Prolonged Field Care: Beyond the "Golden Hour".

Prolonged field care (PFC) has emerged as a recent area of focus for US military Special Operations Forces (SOF) medical experts. Focused on the current reality of providing medical care to military forces often deployed in remote and austere locations far from medical support or a robust casualty evacuation chain, PFC encompasses evolving operational situations not unlike many wilderness medicine practice environments. SOF currently operates in all areas of the world and on a variety of different missions, which finds these small teams far from the accustomed practice environment of robust deployed medical infrastructure commonly seen during the last 15 years of military conflicts. In light of this evolving operational situation, the Prolonged Field Care Working Group has undertaken a comprehensive approach to better define and tackle this challenge. The approach to training and educating SOF medics on PFC is based on defined capabilities and operational situations that incorporate best medical practices and seeks to place advance resuscitative capabilities into the hands of providers closest to the point of injury. By transitioning from an approach solely driven by acute trauma aide, incorporating the best practices of Tactical Combat Casualty Care (TCCC), PFC builds upon best practices for the continuing management of both medical and trauma patients in wilderness environments. PFC incorporates best practices in generally hospital-based management of serious and critical casualties to decrease both mortality and morbidity in austere, prehospital operational settings.