In this episode of the World Extreme Medicine Podcast, we explore one of the most talked-about studies in pre-hospital trauma care: “Beyond IO and IV - Trauma Lines in Pre-Hospital Haemorrhagic Shock.”

Host Eoin Walker is joined by Paolo Pallavicini, final-year medical student and research fellow with London’s Air Ambulance and the Centre for Trauma Sciences, to unpack a groundbreaking study analysing over 8,000 trauma patients.

They discuss:

• Why standard IV and IO access can be inadequate in exsanguinating trauma

• How trauma lines can double pre-hospital blood delivery rates

• Success, complication, and survival outcomes from the study

• The future of central venous access in pre-hospital care

Paolo also offers key insights into the realities of working in a chaotic roadside environment, the importance of governance and training, and how clinical risk-benefit decisions are made when every second counts.

Read the paper here.

Find out more about London Air Ambulance Service.

From conflict zones to refugee camps, from neonatal units to global health leadership—nurses are at the heart of humanitarian medicine.

In this episode, host Eoin Walker is joined by Elsa Afonso and Marcus Wootton from the Royal College of Nursing’s International Academy. Together they bring decades of frontline and strategic experience with organisations including MSF, UNICEF, and academic institutions worldwide.

We explore:

• What drives nurses into humanitarian work

• Lessons learned from conflict zones, HIV & AIDS programs, and neonatal care

• The power of education and capacity-building in fragile health systems

• Leadership, advocacy, and cultural adaptability in global health

• The future of nursing in humanitarian response

A powerful conversation about resilience, leadership, and the global role of nurses.

Important links:

• RCN International Academy
  

• Phoenix Nursing Myanmar
  

• RCN Report: Care Amongst the Chaos – The Voices of Nurses Working in Conflict (PDF)

At just 28 years old, Rachel Smith is preparing to make history.

Diagnosed with type 1 diabetes before her third birthday, she has never let her condition define her limits. Already having summited the highest peaks in South America, Africa, and Australia, Rachel now sets her sights on Mount Vinson, Antarctica’s highest peak at 4,892m.

In this conversation with host Eoin Walker, Rachel shares her remarkable journey:

• Growing up as the first child in Northern Ireland to use an insulin pump

• How evolving technology has supported her ambitions in medicine and mountaineering

• The unique physiological challenges of managing diabetes at high altitude and in extreme cold

• The balance between risk, resilience, and pushing human potential

• Her partnership with Breakthrough T1D and the importance of raising awareness

This is a story of grit, adaptability, and proving that chronic conditions don’t have to hold you back from extraordinary goals.

Learn about Rachel and follow her journey here.

Find out more about Breakthrough T1D.

In this episode of the World Extreme Medicine Podcast, host Eoin Walker speaks with Leif Rognås (consultant anaesthetist and clinical lead with the Danish Air Ambulance) and Karina Damsgaard (psychologist specialising in emergency medicine and resilience in high-performance teams).

Together, they unpack the concept of Compassionate Debriefing, an approach designed to replace traditional “honest debriefs” with something more supportive, psychologically safe, and effective for learning.

The discussion explores:

• Why traditional debrief models can fall short in complex, high-stakes environments

• How compassionate debriefing fosters resilience, retention, and psychological safety

• Practical steps for shifting from critique to care in post-mission reflections

• What further research is needed to embed this approach into HEMS and beyond

A must-listen for clinicians, leaders, and anyone interested in the future of healthcare culture, wellbeing, and team performance.

You can read Karina's paper 'Common Mental Health Symptoms in Personnel Working in Helicopter Emergency Medical Services: A Systematic Review' here.

In this episode of the World Extreme Medicine Podcast, host Eoin Walker is joined by Hannah Lock, an emergency medicine doctor, expedition specialist, and seasoned mountaineer with experience across six continents. Together, they go beyond the basics of acute mountain sickness (AMS) to explore the lesser-known high-altitude illnesses and how they’re managed in the field.

From HAPE and HACE to retinal haemorrhages, chronic mountain sickness, high-altitude cough, frostbite, and the impact of altitude on muscle mass and sleep, this deep dive unpacks the realities clinicians and expedition leaders face at altitude.

Hannah also shares insights on managing risk in clients with comorbidities, new technologies shaping safety in the mountains, and practical strategies for hydration, acclimatisation, and performance at elevation.

Learn more about Hannah and her work here.

In this episode of the World Extreme Medicine Podcast, host Eoin Walker speaks with Luke Apisa about his extraordinary journey from wilderness medicine to space medicine.

Luke shares insights from treating climbers at 14,000 feet in Nepal, supporting ultramarathon runners in the deserts of Arizona and Utah, and helping to develop future medical capabilities for space exploration with NASA and SpaceX.

From designing innovative altitude breathing devices to researching pulmonary edema treatment at high altitude, Luke’s career sits at the cutting edge of medicine in extreme environments.

Discover how wilderness and space medicine connect, what it’s like to practice in the Himalayas, and the challenges facing long-duration spaceflight.

In this episode of the World Extreme Medicine Podcast, Eoin Walker sits down with chef, explorer, and researcher Mike Keen to unpack an extraordinary Arctic journey.

Mike kayaked the entire 3,000km length of Greenland’s rugged west coast, surviving solely on a traditional Inuit diet of seal, whale, dried fish, and wild foraged plants.

Working with researchers at King’s College London, he tested how an ancestral, high-fat, low-carb diet impacts health, endurance, and resilience in one of the most extreme environments on Earth.

We explore:

• The science behind ancestral diets and their potential to improve health and performance

• The physical and mental challenges of solo Arctic travel

• Climate change impacts on Greenland’s ice and wildlife

• Lessons from indigenous communities on food, sustainability, and survival

  
  

Follow Mike’s work:

Website

Instagram

In this episode of the World Extreme Medicine Podcast, host Eoin Walker is joined by Luca Carenzo, intensive care consultant, and Federico Emiliano Ghio, critical care nurse and medical lead for high-altitude emergency services in Livigno, Italy, one of the busiest ski resorts in the Alps.

From sub-zero slopes and altitude-induced illness to managing cardiac arrests at 2800m with no hospital in sight, Federico and Luca explore the real-time challenges of delivering care in extreme alpine environments.

Featuring:

• Advanced pain relief protocols in –20°C conditions

• How fluids freeze, defibs fail, and ventilators adapt

• Why governance matters when you don’t have paramedics

• Planning for the Milan-Cortina 2026 Winter Olympics

• The future of ski patrol: drones, slope-side diagnostics, and real-time triage

This is high-acuity medicine, on ice.

📍 This session was recorded remotely in December 2024.

In this episode of the World Extreme Medicine Podcast, host Eoin Walker speaks with Mardi Steere, Executive General Manager of Medical and Retrieval Services at the Royal Flying Doctor Service, about a groundbreaking innovation in rural healthcare delivery, the Virtual Emergency Centre (VEC).

Operating in one of the most remote regions of Australia, the VEC integrates telehealth, remote diagnostics, and trained layperson intervention to deliver hospital-grade care in areas where no medical staff are physically present. Mardi shares the origins of the project, the role of technology like Starlink and wearables, and how the model is saving lives and reducing retrieval costs.

We discuss the governance and logistics behind delivering high-risk medications remotely, the scalability of the model, and how learnings from Africa, India, and Rwanda are being adapted to suit Australia’s unique geographical challenges.

Mardi also reflects on the future of healthcare innovation, from drone-delivered AEDs to virtual ultrasonography and beyond.

Learn more about the VEC and the work of the Royal Flying Doctor Service: https://www.flyingdoctor.org.au

What happens when your first major expedition is one of the world’s Seven Summits?

In this episode of the World Extreme Medicine Podcast, emergency medicine doctor Ffyon Smith is joined by Kacylia Roy Proulx, a medical student at McGill University and President of her university’s Wilderness Medicine Society.

Together, they explore Kacylia’s experience of climbing Mount Kilimanjaro, from early trail excitement to summit-day exhaustion, team dynamics, and the real-time challenge of acute mountain sickness.

This is an honest, insightful conversation about why we climb, how we build mental resilience, and what expedition medicine means to someone just starting out.

You’ll hear about:

• The reality of altitude acclimatisation and AMS symptoms

• Navigating ethical dilemmas on the trail

• How expedition teamwork makes or breaks the journey

• Finding identity, purpose, and introspection at high altitude

• Advice for medical students looking to break into expedition medicine

📝 Please note: Due to internet connection issues during recording, there’s a slight delay or glitch in Kacylia’s audio and video at times. Thanks for bearing with us, the conversation is well worth it.

Please note that this session was recorded in January 2025.