Podcasts about proppr

In this episode, I have discussed a little bit about some advances in trauma resuscitation, some goals and how ATLS should be the basic trauma skill an emergency physician should have. I did not mean to break any hearts, but yes trauma resus goes beyond ATLS. Do not believe what I say blindly, do your research. You can go through the following mind blowing papers and up your trauma game and prepare your own trauma protocols for your emergency departments. The papers you can go through (not in any order of preference). And these are not exhaustive - 1. Harris T, Davenport R, Mak M, Brohi K. The Evolving Science of Trauma Resuscitation. Emerg Med Clin North Am. 2018 Feb;36(1):85-106. doi: 10.1016/j.emc.2017.08.009. PMID: 29132583. 2. Leibner E, Andreae M, Galvagno SM, Scalea T. Damage control resuscitation. Clin Exp Emerg Med. 2020;7(1):5-13. doi:10.15441/ceem.19.089 3. Carrick MM, Leonard J, Slone DS, Mains CW, Bar-Or D. Hypotensive Resuscitation among Trauma Patients. Biomed Res Int. 2016;2016:8901938. doi: 10.1155/2016/8901938. Epub 2016 Aug 9. PMID: 27595109; PMCID: PMC4993927. 4. https://www.jsomonline.org/References/PDF/Damage_Control_Resuscitation_03_Feb_2017_ID18.pdf 5. Petrosoniak A, Hicks C. Resuscitation Resequenced: A Rational Approach to Patients with Trauma in Shock. Emerg Med Clin North Am. 2018 Feb;36(1):41-60. doi: 10.1016/j.emc.2017.08.005. PMID: 29132581. 6. Mutschler, M., Nienaber, U., Münzberg, M., Wölfl, C., Schoechl, H., Paffrath, T., Bouillon, B., Maegele, M., & TraumaRegister DGU (2013). The Shock Index revisited - a fast guide to transfusion requirement? A retrospective analysis on 21,853 patients derived from the TraumaRegister DGU. Critical care (London, England), 17(4), R172. https://doi.org/10.1186/cc12851 7. Brohi K, Singh J, Heron M, Coats T. Acute traumatic coagulopathy. J Trauma. 2003 Jun;54(6):1127-30. doi: 10.1097/01.TA.0000069184.82147.06. PMID: 12813333. 8. Holcomb JB, Tilley BC, Baraniuk S, Fox EE, Wade CE, Podbielski JM, del Junco DJ, Brasel KJ, Bulger EM, Callcut RA, Cohen MJ, Cotton BA, Fabian TC, Inaba K, Kerby JD, Muskat P, O'Keeffe T, Rizoli S, Robinson BR, Scalea TM, Schreiber MA, Stein DM, Weinberg JA, Callum JL, Hess JR, Matijevic N, Miller CN, Pittet JF, Hoyt DB, Pearson GD, Leroux B, van Belle G; PROPPR Study Group. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA. 2015 Feb 3;313(5):471-82. doi: 10.1001/jama.2015.12. PMID: 25647203; PMCID: PMC4374744. 9. Spahn DR, Bouillon B, Cerny V, Duranteau J, Filipescu D, Hunt BJ, Komadina R, Maegele M, Nardi G, Riddez L, Samama CM, Vincent JL, Rossaint R. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition. Crit Care. 2019 Mar 27;23(1):98. doi: 10.1186/s13054-019-2347-3. PMID: 30917843; PMCID: PMC6436241. 10. Spinella PC, Holcomb JB. Resuscitation and transfusion principles for traumatic hemorrhagic shock. Blood Rev. 2009 Nov;23(6):231-40. doi: 10.1016/j.blre.2009.07.003. Epub 2009 Aug 19. PMID: 19695750; PMCID: PMC3159517. 11. Wiles MD. ATLS: Archaic Trauma Life Support? Anaesthesia. 2015 Aug;70(8):893-7. doi: 10.1111/anae.13166. PMID: 26152249. 12. Mutschler M, Nienaber U, Brockamp T, Wafaisade A, Wyen H, Peiniger S, Paffrath T, Bouillon B, Maegele M; TraumaRegister DGU. A critical reappraisal of the ATLS classification of hypovolaemic shock: does it really reflect clinical reality? Resuscitation. 2013 Mar;84(3):309-13. doi: 10.1016/j.resuscitation.2012.07.012. Epub 2012 Jul 24. PMID: 22835498.

Meet the two Aussie women who went from zero to global in just six months with a very interesting and unique product. In this episode of the MyBusiness Podcast, our editor Maja Garaca Djurdjevic speaks to Zhenya Gerson and Jacqueline Weiley, the owners of PROPPR - an Australian-made and designed luxury foot stool that has taken the world, and Gwyneth Paltrow, by storm. Tune in to hear how these women took a frail business, capitalised on its uniqueness and the very important issue of gut health, and turned it into a global success, winning a Good Design Award for innovation in the process. Full of passion and energy, Zhenya and Jacqueline talk about the ins and outs of running a business, the importance of celebrating small victories, the impacts of COVID on business, and more.

Zhenya Gerson had a goal when she established Exhale Wellness Spa - to create a space for people to relax, be nourished and supported through whatever health issues they may be experiencing. She is deeply passionate about helping people with their gut health, making it easier to get through their day, to think more clearly, and avoid the ‘tummy rumble’ in middle of that important meeting with your boss. Colonics are not just for those with tummy troubles, they have so many benefits. Zhenya has been a long-term and passionate advocate for the use of a footstool when doing your ‘bathroom business’ and was introduced to the PROPPR.  She immediately loved its sleek and attractive design and the clinic soon became a stockist. THEN .... the Proppr Products business was listed on the market. Fast forward a few months and Zhenya is now the co-owner of the PROPPR with business partner Jacqueline. In this interview Zhenya speaks candidly about her business journey - both her Wellness Spa as well as now owning a product business. www.theproppr.com  www.exhale.net.au @exhalewellness @theproppr This episode is brought to you by my book "So You Want to Start a Business; the 7 steps to create, start and grow your own business" and you can order your FREE copy right here: http://bit.ly/ThatBook This is the only advertising on this podcast! My guess is that you are here for one of 2 reasons: Are you curious about what it’s like to start a business? Do you wonder if you have what it takes? Would your idea work? How much does it actually coss to build a successful business? OR Have you been in business for a few months or a year or 2 and things aren't going quite the way you thought they might? I’ve written this book to answer pretty much all of your questions “So You Want to Start a Business” and you can order your FREE copy right here: http://bit.ly/ThatBook My 15 years of experience working with start up and small businesses are condensed into this book. This is your step by step guide to launch your business smarter and faster. It’s so exciting to be sharing it with you. Please share your progress If you prefer the kindle Head over to Amazon Happy reading!

Zhenya is, an I-ACT Certified Colon Hydrotherapist, with Level 2 study and certification, Holistic Nutritionist, Wellness Consultant and Yoga Instructor with 16 years in the wellness industry, is driven to empower people to be aware of their own bodies, to live a healthy life and make conscious decisions about their own health and for their personal wellbeing. Zhenya is also the co-owner of Proppr - which is an elegant australian designed footstool to get you in the Proppr position for your next trip to the bathroom._______________ Social & Website Links:https://exhale.net.au/ https://www.instagram.com/exhalewellness/ https://theproppr.com/ https://www.instagram.com/theproppr/ _______________ Topics include: What is an enema? The difference between enemas and colonics When or why someone would choose to do an enema over a colonic Different types of enemas and why choose one over the other Who enemas are a good idea for and who should not be doing enemas A walk through exactly how to perform one at home Diet prep leading up to enema Frequency to avoid dependency or damage to the gut Risks associated with doing them at home When purchasing an enema kit what the do's and don't s are A few bonus Christmas tips to stay on track _________ Resources/links mentioned in the podcast: Enema kits: https://lovethyself.com.au/detox/enema-kits/ https://www.happybumco.com.au/ DIY enemas resources: https://www.nursingtimes.net/clinical-archive/gastroenterology/how-to-administer-an-enema-16-05-2006/  

Zhenya Gerson is an I-ACT Certified Colon Hydrotherapist, with Level 2 study and certification, Holistic Nutritionist, Wellness Consultant and Yoga Instructor with 16 years in the wellness industry, is driven to empower people to be aware of their own bodies, to live a healthy life and make conscious decisions about their own health and for their personal wellbeing. Zhenya is also the co-founder of Proppr - which is an elegant australian designed footstool to get you in the Proppr position for your next trip to the bathroom. Topics Include: Zhenya's journey into colon hydrotherapy Colon hydrotherapy 101 What ACTUALLY happens in a session Different types and what to look for Who should be getting colonics How often you should go Can you go too much? Tips on finding a good colon hydrotherapist Contraindications and cautions  HOW we should be pooping The power of footstools The best footstool on the market and how you can access it Links and where to find out more about Zhenya, and the Proppr: https://exhale.net.au/ https://www.instagram.com/exhalewellness/ https://theproppr.com/ https://www.instagram.com/theproppr/  

So as promised, and following on from our previous shock episode, this time we've covered the topic of shock in Trauma. It's a massive topic and one that we all, yet again, can make a huge difference for our patients' outcomes.  There is some crossover as you'd expect from the concepts and assessment that we covered in our Shock episode, so we'd recommend taking a listen to that one first. Make sure you have a comfy seat and plenty of refreshments to keep you going for this one as we cover the following; Definition Aetiology Hypovolaemic shock Neurogenic shock Obstructive shock Cardiogenic shock Physiology; Traumatic coagulopathy Other diagnostics Controlling external haemorrhage Pelvic binders REBOA Avoiding coagulopathy BP targets & permissive hypotension Fluid choices & supporting evidence TEG/ROTEM Calcium TXA Vasopressors Preventing hypothermia Relieving obstruction Interventional radiology Damage control surgery As always we’d love to hear any thoughts or comments you have on the website and via twitter, and make sure you take a look at the references and guidelines linked below to draw your own conclusions. Enjoy! Simon, Rob & James References Shock;The Resus Room podcast REBOA;The Resus Room podcast External Haemorrhage;The Resus Room podcast Blood;PHEMCAST TEG & ROTEM;FOAMcast Major Trauma guideline;NICE Resuscitative endovascular balloon occlusion of the aorta (REBOA):a population based gap analysis of trauma patients in England and Wales Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma. Joseph B. JAMA Surg. 2019 The Pre-hospital Management of Pelvic Fractures: Initial Consensus Statement. I Scott. FPHC. 2012 RePHILL;Birmingham University Trials Assessment and Treatment of Spinal Cord Injuries and Neurogenic Shock;Fox A. JEMS Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. Holcomb JB. JAMA. 2015 Risks and benefitsof hypotensive resuscitation in patients with traumatic hemorrhagic shock: a meta-analysis. Owattanapanich N. Scand J Trauma Resusc Emerg Med. 2018 The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients.Roberts I. Health Technol Assess. 2013 TEG and ROTEM for diagnosing trauma‑induced coagulopathy (disorder of the clotting system) in adult trauma patients with bleeding;Cochrane Review. 2015  Optimal Dose, Timing and Ratio of Blood Products in Massive Transfusion: Results from a Systematic Review.McQuilten ZK. Transfus Med Rev. 2018 Prehospital Plasma during Air Medical Transport in Trauma Patients at Risk for Hemorrhagic Shock.Sperry JL. N Engl J Med. 2018

El debate de cuál es el mejor fluido intravenoso sintético lleva más de 40 años y parece que nunca se va a acabar. El debate de cuál es el mejor fluido en la resucitación del paciente que está sangrando, entre sangre versus cristaloides, la respuesta es sangre. Pero el debate de qué tan rápido debe comenzar la transfusión está tan claro como la sangre. En trauma hay 4 preguntas esenciales: ¿Cuál es el problema del paciente? ¿Cuál es el tratamiento definitivo para ese problema? ¿Dónde tiene que estar el paciente para recibir ese tratamiento? ¿Qué debemos hacer entre ahora y cuando llegue allí? De este otro episodio del ECCpodcast sobre el protocolo de transfusión masiva, La meta en el manejo del paciente que requiere resucitación con fluidos es: Detener el sangrado El tratamiento con fluidos no debe retrasar el control definitivo del sangrado. Restablecer el volumen circulante La sangre no se mueve fácilmente cuando los vasos sanguíneos están colapsados. Es necesario mantener cierto tono vascular para facilitar el flujo. Mantener la composición normal de la sangre El término «sangre» es el colectivo de varios componentes que llevan a cabo tareas diferentes. Este líquido está compuesto de elementos que sirven para producir hemostasis (plaquetas), otros que transportan oxígeno (hemoglobina), otros que mantienen la presión oncótica (plasma) y electrolitos asociados. La pérdida de sangre produce la pérdida equitativa de estos componentes. Es decir, el hemograma de una persona agudamente y activamente sangrando no muestra un desequilibrio en los primeros minutos u horas porque se está perdiendo una cantidad igual de componentes. El problema ocurre cuando se reemplazan estos componentes. Hay que reemplazarlos todos. Si se provee solamente Lactato de Ringer (o cloruro de sodio), el hematocrito va a disminuir porque va a haber menos glóbulos rojos en la solución…¡los estás diluyendo! A través del XABCDE del PHTLS, los principios básicos del manejo hoy día del paciente en shock hemorrágico consisten en: Resucitación controlada con cristaloides Resuscitación hemostática con productos sanguíneos Control inmediato del sangrado JAMA 2015 (PROPPR) - Transfundir 1:1:1 El estudio PROPPR publicado en el 2015 recomienda la administración de fluidos a una proporción de 1:1:1. Como resultado, cada vez más se busca poder comenzar la reanimación temprana con plasma versus cristaloides. Sangre... ¡ahora!

Drs. Don Jenkins and Michelle Price from the National Trauma Institute introduce the National Trauma Research Repository (NTRR) an exciting new undertaking that aims to combine data from previous and future trauma research sources, such as PROPPR, PROMMTT, the Glue Grant, DOD, etc.  They also discuss how researchers can access these data and contribute their own data to the ever-growing repository.  Got a project idea for a large national database? Check out NTRR to see if this could work for you.  Disclaimer Statement:The National Trauma Research Repository is sponsored by the Department of the Army, Prime award #W81XWH-15.2.0089. The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD21702-5014 is the awarding and administering acquisition office. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the view of the Department of the Army or the Department of Defense.  

The lead paper is by Dr. Junichi Inoue and colleagues from the Tokyo Medical University who analyze the Japan Trauma Data Bank to determine the impact of REBOA. The next paper is by Dr. Vicente Undurraga and colleagues from the PROPPR group. In this subgroup the authors selected patients requiring emergency laparotomy, defined as within 90 minutes of hospital arrival, with the hypothesis that this high risk group would be most likely to benefit from an initial 1:1:1 transfusion strategy. The next paper by Dr. Shibani Pati and colleagues from the University of California at San Francisco and colleagues from Portland and Houston, examine the type of plasma to deliver to attenuate the endotheliopathy of trauma. Finally, I believe another timely report is by Dr. James Byrne and associates from the University of Toronto who analyze the impact of EMS prehospital times on trauma center outcome. Transcript

Welcome to the April issue of the Journal. The lead paper is by Dr. Junichi Inoue and colleagues from the Tokyo Medical University who analyze the Japan Trauma Data Bank to determine the impact of REBOA. REBOA has been used in Japan since 1990 and the national data bank was established in 2003. The next paper is by Dr. Vicente Undurraga and colleagues from the PROPPR group. In this subgroup the authors selected patients requiring emergency laparotomy, defined as within 90 minutes of hospital arrival, with the hypothesis that this high risk group would be most likely to benefit from an initial 1:1:1 transfusion strategy. The next paper by Dr. Shibani Pati and colleagues from the University of California at San Francisco and colleagues from Portland and Houston, examine the type of plasma to deliver to attenuate the endotheliopathy of trauma. Finally, I believe another timely report is by Dr. James Byrne and associates from the University of Toronto who analyze the impact of EMS prehospital times on trauma center outcome. The authors linked EMS data from the National EMS Information System to trauma centers using ACS TQIP by destination zip code. Transcript

Episode 7 Dr. John Holcomb former Army surgeon, now  Professor of Surgery at UT Houston where he also serves as Chief of Acute Care Surgery, and Director of  Center for Translational Injury Research.   On the Podcast he discusses (All Things Trauma) -Taking care of soldier in Mogadishu, during the Blackhawk down incident -Being lead author of PROPPR trial, and what we can really take away from this  -Massive resuscitation with blood products   -Using thromboelastography to guide resuscitation

The biggest news in the management of traumatic hemorrhage is the PROPPR Trial. Want to hear from the lead author?