Episode
PFC Podcast: Traumatic Cardiac Arrest - Real-World ACLS for Austere & Combat Medicine
- Podcast
- Prolonged Field Care Podcast
- Published
- May 21, 2026
- Duration seconds
- 2220
- Processing state
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Summary
In this hard-hitting episode of the PFC Podcast, Dennis sits down with Doug, a cardiothoracic ICU physician, for a no-fluff deep dive into ACLS with a heavy focus on pulseless VT and VFib in austere, military, and prolonged field care environments. From deciding when CPR is worth it under fire or in a mass casualty scenario, to running a lean team code with minimal personnel, nailing high-quality BLS, working the H’s and T’s under chaos, post-ROSC pitfalls, antiarrhythmics, and the gut-wrenching decision of when to call it — this conversation delivers practical, experience-based wisdom you won’t find in standard ACLS class. Whether you’re a medic, PA, physician, or team leader operating far from a hospital, this episode gives you the mental framework and tactical edge to give your teammate the best possible shot at survival. Key Takeaways: Scene safety and triage realities — when not to start CPR How one knowledgeable person can effectively run an entire code by delegating roles (CPR rotations, timer, airway, meds, defibrillator) Prioritizing actions in resource-limited environments: early high-quality CPR + epi > everything else When and how to practically apply the H’s and T’s (especially hypovolemia, acidosis, hypoxia, and tension pneumo) Post-ROSC critical care: preventing rearrest, airway management, sedation, and treating the “two patients” (heart + brain) Amiodarone vs Lidocaine — when to use what Realistic termination of resuscitation guidelines, the difference between witnessed vs unwitnessed arrest, and the value of objective outside input (telemedicine) The power of bringing the team in for closure when the fight is over Chapters 00:00 – Intro & Welcome 00:57 – Can you really do CPR in the field? Safety, triage, and mass casualty realities 02:57 – Run…