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

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

The College releases a new podcast each Friday discussing wilderness medicine, austere healthcare and emergency medicine. Host Aebhric O'Kelly invites guests from around the world working in remote, austere and resource-limited environments.

  1. 4 DAYS AGO

    115-New Clinical Placements in Ghana

    This week, Aebhric, John Clark and Emmanuel Acheampong discuss a new collaboration in Kumasi, Ghana. The College is creating a collaboration with Komfo Anokye Teaching Hospital to enhance medical education and training. They discuss the hospital's capabilities, the emergency department's operations, the triage system, and the potential for student placements and training initiatives. The discussion highlights the importance of building sustainable relationships and the shared challenges faced in healthcare across different regions. https://kath.gov.gh/ Takeaways • The visit aims to explore collaboration opportunities with Komfo Anokye Teaching Hospital. • The hospital has a wide range of departments, including emergency medicine. • The emergency department has evolved significantly over the years. • Triage is a critical component of patient flow in the emergency department. • There is a growing emphasis on training and certification for healthcare professionals. • The collaboration will provide advanced clinical experiences for students. • Building relationships is essential for successful partnerships in healthcare. • The hospital aims to implement BLS and ACLS training for all staff. • Future plans include establishing a sustainable relationship that benefits both organisations. Chapters 00:00 Introduction and Context of the Visit 04:04 Emergency Department Insights 09:12 Triage System and Patient Flow 11:31 Collaboration Opportunities and Student Placements 15:06 Training and Certification Initiatives 17:08 Future Plans and Sustainable Relationships 19:01 Advice for New Medical Professionals

    21 min
  2. 114-Nunavut, Canada Nurse, Anke Krug

    OCT 25

    114-Nunavut, Canada Nurse, Anke Krug

    This week, Aebhric talks with Anke Krug, who is a community nurse in Nunavut, Canada, and shares her experiences and challenges in providing healthcare in a remote Arctic environment. She discusses the complexities of medevac nursing, the environmental considerations for patient care, and the importance of collaboration and communication in remote healthcare settings. Anke also highlights the evolving roles in nursing and paramedicine, the need for ongoing training and education, and the significance of patient assessment and decision-making in austere conditions. The conversation concludes with advice for new nurses entering the field. Takeaways The Arctic presents unique challenges for healthcare delivery. Medevac nursing requires careful preparation and environmental awareness. Collaboration with other healthcare professionals is essential. Telehealth plays a crucial role in remote patient care. Nursing roles are evolving to include advanced paramedic skills. Patient assessment is critical in making treatment decisions. Guidelines for prolonged field care can enhance patient outcomes. Technology is improving healthcare delivery in remote areas. Community engagement is essential for mental well-being in harsh environments. New nurses should seek mentorship and focus on continuous learning. Chapters 00:00 Introduction to Community Nursing in Nunavut 03:00 The Challenges of Medivac Nursing 05:54 Environmental Considerations in Patient Care 08:59 Collaboration and Communication in Remote Healthcare 12:12 Evolving Roles in Nursing and Paramedicine 14:58 Training and Education for Remote Healthcare 18:05 Patient Assessment and Decision Making 20:59 Utilising Guidelines for Prolonged Field Care 23:52 Technology and Innovations in Remote Medicine 27:09 Community Engagement and Fun in Nunavut 30:01 Advice for New Nurses in Austere Environments

    40 min
  3. 113-MERP with Rhod Jordan

    OCT 18

    113-MERP with Rhod Jordan

    This week, Aebhric OKelly speaks with Rhod Jordan, a remote paramedic working in Kurdistan, about the intricacies of the Medical Emergency Response Plan (MERP). Rhod shares his experiences and insights on the importance of planning, communication, and training in emergency medical situations. He emphasises the need for thorough assessments of local medical facilities and the significance of building relationships with local healthcare providers. The discussion also covers the training and development of medical teams in austere environments and advice for new medics entering the field. Takeaways The MERP is essential for efficient emergency response. Communication protocols are critical in emergencies. Regular training and drills improve readiness. Local medical facilities should be audited before use. Building relationships with local healthcare providers is vital. Documentation and evaluation are vital to improving plans. New medics should seek guidance from experienced professionals. Understanding local laws regarding medical supplies is crucial. Prolonged field care concepts are essential in remote areas. Utilising technology can enhance patient care and communication. Chapters 00:00 Introduction to Remote Paramedicine in Kurdistan 01:21 Understanding the Medical Emergency Response Plan (MERP) 03:37 Components of a Successful MERP 15:06 Communication and Coordination in Emergencies 22:48 Evaluating Local Medical Facilities 36:20 Training and Development for Medical Teams 41:39 Advice for New Medics in Austere Environments

    41 min
  4. 112-NSOCM Past and Future with PAC

    OCT 11

    112-NSOCM Past and Future with PAC

    This week, Aebhric chats with Dr Peter Anders Christiansen (PAC), a former senior medical officer in the Danish Special Forces, who discusses his work in PTSD treatment using Stellate Ganglion Block (SGB) and his role in developing the Nordic Special Operations Combat Medic Course. He shares insights on the effectiveness of SGB for veterans suffering from PTSD, the challenges of medical training in NATO countries, and the future of special operations medical education in Europe. PAC also offers valuable advice for new medics entering austere medical environments. safenordicsolutions.com stellatumklinikken.com Takeaways SGB is effective for treating hyperarousal in PTSD. The amygdala's reset can significantly improve PTSD symptoms. The Nordic Special Operations Combat Medic Course was developed to standardise training. Collaboration among Nordic countries was vital to creating the NSOC. Future funding and strategic changes will impact medical training in Europe. Interoperability among NATO countries is essential for effective medical support. Cultural differences affect the implementation of medical training across nations. New medics must adapt to austere medical environments. Improvisation is crucial in emergency medical situations. The importance of continuous education and recertification for medics. Chapters 00:00 Introduction to Dr. Peter Anders Christiansen 01:31 Innovative PTSD Treatment: Stellate Ganglion Block 12:34 The Nordic Special Operations Combat Medic Course 34:34 Future of NSOCM and European Medical Training 49:27 Advice for New Medics in Austere Medicine

    42 min
  5. 111-PCC vs PFC with Jamie Riesberg

    OCT 4

    111-PCC vs PFC with Jamie Riesberg

    This week, Aebhric O’Kelly talks with Dr Jamie Riesberg, who created the separation of Prolonged Casualty Care (PCC) from Prolonged Field Care (PFC). Dr Riesberg has extensive experience in military medicine, focusing on the evolution of prolonged field care and the transition from the Global War on Terror (GWOT) to future conflicts. He emphasises the importance of adapting medical training to current battlefield realities, including lessons from Ukraine. Dr Riesberg advocates for a shift in mindset towards PCC and the need for continuous hands-on experience for medics. They also discuss the challenges posed by policy and training limitations, urging a more robust approach to medical care in combat situations. Takeaways Prolonged field care is essential for future military operations. Past conflicts influence the evolution of military medicine. NATO plays a crucial role in standardising medical training. Lessons from Ukraine highlight the need for adaptability in medical care. Medics must be prepared for prolonged care situations. The environment significantly impacts medical decision-making. Continuous training and hands-on experience are vital for medics. Policy changes are necessary to enhance medical training opportunities. Expectant casualty management is a growing concern in military medicine. Curiosity and creativity are critical traits for success in austere medicine. Chapters 00:00 Introduction to Dr. Jamie Riesberg 02:54 The Evolution of Military Medicine 05:48 The Importance of Prolonged Field Care 09:02 Transitioning from GWAT to LISCO 12:04 The Role of NATO in Medical Training 15:00 Lessons from Ukraine and Future Conflicts 17:49 The Concept of Prolonged Casualty Care 20:51 Challenges in Training and Policy 24:05 The Future of Medical Care in Combat 27:03 Advice for New Medics in Austere Medicine

    53 min
  6. 110-New Faculty of Operational Medicine with Eirik and Laszlo

    SEP 27

    110-New Faculty of Operational Medicine with Eirik and Laszlo

    This week, Aebhric O’Kelly talks with Eric Holmstrom and Laszlo Hegedus about creating a new faculty within CoROM. They discuss their recent activities, including organising law enforcement competitions and teaching various medical courses. They highlight the importance of hands-on training and the need for continuous learning in operational medicine. The conversation also touches on the upcoming developments at the college, such as the establishment of the Faculty of Operational Medicine and the implementation of new monitoring devices for patient care. They emphasise the importance of documentation and research in improving medical practices. The discussion concludes with advice for healthcare professionals starting their careers. keywords operational medicine, law enforcement competitions, medical courses, hands-on training, continuous learning, college developments, Faculty of Operational Medicine, monitoring devices, documentation, research, advice for healthcare professionals Takeaways Hands-on training and continuous learning are essential in the field of operational medicine. The college is establishing the Faculty of Operational Medicine to bring together subject matter experts and advance the field. Implementation of new monitoring devices and documentation systems can improve patient care and facilitate research. Healthcare professionals should be bold and ask questions, seek learning opportunities, and get involved in patient care. Interoperability and adherence to evidence-based guidelines are crucial in providing quality medical care. Chapters 00:00 Introduction and Recent Activities 03:16 Teaching Experiences and Motivated Students 06:05 Improvisation and Moulage Training 09:20 The Importance of Tropical Medicine 13:02 The Growing Momentum of Ultrasound Training 17:59 The Need for Prolonged Field Care and AEC Courses 19:39 The Faculty of Operational Medicine 22:16 Implementing New Monitoring Devices and Documentation Systems 27:29 NEAMT Certification and Offering Additional Courses 29:39 Advice for Healthcare Professionals Starting Their Careers

    30 min
  7. 109-Kibosho District Hospital with Cole and Greydon

    SEP 20

    109-Kibosho District Hospital with Cole and Greydon

    Cole Shaver and Graydon Ratushny are paramedics working in British Columbia who share their experiences working in Kibosho District Hospital in Moshi, Tanzania, as part of the Austere Critical Care Master's program. They discuss the challenges of practising medicine in a resource-limited setting and the importance of improvising and adapting clinical skills to the local context. They highlight basic clinical assessments, such as percussion and auscultation, and the value of non-technical skills in making diagnoses and providing care. They also discuss the social determinants of healthcare and the impact of a user-pay system on patient access to medical services. The conversation explores the themes of telehealth and remote health assessments, the importance of old-school clinical skills, the resilience of patients in resource-limited settings, the use of CPAP in rural healthcare, the value of the CoROM Field Guide, and the benefits of international healthcare experiences. takeaways Adapting clinical skills to a resource-limited setting is crucial for providing effective care. Basic clinical assessments, such as percussion and auscultation, can be valuable tools without advanced diagnostic equipment. Non-technical skills, such as observation and clinical gestalt, play a significant role in making diagnoses and guiding treatment decisions. The social determinants of healthcare, including a user-pay system, can profoundly impact patient access to medical services. Telehealth and remote health assessments are shaping the future of healthcare, allowing for transmitting imaging and audio findings to specialists in established facilities. Old-school clinical skills, such as physical assessments and clinical signs, are underappreciated in Western medicine but highly relevant in resource-limited settings. Patients in rural and remote areas are often more resilient than expected, and healthcare providers can take a step back and gather more information before intervening. CPAP devices can effectively manage respiratory distress in resource-limited settings, and collaborative teaching and learning between healthcare professionals from different backgrounds is invaluable. The CoROM Field Guide is a valuable resource for remote and rural clinicians. It provides essential information and prompts when data connectivity is limited. International healthcare experiences provide a broader perspective and appreciation for different healthcare systems and practices, fostering collaboration and knowledge sharing. Chapters 00:00 Introduction and Background 03:00 Adapting Clinical Skills in a Resource-Limited Setting 08:34 The Value of Basic Clinical Assessments 13:42 The Role of Non-Technical Skills in Diagnosis 20:04 The Impact of Social Determinants on Healthcare Access 29:48 The Future of Healthcare: Telehealth and Remote Assessments 32:23 The Value of Old School Clinical Skills in Resource-Limited Settings 35:35 Resilience of Patients in Rural and Remote Areas 39:23 CPAP: A Game-Changer in Resource-Limited Healthcare 52:51 The Quorum Field Guide: A Must-Have for Remote Clinicians 56:11 The Benefits of International Healthcare Experiences

    59 min
  8. 108-Security Medic with Timm Smith

    SEP 13

    108-Security Medic with Timm Smith

    This week, Aebhric O’Kelly talks with Ronin's founder, Timm Smith, who shares his journey from being a lawyer to becoming a close protection officer and paramedic. He discusses the importance of being a whole bodyguard, protecting clients from external and internal threats. Tim emphasises the need for excellence, reality, and truth in the close protection industry. He also highlights the value of training paramedics to be close protection officers and vice versa. The conversation touches on the impact of Gregorii Tsekmistrenko's death, a Ronin graduate, and the importance of humility and learning from mistakes in austere medicine. https://www.ronin.co.za/ Takeaways Being a whole bodyguard means protecting clients from both external and internal threats. Excellence, reality, and truth is essential in the close protection industry. Training paramedics to be close protection officers and vice versa is a valuable career path. Humility and learning from mistakes are crucial in austere medicine. Chapters 00:00 Introduction and Background 07:11 From Law to Close Protection 10:29 Becoming a Paramedic 17:33 Founding Ronin: A Centre of Excellence 24:23 The Connection to Malta 28:30 Training Paramedics in Close Protection 35:02 Remembering Gregorii Tsekmistrenko 38:03 Advice for New Medics

    38 min
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The College releases a new podcast each Friday discussing wilderness medicine, austere healthcare and emergency medicine. Host Aebhric O'Kelly invites guests from around the world working in remote, austere and resource-limited environments.

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