Advertise on podcast: CoROM cast. Wilderness, Austere, Remote and Resource-limited Medicine.

This week, Aebhric O'Kelly is joined by Dr Ella Corrick, Dr Sean Bilodeau and Dr Tom Mallinson as the CoROM faculty attend The Big Sick conference hosted by Air Zermatt. CoROM gave three lectures and two workshops including the Improvised Medicine workshop and the Austere Emergency Care workshop. Takeaways The challenge of compressing prolonged field care education into short workshops. Engagement of diverse professional backgrounds enhances learning experiences. Realistic simulations provide valuable insights into emergency care. The importance of bridging the gap between pre-hospital and hospital care. Innovations in emergency medicine practices are crucial for improving patient outcomes. Data plays a significant role in shaping emergency response strategies. Continuous education is essential for adapting to new medical practices. The value of informal discussions among professionals at conferences. Understanding the unique challenges faced by pre-hospital care providers. The need for a shift in perception regarding the role of EMS professionals. Chapters 00:00 Introduction to the Big Sick Conference 02:34 Challenges in Prolonged Field Care Education 05:43 Diverse Professional Backgrounds in Medical Education 08:09 Learning Through Realistic Simulations 11:04 Bridging the Gap Between Pre-Hospital and Hospital Care 13:39 Innovations in Emergency Medicine Practices 16:46 The Role of Data in Emergency Response 19:10 Future Directions in Pre-Hospital Care 21:39 Conclusion and Reflections on the Conference

This week, we hear from Burjor Langdana, who runs the Wilderness and Expedition Dentistry workshop for CoROM. Burjor discusses the management of dental pain, focusing on assessing sensitivity, identifying causes, and evaluating treatment options. It emphasises the importance of patient care, oral hygiene, and antibiotic use in the management of dental conditions. The discussion also covers cultural considerations and improvisation in emergency situations, providing valuable insights for dental practitioners. https://wildernessdentistry.com/ Takeaways Understanding the characteristics of dental sensitivity is crucial. Location and duration of pain are key indicators. Aggressive brushing can lead to gum recession and sensitivity. Clove oil can be effective but should be used cautiously. Flossing is essential to prevent food buildup and gum irritation. Antibiotics may be necessary for managing infections. Improvisation is important in emergency dental care. Cultural beliefs can impact patient care and treatment acceptance. Communication with patients about procedures is vital. Managing expectations regarding treatment outcomes is essential. Chapters 00:00 Introduction to Managing Dental Pain 00:57 Understanding Sensitivity: Duration and Location 06:32 Identifying Causes of Sensitivity 12:12 Managing Sensitivity with Home Remedies 12:40 Addressing Food-Related Pain 18:37 Techniques for Filling Cavities 29:11 Improvising Without Instruments 29:39 The Role of Salt Water in Oral Health 34:53 Managing Tooth Pain and Food Impaction 39:06 Understanding Fillings and Their Complications 45:42 Gumboils: Causes and Management 49:48 Skills for Remote Dental Care 56:04 Cultural Sensitivity in Dental Treatment

This week, Aebhric O’Kelly is again joined by Dr Sam Slishman. They discuss medical innovation and Aebhric’s invention called the AirBase. They discuss medical innovation, focusing on inventions, such as the Slishman Traction Splint and the Airbase. They emphasise the importance of evidence-based medicine, particularly in the use of tourniquets and bleeding control techniques. The discussion also addresses the challenges of marketing medical devices, the role of 3D printing in healthcare, and advice for aspiring medical professionals in austere environments. Takeaways Innovations in medical devices can significantly impact patient care. Tourniquets are effective but should be used with caution. Direct pressure is often more effective than tourniquets for certain injuries. The Airbase serves multiple purposes during emergencies. 3D printing can revolutionise medical device development. Standard of care is not static and can vary by location. Patient comfort is crucial in emergency medicine. Research in austere medicine faces unique challenges. Continuous learning and adaptation are essential for medics. Chapters 00:00 Introduction to Dr Sam Slishman 01:31 Innovations in Medical Devices 04:25 Tourniquet Efficacy and Research 09:38 Direct Pressure vs. Tourniquets 17:50 The Airbase: A New Medical Tool 24:14 Challenges in Medical Device Development 31:20 The Role of 3D Printing in Medicine 39:19 Advice for Aspiring Medics

This week, Aebhric O’Kelly is joined by Rabbit, who is an EU SOF medic who shares his extensive background in military medicine and his current focus on researching the effects of higher education on individuals with PTSD. He discusses his personal experiences with PTSD and how education has played a role in his recovery. The conversation also touches on the importance of engaging the younger generation in military medicine, adapting to the changing battlefield, and the need for collaboration between special operations and conventional forces. Rabbit emphasises the significance of education and teamwork in improving outcomes for those affected by trauma. Takeaways Rabbit has a rich background in military medicine and education. His PhD research focuses on PTSD and higher education. Education can provide hope and support for individuals with PTSD. There is a need for specialised programs for military personnel with PTSD. Engaging the younger generation is crucial for the future of military medicine. Collaboration between special operations and conventional forces is essential. Rabit emphasises the importance of teaching and enabling others in medicine. The battlefield is evolving with new technologies and challenges. Personal experiences with PTSD can inform research and treatment. Teamwork is vital in prolonged field care situations. Chapters 00:00 Introduction to Rabbit and His Background 02:52 Exploring PTSD and Higher Education 10:22 Personal Experiences with PTSD and Education 17:12 The Role of SOMA and Engaging the Younger Generation 26:57 Advice for New Medics and Collaboration in Medicine

This week, Aebhric O’Kelly talks with Zach Andrews, a SOF medic, to discuss his journey through the MSc in Austere Critical Care, with a focus on his thesis on microcirculation in resource-limited settings. He shares insights into the challenges and learning experiences of his studies, the development of the AMSS score for assessing microcirculation, and his future aspirations in medicine, particularly in rural EMS and education. Takeaways Zach is on active duty in the U.S. Army as a SOF medic. He works as a critical care paramedic in a rural county. His thesis focused on microcirculation in resource-limited settings. He explored noninvasive methods for assessing microcirculation. Zach developed the mottling score to evaluate microcirculation. He emphasises the importance of basic medical skills. Zach plans to pursue a doctorate in the near future. He aims to validate his Microcirculatory Integrated Severity Scale (AMSS) in real-world settings. Zach believes in the significance of education in rural healthcare. He appreciates collaborative problem-solving in medical training. Chapters 00:00 Introduction to Zach Andrews and His Journey 06:08 Exploring the Master's Program in Osteo-Critical Care 13:20 Thesis Topic: Microcirculation in Resource-Limited Environments 20:24 Developing the Microcirculatory Integrated Severity Scale (AMSS) 24:25 Future Plans and Advice for New Practitioners

This week, Aebhric O’Kelly, Bill Vasios, and Rhod Jordan lead an open discussion examining the critical role of nutrition in prolonged field care. The conversation explores enteral and parenteral feeding modalities, outlining their respective indications, benefits, and practical limitations in austere and resource-constrained environments. Particular emphasis is placed on the value of early nutritional intervention in supporting physiological recovery, including practical techniques for nasogastric tube placement and for identifying and managing feeding-related complications. The discussion further considers the challenges of maintaining nutritional support during patient transport. It highlights the importance of interdisciplinary collaboration, including consultation with nutrition specialists, to develop safe and effective nutritional care plans. Takeaways Nutrition is crucial in prolonged field care. Enteral nutrition is less invasive and safer. Early feeding improves healing and recovery. Consult a nutritionist for feeding plans. NG tubes can reduce complications in feeding. Monitor for complications during feeding. Parenteral nutrition may be necessary in some cases. Feeding techniques can vary based on patient condition. Understanding nutritional needs is essential for care. Future discussions will focus on advanced topics. Chapters 00:00 Introduction to Prolonged Field Care and Nutrition 02:40 Understanding Enteral and Parenteral Nutrition 04:53 Benefits of Early Nutritional Support 07:47 Indications and Contraindications for Feeding 09:32 Practical Considerations for Feeding in Austere Environments 11:51 Calculating Nutritional Requirements 14:30 Challenges in Nutritional Support During Transport 17:16 Techniques for NG Tube Placement 20:00 Monitoring and Managing Feeding Complications 22:19 Discussion on Parenteral Nutrition 24:41 Conclusion and Future Topics

This week, Aebhric O’Kelly and Bill Vasios host an online discussion on the JTS sepsis CPG. CoROM students and members of the college join this live discussion about how to assess and treat the septic casualty in remote and austere environments. Chapters 00:00 Introduction to C-Circulation Problems 01:34 Understanding Sepsis and Its Management 09:17 Early Warning Systems for Sepsis 14:15 Clinical Acumen in Remote Care 20:20 Monitoring and Assessing Patient Status 27:52 Antibiotic Administration in Remote Settings 33:02 Malaria Treatment Protocols 37:33 Resuscitation Strategies for Sepsis 42:52 Point of Care Ultrasound in Patient Monitoring 48:12 Final Thoughts and Future Topics You can download the JTS CPG on Sepsis here. https://jts.health.mil/assets/docs/cpgs/Sepsis_Management_PFC_28_Oct_2020_ID83.pdf

This week, Aebhric O’Kelly, Bill Vasios, and Rhod Jordan will host an open discussion on managing austere burn patients, covering airway management, fluid resuscitation, infection control, and pain management. The speakers emphasise the complexity of burn cases and the importance of accurate assessment and treatment protocols. They also highlight the need for effective communication and patient involvement in care, as well as the use of innovative techniques like topical morphine for pain management. Takeaways Burns are incredibly complicated, but they're complex patients. Managing an individual patient's airway has to be factored in. You want to protect and secure the airway and avoid obstructions. The goal is to achieve maximal accuracy in fluid resuscitation. You can infuse that fluid rectally if you don't have IV fluids. Prophylactic antibiotics are not indicated in burn patients. Topical morphine works really, really well for pain management. Involving the patient in their care has a positive effect. Infection control is the means of preventing infection. Burn management is more art than science. Chapters 00:00 Introduction to Burns Management 03:08 Airway Management in Burn Patients 05:52 Assessing Burn Size and Fluid Resuscitation 09:00 Fluid Administration Techniques 11:38 Oral vs IV Resuscitation 14:53 Monitoring and Adjusting Treatment 17:36 Dynamic Management of Burn Patients 25:18 Vital Signs Monitoring in Critical Care 28:01 Continuous Assessment and Patient Management 32:07 Patient Involvement in Vital Signs Monitoring 35:10 Urine Output and Fluid Resuscitation 41:33 Infection Control in Burn Management 48:20 Pain Management Strategies in Burns

This is a brief introduction to the AI roundtable to be held at the Medicine in the Mediterranean conference, running from 31 January to 2 February. You can join us using the link below. https://corom.edu.mt/medicine-in-the-mediterranean-2026/

This is a brief introduction to the AI roundtable to be held at the Medicine in the Mediterranean conference, running from 31 January to 2 February. You can join us using the link below. https://corom.edu.mt/medicine-in-the-mediterranean-2026/

This is a short introduction to the two lectures that Dr Slaven Bajic will be giving at the Medicine in the Mediterranean conference running from 31 January to 2 February. You can join us using the link below. https://corom.edu.mt/medicine-in-the-mediterranean-2026/

This week, Aebhric is joined by Bill Vasios and Rhod Jordan, who recorded during the November 2025 CoROM Conversations. They discuss Practical Prolonged Casualty Care, a PDF from the US Military University, designed to equip lay responders with foundational skills for managing casualties over extended periods. The speakers underscore the critical role of clear communication, the value of structured training for non-medical personnel, and the practical relevance of the book’s guidance in real-world scenarios. They highlight the importance of engaging patients actively in their own care, as well as the inherent challenges associated with preparing laypersons for such responsibilities. Considerations of cultural context and the necessity of a collaborative, team-based approach to patient management are also brought to the forefront. Takeaways The book is designed for laypeople to understand basic medical care. Effective communication is crucial in patient care. Training non-medical personnel can enhance patient outcomes. Involving patients in their own care is beneficial. Cultural considerations play a significant role in patient care. The book provides practical techniques for prolonged casualty care. Regular assessment and monitoring are essential for patient safety. Lay responders should be trained to recognise nonverbal cues of discomfort. The importance of maintaining a regular routine for patients is emphasised. Cross-training team members can improve overall care. Chapters 00:00 Introduction to Prolonged Casualty Care 02:50 Deep Dive into the Book's Content 06:04 Engaging Laypersons in Medical Care 08:55 Communication and Patient Interaction 11:37 Training Non-Medical Personnel 14:49 Practical Applications and Techniques 17:51 Understanding Patient Needs 20:39 Challenges in Training and Implementation 23:28 Cultural Considerations in Patient Care 26:16 Conclusion and Future Directions https://www.usuhs.edu/sites/default/files/2025-09/Layperson%27s_Guide_to_Prolonged_Casualty_Care_090825_ACC.pdf

Discover the voices shaping the future of remote, austere, and expeditionary healthcare. In this special podcast preview, you will hear directly from the expert presenters who will be leading sessions at ⁠Medicine in the Mediterranean⁠, held from 31 January to 2 February. This annual gathering brings together clinicians, researchers, and operational medics from across the globe, professionals delivering care in deserts, jungles, mountains, conflict zones, offshore platforms, and every environment in between. Places are still available, offering a rare opportunity to network with colleagues working at the cutting edge of remote medicine, gain insights from internationally recognised leaders, and strengthen your practice through evidence-based, real-world learning. If your goal is to elevate your capability in challenging environments, this is the forum. Excel by learning from those who set the standard. https://corom.edu.mt/medicine-in-the-mediterranean-2026/

Discover the voices shaping the future of remote, austere, and expeditionary healthcare. In this special podcast preview, you will hear directly from the expert presenters who will be leading sessions at ⁠Medicine in the Mediterranean⁠, held from 31 January to 2 February. This annual gathering brings together clinicians, researchers, and operational medics from across the globe, professionals delivering care in deserts, jungles, mountains, conflict zones, offshore platforms, and every environment in between. Places are still available, offering a rare opportunity to network with colleagues working at the cutting edge of remote medicine, gain insights from internationally recognised leaders, and strengthen your practice through evidence-based, real-world learning. If your goal is to elevate your capability in challenging environments, this is the forum. Excel by learning from those who set the standard. https://corom.edu.mt/medicine-in-the-mediterranean-2026/

Discover the voices shaping the future of remote, austere, and expeditionary healthcare. In this special podcast preview, you will hear directly from the expert presenters who will be leading sessions at Medicine in the Mediterranean, held from 31 January to 2 February. This annual gathering brings together clinicians, researchers, and operational medics from across the globe, professionals delivering care in deserts, jungles, mountains, conflict zones, offshore platforms, and every environment in between. Places are still available, offering a rare opportunity to network with colleagues working at the cutting edge of remote medicine, gain insights from internationally recognised leaders, and strengthen your practice through evidence-based, real-world learning. If your goal is to elevate your capability in challenging environments, this is the forum. Excel by learning from those who set the standard. https://corom.edu.mt/medicine-in-the-mediterranean-2026/