By College of Remote and Offshore Medicine
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The podcast currently has 111 episodes available.
This week, Aebhric O’Kelly talks with Eric Holmstrom and Laszlo Hegedus about creating a new faculty within CoROM. They discuss their recent activities, including organising law enforcement competitions and teaching various medical courses. They highlight the importance of hands-on training and the need for continuous learning in operational medicine. The conversation also touches on the upcoming developments at the college, such as the establishment of the Faculty of Operational Medicine and the implementation of new monitoring devices for patient care. They emphasise the importance of documentation and research in improving medical practices. The discussion concludes with advice for healthcare professionals starting their careers.
keywords
operational medicine, law enforcement competitions, medical courses, hands-on training, continuous learning, college developments, Faculty of Operational Medicine, monitoring devices, documentation, research, advice for healthcare professionals
Takeaways
Hands-on training and continuous learning are essential in the field of operational medicine.
The college is establishing the Faculty of Operational Medicine to bring together subject matter experts and advance the field.
Implementation of new monitoring devices and documentation systems can improve patient care and facilitate research.
Healthcare professionals should be bold and ask questions, seek learning opportunities, and get involved in patient care.
Interoperability and adherence to evidence-based guidelines are crucial in providing quality medical care.
Chapters
00:00 Introduction and Recent Activities
03:16 Teaching Experiences and Motivated Students
06:05 Improvisation and Moulage Training
09:20 The Importance of Tropical Medicine
13:02 The Growing Momentum of Ultrasound Training
17:59 The Need for Prolonged Field Care and AEC Courses
19:39 The Faculty of Operational Medicine
22:16 Implementing New Monitoring Devices and Documentation Systems
27:29 NEAMT Certification and Offering Additional Courses
29:39 Advice for Healthcare Professionals Starting Their Careers
Cole Shaver and Graydon Ratushny are paramedics working in British Columbia who share their experiences working in Kibosho District Hospital in Moshi, Tanzania, as part of the Austere Critical Care Master's program. They discuss the challenges of practising medicine in a resource-limited setting and the importance of improvising and adapting clinical skills to the local context. They highlight basic clinical assessments, such as percussion and auscultation, and the value of non-technical skills in making diagnoses and providing care. They also discuss the social determinants of healthcare and the impact of a user-pay system on patient access to medical services. The conversation explores the themes of telehealth and remote health assessments, the importance of old-school clinical skills, the resilience of patients in resource-limited settings, the use of CPAP in rural healthcare, the value of the CoROM Field Guide, and the benefits of international healthcare experiences.
takeaways
Adapting clinical skills to a resource-limited setting is crucial for providing effective care.
Basic clinical assessments, such as percussion and auscultation, can be valuable tools without advanced diagnostic equipment.
Non-technical skills, such as observation and clinical gestalt, play a significant role in making diagnoses and guiding treatment decisions.
The social determinants of healthcare, including a user-pay system, can profoundly impact patient access to medical services. Telehealth and remote health assessments are shaping the future of healthcare, allowing for transmitting imaging and audio findings to specialists in established facilities.
Old-school clinical skills, such as physical assessments and clinical signs, are underappreciated in Western medicine but highly relevant in resource-limited settings.
Patients in rural and remote areas are often more resilient than expected, and healthcare providers can take a step back and gather more information before intervening.
CPAP devices can effectively manage respiratory distress in resource-limited settings, and collaborative teaching and learning between healthcare professionals from different backgrounds is invaluable.
The CoROM Field Guide is a valuable resource for remote and rural clinicians. It provides essential information and prompts when data connectivity is limited.
International healthcare experiences provide a broader perspective and appreciation for different healthcare systems and practices, fostering collaboration and knowledge sharing.
Chapters
00:00 Introduction and Background
03:00 Adapting Clinical Skills in a Resource-Limited Setting
08:34 The Value of Basic Clinical Assessments
13:42 The Role of Non-Technical Skills in Diagnosis
20:04 The Impact of Social Determinants on Healthcare Access
29:48 The Future of Healthcare: Telehealth and Remote Assessments
32:23 The Value of Old School Clinical Skills in Resource-Limited Settings
35:35 Resilience of Patients in Rural and Remote Areas
39:23 CPAP: A Game-Changer in Resource-Limited Healthcare
52:51 The Quorum Field Guide: A Must-Have for Remote Clinicians
56:11 The Benefits of International Healthcare Experiences
This week, Aebhric O’Kelly talks with Ronin's founder, Timm Smith, who shares his journey from being a lawyer to becoming a close protection officer and paramedic. He discusses the importance of being a whole bodyguard, protecting clients from external and internal threats. Tim emphasises the need for excellence, reality, and truth in the close protection industry. He also highlights the value of training paramedics to be close protection officers and vice versa. The conversation touches on the impact of Gregorii Tsekmistrenko's death, a Ronin graduate, and the importance of humility and learning from mistakes in austere medicine.
https://www.ronin.co.za/
Takeaways
Being a whole bodyguard means protecting clients from both external and internal threats.
Excellence, reality, and truth is essential in the close protection industry.
Training paramedics to be close protection officers and vice versa is a valuable career path.
Humility and learning from mistakes are crucial in austere medicine.
Chapters
00:00 Introduction and Background
07:11 From Law to Close Protection
10:29 Becoming a Paramedic
17:33 Founding Ronin: A Centre of Excellence
24:23 The Connection to Malta
28:30 Training Paramedics in Close Protection
35:02 Remembering Gregorii Tsekmistrenko
38:03 Advice for New Medics
This week, Aebhric O’Kelly talks with John Clark, the College's Executive Dean, about the new 2024-2025 academic year. They discuss the recent developments and plans for the college. John discusses the college's collaborations with organisations like WMS and IBSC and upcoming trips to Ghana and Tanzania. He also mentions the expansion of the college's facilities and the launch of a peer-reviewed journal. The conversation concludes with advice for healthcare professionals starting their careers in austere medicine.
takeaways
The college has launched the doctorate in health studies and has seen growth in the bachelor's program in remote paramedic practice.
The Master's in Austere Critical Care program is also growing, and the college is launching a new Master's in Global Health program.
The college collaborates with organisations like WMS and IBSC and is working to expand the reach of paramedic certifications.
Upcoming trips to Ghana and Tanzania will focus on establishing new clinical sites and improving existing ones.
The college is expanding its facilities and launching a peer-reviewed journal called the Journal of Improvised Medicine.
Advice for healthcare professionals starting their careers in austere medicine is to seek education and continuously improve their skills.
Chapters
00:00 Introduction and Overview
01:03 Recent Developments and Plans for the College
02:30 Expanding Programs and Collaborations
04:52 Trips to Ghana and Tanzania
10:41 Facility Expansion and Peer-Reviewed Journal
18:30 Advice for Healthcare Professionals in Austere Medicine
This week, Aebhric OKelly interviews Bill Vasios, a physician assistant who started as an 18 Delta and had several other 18 series jobs. Bill is pursuing a PhD in education focusing on instructional design and technology. He is also doing a simulation fellowship at East Carolina University. They talk about online learning, designing a perfect online learning system, the challenges of teaching in the medical field, and the importance of credible sources in education.
Takeaways
Bill is a physician assistant with a background in the military, having served as an 18 Delta and held other 18 series jobs.
He is pursuing a PhD in education, focusing on instructional design and technology.
Bill discusses the challenges and benefits of online learning and the importance of credible sources in education.
He also discusses the need for adaptive and interactive learning systems in medicine. Stay thirsty for knowledge and continuously learn throughout your career.
Ultrasound is a valuable tool for Special Forces medics, but training and sustainment are crucial.
Hands-on training and mentorship are essential for developing ultrasound skills.
Effective teaching requires authenticity, care, and adapting to individual learning needs.
The art of teaching lies in respectfully challenging and guiding students to improve their skills.
Access to ultrasound equipment and regular scanning practice are necessary for maintaining competence.
The ability to compare normal and injured scans is valuable for identifying abnormalities.
Being surrounded by excellent people raises everyone's skills and abilities.
Chapters
00:00 Introduction and Correction of Name
01:31 Bill's Background and Current Pursuits
08:18 Designing an Adaptive Learning System
12:22 The Challenges of Teaching in the Medical Field
14:12 The Future of Online Learning in the Medical Field
16:24 Balancing Online and Face-to-Face Learning
18:12 The Importance of Credible Sources in Education
23:51 Creating Curriculum for Soft Medics
24:29 Getting to Know Bill Vasio
30:12 Bill's Military Background and Transition to PA
33:39 Bill's Military Journey and Learning Code
35:10 Selection and Robin Sage
38:52 Becoming a PA and Returning to SF
40:47 The SOLCUS Program and Ultrasound in SF
43:04 Special Operator Level Clinical Ultrasound Programme and Advancements in Ultrasound
45:00 Sustaining Ultrasound Skills in 18 Delta Medics
49:04 Advice for New Medics and the Importance of Continuous Learning
53:05 The Art of Effective Teaching and Mentoring
56:30 Challenges of Ultrasound Training and Sustainment
01:05:00 Conclusion and Final Thoughts
This week, Aebhric O’Kelly talks with Antonio from European Medics about their work and focus on guerrilla, austere, and remote medicine. European Medics started as a community of passionate individuals in emergency medicine and has grown to focus on education and enhancing medicine.
European Medics is currently working on creating training material and educative resources for their Advanced Guerrilla First Responder (AGFR) course.
European Medics (EURMED) is focused on providing evidence-based guidance in unconventional and guerrilla medicine.
Guerrilla medicine overlaps with other fields, such as wilderness medicine, medical support for irregular warfare, and disaster relief. The goal is to be better prepared for future conflicts and disasters and to save lives.
Takeaways
European Medics started as a community of passionate individuals in emergency medicine and has grown to focus on education and enhancing medicine.
They are currently working on creating training material and educative resources for their Advanced Guerrilla First Responder (AGFR) course.
European Medics has a podcast with multiple shows, including medical basics, field clinic, and long-format discussions with subject matter experts.
Their goal is to provide training and education in austere and remote medicine to enhance the capabilities of healthcare providers in resource-limited environments—European Medics evidence-based guidance in unconventional and guerrilla medicine.
EURMED has published a paper on gorilla medicine and plans to publish more papers on the topic.
EURMED aims to be a neutral ground for the medical community to exchange experiences and provide expert medical education.
The future of guerrilla medicine is seen as an integrated part of forward medicine, focusing on providing care to civilians affected by conflicts.
Guerrilla medicine overlaps with other fields, such as wilderness medicine, medical support for irregular warfare, and disaster relief.
The goal is to be better prepared for future conflicts and disasters and to save lives.
Chapters
00:00 Introduction and Background
03:10 European Medics: Community and Education
06:12 The Advanced Guerrilla First Responder Course
09:02 Podcast: Medical Basics and Field Clinic
23:02 Publishing Concepts and Lessons Learned in Ukraine
27:11 The Future of European Medics
29:13 European Medics: A Neutral Ground for Medical Education
31:37 Expanding European Medics to the United States
36:48 Guerrilla Medicine and Overlapping Fields
41:37 The Clandestine Nature of Guerrilla Medicine
44:45 Preparing for Future Conflicts and Disasters
46:51 Advice for New Medical Professionals
This week, Aebhric talks with Dr Alastair Fraser, chair of the faculty advisory board for the Faculty of Remote Rural and Humanitarian Health care for the Royal College of Surgeons of Edinburgh, and discusses his diverse medical career and experiences in remote and rural areas. He shares stories from his time in the Antarctic, Nigeria, and with Shell, highlighting the challenges and unique situations he encountered. Dr Fraser also discusses the importance of mental health support for medics in remote locations and the need for ongoing training and resources. The conversation discusses the creation and purpose of the Faculty of Rural Remote Humanitarian Health, a specialised area under the Royal College of Surgeons of Edinburgh. The faculty aims to provide training and recognition for healthcare professionals in remote, rural, and humanitarian settings. It addresses the challenges of delivering healthcare in these areas and seeks to improve the quality of training and competence. The conversation also highlights the importance of community and networking among professionals in these fields. The faculty offers fellowship and membership to individuals who have demonstrated competence and contribution to the field.
Takeaways
Dr Alastair Fraser has had a diverse medical career, working in remote and rural areas and with Shell in various locations.
He emphasises the challenges and unique situations in remote healthcare, where medics are often asked to handle various medical issues.
Dr Fraser highlights the importance of mental health support for medics in remote locations and the need for ongoing training and resources.
He discusses the potential benefits of incorporating ultrasound devices into the toolkit of offshore medics but acknowledges the challenges in implementing this due to company policies and liability concerns. The Faculty of Rural Remote Humanitarian Health is a specialised area under the Royal College of Surgeons of Edinburgh that provides training and recognition for healthcare professionals working in remote, rural, and humanitarian settings.
The faculty addresses the challenges of delivering healthcare in these areas and aims to improve the quality of training and competence.
Membership in the faculty is open to anyone interested in the field, not just doctors or medics.
The faculty plans to offer more online courses that cover various skills needed in remote, rural, and humanitarian healthcare.
The faculty is voluntary and relies on volunteers and funding to operate.
Networking and community-building among professionals in these fields are important for sharing ideas and experiences.
The faculty is working towards providing educational credits and accreditation for its courses.
Healthcare professionals interested in working in austere environments should seek training, talk to experienced professionals, and develop skills in working under pressure and uncertainty.
Chapters
00:00 Introduction and Background
02:10 Experiences in the Antarctica
03:00 Challenges and Unique Situations in Remote Healthcare
08:05 Limited Medical Resources in Remote Locations
15:23 Importance of Mental Health Support for Medics
20:21 Implementing Ultrasound for Offshore Medics
21:10 Introduction to the Faculty of Rural Remote Humanitarian Health
23:50 Challenges of Delivering Healthcare in Remote and Rural Areas
27:35 Membership and Community in the Faculty
33:57 Expanding Online Courses for Remote Healthcare
39:02 The Humanitarian Healthcare Course and Accreditation
43:47 Advice for Healthcare Professionals in Austere Environments
This week, Aebhric talks with Frida Svahn, a nurse from Sweden, who discusses her experiences teaching medical training in various countries and her work with the Swedish Civil Contingencies Agency (MSB). She shares her journey from serving in the Swedish Armed Forces to becoming a nurse and her passion for working in austere environments. Frida highlights the importance of training the trainers and its impact in countries like Ukraine. She also mentions the upcoming National Seminar Exercise in Sweden and the role of MSB in civil defence and NATO. Frida advises new healthcare professionals interested in working in austere environments to invest in good courses, build a network, and stay motivated.
Takeaways
Teaching medical training in austere environment is a rewarding experience that allows healthcare professionals to make a difference in countries like Ukraine.
MSB plays a significant role in civil defence and NATO, providing training and expertise in emergency response and crisis management.
Investing in good courses, building a network, and staying motivated are essential for healthcare professionals working in austere environments.
Training the trainers is a force multiplier that spreads knowledge and skills to a larger population.
Sweden's upcoming National Seminar Exercise will involve multiple nations, focusing on casualty move and patient flow management.
This week, Aebhric O'Kelly talks with Dr John Quinn and Eirik Holmstrøm, who all went to Ukraine to teach the Damage Control Resus Ukraine (DCRU) course. They discuss the curriculum, the use of clinical practice guidelines (CPGs), and the importance of access to blood in the pre-hospital setting. They highlight the collaboration with Tactical Medicine North and the professional partner forces in Ukraine. The hosts also mention the Defence Health Administration's (DHA) role and the resources on the DHA website and app. The conversation emphasises evidence-based practices and knowledge exchange's significance in improving military medicine. The conversation focuses on the challenges and solutions in Ukraine's implementation of damage control resuscitation (DCR). The speakers discuss the need for interoperability in large-scale combat operations (LSCO) and the importance of rethinking traditional medical practices. They highlight the limitations of blood transfusion in the field and the need for a logistic system to support the transportation of blood. The conversation also covers training Ukrainian combat medics in advanced skills such as resuscitative endovascular balloon occlusion of the aorta (REBOA) and ultrasound. The speakers emphasise the importance of continuous learning, adapting to failures, and the potential for DCR to increase combat effectiveness in Ukraine.
Keywords
Damage Control Resus Ukraine, DCRU, curriculum, clinical practice guidelines, CPGs, pre-hospital setting, blood access, Tactical Medicine North, partner forces, Defence Health Administration, DHA, evidence-based practices, military medicine, damage control resuscitation, interoperability, large-scale combat operations, blood transfusion, logistic system, training, combat medics, REBOA, ultrasound, continuous learning, combat effectiveness
Takeaways
The DCRU course in Ukraine focused on damage control resuscitation in the pre-hospital setting.
The curriculum was based on clinical practice guidelines (CPGs) from the Defence Health Administration (DHA).
Access to blood and blood components was highlighted as crucial in effective care.
Collaboration with Tactical Medicine North and professional partner forces in Ukraine was instrumental in the course's success.
The DHA website and app provided valuable resources for learning and reference in austere environments.
The exchange of knowledge and lessons learned is essential for improving military medicine. Implementing damage control resuscitation in large-scale combat operations requires interoperability and a logistic system to support the transportation of blood.
Traditional medical practices need to be rethought to align with the evolving nature of warfare.
Training combat medics in advanced skills such as REBOA and ultrasound can improve patient care and increase patient transport confidence.
Continuous learning and adapting to failures are essential in austere medicine.
Damage control resuscitation has the potential to increase combat effectiveness in Ukraine.
Chapters
00:00 Introduction to Dr John Quinn and Eirik Holmstrom
02:07 Adding Co-Authors and References
04:01 Introduction to the DCRU Course
08:09 Overview of the DCRU Curriculum
13:49 Importance of Access to Blood
16:40 Acknowledging the Defence Health Administration
18:56 Interoperability and Logistic Challenges
23:35 Rethinking Traditional Medical Practices
29:24 Training Combat Medics in Advanced Skills
38:34 Continuous Learning and Adapting to Failures
41:10 The Potential of Damage Control Resuscitation
This week, Aebhric O'Kelly talks with the faculty from Tactical Medicine North from Ukraine. The College was invited to return to Ukraine to teach the DCR-U course for the TacMedNorth faculty.
Summary
Tactical Medicine North in Ukraine is focused on teaching prolonged casualty care and damage control recess. They started gathering information and teaching combatants in 2022 during the full-scale invasion. Their courses range from basic to advanced levels, including AEMT courses and blood resuscitation training. The goal is to provide proper training and knowledge to combat medics and non-medics. The experience of running the advanced damage control recess course was positive, with motivated students who wanted a deeper understanding of medicine. The use of guidelines and documents was emphasised to ensure proper care. The future goal is to spread the training and continue teaching at a high level.
Keywords
Tactical Medicine North, Ukraine, prolonged casualty care, damage control recess, combat medics, EMT courses, blood resuscitation, guidelines, training
Takeaways
Tactical Medicine North focuses on teaching prolonged casualty care and damage control recess in Ukraine.
They offer a range of courses, from basic to advanced levels, including AEMT courses and blood resuscitation training.
The use of DHA CPGs guidelines and documents is emphasised to ensure proper care.
The goal is to spread the training and continue teaching at a high level.
Chapters
00:00 Introduction and Background of Tactical Medicine North
03:36 Teaching Prolonged Casualty Care
08:10 The Need for a Damage Control Recess Ukraine Course
14:20 Impact of the Course on Students' Perspective
19:46 Importance of Guidelines and Documents in Tactical Medicine
23:47 Future Plans for Tactical Medicine North
30:54 Continuing Training and Education
35:41 Conclusion and Thanks
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