Guest blog - Krissie Stiles

At Red Square Medical, we love a bit of social media, especially LinkedIn, and we literally fell in love with this month’s guest blogger, Krissie Stiles, for the power of her LinkedIn posts. Krissie’s personality and passion for her work just fly off the screen and grab the attention. So we’re delighted to introduce the amazing Krissie to our followers and let you all enjoy and learn from a very special guest blogger!

Hi everyone, I’m Krissie and I’ve spent the last few years working as the Plastic Surgery Clinical Nurse Specialist (CNS), caring for patients with soft tissue and orthopaedic trauma.


I’m 44 and have lived in the UK since I was 15 years old. I was actually born in Riga, Latvia and am a child of the Soviet era.


I started my career studying adult nursing at the University of Brighton where a burn specialist nurse’s lecture in the 2nd year drew my attention to the burns speciality. I was fascinated by the impact of burns trauma on a human body and the incredible reconstructive techniques available to recover soft tissue. The dressing techniques required to care for these injuries, and the amazing burns multidisciplinary team that supports burn survivors for the rest of their lives. 


I knew straight away that I wanted to be part of this world. I requested a burns unit as my Elective and Management placements towards the end of my training, and once qualified in 2003, I was invited to stay on as burns unit staff nurse at the world-renowned Queen Victoria Hospital – the home of the Guinea Pig Club and the RAF pilots who received pioneering reconstructive surgery at the hands of Sir Archibald McIndoe in WW2. 

The set up on the burns unit was such that a staff nurse could rotate and work across all of the aspects of burns unit care – from the burns ward, operating theatre, burns outreach, critical care and outpatients, which were all integrated in a single burns unit. With a desire to progress, I passed the British Burn Association’s Emergency Management of Severe Burns course and achieved a Diploma in Professional Clinical Practice: Burns, Plastic and Maxillofacial Reconstruction Pathway.


Later, as my clinical work shifted towards the burns ICU, I completed BSc in Acute Clinical Practice and in 2019 I graduated with an MSc in Burn Care from Queen Mary University of London (QMUL). My dissertation followed my interest and passion in out of hospital care, titled ‘Preventing hypothermia: defining standards for the UK pre-hospital burn care and transfer’. I passed with a Distinction and was invited back to the QMUK PGCert/MSc Burn Care programme as an Honorary Lecturer.


It might sound strange, but burn blister deroofing is my favourite procedure. It’s exactly what it says and is what we do to remove the blister so that we can fully assess the wound and promote healing. I know it may seem gruesome, but I love doing it – there is something really satisfying about having a pristine and clean wound bed.

In 2011, I was offered the post of the Burn Care Advisor – an innovative post across the London and South East of England Burn Network (LSEBN), which devoted a burn specialist nurse to work outside of the burns unit. The aim was to improve pre-burn centre care of burn survivors and supporting education of the pre-hospital and ED clinicians who cared for our patients first. 


This was a fantastic opportunity to build relationships with our referring clinicians and  improve understanding of each other’s resources, challenges and limitations in the emergency care of burn injured casualties. I worked closely with Fire and Rescue Services (FRS), road and air Ambulance Services, Emergency Departments and GP practices across three counties, which formed the catchment area for referrals into our specialist hospital. It was the most eye opening and most productive and fun role I have ever done! I learned to teach my subject in a way that is relatable and practical for those with resources way more limited than mine.


I took part in prehospital clinical governance days where burns scenarios were played out in real time. This made me realise the importance of key interventions delivered well, and the  importance of practical guidance tailored to the capacity and resources of the first responders. I designed and delivered Burns Management Study Days for clinicians outside of the burn speciality who wanted to improve their understanding and skills in burn care – whether in pre-hospital, trauma or community settings. I also got to ride on a big red truck, fly in an air ambulance on an observer shift and organised an iconic photo shoot for the National Burns Awareness Day with FRS, road and air Ambulance Service, and our burns unit team. I could go on… the highlights are just too many to mention!


Soon after, I also added the LSEBN Lead Nurse title to my name – a post that enabled me to lead on development of regional burns referral and initial management clinical practice guidelines (CPG), which are used to this day. A while later I joined the British Burn Association (BBA) as a nurse member of the Executive Committee, which saw me pioneer the first ever BBA Pre-Hospital Special Interest Group and progressed the previously developed regional CPG’s to be accepted at a national level. 


In 2017, I took on a Trauma Outreach CNS post, which took me into patients’ homes and into tertiary hospitals to help non-specialist clinicians assess and treat soft tissue trauma. 

After a year in the role, I was given an opportunity of a lifetime when I was invited to join The Katie Piper Foundation as the Head of Clinical Services. This role tasked me with setting up the first ever UK-based residential rehabilitation centre for burn survivors and allowed me a privileged insight into the long-term impact of burns. It reaffirmed to me the life changing effects of early interventions on burn survivors’ long-term quality of life and the role I have in advocating and sharing this knowledge to the healthcare professionals who hold an incredible power in their first responder hands. 


I wanted an opportunity to work at a Major Trauma Centre and when one came up within the plastics trauma field – I couldn’t turn it down. I was keen to continue to develop my role as an autonomous practitioner, but I didn’t want to lose my place as a bedside nurse. The CNS role is a perfect combination of autonomy and clinical expertise, an opportunity to see trauma patients from admission to healing. 


I started my current post in January 2020, returning myself to patients' bedsides at one of London’s Major Trauma Centres, just before the COVID pandemic stopped the world. After a redeployment to COVID ICU within months’ of starting in my new role, I eventually re-commenced my clinical practice of caring for survivors of trauma. 


My patients are survivors of trauma. Their injuries may be due to a fall, road traffic collision, assault, suicide attempt, or an animal bite, resulting in full thickness soft tissue loss. 


On a typical day, I would  join the plastic surgery team, visiting patients who are either awaiting or have already undergone reconstructive surgery across the hospital’s wards. Each visit is different – sometimes the purpose is wound assessment or a dressing change, sometimes it is a preliminary chat to explain what surgery may be required and how it will be carried out, sometimes it is to offer aftercare advice and education to the patients about to go home. I also frequently saw returning patients in the outpatients’ clinic for wound reviews. 


Teaching is a large part of the role – training and supporting the recovery, ward and clinic nurses, who are tasked with caring for patients who have undergone reconstructive surgery. I also educated adult and paediatric ED teams on initial care of burn injured patients. You’d also maybe see me sneak in to support the Emergency Department Resus team with care of the major burns admissions - in the initial assessment, management and onward referral to the specialist burn service. 

I was a lone CNS working with 4 Plastic Surgery Consultants and it wasn’t until I became an autonomous practitioner that I realised what a blessing it is to have a large team around you – someone to check in with you, someone to notice when you’re flagging and in need of a cuppa, someone who can celebrate the days’ successes with you and someone who ‘gets it’ when it comes to the type of traumatising and yet rewarding work we do. On the other hand, being with patients was my favourite part of the job. 

I love getting to know the humans behind the injuries, the bandages and the trauma. Our patients tend to stay with us for a while, making this possible. And the nice thing is that when they return to the clinic for follow-up and continue to come back for many weeks or months, it feels more like a family reunion rather than a job. There’s nothing more satisfying than achieving healing for patients and knowing they can now get on with the rest of their lives. 


My second best part of the job  is teaching. I have students who, years later, tell me how memorable and impactful my training sessions were. I have had applause, had the audience in tears, had clinicians queuing up after my talk either wanting to tell me of their own personal experience with a burn injury or one they’ve been challenged by in their clinical practice. No one forgets their encounter with burns quickly – they are rare, but when they do happen, they stick with you. (The Red Square Medical team can vouch for this fact too!)


Luckily in my role, emergencies are rare as we tend to enter the process once the patient is in hospital. But one of the main surgeries our plastic surgery team performs to salvage limbs with massive soft tissue trauma, is microvascular free tissue transfer – a flap, for short. Flap is dependent on adequate arterial and venous blood flow and a lot of post operative nursing care is to monitor for any signs of tissue compromise. Any sign of deterioration will require an urgent return to the operating theatre to save the flap, and more importantly, the patient's limb. In this case, nursing observations are essential to the timely identification of any concerns. 


When it comes to patients with burns, compartment syndrome is probably the most time critical for limb or digit salvage. When the burns are deep and circumferential, these can impair chest expansion and breathing or compromise viability of a limb or a digit, unless emergency decompression (called escharotomy) is performed. The bedside clinician needs to be attuned to the risks of deep and circumferential burns and monitor for signs of patient deterioration and neurovascular complications. The escharotomy procedure is usually performed in an operating theatre. It is very bloody and can appear almost barbaric, but it releases the constricting tight flesh, and re-establishes blood flow to the struggling tissues. 

Before I was known as ‘Krissie Plastics’, I was for a long time ‘Krissie Burns’ and I’ve already mentioned my journeys in burn care. My legacy (if I ever have one) would be to improve the sharing of specialist knowledge with those clinicians (such as Paramedics, and other pre-hospital medics) who work outside of the specialist services, and who often care for our patients first.


If we are to truly aspire to improve the quality of outcome for our patients, then we have to embrace the fact that those first responders on scene – the Fire and Rescue Service, Ambulance Service and Emergency Departments - are our extended burns team, with capacity to influence our patients’ long-term quality of life outcomes with their early interventions. In a maritime context, this also includes YOU!


It may seem strange that my work in burn care has actually taken me outside of the burns unit, but this is exactly where I feel we can reap some of the largest gains for our patients. 


My interactions and work with the Fire and Rescue and Ambulance Services have resulted in some immensely impactful and potentially life-altering practice changes. These were simple changes that followed the latest evidence and were capable of positively influencing the outcome trajectory of individuals affected by burns. 


Around this time, a Paramedic colleague of mine reflected on the changes that have been implemented with my support and jested: ‘Krissie said. We did’!. Since then, ‘Krissie said’ became a thing! So much so that I have since been described as ‘the Google of burns care’ and in fact my Twitter handle is quite idyllically @krissiesaid as a nod to my professional history in burns.


I am lucky to work in a fast-evolving speciality, where the surgical team are very hands-on with wound care, which allows me to access mentorship and supervision at the bedside. I attend burns, pre-hospital and wound care conferences, and follow the latest developments in practice through reading journal publications, attending webinars and listening to podcasts on the subjects that interest me and those useful to my clinical practice. The most recent training I attended was in sharp debridement – a fantastic tool to have as an autonomous wound care practitioner. 

It’s fascinating to take a look at the world in which Red Square Medical operates and my key advice for anyone going out to sea is… sunscreen! High factor, and I mean 50+ SPF, suncream generously applied. Radiation (sunburn) burns are unpleasant at best and incredibly debilitating at worst - so prevention is key. 


We all should have SPF in our daily skin care routine, as sun damage doesn’t only pose a risk of burns, it actually ages our skin quicker and can lead to skin cancer. As the recent Melanoma UK campaign says: ‘Be good to your skin – you’ll wear it every day for the rest of your life’. 


While burn prevention is the ideal, burn injuries are still relatively common at sea and can range from minor to the most severe burns. 

Severe burns can be life-threatening in themselves, but can also obscure other time-critical injuries, so their assessment must follow the ATLS trauma protocol. Patients will require an emergency evacuation to a land-based hospital for initial assessment and stabilisation, from where the patient will require onward transfer to a specialist burn centre. 

Minor burns are likely to be more common onboard and will require what we call a FACADE approach to initial care, especially if you’re looking to keep the patient onboard. 


FACADE stands for First Aid, Analgesia, Clean, Assess, Dress and Elevate. 


F - First Aid with cool running water for 20 minutes within 3 hours of the burn.

A - Analgesia - we need to proactively manage their pain.

C - Clean and deroof all blisters (see later note!).

A - Assess the depth and size of the burn.

D - Dress with clingfilm (for transfer) or non-adherent absorbent dressing (for local treatment).

E - Elevate limbs to reduce oedema.

My key pieces of advice for any crew and onboard medic would be:


  1. Ensure you have a ‘water strategy’. Have a Plan A,  for when you have 20 minutes worth of water (great – this is the gold standard!). But when you only have a limited water supply using alternating wet compresses over a 20 minute period is the next best thing. If you don’t have access to running water, consider sea water as an alternative cooling solution. Of course there is a risk of infection, but that can be dealt with later on, cooling is the immediate priority.

  2. However, always be mindful of hypothermia when cooling, as this can negatively affect your patient’s condition and long-term outcome. Cool the burn only but keep the rest of your patient wrapped up and warm, even if you’re in a warm or hot climate. If you notice any signs of hypothermia – stop the cooling and actively warm your patient.

  3. Have really good analgesia onboard if you are able. Burns hurt. Like – a lot! And if you are looking to treat your patients on board, and especially if you are attempting the ‘C’ element of FAÇADE – your patient will appreciate some decent pain relief before the procedure and at regular intervals afterwards, as their burn wounds are healing.

  4. If you are unable to deroof burn blisters due to confidence, skills set and/or resources – you will not be able to assess the severity and the extent of your patient’s burn wounds. This is an essential burn wound care step, which will not only allow accurate assessment, but will also reduce the risk of infection for your patient (by removing non-viable tissue). Depending on the situation, your Telemed Doctor may advise and guide you through this process.

  5. If a burn wound has been deroofed, it will be painful, leak a lot, and require frequent (often daily) dressing changes. Make sure you have wound care products that will not stick, will absorb wound exudate (the gooey, sticky stuff), prevent infection, and allow movement.

  6. Reducing oedema and maintaining movement are key to expediting burn wound healing. This is especially significant for upper limbs, which have a huge functional component to our quality of life. Elevation is a passive way of reducing the impact of oedema and can be helpful when patients are resting. Make sure your patients are instructed that movement is necessary while they are healing. If you wait until the wounds are fully healed, your patients will have incredibly stiff and immovable joints, and it will take weeks of therapy to regain function once again. Avoid this by getting your patient to move as soon as you’ve applied your first dressing! And ensure you bandage in a way that will not restrict movement.

  7. Always seek advice from a burn specialist for any burns that are deep or affect significant areas like face, hands, feet, and genitals, as these can have lifelong complications for your patients, however small and insignificant these may seem to your clinical eye. In the very least, advise patients to have follow up with a burn service once you dock. 


Facial burns are an interesting thing, and we rarely dress them. Instead we apply soft yellow paraffin (Vaseline) to reduce the discomfort of air against the open wound bed. Faces heal really well when kept clean and Vaseline’d. They also tend to look really bad as they heal – oozy, scabby, crusty, before they look absolutely awesome. The trick is in the regular washing with soap and water as tolerated, and lots and lots of Vaseline, especially on lips (they tend to be the sorest). And obviously, tell patients to stay away from naked flames and no smoking when wearing all that flammable grease on their skin! Oh, and make sure to tell them to sleep propped up on lots of pillows as this will really help with facial swelling and may prevent the momentary panic when waking in the morning and being unable to open severely swollen eyes!


Of course, some of the things I’ve seen and experienced over the years have been traumatic and I am an emotional person, so mental fitness is a fine balance for me. In the first instance, debriefing with my colleagues is instrumental – it is validation of my experience and my feelings by people who’ve been there too.


I also have a great support at home, and this is a safety blanket that I come home to, it nourishes me and restores me when I need it. I love to work out - I exercise to feel physical achievement through discomfort, to elevate my mood and attitude, and sometimes I exercise to exorcise. Fitness has been my best and my most consistent ‘therapy’ over decades.


Finally, I met my husband, David Wales, at an international burn conference where he was a single Firefighter amongst hundreds of burns professionals, presenting on his research of human behaviour in fires. I approached him as a keen, newly appointed Burn Care Advisor to discuss care on scene and to find out exactly why the Fire and Rescue Service don’t ever use the huge tank of water, they carry on their appliances, to deliver essential first aid to burn injured casualties!


This struck a chord with him and led to years of collaborative working, culminating in publication of an award-winning ‘Saving Lives is Not Enough’ report on the  importance of the role of FRS in burn survivors’ long-term outcomes. Ten years after meeting and working together, a firefighter and a burns nurse became husband and wife!


To find out more about Krissie’s incredible work and keep up to date with the latest in burns information, you can follow Krissie on LinkedIn here: https://www.linkedin.com/in/kristina-stiles-msc

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FleetMed Support - Launch

by Rachel Smith • 29 January 2025
Get ready for something super exciting! After a full year of intense planning and meticulous preparation, we're thrilled to announce the launch of our all-encompassing medical support service — FleetMed Support! Customised Maritime Medical Solutions Whether you have a fleet of ships or a single vessel, managing medical operations can be daunting without dedicated support. This makes FleetMed Support a perfect solution for the cruise, expedition and superyacht sectors. Our approach is simple: We take the burden of medical management off your shoulders, allowing you to focus on the bigger picture. With 24/7 support, we create a customized service level agreement for your fleet, ensuring that every detail is taken care of. So what’s new and why haven’t we done this before? Well, we're not a company that rushes into things. Instead, we take the time to thoroughly research and understand what's needed, ensuring we can deliver to the very high standards we set for ourselves and maintain those standards at all costs. Let's be honest, it's the continuous pursuit of excellence, the commitment to always improve, and the understanding that there's always more to learn that drives us forward each day. This means we are now ready to launch what we believe is a truly great portfolio of customisable services. So, how could this look for your company? Working with us is straightforward and hassle-free. We start by listening carefully to your specific requirements so that we can thoroughly understand your needs, and discuss your current gaps. Once we have a clear picture, we craft a tailored plan to deliver the precise services you require. Our process is marked by clear and concise communication at every step. We believe in total transparency, ensuring that you are kept in the loop throughout the entire process. We pride ourselves on our efficiency and dedication. Once the plan is in place, our experienced team gets to work, executing the agreed-upon services with precision and care. Our goal is to deliver exceptional results without any drama, making your experience as smooth and stress-free as possible.

Vaccinations - A useful overview for seafarers

by Rachel Smith • 15 January 2025
From Flu jabs to far flung destinations… Vaccinations are a hotly debated topic across the globe, particularly after COVID-19 and the rapid response to the need for a vaccination to help reduce the burden on the health services in different countries. While the majority of healthcare workers and the general population support the ‘prevention is better than cure’ line of thinking, and therefore vaccinations, there are others who are determinedly against vaccinations for any disease, whatever the risk of mortality and death may be. In the UK, the BCG (Bacillus Calmette-Guerin) vaccination used to be given to all children in their teenage years to protect against tuberculosis. The vaccine has been so successful that TB is virtually eradicated now, and the majority of cases are due to migration. Now it’s only given to those deemed at high risk - babies and children at high risk, those travelling to high risk regions and adults coming into the UK from high risk countries. Depending on your country of origin, you should receive a range of vaccinations as a child or young adult. This will most likely include diphtheria, tetanus, polio and whooping cough, hepatitis and HIB (Influenza type B). Then MMR (measles, mumps and rubella), the pneumococcal vaccine (meningitis, pneumonia and sepsis) and HPV (Human Papilloma Virus) with a variety of boosters along the way. At the other end of the scale, the over 65s can receive vaccines for shingles, pneumococcal vaccine and respiratory syncytial virus along with flu and covid vaccines.

Red Square Medical – End of Year Review

by Rachel Smith • 30 December 2024
Reflection is an essential part of medicine and our regular followers will know that every year, we like to take a look back and assess where we started and how far we’ve come over the last 12 months. So, please join us on our whirlwind recap of 2024 as we get ready for a fabulous 2025… In 2024 we increased the number of STCW training clients to 4 organisations in 6 locations. We delivered STCW training at all levels to over 250 students. We delivered bespoke training to over 75 students onboard Superyachts and cruise ships. We delivered first aid at work or oxygen training to over 40 students, on land and on ships.

The Recovery Position - an STCW refresh

by Rachel Smith • 18 December 2024
Welcome to our December blog, which is all about the recovery position and how to manage an unconscious casualty who is breathing normally. Unconsciousness is a medical emergency as the person is very vulnerable and may not be able to manage their own airway effectively. We also need to think about the cause of unconsciousness. Is it a simple fainting episode due to illness? Is it a massive hemorrhage causing hypovolemic shock? Or is it due to some kind of external factor or injury? This blog looks at how to manage an unconscious casualty. So, if we have a casualty who is unconscious, but who is breathing normally for themselves, and we’re not suspecting a serious injury, the recovery position is the best position to use while monitoring them. The recovery position keeps their airway open and makes sure that vomit or liquid won’t cause them to choke.

Revisiting our guest blogs

by Rachel Smith • 11 December 2024
All the guest blogs! When we started adding blogs to our website back in early 2021, we did a little feature on each of our instructors of the time. They’re quite a fascinating bunch and the series proved quite popular amongst our followers. In addition to our amazing instructors, we work with some utterly incredible human beings all over the world, and the idea of sharing their stories grew and developed into what eventually became a monthly guest blog. It’s been interesting to find out more about how medical care at sea or in remote locations features in their work, and to discover a few fun facts along the way. This month, we thought that it might be a fun idea to give you a chance to go back into the archives and review all the guest blogs over the last few years! Maybe even let us know which your favourite one is?

Cayman Maritime Report 2023

by Rachel Smith • 27 November 2024
We’ve taken a look at the 2023 Casualty Summary Report from the Maritime Authority of the Cayman Islands (MACI) to see what kind of incidents and trends their data shows us, even with relatively small data sets, and how this may be able to transfer to our own risk assessments and actual practice. You can find the report here: Cayman Maritime Report 2023 The first thing we noted was the authors note that the data is split out into incidents. This means that one incident may include a number of events. So a collision and any resulting injury is one incident, but is reported as two events, or more, if more than one person is injured. It made us wonder whether this method of reporting by an authority represents how incidents are reported onboard and whether it should be a consideration? Of course, for any set of statistics presented at the moment, we also have to consider the COVID-19 pandemic and the impact this has on trends including that period. While essential shipping continued, the cruise and superyacht sectors reduced activity and staffing, often to a skeleton crew while anchored somewhere. So this will be reflected in the historic data sets that we analyse from 2019 to 2021 and may not accurately reflect increases and decreases during and since then. In some situations, we may need to look further back for accurate data. We also need to consider whether increases in incidents and events is also down to increased reporting - suggesting an improvement in the awareness of reporting requirements and greater engagement from the industry and individual sectors - this can only be a good development. Since 2020, the type of injury has been recorded in 8 different categories, with hand and foot injuries topping the leaderboard, closely followed by head, body, and back injuries. So if you were looking to run drills, or practise medical skills, these would be the key areas to cover. Only one death was an occupational accident, and is being investigated here: MAIB Investigations (search for case #9229607). It relates to a fall down a ventilation shaft on a bulk carrier in a Greek shipyard. The full report was still pending at the time of writing. Merchant ships are heavily regulated by a number of authorities, and the requirements for personal protective equipment and safe systems of work are enforced and applied to reduce accidents and incidents onboard. This has led to a lower reporting of incidents than in the commercial yacht sector. Could there be room for improvement here in this area? We certainly think so. Many of the hand and foot injuries reported can be career ending or life changing, but are preventable. Follow up has shown that there is a link here with injuries being sustained when inappropriate or no PPE was used. The supply and use of appropriate PPE is mandatory on vessels subject to the MLC and it’s worth remembering that some PPE can be produced in styles and designs compatible with the aesthetics of a yacht if required! On a much wider scale, a lack of transparency and standardisation globally can affect the collection of data and the issue of under reporting. While the MACI figures may be accurate, we need other accurate figures to compare them to, in order to build a bigger picture across the world as we have in aviation. From December 2024, the Maritime Labour Convention (MLC) will be enforcing an amendment so that seafarer deaths will be recorded and reported annually. The MACI and Cayman Islands Shipping Registry produces a number of safety flyers that are publicly available HERE that may be useful. In summary, analysing data can sometimes result in more questions than answers. But even this can lead to interesting and important developments that result in improved safety and reduced incidents and accidents onboard. Key points to take from this report are: Use the correct PPE for the task. Employ approved systems of work and risk assessments for the task. Reporting is key for safety in the future of our industry. Enjoy a night ashore, but don’t over do the cocktails! As always, if you’d like any input on medical training onboard or ashore, or drills that you can run yourselves, please just get in touch. References: https://www.lloydslist.com/LL1145359/Increase-in-incidents-of-deaths-at-sea

James Griffiths - Guest Blog

by Rachel Smith • 6 November 2024
Welcome to our latest guest blog where we’ve been chatting to James Griffiths, General Manager of Ocean Operations for Scenic Group and finding out more about what happens behind the scenes in order to keep a fleet of luxury expedition ships running. Here’s what James told us… As General Manager of Ocean Operations, I’m responsible for the operations of our fleet which includes four ships in service with around 850 colleagues. I currently live in Mumbles, near Swansea in the UK, but due to the nature of my work I spend a significant amount of time living in Croatia. Prior to this role, I spent many years working at sea and worked up through the ranks to Captain and over the last 15 years, my main focus has been on polar expedition travel. I hold a master mariner certificate of competency in addition to a degree in engineering and a post graduate diploma in law. Part of my job is to work with our medical service provider (Red Square Medical) to ensure that our ships are offering medical services that are appropriate for their deployment, and this can often be to some of the most extreme and remote locations around the world. It’s extremely varied, though during the COVID-19 pandemic, I came ashore when our operations paused for a significant period of time. I was fortunate enough to be given the opportunity to lead the restart of our Ocean Operations, which included setting up everything from a company to manage the ships, to selecting our crewing, medical, helicopter and submarine partners and providers, amongst many other things. Our areas of operation, and the nature of our cruises (expedition), plus having aircraft and submersibles onboard some, do mean additional elements involved in the management of these ships. You could say that this current position is more of a happy coincidence than one that I actually planned for! In some ways this is a great positive - I do think it’s possible to plan a little too much and then be disappointed if things don’t go quite the way you had imagined. But there’s no danger of that here!

Paramedic on tour - Simon Lawton heads to Mexico

by Rachel Smith • 3 October 2024
Back in February 2022, we brought you one of our very first guest blogs from Simon Lawton, a Paramedic who has swapped out his ambulance for a Superyacht! You can read the original blog here: https://www.redsquaremedical.com/superyacht-paramedic-a-guest-blog-from-simon-lawton Over the last 2+ years, we’ve followed Simon’s career, and some of you may even recognise him as he does put a Red Square Medical instructor hat on from time to time. But, as for all healthcare professionals, Simon has to keep his skills up to date. So, we asked him to tell us a bit more about how he juggles this along with a rota onboard. Here’s what he told us… I’m originally from Stoke-on-Trent in the UK and trained as a HCPC registered Paramedic. I’ve spent almost 5 years working at sea now, with almost continuous employment on three different vessels, after leaving the ambulance service in 2019. My first role was as a Paramedic/Deck hand on Superyachts, and I now work as a Medical Officer on a maritime vessel. Even before I applied to become a Paramedic, I intended to complete my studies to help find employment in a remote or offshore environment. I had always been attracted to the idea of being able to travel the world while earning a salary. Working at sea has meant that I have travelled extensively, earnt a higher salary, and have a better work/rest balance than would be possible in a role on land. Note: At the time of writing, a qualified Paramedic’s starting pay in the UK was £28,407 and Simon’s old rota was 2 days, 2 nights (all 12 hours) and 4 days off with very inflexible annual leave. This year I decided to carry out some continual professional development (CPD) at a hospital in Mexico, to keep my skills up to date. I was interested in travelling to find out more about how healthcare services are provided outside the UK and Europe. The CPD activity in Mexico allowed me to do exactly that, while caring for and treating a wide variety of patients who had either self-presented in the emergency department, or been conveyed to hospital by ambulance.

Inequalities in CPR on Women

by Rachel Smith • 25 September 2024
Welcome to our September blog, and as we all start (in the UK at least!) to think about adding a few layers for warmth, we’d like to talk about getting naked! Well, to be more specific, getting bra’s off. Fact: Women are dying because bystanders are less likely to carry out CPR on women than men. Research shows that women are 27% less likely to receive CPR than men and if a defibrillator is used, their chance of survival is affected by bra’s being left on. Most of us have never had the chance to train using a female manikin. The #BraOffDefibOn campaign aims to address the inequality in CPR for women and we’re supporting it.

Dr. Will Duffin - Joint Medical Director WEM

by Rachel Smith • 4 September 2024
In August, we brought you a Guest Blog from Mark Hannaford, the founder of World Extreme Medicine. This month, it’s the turn of another of the key WEM faculty members… introducing Dr Will Duffin. Hello everyone, I’m Dr Will Duffin and I’m a GP in Devon in the UK. I’m the Joint Medical Director of World Extreme Medicine (WEM) and the Lead Medic for the US CBS TV show ‘Survivor’ - for Seasons 43, 44, 46 and 48, which is also through WEM. Extreme Medicine is healthcare that is delivered across the full spectrum of remote, austere and challenging environments. This includes high mountains, deep oceans, jungles, deserts, polar, low earth orbit and refugee camps… the list is endless. Being a part of the wider Extreme Medicine community through WEM has been a portal into new worlds of possibility and opportunity in my medical career as an NHS GP. It’s a huge privilege to treat patients in a remote setting. You get to do proper ‘hands on’ medicine that truly tests your clinical skills, risk management and decision making. Even basic techniques and principles done well can transform patient outcomes. That’s the big reward. I graduated from Bristol Medical School in 2008 and completed my GP Training in Cornwall, UK in 2016. In between, I spent 18 months in Australia to gain as much emergency department experience as I could, whilst doing Wilderness Medicine Courses. I landed my first expedition gig 12 years ago when I was post-FY2 (Foundation Years follow on after qualifying as a doctor). I covered a Kilimanjaro Trek after another doctor dropped out at the last minute. Once I had this under my belt, I was able to leverage this experience to get the next trip. So, I soon found myself providing regular medical cover for various commercial and charity sector expeditions. These expeditions have taken me all over the world: Kilimanjaro, the Peruvian Andes, the Himalayas, Northern China, Eastern Europe, Myanmar and Madagascar. One highlight was working as the private doctor for a Luxury Trans-Siberian Train! Though I became frustrated having to constantly wrangle annual leave to go away, so I made the switch to being a freelance (locum) GP, which has given me the flexibility I need. I joined WEM in 2018 after responding to a Facebook Ad for the ‘Survivor’ job. I was invited to a selection weekend in the Peak District, which is when I first met Mark Hannaford WEM founder and CEO and Dr Joe Rowles, WEM’s other Medical Director, and it all went on from there. Early on, I was given the opportunity to lead on the content for the annual World Extreme Medicine Conference and our various podcasts and webinars. Through doing this, I have met a colourful cast of characters; other extreme medics who are as audacious as they are inspirational! We have a lot of fun at the conference every year, learning from one another. https://worldextrememedicine.com/registration/wem-conference-2024 (Note from the RSM team – the conference is highly recommended and well worth a visit!)
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