This piece explores the current thinking on hemodynamics, get ready for a deep dive into the conversation and controversies. Originally streamed live from www.topmedtalk.com as part of our coverage of The EBPOM USA Dallas Master's Course 2019. This panel discussion is chaired by Desiree Chappell, CRNA from Louisville Kentucky and Board Member of ASER. It features Monty Mythen, TopMedTalk Editor In Chief, Smiths Medical Professor of Anaesthesia and Critical Care at University College London, Tim ...
Apr 21, 2019•47 min•Season 2Ep. 13
Speaking with a legend in the world of anaesthesia; this piece allows us to explore some of the bigger issues and milestones in the profession. How has it evolved, particularly in relation to the simultanious evolution of perioperative practice? Where are we now and where do things look set to go in the future? This piece was originally streamed live on www.TopMedTalk.com under the title: "Educational Dinner Symposium: In God we trust, all others must bring data" as part of the EBPOM USA Dallas ...
Apr 20, 2019•29 min•Season 2Ep. 6
How can your value based care proposition be further enhanced by a centre for geriatric surgey and palliative care? How important is shared decision making to your practice? What are the opportunities for an institution to improve in this area? Presented by Desiree Chappell and Monty Mythen with their guest Angela Bader, Vice Chair of Perioperative Medicine at Brigham and Women's Hospital.
Apr 19, 2019•11 min
From a leadership perspective should enhanced recovery for obstetrics be "standard of care" across the nation? Interest in this field seems to be growing, how widely accepted is this practice in the US? Finally, what recommendations are there for institutions and practitioners who want to try to apply some of the principles of enhanced recovery after surgery for obstetrics immediately after listening to this podcast? The SOAP website is here: https://soap.org/ Presented by Robin Schiller and Bri...
Apr 18, 2019•12 min
"Leading a large, single group towards excellence" - 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 If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com Presented by Dr Elizabeth Cherot, Vice President of medical affairs at Axia ...
Apr 17, 2019•35 min
Discussion begins with a hugely successful Enhanced Recovery program at a large community hospital, continued improvements and service line expansion. Learn about both the advantages and the challenges of a perioperative practice here. 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 Me...
Apr 16, 2019•10 min•Season 2Ep. 15
In critically ill patients where are we with haemodynamic monitoring and management? What is an ideal mean arterial pressure (MAP) during the process? What about chronic hypotensive patients? How do we safely avoid being too dogmatic about guidelines? Presented by Monty Mythen and Desiree Chappell with their guests Professor Mervyn Singer, Intensive Care Medicine at University College London and Fintan Hughes, Academic Intern at St. James's Hospital Dublin.
Apr 15, 2019•13 min•Season 2Ep. 9
The debate ' Direct laryngoscopes should be consigned to history ', was hosted by The Royal College Of Anaesthetists and carried out by our two guests on this piece. Here we get into the advantages and challenges behind the two techniques; video laryngoscopy and direct laryngoscopy. The conversation explores the fact that these skills are a key part of the job of practitioners, are we "de-skilling" the profession in an overly enthusiastic race toward new technology or are some resisting it simpl...
Apr 14, 2019•19 min•Season 2Ep. 12
Can artificial intelligence drive new changes in care and the value of big data? We're already comfortable with using tools that help us to do our job better, what are the opportunities and pitfalls related to this new technology? Are we ready yet for big data? The changes it may cause are staggering but equally; nuance is the friend of truth, do we have enough 'data literacy' to handle it all? Also - can the way you pronounce 'scone' give you an idea of your life expectancy? How do we balance p...
Apr 13, 2019•18 min
This piece focuses on the rise of cardiopulmonary exercise testing (CPET) in the wake of the Measurement of Exercise Tolerance before Surgery (METS) Trial, which seems to have shifted opinions, does a genuine 'perioptimist' have a deeper insight into the issues there? Presented by Desiree Chappell and Monty Mythen with their guest Dr Elena Koepke, Assistant Professor at Moffitt Cancer Center/USF, Physician Anesthesiologist, Perioperative Medicine Specialist.
Apr 12, 2019•8 min
What's the need for a perioperative surgical home? How do issues with aging populations and higher risk patients increase the need to intervene early in their care and treatment? How do you build institutional credibility in this area? How do you approach this area from the point of view of patient need? Crucially, how do you build and inspire a multidisciplinary team around these essential strategic needs? What pitfalls arise in the process, how do you inspire a "volunteer army" to help you dis...
Apr 11, 2019•15 min
This talk is a powerful look at a new world where we commit your institution and practice to achieving an end goal of "zero preventable deaths". The Patient Safety Movement Foundation (PSMF) has generated an enormous amount of global news media coverage as it promotes that aim; celebrities, statesmen, politicians and industry leaders are all getting behind an ambition which, after hearing this talk, you are likely to want to see come to pass as much as they do. The clips used in this presentatio...
Apr 10, 2019•38 min
Originally streamed live from the EBPOM USA 2019 conference in Dallas this piece looks into the realities of enhanced recovery. Patient satisfaction and outcomes rise to the top of the priority list as an institution invests in the idea, how long does it take for a clear financial return on the investments required to get it off the ground? How do we get a team motivated to work towards these ideas? Are there any disadvantages to enhanced recovery? How do patients react to it? Also, how does blo...
Apr 09, 2019•29 min•Season 2Ep. 14
"Without data you cannot sustain your programme" - this piece is about understanding the importance of data collection as part of the perioperative process. Quality improvement stems from this, consistent definitions and measures allow you to do the job properly. They also allow you to build the case and put a story to the process which higher management and resource allocation can work with. "If we don't know it's broke we can't fix it" - just as we need to know and recognise success in order t...
Apr 08, 2019•6 min•Season 2Ep. 8
Everything you ever wanted to know about CPET (Cardio Pulmonary Exercise Testing) but were too afraid to ask; this conversation is a fascinating deep dive into the topic with two experts in the field. Discover how widely practiced this technique is across the UK, hear about the advantages people who use it have in terms of outcomes and patient safety. Also, what do institutions then do with the data and how does that increase our understanding of the human body? Some of the UCL podcasts mentione...
Apr 07, 2019•35 min•Season 2Ep. 11
Why do anaesthetists suffer from mental health problems, what help is there available for them? Learn here about 'The Practitioner Health Programme' and hear why anaesthetists are uniquely placed to deal with the inevitable pressures related to healthcare and how they can become leaders, helping to destigmatise and tackle mental health issues. Presented by Desiree Chappell and Monty Mythen with their guest Dr Clare Gerada, Medical Director, Physician Health, Practitioner Health Service....
Apr 06, 2019•6 min
"If you don't have respect you really can't do anything ... healthcare is a team sport!" What is a "Respect Officer"? Why is respect so important in perioperative care? What is a "huddle" and should your team include one in your practice? Presented by Desiree Chappell and Monty Mythen with their guest Amir Jaffer, Chief Medical Officer, New York Presbyterian/ Queens.
Apr 05, 2019•13 min
How does enhanced recovery after surgery (ERAS) work for cardiac patients? What lessons have been learned and how have pathways and protocols evolved? How do you get the whole team onboard with such innovations and the multidisciplinary aspect of these notions? Presented by Robin Schiller and Bridger Bach with their guests Dr Mike Grant, Assistant Professor of Anesthesiology and Critical Care Medicine (ACCM) at the Johns Hopkins University School of Medicine.
Apr 04, 2019•30 min
"Emergency laparotomy Collaborative" - 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 Nial Quiney, Consultant Anaesthetist at Royal Surrey County Hospital...
Apr 03, 2019•15 min
The American Associaton of Retired People (AARP), an organisation with a membership almost equal to the entire voting population of the United Kingdom, are focusing on brain health, in response to the demands of their members. Further conversation includes how practitioners both explain the risks of surgery and also calm possible misunderstandings or fears regarding them, as well as wider reflections on 'The Brain Health Initiative'. Presented by Desiree Chappell with Mike Grocott and their gues...
Apr 02, 2019•16 min•Season 2Ep. 13
Pain is seen by many as the so-called fifth vital sign but is it reasonable to expect us to eliminate it entirely? The long term consequences for medicine and our patients are now manifesting in daily newscasts regarding "the opioid epidemic". Presented by Monty Mythen with Dr Patrick Shanahan, Anesthesiology Consultants Enterprises, Louisville KY and Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton.
Apr 01, 2019•8 min•Season 2Ep. 7
The EBPOM-USA Dallas Masters Course, held between the 22nd - 24th of March 2019, has provided TopMedTalk with a wealth of exciting new material which we will be sharing with you over the next few months. Here you can reflect on the conference or, if you didn't manage to attend, whet your appitite for what is to come. Presented by Desiree Chappell with Monty Mythen, Sol Aronson and Vicki Morton.
Mar 31, 2019•17 min•Season 2Ep. 10
Here we feature a central figure in the ongoing Great World Fluid debate. He was sadly unable to attend EBPOM 2018 so we wanted to get a very important contribution from him: What are the big takeaways from some of the larger trials such as Saline versus Albumin Fluid Evaluation ( SAFE )? What about the long term implications of Crystalloid versus Hydroxyethyl Starch Trial (CHEST)? What new trials should be on the horizon - given the information we now have? Monty Mythen speaks with his guest Pr...
Mar 30, 2019•38 min
What's the relationship between Enhanced Recovery after Surgery (ERAS) and Prehabilitation? Should prehabilitation be thought of as a natural part of perioperative enhancement? Should practitioners learn to think of exercise as an anabolic stimulant? Mike Grocott presents with his guests Olle Ljungqvist, Prof. of Surgery, MD, PhD, Surgeon, Örebro University Hospital & Karolinska Institutet, Sweden and Franco Carli, Prof. MD, PhD, Anesthesiologist, McGill University, Canada.
Mar 29, 2019•7 min
How has perioperative medicine impacted upon our understanding of obstetrics? Hear how implimenting an ERAS programme in 2016 has benefitted the pioneers who led the way here. Is it something you could impliment in your practice? Presented by Robin Schiller and Bridger Bach with their guests Dr Attila Kett, anaesthesiologist and Chairman at St Peter’s University Hospital at New Jersey and Dr Elizabeth Cherot, Vice President of medical affairs at Axia Women’s Health.
Mar 28, 2019•17 min
"Colloid vs Crystalloid - Goal Directed Therapy" - 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 Monty Mythen, Smiths Medical Professor of Anaesthesia an...
Mar 27, 2019•10 min
Adverse outcomes, we all know they happen but how do we handle them, record them and avoid them in the first place? The discussion then moves to (Patient Recorded Outcome Measures) PROMS. Patient optimisation is then discussed. Exercise, could it be so effective because it works as an anti inflammatory? A deep dive into the research on that is contained in this conversation. The RELIEF trial is discussed as the team get into a discussion about what a patient sees as a good outcome. How do we com...
Mar 26, 2019•23 min•Season 2Ep. 12
How important is it to weigh your patients, both before and after surgery? Should this then continue during their stay each day they have an i.v. running? Presented by Monty Mythen and Henry Howe with their guests Tom Woodcock, an independent consultant in patient safety, medical law and ethics, and Manu Malbrain, Professor at Faculty of Medicine and Pharmacology Vrije University in Brussells.
Mar 25, 2019•8 min•Season 2Ep. 6
How do we develop an agreed curriculum that speaks to what perioperative medicine should be? Once that's in place, how should it be overseen? What sort of official endorsements would it need? Running in parallel to this are the MOOCs - Massive Online Open Courses - that are being developed. Developing a broad knowledge of the process is distinct from being a perioperative specialist, how do we develop that even further - without developing a schism? These complicated topics are discussed alongsi...
Mar 24, 2019•20 min•Season 2Ep. 9
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 our Editor in Chief about TopMedTalk and perioperative medicine. We regularly enjoy reading your feedback: contact@topmedtalk.com
Mar 23, 2019•15 min
