This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. Check out the AANA here: https://www.aana.com/ Presented by Desiree Chappell with Monty Mythen and their guest Brett Kendon, DNP, CRNA, CHSE, Assistant Clinical Professor, Assistant Program Director, Nurse Anesthesia Program, Northern Kentucky University.
This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. Check out the AANA here: https://www.aana.com/ The Peer Assistance section of the AANA’s website is here: www.AANAPeerAssistance.com . Also see www.AANA.com/AboutPeerAssistance for additional facts and information. Presented by Desiree Chappell and Monty Mythen with their guests, Linda Stone, DNP, CRNA Assistant Program Director at Raleigh School of Nurse Anesthe...
This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. Check out the AANA here: https://www.aana.com/ Our guest kindly allowed us to share her email with you: andrea.bittinger@beaumont.org Presented by Desiree Chappell and Monty Mythen with their guest, Andrea Bittinger, CRNA at William Beaumont Hospital....
Enhanced Recovery continues to be a hot topic in institutions around America, this piece gives us an update regarding its ongoing applicaiton at Vanderbilt University. Prehabilitation contitnues to gather pace in the wake of the Prehabilitation conference held earlier this year. We also discuss The Respiratory Compromise Institute, which you can read more about here: http://www.respiratorycompromise.org/ This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) ...
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/...
This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. Check out the AANA here: https://www.aana.com/ This link leads you to the paper in question: https://www.ncbi.nlm.nih.gov/pubmed/31247096 Presented by Desiree Chappell and Monty Mythen with their guests Robert Fabich, Doctor of Nursing Practice, CRNA, Veteran and Sharrod R. Greene, CRNA, Sentara Anesthesiology Specialists....
This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. Check out the AANA here: https://www.aana.com/ The Facebook Group "CRNA Inventors and Innovators" mentioned in this piece is here: https://www.facebook.com/groups/2150893568464906/ Presented by Desiree Chappell and Monty Mythen with their guests Diane Miller, Pediatric Devices for Induction of Anesthesia | Product Development | PeDIA, LLC and Jean Snyder, CRNA In...
This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. Check out the AANA here: https://www.aana.com/ If you would like to contact our guest he has allowed us to post his email here: msilberman@beneschlaw.com Presented by Desiree Chappell and Monty Mythen with Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology and their guest, Mark Silberman, Partner, B...
This piece is part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. Check out the AANA here: https://www.aana.com/ The NHS's guidelines are here: https://www.nhs.uk/conditions/gender-dysphoria/guidelines/ Presented by Desiree Chappell and Monty Mythen with Jose Castillo, PhD, CRNA Faculty, Texas Wesleyan University, AANA Diversity and Inclusion Committee....
What do we now know about perioperative asprin? More specifically, what is the latest thinking on the results of the PeriOperative ISchemic Evaluation-2 Trial (POISE-2)? How do we educate patients about exercise? How do we support and help patients who have adverse outcomes to surgery? What's the best screening tool for malnutrition? Moderated by Dr Catherine Gibb, Consultant physician in perioperative care, Monash University and featuring Harry Gibbs, FRACP, FCSANZ, The Alfred, Melbourne, Steph...
"Our hospital now has twice the capacity it had" cost of care and efficiency are up. Hear how enhanced recovery after surgery (ERAS) and the power of prehabilitation has dramatically shifted institutions towards better outcomes and a higher value of care. Also in this piece; what is immunonutrition? How does stress alter our immune responses? The piece mentioned in the podcast can be found here: https://journals.lww.com/annalsofsurgery/Abstract/2018/10000/Impact_of_a_Novel_Preoperative_Patient_c...
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...
How can you make a difference in the preoperative assessment clinic? How do we remain working as a team while respecting everyone's skillset in a multidisciplinary environment? The value of a good comprehensive preoperative evaluation is clear; how do we ensure that, when this can happen, it does? How do we best use the 'teachable moment' that prehabilitation for surgery is? Looking at the data is it fair to "try to tell patients, you don't have to stop smoking for good but can't you stop for th...
How can goal directed therapy be used to prevent acute kidney injury (AKI)? What do we know about AKI? Which members of the surgical team should be involved in AKI detection? Where do we stand on ACE inhibitors (angiotensin converting enzyme inhibitors) and ARBs (angiotensin-receptor blockers)? Where should a perioperative practitioner stand on the choice between restrictive versus liberal fluid therapy? The slides for this piece are here: http://www.anzca.edu.au/documents/02-vincent-dintini_goa...
Is it fair to say that prehabilitation is the new direction for practitioners of Enhanced Recovery After Surgery (ERAS)? Discussion expands into patient awareness initatives, The Macmillan Cancer Support, Principles and guidance for prehabilitation guide mentioned is here: https://www.macmillan.org.uk/about-us/health-professionals/resources/practical-tools-for-professionals/prehabilitation.html Age care naturally follows as the roundtable discussion continues. This piece gives a truly pan-nation...
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...
This is the panel discussion which tackles emergency surgery. Discussion begins with more detail regarding the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial. Featuring, Professor Carol Peden, Executive Director of the Center for Heath System Innovation and Professor of Anesthesiology at the Keck School of Medicine of the University of Southern California, Fellow of the Institute for Healthcare Improvement (IHI), Ben Griffiths, consultant anesthetist at Auckland City Hospital,...
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...
What should we think about issues regarding the Perioperative Ischemic Evaluation Study (POISE)? Is it time to treat men and women equally when it comes to haemoglobin levels? What advice should we give to clinicians who are managing change at a hospital? What should our approach to iron be and can interventions make a real difference? Featuring; Bruce Waxman, Adjunct Associate Professor (Honorary) at Monash University Dept. of Surgery School of Clinical Sciences, Monash Health and Chief Medical...
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...
This panel discussion provides a vital and thought provoking insight into frailty in a perioperative patient. Further, as perioperative medicine evolves, how do we know enhanced recovery after surgery (ERAS) works? Are there any large randomised controlled trials that prove it? This piece is moderated by Dr Ming Loh, Staff Specialist Geriatrician and Clinical Lecturer at Westmead Hospital and the University of Sydney, Clinical Lead for the Orthogeriatric Service, Subacute Rehabilitation Ward and...
How important is it to triage the patient? Which triage tool should we use? How do we determine which of our surgical patients is most at risk? Which procedures carry the highest risks? What should our approach be towards managing patient deterioration? What about when it comes to acute clinical deterioration? What, in terms of research and technology, can we expect in the future to help us? The slides for this piece are here: http://www.anzca.edu.au/documents/03-imogen-mitchell_how-do-we-minimi...
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.
Implementing better practice and "ERAS 2.0". The ground up approach of a 'council of nurses' sparks some fascinating debate and discussion. Can a roundtable approach sometimes work better than the traditional hierarchical power structure? Presented by Desiree Chappell with her guests Dr Ruchir Gupta, medical lead for enhanced recovery at Stony Brook University and Joni Brady, Perianesthesia, Pain Management Nursing Consultant Alexandria, Virginia.
This piece is a chance to reflect upon the importance of new media within the sphere of medical education. As the run away success of TopMedTalk and other podcasts in this area shows people are hungry to use the unique potential of this medium. Also - how has social media, video casting and live streaming altered the way conferences are both organised, executed and received? Finally, our team of experts tackle the eternal question; where to next? Presented by Joff Lacey with his guests; David Ly...
The Hypotension Prediction Index (HPI), which uses a machine learning algorithm to help predict intraoperative hypotension. Regular listeners to www.topmedtalk.com will be familiar with concerns about perioperative hypotension. For those who have just joined us, or anyone who fancies a quick refresher on this issue, it is covered in detail here: https://www.topmedtalk.com/live-from-boston-asa-2017-the-elephant-in-the-room-intraoperative-hypotension/ Many practitioners believe they can predict hy...
What is a 'micromort'? Even more of a worry, what does ten of them mean? How do we measure and communicate risk to patients? Everyday activities all carry inherent risks, how do we put surgery into a context 'everyday people' can more easily understand? Professor Monty Mythen presents with 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 Anaesthesiology, Univ...
This piece explores some of the talking points and controversies related to dealing with frail patients who are in need of prehabilitation. How do we meet the needs and concerns of elderly patients while delivering a comprehensive standard of perioperative care? Presented by David Storey, Head of Anaesthesia, Perioperative and Pain Medicine Unit (APPMU), Melbourne Medical School, University of Melbourne; Director, Melbourne Clinical and Translational Sciences (MCATS) research platform....
"Post-operative critical care: what should we do?" was 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 Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton....
What is after ERAS, do we have an 'ERAS of ERAS' - so to speak? This conversation focuses upon bringing about change, managing and sustaining it over time and helping relate it to patient outcomes. Presented by Desiree Chappell with her guest Arman Dagal, Medical Director - Spine COAP at Foundation for Health Care Quality.
