Explore every episode of the podcast CoROM cast. Wilderness, Austere, Remote and Resource-limited Medicine.
| Title | Pub. Date | Duration | |
|---|---|---|---|
| 220-Caribbean Paramedic with Marlon Flanders | 06 Nov 2026 | 00:28:17 | |
This week, Aebhric O’Kelly welcomes Marlon Flanders, a paramedic from Trinidad and Tobago and MSc in Austere Critical Care student at CoROM. After 13 years in ambulance services, Marlon has transitioned into offshore medicine, providing healthcare aboard oil and gas installations and deep-sea pipeline vessels in the Caribbean. He discusses the challenges of moving from urban emergency medical services into an environment where primary care, logistics, occupational health and evacuation planning become essential responsibilities. The conversation explores the development of paramedicine in Trinidad and Tobago, including clinical scope of practice, international certification, advanced paramedic education and the challenges of maintaining consistent professional standards across national borders. Marlon reflects on his experience completing the MSc in Austere Critical Care, including practical ultrasound training in Malta, and explains how postgraduate education has helped him adapt to the demands of remote healthcare. Chapters 00:00 – Opening hook: Offshore versus urban paramedicine
#CoROM #CoROMConversations #Paramedic #CaribbeanEMS #TrinidadAndTobago #OffshoreMedicine #AustereMedicine #RemoteMedicine #CriticalCareParamedic #CommunityParamedicine #HumanitarianMedicine #EMS #MedicalEducation | |||
| 219-Wilderness & Rescue EMS in Iceland with Axel Višarsson | 30 Oct 2026 | 00:37:47 | |
This week, Aebhric O'Kelly speaks with Axel Ernir Viðarsson, an advanced EMT, firefighter and search and rescue instructor based in Akureyri, northern Iceland. With more than 20 years of volunteer search and rescue experience, Axel offers fascinating insight into Iceland's emergency medical services, wilderness rescue operations, and the challenges of delivering prehospital care in one of Europe's most geographically demanding environments. Chapters 00:00 – Introduction to Axel Ernir Viðarsson 01:18 – Rescue 26: Iceland's International Search and Rescue Conference 03:27 – Bringing Prehospital Ultrasound to Iceland 05:39 – The Future of POCUS in Icelandic Ambulance Services 07:15 – Firefighting, Ambulances and Fixed-Wing Air Evacuation 09:55 – What Is a Smoke Diver? 11:34 – How Iceland's EMS and Search and Rescue Systems Work Together 13:26 – Volcanic Eruptions and Search and Rescue Operations 16:29 – Tourist Rescues, Blizzards and Wilderness Emergencies 17:56 – Iceland's Paramedic Education and Overseas Training 19:41 – Designing the Ideal Icelandic EMS System 21:22 – Advanced EMT Training in Iceland 24:44 – Could CoROM's BSc Remote Paramedic Practice Work in Iceland? 27:17 – Prolonged Patient Care in Iceland's Remote Wilderness 29:32 – Coordinating EMS, Search and Rescue and Air Ambulance Evacuation 32:29 – Choosing Between Akureyri and Reykjavík Hospitals 33:26 – When the Patient Is Nothing Like the Dispatch Report 34:29 – Axel's Journey into Search and Rescue 37:06 – Becoming a Wilderness Medicine Instructor 38:54 – Teaching, Avalanche Rescue and Wilderness First Aid 40:11 – Why Austere Medicine Makes Better Clinicians 41:21 – Learning from Students and Fellow Instructors 42:32 – Advice for New Austere Medicine Practitioners 43:38 – Getting Involved in Conferences and Professional Education 44:26 – Final Thoughts and Future CoROM Training in Iceland Topics Discussed - Icelandic emergency medical services and advanced EMT practice - Volunteer search and rescue and the Icelandic Association for Search and Rescue (ICE-SAR/ISAR) - Volcanic eruptions, avalanche rescue and wilderness emergencies - Fixed-wing air ambulance operations and Coast Guard helicopter evacuation - Prolonged field care and remote patient transport - Point-of-care ultrasound in prehospital medicine - Advanced EMT and paramedic education pathways - International collaboration in remote paramedic education - Wilderness medicine instruction and professional development - The importance of networking, conferences and lifelong learning | |||
| 218-Austere Medicine in a Level One Trauma Centre | 23 Oct 2026 | 00:37:54 | |
This week, Aebhric O'Kelly speaks with John Crofts, a nurse working at Zuckerberg San Francisco General Hospital, the city's Level I trauma centre. John brings an extraordinary perspective to austere medicine, combining emergency nursing, humanitarian logistics, infectious disease research and international humanitarian advocacy. Chapters 00:00 – Introduction: Meet John Crofts, emergency nurse and humanitarian advocate. 00:46 – Nursing at San Francisco General: Working in a Level I trauma centre. 02:10 – Violence and Burnout in Emergency Departments: A pilot programme addressing patient agitation and healthcare worker wellbeing. 04:14 – When Violence Compromises Critical Care: How competing demands divert resources from critically ill patients. 06:19 – Healthcare Violence and Ebola: Parallels between American emergency departments and humanitarian responses in resource-limited environments. 08:38 – When Patients Lose Trust in Healthcare: Inequality, frustration and violence against healthcare workers. 09:20 – Why Study Austere Medicine?: John's interest in CoROM and international humanitarian medicine. 10:16 – Humanitarian Logistics and Advocacy: Learning from clinicians working in Somalia, Ukraine and other challenging environments. 11:20 – The ICARE Experience in Malta: What John gained from the course. 12:19 – Learning from Other Clinicians: Scenario-based training, shared experience and challenging clinical assumptions. 14:31 – Bringing Austere Medicine Back to San Francisco: Why experienced emergency nurses can benefit from resource-limited training. 16:56 – Gunshot Wounds Outside the Hospital: When critical care begins on the street with minimal resources. 18:28 – An Unconventional Journey into Nursing: How John found his way into healthcare. 19:15 – From Helicopter Pilot to Humanitarian Logistics: Aviation, maritime operations and the importance of logistics. 20:41 – Nursing Education in Micronesia: Training at a hospital in Palau. 23:00 – Refugee Advocacy in Palau: Working with displaced Uyghur former Guantánamo detainees. 24:00 – Clearing Explosive Remnants of War: Humanitarian demining and environmental hazards in the Pacific. 25:20 – From Alaska to Austere Medicine: How John's experiences shaped his clinical and humanitarian interests. 26:55 – Studying Infectious Disease: The London School of Hygiene & Tropical Medicine and global health research. 27:30 – Sierra Leone After Ebola: Questions about outbreak preparedness and the sustainability of international aid. 28:51 – What's Next for John?: Returning to humanitarian work and strengthening healthcare systems. 30:00 – Bioethics and Global Health: Ethical challenges involving technology, resource allocation and healthcare inequality. 31:01 – Humanitarian Medicine Beyond Academia: Why practical advocacy remains important. 33:26 – Humanitarian Work in Myanmar: Landmines, local communities, political pressures and deportation. 35:39 – Research, Publications and Advocacy: Sharing lessons from humanitarian practice. 36:28 – Advice for New Austere Clinicians: Following an unconventional career path and embracing uncertainty. 38:32 – Compassionate Care in Challenging Systems: Why healthcare professionals must advocate for patients and meaningful change. 39:15 – Closing Thoughts: The importance of learning, professional relationships and returning to Malta. | |||
| 217-CoROM BSc to HCPC with Dmytro Vozniuk | 16 Oct 2026 | 00:29:24 | |
This week, Aebhric O’Kelly catches up with Dmytro following his graduation from CoROM’s BSc in Remote Paramedic Practice and his successful registration as a paramedic with the UK Health and Care Professions Council (HCPC). Dmytro describes his current work providing medical care on a remote Caribbean island and reflects on previous roles in humanitarian and military medicine in sub-Saharan Africa. He explains why working remotely requires a different clinical mindset—particularly when weather, geography or resources prevent evacuation, and a patient may remain in your care for hours or even days. Chapters 00:00 – Welcome Back, Dmytro: From CoROM graduate to HCPC-registered paramedic. 00:33 – Remote Medicine in the Caribbean: Providing healthcare for thousands of guests and staff on a private island. 01:30 – An ICU on a Remote Island: Ventilation, capnography, laboratory diagnostics, POCUS and advanced monitoring. 02:58 – Paramedics Doing Radiography: The expanding role of the remote paramedic. 03:18 – From Africa to the Caribbean: Humanitarian medicine, military medicine and remote clinic operations. 04:40 – Qualifications for Remote Paramedic Work: How education and operational experience helped Dmytro secure his current position. 05:33 – Why CoROM?: Why one year of paramedic education wasn't enough and why Dmytro continued through the full BSc. 07:20 – Becoming a UK-Registered Paramedic: Starting the HCPC international registration process. 09:27 – HCPC Standards of Proficiency: Demonstrating education, experience, autonomy and clinical competence. 11:36 – Lessons from the HCPC Application: Documentation mistakes that can add weeks or months to the process. 13:58 – AI, Plagiarism and HCPC Applications: Why applicants need to ensure their submission is genuinely their own work. 14:15 – The First HCPC Assessment: Where additional evidence was required. 15:58 – Preparing for the Test of Competence: UK clinical guidance, common conditions and targeted preparation. 18:17 – UK Law and Paramedic Practice: Consent, safeguarding, mental capacity, resuscitation and verification of death. 18:50 – What Happens During the Test of Competence?: Clinical scenarios and assessment by practising NHS paramedics. 20:38 – Finally Registered: Completing an eight-month HCPC journey. 21:31 – What This Means for CoROM Graduates: Dmytro's pathway as a BSc Remote Paramedic Practice graduate. 22:03 – Graduation and the People Behind the Degree: Recognising the instructors and clinicians who shape a paramedic. 23:21 – Advice for Future BSc Students: Patience, practical training and making the most of KCMC. 25:09 – What Comes After the BSc?: MSc Austere Critical Care, offshore medicine and diving medicine. 26:19 – Does Austere Training Change How You Practise?: Why remote medicine requires a different professional perspective. 26:39 – Hospital Skills vs Remote Skills: Lessons from military medicine in sub-Saharan Africa. 28:29 – When You Cannot Evacuate: Managing patients for hours or days aboard ships and in remote locations. 29:40 – What Would Dmytro Do Differently?: More pharmacology, more KCMC and more exposure to ICU practice. 30:46 – Hurricanes, No Helicopter and No Boat: Why remote clinicians need critical care skills when evacuation fails. 31:40 – Advice for New Austere Clinicians: Learn remote medicine from people who actually work in resource-limited environments. 32:45 – Looking Back on the Journey: From student to degree-qualified, HCPC-registered remote paramedic. 32:56 – Acknowledgements: Dmytro thanks the CoROM faculty, colleagues and organisations that supported his journey. 34:20 – Closing Remarks: Continuing the journey in austere and remote medicine. | |||
| 216-MSc Student Rob Schembri | 09 Oct 2026 | 00:29:21 | |
This week, Aebhric O’Kelly is joined by Rob Schembri, a Canadian critical care paramedic with Ornge, Ontario’s air ambulance service, and a student on CoROM’s MSc in Austere Critical Care. Rob discusses his journey through critical care paramedicine, his recent move onto a special operations team and why, after decades in the profession, he decided to pursue postgraduate education in austere medicine. His new role includes supporting the transport of patients with high-risk pathogens and mechanical cardiac support, as well as USAR and other specialist operations. The conversation explores the Canadian paramedic system, including the progression from Primary Care Paramedic to Advanced Care Paramedic and ultimately Critical Care Paramedic. Rob explains the extensive training required at the critical care level and how international paramedics can enter the Ontario system. Rob also talks candidly about undertaking his first research project, navigating ethics approval and discovering that the thesis he initially dreaded has become one of the most interesting parts of his MSc. The episode finishes with a discussion about lifelong learning, career development and Rob’s advice to clinicians beginning a career in austere medicine: learn as much as you can, experience as much as you can—and enjoy what you do. Chapters 00:00 – Meet Rob Schembri: Critical care paramedicine, Ornge and joining the special operations team. 01:18 – The Malta Connection: Rob's Maltese heritage and his family's move to Canada. 03:03 – Returning to Malta for a Master's Degree: The irony of pursuing postgraduate education in the country his parents left. 03:25 – Why the MSc in Austere Critical Care?: Preparing for specialist critical care and special operations. 05:02 – High-Risk and Special Operations Medicine: High-risk pathogens, mechanical cardiac support, USAR and specialist transport. 06:50 – Why Study Austere Critical Care in Malta?: Choosing CoROM rather than a conventional Canadian critical care programme. 08:18 – POCUS and Future Training: Bringing austere prehospital ultrasound into specialist practice. 11:05 – Reaching the MSc Thesis: Rob's progress through the programme. 11:36 – Researching Cognitive Load in Austere Conditions: Identifying a gap in conventional critical care paramedic training. 13:32 – Designing the Research: Comparing conventional scenarios with scenarios incorporating austere stressors. 15:02 – From Dreading Research to Enjoying It: Becoming a first-time clinical researcher. 16:01 – Research Ethics: The challenges of preparing an ethics submission. 17:42 – Why an MSc Should Include Research: Thesis versus coursework and what it means to earn a Master of Science. 19:42 – What Comes After the MSc?: PhDs, lifelong education and knowing when to give the family a break. 20:32 – Taking a Maltese MSc Back to Canada: Recognition, professional development and teaching opportunities. 22:31 – How Canadian Paramedicine Works: PCP, ACP and Critical Care Paramedic pathways. 24:43 – Moving Between Canadian Provinces: Reciprocity and employment across provincial systems. 25:40 – Is There a Canadian Paramedic Registry?: How Ontario regulates and identifies paramedics. 26:59 – International Paramedics Coming to Ontario: Where UK, Australian, South African and other clinicians may fit. 28:09 – Comparing US and Canadian Paramedic Education: Training pathways and entry into critical care practice. 30:06 – Becoming a Critical Care Paramedic in Ontario: The 16–18-month training process and clinical placements. 31:17 – “It's Never Too Late”: Rob became a critical care paramedic in his fifties. 32:04 – What Would Rob Do Differently?: Looking back on the MSc and a 36-year career. 32:54 – Advice for the Next Generation: Learn, experience, enjoy your work and value the people around you. 33:53 – Coming Home to Malta: Pastizzi, cannoli and plans to finally meet in person. | |||
| 215-BSc Remote Paramedic Practice graduate Kevin Fox | 02 Oct 2026 | 00:40:36 | |
In this episode of the CoROM Podcast, Aebhric O'Kelly speaks with Kevin Fox, a Belgian EMT, maritime security professional and recent graduate of CoROM's BSc in Remote Paramedic Practice. Kevin's journey into medicine began following the 2016 Brussels terrorist attacks. Working in security at the time, he realised he lacked the medical knowledge to help casualties in a similar emergency. That experience eventually led him through tactical medical training, Belgian EMT education and CoROM's three-year degree. Kevin discusses his clinical placements in South Africa and Suriname, where he gained experience managing polytrauma, paediatric emergencies, childbirth and tropical infectious diseases. He describes how resource limitations challenged him to improvise, adapt and develop clinical judgement while working alongside local medical teams. The conversation then turns to tropical medicine in Europe. Kevin shares two memorable ambulance cases involving patients returning from India and Italy, explaining how a detailed travel history helped him recognise possible malaria and dengue. These experiences inspired his proposed research into incorporating recent travel more explicitly into prehospital patient assessment. Kevin also discusses his dissertation on Belgium's dengue preparedness, the importance of community education and his plans for further research and postgraduate study. Finally, he reflects on his three years at CoROM, the value of supervised clinical placements and the importance of recognising one's limitations. His advice to clinicians entering remote medicine is simple: test your equipment, remain self-critical and never become a toxic leader. 00:00 – Introducing Kevin Fox: From maritime security to remote paramedicine. 01:04 – The Brussels Terrorist Attacks: The event that inspired Kevin to pursue medical training. 03:05 – Why a Bachelor's Degree?: Professional development and European academic recognition. 04:30 – Future Academic Ambitions: Tropical medicine and postgraduate opportunities. 06:34 – Clinical Placements in Suriname: How TTEMS prepared Kevin for remote clinical practice. 08:35 – Why Suriname?: Language, culture and healthcare challenges. 10:30 – Working in a Surinamese Emergency Department: Trauma assessment and growing clinical responsibility. 13:12 – Memorable Clinical Cases: Polytrauma, paediatric emergencies and delivering a baby. 14:54 – Tropical Diseases in Suriname: Dengue, chikungunya and patients presenting with sepsis. 16:51 – Knowing Your Limitations: Clinical supervision, teamwork and asking for help. 20:10 – Three Years at CoROM: Practical training, student experiences and suggestions for improvement. 23:11 – Advice for First-Year Students: Why anatomy and physiology matter later in clinical practice. 25:28 – Kevin's Dissertation: Dengue preparedness and the establishment of tiger mosquitoes in Belgium. 28:44 – The Importance of Travel History: Recognising malaria in a patient returning from India. 30:00 – Could It Be Dengue?: A patient returning from Italy challenges clinical assumptions. 32:01 – The SAMPLER Research Project: Investigating tropical fever recognition among Belgian ambulance personnel. 33:48 – Tropical Medicine in Europe: Why clinicians need to consider emerging and imported infections. 35:19 – UK Paramedic Registration: Kevin's professional plans after graduation. 36:05 – Maritime and Offshore Medicine: Combining paramedicine with maritime security. 37:05 – Continuing Education: Tropical medicine, clinical laboratory skills and professional networks. 39:02 – Advice for Austere Clinicians: Never assume, remain self-critical and avoid toxic leadership. 40:25 – Closing Remarks. Chapters | |||
| 214-Remote Orthopaedics with Dr Bob Dichiera | 25 Sep 2026 | 00:50:12 | |
In this episode of CoROM Conversations, Bill Vasios is joined by Dr Bob Dichiera, a retired US Army veteran with experience in operational medicine, primary care and orthopaedic surgery, and an associate professor at East Carolina University's PA programme. Bob introduces a practical approach to remote orthopaedics built around four questions: Is the patient dying? Is a limb dying? Can I stabilise it? Does the patient need evacuation? The discussion examines the orthopaedic emergencies that clinicians cannot afford to miss, including open fractures and dislocations, neurovascular compromise, compartment syndrome, vascular injuries, pelvic fractures and traumatic amputations. Throughout the session, Bob emphasises repeated pulse, motor and sensory (PMS) assessment before and after interventions. Using clinical cases, the conversation explores closed and open tibial fractures, field-expedient fracture assessment, compartment syndrome, irrigation and antibiotics, splinting, shoulder dislocations and reduction decisions. The discussion considers when reduction may be appropriate in a remote environment, particularly when prolonged transport is combined with neurovascular compromise. The later discussion examines pelvic and hip injuries, field assessment, ultrasound and the difficult question of whether procedures such as fasciotomy have a role in genuinely remote care. Bob also considers how telemedicine and remote specialist support may extend what clinicians can safely accomplish in austere environments. 00:00 – Tuning-fork fracture diagnosis cold open 00:18 – Introduction to Remote Orthopaedics 01:58 – Why MSK injuries matter in remote medicine 03:00 – Orthopaedic emergencies you cannot miss 04:18 – Damage-control orthopaedics 05:00 – Is the patient dying? Is the limb dying? 06:42 – Closed tibial fractures 07:40 – Diagnosing fractures with a tuning fork 09:06 – Splinting and traction decisions 11:31 – Compartment syndrome 14:00 – Pain with passive stretch 15:30 – Open fractures 16:20 – Irrigation 17:00 – Antibiotics for open fractures 21:06 – Field splinting and improvised splints 23:30 – Shoulder dislocations 25:55 – Shoulder reduction techniques 28:21 – Immobilisation and rehabilitation 30:45 – When should remote clinicians reduce a dislocation? 33:07 – PMS and neurovascular assessment 34:00 – Knee dislocations 35:35 – The easily missed vascular injury 37:56 – Reduction, ABI and evacuation 38:45 – Ankle injuries and Ottawa Ankle Rules 40:20 – Why weight-bearing does not exclude fracture 42:00 – Hand and wrist injuries 42:43 – Pelvic fractures 44:00 – Pelvic binders and avoiding repeated pelvic assessment 45:30 – Haemorrhage and pelvic trauma 46:00 – Pelvis versus femoral neck fracture 47:30 – Ultrasound in remote orthopaedics 47:50 – Should remote clinicians perform fasciotomies? 48:30 – Telemedicine and remote procedural guidance 49:53 – Closing | |||
| 213-From the White House to Ukraine: Lessons in Austere Medicine with Dr Travis Kaufman | 18 Sep 2026 | 00:47:37 | |
This week, Aebhric O'Kelly speaks with Dr Travis Kaufman and they explore his 25-year US Army career, his transition from combat engineer and military diver to Physician Assistant (PA), and five years providing medical support through the White House Medical Unit. Travis describes one of the most difficult lessons emerging from Ukraine: prolonged tourniquet use. A Ukrainian medic explains the decision as “triage of the limb or the life” when attempting tourniquet conversion after several hours may place the casualty at considerable risk. The discussion examines unnecessary tourniquet use, the importance of reassessment, contaminated wounds and the increasing problem of sepsis when evacuation is delayed for hours or days. Travis argues that the traditional TCCC assumption of rapid evacuation can create a training scar when casualties instead remain with combat lifesavers and medics for prolonged periods. The episode then explores what PCC actually looks like in practice: trending observations, wound debridement, antimicrobial planning, pain management, positioning, pulmonary care and the fundamental nursing interventions that can determine whether a casualty deteriorates. Travis also shares examples of improvisation from the field, including improvised PEEP and wound-vacuum techniques, and discusses why clinicians need to rediscover simple solutions when sophisticated equipment is unavailable. Chapters 00:00 – Meet Dr Travis Kaufman: From Army diver to PA, White House medicine and Ukraine. 02:26 – Becoming a Military Deep-Sea Diver: Training, attrition and operational diving. 06:12 – From Diver to Physician Assistant: Changing careers and entering military medicine. 07:15 – What Is a Physician Assistant?: Origins, training and the military PA role. 10:38 – PA vs Nurse Practitioner: Different educational and clinical models. 13:06 – Advising Across Eastern Europe: Building capability and interoperability. 14:19 – Inside the White House Medical Unit: Medical support for the President and First Family. 15:35 – Medical Planning for the President: Preparing for presidential travel worldwide. 17:32 – Training for High-Consequence Medicine: Trauma preparation and live-tissue training. 19:43 – Humanitarian Medicine in Tanzania: Wilderness medicine and community healthcare. 21:00 – Schistosomiasis and Sickle-Cell Care: Managing disease in resource-limited communities. 24:40 – HIV and the Problem of Follow-Up: When treatment exists but access remains difficult. 27:07 – Inside a Ukrainian Stabilisation Point: Damage-control resuscitation with limited resources. 28:45 – The Limb or the Life: The realities of prolonged tourniquet use. 30:00 – Preventing Unnecessary Limb Loss: Tourniquet reassessment and conversion. 31:56 – Sepsis in Prolonged Casualty Care: The consequences of delayed evacuation. 33:30 – Debridement Without Water: Managing contaminated battlefield wounds. 34:47 – Airways with Limited Equipment: Facial trauma and conserving resources. 36:14 – Taking PCC to the CLS and CMC: Moving prolonged-care skills further forward. 39:09 – What Should a Two-Day PCC Course Teach?: Reassessment, wounds and prolonged-care thinking. 40:45 – Stop Taking Snapshots — Start Trending: Following physiology over time. 42:13 – The “Boring” Care That Saves Lives: Nursing care, positioning, pain and pulmonary management. 43:40 – Improvised PEEP and Wound VACs: Field-expedient solutions when equipment runs out. 45:13 – Rediscovering Old Lessons: What previous wars may teach modern austere medicine. 46:27 – Medicine in the Mediterranean: Travis previews his keynote presentation. 47:45 – “Sir, Are We Gonna Be Okay?”: Trust, responsibility and caring for severely wounded soldiers. 49:49 – Advice for the Austere Clinician: Lose the ego, stay curious and learn from experience. | |||
| 212-What makes a paramedic? With David Page | 11 Sep 2026 | 00:41:52 | |
This week, Aebhric O'Kelly is joined by David Page, a paramedic with more than 40 years of experience spanning frontline EMS, education, accreditation and research. David directs the Prehospital Care Research Forum at UCLA and is closely involved with the International Paramedic Registry (IPR). The conversation explores the enormous variation in paramedic education and practice around the world. David discusses his work with training centres in more than 20 countries and explains why sophisticated simulation facilities are not necessarily required to deliver excellent education. Chapters 00:00 – Meet David Page: 40 years of paramedicine, research and education. 01:45 – Assessing EMS Education Around the World: Lessons from training centres in 23 countries. 04:30 – Simulation Without the Million-Dollar Lab: Creating effective training with limited resources. 05:20 – What Is the International Paramedic Registry?: Establishing international standards for paramedicine. 08:01 – Learning from the US National Registry: Why independent certification matters. 10:28 – Defining Levels of Paramedicine: Responder, basic and advanced practice. 13:03 – What Should Every Paramedic Know?: Building and validating 1,028 international competencies. 17:32 – Is IPR Becoming an International Standard?: Adoption, recognition and international mobility. 19:44 – Certification vs Licensure: An important distinction for international paramedics. 21:47 – Degree vs Certification: Does graduating from university prove clinical competency? 26:47 – Does a Degree Guarantee Competence?: Why David argues for independent verification. 28:20 – US vs UK Paramedics: Who Is Better?: Why minimum standards matter more than comparison. 29:17 – When the Same Job Title Means Different Skills: Comparing paramedic education and scope internationally. 30:35 – Does Programme Length Matter?: Why three years of education can mean very different things. 33:40 – Australia's Nurse–Paramedic Model: Different professions and different clinical environments. 36:43 – The UK Paramedic Model: Degrees, registration and the changing ambulance workforce. 39:36 – Germany, Spain and European EMS: Different routes to prehospital practice. 41:50 – Does France Have Paramedics?: Looking beyond professional labels. 44:12 – Can Nurses Take the IPR Exam?: Why hospital expertise does not automatically equal prehospital expertise. 44:52 – Paramedicine Is a Specialty: A separate environment requires a separate body of knowledge. 45:25 – Research, Education and Clinical Practice: David's three-legged stool of paramedicine. 46:56 – “Soak It Up, Buttercup”: David's advice for the next generation. 47:38 – The Privilege of Being a Paramedic: Human dignity, patients and why the work matters. | |||
| 211-CaBAMiquine One Dose Malaria Treatment? | 04 Sep 2026 | 00:29:49 | |
This week, Aebhric O'Kelly is joined by Jason Jarvis, a former US Army Special Forces medic, tropical medicine educator, and researcher, for a practical discussion of malaria management in remote and resource-limited environments. Jason reviews the malaria parasite life cycle and explains why understanding the liver and blood stages is important when selecting treatment. The discussion covers current management with artemether–lumefantrine (Coartem) for uncomplicated malaria and IV artesunate for severe disease. Prevention remains essential. Jason discusses bed nets, repellents and chemoprophylaxis, including Malarone, doxycycline and mefloquine, along with the advantages and adverse effects of each. The centrepiece of the episode is cabamiquine–pyronaridine. Jason discusses the recent Phase 2a research and two particularly exciting possibilities: single-dose treatment and potential activity against multiple stages of the malaria parasite. If subsequent trials support these findings, this could significantly simplify malaria treatment, particularly in remote settings where adherence to multi-dose regimens can be difficult. Jason also emphasises that cabamiquine remains investigational and requires further clinical evaluation. The conversation also explores antimalarial resistance, G6PD considerations, R21 and RTS,S malaria vaccines, and the importance of antimicrobial stewardship. Finally, Jason brings the discussion back to the remote medic: prevent mosquito bites, ensure chemoprophylaxis is taken, carry appropriate contingency treatment and have a realistic diagnostic plan. The episode closes with a discussion of microscopy, malaria rapid diagnostic tests (RDTs), and clinical diagnosis when neither is available. 00:00 – Jason Jarvis Returns: Tropical medicine and infectious-disease education. 02:00 – What Is Malaria?: Understanding the parasite. 04:30 – The Malaria Life Cycle: Mosquito, liver and blood stages. 07:00 – Treating Malaria Today: Current antimalarial therapy. 08:10 – Coartem or IV Artesunate?: Uncomplicated versus severe malaria. 09:15 – Preventing Malaria: Bed nets, repellents and mosquito avoidance. 10:00 – Chemoprophylaxis: Malarone, doxycycline and mefloquine. 11:15 – The Remote Medic's Malaria Kit: Prevention and contingency treatment. 13:30 – Mefloquine and the Nightmares: Benefits and neuropsychiatric effects. 16:15 – Introducing Cabamiquine: A potential new antimalarial. 17:30 – The Phase 2a Trial: Early clinical evidence. 20:30 – Could One Dose Treat Malaria?: The potential for single-dose treatment. 21:15 – The Resistance Problem: Protecting new antimalarials. 22:15 – Why One Dose Matters: Potential benefits in remote settings. 23:00 – Targeting Multiple Parasite Stages: Potential liver and blood-stage activity. 24:00 – Cabamiquine and Primaquine: Implications for liver-stage treatment. 25:30 – What About G6PD?: An important unanswered question. 26:15 – The Future of Malaria Treatment: Could treatment become considerably simpler? 27:10 – Malaria Vaccines: R21 and RTS,S. 28:40 – Antimalarial Resistance: Lessons from Southeast Asia. 30:00 – Advice for the Remote Medic: Practical preparation for malaria. 32:30 – Diagnosing Malaria in the Field: Microscopy and diagnostic planning. 34:15 – Choosing a Malaria RDT: HRP2 and pLDH testing. 35:30 – No RDT, No Microscope: Clinical diagnosis and presumptive treatment. 37:00 – Final Thoughts: Key lessons for austere clinicians. | |||
| 210-Lessons from Northern Sweden and Ukraine | 28 Aug 2026 | 00:32:32 | |
This week, Aebhric O'Kelly speaks with Christoffer Mäkitalo, a Swedish ambulance and anaesthesia nurse whose career spans remote prehospital care, the Swedish Civil Defence and Resilience Agency, military medicine and repeated training deployments to Ukraine. For Christoffer, prolonged care is not an unusual operational scenario. After 20 years working in northern Sweden, long response and transport times are part of routine ambulance practice. A call may involve a 45–60-minute response, followed by several hours of transport to a hospital capable of providing the required definitive care. With limited ambulance and helicopter resources covering enormous distances, clinicians must continually balance clinical need, transport decisions and system availability. The conversation then moves to Ukraine, where Christoffer has worked alongside Tactical Medicine North to support the development of TCCC, Combat Lifesaver, Combat Medic/Corpsman, instructor, blood resuscitation and ultrasound training. His next deployment will include piloting a two-day prolonged field care programme aimed at the CLS level. A central theme is that the changing battlefield requires prolonged casualty care skills to move further forward. Casualties may remain with combat lifesavers and medics for extended periods, making seemingly basic nursing interventions, keeping patients clean, dry and warm, managing elimination, monitoring wounds and preventing complications, increasingly important. As Christoffer puts it, many combat lifesavers had no healthcare background before the war; skills clinicians consider obvious must therefore be deliberately taught. Chapters 00:00 – Introduction: Christoffer Mäkitalo Twenty years of prehospital medicine, military nursing and civil defence work in northern Sweden. 01:41 – When Prolonged Care Is Just Normal Care Why one-hour-plus evacuation timelines are an everyday reality for ambulance clinicians in northern Sweden. 03:44 – Medical Training in Ukraine Christoffer's repeated deployments and the evolution from basic TCCC towards instructor development, blood resuscitation and ultrasound. 06:20 – Taking Prolonged Casualty Care to the CLS Piloting a two-day prolonged field care programme and why these skills need to move beyond highly trained medical personnel. 09:16 – Nursing Skills on the Modern Battlefield Wound care, hygiene, keeping casualties dry and warm, elimination and other fundamental care when evacuation is delayed. 11:34 – The Battlefield Has Changed Why assumptions based on rapid evacuation and air superiority no longer reflect the realities being reported from Ukraine. 12:56 – Sweden's Civil Defence and Resilience Agency Humanitarian operations, international deployments and supporting UN and EU missions around the world. 17:12 – Working as a Swedish Combat Nurse Combining civilian clinical practice with military medicine 19:49 – Remote Ambulance Medicine in Northern Sweden Working with limited resources, long distances and the need to become an effective clinical problem-solver. 23:28 – When HEMS Is Not Available Deciding when to request helicopter support and the operational challenges of weather, icing and enormous geographical coverage. 26:23 – Cross-Border Rescue and Evacuation Cooperation with Norwegian and Finnish services and the capabilities available across Scandinavia. 27:28 – The Swedish Ambulance Nurse Education, scope of practice, anaesthesia training and differences between civilian and military clinical capabilities. 30:36 – Treat, Release or Transport? Why does transporting every patient simply not work when one ambulance journey can take six to eight hours? 33:26 – Fixed-Wing Evacuation Moving patients over long distances for specialist and critical care unavailable locally. 35:14 – Advice for the New Austere Clinician Curiosity, humility, lifelong learning and finding the area of medicine that genuinely matters to you. | |||
| 209-Ten years of CoROM Rethinking How We Teach Austere Medicine | 21 Aug 2026 | 00:28:37 | |
Aebhric O'Kelly is joined by Dr Csaba Dioszeghy, CoROM co-founder and CEO, critical care and emergency medicine consultant, cardiologist, and experienced prehospital clinician. The conversation explores what makes education for remote and austere clinicians fundamentally different from conventional medical education. CoROM students work across the world in military, humanitarian, offshore and other resource-limited environments. Csaba discusses why education needs to adapt to these clinicians rather than expecting their professional lives to conform to a traditional university model. A major theme is listening to students. Aebhric and Csaba discuss how student feedback has directly influenced CoROM's curriculum, facilities, administration and teaching methods — including significant changes being introduced for the new academic year. They also discuss the redevelopment of the MSc in Austere Critical Care, including more interactive online learning, greater flexibility for students who cannot travel to Malta, and expanded opportunities for practical education. The discussion considers an important question for modern medical education: how much of postgraduate austere medicine can genuinely be taught online, and what still requires hands-on experience? Chapters 00:00 – Welcome to Season 5 A new academic year, a new podcast season and the changing face of CoROM. 00:38 – CoROM's Next Chapter Csaba's role as CEO, consolidating a decade of growth and the College's ambitions for the future. 03:02 – What Makes CoROM Different? Building flexible education for clinicians working across military, humanitarian, offshore and resource-limited environments. 06:52 – Listening to Our Students How student feedback directly influences curriculum, facilities and the way CoROM teaches. 09:23 – Changing the Practical Curriculum Revamping classroom education, investing in facilities and placing greater emphasis on hands-on learning. 11:34 – Rebuilding the MSc in Austere Critical Care New modules, interactive education and moving beyond traditional recorded online lectures. 13:07 – Can You Teach Austere Critical Care Online? Accessibility, international students and why the redesigned MSc can now be completed without compulsory travel to Malta. 18:01 – Improving Support for Online Students Human faculty support, central administration and improving communication with students. 19:54 – Building a Better Student Information System Modernising the administrative infrastructure behind a growing international College. 21:02 – Building the CoROM Community The future of CoROM's membership structure and strengthening the wider professional community. 23:05 – The CoROM Digital Library Building offline access to field guides, publications and educational resources. 25:41 – A New Digital and Physical CoROM New content, facilities, Moodle, equipment and the systems being developed for the new academic year. 28:05 – Quality Assurance and the Future of CoROM Institutional review, reaccreditation and the longer-term direction of the College. 29:33 – More Hands-On, Less PowerPoint Updating the BSc and MSc programmes and increasing practical learning when students come to Malta. 32:17 – International Partnerships Growing educational, clinical and research relationships around the world. 34:02 – Advice for the New Austere Medic What should a doctor, nurse or medic entering austere medicine concentrate on? 35:00 – When Guidelines Don't Fit the Environment Why guidelines developed in well-resourced healthcare systems may not always translate directly into resource-limited care. 36:02 – Your Brain Is Still a Resource Understanding physiology, thinking beyond protocols, innovation and Csaba's final advice: be brave and don't give up. | |||
| 208-WEM with Prof Mark Hannaford | 14 Aug 2026 | 00:38:58 | |
This week, Aebhric O'Kelly is joined by Professor Mark Hannaford, founder and CEO of World Extreme Medicine, to discuss the evolution of expedition medicine, humanitarian response, and the growing importance of prolonged casualty care in modern conflict. From kayaking in Patagonia and Antarctica to developing one of the world's leading extreme medicine organisations, Professor Hannaford shares the experiences that shaped his career and explains how World Extreme Medicine has become a global leader in expedition medicine education, research and humanitarian training. About the Speaker Professor Mark Hannaford is the Founder and CEO of World Extreme Medicine (WEM), an organisation dedicated to advancing healthcare in remote, austere and expeditionary environments. Topics Covered
Chapters 00:00 – Introduction Introducing Professor Mark Hannaford Correct pronunciation and welcome 00:36 – Mark's background From geographer to expedition leader Living in Abu Dhabi A lifetime in expedition and remote medicine 02:02 – Supporting Ukraine The origins of the World Extreme Medicine Fund Choosing a focused humanitarian mission Current work in Ukraine 04:43 – Adventures in British Columbia Kayaking with orcas Patagonia expeditions Antarctica and the Arctic Wildlife and expedition life 09:56 – How World Extreme Medicine began Early expedition medicine Standardising expedition medical support Paying expedition medics Building multidisciplinary teams 15:04 – Breaking down medical silos Why WEM became World Extreme Medicine Bringing together military, humanitarian, wilderness and expedition medicine The evolution of the WEM Conference 17:47 – Medicine beyond medicine Expedition skills Bushcraft Vehicle safety Risk management 19:17 – Primary care versus trauma The reality of expedition medicine Why prevention matters 20:29 – The WEM Fund in Ukraine Medical supply convoys TCCC and Stop the Bleed Training civilians Building local capability 27:44 – Prolonged Casualty Care Changing battlefield realities Drone warfare Extended evacuation times Adapting PCC education to frontline needs 30:03 – Sharing Ukraine's lessons Teaching civilians NATO exercises Disseminating battlefield medical lessons 32:27 – Creating the MSc in Extreme Medicine Partnership with the University of Exeter Professionalising expedition medicine Research priorities Translating austere medicine into mainstream healthcare 37:59 – Advice for new expedition medics Master the basics Know your limits Gain domestic experience Find mentors Say yes to opportunities 40:36 – Final advice Prepare for your environment Listen more than you speak 41:22 – Closing remarks Reflections on Professor Hannaford's contribution Final thoughts and thanks | |||
| 207-OTC Drugs for Austere Primary Care | 07 Aug 2026 | 00:41:52 | |
In this episode of CoROM Conversations, Aebhric O'Kelly is joined by Dr Bill Vasios to discuss one of the most overlooked aspects of remote and austere medicine: the intelligent use of over-the-counter (OTC) medications in austere primary care. Rather than focusing on advanced equipment and prescription drugs, this discussion explores how a carefully selected collection of inexpensive, widely available medications can effectively manage many of the illnesses and injuries encountered in remote, expeditionary, humanitarian and disaster settings. The conversation emphasises clinical reasoning, careful assessment, conservative prescribing, and making the most of simple interventions before escalating treatment. Chapters 00:00 – Introduction: Why OTC medicines matter in austere medicine 02:22 – Traveller's diarrhoea
06:54 – Upper respiratory infections
13:34 – Musculoskeletal injuries
20:45 – Allergic rashes and contact dermatitis
23:02 – Insect bites and stings
25:21 – Dehydration
29:59 – Heat illness
32:15 – Acid reflux in austere environments
32:15 – Minor wound care
36:45 – Building the ideal austere OTC medical kit
41:20 – Final discussion, audience questions and wrap-up The discussion concludes by assembling a practical remote medicine kit, including:
Key Take-Home Messages Good assessment should always precede medication. Oral hydration remains the cornerstone of treating dehydration. Many common conditions can be managed safely with inexpensive OTC medications. Every item carried should ideally have multiple uses. Patient education and involvement improve outcomes. Simple treatments, applied correctly, are often more effective than complicated ones. Featured Speakers Aebhric O'Kelly: Paramedic, educator and Rector of the College of Remote and Offshore Medicine. Dr Bill Vasios: Physician Associate, educator and specialist in austere and remote healthcare. Resources Mentioned World Health Organization Oral Rehydration Solution (ORS) Wilderness Medical Society clinical practice guidelines Joint Trauma System Clinical Practice Guidelines (JTS CPGs) Bristol Stool Chart Ottawa Ankle Rules Listen, Learn, Deploy Whether you're preparing for an expedition, humanitarian mission, offshore deployment or remote clinic, this episode provides practical, evidence-informed advice on building a lightweight, effective medical kit capable of managing the conditions you are most likely to encounter. | |||
| 206-World Extreme Medicine Fund with Luca Alfatti | 31 Jul 2026 | 00:36:24 | |
This week, Aebhric is joined by Luca Alfatti, an advanced paramedic and co-founder of the World Extreme Medicine Fund, who shares insights from his global medical missions, including recent work in Ukraine and NATO exercises. Discover how adaptable training and international collaboration are transforming emergency medicine in conflict zones. Chapters 00:00 Introduction to Luca Alfadi and his background 02:10 Luca's journey from expedition leader to advanced paramedic 05:02 Founding of the World Extreme Medicine Fund 06:57 Medical aid efforts in Ukraine during the war 11:59 Training Ukrainian medics in prolonged casualty care 15:59 Challenges of medical resource limitations in conflict zones 20:09 Adapting training to frontline needs and experience levels 25:06 Participation in NATO Vigorous Warrior exercise 27:59 Lessons learned from NATO exercise on prolonged casualty care 31:59 Upcoming publication in the Journal of Special Operations Medicine 35:03 Psychological and societal impacts of war on healthcare workers 38:01 The importance of international collaboration and relationships 39:06 Advice for new medics entering austere medicine 39:50 Closing remarks and future outlook Keywords extreme medicine, Ukraine, prolonged casualty care, NATO exercises, medical training, humanitarian aid, expedition medicine, medical innovation, war zones, emergency response Key Topics International medical aid in Ukraine Prolonged casualty care training NATO Vigorous Warrior exercise insights Innovations in casualty extraction and treatment Adapting medical practices to resource-limited settings The importance of listening to frontline medics Psychological impacts of war on healthcare workers Building international medical collaborations | |||
| 205-Good ALS starts with great BLS with David Stanton | 24 Jul 2026 | 00:33:21 | |
This week, Aebhric O'Kelly speaks with David Stanton, a search and rescue paramedic, former Medic One paramedic, wilderness medicine educator, researcher at the University of Nottingham, and humanitarian medical instructor. David discusses why exceptional basic life support remains the foundation of all advanced medical care, explores innovations from Seattle's renowned Medic One system, shares lessons from Ukraine, and explains his research into prolonged casualty care and medical intelligence. Chapters 00:00 – Introduction and David Stanton's background 01:00 – The Seattle Medic One system explained 03:00 – Why Seattle achieves exceptional cardiac arrest survival 06:30 – Innovation, research and improving patient outcomes 08:20 – Head-up CPR and evolving resuscitation science 10:00 – Good ALS begins with great BLS 13:00 – Building confident and capable EMTs 17:00 – Should every EMT become an Advanced EMT? 20:30 – Teaching maxillofacial trauma management in Ukraine 23:00 – Learning from Ukrainian combat medicine 27:30 – Teaching wilderness medicine at Nottingham 29:20 – Medical intelligence as an intelligence discipline 32:00 – Rethinking prolonged casualty care 35:00 – Constraint as the foundation of prolonged casualty care 38:30 – NATO's Vigorous Warrior exercise 40:20 – Final advice for new austere medical providers About the Guest David Stanton is a search and rescue paramedic with nearly two decades of pre-hospital experience. His career includes service within Washington State's Medic One system, international rescue operations, humanitarian medical education, and research at the University of Nottingham. His current work focuses on prolonged casualty care, medical intelligence, wilderness medicine, and improving healthcare delivery in austere and conflict environments. Keywords Seattle Medic One, David Stanton, paramedic, EMT, Advanced EMT, CPR, cardiac arrest, BLS, ALS, wilderness medicine, austere medicine, prolonged casualty care, combat medicine, Ukraine, medical intelligence, NATO, Vigorous Warrior, TCCC, JTS, CoROM Podcast | |||
| 204-Frontline Medic in Ukraine | 17 Jul 2026 | 00:25:03 | |
This week, Aebhric is joined by Fred, who has spent almost four and a half years working in military and military-adjacent medicine in Ukraine, primarily on the forward line of troops (FLOT), with additional experience at casualty collection points and stabilisation points. In this episode, he and Aebhric trace how combat casualty care has changed since 2022: evacuation timelines have stretched from minutes to weeks, wounding patterns have shifted as troop formations disperse to avoid drone strikes, and medics on the ground are being asked to deliver prolonged field care (PFC) far beyond their training. The conversation covers current combat wound pack medications, the phase-out of nalbuphine, tramadol's hepatotoxicity risk in dehydrated patients, the training gap between CLS/CMC-qualified providers, and the disease and non-battle injury (DNBI) burden from leptospirosis to Lyme disease to anthrax that frontline medics are managing largely on their own. Chapters 00:00 – Introduction and guest welcome 01:00 – Four years of medical experience on the Ukrainian front 02:00 – How drone warfare has changed casualty patterns 03:10 – Evolution of TCCC and prolonged evacuation 04:20 – Changes to battlefield medications and analgesia 06:00 – Ketamine, morphine and tramadol in prolonged casualty care 08:00 – The challenge of prolonged pain management 09:15 – Nerve blocks and expanding combat medic skills 10:15 – Closing the knowledge gap for frontline medics 12:00 – Self-directed learning and educational resources 13:15 – Current medical training available in Ukraine 15:00 – Could prolonged casualty care become a formal certification? 16:00 – A day in the life of a frontline combat medic 18:15 – Drone casualty evacuation: promise and limitations 20:00 – What knowledge do combat medics really need? 22:00 – Disease, dehydration and prolonged field medicine 23:20 – Final advice for new austere medical providers Evolving battlefield medicine. Evacuation that once happened within minutes from positions near the front now can take weeks, driven by pervasive drone surveillance and strike capability. Mass casualty incidents near the front line have become less common as units disperse, changing the injury and casualty flow medics have to plan for. Training and knowledge gaps. There's a wide spread in provider background — from Ukrainian feldshers (registered-nurse equivalent) to personnel who completed a seven-day CMC course — all filling the same frontline medic role. Nerve blocks beyond digital blocks aren't commonly taught. Fred argues CMC training was never meant to stand alone; it assumes a prior EMT-level foundation that many providers don't have. Training availability is inconsistent and largely filled by NGOs of varying quality, with NAMT/CLS/CMC certification currently the closest thing to a standard. Evacuation reality on the ground. Getting to a casualty may take hours to days depending on drone "weather windows." Waits of 30–60 days for evacuation are not unheard of. As a result, stabilisation points are increasingly seeing patients who would survive regardless of intervention, rather than the critical mid-triage-category patients medics are most needed for. Ground evacuation drones (UGVs) are seeing real use but only for stable patients, since medics can't manage an airway or maintain a sedated patient during transit; aerial casualty evacuation is currently considered infeasible due to drone threats. Disease and non-battle injury (DNBI). Fred and Aebhric discuss the need for a Ukraine-specific DNBI framework and better environmental/threat updates reaching medics in the field. Closing advice. Fred's advice for new medics, nurses, and physicians entering austere medicine: keep learning and keep developing — people are counting on you to do your job well. | |||
| 203-Austere Primary Care Webinar | 10 Jul 2026 | 00:41:30 | |
This week, Aebhric O’Kelly is joined by Bill Vasios and Rhod Jordan for an interactive discussion on one of the most important and often overlooked areas of remote medicine: Austere Primary Care. Whilst trauma often dominates training, the reality is that most remote clinicians spend far more time managing diarrhoeal illness, skin infections, musculoskeletal injuries, respiratory complaints, fever, environmental illnesses, and preventative healthcare. The panel discusses the clinical mindset required to work in resource-limited environments, introduces CoROM's CHART patient assessment system, and explores practical approaches to diagnosis when advanced investigations are unavailable. Whether you work in expedition medicine, offshore healthcare, humanitarian operations, military medicine, or remote primary care, this episode provides practical insights into becoming a more capable austere clinician. Chapters 00:05 – Welcome to CoROM Conversations 00:17 – Why primary care matters more than trauma in remote medicine 01:10 – Defining austere and resource-limited environments 02:00 – Developing the austere clinical mindset 02:40 – Becoming comfortable with uncertainty and limited resources 04:00 – Building confidence through deliberate practice 05:00 – Wilderness medicine and learning outside the ambulance 07:15 – Resilience and supporting expedition teams 08:00 – Common primary care presentations in austere environments 08:15 – Gastrointestinal illness, dehydration and traveller's diarrhoea 08:45 – Skin disease, wound care and blister management 09:30 – Environmental illness: hypothermia, frostbite and heat injury 10:10 – Musculoskeletal injuries in expedition medicine 11:55 – Learning orthopaedic assessment through repetition 13:00 – ENT, eye and dental emergencies 14:20 – Introducing the CoROM CHART assessment framework 16:40 – Chief Complaint, Condition and the CPRO assessment 17:20 – Recognising the critically ill patient 20:15 – History taking using SAMPLER with additional risk assessment 22:00 – Secondary assessment using the BEAST observations 26:10 – Review of systems using CRANES 27:30 – Treatment, disposition and clinical trending 28:10 – Diagnostic tools for austere medicine 30:30 – Essential point-of-care investigations 31:00 – Why every diagnostic tool needs a backup plan 33:00 – Altitude, pulse oximetry and interpreting observations 34:00 – Fever assessment in austere environments 34:45 – Measuring temperature correctly in older adults and children 35:40 – Managing fever of unknown origin and malaria 36:10 – Nursing care and prolonged patient management 36:45 – Public health and preventative medicine 37:30 – Recognising clinical red flags 38:00 – Key learning points and deployment preparation 39:00 – The importance of clinical examination over technology 40:00 – Trusting your senses and treating the patient—not the monitor 41:00 – Closing remarks and CoROM CPD opportunities Key Topics Discussed Austere primary care Clinical reasoning in resource-limited environments The austere clinical mindset Preventative medicine Travel medicine Wilderness medicine Expedition healthcare Remote diagnostics Fever of unknown origin Malaria diagnosis Environmental medicine Musculoskeletal injuries Skin disease Point-of-care ultrasound Nursing care in prolonged field care The CoROM CHART assessment system CPRO and BEAST observations Differential diagnosis Key Takeaways Most remote clinicians spend considerably more time managing primary care conditions than major trauma. Clinical confidence develops through experience, deliberate practice and mentorship. Every piece of diagnostic equipment should have a backup plan. Careful history taking remains one of the most valuable diagnostic tools available. Trend observations over time rather than relying on single measurements. In malaria-endemic regions, malaria should remain high on the differential diagnosis for every patient with fever. | |||
| 202-A Life in Medicine with Dr Winston de Mello | 03 Jul 2026 | 00:44:20 | |
In this special episode of the CoROM Podcast, Dr Winston de Mello joins Aebhric O’Kelly for a wide-ranging discussion on burns, military medicine, medical education, mentorship, and the evolution of austere healthcare. A founding influence behind CoROM and a former Commanding Officer of the UK military's Battlefield Advanced Trauma Life Support (BATLS) programme, Winston reflects on decades of service, from treating burn casualties after the Falklands War to helping shape generations of military medics, doctors, nurses, and paramedics. The conversation explores prehospital burn care, topical morphine, ketamine procedural sedation, the origins of several austere medicine assessment techniques still taught today, and the importance of lifelong learning and compassionate patient care. Chapters 00:05 – Introduction to Dr. Winston DeMello 00:53 – Current work in burn care and pelvic pain medicine 01:17 – The origins of Severe Burn Life Support (SBLS) 02:46 – Burn education at bachelor's and master's level 03:29 – How the Falklands War sparked a lifelong interest in burns 04:50 – Why severe burns remain a chronic disease 06:07 – The importance of burn education in austere medicine 06:55 – The fundamentals of burn management 07:09 – Why cling film remains one of the best burn dressings 08:02 – Infection prevention and moisture control with cling film 08:59 – Teaching burn care internationally 09:29 – The story behind topical morphine for burns 11:11 – Twenty years of experience using topical morphine 11:41 – Why morphine should be diluted with water rather than saline 12:20 – Topical morphine for ulcers, wounds, and joint pain 13:11 – What is a ketamine shower? 14:00 – Burn dressing changes under ketamine procedural sedation 15:28 – Why ketamine remains underutilised in medicine 17:27 – First meeting at the BATLS course 18:59 – Teaching catastrophic haemorrhage during wartime deployments 21:20 – The importance of passion in medical education 24:20 – The multiplier effect of teaching future instructors 25:24 – End-of-life care and battlefield medicine 26:41 – Burns education and the evolution of austere medicine 27:10 – Learning how to teach at BATLS 28:29 – The influence of legendary military instructors 30:36 – Building the BATLS faculty team 31:11 – Teaching others how to teach 32:36 – The origins of CoROM and early wilderness medicine training in Ireland 33:33 – Persistence, resilience, and building educational programmes 34:37 – Mentoring students including Grigory Tisenovich 35:14 – The origins of the "Winston Sign" for estimating CVP 38:24 – The importance of historical medical knowledge 39:18 – The "Palmar Crease Sign" and assessing anaemia 40:46 – Treating the future King of Jordan at Sandhurst 43:26 – How a military patient inspired a career in pelvic pain medicine 45:11 – Meeting Dr. Mallampati and airway management history 47:22 – The story behind the Trendelenburg name 48:29 – Reflections on mentorship and professional legacy 49:25 – Advice for the next generation of austere clinicians 50:49 – "Do the basics well, but always in style" 51:01 – Closing thoughts and future collaboration Guest Biography Dr Winston DeMello is an anaesthetist, military medical educator, burns specialist, and one of the founding influences behind the College of Remote and Offshore Medicine Foundation. He served as Commanding Officer of the UK military's BATLS programme and has held fellowships from all four Royal Colleges. His career has included extensive work in burn care, military medicine, procedural sedation, prehospital care, and pelvic pain medicine. He continues to contribute to international education through Severe Burn Life Support (SBLS) and advanced burn care training. | |||
| 201-Doctorate in Health Studies with Dr Ella Corrick | 26 Jun 2026 | 00:39:19 | |
This week, Aebhric O’Kelly sits down with Dr Ella Corrick, Head of Postgraduate Studies at the College of Remote and Offshore Medicine (CoROM) and Director of the Doctor of Health Studies (DHS) programme. Ella discusses her work as a rural physician in the Scottish Highlands, her role in mountain rescue, and how CoROM is helping clinicians transform operational experience into meaningful doctoral research. The conversation explores rural medicine, doctoral education, research methodology, healthcare systems in austere environments, and the future of research in remote and resource-limited settings. Chapters 00:00 Introduction and welcome back to the podcast 00:25 Working as a physician in the Scottish Highlands 01:00 Life after becoming a new parent 01:40 Mountain rescue and rural emergency medicine 02:00 Joining CoROM and taking over the DHS programme 03:00 Shared challenges in rural and austere medicine 04:20 Transforming operational experience into research 06:30 Who are CoROM doctoral students? 08:30 Future directions for doctoral research 11:00 Why CoROM focuses on applied rather than laboratory research 12:30 Understanding the Doctor of Health Studies (DHS) 16:00 How long does a doctorate really take? 17:50 Oxford, Nottingham, and Ella’s research journey 22:00 Research on prescribing quality in children 25:40 How doctoral study improves clinical practice 27:40 DHS versus a traditional PhD 29:20 Advice for prospective doctoral students 32:30 Ella’s current research interests 35:00 Mountain rescue, resilience, and rural healthcare 38:00 Books, science fiction, and lifelong curiosity 40:30 Advice for clinicians entering austere medicine 41:40 Closing thoughts Topics Discussed Rural and island medicine Mountain rescue Doctoral education Research methodology Telemedicine Resource-limited healthcare Prolonged casualty care Clinical leadership Research literacy Volunteer emergency services Healthcare resilience Evidence-based medicine | |||
| 200-CoROM Founders discuss 10 years of CoROM | 19 Jun 2026 | 00:40:02 | |
This special 200th episode of the CoROM podcast celebrates four years of continuous weekly episodes and reflects on the journey of the College of Remote and Offshore Medicine. Founder Aebhric O’Kelly is joined by fellow founders John Clark and Dr Csaba Dioszeghy to discuss how CoROM began, why Malta was chosen as its home, the growth of the organisation over the past decade, and the vision for the next five years. The conversation explores CoROM’s evolution from a small training organisation into an internationally recognised higher education institution serving students from more than 30 countries across five continents. Chapters 00:00 Introduction and celebrating 200 podcast episodes 00:50 How the three founders came together 01:20 Why CoROM moved to Malta 03:40 Malta’s medical history and its connection to CoROM 08:10 Why Pretty Bay became CoROM’s home 10:20 Historical medicine in Malta and the Hospitallers 12:00 Growth of CoROM over the past three years 13:00 Launch of the Doctorate in Health Studies (DHS) 14:00 The impact of the CoROM podcast 15:00 Building a non-profit educational institution 15:50 The origins of Remote Medicine Ireland 20:00 Student growth and global reach 22:40 Medicine in the Mediterranean (MIM) Conference 26:30 The CoROM family culture 28:20 Looking ahead: the next 12 years 28:40 John Clark’s five-year vision 34:00 Dr Csaba Dioszeghy’s five-year vision 38:00 Keeping education affordable 39:00 Impact stories from Tanzania 40:20 CoROM’s mission and global influence 41:40 Reflections on 200 podcast episodes 42:30 Closing remarks
Key Discussion Points Why Malta? The founders discuss the circumstances that led CoROM to Malta in 2014. What began as an opportunity to support paramedic education evolved into the establishment of a permanent educational institution. Malta’s strategic location, English-speaking environment, rich medical history, and accessibility for international students all contributed to the decision. John Clark highlights Malta’s historical identity as the “Hospital of the Mediterranean” and its longstanding connection to military and austere medicine traditions.
Building CoROM Aebhric reflects on the origins of Remote Medicine Ireland and how frustration with expensive, poor-quality educational programmes motivated the creation of something different. The founders describe the progression from wilderness medicine courses to paramedic education, postgraduate programmes, and doctoral-level education. Global Reach CoROM currently serves more than 160 students from over 30 countries across five continents. The founders discuss the importance of maintaining a truly international perspective while preserving a close-knit educational culture.
Medicine in the Mediterranean (MIM27) The founders discuss the rapid growth of the Medicine in the Mediterranean conference, which has become a recognised gathering point for practitioners interested in remote, austere, wilderness, expedition, military, and offshore medicine. | |||
| 199-Snake Bites with Dr Evan Baines | 12 Jun 2026 | 00:59:06 | |
This month, CoROM Conversations is joined by Dr Evan Baines, Emergency Medicine Physician, EMS Fellow, former 18D, and contributor to the JTS Snake Envenomation Clinical Practice Guideline (CPG). Snake envenomation remains a major global health problem, with millions of bites occurring annually and a disproportionate burden falling on remote and resource-limited regions. In this episode, Dr Evan Baines discusses the development of the JTS Snake Envenomation CPG, practical field management, antivenom selection, operational planning, and common misconceptions surrounding snakebite treatment. Chapters 00:00 – Introduction to Snake Envenomation 01:45 – Why Snake Bites Matter in Austere Medicine 04:00 – Snakebite Myths and Immediate First Aid 05:00 – The Four Envenomation Syndromes 08:00 – Operational Planning and Antivenom Selection 11:20 – Understanding the JTS Treatment Algorithms 16:00 – Case Study: Pit Viper Envenomation 22:00 – Determining When Antivenom Has Worked 24:00 – Antivenom Dosing Principles 26:00 – Field Diagnostics and Coagulopathy Assessment 28:00 – Neurotoxic Snake Bites and Respiratory Failure 33:00 – Why Identifying the Snake Often Doesn't Matter 34:00 – Dry Bites and Return-to-Duty Decisions 36:00 – Antivenom Reactions and Anaphylaxis Management 39:00 – Tourniquets, Pressure Bandages, and Controversies 46:00 – Life Over Limb? Risk-Benefit Decision Making 51:00 – Airway Management in Neurotoxic Envenomation 55:00 – Regulatory Challenges and Deployment Considerations 57:45 – Key Take-Home Messages | |||
| 198-eFAST for Combat Life Savers with TacMedNorth | 05 Jun 2026 | 00:35:49 | |
This week, Aebhric O'Kelly speaks with three combat medics from Tactical Medicine North following a Tactical APUS instructor development programme in Malta. The discussion explores whether ultrasound can be taught to non-medical personnel operating in combat environments, including Combat Lifesavers (CLS) and Combat Medic Corpsmen (CMC), and how ultrasound may support prolonged casualty care, triage, and telemedicine in Ukraine. The conversation challenges traditional assumptions regarding ultrasound education, introduces the Tactical APUS concept, discusses modifications to the standard eFAST examination sequence, and reviews preliminary observations from a study comparing parasternal long-axis (PLAX) and subxiphoid cardiac views. Chapters 00:00 – Introduction 01:06 – Can Non-Medics Learn Ultrasound? 03:00 – Lessons from the APUS Course 05:30 – The Power of Home Points07:50 – What is Tactical APUS? 10:00 – Adapting eFAST for Combat Operations 12:30 – Hypothermia Prevention During Ultrasound 15:20 – The Controversial Change: Heart Last 20:00 – PLAX vs Subxiphoid Cardiac Views 24:40 – Teaching Maltese Nurses 29:10 – Should We Teach Ultrasound to Combat Lifesavers? 32:20 – Ultrasound as a Triage Tool 35:10 – Advice for Future Tactical Ultrasound Providers 38:00 – Closing Remarks Key Takeaways The parasternal long-axis cardiac viewappears easier for novice learners than the traditional subxiphoid view. Overview of the APUS and Tactical APUS training programme conducted in Malta. Discussion on teaching eFAST ultrasound to Combat Lifesavers and Combat Medic Corpsmen. Comparison with early challenges teaching combat medicine to personnel without formal medical backgrounds. Importance of simple teaching techniques and instructor adaptability. Introduction of the "Home Point" concept for each eFAST window. How home points help students recover when they become disoriented during scanning. Development of a one-day ultrasoundcurriculum for tactical providers. Focus on eFAST as a trauma tool for prolonged field care and telemedicine support. Discussion of modifying the traditional eFAST sequence. Prioritising lung assessment over cardiac views. The dangers of exposing casualties during scanning. Importance of maintaining casualty insulation and minimising gel exposure. Why the Tactical APUS team moved cardiac assessment after lung assessment. Students consistently finding the parasternal long-axis view easier to obtain. Experience using Maltese nurses as pilot students. Differences between teaching healthcare professionals and non-medical personnel. Language barriers and instructional adaptations. Moving beyond "Can we?" to "Should we?" Ultrasound as a prolonged casualty care and telemedicine tool. Supporting decision-making during extended evacuations. Using eFAST to prioritise casualties during mass casualty situations. Early identification of internal bleedingand pneumothorax. Potential role of optic nerve sheath diameter (ONSD) assessment in blast-related head injuries. Importance of accessibility of handheld ultrasound devices. The role of deliberate practice and repetition in ultrasound mastery. Reflections on the success of the Tactical APUS pilot programme. Future collaboration between CoROM and Tactical Medicine North. Final thoughts from the Ukrainian instructors. Ultrasound can be successfully taught to Combat Lifesavers and Combat Medic Corpsmen when training is focused on pattern recognition and image acquisition rather than advanced interpretation. "Home Points" provide a powerful cognitive aid for novice sonographers. Lung ultrasound may provide greater battlefield utility than cardiac ultrasound because interventions can be performed immediately. Hypothermia prevention must remainintegrated into all ultrasound training and operational use. | |||
| 197-Poland PFC with Eagle-Med Systems | 29 May 2026 | 00:22:09 | |
This week, Aebhric O’Kelly is joined by Robert Jędrych, a Polish tactical medicine instructor and founder of the Eagle Med System, who appears on the CoROM Podcast to discuss the evolution of tactical medicine and prolonged field care (PFC) training in Poland and Central Europe. Drawing from more than two decades of experience as a paramedic and tactical medicine educator, Robert shares insights into the realities of preparing civilian and military medical personnel for austere and conflict-adjacent environments. The discussion explores the growing demand for prolonged casualty care education due to the ongoing war in Ukraine, the limitations of current civilian tactical medicine pathways, and the importance of realistic scenario-based training. Robert also reflects on his first attendance at the Special Operations Medical Association Scientific Assembly conference and outlines his vision for the future of tactical medicine education in Poland.
Chapters • 00:00 – Introduction to Robert Jędrych and his background in tactical and austere medicine • 02:20 – Launching the first Austere Emergency Care (AEC) programme in Poland • 03:40 – Why prolonged field care training is increasingly important in Eastern Europe • 04:40 – Medical support and casualty flow from Ukraine into Poland • 05:10 – Building Eagle Med System and tactical medicine education in Poland • 05:45 – Civilian TCCC versus TECC: the confusion in tactical medicine education • 07:30 – Why TECC lacks a Combat Medic/Corpsman equivalent pathway • 11:15 – Discussion on developing an advanced TECC training framework • 14:50 – The impact of prolonged field care and AEC training on operational readiness • 16:20 – What is missing from current tactical medicine training programmes • 17:20 – The importance of realistic scenarios, stress inoculation, and live tissue/cadaver training • 20:50 – Lessons learned from prolonged field care scenarios and provider fatigue • 21:00 – Attending the Special Operations Medical Association Scientific Assembly conference for the first time • 23:05 – Robert’s five-year plan for tactical medicine and PFC development in Poland • 25:00 – Advice for new medics entering austere and tactical medicine • 27:10 – Final thoughts and future collaboration
Key Discussion Points The Growth of Austere Emergency Care in Poland Robert discusses implementing the first AEC programme in Poland and the growing recognition that prolonged casualty care requires far more than procedural medicine. Topics include leadership, communication, patient monitoring, documentation, and decision-making in hostile and resource-limited environments. Civilian Tactical Medicine and the TECC Gap The episode examines the disconnect between civilian tactical medicine needs and current educational pathways. While TCCC remains widely recognised, Robert and Aebhric discuss the absence of a TECC equivalent to the Combat Medic/Corpsman pathway and the need for advanced civilian tactical medical training. Realistic Scenario Training Robert emphasises that high-fidelity scenarios, environmental stress, fatigue, noise, and realistic casualty simulation are essential for preparing providers to function under pressure. He highlights the importance of moving beyond classroom mannequin training into operationally relevant simulation. Lessons from Ukraine Poland’s proximity to the war in Ukraine has shaped the urgency of tactical medicine education. Robert explains how exposure to real-world casualty care challenges has reinforced the need for prolonged field care training among both military and civilian healthcare providers. Building the Future of Tactical Medicine Robert outlines his vision for creating a dedicated training centre, expanding international partnerships, and building a stronger community of instructors capable of teaching evidence-based medicine grounded in operational realities. | |||
| 196-MSIW and Guerrilla Medicine with Antonio from EuroMedics | 22 May 2026 | 00:32:33 | |
This week, Aebhric O’Kelly is joined by Antonio from European Medics to discuss his first experience attending the Special Operations Medical Association Symposium, the growing importance of Medical Support to Irregular Warfare (MSIW), and how civilian and military healthcare systems must integrate to prepare for future conflicts and disasters. Antonio reflects on lessons from occupied Poland, resistance medicine, Ukrainian battlefield realities, and the importance of resilience, logistics, telemedicine, and improvised medicine in modern austere healthcare systems. Chapters 00:00 Introduction and Antonio’s background 01:10 First experience attending SOMA 03:10 “People over products” in tactical medicine 04:30 Civilian involvement in special operations medicine 06:50 Key lessons from the MSIW track 09:45 What is Medical Support to Irregular Warfare (MSIW)? 11:10 Historical resistance medicine in Poland and the Baltics 15:00 Underground clinics and covert evacuation chains 17:30 Telemedicine in resistance healthcare 18:30 How civilian medics can prepare for MSIW 21:00 TCCC, JTS CPGs, and tactical medicine education 22:00 European Medics Tactical Clinical Operations (TCO) course 23:30 Taiwan, resilience, and whole-of-society defence 26:20 Logistics and manufacturing challenges in conflict 28:40 Relationship building and NATO interoperability 29:10 3D printing and improvised medicine 31:20 Antonio’s passion for guerrilla medicine 34:00 Future plans: anaesthesia, ICU, and flight medicine 35:10 Advice for new medics entering austere medicine 37:00 Closing remarks Episode Highlights First impressions from the SOMA Symposium Why “people over products” matters in tactical medicine Civilian-military integration in modern conflict What MSIW (Medical Support to Irregular Warfare) actually means Historical resistance medicine in Poland and the Baltics Lessons from Ukraine and occupied territories Underground clinics and covert casualty evacuation Telemedicine and distributed healthcare networks Why civilian clinicians should learn TCCC Logistics, supply chains, and local manufacturing during war 3D printing and improvised medical equipment The future of European resilience medicine Advice for new medics entering austere medicine | |||
| 195-Damage Control Procedures with Dr John Quinn | 15 May 2026 | 00:49:04 | |
This week, Dr John Quinn joins Aebhric O’Kelly to discuss the emerging field of Damage Control Procedures (DCP) for austere, prolonged, and contested environments. Dr Quinn explores the growing operational gap between Tactical Combat Casualty Care (TCCC) and definitive surgical care, particularly in Ukraine and other high-threat environments where evacuation delays can extend for days. The discussion covers the development of DCP curricula, governance challenges, telemedicine oversight, surgical skills for non-surgeons, and the operational realities driving innovation in prolonged casualty care. The episode also examines lessons learned from Ukraine, the future of austere procedural medicine, and how modern conflict is reshaping medical doctrine across NATO and partner nations. Chapters 00:05 – Introduction to Dr John Quinn and current operational work00:39 – Volunteering in Ukraine and advancing damage control resuscitation01:20 – What are Damage Control Procedures (DCP)?02:01 – The gap between TCCC and definitive surgery03:25 – Why delayed evacuation changes medical doctrine04:29 – Surgical skills for paramedics, nurses, and combat medics05:20 – Governance and legal challenges surrounding DCP06:26 – How surgeons may react to DCP concepts07:16 – Telemedicine oversight and surgeon mentorship in austere care09:11 – Surgical expertise shaping the DCP curriculum10:08 – Overview of the DCP programme structure11:16 – Tier 1 skills: surgical airways, thoracostomy, tourniquet conversion, traumatic amputations12:43 – Tier 2 skills: laparotomy, external fixation, fasciotomy, advanced burns14:29 – Tier 3 concepts: burr holes and REBOA15:47 – Future concepts: haemofiltration and advanced austere ICU care18:22 – Why DCP sounds controversial — and why it may still be necessary19:16 – Telemedicine vs autonomous procedural decision-making22:05 – Clinical governance and parallels with paramedic evolution23:38 – Why basic life support remains foundational25:35 – Historical parallels with early paramedic medicine26:36 – Expansion of chest tube and intraosseous use in Ukraine30:11 – What happens next for the DCP pathway?31:24 – The importance of listening to Ukrainian clinicians32:21 – DCP beyond special operations medicine33:32 – Introduction to the Disaster Health Institute (DHI)35:37 – Bridging strategic and operational medicine36:17 – SOF Combat Medical Conference (CMC) discussion38:19 – Upcoming RCSEd webinar on DCP39:30 – Lessons learned from Ukrainian workshops and role-zero care41:40 – Drone warfare, attacks on medical personnel, and evacuation challenges43:18 – Why Ukrainian medics are requesting Tier 1 and Tier 2 DCP capability45:18 – Upcoming DCP workshop at Medicine in the Mediterranean46:31 – Advice for clinicians entering austere medicine50:27 – AI, education, digital twins, and the future of medical content Guest bio Dr John Quinn is an operational clinician, researcher, and educator working across prehospital care, austere medicine, disaster health, and military medicine. Originally trained as a paramedic, he later completed both medical and doctoral training and now works clinically within the United Kingdom while supporting medical projects and training initiatives in Ukraine. Dr. Quinn is involved in the development of Damage Control Procedures curricula and collaborates with international subject matter experts, surgeons, and operational clinicians to improve prolonged casualty care capability in contested environments. Disaster Health Institute is a collaborative network focused on disaster health, operational medicine, epidemiology, humanitarian response, and strategic healthcare preparedness. The organisation works with subject matter experts across Europe, North America, Central Asia, Africa, and South America to develop evidence-informed approaches to modern operational health challenges. | |||
| 194-MScACC graduate William Krupa | 08 May 2026 | 00:35:12 | |
This week, Aebhric O'Kelly is joined by William Krupa, who recently graduated from the MSc Austere Critical Care programme. They discuss wilderness medicine, tactical medicine education, prolonged field care, and his experience completing the MSc in Austere Critical Care at the College of Remote and Offshore Medicine Foundation. William shares his journey from infantry soldier to paramedic educator, discusses teaching Wilderness First Responder (WFR) programmes, reflects on attending the Medicine in the Mediterranean Conference in Malta, and provides an overview of his MSc thesis on austere mechanical ventilation using portable oxygen concentrators and closed-circuit systems. This episode explores how austere medicine education can reinvigorate clinicians, improve critical thinking, and bridge the gap between theory and operational practice.
Chapters 00:00 – Introduction to the episode and guest welcome 00:41 – William’s current work in paramedicine, wilderness medicine, and tactical medicine education 01:20 – Military background and transition into medicine 02:30 – Repeating EMT training after military service 03:53 – Why repeated teaching improves clinicians and educators 05:07 – The value of teaching Wilderness First Responder (WFR) courses 07:22 – Deep dives into improvised medicine during longer wilderness courses 07:55 – The history of CoROM and how WFR led to degree programmes 09:33 – William’s first trip to Malta for APUS and ICARE 10:20 – Scenario-based learning and hands-on education at CoROM 11:34 – The realism of the ICARE moulage and burn simulations 14:05 – Medicine in the Mediterranean Conference experience 14:51 – Ukraine battlefield medicine workshop and WPC certification 15:40 – Graduation and earning the MSc in Austere Critical Care 16:14 – Publishing research and future doctoral plans 17:18 – Why William chose the MSc in Austere Critical Care 19:23 – What makes CoROM different from other critical care programmes 22:16 – Mentorship from MD-PhD faculty and practical education 26:08 – William’s MSc thesis on austere mechanical ventilation 27:39 – Using oxygen concentrators and closed-circuit systems in austere care 29:28 – Research discussion: dual oxygen concentrators and FiO₂ optimisation 31:15 – Challenges during the MSc programme 33:32 – How the MSc changed William’s clinical practice 34:44 – Suggestions for future development of the MSc programme 36:47 – Teaching WFR in Utah with Black Swan and Human Path 39:01 – Achieving Fellowship of the Academy of Wilderness Medicine (FAWM) 41:08 – Why wilderness fellowships carry professional value 43:46 – Advice for new medics entering austere medicine 45:11 – Closing remarks and congratulations
Key Topics • Wilderness medicine education • WMS FAWM • Tactical medicine and TC3 instruction • Prolonged Field Care (PFC) • Austere Critical Care education • Scenario-based simulation training • Improvised medicine • Mechanical ventilation in austere environments • Oxygen conservation strategies • Wilderness medicine fellowships • Medical education mentorship • International austere medicine collaboration
Key Takeaways • Scenario-based education improves retention and operational performance. • Wilderness medicine often reignites clinicians’ passion for medicine. • Austere medicine requires adaptability rather than dependence on resources. • International collaboration broadens clinical understanding and perspective. • Practical mentorship from operational clinicians is critical in advanced education. • Mechanical ventilation in austere environments may be feasible with low-resource systems. • Long-form wilderness courses allow deeper exploration of improvised medicine concepts. • Continuous learning is essential for clinicians operating in remote and austere environments. | |||
| 193-Severe Malaria Patient Featuring Zach Andrews | 01 May 2026 | 00:58:07 | |
This week, Aebhric is again joined by Zach Andrews, who leads the latest episode of CoROM Conversations, which explores the recognition and management of severe malaria in resource-limited and austere environments. Drawing on field-relevant clinical reasoning, the discussion focuses on the progression from uncomplicated to life-threatening disease, with emphasis on Plasmodium falciparum as the primary driver of severe pathology. The conversation highlights the diagnostic challenges faced by remote medics, where laboratory confirmation may be delayed or unavailable, and underscores the importance of clinical pattern recognition, early intervention, and ongoing reassessment. Particular attention is given to complications such as cerebral malaria, severe anaemia, metabolic acidosis, and hypoglycaemia—all of which significantly increase mortality if not rapidly addressed. From a prolonged field care perspective, the episode integrates pragmatic strategies for stabilisation, monitoring, and evacuation decision-making. It reinforces the need for structured patient assessment using frameworks such as CABCDEFGH, along with trending vital signs over time. The discussion ultimately bridges tropical medicine with austere critical care, offering actionable insights for medics operating far from definitive care. Key Learning Points Severe malaria is a time-critical diagnosis, most commonly associated with Plasmodium falciparum, requiring immediate treatment even before confirmatory testing. Red flag features include altered mental status, respiratory distress, severe anaemia, hypoglycaemia, and shock. Hypoglycaemia is both a complication of malaria and a side effect of treatment (e.g., quinine), necessitating frequent glucose monitoring. In austere environments, clinical diagnosis often precedes laboratory confirmation, requiring high suspicion in febrile patients with travel or endemic exposure. Fluid management must be cautious, balancing the risks of hypovolaemia and pulmonary oedema. Prolonged care requires integration of nursing principles (HITMAN, SHEEP VOMIT) to prevent secondary deterioration. Early administration of parenteral antimalarials (e.g., artesunate where available) is critical to survival. Evacuation planning should be initiated early, but delays must not postpone life-saving interventions. Timestamps 00:00 – Introduction Overview of the case and relevance to austere medicine 02:30 – Pathophysiology of Severe Malaria Mechanisms of microvascular obstruction and organ dysfunction 06:00 – Clinical Presentation Recognising early vs severe disease in the field 10:30 – Assessment Frameworks Applying structured approaches (CABCDEFGH, CPRO, BEAST) 15:00 – Management Priorities Antimalarials, glucose, fluids, and airway considerations 20:30 – Complications and Monitoring Cerebral malaria, acidosis, anaemia, and respiratory failure 25:00 – Prolonged Field Care Considerations Nursing care, documentation, and trending 30:00 – Evacuation and Decision-Making When and how to move the patient 33:00 – Key Takeaways and Closing Thoughts Clinical Pearls / Take-Home Messages Treat first, confirm later: In suspected severe malaria, delays in treatment increase mortality. Check glucose early and often: Hypoglycaemia can be rapidly fatal and easily missed. Think beyond fever: Altered mental status or respiratory changes may be the first sign of severe disease. Your greatest tool is reassessment: Trends in vital signs are more valuable than single data points. Good nursing care saves lives: Positioning, hydration, hygiene, and monitoring are critical in prolonged care environments. Suggested References World Health Organization. Guidelines for the Treatment of Malaria (latest edition). Joint Trauma System Clinical Practice Guidelines: Prolonged Casualty Care. World Health Organization. Severe Malaria (Tropical Medicine reference standards). White NJ et al. Malaria. The Lancet. | |||
| 192-Setting up a Jungle ICU with Zach Andrews | 24 Apr 2026 | 00:32:57 | |
This week, Aebhric O’Kelly is again joined by Zach Andrews, a MSc Austere Critical Care graduate and expert in jungle medicine, who shares his extensive experience in remote critical care, setting up ICUs in challenging environments, and improving medical education. Discover practical tips for medical professionals working in remote areas and learn about innovative approaches to medical training and patient care. Chapters 00:00 Introduction and Guest Introduction 00:26 Zach Andrews' Background and Current Projects 01:06 Role in Student Success Department 02:34 Student Program Feedback and Challenges 05:50 Faculty and Program Cost-Effectiveness 11:27 Setting Up ICUs in Remote and Austere Areas 20:42 Importance of Hands-On Assessment in Remote Settings 23:00 The Jack of All Trades in Jungle ICU Setup 25:18 Lessons from Masters of Austere Care 27:33 SOMA Scholarship and Zach's Presentation 29:34 Advice for New Medics in Austere Medicine 30:52 Closing Remarks and Final Thoughts | |||
| 191-AMLS and PHTLS in Pretty Bay, Malta | 17 Apr 2026 | 00:33:51 | |
This week, Aebhric talks with Alfredo Leal, who shares his extensive experience in emergency medical services, including his work with the WHO, offshore rescue missions, and medical training courses like AMLS and PHTLS. Discover valuable insights on pre-hospital care, medical assessment, and the future of emergency medicine training. Chapters 00:00 Introduction to Alfredo Leal's Journey 01:48 Experiences with the World Health Organisation 04:10 Deployment in Ukraine and Its Challenges 04:59 Advanced Medical Life Support Course Insights 07:43 The Importance of Medical Training 12:01 Differential Diagnosis in Pre-Hospital Care 16:11 Dynamic Patient Assessment Techniques 19:26 Teaching and Training in Emergency Medical Services 23:52 Future of Emergency Medical Training 27:48 Advice for New Medics in Austere Environments | |||
| 190-DHS Graduate Dr Michael Klopper | 10 Apr 2026 | 00:32:29 | |
This week, Aebhric O’Kelly is joined by Dr Michael Klopper, who recently earned his doctorate from CoROM and shares his journey from South Africa to becoming a doctoral candidate in AI, his extensive experience in remote medicine and mountain rescue, and his views on the future of AI in medical research and education. Discover insights on mountain medicine training, AI's role in healthcare, and practical advice for medical professionals in challenging environments. Chapters 00:00 Introduction and Dr Klopper's background 01:42 Early connection with the College and initial projects 04:06 Setting up clinical placements and courses in South Africa 05:44 East London clinical work and EMS programs 07:28 Dr Klopper's Wilderness Medicine Fellow (FAWM) and future plans 11:48 Dr Klopper's PhD thesis on AI in medicine 18:19 The importance of search mechanisms and AI in research 21:57 Risks and best practices for AI in academic research 24:57 Advice for new medical professionals and outdoor enthusiasts 28:48 Preparing for deployment in challenging environments 29:30 The role of aviation safety and small details in rescue missions 32:16 Closing remarks and future plans for Dr Klopper | |||
| 189-Faculty of Offshore and Maritime Medicine | 03 Apr 2026 | 00:34:13 | |
This week, Aebhric O'Kelly is joined by Dr Aris Exadaktylos and Dr Susie DiMartini to discuss the critical need for specialised maritime medicine training. They explore the creation of the International Maritime Ships Doctors course, the unique challenges of offshore medical care, and the future of remote healthcare technology. They are the founding faculty for the new Faculty of Offshore and Maritime Medicine from CoROM. Chapters 00:00 Introduction to Maritime Medicine Faculty 02:14 Personal Journeys in Maritime Medicine 05:02 The Need for Maritime Medical Training 10:11 The Role and Responsibilities of Ship Doctors 16:51 Innovations in Maritime Medical Care 25:49 The International Maritime Ship Doctors Course 29:03 Future of Maritime Medicine Education | |||
| 188-How to set up an ICU in the jungle | 27 Mar 2026 | 00:49:37 | |
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. Chapters 00:00 Introduction and Content Overview 00:41 Premise and Scenario Setup for Jungle ICU 01:33 Site Selection Criteria in Jungle Environments 02:19 Environmental Challenges: Rain, Creepy Crawlies, and Hypothermia 03:08 Privacy, Lighting, and Visibility in Remote Settings 03:53 Creating a Functional Jungle Clinic Layout 04:34 Lighting and Visibility Strategies at Night 05:31 Accessibility and Zone Planning in Field Clinics 06:09 Assessing Capacity: Multiple Patients and Beds 07:01 Monitoring Equipment: Minimum and Advanced Options 08:04 Power, Water, and Communication Logistics 08:42 Prolonged Casualty Care and Exfil Planning 09:59 Medical Supplies: Drugs, Medications, and Sterility 10:42 Camp Craft and Bushcraft Skills for Remote Medics 11:35 Wildcrafted Plants and Improvised Medicine 12:12 Communication Strategies in Dense Canopy Environments 13:08 Team Coordination and Role Assignments 14:08 Dealing with Critical Patients and Exfil Decisions 14:57 Infection Control and Hygiene in the Field 15:54 Personal and Team Safety Measures 16:39 Additional Non-Medical Gear for Remote Operations 17:16 Lighting Solutions and Bug Management at Night 18:08 Medications and Drugs for Jungle Medicine 18:45 Over-the-Counter and Emergency Medications 19:34 Special Considerations for Malaria and Vector-borne Diseases 20:04 Infection Control and Hygiene Protocols 20:56 Water Purification and Boiling Techniques 21:35 Field Sterilisation and Maintaining Sterility 22:25 Managing Glove Supplies and Hand Hygiene 23:00 Dermatology and Common Skin Conditions 23:38 Malaria Prophylaxis and Treatment Strategies 24:32 Infection Control and Personal Hygiene 25:14 Power and Charging Solutions in Remote Areas 26:04 Water Supply and Filtration Methods 26:45 Field Sterilisation and Water Boiling Techniques 27:21 Camp Craft and Bushcraft Skills for Field Survival 27:56 Wildcrafting and Medicinal Plants in the Jungle 28:47 Communication Equipment and Strategies in Dense Canopy 29:41 Team Coordination and Medical Decision-Making 30:17 Water Safety and Potable Water Management 31:05 Team Safety and Preventing Illness in the Field 32:04 Bushcraft Skills for Remote Medical Operations 32:58 Survival Skills and Improvised Medicine 33:48 Communication Tools and Emergency Signalling 34:28 Exfil Planning and Evacuation Protocols 35:14 Prolonged Casualty Care and Equipment Needs 36:01 Medical Kits and Supplies for Extended Operations 36:51 Decision-Making in Critical Situations 37:23 Non-Medical Essentials: Woobies, Tools, and Comfort Items 38:10 Maintaining Morale and Team Cohesion 38:42 Summary and Final Tips for Jungle ICU Setup | |||
| 187-Austere Primary Care | 20 Mar 2026 | 00:30:55 | |
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/ | |||
| 186-Enhanced MSc Austere Critical Care | 13 Mar 2026 | 00:30:23 | |
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. Chapters 00:00 Introduction to the New Masters of Austere Critical Care Program 01:03 The Complete Rehaul of the Curriculum 01:57 Flexibility and Pathways in the New Program 02:51 Comparison with UK Advanced Practice Programs 03:46 Four Pillars of the New Curriculum 04:41 Special Focus: Medical Support to Resistance Healthcare 07:02 Innovations in Improvised Medicine 08:21 Practical Modules: Ultrasound and Tropical Medicine 09:44 Student Research and Thesis Projects 11:30 Program Launch and Future Outlook | |||
| 185-Origins of ICARE and Future Plans | 06 Mar 2026 | 00:28:59 | |
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. Chapters 00:00 Introduction to the ICARE Course in Malta 00:58 BSc Student Splinter talks about his experience in ICARE 02:04 Diverse Participants and Their Backgrounds 02:53 Skills Gained: Ultrasound, Central Lines, and Improvisation 03:47 Blue Time: Practice and Muscle Memory 05:06 Overview of Scenarios: Crush Injuries, Tropical Diseases, and Trauma 05:52 Building a Remote ICU: Key Components and Challenges 06:30 Setting Up an ICU in the Jungle: Precautions and Planning 07:14 Impact on Paramedic Practice and Future Plans 08:16 Introduction to Dr Csaba Dioszeghy and Critical Care Education 09:06 Origins of Critical Care Teaching and Collaboration 10:51 Simplifying Critical Care for Resource-Limited Settings 13:07 Development of the MSc in Critical Care 14:29 Teaching Principles: Using Critical Care Without Fancy Equipment 15:26 From Aeromedical Transport to Specialised Critical Care Training 16:22 Addressing the Gap in Critical Care Education 16:47 Curriculum Focus: Basic to Advanced Critical Care Concepts 17:43 Teamwork and Non-Technical Skills in Critical Care 18:40 The Importance of Crew Resource Management 20:20 Simulation-Based Training for Teamwork and Skills 21:15 Elective Courses and International Participation 22:10 The Future of the MSc Program and Crew Resource Management 24:04 Technical Skills Practice: Ultrasound, Suturing, and Intubation 24:57 The Value of the iCare Course and Its Evolution 25:50 Upcoming Deep Dive into the Masters of Austere Critical Care We 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. | |||
| 184-CoROM Conversations - Nursing CPG | 27 Feb 2026 | 00:44:13 | |
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/U63NaFLaxZ0 Chapters 00:00 Introduction to Nursing Interventions 00:53 Exploring CPGs and Nursing Interventions 02:25 Comparing Non-Medical and Medical Personnel Guidelines 05:50 Simplifying Nursing Interventions for Non-Medical Personnel 09:05 Wound Care Disparities in Guidelines 11:05 Identifying Gaps in Nursing Care Guidelines 12:07 The Need for Simplified Guidelines 16:15 Importance of Structured Handover 24:03 Trending and Serial Assessment in Patient Care 26:17 Understanding Patient Comfort and Injury Prevention 27:36 The Importance of Hands-On Nursing 28:32 Pressure Injury Prevention Strategies 29:52 Efficient Patient Care Techniques 31:17 Pain Management in Nursing 33:12 Pulmonary Hygiene and Patient Mobility 35:14 Nutrition and Hydration in Patient Care 35:37 The Role of Checklists in Medical Practice 41:33 Infection Prevention and Wound Care 43:34 Final Thoughts on Patient Care Practices 44:01 Any Questions? | |||
| 183-Harrison Steins MiM26 SIPE | 20 Feb 2026 | 00:34:36 | |
This week, Aebhric is joined by Dr Harrison Steins, who is finishing his MSc in Austere Critical Care with CoROM. He also finished medical school and is starting his emergency medicine training. His master’s thesis was on the complexities of swimming-induced pulmonary oedema (SIPE), a rare condition affecting athletes, particularly in high-altitude environments. The speaker, Harrison Steins, discusses the pathophysiology, clinical presentation, diagnosis, and management strategies for SIPE, emphasising the importance of context in medical practice. He shares case studies, research findings, and future directions for understanding and treating this condition, highlighting the role of ultrasound in diagnosis and the need for tailored prevention strategies. Takeaways Swimming-induced pulmonary oedema is a rare condition with a prevalence of less than 1%. Understanding the context of patient presentation is crucial for diagnosis. Acute-onset cough and dyspnoea are key symptoms of SIPE. Diagnosis requires a broad differential, ruling out other conditions first. Management focuses on immediate life threats before addressing SIPE. Hydration strategies can prevent SIPE, especially in athletes. Sildenafil may be effective in preventing SIPE, but it is not widely recommended. Handheld ultrasound is a reliable tool for diagnosing pulmonary oedema in the field. Females may have a higher incidence of SIPE at lower elevations than males do. Knowledge of population-specific pathology is essential for effective treatment. Chapters 00:00 Introduction to Swimming-Induced Pulmonary Oedema 04:47 Understanding the Pathophysiology of Swimming-Induced Pulmonary Oedema 09:18 Case Studies and Clinical Presentation 13:48 Diagnosis and Imaging Techniques 19:26 Management Strategies and Treatment 24:17 Research Findings and Future Directions | |||
| 182-TTEMS Review by BSc RPP Students | 13 Feb 2026 | 00:14:15 | |
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). | |||
| 181-TBS26 Conference Review | 06 Feb 2026 | 00:37:36 | |
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. Takeaways The 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. Chapters 00:00 Introduction to the Big Sick Conference 02:34 Challenges in Prolonged Field Care Education 05:43 Diverse Professional Backgrounds in Medical Education 08:09 Learning Through Realistic Simulations 11:04 Bridging the Gap Between Pre-Hospital and Hospital Care 13:39 Innovations in Emergency Medicine Practices 16:46 The Role of Data in Emergency Response 19:10 Future Directions in Pre-Hospital Care 21:39 Conclusion and Reflections on the Conference | |||
| 180-Wilderness and Expedition Dentistry with Burjor Langdana | 30 Jan 2026 | 01:02:55 | |
This week, we hear from Burjor Langdana, who runs the Wilderness and Expedition Dentistry workshop for CoROM. Burjor discusses the management of dental pain, focusing on assessing sensitivity, identifying causes, and evaluating treatment options. It emphasises the importance of patient care, oral hygiene, and antibiotic use in the management of dental conditions. The discussion also covers cultural considerations and improvisation in emergency situations, providing valuable insights for dental practitioners. https://wildernessdentistry.com/ Takeaways Understanding the characteristics of dental sensitivity is crucial. Location and duration of pain are key indicators. Aggressive brushing can lead to gum recession and sensitivity. Clove oil can be effective but should be used cautiously. Flossing is essential to prevent food buildup and gum irritation. Antibiotics may be necessary for managing infections. Improvisation is important in emergency dental care. Cultural beliefs can impact patient care and treatment acceptance. Communication with patients about procedures is vital. Managing expectations regarding treatment outcomes is essential. Chapters 00:00 Introduction to Managing Dental Pain 00:57 Understanding Sensitivity: Duration and Location 06:32 Identifying Causes of Sensitivity 12:12 Managing Sensitivity with Home Remedies 12:40 Addressing Food-Related Pain 18:37 Techniques for Filling Cavities 29:11 Improvising Without Instruments 29:39 The Role of Salt Water in Oral Health 34:53 Managing Tooth Pain and Food Impaction 39:06 Understanding Fillings and Their Complications 45:42 Gumboils: Causes and Management 49:48 Skills for Remote Dental Care 56:04 Cultural Sensitivity in Dental Treatment | |||
| 179-The AOK AirBase with Sam Slishman | 22 Jan 2026 | 00:47:06 | |
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. Takeaways Innovations 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. Chapters 00:00 Introduction to Dr Sam Slishman 01:31 Innovations in Medical Devices 04:25 Tourniquet Efficacy and Research 09:38 Direct Pressure vs. Tourniquets 17:50 The Airbase: A New Medical Tool 24:14 Challenges in Medical Device Development 31:20 The Role of 3D Printing in Medicine 39:19 Advice for Aspiring Medics | |||
| 178-Academia with PTSD with EU SOF Medic Rabbit | 16 Jan 2026 | 00:28:32 | |
This week, Aebhric O’Kelly is joined by Rabbit, who is an EU SOF medic who shares his extensive background in military medicine and his current focus on researching the effects of higher education on individuals with PTSD. He discusses his personal experiences with PTSD and how education has played a role in his recovery. The conversation also touches on the importance of engaging the younger generation in military medicine, adapting to the changing battlefield, and the need for collaboration between special operations and conventional forces. Rabbit emphasises the significance of education and teamwork in improving outcomes for those affected by trauma. Takeaways Rabbit has a rich background in military medicine and education. His PhD research focuses on PTSD and higher education. Education can provide hope and support for individuals with PTSD. There is a need for specialised programs for military personnel with PTSD. Engaging the younger generation is crucial for the future of military medicine. Collaboration between special operations and conventional forces is essential. Rabit emphasises the importance of teaching and enabling others in medicine. The battlefield is evolving with new technologies and challenges. Personal experiences with PTSD can inform research and treatment. Teamwork is vital in prolonged field care situations. Chapters 00:00 Introduction to Rabbit and His Background 02:52 Exploring PTSD and Higher Education 10:22 Personal Experiences with PTSD and Education 17:12 The Role of SOMA and Engaging the Younger Generation 26:57 Advice for New Medics and Collaboration in Medicine | |||
| 177-Microcirculation in PFC with Zach Andrews | 09 Jan 2026 | 00:32:16 | |
This week, Aebhric O’Kelly talks with Zach Andrews, a SOF medic, to discuss his journey through the MSc in Austere Critical Care, with a focus on his thesis on microcirculation in resource-limited settings. He shares insights into the challenges and learning experiences of his studies, the development of the AMSS score for assessing microcirculation, and his future aspirations in medicine, particularly in rural EMS and education. Takeaways Zach is on active duty in the U.S. Army as a SOF medic. He works as a critical care paramedic in a rural county. His thesis focused on microcirculation in resource-limited settings. He explored noninvasive methods for assessing microcirculation. Zach developed the mottling score to evaluate microcirculation. He emphasises the importance of basic medical skills. Zach plans to pursue a doctorate in the near future. He aims to validate his Microcirculatory Integrated Severity Scale (AMSS) in real-world settings. Zach believes in the significance of education in rural healthcare. He appreciates collaborative problem-solving in medical training. Chapters 00:00 Introduction to Zach Andrews and His Journey 06:08 Exploring the Master's Program in Osteo-Critical Care 13:20 Thesis Topic: Microcirculation in Resource-Limited Environments 20:24 Developing the Microcirculatory Integrated Severity Scale (AMSS) 24:25 Future Plans and Advice for New Practitioners | |||
| 176-Nutrition in Prolonged Field Care from the JTS CPG | 02 Jan 2026 | 00:44:05 | |
This week, Aebhric O’Kelly, Bill Vasios, and Rhod Jordan lead an open discussion examining the critical role of nutrition in prolonged field care. The conversation explores enteral and parenteral feeding modalities, outlining their respective indications, benefits, and practical limitations in austere and resource-constrained environments. Particular emphasis is placed on the value of early nutritional intervention in supporting physiological recovery, including practical techniques for nasogastric tube placement and for identifying and managing feeding-related complications. The discussion further considers the challenges of maintaining nutritional support during patient transport. It highlights the importance of interdisciplinary collaboration, including consultation with nutrition specialists, to develop safe and effective nutritional care plans. Takeaways Nutrition is crucial in prolonged field care. Enteral nutrition is less invasive and safer. Early feeding improves healing and recovery. Consult a nutritionist for feeding plans. NG tubes can reduce complications in feeding. Monitor for complications during feeding. Parenteral nutrition may be necessary in some cases. Feeding techniques can vary based on patient condition. Understanding nutritional needs is essential for care. Future discussions will focus on advanced topics. Chapters 00:00 Introduction to Prolonged Field Care and Nutrition 02:40 Understanding Enteral and Parenteral Nutrition 04:53 Benefits of Early Nutritional Support 07:47 Indications and Contraindications for Feeding 09:32 Practical Considerations for Feeding in Austere Environments 11:51 Calculating Nutritional Requirements 14:30 Challenges in Nutritional Support During Transport 17:16 Techniques for NG Tube Placement 20:00 Monitoring and Managing Feeding Complications 22:19 Discussion on Parenteral Nutrition 24:41 Conclusion and Future Topics | |||
| 175-Sepsis Discussion from the JTS CPG | 26 Dec 2025 | 00:57:34 | |
This week, Aebhric O’Kelly and Bill Vasios host an online discussion on the JTS sepsis CPG. CoROM students and members of the college join this live discussion about how to assess and treat the septic casualty in remote and austere environments. Chapters 00:00 Introduction to C-Circulation Problems 01:34 Understanding Sepsis and Its Management 09:17 Early Warning Systems for Sepsis 14:15 Clinical Acumen in Remote Care 20:20 Monitoring and Assessing Patient Status 27:52 Antibiotic Administration in Remote Settings 33:02 Malaria Treatment Protocols 37:33 Resuscitation Strategies for Sepsis 42:52 Point of Care Ultrasound in Patient Monitoring 48:12 Final Thoughts and Future Topics You can download the JTS CPG on Sepsis here. https://jts.health.mil/assets/docs/cpgs/Sepsis_Management_PFC_28_Oct_2020_ID83.pdf | |||
| 174-Austere Burns Management from the JTS CPG | 19 Dec 2025 | 00:49:18 | |
This week, Aebhric O’Kelly, Bill Vasios, and Rhod Jordan will host an open discussion on managing austere burn patients, covering airway management, fluid resuscitation, infection control, and pain management. The speakers emphasise the complexity of burn cases and the importance of accurate assessment and treatment protocols. They also highlight the need for effective communication and patient involvement in care, as well as the use of innovative techniques like topical morphine for pain management. Takeaways Burns are incredibly complicated, but they're complex patients. Managing an individual patient's airway has to be factored in. You want to protect and secure the airway and avoid obstructions. The goal is to achieve maximal accuracy in fluid resuscitation. You can infuse that fluid rectally if you don't have IV fluids. Prophylactic antibiotics are not indicated in burn patients. Topical morphine works really, really well for pain management. Involving the patient in their care has a positive effect. Infection control is the means of preventing infection. Burn management is more art than science. Chapters 00:00 Introduction to Burns Management 03:08 Airway Management in Burn Patients 05:52 Assessing Burn Size and Fluid Resuscitation 09:00 Fluid Administration Techniques 11:38 Oral vs IV Resuscitation 14:53 Monitoring and Adjusting Treatment 17:36 Dynamic Management of Burn Patients 25:18 Vital Signs Monitoring in Critical Care 28:01 Continuous Assessment and Patient Management 32:07 Patient Involvement in Vital Signs Monitoring 35:10 Urine Output and Fluid Resuscitation 41:33 Infection Control in Burn Management 48:20 Pain Management Strategies in Burns | |||
| MiM26 Shorts-AI in Academia with Dr Ella | 18 Dec 2025 | 00:15:55 | |
This is a brief introduction to the AI roundtable to be held at the Medicine in the Mediterranean conference, running from 31 January to 2 February. You can join us using the link below. https://corom.edu.mt/medicine-in-the-mediterranean-2026/ | |||
| MiM26 Shorts - AI in Healthcare with Phill Clarke | 16 Dec 2025 | 00:06:21 | |
This is a brief introduction to the AI roundtable to be held at the Medicine in the Mediterranean conference, running from 31 January to 2 February. You can join us using the link below. https://corom.edu.mt/medicine-in-the-mediterranean-2026/ | |||
| MiM26 Shorts - CRM with Slaven Bajic | 15 Dec 2025 | 00:05:02 | |
This is a short introduction to the two lectures that Dr Slaven Bajic will be giving at the Medicine in the Mediterranean conference running from 31 January to 2 February. You can join us using the link below. https://corom.edu.mt/medicine-in-the-mediterranean-2026/ | |||