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This talk provides an approach to life-threatening upper GI bleeding, including management of the grossly contaminated airway, the impact of hypothermia on bleeding, and balloon tamponade insertion. Knowing which balloon tamponade device you stock (is it a Minnesota or a Blakemore?), and where to find it, are just as important as knowing how to insert it. Refining your approach to variceal bleeding can help you optimize your resuscitation of these challenging cases. For more head to: codachange.org/podcasts.

Unprofessional behaviours by health professionals, in hospitals, are associated with a significantly increased risk of preventable patient complications. Such behaviours result in an environment that results in increased, and unnecessary psychological stress of health professionals and resulting in teams not working to the best of their ability. Flattening the hospital hierarchy creates an environment where team members feel safe to speak up, without fear of reprisal and knowing their opinion will be given appropriate consideration. Speaking up and calling out inappropriate behaviours, in a respectful, non judgmental manner will result in the majority of people modifying their behaviour. Improving the culture of our workplaces will result in people wanting to go to work, improved team communication and performance, and ultimately better patient outcomes. For more: codachange.org/podcasts.

You are a member of the resuscitation team looking after a shocked blunt polytrauma patient. The patient is intubated and ventilated, splinted, and is receiving a massive intravenous blood product transfusion. To your surprise, Whole Body CT scan fails to show any active haemorrhage. This talk describes the common and rarer causes of hypotension following trauma and highlights how a meticulous history and primary survey examination may often reveal the cause before imaging. For more: codachange.org/podcasts.

What's next after RESCUEicp? -The results of this study may have been disappointing, but there are some questions about the trial itself which we review. Irrespective, study into how to improve outcome for TBI patients marches on, with a look at goal directed therapy and multi-modal monitoring as a couple of examples of the future in TBI research. Prognosis in TBI - What tools do we have to help patients and families faced with the question of "what next?" after TBI? We will look at some of the available tools and discuss the dilemmas in reconciling what we know and more importantly what we don't know with what the patient and families are seeking.  For more head to: codachange.org/podcasts.

I review multiple papers that cover the merits of ultrasound use in the prehospital field. From identification of CHF, to IV starts, to a possible treatment modality for strokes. For more head over to codachange.org/podcasts

Inequity within the healthcare profession harms both providers and patients. Diverse teams have been shown to offer better care and improved productivity. The Coda community has the goal of developing achievable, sustainable and measurable actions (within the Ethics pillar) to tackle inequity within healthcare and disseminating these in 2022. In order to take action we need to develop plans through a five-stage process. Stage One is to Identify: This preliminary stage, which is where the Ethics domain is currently, seeks to identify possible actions. Once identified these actions enter stage Two where they are examined by a global team of experts for the feasibility of application. The expert recommendations then return to the community in stage three where they are proposed for modification and acceptance. Once accepted these expert designed but community modified actions enter the Fourth Stage of Sharing or implementation. Finally the outcomes from implementing the actions must be measured. Coda.Zero provid

In this conversation Lauren challenges us to consider: "What does hate look like in the world today?" The conclusion she draws is that hate looks like pain. Pain as a result of the pandemic, the marginalisation of women and girls, colonisation and the exploitation of people. And who does hate hurt? It hurts the individuals, whether they be practitioners or vulnerable patients. It hurts the broader community through inequitable distribution of services, wealth and opportunities. Finally, hate hurts you, it hurts all of us! What puts me at risk, puts you at risk, because we all need to live in this world together. So how can we cure this ‘hate virus’? Don't miss this compelling conversation and the conclusions from the incredible panel. For more head over to codachange.org/podcasts

Amy challenges us to think about our healthcare systems and the entrenched inequality within them. How does a legacy of white supremacy impact healthcare in 2020? Why do we continue to see the same power imbalances repeated again and again, whether it be in healthcare, education or politics? We have a young system and pushing back should not be seen as threatening. Many of our healthcare systems were built in a time when women and in particular Indigenous women, were not seen as equal. That legacy continues to live on because at no time have we stopped the old system for a hard reboot. The same teachings still live on and are now deeply embedded in our healthcare systems, perpetuating the harm! For more head over to codachange.org/podcasts

Not all women experience discrimination to the same extent or in the same ways. The pandemic has resulted in a dramatic increase in women's caregiving responsibilities to both children and the elderly. Additionally everyone is in the home so the domestic load has increased. Prior to the pandemic women in Australia were spending on average 1.7 hours more per day on care and domestic duties than men and now in the pandemic this has increased by a staggering 50% to mean women are providing 2.5 more hours of care than men! We need to disrupt.... so that both men and women can both work in high value roles from caring through to strong technical roles as well. We need to redistribute paid work and domestic work more evenly between men and women. For more head over to codachange.org/podcasts

Is sexism in healthcare subtle or overt? - The answer is both! .Dr Kate Ahmad shares her experiences training in medicine. Women are frequently not recognised as doctors because of their gender and they are more likely to have comments made about their appearance or questions about their relationship status....these examples are subtle, undermining the position of a woman as a doctor. At the same time there are often far more confronting examples of overt sexism. We need better systems for calling this out and we need to protect the women who come forward. We also need to ensure that bystanders come forward and don't keep their mouths shut. This needs to be called out in public. Women enter medicine at the same rate as men but their ascension up the career ladder is far from equal. This is because of sexism, a system set up by men for men and unequal family responsibilities which is a societal problem. Female patients often chose a female specialist and there is some evidence that female patients have better

Australia has established a global competitive advantage in agriculture. However innovation in the agriculture and food industries globally is changing and the entrance of new technologies, capital, and perspectives is putting pressure on existing systems and ways of thinking. Entrepreneurs especially are playing a critical role in this transformation. This presentation will provide insights into how Australia can build on a competitive advantage in agriculture to become a competitive global player in agrifood technologies and will give practical take-home principles for how we can all innovate to improve the world we live in. codachange.org/podcasts

Brandon will be giving high-impact, rapid-fire talks on assessing stroke symptoms, using EEG after acute brain injury, and advanced multimodality monitoring. For more head to: codachange.org/podcasts

Anne Creaton is interviewed by Peter Brindley. She talks about her experience in setting up Emergency Medicine Training in Fiji and give advice to those who may want to work in a similar setting. www.codachange.org/podcasts  

Sexual assault affects 1 in 3 women and 1 in 6 men during their lifetime worldwide. It is more common than most medical issues we are trained to look for, despite this being a patient population we are going to see by virtue of the "anyone, anytime" nature of an emergency and critical care. Generous estimates find than only 20% of survivors present for medical care and may not disclose this initially in their visit. Look for it during public holidays, large parties or concerts, college or university fresh week, particularly in young women. Other scene awareness clues that a sexual assault may have occurred include sedation that does not match the substances taken or clinical level seen, ripped or missing clothing, or being separated from their group. Documenting your suspicions and findings is key - as this chart is more likely to go to court, but not for 2 years. Direct quotations of what was said by the patient or EMS, body diagrams for what was found, and your clinical decision making are the essentials.

This first episode of Coda Cure has set the scene. The importance of clear definitions, treatment strategies, managing Antimicrobial Resistance, vaccination programs and dealing with the long term outcomes of sepsis were all identified. The Cure pillar remains in the early stages of identifying areas for our community to take meaningful action on global sepsis. codachange.org/podcasts

We apologise for the low quality audio, Dr Flavia Machado kindly delivered her talk in the middle of a hospital shift in São Paulo during the global pandemic.

Blanket standards applied in research design, particularly those applied traditionally in a "peace time" setting are worth being carefully examined for their relevance now in this pandemic "war time" setting so that we don't hog-tie ourselves with irrelevant and unhelpful regulations. At the same time, we don't want the 'wild wacky west'. Everyone is under pressure in research to move quickly, but we need to ensure that if we change standards we do so intelligently so that the choices we make for more pragmatic design are perfect. The pandemic has shown how as experts we are so narrow minded. It is sad how little we really listen to each other. On a large scale COVID-19 has really shown up that many of us in medicine have become super-specialised, and it is very hard for us to think across different domains and to think with any range. codachange.org/podcasts

While the timely use of Antibiotics for sepsis is well recognised, the rise of Antimicrobial Resistance (AMR) is a huge threat to global health. The current pandemic has highlighted our vulnerability to infection and we are now experiencing first hand the public health and economic cost of a pandemic. We know now what it really means to not have effective diagnostics, treatments and vaccines for an infectious pathogen. AMR accounts for 700,000 deaths annually. Antibiotic use is the key driver for AMR. Some use of antibiotics in COVID-19 infections is likely appropriate and some likely inappropriate, so this is where AMR comes in. Vaccines can help in AMR by reducing the carriage and transmission of AMR pathogens and by reducing the clinical symptoms of certain infections that can result in appropriate antibiotic use. Vaccines can specifically help reduce AMR within three categories: 1: Vaccines against common bacterial pathogens like Haemophilus Influenzae 2: Vaccines against specific AMR pathogens like Tuber

The global burden of Sepsis continues to challenge clinicians in its definition, diagnosis and treatment. The current Covid-19 pandemic seems to have almost taken our understanding of the Sepsis Syndrome back decades. What are the similarities between the current pandemic and sepsis? And what can we learn? We have never avoided healthy controversy and in this episode Simon Finfer puts the case that the multi-organ dysfunction and cytokine storm seen in critically ill Covid19 infected patients is analogous to the conventional Sepsis Syndrome and ARDS. Perhaps if we consider the current pandemic through a Sepsis lens, we can avoid making the same mistakes that we have made in Sepsis research for decades resulting in no licenced treatments for the Sepsis Syndrome. Derek Angus agrees but makes the case that there are two distinct differences. Firstly that the endothelial dysfunction appears different in Covid-19 and secondly unlike sepsis in the case of Covid-19 the pathogen itself proceeds unabated by any curre

Rhonda Cadena talks IV Alteplase for wake up strokes using MRI criteria. Tiger territory! After a NEJM paper in 2018 this is now on the table - hear the perspective from Rhonda, an ED / neurocritical care specialist from North Carolina. For more head to: codachange.org/podcasts