![Paracetamol Overdoses with Daniel Gaetani.]()
July 27, 2020
This week I travelled to one of the busiest emergency departments in the state, where I chatted to emergency consultant Daniel Gaetani. Daniel is an emergency doctor with a love for toxicology and all things ultrasound. This episode we unpacked the new paracetamol overdoses guidelines.
We talked through four real cases and discussed indications for NAC infusions. The episode included pharmacokinetics of Panadol and how different formulations can affect our patients. We discussed the
rumack-matthews nomogram, LFTS , Panadol levels and even phosphate. Daniel gave us insight into when you should call toxicology and when to refer to transplant teams. We also went through how Daniel is using ultrasound in his Emergency department and where he envisions it being used in the future.
Please see links below for all content used on this episode.
Paracetamol Specific Resources
Chiew, A. et al. (2020). ‘Updated Guidelines for Management of Paracetamol Poisoning in Australian and New Zealand.’ Medical Journal of Australia 212(4): 175 – 183.
Katzung & Trevor’s Basic and Clinical Pharmacology 14th Edition Section VI: Drugs used to treat diseases of the blood, inflammation and gout
Life in the Fastlane (2020). ‘Paracetamol Toxicity.’ Accessed July 2020.
Murray, L. et al. (2015). ‘Toxicology Handbook, 3rd edition: Chapters 3.60 Paracetamol: Acute overdose, 3.61 Paracetamol: Modified-release formulation and 3.62 Paracetamol: Repeated supratherapeutic ingestion.’ Churchill Livingstone, Australia.
Murray, L. et al. (2015). ‘Toxicology Handbook, 3rd edition: Chapters 3.60 Paracetamol: Acute overdose, 3.61 Paracetamol: Modified-release formulation and 3.62 Paracetamol: Repeated supratherapeutic ingestion.’ Churchill Livingstone, Australia.
General Toxicology Resources
Murray, L. et al. (2015). ‘Toxicology Handbook, 3rd edition.' Churchill Livingstone, Australia.
Local Policies and Procedures.
NSW Poisons Information Centre 13 11 26.
Case Notes Below
https://docs.google.com/presentation/d/1BEws0s6CeAw-zG1jhumbIH6Kd5qVKuzD8bvbvglD8yo/mobilepresent?slide=id.g8dad0fe5d3_0_25
June 15, 2020
This week I traveled to Prince of Wales hospital and sat down at one of the biggest genomics/genetics laboratories in the country to talk to Rebecca. Dr Rebecca Walsh is a scientist, hematologist and genomisist (only a few of her titles!). Within the episode we discussed sickle cell crisis and what every ED staffer needs to know. We also discussed CAR-T cell therapy; currently a very hot topic. We also touched on febrile neutropenia, anaemia and pancytopenia. This episode will leave you with some key learning points from haematological emergencies. The episode finishes up with two cases that will have you in tears.
CART-T cell therapy articles
Chimeric Antigen Receptor Therapy- Journal 2018
Sickle Cell Article
Sickle Cell Disease - Piel et al, 2017
life in the fast lane
sickle-cell-crisis
For anyone interested in supporting people with sickle cell there is a support advocacy group
https://aussicklecelladvocacy.org
Follow the EDJAM
instagram @edjam_podcast
![Crossbows and Snakebites An insight into Australian rural health.]()
May 5, 2020
On Episode 10, we discuss crossbows and snakebites with emergency nurse/midwife and author Christian Wright. Christian is a remote health nurse in the Northern Territory with extensive experience in emergency/paediatric rural medicine. Christian highlights the treatment of patients from minor to major in areas where access, circumstance and culture play a significant role.
We discuss cross-cultural medicine, aboriginal sensitivities, working as a sole practioner and dealing with minor to major trauma. Christian also gives advice about support networks and cultural immersion.
The case of the week is an interesting listen as Christian retells his encounter with a brown snake where he found himself as the patient.
Snake bite article Stars align for Perth nurse bitten by a snake in Karijini National Park
Christian Wrights Publications
Are male partners of pregnant women treated negatively in maternity care?
click this link to article full text
Gastroschisis: A review of practice
click this link to article
Barriers to implementing diagnostic domestic violence screening
click this Link to full text article
Mind over Matter: Inside Hypnobirthing
Click this link to full text article
Recommended Readings for rural Health Professionals
CARPA Standard Treatment Manual 7th Edition
CARPA manual Link
Growing Up Our Way: The First Year of Life in Remote Aboriginal Australia
Link to full text article
BOOK
“Why Warriors Lie Down and Die” by Richard Trudgen
link to book
April 16, 2020
In this week's episode I chat with Kevin, an emergency consultant and retrivealist. We discuss the role of retrieval systems in NSW, prehospital vs inter hospital transfers, doctor-paramedic teams, preparation of patient for retrieval and packaging a patient for transfer. We also discuss the impact of COVID 19 and as always a case of the week. This Canadian born legend is worth a listen.
Show notes and Links
Sydney Hems link
Careflight website
April 1, 2020
This week we chat with Dr Sarah Newman, emergency and retrieval doctor, about all things Trauma. Sarah unpacks patient assessments, primary survey, blood products and shares some experiences from her time with NSW ambulance (think Helicopters).
Show notes
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.
https://www.ncbi.nlm.nih.gov/pubmed/23477634
March 16, 2020
Dr Stephanie Fletcher, epidemiologist and public health expert, discusses all things COVID-19. What is a pandemic? What is COVID-19? What are the global effects of infectious diseases? What should we do to prepare for COVID-19 in Australia as both health care workers and the general population?
Links
https://www.health.nsw.gov.au/Infectious/alerts/Pages/coronavirus-faqs.aspx
