This week, Aebhric O’Kelly, Bill Vasios, and Rhod Jordan lead an open discussion examining the critical role of nutrition in prolonged field care. The conversation explores enteral and parenteral feeding modalities, outlining their respective indications, benefits, and practical limitations in austere and resource-constrained environments. Particular emphasis is placed on the value of early nutritional intervention in supporting physiological recovery, including practical techniques for nasogastric tube placement and for identifying and managing feeding-related complications. The discussion further considers the challenges of maintaining nutritional support during patient transport. It highlights the importance of interdisciplinary collaboration, including consultation with nutrition specialists, to develop safe and effective nutritional care plans.

Takeaways

Nutrition is crucial in prolonged field care.

Enteral nutrition is less invasive and safer.

Early feeding improves healing and recovery.

Consult a nutritionist for feeding plans.

NG tubes can reduce complications in feeding.

Monitor for complications during feeding.

Parenteral nutrition may be necessary in some cases.

Feeding techniques can vary based on patient condition.

Understanding nutritional needs is essential for care.

Future discussions will focus on advanced topics.

Chapters

00:00 Introduction to Prolonged Field Care and Nutrition

02:40 Understanding Enteral and Parenteral Nutrition

04:53 Benefits of Early Nutritional Support

07:47 Indications and Contraindications for Feeding

09:32 Practical Considerations for Feeding in Austere Environments

11:51 Calculating Nutritional Requirements

14:30 Challenges in Nutritional Support During Transport

17:16 Techniques for NG Tube Placement

20:00 Monitoring and Managing Feeding Complications

22:19 Discussion on Parenteral Nutrition

24:41 Conclusion and Future Topics

This week, Aebhric O’Kelly and Bill Vasios host an online discussion on the JTS sepsis CPG. CoROM students and members of the college join this live discussion about how to assess and treat the septic casualty in remote and austere environments.

Chapters

00:00 Introduction to C-Circulation Problems

01:34 Understanding Sepsis and Its Management

09:17 Early Warning Systems for Sepsis

14:15 Clinical Acumen in Remote Care

20:20 Monitoring and Assessing Patient Status

27:52 Antibiotic Administration in Remote Settings

33:02 Malaria Treatment Protocols

37:33 Resuscitation Strategies for Sepsis

42:52 Point of Care Ultrasound in Patient Monitoring

48:12 Final Thoughts and Future Topics

You can download the JTS CPG on Sepsis here. https://jts.health.mil/assets/docs/cpgs/Sepsis_Management_PFC_28_Oct_2020_ID83.pdf

This week, Aebhric O’Kelly, Bill Vasios, and Rhod Jordan will host an open discussion on managing austere burn patients, covering airway management, fluid resuscitation, infection control, and pain management. The speakers emphasise the complexity of burn cases and the importance of accurate assessment and treatment protocols. They also highlight the need for effective communication and patient involvement in care, as well as the use of innovative techniques like topical morphine for pain management.

Takeaways

Burns are incredibly complicated, but they're complex patients.

Managing an individual patient's airway has to be factored in.

You want to protect and secure the airway and avoid obstructions.

The goal is to achieve maximal accuracy in fluid resuscitation.

You can infuse that fluid rectally if you don't have IV fluids.

Prophylactic antibiotics are not indicated in burn patients.

Topical morphine works really, really well for pain management.

Involving the patient in their care has a positive effect.

Infection control is the means of preventing infection.

Burn management is more art than science.

Chapters

00:00 Introduction to Burns Management

03:08 Airway Management in Burn Patients

05:52 Assessing Burn Size and Fluid Resuscitation

09:00 Fluid Administration Techniques

11:38 Oral vs IV Resuscitation

14:53 Monitoring and Adjusting Treatment

17:36 Dynamic Management of Burn Patients

25:18 Vital Signs Monitoring in Critical Care

28:01 Continuous Assessment and Patient Management

32:07 Patient Involvement in Vital Signs Monitoring

35:10 Urine Output and Fluid Resuscitation

41:33 Infection Control in Burn Management

48:20 Pain Management Strategies in Burns

This is a brief introduction to the AI roundtable to be held at the Medicine in the Mediterranean conference, running from 31 January to 2 February.

You can join us using the link below.

https://corom.edu.mt/medicine-in-the-mediterranean-2026/

This is a brief introduction to the AI roundtable to be held at the Medicine in the Mediterranean conference, running from 31 January to 2 February.

You can join us using the link below.

https://corom.edu.mt/medicine-in-the-mediterranean-2026/

This is a short introduction to the two lectures that Dr Slaven Bajic will be giving at the Medicine in the Mediterranean conference running from 31 January to 2 February.

You can join us using the link below.

https://corom.edu.mt/medicine-in-the-mediterranean-2026/

This week, Aebhric is joined by Bill Vasios and Rhod Jordan, who recorded during the November 2025 CoROM Conversations. They discuss Practical Prolonged Casualty Care, a PDF from the US Military University, designed to equip lay responders with foundational skills for managing casualties over extended periods. The speakers underscore the critical role of clear communication, the value of structured training for non-medical personnel, and the practical relevance of the book’s guidance in real-world scenarios. They highlight the importance of engaging patients actively in their own care, as well as the inherent challenges associated with preparing laypersons for such responsibilities. Considerations of cultural context and the necessity of a collaborative, team-based approach to patient management are also brought to the forefront.

Takeaways

The book is designed for laypeople to understand basic medical care.

Effective communication is crucial in patient care.

Training non-medical personnel can enhance patient outcomes.

Involving patients in their own care is beneficial.

Cultural considerations play a significant role in patient care.

The book provides practical techniques for prolonged casualty care.

Regular assessment and monitoring are essential for patient safety.

Lay responders should be trained to recognise nonverbal cues of discomfort.

The importance of maintaining a regular routine for patients is emphasised.

Cross-training team members can improve overall care.

Chapters

00:00 Introduction to Prolonged Casualty Care

02:50 Deep Dive into the Book's Content

06:04 Engaging Laypersons in Medical Care

08:55 Communication and Patient Interaction

11:37 Training Non-Medical Personnel

14:49 Practical Applications and Techniques

17:51 Understanding Patient Needs

20:39 Challenges in Training and Implementation

23:28 Cultural Considerations in Patient Care

26:16 Conclusion and Future Directions

https://www.usuhs.edu/sites/default/files/2025-09/Layperson%27s_Guide_to_Prolonged_Casualty_Care_090825_ACC.pdf

Discover the voices shaping the future of remote, austere, and expeditionary healthcare. In this special podcast preview, you will hear directly from the expert presenters who will be leading sessions at ⁠Medicine in the Mediterranean⁠, held from 31 January to 2 February.

This annual gathering brings together clinicians, researchers, and operational medics from across the globe, professionals delivering care in deserts, jungles, mountains, conflict zones, offshore platforms, and every environment in between.

Places are still available, offering a rare opportunity to network with colleagues working at the cutting edge of remote medicine, gain insights from internationally recognised leaders, and strengthen your practice through evidence-based, real-world learning.

If your goal is to elevate your capability in challenging environments, this is the forum. Excel by learning from those who set the standard.

https://corom.edu.mt/medicine-in-the-mediterranean-2026/

Discover the voices shaping the future of remote, austere, and expeditionary healthcare. In this special podcast preview, you will hear directly from the expert presenters who will be leading sessions at ⁠Medicine in the Mediterranean⁠, held from 31 January to 2 February.

This annual gathering brings together clinicians, researchers, and operational medics from across the globe, professionals delivering care in deserts, jungles, mountains, conflict zones, offshore platforms, and every environment in between.

Places are still available, offering a rare opportunity to network with colleagues working at the cutting edge of remote medicine, gain insights from internationally recognised leaders, and strengthen your practice through evidence-based, real-world learning.

If your goal is to elevate your capability in challenging environments, this is the forum. Excel by learning from those who set the standard.

https://corom.edu.mt/medicine-in-the-mediterranean-2026/

Discover the voices shaping the future of remote, austere, and expeditionary healthcare. In this special podcast preview, you will hear directly from the expert presenters who will be leading sessions at Medicine in the Mediterranean, held from 31 January to 2 February.

This annual gathering brings together clinicians, researchers, and operational medics from across the globe, professionals delivering care in deserts, jungles, mountains, conflict zones, offshore platforms, and every environment in between.

Places are still available, offering a rare opportunity to network with colleagues working at the cutting edge of remote medicine, gain insights from internationally recognised leaders, and strengthen your practice through evidence-based, real-world learning.

If your goal is to elevate your capability in challenging environments, this is the forum.
Excel by learning from those who set the standard.

https://corom.edu.mt/medicine-in-the-mediterranean-2026/