Coda Change

A demonstration in the ECMO-CPR process and then going back to basics, to understand the need for such a process and how to design and develop it from scratch using simulation to cut lead time and highlight and remove issues prior to rolling out on the patients. Making E-CPR both possible and safer.

Sara Gray presents an incredible case highlighting the importance of resuscitative hysterotomy. The story is full of drama, moments that went well and moments that went poorly. It demonstrates the key points when considering this emergency lifesaving procedure. The case is a woman who is eight months pregnant and has an out of hospital cardiac arrest. The call comes in advising of an imminent arri...

David Halliwell presents the science of cardiopulmonary resuscitation. Resuscitation means lots of things to different people – compression, CPR, mouth to mouth, ventilation, return to normal and reanimation all come to mind. But how and why does resuscitation really work – let David explain. This talk uses a case study approach to discuss why resuscitation practitioners should focus upon technica...

The child with the reduced conscious level presents a unique challenge to the Emergency provider - how can we recognise normal sleepiness versus pathology? Natalie May reminds us that, even if it's after bedtime, we have to take the time to wake children up fully as part of our routine assessment. She then explores the common pathologies - 5MF! - we need to consider in children with a reduced cons...

Pierre Carli expands on the prehospital and critical care responses to terrorist attacks. For retrieval medicine specialists and prehospital care providers, terrorist attacks are a new and unique threat. As Pierre impresses on you, terrorist attacks are not accidents. They are a targeted human activity whose purpose is to kill, injure, and inflict the maximum amount of human casualty as possible....

Ciaran McKenna discusses 3D printing of high fidelity simulation equipment. Simulation training is useful, but it is often a costly exercise. However, according to Ciaran McKenna, it doesn't have to be.  Ciaran shares his experience of using 3D printing to create simulation equipment. According to Ciaran, anyone with basic computer skills is capable of making their own 3D solutions for simulation...

Diana Badcock begins the talk by discussing her decision to take up the role of Chief Medical Informatics Officer (CMIO). Diana was optimistic about taking this job. However, she left the job after a year. Though she failed in the job, Diana thinks she learnt a lot about failing with fortitude. Diana next talks about the death of her father who was very healthy throughout his life. Three months be...

Resa Lewiss tells you how ultrasound improves resuscitation outcomes in critical care. Ultrasound helps you make more accurate diagnoses. It allows you to perform procedures with fewer complications, and ultrasound enables you to be more time and cost efficient. However, there may be more to ultrasound - Resa enlightens you. The ultrasound allows the clinician to interact with their patients. Furt...

'"Think of the danger while things are going smoothly." Chicago's own Lisa McQueen picks apart the challenges of identifying those children who genuinely need sepsis resucitation in the "pre-shock phase" and explores the pathophysiology and treatment of shock in children.

Two simulations for prehospital care - tactical and motorcycle pit crew with a panel discussion debrief following. Demonstration and discussion of the medical response to these incidents.

Haney Mallemat informs you how technology is improving healthcare. Haney's talk is grounded in a patient experience. Jim is a gentleman from a small farm in a rural area of United States. His farm is everything to him and his wife and daughter. When Jim got seriously sick, he had to have an extended stay in a major tertiary hospital. As a result, he and his family lost their farm, which was their...

Flavia Machado gives you the ins and outs of a day in the life of an ICU doctor working in Brazil. She addresses healthcare inequality, ethics, and the challenges she faces in a developing country. By sharing a blow-by-blow account of a day at work, Flavia demonstrates the challenges and inequality that exists. And whilst poverty is shocking, Flavia believes inequality is worse. Flavia's day begin...

Dr Anne Creaton talks about the healthcare capacity building in Fiji. Fiji was struck by Cyclone Winston in 2016. It caused widespread devastation and the impact will be felt for a long time in the future. The most important thing that Fiji has taught her is faith, patience and persistence. Anne begins by talking about the three Rs that are essential in trainees who want to work in Fiji or similar...

The paediatric airway terrifies many of us: at the smaccMINI paediatric critical care workshop, Fran Lockie explores some real-life examples of airway challenges and considerations. He takes us through the concept of the "airway bundle" and how teamworking and communication is key to improving paediatric airway care, emphasising the concepts we can borrow from adult practice to offload some of our...

Andrew Chow gives a rapid breakdown of malignant cerebral artery (MCA) infarction and the utility of decompressive craniectomy. An MCA infarction is an ischaemic stroke, affecting the total or subtotal area of the MCA. It involves the basal ganglia (at least partially) and may involve the adjacent territories. The incidence is 10-20 per 100 000 and there is a high mortality rate of up to 80%. Earl...

Natalie Thrutle educates on the critical issue of lead poisoning in developing countries. Critical care means different things to different people. In the context of lead poisoning, you may or may not think of developing countries such as Nigeria. The response to the Zamfara state, lead poisoning outbreak, in Northern Nigeria, is unprecedented and requires a nuanced interpretation of 'critical car...

Nikki Blackwell tells her story of the emergency response to the Ebola outbreak in Nzerekore, Guinea. She chronicles the enormous challenges of providing care to some of the most vulnerable people in the world, in one of the most under resourced and challenging environments. The Ebola virus was first isolated in 1976. Between then and 2013 there were twenty outbreaks of Ebola. However, the outbrea...

In this podcast, Mervyn Singer talks about the link between stress and multiple organ failure. Often, the organs involved in multi-organ failure show no signs of structural damage or cell damage that would indicate these organs might be under stress. Stress might cause functional damage rather than structural damage. Stress is a normal coping mechanism which helps to deal with the various stressor...

Jon McCormack gives you what you need to know in the case of paediatric blunt traumatic cardiac arrest. This is a rare but deadly occurrence. Data shows that the population incidence for paediatric blunt traumatic arrest is 1 in 100 000. Of these, most are male, and most are involved in vehicle traffic accidents, along with falls and non-accidental injuries. The median age is 7 years old. The inju...

Stephen Bernard shares his thoughts and the current evidence for using oxygen for cardiac arrest patients. Oxygen is ubiquitous in society! You can buy it in bottles and there are even oxygen cafes. This is especially true in hospitals where oxygen is used frequently and often without much thought. Oxygen is a natural substance. So surely, a short time on 100% oxygen can't be harmful, right? Steph...

John Myburgh speaks passionately about the use of oxygen in resuscitation, and clinical outcomes in critical care. For the 30 years, clinical understanding of haemodynamic resuscitation has been based on physiological paradigms that focus on convective oxygen delivery. Most of these emphasise the role of cardiac output, haemoglobin and recommend interventions using synthetic agents such as dobutam...

Scott Weingart discusses the scientific aspects of meditation. He believes meditation is to the mind what exercise is to the body. There are two types of meditation: focussed attention meditation or vipassana, and contemplative meditation. Generally, people exist in a default mode network. This happens when we are not focussed on anything in particular and thoughts occur in our brain without us be...

Paul Young discusses remote ischaemic preconditioning and along he delves into the pitfalls of clinical research. 2016 was the 30th anniversary of ischaemic preconditioning. Remote ischaemic preconditioning is the magical offspring of ischaemic preconditioning and refers to the phenomenon whereby brief periods of ischaemia in one organ can protect other organs from subsequent prolonged ischaemic i...

Marius Rehn examines the difficulties and importance of evidence based medicine in prehospital resuscitation. Notably, combining academic activity with pre- and in-hospital clinical practice is hard work. Being an academic in a flight suit can be quite lonely. Marius wants this to change and is passionate about increasing the quantity and quality of prehospital research. Prehospital research that...

Anand Swaminathan brings precision emergency medicine and outcomes in critical care into the light. He will convince you to start calling diseases for what they are and as a result start offering the proper treatments and care. All disease exists on a spectrum. You can't treat one end of the spectrum the same way you treat the other end. This talk is inspired by a case of Anand's. An older man pre...