CoROM cast. Wilderness, Austere, Remote and Resource-limited Medicine.

This week, Aebhric O’Kelly talks with Mike Morrow, the CoROM BSc Remote Paramedic programme coordinator, on his journey from being a paramedic to evaluating organs for transplantation. He discusses the unique challenges faced in emergency medical services, particularly in Africa, and highlights the dedication of students in the BSc Remote Paramedic Programme. Morrow emphasises the importance of experience in austere environments and compares the training and practices of U.S. paramedics with those of BSc graduates. He provides valuable insights and advice for new medics and nurses starting their careers.

Takeaways

• Mike Morrow evaluates hearts and lungs for organ transplantation.

• He has a rich background in paramedic training and critical care.

• The BSc Remote Paramedic Program offers unique opportunities for students.

• Students are dedicated to helping in austere settings.

• There needs to be more EMS in many African countries.

• Experience in austere environments is crucial for paramedics.

• Morrow emphasises the importance of adaptability in emergency care.

• The programme prepares students for real-world challenges in healthcare.

• Morrow encourages new medics to gain as much experience as possible.

Chapters

00:00 Introduction to Mike Morrow

05:53 Transitioning to Academia and Teaching

14:22 Challenges in African Emergency Medical Services

19:28 Comparing U.S. and BSc Paramedic Practices

24:38 Prolonged Care in Austere Environments

29:46 Advice for New Medics and Nurses

This week, Aebhric, John Clark and Emmanuel Acheampong discuss a new collaboration in Kumasi, Ghana. The College is creating a collaboration with Komfo Anokye Teaching Hospital to enhance medical education and training. They discuss the hospital's capabilities, the emergency department's operations, the triage system, and the potential for student placements and training initiatives. The discussion highlights the importance of building sustainable relationships and the shared challenges faced in healthcare across different regions.

https://kath.gov.gh/

Takeaways

• The visit aims to explore collaboration opportunities with Komfo Anokye Teaching Hospital.

• The hospital has a wide range of departments, including emergency medicine.

• The emergency department has evolved significantly over the years.

• Triage is a critical component of patient flow in the emergency department.

• There is a growing emphasis on training and certification for healthcare professionals.

• The collaboration will provide advanced clinical experiences for students.

• Building relationships is essential for successful partnerships in healthcare.

• The hospital aims to implement BLS and ACLS training for all staff.

• Future plans include establishing a sustainable relationship that benefits both organisations.

Chapters

00:00 Introduction and Context of the Visit

04:04 Emergency Department Insights

09:12 Triage System and Patient Flow

11:31 Collaboration Opportunities and Student Placements

15:06 Training and Certification Initiatives

17:08 Future Plans and Sustainable Relationships

19:01 Advice for New Medical Professionals

This week, Aebhric talks with Anke Krug, who is a community nurse in Nunavut, Canada, and shares her experiences and challenges in providing healthcare in a remote Arctic environment. She discusses the complexities of medevac nursing, the environmental considerations for patient care, and the importance of collaboration and communication in remote healthcare settings. Anke also highlights the evolving roles in nursing and paramedicine, the need for ongoing training and education, and the significance of patient assessment and decision-making in austere conditions. The conversation concludes with advice for new nurses entering the field.

Takeaways

The Arctic presents unique challenges for healthcare delivery.

Medevac nursing requires careful preparation and environmental awareness.

Collaboration with other healthcare professionals is essential.

Telehealth plays a crucial role in remote patient care.

Nursing roles are evolving to include advanced paramedic skills.

Patient assessment is critical in making treatment decisions.

Guidelines for prolonged field care can enhance patient outcomes.

Technology is improving healthcare delivery in remote areas.

Community engagement is essential for mental well-being in harsh environments.

New nurses should seek mentorship and focus on continuous learning.

Chapters

00:00 Introduction to Community Nursing in Nunavut

03:00 The Challenges of Medivac Nursing

05:54 Environmental Considerations in Patient Care

08:59 Collaboration and Communication in Remote Healthcare

12:12 Evolving Roles in Nursing and Paramedicine

14:58 Training and Education for Remote Healthcare

18:05 Patient Assessment and Decision Making

20:59 Utilising Guidelines for Prolonged Field Care

23:52 Technology and Innovations in Remote Medicine

27:09 Community Engagement and Fun in Nunavut

30:01 Advice for New Nurses in Austere Environments

This week, Aebhric OKelly speaks with Rhod Jordan, a remote paramedic working in Kurdistan, about the intricacies of the Medical Emergency Response Plan (MERP). Rhod shares his experiences and insights on the importance of planning, communication, and training in emergency medical situations. He emphasises the need for thorough assessments of local medical facilities and the significance of building relationships with local healthcare providers. The discussion also covers the training and development of medical teams in austere environments and advice for new medics entering the field.

Takeaways

The MERP is essential for efficient emergency response.

Communication protocols are critical in emergencies.

Regular training and drills improve readiness.

Local medical facilities should be audited before use.

Building relationships with local healthcare providers is vital.

Documentation and evaluation are vital to improving plans.

New medics should seek guidance from experienced professionals.

Understanding local laws regarding medical supplies is crucial.

Prolonged field care concepts are essential in remote areas.

Utilising technology can enhance patient care and communication.

Chapters

00:00 Introduction to Remote Paramedicine in Kurdistan

01:21 Understanding the Medical Emergency Response Plan (MERP)

03:37 Components of a Successful MERP

15:06 Communication and Coordination in Emergencies

22:48 Evaluating Local Medical Facilities

36:20 Training and Development for Medical Teams

41:39 Advice for New Medics in Austere Environments

This week, Aebhric chats with Dr Peter Anders Christiansen (PAC), a former senior medical officer in the Danish Special Forces, who discusses his work in PTSD treatment using Stellate Ganglion Block (SGB) and his role in developing the Nordic Special Operations Combat Medic Course. He shares insights on the effectiveness of SGB for veterans suffering from PTSD, the challenges of medical training in NATO countries, and the future of special operations medical education in Europe. PAC also offers valuable advice for new medics entering austere medical environments.

safenordicsolutions.com

stellatumklinikken.com

Takeaways

SGB is effective for treating hyperarousal in PTSD.

The amygdala's reset can significantly improve PTSD symptoms.

The Nordic Special Operations Combat Medic Course was developed to standardise training.

Collaboration among Nordic countries was vital to creating the NSOC.

Future funding and strategic changes will impact medical training in Europe.

Interoperability among NATO countries is essential for effective medical support.

Cultural differences affect the implementation of medical training across nations.

New medics must adapt to austere medical environments.

Improvisation is crucial in emergency medical situations.

The importance of continuous education and recertification for medics.

Chapters

00:00 Introduction to Dr. Peter Anders Christiansen

01:31 Innovative PTSD Treatment: Stellate Ganglion Block

12:34 The Nordic Special Operations Combat Medic Course

34:34 Future of NSOCM and European Medical Training

49:27 Advice for New Medics in Austere Medicine

This week, Aebhric O’Kelly talks with Dr Jamie Riesberg, who created the separation of Prolonged Casualty Care (PCC) from Prolonged Field Care (PFC).

Dr Riesberg has extensive experience in military medicine, focusing on the evolution of prolonged field care and the transition from the Global War on Terror (GWOT) to future conflicts. He emphasises the importance of adapting medical training to current battlefield realities, including lessons from Ukraine. Dr Riesberg advocates for a shift in mindset towards PCC and the need for continuous hands-on experience for medics. They also discuss the challenges posed by policy and training limitations, urging a more robust approach to medical care in combat situations.

Takeaways

Chapters

00:00 Introduction to Dr. Jamie Riesberg

02:54 The Evolution of Military Medicine

05:48 The Importance of Prolonged Field Care

09:02 Transitioning from GWAT to LISCO

12:04 The Role of NATO in Medical Training

15:00 Lessons from Ukraine and Future Conflicts

17:49 The Concept of Prolonged Casualty Care

20:51 Challenges in Training and Policy

24:05 The Future of Medical Care in Combat

27:03 Advice for New Medics in Austere Medicine

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