This piece discusses how the contributors are driving better perioperative care in their clinics; the importance of getting patient records in advance; ERAS for obstetrics; challenging opioid use with the multimodal pain management; shared decision making in pain management; the importance of clear communication pathways and patient literacy. This podcast features Desiree Chappell interviewing; Dr Ellen Flanagan, anaesthesiologist and medical director at the Duke preoperative assessment testing ...
Feb 01, 2019•19 min
Triple-low Alerts Do Not Reduce Mortality: A Real-time Randomized Trial. Sessler DI, Turan A, Stapelfeldt WH, Mascha EJ, Yang D, Farag E, Cywinski J, Vlah C, Kopyeva T, Keebler AL, Perilla M, Ramachandran M, Drahuschak S, Kaple K, Kurz A. Anesthesiology. 2019 Jan;130(1):72-82. doi: 10.1097/ALN.0000000000002480. https://www.ncbi.nlm.nih.gov/pubmed/30312182 Why Money Alone Can't (Always) "Nudge" Physicians: The Role of Behavioral Economics in the Design of Physician Incentives. Lubarsky DA, French...
Jan 31, 2019•12 min
"Post-operative critical care: what should we do?" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com Hear this excellent talk, for free, on this podcast. If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com Presented by Denny Levett, Professor in Perioperative Medicine and ...
Jan 30, 2019•22 min
Should we still measure urine output? How useful is permissive oliguria? Presented by Professor Monty Mythen and Dr Joff Lacey featuring guests Dr Tim Miller from Duke University Medical Centre and John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh.
Jan 28, 2019•5 min•Season 1Ep. 8
How do the insights of a 'medical linguistic anthropologist' impact upon our understanding of 'shared decision making'? How do patients make decisions about surgery? When, in the perioperative process, do they decide what is best for them? Does patient autonomy actually even exist? A bubble bursting conversation with a frequent favourite on TopMedTalk, this podcast is bound to get you thinking! Presented by Desiree Chappell and Monty Mythen with their guest Dr Lee Fleisher Professor and Chair of...
Jan 27, 2019•16 min
The concern for patient safety naturally flows throughout the healthcare continuum. In our discussion with Masimo Founder, Joe Kiani, we discuss the 'planning for zero’ initiative and how we can realistically reach perfection in this area. The Patient Safety Movement Foundation is an organization dedicated to a goal of ZERO in-hospital preventable deaths by 2020. They request that you and your organization get involved and commit to this goal. Find out more at www.patientsafetymovement.org Prese...
Jan 26, 2019•11 min
How important is it to screen patients for anaemia before surgery? Has anaemia fallen off the health care agenda? We begin with a conversation about patients who are anaemic and then turn to why this is sometimes not checked enough. Monty Mythen mentions UK University students appear to suffer from the condition more these days and Lori Heller points out that treating the condition, as part of patient optimisation, is something of a revelation for some, even occasionally removing the need for su...
Jan 25, 2019•22 min
Journal Club Express this week focuses upon a piece in Anesthesiology; Cognitive Effects of Perioperative Pregabalin: Secondary Exploratory Analysis of a Randomized Placebo-controlled Study. Link here: http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2708941
Jan 24, 2019•4 min
Originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com Hear this excellent talk, for free, on this podcast. If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com Presented by Angela Coulter, a UK based health policy analyst and researcher....
Jan 23, 2019•23 min
How do the insights from experience in Enhanced Recovery apply to critical care patients and care postoperative care pathways? We also discuss utilization of advanced monitoring technology for the critically ill patient postoperatively. Presented by Desiree Chappell with her guests Philip Corvo, Chairman of Surgery Stanley J Dudrick Dept of Surgery at Saint Mary's Hospital and Vicki Morton, DNP and Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates University of So...
Jan 22, 2019•11 min•Season 2Ep. 4
This episode of The Perioperative Coach reflects on the pain management discussions being had by the American Society of Enhanced Recovery (ASER) and its members. For further reading see the articles in Perioperative Medicine Journal: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0064-5 This conversation taken from a longer piece to be found here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/ Presented by Monty Mythen with Dr Jof...
Jan 21, 2019•5 min•Season 1Ep. 7
Joff and his guests visit the hallowed turf that is the Boston Ether Dome, in the Bulfinch Building, Massachusetts General Hospital. How have times moved on since those early pioneering days when the relatively young profession of Anaesthesia was born? Back then the word wasn't as widely used and the gentlemen in question described their activities as "rendering people insensible using sulphuric ether for the conduct of surgery". Recorded last year this piece has Dr Joff Lacey paying tribute to ...
Jan 20, 2019•8 min•Season 2Ep. 2
This podcast concerns sleep apnea as part of pre-operative patient optimisation. How important is it to evaluate patients for sleep disorders before surgery? Are patients with sleep apnea aware of their condition and are they using some form of treatment? What are the health problems associated with sleep disorders? How do you build a financial case for including this in your practice? A piece originally streamed live from Atlanta Georgia during TopMedTalk's coverage of "EBPOM-USA Masters Course...
Jan 19, 2019•18 min•Season 2Ep. 3
This piece discusses the changes enhanched recovery brings, the conversation then moves to narcotics and the opioid epidemic. Presented by Desiree Chappell, Dr Vijaya Gottumukkala, cardiac anaesthesiologist from MD Anderson and member of the board of directors for the American Society of Enhanced Recovery (ASER) and Dr George Nassif, colorectal surgeon at the Center for Colon & Rectal Surgery in Florida.
Jan 18, 2019•14 min
J Clin Anesth. 2018 Dec 29;55:83-91. doi: 10.1016/j.jclinane.2018.12.038. [Epub ahead of print] The effects of dexamethasone, light anesthesia, and tight glucose control on postoperative fatigue and quality of life after major noncardiac surgery: A randomized trial. Abdelmalak BB, You J, Kurz A, Kot M, Bralliar T, Remzi FH, Sessler D. https://www.ncbi.nlm.nih.gov/pubmed/30599425
Jan 17, 2019•7 min
Originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com Hear this excellent talk, for free, on this podcast. If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com Presented by Sarah Hare, of the National Emergency Laparotomy Audit (NELA)....
Jan 16, 2019•29 min
A discussion about the changes enhanched recovery has brought into practices, the conversation then moves to narcotics and the opiode epidemic. Desiree Chappell speaks with Dr Vijaya Gottumukkala, Professor of Anesthesia and Deputy Chair at MD Anderson and Dr George Nassif colorectal surgeon from The Florida Hospital.
Jan 15, 2019•13 min•Season 2Ep. 3
Professor John Kellum gives a thumbnail sketch summary of the fluid debate. Presented by Professor Monty Mythen and Dr Joff Lacey with guest John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh. Join in the debate: contact@topmedtalk.com This conversation taken from a longer piece here: http://www.topmedtalk.com/ebpom-2017-pod-one-live-from-london/...
Jan 14, 2019•12 min•Season 1Ep. 6
A discussion about consent, staying on the right side of the law, shared decision making and a 'The Montgomery case' which has defined a Doctor's duty in these sorts of areas. Presented by Monty Mythen with Desiree Chappell and their guests Hugh Montgomery, and Paul Sankey, Enable Law partner and Clinical Negligence solicitor acting for patients, an accredited expert in his field.
Jan 13, 2019•20 min
This podcast includes discussion about psychological optimisation for surgery; who should have it, what does it mean and how does it work? Further conversation moves into weaning patients off opioids in advance of surgery and cutting their dependency afterwards. Also, the question of consent to opioids during and after surgery comes up - should we be educating patients more and is it time to look more deeply at the issue of consent? Hosted by Desiree Chappell and Vicki Morton featuring Dr. Padma...
Jan 12, 2019•17 min•Season 2Ep. 2
Discussion begins with an explanation of 'Trainees with an Interest in Perioperative Medicine' (TRIPOM), a big hit at the conference this year, then a wider discussion follows which includes thoughts regarding further research and application of the perioperative method as well as where it impacts medicine and care. The importance of a multidisciplinary team based approach is strongly emphasised. The Getting It Right First Time (GIRFT) initiative is also discussed, more on that here: http://topm...
Jan 11, 2019•11 min
Two articles, which both feature in The British Journal of Anaesthesia (BJA), are dissected in this week's Journal Club. They both discuss oxygen, the two articles are linked to here: Effectiveness of 80% vs 30–35% fraction of inspired oxygen in patients undergoing surgery: an updated systematic review and meta-analysis: https://bjanaesthesia.org/article/S0007-0912(18)31346-1/fulltext Safety of 80% vs 30–35% fraction of inspired oxygen in patients undergoing surgery: a systematic review and meta...
Jan 10, 2019•21 min
Originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com Presented by Dr Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL)...
Jan 09, 2019•21 min
An entertaining and informative discussion about the implementation process; how do you bring everyone to the table? Desiree Chappell speaks with Robin Anderson, Enhanced Recovery (ERAS) program coordinator at Duke University, Bethany Sarosiek, Enhanced Recovery After Surgery (ERAS) Development Coordinator at UVA Health System, and Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates. All of them are ASER nursing committee members.
Jan 08, 2019•10 min•Season 2Ep. 2
A discussion about fluid management in an enhanced surgical recovery pathway in relation to the guidelines from ASER and the work of The Perioperative Quality Initiative (POQI http://www.poqi.org ). Presented by Monty Mythen with his guest Dr Tim Miller, anaesthesiologist at Duke Medical Centre and Vice President of ASER. For more come to our meetings: http://www.ebpom.org/EBPOM-USA This highlight clip is taken from a longer conversation to be found here: http://www.topmedtalk.com/aser-ebpom-201...
Jan 07, 2019•7 min•Season 1Ep. 5
2019 brings lots of new opportunities for your favourite medical podcast, including the chance to see us at a live event. Maybe you'll join us in real life, or maybe you'll join us online. This conversation looks forward to 2019, inviting you to become a bigger part of TopMedTalk. We're also extending an invitation to listeners to join us in an episode of TopMedTalk soon, listen to the podcast for more details and email us if you'd be interested in doing a piece with us in your area of specialty...
Jan 06, 2019•37 min•Season 2Ep. 1
Treating patients as people rather than 'jobs to be done' and 'boxes to be ticked' is the focus of this piece. What can Doctors do better when it comes to treating patients? Find out what happened when a perioperative care doctor became a patient. A fascinating conversation streamed live from Atlanta Georgia during the second day of TopMedTalk's coverage of "EBPOM-USA Masters Course, A Perioperative Care Practicum". Hosted by Desiree Chappell and Monty Mythen. Featuring Dr Paul Wischmeyer, Profe...
Jan 05, 2019•25 min•Season 2Ep. 1
Should we refuse surgery to those who won't change? What about pathological issues, such as smoking, should practitioners become more didactic in their approach? How do we effectively communicate risk, both to the patient and the institution you work for? Professor Monty Mythen presents with Dr Joff Lacey and guests, Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and Dr Mike Irwin, Professor and Head, Department of A...
Jan 04, 2019•8 min
This week's Journal Club takes a piece from Anaesthesia and Analgesia; "Implication of Major Adverse Postoperative Events and Myocardial Injury on Disability and Survival: A Planned Subanalysis of the ENIGMA-II Trial". A link to the article is here: https://www.ncbi.nlm.nih.gov/pubmed/29533264 Presented by Monty Mythen and Desiree Chappell.
Jan 03, 2019•10 min
Originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com Hear this excellent talk, for free, on this podcast. If you want to attend an event like this ensure your next click is here: www.ebpom.org/meetings If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com Presented by Andrew Klein, Cardiothoracic Anaesthetist at Royal Papworth Hospital, Cambridge and Editor-in-Chief of Anaest...
Jan 02, 2019•26 min
