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

This week, Aebhric O’Kelly is joined by Rhod Jordan and Bill Vasios as they discuss how to create an ICU in the jungle. They discuss setting up and managing a remote ICU in jungle environments, focusing on site selection, equipment, logistics, and medical considerations for field medics and responders.Chapters00:00 Introduction and Content Overview00:41 Premise and Scenario Setup for Jungle ICU01:33 Site Selection Criteria in Jungle Environments02:19 Environmental Challenges: Rain, Creepy Crawlies, and Hypothermia03:08 Privacy, Lighting, and Visibility in Remote Settings03:53 Creating a Functional Jungle Clinic Layout04:34 Lighting and Visibility Strategies at Night05:31 Accessibility and Zone Planning in Field Clinics06:09 Assessing Capacity: Multiple Patients and Beds07:01 Monitoring Equipment: Minimum and Advanced Options08:04 Power, Water, and Communication Logistics08:42 Prolonged Casualty Care and Exfil Planning09:59 Medical Supplies: Drugs, Medications, and Sterility10:42 Camp Craft and Bushcraft Skills for Remote Medics11:35 Wildcrafted Plants and Improvised Medicine12:12 Communication Strategies in Dense Canopy Environments13:08 Team Coordination and Role Assignments14:08 Dealing with Critical Patients and Exfil Decisions14:57 Infection Control and Hygiene in the Field15:54 Personal and Team Safety Measures16:39 Additional Non-Medical Gear for Remote Operations17:16 Lighting Solutions and Bug Management at Night18:08 Medications and Drugs for Jungle Medicine18:45 Over-the-Counter and Emergency Medications19:34 Special Considerations for Malaria and Vector-borne Diseases20:04 Infection Control and Hygiene Protocols20:56 Water Purification and Boiling Techniques21:35 Field Sterilisation and Maintaining Sterility22:25 Managing Glove Supplies and Hand Hygiene23:00 Dermatology and Common Skin Conditions23:38 Malaria Prophylaxis and Treatment Strategies24:32 Infection Control and Personal Hygiene25:14 Power and Charging Solutions in Remote Areas26:04 Water Supply and Filtration Methods26:45 Field Sterilisation and Water Boiling Techniques27:21 Camp Craft and Bushcraft Skills for Field Survival27:56 Wildcrafting and Medicinal Plants in the Jungle28:47 Communication Equipment and Strategies in Dense Canopy29:41 Team Coordination and Medical Decision-Making30:17 Water Safety and Potable Water Management31:05 Team Safety and Preventing Illness in the Field32:04 Bushcraft Skills for Remote Medical Operations32:58 Survival Skills and Improvised Medicine33:48 Communication Tools and Emergency Signalling34:28 Exfil Planning and Evacuation Protocols35:14 Prolonged Casualty Care and Equipment Needs36:01 Medical Kits and Supplies for Extended Operations36:51 Decision-Making in Critical Situations37:23 Non-Medical Essentials: Woobies, Tools, and Comfort Items38:10 Maintaining Morale and Team Cohesion38:42 Summary and Final Tips for Jungle ICU Setup

This week, Aebhric O'Kelly talks with Eirik Holmstrom about the newly updated MIC MEC and Pharm CPD courses, which have been combined into a new online CPD programme called 'Austere Primary Care.' This APC is a package that includes Disease and Non-Battle Injuries (DNBI) encountered on expeditions, in military operations, at remote clinical sites, and in resource-limited environments. You can find up-to-date information on our course webpage https://corom.moodlecloud.com/

This week, Aebhric O’Kelly talks with Dr Csaba Dioszeghy about the redesign and upgrade of the MSc Austere Critical Care programme. Every 5 years, the degree programmes undergo reaccreditation. The College has decided to double the programme's size following feedback from graduates. Chapters00:00 Introduction to the New Masters of Austere Critical Care Program01:03 The Complete Rehaul of the Curriculum01:57 Flexibility and Pathways in the New Program02:51 Comparison with UK Advanced Practice Programs03:46 Four Pillars of the New Curriculum04:41 Special Focus: Medical Support to Resistance Healthcare07:02 Innovations in Improvised Medicine08:21 Practical Modules: Ultrasound and Tropical Medicine09:44 Student Research and Thesis Projects11:30 Program Launch and Future Outlook

This week, Aebhric O’Kelly is joined by Splinter Knoppert, who is a 2nd-year BSc student attending the Intensive Care for Austere and Remote Environments (ICARE) course in Malta. They discuss his experiences during the week, including the practical skills, teamwork, resource-limited environments, and innovative teaching methods.Aebhric is then joined by Dr Csaba Dioszeghy, and they discuss the origin of the ICARE course 14 years ago. Chapters00:00 Introduction to the ICARE Course in Malta00:58 BSc Student Splinter talks about his experience in ICARE02:04 Diverse Participants and Their Backgrounds02:53 Skills Gained: Ultrasound, Central Lines, and Improvisation03:47 Blue Time: Practice and Muscle Memory05:06 Overview of Scenarios: Crush Injuries, Tropical Diseases, and Trauma05:52 Building a Remote ICU: Key Components and Challenges06:30 Setting Up an ICU in the Jungle: Precautions and Planning07:14 Impact on Paramedic Practice and Future Plans08:16 Introduction to Dr Csaba Dioszeghy and Critical Care Education09:06 Origins of Critical Care Teaching and Collaboration10:51 Simplifying Critical Care for Resource-Limited Settings13:07 Development of the MSc in Critical Care14:29 Teaching Principles: Using Critical Care Without Fancy Equipment15:26 From Aeromedical Transport to Specialised Critical Care Training16:22 Addressing the Gap in Critical Care Education16:47 Curriculum Focus: Basic to Advanced Critical Care Concepts17:43 Teamwork and Non-Technical Skills in Critical Care18:40 The Importance of Crew Resource Management20:20 Simulation-Based Training for Teamwork and Skills21:15 Elective Courses and International Participation22:10 The Future of the MSc Program and Crew Resource Management24:04 Technical Skills Practice: Ultrasound, Suturing, and Intubation24:57 The Value of the iCare Course and Its Evolution25:50 Upcoming Deep Dive into the Masters of Austere Critical CareWe will have questions about the episode icon, which is a picture of an ancient carving of the Rod of Asclepius. This is on a church outer wall in Mdina, Malta, with origins in the Knights Hospitaler.

This week, Aebhric O'Kelly and Bill Vasios host another CoROM Conversations. This month, they discuss the comprehensive nursing interventions, training strategies, and best practices for prolonged field care, emphasising simplicity, effective handovers, and patient safety.https://youtu.be/U63NaFLaxZ0Chapters00:00 Introduction to Nursing Interventions00:53 Exploring CPGs and Nursing Interventions02:25 Comparing Non-Medical and Medical Personnel Guidelines05:50 Simplifying Nursing Interventions for Non-Medical Personnel09:05 Wound Care Disparities in Guidelines11:05 Identifying Gaps in Nursing Care Guidelines12:07 The Need for Simplified Guidelines16:15 Importance of Structured Handover24:03 Trending and Serial Assessment in Patient Care26:17 Understanding Patient Comfort and Injury Prevention27:36 The Importance of Hands-On Nursing28:32 Pressure Injury Prevention Strategies29:52 Efficient Patient Care Techniques31:17 Pain Management in Nursing33:12 Pulmonary Hygiene and Patient Mobility35:14 Nutrition and Hydration in Patient Care35:37 The Role of Checklists in Medical Practice41:33 Infection Prevention and Wound Care43:34 Final Thoughts on Patient Care Practices44:01 Any Questions?

A deep dive into swimming-induced pulmonary oedema, covering who gets it and why context like altitude and exertion matter. Case vignettes and field assessment steps bring the condition to life. Practical lung ultrasound techniques and immediate management actions are explained. Research findings, prevalence numbers, and thoughts on prevention and prophylaxis round out the conversation.

This week, Aebhric O'Kelly interviews four students from our BSc in Remote Paramedic Practice programme. They discuss the Tropical Travel and Expedition Medical Skills course (TTEMS).

This week, Aebhric O'Kelly is joined by Dr Ella Corrick, Dr Sean Bilodeau and Dr Tom Mallinson as the CoROM faculty attend The Big Sick conference hosted by Air Zermatt. CoROM gave three lectures and two workshops including the Improvised Medicine workshop and the Austere Emergency Care workshop. TakeawaysThe challenge of compressing prolonged field care education into short workshops.Engagement of diverse professional backgrounds enhances learning experiences.Realistic simulations provide valuable insights into emergency care.The importance of bridging the gap between pre-hospital and hospital care.Innovations in emergency medicine practices are crucial for improving patient outcomes.Data plays a significant role in shaping emergency response strategies.Continuous education is essential for adapting to new medical practices.The value of informal discussions among professionals at conferences.Understanding the unique challenges faced by pre-hospital care providers.The need for a shift in perception regarding the role of EMS professionals.Chapters00:00 Introduction to the Big Sick Conference02:34 Challenges in Prolonged Field Care Education05:43 Diverse Professional Backgrounds in Medical Education08:09 Learning Through Realistic Simulations11:04 Bridging the Gap Between Pre-Hospital and Hospital Care13:39 Innovations in Emergency Medicine Practices16:46 The Role of Data in Emergency Response19:10 Future Directions in Pre-Hospital Care21:39 Conclusion and Reflections on the Conference

Burjor Langdana, a wilderness and expedition dentist who teaches remote, austere dental care. He talks about assessing dental sensitivity by location and duration. He covers improvised techniques for pain relief and temporary fillings. He discusses when to use antibiotics, safe analgesia combinations, and working respectfully with local cultures.

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