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/
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/
This week, Aebhric O’Kelly talks with Dr Chris Carter, a critical care nurse and academic, who shares his journey from military nursing to working in Zambia, where he has been instrumental in developing critical care nursing programs. He discusses the challenges and innovations in critical care nursing, particularly in resource-limited environments, and reflects on the impact of COVID-19 on the healthcare landscape. Dr Carter emphasises the importance of education, collaboration, and flexibility in nursing practice and offers advice for new professionals entering the field.
Takeaways
Dr Chris Carter transitioned from military nursing to academia.
He is currently working in Zambia to enhance critical care education.
COVID-19 highlighted the need for investment in critical care nursing.
Collaboration with local stakeholders is crucial for program development.
Innovations in critical care can improve patient outcomes.
Education programs must be tailored to local needs and resources.
There is a growing recognition of the importance of critical care nursing.
Flexibility and adaptability are key in austere medical settings.
Dr Carter advocates for updates to critical care nursing literature.
New professionals should embrace every opportunity in their careers.
Chapters
00:00 Introduction to Dr. Chris Carter
03:35 Journey to Zambia and Critical Care Education
09:01 Developing Critical Care Nursing Programs
12:34 The Impact of COVID-19 on Critical Care
16:13 Innovations in Critical Care Nursing
19:52 Future of Critical Care Nursing Education
26:51 Advice for New Professionals in Austere Medicine
This week, Aebhric O’Kelly talks with Greydon Ratushny about his master’s thesis. He recently graduated from the MSc Austere Critical Care programme. They discuss the significant challenges faced in delivering quality healthcare in remote and rural areas of British Columbia. Greydon emphasises the critical role of pain management in improving patient experiences and outcomes, particularly in paramedic services. Ratushny highlights the immediate impact that effective pain management can have on patients and its importance in their overall healthcare journey.
Takeaways
There are significant challenges in delivering quality healthcare in rural areas.
Pain management is a key focus for improving patient outcomes.
An immediate impact on pain can enhance the patient experience.
The quintuple aim concept is essential in healthcare delivery.
Paramedics play a crucial role in managing pain effectively.
Rural communities require tailored healthcare solutions.
Understanding patient experiences is vital for healthcare improvement.
Effective pain management can influence long-term patient recall.
Healthcare delivery must adapt to the unique needs of remote areas.
Research and innovation are needed to address rural healthcare challenges.
Chapters
00:01 – Introduction and guest welcome
02:30 – ACC learning experience and placements
06:15 – Motivation for choosing ACC
09:50 – Curriculum gaps and collaboration
13:55 – Programme redesign and electives
15:40 – Thesis focus: austere nerve blocks
20:10 – Scope of practice and POCUS
24:30 – Pain management in prolonged transport
29:40 – Rural healthcare equity challenges
32:50 – Doctoral research ambitions
35:40 – Advice to future candidates
36:30 – Closing reflections
This week, Aebhric OKelly and Sam Coffman continue their discussion on the Guerrilla Medic and what to grow in their garden to supplement their ICU. Sam discusses the unique advantages of herbal remedies in treating viral infections. They discuss easy-to-find herbal medicine from your camp kitchen.
Takeaways
Herbs can address specific health niches that pharmaceuticals cannot.
Herbal formulas are effective for various viral infections.
Herbs can help repair and restore tissue health.
The mucosa and lymph movement are supported by herbal remedies.
Herbs can slow down and stop virus shedding.
Pharmaceuticals lack the holistic approach that herbs provide.
Herbs can enhance the body's terrain for better health.
Herbal remedies can be more effective in certain health conditions.
The use of herbs can lead to better overall health outcomes.
Understanding the unique benefits of herbs is crucial for health.
Chapters
00:00 Introduction to Medicinal Herbs
10:46 Key Herbs for Upper Respiratory Health
14:10 Herbs for Gut and Liver Support
17:42 Common Kitchen Herbs to Support your ICU
26:56 Honey as Medicine
31:26 More Kitchen Herbs
35:44 Improvised Medicine Workshop at SOMSA
This week, Aebhric and Sam continue their discussion of Medical Support for Irregular Warfare, specifically focusing on the use of the Guerrilla Garden. They discuss the unique advantages of herbal remedies compared to pharmaceuticals, particularly in treating viral infections. He highlights how herbs can effectively slow down virus shedding, repair tissue, and support overall health in ways that pharmaceuticals cannot.
Takeaways
Herbs can address specific health niches that pharmaceuticals cannot.
Herbal formulas are effective for various viral infections.
Herbs can help repair and restore tissue health.
Herbal remedies support the mucosal and lymphatic systems.
Herbs can slow down and stop virus shedding.
Pharmaceuticals lack the holistic approach that herbs provide.
Herbs can enhance the body's terrain for better health.
Herbal remedies can be more effective in certain health conditions.
Using herbs can lead to better overall health outcomes.
Understanding the unique benefits of herbs is crucial for health.
Chapters
00:00 Intro to Guerrilla Gardening and Nutrition
01:48 Foraging and Wildcrafting for Food
04:45 The Importance of Cooking Wild Foods
07:33 Identifying Nutrient-Dense Plants
10:06 Sprouting Seeds for Quick Nutrition
13:06 Microgreens and Mushrooms as Food Sources
16:17 Safe Mushroom Identification
21:00 Planning for Sustainable Winter Nutrition
24:27 Utilising Humanure for Soil Health
26:04 Guerrilla Gardening Techniques
33:37 Top Edible Plants for Guerrilla Medics
This week, Aebhric OKelly talks with Sam Coffman about the Guerrilla Medic and supplementing Medical Support for Irregular Warfare using locally procured plants. They discuss their training as Green Berets in MSIW and how the medic on the ground can learn and use plants to support the Guerrilla Clinic.
This first episode lays the groundwork for this concept. They discuss the integration of herbal medicine with Western medical practices, emphasising the unique benefits of herbal formulas, particularly in treating viral infections and repairing tissue. The discussion highlights the potential of herbal medicine to address acute health issues where pharmaceuticals may fall short, and encourages practitioners to find specific niches where herbal remedies excel.
Episode two drops next week and focuses on the use of plants to supplement the nutritional requirements for acute casualties and healthcare staff working in a hidden, remote clinic in semi-permissive environments.
Takeaways
Herbs provide unique benefits that pharmaceuticals do not.
Acute care is a significant area for herbal medicine.
Finding niches for herbs can enhance treatment efficacy.
Herbal medicine can complement Western medical practices.
Viral infections can be treated with herbal treatments.
Integrating herbal and Western medicine can support the Guerrilla clinic.
Practitioners can easily master specific applications of herbs.
Chapters
00:00 Introduction to Herbal Medicine and Survival Gardening
02:50 Sustainable Food Production in Crisis Situations
05:38 Integrating Herbal Medicine into Resistance Healthcare
12:16 Acute Care and Herbal Remedies
14:28 Food Sources for Resistance Healthcare
19:17 Foraging and Utilising Local Plants
22:26 The Use of Alder and Medicinal Herbs
24:45 Lessons from Guerrilla Medicine in WWII
26:59 Building a Decentralised Medical System
30:38 Wildcrafting: Harnessing Nature’s Pharmacy
35:12 Creating a Learning Pathway for Remote Medics
42:19 Integrating Herbal Medicine into Resistance Healthcare
This week, Aebhric OKelly talks with Eric Linder, who shares the inspiring journey of Team 5, an organisation dedicated to providing remote medical care in underserved communities. Starting as a small group of friends, Team 5 has evolved over 15 years, focusing on humanitarian work without political or religious affiliations. Eric discusses the importance of education and training in remote medicine, emphasising the need for adaptability and cultural understanding. He also offers valuable advice for aspiring remote medics, highlighting the significance of hands-on experience and proper education in making a meaningful impact in global health.
Takeaways
Team 5 started as a small group of friends wanting to help others.
The mission evolved from Belize to Guatemala due to logistical challenges.
Team 5 focuses on providing medical care without political or religious affiliations.
The organisation has grown, but it aims to keep missions small and effective.
Eric Linder integrates educational programs with practical missions for students.
Remote medicine requires adaptability and understanding of local cultures.
Training in remote medicine is essential for effective humanitarian work.
Volunteering in underserved areas can provide valuable experience.
Education in public health is crucial for addressing global health issues.
Team 5 emphasises the importance of being prepared for challenging environments.
Chapters
00:00 The Birth of Team 5
13:16 Expanding Horizons in Remote Medicine
26:53 Education and Training in Remote Medicine
30:55 Advice for Aspiring Remote Medics
This week, Aebhric talks with Jason Jarvis, a former Special Forces medic and current PhD candidate, and discusses Chagas disease, a tropical disease transmitted by the kissing bug. He explains the life cycle of the bug, the transmission of the disease, its clinical presentation, and the challenges in diagnosis and treatment. The conversation emphasises the importance of awareness and preventive measures, especially as Chagas disease is spreading to new regions, including parts of the United States. The discussion concludes with key take-home messages for healthcare providers and the need for ongoing education in tropical medicine.
Takeaways
Chagas disease is transmitted by the kissing bug, primarily in Central and South America.
The life cycle of the kissing bug involves several stages, including the transmission of the parasite through its faeces.
Clinical diagnosis is essential, especially in endemic areas where the disease is prevalent.
The acute phase of Chagas disease is easier to treat than the chronic phase, which can lead to severe complications.
Preventive measures include avoiding exposure to kissing bugs and ensuring blood products are screened for the disease.
Chagas disease can also be transmitted through blood transfusions and organ transplants.
Healthcare providers should be aware of the symptoms and risk factors associated with Chagas disease.
The disease is now spreading to parts of the continental US, raising public health concerns.
Ongoing education and awareness of tropical diseases are crucial for healthcare providers.
The conversation highlights the importance of understanding the global health implications of diseases like Chagas.
Chapters
00:00 Introduction to Chagas Disease and Its Relevance
02:36 Life Cycle of the Kissing Bug and Transmission of Chagas Disease
04:58 Understanding the Pathophysiology of Chagas Disease
07:31 Clinical Presentation and Diagnosis of Chagas Disease
10:18 Chronic Phase and Long-term Effects of Chagas Disease
12:41 Treatment Options and Challenges in Managing Chagas Disease
14:51 Preventive Measures and Risk Factors for Chagas Disease
17:39 Chagas Disease in the Context of Global Health
19:42 Take-Home Messages for Healthcare Providers
22:20 Future Considerations and Closing Thoughts
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.
Takeaways
The 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.
Chapters
00:00 Introduction to the Quorum Podcast and Course Overview
01:04 Experiences with the Quorum Ultrasound Teaching Method
03:26 Integrating Ultrasound with Anatomy Education
06:29 Peer-to-Peer Teaching in Ultrasound Training
08:53 The Role of Ultrasound in Clinical Education
11:43 Challenges and Support in Implementing Ultrasound Training
15:09 Innovative Teaching Approaches in Ultrasound Education
17:57 Understanding Ultrasound Through Hands-On Experience
19:53 Future Plans for Ultrasound Curriculum Integration
23:43 The Importance of Peer-to-Peer Learning in Medicine
26:51 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.
Takeaways
Andrew 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.
Chapters
00:00 Introduction to Andrew Aselton and His Journey
02:37 Challenges and Growth in the Master's Program
05:10 The State of EMS Education in the U.S.
07:47 Advanced Practice Paramedics: A Path Forward
10:41 The Future of EMS and Advanced Practice Opportunities
12:00 Designing the Advanced Practice Paramedic
14:52 Comparing EMS Systems: U.S. vs Europe
18:00 Funding Challenges in EMS
21:50 The Role of Advanced Practice Providers
24:08 Creating a New Pathway for Paramedics
29:59 The Future of Paramedic Education
32:59 Advice for New Medics in Austere Medicine