Episode 21: Critical Care - Part 3 - ARDS & Ventilation Strategies

Guest Speaker:
Dr Indika De Lanerolle (MBBS, MD, MRCEM) is a Consultant Emergency Physician at the National Hospital of Sri Lanka in Colombo. He is also the first emergency physician in Sri Lanka.

Interviewed By:
Samoda Wilegoda - ED trainee at Westmead Hospital. 

Music/Sound Effects:

• Awakening by Vlad Gluschenko | https://soundcloud.com/vgl9, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
• Denna Dena Na (Papara Song). 
• Electronic Rock (King Around Here) by Alex Grohl, available via https://pixabay.com/music/beats-electronic-rock-king-around-here-15045/. 
• Tropical Evening by Vlad Gluschenko | https://soundcloud.com/vgl9, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.

Promotional Video
Music - 

• Tropical Evening by Vlad Gluschenko | https://soundcloud.com/vgl9, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.

Disclaimer:

• Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.

Thank you for listening!

Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.

You can also follow us on Facebook, Instagram, and Twitter!

See you next time!

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Panel:
Pramod Chandru and Shreyas Iyer.

Music/Sound Effects:

• Bullet Train by tubebackr | https://www.tubebackrmusic.com/Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution-NoDerivs 3.0 Unported (CC BY-ND 3.0), https://creativecommons.org/licenses/by-nd/3.0/.
• Hands High by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
• Love Trip by Sarah Jansen Music | https://soundcloud.com/sarahjansenmusic, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
• Stay by Thomas Gresen | https://soundcloud.com/thomasgresen, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.

References:

• Carne B, Kennedy M, Gray T. Review article: Crisis resource management in emergency medicine. Emerg Med Australas. 2012 Feb;24(1):7-13. doi: 10.1111/j.1742-6723.2011.01495.x. Epub 2011 Oct 13. Review. PubMed PMID: 22313554.
• St Pierre M, Hofinger G, Buerschaper C, Simon R. Crisis Management in Acute Care Settings: Human Factors, Team Psychology, and Patient Safety in a High Stakes Environment. (2nd edn) Springer, 2011.

Disclaimer:

• Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.

Thank you for listening!

Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.

You can also follow us on Facebook, Instagram, and Twitter!

See you next time!

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Special Episode: The Indigenous Voice To The Australian Parliament

Presenter: Shreyas Iyer.

Summary:

• There is a toxic amount of lies and misinformation regarding what is a very simple proposal for providing dignity to the First Nations people and helping our government make good decisions. 
• Polls show that the overwhelming majority of First Nations people are in favour of this proposal. 
• Better government policy and better use of government resources benefit all of us. 
• Listening to First Nations people and learning from their knowledge of the land also benefits all of us. 
• We shouldn’t expect this to be a panacea, but the status quo of wasting money and allowing our First Nations communities to languish is not tenable. 
• The 'No' campaign has not actually offered any alternative viable solutions.
• Our community is a melting pot of different peoples, but we all love this country and want to play our part in it. 
• We have provided our references, and also some useful resources for information regarding the Voice below.
• If you found this video helpful, please feel free to share and spread the word. If you would like to discuss this topic further or have any questions please feel free to reach out to us on social media. 
• On 14th October we have a chance to make a good decision for the future of this country, we have a chance to vote YES to the Aboriginal and Torres Strait Islander Voice to Parliament. 

References

• https://www.wslhd.health.nsw.gov.au/ArticleDocuments/1232/WSLHD%20Year%20in%20Review%202021-22.pdf.aspx 
• https://www.abs.gov.au/articles/new-south-wales-aboriginal-and-torres-strait-islander-population-summary#where-aboriginal-and-torres-strait-islander-people-live
• https://www.abs.gov.au/statistics/people/aboriginal-and-torres-strait-islander-peoples/census-population-and-housing-counts-aboriginal-and-torres-strait-islander-australians/2021#new-south-wales 
• https://ulurustatement.org/history/the-journey-so-far/ 
• https://aci.health.nsw.gov.au/projects/co-design 
• https://www.aph.gov.au/About_Parliament/Senate/Powers_practice_n_procedures/Constitution.aspx 
• https://theconversation.com/indigenous-recognition-in-our-constitution-matters-and-will-need-greater-political-will-to-achieve-90296 
• https://about.abc.net.au/speeches/noel-pearson-boyer-lecture-series-who-we-were-and-who-we-can-be/ 
• https://www.survivalinternational.org/tribes/aboriginals#:~:text=There%20are%20about%20500%20different,large%20number%20of%20separate%20clans.&text=Archaeologists%20believe%20that%20the%20Aboriginals,continent%20around%2045%2C000%20years%20ago 
• https://www.indigenoushpf.gov.au/Measures/1-19-Life-expectancy-birth 
• https://www.indigenoushpf.gov.au/Measures/2-11-Contact-criminal-justice-system#keymessages 
• https://www.abc.net.au/news/2015-12-03/fact-check-aboriginal-men-in-jail-and-university/6907540 
• https://www.aihw.gov.au/reports/australias-health/indigenous-health-andwellbeing#Suicide%20and%20self-harm     
• https://www.abc.net.au/news/2022-11-30/closing-the-gap-report-released/101713892 
• https://www.pc.gov.au/closing-the-gap-data/annual-data-report/report/snapshot-socioeconomic#seo10 
• https://www.abc.net.au/news/2023-10-02/preventable-blindness-rates-have-been-halved/102916184  
• https://theconversation.com/governments-are-failing-to-share-decision-making-with-indigenous-people-productivity-commission-finds-210392#:~:text=The%20commission%20says%20too%20many,Agreement%20on%20Closing%20the%20Gap” 
• https://theconversation.com/many-claim-australias-longest-running-indigenous-body-failed-heres-why-thats-wrong-209511 

Useful Resources

• https://voice.gov.au 
• https://ulurustatement.org 
• https://www.reconciliation.org.au/reconciliation/support-a-voice-to-parliament/ 
• https://theconversation.com/the-voice-what-is-it-where-did-it-come-from-and-what-can-it-achieve-202138 
• https://theconversation.com/au/voice 
• https://www.abc.net.au/listen/programs/the-voice-referendum-explained 
• https://www.abc.net.au/news/2023-09-29/fact-check-voice-to-parliament-misinformation/102913680 
• https://www.amnesty.org.au/the-voice-to-parliamentfaqs/#:~:text=The%20Voice%20will%20give%20independent,gender%20balanced%20and%20include%20youth 

Guest Speaker: 
Dr Kavita Varshney (MBBS EMDM FACEM FCEM) is an emergency physician with a special interest in disaster medicine and clinical education. She is also the deputy director of Emergency Medicine at Westmead Hospital.

Interviewed By:
Dr Pramod Chandru (FACEM). 

Music/Sound Effects:

• Adventure by Roa Music | https://soundcloud.com/roa_music1031, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
• Lagoon by LiQWYD & Luke Bergs | https://www.liqwydmusic.com, https://soundcloud.com/bergscloud, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.

Disclaimer:

• Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.

Thank you for listening!

Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.

You can also follow us on Facebook, Instagram, and Twitter!

See you next time!

~

Guest Speaker:
Dr Amith Shetty (FACEM, PhD) - Clinical Director, Patient Experience and System Performance Support Division, NSW Health, Australia.

Interviewed By:
Dr Pramod Chandru (FACEM). 

Music/Sound Effects:

• Ascension by Keys of Moon | https://soundcloud.com/keysofmoon, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 4.0 International (CC BY 4.0), https://creativecommons.org/licenses/by/4.0/.
• Eternal Sunshine by LiQWYD & Luke Bergs | https://www.liqwydmusic.com, https://www.lukebergsmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution-ShareAlike 3.0 Unported (CC BY-SA 3.0), https://creativecommons.org/licenses/by-sa/3.0/deed.en_US.
• Somebody by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US. 

Promotional Video (Soundtrack):
Somebody by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US. 

Disclaimer:

• Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.

Thank you for listening!

Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.

You can also follow us on Facebook, Instagram, and Twitter!

See you next time!

~

Panel:
Pramod Chandru and Shreyas Iyer.

Case Summary:

• 61-year-old male presenting with 2 distinct episodes of shortness of breath, chest pain, and associated presyncope.  
• Asymptomatic by the time of arrival to the emergency department.  
• ECG and observations at triage were unremarkable. 
• No recent travel or recent major surgeries. 
• Initial troponin and serial troponin were 80ng/L.  
• D-dimer was ordered given static troponin and the nature of symptoms: 0.58. 
• Although this D-dimer was negative when age-adjusted, a V/Q scan was pursued as the patient was not felt to fit a ‘low risk’ pre-test probability for PE (IV contrast shortage dictated V/Q over CTPA). 
• Bilateral segmental pulmonary PE identified on V/Q scan with mild right heart strain evident on subsequent CTPA and TTE.  

Key Discussion Points:

• If a case does not follow the usual ‘pattern’ of your initial diagnosis, consider alternate aetiologies. 
• There are many tools available for risk-stratifying PE including PERC, age-adjusted D-dimer, and the YEARS diagnostic pathway. However, the way in which to appropriately utilize these tools is nuanced.  
• A paper published in JAMA in December 2021 demonstrates some ways in which these tools can be used together (see first reference below).  
• The PESI score (even prior to definitive diagnosis) can be useful to risk stratify patients with possible PE and help determine their disposition.  

Take-Home Points:

• Pre-test probability is incredibly important, particularly in entities such as PE where only highly invasive imaging modalities are diagnostic. 
• Having a structured approach to protect yourself from your own mistakes is extremely important (such as a hypothesis and hypothesis testing approach). 

References & Background Reading: 

• Effect of a Diagnostic Strategy Using an Elevated and Age-Adjusted D-Dimer Threshold on Thromboembolic Events in Emergency Department Patients With Suspected Pulmonary Embolism: A Randomized Clinical Trial. JAMA. 2021 Dec 7;326(21):2141-2149. doi: 10.1001/jama.2021.20750. 
• Thiruganasambandamoorthy, V., Stiell, I.G., Sivilotti, M.L. et al. Risk stratification of adult emergency department syncope patients to predict short-term serious outcomes after discharge (RiSEDS) study. BMC Emerg Med 14, 8 (2014). https://doi.org/10.1186/1471-227X-14-8.
• Crane SD, Risk stratification of patients with syncope in an accident and emergency department Emergency Medicine Journal 2002;19:23-27.
• Almulhim KN. The Characteristics of Syncope-Related Emergency Department Visits: Resource Utilization and Admission Rate Patterns in Emergency Departments. Cureus. 2022 Feb 8;14(2):e22039. doi: 10.7759/cureus.22039. PMID: 35340474; PMCID: PMC8913182. 
• Iwuji K, Almekdash H, Nugent KM, Islam E, Hyde B, Kopel J, Opiegbe A, Appiah D. Age-Adjusted D-Dimer in the Prediction of Pulmonary Embolism: Systematic Review and Meta-analysis. J Prim Care Community Health. 2021 Jan-Dec;12:21501327211054996. doi: 10.1177/21501327211054996. PMID: 34814782; PMCID: PMC8640977. 
• Schouten HJ, Geersing GJ, Koek HL, et al. Diagnostic accuracy of conventional or age-adjusted D-dimer cut-off values in older patients with suspected venous thromboembolism: systematic review and meta-analysis. 2012. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK133492/.
• Franco-Moreno AI, Bustamante-Fermosel A, Ruiz-Giardin JM, Muñoz-Rivas N, Torres-Macho J, Brown-Lavalle D. Utility of probability scores for the diagnosis of pulmonary embolism in patients with SARS-CoV-2 infection: A systematic review. Rev Clin Esp (Barc). 2023 Jan;223(1):40-49. doi: 10.1016/j.rceng.2022.07.004. Epub 2022 Sep 22. PMID: 36241500; PMCID: PMC9492501. 
• Christ M, Geier F, Popp S, Singler K, Smolarsky A, Bertsch T, Müller C, Greve Y. Diagnostic and prognostic value of high-sensitivity cardiac troponin T in patients with syncope. Am J Med. 2015 Feb;128(2):161-170.e1. doi: 10.1016/j.amjmed.2014.09.021. Epub 2014 Oct 15. PMID: 25447619. 
• Lindner G, Pfortmueller CA, Funk GC, Leichtle AB, Fiedler GM, Exadaktylos AK. High-Sensitive Troponin Measurement in Emergency Department Patients Presenting with Syncope: A Retrospective Analysis. PLoS One. 2013 Jun 18;8(6):e66470. doi: 10.1371/journal.pone.0066470. PMID: 23823330; PMCID: PMC3688899. 

Music/Sound Effects:

• ENGINE by Alex-Productions | https://onsound.eu/, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US. 
• Feel It by MBB feat. JV Saxx | https://soundcloud.com/mbbofficial, https://www.instagram.com/JVSAXX/, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution-ShareAlike 3.0 Unported (CC BY-SA 3.0), https://creativecommons.org/licenses/by-sa/3.0/deed.en_US.
• Lakeside by Scandinavianz | https://soundcloud.com/scandinavianz, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US. 
• Ocean Love by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
• Nostalgic Marshmallows by Arthur Vyncke | https://soundcloud.com/arthurvost, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution-ShareAlike 3.0 Unported (CC BY-SA 3.0), https://creativecommons.org/licenses/by-sa/3.0/deed.en_US.
• Sound effects from https://www.free-stock-music.com.

Promotional Video (Soundtrack):
Pina Colada by Scandinavianz | https://soundcloud.com/scandinavianz,Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.

Disclaimer:

• Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.

Thank you for listening!

Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.

You can also follow us on Facebook, Instagram, and Twitter!

See you next time!

~

Theme: Orthopaedics. 

Participants: Professor Herwig Drobetz (orthopaedic trauma surgeon at Lismore Base Hospital), Dr Anthony Wilson (orthopaedics registrar at Lismore Base Hospital), Pramod Chandru, Caroline Tyers, Mariez Gorgi and Kim Van Vu. 

Discussion:
Gibson, P. D., Adams, M. R., Koury, K. L., Shaath, M. K., Sirkin, M. S., & Reilly, M. C. (2016). Inadvertent Reduction of Symphyseal Diastasis During Computed Tomography. Journal of orthopaedic trauma, 30(9), 474–478. https://doi.org/10.1097/BOT.0000000000000627.

Presenter: Kim Van Vu - emergency medicine trainee at Westmead Hospital.

Music/Sound Effects:

• Esta Noche by Vendredi & Shifumi | https://soundcloud.com/vendrediduo, Music promoted by https://www.free-stock-music.com,  Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
• Picasso by Ikson | https://youtube.com/ikson, Music promoted by https://www.free-stock-music.com.

Disclaimer:

• Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.

Thank you for listening!

Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.

You can also follow us on Facebook, Instagram, and Twitter!

See you next time!

~

Theme: Orthopaedics. 

Participants: Professor Herwig Drobetz (orthopaedic trauma surgeon at Lismore Base Hospital), Dr Anthony Wilson (orthopaedics registrar at Lismore Base Hospital), Pramod Chandru, Caroline Tyers, Mariez Gorgi and Kim Van Vu. 

Discussion:
Combined Randomised and Observational Study of Surgery for Fractures in the Distal Radius in the Elderly (CROSSFIRE) Study Group, Lawson, A., Naylor, J. M., Buchbinder, R., Ivers, R., Balogh, Z. J., Smith, P., Xuan, W., Howard, K., Vafa, A., Perriman, D., Mittal, R., Yates, P., Rieger, B., Smith, G., Adie, S., Elkinson, I., Kim, W., Sungaran, J., Latendresse, K., … Harris, I. A. (2021). Surgical Plating vs Closed Reduction for Fractures in the Distal Radius in Older Patients: A Randomized Clinical Trial. JAMA surgery, 156(3), 229–237. https://doi.org/10.1001/jamasurg.2020.5672.

Presenter: Mariez Gorgi - emergency medicine advanced trainee at Westmead Hospital.

Music/Sound Effects:

• Got My Love by LiQWYD & Markvard | https://www.liqwydmusic.com, https://soundcloud.com/markvard, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
• Sunset Beach by Scandinavianz | https://soundcloud.com/scandinavianz, Music promoted by https://www.free-stock-music.com
  Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.

Disclaimer:

• Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.

Thank you for listening!

Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.

You can also follow us on Facebook, Instagram, and Twitter!

See you next time!

~

Theme: Orthopaedics. 

Participants: Professor Herwig Drobetz (orthopaedic trauma surgeon at Lismore Base Hospital), Dr Anthony Wilson (orthopaedics registrar at Lismore Base Hospital), Pramod Chandru, Caroline Tyers, Mariez Gorgi and Kim Van Vu. 

Discussion:
Weinberg, D. S., Scarcella, N. R., Napora, J. K., & Vallier, H. A. (2016). Can Vascular Injury be Appropriately Assessed With Physical Examination After Knee Dislocation?. Clinical orthopaedics and related research, 474(6), 1453–1458. https://doi.org/10.1007/s11999-016-4730-6.

Presenter: Anthony Wilson - orthopaedics registrar at Lismore Base Hospital.

References:
Welling, D. R., Ryan, J. M., Burris, D. G., & Rich, N. M. (2010). Seven sins of humanitarian medicine. World journal of surgery, 34(3), 466–470. https://doi.org/10.1007/s00268-009-0373-z.

Music/Sound Effects:

• Faces by RYYZN | https://soundcloud.com/ryyzn, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
• Get Away by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
• Slipz (audio logo) by tubebackr | https://www.tubebackrmusic.com/, Music promoted by https://www.free-stock-music.com.
• Swing by LiQWYD & Luke Bergs | https://www.liqwydmusic.com, https://soundcloud.com/bergscloud, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US.
• Thinking Of You by Ron Gelinas Chillout Lounge | https://open.spotify.com/artist/03JYfsI9Ke7JFuxHD239m2
  Music promoted by https://www.free-stock-music.com.

Disclaimer:

• Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.

Thank you for listening!

Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.

You can also follow us on Facebook, Instagram, and Twitter!

See you next time!

~

Theme: Critical Care.

Participants: Dr Alex Yartsev (intensivist at Westmead Hospital), Dr Mark Salter (emergency physician at Westmead Hospital), Maddy Jegatheeswaran (intensive care Fellow at Westmead Hospital), Gladis Kabil (registered nurse at Westmead Hospital), Kristian Adams, Pramod Chandru, Caroline Tyers, Amanda De Silva, Shreyas Iyer, and Samoda Wilegoda. 

Discussion:
Sud, S., Friedrich, J. O., Adhikari, N. K. J., Fan, E., Ferguson, N. D., Guyatt, G., & Meade, M. O. (2021). Comparative Effectiveness of Protective Ventilation Strategies for Moderate and Severe Acute Respiratory Distress Syndrome. A Network Meta-Analysis. American journal of respiratory and critical care medicine, 203(11), 1366–1377. https://doi.org/10.1164/rccm.202008-3039OC.

Presenter: Maddy Jegatheeswaran intensive care Fellow at Westmead Hospital.

Music/Sound Effects:

• Blue Sweater by RYYZN | https://soundcloud.com/ryyzn, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.
• Good Day by Ikson | https://youtube.com/ikson, Music promoted by https://www.free-stock-music.com.
• Slipz (audio logo) by tubebackr | https://soundcloud.com/tubebackr, Music promoted by https://www.free-stock-music.com.

Disclaimer:

• Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.

Thank you for listening!

Please send us an email to let us know what you thought.
You can contact us at westmeadedjournalclub@gmail.com.

You can also follow us on Facebook, Instagram, and Twitter!

See you next time!

~