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    IS-EMERCAST

    Welcome to IS-EMERCAST!. This is the partner and supplement to Med from the SHED – that highly useful resource on the net for Emergency Clinicians in the Illawarra-Shoalhaven. The perennial problem with trying to provide educational resources to a broad geographical area and a disparate group of clinicians always stumps us. Here is part of the answer. This podcast allows easily accessible clinical education and perspectives with a local flavour for those of us working in the Illawarra-Shoalhaven. It is brought to you by the Emergency Medicine Education and Training Program under the Auspices of the Australasian College for Emergency Medicine (ACEM) and funded by the Commonwealth Government. Whilst all efforts are made to ensure content is appropriate and up to date, all information and perspectives are those of the presenters themselves and do not represent the position of ACEM or Illawarra Shoalhaven Local Health District.
    en18 Episodes

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    Episodes (18)

    Episode 19 - The Illusion of Certainty

    Episode 19 - The Illusion of Certainty
    Medicine has seen the proliferation of guidelines/pathways/clinical decision rules in a dizzying white noise of advisories. They have been developed on the charitable side to minimise variance and provide some certainty of benefit for patients and ease for clinicians. But "do they do what it says on the packet"? This is a perspective and caution on the use of guidelines and pathways and a plea to remember critical thinking and clinical acumen.

    Episode 17 - Under Pressure

    Episode 17 - Under Pressure

    Emergency Medicine is a practice that requires good procedural skills and clinical acumen but also good "soft" skills such as communication and team management but equally importantly self management. Dr Karen Coss, Director of Emergency Medicine at Tamworth Regional Referral Hospital in North Western NSW provides us with the insights she has learned through her reading and personal experience. 

    Episode 15 - The Difficult Consult

    Episode 15 - The Difficult Consult
    • There are many stressful elements to working in the Emergency Department many of them often not related to the patient interaction. One that has to be well up there especially for people who hate confrontation is the “difficult consult”. You ring the inpatient team representative and are faced with obstruction/interrogation/disrespect/anger/sometimes downright bullying……. Dr Tucker is a highly experienced EP including at a departmental management level – so we explore some of his views on this issue and how to manage it.
    IS-EMERCAST
    enDecember 14, 2020

    Episode 14 - Perspective is Key

    Episode 14 - Perspective is Key

    Working as clinicians in the ED, especially in the one ED over time, it's easy to develop a fixed view on life and where you fit in "the system". This is a road to cynicism, pessimism and burn out for many people. Dr Anne Smith provides perspectives balanced by an international career, experience in multiple Australian  EDs and finally but not least from a woman's perspective in the world of Emergency Medicine.

    IS-EMERCAST
    enOctober 27, 2020

    Episode 12 - The Orphan ED

    Episode 12 - The Orphan ED
    A discussion with Dr Peter Smith around some of the issues that face EDs without a range of on site support services. Peter provides the benefits of his insights based on experience as a clinician and a department DIrector.
    IS-EMERCAST
    enSeptember 09, 2020

    Episode 10 - To do or Not to Do? - End of Life

    Episode 10 - To do or Not to Do? - End of Life
    Managing the critically ill patient with multiple co-morbidities is a complex and difficult problem. Patient, family, carers and staff all need care in a busy environment with multiple competing priorities. Here is a way to consider it.
    IS-EMERCAST
    enMay 12, 2020

    Episode 9 - Paediatric Fever - a sensible approach

    Episode 9 - Paediatric Fever - a sensible approach
    This is an open discussion with local expert Dr Simon Binks on how he approaches paediatric fever presentations in practical terms. We cover some of the basic questions around investigation strategies, use of pathways and risk stratification.
    IS-EMERCAST
    enFebruary 27, 2020

    Episode 8 - A Walk in the pARC - paediatric appendicitis

    Episode 8 - A Walk in the pARC - paediatric appendicitis

    Kharbanda AB  et al Development and Validation of a Novel Pediatric Appendicitis Risk Calculator (pARC). Pediatrics 2018 141:4  

    https://pediatrics.aappublications.org/content/pediatrics/early/2018/03/09/peds.2017-2699.full.pdf

    Cotton D et al Validation of the Pediatric Appendicitis Risk Calculator in a Community Emergency Department Setting Ann Emerg Med Vol 74:4 October 2019

    https://www.annemergmed.com/article/S0196-0644(19)30346-4/fulltext

    MD Calc - www.mdcalc.com  

    Episode 7 - Acute Coronary Syndrome - at last some consistency - PACSA

    Episode 6 - The Headache of Headache in ED

    Episode 6 - The Headache of Headache in ED

    D W Dodick - Nosological Entities? Thunderclap Headache.  J Neurol Neurosurg Psychiatry 2002;72:6–11.        https://jnnp.bmj.com/content/72/1/6.info

    Long BJ, Koyfman A. - Benign Headache Management in the Emergency Department

    The Journal of Emergency Medicine, Vol. 54, No. 4, pp. 458–468, 2018

    https://www.jem-journal.com/article/S0736-4679(17)31189-7/fulltext 

    Edlow JA et al  Clinical Policy: Critical Issues in the Evaluation and Management
    of Adult Patients Presenting to the Emergency Department With Acute Headache

    Ann Emerg Med. 2008;52:407-436.  

    https://www.annemergmed.com/article/S0196-0644(08)01463-7/fulltext

    Episode 5 - COPD - who's driving here?

    Episode 5 - COPD - who's driving here?

    Wilson F Abdo and Leo MA Heunks - Oxygen-induced hypercapnia in COPD:myths and facts

    Critical Care 2012, 16:323  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3682248/

    Austin M Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomised controlled trial. BMJ 2010;341:c5462  

    https://www.bmj.com/content/341/bmj.c5462

    Robinson T  The Role of Hypoventilation and Ventilation-Perfusion Redistribution in Oxygen-induced Hypercapnia
    during Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med Vol 161. pp 1524–1529, 2000.  https://www.atsjournals.org/doi/full/10.1164/ajrccm.161.5.9904119?url_ver=Z39.88-2003𝔯_id=ori%3Arid%3Acrossref.org𝔯_dat=cr_pub%3Dpubmed