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PJ Medcast

PJ MEDCAST are the podcasts for PJ MED (Pararescue Medicine). Besides PJs, these podcasts may be useful to other Military, Law Enforcement and Civilian Medical Personnel involved in Tactical and Technical Rescue Medicine, and other facets of Operational Medicine. PJs may document the time they spend listening to podcasts as training for their training folders, and also apply towards Paramedic Recertification. This podcast represents the positions of the authors and may not represent the offical position of the Department of the Defense or the United States Government.
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Now displaying: Page 1
Apr 3, 2020

Dr Romaguera's work focuses on the children of our service members and has provided a lot of support to the 103rd Rescue Squadron over the years.
Doc Romaguera discusses how to communicate with your children about COVID and what to look for while staying at home for prolonged periods.

If you like this and find it helpful please email me if there are other issues you would like her to address.

THAT OTHERS MAY LIVE

Apr 3, 2020

Vighter- contact chill@vighter.com

 

TeamRubiconUSA.org  

 

Apr 1, 2020

Intro to basic info on COVID

Prepping ANG PJs if needed to support

Will try to keep this as a concise repository of useful intel and background for operators and your families

Stay safe- distance-hand wash - use PPE meticulously- solve problems!

THAT OTHERS MAY LIVE

Mar 12, 2020

Col S continues her discussion with the future organization of combat trauma systems.

 

Everybody be safe and use common sense.

Our hearts go out to the family, friends and brothers of the Marine Raiders.

That Others May Live.

 

Mar 5, 2020

Col Shackelford is an AF Trauma Surgeon and Director of the Joint Trauma System. She is an important friend of the community.

In this episode she discusses how the DOD looks at and organizes its approach to trauma care and improving it. This is mission critical intel for PJs and SOF medics and why its so important to document care.


THAT OTHERS MAY LIVE

Feb 26, 2020

more chest trauma petals from Doc Dubose

Feb 26, 2020

Doc Dubose is an experienced AF Trauma Surgeon with decades of GWOT experience.

Col D discusses the trauma surgeon's perspective on incoming chest trauma, and things for PJs and Medics to think about.

THAT OTHERS MAY LIVE

Feb 21, 2020

Easily one of our best vent podcasts.  Good sound! We are in the process of fixing the sound (of course by a NY PJ- not me).

This talk covers the basics but also blast lung, TBI and trouble shooting from an experienced respiratory tech with deployments under his belt. He is currently at Baltimore Shock Trauma where we have a great rotation going. Your Flight Doc knows how to get you set up.

Notes from Sgt Noll-

Vent Bullet Points

BASICS
Initial calculation for TV is 6ml/kg
increasing RR or TV lowers C02
decreasing RR or TV increases C02
increasing fio2 increases pao2 and sat
increasing peep will increase pa02 sat o2 sat
initial peep setting on vent is usually 5, can increase 1-2 at a time to 12 maximum

CONTINUOUS SEDATION
Primary indications for resedation of intubated Pt:

Increased HR, Increased BP,
Is Pt diaphoretic? Bucking?

Consider using “Boom stick” Take a 10cc syringe if Flight Doc approved:

Draw up 3cc Ketamine (150 mg) Draw up 5cc Fentanyl (250 mcg) Draw up 2cc Midazolam (10 mg)

Recommend a 1cc push PRN every 10-15 mns

Re-paralyzing the intubated patient:
sTBI Patient – consider re-paralyzing w 100mg ROC if:
continuous bucking and not responding to sedation and is hypertensive.

Management of intubated patients (pulmonary contusion, blast lung, sTBI,)

Pulmonary contusions:

S/S: hypoxia, build up of fluid (blood) in lungs, high PIP ie: above 30 or 35 (if no DOPE issues) -Can be bi-lateral but more often unilateral from blunt force trauma
TX:
-increase Fio2

-If contusion is unilateral (only one side is affected) consider placing in recovery position with the “good” lung down (more blood will go to the lung)

-consider lowering TV and increasing RR in order to maintain proper minute ventilation Blast Lung

BLAST LUNG

S/S:

-hypoxia, dyspnea, cyanosis, increased Etco2

-high PIP over time as lung compliance decreases

-reverberations for the blast can damage AC (alveolar capillary) membrane

-damaged alveoli become damaged and cannot get rid of C02 properly

TX:

- increase fio2

-consider lowering TV and increasing RR (note: this is only temporary as Pt will clinically deteriorate as compliance will be poor)

sTBI
S/S per PJmed handbook

Tx: per PJmed handbook
Vent: maintain target 35-40 etco2

COMPARING THE IMPACT 731 AND SAVe II

Impact 731

Pros: manipulation of I:E times, advanced synchronization settings, can detect patient effort and be triggered by Pt, can maintain 100% fio2 w supplemental O2, can be used down to a 5 kg Pt

Cons: weight and cube size, complicated to use if not current, must manually calculated weight/size of patient

page2image23119168

SAVe II
Pros: Small, light, automatically populates initial settings after pushing Pt height, simple to use Cons: Does not detect patient effort resulting in patient-ventilator “desynchrony”

THAT OTHERS MAY LIVE!

Feb 3, 2020

an SF Doc and Duke neurointensivist talks more about sTBI

Feb 3, 2020
Feb 1, 2020

Tell family and friends to support and go see the new feature film

"The Last Full Measure" to help the box office opening.

Evolving info on sTBI.

Support Ret PJ Mike Malloy raising money for the PJ Foundation in the Mint Race by going to mightycause.com and searching for rescue warriors/PJF

 

Jan 27, 2020

We explore the role of osmotic therapy, in our protocols that is 3% saline.

We will reexmaine the role in the next few months and explore more we can do to do a better job at the POI and in PFC

Jan 21, 2020

Dr Rajajee is a Neuro Critical Care Specialist at the University of Michigan in Ann Arbor. We begin our deep dive into TBI with some physiology and will begin to look at some possible modifications we need to consider for point of injury and PFC settings.  

Jan 9, 2020

Preston Cline, the founder of the Mission Critical Teams Institute talks about the challenges selecting instructor cadre and training SOF forces.

Check him out at:

 

MISSIONCTI.com

 

 

Dec 30, 2019

Steve discusses philosophy and ideas on training for mountain mobility.

Find Steve-

for training at uphill athlete.com

and 

for mountain mobility with Vince Anderson at skyward mountaineering.com

Please remember the Pararescue Foundation in your end of year giving. Its a great way to give gifts to people - make a contribution in their honor.

Dec 24, 2019

Steve House and partner Vince Anderson summitted the Rupal Face of Nanga Parbat and were awarded the Piolet d'Or- in 2005. 
Steve and Vince at Skyward Mountaineering train SOF.

Steve has also codified and incorporated modern PT to optimize performance in the mountains.
This is a great discussion with a world class athlete to enjoy and learn from. He talks about the mountains and how his training program evolved.

Find Steve at uphillathlete.com

Find Steve and Vince at skyward mountaineering 

Read his books- Training for the New Alpinism and Training for the Uphill Athlete

 

Happy Holidays!

Dec 22, 2019

I did 2 talks at MOAB.

I reviewed how PJ PFC training has evolved and a philosophy for training, as well as validation and experience;  expansion for all Teams to do O Low Titer testing, experience with Telemedicine Consultation (telecon), and important clinical training opportunities.

 

Please ask friends and family support the Pararescue Foundation this holiday season. Its a great gift idea for them to make a contribution in your honor, or you for them!

Dec 18, 2019

The Pararescue Medical Operations Advisory Board met last week.

We discussed missions, meds, gear and HPO.

Please remember the Pararescue Foundation in your holiday giving  and suggest it to your family and friends.

Dec 5, 2019

Thank you for listening and taking us to over 800,000 downloads!

If you are trying to find prior podcasts not showing up on iTunes refer to pjmed.libsyn.com

Stay tuned for some great upcoming podcasts.

There are still  few slots left for PJ paramedic recertification  FEB 2020 in NY.  Intel can be found on PJMED.com

Nov 25, 2019

NY PJ VP who is a PA went to a wilderness med meeting and shares his take home points.

Nov 12, 2019

Doug Kechijian is a prior NY PJ, no elite physical therapist and strength coach in NYC at resilient performance physical therapy.  Check out his podcasts: resilient performance podcasts and website

https://resilientperformance.com

 

 

 

Oct 29, 2019

George is an Operational Psychologist with a career worth of exprience supporting Teams. He discusses psychological tools to improve psychological performance and resilience. 

1. Commit to a purpose

2. Take a step

3. Move in

4. Mind the mind, mind the body

5. Own it!

George discusses things like mindfulness, striking the right balance of being self critical but not self destructive and more.  This is a practical and insightful discussion.

You can reach George at George@OpPsychAssociates.com

 

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