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In this episode, Trooper Mike Allen joins us to discuss the Arizona State Police's Aviation Unit. Trooper Allen is a flight paramedic who came to AZDPS from the fire service. Mike discusses the history of the program, the criteria for flight medic selection, the types of missions they respond to, the types of continuing education they run, and some…
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Canadian Army Master Corporal Justin Weiler joins Max and Trevor to talk about his new country's rotary-wing medical program. Canada is one of our closest allies, but they have taken a different approach to clearing the battlefield. Listen up for interesting differences in how they equip and crew their aircraft. You can learn more about CMERTs capa…
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Seain, Keegan, and Joe were the last three DUSTOFF medics in Afghanistan during the 2021 U.S. withdrawal. In this episode, they describe their experiences in the days and weeks leading up to the attack at Hamid Karzai International Airport's Abbey Gate. ProPublica is a non-profit news site that published a comprehensive account of the Abbey Gate at…
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Max sits down with US Air Force Lt. Col. Michael Policastro, MD for a capabilities briefing on the Air Force's Critical Care Air Transport Team program. CCATT is a team of highly skilled clinicians who provide enroute treatment to our sickest patients, and Dr. Policastro goes in depth into not only CCATTs medical skills, but also their selection pr…
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COL (ret.) Jonathan Newmark, MD sits down with Max for an in-depth discussion of nerve agents. Dr. Newmark dedicated much of his career to researching the treatment of chemical and biological casualties, giving him an extraordinary depth of knowledge on this topic. Dr. Newmark retired from the military in 2013, but continues to serve as a professor…
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Max sits down with David Shablak to discuss how to conduct high-quality training at the unit level. David is the co-host of the SimGeeks Podcast, a paramedic, and an expert in healthcare simulation. This is a great conversation for Medical NCOs and platoon-sized unit leaders who build and conduct training at their level. During the conversation, Da…
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Sgt. 1st Class Christopher A. Celiz was awarded the Medal of Honor for heroic acts during an engagement with the enemy in Paktia Province, Afghanistan, on July 12, 2018. SFC Celiz saved the life of a wounded soldier from a partner force, and later used his body as a shield to cover the DUSTOFF aircraft that arrived to retrieve the wounded. SFC Celi…
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Sgt. 1st Class Christopher A. Celiz was awarded the Medal of Honor for heroic acts during an engagement with the enemy in Paktia Province, Afghanistan, on July 12, 2018. SFC Celiz saved the life of a wounded soldier from a partner force, and later used his body as a shield to cover the DUSTOFF aircraft that arrived to retrieve the wounded. SFC Celi…
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Dr. Haney Mallemat, a triple-boarded critical care physician and Editor-in-Chief at criticalcarenow.com, joins us to discuss all things vasopressor related. During the interview, Dr. Mallemat mentions the Arginine Vasopressin During the Early Resuscitation of Traumatic Shock (AVERTShock) trial. You can find a summary of that study here, and deploye…
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There's a new Training Circular 8-800, Medical Education & Demonstration of Individual Competence (MEDIC), and it is a major change from the last version. This episode is a deep dive into the new TC with the primary enlisted authors, MSG Kaleb Twilligear and MSG Hunter Black. Listen up as they talk about returning the responsibility for a ready med…
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Dr. Steven Schauer returns to the podcast with Trevor and Morgan to talk about pain management. Managing pain is a complex topic involving both different types of pain and different medications. During the conversation, Dr. Schauer mentions JTS CPG 61, Analgesia and Sedation Management During Prolonged Field Care. You can find this on the link at o…
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Dr. Sean Stuart finishes up a discussion on chest tubes with Claire and Morgan. This episode discusses some of the finer points of the procedure. Dr. Stuart also describes how to make an inexpensive task trainer so you can practice thoracotomies at your unit. Finally, he describes an improvised Heimlich valve that you can make with an exam glove if…
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Dr. Sean Stuart joins Claire and Morgan for the first in a two-part series about chest tubes. Dr. Stuart is a Navy emergency medicine physician and is the Research Director of the Combat Trauma Research Group. This first episode covers a lot of ground, from a detailed discussion of the procedure itself to a thorough exploration of a recent paper co…
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We all learned it. We've all done it. And we (mostly) all know that it's wrong. Dr. Seth Collings Hawkins joins Trevor and Claire to discuss spinal immobilization. Rigid immobilization of trauma patients is entrenched dogma, but we've probably all heard that this procedure is not just without benefit, but is in fact harmful to our patients. Dr. Col…
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Captain Madison Anderson, RN, joins Claire and Morgan to discuss the pre-hospital care of sexual assault victims (SMOG SPECIAL POP V). It's a difficult topic, but it is critical for flight medics to understand the specialized care this patient population requires. CPT Anderson is a Sexual Assault Medical Forensic Examiner (SAMFE), and she makes imp…
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Lt. Col. Joe Maddry joins Max and Morgan to talk about SMOG Medical XIX, Toxic Ingestions. Toxicology is extraordinarily complex, and this discussion ranges beyond ingestions. Dr. Maddry is an emergency medicine physician and has completed a toxicology fellowship. Listen up as he breaks down initial treatment for a range of emergencies from reptile…
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New Zealand Army Nursing Officer Captain Buffy Little joins Max and Trevor to talk about her service's rotary-wing MEDEVAC program. New Zealand is one of our closest allies, but their Army's small size and remote geography mean their operations are dramatically different from ours. Listen up for interesting differences in how they equip and crew th…
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This is a packed episode from one of the leaders in our field! Doc Rush joins us again to talk about traumatic brain injury, head injury, and why those two are not the same. Listen closely as Doc Rush boils down this complex topic to its essentials. First he hits on the three main causes of altered mental status in trauma: Hypoxemia from chest inju…
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Chief of the Joint Trauma System Colonel Stacy Shackelford joins Max and Claire to talk about the history, mission, and future vision for the organization singularly focused on reducing morbidity and mortality on the battlefield. During this wide-ranging discussion, Dr. Shackelford describes JTS initiatives directly relevant to our role in rotary-w…
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COL (ret.) Joseph DuBose joins Trevor and Max to provide an overview of ECMO, and discuss its use in flight. ECMO isn't a new procedure, but it has become more visible in recent years as its use has expanded. In Europe, there are pre-hospital ECMO teams, and the US Air Force CCAT program has brought the technology far forward. Dr. DuBose has been i…
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Here's the second part of our interview with Joel. Listen as he describes conducting multiple hoists in combat, and listen for some valuable lessons learned. Joel talks about PACE planning, patient handoff techniques, and we explore the dogma that surrounds the transport of deceased patients. Have a listen, and let us know what you think. Our comme…
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We begin with a remembrance of our fallen Navy comrades. Today's episode is the start of our second AAR series. We talk with Joel, an Army flight medic who conducted a hoist mission in combat. His experience is important for several reasons, not least of which because we have a very frank discussion of what can happen when hoist training and mainte…
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Aebhric O’Kelly from the College of Remote and Offshore Medicine joins Max and Morgan to discuss medical training and education for austere settings. CoROM is a unique educational institution with many military alumni. Aebhric discusses opportunities at CoROM, including some important information on the number of credits required to apply (hint: yo…
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Rob Munday from Blackcomb Helicopters & SR3 Rescue Concepts, Jon, and Wayne wrap up their discussion of hoist techniques. This episode focuses on safety, training, and emergency procedures. It's a must-listen for pilots, hoist operators, and hoist riders alike, because the discussion has the potential to change your perspective on what makes a safe…
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Rob Munday from Blackcomb Helicopters & SR3 Rescue Concepts joins Wayne and Jon to discuss hoist techniques. Riding the hoist makes great social media posts, but behind the cool pictures is a skill that must be continuously honed and refined. The Army Hoist SOP is a relatively progressive document, but too many units ignore the important informatio…
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Dr. Steven Schauer joins us to discuss supraglottic airways. These devices are often considered to be 'rescue' adjuncts for a 'failed' airway, but this discussion may change the way you approach out-of-hospital airway control. Listen as Dr. Schauer talks about the types of patients who should receive SGAs, tips and tricks for using them, and the im…
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Our conversation with Dr. Cap continues! There’s an in-depth discussion of blood physiology, a comparison of DOD blood protocols, and an interesting rethinking of blood as an organ. Dr. Cap also provides an important overview of how to train transfusions and walking blood banks. The information he shares can be a valuable resource if your medical d…
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Dr. Andre Cap joins us for the first in a multi-part series covering the SMOGs En Route Damage Control Resuscitation, Blood Component/Fresh Whole Blood Use, and Blood Transfusion Related Reactions protocols. COL Cap is amongst the world's foremost experts on this topic, yet he is well aware of the capabilities and limitations of practicing pre-hosp…
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Dr. Andy Fisher and Dr. Steve Schauer join us along with Sarah Johnson and Ryann Lauby to discuss their paper, "An Analysis of Conflicts Across Role 1 Guidelines." The paper, published last year in Military Medicine, compared a number of DOD pre-hospital care guidelines, including the SMOG. The authors concluded that "the reduction or elimination o…
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In this episode, Trevor and Morgan talk to Dr. Whit Harvey, USN, about one of the foundational skills of out-of-hospital care: IV and IO access. Dr. Harvey has done important research on IO efficacy, and he shares some of his findings about the pressure required to keep IOs flowing, as well as techniques to generate that pressure (it's more than yo…
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Drs. Will Smith, Steve Rush, and Ben Walrath join us for a great conversation about the role of the military EMS director. These three men have accumulated significant experience leading MEDEVAC/CASEVAC organizations, and their perspective is valuable for flight medics and Flight Surgeons alike. During the episode, the conversation frequently empha…
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Dr. Steven Bradley joins us to discuss the SMOG Propofol guideline, along with sedation and analgesia pearls. Lieutenant Commander Bradley is a U.S. Navy anesthesiologist, and he is very active in mentoring aspiring physicians. During the episode, Trevor mentions the Military Enroute Care Performance Improvement Report 2019 Events, as well as Tyler…
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In 2019, Jamie and Jon flew a combat mission where they evacuated several patients. Later that day, they transported the same patients to a higher level of care. In this third and final episode, we hear about the interfacility transport phase of the mission, and we get some good wisdom as both men evaluate their own performance.…
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In 2019, Jamie and Jon flew a combat mission where they evacuated several patients. Later that day, they transported the same patients to a higher level of care. In this first episode, hear from both men as they describe how the mission dropped, and their initial actions at the point of injury. There are plenty of lessons to be learned from this ca…
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In this episode, Trooper Adam Murray joins us to discuss the Maryland State Police's use of Trooper/Flight Paramedics in their Aviation Command. Trooper Murray is a critical care flight paramedic and field training officer for the Maryland State Police in southern Maryland. Adam discusses the history of the program, the criteria for flight medic se…
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In this episode, Ricky Ditzel joins us to discuss the role of calcium in trauma patients. Ricky is a former critical care flight paramedic for the 160th Special Operations Aviation Regiment (SOAR), currently a pre-medical student at Colombia University, and the lead author of a groundbreaking paper on the role of calcium in the decompensation cycle…
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In this episode, Dennis from the Prolonged Field Care Podcast joins us to discuss the basics of prolonged field care on medics and their patients. Dennis is a Special Forces Medical Sergeant and an instructor at the Special Warfare Medical Group. In this podcast we talk about the definition of prolonged field care, the operational considerations, a…
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In this episode, Dr. Ben Walrath joins us to discuss the SMOG Shock/Hypotension guideline. The conversation focuses on hypovolemic shock, but also includes a discussion of other types of shock that sometimes get less attention in the tactical setting. Commander Walrath is a U.S. Navy emergency medicine physician and the EMS Director at Navy Medical…
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Dr. Will Smith joins us to discuss the SMOG Altitude Illness guideline. COL Smith, MD, brings his decades of military and wilderness medicine experience to bear in a discussion of "mountain sickness." Altitude illnesses have a significant spectrum of symptoms and severity, and this episode's conversation ranges from initial diagnosis to evacuation …
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Dr. Seth Assar joins us to discuss the SMOG Respiratory Distress guideline. This is a wide-ranging discussion that covers many of the differential diagnoses for a patient who is having difficulty breathing. Listen closely for a use of Ketamine that you may be less familiar with. Dr. Assar points out the inherent risks of intubation and mentions a s…
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We're stepping back from our clinical medical discussions this week to hear from Los Angeles County Sheriff's Deputy Stephen Doucette. In this episode, Dep. Doucette talks about his role as a tactical medic on the LASD Special Enforcement Bureau. SEB has a comprehensive tactical medical program that includes SWAT medicine, mountain rescue, and rota…
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Dr. Jeffrey Siegler joins us to discuss the SMOG Airway Confirmation guideline. The first half of this episode follows the SMOG, then we pivot to discuss "the sledgehammer." Dr. Siegler has conducted important research on the excessive tidal volumes delivered by the "adult" BVM. After you've listened to this episode, watch his presentation to the J…
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MAJ Lani Pineda, RN, joins Max and Wayne to discuss Clinical Practice Guideline 27, Interfacility Transport of Patients Between Theater Medical Treatment Facilities. Wayne mentions several studies that preceded the most recent update to this CPG. These include: JROCM 026-12, Tactical Critical Care Transport DOTMLPF Change Recommendation (click 'Res…
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Dr. Jennifer Gurney joins us to discuss the SMOG Multiple Trauma guideline. Dr. Gurney discusses challenges in military pre-hospital documentation. Schauer, et al discuss this at length: Schauer, S. G., April, M. D., Naylor, J. F., Oliver, J. J., Cunningham, C. W., Fisher, A. D., & Kotwal, R. S. (2017). A descriptive analysis of data from the Depar…
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Dr. Andy Fisher joins us to discuss the SMOG Hemorrhage guideline. Dr. Fisher mentions a case involving manual compression of a patient's aorta: Lewis, C., Nilan, M., Srivilasa, C., Knight, R. M., Shevchik, J., Bowen, B., ... & Kreishman, P. (2020). Fresh Whole Blood Collection and Transfusion at Point of Injury, Prolonged Permissive Hypotension, a…
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