CoROM cast. Wilderness, Austere, Remote and Resource-limited Medicine. – Details, episodes & analysis

This week, Aebhric OKelly interviews Bill Vasios, a physician assistant who started as an 18 Delta and had several other 18 series jobs. Bill is pursuing a PhD in education focusing on instructional design and technology. He is also doing a simulation fellowship at East Carolina University. They talk about online learning, designing a perfect online learning system, the challenges of teaching in the medical field, and the importance of credible sources in education.

Takeaways

Bill is a physician assistant with a background in the military, having served as an 18 Delta and held other 18 series jobs.

He is pursuing a PhD in education, focusing on instructional design and technology.

Bill discusses the challenges and benefits of online learning and the importance of credible sources in education.

He also discusses the need for adaptive and interactive learning systems in medicine. Stay thirsty for knowledge and continuously learn throughout your career.

Ultrasound is a valuable tool for Special Forces medics, but training and sustainment are crucial.

Hands-on training and mentorship are essential for developing ultrasound skills.

Effective teaching requires authenticity, care, and adapting to individual learning needs.

The art of teaching lies in respectfully challenging and guiding students to improve their skills.

Access to ultrasound equipment and regular scanning practice are necessary for maintaining competence.

The ability to compare normal and injured scans is valuable for identifying abnormalities.

Being surrounded by excellent people raises everyone's skills and abilities.

Chapters

00:00 Introduction and Correction of Name

01:31 Bill's Background and Current Pursuits

08:18 Designing an Adaptive Learning System

12:22 The Challenges of Teaching in the Medical Field

14:12 The Future of Online Learning in the Medical Field

16:24 Balancing Online and Face-to-Face Learning

18:12 The Importance of Credible Sources in Education

23:51 Creating Curriculum for Soft Medics

24:29 Getting to Know Bill Vasio

30:12 Bill's Military Background and Transition to PA

33:39 Bill's Military Journey and Learning Code

35:10 Selection and Robin Sage

38:52 Becoming a PA and Returning to SF

40:47 The SOLCUS Program and Ultrasound in SF

43:04 Special Operator Level Clinical Ultrasound Programme and Advancements in Ultrasound

45:00 Sustaining Ultrasound Skills in 18 Delta Medics

49:04 Advice for New Medics and the Importance of Continuous Learning

53:05 The Art of Effective Teaching and Mentoring

56:30 Challenges of Ultrasound Training and Sustainment

01:05:00 Conclusion and Final Thoughts

This week, Aebhric O’Kelly talks with Antonio from European Medics about their work and focus on guerrilla, austere, and remote medicine. European Medics started as a community of passionate individuals in emergency medicine and has grown to focus on education and enhancing medicine.

European Medics is currently working on creating training material and educative resources for their Advanced Guerrilla First Responder (AGFR) course.

European Medics (EURMED) is focused on providing evidence-based guidance in unconventional and guerrilla medicine.

Guerrilla medicine overlaps with other fields, such as wilderness medicine, medical support for irregular warfare, and disaster relief. The goal is to be better prepared for future conflicts and disasters and to save lives.

Takeaways

European Medics started as a community of passionate individuals in emergency medicine and has grown to focus on education and enhancing medicine.

They are currently working on creating training material and educative resources for their Advanced Guerrilla First Responder (AGFR) course.

European Medics has a podcast with multiple shows, including medical basics, field clinic, and long-format discussions with subject matter experts.

Their goal is to provide training and education in austere and remote medicine to enhance the capabilities of healthcare providers in resource-limited environments—European Medics evidence-based guidance in unconventional and guerrilla medicine.

EURMED has published a paper on gorilla medicine and plans to publish more papers on the topic.

EURMED aims to be a neutral ground for the medical community to exchange experiences and provide expert medical education.

The future of guerrilla medicine is seen as an integrated part of forward medicine, focusing on providing care to civilians affected by conflicts.

Guerrilla medicine overlaps with other fields, such as wilderness medicine, medical support for irregular warfare, and disaster relief.

The goal is to be better prepared for future conflicts and disasters and to save lives.

Chapters

00:00 Introduction and Background

03:10 European Medics: Community and Education

06:12 The Advanced Guerrilla First Responder Course

09:02 Podcast: Medical Basics and Field Clinic

23:02 Publishing Concepts and Lessons Learned in Ukraine

27:11 The Future of European Medics

29:13 European Medics: A Neutral Ground for Medical Education

31:37 Expanding European Medics to the United States

36:48 Guerrilla Medicine and Overlapping Fields

41:37 The Clandestine Nature of Guerrilla Medicine

44:45 Preparing for Future Conflicts and Disasters

46:51 Advice for New Medical Professionals

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

Aebhric O'Kelly interviews two third-year BSc Remote Paramedic students about the paths that led them to join the CoROM programme. Jim first came to the College for the Remote EMT course seven years ago. He was working for BBC and needed more medical training for the locations he was going. Simon wanted to branch out from his corporate job and learn something very different from his day-to-day job.

Listen to their experiences whilst going through the Remote Paramedic Practice degree programme. 

Dr Winston de Mello discusses pulse oximetry and its use during the Covid pandemic. Dr de Mello is an anaesthetist and pain specialist. 

Reference: 

https://pubmed.ncbi.nlm.nih.gov/35798377/

Dr Francis Sakita is CoROM faculty and runs the Emergency Department in Kilimanjaro Christian Medical Center in Tanzania. Each month he will present a clinical case from KCMC, located at the base of Mount Kilimanjaro. 

Today, Dr Francis talks about a patient presenting with difficulty breathing and shortness of breath. 

CoROM faculty Tim Cranton talks with Radan Doubrava about his work in the remote areas of Czechia and his experiences in Ukraine. 

Glib attended the CoROM Remote Paramedic programme whilst working at the Ministry of Health in Ukraine. He brought that curriculum back to his country and requested that the College create an instructor and transition programme to convert the Ukrainian EMS into the US model of the ALS paramedic. 

In 2019, the College of Remote and Offshore Medicine Foundation collaborated with the Ternopil National Medical University to offer paramedic instructor programmes. Additionally, they set up TSMU to provide ITLS trauma courses for their doctors and medics. 

Aebhric and Glib discuss the current EMS situation in Ukraine and options for improvement as the conflict continues. 

Dr Gara MD PhD teaches in the MSc Austere Critical Care programme. Today she will discuss chest pain and shortness of breath - relating to major vascular events, acute coronary syndrome – STEMI, NSTEMI, unstable angina, haemodynamics – physiology and pharmacology, pulmonary embolism, palpitation, collapse, syncope, arrhythmias, and traumatic heart disease.

Dr Gara is a cardiologist based in Budapest, Hungary. She has worked in prehospital medicine on both ground ambulances and HEMS. 

This episode introduces the four CoROM faculty members who will present discussions over the next 12 months focusing on healthcare practice in remote, austere and resource-limited environments. 

Dr Winston de Mello is a COL(ret) anaesthetist focusing on burns and pain. He leads discussions on our MSc Austere Critical Care programme and is one of the Founders of the College.

Dr Edit Gara MD PhD is a cardiologist with prehospital experience. She will discuss cardiology and critical care. She is the programme lead for our MSc Austere Critical Care and a mentor in our BSc Remote Paramedic Practitioner programme.

Tim Cranton is an HCPC paramedic, an offshore medic and a Tropical Nurse working on an oil rig in the North Sea. He has also deployed to Ukraine and other exciting locations. He will be discussing remote and austere medicine from a paramedic perspective.

Aebhric OKelly is a former Green Beret and a critical care paramedic. He created the College and is a founder. He will be interviewing various movers and shakers of the austere medical community.