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

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/TakeawaysUnderstanding 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.Chapters00:00 Introduction to Managing Dental Pain00:57 Understanding Sensitivity: Duration and Location06:32 Identifying Causes of Sensitivity12:12 Managing Sensitivity with Home Remedies12:40 Addressing Food-Related Pain18:37 Techniques for Filling Cavities29:11 Improvising Without Instruments29:39 The Role of Salt Water in Oral Health34:53 Managing Tooth Pain and Food Impaction39:06 Understanding Fillings and Their Complications45:42 Gumboils: Causes and Management49:48 Skills for Remote Dental Care56:04 Cultural Sensitivity in Dental Treatment

This week, Aebhric O’Kelly is again joined by Dr Sam Slishman. They discuss medical innovation and Aebhric’s invention called the AirBase. They discuss medical innovation, focusing on inventions, such as the Slishman Traction Splint and the Airbase. They emphasise the importance of evidence-based medicine, particularly in the use of tourniquets and bleeding control techniques. The discussion also addresses the challenges of marketing medical devices, the role of 3D printing in healthcare, and advice for aspiring medical professionals in austere environments.TakeawaysInnovations in medical devices can significantly impact patient care.Tourniquets are effective but should be used with caution.Direct pressure is often more effective than tourniquets for certain injuries.The Airbase serves multiple purposes during emergencies.3D printing can revolutionise medical device development.Standard of care is not static and can vary by location.Patient comfort is crucial in emergency medicine.Research in austere medicine faces unique challenges.Continuous learning and adaptation are essential for medics.Chapters00:00 Introduction to Dr Sam Slishman01:31 Innovations in Medical Devices04:25 Tourniquet Efficacy and Research09:38 Direct Pressure vs. Tourniquets17:50 The Airbase: A New Medical Tool24:14 Challenges in Medical Device Development31:20 The Role of 3D Printing in Medicine39:19 Advice for Aspiring Medics

This week, Aebhric O’Kelly is joined by Rabbit, who is an EU SOF medic who shares his extensive background in military medicine and his current focus on researching the effects of higher education on individuals with PTSD. He discusses his personal experiences with PTSD and how education has played a role in his recovery. The conversation also touches on the importance of engaging the younger generation in military medicine, adapting to the changing battlefield, and the need for collaboration between special operations and conventional forces. Rabbit emphasises the significance of education and teamwork in improving outcomes for those affected by trauma.TakeawaysRabbit has a rich background in military medicine and education.His PhD research focuses on PTSD and higher education.Education can provide hope and support for individuals with PTSD.There is a need for specialised programs for military personnel with PTSD.Engaging the younger generation is crucial for the future of military medicine.Collaboration between special operations and conventional forces is essential.Rabit emphasises the importance of teaching and enabling others in medicine.The battlefield is evolving with new technologies and challenges.Personal experiences with PTSD can inform research and treatment.Teamwork is vital in prolonged field care situations.Chapters00:00 Introduction to Rabbit and His Background02:52 Exploring PTSD and Higher Education10:22 Personal Experiences with PTSD and Education17:12 The Role of SOMA and Engaging the Younger Generation26:57 Advice for New Medics and Collaboration in Medicine

Zach Andrews, an active-duty U.S. Army SOF medic and rural critical care paramedic, shares his journey through an MSc in Austere Critical Care. He dives into his research on microcirculation in resource-limited settings, detailing the development of the Andrews Microcirculatory Severity Scale (AMSS). Zach emphasizes the importance of noninvasive methods for assessing microcirculation and discusses his ambitions to validate AMSS in real-world scenarios while promoting education in rural healthcare. His insights on collaborative problem-solving in austere environments are both inspiring and practical.

Bill Vasios, a physician assistant and former 18 Delta, shares his expertise in prolonged field care and nutrition. He discusses the critical role of enteral and parenteral feeding in austere environments, emphasizing early nutritional intervention to enhance recovery. Vasios highlights practical techniques such as nasogastric tube placement and the importance of interdisciplinary collaboration for effective care plans. The conversation also addresses challenges in maintaining nutrition during transport and the psychological benefits of oral intake for patients.

Join a riveting discussion on managing sepsis in remote care. The hosts dive into assessing septic patients with focused history and trending vitals. Learn about the importance of early warning systems like QSOFA and NEWS2. They explore the critical role of point-of-care ultrasound and monitoring techniques, including MAP and urine output. Antibiotic strategies in austere settings are highlighted, alongside malaria treatment protocols. The episode wraps up with innovative care methods like telemedicine consultations and the FLASH mnemonic for risk assessment.

Bill Vasios, an experienced clinician in austere care, and Rhod Jordan, a clinical practitioner focused on remote medicine, dive into the intricacies of burn management. They discuss critical airway management, innovative fluid resuscitation strategies, and the importance of patient involvement in care. The duo highlights methods like the use of topical morphine for pain relief and the necessity of accurate assessments to prevent infection. Their insights reveal that managing burns is as much about art as it is about science.

This is a brief introduction to the AI roundtable to be held at the Medicine in the Mediterranean conference, running from 31 January to 2 February. You can join us using the link below.https://corom.edu.mt/medicine-in-the-mediterranean-2026/

This is a brief introduction to the AI roundtable to be held at the Medicine in the Mediterranean conference, running from 31 January to 2 February. You can join us using the link below.https://corom.edu.mt/medicine-in-the-mediterranean-2026/

This is a short introduction to the two lectures that Dr Slaven Bajic will be giving at the Medicine in the Mediterranean conference running from 31 January to 2 February. You can join us using the link below.https://corom.edu.mt/medicine-in-the-mediterranean-2026/