The Patient Safety Movement Foundation (PSMF) has ambitious targets to limit preventable deaths in healthcare, this piece explains how they intend to reduce them down to zero. They need your help, this is a global movement with an action plan to improve the world in an important but achievable way. Their website is here: https://patientsafetymovement.org/ Monty Mythen and Desiree Chappell speak with their guest Michael Ramsay, Chairman, Department of Anesthesiology and Pain Management, Baylor Un...
Sep 09, 2020•11 min
"Coming out of this pandemic, and this crisis, I think the future for perioperative medicine is very bright and we should definitely take the opportunity and really build on that now..." The two co-vice presidents of The International Board of Perioperative Medicine join Desiree's POCAPALOOZA; this conversation is global in its context, with perceptive reflections upon the US healthcare market specifically. "Towards high‐quality peri‐operative care: a global perspective" - the paper we begin by ...
Sep 08, 2020•20 min
"Patients undergo surgery for important reasons, we need to improve surgical outcomes to the point where anyone can have surgery - and I believe that is do-able; we need to implement what we know, we need to avoid missed opportunities and we need to conduct more research. We should learn from the history of anesthesiology and how intraoperative care so dramatically improved outcomes" This powerful data based talk sets a bold standard for the year, a highlight from the momentous (Evidence Based P...
Sep 07, 2020•31 min
What are the two prime components of any good nutrition programme? How is avoiding malnutrition different from supporting anabolism? What's the best way to screen patients for malnutrition risk? How can a patient's anthropomitry be assesed alongside their stated needs and preferred outcomes? How important are protein supplements? What are the wider benefits of a good diet? How do we devise nutrition care plans for malnurished patients who need a more aggressive approach? Is it fair to say that e...
Sep 06, 2020•18 min
What is TopMedTalk and how did it come about? Why is perioperative medicine such an inspiration to us? Why is our Editor in Chief such an advocate? What is the opioid crisis? Broadcaster Nick Margerrison speaks with Monty Mythen our Editor in Chief about TopMedTalk and perioperative medicine. We regularly enjoy reading your feedback: contact@topmedtalk.com
Sep 05, 2020•15 min
Is methadone "the opioid sparing opioid"? This talk looks at where we are at as regards opioids, in the shadow of a national crisis for the USA; is it possible that methapone might offer us answers? This piece looks at the idea that methadone might be a way to deliver a better more effective, multimodal, opioid sparing, analgesia with a reduced chance of a post operative repiratory events and decreased post-operative pain. This talk is complimented well by our consersation, live from the confere...
Sep 04, 2020•40 min
What can the experiences of a team who helped to introduce pre-operative assesment and prehabilitation to Barcelona teach us about how to most effectively implement and sustain similar programmes where we are? How and why is prehabilitation helpful in terms out outcomes and value based care? How long can the benefits of prehabilitation be maintained? What is the value of nutritional consultation, how important is it to asses your patients pre-operative protien intake? Would it help to offer all ...
Sep 03, 2020•23 min
The International PREHAB trial. This short piece explains the trial's protocol and the scope of the study. Presented by Charlotte Molenaar, PhD Candidate, multimodal prehabilitation in colorectal cancer care, BIJ Maxima Medisch Centrum, Coordinator of the international PREHAB trial.
Sep 02, 2020•9 min
EBPOM might be over but the global perioperative festival, the POCAPALOOZA, continues. Either we've locked our team in their rooms and forced them to continue broadcasting or they're driven by a raw enthusiasm for the results of perioperative care to be shared around the world, either way this piece is our penultimate installment before we return to Cape Town. What's the situation like, in terms of medicine, in Hong Kong at the moment in the wake of COVID 19? "Early intervention and people takin...
Sep 02, 2020•32 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...
Sep 01, 2020•12 min
Insights and perspectives on the science of prehabilitation from a very different angle. It's often said on TopMedTalk that preparing for an operation is not unlike getting ready for a marathon; how do the insights of professionals who work with elite sports men and women to ensure they are fully prepared to do their physical best, on the world stage? Also, what about the teamwork inherent in such activities as the pitstop of a formula one car? Athletes, coaches and a wide number of different ex...
Aug 31, 2020•33 min
What are the opportunities presented to a perioperative practitioner when political devolution becomes a reality? What can we learn from the experiences of a team leading the introduction of ERAS+ and prehabilitation across Greater Manchester with a 'Spread and Scale innovation grant' from the Health Foundation? How do you demonstrate benefits which patients and fee payers can understand? How do you go about leading a prehab transformation program, which aims to provide prehab for more than 2000...
Aug 30, 2020•23 min
This piece gives us a look at some of the latest thinking on Post Operative Nausea and Vomiting (PONV). It includes a discussion about Amisulpride and discusses new, yet to be published, consensus guidelines for PONV. The original guidelines are here: https://www.ncbi.nlm.nih.gov/pubmed/24356162 Also, you may like to check out the details of this paper here: Amisulpride: A New Dopamine Antagonist for Treatment of Postoperative Nausea and Vomiting https://www.ncbi.nlm.nih.gov/pubmed/31094771 Pres...
Aug 29, 2020•8 min
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...
Aug 28, 2020•22 min
This piece focuses upon patient safety and the work of our guest. How does perioperative medicine fit into the picture, are anesthetists right to take the lead in this field? You can find the Anesthesia Patient Safety Foundation here: https://www.apsf.org/ Learn more about the Perioperative Surgical Home here: https://www.asahq.org/psh Presented by Desiree Chappell with Monty Mythen and Henry Howe alongside their guest Mark Warner, Annenberg Professor of Anesthesiology at the Mayo Clinic in Roch...
Aug 27, 2020•25 min
"POETTS 2018 | The evolution of a community-based Prehabilitation service" - 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 Gerard Danjoux, consultant in ...
Aug 26, 2020•23 min
The focus for the first part of this POCAPALOOZA was Duke University's PASS clinic. Find out more about the PASS clinic: https://www.dukehealth.org/locations/duke-pre-anesthesia-testing-center-clinic-2d "So it's a new approach to really changing the paradigm from just evaluating a patient and sort of passing that information forward to the receiving team [...] rather we take a much more proactive progressive approach to identify those chronic co-morbid conditions and try to bend that curve, we t...
Aug 25, 2020•26 min
Some of the big questions: Is the pulmonary artery catheter back? What have been some of the big take aways in nutrition? Why should you feed a cold and starve a fever? More Protein or less? Finally, ‘humanizing intensive care’ is discussed, do we need more ITU pets? Presented by Desiree Chappell and Monty Mythen confer on the events of the day with their guest Hugh Montgomery, Intensive Care Society Board Member and, Professor of Cardiovascular Genetics and Critical Care University College Lond...
Aug 24, 2020•36 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...
Aug 23, 2020•28 min
Care of older people in surgery (COPS). Are you properly assesing your patients for cognition? Surgery can be appropriate for some to reduce pain in palliative care, how do we make decisions regarding a possible intervention? How important is frailty in this process? The slides from this talk are here: http://www.anzca.edu.au/documents/03-jacqueline-close_care-of-older-people-in-surger.pdf Presented by Professor Jacqueline Close, Geriatrician, Prince Of Wales Hospital, Clinical Director, Falls, ...
Aug 22, 2020•27 min
This discussion begins with a focus upon some of the networking and information sharing events that go on in our field; The Society for Perioperative Assessment and Quality Improvement (SPAQI, website here: https://www.spaqi.org/2020/ ) The 17th World Congress of Anaesthesiologists, September 5-9, 2020, Prague, Czech Republic (website: https://www.wcaprague2020.com/ ). Discussion then moves to specific "The SQUEEZE Study"; A prospective multi-centre international observational study of postopera...
Aug 21, 2020•17 min
"It's like running an election campaign..." Perioperative hemodynamic management; how do you make it really work within an institution? With extensive reference to real life experience hear first hand stories from our guest and Editor in Chief's experience of doing just that. How do you get people both in and outside of the team to understand the importance of it? Hear about new developments in Enhanced Recovery After Surgery (ERAS) and perioperative haemodynamic management. Find out how new tec...
Aug 20, 2020•30 min
The POCAPALOOZA story begins with our fascination with The African Surgical Outcomes Study. Over the last year regular listeners have heard key parts of the narrative fall into place during TopMedTalk interviews and discussions. Learn how the European Surgical Outcomes Study (EUSOS), presented at a previous Evidence Based Perioperative Medicine (EBPOM) conference, helped to inspire the African Surgical Outcomes Study ASOS which then went on to inspire us all; after an international gathering in ...
Aug 19, 2020•24 min
Pediatric patients can present quite a challenge when emerging from anesthesia. Here we discuss ways to “ACE” your transition to PACU! “A”void Emergence Agitation, and discover the latest evidence about “C"riteria for “E”xtubation in this challenging population. How do the protocols and standard of care compare between the UK and US. What does the evidence tell us? Also, how is Enhanced Recovery After Surgery progressing in pediatrics? Presented by Desiree Chappell and Monty Mythen with their gu...
Aug 18, 2020•35 min
After working at a Veterans Affair Medical Center, hear how our guests moved into the field of emergence delirium: "upon emergence our patients were swinging and very aggressive ... there must be some way to prevent this". This fascinating piece enjoys an engaging discussion about an important topic for both patients and practitioners; how important is it for you to know a patient may suffer from post traumatic stress disorder? Do different anesthetics promote or avoid emergence delirium? Can em...
Aug 17, 2020•27 min
The electronic cigarette market is a $14 billion industry worldwide. As of August 2019, 215 cases of severe pulmonary illness related to e-cigarette use are being investigated in the United States. The known hazards of e-cigarette use are rapidly coming to light with the sudden onset of serious bronchiolitis-related pulmonary disease in otherwise healthy people who were known to use e-cigarettes. Learn also how COVID 19 has increased these dangers. Presented by Desiree Chappell with Monty Mythen...
Aug 16, 2020•38 min
Pain is a subjective experience that affects all segments of the population. However, there are inter-individual differences in pain. The biopsychosocial model proposes that the intersection of biological, psychological, and social factors create a pain experience and pain outcomes that differ by sex, race, and socioeconomic status. "The minority stress theory ... the idea that for racial minorities, especially blacks, they are exposed to chronic stress; the stress of daily racism" Could epigene...
Aug 15, 2020•38 min
This invaluable piece is a chance to attend a workshop which looks at the latest thinking on "perioperative cognition" and 'post-operative cognitive dysfuntion'. We advise you use this link here to find the PDF of the paper being discussed: https://bjanaesthesia.org/article/S0007-0912(17)54082-9/fulltext Presented by David Scott, Professor, University of Melbourne, Director, Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne and Lis Evered, Scientific Head of Research, Departm...
Aug 15, 2020•16 min
"My first thought was - why can't we do this here?" What is ketamine, what sort of drug is it and how is it used? How was it first synthesized? Was it intentionally found or another of science's happy accidents? This piece is a fascinating look into the history and future of ketamine with a focus on outpatient infusion centers. Could this unusual and "dirty" drug - meaning it acts on many parts of the body and is not fully understood - have incredibly useful consequences for people who face the ...
Aug 14, 2020•34 min
"4-10% of opioid naïve patients will continue to use opioids more than 90 days after surgery" Opioids are good for pain control but there's another issue, they also numb emotional pain. How do we responsibly deal with this? It's important to remember: "When you give patients high doses, you're putting them at risk". Long term listeners will recall TopMedTalk spent the best part of our launch year on this topic. If you're one of our many new listeners please use this huge resource of podcasts to ...
Aug 14, 2020•25 min
