Catalina Sokoloff presents Milrinone for treatment of post-aneurysmal subarachnoid haemorrhage vasospasm (delayed cerebral ischaemia.) Catalina firsts explains the pathophysiology of delayed cerebral ischaemia. She makes the point that there is still much we do not know. Probable mechanisms at the microcirculation level include release of free radicals, lipid peroxidation, cortical depression spreading and microthrombi formation. The ideal treatment once delayed cerebral ischaemia is present is ...
May 18, 2022•13 min
Communicating Science In A Pandemic (Pt. 2) The power & presence that social media has in healthcare communication cannot be ignored. However, many are still reluctant to embrace its usefulness as a tool which can enhance education and patient connections. IN PART 2 OF THIS PODCAST, DR JESSICA STOKES-PARISH CONTINUES TO DISSECT THE ROLE OF SOCIAL MEDIA IN SCIENCE COMMUNICATION, ALONGSIDE REGISTERED NURSES PENNY BLUNDEN (@sick.happens) & PATRICK MCMURRAY (@patmacrn). The trio begin by add...
May 11, 2022•19 min
In Part 2 of this podcast Hugh Montgomery, Liz Crowe, and Shelly Dev along with Peter Brindley continue their discussion on wellness, resilience, burn out and being a healthcare worker in the world now. IN THIS EPISODE THE TEAM DISCUSSES THE BROADER ORGANISATION STRUCTURE AND HOW THIS CONTRIBUTES TO (OR DETRACTS FROM) TEAMWORK AND HEALTHCARE WORKER WELLNESS AND SATISFACTION. Shelly delves into the topic of the organisations and whether they are supporting the clinicians on the ground in the best...
May 10, 2022•24 min
This episode discusses the effect of the pandemic on healthcare professionals at an individual level, and how this has broad reaching ramifications at a team and industry level across different country contexts. I N THIS PODCAST PETER BRINDLEY IS JOINED BY HUGH MONTGOMERY, LIZ CROWE, AND SHELLY DEV TO DISCUSS WELLNESS, RESILIENCE, BURN OUT AND BEING A HEALTHCARE WORKER IN THE WORLD NOW. THIS EPISODE EXPLORES JOB SECURITY, PUBLIC RECOGNITION, AND THE EFFECT OF THE PANDEMIC AT A PERSONAL LEVEL FOR...
May 10, 2022•18 min
Communicating scientific information as a health professional is far more than just posting healthcare tips online. What can & can’t be posted? Who do we really listen to? And who is allowed to say what? DR JESSICA STOKES-PARISH CHATS WITH REGISTERED NURSES & SOCIAL MEDIA PERSONALITIES PENNY BLUNDEN (@sick.happens) & PARTICK MCMURRAY (@patmacrn) ABOUT THE BARRIERS FACING HEALTH PROFESSIONALS WHEN COMMUNICATING WITH THEIR AUDIENCES ONLINE. Picking up where Professor Tim Caulfield’s “G...
Apr 27, 2022•25 min
Nazih Assaad provides his expertise on the treatment of subarachoid haemorrhage. Treatment for aneurysmal subarachnoid haemorrhage (SAH) is an area that has had extensive research but not a great deal of success. Promising animal studies have not turned out as hoped in clinical trials and many questions remain unanswered. Nazih guides the listener through his approach on how to address the complicated presentation of SAH. Firstly, subarachnoid haemorrhages can be graded clinically and radiologic...
Apr 22, 2022•38 min
Whilst US medicine has always had issues, the pandemic sent the practice of medicine into a state of disarray. DR JUSTIN HENSLEY DISCUSSES THE STATE OF US MEDICINE THROUGHOUT THE PANDEMIC. THE POWER OF INSURANCE COMPANIES AND DESPERATE WORKING CONDITIONS IN US HOSPITALS. In this talk, Justin outlines the "idealistic" view he had of emergency care before working in the ED. However, he was not prepared for the “joyless” nature of a medical system which seemed to place profits above patients. Throu...
Apr 12, 2022•17 min
In part 2 of The Great Rejection, Peter Brindley and Tim Caulfield return to continue their discussion of misinformation in the world of health science. This episode examines how to teach the public to think critically, how to deal with uncertainty as a clinician and how to better understand the pros and cons of transparency. How do we teach science in an ever-expanding world of knowledge and information? Tim suggests going back to first principles and reinforcing to the public that science is a...
Mar 30, 2022•26 min
Please note this episode was recorded in November 2018 as part of Brain, a CICM Neuro Special Interest Group meeting click here for more info. Oli Flower gives us a preview into the future of traumatic brain injury (TBI) management. It is late in the 21st century and a man suffers a TBI. Oli describes the on scene immediate management of this patient. Drones and closed-circuit cameras combine to provide the closest ever trauma centre, taking tissue samples and patient images. Not only that, but ...
Mar 25, 2022•9 min
Peter Brindley and Timothy Caulfield answer the big questions around how science and health are represented in the public sphere. What is science? When do we accept it and when do we reject it? The representation of science and medical information on social media has erupted in recent times – in large part thanks to the Covid-19 pandemic. Along the way, misinformation has come to the forefront. Why do people believe misinformation, where does it come from and what damage is it doing? These quest...
Mar 18, 2022•26 min
Reuben Strayer and Duncan Grossman discuss all things airway. Specifically, how the introduction of many airway technologies at once–some of them revolutionary, some not–have confused our airway strategy. So how can we incorporate the best of these technologies into contemporary airway management? They begin with a big question – what equipment should you choose? There are many options, including direct or video laryngoscopy as well as multiple versions of the laryngoscope blade itself. As Reube...
Mar 03, 2022•18 min
Please note this episode was recorded in November 2018 as part of Brain, a CICM Neuro Special Interest Group meeting click here Terry O’Brien presents the evidence and recommendations around the use of continuous EEG. EEG is an old technology, first introduced clinically in the 1920s. As we move deeper into the 21st century, Terry argues that this technology should be brought to the forefront in ICUs around the world. EEG works in a simple manner. Electrodes are placed on the scalp, measuring th...
Feb 25, 2022•50 min
Alex Rowell, Fahad Ashraf, Greg Selkirk & Luke Torre continue their discussion stroke management. In this talk they tackle imaging and treatment of stroke, including mechanical thrombectomy. Imaging is an enormous part of the process of stroke management. It is critical for diagnosis and stratifying patient treatments. The first imaging modality to order is a non-contrast CT head. As Greg explains, not everyone with neurological symptoms has an ischemic stroke. Other diagnoses to consider in...
Feb 17, 2022•24 min
In this podcast, Alex Rowell, Fahad Ashraf, Greg Selkirk & Luke Torre review stroke management in 2022. Stroke management has changed dramatically in the last 10 years. In 2015, we proved the efficacy of mechanical thrombectomy. In 2018, we established evidence for mechanical thrombectomy beyond 6 hours in patients with favourable imaging. Moreover, there has been extensive research into dual anti-platelet therapy to prevent recurring stroke in minor stroke patients. From a technical point o...
Feb 02, 2022•15 min
In the Emergency Management of Chronic Pain podcast, Duncan Grossman and Reuben Strayer discuss how and why patients with chronic pain present to the ED. Managing patients with chronic pain is challenging and often it feels like these patients present to the ED during every shift. But… is it as common as it feels? Statistics suggest that 20% of American adults suffer from chronic pain. Why? Well, opioids are both the disease and the cure. Opioids are effective for managing acute pain. However, w...
Jan 11, 2022•15 min
In this podcast, Roger Harris sits down for a second time with South African Emergency Physician, Victoria Stephen (Tori). Tori delves deeper into her first hand experience of the frightening political unrest and violence which erupted during the third wave of Covid-19 in Johannesburg in mid-2021. Managing Covid cases and gunshot wounds simultaneously was incredibly challenging both professionally and personally. In the midst of the violence, Victoria made the courageous decision to leave the sa...
Dec 21, 2021•22 min
Trauma Resuscitation and the Covid-19 Pandemic in South Africa In this podcast, Roger Harris interviews Victoria Stephen about her experience as an emergency physician in a regional South African hospital. Sadly, trauma resuscitation is a big part of working in Emergency Medicine in South Africa. Blunt force assaults and stab wounds are regular presentations. However, July 2021 was unlike anything Doctor Victoria Stephen had ever experienced. In July, South Africa was deep into its' third wave o...
Dec 07, 2021•24 min
Tune in to a cross over episode with Simulcast, as Jesse Spurr and Victoria Brazil discuss Safety-II, Drugs and Design Sprints in Intensive Care. In this episode, Vic and Jesse catch up to talk through a human centred design project aimed at improving medication safety in the Intensive Care Unit. Vic and Jesse discuss real world applications of Safety-II approaches, the core philosophy and practices of psychological safety and the importance of clinician led approaches to risk in practice. The e...
Nov 23, 2021•40 min
Irma Bilgrami, Alissa Starritt and Paula Lyons believe that the pandemic has narrowed the great divide between ICU and ward care. Covid has put incredible pressure on healthcare systems around the world. This has forced hospitals into overdrive, whereby staff have been redeployed and models of care have changed. Evidently, the pandemic has challenged the strict guidelines which we use to direct patient care and define critical illness. Wards are managing patients with much higher acuity, sparkin...
Nov 10, 2021•19 min
In this cross over chat between Medical Mums and Coda, Dr Chris Bowles & A/Prof Nada Hamad discuss gender equity – What is it and why does it matter? Chris and Nada take a deep dive into gender equity in medicine, the impact of the pandemic and the possible solutions. First, they discuss the difference between gender equity and equality. Equality is the act of treating everyone the same. Whereas equity, focuses on levelling the playing field so that there is more representation and participa...
Oct 26, 2021•45 min
From CodaZero Live, Steve Morgan talks to us about temporary mechanical circulatory support in cardiogenic shock. Steve gives an example of a patient with refractory cardiogenic shock, who hasn’t responded to pharmacological support. So, how do we go about choosing between temporary circulatory support options? First, Steve acknowledges that critical care echocardiography is central. Additionally, he discusses the use of pulmonary artery catheters. Finally, Steve hopes that future Randomised Con...
Oct 13, 2021•14 min
Brain injury outcomes and predictors by Kiran Lele Being able to prognosticate in the aftermath of a traumatic brain injury (TBI) is important as it assists with counselling patients and families. Moreover, it helps rationally allocate healthcare resources. However, due to the heterogenous nature of TBI and variable pre brain injury patient factors and post brain injury course, this has proven to be a difficult task. Large cohort studies have enabled improved accuracy in the prediction of 6 mont...
Oct 06, 2021•9 min
In this podcast, Celia Bradford talks to Bing Brotohusodo about a challenging time in his life. Early in 2020, Bing contracted COVID-19. This resulted in a two-month hospital stay and admission to the ICU. Celia was one of Bing's physicians and together, they reflect on Bing's time in hospital and his recovery. Bing was as a helpful patient. So much so, that he was able to prone himself! However, Celia recalls how challenging it was treating Covid in those early days. Staff were desperately tryi...
Sep 29, 2021•15 min
In this second episode on vascular access, the team from the Australian Vascular Access Society (AVAS) discuss vessel assessment with RaCeVa and RaPeVa as well as the use of Micropuncture and establishing optimal catheter tip position. Before puncturing a vessel for vascular access it is important to: Trace the anatomy of the vascular pathway for aberrancy Ensure that the vessel calibre is suitable for the chosen catheter Ensure no obstruction with thrombus or occlusion Moreover, it is vital tha...
Sep 22, 2021•14 min
The prehospital management of patients with moderate and severe TBI can be complex. In this podcast, Marty Nichols talks us through managing patients with TBI in a prehospital environment. This involves avoiding hypoxia and hypotension, ensuring a safe transportation and getting to the right treatment centre the first time. Notably, due to the nature of the accident, patients with a severe head injury also often present with other injuries. Managing multiple injuries at the same time has implica...
Sep 15, 2021•10 min
In this podcast, Ed Litton summarises 10 clinical trials in 10 minutes. Ed invites you to choose, based on the title alone, whether the findings were consistent with, or contrary to, the study hypothesis. Ed discusses 10 non-covid clinical trials, all published in 2020. Notably, all of these were published in the New England Journal, JAMA or Lancet and had important findings. The following hypothesises are discussed: 10. Firstly, the impact of resident physician schedules and the affect on patie...
Sep 08, 2021•19 min
In this podcast, Claire discusses the role of clinician communication and its impact on acute pain management. Claire explains how pain management outcomes can be optimised by enhancing patient expectations of benefit via patient-provider communication. Firstly, what we say to patients matters. Secondly, how we say it also matters. Pain is a complex phenomenon and managing expectations of pain and people’s experience of empathy is crucial. As healthcare professionals, we see multiple patients an...
Sep 01, 2021•13 min
From CodaZero Live, Alex Rowell reviews the available advanced liver supports for patients with acute liver failure. Artificial supports for the liver are quite complex and difficult. This is largely due to the liver's complex function. Some of the advanced liver supports include CVVHDF, Molecular Adsorbent Recirculating System (MARS), Single Pass Albumin Dialysis (SPAD) and high volume plasma exchange. In this podcast, Alex takes us through the research and evidence for these supports and share...
Aug 24, 2021•16 min
In this podcast, Ruth provides a summary of surgical considerations when managing an injured spine patient. She covers imaging considerations, indications for surgery and challenges to delivering excellent surgical care. Ruth shares a story of one of the most severely injured patients she has ever looked after. A 78 year old woman came into a trauma centre having been driven over by a 4WD... twice. She had a fractured lower limb, significant chest trauma, a significantly deformed torso, she coul...
Aug 19, 2021•15 min
Chris provides a brief update on some of the postulated underlying mechanisms involved in subarachnoid haemorrhage associated brain injury. These mechanisms provide hints to future therapeutic targets that will hopefully expand our currently limited repertoire of options. Subarachnoid haemorrhage is a catastrophic type of stroke. Subarachnoid haemorrhage represents only 5% of the total stroke burden. Notably however, as it is most common in people aged 40-60 years, it has a disproportionate effe...
Aug 17, 2021•18 min