In this episode of the World Extreme Medicine Podcast, we explore one of the most talked-about studies in pre-hospital trauma care: “Beyond IO and IV - Trauma Lines in Pre-Hospital Haemorrhagic Shock.”Host Eoin Walker is joined by Paolo Pallavicini, final-year medical student and research fellow with London’s Air Ambulance and the Centre for Trauma Sciences, to unpack a groundbreaking study analysing over 8,000 trauma patients.They discuss:Why standard IV and IO access can be inadequate in exsanguinating traumaHow trauma lines can double pre-hospital blood delivery ratesSuccess, complication, and survival outcomes from the studyThe future of central venous access in pre-hospital carePaolo also offers key insights into the realities of working in a chaotic roadside environment, the importance of governance and training, and how clinical risk-benefit decisions are made when every second counts.Read the paper here.Find out more about London Air Ambulance Service.
From conflict zones to refugee camps, from neonatal units to global health leadership—nurses are at the heart of humanitarian medicine.In this episode, host Eoin Walker is joined by Elsa Afonso and Marcus Wootton from the Royal College of Nursing’s International Academy. Together they bring decades of frontline and strategic experience with organisations including MSF, UNICEF, and academic institutions worldwide.We explore:What drives nurses into humanitarian workLessons learned from conflict zones, HIV & AIDS programs, and neonatal careThe power of education and capacity-building in fragile health systemsLeadership, advocacy, and cultural adaptability in global healthThe future of nursing in humanitarian responseA powerful conversation about resilience, leadership, and the global role of nurses.Important links:RCN International AcademyPhoenix Nursing MyanmarRCN Report: Care Amongst the Chaos – The Voices of Nurses Working in Conflict (PDF)
At just 28 years old, Rachel Smith is preparing to make history. Diagnosed with type 1 diabetes before her third birthday, she has never let her condition define her limits. Already having summited the highest peaks in South America, Africa, and Australia, Rachel now sets her sights on Mount Vinson, Antarctica’s highest peak at 4,892m.In this conversation with host Eoin Walker, Rachel shares her remarkable journey:Growing up as the first child in Northern Ireland to use an insulin pumpHow evolving technology has supported her ambitions in medicine and mountaineeringThe unique physiological challenges of managing diabetes at high altitude and in extreme coldThe balance between risk, resilience, and pushing human potentialHer partnership with Breakthrough T1D and the importance of raising awarenessThis is a story of grit, adaptability, and proving that chronic conditions don’t have to hold you back from extraordinary goals.Learn about Rachel and follow her journey here.Find out more about Breakthrough T1D.
In this episode of the World Extreme Medicine Podcast, host Eoin Walker speaks with Leif Rognås (consultant anaesthetist and clinical lead with the Danish Air Ambulance) and Karina Damsgaard (psychologist specialising in emergency medicine and resilience in high-performance teams).Together, they unpack the concept of Compassionate Debriefing, an approach designed to replace traditional “honest debriefs” with something more supportive, psychologically safe, and effective for learning.The discussion explores:Why traditional debrief models can fall short in complex, high-stakes environmentsHow compassionate debriefing fosters resilience, retention, and psychological safetyPractical steps for shifting from critique to care in post-mission reflectionsWhat further research is needed to embed this approach into HEMS and beyondA must-listen for clinicians, leaders, and anyone interested in the future of healthcare culture, wellbeing, and team performance.You can read Karina's paper 'Common Mental Health Symptoms in Personnel Working in Helicopter Emergency Medical Services: A Systematic Review' here.
In this episode of the World Extreme Medicine Podcast, host Eoin Walker is joined by Hannah Lock, an emergency medicine doctor, expedition specialist, and seasoned mountaineer with experience across six continents. Together, they go beyond the basics of acute mountain sickness (AMS) to explore the lesser-known high-altitude illnesses and how they’re managed in the field.From HAPE and HACE to retinal haemorrhages, chronic mountain sickness, high-altitude cough, frostbite, and the impact of altitude on muscle mass and sleep, this deep dive unpacks the realities clinicians and expedition leaders face at altitude.Hannah also shares insights on managing risk in clients with comorbidities, new technologies shaping safety in the mountains, and practical strategies for hydration, acclimatisation, and performance at elevation.Learn more about Hannah and her work here.
In this episode of the World Extreme Medicine Podcast, host Eoin Walker speaks with Luke Apisa about his extraordinary journey from wilderness medicine to space medicine.Luke shares insights from treating climbers at 14,000 feet in Nepal, supporting ultramarathon runners in the deserts of Arizona and Utah, and helping to develop future medical capabilities for space exploration with NASA and SpaceX.From designing innovative altitude breathing devices to researching pulmonary edema treatment at high altitude, Luke’s career sits at the cutting edge of medicine in extreme environments.Discover how wilderness and space medicine connect, what it’s like to practice in the Himalayas, and the challenges facing long-duration spaceflight.
In this episode of the World Extreme Medicine Podcast, Eoin Walker sits down with chef, explorer, and researcher Mike Keen to unpack an extraordinary Arctic journey.Mike kayaked the entire 3,000km length of Greenland’s rugged west coast, surviving solely on a traditional Inuit diet of seal, whale, dried fish, and wild foraged plants. Working with researchers at King’s College London, he tested how an ancestral, high-fat, low-carb diet impacts health, endurance, and resilience in one of the most extreme environments on Earth.We explore:The science behind ancestral diets and their potential to improve health and performanceThe physical and mental challenges of solo Arctic travelClimate change impacts on Greenland’s ice and wildlifeLessons from indigenous communities on food, sustainability, and survivalFollow Mike’s work: WebsiteInstagram
In this episode of the World Extreme Medicine Podcast, host Eoin Walker is joined by Luca Carenzo, intensive care consultant, and Federico Emiliano Ghio, critical care nurse and medical lead for high-altitude emergency services in Livigno, Italy, one of the busiest ski resorts in the Alps.From sub-zero slopes and altitude-induced illness to managing cardiac arrests at 2800m with no hospital in sight, Federico and Luca explore the real-time challenges of delivering care in extreme alpine environments.Featuring:Advanced pain relief protocols in –20°C conditionsHow fluids freeze, defibs fail, and ventilators adaptWhy governance matters when you don’t have paramedicsPlanning for the Milan-Cortina 2026 Winter OlympicsThe future of ski patrol: drones, slope-side diagnostics, and real-time triageThis is high-acuity medicine, on ice.📍 This session was recorded remotely in December 2024.
In this episode of the World Extreme Medicine Podcast, host Eoin Walker speaks with Mardi Steere, Executive General Manager of Medical and Retrieval Services at the Royal Flying Doctor Service, about a groundbreaking innovation in rural healthcare delivery, the Virtual Emergency Centre (VEC).Operating in one of the most remote regions of Australia, the VEC integrates telehealth, remote diagnostics, and trained layperson intervention to deliver hospital-grade care in areas where no medical staff are physically present. Mardi shares the origins of the project, the role of technology like Starlink and wearables, and how the model is saving lives and reducing retrieval costs.We discuss the governance and logistics behind delivering high-risk medications remotely, the scalability of the model, and how learnings from Africa, India, and Rwanda are being adapted to suit Australia’s unique geographical challenges. Mardi also reflects on the future of healthcare innovation, from drone-delivered AEDs to virtual ultrasonography and beyond.Learn more about the VEC and the work of the Royal Flying Doctor Service: https://www.flyingdoctor.org.au
What happens when your first major expedition is one of the world’s Seven Summits?In this episode of the World Extreme Medicine Podcast, emergency medicine doctor Ffyon Smith is joined by Kacylia Roy Proulx, a medical student at McGill University and President of her university’s Wilderness Medicine Society. Together, they explore Kacylia’s experience of climbing Mount Kilimanjaro, from early trail excitement to summit-day exhaustion, team dynamics, and the real-time challenge of acute mountain sickness.This is an honest, insightful conversation about why we climb, how we build mental resilience, and what expedition medicine means to someone just starting out.You’ll hear about:The reality of altitude acclimatisation and AMS symptomsNavigating ethical dilemmas on the trailHow expedition teamwork makes or breaks the journeyFinding identity, purpose, and introspection at high altitudeAdvice for medical students looking to break into expedition medicine📝 Please note: Due to internet connection issues during recording, there’s a slight delay or glitch in Kacylia’s audio and video at times. Thanks for bearing with us, the conversation is well worth it.Please note that this session was recorded in January 2025.
In this episode of the World Extreme Medicine Podcast, host Eoin Walker is joined by expedition doctor, GP, and WEM faculty member Daniel Grace to explore the essential medications needed for remote and high-risk environments.From his recent work in Zambia, Daniel unpacks real-world pharmacology strategies: what drugs matter most, how to balance ideal vs. realistic care, and how to make limited supplies go further in the field.Together, they discuss:The non-negotiables in your expedition med kitAdapting to extreme heat, altitude, and remote terrainPain management without controlled substancesAntibiotics, wound care, and infection controlStorage challenges in hot, cold, and humid conditionsRisk assessment, planning, and reach-back strategies🎧 Listen now and gear up with practical insights from the front lines of expedition medicine.📚 Find out more about WEM’s training
What does it take to finish one of the most extreme endurance races on the planet?In this episode of the World Extreme Medicine Podcast, host Eoin Walker is joined by ultra-endurance athlete Sébastien Marlier, who recently completed the Bretzel Ultra Triathlon — a continuous event five times longer than a standard Ironman.With 19km of swimming, 900km of cycling, and 211km of running, this race demands everything from the human body — and mind. Sébastien unpacks his physical and psychological preparation, from training his digestion system to handle real food, to using mental conditioning tools like the “thermometer” and “VACOG” techniques to stay grounded under pressure.We explore:How he adapted his nutrition and hydration to avoid fatigue and GI distressWhy mental resilience tools were key to finishing strongThe role of ego, emotion, and community in ultra-endurance performanceWhat he’d do differently next time (hint: sunscreen and compression socks!)Lessons from pain, recovery, and the post-race crashSébastien also shares a heartfelt thank-you to the two fellow athletes who helped him during the race:Shanda Hill (Canada), who offered advice and anaesthetic cream during a critical momentGoulwen Tristan (France), who shared essential hygiene tips on the bike courseBoth went on to win this year’s Bretzel Ultra Triathlon, and their kindness helped Sébastien reach the finish line.Since the recording, Sébastien has also completed the Double Ultratriathlon World Championships in Emsdetten, Germany, placing 7th overall with a time of 25h28min, and he’s just getting started.His future plans include taking on the Deca Ironman in 2026 (10x the Ironman distance) and applying for the legendary Enduroman Arch to Arc challenge. Both will raise money to support children and teenagers who can’t afford access to sport.Whether you’re an endurance athlete, medic, or just curious about the limits of human performance — this conversation is packed with practical insights and powerful reflection.📌 Find out more about the Bretzel Ultra Triathlon here
In the final part of our 3-part series marking the anniversary of the 7/7 London bombings, we hear from paramedic Sam Sinclair, who was deployed to Tavistock Square, the site of the fourth and final explosion.Sam shares his experience of arriving on scene, witnessing the scale of the devastation, and making impossible decisions under pressure. In this conversation with WEM’s Eoin Walker, he reflects on the lessons 7/7 taught him about teamwork, instinct, and how to carry the emotional weight of a major incident across a long career in emergency medicine.Listen to part 1: https://spotifycreators-web.app.link/e/Lax8tb35UUbListen to part 2: https://spotifycreators-web.app.link/e/5WXsGa35UUb⚠️ Content Warning: This episode contains descriptions of traumatic events, injuries, and first-hand reflections from a major incident response. Listener discretion is advised.
In Part 2 of our 20 year anniversary series on the 7/7 London bombings, paramedic Adam Desmond shares his deeply personal and unflinchingly honest account of responding to the attacks at King's Cross.Speaking with WEM’s Eoin Walker, Adam reflects on the chaos, the human cost, and the enduring psychological impact of working at the heart of one of the UK’s worst terrorist attacks. From navigating trauma in the underground tunnels to confronting system breakdowns and personal grief, this conversation is a vital listen for anyone working in emergency response, healthcare, or disaster medicine.Listen to part 3: https://spotifycreators-web.app.link/e/5WXsGa35UUbListen to part 1: https://spotifycreators-web.app.link/e/Lax8tb35UUb⚠️ This episode contains detailed and graphic descriptions of traumatic events and injuries, including references to death, psychological trauma, and mass casualty response. Listener discretion is advised.
In this special 3-part podcast series marking 20 years since the 7/7 London bombings, we begin with a personal testimony from paramedic & WEM podcast host Eoin Walker, who was just one year out of training when he found himself responding to the worst terrorist attack in UK history.In Part 1 hosted by Will Duffin, Eoin shares what it was like to arrive at the scene, navigate confusion and risk, and deliver care in an environment few are ever truly prepared for. From descending into the darkness of the Underground to confronting the human cost of mass casualty trauma, this episode is a raw, honest account of a day that shaped his life and career.Listen to part 2: https://spotifycreators-web.app.link/e/5WXsGa35UUbListen to Part 3: https://spotifycreators-web.app.link/e/5WXsGa35UUb⚠️ Content Warning: This episode contains detailed and graphic descriptions of traumatic injuries, death, and first-person reflections on the 7/7 bombings. Listener discretion is advised.
In this episode of the World Extreme Medicine podcast, Eoin Walker speaks with humanitarian health leader Hareen De Silva about his recent deployments in Gaza, Syria, and beyond. From mass casualty incidents and waterborne disease outbreaks to the psychological toll on healthcare workers, Hareen shares vital insights into what it takes to deliver medical care in conflict zones.We explore:The worsening humanitarian crisis in GazaLessons from Syria and UkraineMental health challenges for aid workersThe complexities of coordinating care under fireWhat needs to change in humanitarian operationsThis conversation offers a powerful look at the realities on the ground.🧭 Learn more about Hareen's work by clicking here.Please note that this session was recorded in October 2024.
What do helicopters, humanitarian crises, and high-pressure hospital wards have in common? In this episode, we sit down with Jan Becker, CEO, helicopter pilot, midwife, and international educator, to explore the vital role of non-technical skills in high-stakes environments.From aviation to midwifery to emergency medicine, Jan unpacks Crew Resource Management (CRM), situational awareness, closed-loop communication, and how to lead without overpowering. We dive into decision-making under pressure, how to manage amygdala hijack, and why simulation training (and humility) might just save lives.Highlights include:The link between cockpit discipline and clinical calmWhy humanitarian medicine demands quiet confidenceHow to build collective efficacy and empower teamsTeaching others to lead without egoLearn more from Jan by joining us at our annual conference.⚠️ Please note: This episode contains occasional strong language.
In this episode of the World Extreme Medicine Podcast, WEM's Sarah Spelsberg is joined by emergency physician and seasoned kayaker Robert Knopp to explore what happens when outdoor adventure meets unexpected injury.Together, they dive into shoulder dislocations in the wilderness; from real-life field reductions to improvised rescue gear, and what every paddler or outdoor leader should know before they head out.Whether you're a medical professional, adventure athlete, or just someone who likes to play in wild places, this episode brings practical insight and powerful storytelling that could one day make all the difference.Topics include:Self-reduction techniques like the Davos methodKit hacks using rock climbing gear and Flex SealRisk assessment and when not to relocateKayaker culture, shoulder-saving technique, and field stories from the riverListen, learn, and maybe rethink what’s in your first aid kit.👉 For more resources or to explore wilderness medical training, visit our website.
Cara Sheppard is the Senior Medical Officer at Puntukurnu Aboriginal Medical Service (PAMS), an Aboriginal Community Controlled Health Service in Western Australia's East Pilbara. In this episode, Marcus chats with Cara about what it really means to deliver healthcare in remote desert communities, where cultural safety, chronic disease, and deep-rooted systemic challenges intersect.From the realities of diabetes in young people to the complexities of rheumatic heart disease, spiritual beliefs, and payback culture, Cara offers a brutally honest look at the highs, lows, and hard truths of her role.Working with limited resources, vast distances, and the constant presence of cultural nuance, Cara shares:The myths and facts about remote medicineWhat makes PAMS uniqueHow she juggled becoming a mother while working fly-in fly-outThe reality behind staff safety and clinical decisions in remote settingsYou can find out more about PAMS here. Acknowledgement of CountryWe acknowledge the Traditional Custodians of the land on which this episode was recorded and the communities discussed. We pay our respects to Elders past and present, and extend that respect to all Aboriginal and Torres Strait Islander peoples listening.We recognise the deep spiritual connection Aboriginal peoples have to land, water, and culture, and honour their enduring presence and knowledge systems, which have existed for tens of thousands of years.
In this powerful episode, Eoin sits down with Ryan Ahlgren — a wilderness and humanitarian medicine practitioner whose career spans some of the most challenging environments on the planet.From frontline trauma care during the ISIL occupation in Iraq, to medevac operations in Ukraine, to six-week stints deep in the jungles of Papua New Guinea, Ryan shares what it's really like to provide medical care in the face of heat, hardship, and uncertainty. He also discusses his recent role in Antarctica and how diverse experiences have shaped his approach to both emergency and primary care.This episode explores:The realities of conflict and humanitarian medicineLessons in leadership, flexibility, and riskThe importance of ultrasound and sonography in remote settingsAspirations for the future – including medicine in spaceWhether you're a clinician, adventurer, or just fascinated by global health, this one’s for you.You can connect with Ryan on LinkedIn here.