Ward Calls: Recent Episodes
Ward Calls
Ward Calls is a New Zealand podcast that dissects common ward calls you will need to confidently manage as a PGY1 doctor and beyond. We discuss practical, safe and comprehensive approaches that are achievable in the limited time available when working on the ward.
Dr Ivor Popovich presents examples of evidence-based decision making during ward calls. We also highlight some recommendations from Choosing Wisely and give an update on death certification.
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The Intern Suppository – Ivor’s EBM blog
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The Rational Clinical Examination – JAMA
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Plain film in small bowel obstruction
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The gas-less abdomen
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Paucity of gas
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Non-specific bowel gas pattern
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Read more in the blog post here
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Plasmalyte in renal failure
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Not contra-indicated
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Actually alkalinises plasma, driving potassium into cells
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The chloride in NaCl acidifies plasma, drawing potassium into the extracellular space
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Read more in the blog post here
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Asthma admission
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Tachycardia is not explained by salbutamol administration alone
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A large diurnal variation in peak flow (e.g. >50%) is a major risk factor for in-hospital cardiac arrest (not severity of asthma exacerbation at admission).
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Severity of wheeze does not correlate with severity of exacerbation
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Read more in the blog post here
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Choosing wisely
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New Death Documents website
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MOH Completing the Medical Certificate Cause of Death form (March 2018)
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MOH Examples of incorrect and correct cause of death certification (March 2018)
Cardiology expert Adele Pope returns with an approach differentiating tachycardia and managing atrial fibrillation. We also discuss ventricular ectopics, bigeminy and peri-operative anticoagulant and anti-platelet adjustment.
Detailed show notes at https://samholford.github.io/wardcalls/af-tachycardia/
Foremost expert on all things NZRDA, Dr Deborah Powell, explains why RMOs get free meals, what 8.1.2 is, and the RDA’s role in helping members in trouble.
Detailed show notes at https://samholford.github.io/wardcalls/dr-deborah-powell/
Sam meets some podcasting celebrities and experts in clinical reasoning Dr Art Nahill and Dr Nic Szecket – hosts of the podcast IM Reasoning. We talk cognitive bias and and some approaches to minimising their impact.
Detailed show notes at https://samholford.github.io/wardcalls/clinical-reasoning/
Vani and Sam give suggestions on how to improve these everyday skills that can otherwise take a lifetime to learn.
Detailed show notes at https://samholford.github.io/wardcalls/documentation-prioritisation-and-handover/
Sam speaks to Dr Adele Pope, advanced cardiology trainee at Auckland Hospital, about how to attack the most common, and often the most uncertain, ward call.
Detailed show notes at https://samholford.github.io/wardcalls/chest-pain/
Sam and Vani explore the most common requests for after hours prescribing and how to safely and quickly approach prescribing of insulin, warfarin, analgesia, antiemetics, and sleeping tablets.
Detailed show notes at https://samholford.github.io/wardcalls/prescribing-calls/
Most RMOs don’t ever get around to reading the their employment contract (MECA). In this episode, Sam talks to NZRDA advocates Melissa Dobbyn and Tara Martin about what you need to know, and where to get help.
Detailed show notes at https://samholford.github.io/wardcalls/starting-work-and-the-meca/
Sam speaks to Intensivists Dr Jonathan Casement and Dr Rob Everitt about reduced consciousness and acute and post-seizure management.
Detailed show notes at https://samholford.github.io/wardcalls/fluctuating-gcs-and-seizures/
Sam talks to Infectious Diseases Physician Assoc. Prof Mark Thomas about fever and the minutiae of microbiological investigations.
Detailed show notes at https://samholford.github.io/wardcalls/fever-and-infection/
Patient has fallen, please review. Vani talks to Geriatrician and fall expert Dr Cheryl Johnson about an approach to falls and when to order that head CT.
Detailed show notes at https://samholford.github.io/wardcalls/falls/
Sam speaks to Intensivists Dr Jonathan Casement and Dr Rob Everitt about differentiating and managing hypotension.
Detailed show notes at https://samholford.github.io/wardcalls/hypotension/
Sam discusses shortness of breath and oxygen use with Respiratory and General Medicine advanced trainee Dr Cam Sullivan. We also delve into more advanced pneumonia management and investigation as well general expectations of house officers on ward calls.
Detailed show notes at https://samholford.github.io/wardcalls/shortness-of-breath-and-oxygen/
Despite its significance, the verification and certification of death are tasks few RMOs excel at. Sam talks to Dr Garry Clearwater, FACEM and Medical Referee, about the practical aspects of verifying death, and completing the paperwork.
Detailed show notes at https://samholford.github.io/wardcalls/verifying-and-certifying-death/
The Ward Calls podcast dissects common ward calls you will need to confidently manage as a PGY1 doctor and beyond. We discuss practical, safe and comprehensive approaches that are achievable in the limited time available when working on the ward.
The podcast is co-hosted by Dr Vani Chandran and Dr Sam Holford, based in Auckland, New Zealand.
We hope to provide guidance applicable to hospitals throughout New Zealand, and expect most of the content to apply to Australia and further abroad. Thanks to the NZRDA Education Trust for making this podcast possible.
Disclaimer
Practicing medicine is to make black and white decisions based on grey information. We can’t cover every possible scenario on this podcast and cannot guarantee accuracy. We’ve done our best to bring you useful and reliable advice, from guests volunteering their time to give expert opinion. Our advice does not replace your local hospital policy or guidelines, nor good clinical judgement.