The most played episodes among Podcast App listeners.

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   Number 1: 213-From the White House to Ukraine: Lessons in Austere Medicine with Dr Travis Kaufman

   This week, Aebhric O'Kelly speaks with Dr Travis Kaufman and they explore his 25-year US Army career, his transition from combat engineer and military diver to Physician Assistant (PA), and five years providing medical support through the White House Medical Unit. Travis describes one of the most difficult lessons emerging from Ukraine: prolonged tourniquet use. A Ukrainian medic explains the decision as “triage of the limb or the life” when attempting tourniquet conversion after several hours may place the casualty at considerable risk. The discussion examines unnecessary tourniquet use, the importance of reassessment, contaminated wounds and the increasing problem of sepsis when evacuation is delayed for hours or days. Travis argues that the traditional TCCC assumption of rapid evacuation can create a training scar when casualties instead remain with combat lifesavers and medics for prolonged periods. The episode then explores what PCC actually looks like in practice: trending observations, wound debridement, antimicrobial planning, pain management, positioning, pulmonary care and the fundamental nursing interventions that can determine whether a casualty deteriorates. Travis also shares examples of improvisation from the field, including improvised PEEP and wound-vacuum techniques, and discusses why clinicians need to rediscover simple solutions when sophisticated equipment is unavailable. Chapters 00:00 – Meet Dr Travis Kaufman: From Army diver to PA, White House medicine and Ukraine. 02:26 – Becoming a Military Deep-Sea Diver: Training, attrition and operational diving. 06:12 – From Diver to Physician Assistant: Changing careers and entering military medicine. 07:15 – What Is a Physician Assistant?: Origins, training and the military PA role. 10:38 – PA vs Nurse Practitioner: Different educational and clinical models. 13:06 – Advising Across Eastern Europe: Building capability and interoperability. 14:19 – Inside the White House Medical Unit: Medical support for the President and First Family. 15:35 – Medical Planning for the President: Preparing for presidential travel worldwide. 17:32 – Training for High-Consequence Medicine: Trauma preparation and live-tissue training. 19:43 – Humanitarian Medicine in Tanzania: Wilderness medicine and community healthcare. 21:00 – Schistosomiasis and Sickle-Cell Care: Managing disease in resource-limited communities. 24:40 – HIV and the Problem of Follow-Up: When treatment exists but access remains difficult. 27:07 – Inside a Ukrainian Stabilisation Point: Damage-control resuscitation with limited resources. 28:45 – The Limb or the Life: The realities of prolonged tourniquet use. 30:00 – Preventing Unnecessary Limb Loss: Tourniquet reassessment and conversion. 31:56 – Sepsis in Prolonged Casualty Care: The consequences of delayed evacuation. 33:30 – Debridement Without Water: Managing contaminated battlefield wounds. 34:47 – Airways with Limited Equipment: Facial trauma and conserving resources. 36:14 – Taking PCC to the CLS and CMC: Moving prolonged-care skills further forward. 39:09 – What Should a Two-Day PCC Course Teach?: Reassessment, wounds and prolonged-care thinking. 40:45 – Stop Taking Snapshots — Start Trending: Following physiology over time. 42:13 – The “Boring” Care That Saves Lives: Nursing care, positioning, pain and pulmonary management. 43:40 – Improvised PEEP and Wound VACs: Field-expedient solutions when equipment runs out. 45:13 – Rediscovering Old Lessons: What previous wars may teach modern austere medicine. 46:27 – Medicine in the Mediterranean: Travis previews his keynote presentation. 47:45 – “Sir, Are We Gonna Be Okay?”: Trust, responsibility and caring for severely wounded soldiers. 49:49 – Advice for the Austere Clinician: Lose the ego, stay curious and learn from experience.

   September 18, 2026·48min
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   Number 2: 214-Remote Orthopaedics with Dr Bob Dichiera

   In this episode of CoROM Conversations, Bill Vasios is joined by Dr Bob Dichiera, a retired US Army veteran with experience in operational medicine, primary care and orthopaedic surgery, and an associate professor at East Carolina University's PA programme. Bob introduces a practical approach to remote orthopaedics built around four questions: Is the patient dying? Is a limb dying? Can I stabilise it? Does the patient need evacuation? The discussion examines the orthopaedic emergencies that clinicians cannot afford to miss, including open fractures and dislocations, neurovascular compromise, compartment syndrome, vascular injuries, pelvic fractures and traumatic amputations. Throughout the session, Bob emphasises repeated pulse, motor and sensory (PMS) assessment before and after interventions. Using clinical cases, the conversation explores closed and open tibial fractures, field-expedient fracture assessment, compartment syndrome, irrigation and antibiotics, splinting, shoulder dislocations and reduction decisions. The discussion considers when reduction may be appropriate in a remote environment, particularly when prolonged transport is combined with neurovascular compromise. The later discussion examines pelvic and hip injuries, field assessment, ultrasound and the difficult question of whether procedures such as fasciotomy have a role in genuinely remote care. Bob also considers how telemedicine and remote specialist support may extend what clinicians can safely accomplish in austere environments. 00:00 – Tuning-fork fracture diagnosis cold open 00:18 – Introduction to Remote Orthopaedics 01:58 – Why MSK injuries matter in remote medicine 03:00 – Orthopaedic emergencies you cannot miss 04:18 – Damage-control orthopaedics 05:00 – Is the patient dying? Is the limb dying? 06:42 – Closed tibial fractures 07:40 – Diagnosing fractures with a tuning fork 09:06 – Splinting and traction decisions 11:31 – Compartment syndrome 14:00 – Pain with passive stretch 15:30 – Open fractures 16:20 – Irrigation 17:00 – Antibiotics for open fractures 21:06 – Field splinting and improvised splints 23:30 – Shoulder dislocations 25:55 – Shoulder reduction techniques 28:21 – Immobilisation and rehabilitation 30:45 – When should remote clinicians reduce a dislocation? 33:07 – PMS and neurovascular assessment 34:00 – Knee dislocations 35:35 – The easily missed vascular injury 37:56 – Reduction, ABI and evacuation 38:45 – Ankle injuries and Ottawa Ankle Rules 40:20 – Why weight-bearing does not exclude fracture 42:00 – Hand and wrist injuries 42:43 – Pelvic fractures 44:00 – Pelvic binders and avoiding repeated pelvic assessment 45:30 – Haemorrhage and pelvic trauma 46:00 – Pelvis versus femoral neck fracture 47:30 – Ultrasound in remote orthopaedics 47:50 – Should remote clinicians perform fasciotomies? 48:30 – Telemedicine and remote procedural guidance 49:53 – Closing

   September 25, 2026·51min
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   Number 3: 212-What makes a paramedic? With David Page

   This week, Aebhric O'Kelly is joined by David Page, a paramedic with more than 40 years of experience spanning frontline EMS, education, accreditation and research. David directs the Prehospital Care Research Forum at UCLA and is closely involved with the International Paramedic Registry (IPR). The conversation explores the enormous variation in paramedic education and practice around the world. David discusses his work with training centres in more than 20 countries and explains why sophisticated simulation facilities are not necessarily required to deliver excellent education. Chapters 00:00 – Meet David Page: 40 years of paramedicine, research and education. 01:45 – Assessing EMS Education Around the World: Lessons from training centres in 23 countries. 04:30 – Simulation Without the Million-Dollar Lab: Creating effective training with limited resources. 05:20 – What Is the International Paramedic Registry?: Establishing international standards for paramedicine. 08:01 – Learning from the US National Registry: Why independent certification matters. 10:28 – Defining Levels of Paramedicine: Responder, basic and advanced practice. 13:03 – What Should Every Paramedic Know?: Building and validating 1,028 international competencies. 17:32 – Is IPR Becoming an International Standard?: Adoption, recognition and international mobility. 19:44 – Certification vs Licensure: An important distinction for international paramedics. 21:47 – Degree vs Certification: Does graduating from university prove clinical competency? 26:47 – Does a Degree Guarantee Competence?: Why David argues for independent verification. 28:20 – US vs UK Paramedics: Who Is Better?: Why minimum standards matter more than comparison. 29:17 – When the Same Job Title Means Different Skills: Comparing paramedic education and scope internationally. 30:35 – Does Programme Length Matter?: Why three years of education can mean very different things. 33:40 – Australia's Nurse–Paramedic Model: Different professions and different clinical environments. 36:43 – The UK Paramedic Model: Degrees, registration and the changing ambulance workforce. 39:36 – Germany, Spain and European EMS: Different routes to prehospital practice. 41:50 – Does France Have Paramedics?: Looking beyond professional labels. 44:12 – Can Nurses Take the IPR Exam?: Why hospital expertise does not automatically equal prehospital expertise. 44:52 – Paramedicine Is a Specialty: A separate environment requires a separate body of knowledge. 45:25 – Research, Education and Clinical Practice: David's three-legged stool of paramedicine. 46:56 – “Soak It Up, Buttercup”: David's advice for the next generation. 47:38 – The Privilege of Being a Paramedic: Human dignity, patients and why the work matters.

   September 11, 2026·42min
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   Number 4: 210-Lessons from Northern Sweden and Ukraine

   This week, Aebhric O'Kelly speaks with Christoffer Mäkitalo, a Swedish ambulance and anaesthesia nurse whose career spans remote prehospital care, the Swedish Civil Defence and Resilience Agency, military medicine and repeated training deployments to Ukraine. For Christoffer, prolonged care is not an unusual operational scenario. After 20 years working in northern Sweden, long response and transport times are part of routine ambulance practice. A call may involve a 45–60-minute response, followed by several hours of transport to a hospital capable of providing the required definitive care. With limited ambulance and helicopter resources covering enormous distances, clinicians must continually balance clinical need, transport decisions and system availability. The conversation then moves to Ukraine, where Christoffer has worked alongside Tactical Medicine North to support the development of TCCC, Combat Lifesaver, Combat Medic/Corpsman, instructor, blood resuscitation and ultrasound training. His next deployment will include piloting a two-day prolonged field care programme aimed at the CLS level. A central theme is that the changing battlefield requires prolonged casualty care skills to move further forward. Casualties may remain with combat lifesavers and medics for extended periods, making seemingly basic nursing interventions, keeping patients clean, dry and warm, managing elimination, monitoring wounds and preventing complications, increasingly important. As Christoffer puts it, many combat lifesavers had no healthcare background before the war; skills clinicians consider obvious must therefore be deliberately taught. Chapters 00:00 – Introduction: Christoffer Mäkitalo Twenty years of prehospital medicine, military nursing and civil defence work in northern Sweden. 01:41 – When Prolonged Care Is Just Normal Care Why one-hour-plus evacuation timelines are an everyday reality for ambulance clinicians in northern Sweden. 03:44 – Medical Training in Ukraine Christoffer's repeated deployments and the evolution from basic TCCC towards instructor development, blood resuscitation and ultrasound. 06:20 – Taking Prolonged Casualty Care to the CLS Piloting a two-day prolonged field care programme and why these skills need to move beyond highly trained medical personnel. 09:16 – Nursing Skills on the Modern Battlefield Wound care, hygiene, keeping casualties dry and warm, elimination and other fundamental care when evacuation is delayed. 11:34 – The Battlefield Has Changed Why assumptions based on rapid evacuation and air superiority no longer reflect the realities being reported from Ukraine. 12:56 – Sweden's Civil Defence and Resilience Agency Humanitarian operations, international deployments and supporting UN and EU missions around the world. 17:12 – Working as a Swedish Combat Nurse Combining civilian clinical practice with military medicine 19:49 – Remote Ambulance Medicine in Northern Sweden Working with limited resources, long distances and the need to become an effective clinical problem-solver. 23:28 – When HEMS Is Not Available Deciding when to request helicopter support and the operational challenges of weather, icing and enormous geographical coverage. 26:23 – Cross-Border Rescue and Evacuation Cooperation with Norwegian and Finnish services and the capabilities available across Scandinavia. 27:28 – The Swedish Ambulance Nurse Education, scope of practice, anaesthesia training and differences between civilian and military clinical capabilities. 30:36 – Treat, Release or Transport? Why does transporting every patient simply not work when one ambulance journey can take six to eight hours? 33:26 – Fixed-Wing Evacuation Moving patients over long distances for specialist and critical care unavailable locally. 35:14 – Advice for the New Austere Clinician Curiosity, humility, lifelong learning and finding the area of medicine that genuinely matters to you.

   August 28, 2026·33min
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   Number 5: 209-Ten years of CoROM Rethinking How We Teach Austere Medicine

   Aebhric O'Kelly is joined by Dr Csaba Dioszeghy, CoROM co-founder and CEO, critical care and emergency medicine consultant, cardiologist, and experienced prehospital clinician. The conversation explores what makes education for remote and austere clinicians fundamentally different from conventional medical education. CoROM students work across the world in military, humanitarian, offshore and other resource-limited environments. Csaba discusses why education needs to adapt to these clinicians rather than expecting their professional lives to conform to a traditional university model. A major theme is listening to students. Aebhric and Csaba discuss how student feedback has directly influenced CoROM's curriculum, facilities, administration and teaching methods — including significant changes being introduced for the new academic year. They also discuss the redevelopment of the MSc in Austere Critical Care, including more interactive online learning, greater flexibility for students who cannot travel to Malta, and expanded opportunities for practical education. The discussion considers an important question for modern medical education: how much of postgraduate austere medicine can genuinely be taught online, and what still requires hands-on experience? Chapters 00:00 – Welcome to Season 5 A new academic year, a new podcast season and the changing face of CoROM. 00:38 – CoROM's Next Chapter Csaba's role as CEO, consolidating a decade of growth and the College's ambitions for the future. 03:02 – What Makes CoROM Different? Building flexible education for clinicians working across military, humanitarian, offshore and resource-limited environments. 06:52 – Listening to Our Students How student feedback directly influences curriculum, facilities and the way CoROM teaches. 09:23 – Changing the Practical Curriculum Revamping classroom education, investing in facilities and placing greater emphasis on hands-on learning. 11:34 – Rebuilding the MSc in Austere Critical Care New modules, interactive education and moving beyond traditional recorded online lectures. 13:07 – Can You Teach Austere Critical Care Online? Accessibility, international students and why the redesigned MSc can now be completed without compulsory travel to Malta. 18:01 – Improving Support for Online Students Human faculty support, central administration and improving communication with students. 19:54 – Building a Better Student Information System Modernising the administrative infrastructure behind a growing international College. 21:02 – Building the CoROM Community The future of CoROM's membership structure and strengthening the wider professional community. 23:05 – The CoROM Digital Library Building offline access to field guides, publications and educational resources. 25:41 – A New Digital and Physical CoROM New content, facilities, Moodle, equipment and the systems being developed for the new academic year. 28:05 – Quality Assurance and the Future of CoROM Institutional review, reaccreditation and the longer-term direction of the College. 29:33 – More Hands-On, Less PowerPoint Updating the BSc and MSc programmes and increasing practical learning when students come to Malta. 32:17 – International Partnerships Growing educational, clinical and research relationships around the world. 34:02 – Advice for the New Austere Medic What should a doctor, nurse or medic entering austere medicine concentrate on? 35:00 – When Guidelines Don't Fit the Environment Why guidelines developed in well-resourced healthcare systems may not always translate directly into resource-limited care. 36:02 – Your Brain Is Still a Resource Understanding physiology, thinking beyond protocols, innovation and Csaba's final advice: be brave and don't give up.

   August 21, 2026·29min
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