In this special episode of the CoROM Podcast, Dr Winston de Mello joins Aebhric O’Kelly for a wide-ranging discussion on burns, military medicine, medical education, mentorship, and the evolution of austere healthcare.
A founding influence behind CoROM and a former Commanding Officer of the UK military's Battlefield Advanced Trauma Life Support (BATLS) programme, Winston reflects on decades of service, from treating burn casualties after the Falklands War to helping shape generations of military medics, doctors, nurses, and paramedics.
The conversation explores prehospital burn care, topical morphine, ketamine procedural sedation, the origins of several austere medicine assessment techniques still taught today, and the importance of lifelong learning and compassionate patient care.
Chapters
00:05 – Introduction to Dr. Winston DeMello
00:53 – Current work in burn care and pelvic pain medicine
01:17 – The origins of Severe Burn Life Support (SBLS)
02:46 – Burn education at bachelor's and master's level
03:29 – How the Falklands War sparked a lifelong interest in burns
04:50 – Why severe burns remain a chronic disease
06:07 – The importance of burn education in austere medicine
06:55 – The fundamentals of burn management
07:09 – Why cling film remains one of the best burn dressings
08:02 – Infection prevention and moisture control with cling film
08:59 – Teaching burn care internationally
09:29 – The story behind topical morphine for burns
11:11 – Twenty years of experience using topical morphine
11:41 – Why morphine should be diluted with water rather than saline
12:20 – Topical morphine for ulcers, wounds, and joint pain
13:11 – What is a ketamine shower?
14:00 – Burn dressing changes under ketamine procedural sedation
15:28 – Why ketamine remains underutilised in medicine
17:27 – First meeting at the BATLS course
18:59 – Teaching catastrophic haemorrhage during wartime deployments
21:20 – The importance of passion in medical education
24:20 – The multiplier effect of teaching future instructors
25:24 – End-of-life care and battlefield medicine
26:41 – Burns education and the evolution of austere medicine
27:10 – Learning how to teach at BATLS
28:29 – The influence of legendary military instructors
30:36 – Building the BATLS faculty team
31:11 – Teaching others how to teach
32:36 – The origins of CoROM and early wilderness medicine training in Ireland
33:33 – Persistence, resilience, and building educational programmes
34:37 – Mentoring students including Grigory Tisenovich
35:14 – The origins of the "Winston Sign" for estimating CVP
38:24 – The importance of historical medical knowledge
39:18 – The "Palmar Crease Sign" and assessing anaemia
40:46 – Treating the future King of Jordan at Sandhurst
43:26 – How a military patient inspired a career in pelvic pain medicine
45:11 – Meeting Dr. Mallampati and airway management history
47:22 – The story behind the Trendelenburg name
48:29 – Reflections on mentorship and professional legacy
49:25 – Advice for the next generation of austere clinicians
50:49 – "Do the basics well, but always in style"
51:01 – Closing thoughts and future collaboration
Guest Biography
Dr Winston DeMello is an anaesthetist, military medical educator, burns specialist, and one of the founding influences behind the College of Remote and Offshore Medicine Foundation.
He served as Commanding Officer of the UK military's BATLS programme and has held fellowships from all four Royal Colleges. His career has included extensive work in burn care, military medicine, procedural sedation, prehospital care, and pelvic pain medicine. He continues to contribute to international education through Severe Burn Life Support (SBLS) and advanced burn care training.
