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

This week, Aebhric O’Kelly talks with Dr Chris Carter, a critical care nurse and academic, who shares his journey from military nursing to working in Zambia, where he has been instrumental in developing critical care nursing programs. He discusses the challenges and innovations in critical care nursing, particularly in resource-limited environments, and reflects on the impact of COVID-19 on the healthcare landscape. Dr Carter emphasises the importance of education, collaboration, and flexibility in nursing practice and offers advice for new professionals entering the field.

Takeaways

Dr Chris Carter transitioned from military nursing to academia.

He is currently working in Zambia to enhance critical care education.

COVID-19 highlighted the need for investment in critical care nursing.

Collaboration with local stakeholders is crucial for program development.

Innovations in critical care can improve patient outcomes.

Education programs must be tailored to local needs and resources.

There is a growing recognition of the importance of critical care nursing.

Flexibility and adaptability are key in austere medical settings.

Dr Carter advocates for updates to critical care nursing literature.

New professionals should embrace every opportunity in their careers.

Chapters

00:00 Introduction to Dr. Chris Carter

03:35 Journey to Zambia and Critical Care Education

09:01 Developing Critical Care Nursing Programs

12:34 The Impact of COVID-19 on Critical Care

16:13 Innovations in Critical Care Nursing

19:52 Future of Critical Care Nursing Education

26:51 Advice for New Professionals in Austere Medicine

This week, Aebhric O’Kelly talks with Greydon Ratushny about his master’s thesis. He recently graduated from the MSc Austere Critical Care programme. They discuss the significant challenges faced in delivering quality healthcare in remote and rural areas of British Columbia. Greydon emphasises the critical role of pain management in improving patient experiences and outcomes, particularly in paramedic services. Ratushny highlights the immediate impact that effective pain management can have on patients and its importance in their overall healthcare journey.

Takeaways

There are significant challenges in delivering quality healthcare in rural areas.

Pain management is a key focus for improving patient outcomes.

An immediate impact on pain can enhance the patient experience.

The quintuple aim concept is essential in healthcare delivery.

Paramedics play a crucial role in managing pain effectively.

Rural communities require tailored healthcare solutions.

Understanding patient experiences is vital for healthcare improvement.

Effective pain management can influence long-term patient recall.

Healthcare delivery must adapt to the unique needs of remote areas.

Research and innovation are needed to address rural healthcare challenges.

Chapters

00:01 – Introduction and guest welcome

02:30 – ACC learning experience and placements

06:15 – Motivation for choosing ACC

09:50 – Curriculum gaps and collaboration

13:55 – Programme redesign and electives

15:40 – Thesis focus: austere nerve blocks

20:10 – Scope of practice and POCUS

24:30 – Pain management in prolonged transport

29:40 – Rural healthcare equity challenges

32:50 – Doctoral research ambitions

35:40 – Advice to future candidates

36:30 – Closing reflections

This week, Aebhric OKelly and Sam Coffman continue their discussion on the Guerrilla Medic and what to grow in their garden to supplement their ICU. Sam discusses the unique advantages of herbal remedies in treating viral infections. They discuss easy-to-find herbal medicine from your camp kitchen.

Takeaways

Herbs can address specific health niches that pharmaceuticals cannot.

Herbal formulas are effective for various viral infections.

Herbs can help repair and restore tissue health.

The mucosa and lymph movement are supported by herbal remedies.

Herbs can slow down and stop virus shedding.

Pharmaceuticals lack the holistic approach that herbs provide.

Herbs can enhance the body's terrain for better health.

Herbal remedies can be more effective in certain health conditions.

The use of herbs can lead to better overall health outcomes.

Understanding the unique benefits of herbs is crucial for health.

Chapters

00:00 Introduction to Medicinal Herbs

10:46 Key Herbs for Upper Respiratory Health

14:10 Herbs for Gut and Liver Support

17:42 Common Kitchen Herbs to Support your ICU

26:56 Honey as Medicine

31:26 More Kitchen Herbs

35:44 Improvised Medicine Workshop at SOMSA

This week, Aebhric and Sam continue their discussion of Medical Support for Irregular Warfare, specifically focusing on the use of the Guerrilla Garden. They discuss the unique advantages of herbal remedies compared to pharmaceuticals, particularly in treating viral infections. He highlights how herbs can effectively slow down virus shedding, repair tissue, and support overall health in ways that pharmaceuticals cannot.

Takeaways

Herbs can address specific health niches that pharmaceuticals cannot.

Herbal formulas are effective for various viral infections.

Herbs can help repair and restore tissue health.

Herbal remedies support the mucosal and lymphatic systems.

Herbs can slow down and stop virus shedding.

Pharmaceuticals lack the holistic approach that herbs provide.

Herbs can enhance the body's terrain for better health.

Herbal remedies can be more effective in certain health conditions.

Using herbs can lead to better overall health outcomes.

Understanding the unique benefits of herbs is crucial for health.

Chapters

00:00 Intro to Guerrilla Gardening and Nutrition

01:48 Foraging and Wildcrafting for Food

04:45 The Importance of Cooking Wild Foods

07:33 Identifying Nutrient-Dense Plants

10:06 Sprouting Seeds for Quick Nutrition

13:06 Microgreens and Mushrooms as Food Sources

16:17 Safe Mushroom Identification

21:00 Planning for Sustainable Winter Nutrition

24:27 Utilising Humanure for Soil Health

26:04 Guerrilla Gardening Techniques

33:37 Top Edible Plants for Guerrilla Medics

This week, Aebhric OKelly talks with Sam Coffman about the Guerrilla Medic and supplementing Medical Support for Irregular Warfare using locally procured plants. They discuss their training as Green Berets in MSIW and how the medic on the ground can learn and use plants to support the Guerrilla Clinic.

This first episode lays the groundwork for this concept. They discuss the integration of herbal medicine with Western medical practices, emphasising the unique benefits of herbal formulas, particularly in treating viral infections and repairing tissue. The discussion highlights the potential of herbal medicine to address acute health issues where pharmaceuticals may fall short, and encourages practitioners to find specific niches where herbal remedies excel.

Episode two drops next week and focuses on the use of plants to supplement the nutritional requirements for acute casualties and healthcare staff working in a hidden, remote clinic in semi-permissive environments.

Takeaways

Herbs provide unique benefits that pharmaceuticals do not.

Acute care is a significant area for herbal medicine.

Finding niches for herbs can enhance treatment efficacy.

Herbal medicine can complement Western medical practices.

Viral infections can be treated with herbal treatments.

Integrating herbal and Western medicine can support the Guerrilla clinic.

Practitioners can easily master specific applications of herbs.

Chapters

00:00 Introduction to Herbal Medicine and Survival Gardening

02:50 Sustainable Food Production in Crisis Situations

05:38 Integrating Herbal Medicine into Resistance Healthcare

12:16 Acute Care and Herbal Remedies

14:28 Food Sources for Resistance Healthcare

19:17 Foraging and Utilising Local Plants

22:26 The Use of Alder and Medicinal Herbs

24:45 Lessons from Guerrilla Medicine in WWII

26:59 Building a Decentralised Medical System

30:38 Wildcrafting: Harnessing Nature’s Pharmacy

35:12 Creating a Learning Pathway for Remote Medics

42:19 Integrating Herbal Medicine into Resistance Healthcare

This week, Aebhric OKelly talks with Eric Linder, who shares the inspiring journey of Team 5, an organisation dedicated to providing remote medical care in underserved communities. Starting as a small group of friends, Team 5 has evolved over 15 years, focusing on humanitarian work without political or religious affiliations. Eric discusses the importance of education and training in remote medicine, emphasising the need for adaptability and cultural understanding. He also offers valuable advice for aspiring remote medics, highlighting the significance of hands-on experience and proper education in making a meaningful impact in global health.

Takeaways

Team 5 started as a small group of friends wanting to help others.

The mission evolved from Belize to Guatemala due to logistical challenges.

Team 5 focuses on providing medical care without political or religious affiliations.

The organisation has grown, but it aims to keep missions small and effective.

Eric Linder integrates educational programs with practical missions for students.

Remote medicine requires adaptability and understanding of local cultures.

Training in remote medicine is essential for effective humanitarian work.

Volunteering in underserved areas can provide valuable experience.

Education in public health is crucial for addressing global health issues.

Team 5 emphasises the importance of being prepared for challenging environments.

Chapters

00:00 The Birth of Team 5

13:16 Expanding Horizons in Remote Medicine

26:53 Education and Training in Remote Medicine

30:55 Advice for Aspiring Remote Medics

This week, Aebhric talks with Jason Jarvis, a former Special Forces medic and current PhD candidate, and discusses Chagas disease, a tropical disease transmitted by the kissing bug. He explains the life cycle of the bug, the transmission of the disease, its clinical presentation, and the challenges in diagnosis and treatment. The conversation emphasises the importance of awareness and preventive measures, especially as Chagas disease is spreading to new regions, including parts of the United States. The discussion concludes with key take-home messages for healthcare providers and the need for ongoing education in tropical medicine.

Takeaways

Chagas disease is transmitted by the kissing bug, primarily in Central and South America.

The life cycle of the kissing bug involves several stages, including the transmission of the parasite through its faeces.

Clinical diagnosis is essential, especially in endemic areas where the disease is prevalent.

The acute phase of Chagas disease is easier to treat than the chronic phase, which can lead to severe complications.

Preventive measures include avoiding exposure to kissing bugs and ensuring blood products are screened for the disease.

Chagas disease can also be transmitted through blood transfusions and organ transplants.

Healthcare providers should be aware of the symptoms and risk factors associated with Chagas disease.

The disease is now spreading to parts of the continental US, raising public health concerns.

Ongoing education and awareness of tropical diseases are crucial for healthcare providers.

The conversation highlights the importance of understanding the global health implications of diseases like Chagas.

Chapters

00:00 Introduction to Chagas Disease and Its Relevance

02:36 Life Cycle of the Kissing Bug and Transmission of Chagas Disease

04:58 Understanding the Pathophysiology of Chagas Disease

07:31 Clinical Presentation and Diagnosis of Chagas Disease

10:18 Chronic Phase and Long-term Effects of Chagas Disease

12:41 Treatment Options and Challenges in Managing Chagas Disease

14:51 Preventive Measures and Risk Factors for Chagas Disease

17:39 Chagas Disease in the Context of Global Health

19:42 Take-Home Messages for Healthcare Providers

22:20 Future Considerations and Closing Thoughts

This week, Aebhric talks with students from the University of Pavia in Italy who were attending the Austere and Prehospital Ultrasound course. They discuss innovative teaching methods of ultrasound in medical education, particularly focusing on peer-to-peer learning and the integration of ultrasound training with anatomy education. The students share their experiences with the CoROM ultrasound course, emphasising the practical approach that enhances their understanding of anatomy and clinical skills. They also discuss the challenges of implementing ultrasound training within the medical curriculum and the importance of hands-on experience in mastering ultrasound skills. The conversation highlights the need for supportive faculty and the potential for peer-to-peer teaching to improve learning outcomes in medical education.

Takeaways

The CoROM ultrasound course emphasises practical learning over theoretical knowledge.

Peer-to-peer teaching enhances understanding and retention of ultrasound skills.

Integrating ultrasound training with anatomy education provides a dynamic learning experience.

Students benefit from hands-on experience in real clinical settings.

Ultrasound is a skill-based tool that requires practice to master.

The importance of having supportive faculty in implementing new teaching methods.

Innovative teaching approaches can make learning more engaging and effective.

Students are motivated to continue learning and teaching ultrasound skills.

There is a need for a standardised curriculum for ultrasound training in medical education.

Continuous assessment and practice are key to becoming proficient in ultrasound.

Chapters

00:00 Introduction to the Quorum Podcast and Course Overview

01:04 Experiences with the Quorum Ultrasound Teaching Method

03:26 Integrating Ultrasound with Anatomy Education

06:29 Peer-to-Peer Teaching in Ultrasound Training

08:53 The Role of Ultrasound in Clinical Education

11:43 Challenges and Support in Implementing Ultrasound Training

15:09 Innovative Teaching Approaches in Ultrasound Education

17:57 Understanding Ultrasound Through Hands-On Experience

19:53 Future Plans for Ultrasound Curriculum Integration

23:43 The Importance of Peer-to-Peer Learning in Medicine

26:51 Advice for Beginners in Ultrasound Training

This week, Aebhric talks with Andrew Azelton, a CoROM MSc student, discussing his journey through the EMS field and the challenges faced in pursuing advanced practice as a paramedic. He highlights the lack of master's programs in the U.S. that focus on clinical experience, contrasting it with the more developed systems in Europe. The discussion explores state regulations, the variability of care across different regions, and potential pathways for paramedics to advance their roles within the healthcare system.

They explore the concept of an advanced practice paramedic, comparing EMS systems in the U.S. and Europe, discussing funding challenges, and the potential for creating new pathways for paramedics. It emphasises the need for advanced education and training, as well as the importance of funding in implementing changes in the EMS system. The discussion also touches on the future of paramedic education and offers advice for new medics entering austere medicine.

Takeaways

Andrew Aselton is pursuing a master's program in EMS.

The U.S. lacks master's programs focused on clinical experience for paramedics.

The EMS system in the U.S. is fractured and varies by state.

In Europe, paramedics have their own licenses and greater autonomy.

State regulations have a significant impact on the practice of paramedics in the U.S.

Advanced practice paramedics are emerging in some states, like Kentucky.

There is a need for a structured pathway for advanced practice paramedics in the U.S.

The conversation highlights the differences in EMS practices between the U.S. and Europe.

Waving a magic wand could lead to significant changes in paramedic education.

The discussion raises questions about the future of paramedics in advanced roles.

An advanced practice paramedic should have field experience and a graduate degree.

Hands-on learning and clinical attachments are crucial for paramedic education.

The EMS system in the U.S. varies significantly by state and funding.

Funding challenges hinder the implementation of advanced practice paramedics in the U.S.

EMS is often not considered an essential service, which can impact funding and resources.

Data shows that treatment release can save money and reduce hospital admissions.

A national support system is needed for advanced practice paramedics.

Creating a nurse practitioner pathway for paramedics could be beneficial.

Funding disparities exist between tax-based and for-profit EMS systems.

New medical professionals should seek appropriate training and be prepared for the challenges of working in austere environments.

Chapters

00:00 Introduction to Andrew Aselton and His Journey

02:37 Challenges and Growth in the Master's Program

05:10 The State of EMS Education in the U.S.

07:47 Advanced Practice Paramedics: A Path Forward

10:41 The Future of EMS and Advanced Practice Opportunities

12:00 Designing the Advanced Practice Paramedic

14:52 Comparing EMS Systems: U.S. vs Europe

18:00 Funding Challenges in EMS

21:50 The Role of Advanced Practice Providers

24:08 Creating a New Pathway for Paramedics

29:59 The Future of Paramedic Education

32:59 Advice for New Medics in Austere Medicine

This week, Aebhric OKelly speaks with Giuseppe Mercieca, the CoROM student representative. They discuss his role as a student advocate, the importance of improvisation in medical training, and the college's future aspirations. The conversation also touches on student feedback, career pathways for paramedics, and advice for new students considering a paramedic program.

Takeaways

Giuseppe is a bachelor's student preparing for his clinical placement.

He aims to improve communication and support for students.

High-fidelity scenarios enhance learning experiences.

Improvised medical techniques are crucial in austere environments.

Student feedback is essential for program development.

Career opportunities exist in remote and offshore medical positions.

Networking and volunteering are key to finding jobs.

The college is expanding programs based on student demand.

CPD courses can serve as an introduction to the program.

Collaboration with other medical professionals is vital for progress.

Chapters

00:00 Introduction to Eye Care Course in Malta

02:29 Role of Student Representative

05:09 Improvised Medical Techniques

07:20 Future Aspirations for the College

09:27 Student Feedback and Engagement

11:55 Career Pathways for Paramedics

14:24 Advice for New Paramedic Students