What is "The Brain Health Initiative"? Why is it that so many aspects of brain function are so hard to understand? Why is cognitive dysfunction such a difficult topic to discuss? How far away are we from the days when we will have a biomarker that can help us in this area? Desiree Chappell presents, with her guests; Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania and Miles Berger, Neuroanesthesiologist at Duke University Medical Center....
Jan 17, 2020•18 min
Anaesthesia is the official journal of the Association of Anaesthetists with comprehensive coverage of publications in anaesthesia, ICU and pain. This piece gets into the detail of their hugely popular perioperative care supplement, a collaboration with BJS (formerly the British Journal of Surgery). Surgeons and Anaesthetists around the world are engaging in the debate as a result with thousands of tweets about the subject, after publication only days before the 2020 Winter Scientific Meeting. F...
Jan 16, 2020•28 min
"It's all about safety and recovery, it's not about speed"; this conversation focuses on enhanced recovery, are we getting it right and where are people getting it wrong? How reliable and well understood is the data behind it? Also, what are the current thoughts on perioperative steroids? How do we refocus and move back to enhanced recovery after surgery rather than "enhanced discharge" after surgery. Presented by Monty Mythen and Desiree Chappell with Sol Aronson, tenured Professor at Duke Univ...
Jan 15, 2020•33 min
In this piece we're joined by a TopMedTalk favorite for a few predictions regarding the year 2020. Prehabilitation, "the word of the year" for 2019 and now something we expect to see break into the mainstream? How is anesthesia going to develop and what's the future for artificial intelligence in surgery? PQIP link: https://pqip.org.uk Multimodal analgesia: https://www.topmedtalk.com/ebpom-usa-part-5-a-perioperative-practicum-with-tj-gan/ TopMedTalk has covered methadone on a couple of occasions...
Jan 14, 2020•19 min
This panel discussion and extended question and answer session focuses upon troponin screening. Where is the latest evidence as regards this debate? Is MINS ( Myocardial injury after noncardiac surgery) the most common postoperative complication associated with death and if so why is there a transatlantic divide as regards the evidence? Is there a place for troponin screening preoperatively for risk stratification? What should one do with an asymptomatic post operative patient with raised tropon...
Jan 13, 2020•32 min
To celebrate the launch of his book Fluid Physiology, A Handbook for Anaesthesia and Critical Care Practice: https://books.google.co.uk/books?id=F-m4DwAAQBAJ&printsec=copyright&redir_esc=y#v=onepage&q&f=false What are Tom's big areas to watch in 2020? Also how are surgical teams similar to the team behind the moon landing and what should we be thinking about the use of steroids in surgery? Check out Fluid Physiology: www.fluidphysiology.org The 13 Minutes To The Moon podcast is h...
Jan 12, 2020•9 min
"One of the best sessions of the entire conference" was presented by our guest on this piece. In this podcast there's a chance to really discuss perioperative optimisation, with a focus on delirium, in post operative patients. Are we getting to where we need to be or is there more work to be done? Presented by Desiree Chappell with Sol Aronson and their guest Charles Brown, associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine....
Jan 11, 2020•15 min
This piece dives into "The new www revolution?: Wireless Wearables on the Ward". Improving the monitoring of patients on the wards is an exciting prospect for any modern practitioner and as personal health monitoring technology becomes mainstream for the public it's surely an inevitable part of the future of medicine. The website mentioned in the podcast is here: https://www.michardconsulting.com/ The Global burden of postoperative death - The Lancet is here: https://www.thelancet.com/journals/l...
Jan 11, 2020•15 min
This passionate talk is a call to action for the peioperative practitioners who are serious about the wider issue of population health. How can the protocols and pathways of your practice be adjusted to seriously contend with the global issue regarding the stewardship of one of medicine's most vital resources? Presented by Alison Holmes, Professor of Infectious Diseases at Imperial College, Fellow of the Academy of Medical Sciences and an Senior Investigator at the National Institute of Health R...
Jan 10, 2020•9 min
How serious an issue is 'burn out'? What's the best way to transfer a patient from ward to ward or from institution to institution? What do we think about remote supervision and monitoring? What problems will Artificial Intelligence help us solve? Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020, from The Queen Elizabeth II Centre, London, UK. This piece follows on from part one, which you can find here: https://www.topmedtalk.com/topmedtalk-matt-wiles-and-marcus...
Jan 10, 2020•48 min
In our online world is there still a place for a paper based journal? What are the big stories and hot topics of 2020 going to be? What are the latest thoughts about 'depth of anaesthesia'? Can we use ultrasound technologies to enhance patient care? Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020 in the centre of London from The Queen Elizabeth II Centre. Presented by Monty Mythen with his guests Matt Wiles, Consultant Anaesthetist & Senior Clinical Lecturer...
Jan 09, 2020•32 min
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,...
Jan 09, 2020•15 min
"ERAS in Obstetric Surgery" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 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 This piece is presented by Attila Kett, anaesthesiologist and Chairman at St Peter's University Hospital at New Jersey, he is introduced by Vicki Morton, Doctor of Nursing Practice and Director of C...
Jan 08, 2020•12 min
How do the insights from experience in Enhanced Recovery apply to critical care patients and 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 South C...
Jan 07, 2020•12 min•Season 3Ep. 1
This piece argues that troponin screening might be overused, "it's not all about the heart". Myocardial injury after noncardiac surgery (MINS) is seen as a relatively common issue driving post-operative harm. This piece gets into the detail and asks some important questions as to how focused practitioners should be upon troponin screening. It's part 2 of 3 from The EBPOM 2019 TopMedTalk session which debated the issue. Presented by Mike Grocott, Professor of Anaesthesia and critical care at the ...
Jan 06, 2020•13 min
This is the panel discussion which followed the address at EBPOM 2018 by Professor Sir Bruce Keogh on the eve of the 70th anniversary of the NHS. Various questions from the audience are considered; where should we be in ten years from now, what are the disruptive forces headed our way? The panel features; Sir Bruce Keogh, Professor Monty Mythen, University College London, Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Souther...
Jan 05, 2020•22 min
On the last occasion we spoke with our guest she was a Perioperative Medicine Fellow at Duke University; learn now how her experiences have helped change her practice and the edge she has dealing with healthcare. The conference is producing a number of talking points, the Measurement of Exercise Tolerance before Surgery (METS) Trial seems to have shifted opinions, does a genuine 'perioptimist' have a deeper insight into the issues there? Also - does North America really lack the resources, exper...
Jan 04, 2020•19 min
How do new technologies impact the postoperative elements of Enhanced Recovery? Here we discuss "ward monitoring 3.0" and new technologies which are now available, or in the pipeline, to improve outcomes. How do we best use this information and these innovations? The website mentioned in the podcast is here: https://www.michardconsulting.com/ Presented by Desiree Chappell with Monty Mythen and their guest Frederic Michard of MiCo Consulting....
Jan 03, 2020•14 min
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...
Jan 02, 2020•29 min
Doesn't the decision to delay surgery depend upon the type of cancer? Can you measure complications as an outcome? What's the cause of non cardiac complications that are related to lack of exercise? Can we change the mindset of prehabilitation by explaining that prehabilitation is the start of treatment? How do we convince patients and decision makers that delaying surgery is a good idea? How involved are oncologists in perioperative decisions? Presented by Duminda Wijeysundera, Professor in the...
Jan 01, 2020•16 min
This question and answer session is a valuable insight into where the latest thinking is as regards tackling the opioid crisis. How do we get to an understanding where the entire continuum of care is on the same page as regards pain relief? What's the level of adoption for opioid free anaesthesia? Can re-languaging pain or "re-writing the narrative" help, for example is it better to speak of 'comfort levels' as opposed to pain? What's the latest thinking as regards caffeine as an aid to comfort?...
Dec 31, 2019•15 min
This piece argues that troponin screening is useful, if used appropriately. Is it the case that this test has been 'over sold' and as a result has provoked unhelpful pushback from practitioners? It's part 1 of 3 from The EBPOM 2019 TopMedTalk session which debated the issue. Presented by Duminda Wijeysundera, Professor in the Department of Anaesthesia and the Institute of Health Policy Management and Evaluation at the University of Toronto, and a Staff Anesthesiologist at St Michael’s Hospital....
Dec 30, 2019•17 min
A special edition of TopMedTalk recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum. How can cold water adaption help people deal with medical issues? There's evidence to suggest that cold water adaption reduces inflamation, can open water swimming help with issues such as chrohn's disease? On the other hand how important is it to ensure patients do not become cold while in our care? Hypothermia is never good, how imp...
Dec 29, 2019•45 min
Post op respiratory complications are the focus of this piece. How can they be anticipated, detected early and dealt with appropriately? What about objective neuromuscular monitoring? Should you revese every single patient? If so, how do you do it? What about the risk of pulmonary complications? Presented by Desiree Chappell with her guest Frances Chung, Professor, Department of Anesthesiology and Pain Medicine, University of Toronto.
Dec 28, 2019•11 min
Learn about the Perioperative Anesthesia and Surgical Screening Clinic (PASS Clinic), do you need one at your practice? What is pain control for a perioperative patient? Hear also about the 'subacute period' and how you can incorporate it into your practice. Also, how do we keep patients 'opioid free' once they leave our care? Finally, how does individualised pain management and pain education fit into this picture? Presented by Desiree Chappell and Vicki Morton, with their guests; Professor Pad...
Dec 27, 2019•10 min
Our Holiday Special, part 3 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year. 🙏🙏 All of us at TopMedTalk want to send a BIG thank you to ALL of our amazing fans and listeners. The support these past 2 years is inspiring ...
Dec 26, 2019•32 min
Our Holiday Special, part 2 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year. 🙏🙏 All of us at TopMedTalk want to send a BIG thank you to ALL of our amazing fans and listeners. The support these past 2 years is inspiring ...
Dec 25, 2019•30 min
Our Holiday Special, part 1 of 3, is a sampling of our favorite conversations and lectures from 2019. It is a chance for new listeners to the hear the outstanding content that has made TopMedTalk the success it is after 2 amazing years. And for our regular listeners, a check in to make sure they've not missed some of the crucial pieces of the last year. 🙏🙏 All of us at TopMedTalk want to send a BIG thank you to ALL of our amazing fans and listeners. The support these past 2 years is inspiring ...
Dec 24, 2019•36 min
This piece discusses The Brain Health Initiative and the sixth Peri-Operative Quality Initiative which focused upon delirium. How can progress in these areas be built upon and encouraged? Where is the data in regards to detecting and dealing with delirium? Beers Criteria Medication List; Potentially Inappropriate Medications for the Elderly According to the Revised Beers Criteria is here: https://dcri.org/beers-criteria-medication-list/ The website for the AARP is here: https://www.aarp.org/ Pre...
Dec 23, 2019•27 min
Twitter is ablaze with talk of the Society for Perioperative Assessment and Quality Improvement (SPAQI). How did they do it? This piece is a thought provoking discussion about new media and the consequences of our online world for medicine. 'The democratisation of education' is a phrase we've heard here on TopMedTalk in the past. How does direct access to information and experts in our field alter the state of play in the perioperative field? Desiree Chappell and Monty Mythen are presenting with...
Dec 22, 2019•14 min
