Coda Change

Treatment of cardiac arrest requiring CPR has been transformed by the use of extra-corporeal membrane oxygenation. Patient stabilised on this innovative therapy can be transferred for coronary angiography and possible stent intervention. Time is critical, time is muscle! However when the muscle is gone but the other organs still work what options do we now have? For the patient in sustained unrecoverable cardiogenic shock with neurology intact where should we go? What therapies are appropriate and possible? For more head to: codachange.org/podcasts.

This talk provides an approach to life-threatening upper GI bleeding, including management of the grossly contaminated airway, the impact of hypothermia on bleeding, and balloon tamponade insertion. Knowing which balloon tamponade device you stock (is it a Minnesota or a Blakemore?), and where to find it, are just as important as knowing how to insert it. Refining your approach to variceal bleeding can help you optimize your resuscitation of these challenging cases. For more head to: codachange.org/podcasts.

Unprofessional behaviours by health professionals, in hospitals, are associated with a significantly increased risk of preventable patient complications. Such behaviours result in an environment that results in increased, and unnecessary psychological stress of health professionals and resulting in teams not working to the best of their ability. Flattening the hospital hierarchy creates an environment where team members feel safe to speak up, without fear of reprisal and knowing their opinion will be given appropriate consideration. Speaking up and calling out inappropriate behaviours, in a respectful, non judgmental manner will result in the majority of people modifying their behaviour. Improving the culture of our workplaces will result in people wanting to go to work, improved team communication and performance, and ultimately better patient outcomes. For more: codachange.org/podcasts.

You are a member of the resuscitation team looking after a shocked blunt polytrauma patient. The patient is intubated and ventilated, splinted, and is receiving a massive intravenous blood product transfusion. To your surprise, Whole Body CT scan fails to show any active haemorrhage. This talk describes the common and rarer causes of hypotension following trauma and highlights how a meticulous history and primary survey examination may often reveal the cause before imaging. For more: codachange.org/podcasts.

What's next after RESCUEicp? -The results of this study may have been disappointing, but there are some questions about the trial itself which we review. Irrespective, study into how to improve outcome for TBI patients marches on, with a look at goal directed therapy and multi-modal monitoring as a couple of examples of the future in TBI research. Prognosis in TBI - What tools do we have to help patients and families faced with the question of "what next?" after TBI? We will look at some of the available tools and discuss the dilemmas in reconciling what we know and more importantly what we don't know with what the patient and families are seeking. For more head to: codachange.org/podcasts.

I review multiple papers that cover the merits of ultrasound use in the prehospital field. From identification of CHF, to IV starts, to a possible treatment modality for strokes. For more head over to codachange.org/podcasts

Inequity within the healthcare profession harms both providers and patients. Diverse teams have been shown to offer better care and improved productivity. The Coda community has the goal of developing achievable, sustainable and measurable actions (within the Ethics pillar) to tackle inequity within healthcare and disseminating these in 2022.

In order to take action we need to develop plans through a five-stage process. Stage One is to Identify: This preliminary stage, which is where the Ethics domain is currently, seeks to identify possible actions. Once identified these actions enter stage Two where they are examined by a global team of experts for the feasibility of application. The expert recommendations then return to the community in stage three where they are proposed for modification and acceptance. Once accepted these expert designed but community modified actions enter the Fourth Stage of Sharing or implementation. Finally the outcomes from implementing the actions must be measured.

Coda.Zero provides the perfect platform for the early stages of developing our action plans. In this episode we explore what does gender inequity and racism look like within healthcare today. The pandemic has exposed and exacerbated many inequalities. What are the challenges? In the final conversation the panel proposes some powerful advice for our community action:

· Speak up / don't be a bystander: Become an activist · Human rights start at home: Educate our children · Read literature from authors with diverse experiences / cultures: We need insights into these lived experiences · Have tough conversations – discussions not debates

We have brought together a dynamic and diverse group of opinion leaders to launch this topic. Each conversation is both informative and highly engaging. Welcome to Coda Zero.

For more head to: codachange.org/podcasts.

In this conversation Lauren challenges us to consider: "What does hate look like in the world today?" The conclusion she draws is that hate looks like pain. Pain as a result of the pandemic, the marginalisation of women and girls, colonisation and the exploitation of people. And who does hate hurt? It hurts the individuals, whether they be practitioners or vulnerable patients. It hurts the broader community through inequitable distribution of services, wealth and opportunities. Finally, hate hurts you, it hurts all of us! What puts me at risk, puts you at risk, because we all need to live in this world together. So how can we cure this 'hate virus'? Don't miss this compelling conversation and the conclusions from the incredible panel. For more head over to codachange.org/podcasts

Amy challenges us to think about our healthcare systems and the entrenched inequality within them. How does a legacy of white supremacy impact healthcare in 2020? Why do we continue to see the same power imbalances repeated again and again, whether it be in healthcare, education or politics? We have a young system and pushing back should not be seen as threatening. Many of our healthcare systems were built in a time when women and in particular Indigenous women, were not seen as equal. That legacy continues to live on because at no time have we stopped the old system for a hard reboot. The same teachings still live on and are now deeply embedded in our healthcare systems, perpetuating the harm! For more head over to codachange.org/podcasts

Not all women experience discrimination to the same extent or in the same ways. The pandemic has resulted in a dramatic increase in women's caregiving responsibilities to both children and the elderly. Additionally everyone is in the home so the domestic load has increased. Prior to the pandemic women in Australia were spending on average 1.7 hours more per day on care and domestic duties than men and now in the pandemic this has increased by a staggering 50% to mean women are providing 2.5 more hours of care than men! We need to disrupt.... so that both men and women can both work in high value roles from caring through to strong technical roles as well. We need to redistribute paid work and domestic work more evenly between men and women. For more head over to codachange.org/podcasts