Spiked Out

Field Trauma Care for Wildland Firefighters: What to Carry and How to Use It

The Journeyman Season 1 Episode 11

Miles from pavement, the rules change. Field trauma care isn't optional—it's the difference between a recovery and a rescue.

We sat down with Brennen—Army 68W combat medic turned paramedic, REMS lead to unpack how combat medicine principles make wildland firefighting safer, faster, and more self-sufficient when evacuation is uncertain.

What we cover:
Austere Care Fundamentals
Why supraglottic airways often beat intubation in the woods
When a cric might be the right call
Prolonged field care realities when you may sit on a patient for hours

Stop the Bleed for Fire Crews
Tourniquet selection and junctional wound packing
Hemostatics that work and how to use them
Commercial vs improvised tourniquets: time and success rates
Simple SOPs that save minutes under stress

What Every Firefighter Should Carry
Tourniquet
Hemostatic gauze
Epi auto-injector (where protocols allow)
Intranasal naloxone
Crew SOPs for staging gear and self-rescue

Building Your Career
From Army 68W to wildland fire and REMS
Cooperator vs contractor roles and ordering pathways
How to open and complete task books efficiently
Timing USAJOBS applications for federal EMS positions

Medical Support Trailers
Bringing mid-level providers to incidents
Suturing, antibiotics, and expanded ALS capability in camp
Keeping crews in the fight and improving quality of life

Severity Assignments & Behind the Scenes
Patrolling for smokes and IA readiness
Cache work that powers big fires
Day-to-day reality of severity roles

The Bottom Line:
Whether you run a saw, lead a crew, or want to build your medical edge on the fireline, this episode is loaded with field-ready skills you can use tomorrow. Translating TCCC (Tactical Combat Casualty Care) to wildland fire isn't just smart—it's necessary when help is hours away.

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[00:00:00] Combat Medicine Meets Wildland Fire
[00:06:57] Brennen's Path: Army Medic To Paramedic
[00:15:56] Wilderness Versus City Medic: Different Niches
[00:24:20] What To Carry: TQs, Hemostatics, Epi, Narcan
[00:36:20] Crew SOPs, Pace Plans, And Self‑Rescue
[00:40:00] Red Desert Rescue: Building MST Capability
[00:47:44] Task Books, Qualifications, And Career Strategy
[00:55:10] Training Offers: Stop The Bleed And WFR Skills