Coda Change

Resuscitation fluids save lives in humans with life-threatening hypovolaemia. The fluid of choice should have biochemical characteristics close to the type of fluid lost and replaced at a rate and volume sufficient to correct severe fluid deficit. Then stop and consider the early use of catecholamines. There are few indications to give critically ill patients resuscitation fluids after 24 hours of admission. There is no place for synthetic colloids of non-physiological crystalloids. The effects of unnecessary fluids last well beyond the initial resuscitation period and are associated with adverse effects and harm to the patient. Fluids are toxic drugs and must be used with great care.

"The pandemic is a reminder of the intimate and delicate relationship between people and planet. Any efforts to make our world safer are doomed to fail unless they address the critical interface between people and pathogens, and the existential threat of climate change that is making our earth less habitable." Dr Tedros Adhanom Ghebreyesus, WHO Director-General. In this cross generational catch up on the post COVID world, Roger Harris, Courtney Howard and Omnia El Omrani are talking about the old normal, and the opportunities within the new normal. 

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!

My experience as physician, mother and organ donator to my son.  By Dara Kass

This talk introduces the concept of a new generation of pulmonary embolism (PE). What was once considered a deadly disease process now carries a mortality rate of <3%, which may be driven by overtesting as well as overdiagnosis. This talk will explore this phenomenon and current evidence-based approaches to the evaluation and treatment of PEs. By Lauren Westafer

Naomi Hammond talks about why follow up after critical illness matters, and why we need to know more about how to do it. Presented at SMACC 2019 in Sydney, Australia

In Australia, we have been hearing from colleagues and the media about how challenging it has been providing healthcare during the pandemic in many parts of the world. We have expected and are prepared for the battle and perhaps to get a chance to be “heroes”. Given that Australia has experienced relatively few COVID infections, some people may feel almost as if they have missed out on their “hero” moment. Some colleagues have expressed feelings such as 'I have had it easy and my colleagues overseas are having it so tough?' There have been an unusual mixture of emotions from relief to guilt. It seems for some of us that after the “hero” phase comes the “disillusionment” phase. What should we do with these emotions? Tune in to join Roger Harris, Mary Freer, Karen Gaunson, and Kym Jenkins in conversation.

The pandemic has turned everything on its head, and, like with any major catastrophic event, there is an abundance of lessons, take-aways and the new opportunities to be explored in the healthcare setting. By harnessing the power of digital technology, we are now able to connect with the people from different departments, and open up to new ways to communicate. Sliding briefing and debriefing into the frontline work- briefing at the beginning of the shift and debriefing at the end, including mental rehearsal- provides the comfort of predictability, which enables us to better cope with the unexpected. What lessons have you learnt from the COVID-19 pandemic, and what does your new normal look like? Read more

An anaesthetist, Dr Rachael Grimaldi is a mum of 3 children under the age of 4, and is currently on maternity leave. Frustrated at not being able to join the frontline in the fight against COVID-19, Rachael saw an opportunity to improve communications with the patients whilst in full PPE by developing an innovative and simple resource, an app called CardMedic. Launched in 72 hours, the app is now improving patient care in 50 counties across the world. Tune in to hear Rachael tell Roger her remarkable story. MORE

Jesse, David and Swami are back in the second part of the Carr's Clinic podcast, nerding out on the ESPN's Last Dance documentary, featuring Michael Jordan and the Chicago Bulls. It's interesting to see how the popularity of sport is leaning into the public health. What are the lessons can we learn from the NBA and The Last Dance documentary? Let's chat! https://codachange.org/2020/06/01/carrs-clinic-part-two/