"Increasing the richness and the reach of what we do" is the mantra of 'Anesthesiology'; hear from its Editor in Chief how it managed to self study and discover the essential idea behind the journal: "trusted evidence, from discovery to practice". Conversation then moves on to methadone, the overlooked opiate; where do you use it and what sort of dose is appropriate? What are the benefits of including this in your practice and should it really be considered in the same category as most other opi...
Apr 15, 2020•35 min
"If you ring up and start to apply pressure to them to say 'have you thought about giving my loved one drug A or drug B?' It might be helping them to get better but you might be encouraging them to do something that might hurt your loved one; so we have to do this with trials". This piece gets into one of the debates surrounding the treatment of COVID 19. What do we mean when we suggest people think outside the box? Do we still need to bother about ideas and principles such as evidence and data ...
Apr 14, 2020•17 min•Season 1Ep. 30
The UK has accelerated the graduation of medical students to help fight COVID 19. We speak to some of Britain's newest doctors to hear what it's like getting ready for - and going into - action against one of the most dramatic health crisis in living memory. Discussions about palliative care, end of life decisions and rapid patient decline are just some of the experiences they are learning to cope with, fresh out of medical school. Presented by Desiree Chappell and Dr Henry Howe with Dr Dolcie P...
Apr 13, 2020•31 min•Season 1Ep. 29
(REPOST) After a quick update from Desiree and Monty this piece focuses on Philadelphia Pennsylvania and gets into specifics regarding caring for COVID 19 positive patients. As regards The Jefferson Hospital; where has the ICU "take over" expanded to? Have critical care ventilators been deployed to all new ICU beds or have acceptable compromises been made? "Staffing is tougher than the equipment" but how has a "critical care pool" system, prepared over a year ago, helped? What does the typical C...
Apr 12, 2020•38 min•Season 1Ep. 28
This piece is intended as a chance for listeners to TopMedTalk to both raise money for the effort to tackle COVID 19 and have a bit of relaxation and entertainment while doing so. Our Editor in Chief Monty Mythen will be joining our guest, Jeremy Sassoon live on Facebook at 5pm on Saturday 11th of April. In advance of that this piece explains how the two of them got to know each other along with some live music from Jeremy and reflections on how this crisis is effecting everyone. Presented by De...
Apr 11, 2020•37 min•Season 1Ep. 27
This piece is both a chance to relax and an opportunity to join the TopMedTalk team online as we unwind to our favourite Jazz musician, Jeremy Sassoon. As well as being an excellent and renowned musical talent he also happens to be a school friend of Monty's so we managed to convince him to join us for an exclusive interview tomorrow, in advance of which we're giving you a heads up that he will be live in concert on Facebook raising money for NHS Charities Together. Follow this link and click "i...
Apr 10, 2020•9 min•Season 1Ep. 26
Smoking is bad for you, there's little debate about that, even among users of the drug. However, further to the widely known consequences, the bottom line in the perioperative period is that smokers are 40% more likely to die after major surgery. Do patients also know this? Tissue healing, increased risk of infection and increased possiblities of complications with the anaesthetic; with these risks in mind how do we cut through the ubiquitous, but often ignored, government health risk messaging ...
Apr 10, 2020•17 min
TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis. It's vital you remain active after a cancer diagnosis, why is this? Hear the fascinating story behind the discovery that activity not only reduces your overall levels of fatigue but also improves your chances of recuperation. "You have to pace yourself [...] listen to your body"; but any physical activity will help fight fee...
Apr 09, 2020•27 min
TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis. We know food gives us energy "but it also provides so much more". This podcast looks at the raw materials you'll need, when facing a cancer diagnosis, to get a better outcome; the vitamins, minerals and proteins, as well as the energy sources you're best using. What is a balanced diet when you have cancer? "We're talking abo...
Apr 09, 2020•14 min
TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis. "It's very normal to sit with some difficult thoughts and feelings" after a cancer diagnosis. Broadly there are two types of mindsets; anxiety, which can be helpful, an element of wanting to 'do something' and, on the other hand, low mood, a feeling of not wanting to do anything, this can be unhelpful if not addressed at a c...
Apr 09, 2020•25 min
After a quick update from Desiree and Monty this piece focuses on Philadelphia Pennsylvania and gets into specifics regarding caring for COVID 19 positive patients. As regards The Jefferson Hospital; where has the ICU "take over" expanded to? Have critical care ventilators been deployed to all new ICU beds or have acceptable compromises been made? "Staffing is tougher than the equipment" but how has a "critical care pool" system, prepared over a year ago, helped? What does the typical COVID 19 c...
Apr 09, 2020•38 min•Season 1Ep. 25
Why has 'prehabilitation' suddenly picked up pace in terms of both practice and interest? This piece takes a serious look at the widening interest in an idea familiar to many sportsmen. Learn how the marginal gains we get through the application of science to optimise the moment of surgery as a real opportunity to apply everything we know. Also; what are ketones and how can they be used to promote health? Presented By Desire Chappell and Monty Mythen with their guests Gerard Danjoux, consultant ...
Apr 09, 2020•12 min
We get a quick update from Monty, how is his return to work going after quarantining at home with COVID 19 Further conversation takes a look at the care being given to COVID 19 patients and their providers. What is PPE fatigue? Where is the debate regarding COVID 19 positive patients and fluid management? A lot of it boils down to the mantra "keep it simple", do the job as correctly and properly as possible and know what you are capable of. Please listen to the end of this piece for a vitally im...
Apr 08, 2020•37 min•Season 1Ep. 23
What are the latest developments in quality improvement programs that help operative teams around the world take what they do to the next level? When does the surgical journey begin? How has a focus upon patients prior to surgery improved outcomes? What are "the five phases of care"? How has data collection and management helped us to continually improve a patient's surgical journey? This piece is a talk which was given during the 8th Australian and New Zealand Symposium of Perioperative Medicin...
Apr 08, 2020•35 min
This piece sees us catch up with a the TopMedTalk team favorite; Joff Lacey. A popular presenter here on TopMedTalk, Joff tells us of his first hand experiences in the ongoing battle against COVID 19 in South London. We also get an update on Monty's condition. Presented by Desiree Chappell with Dr Joff Lacey, Consultant Anaesthetist at St George's Hospital in South West London. Thank you to our sponsor Edwards Lifesciences. Edwards clinical education (ECE): https://www.edwards.com/clinicaleducat...
Apr 07, 2020•10 min•Season 1Ep. 22
Emotional intelligence is the ability to perceive, integrate, understand and utilize emotions in an effective and meaningful way in order to cope and adapt to the situation. It's a hot topic at the moment, here we speak with the first CRNA to be certified in emotional intelligence. Stress and burn out is a common problem in the CRNA community, handling that could have a real impact on performance and outcomes. Our guest mentions the Mayer-Salovey-Caruso Emotional Intelligence Test™ which can be ...
Apr 07, 2020•19 min
This week begins with an update on Monty's progress after his COVID 19 diagnosis. Have the symptoms returned or is he back to his usual self? One thing we know for certain when it comes to this virus and our treatment of it's symptoms; it is a dynamic situation. Management of the COVID patient is constantly changing. Do we treat our patients as having Acute respiratory distress syndrome (ARDS) or do we take a standard approach to ventilation? This piece looks at how our understanding of COVID 19...
Apr 06, 2020•26 min•Season 1Ep. 21
Burn out and stress management have been an important theme on TopMedTalk recently, here we have a top medical professional sharing their story in relation to the topic. How do we describe "burn out", are certain words a barrier to discussion? How do we cut through to people who are most likely to suffer from this incredibly dangerous condition? Is the medical profession finally making progress here? Our interview with Sasha Shillcut is here "Sunday Special | Burn out": https://www.topmedtalk.co...
Apr 06, 2020•20 min
This week's Women In Anaesthesia focuses in on TopMedTalk favourite Carol Peden. The British Journal of Anaesthesia article, which inspired this series, is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext -- "The Power of The Interdisciplinary Team"; introducing the Enhanced Recovery team from Keck Medical Center at The University of Southern California (USC). Our guests kindly share an email address you can contact them on: Enhanced.Recovery@med.usc.edu Presented by Desire...
Apr 05, 2020•25 min•Season 1Ep. 6
This hugely important talk was the centerpiece of EBPOM 2019 and, appropriately enough, it focuses on a big topic for us here at TopMedTalk; the future of fluid therapy. Originally given as the EBPOM 2019 Ernest Henry Starling plenary lecture the talk is complimented by this piece which was recorded on the same day: https://www.topmedtalk.com/desirees-roundtable-fluids-in-the-2020s/ Where is the latest thinking on fluid therapy, what new evidence and understandings do we now have? Presented by D...
Apr 05, 2020•54 min
This piece focuses upon the African Surgical Outcomes Study (ASOS-2). More than a thousand people across Africa have combined forces to make this research into perioperative medicine in a resource limited environment happen. We know patients in Africa are twice as likely to die following surgery when compared to the global average, why is this? How does "failure to rescue" play into this? The website mentioned in this piece for more details: https://www.asos.org.za Presented by Desiree Chappell ...
Apr 04, 2020•24 min
This piece is a reliable first hand account of COVID 19, directly from a patient, our Editor in Chief Monty Mythen. "This kind of reassurance that seemed to go with it, to seem to say to people: 'nah, nah, nah, it's ok; you've just got a bit of a sore throat and a bit of a dribbly nose, crack on!' Was not supported by the available evidence at all" How is Monty feeling? What are the actual symptoms of COVID 19? Why has misleading information been apparently knowingly released regarding this? Wha...
Apr 04, 2020•31 min•Season 1Ep. 20
"We're not a big teaching hospital [...] and I think there is a slightly different perspective..." This piece focuses on the realities of preparing for and dealing with COVID 19 patients in the town of Bath in the UK. Innovation with staff training, cautionary tales regarding our advance warning of the current situation and fluctuating guidelines are the opening points of discussion before a fascinating deep dive into the potential merits of video laryngoscopy. Further discussion includes reflec...
Apr 03, 2020•43 min•Season 1Ep. 19
The team aspect of perioperative care is an essential element, this piece gets into the details as thought leaders and key opinion makers engage with the debate regarding how that actually works in practice. Moderated by Ross Kerridge, John Hunter Hospital, Newcastle, Australia, often cited as 'the father of Modern Perioperative Medicine'; the panel consists of, Charlie Corke, Associate Professor, Senior Intensive Care Specialist, Barwon Health, Kerin Fielding, Associate Professor, University of...
Apr 03, 2020•29 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...
Apr 02, 2020•16 min
This piece takes a look at the frontline fight against COVID 19 at Penn Medicine Princeton Medical Center in New Jersey, USA. Details of airway, ventilation and hemodynamic management are discussed with the director of Critical care and Anesthesiology. Resource management is a clear front runner as the virus creates a public health emergency for medics to try to battle. Additional beds and treatment facilities are being prepared, what other innovations are being brought to the fore. Presented by...
Apr 01, 2020•36 min•Season 1Ep. 18
Extended periods of intraoperative hypotension are firmly associated with harm. This piece looks into the detail behind concerns regarding hypotension. Are we now in a position where we can eliminate it entirely? The paper mentioned in this piece, "Ability of an Arterial Waveform Analysis–Derived Hypotension Prediction Index to Predict Future Hypotensive Events in Surgical Patients", is here: https://journals.lww.com/anesthesia-analgesia/Abstract/publishahead/Ability_of_an_Arterial_Waveform_Anal...
Apr 01, 2020•22 min
In this piece we look at how Australia is dealing with the COVID 19 crisis. What restrictions are being placed upon people and how strict are they? How does "the father of perioperative medicine" see the world which is now being asked to face one of its most urgent medical emergencies? Has the time come to honour 'the whole team' in the institutions where we work? How can medics help to rebuild our societies after the already devastating consequences of a global pandemic? Presented by Desiree Ch...
Mar 31, 2020•23 min•Season 1Ep. 17
Preoperative risk stratification; what is are the risks and controversies behind preoperative exercise testing and the six minute walk test? This piece looks at the evidence behind both and some practical guidance for informing clinical care. Does the six minute walk test predict complications? What is the true value for cardiopulminary exercise testing (CPET)? For more on the METS study go here: https://www.topmedtalk.com/the-measurement-of-exercise-tolerance-before-surgery-mets-trial/ Presente...
Mar 31, 2020•18 min
This piece takes a look at the San Diego front line of the global fight against COVID 19. What unique pressures are there here; the large homeless population is a particular challenge, how do psychiatric patients further the conundrum. Also, what about the assumption that patients are likely to be carrying the virus so should all be treated as if that is the case, does that apply here? There is also a short update on our Editor in Chief, another front line medical provider, who tested positive f...
Mar 30, 2020•16 min•Season 1Ep. 16
