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

This week, Aebhric talks with students from the University of Pavia in Italy who were attending the Austere and Prehospital Ultrasound course. They discuss innovative teaching methods of ultrasound in medical education, particularly focusing on peer-to-peer learning and the integration of ultrasound training with anatomy education. The students share their experiences with the CoROM ultrasound course, emphasising the practical approach that enhances their understanding of anatomy and clinical skills. They also discuss the challenges of implementing ultrasound training within the medical curriculum and the importance of hands-on experience in mastering ultrasound skills. The conversation highlights the need for supportive faculty and the potential for peer-to-peer teaching to improve learning outcomes in medical education.TakeawaysThe CoROM ultrasound course emphasises practical learning over theoretical knowledge.Peer-to-peer teaching enhances understanding and retention of ultrasound skills.Integrating ultrasound training with anatomy education provides a dynamic learning experience.Students benefit from hands-on experience in real clinical settings.Ultrasound is a skill-based tool that requires practice to master.The importance of having supportive faculty in implementing new teaching methods.Innovative teaching approaches can make learning more engaging and effective.Students are motivated to continue learning and teaching ultrasound skills.There is a need for a standardised curriculum for ultrasound training in medical education.Continuous assessment and practice are key to becoming proficient in ultrasound. Chapters00:00 Introduction to the Quorum Podcast and Course Overview01:04 Experiences with the Quorum Ultrasound Teaching Method03:26 Integrating Ultrasound with Anatomy Education06:29 Peer-to-Peer Teaching in Ultrasound Training08:53 The Role of Ultrasound in Clinical Education11:43 Challenges and Support in Implementing Ultrasound Training15:09 Innovative Teaching Approaches in Ultrasound Education17:57 Understanding Ultrasound Through Hands-On Experience19:53 Future Plans for Ultrasound Curriculum Integration23:43 The Importance of Peer-to-Peer Learning in Medicine26:51 Advice for Beginners in Ultrasound Training

This week, Aebhric talks with Andrew Azelton, a CoROM MSc student, discussing his journey through the EMS field and the challenges faced in pursuing advanced practice as a paramedic. He highlights the lack of master's programs in the U.S. that focus on clinical experience, contrasting it with the more developed systems in Europe. The discussion explores state regulations, the variability of care across different regions, and potential pathways for paramedics to advance their roles within the healthcare system.They explore the concept of an advanced practice paramedic, comparing EMS systems in the U.S. and Europe, discussing funding challenges, and the potential for creating new pathways for paramedics. It emphasises the need for advanced education and training, as well as the importance of funding in implementing changes in the EMS system. The discussion also touches on the future of paramedic education and offers advice for new medics entering austere medicine.TakeawaysAndrew Aselton is pursuing a master's program in EMS.The U.S. lacks master's programs focused on clinical experience for paramedics.The EMS system in the U.S. is fractured and varies by state.In Europe, paramedics have their own licenses and greater autonomy.State regulations have a significant impact on the practice of paramedics in the U.S.Advanced practice paramedics are emerging in some states, like Kentucky.There is a need for a structured pathway for advanced practice paramedics in the U.S.The conversation highlights the differences in EMS practices between the U.S. and Europe.Waving a magic wand could lead to significant changes in paramedic education.The discussion raises questions about the future of paramedics in advanced roles.An advanced practice paramedic should have field experience and a graduate degree.Hands-on learning and clinical attachments are crucial for paramedic education.The EMS system in the U.S. varies significantly by state and funding.Funding challenges hinder the implementation of advanced practice paramedics in the U.S.EMS is often not considered an essential service, which can impact funding and resources.Data shows that treatment release can save money and reduce hospital admissions.A national support system is needed for advanced practice paramedics.Creating a nurse practitioner pathway for paramedics could be beneficial.Funding disparities exist between tax-based and for-profit EMS systems.New medical professionals should seek appropriate training and be prepared for the challenges of working in austere environments.Chapters00:00 Introduction to Andrew Aselton and His Journey02:37 Challenges and Growth in the Master's Program05:10 The State of EMS Education in the U.S.07:47 Advanced Practice Paramedics: A Path Forward10:41 The Future of EMS and Advanced Practice Opportunities12:00 Designing the Advanced Practice Paramedic14:52 Comparing EMS Systems: U.S. vs Europe18:00 Funding Challenges in EMS21:50 The Role of Advanced Practice Providers24:08 Creating a New Pathway for Paramedics29:59 The Future of Paramedic Education32:59 Advice for New Medics in Austere Medicine

This week, Aebhric OKelly speaks with Giuseppe Mercieca, the CoROM student representative. They discuss his role as a student advocate, the importance of improvisation in medical training, and the college's future aspirations. The conversation also touches on student feedback, career pathways for paramedics, and advice for new students considering a paramedic program.TakeawaysGiuseppe is a bachelor's student preparing for his clinical placement.He aims to improve communication and support for students.High-fidelity scenarios enhance learning experiences.Improvised medical techniques are crucial in austere environments.Student feedback is essential for program development.Career opportunities exist in remote and offshore medical positions.Networking and volunteering are key to finding jobs.The college is expanding programs based on student demand.CPD courses can serve as an introduction to the program.Collaboration with other medical professionals is vital for progress.Chapters00:00 Introduction to Eye Care Course in Malta02:29 Role of Student Representative05:09 Improvised Medical Techniques07:20 Future Aspirations for the College09:27 Student Feedback and Engagement11:55 Career Pathways for Paramedics14:24 Advice for New Paramedic Students

In this episode, host Aebhric O’Kelly kicks off the new academic year and reflects on the growth of the College of Remote and Offshore Medicine (CoROM), which will celebrate its 10-year anniversary next year. What began in 2016 with just 16 students has grown into an international institution with over 100 students across four degree programmes.This episode features conversations with the leaders of CoROM’s three postgraduate programmes:Dr Ella Corrick – Director of the Doctorate in Health Sciences (DHS), who discusses the growth of the doctoral cohort, the possibility of transitioning to a PhD programme, and the vital role of building a strong online academic community.Dr Csaba Dioszeghy – Programme Manager of the MSc in Austere Critical Care (ACC), who shares upcoming updates, including flexible online pathways, new elective modules in ultrasound and paediatric critical care, and stronger international clinical placement partnerships.Dr Nick Zuber – Programme Director of the Masters in Global Health (MGH), who explains the difference between global and public health, the diverse career opportunities for graduates, and how this degree prepares clinicians for leadership roles in international healthcare systems and disaster relief.

This week, Aebhric OKelly talks with Pierto Batistoni, Grant Hollyoake, and Finn McNamara, who are currently going through the BSc Remote Paramedic Practice programme. They explore the experiences of paramedic students during their clinical placements in Tanzania, focusing on their integration with local medical staff, the challenges they face in emergency medicine, and the unique medical cases they encounter, particularly related to altitude sickness. The students share insights on their learning experiences, the skills they are developing, and the cultural aspects of living and working in Tanzania. They also discuss the importance of building relationships with local healthcare professionals and the impact of their experiences on their future careers in medicine.TakeawaysThe integration with local staff enhances learning and trust.Emergency medicine in Tanzania presents unique challenges.Improvised medical solutions are often necessary in resource-limited settings.Altitude sickness is a common issue for climbers on Kilimanjaro.Building relationships with local healthcare professionals is crucial.Clinical placements provide hands-on experience in real-life scenarios.Students experience a wide range of medical cases during their placements.Cultural experiences enrich the overall learning process.Living conditions can vary, impacting student experiences.Advice for future students includes joining local networks for support.Chapters00:00 Introduction to Clinical Experiences in Tanzania01:59 Diverse Backgrounds and Initial Challenges04:16 Integration with Medical Staff06:12 Experiences in the Emergency Department07:46 Improvised Medical Practices09:54 Common Injuries and Case Studies12:08 Altitude-Related Illnesses14:51 Clinical Skills and Learning Opportunities20:21 Living Conditions and Accommodation24:34 Leisure Activities and Cultural Experiences27:17 Advice for Future Students

This week, Aebhric O’Kelly talks with Jonathan Downham, an advanced critical care practitioner, who shares his journey and insights into the evolving role of advanced practitioners in healthcare. He discusses the training pathways, responsibilities, and the importance of collaboration with junior doctors. Jonathan emphasises the need for continuous learning, research opportunities, and the future of advanced practice in critical care. He also highlights his innovative approach to training through e-learning and podcasts, aiming to enhance the skills of healthcare professionals.TakeawaysJonathan Downham is an advanced critical care practitioner with extensive experience in nursing.The role of advanced critical care practitioners (ACCPs) is to provide consistency in critical care units.ACCPs are trained to perform many tasks traditionally done by junior doctors, enhancing patient care.Training for ACCPs includes a postgraduate diploma and a master's degree, focusing on clinical skills and research.ACCPs have their own license to practice and can prescribe medications independently.The role of ACCPs is evolving, with opportunities in research and education.There is a growing recognition of the value of ACCPs in the healthcare system.The future of ACCPs may involve more independence and leadership roles in healthcare.Jonathan has created an e-learning platform to enhance training for critical care practitioners.Continuous learning and curiosity are essential for success in healthcare.Chapters00:00 Introduction to Advanced Critical Care Practice04:34 The Role of Advanced Critical Care Practitioners09:09 Training Pathways and Qualifications14:06 Independence and Responsibilities of ACCPs19:44 Research and Publication in Advanced Practice26:40 Future of Advanced Critical Care Practitioners29:21 Creating Educational Resources for Critical Care33:22 Advice for New Practitioners

This week, Aebhric talks with Mark Lopshire, who shares his extensive experience in humanitarian medical support, particularly in crisis zones. He discusses the challenges faced in providing medical care in conflict areas, the innovative solutions developed in austere environments, and the importance of training in wilderness medicine. Mark emphasises the need for flexibility and cultural understanding when working in diverse settings, and he highlights the role of organisations like the Wilderness Medical Society in advancing the field of wilderness medicine.TakeawaysMark Lopshire has a diverse background in the military and medical fields.He is involved with an NGO that provides medical support in crisis situations.The organisation deploys quickly to areas affected by disasters or conflict.Medical care in austere environments requires improvisation and innovation.Local economies are supported by purchasing supplies locally when possible.Flexibility and patience are crucial for medical professionals in crisis zones.Wilderness medicine training is essential for effective practice in remote areas.Cultural understanding is vital when working with diverse populations.The Wilderness Medical Society offers valuable resources for practitioners.Mark encourages new practitioners to embrace challenges and learn from experiences. Chapters00:00 Introduction to Mark Lopshire and His Background03:09 Wilderness Medical Society's Role in Crisis Response05:50 Experiences in Ukraine and International Medical Support08:59 Challenges of Providing Medical Care in Conflict Zones11:40 Innovative Solutions in Austere Environments14:09 Haiti: Lessons from a Major Earthquake Response16:54 Getting Involved in Humanitarian Medical Efforts19:50 The Wilderness Medical Society and Its Importance22:48 Fellowship in Wilderness Medicine: Benefits and Opportunities25:42 Future Aspirations and Advice for New Medical Professionals 32:36 Advice for newly qualified

This week, Aebhric O’Kelly talks with Dr. Andrew Blaikie and Dr Helena Feasey, from St Andrews University in Scotland. They discuss the ArcLight device, a revolutionary tool designed for eye and ear examinations in low-resource settings. They share insights into the device's features, its development journey, and its potential impact on global health. The discussion highlights the importance of training healthcare workers, the device's telemedicine capabilities, and ongoing research aimed at reducing preventable blindness and deafness in communities worldwide.TakeawaysThe ArcLight device is a portable eye and ear examination tool.It uses solar power and is designed for low-resource settings.The device has been in development for over a decade.It allows healthcare workers to perform comprehensive examinations.The device is robust and can withstand harsh conditions.Telemedicine capabilities enhance its utility in remote areas.Research shows it is clinically equivalent to traditional devices.Training programs are essential for effective implementation.Future research aims to reduce preventable blindness and deafness.The ArcLight project collaborates with various NGOs globally.Chapters00:00 Introduction to ArcLight and Its Creators03:32 The ArcLight Device: Features and Benefits08:49 Clinical Applications and Telemedicine Potential14:06 Research and Development of ArcLight18:58 Future Directions and Community Impact

This week, Aebhric O’Kelly talks with Tim Cranton, who shares his experiences as an offshore medic, detailing a challenging patient case involving dental pain and the complexities of providing care in a remote setting. He discusses the importance of proper patient management, the challenges of medication availability, and the need for improved training in offshore medical practice. Tim emphasises the significance of networking and continuous education for aspiring offshore medics, as well as the potential for developing specialised courses in dental care for medics working in remote environments.TakeawaysTim Cranton is an experienced offshore medic with a background in global health.Managing patients in remote settings requires careful observation and assessment.Antibiotic stewardship is crucial in offshore medical practice.Pain management is a key aspect of treating dental emergencies.Communication with topside medical services is essential for patient care.Remote healthcare often involves waiting for transport due to weather conditions.Continuous education and training are vital for offshore medics.Networking is important for career advancement in offshore medicine.There is a need for more specialised training in dental care for medics.Tim advocates for the development of a dedicated offshore medics course. Chapters00:00 Introduction to Offshore Medicine26:37 Challenges in Remote Healthcare35:19 Future of Offshore Medic Training

This week, Aebhric O’Kelly talks with James Brogan, a UK paramedic and lecturer at Robert Gordon University, who discusses the unique challenges and opportunities in paramedicine, particularly in rural and remote areas of Scotland. He emphasises the importance of practice-based learning, the role of paramedics in public health, and the evolution of paramedic education towards a more academic and professionalised approach. Brogan also highlights the significance of decision-making skills in austere environments and offers advice for new paramedics entering the field.TakeawaysJames Brogan is a principal lecturer of paramedicine at Robert Gordon University.The university focuses on rural and remote paramedicine education.Practice-based learning is crucial for paramedic training.Paramedics play a significant role in public health initiatives.Austere medicine requires unique skills and decision-making abilities.The evolution of paramedic education has led to a more academic approach.Professionalisation of paramedics is essential for adapting to healthcare needs.Future paramedics will need to be versatile in various environments.Decision-making is more critical than just technical skills.New paramedics should focus on evidence-based practice and holistic care.Chapters00:00 Introduction to Paramedicine in Scotland02:22 The Unique Challenges of Rural and Remote Paramedicine04:56 Practice-Based Learning and Its Importance07:54 The Role of Paramedics in Public Health10:13 Austere Medicine and Prolonged Field Care13:05 The Evolution of Paramedic Education15:32 The Professionalisation of Paramedicine18:17 The Future of Paramedicine20:55 Advice for New Paramedics23:29 Conclusion and Reflections on Paramedicine

This week, we have another presentation from the Medicine in the Mediterranean conference from January 2025. Dr Matt Moront is a pediatric surgeon who provides an in-depth exploration of pediatric trauma care, emphasising the unique anatomical and physiological differences in children compared to adults. The speaker discusses common pediatric injuries, particularly in urban settings, and highlights the importance of airway management, weight estimation for medication dosing, and recognising signs of shock. Techniques for intubation and intravenous access in children are also covered, along with concerns regarding radiation exposure in pediatric imaging. The session concludes with key takeaways for healthcare providers working with pediatric patients.TakeawaysAirway management is critical in pediatric patients.Children are not just smaller adults; they have unique anatomical differences.Most pediatric trauma cases involve motor vehicle accidents and falls.Weight estimation is crucial for medication dosing in children.Children can maintain blood pressure until a significant volume of blood is lost.Intubation in children requires specific techniques and considerations.Radiation exposure in children should be minimised due to their sensitivity.Pediatric patients often present differently than adults in shock situations.Using the right size equipment is essential for pediatric care.Clinical indicators of shock in children are often visual rather than reliant on technology.Chapters00:00 Introduction to Pediatric Trauma Care02:40 Understanding Pediatric Injuries in Urban Settings05:23 Anatomical and Physiological Differences in Children08:34 Airway Management in Pediatric Patients11:21 Weight Estimation and Medication Dosing for Children14:12 Assessing Pediatric Vital Signs and Shock Indicators16:54 Intubation Techniques and Considerations for Children20:08 Practical Tips for Pediatric Emergency Care25:55 Intubation Techniques for Pediatric Patients29:00 Medications in Pediatric Intubation33:57 IV Access in Children40:00 Radiation Considerations in Pediatric Care

This week, Aebhric O’Kelly talks with CoROM student Dmitry Vosnyak, who shares his experiences as a remote paramedic student currently completing clinical placements in Kilimanjaro, Tanzania. He discusses his background in emergency medicine, the challenges faced in chaotic environments, and the importance of practical training alongside theoretical knowledge. Dmitry reflects on a mass casualty incident he encountered, emphasising the need for effective pre-hospital care and communication. He also shares insights on how to prepare for such situations and his aspirations for further education in critical care.TakeawaysDmitry has extensive experience as a paramedic in various settings.Studying alongside practical experience enhances learning.The chaotic environment in emergency medicine requires adaptability.Mass casualty incidents highlight the need for pre-hospital care.Preparation and communication are crucial in emergencies.Dmitry emphasises the importance of hands-on training.He values the connections made with local medical teams.Continuous learning is essential for paramedics.Dmitry aims to improve his skills in critical care.He encourages new paramedics to study and gain practical experience.Chapters00:00 Introduction to Dmitry Vosnyak's Journey04:50 The Importance of Practical Training10:53 Clinical Placements and Skill Development17:35 Mass Casualty Incident Experience23:55 Reflections on Improvement and Preparation30:37 Future Aspirations in Critical Care43:03 Advice for new paramedics

This week, Dr. Slaven Bajic we have another presentation from our Medicine in the Mediterreanean conference from January 2025. In this lecture, Slaven discusses the importance of ultrasound in pre-hospital settings, its advantages, limitations, and a case study demonstrating its application in trauma care. The discussion emphasises the need for clinical judgment alongside ultrasound findings and the growing role of ultrasound in modern emergency medicine.TakeawaysFocused ultrasound is revolutionising emergency medicine.The FAST protocol is essential for trauma assessment.Ultrasound can be more effective than traditional methods.Rapid identification of unstable patients is critical.FAST exams must be repeated to ensure accuracy.Ultrasound is a non-invasive and portable technology suitable for field use.Clinical judgment is crucial when interpreting FAST results.Ultrasound can facilitate prompt decision-making in emergency situations.Training and practice are vital for effective ultrasound use.Ultrasound technology is becoming indispensable in emergency settings.Chapters00:00 Introduction to Focused Ultrasound in Emergency Medicine02:27 Understanding the FAST Protocol04:40 Advantages of FAST in Pre-Hospital Settings07:28 Limitations and Challenges of FAST09:49 Case Study: Application of FAST in Trauma17:32 Conclusion and Future of Ultrasound in Emergency Medicine

This week, Aebhric O’Kelly talks with Bryony Palmer, who shares her unique journey as a nurse who transitioned to sailing and humanitarian work. She discusses her experiences in offshore medicine, the challenges of providing medical care at sea, and her efforts to improve training and safety within the sailing community. Bryony also recounts a harrowing incident involving her husband's dislocated shoulder during a storm, highlighting the importance of preparation and adaptability in emergency situations. Throughout the discussion, she emphasises the need for better training and resources for sailors, as well as the value of thinking outside the box in medical practice.TakeawaysBryony Palmer is a nurse specialising in offshore and wilderness medicine.She aims to improve medical training in the sailing community.Bryony coordinated a humanitarian response with 65 sailing vessels after a hurricane.She emphasises the importance of preparation and training for sailors.Dealing with medical emergencies at sea requires adaptability and quick thinking.Bryony faced a challenging situation when her husband dislocated his shoulder at sea.She highlights the need for better medical resources on sailing vessels.Training for medical emergencies should include context-specific scenarios.Bryony encourages future sailors to practice solo sailing before embarking on long journeys.She believes in thinking outside the box to improve healthcare delivery.Chapters00:00 Introduction to Bryony Palmer and Her Journey02:48 Background in Nursing and Transition to Sailing06:41 Coordinating Humanitarian Aid in Disaster Response08:56 Training and Preparation for Sailing13:42 Dealing with Medical Emergencies at Sea36:59 Lessons Learned and Advice for Future Sailors

This week, we have another presentation from the Medicine in the Mediterranean conference, held in January 2025. CoROM faculty member Vish Rajan delves into the intricacies of hyperbaric medicine, exploring its history, types of chambers, notable accidents, and the human factors that contribute to safety and efficacy in treatment. TakeawaysHyperbaric medicine has a rich history dating back centuries.Regulations in hyperbarics often arise from tragic accidents.Different types of hyperbaric chambers serve various medical purposes.Key accidents highlight the importance of safety protocols.Human factors play a significant role in hyperbaric treatment outcomes.Training and proper maintenance are crucial for chamber safety.Case studies reveal systemic issues in hyperbaric practices.Communication failures can lead to catastrophic results in emergencies.Recommendations for improving safety include regular training and audits.Understanding the risks associated with hyperbaric treatment is essential for practitioners.Chapters00:00 Introduction to Hyperbarics and Accidents02:07 History and Development of Hyperbaric Medicine04:48 Approved Indications and Misuse of Hyperbaric Therapy06:28 Types of Hyperbaric Chambers07:06 Key Accidents in Hyperbaric History12:28 Case Study: Apollo 1 Incident18:50 Case Study: Hanover Chamber Incident25:25 Case Study: Malta Diving Incident30:00 Analysis of Human Factors in Hyperbaric Accidents33:02 Recommendations for Safe Hyperbaric Practices

This week, Aebhric O’Kelly talks with Andy Bell, Deputy Director of Paramedicine for St. John's Ambulance in Western Australia, who shares his extensive experience in paramedicine, discussing the evolution of the profession, the role of critical care paramedics, and the challenges faced in remote healthcare settings. He emphasises the importance of academic advancement in paramedicine and the need for a mindset shift towards prolonged field care in austere environments. Bell also provides insights into the future of paramedicine, highlighting the growing role of community paramedics and the integration of evidence-based practices in patient care.TakeawaysAndy Bell is originally from New Zealand and has extensive experience in paramedicine.Paramedics in Australia are now registered medical health professionals under APRA.The critical care paramedics have the most advanced scope of practice in Australia.There is a significant push for academic advancement in paramedicine.Evidence-based practice is essential for the future of paramedicine.Prolonged field care is a common practice in remote areas of Australia.Communication and coordination are crucial in managing patients in remote locations.Community paramedics are becoming increasingly important in the healthcare system.New practitioners should focus on mastering the basics of patient care.A mindset shift is necessary for effective, prolonged field care. Chapters00:00 Introduction to Andy Bell and His Background03:30 Understanding Paramedicine in Australia08:15 The Role of Critical Care Paramedics12:39 The Evolution of Paramedicine and Academia18:02 The Future of Academic Paramedicine22:42 Prolonged Field Care in Remote Areas29:10 Challenges in Patient Management in Remote Locations35:46 Advice for New Practitioners in Austere Medicine

In this episode of the CoROM Podcast, Dr. Sean Bilodeau discusses the intricacies of pre-hospital medicine, focusing on thoracostomy techniques and the challenges paramedics face in emergency medical services. Through case studies, he highlights the importance of evidence-based practices in needle decompression and the need for improved training methods for paramedics. The conversation emphasises the critical role of paramedics in saving lives and the ongoing efforts to enhance their skills and knowledge in trauma care.TakeawaysThe importance of thoracostomy in pre-hospital settings.Challenges faced by paramedics in emergency situations.Case studies illustrate the complexities of needle decompression.Evidence supports the effectiveness of pre-hospital interventions.Training methods for paramedics need to be improved.The role of paramedics is crucial in trauma care.Understanding the anatomy is essential for successful procedures.Finger thoracostomy may be more effective than needle decompression.There is a need for ongoing research in emergency medical practices.Collaboration between EMS and hospital staff is vital for patient outcomes.Chapters00:00 Introduction to Pre-Hospital Medicine01:28 Understanding Needle Thoracostomy06:04 Case Studies in Needle Decompression13:11 Evidence-Based Practice in EMS21:00 Teaching Techniques for Paramedics

This week, Aebhric O’Kelly talks with Alan O'Brien, OB, who is a paramedic from Ireland with a military background; they discuss his journey from the Irish Army to becoming a paramedic. He shares insights into the evolution of paramedic training in Ireland, the importance of academic pathways for military medics, and the significance of the NATO Special Operations Combat Medic (NSOCM) programme. The conversation also touches on the role of drones in modern combat medicine and the need for standardised medical training across NATO countries. In this conversation, OB discusses various aspects of military medical training, focusing on the NATO SOMT course, the future of the NSOCM programme, and the challenges faced in sustainment training for medics. He shares insights into the Irish Army Ranger Wing and the Nordic programme's impact on medical training. OB also outlines his aspirations for developing a master's programme in security and defence medicine and offers valuable advice for new medics entering the field.TakeawaysAlan O'Brien is a paramedic with a military background.He transitioned from the Irish Army to paramedic training.The paramedic training programme in Ireland has evolved significantly.Academic pathways are crucial for military medics post-service.The NSOCM programme standardises medical training across NATO.Drones are becoming increasingly influential in combat medicine.The gap between paramedic and advanced paramedic roles is decreasing.Military medics need academic recognition for their training.Standardised training improves interoperability among NATO forces.Understanding modern threats is essential for medical training. The NATO SOMT course is based on the Canadian SOMT program.SOMTs are support medics skilled in advanced medical techniques.NSOCM is evolving to include advanced medical skills training.Time constraints are a significant challenge for medics.Clinical placements are crucial for maintaining skills.The Irish Army Ranger Wing was established for counterterrorism.The unit is modeled on tier one special operations forces.The Nordic program enhances medical training across countries.A master's program in security and defence medicine is in development.New medics should take ownership of their skill set.Chapters00:00 Introduction to Alan O'Brien and His Background02:59 Transition from Military to Paramedic Training05:56 The Evolution of Paramedic Training in Ireland08:54 Academic Pathways for Military Medics12:03 The NSOCCM Program and Its Importance16:50 The Role of Drones in Modern Combat Medicine25:47 Understanding the NATO SOMT Course28:11 The Future of NSACM and Advanced Medical Skills32:21 Challenges in Sustainment Training for Medics34:28 Designing an Effective NSOCCM Sustainment Course41:12 Insights into the Irish Army Ranger Wing46:07 The Nordic Program and Its Impact48:20 Future Aspirations and Advancements in Medical Training52:16 Advice for New Medics and Medical Personnel

This week, we have another Medicine in the Mediterranean Conference speaker from January 2025. Our Vice Dean Eric Bauer talks about the PHACTORS mnemonic for managing patients in the post-intubation phase, emphasising the importance of understanding and addressing post-intubation hypotension, the role of positive pressure ventilation, and the need for ongoing resuscitation efforts. The discussion highlights various factors that can impact patient outcomes, including the transfer phase and the importance of proactive care in emergency medical settings.TakeawaysPost-intubation hypotension remains a significant challenge.The 'Platinum 10' refers to the critical 10 minutes post-intubation.Positive pressure ventilation can negatively impact haemodynamics.Hypoxia must be evaluated continuously after intubation.The transfer phase is often overlooked but crucial for patient care.Ongoing resuscitation is essential and should not stop after intubation.Good BLS and ALS care can significantly improve outcomes.Understanding the patient's history is vital for effective management.Proactive airway management leads to better patient outcomes.Continuous education on ventilation techniques is necessary.Chapters00:00 Introduction to Post-Intubation Management01:14 Understanding Post-Intubation Hypotension03:49 Factors Affecting Post-Intubation Outcomes10:10 The Role of Positive Pressure Ventilation14:19 Evaluating Hypoxia and Its Causes19:15 The Importance of Transfer Phase23:09 Ongoing Resuscitation and Pharmacology28:57 Final Thoughts on Post-Intubation Care

This week, Aebhric O’Kelly talks with Dr Matias Nocetto, the Vice President of Divers Alert Network (DAN), who shares his journey from Argentina to becoming a key figure in diving medicine. He discusses DAN's unique operations, the importance of understanding diving-related medical issues, and the challenges faced in diagnosing and treating divers. Dr. Nocetto emphasises the significance of training in diving medicine and offers advice for new medical professionals looking to enter this field.TakeawaysDr. Nochetto's journey reflects a lifelong passion for diving and medicine.DAN serves as a global resource for divers experiencing medical issues.The hotline operates 24/7, providing critical support to divers worldwide.Understanding the symptoms and history is crucial for diagnosing diving-related conditions.Decompression sickness is often misunderstood; cardiac events are a significant risk.In-water recompression is a controversial practice with many risks.Training opportunities in diving medicine are available for various medical professionals.DAN offers CME courses for those interested in diving medicine.Collaboration and support from the diving community are vital for DAN's mission.Following one's passion can lead to unexpected and fulfilling career paths.Chapters00:00 Introduction to Dr. Matias Nochetto and DAN02:52 The Journey into Diving and Medicine10:55 Day-to-Day Operations at DAN19:47 Understanding Diving Medicine and Decompression Sickness30:08 In-Water Recompression: Risks and Considerations36:15 Training Opportunities in Diving Medicine41:59 Advice for New Medical Professionals in Diving Medicine