Coda Change
1,179 episodes - English - Latest episode: 16 days ago - ★★★★★ - 77 ratingsCoda Conference: Clinical Knowledge, Advocacy and Community.
Melbourne: 11-14 Sept 2022
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Episodes
How to Give the Greatest Presentation in the World: Ross Fisher
April 24, 2017 21:00 - 37 minutes - 51.4 MBRoss Fisher gives his take on how to make your presentations better! Delivering a presentation is a skill like any other, yet few people are actually develop this skill. Instead, they merely copy those they observe and reach the same level of mediocrity. There is more to a presentation than your slides. Ross gives his three main elements of any presentation: The story, the media, and the delivery. In Ross’ view, these elements are all equally crucial to delivering a great presentatio...
Communication in Healthcare (via Music): Suman Biswas
April 24, 2017 00:01 - 27 minutes - 25.2 MBSuman Biswas is an anaesthetist from London, however probably more famous for his satirical song writing career, gives a poignant talk about communication. Suman provides his ideas about talking and communicating with patients. As everyone knows, anaesthetists do not need to talk to their patients! Quite the contrary, as Suman divulges they indeed do. They need to establish rapport, gain trust and share information – much like every other member of the healthcare team. Therefore, Suman...
Prick with a Needle - Suman Biswas
April 24, 2017 00:01 - 27 minutes - 25.2 MBMusical genius Suman Biswas (@amateursuman) gave one of the most popular talks at SMACCDUB: A Prick with a Needle. The Anaesthetist from London, probably more famous for his satirical songwriting career, gives a poignant talk about communication. Punctuated with some classic songs and delivered with his stand-up comic timing and panache, this is what SMACC is all about: an important message that could change your practice, delivered in a unique and unforgettable way. Language warning.
The FemInEM Story - Dara Kass, Jenny Beck-Esmay and Stacey Poznansk
April 23, 2017 21:00 - 29 minutes - 26.9 MBWe accept that knowledge translation is critical to the practice of emergency medicine, yet when it comes to the practice of BEING an emergency physician, we do always practice evidence-based medicine. We realized that the experiences of many female emergency physicians were similar but not shared, so we created an open access resource to address that. FemInEM was born out of the real but unfortunate truth that the gender pay gap is alive and well, and promotion of women through the academi...
The FemInEM Story: Celebrating Women in Emergency Medicine
April 23, 2017 21:00 - 29 minutes - 26.9 MBJenny Beck-Esmay, Dara Kass and Stacey Poznanski tell the story of FemInEM and celebrate women in Emergency Medicine. Jenny shares the story of Casey Drawert, a doctor who was tragically shot to death by her husband. This incident opened the discussion regarding how common domestic violence in physician relationships is. In response to this incident, Esther Choo wrote "Intimate partner violence, a physician mother and our call to action" for FemInEM. Esther's post garnered a lot of atten...
The Art of Learning Medicine: Sandra Viggers
April 17, 2017 21:00 - 26 minutes - 24.2 MBSandra Viggers delves into the art of learning medicine. Sandra asks the question: can students choreograph their own education? On one hand, people believe students cannot choreograph their own education for various reasons. She calls such people behaviourists who push others back in line if they do not agree with their views. Behaviourism is a top to bottom approach. The teacher is not a facilitator but an instructor. It produces MDs with knowledge that is not applicable to real life...
How Medical Students Can Choreograph Their Own Education - Sandra Viggers
April 17, 2017 21:00 - 26 minutes - 24.2 MBMore than a hundred years ago Osler moved medical education to the bedside. Somehow today, most medical education still takes place in the lecture hall far away from patients. Medical education is often thought of as a top to bottom process where experienced professors and clinicians provide information and feedback to novice learners, with the goal of increasing knowledge and adjusting behavior. This approach to medical education can be effective, but may also only provide situationa...
Lessons from elite sport brought to medical training
April 16, 2017 21:00 - 29 minutes - 27.5 MBTom Evans wants to bring lessons from elite sport development and training to medical education. Caring for the critically unwell is an important and difficult task. So, preparing our people to meet this challenge should be all about excellence. These are all true of sport – and Tom contends perhaps medical training! Nothing happens quickly in sport. It takes time, often many years. There are a number of challenging tests along the way for an athlete to reach the pinnacle of representa...
Playing the Long Game: Commitment, marginal gains and self-compassion - Tom Evens
April 16, 2017 21:00 - 29 minutes - 27.5 MBCaring for the critically unwell is an important and difficult task. So preparing our people to meet this challenge should be all about excellence. Too often, the structures and pressures that define medical training focus on competence rather than excellence. Competence is measurable. It can logged, assessed, and can be applied to across big organisations. But aspiring only to competence limits us - our patients need more. So can we learn from how other high-performance organisations tr...
Prehospital care, how do I get trained properly, panel discussion - Gareth Grier
April 13, 2017 21:00 - 11 minutes - 16.3 MBThis will be a panel discussion with a focus on the different styles of training and education in prehospital care.
Going Wild: Lessons from Wilderness Medicine - Ross Hofmeyr
April 11, 2017 21:00 - 28 minutes - 39.1 MBWilderness and expedition medicine is the epitome of practical, pragmatic, minimalist and thoughtful care. Austere and extreme environments require special knowledge, critical thinking, innovative practice and sometimes cunning improvisation. Diagnosis in the wilderness relies heavily on clinical examination skills, monitoring and special investigations are very limited, and treatment options are determined by the breadth and depth of the individual practitioner’s hands-on skills. The impli...
Lessons from Wilderness Medicine: Ross Hofmeyr
April 11, 2017 21:00 - 28 minutes - 39.1 MBRoss Hofmeyr divulges some stories from his experience of wilderness and expedition medicine. In his words, wilderness and expedition medicine is the epitome of practical, pragmatic, minimalist and thoughtful care. Austere and extreme environments require special knowledge, critical thinking, innovative practice, and sometimes cunning improvisation. Moreover, diagnosis in the wilderness relies heavily on clinical examination skills. Monitoring is limited and treatment options are determi...
Oh s**t, they’re bombing our hospital! Is this a new paradigm for war? - Kathleen Thomas
April 10, 2017 21:00 - 27 minutes - 37.8 MBAfter five months working in the ICU and ED of the Médecins Sans Frontières run Kunduz Trauma Centre (KTC) in northern Afghanistan, I found myself caught up in an eruption of war as the Taliban forcibly took control of Kunduz from the US backed Afghan Military. This marked the beginning of a challenging week of heavy conflict in which our hospital was the only facility providing impartial medical care to war wounded civilians and soldiers from both sides of the conflict. Despite the proximi...
Bombing of Hospitals in Warzones: Kathleen Thomas
April 10, 2017 21:00 - 27 minutes - 37.8 MBKathleen Thomas describes her harrowing experience of a warzone whilst working in the ICU and ED of the Médecins Sans Frontières run Kunduz Trauma Centre (KTC) in northern Afghanistan. Kathleen describes her work during a week where she found herself caught up in an eruption of war. The Taliban forcibly took control of Kunduz from the US backed Afghan Military. This marked the beginning of a challenging week of heavy conflict in which the hospital was the only facility providing impartia...
POCUS in Resource Limited Environments: Trish Henwood
April 09, 2017 21:00 - 23 minutes - 9.24 MBTrish Henwood talks on all things point of care ultrasound (POCUS) in resource limited environments. According to the World Health Organisation, 80-90% of all diagnostic problems can be solved by basic radiograph (x-ray) and ultrasound (US) examinations. However, the problem is that two-thirds of the world’s population currently has no access to imaging technologies. From refugee camps in Greece, to rural clinics in Australia, to Everest Base Camp, POCUS is one of the most powerful diagn...
PURE: Point-of-Care Ultrasound in Resource-limited Environments - Trish Henwood
April 09, 2017 21:00 - 23 minutes - 9.24 MBThe World Health Organization notes that 80-90% of all diagnostic problems could potentially be solved by basic radiograph (x-ray) and ultrasound (US) examinations; however, the problem is that two-thirds of the world’s population currently has no access to imaging technologies (1). From refugee camps in Greece, to rural clinics in Australia, to Everest Base Camp, point-of-care ultrasound is one of the most powerful diagnostic and procedural tools in any austere clinical setting. This tr...
How Not To Miss Aortic Dissections: David Carr
April 06, 2017 13:09 - 23 minutes - 9.51 MBDavid Carr teaches you how not to miss the diagnosis of aortic dissection. David breaks down the key pearls on history and physical exam that guide you into correctly suspecting a dissection. Aortic dissection is a challenging diagnosis that you cannot afford to miss. The talk aims to give you the framework to avoid missing the diagnosis. Firstly, David begins by teaching you what questions to ask in the history to raise the suspicion of an aortic dissection. These include onset, quali...
The Aorta Will %$#@!& You UO - David Carr
April 06, 2017 13:09 - 23 minutes - 9.51 MBThe talk focuses on why clinicians miss the diagnosis on aortic dissection. It breaks down the key pearls on history and physical exam that guide you into correctly suspecting a dissection. Aortic dissection is a challenging diagnosis that you can not afford to miss. The talk aims to give you the framework to avoid missing the diagnosis. I want to raise the bar so that the standard of care is not to miss a dissection when it presents atypically. The talk will also highlight strategies on wh...
Who should be intubated pre-hospital - Gareth Grier
April 06, 2017 13:02 - 11 minutes - 16.1 MBGareth Grier discusses who should be intubated following severe trauma pre-hospital.
Pre oxygenation, the powerful pawn in Prehospital RSI - Dr Geoff Healy
April 04, 2017 21:00 - 14 minutes - 20.6 MBThis talk will look at current and previous pre oxygenation practices and some of the current research. It will also discuss the notion of commitment to evolution of practice, the breakdown of cognitive biases and how to move forward with adequate self reflected practice.
Teamwork: The strongest drug in the hospital - Peter Brindley
April 02, 2017 21:00 - 24 minutes - 34.2 MBModern acute care medicine is eye-wateringly complex and potentially dangerous. It really can't be delivered safely without deliberately addressing our teamwork (in both acute and chronic situations). Unfortunately, historically, human factors were commonly left to chance, and recently have been threatened by decerebrate checklists and meaningless psychobabble. Practical strategies exist (thank goodness!) and will be reviewed. We have much to learn, but must also avoid overly simple answers...
Teamwork and Communication in Critical Care: Peter Brindley
April 02, 2017 21:00 - 24 minutes - 34.2 MBPeter Brindley explains why teamwork is the strongest drug in the hospital. Modern acute care medicine is eye-wateringly complex and potentially dangerous. It really can’t be delivered safely without deliberately addressing our teamwork (in both acute and chronic situations). Unfortunately, historically, human factors were commonly left to chance, and recently have been threatened by decerebrate checklists and meaningless ‘psychobabble’. Peter describes communication and its critical role in...
Prehospital red blood cell transfusion - is it enough? - Richard Lyon
April 01, 2017 21:00 - 11 minutes - 16 MBRichard will cover the rationale and evidence for prehospital blood product transfusion in trauma, look at the available current and future options, suggest best clinical practice and highlight areas of future research.
Management of Extra-Cranial Injuries in Patients with TBI
March 30, 2017 20:00 - 17 minutes - 24.6 MBWilliam Knight presents the considerations in the management of extra-cranial injuries in patients with traumatic brain injuries (TBI). Patients with TBI often have concomitant systemic injuries that complicate the management of the TBI. In this talk William presents his five top areas to think about – prognostication, suitability for the operating room, use of ventilators, pressure considerations and monitoring. Prognostication becomes difficult when a brain injury is added to other i...
Management of extra-cranial injuries in patients with TBI - William Knight
March 30, 2017 20:00 - 17 minutes - 24.6 MBPatients with TBI (traumatic brain injury) often have concomitant systemic injuries that complicate the management of the TBI. How does the practitioner balance the needs of the hypotensive resuscitation with CPP? How does ICP affect emergent operative needs? Thoracic injuries complicate cerebral oxygenation - are there effective management strategies? Where is the best place to care for these patients?
Hospital Handover of Major Trauma: Kieran Henry
March 28, 2017 20:00 - 8 minutes - 8.28 MBKieran Henry gives his insights into hospital handovers of major trauma. He makes the comparison between prehospital care and the life lived in a Western movie. Kieran stresses that he does not want you to behave like a cowboy, jumping off your horse (ambulance) as it is still moving into town, without much dialogue and with no one really knowing what is happening. Instead, be the preacher man! Be cool, concise, and clear in your messaging. Prepare, practice and be professional. Much...
Hospital Handover of Major Trauma - Make them Listen - Kieran Henry
March 28, 2017 20:00 - 8 minutes - 8.28 MBDescribing the importance of patient handover and the critical time when the pre-hospital practitioner will give this information to the receiving hospital staff. Using an analogy of the characters that appear in cowboy films, the preacher stands out as one who usually plays a small but significant role in getting his message across. We will compare this to the modern day practitioner and how they should achieve the objective of giving a good handover to the receivers, who may or may not be...
Learning from Error in Paediatric Sepsis
March 28, 2017 20:00 - 24 minutes - 22.7 MBJo Anna Leuck discusses how to learn from error in paediatric sepsis. Rory was a healthy 12-year-old boy, known for his smile and for standing up for others. A simple fall during basketball practice caused an abrasion on his arm. This is the suspected beginning of a cascade of events that led to his death from sepsis. Rory was seen by both his paediatrician and a local Emergency Department and was sent home with a diagnosis of a viral illness. He returned the next day in septic shock a...
Remembering Rory: Sepsis and Learning from Error - Jo Anna Leuck
March 28, 2017 20:00 - 24 minutes - 22.7 MBRory Staunton was a healthy 12-year old boy, known for his smile and his work standing up for others. A simple fall during basketball practice caused an abrasion on his arm, which is the suspected beginning of a cascade of events that led to his death from sepsis. Rory was seen by both his pediatrician and a local emergency department, and was sent home with a diagnosis of a viral illness. He returned the next day in septic shock and died shortly thereafter. A review of the medical records...
Life after sepsis - is it worth living? - Simon Finfer
March 27, 2017 20:00 - 26 minutes - 35.8 MBSepsis is the life-threatening condition that arises when the body's response to an infection damages its own tissues and organs. It can lead to shock, failure of multiple organs, and death. Organ failure and death are more likely if sepsis is not recognized early and not treated promptly. Sepsis is the leading cause of death from infection around the world and contributes to or causes half of all deaths occurring in hospitals in the USA. Many people who survive severe sepsis recover compl...
Life and Treatment After Sepsis: Simon Finfer
March 27, 2017 20:00 - 26 minutes - 35.8 MBSimon Finfer explains the future of sepsis treatment focusing on life after surviving sepsis. Sepsis is the life-threatening condition that arises when the body’s response to an infection damages its own tissues and organs. It can lead to shock, failure of multiple organs, and death. Organ failure and death are more likely if sepsis is not recognised early and not treated promptly. Sepsis is the leading cause of death from infection around the world and contributes to or causes half of...
Hypothermia in Treatment of Traumatic Brain Injury
March 26, 2017 20:00 - 23 minutes - 21.3 MBAlistair Nichol explains the use of hypothermia in the treatment of traumatic brain injury (TBI). TBI is a major cause of mortality and long-term morbidity. It leads to terrible outcomes and is a major cause of health burden across the globe. Prophylactic hypothermia presents a promising treatment to address this hidden epidemic. The pathophysiology of TBI is exceedingly complex. Evidently, one drug will likely not be the answer. This leads Alistair to discuss hypothermia as a treatmen...
Cooling the Injured Brain - Alistair Nichol
March 26, 2017 20:00 - 23 minutes - 21.3 MBTo cool or not to cool. Traumatic brain injury is a major cause of mortality and long term morbidity. Hypothermia has been suggested as a potential treatment to limit secondary brain injury and improve outcomes. However, this currently remains controversial. Despite many small studies and meta-analyses suggesting benefit this has not been reflected in the recent larger studies. This may have been due to significant methodological limitations. The Eurotheum study completed last year which ex...
Rethinking Acute Management of Stroke: Ryan Radecki
March 21, 2017 20:00 - 17 minutes - 16.2 MBRyan Radecki urges you to rethink the acute management of stroke. The current way of thinking about stroke and the acute treatment has been around for decades. In this time, a lot has changed, new technologies have been developed and we have learnt a lot about the underlying physiology of stroke. Endovascular therapy, CT perfusion, and patient-level predictive modelling are now all at the disposal of clinicians. Moreover, Ryan wonders if we are using the current treatments – namely tPA...
Stroke Emergency! Don't Have a Stroke .... - Ryan Radecki
March 21, 2017 20:00 - 17 minutes - 16.2 MBIt’s been two decades since NINDS and MAST and ECASS and the other clot-busting lore cluttering up your brain. Have we learned anything in the interim? Are we using tPA more safely, more appropriately – or just more? And, what now, of endovascular therapy, CT perfusion, and patient-level predictive modeling – are you ready for the next decade of evolution in stroke care? In this talk, we’ll go into the most recent trial evidence relating to saving neurons, and whether we should be suspic...
Neurosurgeons aren't idiots, honestly - Ronan O'Leary
March 20, 2017 20:00 - 24 minutes - 22.5 MBUndertaking a decompressive crainectomy is perhaps one of the most challenging decisions we face within critical care, we don't know if we should do the operation, and even if we think we should we don't know when, or even how. Perhaps more importantly we don't do the operation, the neurosurgeons do, but we frequently put them in the position of doing the operation when we are at our wits end, or they do the operation without asking us when we still feel we have space to play. How can we re...
How to manage conflict in Critical Care: Ronan O’Leary
March 20, 2017 20:00 - 24 minutes - 22.5 MBIn this entertaining talk, Ronan O’Leary discusses conflict in critical care. Ronan explains how to make a team decision about whether or not to perform a decompressive craniectomy. Undertaking a decompressive craniectomy is perhaps one of the most challenging decisions we face within critical care. Ronan contends that we do not know if we should do the operation. As he explains, even if we think we should do it, we don’t know when, or even how. Perhaps more importantly, intensivists...
The Controversies in Brain Death: Martin Smith
March 19, 2017 20:00 - 22 minutes - 20.8 MBMartin Smith persuades you that controversies in brain death should not, and do not, exist. Almost fifty years since the concept of brain death was first introduced, some individuals and whole nations still struggle with its concept and justification. Many controversies continue to surround brain death, although there is broad consensus that human death is ultimately death of the brain. Martin provides a history of the concept of brain death. He describes how advances in modern medicin...
Controversies in Brain Death - Martin Smith
March 19, 2017 20:00 - 22 minutes - 20.8 MBAlmost fifty years since the concept of brain death was first introduced, some individuals and whole nations still struggle with its concept and justification. Many controversies continue to surround brain death, although there is broad consensus that human death is ultimately death of the brain. This crucially involves the irreversible loss of the capacity for consciousness combined with the irreversible loss of the capacity to breathe since, taken together, these elements represent the mo...
Small Packages, Big Lessons: Neonatal and paediatric retrieval - Hazel Talbot
March 15, 2017 20:00 - 27 minutes - 38 MBHazel Talbot provides an insightful look at neonatal and paediatric retrieval in her talk "Small Packages, Big Lessons"
Neonatal and Paediatric Retrieval: Hazel Talbot
March 15, 2017 20:00 - 27 minutes - 38 MBHazel Talbot gives her insights from working in neonatal and paediatric retrieval. She delivers her talk with all the passion and dedication that she brings to her work as a neonatal and paediatric transport consultant. Equipment failure, rapidly deteriorating children and miscommunication are all common challenges that Hazel and her team encounter in their line of work. This is on top of the challenge of caring for neonates and children. How are children different? They differ in phys...
When to Transfuse in Acute Brain Injury: Oli Flower & Simon Finfer
March 14, 2017 20:00 - 24 minutes - 33 MBSimon Finfer argues that the transfusion threshold should be 70 g/L. Simon first raises the Choosing Wisely Guidelines for Critical Care. These state that one should not transfuse red blood cells in haemodynamically stable patients with a haemoglobin concentration of greater than 70g/L. He continues to discuss the application of this specifically to patients with an acute brain injury. In doing so he will talk about evidence generally and how one must approach the use of evidence in spec...
Transfusion Thresholds in Acute Brain Injury - Oliver Flower & Simon Finfer
March 14, 2017 20:00 - 24 minutes - 33 MBA bare knuckle pit fight between Oli Flower & Simon Finfer over when to transfuse in acute brain injury... Oli argues that the transfusion threshold should be 90 g/L, whereas Simon takes 70 g/L to be a more appropriate trigger to transfuse blood in the context of acute brain injury. The transfusion trigger is remarkable heterogeneous around the world and even within individual institutions and this drives crit care professionals mad - surely there must be a "right" number. Unfortunately t...
Paed-Iconoclasm: Breaking the Myths without Breaking Your Patient - Tim Horeczko
March 13, 2017 20:00 - 20 minutes - 28 MBMyths persist because they are essential to the human experience and our development as a society. They fill the gap between what we know and what we think we know. Where does this gap hurt us the most? In our vulnerable populations, for example, in our care of children. The “myth incarnate” in medicine: defective dogma. Not all dogma is bad – after all, dogma means “that which is believed universally to be true”. The problem with medical dogma is that our critical thought processe...
How to Spot the Sick Child in the Emergency Department
March 12, 2017 20:00 - 25 minutes - 23.4 MBFfion Davies gives her take on how to spot the sick child in the Emergency Department. Paediatric medicine is no doubt hard and can at times be scary. There is nothing worse, in Ffion’s opinion, than sending a child home who later represents to the hospital in a worse condition, or even worse, later dies. So, how does one spot the sick child amongst the droves of children who will present with fever and vomiting. In this talk, Ffion gives a lesson on how to spot the sick children in th...
Spotting the sick child - Ffion Davies
March 12, 2017 20:00 - 25 minutes - 23.4 MBReflecting on 26 years of frontline practice in paediatric emergency care: while there’s no substitute for knowledge and experience, I can see some common themes to failing to spot a sick child. By sick, I mean injuries and illness that need hospital attention or hospitalisation. This talk tries to draw from all those errors I’ve both made and seen, into a couple of easy-to-apply mantras. Physiology matters. It really does. Scrutinising a full set of observations/vitals (in the context o...
Should we Transfuse the Sick Child in Africa? - Kathryn Maitland
March 07, 2017 20:00 - 26 minutes - 24.2 MBIn sub-Saharan Africa, where infectious diseases and nutritional deficiencies are common, severe anaemia is a common cause of paediatric hospital admission, yet the evidence to support current treatment recommendations is limited. The TRansfusion and TReatment of severe Anaemia in African Children: (TRACT ISRCTN84086586) is a 3x2x2 factorial controlled trial involving 3954 children (aged 2m to 12y) with severe anaemia (haemoglobin <6g/dl). The trial has been designed to address the poor out...
The Problem with Hospital Systems: Alex Psirides
March 06, 2017 20:00 - 32 minutes - 44.9 MBAlex Psirides discusses the problem with major hospitals and the systems that they use. Throughout he uses a case example to highlight how and why things go wrong. Moreover, he suggests potential strategies to reframe the way care is provided in the hospital system. As patients become more complex, the tribal systems we use to look after them remain stuck in the 18th Century. Back when the treatment for everything was amputation and, if you survived, leeches. The large modern hospital ...
Why Your Hospital Is Broken - Alex Psirides
March 06, 2017 20:00 - 32 minutes - 44.9 MBAs patients becomes more complex, the tribal systems we use to look after them remain stuck in the 18th Century when the treatment for everything was amputation and, if you survived, leeches. The large modern hospital is becoming a battleground of competing SODs* and SONs** practising their art in a multi-organ (failure) world. Many staff lack acute medical skills; those with such expertise are siloed far away from the ward in emergency departments, operating theatres and ICUs. Despite dise...
Tactical Medicine in Response to the Active Shooter - Anthony Baca
March 05, 2017 20:00 - 12 minutes - 17.7 MBCops and robbers, cowboy and Indians, and military movies have filled the minds of generations of healthcare providers with a vision of what gun fights and combat look like. Unfortunately, real violence looks nothing like any of these. As emergency and critical care providers, we forge additional perspectives as we care for the victims of violence. Yet, views of violence aftermath only scratch the surface of first-hand experience during the brutal, scary, gritty, and dirty realities of real...