Dr. John Holcomb returns to discuss a Ukrainian single-center paper on morbidity and mortality from ischemia-reperfusion injury after prolonged tourniquet use. One forward surgery team saw roughly 1,945 patients over nine months. After excluding obviously non-salvageable limbs, minor injuries with short tourniquet tim…

Stacey Shackelford retired from the Air Force after serving as Joint Trauma System chief and trauma medical director in Colorado Springs. She now works at the Center for Combat Medicine at the University of Colorado. Dennis brings her on to walk through the 2021 case-control analysis of prehospital death and prolonged…

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 similar exposure. Zo…

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 Special Forces medic w…

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 patient is stabilized. Tha…

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, meloxicam, suzetrigine, keta…

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, patients dying on the d…

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 TCCC still applies, bu…

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 breathing pattern are good…

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 breathing pattern are good…

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. Fill the cookie-cutter…

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 per patient on a lin…

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 delivering oxygen to organs. Cl…

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 through the existing n…

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 built for arterioles, no…

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 analgesics. They buil…

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 intuitive, intervent…

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 logistician and acquisition…

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 limb outcomes: tourniqu…

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 washout—remains the foundati…

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 assessment of a critical…

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 getting tourniquets o…

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 casualties, the retur…

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 zone. They share the har…

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. Drawing from cold-soak…

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 decisions in small ch…

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 maps, and personal account…

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 how the company starte…

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 organizations including AC…

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 with nothing but a sma…