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The chair, Kate Charlesworth opens by explaining that the healthcare system has a big problem – we are, in effect, producing our own patients. We use huge amounts of resources; produce vast amounts of waste and have a big carbon footprint. Globally, if the healthcare system was a country, it would be the fifth biggest polluter on the planet. The irony is then of course that we’re therefore contributing towards the climate crisis which is harming human health. We’ve seen that with storms, fires, floods, and all the associated impact they’re having on our health. We have a huge job ahead of us – to decarbonise or to get to a net zero health system. Nick Watts, doctor, and chief sustainability office for the National Health Service in England says that he wants to discuss three things: why the NHS cares about climate change, what we can do about it and exactly what that change needs to looks like. He then goes on to explain the steps that the NHS is taking to reach net zero by 2045, and the exact steps that we n

Beyond Zero Emissions is an independent think tank that shows through research and innovative solutions how Australia can prosper in a zero-emissions economy. Over the past 10 years we have published research on how to decarbonise sectors of the economy such as energy, transport, buildings and heavy industry. Healthcare is a significant energy consumer - around 7% of national emissions come from healthcare facilities and services. Within this important sector, energy use holds the most emissions reduction potential, while manufacturing has the strongest ‘multiplier effect’ - the ability to deliver widespread benefits from decarbonisation. We can power our healthcare sector on 100% renewable energy right now. Energy is used in health facilities for heating water, air, running medical equipment and keeping the lights on. It is also used in vehicles transporting supplies, patients and staff. With clean technologies available now, e.g. heat pumps and electric vehicles, there are readily-available means to run our

Each speaker delivers a short high impact clinical case from practice ranging from conflict zones to 2 week boarding in the emergency department in India. These cases have been chosen because of the profound personal impact upon the clinician. Following the clinical cases, Ben will facilitate a debrief to explore how these clinicians prepared for, performed in, or recovered from the situations.  

Ankur Verma opens the podcast by telling his listeners that he’s going to share with them something that happened during the time that Delta was in its dreadful stages in both Australia and India. He goes on to talk about a case that took place during the Delta wave, when minutes matter. He recounts a patient - Mrs P - who had come in gasping and immediately went into cardiac arrest, and notes that – as is often the case – she immediately became part of the ward’s family. After testing positive for Covid, they then gave her a CT scan to see if she had pneumonia and subsequently put her on various experimental medications, including steroids. She got better over the next four or five days and was weaned off the ventilator and over the next couple of days we removed her TPI (trigger point injection) but then her sugars went up. Ankur explains that just when he thought she was becoming much better, she started becoming hypoxic again and he then found out her left lung had collapsed. She then went on to improve –

Bec Szabo – an obstetrician, gynaecologist, and medical educator – begins the podcast by asking the audience to go back to Melbourne with her on a journey through the looking glass. She notes that while taking her listeners to Wonderland might be a bit quirky, but that it’s essential for the point of the story. Bec also wants to preface the talk with a trigger warning; and acknowledges that the subject matter of her talk might be triggering – so please do bear in mind that this talk covers Covid, ICU and pregnancy before listening.   As per the notion of taking her readers through the looking glass, Bec wants to take listeners back to spring 2021 – a time that Melbourne was looking down the barrel of a sixth lockdown. Known as having had one of the longest – and strictest – lockdowns in the world - people in Melbourne were tired and had done a lot. Many were already vaccinated.   Bec then goes on to say that she wants to talk about Covid and pregnancy and, explains to listeners that she wants to paint a pictu

In this week’s podcast Liz Crowe – an advanced clinician social worker who has worked in Brisbane’s major children’s hospitals in intensive care, emergency departments and cancer wards - begins the podcast with the question – is all this talk of burn out, actually making us burnt out?   In this podcast, Liz goes on to address exactly what the term burn out actually means and discusses how the literature on burnout in healthcare workers is prolific. She discusses how healthcare presents as an occupation of high risk, distress, and despair, with an escalation of risk post pandemic. Yet, she says, burnout is not the whole story even though it is the only story being told. Liz speaks about the extensive research into burnout and what it reveals, and the risk factors for burnout, which include excessive workload, lack of control or recognition, mismatch of values, lack of meaning and emotional contagion. However, she notes that none of these are individual deficits and says that it is concerning that ‘wellbeing’ i

"Death is not the enemy but occasionally needs help with timing." Peter Josef Safar (1924 – 2003) 'The Father of Modern CPR' In this week’s episode of the Coda podcast, former flight paramedic Gary Berkowitz – who previously worked in Afghanistan and now works for Queensland Ambulance Service - explores how when death is inevitable, the way of dying matters.   To open the discussion, he addresses the fact that out of hospital emergency care practitioners are often faced with time critical decisions. He notes that fortunately, most of these situations often have clear guidelines because – generally speaking - they follow pathways with expected outcomes. When it comes to ethics in healthcare, however, it can be a nuanced topic. For example, the decision to not commence resuscitation, or to withdraw life saving measures in a patient who appears to have no meaningful prospect of recovery, can be a difficult one. Gary goes on to note that in this environment, it’s impossible to design a guideline that could encomp

Working in medicine presents truly testing challenges for anyone. Adding the uncertainty that comes with autism can take these challenges to new heights. So how do those with autism break down the barriers of their diagnoses to become effective members of the healthcare community? And are there benefits to having such a unique mental approach to tasks?   HEALTH & WELLBEING SPECIALIST LIZ CROWE SITS DOWN WITH CANDICE CARLISLE – A NURSE IN THE ACUTE PAIN SPECIALTY TEAM WHO ALSO HAS AUTISM. CANDICE ADDRESSES THE ASSUMPTIONS, CHALLENGES & UNEXPECTED BENEFITS OF BEING AN AUTISTIC MEMBER OF THE HEALTHCARE WORKFORCE.   Candice begins by recognising the key role that autism plays in shaping her identity, and the importance of not shying away from her diagnosis. In saying this, she also affirms that having autism does not define who she is. Having two children with autism, Candice also ensures that they embrace the condition and see it as a good thing.   CANDICE GOES ON TO EXPLAIN HOW THOSE WITHOUT AUTISM CAN

Health care constitutes 7% of Australians domestic carbon footprint with hospitals and pharmaceuticals being responsible for almost 2/3rd of these emissions. We can reduce this carbon burden by addressing our practice habits, taking emissions into account, while achieving best practice care. Three areas where we can really make a difference are in pathology ordering, asthma management and anaesthetic gases. In each of these, low carbon practice also constitutes good clinical practice, making climate action a win for emissions and a win for our patients. In this recorded After Hours Webinar presented by Kate Wylie, Dr Roger Harris presents the excellent work that Coda Change is doing to address these three climate actions. Dr Harris is a co-founder of Coda and a senior staff specialist in the intensive care unit at the Royal North Shore hospital and the Sydney Adventist hospital (SAN). He is dual qualified in Emergency Medicine and Intensive Care and is passionate about education and climate change.   This is

“5 THINGS YOU CAN DO TO SAVE THE PLANET” with Hugh Montgomery (w. Liz Crowe)   SCIENTIST & CLIMATE EXPERT HUGH MONTGOMERY DISCUSSES THE CONCERNING STATE OF THE PLANET & OUTLINES WHY WE NEED TO BEGIN TAKING REAL, IMMEDIATE ACTION TO SAVE IT.   In this chat with wellbeing specialist Liz Crowe, Hugh begins by addressing the satirical Netflix film “Don’t Look Up” and pointing out that it may not be as far from reality as people think. We’ve been sitting on our hands & ignoring warnings in terms of greenhouse gases for too long, and Hugh warns that the “asteroid is about to strike”.   HUGH CITES REPORTS WHICH CLAIM WE HAVE JUST A FEW YEARS TO TURN AROUND THE CLIMATE CRISIS. HE DETAILS WHAT COULD HAPPEN IF THINGS DON’T CHANGE.   Extreme weather will be one of the most notable signs. Global sea levels will also rise noticeably and temperatures across the world will reach record highs. These will be “colossal changes” according to Hugh. This will lead to up to 2/3 of the world’s population needing to move

James Anstey provides his thoughts on the recent developments in delayed cerebral ischaemia following a subarachnoid haemorrhage (SAH). Unlike TBI, where outcomes have plateaued after 20 years, outcomes have steadily improved for aneurysmal SAH. Early intervention, with an increasing amount of coiling as opposed to clipping as well as ICU all likely playing a part.   However, there is still a subsection of patients who deteriorate three days or more post their event. This is likely due to delayed cerebral ischaemia (as opposed to pure vasospasm). This is a diagnosis of exclusion in a patient who deteriorates after three days post bleed and without hydrocephalus, seizures, infection or another identifiable causal pathology.   There are several pathophysiological factors at play. Firstly, microcirculatory problems, including vasoconstriction in capillary beds and clumping with endothelial damage. This is perhaps why treatments to improve perfusion have had little success. Next, a combination of cortical spreadi

Peter Brindley joins you again to bring you The Great Re-Engagement, alongside Pelesa Motshabi Chakane, Silvia Perez-Protto and Andrew Shaw.   This episode explores the future of healthcare, and the ways to utilise the global community, research, and technology to enable greater contentment for clinicians to enable excellent healthcare at a global level.   What will successful medicine look like in 10 years’ time if we get it right? It is a daunting prospect to consider. Palesa hopes that the positivity that has been borne out of the Covid-19 pandemic continues. She believes it will be the capacity for the healthcare system to utilise the unity that has been exhibited over the last two years will be the driving force for ongoing positive change. Ideally, this leads to healthcare for everyone, prevention of sickness and disease and exceptional care for the whole person. Silvia speaks of her dream of the abolition of healthcare disparity and universal access for all.   Andrew hopes that the medical community wi

Climate change is a real and accelerating existential danger. Urgent action is required to halt its progression, and everyone can contribute. Pollution mitigation represents an important opportunity for much needed leadership from the health community, addressing a threat that will directly and seriously impact the health and well-being of current and future generations.   Inhalational anaesthetics are a significant contributor to healthcare-related greenhouse gas emissions and minimising their climate impact represents a meaningful and achievable intervention. A challenge exists in translating well-established knowledge about inhalational anaesthetic pollution into practical action.   This new guideline is designed to provide a platform that engages health professionals as an active learning community, and invites sharing of success stories and evolving solutions across varied global practice settings.   For this podcast, @GongGasGirl interviews @jessahegedus about how they did it and why it is import

In this episode of the #CodaEarth podcast about reducing harmful gases in anaesthesia, host Laura Raiti is joined by Jessica Hegedus - an anaesthetist working in Wollongong, New South Wales, who is also a member of Doctors for the Environment.   As someone passionate about environmental sustainability within anaesthesia, Jessica starts by telling Laura that the one thing that motivates her the most when it comes to the climate crisis is the fact that it’s an emergency that will end up impacting us all; as both citizens living in the community, and professionally as healthcare workers responding to its impacts. This puts many of us in the unique position in that we’re contributing to a crisis inadvertently as healthcare professionals, that we’ll also be on the frontline responding to.   They talk about the importance of reframing climate change as a health problem, and how as healthcare professionals we have the responsibility to protect and preserve health.   Jessica notes that while reducing healthcare admis

In this episode of the #CodaEarth podcast, host Laura Raiti speaks to Brett Montgomery, a Perth-based GP &  senior lecturer at the University of Western Australia. As someone who is passionate about the climate emergency and the role each of us play in reducing the carbon footprint of healthcare, Brett is also the lead author of our Coda action plan to reduce usage of metered dose inhalers (pMDIs).   To kick off the podcast, Brett touches upon the fact that while much of society sees climate change as a political or environmental issue more commonly associated with polar bears and icebergs melting, he believes it’s important that we begin to see it as a huge public health issue to cultivate real change. Brett believes that by reframing it as an issue that has real and serious health consequences, it will ensure people who aren’t currently concerned by its effect are motivated to act when it comes to both climate change and their own health.   Brett then goes on to discuss in further detail his particular

In this special podcast focused on the ‘Reduce Pathology Test Ordering’ step of the Coda Earth Action Agenda, host Laura Rati is joined by Forbes McGain. Forbes is an antitheist and intensive care physician who works at Western Health Melbourne and is also an associate professor of medicine at the University of both Sydney and Melbourne. He is passionate about making seemingly small, environmental financial and social sustainability changes to how we practise medicine, and is currently examining ways in which we can make hospitals more sustainable.   To open the podcast, Forbes and Laura discuss exactly what it is that makes Forbes most passionate about championing change when it comes to the environment. Forbes credits two main driving factors – the first being that he is a strong believer that nature truly is extraordinary and delicate, and thanks to his childhood spent growing up on a farm - he’s really been close to nature, and he believes that loosing that would be deeply sad for people the world over. H

In part 2 of this episode of the Coda podcast, Coda co-founder Roger Harris is again joined by Sydney-based Chris Anderson and Lausanne-based Frederic Michard, as they discuss how we can do better when it comes to deteriorating patients. In part 1, the three intensive care specialists explored precisely what a deteriorating patient is, how big a problem they are and exactly why we should care – in this episode Harris, Anderson and Michard now look at ways in which the problem can be resolved.   Hosted by Roger Harris, he is joined by guests Frederic Michard - a Critical Care MD, PhD and Chris Anderson - a fellow intensive care specialist. Roger speaks to Frederic and Chris about ways in which healthcare professionals can recognise deteriorating patients sooner, and how they should be responded to, as well as discussing both solutions and how deteriorating patients can be better detected.   By way of a resolution, the three experts explore the idea of wearable, mobile solutions and – imagining the future of pa

In this episode of the Coda podcast, Coda co-founder Roger Harris is joined by Sydney-based Chris Anderson and Lausanne-based Frederic Michard, as they explore precisely what a deteriorating patient is, how big a problem they are and exactly why we should care.   Hosted by Roger Harris, guest Frederic Michard is a Critical Care MD, PhD, based in Lausanne, Switzerland, who trained in Paris University Hospitals and in Boston and is well known for his research work and publications, while Chris Anderson is a fellow intensive care specialist, also based in Sydney. Roger speaks to Frederic and Chris about why it is that many patients who are admitted to hospital for surgery end up staying due to complications, and the implications this has on both hospitals and nurses as a whole.   Also touched upon within the podcast is failure to rescue – or FTR – which is the failure or delay in recognizing and responding to a hospitalized patient experiencing complications from a disease process or medical intervention. They d

Following on from the Commit step episode, in which the Coda team discussed turning anxiety into action as a way to start bringing about change, host Dr Laura Raiti - who is both a paediatric oncology fellow, and a Coda team member – speaks to Dr Fintan Hughes, an anaesthesiology resident, about the next step we should be taking as a collective Coda community.   In this episode, Laura and Fintan start by discussing the urgent need to come together to bring about necessary change, which forms the basis for this step – which is to examine our behaviours and the impact they’re having on our own carbon footprint. They touch upon how using a carbon footprint calculator (such as the one on our website) is the first step when it comes to identifying areas in which we can do better by looking at our own personal footprint, and the importance of doing so, without feeling guilty.   From committing to change to examining where that change should start, the podcast explores the idea of flipping the script, and using the

In the first episode of Coda Earth’s unmissable new podcast, listeners will hear Coda co-founders Roger Harris and Oli Flower discuss a wide range of topics from exactly how and why Coda came to be, to how each and every one of us can make small, simple, and actionable changes that will make a real difference to the planet.   Hosted by Dr Laura Raiti - who is both a paediatric oncology fellow, and a Coda team member - she speaks to Roger and Oli about just how easy it is to commit to change – and why it’s the first step toward more sustainable healthcare delivery. The three of them discuss everything from the pandemic, to the bigger issue of climate crisis, and exactly why it’s the biggest threat to global health.   They also touch on the fact that while many of us feel helpless as individuals, and that there is a real sense of anxiety in the community, that together, we can turn that anxiety into action.   From committing to adding your voice to the movement, to acting together as a community to have a real