Network Five Emergency Medicine Journal Club
Pramod Chandru, Shreyas Iyer, Kit Rowe, Caroline Tyers & Samoda Wilegoda
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This is a podcast designed to bring exciting emergency research to you!
Available episodes
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Oldest first
6 days ago
Emergency Medicine Case Series - Episode 2
Panel:
Pramod Chandru and Shreyas Iyer.
Music/Sound Effects:
* Bullet Train by tubebackr | https://www.tubebackrmusic.com/Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution-NoDerivs 3.0 Unported (CC BY-ND 3.0), https://creativecommons.org/licenses/by-nd/3.0/.
* Hands High by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Love Trip by Sarah Jansen Music | https://soundcloud.com/sarahjansenmusic, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Stay by Thomas Gresen | https://soundcloud.com/thomasgresen, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
References:
* Carne B, Kennedy M, Gray T. Review article: Crisis resource management in emergency medicine. Emerg Med Australas. 2012 Feb;24(1):7-13. doi: 10.1111/j.1742-6723.2011.01495.x. Epub 2011 Oct 13. Review. PubMed PMID: 22313554.
* St Pierre M, Hofinger G, Buerschaper C, Simon R. Crisis Management in Acute Care Settings: Human Factors, Team Psychology, and Patient Safety in a High Stakes Environment. (2nd edn) Springer, 2011.
Disclaimer:
* Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.
Thank you for listening!
Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.
You can also follow us on Facebook, Instagram, and Twitter!
See you next time!
~
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Oct 7, 2023
Special Episode: The Indigenous Voice To The Australian Parliament
Special Episode: The Indigenous Voice To The Australian Parliament
Presenter: Shreyas Iyer.
Summary:
* There is a toxic amount of lies and misinformation regarding what is a very simple proposal for providing dignity to the First Nations people and helping our government make good decisions.
* Polls show that the overwhelming majority of First Nations people are in favour of this proposal.
* Better government policy and better use of government resources benefit all of us.
* Listening to First Nations people and learning from their knowledge of the land also benefits all of us.
* We shouldn’t expect this to be a panacea, but the status quo of wasting money and allowing our First Nations communities to languish is not tenable.
* The 'No' campaign has not actually offered any alternative viable solutions.
* Our community is a melting pot of different peoples, but we all love this country and want to play our part in it.
* We have provided our references, and also some useful resources for information regarding the Voice below.
* If you found this video helpful, please feel free to share and spread the word. If you would like to discuss this topic further or have any questions please feel free to reach out to us on social media.
* On 14th October we have a chance to make a good decision for the future of this country, we have a chance to vote YES to the Aboriginal and Torres Strait Islander Voice to Parliament.
References
* https://www.wslhd.health.nsw.gov.au/ArticleDocuments/1232/WSLHD%20Year%20in%20Review%202021-22.pdf.aspx
* https://www.abs.gov.au/articles/new-south-wales-aboriginal-and-torres-strait-islander-population-summary#where-aboriginal-and-torres-strait-islander-people-live
* https://www.abs.gov.au/statistics/people/aboriginal-and-torres-strait-islander-peoples/census-population-and-housing-counts-aboriginal-and-torres-strait-islander-australians/2021#new-south-wales
* https://ulurustatement.org/history/the-journey-so-far/
* https://aci.health.nsw.gov.au/projects/co-design
* https://www.aph.gov.au/About_Parliament/Senate/Powers_practice_n_procedures/Constitution.aspx
* https://theconversation.com/indigenous-recognition-in-our-constitution-matters-and-will-need-greater-political-will-to-achieve-90296
* https://about.abc.net.au/speeches/noel-pearson-boyer-lecture-series-who-we-were-and-who-we-can-be/
* https://www.survivalinternational.org/tribes/aboriginals#:~:text=There%20are%20about%20500%20different,large%20number%20of%20separate%20clans.&text=Archaeologists%20believe%20that%20the%20Aboriginals,continent%20around%2045%2C000%20years%20ago
* https://www.indigenoushpf.gov.au/Measures/1-19-Life-expectancy-birth
* https://www.indigenoushpf.gov.au/Measures/2-11-Contact-criminal-justice-system#keymessages
* https://www.abc.net.au/news/2015-12-03/fact-check-aboriginal-men-in-jail-and-university/6907540
* https://www.aihw.gov.au/reports/australias-health/indigenous-health-andwellbeing#Suicide%20and%20self-harm
* https://www.abc.net.au/news/2022-11-30/closing-the-gap-report-released/101713892
* https://www.pc.gov.au/closing-the-gap-data/annual-data-report/report/snapshot-socioeconomic#seo10
* https://www.abc.net.au/news/2023-10-02/preventable-blindness-rates-have-been-halved/102916184
* https://theconversation.com/governments-are-failing-to-share-decision-making-with-indigenous-people-productivity-commission-finds-210392#:~:text=The%20commission%20says%20too%20many,Agreement%20on%20Closing%20the%20Gap”
* https://theconversation.com/many-claim-australias-longest-running-indigenous-body-failed-heres-why-thats-wrong-209511
Useful Resources
* https://voice.gov.au
* https://ulurustatement.org
* https://www.reconciliation.org.au/reconciliation/support-a-voice-to-parliament/
* https://theconversation.com/the-voice-what-is-it-where-did-it-come-from-and-what-can-it-achieve-202138
* https://theconversation.com/au/voice
* https://www.abc.net.au/listen/programs/the-voice-referendum-explained
* https://www.abc.net.au/news/2023-09-29/fact-check-voice-to-parliament-misinformation/102913680
* https://www.amnesty.org.au/the-voice-to-parliamentfaqs/#:~:text=The%20Voice%20will%20give%20independent,gender%20balanced%20and%20include%20youth
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Sep 30, 2023
EM Conversations 2 - Clinical Education, Leadership, Mentorship & EM Feat. Dr Kavita Varshney
Guest Speaker:
Dr Kavita Varshney (MBBS EMDM FACEM FCEM) is an emergency physician with a special interest in disaster medicine and clinical education. She is also the deputy director of Emergency Medicine at Westmead Hospital.
Interviewed By:
Dr Pramod Chandru (FACEM).
Music/Sound Effects:
* Adventure by Roa Music | https://soundcloud.com/roa_music1031, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Lagoon by LiQWYD & Luke Bergs | https://www.liqwydmusic.com, https://soundcloud.com/bergscloud, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
Disclaimer:
* Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.
Thank you for listening!
Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.
You can also follow us on Facebook, Instagram, and Twitter!
See you next time!
~
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Aug 15, 2023
EM Conversations 1 - Leadership, Medical Admin., Research & EM, Feat. Dr Amith Shetty
Guest Speaker:
Dr Amith Shetty (FACEM, PhD) - Clinical Director, Patient Experience and System Performance Support Division, NSW Health, Australia.
Interviewed By:
Dr Pramod Chandru (FACEM).
Music/Sound Effects:
* Ascension by Keys of Moon | https://soundcloud.com/keysofmoon, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 4.0 International (CC BY 4.0), https://creativecommons.org/licenses/by/4.0/.
* Eternal Sunshine by LiQWYD & Luke Bergs | https://www.liqwydmusic.com, https://www.lukebergsmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution-ShareAlike 3.0 Unported (CC BY-SA 3.0), https://creativecommons.org/licenses/by-sa/3.0/deed.en_US.
* Somebody by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
Promotional Video (Soundtrack):
Somebody by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
Disclaimer:
* Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.
Thank you for listening!
Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.
You can also follow us on Facebook, Instagram, and Twitter!
See you next time!
~
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Jul 17, 2023
Emergency Medicine Case Series: Episode 1
Panel:
Pramod Chandru and Shreyas Iyer.
Case Summary:
* 61-year-old male presenting with 2 distinct episodes of shortness of breath, chest pain, and associated presyncope.
* Asymptomatic by the time of arrival to the emergency department.
* ECG and observations at triage were unremarkable.
* No recent travel or recent major surgeries.
* Initial troponin and serial troponin were 80ng/L.
* D-dimer was ordered given static troponin and the nature of symptoms: 0.58.
* Although this D-dimer was negative when age-adjusted, a V/Q scan was pursued as the patient was not felt to fit a ‘low risk’ pre-test probability for PE (IV contrast shortage dictated V/Q over CTPA).
* Bilateral segmental pulmonary PE identified on V/Q scan with mild right heart strain evident on subsequent CTPA and TTE.
Key Discussion Points:
* If a case does not follow the usual ‘pattern’ of your initial diagnosis, consider alternate aetiologies.
* There are many tools available for risk-stratifying PE including PERC, age-adjusted D-dimer, and the YEARS diagnostic pathway. However, the way in which to appropriately utilize these tools is nuanced.
* A paper published in JAMA in December 2021 demonstrates some ways in which these tools can be used together (see first reference below).
* The PESI score (even prior to definitive diagnosis) can be useful to risk stratify patients with possible PE and help determine their disposition.
Take-Home Points:
* Pre-test probability is incredibly important, particularly in entities such as PE where only highly invasive imaging modalities are diagnostic.
* Having a structured approach to protect yourself from your own mistakes is extremely important (such as a hypothesis and hypothesis testing approach).
References & Background Reading:
* Effect of a Diagnostic Strategy Using an Elevated and Age-Adjusted D-Dimer Threshold on Thromboembolic Events in Emergency Department Patients With Suspected Pulmonary Embolism: A Randomized Clinical Trial. JAMA. 2021 Dec 7;326(21):2141-2149. doi: 10.1001/jama.2021.20750.
* Thiruganasambandamoorthy, V., Stiell, I.G., Sivilotti, M.L. et al. Risk stratification of adult emergency department syncope patients to predict short-term serious outcomes after discharge (RiSEDS) study. BMC Emerg Med 14, 8 (2014). https://doi.org/10.1186/1471-227X-14-8.
* Crane SD, Risk stratification of patients with syncope in an accident and emergency department Emergency Medicine Journal 2002;19:23-27.
* Almulhim KN. The Characteristics of Syncope-Related Emergency Department Visits: Resource Utilization and Admission Rate Patterns in Emergency Departments. Cureus. 2022 Feb 8;14(2):e22039. doi: 10.7759/cureus.22039. PMID: 35340474; PMCID: PMC8913182.
* Iwuji K, Almekdash H, Nugent KM, Islam E, Hyde B, Kopel J, Opiegbe A, Appiah D. Age-Adjusted D-Dimer in the Prediction of Pulmonary Embolism: Systematic Review and Meta-analysis. J Prim Care Community Health. 2021 Jan-Dec;12:21501327211054996. doi: 10.1177/21501327211054996. PMID: 34814782; PMCID: PMC8640977.
* Schouten HJ, Geersing GJ, Koek HL, et al. Diagnostic accuracy of conventional or age-adjusted D-dimer cut-off values in older patients with suspected venous thromboembolism: systematic review and meta-analysis. 2012. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK133492/.
* Franco-Moreno AI, Bustamante-Fermosel A, Ruiz-Giardin JM, Muñoz-Rivas N, Torres-Macho J, Brown-Lavalle D. Utility of probability scores for the diagnosis of pulmonary embolism in patients with SARS-CoV-2 infection: A systematic review. Rev Clin Esp (Barc). 2023 Jan;223(1):40-49. doi: 10.1016/j.rceng.2022.07.004. Epub 2022 Sep 22. PMID: 36241500; PMCID: PMC9492501.
* Christ M, Geier F, Popp S, Singler K, Smolarsky A, Bertsch T, Müller C, Greve Y. Diagnostic and prognostic value of high-sensitivity cardiac troponin T in patients with syncope. Am J Med. 2015 Feb;128(2):161-170.e1. doi: 10.1016/j.amjmed.2014.09.021. Epub 2014 Oct 15. PMID: 25447619.
* Lindner G, Pfortmueller CA, Funk GC, Leichtle AB, Fiedler GM, Exadaktylos AK. High-Sensitive Troponin Measurement in Emergency Department Patients Presenting with Syncope: A Retrospective Analysis. PLoS One. 2013 Jun 18;8(6):e66470. doi: 10.1371/journal.pone.0066470. PMID: 23823330; PMCID: PMC3688899.
Music/Sound Effects:
* ENGINE by Alex-Productions | https://onsound.eu/, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Feel It by MBB feat. JV Saxx | https://soundcloud.com/mbbofficial, https://www.instagram.com/JVSAXX/, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution-ShareAlike 3.0 Unported (CC BY-SA 3.0), https://creativecommons.org/licenses/by-sa/3.0/deed.en_US.
* Lakeside by Scandinavianz | https://soundcloud.com/scandinavianz, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Ocean Love by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Nostalgic Marshmallows by Arthur Vyncke | https://soundcloud.com/arthurvost, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution-ShareAlike 3.0 Unported (CC BY-SA 3.0), https://creativecommons.org/licenses/by-sa/3.0/deed.en_US.
* Sound effects from https://www.free-stock-music.com.
Promotional Video (Soundtrack):
Pina Colada by Scandinavianz | https://soundcloud.com/scandinavianz,Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
Disclaimer:
* Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.
Thank you for listening!
Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.
You can also follow us on Facebook, Instagram, and Twitter!
See you next time!
~
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Apr 5, 2023
Episode 22: Orthopaedics - Part 3: Pelvic Fractures, Binders, Imaging Modalities & More!
Theme: Orthopaedics.
Participants: Professor Herwig Drobetz (orthopaedic trauma surgeon at Lismore Base Hospital), Dr Anthony Wilson (orthopaedics registrar at Lismore Base Hospital), Pramod Chandru, Caroline Tyers, Mariez Gorgi and Kim Van Vu.
Discussion:
Gibson, P. D., Adams, M. R., Koury, K. L., Shaath, M. K., Sirkin, M. S., & Reilly, M. C. (2016). Inadvertent Reduction of Symphyseal Diastasis During Computed Tomography. Journal of orthopaedic trauma, 30(9), 474–478. https://doi.org/10.1097/BOT.0000000000000627.
Presenter: Kim Van Vu - emergency medicine trainee at Westmead Hospital.
Music/Sound Effects:
* Esta Noche by Vendredi & Shifumi | https://soundcloud.com/vendrediduo, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Picasso by Ikson | https://youtube.com/ikson, Music promoted by https://www.free-stock-music.com.
Disclaimer:
* Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.
Thank you for listening!
Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.
You can also follow us on Facebook, Instagram, and Twitter!
See you next time!
~
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Apr 4, 2023
Episode 22: Orthopaedics - Part 2: Distal Radius Fracture Management - Operative? Non-Operative?
Theme: Orthopaedics.
Participants: Professor Herwig Drobetz (orthopaedic trauma surgeon at Lismore Base Hospital), Dr Anthony Wilson (orthopaedics registrar at Lismore Base Hospital), Pramod Chandru, Caroline Tyers, Mariez Gorgi and Kim Van Vu.
Discussion:
Combined Randomised and Observational Study of Surgery for Fractures in the Distal Radius in the Elderly (CROSSFIRE) Study Group, Lawson, A., Naylor, J. M., Buchbinder, R., Ivers, R., Balogh, Z. J., Smith, P., Xuan, W., Howard, K., Vafa, A., Perriman, D., Mittal, R., Yates, P., Rieger, B., Smith, G., Adie, S., Elkinson, I., Kim, W., Sungaran, J., Latendresse, K., … Harris, I. A. (2021). Surgical Plating vs Closed Reduction for Fractures in the Distal Radius in Older Patients: A Randomized Clinical Trial. JAMA surgery, 156(3), 229–237. https://doi.org/10.1001/jamasurg.2020.5672.
Presenter: Mariez Gorgi - emergency medicine advanced trainee at Westmead Hospital.
Music/Sound Effects:
* Got My Love by LiQWYD & Markvard | https://www.liqwydmusic.com, https://soundcloud.com/markvard, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Sunset Beach by Scandinavianz | https://soundcloud.com/scandinavianz, Music promoted by https://www.free-stock-music.com
Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
Disclaimer:
* Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.
Thank you for listening!
Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.
You can also follow us on Facebook, Instagram, and Twitter!
See you next time!
~
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Apr 3, 2023
Episode 22: Orthopaedics - Part 1: Knee Dislocation & Vascular Injury
Theme: Orthopaedics.
Participants: Professor Herwig Drobetz (orthopaedic trauma surgeon at Lismore Base Hospital), Dr Anthony Wilson (orthopaedics registrar at Lismore Base Hospital), Pramod Chandru, Caroline Tyers, Mariez Gorgi and Kim Van Vu.
Discussion:
Weinberg, D. S., Scarcella, N. R., Napora, J. K., & Vallier, H. A. (2016). Can Vascular Injury be Appropriately Assessed With Physical Examination After Knee Dislocation?. Clinical orthopaedics and related research, 474(6), 1453–1458. https://doi.org/10.1007/s11999-016-4730-6.
Presenter: Anthony Wilson - orthopaedics registrar at Lismore Base Hospital.
References:
Welling, D. R., Ryan, J. M., Burris, D. G., & Rich, N. M. (2010). Seven sins of humanitarian medicine. World journal of surgery, 34(3), 466–470. https://doi.org/10.1007/s00268-009-0373-z.
Music/Sound Effects:
* Faces by RYYZN | https://soundcloud.com/ryyzn, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Get Away by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Slipz (audio logo) by tubebackr | https://www.tubebackrmusic.com/, Music promoted by https://www.free-stock-music.com.
* Swing by LiQWYD & Luke Bergs | https://www.liqwydmusic.com, https://soundcloud.com/bergscloud, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Thinking Of You by Ron Gelinas Chillout Lounge | https://open.spotify.com/artist/03JYfsI9Ke7JFuxHD239m2
Music promoted by https://www.free-stock-music.com.
Disclaimer:
* Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.
Thank you for listening!
Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.
You can also follow us on Facebook, Instagram, and Twitter!
See you next time!
~
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Dec 7, 2022
Episode 21: Critical Care - Part 3 - ARDS & Ventilation Strategies
Theme: Critical Care.
Participants: Dr Alex Yartsev (intensivist at Westmead Hospital), Dr Mark Salter (emergency physician at Westmead Hospital), Maddy Jegatheeswaran (intensive care Fellow at Westmead Hospital), Gladis Kabil (registered nurse at Westmead Hospital), Kristian Adams, Pramod Chandru, Caroline Tyers, Amanda De Silva, Shreyas Iyer, and Samoda Wilegoda.
Discussion:
Sud, S., Friedrich, J. O., Adhikari, N. K. J., Fan, E., Ferguson, N. D., Guyatt, G., & Meade, M. O. (2021). Comparative Effectiveness of Protective Ventilation Strategies for Moderate and Severe Acute Respiratory Distress Syndrome. A Network Meta-Analysis. American journal of respiratory and critical care medicine, 203(11), 1366–1377. https://doi.org/10.1164/rccm.202008-3039OC.
Presenter: Maddy Jegatheeswaran intensive care Fellow at Westmead Hospital.
Music/Sound Effects:
* Blue Sweater by RYYZN | https://soundcloud.com/ryyzn, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Good Day by Ikson | https://youtube.com/ikson, Music promoted by https://www.free-stock-music.com.
* Slipz (audio logo) by tubebackr | https://soundcloud.com/tubebackr, Music promoted by https://www.free-stock-music.com.
Disclaimer:
* Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.
Thank you for listening!
Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.
You can also follow us on Facebook, Instagram, and Twitter!
See you next time!
~
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Dec 5, 2022
Episode 21: Critical Care - Part 2: Intravenous Fluids & Sepsis
Theme: Critical Care.
Participants: Dr Alex Yartsev (intensivist at Westmead Hospital), Dr Mark Salter (emergency physician at Westmead Hospital), Maddy Jegatheeswaran (intensive care Fellow at Westmead Hospital), Gladis Kabil (registered nurse at Westmead Hospital), Kristian Adams, Pramod Chandru, Caroline Tyers, Amanda De Silva, Shreyas Iyer, and Samoda Wilegoda.
Discussion:
Kabil, G., Liang, S., Delaney, A., Macdonald, S., Thompson, K., Saavedra, A., Suster, C., Moscova, M., McNally, S., Frost, S., Hatcher, D., & Shetty, A. (2021). Association between intravenous fluid resuscitation and outcome among patients with suspected infection and sepsis: A retrospective cohort study. Emergency Medicine Australasia, 34(3), 361–369. https://doi.org/10.1111/1742-6723.13893.
Presenter: Gladis Kabil - registered nurse at Westmead Hospital and PhD candidate.
Music/Sound Effects:
* Lagoon by LiQWYD & Luke Bergs | https://www.liqwydmusic.com, https://soundcloud.com/bergscloud, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* My Old East Coast by Vendredi feat. Melanie | https://soundcloud.com/vendrediduo, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Slipz (audio logo) by tubebackr | https://soundcloud.com/tubebackr, Music promoted by https://www.free-stock-music.com.
* Trick Or Treat by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com
Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* When The Lights Go On by Vlad Gluschenko | https://soundcloud.com/vgl9, Music promoted by https://www.free-stock-music.com
Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
Disclaimer:
* Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.
Thank you for listening!
Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.
You can also follow us on Facebook, Instagram, and Twitter!
See you next time!
~
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Nov 15, 2022
Episode 21: Critical Care - Part 1: Cardiogenic Shock
Theme: Critical Care.
Participants: Dr Alex Yartsev (intensivist at Westmead Hospital), Dr Mark Salter (emergency physician at Westmead Hospital), Maddy Jegatheeswaran (intensive care Fellow at Westmead Hospital), Gladis Kabil (registered nurse at Westmead Hospital), Kristian Adams, Pramod Chandru, Caroline Tyers, Amanda De Silva, Shreyas Iyer, and Samoda Wilegoda.
Discussion:
Ameloot, K. et al. (2020) “Optimum blood pressure in patients with shock after acute myocardial infarction and cardiac arrest,” Journal of the American College of Cardiology, 76(7), pp. 812–824. Available at: https://doi.org/10.1016/j.jacc.2020.06.043.
Presenter: Kristian Adams - intensive care trainee at Westmead Hospital.
Music/Sound Effects:
* Alicante by Scandinavianz | https://soundcloud.com/scandinavianz, Music promoted by https://www.free-stock-music.com
Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Dance by LiQWYD | https://www.…
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Oct 10, 2022
Episode 20: Healthcare Worker Well-Being - Part 3: Burnout & Way Forward
Theme: Healthcare Worker Well-Being.
Participants: Dr Felicity Day (emergency physician), Dr Laura Brown (emergency physician), Natalie Harman (psychotherapist and counselor), Diane Premnath, Nasim Erfani, Caroline Tyers, Jack Ashley, Shreyas Iyer, and Mariez Gorgi.
Discussion:
Brand, S. L., Thompson Coon, J., Fleming, L. E., Carroll, L., Bethel, A., & Wyatt, K. (2017). Whole-system approaches to improving the health and wellbeing of healthcare workers: A systematic review. PloS one, 12(12), e0188418. https://doi.org/10.1371/journal.pone.0188418.
Presenter: Diane Premnath - ED advanced trainee at Westmead Hospital.
Music/Sound Effects:
* Adrenaline by Alex-Productions | https://onsound.eu/, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Down by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0…
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Sep 27, 2022
Episode 20: Healthcare Worker Well-Being - Part 2: Is It Burnout Or Stress?
Theme: Healthcare Worker Well-Being.
Participants: Dr Felicity Day (emergency physician), Dr Laura Brown (emergency physician), Natalie Harman (psychotherapist and counsellor), Diane Premnath, Nasim Erfani, Caroline Tyers, Jack Ashley, Shreyas Iyer and Mariez Gorgi.
Discussion:
Kendrick, M., Kendrick, K., Morton, P., Taylor, N., & Leggat, S. (2020). Hospital Staff Report It Is Not Burnout, but a Normal Stress Reaction to an Uncongenial Work Environment: Findings from a Qualitative Study. International Journal Of Environmental Research And Public Health, 17(11), 4107. https://doi.org/10.3390/ijerph17114107.
Presenter: Jack Ashley - ED trainee at Liverpool Hospital.
Music/Sound Effects:
* Love Me Now by Vishmak | https://soundcloud.com/vishmak, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Motivational Piano Background Music by Nikita Lukyanov | https://soundcloud.c…
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Sep 26, 2022
Episode 20 - Healthcare Worker Well-Being - Part 1: Burnout In Emergency Medicine
Theme: Healthcare Worker Well-Being.
Participants: Dr Felicity Day (emergency physician), Dr Laura Brown (emergency physician), Natalie Harman (psychotherapist and counselor), Diane Premnath, Nasim Erfani, Caroline Tyers, Jack Ashley, Shreyas Iyer and Mariez Gorgi.
Discussion:
Zhang Q, Mu M-c, He Y, Cai Z-l, Li Z-c. Burnout in emergency medicine physicians: a meta-analysis and systematic review. Medicine 2020; 99:32(e21462).
Presenter: Nasin Erfani - ED advanced trainee at Westmead Hospital.
Music/Sound Effects:
* Coastline by Ikson | https://youtube.com/ikson, Music promoted by https://www.free-stock-music.com.
* Gatekeeper by The Piano Says | https://soundcloud.com/thepianosays, https://spoti.fi/3uvxbRU, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Paradise by Ikson | https://youtube.com/ikson, Music promoted by https://www.free-stock-music.com.
* Piano Roc…
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Aug 26, 2022
Episode 19 - Toxicology - Part 3: Tokyo Subway Sarin Attack
Theme: Toxicology.
Participants: A/Prof. Naren Gunja (clinical toxicologist), Pramod Chandru, Amanda De Silva, Mariez Gorgi, Tim Selvaraj and Kit Rowe.
Discussion:
Tokuda, Y., Kikuchi, M., Takahashi, O., & Stein, G. (2006). Prehospital management of sarin nerve gas terrorism in urban settings: 10 years of progress after the Tokyo subway sarin attack. Resuscitation, 68(2), 193-202. https://doi.org/10.1016/j.resuscitation.2005.05.023.
Presenter: Mariez Gorgi - ED advanced trainee at Westmead Hospital.
Music/Sound Effects:
* Eternal Sunshine by LiQWYD & Luke Bergs | https://www.liqwydmusic.com, https://www.lukebergsmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution-ShareAlike 3.0 Unported, https://creativecommons.org/licenses/by-sa/3.0/deed.en_US.
* Legendary Epic Heroic Cinematic Music | Heroic by Alex-Productions | https://www.youtube.com/channel/UCx0_M61F81Nfb-BRXE-SeVA, Music promoted by https://www.free-stock-music.com, Creative Commo…
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Aug 26, 2022
Episode 19 - Toxicology - Part 2: Deliberate Self Poisoning & Pregnancy
Theme: Toxicology.
Participants: A/Prof. Naren Gunja (clinical toxicologist), Pramod Chandru, Amanda De Silva, Mariez Gorgi, Tim Selvaraj and Kit Rowe.
Discussion:
Salter MD, Chandru P, Rowe K, Smith P, Gunja N. Prevalence of Pregnancy in Drug Overdose Presenting to a Tertiary Toxicology Service. Clinical Audit. 2022;14:19-29, https://doi.org/10.2147/CA.S341432.
Presenter: Tim Selvaraj - ED trainee at Westmead Hospital.
Music/Sound Effects:
* Hands High by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Mamacita by Mike Leite | https://soundcloud.com/mikeleite, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Paradise by Ikson | https://youtube.com/ikson, Music promoted by https://www.free-stock-music.com.
* Slipz…
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Aug 23, 2022
Episode 19 - Toxicology - Part 1: Clozapine & Its Adverse Effects
Theme: Toxicology.
Participants: A/Prof. Naren Gunja (clinical toxicologist), Pramod Chandru, Amanda De Silva, Mariez Gorgi, Tim Selvaraj and Kit Rowe.
Discussion:
De Fazio, P., Gaetano, R., Caroleo, M., Cerminara, G., Maida, F., Bruno, A., Muscatello, M. R., Moreno, M. J., Russo, E., & Segura-García, C. (2015). Rare and very rare adverse effects of clozapine. Neuropsychiatric disease and treatment, 11, 1995–2003. https://doi.org/10.2147/NDT.S83989.
Presenter: Pramod Chandru.
Music/Sound Effects:
* Descriptions by RYYZN | https://soundcloud.com/ryyzn, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Get Away by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Last Summer by Ikson | https://youtube.com/ikson, Music…
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Jul 30, 2022
Episode 18 - Environmental Medicine - Part 3: Parachute Use & Aviation
Theme: Environmental Medicine.
Participants: Dr Scott Squires, A/Prof. Andrew Coggins, Tim Selvaraj, Shoahaib Karimi, Yelise Foon, Mariez Gorgi, Shreyas Iyer, Kit Rowe, and Harry Hong.
Discussion:
Yeh, R., Valsdottir, L., Yeh, M., Shen, C., Kramer, D., & Strom, J. et al. (2018). Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial. BMJ, k5094. https://doi.org/10.1136/bmj.k5094.
Presenter: Harry Hong - critical care trainee at Ryde Hospital.
Music/Sound Effects:
* Fire by Noise Badger | https://soundcloud.com/noisebadger, Music promoted by https://www.free-stock-music.com
Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Never Give Up by Jay Someday | https://soundcloud.com/jaysomeday, Music promoted by https://www.free-stock-music.com
Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Nightswim by Scandinavian…
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Jul 30, 2022
Episode 18 - Environmental Medicine - Part 2: Diving & Otology
Theme: Environmental Medicine.
Participants: Dr Scott Squires, A/Prof. Andrew Coggins (emergency physician), Tim Selvaraj, Yelise Foon, Mariez Gorgi, Shreyas Iyer, Kit Rowe, and Harry Hong.
Discussion:
Livingstone, D., Smith, K., & Lange, B. (2017). Scuba diving and otology: a systematic review with recommendations on diagnosis, treatment and post-operative care. Diving And Hyperbaric Medicine Journal, 47(2), 97-109. https://doi.org/10.28920/dhm47.2.97-109.
Presenter: - Yelise Foon - emergency medicine trainee at Westmead Hospital.
Music/Sound Effects:
* Ascension by Keys of Moon | https://soundcloud.com/keysofmoon, Music promoted by https://www.free-stock-music.com
Attribution 4.0 International (CC BY 4.0), https://creativecommons.org/licenses/by/4.0/.
* Dance by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Keep Going by…
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Jul 16, 2022
Episode 18 - Environmental Medicine - Part 1: Heat Stroke & Cooling Techniques
Theme: Environmental Medicine.
Participants: Dr Scott Squires, A/Prof. Andrew Coggins, Tim Selvaraj, Yelise Foon, Mariez Gorgi, Shreyas Iyer, Kit Rowe, and Harry Hong.
Discussion:
Douma, M., Aves, T., Allan, K., Bendall, J., Berry, D., & Chang, W. et al. (2020). First aid cooling techniques for heat stroke and exertional hyperthermia: A systematic review and meta-analysis. Resuscitation, 148, 173-190. https://doi.org/10.1016/j.resuscitation.2020.01.007.
Presenter: Tim Selvaraj - emergency medicine trainee at Westmead Hospital.
Music/Sound Effects:
* Maximalism by Punch Deck | https://soundcloud.com/punch-deck, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Slipz (audio logo) by tubebackr | https://soundcloud.com/tubebackr, Music promoted by https://www.free-stock-music.com.
* Wanna by Ikson | https://youtube.com/ikson, Music promoted by https://www.free-stock-mus…
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Jun 25, 2022
Episode 17 - Gastroenterology - Part 3: Upper GI Bleeding & Proton Pump Inhibitors
Theme: Gastroenterology.
Participants: Dr Tim O'Sullivan (gastroenterologist and endoscopy fellow), Dr Oksana Williamns (emergency physician), Varan Perananthan (gastroenterology advanced trainee), Maria Martino (emergency medicine advanced trainee), Amanda De Silva, Shreyas Iyer, Jack Ashley.
Discussion:
Sreedharan, A., Martin, J., Leontiadis, G., Dorward, S., Howden, C., Forman, D., & Moayyedi, P. (2010). Proton pump inhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding. Cochrane Database Of Systematic Reviews. https://doi.org/10.1002/14651858.cd005415.pub3.
Presenter: Maria Martino - emergency medicine advanced trainee at Westmead Hospital.
Music/Sound Effects:
* Good Day by Ikson | https://youtube.com/ikson, Music promoted by https://www.free-stock-music.com.
Bring Me The Sky by Scott Buckley | https://soundcloud.com/scottbuckley, Music promoted by https://www.free-stock-music.com
Attribution 4.0 International (CC BY 4.0),https://crea…
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Jun 23, 2022
Episode 17 - Gastroenterology - Part 2: TEG In Variceal Bleeding
Theme: Gastroenterology.
Participants: Dr Tim O'Sullivan (gastroenterologist and endoscopy fellow), Dr Oksana Williamns (emergency physician), Varan Perananthan (gastroenterology advanced trainee), Maria Martino (emergency medicine advanced trainee), Amanda De Silva, Shreyas Iyer, Jack Ashley.
Discussion:
Rout, G., Shalimar, Gunjan, D., Mahapatra, S., Kedia, S., Garg, P., & Nayak, B. (2020). Thromboelastography-guided Blood Product Transfusion in Cirrhosis Patients With Variceal Bleeding. Journal Of Clinical Gastroenterology, 54(3), 255-262. https://doi.org/10.1097/mcg.0000000000001214.
Presenter: Varan Perananthan - gastroenterology advanced trainee at Westmead Hospital.
Music/Sound Effects:
* Faces by RYYZN | https://soundcloud.com/ryyzn, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Help You Out by Leonell Cassio ft. Jonathon Robins | https://soundcloud.com/leo…
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Jun 13, 2022
Episode 17 - Gastroenterology - Part 1: Upper GI Bleeding & Endoscopy Timing
Theme: Gastroenterology.
Participants: Dr Tim O'Sullivan (gastroenterologist and endoscopy fellow), Dr Oksana Williamns (emergency physician), Varan Perananthan (gastroenterology advanced trainee), Maria Martino (emergency medicine advanced trainee), Amanda De Silva, Shreyas Iyer, Jack Ashley.
Discussion:
Horibe, M., Iwasaki, E., Matsuzaki, J., Bazerbachi, F., Kaneko, T., & Minami, K. et al. (2021). Superiority of urgent vs early endoscopic hemostasis in patients with upper gastrointestinal bleeding with high-risk stigmata. Gastroenterology Report, 9(6), 543-551. https://doi.org/10.1093/gastro/goab042.
Presenter: Jack Ashley - emergency medicine trainee at Liverpool Hospital.
Music/Sound Effects:
* Blue Sweater by RYYZN | https://soundcloud.com/ryyzn, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Outside by Ikson | https://youtube.com/ikson, Music promoted by http…
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May 29, 2022
Episode 16 - Neurology: Part 3 - Status Epilepticus & Pharmacological Agents
Theme: Neurology.
Participants: Dr Hugo Morales (neurologist), Dr James Tadros (emergency physician), Jessica Stabler (epilepsy fellow), Kim Van Vu, Mariez Gorgi and Shreyas Iyer.
Discussion:
Chamberlain, J., Kapur, J., Shinnar, S., Elm, J., Holsti, M., & Babcock, L. et al. (2020). Efficacy of levetiracetam, fosphenytoin, and valproate for established status epilepticus by age group (ESETT): a double-blind, responsive-adaptive, randomised controlled trial. The Lancet, 395(10231), 1217-1224. https://doi.org/10.1016/s0140-6736(20)30611-5.
Presenter: Jessica Stabler
Music/Sound Effects:
* Help You Out by Leonell Cassio ft. Jonathon Robins | https://soundcloud.com/leonellcassio, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution-ShareAlike 3.0 Unported, https://creativecommons.org/licenses/by-sa/3.0/deed.en_US.
* Nightswim by Scandinavianz | https://soundcloud.com/scandinavianz, Music promoted by https://www.free-stock-music.com
Creative Commons Attri…
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May 16, 2022
Episode 16 - Neurology: Part 2 - Guillain-Barré Syndrome
Theme: Neurology.
Participants: Dr Hugo Morales (neurologist), Dr James Tadros (emergency physician), Jessica Stabler (epilepsy fellow), Kim Van Vu, Mariez Gorgi and Shreyas Iyer.
Discussion:
Keh, R., Scanlon, S., Datta-Nemdharry, P., Donegan, K., Cavanagh, S., & Foster, M. et al. (2022). COVID-19 vaccination and Guillain-Barré syndrome: analyses using the National Immunoglobulin Database. Brain. https://doi.org/10.1093/brain/awac067.
Presenter: Kim Van Vu - ED Trainee at Westmead Hospital.
Interude Reference:
http://www.petervuust.dk/
Credits:
This episode is produced with help of HETI's Emergency Medicine Training Network 5.
Music/Sound Effects:
* Open Arms by Jay Someday | https://soundcloud.com/jaysomeday, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Motivational Piano Background Music by Nikita Lukyanov | https://soundcloud.com/lukyanovnikita, Music promo…
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May 15, 2022
Episode 16 - Neurology: Part 1 - Vertigo
Theme: Neurology.
Participants: Dr Hugo Morales (neurologist), Dr James Tadros (emergency physician), Jessica Stabler (epilepsy fellow), Sai Nagaratnam (neurology advanced trainee), Mariez Gorgi and Shreyas Iyer.
Discussion: Nham, B., Reid, N., Bein, K., Bradshaw, A., McGarvie, L., & Argaet, E. et al. (2021). Capturing vertigo in the emergency room: three tools to double the rate of diagnosis. Journal Of Neurology, 269(1), 294-306. https://doi.org/10.1007/s00415-021-10627-1.
Presenter: Sai Nagaratnam.
Resources:
Emergency Care Institute: https://aci.health.nsw.gov.au/networks/eci.
Credits:
This episode is produced with help of HETI's Emergency Medicine Training Network 5.
Music/Sound Effects:
* Energetic Electronic Vlog Music | Breeze by Alex-Productions | https://www.youtube.com/channel/UCx0_M61F81Nfb-BRXE-SeVA,
Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Med…
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Apr 17, 2022
Episode 15 - Paediatrics: Part 3 - Mental Health & Challenges
Theme: Paediatrics.
Participants:
Dr Kerf Tan (emergency physician), Dr Karl Pobre (paediatric emergency physician and paediatrician), Mariez Gorgi, Amanda De Silva, Shreyas Iyer, Harry Hong, and Samoda Wilegoda
Discussion:
Bourke, E., Say, D., Carison, A., Hill, A., Craig, S., & Hiscock, H. et al. (2021). Emergency mental health presentations in children with autism spectrum disorder and attention deficit hyperactivity disorder. Journal Of Paediatrics And Child Health, 57(10), 1572-1579. https://doi.org/10.1111/jpc.15535.
Presenter: Shreyas Iyer.
Summary:
* This was a retrospective cross-sectional study which aimed to explore the issues faced by young people with a known diagnosis of autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD) presenting to the emergency department with a mental health complaint.
* This study found 374 mental health presentations to the Royal Children’s Hospital in Melbourne in 2018 in which patients had a background o…
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Apr 16, 2022
Episode 15 - Paediatrics: Part 2 - Family Presence During Cardiac Arrest
Theme: Paediatrics.
Participants:
Dr Kerf Tan (emergency physician), Dr Karl Pobre (paediatric emergency physician and paediatrician), Mariez Gorgi, Shreyas Iyer, Harry Hong, and Samoda Wilegoda
Discussion:
Dainty, K., Atkins, D., Breckwoldt, J., Maconochie, I., Schexnayder, S., & Skrifvars, M. et al. (2021). Family presence during resuscitation in paediatric and neonatal cardiac arrest: A systematic review. Resuscitation, 162, 20-34. https://doi.org/10.1016/j.resuscitation.2021.01.017.
Presenter: Mariez Gorgi (emergency medicine advanced trainee).
Summary:
* This systematic review set out to determine the impact of family presence during resuscitation (specifically in cardiac arrest) on patient outcomes, family-centered outcomes and healthcare-provider outcomes.
* A total of 38 papers were included in the review; consisting of observational studies, qualitative interviews or surveys, spanning from 1999 to 2019 in 11 different countries.
* No papers explored the impact of f…
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Apr 13, 2022
Episode 15 - Paediatrics: Part 1 - Racial Disparities In Healthcare
Theme: Paediatrics.
Participants:
Dr Kerf Tan (emergency physician), Dr Karl Pobre (paediatric emergency physician and paediatrician), Yelise Foon, Mariez Gorgi, Shreyas Iyer, Harry Hong, and Samoda Wilegoda
Discussion:
Goyal, M., Chamberlain, J., Webb, M., Grundmeier, R., Johnson, T., & Lorch, S. et al. (2020). Racial and ethnic disparities in the delayed diagnosis of appendicitis among children. Academic Emergency Medicine, 28(9), 949-956. https://doi.org/10.1111/acem.14142.
Presenter: Yelise Foon.
Summary:
* Delay in the diagnosis of appendicitis is associated with perforation and significant subsequent morbidity.
* Currently the pre-operative perforation rate for appendicitis is 30%.
* Some known risk factors for a delayed diagnosis for appendicitis include a young age, female gender, African-American race, non-English speaking backgrounds and government insurance factors (predominantly in the US).
* This was a multi-centre retrospective cohort study conducted over 3…
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Mar 15, 2022
Episode 14 - Cardiology - Part 3: The Future
Theme: Cardiology.
Participants:
Dr Karan Rao (cardiologist), Dr Nick Moore (ED consultant), Dr Hao Tran (cardiology advanced trainee), David Emmerig (ED trainee), Aran Sandrasegaran, Amanda De Silva, Pramod Chandru, Shreyas Iyer, and Samoda Wilegoda
Discussion:
Stewart, J., Lu, J., Goudie, A., Bennamoun, M., Sprivulis, P., Sanfillipo, F., & Dwivedi, G. (2021). Applications of machine learning to undifferentiated chest pain in the emergency department: A systematic review. PLOS ONE, 16(8), e0252612. https://doi.org/10.1371/journal.pone.0252612.
Presenter: Hao Tran.
Credits:
This episode was produced by HETI's Emergency Medicine Training Network 5.
Music/Sound Effects
* Descriptions by RYYZN | https://soundcloud.com/ryyzn, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Got My Love by LiQWYD & Markvard | https://www.liqwydmusic.com, https://soundcloud.com/markvard,…
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Mar 14, 2022
Episode 14 - Cardiology - Part 2: The EDACS
Theme: Cardiology.
Participants:
Dr Karan Rao (cardiologist), Dr Nick Moore (ED consultant), Dr Hao Tran (cardiology advanced trainee), David Emmerig (ED trainee), Aran Sandrasegaran, Amanda De Silva, Pramod Chandru, Shreyas Iyer, and Samoda Wilegoda
Discussion:
Boyle, R., & Body, R. (2021). The Diagnostic Accuracy of the Emergency Department Assessment of Chest Pain (EDACS) Score: A Systematic Review and Meta-analysis. Annals Of Emergency Medicine, 77(4), 433-441. https://doi.org/10.1016/j.annemergmed.2020.10.020.
Presenter: David Emmerig.
Credits:
This episode was produced by HETI's Emergency Medicine Training Network 5.
Music/Sound Effects
* Ascension by Keys of Moon | https://soundcloud.com/keysofmoon, Music promoted by https://www.free-stock-music.com
Attribution 4.0 International (CC BY 4.0), https://creativecommons.org/licenses/by/4.0/.
* Descriptions by RYYZN | https://soundcloud.com/ryyzn, Music promoted by https://www.free-stock-music.com, Creative Commons Attribu…
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Mar 13, 2022
Episode 14 - Cardiology - Part 1: HEART Score
Theme: Cardiology.
Participants:
Dr Karan Rao (cardiologist), Dr Nick Moore (ED consultant), Dr Hao Tran (cardiology advanced trainee), David Emmerig (ED trainee), Aran Sandrasegaran, Amanda De Silva, Pramod Chandru, Shreyas Iyer, and Samoda Wilegoda
Discussion:
Green, S., & Schriger, D. (2021). A Methodological Appraisal of the HEART Score and Its Variants. Annals Of Emergency Medicine, 78(2), 253-266. https://doi.org/10.1016/j.annemergmed.2021.02.007.
Presenter: Shreyas Iyer.
Credits:
This episode was produced by HETI's Emergency Medicine Training Network 5.
Music/Sound Effects
* Descriptions by RYYZN | https://soundcloud.com/ryyzn, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Feel It by MBB feat. JV Saxx | https://soundcloud.com/mbbofficial, https://www.instagram.com/JVSAXX/, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution-Sh…
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Feb 20, 2022
Episode 13 - Workplace Violence: Part 3
Theme: Workplace Violence.
Participants:
Dr Margaret Murphy, Dr Lex Narushevich, Arvind Karthikeyan, Adamina Drazkiewicz, Aran Sandrasegaran, Amanda De Silva, Pramod Chandru, Harry Hong, Shreyas Iyer, and Caroline Tyers.
Discussion:
Davids J, Murphy M, Moore N, Wand T, Brown M. Exploring staff experiences: A case for redesigning the response to aggression and violence in the emergency department. Int Emerg Nurs. 2021 Jul;57:101017. doi: 10.1016/j.ienj.2021.101017. Epub 2021 Jun 24. PMID: 34174545.
Presenter:
Amanda De Silva (emergency medicine trainee at Westmead Hospital).
Summary:
* It is widely recognized that emergency departments (EDs) are a high-risk environment when it comes to violence towards healthcare workers.
* A big contributor to this is the environment in the ED – it is chaotic, messy, busy, and sees a large turnover of patients. Compounded by access block and understaffing, this often exacerbates tense and potentially volatile situations.
* The Australian…
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Jan 29, 2022
Episode 13 - Workplace Violence: Part 2
Theme: Workplace Violence.
Participants:
Dr Margaret Murphy, Dr Lex Narushevich, Arvind Karthikeyan, Adamina Drazkiewicz, Amanda De Silva, Pramod Chandru, Harry Hong, Shreyas Iyer, and Caroline Tyers.
Discussion:
Jeong, I., & Kim, J. (2018). The relationship between intention to leave the hospital and coping methods of emergency nurses after workplace violence. Journal Of Clinical Nursing, 27(7-8), 1692-1701. https://doi.org/10.1111/jocn.14228.
Presenter:
Dr Arvind Karthikeyan - ED Trainee at Tweed Hospital.
Summary:
* The main aim of this study was to identify the relationship between emergency nurses’ intention to leave the hospital and their coping methods following workplace violence.
* The coping methods were split into emotion-focused and problem-focused mechanisms.
* The study was a cross-sectional study in which surveys were sent out to 7 hospitals in 7 different cities around Korea (completed by nursing staff working in the emergency department).
* They receive…
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Jan 28, 2022
Episode 13 - Workplace Violence: Part 1
Theme: Workplace Violence.
Participants:
Dr Margaret Murphy, Dr Lex Narushevich, Arvind Karthikeyan, Adamina Drazkiewicz, Aran Sandrasegaran, Amanda De Silva, Pramod Chandru, Harry Hong, Shreyas Iyer, and Caroline Tyers.
Discussion:
Nikathil, S., Olaussen, A., Symons, E., Gocentas, R., and Mitra, B., 2017. Review article: Workplace violence in the emergency department: A systematic review and meta-analysis. Emergency medicine Australasia : EMA. 29. 10.1111/1742-6723.12761. (Nikathil et al., 2017).
Presenter:
Aran Sandrasegaran - ED SRMO at Westmead Hospital.
Summary:
* Workplace violence in the emergency department is a systematic review and meta-analysis published in 2017 in EMA by Nikathil, et al.
* From 7235 abstracts, 22 studies were deemed relevant.
* A meta-analysis was conducted on the primary outcome variable-proportion of violent patients among total ED presentations.
* A secondary meta-analysis used studies reporting on the proportion of drug and alcohol-affecte…
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Dec 31, 2021
Episode 12 - The Christmas Special - Part 3: Injuries & The Holiday Period
Theme:
Christmas Special
Participants:
Kit Rowe, Harry Hong, Caroline Tyers and Shreyas Iyer.
Discussion:
Mohammad, M., Karlsson, S., Haddad, J., Cederberg, B., Jernberg, T., & Lindahl, B. et al. (2018). Christmas, national holidays, sport events, and time factors as triggers of acute myocardial infarction: SWEDEHEART observational study 1998-2013. BMJ, k4811. https://doi.org/10.1136/bmj.k4811.
Ferner, R., & Aronson, J. (2020). Harms and the Xmas factor. BMJ, m4067. https://doi.org/10.1136/bmj.m4067.
Presenter:
Caroline Tyers.
Credits:
This episode was produced by the Emergency Medicine Training Network 5 with the assistance of Dr Kavita Varshney and, Deepa Dasgupta.
Music/Sound Effects
* Arcade by Flanzen | https://soundcloud.com/flanzen, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Jingle Bells by Alexander Nakarada | https://www.serpentsoundstudios.com, Musi…
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Dec 31, 2021
Episode 12 - The Christmas Special - Part 2: Snake Bites
Theme:
Christmas Special
Participants:
Pramod Chandru, Kit Rowe, Caroline Tyers and Shreyas Iyer.
Discussion:
Snake Bites - a case from The Australiasian Medical Gazette (from the late 1800s).
Presenter:
Kit Rowe.
Credits:
This episode was produced by the Emergency Medicine Training Network 5 with the assistance of Dr Kavita Varshney and, Deepa Dasgupta.
Music/Sound Effects
* We Wish You A Merry Christmas by Alexander Nakarada | https://www.serpentsoundstudios.com, Music promoted by https://www.free-stock-music.com, Attribution 4.0 International (CC BY 4.0), https://creativecommons.org/licenses/by/4.0/.
* Sound effects from https://www.free-stock-music.com.
* Time by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
* Time by Mike Leite | https://soundcloud.com/mikeleite, Music promoted by https://www.free-stock-music.com, Crea…
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Dec 24, 2021
Episode 12 - The Christmas Special - Part 1: Q Fever
Theme:
Christmas Special
Participants:
Harry Hong, Kit Rowe, Caroline Tyers and Shreyas Iyer.
Discussion:
Brookfield, C., Phillips, P., & Shorten, R. (2019). Q fever—the superstition of avoiding the word “quiet” as a coping mechanism: randomised controlled non-inferiority trial. BMJ, l6446. https://doi.org/10.1136/bmj.l6446.
Presenter:
Harry Hong - ED trainee at Westmead Hospital.
Credits:
This episode was produced by the Emergency Medicine Training Network 5 with the assistance of Dr Kavita Varshney and, Deepa Dasgupta.
Music/Sound Effects
* Christmas Is Coming by MaxKoMusic | https://maxkomusic.com/, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution-ShareAlike 3.0 Unported, https://creativecommons.org/licenses/by-sa/3.0/deed.en_US.
* Sound effects from https://www.free-stock-music.com.
* Winter by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License…
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Dec 23, 2021
Episode 11 - Pulmonary Embolism: Part 3 - YEARS Algorithm
Theme:
Pulmonary Embolism.
Participants:
Dr Bristi Roy (respiratory physician), Dr Vanessa Wong (respiratory advanced trainee), Dr Arwen Morath (emergency physician), Dr Pramod Chandru, Kit Rowe, and Caroline Tyers.
Discussion:
van der Pol, L., Tromeur, C., Bistervels, I., Ni Ainle, F., van Bemmel, T., & Bertoletti, L. et al. (2019). Pregnancy-Adapted YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism. New England Journal Of Medicine, 380(12), 1139-1149. https://doi.org/10.1056/nejmoa1813865.
Presenter:
Dr Vanessa Wong (respiratory advanced trainee at Westmead Hospital).
Summary:
* PE is a leading cause of maternal death in pregnant women.
* However, the radiation exposure to both mother and foetus involved in the diagnosis of PE remains a complex issue.
* This is a multi-centre prospective study that utilised the YEARS algorithm (published several years prior) and a D-dimer to predict PE in pregnant women presenting with suspected PE.
* The study was conducted…
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Dec 22, 2021
Episode 11 - Pulmonary Embolism: Part 2 - PERT
Theme:
Pulmonary Embolism.
Participants:
Dr Jimmy Chien (senior respiratory physician), Dr Kevin Lai (senior emergency physician), Dr Arwen Morath (emergency physician), Dr Pramod Chandru, Harry Hong, Kit Rowe, and Caroline Tyers.
Discussion:
The Use of PE Response Teams (PERT) in the Care of High-Risk Pulmonary Embolism
* This is a discussion with senior respiratory physician Dr Jimmy Chien who helped to develop the PERT system at Westmead Hospital.
* Within this segment, “Venoarterial Extracorporeal Membrane Oxygenation in Massive Pulmonary Embolism-Related Cardiac Arrest: A Systematic Review” by Scott et al, is also discussed.
* The graphs included in this study are examined closely, so we would recommend reviewing this article while listening to this segment.
Summary:
* The first place to establish a PE response team was in Massachusetts.
* It took 2 years to form the PE response team at Westmead Hospital (involving a respiratory physician, an ED physician, an in…
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Dec 12, 2021
Episode 11 - Pulmonary Embolism: Part 1 - The Age-Adjusted D Dimer
Theme:
Pulmonary Embolism.
Participants:
Dr Kevin Lai (senior emergency physician), Dr Arwen Morath (emergency physician), Dr Pramod Chandru, Naveendran Rajendran, Harry Hong, Samoda Wilegoda Mudalige, Kit Rowe and Caroline Tyers.
Discussion:
Robert-Ebadi, H., Robin, P., Hugli, O., Verschuren, F., Trinh-Duc, A., & Roy, P. et al. (2021). Impact of the Age-Adjusted D-Dimer Cutoff to Exclude Pulmonary Embolism. Circulation, 143(18), 1828-1830. https://doi.org/10.1161/circulationaha.120.052780.
Presenter:
Naveendran Rajendran - ED Resident at Westmead Hospital.
Summary:
* This was a multinational, prospective, diagnostic outcome study designed to determine the impact of the use of age-adjusted D-dimer on clinical practice in the outpatient setting.
* This study follows on from the ADJUST-PE study released in 2014, which established the safety of using an age-adjusted D-dimer cut-off retrospectively.
* The primary outcome was the incidence of symptomatic thromboembolic events in…
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Nov 11, 2021
Episode 10 - General Surgery: Part 3 - Appendicitis
Theme:
General Surgery
Participants:
Dr Michael Haddock (ED consultant), Dr Sergei Tsakanov (general surgical Fellow), Sunny Rajput (ED trainee), Edgardo Solis (general surgical registrar), Shreyas Iyer, Samoda Wilegoda Mudalige, Kit Rowe, Caroline Tyers, Harry Hong and Yelise Foon.
Discussion:
A Randomized Trial Comparing Antibiotics with Appendectomy for Appendicitis. The CODA Collaborative. (2020), 383(20), 1907-1919. https://doi.org/10.1056/nejmoa2014320.
Summary:
* This study was undertaken in the United States towards the end of their initial COVID-19 wave.
* The results were reported at 90-days, however, they still have analysis intended for the first 2 years (so it is an ongoing study).
* It looked at patients 18 years or older, with image-confirmed acute appendicitis in emergency departments across 25 centers in the United States.
* Septic, diffusely peritonitic, complicated, or recurrent appendicitis patients were excluded.
* The study compared antibiotics (wit…
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Nov 7, 2021
Episode 10 - General Surgery: Part 2 - Peri-Operative COVID-19 Infection
Theme:
General Surgery
Participants:
Dr Michael Haddock (ED consultant), Dr Sergei Tsakanov (general surgical Fellow), Sunny Rajput (ED trainee), Edgardo Solis (general surgical registrar), Andy Chen (general surgical registrar), Shreyas Iyer, Samoda Wilegoda Mudalige, Kit Rowe, Caroline Tyers, Harry Hong and Yelise Foon.
Discussion:
Nepogodiev, D., Bhangu, A., Glasbey, J., Li, E., Omar, O., & Simoes, J. et al. (2020). Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. The Lancet, 396(10243), 27-38. https://doi.org/10.1016/s0140-6736(20)31182-x.
Summary:
* This was a cohort study extending over 24 countries hit by the initial COVID-19 pandemic, conducted from January 1st to March 31st 2020.
* The aim of the study was to evaluate the effect of COVID-19 infection on post-operative recovery, with particular focus on 30-day mortality and pulmonary complication rates in patients with peri-oper…
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Oct 31, 2021
Episode 10 - General Surgery: Part 1 - Uncomplicated Diverticulitis & Antibiotics
Theme:
General Surgery
Participants:
Dr Michael Haddock (ED consultant), Dr Sergei Tsakanov (general surgical Fellow), Edgardo Solis (general surgical registrar), Shreyas Iyer, Samoda Wilegoda Mudalige, Kit Rowe, Caroline Tyers, Harry Hong and Yelise Foon.
Discussion:
Jaung, R., Nisbet, S., Gosselink, M., Di Re, A., Keane, C., & Lin, A. et al. (2021). Antibiotics Do Not Reduce Length of Hospital Stay for Uncomplicated Diverticulitis in a Pragmatic Double-Blind Randomized Trial. Clinical Gastroenterology And Hepatology, 19(3), 503-510.e1. https://doi.org/10.1016/j.cgh.2020.03.049.
Summary:
* This was the first randomized-controlled trial comparing antibiotics to no antibiotics in uncomplicated acute diverticulitis with a placebo control.
* The primary outcome assessed was the length of stay in hospital, with secondary outcomes including withdrawal rates from the study, the occurrence of adverse events, readmission to hospital within 1 week and 30 days, procedural interventions,…
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Oct 5, 2021
Episode 9 - COVID-19 Series: Part 3 - Current Treatment Options
Theme:
COVID-19.
Participants:
Dr Matthew O'Sullivan (infectious diseases specialist), Prof. Sanjay Swaminathan (immunologist), Dr George Zhou (intensivist), Ali Sayeed (ICU registrar), Dr James Tadros (ED consultant), Dr Pramod Chandru (ED consultant), Harry Hong, Samoda Wilegoda Mudalige, Shreyas Iyer, Kit Rowe, and Caroline Tyers.
Discussion:
Ansems, K., Grundeis, F., Dahms, K., Mikolajewska, A., Thieme, V., & Piechotta, V. et al. (2021). Remdesivir for the treatment of COVID-19. Cochrane Database Of Systematic Reviews, 2021(8). https://doi.org/10.1002/14651858.cd014962.
Presenter - Ali Sayeed, ICU Registrar at Westmead Hospital.
Summary:
* Remdesivir is a small molecule pro-drug that inhibits viral replication via its inhibition of RNA polymerase - In Australia, it has been provisionally approved by the TGA for its use in COVID-19.
* The theory behind using Remdesivir is really in the early stages of COVID-19 pneumonitis (by reducing the viral load and thereby preventing…
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Sep 21, 2021
Episode 9 - COVID-19 Series: Part 2 - Vaccine-Induced Thrombotic Thrombocytopenia
Theme:
COVID-19.
Participants:
Dr Nicole Gilroy (infectious diseases specialist), Prof. Sanjay Swaminathan (immunologist), Dr Caroline Bahn (infectious diseases advanced trainee), Dr Joanna Koryzna (ED consultant), Dr James Tadros (ED consultant), Dr Pramod Chandru (ED consultant), Harry Hong, Samoda Wilegoda Mudalige, Shreyas Iyer, Kit Rowe, and Caroline Tyers.
Discussion:
Sharifian-Dorche, M., Bahmanyar, M., Sharifian-Dorche, A., Mohammadi, P., Nomovi, M., & Mowla, A. (2021). Vaccine-induced immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis post COVID-19 vaccination; a systematic review. Journal Of The Neurological Sciences, 428, 117607. https://doi.org/10.1016/j.jns.2021.117607.
Presenter - Vincent Tsui, ED Trainee at Westmead Hospital.
Summary:
* According to the European Medicine Agency's Pharmacovigilance Risk Assessment Committee, 169 cases of central venous sinus thrombosis and 53 cases of splanchnic vein thrombosis were reported from 34 million pe…
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Sep 16, 2021
Episode 9 - COVID-19 Series: Part 1 - Awake Prone Positioning
Theme:
COVID-19.
Participants:
Dr George Zhou (intensivist), Dr James Tadros (ED consultant), Dr Pramod Chandru (ED consultant), Dr Nicole Gilroy (infectious diseases specialist), Prof. Sanjay Swaminathan (immunologist), Harry Hong, Samoda Wilegoda Mudalige, Shreyas Iyer, Kit Rowe, and Caroline Tyers.
Discussion:
Rosén, J., von Oelreich, E., Fors, D., Jonsson Fagerlund, M., Taxbro, K., & Skorup, P. et al. (2021). Awake prone positioning in patients with hypoxemic respiratory failure due to COVID-19: the PROFLO multicenter randomized clinical trial. Critical Care, 25(1). https://doi.org/10.1186/s13054-021-03602-9.
Presenter - Caroline Tyers, ED Trainee at Westmead Hospital.
Summary:
* This was a prospective, multicentre, open-label, parallel-arm, randomized clinical superiority trial conducted in Sweden between October 2020 and February 2021, which examined the impact of awake prone positioning on the rates of endotracheal intubation in COVID-19 patients with hypoxaemic respira…
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Aug 29, 2021
Episode 8 - The Lockdown Special
Theme:
Emergency Medicine
Participants:
Yelise Foon, Harry Hong, Dr Pramod Chandru, Shreyas Iyer, Caroline Tyers, Kit Rowe, and Samoda Wilegoda.
Discussion 1:
Morley, C., Unwin, M., Peterson, G., Stankovich, J., & Kinsman, L. (2018). Emergency department crowding: A systematic review of causes, consequences and solutions. PLOS ONE, 13(8), e0203316. https://doi.org/10.1371/journal.pone.0203316
Presenter - Kit Rowe, ED Trainee at Westmead Hospital.
Summary:
* This is a systematic review from 2018 involving 102 studies.
* 47% of these studies were from the US, with 18% from Australia and 9% from Canada.
* 14 studies investigated causes, while 52 studies looked at potential solutions to emergency department (ED) crowding, and 40 studies examined the consequences of ED crowding.
* The findings were divided into consequences (regarding the patient, staff, and system-level effects), causes, and solutions (both with reference to input into ED, throughput within ED, and output out…
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Jul 20, 2021
Episode 7 - Medical Oncology
Theme:
Medical Oncology.
Participants:
Professor Nicholas Wilcken, Sarah Rashid, Bratati Karmakar, Harry Hong, Dr Pramod Chandru, Shreyas Iyer, Caroline Tyers, and Kit Rowe.
Discussion 1:
Thomas, B., Lo, W., Nangati, Z., & Barclay, G. (2021). Dexmedetomidine for hyperactive delirium at the end of life: An open-label single-arm pilot study with dose escalation in adult patients admitted to an inpatient palliative care unit. Palliative Medicine, 35(4), 729-737. https://doi.org/10.1177/0269216321994440.
Presenter - Sarah Rashid, physician trainee at Westmead Hospital.
Summary:
* Terminal agitation and delirium are difficult to define and even harder to design studies around which to improve its management.
* The current treatment algorithm advises the use of neuroleptics, benzodiazepines, opiates, and barbiturates; often at the cost of wakefulness and interaction with loved ones.
* Dexmedetomidine can provide rousable sedation, a decreased severity of delirium, analgesia, a de…
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Jun 15, 2021
Episode 6 - Retrieval Medicine
Theme:
Retrieval Medicine.
Participants:
Dr Ruby Hsu, Dr Ruth Parsell, Dr Pramod Chandru, Shannon Townsend, Yelise Foon, Shreyas Iyer and Samoda Wilegoda Mudalige.
Discussion 1:
Benoit, J., Stolz, U., McMullan, J., & Wang, H. (2021). Duration of exposure to a prehospital advanced airway and neurological outcome for out-of-hospital cardiac arrest: A retrospective cohort study. Resuscitation, 160, 59-65. https://doi.org/10.1016/j.resuscitation.2021.01.009.
Presenter - Yelise Foon - ED senior resident medical officer.
Summary:
* This study was a retrospective cohort study that looked at adult, non-traumatic OOHCA patients with an advanced airway (supraglottic or endotracheal).
* The timing of airway placement (intra-arrest versus post-ROSC) and patient outcomes (with respect to the cerebral performance category, or CPC) were analyzed.
* They observed a higher CPC in the group that had the advanced airway placed post-ROSC (i.e. 21.7% in post-arrest group versus 7.5% in intra-ar…
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May 20, 2021
Episode 5 - Paediatrics
Theme:
Paediatrics.
Participants:
Dr Surbhi Rikhi, Dr Kerf Tan, Dr Pramod Chandru, Johann De Alwis (PEM trainee) Omal Fernando (PEM trainee), Min Park (EM trainee), Shreyas Iyer, Kit Rowe, Caroline Tyers and Samoda Wilegoda Mudalige.
Discussion 1:
Kuppermann, N., Dayan, P., Levine, D., Vitale, M., Tzimenatos, L., & Tunik, M. et al. (2019). A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. JAMA Pediatrics, 173(4), 342. https://doi.org/10.1001/jamapediatrics.2018.5501.
Presenter - Johann De Alwis.
Summary:
* Serious bacterial infections (SBIs); which include UTI, meningitis, and bacteraemia, lead to dangerous complications in infants.
* This was a prospective observational study between 2011 and 2013, looking at previously healthy febrile infants aged 60 days or younger, who were evaluated for SBIs.
* The clinical rule considered the urinalysis, absolute neutrophil count (ANC), and serum procalcitonin, and…
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Apr 21, 2021
Episode 4 - Women In Medicine
Theme:
Women In Medicine.
Participants:
Dr Danielle Unwin, Amanda De Silva (ED advanced trainee) Jessica Stabler (neurology advanced trainee), Istabraq Raashed (ED advanced trainee), Harry Hong (ED SRMO), Shreyas Iyer, Caroline Tyers and Samoda Wilegoda Mudalige.
Discussion 1:
Stehli, J., Martin, C., Brennan, A., Dinh, D., Lefkovits, J., & Zaman, S. (2019). Sex Differences Persist in Time to Presentation, Revascularization, and Mortality in Myocardial Infarction Treated With Percutaneous Coronary Intervention. Journal Of The American Heart Association, 8(10). https://doi.org/10.1161/jaha.119.012161.
Presenter - Amanda De Silva.
Starting - 02:30.
Take-Home Points:
* Women with STEMI had longer times to presentation and door to balloon times, compared with their male counterparts, with a higher rate of mortality.
* Such data has been produced before, however, the underlying reason for these discrepancies is unclear.
* Possible reasons behind delayed presentation to the emerge…
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Apr 7, 2021
Bonus Episode
Theme:
Bonus Episode.
Participants:
Dr Pramod Chandru, Kit Rowe, Shreyas Iyer, Caroline Tyers and, Samoda Wilegoda Mudalige.
Discussion 1:
Chandru, P., Priyambada Mitra, T., Dutt Dhanekula, N., Dennis, M., Eslick, A., Kruit, N., & Coggins, A. Out of hospital cardiac arrest in Western Sydney: an analysis of outcomes and estimation of future eCPR eligibility - not yet available online.
Take-Home Points:
* This paper was a prospective observational study of consecutive out-of-hospital of cardiac arrests (OOHCAs) at Westmead Hospital over a 3-year period.
* It looked at the feasibility of setting up an ECMO service for refractory OOHCAs (i.e. for patients who have received CPR for 20 minutes or longer, between the ages of 18 and 70 years, and had a VF arrest).
* This study had 17 patients who would have qualified as true refractory OOHCAs (none of whom survived to hospital discharge).
* This proportion of patients was similar to other studies that have been undertaken on this…
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Mar 17, 2021
Episode 3 - POCUS
Theme:
POCUS.
Participants:
Oliver Archer (ED resident and previous cardiac sonographer), Hung Diep (ED advanced trainee), Dr Richard McNulty, Dr Kenny Yee, Dr Pramod Chandru, Kit Rowe, Shreyas Iyer, Caroline Tyers and Samoda Wilegoda Mudalige.
Discussion 1:
Presenter - Oliver Archer.
Starting - 02:00.
Atkinson, P., Beckett, N., French, J., Banerjee, A., Fraser, J., & Lewis, D. (2019). Does Point-of-care Ultrasound Use Impact Resuscitation Length, Rates of Intervention, and Clinical Outcomes During Cardiac Arrest? A Study from the Sonography in Hypotension and Cardiac Arrest in the Emergency Department (SHoC-ED) Investigators. Cureus. https://doi.org/10.7759/cureus.4456.
Take-Home Points:
* This study showed that visualizing cardiac activity on ultrasound resulted in increased duration and effort of resuscitation, and was associated with improved clinical outcomes.
* It is difficult to know whether the improved clinical outcomes were secondary to increased resuscitation effort…
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Feb 18, 2021
Episode 2 - Cardiology
Theme:
Cardiology.
Participants:
Dr Aaisha Ferkh (cardiology fellow), Dr Samia Kazi (cardiology fellow), Dr Khanh Nguyen, Dr Pramod Chandru, Kit Rowe, Shreyas Iyer, Caroline Tyers and Samoda Wilegoda Mudalige.
Discussion 1:
Lemkes, J., Janssens, G., van der Hoeven, N., Jewbali, L., Dubois, E., & Meuwissen, M. et al. (2019). Coronary Angiography after Cardiac Arrest without ST-Segment Elevation. New England Journal Of Medicine, 380(15), 1397-1407. https://doi.org/10.1056/nejmoa1816897.
Take-Home Points:
* This study showed that in patients successfully resuscitated from out-of-hospital cardiac arrest, who did not have STEMI, immediate coronary angiography and revascularisation did not improve survival at 90 days.
* It may be reasonable to consider early coronary angiography in certain patients after discussion with the interventional cardiologist (e.g. if there is a good history of ischemic symptoms prior to the arrest or if the patient has a significant cardiac background).…
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Jan 18, 2021
Episode 1 - Toxicology
Theme:
Toxicology.
Participants:
Dr Satish Mitter, Pramod Chandru, Samoda Wilegoda Mudalige, Kit Rowe, Rachel Ng, Shreyas Iyer, and Caroline Tyers.
Discussion 1:
“Clinical outcomes from early use of digoxin specific antibodies versus observation in chronic digoxin poisoning (ATOM-4)”
Betty S. Chan, Geoffrey K. Isbister, Colin B. Page, Katherine Z. Isoardi, Angela L. Chiew, Katharine A. Kirby & Nicholas A. Buckley
https://doi.org/10.1080/15563650.2018.1546010.
Take-Home Points:
* The results from this study suggest no benefit from routine use of DigiFab for chronic digoxin toxicity.
* Clinical indications for DigiFab use include - cardiac arrest, ventricular arrhythmias or runs of ventricular ectopic complexes and bradyarrhythmias associated with hypotension.
* Digoxin levels should only be performed under specific circumstances (not routinely for all patients on digoxin but rather in the context of an AKI or when there is a clinical suspicion of potential toxicity).…
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