This piece is the first in a new series of programs we are making in response to COVID-19, now described by The World Health Organisation as a global pandemic. How can we, the TopMedTalk community, rise to this challenge and help each other as we share information and experiences? Where can people look for the sort of information they would ordinarily have gained from the conference circuit this year? How can listeners to TopMedTalk get involved directly with us? Presented by Desiree Chappell an...
Mar 16, 2020•10 min
Does perioperative medicine alow institutions to take a broader view? Population health has been a theme on TopMedTalk, is it a logical extension of the perioperative process? How do we manage specialist care for the elderly and ensure high quality shared decision making? What lies behind the mindset change needed for some to accept surgery is not always the answer? Should we expect medical students to be taught the principles of perioperative medicine? What are some of the unique tensions in th...
Mar 15, 2020•29 min•Season 1Ep. 3
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...
Mar 14, 2020•11 min
"ERAS in Colorectal Surgery" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 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 Anthony Senagore, Professor and Vice Chair Western Michigan University-Homer Stryker MD School of Medicine Borgess Medical Center Kalamazo...
Mar 13, 2020•11 min
Learn how and why the benefits of real-life health care simulation situations are used by institutions such as Northern Kentucky University. Interviewing a patient, reading an X-ray, or administering an injection, in a convincing virutal environment. The St. Elizabeth Healthcare Simulation Center features seven simulation rooms including an operating room and intensive care unit. What are the future applications we can look forward to? Furthermore how is the AANA developing the way in which simu...
Mar 12, 2020•28 min
How do cardiac surgeons adapt to the changing environment and information that we now have at our fingertips? Minimally invasive robotic surgery provides additional options to the perioperative patient, what unconventional therapies might compliment this? This piece gets into specifics regarding pain management and the multimodal approach. How do you prepare patients with an understanding regarding how and what you're doing? How important is collaboration with surgical colleagues? This piece is ...
Mar 11, 2020•11 min
This piece focuses on the article "The malnourished surgery patient, a silent epidemic in perioperative outcomes?" which you can find here: https://journals.lww.com/co-anesthesiology/Abstract/2019/06000/The_malnourished_surgery_patient__a_silent.23.aspx The Perioperative Quality Initiative is here: www.poqi.org Presented by Desiree Chappell with Monty Mythen and their guests Jeroen Molinger, Clinical Medical Exercise Physiologist at Duke University Medical Center, Department of Anesthesiology &a...
Mar 10, 2020•16 min•Season 3Ep. 5
This podcast covers the physiological principles of goal directed fluid therapy, fluid responsiveness, the stressed system and the glycocalyx. Originally streamed live on www.topmedtalk.com Presented by Dr Joff Lacey with his guest Dr Randall Dull of the University of Illinois, live from the ASA in 2017.
Mar 09, 2020•20 min•Season 5Ep. 5
Learn here about The 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care provision after Surgery (SNAP-2: EpiCCS). Is anxiety the worst thing about an operation? How common a problem for patients is feeling thirsty? What about pain, how do we best manage it? In the second part of the piece we a focus on "Women in Anaesthesia"; Is there an 'opportunity gap'? How do we correct imbalances in the profession? Most importantly, how do we avoid "tokenism"? Is there room for a 'name a...
Mar 08, 2020•33 min•Season 1Ep. 2
This piece takes a look at some of the big areas we expect to see over the next twelve months as Desiree Chappell and Monty Mythen are joined in the studio by TopMedTalk favourite Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton. Could political change and necessity improve things in the UK? Hopefully this time next year will be a "champagne moment" rather than a "sham moment". As expected, the interest in prehabilitation over this year has been huge and ...
Mar 08, 2020•17 min
"The predominant emotion was fear..."; this piece is essential listening for every TopMedTalk listener who really cares about the experience of their patients. Hear what it was like to participate in the pioneering, tailored exercise training programme, The Encourage Trial. Also, find out about "the Buddy Scheme" and how becoming a member of a local support group: SPICOS (Support for People Impacted by Cancer of the Oesophagus and Stomach) led to it. Could a 'Buddy', volunteers who have been in ...
Mar 07, 2020•18 min
Hear how evidence based practices can reduce costs and improve outcomes. What are the key areas most institutions can work on to get the best and most rapid return on time invested? Neuro, atrial fibrillation, acute kidney injury (AKI) and blood management are big key areas. The article discussed in this piece is here: https://www.scahq.org/Portals/0/Documents/Clinical%20Practice%20Guidelines/SCA_EACTA%20Practice%20Advisory.pdf This piece was recorded live at 'The Society of Cardiovascular Anest...
Mar 06, 2020•12 min
Enhanced Recovery After Surgery, (ERAS) is a familiar concept to the typical TopMedTalk listener but what is ERAS+? How can you target high risk surgery patients with a comprehensive plan for them to help themselves get a better outcome? From managing expectations, to breathing exercises all the way up to significant lifestyle changes such as exercise and smoking cessation. The ERAS+ website is here: https://www.erasplus.co.uk/ Presented by Joff Lacey with Desiree Chappell with their guest Danie...
Mar 05, 2020•17 min
Frailty is a common condition which has been topical in geriatric medicine for some time but now it is appearing in the surgical and anaesthetic literature. This talk explores how our understanding and discussion has improved regarding a condition that is still yet to have a clear, universally accepted, definition. How do we build a patient's physical reserve? What is the best way to conceptualise frailty? Are there any universal treatments available? Presented by Dr Jugdeep Dhesi, Clinical Lead...
Mar 04, 2020•22 min
Should prehabilitation be thought of also as "primary prevention" and used to avoid health problems occuring in the first place? If "exercise is real medicine" how do we change the culture so GPs are comfortable prescribing physical activity to patients? How can we get people to exercise more when the political mood is turning against Government interference and the so-called "nanny state"? What is 'the business case' for prehabilitation? Co-chaired by Mike Grocott and Stefan van Rooijen and fea...
Mar 03, 2020•18 min
This is TopMedTalk's first in a our series 'Women in Anaesthesia': a celebration of the women who drive academic research and perioperative practice around the world. Inspired by the British Journal of Anaesthesia's March edition of the same name this series will profile some of the women who take frontline roles in our profession, all of them contributors to TopMedTalk. Angela Bader features on TopMedTalk here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-03-angela-bader/ Car...
Mar 02, 2020•13 min•Season 1Ep. 1
Global health is something TopMedTalk listeners are naturally passionate about; here you can listen to the keynote address from the 42nd President of The United States, Bill Clinton, to the World Patient Safety, Science & Technology Summit. 273,077 lives have been saved over the last 7 years with over 90,000 of those in just the last year alone. 4,700 hospitals around the world that are part of this effort. 89 technology companies have committed to share data to help develop algorithms and p...
Mar 01, 2020•43 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...
Feb 29, 2020•17 min
"Does choice of opioid influence health outcomes?" - 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 Padma Gulur, Professor of Anaesthesia and Executive Vi...
Feb 28, 2020•28 min
What insights does a history of working in military healthcare bring? How do we cut back on readmissions to hospital after time spent in the intensive care unit? How serious an issue is 'burn out' within healthcare? How did standardisation help when designing an award winning patient transfer bag? What's the best way to transfer a patient from ward to ward or from institution to institution? How do we handle data during this period? What do we think about remote supervision and monitoring? Could...
Feb 27, 2020•48 min
Recorded live at the Association of Anaesthetists' Winter Scientific Meeting 2020 in the centre of London from The Queen Elizabeth II Centre. Hear the conversation and questions asked by our online audience. 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 about hyperoxia? How does what we do effect the environment? What are the latest thoughts about 'depth of anaesthesia'? The podcast mentioned in this piece ...
Feb 26, 2020•32 min
This piece is a discussion regarding the SQUEEZE Study: A prospective multi-centre international observational study of postoperative vasopressor use. The website mentioned in this piece is here: https://www.esahq.org/research/clinical-trial-network/planned-trials/squeeze/ Our conversation with Konstantin Balonov is here: https://www.topmedtalk.com/euroanaes2019-konstantin-balonov/ Presented by Desiree Chappell with Monty Mythen and their guest Ben Creagh-Brown, Clinical Academic Intensivist, Di...
Feb 25, 2020•11 min
What can practitioners do to preoperatively screen for signs that their patients may have issues with post operative delirium? How do we get patients fit for surgery, particularly as regards delirium? Can you build up mental resilience in the run up to an operation, do suggestions that puzzles and mental activity such as sudoku and a good crossword help have any evidence behind them? This piece features Monty Mythen and Desiree Chappell in conversation with Dan Cole, professor of clinical anesth...
Feb 24, 2020•14 min•Season 5Ep. 3
This panel discussion reacts to various questions from the online audience and those in attendance. Questions include; Is there any good evidence for the use of wearable tech in prehabilitation? How come, if the evidence is almost there, prehabilitation is not yet included in every pathway? In this respect, is change just around the corner? How do we have patients are partners rather than passive participants? What are the benefits of prehabilitation which can be seen in two weeks? How does one ...
Feb 23, 2020•27 min
This piece focuses on the "SupPoRtive Exercise Programmes for Accelerating REcovery after major ABdominal Cancer surgery" (PREPARE-ABC) trial. How do we establish the effectiveness of pre and post exercise plans? Do they really form a sensible part of a "value based care" package? This concise presentation gives you a clear idea of the aims and structure of the trial. Prepare ABC tweet here: https://twitter.com/prepareabc Their website is here: https://www.uea.ac.uk/prepare-abc Presented by Jame...
Feb 22, 2020•13 min
"Evidence ... is only as useful as the end user is willing to put it into practice". This piece begins with a discussion about translational research, the way in which individual studies are looked at and combined into more accessible guidelines. How do you become an 'informed consumer' of information and evidence? Also, what is the latest thinking as regards "pharmacogenomics"? Is it true to say that "within the next ten years we're not going to see healthcare delivered ... without genetic info...
Feb 21, 2020•31 min
This piece gives you information that will empower you when using Warfarin in the perioperative period. How should you sensibly balance bleeding and thrombotic risk? Anti-coagulants are increasing in number, what are the principles behind them which we should learn? An understanding of patient, procedure and type of drug being used is essential, are there other factors that can come into play? Here is a link to the slides used in this talk: http://www.anzca.edu.au/documents/02-kate-burbury_fast-...
Feb 20, 2020•26 min
"Perioperative nutrition" - 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 Paul Wischmeyer, Professor of the Department of Anesthesiology, Duke University...
Feb 19, 2020•26 min
The Hypotension Prediction Index (HPI) Monitor takes 2.6 million features from a single waveform which it then applies to 150 million different wave forms looking for factors which can predict hypotension. It's the first fully approved foray into predictive analyitics for the world of anaesthesia. This conversation looks at how it works and how it is being adopted in detail. Presented by Desiree Chappell with Monty Mythen and Feras Hatib Phd, Director, Research and Development, Algorithms and Si...
Feb 18, 2020•27 min•Season 3Ep. 4
This piece starts with the question: Is there a hierarchy amongst the various elements of an enhanced recovery pathway? The conversation that follows tackles some of the essential elements of perioperative care. This conversation is taken from a longer piece to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-2/ For further expert discussion regarding the Drink, Eat, Mobilise, Sleep (DrEaMS) concept there is another short piece you can find here: https://www.topmedtalk.com/stand...
Feb 17, 2020•4 min•Season 5Ep. 2
