Hello everyone and welcome to the Quorum podcast.
This is where academic medicine meets remote, austere and
resource limited areas. Welcome back to the podcast.
This is Avrico Kelly. This week we are with Robert
Yedrick from Poland. He has been the forefront of
prolonged field care learning in Central and Eastern Europe.
And Robert, welcome to the podcast.
Hello. Thank you every.
Hello. So tell us a bit about yourself
and what's keeping you busy. OK, my name is Robert Iandri.
I'm from 21 years. I'm paramedic.
I have been involved in emergency medicine, tactical
medicine and medical training for many years.
Mine areas are TCC, tech, PHDLS and from the last year also
emergency course. Emergency course, sorry.
And in simple terms my work is about preparing people to work
in the situation. It's difficult, it's far from
ideal and they are in big stress.
I train medic, first responders, Polish Army, Polish
counterterrorism units, Polish Border guard and our another our
government units. We keep what keep me busy right
now is training, developing education programme and build a
practical standard for the best teaching which we can give for
this moment. For me the goal is not just for
someone to complete a course or receive a certificate.
The real goals is for them to be able able to make good decision
under pressure, in real condition.
Yeah, it's it's little about me. Nice, nice.
And, and, and a couple weeks ago you attended the SOMSA
conference for the first time. But we, we first met in Poland
last year and you set up the first Auster emergency care
training programme in Poland. Yes.
And you've been running the AEC course for a year now.
How? How is that going for you?
In my opinion, AEC is very important project for me because
it's focused on areas that we often under limited and we stay
with our patient in our service condition and we don't have
enough rapid evacuation. After one year of running the
course, I can clearly see that there is real needs for this
kind of training. Our courses come with strong
medical knowledge or strong tactical experience and but AC
give for them some new skills and they start understanding
that AC or prolonged fit care. It's not only medicine, it's a
lot of more more skills like communication like hook of the
team can be good leader and how prepare good team to work in
hostile environment. The school is not only about
procedure, it's about clinical thinking, characterization,
patient monitoring, commendation, decision making
when condition are far from perfect.
For me these schools is very important because for four years
we have war close to our country and I think in this moment a lot
of not only army medics, but every civilian medics it's
needs. It's very important to know some
basis basics about Pfc. Yeah, because I think if
something bad happened in our country, it's very similar
situation back in Ukraine. Indeed, and you're seeing a lot
of that that conflict in Poland. You're having tonnes of people
coming from wounded and non wounded coming from Ukraine into
Poland. Yes, we have a lot casualty from
Ukraine become here and our our medical health system and give
support for this these people. Nice.
So Robert, you started a training company in Poland.
Tell us about that. Yeah, I from 6016 years, I
provide the government system, my training company and we are
certificate man that centre for TCC, pH, DLS and Tech.
And from last year, we are specialist medical standard
certificate centre to provide our sort of emergency care
course. Nice you you run T Triple C as a
civilian organisation because isn't there a requirement from
an AEM T to only allow military to teach T triple C?
But you you teach T triple C. Yes, we teach triple C for
civilian people because in last year's in Poland start a lot of
government support to train civilian people with basic
combat medicine. Yeah, we provide TCC course, but
it's, it's not a certificate, but not from 90.
It's our our company. It's only our company
certificate and we don't we teach only it's more similar
like tag. But you know, not everybody in
our country understand different between tech or TCC.
Because if we speak about combat medicine, everybody knows what
TCC is almost only combat medicine.
Yeah, they then don't know that for civilian people it's better
to provide tech. That's why they always ask or
call for my company and they they looking for TCC course.
And we give only our company certificate because a lot of a
lot of people from government units, it's not from military
and it's like civilian like critical infrastructure units.
And they don't understand that TCC is only for army.
They looking for information in Internet combat medicine Is TCC
OK? We need to buy this course,
Yeah. Nice.
This past week we had an affiliate faculty from the NAMT
here in, in Pretty Bay and they were going through our AMLS and
PSTLS programmes and they, they've given us approval to run
them. And it was interesting that,
that your, your comment with, but this is something we talked
about as well. The difference between T triple
C and TECC. And there needs to be a
development within NEMT for the TEC pathway because we're at the
moment there's just TECC and that's the only thing that
really is equal to the TCCC course.
But there's nothing for CMC level within it.
The TCC programme or this or the is there a need?
Do you think you've been running TCC for a while?
Do you think there's a need for a combat medic corpsman level
for the civilians? Yes, I think every, every
civilian medic, paramedic, nurse, doctor in this situation
needs some basic information about combat medicine.
And if we are on the level of medical personnel, I think the
good course is CMC. Of course that can be CMC
course, of course, without the first phase like car under fire,
because civilian medic, if he's in the car under fire, he must
go somewhere to to hide. Yeah.
And that's why I think we can it's good idea to prepare some
special version or addition CMC course for civilian medics.
Yeah. That was the discussion that we
had with the affiliate faculty from NAMT, that there hasn't
been a movement in that direction yet.
And are you seeing the same thing in Poland, that there
needs to be more than just the TECC course?
Yes, I think I see the same situation.
And because a lot of people they are on the they understand they
don't have enough knowledge about combat medicine, how to
work in which zone and what type of equipment we need to provide
professional help on the battlefield.
Of course a lot of people become to PHDLS and our CMC and we
provide some CMC version for civilian medics, but without
certificate Manta yeah. And I think it's very good idea
to prepare some some type of these schools that that can be
the same course, the same programme, of course, without
this car under fire, this first phase when we have fire
superiority, when we have fight tactics and a lot of combat
elements. Yeah, because they don't know
this. But I think the idea about some
like we have TCC and tech and maybe it's good to prepare
advanced tech for like CMC or something like that.
I think there's a need for it because if we are going to
prepare the population for the risk of a coming conflict,
they're not going to be taking T Triple C.
They're going to be in the civilian environment.
So maybe having a tactical emergency casualty care pathway
like the T Triple C does. So they have the 2 day T triple
C, they have the five day combat lifesaver and then the 63 hour
combat medic corpsman and then the brand new combat paramedic,
which I believe is four months. So and obviously in a civilian
world we have our paramedic. So we have that in place.
What we don't have is the combat medic corpsman equivalent in
TECC. Yeah, I think it's very good
idea and I hope if you speak with, I feel faculty in from the
IMDb about this, maybe they can start this course, about this
course, Yeah. Yeah, and you've been an NAMT
training centre longer than we have.
We're this is day 2 for our college, so you have a lot more
experience on how that works and you've run TECC and we are still
in the beginning process of that.
So it'll be interesting to talk about that as we move forward.
Yeah, I think it's very, very important because from I provide
my company from 2010 and every civilian shooter, every police,
police officer and a lot of guys from Army, they know only TCC
course yeah, they know it's combat medicine, It's TCC.
A lot of times when the people ask me, OK, I'm from civilian
company, I need combat medicine, I want to join to TCC.
And I told OK, if you are not in Army and maybe it's better to
you can join in tech. And a lot of answer is what is
tech? I don't know nothing about the
tech. I think this is because TCC is
more better marketing in in the market.
Yeah more more people know this this name of this course and
it's it's hard to change the decision.
Yeah, sometimes I can do this. Of course, when the people they
have time to explain what is different between this course
and the second one and they they thinking, OK, you could write
Robert, it's better for me to join to tech.
Yeah, because they don't, in my opinion, it's without science to
train civil people in TCC because they don't know tactic,
they don't know how to combat, how to shooting in tactical
situation. And I think a lot of company
when provide this training in Poland.
And when they start scenario, OK, you have contact.
Now the contact is over and you have casual.
And this is type of scenario, a lot of scenario.
And in my opinion, it's not TCC scenario, it's more tech.
Yeah, because it's finished. As valid point, so you've been
running the AEC course, the prolonged field care course from
specialised medical standards for a while now.
And I would like to hear about your experiences with that.
And then how you see the prolonged field care training
affecting Poland or how is the improvement from your your, your
training? I think it's very important in
this moment. Like I told you, it's good
because AC is certificate tool, Yeah, like PHDLS, like TCC.
And it's good because if every humanics know this tool, if
something happened and we talk about war, we can better
cooperate with another medics with with another another
country. Yeah.
And that's why I think we need to provide as more course as
possible. Yeah, I think you're right and
I'm delighted that you're pushing that forward in Poland.
And looking at the medical training, the current tactical
medical training, the austere medical training, what's
missing? What do you think is needed in
Poland for Austria medicine? I think the most important in as
realistic scenario as possible, yeah.
Because we know that in classroom everything is clear.
When we work on the mannequin everything is clear.
But when we start scenario and something and we have little
stress, we give you little stress for our student and they
start having problem with easy processor like tourniquet wound
packing. And I think the most important
is building the skills step by step first.
Always the most important in my opinion is always basic skills
like basic March. And after that when we have very
good fundament with basic tactical medicine, we can moving
forward. And about medical skills, in my
opinion one of the most important thing is life tissue
trauma training or cadaver training to we can give better
quality of every procedure, react about scenario if we can
use a lot of special effects, you know like smokes, like
grenades, like some lights, like stroboscope and with good role
players. And we can prepare as realistic
scenario as possible. And I think this is very
important. I agree it it's not the same.
If you're doing a scenario with just a a plastic mannequin in
the classroom, you do need to get out and and give some
challenge to the to the students.
Yes, exactly. And I think most important thing
is when we train AC or Pfc and the people start understanding
that they after a few, few hours of scenario, they are very
tired. And I remember my first AC in
Norway two years ago, we prepare a lot of equipment, medical
equipment for our casualty. We prepare water and eat for our
casualty. And I forgot something to eat
for me. And it's very cold in December.
And after four or five years, I'm really tired And I feel that
I need some, some, some, some sugar I add to to my brain
because he starts working slowly.
And this is very important and for me, it's very good
experience, yeah. Because for every training,
every scenario, we have some some information about what our
students feel what he have. We we which have they have
problem what is most important for them.
And we have good feedback for our role players because because
if every scenario they have I I have problem because somebody
give me too much pressure here or I have pain for here because
the part of stretchers give me pressure on my back.
Yep. That's part of prolonged field
care. Yeah.
Robert, you attended the Special
Operations Medical Association conference earlier this month.
How was that experience for you? For me, it's very, very, very
good experience and I'm appreciate that I can be there.
Last year I was in CMC and in, in Germany and here it's a lot
of new people from around the world.
I meet with a lot of, a lot of people which one?
I have some contact, but you know, it's only for Internet
contract contact like LinkedIn or e-mail or Instagram.
And now we can speak face to face.
It's a lot of colour to me. And it's very nice because a lot
of a lot of these guys, they, they know my company when I told
that I'm from Poland, from the government system, they know our
logo, but they know our name. Very nice.
Doesn't mean our marketing is good and doesn't mean we have
good opinion about our training. It's a lot of new equipment,
which one I can observe. I bring for Poland some contacts
to buy or the company can send us for free for one hemostatical
or one cell device or something. Yeah, I'm waiting for this now.
It's amazing, Amazing, amazing event.
Yeah, it's first time, but I, I hope not, not last time in the
United States, but because I think maybe I can go there to,
to go to the next some better or more advanced courses.
Yeah. Nice.
Yep. So what is your five year plan
Robert? What are you planning to do with
your company and and what are you planning to do to expand or
or change or push evidence based medicine forward?
My five year plan is to continue developing, developing tactical
meditation as best as we can. Of course now we can have the
prolonged field care training in Poland.
We prepare to start building our training centre, waiting for
decision and permission to start building I.
I would like to help build a stronger community of
instructors and practitioners, people who do not only teach
protesters, but who really understand the philosophy of
operating in difficult environment.
I want to develop courses that are practical, demanding and
basis of current knowledge, but also on real operational
experience. And I'm thinking about start
some international cooperation, because it's very important to
me. And Poland has a unique
position. Today we are close to war in
Ukraine, we see it conquences and we have contact with people
who bring back real experience and that us our responsibility.
And I I would like to use to take this lesson and turn them
to into better training, better preparation and better systems.
And in five years, I would like to see a more connected, more
professional and more prepared tactical medicine community in
Poland. And our legion and I hope we can
bring for Poland a lot of good specialists around the world.
That is a good plan to lay down and I look forward to seeing
that. Robert, my final question for
you is this. What advice do you have for the
new medic, the new nurse, the new Doctor who is just starting
out in their career in austere medicine?
My first advice would be be master of basic, of course,
because a lot of people thinking about more very advanced
medicine, Yeah, very advanced prolonged field and a lot of
people forget about the basics. Yeah.
Last year I dirt for two or three tactical paramedic
challenge and we do only very easy case with junctional
haemorrhage. And on the last challenge I
prepare trauma, brain injury. It's a lot of complicated for
this team. That's why we focused only on
basic much protocol. Yeah.
And after medicine, the most complicated procedure is not.
Not always what saves the patient.
Very often what matters most is strong understanding of
philosophy, patient assessment. Second, stay humble.
Australian medicine quickly teach you that nobody knows
everything. A doctor knows a medic and
operator and and driver. Each person may hold an imported
piece of the puzzle. The sooner we learn to listen to
each other and work as them, the better is for the patient.
And finally, do not romantic. This work after romantic can be
hard, dirty, exhausting and mentally demanding.
But it's also extreme important if you keep learning.
Study humble, train seriously and remember that patient is
always at the centre of everything we do.
Robert, that is great advice and I really appreciate you taking
the time today to join us as a guest and to be on our podcast.
And I look forward to again meeting you in some very
interesting location. Thank you very much Abrek.
It's always for me and my team to honour, to give for you some
support and it's very honoured to us, to we can cooperate and
we can provide good medicine in our country and I hope around
the world. This.
Has been a presentation from the College of Remote and Offshore
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