Sarah Spelsberg is an Emergency medicine Physicians Assistant and Fellow of Extreme and Wilderness Medicine (FEWM), who has spent the last 4 years working in a remote outpost in the Aleutian Islands - sandwiched between the Pacific Ocean and the Bering Sea - a truly rugged place, where ‘The Deadliest Catch’ was filmed! Sarah's desire to challenge herself and her clinical skills has enabled her to push boundaries in remote medicine delivering exceptional medical care under extreme circumstances. In this episode, host Dr Will Duffin and Sarah discuss remote and rural healthcare and Sarah’s experience of dealing with some very unconventional scenarios including: Delivering a baby outside in the rain in her pyjamas and flip flops no gloves Prolonged field care during a “cyclone bomb” aka “arctic hurricane” where no medivac was possible for a patient who was compromised from a massive pleural effusion. Sarah performed a makeshift thoracentesis with a spinal needle and empty IV bag in a patient with a massive pleural effusion Transporting a critical patient in a Coast Guard helo past an actively erupting volcano to rendezvous with commercial medevac in Cold Bay. Building homemade ‘vent-splitters’ using bits from the island hardware store to double the ventilator capacity during covid-19. Treating dogs and cats on the island when there is no vet around, including how to sedate a dog, gain access and give morphine! Sarah has managed to combine what’s she loves which is travel and being off the grid. She has developed skills of versatility and the ability to adapt to any situation presented to her. She is constantly working on maintaining her survival skills and capacity to create solutions out of random pieces of equipment to save lives, all whilst projecting calm to the rest of the team! You can hear more from Sarah at this year's World Extreme Medicine Conference 13-15 November 2021, in which she’s presenting 2 sessions. More about Sarah: Part-time: Physician Assistant Department of Orthopedic Surgery at Mayo Clinic in Jacksonville, Florida. Consultant Clinovations/The Advisory Board Company. IFHS Dutch Harbor Emergency Department. Wilderness Emergency Medical Consultant RogueMed. Twitter @Rogue_Med FEWM Fellow of Extreme and Wilderness Medicine https://www.extreme-fellowship.com FAWM Fellow Academy of Wilderness Medicine www.wms.org.

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