This week, Aebhric O’Kelly talks with Antonio from European Medics about their work and focus on guerrilla, austere, and remote medicine. European Medics started as a community of passionate individuals in emergency medicine and has grown to focus on education and enhancing medicine.

European Medics is currently working on creating training material and educative resources for their Advanced Guerrilla First Responder (AGFR) course.

European Medics (EURMED) is focused on providing evidence-based guidance in unconventional and guerrilla medicine.

Guerrilla medicine overlaps with other fields, such as wilderness medicine, medical support for irregular warfare, and disaster relief. The goal is to be better prepared for future conflicts and disasters and to save lives.

Takeaways

European Medics started as a community of passionate individuals in emergency medicine and has grown to focus on education and enhancing medicine.

They are currently working on creating training material and educative resources for their Advanced Guerrilla First Responder (AGFR) course.

European Medics has a podcast with multiple shows, including medical basics, field clinic, and long-format discussions with subject matter experts.

Their goal is to provide training and education in austere and remote medicine to enhance the capabilities of healthcare providers in resource-limited environments—European Medics evidence-based guidance in unconventional and guerrilla medicine.

EURMED has published a paper on gorilla medicine and plans to publish more papers on the topic.

EURMED aims to be a neutral ground for the medical community to exchange experiences and provide expert medical education.

The future of guerrilla medicine is seen as an integrated part of forward medicine, focusing on providing care to civilians affected by conflicts.

Guerrilla medicine overlaps with other fields, such as wilderness medicine, medical support for irregular warfare, and disaster relief.

The goal is to be better prepared for future conflicts and disasters and to save lives.

Chapters

00:00 Introduction and Background

03:10 European Medics: Community and Education

06:12 The Advanced Guerrilla First Responder Course

09:02 Podcast: Medical Basics and Field Clinic

23:02 Publishing Concepts and Lessons Learned in Ukraine

27:11 The Future of European Medics

29:13 European Medics: A Neutral Ground for Medical Education

31:37 Expanding European Medics to the United States

36:48 Guerrilla Medicine and Overlapping Fields

41:37 The Clandestine Nature of Guerrilla Medicine

44:45 Preparing for Future Conflicts and Disasters

46:51 Advice for New Medical Professionals

This week, Aebhric talks with Dr Alastair Fraser, chair of the faculty advisory board for the Faculty of Remote Rural and Humanitarian Health care for the Royal College of Surgeons of Edinburgh, and discusses his diverse medical career and experiences in remote and rural areas. He shares stories from his time in the Antarctic, Nigeria, and with Shell, highlighting the challenges and unique situations he encountered. Dr Fraser also discusses the importance of mental health support for medics in remote locations and the need for ongoing training and resources. The conversation discusses the creation and purpose of the Faculty of Rural Remote Humanitarian Health, a specialised area under the Royal College of Surgeons of Edinburgh. The faculty aims to provide training and recognition for healthcare professionals in remote, rural, and humanitarian settings. It addresses the challenges of delivering healthcare in these areas and seeks to improve the quality of training and competence. The conversation also highlights the importance of community and networking among professionals in these fields. The faculty offers fellowship and membership to individuals who have demonstrated competence and contribution to the field.

Takeaways

Dr Alastair Fraser has had a diverse medical career, working in remote and rural areas and with Shell in various locations.

He emphasises the challenges and unique situations in remote healthcare, where medics are often asked to handle various medical issues.

Dr Fraser highlights the importance of mental health support for medics in remote locations and the need for ongoing training and resources.

He discusses the potential benefits of incorporating ultrasound devices into the toolkit of offshore medics but acknowledges the challenges in implementing this due to company policies and liability concerns. The Faculty of Rural Remote Humanitarian Health is a specialised area under the Royal College of Surgeons of Edinburgh that provides training and recognition for healthcare professionals working in remote, rural, and humanitarian settings.

The faculty addresses the challenges of delivering healthcare in these areas and aims to improve the quality of training and competence.

Membership in the faculty is open to anyone interested in the field, not just doctors or medics.

The faculty plans to offer more online courses that cover various skills needed in remote, rural, and humanitarian healthcare.

The faculty is voluntary and relies on volunteers and funding to operate.

Networking and community-building among professionals in these fields are important for sharing ideas and experiences.

The faculty is working towards providing educational credits and accreditation for its courses.

Healthcare professionals interested in working in austere environments should seek training, talk to experienced professionals, and develop skills in working under pressure and uncertainty.

Chapters

00:00 Introduction and Background

02:10 Experiences in the Antarctica

03:00 Challenges and Unique Situations in Remote Healthcare

08:05 Limited Medical Resources in Remote Locations

15:23 Importance of Mental Health Support for Medics

20:21 Implementing Ultrasound for Offshore Medics

21:10 Introduction to the Faculty of Rural Remote Humanitarian Health

23:50 Challenges of Delivering Healthcare in Remote and Rural Areas

27:35 Membership and Community in the Faculty

33:57 Expanding Online Courses for Remote Healthcare

39:02 The Humanitarian Healthcare Course and Accreditation

43:47 Advice for Healthcare Professionals in Austere Environments

This week, Aebhric talks with Frida Svahn, a nurse from Sweden, who discusses her experiences teaching medical training in various countries and her work with the Swedish Civil Contingencies Agency (MSB). She shares her journey from serving in the Swedish Armed Forces to becoming a nurse and her passion for working in austere environments. Frida highlights the importance of training the trainers and its impact in countries like Ukraine. She also mentions the upcoming National Seminar Exercise in Sweden and the role of MSB in civil defence and NATO. Frida advises new healthcare professionals interested in working in austere environments to invest in good courses, build a network, and stay motivated.

Takeaways

Teaching medical training in austere environment is a rewarding experience that allows healthcare professionals to make a difference in countries like Ukraine.

MSB plays a significant role in civil defence and NATO, providing training and expertise in emergency response and crisis management.

Investing in good courses, building a network, and staying motivated are essential for healthcare professionals working in austere environments.

Training the trainers is a force multiplier that spreads knowledge and skills to a larger population.

Sweden's upcoming National Seminar Exercise will involve multiple nations, focusing on casualty move and patient flow management.

This week, Aebhric O'Kelly talks with Dr John Quinn and Eirik Holmstrøm, who all went to Ukraine to teach the Damage Control Resus Ukraine (DCRU) course. They discuss the curriculum, the use of clinical practice guidelines (CPGs), and the importance of access to blood in the pre-hospital setting. They highlight the collaboration with Tactical Medicine North and the professional partner forces in Ukraine. The hosts also mention the Defence Health Administration's (DHA) role and the resources on the DHA website and app. The conversation emphasises evidence-based practices and knowledge exchange's significance in improving military medicine. The conversation focuses on the challenges and solutions in Ukraine's implementation of damage control resuscitation (DCR). The speakers discuss the need for interoperability in large-scale combat operations (LSCO) and the importance of rethinking traditional medical practices. They highlight the limitations of blood transfusion in the field and the need for a logistic system to support the transportation of blood. The conversation also covers training Ukrainian combat medics in advanced skills such as resuscitative endovascular balloon occlusion of the aorta (REBOA) and ultrasound. The speakers emphasise the importance of continuous learning, adapting to failures, and the potential for DCR to increase combat effectiveness in Ukraine.

Keywords

Damage Control Resus Ukraine, DCRU, curriculum, clinical practice guidelines, CPGs, pre-hospital setting, blood access, Tactical Medicine North, partner forces, Defence Health Administration, DHA, evidence-based practices, military medicine, damage control resuscitation, interoperability, large-scale combat operations, blood transfusion, logistic system, training, combat medics, REBOA, ultrasound, continuous learning, combat effectiveness

Takeaways

The DCRU course in Ukraine focused on damage control resuscitation in the pre-hospital setting.

The curriculum was based on clinical practice guidelines (CPGs) from the Defence Health Administration (DHA).

Access to blood and blood components was highlighted as crucial in effective care.

Collaboration with Tactical Medicine North and professional partner forces in Ukraine was instrumental in the course's success.

The DHA website and app provided valuable resources for learning and reference in austere environments.

The exchange of knowledge and lessons learned is essential for improving military medicine. Implementing damage control resuscitation in large-scale combat operations requires interoperability and a logistic system to support the transportation of blood.

Traditional medical practices need to be rethought to align with the evolving nature of warfare.

Training combat medics in advanced skills such as REBOA and ultrasound can improve patient care and increase patient transport confidence.

Continuous learning and adapting to failures are essential in austere medicine.

Damage control resuscitation has the potential to increase combat effectiveness in Ukraine.

Chapters

00:00 Introduction to Dr John Quinn and Eirik Holmstrom

02:07 Adding Co-Authors and References

04:01 Introduction to the DCRU Course

08:09 Overview of the DCRU Curriculum

13:49 Importance of Access to Blood

16:40 Acknowledging the Defence Health Administration

18:56 Interoperability and Logistic Challenges

23:35 Rethinking Traditional Medical Practices

29:24 Training Combat Medics in Advanced Skills

38:34 Continuous Learning and Adapting to Failures

41:10 The Potential of Damage Control Resuscitation

This week, Aebhric O'Kelly talks with the faculty from Tactical Medicine North from Ukraine. The College was invited to return to Ukraine to teach the DCR-U course for the TacMedNorth faculty.

Summary

Tactical Medicine North in Ukraine is focused on teaching prolonged casualty care and damage control recess. They started gathering information and teaching combatants in 2022 during the full-scale invasion. Their courses range from basic to advanced levels, including AEMT courses and blood resuscitation training. The goal is to provide proper training and knowledge to combat medics and non-medics. The experience of running the advanced damage control recess course was positive, with motivated students who wanted a deeper understanding of medicine. The use of guidelines and documents was emphasised to ensure proper care. The future goal is to spread the training and continue teaching at a high level.

Keywords

Tactical Medicine North, Ukraine, prolonged casualty care, damage control recess, combat medics, EMT courses, blood resuscitation, guidelines, training

Takeaways

Tactical Medicine North focuses on teaching prolonged casualty care and damage control recess in Ukraine.

They offer a range of courses, from basic to advanced levels, including AEMT courses and blood resuscitation training.

The use of DHA CPGs guidelines and documents is emphasised to ensure proper care.

The goal is to spread the training and continue teaching at a high level.

Chapters

00:00 Introduction and Background of Tactical Medicine North

03:36 Teaching Prolonged Casualty Care

08:10 The Need for a Damage Control Recess Ukraine Course

14:20 Impact of the Course on Students' Perspective

19:46 Importance of Guidelines and Documents in Tactical Medicine

23:47 Future Plans for Tactical Medicine North

30:54 Continuing Training and Education

35:41 Conclusion and Thanks

This week, Aebhric talks with Dr Sean Keenan, one of the founders of the Prolonged Field Care Working Group. They discuss his background and the development of PFC. They talk about creating the Austere Emergency Care course, which brings the lessons of prolonged field care to the civilian environment. He emphasises the importance of providing relevant and practical training that sparks interest and fosters collaboration among healthcare professionals. The conversation covers the benefits of being a non-profit organisation, the importance of continuous learning and humility in austere environments, the role of professional organisations like SOMA in supporting special operations medics, and the value of connecting with like-minded individuals in the field. The guests advise new paramedics, SOCM medics, nurses, and doctors interested in working in austere environments.

Chapters

00:00 Introduction and Background

05:44 Formation of the Prolonged Field Care Working Group

30:20 The Creation of Specialized Medical Standards

40:16 The Benefits of Being a Non-profit Organisation

42:40 The Role of Professional Organizations in Supporting Special Operations Medics

45:04 Connecting with Like-Minded Individuals in the Field

49:02 Advice for new Paramedics, SOCMs, Nurses, and Doctors in working in austere environments

Takeaways

The Prolonged Field Care Working Group was formed to address the need for extended medical care in austere environments by Sean Keenan, Paul Loos and Dennis Jarema.

The group developed the Austere Emergency Care course to teach civilian remote medics the lessons of prolonged field care.

The course is designed to provide relevant and practical training that sparks interest and fosters collaboration among healthcare professionals.

Creating the Specialized Medical Standards

Continuous learning, humility, and being a team player are essential qualities for working in austere environments.

Professional organisations like SOMA provide a platform for networking, exchanging ideas, and solving operational problems in special operations medicine.

Connecting with like-minded individuals in the field can lead to valuable collaborations and sharing of knowledge and experiences.

New paramedics, SOCMs, nurses, and doctors should focus on being excellent medical professionals, always learning, and acting in the best interests of their patients and teams.

This week, Aebhric O'Kelly talks with Rae Richburg, who attended almost three months of CoROM short courses this Spring term. Rae talks about her work as a registered nurse in prison psychiatric wards.

She discussed her experiences spending three months in Pretty Bay, Malta, taking every CPD course on the schedule.

This week, Aebhric O'Kelly talks with Bobby Litton, a paramedic and teacher, and discusses his career and aspirations in pre-hospital medicine. He shares his experiences working in Iraq and the UK and his pursuit of advanced degrees and certifications. Bobby emphasizes the importance of continuous learning and surrounding oneself with knowledgeable and skilled

Keywords

paramedic, pre-hospital medicine, career,

Takeaways

Continuous learning and self-improvement are essential in the field of pre-hospital medicine. To enhance your skills and knowledge, surround yourself with knowledgeable and skilled individuals.

Gaining experience through volunteering and participating in expeditions can be valuable for working in austere environments.

Investing in education and pursuing advanced degrees and certifications can open up opportunities for career advancement.

Strive to be a better medic and constantly evaluate and improve your skills and knowledge.

Sound Bites

"We all love trauma. It's all the primary care stuff that is our bread and butter."

"The course is shifted to the environment with training paramedics to work in a pre-hospital condition that can provide the prolonged field care treatment in resource-poor environments without a lot of help."

Chapters 

00:00 Introduction and Background

02:50 Paramedic Training and Challenges

07:52 Career Path and Future Plans

11:02 Working in the UK and Hospital Challenges

14:56 Transitioning to ACP and Specializations

25:08 Importance of Education and Continuous Learning

29:03 Teaching and Mentoring in Pre-hospital Medicine

32:00 Advice for New Paramedics and Healthcare Professionals

This week, Aebhric O’Kelly talks with Yvette Nunes, a cruise ship nurse, who shares her experience working on an expedition ship and the unique challenges and opportunities it presents. She discusses the expedition's mission: to take guests to new and remote areas and provide them with close-up nature experiences. Yvette explains the day-to-day life of a nurse on board, including managing the medical centre, accompanying the expedition team on landings, and being on call 24/7. She also highlights the importance of continuous professional development and her training in Malta.

Takeaways

Embarking on a career as a nurse on an expedition ship is a unique journey filled with challenges and opportunities.

In this field, continuous professional development is not just encouraged, it's a necessity. It's a commitment to enhancing your skills and knowledge in emergency and critical care medicine, a journey that will keep you motivated and always striving for more.

The medical team on board must be prepared to handle various medical conditions and emergencies, from myocardial infarctions to anaphylaxis.

Having telemedicine capabilities and access to specialists is crucial when working in remote areas with limited access to definitive care.

Healthcare professionals interested in working in austere environments should take advantage of online learning opportunities and seek out companies that invest in training and development.

Chapters

00:00 Introduction and Background

01:31 The Mission of the Expedition Ship

09:11 Medical Challenges and Responsibilities

13:08 Importance of Continuous Professional Development

21:24 Daily Life on an Expedition Cruise Ship

26:20 Training and Qualifications for Shipboard Medical Staff

28:25 Memorable Medical Cases

31:27 Future Plans and Career Advancement

39:02 Advice for Healthcare Professionals in Austere Environments

Mike Turconi is a CoROM MSc student working as an advanced care paramedic in Canada with experience in austere medicine; he shares insights from his career and academic pursuits. He discusses his experiences in Canada, Ukraine, and Tanzania, highlighting the challenges and rewards of working in austere environments. Mike also provides advice for healthcare professionals interested in this field.

Keywords

austere medicine, paramedic, healthcare, clinical practice, academic pursuit, career advice, remote medicine, critical care, humanitarian work

Takeaways

Austere medicine requires a different mindset and approach to problem-solving because it requires more resources and diagnostic equipment.

Clinical experience in austere environments provides valuable learning opportunities and requires a willingness to engage in all aspects of patient care.

New healthcare professionals interested in austere medicine should open their minds, look at problems from different perspectives, and be prepared for unconventional solutions.

Mike Turconi emphasises the importance of enjoying and excelling in one's current role rather than constantly seeking the next certification or degree.

Chapters

00:00 Introduction to Mike Turconi and His Career

03:01 Transitioning to Austere Environments and Clinical Practice

12:57 Experiences in Tanzania and Lessons Learned

38:56 Advice for Healthcare Professionals Interested in Austere Medicine