Prolonged Field Care Podcast
by Dennis
Become a Paid Subscriber: https://creators.spotify.com/pod/show/dennis3211/subscribeThis podcast and website is dedicated to the healthcare professional who needs to provide high quality care in a very austere location. For more content: www.prolongedfieldcare.orgConsider supporting us on: patreon.com/ProlongedFieldCareCollective
Episodes
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Neck Junctional Injuries: Zones, Pressure, and Placement
Max and Dennis walk through neck and upper-chest junctional injuries, the pattern he expects more of with top-down penetrating trauma. The neck is divided into three zones for a reason. Zone 1 (sternal notch to cricoid) raises immediate concern for chest involvement and the need for sternotomy or...
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300: What Are We Missing? SOF Medics on Veteran Suicide
17.7 veterans die by suicide every single day. Almost everyone listening knows someone. Episode 300 of the PFC Podcast puts three retired special operations medics in the room to talk about why the people who looked fine still did it, and what the rest of us can actually do. Justin is a retired...
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When does Nursing Care start?
Kevin is a nurse anesthetist with more than a decade of bedside nursing. Dennis brings him on to talk about the part of prolonged field care that the CPG describes but does not time: nursing care. The conversation starts with a practical definition. Life-saving interventions finish, and the…
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299 - TCCC Analgesia: After the Opioids Left
We covered the new analgesia guidelines from TCCC, now lets talk about how to get it done. Ryan Knight — emergency physician and Deep, Army anesthesiologist now at UNC, walk the new battlefield analgesia list. Ryan’s views are his. Not the committee’s What is on the card: acetaminophen…
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SOMA '26 - Lessons Learned: Humanitarian Field Hospitals in Syria and Gaza
Recorded live at SOMA 26 Dr. Sam, an orthopedic and surgical oncologist, shares hard-won lessons from humanitarian deployments in Syria, Ukraine, and Gaza. Operating in underground basements under airstrikes, he describes mass-casualty events that overwhelm capacity (hundreds arriving at once,...
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-40 Changes MARCH: Arctic TCCC
A healthy person lying in the snow at -30 or -40 dies of hypothermia. Add a gunshot wound, wet clothes, and twenty minutes on the X while the team finishes the fight, and the cold competes with the bleeding. Thomas spent nine years as a Danish Special Forces operator and medic. His view is that...
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When is When: Withdrawing Interventions in PFC
Medics add interventions easily. Prolonged field care is where those interventions start charging rent. Dave walks the unwind. A cut endotracheal tube used as a cric can come out if the patient no longer needs it. Unhook the bag. Moving air through the tube, following commands, and a normal...
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When is When: Withdrawing Interventions in PFC
Medics add interventions easily. Prolonged field care is where those interventions start charging rent. Dave walks the unwind. A cut endotracheal tube used as a cric can come out if the patient no longer needs it. Unhook the bag. Moving air through the tube, following commands, and a normal...
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298 - Starting a VA Disability Claim After the Service
The internet will tell you how to “win” a VA claim. Almost none of it is how the exam is actually written. Will spent 11 years Navy EOD, 9 as a SOF medic, and now sits as a National Guard battalion PA. In the middle he worked the other side of the table: third-party C&P exams. Meet the veteran....
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Blood Sweep, Deep Breath, Pulse Check: Point-of-Injury Triage
Most of us were taught START, the sieve, RAMP, DIME, P1–P3. Andrew — EM physician on a small surgical team out of Fort Liberty — used none of it the night a helicopter went down with 22 people on board. The rest of his medical team could not walk. Dust, firelight, yelling. Thirty-to-sixty seconds...
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Don’t Wait for Hypotension: Resuscitation Decision-Making
Dennis sits down with Max to walk through hemorrhagic shock the way it actually behaves in young, healthy military-age casualties—not the tidy textbook ladder of Class I–IV. They start with the only split that matters: compensated versus uncompensated. Class I–II means the body is still…
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297 -Train The Trainer In The Jungle TCCC For A Resistance Force
Ben walks Dennis through a six-month plan that became a jungle course for about 200 unpaid resistance volunteers. Vic built the curriculum from TCCC, the Ranger Medic Handbook, and what that force actually needed — then wrote it to their education level, culture, and organization. Supplies moved...
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Pack to the Vessel: Hemorrhage Control Is Not a Mind-less Skill
Mike Weisman — 25 years as a Navy Corpsman and SARC, 27 years on a busy Vegas fire department, now clinical education at Celox — does not sell magic dust. He sells a hydraulic problem. A femoral-rate bleed can dump on the order of 500 mL a minute. The clotting cascade is a 14-step masterpiece…
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296 - Mission Capable Pain Control: The TCCC Analgesia Update Explained
OTFC is gone. That was not a small supply hiccup. It punched a hole in the old TCCC pain plan. George Barbee, a PA and co-author of TCCC Guideline Change 25-03, walks Dennis through why the committee rebuilt battlefield analgesia instead of patching the old triple-option chart. They screened 56...
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SOMA 26' - Ultrasound-Augmented Triage A Proposal To Refine Field Decision Making In Tactical Combat Casualty Care
Recorded live at SOMA 26 In a near-peer MASCAL, one medic and one junior medic may face twenty penetrating torso casualties, one unit of blood, and no time to empirically needle or finger-decompress every chest. This SOMA presentation argues that formal triage algorithms are already giving way to...
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295- Logistics For LSCO: Why SOF Med Supplies Fail When The War Changes
Medical logistics was an afterthought for a lot of us in GWOT. You submitted a request, something showed up, and everyone joked that the warehouse never read the order. That model does not survive large-scale combat operations. In this episode, Dennis sits down with Jesse Bashel, a medical...
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SOMA 26' - Role 1.5: Fighting Tourniquet Syndrome at the Forefront
Ukrainian orthopedic and reconstructive surgeon describes what prolonged field care actually looks like when evacuation from the front line to Role 2 takes three to four days, and sometimes longer. After years of Role 1, Role 2, and evacuation-stage work, he focuses on a problem that now drives...
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294 - Do Antibiotics Really Reduce Mortality in Trauma? Wound Care First in Prolonged Field Care
Antibiotics are not magic. In this episode of the PFC Podcast, Dennis sits down with Ryan to cut through the common myth that “I’ve given antibiotics, so the wound is protected.” They unpack why vigorous wound care—irrigation, debridement of dead tissue, clean dressings, and early surgical...
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SOMA 26' - Fresh Whole Blood is Not The Answer: It's Still a Question
Whole Blood Is Not a Solution (Until Conventional Forces Can Deliver It) Recorded live at SOMA 26 Dr. Vanessa Hanick (emergency physician, former active-duty Army, now National Guard) and 1SG Cy Clayton (Ranger Regiment veteran, currently a conventional Role 2 first sergeant) deliver a blunt...
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293 - Dead Tissue Kills in Prolonged Field Care: 4 C’s, Early Debridement & Delayed Primary Closure Lessons from the Field
In this episode of the PFC Podcast, Dennis sits down with missionary surgeon Jason to cut through the noise on real-world wound care in austere and unconventional warfare environments. From the bridge two miles from the front to resource-scarce guerrilla settings, Jason shares hard-won lessons on...
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SOMA 26' - European Medical Preparations for Major Engagements and Large-Scale Combat Operations
Recorded live at SOMA 26 Pierre Pasquier (France) and his German counterpart deliver a clear-eyed assessment of how European military medical systems are preparing for large-scale combat operations and major engagements, drawing heavily on lessons from Ukraine. They examine the scale of expected...
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292-Building Mobile Surgical Capability in Denied Environments
In this episode of the Prolonged Field Care Podcast, Dennis sits down with Mitch (U.S. family practice/ER physician) and Augustine (frontline surgeon with five years of experience) to unpack what it actually takes to build and sustain mobile surgical capability in a high-threat Asian conflict…
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SOMA 26 - Optimizing the Efficacy of Commonly Used Tactical Medical Gear and Medications In The Arctic Extreme Cold Operational Environment
Recorded live at SOMA 26 Dr. Emily Johnston (Cascadia Mountain Institute) and SFC Ezequiel Mendoza (Arctic Dustoff, Fairbanks) deliver a hard-hitting, field-validated look at how standard tactical medical gear and medications actually perform—and fail—in true Arctic and extreme cold conditions....
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291 - Pediatric Burns In Prolonged Field Care Assessment, Resuscitation & Airway Management
In this essential episode of the Prolonged Field Care Podcast, Dennis sits down with pediatric intensivist Dr. Sara Bibbens to tackle one of the most challenging and anxiety-inducing scenarios in austere medicine: pediatric burns. From initial trauma assessment using MARCH/ABCDE to nuanced airway...
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SOMA 26 - A History of Mobile Surgical Teams Role 1-3 and Horizon Scan
In this presentation, we take a deep dive into the 300-year history of mobile surgery supporting land campaigns — from Dominique Larrey’s ambulance volantes through the Letterman system, Arnhem, the Falklands, Mali, and the current Russia-Ukraine war. Drawing on rare surgical memoirs, battle…
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290 -Manufacturing Medical Gear In A War Zone: Aluminum Splints, Plastic Drag Litters & The Human Side Of War
In this episode of the Prolonged Field Care Podcast, Dennis sits down with Alex, CEO of Shannon Mechanics, a Ukrainian company that has produced more than 8,000 drag stretchers and over 330,000 immobilization splints for the front line since the full-scale invasion. Alex shares the raw story of…
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Managing the Combative Patient: Hyperactive Delirium with Severe Agitation, Ketamine & Field Reality
In this episode of the Prolonged Field Care Podcast, Dennis sits down with J.R. Pickett — unpack the controversial and high-stakes topic of what used to be called excited delirium. They dig into the history of the syndrome (Bell’s mania, acute exhaustive mania, agitated delirium), why major...
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289: Guerrilla Surgeon: Life-Saving Surgery in Caves, Dirt Rooms & War Zones
In this raw and eye-opening episode of the PFC Podcast, Dennis sits down with Jason, a general surgeon who completed nine combat deployments (seven in special operations) and has since operated in caves, dirt-floored schoolhouses, living rooms, and active conflict zones across multiple countries...
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From Tourniquet to Crush: Mastering Hyperkalemia with Calcium in Prolonged Field Care
In this episode of the Prolonged Field Care Podcast, Dennis sits down with Alex to dissect a controversial claim that calcium is useless for hyperkalemia during cardiac arrest. What started as a social media post that "set his hair on fire" led to a full investigation: reading the primary paper,...
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288: Blood, Citrate & Cardiac Chaos – Rethinking Calcium in Prolonged Field Care
In this episode of the Prolonged Field Care Podcast, Dennis sits down with Dr. Andre Cap to unpack the evolving role of calcium in trauma resuscitation. What started as the “new hotness” in forward blood transfusion protocols has become far more nuanced. They discuss the dangers of both...
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Burn Resuscitation Revelation: Fluid Restriction + Early Plasma Beats Parkland in PFC
In this episode of the Prolonged Field Care Podcast, Dennis sits down with Alex to break down a hot-off-the-press retrospective study from the Journal of the American College of Surgeons titled “Challenging Legacy Burn Resuscitation Paradigms with Fluid Restriction and Early Plasma.” They…
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287: Drone Evacs Are Coming… But Can They Handle Real Critical Care Patients
In this episode, Dennis sits down with Brock, a civilian critical care flight paramedic who flies Medevac in the States, to break down what it actually takes to move a sick patient from point A to point B — and why drone evacuations are nowhere near as simple as the headlines suggest. They cover...
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War Wounds Unfiltered: Cleaning, Debridement & Why You Shouldn’t Close Early
In this high-yield episode, Dennis sits down with Dr. Jennifer Gurney, Army trauma/burn surgeon and Chief of the Joint Trauma System. They dive deep into the practical realities of wound management in prolonged field care when evacuation is delayed for hours or days. Dr. Gurney shares hard-earned...
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286: Antibiotic Resistance - Smart Stewardship in Austere Care
In this episode of the Prolonged Field Care Podcast, Dennis talks with Dr. Ryan Maves (infectious disease physician and retired military ID doc) about one of the biggest silent threats in modern combat casualty care: antimicrobial resistance. From the Acinetobacter outbreaks that hit U.S. forces…
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S Ketamine Mastery in Austere Care: S-Ketamine Dosing, Tricks, and TCCC Updates
S-Ketamine is now part of the TCCC pharmacopeia; you'd better understand how to use it. Dennis sits down with Pat — a veteran military anesthetist, former Danish Special Operations medical leader, and decades-long ketamine expert — for a deep dive into S-Ketamine. From its development and...
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PFC Podcast 285: Adapt or Die - How Ukraine is Rewriting Combat Medicine
In this powerful episode of the Prolonged Field Care Podcast, Dennis sits down with Viktoriia, Chief Medical Officer, responsible for medical care across more than 150 kilometers of active front line. A former OB/GYN who served as a combat medic in 2014–2015 and later on Medevac, Viktoriia shares...
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PFC Podcast: Silent Brain Killer - SpO2 Goals, Airway Triggers & Saving Lives When Oxygen Is Scarce
In this episode of the Prolonged Field Care Podcast, Dennis sits down with Jeff to tackle one of the most time-sensitive and under-appreciated threats in tactical and austere medicine: anoxic brain injury. They break down exactly what it is, how fast it can progress from unnoticed hypoxia to...
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PFC Podcast 284: Pediatric Trauma in Denied Environments
In this episode of the Prolonged Field Care Podcast, Dennis sits down with Dr. Mike Falk — pediatric ICU physician with multiple deployments to Iraq, Gaza, and Ukraine — for a raw, practical, deep dive into pediatric care when you’re the only asset and evacuation is denied. Most combat medics…
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PFC Podcast: TXA - 2g Slam and other myths busted
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...
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PFC Podcast 283: Underground Manufacturing - Ukraine’s Shadow Factories Saving Lives
In this episode of the PFC Podcast, Dennis sits down with David Plaster — former U.S. Army combat nurse, medic, and 68 Delta who has lived and worked in Ukraine since 2012, long before the full-scale invasion. David pulls back the curtain on one of the most remarkable stories in modern tactical...
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PFC Podcast: Velocity Kills - Wound Ballistics, Shotguns & Unpredictable Trauma in Prolonged Field Care
In this episode of the Prolonged Field Care Podcast, Dennis sits down with trauma surgeon Mark Shapiro for a no-BS masterclass on wound ballistics. They break down why understanding the physics of penetrating and blast trauma matters in austere and combat environments — even when experience makes...
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PFC Podcast 282: Blast Lung - Expert Tactics for Blast Lung Injury in Prolonged Field Care
In this high-signal PFC Podcast episode, Dennis sits down with Dr. John Wightman — former 24th Special Operations Wing Surgeon, emergency physician, and one of the world’s leading experts on blast injuries. Drawing from decades of clinical, combat, and academic experience (including co-authoring…
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PFC Podcast: Guerrilla Hospitals - How to Actually Build Medical Systems When Evacuation & Resupply Are Gone
In this episode, Dennis sits down with Reagan Lyon, an Emergency Medicine physician and 17-year Air Force veteran who spent the majority of her career in special operations, including time on Special Operations Surgical Teams. While at the Naval Postgraduate School, Reagan wrote a thesis on one…
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PFC Podcast 281: Crisis Standards of Care: The Hardest Conversations Medics and Teams Must Have
In this raw and unflinching episode of the Prolonged Field Care Podcast, Dennis sits down with Thad Snyder (physician, former medic, and brigade surgeon) to tackle one of the most uncomfortable topics in combat medicine: what happens when resources run out, evacuation timelines collapse, and…
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PFC Podcast: Building the Ideal SOF Clinic - Setting Up a World-Class Austere SOF Clinic
In this powerful episode of the Prolonged Field Care Podcast, Special Forces Detachment Commander Nate shares his journey from medical novice to building a highly effective team clinic SOP. With only one 18D on the team, Nate realized that top cover and systems thinking were critical for success…
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PFC Podcast 280: Hantavirus in the Field: Cruise Ship Outbreak, Deadly Clues & Field-Ready Lessons Every Medic Must Know
What happens when a sharp-eyed cruise ship doctor spots a hantavirus amid a sea of hangovers and flu symptoms? In this high-stakes episode of the Prolonged Field Care Podcast, Dennis sits down with Dr. Ryan Maves — combat-experienced infectious disease expert and military medicine veteran — to...
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PFC Podcast: Traumatic Cardiac Arrest - Real-World ACLS for Austere & Combat Medicine
In this hard-hitting episode of the PFC Podcast, Dennis sits down with Doug, a cardiothoracic ICU physician, for a no-fluff deep dive into ACLS with a heavy focus on pulseless VT and VFib in austere, military, and prolonged field care environments. From deciding when CPR is worth it under fire or...
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PFC Podcast 279: Mastering Abdominal Trauma in Prolonged Field Care
In this no-fluff, high-stakes episode of the PFC Podcast, Dennis sits down with Patrick Liebel - trauma/ICU surgeon to tackle the injury that makes every medic’s stomach drop: penetrating abdominal trauma. When the golden hour stretches into days, evacuation is delayed, and your patient’s belly…
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PFC Podcast: The Moment Prolonged Field Care Actually Begins
In this episode of the PFC Podcast, Dennis sits down with Kevin — a Nurse Anesthetist (CRNA) with deep experience in hospice/oncology floors, Level I trauma ICUs and ERs, military nursing, and years in austere environments, including a Role III in Baghdad. Kevin delivers straight talk on the most...
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PFC Podcast 278: Pediatric Airway Nightmares in Prolonged Field Care
In this high-yield, no-fluff episode, Dennis is joined by Dr. Michael Falk, a pediatric emergency medicine physician, former academic, and combat-experienced relief worker who has run airways in Haiti post-earthquake, Mosul during the ISIS fight, Ukraine, and Gaza. They break down exactly why...
About this show
Become a Paid Subscriber: https://creators.spotify.com/pod/show/dennis3211/subscribeThis podcast and website is dedicated to the healthcare professional who needs to provide high quality care in a very austere location. For more content: www.prolongedfieldcare.orgConsider supporting us on: patreon.com/ProlongedFieldCareCollective
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