Podfour's podcast

Part two identifies the different adjuncts used for intubation, some of the medications used for intubation and reversal, positioning and briefly touches on tracheostomy.

Join myself and Sally as we dive into advanced respiratory management with Dr Neil Greensmith and Dr Ravi Mistry. In Part One we cover who you might need for intubation, the use of checklists, medication, staff and optimal patient positioning. I loved this conversation and we hope you get as mch out of it as we did.

Today we welcome Dr Eve Purdy to talk about teamwork in emergent situations in critical care. Teamwork is an essential aspect of all areas of health care and we loved gaining an understanding about what makes teams function effectively.   Readings as recommended by Eve include The Culture Code by Daniel Coyle https://danielcoyle.com/the-culture-code/ and Teams that Work by Edwardo Salas https://www.teamsthatwork.com/  

Join us as we chat to Dr Liz Crowe about unprofessional behaviour in healthcare. If anyone would like to listen to any further podcasts from Liz, her odcast https://fivethingsnursing.podbean.com/ is available on your streaming platforms.

Whilst not common complications during pregnancy and birth can be quite serious, requiring admission to ICU. Sally Byford (Obstetrician/gynaecologist) joins us today to talk about these complications and how we might manage them. This episode may be triggering for some people as it touches on infant and maternal death.

Simulation refers to an artificial interpretation of real world processess and is used as an educational tool within the healthcare setting. Join Sally and Kahl as we chat to Jack Matulich who works within the simulation team and Angela who is a nurse educator within the ICU. They enlighten us around the process of simulation and how it can be used as a learning tool within the hospital setting.

Whilst we are all familiar with the components of cardiac output. Cardiac output = Heart rate x Stroke volume, in this months podcast Harley and myself chat to Dr Ravi Mistry about how each element of cardiac output is manipulated in the intensive care using drugs and other adjuncts.

Approximately 1-5% of patients are admitted to ICU for liver failure. The liver can be the initiator of remote organ damage and the development of multiple organ dysfunction syndrome during liver injury, therefore requiring the support of multiple organs in the intensive care unit.   Join Kahli and Sally as we talk to Jack Simpson, ICU intensivist, about all things liver failure and how we manage it in ICU.

Renal Replacement Therapy (RRT) is a complex treatment for patients both in and out of the ICU environment.  There are multiple different modes, machines and functions and this episode is about addressing the confusion and answering all your questions in relation to RRT. Below are the links to articles referred to throughout the podcast Systematic review and meta-analysis of renal replacement therapy modalities for acute kidney injury in the intensive care unit   https://eds.p.ebscohost.com/eds/viewarticle/render?data=dGJyMPPp44rp2%2fdV0%2bnjisfk5Ie46a9Ir66yUbWk63nn5Kx94um%2bUa2orkewprBKnqy4SbSws1Get8s%2b8ujfhvHX4Yzn5eyB4rOvUbSnrkmyr7dKpOnnfLvbsEvfp7RRtaOufeKtq0y2qbJF4KzjS6vasU7iqLd7sKy3ed%2b28H3i3%2fE%2b6tfsf7vb7D7i2Lt94unjhO6c8nnls79mpNfsVdGmtlCxr7JMr6e1S66ntUq1nOSH8OPfjLvc84Tq6uOQ8gAA&vid=0&sid=e23a1697-0ed7-4834-b6e3-d36d29c269aa@redis     Comparing Renal Replacement Therapy Modalities in Critically ill Patients with Acute Kidney Injury:  A Systematic Review and Network Meta-Analysis   https://eds.p.ebscohost.com/eds/viewarticle/render?data=dGJyMPPp44rp2%2fdV0%2bnjisfk5Ie46a9Ir66yUbWk63nn5Kx94um%2bUa2orkewprBKnqy4SbSws1Get8s%2b8ujfhvHX4Yzn5eyB4rOvUbSnrkmyr7dKpOnnfLvbsEvfp7RRtaOufeKtq0y2qbJF4KzjS6vasU7iqLd7sKy3ed%2b28H3i3%2fE%2b6tfsf7vb7D7i2Lt94unih%2bic8nnls79mpNfsVePa8Xzt4KxPsq7gS7CqsXmvq7BMr6%2fjULCn4H6z265%2br6yyS6%2fc5D7k5fCF3%2bq7fvPi6ozj7vIA&vid=1&sid=e23a1697-0ed7-4834-b6e3-d36d29c269aa@redis   Effect of sustained low efficient dialysis versus continuous renal replacement therapy on renal recovery after acute kidney injury in the intensive care unit   https://eds.p.ebscohost.com/eds/viewarticle/render?data=dGJyMPPp44rp2%2fdV0%2bnjisfk5Ie46a9Ir66yUbWk63nn5Kx94um%2bUa2orkewprBKnqy4SbSws1Get8s%2b8ujfhvHX4Yzn5eyB4rOvUbSnrkmyr7dKpOnnfLvbsEvfp7RRtaOufeKtq0y2qbJF4KzjS6vasU7iqLd7sKy3ed%2b28H3i3%2fE%2b6tfsf7vb7D7i2LuF4tmkjN%2fdu1nMnN%2bGu6i2SbCutlCvnOSH8OPfjLvc84Tq6uOQ8gAA&vid=5&sid=e23a1697-0ed7-4834-b6e3-d36d29c269aa@redis

Diabetes has a prevalence of 1.2million people in Australia and places a massive burden on the healthcare system. Today we have Daniel Jones who is a resident at Tweed Heads hospital in to talk about diabetes, from diagnosis through to management. Hope you enjoy 

Ventilation is the bread and butter of Intensive Care but how do we liberate a patient from the ventilator?  Join us for a discussion where we identify how to wean a patient from the ventilator, the role of physiotherapists in assisting with this weaning and tackling some basic ventilation questions.

Yes i know this sounds niche, but anti-arrythmics are commonly used within the hospital and Intensive care setting and come in a multitude of different classes. Senior pharmacist Dan Adams and Senior ICU registrar Jay Mahendra Ray join us to talk about different arrhythmias and the different classes of anti-arrythmics we use in ICU.

 Ketogenic diet in refractory seizures, this episode whilst niche was so interesting to learn about. With our guests Damien (ICU registrar) and Lisa (Dietician) we delve into ketosis and what that means for our seizing patients.

This month we have Dr Mat Brun with us to discuss ARDs.  We run through how ARDs develops and the different treatment options available within the ICU.

Pancreatitis is an inflammatory condition of the pancreas which causes the activation of pancreatic enzymes that causes destruction of the pancreas itself.  In this episode of Podfour we chat to Dr David Parker an upper GI surgeon and Dr Angelley Martinez an ICU intensivist about the care and management of pancreatitis throughout the patients journey from admission to discharge.

Sepsis and septic shock are leading causes of death worldwide as identified by the Surviving Sepsis Campaign which initiated the implementation of the surviving sepsis campaign bundles in an effort to reduce morbidity and mortality. Intensivist Peter Velloza joins us to talk about sepsis in general and within the ICU.

The acute pain service is a multidisciplinary team specialised in addressing acute pain in patients within the hospital. Alongside this service runs an opioid stewardship program which addresses the misuse of opioids and pain medications not just within the hospital but within the community. We were privileged to have Dr Yvette McKellar who is a senior staff specialist anaesthetist and clinical lead of the Acute pain team, Andrea Freeman who is a CNC within the acute pain team and James Alderson who is the lead pharmacist for the surgical division and secretary of the opioid stewardship working group. We hope you enjoy :)

Occupational therapists work with sick, injured or disabled patients by helping to develop, recover, improve as well as maintain the skills needed for every day living. In an ICU setting where does occupational therapy fit in? We talk to senior occupational therapist Alexandra Walters about what occupational therapy can offer to patients in ICU.

Cardiac Advanced Life Support (CALS) is a course   that covers the management of the deteriorating and/or arresting patient following cardiac surgery. The CALS algorithm is considered the standard to optimally manage an arresting cardiothoracic patient and this podcast will explore the elements of this protocol. Join us as we chat to Dr Chris Hebel an ICU intensivist who runs the CALS course at GCUH and Sarah Croton, ICU CN who assists with the CALS course and has also been involved in multiple re-opens. Please find below the CALS algorithm...  

The subject of recreational drugs might be a bit taboo, but working within the ICU there are a large number of patients who either incidentally or purposefully overdose or have a history of drug abuse. Our senior pharmacist Dan explores the different types of drugs typically used by our patients, which receptors these drugs work on and the effects they can have on our patients. 

Subarachnoid haemorrhage (SAH) is the sudden leaking of a blood vessel in the subarachnoid space in the brain. We chat to Dr Teresa Withers the director of neurosurgery at GCUH and Angelly Martinez, ICU Intensivist about all things SAH. We follow a case study from medical history, presentation, interventions and management in ICU. We were really looking forward to this chat and it did not disappoint. We hope you can learn a few things from this one and it can shed some light on the management of SAH and why it is so important. Enjoy 

The trauma team is a specialised team within Gold Coast University Hospital that provide care to trauma patients from pre-admission to post discharge. In ICU we catch a brief glimpse of the initial phases of care for trauma patients before they are stepped down to the ward. The trauma team follow these patients through all aspects of their admission from their arrival in ED, theatre, ICU, ward and then transfer home. Join us as we unpack the role of the trauma team, led by Bhavik Patel consultant surgeon for acute care and trauma surgery.

Today we gain an insight into the ICU experience through the eyes of the patient. With us we have Jess Eels and Tony Wilson who are both nurses within our ICU but have also been on the other side as a patient. Their experiences are eye opening to us as nursing/medical staff and help to guide how we nurse our patients that are sedated and intubated.

Extracorporeal membrane oxygenation (ECMO) is a technique which provides cardiac and respiratory support to people who's heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life. Dr James Winearls along with ECMO CN Jacquie Whincup and fellow CN Lisa Mackie are around the table today to talk all things ECMO and to delve into the retrieval process.

Delirium is defined as a disturbance in mental abilities that results in confused thinking and reduced awareness of surroundings. In ICU we focus on prevention strategies instead of treatment of delirium. This episode we have Senior physiotherapist Lauren and CNC Niki to discuss strategies that are used to prevent delirium.

Diabetic ketoacidosis (DKA) is a serious diabetic complication that, when severe is often seen in Intensive care. ICU registrar Ivan Basic gives us an insight into this condition and how to manage it within the ICU.

If you do not work in the Intensive care or Emergency department, organ donation can be a foreign concept. Today we chat with Mandy who is the organ donation coordinator for the Gold Coast. Just in time for donation awareness week at the end of July.   https://donatelife.gov.au  

Part Two of this episode focuses on valvular surgery such as valve replacement/repair for issues such as stenosis and regurgitation. We also look at nursing care of a cardiothoracic patient post op.

In Part one of this episode i chat with Jucel a registered nurse within the ICU and Sylvio Provenzano one of GCUH's cardiothoracic surgeons about Coronary Artery Bypass Grafts (CABG), cannulation for bypass and the bypass machine itself. 

Shock results from inadequate perfusion tissues, leading to a decrease in the supply of oxygen and vital nutrients needed to maintain cellular metabolism. Dr Matt Brun and Jacquie Dwyer join us to chat about all the different classifications of shock and how we can identify and treat within the ICU.

Traumatic Brain Injury is an insult to the brain caused by trauma that results in neurological dysfunction. Sal and i have a chat to neurosurgical registrar Tom about TBI's and the management and prevention of secondary injury in the intensive care unit.

 Continuous Renal Replacement Therapy (CRRT) involves pumping blood through a dialysis circuit. When the blood comes in contact with this surface it tends to clot which is why we anticoagulate blood that is being dialysed. CRRT involves and extended period of treatment at slower blood pump rates and is therefore more likely to clot. Citrate has quickly become the gold standard for anticoagulation due to the limited adverse events and a decrease in cost compared to the use of heparin. Citrate works by binding to ionised calcium therefore rendering it unable to perform in the clotting cascade. GCUH will be rolling out citrate for CRRT in November, so we had a chat to the driving force behind this Lisa Gray (Nursing educator) and Matt Ostwald (ICU Consultant).

Acute respiratory failure is the inability of the respiratory system to maintain gas exchange and is a popular occurrence in the Intensive Care Environment. During this episode of the podcast myself (Kahli), Sally, James and Andi talk about the definition of respiratory failure, along with the different types (Type 1 and type 2) and the common disorders that can lead to respiratory failure. We also address the clinical assessment of respiratory failure and what is expected of the ICU nurse as well as the different treatment options there are for respiratory failure.   Below is the Cochrane review we discussed in regards to incentive spirometry in the ICU patient post cardiac surgery. https://doi.org/10.1002/14651858.CD004466.pub3   :)  

A pressure injury is any breach in skin integrity caused by the failure to relieve pressure, most commonly found in areas covering bony prominences. The Intensive Care Department (ICU) has the highest incidence rate of pressure injuries within the hospital system, due to a multitude of factors which ultimately decrease the skin integrity of these patients. Due to impaired skin integrity ICU patients are at a very high risk of developing pressure injuries and relieving the pressure is often not a simple solution due to the acuity of the illness, such as patients who are respiratory or cardiovascularly unstable, centrally cannulized ECMO patients and spinal and complex pelvic fractures. Along with the vast array of medications such as high dose steroids and inotropes which decrease skin integrity. This episode aims to look at the different stages/classifications of pressure injuries, the multiple adjuncts we can use to assist in relieving pressure, documentation of pressure injuries and what dressings (if any) are the best to use. Please join myself Kahli, Sally, Andi and Tannah as we delve into the world of pressure injuries.