Smacc

In the second part of the podcast focused on POCUS, Cian, Trish, Kylie and Rachel take a deep dive into the ultrasound process during the COVID-19 pandemic. How do we keep our equipment clean? Who do we turn to as a reliable and up-to-date source of information? Now, that the traditional literature is struggling to keep up with the times, and social learning networks aren’t always best evidence where is the knowledge. The “InfoDemic” has been experienced by all. What we do know is that strong POCUS infrastructure and collaboration underpins flexible opportunities for innovation. Jump into the comments section to join the discussion! https://codachange.org/2020/06/17/pocus-and-the-infodemic/

A round table check in between Ireland, Australia and the United States. Hosted by Cian McDermott from Dublin, Trish Henwood (Philadelphia, US), Kylie Baker (Queensland, AU) and Rachel Liu (New Haven, US) share their local experiences on remote education, innovation, and ultrasound in the remote environment. Finding new ways to work, changing priorities, and pivoting fast and hard.

The Future of Battlefield Surgery. The traditional battlefield involved soldiers on both sides, fighting against each other. Today, the battlefield is quite different and this has impacted how we practice surgery. Why? First, the world is full, more than half of humanity lives in cities. Hospitals in developing countries are exhausted and under-resourced. Furthermore, the threats we face today are global - global warming, pollution, air pollution, terrorism and water supply. Modern-day weapons are so powerful that conventional warfare is almost obsolete - atomic weapons, cyber warfare.. the list goes on. Finally, diagnosis and surgical intervention relies on extensive technology and minimal invasiveness. This is unsuitable to battlefield situations and makes it incredibly challenging to provide care. MSF goes where no one else will go, but doing this kind of good is not getting any easier. For more head to: codachange.org/podcasts

Pacific Island Playlist 5: Mental Health. From #SMACC2019, the incredible Jess Morton speaks candidly about her own mental health journey. Jess knows first-hand how important it is that we give mental health the focus it deserves. Eliminating the stigma that surrounds mental health starts with us as healthcare professionals. We need to lead the way. Pacific Island Playlist song: Unwell by Matchbox Twenty For more head to: codachange.org/podcasts

In this episode, we examine accessibility in healthcare and the limitations to accessing equitable care for all. We must understand both the limitations posed by a patient's disability and the predicted accessibility challenges they face. This requires asking questions about a patient's disability. Healthcare accessibility is not only the physical ability to reach care but also the ability to engage and connect holistically with that care. To truly design a more accessible healthcare system, we need to involve people with accessibility issues right from the start and design new systems, based on them. Tune in to the podcast or watch the video to better your understanding of what accessible healthcare really looks like.  For more head to: codachange.org/podcasts

The Covid restrictions saw an increase in Telehealth services and a flow-on effect was that it provided a safe space for people with accessibility differences. To sustain this, planning must go into adapting existing clinical practices. We need triage tools to identify which consultations are suitable to provide virtual care before we can engage with patients and provide them with a choice. We need to better understand the problem before we can determine what service changes might appeal to people with accessibility differences. People with lived experience need to be involved right from the start in the planning process. Healthcare must be open to the knowledge of what it is actually like to live with a disability. Then we can design new systems that narrow the gap and make the process of getting a diagnosis and seeing a clinician faster. As healthcare professionals, we are all incredibly busy, but taking the time to listen is when patient-centred care shines. For more head to: codachange.org/podcasts

Healthcare should be equitable and accessible for everyone, but what exactly is equitable access to healthcare? Access is the ability to seek healthcare. The ability to physically connect and to pay for healthcare. Most importantly, access is the ability to engage with healthcare. Open and honest communication with patients is key. Empower people to make decisions about their own care, finding a way to communicate even if in a non-traditional way. The reality is, a lot of clinicians live and work with disabilities themselves, yet healthcare is void of a system that caters to everyone. It is really important as clinicians, to not just look at the numbers but to look at the patient as a whole. We need to come together and reinvent how we deliver healthcare – to suit everyone. For more head to: codachange.org/podcasts

Inspiring clinicians to embrace accessibility will deliver better patient outcomes. It is vital we consult consumers about their disabilities and about what would make their health experience better. This must include listening to patients' stories and understanding both their abilities and limitations. It's an important step towards an equitable healthcare system. When considering whether or not to offer a patient the choice of face-to-face or Telehealth, reflect on their ability to access healthcare. Patients with a disability require a lot more time and planning to meet the needs of everyday life. People with disabilities face a lot of barriers to equitable healthcare but the biggest barrier is the attitudes and beliefs entrenched in the system. A small step towards embracing the requirements of people with a disability is a large step in the right direction towards equitable healthcare. For more head to: codachange.org/podcasts

Nas Campanella is a high-profile public media identity whose experience of being a blind patient provides a first-hand account of the access and inclusion challenges she faced within the healthcare system. Facing early childhood memories which involved countless hospital visits, she remembers needles, cannulas and feeling incredibly anxious about going into the operating theatre. That was, until the day that she stopped and said, I’ll do this (surgery) if it is my last. Nas wanted to live a happy life and to live her life blind. She wasn’t interested in cures, or medical procedures, because being blind is part of who she is. It is common for healthcare providers to see patients with a disability through a medical treatment lens, focusing on fixing or curing the ‘issue’. The concept that a patient with a disability isn't necessarily seeking a cure for a problem is often difficult to understand for healthcare professionals, who go into medicine to make people better. Nas’s experience taught her a lot about acce

Energy = mass x velocity2, something that travels fast has twice the fatality of potential injury. In the US firearm injuries are unfortunately common and this is a public health crisis. We need to learn how to best treat patients with penetrating neurotrauma injuries. Wendy Chang takes us through methods to best treat these patients. For more head to: codachange.org/podcasts

Creativity in: non fiction  Let's face it, your real life is too strange for fiction. And why go looking for the stories, when they come right to you? During this session, we'll explore the tension between telling them, and taking them, how to keep their beauty, or their hilarity, without betraying confidence. Bring your best story, and your worst, and we'll find their true heart. One of the most common questions that gets asked by fellow clinicians, is what it takes to be a writer. Well, if you're an ER doctor, medic, or nurse, you've already checked the "weirdo" box. Pivotal. You can also add a position at the interface between the personal and the general as the right one for perspective. Everyone wants to know what you've seen, what happened next, and what matters most. The real answer, though, I stole from Annie Dillard: "Do you like sentences?" I mean, really REALLY like them? Enough to spend even more time alone, in dark basements, puzzling over whether to remove a "that" or keep it? Well, then you mig

FOAMed (Free Open Access Medical Education) is an important tool that so many of us are passionate about. The ability for medical education to reach countries around the world is powerful and is driving us towards a healthier future. In this episode of PIP, Alexandra Presler encourages us to lean into the FOAMed community. Everyone can utilise FOAMed, regardless of your position, so talk to everyone, branch out and help make the community bigger. For more head to: codachange.org/podcasts

Emily Granger takes us through the original cardiothoracic conundrum: what to do about chest injuries and rib fractures? New approaches to the management of severe chest trauma and rib fractures are re-shaping our practice. Tune in to discover how. For more head to: codachange.org/podcasts  

Andrew Dixon takes us through five Common Trauma Radiology Misses and Misinterpretations. For more head to: codachange.org/podcasts

Jim Manning tells us why the time is now for Selective Aortic Arch Perfusion in improving cardiac arrest outcomes. For more head to: codachange.org/podcasts

Does adrenaline require resuscitation or is adrenaline good for resuscitation? Gavin Perkins takes us through the research and findings. For more head to: codachange.org/podcasts

Previously at SMACC, Steve talked about NonSTEMI that needed the cath lab immediately and showed many ECGs which represented acute coronary occlusion (Myocardial Infarctions) but present on the ECG as very subtle findings (http://hqmeded-ecg.blogspot.com/search?q=subtle), particularly as subtle ST segment elevation that does not meet “STEMI” criteria and is diagnosed as NonSTEMI. Now, he builds on that idea and challenges the whole idea of a dichotomy between STEMI and NonSTEMI. These are NOT distinct pathologies, but rather exist on a continuum of intracoronary thrombus. Nevertheless, this false dichotomy is rarely recognised by emergency physicians or cardiologists, and patients suffer because of it. There are obvious STEMI, which always need the cath lab emergently, and for which time is myocardium. On the other hand, there are patients whose symptoms are resolved, ECG is non-diagnostic, shows no active ischemia nor subtle ST elevation, but whose troponin is positive and their resolved chest pain is due to

Trauma care should be easy… shouldn’t it? So why doesn’t it feel easy? The clinical component is the easy bit, the challenge is the non-technical factors. Clare Richmond, Chris Hicks, Cliff Reid take us through a SMACCForce simulation debrief and discuss the human factors of trauma care. For more head to: codachange.org/podcasts

An asthmatic who is hemodynamic compromised, can be killed instantly. This distinguishes these asthmatics from the standard asthmatic and how these patients are treated will make a huge difference to the outcome. Haney Mallemat recounts a story of an asthmatic who minutes after he was intubated, became bradycardic, hypertensive and coded. Haney discusses how breath stacking is what kills the asthmatic patient and how we can best avoid this happening to ultimately save lives. For more head to: codachange.org/podcasts

Airway management needs to be proven, predictable and as simple as possible. Silence = death. It is hard to open yourself up and ask to be coached through something but it can be lifesaving. Laura Duggan explains how to survive Trauma RSI and come out the other side. For more head to: codachange.org/podcasts