CCP Podcast 032: Hello South Africa!

 September 24

by Jonathan Downham

Kirsten Kingma (@surferkirst) is currently a medical student, traning to be one of the Doctors in South Africa who started her health care career as a paramedic

We start by talking about the role of the paramedic in South Africa and how the different funding system impacts upon health care.

We also talk about the medical staffing issues in South Africa and then finish up agreeing about how wonderful Twitter and FOAMed is for the ambitious practitioner.

I think I may have persuaded her to come back for more in the future as my South Africa correspondent!


A Randomized Trial on Subject Tolerance and the Adverse Effects Associated With Higher- versus Lower-Flow Oxygen Through a Standard Nasal Cannula

Another article has been highlighted via twitter which further advances the cause for the practice of NODESAT or the use of nasal oxygen during rapid sequence induction. This is a simple thing to do for the patient and it has been shown to be effective and not uncomfortable for the patient:

Use of High-Flow Nasal Cannula Oxygen Therapy to Prevent Desaturation During Tracheal Intubation of Intensive Care Patients With Mild-to-Moderate Hypoxemia Miguel-Montanes, R., Hajage, D., Messika, J., Bertrand, F., Gaudry, S., Rafat, C., … Ricard, J.-D. (2014). . Critical Care Medicine

Apneic oxygenation via nasal prongs at 10 L/min prevents hypoxemia during tracheal intubation for elective surgery. Christodoulou, C., Rohald, P., Mullen, T., Tran, T., Hiebert, B., Lee, T., & Sharma, S. (2013).  Eur. Respir. J.

A Randomized Trial on Subject Tolerance and the Adverse Effects Associated With Higher- versus Lower-Flow Oxygen Through a Standard Nasal Cannula. Brainard, A., Chuang, D., Zeng, I., & Larkin, G. L. (2015). . Annals of Emergency Medicine, .2014.10.023

Evidence Based Preoxygenation from Rob from ercast on Vimeo.



I had a very interesting conversation with one of my Twitter contacts last week, Dr Todd Fraser (@Sunnydoc72). He has become concerned over the years that health care professionals seem to have no consistency over the benchmarking and recording of their skills. As a consequence he has started a crowdfunding campaign to try to get the necessary finance together to produce.

Osler is a digital technology that will allow you to benchmark your performance against others in a similar position providing you a report card of procedural and clinical capability. There will be access to a learning platform with multimedia, interactive and patient focused learning resources. You can keep up to date with the latest literature and Osler Knowledge will give access to a database of latest research, which it will search for you depending on the question you ask.

You will also be able to connect with your peers to help you understand difficulties you maybe having. There will be an authentication process throughout all of this so that you can be sure that the information you get is reliable and the people you are interacting with are trustworthy.

The crowd funding process asks that you make a financial promise. It aims to reach a target of $300,00 within 30 days. You can pledge as little as $10 all the way up to $5000. This money will not be taken from you until the target is reached. If you pledge then there are some incentives offered.

I think this looks like a fantastic idea, but will need some support to get it off the ground. Todd has clearly worked very hard at this and is very passionate. Worth a few dollars I think.


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