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

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. Yvette shares memorable cases she has dealt with, such as managing bleeding oesophageal varices and performing blood transfusions on board. She offers advice for healthcare professionals interested in working in austere environments.   Takeaways Embarking on a career as a nurse on an expedition ship is a unique journey filled with challenges and opportunities. It's a chance to experience remote areas and provide medical care in diverse environments, a prospect that is both thrilling and inspiring. 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

This week, Aebhric O'Kelly talks with Eric Bauer, a pillar in the nursing and paramedic education community. They discuss his journey with FlightBridgeEd, his passion for medical education, and the impact of global healthcare. The conversation covers the founding of FlightBridg Ed, the importance of education in underserved areas, and the collaboration between FlightBridgeEd and the College. Eric shares insights on the future of medical education and the need for continuous learning and humility in the medical field. Chapters 00:00 Introduction to Eric Bauer and FlightBridge Ed 08:53 The Founding of FlightBridge Ed and its Impact 33:32 The Future of Medical Education and Continuous Learning Takeaways The founding of FlightBridge Ed and its impact on advanced medical training The importance of education in underserved areas and the potential for a nonprofit arm of FlightBridgeEd The collaboration between FlightBridgeEd and the College, focusing on cross-pollination and strategic planning The future of medical education and the need for continuous learning and humility in the medical field

This week, Aebhric talks with Angela Jedlicka, who is the CoROM registrar. They discuss her passion for mentoring students, junior nurses and flight medics.

Dr Ella Corrick discusses her experiences at the Special Operations Medical Association's conference, her work in mountain rescue, and her insights from the AEC instructor development course. She also shares her experiences with traditional American food and her involvement in the CoROM doctoral programme.   Keywords Special Operations Medical Association, conference experiences, mountain rescue, AEC instructor development course, traditional American food, Coram doctoral program   Takeaways Cross-pollination of ideas and practices at the SOMA conference Challenges and experiences in mountain rescue operations Insights from the AEC instructor development course Exploring traditional American food experiences Overview of the CoROM doctoral program   Sound Bites "I enjoyed it so much more than I expected. I don't eat a lot of kind of fried food. I eat a lot of unhealthy food, don't get me wrong." "The doctoral programme that Coram offers is a taught doctorate, by which I mean there are several taught modules which cover aspects such as global health, medical ethics, academic writing, research methodology, and then there is a two -year period if you're full -time to work on your thesis exclusively, so there's still a very heavy researchcomponent."   Chapters 00:00 Insights from the SOMA Conference 05:00 Challenges in Mountain Rescue Operations 20:00 Exploring Traditional American Food 25:00 CoROM Doctoral Program Overview

This week, Aebhric O’Kelly talks with Eric Holmstrøm, who runs the mobile training team and short courses in Malta, and discusses his experiences and upcoming projects. He talks about his background in the Norwegian military and his involvement in training NATO Special Forces. Eric also mentions the success of the tactical paramedic exam and the need for more European representation in the exam. He highlights the popularity of the courses in Malta, such as the Austere and prehospital ultrasound course, the Tropical Travel and Expeditionary Medicine course, and the ICARE course. Eric also discusses upcoming MTTs in Ukraine and the importance of teaching proper tourniquet use. The conversation covers topics related to austere medicine and training in challenging environments. One key theme is using technology, such as the Medic Tool app, to improve documentation and patient care. The app provides alarms for tourniquet and medication timing and the ability to send digital patient information to the next level of care. They also discuss the importance of improvised medicine and the ability to manage critically ill patients with minimal equipment. The conversation also mentions upcoming courses in Sweden, Norway, and Germany and the potential for an Arctic AEC course. Takeaways Eric Holmstrom runs the mobile training team and short courses in Malta. He has a background in the Norwegian military and has trained NATO Special Forces. The tactical paramedic exam has been successful, but there is a need for more European representation. Courses in Malta, such as Austere and prehospital ultrasound, Tropical Travel and Expeditionary Medicine, and ICARE, are popular. Upcoming MTTs in Ukraine will focus on eye care and training instructors. Proper tourniquet use is important, as misuse can lead to amputations. The Medic Tool app provides alarms and documentation features to improve patient care in austere environments. Improvised medicine skills are crucial for managing critically ill patients with minimal equipment. Training courses in Sweden, Norway, and Germany offer opportunities to learn about austere medicine and general practitioner medicine in rural areas. The potential for an Arctic AEC course highlights the unique challenges of working in cold environments. Using technology in austere medicine can help lighten the load and provide better patient care. Chapters 00:00 Introduction and Background 02:23 Experience at SOMA and the Success of the Tactical Paramedic Exam 08:57 Popular Courses in Malta 13:12 Upcoming MTTs in Ukraine 27:33 Enhancing Documentation and Nursing Care 31:18 Improving Information Sharing and Telemedicine 35:08 Upcoming Training Courses 42:35 The Importance of Improvised Medicine 45:26 Using Technology to Enhance Austere Medicine Keywords Eric Holmstrom, mobile training team, short courses, Malta, Norwegian military, NATO Special Forces, tactical paramedic exam, European representation, Austere and prehospital ultrasound, Tropical Travel and Expeditionary Medicine, ICARE, MTT, Ukraine, tourniquet use, austere medicine, training, technology, documentation, patient care, Medic Tool app, tourniquet, medication timing, improvised medicine, courses, Sweden, Norway, Germany, Arctic AEC course

This week, Aebhric O'Kelly talks with Jason Jarvis about the operational importance of helminths. Takeaways Tropical medicine focuses on helping people in tropical areas with high rates of parasitic worms and tropical diseases. Parasitic worms are classified into species, including Annelida, Nematodes, and Platyhelminths. Worm infestations are more common in developing countries and rural areas. Diagnosing and treating worm infestations are crucial, especially in remote and austere environments. Various worms, such as pinworms, filariasis, schistosomiasis, and tapeworms, can cause significant health problems. Prevention measures, such as avoiding contaminated food and water, are essential in reducing the risk of worm infestations. Ask patients about their travel history and potential exposure to parasitic worms Different species of trematodes have other risk factors and manifestations Diseases and non-battle injuries (DNBI) can have a significant impact in military settings Climate change is contributing to the spread of tropical diseases in new areas   Chapters 00:00 Introduction and Background 02:24 Classification of Parasitic Worms 07:53 Prevalence of Worm Infections 24:39 Prevention and Conclusion 34:50 The Importance of Travel History 37:23 The Role of Recent Travel in Diagnosis 45:57 Diseases and Non-Battle Injuries (DNBI) in Military Settings 49:38 Climate Change and the Spread of Tropical Diseases   Sound Bites "I enjoy having a microscope and little friends to look at." "Approximately four billion people in the world are infected with one type of helminth or another." "Many of these roundworms and helminths cause problems we'll see as medics." "We've got five species of trematodes, five different species of schistosomes that are clinically important to us in human medicine." "When doing a clinical workup, it's important that we ask our patients where they have been?" "The sample is great and universal, but that R is vastly important for recent travel."

This week, Aebhric talks with Dr Sam Slishman, who is a medical doctor and inventor of the Slishman traction splint and other medical kit. https://slishmanpressurewrap.com/

This week, Aebhric O'Kelly talks with Dr Giulio Novarese, an operational medic for many different tactical organisations. They discuss lessons learned in operational medicine over the decades and discuss teaching for Dr John Hagmann and Deployment Medicine International.

This week, Aebhric talks with Cole Shaver and Greydon Ratushny, who are Critical Care Paramedics working in British Columbia, Canada. They discuss their experience in the MSc Austere Critical Care programme and what it is like to work as a paramedic in Canada.