Ensure patient stability during transport. Communicate the patient’s condition effectively. Establish communication with a medical provider capable of guiding medical treatment. Perform interventions necessary for preserving life, preventing morbidity, and improving outcome. Ensure your patient is kept warm, clean, and dry. Be able to obtain information about your patient’s present condition and predict unseen injuries. Use sedation to accomplish any procedural tasks. Use adequate and appropriate pain control. Control and maintain a patient’s airway to prevent hypoxia or aspiration. Provide positive pressure ventilation while protecting the lungs from further injury. Be able to initiate appropriate fluid resuscitation to improve outcomes. Use a method to accurately document what you see. Be able to obtain, interpret and understand a patient’s vital signs. This short and simple list gives providers an idea of the basic skills and equipment needed to prepare for “sitting on a patient”. PFC is built around ten core essential medical capabilities. The MEDEVAC helicopter was delayed for six hours following a dust storm. An HH-60M helicopter lands at a forward outpost in Afghanistan to pick up patients from a Role 1 BAS. PFC is meant to address the training gap which becomes apparent when MEDEVAC isn’t on their way and you are forced to hold your sick patient. PFC isn’t intended to create holding capability. They have neither the equipment nor the space to take care of a patient who isn’t either being evacuated or returned to duty. The question is, will we be ready?ĭoctrinally, Role I medical providers, whether that’s the platoon medic, or the Physician Assistant working in the battalion aid station (BAS) do not have patient holding capabilities. As we move into places without the benefit of the robust evacuation capability we are used to, we will be faced with the operational problem of PFC. As we draw down in places like Iraq and Afghanistan, many medics and corpsmen have since realized that a delay in medical evacuation is not only possible but increasingly likely. Air Force’s Pararescue Squadrons, can be grounded in bad weather. Even armed evacuation assets like Pedro, the U.S. However, there have been many occasions where evacuation was delayed by hostile fire or “red” grounding weather conditions. Medical personnel of all ranks take for granted the rapid response of medical evacuation assets. Often, a wounded Soldier or Marine could expect to be in an operating room within 45 minutes of being injured. Over the last two decades, we have become accustomed to well-developed theaters of war where medical assets were positioned close to the fighting. In its original form, PFC applied only to Special Operations medics and corpsmen operating in regions where medical support was limited. Prolonged Field Care is “taking care of a patient who you know needs to be somewhere else for much longer than you are comfortable with.” How Does this Apply to a Combat Medic? COL Sean Keenan, a former Special Forces Group Surgeon, put it “a really situation to be in”. PFC is not a defined set of skills or a phase of care. Prolonged Field Care is field medical care applied beyond doctrinal planning timelines until the patient can be delivered to definitive care. The push comes in anticipation of future large-scale combat operations (LSCO) where evacuation will present a significant logistical challenge, but there are plenty of stories from the last 20 years where a MEDEVAC has been slow or delayed. The Army Surgeon General, LTG Nadja West, reinforced this concept during an address to Congress. The Army Medical Department is pushing for medics to be capable of caring for a wounded patient in the event of a delayed MEDEVAC. LTG Nadja West, Army Surgeon General addressing the Senate Committee on Appropriations, March 2017 We anticipate the future threat environment may require casualty care holding that exceeds current evacuation planning factors (i.e.
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