In light of trials suggesting pocus delays CPR in cardiac arrest, should we be doing more transesophageal echocardiography in the resus room? A pro-con case-based debate. For more head to: codachange.org/podcasts
Abuse in the financial system impacts over 40% of the adult population, and CommBank is taking action. They studied 11 million transactions within the 3 months period, and found that 8,000 people have received abusive messages in the transaction description. Why would CommBank have an interest in customer vulnerability? Catherine Fitzpatrick has joined Roger Harris and Mary Freer for a fascinating discussion around financial toxicity, and what actions have been taken to combat abuse in the finan...
Creativity is a highly valued and sought after skill; we all need to solve problems, think in novel ways, and generate ideas, but can creativity be learned? This talk provides a practical framework to help you improve your creative thinking, enhance your problem solving and get greater access to your naturally creative brain. You'll discover how creativity follows a process that can be developed at every stage. You'll learn how to challenge your assumptions and reframe problems. You'll discover ...
It can be particularly challenging to care for dying patients who insist that they are not and request intensive, seemingly futile treatments. Physicians often feel disconnected from such patients. For many, there is the belief that we are different from these patients, more able to accept our own mortality, less likely to desire high intensity, high technology treatments at the EOL. The literature on physician utilization of resources at the EOL paints a different picture. We are reminded how v...
Clinical supervision in our busy workplaces is hard. We balance patient safety, learning opportunities, and the workloads of senior and junior staff. The conversations we have to navigate this balancing act can affect patient outcomes, and how we feel about each other and our work. But these conversations don't always happen, and may not always go well. Sometimes the feeling of "I'm scared', comes out as, "I don't think we need to intubate the patient".... In a given clinical circumstance, a sup...
Concussions have gained lay person attention over the past several years, due to high profile media stories from military conflict and professional sports. Also known as "mild" TBI, concussion affects millions of patients worldwide, many never seeking formal medical care. Concussion remains a unique injury, in that no one medical speciality "owns" the disease, leaving treatment variable across the world. Concussion is not a mild injury, resulting in a spectrum of sequelae that plague patients fo...
Mark Wilson and John Myburgh discuss intracranial pressure. Some fundamentals, some history to put it all in perspective and all the issues with focusing on just one number. Fascinating insights from two true experts. For more head to: codachange.org/podcasts
Creativity is a highly valued and sought after skill; we all need to solve problems, think in novel ways, and generate ideas, but can creativity be learned? This talk provides a practical framework to help you improve your creative thinking, enhance your problem solving and get greater access to your naturally creative brain. You discover how creativity follows a process that can be developed at every stage. You learn how to challenge your assumptions and reframe problems. You discover technique...
High quality Virtual Reality (VR) gaming is not a thing of the (dystopian) future; the technology is here and showing promising therapeutic benefits for patients. Consumer VR is projected to be a $21Billion global industry by 2020. Home grade systems are available providing deep sensory immersion including touch sensors (haptics). Healthcare has a poor track record of adopting new technologies. We need to understand our work better to forecast where emerging technologies may do a better job for ...
Treatment of cardiac arrest requiring CPR has been transformed by the use of extra-corporeal membrane oxygenation. Patient stabilised on this innovative therapy can be transferred for coronary angiography and possible stent intervention. Time is critical, time is muscle! However when the muscle is gone but the other organs still work what options do we now have? For the patient in sustained unrecoverable cardiogenic shock with neurology intact where should we go? What therapies are appropriate a...
This talk provides an approach to life-threatening upper GI bleeding, including management of the grossly contaminated airway, the impact of hypothermia on bleeding, and balloon tamponade insertion. Knowing which balloon tamponade device you stock (is it a Minnesota or a Blakemore?), and where to find it, are just as important as knowing how to insert it. Refining your approach to variceal bleeding can help you optimize your resuscitation of these challenging cases. For more head to: codachange....
Unprofessional behaviours by health professionals, in hospitals, are associated with a significantly increased risk of preventable patient complications. Such behaviours result in an environment that results in increased, and unnecessary psychological stress of health professionals and resulting in teams not working to the best of their ability. Flattening the hospital hierarchy creates an environment where team members feel safe to speak up, without fear of reprisal and knowing their opinion wi...
You are a member of the resuscitation team looking after a shocked blunt polytrauma patient. The patient is intubated and ventilated, splinted, and is receiving a massive intravenous blood product transfusion. To your surprise, Whole Body CT scan fails to show any active haemorrhage. This talk describes the common and rarer causes of hypotension following trauma and highlights how a meticulous history and primary survey examination may often reveal the cause before imaging. For more: codachange....
What's next after RESCUEicp? -The results of this study may have been disappointing, but there are some questions about the trial itself which we review. Irrespective, study into how to improve outcome for TBI patients marches on, with a look at goal directed therapy and multi-modal monitoring as a couple of examples of the future in TBI research. Prognosis in TBI - What tools do we have to help patients and families faced with the question of "what next?" after TBI? We will look at some of the ...
I review multiple papers that cover the merits of ultrasound use in the prehospital field. From identification of CHF, to IV starts, to a possible treatment modality for strokes. For more head over to codachange.org/podcasts
Inequity within the healthcare profession harms both providers and patients. Diverse teams have been shown to offer better care and improved productivity. The Coda community has the goal of developing achievable, sustainable and measurable actions (within the Ethics pillar) to tackle inequity within healthcare and disseminating these in 2022. In order to take action we need to develop plans through a five-stage process. Stage One is to Identify: This preliminary stage, which is where the Ethics ...
In this conversation Lauren challenges us to consider: "What does hate look like in the world today?" The conclusion she draws is that hate looks like pain. Pain as a result of the pandemic, the marginalisation of women and girls, colonisation and the exploitation of people. And who does hate hurt? It hurts the individuals, whether they be practitioners or vulnerable patients. It hurts the broader community through inequitable distribution of services, wealth and opportunities. Finally, hate hur...
Amy challenges us to think about our healthcare systems and the entrenched inequality within them. How does a legacy of white supremacy impact healthcare in 2020? Why do we continue to see the same power imbalances repeated again and again, whether it be in healthcare, education or politics? We have a young system and pushing back should not be seen as threatening. Many of our healthcare systems were built in a time when women and in particular Indigenous women, were not seen as equal. That lega...
Not all women experience discrimination to the same extent or in the same ways. The pandemic has resulted in a dramatic increase in women's caregiving responsibilities to both children and the elderly. Additionally everyone is in the home so the domestic load has increased. Prior to the pandemic women in Australia were spending on average 1.7 hours more per day on care and domestic duties than men and now in the pandemic this has increased by a staggering 50% to mean women are providing 2.5 more...
Is sexism in healthcare subtle or overt? - The answer is both! .Dr Kate Ahmad shares her experiences training in medicine. Women are frequently not recognised as doctors because of their gender and they are more likely to have comments made about their appearance or questions about their relationship status....these examples are subtle, undermining the position of a woman as a doctor. At the same time there are often far more confronting examples of overt sexism. We need better systems for calli...
Australia has established a global competitive advantage in agriculture. However innovation in the agriculture and food industries globally is changing and the entrance of new technologies, capital, and perspectives is putting pressure on existing systems and ways of thinking. Entrepreneurs especially are playing a critical role in this transformation. This presentation will provide insights into how Australia can build on a competitive advantage in agriculture to become a competitive global pla...
Brandon will be giving high-impact, rapid-fire talks on assessing stroke symptoms, using EEG after acute brain injury, and advanced multimodality monitoring. For more head to: codachange.org/podcasts
Anne Creaton is interviewed by Peter Brindley. She talks about her experience in setting up Emergency Medicine Training in Fiji and give advice to those who may want to work in a similar setting. www.codachange.org/podcasts
Sexual assault affects 1 in 3 women and 1 in 6 men during their lifetime worldwide. It is more common than most medical issues we are trained to look for, despite this being a patient population we are going to see by virtue of the "anyone, anytime" nature of an emergency and critical care. Generous estimates find than only 20% of survivors present for medical care and may not disclose this initially in their visit. Look for it during public holidays, large parties or concerts, college or univer...
This first episode of Coda Cure has set the scene. The importance of clear definitions, treatment strategies, managing Antimicrobial Resistance, vaccination programs and dealing with the long term outcomes of sepsis were all identified. The Cure pillar remains in the early stages of identifying areas for our community to take meaningful action on global sepsis. codachange.org/podcasts
We apologise for the low quality audio, Dr Flavia Machado kindly delivered her talk in the middle of a hospital shift in São Paulo during the global pandemic. LMIC's bear 85% of the global burden of septicaemia. There are three main determinants of mortality: 1. Pathogenic factors 2. Host Factors 3. Healthcare Inequality Factors (Prevention / Water & Sanitation / Access to Care,Resources, Education) Interestingly, the effects of the current Covid-19 Pandemic appear to be more related to the ...
Blanket standards applied in research design, particularly those applied traditionally in a "peace time" setting are worth being carefully examined for their relevance now in this pandemic "war time" setting so that we don't hog-tie ourselves with irrelevant and unhelpful regulations. At the same time, we don't want the 'wild wacky west'. Everyone is under pressure in research to move quickly, but we need to ensure that if we change standards we do so intelligently so that the choices we make fo...
While the timely use of Antibiotics for sepsis is well recognised, the rise of Antimicrobial Resistance (AMR) is a huge threat to global health. The current pandemic has highlighted our vulnerability to infection and we are now experiencing first hand the public health and economic cost of a pandemic. We know now what it really means to not have effective diagnostics, treatments and vaccines for an infectious pathogen. AMR accounts for 700,000 deaths annually. Antibiotic use is the key driver fo...
The global burden of Sepsis continues to challenge clinicians in its definition, diagnosis and treatment. The current Covid-19 pandemic seems to have almost taken our understanding of the Sepsis Syndrome back decades. What are the similarities between the current pandemic and sepsis? And what can we learn? We have never avoided healthy controversy and in this episode Simon Finfer puts the case that the multi-organ dysfunction and cytokine storm seen in critically ill Covid19 infected patients is...
Rhonda Cadena talks IV Alteplase for wake up strokes using MRI criteria. Tiger territory! After a NEJM paper in 2018 this is now on the table - hear the perspective from Rhonda, an ED / neurocritical care specialist from North Carolina. For more head to: codachange.org/podcasts
