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// Prolonged Field Care - welcome to the home of civilian PFC in the UK. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

R2Ri is the only Wilderness Medical Society Affiliate headquartered in England and Wales and one of only two WMS Affiliates in the UK - the other being the Faculty of Pre Hospital Care, Royal College of Surgeons (Edinburgh). R2Ri team members sit on a number of WMS committees including Operational Medicine (military medicine including environmental and PFC), Expedition Medicine and Global Health.

// Prolonged Field Care: 'No help inbound? It's just you. Trained for the Duration?'

Our civilian emphasis Prolonged field Care specific course is the first of its kind in the UK, possibly globally.  Running for several years now, we know the training works and makes a difference. It has been used in anger in very remote areas and made a difference. We are working with an internationally renowned UK University on Prolonged Field Care research. The course is part of an academic study, providing input into a PhD, global first of its kind, multi-agency study, with another very relevant organisation providing input into the study alongside Remote Area Risk International.

Due to the specialist nature of the project, we are very lucky to have appropriate guest lecturers demonstrating specialist, PFC relevant equipment.

 

The R2Ri team are experienced remote area medics. The team includes those experienced in Prolonged field care from both military and civilian operations - whether terrestrial or ship board PFC experience, prolonged evacuations and more. The team also includes University lecturers and academics. We have combined the expertise of team members with Masters Degrees focusing on Prolonged Field and Nursing Care (now undertaking PhD's in Prolonged Field Care), with military and civilian experience.

We have an unparalleled Faculty in the UK to deliver PFC training: Ex British Antarctic Survey Doctor, Ex Everest ER Pre Hospital Emergency Medical Consultant, Military Doctor, Experienced Remote Area Paramedics, Military Medics, Military Nurses, two Nursing Lecturers (University degree lecturers), Off Shore Medics, Telemedicine and Repatriation expert Doctors.

Delegates have come from all branches of the UK military, Army, Navy, Air Force, Royal Marines, Special Forces Medics, research scientists, expedition leaders, ex UK Special Forces Medics, expedition  medics, expedition leaders and many more. All gave exceptional feedback and would recommend the course. 

What is Prolonged Field Care?

It is NOT simply care in the field - eg hygiene, pro active first aid application/ prevention/awareness of associated conditions arising due to time in the field.

'Prolonged Field Care is field medical care applied beyond doctrinal planning timelines until the patient can be delivered to definitive care. PFC is not a defined set of skills or a phase of care. PFC is an operational problem. COL Sean Keenan, a former US Special Forces Group Surgeon, put it “a really [bad] situation to be in”. 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.”...'

 “Field medical care, applied beyond ‘doctrinal planning time-lines’ ...in order to decrease patient mortality and morbidity. Utilizes limited resources, and is sustained until the patient arrives at an appropriate level of care.” This definition was developed and adopted by a North Atlantic Treaty Organization (NATO) SOF medical expert panel and reflects the prolonged management of serious casualties in a field or austere setting with limited resources. This approach to complex medical problems mirrors wilderness medicine in its scope and application, and, in fact, has direct application to nonmilitary medical practice.

In a civilian context, our patient is ill or injured, we are some time/distance away from help and we need to get them to help or get help to us. Assistance is not coming any time soon. PFC fills the gap between our incident response to safe handover. We have to do what we can, with what we have available. How do we do this? PFC starts where traditional Pre Hospital Care/First Aid training stops. 

The course is an introduction to PFC level course, which very much complements and is intended for those who have undertaken previous medical training, such as our Remote Medical Responder: A Wilderness First Responder course or Remote Medic programmes. Those courses cover hygiene to wound care, evacuation necessary ailments and injuries and much more besides. The PFC course does not teach medical skills but provides a framework for care for extended periods, with little help. 

The course is designed to rapidly introduce delegates to this subject, provide a real world hands on scenario and allow the delegates to go away from the course, well equipped to consider how they can improve their performance on the next occasion and prepare for a real life PFC scenario. 

We also deliver follow on training for those wanting to study these skills over a longer period in more depth. 

Course content:

The course will take delegates through a systematic approach to PFC including with memorable Mnemonics - assisted by our field proof flow charts and aide memoires.

Delegates will also be taught a framework - relevant to their skill levels - to enable them to implement PFC in the field and introduced to lightweight, real world kit, that you would have with you on expedition/ in the field.

  • What is Prolonged Field Care?

  • The problem - loss of the Golden Hour

  • The solution

  • Case Study examples

  • The PFC Algorithm - from primary survey to pain assessment and control, ravine to nursing care, unwell ruminants to telemedicine, packaging, transport and handover.

  • Equipment and improvisation .

  • Introduction to field documentation 

  • Skill stations

  • Communications and power in the field

  • Telemedicine

  • Evacuation ladder

  • Patient Packaging

  • Stretcher Systems 

  • Local evacuation

  • Working with Helicopters

  • Handover

  • International Evacuation and Insurance

  • Practical exercise

  • Post course CPD

  • Further learning/experience options

  • Academic PFC case study capture

 

Course format and Pre Requisites:

 

The course is suitable for both Health Care Professionals (Doctor, Nurse, Paramedic, Military Medic) with suitable remote area medical training and non health care professionals who have undergone suitable training (such as our Remote medical Responder course or FREC 4 with additional remote area medical training). The course IS run over two days at the National Outdoor Centre, Plas y Brenin. Both streams (medic and non medic) are run together and involve pre reading, lectures and skill stations, introducing delegates to a formula to undertake Prolonged Field Care post incident and to practice these skills as well as gain experience in a friendly, supportive environment - culminating in an overnight exercise, treating, monitoring and caring for the patient in an outdoor setting, with minimal (expedition typical only kit), utilising telemedicine and more. The exercise culminates in an evacuation to an intended Helicopter Landing Site. 

 

The practical phase of the course concludes at lunch time of day 2, followed by hot showers, lunch, debrief and then running the course to conclusion.

The course is complemented by post course resources including wipe clean, PFC specific field aide memoires.

The Medic and Non Medic streams are run in Parallel with each aimed at the skill set of the respective group.

Course Dates:

Our next PFC courses are:

2024 dates will be published early to mid October 2023.

Venue: The National Outdoor Centre, Plas y Brenin, Snowdonia.

Cost: 2 day £325.00

Accommodation and food are not included as clients tell us that they want flexibility and we wish to be as inclusive as possible. Inexpensive accommodation can be booked at the venue itself. Note that the end of day 1 sees delegates go up in to the hills for an overnight exercise using their own tents.

How to book:

Click the link below to access the booking course pack for the course dates you are interested in. Download the pack, save it your computer and you can complete the booking form electronically and email to us. The booking form is editable. Alternatively, print off the pack, complete and scan the booking form back to us. Terms and Conditions can be found in the booking pack and any booking form submitted to us is subject to these booking terms and conditions (including cancellation charges).

Important/eligibility:

Please note that places on courses are limited. Our 'Why' is supporting organisations and good causes such as NGO's, Rescue Organisations, expedition teams and others that need excellent training at reasonable cost. We support a number of organisations who cycle volumes of delegates through our courses. Priority in terms of bookings/places will be given to operational remote area medics, NGO's and Rescue teams as well as other good causes. This is who we are set up to support. Instructors or individuals from or who deliver training for or are involved in or have links to other remote area medical training companies are not eligible to join this course. Simply put, this is a conflict of interest. Our training has taken years to develop and hone and we value our Intellectual Property.  We have a legitimate interest in ensuring that our Project and our 'Why' are not undermined and that our instructors can enjoy delivery of the courses, to maximise learning for our clients. Our priority is training our long standing client bases and to maximise the benefit of our training for those communities -  and not other training organisations. For that reason, delegates should pay particular attention to reading our terms and conditions in this regard, before submitting any Booking Form.  These terms and conditions include protections for us and are in place specifically to safeguard the great work we do for and with great people and to ensure the sustainability of our Project. We are very robust in protecting our intellectual property.

Booking link:

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Course review in Adventure Medic: Click.

Testimonials:

 
“World class. Experts in their fields. Role models”.

Well done team !!:

'Stupendous.'

'Practical scenarios were awesome.'


'Definitely stands up with internationally recognised courses I have taken in the US.'

Whether you found the course useful;'Yes, massively.' (Analogue Astronaut taking part in the UK's first space analogue mission').

Whether you found the course useful: 'Very' ex UK Special Forces medic.

Whether you found the course useful; 'Extremely.'

Real world experience PFC of the instructors in remote area 'really enriched the course and sent it apart.'

'It was very comprehensive. Also, scenarios not only reflected medical care issues but other human factors/other psychological/team issues which was very realistic.'

'Scenarios were complex testing which is what I wanted.'

“Amazing 2 days. The instructors have a wealth of knowledge between them & team exercises are testing but also great for additional learning.”

“The ultimate test of everything I have learned in the past 12 months.”

'Can't recommend the course highly enough.'


'The standard that R2Ri delivers to is first division. Industry leaders.'

What I found most useful: 'The combination of lectures with practical examples and then a practical immersive exercise putting it into practice.'

Huge shout out to  Remote Area Risk International for running such a slick, professional & incredibly educational course.

“A fantastic scenario with excellent instruction. I will be highly recommending R2Ri to my colleagues and friends. Thank you !”

10/10. Thoroughly appreciated enjoyed it & incredibly useful.”

'Un surpassed in any other training I've attended.'

'Great delivery.'

'Extremely useful. Very high level of knowledge, instruction and support from all instructors.'


The (PFC) course has been designed & delivered by a team that, in my opinion, are leading the industry in PFC.

“excellent instruction, resources & training facilities. It is the best med course I have attended to date, both in the military & privately.”

'Different league. In its own league as an industry leader.'

“Thank you for the weekend. It was a fantastic course.”

'Bloody brilliant!'


Do you feel the course would improve patient care/outcomes?

Definitely - especially post the initial 10-30 minutes initial incident timelines that are usually taught.”

10/10

“Excellent 

'Brilliant couple of days.'


How does it compare to previous courses?

“Nothing like this !”

“Much more hands on in terms of scenario. Location is great !”

“Better! More relaxed & educational ‘no stupid questions’ environment makes learning more productive.”

“No worries about asking ‘stupid’ questions.”

“Incredibly useful feedback.”

“The chance to complete all parts of the assessments without the get out of jail card of ‘at this point I would …’

“Thank you !”

'Very useful...would definitely feel more confident...I go to extreme environments, for my job as a scientist, normally 2-3 times a year. Would definitely recommend to others...

How do you rate the experience or instructors in the subject matter covered?:

“10/10 - so invaluable having the personal experience & willingness to share & bounce ideas off of. Clearly passionate & credibility is boosted by PhD work.”

“10/10 for instructor knowledge & experience.”

“Excellent, genuine, passionate.”

“The subject matter has made this unique ... the scenario was excellent.”

“Extremely Useful.”

“Highly experienced and broad spectrum”

“Great practical and evacuation - not just theoretical”

“Faculty Excellent. Wealth of knowledge”

“A much greater understanding of clinical skills application over an extended period of time and how a patients priorities change over time ...No conventional training prepares you as well for this scenario”

“Wow.”

“Very well thought out course - learned a lot from the Faculty”

 

Very knowledgeable and excellent team worked with us and assisted my learning experience. 

 

Excellent. Thank you. 

 

Excellent and very knowledgeable of both theory and most importantly the practical.  Excellent to have a mix of civilian and military medical experience.

 

We had a very mixed group, multiple experiences Doctors, Nurses and Paramedics with military medical backgrounds, attending in overseas disaster response capacity, expedition medics, non HCP’s and more. 

 

From a very experienced disaster responder and health care professional :  ‘Lots of people say they’re experts when they are clearly not. R2Ri truly are experts. No arrogance, no egos, professional but it’s like learning with a group of mates. Spot on ! ‘

 

‘This course should be a standard for any pre hospital care personnel/team.’

 

The standard of instruction from the Faculty was superb, practicing in the environment we did was highly beneficial. 

 

Med lead for a disaster response organisation with 25 years expedition experience as well as military experience: ‘very useful and appropriate to our needs…Credible, experienced, good trainers, very approachable…Much more comprehensive and detailed (than previous, shorter PFC training exercise elsewhere)….Many congratulations delivering a great course.’

 

Most useful: ‘General discussion points and Faculty ‘gems’ arose during Q & A. 

 

Very useful. Big learning curve.

 

Faculty: pretty cool. 

 

Great course, instructors tip top and broke down everything to non medical level. 

 

Superb.

 

Valuable addition to core foundation knowledge. 

 

Very good.

 

The course gave a clear and concise teaching and understanding of PFC.

 

Knowledgeable and well organised.

 

Would you be more confident with a remote medical incident now you have undertaken  the course ? 

 

All said yes

 

Yes, absolutely. 

 

Very and certainly have a clearer understanding of that arena.

 

Would you recommend the course to others ?

 

All delegates said they would. 

 

Highly 

 

Yes and already have done. 

 

Excellent course and look forward to returning for further training. 

 

Exercising for a (much) longer period makes it very much close to ‘real life’ as possible.

 

Yes, hugely beneficial in a range of areas including planning, clinical/nursing area and operational strategy.

 

Faculty: Valuable, widespread range of clinical and operational backgrounds.

 

Most useful: Opportunity to participate in high fidelity simulations introducing real clinical and logistical problems with fatigue. 

 

Variety and range of experience was very useful when relating teaching topics to real life.

 

Very useful and realistic sim with realistic time frames. 

 

Faculty: Amazing backgrounds and skill mixes.

 

Very useful. 

 

What did you find most useful ? Breadth of discussion and beyond sole focus of medical practice. 

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