DUSTOFF Medic Podcast
51 episodes - English - Latest episode: over 1 year ago - ★★★★★ - 49 ratingsEducation and issues for military flight medics.
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Episodes
Important for COMPO 1 F2s!
November 28, 2022 11:00 - 11 minutes - 8.27 MBMatthew Sovine joins the pod for a quick conversation about research he's conducting into sustainment training for active duty flight medics. Have a listen and make sure to fill out the survey in your work email.
Arizona Department of Public Safety Aviation Unit
November 08, 2022 22:00 - 1 hour - 51.3 MBIn 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 pearls of wisdom for medics looking to use their skills in the civilian sector.
Canadian Armed Forces MERT
October 25, 2022 21:00 - 43 minutes - 29.8 MBCanadian 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 capabilities at aerospace medicine.ca, and you can reach the CMERT team at fwdaeops&[email protected]. Have a listen and let us know what you think!
HKIA AAR Part 2
October 09, 2022 22:00 - 54 minutes - 37.7 MBSeain, Keegan, and Joe were the last three DUSTOFF medics in Afghanistan during the 2021 U.S. withdrawal. In this episode, they describe their experience during the attack at Hamid Karzai International Airport's Abbey Gate.
HKIA AAR Part 1
September 21, 2022 16:00 - 41 minutes - 28.7 MBSeain, 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 attack earlier this year; you can read it here. The U.S. Central Command conducted an investigation into the facts and circumstances surrounding th...
Critical Care Air Transport Team
September 08, 2022 04:00 - 44 minutes - 30.3 MBMax 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 process, training, and team dynamics. Have a listen, share the podcast with colleagues who might enjoy it, and let us know what you think!
Nerve Agents Part 2
August 21, 2022 22:00 - 39 minutes - 27.4 MBCOL (ret.) Jonathan Newmark, MD finishes up a fascinating conversation with Max on nerve agents. Dr. Newmark is a true expert in this subject and his depth of knowledge makes this episode a must-hear. Have a listen, and let us know what you think!
Nerve Agents Part 1
August 02, 2022 17:00 - 47 minutes - 32.8 MBCOL (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 of neurology at the Uniformed Services University of the Health Sciences. This is a rare opportunity to hear from one of the nation’s leading aut...
Medical Simulation
July 18, 2022 10:00 - 1 hour - 44.6 MBMax 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, David mentions a number of different resources for training, including the "This Old Man Manikin" series on his own YouTube channel, the Laerdal L...
SFC Christopher Celiz MOH AAR Part 2
July 05, 2022 10:00 - 26 minutes - 18.3 MBSgt. 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 Celiz was mortally wounded during the engagement. In this episode, we finish our conversation with the lead flight medic and pilot in command of the a...
SFC Christoper Celiz MOH AAR Part 1
June 20, 2022 19:00 - 58 minutes - 39.9 MBSgt. 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 Celiz was mortally wounded during the engagement. In this episode, we talk with the lead flight medic and pilot in command of the aircraft present tha...
Vasopressors
April 27, 2022 18:00 - 1 hour - 42.9 MBDr. 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 deployedmedicine.com has a good video discussing the trial as well. Dr. Mallemat also mentions a study describing a "central line-less" ICU while discus...
Training Circular 8-800
March 28, 2022 16:00 - 59 minutes - 40.9 MBThere'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 medical force to the NCO level. Much of the conversation involves focusing on basic skills, from TCCC at deployedmedicine.com, to the 8-Step Training...
Pain Management
February 21, 2022 00:00 - 1 hour - 51.3 MBDr. 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 our website, or by searching "JTS CPG." Military members, use your free UpToDate access to read their article entitled "Pain Control in the Critica...
Tube Thoracostomy Part 2
January 26, 2022 22:00 - 36 minutes - 25.4 MBDr. 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 you're in a pinch and don't have a chest drain system immediately available. Photos on our website! Have a listen and please let us know what ...
Tube Thoracostomy Part 1
January 17, 2022 11:00 - 47 minutes - 32.3 MBDr. 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 contrasting the efficacy of traditional chest tubes against pigtail catheters. Dr. Stuart calls out a couple important pearls, notably that oxyge...
Spinal Immobilization
December 31, 2021 20:00 - 59 minutes - 41.1 MBWe 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. Collings Hawkins is a leader in the wilderness EMS community, and he breaks down the reality of spinal immobilization and how we can all do better...
Sexual Assault
December 13, 2021 17:00 - 39 minutes - 26.9 MBCaptain 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 important points about balancing patient care protocols with the need to minimize disturbing the victim. She also speaks extensively about the contin...
Toxic Emergencies
November 29, 2021 11:00 - 1 hour - 46.5 MBLt. 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 bites to rocket fuel inhalation to intentional overdose. Dr. Maddry is the Deputy Commander of the Walter Reed Army Institute of Research and i...
New Zealand Defence Force MEDEVAC
November 14, 2021 18:00 - 56 minutes - 38.7 MBNew 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 their aircraft, as well as major differences in their pre-hospital training and certification levels. Captain Little is an inspiration. She's deploy...
Head Injury/TBI
November 01, 2021 03:00 - 1 hour - 50.9 MBThis 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 injury Hypoperfusion from hemorrhage A blow or jolt to head Next, he discusses the mortality associated with status epileptics, usually defined ...
Joint Trauma System
October 19, 2021 22:00 - 58 minutes - 40.3 MBChief 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-wing MEDEVAC. She also specifically mentions resources available on the JTS website, including Clinical Practice Guidelines, the Deployed Medicine ...
ECMO
October 04, 2021 13:00 - 44 minutes - 30.4 MBCOL (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 involved with some of these efforts, along with research supporting its use. Recently, Dr. DuBose co-authored a paper describing a feasibility stu...
Hoist AAR Part 2
September 16, 2021 18:00 - 42 minutes - 29.4 MBHere'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 comments section, DMs, and email are always open!
Hoist AAR Part 1
September 06, 2021 19:00 - 52 minutes - 36.1 MBWe 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 maintenance is de-prioritized. Have a listen and let us know what you think!
College of Remote and Offshore Medicine
August 30, 2021 20:00 - 37 minutes - 26 MBAebhric 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: you probably already have enough). The conversation progresses to austere critical care pearls, the importance of knowing how to treat disease and n...
Hoist Part 2
August 09, 2021 14:00 - 37 minutes - 26.1 MBRob 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 hoist both in training and during operations.
Hoist Part 1
July 24, 2021 17:00 - 40 minutes - 27.9 MBRob 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 information in the SOP because of an ill-informed "belief there is greater risk involved." Setting aside certain hoist techniques as only suitable for comba...
Supraglottic Airway
July 12, 2021 10:00 - 47 minutes - 32.8 MBDr. 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 importance of training on these devices now matter how simple they appear. Dr. Schauer discusses why SGAs aren't prevalent yet in the furthest forw...
Blood Part 2
June 28, 2021 11:00 - 1 hour - 50.5 MBOur 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 director isn’t quite onboard yet with training blood collection and administration.
Blood
June 14, 2021 13:00 - 1 hour - 43.5 MBDr. 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-hospital medicine in flight. This is a detailed discussion that you'll definitely get a lot out of. Dr. Cap mentions the PAMPER trial as well as the ...
Conflicts Across Role 1 Guidelines
June 01, 2021 00:00 - 56 minutes - 39.1 MBDr. 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 of conflicting information across the various guidelines, augmentation of guidance for pediatric care, more specific guidance for unique levels of ...
Conflicts Across Role 1 Guidelines
June 01, 2021 00:00 - 56 minutes - 39.1 MBDr. 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 of conflicting information across the various guidelines, augmentation of guidance for pediatric care, more specific guidance for unique levels of ...
IV/IO Protocol
May 17, 2021 00:00 - 47 minutes - 32.7 MBIn 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 you think!). Additionally, Trevor mentions some critical points about flow rates through IV tubing and lock devices. This can be a blind spot for a ...
Progressive Medical Direction
April 30, 2021 20:00 - 1 hour - 44.5 MBDrs. 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 emphasizes the importance of educational resources for flight docs, especially: deployedmedicine.com The Joint Trauma System's Pre-deployment Priori...
Propofol & Sedation
April 19, 2021 10:00 - 51 minutes - 35.1 MBDr. 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 Christifulli's 2018 FOAMfrat article on post-intubation strategies. Trevor also discusses using the Richmond Agitation-Sedation Scale (RASS). Y...
MCI AAR Part 3
April 05, 2021 08:00 - 49 minutes - 34.1 MBIn 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.
MCI AAR Part 2
March 22, 2021 10:00 - 50 minutes - 34.5 MBIn 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 second episode, hear about the difficult landings Jon executed to pick up patients, as well as the textbook care Jamie provided in the back.
MCI AAR Part 1
March 08, 2021 11:00 - 33 minutes - 22.9 MBIn 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 call for pilots, medics, crew chiefs, and ECCNs.
Maryland State Police Aviation Command
February 21, 2021 09:00 - 45 minutes - 31.4 MBIn 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 selection, the types of missions they respond to, the types of continuing education they run, and some pearls of wisdom for medics looking to use t...
Hypocalcemia
February 08, 2021 09:00 - 1 hour - 46.6 MBIn 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 in trauma. Ricky talks with us about how calcium works in the body, how trauma induces hypocalcemia, and how the flight medic can use calcium d...
Prolonged Field Care for Flight Medics
January 21, 2021 00:00 - 59 minutes - 40.7 MBIn 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, and the specific considerations when picking up patients who have received care under PFC conditions. Check out the Prolonged Field Care Working...
Hypotension/Shock
January 11, 2021 06:00 - 1 hour - 42.5 MBIn 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 Forces Pacific. He has made major contributions to military medical literature. Here's his Google Scholar citation list. Trevor mentions an e...
Altitude Illness
December 28, 2020 06:00 - 30 minutes - 21.1 MBDr. 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 strategies. Keep the SMOG handy during this episode, and find more detailed information in the Wilderness Medical Society's (WMS) Clinical Practi...
Respiratory Distress
December 14, 2020 15:00 - 1 hour - 44.5 MBDr. 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 study identifying a real risk of mortality with the procedure: Schwartz, D. E., Matthay, M. A., & Cohen, N. H. (1995). Death and other complicat...
Los Angeles County Sheriff's Department Special Enforcement Bureau
November 29, 2020 05:00 - 54 minutes - 37.3 MBWe'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 rotary-wing capabilities. Dep. Doucette gives a great overview of his Department's program, talks about some critical patients that he has treated in ...
Airway Confirmation
November 15, 2020 19:00 - 48 minutes - 33.1 MBDr. 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 Joint Trauma System, and read Siegler, J., Kroll, M., Wojcik, S., & Moy, H. P. (2017). Can EMS providers provide appropriate tidal volumes in a s...
Interfacility Transport Clinical Practice Guideline
November 02, 2020 08:00 - 43 minutes - 30.2 MBMAJ 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 'Resources,' at dustoffmedicpodcast.com) Mabry, R. L., Apodaca, A., Penrod, J., Orman, J. A., Gerhardt, R. T., & Dorlac, W. C. (2012). Impact of cr...
Multiple Trauma
October 19, 2020 14:00 - 40 minutes - 28.1 MBDr. 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 Department of Defense Joint Trauma System Prehospital Trauma Registry. US Army Medical Department Journal. Dr. Gurney further emphasizes the need fo...
Hemorrhage
October 05, 2020 14:00 - 33 minutes - 22.7 MBDr. 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, and Intermittent REBOA: Extreme Measures Led to Survival in a Severely Injured Soldier-A Case Report. Journal of special operations medicine: a ...