This week, Aebhric O'Kelly speaks with Jason Jarvis, a former Special Forces medic and current PhD student, about his experiences in military medicine, the evolution of prolonged field care, and the development of the 'SHEEP VOMIT' mnemonic for patient care in austere environments. They discuss the importance of nursing care, the practical applications of medical knowledge in the field, and the challenges medical practitioners face in remote settings. This conversation delves into critical aspects of patient care, particularly in prolonged field care settings. It emphasises the importance of managing pressure points, understanding vital signs, monitoring core temperature, maintaining oral hygiene, preventing DVT, and ensuring proper input and output monitoring. The discussion also highlights the significance of turning, coughing, and deep breathing for patient recovery, culminating in the legacy of the 'sheep vomit' concept in medical training.

Takeaways

Jason Jarvis has a master's in infectious disease and is pursuing a PhD.

Military experiences shaped his interest in tropical medicine.

Prolonged field care is a systematic approach to patient care in remote settings.

The 'SHEEP VOMIT' mnemonic was developed to aid in prolonged field care.

Skin protection is crucial in austere environments.

Hypothermia prevention is a key focus in field care.

Patient mobility and exercises are essential for recovery.

Checklists help ensure comprehensive patient care.

The evolution of medical mnemonics reflects advancements in field medicine.

Pressure sores develop in specific areas when supine.

Vital signs must be documented and trended over time.

Core temperature is crucial for assessing trauma patients.

Oral hygiene prevents infections that can lead to pneumonia.

DVT prevention is essential for immobilised patients.

Urine output is a key indicator of hydration and health.

Turning and coughing help maintain lung function.

The 'SHEEP VOMIT' concept aids in prolonged field care training.

Training should prepare providers for practical challenges.

Community impact is a goal of medical training.

Chapters

00:00 Introduction to Jason Jarvis

00:46 Jason Jarvis: Background and Current Work

02:37 Military Experiences and Deployments

05:58 Transitioning to Civilian Life and DMI

09:52 Prolonged Field Care: Concepts and Evolution

13:45 Developing the Sheep Vomit Mnemonic

18:35 Understanding the Sheep Vomit Mnemonic

21:58 Practical Applications of Prolonged Field Care

26:12 Exercises and Patient Mobility

29:35 Managing Pressure Points in Patient Care

30:05 Understanding Vital Signs and Their Importance

31:10 The Role of Core Temperature in Patient Assessment

32:40 Oral Hygiene and Its Clinical Significance

36:02 Preventing Deep Vein Thrombosis (DVT) in Immobilised Patients

40:44 Monitoring Input and Output: A Vital Sign

49:04 The Importance of Turning, Coughing, and Deep Breathing

55:00 The Legacy of Sheep Vomit in Medical Training

This week, Aebhric O’Kelly talks with Professor Enrico Brunetti about his extensive experience with ultrasound in infectious diseases and tropical medicine. He shares insights into the evolution of ultrasound technology, its applications in clinical practice, and the importance of education in this field. The discussion also covers the short course he developed at the University of Pavia, the challenges faced in tropical medicine, and advice for new medics interested in ultrasound.

Takeaways

Ultrasound has been a clinical tool since the 1980s.

There are continuous advancements in ultrasound applications.

Training is crucial for effective ultrasound use.

The short course aims to broaden understanding of ultrasound in tropical medicine.

Postgraduate certification is available for online courses.

Ultrasound can diagnose and treat various tropical diseases.

Networking and collaboration are key in medical education.

Challenges in tropical medicine require innovative solutions.

Patience is essential for mastering ultrasound skills.

The global movement for ultrasound in emergency medicine is growing.

Chapters

00:00 Introduction to Professor Enrico Brunetti

05:02 The Evolution of Ultrasound in Clinical Practice

10:04 Ultrasound Applications in Infectious Diseases

15:03 The Short Course in Ultrasound and Tropical Medicine from Pavia

19:48 Postgraduate Certification and Online Learning

24:52 Challenges and Opportunities in Tropical Medicine

29:49 Advice for New Medics in Ultrasound Practice

This week, we have another MiM25 presentation from Dr John Quinn discussing Damage Control Resuscitation in large-scale combat operations, particularly in Ukraine. He shares insights from his extensive experience in emergency medicine and highlights the unique challenges faced in combat medicine, including medical logistics, terminology, and telemedicine. Dr. Quinn emphasises the importance of training, clinical governance, and the need for effective blood supply management in austere environments. The conversation also touches on the evolving practices in casualty care and the impact of modern warfare on medical operations.

Takeaways

Ukraine has surpassed NATO in counterinsurgency experience.

Effective medical planning is crucial for combat operations.

Telemedicine enhances clinical decision-making in remote areas.

Logistical challenges significantly impact casualty evacuation.

Understanding the terminology is essential for interoperability.

Innovations like RBOA are being utilised in combat medicine.

Training and capacity building are vital for partner forces.

Blood supply issues are critical in combat settings.

Tourniquet management is a significant concern in Ukraine.

Plasma is being used due to a lack of blood supply.

Chapters

00:00 Introduction to the CoROM Podcast

00:45 Dr. John Quinn's Background and Experience

02:13 Key Assumptions in Damage Control Resuscitation

03:42 Medical Planning in Large-Scale Combat Operations

05:11 Challenges in Medical Logistics and Command

07:35 Understanding Terminology and Echelons of Care

09:58 Tactical Combat Casualty Care and Innovations

11:52 Telemedicine's Role in Combat Medicine

13:47 Challenges in Casualty Evacuation

15:40 Logistical Challenges in Blood Supply

17:34 Wounding Patterns and Weapon Systems

19:50 Medical Evacuation in Challenging Environments

22:35 Training and Capacity Building in Ukraine

24:59 Clinical Governance and Standards in Ukraine

27:39 Transfusion Practices and Challenges

30:54 Addressing Tourniquet Issues and Training

33:39 Plasma Use and Blood Supply Challenges

36:51 Conclusion and Future Directions

This week, Aebhric OKelly talks with Leandra Lynn, a combat medic and Divers Alert Network (DAN) professional, who shares her experiences and insights into the world of diving medicine. She discusses her journey from being a linguist to a combat medic, the critical role of DAN in dive safety, and the challenges faced in handling emergency calls related to diving injuries. Leandra emphasises the importance of proper medical guidance for divers, the varying standards of diving medicine across the globe, and the benefits of DAN membership for divers. She also advises new medics entering the field of diving medicine, highlighting the significance of utilising available resources and seeking expert guidance.

Takeaways

Leandra Lynn is a combat medic and works with DAN.

DAN provides a 24-hour emergency hotline for divers.

Diving procedures vary by region due to different medical standards.

Barotrauma is the most common diving injury reported to DAN.

DAN membership offers benefits like medical evacuation and insurance.

Divers should consult dive medicine specialists for complex medical histories.

Learning to dive in challenging conditions prepares divers for emergencies.

DAN assists with global non-emergency dive safety questions.

Effective communication is crucial in handling diving emergencies.

New medics should leverage resources and ask questions for better outcomes.

Chapters

00:00 Introduction to Leandra Lynn and Her Work

03:01 Diving into the Role of a Combat Medic

05:51 Understanding Divers Alert Network (DAN)

09:02 Challenges in Diving Medicine Calls

12:02 Diving Procedures and Medical Standards Worldwide

14:57 The Importance of DAN Membership

17:50 Common Diving Emergencies and Injuries

20:46 Resources for Diving Medicine

24:01 Advice for New Medics in Diving Medicine

This week, we have another MiM25 presentation. Dr Trevor Abela discusses the unique role of nurses in Malta's emergency services, the historical context of nursing in the region, and the importance of holistic care and building trust in nursing practice. Dr Abela emphasises the need for nurses to focus on the patient as a person rather than just a set of medical needs and highlights the significance of context in providing effective care.

Takeaways

Malta has a unique nurse-led ambulance service.

Historical context is crucial for understanding current nursing practices.

Nurses should focus on the person, not just on medical tasks.

Building trust with patients is essential for effective care.

Holistic care includes addressing social and psychological factors.

Emergency care must go beyond basic medical priorities.

Nursing education should emphasise patient-centred care.

The relationship between nurse and patient impacts treatment outcomes.

Nurses play a vital role in community health beyond hospitals.

Clinical outcomes do not solely define success in nursing.

Chapters

00:00 Introduction to the Quorum Podcast

00:44 Nursing in Malta: A Unique Perspective

03:11 Historical Context of Nursing in Malta

06:34 The Role of Nurses in Emergency Services

11:37 Understanding Nursing: Capital N vs. Small n

18:02 The Importance of Context in Nursing Care

25:42 Holistic Care in Pre-Hospital Settings

34:19 Building Trust and Relationships in Nursing

40:48 Conclusions and Reflections on Nursing Practice

In this episode, Aebhric OKelly interviews Dr Ella Corrick and Dr Tom Mallinson to discuss their experiences at the SOMA Conference, focusing on the Wilderness Paramedic Workshop. They explore the common challenges faced in austere medicine, the significance of prolonged field care, and the preparation for the Wilderness Paramedic Certification exam. The conversation also delves into creating educational resources to enhance decision-making skills in wilderness medicine. In this conversation, Dr Tom and Dr Ella discuss their experiences and insights into wilderness medicine, focusing on exam preparation for the Wilderness Paramedic Certification (WP-C) and creating a revision guide tailored for practitioners in austere settings. They highlight the challenges of multiple-choice exams, the importance of distilling complex medical knowledge into practical applications, and the value of interactive learning experiences at conferences like SOMA. The discussion also emphasises the significance of networking, learning from peers, and embracing challenges in medical practice.

Takeaways

SOMA Conference fosters a welcoming environment for civilian practitioners.

Common challenges in austere medicine include distance to hospitals and limited resources.

Wilderness Paramedic Certification covers a broad curriculum that includes environmental medicine.

Exam preparation requires understanding both wilderness concepts and core medical principles.

Prolonged field care is essential for managing critically ill patients in remote settings.

Teaching decision-making in wilderness medicine is challenging but crucial.

Educational resources aim to bridge knowledge gaps for WPC candidates.

Collaboration between military and civilian practitioners enhances learning.

Experience in austere settings improves exam performance and patient care.

The integration of nursing and paramedic skills is beneficial in prolonged field care. The challenge was to distil down the knowledge needed for the exam.

Multiple choice exams can be misleading in complex scenarios.

The WPC revision guide focuses on core concepts for wilderness medicine.

Each chapter of the guide could be a whole textbook.

The workshop aims to address common blind spots in practice.

Exam techniques are crucial for success in certification.

Networking at conferences enhances learning opportunities.

Embracing challenges leads to better patient care.

Learning from others' mistakes accelerates professional growth.

Take opportunities that excite you for long-term benefits.

Chapters

00:00 Introduction to SOMA Conference and Wilderness Paramedic Workshop

02:52 Common Ground in Austere Medicine

06:03 Overview of Wilderness Paramedic Certification

09:12 Exam Insights and Preparation Strategies

11:57 Prolonged Field Care and Patient Management

14:48 Creating Educational Resources for WP-C

18:10 Challenges in Teaching Decision-Making in Wilderness Medicine

24:57 Distilling Knowledge for Exam Preparation

25:36 Challenges of Multiple-Choice Exams

This week, we have another Medicine in the Mediterranean conference presentation. We will hear from Tactical Medicine North, a volunteer medical unit operating in Ukraine. The discussion covers their formation, mission, and challenges in training combat medics on the frontlines. Key topics include injury patterns, trauma management, blood logistics, and improved training in prolonged casualty care. The presenters emphasise the importance of adapting medical practices to the unique challenges of combat situations in Ukraine.

Takeaways

Tactical Medicine North was formed out of necessity due to the war in Ukraine.

Training combat medics is crucial for effective frontline care.

Injury patterns in Ukraine reveal a high incidence of non-combat injuries.

TCCC is essential but needs adaptation to local conditions.

Blood management logistics are a significant challenge in combat zones.

Tourniquet use and wound management require more comprehensive training.

Prolonged casualty care is often neglected in training programs.

Collaboration with international organisations enhances training effectiveness.

Understanding the unique challenges of Russian casualties is important for medical personnel.

Future training must focus on nursing skills and prolonged care techniques.

Chapters

00:00 Introduction to Tactical Medicine in Ukraine

02:49 The Formation and Mission of Tactical Medicine North

05:12 Training and Challenges on the Frontline

09:51 Understanding Injury Patterns and Casualty Statistics

13:00 Trauma Challenges: TBI and Pre-Hospital Care

20:28 Blood Management and Logistics in Combat

23:43 Tourniquet Use and Wound Management

26:58 Challenges with Russian Casualties and Evacuation

30:23 Prolonged Casualty Care and Training Needs

34:41 Conclusion and Future Directions

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