On The Wards: On The Pods Medical Podcast for Doctors

Antibiotic allergies

Antibiotic allergies are the most commonly reported type of medication allergy and pose a challenge for doctors on the wards.

Often, a junior doctor will be the first port of call for the patient who reports an antibiotic allergy. And it can be difficult to determine what the correct course of action is. Many patients who report allergies will not, in fact, be allergic to the medication in question. They may unnecessarily miss out on treatment with the most appropriate antibiotic. Or, suffer other negative effects as a result. On the other hand, administering a culprit medication to a patient who is truly allergic will result in an allergic reaction which can be dangerous and even life-threatening.

Summary Writer:  Dennis Neuen

Script Writer: Alice Grey

Editor:  Alice Grey

Interviewee: Alice Grey

James talks to Dr Alice Grey to help give junior doctors a guide to making safe and sensible decisions about a patient with a reported penicillin allergy. In this podcast, we will share an example case with you to help you consolidate the information and develop your skills and confidence in how to approach patients with antibiotic allergy.

About Dr Alice Grey

Alice Grey is an Immunology & Allergy Advanced Trainee. Her training program has taken her to Royal Prince Alfred, Campbelltown, Liverpool and Concord Hospitals.

James talks to Dr Jane Standen about chronic post-surgical pain.

Summary Writer:  Rose McCarthy

Script Writer:  David d' Silva

Editor:  Jane Standen

Interviewee:  Jane Standen

About Dr Jane Standen

Jane is a Consultant Anaesthetist and interventional Pain Specialist. She studied medicine at the University of Sydney and trained in anaesthesia at the Prince of Wales Hospital, Sydney. Subspecialty training in pain management was undertaken at the Michael J Cousins Pain Management and Research Centre at Royal North Shore Hospital.

Jane has expertise in the treatment of both early-onset and persistent pain. She specialises in minimally invasive procedures, aiming to reduce pain and enhance quality of life. She practices with an empathetic manner and takes an evidence-based approach.

Jane is an honorary tutor with the University of Sydney Masters in Pain Management and is actively involved in pain management education at the Mater Hospital and Royal North Shore Hospital. She regularly conducts GP educational sessions.

She is appointed at Norwest Private Hospital, the Sydney Adventist Hospital, the Mater Hospital and Royal North Shore Hospital.

James talks to Dr Sarah Dalton about job interview preparation. Interviews are an important process. They allow interviewers to assess whether a candidate would fit into the particular work environment, for instance. Interviewees are also evaluated on if they are perceived to perform well in the position. The ability to interview well is very important. There are many ways one can do some job interview preparation in order to improve performance.

Summary Writer:  Nicholas Malouf

Script Writer:  James Edwards

Editor:  Sarah Dalton

Interviewee:  Sarah Dalton

About Dr Sarah Dalton

Sarah Dalton is a Consultant in Paediatric Emergency Medicine at the Children’s Hospital at Westmead. Furthermore, she is a Clinical Director at the Clinical Excellence Commission in NSW. There she oversees a Clinical Leadership Development program. Sarah is President-Elect for the Division of Paediatrics and Child Health at the Royal Australasian College of Physicians. Moreover, she holds a Masters in Applied Management in Health.

Sarah has a long-standing interest in the translation of evidence into practice. Additionally, she is a strong advocate for improving Quality and Safety in Healthcare. She has a particular interest in clinicians leading change. Furthermore, she has completed a Fulbright Scholarship to evaluate Clinical Leadership Development Programs in the United States.

Rapid response is a strategy to identify deteriorating patients and enact interventions before more serious deteriorations. For example, Between the Flags is a rapid response system program that has been implemented in NSW. Between the Flags has led to a reduction in cardiac arrests in NSW.

Hypoxia, hypotension and reduced mental state make up the majority of rapid responses, followed by alterations in the other vital signs. In this podcast, you will also learn about the initial approach to take and how to follow through as a junior doctor. Assess your ABCD’s and resuscitate simultaneously. Escalate if needed.

Summary Writer:  Alexandra Bolger

Script Writer:  Claudia Hurwitz

Editors:  Luke Collett, Sam Orton

Interviewee:  Luke Collett

About Dr Luke Collett

Dr Luke Collett is an ICU Clinical Fellow at Royal North Shore Hospital. He completed his ICU clinical training in 2016, after separate diversions into Emergency Medicine and Infectious Diseases. Furthermore, Luke recently returned from a fellowship year in Severe Respiratory Failure and ECMO at Guy's and St Thomas' Hospitals in London.

Luke is a keen educator. For instance, he is a trained simulation instructor and faculty on a number of courses. Also, Luke has previously run the MET calls workshop at the NSW Pre-Intern Conference.

Orthopaedic injuries are a common presentation within the Emergency Department. It is important for junior doctors to be able to develop the skills necessary to identify and confidently manage the most commonly presenting orthopaedic injuries in the general population.

James talks to  Dr Nicholas Maluga, Orthopaedic Registrar, about common emergency medicine orthopaedic presentations.

Summary Writer:  Aisha Khan

Script Writer: John Farey

Editors:  Nicholas Maluga and Dan Heitman

Interviewee: Nicholas Maluga

About Dr Nicholas Maluga

Dr Nicholas Maluga graduated from the University of Tasmania in 2009 with a double degree of Bachelor of Medical Science and Bachelor of Surgery. He completed his internship and resident years at the Monash Medical Centre in Melbourne and relocated to Sydney to complete his Masters of Surgery from University of Sydney in 2013. Since then, Nick has been working as an Orthopaedic Registrar at St Vincents Hospital, John Hunter Hospital and is currently at Nepean Hospital. Nick is currently working to complete his second Masters of Clinical Epidemiology from University of Newcastle. His early research interests were in Paediatric Orthopaedics and he completed and presented at the Australian Orthopaedic Association meeting a large research project which looked into physiotherapist-led screening for Developmental Dysplasia of the Hip in newborns. Nick’s current research interest lies in utilising technologies to deliver and streamline healthcare and physiotherapy access to remote areas.

Anaphylaxis is a severe, potentially life-threatening hypersensitivity reaction that occurs due to systemic mast cell mediator release. It is a common presentation and requiring prompt recognition and urgent management.

James chats to Associate Professor Roger Garsia about anaphylaxis in this podcast.

Summary Writer:  Nadia Perera

Script Writer: Alice Grey

Editor: Alice Grey

Interviewee: Roger Garsia

About Roger Garsia

Roger Garsia is a Consultant Physician in Immunology and Immunopathologist at Royal Prince Alfred Hospital, Sydney. He holds Fellowships of Royal Australasian College of Physicians and Royal College Pathologists of Australasia in Immunology. Roger is the Head of the Central Clinical School of University of Sydney and the Former President of Australasian Society of Clinical Immunology and Allergy (ASCIA).

Eamon Merrick, Registered Nurse, Assistant Professor & Clinical Academic with the University of Canberra, talks with Professor Imogen Mitchell about end of life care, which presents a number of clinical and communication challenges in the hospital setting.

Summary Writer:  Alex Bolger

Script Writer:  Jared Ellsmore

Editor:  Eamon Merrick

Interviewee:  Imogen Mitchell

About Imogen Mitchell

With a background as an Intensive Care specialist, Imogen Mitchell is committed to improving medical delivery and education and to making a difference to practice through research and teaching that benefits patients, students and colleagues.

Imogen was in 2013 the recipient of a Harkness Fellowship for Health Policy and Practice, which she undertook at Johns Hopkins Bloomberg School of Public Health in the United States. She is a nationally and internationally recognised clinical and health systems researcher, specifically in the development of sustainable processes to manage patient deterioration and the early mobilisation of intensive care patients. Her research is currently focused on improving end-of-life care. Imogen's teaching has been recognised with multiple awards, including Senior Fellowship of the Higher Education Academy and the Taoiseach Public Service Excellence Award (Ireland). She played a key role in the development of an innovative patient deterioration teaching program, COMPASS©, which is now embedded in healthcare organisations internationally.

Musculoskeletal injuries represent a significant proportion of presentations to the Emergency Department. In this podcast, James talks with Dr Nicholas Maluga about the initial fracture assessment and management priorities for patients with trauma and fractures.

Summary Writer:  Dennis Neuen

Script Writer: Dan Heitman

Editor:  Nicholas Maluga

Interviewee: Nicholas Maluga

About Dr Nicholas Maluga

Dr Nicholas Maluga graduated from the University of Tasmania in 2009 with a double degree of Bachelor of Medical Science and Bachelor of Surgery. He completed his internship and resident years at the Monash Medical Centre in Melbourne and relocated to Sydney to complete his Masters of Surgery from University of Sydney in 2013. Since then, Nick has been working as an Orthopaedic Registrar at St Vincents Hospital, John Hunter Hospital and is currently at Nepean Hospital.

Nick is currently working to complete his second Masters of Clinical Epidemiology from University of Newcastle. His early research interests were in Paediatric Orthopaedics and he completed and presented at the Australian Orthopaedic Association meeting a large research project which looked into physiotherapist led screening for Developmental Dysplasia of the Hip in newborns. Nick’s current research interest lies in utilising technologies to deliver and streamline healthcare and physiotherapy access to remote areas.

Osteoporosis is common in women and men over the age of 50. James talks with Kirtan Ganda about the diagnosis and management of bone health.

Summary Writer:  Claudia Hurwitz

Script Writer:  Barath Arunasalam

Editor:  Kirtan Ganda

Interviewee:  Kirtan Ganda

About Dr Kirtan Ganda

Dr Kirtan Ganda is an Endocrinologist based in Concord, NSW Australia. Dr Ganda manages patients with a number of hormone-related disorders such as osteoporosis, diabetes mellitus, thyroid, adrenal and pituitary disorders. His training in Endocrinology has been extensive with placements across Australia, with involvement in clinical and research activities.

Kirtan completed his PhD in 2014, which focused upon improving the management of patients with osteoporosis, the hallmark of which are minimal trauma fractures. The outcomes have been published in internationally reputed journals. Kirtan is engaged in speaking at national and international conferences. He also has a passion for patient education and speaking to public audiences about endocrine disorders such as osteoporosis, diabetes mellitus and Addison's disease.

Kirtan holds appointments at Concord Hospital as a Consultant Endocrinologist as well as Senior Lecturer at the University of Sydney, where he is engaged in teaching and coordination of education for Sydney Medical Program students. He is actively engaged in teaching and research. Dr Ganda was the recipient of the prestigious Professor Philip Sambrook for the Outstanding Early Career Investigator Award in 2014.

James discusses an approach to stroke with Dr Alice Ma. A stroke is an acute neurological deficit that lasts for more than 24 hours and is caused by cerebrovascular aetiology.

Summary Writer:  Dennis Neuen

Script Writer:  Barath Arunasalam

Editor:  Alice Ma

Interviewee:  Alice Ma

About Dr Alice Ma

Alice Ma graduated from the University of Sydney Medical School in 2010. She has trained in ICU and Neurology. Alice is currently the neurointerventional fellow at Royal North Shore Hospital with a particular interest in stroke and endovascular clot retrieval.