"Hypotension probability in practice" - 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 Mike Spiro, anaesthetic consultant at the Royal Free Hospital and J...
Feb 20, 2019•12 min
How has the Royal College of Anaethestists (RCoA) evolved over the years and why is perioperative medicine so crucial to its agenda? How has this leadership in perioperative medicine become a force for change and improvement worldwide and what are the common themes that emerge as we take a global perspective on the discipline? The RCoA's global partnership programme is explained, how can perioperative medicine be part of helping less developed healthcare systems? The considerations are different...
Feb 19, 2019•20 min•Season 2Ep. 7
The Silver Tsunami is coming, are you prepared to assess the elderly patient? Mature patients present unique and interesting opportunities to perioperative practitioners. New ways of thinking and different approaches are always necessary. The British Geriatric Society's "Fit For Frailty" is here: https://www.bgs.org.uk/resources/resource-series/fit-for-frailty Presented by Desiree Chappell and Monty Mythen with their guest Houman Javedan, MD. Geriatrician at Brigham and Women’s Hospital, assista...
Feb 18, 2019•14 min
We begin with a question from the audience; 'how do we drive change in our institutions towards enhanced recovery after surgery?' The GIRFT (Getting It Right First Time) project is explained. The Health Foundation is also mentioned. This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum. The conversation features questioner Paul Hutchings, Consultant Anaesthetist at Norfolk and Norwich Univ...
Feb 18, 2019•7 min•Season 2Ep. 1
Trainees with an interest in perioperative medicine (TRIPOM) is an ever growing organisation set to continue the global push for perioperative care. This high energy podcast gives you a taste of the enthusiasm people pick up as they learn more about the value of these ideas. The focus here is on promoting healthy aging across two primary domains: cognitive function and physical ability. Discover how multiple features of aging—including physical and cognitive decline—are strongly associated with ...
Feb 17, 2019•24 min•Season 2Ep. 5
This piece acts as a great summary of some of the big takaways from the conference this year. Discussion about a hugely successful Enhanced Recovery program at a large community hospital, continued improvements and service line expansion. Presented by Desiree Chappell and Monty Mythen with their guests Kim Duggan, Perioperative Surgical Home (PSH) - Enhanced Recovery After Surgery (ERAS) Manager, New Hanover Medical Centre and Robin Davis, Clinical Education Specialist II at New Hanover Regional...
Feb 17, 2019•12 min
How does one go about becoming a Master of Perioperative Medicine? This piece takes a look at the growing movement which all TopMedTalk listeners are at the forefront of. Further debate covers, "NPO after midnight", getting buy in from the institution to practice perioperatively and keeping the momentum going after one leaves a conference. Presented by Desiree Chappell and Monty Mythen with their guests, Marc Koch President & CEO of Somnia Inc and Gregory Pato, internal medicine physician as...
Feb 16, 2019•12 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. -- Do you have your ticket to the Dallas Master's Course bein...
Feb 16, 2019•12 min
How is the AANA facilitating the care of patients? How can you make a patient a 'partner in safety'? How do we coordinate so many disaparate systems of information and care? Patient records and data ownership is discussed, as is Paul Upton's excellent interview on TopMedTalk regarding "My Preop". The original piece is here: https://www.topmedtalk.com/my-pre-op-empowering-patients-before-surgery/ How do we reach out to patients and inform them about the risks and choices which will be presented t...
Feb 16, 2019•20 min
This piece ploughs into some of the academic papers that have provoked discussion recently in the perioperative community. We discuss the following papers: Risk factors for opioid-induced respiratory depression in surgical patients: a systematic review and meta-analyses. https://www.ncbi.nlm.nih.gov/pubmed/30552274 Increased Postoperative Glucose Variability Is Associated with Adverse Outcomes Following Total Joint Arthroplasty. https://www.ncbi.nlm.nih.gov/pubmed/29975266 Effect of A1C and Gluc...
Feb 16, 2019•14 min
On the last occasion where we spoke with our guest she was a Perioperative Medicine Fellow at Duke University; learn how her experiences have helped change her practice and the edge she now has in 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 resourc...
Feb 15, 2019•20 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...
Feb 15, 2019•15 min
Conversation begins with reflections on the conference and the impact of social media, Twitter, Facebook and so forth, on the global perioperative scene before tucking into some of the big stories that are emerging from the conference. Learn more about STOP BANG; Snoring, Tiredness, Observed Apnea, PBP (>140/90) R X or no. How do opioid sensitivity and obstructive sleep apnea effect each other? The opioid crisis, pain as the fifth vital sign and multimodal pain management produce some fascina...
Feb 15, 2019•28 min
What are some of the big take home messages from this conference so far? Lots of material on preoperative assesment, discussion of some of the big trials and papers that have occured in the field and reflections on research into myocardial injury after noncardiac surgery (MINS). This podcast is recorded 'as live' and the team mention interviews which have now been recorded and are available online. The Steven Cohen and Barbara Slawski conversation is here: https://www.topmedtalk.com/perioperativ...
Feb 15, 2019•23 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...
Feb 15, 2019•29 min
Discussion begins with an overview of the conference and its roots. Special mention is made regarding the Frank Michota Memorial Lecture which takes place on the Friday morning of the conference. Also on this podcast, what is a "Respect Officer"? Why is respect so important in perioperative care? How does improving 'the culture of safety' also help to improve outcomes? Should we be overly concerned about high cancelation rates for surgery? And what are the advantages of a preoperative risk asses...
Feb 15, 2019•23 min
The Society for Perioperative Assessment and Quality Improvement (SPAQI) are in Orlando Florida for their 14th annual summit and, of course, we're there to cover it. Find out what you can expect, if you are attending the conference, and what we're going to be bringing you on TopMedTalk, if you couldn't make it this year. Hypotension, the Measurement of Exercise Tolerance before Surgery (METS) Trial and the improving fortunes of asprin. The SPAQI website is here: https://www.spaqi.org Presented b...
Feb 14, 2019•20 min
The full title of today's paper is: Prospective observational cohort study of the association between antiplatelet therapy, bleeding and thrombosis in patients with coronary stents undergoing noncardiac surgery and you can find it here: https://www.ncbi.nlm.nih.gov/pubmed/30686302 Presented by Dr Joff Lacey, registrar in anaesthesia at St George’s Hospital in London, currently undertaking a fellowship in Perioperative Medicine at UCLH. -- Do you have your ticket to the Dallas Master's Course bei...
Feb 14, 2019•5 min
"Antibiotic stewardship in perioperative care" - 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 Alison Holmes, Professor of Infectious Diseases at Imperia...
Feb 13, 2019•15 min
What's it like in rural America working at a small hospital, 'way out on the frontier'? What best practice initiatives are there to help? How can you implement a process of rapid opioid reduction, more than 70%, in just two years? Presented by Desiree Chappell with her guest Bill Prosser, CRNA Peacehealth Florence Oregon. -- Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet? Find out more here: https://www.ebpom.org/EBPOM-USA-2019 As a TopMedTalk sub...
Feb 12, 2019•22 min•Season 2Ep. 6
What are the results if you apply Enhanced Recovery to obstetrics? This podcast features Desiree Chappell interviewing Dr Attila Kett, anaesthesiologist and Chairman at St Peter’s University Hospital at New Jersey. Join in the debate: contact@topmedtalk.com
Feb 11, 2019•5 min•Season 1Ep. 10
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...
Feb 10, 2019•44 min•Season 2Ep. 4
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...
Feb 09, 2019•11 min
The patient experience can be quite passive and, as a result, people can lose temperature quickly. The consequences can be very negative, this conversation revolves around how you can keep your patients warm. This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-1/ This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum. The conve...
Feb 08, 2019•7 min
This week on Journal Club we reflect upon the pulmonary artery (PA) catheter. The following articles were discussed: JAMA: The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators: https://www.ncbi.nlm.nih.gov/pubmed/8782638 BJA: Effect of goal-directed haemodynamic therapy on postoperative complications in low–moderate risk surgical patients: a multicentre randomised controlled trial (FEDORA trial): https://bjanaesthesia.org/article/...
Feb 07, 2019•18 min
"Rehabilitation post critical care" - 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 Linda Denehy, Head of the Melbourne School of Health Sciences and Pro...
Feb 06, 2019•22 min
How is the AANA facilitating the care of patients? How can you make a patient a 'partner in safety'? How do we coordinate so many disaparate systems of information and care? Patient records and data ownership is discussed, as is Paul Upton's excellent interview on TopMedTalk regarding "My Preop". The original piece is here: https://www.topmedtalk.com/my-pre-op-empowering-patients-before-surgery/ How do we reach out to patients and inform them about the risks and choices which will be presented t...
Feb 05, 2019•20 min•Season 2Ep. 5
In short; Post-Op recovery in less than 3 days with over 90% mobilised on day 1. This in depth discussion relates to the consensus paper from the Perioperative Quality Initiative, see link below. It focuses on: outcomes, length of stay and DREAMS (Drinking, Eating and Mobilising) within hours after major surgery- all key measures of compliance and success in an Enhanced Recovery Program. Monty Mythen and Joff Lacey with Mike Grocott presenting with contributions from Dr Julie Thacker, Colorectal...
Feb 04, 2019•11 min•Season 1Ep. 9
Please do all you can to help share this a hugely important piece, both for practitioners and patients. Adverse outcomes can be avoided , stories like the one on this podcast are fuel in the engine of those who advocate true perioperative care. If you want to help go to the Greater National Advocates website here: https://www.gnanow.org/ The Patient Safety Movement is here: https://patientsafetymovement.org/ Presented by Desiree Chappell and Monty Mythen with their guests L. Bradley Schwartz, pr...
Feb 03, 2019•21 min•Season 2Ep. 3
Desiree and Monty catch up with Dan Martin, OBE, and speak with him about treating infectious diseases and in particular patients with ebola. Presented by Desiree Chappell and Monty Mythen with their guest Dan Martin, OBE anaesthetist and intensivist at the Royal Free Hospital and Reader at University College London (UCL).
Feb 02, 2019•14 min•Season 2Ep. 4
