How it All Began

Prolonged Field Care

The term prolonged field care was first coined in 2013 by the US Special Operations Forces (SOF) medical providers, following a lead from NATO SOF developers. Prolonged Field Care (PFC) describes a situation where a critical patient needs to be managed in a remote setting (i.e. your “worst day”).  The original working group members tapped into the experience of over one hundred providers, representing decades of direct medical support to military forces in some of the most harsh and remote conditions on earth. 

With an interest in sharing these best practices with a wider audience, the PFC Working Group, now the Prolonged Field Care Collective, was formed in December 2013, led by Dr. Sean Keenan. In 2014, this group launched the infamous Prolonged Field Care Podcast and website, prolongedfieldcare.org. These two platforms have resources and interviews, which today are downloaded by people in more than 100 countries on a monthly basis. 

Military Best Practices 

Between the years of 2014 and 2018, active duty US Army Special Forces medical teams from the 10thSpecial Forces Group (SFG) in Colorado, and the 3rd Special Forces Group in North Carolina began developing robust training platforms to prepare small teams to deploy regularly to Africa. The conditions in Africa, characterized by huge distances and harsh conditions, were particularly austere, being resource-limited and logistically challenging. For example, evacuation of patients was routinely challenging, with some being held on small bases for over a day before flying out to a hospital. Many medics required additional knowledge and skills to handle these situations –unlike their previous experiences in Iraq and Afghanistan. And so, due to the remote and austere conditions of this problem set, the Mountain Path medical exercise was created, based on the principals of Prolonged Field Care.

Ragged Edge Solutions

The Mountain Path exercise was successful and held up as an example of PFC best practices, but soon proved to be unstainable as a program within the military. Consequently, a privately owned training company was founded to continue the important work of training medics to work within austere conditions. In 2018, the original founder, Roger Dail, combined forces with Special Operations and PFC experts, Sean Keenan, Bill Vasios, and Rich Salve. They founded what is now Ragged Edge Solutions.

Today, Ragged Edge Solutions trains military and government personnel using the Dark+Woods course, derived and designed through best practices from the original Mountain Path program. This course combines classroom instruction with live action scenerios, which immerses students in a hyper-realistic training environment. Known as the gold standard in prolonged field care training, this course is highly sought after by both US and international special operations medics and their teams.

After a few years of running these military trainings, the team at Ragged Edge Solutions learned that there is a strong need for PFC training for civilian emergency medical responders (EMS). In the US alone, 18% of the population is considered to be living in rural areas. Access to hospitals can sometimes be hours, if not days, away from the patient’s home. Because most EMS training focuses on urban environments, many of these EMS professionals are lacking the skills and knowledge to handle emergency situations in remote or austere conditions.

Specialized Medical Standards

With Dr. Sean Keenan at the helm as CEO, Specialized Medical Standards was formed in 2020 as a non-profit company. Our mission is to develop and maintain education and training resources, and our flagship program is a robust curriculum based upon PFC best practices for EMS practitioners. The curriculum for our Austere Emergency Care (AEC) courses is derived from the Ragged Edge Solutions’s Dark+Woods course, utilizing scenarios and educational materials that are directly relevant to a much wider audience of professional prehospital providers. 

The AEC Basic Life Support and AEC-Advanced courses, designed as stand-alone robust continuing education (CE) curricula, were validated in 2022 and have since been adopted by a handful of SMS-licensed training partners. We rely on critical care thought leaders, our partners, and course participants to continually enhance the material. Initial feedback also confirms that this is industry-leading medical education and training. 

Today, SMS operates with a small team, volunteers, and subject-matter expert contractors.  In addition to our Board of Trustees, SMS hosts the International Committee for Austere Emergency Care, an advisory board of medical education leaders who advise the AEC curriculum.  Additionally, we are incredibly proud to also directly host and support the Prolonged Field Care Collective and the PFC podcast.