The Safe Practice Podcast Dr Maria Li

It has long been accepted that in patients who have undergone axillary lymph node dissection/clearance, the ipsilateral arm must not be used again for any sort of medical instrumentation. This frequently results in overuse of the other arm (and sometimes the feet and other creative sites) for vascular access. The outcome was often impracticality, discomfort, distress, and occasionally overt harm to the patient. All due to the theoretical risk of lymphoedema.



But just just how theoretical is that risk? Very, it appears. Over the past 14 years, the weight of cumulative evidence has shown that there is very little to prove that instrumenting the affected arm increases the risk of lymphedemga.



All of this has caused a recent shift in the clinical paradigm - so much so that the latest guidance in 2023 from The Australian and New Zealand College of Anaesthetists says it is safe to use the patient's affected arm for vascular access, vaccination, BP monitoring.



In fact, ANZCA has a media release and a patient factsheet on this very topic.



In this episode of the podcast, I chatted to anaesthetist Dr James Marckwald to clarify the evidence and context behind this new guidance.



Hooray for medical advancement!



** All content and opinions expressed are those of the host and guest, and do not represent the views of any of the organisations with which they are affiliated.

The ability to acknowledge our limits is a foundational pillar of safe clinical practice, at all levels of experience and training. I began exploring this subject in Episode 12, and continued it in Episode 15 where I interviewed JMO Dr Jade Bevan to get a JMO perspective.

In this episode, I am joined by surgical registrar and fellow medical podcast host Dr Anne Atkins to further enrich our exploration of this topic.

Anne brings a wealth of experience as both a previous paediatrics trainee, and now as a general surgical registrar.

For those interested in paediatrics, Anne and her colleague Dr Freya Bleathman host an excellent Paediatric Medicine and Surgery podcast called You're Kidding Right which I highly recommend.

** All content and opinions contained within this podcast are those of the host and guest, and do not represent the views of any organisations with which they are affiliated.

ENT surgeon Dr Marco Raftopulos joins me to discuss sudden sensorineural hearing loss: an otologic diagnosis that, if missed, results in a 70% chance of irreversible deafness.

The good news is that if it is diagnosed and treated promptly, there is a 70% chance of recovery.

This episode covers symptoms, assessment and emergency management, through the lens of a highly alarming case study - alarming because it's easy to see how the poor outcome could happen to any of us in our own clinical practice!

An episode not to be missed for primary care practitioners, critical care clinicians and paediatricians (or indeed anyone to whom a patient may present with aural symptoms).

📌 All content and opinions expressed on this forum are those of the podcast host and guests, and do not represent the views of any organisation with which they are affiliated.

Bowel cancer is increasing at an alarming rate in young people, and is currently the biggest cancer killer of young Australians aged 25-44.

In this episode, I sit down with colorectal surgeon and Bowel Cancer Australia spokesperson Dr Penelope De Lacavalerie to discuss some diagnostic pitfalls to avoid when it comes to the investigation and referral of suspicious bowel symptoms, in particular in young people.

How young is too young to have bowel cancer?
How can clinicians tell if PR bleeding is just haemorrhoids and not something more sinister?
Should colonoscopy be delayed for pregnant or lactating women who present with suspicious symptoms?

We answer to these questions, and more. The answers may surprise you.

If you want to find Penelope, she has a website (mysydneysurgeon.com.au) and Instagram (@mysydneysurgeon).

** All content and opinions expressed in this podcast are the personal views of the host and the guests, and do not represent the views of any organisations with which they are affiliated.

As clinicians, we all know that it's important to ask for help early when we reach the limits of our scope. But what does that look like practically, when you are a junior doctor?



To answer this question, I interview Resident Medical Officer Dr Jade Bevan for her insights. We discuss the principles and realities of acknowledging our limits and asking for help through the lens of real-life clinical scenarios (modified to protect the innocent).



An episode not to miss if you are a JMO, about to become a JMO, or have a JMO in the family.



**All content and opinions expressed in this podcast are those of the host and guest, and do not represent the views of any organisations which which they are affiliated.

As of 1 Nov 2023, Medicare rebates came into effect for reproductive genetic carrier screening. In this episode, I interview one of the clinical brains behind Mackenzie's Mission - Clinical Geneticist and Genetic Pathologist Professor Edwin Kirk.



We discuss the clinical nuances of RGCS, and also shed light on some uncommon pitfalls and ways to address them.



A must-listen episode for anyone who looks after pregnant women, is pregnant, or wishes to have biological children themselves.



Resources alluded to in the podccast:




Edwin's book - The Genes That Make Us.




Public consultation process on Genetic Discrimination (open until 31 January 2024).




NSW Health Centre for Genetics Education website on RCGS.





** All content and opinions expressed in this podcast are those of the host and guest, and do not represent the views of any of the organisations with which they are affiliated.