207-OTC Drugs for Austere Primary Care

<p>In this episode of CoROM Conversations, Aebhric O&#39;Kelly is joined by Dr Bill Vasios to discuss one of the most overlooked aspects of remote and austere medicine: the intelligent use of over-the-counter (OTC) medications in austere primary care.</p><p>Rather than focusing on advanced equipment and prescription drugs, this discussion explores how a carefully selected collection of inexpensive, widely available medications can effectively manage many of the illnesses and injuries encountered in remote, expeditionary, humanitarian and disaster settings.</p><p>The conversation emphasises clinical reasoning, careful assessment, conservative prescribing, and making the most of simple interventions before escalating treatment.</p><p><br></p><p><u><strong>Chapters</strong></u></p><p>00:00 – Introduction: Why OTC medicines matter in austere medicine</p><p>02:22 – Traveller&#39;s diarrhoea</p><ul><li>Assessment</li><li>Oral rehydration</li><li>Loperamide: when to use it (and when not to)</li></ul><p>06:54 – Upper respiratory infections</p><ul><li>Symptom management</li><li>Salt-water gargles</li><li>Saline sprays</li><li>When antibiotics are unnecessary</li></ul><p>13:34 – Musculoskeletal injuries</p><ul><li>Pain packs</li><li>Diclofenac</li><li>Patient-guided pain management</li><li>RICE and the ice debate</li></ul><p>20:45 – Allergic rashes and contact dermatitis</p><ul><li>Hydrocortisone</li><li>Antihistamines</li><li>Oatmeal</li><li>Recognising anaphylaxis</li></ul><p>23:02 – Insect bites and stings</p><ul><li>Local treatment</li><li>Cold therapy</li><li>When to escalate care</li></ul><p>25:21 – Dehydration</p><ul><li>Oral rehydration</li><li>IV versus oral fluids</li><li>Hydration strategies in the field</li></ul><p>29:59 – Heat illness</p><ul><li>Cooling methods</li><li>Field management</li><li>Preventing heat injury</li></ul><p>32:15 – Acid reflux in austere environments</p><ul><li>Antacids</li><li>Ginger</li><li>Practical management tips</li></ul><p>32:15 – Minor wound care</p><ul><li>Irrigation</li><li>Soap versus antiseptics</li><li>Dakin&#39;s solution</li><li>Alcohol and iodine</li><li>Practical wound cleaning</li></ul><p>36:45 – Building the ideal austere OTC medical kit</p><ul><li>Essential medications</li><li>Dressings</li><li>Tape</li><li>Water purification</li><li>Splints</li><li>EpiPens</li><li>Multi-use equipment</li></ul><p>41:20 – Final discussion, audience questions and wrap-up</p><p><br></p><p><u><strong>The discussion concludes by assem