This week, Aebhric OKelly talks with Cory Igo, who is an alumnus of the CoROM Remote Paramedic programme. Cory shares his journey from being a United States Marine to becoming a remote paramedic, highlighting his experiences in veteran rehabilitation through Brazilian Jiu Jitsu, the challenges of working in remote medical settings, and the lessons learned from his deployments in Ukraine. He discusses the importance of adaptability in medicine, especially in challenging environments, and offers insights into the future of rehabilitation for injured veterans.

Takeaways

Cory Igo is a former Marine turned remote paramedic.

Brazilian Jiu Jitsu aids in the rehabilitation of veterans.

The transition from military to medical work can be challenging.

Choosing the right paramedic program is crucial for practical skills.

Cory's first paid job involved a reality show in Tanzania.

Altitude sickness can affect individuals differently during climbs.

Ukrainians are innovating in medical practices amidst conflict.

3D printing is becoming significant in medical applications.

Learning to adapt is essential for new medical professionals.

Cory emphasises the importance of local knowledge in medicine.

Chapters

00:00 Introduction to Corey Igo

03:01 The Role of Brazilian Jiu Jitsu in Veteran Rehabilitation

06:04 Transitioning from Marine to Paramedic

08:57 Choosing the Right Paramedic Program

12:08 Experiences in Remote Paramedicine

15:07 First Paid Job as a Paramedic

17:57 Altitude Medicine and Climbing Kilimanjaro

21:08 Working in Ukraine and Lessons Learned

24:06 Future Aspirations in Rehabilitation

27:09 Advice for New Medical Professionals

This week, Dr Jon Christensen discusses the critical role of mindset in medical practice, particularly in remote and resource-limited environments. He emphasises the importance of psychological first aid, decision-making under stress, and building resilience through self-care practices. Drawing from personal experiences and historical examples, Dr Christensen illustrates how mindset can shape outcomes in personal and professional contexts, ultimately leading to better patient care and personal growth.

Takeaways

Mindset significantly influences personal and professional outcomes.

Understanding psychological first aid is crucial for first responders.

Resilience can be built through self-care and awareness practices.

Decision-making is often influenced by biases and heuristics.

Isolation can lead to increased mental health issues.

Nutrition and exercise play vital roles in mental well-being.

Meditation and mindfulness can help manage stress and improve focus.

Building connections and mentorship is essential for personal growth.

Understanding one's legacy can motivate personal change.

Success is defined by personal growth and the impact on others.

Chapters

00:00 Introduction to Mindset in Medicine

03:08 The Importance of Mindset

18:52 Risk and Decision-Making in Medicine

27:03 Psychological First Aid and Its Importance

33:10 Building Resilience and Self-Care

49:20 Personal Journey and Lessons Learned

This week, Aebhric O’Kelly talks with Francois Duquette, a Quebec nurse who shares his unique experiences working in remote northern communities. He discusses the challenges of providing emergency care without immediate physician support, adapting nursing practices, and using technology like point-of-care ultrasound in austere environments. Francois recounts intense experiences, including multiplemedevacs and critical patient care situations, emphasising the need for continuous learning and training in unpredictable scenarios. He also offers valuable advice for new medics and nurses entering the field.

Takeaways

Francois has a diverse academic backgroundin political science and health law.

He has worked in emergency care and remotenursing since 2017.

Nurses in northern Quebec often workwithout immediate physician support.

Adaptation of nursing practice is crucialin remote areas.

Francois emphasizes the importance oftriage in emergency situations.

Technology like POCUS is limited in remotehealthcare settings.

Francois shares intense experiences fromhis nursing career.

Continuous learning is essential forhealthcare professionals in austere environments.

Language skills enhance communication andpatient respect in healthcare.

Francois encourages new medics to embracechallenges and keep learning.

Chapters

00:00 Introduction to Francois Duquette

01:53 Emergency Nursing in Remote Areas

05:50 Challenges of Medical Practice Without Immediate Support

09:50 Utilising Technology in Remote Healthcare

13:55 Intense Experiences in Northern Nursing

22:07 The Reality of Triage in Austere Environments

28:03 Lessons Learned from High-Pressure Situations

33:53 The Importance of Continuous Learning in Nursing

39:59 Advice for New Medics and Nurses

This week, Aebhric O’Kelly talks with David Steade, who shares his journey through emergency medical services and military service. He details his experiences in Germany, his transition to the 160th Special Operations, and the challenges of flight medic training. He emphasizes the importance of continuous learning in the medical field and offers valuable insights for new medics and nurses entering austere medicine.

Takeaways

David’s journey into EMS began in the 1990s.

He experienced a culture shock when moving to Germany.

His time in Germany included both medical training and cultural exploration.

David transitioned to the 160th Special Operations for advanced training.

Flight medic training was highly competitive and intense.

The 160th is known for its role in special operations and support.

David shared memorable medical cases from his time in the 160th.

He emphasized the importance of learning from mistakes in medicine.

David recommended practical advice for new medics entering austere medicine.

Continuous learning is essential for all medical professionals.

Chapters

00:00nIntroduction to David Steade

02:50 David's Journey into EMS and Military Service

06:45 Experiences in Germany as a Medic

09:23 Transitioning to the 160th Special Operations

12:00 Flight Medic Training and Challenges

18:14 Understanding the 160th Special Operations

24:10 Memorable Medical Cases in the 160th

28:00 Advice for New Medics and Nurses

This week, Jason Jarvis joins Aebhric O’Kelly on a deep dive into malaria, covering the lifecycle, symptoms, diagnostic tools, treatment options, and the latest vaccine developments. The discussion emphasises the importance of understanding malaria's complexities, the challenges in diagnosis and treatment, and the promising advancements in vaccine research to eradicate this deadly disease.

Takeaways

Parasitic protozoa transmitted by Anopheles mosquitoes cause malaria.

The lifecycle of malaria involves complex stages in both mosquitoes and humans.

Symptoms of malaria can vary significantly based on previous exposure to the disease.

Severe malaria can lead to critical conditions like altered consciousness and hypoglycaemia.

Rapid diagnostic tests (RDTs) are essential but not foolproof in detecting malaria.

The R21 malaria vaccine shows promising efficacy and significantly advances malaria prevention.

Public health efforts primarily focus on protecting vulnerable populations, especially children.

Understanding the fever patterns can aid in diagnosing malaria and other diseases.

Vaccination for adults is being researched, but current recommendations prioritise children.

Staying informed through reputable sources like WHO and CDC is crucial for those travelling to malaria-endemic areas.

Chapters

00:00 Introduction to Malaria and Its Lifecycle

14:58 Understanding Malaria Symptoms and Severity

30:07 Diagnostic Tools and Treatment Options

34:09 Vaccines: Current Developments and Future Prospects

44:57 Resources for Further Learning

This week, Aebhric O’Kelly talks with Dr Daniel Grace, who shares his journey into expedition medicine, discussing his unconventional path from general practice to working in the outdoors. He emphasises the importance of academic frameworks in expedition medicine, the human factors influencing pre-hospital care, and his experiences with mountain rescue and tropical medicine initiatives. Dr Grace also reflects on memorable expeditions and offers advice for aspiring expedition medics.

Takeaways

Dr Grace has been a GP since 2017, seeking unconventional medical paths.

His interest in expedition medicine was sparked by a wilderness medicine course.

There is a lack of a recognised framework for expedition medicine in the UK.

Human factors play a crucial role in the success of pre-hospital care.

Mountain rescue provides an opportunity to develop technical skills in a local setting.

Training for mountain rescue includes various medical competencies and practical exams.

Tropical medicine knowledge is beneficial for expedition work and telemedicine roles.

The Virtual Doctors charity connects UK doctors with clinicians in Zambia for telemedical advice.

Dr Grace's favourite expedition was working in the Yukon during extreme winter conditions.

He advises new medics to always say yes to opportunities, as they can lead to unexpected paths.

Chapters

00:00 Introduction to Expedition Medicine and Dr Daniel Grace

02:13 The Journey into Expedition Medicine

05:50 The Need for Academic Framework in Expedition Medicine

10:02 Human Factors in Pre-Hospital Care

12:10 Experiences in Mountain Rescue

18:02 Training and Development in Mountain Rescue

21:00 Tropical Medicine and Telemedicine Initiatives

27:04 Memorable Expeditions and Future Aspirations

30:02 Advice for Aspiring Expedition Medics

This week, Aebhric O’Kelly talks with the new CoROM faculty, Dr Sean Bilodeau, an emergency physician and EMS fellow, and discusses his experiences and insights into the field of emergency medicine, mainly focusing on pre-hospital care and the evolving roles of paramedics. He highlights the differences between the US and European models of emergency medical services, the importance of education and training for paramedics, and the critical need for blood management in emergencies. Dr Bilodeau also shares his plans for research and education within the EMS field, emphasising the importance of community buy-in and the need for systemic changes in delivering pre-hospital care.

Takeaways

Dr Bilodeau is an ER doctor in Maine, completing an EMS Fellowship.

He emphasises the importance of education in pre-hospital care.

The US EMS model differs significantly from European models, particularly in physician involvement.

There is a need for cultural change regarding paramedic roles in the US.

Dr Bilodeau advocates for treating and releasing patients in the field when appropriate.

He is involved in research on teaching critical skills to paramedics.

The conversation highlights the logistical challenges of blood management in emergency care.

Dr Bilodeau discusses the potential of using freeze-dried plasma in austere environments.

He encourages new practitioners to seek opportunities and engage in projects actively.

The finger thoracostomy is presented as a more effective technique than traditional needle decompression.

Chapters

00:00 Introduction to Dr Sean Bilodeau

01:01 Emergency Medicine and EMS Fellowship

02:34 Differences in Pre-Hospital Care Models

05:31 Reimagining Paramedic Roles

11:49 Future Plans and Research in EMS

16:34 Global Perspectives on EMS Education

21:55 The Importance of Blood in Emergency Care

27:21 Challenges in Wilderness Medicine

34:15 Advice for New Practitioners in Austere Medicine

This week, Aebhric O’Kelly talks with Dr Derrick Tin, a professor of critical care and director of counterterrorism medicine at Harvard University, and discusses the multifaceted field of disaster medicine. He explains the importance of providing quality care in resource-limited environments and the various pathways for medical professionals to get involved in this speciality. Dr Tin shares his journey from critical care to disaster medicine, emphasising the need for practical training and the psychological aspects of working in disaster scenarios. He also highlights the significance of mentorship and the evolving nature of disaster medicine as a recognised subspecialty.

Takeaways

Disaster medicine focuses on providing care in resource-limited environments.

Soft skills are crucial for disaster medicine specialists.

There are various pathways to enter disaster medicine, including courses and fellowships.

Critical care experience is valuable in disaster medicine.

Training should include practical, hands-on experiences.

Mental health support is essential for disaster responders.

Disaster medicine should be integrated into medical school curricula.

The Harvard DM Fellowship offers unique resources and training.

Networking and collaboration are vital in the disaster medicine community.

Future developments in disaster medicine should focus on recognition as a standalone subspecialty.

Chapters

00:00 Introduction to Disaster Medicine

02:57 Understanding Disaster Medicine

06:07 Pathways into Disaster Medicine

09:14 The Role of Critical Care in Disaster Medicine

11:47 Training for Disaster Medicine

15:05 The Ideal Disaster Medicine Course

18:04 Harvard's Disaster Medicine Fellowship

20:57 Experiences in Disaster Response

24:13 Psychological Aspects of Disaster Medicine

27:05 Contributions to the Field Guide

30:03 The Future of Disaster Medicine

32:52 Advice for New Practitioners

36:10 Involvement in WADEM

This week, we explore various topics related to academic medicine in remote and austere environments that were presented during the Medicine in the Mediterranean conference in February 2025. The discussions include ventilation techniques in challenging settings, the impact of human factors in pre-hospital care, the importance of nursing care, and the complexities of treating critical casualties. We also delve into hyperbaric medicine, paediatric trauma, and the significance of mindset in medical practice. Each segment features insights from experts in their respective fields, providing valuable knowledge for medical professionals working in resource-limited areas.

Takeaways

Continuous education is essential for effective patient care.

Positive pressure ventilation can impact hemodynamic status.

Human factors play a crucial role in pre-hospital care.

Needle decompression techniques need proper training and feedback.

Empathy in nursing care is vital for building trust with patients.

Understanding the environment is key in treating critical casualties.

Diving medicine requires awareness of hyperbaric risks and regulations.

Urban environments significantly influence paediatric trauma.

Mindset can shape a medical provider's legacy and effectiveness.

Collaboration and communication are essential in emergency medical services.

Chapters

00:00 Introduction to the Quorum Podcast

05:14 Ventilation in Austere Environments

10:01 Human Factors in Pre-Hospital Care

17:25 Needle Decompression in Pre-Hospital Care

20:09 Nursing Care in Pre-Hospital Environments

23:19 Treating Critical Casualties

28:19 Hyperbaric Medicine and Diving Accidents

33:19 Paediatric Trauma

35:13 The Importance of Mindset

This week, Dr Sean Keenan gives the keynote address for the Medicine in the Mediterranean 2025 conference held last week in Malta. He discusses the evolution and current practices of Prolonged Field Care (PFC) in military and austere environments. Dr Sean Keenan discusses the importance of adapting medical practices to meet the challenges of remote and resource-limited settings, emphasising the need for comprehensive training and guidelines. The discussion highlights the difficulties with transitioning from Tactical Combat Casualty Care to Prolonged Field Care, the significance of clinical practice guidelines, and the ongoing efforts to improve emergency medical response in various contexts. This conversation delves into the development and implementation of Prolonged Casualty Care guidelines, focusing on the challenges faced in training and the importance of mastering basic medical skills. The discussion highlights the need for effective logistics, the significance of the golden hour in trauma care, and the evolving nature of warfare that impacts medical practices. The speaker emphasises the importance of continuous education and adapting to operational needs while maintaining sound medical principles.

Takeaways

Prolonged Field Care has evolved significantly over the past decade.

The importance of audience participation in understanding medical terms.

Learning from past experiences is crucial in medical practices.

The Joint Trauma System collects data to improve best practices.

Pre-hospital care is often overlooked in trauma literature.

Human physiology remains constant regardless of the environment.

Prolonged Field Care addresses the gaps in emergency medical response.

Training and equipping personnel is essential for effective care.

The transition from Tactical Combat Casualty Care to Prolonged Field Care is vital.

Understanding the context of care is key to effective medical response. Prolonged Casualty Care guidelines are evolving to meet modern warfare needs.

Curriculum development requires feedback from experienced practitioners.

Basic medical skills are crucial for effective, prolonged field care.

The golden hour is critical for reducing mortality in trauma cases.

Logistics play a significant role in successful medical interventions.

Training must adapt to the realities of current combat situations.

Understanding human physiology is essential for effective medical care.

Expecting casualty care is a new concept that needs training.

Continuous education is vital for paramedics and medical personnel.

Operational needs drive the development of medical guidelines.

Chapters

00:00 Introduction to Prolonged Field Care

07:03 The Evolution of Prolonged Field Care

29:04 Current Practices and Guidelines in Prolonged Field Care

31:55 Prolonged Casualty Care Guidelines Overview

35:49 Curriculum Development and Feedback Process

40:12 Challenges in Prolonged Field Care Training

44:01 Extending the Golden Hour in Trauma Care

49:34 Current Practices and Future Directions in Prolonged Field Care

54:44 Mastering the Basics of Prolonged Field Care

01:00:42 Future Warfare and Operational Considerations