World Extreme Medicine Podcast

On today's episode we have an emergency medicine doctor, Dr. Luke Mueller, sharing his harrowing story of survival following a mountaineering accident on the Isle of Skye. He recalls the day he set out on the Dubh ridge Scramble alone, subsequently leading to a big void in his memory and awakening to a painful reality weeks later in a hospital. Dr. Luke will dive deep into the details of his rehabilitation, traumatic brain injury impacts, and his continuing journey on balancing his love for outdoor activities and his medicinal career. You'll hear his thoughts on patience as a virtue during recovery, the importance of having a strong support system, and how returning to work post-recovery drastically changed his perspective on patient care. See the details of his gripping experience and more, brought to you by his former partner, who experienced a trauma of her own when she had to report him missing. A story of strength, resilience, and gratitude, stay tuned for an inspiring conversation.

Luke Mueller is a Junior Doctor based in North Wales with a background and interest in Emergency Medicine. He has a passion for Mountain medicine and anything that maximises his time outdoors. He is currently studying the diploma in mountain medicine, hoping that this prepares him for future opportunities for expedition and mountain medicine work. In August 2020 Luke was very fortunate to survive a traumatic mountaineering accident on the Isle of Skye . This led to a challenging rescue by the Skye MRT and a subsequent 7 week hospital stay which included a 10 day ICU stay . Since surviving this and being left with his associated traumatic injuries he gives his unique insights into his rehab process physically and mentally thus far and his journey getting back into working as a Doctor whilst keeping up with enjoying his outdoor passions. 

In this conversation, we will examine some of the current reflections on the Ukraine crisis with David and Shawn. We will examine what it is currently like on the ground, some of the emerging needs and how David and Shawn believe they can be met. We dig into David and Shawn’s background in Ukraine and how this has evolved over time. We will look at our guest's anecdotal reflections on the conflict currently and some of the main factors that have changed and some that have remained over time such as the Ukrainian resiliency and mindset.

David is a special rescue paramedic who specialises in austere environments and low-resource medicine. Often working solo in international theatres, David doubles as a REMS team leader and team barista. In addition to his operational work, David is a professor of prehospital medicine teaching paramedicine, crisis and crew resource management and human factors.

When not working you can usually find him with a book, classic cocktail and cigar.

Shawn Brodzik has over nine years of experience in prehospital and emergency medicine. He has a passion for wilderness medicine, having started his career in Wyoming and Buffalo, New York. In addition to his wilderness experience, Shawn has spent six years serving communities in need around the world, providing capacity building, support to diplomatic missions and performing medevacs for critically ill patients in conflict zones. With his experience in critical care, tactical and austere medicine, Shawn has a wealth of knowledge and expertise to offer. His deep commitment to helping others and providing quality medical care in the most challenging of circumstances has earned him a reputation as a compassionate and skilled medic.

In this episode we will look at the recent changes to the newly revised second edition of ABC of Prehospital Emergency Medicine. We will examine some of the updates to PHEM covered in the book and the recent evidence-based practice and expert opinion that encompasses the PHEM training curriculum. We will examine the three main domains that the updated edition addresses which are operational, clinical and system considerations of PHEM. Other aspects of the conversation will cover updates to monitoring and ultrasound, recent changes to prehospital management of medical, trauma and psychiatric emergencies. We will also examine changes to the considerations in mass casualty and chemical, biological, radiation, and nuclear incidents.

Clare Bosanko is a PHEM consultant with Devon’s Air Ambulance and trained in the Midlands. Clare also works as an Emergency Medicine consultant at University Hospitals Plymouth. She is also a co-host of the PHEM-Cast podcast and a contributor to the new edition.

In today's episode we delve into the critical topic of responder wellbeing. We are joined by Matt Walton who offers insights into the psychological support often lacking in the field and the importance of acknowledging the impact of traumatic events on responders. Among the issues we'll be discussing are the prevalence of PTSD symptoms, the effects of night shifts, and the role of leadership in protecting mental health. Our guests also share personal experiences and provide valuable tips for preserving wellbeing amidst the stress of resuscitation efforts. Additionally, we explore the Resuscitation Council Wellbeing Resource, a comprehensive guide developed to support responders. So, join us as we navigate the complex world of responder wellbeing and delve into meaningful discussions that shed light on this critical aspect of emergency medicine.

Matt is a Doctor working in A+E in Newcastle with an interest in pre-hospital care and wilderness medicine.

Matt has focussed most of his medical career on promoting public campaigns to support frontline staff wellbeing and resilience. He studied medicine at Cambridge University and developed amateur filmmaking skills, subsequently creating a documentary on Responder Wellbeing for the BBC.

He last spoke with WEM from the COVID front line in London following the release of an academic paper for the European Heart Journal guiding support for staff mental health. Matt has just led the creation of the first ever Resuscitation Council UK Responder Wellbeing Resource, which we will discuss in the podcast.

Matt also instructs on the diploma in mountain medicine and the World Extreme Medicine Expedition & Wilderness medicine courses. He has recently travelled to high altitude with WEM and Bear Grylls to make a Netflix film.

Welcome back to the World Extreme Medicine Podcast! In today's episode, this time, we dive into the world of composed sailing medicine with our special guest, Dr. Jamie Jordan. Jamie is an experienced adventurer with vast knowledge in remote and austere settings. He is no stranger to the challenges of providing medical care while sailing in the vast oceans. Join us as we delve into Jamie's remarkable experiences sailing across the Atlantic three times and spending three months in the treacherous Southern Ocean. His most recent adventure took place aboard the Europa, a magnificent tall ship used for tourism, photography, and scientific projects. We'll discover the intricacies of maritime medicine in such a remote and dynamic environment.

Dr Jamie Jordan is a General Practitioner with over a decade of experience in expedition, maritime and remote environment medicine. He thrives on the challenge of providing high quality care in austere environments and has enjoyed applying his skills throughout the world, from sub-Saharan Africa to the Arctic and Antarctica. He provides consultancy services to organisations operating in a diverse range of extreme settings.

Jamie has endless enthusiasm for all forms of adventure and loves exploring travel plans and developing creative health solutions. He has a particular passion for sailing, with tens of thousands of miles of offshore experience including three Atlantic crossings and voyages to the Southern Ocean, Antarctica and Svalbard, plus many trips closer to home.

Alongside his devotion to all things nautical, Jamie is an enthusiastic climber, caver, kayaker, cyclist and outdoor swimmer. He has competed at a high level in a range of endurance sports including the Transcontinental Race, 24-hour mountain bike marathons and the Devizes-Westminster Canoe Marathon. Other personal challenges have included cycling the length of the Rocky Mountains from Canada to Mexico, spending days at a time underground whilst exploring the deep caves of the Picos de Europa, and crossing the Arctic tundra of northern Alaska in a folding canoe.

Welcome back to the World Extreme Medicine podcast, where we delve into fascinating and sometimes unexpected stories from the world of expedition medicine.

In today's episode, we join host Ffyon Davies as she takes us on a journey to the Himalayas, where a team of doctors finds themselves facing unique challenges and making life-saving decisions in a high-altitude, low-resource setting. From treating common colds to unexpected cases like a yak herder's rectal wound, our medical student-turned-expedition doctors Matt and Priya shares their experiences and the moral dilemmas they faced in providing care.

Join us as we explore the intricacies of delivering medical help in a remote and unpredictable environment, where practice guidelines may need to be adapted, and where limited resources can shape life or death outcomes.

In this episode, we speak to our new World Extreme Medicine host Marcus Stevens. 

Marcus is a GP with a longstanding interest in expedition and remote medicine and years of experience working in a variety of resource poor settings. Whilst at medical school he was President of the Oxford Wilderness Medicine Society and in his final year completed his elective with Simien Mountains Mobile Medical Service in Ethiopia’s remote Simien Mountains, a charity for which he now serves as Vice President.

In this episode we delve into the extraordinary world of remote medicine and the opportunities it offers. Marcus takes us on a journey through his own experiences, sharing fascinating tales from his time working in Mali, Scotland and Tibet. Marcus' passion for medical work outside traditional settings takes us to the heights of the Himalayas and the Ethiopian Highlands. We'll hear stories of braving the Sahara to drive to work in a thirty year old Land Cruiser, joining extreme medical expeditions, and being thrust into unexpected roles as an expedition doctor. 

Throughout these adventures Marcus emphasises the importance of solid medical training and the ability to adapt to different cultural practices.

Welcome to part two of the conversation between Dr. Ffyon Davies, and Dr. Benjamin Alba. Ben has gone on to be the doctor for an Everest Base Camp trek and has just finished a season as one of the Everest Base Camp doctors. Following his experiences at Everest Base Camp, he was inspired to write an open essay entitled 'Everest 2023: The Season of Death,' highlighting some of the misconceptions and challenges on Everest.

By the end of the season, there had been 12 confirmed deaths, with 5 missing, assumed dead, bringing the total to 17. Since the 2010 season, 114 people have been killed on Everest. The average number of deaths per season is 8. Besides the avalanche of 2014 that killed 15 and the earthquake of 2015 that killed 20, this makes this season the worst on record for deaths on Everest without a natural disaster.

Welcome to the World Extreme Medicine Podcast. Our host, Dr. Ffyon Davies, an emergency medicine and expedition doctor, speaks with Dr. Benjamin Alba. Ben has gone on to be the doctor for an Everest Base Camp trek and has just finished a season as one of the Everest Base Camp doctors. Following his experiences at Everest Base Camp, he was inspired to write an open essay entitled 'Everest 2023: The Season of Death,' highlighting some of the misconceptions and challenges on Everest.

By the end of the season, there had been 12 confirmed deaths, with 5 missing, assumed dead, bringing the total to 17. Since the 2010 season, 114 people have been killed on Everest. The average number of deaths per season is 8. Besides the avalanche of 2014 that killed 15 and the earthquake of 2015 that killed 20, this makes this season the worst on record for deaths on Everest without a natural disaster.

From the jungles of Cambodia during the final days of the Khmer Rouge in 1979 to the chaos of Baghdad in 2016, Combat Civilian is the powerful story of the response to human catastrophe over four decades.

Turning his back on the convention of a comfortable career in a family business, Gilbert Greenall has quietly dedicated the last four decades of his life to helping others through forty humanitarian aid missions and the delivery of British emergency assistance in eighteen conflicts.

He charts the changes in humanitarian assistance, revealing contradictions and triumphs, from the uncoordinated activities of a few small charities to the multi-billion dollar operations of today. The book guides the reader through wars, famines, earthquakes, floods and volcanic eruptions, yet there is time for humorous observations of misadventure and the absurdity of some decision making.

Greenall describes how it feels to race down the Mostar road under fire in Bosnia and the difficulties of changing a wheel on a Boeing 727 in the midst of a battle in the Angolan highlands, as he risks his life for the goal of humanitarian assistance.

Combat Civilian is a fast moving narrative, an emotional journey and a true-to-life description of the military risks and political constraints demanded by international relief work.

Welcome back to the World Extreme Medicine podcast. Today we have a fascinating conversation with Scott King, a highly experienced paramedic and instructor. He has trained individuals in hostile environments around the world with NGOs and militaries.

We delve into the challenges of preparing teams for these demanding conditions. Scott shares insights on effective training approaches, drawing on his vast experience. He highlights tailoring the training to the audience, incorporating high realism through simulations, and the power of kinaesthetic learning.

Topics include:

• The mixed effectiveness of past trainings
• Differing expectations of military vs NGO participants
• Fidelity concepts for impactful learning
• Benefits of high realism in live scenarios
• Challenges instructors face with language barriers and knowledge transfer
• The growth of simulation training and the role of facilitators
• Key elements like safety, mission planning, and muscle memory

If you want to learn more about operating in hostile environments, be sure to check out our new Hostile Environments Medicine course. It's the perfect way to gain crucial hostile medical skills following Scott's insights.

In this episode we will look at the benefit and utility of Methoxyflurane, more commonly known as Penthrox. Penthrox is a volatile, self-administered inhalation analgesic indicated for short-term pain relief. Penthrox is a portable, lightweight, non-invasive inhaler for self-administration of the Methoxyflurane vapor. The Methoxyflurane vapour provides analgesia when inhaled at low concentrations. At analgesic therapeutic doses, pain relief can reduce and mitigate even severe pain yet has a short half-life. In this episode I will be speaking to Will about it’s use and limitations within the expedition environment and how and when it can be optimally used as either a sole adjunctive pain relief agent or as part of a larger pain relief strategy.

Will is our Joint Medical Director and provides clinical oversight for all World Extreme Medicine’s activities. Will is a jobbing Devon based GP, educator and adventure addict who thrives in wild places with newly formed teams and limited resources.

He has provided medical cover for dozens of very different expeditions and projects; including commercial high-altitude treks in The Himalayas and The Andes, a luxury Trans-Siberian private train, a reality TV show in the South Pacific and he has worked with UNICEF out in forgotten corners of Myanmar.

We speak to some of the most extreme medics in some of the world's most remote locations, due to this there can sometimes be an issue with sound quality, so there are a few quality dips in this episode, but we felt it was an important conversation to share.

Welcome back to the podcast that explores the exhilarating world of extreme medicine. In today's episode, we delve into the impact of PTSD and PTSI on individuals in high-stress professions like the military. Boxxy shares personal experiences and insights, emphasising the importance of acknowledging emotional trauma and fatigue and the need for early intervention and open communication about mental health. Join us as we uncover the evolving landscape of military medicine, survival training in extreme environments, and the rewarding nature of saving lives. Stay tuned for an adventurous journey into the world of extreme medicine.

On this episode, our guest Klara Weaver talks about Wedel seals farting in her face in Antarctica, peeing in a Nalgene in the middle of the night (and the need to practice in the shower), sexism in expedition medicine, the role of social media in expedition medicine self promotion and keeping it grounded, the importance of ‘mentally’ unpacking after expedition, shout out to our supportive family friends and partners who put up with us! And her love affair with grass post Antarctica. 

We also discuss the allure of buying new kit for hobbies and how it has inspired her side hustles. Klara shares her passion for arts and crafts, being outdoors, and her interest in business and small businesses. Klara also talks about her foray into carpentry and making things with power tools when converting a campervan. During her time in Antarctica, Klara learned crochet as a distraction and a way to quiet her mind. She emphasises the importance of having something outside of medicine, whether it's a hobby, sport, or other skill. Klara believes that having a side hustle can bring valuable skills back into medicine and make it more interesting. She mentions the potential for quality improvement projects in medicine inspired by business practices. Having diverse interests makes one a more well-rounded doctor and makes the less exciting aspects of medicine more enjoyable. Klara shares that her family and friends have a short attention span when it comes to her experiences in Antarctica. She highlights that people often want her 20-month expedition to be condensed into a few sentences, not fully understanding the challenges and intensity of the experience. She warns that social media can give a misleading perception of expeditions, emphasizing the behind-the-scenes work, anxiety, and potential risks involved.

In this episode, we sit down with Dr. Shawn Rowland, a Hawaiian physician who stepped onto the frontlines of the intense Lahaina fire disaster. Dr. Rowland, a board-certified Family Medicine physician and the founder of Jase Medical, brings a unique perspective to the challenges of disaster response. With a background that spans rural and critical access hospitals, as well as international medical work in Mexico and across the United States, Dr. Rowland's experiences are both diverse and impactful. However, it's his involvement in search and rescue that truly sets him apart. Starting with his EMT days at the University of Utah, where he served for six years with the Salt Lake County Sheriff’s Search and Rescue Team, he's honed skills that range from Mountain Rescue to Swift Water Rescue. Currently residing on the tranquil north shore of Oahu, Hawaii, alongside his family, Dr. Rowland's insights into the Lahaina fire disaster are both personal and professional. Join us as we explore his journey through the chaos, his unwavering commitment to saving lives, and the unique challenges that come with responding to a disaster of this magnitude. Tune in for a compelling conversation that sheds light on the experiences of medical professionals who stand strong on the frontlines when their community needs them the most.

On this episode, join host Eoin Walker as he sits down with Jim Bond, an experienced consultant in travel and exhibition medicine, to discuss the critical decline of the African wild dog population across Africa. Jim shares his extensive knowledge and passion for one health, particularly in the context of the rabies risk reduction scheme. Together, they explore the various threats facing the African wild dogs, from persecution and poaching to diseases and habitat loss. They delve into the importance of vaccination and the challenges of reaching remote areas with low population density. Jim also discusses his plans for conducting a real-world prospective study on rabies vaccination in African wild dogs, comparing different methods of vaccination. Throughout the episode, they highlight the need to engage local communities, address vaccine hesitancy, and implement community-led public health approaches. As they wrap up the conversation, they emphasise the urgency of prevention and the goal of eliminating rabies from Africa by 2030. Tune in to this eye-opening episode to learn more about the fascinating African wild dogs, their unique social structure, and the efforts being made to protect this critically endangered species.

Jim Bond is a passionate wildlife enthusiast who has dedicated his life to studying and protecting the African wild dog, also known as the painted wolf. With over 50 names associated with this unique species, Jim is fascinated by its distinct characteristics that set it apart from other members of the dog family. Having diverged from other wolf-like species millions of years ago, the African wild dog's four toes on its front feet allow for an extended stride, making it the most efficient carnivore predator in Africa. Jim is amazed by the success rate of the African wild dog, with a remarkable 70% to 80% success rate in hunts. He is particularly captivated by their large, round ears, which possess an incredible sense of hearing. Jim never ceases to be astounded by the beautifully patterned coat of the African wild dog, which comprises a random mix of blacks, whites, browns, yellows, and even reds. Lastly, Jim admires the species' specially adapted teeth that are second in size only to the hyena's, enabling them to quickly tear apart their prey. To Jim, studying and protecting these fascinating creatures is not only a duty but a deeply rewarding experience that highlights the intricate beauty of the natural world.

In this episode we have a fascinating conversation, we have an incredible interview with a true renaissance man, Emil Sante. With an impressive background as a paramedic, ski patroller, search and rescue member, and even a coroner, Emil has truly seen it all. From his adventures on treacherous mountainsides to the solemn duties of unravelling the mysteries of death, Emil's stories will leave you on the edge of your seat. So sit back, relax, and prepare to be captivated by the remarkable tales of Emil Sante, the composed paramedic, ski patroller, search and rescue hero, and coroner.

Emil Sante is the Lieutenant Paramedic for the Telluride Fire Protection District. He has amassedan incredibly diverse and dynamic career with 26 years in EMS, 25 years in SkiPatrol, 12 years as a extremely rural County Coroner, and 5 years as a flight medic. He has always been willing to step up and serve the needs of hiscommunity in remote San Miguel County Colorado.

Today we have a topical special on heat stroke, following the record-breaking temperatures across Europe recently peaking at 44 degrees Celsius!

Heat stroke is one of the truly terrifying environmental emergencies, with a mortality rate approaching a staggering 33% (when associated with hypotension). Not only does it have an extremely high mortality rate – but also leaves many patients with significant functional impairment with around 1 in 3 having moderate to severe functional impairment at discharge. In a wilderness environment it can be challenging to treat and is a truly time critical emergency where ‘time is organ function’.

Eoin and Ffyon discuss the Wilderness Medicine Society's guidelines and their own experiences of managing heatstroke in wilderness environments.

Welcome to part two of Kilimanjaro Diaries!

Ffyon Davies was invited to support a charity trek up Mount Kilimanjaro as the medic last year, alongside Francis Screech. Their first-time ascent of the tallest freestanding mountain in the world was both thrilling and nerve-wracking for her. Although she had prior experience climbing Mont Blanc, Kilimanjaro presented new challenges with its extreme altitude. In this episode, Ffyon and a fellow medic reflect on their adventure to the top by listening to Ffyon's voice recordings made during the climb. They discuss the realities of climbing Kilimanjaro as expedition medics, from managing altitude sickness to the underestimated demands on the body at 19,000ft. Both gained valuable insights from this unforgettable trip to Africa's highest peak.

Welcome, to Kilimanjaro Diaries... Part one!

Ffyon Davies was invited to support a charity trek up Mount Kilimanjaro as the medic last year, alongside Francis Screech. Their first-time ascent of the tallest freestanding mountain in the world was both thrilling and nerve-wracking for her. Although she had prior experience climbing Mont Blanc, Kilimanjaro presented new challenges with its extreme altitude. In this episode, Ffyon and a fellow medic reflect on their adventure to the top by listening to Ffyon's voice recordings made during the climb. They discuss the realities of climbing Kilimanjaro as expedition medics, from managing altitude sickness to the underestimated demands on the body at 19,000ft. Both gained valuable insights from this unforgettable trip to Africa's highest peak.

Stay tuned for part two of the Kilimanjaro Diaries by subscribing to the podcast today so you don't miss out on the next chapter of Ffyon and Francis' journey up Kilimanjaro!

In this session Eoin speaks with Claire Park on a new primary triage tool developed by Claire and a research team. It has been accepted and agreed by NHS England for use by all UK ambulance services and prospectively by National Police and Fire Services. It has also been adopted by the UK MOD to roll out across all UK military personnel internationally.

Claire Park is a Consultant in Pre-hospital Emergency Medicine for London HEMS, and Anaesthesia and Critical Care Medicine at Kings College Hospital in London. She also is an army consultant with over 20 years of deployed military experience. Claire is the medical adviser to the Specialist Firearms teams of the Metropolitan Police Service, and has worked closely with all of the emergency services in London on developing the joint response to high threat incidents, in particular following the attacks of 2017.

She is the Chief Investigator on a UK nationally funded research grant looking at evidence for improving patient outcomes in the hot zone in major incidents and has developed relationships in this area with many members of the Committee Tactical Emergency Casualty Care CTECC over the last 4 to 5 years.

In this session we are speaking with Justin Shook on his experiences as a Parachute Jump Medic (PJ for short) with 131st Rescue squadron Pararescue. Justin is a senior team leader, paramedic, jump master, dive supervisor and instructor, evaluator and chief of weapons and tactics at Moffett Federal Air Field in California.

Get ready for a podcast journey as Justin takes us deep into the captivating world of debriefing, preparedness, and the extraordinary life of a parachute jump medic. Learn how these principles extend beyond the boundaries of mere lifesaving, reaching into the very heart of thriving in both business and military environments.

We dive into the exclusive selection process for pararescue, where candidates are pushed to their absolute limits, both mentally and physically. Justin spills the beans on the intense training program, advanced medical certifications, and even their involvement in space shuttle astronaut recovery.

Plus, we discover the awe-inspiring challenges faced by parachute jump medics in remote areas like Colombia and Mongolia. Justin's gripping accounts of building relationships with local forces and overcoming communication barriers will leave you on the edge of your seat.

Be inspired by the art of improvisation and the unwavering mindset that sets parachute jump medics apart. Justin's tales of resilience and determination will resonate deeply with you as he unveils the never-give-up attitude that defines this extraordinary community.

So, whether you're a thrill-seeker or simply someone hungry for remarkable stories of courage and expertise, this episode promises to take you on an unforgettable rollercoaster ride through the realms of debriefing, preparation, and the incredible life of a parachute jump medic.

Following International Paramedics Days we wanted to carry on the conversation. In this episode we will examine the current climate of critical care within the UK, how that looks and the journey of where its come from. We examine the anatomy of competency, portfolios, the journey towards MSc established programmes, intervention & drugs Vs critical thinking and much more.

 Eoin Walker is joined by Tom Archer and Mike Palmer. Tom started his career in the ambulance service in London in 2004 before moving to Wales in 2010, predominantly working in central London as a Paramedic, fast response paramedic and now an Retrieval practitioner in Critical Care with ERMTS in Wales. Mike Palmer qualified in London Ambulance Service as a Paramedic and specialised in Hazardous Area Response before becoming a flight paramedic on London’s Air Ambulance. He now flies as a Critical Care and Retrieval practitioner for EMRTS in Wales.

In this session our newest podcast host Sarah Spelsberg speaks with Stephen Wood about emergency concerns and preventive warnings heading into the Fourth of July holiday in the US – a holiday renowned for increased trauma, burns, and explosive injuries - as well as how he balances his extreme/tactical medicine careers with his leadership, research and academia. Stephen proves that you really can have it all in your career.

Stephen is an acute care nurse practitioner and program director for the acute care nurse practitioner program and the new Extreme Medicine program at Northeastern University in Boston, Massachusetts. He is also the Field Operations Director for the US for World Extreme Medicine. He is currently working clinically in the ED at Carney Hospital in Boston, Massachusetts. Previous to this he was the director of advanced practice providers in the division of pulmonary and critical care medicine at St. Elizabeth’s Medical Center from 2021 - 2023 and the director of affiliated providers in the division of pulmonary and critical care medicine at Carney Hospital from 2020- 2021 during the COVID Pandemic. Prior to this he spent 11 years practicing as a nurse practitioner in emergency medicine. His roots are in EMS, and he has over 30 years of field experience, including nine years as a flight paramedic. Most recently, he was a medic for a regional SWAT team and an event EMT for the Boston Red Sox. His EMS involvement currently includes his work with the FDNY EMS fellowship and with training various fire departments in Rescue Task Force. He is a former fellow in Bioethics at the Center for Bioethics at Harvard Medical School and a current visiting researcher at the Petrie-Flom Center at the Harvard Law School Petrie-Flom Center for Health Policy.  He was the associate director for the BIDMC Disaster Medicine Fellowship for five years and worked with the Be Like Brit orphanage in Haiti both on-ground and doing telemedicine. He holds a Master of Science in Nursing as well as a Master of Science in Toxicology. He has also been a podcaster and conference host for World Extreme Medicine. He has a number of scholarly publications including book chapters, peer-reviewed articles and blogs. His hobbies include writing, reading, magic and lobstering.

On this episode, Eoin Walker and guest Gregg Brady discuss the importance of pre-hospital triage, particularly in high-stress environments like active shooter incidents. Brady, who is the Deputy Chief for FDNY, discuss pre-hospital triage, its evolution and utility in modern day medicine. Incidents involving active shooters, violent extremists, barricade situations or other acts of aggressive deadly behaviours represent some of the most challenging responses to the first responder community. These types of responses test the capabilities of first responders—including mass-casualty care. The FDNY is the primary response agency to mass casualty incidents in New York City, which continues to be a potential target for domestic and international terrorism. Captain Gregg Brady has spearheaded an innovative approach to FDNY Warm Zone Triage to quickly address severely injured patients in an environment under possible threat. The discussion also covers assessment techniques for airway, massive haemorrhage, chest wounds, tension pneumothorax, and the importance of categorising patients appropriately in order to provide the best possible care. Brady emphasizes the importance of simplicity in interventions and treatments, and stresses the need for a shift in mindset for healthcare professionals in mass casualty incidents.

Jeremy Joseph, a consultant ophthalmic surgeon began his medical school training in 1977. He then conducted his ophthalmology training at the Royal London Hospital. He was appointed as a consultant in 1994. He then continued his post at the Central Middlesex Hospital. Mr. Joseph retired from practice in 2018 with the intention of continuing to work abroad for charities.

On this episode Jeremy speaks to Pavandeep Singh to discuss the world of extreme medicine and ophthalmology. Mr. Joseph, a consultant ophthalmic surgeon with extensive experience in cataract surgery and ophthalmology across the globe, trained Singh in manual small incision cataract surgery during a trip to Bolivia. The speakers delve into the challenges of surgery in low-resource areas and adapting to different environments, including language barriers and inadequately skilled staff. They also highlight the importance of encouraging local surgeons and not imposing methods used in one's home country. Jeremy emphasise the life-changing benefits of going on expeditions as a way to give back and make a difference. The episode also features the Jeremy's personal experiences, including his first expedition abroad to Brazil and his resilient mindset.

On this episode, host Ffyon Davies speaks with Charlie Mize about his experience establishing specialty care and a prehospital critical care air retrieval program in Bhutan, as well as founding his own aviation consulting company. Charlie also discusses his expertise in emergency medicine and offers insights on providing elite care in low-resource settings. He emphasises the importance of returning to first principles to save lives and prevent morbidity, and shares examples from his own work including a group of nurses providing medical assistance in a remote area of Bhutan. The episode covers a range of medical topics from epidural decompression to wildlife safety, and offers valuable lessons for emergency medicine professionals and enthusiasts alike.

Charlie Mize is a trained emergency medicine specialist with experience in both pre-hospital and in-department emergency care. He first trained as a general physician in the US before specialising in emergency medicine and resuscitation. He spent a year teaching at Yale's emergency medicine residency program before moving overseas to work in southeast Asia. While in Bhutan, he helped establish their pre-hospital care system and founded their pre-hospital critical care air retrieval program. This led to the creation of Bear Badger, a company that provides medical consulting, design, and capacity-building services. They work on projects like high-risk cartography to facilitate rescue operations in austere locations. Charlie is currently involved in discussion for another mapping project and aims to focus on creating consistent medical care during treacherous evacuation programs.

"Nothing is impossible if you believe in yourself, despite the difficulties you may face."

Rebekka started her career as a medical technician before qualifying as a paramedic in Switzerland. After completing her Master’s degree in Mountain Emergency Medicine, she started working as a freelance flight paramedic, which led her to working as the lead critical care and flight paramedic on Denali. After working as a freelance for Air Zermatt for 3 years, she now works for them full time and is their first female paramedic.

Our host Ffyon, discusses her journey into the profession, including her time spent on high patrol for Mount Denali, the highest peak in North America. We also speak to Rebekka about Air Zermatt, a helicopter-based rescue organisation in the Swiss Alps that performs various rescues, including the use of Dynamic Winching, a technique not commonly used in the UK.

Join us as we delve into the mental and physical challenges of high altitude medicine and what it takes to perform rescues in some of the world's toughest terrains.

Cat is an NHS dentist in Cornwall and a recent faculty member of World Extreme Medicine, teaching expedition dentistry. She has always had a passion for adventure and helping others and this has led her on a journey across the globe. From the jungles of Borneo to the deserts of the Gobi, the African grasslands and the mountain regions of Nepal and Patagonia, Cat has travelled extensively to provide dental care and training to remote communities. She has now set her sights on the most remote continent on earth and a more ambitious challenge...

This will involve her skiing 700 miles in an unsupported expedition to the South Pole, in temperatures as low as -50c and wind speeds of up to 60 mph. Only a handful of female adventurers have completed this solo, unsupported trek to the South Pole. She is hoping to add her name to that number and also in the process raise funds for charities ‘Bridge to Aid’ and ‘Community Action Nepal’

You can support Cat here: https://www.gofundme.com/f/molarexplorer

In this episode we explore unconventional career paths into extreme medicine. Many people in extreme medicine have led extraordinary careers – and sometimes they have even led more than one extraordinary career. Most of us in extreme medicine start out in medicine as our primary career …..and then work to combine our passion for medicine with our passion for the extreme!  Jamie flipped that idea on its head, starting out as a mountaineering instructor and later qualifying as a doctor following his experiences in the Ogwen Valley Mountain Rescue Team.

Jamie is a mountaineering instructor, mountain rescue medical lead and doctor in North Wales. Jamie started out his career as a marine biologist, before qualifying as a mountaineering instructor, and going on to join Ogwen Valley Mountain Rescue and discovering a passion for pre-hospital and emergency medicine. Following this he retrained as a doctor and continues to pursue an unconventional career path in North Wales as an anaesthetist with a passion for teaching and the outdoors!

Eric Pirie has taken an interesting career path; starting in a non medical job, journeying through Mountain Rescue, a full time outdoors instructor and culminating in qualifying as a paramedic in his fifties.

Eric joins Deb Swann to discuss how you can forge your own career pathway to combine an outdoors passion with a medical career. Eric discusses his experience of working with Mountain Rescue, the skills and experiences needed to support the teams, and how it ultimately encouraged him to qualify in paramedicine where he now works for the Scottish Ambulance Service.

James Thacker is a IFMGA Mountain Guide, member of the British Association of Mountain Guides (BMG) and Mountaineering Instructor (WMCI) splitting time between Chamonix, France, and Kingussie, Scotland. James' enthusiasm for working in the mountains has taken him to Arctic Greenland, the Himalayas, the "classic north faces" of the European Alps and rock climbing around the world.

For sixteen years James was actively involved with Mountain Rescue in the Peak District as a member of Derby MRT and Edale MRT. With this casualty care experience James has also developed an interest in the management of patients in the mountains, and is enrolled on the ORMS Hazardous Environment Medical Technician (HEMT) scheme. In recent years James has also contributed to the wider agenda of mountain safety via the British Mountaineering Council (BMC), and is a Trustee of the Chris Walker Memorial Trust (CWMT). CWMT strives to fund and deliver, in conjunction with the Scottish Avalanche Information Service (SAIS), continuing professional development training in avalanche awareness in Scotland. James is also an Observer/Forecaster for the Scottish Avalanche Information Service (SAIS) and member of the Applied Psychology and Human Factors (APHF) group, collaborating with Aberdeen University and various sectors of industry.

In this session James speaks to us about fundamentals of Mountain Rescue in the Alps, including:

Origins of:

• James MR experience
• Derby MRT and Edale MRT
• The HEMT scheme and what it gave James
• Involvement with the BMC

Alps:

• The differences in landscape and challenges between the alps and Cairngorms
• Technicality of rescue in the Alps
• Changing conditions/factors to consider
• Avalanche risk
• Cold injury
• Altitude
• Seminal cases

In this episode, Will Duffin is joined by Ffyon Davies, a fellow extreme medic, to discuss her most memorable moments in the field. They delve into her experiences in Mountain Rescue and as an Expedition Medic on Mount Kilimanjaro, which is considered one of the most challenging roles in the field. The conversation covers a range of topics including team dynamics, leadership, casualty management, wilderness fracture management, and more. They also explore how to tackle the unique challenges of expedition medical care such as preventing water from freezing at high altitudes and managing a spread-out group. Other important aspects discussed include understanding one's limits, vulnerability modeling, the significance of having a trusted colleague to confide in, and coping when one is struggling at altitude while others in the group need treatment. The episode is packed with valuable insights and practical advice for anyone interested in extreme medicine.

About Ffyon:

Ffyon is an ED Registrar based in North Wales. Usually found either outdoors, at work or both, she is currently a clinical fellow in ED, ICU and PHEM (working with EMRTS Air Ambulance) at Ysbyty Glan Clwyd. She is an 'FY5', taking a slightly circuitous route to qualifying in Emergency Medicine via the CESR pathway, taking time out wherever possible to do what she loves undertaking expedition medicine roles which have included working as chief medical officer on worked as chief medical officer on board Tall Ship P