862 episodes

Coda Conference: Clinical Knowledge, Advocacy and Community.
Melbourne: 11-14 Sept 2022
codachange.org

Coda Change Coda Change

    • Health & Fitness
    • 4.6 • 46 Ratings

Coda Conference: Clinical Knowledge, Advocacy and Community.
Melbourne: 11-14 Sept 2022
codachange.org

    After Hours: Climate Action: Addressing Emissions from Clinical Practice

    After Hours: Climate Action: Addressing Emissions from Clinical Practice

    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 a recorded version of an After Hours webinar.
    For more like this, head to our podcast page. #CodaPodcast

    • 1 hr 8 min
    5 Things You Can Do to Save the Planet

    5 Things You Can Do to Save the Planet

    “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 to try and escape these extreme changes. There is a “rapidly closing window to secure a liveable future”.
     
    BUT WHAT CAN WE DO? HUGH SAYS WE NEED TO BEGIN TAKING RADICAL ACTION.
     
    For those wanting to take greater steps toward saving the planet, Hugh recommends starting with the following ways:
     
    Buddy up with like-minded people who want to make a change Exert your influence to get family & friends to also begin taking action Find a good carbon calculator to measure your personal footprint Make improvements in whichever areas you can, with emphasis on the more damaging areas like heating, food & transport. After making personal changes, shift your focus to your workplace  
    To finish on a lighter note, Hugh states that “we are the only generation that has ever had the chance to save humanity” and reminds us that yes, we CAN do it.
     
     
    Tune in to this eye-opening assessment of our ever-changing climate with Hugh Montgomery & Liz Crowe.
     
    For more like this, head to our podcast page
    #CodaPodcast

    • 29 min
    Delayed Cerebral Ischaemia - The Elephant in the Room After SAH

    Delayed Cerebral Ischaemia - The Elephant in the Room After SAH

    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 spreading ischaemia and angiographic vasospasm.
     
    Gold standard diagnosis of vasospasm remains the catheters angiography. Transcranial Doppler and CT angiography are both being used more and more and certainly have a role to play. CT angiography in particular stacks up reasonably well to catheter angiography and has a negative predictive value approaching 100%. One potential problem is overcalling the narrowing at times and has occasional artefacts. Transcranial Doppler is used occasionally however has challenges with reliable operators, is user dependent and only visualises a part of the cerebral circulation. 
     
    Patients deteriorate, and we of course want to make sense of it. But what do we do thereafter? Hypertensive therapy with the aim to improve cerebral perfusion is often the go to method. James shares his thoughts on this technique, with reference to the current literature. Similarly, we diagnose vessel narrowing as the problem, however therapies that reverses this does not seem to confer good clinical outcomes. There is a large list of failed therapies because of this fact. 
     
    This raises lots of questions about this patient group. Jame’s main messages are to not become obsessive with vasospasm, use CT angiography as a good substitute for catheter angiography and be cautious of vasodilator therapies as they generally do not seem to affect long term prognosis.



    This #CodaPodcast was recorded in November 2018 as part of Brain, a CICM Neuro Special Interest Group meeting.
    For more like this, head to our podcast page. #CodaPodcast

    • 12 min
    The Great Re-Engagement: The Future of Global Healthcare

    The Great Re-Engagement: The Future of Global Healthcare

    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 will engage both science and art to make these dreams reality. Andrew speaks about the integration of technology into the practise of medicine and explores the potential benefits and disadvantages. Further he speaks to the changing nature of healthcare to be servicing customers as opposed to patients. This comes with greater choice for individuals accessing healthcare. He sees this “relationship based” healthcare as key to ensuring technology does not become all consuming.
     
    Prevention, rather than cure, is a key tenant to the development of healthcare in Andrew’s opinion. This sentiment is founded on an agreement to a moral contract by the medical community. The moral contract contains within it a right to affordable and accessible healthcare for all.
     
    Silvia feels poor data collection, especially in terms of underrepresented groups, is hindering the design and implementation of health care systems. The way forward is meaningful engagement with all patients to better design systems. Palesa provides a viewpoint from a system in lower income countries. Whilst the medium and high-income countries are faced with challenges surrounded by the rising use of technology and perhaps patient disengagement, Palesa makes the point that for most of the world, burden of disease is still the major challenge to be faced. Utilising technology in an appropriate way to bridge the gap between low- and high-income countries is the way forward
     
    Balancing education, research and clinical care is another challenge that is becoming more and more apparent. Andrew thinks that clinical care is, and must be, at the forefront of medical practise. It is what the patients hold most highly and for good reason. Whilst education and research are important, these pursuits may be best to be left to those who are legitimately good at them. The team discuss the best ways to balance being pulled in multiple directions whilst keeping the patients at the forefront.
     
    For more like this, head to our podcast page. #CodaPodcast

    • 28 min
    Action Guidance for Addressing Pollution from Inhalational Anaesthetics

    Action Guidance for Addressing Pollution from Inhalational Anaesthetics

    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 important. 
     
    This podcast was recorded for the Anaesthesia Journal.
    For more like this, head to our podcast page. #CodaPodcast

    • 28 min
    Coda Earth: Reduce Anaesthetic Gases

    Coda Earth: Reduce Anaesthetic Gases

    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 admissions won’t resolve the climate crisis, that our leadership is essential, and that healthcare professionals are an important and trusted voice for action. She believes that we can send a powerful signal by getting our own house in order and that all contributions towards a low carbon society are important, however small.
     
    Focus then shifts to the #CodaEarth Action – reducing harmful volatile agents used in anaesthesia - which not only make a significant contribution to CO2 healthcare emissions, but whose use is also directly within our control. Collective attention to reducing the impact is both meaningful and achievable opportunity for healthcare providers to demonstrate their leadership.
     
    Laura and Jess also discuss six evidence-based actions to reduce anaesthetic gas usage that are practical and don’t compromise patient care. The actions include removing Desflurane from clinical use, de-commissioning Nitrous oxide piping, rationalizing Nitrous oxide where possible, advocating that healthcare workers use the lowest possible fresh gas flow, prioritising alternatives that have less environmental impact, and tracking progress, sharing results, and engaging with others.
     
    Jess was inspired due to frustrations with slow progress on climate change, combined with increasingly visible effects of the crisis on the community and her practice, and has found that it can be both empowering and rewarding to exercise advocacy and effect change within her patch.
     
    Jess also tells Laura that she believes there are meaningful actions we can all take that will contribute to a greater whole, and that the potential for healthcare providers to do this is immense. Jess believes that all contributions are meaningful and all roles are important, and that people shouldn’t be deterred by how big the problem is; perfect is the enemy of good and something is better than nothing.
     
     
    Join Coda Earth now to safely reduce pMDI usage in your own practice.

    • 17 min

Customer Reviews

4.6 out of 5
46 Ratings

46 Ratings

Hannahgaulke ,

Absolute brilliance

What #FOAMed is all about!!!! Great speakers with great informative topics.

CuddyCudmore ,

Please make it video

Love SMACC but I feel I miss valuable visuals. Would really appreciate a video option. Also need to mic up questioners in Q&A section. Thanks.

Rfdsdoc ,

Why SMACC 2013 is worth a listen again & again &again!

Call me biased as I was involved in helping run SMACC 2013 to a small degree, but the presentations and activities of this conference were mind blowing. And now they are freely available to ANYONE!
If you are a doctor, nurse , paramedic, student, artist, raconteur, THERE IS SOMETHING AWESOME FOR EVERYONE HERE.

World renowned speakers in critical care, emergency medicine.
Talks on social media and its role in the vanguard of distance/asynchronous education.
Speakers who make you laugh..cry and be inspired.

THats what is best : INSPIRATION
subscribe, download, share..and be inspired!

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