panama City, Fla., where he helped develop many of the diving techniques and procedures used by Navy SEALs today. Show notes: [00:03:31] Dawn opens the interview asking Frank what it was like growing up in Savannah, Ga., in the 50s and 60s. [00:04:40] Dawn asks Frank about his father, who was an industrial engineer, and who became director of urban housing in Savannah during a time when the city was developing public housing. [00:05:47] Ken asks Frank if it's true that most of his family went into the medical field. [00:06:33] Ken asks Frank about his experience attending a Navy SEALs demonstration during his sophomore year of college. [00:08:09] Dawn asks Frank about his experience going through Navy SEAL training, particularly the Basic Underwater Demolition SEALs School. [00:09:29] Dawn asks if it's true that five people in Frank's family have become Navy SEALs. [00:10:08] Ken explains that after Frank left the SEALs in 1975, he had to figure out what to do next with his life. Frank talks about what led to his decision to go to medical school. [00:11:14] Ken asks Frank how he ended up at Jacksonville Naval Hospital to do an internship in family medicine. [00:11:46] Dawn explains that after Frank's internship, he was assigned to the Navy Experimental Dive Unit. She asks him to talk about this experience. [00:12:25] Frank talks about some of the projects he worked on during this period. [00:14:43] Ken asks Frank how he decided on ophthalmology as his surgical specialization. [00:15:47] Dawn asks Frank what his experience as a resident at Bethesda Naval Hospital was like. [00:16:52] Dawn explains that after Frank completed his residency, he was assigned to Pensacola Naval Hospital. Dawn asks Frank how he ended up becoming the biomedical research director for the Navy SEALs. [00:18:48] Ken mentions that Frank worked on several important projects as research director for the SEALs, including battlefield trauma care, a tactical athlete program, improved treatment of decompression sickness, and the Navy SEAL nutrition guide. Ken begins by asking Frank to talk about his work on the tactical athlete program. [00:20:33] Dawn explains that another one of Frank's projects as research director for the SEALs was the design of the Navy special warfare decompression computer. Dawn asks Frank to explain what a decompression computer does for a diver. [00:21:35] Dawn asks Frank to elaborate on the process of designing this decompression computer and the algorithm as well as the process of getting it approved for the Navy. [00:23:31] Ken asks Frank to talk about a program he worked on to promote refractive surgery. While this program was initially designed to improve combat vision for SEALs, the program has expanded to all active-duty service members, including aviators.

     What if the training that saves lives on a battlefield could be applied to your everyday world? Retired Navy CAPT Dr. Frank Butler joins us on War Docs to unravel how the rigorous life of a Navy SEAL shaped his journey into pioneering military medicine. Hear firsthand how Dr. Butler transitioned from the relentless demands of SEAL training to medical school, contributing to the development and implementation of Tactical Combat Casualty Care (TCCC). He offers a unique perspective on the historical evolution of military medical practices and their profound impact on survival rates in combat situations    Dr. Butler takes us through the history, challenges, and triumphs of TCCC, shedding light on its rocky beginnings and eventual adoption post-9/11. With stories ranging from the life-saving use of tourniquets during D-Day to modern-day practices in Afghanistan and Iraq, this episode highlights the need for evidence-based practices and the importance of learning from historical medical knowledge. Moreover, Dr. Butler emphasizes how TCCC's success has transcended military lines, influencing tactical law enforcement and first responders nationwide.    As we dive into the practical applications of TCCC, we explore the importance of balancing medical care with tactical advantage in combat, illustrated by real-world examples and personal anecdotes from military leaders and medics. The episode closes with a call to action to sustain these medical advances and ensure that the lessons learned are not lost in peacetime. Join us for this engaging conversation with Dr. Frank Butler and discover how the lessons from the battlefield continue to shape and save lives, both in military and civilian contexts.   Chapters Military Medicine Evolution and Impact (00:04)    Retired Navy SEAL Dr. Frank Butler discusses TCCC, combat medics, Stop the Bleed, Hartford Consensus, and refractive surgery in military medicine. Medical Innovations Impacting Battlefield Medicine (18:30)     Tourniquets and whole blood's historical evolution and usage in military medicine, emphasizing the importance of time and evidence-based practices. TCCC Evolution and Preventable Death Analysis (26:02)     TCCC faced resistance but was adopted after 9/11, highlighting the need for improved trauma care. Tactical Combat Casualty Care Expansion (33:10)   TCCC principles have been adopted by law enforcement and first responders, saving lives beyond the battlefield. Improving Medical Care in Combat (38:24) TCCC prioritizes threats over immediate medical intervention, using field experiences to improve guidelines for better outcomes. Sustaining Tactical Combat Casualty Care (54:19) TCCC's role in military and civilian medical practices, ownership by combat commanders, and learning from past conflicts.   Take Home Messages: Advancements in Tactical Combat Casualty Care (TCCC): The podcast highlights the significant evolution of TCCC, emphasizing the importance of evidence-based practices in saving lives on the battlefield. The development and widespread adoption of TCCC principles have been crucial in reducing preventable deaths during military operations. Integration Beyond the Military: The principles of TCCC have transcended military applications and are now integral to tactical law enforcement and first responder protocols. Initiatives like Stop the Bleed have demonstrated the impact of military medical advancements on community safety and emergency response, illustrating the broader influence of these practices on civilian medical care. The Role of Combat Medics: The episode underscores the unique position of combat medics as both healers and warriors. Their critical role in providing immediate care in combat scenarios and the trust and respect they command within their units are highlighted. Learning from Past Conflicts: A key takeaway is the necessity of learning from past combat experiences to continually improve medical care practices. The importance of understanding each combat fatality and integrating those lessons into future strategies is emphasized to ensure ongoing advancements in military medicine. Balancing Medical Care and Tactical Advantage: The podcast discusses the challenges of providing medical care in high-pressure combat situations while maintaining tactical advantage. It stresses the importance of prioritizing threats over immediate medical intervention to ensure the safety and effectiveness of operations.   Episode Keywords: Military Medicine, Navy SEAL, Medical Innovation, Tactical Combat Casualty Care, TCCC, Combat Medics, Evidence-based Practices, Stop the Bleed, Hartford Consensus, Specialized Training, Trauma Care, Preventable Deaths, Committee on Tactical Combat Casualty Care, Chicago Police Department, Law Enforcement, Emergency Response, Tactical Advantage, Combat Commanders, Combat Fatality, Podcast Support   Hashtags: #BattlefieldMedicine #MilitaryInnovation #TCCC #FrankButler #WarDocsPodcast #CombatCare #StopTheBleed #HartfordConsensus #NavySEAL #TraumaCare Honoring the Legacy and Preserving the History of Military Medicine The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation.   Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/our-guests Subscribe and Like our Videos on our YouTube Channel: https://www.youtube.com/@wardocspodcast Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm   WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield,demonstrating dedication to the medical care of fellow comrades in arms.     Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast YouTube Channel: https://www.youtube.com/@wardocspodcast

GOD Provides / JESUS SavesPatreon https://bit.ly/3jcLDuZServant MilitoBecome a supporter of this podcast: https://www.spreaker.com/podcast/gunfighter-life-survival-guns--4187306/support.

This show Aaron and Eric talk about the recent victory for Donald Trump winning a landslide election to become the 47th President Nov 5th 2024.  They talk about the true impact of him winning vs if Harris had won the election; how would both scenarios affect liberty and the second amendment.  Eric also hits on a recent TCCC medical class he attended, and talks about more evidence of why Ham radio and even basic FM/AM radio is crucial for emergencies.  HamStudy.org: Cutting edge amateur radio study tools I used an app on my ipad and phone, since I could easily study on the road. Ham Test Prep: Technician (Not Lite version), I believe they have same app on Android HAM Test Prep: Technician on the App Store (apple.com) HF is limited but you will have a section of the 10M band which is in the 28 MHz  Basic Emergency Prep FEMAs Basic Preparedness pdf untitled (fema.gov) Prepared by Mike Glover  Prepared: A Manual for Surviving Worst-Case Scenarios: Glover, Mike, Carr, Jack: 9780593538142: Amazon.com: Books WE ARE PUMPED TO HAVE A NEW AFFILIATE LINK FOR ORIGIN AND JOCKO FUEL!!!  Help support this show by purchasing any of your JiuJitsu gear, Jocko Supplements, books clothing and more... link below. Origin/Jocko Fuel – Bringing back American manufacturing, producing the best Jiu-Jitsu Gis on the market, Jeans, rash guards, and world class supplements to help you on the path.  Use EvoSec10 at checkout for 10% off, this helps us greatly.  EVOSEC Originusa.com AFFILIATE LINK Tenicor – www.tenicor.com they are educators, and innovators in the holster market.  They are firearms instructors themselves, pressure testing their gear in multiple force on force events every year.  We support those who do the work.   Please visit our new sponsor Training Ground at https://thetrainingground.life  Training Ground offers top notch trianing in Jiu Jitsu, Judo, Tang Soo Do and Firearms.  An environment where learning is paramount for both students and instructors.   Again, patronizing our sponsors helps us greatly. 

Anyone familiar with tactical medicine knows the name Dr. Frank Butler—Navy SEAL, captain, ophthalmologist, former director of the SEAL biomedical research program, and one of the founders of tactical combat casualty care (TCCC). Butler's new book Tell Them Yourself: It's Not Your Day to Die is the extraordinary account of how a small group of world-class trauma experts joined forces with America's best combat medics to rewrite the rule book in battlefield medicine—and then to sell these revolutionary new concepts to a disbelieving medical world. Mike McCabe gets some time with one of the most distinguished, decorated and influential medical minds in TCCC to discuss challenges and innovations in battlefield medicine and what those lessons can bring to civilian EMS.

GOD Provides / JESUS SavesPatreon https://bit.ly/3jcLDuZServant MilitoBecome a supporter of this podcast: https://www.spreaker.com/podcast/gunfighter-life-survival-guns--4187306/support.

In this episode we sat with the education coordinator Mrs Woeser Lhamo and student Kunga Palden and Namdol Kunga Palden from the Tibetan Canadian Cultural Centre who are in Dharamshala for a month long Education Tour. Mrs Woeser talks about the centre and its programs while the students talk about their learning experiences in Dharamshala visiting CTA and Non-governmental organisations.

Is Training Arena the next Big Tech innovation for training & education? Is this a more focused versions of Youtube or MasterClass for the tactical & medical(TCCC) world? April created the Training Arena in response to a need she saw in her own life and she is now offering advanced online learning for those who want high level medical & combat training online. Is this Viable? or like many tech start-ups, is it doomed to fail. Lets find out https://armedatlas.locals.com/ trainingarena.com Join us for a members only final segment of the show here(code free24 when you sign up): https://armedatlas.locals.com/post/5432171/big-tech-is-helping-gun-nuts-ep-95 Join our members 24/7 chat on discord 100% Free! https://discord.gg/ERznmkXM4p 00:00 Welcome to Costly Conversations: The Next Elon Musk of 2A? 01:28 the future of medical & Tactical training 02:18 Training Arena: Masterclass for Tactical World? 09:41 Data Privacy for gun owners 18:12 I froze: Near death experience changed my life 38:22 Building a Safer 2A Community: Vetted Training 41:59 your marketing sucks 43:57 using tech to empower teachers/ instructors 47:16 Will this business fail? 47:52 Education and Support 01:13:23 The Importance of Mental Health and Support Networks #Tactical #Veteran #SecondAmendment #Gun Safety and Education #Self-Defense #StrategicMarketing #TechStartup #Startup #Innovations #Technology #FirearmsEducation #ResponsibleGunOwnership --- Support this podcast: https://podcasters.spotify.com/pod/show/costlypod/support

In this conversation, Dennis and John discuss chest trauma management, specifically the use of chest seals and the sequence of interventions. They explore the overuse of chest seals and the potential complications they can cause. They also discuss the importance of assessing the patient and determining if a chest seal is necessary. John shares his insights on the use of finger thoracostomy and the technique for performing it. They also touch on the revision of the TCCC algorithm and the need to prioritize hemorrhage control. The conversation explores the challenges and approaches in operational medicine, emphasizing the need to align policy and guidelines with the experiences of field practitioners. It highlights the importance of preserving the rich experience and lessons learned by experienced personnel. The discussion also delves into the management of chest trauma, specifically focusing on emergent situations and the challenges in current practices. The conversation concludes with the anticipation of future discussions and the potential for further exploration of the topics. Takeaways Chest seals should be used specifically for sucking chest wounds or open pneumothorax. Chest seals can cause tension pneumothorax if used inappropriately. The decision to use a chest seal should be based on the patient's breathing status and the nature of the injury. Negative suction can be beneficial in re-inflating the lung and improving oxygenation in patients with chest trauma. The TCCC algorithm may need revision to prioritize hemorrhage control. Operational medicine requires a balance between algorithmic approaches and the practical experiences of field practitioners. Preserving the experience and lessons learned by experienced personnel is crucial for the development of effective policies and guidelines. Chest trauma management involves various emergent situations, including tension pneumothorax, hemothorax, and pneumothorax. Challenges in chest trauma management include the use of occlusive dressings and the need for surgical interventions. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠ or ⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this conversation, Dennis and John discuss chest trauma management, specifically the use of chest seals and the sequence of interventions. They explore the overuse of chest seals and the potential complications they can cause. They also discuss the importance of assessing the patient and determining if a chest seal is necessary. John shares his insights on the use of finger thoracostomy and the technique for performing it. They also touch on the revision of the TCCC algorithm and the need to prioritize hemorrhage control. The conversation explores the challenges and approaches in operational medicine, emphasizing the need to align policy and guidelines with the experiences of field practitioners. It highlights the importance of preserving the rich experience and lessons learned by experienced personnel. The discussion also delves into the management of chest trauma, specifically focusing on emergent situations and the challenges in current practices. The conversation concludes with the anticipation of future discussions and the potential for further exploration of the topics. Takeaways Chest seals should be used specifically for sucking chest wounds or open pneumothorax. Chest seals can cause tension pneumothorax if used inappropriately. The decision to use a chest seal should be based on the patient's breathing status and the nature of the injury. Negative suction can be beneficial in re-inflating the lung and improving oxygenation in patients with chest trauma. The TCCC algorithm may need revision to prioritize hemorrhage control. Operational medicine requires a balance between algorithmic approaches and the practical experiences of field practitioners. Preserving the experience and lessons learned by experienced personnel is crucial for the development of effective policies and guidelines. Chest trauma management involves various emergent situations, including tension pneumothorax, hemothorax, and pneumothorax. Challenges in chest trauma management include the use of occlusive dressings and the need for surgical interventions. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠ or ⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In a recent earnings report call, James Quincey, the CEO of The Coca-Cola Company, outlined the company's financial performance. He noted, "During the quarter, we benefited from strong performance across many of our markets. However, some were impacted by elevated inflation and others by geopolitical tensions and conflict." Despite these challenges, the company disclosed a 12% organic revenue growth. This increase included a 2-point rise in volume, underscoring the firm's ongoing positive annual volume trend. Quincey attributed these results to effective navigation through the markets' fluctuating conditions and the company's unrelenting effort to provide an extensive portfolio of brands and packages to satisfy and engage more consumers. The Coca-Cola Company demonstrated steady financial performance through the fiscal year, marked by 12% organic revenue growth and consistent volume growth. All these occurred amidst adversities such as inflation and geopolitical turmoil. Integral to Coca-Cola's success is the company's strategic investment in marketing transformation, which aligns with its innovative brand campaign, "Create Real Magic." The embodiment of this investment in their operations has amplified consumer engagement and enabled the company to adapt innovatively to changing consumer needs. To drive progress and meet consumer demands, Coca-Cola introduced various strategic initiatives. These include innovative enhancements across the entire beverage portfolio, refining revenue growth management strategies, prioritizing operational agility and efficiency, and expanding packaging options and affordability. These strategic measures have facilitated the company's ability to cater to evolving consumer requirements while simultaneously boosting brand value. The earnings call transcript provided invaluable insights into regional consumer behavior. While consumer expenditure in North America remained stable, a noticeable thrift consciousness was observed among European consumers. Meanwhile, substantial consumer demand emerged from Australia, India, Latin America, Japan, and South Korea. Conversely, macro uncertainties persist in Africa and China, with Middle Eastern consumer behavior influenced by geopolitical tensions. Exhibiting a forward-thinking perspective, CEO James Quincey shared, "During 2023, we achieved our near-term goals while also positioning our business for the long-term. Our all-weather strategy delivered 8% comparable earnings per share growth despite greater than expected 7% currency headwinds. Today, we are leveraging our scale globally and winning locally, which gives us confidence that we can deliver on our 2024 guidance." The Coca-Cola Company plans to carry on implementing its 'all-weather' strategy with focus centers on driving volume growth, addressing inflationary challenges, maintaining their marketing transformation momentum, optimizing revenue growth management execution capabilities, and investing in capacity building for specific brands. The company also expressed its intention to augment dividends while retaining a flexible posture on share repurchases. In conclusion, recent indicators from The Coca-Cola Company's earnings call reveal a competent entity adept at steering through market challenges and adapting suitably to meet changing consumer needs. Taking into account the company's track record and strategy, they are on track toward meeting consumer expectations. However, as with any business, fulfilling future projections will largely depend on adapting to evolving market conditions and successfully managing unforeseen challenges. KO Company info: https://finance.yahoo.com/quote/KO/profile For more PSFK research : www.psfk.com  This email has been published and shared for the purpose of business research and is not intended as investment advice.

This week, Aebhric talks with Brian Foy, former Marine Recon, who became a paramedic and is currently working in Kenya teaching TCCC and Remote Medicine to the military and for civilians.

Dennis is interviewing Dr. John Quinn who's on the ground working Role 1 medical operations for an NGO somewhere in Ukraine. The lessons being learned by John and others during the early days of this conflict and the past 8 years can be used to help those on the ground now and into the future. This is an amazing opportunity to stay informed of current events and prepare ourselves by narrowing expectations and tweaking training. During the interview John stated that anything that can be done to further enable FWB availability and knowledge would be greatly appreciated. In particular, when asked what we could translate, he asked for: Damage Control Resuscitation guidelines to be translated, Prehospital Blood guidelines, anything on Damage Control Surgery for non-surgeons (they have a lot of OB/GYNs and others like OMFS functioning as DCS surgeons at Role 2s). He also stated that they're seeing a TON of TBI "walking wounded" and anything on mild to moderate TBI management would be great. When asked about a trauma registry, John stated that the Ministry of Health is attempting to catalogue all civilian casualty numbers. The Ministry of Defense is VERY close-hold with any info and it would be very hard to elicit the ground-truth there for the time being. John stated that many organizations are using the TCCC cards and all documentation is trying to be written in BOTH Ukranian and English, due to the large number of non-native providers helping in country. They LOVE the DeployedMedicine app, the translation of TCCC and Emergency War Surgery and absolutely look to US and NATO standards of care. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org Consider supporting us: patreon.com/ProlongedFieldCareCollective

Dr. Givens talks about dealing with CBRNE patients in the field. They discuss the need for standardized approaches and clinical guidelines. I'm all about simplifying things and making them user-friendly. The hot zone requires quick thinking and auto injectors for CBRNE agents. They emphasize the importance of TCCC and teamwork. Dr. Givens covers various agents like nerve agents, cyanide, chlorine, and more, offering practical insights for handling them. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org Consider supporting us: patreon.com/ProlongedFieldCareCollective

    Get ready to embark on a captivating journey through the pages of military medicine history as we speak with retired Army Colonel Dr. Evan Renz on WarDocs. Dr. Renz, a seasoned General/Trauma Surgeon and Burn Specialist with a rich trove of experience unfolds the evolution of military wound care from the era of World War II to the present day. As we trace the progression from hemorrhage control and debridement to advancements in medications, Damage Control concepts, and the use of innovative wound care technologies, Dr. Renz champions the importance of learning from our past and integrating these lessons into future military medical training.    Drawing from his first-hand experience, Dr. Renz guides us through the intricate landscape of wound management in damage control resuscitation and surgery scenarios. We speak about the world of negative pressure wound therapy, starting from his initial use of a Wound Vac in 1997 to its evolution over the years. Experience the crux of Army Medicine as we venture into the crucial considerations surgeons must take when evaluating wounds where a tourniquet is applied to control bleeding and preserve the patient's hemodynamic stability.    Our exploration takes a detour to the US Institute of Surgical Research Burn Center in San Antonio, where Dr. Renz shares his valuable insights on complex burns and wound care management. The discussion reveals intriguing practices such as avoiding prophylaxis antibiotics for isolated burn injuries and the strategic use of negative pressure wound treatment. Learn more about the fine balance of initiating and adjusting fluid for patients, the crucial decision-making process involved in combat wound closure, and the pressing need to pass on knowledge and training in the advances of technology. We guarantee that this episode will leave you with a newfound respect for Military Medicine and those who dedicate their lives to its advancement. So, join us for an eye-opening journey into the world of military medicine with Dr. Renz!   Chapters: (0:00:00) - Military Wound Care Evolution (0:13:59) - Wound Management in Damage Control (0:28:44) - Burn Center and Wound Care Management (0:46:13) - Decisions in Combat Wound Closure   Chapter Summaries: (0:00:00) - Military Wound Care Evolution (14 Minutes) Retired Army Colonel Dr Evan Renz, a General/Trauma Surgeon with extensive experience in training and working at the US Institute of Surgical Research's Burn Unit in San Antonio, provides insights into the evaluation and treatment of complex wounds. He emphasizes the critical importance of documenting and learning from our past to help prepare us for future conflicts and to make sure that these lessons are included in military medical training opportunities. We discuss the changes in wound management from World War II to today, from the importance of hemorrhage control and debridement to advancements in medications and technologies improving wound care.   (0:13:59) - Wound Management in Damage Control (15 Minutes) Dr. Evan Renz discusses the importance of wound management in damage control resuscitation. He shares his experience with his first use of a Wound Vac in 1997 and how the use of negative pressure wound therapy evolved over time. We explore the special considerations surgeons must take when evaluating a wound where a tourniquet is in place and how these decisions can help preserve the patient's hemodynamic stability.   (0:28:44) - Burn Center and Wound Care Management (17 Minutes) Dr. Renz explains that isolated burn injuries do not require prophylactic antibiotics; however, traumatic combat wounds should be treated with an initial dose of antibiotics in addition to a Tetanus booster.  Dr. Renz shares his experience with the use of the Wound Vac in the Burn Center and the key questions that he would ask when taking calls for burn management care. He also explains the importance of avoiding over-resuscitation and how to initiate and adjust fluid for the patient. Finally, he outlines the care that the patient would receive in regard to their wounds once they reach Role 4 or 5 facilities.   (0:46:13) - Decisions in Combat Wound Closure (7 Minutes) Dr. Evan Renz shares his experience with the Emergency War Surgery manuals and the use of Wound Vacs in the field.  We also discuss the importance of repeating a primary and secondary survey with each transfer of care and how to identify when a wound can or should be closed primarily or covered by a flap or graft. Finally, Dr. Renz speaks to the importance of passing on knowledge and training in the advances of technology so that it is not forgotten.   Take Home Messages: Military medicine has evolved significantly from the World War II era to the present day, highlighting the importance of learning from the past to enhance future medical training. Advances in medications and wound management techniques, such as leaving more wounds open and exteriorizing the bowel for abdominal injuries, have marked significant milestones in military medicine. Negative pressure wound therapy has seen remarkable evolution over the years and plays a crucial role in wound management in damage control resuscitation. Surgeons need to make critical considerations when evaluating a wound downstream from a tourniquet in order to preserve the patient's hemodynamic stability. Burn centers play a crucial role in wound care management, with innovative practices like avoiding prophylaxis antibiotics for isolated burn injuries and the strategic use of wound vac. Adjusting and initiating fluid for patients and making critical decisions on combat wound closure are part of the complex process in wound care management. Knowledge and training in technological advances in wound care need to be passed on to future generations to ensure continuous improvement. Initial wound care at the point of injury prioritizes hemorrhage control, as highlighted by the TCCC guidelines. Wound management in damage control resuscitation involves the careful evaluation and treatment of wounds and extensive documentation of each treatment process to guide subsequent care. Wound care management, especially in a resource-limited setting, requires a practical approach, including bedside care, ensuring proper lighting and pain control.   Episode Keywords: Military Medicine, Wound Care, Damage Control, Burn Center, Wound Management, Negative Pressure Wound Therapy, Tourniquet, Hemodynamic Stability, Prophylaxis Antibiotics, Image Control, Debridement, Fluid Management, Combat Wound Closure, War Surgery, Wound Vac, Technology Training   Hashtags: #wardocs #military #medicine #podcast #MilMed #MedEd #MilitaryMedicine #CombatWoundCare #DrEvanRenz #WarDogsPodcast #MedicalEvolution #MilitaryTraining #BurnInjuries #DamageControlResuscitation #WoundVacTherapy #BattlefieldMedicine   Honoring the Legacy and Preserving the History of Military Medicine   The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation.   Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/episodes  Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm   WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield, demonstrating dedication to the medical care of fellow comrades in arms.     Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast

Dennis interviews Thomas Trust Have, a former Danish Special Forces operative turned doctor, discussing the challenges of providing medical care in Arctic environments. Thomas emphasizes the extreme conditions, highlighting a hypothetical scenario involving a special operations team enduring frigid temperatures and harsh winds. He underscores the importance of preparation, teamwork, and proper gear in these situations. Thomas also addresses medical considerations such as tourniquet use, fluid warming, and the complexity of providing care in cold conditions. The episode sheds light on the unique challenges faced by healthcare providers in remote, freezing environments. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org Consider supporting us: patreon.com/ProlongedFieldCareCollective

We speak to some of the most extreme medics in some of the world's most remote locations, due to this there can sometimes be an issue with sound quality, so there are a few quality dips in this episode, but we felt it was an important conversation to share. Welcome back to the podcast that explores the exhilarating world of extreme medicine. In today's episode, we delve into the impact of PTSD and PTSI on individuals in high-stress professions like the military. Boxxy shares personal experiences and insights, emphasising the importance of acknowledging emotional trauma and fatigue and the need for early intervention and open communication about mental health. Join us as we uncover the evolving landscape of military medicine, survival training in extreme environments, and the rewarding nature of saving lives. Stay tuned for an adventurous journey into the world of extreme medicine.

Empiric vs deliberate TQ TQ conversion vs. replacement Conversion of TQ to pressure dressing and pressure dressing to non-pressure dressing TQ risks- amputation, compartment syndrome, neurologic or muscle injury, renal failure and more

      Picture this - you're in the middle of a war zone, your resources are limited, and lives hang in the balance. Now you're starting to grasp the reality of retired Air Force Chief Master Sergeant Steve Cum's three-decade-long career in the Air Force. In this episode, Steve recounts his remarkable journey, sharing insights on how medical training has evolved over the years, his time in special ops, and his firsthand experiences during the 9-11 deployments, all while highlighting the crucial role of medical personnel in the world's most challenging environments.   As Steve takes us through his time as an aeromedical specialist, the challenges he faced in the demanding Independent Duty Technician Course, and his experiences in the Special Operations community, we can't help but marvel at his resilience and dedication to the cause. When he talks about his experience in Afghanistan, his tales of patient care under extreme conditions, and the complex logistics of patient evacuation, you'll feel the tension of life on the frontlines, the adrenaline rush, and the immense responsibility that comes with it.  Steve shares valuable leadership lessons that he's picked up from his deployments, his passion for training medical personnel, and the invaluable experiences he gained from his time deployed around the globe. He offers valuable advice to young Air Force airmen looking to make a career in military medicine while reminiscing over the changes he has seen in Air Force Medicine during his illustrious career and contemplating the legacy he hopes to leave in military medicine. Join us as we navigate the highs and lows of a military medic's life with retired Chief Master Sergeant Steve Cum. Chapters: (0:00:00) - Air Force Medic Training and Journey (0:05:20) - Aeromedical Specialist and Independent Duty Medical Technician (0:12:10) - Medical Response to 9-11 Deployments (0:18:52) - Medical Response in War Zone (0:23:38) - Special Operations Medical Training Lessons Learned (0:36:30) - Leadership Lessons and Memorable Deployments (0:40:17) - Success in Military Medicine   Chapter Summaries: (0:00:00) - Air Force Medic Training and Journey (5 Minutes) Retired Chief Master Sergeant Steve Cum shares his story of joining the Air Force, as well as the unique opportunities and experiences he encountered throughout his 30 years of Active Duty service. We discuss how the training of Air Force medics has changed from the 1990s to now and the clinical skills they must have to be successful. Steve also shares valuable leadership advice from his distinguished career in Special Operations and at the top strategic echelons of military medicine.   (0:05:20) - Aeromedical Specialist and Independent Duty Medical Technician (7 Minutes) Steve describes his first assignment as an Aeromedical Specialist, the challenges of the Independent Duty Technician Course, and his experiences in the Special Operations community. He talks about the various schools he attended in the pre-911 era and explains what motivated him to pursue each one.   (0:12:10) - Medical Response to 9-11 Deployments (7 Minutes) We discuss the real-world patient experiences and 9-11 story of Chief Master Sergeant Steve Cum. We explore the planning process for missions and trips, the activation of medical personnel after 9-11, and the priority of establishing medical care at an abandoned Russian airfield. Steve shares his experience coordinating a forklift and setting up a small clinic with limited resources. We learn how the Air Force secured the airfield and how they managed patient movement without vehicles.   (0:18:52) - Medical Response in War Zone (5 Minutes) Chief Master Sergeant Steve Cum shares his experience as a medic in Afghanistan. He tells the story of a patient who went into the OR with severe internal bleeding and the process of collecting blood from fellow Soldiers and Airmen. He explains how the team managed to get the patient evacuated for further treatment and shares his story of responding to a JDAM mass casualty. He also discusses the evacuation process for patients and the different types of missions the team flew on.   (0:23:38) - Special Operations Medical Training Lessons Learned (13 Minutes) We hear from Chief Master Sergeant Steve Cum about the lessons learned during his deployments, the value of TCCC and Prolonged Field Care in the Special Operations community, and his experience in medical exercises and deployments. We also hear about Steve's passion for training medical personnel and his mission as the Chief of the Medical Enlisted Force for the Air Force Special Operations Command.   (0:36:30) - Leadership Lessons and Memorable Deployments (4 Minutes) Chief Master Sergeant Steve Cum recounts his most memorable deployment story from Haiti. He shares the experience of working with the media in the wake of the Haiti earthquake, as well as the process of transporting a patient who had jumped out of a two-story hotel window. We hear about the challenges of getting the man to an appropriate medical facility and how medics play a critical role in en-route care. We also consider the value of this experience in terms of learning about leadership and growing up.   (0:40:17) - Success in Military Medicine (6 Minutes) Chief Master Sergeant Steve Cum shares the advice he provides to young Air Force airmen looking to make a career in Military Medicine, the most essential leadership lesson he learned, and the remarkable changes he noticed in Air Force Medicine over his 30-plus year career. He also shares his thoughts on the remarkable young medics coming into the service, as well as the legacy he hopes to leave in Military Medicine.   Episode Keywords: Air Force, Medical Training, Special Ops, 9-11 Deployments, War Zone, Aeromedical Specialist, Independent Duty Medical Technician, Patient Care, Logistics, Patient Evacuation, Leadership Lessons, Haiti Earthquake, Military Medicine, Young Medics, Air Force Airmen, TCCC, Prolonged Field Care, Media, JDAM Mass Casualty   Hashtags: #MilitaryMedicine #AirForceJourney #MedicOnFrontlines #WarZoneExperiences #SpecialOpsMedics #LeadershipLessons #MilitaryService #AirForceMedic #AirForceTraining Honoring the Legacy and Preserving the History of Military Medicine  The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation. Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/episodes Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield, demonstrating dedication to the medical care of fellow comrades in arms.   Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast

Apologies for the hiatus! On this week's episode of the Tiger Bloc Podcast, we feature a good friend and one of the best medical trainers in the business, Dan Bernal of Grizzly Medical! Dan is a former US Army combat medic, having directly saved lives in missions as well as having taught Iraqi and Kurdish medics in joint combat operations. He also served as an on-site TCCC and EMT trainer. Recognizing a severe lack of knowledge for practical first aid training in the civilian world, Dan created Grizzly Medical. The company's mission is to provide the latest in TCCC doctrine and combine this with live simulations in order to bring the most grounded, truth-to-life first-aid training possible to non-professionals.  Together, Soju Operator and Dan discuss the insufficiency of current Stop the Bleed training, why you should always be carrying a medical kit, medical misconceptions, first-hand experience in saving a man's life, the tourniquet market, the value of live simulation training, and what his classes offer. Host: Soju Operator Guests: Dan Bernal Shownotes: Soju Operator Follow us on Instagram: https://www.instagram.com/yellow_peril_tactical  Follow us on Twitter: https://twitter.com/yptactual  Subscribe to our Patreon: https://www.patreon.com/yellow_peril_tactical Follow Grizzly Medical on Instagram: https://www.instagram.com/grizzlymedical/   Follow Grizzly Medica on Facebook: https://www.facebook.com/grizzlymedical/   Visit Grizzly Medica's website and organize host a class: https://grizzlymedical.org/  Music credit: Palm Tree Jam by Ronin Saedi Listen to more: https://viennaundergroundtraxx.bandcamp.com/album/cosmic-conscious  https://open.spotify.com/artist/1BxaGq5S5A6Bck2DquttJM 

Dennis introduces the Prolonged Field Care (PFC) Podcast 130, welcoming Alex as his guest speaker. Alex, Dan, and Rick are working on a project for the upcoming SOMSA, where they will present the idea of defining the different phases of care in PFC, just like TCCC. They believes that the medics should think about March for taking care of their patients, where they would continue to think about March irrespective of the setting, but maybe through a different lens when they're in PFC. Alex talks about the phases of care in prolonged field care, which are preparation, stabilization, normalization, observation, and transportation, (PSNOT) and compares them to the thought process of doctors in damage control surgery. Dennis and Alex discuss the importance of SOF medics finding time to be good at SOF medicine, and how they need to understand their true capabilities and reach out to others for help when needed. Thank you to Delta Development Team for sponsoring this podcast in part. deltadevteam.com For more content go to www.prolongedfieldcare.org Consider supporting us: patreon.com/ProlongedFieldCareCollective

On today's episode we have with us, Lou & Mike from ZERT to talk about the medical training that we provide and encourage people to seek out. We had a TCCC and Stop the bleed class recently held here at the HQ and members and non members got to learn a bit about why medical training might be the most important tool in their tool box. On the show in the past we have discussed the most realistic scenario you will face and the mindset and gear you need to come out alive and we recently had the chance to put that to the test. Enjoy this weeks episode with long time members of ZERT and what ZERT means to them.  The post ZERT Coffee & Chaos 007 – Medical Training Might Be The Most Important Tool In Your Tool Box appeared first on Firearms Radio Network.

We're continuing the regular podcast episodes. This week is a bit random and we discuss a lot of different topics ranging from dumb 2LT purchases to law school/med school. We should have James back for the next episode. 3:00 - preworkout 8:00 - San Antonio, TCCC, BAMC 15:00 - dumb 2LT purchases 27:00 - lawyers/law school, med school 46:00 - good things to buy as a 2LT 1:02:00 - food talk

On today's Coffee with Rich, we will be joined by Dr. Sherman House of Civilian Defender. Dr. Sherman A. House is currently in his third decade as a healthcare provider, and is a Hospital Dentist and Assistant Professor of Oral and Maxillofacial Surgery at the Meharry Medical College in Nashville TN. He is also a Reserve Peace Officer in a busy Middle Tennessee Department. Prior to his career in dentistry, Dr. House was a Fireman and Emergency Medical Technician in Washington State. Concurrently, he was a Shotgun Messenger for several West Coast Armored Truck companies. He participated in security operations at the 1999 WTO Riots in Seattle WA. He holds undergraduate degrees in Law Enforcement, Cell Biology and Philosophy from Gonzaga University. He completed his Doctorate of Dental Surgery at the Meharry Medical College with Honors in Nashville TN. He earned a Hospital Dentistry Certificate as the Chief Resident from the Metro General Hospital also in Nashville. Dr. House is the originator of the CIVILIAN DEFENDER training concept. He has personally saved lives using CPR, Rescue Breathing, AED, TCCC, ACLS, PHTLS and Heimlich Manuever techniques. He has studied extensively in the defensive arts, both armed and unarmed, as well as self-defense law, emergency medicine, criminal psychology, tactical driving and other survival skills, and has certificates from Tom and Lynn Givens (Dr. House is a Rangemaster-Certified Pistol AND Shotgun Instructor), Paul Gomez (Fighting Shotgun), James Yeager (Inaugural Tactical Response Instructor Class Graduate), Gabe White (Light Pin Winner), John Farnam (DTI Instructor), Greg Sullivan (AR Armorer), Rob Edwards (Fighting Pistol), John Chapman (Fighting Rifle), Aaron Little (Fighting Rifle), Dr. William Aprill, Massad Ayoob (MAG20), Larry Vickers (AK Operator), Lee Weems (Pistol and Shotgun), Dave Spaulding (Combative Pistol), Andrew Branca (LOSD TN/KY). Civilian Defender: https://civiliandefender.com/about/ SWAG: https://shop.americanwarriorsociety.com/ American Warrior Society please visit: https://americanwarriorsociety.com/