In this episode of the PFC Podcast, Rick Kelly, a retired 18 Delta Special Forces medic, shares insights into the unique challenges faced by Special Forces medics in austere environments. He discusses the critical role these medics play in providing life-saving surgical procedures in areas lacking medical infrastructure, emphasizing the importance of understanding their training and operational constraints. Kelly highlights the evolution of medical practices within Special Forces, particularly the adoption of methods from the International Committee of the Red Cross (ICRC) to improve patient outcomes in combat situations.

Kelly elaborates on the specific surgical techniques taught to Special Forces medics, including wound excision, closure, and amputation, all tailored to the limited resources available in the field. He contrasts these practices with conventional medical approaches, underscoring the necessity for adaptability and efficiency in high-pressure environments. The episode concludes with a call for healthcare providers to better understand the realities of austere medicine, enabling them to support Special Forces medics more effectively.

Understanding austere medicine is crucial for effective healthcare delivery.

The ICRC's methods have significantly influenced Special Forces medical training.

Infection rates can be drastically reduced with proper wound management.

Chapters

05:30 Adopting ICRC Methods

10:39 Challenges in Austere Environments

16:46 Conclusion and Key Takeaways

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 speaks with Rima, a combat medic in Ukraine, about the critical aspects of unit safety, tactical training, and the challenges faced in medical evacuations during an active war zone. Rima shares insights on the importance of personnel over equipment, the necessity of telemedicine, and the realities of training medics under resource constraints. The conversation also delves into wound management, infection control, and the unique challenges posed by winter conditions in the field.

Takeaways

The priority in combat medicine is personnel over equipment.

Training for medics is often condensed due to active war conditions.

Telemedicine plays a crucial role in providing care in remote areas.

Wound management and infection control are critical in combat situations.

Adapting to resource limitations is essential for effective medical care.

Basic skills in combat medicine can save lives more than advanced techniques.

The drone threat complicates medical evacuations significantly.

Improvisation is key when standard resources are unavailable.

Understanding the basics of medicine is vital for effective care.

Every situation in combat medicine requires quick and adaptable responses.

Chapters

00:00 Introduction to Combat Medicine in Ukraine

02:57 Unit Safety and Tactical Training

06:00 Challenges of Medical Evacuations

08:47 Training Medics in Active War Zones

12:02 Telemedicine in Combat Situations

14:57 Wound Management and Infection Control

17:55 Prioritizing Gear and Equipment

21:10 Adapting to Resource Limitations

23:46 Winter Challenges in Hemorrhage Control

27:01 Concluding Thoughts on Tactical Medicine

For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

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

Takeaways

• Tourniquet conversion is essential in trauma care.
• Understanding the difference between conversion and replacement is crucial.
• Resuscitation is a key factor before converting a tourniquet.
• The two-hour mark for tourniquet use is based on physiological considerations.
• Prolonged tourniquet time can lead to significant metabolic issues.
• Be prepared for reperfusion injury when converting a tourniquet.
• Confidence in tourniquet conversion skills is often lacking among providers.
• Patient assessment is critical before converting a tourniquet.
• Limb salvageability can vary and should be assessed carefully.
• The decision to convert a tourniquet should prioritize patient stability. Imperfect situations require difficult decisions in patient care.
• Triage decisions are crucial when resources are limited.
• Resuscitation is the primary goal in trauma care.
• Understanding reperfusion injury is essential for medics.
• Managing acidosis can significantly impact patient outcomes.
• Blood transfusions are critical in trauma situations.
• Medics must be prepared for potential complications.
• Always monitor and assess the patient's condition continuously.
• Reading medication labels is vital for safe practice.
• Confidence in converting tourniquets is essential for medics.

Chapters

00:00 Introduction to Tourniquet Management

02:56 Understanding Tourniquet Conversion vs. Replacement

06:10 Resuscitation Goals and Tourniquet Timing

08:58 Physiological Implications of Prolonged Tourniquet Use

11:47 Techniques for Safe Tourniquet Conversion

15:09 Challenges in Tourniquet Management

17:53 Assessing Limb Salvageability and Patient Stability

25:44 Navigating Imperfect Situations in Patient Care

30:32 Triage Decisions: When to Save a Limb

31:03 Understanding Reperfusion Injury and Its Challenges

35:43 Managing Acidosis in Trauma Patients

46:34 Advice for Medics: The Importance of Conversion

For more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠⁠