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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
Jan 12, 2021

Doc Johnston is  back for part 2

 

THAT OTHERS MAY LIVE

Jan 5, 2021

Dr Emily Johnston is an Emergency Medicine Physician, High Altitude Mountain Guide, and civilian instructor for the Military Mountain Medicine Program with Col (RET) Wedmore.

She discusses the latest on altitude illness and treatment, with many practical tips.


THAT OTHERS MAY LIVE

Dec 28, 2020

https://www.benning.army.mil/infantry/amws/

 

This is great stuff. This Senior Medic talks about lessons learned from the Army Mountain Warfare Center in Jericho, VT.

These practical and wise LLs are relatable to all of combat medicine.

1- be present in the moment and thrive

2-cut weight where it makes sense, knowledge weighs nothing

3-while being present, look ahead. Understand the consequence of every choice you make

4-be able to improvise, but don't make it your plan

5-understand why you are there and crush that role

Look them up and go train with them! Check out the rough evacuation courses and critical care in the mountains.

THAT OTHERS MAY LIVE

Dec 16, 2020

Dr. David Hirschwerk is an Infectious Disease specialist at North Shore University Hospital on Long Island, which is an educational partner of the 103rd Rescue Squadron.

We are in our second wave, over 300,000 deaths and the vaccine came out this week. 

Dr. Hirschwerk discusses how we got here and what we have learned.


THAT OTHERS MAY LIVE

Dec 2, 2020

Max is a New Yorker who is in the Army and served in Congress. Max shares thoughts as a Citizen Soldier and explains from a Service Member's perspective issues in Congress, and the role of Congress regarding War and Military Action.

He also discusses issues re: a volunteer force vs. a draft.

 

THAT OTHERS MAY LIVE

Nov 24, 2020

Doc Becker is the PJ Doc for the 131st and Emergency Medicine and Global Health Doc at Stanford. He has years of experience as a Doc in Africa.

We are lucky to have one of our Flight Docs who is a subject matter expert.

THAT OTHERS MAY LIVE

Nov 17, 2020

Mr Castleton from the Armed Forces Blood program discusses how to do it. This is mission critical for PJ Teams and you should insatiate this now.

The ability to have a walking blood bank with universal donors is game changing on the ground.

THAT OTHERS MAY LIVE

Nov 3, 2020

This is a unique program. Veteran led, no diagnosis required, formal program focused on post traumatic growth.

If you feel you are not right- you are a candidate!

Call them to discuss.

If you go to this program please give me feedback.

boulder crest.org

 

Oct 26, 2020

The PJ Med Director and the PJ Medical Programs Manager discuss Ten key changes to the new handbook.

The handbook is being formatted and then out for print with the Journal of Special Operations Medicine.

DO NOT INSTITUTE THESE UNTIL THE HANDBOOK IS RELEASED OR YOUR FLIGHT DOC DIRECTS YOU TO.

  1. Updated MARCH assessment to align w/ JTS TCCC guidelines
    1. Moved pelvic binder to circulation, specified how/how not to assess pelvis
  2. Combat/Hemorrhagic Shock and blood protocol
    1. TXA – 2gm (1 minute slow IV push)-also used for suspected TBI
    2. cold stored type 'O' whole blood>fresh low titer-'O' whole blood >PRBCs and plasma>plasma alone>PRBCs alone>non-titered type ‘O’ fresh whole blood>non-titered type specific fresh whole blood
    3. added 10mL of 10% calcium gluconate
  3. “bougie assisted cric” method
  4. Added vent troubleshooting and adjustment guide
  5. General fluid guidance
    1. Omitted Hextend
    2. LR is primary crystalloid for non-hemorrhagic shock casualties (may still carry 100CC for med recon)
    3. Removing 3% Saline (see TBI protocol update)
  6. TBI
    1. Replaced 3% Saline with 30mL of 23.4% hypertonic saline (learn the technique first)
    2. Versed for active seizures, Keppra for prophylactic (depressed skull fx/penetrating head wounds)
  7. Procedural Sedation
    1. Replaced procedural analgesia w/ procedural sedation and provided protocol
    2. No longer promoting ketamine/fentanyl/versed rotation
      1. Dilauded f/ long term pain control in hemodynamically stable
      2. Ketamine for unstable
    3. Medications added to formulary to support ATP small unit care capability/modified TMEPS
      1. Famotidine (Pepcid) – Zantac replacement
      2. Amoxicillin
      3. Azithromycin
      4. 1% Hydrocortisone cream
      5. Metronidazole (Flagyl)
      6. Malarone/primaquine
      7. Ciprofloxacin
      8. 4% saline
    4. Medications removed
      1. Albumin
      2. Ranitidine (Zantac)
    5. CBRNE updates
      1. Added CRESS acronym (Consciousness, Respirations, Eyes, Secretions, Skin)-NATO method
      2. Added MARCH Squared
      3. Updated Cyanide Antidote
        1. Hydroxycobalimin, Sodium thiosulfate and activated charcoal

Doc Dorsch then gives us an ATP update amongst other intel.

THAT OTHERS MAY LIVE

 

Oct 20, 2020

Insightful discussion with Brian and Aaron from Ones Ready. Hear about the podcast and insights from their careers and time at A & S.

Support our Operators at: PararescueFoundation.org

Follow instagram pjrqmed, and on the internet at pjmed.com

THAT OTHERS MAY LIVE

 

 

Oct 17, 2020

CAPT (RET) Butler received this award from the American College of Surgeons.

Thanks for pushing this podcast over 1 million downloads!

Think of krazy / super glue for painful cracks in the heels and around nail beds.

THAT OTHERS MAY LIVE

Oct 15, 2020

PJ Jon discusses the mission, stroke and it relevance to sTBI management.

THAT OTHERS MAY LIVE

 

Oct 12, 2020

This discussion represents an excellent primer into how ketamine and fentanyl are interacting with the brain.

Thanks to Dr Perusine and for her work at neurovationlabs.com

 

Oct 7, 2020

Dr Jen Perusini explains her discovery with the labs she has worked at on some of the basic brain biochemistry of PTSD. She discusses basic science research establishing localization of increase in distinct pathways in the fear center of the brain, the amygdala.

I am posting this unusual basic science discussion because Dr Persuini explains it a meaningful way. She discusses where they are in the effort to begin human clinical trials. In discovering the the possible mechanistic target for PTSD, they are able to begin to craft a trageted therapeutic response. Hear about the promising work Dr Perusini is doing on behalf of our Warriors.

It covers information that is the prelude to next weeks podcast re: some of the actions related with ketamine and fentanyl.

Find out more:

neurovationlabs.com


THAT OTHERS MAY LIVE

Oct 2, 2020

Chris discusses providing extremely remote medical support in up to 80-100 degrees below zero.  Med planning, Evac, etc.

The program is through the University of Texas Medical Branch and the Center for Polar Medical Operations. They support the National Science Foundation.

Note- Chris is not officially representing the Univ of Texas or in any other official capacity. He is sharing his experience and letting our community know about this unique contracting opportunity.

Find info at :

https://www.utmb.edu/polar

THAT OTHERS MAY LIVE

 

 

Sep 28, 2020

USAF Pararescuemen (PJs) perform daring and unique rescues. Among the most unique are long range (>300 miles) ocean rescue missions accomplished by parachute insertion or helicopter using aerial refueling.

Learn about the infil and med details of these missions. This podcast is based on the article we published in the Journal of Special Operations Medicine.

THAT OTHERS MAY LIVE

Sep 23, 2020

Last week the 212th responded to a hunter who fell 100 feet down a slope and experienced significant skeletal trauma.

Dan reviews the technical and sometimes heinous rescue in unforgiving terrain during a windy, freezing rainstorm. 

Pearls-

1. To help dial in a diagnosis of sTBI- can the patient follow commands?

2- Med care in the elements focuses on hypothermia management and pain control to get into a place you can treat vs. thickets where it is impossible.

212th RQS!!! THAT OTHERS MAY LIVE

 

Sep 15, 2020

Mt Sinai Icahn School of Medicine Flex Program


Hofstra Zucker School of Medicine Direct admissions for SOF, no MCAT if qualified

Intro to 23.4 hypertonic saline for brain herniation in the field

Teaser on MCI research

THAT OTHERS MAY LIVE

Sep 10, 2020

A sailor fell ~35 feet on a ship in the Pacific- way out. Jump mission, 48 hrs PFC for spine, pelvis and extremity trauma, helo hoist off with multiple ARs. 

Stay tuned for the 212th high angle mish coming up...

 

THAT OTHERS MAY LIVE 

Sep 5, 2020

Dr Christine Sanchez is a SOF Performance Psychologist with over a decade of experience. She is an asset available to Guard and Reserve Teams, as well as AD, as a consultant.

5 Habits of High Performers to maintain cognitive bandwidth (direct focus & self-regulate psychophysiology)

 
1) Optimize mindset and facilitate productive failures
2) Engage in deliberate recovery to manage chronic stress and quiet busy brain
3) Develop performance routines to direct focus, energy levels, and mindset
4) Expand expertise through deliberate practice
5) Utilize strategic brain breaks to maximize productivity and energy levels
 
Best ways for listeners to contact Dr Sanchez (or learn more about her services/background)
1) Email: drchristinesanchez@gmail.com
2) LinkedIn: https://www.linkedin.com/in/drchristinesanchezphd/

 

Aug 18, 2020

Travis is a TCCC Committee member, and prior Pararescue Medical Programs Manager.

Travis is reviewing the TCCC Airway guidelines and found some surprising literature and details about the basics.
This is a great discussion reflecting a lot of detective work.

Thanks to Travis for dong this, emphasizing how important it is to question and validate what we do.

THAT OTHERS MAY LIVE

Aug 15, 2020

Sleep consistency

Cool Dark Quiet

Don't eat meals within 2-3 hours of sleeping

Find what time of day exercising is best for you- upon waking may be best

Go to sleep as soon after your shift that you can

 

Thanks to WHOOP for allowing us to use their email briefs

You can find data and more info at whoop.com and click on THE LOCKER

Aug 12, 2020

Check out Preston Cline and Coleman Ruiz on their podcast and website at Mission Critical Teams Institute.

Improving performance for special teams, from an academic and Tier 1 perspective.

Website:   MissionCTI.com

Check out their podcast at MCTI TEAMCAST

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