This week, Aebhric O'Kelly is joined by Dr Aris Exadaktylos and Dr Susie DiMartini to discuss the critical need for specialised maritime medicine training. They explore the creation of the International Maritime Ships Doctors course, the unique challenges of offshore medical care, and the future of remote healthcare technology. They are the founding faculty for the new Faculty of Offshore and Maritime Medicine from CoROM.

Chapters

00:00 Introduction to Maritime Medicine Faculty

02:14 Personal Journeys in Maritime Medicine

05:02 The Need for Maritime Medical Training

10:11 The Role and Responsibilities of Ship Doctors

16:51 Innovations in Maritime Medical Care

25:49 The International Maritime Ship Doctors Course

29:03 Future of Maritime Medicine Education

This week, Aebhric O’Kelly is joined by Rhod Jordan and Bill Vasios as they discuss how to create an ICU in the jungle. They discuss setting up and managing a remote ICU in jungle environments, focusing on site selection, equipment, logistics, and medical considerations for field medics and responders.

Chapters

00:00 Introduction and Content Overview

00:41 Premise and Scenario Setup for Jungle ICU

01:33 Site Selection Criteria in Jungle Environments

02:19 Environmental Challenges: Rain, Creepy Crawlies, and Hypothermia

03:08 Privacy, Lighting, and Visibility in Remote Settings

03:53 Creating a Functional Jungle Clinic Layout

04:34 Lighting and Visibility Strategies at Night

05:31 Accessibility and Zone Planning in Field Clinics

06:09 Assessing Capacity: Multiple Patients and Beds

07:01 Monitoring Equipment: Minimum and Advanced Options

08:04 Power, Water, and Communication Logistics

08:42 Prolonged Casualty Care and Exfil Planning

09:59 Medical Supplies: Drugs, Medications, and Sterility

10:42 Camp Craft and Bushcraft Skills for Remote Medics

11:35 Wildcrafted Plants and Improvised Medicine

12:12 Communication Strategies in Dense Canopy Environments

13:08 Team Coordination and Role Assignments

14:08 Dealing with Critical Patients and Exfil Decisions

14:57 Infection Control and Hygiene in the Field

15:54 Personal and Team Safety Measures

16:39 Additional Non-Medical Gear for Remote Operations

17:16 Lighting Solutions and Bug Management at Night

18:08 Medications and Drugs for Jungle Medicine

18:45 Over-the-Counter and Emergency Medications

19:34 Special Considerations for Malaria and Vector-borne Diseases

20:04 Infection Control and Hygiene Protocols

20:56 Water Purification and Boiling Techniques

21:35 Field Sterilisation and Maintaining Sterility

22:25 Managing Glove Supplies and Hand Hygiene

23:00 Dermatology and Common Skin Conditions

23:38 Malaria Prophylaxis and Treatment Strategies

24:32 Infection Control and Personal Hygiene

25:14 Power and Charging Solutions in Remote Areas

26:04 Water Supply and Filtration Methods

26:45 Field Sterilisation and Water Boiling Techniques

27:21 Camp Craft and Bushcraft Skills for Field Survival

27:56 Wildcrafting and Medicinal Plants in the Jungle

28:47 Communication Equipment and Strategies in Dense Canopy

29:41 Team Coordination and Medical Decision-Making

30:17 Water Safety and Potable Water Management

31:05 Team Safety and Preventing Illness in the Field

32:04 Bushcraft Skills for Remote Medical Operations

32:58 Survival Skills and Improvised Medicine

33:48 Communication Tools and Emergency Signalling

34:28 Exfil Planning and Evacuation Protocols

35:14 Prolonged Casualty Care and Equipment Needs

36:01 Medical Kits and Supplies for Extended Operations

36:51 Decision-Making in Critical Situations

37:23 Non-Medical Essentials: Woobies, Tools, and Comfort Items

38:10 Maintaining Morale and Team Cohesion

38:42 Summary and Final Tips for Jungle ICU Setup

This week, Aebhric O'Kelly talks with Eirik Holmstrom about the newly updated MIC MEC and Pharm CPD courses, which have been combined into a new online CPD programme called 'Austere Primary Care.'

This APC is a package that includes Disease and Non-Battle Injuries (DNBI) encountered on expeditions, in military operations, at remote clinical sites, and in resource-limited environments.

You can find up-to-date information on our course webpage https://corom.moodlecloud.com/

This week, Aebhric O’Kelly talks with Dr Csaba Dioszeghy about the redesign and upgrade of the MSc Austere Critical Care programme. Every 5 years, the degree programmes undergo reaccreditation. The College has decided to double the programme's size following feedback from graduates.

Chapters

00:00 Introduction to the New Masters of Austere Critical Care Program

01:03 The Complete Rehaul of the Curriculum

01:57 Flexibility and Pathways in the New Program

02:51 Comparison with UK Advanced Practice Programs

03:46 Four Pillars of the New Curriculum

04:41 Special Focus: Medical Support to Resistance Healthcare

07:02 Innovations in Improvised Medicine

08:21 Practical Modules: Ultrasound and Tropical Medicine

09:44 Student Research and Thesis Projects

11:30 Program Launch and Future Outlook

This week, Aebhric O’Kelly is joined by Splinter Knoppert, who is a 2nd-year BSc student attending the Intensive Care for Austere and Remote Environments (ICARE) course in Malta. They discuss his experiences during the week, including the practical skills, teamwork, resource-limited environments, and innovative teaching methods.

Aebhric is then joined by Dr Csaba Dioszeghy, and they discuss the origin of the ICARE course 14 years ago.

Chapters

00:00 Introduction to the ICARE Course in Malta

00:58 BSc Student Splinter talks about his experience in ICARE

02:04 Diverse Participants and Their Backgrounds

02:53 Skills Gained: Ultrasound, Central Lines, and Improvisation

03:47 Blue Time: Practice and Muscle Memory

05:06 Overview of Scenarios: Crush Injuries, Tropical Diseases, and Trauma

05:52 Building a Remote ICU: Key Components and Challenges

06:30 Setting Up an ICU in the Jungle: Precautions and Planning

07:14 Impact on Paramedic Practice and Future Plans

08:16 Introduction to Dr Csaba Dioszeghy and Critical Care Education

09:06 Origins of Critical Care Teaching and Collaboration

10:51 Simplifying Critical Care for Resource-Limited Settings

13:07 Development of the MSc in Critical Care

14:29 Teaching Principles: Using Critical Care Without Fancy Equipment

15:26 From Aeromedical Transport to Specialised Critical Care Training

16:22 Addressing the Gap in Critical Care Education

16:47 Curriculum Focus: Basic to Advanced Critical Care Concepts

17:43 Teamwork and Non-Technical Skills in Critical Care

18:40 The Importance of Crew Resource Management

20:20 Simulation-Based Training for Teamwork and Skills

21:15 Elective Courses and International Participation

22:10 The Future of the MSc Program and Crew Resource Management

24:04 Technical Skills Practice: Ultrasound, Suturing, and Intubation

24:57 The Value of the iCare Course and Its Evolution

25:50 Upcoming Deep Dive into the Masters of Austere Critical Care

We will have questions about the episode icon, which is a picture of an ancient carving of the Rod of Asclepius. This is on a church outer wall in Mdina, Malta, with origins in the Knights Hospitaler.

This week, Aebhric O'Kelly and Bill Vasios host another CoROM Conversations. This month, they discuss the comprehensive nursing interventions, training strategies, and best practices for prolonged field care, emphasising simplicity, effective handovers, and patient safety.

https://youtu.be/U63NaFLaxZ0

Chapters

00:00 Introduction to Nursing Interventions

00:53 Exploring CPGs and Nursing Interventions

02:25 Comparing Non-Medical and Medical Personnel Guidelines

05:50 Simplifying Nursing Interventions for Non-Medical Personnel

09:05 Wound Care Disparities in Guidelines

11:05 Identifying Gaps in Nursing Care Guidelines

12:07 The Need for Simplified Guidelines

16:15 Importance of Structured Handover

24:03 Trending and Serial Assessment in Patient Care

26:17 Understanding Patient Comfort and Injury Prevention

27:36 The Importance of Hands-On Nursing

28:32 Pressure Injury Prevention Strategies

29:52 Efficient Patient Care Techniques

31:17 Pain Management in Nursing

33:12 Pulmonary Hygiene and Patient Mobility

35:14 Nutrition and Hydration in Patient Care

35:37 The Role of Checklists in Medical Practice

41:33 Infection Prevention and Wound Care

43:34 Final Thoughts on Patient Care Practices

44:01 Any Questions?

This week, Aebhric is joined by Dr Harrison Steins, who is finishing his MSc in Austere Critical Care with CoROM. He also finished medical school and is starting his emergency medicine training. His master’s thesis was on the complexities of swimming-induced pulmonary oedema (SIPE), a rare condition affecting athletes, particularly in high-altitude environments. The speaker, Harrison Steins, discusses the pathophysiology, clinical presentation, diagnosis, and management strategies for SIPE, emphasising the importance of context in medical practice. He shares case studies, research findings, and future directions for understanding and treating this condition, highlighting the role of ultrasound in diagnosis and the need for tailored prevention strategies.

Takeaways

Swimming-induced pulmonary oedema is a rare condition with a prevalence of less than 1%.

Understanding the context of patient presentation is crucial for diagnosis.

Acute-onset cough and dyspnoea are key symptoms of SIPE.

Diagnosis requires a broad differential, ruling out other conditions first.

Management focuses on immediate life threats before addressing SIPE.

Hydration strategies can prevent SIPE, especially in athletes.

Sildenafil may be effective in preventing SIPE, but it is not widely recommended.

Handheld ultrasound is a reliable tool for diagnosing pulmonary oedema in the field.

Females may have a higher incidence of SIPE at lower elevations than males do.

Knowledge of population-specific pathology is essential for effective treatment.

Chapters

00:00 Introduction to Swimming-Induced Pulmonary Oedema

04:47 Understanding the Pathophysiology of Swimming-Induced Pulmonary Oedema

09:18 Case Studies and Clinical Presentation

13:48 Diagnosis and Imaging Techniques

19:26 Management Strategies and Treatment

24:17 Research Findings and Future Directions

This week, Aebhric O'Kelly interviews four students from our BSc in Remote Paramedic Practice programme. They discuss the Tropical Travel and Expedition Medical Skills course (TTEMS).

This week, Aebhric O'Kelly is joined by Dr Ella Corrick, Dr Sean Bilodeau and Dr Tom Mallinson as the CoROM faculty attend The Big Sick conference hosted by Air Zermatt.

CoROM gave three lectures and two workshops including the Improvised Medicine workshop and the Austere Emergency Care workshop.

Takeaways

The challenge of compressing prolonged field care education into short workshops.

Engagement of diverse professional backgrounds enhances learning experiences.

Realistic simulations provide valuable insights into emergency care.

The importance of bridging the gap between pre-hospital and hospital care.

Innovations in emergency medicine practices are crucial for improving patient outcomes.

Data plays a significant role in shaping emergency response strategies.

Continuous education is essential for adapting to new medical practices.

The value of informal discussions among professionals at conferences.

Understanding the unique challenges faced by pre-hospital care providers.

The need for a shift in perception regarding the role of EMS professionals.

Chapters

00:00 Introduction to the Big Sick Conference

02:34 Challenges in Prolonged Field Care Education

05:43 Diverse Professional Backgrounds in Medical Education

08:09 Learning Through Realistic Simulations

11:04 Bridging the Gap Between Pre-Hospital and Hospital Care

13:39 Innovations in Emergency Medicine Practices

16:46 The Role of Data in Emergency Response

19:10 Future Directions in Pre-Hospital Care

21:39 Conclusion and Reflections on the Conference

This week, we hear from Burjor Langdana, who runs the Wilderness and Expedition Dentistry workshop for CoROM. Burjor discusses the management of dental pain, focusing on assessing sensitivity, identifying causes, and evaluating treatment options. It emphasises the importance of patient care, oral hygiene, and antibiotic use in the management of dental conditions. The discussion also covers cultural considerations and improvisation in emergency situations, providing valuable insights for dental practitioners.

https://wildernessdentistry.com/

Takeaways

Understanding the characteristics of dental sensitivity is crucial.

Location and duration of pain are key indicators.

Aggressive brushing can lead to gum recession and sensitivity.

Clove oil can be effective but should be used cautiously.

Flossing is essential to prevent food buildup and gum irritation.

Antibiotics may be necessary for managing infections.

Improvisation is important in emergency dental care.

Cultural beliefs can impact patient care and treatment acceptance.

Communication with patients about procedures is vital.

Managing expectations regarding treatment outcomes is essential.

Chapters

00:00 Introduction to Managing Dental Pain

00:57 Understanding Sensitivity: Duration and Location

06:32 Identifying Causes of Sensitivity

12:12 Managing Sensitivity with Home Remedies

12:40 Addressing Food-Related Pain

18:37 Techniques for Filling Cavities

29:11 Improvising Without Instruments

29:39 The Role of Salt Water in Oral Health

34:53 Managing Tooth Pain and Food Impaction

39:06 Understanding Fillings and Their Complications

45:42 Gumboils: Causes and Management

49:48 Skills for Remote Dental Care

56:04 Cultural Sensitivity in Dental Treatment