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Start some initial treatment, some pain relief, some anti-platelet therapy, that sort of thing. Make sure that we've got an ECG and other investigations as we need them. And probably once we've started that, and once you've contacted the local SMO for some help, that's probably the time to start thinking about the next... |
And inevitably, these patients do evolve. And so identifying that early is very useful. All right, that's excellent advice. So what are some of the considerations that the retrieval team needs to make in terms of how they transport trauma patients? Let's talk perhaps specifically about this patient who appears to have ... |
Okay, welcome everyone to On The Wards. Today we have Safe Professor Shabel Sandrisa with us. Welcome Shabel. Thank you. Thank you for asking me to participate. So look, we're doing something I think most junior doctors don't know much about. I know as a senior doctor I don't know much about, is nutrition. So we're goi... |
There are other surgical things, patients with enterocutaneous fistulas, delayed gastric emptying, and to have those who have abdominal surgical complications which prevent them from having food entered via a normal route. And then there are people who don't have enough intestine and they have short bowel syndrome and ... |
Welcome to On The Wards, it's James Edwards and today we're talking about interviewing, well we have Dr. Sarah Dalton with us. Welcome Sarah. Hello James. Sarah is a regular on the wards and it's a consultant paediatric emergency physician and also currently the president for the division of paediatrics and child healt... |
The next question that often comes is something like, and why do you actually want the job? And I think that both those are a good opportunity. You really, in my book, you really need to be prepared to answer those questions. Because the first one gives you an opportunity to showcase what you think is the specific thin... |
So if you've showed your clinical ability in other ways that feed into the interview, it might be the interview panel don't want to hear that. But on the other hand, using a clinical scenario can actually give people a sense of what experience you've had, how you would approach a problem, but also perhaps an insight in... |
I think that's right and in fact when you're asked the question of why do you want this job, which could be the second question like we talked about before, I think it's not just a matter of saying I want it because it's good for me. I mean I think that that's of course why we want the job and that's inevitable and it ... |
Welcome to On The Wards. It's James Dent and today we're talking about clinical pathology with Dr. Robert Rawson. Welcome Robert. Thanks James, nice to be here. So Robert's a pathologist at Royal Prince Alfred Hospital. He's worked around Sydney and around Australia, most recently up in Darwin and has returned back to ... |
So it's fixed usually in formalin. And then it goes under a series of chemical processing steps to make the specimen stable so it can be stored and looked at for a long time. And that often happens overnight. And after that, the tissue is placed in a block of wax. It's cut very, very thinly, so thin enough so we can sh... |
We really look at microbiology and serology as well. We're always checking PowerChart and seeing how our findings sort of interact with other findings from other pathologists and clinicians. Okay. Now, some of the results I suspect that you get on patients have implications for those patients' families. So how do you a... |
So, Rob, look, thank you very much for doing this with me today. I, as an emergency physician, am often quite removed from this area of medicine, but nonetheless always find it fascinating. So thank you for shining a light on it, and I've certainly learned learned a lot. No problems thanks for having me. Thanks for lis... |
Okay, so welcome to On The Wards, it's Tom Aiton. Today we're talking about a new way of reconstructing the eyelids, which is commonly indicated following skin cancer removal with Dr. Michelle Sun. This podcast is produced in collaboration with Avant, a proud partner of On The Wards. Welcome, Michelle. So Michelle has ... |
The other thing is that, you know, anything to progress to human trials takes not just time but a lot of checks and balances. So you need to make sure, I see that it's compatible in animals. You need to make sure all your materials are FDA approved, TGA approved. So all those things make it quite slow. So it's definite... |
Welcome to On The Wards. It's James Edwards and today we're talking about approaching biomedical research and interpreting the data. I'd like to welcome Professor John Myberg. Welcome, John. Thank you, James. Professor Myberg is an intensive care consultant at St George Hospital in Sydney, also a professor of intensive... |
More importantly we collaborated with our colleagues and friends in Scandinavia and in the United Kingdom and in Saudi Arabia and we had more generalizability across different health systems, even though Scandinavia, United Kingdom, Australia, and New Zealand are similar systems. And we saw some differences in mortalit... |
Whether it's a survey or a case report or a case series. To take one message at a time to inform clinicians. And don't over editorialise and don't over speculate. And keep it simple. It's important. Surveys are important, but survey design is a science. You can do a survey and get the answer to any question you want to... |
Hey, and welcome to the On The Wards podcast. My name is Eli Mattar, and I'm joined today by my good friend and colleague, Dr. Arby Powell. It's our first international edition of the On The Wards podcast. We're recording from the United Kingdom in London. Today, we're going to be talking about overseas fellowships. So... |
So Australians will go to places like the US, Canada or the UK. And that's a fairly simple decision because the US requires licensing examinations. Canada requires a weather change. The UK requires GMC. So just thinking about which country you want to go to and that's probably guided by the centre you want to go to. So... |
And the reality is when I've come to the UK, I've realized there are so many more opportunities that I didn't even know about. So the best advice that I can give is that talk to someone who's been overseas, talk to someone who's been in the unit or near the unit, and so you can work out what options are available becau... |
Welcome to On The Wards, it's James Edwards here again. We have a podcast today on identifying the sick patient and we're the pleasure of welcoming Dr. Olly. Welcome, Ollie. Hi, James. Thanks for having me. Ollie is an intensivist at Royal North Shore Hospital in Sydney, also is the founder of the Intensive Care Networ... |
They might be assumed that that's what their baseline mental status is like, but it's altered and that can be a significant factor. For example, if someone's hyponatremic and they're acutely delirious, they might just have a slightly altered mental state, but that might be the only finding you have. Yeah, I think, yeah... |
Welcome to On The Wards. My name is Michael Seker and I'm an intern at RPA. I'm speaking to Dr. Rewa Keegan today about planning an operating list. Rewa is a general surgeon and is currently working as a surgical superintendent here at RPA. Welcome Rewa. Thanks for having me. So we're going to start with a scenario. Yo... |
So for example, the easiest surgical case on the list may be the most anaesthetically complicated. They might have a difficult airway. And so a balance needs to be found between the priorities of the two teams. The anaesthetist is obviously very important in the pre-admissions process. So usually once the patient has s... |
Okay, thank you very much Rewa for speaking to our listeners today. No worries. Bye. |
Welcome to On The Wards and it's James Edwards and I'm here again and we're talking today about stroke and I have Dr. Alice Maher. Welcome Alice. Thank you. Now Alice, you've got a bit of a different background, trained in ICU and neurology and now you're doing a neuro-interventional fellowship at Royal North Shore. Ye... |
And then there's different subtypes of ischemic and hemorrhagic strokes. So the main thing is in simple terms whether there's a blockage of a vessel or there's bleeding into the brain and we treat them quite differently. Most strokes are ischemic about 80% and we need to give these patients medication that opens up the... |
But rehab is an ongoing process and as we understand more about neuroplasticity, we would have our patients continue to participate in rehab programs for many months down the track. So I think it's a really good, I guess, an outline, which is a very big subject, looking at stroke. Do you have any kind of final take-hom... |
Hi, I'm Anna McLean, one of the Respiratory Registrars at RPA, and I'll be talking today with Dr Laura Glenn, a fellow Respiratory Registrar with me at RPA. Hi, Laura, and thank you for being involved in this podcast. We'll be discussing how to recognise the deteriorating respiratory patient in the context of the COVID... |
Is there anything you would do now immediately for this patient, Laura? And what other investigations do you think you'd do to help you initiate management in this patient? Okay, so at the bedside, I would recheck and continue to monitor the patient's oxygenation by checking their oxygen saturation with a pulse oximete... |
Number three, escalate early if concerned and number four, if you are worried or you don't know what to do, please know who to call and how to call them. We're all here to help and we should all be working together to get through this. Yeah, I think they're four very important points. Thank you, Laura. Finally, there a... |
Welcome to On The Wards, it's James Edwards and I have the pleasure of welcoming back Dr. Paul Hamer. Very glad to be back,, James. Paul, as many of you know, is the DPET here at RPO. He's also a respiratory physician and has spoken to us on a number of occasions about respiratory topics, and one of them was non-invasi... |
You might want to have a listen to the heart and see if she's got any signs of pulmonary hypertension, such as a loud P2, that might be co-contributing. They're the main things I'd be looking at in this lady. You get a bit more information. It sounds like she has had a chronic cough, which you state is unchanged. And o... |
Look, this guy's much sicker. I mean, he's already saturating or requiring six litres of oxygen and he's only saturating at 90%. So if he gets a little bit worse, you're going to run into trouble. So he's almost at the level that he needs to go to intensive care for observation. He's had a fever, which suggests that th... |
Welcome to On The Wards, it's James Edmondson today. We're talking a very important topic of consent and we'd like to invite one of our partner organisations, AVAR, and two guests from AVAR, Georgie Hasem and Dr Jane Hingham. Welcome Georgie and Jane. Thanks James. Georgie is the Head of Research, Education and Advocac... |
So putting your arm out for a cannula put in or something like that would be sufficient implied consent for a procedure. Another important thing in that regard though is that you document consent. So if it's not an express consent form, you should still document that a patient has consented to having an intervention. A... |
Welcome to On The Wards, it's James Edwards and today we're talking about the concerning and scary post-operative airway problem and we welcome Dr. Timato. Welcome, Tim. Thank you for having me. Tim's our anaesthetist at Nepean Hospital in Sydney. And we're going to go to an initial overview of how would you define a p... |
Certainly major head and neck surgeries. A lot of the patients will go to intensive care anyway to begin with. They might have an elective tracheostomy that's done during the procedure. Things like anterior cervical decompression infusions, the surgeries where you've got shared airways, adenotonsillectomies, or even di... |
Okay, welcome everyone to On The Wards. It's James Edwards and it's March 2015 and today we have Dr. David Joe, an upper GI surgeon and transplant surgeon here at Rupert and Salvatore Hospital and he's going to talk about surgical drains. Welcome David. Thanks for having me James. Look we may just ask some general ques... |
And so you want to examine the abdomen, make sure they have a soft and non-tender abdomen. Sometimes it's difficult to assess when someone's had recent surgery, but you do want to assess whether they've got any peritonism, because if there is bile in a drain, it might mean that the bile is not only in the drain, but it... |
It's an area whereby there's going to be bugs from the skin which have been able to at least superficially infiltrate the area. So I think you don't want to generally suture it. Sometimes if a chest drain comes out, you do put a suture in because you want to ensure that there's no pneumothorax, that no gas goes in, par... |
Okay, welcome to On The Wards, it's James Edwards and today we're doing something a bit different. Rather than talking about a clinical topic, we're going to talk about what makes a good junior doctor. And we've invited a number of different people today. We've invited Ken Liu, who's our liver transplant fellow. Welcom... |
This is how you need to do it. Do you know what I mean? And we're okay with that. Like, we would rather that and know that it's done correctly for the patient than it just not be done or we have to wait four hours or something for it to be done and just get frustrated. I mean, I know it's a fine line between asking for... |
Yeah. Maybe you should have called me before. Yeah, that's right. Do you say that or do you think that? I mean, we do say it. And obviously, I mean, there are certain types of discharges where something will come up all of a sudden and we understand that when things need to happen happen but when it's being planned and... |
Just communication, be approachable, hard-working and ask questions. It's okay to ask questions. And the point you said that everyone's here for the same focus and just for patient care so just remembering that at the end of the day and being open to raise concerns themselves because a concern may not be about them it ... |
Welcome to On The Wallwards, it's James Edwards and today I'm not talking but we have an invited interviewer, Dr Bruce Way. Welcome Bruce. Thanks James, it's good to be here. So Bruce is similar to me, he's an emergency physician, works at Prince of Wales Hospital in the eastern suburbs of Sydney, not far from Bondi Be... |
And in the army, they teach soldiers to do this tactical breathing where you breathe in for three or four seconds, you hold it for three or four seconds, breathe out for four seconds and then hold it. And you just keep doing that box breathing and it will slow your mind a little bit and actually allow you to focus a li... |
So when a patient isn't traveling according to what you expect or when something is just not quite right and the sense of not quite right is something that improves as you get more experience. So often you'll hear consultants and registrars kind of you'll see them smelling a rat they'll identify something is wrong and ... |
Okay, welcome everybody to On The Wards. It's James Edwards and today I have the pleasure of speaking with Dr. Nhi Nguyen. Welcome Nhi. Good morning James. Nhi is an intensive care specialist at Nepean Hospital, also the Director of Pre-Vacational Education and Training and an obstetric physician. So very well placed t... |
The one thing that may impact is what their shivers are. So certainly we didn't mention earlier, but hypoglycemia can certainly cause seizures. And there's an increasing number of patients who develop gestational diabetes during pregnancy. And during delivery, they're often managed with an insulin dextrose infusion bec... |
If the obstetric physicians aren't available, then certainly the next appropriate clinician would be a respiratory physician. They're used to looking after patients with PEs, and they certainly will follow these patients up as well. Any take-home messages from this case? Look, I think the take-home messages are that as... |
Okay, welcome to On The Wards, it's James Edwards and I haven't done a podcast for a while but really excited to do one today and we're talking about something different, aviation medicine. And with us today is Squadron Leader Nicola Boyd. Welcome, Nicola, or Nick. Nick is fine. So Squadron Leader Nicola Boyd is part o... |
So all the aviation medical officers are assigned to a squadron. And so they might attend their weekly brief or provide some education to the squadron on an aviation medicine issue or they might be lucky enough to go flying for the afternoon which is of course a lot of fun, a real perk of the job. You know and then the... |
Yeah. I let many of my colleagues who are retrieval medicine specialists know they think a lot about this stuff in regard to getting someone from point A to point B the most appropriate way, whether it's flying or actually by land because of some of those complicating factors. Exactly, yeah. And certainly you can't ask... |
Welcome to On The Wards, I'm James Edwards and today we're talking about mandatory reporting. Mandatory reporting has been in the news of late here in Australia and I'm welcoming Georgie Hasen with us. Welcome Georgie. Thanks James. Georgie is the head of advocacy at Avant, one of our partner sponsors and has worked in... |
So you need to think carefully, make sure you've got enough evidence and it's not, as I mentioned before, based on gossip or hearsay or innuendo or something. So as I said before, you don't have to prove it, but you've got to have, it can't just be, oh, I've just heard on the traps, you know. Often with practitioners w... |
Okay, welcome everyone to the JMO RPA podcast program. We've had a number of different podcasts over the previous weeks and now we've got Dr. Peter Lim, gastroenterologist at RPA, who's going to talk about upper GI bleeding. Welcome, Peter. Thanks, James. Okay, we're going to start with a case scenario. Imagine you're ... |
I think one of the things or one of the big delays to getting someone to endoscopy is getting those blood products down to the ward or down to emergency and actually administering those blood products. The sooner you can resuscitate a patient, the sooner we can scope them. Okay. So give a bolus of fluid. You mentioned ... |
And I think it would be important for those people to have a bit more reserve. And so I think a target of about 100, if you have any of those conditions, is probably appropriate. In a patient who is not exsanguinating, I think given that evidence, the answer is probably we should aim for a haemoglobin of about 80 to 90... |
Welcome to On The Wall, it's James Edwards and today we're speaking to Dr Rewa Keegan. Welcome Rewa. Thanks James. Rewa's a general surgeon who's currently working as a surgical superintendent at RPA. And today we're going to talk about nasogastric tubes. And obviously nasogastric tubes are commonly used on surgical wa... |
And obviously pick the side that looks the easiest to access. You want the patient to be upright, slightly leaning forward and the neck relaxed and in slight flexion and the chin on the chest. So once you've selected a side, you want to give them a couple of sprays of the xylocaine. Leave that for a few minutes while y... |
So in this case, if it was on suction, you should take it off suction and see if you can aspirate. If you can put a large spigot tip catheter in and aspirate some fluid out, then usually that will clear if there's a small blockage. The actual contents of the stomach can block the tubing and sometimes either flushing or... |
Welcome to our next series of our RPA podcast series and we're talking with Rob Hissop, one of the intensives here at RPA and talking about one of Rob's pet topics, oligouria. So it's a very common case scenario that our junior doctors will see, especially when they're at night nights and we'll start with the case rob ... |
In which case, what I would suggest is if we're going to give a fluid bolus, we should give a reasonable sized bolus and we should do it as quickly as possible so we can assess well what sort of change we're making to that system. And I always advocate if we're going to give a fluid bolus we should have looked at the J... |
But we wised up the day later when we saw the hyponatremia. And I'm saying we can be smarter than that, because we can pick the patients who will be hyponatremic tomorrow if we think about them better today. So if we look at this patient with this lowish urine output, but certainly more urine output than Frank Oliguria... |
And what do you think he found? The renal blood flow didn't change between... He actually found that the renal blood flow went up. So most people would imagine or would guess when I asked them, most people would say, look, the renal blood flow will be going down. But what he showed was the renal blood flow in these ear... |
Welcome to On The Wards. This is Jules Wilcox and today we're going to be talking about well-being with John Scott. John is an emergency physician up at Gosford and the director of well-being at Gosford Emergency Department, or as it has been renamed now, director of performance and culture. And I'm also an emergency p... |
Yeah, we'll go through both. So I mean, I kind of mentioned them when I was saying that those symptoms that I had when I was feeling burnt out, the term that we're using. And the first thing is, the first tenet of it is emotional exhaustion when you just get up in the morning, you feel like you haven't got the energy t... |
Yeah. And I think the evidence on the amount of research on meditation now has gone up exponentially in the last 10 years. I mean, I learned to meditate in 2000, I think it was. My wife's been doing it since she was about 16. She got me into it, and just what an amazing difference that made. It really does, yeah. Yeah,... |
And it takes a couple of minutes. Tonight, I'm going to be playing tennis with some friends. So that's going to tick off my exercise. It's going to tick off my connection and happiness all in one go. And it's scheduled. But if I didn't schedule it, because I've already replied on the WhatsApp group that I'm going to go... |
And so if you're type A and perfectionist out there, you know, there you go, there's a reason. Yeah, yeah, yeah, exactly. But yeah, if you want to be a really good doctor for the whole of your career, what kind of doctor do you want to be remembered as when you retire? You know, think about that. Yeah, do you want to b... |
Welcome to On The Wards, it's James Edwards and today we're going to be talking about hyperkalemia. And given we're talking about hyperkalemia, I have the pleasure of introducing Associate Professor Darren Roberts, who's a physician who works in both clinical pharmacology, toxicology and nephrology. But we're going to ... |
And that's due to the very prolonged QRS with a big T wave. These are a range of possible ECG changes that can be seen, but not all of them will happen in any particular order. And in particular, some of these things may be hard to interpret in an elderly patient. For example, if he's had a prolonged history of hyperte... |
But in terms of treatment of an acute case of hyperkalemia, it wouldn't be one of your first-line treatments. The other treatment that we sometimes talk about is sodium bicarbonate. Bicarbonate, anything which alkalemia causes a hypokalemia, drops of potassium. The problem with giving bicarbonate is it's associated wit... |
Yes. Often it's a blood gets done and it's a just chase a level and we know how busy gene doctors are on the ward, but it's important to hand over things like that because you commonly see they don't get picked up till the next morning and that can obviously lead to poor outcomes. Completely agree. Thanks for speaking ... |
Welcome Junior Doctors to our podcast series and I'd like to welcome Dr Raj Puranik. Thank you James. Raj is a cardiologist here at RPA but also did his Junior Doctor training at RPA, is that right Raj? That's right, been here since about 1993. Okay, that is a long time. Look, we're going to talk predominantly about ch... |
So they can be managed with simple anti-platelets on the ward and anti-anginals or you can escalate the type of therapy so that they are monitored in a monitored facility and not in a general post-operative ward where you're worried because in the first 48 hours after a significant coronary event you're at risk of arrh... |
And we're trying to reduce the time that the myocardium is exposed to ischemia. And so oxygen is extremely important in that setting. And I think as a fundamental aspect of resuscitation, that's very, very important. Now Now you'll usually know if someone has airways disease significant enough and in the acute process ... |
Okay welcome everyone to On The Wards, it's James Edwards and today I have the pleasure of speaking to Dr Ying Li. Hi Ying. Hi, hello. Thank you for inviting me. Dr. Ying Li is a self-specialty fellow in reproductive endocrinology and infertility at Jenea and Aurope and Salvatore Hospital. And today we're talking about... |
And finally with the bimanual, it gives you an idea about what kind of uterus they're dealing with. So for an irregular-shaped uterus, you can feel the fibroids. And for an adenomyotic uterus, they can be quite round and just generalised bulky. And of course, for malignancies, you can look for masses and irregularities... |
Okay, welcome to In The Wards, it's James Edwards and today we're talking about fracture assessment and management and I'd like to introduce Dr. Nick Maluga. Welcome Nick. Thanks James, very good to be here. Thank you very much for inviting me. Nick's an orthopaedic registrar currently working in Sydney, currently at N... |
That kind of gives you an indication of the potential surrounding damage and whether the joint is likely to be involved. Sometimes naming an anatomical part of the bone would be helpful such as you know base or shaft or neck or the head. So knowing your anatomy is very important if you don't look it up it's very easy. ... |
You've noticed that they've actually had 50 milligrams of morphine in the last hour, and their pain's still 10 out of 10. What are you worried about? Well, the first and foremost and the most dangerous thing to rule out at this stage is the compartment syndrome. And that is something that's often delayed as the pain is... |
Welcome to On The Wards, it's James as I'm here again and today we'll be talking about quality and safety for junior doctors. Before I start I would like to tell everyone that On The Wards is available through iTunes and also we would please ask that you write a review on iTunes about On The Wards. And today I have the... |
And who should they approach in regard to wanting to do audit? Is it the consultant, nursing staff or someone external? I guess it depends what you're going to audit. So if you think about the problem that you're trying to solve and what you're collecting data for, if you think about the people who are most involved in... |
Welcome to On The Wards. It's James Edwards and today we're talking about Haematuria and I have the pleasure of inviting back Dr. Jo Dargan who's a Urologist in training. Welcome back Jo. Hi, thanks very much. Jo's spoken before on urine retention and today we're talking on Haematuria and as usual we'll start with a ca... |
Okay. And putting a three-way catheter, is the technique just like a normal two-way catheter? Yeah. So a three-way catheter is quite specialised in that it has an inflow channel for saline irrigation, an outflow channel for the urine, which is the largest channel, and then the balloon port. And they come in different m... |
Welcome to On The Wards. It's James Edwards and today we're talking about clinical reasoning in general practice. So we're going off the wards into general practice which is exciting and we have Associate Professor Charlotte Hespie with us. Welcome Charlotte. Hi, thank you very much for having me. Associate Professor H... |
But in the framework of general practice rather than in the framework of an acute hospital setting where it's really quite different because you do have an ability to leave it because someone else might pick it up. Whereas in general practice, you are responsible for making sure that it gets followed through safely fro... |
Time tells you a lot about the evolution. Oh, I love time. We're very, very fortunate with time. And it is because, too, you also have that knowledge about, you know, like I've got some patients who are more histrionic and will come to you immediately they get a pain versus someone else who comes to you when they've ha... |
So I'll have a script that they go out with, so a plan, and then a time that they'll come back and check back with me. And again, things that, you know, and that I'll contact them with the results. Okay. So it's a fantastic description of some of the clinical reasoning strategies you use within your general practice. A... |
Welcome to a thought-provoking discussion. My name is Dr. James Edwards. Today we'll be discussing diagnostic error and this is an initiative of our partnership between On The Wards and Avant and I have the pleasure of welcoming today Dr. Mark Graber. Good morning James. Mark is a leader in the field of patient safety ... |
Welcome to London Awards. Welcome back, Associate Professor Samuel McGill, who's just given us an excellent outline of the assessment and management of septic arthritis. And now we go into another very common topic that's seen on the wards and in the nurse department, and that is gout. And as we commonly do, we start i... |
Let's presume for the moment that we haven't done that because we didn't know what the diagnosis was, but it's come back that there were uracrystals found. Then the management now depends all on the comorbidities of the patient. So there isn't a right management. We need to assess for this particular person what drugs ... |
Welcome to On The Roads, it's James Edwards and today I'm with Professor Jane Bleasel. Welcome Jane. Thanks James. Professor Bleasel is a rheumatologist at RPA, and we're going to talk about a common problem of back pain. Now, I guess the frame we're going to put this case is, is that you're an intern working in a busy... |
I think a lot of the anxiety comes from the patient because they think they've got something that's serious and that's not going to get better. So trying to reassure the patient, tell them to keep active, give them analgesia. So simple paracetamol, if they don't have a contraindication, non-steroidal anti-inflammatory ... |
Welcome to On The Wards, it's James Edwards and I'm back again speaking to Dr. Tim Saharto on acute pain. Yes, I mean you did mention kind of 5 to 10 mg six hourly PRN. So have you got somebody who's got pain such as a neck and femur fracture but they are not going to surgery for 24 hours and sort of oral amortization ... |
What are the considerations of when you would ask HSC acute pain service to see the patient and also whether you'd ask them to consider a PCA? Look, I think that's a good question because I think a lot of GMOs are perhaps reticent to call up thinking that they might, I don't know, be, you know, feeling like they're bot... |
Okay, welcome to All New Awards everybody. It's James Edwards and today we're going to talk about an approach to a management of bleeding. And this is from the perspective of a haematologist and we have the pleasure of inviting Shaka Inam back to On The Wards who's a haematologist registrar at RPA and at Concord Hospit... |
Significant blood loss will usually require blood transfusions as intravenous fluids given in large amounts can replace volume but not all the other important components of blood like red cells and coagulation factors. Dilution with fluid can actually worsen the tendency to bleed. Make sure you put into place any impor... |
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