On The Wards: On The Pods Medical Podcast for Doctors

James talks to Professor Steve Chadban about acute kidney injury (AKI). AKI develops in 5 - 20% of hospitalised patients and is a significant contributor to morbidity and mortality in the critically ill. Acute kidney injury ranges from mild to severe disease requiring renal replacement therapy. Here, we'll deconstruct the causes of AKI to outline a helpful and systemic approach for junior doctors.

Summary Writer:  Amanda White

Editor:  James Edwards

Interviewee:  Steve Chadban

About Steve Chadban

Steve Chadban studied Medicine at the University of Newcastle, Australia, where he received the University Medal in Medicine. He undertook physician training in Newcastle, before specialising in Nephrology, completing a PhD in macrophage biology at Monash University, then a post-doctoral study period in immunology at the University of Cambridge, UK.

Steve returned to Monash University to run the Transplantation Program from 1999–2002 before moving to Royal Prince Alfred Hospital, where he is a full-time staff Nephrologist, Director of Kidney Transplantation, Professor of Medicine (Nephrology) at The University of Sydney and researcher in basic and clinical sciences. Steve is the President-elect of the TSANZ, Executive member of ANZDATA and a Lead Investigator in the AusDiab Kidney Study. He has spoken at numerous National and International meetings and produced over 170 papers published in leading international journals including The New England Journal of Medicine, JAMA and The Journal of Clinical Investigation.

Steve’s research interests include the molecular mechanisms of transplant rejection, with a focus on macrophages and innate immunity, clinical transplantation, diabetes and outcomes in CKD and transplantation.

James talks to Dr Lauren Troy about hypoxia and the management of the hypoxic patient. Hypoxia is a common issue that many junior doctors will face when working on the wards. It can significantly contribute to the morbidity and mortality of patients, so it needs to be managed early. In this podcast, you'll learn a structured approach to the hypoxic patient and gain sound knowledge of oxygen therapies available for patients in the hospital setting.

Summary writer:  Jorja Braden

Editor:  James Edwards

Interviewee:  Lauren Troy

About Dr Lauren Troy

Lauren Troy is a Respiratory Physician, working as a Staff Specialist in the Department of Respiratory and Sleep Medicine at Royal Prince Alfred Hospital. She is currently undertaking a PhD in exercise and sleep physiology in interstitial lung disease. Lauren has a strong interest in training and education, with involvement in teaching programs for general practitioners, junior medical officers, basic physician trainees and respiratory advanced trainees. Lauren has been a communications tutor with The Sydney Medical School since 2008 and holds a Clinical Associate Lecturer position with the University of Sydney.

Insertion and placement of nasogastric tubes

James talks to Rewa Keegan, General Surgical Fellow and Surgical Superintendent at Royal Prince Alfred Hospital about the insertion of nasogastric tubes.

Summary Writer:  James Paterson

Editor:  James Edwards

Interviewee:  Rewa Keegan

About Dr Rewa Keegan

Dr Rewa Keegan completed her intern and resident years at Royal Prince Alfred Hospital and commenced general surgical training in 2010, successfully gaining her fellowship in 2014. Rewa loves clinical teaching from a medical student to registrar level. Particularly in the areas of surgical simulation and working with aspiring surgeons on developing their career plans.

She is very interested in surgical education and has undertaken a number of research projects looking at how registrars perceive their experience in surgical training. Rewa plans to undertake further training in oncoplastic breast surgery. And she and her husband ultimately plan to settle in a regional coastal centre after completing fellowships overseas.

James asks Dr Ken Liu, Liver Transplant Fellow, Bridget Barbaro, Acting Nursing Unit Manager, and Amy Freeman-Sanderson, Senior Speech Pathologist from Royal Prince Alfred Hospital. The question - What makes a good Intern?

Interviewees:  Ken Liu, Bridget Barbaro, Amy Freeman-Sanderson

About Dr Ken Liu

Dr Ken Liu is currently the liver transplant fellow at Royal Prince Alfred Hospital. Ken completed his internship, residency and Basic Physician Training at Royal Prince Alfred Hospital. He also completed 2 years of advanced training in Gastroenterology at Concord Hospital.

About Dr Brigid Barbaro

Brigid Barbaro is an Acting Nursing Unit Manager at Royal Prince Alfred Hospital. In 2004, Brigid completed her training to become a registered nurse. Brigid has worked in various roles including clinical education, project management, management and was the Nursing Executive Officer in 2014 at Royal Prince Alfred Hospital. In 2012 she completed her MBA, majoring in Health Management. Brigid enjoys being a NUM, leading a team and having the ability to maintain patient contact and make impact changes for the benefit of patients.

About Dr Amy Freeman-Sanderson

Amy Freeman-Sanderson is the manager of Speech Pathology at Royal Prince Alfred Hospital. She graduated from the University of Sydney in 2001 and has been working in the hospital environment since graduation. Amy has worked in a number of tertiary facilities both in Australia and England. She has experience working within a multidisciplinary team in both the inpatient and outpatient setting. Her current caseload is critical care and Amy is completing her PhD in communication facilitation in mechanically ventilated tracheostomy patients.

James talks to Dr Rewa Keegan about bowel obstruction, a common surgical presentation.

Rewa Keegan is a general surgeon and is currently working as the surgical superintendent at Royal Prince Alfred Hospital. She completed her intern and resident years at Royal Prince Alfred, and commenced general surgical training in 2010, successfully gaining her fellowship in 2014. Rewa loves clinical teaching from a medical student to registrar level, particularly in the areas of surgical simulation and working with aspiring surgeons on developing their career plans. She is very interested in surgical education, and has undertaken a number of research projects looking at how registrars perceive their experience in surgical training. Rewa plans to undertake further training in oncoplastic breast surgery, and she and her husband ultimately plan to settle in a regional coastal centre after completing fellowships overseas.

James talks to Professor Ian Caterson about the management of Type 2 diabetes blood sugar issues that may confront the junior doctor working on the wards.

Summary Writer:  George McClintock

Editor:  James Edwards

Interviewee: Ian Caterson

About Ian Caterson

Professor Ian Caterson is currently Foundation Director of the Boden Institute of Obesity Nutrition Exercise and Eating Disorders and Boden Professor of Human Nutrition at the University of Sydney. He has held the latter position since 1997. Prior to that Ian was Senior Staff Specialist and Director of Clinical Endocrinology at Royal Prince Alfred Hospital.

He has been president of both the Australian Diabetes Society and the Australasian Society for the Study of Obesity and is president-elect of the World Obesity Federation.

Ian is a recognised expert on obesity, its causes, prevention and management. He is on the Clinical Care group of World Obesity, chairs the Expert Obesity Committee for the Australian National Preventive Health Agency, and is on the Prevention and Community Health Committee of the NHMRC of Australia.

James talks to Dr Ryan Downey about his cannula tips and tricks for the insertion of an intravenous cannula.

Summary Writer:  Andrew Tan

Editor:  James Edwards

Interviewee:  Ryan Downey

About Dr Ryan Downey

Dr Ryan Downey completed his Residency at Royal Prince Alfred Hospital and is a Clinical Lecturer with the Department of Medicine at the University of Sydney and Senior Fellow in Anaesthetics at Royal Prince Alfred Hospital.

Ryan commenced his Staff Specialist position in Anaesthetics with a focus on Head and Neck, ENT, Obstetric and Ophthalmic Anaesthesia in August 2015. He has a keen interest in medical education, particularly crisis simulation and assists in the Department of Anaesthetics Simulation Laboratory. Ryan has extensive experience in difficult intravenous cannulation.

James talks to Professor Jane Bleasel about an approach to back pain, a common condition.

Summary Writer:  Antonia Clarke

Editor:  James Edwards

Interviewee:  Jane Bleasel

About Jane Bleasel

Professor Jane Bleasel is a Rheumatologist and Staff Specialist at Royal Prince Alfred Hospital. Jane was the Head of Department of Rheumatology for the last 15 years. She has recently taken up appointment at the University of Sydney as Co-Director of the Sydney Medical program and is also Professor of Medicine. Jane has published guidelines on back pain and red flag conditions and was part of an NHMRC grant looking at back pain presenting to GPs, Physiotherapist and Chiropractors.

James talks to Associate Professor Charbel Sandroussi about nutrition. Nutrition is an important topic that many junior (and senior) doctors don't know much about.

Summary Writer:  George McClintock

Editor:  James Edwards

Interviewee:  Charbel Sandroussi

About Charbel Sandroussi

Associate Professor Charbel Sandroussi is a Specialist Surgeon in hepatobiliary, upper gastrointestinal, transplantation and general surgery at Royal Prince Alfred and the Mater Hospitals in Sydney. Charbel’s clinical interests are live donor liver transplantation, complex liver and pancreas resection including major vascular resection and organ preservation techniques in oncology. He has published and presented on transplantation and hepatobiliary surgery. Charbel’s research interests are in complex vascular resection for cancer, the impact of neoadjuvant and adjuvant treatment on the recurrence of hepatocellular cancer after resection and transplantation and downstaging of pancreas cancers that are borderline for resection.

James talks to Associate Professor Kate Wyburn about the approach to managing a dialysis patient on the wards.

Summary Writer:  George McClintock

Editor:  James Edwards

Interviewee:  Kate Wyburn

About Kate Wyburn

Associate Professor Kate Wyburn is a Senior Staff Specialist Nephrologist at Royal Prince Alfred Hospital and a Clinical Associate Professor at the Faculty of Medicine, Central Clinical School, University of Sydney. Kate Wyburn is the current Chair of the NSW Transplant Advisory Committee. She has a long-standing interest in immunology and its relationship to renal disease and undertook a PhD in Transplant Immunology at The University of Sydney. Her main clinical and research interests include highly sensitised kidney transplantation, both HLA and ABO-incompatible and B cell immunobiology.