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

This week, Aebhric OKelly talks with Daniele Manno, a graduate of the CoROM Remote Paramedic programme. He shares his unique journey from being a pilot to a paramedic, emphasising the importance of wilderness medicine and survival training. He discusses his experiences in clinical practice, particularly in trauma care, and reflects on the challenges and rewards of teaching remote life support courses. Daniele also highlights the need for a broader understanding of medical practices in austere environments and offers advice for new medics entering the field.   Takeaways Daniele transitioned from a 30-year career as a pilot to medicine at age 50. He emphasises that survival skills alone are insufficient without medical knowledge. Wilderness medicine training is crucial for those leading outdoor activities. Daniele's remote life support courses cover a wide range of medical situations. He believes curiosity is essential for deeper learning in medicine. His clinical experience in Africa provided hands-on learning opportunities. Daniele advocates for the recognition of paramedics in Italy's healthcare system. He stresses the importance of being broad-minded in austere medicine. Daniele's teaching aims to inspire students to pursue further medical education. He encourages new medics to be prepared for diverse medical challenges.   Chapters 00:00 From Pilot to Paramedic: A Unique Journey 09:13 The Importance of Wilderness Medicine 15:35 Transitioning to Remote Paramedic Training 27:38 Experiences in Clinical Practice 31:48 Preparing for the Future of Medicine

This week, Aebhric O’Kelly reflects on the highlights of 2024, showcasing insights from various guests who have contributed to the field of austere and remote medicine. The conversation covers prolonged casualty care, the importance of guerrilla medicine, and the challenges medics face in rural settings. The guests share their experiences and advice for new medics, emphasising the need for continuous learning and adaptability in the face of unique medical challenges.   Guests: Mike Turconi Dr Sean Keenan Dr Jaime Riesberg CJ Malcolm Antonio from EuroMedic Dr Jørgen Melau Dr Peter Anders Christiensen TacMedNorth from Ukraine   Takeaways 2024 has seen over 30,000 downloads from 43 countries. Austere medicine requires a different approach than traditional settings. Continuous learning is essential for medical professionals. Guerrilla medicine is becoming increasingly relevant in modern conflicts. Training in prolonged casualty care is crucial for medics in the field. Hyperthermia management is vital in cold operational settings. Rural populations often lack access to timely medical care. Improvisation is key in austere medical environments. Education is fundamental to improving medical practices worldwide. New medics should always strive to improve their knowledge and skills. You have to be prepared to improvise.   Chapters 00:00 Introduction to the CoROM Podcast 00:42 Highlights from 2024 Guests 06:09 Insights on Austere Medicine 09:29 Prolonged Casualty Care vs. Prolonged Field Care 13:12 The Importance of Guerrilla Medicine 15:10 Hyperthermia in Operational Settings 18:40 Challenges in Rural and Austere Medicine 20:27 Nordic Special Operations Combat Medic Program 23:09 Training Medics in Ukraine 27:24 Final Advice for New Medics

This week, Aebhric O’Kelly talks with Nick Hill about his extensive experience in military nursing, detailing his journey from the New Zealand Defence Force to the Danish military. He discusses the roles he has held, the challenges faced in various environments, and the importance of improvisation in medical practice. Nick emphasises the need for continuous learning and adaptation in austere medicine, drawing insights from his Austere Emergency Care course participation. He also highlights the cultural differences between military practices in different countries and the importance of collaboration in improving medical care. Takeaways Soldering is a universal concept across different militaries. Improvisation is crucial in austere medical settings. Continuous learning is essential for medical professionals. Cultural differences impact military medical practices. The importance of teamwork in emergency care. Adaptation and improvisation can enhance clinical practice. Engaging civilians in medical training is vital. Nordic countries show a strong commitment to medical readiness. Understanding logistics is key in prolonged field care. Seek knowledge from diverse sources for better practice. Chapters 00:00 Introduction to Nick Hill's Military Journey 03:12 Roles and Responsibilities in New Zealand's Military 05:57 Transitioning to Denmark and Cultural Differences 09:00 Experiences in Australia and Unique Challenges 11:56 Austere Emergency Care Course Insights 15:06 Improvisation in Medical Practice 18:08 Learning from Diverse Medical Environments 20:53 Advice for New Medics in Austere Medicine

This week, Aebhric O’Kelly talks with Dr Jørgen Melau. They discuss the intricacies of providing prolonged field care (PFC) in Arctic environments. They emphasise the importance of knowledge over gear, the challenges of managing cold casualties, and the necessity of shelter and improvisation. The discussion also covers protocols for PFC, the difficulties of vapour barriers, transportation strategies, and future developments in Arctic medical care. Dr Melau provides valuable advice for new medics interested in working in cold environments, highlighting the need for comfort and experience in such conditions.   Takeaways Knowledge is more vital than the actual gear. Training should focus on the person, not just products. Shelter is vital for casualty care in the Arctic. Improvisation can save lives in cold environments. Condensation is a considerable problem in cold weather operations. Breathable fabrics could improve vapour barriers. Keeping hands warm is vital for medics in cold environments. You must be comfortable in the cold before being a medic. Training in cold environments is essential for medics. Human performance is key in prolonged care situations.   Chapters 00:00 Introduction to Arctic Prolonged Field Care 01:10 The Importance of Knowledge Over Gear 07:04 Managing Cold Casualties in the Arctic 11:37 Shelter and Improvisation Techniques 17:00 Protocols for Prolonged Field Care 23:02 Challenges of Vapor Barriers and Heating 30:03 Transportation and Evacuation Strategies 34:48 Future Developments in Arctic PFC 44:58 Advice for New Medics in Cold Environments

This week, Aebhric O’Kelly talks with Phill Clark about his journey from a career in product management to becoming involved in medical education at the Masters of Austere Critical Care. He discusses the importance of practical skills in medicine, his role in improving student experiences, and the unique challenges adult learners face. Phil also highlights advancements in digital microscopy and AI, emphasising the collaborative potential of technology in healthcare. He concludes with advice for new medics, stressing the value of hands-on experience and the offerings of CoROM.   Takeaways Phil transitioned from product management to medical education during COVID. He emphasizes the importance of practical skills in medicine. Phil's role involves improving student experiences in the Masters programme. He advocates for a centralised communication system for student inquiries. Phil believes in the value of individualised responses to student needs. CoROM’s student body is generally older and more experienced. Lifelong learning is crucial for personal and professional growth. Advancements in AI and digital microscopy can enhance healthcare delivery. Phil stresses the importance of hands-on experience for new medics. He encourages exploring Co-ROM's courses for aspiring medical professionals.   Chapters 00:00 Introduction to Phil Clark 05:10 Phil's Journey to Medical Education 13:28 Improving Student Experience 18:52 The Importance of Individualized Responses 25:27 Lifelong Learning and Experience 38:11 Advice for New Medics

This week, Aebhric O’Kelly talks with Dr David Newman, an aerospace medicine expert who shares his extensive experience in military aviation, the evolution of fighter aircraft, and the future of human pilots in an increasingly automated world. He discusses his recent presentation at the Taipei International Military Medicine Forum, the importance of aerospace medicine education, and the challenges posed by AI in academic publishing. Takeaways • Dr Newman has a rich background in military aviation and aerospace medicine. • The F-18 is considered one of the best aircraft to fly. • The future of piloting may shift towards AI and drones. • Ejection from aircraft can lead to hidden injuries like vertebral fractures. • Aerospace medicine education is crucial for both civil and military doctors. • AI poses challenges in maintaining the integrity of academic publishing. • Crazy Socks for Docs raises awareness for mental health in healthcare professionals. • Mental health issues in healthcare are often overlooked. • Interest in a subject is key to completing a PhD. • The evolution of fighter jets reflects advancements in technology.   Chapters 00:00 Introduction to Dr David Newman 02:59 Aviation Medicine and Military Experience 06:01 The Evolution of Fighter Aircraft 08:52 The Future of Human Pilots in Aviation           11:59 Insights from the Taipei International Military Medicine Forum 15:04 Aerospace Medicine Education and Training 17:51 The Role of AI in Academic Publishing 20:58 Crazy Socks for Docs: A Movement for Mental Health 23:53 Advice for New Medics in Aerospace Medicine

This week, Aebhric O’Kelly talks with Tanguy Bader, a second-year BSc Paramedic student, who shares his journey in paramedicine, discussing his experiences in New Orleans EMS, the importance of continuous learning, and his aspirations for the future. He emphasises the significance of basic skills in emergency medicine, the value of patient interactions, and his desire to contribute to international healthcare efforts. Tanguy reflects on his educational experiences and the impact they have on his clinical practice, highlighting the importance of being a compassionate and competent clinician.   Takeaways •   Continuous learning is essential in paramedicine. •   Basic skills are crucial for effective patient care. •   Patient interactions provide valuable insights into care. •   Paramedic education enhances clinical practice significantly. •   Experience in the field complements academic learning. •   Building relationships with partners is vital in EMS. •   A focus on patient dignity and respect is paramount. •   International work offers unique challenges and rewards. •   Communication and teamwork are key in emergency situations. •   Embracing technology can aid in overcoming learning challenges.   Chapters 00:00 Introduction to Tanguy Bader and His Journey 03:10 Learning and Growth in Paramedic Education 09:32 Pathway to Becoming a Paramedic 17:11 Future Aspirations in Paramedicine 20:49 The Importance of Patient Interaction 27:00 Experiences in New Orleans EMS 30:37 Advice for New Paramedics 33:45 Conclusion and Reflections

This week, Aebhric O’Kelly talks with Mike Morrow, the CoROM BSc Remote Paramedic programme coordinator, on his journey from being a paramedic to evaluating organs for transplantation. He discusses the unique challenges faced in emergency medical services, particularly in Africa, and highlights the dedication of students in the BSc Remote Paramedic Programme. Morrow emphasises the importance of experience in austere environments and compares the training and practices of U.S. paramedics with those of BSc graduates. He provides valuable insights and advice for new medics and nurses starting their careers. Takeaways • Mike Morrow evaluates hearts and lungs for organ transplantation. • He has a rich background in paramedic training and critical care. • The BSc Remote Paramedic Program offers unique opportunities for students. • Students are dedicated to helping in austere settings. • There needs to be more EMS in many African countries. • Experience in austere environments is crucial for paramedics. • Morrow emphasises the importance of adaptability in emergency care. • The programme prepares students for real-world challenges in healthcare. • Morrow encourages new medics to gain as much experience as possible. Chapters 00:00 Introduction to Mike Morrow 05:53 Transitioning to Academia and Teaching 14:22 Challenges in African Emergency Medical Services 19:28 Comparing U.S. and BSc Paramedic Practices 24:38 Prolonged Care in Austere Environments 29:46 Advice for New Medics and Nurses

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

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

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

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

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

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

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

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

This week, Aebhric O’Kelly talks with John Clark, the College's Executive Dean, about the new 2024-2025 academic year. They discuss the recent developments and plans for the college. John discusses the college's collaborations with organisations like WMS and IBSC and upcoming trips to Ghana and Tanzania. He also mentions the expansion of the college's facilities and the launch of a peer-reviewed journal. The conversation concludes with advice for healthcare professionals starting their careers in austere medicine. takeaways The college has launched the doctorate in health studies and has seen growth in the bachelor's program in remote paramedic practice. The Master's in Austere Critical Care program is also growing, and the college is launching a new Master's in Global Health program. The college collaborates with organisations like WMS and IBSC and is working to expand the reach of paramedic certifications. Upcoming trips to Ghana and Tanzania will focus on establishing new clinical sites and improving existing ones. The college is expanding its facilities and launching a peer-reviewed journal called the Journal of Improvised Medicine. Advice for healthcare professionals starting their careers in austere medicine is to seek education and continuously improve their skills. Chapters 00:00 Introduction and Overview 01:03 Recent Developments and Plans for the College 02:30 Expanding Programs and Collaborations 04:52 Trips to Ghana and Tanzania 10:41 Facility Expansion and Peer-Reviewed Journal 18:30 Advice for Healthcare Professionals in Austere Medicine

This week, Aebhric OKelly interviews Bill Vasios, a physician assistant who started as an 18 Delta and had several other 18 series jobs. Bill is pursuing a PhD in education focusing on instructional design and technology. He is also doing a simulation fellowship at East Carolina University. They talk about online learning, designing a perfect online learning system, the challenges of teaching in the medical field, and the importance of credible sources in education. Takeaways Bill is a physician assistant with a background in the military, having served as an 18 Delta and held other 18 series jobs. He is pursuing a PhD in education, focusing on instructional design and technology. Bill discusses the challenges and benefits of online learning and the importance of credible sources in education. He also discusses the need for adaptive and interactive learning systems in medicine. Stay thirsty for knowledge and continuously learn throughout your career. Ultrasound is a valuable tool for Special Forces medics, but training and sustainment are crucial. Hands-on training and mentorship are essential for developing ultrasound skills. Effective teaching requires authenticity, care, and adapting to individual learning needs. The art of teaching lies in respectfully challenging and guiding students to improve their skills. Access to ultrasound equipment and regular scanning practice are necessary for maintaining competence. The ability to compare normal and injured scans is valuable for identifying abnormalities. Being surrounded by excellent people raises everyone's skills and abilities. Chapters 00:00 Introduction and Correction of Name 01:31 Bill's Background and Current Pursuits 08:18 Designing an Adaptive Learning System 12:22 The Challenges of Teaching in the Medical Field 14:12 The Future of Online Learning in the Medical Field 16:24 Balancing Online and Face-to-Face Learning 18:12 The Importance of Credible Sources in Education 23:51 Creating Curriculum for Soft Medics 24:29 Getting to Know Bill Vasio 30:12 Bill's Military Background and Transition to PA 33:39 Bill's Military Journey and Learning Code 35:10 Selection and Robin Sage 38:52 Becoming a PA and Returning to SF 40:47 The SOLCUS Program and Ultrasound in SF 43:04 Special Operator Level Clinical Ultrasound Programme and Advancements in Ultrasound 45:00 Sustaining Ultrasound Skills in 18 Delta Medics 49:04 Advice for New Medics and the Importance of Continuous Learning 53:05 The Art of Effective Teaching and Mentoring 56:30 Challenges of Ultrasound Training and Sustainment 01:05:00 Conclusion and Final Thoughts

This week, Aebhric O’Kelly talks with Antonio from European Medics about their work and focus on guerrilla, austere, and remote medicine. European Medics started as a community of passionate individuals in emergency medicine and has grown to focus on education and enhancing medicine. European Medics is currently working on creating training material and educative resources for their Advanced Guerrilla First Responder (AGFR) course. European Medics (EURMED) is focused on providing evidence-based guidance in unconventional and guerrilla medicine. Guerrilla medicine overlaps with other fields, such as wilderness medicine, medical support for irregular warfare, and disaster relief. The goal is to be better prepared for future conflicts and disasters and to save lives. Takeaways European Medics started as a community of passionate individuals in emergency medicine and has grown to focus on education and enhancing medicine. They are currently working on creating training material and educative resources for their Advanced Guerrilla First Responder (AGFR) course. European Medics has a podcast with multiple shows, including medical basics, field clinic, and long-format discussions with subject matter experts. Their goal is to provide training and education in austere and remote medicine to enhance the capabilities of healthcare providers in resource-limited environments—European Medics evidence-based guidance in unconventional and guerrilla medicine. EURMED has published a paper on gorilla medicine and plans to publish more papers on the topic. EURMED aims to be a neutral ground for the medical community to exchange experiences and provide expert medical education. The future of guerrilla medicine is seen as an integrated part of forward medicine, focusing on providing care to civilians affected by conflicts. Guerrilla medicine overlaps with other fields, such as wilderness medicine, medical support for irregular warfare, and disaster relief. The goal is to be better prepared for future conflicts and disasters and to save lives. Chapters 00:00 Introduction and Background 03:10 European Medics: Community and Education 06:12 The Advanced Guerrilla First Responder Course 09:02 Podcast: Medical Basics and Field Clinic 23:02 Publishing Concepts and Lessons Learned in Ukraine 27:11 The Future of European Medics 29:13 European Medics: A Neutral Ground for Medical Education 31:37 Expanding European Medics to the United States 36:48 Guerrilla Medicine and Overlapping Fields 41:37 The Clandestine Nature of Guerrilla Medicine 44:45 Preparing for Future Conflicts and Disasters 46:51 Advice for New Medical Professionals

This week, Aebhric talks with Dr Alastair Fraser, chair of the faculty advisory board for the Faculty of Remote Rural and Humanitarian Health care for the Royal College of Surgeons of Edinburgh, and discusses his diverse medical career and experiences in remote and rural areas. He shares stories from his time in the Antarctic, Nigeria, and with Shell, highlighting the challenges and unique situations he encountered. Dr Fraser also discusses the importance of mental health support for medics in remote locations and the need for ongoing training and resources. The conversation discusses the creation and purpose of the Faculty of Rural Remote Humanitarian Health, a specialised area under the Royal College of Surgeons of Edinburgh. The faculty aims to provide training and recognition for healthcare professionals in remote, rural, and humanitarian settings. It addresses the challenges of delivering healthcare in these areas and seeks to improve the quality of training and competence. The conversation also highlights the importance of community and networking among professionals in these fields. The faculty offers fellowship and membership to individuals who have demonstrated competence and contribution to the field. Takeaways Dr Alastair Fraser has had a diverse medical career, working in remote and rural areas and with Shell in various locations. He emphasises the challenges and unique situations in remote healthcare, where medics are often asked to handle various medical issues. Dr Fraser highlights the importance of mental health support for medics in remote locations and the need for ongoing training and resources. He discusses the potential benefits of incorporating ultrasound devices into the toolkit of offshore medics but acknowledges the challenges in implementing this due to company policies and liability concerns. The Faculty of Rural Remote Humanitarian Health is a specialised area under the Royal College of Surgeons of Edinburgh that provides training and recognition for healthcare professionals working in remote, rural, and humanitarian settings. The faculty addresses the challenges of delivering healthcare in these areas and aims to improve the quality of training and competence. Membership in the faculty is open to anyone interested in the field, not just doctors or medics. The faculty plans to offer more online courses that cover various skills needed in remote, rural, and humanitarian healthcare. The faculty is voluntary and relies on volunteers and funding to operate. Networking and community-building among professionals in these fields are important for sharing ideas and experiences. The faculty is working towards providing educational credits and accreditation for its courses. Healthcare professionals interested in working in austere environments should seek training, talk to experienced professionals, and develop skills in working under pressure and uncertainty. Chapters 00:00 Introduction and Background 02:10 Experiences in the Antarctica 03:00 Challenges and Unique Situations in Remote Healthcare 08:05 Limited Medical Resources in Remote Locations 15:23 Importance of Mental Health Support for Medics 20:21 Implementing Ultrasound for Offshore Medics 21:10 Introduction to the Faculty of Rural Remote Humanitarian Health 23:50 Challenges of Delivering Healthcare in Remote and Rural Areas 27:35 Membership and Community in the Faculty 33:57 Expanding Online Courses for Remote Healthcare 39:02 The Humanitarian Healthcare Course and Accreditation 43:47 Advice for Healthcare Professionals in Austere Environments