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.

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.

This week, Aebhric talks with Krissie Stiles who is a nurse focusing on burns casualties. She has great advice for the Remote Medic on how to assess and manage the burns casualty in austere environments.

This week, Aebhric talks with Dr Alastair Fraser, chair of the faculty advisory board for the Faculty of Remote Rural and Humanitarian Health care for the Royal College of Surgeons of Edinburgh, and discusses his diverse medical career and experiences in remote and rural areas. He shares stories from his time in the Antarctic, Nigeria, and with Shell, highlighting the challenges and unique situations he encountered. Dr Fraser also discusses the importance of mental health support for medics in remote locations and the need for ongoing training and resources. The conversation discusses the creation and purpose of the Faculty of Rural Remote Humanitarian Health, a specialised area under the Royal College of Surgeons of Edinburgh. The faculty aims to provide training and recognition for healthcare professionals in remote, rural, and humanitarian settings. It addresses the challenges of delivering healthcare in these areas and seeks to improve the quality of training and competence. The conversation also highlights the importance of community and networking among professionals in these fields. The faculty offers fellowship and membership to individuals who have demonstrated competence and contribution to the field.

Takeaways

Dr Alastair Fraser has had a diverse medical career, working in remote and rural areas and with Shell in various locations.

He emphasises the challenges and unique situations in remote healthcare, where medics are often asked to handle various medical issues.

Dr Fraser highlights the importance of mental health support for medics in remote locations and the need for ongoing training and resources.

He discusses the potential benefits of incorporating ultrasound devices into the toolkit of offshore medics but acknowledges the challenges in implementing this due to company policies and liability concerns. The Faculty of Rural Remote Humanitarian Health is a specialised area under the Royal College of Surgeons of Edinburgh that provides training and recognition for healthcare professionals working in remote, rural, and humanitarian settings.

The faculty addresses the challenges of delivering healthcare in these areas and aims to improve the quality of training and competence.

Membership in the faculty is open to anyone interested in the field, not just doctors or medics.

The faculty plans to offer more online courses that cover various skills needed in remote, rural, and humanitarian healthcare.

The faculty is voluntary and relies on volunteers and funding to operate.

Networking and community-building among professionals in these fields are important for sharing ideas and experiences.

The faculty is working towards providing educational credits and accreditation for its courses.

Healthcare professionals interested in working in austere environments should seek training, talk to experienced professionals, and develop skills in working under pressure and uncertainty.

Chapters

00:00 Introduction and Background

02:10 Experiences in the Antarctica

03:00 Challenges and Unique Situations in Remote Healthcare

08:05 Limited Medical Resources in Remote Locations

15:23 Importance of Mental Health Support for Medics

20:21 Implementing Ultrasound for Offshore Medics

21:10 Introduction to the Faculty of Rural Remote Humanitarian Health

23:50 Challenges of Delivering Healthcare in Remote and Rural Areas

27:35 Membership and Community in the Faculty

33:57 Expanding Online Courses for Remote Healthcare

39:02 The Humanitarian Healthcare Course and Accreditation

43:47 Advice for Healthcare Professionals in Austere Environments

Aebhric OKelly talks with Burjor Langdana about Wilderness and Expedition Dentistry.

wildernessdentistry.com

Aebhric talks with Kate, who is a Polish paramedic working on the front lines of Ukraine.

How to donate to Kate's non-profit: https://zrzutka.pl/w7dfhk

Kate's social media:

https://www.facebook.com/awangardamedycy

https://www.instagram.com/awangardamedycy

Aebhric talks with CJ Malcolm, who runs the EMS in Gunnison, Colorado. CJ has introduced blood and blood products to his department. He has also pushed for ultrasound and prolonged field care training.

The Gunnison paramedics are practising in extreme austere environments.

Aebhric talks with Alfredo Leal, who is a critical care flight paramedic working in Saudi Arabia and who will be defending his master's thesis for the Austere Critical Care programme.

Aebhric O'Kelly talks with Dr. Jørgen Melau from Norway, who has published research on cold weather medicine. They discuss the difficulties of operating in cold environments and the options available to keep a casualty warm.

This week, Aebhric talks with Ella Corrick, MD PhD, about her experiences working prehospital, on mountain rescue teams and her work with the College on the postgraduate faculty.

They discuss the best way to treat blisters.

Aebhric mentioned the Valkyrie Extraction System, which can be found here.

https://www.britishrescue.com/pages/the-valkyrie-extraction-system

This week, Aebhric O'Kelly talks with Dan Taylor, who graduated from the CoROM Remote Paramedic programme and has deployed to Ukraine many times, as well as Iraq and other interesting places.

Dr Will Smith is a pillar in the wilderness medical community and military medicine. He has been part of the Wilderness Medical Society and the Special Operations Medicine Association. He recently joined the CoROM faculty and will teach the MSc Austere Critical Care.

This week, Aebhric talks with Darren Torpey who works on the search and rescue helicopter in NW Ireland.

Darren is an alumnus of the Remote Paramedic programme and used his training to get a job on the SAR helicopters.

He talks about his experience working in difficult and austere environments and how he uses prolonged field care daily.

This week, Aebhric talks with Nick, who is a doctorate-level paramedic who works in Gunnison, CO, where he provides extended EMS care in austere environments.

This week, Aebhric talks with Frida Svahn, a nurse from Sweden, who discusses her experiences teaching medical training in various countries and her work with the Swedish Civil Contingencies Agency (MSB). She shares her journey from serving in the Swedish Armed Forces to becoming a nurse and her passion for working in austere environments. Frida highlights the importance of training the trainers and its impact in countries like Ukraine. She also mentions the upcoming National Seminar Exercise in Sweden and the role of MSB in civil defence and NATO. Frida advises new healthcare professionals interested in working in austere environments to invest in good courses, build a network, and stay motivated.

Takeaways

Teaching medical training in austere environment is a rewarding experience that allows healthcare professionals to make a difference in countries like Ukraine.

MSB plays a significant role in civil defence and NATO, providing training and expertise in emergency response and crisis management.

Investing in good courses, building a network, and staying motivated are essential for healthcare professionals working in austere environments.

Training the trainers is a force multiplier that spreads knowledge and skills to a larger population.

Sweden's upcoming National Seminar Exercise will involve multiple nations, focusing on casualty move and patient flow management.

Aebhric OKelly and Dennis Jarema do a deep dive into improvised medicine. This recording was 2.5 hours long. So, we split it into two podcasts.

This is part 2, where we discuss Circulation emergencies and Prolonged Field Care improvisation.

Aebhric OKelly and Dennis Jarema do a deep dive into improvised medicine. This recording was 2.5 hours long. So we split it into two podcasts.

This is part 1, where we discuss Massive Haemmoraghe, Airway and Breathing improvisation.

Stay tuned next week for part 2.

This week, Aebhric talks with Brian Foy, former Marine Recon, who became a paramedic and is currently working in Kenya teaching TCCC and Remote Medicine to the military and for civilians.

This week, Aebhric OKelly talks with Nick Dillon, a masters-level paramedic who has worked as a Remote Medic in many environments. He has been a country manager for several organisations and is an academic lecturer for a paramedic university in the UK.

Nick and Aebhric discuss their history together and some of the extraordinary deployments that Nick has been part of.

This week, Aebhric OKelly talks with Adam Gent who runs the Real First Aid programme in the UK. Adam focuses on getting the basic medical skills practiced to perfection.

He teaches PFC at the BLS level and created the HEROTIME mneumonic for the Prolonged Field Care skills.

• Hygiene
• Elevation
• Rehydration
• Observations and Records
• Testing and Diagnostics
• Infection
• Medication
• Environmental

This week, Aebhric recaps the 2023 podcast analytics and how we grew and developed this year.

Top Five Podcasts of 2023

1. MSc Paramedic Practitioner with David Fifer (57)

2. Tropical Medicine Update with Jason Jarvis (48)

3. Ukraine Aeromedical Evac team from Norway (42)

4. Life as an Offshore Medic (66)

5. PFC for EMS with Dr Tom (68)

This week, Aebhric talks with Arne Dierlich who is a German offshore paramedic working on the windfarms in the North Sea. They discuss the requirements for the job and why Prolonged Field Care needs to be in the required curriculum.

This week, Aebhric talks with Simon Puparelia, a 3rd year BSc Remote Paramedic student. They discussed his experience at the Kibosho District Hospital, which is 14km up Mount Kilimanjaro.

Aebhric set this placement up specifically for SOF medics but found it a perfect place for the advanced paramedic practice.

This week, Aebhric talks with Dr Tom Mallinson about their published article focusing on prolonged field care for EMS. In the UK, it is common for ambulances to sit in the car park of the hospital for six hours waiting to hand over their patient to the A&E department.

Their research shows that the PFC protocols would be beneficial for paramedics.

This week, Aebhric talks with Dr Theo Aslanidis who runs the PhD programme for the College. They discuss research for paramedics and healthcare providers working in remote and austere environments.

This week, Aebhric O'Kelly talks with Dr John Quinn and Eirik Holmstrøm, who all went to Ukraine to teach the Damage Control Resus Ukraine (DCRU) course. They discuss the curriculum, the use of clinical practice guidelines (CPGs), and the importance of access to blood in the pre-hospital setting. They highlight the collaboration with Tactical Medicine North and the professional partner forces in Ukraine. The hosts also mention the Defence Health Administration's (DHA) role and the resources on the DHA website and app. The conversation emphasises evidence-based practices and knowledge exchange's significance in improving military medicine. The conversation focuses on the challenges and solutions in Ukraine's implementation of damage control resuscitation (DCR). The speakers discuss the need for interoperability in large-scale combat operations (LSCO) and the importance of rethinking traditional medical practices. They highlight the limitations of blood transfusion in the field and the need for a logistic system to support the transportation of blood. The conversation also covers training Ukrainian combat medics in advanced skills such as resuscitative endovascular balloon occlusion of the aorta (REBOA) and ultrasound. The speakers emphasise the importance of continuous learning, adapting to failures, and the potential for DCR to increase combat effectiveness in Ukraine.

Keywords

Damage Control Resus Ukraine, DCRU, curriculum, clinical practice guidelines, CPGs, pre-hospital setting, blood access, Tactical Medicine North, partner forces, Defence Health Administration, DHA, evidence-based practices, military medicine, damage control resuscitation, interoperability, large-scale combat operations, blood transfusion, logistic system, training, combat medics, REBOA, ultrasound, continuous learning, combat effectiveness

Takeaways

The DCRU course in Ukraine focused on damage control resuscitation in the pre-hospital setting.

The curriculum was based on clinical practice guidelines (CPGs) from the Defence Health Administration (DHA).

Access to blood and blood components was highlighted as crucial in effective care.

Collaboration with Tactical Medicine North and professional partner forces in Ukraine was instrumental in the course's success.

The DHA website and app provided valuable resources for learning and reference in austere environments.

The exchange of knowledge and lessons learned is essential for improving military medicine. Implementing damage control resuscitation in large-scale combat operations requires interoperability and a logistic system to support the transportation of blood.

Traditional medical practices need to be rethought to align with the evolving nature of warfare.

Training combat medics in advanced skills such as REBOA and ultrasound can improve patient care and increase patient transport confidence.

Continuous learning and adapting to failures are essential in austere medicine.

Damage control resuscitation has the potential to increase combat effectiveness in Ukraine.

Chapters

00:00 Introduction to Dr John Quinn and Eirik Holmstrom

02:07 Adding Co-Authors and References

04:01 Introduction to the DCRU Course

08:09 Overview of the DCRU Curriculum

13:49 Importance of Access to Blood

16:40 Acknowledging the Defence Health Administration

18:56 Interoperability and Logistic Challenges

23:35 Rethinking Traditional Medical Practices

29:24 Training Combat Medics in Advanced Skills

38:34 Continuous Learning and Adapting to Failures

41:10 The Potential of Damage Control Resuscitation

This week, Aebhric talks with Tim Cranton, who has worked as an offshore medic for 25 years. They discuss his daily routines and what medical emergencies he can expect.

Tim talks about what courses and training are required to get a job as an Offshore Medic.

Aebhric talks with Dr John Quinn, who has been going to Ukraine since 2001. He has worked in Eastern Ukraine since the war started in 2014. John was instrumental in getting blood approved by non-doctors in Ukraine for prehospital use.

This week, Aebhric O'Kelly and Jason Jarvis discuss current tropical disease outbreaks in the US and Europe.

The discussion went over time, so we broke the talk into two parts.

Part 1: Malaria and Dengue (dropped last week)

Part 2: Leishmaniasis and Schistosomiasis

This week, Aebhric O'Kelly and Jason Jarvis discuss current tropical disease outbreaks in the US and Europe.

The discussion went over time, so we broke the talk into two parts.

Part 1: Malaria and Dengue

Part 2: Leishmaniasis and Schistosomiasis will be dropped next Friday

This week, Aebhric talks with Dr Winston de Mello about pain.

This week, Aebhric talks with Vlad Chumachenko, who came for our Austere Emergency Care course in Pretty Bay, Malta. They discuss the training that Ukraine medics receive before heading to the front. There is a need for prolonged field care training at all medical levels.

This week, Aebhric talks with Price Parker, 18D and Eirik Holmstrom about their experiences in Malta whilst teaching at the College. They talk about the Intensive Care for Austere and Remote Environments (ICARE) course that ran this week. They also talk about the history of the Knights of St. John and how that lineage can be found in Special Forces Medicine.

This week, Aebhric talks with Dr Edit Gara, MD PhD about how to assess and manage the paediatric patient who is dehydrated.