SOMA

Official Twitter of Special Operations Medical Association. Pre-hospital, tactical, austere, disaster, wilderness, & deployed medicine. RT≠endorsement. #SOMSA19

[Prolonged Field Care Collective @PFCCollective24]

🩸 MENTAL STATUS IS YOUR #1 BLOOD TRIGGER 🧠

Trauma surgeon Max on PFC Podcast 252.

“Change in mental status?
HEMORRHAGE until you PROVE otherwise.
Don’t blame drugs or TBI first—prove it.”

⏰ From the SECOND you get the patient:
👉 “Where you from?”
👉 “Favorite movie?”
👉 “What’d you eat today?”
👿NOT just “You okay, buddy?

→ Ask random, thought-provoking Qs to test higher brain function.

✅ Coherent & fast? → Brain’s perfused.

❌ Slow, quiet, confused, “drunk”? → START BLOOD NOW.

🚨 This beats waiting for BP to tank.

Mental decline = brain starving = about to CRASH.

Your Protocol:
Talk non-stop from contact → evacuation.
Re-check mental status with every intervention.
Any drop? → Transfuse EARLY.

🎙️ Full ep: https://t.co/lZsRqDZmUg

📲 Tag a medic. Train this. Save a life.

#MentalStatus #HemorrhagicShock #GiveBloodEarly #ProlongedFieldCare #TCCC #CombatMedicine #TraumaResus #FOAMed #MedTwitter
@GreenBeretMD @SpecOpsMedics @DeltaDev_Team @NARescue @CeloxMedical

[Prolonged Field Care Collective @PFCCollective24]

Posting tomorrow... PFC Podcast 252: Prolonged Tourniquet Conversion

Posting tomorrow... PFC Podcast 252: Prolonged Tourniquet Conversion

🚨 Battlefield Hack: Convert Tourniquets Early to Save Limbs! 🩹

In the chaos of Ukraine's front lines, up to 75% of tourniquets applied pre-hospital were unnecessary in hindsight. But for those that are? Delaying conversion can lead to deadly ischemia-reperfusion injury – think kidney failure from potassium overload.

From the latest Ukrainian study (via @prolongedfieldcare podcast):
🔹 Focus on the "middle group" – stable patients where surgeons fight to save the limb.
🔹 Key tip: Convert ASAP at the aid station. Success rate? 50-75%!
🔹 Winter woes: Extra layers make wound assessment tougher – double-check those bleeds.

Watch the full breakdown with Dr. John Holcomb on PFC Podcast Ep. 255. Link in bio! What's your go-to TQ conversion strategy? Drop it below 👇

#TacticalMedicine #TourniquetTraining #UkraineWarLessons #ProlongedFieldCare #CombatMedic #SOFMed #AustereMedicine #PFCpodcast
@SpecOpsMedics @GreenBeretMD @armyemdoc @DeltaDev_Team @NARescue

[Prolonged Field Care Collective @PFCCollective24]

Posting tomorrow... PFC Podcast 251: Hemorrhagic Shock Progression.

🚨 Don’t Wait for the Crash: Act Smart in Hemorrhagic Shock 🚨

In the heat of trauma care, guidelines like TCCC are critical, but they’re NOT the law. On the latest PFC Podcast, trauma surgeon Max drops a vital truth: **Don’t hang your patient’s life on an algorithm.** Here’s how to make life-saving decisions in hemorrhagic shock:

🩺 Trust Your Instincts: If hemorrhage control feels shaky and vital signs are trending wrong—rising heart rate, narrowing pulse pressure, worsening mental status, or heavier breathing—don’t wait for a blood pressure drop to act. That trigger might come too late.

🔍 Key Signs to Watch:

- Sympathetic Tone: Is it ramping up? That’s your body fighting to compensate.

- Pulse Pressure: Narrowing means trouble’s brewing.

- Mental Status & Breathing: Changes here scream urgency.

💡 Why It Matters: In Class 2 shock, patients can look “fine” but be on the edge of decompensation. If you’re not a surgeon or can’t intervene further, act early to prevent a crash into Class 3 or 4.

🛠️ Pro Move: Use at least two data points (e.g., heart rate + mental status) to guide decisions. One data point can mislead; two confirm the trend. Be proactive—stop the bleed, reassess, and act fast.

🎧 Dive deeper into real-world trauma care at https://t.co/lZsRqDZmUg. Learn to read the signs, trust your gut, and save lives! 💪

#HemorrhagicShock #CombatMedicine #TraumaCare #MedicTraining #ProlongedFieldCare #TCCC #EmergencyMedicine #BattlefieldMedicine

[Prolonged Field Care Collective @PFCCollective24]

PFC Podcast 251: Hemorrhagic Shock Progression

🚨 Understanding Hemorrhagic Shock: Key Insights from the PFC Podcast 🚨

In our latest PFC Podcast episode, Dennis and trauma expert Max dive deep into hemorrhagic shock—a critical topic for medics, first responders, and anyone in high-stakes trauma care. Here’s what you need to know:

🩺 Classes of Shock Simplified:
- Class 1: Up to 750cc blood loss (~15%). Your body compensates by mobilizing venous reserves. Vital signs? Normal. Think "first gear."

- Class 2: 750-1500cc (~15-30%). Heart rate spikes, pulse pressure narrows, and breathing gets heavy. You’re in high gear, but still compensating.

- Class 3 & 4: Over 1500cc (30-40%+). The wheels come off—blood pressure drops, organs lose perfusion, and you’re in uncompensated shock. Act fast!

⚠️ Key Takeaway: Young, healthy individuals (like military operators) can mask severe blood loss, staying in Class 2 until they crash into Class 4. Don’t wait for a blood pressure drop to intervene!

🩹 When to Act:
1. Hemorrhage Control: Stop the bleeding first—check extremities, abdomen, chest, pelvis, and thighs.

2. Trend Vital Signs: Look for worsening tachycardia, narrowing pulse pressure, or mental status changes. Two red flags? Time to act, even if systolic BP is above 100.

3. Don’t Rely on Guidelines Alone: Algorithms like TCCC are guides, not law. Trust your assessment.

🎧 **Listen to the full episode** at https://t.co/lZsRqDZmUg for a masterclass in trauma care from real-world experience. Stay sharp, save lives! 💪

#CombatMedicine #HemorrhagicShock #TraumaCare #MedicTraining #ProlongedFieldCare #TCCC #EmergencyMedicine

[Prolonged Field Care Collective @PFCCollective24]

Don't burn patients need to "Swell to get Well"? Posting tomorrow... PFC Podcast 247: Plasma for Burns

Link tree
https://t.co/DtnP8nfTFg
@SpecOpsMedics @NextGenComMed @NARescue @DeltaDev_Team @GreenBeretMD @armyemdoc @ATMA_Tactical @emcrit @FlightBridgeED

[Prolonged Field Care Collective @PFCCollective24]

Take the airway before it's too late. PFC Podcast 244: Penetrating Neck Injury

Link tree
https://t.co/DtnP8nflPI
@SpecOpsMedics
@GreenBeretMD @armyemdoc @NARescue @NextGenComMed @DeltaDev_Team @ATMA_Tactical @CommitteeonTCCC @CeloxMedical @TacticalMedical @TacmedAus

[Prolonged Field Care Collective @PFCCollective24]

You have to know what you're doing, before getting the gear to help you do it. You can't just buy your way to victory. Out now... PFC Podcast 246: Maritime IW Medicine Deep dive.

Link tree
https://t.co/DtnP8nfTFg
@SpecOpsMedics @NARescue @NextGenComMed @armyemdoc

[Prolonged Field Care Collective @PFCCollective24]

Managing a Zone 1 Neck injury. PFC Podcast 244: Penetrating Neck Injury

Link tree
https://t.co/DtnP8nflPI
@SpecOpsMedics @GreenBeretMD @NARescue @NextGenComMed @CommitteeonTCCC @CeloxMedical @ATMA_Tactical @FlightBridgeED @armyemdoc @DeltaDev_Team

[Prolonged Field Care Collective @PFCCollective24]

PFC Podcast 238: End of Life Care...Out now.

If we don't train for making these kinds of medical decisions, how do we believe we will perform when it happens?
Link tree
https://t.co/DtnP8nfTFg
@SpecOpsMedics
@armyemdoc @DeltaDev_Team @NARescue @CeloxMedical

[Prolonged Field Care Collective @PFCCollective24]

Tourniquets can't fix everything. Probably should train on that scenario. PFC Podcast 236: Hemostatic Agents

Out now... Link tree
https://t.co/DtnP8nflPI

Listen ad free on Spotify, Apple Podcast, or Patreon
@SpecOpsMedics @DeltaDev_Team @CeloxMedical @NARescue

[Prolonged Field Care Collective @PFCCollective24]

Posting tomorrow... PFC Podcast 236: Hemostatic Agents
Dennis and Michael discuss the critical role of hemostatic agents in hemorrhage control.

Link tree
https://t.co/DtnP8nflPI

Listen ad free with premium membership on Spotify, Apple Podcast, or Patreon.
@SpecOpsMedics

[SOMA @SpecOpsMedics]

Don't complain, do something about it. PFC Podcast 234: SOMA
Link tree
https://t.co/oANX2vaeKZ
@PFCCollective24 @armyemdoc @TacmedAus @NextGenComMed @NARescue @DeltaDev_Team

[Prolonged Field Care Collective @PFCCollective24]

Former Ranger Medic Victor, goes over his lessons learned while helping in Burma. Full of hard lessons working with the resistance.
Link tree
https://t.co/DtnP8nflPI
@SpecOpsMedics
@NextGenComMed @armyemdoc @GreenBeretMD @DeltaDev_Team @NARescue

[SOMA @SpecOpsMedics]

DNBI is very common, but should combat medics spend the majority of their time on this?

This presentation and many more available on SOMA's LMS. Become a member and enjoy whenever you want.
@PFCCollective24 @armyemdoc @NextGenComMed

[SOMA @SpecOpsMedics]

DNBI pops up whenever... Whenever

This presentation and many more are available now on SOMED.

https://t.co/0EvZSrp3FS

@armyemdoc @NextGenComMed @PFCCollective24

[Prolonged Field Care Collective @PFCCollective24]

Posting tomorrow...Rick asks us if we're focused on the right outcomes in our medic courses. SOMSA'25 - Squaring the Foundations

Link tree
https://t.co/DtnP8nflPI
@SpecOpsMedics @DeltaDev_Team @NARescue @NextGenComMed @armyemdoc @ATMA_Tactical @theCoROM @CommitteeonTCCC

[Prolonged Field Care Collective @PFCCollective24]

Airway management is over after the time goes in. You have to have a plan to maintain it before you start. PFC Podcast 231: Emergence

Link tree
https://t.co/DtnP8nflPI
@DeltaDev_Team @NARescue @SpecOpsMedics @NextGenComMed @armyemdoc @GreenBeretMD @ATMA_Tactical

[Prolonged Field Care Collective @PFCCollective24]

Suction is the one thing that you can't reproduce. ALWAYS, have a suction device as part of your airway kit... ready to go. PFC Podcast 231: Emergence

https://t.co/DtnP8nflPI
@SpecOpsMedics
@NextGenComMed @NARescue @DeltaDev_Team @cromedical @ATMA_Tactical @armyemdoc

[Prolonged Field Care Collective @PFCCollective24]

You sedated for the procedure, what's your plan for after?

PFC Podcast 231: Emergence... Posting tomorrow

PFC Website: https://t.co/jOF9C8P3jk

Patreon: https://t.co/UkEvvkKBzH

Apple podcast https://t.co/VjUZwvb1kf

Spotify https://t.co/O3frLosctn

[SOMA @SpecOpsMedics]

Pushing best practices to extreme environments always presents new challenges. SOMSA is where collaborations begin.

This presentation and many others available now on SOMED.

https://t.co/0EvZSrp3FS
@PFCCollective24 @NextGenComMed @DeltaDev_Team @ResusPadawan @armyemdoc